Minnesota Legislature
SF 4699
1st Engrossment - 93rd Legislature (2023 - 2024) Posted on 05/02/2024 10:37am
3.46 3.47
3.48 3.49 3.50 3.51 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 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 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 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 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 12.1 12.2
12.3
12.4 12.5 12.6 12.7 12.8 12.9 12.10 12.11 12.12 12.13 12.14 12.15 12.16 12.17 12.18 12.19 12.20 12.21 12.22 12.23 12.24 12.25 12.26 12.27 12.28 12.29 12.30 12.31 12.32 12.33 12.34 12.35 13.1 13.2 13.3 13.4 13.5 13.6 13.7 13.8 13.9 13.10 13.11 13.12 13.13 13.14 13.15 13.16 13.17 13.18 13.19 13.20 13.21 13.22 13.23 13.24 13.25 13.26 13.27 13.28 13.29 13.30 13.31 13.32 13.33 13.34 13.35 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 14.34 14.35 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 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 17.1 17.2
17.3 17.4 17.5 17.6 17.7 17.8 17.9 17.10 17.11 17.12 17.13 17.14 17.15 17.16 17.17 17.18 17.19 17.20 17.21 17.22 17.23 17.24 17.25 17.26 17.27 17.28 17.29 17.30 17.31 17.32 18.1 18.2 18.3
18.4 18.5 18.6 18.7 18.8 18.9 18.10 18.11 18.12
18.13 18.14
18.15 18.16 18.17 18.18 18.19 18.20 18.21 18.22 18.23 18.24 18.25 18.26 18.27
18.28 18.29 18.30 18.31 19.1 19.2 19.3 19.4 19.5 19.6 19.7
19.8
19.9 19.10 19.11 19.12 19.13 19.14 19.15 19.16 19.17 19.18 19.19 19.20 19.21 19.22 19.23 19.24
19.25 19.26 19.27 19.28 19.29 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 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 24.1 24.2 24.3 24.4 24.5 24.6 24.7 24.8 24.9 24.10 24.11 24.12 24.13 24.14 24.15 24.16 24.17 24.18 24.19 24.20 24.21 24.22 24.23 24.24 24.25 24.26
24.27 24.28 24.29 24.30 24.31 24.32 25.1 25.2 25.3 25.4 25.5 25.6 25.7 25.8 25.9 25.10 25.11 25.12 25.13 25.14 25.15 25.16
25.17
25.18 25.19 25.20 25.21 25.22 25.23 25.24
25.25
25.26 25.27 25.28 25.29 25.30 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 26.35 26.36 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 27.33 27.34 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 28.32 28.33 28.34 28.35 29.1 29.2 29.3 29.4 29.5 29.6 29.7
29.8 29.9 29.10 29.11 29.12 29.13 29.14
29.15 29.16 29.17 29.18 29.19 29.20 29.21 29.22 29.23 29.24 29.25 29.26
29.27 29.28 29.29 29.30 29.31 30.1 30.2 30.3 30.4 30.5 30.6 30.7 30.8 30.9 30.10 30.11 30.12 30.13 30.14 30.15 30.16 30.17 30.18 30.19 30.20 30.21 30.22 30.23
30.24 30.25 30.26 30.27 30.28 30.29 30.30 30.31 31.1 31.2 31.3 31.4 31.5 31.6 31.7 31.8 31.9 31.10
31.11 31.12 31.13 31.14 31.15 31.16 31.17 31.18 31.19 31.20 31.21 31.22 31.23
31.24 31.25 31.26 31.27 31.28 31.29 31.30 31.31 31.32 32.1 32.2 32.3 32.4 32.5 32.6 32.7 32.8 32.9 32.10 32.11 32.12 32.13 32.14 32.15 32.16 32.17 32.18 32.19 32.20 32.21 32.22 32.23 32.24 32.25 32.26 32.27 32.28 32.29 32.30 32.31 32.32 32.33 32.34 32.35 33.1 33.2 33.3 33.4 33.5 33.6 33.7 33.8 33.9 33.10 33.11 33.12 33.13 33.14 33.15 33.16 33.17 33.18 33.19 33.20 33.21 33.22 33.23 33.24 33.25 33.26 33.27 33.28 33.29 33.30 33.31 33.32 33.33 33.34 33.35 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 34.32 34.33 34.34 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 35.33 35.34 35.35 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 37.1 37.2 37.3 37.4 37.5 37.6 37.7 37.8 37.9 37.10 37.11 37.12 37.13 37.14 37.15 37.16 37.17 37.18 37.19 37.20 37.21 37.22 37.23 37.24
37.25 37.26 37.27 37.28 37.29 37.30 37.31 38.1 38.2 38.3 38.4 38.5 38.6 38.7
38.8 38.9 38.10 38.11 38.12 38.13 38.14 38.15 38.16 38.17
38.18 38.19 38.20 38.21 38.22 38.23 38.24 38.25 38.26 38.27 38.28 38.29 38.30 38.31 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
40.1 40.2 40.3 40.4 40.5 40.6 40.7 40.8 40.9 40.10 40.11 40.12 40.13 40.14 40.15 40.16 40.17 40.18 40.19 40.20 40.21 40.22 40.23 40.24
40.25 40.26 40.27
40.28 40.29 40.30 40.31 41.1 41.2 41.3 41.4 41.5 41.6 41.7 41.8 41.9
41.10 41.11 41.12
41.13 41.14 41.15 41.16 41.17 41.18 41.19 41.20 41.21 41.22 41.23 41.24 41.25 41.26 41.27 41.28 41.29 41.30 41.31 41.32 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 43.1 43.2 43.3 43.4 43.5 43.6 43.7 43.8
43.9 43.10 43.11
43.12 43.13 43.14 43.15 43.16 43.17 43.18 43.19 43.20 43.21 43.22 43.23 43.24 43.25 43.26 43.27 43.28 43.29 43.30 43.31 43.32 44.1 44.2 44.3 44.4 44.5 44.6 44.7 44.8 44.9 44.10 44.11 44.12 44.13 44.14 44.15 44.16 44.17 44.18 44.19 44.20 44.21 44.22 44.23 44.24 44.25
44.26 44.27 44.28
44.29 44.30 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
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 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 49.32 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 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 52.31 52.32 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 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 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
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
59.1 59.2 59.3 59.4 59.5 59.6 59.7 59.8 59.9 59.10 59.11 59.12 59.13 59.14 59.15 59.16 59.17 59.18 59.19 59.20 59.21 59.22 59.23 59.24 59.25 59.26 59.27
59.28 59.29 59.30
60.1 60.2 60.3 60.4 60.5 60.6 60.7 60.8 60.9 60.10 60.11 60.12 60.13 60.14 60.15 60.16 60.17 60.18 60.19 60.20 60.21 60.22 60.23 60.24 60.25 60.26 60.27 60.28 60.29 60.30 60.31 60.32 60.33 60.34 60.35 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
62.1 62.2 62.3 62.4 62.5 62.6 62.7 62.8 62.9 62.10 62.11 62.12 62.13 62.14 62.15 62.16
62.17 62.18 62.19 62.20 62.21 62.22 62.23 62.24 62.25 62.26 62.27 62.28 62.29 62.30 63.1 63.2 63.3 63.4 63.5 63.6 63.7 63.8 63.9 63.10 63.11 63.12 63.13 63.14 63.15 63.16 63.17 63.18 63.19 63.20 63.21 63.22 63.23 63.24 63.25 63.26 63.27 63.28 63.29 63.30 63.31 63.32 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 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 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 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
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 69.30 69.31 69.32
70.1 70.2
70.3 70.4 70.5 70.6 70.7 70.8 70.9 70.10
70.11 70.12 70.13 70.14 70.15 70.16 70.17 70.18 70.19
70.20 70.21
70.22 70.23 70.24 70.25 70.26 70.27 70.28 70.29 70.30 70.31
71.1 71.2 71.3 71.4
71.5 71.6 71.7 71.8 71.9 71.10 71.11 71.12 71.13 71.14 71.15 71.16 71.17 71.18 71.19 71.20 71.21 71.22 71.23 71.24 71.25 71.26 71.27
71.28 71.29 71.30 71.31 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
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 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 76.1 76.2 76.3 76.4 76.5 76.6 76.7 76.8 76.9 76.10 76.11 76.12 76.13 76.14 76.15 76.16 76.17 76.18 76.19 76.20 76.21 76.22 76.23 76.24 76.25 76.26 76.27 76.28 76.29 76.30 76.31 76.32
77.1 77.2
77.3 77.4 77.5 77.6 77.7 77.8 77.9 77.10 77.11 77.12 77.13 77.14 77.15 77.16 77.17 77.18
77.19 77.20
77.21 77.22 77.23 77.24 77.25 77.26 77.27 77.28 77.29 77.30 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 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 82.1 82.2 82.3 82.4 82.5 82.6 82.7 82.8 82.9 82.10 82.11 82.12 82.13 82.14 82.15 82.16 82.17 82.18 82.19 82.20
82.21 82.22
82.23 82.24 82.25 82.26 82.27 82.28 82.29 82.30 82.31 82.32 82.33
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 84.31 84.32 84.33 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
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
87.1 87.2 87.3 87.4 87.5 87.6 87.7
87.8 87.9
87.10 87.11 87.12 87.13 87.14 87.15
87.16 87.17 87.18 87.19 87.20 87.21 87.22 87.23 87.24 87.25 87.26 87.27 87.28 87.29 87.30 87.31 88.1 88.2 88.3 88.4 88.5 88.6 88.7 88.8 88.9 88.10 88.11 88.12 88.13 88.14 88.15 88.16 88.17 88.18 88.19 88.20 88.21 88.22 88.23 88.24 88.25 88.26 88.27 88.28 88.29 88.30 88.31 88.32 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 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
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 92.31 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 94.1 94.2 94.3 94.4 94.5 94.6 94.7 94.8 94.9 94.10 94.11 94.12 94.13 94.14 94.15 94.16 94.17 94.18 94.19 94.20 94.21 94.22 94.23 94.24 94.25 94.26 94.27 94.28 94.29 94.30 94.31 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 95.32 95.33 96.1 96.2 96.3 96.4 96.5 96.6 96.7 96.8 96.9 96.10 96.11
96.12 96.13 96.14 96.15 96.16 96.17 96.18 96.19 96.20 96.21 96.22 96.23 96.24 96.25 96.26 96.27 96.28 96.29 96.30 96.31 96.32 96.33 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 98.34 99.1 99.2 99.3 99.4 99.5 99.6 99.7 99.8 99.9 99.10 99.11 99.12 99.13 99.14 99.15 99.16 99.17 99.18 99.19 99.20 99.21 99.22
99.23 99.24 99.25 99.26 99.27 99.28 99.29 99.30 99.31 99.32 99.33
100.1 100.2 100.3 100.4 100.5 100.6 100.7 100.8 100.9 100.10 100.11 100.12 100.13 100.14 100.15 100.16 100.17 100.18 100.19 100.20 100.21 100.22 100.23 100.24 100.25 100.26 100.27 100.28 100.29 100.30 100.31 100.32 101.1 101.2 101.3 101.4 101.5 101.6 101.7 101.8 101.9 101.10 101.11 101.12 101.13 101.14 101.15 101.16 101.17 101.18 101.19 101.20 101.21 101.22 101.23 101.24 101.25 101.26 101.27 101.28 101.29 101.30
101.31 101.32 101.33 102.1 102.2 102.3 102.4 102.5 102.6 102.7 102.8 102.9 102.10 102.11 102.12 102.13 102.14 102.15 102.16 102.17
102.18 102.19 102.20 102.21 102.22 102.23 102.24 102.25 102.26 102.27 102.28 102.29 102.30 103.1 103.2 103.3 103.4 103.5 103.6 103.7 103.8 103.9
103.10 103.11 103.12 103.13 103.14 103.15 103.16 103.17 103.18 103.19 103.20 103.21 103.22 103.23 103.24 103.25 103.26 103.27 103.28 103.29 103.30 104.1 104.2 104.3 104.4 104.5 104.6 104.7 104.8 104.9 104.10 104.11 104.12 104.13 104.14 104.15 104.16 104.17 104.18 104.19 104.20 104.21 104.22 104.23 104.24
104.25 104.26 104.27 104.28
105.1 105.2 105.3 105.4 105.5 105.6 105.7 105.8 105.9 105.10 105.11 105.12
105.13 105.14 105.15 105.16 105.17 105.18 105.19 105.20 105.21 105.22 105.23 105.24 105.25 105.26
105.27 105.28 105.29 105.30 105.31 105.32 106.1 106.2 106.3 106.4 106.5 106.6 106.7 106.8 106.9
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
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
108.29 108.30 108.31 109.1 109.2 109.3 109.4 109.5 109.6 109.7 109.8 109.9 109.10 109.11 109.12 109.13 109.14 109.15 109.16 109.17 109.18 109.19 109.20 109.21 109.22 109.23 109.24 109.25 109.26 109.27 109.28 109.29 109.30 109.31 109.32 110.1 110.2 110.3 110.4 110.5 110.6 110.7 110.8 110.9
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
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
112.1 112.2 112.3 112.4 112.5
112.6 112.7 112.8 112.9 112.10
112.11 112.12 112.13 112.14 112.15 112.16
112.17 112.18 112.19 112.20 112.21 112.22 112.23 112.24
112.25 112.26 112.27 112.28 112.29 112.30 113.1 113.2 113.3 113.4 113.5 113.6 113.7 113.8 113.9 113.10 113.11 113.12 113.13 113.14 113.15 113.16 113.17 113.18 113.19 113.20 113.21 113.22 113.23 113.24 113.25 113.26
113.27 113.28 113.29 113.30 114.1 114.2 114.3 114.4 114.5 114.6 114.7 114.8 114.9 114.10 114.11 114.12 114.13 114.14 114.15 114.16 114.17 114.18 114.19 114.20 114.21 114.22 114.23 114.24 114.25 114.26 114.27 114.28 114.29 114.30 114.31 114.32 114.33 115.1 115.2 115.3 115.4 115.5 115.6 115.7 115.8 115.9 115.10 115.11 115.12 115.13 115.14 115.15 115.16 115.17 115.18 115.19 115.20
115.21 115.22 115.23 115.24 115.25 115.26 115.27 115.28 115.29 115.30 115.31 115.32 116.1 116.2 116.3 116.4 116.5 116.6 116.7 116.8 116.9 116.10 116.11 116.12 116.13 116.14 116.15 116.16 116.17 116.18 116.19 116.20 116.21 116.22 116.23 116.24 116.25 116.26 116.27 116.28 116.29 116.30 116.31 116.32 116.33 116.34 117.1 117.2 117.3 117.4
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
118.26 118.27 118.28 118.29 118.30 118.31 118.32
119.1 119.2 119.3 119.4 119.5 119.6 119.7 119.8 119.9 119.10 119.11 119.12 119.13 119.14 119.15 119.16 119.17 119.18 119.19 119.20 119.21 119.22 119.23 119.24 119.25 119.26 119.27 119.28 119.29 119.30 119.31 120.1 120.2 120.3 120.4 120.5 120.6 120.7 120.8 120.9 120.10 120.11 120.12 120.13 120.14 120.15 120.16 120.17 120.18 120.19 120.20 120.21 120.22 120.23 120.24 120.25 120.26 120.27 120.28 120.29 120.30 120.31 120.32 121.1 121.2 121.3 121.4 121.5 121.6 121.7 121.8 121.9 121.10 121.11 121.12 121.13 121.14 121.15 121.16 121.17 121.18 121.19 121.20 121.21 121.22 121.23 121.24 121.25 121.26 121.27 121.28 121.29 121.30 121.31 122.1 122.2 122.3 122.4 122.5 122.6 122.7 122.8 122.9 122.10 122.11 122.12 122.13 122.14 122.15 122.16 122.17 122.18 122.19 122.20 122.21 122.22 122.23 122.24 122.25 122.26 122.27 122.28 122.29 122.30 122.31 122.32 122.33 123.1 123.2 123.3 123.4 123.5 123.6 123.7 123.8 123.9 123.10 123.11 123.12 123.13 123.14 123.15 123.16 123.17 123.18 123.19 123.20 123.21 123.22 123.23 123.24 123.25 123.26 123.27 123.28 123.29 123.30 123.31 123.32
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
124.29 124.30 124.31 124.32 125.1 125.2
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
125.21 125.22 125.23 125.24 125.25 125.26 125.27 125.28 125.29 125.30 125.31 125.32 126.1 126.2
126.3 126.4 126.5 126.6 126.7 126.8
126.9 126.10 126.11 126.12 126.13 126.14
126.15 126.16 126.17 126.18 126.19 126.20 126.21 126.22 126.23 126.24 126.25 126.26 126.27 126.28 126.29 126.30 126.31 127.1 127.2 127.3 127.4 127.5 127.6 127.7 127.8 127.9 127.10 127.11 127.12 127.13 127.14 127.15 127.16 127.17 127.18 127.19 127.20 127.21 127.22 127.23 127.24 127.25 127.26 127.27 127.28 127.29 127.30 127.31 128.1 128.2 128.3 128.4 128.5 128.6 128.7 128.8 128.9 128.10 128.11 128.12 128.13 128.14 128.15 128.16 128.17 128.18 128.19 128.20 128.21 128.22 128.23 128.24 128.25 128.26 128.27 128.28 128.29 128.30 128.31 128.32 128.33 129.1 129.2 129.3 129.4 129.5 129.6 129.7 129.8 129.9 129.10 129.11 129.12 129.13 129.14 129.15 129.16 129.17 129.18 129.19 129.20 129.21 129.22 129.23 129.24 129.25 129.26 129.27 129.28 129.29 129.30 129.31 129.32 129.33 129.34 129.35 130.1 130.2 130.3 130.4 130.5 130.6 130.7 130.8 130.9 130.10 130.11 130.12 130.13 130.14 130.15 130.16 130.17 130.18 130.19 130.20 130.21 130.22 130.23 130.24 130.25 130.26 130.27 130.28 130.29 130.30 130.31 130.32 130.33 131.1 131.2 131.3 131.4 131.5 131.6 131.7 131.8 131.9 131.10 131.11 131.12 131.13 131.14 131.15 131.16 131.17 131.18 131.19 131.20 131.21 131.22 131.23 131.24 131.25 131.26 131.27 131.28 131.29 131.30 131.31 131.32 132.1 132.2 132.3 132.4 132.5 132.6 132.7 132.8 132.9 132.10 132.11 132.12 132.13 132.14 132.15 132.16 132.17 132.18 132.19 132.20 132.21 132.22 132.23 132.24 132.25 132.26 132.27 132.28 132.29 132.30 132.31 132.32 133.1 133.2 133.3 133.4 133.5 133.6 133.7 133.8 133.9 133.10 133.11 133.12 133.13 133.14 133.15 133.16 133.17 133.18 133.19 133.20 133.21 133.22 133.23 133.24 133.25 133.26 133.27 133.28 133.29 133.30 133.31 133.32 134.1 134.2 134.3 134.4 134.5 134.6 134.7
134.8 134.9 134.10 134.11 134.12 134.13 134.14 134.15 134.16 134.17 134.18 134.19 134.20 134.21 134.22 134.23 134.24 134.25 134.26 134.27 134.28 134.29 134.30 134.31 134.32 135.1 135.2 135.3 135.4 135.5 135.6 135.7 135.8 135.9 135.10 135.11 135.12 135.13 135.14 135.15 135.16 135.17 135.18 135.19 135.20 135.21 135.22 135.23 135.24 135.25 135.26
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
136.11 136.12 136.13 136.14 136.15 136.16 136.17 136.18 136.19 136.20 136.21 136.22 136.23 136.24 136.25 136.26 136.27 136.28 136.29 136.30 136.31 136.32 137.1 137.2 137.3 137.4 137.5 137.6 137.7 137.8 137.9 137.10 137.11 137.12 137.13 137.14 137.15 137.16 137.17 137.18 137.19 137.20 137.21 137.22 137.23 137.24 137.25 137.26 137.27 137.28 137.29 137.30 137.31 138.1 138.2 138.3 138.4 138.5 138.6 138.7 138.8 138.9 138.10 138.11 138.12 138.13 138.14 138.15 138.16
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
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
140.13 140.14 140.15 140.16 140.17 140.18 140.19 140.20 140.21 140.22 140.23 140.24 140.25 140.26 140.27 140.28 140.29 141.1 141.2 141.3 141.4 141.5 141.6 141.7 141.8 141.9 141.10 141.11
141.12 141.13 141.14 141.15 141.16 141.17 141.18 141.19 141.20 141.21 141.22 141.23 141.24 141.25 141.26 141.27 141.28 141.29 141.30 141.31 141.32 142.1 142.2 142.3 142.4 142.5 142.6 142.7 142.8 142.9 142.10
142.11 142.12 142.13 142.14 142.15 142.16 142.17 142.18 142.19 142.20 142.21 142.22 142.23 142.24 142.25 142.26 142.27 142.28 142.29
142.30 142.31 142.32 143.1 143.2 143.3 143.4 143.5 143.6 143.7 143.8 143.9 143.10 143.11 143.12 143.13 143.14 143.15 143.16 143.17 143.18 143.19 143.20 143.21 143.22 143.23 143.24 143.25 143.26 143.27 143.28 143.29 143.30 143.31 143.32 144.1 144.2 144.3 144.4 144.5 144.6 144.7 144.8 144.9 144.10 144.11 144.12 144.13 144.14 144.15 144.16 144.17 144.18 144.19 144.20 144.21
144.22 144.23 144.24 144.25 144.26 144.27 144.28 144.29 144.30 144.31 144.32 145.1 145.2 145.3 145.4 145.5 145.6 145.7
145.8 145.9 145.10 145.11 145.12 145.13 145.14 145.15 145.16 145.17 145.18 145.19 145.20 145.21 145.22 145.23 145.24
145.25 145.26 145.27 145.28 145.29 145.30 145.31 146.1 146.2 146.3 146.4 146.5 146.6 146.7 146.8 146.9 146.10 146.11 146.12 146.13 146.14 146.15 146.16 146.17 146.18 146.19 146.20 146.21 146.22 146.23 146.24 146.25 146.26 146.27 146.28 146.29 146.30 146.31 146.32 146.33 147.1 147.2 147.3 147.4 147.5 147.6 147.7 147.8 147.9 147.10 147.11 147.12 147.13 147.14 147.15 147.16 147.17 147.18 147.19 147.20 147.21 147.22 147.23 147.24 147.25 147.26 147.27 147.28 147.29 147.30 147.31 147.32 147.33 148.1 148.2
148.3 148.4 148.5 148.6 148.7 148.8 148.9 148.10 148.11 148.12 148.13 148.14 148.15 148.16 148.17 148.18 148.19 148.20 148.21 148.22 148.23 148.24 148.25 148.26 148.27 148.28 148.29 148.30 148.31 148.32 148.33 149.1 149.2 149.3 149.4 149.5 149.6 149.7 149.8 149.9 149.10 149.11 149.12 149.13 149.14 149.15 149.16 149.17 149.18 149.19 149.20 149.21 149.22
149.23 149.24 149.25 149.26 149.27 149.28 149.29 149.30 150.1 150.2 150.3 150.4 150.5 150.6 150.7 150.8 150.9 150.10 150.11 150.12 150.13 150.14 150.15 150.16 150.17 150.18 150.19 150.20 150.21 150.22 150.23 150.24 150.25 150.26 150.27 150.28 150.29 150.30
151.1 151.2 151.3 151.4 151.5 151.6 151.7
151.8 151.9 151.10 151.11 151.12 151.13 151.14 151.15 151.16 151.17 151.18 151.19 151.20 151.21 151.22 151.23 151.24 151.25 151.26 151.27 151.28 151.29 151.30 151.31 152.1 152.2 152.3 152.4 152.5 152.6 152.7 152.8
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
153.17 153.18 153.19 153.20 153.21 153.22 153.23 153.24 153.25 153.26 153.27 153.28 153.29 153.30 154.1 154.2 154.3 154.4 154.5 154.6 154.7
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
156.4 156.5 156.6 156.7 156.8 156.9 156.10 156.11 156.12 156.13 156.14 156.15 156.16 156.17 156.18 156.19 156.20 156.21 156.22 156.23 156.24 156.25 156.26 156.27 156.28 156.29 156.30 156.31 156.32 157.1 157.2 157.3 157.4 157.5 157.6 157.7 157.8 157.9 157.10 157.11 157.12 157.13 157.14 157.15 157.16 157.17 157.18 157.19 157.20 157.21 157.22 157.23 157.24 157.25 157.26 157.27 157.28 157.29 157.30 157.31 157.32 157.33 157.34 158.1 158.2 158.3 158.4 158.5 158.6 158.7 158.8 158.9 158.10 158.11 158.12 158.13 158.14 158.15 158.16 158.17 158.18 158.19 158.20 158.21 158.22 158.23 158.24 158.25 158.26 158.27 158.28 158.29 158.30 158.31 158.32 159.1 159.2 159.3 159.4 159.5 159.6 159.7 159.8 159.9 159.10 159.11 159.12 159.13 159.14 159.15 159.16 159.17 159.18 159.19 159.20 159.21 159.22 159.23 159.24 159.25 159.26 159.27 159.28 159.29 160.1 160.2 160.3 160.4 160.5 160.6 160.7 160.8 160.9 160.10 160.11 160.12 160.13 160.14 160.15 160.16 160.17 160.18 160.19 160.20 160.21 160.22 160.23 160.24 160.25 160.26 160.27 160.28 160.29 160.30 160.31 160.32 160.33 160.34 161.1 161.2 161.3 161.4 161.5 161.6 161.7 161.8 161.9 161.10 161.11 161.12 161.13 161.14 161.15 161.16 161.17 161.18 161.19 161.20 161.21 161.22 161.23 161.24 161.25 161.26 161.27 161.28 161.29 161.30 161.31 161.32 161.33 161.34 161.35 162.1 162.2 162.3 162.4 162.5 162.6 162.7 162.8
162.9 162.10 162.11 162.12 162.13 162.14 162.15 162.16 162.17 162.18 162.19 162.20 162.21 162.22 162.23 162.24 162.25 162.26 162.27 162.28 162.29 162.30 162.31 162.32 163.1 163.2 163.3 163.4 163.5 163.6 163.7 163.8 163.9 163.10 163.11 163.12 163.13 163.14 163.15 163.16 163.17 163.18 163.19 163.20 163.21 163.22 163.23 163.24 163.25 163.26 163.27 163.28 163.29 163.30 163.31 163.32 163.33 164.1 164.2 164.3 164.4 164.5 164.6 164.7 164.8 164.9 164.10 164.11 164.12 164.13 164.14 164.15 164.16 164.17 164.18 164.19 164.20 164.21 164.22 164.23 164.24 164.25 164.26 164.27 164.28 164.29 164.30 164.31 164.32 165.1 165.2 165.3 165.4 165.5 165.6 165.7 165.8 165.9 165.10 165.11 165.12 165.13 165.14 165.15 165.16 165.17 165.18 165.19 165.20 165.21 165.22 165.23 165.24 165.25 165.26 165.27 165.28 165.29 165.30 165.31 166.1 166.2 166.3 166.4 166.5 166.6 166.7 166.8 166.9 166.10 166.11 166.12 166.13 166.14 166.15 166.16 166.17 166.18 166.19 166.20 166.21 166.22 166.23 166.24 166.25 166.26 166.27 166.28 166.29 166.30 166.31 166.32 166.33 167.1 167.2 167.3 167.4 167.5 167.6 167.7 167.8 167.9 167.10 167.11 167.12 167.13 167.14 167.15 167.16 167.17 167.18 167.19 167.20 167.21 167.22 167.23 167.24 167.25 167.26 167.27 167.28 167.29 167.30 167.31 167.32 167.33 167.34 168.1 168.2 168.3 168.4 168.5 168.6 168.7 168.8 168.9 168.10 168.11 168.12 168.13 168.14 168.15 168.16 168.17 168.18 168.19 168.20 168.21
168.22 168.23 168.24 168.25 168.26
168.27 168.28 168.29 168.30 168.31 168.32 169.1 169.2 169.3 169.4 169.5 169.6 169.7 169.8 169.9 169.10 169.11 169.12
169.13
169.14 169.15 169.16 169.17 169.18 169.19 169.20 169.21 169.22
169.23
169.24 169.25 169.26 169.27 169.28 169.29 169.30 169.31 169.32 170.1 170.2 170.3 170.4 170.5 170.6 170.7 170.8 170.9 170.10 170.11 170.12 170.13 170.14 170.15 170.16 170.17 170.18 170.19 170.20 170.21 170.22 170.23 170.24 170.25 170.26 170.27 170.28 170.29 170.30 170.31 170.32 170.33 171.1 171.2 171.3 171.4 171.5 171.6 171.7 171.8 171.9 171.10 171.11 171.12 171.13 171.14 171.15 171.16 171.17 171.18 171.19 171.20 171.21 171.22 171.23 171.24 171.25 171.26
171.27 171.28 171.29 171.30 171.31
172.1 172.2 172.3 172.4 172.5 172.6 172.7 172.8 172.9 172.10 172.11 172.12 172.13 172.14 172.15 172.16 172.17 172.18 172.19 172.20 172.21 172.22 172.23 172.24 172.25 172.26 172.27 172.28 172.29 172.30 173.1 173.2 173.3 173.4 173.5 173.6 173.7 173.8 173.9 173.10 173.11 173.12 173.13 173.14 173.15 173.16 173.17 173.18 173.19 173.20 173.21 173.22 173.23 173.24 173.25 173.26 173.27 173.28 173.29 173.30 173.31 174.1 174.2 174.3 174.4 174.5 174.6 174.7 174.8 174.9 174.10 174.11 174.12 174.13 174.14 174.15 174.16 174.17 174.18
174.19 174.20 174.21 174.22 174.23 174.24
174.25 174.26 174.27 174.28 174.29 174.30 175.1 175.2 175.3 175.4 175.5 175.6 175.7 175.8 175.9 175.10
175.11 175.12 175.13 175.14 175.15 175.16 175.17 175.18 175.19 175.20 175.21 175.22 175.23 175.24 175.25 175.26 175.27 175.28 175.29 175.30 176.1 176.2 176.3
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
177.1 177.2 177.3 177.4 177.5 177.6 177.7
177.8 177.9 177.10 177.11 177.12 177.13 177.14 177.15 177.16 177.17 177.18 177.19 177.20 177.21 177.22 177.23 177.24 177.25 177.26 177.27 177.28 177.29 177.30 177.31 178.1 178.2 178.3 178.4 178.5
178.6
178.7 178.8 178.9 178.10 178.11 178.12 178.13 178.14 178.15 178.16 178.17 178.18 178.19 178.20 178.21 178.22 178.23 178.24 178.25 178.26 178.27 178.28 178.29 178.30 178.31
179.1 179.2 179.3 179.4 179.5 179.6 179.7 179.8 179.9 179.10 179.11 179.12 179.13 179.14 179.15 179.16 179.17 179.18 179.19 179.20 179.21 179.22
179.23 179.24 179.25
179.26 179.27 179.28 179.29
180.1 180.2 180.3 180.4 180.5 180.6
180.7 180.8 180.9 180.10 180.11
180.12 180.13 180.14 180.15 180.16 180.17 180.18 180.19 180.20 180.21 180.22 180.23 180.24 180.25 180.26 180.27 180.28 181.1 181.2 181.3 181.4 181.5
181.6 181.7 181.8 181.9 181.10 181.11 181.12 181.13 181.14 181.15 181.16 181.17 181.18 181.19
181.20 181.21 181.22 181.23
181.24 181.25 181.26 181.27 181.28 181.29 181.30 181.31 181.32 182.1 182.2 182.3 182.4 182.5
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
183.19 183.20 183.21 183.22 183.23 183.24 183.25 183.26 183.27 183.28 183.29 183.30 183.31 184.1 184.2 184.3 184.4 184.5 184.6 184.7 184.8 184.9 184.10 184.11 184.12 184.13 184.14 184.15 184.16 184.17 184.18 184.19
184.20 184.21 184.22 184.23 184.24 184.25 184.26
184.27 184.28 184.29 184.30 184.31 185.1 185.2 185.3 185.4 185.5 185.6 185.7 185.8 185.9 185.10 185.11 185.12 185.13 185.14 185.15 185.16 185.17 185.18 185.19
185.20 185.21 185.22 185.23 185.24 185.25 185.26 185.27 185.28 185.29 185.30 185.31 186.1 186.2 186.3 186.4 186.5
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
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
188.3 188.4 188.5 188.6 188.7 188.8 188.9 188.10 188.11 188.12 188.13 188.14 188.15 188.16 188.17 188.18 188.19 188.20 188.21 188.22 188.23 188.24 188.25 188.26 188.27 188.28 189.1 189.2 189.3 189.4 189.5 189.6 189.7 189.8 189.9 189.10 189.11 189.12 189.13
189.14
189.15 189.16 189.17 189.18 189.19 189.20 189.21 189.22 189.23 189.24 189.25 189.26 189.27 189.28 189.29 189.30 190.1 190.2 190.3 190.4 190.5 190.6 190.7 190.8 190.9 190.10 190.11 190.12 190.13 190.14 190.15
190.16
190.17 190.18 190.19 190.20 190.21 190.22
190.23
190.24 190.25 190.26 190.27 190.28 190.29 190.30 191.1 191.2 191.3 191.4 191.5 191.6 191.7 191.8 191.9 191.10 191.11
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
192.32
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
196.20 196.21 196.22 196.23 196.24 196.25 196.26 196.27 196.28 196.29 196.30 196.31 197.1 197.2 197.3 197.4 197.5 197.6 197.7 197.8 197.9 197.10 197.11 197.12 197.13 197.14 197.15 197.16 197.17 197.18 197.19
197.20
197.21 197.22 197.23 197.24 197.25 197.26 197.27 197.28 197.29 197.30 197.31 197.32 198.1 198.2 198.3 198.4 198.5 198.6 198.7 198.8 198.9 198.10 198.11 198.12 198.13 198.14 198.15 198.16 198.17 198.18 198.19 198.20 198.21 198.22 198.23
198.24 198.25 198.26 198.27 198.28 198.29 198.30 198.31 198.32 199.1 199.2 199.3 199.4 199.5 199.6 199.7 199.8 199.9 199.10 199.11 199.12 199.13 199.14 199.15
199.16 199.17 199.18 199.19 199.20 199.21 199.22 199.23 199.24 199.25 199.26 199.27 199.28 199.29 199.30 199.31 200.1 200.2 200.3 200.4 200.5 200.6 200.7 200.8 200.9 200.10 200.11 200.12 200.13 200.14 200.15 200.16 200.17 200.18 200.19 200.20 200.21 200.22 200.23 200.24 200.25 200.26 200.27 200.28 200.29 200.30 200.31 200.32 200.33 201.1 201.2 201.3 201.4 201.5 201.6 201.7
201.8 201.9 201.10 201.11 201.12 201.13 201.14 201.15 201.16 201.17 201.18 201.19 201.20 201.21 201.22 201.23 201.24 201.25 201.26 201.27 201.28 201.29 201.30 201.31 201.32 201.33 202.1 202.2 202.3 202.4 202.5 202.6 202.7 202.8 202.9 202.10 202.11 202.12 202.13 202.14 202.15 202.16 202.17 202.18 202.19 202.20 202.21 202.22 202.23 202.24 202.25 202.26 202.27 202.28 202.29 202.30 202.31 203.1 203.2 203.3 203.4 203.5 203.6 203.7 203.8 203.9 203.10 203.11 203.12 203.13 203.14 203.15 203.16 203.17 203.18
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
205.24 205.25 205.26 205.27 205.28 205.29 205.30 206.1 206.2 206.3 206.4 206.5 206.6 206.7 206.8 206.9 206.10 206.11 206.12 206.13 206.14 206.15 206.16 206.17 206.18 206.19 206.20 206.21 206.22 206.23 206.24 206.25 206.26 206.27 206.28 206.29 206.30 206.31 207.1 207.2 207.3 207.4 207.5 207.6 207.7 207.8
207.9 207.10 207.11 207.12 207.13 207.14 207.15 207.16 207.17 207.18 207.19 207.20 207.21 207.22 207.23 207.24 207.25 207.26 207.27 207.28 207.29 207.30 207.31 207.32 208.1 208.2 208.3 208.4 208.5 208.6 208.7 208.8 208.9 208.10 208.11 208.12 208.13 208.14 208.15 208.16 208.17 208.18 208.19 208.20 208.21 208.22 208.23
208.24
208.25 208.26 208.27 208.28 208.29 208.30 208.31 209.1 209.2 209.3 209.4 209.5 209.6 209.7 209.8 209.9 209.10 209.11 209.12 209.13 209.14 209.15 209.16 209.17 209.18 209.19 209.20 209.21 209.22 209.23 209.24 209.25 209.26
209.27 209.28 209.29 209.30 209.31 209.32 209.33
210.1 210.2 210.3 210.4 210.5 210.6 210.7 210.8 210.9 210.10 210.11 210.12 210.13 210.14 210.15 210.16 210.17 210.18 210.19 210.20 210.21 210.22 210.23 210.24 210.25 210.26 210.27 210.28 210.29 210.30 211.1 211.2 211.3 211.4 211.5 211.6 211.7 211.8 211.9 211.10 211.11 211.12 211.13 211.14 211.15 211.16 211.17 211.18
211.19
211.20 211.21 211.22 211.23 211.24 211.25 211.26 211.27 211.28 211.29 211.30 211.31 211.32 212.1 212.2 212.3 212.4 212.5 212.6 212.7 212.8 212.9 212.10 212.11 212.12 212.13 212.14 212.15 212.16 212.17
212.18
212.19 212.20 212.21 212.22 212.23 212.24 212.25 212.26 212.27 212.28 212.29 212.30 212.31 212.32 213.1 213.2 213.3 213.4 213.5 213.6
213.7 213.8 213.9 213.10 213.11 213.12 213.13 213.14 213.15 213.16 213.17 213.18 213.19 213.20 213.21 213.22 213.23 213.24 213.25 213.26 213.27 213.28 213.29 213.30 214.1 214.2 214.3 214.4 214.5 214.6 214.7 214.8 214.9 214.10 214.11 214.12
214.13 214.14 214.15 214.16 214.17 214.18 214.19 214.20 214.21
214.22 214.23 214.24 214.25 214.26 214.27 214.28 214.29 214.30 214.31 215.1 215.2 215.3 215.4 215.5 215.6 215.7 215.8
215.9 215.10 215.11 215.12 215.13 215.14 215.15 215.16 215.17 215.18 215.19 215.20 215.21 215.22 215.23 215.24 215.25 215.26 215.27 215.28 215.29 215.30 215.31 216.1 216.2 216.3 216.4 216.5 216.6 216.7 216.8
216.9 216.10 216.11 216.12 216.13 216.14 216.15 216.16 216.17 216.18 216.19 216.20 216.21 216.22 216.23
216.24 216.25 216.26 216.27 216.28 216.29 216.30 217.1 217.2 217.3 217.4 217.5 217.6 217.7 217.8 217.9 217.10 217.11 217.12 217.13 217.14 217.15 217.16 217.17 217.18 217.19 217.20 217.21 217.22 217.23 217.24 217.25
217.26
217.27 217.28 217.29 217.30 217.31 217.32 217.33
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
218.22 218.23 218.24 218.25 218.26 218.27 218.28 218.29 218.30 219.1 219.2 219.3 219.4 219.5 219.6 219.7 219.8 219.9 219.10 219.11 219.12 219.13 219.14 219.15 219.16 219.17 219.18 219.19 219.20 219.21 219.22 219.23 219.24 219.25 219.26 219.27 219.28 219.29 219.30 219.31 219.32 220.1 220.2 220.3 220.4 220.5 220.6 220.7 220.8 220.9 220.10 220.11 220.12 220.13 220.14 220.15 220.16 220.17 220.18 220.19 220.20 220.21 220.22 220.23 220.24 220.25 220.26 220.27 220.28 220.29 220.30 220.31 221.1 221.2 221.3 221.4 221.5 221.6 221.7 221.8 221.9 221.10 221.11 221.12 221.13 221.14 221.15 221.16 221.17 221.18 221.19 221.20 221.21 221.22 221.23 221.24 221.25 221.26 221.27 221.28 221.29 221.30 221.31 222.1 222.2 222.3 222.4 222.5 222.6 222.7 222.8 222.9 222.10 222.11 222.12 222.13 222.14 222.15 222.16 222.17 222.18 222.19 222.20 222.21 222.22 222.23 222.24 222.25 222.26 222.27 222.28 222.29 222.30 222.31 222.32 222.33 223.1 223.2 223.3 223.4 223.5 223.6 223.7 223.8 223.9 223.10 223.11 223.12 223.13 223.14 223.15 223.16 223.17 223.18 223.19 223.20 223.21 223.22 223.23 223.24 223.25 223.26 223.27 223.28 223.29 223.30 223.31 223.32 223.33 224.1 224.2 224.3 224.4 224.5 224.6
224.7
224.8 224.9 224.10 224.11 224.12 224.13 224.14
224.15
224.16 224.17 224.18 224.19 224.20 224.21 224.22 224.23 224.24
224.25
224.26 224.27 224.28 224.29 224.30 224.31
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
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
227.13 227.14 227.15 227.16 227.17 227.18 227.19 227.20 227.21 227.22 227.23 227.24 227.25 227.26 227.27 227.28 227.29 227.30 227.31 227.32 228.1 228.2 228.3
228.4 228.5 228.6 228.7
228.8
228.9 228.10
228.11 228.12 228.13 228.14 228.15 228.16 228.17 228.18 228.19 228.20 228.21 228.22 228.23 228.24 228.25 228.26 228.27 228.28 228.29 228.30 228.31 229.1 229.2 229.3 229.4 229.5 229.6 229.7 229.8 229.9 229.10 229.11 229.12 229.13 229.14 229.15 229.16 229.17 229.18 229.19 229.20 229.21 229.22 229.23 229.24 229.25 229.26 229.27 229.28 229.29 229.30 229.31 229.32 230.1 230.2 230.3 230.4 230.5 230.6 230.7 230.8 230.9 230.10
230.11 230.12
230.13 230.14 230.15 230.16 230.17 230.18 230.19 230.20 230.21 230.22 230.23 230.24 230.25
230.26
230.27 230.28 230.29 230.30 230.31 230.32 231.1 231.2 231.3 231.4 231.5 231.6 231.7 231.8 231.9 231.10 231.11 231.12 231.13 231.14 231.15 231.16 231.17 231.18 231.19 231.20 231.21 231.22 231.23 231.24 231.25 231.26 231.27 231.28 231.29 231.30 231.31 231.32 231.33 231.34 232.1 232.2 232.3 232.4 232.5 232.6 232.7 232.8 232.9 232.10 232.11 232.12 232.13 232.14 232.15 232.16 232.17 232.18 232.19 232.20 232.21 232.22 232.23 232.24 232.25 232.26 232.27 232.28 232.29 232.30 232.31 232.32 233.1 233.2 233.3 233.4 233.5 233.6 233.7 233.8 233.9 233.10 233.11 233.12 233.13 233.14 233.15 233.16 233.17 233.18 233.19 233.20 233.21 233.22 233.23 233.24 233.25 233.26 233.27 233.28 233.29 233.30 233.31 233.32 234.1 234.2 234.3 234.4 234.5 234.6 234.7
234.8 234.9 234.10 234.11 234.12 234.13 234.14 234.15 234.16 234.17 234.18 234.19 234.20 234.21 234.22 234.23 234.24 234.25 234.26 234.27 234.28 234.29 234.30 234.31 234.32 235.1 235.2 235.3 235.4 235.5 235.6 235.7 235.8 235.9 235.10 235.11 235.12 235.13 235.14 235.15 235.16 235.17 235.18 235.19 235.20 235.21 235.22 235.23 235.24 235.25 235.26 235.27 235.28 235.29 235.30 235.31 235.32 236.1 236.2 236.3 236.4 236.5 236.6 236.7 236.8 236.9 236.10 236.11 236.12 236.13 236.14 236.15 236.16 236.17 236.18 236.19 236.20 236.21 236.22 236.23 236.24 236.25 236.26 236.27 236.28 236.29 236.30 236.31 237.1 237.2 237.3
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
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
239.12 239.13 239.14 239.15 239.16 239.17 239.18 239.19 239.20 239.21 239.22 239.23 239.24 239.25 239.26 239.27 239.28 239.29 239.30 239.31 239.32 239.33 240.1 240.2 240.3 240.4 240.5 240.6 240.7 240.8 240.9 240.10 240.11
240.12 240.13 240.14 240.15 240.16 240.17 240.18 240.19 240.20 240.21 240.22 240.23 240.24 240.25 240.26 240.27 240.28 240.29 240.30 240.31 241.1 241.2
241.3 241.4 241.5 241.6 241.7 241.8 241.9 241.10 241.11 241.12 241.13 241.14 241.15 241.16 241.17 241.18 241.19 241.20 241.21 241.22 241.23 241.24 241.25 241.26 241.27 241.28 241.29 241.30 241.31 241.32 241.33 242.1 242.2 242.3 242.4 242.5
242.6 242.7
242.8 242.9 242.10 242.11 242.12 242.13 242.14 242.15 242.16 242.17 242.18 242.19 242.20 242.21 242.22 242.23 242.24 242.25 242.26 242.27 242.28 242.29 242.30 243.1 243.2 243.3 243.4 243.5 243.6 243.7 243.8 243.9 243.10 243.11 243.12 243.13 243.14 243.15 243.16 243.17 243.18 243.19 243.20 243.21 243.22 243.23 243.24 243.25 243.26 243.27
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
244.20 244.21 244.22 244.23 244.24 244.25 244.26 244.27 244.28 244.29 244.30 244.31 244.32 245.1 245.2 245.3 245.4 245.5 245.6 245.7 245.8 245.9 245.10 245.11
245.12 245.13 245.14 245.15 245.16 245.17 245.18 245.19 245.20 245.21 245.22 245.23 245.24 245.25 245.26 245.27 245.28 245.29 245.30 245.31 245.32 246.1 246.2 246.3 246.4 246.5 246.6 246.7 246.8 246.9 246.10 246.11 246.12 246.13 246.14 246.15 246.16 246.17 246.18 246.19 246.20 246.21 246.22 246.23 246.24 246.25 246.26 246.27 246.28 246.29 246.30 246.31 246.32 247.1 247.2 247.3 247.4 247.5 247.6 247.7 247.8 247.9 247.10 247.11 247.12 247.13
247.14 247.15 247.16 247.17 247.18 247.19 247.20 247.21 247.22 247.23 247.24 247.25 247.26 247.27 247.28 247.29 247.30 247.31 247.32 247.33 247.34 248.1 248.2 248.3 248.4 248.5 248.6 248.7 248.8 248.9 248.10 248.11 248.12 248.13 248.14 248.15 248.16 248.17 248.18
248.19 248.20 248.21 248.22 248.23 248.24 248.25 248.26 248.27 248.28 248.29 248.30 248.31 248.32 248.33 249.1 249.2 249.3 249.4 249.5 249.6 249.7 249.8 249.9 249.10 249.11 249.12 249.13 249.14 249.15 249.16 249.17
249.18 249.19 249.20 249.21 249.22 249.23 249.24 249.25 249.26 249.27 249.28
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
250.21 250.22 250.23 250.24 250.25 250.26 250.27 250.28 250.29 250.30 251.1 251.2 251.3 251.4 251.5 251.6 251.7 251.8 251.9 251.10
251.11 251.12 251.13 251.14 251.15 251.16 251.17 251.18 251.19 251.20 251.21 251.22 251.23 251.24 251.25 251.26 251.27 251.28 251.29 251.30 251.31 251.32 252.1 252.2 252.3 252.4 252.5 252.6 252.7 252.8 252.9 252.10 252.11 252.12 252.13 252.14 252.15 252.16 252.17 252.18 252.19 252.20 252.21 252.22 252.23 252.24 252.25 252.26 252.27 252.28 252.29 252.30 252.31 252.32 252.33 252.34 253.1 253.2 253.3 253.4 253.5 253.6 253.7 253.8 253.9 253.10 253.11 253.12
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
253.28 253.29 253.30 253.31 253.32 254.1 254.2 254.3 254.4 254.5
254.6 254.7 254.8 254.9 254.10 254.11 254.12 254.13
254.14
254.15 254.16
254.17 254.18 254.19 254.20 254.21 254.22 254.23 254.24 254.25 254.26 254.27 254.28 254.29 255.1 255.2 255.3 255.4
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
255.18 255.19 255.20 255.21 255.22 255.23 255.24 255.25 255.26 255.27 255.28 255.29 255.30 256.1 256.2 256.3 256.4 256.5 256.6 256.7 256.8 256.9 256.10 256.11 256.12 256.13 256.14 256.15 256.16 256.17 256.18 256.19 256.20 256.21 256.22 256.23 256.24 256.25 256.26 256.27 256.28 256.29 256.30 256.31 257.1 257.2 257.3 257.4 257.5 257.6 257.7 257.8 257.9 257.10 257.11 257.12 257.13
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
257.30 257.31 257.32 258.1 258.2 258.3 258.4 258.5 258.6 258.7 258.8 258.9 258.10 258.11 258.12 258.13 258.14 258.15 258.16 258.17 258.18 258.19 258.20 258.21 258.22 258.23 258.24 258.25 258.26 258.27 258.28 258.29 258.30
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
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
260.25 260.26 260.27 260.28 260.29 260.30 260.31 261.1 261.2 261.3 261.4 261.5 261.6 261.7 261.8 261.9 261.10 261.11 261.12 261.13 261.14 261.15 261.16 261.17 261.18 261.19 261.20 261.21 261.22 261.23 261.24 261.25
261.26 261.27 261.28 261.29 261.30 261.31 261.32 261.33 261.34 262.1 262.2 262.3 262.4 262.5 262.6 262.7 262.8 262.9 262.10 262.11 262.12 262.13 262.14 262.15 262.16 262.17 262.18 262.19 262.20 262.21 262.22 262.23 262.24 262.25 262.26 262.27 262.28 262.29 262.30 262.31 262.32 263.1 263.2 263.3 263.4 263.5 263.6 263.7 263.8 263.9 263.10 263.11
263.12 263.13 263.14
263.15 263.16 263.17 263.18 263.19 263.20 263.21 263.22 263.23 263.24 263.25 263.26 263.27 263.28 263.29 263.30 263.31 264.1 264.2 264.3 264.4 264.5 264.6 264.7 264.8 264.9
264.10 264.11
264.12 264.13 264.14 264.15 264.16 264.17 264.18 264.19 264.20 264.21 264.22 264.23 264.24 264.25 264.26 264.27 264.28 264.29 264.30 264.31 264.32 265.1 265.2 265.3 265.4 265.5 265.6 265.7 265.8 265.9 265.10 265.11 265.12 265.13 265.14 265.15 265.16 265.17 265.18 265.19 265.20 265.21 265.22 265.23 265.24 265.25 265.26 265.27 265.28 266.1 266.2 266.3 266.4 266.5 266.6 266.7 266.8 266.9 266.10
266.11 266.12 266.13 266.14 266.15 266.16 266.17 266.18 266.19 266.20 266.21 266.22 266.23 266.24 266.25 266.26 266.27 266.28 266.29 266.30 267.1 267.2 267.3 267.4 267.5 267.6
267.7 267.8 267.9 267.10 267.11 267.12 267.13 267.14 267.15 267.16 267.17 267.18 267.19 267.20 267.21 267.22 267.23 267.24 267.25 267.26 267.27 267.28 267.29 267.30 267.31 268.1 268.2 268.3 268.4 268.5 268.6 268.7 268.8 268.9 268.10 268.11 268.12 268.13 268.14 268.15 268.16 268.17 268.18 268.19 268.20 268.21 268.22 268.23 268.24 268.25 268.26 268.27 268.28 268.29 268.30 268.31 268.32 268.33 269.1 269.2 269.3 269.4 269.5 269.6 269.7 269.8 269.9 269.10 269.11 269.12 269.13 269.14 269.15 269.16 269.17 269.18 269.19 269.20 269.21 269.22 269.23 269.24 269.25 269.26 269.27 269.28 269.29 269.30 269.31 269.32 269.33 270.1 270.2 270.3 270.4 270.5 270.6 270.7 270.8 270.9 270.10 270.11 270.12 270.13 270.14 270.15 270.16 270.17 270.18 270.19 270.20 270.21 270.22 270.23 270.24 270.25 270.26 270.27 270.28 270.29
271.1 271.2 271.3 271.4 271.5 271.6 271.7 271.8 271.9 271.10 271.11 271.12 271.13 271.14 271.15 271.16 271.17 271.18 271.19 271.20 271.21 271.22 271.23 271.24 271.25 271.26 271.27 271.28 271.29 271.30 271.31 271.32 271.33 272.1 272.2 272.3 272.4 272.5 272.6 272.7 272.8 272.9 272.10 272.11 272.12 272.13 272.14 272.15 272.16 272.17 272.18 272.19 272.20 272.21 272.22 272.23 272.24 272.25 272.26 272.27 272.28 272.29 272.30 272.31 273.1 273.2 273.3 273.4 273.5 273.6 273.7 273.8 273.9 273.10 273.11 273.12 273.13 273.14 273.15 273.16 273.17 273.18 273.19 273.20 273.21 273.22 273.23 273.24
273.25 273.26 273.27 273.28 273.29 273.30 273.31 273.32 274.1 274.2 274.3 274.4 274.5 274.6 274.7 274.8 274.9 274.10 274.11 274.12 274.13 274.14 274.15 274.16 274.17 274.18 274.19 274.20 274.21 274.22 274.23 274.24 274.25 274.26 274.27 274.28 274.29 274.30 274.31 274.32 274.33 275.1 275.2 275.3 275.4 275.5 275.6 275.7 275.8 275.9 275.10 275.11 275.12 275.13 275.14 275.15 275.16 275.17 275.18 275.19 275.20 275.21
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
276.8 276.9 276.10 276.11 276.12 276.13 276.14 276.15 276.16 276.17 276.18 276.19 276.20 276.21 276.22 276.23 276.24 276.25 276.26 276.27 276.28 276.29 276.30 276.31 276.32 276.33 277.1 277.2 277.3 277.4 277.5 277.6 277.7 277.8 277.9 277.10 277.11 277.12 277.13 277.14 277.15 277.16 277.17 277.18 277.19 277.20 277.21 277.22 277.23 277.24 277.25 277.26 277.27 277.28 277.29 277.30 277.31 277.32 277.33 277.34 278.1 278.2 278.3 278.4 278.5 278.6 278.7 278.8 278.9 278.10 278.11 278.12 278.13 278.14 278.15 278.16 278.17 278.18 278.19 278.20 278.21 278.22 278.23 278.24 278.25 278.26 278.27 278.28 278.29 278.30 278.31 278.32 279.1 279.2 279.3 279.4 279.5 279.6 279.7 279.8 279.9 279.10 279.11 279.12 279.13
279.14 279.15 279.16 279.17 279.18 279.19 279.20 279.21 279.22 279.23 279.24 279.25 279.26 279.27 279.28 279.29 279.30 279.31 279.32 279.33 280.1 280.2 280.3 280.4 280.5 280.6 280.7 280.8 280.9 280.10 280.11 280.12 280.13 280.14 280.15 280.16 280.17 280.18 280.19 280.20 280.21 280.22 280.23 280.24 280.25 280.26 280.27 280.28 280.29 280.30 280.31 280.32 280.33 280.34 281.1 281.2 281.3 281.4 281.5 281.6 281.7 281.8 281.9 281.10 281.11 281.12 281.13 281.14 281.15 281.16 281.17 281.18 281.19 281.20 281.21 281.22 281.23 281.24 281.25 281.26 281.27 281.28 281.29 281.30 281.31 282.1 282.2
282.3 282.4 282.5 282.6 282.7 282.8 282.9 282.10 282.11 282.12 282.13 282.14 282.15 282.16 282.17 282.18 282.19 282.20 282.21 282.22 282.23 282.24 282.25 282.26 282.27 282.28 282.29 282.30 282.31 282.32 283.1 283.2
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
284.1 284.2 284.3 284.4 284.5 284.6 284.7 284.8 284.9 284.10 284.11 284.12 284.13 284.14 284.15 284.16 284.17 284.18 284.19 284.20 284.21 284.22 284.23 284.24 284.25 284.26 284.27 284.28 284.29 284.30 285.1 285.2 285.3 285.4 285.5 285.6 285.7 285.8 285.9 285.10 285.11 285.12 285.13 285.14 285.15 285.16 285.17 285.18 285.19 285.20 285.21 285.22 285.23 285.24 285.25 285.26 285.27 285.28 285.29 285.30 286.1 286.2 286.3 286.4 286.5 286.6 286.7 286.8 286.9 286.10 286.11 286.12 286.13 286.14 286.15 286.16
286.17 286.18 286.19 286.20 286.21 286.22 286.23 286.24 286.25 286.26 286.27 286.28 286.29 286.30 286.31 287.1 287.2 287.3 287.4 287.5 287.6 287.7 287.8 287.9 287.10 287.11 287.12 287.13 287.14 287.15 287.16 287.17 287.18 287.19 287.20 287.21 287.22 287.23 287.24 287.25 287.26 287.27 287.28 287.29 287.30 287.31 287.32 287.33 287.34 287.35 288.1 288.2 288.3 288.4 288.5 288.6 288.7 288.8 288.9 288.10 288.11 288.12 288.13
288.14 288.15 288.16
288.17 288.18 288.19 288.20 288.21 288.22 288.23 288.24 288.25 288.26 288.27 288.28 288.29 288.30 288.31 288.32 288.33
289.1 289.2 289.3 289.4 289.5 289.6 289.7 289.8 289.9 289.10 289.11 289.12 289.13 289.14 289.15 289.16 289.17 289.18 289.19 289.20 289.21 289.22 289.23 289.24 289.25 289.26 289.27 289.28 289.29 290.1 290.2 290.3 290.4 290.5 290.6 290.7 290.8 290.9
290.10
290.11 290.12 290.13 290.14 290.15 290.16 290.17 290.18 290.19 290.20 290.21 290.22 290.23 290.24 290.25 290.26 290.27 290.28 290.29 291.1 291.2 291.3 291.4 291.5 291.6 291.7 291.8 291.9 291.10 291.11 291.12 291.13 291.14 291.15 291.16 291.17 291.18 291.19 291.20 291.21 291.22 291.23
291.24
291.25 291.26 291.27 291.28 291.29 291.30 292.1 292.2
292.3 292.4 292.5 292.6 292.7 292.8 292.9 292.10 292.11 292.12 292.13 292.14 292.15 292.16 292.17 292.18 292.19 292.20 292.21 292.22 292.23 292.24 292.25 292.26 292.27 292.28 292.29 292.30 293.1 293.2 293.3 293.4 293.5 293.6 293.7
293.8
293.9 293.10 293.11 293.12 293.13 293.14 293.15
293.16 293.17
293.18 293.19
293.20 293.21 293.22 293.23 293.24 293.25 293.26 293.27 293.28 293.29 293.30 293.31 294.1 294.2 294.3 294.4 294.5 294.6 294.7 294.8 294.9 294.10 294.11 294.12 294.13 294.14 294.15 294.16 294.17 294.18 294.19 294.20 294.21 294.22 294.23 294.24 294.25 294.26 294.27 294.28 294.29 294.30 294.31 294.32 295.1 295.2 295.3 295.4 295.5 295.6 295.7 295.8 295.9 295.10 295.11 295.12 295.13 295.14 295.15 295.16 295.17 295.18 295.19 295.20 295.21 295.22 295.23 295.24 295.25 295.26 295.27 295.28 295.29 295.30 295.31 295.32 296.1 296.2 296.3
296.4
296.5 296.6 296.7 296.8 296.9 296.10 296.11 296.12 296.13 296.14 296.15 296.16 296.17 296.18 296.19 296.20 296.21 296.22 296.23 296.24 296.25 296.26 296.27 296.28 296.29 296.30 296.31 296.32 297.1 297.2 297.3 297.4 297.5 297.6 297.7 297.8 297.9 297.10 297.11 297.12 297.13 297.14
297.15 297.16 297.17 297.18 297.19 297.20 297.21 297.22 297.23 297.24 297.25 297.26 297.27 297.28 297.29 297.30 297.31 297.32 298.1 298.2 298.3 298.4 298.5 298.6 298.7 298.8 298.9 298.10 298.11 298.12 298.13 298.14 298.15 298.16 298.17 298.18 298.19 298.20 298.21
298.22 298.23 298.24 298.25
298.26 298.27 298.28 298.29 298.30 298.31 299.1 299.2 299.3 299.4 299.5 299.6 299.7 299.8 299.9 299.10 299.11 299.12 299.13 299.14 299.15 299.16 299.17 299.18 299.19 299.20 299.21 299.22 299.23 299.24
299.25 299.26 299.27 299.28 299.29 299.30 300.1 300.2 300.3 300.4 300.5 300.6 300.7 300.8 300.9 300.10 300.11 300.12 300.13 300.14 300.15 300.16 300.17 300.18 300.19 300.20 300.21 300.22 300.23 300.24 300.25 300.26 300.27 300.28 300.29 300.30 300.31 301.1 301.2 301.3 301.4 301.5 301.6 301.7 301.8 301.9 301.10 301.11 301.12 301.13 301.14 301.15 301.16 301.17 301.18 301.19 301.20 301.21 301.22 301.23 301.24 301.25 301.26 301.27 301.28 301.29 301.30 301.31 302.1 302.2 302.3 302.4 302.5 302.6 302.7 302.8 302.9 302.10
302.11 302.12 302.13 302.14 302.15 302.16 302.17 302.18 302.19 302.20 302.21 302.22 302.23 302.24 302.25 302.26 302.27 302.28 302.29 302.30 303.1 303.2 303.3 303.4 303.5 303.6 303.7 303.8 303.9 303.10 303.11 303.12 303.13 303.14 303.15 303.16 303.17 303.18 303.19 303.20 303.21 303.22 303.23 303.24 303.25 303.26 303.27 303.28 303.29 303.30 304.1 304.2 304.3 304.4 304.5 304.6 304.7 304.8 304.9 304.10 304.11 304.12 304.13 304.14 304.15 304.16 304.17 304.18 304.19 304.20 304.21 304.22 304.23 304.24 304.25 304.26 304.27 304.28 304.29 304.30 304.31 304.32 305.1 305.2 305.3 305.4 305.5 305.6 305.7 305.8 305.9 305.10 305.11 305.12 305.13 305.14 305.15 305.16 305.17 305.18 305.19 305.20 305.21 305.22 305.23 305.24 305.25 305.26 305.27 305.28 305.29 305.30 305.31 305.32 305.33 305.34 306.1 306.2 306.3 306.4 306.5 306.6 306.7 306.8 306.9 306.10 306.11 306.12 306.13 306.14 306.15 306.16 306.17 306.18 306.19 306.20 306.21 306.22 306.23 306.24 306.25 306.26 306.27 306.28 306.29 306.30 306.31 306.32 306.33 306.34 307.1 307.2 307.3
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
307.24 307.25 307.26 307.27 307.28 307.29 307.30 308.1 308.2 308.3 308.4 308.5 308.6 308.7 308.8 308.9 308.10 308.11 308.12 308.13 308.14 308.15 308.16
308.17 308.18 308.19 308.20 308.21 308.22 308.23 308.24 308.25 308.26 308.27 308.28 308.29 308.30 308.31 309.1 309.2
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
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
310.23 310.24 310.25 310.26 310.27 310.28 310.29 310.30 310.31 311.1 311.2 311.3 311.4 311.5 311.6 311.7 311.8 311.9 311.10 311.11 311.12 311.13 311.14 311.15 311.16 311.17 311.18 311.19 311.20 311.21 311.22 311.23 311.24 311.25 311.26 311.27 311.28 311.29 311.30 311.31 311.32 312.1 312.2 312.3
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
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
313.27 313.28 313.29 313.30 314.1 314.2 314.3 314.4 314.5 314.6 314.7 314.8 314.9 314.10 314.11 314.12 314.13 314.14 314.15 314.16 314.17
314.18 314.19 314.20 314.21 314.22 314.23 314.24 314.25 314.26 314.27 314.28 314.29
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
315.21 315.22 315.23 315.24 315.25 315.26 315.27 315.28 315.29 315.30 316.1 316.2 316.3 316.4 316.5
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
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
317.20 317.21 317.22 317.23 317.24 317.25 317.26 317.27 317.28 317.29 317.30 317.31 318.1 318.2 318.3 318.4 318.5 318.6 318.7 318.8 318.9 318.10 318.11 318.12
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
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
320.27 320.28 320.29 320.30 320.31 320.32 320.33 321.1 321.2 321.3 321.4 321.5
321.6 321.7 321.8 321.9 321.10 321.11 321.12 321.13 321.14 321.15 321.16 321.17 321.18 321.19 321.20 321.21 321.22 321.23 321.24 321.25 321.26 321.27 321.28 321.29 321.30 321.31 322.1 322.2 322.3 322.4 322.5 322.6 322.7 322.8 322.9 322.10 322.11 322.12 322.13 322.14 322.15 322.16 322.17 322.18 322.19 322.20 322.21 322.22 322.23 322.24 322.25 322.26 322.27 322.28 322.29 322.30 322.31 322.32 322.33 323.1 323.2
323.3 323.4 323.5 323.6 323.7 323.8 323.9 323.10 323.11 323.12 323.13 323.14 323.15 323.16 323.17 323.18 323.19 323.20 323.21 323.22 323.23 323.24 323.25 323.26 323.27 323.28 323.29 323.30 323.31 324.1 324.2 324.3 324.4 324.5
324.6 324.7 324.8 324.9 324.10 324.11 324.12 324.13 324.14 324.15 324.16 324.17 324.18 324.19 324.20 324.21 324.22 324.23 324.24 324.25 324.26 324.27 324.28 324.29 324.30 324.31 325.1 325.2 325.3 325.4 325.5 325.6 325.7 325.8 325.9 325.10 325.11 325.12 325.13 325.14 325.15 325.16 325.17 325.18 325.19 325.20 325.21 325.22 325.23 325.24 325.25 325.26 325.27 325.28 325.29 325.30 325.31 325.32 325.33 325.34 326.1 326.2 326.3 326.4 326.5 326.6 326.7 326.8 326.9 326.10 326.11 326.12 326.13 326.14 326.15 326.16 326.17 326.18 326.19 326.20 326.21 326.22 326.23 326.24 326.25 326.26 326.27 326.28 326.29 326.30 326.31 326.32 326.33 326.34 326.35 327.1 327.2 327.3 327.4 327.5 327.6 327.7 327.8 327.9 327.10 327.11 327.12 327.13 327.14 327.15 327.16 327.17 327.18 327.19
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
328.25 328.26 328.27 328.28 328.29 328.30 328.31 328.32 328.33 328.34 329.1 329.2 329.3 329.4 329.5 329.6 329.7 329.8 329.9 329.10 329.11 329.12 329.13 329.14 329.15 329.16 329.17 329.18 329.19 329.20 329.21 329.22 329.23 329.24 329.25 329.26 329.27 329.28 329.29 329.30
329.31 329.32 329.33 329.34 330.1 330.2 330.3 330.4 330.5 330.6 330.7 330.8 330.9 330.10 330.11 330.12 330.13 330.14 330.15 330.16 330.17 330.18 330.19 330.20 330.21
330.22 330.23 330.24 330.25 330.26 330.27 330.28 330.29 330.30 330.31 330.32 330.33 330.34 330.35 331.1 331.2 331.3 331.4
331.5 331.6 331.7 331.8 331.9 331.10 331.11 331.12 331.13 331.14 331.15 331.16 331.17 331.18 331.19 331.20 331.21 331.22 331.23 331.24 331.25 331.26 331.27 331.28 331.29 331.30 331.31 331.32 331.33 332.1 332.2 332.3 332.4 332.5 332.6 332.7 332.8 332.9 332.10 332.11 332.12 332.13 332.14 332.15 332.16 332.17 332.18 332.19 332.20
332.21 332.22 332.23 332.24 332.25 332.26 332.27 332.28 332.29 332.30 332.31 332.32 332.33 333.1 333.2 333.3 333.4 333.5 333.6
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
333.30 333.31 333.32 334.1 334.2 334.3 334.4 334.5 334.6 334.7 334.8 334.9 334.10 334.11 334.12 334.13 334.14 334.15 334.16 334.17 334.18 334.19 334.20 334.21 334.22 334.23 334.24 334.25 334.26 334.27 334.28 334.29 335.1 335.2 335.3 335.4 335.5 335.6 335.7 335.8 335.9 335.10 335.11 335.12 335.13 335.14 335.15 335.16 335.17 335.18 335.19 335.20 335.21 335.22 335.23 335.24 335.25 335.26 335.27 335.28 335.29 336.1 336.2 336.3 336.4 336.5 336.6 336.7 336.8 336.9 336.10 336.11 336.12 336.13 336.14 336.15 336.16 336.17 336.18
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
337.26 337.27 337.28 338.1 338.2 338.3 338.4 338.5 338.6 338.7 338.8 338.9 338.10 338.11 338.12 338.13 338.14 338.15 338.16 338.17 338.18 338.19 338.20 338.21 338.22 338.23 338.24 338.25 338.26 338.27 338.28 338.29 338.30 338.31 338.32 338.33 338.34 339.1 339.2 339.3 339.4 339.5 339.6 339.7 339.8 339.9 339.10 339.11 339.12 339.13 339.14 339.15 339.16 339.17 339.18 339.19 339.20 339.21 339.22 339.23 339.24 339.25 339.26 339.27 339.28
339.29 339.30 339.31 339.32 339.33 340.1 340.2 340.3 340.4 340.5 340.6 340.7 340.8 340.9 340.10 340.11 340.12 340.13 340.14 340.15 340.16 340.17 340.18 340.19 340.20 340.21 340.22 340.23 340.24 340.25 340.26 340.27 340.28 340.29 340.30 340.31 340.32
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
341.21 341.22 341.23 341.24 341.25 341.26 341.27 341.28 341.29 341.30 341.31 341.32 341.33 342.1 342.2 342.3 342.4 342.5 342.6 342.7
342.8 342.9 342.10 342.11 342.12
342.13 342.14 342.15 342.16 342.17 342.18 342.19 342.20 342.21 342.22 342.23 342.24 342.25 342.26 342.27 342.28 342.29 342.30 342.31 342.32 342.33 343.1 343.2 343.3 343.4 343.5 343.6 343.7 343.8 343.9 343.10 343.11 343.12 343.13 343.14 343.15 343.16 343.17 343.18 343.19 343.20 343.21 343.22 343.23 343.24 343.25 343.26 343.27 343.28 343.29 343.30 343.31 343.32 343.33 343.34 343.35 343.36 343.37 343.38 344.1 344.2
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
344.20 344.21 344.22 344.23 344.24 344.25 344.26 344.27 344.28 344.29 344.30 344.31 345.1 345.2 345.3 345.4 345.5
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
345.26 345.27 345.28 345.29 345.30 345.31 345.32 346.1 346.2 346.3 346.4 346.5 346.6 346.7 346.8 346.9 346.10 346.11 346.12 346.13 346.14 346.15 346.16 346.17 346.18 346.19 346.20 346.21 346.22 346.23 346.24 346.25 346.26 346.27 346.28 346.29 346.30 346.31 347.1 347.2 347.3 347.4 347.5 347.6 347.7 347.8 347.9 347.10 347.11
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
348.7 348.8 348.9 348.10 348.11 348.12 348.13 348.14 348.15 348.16 348.17 348.18 348.19 348.20 348.21 348.22 348.23 348.24 348.25 348.26 348.27 348.28 348.29 348.30 348.31 348.32 348.33 348.34 348.35 349.1 349.2 349.3 349.4 349.5 349.6 349.7 349.8 349.9 349.10 349.11 349.12 349.13 349.14 349.15 349.16 349.17 349.18 349.19 349.20 349.21 349.22 349.23 349.24 349.25 349.26 349.27 349.28 349.29 349.30 349.31 349.32 349.33 349.34 349.35 349.36 350.1 350.2
350.3 350.4 350.5 350.6 350.7 350.8 350.9 350.10 350.11 350.12 350.13 350.14 350.15 350.16 350.17 350.18 350.19 350.20 350.21 350.22 350.23 350.24 350.25 350.26 350.27 350.28 350.29 350.30 350.31 350.32 350.33 350.34 350.35 351.1 351.2 351.3 351.4 351.5 351.6 351.7 351.8 351.9 351.10 351.11 351.12 351.13
351.14 351.15 351.16 351.17 351.18 351.19 351.20 351.21 351.22 351.23 351.24 351.25 351.26 351.27 351.28 351.29 351.30 351.31 351.32 351.33 351.34 352.1 352.2 352.3 352.4 352.5
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
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
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
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
356.28 356.29 356.30 356.31 357.1 357.2 357.3 357.4
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
357.26 357.27 357.28 357.29 357.30 357.31 358.1 358.2 358.3 358.4 358.5 358.6 358.7 358.8 358.9
358.10 358.11 358.12 358.13 358.14 358.15 358.16 358.17 358.18 358.19
358.20 358.21 358.22 358.23 358.24 358.25 358.26 358.27 358.28 358.29 358.30 358.31 358.32 359.1 359.2 359.3 359.4 359.5 359.6 359.7 359.8 359.9
359.10 359.11 359.12 359.13 359.14 359.15 359.16 359.17 359.18 359.19 359.20 359.21 359.22 359.23 359.24 359.25 359.26 359.27 359.28 359.29 359.30 359.31 359.32 360.1 360.2 360.3 360.4 360.5 360.6 360.7 360.8 360.9 360.10 360.11 360.12 360.13 360.14 360.15 360.16 360.17 360.18 360.19 360.20 360.21 360.22 360.23 360.24 360.25 360.26 360.27 360.28 360.29 360.30 360.31 360.32 360.33 360.34 360.35 361.1 361.2 361.3 361.4 361.5 361.6 361.7 361.8 361.9 361.10 361.11 361.12 361.13 361.14 361.15 361.16 361.17 361.18 361.19 361.20 361.21 361.22 361.23 361.24 361.25 361.26 361.27 361.28 361.29 361.30 361.31 361.32 361.33 362.1 362.2 362.3 362.4 362.5 362.6 362.7 362.8 362.9 362.10 362.11 362.12 362.13 362.14 362.15 362.16 362.17 362.18 362.19 362.20 362.21 362.22 362.23 362.24 362.25 362.26 362.27 362.28 362.29 362.30 362.31 362.32 362.33 363.1 363.2 363.3 363.4 363.5 363.6 363.7 363.8 363.9 363.10 363.11 363.12 363.13 363.14 363.15 363.16 363.17 363.18 363.19 363.20 363.21 363.22 363.23 363.24 363.25 363.26 363.27 363.28 363.29 363.30 363.31 363.32 363.33 363.34 364.1 364.2 364.3 364.4 364.5 364.6 364.7
364.8 364.9 364.10 364.11 364.12 364.13 364.14 364.15 364.16 364.17 364.18 364.19 364.20 364.21 364.22 364.23 364.24 364.25 364.26 364.27 364.28 364.29 364.30 364.31 364.32 364.33 365.1 365.2 365.3 365.4 365.5 365.6 365.7 365.8 365.9 365.10 365.11 365.12 365.13 365.14 365.15 365.16 365.17 365.18 365.19 365.20 365.21 365.22 365.23 365.24 365.25 365.26 365.27 365.28 365.29 365.30 365.31 365.32 365.33 365.34 366.1 366.2 366.3 366.4 366.5 366.6 366.7 366.8 366.9 366.10 366.11 366.12 366.13 366.14 366.15 366.16 366.17 366.18 366.19 366.20 366.21 366.22 366.23 366.24 366.25 366.26 366.27 366.28 366.29 366.30 366.31 366.32 366.33 366.34 367.1 367.2 367.3 367.4 367.5 367.6 367.7 367.8 367.9 367.10 367.11 367.12 367.13 367.14 367.15 367.16 367.17 367.18 367.19 367.20 367.21 367.22 367.23 367.24 367.25 367.26 367.27 367.28 367.29 367.30 367.31 367.32 367.33 367.34 368.1 368.2 368.3 368.4 368.5 368.6 368.7 368.8 368.9 368.10 368.11 368.12 368.13 368.14 368.15 368.16 368.17 368.18 368.19 368.20 368.21 368.22 368.23 368.24 368.25 368.26 368.27 368.28 368.29 368.30 368.31 368.32 368.33 368.34 369.1 369.2 369.3 369.4 369.5 369.6 369.7 369.8 369.9 369.10 369.11 369.12
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
369.27 369.28 369.29 369.30 369.31 369.32 369.33 370.1 370.2 370.3 370.4 370.5 370.6
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
370.29 370.30 370.31 370.32 370.33 371.1 371.2 371.3 371.4 371.5 371.6 371.7
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
372.18 372.19 372.20 372.21 372.22 372.23 372.24 372.25 372.26 372.27 372.28 372.29 372.30 372.31 372.32 373.1 373.2 373.3
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
374.1 374.2 374.3 374.4 374.5 374.6 374.7 374.8 374.9 374.10 374.11 374.12 374.13 374.14 374.15 374.16 374.17 374.18 374.19 374.20 374.21 374.22 374.23 374.24 374.25 374.26 374.27 374.28 374.29 374.30 374.31 375.1 375.2 375.3 375.4 375.5 375.6 375.7 375.8 375.9 375.10 375.11 375.12 375.13 375.14 375.15 375.16 375.17 375.18
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
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
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
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
380.2 380.3 380.4 380.5 380.6 380.7 380.8 380.9 380.10 380.11 380.12 380.13 380.14 380.15 380.16 380.17 380.18 380.19 380.20 380.21 380.22 380.23 380.24 380.25 380.26 380.27 380.28 380.29 380.30 380.31 380.32 381.1 381.2 381.3
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
381.22 381.23 381.24 381.25 381.26 381.27 381.28 381.29 381.30 382.1 382.2 382.3 382.4 382.5 382.6 382.7 382.8 382.9 382.10 382.11 382.12 382.13 382.14 382.15 382.16 382.17 382.18 382.19 382.20 382.21 382.22 382.23 382.24 382.25 382.26 382.27 382.28 382.29 382.30 383.1 383.2 383.3 383.4 383.5 383.6 383.7 383.8 383.9 383.10 383.11
383.12 383.13 383.14 383.15 383.16 383.17
383.18 383.19 383.20 383.21 383.22 383.23
383.24 383.25 383.26 383.27 383.28 383.29 383.30 383.31 383.32 384.1 384.2 384.3 384.4 384.5 384.6 384.7 384.8 384.9 384.10 384.11 384.12 384.13 384.14 384.15 384.16 384.17 384.18 384.19 384.20 384.21 384.22 384.23 384.24 384.25 384.26 384.27 384.28 384.29 384.30 384.31 384.32 384.33 384.34 385.1 385.2 385.3 385.4 385.5 385.6 385.7 385.8 385.9 385.10 385.11 385.12 385.13 385.14 385.15 385.16 385.17 385.18 385.19 385.20 385.21 385.22 385.23 385.24 385.25 385.26 385.27 385.28 385.29 385.30 385.31 385.32 385.33 386.1 386.2 386.3 386.4 386.5 386.6 386.7 386.8 386.9 386.10 386.11 386.12 386.13 386.14 386.15 386.16 386.17 386.18 386.19 386.20 386.21 386.22 386.23 386.24 386.25 386.26 386.27 386.28 386.29 386.30 386.31 386.32 386.33 386.34 387.1 387.2 387.3 387.4 387.5 387.6 387.7
387.8 387.9 387.10 387.11 387.12 387.13 387.14 387.15 387.16 387.17 387.18 387.19 387.20 387.21 387.22 387.23 387.24 387.25 387.26 387.27 387.28 387.29 387.30 387.31 388.1 388.2 388.3 388.4 388.5 388.6 388.7 388.8 388.9 388.10 388.11 388.12 388.13 388.14 388.15 388.16 388.17 388.18 388.19 388.20 388.21 388.22 388.23 388.24 388.25 388.26 388.27 388.28 388.29 388.30 388.31 388.32 388.33 389.1 389.2 389.3 389.4 389.5 389.6 389.7 389.8 389.9 389.10 389.11 389.12 389.13 389.14 389.15 389.16 389.17 389.18 389.19 389.20 389.21 389.22 389.23 389.24 389.25 389.26 389.27 389.28 389.29 389.30 389.31 389.32 389.33 390.1 390.2
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
390.24 390.25 390.26 390.27 390.28 390.29 390.30 390.31 391.1 391.2 391.3 391.4 391.5 391.6 391.7 391.8 391.9 391.10 391.11 391.12 391.13 391.14 391.15 391.16 391.17 391.18 391.19 391.20 391.21 391.22 391.23 391.24 391.25 391.26 391.27 391.28 391.29 391.30 392.1 392.2 392.3 392.4 392.5 392.6 392.7 392.8 392.9 392.10 392.11 392.12 392.13 392.14 392.15 392.16 392.17
392.18 392.19
392.20 392.21 392.22
392.23 392.24 392.25
392.26 392.27
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
393.16 393.17 393.18 393.19 393.20 393.21 393.22 393.23 393.24 393.25 393.26 393.27 393.28 393.29 393.30 393.31 393.32 393.33 394.1 394.2 394.3 394.4 394.5 394.6 394.7 394.8 394.9 394.10 394.11 394.12 394.13 394.14 394.15 394.16 394.17 394.18 394.19 394.20 394.21 394.22 394.23 394.24 394.25 394.26 394.27 394.28 394.29 394.30 394.31 395.1 395.2 395.3 395.4 395.5 395.6 395.7 395.8 395.9 395.10 395.11 395.12 395.13 395.14 395.15 395.16 395.17 395.18 395.19 395.20 395.21 395.22 395.23 395.24 395.25 395.26 395.27 395.28 395.29 395.30 395.31 395.32 395.33 396.1 396.2 396.3 396.4 396.5 396.6 396.7 396.8 396.9 396.10 396.11 396.12 396.13 396.14 396.15 396.16 396.17 396.18 396.19 396.20 396.21 396.22 396.23 396.24 396.25
396.26 396.27
396.28 396.29 396.30 396.31 396.32 397.1 397.2 397.3 397.4 397.5 397.6 397.7 397.8 397.9 397.10 397.11 397.12 397.13 397.14 397.15 397.16 397.17 397.18 397.19 397.20 397.21 397.22 397.23 397.24 397.25 397.26 397.27 397.28 397.29 397.30 397.31 397.32 398.1 398.2 398.3 398.4 398.5 398.6 398.7 398.8 398.9 398.10 398.11
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
398.27 398.28 398.29 398.30 398.31 398.32 398.33 399.1 399.2 399.3 399.4 399.5 399.6 399.7 399.8 399.9 399.10 399.11 399.12 399.13 399.14 399.15 399.16 399.17 399.18 399.19 399.20 399.21 399.22 399.23 399.24 399.25 399.26 399.27 399.28 399.29 399.30 399.31 399.32 399.33 399.34 400.1 400.2 400.3 400.4 400.5 400.6 400.7 400.8 400.9 400.10 400.11 400.12
400.13 400.14
400.15 400.16 400.17 400.18 400.19 400.20 400.21 400.22 400.23 400.24 400.25 400.26 400.27 400.28 400.29 400.30 400.31 400.32 400.33 401.1 401.2 401.3 401.4 401.5 401.6 401.7 401.8 401.9 401.10 401.11 401.12 401.13 401.14 401.15 401.16 401.17 401.18 401.19 401.20 401.21 401.22 401.23 401.24 401.25 401.26 401.27 401.28 401.29 401.30 401.31 401.32 401.33 402.1 402.2 402.3 402.4 402.5 402.6 402.7
402.8 402.9
402.10 402.11 402.12 402.13 402.14 402.15 402.16 402.17 402.18 402.19 402.20 402.21 402.22 402.23 402.24 402.25 402.26 402.27 402.28 402.29 402.30 402.31 402.32 402.33 403.1 403.2 403.3 403.4 403.5 403.6 403.7 403.8 403.9 403.10 403.11 403.12 403.13 403.14 403.15 403.16 403.17 403.18 403.19 403.20 403.21
403.22 403.23
403.24 403.25 403.26 403.27 403.28 403.29 403.30 403.31 403.32 403.33 404.1 404.2 404.3 404.4 404.5 404.6 404.7 404.8 404.9 404.10 404.11 404.12 404.13 404.14 404.15 404.16 404.17 404.18 404.19 404.20 404.21 404.22 404.23 404.24 404.25 404.26 404.27 404.28 404.29 404.30 404.31 404.32 404.33 404.34 404.35 405.1 405.2 405.3 405.4 405.5 405.6 405.7 405.8 405.9 405.10 405.11 405.12 405.13 405.14 405.15 405.16 405.17 405.18 405.19 405.20 405.21 405.22 405.23 405.24 405.25 405.26 405.27 405.28 405.29 405.30 405.31 406.1 406.2 406.3 406.4 406.5 406.6 406.7 406.8 406.9 406.10 406.11 406.12 406.13 406.14 406.15 406.16
406.17 406.18
406.19 406.20 406.21 406.22 406.23 406.24 406.25 406.26 406.27 406.28 406.29 406.30 406.31 406.32 406.33 407.1 407.2 407.3 407.4 407.5 407.6 407.7 407.8 407.9 407.10 407.11 407.12 407.13 407.14 407.15 407.16 407.17
407.18 407.19
407.20 407.21 407.22 407.23 407.24 407.25 407.26 407.27 407.28 407.29 407.30 407.31 408.1 408.2 408.3 408.4 408.5 408.6 408.7 408.8 408.9 408.10 408.11 408.12 408.13 408.14 408.15 408.16 408.17 408.18 408.19 408.20 408.21 408.22 408.23 408.24 408.25 408.26 408.27 408.28 408.29 408.30 408.31 408.32 408.33
408.34
409.1 409.2 409.3 409.4 409.5 409.6 409.7 409.8 409.9 409.10 409.11 409.12 409.13 409.14 409.15 409.16 409.17 409.18 409.19 409.20 409.21 409.22 409.23 409.24 409.25 409.26 409.27 409.28 409.29 409.30 409.31 409.32 410.1 410.2 410.3 410.4 410.5 410.6 410.7 410.8 410.9 410.10 410.11 410.12 410.13 410.14 410.15 410.16 410.17 410.18 410.19 410.20 410.21 410.22 410.23 410.24 410.25 410.26 410.27
410.28
410.29 410.30 410.31 410.32 410.33 411.1 411.2 411.3 411.4 411.5 411.6 411.7 411.8 411.9 411.10 411.11 411.12 411.13 411.14 411.15 411.16 411.17 411.18 411.19 411.20 411.21 411.22 411.23 411.24 411.25 411.26 411.27 411.28 411.29 411.30 411.31 411.32 412.1 412.2 412.3 412.4 412.5 412.6 412.7 412.8 412.9 412.10 412.11 412.12 412.13 412.14
412.15
412.16 412.17 412.18 412.19 412.20 412.21 412.22 412.23 412.24 412.25 412.26 412.27 412.28 412.29 412.30 412.31 413.1 413.2 413.3 413.4 413.5 413.6
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
413.26 413.27 413.28 413.29 414.1 414.2
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
414.26 414.27 414.28 414.29 414.30 414.31 415.1 415.2 415.3 415.4 415.5
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
415.23 415.24 415.25 415.26 415.27 415.28 415.29 415.30 415.31 416.1 416.2 416.3
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
416.19 416.20 416.21 416.22 416.23 416.24 416.25 416.26 416.27 416.28 416.29 416.30 417.1 417.2 417.3 417.4 417.5 417.6 417.7 417.8 417.9 417.10 417.11 417.12 417.13 417.14 417.15 417.16 417.17 417.18
417.19
417.20 417.21 417.22 417.23 417.24 417.25 417.26 417.27 417.28 417.29 417.30 417.31 418.1 418.2 418.3 418.4 418.5 418.6 418.7 418.8 418.9 418.10 418.11 418.12
418.13
418.14 418.15 418.16 418.17 418.18 418.19 418.20 418.21 418.22 418.23 418.24 418.25 418.26 418.27 418.28 418.29 418.30 418.31 419.1 419.2
419.3
419.4 419.5 419.6 419.7 419.8 419.9 419.10 419.11 419.12 419.13 419.14 419.15 419.16 419.17 419.18 419.19 419.20 419.21 419.22 419.23 419.24 419.25 419.26 419.27 419.28 419.29 419.30 419.31 419.32
420.1 420.2 420.3 420.4 420.5 420.6 420.7 420.8 420.9 420.10
420.11 420.12 420.13 420.14 420.15 420.16 420.17 420.18 420.19 420.20 420.21 420.22 420.23 420.24 420.25 420.26 420.27 420.28 420.29 420.30 420.31 421.1 421.2 421.3 421.4 421.5 421.6 421.7 421.8 421.9 421.10 421.11 421.12 421.13
421.14
421.15 421.16 421.17 421.18 421.19 421.20 421.21 421.22 421.23 421.24 421.25 421.26 421.27 421.28 421.29 421.30 421.31 421.32 422.1 422.2 422.3 422.4 422.5 422.6 422.7 422.8
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
423.22 423.23 423.24 423.25 423.26 423.27 423.28 423.29 423.30 423.31 423.32 424.1 424.2 424.3 424.4 424.5 424.6 424.7 424.8 424.9 424.10 424.11 424.12 424.13 424.14 424.15 424.16 424.17 424.18 424.19 424.20 424.21 424.22 424.23 424.24 424.25 424.26 424.27 424.28 424.29 424.30 424.31 424.32 424.33 425.1 425.2 425.3 425.4 425.5 425.6 425.7 425.8 425.9 425.10 425.11 425.12 425.13 425.14 425.15 425.16 425.17 425.18 425.19 425.20 425.21 425.22 425.23 425.24 425.25 425.26 425.27 425.28 425.29 425.30 425.31 425.32 425.33 425.34 426.1 426.2 426.3 426.4 426.5 426.6 426.7 426.8 426.9 426.10 426.11 426.12 426.13 426.14 426.15 426.16 426.17 426.18 426.19 426.20 426.21 426.22 426.23 426.24 426.25 426.26 426.27 426.28 426.29 426.30 426.31 426.32 426.33 426.34 427.1 427.2 427.3 427.4 427.5
427.6 427.7 427.8 427.9 427.10 427.11 427.12 427.13 427.14 427.15 427.16 427.17 427.18 427.19 427.20 427.21 427.22 427.23 427.24 427.25 427.26 427.27 427.28 427.29 427.30 427.31 427.32 428.1 428.2 428.3 428.4 428.5 428.6 428.7 428.8 428.9 428.10 428.11 428.12 428.13 428.14
428.15
428.16 428.17 428.18 428.19 428.20 428.21 428.22 428.23 428.24 428.25 428.26 428.27 428.28 428.29 429.1 429.2 429.3 429.4 429.5
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
429.19 429.20 429.21 429.22 429.23 429.24 429.25 429.26 429.27 429.28 429.29 429.30 430.1 430.2 430.3 430.4 430.5 430.6 430.7 430.8 430.9 430.10 430.11 430.12 430.13 430.14 430.15 430.16 430.17 430.18 430.19 430.20 430.21 430.22 430.23 430.24 430.25 430.26 430.27
430.28 430.29 430.30 430.31 430.32 430.33 431.1 431.2 431.3 431.4 431.5 431.6 431.7 431.8 431.9 431.10 431.11 431.12 431.13 431.14 431.15 431.16 431.17 431.18
431.19 431.20 431.21 431.22 431.23 431.24 431.25 431.26 431.27 431.28 431.29 431.30 431.31 431.32 431.33 432.1 432.2 432.3 432.4 432.5 432.6 432.7 432.8 432.9 432.10 432.11
432.12 432.13 432.14 432.15 432.16 432.17
432.18 432.19 432.20 432.21 432.22 432.23 432.24 432.25 432.26 432.27 432.28 432.29 432.30 432.31 433.1 433.2 433.3
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
435.1 435.2 435.3 435.4 435.5 435.6 435.7 435.8 435.9 435.10 435.11 435.12 435.13 435.14 435.15 435.16 435.17 435.18 435.19 435.20 435.21 435.22 435.23 435.24 435.25 435.26 435.27 435.28 435.29 435.30 435.31 435.32 435.33 436.1 436.2 436.3 436.4 436.5 436.6
436.7
436.8 436.9 436.10 436.11 436.12 436.13 436.14 436.15 436.16 436.17 436.18 436.19 436.20 436.21 436.22 436.23 436.24 436.25 436.26 436.27 436.28 436.29 436.30 436.31
436.32 436.33
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
437.27 437.28 437.29 437.30 437.31 437.32 437.33 438.1 438.2 438.3 438.4 438.5 438.6 438.7 438.8 438.9 438.10 438.11 438.12 438.13 438.14 438.15 438.16 438.17 438.18
438.19 438.20 438.21 438.22 438.23 438.24 438.25 438.26 438.27 438.28 438.29 438.30 438.31 438.32 438.33
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
439.20 439.21 439.22 439.23 439.24 439.25 439.26 439.27 439.28 439.29 440.1 440.2 440.3 440.4 440.5 440.6 440.7 440.8 440.9 440.10 440.11 440.12 440.13 440.14 440.15 440.16 440.17 440.18 440.19 440.20 440.21 440.22 440.23 440.24 440.25 440.26 440.27 440.28 440.29 440.30 440.31 441.1 441.2 441.3 441.4 441.5 441.6 441.7 441.8 441.9 441.10 441.11 441.12 441.13 441.14 441.15 441.16 441.17 441.18 441.19
441.20 441.21 441.22 441.23 441.24 441.25 441.26 441.27 441.28 441.29 441.30 441.31 441.32 442.1 442.2 442.3 442.4 442.5 442.6 442.7 442.8 442.9 442.10 442.11 442.12 442.13 442.14 442.15 442.16 442.17 442.18 442.19 442.20 442.21 442.22 442.23 442.24
442.25 442.26 442.27 442.28 442.29 442.30 442.31 442.32 442.33 442.34 443.1 443.2 443.3 443.4 443.5 443.6 443.7 443.8 443.9 443.10 443.11 443.12 443.13 443.14 443.15 443.16
443.17 443.18
443.19 443.20 443.21 443.22 443.23 443.24 443.25 443.26 443.27 443.28 443.29 443.30 443.31 444.1 444.2 444.3 444.4 444.5 444.6 444.7 444.8 444.9 444.10 444.11 444.12 444.13 444.14 444.15 444.16 444.17 444.18 444.19 444.20 444.21 444.22 444.23 444.24 444.25 444.26 444.27 444.28
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
445.27 445.28 445.29 445.30 445.31 446.1 446.2 446.3 446.4 446.5 446.6 446.7 446.8 446.9 446.10 446.11 446.12 446.13 446.14 446.15 446.16 446.17 446.18 446.19 446.20 446.21 446.22 446.23 446.24 446.25 446.26 446.27 446.28 446.29 446.30 446.31 446.32 446.33 446.34 447.1 447.2 447.3 447.4 447.5 447.6 447.7 447.8 447.9 447.10 447.11 447.12 447.13 447.14 447.15 447.16 447.17 447.18 447.19 447.20 447.21 447.22 447.23 447.24 447.25 447.26 447.27 447.28 447.29 447.30 447.31 447.32 447.33 447.34 448.1 448.2 448.3 448.4 448.5 448.6 448.7 448.8 448.9 448.10 448.11 448.12 448.13 448.14 448.15 448.16 448.17 448.18 448.19 448.20 448.21 448.22 448.23 448.24 448.25 448.26 448.27 448.28 448.29 448.30 448.31 448.32 449.1 449.2 449.3 449.4 449.5 449.6 449.7 449.8 449.9 449.10 449.11 449.12 449.13 449.14 449.15 449.16 449.17 449.18 449.19 449.20 449.21 449.22 449.23 449.24 449.25 449.26 449.27 449.28 449.29 449.30 449.31 450.1 450.2 450.3 450.4 450.5 450.6 450.7 450.8 450.9 450.10 450.11 450.12 450.13 450.14 450.15 450.16 450.17 450.18 450.19 450.20 450.21 450.22 450.23 450.24 450.25 450.26 450.27 450.28 450.29 450.30 450.31 450.32 451.1 451.2 451.3 451.4 451.5 451.6 451.7 451.8 451.9 451.10 451.11
451.12 451.13 451.14 451.15 451.16 451.17 451.18 451.19 451.20 451.21 451.22 451.23 451.24 451.25 451.26 451.27 451.28 451.29 451.30 451.31 451.32 452.1 452.2 452.3 452.4 452.5 452.6 452.7 452.8 452.9 452.10 452.11 452.12 452.13 452.14 452.15 452.16 452.17 452.18 452.19 452.20 452.21 452.22 452.23 452.24 452.25 452.26 452.27 452.28 452.29 452.30 452.31 452.32 453.1 453.2 453.3 453.4 453.5 453.6 453.7 453.8 453.9 453.10 453.11 453.12 453.13 453.14
453.15 453.16 453.17 453.18 453.19 453.20 453.21 453.22 453.23 453.24 453.25 453.26 453.27 453.28 453.29 453.30 453.31 453.32 454.1 454.2 454.3 454.4 454.5 454.6 454.7 454.8 454.9 454.10 454.11 454.12 454.13 454.14 454.15 454.16 454.17 454.18 454.19 454.20 454.21 454.22 454.23 454.24 454.25 454.26 454.27 454.28 454.29 454.30 454.31 454.32 454.33 455.1 455.2 455.3 455.4 455.5 455.6 455.7 455.8 455.9 455.10 455.11 455.12 455.13 455.14 455.15 455.16 455.17 455.18 455.19 455.20 455.21 455.22 455.23 455.24 455.25 455.26
455.27 455.28 455.29 455.30 455.31 456.1 456.2 456.3 456.4 456.5 456.6 456.7 456.8 456.9 456.10 456.11 456.12 456.13 456.14 456.15 456.16 456.17 456.18 456.19 456.20 456.21 456.22 456.23 456.24 456.25 456.26 456.27 456.28 456.29 456.30 456.31 456.32 457.1 457.2 457.3 457.4 457.5 457.6 457.7 457.8 457.9 457.10 457.11 457.12 457.13 457.14 457.15 457.16 457.17 457.18 457.19 457.20 457.21 457.22 457.23 457.24 457.25 457.26 457.27 457.28 457.29 457.30 457.31 457.32 457.33 458.1 458.2 458.3 458.4 458.5 458.6 458.7 458.8
458.9 458.10 458.11 458.12 458.13 458.14 458.15 458.16 458.17 458.18 458.19 458.20
458.21 458.22 458.23 458.24 458.25 458.26 458.27 458.28 458.29 458.30 458.31 458.32 459.1 459.2 459.3 459.4 459.5 459.6 459.7 459.8 459.9 459.10 459.11 459.12 459.13 459.14 459.15 459.16 459.17 459.18 459.19 459.20 459.21 459.22 459.23 459.24 459.25 459.26 459.27 459.28 459.29 459.30 459.31 459.32 459.33 460.1 460.2 460.3 460.4 460.5 460.6 460.7 460.8 460.9 460.10 460.11 460.12 460.13 460.14 460.15 460.16 460.17 460.18 460.19 460.20 460.21 460.22 460.23 460.24 460.25 460.26 460.27 460.28 460.29 460.30 460.31 460.32 460.33 461.1 461.2 461.3
461.4 461.5 461.6 461.7 461.8 461.9 461.10 461.11 461.12 461.13 461.14 461.15 461.16 461.17 461.18 461.19 461.20 461.21 461.22 461.23 461.24 461.25 461.26 461.27 461.28 461.29 461.30 461.31 461.32 462.1 462.2
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
462.25 462.26 462.27 462.28 462.29 462.30 463.1 463.2 463.3 463.4 463.5 463.6 463.7 463.8 463.9 463.10 463.11 463.12 463.13 463.14 463.15 463.16
463.17 463.18 463.19 463.20 463.21 463.22 463.23 463.24 463.25 463.26 463.27 463.28 463.29 464.1 464.2 464.3 464.4 464.5 464.6
464.7 464.8 464.9 464.10 464.11 464.12 464.13 464.14 464.15 464.16 464.17 464.18
464.19 464.20 464.21 464.22 464.23 464.24 464.25 464.26 464.27 464.28 464.29 464.30 464.31 465.1 465.2 465.3 465.4
465.5 465.6
465.7 465.8
465.9 465.10 465.11 465.12 465.13 465.14 465.15 465.16 465.17 465.18 465.19 465.20 465.21 465.22 465.23 465.24 465.25 465.26 465.27 465.28 465.29 465.30 465.31 466.1 466.2 466.3 466.4 466.5 466.6 466.7 466.8 466.9 466.10 466.11 466.12 466.13 466.14 466.15 466.16 466.17 466.18 466.19 466.20 466.21 466.22 466.23 466.24 466.25 466.26 466.27 466.28 466.29 466.30 466.31 466.32 466.33 467.1 467.2 467.3 467.4 467.5 467.6 467.7 467.8 467.9 467.10 467.11 467.12 467.13 467.14 467.15 467.16 467.17 467.18 467.19 467.20 467.21 467.22 467.23 467.24 467.25 467.26 467.27 467.28 467.29 467.30 467.31 467.32 467.33 467.34 468.1 468.2 468.3 468.4 468.5 468.6 468.7 468.8 468.9 468.10 468.11 468.12 468.13 468.14 468.15 468.16 468.17 468.18 468.19 468.20 468.21 468.22 468.23 468.24 468.25 468.26 468.27 468.28 468.29 468.30 468.31 468.32 468.33 468.34 469.1 469.2 469.3 469.4 469.5 469.6 469.7
469.8
469.9 469.10 469.11 469.12 469.13
469.14
469.15 469.16 469.17 469.18 469.19 469.20 469.21 469.22 469.23 469.24 469.25 469.26 469.27 469.28 469.29 469.30 470.1 470.2 470.3 470.4 470.5 470.6 470.7 470.8 470.9 470.10 470.11 470.12 470.13 470.14 470.15 470.16 470.17 470.18 470.19 470.20 470.21 470.22 470.23 470.24 470.25 470.26 470.27 470.28 470.29 471.1 471.2 471.3 471.4 471.5 471.6 471.7 471.8 471.9 471.10 471.11 471.12 471.13 471.14 471.15 471.16 471.17 471.18 471.19 471.20 471.21
471.22 471.23 471.24 471.25 471.26 471.27 471.28 471.29 471.30 471.31 472.1 472.2 472.3 472.4 472.5
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
472.24 472.25 472.26 472.27 472.28 472.29 472.30 473.1 473.2 473.3 473.4 473.5 473.6 473.7 473.8 473.9 473.10 473.11
473.12 473.13 473.14 473.15 473.16 473.17 473.18 473.19 473.20 473.21 473.22 473.23 473.24 473.25 473.26 473.27 473.28 473.29 473.30 473.31 473.32 473.33 474.1 474.2 474.3 474.4 474.5 474.6 474.7 474.8 474.9 474.10 474.11 474.12 474.13 474.14 474.15 474.16 474.17 474.18 474.19 474.20 474.21 474.22 474.23 474.24 474.25 474.26 474.27 474.28 474.29 474.30 474.31
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
475.31
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
476.27 476.28 476.29 476.30 476.31
476.32
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
477.32
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
478.21 478.22 478.23 478.24 478.25 478.26 478.27 478.28 478.29 478.30 478.31 478.32 479.1 479.2 479.3 479.4 479.5 479.6 479.7 479.8 479.9 479.10 479.11 479.12 479.13 479.14 479.15 479.16 479.17 479.18 479.19
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
480.4 480.5 480.6 480.7 480.8 480.9 480.10 480.11 480.12 480.13 480.14 480.15 480.16 480.17 480.18 480.19 480.20 480.21 480.22 480.23 480.24 480.25 480.26 480.27 480.28 480.29 480.30 480.31 481.1 481.2 481.3 481.4 481.5 481.6 481.7 481.8 481.9 481.10
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
481.28 481.29 481.30 481.31 482.1 482.2 482.3 482.4 482.5 482.6 482.7 482.8 482.9 482.10 482.11 482.12 482.13 482.14 482.15 482.16 482.17 482.18 482.19 482.20 482.21
482.22
482.23 482.24 482.25 482.26 482.27 482.28 482.29 482.30 482.31 482.32
483.1 483.2 483.3 483.4 483.5 483.6 483.7 483.8 483.9 483.10
483.11 483.12 483.13 483.14 483.15 483.16 483.17 483.18 483.19 483.20 483.21 483.22 483.23 483.24 483.25 483.26 483.27 483.28 483.29 483.30 483.31 483.32 484.1 484.2 484.3 484.4 484.5 484.6 484.7 484.8 484.9 484.10 484.11 484.12 484.13 484.14 484.15 484.16 484.17 484.18 484.19 484.20 484.21 484.22 484.23 484.24 484.25 484.26 484.27 484.28 484.29 485.1 485.2 485.3 485.4 485.5 485.6 485.7
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
486.20 486.21 486.22 486.23 486.24 486.25 486.26 486.27 486.28 486.29 486.30 486.31 486.32 487.1 487.2 487.3 487.4 487.5 487.6 487.7 487.8 487.9 487.10 487.11
487.12 487.13 487.14 487.15 487.16
487.17 487.18 487.19 487.20 487.21 487.22 487.23 487.24 487.25 487.26 487.27 487.28 487.29 487.30 487.31 487.32 488.1 488.2
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
488.24 488.25 488.26 488.27 488.28 488.29 488.30 488.31 488.32 489.1 489.2 489.3 489.4 489.5 489.6 489.7 489.8 489.9 489.10 489.11 489.12 489.13 489.14 489.15 489.16 489.17 489.18 489.19 489.20 489.21 489.22 489.23 489.24 489.25 489.26
489.27 489.28 489.29 489.30 489.31 490.1 490.2 490.3 490.4 490.5 490.6 490.7 490.8 490.9 490.10 490.11 490.12 490.13 490.14 490.15 490.16 490.17 490.18 490.19 490.20 490.21 490.22 490.23 490.24 490.25 490.26 490.27 490.28 490.29 490.30 490.31 490.32 490.33 491.1 491.2 491.3 491.4 491.5 491.6 491.7 491.8 491.9 491.10 491.11 491.12 491.13 491.14 491.15 491.16 491.17 491.18 491.19 491.20 491.21 491.22 491.23 491.24 491.25 491.26 491.27 491.28 491.29 491.30 491.31 491.32 491.33 492.1 492.2 492.3 492.4
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
493.12 493.13 493.14 493.15 493.16 493.17 493.18 493.19 493.20 493.21 493.22 493.23 493.24 493.25 493.26 493.27 493.28 493.29 493.30 493.31 493.32 494.1 494.2 494.3 494.4 494.5 494.6 494.7 494.8 494.9 494.10 494.11 494.12
494.13 494.14 494.15 494.16 494.17 494.18
494.19 494.20 494.21 494.22 494.23 494.24 494.25 494.26 494.27 494.28 494.29 494.30 494.31 494.32 494.33 495.1 495.2 495.3 495.4 495.5 495.6 495.7 495.8 495.9 495.10 495.11 495.12 495.13 495.14 495.15 495.16 495.17 495.18 495.19 495.20 495.21 495.22 495.23 495.24 495.25 495.26 495.27 495.28 495.29 495.30 495.31 495.32 495.33 495.34 496.1 496.2 496.3 496.4 496.5 496.6 496.7 496.8 496.9 496.10 496.11 496.12 496.13 496.14
496.15 496.16 496.17 496.18 496.19 496.20 496.21 496.22 496.23 496.24 496.25 496.26 496.27 496.28 496.29 496.30 496.31 496.32 496.33 496.34 497.1 497.2 497.3 497.4 497.5 497.6 497.7 497.8 497.9 497.10 497.11 497.12 497.13 497.14 497.15 497.16 497.17 497.18 497.19 497.20 497.21 497.22 497.23 497.24 497.25 497.26 497.27 497.28
497.29 497.30 497.31 497.32 497.33 497.34 498.1 498.2 498.3 498.4 498.5 498.6 498.7 498.8 498.9 498.10 498.11 498.12 498.13 498.14 498.15 498.16 498.17 498.18 498.19 498.20 498.21 498.22 498.23 498.24 498.25 498.26 498.27 498.28 498.29 498.30 498.31 498.32 498.33 498.34 499.1 499.2 499.3 499.4 499.5 499.6 499.7 499.8 499.9 499.10 499.11 499.12
499.13 499.14 499.15 499.16 499.17 499.18 499.19 499.20 499.21 499.22 499.23 499.24 499.25 499.26 499.27 499.28 499.29 499.30 499.31 499.32 499.33 499.34 500.1 500.2 500.3 500.4 500.5 500.6 500.7 500.8 500.9 500.10 500.11 500.12 500.13 500.14 500.15 500.16 500.17 500.18 500.19 500.20 500.21 500.22 500.23 500.24 500.25 500.26 500.27 500.28 500.29 500.30 500.31 500.32 500.33 500.34 501.1 501.2 501.3 501.4 501.5 501.6 501.7 501.8 501.9 501.10 501.11 501.12 501.13 501.14 501.15 501.16 501.17 501.18 501.19 501.20 501.21 501.22 501.23 501.24 501.25 501.26 501.27 501.28 501.29 501.30 501.31 501.32 501.33 501.34 501.35 502.1 502.2 502.3 502.4 502.5 502.6 502.7 502.8 502.9 502.10 502.11 502.12 502.13 502.14 502.15 502.16 502.17 502.18 502.19 502.20 502.21 502.22 502.23 502.24 502.25 502.26 502.27 502.28 502.29 502.30 502.31 503.1 503.2 503.3 503.4 503.5 503.6
503.7 503.8 503.9 503.10 503.11 503.12 503.13 503.14 503.15 503.16 503.17 503.18 503.19 503.20 503.21 503.22 503.23 503.24 503.25 503.26 503.27 503.28 503.29 503.30 503.31 504.1 504.2 504.3 504.4 504.5 504.6 504.7 504.8 504.9 504.10 504.11 504.12 504.13 504.14 504.15 504.16 504.17 504.18
504.19 504.20 504.21 504.22 504.23 504.24 504.25 504.26 504.27 504.28 504.29 504.30 504.31 504.32 505.1 505.2 505.3 505.4 505.5 505.6 505.7 505.8 505.9 505.10 505.11 505.12 505.13 505.14 505.15 505.16 505.17 505.18 505.19 505.20 505.21 505.22 505.23 505.24 505.25 505.26 505.27 505.28 505.29 505.30
505.31 505.32 505.33 505.34 506.1 506.2
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
506.28 506.29 506.30 506.31 507.1 507.2 507.3 507.4 507.5 507.6 507.7 507.8 507.9 507.10 507.11 507.12 507.13 507.14 507.15 507.16 507.17 507.18 507.19 507.20 507.21 507.22 507.23 507.24 507.25 507.26 507.27 507.28 507.29 507.30 508.1 508.2 508.3 508.4 508.5 508.6 508.7 508.8 508.9 508.10 508.11 508.12 508.13 508.14 508.15 508.16 508.17 508.18 508.19 508.20 508.21
508.22
508.23 508.24 508.25 508.26 508.27 508.28 508.29 508.30 508.31
508.32
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
509.14 509.15 509.16 509.17 509.18 509.19 509.20 509.21 509.22 509.23 509.24 509.25 509.26 509.27 509.28 509.29 509.30 510.1 510.2 510.3 510.4 510.5 510.6 510.7 510.8 510.9 510.10 510.11 510.12 510.13 510.14 510.15 510.16 510.17 510.18 510.19 510.20 510.21 510.22 510.23 510.24 510.25 510.26 510.27 510.28 510.29 510.30 510.31 510.32 510.33 511.1 511.2 511.3 511.4 511.5 511.6 511.7
511.8
511.9 511.10 511.11 511.12 511.13 511.14 511.15 511.16 511.17 511.18 511.19 511.20 511.21 511.22 511.23 511.24 511.25 511.26 511.27 511.28 511.29 511.30 511.31 512.1 512.2 512.3 512.4 512.5 512.6 512.7 512.8 512.9 512.10 512.11 512.12 512.13 512.14 512.15 512.16 512.17 512.18 512.19 512.20 512.21 512.22 512.23 512.24 512.25
512.26
512.27 512.28 512.29 513.1 513.2 513.3 513.4 513.5 513.6 513.7 513.8 513.9 513.10 513.11 513.12 513.13 513.14 513.15
513.16
513.17 513.18 513.19 513.20 513.21 513.22 513.23 513.24 513.25 513.26
513.27
513.28 513.29 513.30 513.31 514.1 514.2 514.3 514.4 514.5 514.6 514.7 514.8 514.9 514.10 514.11 514.12 514.13 514.14 514.15 514.16 514.17 514.18 514.19 514.20 514.21 514.22 514.23 514.24 514.25
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
515.25 515.26 515.27 515.28 515.29 515.30 515.31 516.1 516.2 516.3 516.4 516.5 516.6 516.7 516.8 516.9 516.10 516.11 516.12 516.13 516.14 516.15 516.16 516.17 516.18
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
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
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
519.25 519.26 519.27 519.28 519.29 519.30 519.31 520.1 520.2 520.3 520.4 520.5 520.6 520.7 520.8 520.9 520.10 520.11 520.12 520.13 520.14 520.15 520.16
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
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
522.23 522.24 522.25 522.26 522.27 522.28 522.29 522.30 522.31 522.32 523.1 523.2 523.3 523.4 523.5
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
523.25 523.26 523.27 523.28 523.29 524.1 524.2 524.3 524.4 524.5 524.6
524.7 524.8 524.9 524.10 524.11 524.12 524.13 524.14 524.15 524.16 524.17 524.18 524.19 524.20 524.21 524.22 524.23 524.24 524.25 524.26 524.27 524.28 524.29 524.30 524.31 525.1 525.2 525.3 525.4
525.5
525.6 525.7 525.8 525.9 525.10 525.11 525.12 525.13 525.14 525.15 525.16 525.17 525.18 525.19 525.20 525.21 525.22 525.23 525.24 525.25 525.26 525.27 525.28 525.29 525.30 526.1 526.2 526.3 526.4 526.5 526.6 526.7 526.8 526.9 526.10 526.11 526.12 526.13 526.14 526.15 526.16 526.17 526.18 526.19 526.20 526.21 526.22 526.23 526.24 526.25 526.26 526.27 526.28 526.29 526.30 526.31 527.1 527.2 527.3 527.4 527.5 527.6 527.7 527.8 527.9 527.10 527.11 527.12 527.13
527.14
527.15 527.16 527.17 527.18 527.19 527.20 527.21 527.22 527.23 527.24 527.25 527.26 527.27 527.28 527.29 527.30 527.31 527.32 528.1 528.2 528.3 528.4 528.5 528.6 528.7 528.8 528.9 528.10
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
528.24 528.25 528.26 528.27 528.28 528.29 528.30 528.31 528.32 529.1 529.2 529.3 529.4 529.5 529.6 529.7 529.8 529.9 529.10 529.11 529.12 529.13 529.14 529.15 529.16 529.17 529.18 529.19 529.20 529.21 529.22 529.23 529.24
529.25 529.26 529.27 529.28 529.29 529.30 529.31 529.32 529.33 529.34 530.1 530.2 530.3 530.4 530.5 530.6 530.7 530.8 530.9 530.10 530.11 530.12 530.13 530.14 530.15 530.16 530.17 530.18 530.19
530.20 530.21 530.22 530.23 530.24 530.25 530.26 530.27 530.28 530.29 530.30 530.31 531.1 531.2 531.3 531.4 531.5 531.6 531.7 531.8
531.9
531.10 531.11 531.12 531.13 531.14 531.15 531.16 531.17 531.18 531.19 531.20 531.21 531.22 531.23 531.24 531.25 531.26 531.27 531.28 531.29 531.30 531.31 531.32 531.33 531.34 532.1 532.2 532.3 532.4 532.5 532.6 532.7
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
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
534.19 534.20 534.21 534.22 534.23 534.24 534.25 534.26 534.27 534.28 534.29 534.30 534.31 534.32 535.1 535.2 535.3 535.4 535.5 535.6 535.7 535.8 535.9 535.10 535.11 535.12 535.13 535.14 535.15
535.16
535.17 535.18 535.19 535.20 535.21
535.22
535.23 535.24 535.25 535.26 535.27 535.28 536.1 536.2 536.3 536.4 536.5 536.6 536.7 536.8 536.9 536.10 536.11 536.12 536.13 536.14 536.15 536.16 536.17 536.18 536.19 536.20 536.21 536.22 536.23 536.24 536.25 536.26 536.27 536.28 536.29 536.30 536.31 536.32
536.33
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
537.21 537.22 537.23 537.24 537.25 537.26 537.27 537.28 537.29 537.30 537.31 537.32 538.1 538.2 538.3 538.4 538.5 538.6 538.7
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
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
540.1 540.2 540.3 540.4 540.5 540.6 540.7 540.8 540.9 540.10 540.11 540.12 540.13 540.14 540.15 540.16 540.17 540.18 540.19 540.20 540.21 540.22 540.23 540.24 540.25 540.26 540.27 540.28 540.29 540.30 541.1 541.2 541.3 541.4 541.5 541.6 541.7
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
541.21 541.22 541.23 541.24 541.25 541.26 541.27 541.28 541.29 541.30 541.31 542.1 542.2 542.3 542.4 542.5 542.6 542.7 542.8 542.9 542.10 542.11 542.12 542.13 542.14 542.15 542.16 542.17 542.18 542.19 542.20 542.21 542.22 542.23 542.24 542.25 542.26 542.27 542.28 542.29 542.30 542.31 542.32 542.33 543.1 543.2 543.3 543.4 543.5 543.6 543.7 543.8
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
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
544.21 544.22 544.23 544.24 544.25 544.26 544.27 544.28 544.29 545.1 545.2 545.3 545.4 545.5 545.6 545.7 545.8 545.9
545.10 545.11
545.12 545.13 545.14 545.15 545.16 545.17 545.18 545.19 545.20 545.21 545.22 545.23 545.24 545.25 545.26 545.27 545.28 545.29 546.1 546.2 546.3 546.4 546.5 546.6
546.7
546.8 546.9 546.10 546.11 546.12 546.13 546.14 546.15 546.16 546.17 546.18 546.19 546.20 546.21 546.22 546.23 546.24 546.25 546.26 546.27 546.28 546.29 546.30 546.31 547.1 547.2 547.3 547.4 547.5 547.6 547.7 547.8 547.9 547.10 547.11 547.12 547.13 547.14 547.15 547.16 547.17 547.18 547.19 547.20 547.21 547.22
547.23
547.24 547.25 547.26 547.27 547.28 547.29 547.30 547.31 547.32 547.33
547.34
548.1 548.2 548.3 548.4 548.5 548.6 548.7 548.8 548.9 548.10 548.11 548.12 548.13 548.14 548.15 548.16 548.17 548.18 548.19 548.20 548.21 548.22 548.23 548.24 548.25 548.26 548.27 548.28 548.29 548.30 548.31 548.32 549.1 549.2 549.3
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
550.19 550.20 550.21 550.22 550.23 550.24 550.25 550.26 550.27 550.28 550.29 550.30 551.1 551.2 551.3
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
551.17 551.18 551.19 551.20 551.21 551.22 551.23 551.24 551.25 551.26 551.27 551.28 551.29 551.30 552.1 552.2 552.3 552.4 552.5 552.6 552.7 552.8 552.9 552.10 552.11 552.12 552.13 552.14 552.15 552.16 552.17 552.18 552.19 552.20 552.21 552.22 552.23
552.24
552.25 552.26 552.27 552.28 553.1 553.2 553.3 553.4 553.5 553.6 553.7 553.8 553.9 553.10 553.11
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
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
554.16 554.17 554.18 554.19 554.20 554.21 554.22 554.23 554.24 554.25 554.26 554.27 554.28 554.29 554.30 554.31 555.1 555.2 555.3 555.4 555.5 555.6 555.7 555.8 555.9 555.10 555.11 555.12 555.13 555.14 555.15 555.16 555.17 555.18 555.19 555.20 555.21 555.22 555.23 555.24 555.25 555.26 555.27 555.28 555.29 555.30 556.1 556.2 556.3 556.4 556.5 556.6 556.7 556.8 556.9 556.10 556.11 556.12 556.13 556.14
556.15 556.16 556.17 556.18 556.19 556.20 556.21 556.22 556.23 556.24 556.25 556.26 556.27 556.28 556.29 556.30 557.1 557.2 557.3 557.4 557.5
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
558.31 558.32 558.33 559.1 559.2 559.3 559.4 559.5 559.6 559.7 559.8 559.9 559.10 559.11 559.12 559.13 559.14 559.15 559.16 559.17 559.18 559.19 559.20 559.21 559.22 559.23 559.24 559.25 559.26 559.27 559.28 559.29 559.30 559.31 559.32 559.33 560.1 560.2 560.3 560.4 560.5 560.6 560.7 560.8 560.9 560.10 560.11 560.12 560.13 560.14 560.15 560.16 560.17 560.18 560.19 560.20 560.21 560.22 560.23 560.24 560.25 560.26 560.27 560.28 560.29 560.30 560.31 560.32 560.33 560.34 561.1 561.2 561.3 561.4 561.5 561.6 561.7 561.8 561.9 561.10 561.11 561.12 561.13 561.14 561.15 561.16 561.17 561.18 561.19 561.20 561.21 561.22 561.23 561.24 561.25 561.26 561.27 561.28 561.29 561.30 561.31 561.32 561.33 561.34 561.35 562.1 562.2 562.3 562.4 562.5 562.6 562.7 562.8 562.9 562.10 562.11 562.12 562.13 562.14 562.15 562.16 562.17 562.18 562.19 562.20 562.21 562.22 562.23 562.24 562.25 562.26 562.27 562.28 562.29 562.30 562.31 562.32 563.1 563.2 563.3 563.4 563.5 563.6 563.7 563.8 563.9 563.10 563.11 563.12 563.13 563.14 563.15 563.16 563.17 563.18 563.19 563.20 563.21 563.22 563.23 563.24 563.25 563.26 563.27 563.28 563.29 563.30 563.31 563.32 563.33 563.34 563.35 564.1 564.2 564.3 564.4 564.5 564.6 564.7 564.8 564.9 564.10 564.11 564.12 564.13 564.14 564.15 564.16 564.17 564.18 564.19 564.20 564.21 564.22 564.23 564.24 564.25 564.26 564.27 564.28 564.29 564.30 564.31 564.32 564.33 564.34 565.1 565.2 565.3 565.4 565.5 565.6 565.7 565.8 565.9 565.10 565.11 565.12 565.13 565.14 565.15 565.16 565.17 565.18 565.19 565.20 565.21 565.22 565.23 565.24 565.25 565.26 565.27 565.28 565.29 565.30 565.31 565.32 565.33 565.34 566.1 566.2 566.3 566.4 566.5 566.6 566.7 566.8 566.9 566.10 566.11 566.12 566.13 566.14 566.15 566.16 566.17 566.18 566.19 566.20 566.21 566.22 566.23 566.24 566.25 566.26 566.27 566.28 566.29 566.30 566.31 566.32 566.33 566.34 566.35 567.1 567.2 567.3 567.4 567.5 567.6 567.7 567.8 567.9 567.10 567.11 567.12 567.13 567.14
567.15
567.16 567.17 567.18 567.19 567.20 567.21 567.22 567.23 567.24 567.25 567.26 567.27 567.28 567.29 567.30 567.31 567.32 567.33 567.34 568.1 568.2 568.3 568.4 568.5 568.6 568.7 568.8 568.9 568.10 568.11 568.12 568.13 568.14 568.15 568.16 568.17 568.18 568.19 568.20 568.21 568.22 568.23 568.24 568.25 568.26 568.27 568.28 568.29 568.30 568.31 568.32 568.33 568.34 568.35 569.1 569.2 569.3 569.4 569.5 569.6 569.7 569.8 569.9 569.10 569.11 569.12 569.13 569.14 569.15 569.16 569.17 569.18 569.19 569.20 569.21 569.22 569.23 569.24 569.25 569.26 569.27 569.28 569.29 569.30 569.31 569.32 569.33 569.34 569.35 570.1 570.2 570.3 570.4 570.5 570.6 570.7 570.8 570.9 570.10 570.11 570.12 570.13 570.14 570.15 570.16 570.17 570.18 570.19 570.20 570.21 570.22 570.23 570.24 570.25 570.26 570.27 570.28 570.29 570.30 570.31 570.32 570.33 570.34 570.35 571.1 571.2 571.3 571.4 571.5 571.6 571.7 571.8 571.9 571.10 571.11 571.12
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
571.29 571.30 571.31 571.32 571.33 571.34 572.1 572.2 572.3 572.4 572.5 572.6 572.7
572.8 572.9 572.10 572.11 572.12 572.13 572.14 572.15 572.16 572.17 572.18 572.19 572.20 572.21 572.22 572.23 572.24 572.25 572.26 572.27 572.28 572.29 572.30 572.31 572.32 572.33 572.34 572.35
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
573.31 573.32 573.33 573.34 573.35 574.1 574.2 574.3 574.4 574.5
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
575.23 575.24 575.25 575.26 575.27 575.28 575.29 575.30 575.31 575.32 576.1 576.2 576.3 576.4 576.5 576.6 576.7 576.8 576.9 576.10 576.11 576.12 576.13 576.14 576.15 576.16 576.17 576.18 576.19 576.20 576.21 576.22 576.23 576.24 576.25 576.26 576.27 576.28 576.29 576.30 576.31 576.32 576.33 576.34 577.1 577.2 577.3 577.4 577.5 577.6 577.7 577.8 577.9 577.10 577.11 577.12 577.13 577.14 577.15 577.16 577.17 577.18 577.19 577.20
577.21 577.22 577.23 577.24 577.25 577.26 577.27 577.28 577.29 577.30 577.31 577.32 577.33 577.34 578.1 578.2 578.3 578.4 578.5 578.6 578.7 578.8 578.9 578.10 578.11 578.12 578.13 578.14 578.15 578.16 578.17 578.18 578.19 578.20 578.21 578.22 578.23 578.24 578.25 578.26 578.27 578.28 578.29 578.30 578.31 578.32 578.33 578.34 579.1 579.2 579.3 579.4 579.5 579.6 579.7 579.8 579.9 579.10 579.11 579.12 579.13 579.14 579.15 579.16 579.17 579.18 579.19 579.20 579.21 579.22 579.23 579.24 579.25 579.26 579.27 579.28 579.29 579.30 579.31 579.32 579.33 579.34 580.1 580.2 580.3 580.4 580.5 580.6 580.7 580.8 580.9 580.10 580.11 580.12 580.13 580.14 580.15 580.16 580.17 580.18 580.19 580.20 580.21 580.22 580.23 580.24 580.25 580.26 580.27 580.28 580.29 580.30 580.31 580.32 580.33 580.34 581.1 581.2 581.3 581.4 581.5 581.6
581.7 581.8 581.9 581.10 581.11 581.12 581.13 581.14 581.15 581.16 581.17 581.18 581.19 581.20 581.21 581.22 581.23 581.24 581.25 581.26 581.27 581.28 581.29 581.30 581.31 581.32 582.1 582.2 582.3 582.4 582.5 582.6 582.7 582.8 582.9 582.10 582.11 582.12 582.13 582.14 582.15 582.16 582.17 582.18 582.19 582.20 582.21 582.22 582.23 582.24 582.25 582.26 582.27 582.28 582.29 582.30 582.31 582.32 583.1 583.2 583.3 583.4 583.5 583.6 583.7 583.8 583.9 583.10 583.11 583.12 583.13 583.14 583.15 583.16 583.17 583.18 583.19 583.20 583.21 583.22 583.23 583.24 583.25 583.26 583.27 583.28 583.29 583.30 583.31 583.32 584.1 584.2 584.3 584.4 584.5 584.6 584.7 584.8 584.9 584.10 584.11 584.12 584.13 584.14 584.15 584.16 584.17 584.18 584.19 584.20 584.21 584.22 584.23 584.24 584.25 584.26 584.27 584.28 584.29 584.30 584.31 584.32 584.33 584.34 585.1 585.2 585.3 585.4 585.5 585.6 585.7 585.8 585.9 585.10 585.11 585.12 585.13 585.14 585.15 585.16 585.17 585.18 585.19 585.20 585.21 585.22 585.23 585.24 585.25 585.26 585.27 585.28 585.29 585.30 585.31 585.32 585.33 585.34 585.35 586.1 586.2 586.3 586.4 586.5 586.6 586.7
586.8
586.9 586.10 586.11 586.12 586.13 586.14 586.15 586.16 586.17 586.18 586.19 586.20 586.21 586.22 586.23 586.24 586.25 586.26 586.27 586.28 586.29 586.30 586.31 586.32 586.33 586.34 587.1 587.2 587.3 587.4 587.5 587.6 587.7 587.8 587.9 587.10 587.11 587.12 587.13 587.14 587.15 587.16 587.17 587.18 587.19 587.20 587.21 587.22 587.23 587.24 587.25 587.26 587.27 587.28 587.29 587.30 587.31 587.32 587.33 588.1 588.2 588.3
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
588.18 588.19 588.20 588.21 588.22 588.23 588.24 588.25 588.26 588.27 588.28 588.29 588.30 588.31 588.32 588.33 589.1 589.2 589.3 589.4 589.5 589.6 589.7 589.8 589.9 589.10 589.11 589.12 589.13 589.14 589.15 589.16 589.17 589.18 589.19 589.20 589.21 589.22 589.23 589.24 589.25 589.26 589.27 589.28 589.29 589.30 589.31 589.32 589.33 589.34 590.1 590.2 590.3 590.4 590.5 590.6 590.7 590.8 590.9 590.10 590.11 590.12 590.13 590.14 590.15 590.16 590.17 590.18 590.19 590.20 590.21 590.22 590.23 590.24 590.25 590.26 590.27 590.28 590.29 590.30 590.31 590.32 590.33 590.34 590.35 591.1 591.2 591.3 591.4 591.5 591.6 591.7 591.8 591.9 591.10 591.11 591.12 591.13 591.14 591.15 591.16 591.17 591.18 591.19 591.20 591.21 591.22 591.23 591.24 591.25 591.26 591.27 591.28 591.29 591.30 591.31 591.32 591.33 591.34 592.1 592.2 592.3 592.4 592.5 592.6 592.7 592.8 592.9 592.10 592.11 592.12 592.13 592.14 592.15 592.16 592.17 592.18 592.19 592.20 592.21 592.22 592.23 592.24 592.25 592.26 592.27 592.28 592.29 592.30 592.31 592.32 592.33 592.34 593.1 593.2 593.3 593.4 593.5 593.6 593.7 593.8 593.9 593.10 593.11 593.12 593.13 593.14 593.15 593.16 593.17 593.18 593.19 593.20 593.21 593.22 593.23 593.24 593.25 593.26 593.27 593.28 593.29 593.30 593.31 593.32 593.33 594.1 594.2 594.3 594.4 594.5 594.6 594.7 594.8 594.9 594.10 594.11 594.12 594.13 594.14 594.15 594.16 594.17 594.18 594.19 594.20 594.21 594.22 594.23 594.24 594.25 594.26 594.27 594.28 594.29 594.30 594.31 594.32 594.33 594.34 594.35 595.1 595.2 595.3 595.4 595.5 595.6 595.7 595.8 595.9 595.10 595.11 595.12 595.13 595.14 595.15 595.16 595.17 595.18 595.19 595.20 595.21 595.22 595.23 595.24 595.25 595.26 595.27 595.28 595.29 595.30 595.31 595.32 595.33 595.34 596.1 596.2 596.3 596.4 596.5 596.6 596.7 596.8 596.9 596.10 596.11 596.12 596.13 596.14 596.15 596.16 596.17 596.18 596.19 596.20 596.21 596.22 596.23 596.24 596.25 596.26 596.27 596.28 596.29 596.30 596.31 596.32 596.33 597.1 597.2 597.3 597.4 597.5 597.6 597.7 597.8 597.9 597.10 597.11 597.12 597.13 597.14 597.15 597.16 597.17 597.18 597.19 597.20 597.21 597.22 597.23 597.24 597.25 597.26 597.27 597.28 597.29 597.30 597.31 597.32 597.33 597.34 597.35 598.1 598.2 598.3 598.4 598.5 598.6 598.7 598.8 598.9 598.10 598.11 598.12 598.13 598.14 598.15 598.16 598.17 598.18 598.19 598.20 598.21 598.22 598.23 598.24 598.25 598.26 598.27 598.28 598.29 598.30 598.31 598.32 598.33 598.34 599.1 599.2 599.3 599.4 599.5 599.6 599.7 599.8 599.9 599.10 599.11 599.12 599.13 599.14 599.15 599.16 599.17 599.18 599.19 599.20 599.21 599.22 599.23 599.24 599.25 599.26 599.27 599.28 599.29 599.30 599.31 599.32 599.33 599.34 599.35 600.1 600.2 600.3 600.4 600.5 600.6 600.7 600.8 600.9 600.10 600.11 600.12 600.13 600.14 600.15 600.16 600.17 600.18 600.19 600.20 600.21 600.22 600.23 600.24 600.25 600.26 600.27 600.28 600.29 600.30 600.31 600.32 600.33 600.34 600.35 601.1 601.2 601.3 601.4 601.5 601.6 601.7 601.8 601.9 601.10 601.11 601.12 601.13 601.14 601.15 601.16 601.17 601.18 601.19 601.20 601.21 601.22 601.23 601.24 601.25 601.26 601.27 601.28
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
602.29 602.30 602.31 602.32 602.33 603.1 603.2 603.3 603.4 603.5 603.6 603.7 603.8 603.9 603.10 603.11 603.12 603.13 603.14 603.15
603.16 603.17 603.18
603.19 603.20 603.21
A bill for an act
relating to state government; modifying provisions governing health care, health
insurance, health policy, emergency medical services, the Department of Health,
the Department of Human Services, MNsure, health care workforce, health-related
licensing boards, health care affordability and delivery, background studies, child
protection and welfare, child care licensing, behavioral health, economic assistance,
housing and homelessness, human services policy, the Minnesota Indian Family
Preservation Act, and the Department of Children, Youth, and Families; establishing
the Office of Emergency Medical Services; establishing the Minnesota African
American Family Preservation and Child Welfare Disproportionality Act; making
technical and conforming changes; requiring reports; imposing penalties; providing
appointments; making forecast adjustments; appropriating money; amending
Minnesota Statutes 2022, sections 16A.055, subdivision 1a, by adding a subdivision;
62A.0411; 62A.15, subdivision 4, by adding a subdivision; 62A.28, subdivision
2; 62D.02, subdivisions 4, 7; 62D.03, subdivision 1; 62D.05, subdivision 1; 62D.06,
subdivision 1; 62D.14, subdivision 1; 62D.19; 62D.20, subdivision 1; 62D.22,
subdivision 5; 62E.02, subdivision 3; 62J.49, subdivision 1; 62J.61, subdivision
5; 62M.01, subdivision 3; 62Q.097, by adding a subdivision; 62Q.14; 62V.02, by
adding subdivisions; 62V.03, subdivisions 1, 3; 62V.05, subdivisions 3, 6, 11, 12,
by adding a subdivision; 62V.051; 62V.06, subdivision 4; 62V.08; 62V.11,
subdivision 4; 103I.621, subdivisions 1, 2; 121A.15, subdivision 3, by adding a
subdivision; 144.05, subdivision 6, by adding a subdivision; 144.058; 144.0724,
subdivisions 2, 3a, 4, 6, 7, 8, 9, 11; 144.1464, subdivisions 1, 2, 3; 144.1501,
subdivision 5; 144.1911, subdivision 2; 144.212, by adding a subdivision; 144.216,
subdivision 2, by adding subdivisions; 144.218, by adding a subdivision; 144.292,
subdivision 6; 144.293, subdivisions 2, 4, 9, 10; 144.493, by adding a subdivision;
144.494, subdivision 2; 144.551, subdivision 1; 144.555, subdivisions 1a, 1b, 2,
by adding subdivisions; 144.605, by adding a subdivision; 144.99, subdivision 3;
144A.10, subdivisions 15, 16; 144A.44, subdivision 1; 144A.471, by adding a
subdivision; 144A.474, subdivision 13; 144A.61, subdivision 3a; 144A.70,
subdivisions 3, 5, 6, 7; 144A.71, subdivision 2, by adding a subdivision; 144A.72,
subdivision 1; 144A.73; 144E.001, subdivision 3a, by adding subdivisions;
144E.101, by adding a subdivision; 144E.16, subdivisions 5, 7; 144E.19,
subdivision 3; 144E.27, subdivisions 3, 5, 6; 144E.28, subdivisions 3, 5, 6, 8;
144E.285, subdivisions 1, 2, 4, 6, by adding subdivisions; 144E.287; 144E.305,
subdivision 3; 144G.08, subdivision 29; 144G.10, by adding a subdivision;
144G.16, subdivision 6; 146B.03, subdivision 7a; 146B.10, subdivisions 1, 3;
148.235, subdivision 10; 149A.02, subdivisions 3, 3b, 16, 23, 26a, 27, 35, 37c, by
adding subdivisions; 149A.03; 149A.65; 149A.70, subdivisions 1, 2, 3, 5; 149A.71,
subdivisions 2, 4; 149A.72, subdivisions 3, 9; 149A.73, subdivision 1; 149A.74,
subdivision 1; 149A.93, subdivision 3; 149A.94, subdivisions 1, 3, 4; 149A.97,
subdivision 2; 151.01, subdivisions 23, 27; 151.065, by adding subdivisions;
151.066, subdivisions 1, 2, 3; 151.212, by adding a subdivision; 151.37, by adding
a subdivision; 151.74, subdivision 6; 152.22, subdivision 14, by adding a
subdivision; 152.25, subdivision 2; 152.27, subdivisions 2, 6, by adding a
subdivision; 176.175, subdivision 2; 214.025; 214.04, subdivision 2a; 214.29;
214.31; 214.355; 243.166, subdivision 7, as amended; 245.096; 245.462,
subdivision 6; 245.4663, subdivision 2; 245A.04, subdivision 10, by adding a
subdivision; 245A.043, subdivisions 2, 4, by adding subdivisions; 245A.07,
subdivision 6; 245A.10, subdivisions 1, as amended, 2, as amended; 245A.14,
subdivision 17; 245A.144; 245A.175; 245A.52, subdivision 2, by adding a
subdivision; 245A.66, subdivision 2; 245C.03, by adding a subdivision; 245C.05,
subdivision 5; 245C.08, subdivision 4; 245C.10, subdivision 18; 245C.14,
subdivision 1, by adding a subdivision; 245C.15, subdivisions 3, 4; 245C.22,
subdivision 4; 245C.24, subdivisions 2, 5; 245C.30, by adding a subdivision;
245E.08; 245F.09, subdivision 2; 245F.14, by adding a subdivision; 245F.17;
245G.07, subdivision 4; 245G.08, subdivisions 5, 6; 245G.10, by adding a
subdivision; 245G.22, subdivisions 6, 7; 245H.01, by adding subdivisions; 245H.08,
subdivision 1; 245H.14, subdivisions 1, 4; 245I.02, subdivisions 17, 19; 245I.10,
subdivision 9; 245I.11, subdivision 1, by adding a subdivision; 245I.20, subdivision
4; 245I.23, subdivision 14; 256.01, subdivision 41, by adding a subdivision;
256.029, as amended; 256.045, subdivisions 3b, as amended, 5, as amended, 7, as
amended; 256.0451, subdivisions 1, as amended, 22, 24; 256.046, subdivision 2,
as amended; 256.9657, subdivision 8, by adding a subdivision; 256.969, by adding
subdivisions; 256B.056, subdivisions 1a, 10; 256B.0622, subdivisions 2a, 3a, 7a,
7d; 256B.0623, subdivision 5; 256B.0625, subdivisions 12, 20, 39, by adding
subdivisions; 256B.0757, subdivisions 4a, 4d; 256B.0943, subdivision 12;
256B.0947, subdivision 5; 256B.79, subdivision 6; 256I.04, subdivision 2f; 256J.08,
subdivision 34a; 256J.28, subdivision 1; 256K.45, subdivision 2; 256L.01, by
adding subdivisions; 256L.04, subdivisions 1c, 7a, by adding a subdivision;
256L.07, subdivision 1; 256L.12, subdivision 7; 256N.22, subdivision 10; 256N.24,
subdivision 10; 256N.26, subdivisions 12, 13, 15, 16, 18, 21, 22; 256P.05, by
adding a subdivision; 256R.02, subdivision 20; 259.20, subdivision 2; 259.37,
subdivision 2; 259.52, subdivisions 2, 4; 259.53, by adding a subdivision; 259.79,
subdivision 1; 259.83, subdivision 4; 260.755, subdivisions 2a, 5, 14, 17a, by
adding subdivisions; 260.775; 260.785, subdivisions 1, 3; 260.810, subdivision 3;
260C.007, subdivisions 6, 26b; 260C.178, subdivisions 1, as amended, 7; 260C.201,
by adding a subdivision; 260C.202; 260C.209, subdivision 1; 260C.212,
subdivisions 1, 2; 260C.301, subdivision 1, as amended; 260C.329, subdivisions
3, 8; 260C.4411, by adding a subdivision; 260C.515, subdivision 4; 260C.607,
subdivisions 1, 6; 260C.611; 260C.613, subdivision 1; 260C.615, subdivision 1;
260D.01; 260E.03, subdivision 23, as amended; 260E.30, subdivision 3, as
amended; 260E.33, subdivision 2, as amended; 317A.811, subdivisions 1, 2, 4;
393.07, subdivision 10a; 518.17, by adding a subdivision; 519.05; 524.3-801, as
amended; Minnesota Statutes 2023 Supplement, sections 13.46, subdivision 4, as
amended; 15A.0815, subdivision 2; 43A.08, subdivision 1a; 62J.84, subdivision
10; 62Q.46, subdivision 1; 62Q.522, subdivision 1; 62V.13, subdivision 3;
119B.011, subdivision 15; 119B.16, subdivisions 1a, 1c; 119B.161, subdivision
2; 124D.142, subdivision 2, as amended; 142A.03, by adding a subdivision;
144.0526, subdivision 1; 144.1501, subdivisions 1, 2, 3, 4; 144.1505, subdivision
2; 144.2252, subdivision 2; 144.2253; 144.587, subdivision 4; 144A.4791,
subdivision 10; 144E.101, subdivisions 6, 7, as amended; 145.561, subdivision 4;
151.555, subdivisions 1, 4, 5, 6, 7, 8, 9, 11, 12; 151.74, subdivision 3; 152.126,
subdivision 6; 152.28, subdivision 1; 245.4889, subdivision 1; 245A.02, subdivision
2c; 245A.03, subdivisions 2, as amended, 7, as amended; 245A.043, subdivision
3; 245A.07, subdivision 1, as amended; 245A.11, subdivision 7; 245A.16,
subdivisions 1, as amended, 11; 245A.211, subdivision 4; 245A.242, subdivision
2; 245A.50, subdivisions 3, 4; 245A.66, subdivision 4, as amended; 245C.02,
subdivisions 6a, 13e; 245C.033, subdivision 3; 245C.08, subdivision 1; 245C.10,
subdivision 15; 245C.15, subdivisions 2, 4a; 245C.31, subdivision 1; 245G.22,
subdivisions 2, 17; 245H.06, subdivisions 1, 2; 245H.08, subdivisions 4, 5;
254B.04, subdivision 1a; 256.01, subdivision 12b; 256.043, subdivisions 3, 3a;
256.045, subdivision 3, as amended; 256.046, subdivision 3; 256.0471, subdivision
1, as amended; 256.969, subdivision 2b; 256B.0622, subdivisions 7b, 8; 256B.0625,
subdivisions 3a, 5m, 9, 13e, as amended, 13f, 13k, 16; 256B.064, subdivision 4;
256B.0671, subdivision 5; 256B.0701, subdivision 6; 256B.0947, subdivision 7;
256B.764; 256D.01, subdivision 1a; 256E.38, subdivision 4; 256I.05, subdivisions
1a, 11; 256L.03, subdivisions 1, 5; 256M.42, by adding a subdivision; 256P.06,
subdivision 3; 259.83, subdivisions 1, 1b, 3a; 260.014, by adding a subdivision;
260.755, subdivisions 1a, 3, 3a, 5b, 20, 22; 260.758, subdivisions 2, 4, 5; 260.761;
260.762; 260.763, subdivisions 1, 4, 5; 260.765, subdivisions 2, 3a, 4b; 260.771,
subdivisions 1a, 1b, 1c, 2b, 2d, 6, by adding a subdivision; 260.773, subdivisions
1, 2, 3, 4, 5, 10, 11; 260.774, subdivisions 1, 2, 3; 260.781, subdivision 1; 260.786,
subdivision 2; 260.795, subdivision 1; 342.01, subdivision 63; 342.52, subdivision
3; 342.53; 342.54, subdivision 2; 342.55, subdivision 2; 518A.42, subdivision 3;
Laws 2023, chapter 22, section 4, subdivision 2; Laws 2023, chapter 57, article 1,
section 6; Laws 2023, chapter 70, article 1, section 35; article 11, section 13,
subdivision 8; article 12, section 30, subdivisions 2, 3; article 14, section 42,
subdivision 6; article 20, sections 2, subdivisions 5, 22, 24, 29, 31; 3, subdivision
2; 12, as amended; 23; Laws 2024, chapter 80, article 1, sections 38, subdivisions
1, 2, 5, 6, 7, 9; 96; article 2, sections 5, subdivision 21, by adding a subdivision;
6, subdivisions 2, 3, 3a, by adding a subdivision; 7, subdivision 2; 10, subdivisions
1, 6; 16, subdivision 1, by adding a subdivision; 30, subdivision 2; 31; 74; article
4, section 26; article 6, section 4; article 7, section 4; proposing coding for new
law in Minnesota Statutes, chapters 62D; 62J; 62Q; 62V; 137; 142A; 144; 144A;
144E; 145; 149A; 151; 214; 245C; 245H; 256B; 256L; 259; 260; 260D; 260E;
524; proposing coding for new law as Minnesota Statutes, chapters 142B; 142F;
332C; repealing Minnesota Statutes 2022, sections 62A.041, subdivision 3; 144.218,
subdivision 3; 144.497; 144E.001, subdivision 5; 144E.01; 144E.123, subdivision
5; 144E.27, subdivisions 1, 1a; 144E.50, subdivision 3; 245A.065; 245C.125;
256.01, subdivisions 12, 12a; 256D.19, subdivisions 1, 2; 256D.20, subdivisions
1, 2, 3, 4; 256D.23, subdivisions 1, 2, 3; 256R.02, subdivision 46; 260.755,
subdivision 13; Minnesota Statutes 2023 Supplement, sections 62J.312, subdivision
6; 62Q.522, subdivisions 3, 4; 144.0528, subdivision 5; 245C.08, subdivision 2;
Laws 2023, chapter 25, section 190, subdivision 10; Laws 2024, chapter 80, article
1, sections 38, subdivisions 3, 4, 11; 39; 43, subdivision 2; article 2, sections 1,
subdivision 11; 3, subdivision 3; 4, subdivision 4; 6, subdivision 4; 10, subdivision
4; 33; 69; article 7, sections 3; 9; Minnesota Rules, parts 2960.0620, subpart 3;
9502.0425, subparts 5, 10; 9545.0805, subpart 1; 9545.0845; 9560.0232, subpart
5.
BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF MINNESOTA:
ARTICLE 1
DEPARTMENT OF HUMAN SERVICES HEALTH CARE FINANCE
Section 1.
Minnesota Statutes 2022, section 256.9657, is amended by adding a subdivision
to read:
new text begin Subd. 2a. new text end
new text begin Teaching hospital surcharge. new text end
new text begin
(a) Each teaching hospital shall pay to the
medical assistance account a surcharge equal to 0.01 percent of net non-Medicare patient
care revenue. The initial surcharge must be paid 60 days after both this subdivision and
section 256.969, subdivision 2g, have received federal approval, and subsequent surcharge
payments must be made annually in the form and manner specified by the commissioner.
new text end
new text begin
(b) The commissioner shall use revenue from the surcharge only to pay the nonfederal
share of the medical assistance supplemental payments described in section 256.969,
subdivision 2g, and to supplement, and not supplant, medical assistance reimbursement to
teaching hospitals. The surcharge must comply with Code of Federal Regulations, title 42,
section 433.63.
new text end
new text begin
(c) For purposes of this subdivision, "teaching hospital" means any Minnesota hospital,
except facilities of the federal Indian Health Service and regional treatment centers, with a
Centers for Medicare and Medicaid Services designation of "teaching hospital" as reported
on form CMS-2552-10, worksheet S-2, line 56, that is eligible for reimbursement under
section 256.969, subdivision 2g.
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
of this section, the amendment in this act to section 256.969, subdivision 2b, and section
256.969, subdivision 2g, whichever is later. The commissioner of human services shall
notify the revisor of statutes when federal approval is obtained.
new text end
Sec. 2.
Minnesota Statutes 2023 Supplement, 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, except
that the base years for the rebasing effective July 1, 2023, are calendar years 2018 and 2019.
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.
(k) new text begin Subject to section 256.969, subdivision 2g, paragraph (i), new text end 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 begin EFFECTIVE DATE. new text end
new text begin
This section is effective January 1, 2025, or upon federal approval
of this section, section 256.969, subdivision 2g, and the teaching hospital surcharge described
in section 256.9657, subdivision 2a, whichever is later. The commissioner of human services
shall notify the revisor of statutes when federal approval is obtained.
new text end
Sec. 3.
Minnesota Statutes 2022, section 256.969, is amended by adding a subdivision to
read:
new text begin Subd. 2g. new text end
new text begin
Annual supplemental payments; direct and indirect physician graduate
medical education.
new text end
new text begin
(a) For discharges occurring on or after January 1, 2025, the
commissioner shall determine and pay annual supplemental payments to all eligible hospitals
as provided in this subdivision for direct and indirect physician graduate medical education
cost reimbursement. A hospital must be an eligible hospital to receive an annual supplemental
payment under this subdivision.
new text end
new text begin
(b) The commissioner must use the following information to calculate the total cost of
direct graduate medical education incurred by each eligible hospital:
new text end
new text begin
(1) the total allowable direct graduate medical education cost, as calculated by adding
form CMS-2552-10, worksheet B, part 1, columns 21 and 22, line 202; and
new text end
new text begin
(2) the Medicaid share of total allowable direct graduate medical education cost
percentage, representing the allocation of total graduate medical education costs to Medicaid
based on the share of all Medicaid inpatient days, as reported on form CMS-2552-10,
worksheets S-2 and S-3, divided by the hospital's total inpatient days, as reported on
worksheet S-3.
new text end
new text begin
(c) The commissioner may obtain the information in paragraph (b) from an eligible
hospital upon request by the commissioner or from the eligible hospital's most recently filed
form CMS-2552-10.
new text end
new text begin
(d) The commissioner must use the following information to calculate the total allowable
indirect cost of graduate medical education incurred by each eligible hospital:
new text end
new text begin
(1) for eligible hospitals that are not children's hospitals, the indirect graduate medical
education amount attributable to Medicaid, calculated based on form CMS-2552-10,
worksheet E, part A, including:
new text end
new text begin
(i) the Medicare indirect medical education formula, using Medicaid variables;
new text end
new text begin
(ii) Medicaid payments for inpatient services under fee-for-service and managed care,
as determined by the commissioner in consultation with each eligible hospital;
new text end
new text begin
(iii) total inpatient beds available, as reported on form CMS-2552-10, worksheet E, part
A, line 4; and
new text end
new text begin
(iv) full-time employees, as determined by adding form CMS-2552-10, worksheet E,
part A, lines 10 and 11; and
new text end
new text begin
(2) for eligible hospitals that are children's hospitals:
new text end
new text begin
(i) the Medicare indirect medical education formula, using Medicaid variables;
new text end
new text begin
(ii) Medicaid payments for inpatient services under fee-for-service and managed care,
as determined by the commissioner in consultation with each eligible hospital;
new text end
new text begin
(iii) total inpatient beds available, as reported on form CMS-2552-10, worksheet S-3,
part 1; and
new text end
new text begin
(iv) full-time equivalent interns and residents, as determined by adding form
CMS-2552-10, worksheet E-4, lines 6, 10.01, and 15.01.
new text end
new text begin
(e) The commissioner shall determine each eligible hospital's maximum allowable
Medicaid direct graduate medical education supplemental payment amount by calculating
the sum of:
new text end
new text begin
(1) the total allowable direct graduate medical education costs determined under paragraph
(b), clause (1), multiplied by the Medicaid share of total allowable direct graduate medical
education cost percentage in paragraph (b), clause (2); and
new text end
new text begin
(2) the total allowable direct graduate medical education costs determined under paragraph
(b), clause (1), multiplied by the most recently updated Medicaid utilization percentage
from form CMS-2552-10, as submitted to Medicare by each eligible hospital.
new text end
new text begin
(f) The commissioner shall determine each eligible hospital's indirect graduate medical
education supplemental payment amount by multiplying the total allowable indirect cost
of graduate medical education amount calculated in paragraph (d) by:
new text end
new text begin
(1) 0.95 for prospective payment system, for hospitals that are not children's hospitals
and have fewer than 50 full-time equivalent trainees;
new text end
new text begin
(2) 1.0 for prospective payment system, for hospitals that are not children's hospitals
and have equal to or greater than 50 full-time equivalent trainees; and
new text end
new text begin
(3) 1.05 for children's hospitals.
new text end
new text begin
(g) An eligible hospital's annual supplemental payment under this subdivision equals
the sum of the amount calculated for the eligible hospital under paragraph (e) and the amount
calculated for the eligible hospital under paragraph (f).
new text end
new text begin
(h) The annual supplemental payments under this subdivision are contingent upon federal
approval and must conform with the requirements for permissible supplemental payments
for direct and indirect graduate medical education under all applicable federal laws.
new text end
new text begin
(i) An eligible hospital is only eligible for reimbursement under section 62J.692 for
nonphysician graduate medical education training costs that are not accounted for in the
calculation of an annual supplemental payment under this section. An eligible hospital must
not accept reimbursement under section 62J.692 for physician graduate medical education
training costs that are accounted for in the calculation of an annual supplemental payment
under this section.
new text end
new text begin
(j) For purposes of this subdivision, "children's hospital" means a Minnesota hospital
designated as a children's hospital under Medicare.
new text end
new text begin
(k) For purposes of this subdivision, "eligible hospital" means a hospital located in
Minnesota:
new text end
new text begin
(1) participating in Minnesota's medical assistance program;
new text end
new text begin
(2) that has received fee-for-service medical assistance payments in the payment year;
and
new text end
new text begin
(3) that is either:
new text end
new text begin
(i) eligible to receive graduate medical education payments from the Medicare program
under Code of Federal Regulations, title 42, section 413.75; or
new text end
new text begin
(ii) a children's hospital.
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
of this section, the amendment in this act to section 256.969, subdivision 2b, and the teaching
hospital surcharge described in section 256.9657, subdivision 2a, whichever is later. The
commissioner of human services shall notify the revisor of statutes when federal approval
is obtained.
new text end
Sec. 4.
Minnesota Statutes 2022, section 256.969, is amended by adding a subdivision to
read:
new text begin Subd. 32. new text end
new text begin Biological products for cell and gene therapy. new text end
new text begin
(a) Effective July 1, 2024,
the commissioner shall provide separate reimbursement to hospitals for biological products
provided in the inpatient hospital setting as part of cell or gene therapy to treat rare diseases,
as defined in United States Code, title 21, section 360bb. This payment must be separate
from the diagnostic related group reimbursement for the inpatient admission or discharge
associated with a stay during which the patient received a product subject to this paragraph.
new text end
new text begin
(b) The commissioner shall establish the separate reimbursement rate for biological
products provided under paragraph (a) based on the methodology used for drugs administered
in an outpatient setting under section 256B.0625, subdivision 13e, paragraph (e).
new text end
new text begin
(c) Upon necessary federal approval of documentation required to enter into a value-based
arrangement under section 256B.0625, subdivision 13k, a drug manufacturer must enter
into a value-based arrangement with the commissioner in order for a biological product
provided in the inpatient hospital setting as part of cell or gene therapy to treat rare diseases
to remain paid under paragraph (a). Any such value-based arrangement that replaces the
payment in paragraph (a) will be effective 120 days after the date of the necessary federal
approval required to enter into the value-based arrangement under section 256B.0625,
subdivision 13k.
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. 5.
Minnesota Statutes 2023 Supplement, section 256B.0625, subdivision 13e, as
amended by Laws 2024, chapter 85, section 66, is amended to read:
Subd. 13e.
Payment rates.
(a) The basis for determining the amount of payment shall
be the lower of the ingredient costs of the drugs plus the professional dispensing fee; or the
usual and customary price charged to the public. The usual and customary price means the
lowest price charged by the provider to a patient who pays for the prescription by cash,
check, or charge account and includes prices the pharmacy charges to a patient enrolled in
a prescription savings club or prescription discount club administered by the pharmacy or
pharmacy chain. The amount of payment basis must be reduced to reflect all discount
amounts applied to the charge by any third-party provider/insurer agreement or contract for
submitted charges to medical assistance programs. The net submitted charge may not be
greater than the patient liability for the service. The professional dispensing fee shall be
deleted text begin $10.77deleted text end new text begin $11.55new text end for prescriptions filled with legend drugs meeting the definition of "covered
outpatient drugs" according to United States Code, title 42, section 1396r-8(k)(2). The
dispensing fee for intravenous solutions that must be compounded by the pharmacist shall
be deleted text begin $10.77deleted text end new text begin $11.55new text end per claim. The professional dispensing fee for prescriptions filled with
over-the-counter drugs meeting the definition of covered outpatient drugs shall be deleted text begin $10.77deleted text end new text begin
$11.55new text end for dispensed quantities equal to or greater than the number of units contained in
the manufacturer's original package. The professional dispensing fee shall be prorated based
on the percentage of the package dispensed when the pharmacy dispenses a quantity less
than the number of units contained in the manufacturer's original package. The pharmacy
dispensing fee for prescribed over-the-counter drugs not meeting the definition of covered
outpatient drugs shall be $3.65 for quantities equal to or greater than the number of units
contained in the manufacturer's original package and shall be prorated based on the
percentage of the package dispensed when the pharmacy dispenses a quantity less than the
number of units contained in the manufacturer's original package. The National Average
Drug Acquisition Cost (NADAC) shall be used to determine the ingredient cost of a drug.
For drugs for which a NADAC is not reported, the commissioner shall estimate the ingredient
cost at the wholesale acquisition cost minus two percent. The ingredient cost of a drug for
a provider participating in the federal 340B Drug Pricing Program shall be either the 340B
Drug Pricing Program ceiling price established by the Health Resources and Services
Administration or NADAC, whichever is lower. Wholesale acquisition cost is defined as
the manufacturer's list price for a drug or biological to wholesalers or direct purchasers in
the United States, not including prompt pay or other discounts, rebates, or reductions in
price, for the most recent month for which information is available, as reported in wholesale
price guides or other publications of drug or biological pricing data. The maximum allowable
cost of a multisource drug may be set by the commissioner and it shall be comparable to
the actual acquisition cost of the drug product and no higher than the NADAC of the generic
product. Establishment of the amount of payment for drugs shall not be subject to the
requirements of the Administrative Procedure Act.
(b) Pharmacies dispensing prescriptions to residents of long-term care facilities using
an automated drug distribution system meeting the requirements of section 151.58, or a
packaging system meeting the packaging standards set forth in Minnesota Rules, part
6800.2700, that govern the return of unused drugs to the pharmacy for reuse, may employ
retrospective billing for prescription drugs dispensed to long-term care facility residents. A
retrospectively billing pharmacy must submit a claim only for the quantity of medication
used by the enrolled recipient during the defined billing period. A retrospectively billing
pharmacy must use a billing period not less than one calendar month or 30 days.
(c) A pharmacy provider using packaging that meets the standards set forth in Minnesota
Rules, part 6800.2700, is required to credit the department for the actual acquisition cost
of all unused drugs that are eligible for reuse, unless the pharmacy is using retrospective
billing. The commissioner may permit the drug clozapine to be dispensed in a quantity that
is less than a 30-day supply.
(d) If a pharmacy dispenses a multisource drug, the ingredient cost shall be the NADAC
of the generic product or the maximum allowable cost established by the commissioner
unless prior authorization for the brand name product has been granted according to the
criteria established by the Drug Formulary Committee as required by subdivision 13f,
paragraph (a), and the prescriber has indicated "dispense as written" on the prescription in
a manner consistent with section 151.21, subdivision 2.
(e) The basis for determining the amount of payment for drugs administered in an
outpatient setting shall be the lower of the usual and customary cost submitted by the
provider, 106 percent of the average sales price as determined by the United States
Department of Health and Human Services pursuant to title XVIII, section 1847a of the
federal Social Security Act, the specialty pharmacy rate, or the maximum allowable cost
set by the commissioner. If average sales price is unavailable, the amount of payment must
be lower of the usual and customary cost submitted by the provider, the wholesale acquisition
cost, the specialty pharmacy rate, or the maximum allowable cost set by the commissioner.
The commissioner shall discount the payment rate for drugs obtained through the federal
340B Drug Pricing Program by 28.6 percent. The payment for drugs administered in an
outpatient setting shall be made to the administering facility or practitioner. A retail or
specialty pharmacy dispensing a drug for administration in an outpatient setting is not
eligible for direct reimbursement.
(f) The commissioner may establish maximum allowable cost rates for specialty pharmacy
products that are lower than the ingredient cost formulas specified in paragraph (a). The
commissioner may require individuals enrolled in the health care programs administered
by the department to obtain specialty pharmacy products from providers with whom the
commissioner has negotiated lower reimbursement rates. Specialty pharmacy products are
defined as those used by a small number of recipients or recipients with complex and chronic
diseases that require expensive and challenging drug regimens. Examples of these conditions
include, but are not limited to: multiple sclerosis, HIV/AIDS, transplantation, hepatitis C,
growth hormone deficiency, Crohn's Disease, rheumatoid arthritis, and certain forms of
cancer. Specialty pharmaceutical products include injectable and infusion therapies,
biotechnology drugs, antihemophilic factor products, high-cost therapies, and therapies that
require complex care. The commissioner shall consult with the Formulary Committee to
develop a list of specialty pharmacy products subject to maximum allowable cost
reimbursement. In consulting with the Formulary Committee in developing this list, the
commissioner shall take into consideration the population served by specialty pharmacy
products, the current delivery system and standard of care in the state, and access to care
issues. The commissioner shall have the discretion to adjust the maximum allowable cost
to prevent access to care issues.
(g) Home infusion therapy services provided by home infusion therapy pharmacies must
be paid at rates according to subdivision 8d.
(h) The commissioner shall contract with a vendor to conduct a cost of dispensing survey
for all pharmacies that are physically located in the state of Minnesota that dispense outpatient
drugs under medical assistance. The commissioner shall ensure that the vendor has prior
experience in conducting cost of dispensing surveys. Each pharmacy enrolled with the
department to dispense outpatient prescription drugs to fee-for-service members must
respond to the cost of dispensing survey. The commissioner may sanction a pharmacy under
section 256B.064 for failure to respond. The commissioner shall require the vendor to
measure a single statewide cost of dispensing for specialty prescription drugs and a single
statewide cost of dispensing for nonspecialty prescription drugs for all responding pharmacies
to measure the mean, mean weighted by total prescription volume, mean weighted by
medical assistance prescription volume, median, median weighted by total prescription
volume, and median weighted by total medical assistance prescription volume. The
commissioner shall post a copy of the final cost of dispensing survey report on the
department's website. The initial survey must be completed no later than January 1, 2021,
and repeated every three years. The commissioner shall provide a summary of the results
of each cost of dispensing survey and provide recommendations for any changes to the
dispensing fee to the chairs and ranking minority members of the legislative committees
with jurisdiction over medical assistance pharmacy reimbursement. Notwithstanding section
256.01, subdivision 42, this paragraph does not expire.
(i) The commissioner shall increase the ingredient cost reimbursement calculated in
paragraphs (a) and (f) by 1.8 percent for prescription and nonprescription drugs subject to
the wholesale drug distributor tax under section 295.52.
new text begin EFFECTIVE DATE. new text end
new text begin
This section is effective July 1, 2024.
new text end
Sec. 6.
Minnesota Statutes 2023 Supplement, section 256B.0625, subdivision 13k, is
amended to read:
Subd. 13k.
Value-based purchasing arrangements.
(a) The commissioner may enter
into a value-based purchasing arrangement under medical assistance or MinnesotaCare, by
written arrangement with a drug manufacturer based on agreed-upon metrics. The
commissioner may contract with a vendor to implement and administer the value-based
purchasing arrangement. A value-based purchasing arrangement may include but is not
limited to rebates, discounts, price reductions, risk sharing, reimbursements, guarantees,
shared savings payments, withholds, or bonuses. A value-based purchasing arrangement
must provide at least the same value or discount in the aggregate as would claiming the
mandatory federal drug rebate under the Federal Social Security Act, section 1927.
(b) Nothing in this section shall be interpreted as requiring a drug manufacturer or the
commissioner to enter into an arrangement as described in paragraph (a).
(c) Nothing in this section shall be interpreted as altering or modifying medical assistance
coverage requirements under the federal Social Security Act, section 1927.
(d) If the commissioner determines that a state plan amendment is necessary before
implementing a value-based purchasing arrangement, the commissioner shall request the
amendment and may delay implementing this provision until the amendment is approved.
new text begin
(e) The commissioner may provide separate reimbursement to hospitals for drugs provided
in the inpatient hospital setting as part of a value-based purchasing arrangement. This
payment must be separate from the diagnostic related group reimbursement for the inpatient
admission or discharge associated with a stay during which the patient received a drug under
this section. For payments made under this section, the hospital must not be reimbursed for
the drug under the payment methodology in section 256.969. The commissioner shall
establish the separate reimbursement rate for drugs provided under this section based on
the methodology used for drugs administered in an outpatient setting under section
256B.0625, subdivision 13e, paragraph (e).
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. new text begin CONTINGENT PROPOSAL TO FUND MEDICAL EDUCATION.
new text end
new text begin
(a) If the federal Centers for Medicare and Medicaid Services deny the request by the
commissioner of human services to implement the teaching hospital surcharge under
Minnesota Statutes, section 256.9657, subdivision 2a, the commissioner of human services,
in cooperation with the commissioner of health, shall work with a third-party consultant
identified by the Health Care Workforce and Education Committee established by the
commissioner of health that has agreed to provide consulting services without charge to
Minnesota to develop a proposal to finance the nonfederal share of the medical assistance
supplemental payments described in Minnesota Statutes, section 256.969, subdivision 2g.
new text end
new text begin
(b) The proposal must be designed to:
new text end
new text begin
(1) enhance health care quality and the economic benefits that result from a well-trained
workforce;
new text end
new text begin
(2) ensure that Minnesota has trained a sufficient number of adult and pediatric primary
and specialty care physicians by 2030;
new text end
new text begin
(3) improve the cultural competence of and health care equity within the state's medical
workforce;
new text end
new text begin
(4) maintain and improve the quality of academic medical centers and teaching hospitals
within the state;
new text end
new text begin
(5) strengthen Minnesota's health care infrastructure; and
new text end
new text begin
(6) satisfy any requirements for approval by the federal Centers for Medicare and
Medicaid Services.
new text end
new text begin
(c) The commissioner of human services shall present the proposal to the chairs and
ranking minority members of the legislative committees with jurisdiction over medical
education within six months of federal denial of the request by the commissioner to
implement the teaching hospital surcharge.
new text end
Sec. 8. new text begin COUNTY-ADMINISTERED RURAL MEDICAL ASSISTANCE MODEL.
new text end
new text begin Subdivision 1. new text end
new text begin Model development. new text end
new text begin
(a) The commissioner of human services, in
collaboration with the Association of Minnesota Counties and county-based purchasing
plans, shall develop a county-administered rural medical assistance (CARMA) model and
a detailed plan for implementing the CARMA model.
new text end
new text begin
(b) The CARMA model must be designed to achieve the following objectives:
new text end
new text begin
(1) provide a distinct county owned and administered alternative to the prepaid medical
assistance program;
new text end
new text begin
(2) facilitate greater integration of health care and social services to address social
determinants of health in rural communities, with the degree of integration of social services
varying with each county's needs and resources;
new text end
new text begin
(3) account for the smaller number of medical assistance enrollees and locally available
providers of behavioral health, oral health, specialty and tertiary care, nonemergency medical
transportation, and other health care services in rural communities; and
new text end
new text begin
(4) promote greater accountability for health outcomes, health equity, customer service,
community outreach, and cost of care.
new text end
new text begin Subd. 2. new text end
new text begin County participation. new text end
new text begin
The CARMA model must give each rural county the
option of applying to participate in the CARMA model as an alternative to participation in
the prepaid medical assistance program. The CARMA model must include a process for
the commissioner to determine whether and how a rural county can participate.
new text end
new text begin Subd. 3. new text end
new text begin Report to the legislature. new text end
new text begin
(a) The commissioner shall report recommendations
and an implementation plan for the CARMA model to the chairs and ranking minority
members of the legislative committees with jurisdiction over health care policy and finance
by January 15, 2025. The CARMA model and implementation plan must address the issues
and consider the recommendations identified in the document titled "Recommendations
Not Contingent on Outcome(s) of Current Litigation," attached to the September 13, 2022,
e-filing to the Second Judicial District Court (Correspondence for Judicial Approval Index
#102), that relates to the final contract decisions of the commissioner of human services
regarding South Country Health Alliance v. Minnesota Department of Human Services, No.
62-CV-22-907 (Ramsey Cnty. Dist. Ct. 2022).
new text end
new text begin
(b) The report must also identify the clarifications, approvals, and waivers that are needed
from the Centers for Medicare and Medicaid Services and include any draft legislation
necessary to implement the CARMA model.
new text end
Sec. 9. new text begin REVISOR INSTRUCTION.
new text end
new text begin
When the proposed rule published at Federal Register, volume 88, page 25313, becomes
effective, the revisor of statutes must change: (1) the reference in Minnesota Statutes, section
256B.06, subdivision 4, paragraph (d), from Code of Federal Regulations, title 8, section
103.12, to Code of Federal Regulations, title 42, section 435.4; and (2) the reference in
Minnesota Statutes, section 256L.04, subdivision 10, paragraph (a), from Code of Federal
Regulations, title 8, section 103.12, to Code of Federal Regulations, title 45, section 155.20.
The commissioner of human services shall notify the revisor of statutes when the proposed
rule published at Federal Register, volume 88, page 25313, becomes effective.
new text end
ARTICLE 2
DEPARTMENT OF HUMAN SERVICES HEALTH CARE POLICY
Section 1.
Minnesota Statutes 2022, section 62M.01, subdivision 3, is amended to read:
Subd. 3.
Scope.
(a) Nothing in this chapter applies to review of claims after submission
to determine eligibility for benefits under a health benefit plan. The appeal procedure
described in section 62M.06 applies to any complaint as defined under section 62Q.68,
subdivision 2, that requires a medical determination in its resolution.
(b) new text begin Effective January 1, 2026, new text end this chapter deleted text begin does not applydeleted text end new text begin appliesnew text end to managed care plans
or county-based purchasing plans when the plan is providing coverage to state public health
care program enrollees under chapter 256B or 256L.
new text begin
(c) Effective January 1, 2026, the following sections of this chapter apply to services
delivered through fee-for-service under chapters 256B and 256L: sections 62M.02,
subdivisions 1 to 5, 7 to 12, 13, 14 to 18, and 21; 62M.04; 62M.05, subdivisions 1 to 4;
62M.06, subdivisions 1 to 3; 62M.07; 62M.072; 62M.09; 62M.10; 62M.12; and 62M.17,
subdivision 2.
new text end
Sec. 2.
Minnesota Statutes 2023 Supplement, section 256.0471, subdivision 1, as amended
by Laws 2024, chapter 80, article 1, section 76, is amended to read:
Subdivision 1.
Qualifying overpayment.
Any overpayment fornew text begin state-funded medicalnew text end
assistancenew text begin under chapter 256B and state-funded MinnesotaCare under chapter 256Lnew text end granted
pursuant to section 256.045, subdivision 10; deleted text begin chapter 256B for state-funded medical
assistance;deleted text end and chapters 256D, 256I, 256K, and 256L for state-funded MinnesotaCare 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, 2024.
new text end
Sec. 3.
Minnesota Statutes 2022, section 256.9657, subdivision 8, is amended to read:
Subd. 8.
Commissioner's duties.
deleted text begin
(a) Beginning October 1, 2023, the commissioner of
human services shall annually report to the chairs and ranking minority members of the
legislative committees with jurisdiction over health care policy and finance regarding the
provider surcharge program. The report shall include information on total billings, total
collections, and administrative expenditures for the previous fiscal year. This paragraph
expires January 1, 2032.
deleted text end
deleted text begin (b)deleted text end new text begin (a)new text end The surcharge shall be adjusted by inflationary and caseload changes in future
bienniums to maintain reimbursement of health care providers in accordance with the
requirements of the state and federal laws governing the medical assistance program,
including the requirements of the Medicaid moratorium amendments of 1991 found in
Public Law No. 102-234.
deleted text begin (c)deleted text end new text begin (b)new text end The commissioner shall request the Minnesota congressional delegation to support
a change in federal law that would prohibit federal disallowances for any state that makes
a good faith effort to comply with Public Law 102-234 by enacting conforming legislation
prior to the issuance of federal implementing regulations.
Sec. 4.
Minnesota Statutes 2022, section 256.969, is amended by adding a subdivision to
read:
new text begin Subd. 2h. new text end
new text begin Alternate inpatient payment rate for a discharge. new text end
new text begin
(a) Effective retroactively
from January 1, 2024, in any rate year in which a children's hospital discharge is included
in the federally required disproportionate share hospital payment audit, where the patient
discharged had resided in a children's hospital for over 20 years, the commissioner shall
compute an alternate inpatient rate for the children's hospital. The alternate payment rate
must be the rate computed under this section excluding the disproportionate share hospital
payment under subdivision 9, paragraph (d), clause (1), increased by an amount equal to
99 percent of what the disproportionate share hospital payment would have been under
subdivision 9, paragraph (d), clause (1), had the discharge been excluded.
new text end
new text begin
(b) In any rate year in which payment to a children's hospital is made using this alternate
payment rate, payments must not be made to the hospital under subdivisions 2e, 2f, and 9.
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. 5.
Minnesota Statutes 2022, section 256B.056, subdivision 1a, is amended to read:
Subd. 1a.
Income and assets generally.
(a)(1) Unless specifically required by state law
or rule or federal law or regulation, the methodologies used in counting income and assets
to determine eligibility for medical assistance for persons whose eligibility category is based
on blindness, disability, or age of 65 or more years, the methodologies for the Supplemental
Security Income program shall be used, except as provided deleted text begin underdeleted text end new text begin in clause (2) andnew text end
subdivision 3, paragraph (a), clause (6).
new text begin
(2) State tax credits, rebates, and refunds must not be counted as income. State tax credits,
rebates, and refunds must not be counted as assets for a period of 12 months after the month
of receipt.
new text end
deleted text begin (2)deleted text end new text begin (3)new text end Increases in benefits under title II of the Social Security Act shall not be counted
as income for purposes of this subdivision until July 1 of each year. Effective upon federal
approval, for children eligible under section 256B.055, subdivision 12, or for home and
community-based waiver services whose eligibility for medical assistance is determined
without regard to parental income, child support payments, including any payments made
by an obligor in satisfaction of or in addition to a temporary or permanent order for child
support, and Social Security payments are not counted as income.
(b)(1) The modified adjusted gross income methodology as defined in United States
Code, title 42, section 1396a(e)(14), shall be used for eligibility categories based on:
(i) children under age 19 and their parents and relative caretakers as defined in section
256B.055, subdivision 3a;
(ii) children ages 19 to 20 as defined in section 256B.055, subdivision 16;
(iii) pregnant women as defined in section 256B.055, subdivision 6;
(iv) infants as defined in sections 256B.055, subdivision 10, and 256B.057, subdivision
1; and
(v) adults without children as defined in section 256B.055, subdivision 15.
For these purposes, a "methodology" does not include an asset or income standard, or
accounting method, or method of determining effective dates.
(2) For individuals whose income eligibility is determined using the modified adjusted
gross income methodology in clause (1):
(i) the commissioner shall subtract from the individual's modified adjusted gross income
an amount equivalent to five percent of the federal poverty guidelines; and
(ii) the individual's current monthly income and household size is used to determine
eligibility for the 12-month eligibility period. If an individual's income is expected to vary
month to month, eligibility is determined based on the income predicted for the 12-month
eligibility period.
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 256B.056, subdivision 10, is amended to read:
Subd. 10.
Eligibility verification.
(a) The commissioner shall require women who are
applying for the continuation of medical assistance coverage following the end of the
12-month postpartum period to update their income and asset information and to submit
any required income or asset verification.
(b) The commissioner shall determine the eligibility of private-sector health care coverage
for infants less than one year of age eligible under section 256B.055, subdivision 10, or
256B.057, subdivision 1, paragraph (c), and shall pay for private-sector coverage if this is
determined to be cost-effective.
(c) The commissioner shall verify assets and income for all applicants, and for all
recipients upon renewal.
(d) The commissioner shall utilize information obtained through the electronic service
established by the secretary of the United States Department of Health and Human Services
and other available electronic data sources in Code of Federal Regulations, title 42, sections
435.940 to 435.956, to verify eligibility requirements. The commissioner shall establish
standards to define when information obtained electronically is reasonably compatible with
information provided by applicants and enrollees, including use of self-attestation, to
accomplish real-time eligibility determinations and maintain program integrity.
(e) Each person applying for or receiving medical assistance under section 256B.055,
subdivision 7, and any other person whose resources are required by law to be disclosed to
determine the applicant's or recipient's eligibility must authorize the commissioner to obtain
information from financial institutions to deleted text begin identify unreported accountsdeleted text end new text begin verify assetsnew text end as
required in section 256.01, subdivision 18f. If a person refuses or revokes the authorization,
the commissioner may determine that the applicant or recipient is ineligible for medical
assistance. For purposes of this paragraph, an authorization to deleted text begin identify unreported accountsdeleted text end new text begin
verify assetsnew text end meets the requirements of the Right to Financial Privacy Act, United States
Code, title 12, chapter 35, and need not be furnished to the financial institution.
(f) County and tribal agencies shall comply with the standards established by the
commissioner for appropriate use of the asset verification system specified in section 256.01,
subdivision 18f.
Sec. 7.
Minnesota Statutes 2023 Supplement, section 256B.0622, subdivision 8, is amended
to read:
Subd. 8.
Medical assistance payment for assertive community treatment and
intensive residential treatment services.
(a) Payment for intensive residential treatment
services and assertive community treatment in this section shall be based on one daily rate
per provider inclusive of the following services received by an eligible client in a given
calendar day: all rehabilitative services under this section, staff travel time to provide
rehabilitative services under this section, and nonresidential crisis stabilization services
under section 256B.0624.
(b) Except as indicated in paragraph (c), payment will not be made to more than one
entity for each client for services provided under this section on a given day. If services
under this section are provided by a team that includes staff from more than one entity, the
team must determine how to distribute the payment among the members.
(c) The commissioner shall determine one rate for each provider that will bill medical
assistance for residential services under this section and one rate for each assertive community
treatment provider. If a single entity provides both services, one rate is established for the
entity's residential services and another rate for the entity's nonresidential services under
this section. A provider is not eligible for payment under this section without authorization
from the commissioner. The commissioner shall develop rates using the following criteria:
(1) the provider's cost for services shall include direct services costs, other program
costs, and other costs determined as follows:
(i) the direct services costs must be determined using actual costs of salaries, benefits,
payroll taxes, and training of direct service staff and service-related transportation;
(ii) other program costs not included in item (i) must be determined as a specified
percentage of the direct services costs as determined by item (i). The percentage used shall
be determined by the commissioner based upon the average of percentages that represent
the relationship of other program costs to direct services costs among the entities that provide
similar services;
(iii) physical plant costs calculated based on the percentage of space within the program
that is entirely devoted to treatment and programming. This does not include administrative
or residential space;
(iv) assertive community treatment physical plant costs must be reimbursed as part of
the costs described in item (ii); and
(v) subject to federal approval, up to an additional five percent of the total rate may be
added to the program rate as a quality incentive based upon the entity meeting performance
criteria specified by the commissioner;
(2) actual cost is defined as costs which are allowable, allocable, and reasonable, and
consistent with federal reimbursement requirements under Code of Federal Regulations,
title 48, chapter 1, part 31, relating to for-profit entities, and Office of Management and
Budget Circular Number A-122, relating to nonprofit entities;
(3) the number of service units;
(4) the degree to which clients will receive services other than services under this section;
and
(5) the costs of other services that will be separately reimbursed.
(d) The rate for intensive residential treatment services and assertive community treatment
must exclude the medical assistance room and board rate, as defined in section 256B.056,
subdivision 5d, and services not covered under this section, such as partial hospitalization,
home care, and inpatient services.
(e) Physician services that are not separately billed may be included in the rate to the
extent that a psychiatrist, or other health care professional providing physician services
within their scope of practice, is a member of the intensive residential treatment services
treatment team. Physician services, whether billed separately or included in the rate, may
be delivered by telehealth. For purposes of this paragraph, "telehealth" has the meaning
given to "mental health telehealth" in section 256B.0625, subdivision 46, when telehealth
is used to provide intensive residential treatment services.
(f) When services under this section are provided by an assertive community treatment
provider, case management functions must be an integral part of the team.
(g) The rate for a provider must not exceed the rate charged by that provider for the
same service to other payors.
(h) The rates for existing programs must be established prospectively based upon the
expenditures and utilization over a prior 12-month period using the criteria established in
paragraph (c). The rates for new programs must be established based upon estimated
expenditures and estimated utilization using the criteria established in paragraph (c).
(i) Effective for the rate years beginning on and after January 1, 2024, rates for assertive
community treatment, adult residential crisis stabilization services, and intensive residential
treatment services must be annually adjusted for inflation using the Centers for Medicare
and Medicaid Services Medicare Economic Index, as forecasted in the deleted text begin fourthdeleted text end new text begin thirdnew text end quarter
of the calendar year before the rate year. The inflation adjustment must be based on the
12-month period from the midpoint of the previous rate year to the midpoint of the rate year
for which the rate is being determined.
(j) Entities who discontinue providing services must be subject to a settle-up process
whereby actual costs and reimbursement for the previous 12 months are compared. In the
event that the entity was paid more than the entity's actual costs plus any applicable
performance-related funding due the provider, the excess payment must be reimbursed to
the department. If a provider's revenue is less than actual allowed costs due to lower
utilization than projected, the commissioner may reimburse the provider to recover its actual
allowable costs. The resulting adjustments by the commissioner must be proportional to the
percent of total units of service reimbursed by the commissioner and must reflect a difference
of greater than five percent.
(k) A provider may request of the commissioner a review of any rate-setting decision
made under this subdivision.
Sec. 8.
Minnesota Statutes 2023 Supplement, section 256B.0625, subdivision 9, is amended
to read:
Subd. 9.
Dental services.
(a) Medical assistance covers medically necessary dental
services.
(b) The following guidelines apply to dental services:
(1) posterior fillings are paid at the amalgam rate;
(2) application of sealants are covered once every five years per permanent molar; and
(3) application of fluoride varnish is covered once every six months.
(c) In addition to the services specified in paragraph deleted text begin (b)deleted text end new text begin (a)new text end , medical assistance covers
the following services:
(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.
(d) The commissioner shall not require prior authorization for the services included in
paragraph (c), clauses (1) to (3), and shall prohibit managed care and county-based purchasing
plans from requiring prior authorization for the services included in paragraph (c), 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 the day following final enactment.
new text end
Sec. 9.
Minnesota Statutes 2022, section 256B.0625, subdivision 12, is amended to read:
Subd. 12.
Eyeglassesdeleted text begin , dentures,deleted text end and prosthetic and orthotic devices.
(a) Medical
assistance covers eyeglassesdeleted text begin , dentures,deleted text end and prosthetic and orthotic devices if prescribed by
a licensed practitioner.
(b) For purposes of prescribing prosthetic and orthotic devices, "licensed practitioner"
includes a physician, an advanced practice registered nurse, a physician assistant, or a
podiatrist.
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 2023 Supplement, section 256B.0625, subdivision 13e, as
amended by Laws 2024, chapter 85, section 66, is amended to read:
Subd. 13e.
Payment rates.
(a) The basis for determining the amount of payment shall
be the lower of the ingredient costs of the drugs plus the professional dispensing fee; or the
usual and customary price charged to the public. The usual and customary price means the
lowest price charged by the provider to a patient who pays for the prescription by cash,
check, or charge account and includes prices the pharmacy charges to a patient enrolled in
a prescription savings club or prescription discount club administered by the pharmacy or
pharmacy chainnew text begin , unless the prescription savings club or prescription discount club is one
in which an individual pays a recurring monthly access fee for unlimited access to a defined
list of drugs for which the pharmacy does not bill the member or a payer on a
per-standard-transaction basisnew text end . The amount of payment basis must be reduced to reflect all
discount amounts applied to the charge by any third-party provider/insurer agreement or
contract for submitted charges to medical assistance programs. The net submitted charge
may not be greater than the patient liability for the service. The professional dispensing fee
shall be $10.77 for prescriptions filled with legend drugs meeting the definition of "covered
outpatient drugs" according to United States Code, title 42, section 1396r-8(k)(2). The
dispensing fee for intravenous solutions that must be compounded by the pharmacist shall
be $10.77 per claim. The professional dispensing fee for prescriptions filled with
over-the-counter drugs meeting the definition of covered outpatient drugs shall be $10.77
for dispensed quantities equal to or greater than the number of units contained in the
manufacturer's original package. The professional dispensing fee shall be prorated based
on the percentage of the package dispensed when the pharmacy dispenses a quantity less
than the number of units contained in the manufacturer's original package. The pharmacy
dispensing fee for prescribed over-the-counter drugs not meeting the definition of covered
outpatient drugs shall be $3.65 for quantities equal to or greater than the number of units
contained in the manufacturer's original package and shall be prorated based on the
percentage of the package dispensed when the pharmacy dispenses a quantity less than the
number of units contained in the manufacturer's original package. The National Average
Drug Acquisition Cost (NADAC) shall be used to determine the ingredient cost of a drug.
For drugs for which a NADAC is not reported, the commissioner shall estimate the ingredient
cost at the wholesale acquisition cost minus two percent. The ingredient cost of a drug for
a provider participating in the federal 340B Drug Pricing Program shall be either the 340B
Drug Pricing Program ceiling price established by the Health Resources and Services
Administration or NADAC, whichever is lower. Wholesale acquisition cost is defined as
the manufacturer's list price for a drug or biological to wholesalers or direct purchasers in
the United States, not including prompt pay or other discounts, rebates, or reductions in
price, for the most recent month for which information is available, as reported in wholesale
price guides or other publications of drug or biological pricing data. The maximum allowable
cost of a multisource drug may be set by the commissioner and it shall be comparable to
the actual acquisition cost of the drug product and no higher than the NADAC of the generic
product. Establishment of the amount of payment for drugs shall not be subject to the
requirements of the Administrative Procedure Act.
(b) Pharmacies dispensing prescriptions to residents of long-term care facilities using
an automated drug distribution system meeting the requirements of section 151.58, or a
packaging system meeting the packaging standards set forth in Minnesota Rules, part
6800.2700, that govern the return of unused drugs to the pharmacy for reuse, may employ
retrospective billing for prescription drugs dispensed to long-term care facility residents. A
retrospectively billing pharmacy must submit a claim only for the quantity of medication
used by the enrolled recipient during the defined billing period. A retrospectively billing
pharmacy must use a billing period not less than one calendar month or 30 days.
(c) A pharmacy provider using packaging that meets the standards set forth in Minnesota
Rules, part 6800.2700, is required to credit the department for the actual acquisition cost
of all unused drugs that are eligible for reuse, unless the pharmacy is using retrospective
billing. The commissioner may permit the drug clozapine to be dispensed in a quantity that
is less than a 30-day supply.
(d) If a pharmacy dispenses a multisource drug, the ingredient cost shall be the NADAC
of the generic product or the maximum allowable cost established by the commissioner
unless prior authorization for the brand name product has been granted according to the
criteria established by the Drug Formulary Committee as required by subdivision 13f,
paragraph (a), and the prescriber has indicated "dispense as written" on the prescription in
a manner consistent with section 151.21, subdivision 2.
(e) The basis for determining the amount of payment for drugs administered in an
outpatient setting shall be the lower of the usual and customary cost submitted by the
provider, 106 percent of the average sales price as determined by the United States
Department of Health and Human Services pursuant to title XVIII, section 1847a of the
federal Social Security Act, the specialty pharmacy rate, or the maximum allowable cost
set by the commissioner. If average sales price is unavailable, the amount of payment must
be lower of the usual and customary cost submitted by the provider, the wholesale acquisition
cost, the specialty pharmacy rate, or the maximum allowable cost set by the commissioner.
The commissioner shall discount the payment rate for drugs obtained through the federal
340B Drug Pricing Program by 28.6 percent. The payment for drugs administered in an
outpatient setting shall be made to the administering facility or practitioner. A retail or
specialty pharmacy dispensing a drug for administration in an outpatient setting is not
eligible for direct reimbursement.
(f) The commissioner may establish maximum allowable cost rates for specialty pharmacy
products that are lower than the ingredient cost formulas specified in paragraph (a). The
commissioner may require individuals enrolled in the health care programs administered
by the department to obtain specialty pharmacy products from providers with whom the
commissioner has negotiated lower reimbursement rates. Specialty pharmacy products are
defined as those used by a small number of recipients or recipients with complex and chronic
diseases that require expensive and challenging drug regimens. Examples of these conditions
include, but are not limited to: multiple sclerosis, HIV/AIDS, transplantation, hepatitis C,
growth hormone deficiency, Crohn's Disease, rheumatoid arthritis, and certain forms of
cancer. Specialty pharmaceutical products include injectable and infusion therapies,
biotechnology drugs, antihemophilic factor products, high-cost therapies, and therapies that
require complex care. The commissioner shall consult with the Formulary Committee to
develop a list of specialty pharmacy products subject to maximum allowable cost
reimbursement. In consulting with the Formulary Committee in developing this list, the
commissioner shall take into consideration the population served by specialty pharmacy
products, the current delivery system and standard of care in the state, and access to care
issues. The commissioner shall have the discretion to adjust the maximum allowable cost
to prevent access to care issues.
(g) Home infusion therapy services provided by home infusion therapy pharmacies must
be paid at rates according to subdivision 8d.
(h) The commissioner shall contract with a vendor to conduct a cost of dispensing survey
for all pharmacies that are physically located in the state of Minnesota that dispense outpatient
drugs under medical assistance. The commissioner shall ensure that the vendor has prior
experience in conducting cost of dispensing surveys. Each pharmacy enrolled with the
department to dispense outpatient prescription drugs to fee-for-service members must
respond to the cost of dispensing survey. The commissioner may sanction a pharmacy under
section 256B.064 for failure to respond. The commissioner shall require the vendor to
measure a single statewide cost of dispensing for specialty prescription drugs and a single
statewide cost of dispensing for nonspecialty prescription drugs for all responding pharmacies
to measure the mean, mean weighted by total prescription volume, mean weighted by
medical assistance prescription volume, median, median weighted by total prescription
volume, and median weighted by total medical assistance prescription volume. The
commissioner shall post a copy of the final cost of dispensing survey report on the
department's website. The initial survey must be completed no later than January 1, 2021,
and repeated every three years. The commissioner shall provide a summary of the results
of each cost of dispensing survey and provide recommendations for any changes to the
dispensing fee to the chairs and ranking minority members of the legislative committees
with jurisdiction over medical assistance pharmacy reimbursement. Notwithstanding section
256.01, subdivision 42, this paragraph does not expire.
(i) The commissioner shall increase the ingredient cost reimbursement calculated in
paragraphs (a) and (f) by 1.8 percent for prescription and nonprescription drugs subject to
the wholesale drug distributor tax under section 295.52.
Sec. 11.
Minnesota Statutes 2022, section 256B.0625, is amended by adding a subdivision
to read:
new text begin Subd. 25c. new text end
new text begin Applicability of utilization review provisions. new text end
new text begin
Effective January 1, 2026,
the following provisions of chapter 62M apply to the commissioner when delivering services
through fee-for-service under chapters 256B and 256L: sections 62M.02, subdivisions 1 to
5, 7 to 12, 13, 14 to 18, and 21; 62M.04; 62M.05, subdivisions 1 to 4; 62M.06, subdivisions
1 to 3; 62M.07; 62M.072; 62M.09; 62M.10; 62M.12; and 62M.17, subdivision 2.
new text end
Sec. 12.
Minnesota Statutes 2023 Supplement, section 256B.0701, subdivision 6, is
amended to read:
Subd. 6.
Recuperative care facility rate.
(a) The recuperative care facility rate is for
facility costs and must be paid from state money in an amount equal to the deleted text begin medical assistance
room and boarddeleted text end new text begin MSA equivalentnew text end rate new text begin as defined in section 256I.03, subdivision 11a, new text end 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.
(b) Before a recipient is discharged from a recuperative care setting, the provider must
ensure that the recipient's medical condition is stabilized or that the recipient is being
discharged to a setting that is able to meet that recipient's needs.
Sec. 13.
Minnesota Statutes 2023 Supplement, section 256B.0947, subdivision 7, is
amended to read:
Subd. 7.
Medical assistance payment and rate setting.
(a) Payment for services in this
section must be based on one daily encounter rate per provider inclusive of the following
services received by an eligible client in a given calendar day: all rehabilitative services,
supports, and ancillary activities under this section, staff travel time to provide rehabilitative
services under this section, and crisis response services under section 256B.0624.
(b) Payment must not be made to more than one entity for each client for services
provided under this section on a given day. If services under this section are provided by a
team that includes staff from more than one entity, the team shall determine how to distribute
the payment among the members.
(c) The commissioner shall establish regional cost-based rates for entities that will bill
medical assistance for nonresidential intensive rehabilitative mental health services. In
developing these rates, the commissioner shall consider:
(1) the cost for similar services in the health care trade area;
(2) actual costs incurred by entities providing the services;
(3) the intensity and frequency of services to be provided to each client;
(4) the degree to which clients will receive services other than services under this section;
and
(5) the costs of other services that will be separately reimbursed.
(d) The rate for a provider must not exceed the rate charged by that provider for the
same service to other payers.
(e) Effective for the rate years beginning on and after January 1, 2024, rates must be
annually adjusted for inflation using the Centers for Medicare and Medicaid Services
Medicare Economic Index, as forecasted in the deleted text begin fourthdeleted text end new text begin thirdnew text end quarter of the calendar year
before the rate year. The inflation adjustment must be based on the 12-month period from
the midpoint of the previous rate year to the midpoint of the rate year for which the rate is
being determined.
Sec. 14.
Minnesota Statutes 2023 Supplement, 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.
(c) Effective for services provided on or after January 1, 2024, payment rates for family
planningnew text begin , when such services are provided by an eligible community clinic as defined in
section 145.9268, subdivision 1,new text end and abortion services shall be increased by 20 percent.
This increase does not apply to federally qualified health centers, rural health centers, or
Indian health services.
Sec. 15.
Minnesota Statutes 2023 Supplement, section 256L.03, subdivision 1, is amended
to read:
Subdivision 1.
Covered health services.
(a) "Covered health services" means the health
services reimbursed under chapter 256B, with the exception of special education services,
home care nursing services, deleted text begin adult dental care services other than services covered under
section 256B.0625, subdivision 9, orthodontic services,deleted text end nonemergency medical transportation
services, personal care assistance and case management services, community first services
and supports under section 256B.85, behavioral health home services under section
256B.0757, housing stabilization services under section 256B.051, and nursing home or
intermediate care facilities services.
(b) Covered health services shall be expanded as provided in this section.
(c) For the purposes of covered health services under this section, "child" means an
individual younger than 19 years of age.
Sec. 16.
Minnesota Statutes 2022, section 524.3-801, as amended by Laws 2024, chapter
79, article 9, section 20, is amended to read:
524.3-801 NOTICE TO CREDITORS.
(a) Unless notice has already been given under this section, upon appointment of a
general personal representative in informal proceedings or upon the filing of a petition for
formal appointment of a general personal representative, notice thereof, in the form prescribed
by court rule, shall be given under the direction of the court administrator by publication
once a week for two successive weeks in a legal newspaper in the county wherein the
proceedings are pending giving the name and address of the general personal representative
and notifying creditors of the estate to present their claims within four months after the date
of the court administrator's notice which is subsequently published or be forever barred,
unless they are entitled to further service of notice under paragraph (b) or (c).
(b) The personal representative shall, within three months after the date of the first
publication of the notice, serve a copy of the notice upon each then known and identified
creditor in the manner provided in paragraph (c). If the decedent or a predeceased spouse
of the decedent received assistance for which a claim could be filed under section 246.53,
256B.15, 256D.16, or 261.04, notice to the commissioner of human services or direct care
and treatment executive board, as applicable, must be given under paragraph (d) instead of
under this paragraph or paragraph (c). A creditor is "known" if: (i) the personal representative
knows that the creditor has asserted a claim that arose during the decedent's life against
either the decedent or the decedent's estate; (ii) the creditor has asserted a claim that arose
during the decedent's life and the fact is clearly disclosed in accessible financial records
known and available to the personal representative; or (iii) the claim of the creditor would
be revealed by a reasonably diligent search for creditors of the decedent in accessible
financial records known and available to the personal representative. Under this section, a
creditor is "identified" if the personal representative's knowledge of the name and address
of the creditor will permit service of notice to be made under paragraph (c).
(c) Unless the claim has already been presented to the personal representative or paid,
the personal representative shall serve a copy of the notice required by paragraph (b) upon
each creditor of the decedent who is then known to the personal representative and identified
either by delivery of a copy of the required notice to the creditor, or by mailing a copy of
the notice to the creditor by certified, registered, or ordinary first class mail addressed to
the creditor at the creditor's office or place of residence.
(d)(1) Effective for decedents dying on or after July 1, 1997, if the decedent or a
predeceased spouse of the decedent received assistance for which a claim could be filed
under section 246.53, 256B.15, 256D.16, or 261.04, the personal representative or the
attorney for the personal representative shall serve the commissioner or executive board,
as applicable, with notice in the manner prescribed in paragraph (c)new text begin , or electronically in a
manner prescribed by the commissioner or executive board,new text end as soon as practicable after the
appointment of the personal representative. The notice must state the decedent's full name,
date of birth, and Social Security number and, to the extent then known after making a
reasonably diligent inquiry, the full name, date of birth, and Social Security number for
each of the decedent's predeceased spouses. The notice may also contain a statement that,
after making a reasonably diligent inquiry, the personal representative has determined that
the decedent did not have any predeceased spouses or that the personal representative has
been unable to determine one or more of the previous items of information for a predeceased
spouse of the decedent. A copy of the notice to creditors must be attached to and be a part
of the notice to the commissioner or executive board.
(2) Notwithstanding a will or other instrument or law to the contrary, except as allowed
in this paragraph, no property subject to administration by the estate may be distributed by
the estate or the personal representative until 70 days after the date the notice is served on
the commissioner or executive board as provided in paragraph (c), unless the local agency
consents as provided for in clause (6). This restriction on distribution does not apply to the
personal representative's sale of real or personal property, but does apply to the net proceeds
the estate receives from these sales. The personal representative, or any person with personal
knowledge of the facts, may provide an affidavit containing the description of any real or
personal property affected by this paragraph and stating facts showing compliance with this
paragraph. If the affidavit describes real property, it may be filed or recorded in the office
of the county recorder or registrar of titles for the county where the real property is located.
This paragraph does not apply to proceedings under sections 524.3-1203 and 525.31, or
when a duly authorized agent of a county is acting as the personal representative of the
estate.
(3) At any time before an order or decree is entered under section 524.3-1001 or
524.3-1002, or a closing statement is filed under section 524.3-1003, the personal
representative or the attorney for the personal representative may serve an amended notice
on the commissioner or executive board to add variations or other names of the decedent
or a predeceased spouse named in the notice, the name of a predeceased spouse omitted
from the notice, to add or correct the date of birth or Social Security number of a decedent
or predeceased spouse named in the notice, or to correct any other deficiency in a prior
notice. The amended notice must state the decedent's name, date of birth, and Social Security
number, the case name, case number, and district court in which the estate is pending, and
the date the notice being amended was served on the commissioner or executive board. If
the amendment adds the name of a predeceased spouse omitted from the notice, it must also
state that spouse's full name, date of birth, and Social Security number. The amended notice
must be served on the commissioner or executive board in the same manner as the original
notice. Upon service, the amended notice relates back to and is effective from the date the
notice it amends was served, and the time for filing claims arising under section 246.53,
256B.15, 256D.16 or 261.04 is extended by 60 days from the date of service of the amended
notice. Claims filed during the 60-day period are undischarged and unbarred claims, may
be prosecuted by the entities entitled to file those claims in accordance with section
524.3-1004, and the limitations in section 524.3-1006 do not apply. The personal
representative or any person with personal knowledge of the facts may provide and file or
record an affidavit in the same manner as provided for in clause (1).
(4) Within one year after the date an order or decree is entered under section 524.3-1001
or 524.3-1002 or a closing statement is filed under section 524.3-1003, any person who has
an interest in property that was subject to administration by the estate may serve an amended
notice on the commissioner or executive board to add variations or other names of the
decedent or a predeceased spouse named in the notice, the name of a predeceased spouse
omitted from the notice, to add or correct the date of birth or Social Security number of a
decedent or predeceased spouse named in the notice, or to correct any other deficiency in
a prior notice. The amended notice must be served on the commissioner or executive board
in the same manner as the original notice and must contain the information required for
amendments under clause (3). If the amendment adds the name of a predeceased spouse
omitted from the notice, it must also state that spouse's full name, date of birth, and Social
Security number. Upon service, the amended notice relates back to and is effective from
the date the notice it amends was served. If the amended notice adds the name of an omitted
predeceased spouse or adds or corrects the Social Security number or date of birth of the
decedent or a predeceased spouse already named in the notice, then, notwithstanding any
other laws to the contrary, claims against the decedent's estate on account of those persons
resulting from the amendment and arising under section 246.53, 256B.15, 256D.16, or
261.04 are undischarged and unbarred claims, may be prosecuted by the entities entitled to
file those claims in accordance with section 524.3-1004, and the limitations in section
524.3-1006 do not apply. The person filing the amendment or any other person with personal
knowledge of the facts may provide and file or record an affidavit describing affected real
or personal property in the same manner as clause (1).
(5) After one year from the date an order or decree is entered under section 524.3-1001
or 524.3-1002, or a closing statement is filed under section 524.3-1003, no error, omission,
or defect of any kind in the notice to the commissioner or executive board required under
this paragraph or in the process of service of the notice on the commissioner or executive
board, or the failure to serve the commissioner or executive board with notice as required
by this paragraph, makes any distribution of property by a personal representative void or
voidable. The distributee's title to the distributed property shall be free of any claims based
upon a failure to comply with this paragraph.
(6) The local agency may consent to a personal representative's request to distribute
property subject to administration by the estate to distributees during the 70-day period after
service of notice on the commissioner or executive board. The local agency may grant or
deny the request in whole or in part and may attach conditions to its consent as it deems
appropriate. When the local agency consents to a distribution, it shall give the estate a written
certificate evidencing its consent to the early distribution of assets at no cost. The certificate
must include the name, case number, and district court in which the estate is pending, the
name of the local agency, describe the specific real or personal property to which the consent
applies, state that the local agency consents to the distribution of the specific property
described in the consent during the 70-day period following service of the notice on the
commissioner or executive board, state that the consent is unconditional or list all of the
terms and conditions of the consent, be dated, and may include other contents as may be
appropriate. The certificate must be signed by the director of the local agency or the director's
designees and is effective as of the date it is dated unless it provides otherwise. The signature
of the director or the director's designee does not require any acknowledgment. The certificate
shall be prima facie evidence of the facts it states, may be attached to or combined with a
deed or any other instrument of conveyance and, when so attached or combined, shall
constitute a single instrument. If the certificate describes real property, it shall be accepted
for recording or filing by the county recorder or registrar of titles in the county in which the
property is located. If the certificate describes real property and is not attached to or combined
with a deed or other instrument of conveyance, it shall be accepted for recording or filing
by the county recorder or registrar of titles in the county in which the property is located.
The certificate constitutes a waiver of the 70-day period provided for in clause (2) with
respect to the property it describes and is prima facie evidence of service of notice on the
commissioner or executive board. The certificate is not a waiver or relinquishment of any
claims arising under section 246.53, 256B.15, 256D.16, or 261.04, and does not otherwise
constitute a waiver of any of the personal representative's duties under this paragraph.
Distributees who receive property pursuant to a consent to an early distribution shall remain
liable to creditors of the estate as provided for by law.
(7) All affidavits provided for under this paragraph:
(i) shall be provided by persons who have personal knowledge of the facts stated in the
affidavit;
(ii) may be filed or recorded in the office of the county recorder or registrar of titles in
the county in which the real property they describe is located for the purpose of establishing
compliance with the requirements of this paragraph; and
(iii) are prima facie evidence of the facts stated in the affidavit.
(8) This paragraph applies to the estates of decedents dying on or after July 1, 1997.
Clause (5) also applies with respect to all notices served on the commissioner of human
services before July 1, 1997, under Laws 1996, chapter 451, article 2, section 55. All notices
served on the commissioner before July 1, 1997, pursuant to Laws 1996, chapter 451, article
2, section 55, shall be deemed to be legally sufficient for the purposes for which they were
intended, notwithstanding any errors, omissions or other defects.
Sec. 17. new text begin DIRECTION TO COMMISSIONER; REIMBURSEMENT FOR
EXTRACORPOREAL MEMBRANE OXYGENATION CANNULATION AS AN
OUTPATIENT SERVICE.
new text end
new text begin
The commissioner of human services, in consultation with providers and hospitals, shall
determine the feasibility of an outpatient reimbursement mechanism for medical assistance
coverage of extracorporeal membrane oxygenation (ECMO) cannulation performed outside
an inpatient hospital setting or in a self-contained mobile ECMO unit. If an outpatient
reimbursement mechanism is feasible, then the commissioner of human services shall
develop a recommended payment mechanism. By January 15, 2025, the commissioner of
human services shall submit a recommendation and the required legislative language to the
chairs and ranking minority members of the legislative committees with jurisdiction over
health care finance. If such a payment mechanism is infeasible, the commissioner of human
services shall submit an explanation as to why it is infeasible.
new text end
ARTICLE 3
HEALTH CARE
Section 1.
new text begin
[62J.805] DEFINITIONS.
new text end
new text begin Subdivision 1. new text end
new text begin Application. new text end
new text begin
For purposes of sections 62J.805 to 62J.808, the following
terms have the meanings given.
new text end
new text begin Subd. 2. new text end
new text begin Health care provider. new text end
new text begin
"Health care provider" means:
new text end
new text begin
(1) a health professional who is licensed or registered by Minnesota to provide health
treatments and services within the professional's scope of practice and in accordance with
state law;
new text end
new text begin
(2) a group practice; or
new text end
new text begin
(3) a hospital.
new text end
new text begin Subd. 3. new text end
new text begin Health plan. new text end
new text begin
"Health plan" has the meaning given in section 62A.011,
subdivision 3.
new text end
new text begin Subd. 4. new text end
new text begin Hospital. new text end
new text begin
"Hospital" means a health care facility licensed as a hospital under
sections 144.50 to 144.56.
new text end
new text begin Subd. 5. new text end
new text begin Group practice. new text end
new text begin
"Group practice" has the meaning given to health care provider
group practice in section 145D.01, subdivision 1.
new text end
new text begin Subd. 6. new text end
new text begin Medically necessary. new text end
new text begin
"Medically necessary" means:
new text end
new text begin
(1) safe and effective;
new text end
new text begin
(2) not experimental or investigational, except as set forth in Code of Federal Regulations,
title 42, section 411.15(o);
new text end
new text begin
(3) furnished in accordance with acceptable medical standards of medical practice for
the diagnosis or treatment of the patient's condition or to improve the function of a malformed
body member;
new text end
new text begin
(4) furnished in a setting appropriate to the patient's medical need and condition;
new text end
new text begin
(5) ordered and furnished by qualified personnel;
new text end
new text begin
(6) meets, but does not exceed, the patient's medical need; and
new text end
new text begin
(7) is at least as beneficial as an existing and available medically appropriate alternative.
new text end
new text begin Subd. 7. new text end
new text begin Miscode. new text end
new text begin
"Miscode" means a health care provider or a health care provider's
designee, using a coding system and for billing purposes, assigns a numeric or alphanumeric
code to a health treatment or service provided to a patient and the code assigned does not
accurately reflect the health treatment or service provided based on factors that include the
patient's diagnosis and the complexity of the patient's condition.
new text end
new text begin Subd. 8. new text end
new text begin Payment. new text end
new text begin
"Payment" includes co-payments and coinsurance and deductible
payments made by a patient.
new text end
Sec. 2.
new text begin
[62J.806] POLICY FOR COLLECTION OF MEDICAL DEBT.
new text end
new text begin Subdivision 1. new text end
new text begin Requirement. new text end
new text begin
Each health care provider must make available to the
public the health care provider's policy for the collection of medical debt from patients. This
policy must be made available by:
new text end
new text begin
(1) clearly posting it on the health care provider's website, or for health professionals,
on the website of the health clinic, group practice, or hospital at which the health professional
is employed or under contract; and
new text end
new text begin
(2) providing a copy of the policy to any individual who requests it.
new text end
new text begin Subd. 2. new text end
new text begin Content. new text end
new text begin
A policy made available under this section must at least specify the
procedures followed by the health care provider for:
new text end
new text begin
(1) communicating with patients about the medical debt owed and collecting medical
debt;
new text end
new text begin
(2) referring medical debt to a collection agency or law firm for collection; and
new text end
new text begin
(3) identifying medical debt as uncollectible or satisfied, and ending collection activities.
new text end
Sec. 3.
new text begin
[62J.807] DENIAL OF HEALTH TREATMENTS OR SERVICES DUE TO
OUTSTANDING MEDICAL DEBT.
new text end
new text begin
(a) A health care provider must not deny medically necessary health treatments or services
to a patient or any member of the patient's family or household because of outstanding or
previously outstanding medical debt owed by the patient or any member of the patient's
family or household to the health care provider, regardless of whether the health treatment
or service may be available from another health care provider.
new text end
new text begin
(b) As a condition of providing medically necessary health treatments or services in the
circumstances described in paragraph (a), a health care provider may require the patient to
enroll in a payment plan for the outstanding medical debt owed to the health care provider.
new text end
Sec. 4.
new text begin
[62J.808] BILLING AND PAYMENT FOR MISCODED HEALTH
TREATMENTS AND SERVICES.
new text end
new text begin Subdivision 1. new text end
new text begin Participation and cooperation required. new text end
new text begin
Each health care provider
must participate in, and cooperate with, all processes and investigations to identify, review,
and correct the coding of health treatments and services that are miscoded by the health
care provider or a designee.
new text end
new text begin Subd. 2. new text end
new text begin Notice; billing and payment during review. new text end
new text begin
(a) When a health care provider
receives notice, other than notice from a health plan company as provided in paragraph (b),
or otherwise determines that a health treatment or service may have been miscoded, the
health care provider must notify the health plan company administering the patient's health
plan in a timely manner of the potentially miscoded health treatment or service.
new text end
new text begin
(b) When a health plan company receives notice, other than notice from a health care
provider as provided in paragraph (a), or otherwise determines that a health treatment or
service may have been miscoded, the health plan company must notify the health care
provider who provided the health treatment or service of the potentially miscoded health
treatment or service.
new text end
new text begin
(c) When a review of a potentially miscoded health treatment or service is commenced,
the health care provider and health plan company must notify the patient that a miscoding
review is being conducted and that the patient will not be billed for any health treatment or
service subject to the review and is not required to submit payments for any health treatment
or service subject to the review until the review is complete and any miscoded health
treatments or services are correctly coded.
new text end
new text begin
(d) While a review of a potentially miscoded health treatment or service is being
conducted, the health care provider and health plan company must not bill the patient for,
or accept payment from the patient for, any health treatment or service subject to the review.
new text end
new text begin Subd. 3. new text end
new text begin Billing and payment after completion of review. new text end
new text begin
The health care provider
and health plan company may bill the patient for, and accept payment from the patient for,
the health treatment or service that was subject to the miscoding review only after the review
is complete and any miscoded health treatments or services have been correctly coded.
new text end
Sec. 5.
Minnesota Statutes 2022, section 62V.02, is amended by adding a subdivision to
read:
new text begin Subd. 7a. new text end
new text begin MinnesotaCare public option. new text end
new text begin
"MinnesotaCare public option" or "public
option" has the meaning provided in section 256L.01, subdivision 5a.
new text end
new text begin EFFECTIVE DATE. new text end
new text begin
This section is effective January 1, 2028, or upon federal approval,
whichever is later. The commissioner of commerce shall notify the revisor of statutes when
federal approval is obtained.
new text end
Sec. 6.
Minnesota Statutes 2022, section 62V.02, is amended by adding a subdivision to
read:
new text begin Subd. 7b. new text end
new text begin MinnesotaCare public option enrollee. new text end
new text begin
"MinnesotaCare public option
enrollee" or "public option enrollee" has the meaning provided in section 256L.01,
subdivision 5b.
new text end
new text begin EFFECTIVE DATE. new text end
new text begin
This section is effective January 1, 2028, or upon federal approval,
whichever is later. The commissioner of commerce shall notify the revisor of statutes when
federal approval is obtained.
new text end
Sec. 7.
Minnesota Statutes 2022, section 62V.03, subdivision 1, is amended to read:
Subdivision 1.
Creation.
MNsure is created as a board under section 15.012, paragraph
(a), to:
(1) promote informed consumer choice, innovation, competition, quality, value, market
participation, affordability, suitable and meaningful choices, health improvement, care
management, reduction of health disparities, and portability of health plansnew text begin and the public
optionnew text end ;
(2) facilitate and simplify the comparison, choice, enrollment, and purchase of health
plans for individuals purchasing in the individual market through MNsure deleted text begin anddeleted text end new text begin ,new text end for employees
and employers purchasing in the small group market through MNsurenew text begin , and for individuals
purchasing the public optionnew text end ;
(3) assist small employers with access to small business health insurance tax credits and
to assist individuals with access to public health care programs, premium assistance tax
credits and cost-sharing reductions, and certificates of exemption from individual
responsibility requirements;
(4) facilitate the integration and transition of individuals between public health care
programsnew text begin , including the public option,new text end and health plans in the individual or group market
and develop processes that, to the maximum extent possible, provide for continuous coverage;
deleted text begin and
deleted text end
(5) establish and modify as necessary a name and brand for MNsure based on market
studies that show maximum effectiveness in attracting the uninsured and motivating them
to take actiondeleted text begin .deleted text end new text begin ; and
new text end
new text begin
(6) ensure simple, convenient, and understandable access to enrollment in the public
option through the MNsure website.
new text end
new text begin EFFECTIVE DATE. new text end
new text begin
This section is effective January 1, 2028, or upon federal approval,
whichever is later. The commissioner of commerce shall notify the revisor of statutes when
federal approval is obtained.
new text end
Sec. 8.
Minnesota Statutes 2022, section 62V.03, subdivision 3, is amended to read:
Subd. 3.
Continued operation of a private marketplace.
(a) Nothing in this chapter
shall be construed to prohibit: (1) a health carrier from offering outside of MNsure a health
plan to a qualified individual or qualified employer; and (2) a qualified individual from
enrolling in, or a qualified employer from selecting for its employees, a health plan offered
outside of MNsure.
(b) Nothing in this chapter shall be construed to restrict the choice of a qualified individual
to enroll or not enroll in a qualified health plannew text begin , the public option,new text end or to participate in MNsure.
Nothing in this chapter shall be construed to compel an individual to enroll in a qualified
health plannew text begin , the public option,new text end or to participate in MNsure.
(c) For purposes of this subdivision, "qualified individual" and "qualified employer"
have the meanings given in section 1312 of the Affordable Care Act, Public Law 111-148,
and further defined through amendments to the act and regulations issued under the act.
new text begin EFFECTIVE DATE. new text end
new text begin
This section is effective January 1, 2028, or upon federal approval,
whichever is later. The commissioner of commerce shall notify the revisor of statutes when
federal approval is obtained.
new text end
Sec. 9.
Minnesota Statutes 2022, section 62V.05, subdivision 3, is amended to read:
Subd. 3.
Insurance producers.
(a) By April 30, 2013, the board, in consultation with
the commissioner of commerce, shall establish certification requirements that must be met
by insurance producers in order to assist individuals and small employers with purchasing
coverage through MNsure. deleted text begin Prior to January 1, 2015, the board may amend the requirements,
only if necessary, due to a change in federal rules.
deleted text end
(b) Certification requirementsnew text begin under paragraph (a)new text end shall not exceed the requirements
established under Code of Federal Regulations, title 45, deleted text begin partdeleted text end new text begin sectionnew text end 155.220. Certification
shall include training on health plans available through MNsure, available tax credits and
cost-sharing arrangements, compliance with privacy and security standards, eligibility
verification processes, online enrollment tools, and basic information on available public
health care programs. Training required for certification under this subdivision shall qualify
for continuing education requirements for insurance producers required under chapter 60K,
and must comply with course approval requirements under chapter 45.
(c) new text begin For enrollment in qualified health plans, new text end producer compensation shall be established
by health carriers that provide health plans through MNsure. The structure of compensation
to insurance producers must be similar for health plans sold through MNsure and outside
MNsure.
(d) Any insurance producer compensation structure established by a health carrier for
the small group market must include compensation for defined contribution plans that
involve multiple health carriers. The compensation offered must be commensurate with
other small group market defined health plans.
(e) Any insurance producer assisting an individual or small employer with purchasing
coverage through MNsure must disclose, orally and in writing, to the individual or small
employer at the time of the first solicitation with the prospective purchaser the following:
(1) the health carriers and qualified health plans offered through MNsure that the producer
is authorized to sell, and that the producer may not be authorized to sell all the qualified
health plans offered through MNsure;
(2) that the producer may be receiving compensation from a health carrier for enrolling
the individual or small employer into a particular health plan; deleted text begin and
deleted text end
(3) that information on all qualified health plans offered through MNsurenew text begin and the public
optionnew text end is available through the MNsure websitedeleted text begin .deleted text end new text begin ; and
new text end
new text begin
(4) that the producer may receive compensation from the state for enrolling an individual
in the public option.
new text end
For purposes of this paragraph, "solicitation" means any contact by a producer, or any person
acting on behalf of a producer made for the purpose of selling or attempting to sell coverage
through MNsure. If the first solicitation is made by telephone, the disclosures required under
this paragraph need not be made in writing, but the fact that disclosure has been made must
be acknowledged on the application.
(f) Beginning January 15, 2015, each health carrier that offers or sells qualified health
plans through MNsure shall report in writing to the board and the commissioner of commerce
the compensation and other incentives it offers or provides to insurance producers with
regard to each type of health plan the health carrier offers or sells both inside and outside
of MNsure. Each health carrier shall submit a report annually and upon any change to the
compensation or other incentives offered or provided to insurance producers.
(g) Nothing in this chapter shall prohibit an insurance producer from offering professional
advice and recommendations to a small group purchaser based upon information provided
to the producer.
(h) An insurance producer that offers health plans in the small group market shall notify
each small group purchaser of which group health plans qualify for Internal Revenue Service
approved section 125 tax benefits. The insurance producer shall also notify small group
purchasers of state law provisions that benefit small group plans when the employer agrees
to pay 50 percent or more of its employees' premium. Individuals who are eligible for
cost-effective medical assistance will count toward the 75 percent participation requirement
in section 62L.03, subdivision 3.
(i) Nothing in this subdivision shall be construed to limit the licensure requirements or
regulatory functions of the commissioner of commerce under chapter 60K.
new text begin
(j) The board may establish certification requirements that must be met by insurance
producers in order to assist individuals with enrolling in the public option.
new text end
new text begin
(k) Health carriers must pay an insurance producer a $....... application assistance bonus
for each applicant the insurance producer successfully enrolls in the public option.
new text end
new text begin EFFECTIVE DATE. new text end
new text begin
This section is effective upon federal approval of the state's
section 1332 waiver request to establish a public option. The commissioner of commerce
shall notify the revisor of statutes when federal approval is obtained.
new text end
Sec. 10.
Minnesota Statutes 2022, section 62V.05, subdivision 6, is amended to read:
Subd. 6.
Appeals.
(a) The board may conduct hearings, appoint hearing officers, and
recommend final orders related to appeals of any MNsure determinations, except for those
determinations identified in paragraph (d). An appeal by a health carrier regarding a specific
certification or selection determination made by MNsure under subdivision 5 must be
conducted as a contested case proceeding under chapter 14, with the report or order of the
administrative law judge constituting the final decision in the case, subject to judicial review
under sections 14.63 to 14.69. For other appeals, the board shall establish hearing processes
which provide for a reasonable opportunity to be heard and timely resolution of the appeal
and which are consistent with the requirements of federal law and guidance. An appealing
party may be represented by legal counsel at these hearings, but this is not a requirement.
(b) MNsure may establish service-level agreements with state agencies to conduct
hearings for appeals. Notwithstanding section 471.59, subdivision 1, a state agency is
authorized to enter into service-level agreements for this purpose with MNsure.
(c) For proceedings under this subdivision, MNsure may be represented by an attorney
who is an employee of MNsure.
(d) This subdivision does not apply to appeals of determinations where a state agency
hearing is available under section 256.045.
(e) An appellant aggrieved by an order of MNsure issued in an eligibility appeal, as
defined in Minnesota Rules, part 7700.0101, may appeal the order to the district court of
the appellant's county of residence by serving a written copy of a notice of appeal upon
MNsure and any other adverse party of record within 30 days after the date MNsure issued
the order, the amended order, or order affirming the original order, and by filing the original
notice and proof of service with the court administrator of the district court. Service may
be made personally or by mail; service by mail is complete upon mailing; no filing fee shall
be required by the court administrator in appeals taken pursuant to this subdivision. MNsure
shall furnish all parties to the proceedings with a copy of the decision and a transcript of
any testimony, evidence, or other supporting papers from the hearing held before the appeals
examiner within 45 days after service of the notice of appeal.
(f) Any party aggrieved by the failure of an adverse party to obey an order issued by
MNsure may compel performance according to the order in the manner prescribed in sections
586.01 to 586.12.
(g) Any party may obtain a hearing at a special term of the district court by serving a
written notice of the time and place of the hearing at least ten days prior to the date of the
hearing. The court may consider the matter in or out of chambers, and shall take no new or
additional evidence unless it determines that such evidence is necessary for a more equitable
disposition of the appeal.
(h) Any party aggrieved by the order of the district court may appeal the order as in
other civil cases. No costs or disbursements shall be taxed against any party nor shall any
filing fee or bond be required of any party.
(i) If MNsure or district court orders eligibility for qualified health plan coverage through
MNsure, new text begin the MinnesotaCare public option,new text end or eligibility for federal advance payment of
premium tax credits or cost-sharing reductions contingent upon full payment of respective
premiums, the premiums must be paid or provided pending appeal to the district court, court
of appeals, or supreme court. Provision of eligibility by MNsure pending appeal does not
render moot MNsure's position in a court of law.
new text begin EFFECTIVE DATE. new text end
new text begin
This section is effective January 1, 2028, or upon federal approval,
whichever is later. The commissioner of commerce shall notify the revisor of statutes when
federal approval is obtained.
new text end
Sec. 11.
Minnesota Statutes 2022, section 62V.05, subdivision 11, is amended to read:
Subd. 11.
Prohibition on other product lines.
MNsure is prohibited from certifying,
selecting, or offering products and policies of coverage that do not meet the definition of
health plan or dental plan as provided in section 62V.02.new text begin Nothing in this subdivision prevents
the commissioner of human services from offering the public option on the MNsure website.
new text end
new text begin EFFECTIVE DATE. new text end
new text begin
This section is effective January 1, 2028, or upon federal approval,
whichever is later. The commissioner of commerce shall notify the revisor of statutes when
federal approval is obtained.
new text end
Sec. 12.
Minnesota Statutes 2022, section 62V.05, subdivision 12, is amended to read:
Subd. 12.
Reports on interagency agreements and intra-agency transfers.
The
MNsure Board shall provide deleted text begin quarterly reports to the chairs and ranking minority members
of the legislative committees with jurisdiction over health and human services policy and
finance on:deleted text end new text begin legislative reports on interagency agreements and intra-agency transfers according
to section 15.0395.
new text end
deleted text begin
(1) interagency agreements or service-level agreements and any renewals or extensions
of existing interagency or service-level agreements with a state department under section
15.01, state agency under section 15.012, or the Department of Information Technology
Services, with a value of more than $100,000, or related agreements with the same department
or agency with a cumulative value of more than $100,000; and
deleted text end
deleted text begin
(2) transfers of appropriations of more than $100,000 between accounts within or between
agencies.
deleted text end
deleted text begin
The report must include the statutory citation authorizing the agreement, transfer or dollar
amount, purpose, and effective date of the agreement, the duration of the agreement, and a
copy of the agreement.
deleted text end
new text begin EFFECTIVE DATE. new text end
new text begin
This section is effective the day following final enactment.
new text end
Sec. 13.
Minnesota Statutes 2022, section 62V.05, is amended by adding a subdivision to
read:
new text begin Subd. 13. new text end
new text begin MinnesotaCare public option. new text end
new text begin
The board has the powers and duties provided
in section 62V.14, with respect to the MinnesotaCare public option.
new text end
new text begin EFFECTIVE DATE. new text end
new text begin
This section is effective January 1, 2028, or upon federal approval,
whichever is later. The commissioner of commerce shall notify the revisor of statutes when
federal approval is obtained.
new text end
Sec. 14.
Minnesota Statutes 2022, section 62V.051, is amended to read:
62V.051 MNSURE; CONSUMER RETROACTIVE APPOINTMENT OF A
NAVIGATOR OR PRODUCER PERMITTED.
Notwithstanding any other law or rule to the contrary, for up to six months after the
effective date of the qualified health plannew text begin or coverage under the public optionnew text end , MNsure must
permit a qualified health plan policyholdernew text begin or public option enrolleenew text end , who has not designated
a navigator or an insurance producer, to retroactively appoint a navigator or insurance
producer.new text begin In the case of a qualified health plan,new text end MNsure must provide notice of the retroactive
appointment to the health carrier. The health carrier must retroactively pay commissions to
the insurance producer if the producer can demonstrate that they were certified by MNsure
at the time of the original enrollment, were appointed by the selected health carrier at the
time of the enrollment, and that an agent of record agreement was executed prior to or at
the time of the effective date of the policy. MNsure must adopt a standard form of agent of
record agreement for purposes of this section.new text begin In the case of the public option, MNsure must
provide notice of the retroactive appointment to the managed care or county-based purchasing
plan, and the plan must retroactively pay commissions to the insurance producer if the
producer can demonstrate they were certified by MNsure at the time of the original
enrollment.
new text end
new text begin EFFECTIVE DATE. new text end
new text begin
This section is effective January 1, 2028, or upon federal approval,
whichever is later. The commissioner of commerce shall notify the revisor of statutes when
federal approval is obtained.
new text end
Sec. 15.
Minnesota Statutes 2022, section 62V.06, subdivision 4, is amended to read:
Subd. 4.
Application and certification data.
(a) Data submitted by an insurance producer
in an application for certification to sell a health plannew text begin or the public optionnew text end through MNsure,
or submitted by an applicant seeking permission or a commission to act as a navigator or
in-person assister, are classified as follows:
(1) at the time the application is submitted, all data contained in the application are
private data, as defined in section 13.02, subdivision 12, or nonpublic data as defined in
section 13.02, subdivision 9, except that the name of the applicant is public; and
(2) upon a final determination related to the application for certification by MNsure, all
data contained in the application are public, with the exception of trade secret data as defined
in section 13.37.
(b) Data created or maintained by a government entity as part of the evaluation of an
application are protected nonpublic data, as defined in section 13.02, subdivision 13, until
a final determination as to certification is made and all rights of appeal have been exhausted.
Upon a final determination and exhaustion of all rights of appeal, these data are public, with
the exception of trade secret data as defined in section 13.37 and data subject to
attorney-client privilege or other protection as provided in section 13.393.
(c) If an application is denied, the public data must include the criteria used by the board
to evaluate the application and the specific reasons for the denial, and these data must be
published on the MNsure website.
new text begin EFFECTIVE DATE. new text end
new text begin
This section is effective January 1, 2028, or upon federal approval,
whichever is later. The commissioner of commerce shall notify the revisor of statutes when
federal approval is obtained.
new text end
Sec. 16.
Minnesota Statutes 2022, section 62V.08, is amended to read:
62V.08 REPORTS.
(a) MNsure shall submit a report to the legislature by deleted text begin January 15, 2015deleted text end new text begin March 31, 2025new text end ,
and each deleted text begin January 15deleted text end new text begin March 31new text end thereafter, on: (1) the performance of MNsure operations;
(2) meeting MNsure responsibilities; (3) an accounting of MNsure budget activities; (4)
practices and procedures that have been implemented to ensure compliance with data
practices laws, and a description of any violations of data practices laws or procedures; and
(5) the effectiveness of the outreach and implementation activities of MNsure in reducing
the rate of uninsurance.
(b) MNsure must publish its administrative and operational costs on a website to educate
consumers on those costs. The information published must include: (1) the amount of
premiums and federal premium subsidies collected; (2) the amount and source of revenue
received under section 62V.05, subdivision 1, paragraph (b), clause (3); (3) the amount and
source of any other fees collected for purposes of supporting operations; and (4) any misuse
of funds as identified in accordance with section 3.975. The website must be updated at
least annually.
Sec. 17.
Minnesota Statutes 2022, section 62V.11, subdivision 4, is amended to read:
Subd. 4.
Review of costs.
The board shall submit for review the annual budget of MNsure
for the next fiscal year by March deleted text begin 15deleted text end new text begin 31new text end of each year, beginning March deleted text begin 15, 2014deleted text end new text begin 31, 2025new text end .
Sec. 18.
Minnesota Statutes 2023 Supplement, section 62V.13, subdivision 3, is amended
to read:
Subd. 3.
Outreach letter and special enrollment period.
(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.
(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
MNsurenew text begin or in the public optionnew text end . 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 plannew text begin or the public optionnew text end and coverage for the qualifying health plannew text begin or the public
optionnew text end is effective the first day of the month after plan selection.
(c) Taxpayers who have a member of the taxpayer's household currently enrolled in a
qualified health plan through MNsurenew text begin or in the public optionnew text end are not eligible for the special
enrollment under paragraph (b).
(d) MNsure must provide information to the general public about the easy enrollment
health insurance outreach program and the special enrollment period described in this
subdivision.
new text begin EFFECTIVE DATE. new text end
new text begin
This section is effective January 1, 2028, or upon federal approval,
whichever is later. The commissioner of commerce shall notify the revisor of statutes when
federal approval is obtained.
new text end
Sec. 19.
new text begin
[62V.14] PUBLIC OPTION; APPLICATION AND ENROLLMENT.
new text end
new text begin Subdivision 1. new text end
new text begin Public option application. new text end
new text begin
(a) An individual eligible for the public option
must be able to enroll in the public option on the MNsure website.
new text end
new text begin
(b) An individual must be able to apply for and, if eligible, enroll in the public option
by completing the application for a qualified health plan with premium tax credits or
cost-sharing reductions. An individual must provide information needed to confirm they
are not eligible for medical assistance under chapter 256B or MinnesotaCare under chapter
256L through an eligibility pathway other than the public option.
new text end
new text begin
(c) MNsure must ensure that individuals interested in applying for a qualified health
plan or the public option are able to compare coverage options in a simple, convenient, and
understandable manner on the MNsure website. The website must present the coverage
options in a comparable and standardized manner to the extent practicable.
new text end
new text begin
(d) The MNsure website must include clear and conspicuous language stating that
individuals can apply for the public option on the website.
new text end
new text begin Subd. 2. new text end
new text begin Eligibility determinations. new text end
new text begin
(a) MNsure shall process all public option
applications and make all eligibility determinations for the public option. MNsure shall
make all public option eligibility determinations in accordance with section 256L.04,
subdivision 15.
new text end
new text begin
(b) Eligibility for the public option is appealable to the MNsure board under this chapter
and Minnesota Rules, chapter 7700.
new text end
new text begin Subd. 3. new text end
new text begin Administrative functions. new text end
new text begin
MNsure shall provide administrative functions to
facilitate the offering of the public option by the commissioner of human services. These
functions include but are not limited to marketing, call center operations, and certification
of insurance producers. MNsure may provide additional administrative functions as requested
by the commissioner of human services.
new text end
new text begin Subd. 4. new text end
new text begin Diversion of resources. new text end
new text begin
MNsure may utilize existing resources, personnel, and
operations to carry out its duties under this section.
new text end
new text begin Subd. 5. new text end
new text begin No limitation. new text end
new text begin
Nothing in this section limits the rights of MinnesotaCare public
option enrollees or the commissioner of human services under chapter 256L.
new text end
new text begin Subd. 6. new text end
new text begin Contracting authorization. new text end
new text begin
The MNsure board may contract on a single-source
basis under section 16C.10, subdivision 1, with a third-party entity already providing
technical support to the board to develop and implement the technological requirements of
this section.
new text end
new text begin EFFECTIVE DATE. new text end
new text begin
This section is effective upon federal approval of the state's
section 1332 waiver application to establish a public option. The commissioner of commerce
shall notify the revisor of statutes when federal approval is obtained.
new text end
Sec. 20.
Minnesota Statutes 2023 Supplement, section 144.587, subdivision 4, is amended
to read:
Subd. 4.
Prohibited actions.
new text begin (a) new text end 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:
(1) offering to enroll or enrolling the patient in a payment plan;
(2) changing the terms of a patient's payment plan;
(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;
(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 begin or
new text end
deleted 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
deleted text end
deleted text begin (6)deleted text end new text begin (5)new text end accepting a credit card payment of over $500 for the medical debt owed to the
hospital.
new text begin
(b) A violation of section 62J.807 is a violation of this section.
new text end
Sec. 21.
new text begin
[145.076] INFORMED CONSENT REQUIRED FOR SENSITIVE
EXAMINATIONS.
new text end
new text begin Subdivision 1. new text end
new text begin Definition. new text end
new text begin
For the purposes of this section, "sensitive examination"
means a pelvic, breast, urogenital, or rectal examination.
new text end
new text begin Subd. 2. new text end
new text begin Informed consent required; exceptions. new text end
new text begin
A health professional, or a student
or resident participating in a course of instruction, clinical training, or a residency program
for a health profession, shall not perform a sensitive examination on an anesthetized or
unconscious patient unless:
new text end
new text begin
(1) the patient or the patient's legally authorized representative provided prior, written,
informed consent to the sensitive examination, and the sensitive examination is necessary
for preventive, diagnostic, or treatment purposes;
new text end
new text begin
(2) the patient or the patient's legally authorized representative provided prior, written,
informed consent to a surgical procedure or diagnostic examination, and the sensitive
examination is within the scope of care ordered for that surgical procedure or diagnostic
examination;
new text end
new text begin
(3) the patient is unconscious and incapable of providing informed consent, and the
sensitive examination is necessary for diagnostic or treatment purposes; or
new text end
new text begin
(4) a court ordered a sensitive examination to be performed for purposes of collection
of evidence.
new text end
new text begin Subd. 3. new text end
new text begin Penalty; ground for disciplinary action. new text end
new text begin
A person who violates this section
is subject to disciplinary action by the health-related licensing board regulating the person.
new text end
new text begin EFFECTIVE DATE. new text end
new text begin
This section is effective August 1, 2024, and applies to crimes
committed on or after that date.
new text end
Sec. 22.
Minnesota Statutes 2023 Supplement, 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, individual taxpayer
identification number, 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 deleted text begin is in need of accessingdeleted text end new text begin needs to accessnew text end 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.
new text begin
(h) A manufacturer may submit to the commissioner of administration a request for
reimbursement in an amount not to exceed $35 for each 30-day supply of insulin the
manufacturer provides under paragraph (d). The commissioner of administration shall
determine the manner and format for submitting and processing requests for reimbursement.
After receiving a reimbursement request, the commissioner of administration shall reimburse
the manufacturer in an amount not to exceed $35 for each 30-day supply of insulin the
manufacturer provided under paragraph (d).
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. 23.
Minnesota Statutes 2022, section 151.74, subdivision 6, is amended to read:
Subd. 6.
Continuing safety net program; process.
(a) The individual shall submit to
a pharmacy the statement of eligibility provided by the manufacturer under subdivision 5,
paragraph (b). Upon receipt of an individual's eligibility status, the pharmacy shall submit
an order containing the name of the insulin product and the daily dosage amount as contained
in a valid prescription to the product's manufacturer.
(b) The pharmacy must include with the order to the manufacturer the following
information:
(1) the pharmacy's name and shipping address;
(2) the pharmacy's office telephone number, fax number, email address, and contact
name; and
(3) any specific days or times when deliveries are not accepted by the pharmacy.
(c) Upon receipt of an order from a pharmacy and the information described in paragraph
(b), the manufacturer shall send to the pharmacy a 90-day supply of insulin as ordered,
unless a lesser amount is requested in the order, at no charge to the individual or pharmacy.
(d) Except as authorized under paragraph (e), the pharmacy shall provide the insulin to
the individual at no charge to the individual. The pharmacy shall not provide insulin received
from the manufacturer to any individual other than the individual associated with the specific
order. The pharmacy shall not seek reimbursement for the insulin received from the
manufacturer or from any third-party payer.
(e) The pharmacy may collect a co-payment from the individual to cover the pharmacy's
costs for processing and dispensing in an amount not to exceed $50 for each 90-day supply
if the insulin is sent to the pharmacy.
(f) The pharmacy may submit to a manufacturer a reorder for an individual if the
individual's eligibility statement has not expired. Upon receipt of a reorder from a pharmacy,
the manufacturer must send to the pharmacy an additional 90-day supply of the product,
unless a lesser amount is requested, at no charge to the individual or pharmacy if the
individual's eligibility statement has not expired.
(g) Notwithstanding paragraph (c), a manufacturer may send the insulin as ordered
directly to the individual if the manufacturer provides a mail order service option.
new text begin
(h) A manufacturer may submit to the commissioner of administration a request for
reimbursement in an amount not to exceed $105 for each 90-day supply of insulin the
manufacturer provides under paragraphs (c) and (f). The commissioner of administration
shall determine the manner and format for submitting and processing requests for
reimbursement. After receiving a reimbursement request, the commissioner of administration
shall reimburse the manufacturer in an amount not to exceed $105 for each 90-day supply
of insulin the manufacturer provided under paragraphs (c) and (f). If the manufacturer
provides less than a 90-day supply of insulin under paragraphs (c) and (f), the manufacturer
may submit a request for reimbursement not to exceed $35 for each 30-day supply of insulin
provided.
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. 24.
new text begin
[151.741] INSULIN MANUFACTURER REGISTRATION FEE.
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) "Board" means the Minnesota Board of Pharmacy under section 151.02.
new text end
new text begin
(c) "Manufacturer" means a manufacturer licensed under section 151.252 and engaged
in the manufacturing of prescription insulin.
new text end
new text begin Subd. 2. new text end
new text begin Assessment of registration fee. new text end
new text begin
(a) The board shall assess each manufacturer
an annual registration fee of $100,000, except as provided in paragraph (b). The board shall
notify each manufacturer of this requirement beginning November 1, 2024, and each
November 1 thereafter.
new text end
new text begin
(b) A manufacturer may request an exemption from the annual registration fee. The
Board of Pharmacy shall exempt a manufacturer from the annual registration fee if the
manufacturer can demonstrate to the board, in the form and manner specified by the board,
that sales of prescription insulin produced by that manufacturer and sold or delivered within
or into Minnesota totalled $2,000,000 or less in the previous calendar year.
new text end
new text begin Subd. 3. new text end
new text begin Payment of the registration fee; deposit of fee. new text end
new text begin
(a) Each manufacturer must
pay the registration fee by March 1, 2025, and by each March 1 thereafter. In the event of
a change in ownership of the manufacturer, the new owner must pay the registration fee
that the original owner would have been assessed had the original owner retained ownership.
The board may assess a late fee of ten percent per month or any portion of a month that the
registration fee is paid after the due date.
new text end
new text begin
(b) The registration fee, including any late fees, must be deposited in the insulin safety
net program account.
new text end
new text begin Subd. 4. new text end
new text begin Insulin safety net program account. new text end
new text begin
The insulin safety net program account
is established in the special revenue fund in the state treasury. Money in the account is
appropriated each fiscal year to:
new text end
new text begin
(1) the MNsure board in an amount sufficient to carry out assigned duties under section
151.74, subdivision 7; and
new text end
new text begin
(2) the Board of Pharmacy in an amount sufficient to cover costs incurred by the board
in assessing and collecting the registration fee under this section and in administering the
insulin safety net program under section 151.74.
new text end
new text begin Subd. 5. new text end
new text begin Insulin repayment account; annual transfer from health care access fund. new text end
new text begin
(a)
The insulin repayment account is established in the special revenue fund in the state treasury.
Money in the account is appropriated each fiscal year to the commissioner of administration
to reimburse manufacturers for insulin dispensed under the insulin safety net program in
section 151.74, in accordance with section 151.74, subdivisions 3, paragraph (h), and 6,
paragraph (h), and to cover costs incurred by the commissioner in providing these
reimbursement payments.
new text end
new text begin
(b) By June 30, 2025, and each June 30 thereafter, the commissioner of administration
shall certify to the commissioner of management and budget the total amount expended in
the prior fiscal year for:
new text end
new text begin
(1) reimbursement to manufacturers for insulin dispensed under the insulin safety net
program in section 151.74, in accordance with section 151.74, subdivisions 3, paragraph
(h), and 6, paragraph (h); and
new text end
new text begin
(2) costs incurred by the commissioner of administration in providing the reimbursement
payments described in clause (1).
new text end
new text begin
(c) The commissioner of management and budget shall transfer from the health care
access fund to the special revenue fund, beginning July 1, 2025, and each July 1 thereafter,
an amount equal to the amount to which the commissioner of administration certified
pursuant to paragraph (b).
new text end
new text begin Subd. 6. new text end
new text begin Contingent transfer by commissioner. new text end
new text begin
If subdivisions 2 and 3, or the
application of subdivisions 2 and 3 to any person or circumstance, are held invalid for any
reason in a court of competent jurisdiction, the invalidity of subdivisions 2 and 3 does not
affect other provisions of this act, and the commissioner of management and budget shall
annually transfer from the health care access fund to the insulin safety net program account
an amount sufficient to implement subdivision 4.
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. 25.
Minnesota Statutes 2022, section 176.175, subdivision 2, is amended to read:
Subd. 2.
Nonassignability.
No claim for compensation or settlement of a claim for
compensation owned by an injured employee or dependents is assignable. Except as otherwise
provided in this chapter, any claim for compensation owned by an injured employee or
dependents is exempt from seizure or sale for the payment of any debt or liabilitynew text begin , up to a
total amount of $1,000,000 per claim and subsequent awardnew text end .
Sec. 26.
Minnesota Statutes 2022, section 256L.01, is amended by adding a subdivision
to read:
new text begin Subd. 5a. new text end
new text begin MinnesotaCare public option. new text end
new text begin
"MinnesotaCare public option" or "public
option" means health coverage provided under section 256L.29.
new text end
new text begin EFFECTIVE DATE. new text end
new text begin
This section is effective January 1, 2028, or upon federal approval,
whichever is later. The commissioner of commerce shall notify the revisor of statutes when
federal approval is obtained.
new text end
Sec. 27.
Minnesota Statutes 2022, section 256L.01, is amended by adding a subdivision
to read:
new text begin Subd. 5b. new text end
new text begin MinnesotaCare public option enrollee. new text end
new text begin
"MinnesotaCare public option
enrollee" or "public option enrollee" means an individual enrolled in MinnesotaCare under
section 256L.04, subdivision 15.
new text end
new text begin EFFECTIVE DATE. new text end
new text begin
This section is effective January 1, 2028, or upon federal approval,
whichever is later. The commissioner of commerce shall notify the revisor of statutes when
federal approval is obtained.
new text end
Sec. 28.
Minnesota Statutes 2023 Supplement, section 256L.03, subdivision 5, is amended
to read:
Subd. 5.
Cost-sharing.
(a) Co-payments, coinsurance, and deductibles do not apply to
children under the age of 21 and to American Indians as defined in Code of Federal
Regulations, title 42, section 600.5deleted text begin .deleted text end new text begin , but do apply to public option enrollees as provided in
section 256L.29.
new text end
(b) The commissioner must adjust co-payments, coinsurance, and deductibles for covered
services in a manner sufficient to maintain the actuarial value of the benefit to 94 percentnew text begin ,
except as provided for public option enrollees under section 256L.29new text end . The cost-sharing
changes described in this paragraph do not apply to eligible recipients or services exempt
from cost-sharing under state law. deleted text begin The cost-sharing changes described in this paragraph
deleted text end deleted text begin shall not be implemented prior to January 1, 2016.
deleted text end
(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.
(d) Cost-sharing for prescription drugs and related medical supplies to treat chronic
disease must comply with the requirements of section 62Q.481.
(e) 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.
(f) Cost-sharing must not apply to drugs used for tobacco and nicotine cessation or to
tobacco and nicotine cessation services covered under section 256B.0625, subdivision 68.
(g) Co-payments, coinsurance, and deductibles do not apply to pre-exposure prophylaxis
(PrEP) and postexposure prophylaxis (PEP) medications when used for the prevention or
treatment of the human immunodeficiency virus (HIV).
new text begin EFFECTIVE DATE. new text end
new text begin
This section is effective January 1, 2028, or upon federal approval,
whichever is later. The commissioner of commerce shall notify the revisor of statutes when
federal approval is obtained.
new text end
Sec. 29.
Minnesota Statutes 2022, section 256L.04, subdivision 1c, is amended to read:
Subd. 1c.
General requirements.
To be eligible for MinnesotaCare, a person must meet
the eligibility requirements of this section. A person eligible for MinnesotaCare deleted text begin shalldeleted text end new text begin with
an income less than or equal to 200 percent of the federal poverty guidelines mustnew text end not be
considered a qualified individual under section 1312 of the Affordable Care Act, and is not
eligible for enrollment in a qualified health plan offered through MNsure under chapter
62V.
new text begin EFFECTIVE DATE. new text end
new text begin
This section is effective January 1, 2028, or upon federal approval,
whichever is later. The commissioner of commerce shall notify the revisor of statutes when
federal approval is obtained.
new text end
Sec. 30.
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 public option enrollees
under subdivision 15new text end .
new text begin EFFECTIVE DATE. new text end
new text begin
This section is effective January 1, 2028, or upon federal approval,
whichever is later. The commissioner of commerce shall notify the revisor of statutes when
federal approval is obtained.
new text end
Sec. 31.
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 the 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 who
meet all other MinnesotaCare eligibility requirements are eligible for the MinnesotaCare
public option, subject to the enrollment limits and additional requirements established under
section 256L.29. Families and individuals enrolled in the public option under this subdivision
are MinnesotaCare enrollees, and all provisions of this chapter applying generally to
MinnesotaCare enrollees apply to public option enrollees 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, sections 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, 2028, or upon federal approval,
whichever is later. The commissioner of commerce shall notify the revisor of statutes when
federal approval is obtained.
new text end
Sec. 32.
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
optionnew 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, 2028, or upon federal approval,
whichever is later. The commissioner of commerce shall notify the revisor of statutes when
federal approval is obtained.
new text end
Sec. 33.
Minnesota Statutes 2022, section 256L.12, subdivision 7, is amended to read:
Subd. 7.
Managed care plan vendor requirements.
The following requirements apply
to all counties or vendors who contract with the Department of Human Services to serve
MinnesotaCare recipients. Managed care plan contractors:
(1) shall authorize and arrange for the provision of the full range of services listed in
section 256L.03 in order to ensure appropriate health care is delivered to enrollees;
(2) shall accept the prospective, per capita payment or other contractually defined payment
from the commissioner in return for the provision and coordination of covered health care
services for eligible individuals enrolled in the program;
(3) may contract with other health care and social service practitioners to provide services
to enrollees;
(4) shall provide for an enrollee grievance process as required by the commissioner and
set forth in the contract with the department;
(5) shall retain all revenue from enrollee co-payments;
(6) shall accept all eligible MinnesotaCare enrollees, without regard to health status or
previous utilization of health services;
(7) shall demonstrate capacity to accept financial risk according to requirements specified
in the contract with the department. A health maintenance organization licensed under
chapter 62D, or a nonprofit health plan licensed under chapter 62C, is not required to
demonstrate financial risk capacity, beyond that which is required to comply with chapters
62C and 62D; deleted text begin and
deleted text end
(8) shall submit information as required by the commissioner, including data required
for assessing enrollee satisfaction, quality of care, cost, and utilization of servicesdeleted text begin .deleted text end new text begin ; and
new text end
new text begin
(9) shall reimburse health care providers for services provided to MinnesotaCare public
option enrollees at payment rates equal to or greater than the fee-for-service Medicare
payment rate for the same service, or for a similar service if the specific service is not
reimbursed under Medicare.
new text end
new text begin EFFECTIVE DATE. new text end
new text begin
This section is effective January 1, 2028, or upon federal approval,
whichever is later. The commissioner of commerce shall notify the revisor of statutes when
federal approval is obtained.
new text end
Sec. 34.
new text begin
[256L.29] MINNESOTACARE PUBLIC OPTION.
new text end
new text begin Subdivision 1. new text end
new text begin MinnesotaCare requirements. new text end
new text begin
The public option is part of the
MinnesotaCare program and all provisions of this chapter apply to the public option, unless
otherwise specified. These provisions include but are not limited to those related to covered
health services under section 256L.03; eligibility of undocumented noncitizens under section
256L.04, subdivision 10; eligibility requirements under section 256L.07; and premium
payment methods under section 256L.15.
new text end
new text begin Subd. 2. new text end
new text begin Application process and eligibility determination. new text end
new text begin
Individuals shall apply
for coverage under the public option as provided in section 62V.14. Enrollment in the public
option is limited to individuals eligible under section 256L.04, subdivision 15. The Board
of Directors of MNsure shall process public option applications and determine eligibility
for the public option as provided in section 62V.14.
new text end
new text begin Subd. 3. new text end
new text begin Premium scale. new text end
new text begin
Public option enrollees shall pay premiums for individual or
family coverage, as applicable, according to the following premium scale:
new text end
|
new text begin
Household Income as Percentage of Federal Poverty Guidelines new text end |
||
|
new text begin
Greater Than or Equal to new text end |
new text begin
Not Exceeding new text end |
new text begin
Required Premium Contribution as Percentage of Household Income new text end |
|
new text begin
201% new text end |
new text begin
250% new text end |
new text begin
4.88% new text end |
|
new text begin
251% new text end |
new text begin
300% new text end |
new text begin
6.38% new text end |
|
new text begin
301% new text end |
new text begin
400% new text end |
new text begin
7.88% new text end |
|
new text begin
401% new text end |
new text begin
500% new text end |
new text begin
8.5% new text end |
|
new text begin
501% new text end |
new text begin
550% new text end |
new text begin
9.01% new text end |
|
new text begin
551% and over new text end |
new text begin
No maximum new text end |
new text begin
10% new text end |
new text begin Subd. 4. new text end
new text begin Cost-sharing. new text end
new text begin
(a) Public option enrollees are subject to the MinnesotaCare
cost-sharing requirements established under section 256L.03, subdivision 5, except that:
new text end
new text begin
(1) cost-sharing applies to all public option enrollees and there are no exemptions from
cost-sharing for specific groups of individuals, including but not limited to: (i) children
under age 21; (ii) pregnant women; and (iii) American Indians as defined in Code of Federal
Regulations, title 42, section 600.5, who have incomes greater than or equal to 300 percent
of the federal poverty guidelines;
new text end
new text begin
(2) the commissioner shall set cost-sharing for public option enrollees at an actuarial
value of 94 percent, except that the actuarial value for public option enrollees with household
incomes above 400 percent of the federal poverty guidelines may be lower than 94 percent;
new text end
new text begin
(3) the deductibles specified in paragraph (b) apply; and
new text end
new text begin
(4) out-of-pocket maximums for public option enrollees must not exceed those outlined
in Code of Federal Regulations, title 45, section 156.130.
new text end
new text begin
(b) Public option enrollees are subject to the following annual deductibles:
new text end
new text begin
(1) for household incomes 401 percent to 500 percent of federal poverty guidelines,
$500;
new text end
new text begin
(2) for household incomes 501 percent to 600 percent of federal poverty guidelines,
$1,000; and
new text end
new text begin
(3) for household incomes 601 percent of federal poverty guidelines or above, $1,500.
new text end
new text begin
(c) No annual deductible applies to public option enrollees with household incomes not
exceeding 400 percent of the federal poverty guidelines.
new text end
new text begin Subd. 5. new text end
new text begin Enrollment limits. new text end
new text begin
Enrollment in the public option is subject to the following
limits:
new text end
new text begin
(1) for the 2028 plan year, there must not be any enrollment of individuals with household
incomes exceeding 400 percent of the federal poverty guidelines;
new text end
new text begin
(2) for the 2029 plan year, there must not be any enrollment of individuals with household
incomes exceeding 550 percent of the federal poverty guidelines; and
new text end
new text begin
(3) for the 2030 plan year and subsequent plan years, no enrollment limit.
new text end
new text begin Subd. 6. new text end
new text begin Contracting and service delivery. new text end
new text begin
(a) The commissioner may contract with
managed care and county-based purchasing plans for the delivery of services to public
option enrollees using a procurement process that is separate and unique from that used to
contract for the delivery of services to MinnesotaCare enrollees who are not public option
enrollees.
new text end
new text begin
(b) The commissioner shall establish public option participation requirements for managed
care and county-based purchasing plans. Public option enrollees are not considered
MinnesotaCare enrollees for the purpose of the participation requirement specified in section
256B.0644.
new text end
new text begin EFFECTIVE DATE. new text end
new text begin
This section is effective January 1, 2028, or upon federal approval,
whichever is later. The commissioner of commerce shall notify the revisor of statutes when
federal approval is obtained.
new text end
Sec. 35.
new text begin
[332C.01] DEFINITIONS.
new text end
new text begin Subdivision 1. new text end
new text begin Application. new text end
new text begin
For purposes of this chapter, the following terms have the
meanings given.
new text end
new text begin Subd. 2. new text end
new text begin Collecting party. new text end
new text begin
"Collecting party" means a party engaged in the collection
of medical debt. Collecting party does not include banks, credit unions, public officers,
garnishees, and other parties complying with a court order or statutory obligation to garnish
or levy a debtor's property.
new text end
new text begin Subd. 3. new text end
new text begin Debtor. new text end
new text begin
"Debtor" means a person obligated or alleged to be obligated to pay
any debt.
new text end
new text begin Subd. 4. new text end
new text begin Medical debt. new text end
new text begin
"Medical debt" means debt incurred primarily for medically
necessary health treatment or services. Medical debt does not include debt charged to a
credit card unless the credit card is issued under a credit plan offered solely for the payment
of health care treatment or services.
new text end
new text begin Subd. 5. new text end
new text begin Medically necessary. new text end
new text begin
"Medically necessary" means medically necessary as
defined in section 62J.805, subdivision 6.
new text end
new text begin Subd. 6. new text end
new text begin Person. new text end
new text begin
"Person" means any individual, partnership, association, or corporation.
new text end
Sec. 36.
new text begin
[332C.02] PROHIBITED PRACTICES.
new text end
new text begin
No collecting party shall:
new text end
new text begin
(1) in a collection letter, publication, invoice, or any oral or written communication,
threaten wage garnishment or legal suit by a particular lawyer, unless the collecting party
has actually retained the lawyer to do so;
new text end
new text begin
(2) use or employ sheriffs or any other officer authorized to serve legal papers in
connection with the collection of a claim, except when performing their legally authorized
duties;
new text end
new text begin
(3) use or threaten to use methods of collection which violate Minnesota law;
new text end
new text begin
(4) furnish legal advice to debtors or represent that the collecting party is competent or
able to furnish legal advice to debtors;
new text end
new text begin
(5) communicate with debtors in a misleading or deceptive manner by falsely using the
stationery of a lawyer, forms or instruments which only lawyers are authorized to prepare,
or instruments which simulate the form and appearance of judicial process;
new text end
new text begin
(6) publish or cause to be published any list of debtors, use shame cards or shame
automobiles, advertise or threaten to advertise for sale any claim as a means of forcing
payment thereof, or use similar devices or methods of intimidation;
new text end
new text begin
(7) operate under a name or in a manner which falsely implies the collecting party is a
branch of or associated with any department of federal, state, county, or local government
or an agency thereof;
new text end
new text begin
(8) transact business or hold itself out as a debt settlement company, debt management
company, debt adjuster, or any person who settles, adjusts, prorates, pools, liquidates, or
pays the indebtedness of a debtor, unless there is no charge to the debtor, or the pooling or
liquidation is done pursuant to court order or under the supervision of a creditor's committee;
new text end
new text begin
(9) unless an exemption in the law exists, violate Code of Federal Regulations, title 12,
part 1006, while attempting to collect on any account, bill, or other indebtedness. For
purposes of this section, Public Law 95-109 and Code of Federal Regulations, title 12, part
1006, apply to collecting parties;
new text end
new text begin
(10) communicate with a debtor by use of an automatic telephone dialing system or an
artificial or prerecorded voice after the debtor expressly informs the collecting party to cease
communication utilizing an automatic telephone dialing system or an artificial or prerecorded
voice. For purposes of this clause, an automatic telephone dialing system or an artificial or
prerecorded voice includes but is not limited to (i) artificial intelligence chat bots, and (ii)
the usage of the term under the Telephone Consumer Protection Act, United States Code,
title 47, section 227(b)(1)(A);
new text end
new text begin
(11) in collection letters or publications, or in any oral or written communication, imply
or suggest that medically necessary health treatment or services will be denied as a result
of a medical debt;
new text end
new text begin
(12) when a debtor has a listed telephone number, enlist the aid of a neighbor or third
party to request that the debtor contact the collecting party, except a person who resides
with the debtor or a third party with whom the debtor has authorized with the collecting
party to place the request. This clause does not apply to a call back message left at the
debtor's place of employment which is limited solely to the collecting party's telephone
number and name;
new text end
new text begin
(13) when attempting to collect a medical debt, fail to provide the debtor with the full
name of the collecting party, as registered with the secretary of state;
new text end
new text begin
(14) fail to return any amount of overpayment from a debtor to the debtor or to the state
of Minnesota pursuant to the requirements of chapter 345;
new text end
new text begin
(15) accept currency or coin as payment for a medical debt without issuing an original
receipt to the debtor and maintaining a duplicate receipt in the debtor's payment records;
new text end
new text begin
(16) attempt to collect any amount, including any interest, fee, charge, or expense
incidental to the charge-off obligation, from a debtor unless the amount is expressly
authorized by the agreement creating the medical debt or is otherwise permitted by law;
new text end
new text begin
(17) falsify any documents with the intent to deceive;
new text end
new text begin
(18) when initially contacting a Minnesota debtor by mail to collect a medical debt, fail
to include a disclosure on the contact notice, in a type size or font which is equal to or larger
than the largest other type of type size or font used in the text of the notice, that includes
and identifies the Office of the Minnesota Attorney General's general telephone number,
and states: "You have the right to hire your own attorney to represent you in this matter.";
new text end
new text begin
(19) commence legal action to collect a medical debt outside the limitations period set
forth in section 541.053;
new text end
new text begin
(20) report to a credit reporting agency any medical debt which the collecting party
knows or should know is or was originally owed to a health care provider, as defined in
section 62J.805, subdivision 2; or
new text end
new text begin
(21) challenge a debtor's claim of exemption to garnishment or levy in a manner that is
baseless, frivolous, or otherwise in bad faith.
new text end
Sec. 37.
new text begin
[332C.03] MEDICAL DEBT CREDIT REPORTING PROHIBITED.
new text end
new text begin
(a) A collecting party is prohibited from reporting medical debt to a consumer reporting
agency.
new text end
new text begin
(b) A consumer reporting agency is prohibited from making a consumer report containing
an item of information that the consumer reporting agency knows or should know concerns:
(1) medical information; or (2) debt arising from: (i) the provision of medical care, treatment,
services, devices, medicines; or (ii) procedures to maintain, diagnose, or treat a person's
physical or mental health.
new text end
new text begin
(c) For purposes of this section, "consumer report," "consumer reporting agency," and
"medical information" have the meanings given them in the Fair Credit Reporting Act,
United States Code, title 15, section 1681a.
new text end
new text begin
(d) This section also applies to collection agencies and debt buyers licensed under Chapter
332.
new text end
Sec. 38.
new text begin
[332C.04] DEFENDING MEDICAL DEBT CASES.
new text end
new text begin
A debtor who successfully defends against a claim for payment of medical debt that is
alleged by a collecting party must be awarded the debtor's costs, including a reasonable
attorney fee as determined by the court, incurred in defending against the collecting party's
claim for debt payment. For the purposes of this section, a resolution mutually agreed upon
by the debtor and collecting party is not a successful defense.
new text end
Sec. 39.
new text begin
[332C.05] ENFORCEMENT.
new text end
new text begin
(a) The attorney general may enforce this chapter under section 8.31.
new text end
new text begin
(b) A collecting party that violates this chapter is strictly liable to the debtor in question
for the sum of:
new text end
new text begin
(1) actual damage sustained by the debtor as a result of the violation;
new text end
new text begin
(2) additional damages as the court may allow, but not exceeding $1,000 per violation;
and
new text end
new text begin
(3) in the case of any successful action to enforce the foregoing, the costs of the action,
together with a reasonable attorney fee as determined by the court.
new text end
new text begin
(c) A collecting party that willfully and maliciously violates this chapter is strictly liable
to the debtor for three times the sums allowable under paragraph (b), clauses (1) and (2).
new text end
new text begin
(d) The dollar amount limit under paragraph (b), clause (2), changes on July 1 of each
even-numbered year in an amount equal to changes made in the Consumer Price Index,
compiled by the United States Bureau of Labor Statistics. The Consumer Price Index for
December 2024 is the reference base index. If the Consumer Price Index is revised, the
percentage of change made under this section must be calculated on the basis of the revised
Consumer Price Index. If a Consumer Price Index revision changes the reference base index,
a revised reference base index must be determined by multiplying the reference base index
that is effective at the time by the rebasing factor furnished by the Bureau of Labor Statistics.
new text end
new text begin
(e) If the Consumer Price Index is superseded, the Consumer Price Index referred to in
this section is the Consumer Price Index represented by the Bureau of Labor Statistics as
most accurately reflecting changes in the prices paid by consumers for consumer goods and
services.
new text end
new text begin
(f) The attorney general must publish the base reference index under paragraph (c) in
the State Register no later than September 1, 2024. The attorney general must calculate and
then publish the revised Consumer Price Index under paragraph (c) in the State Register no
later than September 1 each even-numbered year.
new text end
new text begin
(g) An action brought under this section benefits the public.
new text end
new text begin
(h) A collecting party may not be held liable in any action brought under this section if
the collecting party shows by a preponderance of evidence that the violation:
new text end
new text begin
(1) was not intentional and resulted from a bona fide error made notwithstanding the
maintenance of procedures reasonably adopted to avoid any such error; or
new text end
new text begin
(2) was the result of inaccurate or incorrect information provided to the collecting party
by a health care provider, as defined in section 62J.805, subdivision 2; a health carrier, as
that term is defined in section 62A.011, subdivision 2; or another collecting party currently
or previously engaged in collection of the medical debt in question.
new text end
Sec. 40.
Minnesota Statutes 2022, section 519.05, is amended to read:
519.05 LIABILITY OF deleted text begin HUSBAND AND WIFEdeleted text end new text begin SPOUSESnew text end .
(a) A spouse is not liable to a creditor for any debts of the other spouse. deleted text begin Where husband
and wife are living together, they shall be jointly and severally liable for necessary medical
services that have been furnished to either spouse, including any claims arising under section
246.53, 256B.15, 256D.16, or 261.04, and necessary household articles and supplies furnished
to and used by the family.deleted text end Notwithstanding this paragraph, in a proceeding under chapter
518 the court may apportion such debt between the spouses.
(b) Either spouse may close a credit card account or other unsecured consumer line of
credit on which both spouses are contractually liable, by giving written notice to the creditor.
new text begin
(c) Nothing in this section prevents a claim against an estate.
new text end
Sec. 41. new text begin REQUEST FOR FEDERAL WAIVER.
new text end
new text begin
(a) The commissioner of commerce, in cooperation with the commissioner of human
services and the Board of Directors of MNsure, shall submit a section 1332 waiver pursuant
to United States Code, title 42, section 18052, to the Secretary of Health and Human Services,
to obtain federal approval to implement this act. The commissioner of commerce shall also
seek through the waiver federal approval for the state to:
new text end
new text begin
(1) continue receiving federal Medicaid payments for Medicaid-eligible individuals and
federal basic health program payments for basic health program-eligible MinnesotaCare
individuals; and
new text end
new text begin
(2) receive federal pass-through money equal to the value of premium tax credits and
cost-sharing reductions that MinnesotaCare public option enrollees with household incomes
greater than 200 percent of the federal poverty guidelines would otherwise have received.
new text end
new text begin
(b) The commissioner of commerce is authorized to contract for any analyses,
certification, data, or other information required to complete the section 1332 waiver
application in accordance with Code of Federal Regulations, title 33, part 108; Code of
Federal Regulations, title 155, part 1308; and any other applicable federal law. The
commissioner must cooperate with the federal government to obtain waiver approval under
this section, and may provide any information the commissioner determines to be necessary
and advisable for waiver approval to the Secretary of Health and Human Services and the
Secretary of the Treasury.
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 4
HEALTH INSURANCE
Section 1.
Minnesota Statutes 2022, section 62A.0411, is amended to read:
62A.0411 MATERNITY CARE.
new text begin Subdivision 1. new text end
new text begin Minimum inpatient care. new text end
Every health plan deleted text begin as defined in section 62Q.01,
subdivision 3, that provides maternity benefitsdeleted text end mustdeleted text begin , consistent with other coinsurance,
co-payment, deductible, and related contract terms,deleted text end provide coverage of a minimum of 48
hours of inpatient care following a vaginal delivery and a minimum of 96 hours of inpatient
care following a caesarean section for a mother and her newborn. The health plan shall not
provide any compensation or other nonmedical remuneration to encourage a mother and
newborn to leave inpatient care before the duration minimums specified in this section.
new text begin Subd. 1a. new text end
new text begin Medical facility transfer. new text end
new text begin
(a) If a health care provider acting within the
provider's scope of practice recommends that either the mother or newborn be transferred
to a different medical facility, every health plan must provide the coverage required under
subdivision 1 for the mother, newborn, and newborn siblings at both medical facilities. The
coverage required under this subdivision includes but is not limited to expenses related to
transferring all individuals from one medical facility to a different medical facility.
new text end
new text begin
(b) The coverage required under this subdivision must be provided without cost sharing,
including but not limited to deductible, co-pay, or coinsurance. The coverage required under
this paragraph must be provided without any limitation that is not generally applicable to
other coverages under the plan.
new text end
new text begin
(c) Notwithstanding paragraph (b), a health plan that is a high-deductible health plan in
conjunction with a health savings account must include cost-sharing for the coverage required
under this subdivision at the minimum level necessary to preserve the enrollee's ability to
make tax-exempt contributions and withdrawals from the health savings account as provided
in section 223 of the Internal Revenue Code of 1986.
new text end
new text begin Subd. 2. new text end
new text begin Minimum postdelivery outpatient care. new text end
new text begin (a) new text end The health plan must also provide
coverage for postdelivery new text begin outpatient new text end care to a mother and her newborn if the duration of
inpatient care is less than the minimums provided in this section.
new text begin (b) new text end Postdelivery care consists of a minimum of one home visit by a registered nurse.
Services provided by the registered nurse include, but are not limited to, parent education,
assistance and training in breast and bottle feeding, and conducting any necessary and
appropriate clinical tests. The home visit must be conducted within four days following the
discharge of the mother and her child.
new text begin Subd. 3. new text end
new text begin Health plan defined. new text end
new text begin
For purposes of this section, "health plan" has the meaning
given in section 62Q.01, subdivision 3, and county-based purchasing plans.
new text end
new text begin EFFECTIVE DATE. new text end
new text begin
This section is effective January 1, 2025, and applies to all policies,
plans, certificates, and contracts offered, issued, or renewed on or after that date.
new text end
Sec. 2.
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 benefits provided by a policy or contract referred to in
subdivision 1 relating to expenses incurred for medical treatment or services provided by
a licensed physician must include services provided by a licensed pharmacist, according to
the requirements of section 151.01, to the extent a licensed pharmacist's services are within
the pharmacist's scope of practice.
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. 3.
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. 4.
Minnesota Statutes 2022, section 62A.28, subdivision 2, is amended to read:
Subd. 2.
Required coverage.
new text begin (a) new text end Every policy, plan, certificate, or contract referred to
in subdivision 1 deleted text begin issued or renewed after August 1, 1987,deleted text end must provide coverage for scalp
hair prosthesesnew text begin , including all equipment and accessories necessary for regular use of scalp
hair prostheses,new text end worn for hair loss suffered as a result of new text begin a health condition, including but
not limited tonew text end alopecia areatanew text begin or the treatment for cancer, unless there is a clinical basis for
limitationnew text end .
new text begin (b) new text end The coverage required by this section is subject to the co-payment, coinsurance,
deductible, and other enrollee cost-sharing requirements that apply to similar types of items
under the policy, plan, certificate, or contract and may be limited to one prosthesis per
benefit year.
new text begin
(c) The coverage required by this section for scalp hair prostheses is limited to $1,000
per benefit year.
new text end
new text begin
(d) A scalp hair prosthesis must be prescribed by a doctor to be covered under this
section.
new text end
new text begin EFFECTIVE DATE. new text end
new text begin
This section is effective January 1, 2025, and applies to all policies,
plans, certificates, and contracts offered, issued, or renewed on or after that date.
new text end
Sec. 5.
Minnesota Statutes 2022, section 62D.02, subdivision 4, is amended to read:
Subd. 4.
Health maintenance organization.
"Health maintenance organization" means
a deleted text begin foreign or domesticdeleted text end new text begin nonprofitnew text end corporationnew text begin organized under chapter 317Anew text end , or a local
governmental unit as defined in subdivision 11, controlled and operated as provided in
sections 62D.01 to 62D.30, which provides, either directly or through arrangements with
providers or other persons, comprehensive health maintenance services, or arranges for the
provision of these services, to enrollees on the basis of a fixed prepaid sum without regard
to the frequency or extent of services furnished to any particular enrollee.
Sec. 6.
Minnesota Statutes 2022, section 62D.02, subdivision 7, is amended to read:
Subd. 7.
Comprehensive health maintenance services.
"Comprehensive health
maintenance services" means a set of comprehensive health services which the enrollees
might reasonably require to be maintained in good health including as a minimum, but not
limited to, emergency care, emergency ground ambulance transportation services, inpatient
hospital and physician care, outpatient health services and preventive health services.
deleted text begin Elective, induced abortion, except as medically necessary to prevent the death of the mother,
whether performed in a hospital, other abortion facility or the office of a physician, shall
not be mandatory for any health maintenance organization.
deleted 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, sold, issued, or renewed on or after that date.
new text end
Sec. 7.
Minnesota Statutes 2022, section 62D.03, subdivision 1, is amended to read:
Subdivision 1.
Certificate of authority required.
Notwithstanding any law of this state
to the contrary, any deleted text begin foreign or domesticdeleted text end new text begin nonprofitnew text end corporation organized to do so or a local
governmental unit may apply to the commissioner of health for a certificate of authority to
establish and operate a health maintenance organization in compliance with sections 62D.01
to 62D.30. No person shall establish or operate a health maintenance organization in this
state, nor sell or offer to sell, or solicit offers to purchase or receive advance or periodic
consideration in conjunction with a health maintenance organization or health maintenance
contract unless the organization has a certificate of authority under sections 62D.01 to
62D.30.
Sec. 8.
Minnesota Statutes 2022, section 62D.05, subdivision 1, is amended to read:
Sec. 9.
Minnesota Statutes 2022, section 62D.06, subdivision 1, is amended to read:
Subdivision 1.
Governing body composition; enrollee advisory body.
The governing
body of any health maintenance organization which is a new text begin nonprofit new text end corporation may include
enrollees, providers, or other individuals; provided, however, that after a health maintenance
organization which is a new text begin nonprofit new text end corporation has been authorized under sections 62D.01
to 62D.30 for one year, at least 40 percent of the governing body shall be composed of
enrollees and members elected by the enrollees and members from among the enrollees and
members. For purposes of this section, "member" means a consumer who receives health
care services through a self-insured contract that is administered by the health maintenance
organization or its related third-party administrator. The number of members elected to the
governing body shall not exceed the number of enrollees elected to the governing body. An
enrollee or member elected to the governing board may not be a person:
(1) whose occupation involves, or before retirement involved, the administration of
health activities or the provision of health services;
(2) who is or was employed by a health care facility as a licensed health professional;
or
(3) who has or had a direct substantial financial or managerial interest in the rendering
of a health service, other than the payment of a reasonable expense reimbursement or
compensation as a member of the board of a health maintenance organization.
After a health maintenance organization which is a local governmental unit has been
authorized under sections 62D.01 to 62D.30 for one year, an enrollee advisory body shall
be established. The enrollees who make up this advisory body shall be elected by the enrollees
from among the enrollees.
Sec. 10.
new text begin
[62D.085] TRANSACTION OVERSIGHT.
new text end
new text begin Subdivision 1. new text end
new text begin
Insurance provisions applicable to health maintenance
organizations.
new text end
new text begin
(a) Health maintenance organizations are subject to sections 60A.135,
60A.136, 60A.137, 60A.16, 60A.161, 60D.17, 60D.18, and 60D.20 and must comply with
the provisions of these sections applicable to insurers. For purposes of applying these sections
to health maintenance organizations, "commissioner" means the commissioner of health.
new text end
new text begin
(b) Health maintenance organizations are subject to all regulations implementing sections
60D.17, 60D.18, and 60D.20 in Minnesota Rules, chapter 2720, and must comply with the
provisions of sections 60D.17, 60D.18, and 60D.20 applicable to insurers, unless the
commissioner of health adopts rules to implement this subdivision.
new text end
new text begin Subd. 2. new text end
new text begin Notice on transfers. new text end
new text begin
No person may acquire all or substantially all of the assets
of a domestic nonprofit health maintenance organization through any means unless, at the
time the agreement is entered into, the person has filed with the commissioner and has sent
to the health maintenance organization a statement containing the information required by
section 60D.17, including its implementing regulations, and the agreement and acquisition
have been approved by the commissioner of health in the manner prescribed for regulatory
approval in section 60D.17. The acquisition of assets subject to this subdivision must be
treated as an acquisition of control for purposes of applying section 60D.17 and its
implementing regulations to this subdivision.
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
[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 benefits provided by a health maintenance contract
relating to expenses incurred for medical treatment or services provided by a licensed
physician must include services provided by a licensed pharmacist to the extent a licensed
pharmacist's services are within the pharmacist's scope of practice.
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. 12.
Minnesota Statutes 2022, section 62D.19, is amended to read:
62D.19 UNREASONABLE EXPENSES.
No health maintenance organization shall incur or pay for any expense of any nature
which is unreasonably high in relation to the value of the service or goods provided. The
commissioner of health shall implement and enforce this section by rules adopted under
this section.
In an effort to achieve the stated purposes of sections 62D.01 to 62D.30new text begin , in order to
safeguard the underlying nonprofit status of health maintenance organizations,new text end and new text begin in order
new text end to ensure that the payment of health maintenance organization money to major participating
entities results in a corresponding benefit to the health maintenance organization and its
enrollees, when determining whether an organization has incurred an unreasonable expense
in relation to a major participating entity, due consideration shall be given to, in addition
to any other appropriate factors, whether the officers and trustees of the health maintenance
organization have acted with good faith and in the best interests of the health maintenance
organization in entering into, and performing under, a contract under which the health
maintenance organization has incurred an expense. The commissioner has standing to sue,
on behalf of a health maintenance organization, officers or trustees of the health maintenance
organization who have breached their fiduciary duty in entering into and performing such
contracts.
Sec. 13.
Minnesota Statutes 2022, section 62D.20, subdivision 1, is amended to read:
Subdivision 1.
Rulemaking.
The commissioner of health may, pursuant to chapter 14,
promulgate such reasonable rules as are necessary or proper to carry out the provisions of
sections 62D.01 to 62D.30. Included among such rules shall be those which provide minimum
requirements for the provision of comprehensive health maintenance services, as defined
in section 62D.02, subdivision 7, and reasonable exclusions therefrom. deleted text begin Nothing in such
rules shall force or require a health maintenance organization to provide elective, induced
abortions, except as medically necessary to prevent the death of the mother, whether
performed in a hospital, other abortion facility, or the office of a physician; the rules shall
provide every health maintenance organization the option of excluding or including elective,
induced abortions, except as medically necessary to prevent the death of the mother, as part
of its comprehensive health maintenance services.
deleted 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, sold, issued, or renewed on or after that date.
new text end
Sec. 14.
Minnesota Statutes 2022, section 62D.22, subdivision 5, is amended to read:
Subd. 5.
Other state law.
Except as otherwise provided in sections 62A.01 to 62A.42
and 62D.01 to 62D.30, deleted text begin and except as they eliminate elective, induced abortions, wherever
performed, from health or maternity benefits,deleted text end provisions of the insurance laws and provisions
of nonprofit health service plan corporation laws shall not be applicable to any health
maintenance organization granted a certificate of authority under sections 62D.01 to 62D.30.
new text begin EFFECTIVE DATE. new text end
new text begin
This section is effective January 1, 2025, and applies to health
plans offered, sold, issued, or renewed on or after that date.
new text end
Sec. 15.
Minnesota Statutes 2022, section 62E.02, subdivision 3, is amended to read:
Subd. 3.
Health maintenance organization.
"Health maintenance organization" means
a new text begin nonprofit new text end corporation licensed and operated as provided in chapter 62D.
Sec. 16.
Minnesota Statutes 2022, section 62Q.097, is amended by adding a subdivision
to read:
new text begin Subd. 3. new text end
new text begin Prohibited application questions. new text end
new text begin
An application for provider credentialing
must not:
new text end
new text begin
(1) require the provider to disclose past health conditions;
new text end
new text begin
(2) require the provider to disclose current health conditions, if the provider is being
treated so that the condition does not affect the provider's ability to practice medicine; or
new text end
new text begin
(3) require the disclosure of any health conditions that would not affect the provider's
ability to practice medicine in a competent, safe, and ethical manner.
new text end
new text begin EFFECTIVE DATE. new text end
new text begin
This section applies to applications for provider credentialing
submitted to a health plan company on or after January 1, 2025.
new text end
Sec. 17.
Minnesota Statutes 2022, section 62Q.14, is amended to read:
62Q.14 RESTRICTIONS ON ENROLLEE SERVICES.
No health plan company may restrict the choice of an enrollee as to where the enrollee
receives services related to:
(1) the voluntary planning of the conception and bearing of childrendeleted text begin , provided that this
clause does not refer to abortion servicesdeleted text end ;
(2) the diagnosis of infertility;
(3) the testing and treatment of a sexually transmitted disease; and
(4) the testing for AIDS or other HIV-related conditions.
new text begin EFFECTIVE DATE. new text end
new text begin
This section is effective January 1, 2025, and applies to health
plans offered, sold, issued, or renewed on or after that date.
new text end
Sec. 18.
Minnesota Statutes 2023 Supplement, section 62Q.522, subdivision 1, is amended
to read:
Subdivision 1.
Definitions.
(a) The definitions in this subdivision apply to this section.
deleted text begin
(b) "Closely held for-profit entity" means an entity that:
deleted text end
deleted text begin
(1) is not a nonprofit entity;
deleted text end
deleted 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
deleted text end
deleted text begin
(3) has no publicly traded ownership interest.
deleted text end
deleted text begin
For purposes of this paragraph:
deleted text end
deleted 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;
deleted text end
deleted text begin
(ii) ownership interests owned by a nonprofit entity are considered owned by a single
owner;
deleted text end
deleted 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
deleted text end
deleted 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.
deleted text end
deleted text begin (c)deleted text end new text begin (b)new text end "Contraceptive method" means a drug, device, or other product approved by the
Food and Drug Administration to prevent unintended pregnancy.
deleted text begin (d)deleted text end new text begin (c)new text end "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.
deleted 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:
deleted text end
deleted text begin
(1) organized as a nonprofit entity and holds itself out to be religious; or
deleted text end
deleted 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.
deleted text end
deleted 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.
deleted text end
deleted text begin (g)deleted text end new text begin (d)new text end "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.
deleted text begin (h)deleted text end new text begin (e)new text end "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:
(1) is approved as safe and effective;
(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;
(3) is bioequivalent in that:
(i) the drug, device, or product does not present a known or potential bioequivalence
problem and meets an acceptable in vitro standard; or
(ii) if the drug, device, or product does present a known or potential bioequivalence
problem, it is shown to meet an appropriate bioequivalence standard;
(4) is adequately labeled; and
(5) is manufactured in compliance with current manufacturing practice regulations.
new text begin EFFECTIVE DATE. new text end
new text begin
This section is effective January 1, 2025, and applies to health
plans offered, sold, issued, or renewed on or after that date.
new text end
Sec. 19.
new text begin
[62Q.524] COVERAGE OF ABORTIONS AND ABORTION-RELATED
SERVICES.
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, "abortion" means any medical
treatment intended to induce the termination of a pregnancy with a purpose other than
producing a live birth.
new text end
new text begin Subd. 2. new text end
new text begin Required coverage. new text end
new text begin
(a) A health plan must provide coverage for abortions and
abortion-related services, including preabortion services and follow-up services.
new text end
new text begin
(b) A health plan must not impose on the coverage under this section any co-payment,
coinsurance, deductible, or other enrollee cost-sharing that is greater than the cost-sharing
that applies to similar services covered under the health plan.
new text end
new text begin
(c) A health plan must not impose any limitation on the coverage under this section,
including but not limited to any utilization review, prior authorization, referral requirements,
restrictions, or delays, that is not generally applicable to other coverages under the plan.
new text end
new text begin Subd. 3. new text end
new text begin Exclusion. new text end
new text begin
This section 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 EFFECTIVE DATE. new text end
new text begin
This section is effective January 1, 2025, and applies to health
plans offered, sold, issued, or renewed on or after that date.
new text end
Sec. 20.
new text begin
[62Q.585] GENDER-AFFIRMING CARE COVERAGE; MEDICALLY
NECESSARY CARE.
new text end
new text begin Subdivision 1. new text end
new text begin Requirement. new text end
new text begin
No health plan that covers physical or mental health
services may be offered, sold, issued, or renewed in this state that:
new text end
new text begin
(1) excludes coverage for medically necessary gender-affirming care; or
new text end
new text begin
(2) requires gender-affirming treatments to satisfy a definition of "medically necessary
care," "medical necessity," or any similar term that is more restrictive than the definition
provided in subdivision 2.
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) "Gender-affirming care" means all medical, surgical, counseling, or referral services,
including telehealth services, that an individual may receive to support and affirm the
individual's gender identity or gender expression and that are legal under the laws of this
state.
new text end
new text begin
(c) "Health plan" has the meaning given in section 62Q.01, subdivision 3, but includes
the coverages listed in section 62A.011, subdivision 3, clauses (7) and (10).
new text end
new text begin
(d) "Medically necessary care" means health care services appropriate in terms of type,
frequency, level, setting, and duration to the enrollee's diagnosis or condition and diagnostic
testing and preventive services. Medically necessary care must be consistent with generally
accepted practice parameters as determined by health care providers in the same or similar
general specialty as typically manages the condition, procedure, or treatment at issue and
must:
new text end
new text begin
(1) help restore or maintain the enrollee's health; or
new text end
new text begin
(2) prevent deterioration of the enrollee's condition.
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. 21.
new text begin
[62Q.665] COVERAGE FOR ORTHOTIC AND PROSTHETIC DEVICES.
new text end
new text begin Subdivision 1. new text end
new text begin Definitions. new text end
new text begin
(a) For the purposes of this section, the following terms have
the meanings given.
new text end
new text begin
(b) "Accredited facility" means any entity that is accredited to provide comprehensive
orthotic or prosthetic devices or services by a Centers for Medicare and Medicaid Services
approved accrediting agency.
new text end
new text begin
(c) "Orthosis" means:
new text end
new text begin
(1) an external medical device that is:
new text end
new text begin
(i) custom-fabricated or custom-fitted to a specific patient based on the patient's unique
physical condition;
new text end
new text begin
(ii) applied to a part of the body to correct a deformity, provide support and protection,
restrict motion, improve function, or relieve symptoms of a disease, syndrome, injury, or
postoperative condition; and
new text end
new text begin
(iii) deemed medically necessary by a prescribing physician or licensed health care
provider who has authority in Minnesota to prescribe orthotic and prosthetic devices, supplies,
and services; and
new text end
new text begin
(2) any provision, repair, or replacement of a device that is furnished or performed by:
new text end
new text begin
(i) an accredited facility in comprehensive orthotic services; or
new text end
new text begin
(ii) a health care provider licensed in Minnesota and operating within the provider's
scope of practice which allows the provider to provide orthotic or prosthetic devices, supplies,
or services.
new text end
new text begin
(d) "Orthotics" means:
new text end
new text begin
(1) the science and practice of evaluating, measuring, designing, fabricating, assembling,
fitting, adjusting, or servicing and providing the initial training necessary to accomplish the
fitting of an orthotic device for the support, correction, or alleviation of a neuromuscular
or musculoskeletal dysfunction, disease, injury, or deformity;
new text end
new text begin
(2) evaluation, treatment, and consultation related to an orthotic device;
new text end
new text begin
(3) basic observation of gait and postural analysis;
new text end
new text begin
(4) assessing and designing orthosis to maximize function and provide support and
alignment necessary to prevent or correct a deformity or to improve the safety and efficiency
of mobility and locomotion;
new text end
new text begin
(5) continuing patient care to assess the effect of an orthotic device on the patient's
tissues; and
new text end
new text begin
(6) proper fit and function of the orthotic device by periodic evaluation.
new text end
new text begin
(e) "Prosthesis" means:
new text end
new text begin
(1) an external medical device that is:
new text end
new text begin
(i) used to replace or restore a missing limb, appendage, or other external human body
part; and
new text end
new text begin
(ii) deemed medically necessary by a prescribing physician or licensed health care
provider who has authority in Minnesota to prescribe orthotic and prosthetic devices, supplies,
and services; and
new text end
new text begin
(2) any provision, repair, or replacement of a device that is furnished or performed by:
new text end
new text begin
(i) an accredited facility in comprehensive prosthetic services; or
new text end
new text begin
(ii) a health care provider licensed in Minnesota and operating within the provider's
scope of practice which allows the provider to provide orthotic or prosthetic devices, supplies,
or services.
new text end
new text begin
(f) "Prosthetics" means:
new text end
new text begin
(1) the science and practice of evaluating, measuring, designing, fabricating, assembling,
fitting, aligning, adjusting, or servicing, as well as providing the initial training necessary
to accomplish the fitting of, a prosthesis through the replacement of external parts of a
human body lost due to amputation or congenital deformities or absences;
new text end
new text begin
(2) the generation of an image, form, or mold that replicates the patient's body segment
and that requires rectification of dimensions, contours, and volumes for use in the design
and fabrication of a socket to accept a residual anatomic limb to, in turn, create an artificial
appendage that is designed either to support body weight or to improve or restore function
or anatomical appearance, or both;
new text end
new text begin
(3) observational gait analysis and clinical assessment of the requirements necessary to
refine and mechanically fix the relative position of various parts of the prosthesis to maximize
function, stability, and safety of the patient;
new text end
new text begin
(4) providing and continuing patient care in order to assess the prosthetic device's effect
on the patient's tissues; and
new text end
new text begin
(5) assuring proper fit and function of the prosthetic device by periodic evaluation.
new text end
new text begin Subd. 2. new text end
new text begin Coverage. new text end
new text begin
(a) A health plan must provide coverage for orthotic and prosthetic
devices, supplies, and services, including repair and replacement, at least equal to the
coverage provided under federal law for health insurance for the aged and disabled under
sections 1832, 1833, and 1834 of the Social Security Act, United States Code, title 42,
sections 1395k, 1395l, and 1395m, but only to the extent consistent with this section.
new text end
new text begin
(b) A health plan must not subject orthotic and prosthetic benefits to separate financial
requirements that apply only with respect to those benefits. A health plan may impose
co-payment and coinsurance amounts on those benefits, except that any financial
requirements that apply to such benefits must not be more restrictive than the financial
requirements that apply to the health plan's medical and surgical benefits, including those
for internal restorative devices.
new text end
new text begin
(c) A health plan may limit the benefits for, or alter the financial requirements for,
out-of-network coverage of prosthetic and orthotic devices, except that the restrictions and
requirements that apply to those benefits must not be more restrictive than the financial
requirements that apply to the out-of-network coverage for the health plan's medical and
surgical benefits.
new text end
new text begin
(d) A health plan must cover orthoses and prostheses when furnished under an order by
a prescribing physician or licensed health care prescriber who has authority in Minnesota
to prescribe orthoses and prostheses, and that coverage for orthotic and prosthetic devices,
supplies, accessories, and services must include those devices or device systems, supplies,
accessories, and services that are customized to the covered individual's needs.
new text end
new text begin
(e) A health plan must cover orthoses and prostheses determined by the enrollee's provider
to be the most appropriate model that meets the medical needs of the enrollee for purposes
of performing physical activities, as applicable, including but not limited to running, biking,
and swimming, and maximizing the enrollee's limb function.
new text end
new text begin
(f) A health plan must cover orthoses and prostheses for showering or bathing.
new text end
new text begin Subd. 3. new text end
new text begin Prior authorization. new text end
new text begin
A health plan may require prior authorization for orthotic
and prosthetic devices, supplies, and services in the same manner and to the same extent as
prior authorization is required for any other covered benefit.
new text end
new text begin EFFECTIVE DATE. new text end
new text begin
This section is effective January 1, 2025, and applies to all health
plans offered, issued, or renewed on or after that date.
new text end
Sec. 22.
new text begin
[62Q.6651] MEDICAL NECESSITY AND NONDISCRIMINATION
STANDARDS FOR COVERAGE OF PROSTHETICS OR ORTHOTICS.
new text end
new text begin
(a) When performing a utilization review for a request for coverage of prosthetic or
orthotic benefits, a health plan company shall apply the most recent version of evidence-based
treatment and fit criteria as recognized by relevant clinical specialists.
new text end
new text begin
(b) A health plan company shall render utilization review determinations in a
nondiscriminatory manner and shall not deny coverage for habilitative or rehabilitative
benefits, including prosthetics or orthotics, solely on the basis of an enrollee's actual or
perceived disability.
new text end
new text begin
(c) A health plan company shall not deny a prosthetic or orthotic benefit for an individual
with limb loss or absence that would otherwise be covered for a nondisabled person seeking
medical or surgical intervention to restore or maintain the ability to perform the same
physical activity.
new text end
new text begin
(d) A health plan offered, issued, or renewed in Minnesota that offers coverage for
prosthetics and custom orthotic devices shall include language describing an enrollee's rights
pursuant to paragraphs (b) and (c) in its evidence of coverage and any benefit denial letters.
new text end
new text begin
(e) A health plan that provides coverage for prosthetic or orthotic services shall ensure
access to medically necessary clinical care and to prosthetic and custom orthotic devices
and technology from not less than two distinct prosthetic and custom orthotic providers in
the plan's provider network located in Minnesota. In the event that medically necessary
covered orthotics and prosthetics are not available from an in-network provider, the health
plan company shall provide processes to refer a member to an out-of-network provider and
shall fully reimburse the out-of-network provider at a mutually agreed upon rate less member
cost sharing determined on an in-network basis.
new text end
new text begin
(f) If coverage for prosthetic or custom orthotic devices is provided, payment shall be
made for the replacement of a prosthetic or custom orthotic device or for the replacement
of any part of the devices, without regard to continuous use or useful lifetime restrictions,
if an ordering health care provider determines that the provision of a replacement device,
or a replacement part of a device, is necessary because:
new text end
new text begin
(1) of a change in the physiological condition of the patient;
new text end
new text begin
(2) of an irreparable change in the condition of the device or in a part of the device; or
new text end
new text begin
(3) the condition of the device, or the part of the device, requires repairs and the cost of
the repairs would be more than 60 percent of the cost of a replacement device or of the part
being replaced.
new text end
new text begin
(g) Confirmation from a prescribing health care provider may be required if the prosthetic
or custom orthotic device or part being replaced is less than three years old.
new text end
new text begin EFFECTIVE DATE. new text end
new text begin
This section is effective January 1, 2025, and applies to all health
plans offered, issued, or renewed on or after that date.
new text end
Sec. 23.
new text begin
[62Q.666] INTERMITTENT CATHETERS.
new text end
new text begin Subdivision 1. new text end
new text begin Required coverage. new text end
new text begin
A health plan must provide coverage for intermittent
urinary catheters and insertion supplies if intermittent catheterization is recommended by
the enrollee's health care provider. At least 180 intermittent catheters per month with insertion
supplies must be covered unless a lesser amount is prescribed by the enrollee's health care
provider. A health plan providing coverage under the medical assistance program may be
required to provide coverage for more than 180 intermittent catheters per month with
insertion supplies.
new text end
new text begin Subd. 2. new text end
new text begin Cost-sharing requirements. new text end
new text begin
A health plan is prohibited from imposing a
deductible, co-payment, coinsurance, or other restriction on intermittent catheters and
insertion supplies that the health plan does not apply to durable medical equipment in general.
new text end
new text begin EFFECTIVE DATE. new text end
new text begin
This section is effective for any health plan issued or renewed
on or after January 1, 2025.
new text end
Sec. 24.
new text begin
[62Q.679] RELIGIONS OBJECTIONS.
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 is not a nonprofit entity, has
more than 50 percent of the value of its ownership interest owned directly or indirectly by
five or fewer owners, and has no publicly traded ownership interest. For purposes of this
paragraph:
new text end
new text begin
(1) 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
(2) ownership interests owned by a nonprofit entity are considered owned by a single
owner;
new text end
new text begin
(3) 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
(4) 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) "Eligible organization" means an organization that opposes providing coverage under
section 62Q.522, 62Q.524, or 62Q.585 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 health benefits under section 62Q.522, 62Q.524,
or 62Q.585 on account of the owners' sincerely held religious beliefs.
new text end
new text begin
(d) "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 Subd. 2. new text end
new text begin Exemption. new text end
new text begin
(a) An exempt organization is not required to provide coverage
under section 62Q.522, 62Q.524, or 62Q.585 if the exempt organization has religious
objections to the coverage. An exempt organization that chooses to not provide coverage
pursuant to this paragraph 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 partial coverage under section 62Q.522, 62Q.524,
or 62Q.585, the notice required under paragraph (a) must provide a list of the portions of
the coverage that the organization refuses to cover.
new text end
new text begin Subd. 3. 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 coverage requirements of sections
62Q.522, 62Q.524, and 62Q.585, with respect to the health benefits 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 the health benefits
under sections 62Q.522, 62Q.524, and 62Q.585.
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 the eligible
organization objects to coverage for some or all of the health benefits under sections 62Q.522,
62Q.524, and 62Q.585, including a list of the health benefits 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 health benefits identified in the notice under
paragraph (a) from the health plan; and
new text end
new text begin
(2) provide separate payments for any health benefits required to be covered under
sections 62Q.522, 62Q.524, and 62Q.585 for an enrollee 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 the health benefits under section 62Q.522 on the enrollee. The health plan
company must not directly or indirectly impose any premium, fee, or other charge for the
health benefits under section 62Q.522, 62Q.524, or 62Q.585 on the eligible organization
or health plan.
new text end
new text begin
(f) On January 1, 2025, 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, 2025, and applies to health
plans offered, sold, issued, or renewed on or after that date.
new text end
Sec. 25.
new text begin
[214.41] PHYSICIAN WELLNESS PROGRAM.
new text end
new text begin Subdivision 1. new text end
new text begin Definition. new text end
new text begin
For the purposes of this section, "physician wellness program"
means a program of evaluation, counseling, or other modality to address an issue related to
career fatigue or wellness related to work stress for physicians licensed under chapter 147
that is administered by a statewide association that is exempt from taxation under United
States Code, title 26, section 501(c)(6), and that primarily represents physicians and
osteopaths of multiple specialties. Physician wellness program does not include the provision
of services intended to monitor for impairment under the authority of section 214.31.
new text end
new text begin Subd. 2. new text end
new text begin Confidentiality. new text end
new text begin
Any record of a person's participation in a physician wellness
program is confidential and not subject to discovery, subpoena, or a reporting requirement
to the applicable board, unless the person voluntarily provides for written release of the
information or the disclosure is required to meet the licensee's obligation to report according
to section 147.111.
new text end
new text begin Subd. 3. new text end
new text begin Civil liability. new text end
new text begin
Any person, agency, institution, facility, or organization employed
by, contracting with, or operating a physician wellness program is immune from civil liability
for any action related to their duties in connection with a physician wellness program when
acting in good faith.
new text end
Sec. 26.
Minnesota Statutes 2023 Supplement, section 256B.0625, subdivision 3a, is
amended to read:
Subd. 3a.
Gender-affirming services.
Medical assistance covers gender-affirming
deleted text begin servicesdeleted text end new text begin care, as defined in section 62Q.585new text end .
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 256B.0625, subdivision 12, is amended to read:
Subd. 12.
Eyeglassesdeleted text begin ,deleted text end new text begin andnew text end denturesdeleted text begin , and prosthetic and orthotic devicesdeleted text end .
deleted text begin (a)deleted text end Medical
assistance covers eyeglassesdeleted text begin ,deleted text end new text begin andnew text end denturesdeleted text begin , and prosthetic and orthotic devicesdeleted text end if prescribed
by a licensed practitioner.
deleted text begin
(b) For purposes of prescribing prosthetic and orthotic devices, "licensed practitioner"
includes a physician, an advanced practice registered nurse, a physician assistant, or a
podiatrist.
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. 28.
Minnesota Statutes 2023 Supplement, section 256B.0625, subdivision 16, is
amended to read:
Subd. 16.
Abortion services.
Medical assistance covers deleted text begin abortion services determined
to be medically necessary by the treating provider and delivered in accordance with all
applicable Minnesota lawsdeleted text end new text begin abortions and abortion-related services, including preabortion
services and follow-up servicesnew 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. 29.
Minnesota Statutes 2022, section 256B.0625, is amended by adding a subdivision
to read:
new text begin Subd. 72. new text end
new text begin Orthotic and prosthetic devices. new text end
new text begin
Medical assistance covers orthotic and
prosthetic devices, supplies, and services according to section 256B.066.
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. 30.
Minnesota Statutes 2022, section 256B.0625, is amended by adding a subdivision
to read:
new text begin Subd. 73. new text end
new text begin Scalp hair prostheses. new text end
new text begin
Medical assistance covers scalp hair prostheses
prescribed for hair loss suffered as a result of treatment for cancer. Medical assistance must
meet the requirements that would otherwise apply to a health plan under section 62A.28,
except for the limitation on coverage required per benefit year set forth in section 62A.28,
subdivision 2, paragraph (c).
new text end
new text begin EFFECTIVE DATE. new text end
new text begin
This section is effective January 1, 2025, and applies to all policies,
plans, certificates, and contracts offered, issued, or renewed on or after that date.
new text end
Sec. 31.
Minnesota Statutes 2022, section 256B.0625, is amended by adding a subdivision
to read:
new text begin Subd. 74. new text end
new text begin Intermittent catheters. new text end
new text begin
Medical assistance covers intermittent urinary catheters
and insertion supplies if intermittent catheterization is recommended by the enrollee's health
care provider. Medical assistance must meet the requirements that would otherwise apply
to a health plan under section 62Q.665.
new text end
Sec. 32.
new text begin
[256B.066] ORTHOTIC AND PROSTHETIC DEVICES, SUPPLIES, AND
SERVICES.
new text end
new text begin Subdivision 1. new text end
new text begin Definitions. new text end
new text begin
All terms used in this section have the meanings given them
in section 62Q.665, subdivision 1.
new text end
new text begin Subd. 2. new text end
new text begin Coverage requirements. new text end
new text begin
(a) Medical assistance covers orthotic and prosthetic
devices, supplies, and services:
new text end
new text begin
(1) furnished under an order by a prescribing physician or licensed health care prescriber
who has authority in Minnesota to prescribe orthoses and prostheses. Coverage for orthotic
and prosthetic devices, supplies, accessories, and services under this clause includes those
devices or device systems, supplies, accessories, and services that are customized to the
enrollee's needs;
new text end
new text begin
(2) determined by the enrollee's provider to be the most appropriate model that meets
the medical needs of the enrollee for purposes of performing physical activities, as applicable,
including but not limited to running, biking, and swimming, and maximizing the enrollee's
limb function; or
new text end
new text begin
(3) for showering or bathing.
new text end
new text begin
(b) The coverage set forth in paragraph (a) includes the repair and replacement of those
orthotic and prosthetic devices, supplies, and services described therein.
new text end
new text begin
(c) Coverage of a prosthetic or orthotic benefit must not be denied for an individual with
limb loss or absence that would otherwise be covered for a nondisabled person seeking
medical or surgical intervention to restore or maintain the ability to perform the same
physical activity.
new text end
new text begin
(d) If coverage for prosthetic or custom orthotic devices is provided, payment must be
made for the replacement of a prosthetic or custom orthotic device or for the replacement
of any part of the devices, without regard to useful lifetime restrictions, if an ordering health
care provider determines that the provision of a replacement device, or a replacement part
of a device, is necessary because:
new text end
new text begin
(1) of a change in the physiological condition of the enrollee;
new text end
new text begin
(2) of an irreparable change in the condition of the device or in a part of the device; or
new text end
new text begin
(3) the condition of the device, or the part of the device, requires repairs and the cost of
the repairs would be more than 60 percent of the cost of a replacement device or of the part
being replaced.
new text end
new text begin Subd. 3. new text end
new text begin Restrictions on coverage. new text end
new text begin
(a) Prior authorization may be required for orthotic
and prosthetic devices, supplies, and services.
new text end
new text begin
(b) A utilization review for a request for coverage of prosthetic or orthotic benefits must
apply the most recent version of evidence-based treatment and fit criteria as recognized by
relevant clinical specialists.
new text end
new text begin
(c) Utilization review determinations must be rendered in a nondiscriminatory manner
and shall not deny coverage for habilitative or rehabilitative benefits, including prosthetics
or orthotics, solely on the basis of an enrollee's actual or perceived disability.
new text end
new text begin
(d) Evidence of coverage and any benefit denial letters must include language describing
an enrollee's rights pursuant to paragraphs (b) and (c).
new text end
new text begin
(e) Confirmation from a prescribing health care provider may be required if the prosthetic
or custom orthotic device or part being replaced is less than three years old.
new text end
new text begin Subd. 4. new text end
new text begin Managed care plan access to care. new text end
new text begin
(a) Managed care plans and county-based
purchasing plans subject to this section must ensure access to medically necessary clinical
care and to prosthetic and custom orthotic devices and technology from at least two distinct
prosthetic and custom orthotic providers in the plan's provider network located in Minnesota.
new text end
new text begin
(b) In the event that medically necessary covered orthotics and prosthetics are not
available from an in-network provider, the plan must provide processes to refer an enrollee
to an out-of-network provider and must fully reimburse the out-of-network provider at a
mutually agreed upon rate less enrollee cost sharing determined on an in-network basis.
new text end
new text begin EFFECTIVE DATE. new text end
new text begin
This section is effective January 1, 2025.
new text end
Sec. 33.
Minnesota Statutes 2022, section 317A.811, subdivision 1, is amended to read:
Subdivision 1.
When required.
(a) Except as provided in subdivision 6, the following
corporations shall notify the attorney general of their intent to dissolve, merge, consolidate,
or convert, or to transfer all or substantially all of their assets:
(1) a corporation that holds assets for a charitable purpose as defined in section 501B.35,
subdivision 2; or
(2) a corporation that is exempt under section 501(c)(3) of the Internal Revenue Code
of 1986, or any successor section.
new text begin
(b) Except as provided in subdivision 6, the following corporations shall notify the
attorney general of their intent to dissolve, merge, consolidate, convert, or transfer at least
ten percent of their assets:
new text end
new text begin
(1) a corporation that is a nonprofit health service plan corporation operating under
chapter 62C; or
new text end
new text begin
(2) a corporation that is a health maintenance organization operating under chapter 62D.
new text end
deleted text begin (b)deleted text end new text begin (c)new text end The notice must include:
(1) the purpose of the corporation that is giving the notice;
(2) a list of assets owned or held by the corporation for charitable purposes;
(3) a description of restricted assets and purposes for which the assets were received;
(4) a description of debts, obligations, and liabilities of the corporation;
(5) a description of tangible assets being converted to cash and the manner in which
they will be sold;
(6) anticipated expenses of the transaction, including attorney fees;
(7) a list of persons to whom assets will be transferred, if known, or the name of the
converted organization;
(8) the purposes of persons receiving the assets or of the converted organization; and
(9) the terms, conditions, or restrictions, if any, to be imposed on the transferred or
converted assets.
The notice must be signed on behalf of the corporation by an authorized person.
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 317A.811, subdivision 2, is amended to read:
Subd. 2.
Restriction on transfers.
new text begin (a) new text end Subject to subdivision 3, a corporation described
in subdivision 1new text begin , paragraph (a),new text end may not transfer or convey assets as part of a dissolution,
merger, consolidation, or transfer of assets under section 317A.661, and it may not convert
until 45 days after it has given written notice to the attorney general, unless the attorney
general waives all or part of the waiting period.
new text begin
(b) Subject to subdivision 3, a corporation described in subdivision 1, paragraph (b),
may not transfer or convey assets as part of a dissolution, merger, consolidation, transfer
of assets under section 317A.661, or transfer of at least ten percent of its assets and it may
not convert until 45 days after it has given written notice to the attorney general, unless the
attorney general waives all or part of the waiting period.
new text end
new text begin
(c) For a notice given by a corporation described in subdivision 1, paragraph (b), the
attorney general may hold a public hearing with respect to the purpose for which the
corporation gave the notice. If the attorney general elects to hold a public hearing, the
attorney general must give at least seven days' notice of the hearing to the corporation filing
the statement and to the public.
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. 35.
Minnesota Statutes 2022, section 317A.811, subdivision 4, is amended to read:
Subd. 4.
Notice after transfer.
When all or substantially all of the assets of a corporation
described in subdivision 1new text begin , paragraph (a), or at least ten percent of the assets of a corporation
described in subdivision 1, paragraph (b),new text end have been transferred or conveyed following
expiration or waiver of the waiting period, the board shall deliver to the attorney general a
list of persons to whom the assets were transferred or conveyed. The list must include the
addresses of each person who received assets and show what assets the person received.
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 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 sections 21 to 23.
new text end
Sec. 37. new text begin TRANSITION.
new text end
new text begin
(a) A health maintenance organization that has a certificate of authority under Minnesota
Statutes, chapter 62D, but that is not a nonprofit corporation organized under Minnesota
Statutes, chapter 317A, or a local governmental unit, as defined in Minnesota Statutes,
section 62D.02, subdivision 11:
new text end
new text begin
(1) must not offer, sell, issue, or renew any health maintenance contracts on or after
August 1, 2024;
new text end
new text begin
(2) may otherwise continue to operate as a health maintenance organization until
December 31, 2025; and
new text end
new text begin
(3) must provide notice to the health maintenance organization's enrollees as of August
1, 2024, of the date the health maintenance organization will cease to operate in this state
and any plans to transition enrollee coverage to another insurer. This notice must be provided
by October 1, 2024.
new text end
new text begin
(b) The commissioner of health must not issue or renew a certificate of authority to
operate as a health maintenance organization on or after August 1, 2024, unless the entity
seeking the certificate of authority meets the requirements for a health maintenance
organization under Minnesota Statutes, chapter 62D, in effect on or after August 1, 2024.
new text end
Sec. 38. new text begin REPEALER.
new text end
new text begin
(a)
new text end
new text begin
Minnesota Statutes 2022, section 62A.041, subdivision 3,
new text end
new text begin
is repealed.
new text end
new text begin
(b)
new text end
new text begin
Minnesota Statutes 2023 Supplement, section 62Q.522, subdivisions 3 and 4,
new text end
new text begin
are
repealed.
new text end
new text begin EFFECTIVE DATE. new text end
new text begin
This section is effective January 1, 2025, and applies to health
plans offered, sold, issued, or renewed on or after that date.
new text end
ARTICLE 5
DEPARTMENT OF HEALTH
Section 1.
Minnesota Statutes 2022, section 103I.621, subdivision 1, is amended to read:
Subdivision 1.
Permit.
(a) Notwithstanding any department or agency rule to the contrary,
the commissioner shall issue, on request by the owner of the property and payment of the
permit fee, permits for the reinjection of water by a properly constructed well into the same
aquifer from which the water was drawn for the operation of a groundwater thermal exchange
device.
(b) As a condition of the permit, an applicant must agree to allow inspection by the
commissioner during regular working hours for department inspectors.
(c) Not more than 200 permits may be issued for small systems having maximum
capacities of 20 gallons per minute or lessnew text begin and that are compliant with the natural resource
water-use requirements under subdivision 2new text end . deleted text begin The small systems are subject to inspection
twice a year.
deleted text end
(d) Not more than deleted text begin tendeleted text end new text begin 100new text end permits may be issued for larger systems having maximum
capacities deleted text begin fromdeleted text end new text begin overnew text end 20 deleted text begin to 50deleted text end gallons per minutenew text begin and that are compliant with the natural
resource water-use requirements under subdivision 2new text end . deleted text begin The larger systems are subject to
inspection four times a year.
deleted text end
(e) A person issued a permit must comply with this section deleted text begin for the permit to be valid.deleted text end new text begin
and permit conditions deemed necessary to protect public health and safety of the
groundwater, which conditions may include but are not limited to:
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) system operation and maintenance;
new text end
new text begin
(3) system location and construction;
new text end
new text begin
(4) well location and construction;
new text end
new text begin
(5) signage requirements;
new text end
new text begin
(6) reports of system construction, performance, operation, and maintenance;
new text end
new text begin
(7) removal of the system upon termination of use or failure;
new text end
new text begin
(8) disclosure of the system at the time of property transfer;
new text end
new text begin
(9) requirements to obtain approval from the commissioner prior to deviation from the
approval plan and conditions;
new text end
new text begin
(10) groundwater level monitoring; and
new text end
new text begin
(11) groundwater quality monitoring.
new text end
new text begin
(f) 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, that provides any information necessary to protect public health and
safety of the groundwater.
new text end
new text begin
(g) A permit granted under this section is not valid if a water-use permit is required for
the project and is not approved by the commissioner of natural resources.
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. 2.
Minnesota Statutes 2022, section 103I.621, subdivision 2, is amended to read:
Subd. 2.
Water-use requirements apply.
Water-use permit requirements and penalties
under chapter deleted text begin 103Fdeleted text end new text begin 103Gnew text end and related rules adopted and enforced by the commissioner of
natural resources apply to groundwater thermal exchange permit recipients. A person who
violates a provision of this section is subject to enforcement or penalties for the noncomplying
activity that are available to the commissioner and the Pollution Control Agency.
new text begin EFFECTIVE DATE. new text end
new text begin
This section is effective the day following final enactment.
new text end
Sec. 3.
Minnesota Statutes 2023 Supplement, 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.
deleted text begin
(h) "Hospital nurse" means an individual who is licensed as a registered nurse and who
is providing direct patient care in a nonprofit hospital setting.
deleted text end
deleted text begin (i)deleted text end new text begin (h)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 (j)deleted text end new text begin (i)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 (k)deleted text end new text begin (j)new text end "Midlevel practitioner" means a nurse practitioner, nurse-midwife, nurse
anesthetist, advanced clinical nurse specialist, or physician assistant.
deleted text begin (l)deleted text end new text begin (k)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 (m)deleted text end new text begin (l)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 (n)deleted text end new text begin (m)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 (o)deleted text end new text begin (n)new text end "Pharmacist" means an individual with a valid license issued under chapter 151.
deleted text begin (p)deleted text end new text begin (o)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 (q)deleted text end new text begin (p)new text end "Physician assistant" means a person licensed under chapter 147A.
deleted text begin (r)deleted text end new text begin (q)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 (s)deleted text end new text begin (r)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 (t)deleted text end new text begin (s)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. 4.
Minnesota Statutes 2023 Supplement, section 144.1501, subdivision 2, is amended
to read:
Subd. 2.
deleted text begin Creation of accountdeleted text end new text begin Availabilitynew text end .
(a) deleted text begin A health professional education loan
forgiveness program account is established.deleted text end The commissioner of health shall use money
deleted text begin from the account to establish adeleted text end new text begin appropriated for health professional educationnew text end loan forgiveness
deleted text begin programdeleted text end new text begin in this sectionnew text end :
(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; in an intermediate
care facility for persons with developmental disability; in 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; in an assisted living facility as defined in section
144G.08, subdivision 7; 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;
(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; and
(7) for nurses employed as a hospital nurse by a nonprofit hospital and providing direct
care to patients at the nonprofit hospital.
(b) Appropriations made deleted text begin to the accountdeleted text end new text begin for health professional education loan forgiveness
in this sectionnew text end 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. 5.
Minnesota Statutes 2023 Supplement, 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; in an intermediate
care facility for persons with developmental disability; in 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; in an assisted living facility as defined in section
144G.08, subdivision 7; 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;new text begin and
new 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 303deleted text begin ; anddeleted text end new text begin .
new text end
deleted text begin
(7) for nurses employed as a hospital nurse by a nonprofit hospital and providing direct
care to patients at the nonprofit hospital.
deleted 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. 6.
Minnesota Statutes 2023 Supplement, 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. deleted text begin A nurse applying under
subdivision 2, paragraph (a), clause (7), must also include proof that the applicant is employed
as a hospital nurse.
deleted 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 of:
(1) 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;new text begin and
new text end
deleted text begin
(2) a nurse selected under subdivision 2, paragraph (a), clause (7), who must agree to
continue as a hospital nurse for a minimum two-year service obligation; and
deleted text end
deleted text begin (3)deleted text end new text begin (2)new text end a nurse who agrees to teach according to subdivision 2, paragraph (a), clause (3),
who must sign a contract to agree to teach for a minimum of two years.
Sec. 7.
Minnesota Statutes 2023 Supplement, section 144.1501, subdivision 4, is amended
to read:
Subd. 4.
Loan forgiveness.
(a) 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 2deleted text begin , except for hospital nursesdeleted 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. Except as specified in paragraph deleted text begin (c)deleted text end new text begin (b)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.
deleted 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. 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 designated loans.
deleted text end
deleted text begin (c)deleted text end new text begin (b)new text end 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.
Sec. 8.
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 3, 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 deleted text begin the health care access fund to be credited
todeleted text end new text begin a dedicated account in the special revenue fund. The balance of the account is appropriated
annually to the commissioner fornew text end the health professional education loan forgiveness program
deleted text begin accountdeleted text end 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 commitment.
Sec. 9.
new text begin
[144.1512] HOSPITAL NURSING EDUCATIONAL LOAN FORGIVENESS
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 definitions
apply.
new text end
new text begin
(b) "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.
new text end
new text begin
(c) "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
(d) "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.
new text end
new text begin Subd. 2. new text end
new text begin Creation of account. new text end
new text begin
(a) A hospital nursing education loan forgiveness program
account is established in the special revenue fund. The commissioner of health shall use
money from the account to establish a loan forgiveness program for licensed registered
nurses employed as hospital nurses by a nonprofit hospital and who provide direct care to
patients at the nonprofit hospital.
new text end
new text begin
(b) Money transferred to or deposited in the account does not cancel and is available
until expended. The balance of the account is appropriated annually to the commissioner
for the hospital nursing educational loan forgiveness program.
new text end
new text begin Subd. 3. new text end
new text begin Eligibility. new text end
new text begin
(a) To be eligible to participate in the hospital nursing educational
loan forgiveness program, an individual must: (1) be a hospital nurse who has been employed
as a hospital nurse for at least three years; (2) submit an application to the commissioner of
health; and (3) submit proof that the applicant is employed as a hospital nurse and has been
so employed for at least three years.
new text end
new text begin
(b) The commissioner must accept a signed work verification form from the applicant's
supervisor as proof of the applicant's tenure providing direct patient care in a nonprofit
hospital setting.
new text end
new text begin
(c) An applicant selected to participate in the loan forgiveness program must sign a
contract to agree to continue as a hospital nurse for a minimum two-year service obligation.
new text end
new text begin Subd. 4. new text end
new text begin Loan forgiveness. new text end
new text begin
(a) Within the limits of available funding, the commissioner
of health shall select applicants each year for participation in the loan forgiveness program.
If the total requests from eligible applicants exceeds the available funding, the commissioner
shall randomly select grantees from among eligible applicants.
new text end
new text begin
(b) Applicants are responsible for securing their own qualified educational loans.
new text end
new text begin
(c) 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.
new text end
new text begin
(d) 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.
new text end
new text begin
(e) Participants who move their practice remain eligible for loan repayment as long as
they practice as required under subdivisions 2 and 3.
new text end
new text begin Subd. 5. new text end
new text begin Penalty for nonfulfillment. new text end
new text begin
(a) If a participant does not fulfill the required
minimum commitment of service according to subdivision 3, the commissioner of health
shall collect from the participant the total amount paid to the participant under the loan
forgiveness program. The commissioner shall deposit the money collected from the
participant in the special revenue fund to be credited to the hospital nursing education loan
forgiveness program account established in subdivision 2.
new text end
new text begin
(b) The commissioner shall allow waivers of all or part of the money owed to the
commissioner as a result of a nonfulfillment penalty if the participant is unable to fulfill the
minimum service commitment due to emergency circumstances, life changes outside the
applicant's control, inability to obtain required hours as a result of a scheduling decision by
the hospital, or other circumstances as determined by the commissioner.
new text end
new text begin Subd. 6. new text end
new text begin Rules. new text end
new text begin
The commissioner may adopt rules to implement this section.
new text end
Sec. 10.
Minnesota Statutes 2022, section 144.555, subdivision 1a, is amended to read:
Subd. 1a.
Notice of closing, curtailing operations, relocating services, or ceasing to
offer certain services; hospitals.
(a) The controlling persons of a hospital licensed under
sections 144.50 to 144.56 or a hospital campus must notify the commissioner of health deleted text begin anddeleted text end new text begin ,new text end
the publicnew text begin , and othersnew text end at least deleted text begin 120deleted text end new text begin 182new text end days before the hospital or hospital campus voluntarily
plans to implement one of the deleted text begin followingdeleted text end scheduled actionsnew text begin listed in paragraph (b), unless
the controlling persons can demonstrate to the commissioner that meeting the advanced
notice requirement is not feasible and the commissioner approves a shorter advanced notice.
new text end
new text begin (b) The following scheduled actions require advanced notice under paragraph (a)new text end :
(1) deleted text begin ceasedeleted text end new text begin ceasingnew text end operations;
(2) deleted text begin curtaildeleted text end new text begin curtailingnew text end operations to the extent that patients must be relocated;
(3) deleted text begin relocatedeleted text end new text begin relocatingnew text end the provision of health services to another hospital or another
hospital campus; or
(4) deleted text begin cease offeringdeleted text end new text begin ceasing to offernew text end maternity care and newborn care services, intensive
care unit services, inpatient mental health services, or inpatient substance use disorder
treatment services.
new text begin
(c) A notice required under this subdivision must comply with the requirements in
subdivision 1d.
new text end
deleted text begin (b)deleted text end new text begin (d)new text end The commissioner shall cooperate with the controlling persons and advise them
about relocating the patients.
Sec. 11.
Minnesota Statutes 2022, section 144.555, subdivision 1b, is amended to read:
Subd. 1b.
Public hearing.
Within deleted text begin 45deleted text end new text begin 30new text end days after receiving notice under subdivision
1a, the commissioner shall conduct a public hearing on the scheduled cessation of operations,
curtailment of operations, relocation of health services, or cessation in offering health
services. The commissioner must provide adequate public notice of the hearing in a time
and manner determined by the commissioner. The controlling persons of the hospital or
hospital campus must participate in the public hearing. The public hearing new text begin must be held at
a location that is within ten miles of the hospital or hospital campus or with the
commissioner's approval as close as is practicable, and that is provided or arranged by the
hospital or hospital campus. Video conferencing technology must be used to allow members
of the public to view and participate in the hearing. The public hearing new text end must include:
(1) an explanation by the controlling persons of the reasons for ceasing or curtailing
operations, relocating health services, or ceasing to offer any of the listed health services;
(2) a description of the actions that controlling persons will take to ensure that residents
in the hospital's or campus's service area have continued access to the health services being
eliminated, curtailed, or relocated;
(3) an opportunity for public testimony on the scheduled cessation or curtailment of
operations, relocation of health services, or cessation in offering any of the listed health
services, and on the hospital's or campus's plan to ensure continued access to those health
services being eliminated, curtailed, or relocated; and
(4) an opportunity for the controlling persons to respond to questions from interested
persons.
Sec. 12.
Minnesota Statutes 2022, section 144.555, is amended by adding a subdivision
to read:
new text begin Subd. 1d. new text end
new text begin Methods of providing notice; content of notice. new text end
new text begin
(a) A notice required under
subdivision 1a must be provided to patients, hospital personnel, the public, local units of
government, and the commissioner of health using at least the following methods:
new text end
new text begin
(1) posting a notice of the proposed cessation of operations, curtailment, relocation of
health services, or cessation in offering health services at the main public entrance of the
hospital or hospital campus;
new text end
new text begin
(2) providing written notice to the commissioner of health, to the city council in the city
where the hospital or hospital campus is located, and to the county board in the county
where the hospital or hospital campus is located;
new text end
new text begin
(3) providing written notice to the local health department as defined in section 145A.02,
subdivision 8b, for the community where the hospital or hospital campus is located;
new text end
new text begin
(4) providing notice to the public through a written public announcement which must
be distributed to local media outlets;
new text end
new text begin
(5) providing written notice to existing patients of the hospital or hospital campus; and
new text end
new text begin
(6) notifying all personnel currently employed in the unit, hospital, or hospital campus
impacted by the proposed cessation, curtailment, or relocation.
new text end
new text begin
(b) A notice required under subdivision 1a must include:
new text end
new text begin
(1) a description of the proposed cessation of operations, curtailment, relocation of health
services, or cessation in offering health services. The description must include:
new text end
new text begin
(i) the number of beds, if any, that will be eliminated, repurposed, reassigned, or otherwise
reconfigured to serve populations or patients other than those currently served;
new text end
new text begin
(ii) the current number of beds in the impacted unit, hospital, or hospital campus, and
the number of beds in the impacted unit, hospital, or hospital campus after the proposed
cessation, curtailment, or relocation takes place;
new text end
new text begin
(iii) the number of existing patients who will be impacted by the proposed cessation,
curtailment, or relocation;
new text end
new text begin
(iv) any decrease in personnel, or relocation of personnel to a different unit, hospital, or
hospital campus, caused by the proposed cessation, curtailment, or relocation;
new text end
new text begin
(v) a description of the health services provided by the unit, hospital, or hospital campus
impacted by the proposed cessation, curtailment, or relocation; and
new text end
new text begin
(vi) identification of the three nearest available health care facilities where patients may
obtain the health services provided by the unit, hospital, or hospital campus impacted by
the proposed cessation, curtailment, or relocation, and any potential barriers to seamlessly
transition patients to receive services at one of these facilities. If the unit, hospital, or hospital
campus impacted by the proposed cessation, curtailment, or relocation serves medical
assistance or Medicare enrollees, the information required under this item must specify
whether any of the three nearest available facilities serves medical assistance or Medicare
enrollees; and
new text end
new text begin
(2) a telephone number, email address, and address for each of the following, to which
interested parties may offer comments on the proposed cessation, curtailment, or relocation:
new text end
new text begin
(i) the hospital or hospital campus; and
new text end
new text begin
(ii) the parent entity, if any, or the entity under contract, if any, that acts as the corporate
administrator of the hospital or hospital campus.
new text end
Sec. 13.
Minnesota Statutes 2022, section 144.555, subdivision 2, is amended to read:
Subd. 2.
Penaltynew text begin ; facilities other than hospitalsnew text end .
Failure to notify the commissioner
under subdivision 1deleted text begin , 1a, or 1c or failure to participate in a public hearing under subdivision
1bdeleted text end may result in issuance of a correction order under section 144.653, subdivision 5.
Sec. 14.
Minnesota Statutes 2022, section 144.555, is amended by adding a subdivision
to read:
new text begin Subd. 3. new text end
new text begin Penalties; hospitals. new text end
new text begin
(a) Failure to participate in a public hearing under
subdivision 1b or failure to notify the commissioner under subdivision 1c may result in
issuance of a correction order under section 144.653, subdivision 5.
new text end
new text begin
(b) Notwithstanding any law to the contrary, the commissioner must impose on the
controlling persons of a hospital or hospital campus a fine of $20,000 for each failure to
provide notice to an individual or entity or at a location required under subdivision 1d,
paragraph (a). The cumulative fines imposed under this paragraph must not exceed $60,000
for any scheduled action requiring notice under subdivision 1a. The commissioner is not
required to issue a correction order before imposing a fine under this paragraph. Section
144.653, subdivision 8, applies to fines imposed under this paragraph.
new text end
Sec. 15.
new text begin
[144.556] RIGHT OF FIRST REFUSAL; SALE OF HOSPITAL OR
HOSPITAL CAMPUS.
new text end
new text begin
(a) The controlling persons of a hospital licensed under sections 144.50 to 144.56 or a
hospital campus must not sell or convey the hospital or hospital campus, offer to sell or
convey the hospital or hospital campus to a person other than a local unit of government
listed in this paragraph, or voluntarily cease operations of the hospital or hospital campus
unless the controlling persons have first made a good faith offer to sell or convey the hospital
or hospital campus to the home rule charter or statutory city, county, town, or hospital
district in which the hospital or hospital campus is located.
new text end
new text begin
(b) The offer to sell or convey the hospital or hospital campus to a local unit of
government under paragraph (a) must be at a price that does not exceed the current fair
market value of the hospital or hospital campus. A party to whom an offer is made under
paragraph (a) must accept or decline the offer within 60 days of receipt. If the party to whom
the offer is made fails to respond within 60 days of receipt, the offer is deemed declined.
new text end
Sec. 16.
Minnesota Statutes 2022, section 144A.61, subdivision 3a, is amended to read:
Subd. 3a.
Competency evaluation program.
new text begin (a) new text end The commissioner of health shall
approve the competency evaluation program.
new text begin (b) new text end A competency evaluation must be administered to persons who desire to be listed
in the nursing assistant registry. The tests may only be administered by technical colleges,
community colleges, or other organizations approved by the deleted text begin Department of Healthdeleted text end new text begin
commissioner of healthnew text end .new text begin The commissioner must ensure any written portions of the
competency evaluation are available in languages other than English that are commonly
spoken by persons who desire to be listed in the nursing assistant registry. The commissioner
may consult with the state demographer or the commissioner of employment and economic
development when identifying languages that are commonly spoken by persons who desire
to be listed in the nursing assistant registry.
new text end
new text begin (c) new text end The commissioner of health shall approve a nursing assistant for the registry without
requiring a competency evaluation if the nursing assistant is in good standing on a nursing
assistant registry in another state.
new text begin EFFECTIVE DATE. new text end
new text begin
This section is effective January 1, 2025.
new text end
Sec. 17.
Minnesota Statutes 2022, section 144A.70, subdivision 3, is amended to read:
Subd. 3.
Controlling person.
"Controlling person" means a business entitynew text begin or entitiesnew text end ,
officer, program administrator, or directornew text begin ,new text end whose responsibilities include deleted text begin the direction of
the management or policies of a supplemental nursing services agencydeleted text end new text begin the management and
decision-making authority to establish or control business policy and all other policies of a
supplemental nursing services agencynew text end . Controlling person also means an individual who,
directly or indirectly, beneficially owns an interest in a corporation, partnership, or other
business association that is a controlling person.
Sec. 18.
Minnesota Statutes 2022, section 144A.70, subdivision 5, is amended to read:
Subd. 5.
Person.
"Person" includes an individual, deleted text begin firm,deleted text end corporation, partnership,new text begin limited
liability company,new text end or association.
Sec. 19.
Minnesota Statutes 2022, section 144A.70, subdivision 6, is amended to read:
Subd. 6.
Supplemental nursing services agency.
"Supplemental nursing services
agency" means a person, deleted text begin firm,deleted text end corporation, partnership, new text begin limited liability company, new text end or
association engaged for hire in the business of providing or procuring temporary employment
in health care facilities for nurses, nursing assistants, nurse aides, and orderlies. Supplemental
nursing services agency does not include an individual who only engages in providing the
individual's services on a temporary basis to health care facilities. Supplemental nursing
services agency does not include a professional home care agency licensed under section
144A.471 that only provides staff to other home care providers.
Sec. 20.
Minnesota Statutes 2022, section 144A.70, subdivision 7, is amended to read:
Subd. 7.
Oversight.
The commissioner is responsible for the oversight of supplemental
nursing services agencies through deleted text begin annualdeleted text end new text begin semiannualnew text end unannounced surveysnew text begin and follow-up
surveysnew text end , complaint investigations under sections 144A.51 to 144A.53, and other actions
necessary to ensure compliance with sections 144A.70 to 144A.74.
Sec. 21.
Minnesota Statutes 2022, section 144A.71, subdivision 2, is amended to read:
Subd. 2.
Application information and fee.
The commissioner shall establish forms and
procedures for processing each supplemental nursing services agency registration application.
An application for a supplemental nursing services agency registration must include at least
the following:
(1) the names and addresses of deleted text begin the owner or ownersdeleted text end new text begin all owners and controlling personsnew text end
of the supplemental nursing services agency;
(2) if the owner is a corporation, copies of its articles of incorporation and current bylaws,
together with the names and addresses of its officers and directors;
(3) deleted text begin satisfactory proof of compliance with section 144A.72, subdivision 1, clauses (5) to
(7)deleted text end new text begin if the owner is a limited liability company, copies of its articles of organization and
operating agreement, together with the names and addresses of its officers and directorsnew text end ;
new text begin
(4) documentation that the supplemental nursing services agency has medical malpractice
insurance to insure against the loss, damage, or expense of a claim arising out of the death
or injury of any person as the result of negligence or malpractice in the provision of health
care services by the supplemental nursing services agency or by any employee of the agency;
new text end
new text begin
(5) documentation that the supplemental nursing services agency has an employee
dishonesty bond in the amount of $10,000;
new text end
new text begin
(6) documentation that the supplemental nursing services agency has insurance coverage
for workers' compensation for all nurses, nursing assistants, nurse aids, and orderlies provided
or procured by the agency;
new text end
new text begin
(7) documentation that the supplemental nursing services agency filed with the
commissioner of revenue: (i) the name and address of the bank, savings bank, or savings
association in which the supplemental nursing services agency deposits all employee income
tax withholdings; and (ii) the name and address of any nurse, nursing assistant, nurse aid,
or orderly whose income is derived from placement by the agency, if the agency purports
the income is not subject to withholding;
new text end
deleted text begin (4)deleted text end new text begin (8)new text end any other relevant information that the commissioner determines is necessary to
properly evaluate an application for registration;
deleted text begin (5)deleted text end new text begin (9)new text end a policy and procedure that describes how the supplemental nursing services
agency's records will be immediately available at all times to the commissionernew text begin and facilitynew text end ;
and
deleted text begin (6)deleted text end new text begin (10)new text end a new text begin nonrefundable new text end registration fee of $2,035.
If a supplemental nursing services agency fails to provide the items in this subdivision
to the department, the commissioner shall immediately suspend or refuse to issue the
supplemental nursing services agency registration. The supplemental nursing services agency
may appeal the commissioner's findings according to section 144A.475, subdivisions 3a
and 7, except that the hearing must be conducted by an administrative law judge within 60
calendar days of the request for hearing assignment.
Sec. 22.
Minnesota Statutes 2022, section 144A.71, is amended by adding a subdivision
to read:
new text begin Subd. 2a. new text end
new text begin Renewal applications. new text end
new text begin
An applicant for registration renewal must complete
the registration application form supplied by the department. An application must be
submitted at least 60 days before the expiration of the current registration.
new text end
Sec. 23.
new text begin
[144A.715] PENALTIES.
new text end
new text begin Subdivision 1. new text end
new text begin Authority. new text end
new text begin
The fines imposed under this section are in accordance with
section 144.653, subdivision 6.
new text end
new text begin Subd. 2. new text end
new text begin Fines. new text end
new text begin
Each violation of sections 144A.70 to 144A.74, not corrected at the time
of a follow-up survey, is subject to a fine. A fine must be assessed according to the schedules
established in the sections violated.
new text end
new text begin Subd. 3. new text end
new text begin Failure to correct. new text end
new text begin
If, upon a subsequent follow-up survey after a fine has been
imposed under subdivision 2, a violation is still not corrected, another fine shall be assessed.
The fine shall be double the amount of the previous fine.
new text end
new text begin Subd. 4. new text end
new text begin Payment of fines. new text end
new text begin
Payment of fines is due 15 business days from the registrant's
receipt of notice of the fine from the department.
new text end
Sec. 24.
Minnesota Statutes 2022, section 144A.72, subdivision 1, is amended to read:
Subdivision 1.
Minimum criteria.
(a) The commissioner shall require that, as a condition
of registration:
new text begin
(1) all owners and controlling persons must complete a background study under section
144.057 and receive a clearance or set aside of any disqualification;
new text end
deleted text begin (1)deleted text end new text begin (2)new text end the supplemental nursing services agency shall document that each temporary
employee provided to health care facilities currently meets the minimum licensing, training,
and continuing education standards for the position in which the employee will be workingnew text begin
and verifies competency for the position. A violation of this provision may be subject to a
fine of $3,000new text end ;
deleted text begin (2)deleted text end new text begin (3)new text end the supplemental nursing services agency shall comply with all pertinent
requirements relating to the health and other qualifications of personnel employed in health
care facilities;
deleted text begin (3)deleted text end new text begin (4)new text end the supplemental nursing services agency must not restrict in any manner the
employment opportunities of its employeesdeleted text begin ;deleted text end new text begin . A violation of this provision may be subject
to a fine of $3,000;
new text end
deleted text begin
(4) the supplemental nursing services agency shall carry medical malpractice insurance
to insure against the loss, damage, or expense incident to a claim arising out of the death
or injury of any person as the result of negligence or malpractice in the provision of health
care services by the supplemental nursing services agency or by any employee of the agency;
deleted text end
deleted text begin
(5) the supplemental nursing services agency shall carry an employee dishonesty bond
in the amount of $10,000;
deleted text end
deleted text begin
(6) the supplemental nursing services agency shall maintain insurance coverage for
workers' compensation for all nurses, nursing assistants, nurse aides, and orderlies provided
or procured by the agency;
deleted text end
deleted text begin
(7) the supplemental nursing services agency shall file with the commissioner of revenue:
(i) the name and address of the bank, savings bank, or savings association in which the
supplemental nursing services agency deposits all employee income tax withholdings; and
(ii) the name and address of any nurse, nursing assistant, nurse aide, or orderly whose income
is derived from placement by the agency, if the agency purports the income is not subject
to withholding;
deleted text end
deleted text begin (8)deleted text end new text begin (5)new text end the supplemental nursing services agency must not, in any contract with any
employee or health care facility, require the payment of liquidated damages, employment
fees, or other compensation should the employee be hired as a permanent employee of a
health care facilitydeleted text begin ;deleted text end new text begin . A violation of this provision may be subject to a fine of $3,000;
new text end
deleted text begin (9)deleted text end new text begin (6)new text end the supplemental nursing services agency shall document that each temporary
employee provided to health care facilities is an employee of the agency and is not an
independent contractor; and
deleted text begin (10)deleted text end new text begin (7)new text end the supplemental nursing services agency shall retain all records for five calendar
years. All records of the supplemental nursing services agency must be immediately available
to the department.
(b) In order to retain registration, the supplemental nursing services agency must provide
services to a health care facility deleted text begin during the yeardeleted text end new text begin in Minnesota within the past 12 monthsnew text end
preceding the supplemental nursing services agency's registration renewal date.
Sec. 25.
Minnesota Statutes 2022, section 144A.73, is amended to read:
144A.73 COMPLAINT SYSTEM.
The commissioner shall establish a system for reporting complaints against a supplemental
nursing services agency or its employees. Complaints may be made by any member of the
public. Complaints against a supplemental nursing services agency shall be investigated by
the deleted text begin Office of Health Facility Complaintsdeleted text end new text begin commissioner of healthnew text end under sections 144A.51
to 144A.53.
Sec. 26.
Minnesota Statutes 2022, section 148.235, subdivision 10, is amended to read:
Subd. 10.
Administration of medications by unlicensed personnel in nursing
facilities.
Notwithstanding the provisions of Minnesota Rules, part 4658.1360, subpart 2,
a graduate of a foreign nursing school who has successfully completed an approved
competency evaluation under the provisions of section 144A.61 is eligible to administer
medications in a nursing facility upon completion of deleted text begin adeleted text end new text begin anynew text end medication training program for
unlicensed personnel deleted text begin offered through a postsecondary educational institution, whichdeleted text end new text begin approved
by the commissioner of health thatnew text end meets the requirements specified in Minnesota Rules,
part 4658.1360, subpart 2, item Bnew text begin , subitems (1) to (6)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. 27.
Minnesota Statutes 2022, section 149A.02, subdivision 3, is amended to read:
Subd. 3.
Arrangements for disposition.
"Arrangements for disposition" means any
action normally taken by a funeral provider in anticipation of or preparation for the
entombment, burial in a cemetery, alkaline hydrolysis, deleted text begin ordeleted text end cremationnew text begin , or, effective July 1,
2025, natural organic reductionnew text end of a dead human body.
Sec. 28.
Minnesota Statutes 2022, section 149A.02, subdivision 16, is amended to read:
Subd. 16.
Final disposition.
"Final disposition" means the acts leading to and the
entombment, burial in a cemetery, alkaline hydrolysis, deleted text begin ordeleted text end cremationnew text begin , or, effective July 1,
2025, natural organic reductionnew text end of a dead human body.
Sec. 29.
Minnesota Statutes 2022, section 149A.02, subdivision 26a, is amended to read:
Subd. 26a.
Inurnment.
"Inurnment" means placing hydrolyzed or cremated remains in
a hydrolyzed or cremated remains container suitable for placement, burial, or shipment.new text begin
Effective July 1, 2025, inurnment also includes placing naturally reduced remains in a
naturally reduced remains container suitable for placement, burial, or shipment.
new text end
Sec. 30.
Minnesota Statutes 2022, section 149A.02, subdivision 27, is amended to read:
Subd. 27.
Licensee.
"Licensee" means any person or entity that has been issued a license
to practice mortuary science, to operate a funeral establishment, to operate an alkaline
hydrolysis facility, deleted text begin ordeleted text end to operate a crematorynew text begin , or, effective July 1, 2025, to operate a natural
organic reduction facilitynew text end by the Minnesota commissioner of health.
Sec. 31.
Minnesota Statutes 2022, section 149A.02, is amended by adding a subdivision
to read:
new text begin Subd. 30b. new text end
new text begin Natural organic reduction or naturally reduce. new text end
new text begin
"Natural organic reduction"
or "naturally reduce" means the contained, accelerated conversion of a dead human body
to soil. This subdivision is effective July 1, 2025.
new text end
Sec. 32.
Minnesota Statutes 2022, section 149A.02, is amended by adding a subdivision
to read:
new text begin Subd. 30c. new text end
new text begin Natural organic reduction facility. new text end
new text begin
"Natural organic reduction facility"
means a structure, room, or other space in a building or real property where natural organic
reduction of a dead human body occurs. This subdivision is effective July 1, 2025.
new text end
Sec. 33.
Minnesota Statutes 2022, section 149A.02, is amended by adding a subdivision
to read:
new text begin Subd. 30d. new text end
new text begin Natural organic reduction vessel. new text end
new text begin
"Natural organic reduction vessel" means
the enclosed container in which natural organic reduction takes place. This subdivision is
effective July 1, 2025.
new text end
Sec. 34.
Minnesota Statutes 2022, section 149A.02, is amended by adding a subdivision
to read:
new text begin Subd. 30e. new text end
new text begin Naturally reduced remains. new text end
new text begin
"Naturally reduced remains" means the soil
remains following the natural organic reduction of a dead human body and the accompanying
plant material. This subdivision is effective July 1, 2025.
new text end
Sec. 35.
Minnesota Statutes 2022, section 149A.02, is amended by adding a subdivision
to read:
new text begin Subd. 30f. new text end
new text begin Naturally reduced remains container. new text end
new text begin
"Naturally reduced remains container"
means a receptacle in which naturally reduced remains are placed. This subdivision is
effective July 1, 2025.
new text end
Sec. 36.
Minnesota Statutes 2022, section 149A.02, subdivision 35, is amended to read:
Subd. 35.
Processing.
"Processing" means the removal of foreign objects, drying or
cooling, and the reduction of the hydrolyzed deleted text begin ordeleted text end new text begin remains, new text end crematednew text begin remains, or, effective
July 1, 2025, naturally reducednew text end remains by mechanical means including, but not limited to,
grinding, crushing, or pulverizing, to a granulated appearance appropriate for final
disposition.
Sec. 37.
Minnesota Statutes 2022, section 149A.02, subdivision 37c, is amended to read:
Subd. 37c.
Scattering.
"Scattering" means the authorized dispersal of hydrolyzed deleted text begin ordeleted text end new text begin
remains,new text end cremated remainsnew text begin , or, effective July 1, 2025, naturally reduced remainsnew text end in a defined
area of a dedicated cemetery or in areas where no local prohibition exists provided that the
hydrolyzed deleted text begin ordeleted text end new text begin ,new text end crematednew text begin , or naturally reducednew text end remains are not distinguishable to the public,
are not in a container, and that the person who has control over disposition of the hydrolyzed
deleted text begin ordeleted text end new text begin ,new text end crematednew text begin , or naturally reducednew text end remains has obtained written permission of the property
owner or governing agency to scatter on the property.
Sec. 38.
Minnesota Statutes 2022, section 149A.03, is amended to read:
149A.03 DUTIES OF COMMISSIONER.
The commissioner shall:
(1) enforce all laws and adopt and enforce rules relating to the:
(i) removal, preparation, transportation, arrangements for disposition, and final disposition
of dead human bodies;
(ii) licensure and professional conduct of funeral directors, morticians, interns, practicum
students, and clinical students;
(iii) licensing and operation of a funeral establishment;
(iv) licensing and operation of an alkaline hydrolysis facility; deleted text begin and
deleted text end
(v) licensing and operation of a crematory;new text begin and
new text end
new text begin
(vi) effective July 1, 2025, licensing and operation of a natural organic reduction facility;
new text end
(2) provide copies of the requirements for licensure and permits to all applicants;
(3) administer examinations and issue licenses and permits to qualified persons and other
legal entities;
(4) maintain a record of the name and location of all current licensees and interns;
(5) perform periodic compliance reviews and premise inspections of licensees;
(6) accept and investigate complaints relating to conduct governed by this chapter;
(7) maintain a record of all current preneed arrangement trust accounts;
(8) maintain a schedule of application, examination, permit, and licensure fees, initial
and renewal, sufficient to cover all necessary operating expenses;
(9) educate the public about the existence and content of the laws and rules for mortuary
science licensing and the removal, preparation, transportation, arrangements for disposition,
and final disposition of dead human bodies to enable consumers to file complaints against
licensees and others who may have violated those laws or rules;
(10) evaluate the laws, rules, and procedures regulating the practice of mortuary science
in order to refine the standards for licensing and to improve the regulatory and enforcement
methods used; and
(11) initiate proceedings to address and remedy deficiencies and inconsistencies in the
laws, rules, or procedures governing the practice of mortuary science and the removal,
preparation, transportation, arrangements for disposition, and final disposition of dead
human bodies.
Sec. 39.
new text begin
[149A.56] LICENSE TO OPERATE A NATURAL ORGANIC REDUCTION
FACILITY.
new text end
new text begin Subdivision 1. new text end
new text begin License requirement. new text end
new text begin
This section is effective July 1, 2025. Except as
provided in section 149A.01, subdivision 3, no person shall maintain, manage, or operate
a place or premises devoted to or used in the holding and natural organic reduction of a
dead human body without possessing a valid license to operate a natural organic reduction
facility issued by the commissioner of health.
new text end
new text begin Subd. 2. new text end
new text begin Requirements for natural organic reduction facility. new text end
new text begin
(a) A natural organic
reduction facility licensed under this section must consist of:
new text end
new text begin
(1) a building or structure that complies with applicable local and state building codes,
zoning laws and ordinances, and environmental standards, and that contains one or more
natural organic reduction vessels for the natural organic reduction of dead human bodies;
new text end
new text begin
(2) a motorized mechanical device for processing naturally reduced remains; and
new text end
new text begin
(3) an appropriate refrigerated holding facility for dead human bodies awaiting natural
organic reduction.
new text end
new text begin
(b) A natural organic reduction facility licensed under this section may also contain a
display room for funeral goods.
new text end
new text begin Subd. 3. new text end
new text begin Application procedure; documentation; initial inspection. new text end
new text begin
(a) An applicant
for a license to operate a natural organic reduction facility shall submit a completed
application to the commissioner. A completed application includes:
new text end
new text begin
(1) a completed application form, as provided by the commissioner;
new text end
new text begin
(2) proof of business form and ownership; and
new text end
new text begin
(3) proof of liability insurance coverage or other financial documentation, as determined
by the commissioner, that demonstrates the applicant's ability to respond in damages for
liability arising from the ownership, maintenance, management, or operation of a natural
organic reduction facility.
new text end
new text begin
(b) Upon receipt of the application and appropriate fee, the commissioner shall review
and verify all information. Upon completion of the verification process and resolution of
any deficiencies in the application information, the commissioner shall conduct an initial
inspection of the premises to be licensed. After the inspection and resolution of any
deficiencies found and any reinspections as may be necessary, the commissioner shall make
a determination, based on all the information available, to grant or deny licensure. If the
commissioner's determination is to grant the license, the applicant shall be notified and the
license shall issue and remain valid for a period prescribed on the license, but not to exceed
one calendar year from the date of issuance of the license. If the commissioner's determination
is to deny the license, the commissioner must notify the applicant, in writing, of the denial
and provide the specific reason for denial.
new text end
new text begin Subd. 4. new text end
new text begin Nontransferability of license. new text end
new text begin
A license to operate a natural organic reduction
facility is not assignable or transferable and shall not be valid for any entity other than the
one named. Each license issued to operate a natural organic reduction facility is valid only
for the location identified on the license. A 50 percent or more change in ownership or
location of the natural organic reduction facility automatically terminates the license. Separate
licenses shall be required of two or more persons or other legal entities operating from the
same location.
new text end
new text begin Subd. 5. new text end
new text begin Display of license. new text end
new text begin
Each license to operate a natural organic reduction facility
must be conspicuously displayed in the natural organic reduction facility at all times.
"Conspicuous display" means in a location where a member of the general public within
the natural organic reduction facility is able to observe and read the license.
new text end
new text begin Subd. 6. new text end
new text begin Period of licensure. new text end
new text begin
All licenses to operate a natural organic reduction facility
issued by the commissioner are valid for a period of one calendar year beginning on July 1
and ending on June 30, regardless of the date of issuance.
new text end
new text begin Subd. 7. new text end
new text begin Reporting changes in license information. new text end
new text begin
Any change of license information
must be reported to the commissioner, on forms provided by the commissioner, no later
than 30 calendar days after the change occurs. Failure to report changes is grounds for
disciplinary action.
new text end
new text begin Subd. 8. new text end
new text begin Licensing information. new text end
new text begin
Section 13.41 applies to data collected and maintained
by the commissioner pursuant to this section.
new text end
Sec. 40.
new text begin
[149A.57] RENEWAL OF LICENSE TO OPERATE A NATURAL
ORGANIC REDUCTION FACILITY.
new text end
new text begin Subdivision 1. new text end
new text begin Renewal required. new text end
new text begin
This section is effective July 1, 2025. All licenses
to operate a natural organic reduction facility issued by the commissioner expire on June
30 following the date of issuance of the license and must be renewed to remain valid.
new text end
new text begin Subd. 2. new text end
new text begin Renewal procedure and documentation. new text end
new text begin
(a) Licensees who wish to renew
their licenses must submit to the commissioner a completed renewal application no later
than June 30 following the date the license was issued. A completed renewal application
includes:
new text end
new text begin
(1) a completed renewal application form, as provided by the commissioner; and
new text end
new text begin
(2) proof of liability insurance coverage or other financial documentation, as determined
by the commissioner, that demonstrates the applicant's ability to respond in damages for
liability arising from the ownership, maintenance, management, or operation of a natural
organic reduction facility.
new text end
new text begin
(b) Upon receipt of the completed renewal application, the commissioner shall review
and verify the information. Upon completion of the verification process and resolution of
any deficiencies in the renewal application information, the commissioner shall make a
determination, based on all the information available, to reissue or refuse to reissue the
license. If the commissioner's determination is to reissue the license, the applicant shall be
notified and the license shall issue and remain valid for a period prescribed on the license,
but not to exceed one calendar year from the date of issuance of the license. If the
commissioner's determination is to refuse to reissue the license, section 149A.09, subdivision
2, applies.
new text end
new text begin Subd. 3. new text end
new text begin Penalty for late filing. new text end
new text begin
Renewal applications received after the expiration date
of a license will result in the assessment of a late filing penalty. The late filing penalty must
be paid before the reissuance of the license and received by the commissioner no later than
31 calendar days after the expiration date of the license.
new text end
new text begin Subd. 4. new text end
new text begin Lapse of license. new text end
new text begin
A license to operate a natural organic reduction facility shall
automatically lapse when a completed renewal application is not received by the
commissioner within 31 calendar days after the expiration date of a license, or a late filing
penalty assessed under subdivision 3 is not received by the commissioner within 31 calendar
days after the expiration of a license.
new text end
new text begin Subd. 5. new text end
new text begin Effect of lapse of license. new text end
new text begin
Upon the lapse of a license, the person to whom the
license was issued is no longer licensed to operate a natural organic reduction facility in
Minnesota. The commissioner shall issue a cease and desist order to prevent the lapsed
license holder from operating a natural organic reduction facility in Minnesota and may
pursue any additional lawful remedies as justified by the case.
new text end
new text begin Subd. 6. new text end
new text begin Restoration of lapsed license. new text end
new text begin
The commissioner may restore a lapsed license
upon receipt and review of a completed renewal application, receipt of the late filing penalty,
and reinspection of the premises, provided that the receipt is made within one calendar year
from the expiration date of the lapsed license and the cease and desist order issued by the
commissioner has not been violated. If a lapsed license is not restored within one calendar
year from the expiration date of the lapsed license, the holder of the lapsed license cannot
be relicensed until the requirements in section 149A.56 are met.
new text end
new text begin Subd. 7. new text end
new text begin Reporting changes in license information. new text end
new text begin
Any change of license information
must be reported to the commissioner, on forms provided by the commissioner, no later
than 30 calendar days after the change occurs. Failure to report changes is grounds for
disciplinary action.
new text end
new text begin Subd. 8. new text end
new text begin Licensing information. new text end
new text begin
Section 13.41 applies to data collected and maintained
by the commissioner pursuant to this section.
new text end
Sec. 41.
Minnesota Statutes 2022, section 149A.65, is amended by adding a subdivision
to read:
new text begin Subd. 6a. new text end
new text begin Natural organic reduction facilities. new text end
new text begin
This subdivision is effective July 1,
2025. The initial and renewal fee for a natural organic reduction facility is $425. The late
fee charge for a license renewal is $100.
new text end
Sec. 42.
Minnesota Statutes 2022, section 149A.70, subdivision 1, is amended to read:
Subdivision 1.
Use of titles.
Only a person holding a valid license to practice mortuary
science issued by the commissioner may use the title of mortician, funeral director, or any
other title implying that the licensee is engaged in the business or practice of mortuary
science. Only the holder of a valid license to operate an alkaline hydrolysis facility issued
by the commissioner may use the title of alkaline hydrolysis facility, water cremation,
water-reduction, biocremation, green-cremation, resomation, dissolution, or any other title,
word, or term implying that the licensee operates an alkaline hydrolysis facility. Only the
holder of a valid license to operate a funeral establishment issued by the commissioner may
use the title of funeral home, funeral chapel, funeral service, or any other title, word, or
term implying that the licensee is engaged in the business or practice of mortuary science.
Only the holder of a valid license to operate a crematory issued by the commissioner may
use the title of crematory, crematorium, green-cremation, or any other title, word, or term
implying that the licensee operates a crematory or crematorium. new text begin Effective July 1, 2025,new text end new text begin
only the holder of a valid license to operate a natural organic reduction facility issued by
the commissioner may use the title of natural organic reduction facility, human composting,
or any other title, word, or term implying that the licensee operates a natural organic reduction
facility.
new text end
Sec. 43.
Minnesota Statutes 2022, section 149A.70, subdivision 2, is amended to read:
Subd. 2.
Business location.
A funeral establishment, alkaline hydrolysis facility, deleted text begin ordeleted text end
crematorynew text begin , or, effective July 1, 2025, natural organic reduction facilitynew text end shall not do business
in a location that is not licensed as a funeral establishment, alkaline hydrolysis facility, deleted text begin ordeleted text end
crematorynew text begin , or natural organic reduction facilitynew text end and shall not advertise a service that is
available from an unlicensed location.
Sec. 44.
Minnesota Statutes 2022, section 149A.70, subdivision 3, is amended to read:
Subd. 3.
Advertising.
No licensee, clinical student, practicum student, or intern shall
publish or disseminate false, misleading, or deceptive advertising. False, misleading, or
deceptive advertising includes, but is not limited to:
(1) identifying, by using the names or pictures of, persons who are not licensed to practice
mortuary science in a way that leads the public to believe that those persons will provide
mortuary science services;
(2) using any name other than the names under which the funeral establishment, alkaline
hydrolysis facility, deleted text begin ordeleted text end crematorynew text begin , or, effective July 1, 2025, natural organic reduction facilitynew text end
is known to or licensed by the commissioner;
(3) using a surname not directly, actively, or presently associated with a licensed funeral
establishment, alkaline hydrolysis facility, deleted text begin ordeleted text end crematory, new text begin or, effective July 1, 2025, natural
organic reduction facility, new text end unless the surname had been previously and continuously used
by the licensed funeral establishment, alkaline hydrolysis facility, deleted text begin ordeleted text end crematorynew text begin , or natural
organic reduction facilitynew text end ; and
(4) using a founding or establishing date or total years of service not directly or
continuously related to a name under which the funeral establishment, alkaline hydrolysis
facility, deleted text begin ordeleted text end crematorynew text begin , or, effective July 1, 2025, natural organic reduction facilitynew text end is currently
or was previously licensed.
Any advertising or other printed material that contains the names or pictures of persons
affiliated with a funeral establishment, alkaline hydrolysis facility, deleted text begin ordeleted text end crematorynew text begin , or, effective
July 1, 2025, natural organic reduction facilitynew text end shall state the position held by the persons
and shall identify each person who is licensed or unlicensed under this chapter.
Sec. 45.
Minnesota Statutes 2022, section 149A.70, subdivision 5, is amended to read:
Subd. 5.
Reimbursement prohibited.
No licensee, clinical student, practicum student,
or intern shall offer, solicit, or accept a commission, fee, bonus, rebate, or other
reimbursement in consideration for recommending or causing a dead human body to be
disposed of by a specific body donation program, funeral establishment, alkaline hydrolysis
facility, crematory, mausoleum, deleted text begin ordeleted text end cemeterynew text begin , or, effective July 1, 2025, natural organic
reduction facilitynew text end .
Sec. 46.
Minnesota Statutes 2022, section 149A.71, subdivision 2, is amended to read:
Subd. 2.
Preventive requirements.
(a) To prevent unfair or deceptive acts or practices,
the requirements of this subdivision must be met. new text begin This subdivision applies to natural organic
reduction and naturally reduced remains, goods, and services effective July 1, 2025.
new text end
(b) Funeral providers must tell persons who ask by telephone about the funeral provider's
offerings or prices any accurate information from the price lists described in paragraphs (c)
to (e) and any other readily available information that reasonably answers the questions
asked.
(c) Funeral providers must make available for viewing to people who inquire in person
about the offerings or prices of funeral goods or burial site goods, separate printed or
typewritten price lists using a ten-point font or larger. Each funeral provider must have a
separate price list for each of the following types of goods that are sold or offered for sale:
(1) caskets;
(2) alternative containers;
(3) outer burial containers;
(4) alkaline hydrolysis containers;
(5) cremation containers;
(6) hydrolyzed remains containers;
(7) cremated remains containers;
(8) markers; deleted text begin and
deleted text end
(9) headstonesdeleted text begin .deleted text end new text begin ; and
new text end
new text begin
(10) naturally reduced remains containers.
new text end
(d) Each separate price list must contain the name of the funeral provider's place of
business, address, and telephone number and a caption describing the list as a price list for
one of the types of funeral goods or burial site goods described in paragraph (c), clauses
(1) to deleted text begin (9)deleted text end new text begin (10)new text end . The funeral provider must offer the list upon beginning discussion of, but
in any event before showing, the specific funeral goods or burial site goods and must provide
a photocopy of the price list, for retention, if so asked by the consumer. The list must contain,
at least, the retail prices of all the specific funeral goods and burial site goods offered which
do not require special ordering, enough information to identify each, and the effective date
for the price list. However, funeral providers are not required to make a specific price list
available if the funeral providers place the information required by this paragraph on the
general price list described in paragraph (e).
(e) Funeral providers must give a printed price list, for retention, to persons who inquire
in person about the funeral goods, funeral services, burial site goods, or burial site services
or prices offered by the funeral provider. The funeral provider must give the list upon
beginning discussion of either the prices of or the overall type of funeral service or disposition
or specific funeral goods, funeral services, burial site goods, or burial site services offered
by the provider. This requirement applies whether the discussion takes place in the funeral
establishment or elsewhere. However, when the deceased is removed for transportation to
the funeral establishment, an in-person request for authorization to embalm does not, by
itself, trigger the requirement to offer the general price list. If the provider, in making an
in-person request for authorization to embalm, discloses that embalming is not required by
law except in certain special cases, the provider is not required to offer the general price
list. Any other discussion during that time about prices or the selection of funeral goods,
funeral services, burial site goods, or burial site services triggers the requirement to give
the consumer a general price list. The general price list must contain the following
information:
(1) the name, address, and telephone number of the funeral provider's place of business;
(2) a caption describing the list as a "general price list";
(3) the effective date for the price list;
(4) the retail prices, in any order, expressed either as a flat fee or as the prices per hour,
mile, or other unit of computation, and other information described as follows:
(i) forwarding of remains to another funeral establishment, together with a list of the
services provided for any quoted price;
(ii) receiving remains from another funeral establishment, together with a list of the
services provided for any quoted price;
(iii) separate prices for each alkaline hydrolysisnew text begin , natural organic reduction,new text end or cremation
offered by the funeral provider, with the price including an alternative container new text begin or shroud
new text end or alkaline hydrolysis new text begin facilitynew text end or cremation containerdeleted text begin ,deleted text end new text begin ;new text end any alkaline hydrolysisnew text begin , natural
organic reduction facility,new text end or crematory chargesdeleted text begin ,deleted text end new text begin ;new text end and a description of the services and
container included in the price, where applicable, and the price of alkaline hydrolysis or
cremation where the purchaser provides the container;
(iv) separate prices for each immediate burial offered by the funeral provider, including
a casket or alternative container, and a description of the services and container included
in that price, and the price of immediate burial where the purchaser provides the casket or
alternative container;
(v) transfer of remains to the funeral establishment or other location;
(vi) embalming;
(vii) other preparation of the body;
(viii) use of facilities, equipment, or staff for viewing;
(ix) use of facilities, equipment, or staff for funeral ceremony;
(x) use of facilities, equipment, or staff for memorial service;
(xi) use of equipment or staff for graveside service;
(xii) hearse or funeral coach;
(xiii) limousine; and
(xiv) separate prices for all cemetery-specific goods and services, including all goods
and services associated with interment and burial site goods and services and excluding
markers and headstones;
(5) the price range for the caskets offered by the funeral provider, together with the
statement "A complete price list will be provided at the funeral establishment or casket sale
location." or the prices of individual caskets, as disclosed in the manner described in
paragraphs (c) and (d);
(6) the price range for the alternative containers new text begin or shrouds new text end offered by the funeral provider,
together with the statement "A complete price list will be provided at the funeral
establishment or alternative container sale location." or the prices of individual alternative
containers, as disclosed in the manner described in paragraphs (c) and (d);
(7) the price range for the outer burial containers offered by the funeral provider, together
with the statement "A complete price list will be provided at the funeral establishment or
outer burial container sale location." or the prices of individual outer burial containers, as
disclosed in the manner described in paragraphs (c) and (d);
(8) the price range for the alkaline hydrolysis container offered by the funeral provider,
together with the statement "A complete price list will be provided at the funeral
establishment or alkaline hydrolysis container sale location." or the prices of individual
alkaline hydrolysis containers, as disclosed in the manner described in paragraphs (c) and
(d);
(9) the price range for the hydrolyzed remains container offered by the funeral provider,
together with the statement "A complete price list will be provided at the funeral
establishment or hydrolyzed remains container sale location." or the prices of individual
hydrolyzed remains container, as disclosed in the manner described in paragraphs (c) and
(d);
(10) the price range for the cremation containers offered by the funeral provider, together
with the statement "A complete price list will be provided at the funeral establishment or
cremation container sale location." or the prices of individual cremation containers, as
disclosed in the manner described in paragraphs (c) and (d);
(11) the price range for the cremated remains containers offered by the funeral provider,
together with the statement, "A complete price list will be provided at the funeral
establishment or cremated remains container sale location," or the prices of individual
cremation containers as disclosed in the manner described in paragraphs (c) and (d);
new text begin
(12) the price range for the naturally reduced remains containers offered by the funeral
provider, together with the statement, "A complete price list will be provided at the funeral
establishment or naturally reduced remains container sale location," or the prices of individual
naturally reduced remains containers as disclosed in the manner described in paragraphs
(c) and (d);
new text end
deleted text begin (12)deleted text end new text begin (13)new text end the price for the basic services of funeral provider and staff, together with a
list of the principal basic services provided for any quoted price and, if the charge cannot
be declined by the purchaser, the statement "This fee for our basic services will be added
to the total cost of the funeral arrangements you select. (This fee is already included in our
charges for alkaline hydrolysis, new text begin natural organic reduction, new text end direct cremations, immediate
burials, and forwarding or receiving remains.)" If the charge cannot be declined by the
purchaser, the quoted price shall include all charges for the recovery of unallocated funeral
provider overhead, and funeral providers may include in the required disclosure the phrase
"and overhead" after the word "services." This services fee is the only funeral provider fee
for services, facilities, or unallocated overhead permitted by this subdivision to be
nondeclinable, unless otherwise required by law;
deleted text begin (13)deleted text end new text begin (14)new text end the price range for the markers and headstones offered by the funeral provider,
together with the statement "A complete price list will be provided at the funeral
establishment or marker or headstone sale location." or the prices of individual markers and
headstones, as disclosed in the manner described in paragraphs (c) and (d); and
deleted text begin (14)deleted text end new text begin (15)new text end any package priced funerals offered must be listed in addition to and following
the information required in paragraph (e) and must clearly state the funeral goods and
services being offered, the price being charged for those goods and services, and the
discounted savings.
(f) Funeral providers must give an itemized written statement, for retention, to each
consumer who arranges an at-need funeral or other disposition of human remains at the
conclusion of the discussion of the arrangements. The itemized written statement must be
signed by the consumer selecting the goods and services as required in section 149A.80. If
the statement is provided by a funeral establishment, the statement must be signed by the
licensed funeral director or mortician planning the arrangements. If the statement is provided
by any other funeral provider, the statement must be signed by an authorized agent of the
funeral provider. The statement must list the funeral goods, funeral services, burial site
goods, or burial site services selected by that consumer and the prices to be paid for each
item, specifically itemized cash advance items (these prices must be given to the extent then
known or reasonably ascertainable if the prices are not known or reasonably ascertainable,
a good faith estimate shall be given and a written statement of the actual charges shall be
provided before the final bill is paid), and the total cost of goods and services selected. At
the conclusion of an at-need arrangement, the funeral provider is required to give the
consumer a copy of the signed itemized written contract that must contain the information
required in this paragraph.
(g) Upon receiving actual notice of the death of an individual with whom a funeral
provider has entered a preneed funeral agreement, the funeral provider must provide a copy
of all preneed funeral agreement documents to the person who controls final disposition of
the human remains or to the designee of the person controlling disposition. The person
controlling final disposition shall be provided with these documents at the time of the
person's first in-person contact with the funeral provider, if the first contact occurs in person
at a funeral establishment, alkaline hydrolysis facility, crematory, new text begin natural organic reduction
facility, new text end or other place of business of the funeral provider. If the contact occurs by other
means or at another location, the documents must be provided within 24 hours of the first
contact.
Sec. 47.
Minnesota Statutes 2022, section 149A.71, subdivision 4, is amended to read:
Subd. 4.
Casket, alternate container, alkaline hydrolysis container, new text begin naturally reduced
remains container, new text end and cremation container sales; records; required disclosures.
Any
funeral provider who sells or offers to sell a casket, alternate container, alkaline hydrolysis
container, hydrolyzed remains container, cremation container, deleted text begin ordeleted text end cremated remains containernew text begin ,
or, effective July 1, 2025, naturally reduced remains containernew text end to the public must maintain
a record of each sale that includes the name of the purchaser, the purchaser's mailing address,
the name of the decedent, the date of the decedent's death, and the place of death. These
records shall be open to inspection by the regulatory agency. Any funeral provider selling
a casket, alternate container, or cremation container to the public, and not having charge of
the final disposition of the dead human body, shall provide a copy of the statutes and rules
controlling the removal, preparation, transportation, arrangements for disposition, and final
disposition of a dead human body. This subdivision does not apply to morticians, funeral
directors, funeral establishments, crematories, or wholesale distributors of caskets, alternate
containers, alkaline hydrolysis containers, or cremation containers.
Sec. 48.
Minnesota Statutes 2022, section 149A.72, subdivision 3, is amended to read:
Subd. 3.
Casket for alkaline hydrolysisnew text begin , natural organic reduction,new text end or cremation
provisions; deceptive acts or practices.
In selling or offering to sell funeral goods or
funeral services to the public, it is a deceptive act or practice for a funeral provider to
represent that a casket is required for alkaline hydrolysis deleted text begin ordeleted text end new text begin ,new text end cremationsnew text begin , or, effective July
1, 2025, natural organic reductionnew text end by state or local law or otherwise.
Sec. 49.
Minnesota Statutes 2022, section 149A.72, subdivision 9, is amended to read:
Subd. 9.
Deceptive acts or practices.
In selling or offering to sell funeral goods, funeral
services, burial site goods, or burial site services to the public, it is a deceptive act or practice
for a funeral provider to represent that federal, state, or local laws, or particular cemeteries,
alkaline hydrolysis facilities, deleted text begin ordeleted text end crematoriesnew text begin , or, effective July 1, 2025, natural organic
reduction facilitiesnew text end require the purchase of any funeral goods, funeral services, burial site
goods, or burial site services when that is not the case.
Sec. 50.
Minnesota Statutes 2022, section 149A.73, subdivision 1, is amended to read:
Subdivision 1.
Casket for alkaline hydrolysisnew text begin , natural organic reduction,new text end or cremation
provisions; deceptive acts or practices.
In selling or offering to sell funeral goods, funeral
services, burial site goods, or burial site services to the public, it is a deceptive act or practice
for a funeral provider to require that a casket be purchased for alkaline hydrolysis deleted text begin ordeleted text end new text begin ,new text end
cremationnew text begin , or, effective July 1, 2025, natural organic reductionnew text end .
Sec. 51.
Minnesota Statutes 2022, section 149A.74, subdivision 1, is amended to read:
Subdivision 1.
Services provided without prior approval; deceptive acts or
practices.
In selling or offering to sell funeral goods or funeral services to the public, it is
a deceptive act or practice for any funeral provider to embalm a dead human body unless
state or local law or regulation requires embalming in the particular circumstances regardless
of any funeral choice which might be made, or prior approval for embalming has been
obtained from an individual legally authorized to make such a decision. In seeking approval
to embalm, the funeral provider must disclose that embalming is not required by law except
in certain circumstances; that a fee will be charged if a funeral is selected which requires
embalming, such as a funeral with viewing; and that no embalming fee will be charged if
the family selects a service which does not require embalming, such as direct alkaline
hydrolysis, direct cremation, deleted text begin ordeleted text end immediate burialnew text begin , or, effective July 1, 2025, natural organic
reductionnew text end .
Sec. 52.
Minnesota Statutes 2022, section 149A.93, subdivision 3, is amended to read:
Subd. 3.
Disposition permit.
A disposition permit is required before a body can be
buried, entombed, alkaline hydrolyzed, deleted text begin ordeleted text end crematednew text begin , or, effective July 1, 2025, naturally
reducednew text end . No disposition permit shall be issued until a fact of death record has been completed
and filed with the state registrar of vital records.
Sec. 53.
Minnesota Statutes 2022, section 149A.94, subdivision 1, is amended to read:
Subdivision 1.
Generally.
Every dead human body lying within the state, except
unclaimed bodies delivered for dissection by the medical examiner, those delivered for
anatomical study pursuant to section 149A.81, subdivision 2, or lawfully carried through
the state for the purpose of disposition elsewhere; and the remains of any dead human body
after dissection or anatomical study, shall be decently buried or entombed in a public or
private cemetery, alkaline hydrolyzed, deleted text begin ordeleted text end crematednew text begin , or, effective July 1, 2025, naturally
reducednew text end within a reasonable time after death. Where final disposition of a body will not be
accomplishednew text begin , or, effective July 1, 2025, when natural organic reduction will not be initiated,new text end
within 72 hours following death or release of the body by a competent authority with
jurisdiction over the body, the body must be properly embalmed, refrigerated, or packed
with dry ice. A body may not be kept in refrigeration for a period exceeding six calendar
days, or packed in dry ice for a period that exceeds four calendar days, from the time of
death or release of the body from the coroner or medical examiner.
Sec. 54.
Minnesota Statutes 2022, section 149A.94, subdivision 3, is amended to read:
Subd. 3.
Permit required.
No dead human body shall be buried, entombed, deleted text begin ordeleted text end crematednew text begin ,
alkaline hydrolyzed, or, effective July 1, 2025, naturally reducednew text end without a disposition
permit. The disposition permit must be filed with the person in charge of the place of final
disposition. Where a dead human body will be transported out of this state for final
disposition, the body must be accompanied by a certificate of removal.
Sec. 55.
Minnesota Statutes 2022, section 149A.94, subdivision 4, is amended to read:
Subd. 4.
Alkaline hydrolysis deleted text begin ordeleted text end new text begin ,new text end cremationnew text begin , or natural organic reductionnew text end .
Inurnment
of alkaline hydrolyzed deleted text begin ordeleted text end new text begin remains,new text end cremated remainsnew text begin , or, effective July 1, 2025, naturally
reduced remainsnew text end and release to an appropriate party is considered final disposition and no
further permits or authorizations are required for transportation, interment, entombment, or
placement of the deleted text begin cremateddeleted text end remains, except as provided in section 149A.95, subdivision 16.
Sec. 56.
new text begin
[149A.955] NATURAL ORGANIC REDUCTION FACILITIES AND
NATURAL ORGANIC REDUCTION.
new text end
new text begin Subdivision 1. new text end
new text begin License required. new text end
new text begin
This section is effective July 1, 2025. A dead human
body may only undergo natural organic reduction in this state at a natural organic reduction
facility licensed by the commissioner of health.
new text end
new text begin Subd. 2. new text end
new text begin General requirements. new text end
new text begin
Any building to be used as a natural organic reduction
facility must comply with all applicable local and state building codes, zoning laws and
ordinances, and environmental standards. A natural organic reduction facility must have on
site a natural organic reduction system approved by the commissioner and a motorized
mechanical device for processing naturally reduced remains and must have in the building
a refrigerated holding facility for the retention of dead human bodies awaiting natural organic
reduction. The holding facility must be secure from access by anyone except the authorized
personnel of the natural organic reduction facility, preserve the dignity of the remains, and
protect the health and safety of the natural organic reduction facility personnel.
new text end
new text begin Subd. 3. new text end
new text begin Aerobic reduction vessel. new text end
new text begin
A natural organic reduction facility must use as a
natural organic reduction vessel a contained reduction vessel that is designed to promote
aerobic reduction and that minimizes odors.
new text end
new text begin Subd. 4. new text end
new text begin Unlicensed personnel. new text end
new text begin
A licensed natural organic reduction facility may employ
unlicensed personnel, provided that all applicable provisions of this chapter are followed.
It is the duty of the licensed natural organic reduction facility to provide proper training for
all unlicensed personnel, and the licensed natural organic reduction facility shall be strictly
accountable for compliance with this chapter and other applicable state and federal regulations
regarding occupational and workplace health and safety.
new text end
new text begin Subd. 5. new text end
new text begin Authorization to naturally reduce. new text end
new text begin
No natural organic reduction facility shall
naturally reduce or cause to be naturally reduced any dead human body or identifiable body
part without receiving written authorization to do so from the person or persons who have
the legal right to control disposition as described in section 149A.80 or the person's legal
designee. The written authorization must include:
new text end
new text begin
(1) the name of the deceased and the date of death of the deceased;
new text end
new text begin
(2) a statement authorizing the natural organic reduction facility to naturally reduce the
body;
new text end
new text begin
(3) the name, address, phone number, relationship to the deceased, and signature of the
person or persons with the legal right to control final disposition or a legal designee;
new text end
new text begin
(4) directions for the disposition of any non-naturally reduced materials or items recovered
from the natural organic reduction vessel;
new text end
new text begin
(5) acknowledgment that some of the naturally reduced remains will be mechanically
reduced to a granulated appearance and included in the appropriate containers with the
naturally reduced remains; and
new text end
new text begin
(6) directions for the ultimate disposition of the naturally reduced remains.
new text end
new text begin Subd. 6. new text end
new text begin Limitation of liability. new text end
new text begin
The limitations in section 149A.95, subdivision 5, apply
to natural organic reduction facilities.
new text end
new text begin Subd. 7. new text end
new text begin Acceptance of delivery of body. new text end
new text begin
(a) No dead human body shall be accepted
for final disposition by natural organic reduction unless the body is:
new text end
new text begin
(1) wrapped in a container, such as a pouch or shroud, that is impermeable or
leak-resistant;
new text end
new text begin
(2) accompanied by a disposition permit issued pursuant to section 149A.93, subdivision
3, including a photocopy of the complete death record or a signed release authorizing natural
organic reduction received from a coroner or medical examiner; and
new text end
new text begin
(3) accompanied by a natural organic reduction authorization that complies with
subdivision 5.
new text end
new text begin
(b) A natural organic reduction facility shall refuse to accept delivery of the dead human
body:
new text end
new text begin
(1) where there is a known dispute concerning natural organic reduction of the body
delivered;
new text end
new text begin
(2) where there is a reasonable basis for questioning any of the representations made on
the written authorization to naturally reduce; or
new text end
new text begin
(3) for any other lawful reason.
new text end
new text begin
(c) When a container, pouch, or shroud containing a dead human body shows evidence
of leaking bodily fluid, the container, pouch, or shroud and the body must be returned to
the contracting funeral establishment, or the body must be transferred to a new container,
pouch, or shroud by a properly licensed individual.
new text end
new text begin
(d) If a dead human body is delivered to a natural organic reduction facility in a container,
pouch, or shroud that is not suitable for placement in a natural organic reduction vessel, the
transfer of the body to the vessel must be performed by a properly licensed individual.
new text end
new text begin Subd. 8. new text end
new text begin Bodies awaiting natural organic reduction. new text end
new text begin
A dead human body must be
placed in the natural organic reduction vessel to initiate the natural reduction process within
a reasonable time after death, pursuant to section 149A.94, subdivision 1.
new text end
new text begin Subd. 9. new text end
new text begin Handling of dead human bodies. new text end
new text begin
All natural organic reduction facility
employees handling the containers, pouches, or shrouds for dead human bodies shall use
universal precautions and otherwise exercise all reasonable precautions to minimize the
risk of transmitting any communicable disease from the body. No dead human body shall
be removed from the container, pouch, or shroud in which it is delivered to the natural
organic reduction facility without express written authorization of the person or persons
with legal right to control the disposition and only by a properly licensed individual. The
person or persons with the legal right to control the body or that person's noncompensated
designee may be involved with preparation of the body pursuant to section 149A.01,
subdivision 3, paragraph (c).
new text end
new text begin Subd. 10. new text end
new text begin Identification of the body. new text end
new text begin
All licensed natural organic reduction facilities
shall develop, implement, and maintain an identification procedure whereby dead human
bodies can be identified from the time the natural organic reduction facility accepts delivery
of the body until the naturally reduced remains are released to an authorized party. After
natural organic reduction, an identifying disk, tab, or other permanent label shall be placed
within the naturally reduced remains container or containers before the remains are released
from the natural organic reduction facility. Each identification disk, tab, or label shall have
a number that shall be recorded on all paperwork regarding the decedent. This procedure
shall be designed to reasonably ensure that the proper body is naturally reduced and that
the remains are returned to the appropriate party. Loss of all or part of the remains or the
inability to individually identify the remains is a violation of this subdivision.
new text end
new text begin Subd. 11. new text end
new text begin Natural organic reduction vessel for human remains. new text end
new text begin
A licensed natural
organic reduction facility shall knowingly naturally reduce only dead human bodies or
human remains in a natural organic reduction vessel.
new text end
new text begin Subd. 12. new text end
new text begin Natural organic reduction procedures; privacy. new text end
new text begin
The final disposition of
dead human bodies by natural organic reduction shall be done in privacy. Unless there is
written authorization from the person with the legal right to control the final disposition,
only authorized natural organic reduction facility personnel shall be permitted in the natural
organic reduction area while any human body is awaiting placement in a natural organic
reduction vessel, being removed from the vessel, or being processed for placement in a
naturally reduced remains container. This does not prohibit an in-person laying-in ceremony
to honor the deceased and the transition prior to the placement.
new text end
new text begin Subd. 13. new text end
new text begin
Natural organic reduction procedures; commingling of bodies
prohibited.
new text end
new text begin
Except with the express written permission of the person with the legal right
to control the final disposition, no natural organic reduction facility shall naturally reduce
more than one dead human body at the same time and in the same natural organic reduction
vessel or introduce a second dead human body into same natural organic reduction vessel
until reasonable efforts have been employed to remove all fragments of remains from the
preceding natural organic reduction. This subdivision does not apply where commingling
of human remains during natural organic reduction is otherwise provided by law. The fact
that there is incidental and unavoidable residue in the natural organic reduction vessel used
in a prior natural organic reduction is not a violation of this subdivision.
new text end
new text begin Subd. 14. new text end
new text begin
Natural organic reduction procedures; removal from natural organic
reduction vessel.
new text end
new text begin
Upon completion of the natural organic reduction process, reasonable
efforts shall be made to remove from the natural organic reduction vessel all the recoverable
naturally reduced remains. The naturally reduced remains shall be transported to the
processing area, and any non-naturally reducible materials or items shall be separated from
the naturally reduced remains and disposed of, in any lawful manner, by the natural organic
reduction facility.
new text end
new text begin Subd. 15. new text end
new text begin
Natural organic reduction procedures; processing naturally reduced
remains.
new text end
new text begin
The naturally reduced remains that remain intact shall be reduced by a motorized
mechanical processor to a granulated appearance. The granulated remains and the rest of
the naturally reduced remains shall be returned to a natural organic reduction vessel for
final reduction.
new text end
new text begin Subd. 16. new text end
new text begin
Natural organic reduction procedures; commingling of naturally reduced
remains prohibited.
new text end
new text begin
Except with the express written permission of the person with the
legal right to control the final deposition or otherwise provided by law, no natural organic
reduction facility shall mechanically process the naturally reduced remains of more than
one body at a time in the same mechanical processor or introduce the naturally reduced
remains of a second body into a mechanical processor until reasonable efforts have been
employed to remove all fragments of naturally reduced remains already in the processor.
The fact that there is incidental and unavoidable residue in the mechanical processor is not
a violation of this subdivision.
new text end
new text begin Subd. 17. new text end
new text begin
Natural organic reduction procedures; testing naturally reduced
remains.
new text end
new text begin
The natural organic reduction facility is responsible for:
new text end
new text begin
(1) ensuring that the materials in the natural organic reduction vessel naturally reach
and maintain a minimum temperature of 131 degrees Fahrenheit for a minimum of 72
consecutive hours during the process of natural organic reduction;
new text end
new text begin
(2) analyzing each instance of the naturally reduced remains for physical contaminants
that include but are not limited to intact bone, dental filings, and medical implants. Naturally
reduced remains must have less than 0.01 mg/kg dry weight of any physical contaminants;
new text end
new text begin
(3) collecting material samples for analysis that are representative of each instance of
natural organic reduction using a sampling method, such as those described in the U.S.
Composting Council 2002 Test Methods for the Examination of Composting and Compost,
Method 02.01-A through E;
new text end
new text begin
(4) developing and using a natural organic reduction process in which the naturally
reduced remains from the process does not exceed the following limits:
new text end
new text begin
(i) for fecal coliform, less than 1,000 most probable number per gram of total solids (dry
weight);
new text end
new text begin
(ii) for salmonella, less than three most probable number per four grams of total solids
(dry weight);
new text end
new text begin
(iii) for arsenic, less than or equal to 11 ppm;
new text end
new text begin
(iv) for cadmium, less than or equal to 7.1 ppm;
new text end
new text begin
(v) for lead, less than or equal to 150 ppm;
new text end
new text begin
(vi) for mercury, less than or equal to 8 ppm; and
new text end
new text begin
(vii) for selenium, less than or equal to 18 ppm;
new text end
new text begin
(5) analyzing, using a third-party laboratory, the natural organic reduction facility's
material samples of naturally reduced remains according to the following schedule:
new text end
new text begin
(i) the natural organic reduction facility must analyze each of the first 20 instances of
naturally reduced remains for the parameters identified in clause (4);
new text end
new text begin
(ii) if any of the first 20 instances of naturally reduced remains yield results exceeding
the limits identified in clause (4), the natural organic reduction facility must conduct
appropriate processes to correct the levels of the chemicals identified in clause (4) and have
the resultant remains tested to ensure they fall within the identified limits;
new text end
new text begin
(iii) if any of the first 20 instances of naturally reduced remains yield results exceeding
the limits identified in clause (4), the natural organic reduction facility must analyze each
additional instance of naturally reduced remains for the parameters identified in clause (4)
until a total of 20 samples, not including those from remains that were reprocessed under
item (ii), have yielded results within the limits of clause (4) on initial testing;
new text end
new text begin
(iv) after 20 material samples of naturally reduced remains have met the limits outlined
in clause (4), the natural organic reduction facility must analyze, at a minimum, 25 percent
of the natural organic reduction facility's monthly instances of naturally reduced remains
for the parameters identified in clause (4) until 80 total material samples of naturally reduced
remains have met the requirements of clause (4), not including any samples that required
reprocessing to meet those requirements; and
new text end
new text begin
(v) after 80 material samples of naturally reduced remains have met the limits of clause
(4), the natural organic reduction facility must analyze, at a minimum, one instance of
naturally reduced remains each month;
new text end
new text begin
(6) complying with any testing requirements established by the commissioner for content
parameters in addition to those specified in clause (4);
new text end
new text begin
(7) not releasing any naturally reduced remains that exceed the limits identified in clause
(4); and
new text end
new text begin
(8) preparing, maintaining, and providing upon request by the commissioner an annual
report each calendar year. The annual report must detail the natural organic reduction
facility's activities during the previous calendar year and must include the following
information:
new text end
new text begin
(i) name and address of the natural organic reduction facility;
new text end
new text begin
(ii) calendar year covered by the report;
new text end
new text begin
(iii) annual quantity of naturally reduced remains;
new text end
new text begin
(iv) results of any laboratory analyses of naturally reduced remains; and
new text end
new text begin
(v) any additional information requested by the commissioner.
new text end
new text begin Subd. 18. new text end
new text begin
Natural organic reduction procedures; use of more than one naturally
reduced remains container.
new text end
new text begin
If the naturally reduced remains are to be separated into two
or more naturally reduced remains containers according to the directives provided in the
written authorization for natural organic reduction, all of the containers shall contain duplicate
identification disks, tabs, or permanent labels and all paperwork regarding the given body
shall include a notation of the number of and disposition of each container, as provided in
the written authorization.
new text end
new text begin Subd. 19. new text end
new text begin
Natural organic reduction procedures; disposition of accumulated
residue.
new text end
new text begin
Every natural organic reduction facility shall provide for the removal and disposition
of any accumulated residue from any natural organic reduction vessel, mechanical processor,
or other equipment used in natural organic reduction. Disposition of accumulated residue
shall be by any lawful manner deemed appropriate.
new text end
new text begin Subd. 20. new text end
new text begin
Natural organic reduction procedures; release of naturally reduced
remains.
new text end
new text begin
Following completion of the natural organic reduction process, the inurned naturally
reduced remains shall be released according to the instructions given on the written
authorization for natural organic reduction. If the remains are to be shipped, they must be
securely packaged and transported by a method that has an internal tracing system available
and which provides a receipt signed by the person accepting delivery. Where there is a
dispute over release or disposition of the naturally reduced remains, a natural organic
reduction facility may deposit the naturally reduced remains in accordance with the directives
of a court of competent jurisdiction pending resolution of the dispute or retain the naturally
reduced remains until the person with the legal right to control disposition presents
satisfactory indication that the dispute is resolved. A natural organic reduction facility must
make every effort to ensure naturally reduced remains are not sold or used for commercial
purposes.
new text end
new text begin Subd. 21. new text end
new text begin Unclaimed naturally reduced remains. new text end
new text begin
If, after 30 calendar days following
the inurnment, the naturally reduced remains are not claimed or disposed of according to
the written authorization for natural organic reduction, the natural organic reduction facility
shall give written notice, by certified mail, to the person with the legal right to control the
final disposition or a legal designee, that the naturally reduced remains are unclaimed and
requesting further release directions. Should the naturally reduced remains be unclaimed
120 calendar days following the mailing of the written notification, the natural organic
reduction facility may return the remains to the earth respectfully in any lawful manner
deemed appropriate.
new text end
new text begin Subd. 22. new text end
new text begin Required records. new text end
new text begin
Every natural organic reduction facility shall create and
maintain on its premises or other business location in Minnesota an accurate record of every
natural organic reduction provided. The record shall include all of the following information
for each natural organic reduction:
new text end
new text begin
(1) the name of the person or funeral establishment delivering the body for natural
organic reduction;
new text end
new text begin
(2) the name of the deceased and the identification number assigned to the body;
new text end
new text begin
(3) the date of acceptance of delivery;
new text end
new text begin
(4) the names of the operator of the natural organic reduction process and mechanical
processor operator;
new text end
new text begin
(5) the times and dates that the body was placed in and removed from the natural organic
reduction vessel;
new text end
new text begin
(6) the time and date that processing and inurnment of the naturally reduced remains
was completed;
new text end
new text begin
(7) the time, date, and manner of release of the naturally reduced remains;
new text end
new text begin
(8) the name and address of the person who signed the authorization for natural organic
reduction;
new text end
new text begin
(9) all supporting documentation, including any transit or disposition permits, a photocopy
of the death record, and the authorization for natural organic reduction; and
new text end
new text begin
(10) the type of natural organic reduction vessel.
new text end
new text begin Subd. 23. new text end
new text begin Retention of records. new text end
new text begin
Records required under subdivision 21 shall be
maintained for a period of three calendar years after the release of the naturally reduced
remains. Following this period and subject to any other laws requiring retention of records,
the natural organic reduction facility may then place the records in storage or reduce them
to microfilm, a digital format, or any other method that can produce an accurate reproduction
of the original record, for retention for a period of ten calendar years from the date of release
of the naturally reduced remains. At the end of this period and subject to any other laws
requiring retention of records, the natural organic reduction facility may destroy the records
by shredding, incineration, or any other manner that protects the privacy of the individuals
identified.
new text end
Sec. 57. new text begin STILLBIRTH PREVENTION THROUGH TRACKING FETAL
MOVEMENT PILOT PROGRAM.
new text end
new text begin Subdivision 1. new text end
new text begin Grant. new text end
new text begin
The commissioner of health shall issue a grant to a grant recipient
to support a stillbirth prevention through tracking fetal movement pilot program and to
provide evidence of the efficacy of tracking fetal movements in preventing stillbirths in
Minnesota. The pilot program shall operate in fiscal years 2025, 2026, and 2027.
new text end
new text begin Subd. 2. new text end
new text begin Use of grant funds. new text end
new text begin
The grant recipient must use grant funds:
new text end
new text begin
(1) for activities to ensure that expectant parents in Minnesota receive information about
the importance of tracking fetal movement in the third trimester of pregnancy, by providing
evidence-based information to organizations that include but are not limited to community
organizations, hospitals, birth centers, maternal health providers, and higher education
institutions that educate maternal health providers;
new text end
new text begin
(2) to provide maternal health providers and expectant parents in Minnesota with access
to free, evidence-based educational materials on fetal movement tracking, including
brochures, posters, reminder cards, continuing education materials, and digital resources;
new text end
new text begin
(3) to assist in raising awareness with health care providers about:
new text end
new text begin
(i) the availability of free fetal movement tracking education for providers through an
initial education campaign;
new text end
new text begin
(ii) the importance of tracking fetal movement in the third trimester of pregnancy by
offering at least three to five webinars and conferences per year; and
new text end
new text begin
(iii) the importance of tracking fetal movement in the third trimester of pregnancy through
provider participation in a public relations campaign; and
new text end
new text begin
(4) to assist in raising public awareness about the availability of free fetal movement
tracking resources through social media marketing and traditional marketing throughout
Minnesota.
new text end
new text begin Subd. 3. new text end
new text begin Data-sharing and monitoring. new text end
new text begin
(a) During the operation of the pilot program,
the grant recipient shall provide the following information to the commissioner on at least
a quarterly basis:
new text end
new text begin
(1) the number of educational materials distributed under the pilot program, broken
down by zip code and the type of facility or organization that ordered the materials, including
hospitals, birth centers, maternal health clinics, WIC clinics, and community organizations;
new text end
new text begin
(2) the number of fetal movement tracking application downloads that may be attributed
to the pilot program, broken down by zip code;
new text end
new text begin
(3) the reach of and engagement with marketing materials provided under the pilot
program; and
new text end
new text begin
(4) provider attendance and participation in awareness-raising events under the pilot
program, such as webinars and conferences.
new text end
new text begin
(b) Each year during the pilot program and at the conclusion of the pilot program, the
grant recipient shall provide the commissioner with an annual report that includes information
on how the pilot program has affected:
new text end
new text begin
(1) fetal death rates in Minnesota;
new text end
new text begin
(2) fetal death rates in Minnesota among American Indian, Black, Hispanic, and Asian
Pacific Islander populations; and
new text end
new text begin
(3) fetal death rates by region in Minnesota.
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 to the legislative committees with
jurisdiction over public health an interim report and a final report on the operation of the
pilot program. The interim report must be submitted by December 1, 2025, and the final
report must be submitted by December 1, 2027. Each report must at least describe the pilot
program's operations and provide information, to the extent available, on the effectiveness
of the pilot program in preventing stillbirths in Minnesota, including lessons learned in
implementing the pilot program and recommendations for future action.
new text end
ARTICLE 6
DEPARTMENT OF HEALTH POLICY
Section 1.
Minnesota Statutes 2022, section 62D.14, subdivision 1, is amended to read:
Subdivision 1.
Examination authority.
The commissioner of health may make an
examination of the affairs of any health maintenance organization and its contracts,
agreements, or other arrangements with any participating entity as often as the commissioner
of health deems necessary for the protection of the interests of the people of this state, but
not less frequently than once every deleted text begin threedeleted text end new text begin fivenew text end years. Examinations of participating entities
pursuant to this subdivision shall be limited to their dealings with the health maintenance
organization and its enrollees, except that examinations of major participating entities may
include inspection of the entity's financial statements kept in the ordinary course of business.
The commissioner may require major participating entities to submit the financial statements
directly to the commissioner. Financial statements of major participating entities are subject
to the provisions of section 13.37, subdivision 1, clause (b), upon request of the major
participating entity or the health maintenance organization with which it contracts.
Sec. 2.
new text begin
[62J.461] 340B COVERED ENTITY REPORT.
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) "340B covered entity" or "covered entity" means a covered entity as defined in United
States Code, title 42, section 256b(a)(4), with a service address in Minnesota as of January
1 of the reporting year. 340B covered entity includes all entity types and grantees. All
facilities that are identified as child sites or grantee associated sites under the federal 340B
Drug Pricing Program are considered part of the 340B covered entity.
new text end
new text begin
(c) "340B Drug Pricing Program" or "340B program" means the drug discount program
established under United States Code, title 42, section 256b.
new text end
new text begin
(d) "340B entity type" is the designation of the 340B covered entity according to the
entity types specified in United States Code, title 42, section 256b(a)(4).
new text end
new text begin
(e) "340B ID" is the unique identification number provided by the Health Resources
and Services Administration to identify a 340B-eligible entity in the 340B Office of Pharmacy
Affairs Information System.
new text end
new text begin
(f) "Contract pharmacy" means a pharmacy with which a 340B covered entity has an
arrangement to dispense drugs purchased under the 340B Drug Pricing Program.
new text end
new text begin
(g) "Pricing unit" means the smallest dispensable amount of a prescription drug product
that can be dispensed or administered.
new text end
new text begin Subd. 2. new text end
new text begin Current registration. new text end
new text begin
Beginning April 1, 2024, each 340B covered entity must
maintain a current registration with the commissioner in a form and manner prescribed by
the commissioner. The registration must include the following information:
new text end
new text begin
(1) the name of the 340B covered entity;
new text end
new text begin
(2) the 340B ID of the 340B covered entity;
new text end
new text begin
(3) the servicing address of the 340B covered entity; and
new text end
new text begin
(4) the 340B entity type of the 340B covered entity.
new text end
new text begin Subd. 3. new text end
new text begin Reporting by covered entities to the commissioner. new text end
new text begin
(a) Each 340B covered
entity shall report to the commissioner by April 1, 2024, and by April 1 of each year
thereafter, the following information for transactions conducted by the 340B covered entity
or on its behalf, and related to its participation in the federal 340B program for the previous
calendar year:
new text end
new text begin
(1) the aggregated acquisition cost for prescription drugs obtained under the 340B
program;
new text end
new text begin
(2) the aggregated payment amount received for drugs obtained under the 340B program
and dispensed or administered to patients;
new text end
new text begin
(3) the number of pricing units dispensed or administered for prescription drugs described
in clause (2); and
new text end
new text begin
(4) the aggregated payments made:
new text end
new text begin
(i) to contract pharmacies to dispense drugs obtained under the 340B program;
new text end
new text begin
(ii) to any other entity that is not the covered entity and is not a contract pharmacy for
managing any aspect of the covered entity's 340B program; and
new text end
new text begin
(iii) for all other expenses related to administering the 340B program.
new text end
new text begin
The information under clauses (2) and (3) must be reported by payer type, including but
not limited to commercial insurance, medical assistance, MinnesotaCare, and Medicare, in
the form and manner prescribed by the commissioner.
new text end
new text begin
(b) For covered entities that are hospitals, the information required under paragraph (a),
clauses (1) to (3), must also be reported at the national drug code level for the 50 most
frequently dispensed or administered drugs by the facility under the 340B program.
new text end
new text begin
(c) Data submitted to the commissioner under paragraphs (a) and (b) are classified as
nonpublic data, as defined in section 13.02, subdivision 9.
new text end
new text begin Subd. 4. new text end
new text begin Enforcement and exceptions. new text end
new text begin
(a) Any health care entity subject to reporting
under this section that fails to provide data in the form and manner prescribed by the
commissioner is subject to a fine paid to the commissioner of up to $500 for each day the
data are past due. Any fine levied against the entity under this subdivision is subject to the
contested case and judicial review provisions of sections 14.57 and 14.69.
new text end
new text begin
(b) The commissioner may grant an entity an extension of or exemption from the reporting
obligations under this subdivision, upon a showing of good cause by the entity.
new text end
new text begin Subd. 5. new text end
new text begin Reports to the legislature. new text end
new text begin
By November 15, 2024, and by November 15 of
each year thereafter, the commissioner shall submit to the chairs and ranking minority
members of the legislative committees with jurisdiction over health care finance and policy,
a report that aggregates the data submitted under subdivision 3, paragraphs (a) and (b). The
data shall be aggregated in a manner that prevents the identification of an individual entity
and any entity's specific data value reported for an individual data element, except that the
following shall be included in the report:
new text end
new text begin
(1) the information submitted under subdivision 2; and
new text end
new text begin
(2) for each 340B entity identified in subdivision 2, that entity's 340B net revenue as
calculated using the data submitted under subdivision 3, paragraph (a), with net revenue
being subdivision 3, paragraph (a), clause (2), less the sum of subdivision 3, paragraph (a),
clauses (1) and (4).
new text end
Sec. 3.
Minnesota Statutes 2022, section 62J.61, subdivision 5, is amended to read:
Subd. 5.
deleted text begin Biennial review of rulemaking procedures and rulesdeleted text end new text begin Opportunity for
commentnew text end .
The commissioner shall deleted text begin biennially seek comments from affected partiesdeleted text end new text begin maintain
an email address for submission of comments from interested parties to provide inputnew text end about
the effectiveness of and continued need for the rulemaking procedures set out in subdivision
2 and about the quality and effectiveness of rules adopted using these procedures. The
commissioner deleted text begin shall seek comments by holding a meeting and by publishing a notice in the
State Register that contains the date, time, and location of the meeting and a statement that
invites oral or written comments. The notice must be published at least 30 days before the
meeting date. The commissioner shall write a report summarizing the comments and shall
submit the report to the Minnesota Health Data Institute and to the Minnesota Administrative
Uniformity Committee by January 15 of every even-numbered yeardeleted text end new text begin may seek additional
input and provide additional opportunities for input as needednew text end .
Sec. 4.
Minnesota Statutes 2023 Supplement, section 62J.84, subdivision 10, is amended
to read:
Subd. 10.
Notice of prescription drugs of substantial public interest.
(a) No later than
January 31, 2024, and quarterly thereafter, the commissioner shall produce and post on the
department's website a list of prescription drugs that the commissioner determines to represent
a substantial public interest and for which the commissioner intends to request data under
subdivisions 11 to 14, subject to paragraph (c). The commissioner shall base its inclusion
of prescription drugs on any information the commissioner determines is relevant to providing
greater consumer awareness of the factors contributing to the cost of prescription drugs in
the state, and the commissioner shall consider drug product families that include prescription
drugs:
(1) that triggered reporting under subdivision 3 or 4 during the previous calendar quarter;
(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
(3) that are identified by members of the public during a public comment process.
(b) Not sooner than 30 days after publicly posting the list of prescription drugs under
paragraph (a), the department shall notify, via email, reporting entities registered with the
department of the requirement to report under subdivisions 11 to 14.
(c) The commissioner must not designate more than 500 prescription drugs as having a
substantial public interest in any one notice.
new text begin
(d) Notwithstanding subdivision 16, the commissioner is exempt from chapter 14,
including section 14.386, in implementing this subdivision.
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 144.05, subdivision 6, is amended to read:
Subd. 6.
Reports on interagency agreements and intra-agency transfers.
The
commissioner of health shall provide quarterly reports to the chairs and ranking minority
members of the legislative committees with jurisdiction over health and human services
policy and finance on:
(1) interagency agreements or service-level agreements and any renewals or extensions
of existing interagency or service-level agreements with a state department under section
15.01, state agency under section 15.012, or the Department of Information Technology
Services, with a value of more than $100,000, or related agreements with the same department
or agency with a cumulative value of more than $100,000; and
(2) transfers of appropriations of more than $100,000 between accounts within or between
agencies.
The report must include the statutory citation authorizing the agreement, transfer or dollar
amount, purpose, and effective date of the agreement, new text begin and new text end duration of the agreementdeleted text begin , and
a copy of the agreementdeleted text end .
Sec. 6.
Minnesota Statutes 2023 Supplement, section 144.0526, subdivision 1, is amended
to read:
Subdivision 1.
Establishment.
The commissioner of health shall establish the Minnesota
One Health Antimicrobial Stewardship Collaborative. The commissioner shall deleted text begin appointdeleted text end new text begin hirenew text end
a director to execute operations, conduct health education, and provide technical assistance.
Sec. 7.
Minnesota Statutes 2022, section 144.058, is amended to read:
144.058 INTERPRETER SERVICES QUALITY INITIATIVE.
(a) The commissioner of health shall establish a voluntary statewide rosterdeleted text begin ,deleted text end and develop
a plan for a registry and certification process for interpreters who provide high quality,
spoken language health care interpreter services. The roster, registry, and certification
process shall be based on the findings and recommendations set forth by the Interpreter
Services Work Group required under Laws 2007, chapter 147, article 12, section 13.
(b) By January 1, 2009, the commissioner shall establish a roster of all available
interpreters to address access concerns, particularly in rural areas.
(c) By January 15, 2010, the commissioner shall:
(1) develop a plan for a registry of spoken language health care interpreters, including:
(i) development of standards for registration that set forth educational requirements,
training requirements, demonstration of language proficiency and interpreting skills,
agreement to abide by a code of ethics, and a criminal background check;
(ii) recommendations for appropriate alternate requirements in languages for which
testing and training programs do not exist;
(iii) recommendations for appropriate fees; and
(iv) recommendations for establishing and maintaining the standards for inclusion in
the registry; and
(2) develop a plan for implementing a certification process based on national testing and
certification processes for spoken language interpreters 12 months after the establishment
of a national certification process.
(d) The commissioner shall consult with the Interpreter Stakeholder Group of the Upper
Midwest Translators and Interpreters Association for advice on the standards required to
plan for the development of a registry and certification process.
(e) The commissioner shall charge an annual fee of $50 to include an interpreter in the
roster. Fee revenue shall be deposited in the state government special revenue fund.new text begin All fees
are nonrefundable.
new text end
Sec. 8.
Minnesota Statutes 2022, section 144.0724, subdivision 2, is amended to read:
Subd. 2.
Definitions.
For purposes of this section, the following terms have the meanings
given.
(a) "Assessment reference date" or "ARD" means the specific end point for look-back
periods in the MDS assessment process. This look-back period is also called the observation
or assessment period.
(b) "Case mix index" means the weighting factors assigned to the deleted text begin RUG-IVdeleted text end new text begin case mix
reimbursementnew text end classificationsnew text begin determined by an assessmentnew text end .
(c) "Index maximization" means classifying a resident who could be assigned to more
than one category, to the category with the highest case mix index.
(d) "Minimum Data Set" or "MDS" means a core set of screening, clinical assessment,
and functional status elements, that include common definitions and coding categories
specified by the Centers for Medicare and Medicaid Services and designated by the
Department of Health.
(e) "Representative" means a person who is the resident's guardian or conservator, the
person authorized to pay the nursing home expenses of the resident, a representative of the
Office of Ombudsman for Long-Term Care whose assistance has been requested, or any
other individual designated by the resident.
deleted text begin
(f) "Resource utilization groups" or "RUG" means the system for grouping a nursing
facility's residents according to their clinical and functional status identified in data supplied
by the facility's Minimum Data Set.
deleted text end
deleted text begin (g)deleted text end new text begin (f)new text end "Activities of daily living" includes personal hygiene, dressing, bathing,
transferring, bed mobility, locomotion, eating, and toileting.
deleted text begin (h)deleted text end new text begin (g)new text end "Nursing facility level of care determination" means the assessment process that
results in a determination of a resident's or prospective resident's need for nursing facility
level of care as established in subdivision 11 for purposes of medical assistance payment
of long-term care services for:
(1) nursing facility services under deleted text begin section 256B.434 ordeleted text end chapter 256R;
(2) elderly waiver services under chapter 256S;
(3) CADI and BI waiver services under section 256B.49; and
(4) state payment of alternative care services under section 256B.0913.
Sec. 9.
Minnesota Statutes 2022, section 144.0724, subdivision 3a, is amended to read:
Subd. 3a.
Resident deleted text begin reimbursementdeleted text end case mix new text begin reimbursementnew text end classifications deleted text begin beginning
January 1, 2012deleted text end .
(a) deleted text begin Beginning January 1, 2012,deleted text end Resident deleted text begin reimbursementdeleted text end case mix
new text begin reimbursementnew text end classifications shall be based on the Minimum Data Set, version 3.0
assessment instrument, or its successor version mandated by the Centers for Medicare and
Medicaid Services that nursing facilities are required to complete for all residents. deleted text begin The
commissioner of health shall establish resident classifications according to the RUG-IV,
48 group, resource utilization groups. Resident classification must be established based on
the individual items on the Minimum Data Set, which must be completed according to the
Long Term Care Facility Resident Assessment Instrument User's Manual Version 3.0 or its
successor issued by the Centers for Medicare and Medicaid Services.deleted text end new text begin Case mix
reimbursement classifications shall also be based on assessments required under subdivision
4. Assessments must be completed according to the Long Term Care Facility Resident
Assessment Instrument User's Manual Version 3.0 or a successor manual issued by the
Centers for Medicare and Medicaid Services. The optional state assessment must be
completed according to the OSA Manual Version 1.0 v.2.
new text end
(b) Each resident must be classified based on the information from the Minimum Data
Set according to new text begin the new text end general categories issued by the Minnesota Department of Healthnew text begin ,
utilized for reimbursement purposesnew text end .
Sec. 10.
Minnesota Statutes 2022, section 144.0724, subdivision 4, is amended to read:
Subd. 4.
Resident assessment schedule.
(a) A facility must conduct and electronically
submit to the federal database MDS assessments that conform with the assessment schedule
defined by the Long Term Care Facility Resident Assessment Instrument User's Manual,
version 3.0, or its successor issued by the Centers for Medicare and Medicaid Services. The
commissioner of health may substitute successor manuals or question and answer documents
published by the United States Department of Health and Human Services, Centers for
Medicare and Medicaid Services, to replace or supplement the current version of the manual
or document.
(b) The assessments required under the Omnibus Budget Reconciliation Act of 1987
(OBRA) used to determine a case mix new text begin reimbursementnew text end classification deleted text begin for reimbursementdeleted text end
include:
(1) a new admission comprehensive assessment, which must have an assessment reference
date (ARD) within 14 calendar days after admission, excluding readmissions;
(2) an annual comprehensive assessment, which must have an ARD within 92 days of
a previous quarterly review assessment or a previous comprehensive assessment, which
must occur at least once every 366 days;
(3) a significant change in status comprehensive assessment, which must have an ARD
within 14 days after the facility determines, or should have determined, that there has been
a significant change in the resident's physical or mental condition, whether an improvement
or a decline, and regardless of the amount of time since the last comprehensive assessment
or quarterly review assessment;
(4) a quarterly review assessment must have an ARD within 92 days of the ARD of the
previous quarterly review assessment or a previous comprehensive assessment;
(5) any significant correction to a prior comprehensive assessment, if the assessment
being corrected is the current one being used for deleted text begin RUGdeleted text end new text begin reimbursementnew text end classification;
(6) any significant correction to a prior quarterly review assessment, if the assessment
being corrected is the current one being used for deleted text begin RUGdeleted text end new text begin reimbursementnew text end classification;new text begin and
new text end
deleted text begin
(7) a required significant change in status assessment when:
deleted text end
deleted text begin
(i) all speech, occupational, and physical therapies have ended. If the most recent OBRA
comprehensive or quarterly assessment completed does not result in a rehabilitation case
mix classification, then the significant change in status assessment is not required. The ARD
of this assessment must be set on day eight after all therapy services have ended; and
deleted text end
deleted text begin
(ii) isolation for an infectious disease has ended. If isolation was not coded on the most
recent OBRA comprehensive or quarterly assessment completed, then the significant change
in status assessment is not required. The ARD of this assessment must be set on day 15 after
isolation has ended; and
deleted text end
(8)new text begin (7)new text end any modifications to the most recent assessments under clauses (1) to deleted text begin (7)deleted text end new text begin (6)new text end .
new text begin
(c) The optional state assessment must accompany all OBRA assessments. The optional
state assessment is also required to determine reimbursement when:
new text end
new text begin
(i) all speech, occupational, and physical therapies have ended. If the most recent optional
state assessment completed does not result in a rehabilitation case mix reimbursement
classification, then the optional state assessment is not required. The ARD of this assessment
must be set on day eight after all therapy services have ended; and
new text end
new text begin
(ii) isolation for an infectious disease has ended. If isolation was not coded on the most
recent optional state assessment completed, then the optional state assessment is not required.
The ARD of this assessment must be set on day 15 after isolation has ended.
new text end
deleted text begin (c)deleted text end new text begin (d)new text end In addition to the assessments listed in deleted text begin paragraphdeleted text end new text begin paragraphsnew text end (b)new text begin and (c)new text end , the
assessments used to determine nursing facility level of care include the following:
(1) preadmission screening completed under section 256.975, subdivisions 7a to 7c, by
the Senior LinkAge Line or other organization under contract with the Minnesota Board on
Aging; and
(2) a nursing facility level of care determination as provided for under section 256B.0911,
subdivision 26, as part of a face-to-face long-term care consultation assessment completed
under section 256B.0911, by a county, tribe, or managed care organization under contract
with the Department of Human Services.
Sec. 11.
Minnesota Statutes 2022, section 144.0724, subdivision 6, is amended to read:
Subd. 6.
Penalties for late or nonsubmission.
(a) A facility that fails to complete or
submit an assessment according to subdivisions 4 and 5 for a deleted text begin RUG-IVdeleted text end new text begin case mix
reimbursementnew text end classification deleted text begin within seven days of the time requirements listed in the
Long-Term Care Facility Resident Assessment Instrument User's Manualdeleted text end new text begin when the
assessment is duenew text end is subject to a reduced rate for that resident. The reduced rate shall be the
lowest rate for that facility. The reduced rate is effective on the day of admission for new
admission assessments, on the ARD for significant change in status assessments, or on the
day that the assessment was due for all other assessments and continues in effect until the
first day of the month following the date of submission and acceptance of the resident's
assessment.
(b) If loss of revenue due to penalties incurred by a facility for any period of 92 days
are equal to or greater than 0.1 percent of the total operating costs on the facility's most
recent annual statistical and cost report, a facility may apply to the commissioner of human
services for a reduction in the total penalty amount. The commissioner of human services,
in consultation with the commissioner of health, may, at the sole discretion of the
commissioner of human services, limit the penalty for residents covered by medical assistance
to ten days.
Sec. 12.
Minnesota Statutes 2022, section 144.0724, subdivision 7, is amended to read:
Subd. 7.
Notice of resident deleted text begin reimbursementdeleted text end case mix new text begin reimbursementnew text end classification.
(a)
The commissioner of health shall provide to a nursing facility a notice for each resident of
the classification established under subdivision 1. The notice must inform the resident of
the case mix new text begin reimbursementnew text end classification assigned, the opportunity to review the
documentation supporting the classification, the opportunity to obtain clarification from the
commissioner, deleted text begin anddeleted text end the opportunity to request a reconsideration of the classificationnew text begin ,new text end and
the address and telephone number of the Office of Ombudsman for Long-Term Care. The
commissioner must transmit the notice of resident classification by electronic means to the
nursing facility. The nursing facility is responsible for the distribution of the notice to each
resident or the resident's representative. This notice must be distributed within three business
days after the facility's receipt.
(b) If a facility submits a deleted text begin modifyingdeleted text end new text begin modifiednew text end assessment resulting in a change in the
case mix new text begin reimbursementnew text end classification, the facility must provide a written notice to the
resident or the resident's representative regarding the item or items that were modified and
the reason for the modifications. The new text begin writtennew text end notice must be provided within three business
days after distribution of the resident case mix new text begin reimbursementnew text end classification notice.
Sec. 13.
Minnesota Statutes 2022, section 144.0724, subdivision 8, is amended to read:
Subd. 8.
Request for reconsideration of resident classifications.
(a) The resident, deleted text begin ordeleted text end
resident's representative, deleted text begin ordeleted text end the nursing facilitynew text begin ,new text end or new text begin thenew text end boarding care home may request that
the commissioner of health reconsider the assigned deleted text begin reimbursementdeleted text end case mix new text begin reimbursementnew text end
classification and any item or items changed during the audit process. The request for
reconsideration must be submitted in writing to the commissioner of health.
(b) For reconsideration requests initiated by the resident or the resident's representative:
(1) The resident or the resident's representative must submit in writing a reconsideration
request to the facility administrator within 30 days of receipt of the resident classification
notice. The written request must include the reasons for the reconsideration request.
(2) Within three business days of receiving the reconsideration request, the nursing
facility must submit to the commissioner of health a completed reconsideration request
form, a copy of the resident's or resident's representative's written request, and all supporting
documentation used to complete the assessment being deleted text begin considereddeleted text end new text begin reconsiderednew text end . If the facility
fails to provide the required information, the reconsideration will be completed with the
information submitted and the facility cannot make further reconsideration requests on this
classification.
(3) Upon written request and within three business days, the nursing facility must give
the resident or the resident's representative a copy of the assessment being reconsidered and
all supporting documentation used to complete the assessment. Notwithstanding any law
to the contrary, the facility may not charge a fee for providing copies of the requested
documentation. If a facility fails to provide the required documents within this time, it is
subject to the issuance of a correction order and penalty assessment under sections 144.653
and 144A.10. Notwithstanding those sections, any correction order issued under this
subdivision must require that the nursing facility immediately comply with the request for
information, and as of the date of the issuance of the correction order, the facility shall
forfeit to the state a $100 fine for the first day of noncompliance, and an increase in the
$100 fine by $50 increments for each day the noncompliance continues.
(c) For reconsideration requests initiated by the facility:
(1) The facility is required to inform the resident or the resident's representative in writing
that a reconsideration of the resident's case mix new text begin reimbursementnew text end classification is being
requested. The notice must inform the resident or the resident's representative:
(i) of the date and reason for the reconsideration request;
(ii) of the potential for a new text begin case mix reimbursementnew text end classification new text begin changenew text end and subsequent
rate change;
(iii) of the extent of the potential rate change;
(iv) that copies of the request and supporting documentation are available for review;
and
(v) that the resident or the resident's representative has the right to request a
reconsideration new text begin alsonew text end .
(2) Within 30 days of receipt of the audit exit report or resident classification notice, the
facility must submit to the commissioner of health a completed reconsideration request
form, all supporting documentation used to complete the assessment being reconsidered,
and a copy of the notice informing the resident or the resident's representative that a
reconsideration of the resident's classification is being requested.
(3) If the facility fails to provide the required information, the reconsideration request
may be denied and the facility may not make further reconsideration requests on this
classification.
(d) Reconsideration by the commissioner must be made by individuals not involved in
reviewing the assessment, audit, or reconsideration that established the disputed classification.
The reconsideration must be based upon the assessment that determined the classification
and upon the information provided to the commissioner of health under paragraphs (a) to
(c). If necessary for evaluating the reconsideration request, the commissioner may conduct
on-site reviews. Within 15 business days of receiving the request for reconsideration, the
commissioner shall affirm or modify the original resident classification. The original
classification must be modified if the commissioner determines that the assessment resulting
in the classification did not accurately reflect characteristics of the resident at the time of
the assessment. The commissioner must transmit the reconsideration classification notice
by electronic means to the nursing facility. The nursing facility is responsible for the
distribution of the notice to the resident or the resident's representative. The notice must be
distributed by the nursing facility within three business days after receipt. A decision by
the commissioner under this subdivision is the final administrative decision of the agency
for the party requesting reconsideration.
(e) The case mix new text begin reimbursementnew text end classification established by the commissioner shall be
the classification which applies to the resident while the request for reconsideration is
pending. If a request for reconsideration applies to an assessment used to determine nursing
facility level of care under subdivision 4, paragraph deleted text begin (c)deleted text end new text begin (d)new text end , the resident shall continue to
be eligible for nursing facility level of care while the request for reconsideration is pending.
(f) The commissioner may request additional documentation regarding a reconsideration
necessary to make an accurate reconsideration determination.
new text begin
(g) Data collected as part of the reconsideration process under this section is classified
as private data on individuals and nonpublic data pursuant to section 13.02. Notwithstanding
the classification of these data as private or nonpublic, the commissioner is authorized to
share these data with the U.S. Centers for Medicare and Medicaid Services and the
commissioner of human services as necessary for reimbursement purposes.
new text end
Sec. 14.
Minnesota Statutes 2022, section 144.0724, subdivision 9, is amended to read:
Subd. 9.
Audit authority.
(a) The commissioner shall audit the accuracy of resident
assessments performed under section 256R.17 through any of the following: desk audits;
on-site review of residents and their records; and interviews with staff, residents, or residents'
families. The commissioner shall reclassify a resident if the commissioner determines that
the resident was incorrectly classified.
(b) The commissioner is authorized to conduct on-site audits on an unannounced basis.
(c) A facility must grant the commissioner access to examine the medical records relating
to the resident assessments selected for audit under this subdivision. The commissioner may
also observe and speak to facility staff and residents.
(d) The commissioner shall consider documentation under the time frames for coding
items on the minimum data set as set out in the Long-Term Care Facility Resident Assessment
Instrument User's Manual new text begin or OSA Manual version 1.0 v.2 new text end published by the Centers for
Medicare and Medicaid Services.
(e) The commissioner shall develop an audit selection procedure that includes the
following factors:
(1) Each facility shall be audited annually. If a facility has two successive audits in which
the percentage of change is five percent or less and the facility has not been the subject of
a special audit in the past 36 months, the facility may be audited biannually. A stratified
sample of 15 percent, with a minimum of ten assessments, of the most current assessments
shall be selected for audit. If more than 20 percent of the deleted text begin RUG-IVdeleted text end new text begin case mix reimbursementnew text end
classifications are changed as a result of the audit, the audit shall be expanded to a second
15 percent sample, with a minimum of ten assessments. If the total change between the first
and second samples is 35 percent or greater, the commissioner may expand the audit to all
of the remaining assessments.
(2) If a facility qualifies for an expanded audit, the commissioner may audit the facility
again within six months. If a facility has two expanded audits within a 24-month period,
that facility will be audited at least every six months for the next 18 months.
(3) The commissioner may conduct special audits if the commissioner determines that
circumstances exist that could alter or affect the validity of case mix new text begin reimbursementnew text end
classifications of residents. These circumstances include, but are not limited to, the following:
(i) frequent changes in the administration or management of the facility;
(ii) an unusually high percentage of residents in a specific case mix new text begin reimbursementnew text end
classification;
(iii) a high frequency in the number of reconsideration requests received from a facility;
(iv) frequent adjustments of case mix new text begin reimbursementnew text end classifications as the result of
reconsiderations or audits;
(v) a criminal indictment alleging provider fraud;
(vi) other similar factors that relate to a facility's ability to conduct accurate assessments;
(vii) an atypical pattern of scoring minimum data set items;
(viii) nonsubmission of assessments;
(ix) late submission of assessments; or
(x) a previous history of audit changes of 35 percent or greater.
(f) If the audit results in a case mix new text begin reimbursementnew text end classification change, the
commissioner must transmit the audit classification notice by electronic means to the nursing
facility within 15 business days of completing an audit. The nursing facility is responsible
for distribution of the notice to each resident or the resident's representative. This notice
must be distributed by the nursing facility within three business days after receipt. The
notice must inform the resident of the case mix new text begin reimbursementnew text end classification assigned, the
opportunity to review the documentation supporting the classification, the opportunity to
obtain clarification from the commissioner, the opportunity to request a reconsideration of
the classification, and the address and telephone number of the Office of Ombudsman for
Long-Term Care.
Sec. 15.
Minnesota Statutes 2022, section 144.0724, subdivision 11, is amended to read:
Subd. 11.
Nursing facility level of care.
(a) For purposes of medical assistance payment
of long-term care services, a recipient must be determined, using assessments defined in
subdivision 4, to meet one of the following nursing facility level of care criteria:
(1) the person requires formal clinical monitoring at least once per day;
(2) the person needs the assistance of another person or constant supervision to begin
and complete at least four of the following activities of living: bathing, bed mobility, dressing,
eating, grooming, toileting, transferring, and walking;
(3) the person needs the assistance of another person or constant supervision to begin
and complete toileting, transferring, or positioning and the assistance cannot be scheduled;
(4) the person has significant difficulty with memory, using information, daily decision
making, or behavioral needs that require intervention;
(5) the person has had a qualifying nursing facility stay of at least 90 days;
(6) the person meets the nursing facility level of care criteria determined 90 days after
admission or on the first quarterly assessment after admission, whichever is later; or
(7) the person is determined to be at risk for nursing facility admission or readmission
through a face-to-face long-term care consultation assessment as specified in section
256B.0911, subdivision 17 to 21, 23, 24, 27, or 28, by a county, tribe, or managed care
organization under contract with the Department of Human Services. The person is
considered at risk under this clause if the person currently lives alone or will live alone or
be homeless without the person's current housing and also meets one of the following criteria:
(i) the person has experienced a fall resulting in a fracture;
(ii) the person has been determined to be at risk of maltreatment or neglect, including
self-neglect; or
(iii) the person has a sensory impairment that substantially impacts functional ability
and maintenance of a community residence.
(b) The assessment used to establish medical assistance payment for nursing facility
services must be the most recent assessment performed under subdivision 4, deleted text begin paragraphdeleted text end new text begin
paragraphsnew text end (b)new text begin and (c)new text end , that occurred no more than 90 calendar days before the effective
date of medical assistance eligibility for payment of long-term care services. In no case
shall medical assistance payment for long-term care services occur prior to the date of the
determination of nursing facility level of care.
(c) The assessment used to establish medical assistance payment for long-term care
services provided under chapter 256S and section 256B.49 and alternative care payment
for services provided under section 256B.0913 must be the most recent face-to-face
assessment performed under section 256B.0911, subdivisions 17 to 21, 23, 24, 27, or 28,
that occurred no more than 60 calendar days before the effective date of medical assistance
eligibility for payment of long-term care services.
Sec. 16.
Minnesota Statutes 2022, section 144.1464, subdivision 1, is amended to read:
Subdivision 1.
Summer internships.
The commissioner of health, through a contract
with a nonprofit organization as required by subdivision 4, shall award grants, within
available appropriations, to hospitals, clinics, nursing facilities,new text begin assisted living facilities,new text end
and home care providers to establish a secondary and postsecondary summer health care
intern program. The purpose of the program is to expose interested secondary and
postsecondary pupils to various careers within the health care profession.
Sec. 17.
Minnesota Statutes 2022, section 144.1464, subdivision 2, is amended to read:
Subd. 2.
Criteria.
(a) The commissioner, through the organization under contract, shall
award grants to hospitals, clinics, nursing facilities,new text begin assisted living facilities,new text end and home care
providers that agree to:
(1) provide secondary and postsecondary summer health care interns with formal exposure
to the health care profession;
(2) provide an orientation for the secondary and postsecondary summer health care
interns;
(3) pay one-half the costs of employing the secondary and postsecondary summer health
care intern;
(4) interview and hire secondary and postsecondary pupils for a minimum of six weeks
and a maximum of 12 weeks; and
(5) employ at least one secondary student for each postsecondary student employed, to
the extent that there are sufficient qualifying secondary student applicants.
(b) In order to be eligible to be hired as a secondary summer health intern by a hospital,
clinic, nursing facility,new text begin assisted living facility,new text end or home care provider, a pupil must:
(1) intend to complete high school graduation requirements and be between the junior
and senior year of high school; and
(2) be from a school district in proximity to the facility.
(c) In order to be eligible to be hired as a postsecondary summer health care intern by
a hospital or clinic, a pupil must:
(1) intend to complete a health care training program or a two-year or four-year degree
program and be planning on enrolling in or be enrolled in that training program or degree
program; and
(2) be enrolled in a Minnesota educational institution or be a resident of the state of
Minnesota; priority must be given to applicants from a school district or an educational
institution in proximity to the facility.
(d) Hospitals, clinics, nursing facilities,new text begin assisted living facilities,new text end and home care providers
awarded grants may employ pupils as secondary and postsecondary summer health care
interns beginning on or after June 15, 1993, if they agree to pay the intern, during the period
before disbursement of state grant money, with money designated as the facility's 50 percent
contribution towards internship costs.
Sec. 18.
Minnesota Statutes 2022, section 144.1464, subdivision 3, is amended to read:
Subd. 3.
Grants.
The commissioner, through the organization under contract, shall
award separate grants to hospitals, clinics, nursing facilities, and home care providers meeting
the requirements of subdivision 2. The grants must be used to pay one-half of the costs of
employing secondary and postsecondary pupils in a hospital, clinic, nursing facility,new text begin assisted
living facilities,new text end or home care setting during the course of the program. No more than 50
percent of the participants may be postsecondary students, unless the program does not
receive enough qualified secondary applicants per fiscal year. No more than five pupils may
be selected from any secondary or postsecondary institution to participate in the program
and no more than one-half of the number of pupils selected may be from the seven-county
metropolitan area.
Sec. 19.
Minnesota Statutes 2023 Supplement, section 144.1505, subdivision 2, is amended
to read:
Subd. 2.
Programs.
(a) For advanced practice provider clinical training expansion grants,
the commissioner of health shall award health professional training site grants to eligible
physician assistant, advanced practice registered nurse, pharmacy, dental therapy, and mental
health professional programs to plan and implement expanded clinical training. A planning
grant shall not exceed $75,000, and anew text begin three-yearnew text end training grant shall not exceed deleted text begin $150,000
for the first year, $100,000 for the second year, and $50,000 for the third yeardeleted text end new text begin $300,000new text end per
deleted text begin programdeleted text end new text begin project. The commissioner may provide a one-year, no-cost extension for grantsnew text end .
(b) For health professional rural and underserved clinical rotations grants, the
commissioner of health shall award health professional training site grants to eligible
physician, physician assistant, advanced practice registered nurse, pharmacy, dentistry,
dental therapy, and mental health professional programs to augment existing clinical training
programs to add rural and underserved rotations or clinical training experiences, such as
credential or certificate rural tracks or other specialized training. For physician and dentist
training, the expanded training must include rotations in primary care settings such as
community clinics, hospitals, health maintenance organizations, or practices in rural
communities.
(c) Funds may be used for:
(1) establishing or expanding rotations and clinical training;
(2) recruitment, training, and retention of students and faculty;
(3) connecting students with appropriate clinical training sites, internships, practicums,
or externship activities;
(4) travel and lodging for students;
(5) faculty, student, and preceptor salaries, incentives, or other financial support;
(6) development and implementation of cultural competency training;
(7) evaluations;
(8) training site improvements, fees, equipment, and supplies required to establish,
maintain, or expand a training program; and
(9) supporting clinical education in which trainees are part of a primary care team model.
Sec. 20.
Minnesota Statutes 2022, section 144.1911, subdivision 2, is amended to read:
Subd. 2.
Definitions.
(a) For the purposes of this section, the following terms have the
meanings given.
(b) "Commissioner" means the commissioner of health.
(c) "Immigrant international medical graduate" means an international medical graduate
who was born outside the United States, now resides permanently in the United Statesnew text begin or
who has entered the United States on a temporary status based on urgent humanitarian or
significant public benefit reasonsnew text end , and who did not enter the United States on a J1 or similar
nonimmigrant visa following acceptance into a United States medical residency or fellowship
program.
(d) "International medical graduate" means a physician who received a basic medical
degree or qualification from a medical school located outside the United States and Canada.
(e) "Minnesota immigrant international medical graduate" means an immigrant
international medical graduate who has lived in Minnesota for at least two years.
(f) "Rural community" 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) "Underserved community" means a Minnesota area or population included in the
list of designated primary medical care health professional shortage areas, medically
underserved areas, or medically underserved populations (MUPs) maintained and updated
by the United States Department of Health and Human Services.
Sec. 21.
Minnesota Statutes 2022, section 144.212, is amended by adding a subdivision
to read:
new text begin Subd. 5a. new text end
new text begin Replacement. new text end
new text begin
"Replacement" means a completion, addition, removal, or
change made to certification items on a vital record after a vital event is registered and a
record is established that has no notation of a change on a certificate and seals the prior vital
record.
new text end
Sec. 22.
Minnesota Statutes 2022, section 144.216, subdivision 2, is amended to read:
Subd. 2.
Status of foundling reports.
A report registered under subdivision 1 shall
constitute the record of birth for the child. new text begin Information about the newborn shall be registered
by the state registrar in accordance with Minnesota Rules, part 4601.0600, subpart 4, item
C. new text end If the child is identified and a record of birth is found or obtained, the report registered
under subdivision 1 shall be confidential pursuant to section 13.02, subdivision 3, and shall
not be disclosed except pursuant to court order.
Sec. 23.
Minnesota Statutes 2022, section 144.216, is amended by adding a subdivision
to read:
new text begin Subd. 3. new text end
new text begin Reporting safe place newborns. new text end
new text begin
Hospitals that receive a newborn under section
145.902 shall report the birth of the newborn to the Office of Vital Records within five days
after receiving the newborn. Information about the newborn shall be registered by the state
registrar in accordance with Minnesota Rules, part 4601.0600, subpart 4, item C.
new text end
Sec. 24.
Minnesota Statutes 2022, section 144.216, is amended by adding a subdivision
to read:
new text begin Subd. 4. new text end
new text begin Status of safe place birth reports and registrations. new text end
new text begin
(a) Information about a
safe place newborn registered under subdivision 3 shall constitute the record of birth for
the child. The record shall be confidential pursuant to section 13.02, subdivision 3.
Information on the birth record or a birth certificate issued from the birth record shall be
disclosed only to the responsible social services agency or pursuant to a court order.
new text end
new text begin
(b) Information about a safe place newborn registered under subdivision 3 shall constitute
the record of birth for the child. If the safe place newborn was born in a hospital and it is
known that a record of birth was registered, filed, or amended, the original birth record
registered under section 144.215 shall be replaced pursuant to section 144.218, subdivision
6.
new text end
Sec. 25.
Minnesota Statutes 2022, section 144.218, is amended by adding a subdivision
to read:
new text begin Subd. 6. new text end
new text begin Safe place newborn; birth record. new text end
new text begin
If a safe place infant birth is registered
pursuant to section 144.216, subdivision 4, paragraph (b), the state registrar shall issue a
replacement birth record free of information that identifies a parent. The prior vital record
shall be confidential pursuant to section 13.02, subdivision 3, and shall not be disclosed
except pursuant to a court order.
new text end
Sec. 26.
Minnesota Statutes 2022, section 144.493, is amended by adding a subdivision
to read:
new text begin Subd. 2a. new text end
new text begin Thrombectomy-capable stroke center. new text end
new text begin
A hospital meets the criteria for a
thrombectomy-capable stroke center if the hospital has been certified as a
thrombectomy-capable stroke center by the joint commission or another nationally recognized
accreditation entity or is a primary stroke center that is not certified as a thrombectomy-based
capable stroke center but the hospital has attained a level of stroke care distinction by offering
mechanical endovascular therapies and has been certified by a department approved certifying
body that is a nationally recognized guidelines-based organization.
new text end
Sec. 27.
Minnesota Statutes 2022, section 144.494, subdivision 2, is amended to read:
Subd. 2.
Designation.
A hospital that voluntarily meets the criteria for a comprehensive
stroke center, new text begin thrombectomy-capable stroke center, new text end primary stroke center, or acute stroke
ready hospital may apply to the commissioner for designation, and upon the commissioner's
review and approval of the application, shall be designated as a comprehensive stroke center,
new text begin a thrombectomy-capable stroke center, new text end a primary stroke center, or an acute stroke ready
hospital for a three-year period. If a hospital loses its certification as a comprehensive stroke
center or primary stroke center from the joint commission or other nationally recognized
accreditation entity, or no longer participates in the Minnesota stroke registry program, its
Minnesota designation shall be immediately withdrawn. Prior to the expiration of the
deleted text begin three-yeardeleted text end designationnew text begin periodnew text end , a hospital seeking to remain part of the voluntary acute stroke
system may reapply to the commissioner for designation.
Sec. 28.
Minnesota Statutes 2022, section 144.551, subdivision 1, is amended to read:
Subdivision 1.
Restricted construction or modification.
(a) The following construction
or modification may not be commenced:
(1) any erection, building, alteration, reconstruction, modernization, improvement,
extension, lease, or other acquisition by or on behalf of a hospital that increases the bed
capacity of a hospital, relocates hospital beds from one physical facility, complex, or site
to another, or otherwise results in an increase or redistribution of hospital beds within the
state; and
(2) the establishment of a new hospital.
(b) This section does not apply to:
(1) construction or relocation within a county by a hospital, clinic, or other health care
facility that is a national referral center engaged in substantial programs of patient care,
medical research, and medical education meeting state and national needs that receives more
than 40 percent of its patients from outside the state of Minnesota;
(2) a project for construction or modification for which a health care facility held an
approved certificate of need on May 1, 1984, regardless of the date of expiration of the
certificate;
(3) a project for which a certificate of need was denied before July 1, 1990, if a timely
appeal results in an order reversing the denial;
(4) a project exempted from certificate of need requirements by Laws 1981, chapter 200,
section 2;
(5) a project involving consolidation of pediatric specialty hospital services within the
Minneapolis-St. Paul metropolitan area that would not result in a net increase in the number
of pediatric specialty hospital beds among the hospitals being consolidated;
(6) a project involving the temporary relocation of pediatric-orthopedic hospital beds to
an existing licensed hospital that will allow for the reconstruction of a new philanthropic,
pediatric-orthopedic hospital on an existing site and that will not result in a net increase in
the number of hospital beds. Upon completion of the reconstruction, the licenses of both
hospitals must be reinstated at the capacity that existed on each site before the relocation;
(7) the relocation or redistribution of hospital beds within a hospital building or
identifiable complex of buildings provided the relocation or redistribution does not result
in: (i) an increase in the overall bed capacity at that site; (ii) relocation of hospital beds from
one physical site or complex to another; or (iii) redistribution of hospital beds within the
state or a region of the state;
(8) relocation or redistribution of hospital beds within a hospital corporate system that
involves the transfer of beds from a closed facility site or complex to an existing site or
complex provided that: (i) no more than 50 percent of the capacity of the closed facility is
transferred; (ii) the capacity of the site or complex to which the beds are transferred does
not increase by more than 50 percent; (iii) the beds are not transferred outside of a federal
health systems agency boundary in place on July 1, 1983; (iv) the relocation or redistribution
does not involve the construction of a new hospital building; and (v) the transferred beds
are used first to replace within the hospital corporate system the total number of beds
previously used in the closed facility site or complex for mental health services and substance
use disorder services. Only after the hospital corporate system has fulfilled the requirements
of this item may the remainder of the available capacity of the closed facility site or complex
be transferred for any other purpose;
(9) a construction project involving up to 35 new beds in a psychiatric hospital in Rice
County that primarily serves adolescents and that receives more than 70 percent of its
patients from outside the state of Minnesota;
(10) a project to replace a hospital or hospitals with a combined licensed capacity of
130 beds or less if: (i) the new hospital site is located within five miles of the current site;
and (ii) the total licensed capacity of the replacement hospital, either at the time of
construction of the initial building or as the result of future expansion, will not exceed deleted text begin 70deleted text end new text begin
100new text end licensed hospital beds, or the combined licensed capacity of the hospitals, whichever
is less;
(11) the relocation of licensed hospital beds from an existing state facility operated by
the commissioner of human services to a new or existing facility, building, or complex
operated by the commissioner of human services; from one regional treatment center site
to another; or from one building or site to a new or existing building or site on the same
campus;
(12) the construction or relocation of hospital beds operated by a hospital having a
statutory obligation to provide hospital and medical services for the indigent that does not
result in a net increase in the number of hospital beds, notwithstanding section 144.552, 27
beds, of which 12 serve mental health needs, may be transferred from Hennepin County
Medical Center to Regions Hospital under this clause;
(13) a construction project involving the addition of up to 31 new beds in an existing
nonfederal hospital in Beltrami County;
(14) a construction project involving the addition of up to eight new beds in an existing
nonfederal hospital in Otter Tail County with 100 licensed acute care beds;
(15) a construction project involving the addition of 20 new hospital beds in an existing
hospital in Carver County serving the southwest suburban metropolitan area;
(16) a project for the construction or relocation of up to 20 hospital beds for the operation
of up to two psychiatric facilities or units for children provided that the operation of the
facilities or units have received the approval of the commissioner of human services;
(17) a project involving the addition of 14 new hospital beds to be used for rehabilitation
services in an existing hospital in Itasca County;
(18) a project to add 20 licensed beds in existing space at a hospital in Hennepin County
that closed 20 rehabilitation beds in 2002, provided that the beds are used only for
rehabilitation in the hospital's current rehabilitation building. If the beds are used for another
purpose or moved to another location, the hospital's licensed capacity is reduced by 20 beds;
(19) a critical access hospital established under section 144.1483, clause (9), and section
1820 of the federal Social Security Act, United States Code, title 42, section 1395i-4, that
delicensed beds since enactment of the Balanced Budget Act of 1997, Public Law 105-33,
to the extent that the critical access hospital does not seek to exceed the maximum number
of beds permitted such hospital under federal law;
(20) notwithstanding section 144.552, a project for the construction of a new hospital
in the city of Maple Grove with a licensed capacity of up to 300 beds provided that:
(i) the project, including each hospital or health system that will own or control the entity
that will hold the new hospital license, is approved by a resolution of the Maple Grove City
Council as of March 1, 2006;
(ii) the entity that will hold the new hospital license will be owned or controlled by one
or more not-for-profit hospitals or health systems that have previously submitted a plan or
plans for a project in Maple Grove as required under section 144.552, and the plan or plans
have been found to be in the public interest by the commissioner of health as of April 1,
2005;
(iii) the new hospital's initial inpatient services must include, but are not limited to,
medical and surgical services, obstetrical and gynecological services, intensive care services,
orthopedic services, pediatric services, noninvasive cardiac diagnostics, behavioral health
services, and emergency room services;
(iv) the new hospital:
(A) will have the ability to provide and staff sufficient new beds to meet the growing
needs of the Maple Grove service area and the surrounding communities currently being
served by the hospital or health system that will own or control the entity that will hold the
new hospital license;
(B) will provide uncompensated care;
(C) will provide mental health services, including inpatient beds;
(D) will be a site for workforce development for a broad spectrum of health-care-related
occupations and have a commitment to providing clinical training programs for physicians
and other health care providers;
(E) will demonstrate a commitment to quality care and patient safety;
(F) will have an electronic medical records system, including physician order entry;
(G) will provide a broad range of senior services;
(H) will provide emergency medical services that will coordinate care with regional
providers of trauma services and licensed emergency ambulance services in order to enhance
the continuity of care for emergency medical patients; and
(I) will be completed by December 31, 2009, unless delayed by circumstances beyond
the control of the entity holding the new hospital license; and
(v) as of 30 days following submission of a written plan, the commissioner of health
has not determined that the hospitals or health systems that will own or control the entity
that will hold the new hospital license are unable to meet the criteria of this clause;
(21) a project approved under section 144.553;
(22) a project for the construction of a hospital with up to 25 beds in Cass County within
a 20-mile radius of the state Ah-Gwah-Ching facility, provided the hospital's license holder
is approved by the Cass County Board;
(23) a project for an acute care hospital in Fergus Falls that will increase the bed capacity
from 108 to 110 beds by increasing the rehabilitation bed capacity from 14 to 16 and closing
a separately licensed 13-bed skilled nursing facility;
(24) notwithstanding section 144.552, a project for the construction and expansion of a
specialty psychiatric hospital in Hennepin County for up to 50 beds, exclusively for patients
who are under 21 years of age on the date of admission. The commissioner conducted a
public interest review of the mental health needs of Minnesota and the Twin Cities
metropolitan area in 2008. No further public interest review shall be conducted for the
construction or expansion project under this clause;
(25) a project for a 16-bed psychiatric hospital in the city of Thief River Falls, if the
commissioner finds the project is in the public interest after the public interest review
conducted under section 144.552 is complete;
(26)(i) a project for a 20-bed psychiatric hospital, within an existing facility in the city
of Maple Grove, exclusively for patients who are under 21 years of age on the date of
admission, if the commissioner finds the project is in the public interest after the public
interest review conducted under section 144.552 is complete;
(ii) this project shall serve patients in the continuing care benefit program under section
256.9693. The project may also serve patients not in the continuing care benefit program;
and
(iii) if the project ceases to participate in the continuing care benefit program, the
commissioner must complete a subsequent public interest review under section 144.552. If
the project is found not to be in the public interest, the license must be terminated six months
from the date of that finding. If the commissioner of human services terminates the contract
without cause or reduces per diem payment rates for patients under the continuing care
benefit program below the rates in effect for services provided on December 31, 2015, the
project may cease to participate in the continuing care benefit program and continue to
operate without a subsequent public interest review;
(27) a project involving the addition of 21 new beds in an existing psychiatric hospital
in Hennepin County that is exclusively for patients who are under 21 years of age on the
date of admission;
(28) a project to add 55 licensed beds in an existing safety net, level I trauma center
hospital in Ramsey County as designated under section 383A.91, subdivision 5, of which
15 beds are to be used for inpatient mental health and 40 are to be used for other services.
In addition, five unlicensed observation mental health beds shall be added;
(29) upon submission of a plan to the commissioner for public interest review under
section 144.552 and the addition of the 15 inpatient mental health beds specified in clause
(28), to its bed capacity, a project to add 45 licensed beds in an existing safety net, level I
trauma center hospital in Ramsey County as designated under section 383A.91, subdivision
5. Five of the 45 additional beds authorized under this clause must be designated for use
for inpatient mental health and must be added to the hospital's bed capacity before the
remaining 40 beds are added. Notwithstanding section 144.552, the hospital may add licensed
beds under this clause prior to completion of the public interest review, provided the hospital
submits its plan by the 2021 deadline and adheres to the timelines for the public interest
review described in section 144.552;
(30) upon submission of a plan to the commissioner for public interest review under
section 144.552, a project to add up to 30 licensed beds in an existing psychiatric hospital
in Hennepin County that exclusively provides care to patients who are under 21 years of
age on the date of admission. Notwithstanding section 144.552, the psychiatric hospital
may add licensed beds under this clause prior to completion of the public interest review,
provided the hospital submits its plan by the 2021 deadline and adheres to the timelines for
the public interest review described in section 144.552;
(31) any project to add licensed beds in a hospital located in Cook County or Mahnomen
County that: (i) is designated as a critical access hospital under section 144.1483, clause
(9), and United States Code, title 42, section 1395i-4; (ii) has a licensed bed capacity of
fewer than 25 beds; and (iii) has an attached nursing home, so long as the total number of
licensed beds in the hospital after the bed addition does not exceed 25 beds. Notwithstanding
section 144.552, a public interest review is not required for a project authorized under this
clause;
(32) upon submission of a plan to the commissioner for public interest review under
section 144.552, a project to add 22 licensed beds at a Minnesota freestanding children's
hospital in St. Paul that is part of an independent pediatric health system with freestanding
inpatient hospitals located in Minneapolis and St. Paul. The beds shall be utilized for pediatric
inpatient behavioral health services. Notwithstanding section 144.552, the hospital may add
licensed beds under this clause prior to completion of the public interest review, provided
the hospital submits its plan by the 2022 deadline and adheres to the timelines for the public
interest review described in section 144.552; or
(33) a project for a 144-bed psychiatric hospital on the site of the former Bethesda
hospital in the city of Saint Paul, Ramsey County, if the commissioner finds the project is
in the public interest after the public interest review conducted under section 144.552 is
complete. Following the completion of the construction project, the commissioner of health
shall monitor the hospital, including by assessing the hospital's case mix and payer mix,
patient transfers, and patient diversions. The hospital must have an intake and assessment
area. The hospital must accommodate patients with acute mental health needs, whether they
walk up to the facility, are delivered by ambulances or law enforcement, or are transferred
from other facilities. The hospital must comply with subdivision 1a, paragraph (b). The
hospital must annually submit de-identified data to the department in the format and manner
defined by the commissioner.
Sec. 29.
Minnesota Statutes 2022, section 144.551, subdivision 1, is amended to read:
Subdivision 1.
Restricted construction or modification.
(a) The following construction
or modification may not be commenced:
(1) any erection, building, alteration, reconstruction, modernization, improvement,
extension, lease, or other acquisition by or on behalf of a hospital that increases the bed
capacity of a hospital, relocates hospital beds from one physical facility, complex, or site
to another, or otherwise results in an increase or redistribution of hospital beds within the
state; and
(2) the establishment of a new hospital.
(b) This section does not apply to:
(1) construction or relocation within a county by a hospital, clinic, or other health care
facility that is a national referral center engaged in substantial programs of patient care,
medical research, and medical education meeting state and national needs that receives more
than 40 percent of its patients from outside the state of Minnesota;
(2) a project for construction or modification for which a health care facility held an
approved certificate of need on May 1, 1984, regardless of the date of expiration of the
certificate;
(3) a project for which a certificate of need was denied before July 1, 1990, if a timely
appeal results in an order reversing the denial;
(4) a project exempted from certificate of need requirements by Laws 1981, chapter 200,
section 2;
(5) a project involving consolidation of pediatric specialty hospital services within the
Minneapolis-St. Paul metropolitan area that would not result in a net increase in the number
of pediatric specialty hospital beds among the hospitals being consolidated;
(6) a project involving the temporary relocation of pediatric-orthopedic hospital beds to
an existing licensed hospital that will allow for the reconstruction of a new philanthropic,
pediatric-orthopedic hospital on an existing site and that will not result in a net increase in
the number of hospital beds. Upon completion of the reconstruction, the licenses of both
hospitals must be reinstated at the capacity that existed on each site before the relocation;
(7) the relocation or redistribution of hospital beds within a hospital building or
identifiable complex of buildings provided the relocation or redistribution does not result
in: (i) an increase in the overall bed capacity at that site; (ii) relocation of hospital beds from
one physical site or complex to another; or (iii) redistribution of hospital beds within the
state or a region of the state;
(8) relocation or redistribution of hospital beds within a hospital corporate system that
involves the transfer of beds from a closed facility site or complex to an existing site or
complex provided that: (i) no more than 50 percent of the capacity of the closed facility is
transferred; (ii) the capacity of the site or complex to which the beds are transferred does
not increase by more than 50 percent; (iii) the beds are not transferred outside of a federal
health systems agency boundary in place on July 1, 1983; (iv) the relocation or redistribution
does not involve the construction of a new hospital building; and (v) the transferred beds
are used first to replace within the hospital corporate system the total number of beds
previously used in the closed facility site or complex for mental health services and substance
use disorder services. Only after the hospital corporate system has fulfilled the requirements
of this item may the remainder of the available capacity of the closed facility site or complex
be transferred for any other purpose;
(9) a construction project involving up to 35 new beds in a psychiatric hospital in Rice
County that primarily serves adolescents and that receives more than 70 percent of its
patients from outside the state of Minnesota;
(10) a project to replace a hospital or hospitals with a combined licensed capacity of
130 beds or less if: (i) the new hospital site is located within five miles of the current site;
and (ii) the total licensed capacity of the replacement hospital, either at the time of
construction of the initial building or as the result of future expansion, will not exceed 70
licensed hospital beds, or the combined licensed capacity of the hospitals, whichever is less;
(11) the relocation of licensed hospital beds from an existing state facility operated by
the commissioner of human services to a new or existing facility, building, or complex
operated by the commissioner of human services; from one regional treatment center site
to another; or from one building or site to a new or existing building or site on the same
campus;
(12) the construction or relocation of hospital beds operated by a hospital having a
statutory obligation to provide hospital and medical services for the indigent that does not
result in a net increase in the number of hospital beds, notwithstanding section 144.552, 27
beds, of which 12 serve mental health needs, may be transferred from Hennepin County
Medical Center to Regions Hospital under this clause;
(13) a construction project involving the addition of up to 31 new beds in an existing
nonfederal hospital in Beltrami County;
(14) a construction project involving the addition of up to eight new beds in an existing
nonfederal hospital in Otter Tail County with 100 licensed acute care beds;
(15) a construction project involving the addition of 20 new hospital beds in an existing
hospital in Carver County serving the southwest suburban metropolitan area;
(16) a project for the construction or relocation of up to 20 hospital beds for the operation
of up to two psychiatric facilities or units for children provided that the operation of the
facilities or units have received the approval of the commissioner of human services;
(17) a project involving the addition of 14 new hospital beds to be used for rehabilitation
services in an existing hospital in Itasca County;
(18) a project to add 20 licensed beds in existing space at a hospital in Hennepin County
that closed 20 rehabilitation beds in 2002, provided that the beds are used only for
rehabilitation in the hospital's current rehabilitation building. If the beds are used for another
purpose or moved to another location, the hospital's licensed capacity is reduced by 20 beds;
(19) a critical access hospital established under section 144.1483, clause (9), and section
1820 of the federal Social Security Act, United States Code, title 42, section 1395i-4, that
delicensed beds since enactment of the Balanced Budget Act of 1997, Public Law 105-33,
to the extent that the critical access hospital does not seek to exceed the maximum number
of beds permitted such hospital under federal law;
(20) notwithstanding section 144.552, a project for the construction of a new hospital
in the city of Maple Grove with a licensed capacity of up to 300 beds provided that:
(i) the project, including each hospital or health system that will own or control the entity
that will hold the new hospital license, is approved by a resolution of the Maple Grove City
Council as of March 1, 2006;
(ii) the entity that will hold the new hospital license will be owned or controlled by one
or more not-for-profit hospitals or health systems that have previously submitted a plan or
plans for a project in Maple Grove as required under section 144.552, and the plan or plans
have been found to be in the public interest by the commissioner of health as of April 1,
2005;
(iii) the new hospital's initial inpatient services must include, but are not limited to,
medical and surgical services, obstetrical and gynecological services, intensive care services,
orthopedic services, pediatric services, noninvasive cardiac diagnostics, behavioral health
services, and emergency room services;
(iv) the new hospital:
(A) will have the ability to provide and staff sufficient new beds to meet the growing
needs of the Maple Grove service area and the surrounding communities currently being
served by the hospital or health system that will own or control the entity that will hold the
new hospital license;
(B) will provide uncompensated care;
(C) will provide mental health services, including inpatient beds;
(D) will be a site for workforce development for a broad spectrum of health-care-related
occupations and have a commitment to providing clinical training programs for physicians
and other health care providers;
(E) will demonstrate a commitment to quality care and patient safety;
(F) will have an electronic medical records system, including physician order entry;
(G) will provide a broad range of senior services;
(H) will provide emergency medical services that will coordinate care with regional
providers of trauma services and licensed emergency ambulance services in order to enhance
the continuity of care for emergency medical patients; and
(I) will be completed by December 31, 2009, unless delayed by circumstances beyond
the control of the entity holding the new hospital license; and
(v) as of 30 days following submission of a written plan, the commissioner of health
has not determined that the hospitals or health systems that will own or control the entity
that will hold the new hospital license are unable to meet the criteria of this clause;
(21) a project approved under section 144.553;
(22) a project for the construction of a hospital with up to 25 beds in Cass County within
a 20-mile radius of the state Ah-Gwah-Ching facility, provided the hospital's license holder
is approved by the Cass County Board;
(23) a project for an acute care hospital in Fergus Falls that will increase the bed capacity
from 108 to 110 beds by increasing the rehabilitation bed capacity from 14 to 16 and closing
a separately licensed 13-bed skilled nursing facility;
(24) notwithstanding section 144.552, a project for the construction and expansion of a
specialty psychiatric hospital in Hennepin County for up to 50 beds, exclusively for patients
who are under 21 years of age on the date of admission. The commissioner conducted a
public interest review of the mental health needs of Minnesota and the Twin Cities
metropolitan area in 2008. No further public interest review shall be conducted for the
construction or expansion project under this clause;
(25) a project for a 16-bed psychiatric hospital in the city of Thief River Falls, if the
commissioner finds the project is in the public interest after the public interest review
conducted under section 144.552 is complete;
(26)(i) a project for a 20-bed psychiatric hospital, within an existing facility in the city
of Maple Grove, exclusively for patients who are under 21 years of age on the date of
admission, if the commissioner finds the project is in the public interest after the public
interest review conducted under section 144.552 is complete;
(ii) this project shall serve patients in the continuing care benefit program under section
256.9693. The project may also serve patients not in the continuing care benefit program;
and
(iii) if the project ceases to participate in the continuing care benefit program, the
commissioner must complete a subsequent public interest review under section 144.552. If
the project is found not to be in the public interest, the license must be terminated six months
from the date of that finding. If the commissioner of human services terminates the contract
without cause or reduces per diem payment rates for patients under the continuing care
benefit program below the rates in effect for services provided on December 31, 2015, the
project may cease to participate in the continuing care benefit program and continue to
operate without a subsequent public interest review;
(27) a project involving the addition of 21 new beds in an existing psychiatric hospital
in Hennepin County that is exclusively for patients who are under 21 years of age on the
date of admission;
(28) a project to add 55 licensed beds in an existing safety net, level I trauma center
hospital in Ramsey County as designated under section 383A.91, subdivision 5, of which
15 beds are to be used for inpatient mental health and 40 are to be used for other services.
In addition, five unlicensed observation mental health beds shall be added;
(29) upon submission of a plan to the commissioner for public interest review under
section 144.552 and the addition of the 15 inpatient mental health beds specified in clause
(28), to its bed capacity, a project to add 45 licensed beds in an existing safety net, level I
trauma center hospital in Ramsey County as designated under section 383A.91, subdivision
5. Five of the 45 additional beds authorized under this clause must be designated for use
for inpatient mental health and must be added to the hospital's bed capacity before the
remaining 40 beds are added. Notwithstanding section 144.552, the hospital may add licensed
beds under this clause prior to completion of the public interest review, provided the hospital
submits its plan by the 2021 deadline and adheres to the timelines for the public interest
review described in section 144.552;
(30) upon submission of a plan to the commissioner for public interest review under
section 144.552, a project to add up to 30 licensed beds in an existing psychiatric hospital
in Hennepin County that exclusively provides care to patients who are under 21 years of
age on the date of admission. Notwithstanding section 144.552, the psychiatric hospital
may add licensed beds under this clause prior to completion of the public interest review,
provided the hospital submits its plan by the 2021 deadline and adheres to the timelines for
the public interest review described in section 144.552;
(31) any project to add licensed beds in a hospital located in Cook County or Mahnomen
County that: (i) is designated as a critical access hospital under section 144.1483, clause
(9), and United States Code, title 42, section 1395i-4; (ii) has a licensed bed capacity of
fewer than 25 beds; and (iii) has an attached nursing home, so long as the total number of
licensed beds in the hospital after the bed addition does not exceed 25 beds. Notwithstanding
section 144.552, a public interest review is not required for a project authorized under this
clause;
(32) upon submission of a plan to the commissioner for public interest review under
section 144.552, a project to add 22 licensed beds at a Minnesota freestanding children's
hospital in St. Paul that is part of an independent pediatric health system with freestanding
inpatient hospitals located in Minneapolis and St. Paul. The beds shall be utilized for pediatric
inpatient behavioral health services. Notwithstanding section 144.552, the hospital may add
licensed beds under this clause prior to completion of the public interest review, provided
the hospital submits its plan by the 2022 deadline and adheres to the timelines for the public
interest review described in section 144.552; deleted text begin or
deleted text end
(33) a project for a 144-bed psychiatric hospital on the site of the former Bethesda
hospital in the city of Saint Paul, Ramsey County, if the commissioner finds the project is
in the public interest after the public interest review conducted under section 144.552 is
complete. Following the completion of the construction project, the commissioner of health
shall monitor the hospital, including by assessing the hospital's case mix and payer mix,
patient transfers, and patient diversions. The hospital must have an intake and assessment
area. The hospital must accommodate patients with acute mental health needs, whether they
walk up to the facility, are delivered by ambulances or law enforcement, or are transferred
from other facilities. The hospital must comply with subdivision 1a, paragraph (b). The
hospital must annually submit de-identified data to the department in the format and manner
defined by the commissionerdeleted text begin .deleted text end new text begin ; or
new text end
new text begin
(34) a project involving the relocation of up to 26 licensed long-term acute care hospital
beds from an existing long-term care hospital located in Hennepin County with a licensed
capacity prior to the relocation of 92 beds to dedicated space on the campus of an existing
safety net, level I trauma center hospital in Ramsey County as designated under section
383A.91, subdivision 5, provided both the commissioner finds the project is in the public
interest after the public interest review conducted under section 144.552 is complete and
the relocated beds continue to be used as long-term acute care hospital beds after the
relocation.
new text end
Sec. 30.
Minnesota Statutes 2022, section 144.605, is amended by adding a subdivision
to read:
new text begin Subd. 10. new text end
new text begin Chapter 16C waiver. new text end
new text begin
Pursuant to subdivisions 4, paragraph (b), and 5,
paragraph (b), the commissioner of administration may waive provisions of chapter 16C
for the purposes of approving contracts for independent clinical teams.
new text end
Sec. 31.
Minnesota Statutes 2022, section 144.99, subdivision 3, is amended to read:
Subd. 3.
Correction orders.
(a) The commissioner may issue correction orders that
require a person to correct a violation of the statutes, rules, and other actions listed in
subdivision 1. The correction order must state the deficiencies that constitute the violation;
the specific statute, rule, or other action; and the time by which the violation must be
corrected.
(b) If the person believes that the information contained in the commissioner's correction
order is in error, the person may ask the commissioner to reconsider the parts of the order
that are alleged to be in error. The request must be in writing, delivered to the commissioner
by certified mail within deleted text begin sevendeleted text end new text begin 15new text end calendar days after receipt of the order, and:
(1) specify which parts of the order for corrective action are alleged to be in error;
(2) explain why they are in error; and
(3) provide documentation to support the allegation of error.
The commissioner must respond to requests made under this paragraph within 15 calendar
days after receiving a request. A request for reconsideration does not stay the correction
order; however, after reviewing the request for reconsideration, the commissioner may
provide additional time to comply with the order if necessary. The commissioner's disposition
of a request for reconsideration is final.
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 144A.10, subdivision 15, is amended to read:
Subd. 15.
Informal dispute resolution.
The commissioner shall respond in writing to
a request from a nursing facility certified under the federal Medicare and Medicaid programs
for an informal dispute resolution within deleted text begin 30 days of the exit date of the facility's surveydeleted text end new text begin ten
calendar days of the facility's receipt of the notice of deficienciesnew text end . The commissioner's
response shall identify the commissioner's decision regarding deleted text begin the continuation ofdeleted text end each
deficiency citation challenged by the nursing facility, as well as a statement of any changes
in findings, level of severity or scope, and proposed remedies or sanctions for each deficiency
citation.
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 144A.10, subdivision 16, is amended to read:
Subd. 16.
Independent informal dispute resolution.
(a) Notwithstanding subdivision
15, a facility certified under the federal Medicare or Medicaid programs new text begin that has been
assessed a civil money penalty as provided by Code of Federal Regulations, title 42, section
488.430, new text end may request from the commissioner, in writing, an independent informal dispute
resolution process regarding any deficiency deleted text begin citation issued to the facilitydeleted text end . The facility must
deleted text begin specify in its written request each deficiency citation that it disputes. The commissioner
shall provide a hearing under sections 14.57 to 14.62. Upon the written request of the facility,
the parties must submit the issues raised to arbitration by an administrative law judgedeleted text end new text begin submit
its request in writing within ten calendar days of receiving notice that a civil money penalty
will be imposednew text end .
new text begin
(b) The facility and commissioner have the right to be represented by an attorney at the
hearing.
new text end
new text begin
(c) An independent informal dispute resolution may not be requested for any deficiency
that is the subject of an active informal dispute resolution requested under subdivision 15.
The facility must withdraw its informal dispute resolution prior to requesting independent
informal dispute resolution.
new text end
deleted text begin (b) Upondeleted text end new text begin (d) Within five calendar days ofnew text end receipt of a written request for an deleted text begin arbitration
proceedingdeleted text end new text begin independent informal dispute resolutionnew text end , the commissioner shall file with the
Office of Administrative Hearings a request for the appointment of an deleted text begin arbitratordeleted text end new text begin
administrative law judge from the Office of Administrative Hearingsnew text end and simultaneously
serve the facility with notice of the request. deleted text begin The arbitrator for the dispute shall be an
administrative law judge appointed by the Office of Administrative Hearings. The disclosure
provisions of section 572B.12 and the notice provisions of section 572B.15, subsection (c),
apply. The facility and the commissioner have the right to be represented by an attorney.
deleted text end
new text begin
(e) An independent informal dispute resolution proceeding shall be scheduled to occur
within 30 calendar days of the commissioner's request to the Office of Administrative
Hearings, unless the parties agree otherwise or the chief administrative law judge deems
the timing to be unreasonable. The independent informal dispute resolution process must
be completed within 60 calendar days of the facility's request.
new text end
deleted text begin (c)deleted text end new text begin (f) Five working days in advance of the scheduled proceeding,new text end the commissioner
and the facility deleted text begin may presentdeleted text end new text begin must submitnew text end written new text begin statements and arguments, documentary
new text end evidence, depositions, and deleted text begin oral statements and arguments at the arbitration proceeding. Oral
statements and arguments may be made by telephonedeleted text end new text begin any other materials supporting their
position to the administrative law judgenew text end .
new text begin
(g) The independent informal dispute resolution proceeding shall be informal and
conducted in a manner so as to allow the parties to fully present their positions and respond
to the opposing party's positions. This may include presentation of oral statements and
arguments at the proceeding.
new text end
deleted text begin (d)deleted text end new text begin (h)new text end Within ten working days of the close of the deleted text begin arbitrationdeleted text end proceeding, the
administrative law judge shall issue findings new text begin and recommendations new text end regarding each of the
deficiencies in dispute. The findings shall be one or more of the following:
(1) Supported in full. The citation is supported in full, with no deletion of findings and
no change in the scope or severity assigned to the deficiency citation.
(2) Supported in substance. The citation is supported, but one or more findings are
deleted without any change in the scope or severity assigned to the deficiency.
(3) Deficient practice cited under wrong requirement of participation. The citation is
amended by moving it to the correct requirement of participation.
(4) Scope not supported. The citation is amended through a change in the scope assigned
to the citation.
(5) Severity not supported. The citation is amended through a change in the severity
assigned to the citation.
(6) No deficient practice. The citation is deleted because the findings did not support
the citation or the negative resident outcome was unavoidable. deleted text begin The findings of the arbitrator
are not binding on the commissioner.
deleted text end
new text begin
(i) The findings and recommendations of the administrative law judge are not binding
on the commissioner.
new text end
new text begin
(j) Within ten calendar days of receiving the administrative law judge's findings and
recommendations, the commissioner shall issue a recommendation to the Center for Medicare
and Medicaid Services.
new text end
deleted text begin (e)deleted text end new text begin (k)new text end The commissioner shall reimburse the Office of Administrative Hearings for the
costs incurred by that office for the deleted text begin arbitrationdeleted text end proceeding. deleted text begin The facility shall reimburse the
commissioner for the proportion of the costs that represent the sum of deficiency citations
supported in full under paragraph (d), clause (1), or in substance under paragraph (d), clause
(2), divided by the total number of deficiencies disputed. A deficiency citation for which
the administrative law judge's sole finding is that the deficient practice was cited under the
wrong requirements of participation shall not be counted in the numerator or denominator
in the calculation of the proportion of costs.
deleted text end
new text begin EFFECTIVE DATE. new text end
new text begin
This section is effective October 1, 2024, or upon federal approval,
whichever is later, and applies to appeals of deficiencies which are issued after October 1,
2024, or on or after the date upon which federal approval is obtained, whichever is later.
The commissioner of health shall notify the revisor of statutes when federal approval is
obtained.
new text end
Sec. 34.
Minnesota Statutes 2022, section 144A.44, subdivision 1, is amended to read:
Subdivision 1.
Statement of rights.
(a) A client who receives home care services deleted text begin in the
community or in an assisted living facility licensed under chapter deleted text end deleted text begin 144Gdeleted text end has these rights:
(1) receive written information, in plain language, about rights before receiving services,
including what to do if rights are violated;
(2) receive care and services according to a suitable and up-to-date plan, and subject to
accepted health care, medical or nursing standards and person-centered care, to take an
active part in developing, modifying, and evaluating the plan and services;
(3) be told before receiving services the type and disciplines of staff who will be providing
the services, the frequency of visits proposed to be furnished, other choices that are available
for addressing home care needs, and the potential consequences of refusing these services;
(4) be told in advance of any recommended changes by the provider in the service plan
and to take an active part in any decisions about changes to the service plan;
(5) refuse services or treatment;
(6) know, before receiving services or during the initial visit, any limits to the services
available from a home care provider;
(7) be told before services are initiated what the provider charges for the services; to
what extent payment may be expected from health insurance, public programs, or other
sources, if known; and what charges the client may be responsible for paying;
(8) know that there may be other services available in the community, including other
home care services and providers, and to know where to find information about these
services;
(9) choose freely among available providers and to change providers after services have
begun, within the limits of health insurance, long-term care insurance, medical assistance,
other health programs, or public programs;
(10) have personal, financial, and medical information kept private, and to be advised
of the provider's policies and procedures regarding disclosure of such information;
(11) access the client's own records and written information from those records in
accordance with sections 144.291 to 144.298;
(12) be served by people who are properly trained and competent to perform their duties;
(13) be treated with courtesy and respect, and to have the client's property treated with
respect;
(14) be free from physical and verbal abuse, neglect, financial exploitation, and all forms
of maltreatment covered under the Vulnerable Adults Act and the Maltreatment of Minors
Act;
(15) reasonable, advance notice of changes in services or charges;
(16) know the provider's reason for termination of services;
(17) at least ten calendar days' advance notice of the termination of a service by a home
care providerdeleted text begin , except at least 30 calendar days' advance notice of the service termination
shall be given by a home care provider for services provided to a client residing in an assisted
living facility as defined in section 144G.08, subdivision 7deleted text end . This clause does not apply in
cases where:
(i) the client engages in conduct that significantly alters the terms of the service plan
with the home care provider;
(ii) the client, person who lives with the client, or others create an abusive or unsafe
work environment for the person providing home care services; or
(iii) an emergency or a significant change in the client's condition has resulted in service
needs that exceed the current service plan and that cannot be safely met by the home care
provider;
(18) a coordinated transfer when there will be a change in the provider of services;
(19) complain to staff and others of the client's choice about services that are provided,
or fail to be provided, and the lack of courtesy or respect to the client or the client's property
and the right to recommend changes in policies and services, free from retaliation including
the threat of termination of services;
(20) know how to contact an individual associated with the home care provider who is
responsible for handling problems and to have the home care provider investigate and
attempt to resolve the grievance or complaint;
(21) know the name and address of the state or county agency to contact for additional
information or assistance;new text begin and
new text end
(22) assert these rights personally, or have them asserted by the client's representative
or by anyone on behalf of the client, without retaliationdeleted text begin ; anddeleted text end new text begin .
new text end
deleted text begin
(23) place an electronic monitoring device in the client's or resident's space in compliance
with state requirements.
deleted text end
(b) When providers violate the rights in this section, they are subject to the fines and
license actions in sections 144A.474, subdivision 11, and 144A.475.
(c) Providers must do all of the following:
(1) encourage and assist in the fullest possible exercise of these rights;
(2) provide the names and telephone numbers of individuals and organizations that
provide advocacy and legal services for clients deleted text begin and residentsdeleted text end seeking to assert their rights;
(3) make every effort to assist clients deleted text begin or residentsdeleted text end in obtaining information regarding
whether Medicare, medical assistance, other health programs, or public programs will pay
for services;
(4) make reasonable accommodations for people who have communication disabilities,
or those who speak a language other than English; and
(5) provide all information and notices in plain language and in terms the client deleted text begin or
residentdeleted text end can understand.
(d) No provider may require or request a client deleted text begin or residentdeleted text end to waive any of the rights
listed in this section at any time or for any reasons, including as a condition of initiating
services deleted text begin or entering into an assisted living contractdeleted text end .
Sec. 35.
Minnesota Statutes 2022, section 144A.471, is amended by adding a subdivision
to read:
new text begin Subd. 1a. new text end
new text begin Licensure under other law. new text end
new text begin
A home care licensee must not provide sleeping
accommodations as a provision of home care services. For purposes of this subdivision, the
provision of sleeping accommodations and assisted living services under section 144G.08,
subdivision 9, requires assisted living licensure under chapter 144G.
new text end
Sec. 36.
Minnesota Statutes 2022, section 144A.474, subdivision 13, is amended to read:
Subd. 13.
Home care surveyor training.
(a) Before conducting a home care survey,
each home care surveyor must receive training on the following topics:
(1) Minnesota home care licensure requirements;
(2) Minnesota home care bill of rights;
(3) Minnesota Vulnerable Adults Act and reporting of maltreatment of minors;
(4) principles of documentation;
(5) survey protocol and processes;
(6) Offices of the Ombudsman roles;
(7) Office of Health Facility Complaints;
(8) Minnesota landlord-tenant deleted text begin and housing with servicesdeleted text end laws;
(9) types of payors for home care services; and
(10) Minnesota Nurse Practice Act for nurse surveyors.
(b) Materials used for the training in paragraph (a) shall be posted on the department
website. Requisite understanding of these topics will be reviewed as part of the quality
improvement plan in section 144A.483.
Sec. 37.
Minnesota Statutes 2023 Supplement, section 144A.4791, subdivision 10, is
amended to read:
Subd. 10.
Termination of service plan.
(a) If a home care provider terminates a service
plan with a client, and the client continues to need home care services, the home care provider
shall provide the client and the client's representative, if any, with a written notice of
termination which includes the following information:
(1) the effective date of termination;
(2) the reason for termination;
(3) for clients age 18 or older, a statement that the client may contact the Office of
Ombudsman for Long-Term Care to request an advocate to assist regarding the termination
and contact information for the office, including the office's central telephone number;
(4) a list of known licensed home care providers in the client's immediate geographic
area;
(5) a statement that the home care provider will participate in a coordinated transfer of
care of the client to another home care provider, health care provider, or caregiver, as
required by the home care bill of rights, section 144A.44, subdivision 1, clause (17);new text begin and
new text end
(6) the name and contact information of a person employed by the home care provider
with whom the client may discuss the notice of terminationdeleted text begin ; anddeleted text end new text begin .
new text end
deleted text begin
(7) if applicable, a statement that the notice of termination of home care services does
not constitute notice of termination of any housing contract.
deleted text end
(b) When the home care provider voluntarily discontinues services to all clients, the
home care provider must notify the commissioner, lead agencies, and ombudsman for
long-term care about its clients and comply with the requirements in this subdivision.
Sec. 38.
Minnesota Statutes 2022, section 144E.16, subdivision 7, is amended to read:
Subd. 7.
Stroke transport protocols.
Regional emergency medical services programs
and any ambulance service licensed under this chapter must develop stroke transport
protocols. The protocols must include standards of care for triage and transport of acute
stroke patients within a specific time frame from symptom onset until transport to the most
appropriate designated acute stroke ready hospital, primary stroke center,
new text begin thrombectomy-capable stroke center, new text end or comprehensive stroke center.
Sec. 39.
Minnesota Statutes 2022, section 144G.08, subdivision 29, is amended to read:
Subd. 29.
Licensed health professional.
"Licensed health professional" means a person
deleted text begin licensed in Minnesota to practice a profession described in section 214.01, subdivision 2deleted text end new text begin ,
other than a registered nurse or licensed practical nurse, who provides assisted living services
within the scope of practice of that person's health occupation license, registration, or
certification as a regulated person who is licensed by an appropriate Minnesota state board
or agencynew text end .
Sec. 40.
Minnesota Statutes 2022, section 144G.10, is amended by adding a subdivision
to read:
new text begin Subd. 5. new text end
new text begin Protected title; restriction on use. new text end
new text begin
(a) Effective January 1, 2026, no person
or entity may use the phrase "assisted living," whether alone or in combination with other
words and whether orally or in writing, to: advertise; market; or otherwise describe, offer,
or promote itself, or any housing, service, service package, or program that it provides
within this state, unless the person or entity is a licensed assisted living facility that meets
the requirements of this chapter. A person or entity entitled to use the phrase "assisted living"
shall use the phrase only in the context of its participation that meets the requirements of
this chapter.
new text end
new text begin
(b) Effective January 1, 2026, the licensee's name for a new assisted living facility may
not include the terms "home care" or "nursing home."
new text end
Sec. 41.
Minnesota Statutes 2022, section 144G.16, subdivision 6, is amended to read:
Subd. 6.
Requirements for notice and transfer.
A provisional licensee whose license
is denied must comply with the requirements for notification and the coordinated move of
residents in sections 144G.52 and 144G.55.new text begin If the license denial is upheld by the
reconsideration process, the licensee must submit a draft closure plan as required by section
144G.57 within ten calendar days of receipt of the reconsideration decision and submit a
final plan within 30 days.
new text end
Sec. 42.
Minnesota Statutes 2023 Supplement, section 145.561, subdivision 4, is amended
to read:
Subd. 4.
988 telecommunications fee.
(a) In compliance with the National Suicide
Hotline Designation Act of 2020, deleted text begin the commissioner shall impose a monthly statewide fee
ondeleted text end each subscriber of a wireline, wireless, or IP-enabled voice service deleted text begin at a rate that providesdeleted text end new text begin
must pay a monthly fee to providenew text end for the robust creation, operation, and maintenance of a
statewide 988 suicide prevention and crisis system.
deleted text begin
(b) The commissioner shall annually recommend to the Public Utilities Commission an
adequate and appropriate fee to implement this section. The amount of the fee must comply
with the limits in paragraph (c). The commissioner shall provide telecommunication service
providers and carriers a minimum of 45 days' notice of each fee change.
deleted text end
deleted text begin (c)deleted text end new text begin (b)new text end The amount of the 988 telecommunications fee deleted text begin must not be more than 25deleted text end new text begin is 12new text end
cents per month deleted text begin on or after January 1, 2024,deleted text end for each consumer access line, including trunk
equivalents as designated by the deleted text begin commissiondeleted text end new text begin Public Utilities Commissionnew text end pursuant to section
403.11, subdivision 1. The 988 telecommunications fee must be the same for all subscribers.
deleted text begin (d)deleted text end new text begin (c)new text end 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).
deleted text begin (e)deleted text end new text begin (d)new text end 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.
deleted text begin (f)deleted text end new text begin (e)new text end All 988 telecommunications fee revenue must be used to supplement, and not
supplant, federal, state, and local funding for suicide prevention.
deleted text begin (g)deleted text end new text begin (f)new text end 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.
deleted text begin (h)deleted text end new text begin (g)new text end The commissioner shall annually report to the Federal Communications
Commission on revenue generated by the 988 telecommunications fee.
new text begin EFFECTIVE DATE. new text end
new text begin
This section is effective September 1, 2024.
new text end
Sec. 43.
Minnesota Statutes 2022, section 146B.03, subdivision 7a, is amended to read:
Subd. 7a.
Supervisors.
(a) A technician must have been licensed in Minnesota or in a
jurisdiction with which Minnesota has reciprocity for at least:
(1) two years as a tattoo techniciannew text begin licensed under section 146B.03, subdivision 4, 6, or
8new text end , in order to supervise a temporary tattoo technician; or
(2) one year as a body piercing techniciannew text begin licensed under section 146B.03, subdivision
4, 6, or 8,new text end or must have performed at least 500 body piercings, in order to supervise a
temporary body piercing technician.
(b) Any technician who agrees to supervise more than two temporary tattoo technicians
during the same time period, or more than four body piercing technicians during the same
time period, must provide to the commissioner a supervisory plan that describes how the
technician will provide supervision to each temporary technician in accordance with section
146B.01, subdivision 28.
(c) The supervisory plan must include, at a minimum:
(1) the areas of practice under supervision;
(2) the anticipated supervision hours per week;
(3) the anticipated duration of the training period; and
(4) the method of providing supervision if there are multiple technicians being supervised
during the same time period.
(d) If the supervisory plan is terminated before completion of the technician's supervised
practice, the supervisor must notify the commissioner in writing within 14 days of the change
in supervision and include an explanation of why the plan was not completed.
(e) The commissioner may refuse to approve as a supervisor a technician who has been
disciplined in Minnesota or in another jurisdiction after considering the criteria in section
146B.02, subdivision 10, paragraph (b).
Sec. 44.
Minnesota Statutes 2022, section 146B.10, subdivision 1, is amended to read:
Subdivision 1.
Licensing fees.
(a) The fee for the initial technician licensurenew text begin applicationnew text end
and biennial licensure renewalnew text begin applicationnew text end is $420.
(b) The fee for temporary technician licensurenew text begin applicationnew text end is $240.
(c) The fee for the temporary guest artist licensenew text begin applicationnew text end is $140.
(d) The fee for a dual body art technician licensenew text begin applicationnew text end is $420.
(e) The fee for a provisional establishment licensenew text begin application required in section 146B.02,
subdivision 5, paragraph (c),new text end is $1,500.
(f) The fee for an initial establishment licensenew text begin applicationnew text end and the two-year license
renewal periodnew text begin applicationnew text end required in section 146B.02, subdivision 2, paragraph (b), is
$1,500.
(g) The fee for a temporary body art establishment event permitnew text begin applicationnew text end is $200.
(h) The commissioner shall prorate the initial two-year technician license fee based on
the number of months in the initial licensure period. The commissioner shall prorate the
first renewal fee for the establishment license based on the number of months from issuance
of the provisional license to the first renewal.
(i) The fee for verification of licensure to other states is $25.
deleted text begin
(j) The fee to reissue a provisional establishment license that relocates prior to inspection
and removal of provisional status is $350. The expiration date of the provisional license
does not change.
deleted text end
deleted text begin (k)deleted text end new text begin (j)new text end The fee to change an establishment name or establishment type, such as tattoo,
piercing, or dual, is $50.
Sec. 45.
Minnesota Statutes 2022, section 146B.10, subdivision 3, is amended to read:
Subd. 3.
Deposit.
Fees collected by the commissioner under this section must be deposited
in the state government special revenue fund.new text begin All fees are nonrefundable.
new text end
Sec. 46.
Minnesota Statutes 2022, section 149A.02, subdivision 3b, is amended to read:
Subd. 3b.
Burial site services.
"Burial site services" means any services sold or offered
for sale directly to the public for use in connection with the final disposition of a dead human
bodynew text begin but does not include services provided under a transportation protection agreementnew text end .
Sec. 47.
Minnesota Statutes 2022, section 149A.02, subdivision 23, is amended to read:
Subd. 23.
Funeral services.
new text begin (a) new text end "Funeral services" means any services which may be
used to: (1) care for and prepare dead human bodies for burial, alkaline hydrolysis, cremation,
or other final disposition; and (2) arrange, supervise, or conduct the funeral ceremony or
the final disposition of dead human bodies.
new text begin
(b) Funeral service does not include a transportation protection agreement.
new text end
Sec. 48.
Minnesota Statutes 2022, section 149A.02, is amended by adding a subdivision
to read:
new text begin Subd. 38a. new text end
new text begin Transportation protection agreement. new text end
new text begin
"Transportation protection agreement"
means an agreement that is primarily for the purpose of transportation and subsequent
transportation of the remains of a dead human body.
new text end
Sec. 49.
Minnesota Statutes 2022, section 149A.65, is amended to read:
149A.65 FEES.
Subdivision 1.
Generally.
This section establishes thenew text begin applicationnew text end fees for registrations,
examinations, initial and renewal licenses, and late fees authorized under the provisions of
this chapter.
Subd. 2.
Mortuary science fees.
Fees for mortuary science are:
(1) $75 for the initial and renewal registration of a mortuary science intern;
(2) $125 for the mortuary science examination;
(3) $200 for deleted text begin issuance ofdeleted text end initial and renewal mortuary science deleted text begin licensesdeleted text end new text begin license applicationsnew text end ;
(4) $100 late fee charge for a license renewalnew text begin applicationnew text end ; and
(5) $250 for deleted text begin issuing adeleted text end new text begin an application fornew text end mortuary science license by endorsement.
Subd. 3.
Funeral directors.
The license renewalnew text begin applicationnew text end fee for funeral directors is
$200. The late fee charge for a license renewal is $100.
Subd. 4.
Funeral establishments.
The initial and renewalnew text begin applicationnew text end fee for funeral
establishments is $425. The late fee charge for a license renewal is $100.
Subd. 5.
Crematories.
The initial and renewalnew text begin applicationnew text end fee for a crematory is $425.
The late fee charge for a license renewal is $100.
Subd. 6.
Alkaline hydrolysis facilities.
The initial and renewalnew text begin applicationnew text end fee for an
alkaline hydrolysis facility is $425. The late fee charge for a license renewal is $100.
Subd. 7.
State government special revenue fund.
Fees collected by the commissioner
under this section must be deposited in the state treasury and credited to the state government
special revenue fund.new text begin All fees are nonrefundable.
new text end
Sec. 50.
Minnesota Statutes 2022, section 149A.97, subdivision 2, is amended to read:
Subd. 2.
Scope and requirements.
This section shall not apply to new text begin a transportation
protection agreement or to new text end any funeral goods or burial site goods purchased and delivered,
either at purchase or within a commercially reasonable amount of time thereafter. When
prior to the death of any person, that person or another, on behalf of that person, enters into
any transaction, makes a contract, or any series or combination of transactions or contracts
with a funeral provider lawfully doing business in Minnesota, other than an insurance
company licensed to do business in Minnesota selling approved insurance or annuity
products, by the terms of which, goods or services related to the final disposition of that
person will be furnished at-need, then the total of all money paid by the terms of the
transaction, contract, or series or combination of transactions or contracts shall be held in
trust for the purpose for which it has been paid. The person for whose benefit the money
was paid shall be known as the beneficiary, the person or persons who paid the money shall
be known as the purchaser, and the funeral provider shall be known as the depositor.
Sec. 51.
Minnesota Statutes 2022, section 152.22, is amended by adding a subdivision to
read:
new text begin Subd. 19. new text end
new text begin Veteran. new text end
new text begin
"Veteran" means an individual who satisfies the requirements in
section 197.447 and is receiving care from the United States Department of Veterans Affairs.
new text end
Sec. 52.
Minnesota Statutes 2022, section 152.25, subdivision 2, is amended to read:
Subd. 2.
Range of compounds and dosages; report.
The commissioner shall review
and publicly report the existing medical and scientific literature regarding the range of
recommended dosages for each qualifying condition and the range of chemical compositions
of any plant of the genus cannabis that will likely be medically beneficial for each of the
qualifying medical conditions. The commissioner shall make this information available to
patients with qualifying medical conditions beginning December 1, 2014, and update the
information deleted text begin annuallydeleted text end new text begin every three yearsnew text end . The commissioner may consult with the independent
laboratory under contract with the manufacturer or other experts in reporting the range of
recommended dosages for each qualifying medical condition, the range of chemical
compositions that will likely be medically beneficial, and any risks of noncannabis drug
interactions. The commissioner shall consult with each manufacturer on an annual basis on
medical cannabis offered by the manufacturer. The list of medical cannabis offered by a
manufacturer shall be published on the Department of Health website.
Sec. 53.
Minnesota Statutes 2022, section 152.27, is amended by adding a subdivision to
read:
new text begin Subd. 3a. new text end
new text begin Application procedure for veterans. new text end
new text begin
(a) Beginning July 1, 2024, the
commissioner shall establish an alternative certification procedure for veterans to confirm
that the veteran has been diagnosed with a qualifying medical condition.
new text end
new text begin
(b) A patient who is also a veteran and is seeking to enroll in the registry program must
submit a copy of the patient's veteran health identification card issued by the United States
Department of Veterans Affairs and an application established by the commissioner to
certify that the patient has been diagnosed with a qualifying medical condition.
new text end
Sec. 54.
Minnesota Statutes 2022, section 152.27, subdivision 6, is amended to read:
Subd. 6.
Patient enrollment.
(a) After receipt of a patient's application, application fees,
and signed disclosure, the commissioner shall enroll the patient in the registry program and
issue the patient and patient's registered designated caregiver or parent, legal guardian, or
spouse, if applicable, a registry verification. The commissioner shall approve or deny a
patient's application for participation in the registry program within 30 days after the
commissioner receives the patient's application and application fee. The commissioner may
approve applications up to 60 days after the receipt of a patient's application and application
fees until January 1, 2016. A patient's enrollment in the registry program shall only be
denied if the patient:
(1) does not have certification from a health care practitionernew text begin , or if the patient is a veteran
receiving care from the United States Department of Veterans Affairs, the documentation
required under subdivision 3a,new text end that the patient has been diagnosed with a qualifying medical
condition;
(2) has not signed and returned the disclosure form required under subdivision 3,
paragraph (c), to the commissioner;
(3) does not provide the information required;
(4) has previously been removed from the registry program for violations of section
152.30 or 152.33; or
(5) provides false information.
(b) The commissioner shall give written notice to a patient of the reason for denying
enrollment in the registry program.
(c) Denial of enrollment into the registry program is considered a final decision of the
commissioner and is subject to judicial review under the Administrative Procedure Act
pursuant to chapter 14.
(d) A patient's enrollment in the registry program may only be revoked upon the death
of the patient or if a patient violates a requirement under section 152.30 or 152.33.
(e) The commissioner shall develop a registry verification to provide to the patient, the
health care practitioner identified in the patient's application, and to the manufacturer. The
registry verification shall include:
(1) the patient's name and date of birth;
(2) the patient registry number assigned to the patient; and
(3) the name and date of birth of the patient's registered designated caregiver, if any, or
the name of the patient's parent, legal guardian, or spouse if the parent, legal guardian, or
spouse will be acting as a caregiver.
Sec. 55.
Minnesota Statutes 2023 Supplement, section 152.28, subdivision 1, is amended
to read:
Subdivision 1.
Health care practitioner duties.
(a) Prior to a patient's enrollment in
the registry program, a health care practitioner shall:
(1) determine, in the health care practitioner's medical judgment, whether a patient suffers
from a qualifying medical condition, and, if so determined, provide the patient with a
certification of that diagnosis;
(2) advise patients, registered designated caregivers, and parents, legal guardians, or
spouses who are acting as caregivers of the existence of any nonprofit patient support groups
or organizations;
(3) provide explanatory information from the commissioner to patients with qualifying
medical conditions, including disclosure to all patients about the experimental nature of
therapeutic use of medical cannabis; the possible risks, benefits, and side effects of the
proposed treatment; the application and other materials from the commissioner; and provide
patients with the Tennessen warning as required by section 13.04, subdivision 2; and
(4) agree to continue treatment of the patient's qualifying medical condition and report
medical findings to the commissioner.
(b) Upon notification from the commissioner of the patient's enrollment in the registry
program, the health care practitioner shall:
(1) participate in the patient registry reporting system under the guidance and supervision
of the commissioner;
(2) report health records of the patient throughout the ongoing treatment of the patient
to the commissioner in a manner determined by the commissioner and in accordance with
subdivision 2;
(3) determine, deleted text begin on a yearly basisdeleted text end new text begin every three yearsnew text end , if the patient continues to suffer from
a qualifying medical condition and, if so, issue the patient a new certification of that
diagnosis; and
(4) otherwise comply with all requirements developed by the commissioner.
(c) A health care practitioner may utilize telehealth, as defined in section 62A.673,
subdivision 2, for certifications and recertifications.
(d) Nothing in this section requires a health care practitioner to participate in the registry
program.
Sec. 56.
Minnesota Statutes 2022, section 256R.02, subdivision 20, is amended to read:
Subd. 20.
Facility average case mix index.
"Facility average case mix index" or "CMI"
means a numerical score that describes the relative resource use for all residents within the
case mix deleted text begin classifications under the resource utilization group (RUG)deleted text end classification system
prescribed by the commissioner based on an assessment of each resident. The facility average
CMI shall be computed as the standardized days divided by the sum of the facility's resident
days. The case mix indices used shall be based on the system prescribed in section 256R.17.
Sec. 57.
Minnesota Statutes 2022, section 259.52, subdivision 2, is amended to read:
Subd. 2.
Requirement to search registry before adoption petition can be granted;
proof of search.
No petition for adoption may be granted unless the agency supervising
the adoptive placement, the birth mother of the child, new text begin the putative father who registered or
the legal father, new text end or, in the case of a stepparent or relative adoption, the county agency
responsible for the report required under section 259.53, subdivision 1, requests that the
commissioner of health search the registry to determine whether a putative father is registered
in relation to a child who is or may be the subject of an adoption petition. The search required
by this subdivision must be conducted no sooner than 31 days following the birth of the
child. A search of the registry may be proven by the production of a certified copy of the
registration form or by a certified statement of the commissioner of health that after a search
no registration of a putative father in relation to a child who is or may be the subject of an
adoption petition could be located. The filing of a certified copy of an order from a juvenile
protection matter under chapter 260C containing a finding that certification of the requisite
search of the Minnesota Fathers' Adoption Registry was filed with the court in that matter
shall also constitute proof of search. Certification that the Minnesota Fathers' Adoption
Registry has been searched must be filed with the court prior to entry of any final order of
adoption. In addition to the search required by this subdivision, the agency supervising the
adoptive placement, the birth mother of the child, or, in the case of a stepparent or relative
adoption, the social services agency responsible for the report under section 259.53,
subdivision 1, or the responsible social services agency that is a petitioner in a juvenile
protection matter under chapter 260C may request that the commissioner of health search
the registry at any time. Search requirements of this section do not apply when the responsible
social services agency is proceeding under Safe Place for Newborns, section 260C.139.
Sec. 58.
Minnesota Statutes 2022, section 259.52, subdivision 4, is amended to read:
Subd. 4.
Classification of registry data.
new text begin (a) new text end Data in the fathers' adoption registry,
including all data provided in requesting the search of the registry, are private data on
individuals, as defined in section 13.02, subdivision 2, and are nonpublic data with respect
to data not on individuals, as defined in section 13.02, subdivision 9. Data in the registry
may be released to:
(1) a person who is required to search the registry under subdivision 2, if the data relate
to the child who is or may be the subject of the adoption petition;
(2) the mother of the child listed on the putative father's registration form who the
commissioner of health is required to notify under subdivision 1, paragraph (c);
(3) new text begin the putative father who registered himself or the legal father;
new text end
new text begin (4) new text end a public authority as provided in subdivision 3; or
deleted text begin (4)deleted text end new text begin (5)new text end an attorney who has signed an affidavit from the commissioner of health attesting
that the attorney represents the birth mothernew text begin , the putative or legal father,new text end or the prospective
adoptive parents.
new text begin (b) new text end A person who receives data under this subdivision may use the data only for purposes
authorized under this section or other law.
Sec. 59.
Minnesota Statutes 2023 Supplement, section 342.54, subdivision 2, is amended
to read:
Subd. 2.
Duties related to the registry program.
The Division of Medical Cannabis
must:
(1) administer the registry program according to section 342.52;
(2) provide information to patients enrolled in the registry program on the existence of
federally approved clinical trials for the treatment of the patient's qualifying medical condition
with medical cannabis flower or medical cannabinoid products as an alternative to enrollment
in the registry program;
(3) maintain safety criteria with which patients must comply as a condition of participation
in the registry program to prevent patients from undertaking any task under the influence
of medical cannabis flower or medical cannabinoid products that would constitute negligence
or professional malpractice;
(4) review and publicly report on existing medical and scientific literature regarding the
range of recommended dosages for each qualifying medical condition, the range of chemical
compositions of medical cannabis flower and medical cannabinoid products that will likely
be medically beneficial for each qualifying medical condition, and any risks of noncannabis
drug interactions. This information must be updated by December 1 deleted text begin of each yeardeleted text end new text begin every three
yearsnew text end . The office may consult with an independent laboratory under contract with the office
or other experts in reporting and updating this information; and
(5) annually consult with cannabis businesses about medical cannabis that the businesses
cultivate, manufacture, and offer for sale and post on the Division of Medical Cannabis
website a list of the medical cannabis flower and medical cannabinoid products offered for
sale by each medical cannabis retailer.
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 2023 Supplement, section 342.55, subdivision 2, is amended
to read:
Subd. 2.
Duties upon patient's enrollment in registry program.
Upon receiving
notification from the Division of Medical Cannabis of the patient's enrollment in the registry
program, a health care practitioner must:
(1) participate in the patient registry reporting system under the guidance and supervision
of the Division of Medical Cannabis;
(2) report to the Division of Medical Cannabis patient health records throughout the
patient's ongoing treatment in a manner determined by the office and in accordance with
subdivision 4;
(3) determine deleted text begin on a yearly basisdeleted text end new text begin , every three years,new text end if the patient continues to have a
qualifying medical condition and, if so, issue the patient a new certification of that diagnosis.
The patient assessment conducted under this clause may be conducted via telehealth, as
defined in section 62A.673, subdivision 2; and
(4) otherwise comply with requirements established by the Office of Cannabis
Management and the Division of Medical Cannabis.
new text begin EFFECTIVE DATE. new text end
new text begin
This section is effective March 1, 2025.
new text end
Sec. 61. new text begin REVISOR INSTRUCTION.
new text end
new text begin
The revisor of statutes shall substitute the term "employee" with the term "staff" in the
following sections of Minnesota Statutes and make any grammatical changes needed without
changing the meaning of the sentence: Minnesota Statutes, sections 144G.08, subdivisions
18 and 36; 144G.13, subdivision 1, paragraph (c); 144G.20, subdivisions 1, 2, and 21;
144G.30, subdivision 5; 144G.42, subdivision 8; 144G.45, subdivision 2; 144G.60,
subdivisions 1, paragraph (c), and 3, paragraph (a); 144G.63, subdivision 2, paragraph (a),
clause (9); 144G.64, paragraphs (a), clauses (2), (3), and (5), and (c); 144G.70, subdivision
7; and 144G.92, subdivisions 1 and 3.
new text end
Sec. 62. new text begin REPEALER; 340B COVERED ENTITY REPORT.
new text end
new text begin
(a)
new text end
new text begin
Minnesota Statutes 2022, sections 144.218, subdivision 3; 144.497; and 256R.02,
subdivision 46,
new text end
new text begin
are repealed.
new text end
new text begin
(b)
new text end
new text begin
Minnesota Statutes 2023 Supplement, sections 62J.312, subdivision 6; and 144.0528,
subdivision 5,
new text end
new text begin
are repealed.
new text end
ARTICLE 7
EMERGENCY MEDICAL SERVICES
Section 1.
Minnesota Statutes 2023 Supplement, section 15A.0815, subdivision 2, is
amended to read:
Subd. 2.
Agency head salaries.
The salary for a position listed in this subdivision shall
be determined by the Compensation Council under section 15A.082. The commissioner of
management and budget must publish the salaries on the department's website. This
subdivision applies to the following positions:
Commissioner of administration;
Commissioner of agriculture;
Commissioner of education;
Commissioner of children, youth, and families;
Commissioner of commerce;
Commissioner of corrections;
Commissioner of health;
Commissioner, Minnesota Office of Higher Education;
Commissioner, Minnesota IT Services;
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;
Commissioner of veterans affairs;
Executive director of the Gambling Control Board;
Executive director of the Minnesota State Lottery;
Commissioner of Iron Range resources and rehabilitation;
Commissioner, Bureau of Mediation Services;
Ombudsman for mental health and developmental disabilities;
Ombudsperson for corrections;
Chair, Metropolitan Council;
Chair, Metropolitan Airports Commission;
School trust lands director;
Executive director of pari-mutuel racing; deleted text begin and
deleted text end
Commissioner, Public Utilities Commissiondeleted text begin .deleted text end new text begin ; and
new text end
new text begin
Director of the Office of Emergency Medical Services.
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. 2.
Minnesota Statutes 2023 Supplement, 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; Children, Youth, and Families; Commerce;
Corrections; Direct Care and Treatment; Education; Employment and Economic
Development; Explore Minnesota Tourism; Management and Budget; Health; Human
Rights; Human Services; Labor and Industry; Natural Resources; Public Safety; 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; deleted text begin anddeleted text end the
Minnesota Zoological Boardnew text begin ; and the Office of Emergency Medical Servicesnew text end .
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 January 1, 2025.
new text end
Sec. 3.
Minnesota Statutes 2022, section 62J.49, subdivision 1, is amended to read:
Subdivision 1.
Establishment.
The new text begin director of the Office of new text end Emergency Medical Services
deleted text begin Regulatory Boarddeleted text end established under chapter deleted text begin 144deleted text end new text begin 144Enew text end shall establish a financial data
collection system for all ambulance services licensed in this state. To establish the financial
database, the deleted text begin Emergency Medical Services Regulatory Boarddeleted text end new text begin directornew text end may contract with
an entity that has experience in ambulance service financial data collection.
new text begin EFFECTIVE DATE. new text end
new text begin
This section is effective January 1, 2025.
new text end
Sec. 4.
Minnesota Statutes 2022, section 144E.001, subdivision 3a, is amended to read:
Subd. 3a.
Ambulance service personnel.
"Ambulance service personnel" means
individuals who are authorized by a licensed ambulance service to provide emergency care
for the ambulance service and are:
(1) EMTs, AEMTs, or paramedics;
(2) Minnesota registered nurses who are: (i) EMTs, are currently practicing nursing, and
have deleted text begin passed a paramedic practical skills test, as approved by the board and administered by
an educational program approved by the boarddeleted text end new text begin been approved by the ambulance service
medical directornew text end ; (ii) on the roster of an ambulance service on or before January 1, 2000;
deleted text begin ordeleted text end (iii) after petitioning the board, deemed by the board to have training and skills equivalent
to an EMT, as determined on a case-by-case basis; new text begin or (iv) certified as a certified flight
registered nurse or certified emergency nurse;new text end or
(3) Minnesota licensed physician assistants who are: (i) EMTs, are currently practicing
as physician assistants, and have deleted text begin passed a paramedic practical skills test, as approved by
the board and administered by an educational program approved by the boarddeleted text end new text begin been approved
by the ambulance service medical directornew text end ; (ii) on the roster of an ambulance service on or
before January 1, 2000; or (iii) after petitioning the board, deemed by the board to have
training and skills equivalent to an EMT, as determined on a case-by-case basis.
Sec. 5.
Minnesota Statutes 2022, section 144E.001, is amended by adding a subdivision
to read:
new text begin Subd. 16. new text end
new text begin Director. new text end
new text begin
"Director" means the director of the Office of Emergency Medical
Services.
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. 6.
Minnesota Statutes 2022, section 144E.001, is amended by adding a subdivision
to read:
new text begin Subd. 17. new text end
new text begin Office. new text end
new text begin
"Office" means the Office of Emergency Medical Services.
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. 7.
new text begin
[144E.011] OFFICE OF EMERGENCY MEDICAL SERVICES.
new text end
new text begin Subdivision 1. new text end
new text begin Establishment. new text end
new text begin
The Office of Emergency Medical Services is established
with the powers and duties established in law. In administering this chapter, the office must
promote the public health and welfare, protect the safety of the public, and effectively
regulate and support the operation of the emergency medical services system in this state.
new text end
new text begin Subd. 2. new text end
new text begin Director. new text end
new text begin
The governor must appoint a director for the office with the advice
and consent of the senate. The director must be in the unclassified service and must serve
at the pleasure of the governor. The salary of the director shall be determined according to
section 15A.0815. The director shall direct the activities of the office.
new text end
new text begin Subd. 3. new text end
new text begin Powers and duties. new text end
new text begin
The director has the following powers and duties:
new text end
new text begin
(1) administer and enforce this chapter and adopt rules as needed to implement this
chapter. Rules for which notice is published in the State Register before July 1, 2026, may
be adopted using the expedited rulemaking process in section 14.389;
new text end
new text begin
(2) license ambulance services in Minnesota and regulate their operation;
new text end
new text begin
(3) establish and modify primary service areas;
new text end
new text begin
(4) designate an ambulance service as authorized to provide service in a primary service
area and to remove an ambulance service's authorization to provide service in a primary
service area;
new text end
new text begin
(5) register medical response units in Minnesota and regulate their operation;
new text end
new text begin
(6) certify emergency medical technicians, advanced emergency medical technicians,
community emergency medical technicians, paramedics, and community paramedics and
register emergency medical responders;
new text end
new text begin
(7) approve education programs for ambulance service personnel and emergency medical
responders and administer qualifications for instructors of education programs;
new text end
new text begin
(8) administer grant programs related to emergency medical services;
new text end
new text begin
(9) report to the legislature by February 15 each year on the work of the office and the
advisory councils in the previous calendar year and with recommendations for any needed
policy changes related to emergency medical services, including but not limited to improving
access to emergency medical services, improving service delivery by ambulance services
and medical response units, and improving the effectiveness of the state's emergency medical
services system. The director must develop the reports and recommendations in consultation
with the office's deputy directors and advisory councils;
new text end
new text begin
(10) investigate complaints against and hold hearings regarding ambulance services,
ambulance service personnel, and emergency medical responders and impose disciplinary
action or otherwise resolve complaints; and
new text end
new text begin
(11) perform other duties related to the provision of emergency medical services in
Minnesota.
new text end
new text begin Subd. 4. new text end
new text begin Employees. new text end
new text begin
The director may employ personnel in the classified service and
unclassified personnel as necessary to carry out the duties of this chapter.
new text end
new text begin Subd. 5. new text end
new text begin Work plan. new text end
new text begin
The director must prepare a work plan to guide the work of the
office. The work plan must be updated biennially.
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.
new text begin
[144E.015] MEDICAL SERVICES DIVISION.
new text end
new text begin
A Medical Services Division is created in the Office of Emergency Medical Services.
The Medical Services Division shall be under the supervision of a deputy director of medical
services appointed by the director. The deputy director of medical services must be a
physician licensed under chapter 147. The deputy director, under the direction of the director,
shall enforce and coordinate the laws, rules, and policies assigned by the director, which
may include overseeing the clinical aspects of prehospital medical care and education
programs for emergency medical service personnel.
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. 9.
new text begin
[144E.016] AMBULANCE SERVICES DIVISION.
new text end
new text begin
An Ambulance Services Division is created in the Office of Emergency Medical Services.
The Ambulance Services Division shall be under the supervision of a deputy director of
ambulance services appointed by the director. The deputy director, under the direction of
the director, shall enforce and coordinate the laws, rules, and policies assigned by the director,
which may include operating standards and licensing of ambulance services, registration
and operation of medical response units, establishment and modification of primary service
areas, authorization of ambulance services to provide service in a primary service area and
revocation of such authorization, coordination of ambulance services within regions and
across the state, and administration of grants.
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. 10.
new text begin
[144E.017] EMERGENCY MEDICAL SERVICE PROVIDERS DIVISION.
new text end
new text begin
An Emergency Medical Service Providers Division is created in the Office of Emergency
Medical Services. The Emergency Medical Service Providers Division shall be under the
supervision of a deputy director of emergency medical service providers appointed by the
director. The deputy director, under the direction of the director, shall enforce and coordinate
the laws, rules, and policies assigned by the director, which may include certification and
registration of individual emergency medical service providers; overseeing worker safety,
worker well-being, and working conditions; implementation of education programs; and
administration of grants.
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. 11.
new text begin
[144E.03] EMERGENCY MEDICAL SERVICES ADVISORY COUNCIL.
new text end
new text begin Subdivision 1. new text end
new text begin Establishment; membership. new text end
new text begin
The Emergency Medical Services Advisory
Council is established and consists of the following members:
new text end
new text begin
(1) one emergency medical technician currently practicing with a licensed ambulance
service, appointed by the Minnesota Ambulance Association;
new text end
new text begin
(2) one paramedic currently practicing with a licensed ambulance service or a medical
response unit, appointed jointly by the Minnesota Professional Fire Fighters Association
and the Minnesota Ambulance Association;
new text end
new text begin
(3) one medical director of a licensed ambulance service, appointed by the National
Association of EMS Physicians, Minnesota Chapter;
new text end
new text begin
(4) one firefighter currently serving as an emergency medical responder, appointed by
the Minnesota State Fire Chiefs Association;
new text end
new text begin
(5) one registered nurse who is certified or currently practicing as a flight nurse, appointed
jointly by the regional emergency services boards of the designated regional emergency
medical services systems;
new text end
new text begin
(6) one hospital administrator, appointed by the Minnesota Hospital Association;
new text end
new text begin
(7) one social worker, appointed by the Board of Social Work;
new text end
new text begin
(8) one member of a federally recognized Tribal Nation in Minnesota, appointed by the
Minnesota Indian Affairs Council;
new text end
new text begin
(9) three public members, appointed by the governor;
new text end
new text begin
(10) one member with experience working as an employee organization representative
representing emergency medical service providers, appointed by an employee organization
representing emergency medical service providers;
new text end
new text begin
(11) one member representing a local government, appointed by the Coalition of Greater
Minnesota Cities;
new text end
new text begin
(12) one member representing a local government in the seven-county metropolitan area,
appointed by the League of Minnesota Cities;
new text end
new text begin
(13) one member of the house of representatives and one member of the senate, appointed
according to subdivision 2; and
new text end
new text begin
(14) the commissioner of health and commissioner of public safety or their designees
as ex officio members.
new text end
new text begin Subd. 2. new text end
new text begin Legislative members. new text end
new text begin
The speaker of the house must appoint one member of
the house of representatives to serve on the advisory council and the senate majority leader
must appoint one member of the senate to serve on the advisory council. Legislative members
appointed under this subdivision serve until successors are appointed. Legislative members
may receive per diem compensation and reimbursement for expenses according to the rules
of their respective bodies.
new text end
new text begin Subd. 3. new text end
new text begin Terms, compensation, removal, vacancies, and expiration. new text end
new text begin
Compensation
and reimbursement for expenses for members appointed under subdivision 1, clauses (1)
to (12); removal of members; filling of vacancies of members; and, except for initial
appointments, membership terms are governed by section 15.059. Notwithstanding section
15.059, subdivision 6, the advisory council does not expire.
new text end
new text begin Subd. 4. new text end
new text begin Officers; meetings. new text end
new text begin
(a) The advisory council must elect a chair and vice-chair
from among its membership and may elect other officers as the advisory council deems
necessary.
new text end
new text begin
(b) The advisory council must meet quarterly or at the call of the chair.
new text end
new text begin
(c) Meetings of the advisory council are subject to chapter 13D.
new text end
new text begin Subd. 5. new text end
new text begin Duties. new text end
new text begin
The advisory council must review and make recommendations to the
director and the deputy director of ambulance services on the administration of this chapter,
the regulation of ambulance services and medical response units, the operation of the
emergency medical services system in the state, and other topics as directed by the director.
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. 12.
new text begin
[144E.035] EMERGENCY MEDICAL SERVICES PHYSICIAN ADVISORY
COUNCIL.
new text end
new text begin Subdivision 1. new text end
new text begin Establishment; membership. new text end
new text begin
The Emergency Medical Services Physician
Advisory Council is established and consists of the following members:
new text end
new text begin
(1) eight physicians who meet the qualifications for medical directors in section 144E.265,
subdivision 1, with one physician appointed by each of the regional emergency services
boards of the designated regional emergency medical services systems;
new text end
new text begin
(2) one physician who meets the qualifications for medical directors in section 144E.265,
subdivision 1, appointed by the Minnesota State Fire Chiefs Association;
new text end
new text begin
(3) one physician who is board-certified in pediatrics, appointed by the Minnesota
Emergency Medical Services for Children program; and
new text end
new text begin
(4) the medical director member of the Emergency Medical Services Advisory Council
appointed under section 144E.03, subdivision 1, clause (3).
new text end
new text begin Subd. 2. new text end
new text begin Terms, compensation, removal, vacancies, and expiration. new text end
new text begin
Compensation
and reimbursement for expenses, removal of members, filling of vacancies of members,
and, except for initial appointments, membership terms are governed by section 15.059.
Notwithstanding section 15.059, subdivision 6, the advisory council does not expire.
new text end
new text begin Subd. 3. new text end
new text begin Officers; meetings. new text end
new text begin
(a) The advisory council must elect a chair and vice-chair
from among its membership and may elect other officers as it deems necessary.
new text end
new text begin
(b) The advisory council must meet twice per year or upon the call of the chair.
new text end
new text begin
(c) Meetings of the advisory council are subject to chapter 13D.
new text end
new text begin Subd. 4. new text end
new text begin Duties. new text end
new text begin
The advisory council must:
new text end
new text begin
(1) review and make recommendations to the director and deputy director of medical
services on clinical aspects of prehospital medical care. In doing so, the advisory council
must incorporate information from medical literature, advances in bedside clinical practice,
and advisory council member experience; and
new text end
new text begin
(2) serve as subject matter experts for the director and deputy director of medical services
on evolving topics in clinical medicine, including but not limited to infectious disease,
pharmaceutical and equipment shortages, and implementation of new therapeutics.
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. 13.
new text begin
[144E.04] LABOR AND EMERGENCY MEDICAL SERVICE PROVIDERS
ADVISORY COUNCIL.
new text end
new text begin Subdivision 1. new text end
new text begin Establishment; membership. new text end
new text begin
The Labor and Emergency Medical Service
Providers Advisory Council is established and consists of the following members:
new text end
new text begin
(1) one emergency medical service provider of any type from each of the designated
regional emergency medical services systems, appointed by their respective regional
emergency services boards;
new text end
new text begin
(2) one emergency medical technician instructor, appointed by an employee organization
representing emergency medical service providers;
new text end
new text begin
(3) two members with experience working as an employee organization representative
representing emergency medical service providers, appointed by an employee organization
representing emergency medical service providers;
new text end
new text begin
(4) one emergency medical service provider based in a fire department, appointed jointly
by the Minnesota State Fire Chiefs Association and the Minnesota Professional Fire Fighters
Association; and
new text end
new text begin
(5) one emergency medical service provider not based in a fire department, appointed
by the League of Minnesota Cities.
new text end
new text begin Subd. 2. new text end
new text begin Terms, compensation, removal, vacancies, and expiration. new text end
new text begin
Compensation
and reimbursement for expenses for members appointed under subdivision 1; removal of
members; filling of vacancies of members; and, except for initial appointments, membership
terms are governed by section 15.059. Notwithstanding section 15.059, subdivision 6, the
advisory council does not expire.
new text end
new text begin Subd. 3. new text end
new text begin Officers; meetings. new text end
new text begin
(a) The advisory council must elect a chair and vice-chair
from among its membership and may elect other officers as the advisory council deems
necessary.
new text end
new text begin
(b) The advisory council must meet quarterly or at the call of the chair.
new text end
new text begin
(c) Meetings of the advisory council are subject to chapter 13D.
new text end
new text begin Subd. 4. new text end
new text begin Duties. new text end
new text begin
The advisory council must review and make recommendations to the
director and deputy director of emergency medical service providers on the laws, rules, and
policies assigned to the Emergency Medical Service Providers Division and other topics as
directed by the director.
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. 14.
Minnesota Statutes 2023 Supplement, section 144E.101, subdivision 6, is amended
to read:
Subd. 6.
Basic life support.
(a) Except as provided in paragraph (f)new text begin or subdivision 6anew text end ,
a basic life-support ambulance shall be staffed by at least two deleted text begin EMTs, one of whomdeleted text end new text begin individuals
who meet one of the following requirements: (1) are certified as an EMT; (2) are a Minnesota
registered nurse who meets the qualification requirements in section 144E.001, subdivision
3a, clause (2); or (3) are a Minnesota licensed physician assistant who meets the qualification
requirements in section 144E.001, subdivision 3a, clause (3). One of the individuals staffing
a basic life-support ambulancenew text end must accompany the patient and provide a level of care deleted text begin so
asdeleted text end to ensure that:
deleted text begin (1)deleted text end new text begin (i)new text end life-threatening situations and potentially serious injuries are recognized;
deleted text begin (2)deleted text end new text begin (ii)new text end patients are protected from additional hazards;
deleted text begin (3)deleted text end new text begin (iii)new text end basic treatment to reduce the seriousness of emergency situations is administered;
and
deleted text begin (4)deleted text end new text begin (iv)new text end patients are transported to an appropriate medical facility for treatment.
(b) A basic life-support service shall provide basic airway management.
(c) A basic life-support service shall provide automatic defibrillation.
(d) A basic life-support service shall administer opiate antagonists consistent with
protocols established by the service's medical director.
(e) A basic life-support service licensee's medical director may authorize ambulance
service personnel to perform intravenous infusion and use equipment that is within the
licensure level of the ambulance service. Ambulance service personnel must be properly
trained. Documentation of authorization for use, guidelines for use, continuing education,
and skill verification must be maintained in the licensee's files.
(f) For emergency ambulance calls and interfacility transfers, an ambulance service may
staff its basic life-support ambulances with one deleted text begin EMTdeleted text end new text begin individual who meets the qualification
requirements in paragraph (a)new text end , who must accompany the patient, and one registered
emergency medical responder driver. deleted text begin For purposes of this paragraph, "ambulance service"
deleted text end deleted text begin means either an ambulance service whose primary service area is mainly located outside
deleted text end deleted text begin the metropolitan counties listed in section deleted text end deleted text begin 473.121, subdivision 4deleted text end deleted text begin , and outside the cities of
deleted text end deleted text begin Duluth, Mankato, Moorhead, Rochester, and St. Cloud; or an ambulance service based in
deleted text end deleted text begin a community with a population of less than 2,500.
deleted text end
new text begin
(g) In order for a registered nurse to staff a basic life-support ambulance as a driver, the
registered nurse must have successfully completed a certified emergency vehicle operators
program.
new text end
Sec. 15.
Minnesota Statutes 2022, section 144E.101, is amended by adding a subdivision
to read:
new text begin Subd. 6a. new text end
new text begin Variance; staffing of basic life-support ambulance. new text end
new text begin
(a) Upon application
from an ambulance service that includes evidence demonstrating hardship, the board may
grant a variance from the staff requirements in subdivision 6, paragraph (a), and may
authorize a basic life-support ambulance to be staffed, for all emergency calls and interfacility
transfers, with one individual who meets the qualification requirements in paragraph (b) to
drive the ambulance and one individual who meets the qualification requirements in
subdivision 6, paragraph (a), and who must accompany the patient. The variance applies to
basic life-support ambulances until the ambulance service renews its license. When the
variance expires, the ambulance service may apply for a new variance under this subdivision.
new text end
new text begin
(b) In order to drive an ambulance under a variance granted under this subdivision, an
individual must:
new text end
new text begin
(1) hold a valid driver's license from any state;
new text end
new text begin
(2) have attended an emergency vehicle driving course approved by the ambulance
service;
new text end
new text begin
(3) have completed a course on cardiopulmonary resuscitation approved by the ambulance
service; and
new text end
new text begin
(4) register with the board according to a process established by the board.
new text end
new text begin
(c) If an individual serving as a driver under this subdivision commits or has a record
of committing an act listed in section 144E.27, subdivision 5, paragraph (a), the board may
temporarily suspend or prohibit the individual from driving an ambulance or place conditions
on the individual's ability to drive an ambulance using the procedures and authority in
section 144E.27, subdivisions 5 and 6.
new text end
Sec. 16.
Minnesota Statutes 2023 Supplement, section 144E.101, subdivision 7, as amended
by Laws 2024, chapter 85, section 32, is amended to read:
Subd. 7.
Advanced life support.
(a) Except as provided in paragraphs (f) and (g), an
advanced life-support ambulance shall be staffed by at least:
(1) one EMT or one AEMT and one paramedic;
(2) one EMT or one AEMT and one registered nurse whonew text begin : (i)new text end is an EMT or an AEMT,
is currently practicing nursing, and deleted text begin has passed a paramedic practical skills test approved by
the board and administered by an education programdeleted text end new text begin has been approved by the ambulance
service medical director; or (ii) is certified as a certified flight registered nurse or certified
emergency nursenew text end ; or
(3) one EMT or one AEMT and one physician assistant who is an EMT or an AEMT,
is currently practicing as a physician assistant, and deleted text begin has passed a paramedic practical skills
test approved by the board and administered by an education programdeleted text end new text begin has been approved
by the ambulance service medical directornew text end .
(b) An advanced life-support service shall provide basic life support, as specified under
subdivision 6, paragraph (a), advanced airway management, manual defibrillation,
administration of intravenous fluids and pharmaceuticals, and administration of opiate
antagonists.
(c) In addition to providing advanced life support, an advanced life-support service may
staff additional ambulances to provide basic life support according to subdivision 6 and
section 144E.103, subdivision 1.
(d) An ambulance service providing advanced life support shall have a written agreement
with its medical director to ensure medical control for patient care 24 hours a day, seven
days a week. The terms of the agreement shall include a written policy on the administration
of medical control for the service. The policy shall address the following issues:
(1) two-way communication for physician direction of ambulance service personnel;
(2) patient triage, treatment, and transport;
(3) use of standing orders; and
(4) the means by which medical control will be provided 24 hours a day.
The agreement shall be signed by the licensee's medical director and the licensee or the
licensee's designee and maintained in the files of the licensee.
(e) When an ambulance service provides advanced life support, the authority of a
paramedic, Minnesota registered nurse-EMT, or Minnesota registered physician
assistant-EMT to determine the delivery of patient care prevails over the authority of an
EMT.
(f) Upon application from an ambulance service that includes evidence demonstrating
hardship, the board may grant a variance from the staff requirements in paragraph (a), clause
(1), and may authorize an advanced life-support ambulance to be staffed by a registered
emergency medical responder driver with a paramedic for all emergency calls and interfacility
transfers. The variance shall apply to advanced life-support ambulance services until the
ambulance service renews its license. When the variance expires, an ambulance service
may apply for a new variance under this paragraph. deleted text begin This paragraph applies only to an
ambulance service whose primary service area is mainly located outside the metropolitan
counties listed in section 473.121, subdivision 4, and outside the cities of Duluth, Mankato,
Moorhead, Rochester, and St. Cloud, or an ambulance service based in a community with
a population of less than 1,000 persons.
deleted text end
(g) After an initial emergency ambulance call, each subsequent emergency ambulance
response, until the initial ambulance is again available, and interfacility transfers, may be
staffed by one registered emergency medical responder driver and an EMT or paramedic.
deleted text begin This paragraph applies only to an ambulance service whose primary service area is mainly
located outside the metropolitan counties listed in section 473.121, subdivision 4, and outside
the cities of Duluth, Mankato, Moorhead, Rochester, and St. Cloud, or an ambulance service
based in a community with a population of less than 1,000 persons.
deleted text end
new text begin
(h) In order for a registered nurse to staff an advanced life-support ambulance as a driver,
the registered nurse must have successfully completed a certified emergency vehicle operators
program.
new text end
Sec. 17.
new text begin
[144E.105] ALTERNATIVE EMS RESPONSE MODEL PILOT 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) "Partnering ambulance services" means the basic life support ambulance service and
the advanced life support ambulance service that partner to jointly respond to emergency
ambulance calls under the pilot program.
new text end
new text begin
(c) "Pilot program" means the alternative EMS response model pilot program established
under this section.
new text end
new text begin Subd. 2. new text end
new text begin Pilot program established. new text end
new text begin
The board must establish and administer an
alternative EMS response model pilot program. Under the pilot program, the board may
authorize basic life support ambulance services to partner with advanced life support
ambulance services to provide expanded advanced life support service intercept capability
and staffing support for emergency ambulance calls.
new text end
new text begin Subd. 3. new text end
new text begin Application. new text end
new text begin
A basic life support ambulance service that wishes to participate
in the pilot program must apply to the board. An application from a basic life support
ambulance service must be submitted jointly with the advanced life support ambulance
service with which the basic life support ambulance service proposes to partner. The
application must identify the ambulance services applying to be partnering ambulance
services and must include:
new text end
new text begin
(1) approval to participate in the pilot program from the medical directors of the proposed
partnering ambulance services;
new text end
new text begin
(2) procedures the basic life support ambulance service will implement to respond to
emergency ambulance calls when the basic life support ambulance service is unable to meet
the minimum staffing requirements under section 144E.101, subdivision 6, and the partnering
advanced life support ambulance service is unavailable to jointly respond to emergency
ambulance calls;
new text end
new text begin
(3) an agreement between the proposed partnering ambulance services specifying which
ambulance service is responsible for:
new text end
new text begin
(i) workers' compensation insurance;
new text end
new text begin
(ii) motor vehicle insurance; and
new text end
new text begin
(iii) billing, identifying which if any ambulance service will bill the patient or the patient's
insurer and specifying how payments received will be distributed among the proposed
partnering ambulance services;
new text end
new text begin
(4) communication procedures to coordinate and make known the real-time availability
of the advanced life support ambulance service to its proposed partnering basic life support
ambulance services and public safety answering points;
new text end
new text begin
(5) an acknowledgment that the proposed partnering ambulance services must coordinate
compliance with the prehospital care data requirements in section 144E.123; and
new text end
new text begin
(6) an acknowledgment that the proposed partnering ambulance services remain
responsible for providing continual service as required under section 144E.101, subdivision
3.
new text end
new text begin Subd. 4. new text end
new text begin Operation. new text end
new text begin
Under the pilot program, an advanced life support ambulance
service may partner with one or more basic life support ambulance services. Under this
partnership, the advanced life support ambulance service and basic life support ambulance
service must jointly respond to emergency ambulance calls originating in the primary service
area of the basic life support ambulance service. The advanced life support ambulance
service must respond to emergency ambulance calls with either an ambulance or a
nontransporting vehicle fully equipped with the advanced life support complement of
equipment and medications required for that nontransporting vehicle by that ambulance
service's medical director.
new text end
new text begin Subd. 5. new text end
new text begin Staffing. new text end
new text begin
(a) When responding to an emergency ambulance call and when an
ambulance or nontransporting vehicle from the partnering advanced life support ambulance
service is confirmed to be available and is responding to the call:
new text end
new text begin
(1) the basic life support ambulance must be staffed with a minimum of one emergency
medical technician; and
new text end
new text begin
(2) the advanced life support ambulance or nontransporting vehicle must be staffed with
a minimum of one paramedic.
new text end
new text begin
(b) The staffing specified in paragraph (a) is deemed to satisfy the staffing requirements
in section 144E.101, subdivisions 6 and 7.
new text end
new text begin Subd. 6. new text end
new text begin Medical director oversight. new text end
new text begin
The medical director for an ambulance service
participating in the pilot program retains responsibility for the ambulance service personnel
of their ambulance service. When a paramedic from the partnering advanced life support
ambulance service makes contact with the patient, the standing orders; clinical policies;
protocols; and triage, treatment, and transportation guidelines for the advanced life support
ambulance service must direct patient care related to the encounter.
new text end
new text begin Subd. 7. new text end
new text begin Waivers and variances. new text end
new text begin
The board may issue any waivers of or variances to
this chapter or Minnesota Rules, chapter 4690, to partnering ambulance services that are
needed to implement the pilot program, provided the waiver or variance does not adversely
affect the public health or welfare.
new text end
new text begin Subd. 8. new text end
new text begin Data and evaluation. new text end
new text begin
In administering the pilot program, the board shall collect
from partnering ambulance services data needed to evaluate the impacts of the pilot program
on response times, patient outcomes, and patient experience for emergency ambulance calls.
new text end
new text begin Subd. 9. new text end
new text begin Transfer of authority. new text end
new text begin
Effective January 1, 2025, the duties and authority
assigned to the board in this section are transferred to the director.
new text end
new text begin Subd. 10. new text end
new text begin Expiration. new text end
new text begin
This section expires June 30, 2026.
new text end
Sec. 18.
Minnesota Statutes 2022, section 144E.16, subdivision 5, is amended to read:
Subd. 5.
Local government's powers.
(a) Local units of government may, with the
approval of the deleted text begin boarddeleted text end new text begin directornew text end , establish standards for ambulance services which impose
additional requirements upon such services. Local units of government intending to impose
additional requirements shall consider whether any benefit accruing to the public health
would outweigh the costs associated with the additional requirements.
(b) Local units of government that desire to impose additional requirements shall, prior
to adoption of relevant ordinances, rules, or regulations, furnish the deleted text begin boarddeleted text end new text begin directornew text end with a
copy of the proposed ordinances, rules, or regulations, along with information that
affirmatively substantiates that the proposed ordinances, rules, or regulations:
(1) will in no way conflict with the relevant rules of the deleted text begin boarddeleted text end new text begin officenew text end ;
(2) will establish additional requirements tending to protect the public health;
(3) will not diminish public access to ambulance services of acceptable quality; and
(4) will not interfere with the orderly development of regional systems of emergency
medical care.
(c) The deleted text begin boarddeleted text end new text begin directornew text end shall base any decision to approve or disapprove local standards
upon whether or not the local unit of government in question has affirmatively substantiated
that the proposed ordinances, rules, or regulations meet the criteria specified in paragraph
(b).
new text begin EFFECTIVE DATE. new text end
new text begin
This section is effective January 1, 2025.
new text end
Sec. 19.
Minnesota Statutes 2022, section 144E.19, subdivision 3, is amended to read:
Subd. 3.
Temporary suspension.
(a) In addition to any other remedy provided by law,
the deleted text begin boarddeleted text end new text begin directornew text end may temporarily suspend the license of a licensee after conducting a
preliminary inquiry to determine whether the deleted text begin boarddeleted text end new text begin director new text end believes that the licensee has
violated a statute or rule that the deleted text begin boarddeleted text end new text begin directornew text end is empowered to enforce and determining
that the continued provision of service by the licensee would create an imminent risk to
public health or harm to others.
(b) A temporary suspension order prohibiting a licensee from providing ambulance
service shall give notice of the right to a preliminary hearing according to paragraph (d)
and shall state the reasons for the entry of the temporary suspension order.
(c) Service of a temporary suspension order is effective when the order is served on the
licensee personally or by certified mail, which is complete upon receipt, refusal, or return
for nondelivery to the most recent address provided to the deleted text begin boarddeleted text end new text begin directornew text end for the licensee.
(d) At the time the deleted text begin boarddeleted text end new text begin directornew text end issues a temporary suspension order, the deleted text begin boarddeleted text end new text begin directornew text end
shall schedule a hearingdeleted text begin , to be held before a group of its members designated by the board,deleted text end
that shall begin within 60 days after issuance of the temporary suspension order or within
15 working days of the date of the deleted text begin board'sdeleted text end new text begin director'snew text end receipt of a request for a hearing from
a licensee, whichever is sooner. The hearing shall be on the sole issue of whether there is
a reasonable basis to continue, modify, or lift the temporary suspension. A hearing under
this paragraph is not subject to chapter 14.
(e) Evidence presented by the deleted text begin boarddeleted text end new text begin directornew text end or licensee may be in the form of an affidavit.
The licensee or the licensee's designee may appear for oral argument.
(f) Within five working days of the hearing, the deleted text begin boarddeleted text end new text begin directornew text end shall issue its order and,
if the suspension is continued, notify the licensee of the right to a contested case hearing
under chapter 14.
(g) If a licensee requests a contested case hearing within 30 days after receiving notice
under paragraph (f), the deleted text begin boarddeleted text end new text begin director new text end shall initiate a contested case hearing according to
chapter 14. The administrative law judge shall issue a report and recommendation within
30 days after the closing of the contested case hearing record. The deleted text begin boarddeleted text end new text begin directornew text end shall issue
a final order within 30 days after receipt of the administrative law judge's report.
new text begin EFFECTIVE DATE. new text end
new text begin
This section is effective January 1, 2025.
new text end
Sec. 20.
Minnesota Statutes 2022, section 144E.27, subdivision 3, is amended to read:
Subd. 3.
Renewal.
(a) The board may renew the registration of an emergency medical
responder who:
(1) successfully completes a board-approved refresher course; deleted text begin and
deleted text end
new text begin
(2) successfully completes a course in cardiopulmonary resuscitation approved by the
board or by the licensee's medical director. This course may be a component of a
board-approved refresher course; and
new text end
deleted text begin (2)deleted text end new text begin (3)new text end submits a completed renewal application to the board before the registration
expiration date.
(b) The board may renew the lapsed registration of an emergency medical responder
who:
(1) successfully completes a board-approved refresher course; deleted text begin and
deleted text end
new text begin
(2) successfully completes a course in cardiopulmonary resuscitation approved by the
board or by the licensee's medical director. This course may be a component of a
board-approved refresher course; and
new text end
deleted text begin (2)deleted text end new text begin (3)new text end submits a completed renewal application to the board within deleted text begin 12deleted text end new text begin 48new text end months after
the registration expiration date.
Sec. 21.
Minnesota Statutes 2022, section 144E.27, subdivision 5, is amended to read:
Subd. 5.
Denial, suspension, revocationnew text begin ; emergency medical responders and
driversnew text end .
(a) new text begin This subdivision applies to individuals seeking registration or registered as an
emergency medical responder and to individuals seeking registration or registered as a driver
of a basic life-support ambulance under section 144E.101, subdivision 6a. new text end The board may
deny, suspend, revoke, place conditions on, or refuse to renew the registration of an individual
who the board determines:
(1) violates sections 144E.001 to 144E.33 or the rules adopted under those sections, an
agreement for corrective action, or an order that the board issued or is otherwise empowered
to enforce;
(2) misrepresents or falsifies information on an application form for registration;
(3) is convicted or pleads guilty or nolo contendere to any felony; any gross misdemeanor
relating to assault, sexual misconduct, theft, or the illegal use of drugs or alcohol; or any
misdemeanor relating to assault, sexual misconduct, theft, or the illegal use of drugs or
alcohol;
(4) is actually or potentially unable to provide emergency medical services new text begin or drive an
ambulance new text end with reasonable skill and safety to patients by reason of illness, use of alcohol,
drugs, chemicals, or any other material, or as a result of any mental or physical condition;
(5) engages in unethical conduct, including, but not limited to, conduct likely to deceive,
defraud, or harm the public, or demonstrating a willful or careless disregard for the health,
welfare, or safety of the public;
(6) maltreats or abandons a patient;
(7) violates any state or federal controlled substance law;
(8) engages in unprofessional conduct or any other conduct which has the potential for
causing harm to the public, including any departure from or failure to conform to the
minimum standards of acceptable and prevailing practice without actual injury having to
be established;
(9) new text begin for emergency medical responders, new text end provides emergency medical services under
lapsed or nonrenewed credentials;
(10) is subject to a denial, corrective, disciplinary, or other similar action in another
jurisdiction or by another regulatory authority;
(11) engages in conduct with a patient that is sexual or may reasonably be interpreted
by the patient as sexual, or in any verbal behavior that is seductive or sexually demeaning
to a patient; or
(12) makes a false statement or knowingly provides false information to the board, or
fails to cooperate with an investigation of the board as required by section 144E.30.
(b) Before taking action under paragraph (a), the board shall give notice to an individual
of the right to a contested case hearing under chapter 14. If an individual requests a contested
case hearing within 30 days after receiving notice, the board shall initiate a contested case
hearing according to chapter 14.
(c) The administrative law judge shall issue a report and recommendation within 30
days after closing the contested case hearing record. The board shall issue a final order
within 30 days after receipt of the administrative law judge's report.
(d) After six months from the board's decision to deny, revoke, place conditions on, or
refuse renewal of an individual's registration for disciplinary action, the individual shall
have the opportunity to apply to the board for reinstatement.
Sec. 22.
Minnesota Statutes 2022, section 144E.27, subdivision 5, is amended to read:
Subd. 5.
Denial, suspension, revocation.
(a) The deleted text begin boarddeleted text end new text begin director new text end may deny, suspend,
revoke, place conditions on, or refuse to renew the registration of an individual who the
deleted text begin boarddeleted text end new text begin director new text end determines:
(1) violates sections 144E.001 to 144E.33 or the rules adopted under those sections, an
agreement for corrective action, or an order that the deleted text begin boarddeleted text end new text begin director new text end issued or is otherwise
empowered to enforce;
(2) misrepresents or falsifies information on an application form for registration;
(3) is convicted or pleads guilty or nolo contendere to any felony; any gross misdemeanor
relating to assault, sexual misconduct, theft, or the illegal use of drugs or alcohol; or any
misdemeanor relating to assault, sexual misconduct, theft, or the illegal use of drugs or
alcohol;
(4) is actually or potentially unable to provide emergency medical services with
reasonable skill and safety to patients by reason of illness, use of alcohol, drugs, chemicals,
or any other material, or as a result of any mental or physical condition;
(5) engages in unethical conduct, including, but not limited to, conduct likely to deceive,
defraud, or harm the public, or demonstrating a willful or careless disregard for the health,
welfare, or safety of the public;
(6) maltreats or abandons a patient;
(7) violates any state or federal controlled substance law;
(8) engages in unprofessional conduct or any other conduct which has the potential for
causing harm to the public, including any departure from or failure to conform to the
minimum standards of acceptable and prevailing practice without actual injury having to
be established;
(9) provides emergency medical services under lapsed or nonrenewed credentials;
(10) is subject to a denial, corrective, disciplinary, or other similar action in another
jurisdiction or by another regulatory authority;
(11) engages 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; deleted text begin or
deleted text end
(12) makes a false statement or knowingly provides false information to the deleted text begin boarddeleted text end new text begin
directornew text end , or fails to cooperate with an investigation of the deleted text begin boarddeleted text end new text begin director new text end as required by
section 144E.30deleted text begin .deleted text end new text begin ; or
new text end
new text begin
(13) fails to engage with the health professionals services program or diversion program
required under section 144E.287 after being referred to the program, violates the terms of
the program participation agreement, or leaves the program except upon fulfilling the terms
for successful completion of the program as set forth in the participation agreement.
new text end
(b) Before taking action under paragraph (a), the deleted text begin boarddeleted text end new text begin director new text end shall give notice to an
individual of the right to a contested case hearing under chapter 14. If an individual requests
a contested case hearing within 30 days after receiving notice, the deleted text begin boarddeleted text end new text begin director new text end shall initiate
a contested case hearing according to chapter 14.
(c) The administrative law judge shall issue a report and recommendation within 30
days after closing the contested case hearing record. The deleted text begin boarddeleted text end new text begin director new text end shall issue a final
order within 30 days after receipt of the administrative law judge's report.
(d) After six months from the deleted text begin board'sdeleted text end new text begin director's new text end decision to deny, revoke, place conditions
on, or refuse renewal of an individual's registration for disciplinary action, the individual
shall have the opportunity to apply to the deleted text begin boarddeleted text end new text begin director new text end for reinstatement.
new text begin EFFECTIVE DATE. new text end
new text begin
This section is effective January 1, 2025.
new text end
Sec. 23.
Minnesota Statutes 2022, section 144E.27, subdivision 6, is amended to read:
Subd. 6.
Temporary suspensionnew text begin ; emergency medical responders and driversnew text end .
(a)
new text begin This subdivision applies to emergency medical responders registered under this section and
to individuals registered as drivers of basic life-support ambulances under section 144E.101,
subdivision 6a. new text end In addition to any other remedy provided by law, the board may temporarily
suspend the registration of an individual after conducting a preliminary inquiry to determine
whether the board believes that the individual has violated a statute or rule that the board
is empowered to enforce and determining that the continued provision of service by the
individual would create an imminent risk to public health or harm to others.
(b) A temporary suspension order prohibiting an individual from providing emergency
medical care new text begin or from driving a basic life-support ambulance new text end shall give notice of the right
to a preliminary hearing according to paragraph (d) and shall state the reasons for the entry
of the temporary suspension order.
(c) Service of a temporary suspension order is effective when the order is served on the
individual personally or by certified mail, which is complete upon receipt, refusal, or return
for nondelivery to the most recent address provided to the board for the individual.
(d) At the time the board issues a temporary suspension order, the board shall schedule
a hearing, to be held before a group of its members designated by the board, that shall begin
within 60 days after issuance of the temporary suspension order or within 15 working days
of the date of the board's receipt of a request for a hearing from the individual, whichever
is sooner. The hearing shall be on the sole issue of whether there is a reasonable basis to
continue, modify, or lift the temporary suspension. A hearing under this paragraph is not
subject to chapter 14.
(e) Evidence presented by the board or the individual may be in the form of an affidavit.
The individual or the individual's designee may appear for oral argument.
(f) Within five working days of the hearing, the board shall issue its order and, if the
suspension is continued, notify the individual of the right to a contested case hearing under
chapter 14.
(g) If an individual requests a contested case hearing within 30 days after receiving
notice under paragraph (f), the board shall initiate a contested case hearing according to
chapter 14. The administrative law judge shall issue a report and recommendation within
30 days after the closing of the contested case hearing record. The board shall issue a final
order within 30 days after receipt of the administrative law judge's report.
Sec. 24.
Minnesota Statutes 2022, section 144E.28, subdivision 3, is amended to read:
Subd. 3.
Reciprocity.
The board may certify an individual who possesses a current
National Registry of Emergency Medical Technicians deleted text begin registrationdeleted text end new text begin certificationnew text end from another
jurisdiction if the individual submits a board-approved application form. The board
certification classification shall be the same as the National Registry's classification.
Certification shall be for the duration of the applicant's deleted text begin registrationdeleted text end new text begin certificationnew text end period in
another jurisdiction, not to exceed two years.
Sec. 25.
Minnesota Statutes 2022, section 144E.28, subdivision 5, is amended to read:
Subd. 5.
Denial, suspension, revocation.
(a) The deleted text begin boarddeleted text end new text begin director new text end may deny certification
or take any action authorized in subdivision 4 against an individual who the deleted text begin boarddeleted text end new text begin director
new text end determines:
(1) violates sections 144E.001 to 144E.33 or the rules adopted under those sections, or
an order that the deleted text begin boarddeleted text end new text begin director new text end issued or is otherwise authorized or empowered to enforce,
or agreement for corrective action;
(2) misrepresents or falsifies information on an application form for certification;
(3) is convicted or pleads guilty or nolo contendere to any felony; any gross misdemeanor
relating to assault, sexual misconduct, theft, or the illegal use of drugs or alcohol; or any
misdemeanor relating to assault, sexual misconduct, theft, or the illegal use of drugs or
alcohol;
(4) is actually or potentially unable to provide emergency medical services with
reasonable skill and safety to patients by reason of illness, use of alcohol, drugs, chemicals,
or any other material, or as a result of any mental or physical condition;
(5) engages in unethical conduct, including, but not limited to, conduct likely to deceive,
defraud, or harm the public or demonstrating a willful or careless disregard for the health,
welfare, or safety of the public;
(6) maltreats or abandons a patient;
(7) violates any state or federal controlled substance law;
(8) engages in unprofessional conduct or any other conduct which has the potential for
causing harm to the public, including any departure from or failure to conform to the
minimum standards of acceptable and prevailing practice without actual injury having to
be established;
(9) provides emergency medical services under lapsed or nonrenewed credentials;
(10) is subject to a denial, corrective, disciplinary, or other similar action in another
jurisdiction or by another regulatory authority;
(11) engages 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; deleted text begin or
deleted text end
(12) makes a false statement or knowingly provides false information to the deleted text begin boarddeleted text end new text begin director
new text end or fails to cooperate with an investigation of the deleted text begin boarddeleted text end new text begin director new text end as required by section
144E.30deleted text begin .deleted text end new text begin ; or
new text end
new text begin
(13) fails to engage with the health professionals services program or diversion program
required under section 144E.287 after being referred to the program, violates the terms of
the program participation agreement, or leaves the program except upon fulfilling the terms
for successful completion of the program as set forth in the participation agreement.
new text end
(b) Before taking action under paragraph (a), the deleted text begin boarddeleted text end new text begin director new text end shall give notice to an
individual of the right to a contested case hearing under chapter 14. If an individual requests
a contested case hearing within 30 days after receiving notice, the deleted text begin boarddeleted text end new text begin director new text end shall initiate
a contested case hearing according to chapter 14 and no disciplinary action shall be taken
at that time.
(c) The administrative law judge shall issue a report and recommendation within 30
days after closing the contested case hearing record. The deleted text begin boarddeleted text end new text begin director new text end shall issue a final
order within 30 days after receipt of the administrative law judge's report.
(d) After six months from the deleted text begin board'sdeleted text end new text begin director's new text end decision to deny, revoke, place conditions
on, or refuse renewal of an individual's certification for disciplinary action, the individual
shall have the opportunity to apply to the deleted text begin boarddeleted text end new text begin director new text end for reinstatement.
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 144E.28, subdivision 6, is amended to read:
Subd. 6.
Temporary suspension.
(a) In addition to any other remedy provided by law,
the deleted text begin boarddeleted text end new text begin directornew text end may temporarily suspend the certification of an individual after conducting
a preliminary inquiry to determine whether the deleted text begin boarddeleted text end new text begin directornew text end believes that the individual
has violated a statute or rule that the deleted text begin boarddeleted text end new text begin directornew text end is empowered to enforce and determining
that the continued provision of service by the individual would create an imminent risk to
public health or harm to others.
(b) A temporary suspension order prohibiting an individual from providing emergency
medical care shall give notice of the right to a preliminary hearing according to paragraph
(d) and shall state the reasons for the entry of the temporary suspension order.
(c) Service of a temporary suspension order is effective when the order is served on the
individual personally or by certified mail, which is complete upon receipt, refusal, or return
for nondelivery to the most recent address provided to the deleted text begin boarddeleted text end new text begin directornew text end for the individual.
(d) At the time the deleted text begin boarddeleted text end new text begin directornew text end issues a temporary suspension order, the deleted text begin boarddeleted text end new text begin directornew text end
shall schedule a hearingdeleted text begin , to be held before a group of its members designated by the board,deleted text end
that shall begin within 60 days after issuance of the temporary suspension order or within
15 working days of the date of the deleted text begin board'sdeleted text end new text begin director'snew text end receipt of a request for a hearing from
the individual, whichever is sooner. The hearing shall be on the sole issue of whether there
is a reasonable basis to continue, modify, or lift the temporary suspension. A hearing under
this paragraph is not subject to chapter 14.
(e) Evidence presented by the deleted text begin boarddeleted text end new text begin directornew text end or the individual may be in the form of an
affidavit. The individual or individual's designee may appear for oral argument.
(f) Within five working days of the hearing, the deleted text begin boarddeleted text end new text begin directornew text end shall issue its order and,
if the suspension is continued, notify the individual of the right to a contested case hearing
under chapter 14.
(g) If an individual requests a contested case hearing within 30 days of receiving notice
under paragraph (f), the deleted text begin boarddeleted text end new text begin directornew text end shall initiate a contested case hearing according to
chapter 14. The administrative law judge shall issue a report and recommendation within
30 days after the closing of the contested case hearing record. The deleted text begin boarddeleted text end new text begin directornew text end shall issue
a final order within 30 days after receipt of the administrative law judge's report.
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 144E.28, subdivision 8, is amended to read:
Subd. 8.
Reinstatement.
(a) Within four years of a certification expiration date, a person
whose certification has expired under subdivision 7, paragraph (d), may have the certification
reinstated upon submission of:
(1) evidence to the board of training equivalent to the continuing education requirements
of subdivision 7new text begin or, for community paramedics, evidence to the board of training equivalent
to the continuing education requirements of subdivision 9, paragraph (c)new text end ; and
(2) a board-approved application form.
(b) If more than four years have passed since a certificate expiration date, an applicant
must complete the initial certification process required under subdivision 1.
new text begin
(c) Beginning July 1, 2024, through December 31, 2025, and notwithstanding paragraph
(b), a person whose certification as an EMT, AEMT, paramedic, or community paramedic
expired more than four years ago but less than ten years ago may have the certification
reinstated upon submission of:
new text end
new text begin
(1) evidence to the board of the training required under paragraph (a), clause (1). This
training must have been completed within the 24 months prior to the date of the application
for reinstatement;
new text end
new text begin
(2) a board-approved application form; and
new text end
new text begin
(3) a recommendation from an ambulance service medical director.
new text end
new text begin
This paragraph expires December 31, 2025.
new text end
Sec. 28.
Minnesota Statutes 2022, section 144E.285, subdivision 1, is amended to read:
Subdivision 1.
Approval required.
(a) All education programs for an new text begin EMR, new text end EMT,
AEMT, or paramedic must be approved by the board.
(b) To be approved by the board, an education program must:
(1) submit an application prescribed by the board that includes:
(i) type deleted text begin and lengthdeleted text end of course to be offered;
(ii) names, addresses, and qualifications of the program medical director, program
education coordinator, and instructors;
deleted text begin
(iii) names and addresses of clinical sites, including a contact person and telephone
number;
deleted text end
deleted text begin (iv)deleted text end new text begin (iii)new text end admission criteria for students; and
deleted text begin (v)deleted text end new text begin (iv)new text end materials and equipment to be used;
(2) for each course, implement the most current version of the United States Department
of Transportation EMS Education Standards, or its equivalent as determined by the board
applicable to new text begin EMR, new text end EMT, AEMT, or paramedic education;
(3) have a program medical director and a program coordinator;
(4) utilize instructors who meet the requirements of section 144E.283 for teaching at
least 50 percent of the course content. The remaining 50 percent of the course may be taught
by guest lecturers approved by the education program coordinator or medical director;
deleted text begin
(5) have at least one instructor for every ten students at the practical skill stations;
deleted text end
deleted text begin
(6) maintain a written agreement with a licensed hospital or licensed ambulance service
designating a clinical training site;
deleted text end
deleted text begin (7)deleted text end new text begin (5)new text end retain documentation of program approval by the board, course outline, and
student information;
deleted text begin (8)deleted text end new text begin (6)new text end notify the board of the starting date of a course prior to the beginning of a course;new text begin
and
new text end
deleted text begin (9)deleted text end new text begin (7)new text end submit the appropriate fee as required under section 144E.29deleted text begin ; anddeleted text end new text begin .
new text end
deleted text begin
(10) maintain a minimum average yearly pass rate as set by the board on an annual basis.
The pass rate will be determined by the percent of candidates who pass the exam on the
first attempt. An education program not meeting this yearly standard shall be placed on
probation and shall be on a performance improvement plan approved by the board until
meeting the pass rate standard. While on probation, the education program may continue
providing classes if meeting the terms of the performance improvement plan as determined
by the board. If an education program having probation status fails to meet the pass rate
standard after two years in which an EMT initial course has been taught, the board may
take disciplinary action under subdivision 5.
deleted text end
Sec. 29.
Minnesota Statutes 2022, section 144E.285, is amended by adding a subdivision
to read:
new text begin Subd. 1a. new text end
new text begin EMR education program requirements. new text end
new text begin
The National EMS Education
Standards established by the National Highway Traffic Safety Administration of the United
States Department of Transportation specify the minimum requirements for knowledge and
skills for emergency medical responders. An education program applying for approval to
teach EMRs must comply with the requirements under subdivision 1, paragraph (b). A
medical director of an emergency medical responder group may establish additional
knowledge and skill requirements for EMRs.
new text end
Sec. 30.
Minnesota Statutes 2022, section 144E.285, is amended by adding a subdivision
to read:
new text begin Subd. 1b. new text end
new text begin EMT education program requirements. new text end
new text begin
In addition to the requirements
under subdivision 1, paragraph (b), an education program applying for approval to teach
EMTs must:
new text end
new text begin
(1) include in the application prescribed by the board the names and addresses of clinical
sites, including a contact person and telephone number;
new text end
new text begin
(2) maintain a written agreement with at least one clinical training site that is of a type
recognized by the National EMS Education Standards established by the National Highway
Traffic Safety Administration; and
new text end
new text begin
(3) maintain a minimum average yearly pass rate as set by the board. An education
program not meeting this standard must be placed on probation and must comply with a
performance improvement plan approved by the board until the program meets the pass
rate standard. While on probation, the education program may continue to provide classes
if the program meets the terms of the performance improvement plan, as determined by the
board. If an education program that is on probation status fails to meet the pass rate standard
after two years in which an EMT initial course has been taught, the board may take
disciplinary action under subdivision 5.
new text end
Sec. 31.
Minnesota Statutes 2022, section 144E.285, subdivision 2, is amended to read:
Subd. 2.
AEMT and paramedic new text begin education program new text end requirements.
(a) In addition to
the requirements under subdivision 1, paragraph (b), an education program applying for
approval to teach AEMTs and paramedics mustnew text begin :
new text end
new text begin (1)new text end be administered by an educational institution accredited by the Commission of
Accreditation of Allied Health Education Programs (CAAHEP)deleted text begin .deleted text end new text begin ;
new text end
new text begin
(2) include in the application prescribed by the board the names and addresses of clinical
sites, including a contact person and telephone number; and
new text end
new text begin
(3) maintain a written agreement with a licensed hospital or licensed ambulance service
designating a clinical training site.
new text end
(b) An AEMT and paramedic education program that is administered by an educational
institution not accredited by CAAHEP, but that is in the process of completing the
accreditation process, may be granted provisional approval by the board upon verification
of submission of its self-study report and the appropriate review fee to CAAHEP.
(c) An educational institution that discontinues its participation in the accreditation
process must notify the board immediately and provisional approval shall be withdrawn.
deleted text begin
(d) This subdivision does not apply to a paramedic education program when the program
is operated by an advanced life-support ambulance service licensed by the Emergency
Medical Services Regulatory Board under this chapter, and the ambulance service meets
the following criteria:
deleted text end
deleted text begin
(1) covers a rural primary service area that does not contain a hospital within the primary
service area or contains a hospital within the primary service area that has been designated
as a critical access hospital under section 144.1483, clause (9);
deleted text end
deleted text begin
(2) has tax-exempt status in accordance with the Internal Revenue Code, section
501(c)(3);
deleted text end
deleted text begin
(3) received approval before 1991 from the commissioner of health to operate a paramedic
education program;
deleted text end
deleted text begin
(4) operates an AEMT and paramedic education program exclusively to train paramedics
for the local ambulance service; and
deleted text end
deleted text begin
(5) limits enrollment in the AEMT and paramedic program to five candidates per
biennium.
deleted text end
Sec. 32.
Minnesota Statutes 2022, section 144E.285, subdivision 4, is amended to read:
Subd. 4.
Reapproval.
An education program shall apply to the board for reapproval at
least deleted text begin three monthsdeleted text end new text begin 30 daysnew text end prior to the expiration date of its approval and must:
(1) submit an application prescribed by the board specifying any changes from the
information provided for prior approval and any other information requested by the board
to clarify incomplete or ambiguous information presented in the application; deleted text begin and
deleted text end
(2) comply with the requirements under subdivision 1, paragraph (b), clauses (2) to deleted text begin (10).deleted text end new text begin
(7);
new text end
new text begin
(3) be subject to a site visit by the board;
new text end
new text begin
(4) for education programs that teach EMRs, comply with the requirements in subdivision
1a;
new text end
new text begin
(5) for education programs that teach EMTs, comply with the requirements in subdivision
1b; and
new text end
new text begin
(6) for education programs that teach AEMTs and paramedics, comply with the
requirements in subdivision 2 and maintain accreditation with CAAHEP.
new text end
Sec. 33.
Minnesota Statutes 2022, section 144E.285, subdivision 6, is amended to read:
Subd. 6.
Temporary suspension.
(a) In addition to any other remedy provided by law,
the deleted text begin boarddeleted text end new text begin directornew text end may temporarily suspend approval of the education program after
conducting a preliminary inquiry to determine whether the deleted text begin boarddeleted text end new text begin directornew text end believes that the
education program has violated a statute or rule that the deleted text begin boarddeleted text end new text begin directornew text end is empowered to
enforce and determining that the continued provision of service by the education program
would create an imminent risk to public health or harm to others.
(b) A temporary suspension order prohibiting the education program from providing
emergency medical care training shall give notice of the right to a preliminary hearing
according to paragraph (d) and shall state the reasons for the entry of the temporary
suspension order.
(c) Service of a temporary suspension order is effective when the order is served on the
education program personally or by certified mail, which is complete upon receipt, refusal,
or return for nondelivery to the most recent address provided to the deleted text begin boarddeleted text end new text begin directornew text end for the
education program.
(d) At the time the deleted text begin boarddeleted text end new text begin directornew text end issues a temporary suspension order, the deleted text begin boarddeleted text end new text begin directornew text end
shall schedule a hearingdeleted text begin , to be held before a group of its members designated by the board,deleted text end
that shall begin within 60 days after issuance of the temporary suspension order or within
15 working days of the date of the deleted text begin board'sdeleted text end new text begin director'snew text end receipt of a request for a hearing from
the education program, whichever is sooner. The hearing shall be on the sole issue of whether
there is a reasonable basis to continue, modify, or lift the temporary suspension. A hearing
under this paragraph is not subject to chapter 14.
(e) Evidence presented by the deleted text begin boarddeleted text end new text begin directornew text end or the individual may be in the form of an
affidavit. The education program or counsel of record may appear for oral argument.
(f) Within five working days of the hearing, the deleted text begin boarddeleted text end new text begin directornew text end shall issue its order and,
if the suspension is continued, notify the education program of the right to a contested case
hearing under chapter 14.
(g) If an education program requests a contested case hearing within 30 days of receiving
notice under paragraph (f), the deleted text begin boarddeleted text end new text begin directornew text end shall initiate a contested case hearing according
to chapter 14. The administrative law judge shall issue a report and recommendation within
30 days after the closing of the contested case hearing record. The deleted text begin boarddeleted text end new text begin directornew text end shall issue
a final order within 30 days after receipt of the administrative law judge's report.
new text begin EFFECTIVE DATE. new text end
new text begin
This section is effective January 1, 2025.
new text end
Sec. 34.
Minnesota Statutes 2022, section 144E.287, is amended to read:
144E.287 DIVERSION PROGRAM.
The deleted text begin boarddeleted text end new text begin directornew text end shall either conduct a health professionals deleted text begin servicedeleted text end new text begin servicesnew text end program
deleted text begin under sections 214.31 to 214.37deleted text end or contract for a diversion program deleted text begin under section 214.28deleted text end
for professionals regulated deleted text begin by the boarddeleted text end new text begin under this chapternew text end who are unable to perform their
duties with reasonable skill and safety by reason of illness, use of alcohol, drugs, chemicals,
or any other materials, or as a result of any mental, physical, or psychological condition.
new text begin EFFECTIVE DATE. new text end
new text begin
This section is effective January 1, 2025.
new text end
Sec. 35.
Minnesota Statutes 2022, section 144E.305, subdivision 3, is amended to read:
Subd. 3.
Immunity.
(a) An individual, licensee, health care facility, business, or
organization is immune from civil liability or criminal prosecution for submitting in good
faith a report to the deleted text begin boarddeleted text end new text begin director new text end under subdivision 1 or 2 or for otherwise reporting in
good faith to the deleted text begin boarddeleted text end new text begin director new text end violations or alleged violations of sections 144E.001 to
144E.33. Reports are classified as confidential data on individuals or protected nonpublic
data under section 13.02 while an investigation is active. Except for the deleted text begin board'sdeleted text end new text begin director's
new text end final determination, all communications or information received by or disclosed to the deleted text begin boarddeleted text end
new text begin director new text end relating to disciplinary matters of any person or entity subject to the deleted text begin board'sdeleted text end new text begin director's
new text end regulatory jurisdiction are confidential and privileged and any disciplinary hearing shall be
closed to the public.
(b) deleted text begin Members of the boarddeleted text end new text begin The directornew text end , persons employed by the deleted text begin boarddeleted text end new text begin directornew text end , persons
engaged in the investigation of violations and in the preparation and management of charges
of violations of sections 144E.001 to 144E.33 on behalf of the deleted text begin boarddeleted text end new text begin directornew text end , and persons
participating in the investigation regarding charges of violations are immune from civil
liability and criminal prosecution for any actions, transactions, or publications, made in
good faith, in the execution of, or relating to, their duties under sections 144E.001 to 144E.33.
deleted text begin
(c) For purposes of this section, a member of the board is considered a state employee
under section 3.736, subdivision 9.
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. 36.
Minnesota Statutes 2023 Supplement, 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) 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;
(4) 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);
(5) 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;
(6) personnel or designees of a health-related licensing board listed in section 214.01,
subdivision 2, or of the new text begin Office of new text end Emergency Medical Services deleted text begin Regulatory Boarddeleted text end , assigned
to conduct a bona fide investigation of a complaint received by that board new text begin or office new text end 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);
(7) 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;
(8) authorized personnel under contract with the board, or under contract with the state
of Minnesota and approved by the board, who are engaged in the design, evaluation,
implementation, operation, or 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);
(9) federal, state, and local law enforcement authorities acting pursuant to a valid search
warrant;
(10) 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;
(11) personnel of the Department of Human Services assigned to access the data pursuant
to paragraph (k);
(12) 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 deleted text begin or the Emergency Medical Services Regulatory
Boarddeleted text end , except as permitted under section 214.33, subdivision 3;
(13) personnel or designees of a health-related licensing board other than the Board of
Pharmacy 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. For the purposes
of this clause, the health-related licensing board may also obtain utilization data; and
(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.
(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), (4), (7), (8),
(10), and (11), 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), (4), (7), (8),
(10), and (11), 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.
new text begin EFFECTIVE DATE. new text end
new text begin
This section is effective January 1, 2025.
new text end
Sec. 37.
Minnesota Statutes 2022, section 214.025, is amended to read:
214.025 COUNCIL OF HEALTH BOARDS.
The health-related licensing boards may establish a Council of Health Boards consisting
of representatives of the health-related licensing boards deleted text begin and the Emergency Medical Services
Regulatory Boarddeleted text end . When reviewing legislation or legislative proposals relating to the
regulation of health occupations, the council shall include the commissioner of health or a
designeenew text begin and the director of the Office of Emergency Medical Services or a designeenew text end .
new text begin EFFECTIVE DATE. new text end
new text begin
This section is effective January 1, 2025.
new text end
Sec. 38.
Minnesota Statutes 2022, section 214.04, subdivision 2a, is amended to read:
Subd. 2a.
Performance of executive directors.
The governor may request that a
health-related licensing board deleted text begin or the Emergency Medical Services Regulatory Boarddeleted text end review
the performance of the board's executive director. Upon receipt of the request, the board
must respond by establishing a performance improvement plan or taking disciplinary or
other corrective action, including dismissal. The board shall include the governor's
representative as a voting member of the board in the board's discussions and decisions
regarding the governor's request. The board shall report to the governor on action taken by
the board, including an explanation if no action is deemed necessary.
new text begin EFFECTIVE DATE. new text end
new text begin
This section is effective January 1, 2025.
new text end
Sec. 39.
Minnesota Statutes 2022, section 214.29, is amended to read:
214.29 PROGRAM REQUIRED.
Each health-related licensing boarddeleted text begin , including the Emergency Medical Services
Regulatory Board under chapter 144E,deleted text end shall either conduct a health professionals service
program under sections 214.31 to 214.37 or contract for a diversion program under section
214.28.
new text begin EFFECTIVE DATE. new text end
new text begin
This section is effective January 1, 2025.
new text end
Sec. 40.
Minnesota Statutes 2022, section 214.31, is amended to read:
214.31 AUTHORITY.
Two or more of the health-related licensing boards listed in section 214.01, subdivision
2, may jointly conduct a health professionals services program to protect the public from
persons regulated by the boards who are unable to practice with reasonable skill and safety
by reason of illness, use of alcohol, drugs, chemicals, or any other materials, or as a result
of any mental, physical, or psychological condition. The program does not affect a board's
authority to discipline violations of a board's practice act. deleted text begin For purposes of sections 214.31
to 214.37, the emergency medical services regulatory board shall be included in the definition
of a health-related licensing board under chapter 144E.
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. 41.
Minnesota Statutes 2022, section 214.355, is amended to read:
214.355 GROUNDS FOR DISCIPLINARY ACTION.
Each health-related licensing boarddeleted text begin , including the Emergency Medical Services
Regulatory Board under chapter 144E,deleted text end shall consider it grounds for disciplinary action if a
regulated person violates the terms of the health professionals services program participation
agreement or leaves the program except upon fulfilling the terms for successful completion
of the program as set forth in the participation agreement.
new text begin EFFECTIVE DATE. new text end
new text begin
This section is effective January 1, 2025.
new text end
Sec. 42. new text begin INITIAL MEMBERS AND FIRST MEETING; EMERGENCY MEDICAL
SERVICES ADVISORY COUNCIL.
new text end
new text begin
(a) Initial appointments of members to the Emergency Medical Services Advisory
Council must be made by January 1, 2025. The terms of initial appointees shall be determined
by lot by the secretary of state and shall be as follows:
new text end
new text begin
(1) eight members shall serve two-year terms; and
new text end
new text begin
(2) eight members shall serve three-year terms.
new text end
new text begin
(b) The medical director appointee must convene the first meeting of the Emergency
Medical Services Advisory Council by February 1, 2025.
new text end
Sec. 43. new text begin INITIAL MEMBERS AND FIRST MEETING; EMERGENCY MEDICAL
SERVICES PHYSICIAN ADVISORY COUNCIL.
new text end
new text begin
(a) Initial appointments of members to the Emergency Medical Services Physician
Advisory Council must be made by January 1, 2025. The terms of initial appointees shall
be determined by lot by the secretary of state and shall be as follows:
new text end
new text begin
(1) five members shall serve two-year terms;
new text end
new text begin
(2) five members shall serve three-year terms; and
new text end
new text begin
(3) the term for the medical director appointee to the Emergency Medical Services
Physician Advisory Council shall coincide with that member's term on the Emergency
Medical Services Advisory Council.
new text end
new text begin
(b) The medical director appointee must convene the first meeting of the Emergency
Medical Services Physician Advisory Council by February 1, 2025.
new text end
Sec. 44. new text begin INITIAL MEMBERS AND FIRST MEETING; LABOR AND EMERGENCY
MEDICAL SERVICE PROVIDERS ADVISORY COUNCIL.
new text end
new text begin
(a) Initial appointments of members to the Labor and Emergency Medical Service
Providers Advisory Council must be made by January 1, 2025. The terms of initial appointees
shall be determined by lot by the secretary of state and shall be as follows:
new text end
new text begin
(1) six members shall serve two-year terms; and
new text end
new text begin
(2) seven members shall serve three-year terms.
new text end
new text begin
(b) The emergency medical technician instructor appointee must convene the first meeting
of the Labor and Emergency Medical Service Providers Advisory Council by February 1,
2025.
new text end
Sec. 45. new text begin TRANSITION.
new text end
new text begin Subdivision 1. new text end
new text begin Appointment of director; operation of office. new text end
new text begin
No later than October
1, 2024, the governor shall appoint a director-designee of the Office of Emergency Medical
Services. The individual appointed as the director-designee of the Office of Emergency
Medical Services shall become the governor's appointee as director of the Office of
Emergency Medical Services on January 1, 2025. Effective January 1, 2025, the
responsibilities to regulate emergency medical services in Minnesota under Minnesota
Statutes, chapter 144E, and Minnesota Rules, chapter 4690, are transferred from the
Emergency Medical Services Regulatory Board to the Office of Emergency Medical Services
and the director of the Office of Emergency Medical Services.
new text end
new text begin Subd. 2. new text end
new text begin Transfer of responsibilities. new text end
new text begin
Minnesota Statutes, section 15.039, applies to
the transfer of responsibilities from the Emergency Medical Services Regulatory Board to
the Office of Emergency Medical Services required by this act. The commissioner of
administration, with the approval of the governor, may issue reorganization orders under
Minnesota Statutes, section 16B.37, as necessary to carry out the transfer of responsibilities
required by this act. The provision of Minnesota Statutes, section 16B.37, subdivision 1,
which states that transfers under that section may be made only to an agency that has been
in existence for at least one year, does not apply to transfers in this act to the Office of
Emergency Medical Services.
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. 46. new text begin REVISOR INSTRUCTION.
new text end
new text begin
(a) In Minnesota Statutes, chapter 144E, the revisor of statutes shall replace "board"
with "director"; "board's" with "director's"; "Emergency Medical Services Regulatory Board"
or "Minnesota Emergency Medical Services Regulatory Board" with "director"; and
"board-approved" with "director-approved," except that:
new text end
new text begin
(1) in Minnesota Statutes, section 144E.11, the revisor of statutes shall not modify the
term "county board," "community health board," or "community health boards";
new text end
new text begin
(2) in Minnesota Statutes, sections 144E.40, subdivision 2; 144E.42, subdivision 2;
144E.44; and 144E.45, subdivision 2, the revisor of statutes shall not modify the term "State
Board of Investment"; and
new text end
new text begin
(3) in Minnesota Statutes, sections 144E.50 and 144E.52, the revisor of statutes shall
not modify the term "regional emergency medical services board," "regional board," "regional
emergency medical services board's," or "regional boards."
new text end
new text begin
(b) In the following sections of Minnesota Statutes, the revisor of statutes shall replace
"Emergency Medical Services Regulatory Board" with "director of the Office of Emergency
Medical Services": sections 13.717, subdivision 10; 62J.49, subdivision 2; 144.604; 144.608;
147.09; 156.12, subdivision 2; 169.686, subdivision 3; and 299A.41, subdivision 4.
new text end
new text begin
(c) In the following sections of Minnesota Statutes, the revisor of statutes shall replace
"Emergency Medical Services Regulatory Board" with "Office of Emergency Medical
Services": sections 144.603 and 161.045, subdivision 3.
new text end
new text begin
(d) In making the changes specified in this section, the revisor of statutes may make
technical and other necessary changes to sentence structure to preserve the meaning of the
text.
new text end
Sec. 47. new text begin REPEALER.
new text end
new text begin
(a)
new text end
new text begin
Minnesota Statutes 2022, sections 144E.001, subdivision 5; 144E.01; 144E.123,
subdivision 5; and 144E.50, subdivision 3,
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 144E.27, subdivisions 1 and 1a,
new text end
new text begin
are repealed.
new text end
new text begin EFFECTIVE DATE. new text end
new text begin
Paragraph (a) is effective January 1, 2025.
new text end
ARTICLE 8
PHARMACY BOARD AND PRACTICE
Section 1.
Minnesota Statutes 2023 Supplement, section 62Q.46, subdivision 1, is amended
to read:
Subdivision 1.
Coverage for preventive items and services.
(a) "Preventive items and
services" has the meaning specified in the Affordable Care Act. Preventive items and services
includes:
(1) evidence-based items or services that have in effect a rating of A or B in the current
recommendations of the United States Preventive Services Task Force with respect to the
individual involved;
(2) immunizations for routine use in children, adolescents, and adults that have in effect
a recommendation from the Advisory Committee on Immunization Practices of the Centers
for Disease Control and Prevention with respect to the individual involved. For purposes
of this clause, a recommendation from the Advisory Committee on Immunization Practices
of the Centers for Disease Control and Prevention is considered in effect after the
recommendation has been adopted by the Director of the Centers for Disease Control and
Prevention, and a recommendation is considered to be for routine use if the recommendation
is listed on the Immunization Schedules of the Centers for Disease Control and Prevention;
(3) with respect to infants, children, and adolescents, evidence-informed preventive care
and screenings provided for in comprehensive guidelines supported by the Health Resources
and Services Administration;
(4) with respect to women, additional preventive care and screenings that are not listed
with a rating of A or B by the United States Preventive Services Task Force but that are
provided for in comprehensive guidelines supported by the Health Resources and Services
Administration;
(5) all contraceptive methods established in guidelines published by the United States
Food and Drug Administration;
(6) screenings for human immunodeficiency virus for:
(i) all individuals at least 15 years of age but less than 65 years of age; and
(ii) all other individuals with increased risk of human immunodeficiency virus infection
according to guidance from the Centers for Disease Control;
(7) all preexposure prophylaxis when used for the prevention or treatment of human
immunodeficiency virus, including but not limited to all preexposure prophylaxis, as defined
in any guidance by the United States Preventive Services Task Force or the Centers for
Disease Control, including the June 11, 2019, Preexposure Prophylaxis for the Prevention
of HIV Infection United States Preventive Services Task Force Recommendation Statement;
and
(8) all postexposure prophylaxis when used for the prevention or treatment of human
immunodeficiency virus, including but not limited to all postexposure prophylaxis as defined
in any guidance by the United States Preventive Services Task Force or the Centers for
Disease Control.
(b) A health plan company must provide coverage for preventive items and services at
a participating provider without imposing cost-sharing requirements, including a deductible,
coinsurance, or co-payment. Nothing in this section prohibits a health plan company that
has a network of providers from excluding coverage or imposing cost-sharing requirements
for preventive items or services that are delivered by an out-of-network provider.
(c) A health plan company is not required to provide coverage for any items or services
specified in any recommendation or guideline described in paragraph (a) if the
recommendation or guideline is no longer included as a preventive item or service as defined
in paragraph (a). Annually, a health plan company must determine whether any additional
items or services must be covered without cost-sharing requirements or whether any items
or services are no longer required to be covered.
(d) Nothing in this section prevents a health plan company from using reasonable medical
management techniques to determine the frequency, method, treatment, or setting for a
preventive item or service to the extent not specified in the recommendation or guideline.
new text begin
(e) A health plan shall not require prior authorization or step therapy for preexposure
prophylaxis or postexposure prophylaxis, except that: if the United States Food and Drug
Administration has approved one or more therapeutic equivalents of a drug, device, or
product for the prevention of HIV, this paragraph does not require a health plan to cover
all of the therapeutically equivalent versions without prior authorization or step therapy, if
at least one therapeutically equivalent version is covered without prior authorization or step
therapy.
new text end
deleted text begin (e)deleted text end new text begin (f)new text end This section does not apply to grandfathered plans.
deleted text begin (f)deleted text end new text begin (g)new text end This section does not apply to plans offered by the Minnesota Comprehensive
Health Association.
new text begin EFFECTIVE DATE. new text end
new text begin
This section is effective January 1, 2026, and applies to health
plans offered, issued, or renewed on or after that date.
new text end
Sec. 2.
Minnesota Statutes 2022, section 151.01, subdivision 23, is amended to read:
Subd. 23.
Practitioner.
"Practitioner" means a licensed doctor of medicine, licensed
doctor of osteopathic medicine duly licensed to practice medicine, licensed doctor of
dentistry, licensed doctor of optometry, licensed podiatrist, licensed veterinarian, licensed
advanced practice registered nurse, or licensed physician assistant. For purposes of sections
151.15, subdivision 4; 151.211, subdivision 3; 151.252, subdivision 3; 151.37, subdivision
2, paragraph (b); and 151.461, "practitioner" also means a dental therapist authorized to
dispense and administer under chapter 150A. For purposes of sections 151.252, subdivision
3, and 151.461, "practitioner" also means a pharmacist authorized to prescribe
self-administered hormonal contraceptives, nicotine replacement medications, or opiate
antagonists under section 151.37, subdivision 14, 15, or 16new text begin , or authorized to prescribe drugs
to prevent the acquisition of human immunodeficiency virus (HIV) under section 151.37,
subdivision 17new text end .
new text begin EFFECTIVE DATE. new text end
new text begin
This section is effective January 1, 2025.
new text end
Sec. 3.
Minnesota Statutes 2022, section 151.01, subdivision 27, is amended to read:
Subd. 27.
Practice of pharmacy.
"Practice of pharmacy" means:
(1) interpretation and evaluation of prescription drug orders;
(2) compounding, labeling, and dispensing drugs and devices (except labeling by a
manufacturer or packager of nonprescription drugs or commercially packaged legend drugs
and devices);
(3) participation in clinical interpretations and monitoring of drug therapy for assurance
of safe and effective use of drugs, including deleted text begin the performance ofdeleted text end new text begin ordering and performingnew text end
laboratory tests that are waived under the federal Clinical Laboratory Improvement Act of
1988, United States Code, title 42, section 263a et seq.deleted text begin , provided that a pharmacist may
interpret the results of laboratory tests but may modifydeleted text end new text begin A pharmacist may collect specimens,
interpret results, notify the patient of results, and refer the patient to other health care
providers for follow-up care and may initiate, modify, or discontinuenew text end drug therapy deleted text begin onlydeleted text end
pursuant to a protocol or collaborative practice agreementnew text begin . A pharmacist may delegate the
authority to administer tests under this clause to a pharmacy technician or pharmacy intern.
A pharmacy technician or pharmacy intern may perform tests authorized under this clause
if the technician or intern is working under the direct supervision of a pharmacistnew text end ;
(4) participation in drug and therapeutic device selection; drug administration for first
dosage and medical emergencies; intramuscular and subcutaneous drug administration under
a prescription drug order; drug regimen reviews; and drug or drug-related research;
(5) drug administration, through intramuscular and subcutaneous administration used
to treat mental illnesses as permitted under the following conditions:
(i) upon the order of a prescriber and the prescriber is notified after administration is
complete; or
(ii) pursuant to a protocol or collaborative practice agreement as defined by section
151.01, subdivisions 27b and 27c, and participation in the initiation, management,
modification, administration, and discontinuation of drug therapy is according to the protocol
or collaborative practice agreement between the pharmacist and a dentist, optometrist,
physician, physician assistant, podiatrist, or veterinarian, or an advanced practice registered
nurse authorized to prescribe, dispense, and administer under section 148.235. Any changes
in drug therapy or medication administration made pursuant to a protocol or collaborative
practice agreement must be documented by the pharmacist in the patient's medical record
or reported by the pharmacist to a practitioner responsible for the patient's care;
(6) deleted text begin participation in administration of influenza vaccines anddeleted text end new text begin initiating, ordering, and
administering influenza and COVID-19 or SARS-CoV-2 new text end vaccines new text begin authorized or new text end approved
by the United States Food and Drug Administration deleted text begin related to COVID-19 or SARS-CoV-2deleted text end
to all eligible individuals deleted text begin sixdeleted text end new text begin threenew text end years of age and older and all other new text begin United States Food
and Drug Administration approvednew text end vaccines to patients deleted text begin 13deleted text end new text begin sixnew text end years of age and older deleted text begin by
written deleted text end deleted text begin protocol with a physician licensed under chapter deleted text end deleted text begin 147deleted text end deleted text begin , a physician assistant authorized
to prescribe drugs under chapter deleted text end deleted text begin 147Adeleted text end deleted text begin , or an advanced practice registered nurse authorized
to prescribe drugs under section 148.235, provided thatdeleted text end new text begin according to the federal Advisory
Committee on Immunization Practices recommendation. A pharmacist may delegate the
authority to administer vaccines under this clause to a pharmacy technician or pharmacy
intern who has completed training in vaccine administration ifnew text end :
deleted text begin
(i) the protocol includes, at a minimum:
deleted text end
deleted text begin
(A) the name, dose, and route of each vaccine that may be given;
deleted text end
deleted text begin
(B) the patient population for whom the vaccine may be given;
deleted text end
deleted text begin
(C) contraindications and precautions to the vaccine;
deleted text end
deleted text begin
(D) the procedure for handling an adverse reaction;
deleted text end
deleted text begin
(E) the name, signature, and address of the physician, physician assistant, or advanced
practice registered nurse;
deleted text end
deleted text begin
(F) a telephone number at which the physician, physician assistant, or advanced practice
registered nurse can be contacted; and
deleted text end
deleted text begin
(G) the date and time period for which the protocol is valid;
deleted text end
deleted text begin (ii)deleted text end new text begin (i)new text end the pharmacist deleted text begin hasdeleted text end new text begin and the pharmacy technician or pharmacy intern havenew text end
successfully completed a program approved by the Accreditation Council for Pharmacy
Education new text begin (ACPE) new text end specifically for the administration of immunizations or a program
approved by the board;
deleted text begin (iii)deleted text end new text begin (ii)new text end the pharmacist deleted text begin utilizesdeleted text end new text begin and the pharmacy technician or pharmacy intern utilizenew text end
the Minnesota Immunization Information Connection to assess the immunization status of
individuals prior to the administration of vaccines, except when administering influenza
vaccines to individuals age deleted text begin ninedeleted text end new text begin threenew text end and older;
deleted text begin (iv)deleted text end new text begin (iii)new text end the pharmacist reports the administration of the immunization to the Minnesota
Immunization Information Connection; deleted text begin and
deleted text end
deleted text begin
(v) the pharmacist complies with guidelines for vaccines and immunizations established
by the federal Advisory Committee on Immunization Practices, except that a pharmacist
does not need to comply with those portions of the guidelines that establish immunization
schedules when administering a vaccine pursuant to a valid, patient-specific order issued
by a physician licensed under chapter
deleted text end
deleted text begin
147
deleted text end
deleted text begin
, a physician assistant authorized to prescribe
drugs under chapter
deleted text end
deleted text begin
147A
deleted text end
deleted text begin
, or an advanced practice registered nurse authorized to prescribe
drugs under section 148.235, provided that the order is consistent with the United States
Food and Drug Administration approved labeling of the vaccine;
deleted text end
new text begin
(iv) if the patient is 18 years of age or younger, the pharmacist, pharmacy technician,
or pharmacy intern informs the patient and any adult caregiver accompanying the patient
of the importance of a well-child visit with a pediatrician or other licensed primary care
provider; and
new text end
new text begin
(v) in the case of a pharmacy technician administering vaccinations while being
supervised by a licensed pharmacist, which supervision must be in-person and must not be
done through telehealth as defined under section 62A.673, subdivision 2:
new text end
new text begin
(A) the pharmacist is readily and immediately available to the immunizing pharmacy
technician;
new text end
new text begin
(B) the pharmacy technician has a current certificate in basic cardiopulmonary
resuscitation; and
new text end
new text begin
(C) the pharmacy technician has completed a minimum of two hours of ACPE-approved,
immunization-related continuing pharmacy education as part of the pharmacy technician's
two-year continuing education schedule;
new text end
(7) participation in the initiation, management, modification, and discontinuation of
drug therapy according to a written protocol or collaborative practice agreement between:
(i) one or more pharmacists and one or more dentists, optometrists, physicians, physician
assistants, podiatrists, or veterinarians; or (ii) one or more pharmacists and one or more
physician assistants authorized to prescribe, dispense, and administer under chapter 147A,
or advanced practice registered nurses authorized to prescribe, dispense, and administer
under section 148.235. Any changes in drug therapy made pursuant to a protocol or
collaborative practice agreement must be documented by the pharmacist in the patient's
medical record or reported by the pharmacist to a practitioner responsible for the patient's
care;
(8) participation in the storage of drugs and the maintenance of records;
(9) patient counseling on therapeutic values, content, hazards, and uses of drugs and
devices;
(10) offering or performing those acts, services, operations, or transactions necessary
in the conduct, operation, management, and control of a pharmacy;
(11) participation in the initiation, management, modification, and discontinuation of
therapy with opiate antagonists, as defined in section 604A.04, subdivision 1, pursuant to:
(i) a written protocol as allowed under clause (7); or
(ii) a written protocol with a community health board medical consultant or a practitioner
designated by the commissioner of health, as allowed under section 151.37, subdivision 13;
(12) prescribing self-administered hormonal contraceptives; nicotine replacement
medications; and opiate antagonists for the treatment of an acute opiate overdose pursuant
to section 151.37, subdivision 14, 15, or 16; and
(13) participation in the placement of drug monitoring devices according to a prescription,
protocol, or collaborative practice agreement.
Sec. 4.
Minnesota Statutes 2022, section 151.01, subdivision 27, is amended to read:
Subd. 27.
Practice of pharmacy.
"Practice of pharmacy" means:
(1) interpretation and evaluation of prescription drug orders;
(2) compounding, labeling, and dispensing drugs and devices (except labeling by a
manufacturer or packager of nonprescription drugs or commercially packaged legend drugs
and devices);
(3) participation in clinical interpretations and monitoring of drug therapy for assurance
of safe and effective use of drugs, including the performance of laboratory tests that are
waived under the federal Clinical Laboratory Improvement Act of 1988, United States Code,
title 42, section 263a et seq., provided that a pharmacist may interpret the results of laboratory
tests but may modify drug therapy only pursuant to a protocol or collaborative practice
agreement;
(4) participation in drug and therapeutic device selection; drug administration for first
dosage and medical emergencies; intramuscular and subcutaneous drug administration under
a prescription drug order; drug regimen reviews; and drug or drug-related research;
(5) drug administration, through intramuscular and subcutaneous administration used
to treat mental illnesses as permitted under the following conditions:
(i) upon the order of a prescriber and the prescriber is notified after administration is
complete; or
(ii) pursuant to a protocol or collaborative practice agreement as defined by section
151.01, subdivisions 27b and 27c, and participation in the initiation, management,
modification, administration, and discontinuation of drug therapy is according to the protocol
or collaborative practice agreement between the pharmacist and a dentist, optometrist,
physician, physician assistant, podiatrist, or veterinarian, or an advanced practice registered
nurse authorized to prescribe, dispense, and administer under section 148.235. Any changes
in drug therapy or medication administration made pursuant to a protocol or collaborative
practice agreement must be documented by the pharmacist in the patient's medical record
or reported by the pharmacist to a practitioner responsible for the patient's care;
(6) participation in administration of influenza vaccines and vaccines approved by the
United States Food and Drug Administration related to COVID-19 or SARS-CoV-2 to all
eligible individuals six years of age and older and all other vaccines to patients 13 years of
age and older by written protocol with a physician licensed under chapter 147, a physician
assistant authorized to prescribe drugs under chapter 147A, or an advanced practice registered
nurse authorized to prescribe drugs under section 148.235, provided that:
(i) the protocol includes, at a minimum:
(A) the name, dose, and route of each vaccine that may be given;
(B) the patient population for whom the vaccine may be given;
(C) contraindications and precautions to the vaccine;
(D) the procedure for handling an adverse reaction;
(E) the name, signature, and address of the physician, physician assistant, or advanced
practice registered nurse;
(F) a telephone number at which the physician, physician assistant, or advanced practice
registered nurse can be contacted; and
(G) the date and time period for which the protocol is valid;
(ii) the pharmacist has successfully completed a program approved by the Accreditation
Council for Pharmacy Education specifically for the administration of immunizations or a
program approved by the board;
(iii) the pharmacist utilizes the Minnesota Immunization Information Connection to
assess the immunization status of individuals prior to the administration of vaccines, except
when administering influenza vaccines to individuals age nine and older;
(iv) the pharmacist reports the administration of the immunization to the Minnesota
Immunization Information Connection; and
(v) the pharmacist complies with guidelines for vaccines and immunizations established
by the federal Advisory Committee on Immunization Practices, except that a pharmacist
does not need to comply with those portions of the guidelines that establish immunization
schedules when administering a vaccine pursuant to a valid, patient-specific order issued
by a physician licensed under chapter 147, a physician assistant authorized to prescribe
drugs under chapter 147A, or an advanced practice registered nurse authorized to prescribe
drugs under section 148.235, provided that the order is consistent with the United States
Food and Drug Administration approved labeling of the vaccine;
(7) participation in the initiation, management, modification, and discontinuation of
drug therapy according to a written protocol or collaborative practice agreement between:
(i) one or more pharmacists and one or more dentists, optometrists, physicians, physician
assistants, podiatrists, or veterinarians; or (ii) one or more pharmacists and one or more
physician assistants authorized to prescribe, dispense, and administer under chapter 147A,
or advanced practice registered nurses authorized to prescribe, dispense, and administer
under section 148.235. Any changes in drug therapy made pursuant to a protocol or
collaborative practice agreement must be documented by the pharmacist in the patient's
medical record or reported by the pharmacist to a practitioner responsible for the patient's
care;
(8) participation in the storage of drugs and the maintenance of records;
(9) patient counseling on therapeutic values, content, hazards, and uses of drugs and
devices;
(10) offering or performing those acts, services, operations, or transactions necessary
in the conduct, operation, management, and control of a pharmacy;
(11) participation in the initiation, management, modification, and discontinuation of
therapy with opiate antagonists, as defined in section 604A.04, subdivision 1, pursuant to:
(i) a written protocol as allowed under clause (7); or
(ii) a written protocol with a community health board medical consultant or a practitioner
designated by the commissioner of health, as allowed under section 151.37, subdivision 13;
(12) prescribing self-administered hormonal contraceptives; nicotine replacement
medications; and opiate antagonists for the treatment of an acute opiate overdose pursuant
to section 151.37, subdivision 14, 15, or 16; deleted text begin and
deleted text end
(13) participation in the placement of drug monitoring devices according to a prescription,
protocol, or collaborative practice agreementdeleted text begin .deleted text end new text begin ;
new text end
new text begin
(14) prescribing, dispensing, and administering drugs for preventing the acquisition of
human immunodeficiency virus (HIV) if the pharmacist meets the requirements in section
151.37, subdivision 17; and
new text end
new text begin
(15) ordering, conducting, and interpreting laboratory tests necessary for therapies that
use drugs for preventing the acquisition of HIV, if the pharmacist meets the requirements
in section 151.37, subdivision 17.
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. 5.
Minnesota Statutes 2022, section 151.065, is amended by adding a subdivision to
read:
new text begin Subd. 4a. new text end
new text begin Application and fee; relocation. new text end
new text begin
A person who is registered with or licensed
by the board must submit a new application to the board before relocating the physical
location of the person's business. An application must be submitted for each affected license.
The application must set forth the proposed change of location on a form established by the
board. If the licensee or registrant remitted payment for the full amount during the state's
fiscal year, the relocation application fee is the same as the application fee in subdivision
1, except that the fees in clauses (6) to (9) and (11) to (16) are reduced by $5,000 and the
fee in clause (16) is reduced by $55,000. If the application is made within 60 days before
the date of the original license or registration expiration, the applicant must pay the full
application fee provided in subdivision 1. Upon approval of an application for a relocation,
the board shall issue a new license or registration.
new text end
Sec. 6.
Minnesota Statutes 2022, section 151.065, is amended by adding a subdivision to
read:
new text begin Subd. 4b. new text end
new text begin Application and fee; change of ownership. new text end
new text begin
A person who is registered with
or licensed by the board must submit a new application to the board before changing the
ownership of the licensee or registrant. An application must be submitted for each affected
license. The application must set forth the proposed change of ownership on a form
established by the board. If the licensee or registrant remitted payment for the full amount
during the state's fiscal year, the application fee is the same as the application fee in
subdivision 1, except that the fees in clauses (6) to (9) and (11) to (16) are reduced by $5,000
and the fee in clause (16) is reduced by $55,000. If the application is made within 60 days
before the date of the original license or registration expiration, the applicant must pay the
full application fee provided in subdivision 1. Upon approval of an application for a change
of ownership, the board shall issue a new license or registration.
new text end
Sec. 7.
Minnesota Statutes 2022, section 151.065, is amended by adding a subdivision to
read:
new text begin Subd. 8. new text end
new text begin Transfer of licenses. new text end
new text begin
Licenses and registrations granted by the board are not
transferable.
new text end
Sec. 8.
Minnesota Statutes 2022, section 151.066, subdivision 1, is amended to read:
Subdivision 1.
Definitions.
(a) For purposes of this section, the following terms have
the meanings given to them in this subdivision.
(b) "Manufacturer" means a manufacturer licensed under section 151.252 deleted text begin that is engaged
in the manufacturing of an opiatedeleted text end new text begin , excluding those exclusively licensed to manufacture
medical gasnew text end .
(c) "Opiate" means any opiate-containing controlled substance listed in section 152.02,
subdivisions 3 to 5, that is distributed, delivered, sold, or dispensed into or within this state.
(d) new text begin "Third-party logistics provider" means a third-party logistics provider licensed under
section 151.471.
new text end
new text begin (e) new text end "Wholesaler" means a wholesale drug distributor licensed under section 151.47 deleted text begin that
is engaged in the wholesale drug distribution of an opiatedeleted text end new text begin , excluding those exclusively
licensed to distribute medical gasnew text end .
Sec. 9.
Minnesota Statutes 2022, section 151.066, subdivision 2, is amended to read:
Subd. 2.
Reporting requirements.
(a) By March 1 of each year, beginning March 1,
2020, each manufacturer and each wholesaler must report to the board every sale, delivery,
or other distribution within or into this state of any opiate that is made to any practitioner,
pharmacy, hospital, veterinary hospital, or other person who is permitted by section 151.37
to possess controlled substances for administration or dispensing to patients that occurred
during the previous calendar year. Reporting must be in the automation of reports and
consolidated orders system format unless otherwise specified by the board. new text begin If no reportable
distributions occurred for a given year, notification must be provided to the board in a
manner specified by the board. new text end If a manufacturer or wholesaler fails to provide information
required under this paragraph on a timely basis, the board may assess an administrative
penalty of $500 per day. This penalty shall not be considered a form of disciplinary action.
(b) By March 1 of each year, beginning March 1, 2020, each owner of a pharmacy with
at least one location within this state must report to the board any intracompany delivery
or distribution into this state, of any opiate, to the extent that those deliveries and distributions
are not reported to the board by a licensed wholesaler owned by, under contract to, or
otherwise operating on behalf of the owner of the pharmacy. Reporting must be in the
manner and format specified by the board for deliveries and distributions that occurred
during the previous calendar year. The report must include the name of the manufacturer
or wholesaler from which the owner of the pharmacy ultimately purchased the opiate, and
the amount and date that the purchase occurred.
new text begin
(c) By March 1 of each year, beginning March 1, 2025, each third-party logistics provider
must report to the board any delivery or distribution into this state of any opiate, to the
extent that those deliveries and distributions are not reported to the board by a licensed
wholesaler or manufacturer. Reporting must be in the manner and format specified by the
board for deliveries and distributions that occurred during the previous calendar year.
new text end
Sec. 10.
Minnesota Statutes 2022, section 151.066, subdivision 3, is amended to read:
Subd. 3.
Determination of an opiate product registration fee.
(a) The board shall
annually assess an opiate product registration fee on any manufacturer of an opiate that
annually sells, delivers, or distributes an opiate within or into the state new text begin in a quantity of
new text end 2,000,000 or more units as reported to the board under subdivision 2.
(b) For purposes of assessing the annual registration fee under this section and
determining the number of opiate units a manufacturer sold, delivered, or distributed within
or into the state, the board shall not consider any opiate that is used for substance use disorder
treatment with medications for opioid use disorder.
(c) The annual registration fee for each manufacturer meeting the requirement under
paragraph (a) is $250,000.
(d) In conjunction with the data reported under this section, and notwithstanding section
152.126, subdivision 6, the board may use the data reported under section 152.126,
subdivision 4, to determine which manufacturers meet the requirement under paragraph (a)
and are required to pay the registration fees under this subdivision.
(e) By April 1 of each year, beginning April 1, 2020, the board shall notify a manufacturer
that the manufacturer meets the requirement in paragraph (a) and is required to pay the
annual registration fee in accordance with section 151.252, subdivision 1, paragraph (b).
(f) A manufacturer may dispute the board's determination that the manufacturer must
pay the registration fee no later than 30 days after the date of notification. However, the
manufacturer must still remit the fee as required by section 151.252, subdivision 1, paragraph
(b). The dispute must be filed with the board in the manner and using the forms specified
by the board. A manufacturer must submit, with the required forms, data satisfactory to the
board that demonstrates that the assessment of the registration fee was incorrect. The board
must make a decision concerning a dispute no later than 60 days after receiving the required
dispute forms. If the board determines that the manufacturer has satisfactorily demonstrated
that the fee was incorrectly assessed, the board must refund the amount paid in error.
(g) For purposes of this subdivision, a unit means the individual dosage form of the
particular drug product that is prescribed to the patient. One unit equals one tablet, capsule,
patch, syringe, milliliter, or gram.
new text begin
(h) For the purposes of this subdivision, an opiate's units will be assigned to the
manufacturer holding the New Drug Application (NDA) or Abbreviated New Drug
Application (ANDA), as listed by the United States Food and Drug Administration.
new text end
Sec. 11.
Minnesota Statutes 2022, section 151.212, is amended by adding a subdivision
to read:
new text begin Subd. 4. new text end
new text begin Accessible prescription drug container labels. new text end
new text begin
(a) A pharmacy must inform
each patient for whom a prescription drug is dispensed that an accessible prescription drug
container label is available to any patient who identifies as a person who is blind, visually
impaired, or otherwise disabled, upon request of the patient or the patient's representative,
at no additional cost.
new text end
new text begin
(b) If a patient requests an accessible container label, the pharmacy shall provide the
patient with an audible, large print, or braille prescription drug container label depending
on the need and preference of the patient.
new text end
new text begin
(c) The accessible container label must:
new text end
new text begin
(1) be affixed on the container;
new text end
new text begin
(2) be available in a timely manner comparable to other patient wait time;
new text end
new text begin
(3) last for at least the duration of the prescription;
new text end
new text begin
(4) conform with the format-specific best practices established by the United States
Access Board;
new text end
new text begin
(5) contain the information required under subdivisions 1 and 2; and
new text end
new text begin
(6) be compatible with a prescription reader if a reader is provided.
new text end
new text begin
(d) This subdivision does not apply to prescription drugs dispensed and administered
by a correctional institution.
new text end
new text begin
(e) For purposes of this subdivision, "prescription reader" means a device that is designed
to audibly convey the information contained on the label of a prescription drug container.
new text end
Sec. 12.
Minnesota Statutes 2022, section 151.37, is amended by adding a subdivision to
read:
new text begin Subd. 17. new text end
new text begin Drugs for preventing the acquisition of HIV. new text end
new text begin
(a) A pharmacist is authorized
to prescribe and administer drugs to prevent the acquisition of human immunodeficiency
virus (HIV) in accordance with this subdivision.
new text end
new text begin
(b) By January 1, 2025, the Board of Pharmacy shall develop a standardized protocol
for a pharmacist to follow in prescribing the drugs described in paragraph (a). In developing
the protocol, the board may consult with community health advocacy groups, the Board of
Medical Practice, the Board of Nursing, the commissioner of health, professional pharmacy
associations, and professional associations for physicians, physician assistants, and advanced
practice registered nurses.
new text end
new text begin
(c) Before a pharmacist is authorized to prescribe a drug described in paragraph (a), the
pharmacist must successfully complete a training program specifically developed for
prescribing drugs for preventing the acquisition of HIV that is offered by a college of
pharmacy, a continuing education provider that is accredited by the Accreditation Council
for Pharmacy Education, or a program approved by the board. To maintain authorization
to prescribe, the pharmacist shall complete continuing education requirements as specified
by the board.
new text end
new text begin
(d) Before prescribing a drug described in paragraph (a), the pharmacist shall follow the
appropriate standardized protocol developed under paragraph (b) and, if appropriate, may
dispense to a patient a drug described in paragraph (a).
new text end
new text begin
(e) Before dispensing a drug described in paragraph (a) that is prescribed by the
pharmacist, the pharmacist must provide counseling to the patient on the use of the drugs
and must provide the patient with a fact sheet that includes the indications and
contraindications for the use of these drugs, the appropriate method for using these drugs,
the need for medical follow up, and any additional information listed in Minnesota Rules,
part 6800.0910, subpart 2, that is required to be provided to a patient during the counseling
process.
new text end
new text begin
(f) A pharmacist is prohibited from delegating the prescribing authority provided under
this subdivision to any other person. A pharmacist intern registered under section 151.101
may prepare the prescription, but before the prescription is processed or dispensed, a
pharmacist authorized to prescribe under this subdivision must review, approve, and sign
the prescription.
new text end
new text begin
(g) Nothing in this subdivision prohibits a pharmacist from participating in the initiation,
management, modification, and discontinuation of drug therapy according to a protocol as
authorized in this section and in section 151.01, subdivision 27.
new text end
new text begin EFFECTIVE DATE. new text end
new text begin
This section is effective January 1, 2025, except that paragraph
(b) is effective the day following final enactment.
new text end
Sec. 13.
Minnesota Statutes 2023 Supplement, section 151.555, subdivision 1, is amended
to read:
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) deleted text begin a health care facility as defined in this subdivisiondeleted text end new text begin 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 donationnew text end ;new text begin or
new text end
(2) deleted text begin a skilled nursing facility licensed under chapter deleted text end deleted text begin 144Adeleted text end deleted text begin ;deleted text end new text begin any entity legally authorized
to possess medicine with a license or permit in good standing in the state in which it is
located, without further restrictions, including but not limited to a health care facility, skilled
nursing facility, assisted living facility, pharmacy, wholesaler, and drug manufacturer.
new text end
deleted text begin
(3) an assisted living facility licensed under chapter
deleted text end
deleted text begin
144G
deleted text end
deleted text begin
;
deleted text end
deleted text begin
(4) a pharmacy licensed under section 151.19, and located either in the state or outside
the state;
deleted text end
deleted text begin
(5) a drug wholesaler licensed under section 151.47;
deleted text end
deleted text begin
(6) a drug manufacturer licensed under section 151.252; or
deleted text end
deleted text begin
(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.
deleted text end
(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 or nonprescription medical
supplies needed to administer a 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.
Sec. 14.
Minnesota Statutes 2023 Supplement, section 151.555, subdivision 4, is amended
to read:
Subd. 4.
Local repository requirements.
(a) To be eligible for participation in the
medication repository program, a health care facility must agree to comply with all applicable
federal and state laws, rules, and regulations pertaining to the medication 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 medication repository program is voluntary. A local repository
may withdraw from participation in the medication 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. deleted text begin 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.
deleted text end
Sec. 15.
Minnesota Statutes 2023 Supplement, section 151.555, subdivision 5, is amended
to read:
Subd. 5.
Individual eligibility and application requirements.
(a) deleted text begin To be eligible for
the medication repository programdeleted text end new text begin At the time of or before receiving donated drugs or
supplies as a new eligible patientnew text end , an individual must submit to a local repository an new text begin electronic
or physical new text end intake application form that is signed by the individual and attests that the
individual:
(1) is a resident of Minnesota;
(2) is uninsured deleted text begin and is not enrolled in the medical assistance program under chapter
deleted text end deleted text begin 256Bdeleted text end deleted text begin or the MinnesotaCare program under chapter deleted text end deleted text begin 256Ldeleted text end , 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.
deleted text begin
(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.
deleted text end
deleted text begin (c)deleted text end new text begin (b)new text end 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.
deleted text begin (d)deleted text end new text begin (c)new text end The board shall develop and make available on the board's website an application
form deleted text begin and the format for the identification carddeleted text end .
Sec. 16.
Minnesota Statutes 2023 Supplement, section 151.555, subdivision 6, is amended
to read:
Subd. 6.
Standards and procedures for accepting donations of drugs and supplies.
(a)
new text begin Notwithstanding any other law or rule, new text end a donor may donate 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 drug is eligible for donation under the medication repository program if the
following requirements are met:
deleted text begin
(1) the donation is accompanied by a medication 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);
deleted text end
deleted text begin (2)deleted text end new text begin (1)new text end 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;
deleted text begin (3)deleted text end new text begin (2)new text end 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;
deleted text begin (4)deleted text end new text begin (3)new text end the drug or the packaging does not have any physical signs of tampering,
misbranding, deterioration, compromised integrity, or adulteration;
deleted text begin (5)deleted text end new text begin (4)new text end 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
deleted text begin (6)deleted text end new text begin (5)new text end the drug is not a controlled substance.
(c) A medical supply is eligible for donation under the medication 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;new text begin and
new text end
deleted text begin
(3) the donation is accompanied by a medication 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
deleted text end
deleted text begin (4)deleted text end new text begin (3)new text end 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 medication repository donor form and make it available
on the board's website. deleted text begin 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.deleted text end new text begin Prior to the first donation from a new donor, a central repository
or local repository shall verify and record the following information on the donor form:
new text end
new text begin
(1) the donor's name, address, phone number, and license number, if applicable;
new text end
new text begin
(2) that the donor will only make donations in accordance with the program;
new text end
new text begin
(3) to the best of the donor's knowledge, only drugs or supplies that have been properly
stored under appropriate temperature and humidity conditions will be donated; and
new text end
new text begin
(4) to the best of the donor's knowledge, only drugs or supplies that have never been
opened, used, tampered with, adulterated, or misbranded will be donated.
new text end
(e) new text begin Notwithstanding any other law or rule, a central repository or a local repository may
receive donated drugs from donors. new text end 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 deleted text begin to accept donationsdeleted text end new text begin prior to
dispensingnew text end . A drop box must not be used to deliver or accept donations.
(f) The central repository and local repository shall new text begin maintain a written or electronic
new text end inventory new text begin of new text end all drugs and supplies donated to the repositorynew text begin upon acceptance of each drug
or supplynew text end . 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.new text begin The board
may waive the requirement under this paragraph if an entity is under common ownership
or control with a central repository or local repository and either the entity or the repository
maintains an inventory containing all the information required under this paragraph.
new text end
Sec. 17.
Minnesota Statutes 2023 Supplement, section 151.555, subdivision 7, is amended
to read:
Subd. 7.
Standards and procedures for inspecting and storing donated 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 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. deleted text begin The pharmacist
or practitioner who inspects the drugs or supplies shall sign an inspection record stating that
the requirements for donation have been met.deleted text end 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 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 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.
new text begin
No other record of destruction is required.
new text end
Sec. 18.
Minnesota Statutes 2023 Supplement, section 151.555, subdivision 8, is amended
to read:
Subd. 8.
Dispensing requirements.
(a) Donated new text begin prescription new text end 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 drugs in compliance with
applicable federal and state laws and regulations for dispensing 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 deleted text begin adeleted text end new text begin the firstnew text end drug or supply is dispensed or administered to an individual, the
individual must sign deleted text begin adeleted text end new text begin an electronic or physicalnew text end drug repository recipient form acknowledging
that the individual understands deleted text begin 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
informationdeleted text end :
(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 medication 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.
Sec. 19.
Minnesota Statutes 2023 Supplement, section 151.555, subdivision 9, is amended
to read:
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
medication repository program shall not receive reimbursement under the medical assistance
program or the MinnesotaCare program for that dispensed or administered drug or supply.
new text begin
(c) A supply or handling fee must not be charged to an individual enrolled in the medical
assistance or MinnesotaCare program.
new text end
Sec. 20.
Minnesota Statutes 2023 Supplement, section 151.555, subdivision 11, is amended
to read:
Subd. 11.
Forms and record-keeping requirements.
(a) The following forms developed
for the administration of this program deleted text begin shall be utilized by the participants of the program
anddeleted text end 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) medication repository donor form described under subdivision 6;
(5) record of destruction form described under subdivision 7; and
(6) medication repository recipient form described under subdivision 8.
new text begin
Participants may use substantively similar electronic or physical forms.
new text end
(b) All records, including drug inventorydeleted text begin , inspection,deleted text end and disposal of donated 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 medication 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.
Sec. 21.
Minnesota Statutes 2023 Supplement, section 151.555, subdivision 12, is amended
to read:
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, deleted text begin ordeleted text end a donor of a drug or medical supplynew text begin , or a person or entity
that facilitates any of the abovenew text end 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 deleted text begin pharmacist
or practitionerdeleted text end new text begin person or entitynew text end 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.
Sec. 22.
Minnesota Statutes 2023 Supplement, 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) Prior authorization must not be required for liquid methadone if only one version of
liquid methadone is available. If more than one version of liquid methadone is available,
the commissioner shall ensure that at least one version of liquid methadone is available
without prior authorization.
(e) Prior authorization may be required for an oral liquid form of a drug, except as
described in paragraph (d). A prior authorization request under this paragraph must be
automatically approved within 24 hours if the drug is being prescribed for a Food and Drug
Administration-approved condition for a patient who utilizes an enteral tube for feedings
or medication administration, even if the patient has current or prior claims for pills for that
condition. If more than one version of the oral liquid form of a drug is available, the
commissioner may select the version that is able to be approved for a Food and Drug
Administration-approved condition for a patient who utilizes an enteral tube for feedings
or medication administration. This paragraph applies to any multistate preferred drug list
or supplemental drug rebate program established or administered by the commissioner. The
commissioner shall design and implement a streamlined prior authorization form for patients
who utilize an enteral tube for feedings or medication administration and are prescribed an
oral liquid form of a drug. 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.
(f) 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.
(g) Prior authorization under this subdivision shall comply with section 62Q.184.
(h) Any step therapy protocol requirements established by the commissioner must comply
with section 62Q.1841.
new text begin
(i) Notwithstanding any law to the contrary, prior authorization or step therapy shall not
be required or utilized for any class of drugs that is approved by the United States Food and
Drug Administration for the treatment or prevention of HIV and AIDS.
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. 23.
Minnesota Statutes 2022, section 256B.0625, is amended by adding a subdivision
to read:
new text begin Subd. 13l. new text end
new text begin Vaccines and laboratory tests provided by pharmacists. new text end
new text begin
(a) Medical
assistance covers vaccines initiated, ordered, or administered by a licensed pharmacist,
according to the requirements of section 151.01, subdivision 27, clause (6), at no less than
the rate for which the same services are covered when provided by any other licensed
practitioner.
new text end
new text begin
(b) Medical assistance covers laboratory tests ordered and performed by a licensed
pharmacist, according to the requirements of section 151.01, subdivision 27, clause (3), at
no less than the rate for which the same services are covered when provided by any other
licensed practitioner.
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. 24.
Minnesota Statutes 2022, section 256B.0625, subdivision 39, is amended to read:
Subd. 39.
Childhood immunizations.
Providers who administer pediatric vaccines
within the scope of their licensure, and who are enrolled as a medical assistance provider,
must enroll in the pediatric vaccine administration program established by section 13631
of the Omnibus Budget Reconciliation Act of 1993. Medical assistance shall pay for
administration of the vaccine to children eligible for medical assistance. Medical assistance
does not pay for vaccines that are available at no cost from the pediatric vaccine
administration programnew text begin unless the vaccines qualify for 100 percent federal funding or are
mandated by the Centers for Medicare and Medicaid Services to be covered outside of the
Vaccines for Children programnew text end .
Sec. 25. new text begin RULEMAKING; BOARD OF PHARMACY.
new text end
new text begin
The Board of Pharmacy must amend Minnesota Rules, part 6800.3400, to permit and
promote the inclusion of the following on a prescription label:
new text end
new text begin
(1) the complete and unabbreviated generic name of the drug; and
new text end
new text begin
(2) instructions written in plain language explaining the patient-specific indications for
the drug.
new text end
new text begin
The Board of Pharmacy must comply with Minnesota Statutes, section 14.389, in adopting
the amendment to the rule.
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 9
BEHAVIORAL HEALTH
Section 1.
Minnesota Statutes 2022, section 245.462, subdivision 6, is amended to read:
Subd. 6.
Community support services program.
"Community support services program"
means services, other than inpatient or residential treatment services, provided or coordinated
by an identified program and staff under the treatment supervision of a mental health
professional designed to help adults with serious and persistent mental illness to function
and remain in the community. A community support services program includes:
(1) client outreach,
(2) medication monitoring,
(3) assistance in independent living skills,
(4) development of employability and work-related opportunities,
(5) crisis assistance,
(6) psychosocial rehabilitation,
(7) help in applying for government benefits, and
(8) housing support services.
The community support services program must be coordinated with the case management
services specified in section 245.4711.new text begin A program that meets the accreditation standards
for Clubhouse International model programs meets the requirements of this subdivision.
new text end
Sec. 2.
Minnesota Statutes 2022, section 245.4663, subdivision 2, is amended to read:
Subd. 2.
Eligible providers.
In order to be eligible for a grant under this section, a mental
health provider must:
(1) 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;
deleted text begin or
deleted text end
(2) primarily serve underrepresented communities as defined in section 148E.010,
subdivision 20deleted text begin .deleted text end new text begin ; or
new text end
new text begin
(3) provide services to people in a city or township that is not within the seven-county
metropolitan area as defined in section 473.121, subdivision 2, and is not the city of Duluth,
Mankato, Moorhead, Rochester, or St. Cloud.
new text end
Sec. 3.
Minnesota Statutes 2023 Supplement, 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 deleted text begin out-of-home placement ordeleted text end new text begin residential treatment or
hospitalization, who arenew text end 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 carenew text begin , who have utilized crisis services or emergency room
services, or who have experienced a loss of in-home staffing supportnew text end . 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 servicesnew text begin . Counties must work to
provide regular access to regularly scheduled respite carenew text end ;
(4) children's mental health crisis services;
(5) child-, youth-, and family-specific mobile response and stabilization services models;
(6) mental health services for people from cultural and ethnic minorities, including
supervision of clinical trainees who are Black, indigenous, or people of color;
(7) children's mental health screening and follow-up diagnostic assessment and treatment;
(8) services to promote and develop the capacity of providers to use evidence-based
practices in providing children's mental health services;
(9) school-linked mental health services under section 245.4901;
(10) building evidence-based mental health intervention capacity for children birth to
age five;
(11) suicide prevention and counseling services that use text messaging statewide;
(12) mental health first aid training;
(13) 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;
(14) transition age services to develop or expand mental health treatment and supports
for adolescents and young adults 26 years of age or younger;
(15) early childhood mental health consultation;
(16) 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;
(17) psychiatric consultation for primary care practitioners; and
(18) providers to begin operations and meet program requirements when establishing a
new children's mental health program. These may be start-up grants.
(c) Services under paragraph (b) must be designed to help each child to function and
remain with the child's family in the community and delivered consistent with the child's
treatment plan. Transition services to eligible young adults under this paragraph must be
designed to foster independent living in the community.
(d) As a condition of receiving grant funds, a grantee shall obtain all available third-party
reimbursement sources, if applicable.
(e) The commissioner may establish and design a pilot program to expand the mobile
response and stabilization services model for children, youth, and families. The commissioner
may use grant funding to consult with a qualified expert entity to assist in the formulation
of measurable outcomes and explore and position the state to submit a Medicaid state plan
amendment to scale the model statewide.
Sec. 4.
Minnesota Statutes 2022, section 245I.02, subdivision 17, is amended to read:
Subd. 17.
Functional assessment.
"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. deleted text begin For a client five years of age or younger, a functional assessment is the
Early Childhood Service Intensity Instrument (ESCII). For a client six to 17 years of age,
a functional assessment is the Child and Adolescent Service Intensity Instrument (CASII).
For a client 18 years of age or older, a functional assessment is the functional assessment
described in section 245I.10, subdivision 9.
deleted text end
Sec. 5.
Minnesota Statutes 2022, section 245I.02, subdivision 19, is amended to read:
Subd. 19.
Level of care assessment.
"Level of care assessment" means the level of care
decision support tool appropriate to the client's age. deleted text begin For a client five years of age or younger,
a level of care assessment is the Early Childhood Service Intensity Instrument (ESCII). For
a client six to 17 years of age, a level of care assessment is the Child and Adolescent Service
Intensity Instrument (CASII). For a client 18 years of age or older, a level of care assessment
is the Level of Care Utilization System for Psychiatric and Addiction Services (LOCUS)
or another tool authorized by the commissioner.
deleted text end
Sec. 6.
Minnesota Statutes 2022, section 245I.10, subdivision 9, is amended to read:
Subd. 9.
Functional assessment; required elements.
new text begin (a) new text end When a license holder is
completing a functional assessment for an adult client, the license holder must:
(1) complete a functional assessment of the client after completing the client's diagnostic
assessment;
(2) use a collaborative process that allows the client and the client's family and other
natural supports, the client's referral sources, and the client's providers to provide information
about how the client's symptoms of mental illness impact the client's functioning;
(3) if applicable, document the reasons that the license holder did not contact the client's
family and other natural supports;
(4) assess and document how the client's symptoms of mental illness impact the client's
functioning in the following areas:
(i) the client's mental health symptoms;
(ii) the client's mental health service needs;
(iii) the client's substance use;
(iv) the client's vocational and educational functioning;
(v) the client's social functioning, including the use of leisure time;
(vi) the client's interpersonal functioning, including relationships with the client's family
and other natural supports;
(vii) the client's ability to provide self-care and live independently;
(viii) the client's medical and dental health;
(ix) the client's financial assistance needs; and
(x) the client's housing and transportation needs;
deleted text begin
(5) include a narrative summarizing the client's strengths, resources, and all areas of
functional impairment;
deleted text end
deleted text begin (6)deleted text end new text begin (5)new text end complete the client's functional assessment before the client's initial individual
treatment plan unless a service specifies otherwise; and
deleted text begin (7)deleted text end new text begin (6)new text end update the client's functional assessment with the client's current functioning
whenever there is a significant change in the client's functioning or at least every deleted text begin 180deleted text end new text begin 365new text end
days, unless a service specifies otherwise.
new text begin
(b) A license holder may use any available, validated measurement tool, including but
not limited to the Daily Living Activities-20, when completing the required elements of a
functional assessment under this subdivision.
new text end
Sec. 7.
Minnesota Statutes 2022, section 245I.11, subdivision 1, is amended to read:
Subdivision 1.
Generally.
new text begin (a) new text end If a license holder is licensed as a residential program,
stores or administers client medications, or observes clients self-administer medications,
the license holder must ensure that a staff person who is a registered nurse or licensed
prescriber is responsible for overseeing storage and administration of client medications
and observing as a client self-administers medications, including training according to
section 245I.05, subdivision 6, and documenting the occurrence according to section 245I.08,
subdivision 5.
new text begin
(b) For purposes of this section, "observed self-administration" means the preparation
and administration of a medication by a client to themselves under the direct supervision
of a registered nurse or a staff member to whom a registered nurse delegates supervision
duty. Observed self-administration does not include a client's use of a medication that they
keep in their own possession while participating in a program.
new text end
Sec. 8.
Minnesota Statutes 2022, section 245I.11, is amended by adding a subdivision to
read:
new text begin Subd. 6. new text end
new text begin Medication administration in children's day treatment settings. new text end
new text begin
(a) For a
program providing children's day treatment services under section 256B.0943, the license
holder must maintain policies and procedures that state whether the program will store
medication and administer or allow observed self-administration.
new text end
new text begin
(b) For a program providing children's day treatment services under section 256B.0943
that does not store medications but allows clients to use a medication that they keep in their
own possession while participating in a program, the license holder must maintain
documentation from a licensed prescriber regarding the safety of medications held by clients,
including:
new text end
new text begin
(1) an evaluation that the client is capable of holding and administering the medication
safely;
new text end
new text begin
(2) an evaluation of whether the medication is prone to diversion, misuse, or self-injury;
and
new text end
new text begin
(3) any conditions under which the license holder should no longer allow the client to
maintain the medication in their own possession.
new text end
Sec. 9.
Minnesota Statutes 2022, section 245I.20, subdivision 4, is amended to read:
Subd. 4.
Minimum staffing standards.
(a) A certification holder's treatment team must
consist of at least four mental health professionals. At least two of the mental health
professionals must be employed by or under contract with the mental health clinic for a
minimum of 35 hours per week each. deleted text begin Each of the two mental health professionals must
specialize in a different mental health discipline.
deleted text end
(b) The treatment team must include:
(1) a physician qualified as a mental health professional according to section 245I.04,
subdivision 2, clause (4), or a nurse qualified as a mental health professional according to
section 245I.04, subdivision 2, clause (1); and
(2) a psychologist qualified as a mental health professional according to section 245I.04,
subdivision 2, clause (3).
(c) The staff persons fulfilling the requirement in paragraph (b) must provide clinical
services at least:
(1) eight hours every two weeks if the mental health clinic has over 25.0 full-time
equivalent treatment team members;
(2) eight hours each month if the mental health clinic has 15.1 to 25.0 full-time equivalent
treatment team members;
(3) four hours each month if the mental health clinic has 5.1 to 15.0 full-time equivalent
treatment team members; or
(4) two hours each month if the mental health clinic has 2.0 to 5.0 full-time equivalent
treatment team members or only provides in-home services to clients.
(d) The certification holder must maintain a record that demonstrates compliance with
this subdivision.
Sec. 10.
Minnesota Statutes 2022, section 245I.23, subdivision 14, is amended to read:
Subd. 14.
Weekly team meetings.
(a) The license holder must hold weekly team meetings
and ancillary meetings according to this subdivision.
(b) A mental health professional or certified rehabilitation specialist must hold at least
one team meeting each calendar week deleted text begin anddeleted text end new text begin . The mental health professional or certified
rehabilitation specialist must lead andnew text end be physically present at the team meetingnew text begin , except as
permitted under paragraph (e)new text end . All treatment team members, including treatment team
members who work on a part-time or intermittent basis, must participate in a minimum of
one team meeting during each calendar week when the treatment team member is working
for the license holder. The license holder must document all weekly team meetings, including
the names of meeting attendeesnew text begin , and indicate whether the meeting was conducted remotely
under paragraph (e)new text end .
(c) If a treatment team member cannot participate in a weekly team meeting, the treatment
team member must participate in an ancillary meeting. A mental health professional, certified
rehabilitation specialist, clinical trainee, or mental health practitioner who participated in
the most recent weekly team meeting may lead the ancillary meeting. During the ancillary
meeting, the treatment team member leading the ancillary meeting must review the
information that was shared at the most recent weekly team meeting, including revisions
to client treatment plans and other information that the treatment supervisors exchanged
with treatment team members. The license holder must document all ancillary meetings,
including the names of meeting attendees.
new text begin
(d) If a treatment team member working only one shift during a week cannot participate
in a weekly team meeting or participate in an ancillary meeting, the treatment team member
must read the minutes of the weekly team meeting required to be documented in paragraph
(b). The treatment team member must sign to acknowledge receipt of this information, and
document pertinent information or questions. The mental health professional or certified
rehabilitation specialist must review any documented questions or pertinent information
before the next weekly team meeting.
new text end
new text begin
(e) A license holder may permit a mental health professional or certified rehabilitation
specialist to lead the weekly meeting remotely due to medical or weather conditions. If the
conditions that do not permit physical presence persist for longer than one week, the license
holder must request a variance to conduct additional meetings remotely.
new text end
Sec. 11.
Minnesota Statutes 2023 Supplement, section 254B.04, subdivision 1a, is amended
to read:
Subd. 1a.
Client eligibility.
(a) Persons eligible for benefits under Code of Federal
Regulations, title 25, part 20, who meet the income standards of section 256B.056,
subdivision 4, and are not enrolled in medical assistance, are entitled to behavioral health
fund services. State money appropriated for this paragraph must be placed in a separate
account established for this purpose.
(b) Persons with dependent children who are determined to be in need of substance use
disorder treatment pursuant to an assessment under section 260E.20, subdivision 1, or in
need of chemical dependency treatment pursuant to a case plan under section 260C.201,
subdivision 6, or 260C.212, shall be assisted by the local agency to access needed treatment
services. Treatment services must be appropriate for the individual or family, which may
include long-term care treatment or treatment in a facility that allows the dependent children
to stay in the treatment facility. The county shall pay for out-of-home placement costs, if
applicable.
(c) Notwithstanding paragraph (a), deleted text begin personsdeleted text end new text begin any personnew text end enrolled in medical assistance
deleted text begin aredeleted text end new text begin or MinnesotaCare isnew text end eligible for room and board services under section 254B.05,
subdivision 5, paragraph (b), clause deleted text begin (12)deleted text end new text begin (9)new text end .
(d) A client is eligible to have substance use disorder treatment paid for with funds from
the behavioral health fund when the client:
(1) is eligible for MFIP as determined under chapter 256J;
(2) is eligible for medical assistance as determined under Minnesota Rules, parts
9505.0010 to 9505.0150;
(3) is eligible for general assistance, general assistance medical care, or work readiness
as determined under Minnesota Rules, parts 9500.1200 to 9500.1318; or
(4) has income that is within current household size and income guidelines for entitled
persons, as defined in this subdivision and subdivision 7.
(e) Clients who meet the financial eligibility requirement in paragraph (a) and who have
a third-party payment source are eligible for the behavioral health fund if the third-party
payment source pays less than 100 percent of the cost of treatment services for eligible
clients.
(f) A client is ineligible to have substance use disorder treatment services paid for with
behavioral health fund money if the client:
(1) has an income that exceeds current household size and income guidelines for entitled
persons as defined in this subdivision and subdivision 7; or
(2) has an available third-party payment source that will pay the total cost of the client's
treatment.
(g) A client who is disenrolled from a state prepaid health plan during a treatment episode
is eligible for continued treatment service that is paid for by the behavioral health fund until
the treatment episode is completed or the client is re-enrolled in a state prepaid health plan
if the client:
(1) continues to be enrolled in MinnesotaCare, medical assistance, or general assistance
medical care; or
(2) is eligible according to paragraphs (a) and (b) and is determined eligible by a local
agency under section 254B.04.
(h) When a county commits a client under chapter 253B to a regional treatment center
for substance use disorder services and the client is ineligible for the behavioral health fund,
the county is responsible for the payment to the regional treatment center according to
section 254B.05, subdivision 4.
new text begin
(i) Persons enrolled in MinnesotaCare are eligible for room and board services when
provided through intensive residential treatment services and residential crisis services under
section 256B.0622.
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. 12.
new text begin
[256B.0617] MENTAL HEALTH SERVICES PROVIDER
CERTIFICATION.
new text end
new text begin
(a) The commissioner of human services shall establish an initial provider entity
application and certification and recertification processes to determine whether a provider
entity has administrative and clinical infrastructures that meet the certification requirements.
This process shall apply to providers of the following services:
new text end
new text begin
(1) children's intensive behavioral health services under section 256B.0946; and
new text end
new text begin
(2) intensive nonresidential rehabilitative mental health services under section 256B.0947.
new text end
new text begin
(b) The commissioner shall recertify a provider entity every three years using the
individual provider's certification anniversary or the calendar year end. The commissioner
may approve a recertification extension in the interest of sustaining services when a certain
date for recertification is identified.
new text end
new text begin
(c) The commissioner shall establish a process for decertification of a provider entity
and shall require corrective action, medical assistance repayment, or decertification of a
provider entity that no longer meets the requirements in this section or that fails to meet the
clinical quality standards or administrative standards provided by the commissioner in the
application and certification process.
new text end
new text begin
(d) The commissioner must provide the following to provider entities for the certification,
recertification, and decertification processes:
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 signed by the commissioner or their designee, if
applicable. In the case of corrective action, the commissioner may schedule interim
recertification site reviews to confirm certification or decertification.
new text end
new text begin EFFECTIVE DATE. new text end
new text begin
This section is effective July 1, 2024, and the commissioner of
human services must implement all requirements of this section by September 1, 2024.
new text end
Sec. 13.
Minnesota Statutes 2022, section 256B.0622, subdivision 2a, is amended to read:
Subd. 2a.
Eligibility for assertive community treatment.
new text begin (a)new text end An eligible client for
assertive community treatment is an individual who meets the following criteria as assessed
by an ACT team:
(1) is age 18 or older. Individuals ages 16 and 17 may be eligible upon approval by the
commissioner;
(2) has a primary diagnosis of schizophrenia, schizoaffective disorder, major depressive
disorder with psychotic features, other psychotic disorders, or bipolar disorder. Individuals
with other psychiatric illnesses may qualify for assertive community treatment if they have
a serious mental illness and meet the criteria outlined in clauses (3) and (4), but no more
than ten percent of an ACT team's clients may be eligible based on this criteria. Individuals
with a primary diagnosis of a substance use disorder, intellectual developmental disabilities,
borderline personality disorder, antisocial personality disorder, traumatic brain injury, or
an autism spectrum disorder are not eligible for assertive community treatment;
(3) has significant functional impairment as demonstrated by at least one of the following
conditions:
(i) significant difficulty consistently performing the range of routine tasks required for
basic adult functioning in the community or persistent difficulty performing daily living
tasks without significant support or assistance;
(ii) significant difficulty maintaining employment at a self-sustaining level or significant
difficulty consistently carrying out the head-of-household responsibilities; or
(iii) significant difficulty maintaining a safe living situation;
(4) has a need for continuous high-intensity services as evidenced by at least two of the
following:
(i) two or more psychiatric hospitalizations or residential crisis stabilization services in
the previous 12 months;
(ii) frequent utilization of mental health crisis services in the previous six months;
(iii) 30 or more consecutive days of psychiatric hospitalization in the previous 24 months;
(iv) intractable, persistent, or prolonged severe psychiatric symptoms;
(v) coexisting mental health and substance use disorders lasting at least six months;
(vi) recent history of involvement with the criminal justice system or demonstrated risk
of future involvement;
(vii) significant difficulty meeting basic survival needs;
(viii) residing in substandard housing, experiencing homelessness, or facing imminent
risk of homelessness;
(ix) significant impairment with social and interpersonal functioning such that basic
needs are in jeopardy;
(x) coexisting mental health and physical health disorders lasting at least six months;
(xi) residing in an inpatient or supervised community residence but clinically assessed
to be able to live in a more independent living situation if intensive services are provided;
(xii) requiring a residential placement if more intensive services are not available; or
(xiii) difficulty effectively using traditional office-based outpatient services;
(5) there are no indications that other available community-based services would be
equally or more effective as evidenced by consistent and extensive efforts to treat the
individual; and
(6) in the written opinion of a licensed mental health professional, has the need for mental
health services that cannot be met with other available community-based services, or is
likely to experience a mental health crisis or require a more restrictive setting if assertive
community treatment is not provided.
new text begin
(b) An individual meets the criteria for assertive community treatment under this section
if they have participated within the last year or are currently in a first episode of psychosis
program if the individual:
new text end
new text begin
(1) meets the eligibility requirements outlined in paragraph (a), clauses (1), (2), (5), and
(6);
new text end
new text begin
(2) is currently participating in a first episode of psychosis program under section
245.4905; and
new text end
new text begin
(3) needs the level of intensity provided by an ACT team, in the opinion of the individual's
first episode of psychosis program, in order to prevent crisis services, hospitalization,
homelessness, and involvement with the criminal justice system.
new text end
Sec. 14.
Minnesota Statutes 2022, section 256B.0622, subdivision 3a, is amended to read:
Subd. 3a.
Provider certification and contract requirements for assertive community
treatment.
(a) The assertive community treatment provider mustdeleted text begin :
deleted text end
deleted text begin
(1) have a contract with the host county to provide assertive community treatment
services; and
deleted text end
deleted text begin (2)deleted text end have each ACT team be certified by the state following the certification process and
procedures developed by the commissioner. The certification process determines whether
the ACT team meets the standards for assertive community treatment under this section,
the standards in chapter 245I as required in section 245I.011, subdivision 5, and minimum
program fidelity standards as measured by a nationally recognized fidelity tool approved
by the commissioner. Recertification must occur at least every three years.
(b) An ACT team certified under this subdivision must meet the following standards:
(1) have capacity to recruit, hire, manage, and train required ACT team members;
(2) have adequate administrative ability to ensure availability of services;
(3) ensure flexibility in service delivery to respond to the changing and intermittent care
needs of a client as identified by the client and the individual treatment plan;
(4) keep all necessary records required by law;
(5) be an enrolled Medicaid provider; and
(6) establish and maintain a quality assurance plan to determine specific service outcomes
and the client's satisfaction with services.
(c) The commissioner may intervene at any time and decertify an ACT team with cause.
The commissioner shall establish a process for decertification of an ACT team and shall
require corrective action, medical assistance repayment, or decertification of an ACT team
that no longer meets the requirements in this section or that fails to meet the clinical quality
standards or administrative standards provided by the commissioner in the application and
certification process. The decertification is subject to appeal to the state.
Sec. 15.
Minnesota Statutes 2022, section 256B.0622, subdivision 7a, is amended to read:
Subd. 7a.
Assertive community treatment team staff requirements and roles.
(a)
The required treatment staff qualifications and roles for an ACT team are:
(1) the team leader:
(i) shall be a mental health professional. Individuals who are not licensed but who are
eligible for licensure and are otherwise qualified may also fulfill this role deleted text begin but must obtain
full licensure within 24 months of assuming the role of team leaderdeleted text end ;
(ii) must be an active member of the ACT team and provide some direct services to
clients;
(iii) must be a single full-time staff member, dedicated to the ACT team, who is
responsible for overseeing the administrative operations of the teamdeleted text begin , providing treatment
supervision of services in conjunction with the psychiatrist or psychiatric care provider,deleted text end and
supervising team members to ensure delivery of best and ethical practices; and
(iv) must be available to deleted text begin providedeleted text end new text begin ensure thatnew text end overall treatment supervision to the ACT
team new text begin is available new text end after regular business hours and on weekends and holidaysdeleted text begin . The team
leader may delegate this duty to anotherdeleted text end new text begin and is provided by anew text end qualified member of the ACT
team;
(2) the psychiatric care provider:
(i) must be a mental health professional permitted to prescribe psychiatric medications
as part of the mental health professional's scope of practice. The psychiatric care provider
must have demonstrated clinical experience working with individuals with serious and
persistent mental illness;
(ii) shall collaborate with the team leader in sharing overall clinical responsibility for
screening and admitting clients; monitoring clients' treatment and team member service
delivery; educating staff on psychiatric and nonpsychiatric medications, their side effects,
and health-related conditions; actively collaborating with nurses; and helping provide
treatment supervision to the team;
(iii) shall fulfill the following functions for assertive community treatment clients:
provide assessment and treatment of clients' symptoms and response to medications, including
side effects; provide brief therapy to clients; provide diagnostic and medication education
to clients, with medication decisions based on shared decision making; monitor clients'
nonpsychiatric medical conditions and nonpsychiatric medications; and conduct home and
community visits;
(iv) shall serve as the point of contact for psychiatric treatment if a client is hospitalized
for mental health treatment and shall communicate directly with the client's inpatient
psychiatric care providers to ensure continuity of care;
(v) shall have a minimum full-time equivalency that is prorated at a rate of 16 hours per
50 clients. Part-time psychiatric care providers shall have designated hours to work on the
team, with sufficient blocks of time on consistent days to carry out the provider's clinical,
supervisory, and administrative responsibilities. No more than two psychiatric care providers
may share this role; and
(vi) shall provide psychiatric backup to the program after regular business hours and on
weekends and holidays. The psychiatric care provider may delegate this duty to another
qualified psychiatric provider;
(3) the nursing staff:
(i) shall consist of one to three registered nurses or advanced practice registered nurses,
of whom at least one has a minimum of one-year experience working with adults with
serious mental illness and a working knowledge of psychiatric medications. No more than
two individuals can share a full-time equivalent position;
(ii) are responsible for managing medication, administering and documenting medication
treatment, and managing a secure medication room; and
(iii) shall develop strategies, in collaboration with clients, to maximize taking medications
as prescribed; screen and monitor clients' mental and physical health conditions and
medication side effects; engage in health promotion, prevention, and education activities;
communicate and coordinate services with other medical providers; facilitate the development
of the individual treatment plan for clients assigned; and educate the ACT team in monitoring
psychiatric and physical health symptoms and medication side effects;
(4) the co-occurring disorder specialist:
(i) shall be a full-time equivalent co-occurring disorder specialist who has received
specific training on co-occurring disorders that is consistent with national evidence-based
practices. The training must include practical knowledge of common substances and how
they affect mental illnesses, the ability to assess substance use disorders and the client's
stage of treatment, motivational interviewing, and skills necessary to provide counseling to
clients at all different stages of change and treatment. The co-occurring disorder specialist
may also be an individual who is a licensed alcohol and drug counselor as described in
section 148F.01, subdivision 5, or a counselor who otherwise meets the training, experience,
and other requirements in section 245G.11, subdivision 5. No more than two co-occurring
disorder specialists may occupy this role; and
(ii) shall provide or facilitate the provision of co-occurring disorder treatment to clients.
The co-occurring disorder specialist shall serve as a consultant and educator to fellow ACT
team members on co-occurring disorders;
(5) the vocational specialist:
(i) shall be a full-time vocational specialist who has at least one-year experience providing
employment services or advanced education that involved field training in vocational services
to individuals with mental illness. An individual who does not meet these qualifications
may also serve as the vocational specialist upon completing a training plan approved by the
commissioner;
(ii) shall provide or facilitate the provision of vocational services to clients. The vocational
specialist serves as a consultant and educator to fellow ACT team members on these services;
and
(iii) must not refer individuals to receive any type of vocational services or linkage by
providers outside of the ACT team;
(6) the mental health certified peer specialist:
(i) shall be a full-time equivalent. No more than two individuals can share this position.
The mental health certified peer specialist is a fully integrated team member who provides
highly individualized services in the community and promotes the self-determination and
shared decision-making abilities of clients. This requirement may be waived due to workforce
shortages upon approval of the commissioner;
(ii) must provide coaching, mentoring, and consultation to the clients to promote recovery,
self-advocacy, and self-direction, promote wellness management strategies, and assist clients
in developing advance directives; and
(iii) must model recovery values, attitudes, beliefs, and personal action to encourage
wellness and resilience, provide consultation to team members, promote a culture where
the clients' points of view and preferences are recognized, understood, respected, and
integrated into treatment, and serve in a manner equivalent to other team members;
(7) the program administrative assistant shall be a full-time office-based program
administrative assistant position assigned to solely work with the ACT team, providing a
range of supports to the team, clients, and families; and
(8) additional staff:
(i) shall be based on team size. Additional treatment team staff may include mental
health professionals; clinical trainees; certified rehabilitation specialists; mental health
practitioners; or mental health rehabilitation workers. These individuals shall have the
knowledge, skills, and abilities required by the population served to carry out rehabilitation
and support functions; and
(ii) shall be selected based on specific program needs or the population served.
(b) Each ACT team must clearly document schedules for all ACT team members.
(c) Each ACT team member must serve as a primary team member for clients assigned
by the team leader and are responsible for facilitating the individual treatment plan process
for those clients. The primary team member for a client is the responsible team member
knowledgeable about the client's life and circumstances and writes the individual treatment
plan. The primary team member provides individual supportive therapy or counseling, and
provides primary support and education to the client's family and support system.
(d) Members of the ACT team must have strong clinical skills, professional qualifications,
experience, and competency to provide a full breadth of rehabilitation services. Each staff
member shall be proficient in their respective discipline and be able to work collaboratively
as a member of a multidisciplinary team to deliver the majority of the treatment,
rehabilitation, and support services clients require to fully benefit from receiving assertive
community treatment.
(e) Each ACT team member must fulfill training requirements established by the
commissioner.
Sec. 16.
Minnesota Statutes 2023 Supplement, section 256B.0622, subdivision 7b, is
amended to read:
Subd. 7b.
Assertive community treatment program deleted text begin size and opportunitiesdeleted text end new text begin scoresnew text end .
deleted text begin (a)deleted text end
Each ACT team deleted text begin shall maintain an annual average caseload that does not exceed 100 clients.
Staff-to-client ratios shall be based on team size as follows:deleted text end new text begin must demonstrate that the team
attained a passing score according to the most recently issued Tool for Measurement of
Assertive Community Treatment (TMACT).
new text end
deleted text begin
(1) a small ACT team must:
deleted text end
deleted text begin
(i) employ at least six but no more than seven full-time treatment team staff, excluding
the program assistant and the psychiatric care provider;
deleted text end
deleted text begin
(ii) serve an annual average maximum of no more than 50 clients;
deleted text end
deleted text begin
(iii) ensure at least one full-time equivalent position for every eight clients served;
deleted text end
deleted text begin
(iv) schedule ACT team staff on weekdays and on-call duty to provide crisis services
and deliver services after hours when staff are not working;
deleted text end
deleted text begin
(v) provide crisis services during business hours if the small ACT team does not have
sufficient staff numbers to operate an after-hours on-call system. During all other hours,
the ACT team may arrange for coverage for crisis assessment and intervention services
through a reliable crisis-intervention provider as long as there is a mechanism by which the
ACT team communicates routinely with the crisis-intervention provider and the on-call
ACT team staff are available to see clients face-to-face when necessary or if requested by
the crisis-intervention services provider;
deleted text end
deleted text begin
(vi) adjust schedules and provide staff to carry out the needed service activities in the
evenings or on weekend days or holidays, when necessary;
deleted text end
deleted text begin
(vii) arrange for and provide psychiatric backup during all hours the psychiatric care
provider is not regularly scheduled to work. If availability of the ACT team's psychiatric
care provider during all hours is not feasible, alternative psychiatric prescriber backup must
be arranged and a mechanism of timely communication and coordination established in
writing; and
deleted text end
deleted text begin
(viii) be composed of, at minimum, one full-time team leader, at least 16 hours each
week per 50 clients of psychiatric provider time, or equivalent if fewer clients, one full-time
equivalent nursing, one full-time co-occurring disorder specialist, one full-time equivalent
mental health certified peer specialist, one full-time vocational specialist, one full-time
program assistant, and at least one additional full-time ACT team member who has mental
health professional, certified rehabilitation specialist, clinical trainee, or mental health
practitioner status; and
deleted text end
deleted text begin
(2) a midsize ACT team shall:
deleted text end
deleted text begin
(i) be composed of, at minimum, one full-time team leader, at least 16 hours of psychiatry
time for 51 clients, with an additional two hours for every six clients added to the team, 1.5
to two full-time equivalent nursing staff, one full-time co-occurring disorder specialist, one
full-time equivalent mental health certified peer specialist, one full-time vocational specialist,
one full-time program assistant, and at least 1.5 to two additional full-time equivalent ACT
members, with at least one dedicated full-time staff member with mental health professional
status. Remaining team members may have mental health professional, certified rehabilitation
specialist, clinical trainee, or mental health practitioner status;
deleted text end
deleted text begin
(ii) employ seven or more treatment team full-time equivalents, excluding the program
assistant and the psychiatric care provider;
deleted text end
deleted text begin
(iii) serve an annual average maximum caseload of 51 to 74 clients;
deleted text end
deleted text begin
(iv) ensure at least one full-time equivalent position for every nine clients served;
deleted text end
deleted text begin
(v) schedule ACT team staff for a minimum of ten-hour shift coverage on weekdays
and six- to eight-hour shift coverage on weekends and holidays. In addition to these minimum
specifications, staff are regularly scheduled to provide the necessary services on a
client-by-client basis in the evenings and on weekends and holidays;
deleted text end
deleted text begin
(vi) schedule ACT team staff on-call duty to provide crisis services and deliver services
when staff are not working;
deleted text end
deleted text begin
(vii) have the authority to arrange for coverage for crisis assessment and intervention
services through a reliable crisis-intervention provider as long as there is a mechanism by
which the ACT team communicates routinely with the crisis-intervention provider and the
on-call ACT team staff are available to see clients face-to-face when necessary or if requested
by the crisis-intervention services provider; and
deleted text end
deleted text begin
(viii) arrange for and provide psychiatric backup during all hours the psychiatric care
provider is not regularly scheduled to work. If availability of the psychiatric care provider
during all hours is not feasible, alternative psychiatric prescriber backup must be arranged
and a mechanism of timely communication and coordination established in writing;
deleted text end
deleted text begin
(3) a large ACT team must:
deleted text end
deleted text begin
(i) be composed of, at minimum, one full-time team leader, at least 32 hours each week
per 100 clients, or equivalent of psychiatry time, three full-time equivalent nursing staff,
one full-time co-occurring disorder specialist, one full-time equivalent mental health certified
peer specialist, one full-time vocational specialist, one full-time program assistant, and at
least two additional full-time equivalent ACT team members, with at least one dedicated
full-time staff member with mental health professional status. Remaining team members
may have mental health professional or mental health practitioner status;
deleted text end
deleted text begin
(ii) employ nine or more treatment team full-time equivalents, excluding the program
assistant and psychiatric care provider;
deleted text end
deleted text begin
(iii) serve an annual average maximum caseload of 75 to 100 clients;
deleted text end
deleted text begin
(iv) ensure at least one full-time equivalent position for every nine individuals served;
deleted text end
deleted text begin
(v) schedule staff to work two eight-hour shifts, with a minimum of two staff on the
second shift providing services at least 12 hours per day weekdays. For weekends and
holidays, the team must operate and schedule ACT team staff to work one eight-hour shift,
with a minimum of two staff each weekend day and every holiday;
deleted text end
deleted text begin
(vi) schedule ACT team staff on-call duty to provide crisis services and deliver services
when staff are not working; and
deleted text end
deleted text begin
(vii) arrange for and provide psychiatric backup during all hours the psychiatric care
provider is not regularly scheduled to work. If availability of the ACT team psychiatric care
provider during all hours is not feasible, alternative psychiatric backup must be arranged
and a mechanism of timely communication and coordination established in writing.
deleted text end
deleted text begin
(b) An ACT team of any size may have a staff-to-client ratio that is lower than the
requirements described in paragraph (a) upon approval by the commissioner, but may not
exceed a one-to-ten staff-to-client ratio.
deleted text end
Sec. 17.
Minnesota Statutes 2022, section 256B.0622, subdivision 7d, is amended to read:
Subd. 7d.
Assertive community treatment assessment and individual treatment
plan.
(a) An initial assessment shall be completed the day of the client's admission to
assertive community treatment by the ACT team leader or the psychiatric care provider,
with participation by designated ACT team members and the client. The initial assessment
must include obtaining or completing a standard diagnostic assessment according to section
245I.10, subdivision 6, and completing a 30-day individual treatment plan. The team leader,
psychiatric care provider, or other mental health professional designated by the team leader
or psychiatric care provider, must update the client's diagnostic assessment deleted text begin at least annuallydeleted text end new text begin
as required under section 245I.10, subdivision 2, paragraphs (f) and (g)new text end .
(b) A functional assessment must be completed according to section 245I.10, subdivision
9. Each part of the functional assessment areas shall be completed by each respective team
specialist or an ACT team member with skill and knowledge in the area being assessed.
(c) Between 30 and 45 days after the client's admission to assertive community treatment,
the entire ACT team must hold a comprehensive case conference, where all team members,
including the psychiatric provider, present information discovered from the completed
assessments and provide treatment recommendations. The conference must serve as the
basis for the first individual treatment plan, which must be written by the primary team
member.
(d) The client's psychiatric care provider, primary team member, and individual treatment
team members shall assume responsibility for preparing the written narrative of the results
from the psychiatric and social functioning history timeline and the comprehensive
assessment.
(e) The primary team member and individual treatment team members shall be assigned
by the team leader in collaboration with the psychiatric care provider by the time of the first
treatment planning meeting or 30 days after admission, whichever occurs first.
(f) Individual treatment plans must be developed through the following treatment planning
process:
(1) The individual treatment plan shall be developed in collaboration with the client and
the client's preferred natural supports, and guardian, if applicable and appropriate. The ACT
team shall evaluate, together with each client, the client's needs, strengths, and preferences
and develop the individual treatment plan collaboratively. The ACT team shall make every
effort to ensure that the client and the client's family and natural supports, with the client's
consent, are in attendance at the treatment planning meeting, are involved in ongoing
meetings related to treatment, and have the necessary supports to fully participate. The
client's participation in the development of the individual treatment plan shall be documented.
(2) The client and the ACT team shall work together to formulate and prioritize the
issues, set goals, research approaches and interventions, and establish the plan. The plan is
individually tailored so that the treatment, rehabilitation, and support approaches and
interventions achieve optimum symptom reduction, help fulfill the personal needs and
aspirations of the client, take into account the cultural beliefs and realities of the individual,
and improve all the aspects of psychosocial functioning that are important to the client. The
process supports strengths, rehabilitation, and recovery.
(3) Each client's individual treatment plan shall identify service needs, strengths and
capacities, and barriers, and set specific and measurable short- and long-term goals for each
service need. The individual treatment plan must clearly specify the approaches and
interventions necessary for the client to achieve the individual goals, when the interventions
shall happen, and identify which ACT team member shall carry out the approaches and
interventions.
(4) The primary team member and the individual treatment team, together with the client
and the client's family and natural supports with the client's consent, are responsible for
reviewing and rewriting the treatment goals and individual treatment plan whenever there
is a major decision point in the client's course of treatment or at least every six months.
(5) The primary team member shall prepare a summary that thoroughly describes in
writing the client's and the individual treatment team's evaluation of the client's progress
and goal attainment, the effectiveness of the interventions, and the satisfaction with services
since the last individual treatment plan. The client's most recent diagnostic assessment must
be included with the treatment plan summary.
(6) The individual treatment plan and review must be approved or acknowledged by the
client, the primary team member, the team leader, the psychiatric care provider, and all
individual treatment team members. A copy of the approved individual treatment plan must
be made available to the client.
Sec. 18.
Minnesota Statutes 2022, section 256B.0623, subdivision 5, is amended to read:
Subd. 5.
Qualifications of provider staff.
Adult rehabilitative mental health services
must be provided by qualified individual provider staff of a certified provider entity.
Individual provider staff must be qualified as:
(1) a mental health professional who is qualified according to section 245I.04, subdivision
2;
(2) a certified rehabilitation specialist who is qualified according to section 245I.04,
subdivision 8;
(3) a clinical trainee who is qualified according to section 245I.04, subdivision 6;
(4) a mental health practitioner qualified according to section 245I.04, subdivision 4;
(5) a mental health certified peer specialist who is qualified according to section 245I.04,
subdivision 10; deleted text begin or
deleted text end
(6) a mental health rehabilitation worker who is qualified according to section 245I.04,
subdivision 14deleted text begin .deleted text end new text begin ; or
new text end
new text begin
(7) a licensed occupational therapist, as defined in section 148.6402, subdivision 14.
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 must notify the revisor of statutes when federal approval is obtained.
new text end
Sec. 19.
Minnesota Statutes 2023 Supplement, section 256B.0625, subdivision 5m, is
amended to read:
Subd. 5m.
Certified community behavioral health clinic services.
(a) Medical
assistance covers services provided by a not-for-profit certified community behavioral health
clinic (CCBHC) that meets the requirements of section 245.735, subdivision 3.
(b) The commissioner shall reimburse CCBHCs on a per-day basis for each day that an
eligible service is delivered using the CCBHC daily bundled rate system for medical
assistance payments as described in paragraph (c). The commissioner shall include a quality
incentive payment in the CCBHC daily bundled rate system as described in paragraph (e).
There is no county share for medical assistance services when reimbursed through the
CCBHC daily bundled rate system.
(c) The commissioner shall ensure that the CCBHC daily bundled rate system for CCBHC
payments under medical assistance meets the following requirements:
(1) the CCBHC daily bundled rate shall be a provider-specific rate calculated for each
CCBHC, based on the daily cost of providing CCBHC services and the total annual allowable
CCBHC costs divided by the total annual number of CCBHC visits. For calculating the
payment rate, total annual visits include visits covered by medical assistance and visits not
covered by medical assistance. Allowable costs include but are not limited to the salaries
and benefits of medical assistance providers; the cost of CCBHC services provided under
section 245.735, subdivision 3, paragraph (a), clauses (6) and (7); and other costs such as
insurance or supplies needed to provide CCBHC services;
(2) payment shall be limited to one payment per day per medical assistance enrollee
when an eligible CCBHC service is provided. A CCBHC visit is eligible for reimbursement
if at least one of the CCBHC services listed under section 245.735, subdivision 3, paragraph
(a), clause (6), is furnished to a medical assistance enrollee by a health care practitioner or
licensed agency employed by or under contract with a CCBHC;
(3) initial CCBHC daily bundled rates for newly certified CCBHCs under section 245.735,
subdivision 3, shall be established by the commissioner using a provider-specific rate based
on the newly certified CCBHC's audited historical cost report data adjusted for the expected
cost of delivering CCBHC services. Estimates are subject to review by the commissioner
and must include the expected cost of providing the full scope of CCBHC services and the
expected number of visits for the rate period;
(4) the commissioner shall rebase CCBHC rates once every two years following the last
rebasing and no less than 12 months following an initial rate or a rate change due to a change
in the scope of servicesnew text begin . For CCBHCs certified after September 31, 2020, and before January
1, 2021, the commissioner shall rebase rates according to this clause beginning for dates of
service provided on January 1, 2024new text end ;
(5) the commissioner shall provide for a 60-day appeals process after notice of the results
of the rebasing;
(6) an entity that receives a CCBHC daily bundled rate that overlaps with another federal
Medicaid rate is not eligible for the CCBHC rate methodology;
(7) payments for CCBHC services to individuals enrolled in managed care shall be
coordinated with the state's phase-out of CCBHC wrap payments. The commissioner shall
complete the phase-out of CCBHC wrap payments within 60 days of the implementation
of the CCBHC daily bundled rate system in the Medicaid Management Information System
(MMIS), for CCBHCs reimbursed under this chapter, with a final settlement of payments
due made payable to CCBHCs no later than 18 months thereafter;
(8) the CCBHC daily bundled rate for each CCBHC shall be updated by trending each
provider-specific rate by the Medicare Economic Index for primary care services. This
update shall occur each year in between rebasing periods determined by the commissioner
in accordance with clause (4). CCBHCs must provide data on costs and visits to the state
annually using the CCBHC cost report established by the commissioner; and
(9) a CCBHC may request a rate adjustment for changes in the CCBHC's scope of
services when such changes are expected to result in an adjustment to the CCBHC payment
rate by 2.5 percent or more. The CCBHC must provide the commissioner with information
regarding the changes in the scope of services, including the estimated cost of providing
the new or modified services and any projected increase or decrease in the number of visits
resulting from the change. Estimated costs are subject to review by the commissioner. Rate
adjustments for changes in scope shall occur no more than once per year in between rebasing
periods per CCBHC and are effective on the date of the annual CCBHC rate update.
(d) Managed care plans and county-based purchasing plans shall reimburse CCBHC
providers at the CCBHC daily bundled rate. The commissioner shall monitor the effect of
this requirement on the rate of access to the services delivered by CCBHC providers. If, for
any contract year, federal approval is not received for this paragraph, the commissioner
must adjust the capitation rates paid to managed care plans and county-based purchasing
plans for that contract year to reflect the removal of this provision. Contracts between
managed care plans and county-based purchasing plans and providers to whom this paragraph
applies must allow recovery of payments from those providers if capitation rates are adjusted
in accordance with this paragraph. Payment recoveries must not exceed the amount equal
to any increase in rates that results from this provision. This paragraph expires if federal
approval is not received for this paragraph at any time.
(e) The commissioner shall implement a quality incentive payment program for CCBHCs
that meets the following requirements:
(1) a CCBHC shall receive a quality incentive payment upon meeting specific numeric
thresholds for performance metrics established by the commissioner, in addition to payments
for which the CCBHC is eligible under the CCBHC daily bundled rate system described in
paragraph (c);
(2) a CCBHC must be certified and enrolled as a CCBHC for the entire measurement
year to be eligible for incentive payments;
(3) each CCBHC shall receive written notice of the criteria that must be met in order to
receive quality incentive payments at least 90 days prior to the measurement year; and
(4) a CCBHC must provide the commissioner with data needed to determine incentive
payment eligibility within six months following the measurement year. The commissioner
shall notify CCBHC providers of their performance on the required measures and the
incentive payment amount within 12 months following the measurement year.
(f) All claims to managed care plans for CCBHC services as provided under this section
shall be submitted directly to, and paid by, the commissioner on the dates specified no later
than January 1 of the following calendar year, if:
(1) one or more managed care plans does not comply with the federal requirement for
payment of clean claims to CCBHCs, as defined in Code of Federal Regulations, title 42,
section 447.45(b), and the managed care plan does not resolve the payment issue within 30
days of noncompliance; and
(2) the total amount of clean claims not paid in accordance with federal requirements
by one or more managed care plans is 50 percent of, or greater than, the total CCBHC claims
eligible for payment by managed care plans.
If the conditions in this paragraph are met between January 1 and June 30 of a calendar
year, claims shall be submitted to and paid by the commissioner beginning on January 1 of
the following year. If the conditions in this paragraph are met between July 1 and December
31 of a calendar year, claims shall be submitted to and paid by the commissioner beginning
on July 1 of the following year.
(g) Peer services provided by a CCBHC certified under section 245.735 are a covered
service under medical assistance when a licensed mental health professional or alcohol and
drug counselor determines that peer services are medically necessary. Eligibility under this
subdivision for peer services provided by a CCBHC supersede eligibility standards under
sections 256B.0615, 256B.0616, and 245G.07, subdivision 2, clause (8).
Sec. 20.
Minnesota Statutes 2022, section 256B.0625, subdivision 20, is amended to read:
Subd. 20.
Mental health case management.
(a) To the extent authorized by rule of the
state agency, medical assistance covers case management services to persons with serious
and persistent mental illness and children with severe emotional disturbance. Services
provided under this section must meet the relevant standards in sections 245.461 to 245.4887,
the Comprehensive Adult and Children's Mental Health Acts, Minnesota Rules, parts
9520.0900 to 9520.0926, and 9505.0322, excluding subpart 10.
(b) Entities meeting program standards set out in rules governing family community
support services as defined in section 245.4871, subdivision 17, are eligible for medical
assistance reimbursement for case management services for children with severe emotional
disturbance when these services meet the program standards in Minnesota Rules, parts
9520.0900 to 9520.0926 and 9505.0322, excluding subparts 6 and 10.
(c) Medical assistance and MinnesotaCare payment for mental health case management
shall be made on a monthly basis. In order to receive payment for an eligible child, the
provider must document at least a face-to-face contact either in person or by interactive
video that meets the requirements of subdivision 20b with the child, the child's parents, or
the child's legal representative. To receive payment for an eligible adult, the provider must
document:
(1) at least a face-to-face contact with the adult or the adult's legal representative either
in person or by interactive video that meets the requirements of subdivision 20b; or
(2) at least a telephone contactnew text begin or contact via secure electronic message, if preferred by
the adult client,new text end with the adult or the adult's legal representative and document a face-to-face
contact either in person or by interactive video that meets the requirements of subdivision
20b with the adult or the adult's legal representative within the preceding two months.
(d) Payment for mental health case management provided by county or state staff shall
be based on the monthly rate methodology under section 256B.094, subdivision 6, paragraph
(b), with separate rates calculated for child welfare and mental health, and within mental
health, separate rates for children and adults.
(e) Payment for mental health case management provided by Indian health services or
by agencies operated by Indian tribes may be made according to this section or other relevant
federally approved rate setting methodology.
(f) Payment for mental health case management provided by vendors who contract with
a county must be calculated in accordance with section 256B.076, subdivision 2. Payment
for mental health case management provided by vendors who contract with a Tribe must
be based on a monthly rate negotiated by the Tribe. The rate must not exceed the rate charged
by the vendor for the same service to other payers. If the service is provided by a team of
contracted vendors, the team shall determine how to distribute the rate among its members.
No reimbursement received by contracted vendors shall be returned to the county or tribe,
except to reimburse the county or tribe for advance funding provided by the county or tribe
to the vendor.
(g) If the service is provided by a team which includes contracted vendors, tribal staff,
and county or state staff, the costs for county or state staff participation in the team shall be
included in the rate for county-provided services. In this case, the contracted vendor, the
tribal agency, and the county may each receive separate payment for services provided by
each entity in the same month. In order to prevent duplication of services, each entity must
document, in the recipient's file, the need for team case management and a description of
the roles of the team members.
(h) Notwithstanding section 256B.19, subdivision 1, the nonfederal share of costs for
mental health case management shall be provided by the recipient's county of responsibility,
as defined in sections 256G.01 to 256G.12, from sources other than federal funds or funds
used to match other federal funds. If the service is provided by a tribal agency, the nonfederal
share, if any, shall be provided by the recipient's tribe. When this service is paid by the state
without a federal share through fee-for-service, 50 percent of the cost shall be provided by
the recipient's county of responsibility.
(i) Notwithstanding any administrative rule to the contrary, prepaid medical assistance
and MinnesotaCare include mental health case management. When the service is provided
through prepaid capitation, the nonfederal share is paid by the state and the county pays no
share.
(j) The commissioner may suspend, reduce, or terminate the reimbursement to a provider
that does not meet the reporting or other requirements of this section. The county of
responsibility, as defined in sections 256G.01 to 256G.12, or, if applicable, the tribal agency,
is responsible for any federal disallowances. The county or tribe may share this responsibility
with its contracted vendors.
(k) The commissioner shall set aside a portion of the federal funds earned for county
expenditures under this section to repay the special revenue maximization account under
section 256.01, subdivision 2, paragraph (o). The repayment is limited to:
(1) the costs of developing and implementing this section; and
(2) programming the information systems.
(l) Payments to counties and tribal agencies for case management expenditures under
this section shall only be made from federal earnings from services provided under this
section. When this service is paid by the state without a federal share through fee-for-service,
50 percent of the cost shall be provided by the state. Payments to county-contracted vendors
shall include the federal earnings, the state share, and the county share.
(m) Case management services under this subdivision do not include therapy, treatment,
legal, or outreach services.
(n) If the recipient is a resident of a nursing facility, intermediate care facility, or hospital,
and the recipient's institutional care is paid by medical assistance, payment for case
management services under this subdivision is limited to the lesser of:
(1) the last 180 days of the recipient's residency in that facility and may not exceed more
than six months in a calendar year; or
(2) the limits and conditions which apply to federal Medicaid funding for this service.
(o) Payment for case management services under this subdivision shall not duplicate
payments made under other program authorities for the same purpose.
(p) If the recipient is receiving care in a hospital, nursing facility, or residential setting
licensed under chapter 245A or 245D that is staffed 24 hours a day, seven days a week,
mental health targeted case management services must actively support identification of
community alternatives for the recipient and discharge planning.
Sec. 21.
Minnesota Statutes 2023 Supplement, section 256B.0671, subdivision 5, is
amended to read:
Subd. 5.
new text begin Child and new text end family psychoeducation services.
(a) Medical assistance coversnew text begin
child andnew text end family psychoeducation services provided to a child up to age 21 deleted text begin withdeleted text end new text begin and the
child's family members when determined to be medically necessary due tonew text end a deleted text begin diagnoseddeleted text end
mental health condition deleted text begin whendeleted text end new text begin or diagnosed mental illnessnew text end identified in the child's individual
treatment plan and provided by a mental health professionalnew text begin who is qualified under section
245I.04, subdivision 2, and practicing within the scope of practice under section 245I.04,
subdivision 3,new text end or a clinical trainee who deleted text begin has determined it medically necessary to involve
family members in the child's caredeleted text end new text begin is qualified under section 245I.04, subdivision 6, and
practicing within the scope of practice under section 245I.04, subdivision 7new text end .
(b) "new text begin Child and new text end family psychoeducation services" means information or demonstration
provided to an individual or family as part of an individual, family, multifamily group, or
peer group session to explain, educate, and support the child and family in understanding
a child's symptoms of mental illness, the impact on the child's development, and needed
components of treatment and skill development so that the individual, family, or group can
help the child to prevent relapse, prevent the acquisition of comorbid disorders, and achieve
optimal mental health and long-term resilience.
new text begin
(c) Child and family psychoeducation services include individual, family, or group skills
development or training to:
new text end
new text begin
(1) support the development of psychosocial skills that are medically necessary to
rehabilitate the child to an age-appropriate developmental trajectory when the child's
development was disrupted by a mental health condition or diagnosed mental illness; or
new text end
new text begin
(2) enable the child to self-monitor, compensate for, cope with, counteract, or replace
skills deficits or maladaptive skills acquired over the course of the child's mental health
condition or mental illness.
new text end
new text begin
(d) Skills development or training delivered to a child or the child's family under this
subdivision must be targeted to the specific deficits related to the child's mental health
condition or mental illness and must be prescribed in the child's individual treatment plan.
Group skills training may be provided to multiple recipients who, because of the nature of
their emotional, behavioral, or social functional ability, may benefit from interaction in a
group setting.
new text end
Sec. 22.
Minnesota Statutes 2022, section 256B.0943, subdivision 12, is amended to read:
Subd. 12.
Excluded services.
The following services are not eligible for medical
assistance payment as children's therapeutic services and supports:
(1) service components of children's therapeutic services and supports simultaneously
provided by more than one provider entity unless prior authorization is obtained;
(2) treatment by multiple providers within the same agency at the same clock timenew text begin ,
unless one service is delivered to the child and the other service is delivered to child's family
or treatment team without the child presentnew text end ;
(3) children's therapeutic services and supports provided in violation of medical assistance
policy in Minnesota Rules, part 9505.0220;
(4) mental health behavioral aide services provided by a personal care assistant who is
not qualified as a mental health behavioral aide and employed by a certified children's
therapeutic services and supports provider entity;
(5) service components of CTSS that are the responsibility of a residential or program
license holder, including foster care providers under the terms of a service agreement or
administrative rules governing licensure; and
(6) adjunctive activities that may be offered by a provider entity but are not otherwise
covered by medical assistance, including:
(i) a service that is primarily recreation oriented or that is provided in a setting that is
not medically supervised. This includes sports activities, exercise groups, activities such as
craft hours, leisure time, social hours, meal or snack time, trips to community activities,
and tours;
(ii) a social or educational service that does not have or cannot reasonably be expected
to have a therapeutic outcome related to the client's emotional disturbance;
(iii) prevention or education programs provided to the community; and
(iv) treatment for clients with primary diagnoses of alcohol or other drug abuse.
Sec. 23.
Minnesota Statutes 2022, section 256B.0947, subdivision 5, is amended to read:
Subd. 5.
Standards for intensive nonresidential rehabilitative providers.
(a) Services
must meet the standards in this section and chapter 245I as required in section 245I.011,
subdivision 5.
(b) The treatment team must have specialized training in providing services to the specific
age group of youth that the team serves. An individual treatment team must serve youth
who are: (1) at least eight years of age or older and under 16 years of age, or (2) at least 14
years of age or older and under 21 years of age.
(c) The treatment team for intensive nonresidential rehabilitative mental health services
comprises both permanently employed core team members and client-specific team members
as follows:
(1) Based on professional qualifications and client needs, clinically qualified core team
members are assigned on a rotating basis as the client's lead worker to coordinate a client's
care. The core team must comprise at least four full-time equivalent direct care staff and
must minimally include:
(i) a mental health professional who serves as team leader to provide administrative
direction and treatment supervision to the team;
(ii) an advanced-practice registered nurse with certification in psychiatric or mental
health care or a board-certified child and adolescent psychiatrist, either of which must be
credentialed to prescribe medications;
deleted text begin
(iii) a licensed alcohol and drug counselor who is also trained in mental health
interventions; and
deleted text end
deleted text begin (iv)deleted text end new text begin (iii) new text end a mental health certified peer specialist who is qualified according to section
245I.04, subdivision 10, and is also a former children's mental health consumerdeleted text begin .deleted text end new text begin ; and
new text end
new text begin
(iv) a co-occurring disorder specialist who meets the requirements under section
256B.0622, subdivision 7a, paragraph (a), clause (4), who will provide or facilitate the
provision of co-occurring disorder treatment to clients.
new text end
(2) The core team may also include any of the following:
(i) additional mental health professionals;
(ii) a vocational specialist;
(iii) an educational specialist with knowledge and experience working with youth
regarding special education requirements and goals, special education plans, and coordination
of educational activities with health care activities;
(iv) a child and adolescent psychiatrist who may be retained on a consultant basis;
(v) a clinical trainee qualified according to section 245I.04, subdivision 6;
(vi) a mental health practitioner qualified according to section 245I.04, subdivision 4;
(vii) a case management service provider, as defined in section 245.4871, subdivision
4;
(viii) a housing access specialist; and
(ix) a family peer specialist as defined in subdivision 2, paragraph (j).
(3) A treatment team may include, in addition to those in clause (1) or (2), ad hoc
members not employed by the team who consult on a specific client and who must accept
overall clinical direction from the treatment team for the duration of the client's placement
with the treatment team and must be paid by the provider agency at the rate for a typical
session by that provider with that client or at a rate negotiated with the client-specific
member. Client-specific treatment team members may include:
(i) the mental health professional treating the client prior to placement with the treatment
team;
(ii) the client's current substance use counselor, if applicable;
(iii) a lead member of the client's individualized education program team or school-based
mental health provider, if applicable;
(iv) a representative from the client's health care home or primary care clinic, as needed
to ensure integration of medical and behavioral health care;
(v) the client's probation officer or other juvenile justice representative, if applicable;
and
(vi) the client's current vocational or employment counselor, if applicable.
(d) The treatment supervisor shall be an active member of the treatment team and shall
function as a practicing clinician at least on a part-time basis. The treatment team shall meet
with the treatment supervisor at least weekly to discuss recipients' progress and make rapid
adjustments to meet recipients' needs. The team meeting must include client-specific case
reviews and general treatment discussions among team members. Client-specific case
reviews and planning must be documented in the individual client's treatment record.
(e) The staffing ratio must not exceed ten clients to one full-time equivalent treatment
team position.
(f) The treatment team shall serve no more than 80 clients at any one time. Should local
demand exceed the team's capacity, an additional team must be established rather than
exceed this limit.
(g) Nonclinical staff shall have prompt access in person or by telephone to a mental
health practitioner, clinical trainee, or mental health professional. The provider shall have
the capacity to promptly and appropriately respond to emergent needs and make any
necessary staffing adjustments to ensure the health and safety of clients.
(h) The intensive nonresidential rehabilitative mental health services provider shall
participate in evaluation of the assertive community treatment for youth (Youth ACT) model
as conducted by the commissioner, including the collection and reporting of data and the
reporting of performance measures as specified by contract with the commissioner.
(i) A regional treatment team may serve multiple counties.
Sec. 24.
Laws 2023, chapter 70, article 1, section 35, is amended to read:
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.
(e) Effective for services rendered on or after January 1, 2024, payment rates for
behavioral health services included in the rate analysis required by Laws 2021, First Special
Session chapter 7, article 17, section 18, except for adult day treatment services under section
256B.0671, subdivision 3; early intensive developmental and behavioral intervention services
under section 256B.0949; and substance use disorder services under chapter 254B, must be
increased by three percent from the rates in effect on December 31, 2023. Effective for
services rendered on or after January 1, 2025, payment rates for behavioral health services
included in the rate analysis required by Laws 2021, First Special Session chapter 7, article
17, section 18deleted text begin , except for adult day treatment services under section 256B.0671, subdivision
3deleted text end ; early intensive developmental behavioral intervention services under section 256B.0949;
and substance use disorder services under chapter 254B, must be annually adjusted according
to the change from the midpoint of the previous rate year to the midpoint of the rate year
for which the rate is being determined using the Centers for Medicare and Medicaid Services
Medicare Economic Index as forecasted in the fourth quarter of the calendar year before
the rate year. For payments made in accordance with this paragraph, if and to the extent
that the commissioner identifies that the state has received federal financial participation
for behavioral health services in excess of the amount allowed under United States Code,
title 42, section 447.321, the state shall repay the excess amount to the Centers for Medicare
and Medicaid Services with state money and maintain the full payment rate under this
paragraph. This paragraph does not apply to federally qualified health centers, rural health
centers, Indian health services, certified community behavioral health clinics, cost-based
rates, and rates that are negotiated with the county. This paragraph expires upon legislative
implementation of the new rate methodology resulting from the rate analysis required by
Laws 2021, First Special Session chapter 7, article 17, section 18.
(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 begin EFFECTIVE DATE. new text end
new text begin
This section is effective January 1, 2025, or upon federal approval,
whichever is later. The commissioner of human services shall notify the revisor of statutes
when federal approval is obtained.
new text end
Sec. 25. new text begin DIRECTION TO THE COMMISSIONER; MEDICAL ASSISTANCE RATE
INCREASES.
new text end
new text begin Subdivision 1. new text end
new text begin Rate increases; services. new text end
new text begin
The commissioner of human services shall
increase payment rates under the medical assistance program for:
new text end
new text begin
(1) residential substance use disorder services rendered on or after January 1, 2025;
new text end
new text begin
(2) inpatient behavioral health services provided by hospitals paid under the
diagnosis-related group methodology, for discharges occurring on or after January 1, 2025;
new text end
new text begin
(3) behavioral health home services under Minnesota Statutes, section 256B.0757,
rendered on or after January 1, 2025;
new text end
new text begin
(4) physician and professional services for mental health and substance use disorder
rendered on or after January 1, 2025; and
new text end
new text begin
(5) services under Minnesota Statutes, section 256B.761, billed and coded under
Healthcare Common Procedure Coding System H, S, and T codes, and rendered on or after
January 1, 2025.
new text end
new text begin Subd. 2. new text end
new text begin Rate increases; amount. new text end
new text begin
The total amount of the rate increases under
subdivision 1 must be equal to $5,727,000 in fiscal year 2025, $6,541,000 in fiscal year
2026, and $7,520,000 in fiscal year 2027.
new text end
Sec. 26. new text begin FIRST EPISODE PSYCHOSIS COORDINATED SPECIALITY CARE
MEDICAL ASSISTANCE BENEFIT.
new text end
new text begin
(a) The commissioner of human services must develop a First Episode Psychosis
Coordinated Specialty Care (FEP-CSC) medical assistance benefit.
new text end
new text begin
(b) The benefit must cover medically necessary treatment. Services must include:
new text end
new text begin
(1) assertive outreach and engagement strategies encouraging individuals' involvement;
new text end
new text begin
(2) person-centered care, delivered in the home and community, extending beyond
typical hours of operation, such as evenings and weekends;
new text end
new text begin
(3) crisis planning and intervention;
new text end
new text begin
(4) team leadership from a mental health professional who provides ongoing consultation
to the team members, coordinates admission screening, and leads the weekly team meetings
to facilitate case review and entry to the program;
new text end
new text begin
(5) employment and education services that enable individuals to function in workplace
and educational settings that support individual preferences;
new text end
new text begin
(6) family education and support that builds on an individual's identified family and
natural support systems;
new text end
new text begin
(7) individual and group psychotherapy that include but are not limited to cognitive
behavioral therapies;
new text end
new text begin
(8) care coordination services in clinic, community, and home settings to assist individuals
with practical problem solving, such as securing transportation, addressing housing and
other basic needs, managing money, obtaining medical care, and coordinating care with
other providers; and
new text end
new text begin
(9) pharmacotherapy, medication management, and primary care coordination provided
by a mental health professional who is permitted to prescribe psychiatric medications.
new text end
new text begin
(c) An eligible recipient is an individual who:
new text end
new text begin
(1) is between the ages of 15 and 40;
new text end
new text begin
(2) is experiencing early signs of psychosis with the duration of onset being less than
two years; and
new text end
new text begin
(3) has been on antipsychotic medications for less than a total of 12 months.
new text end
new text begin
(d) By December 1, 2026, the commissioner must submit a report to the chairs and
ranking minority members of the legislative committees with jurisdiction over human
services policy and finance. The report must include:
new text end
new text begin
(1) an overview of the recommended benefit;
new text end
new text begin
(2) eligibility requirements;
new text end
new text begin
(3) program standards;
new text end
new text begin
(4) a reimbursement methodology that covers team-based bundled costs;
new text end
new text begin
(5) performance evaluation criteria for programs; and
new text end
new text begin
(6) draft legislation with the statutory changes necessary to implement the benefit.
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. 27. new text begin MEDICAL ASSISTANCE CHILDREN'S RESIDENTIAL MENTAL
HEALTH CRISIS STABILIZATION.
new text end
new text begin
(a) The commissioner of human services must consult with providers, advocates, Tribal
Nations, counties, people with lived experience as or with a child in a mental health crisis,
and other interested community members to develop a covered benefit under medical
assistance to provide residential mental health crisis stabilization for children. The benefit
must:
new text end
new text begin
(1) consist of evidence-based promising practices, or culturally responsive treatment
services for children under the age of 21 experiencing a mental health crisis;
new text end
new text begin
(2) embody an integrative care model that supports individuals experiencing a mental
health crisis who may also be experiencing co-occurring conditions;
new text end
new text begin
(3) qualify for federal financial participation; and
new text end
new text begin
(4) include services that support children and families, including but not limited to:
new text end
new text begin
(i) an assessment of the child's immediate needs and factors that led to the mental health
crisis;
new text end
new text begin
(ii) individualized care to address immediate needs and restore the child to a precrisis
level of functioning;
new text end
new text begin
(iii) 24-hour on-site staff and assistance;
new text end
new text begin
(iv) supportive counseling and clinical services;
new text end
new text begin
(v) skills training and positive support services, as identified in the child's individual
crisis stabilization plan;
new text end
new text begin
(vi) referrals to other service providers in the community as needed and to support the
child's transition from residential crisis stabilization services;
new text end
new text begin
(vii) development of an individualized and culturally responsive crisis response action
plan; and
new text end
new text begin
(viii) assistance to access and store medication.
new text end
new text begin
(b) When developing the new benefit, the commissioner must make recommendations
for providers to be reimbursed for room and board.
new text end
new text begin
(c) The commissioner must consult with or contract with rate-setting experts to develop
a prospective data-based rate methodology for the children's residential mental health crisis
stabilization benefit.
new text end
new text begin
(d) No later than October 1, 2025, the commissioner must submit to the chairs and
ranking minority members of the legislative committees with jurisdiction over human
services policy and finance a report detailing the children's residential mental health crisis
stabilization benefit and must include:
new text end
new text begin
(1) eligibility criteria, clinical and service requirements, provider standards, licensing
requirements, and reimbursement rates;
new text end
new text begin
(2) the process for community engagement, community input, and crisis models studied
in other states;
new text end
new text begin
(3) a deadline for the commissioner to submit a state plan amendment to the Centers for
Medicare and Medicaid Services; and
new text end
new text begin
(4) draft legislation with the statutory changes necessary to implement the benefit.
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. 28. new text begin MEDICAL ASSISTANCE CLUBHOUSE BENEFIT ANALYSIS.
new text end
new text begin
The commissioner of human services must conduct an analysis to identify existing or
pending Medicaid Clubhouse benefits in other states, federal authorities used, populations
served, service and reimbursement design, and accreditation standards. By December 1,
2025, the commissioner must submit a report to the chairs and ranking minority members
of the legislative committees with jurisdiction over health and human services finance and
policy. The report must include a comparative analysis of Medicaid Clubhouse programs
and recommendations for designing a medical assistance benefit in Minnesota.
new text end
Sec. 29. new text begin STUDY ON MEDICAL ASSISTANCE CHILDREN'S INTENSIVE
RESIDENTIAL TREATMENT BENEFIT.
new text end
new text begin
(a) The commissioner of human services must consult with providers, advocates, Tribal
Nations, counties, people with lived experience as or with a child experiencing mental health
conditions, and other interested community members to develop a medical assistance state
plan covered benefit to provide intensive residential mental health services for children and
youth. The benefit must:
new text end
new text begin
(1) consist of evidence-based promising practices and culturally responsive treatment
services for children under the age of 21;
new text end
new text begin
(2) adapt to an integrative care model that supports individuals experiencing mental
health and co-occurring conditions;
new text end
new text begin
(3) qualify for federal financial participation; and
new text end
new text begin
(4) include services that support children, youth, and families, including but not limited
to:
new text end
new text begin
(i) assessment;
new text end
new text begin
(ii) individual treatment planning;
new text end
new text begin
(iii) 24-hour on-site staff and assistance;
new text end
new text begin
(iv) supportive counseling and clinical services; and
new text end
new text begin
(v) referrals to other service providers in the community as needed and to support
transition to the family home or own home.
new text end
new text begin
(b) When developing the new benefit, the commissioner must make recommendations
for providers to be reimbursed for room and board.
new text end
new text begin
(c) The commissioner must consult with or contract with rate-setting experts to develop
a prospective data-based rate methodology for the children's intensive residential mental
health services.
new text end
new text begin
(d) No later than August 1, 2026, the commissioner must submit to the chairs and ranking
minority members of the legislative committees with jurisdiction over human services policy
and finance a report detailing the proposed benefit, including:
new text end
new text begin
(1) eligibility criteria, clinical and service requirements, provider standards, licensing
requirements, and reimbursement rates;
new text end
new text begin
(2) the process for community engagement, community input, and residential models
studied in other states;
new text end
new text begin
(3) a deadline for the commissioner to submit a state plan amendment to the Centers for
Medicare and Medicaid Services; and
new text end
new text begin
(4) draft legislation with the statutory changes necessary to implement the benefit.
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 REVISOR INSTRUCTION.
new text end
new text begin
The revisor of statutes, in consultation with the Office of Senate Counsel, Research and
Fiscal Analysis; the House Research Department; and the commissioner of human services
shall prepare legislation for the 2025 legislative session to recodify Minnesota Statutes,
section 256B.0622, to move provisions related to assertive community treatment and intensive
residential treatment services into separate sections of statute. The revisor shall correct any
cross-references made necessary by this recodification.
new text end
Sec. 31. new text begin REPEALER.
new text end
new text begin
Minnesota Rules, part 2960.0620, subpart 3,
new text end
new text begin
is repealed.
new text end
ARTICLE 10
CHILD PROTECTION AND WELFARE
Section 1.
Minnesota Statutes 2023 Supplement, section 256.01, subdivision 12b, is
amended to read:
Subd. 12b.
Department of Human Services systemic critical incident review team.
(a)
The commissioner may establish a Department of Human Services systemic critical incident
review team to review critical incidents reported as required under section 626.557 for
which the Department of Human Services is responsible under section 626.5572, subdivision
13; chapter 245D; deleted text begin ordeleted text end Minnesota Rules, chapter 9544new text begin ; or child fatalities and near fatalities
that occur in licensed facilities and are not due to natural causesnew text end . When reviewing a critical
incident, the systemic critical incident review team shall identify systemic influences to the
incident rather than determine the culpability of any actors involved in the incident. The
systemic critical incident review may assess the entire critical incident process from the
point of an entity reporting the critical incident through the ongoing case management
process. Department staff shall lead and conduct the reviews and may utilize county staff
as reviewers. The systemic critical incident review process may include but is not limited
to:
(1) data collection about the incident and actors involved. Data may include the relevant
critical services; the service provider's policies and procedures applicable to the incident;
the community support plan as defined in section 245D.02, subdivision 4b, for the person
receiving services; or an interview of an actor involved in the critical incident or the review
of the critical incident. Actors may include:
(i) staff of the provider agency;
(ii) lead agency staff administering home and community-based services delivered by
the provider;
(iii) Department of Human Services staff with oversight of home and community-based
services;
(iv) Department of Health staff with oversight of home and community-based services;
(v) members of the community including advocates, legal representatives, health care
providers, pharmacy staff, or others with knowledge of the incident or the actors in the
incident; and
(vi) staff from the Office of the Ombudsman for Mental Health and Developmental
Disabilities and the Office of Ombudsman for Long-Term Care;
(2) systemic mapping of the critical incident. The team conducting the systemic mapping
of the incident may include any actors identified in clause (1), designated representatives
of other provider agencies, regional teams, and representatives of the local regional quality
council identified in section 256B.097; and
(3) analysis of the case for systemic influences.
Data collected by the critical incident review team shall be aggregated and provided to
regional teams, participating regional quality councils, and the commissioner. The regional
teams and quality councils shall analyze the data and make recommendations to the
commissioner regarding systemic changes that would decrease the number and severity of
critical incidents in the future or improve the quality of the home and community-based
service system.
(b) Cases selected for the systemic critical incident review process shall be selected by
a selection committee among the following critical incident categories:
(1) cases of caregiver neglect identified in section 626.5572, subdivision 17;
(2) cases involving financial exploitation identified in section 626.5572, subdivision 9;
(3) incidents identified in section 245D.02, subdivision 11;
(4) behavior interventions identified in Minnesota Rules, part 9544.0110;
(5) service terminations reported to the department in accordance with section 245D.10,
subdivision 3a; and
(6) other incidents determined by the commissioner.
(c) The systemic critical incident review under this section shall not replace the process
for screening or investigating cases of alleged maltreatment of an adult under section 626.557new text begin
or of a child under chapter 260Enew text end . The department may select cases for systemic critical
incident review, under the jurisdiction of the commissioner, reported for suspected
maltreatment and closed following initial or final disposition.
(d) The proceedings and records of the review team are confidential data on individuals
or protected nonpublic data as defined in section 13.02, subdivisions 3 and 13. Data that
document a person's opinions formed as a result of the review are not subject to discovery
or introduction into evidence in a civil or criminal action against a professional, the state,
or a county agency arising out of the matters that the team is reviewing. Information,
documents, and records otherwise available from other sources are not immune from
discovery or use in a civil or criminal action solely because the information, documents,
and records were assessed or presented during proceedings of the review team. A person
who presented information before the systemic critical incident review team or who is a
member of the team shall not be prevented from testifying about matters within the person's
knowledge. In a civil or criminal proceeding, a person shall not be questioned about opinions
formed by the person as a result of the review.
(e) By October 1 of each year, the commissioner shall prepare an annual public report
containing the following information:
(1) the number of cases reviewed under each critical incident category identified in
paragraph (b) and a geographical description of where cases under each category originated;
(2) an aggregate summary of the systemic themes from the critical incidents examined
by the critical incident review team during the previous year;
(3) a synopsis of the conclusions, incident analyses, or exploratory activities taken in
regard to the critical incidents examined by the critical incident review team; and
(4) recommendations made to the commissioner regarding systemic changes that could
decrease the number and severity of critical incidents in the future or improve the quality
of the home and community-based service system.
new text begin EFFECTIVE DATE. new text end
new text begin
This section is effective July 1, 2025.
new text end
Sec. 2.
Minnesota Statutes 2022, section 256N.26, subdivision 12, is amended to read:
Subd. 12.
Treatment of Supplemental Security Income.
new text begin (a) new text end 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. If a child continues to be eligible for SSI 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 SSI payment will be
reduced as required by the Social Security Administration.
new text begin
(b) If a financially responsible agency applies to be the payee for a child who receives
benefits through SSI, or receives the benefits under this subdivision on behalf of a child,
the financially responsible agency must provide written notice by certified mail, return
receipt requested to:
new text end
new text begin
(1) the child, if the child is 13 years of age or older;
new text end
new text begin
(2) the child's next of kin;
new text end
new text begin
(3) the guardian ad litem;
new text end
new text begin
(4) the legally responsible agency; and
new text end
new text begin
(5) the counsel appointed for the child pursuant to section 260C.163, subdivision 3.
new text end
new text begin
(c) If a financially responsible agency receives benefits under this subdivision on behalf
of a child 13 years of age or older, the legally responsible agency and the guardian ad litem
must disclose this information to the child in person in a manner that best helps the child
understand the information. This paragraph does not apply in circumstances where the child
is living outside of Minnesota.
new text end
new text begin
(d) If a financially responsible agency receives the benefits under this subdivision on
behalf of a child, it cannot use those funds for any other purpose than the care of that child.
The financially responsible agency must not commingle any benefits received under this
subdivision and must not put the benefits received on behalf of a child under this subdivision
into a general fund.
new text end
new text begin
(e) If a financially responsible agency receives any benefits under this subdivision, it
must keep a record of:
new text end
new text begin
(1) the total dollar amount it received on behalf of all children it receives benefits for;
new text end
new text begin
(2) the total number of children it applied to be a payee for; and
new text end
new text begin
(3) the total number of children it received benefits for.
new text end
new text begin
(f) By January 1 of each year, each financially responsible agency must submit a report
to the commissioner of human services that includes the information required under paragraph
(c). By January 31 of each year, the commissioner must submit a report to the chairs and
ranking minority members of the legislative committees with jurisdiction over child
protection that compiles the information provided to the commissioner by each financially
responsible agency under paragraph (e); subdivision 13, paragraph (e); and section
260C.4411, subdivision 3, paragraph (d). This paragraph expires January 31, 2034.
new text end
Sec. 3.
Minnesota Statutes 2022, section 256N.26, subdivision 13, is amended to read:
Subd. 13.
Treatment of retirement survivor's disability insurance, veteran's benefits,
railroad retirement benefits, and black lung benefits.
new text begin (a)new text end If a child placed in foster care
receives retirement survivor's disability insurance, veteran's benefits, railroad retirement
benefits, or black lung benefits 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. If it is anticipated that a
child will be eligible to receive retirement survivor's disability insurance, veteran's benefits,
railroad retirement benefits, or black lung benefits after finalization of the adoption or
assignment of permanent legal and physical custody, the permanent caregiver shall apply
to be the payee of those benefits on the child's behalf.
new text begin
(b) If the financially responsible agency applies to be the payee for a child who receives
retirement survivor's disability insurance, veteran's benefits, railroad retirement benefits,
or black lung benefits, or receives the benefits under this subdivision on behalf of a child,
the financially responsible agency must provide written notice by certified mail, return
receipt requested to:
new text end
new text begin
(1) the child, if the child is 13 years of age or older;
new text end
new text begin
(2) the child's next of kin;
new text end
new text begin
(3) the guardian ad litem;
new text end
new text begin
(4) the legally responsible agency; and
new text end
new text begin
(5) the counsel appointed for the child pursuant to section 260C.163, subdivision 3.
new text end
new text begin
(c) If a financially responsible agency receives benefits under this subdivision on behalf
of a child 13 years of age or older, the legally responsible agency and the guardian ad litem
must disclose this information to the child in person in a manner that best helps the child
understand the information. This paragraph does not apply in circumstances where the child
is living outside of Minnesota.
new text end
new text begin
(d) If a financially responsible agency receives the benefits under this subdivision on
behalf of a child, it cannot use those funds for any other purpose than the care of that child.
The financially responsible agency must not commingle any benefits received under this
subdivision and must not put the benefits received on behalf of a child under this subdivision
into a general fund.
new text end
new text begin
(e) If a financially responsible agency receives any benefits under this subdivision, it
must keep a record of:
new text end
new text begin
(1) the total dollar amount it received on behalf of all children it receives benefits for;
new text end
new text begin
(2) the total number of children it applied to be a payee for; and
new text end
new text begin
(3) the total number of children it received benefits for.
new text end
new text begin
(f) By January 1 of each year, each financially responsible agency must submit a report
to the commissioner of human services that includes the information required under paragraph
(e).
new text end
Sec. 4.
Minnesota Statutes 2023 Supplement, section 260.014, is amended by adding a
subdivision to read:
new text begin Subd. 5. new text end
new text begin Carryforward authority. new text end
new text begin
Funds appropriated under this section are available
for two fiscal years.
new text end
Sec. 5.
Minnesota Statutes 2022, section 260C.4411, is amended by adding a subdivision
to read:
new text begin Subd. 3. new text end
new text begin Notice. new text end
new text begin
(a) If the county of financial responsibility under section 256G.02 or
Tribal agency authorized under section 256.01, subdivision 14b, receives any benefits under
subdivision 2 on behalf of a child, it must provide written notice by certified mail, return
receipt requested to:
new text end
new text begin
(1) the child, if the child is 13 years of age or older;
new text end
new text begin
(2) the child's next of kin;
new text end
new text begin
(3) the guardian ad litem;
new text end
new text begin
(4) the legally responsible agency as defined in section 256N.02, subdivision 14; and
new text end
new text begin
(5) the counsel appointed for the child pursuant to section 260C.163, subdivision 3.
new text end
new text begin
(b) If the county of financial responsibility under section 256G.02 or Tribal agency
authorized under section 256.01, subdivision 14b, receives benefits under subdivision 2 on
behalf of a child 13 years of age or older, the legally responsible agency as defined in section
256N.02, subdivision 14, and the guardian ad litem must disclose this information to the
child in person in a manner that best helps the child understand the information. This
paragraph does not apply in circumstances where the child is living outside of Minnesota.
new text end
new text begin
(c) If the county of financial responsibility under section 256G.02 or Tribal agency
authorized under section 256.01, subdivision 14b, receives the benefits under subdivision
2 on behalf of a child, it cannot use those funds for any other purpose than the care of that
child. The county of financial responsibility or Tribal agency must not commingle any
benefits received under subdivision 2 and must not put the benefits received on behalf of a
child under subdivision 2 into a general fund.
new text end
new text begin
(d) If the county of financial responsibility under section 256G.02 or Tribal agency
authorized under section 256.01, subdivision 14b, receives any benefits under subdivision
2, it must keep a record of the total dollar amount it received on behalf of all children it
receives benefits for and the total number of children it receives benefits for. By January 1
of each year, the county of financial responsibility and Tribal agency must submit a report
to the commissioner of human services that includes the information required under this
paragraph.
new text end
Sec. 6.
new text begin
[260E.021] CHILD PROTECTION ADVISORY COUNCIL.
new text end
new text begin Subdivision 1. new text end
new text begin Membership. new text end
new text begin
The Child Protection Advisory Council consists of 24
members, appointed as follows:
new text end
new text begin
(1) the commissioner of human services or a designee;
new text end
new text begin
(2) the commissioner of children, youth, and families or a designee;
new text end
new text begin
(3) the ombudsperson for foster youth or a designee;
new text end
new text begin
(4) two members of the house of representatives, one appointed by the speaker of the
house and one appointed by the minority leader of the house of representatives;
new text end
new text begin
(5) two members of the senate, one appointed by the senate majority leader and one
appointed by the senate minority leader;
new text end
new text begin
(6) a representative from the Association of Minnesota Counties appointed by the
association;
new text end
new text begin
(7) two members representing county social services agencies appointed by the Minnesota
Association of County Social Service Administrators, one from a county outside the
seven-county metropolitan area and one from a county within the seven-county metropolitan
area;
new text end
new text begin
(8) one member with experience working and advocating for children with disabilities
in the child welfare system, appointed by the Minnesota Council on Disability;
new text end
new text begin
(9) two members appointed by Indian Child Welfare Advisory Council, one from a
county outside the seven-county metropolitan area and one from a county within the
seven-county metropolitan area;
new text end
new text begin
(10) one member appointed by the ombudsperson of American Indian Families;
new text end
new text begin
(11) one member appointed by the Children's Alliance;
new text end
new text begin
(12) three members appointed by the ombudsperson for families;
new text end
new text begin
(13) two members from the Children's Justice Task Force, one with experience as an
attorney or judge working in the child welfare system and one with experience as a peace
officer working in the child welfare system; and
new text end
new text begin
(14) four members of the public appointed by the governor, including:
new text end
new text begin
(i) one member 18 years of age or older who has lived experience with the child welfare
system;
new text end
new text begin
(ii) one member 18 years of age or older who has lived experience with the child welfare
system as a parent or caregiver;
new text end
new text begin
(iii) one member who is an advocate who has experience working within the child welfare
system and who has experience working with members of the LGBTQ+ community or
persons who are Black, Indigenous, or people of color; and
new text end
new text begin
(iv) one member with experience working as a pediatrician or nurse specializing in child
abuse.
new text end
new text begin Subd. 2. new text end
new text begin Council administration. new text end
new text begin
(a) For members appointed under subdivision 1,
clauses (6) to (14), section 15.059, subdivisions 1 to 4, apply.
new text end
new text begin
(b) The commissioner of administration shall provide the advisory council with staff
support, office space, and access to office equipment and services.
new text end
new text begin Subd. 3. new text end
new text begin Meetings. new text end
new text begin
(a) The advisory council must meet at least quarterly but may meet
more frequently at the call of the chairperson or at the request of a majority of advisory
council members.
new text end
new text begin
(b) Meetings of the advisory council are subject to the Minnesota Open Meeting Law
under chapter 13D.
new text end
new text begin Subd. 4. new text end
new text begin Chairperson. new text end
new text begin
(a) The advisory council must elect a chairperson from among
the members of the executive committee and other officers as it deems necessary and in
accordance with the advisory council's operating procedures.
new text end
new text begin
(b) The advisory council is governed by an executive committee elected by the members
of the advisory council.
new text end
new text begin
(c) The advisory council shall appoint an executive director. The advisory council may
delegate to the executive director any powers and duties under this section that do not require
advisory council approval. The executive director serves in the unclassified service and
may be removed at any time by a majority vote of the advisory council. The executive
director may employ and direct staff necessary to carry out advisory council mandates,
policies, activities, and objectives.
new text end
new text begin
(d) The executive committee may appoint additional subcommittees and work groups
as necessary to fulfill the duties of the advisory council.
new text end
new text begin Subd. 5. new text end
new text begin Duties. new text end
new text begin
(a) The advisory council must:
new text end
new text begin
(1) conduct reviews of the child mortality review processes originally completed by the
state or counties or through a third-party audit;
new text end
new text begin
(2) review child welfare data provided by the Department of Human Services and
counties;
new text end
new text begin
(3) review and provide guidance on the Family First Prevention Services Act
implementation; and
new text end
new text begin
(4) work with the commissioner of human services to evaluate child protection grants
to address disparities in child welfare pursuant to section 256E.28.
new text end
new text begin
(b) The advisory council may collect additional topic areas for study and evaluation
from the public. For the advisory council to study and evaluate a topic, the topic must be
approved for study and evaluation by the advisory council.
new text end
new text begin
(c) Legislative members may not deliberate about or vote on decisions related to the
issuance of grants of state money.
new text end
new text begin Subd. 6. new text end
new text begin Report. new text end
new text begin
By January 1, 2025, and annually thereafter, the advisory council must
submit a report to the chairs and ranking minority members of the legislative committees
with jurisdiction over child protection and child welfare on the advisory council's activities
under subdivision 5 and other issues on which the advisory council may choose to report.
new text end
new text begin Subd. 7. new text end
new text begin Expiration. new text end
new text begin
The Child Protection Advisory Council expires June 30, 2027.
new text end
Sec. 7.
new text begin
[260E.39] CHILD FATALITY AND NEAR FATALITY REVIEW.
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) "Critical incident" means a child fatality or near fatality in which maltreatment was
a known or suspected contributing cause.
new text end
new text begin
(c) "Joint review" means the critical incident review conducted by the child mortality
review panel jointly with the local review team under subdivision 4, paragraph (b).
new text end
new text begin
(d) "Local review" means the local critical incident review conducted by the local review
team under subdivision 4, paragraph (c).
new text end
new text begin
(e) "Local review team" means a local child mortality review team established under
subdivision 2.
new text end
new text begin
(f) "Panel" means the child mortality review panel established under subdivision 3.
new text end
new text begin Subd. 2. new text end
new text begin Local child mortality review teams. new text end
new text begin
(a) Each county shall establish a
multidisciplinary local child mortality review team and shall participate in local critical
incident reviews that are based on safety science principles to support a culture of learning.
The local welfare agency's child protection team may serve as the local review team. The
local review team shall include but not be limited to professionals with knowledge of the
critical incident being reviewed.
new text end
new text begin
(b) The local review team shall conduct reviews of critical incidents jointly with the
child mortality review panel or as otherwise required under subdivision 4, paragraph (c).
new text end
new text begin Subd. 3. new text end
new text begin Child mortality review panel; establishment and membership. new text end
new text begin
(a) The
commissioner shall establish a child mortality review panel to review critical incidents
attributed to child maltreatment. The purpose of the panel is to identify systemic changes
to improve child safety and well-being and recommend modifications in statutes, rules,
policies, and procedures.
new text end
new text begin
(b) The panel shall consist of:
new text end
new text begin
(1) the commissioner of children, youth, and families or a designee;
new text end
new text begin
(2) the commissioner of human services or a designee;
new text end
new text begin
(3) the commissioner of health or a designee;
new text end
new text begin
(4) the commissioner of education or a designee;
new text end
new text begin
(5) a judge appointed by the Minnesota judicial branch; and
new text end
new text begin
(6) other members appointed by the governor, including but not limited to:
new text end
new text begin
(i) a physician who is a medical examiner;
new text end
new text begin
(ii) a physician who is a child abuse specialist pediatrician;
new text end
new text begin
(iii) a county attorney who works on child protection cases;
new text end
new text begin
(iv) two current child protection supervisors for local welfare agencies, each of whom
has previous experience as a frontline child protection worker;
new text end
new text begin
(v) a current local welfare agency director who has previous experience as a frontline
child protection worker or supervisor;
new text end
new text begin
(vi) two current child protection supervisors or directors for Tribal child welfare agencies,
each of whom has previous experience as a frontline child protection worker or supervisor;
new text end
new text begin
(vii) a county public health worker; and
new text end
new text begin
(viii) a member representing law enforcement.
new text end
new text begin
(c) The governor shall designate one member as chair of the panel from the members
listed in paragraph (b), clauses (5) and (6).
new text end
new text begin
(d) Members of the panel shall serve terms of four years for an unlimited number of
terms. A member of the panel may be removed by the appointing authority for the member.
new text end
new text begin
(e) The commissioner shall employ an executive director for the panel to provide
administrative support to the panel and the chair, including providing the panel with critical
incident notices submitted by local welfare agencies; compile and synthesize information
for the panel; draft recommendations and reports for the panel's final approval; and conduct
or otherwise direct training and consultation under subdivision 7.
new text end
new text begin Subd. 4. new text end
new text begin Critical incident review process. new text end
new text begin
(a) A local welfare agency that has determined
that maltreatment was the cause of or a contributing factor in a critical incident must notify
the commissioner of children, youth, and families and the executive director of the panel
within three business days of making the determination.
new text end
new text begin
(b) The panel shall conduct a joint review with the local review team for:
new text end
new text begin
(1) any critical incident relating to a family, child, or caregiver involved in a local welfare
agency family assessment or investigation within the 12 months preceding the critical
incident;
new text end
new text begin
(2) a critical incident the governor or commissioner directs the panel to review; and
new text end
new text begin
(3) any other critical incident the panel chooses for review.
new text end
new text begin
(c) The local review team must review all critical incident cases not subject to joint
review under paragraph (b).
new text end
new text begin
(d) Within 120 days of initiating a joint review or local review of a critical incident,
except as provided under paragraph (h), the panel or local review team shall complete the
joint review or local review and compile a report. The report must include any systemic
learnings that may increase child safety and well-being, and may include policy or practice
considerations for systems changes that may improve child well-being and safety.
new text end
new text begin
(e) A local review team must provide its report following a local review to the panel
within three business days after the report is complete. After receiving the local review team
report, the panel may conduct a further joint review.
new text end
new text begin
(f) Following the panel's joint review or after receiving a local review team report, the
panel may make recommendations to any state or local agency, branch of government, or
system partner to improve child safety and well-being.
new text end
new text begin
(g) The commissioner shall conduct additional information gathering as requested by
the panel or the local review team. The commissioner must conduct information gathering
for all cases for which the panel requests assistance. The commissioner shall compile a
summary report for each critical incident for which information gathering is conducted and
provide the report to the panel and the local welfare agency that reported the critical incident.
new text end
new text begin
(h) If the panel or local review team requests information gathering from the
commissioner, the panel or local review team may conduct the joint review or local review
and compile the report under paragraph (d) after receiving the commissioner's summary
information gathering report. The timeline for a local or joint review under paragraph (d)
may be extended if the panel or local review team requests additional information gathering
to complete their review. If the local review team extends the timeline for its review and
report, the local welfare agency must notify the executive director of the panel of the
extension and the expected completion date.
new text end
new text begin
(i) The review of any critical incident shall proceed as specified in this section, regardless
of the status of any pending litigation or other active investigation.
new text end
new text begin Subd. 5. new text end
new text begin Critical incident reviews; data practices and immunity. new text end
new text begin
(a) In conducting
reviews, the panel, the local review team, and the commissioner shall have access to not
public data under chapter 13 maintained by state agencies, statewide systems, or political
subdivisions that are related to the child's critical incident or circumstances surrounding the
care of the child. The panel, the local review team, and the commissioner shall also have
access to records of private hospitals as necessary to carry out the duties prescribed by this
section. A state agency, statewide system, or political subdivision shall provide the data
upon request from the commissioner. Not public data may be shared with members of the
panel, a local review team, or the commissioner in connection with an individual case.
new text end
new text begin
(b) Notwithstanding the data's classification in the possession of any other agency, data
acquired by a local review team, the panel, or the commissioner in the exercise of their
duties are protected nonpublic or confidential data as defined in section 13.02 but may be
disclosed as necessary to carry out the duties of the review team, panel, or commissioner.
The data are not subject to subpoena or discovery.
new text end
new text begin
(c) The commissioner shall disclose information regarding a critical incident upon request
but shall not disclose data that was classified as confidential or private data on decedents
under section 13.10 or private, confidential, or protected nonpublic data in the disseminating
agency, except that the commissioner may disclose local social service agency data as
provided in section 260E.35 on individual cases involving a critical incident with a person
served by the local social service agency prior to the date of the critical incident.
new text end
new text begin
(d) A person attending a local review team or child mortality review panel meeting shall
not disclose what transpired at the meeting except to carry out the purposes of the local
review team or panel. The commissioner shall not disclose what transpired during the
information gathering process except to carry out the duties of the commissioner. The
proceedings and records of the local review team, the panel, and the commissioner are
protected nonpublic data as defined in section 13.02, subdivision 13, and are not subject to
discovery or introduction into evidence in a civil or criminal action. Information, documents,
and records otherwise available from other sources are not immune from discovery or use
in a civil or criminal action solely because they were presented during proceedings of the
local review team, the panel, or the commissioner.
new text end
new text begin
(e) A person who presented information before the local review team, the panel, or the
commissioner or who is a member of the local review team or the panel, or an employee
conducting information gathering as designated by the commissioner, shall not be prevented
from testifying about matters within the person's knowledge. However, in a civil or criminal
proceeding, a person may not be questioned about the person's presentation of information
to the local review team, the panel, or the commissioner, or about the information reviewed
or discussed during a critical incident review or the information gathering process, any
conclusions drawn or recommendations made related to information gathering or a critical
incident review, or opinions formed by the person as a result of the panel or review team
meetings.
new text end
new text begin
(f) A person who presented information before the local review team, the panel, or the
commissioner, who is a member of the local review team or the panel, or who is an employee
conducting information gathering as designated by the commissioner, is immune from any
civil or criminal liability that might otherwise result from the person's presentation or
statements if the person was acting in good faith and assisting with information gathering
or in a critical incident review under this section.
new text end
new text begin Subd. 6. new text end
new text begin Child mortality review panel; annual report. new text end
new text begin
Beginning December 15, 2026,
and on or before December 15 annually thereafter, the commissioner shall publish a report
of the child mortality review panel. The report shall include but not be limited to de-identified
summary data on the number of critical incidents reported to the panel, the number of critical
incidents reviewed by the panel and local review teams, and systemic learnings identified
by the panel or local review teams during the period covered by the report. The report shall
also include recommendations on improving the child protection system, including
modifications to statutes, rules, policies, and procedures. The panel may make
recommendations to the legislature or any state or local agency at any time, outside of the
annual report.
new text end
new text begin Subd. 7. new text end
new text begin Local welfare agency critical incident review training. new text end
new text begin
The commissioner
shall provide training and support to local review teams and the panel to assist with local
or joint review processes and procedures. The commissioner shall also provide consultation
to local review teams and the panel conducting local or joint reviews pursuant to this section.
new text end
new text begin Subd. 8. new text end
new text begin Culture of learning and improvement. new text end
new text begin
The local review teams and panel
shall advance and support a culture of learning and improvement within Minnesota's child
welfare system.
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. 8.
Minnesota Statutes 2023 Supplement, section 518A.42, subdivision 3, is amended
to read:
Subd. 3.
Exception.
(a) deleted text begin This sectiondeleted text end new text begin The minimum basic support amount under
subdivision 2new text end does not apply to an obligor who is incarcerated deleted 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)
benefitsdeleted text end .
new text begin
(b) The minimum basic support amount under subdivision 2 does not apply to an obligor
who is a recipient of:
new text end
new text begin
(1) a general assistance grant;
new text end
new text begin
(2) Supplement Security Income;
new text end
new text begin
(3) a Temporary Assistances for Needy Families (TANF) grant; or
new text end
new text begin
(4) comparable state-funded Minnesota family investment program (MFIP) benefits.
new text end
deleted text begin (b)deleted text end new text begin (c)new text end If the court finds the obligor receives no income and completely lacks the ability
to earn income, the minimum basic support amount under deleted text begin thisdeleted text end subdivisionnew text begin 2new text end does not apply.
deleted text begin (c)deleted text end new text begin (d)new text end 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 deleted text begin thisdeleted text end subdivisionnew text begin 2new text end does not apply and the lesser amount is the guideline
basic support.
Sec. 9.
Laws 2023, chapter 70, article 14, section 42, subdivision 6, is amended to read:
Subd. 6.
Community Resource Center Advisory Council; establishment and
duties.
(a) The commissioner, in consultation with other relevant state agencies, shall appoint
members to the Community Resource Center Advisory Council.
(b) Membership must be demographically and geographically diverse and include:
(1) parents and family members with lived experience who lack opportunities;
(2) community-based organizations serving families who lack opportunities;
(3) Tribal and urban American Indian representatives;
(4) county government representatives;
(5) school and school district representatives; and
(6) state partner representatives.
(c) Duties of the Community Resource Center Advisory Council include but are not
limited to:
(1) advising the commissioner on the development and funding of a network of
community resource centers;
(2) advising the commissioner on the development of requests for proposals and grant
award processes;
(3) advising the commissioner on the development of program outcomes and
accountability measures; and
(4) advising the commissioner on ongoing governance and necessary support in the
implementation of community resource centers.
new text begin
(d) Compensation for members of the Community Resource Center Advisory Council
is governed by Minnesota Statutes, section 15.0575.
new text end
Sec. 10. new text begin CHILD PROTECTION ADVISORY COUNCIL; INITIAL TERMS AND
APPOINTMENTS AND FIRST MEETING.
new text end
new text begin Subdivision 1. new text end
new text begin Initial appointments. new text end
new text begin
Appointing authorities for the Child Protection
Advisory Council under Minnesota Statutes, section 260E.021, must appoint members to
the council by August 1, 2024.
new text end
new text begin Subd. 2. new text end
new text begin Terms. new text end
new text begin
Members appointed under Minnesota Statutes, section 260E.021,
subdivision 1, clauses (7), (8), and (9), serve a term that is coterminous with the governor.
Members appointed under Minnesota Statutes, section 260E.021, subdivision 1, clauses
(10) and (12), serve a term that ends one year after the governor's term. Members appointed
under Minnesota Statutes, section 260E.021, subdivision 1, clauses (6), (11), and (13), serve
a term that ends two years after the governor's term. Members appointed under Minnesota
Statutes, section 260E.021, subdivision 1, clause (14), serve a term that ends three years
after the governor's term.
new text end
new text begin Subd. 3. new text end
new text begin Chair; first meeting. new text end
new text begin
The commissioner of human services or the
commissioner's designee will serve as chair until the council elects a chair. The commissioner
must convene the first meeting of the council by September 15, 2024. The council must
elect its executive committee and its chair at its first meeting.
new text end
Sec. 11. new text begin DIRECTION TO COMMISSIONER; CHILD MALTREATMENT
REPORTING SYSTEMS REVIEW AND RECOMMENDATIONS.
new text end
new text begin
The commissioner of children, youth, and families must review current child maltreatment
reporting processes and systems in various states and evaluate the costs and benefits of each
reviewed state's system. In consultation with stakeholders, including but not limited to
counties, Tribes, and organizations with expertise in child maltreatment prevention and
child protection, the commissioner must develop recommendations on implementing a
statewide child abuse and neglect reporting system in Minnesota and outline the benefits,
challenges, and costs of such a transition. By June 1, 2025, the commissioner must submit
a report detailing the commissioner's recommendations to the chairs and ranking minority
members of the legislative committees with jurisdiction over child protection. The
commissioner must also publish the report on the department's website.
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 DIRECTION TO COMMISSIONER OF HUMAN SERVICES; CHILD
WELFARE WORKFORCE SYSTEM IMPROVEMENTS.
new text end
new text begin
When designing, developing, and implementing a data-driven, federally compliant
Comprehensive Child Welfare Information System, the commissioner of human services
must ensure that the system can do the following:
new text end
new text begin
(1) allow counties to track various financial information, including benefits received by
counties on behalf of children in the child protection system;
new text end
new text begin
(2) allow counties to track all fees received by counties from parents with children in
out-of-home placements;
new text end
new text begin
(3) provide ombudspersons with direct access to nonprivileged information necessary
for the discharge of the ombudsperson's duties, including specific child protection case
information;
new text end
new text begin
(4) provide comprehensive statewide data reports; and
new text end
new text begin
(5) track demographic information about children in the child protection system, including
disability, ethnicity, economic status, and cultural identity.
new text end
Sec. 13. new text begin PREVENTING NONRELATIVE FOSTER CARE PLACEMENT GRANTS.
new text end
new text begin
(a) The commissioner of children, youth, and families must award grants to eligible
community-based nonprofit organizations to provide culturally competent supports to relative
caregivers who are caring for relative children and connection to local and statewide
resources.
new text end
new text begin
(b) Grant funds must be used to serve relative caregivers caring for children from
communities that are disproportionately overrepresented in the child welfare system based
on available data, as determined by the commissioner.
new text end
new text begin
(c) Grant funds may be used to assess relative caregiver and child needs, provide
connection to local and statewide culturally competent resources, and provide culturally
competent case management to assist with complex cases. Grant funds may also be used to
provide culturally competent supports to reduce the need for child welfare involvement or
risk of child welfare involvement and increase family stability by preventing nonrelative
foster care placement.
new text end
new text begin
(d) For purposes of this section, "relative" has the meaning given in Minnesota Statutes,
section 260C.007, subdivision 27.
new text end
Sec. 14. new text begin REPEALER.
new text end
new text begin
(a)
new text end
new text begin
Minnesota Statutes 2022, section 256.01, subdivisions 12 and 12a,
new text end
new text begin
are repealed.
new text end
new text begin
(b)
new text end
new text begin
Minnesota Rules, part 9560.0232, subpart 5,
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, 2025.
new text end
ARTICLE 11
ECONOMIC SUPPORTS
Section 1.
new text begin
[142F.103] CAMPUS-BASED EMPLOYMENT AND TRAINING
PROGRAM FOR STUDENTS ENROLLED IN HIGHER EDUCATION.
new text end
new text begin Subdivision 1. new text end
new text begin Designation. new text end
new text begin
(a) Within six months of the effective date of this section,
the Board of Trustees of Minnesota State Colleges and Universities must, and the Board of
Regents of the University of Minnesota is requested to, submit an application to the
commissioner of human services verifying whether each MNSCU institution meets the
requirements to be a campus-based employment and training program that qualifies for the
student exemption for Supplemental Nutrition Assistance Program (SNAP) eligibility, as
described in the Code of Federal Regulations, title 7, section 273.5(b)(11)(iv).
new text end
new text begin
(b) An institution of higher education must be designated as a campus-based employment
and training program by the commissioner of human services if that institution meets the
requirements set forth in the guidance under subdivision 3. The commissioner of human
services must maintain a list of approved programs on its website.
new text end
new text begin Subd. 2. new text end
new text begin Student eligibility. new text end
new text begin
A student is eligible to participate in a campus-based
employment and training program under this section if the student is enrolled in:
new text end
new text begin
(1) a public two-year community or technical college and received a state grant under
section 136A.121, received a federal Pell grant, or has a student aid index of $0 or less;
new text end
new text begin
(2) a Tribal college as defined in section 136A.62 and received a state grant under section
136A.121, received a federal Pell grant, or has a student aid index of $0 or less; or
new text end
new text begin
(3) a public four-year university and received a state grant under section 136A.121,
received a federal Pell grant, or has a student aid index of $0 or less.
new text end
new text begin Subd. 3. new text end
new text begin Guidance. new text end
new text begin
Within three months of the effective date of this section and annually
thereafter, the commissioner of human services, in consultation with the commissioner of
higher education, must issue guidance to counties, Tribal Nations, Tribal colleges, and
Minnesota public postsecondary institutions that:
new text end
new text begin
(1) clarifies the state and federal eligibility requirements for campus-based employment
and training programs for low-income households;
new text end
new text begin
(2) clarifies the application process for campus-based employment and training programs
for low-income households including but not limited to providing a list of the supporting
documents required for program approval;
new text end
new text begin
(3) clarifies how students in an institution of higher education approved as a campus-based
employment and training program for low-income households qualify for a SNAP student
exemption; and
new text end
new text begin
(4) clarifies the SNAP eligibility criteria for students that qualify for a SNAP student
exemption under this section.
new text end
new text begin Subd. 4. new text end
new text begin Application. new text end
new text begin
Within three months of the effective date of this section, the
commissioner of human services, in consultation with the commissioner of higher education,
must design an application for institutions of higher education to apply for a campus-based
employment and training program designation.
new text end
new text begin Subd. 5. new text end
new text begin Notice. new text end
new text begin
At the beginning of each academic semester, an institution of higher
education with a designated campus-based employment and training program must send a
letter to students eligible under this section to inform them that they may qualify for SNAP
benefits and direct them to resources to apply. The letter under this subdivision shall serve
as proof of a student's enrollment in a campus-based employment and training 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 must notify the revisor of statutes when federal approval is obtained.
new text end
Sec. 2.
new text begin
[142F.16] MINNESOTA FOOD BANK PROGRAM.
new text end
new text begin
The Minnesota food bank program is established in the Department of Human Services.
The commissioner of human services shall distribute money appropriated to the Minnesota
food bank program to all regional food banks the commissioner contracts with for the
purposes of The Emergency Food Assistance Program (TEFAP).The commissioner shall
distribute money under this section in accordance with the federal TEFAP formula and
guidelines of the United States Department of Agriculture. Money distributed under this
section must be used by all regional food banks to purchase food that will be distributed
free of charge to TEFAP partner agencies. Money distributed under this section must also
cover the handling and delivery fees typically paid by food shelves to food banks to ensure
costs associated with money under this section are not incurred at the local level.
new text end
Sec. 3.
Minnesota Statutes 2023 Supplement, section 256E.38, subdivision 4, is amended
to read:
Subd. 4.
Eligible uses of grant money.
An eligible applicant that receives grant money
under this section shall use the money to purchase diapers and wipes and may use up to
deleted text begin fourdeleted text end new text begin tennew text end percent of the money for administrative costs.
Sec. 4. new text begin TRANSFER TO DEPARTMENT OF CHILDREN, YOUTH, AND FAMILIES.
new text end
new text begin
The responsibilities for the campus-based employment and training program for students
enrolled in higher education under Minnesota Statutes, section 142F.103, and the Minnesota
food bank program under Minnesota Statutes, section 142F.16, must transfer from the
commissioner of human services to the commissioner of children, youth, and families.
Minnesota Statutes, sections 142F.103 and 142F.16, are incorporated into the transfer of
duties and responsibilities in Laws 2023, chapter 70, article 12, section 30, and the
commissioner shall give the notices of when the transfer is effective as required by Laws
2023, chapter 70, article 12, section 30, subdivision 1.
new text end
ARTICLE 12
HOUSING AND HOMELESSNESS
Section 1. new text begin PREGNANT AND PARENTING HOMELESS YOUTH STUDY.
new text end
new text begin
(a) The commissioner of human services must contract with the Wilder Foundation to
conduct a study of:
new text end
new text begin
(1) the statewide numbers and unique needs of pregnant and parenting youth experiencing
homelessness; and
new text end
new text begin
(2) best practices in supporting pregnant and parenting homeless youth within
programming, emergency shelter, and housing settings.
new text end
new text begin
(b) The Wilder Foundation must submit a final report to the commissioner by December
31, 2025. The commissioner shall submit the report to the chairs and ranking minority
members of the legislative committees with jurisdiction over homeless youth services finance
and policy.
new text end
Sec. 2. new text begin REVIVAL AND REENACTMENT.
new text end
new text begin
Minnesota Statutes 2022, section 256B.051, subdivision 7, is revived and reenacted
effective retroactively from August 1, 2023. The time-limited supplemental rate reduction
in Minnesota Statutes 2022, section 256B.051, subdivision 7, does not restart when the
subdivision is revived and reenacted. Any time frames within or dependent on the subdivision
are based on the original effective date in Laws 2017, First Special Session chapter 6, article
2, section 10.
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 REPEALER.
new text end
new text begin
Laws 2023, chapter 25, section 190, subdivision 10,
new text end
new text begin
is repealed.
new text end
new text begin EFFECTIVE DATE. new text end
new text begin
This section is effective the day following final enactment.
new text end
ARTICLE 13
CHILD CARE LICENSING
Section 1.
new text begin
[142B.171] CHILD CARE WEIGHTED RISK SYSTEM.
new text end
new text begin Subdivision 1. new text end
new text begin Implementation. new text end
new text begin
The commissioner shall develop and implement a child
care weighted risk system that provides a tiered licensing enforcement framework for child
care licensing requirements in this chapter or Minnesota Rules, chapter 9502 or 9503.
new text end
new text begin Subd. 2. new text end
new text begin Documented technical assistance. new text end
new text begin
(a) In lieu of a correction order under section
142B.16, the commissioner shall provide documented technical assistance to a family child
care or child care center license holder if the commissioner finds that:
new text end
new text begin
(1) the license holder has failed to comply with a requirement in this chapter or Minnesota
Rules, chapter 9502 or 9503, that the commissioner determines to be low risk as determined
by the child care weighted risk system;
new text end
new text begin
(2) the noncompliance does not imminently endanger the health, safety, or rights of the
persons served by the program; and
new text end
new text begin
(3) the license holder did not receive documented technical assistance or a correction
order for the same violation at the license holder's most recent annual licensing inspection.
new text end
new text begin
(b) Documented technical assistance must include communication from the commissioner
to the child care provider that:
new text end
new text begin
(1) states the conditions that constitute a violation of a law or rule;
new text end
new text begin
(2) references the specific law or rule violated; and
new text end
new text begin
(3) explains remedies for correcting the violation.
new text end
new text begin
(c) The commissioner shall not publicly publish documented technical assistance on the
department's website.
new text end
Sec. 2.
Minnesota Statutes 2023 Supplement, 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 yearsnew text begin
within 90 days of the date the training was initially takennew text end . deleted text begin License holders, second adult
caregivers, and substitutes must not let the training expire.
deleted text end
(b) Video training reviewed and approved by the county licensing agency satisfies the
training requirement of this subdivision.
Sec. 3.
Minnesota Statutes 2023 Supplement, 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
yearsnew text begin within 90 days of the date the training was initially taken,new text end and new text begin the training new text end must
deleted text begin document the trainingdeleted text end new text begin be documentednew text end in the license holder's records. deleted text begin License holders, second
adult caregivers, and substitutes must not let the training expire.
deleted 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. 4. new text begin REPEALER.
new text end
new text begin
Minnesota Statutes 2022, section 245A.065,
new text end
new text begin
is repealed.
new text end
ARTICLE 14
DEPARTMENT OF CHILDREN, YOUTH, AND FAMILIES
Section 1.
new text begin
[142A.045] CHILDREN, YOUTH, AND FAMILIES
INTERGOVERNMENTAL ADVISORY COMMITTEE.
new text end
new text begin
(a) An intergovernmental advisory committee is established to provide advice,
consultation, and recommendations to the commissioner on the planning, design,
administration, funding, and evaluation of services to children, youth, and families.
Notwithstanding section 15.059, the commissioner, the Association of Minnesota Counties,
and the Minnesota Association of County Social Services Administrators must codevelop
and execute a process to administer the committee that ensures each county is represented.
The committee must meet at least quarterly and special meetings may be called by the
committee chair or a majority of the members.
new text end
new text begin
(b) Subject to section 15.059, the commissioner may reimburse committee members or
their alternates for allowable expenses while engaged in their official duties as committee
members.
new text end
new text begin
(c) Notwithstanding section 15.059, the intergovernmental advisory committee does not
expire.
new text end
Sec. 2.
new text begin
[142B.47] TRAINING ON RISK OF SUDDEN UNEXPECTED INFANT
DEATH AND ABUSIVE HEAD TRAUMA FOR CHILD FOSTER CARE
PROVIDERS.
new text end
new text begin
(a) Licensed child foster care providers that care for infants or children through five
years of age must document that before caregivers assist in the care of infants or children
through five years of age, they are instructed on the standards in section 142B.46 and receive
training on reducing the risk of sudden unexpected infant death and abusive head trauma
from shaking infants and young children. This section does not apply to emergency relative
placement under section 142B.06. The training on reducing the risk of sudden unexpected
infant death and abusive head trauma may be provided as:
new text end
new text begin
(1) orientation training to child foster care providers who care for infants or children
through five years of age under Minnesota Rules, part 2960.3070, subpart 1; or
new text end
new text begin
(2) in-service training to child foster care providers who care for infants or children
through five years of age under Minnesota Rules, part 2960.3070, subpart 2.
new text end
new text begin
(b) Training required under this section must be at least one hour in length and must be
completed at least once every five years. At a minimum, the training must address the risk
factors related to sudden unexpected infant death and abusive head trauma, means of reducing
the risk of sudden unexpected infant death and abusive head trauma, and license holder
communication with parents regarding reducing the risk of sudden unexpected infant death
and abusive head trauma.
new text end
new text begin
(c) Training for child foster care providers must be approved by the county or private
licensing agency that is responsible for monitoring the child foster care provider under
section 142B.30. The approved training fulfills, in part, training required under Minnesota
Rules, part 2960.3070.
new text end
Sec. 3.
Minnesota Statutes 2022, section 245A.10, subdivision 1, as amended by Laws
2024, chapter 80, article 2, section 48, is amended to read:
Subdivision 1.
Application or license fee required, programs exempt from fee.
(a)
Unless exempt under paragraph (b), the commissioner shall charge a fee for evaluation of
applications and inspection of programs which are licensed under this chapter.
(b) Except as provided under subdivision 2, no application or license fee shall be charged
for new text begin a child foster residence setting, new text end adult foster carenew text begin ,new text end or a community residential setting.
Sec. 4.
Minnesota Statutes 2022, section 245A.10, subdivision 2, as amended by Laws
2024, chapter 80, article 2, section 49, is amended to read:
Subd. 2.
County fees for applications and licensing inspections.
(a) For purposes of
adult foster care new text begin and child foster residence setting new text end licensing and licensing the physical plant
of a community residential setting, under this chapter, a county agency may charge a fee to
a corporate applicant or corporate license holder to recover the actual cost of licensing
inspections, not to exceed $500 annually.
(b) Counties may elect to reduce or waive the fees in paragraph (a) under the following
circumstances:
(1) in cases of financial hardship;
(2) if the county has a shortage of providers in the county's area; or
(3) for new providers.
Sec. 5.
Minnesota Statutes 2022, section 245A.144, is amended to read:
245A.144 TRAINING ON RISK OF SUDDEN UNEXPECTED INFANT DEATH
AND ABUSIVE HEAD TRAUMA FOR CHILD FOSTER CARE PROVIDERS.
(a) Licensed child foster care providers that care for infants or children through five
years of age must document that before staff persons deleted text begin and caregiversdeleted text end assist in the care of
infants or children through five years of age, they are instructed on the standards in section
deleted text begin 245A.1435deleted text end new text begin 142B.46 new text end and receive training on reducing the risk of sudden unexpected infant
death and abusive head trauma from shaking infants and young children. deleted text begin This section does
not apply to emergency relative placement under section 245A.035.deleted text end The training on reducing
the risk of sudden unexpected infant death and abusive head trauma may be provided as:
(1) orientation training to child foster care providers, who care for infants or children
through five years of age, under Minnesota Rules, part 2960.3070, subpart 1; or
(2) in-service training to child foster care providers, who care for infants or children
through five years of age, under Minnesota Rules, part 2960.3070, subpart 2.
(b) Training required under this section must be at least one hour in length and must be
completed at least once every five years. At a minimum, the training must address the risk
factors related to sudden unexpected infant death and abusive head trauma, means of reducing
the risk of sudden unexpected infant death and abusive head trauma, and license holder
communication with parents regarding reducing the risk of sudden unexpected infant death
and abusive head trauma.
(c) Training for child foster care providers must be approved by the county deleted text begin or private
licensing agencydeleted text end that is responsible for monitoring the child foster care provider under
section 245A.16. The approved training fulfills, in part, training required under Minnesota
Rules, part 2960.3070.
Sec. 6.
Minnesota Statutes 2023 Supplement, section 245A.16, subdivision 1, as amended
by Laws 2024, chapter 80, article 2, section 65, is amended to read:
Subdivision 1.
Delegation of authority to agencies.
(a) County agencies that have been
designated by the commissioner to perform licensing functions and activities under section
245A.04; to recommend denial of applicants under section 245A.05; to issue correction
orders, to issue variances, and recommend a conditional license under section 245A.06; or
to recommend suspending or revoking a license or issuing a fine under section 245A.07,
shall comply with rules and directives of the commissioner governing those functions and
with this section. The following variances are excluded from the delegation of variance
authority and may be issued only by the commissioner:
(1) deleted text begin dual licensure of family child foster care and family adult foster care,deleted text end dual licensure
of child foster residence setting and community residential settingdeleted text begin , and dual licensure of
family adult foster care and family child caredeleted text end ;
(2) new text begin until the responsibility for family child foster care transfers to the commissioner of
children, youth, and families under Laws 2023, chapter 70, article 12, section 30, dual
licensure of family child foster care and family adult foster care;
new text end
new text begin
(3) until the responsibility for family child care transfers to the commissioner of children,
youth, and families under Laws 2023, chapter 70, article 12, section 30, dual licensure of
family adult foster care and family child care;
new text end
new text begin (4) new text end adult foster care maximum capacity;
deleted text begin (3)deleted text end new text begin (5)new text end adult foster care minimum age requirement;
deleted text begin (4)deleted text end new text begin (6)new text end child foster care maximum age requirement;
deleted text begin (5)deleted text end new text begin (7)new text end variances regarding disqualified individuals;
deleted text begin (6)deleted text end new text begin (8)new text end the required presence of a caregiver in the adult foster care residence during
normal sleeping hours;
deleted text begin (7)deleted text end new text begin (9)new text end variances to requirements relating to chemical use problems of a license holder
or a household member of a license holder; and
deleted text begin (8)deleted text end new text begin (10)new text end variances to section 142B.46 for the use of a cradleboard for a cultural
accommodation.
new text begin
(b) Once the respective responsibilities transfer from the commissioner of human services
to the commissioner of children, youth, and families, under Laws 2023, chapter 70, article
12, section 30, the commissioners of human services and children, youth, and families must
both approve a variance for dual licensure of family child foster care and family adult foster
care or family adult foster care and family child care. Variances under this paragraph are
excluded from the delegation of variance authority and may be issued only by both
commissioners.
new text end
deleted text begin (b)deleted text end new text begin (c)new text end For family adult day services programs, the commissioner may authorize licensing
reviews every two years after a licensee has had at least one annual review.
deleted text begin (c)deleted text end new text begin (d)new text end A license issued under this section may be issued for up to two years.
deleted text begin (d)deleted text end new text begin (e)new text end During implementation of chapter 245D, the commissioner shall consider:
(1) the role of counties in quality assurance;
(2) the duties of county licensing staff; and
(3) the possible use of joint powers agreements, according to section 471.59, with counties
through which some licensing duties under chapter 245D may be delegated by the
commissioner to the counties.
Any consideration related to this paragraph must meet all of the requirements of the corrective
action plan ordered by the federal Centers for Medicare and Medicaid Services.
deleted text begin (e)deleted text end new text begin (f)new text end Licensing authority specific to section 245D.06, subdivisions 5, 6, 7, and 8, or
successor provisions; and section 245D.061 or successor provisions, for family child foster
care programs providing out-of-home respite, as identified in section 245D.03, subdivision
1, paragraph (b), clause (1), is excluded from the delegation of authority to county agencies.
Sec. 7.
Minnesota Statutes 2022, section 245A.175, is amended to read:
245A.175 CHILD FOSTER CARE TRAINING REQUIREMENT; MENTAL
HEALTH TRAINING; FETAL ALCOHOL SPECTRUM DISORDERS TRAINING.
Prior to a nonemergency placement of a child in a foster care home, the child foster care
license holder and deleted text begin caregivers in foster family and treatment foster care settings,deleted text end and all staff
providing care in foster residence settings must complete two hours of training that addresses
the causes, symptoms, and key warning signs of mental health disorders; cultural
considerations; and effective approaches for dealing with a child's behaviors. At least one
hour of the annual training requirement for the deleted text begin foster family license holder and caregivers,
anddeleted text end foster residence staff must be on children's mental health issues and treatment. Except
for providers and services under chapter 245D, the annual training must also include at least
one hour of training on fetal alcohol spectrum disorders, which must be counted toward the
12 hours of required in-service training per year. deleted text begin Short-term substitute caregivers are exempt
from these requirements.deleted text end Training curriculum shall be approved by the commissioner of
human services.
Sec. 8.
Minnesota Statutes 2023 Supplement, section 245A.66, subdivision 4, as amended
by Laws 2024, chapter 80, article 2, section 73, is amended to read:
Subd. 4.
Ongoing training requirement.
new text begin (a) new text end In addition to the orientation training
required by the applicable licensing rules and statutes, children's residential facility license
holders must provide a training annually on the maltreatment of minors reporting
requirements and definitions in chapter 260E to each mandatory reporter, as described in
section 260E.06, subdivision 1.
new text begin
(b) In addition to the orientation training required by the applicable licensing rules and
statutes, all foster residence setting staff and volunteers that are mandatory reporters as
described in section 260E.06, subdivision 1, must complete training each year on the
maltreatment of minors reporting requirements and definitions in chapter 260E.
new text end
Sec. 9.
Minnesota Statutes 2022, section 256.029, as amended by Laws 2024, chapter 80,
article 1, section 66, is amended to read:
256.029 DOMESTIC VIOLENCE INFORMATIONAL BROCHURE.
(a) The commissioner shall provide a domestic violence informational brochure that
provides information about the existence of domestic violence waivers for eligible public
assistance applicants to all applicants of general assistance, medical assistance, and
MinnesotaCare. The brochure must explain that eligible applicants may be temporarily
waived from certain program requirements due to domestic violence. The brochure must
provide information about services and other programs to help victims of domestic violence.
(b) The brochure must be funded with TANF funds.
new text begin
(c) The commissioner must work with the commissioner of children, youth, and families
to create a brochure that meets the requirements of this section and section 142G.05.
new text end
Sec. 10.
Minnesota Statutes 2023 Supplement, section 256.043, subdivision 3, is amended
to read:
Subd. 3.
Appropriations from registration and license fee account.
(a) The
appropriations in paragraphs (b) to (n) shall be made from the registration and license fee
account on a fiscal year basis in the order specified.
(b) The appropriations specified in Laws 2019, chapter 63, article 3, section 1, paragraphs
(b), (f), (g), and (h), as amended by Laws 2020, chapter 115, article 3, section 35, shall be
made accordingly.
(c) $100,000 is appropriated to the commissioner of human services for grants for opiate
antagonist distribution. Grantees may utilize funds for opioid overdose prevention,
community asset mapping, education, and opiate antagonist distribution.
(d) $2,000,000 is appropriated to the commissioner of human services for grants to Tribal
nations and five urban Indian communities for traditional healing practices for American
Indians and to increase the capacity of culturally specific providers in the behavioral health
workforce.
(e) $400,000 is appropriated to the commissioner of human services for competitive
grants for opioid-focused Project ECHO programs.
(f) $277,000 in fiscal year 2024 and $321,000 each year thereafter is appropriated to the
commissioner of human services to administer the funding distribution and reporting
requirements in paragraph (o).
(g) $3,000,000 in fiscal year 2025 and $3,000,000 each year thereafter is appropriated
to the commissioner of human services for safe recovery sites start-up and capacity building
grants under section 254B.18.
(h) $395,000 in fiscal year 2024 and $415,000 each year thereafter is appropriated to
the commissioner of human services for the opioid overdose surge alert system under section
245.891.
(i) $300,000 is appropriated to the commissioner of management and budget for
evaluation activities under section 256.042, subdivision 1, paragraph (c).
(j) $261,000 is appropriated to the commissioner of human services for the provision of
administrative services to the Opiate Epidemic Response Advisory Council and for the
administration of the grants awarded under paragraph (n).
(k) $126,000 is appropriated to the Board of Pharmacy for the collection of the registration
fees under section 151.066.
(l) $672,000 is appropriated to the commissioner of public safety for the Bureau of
Criminal Apprehension. Of this amount, $384,000 is for drug scientists and lab supplies
and $288,000 is for special agent positions focused on drug interdiction and drug trafficking.
(m) After the appropriations in paragraphs (b) to (l) are made, 50 percent of the remaining
amount is appropriated to the commissioner of deleted text begin human servicesdeleted text end new text begin children, youth, and familiesnew text end
for distribution to county social service agencies and Tribal social service agency initiative
projects authorized under section 256.01, subdivision 14b, to provide child protection
services to children and families who are affected by addiction. The commissioner shall
distribute this money proportionally to county social service agencies and Tribal social
service agency initiative projects based on out-of-home placement episodes where parental
drug abuse is the primary reason for the out-of-home placement using data from the previous
calendar year. County social service agencies and Tribal social service agency initiative
projects receiving funds from the opiate epidemic response fund must annually report to
the commissioner on how the funds were used to provide child protection services, including
measurable outcomes, as determined by the commissioner. County social service agencies
and Tribal social service agency initiative projects must not use funds received under this
paragraph to supplant current state or local funding received for child protection services
for children and families who are affected by addiction.
(n) After the appropriations in paragraphs (b) to (m) are made, the remaining amount in
the account is appropriated to the commissioner of human services to award grants as
specified by the Opiate Epidemic Response Advisory Council in accordance with section
256.042, unless otherwise appropriated by the legislature.
(o) Beginning in fiscal year 2022 and each year thereafter, funds for county social service
agencies and Tribal social service agency initiative projects under paragraph (m) and grant
funds specified by the Opiate Epidemic Response Advisory Council under paragraph (n)
may be distributed on a calendar year basis.
(p) Notwithstanding section 16A.28, subdivision 3, funds appropriated in paragraphs
(c), (d), (e), (g), (m), and (n) are available for three years after the funds are appropriated.
Sec. 11.
Minnesota Statutes 2023 Supplement, section 256.043, subdivision 3a, is amended
to read:
Subd. 3a.
Appropriations from settlement account.
(a) The appropriations in paragraphs
(b) to (e) shall be made from the settlement account on a fiscal year basis in the order
specified.
(b) If the balance in the registration and license fee account is not sufficient to fully fund
the appropriations specified in subdivision 3, paragraphs (b) to (l), an amount necessary to
meet any insufficiency shall be transferred from the settlement account to the registration
and license fee account to fully fund the required appropriations.
(c) $209,000 in fiscal year 2023 and $239,000 in fiscal year 2024 and subsequent fiscal
years are appropriated to the commissioner of human services for the administration of
grants awarded under paragraph (e). $276,000 in fiscal year 2023 and $151,000 in fiscal
year 2024 and subsequent fiscal years are appropriated to the commissioner of human
services to collect, collate, and report data submitted and to monitor compliance with
reporting and settlement expenditure requirements by grantees awarded grants under this
section and municipalities receiving direct payments from a statewide opioid settlement
agreement as defined in section 256.042, subdivision 6.
(d) After any appropriations necessary under paragraphs (b) and (c) are made, an amount
equal to the calendar year allocation to Tribal social service agency initiative projects under
subdivision 3, paragraph (m), is appropriated from the settlement account to the commissioner
of deleted text begin human servicesdeleted text end new text begin children, youth, and familiesnew text end for distribution to Tribal social service
agency initiative projects to provide child protection services to children and families who
are affected by addiction. The requirements related to proportional distribution, annual
reporting, and maintenance of effort specified in subdivision 3, paragraph (m), also apply
to the appropriations made under this paragraph.
(e) After making the appropriations in paragraphs (b), (c), and (d), the remaining amount
in the account is appropriated to the commissioner of human services to award grants as
specified by the Opiate Epidemic Response Advisory Council in accordance with section
256.042.
(f) Funds for Tribal social service agency initiative projects under paragraph (d) and
grant funds specified by the Opiate Epidemic Response Advisory Council under paragraph
(e) may be distributed on a calendar year basis.
(g) Notwithstanding section 16A.28, subdivision 3, funds appropriated in paragraphs
(d) and (e) are available for three years after the funds are appropriated.
Sec. 12.
Minnesota Statutes 2023 Supplement, section 256.045, subdivision 3, as amended
by Laws 2024, chapter 79, article 3, section 3, and Laws 2024, chapter 80, article 1, section
67, is amended to read:
Subd. 3.
State agency hearings.
(a) State agency hearings are available for the following:
(1) any person:
(i) applying for, receiving or having received public assistance, medical care, or a program
of social services administered by the commissioner or a county agency on behalf of the
commissioner; and
(ii) whose application for assistance is denied, not acted upon with reasonable promptness,
or whose assistance is suspended, reduced, terminated, or claimed to have been incorrectly
paid;
(2) any patient or relative aggrieved by an order of the commissioner under section
252.27;
(3) a party aggrieved by a ruling of a prepaid health plan;
(4) except as provided under chapter 245C, any individual or facility determined by a
lead investigative agency to have maltreated a vulnerable adult under section 626.557 after
they have exercised their right to administrative reconsideration under section 626.557;
(5) any person to whom a right of appeal according to this section is given by other
provision of law;
(6) an applicant aggrieved by an adverse decision to an application for a hardship waiver
under section 256B.15;
(7) an applicant aggrieved by an adverse decision to an application or redetermination
for a Medicare Part D prescription drug subsidy under section 256B.04, subdivision 4a;
new text begin
(8) except as provided under chapter 245A, an individual or facility determined to have
maltreated a minor under chapter 260E, after the individual or facility has exercised the
right to administrative reconsideration under chapter 260E;
new text end
deleted text begin (8)deleted text end new text begin (9)new text end except as provided under chapter 245C deleted text begin and except for a subject of a background
study that the commissioner has conducted on behalf of another agency for a program or
facility not otherwise overseen by the commissionerdeleted text end , an individual disqualified under sections
245C.14 and 245C.15, following a reconsideration decision issued under section 245C.23,
on the basis of serious or recurring maltreatment; a preponderance of the evidence that the
individual has committed an act or acts that meet the definition of any of the crimes listed
in section 245C.15, subdivisions 1 to 4; or for failing to make reports required under section
260E.06, subdivision 1, or 626.557, subdivision 3. Hearings regarding a maltreatment
determination under clause (4) or (8) deleted text begin or section 142A.20, subdivision 3, clause (4)deleted text end , and a
disqualification under this clause in which the basis for a disqualification is serious or
recurring maltreatment, shall be consolidated into a single fair hearing. In such cases, the
scope of review by the human services judge shall include both the maltreatment
determination and the disqualification. The failure to exercise the right to an administrative
reconsideration shall not be a bar to a hearing under this section if federal law provides an
individual the right to a hearing to dispute a finding of maltreatment;
deleted text begin (9)deleted text end new text begin (10)new text end any person with an outstanding debt resulting from receipt of public assistance
administered by the commissioner or medical care who is contesting a setoff claim by the
Department of Human Services or a county agency. The scope of the appeal is the validity
of the claimant agency's intention to request a setoff of a refund under chapter 270A against
the debt;
deleted text begin (10)deleted text end new text begin (11)new text end a person issued a notice of service termination under section 245D.10,
subdivision 3a, by a licensed provider of any residential supports or services listed in section
245D.03, subdivision 1, paragraphs (b) and (c), that is not otherwise subject to appeal under
subdivision 4a;
deleted text begin (11)deleted text end new text begin (12)new text end an individual disability waiver recipient based on a denial of a request for a
rate exception under section 256B.4914;
deleted text begin (12)deleted text end new text begin (13)new text end a person issued a notice of service termination under section 245A.11,
subdivision 11, that is not otherwise subject to appeal under subdivision 4a; or
deleted text begin (13)deleted text end new text begin (14)new text end a recovery community organization seeking medical assistance vendor eligibility
under section 254B.01, subdivision 8, that is aggrieved by a membership or accreditation
determination and that believes the organization meets the requirements under section
254B.05, subdivision 1, paragraph (d), clauses (1) to (10). The scope of the review by the
human services judge shall be limited to whether the organization meets each of the
requirements under section 254B.05, subdivision 1, paragraph (d), clauses (1) to (10).
(b) The hearing for an individual or facility under paragraph (a), clause (4), (8), or (9),
is the only administrative appeal to the final agency determination specifically, including
a challenge to the accuracy and completeness of data under section 13.04. Hearings requested
under paragraph (a), clause (4), apply only to incidents of maltreatment that occur on or
after October 1, 1995. Hearings requested by nursing assistants in nursing homes alleged
to have maltreated a resident prior to October 1, 1995, shall be held as a contested case
proceeding under the provisions of chapter 14. Hearings requested under paragraph (a),
clause (8), apply only to incidents of maltreatment that occur on or after July 1, 1997. A
hearing for an individual or facility under paragraph (a), clause (4), (8), or (9), is only
available when there is no district court action pending. If such action is filed in district
court while an administrative review is pending that arises out of some or all of the events
or circumstances on which the appeal is based, the administrative review must be suspended
until the judicial actions are completed. If the district court proceedings are completed,
dismissed, or overturned, the matter may be considered in an administrative hearing.
(c) For purposes of this section, bargaining unit grievance procedures are not an
administrative appeal.
new text begin
(d) The scope of hearings involving claims to foster care payments under section 142A.20,
subdivision 2, clause (2), shall be limited to the issue of whether the county is legally
responsible for a child's placement under court order or voluntary placement agreement
and, if so, the correct amount of foster care payment to be made on the child's behalf and
shall not include review of the propriety of the county's child protection determination or
child placement decision.
new text end
deleted text begin (d)deleted text end new text begin (e)new text end The scope of hearings under paragraph (a), clauses (11) and (13), shall be limited
to whether the proposed termination of services is authorized under section 245D.10,
subdivision 3a, paragraph (b), or 245A.11, subdivision 11, and whether the requirements
of section 245D.10, subdivision 3a, paragraphs (c) to (e), or 245A.11, subdivision 2a,
paragraphs (d) and (e), were met. If the appeal includes a request for a temporary stay of
termination of services, the scope of the hearing shall also include whether the case
management provider has finalized arrangements for a residential facility, a program, or
services that will meet the assessed needs of the recipient by the effective date of the service
termination.
deleted text begin (e)deleted text end new text begin (f)new text end A vendor of medical care as defined in section 256B.02, subdivision 7, or a vendor
under contract with a county agency to provide social services is not a party and may not
request a hearing under this section, except if assisting a recipient as provided in subdivision
4.
deleted text begin (f)deleted text end new text begin (g)new text end An applicant or recipient is not entitled to receive social services beyond the
services prescribed under chapter 256M or other social services the person is eligible for
under state law.
deleted text begin (g)deleted text end new text begin (h)new text end The commissioner may summarily affirm the county or state agency's proposed
action without a hearing when the sole issue is an automatic change due to a change in state
or federal law, except in matters covered by paragraph deleted text begin (h)deleted text end new text begin (i)new text end .
deleted text begin (h)deleted text end new text begin (i)new text end When the subject of an administrative review is a matter within the jurisdiction
of the direct care and treatment executive board as a part of the board's powers and duties
under chapter 246C, the executive board may summarily affirm the county or state agency's
proposed action without a hearing when the sole issue is an automatic change due to a
change in state or federal law.
deleted text begin (i)deleted text end new text begin (j)new text end Unless federal or Minnesota law specifies a different time frame in which to file
an appeal, an individual or organization specified in this section may contest the specified
action, decision, or final disposition before the state agency by submitting a written request
for a hearing to the state agency within 30 days after receiving written notice of the action,
decision, or final disposition, or within 90 days of such written notice if the applicant,
recipient, patient, or relative shows good cause, as defined in section 256.0451, subdivision
13, why the request was not submitted within the 30-day time limit. The individual filing
the appeal has the burden of proving good cause by a preponderance of the evidence.
Sec. 13.
Minnesota Statutes 2022, section 256.045, subdivision 3b, as amended by Laws
2024, chapter 80, article 1, section 68, is amended to read:
Subd. 3b.
Standard of evidence for maltreatment and disqualification hearings.
(a)
The state human services judge shall determine that maltreatment has occurred if a
preponderance of evidence exists to support the final disposition under section 626.557 and
chapter 260E. For purposes of hearings regarding disqualification, the state human services
judge shall affirm the proposed disqualification in an appeal under subdivision 3, paragraph
(a), clause (9), if a preponderance of the evidence shows the individual has:
(1) committed maltreatment under section 626.557 or chapter 260E that is serious or
recurring;
(2) committed an act or acts meeting the definition of any of the crimes listed in section
245C.15, subdivisions 1 to 4; or
(3) failed to make required reports under section 626.557 or chapter 260E, for incidents
in which the final disposition under section 626.557 or chapter 260E was substantiated
maltreatment that was serious or recurring.
(b) If the disqualification is affirmed, the state human services judge shall determine
whether the individual poses a risk of harm in accordance with the requirements of section
245C.22, and whether the disqualification should be set aside or not set aside. In determining
whether the disqualification should be set aside, the human services judge shall consider
all of the characteristics that cause the individual to be disqualified, including those
characteristics that were not subject to review under paragraph (a), in order to determine
whether the individual poses a risk of harm. A decision to set aside a disqualification that
is the subject of the hearing constitutes a determination that the individual does not pose a
risk of harm and that the individual may provide direct contact services in the individual
program specified in the set aside.
(c) If a disqualification is based solely on a conviction or is conclusive for any reason
under section 245C.29, the disqualified individual does not have a right to a hearing under
this section.
(d) The state human services judge shall recommend an order to the commissioner of
healthdeleted text begin ,deleted text end new text begin ;new text end educationdeleted text begin ,deleted text end new text begin ; children, youth, and families;new text end or human services, as applicable, who
shall issue a final order. The commissioner shall affirm, reverse, or modify the final
disposition. Any order of the commissioner issued in accordance with this subdivision is
conclusive upon the parties unless appeal is taken in the manner provided in subdivision 7.
In any licensing appeal under chapters 245A and 245C and sections 144.50 to 144.58 and
144A.02 to 144A.482, the commissioner's determination as to maltreatment is conclusive,
as provided under section 245C.29.
Sec. 14.
Minnesota Statutes 2022, section 256.045, subdivision 5, as amended by Laws
2024, chapter 79, article 3, section 4, is amended to read:
Subd. 5.
Orders of the commissioner of human services.
(a) Except as provided for
under subdivision 5a for matters under the jurisdiction of the direct care and treatment
executive boardnew text begin and for hearings held under section 142A.20, subdivision 2new text end , a state human
services judge shall conduct a hearing on the appeal and shall recommend an order to the
commissioner of human services. The recommended order must be based on all relevant
evidence and must not be limited to a review of the propriety of the state or county agency's
action. A human services judge may take official notice of adjudicative facts. The
commissioner of human services may accept the recommended order of a state human
services judge and issue the order to the county agency and the applicant, recipient, former
recipient, or prepaid health plan. The commissioner on refusing to accept the recommended
order of the state human services judge, shall notify the petitioner, the agency, or prepaid
health plan of that fact and shall state reasons therefor and shall allow each party ten days'
time to submit additional written argument on the matter. After the expiration of the ten-day
period, the commissioner shall issue an order on the matter to the petitioner, the agency, or
prepaid health plan.
(b) A party aggrieved by an order of the commissioner may appeal under subdivision
7, or request reconsideration by the commissioner within 30 days after the date the
commissioner issues the order. The commissioner may reconsider an order upon request of
any party or on the commissioner's own motion. A request for reconsideration does not stay
implementation of the commissioner's order. The person seeking reconsideration has the
burden to demonstrate why the matter should be reconsidered. The request for reconsideration
may include legal argument and proposed additional evidence supporting the request. If
proposed additional evidence is submitted, the person must explain why the proposed
additional evidence was not provided at the time of the hearing. If reconsideration is granted,
the other participants must be sent a copy of all material submitted in support of the request
for reconsideration and must be given ten days to respond. Upon reconsideration, the
commissioner may issue an amended order or an order affirming the original order.
(c) Any order of the commissioner issued under this subdivision shall be conclusive
upon the parties unless appeal is taken in the manner provided by subdivision 7. Any order
of the commissioner is binding on the parties and must be implemented by the state agency,
a county agency, or a prepaid health plan according to subdivision 3a, until the order is
reversed by the district court, or unless the commissioner or a district court orders monthly
assistance or aid or services paid or provided under subdivision 10.
(d) A vendor of medical care as defined in section 256B.02, subdivision 7, or a vendor
under contract with a county agency to provide social services is not a party and may not
request a hearing or seek judicial review of an order issued under this section, unless assisting
a recipient as provided in subdivision 4. A prepaid health plan is a party to an appeal under
subdivision 3a, but cannot seek judicial review of an order issued under this section.
Sec. 15.
Minnesota Statutes 2022, section 256.045, subdivision 7, as amended by Laws
2024, chapter 79, article 3, section 7, is amended to read:
Subd. 7.
Judicial review.
Except for a prepaid health plan, any party who is aggrieved
by an order of the commissioner of human servicesdeleted text begin ,deleted text end new text begin ;new text end the commissioner of healthnew text begin ; or the
commissioner of children, youth, and familiesnew text end in appeals within the commissioner's
jurisdiction under subdivision 3bdeleted text begin ,deleted text end new text begin ;new text end or the direct care and treatment executive board in appeals
within the jurisdiction of the executive board under subdivision 5a may appeal the order to
the district court of the county responsible for furnishing assistance, or, in appeals under
subdivision 3b, the county where the maltreatment occurred, by serving a written copy of
a notice of appeal upon the applicable commissioner or executive board and any adverse
party of record within 30 days after the date the commissioner or executive board issued
the order, the amended order, or order affirming the original order, and by filing the original
notice and proof of service with the court administrator of the district court. Service may
be made personally or by mail; service by mail is complete upon mailing; no filing fee shall
be required by the court administrator in appeals taken pursuant to this subdivision, with
the exception of appeals taken under subdivision 3b. The applicable commissioner or
executive board may elect to become a party to the proceedings in the district court. Except
for appeals under subdivision 3b, any party may demand that the commissioner or executive
board furnish all parties to the proceedings with a copy of the decision, and a transcript of
any testimony, evidence, or other supporting papers from the hearing held before the human
services judge, by serving a written demand upon the applicable commissioner or executive
board within 30 days after service of the notice of appeal. Any party aggrieved by the failure
of an adverse party to obey an order issued by the commissioner or executive board under
subdivisions 5 or 5a may compel performance according to the order in the manner prescribed
in sections 586.01 to 586.12.
Sec. 16.
Minnesota Statutes 2022, section 256.0451, subdivision 1, as amended by Laws
2024, chapter 80, article 1, section 72, is amended to read:
Subdivision 1.
Scope.
(a) The requirements in this section apply to all fair hearings and
appeals under deleted text begin sectiondeleted text end new text begin sections 142A.20, subdivision 2, andnew text end 256.045, subdivision 3, paragraph
(a), clauses (1), (2), (3), (5), (6), (7), deleted text begin (8), (11)deleted text end new text begin (10)new text end , and deleted text begin (13)deleted text end new text begin (12)new text end . Except as provided in
subdivisions 3 and 19, the requirements under this section apply to fair hearings and appeals
under section 256.045, subdivision 3, paragraph (a), clauses (4),new text begin (8),new text end (9), deleted text begin (10),deleted text end and deleted text begin (12)deleted text end new text begin (11)new text end .
(b) For purposes of this section, "person" means an individual who, on behalf of
themselves or their household, is appealing or disputing or challenging an action, a decision,
or a failure to act, by an agency in the human services system. When a person involved in
a proceeding under this section is represented by an attorney or by an authorized
representative, the term "person" also means the person's attorney or authorized
representative. Any notice sent to the person involved in the hearing must also be sent to
the person's attorney or authorized representative.
(c) For purposes of this section, "agency" means the county human services agency, the
state human services agency, and, where applicable, any entity involved under a contract,
subcontract, grant, or subgrant with the state agency or with a county agency, that provides
or operates programs or services in which appeals are governed by section 256.045.
Sec. 17.
Minnesota Statutes 2022, section 256.0451, subdivision 22, is amended to read:
Subd. 22.
Decisions.
A timely, written decision must be issued in every appeal. Each
decision must contain a clear ruling on the issues presented in the appeal hearing and should
contain a ruling only on questions directly presented by the appeal and the arguments raised
in the appeal.
(a) A written decision must be issued within 90 days of the date the person involved
requested the appeal unless a shorter time is required by law. An additional 30 days is
provided in those cases where the commissioner refuses to accept the recommended decision.
In appeals of maltreatment determinations or disqualifications filed pursuant to section
256.045, subdivision 3, paragraph (a), clause (4),new text begin (8), ornew text end (9), deleted text begin or (10),deleted text end that also give rise to
possible licensing actions, the 90-day period for issuing final decisions does not begin until
the later of the date that the licensing authority provides notice to the appeals division that
the authority has made the final determination in the matter or the date the appellant files
the last appeal in the consolidated matters.
(b) The decision must contain both findings of fact and conclusions of law, clearly
separated and identified. The findings of fact must be based on the entire record. Each
finding of fact made by the human services judge shall be supported by a preponderance
of the evidence unless a different standard is required under the regulations of a particular
program. The "preponderance of the evidence" means, in light of the record as a whole, the
evidence leads the human services judge to believe that the finding of fact is more likely to
be true than not true. The legal claims or arguments of a participant do not constitute either
a finding of fact or a conclusion of law, except to the extent the human services judge adopts
an argument as a finding of fact or conclusion of law.
The decision shall contain at least the following:
(1) a listing of the date and place of the hearing and the participants at the hearing;
(2) a clear and precise statement of the issues, including the dispute under consideration
and the specific points which must be resolved in order to decide the case;
(3) a listing of the material, including exhibits, records, reports, placed into evidence at
the hearing, and upon which the hearing decision is based;
(4) the findings of fact based upon the entire hearing record. The findings of fact must
be adequate to inform the participants and any interested person in the public of the basis
of the decision. If the evidence is in conflict on an issue which must be resolved, the findings
of fact must state the reasoning used in resolving the conflict;
(5) conclusions of law that address the legal authority for the hearing and the ruling, and
which give appropriate attention to the claims of the participants to the hearing;
(6) a clear and precise statement of the decision made resolving the dispute under
consideration in the hearing; and
(7) written notice of the right to appeal to district court or to request reconsideration,
and of the actions required and the time limits for taking appropriate action to appeal to
district court or to request a reconsideration.
(c) The human services judge shall not independently investigate facts or otherwise rely
on information not presented at the hearing. The human services judge may not contact
other agency personnel, except as provided in subdivision 18. The human services judge's
recommended decision must be based exclusively on the testimony and evidence presented
at the hearing, and legal arguments presented, and the human services judge's research and
knowledge of the law.
(d) The commissioner will review the recommended decision and accept or refuse to
accept the decision according to sectionnew text begin 142A.20, subdivision 3, ornew text end 256.045, subdivision
5.
Sec. 18.
Minnesota Statutes 2022, section 256.0451, subdivision 24, is amended to read:
Subd. 24.
Reconsideration.
(a) Reconsideration may be requested within 30 days of
the date of the commissioner's final order. If reconsideration is requested under sectionnew text begin
142A.20, subdivision 3, ornew text end 256.045, subdivision 5, the other participants in the appeal shall
be informed of the request. The person seeking reconsideration has the burden to demonstrate
why the matter should be reconsidered. The request for reconsideration may include legal
argument and may include proposed additional evidence supporting the request. The other
participants shall be sent a copy of all material submitted in support of the request for
reconsideration and must be given ten days to respond.
(b) When the requesting party raises a question as to the appropriateness of the findings
of fact, the commissioner shall review the entire record.
(c) When the requesting party questions the appropriateness of a conclusion of law, the
commissioner shall consider the recommended decision, the decision under reconsideration,
and the material submitted in connection with the reconsideration. The commissioner shall
review the remaining record as necessary to issue a reconsidered decision.
(d) The commissioner shall issue a written decision on reconsideration in a timely fashion.
The decision must clearly inform the parties that this constitutes the final administrative
decision, advise the participants of the right to seek judicial review, and the deadline for
doing so.
Sec. 19.
Minnesota Statutes 2022, section 256.046, subdivision 2, as amended by Laws
2024, chapter 80, article 1, section 75, is amended to read:
Subd. 2.
Combined hearing.
deleted text begin (a)deleted text end The human services judge may combine a fair hearing
under section 142A.20 or 256.045 and administrative fraud disqualification hearing under
this section or section 142A.27 into a single hearing if the factual issues arise out of the
same, or related, circumstancesdeleted text begin ; the commissioner of human services has jurisdiction over
at least one of the hearings;deleted text end and the individual receives prior notice that the hearings will
be combined. If the administrative fraud disqualification hearing and fair hearing are
combined, the time frames for administrative fraud disqualification hearings specified in
Code of Federal Regulations, title 7, section 273.16, apply. If the individual accused of
wrongfully obtaining assistance is charged under section 256.98 for the same act or acts
which are the subject of the hearing, the individual may request that the hearing be delayed
until the criminal charge is decided by the court or withdrawn.
deleted text begin
(b) The human services judge must conduct any hearings under section 142A.20 or
142A.27 pursuant to the relevant laws and rules governing children, youth, and families
judges.
deleted text end
Sec. 20.
Minnesota Statutes 2023 Supplement, section 256M.42, is amended by adding a
subdivision to read:
new text begin Subd. 7. new text end
new text begin Adult protection grant allocation under Reform 2020. new text end
new text begin
The requirements of
subdivisions 2 to 6 apply to the Reform 2020 adult protection state grants in Minnesota
Statutes 2013 Supplement, section 256M.40, subdivision 1, and Laws 2013, chapter 108,
article 15. The Reform 2020 state adult protection grant must be allocated annually consistent
with the calendar year 2023 allocation made under section 256M.40.
new text end
Sec. 21.
Laws 2023, chapter 70, article 12, section 30, subdivision 2, is amended to read:
Subd. 2.
Department of Human Services.
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:
(1) family services and community-based collaboratives under Minnesota Statutes,
section 124D.23;
(2) child care programs under Minnesota Statutes, chapter 119B;
(3) Parent Aware quality rating and improvement system under Minnesota Statutes,
section 124D.142;
(4) migrant child care services under Minnesota Statutes, section 256M.50;
(5) early childhood and school-age professional development training under Laws 2007,
chapter 147, article 2, section 56;
(6) licensure of family child care and child care centers, child foster care, and private
child placing agencies under Minnesota Statutes, chapter 245A;
(7) certification of license-exempt child care centers under Minnesota Statutes, chapter
245H;
(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;
(9) SNAP under Minnesota Statutes, sections 256D.60 to 256D.63;
(10) electronic benefit transactions under Minnesota Statutes, sections 256.9862,
256.9863, 256.9865, 256.987, 256.9871, 256.9872, and 256J.77;
(11) Minnesota food assistance program under Minnesota Statutes, section 256D.64;
(12) Minnesota food shelf program under Minnesota Statutes, section 256E.34;
(13) MFIP and Temporary Assistance for Needy Families (TANF) under Minnesota
Statutes, sections 256.9864 and 256.9865 and chapters 256J and 256P;
(14) Diversionary Work Program (DWP) under Minnesota Statutes, section 256J.95;
(15) deleted text begin resettlement programs under Minnesota Statutes, section 256B.06, subdivision 6deleted text end new text begin
American Indian food sovereignty program under Minnesota Statutes, section 256E.342new text end ;
(16) child abuse under Minnesota Statutes, chapter 256E;
(17) reporting of the maltreatment of minors under Minnesota Statutes, chapter 260E;
(18) children in voluntary foster care for treatment under Minnesota Statutes, chapter
260D;
(19) juvenile safety and placement under Minnesota Statutes, chapter 260C;
(20) the Minnesota Indian Family Preservation Act under Minnesota Statutes, sections
260.751 to 260.835;
(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;
(22) adoption under Minnesota Statutes, sections 259.20 to 259.89;
(23) Northstar Care for Children under Minnesota Statutes, chapter 256N;
(24) child support under Minnesota Statutes, chapters 13, 13B, 214, 256, 256J, 257, 259,
518, 518A, 518C, 551, 552, 571, and 588, and Minnesota Statutes, section 609.375;
(25) community action programs under Minnesota Statutes, sections 256E.30 to 256E.32;
deleted text begin and
deleted text end
(26) Family Assets for Independence in Minnesota under Minnesota Statutes, section
256E.35deleted text begin .deleted text end new text begin ;
new text end
new text begin
(27) capital for emergency food distribution facilities under Laws 2023, chapter 70,
article 20, section 2, subdivision 24, paragraph (i);
new text end
new text begin
(28) community resource centers under Laws 2023, chapter 70, article 14, section 42;
new text end
new text begin
(29) diaper distribution grant program under Minnesota Statutes, section 256E.38;
new text end
new text begin
(30) emergency services program under Minnesota Statutes, section 256E.36;
new text end
new text begin
(31) emergency shelter facilities grants under Laws 2023, chapter 70, article 11, section
14;
new text end
new text begin
(32) Family First Prevention Services Act support and development grant program under
Minnesota Statutes, section 256.4793;
new text end
new text begin
(33) Family First Prevention Services Act kinship navigator program under Minnesota
Statutes, section 256.4794;
new text end
new text begin
(34) family first prevention and early intervention allocation program under Minnesota
Statutes, section 260.014;
new text end
new text begin
(35) grants for prepared meals food relief under Laws 2023, chapter 70, article 12, section
33;
new text end
new text begin
(36) Homeless Youth Act under Minnesota Statutes, sections 256K.45 to 256K.451;
new text end
new text begin
(37) homeless youth cash stipend pilot under Laws 2023, chapter 70, article 11, section
13;
new text end
new text begin
(38) independent living skills for foster youth under Laws 2023, chapter 70, article 14,
section 41;
new text end
new text begin
(39) legacy adoption assistance under Minnesota Statutes, chapter 259A;
new text end
new text begin
(40) quality parenting initiative grant program under Minnesota Statutes, section
245.0962;
new text end
new text begin
(41) relative custody assistance under Minnesota Statutes, section 257.85;
new text end
new text begin
(42) reimbursement to counties and Tribes for certain out-of-home placements under
Minnesota Statutes, section 477A.0126;
new text end
new text begin
(43) safe harbor shelter and housing under Minnesota Statutes, section 256K.47;
new text end
new text begin
(44) shelter-linked youth mental health grants under Minnesota Statutes, section 256K.46;
new text end
new text begin
(45) Supplemental Nutrition Assistance Program outreach under Minnesota Statutes,
section 256D.65; and
new text end
new text begin
(46) transitional housing programs under Minnesota Statutes, section 256E.33.
new text end
Sec. 22.
Laws 2023, chapter 70, article 12, section 30, subdivision 3, is amended to read:
Subd. 3.
Department of Education.
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:
(1) Head Start Program and Early Head Start under Minnesota Statutes, sections 119A.50
to 119A.545;
(2) the early childhood screening program under Minnesota Statutes, sections 121A.16
to 121A.19;
(3) early learning scholarships under Minnesota Statutes, section 124D.165;
(4) the interagency early childhood intervention system under Minnesota Statutes,
sections 125A.259 to 125A.48;
(5) voluntary prekindergarten programs and school readiness plus programs under
Minnesota Statutes, section 124D.151;
(6) early childhood family education programs under Minnesota Statutes, sections
124D.13 to 124D.135;
(7) school readiness under Minnesota Statutes, sections 124D.15 to 124D.16; deleted text begin and
deleted text end
(8) after-school community learning programs under Minnesota Statutes, section
124D.2211deleted text begin .deleted text end new text begin ; and
new text end
new text begin
(9) grow your own program under Minnesota Statutes, section 122A.731.
new text end
Sec. 23.
Laws 2024, chapter 80, article 1, section 38, subdivision 1, is amended to read:
Subdivision 1.
deleted text begin Children, youth, and families judges; appointmentdeleted text end new text begin Hearings held by
the Department of Human Servicesnew text end .
deleted text begin
The commissioner of children, youth, and families
may appoint one or more state children, youth, and families judges to conduct hearings and
recommend orders in accordance with subdivisions 2, 3, and 5. Children, youth, and families
judges designated pursuant to this section may administer oaths and shall be under the
control and supervision of the commissioner of children, youth, and families and shall not
be a part of the Office of Administrative Hearings established pursuant to sections 14.48 to
14.56. The commissioner shall only appoint as a full-time children, youth, and families
judge an individual who is licensed to practice law in Minnesota and who is:
deleted text end
deleted text begin
(1) in active status;
deleted text end
deleted text begin
(2) an inactive resident;
deleted text end
deleted text begin
(3) retired;
deleted text end
deleted text begin
(4) on disabled status; or
deleted text end
deleted text begin
(5) on retired senior status.
deleted text end
new text begin
All state agency hearings under subdivision 2 must be heard by a human services judge
pursuant to sections 256.045 and 256.0451.
new text end
Sec. 24.
Laws 2024, chapter 80, article 1, section 38, subdivision 2, is amended to read:
Subd. 2.
State agency hearings.
deleted text begin (a)deleted text end State agency hearings are available for the following:
(1) any person:
(i) applying for, receiving, or having received public assistance or a program of social
services administered by the commissioner or a county agency on behalf of the commissioner
or the federal Food and Nutrition Act; and
(ii) whose application for assistance is denied, not acted upon with reasonable promptness,
or whose assistance is suspended, reduced, terminated, or claimed to have been incorrectly
paid;
(2) any person whose claim for foster care payment according to a placement of the
child resulting from a child protection assessment under chapter 260E is denied or not acted
upon with reasonable promptness, regardless of funding source;
(3) any person to whom a right of appeal according to this section is given by other
provision of law;new text begin and
new text end
deleted text begin
(4) except as provided under chapter 142B, an individual or facility determined to have
maltreated a minor under chapter 260E, after the individual or facility has exercised the
right to administrative reconsideration under chapter 260E;
deleted text end
deleted text begin
(5) except as provided under chapter 245C, an individual disqualified under sections
245C.14 and 245C.15, following a reconsideration decision issued under section 245C.23,
on the basis of serious or recurring maltreatment; of a preponderance of the evidence that
the individual has committed an act or acts that meet the definition of any of the crimes
listed in section 245C.15, subdivisions 1 to 4; or for failing to make reports required under
section 260E.06, subdivision 1, or 626.557, subdivision 3. Hearings regarding a maltreatment
determination under clause (4) and a disqualification under this clause in which the basis
for a disqualification is serious or recurring maltreatment shall be consolidated into a single
fair hearing. In such cases, the scope of review by the children, youth, and families judge
shall include both the maltreatment determination and the disqualification. The failure to
exercise the right to an administrative reconsideration shall not be a bar to a hearing under
this section if federal law provides an individual the right to a hearing to dispute a finding
of maltreatment; and
deleted text end
deleted text begin (6)deleted text end new text begin (4)new text end any person with an outstanding debt resulting from receipt of public assistance
or the federal Food and Nutrition Act who is contesting a setoff claim by the commissioner
of children, youth, and families or a county agency. The scope of the appeal is the validity
of the claimant agency's intention to request a setoff of a refund under chapter 270A against
the debt.
deleted text begin
(b) The hearing for an individual or facility under paragraph (a), clause (4) or (5), is the
only administrative appeal to the final agency determination specifically, including a
challenge to the accuracy and completeness of data under section 13.04. A hearing for an
individual or facility under paragraph (a), clause (4) or (5), is only available when there is
no district court action pending. If such action is filed in district court while an administrative
review is pending that arises out of some or all of the events or circumstances on which the
appeal is based, the administrative review must be suspended until the judicial actions are
completed. If the district court proceedings are completed, dismissed, or overturned, the
matter may be considered in an administrative hearing.
deleted text end
deleted text begin
(c) For purposes of this section, bargaining unit grievance procedures are not an
administrative appeal.
deleted text end
deleted text begin
(d) The scope of hearings involving claims to foster care payments under paragraph (a),
clause (2), shall be limited to the issue of whether the county is legally responsible for a
child's placement under court order or voluntary placement agreement and, if so, the correct
amount of foster care payment to be made on the child's behalf and shall not include review
of the propriety of the county's child protection determination or child placement decision.
deleted text end
deleted text begin
(e) An applicant or recipient is not entitled to receive social services beyond the services
prescribed under chapter 256M or other social services the person is eligible for under state
law.
deleted text end
deleted text begin
(f) The commissioner may summarily affirm the county or state agency's proposed action
without a hearing when the sole issue is an automatic change due to a change in state or
federal law.
deleted text end
deleted text begin
(g) Unless federal or Minnesota law specifies a different time frame in which to file an
appeal, an individual or organization specified in this section may contest the specified
action, decision, or final disposition before the state agency by submitting a written request
for a hearing to the state agency within 30 days after receiving written notice of the action,
decision, or final disposition or within 90 days of such written notice if the applicant,
recipient, patient, or relative shows good cause, as defined in section 142A.21, subdivision
13, why the request was not submitted within the 30-day time limit. The individual filing
the appeal has the burden of proving good cause by a preponderance of the evidence.
deleted text end
Sec. 25.
Laws 2024, chapter 80, article 1, section 38, subdivision 5, is amended to read:
Subd. 5.
Orders of the commissioner of children, youth, and families.
(a) A state
deleted text begin children, youth, and familiesdeleted text end new text begin human servicesnew text end judge shall conduct a hearing on deleted text begin thedeleted text end new text begin annew text end appealnew text begin
of a matter listed in subdivision 2new text end and shall recommend an order to the commissioner of
children, youth, and families. The recommended order must be based on all relevant evidence
and must not be limited to a review of the propriety of the state or county agency's action.
A deleted text begin children, youth, and familiesdeleted text end new text begin state human servicesnew text end judge may take official notice of
adjudicative facts. The commissioner of children, youth, and families may accept the
recommended order of a state deleted text begin children, youth, and familiesdeleted text end new text begin human servicesnew text end judge and issue
the order to the county agency and the applicant, recipient, or former recipient. If the
commissioner refuses to accept the recommended order of the state deleted text begin children, youth, and
familiesdeleted text end new text begin human servicesnew text end judge, the commissioner shall notify the petitioner or the agency
of the commissioner's refusal and shall state reasons for the refusal. The commissioner shall
allow each party ten days' time to submit additional written argument on the matter. After
the expiration of the ten-day period, the commissioner shall issue an order on the matter to
the petitioner and the agency.
(b) A party aggrieved by an order of the commissioner may appeal under subdivision deleted text begin 7deleted text end new text begin
5new text end or request reconsideration by the commissioner within 30 days after the date the
commissioner issues the order. The commissioner may reconsider an order upon request of
any party or on the commissioner's own motion. A request for reconsideration does not stay
implementation of the commissioner's order. The person seeking reconsideration has the
burden to demonstrate why the matter should be reconsidered. The request for reconsideration
may include legal argument and proposed additional evidence supporting the request. If
proposed additional evidence is submitted, the person must explain why the proposed
additional evidence was not provided at the time of the hearing. If reconsideration is granted,
the other participants must be sent a copy of all material submitted in support of the request
for reconsideration and must be given ten days to respond. Upon reconsideration, the
commissioner may issue an amended order or an order affirming the original order.
(c) Any order of the commissioner issued under this subdivision shall be conclusive
upon the parties unless appeal is taken in the manner provided by subdivision deleted text begin 7deleted text end new text begin 5new text end . Any order
of the commissioner is binding on the parties and must be implemented by the state agency
or a county agency until the order is reversed by the district court or unless the commissioner
or a district court orders monthly assistance or aid or services paid or provided under
subdivision deleted text begin 10deleted text end new text begin 8new text end .
(d) A vendor under contract with a county agency to provide social services is not a
party and may not request a hearing or seek judicial review of an order issued under this
section, unless assisting a recipient as provided innew text begin section 256.045,new text end subdivision 4.
Sec. 26.
Laws 2024, chapter 80, article 1, section 38, subdivision 6, is amended to read:
Subd. 6.
Additional powers of commissioner; subpoenas.
(a) The commissioner may
initiate a review of any action or decision of a county agency and direct that the matter be
presented to a state deleted text begin children, youth, and familiesdeleted text end new text begin human servicesnew text end judge for a hearing held
under subdivision 2 or deleted text begin 3deleted text end new text begin section 256.045,new text end new text begin subdivision 3bnew text end . In all matters dealing with children,
youth, and families committed by law to the discretion of the county agency, the
commissioner's judgment may be substituted for that of the county agency. The commissioner
may order an independent examination when appropriate.
(b) Any party to a hearing held pursuant to subdivision 2 or deleted text begin 3deleted text end new text begin section 256.045, subdivision
3b,new text end may request that the commissioner issue a subpoena to compel the attendance of witnesses
and the production of records at the hearing. A local agency may request that the
commissioner issue a subpoena to compel the release of information from third parties prior
to a request for a hearing under section 142A.21 upon a showing of relevance to such a
proceeding. The issuance, service, and enforcement of subpoenas under this subdivision is
governed by section 357.22 and the Minnesota Rules of Civil Procedure.
deleted text begin
(c) The commissioner may issue a temporary order staying a proposed demission by a
residential facility licensed under chapter 142B:
deleted text end
deleted text begin
(1) while an appeal by a recipient under subdivision 3 is pending; or
deleted text end
deleted text begin
(2) for the period of time necessary for the case management provider to implement the
commissioner's order.
deleted text end
Sec. 27.
Laws 2024, chapter 80, article 1, section 38, subdivision 7, is amended to read:
Subd. 7.
Judicial review.
Any party who is aggrieved by an order of the commissioner
of children, youth, and families may appeal the order to the district court of the county
responsible for furnishing assistance, or, in appeals undernew text begin section 256.045,new text end subdivision deleted text begin 3deleted text end new text begin
3bnew text end , the county where the maltreatment occurred, by serving a written copy of a notice of
appeal upon the commissioner and any adverse party of record within 30 days after the date
the commissioner issued the order, the amended order, or order affirming the original order,
and by filing the original notice and proof of service with the court administrator of the
district court. Service may be made personally or by mail; service by mail is complete upon
mailing. The court administrator shall not require a filing fee in appeals taken pursuant to
this subdivision, except for appeals taken undernew text begin section 256.045,new text end subdivision deleted text begin 3deleted text end new text begin 3bnew text end . The
commissioner may elect to become a party to the proceedings in the district court. Except
for appeals undernew text begin section 256.045,new text end subdivision deleted text begin 3deleted text end new text begin 3bnew text end , any party may demand that the
commissioner furnish all parties to the proceedings with a copy of the decision, and a
transcript of any testimony, evidence, or other supporting papers from the hearing held
before the deleted text begin children, youth, and familiesdeleted text end new text begin state human servicesnew text end judge, by serving a written
demand upon the commissioner within 30 days after service of the notice of appeal. Any
party aggrieved by the failure of an adverse party to obey an order issued by the commissioner
under subdivision 5 may compel performance according to the order in the manner prescribed
in sections 586.01 to 586.12.
Sec. 28.
Laws 2024, chapter 80, article 1, section 38, subdivision 9, is amended to read:
Subd. 9.
Appeal.
Any party aggrieved by the order of the district court may appeal the
order as in other civil cases. Except for appeals undernew text begin section 256.045,new text end subdivision deleted text begin 3deleted text end new text begin 3bnew text end ,
no costs or disbursements shall be taxed against any party nor shall any filing fee or bond
be required of any party.
Sec. 29.
Laws 2024, chapter 80, article 1, section 96, is amended to read:
Sec. 96. REVISOR INSTRUCTION.
The revisor of statutes must renumber sections or subdivisions in Column A as Column
B.
The revisor of statutes must correct any statutory cross-references consistent with this
renumbering.
Sec. 30.
Laws 2024, chapter 80, article 2, section 5, subdivision 21, is amended to read:
Subd. 21.
Plan for transfer of clients and records upon closure.
(a) Except for license
holders who reside on the premises and child care providers, an applicant for initial or
continuing licensure or certification must submit a written plan indicating how the programnew text begin
new text end new text begin or private agencynew text end will ensure the transfer of clients and records for both open and closed
cases if the program closes. The plan must provide for managing private and confidential
information concerningnew text begin the clients of thenew text end program deleted text begin clientsdeleted text end new text begin or private agencynew text end . The plan must
also provide for notifying affected clients of the closure at least 25 days prior to closure,
including information on how to access their records. A controlling individual of the program
new text begin or private agency new text end must annually review and sign the plan.
(b) Plans for the transfer of open cases and case records must specify arrangements the
program new text begin or private agency new text end will make to transfer clients to another provider or county agency
for continuation of services and to transfer the case record with the client.
(c) Plans for the transfer of closed case records must be accompanied by a signed
agreement or other documentation indicating that a county or a similarly licensed provider
has agreed to accept and maintain the program's new text begin or private agency's new text end closed case records and
to provide follow-up services as necessary to affected clients.
Sec. 31.
Laws 2024, chapter 80, article 2, section 7, subdivision 2, is amended to read:
Subd. 2.
County fees for applications and licensing inspections.
(a) A county agency
may charge a license fee to an applicant or license holder not to exceed $50 for a one-year
license or $100 for a two-year license.
(b) Counties may allow providers to pay the applicant fee in paragraph (a) on an
installment basis for up to one year. If the provider is receiving child care assistance payments
from the state, the provider may have the fee under paragraph (a) deducted from the child
care assistance payments for up to one year and the state shall reimburse the county for the
county fees collected in this manner.
deleted text begin
(c) For purposes of child foster care licensing under this chapter, a county agency may
charge a fee to a corporate applicant or corporate license holder to recover the actual cost
of licensing inspections, not to exceed $500 annually.
deleted text end
deleted text begin
(d) Counties may elect to reduce or waive the fees in paragraph (c) under the following
circumstances:
deleted text end
deleted text begin
(1) in cases of financial hardship;
deleted text end
deleted text begin
(2) if the county has a shortage of providers in the county's area; or
deleted text end
deleted text begin
(3) for new providers.
deleted text end
Sec. 32.
Laws 2024, chapter 80, article 2, section 10, subdivision 6, is amended to read:
Subd. 6.
Appeal of multiple sanctions.
(a) When the license holder appeals more than
one licensing action or sanction that were simultaneously issued by the commissioner, the
license holder shall specify the actions or sanctions that are being appealed.
(b) If there are different timelines prescribed in statutes for the licensing actions or
sanctions being appealed, the license holder must submit the appeal within the longest of
those timelines specified in statutes.
(c) The appeal 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 the prescribed timeline with the first day beginning
the day after the license holder receives the certified letter. If a request is made by personal
service, it must be received by the commissioner within the prescribed timeline with the
first day beginning the day after the license holder receives the certified letter.new text begin If the appeal
is made through the provider hub, the appeal must be received by the commissioner within
the prescribed timeline with the first day beginning the day after the commissioner issued
the order through the hub.
new text end
(d) When there are different timelines prescribed in statutes for the appeal of licensing
actions or sanctions simultaneously issued by the commissioner, the commissioner shall
specify in the notice to the license holder the timeline for appeal as specified under paragraph
(b).
Sec. 33.
Laws 2024, chapter 80, article 2, section 16, subdivision 1, is amended to read:
Subdivision 1.
Delegation of authority to agencies.
(a) County agencies and private
agencies that have been designated or licensed by the commissioner to perform licensing
functions and activities under section 142B.10 deleted text begin and background studies for family child caredeleted text end
deleted text begin under chapter 245Cdeleted text end ; to recommend denial of applicants under section 142B.15; to issue
correction orders, to issue variances, and to recommend a conditional license under section
142B.16; or to recommend suspending or revoking a license or issuing a fine under section
142B.18, shall comply with rules and directives of the commissioner governing those
functions and with this section. The following variances are excluded from the delegation
of variance authority and may be issued only by the commissioner:
(1) dual licensure of family child care and family child foster caredeleted text begin , dual licensure of
family child foster care and family adult foster care, dual licensure of child foster residence
setting and community residential setting, and dual licensure of family adult foster care and
family child caredeleted text end ;
(2) child foster care maximum age requirement;
(3) variances regarding disqualified individuals;
(4) variances to requirements relating to chemical use problems of a license holder or a
household member of a license holder; and
(5) variances to section 142B.74 for a time-limited period. If the commissioner grants
a variance under this clause, the license holder must provide notice of the variance to all
parents and guardians of the children in care.
new text begin
(b) The commissioners of human services and children, youth, and families must both
approve a variance for dual licensure of family child foster care and family adult foster care
or family adult foster care and family child care. Variances under this paragraph are excluded
from the delegation of variance authority and may be issued only by both commissioners.
new text end
new text begin (c) new text end Except as provided in section 142B.41, subdivision 4, paragraph (e), a county agency
must not grant a license holder a variance to exceed the maximum allowable family child
care license capacity of 14 children.
deleted text begin (b)deleted text end new text begin (d)new text end A county agency that has been designated by the commissioner to issue family
child care variances must:
(1) publish the county agency's policies and criteria for issuing variances on the county's
public website and update the policies as necessary; and
(2) annually distribute the county agency's policies and criteria for issuing variances to
all family child care license holders in the county.
deleted text begin (c)deleted text end new text begin (e)new text end Before the implementation of NETStudy 2.0, county agencies must report
information about disqualification reconsiderations under sections 245C.25 and 245C.27,
subdivision 2, paragraphs (a) and (b), and variances granted under paragraph (a), clause
(5), to the commissioner at least monthly in a format prescribed by the commissioner.
deleted text begin (d)deleted text end new text begin (f)new text end For family child care programs, the commissioner shall require a county agency
to conduct one unannounced licensing review at least annually.
deleted text begin (e)deleted text end new text begin (g)new text end A license issued under this section may be issued for up to two years.
deleted text begin (f)deleted text end new text begin (h)new text end A county agency shall report to the commissioner, in a manner prescribed by the
commissioner, the following information for a licensed family child care program:
(1) the results of each licensing review completed, including the date of the review, and
any licensing correction order issued;
(2) any death, serious injury, or determination of substantiated maltreatment; and
(3) any fires that require the service of a fire department within 48 hours of the fire. The
information under this clause must also be reported to the state fire marshal within two
business days of receiving notice from a licensed family child care provider.
Sec. 34.
Laws 2024, chapter 80, article 2, section 30, subdivision 2, is amended to read:
Subd. 2.
Maltreatment of minors ongoing training requirement.
(a) In addition to
the orientation training required by the applicable licensing rules and statutes, private
child-placing agency license holders must provide a training annually on the maltreatment
of minors reporting requirements and definitions in chapter 260E to each mandatory reporter,
as described in section 260E.06, subdivision 1.
(b) In addition to the orientation training required by the applicable licensing rules and
statutes, all family child foster care license holders and caregivers deleted text begin and foster residence
setting staff and volunteersdeleted text end who are mandatory reporters as described in section 260E.06,
subdivision 1, must complete training each year on the maltreatment of minors reporting
requirements and definitions in chapter 260E.
Sec. 35.
Laws 2024, chapter 80, article 2, section 31, is amended to read:
Sec. 31.
142B.80 CHILD FOSTER CARE TRAINING REQUIREMENT; MENTAL
HEALTH TRAINING; FETAL ALCOHOL SPECTRUM DISORDERS TRAINING.
Prior to a nonemergency placement of a child in a foster care home, the child foster care
license holder and caregivers in foster family and treatment foster care settingsdeleted text begin , and all staff
providing care in foster residence settingsdeleted text end must complete two hours of training that addresses
the causes, symptoms, and key warning signs of mental health disorders; cultural
considerations; and effective approaches for dealing with a child's behaviors. At least one
hour of the annual training requirement for the foster family license holder and caregiversdeleted text begin ,
and foster residence staffdeleted text end must be on children's mental health issues and treatment. Except
for providers and services under chapter 245D, the annual training must also include at least
one hour of training on fetal alcohol spectrum disorders, which must be counted toward the
12 hours of required in-service training per year. Short-term substitute caregivers are exempt
from these requirements. Training curriculum shall be approved by the commissioner of
children, youth, and families.
Sec. 36.
Laws 2024, chapter 80, article 2, section 74, is amended to read:
Sec. 74. REVISOR INSTRUCTION.
The revisor of statutes must renumber sections or subdivisions in column A as column
B.
The revisor of statutes must correct any statutory cross-references consistent with this
renumbering.
Sec. 37.
Laws 2024, chapter 80, article 4, section 26, is amended to read:
Sec. 26. REVISOR INSTRUCTION.
(a) The revisor of statutes shall renumber each section of Minnesota Statutes listed in
column A with the number listed in column B. The revisor shall also make necessary
cross-reference changes consistent with the renumbering. The revisor shall also make any
technical, language, and other changes necessitated by the renumbering and cross-reference
changes in this act.
| Column A |
Column B |
|
119A.50 |
142D.12 |
|
119A.52 |
142D.121 |
|
119A.53 |
142D.122 |
|
119A.535 |
142D.123 |
|
119A.5411 |
142D.124 |
|
119A.545 |
142D.125 |
|
119B.195 |
142D.30 |
|
119B.196 |
142D.24 |
|
119B.25 |
142D.20 |
|
119B.251 |
142D.31 |
|
119B.252 |
142D.32 |
|
119B.27 |
142D.21 |
|
119B.28 |
142D.22 |
|
119B.29 |
142D.23 |
|
121A.16 |
142D.09 |
|
121A.17 |
142D.091 |
|
121A.18 |
142D.092 |
|
121A.19 |
142D.093 |
|
new text begin
122A.731 new text end |
new text begin
142D.33 new text end |
|
124D.13 |
142D.10 |
|
124D.135 |
142D.11 |
|
124D.141 |
142D.16 |
|
124D.142 |
142D.13 |
|
124D.15 |
142D.05 |
|
124D.151 |
142D.08 |
|
124D.16 |
142D.06 |
|
124D.165 |
142D.25 |
|
124D.2211 |
142D.14 |
|
124D.23 |
142D.15 |
(b) The revisor of statutes shall codify Laws 2017, First Special Session chapter 5, article
8, section 9, as amended by article 4, section 25, as Minnesota Statutes, section 142D.07.
(c) The revisor of statutes shall change "commissioner of education" to "commissioner
of children, youth, and families" and change "Department of Education" to "Department of
Children, Youth, and Families" as necessary in Minnesota Statutes, chapters 119A and 120
to 129C, to reflect the changes in this act and Laws 2023, chapter 70, article 12. The revisor
shall also make any technical, language, and other changes resulting from the change of
term to the statutory language, sentence structure, or both, if necessary to preserve the
meaning of the text.
Sec. 38.
Laws 2024, chapter 80, article 6, section 4, is amended to read:
Sec. 4. REVISOR INSTRUCTION.
(a) The revisor of statutes must renumber each section of Minnesota Statutes in Column
A with the number in Column B.
| Column A |
Column B |
|
|
245.771 |
142F.05 |
|
|
256D.60 |
142F.10 |
|
|
256D.61 |
142F.11 |
|
|
256D.62 |
142F.101 |
|
|
256D.63 |
142F.102 |
|
|
256D.64 |
142F.13 |
|
|
256D.65 |
142F.12 |
|
|
256E.30 |
142F.30 |
|
|
256E.31 |
142F.301 |
|
|
256E.32 |
142F.302 |
|
|
new text begin
256E.33 new text end |
new text begin
142F.51 new text end |
|
|
256E.34 |
142F.14 |
|
|
new text begin
256E.342 new text end |
new text begin
142F.15 new text end |
|
|
256E.35 |
142F.20 |
|
|
new text begin
256E.36 new text end |
new text begin
142F.52 new text end |
|
|
new text begin
256K.45 new text end |
new text begin
142F.55 new text end |
|
|
new text begin
256K.451 new text end |
new text begin
142F.56 new text end |
|
|
new text begin
256K.46 new text end |
new text begin
142F.57 new text end |
|
|
new text begin
256K.47 new text end |
new text begin
142F.58 new text end |
(b) The revisor of statutes must correct any statutory cross-references consistent with
this renumbering.
Sec. 39.
Laws 2024, chapter 80, article 7, section 4, is amended to read:
Sec. 4.
Minnesota Statutes 2022, section 256J.09, is amended by adding a subdivision to
read:
Subd. 11.
Domestic violence informational brochure.
(a) The commissioner shall
provide a domestic violence informational brochure that provides information about the
existence of domestic violence waivers to all MFIP applicants. The brochure must explain
that eligible applicants may be temporarily waived from certain program requirements due
to domestic violence. The brochure must provide information about services and other
programs to help victims of domestic violence.
(b) The brochure must be funded with TANF funds.
new text begin
(c) The commissioner must work with the commissioner of human services to create a
brochure that meets the requirements of this section and section 256.029.
new text end
Sec. 40. new text begin CHILD FOSTER RESIDENCE SETTINGS TO STAY AT THE
DEPARTMENT OF HUMAN SERVICES.
new text end
new text begin
The responsibility to license child foster residence settings as defined in Minnesota
Statutes, section 245A.02, subdivision 6e, does not transfer to the Department of Children,
Youth, and Families under Laws 2023, chapter 70, article 12, section 30, and remains with
the Department of Human Services.
new text end
Sec. 41. new text begin DIRECTION TO THE COMMISSIONER OF CHILDREN, YOUTH, AND
FAMILIES; COORDINATION OF SERVICES FOR CHILDREN WITH
DISABILITIES AND MENTAL HEALTH.
new text end
new text begin
The commissioner shall designate a department leader to be responsible for coordination
of services and outcomes around children's mental health and for children with or at risk
for disabilities within and between the Department of Children, Youth, and Families; the
Department of Human Services; and related agencies.
new text end
Sec. 42. new text begin REPEALER.
new text end
new text begin
(a)
new text end
new text begin
Laws 2024, chapter 80, article 1, sections 38, subdivisions 3, 4, and 11; 39; and 43,
subdivision 2; Laws 2024, chapter 80, article 2, sections 1, subdivision 11; 3, subdivision
3; 4, subdivision 4; 10, subdivision 4; 33; and 69; and Laws 2024, chapter 80, article 7,
sections 3; and 9,
new text end
new text begin
are repealed.
new text end
new text begin
(b)
new text end
new text begin
Minnesota Rules, part 9545.0845,
new text end
new text begin
is repealed.
new text end
Sec. 43. new text begin EFFECTIVE DATE; TRANSFER OF RESPONSIBILITIES.
new text end
new text begin
(a) This article is effective July 1, 2024.
new text end
new text begin
(b) Notwithstanding paragraph (a), the powers and responsibilities transferred under this
article are effective upon notice of the commissioner of children, youth, and families 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,
pursuant to Laws 2023, chapter 70, article 12, section 30, subdivision 1.
new text end
new text begin
(c) By August 1, 2025, the commissioners of human services and children, youth, and
families shall notify the chairs and ranking minority members of relevant legislative
committees and divisions and the revisor of statutes of any sections of this article or programs
to be transferred that are waiting for federal approval to become effective pursuant to Laws
2023, chapter 70, article 12, section 30, subdivision 1, paragraph (b).
new text end
ARTICLE 15
MINNESOTA INDIAN FAMILY PRESERVATION ACT
Section 1.
Minnesota Statutes 2022, section 259.20, subdivision 2, is amended to read:
Subd. 2.
Other applicable law.
(a) Portions of chapters 245A, 245C, 257, 260, and
317A may also affect the adoption of a particular child.
(b) Provisions of the Indian Child Welfare Act, United States Code, title 25, chapter 21,
sections 1901-1923, deleted text begin may alsodeleted text end new text begin and the Minnesota Indian Family Preservation Act under
sections 260.751 to 260.835new text end apply in the adoption of an Indian childdeleted text begin , and may preempt
specific provisions of this chapterdeleted text end new text begin as described in section 259.201new text end .
(c) Consistent with section 245C.33 and Public Law 109-248, a completed background
study is required before the approval of any foster or adoptive placement in a related or an
unrelated home.
Sec. 2.
new text begin
[259.201] COMPLIANCE WITH FEDERAL INDIAN CHILD WELFARE
ACT AND MINNESOTA INDIAN FAMILY PRESERVATION ACT.
new text end
new text begin
Adoption proceedings under this chapter that involve an Indian child are child custody
proceedings governed by the Indian Child Welfare Act, United States Code, title 25, sections
1901 to 1963; by the Minnesota Indian Family Preservation Act, sections 260.751 to 260.835;
by section 259.20, subdivision 2, paragraph (b); and by this chapter when not inconsistent
with the federal Indian Child Welfare Act and the Minnesota Indian Family Preservation
Act.
new text end
Sec. 3.
Minnesota Statutes 2023 Supplement, section 260.755, subdivision 1a, is amended
to read:
Subd. 1a.
Active efforts.
new text begin (a) new text end "Active efforts" means a rigorous and concerted level of
effort new text begin to preserve the Indian child's family new text end that is ongoing throughout the involvement of
the child-placing agency deleted text begin to continuously involve the Indian child's Tribe and that uses thedeleted text end new text begin
or the petitioner with the Indian child. Active efforts require the engagement of the Indian
child, the Indian child's parents, the Indian custodian, the extended family, and the Tribe in
using thenew text end prevailing social and cultural values, conditions, and way of life of the Indian
child's Tribe tonew text begin : (1)new text end preserve the Indian child's family deleted text begin anddeleted text end new text begin ; (2)new text end prevent placement of an
Indian child deleted text begin and,deleted text end new text begin ; (3)new text end if placement occurs, to return the Indian child to the new text begin Indian new text end child's
family at the earliest possible timenew text begin ; and (4) where a permanent change in parental rights or
custody are necessary, ensure the Indian child retains meaningful connections to the Indian
child's family, extended family, and Tribenew text end .
new text begin (b)new text end Active efforts deleted text begin under sectiondeleted text end new text begin for all Indian child placements includes this section and
sections 260.012 andnew text end 260.762 new text begin and new text end require a higher standard than reasonable efforts new text begin as defined
in section 260.012 new text end to preserve the family, prevent breakup of the family, and reunify the
family. Active efforts deleted text begin include reasonable efforts as required by Title IV-E of the Social
Security Act, United States Code, title 42, sections 670 to 679cdeleted text end new text begin are required for all Indian
child placement proceedings and for all voluntary Indian child placements that involve a
child-placing agency regardless of whether the reasonable efforts would have been relieved
under section 260.012new text end .
Sec. 4.
Minnesota Statutes 2022, section 260.755, subdivision 2a, is amended to read:
Subd. 2a.
Best interests of an Indian child.
"Best interests of an Indian child" means
compliance with the new text begin federal new text end Indian Child Welfare Act and the Minnesota Indian Family
Preservation Act to preserve and maintain an Indian child's family. The best interests of an
Indian child support the new text begin Indian new text end child's sense of belonging to family, extended family, and
Tribe. The best interests of an Indian child are interwoven with the best interests of the
Indian child's Tribe.
Sec. 5.
Minnesota Statutes 2023 Supplement, section 260.755, subdivision 3, is amended
to read:
Subd. 3.
Child placement proceeding.
(a) "Child placement proceeding" includes a
judicial proceeding which could result in:
(1) "adoptive placement," meaning the permanent placement of an Indian child for
adoption, including an action resulting in a final decree of adoption;
(2) "involuntary foster care placement," meaning an action removing an Indian child
from the child's parents or Indian custodian for temporary placement in a foster home,
institution, or the home of a guardian. The parent or Indian custodian cannot have the Indian
child returned upon demand, but parental rights have not been terminated;
(3) "preadoptive placement," meaning the temporary placement of an Indian child in a
foster home or institution after the termination of parental rights, before or instead of adoptive
placement; or
(4) "termination of parental rights," meaning an action resulting in the termination of
the parent-child relationship under section 260C.301.
(b) The term child placement proceeding new text begin is a domestic relations proceeding that new text end includes
all placements where Indian children are placed deleted text begin out-of-home ordeleted text end away from the care, custody,
and control of their parent or parents or Indian custodian that do not implicate custody
between the parents. Child placement proceeding also includes any placement based upon
juvenile status offensesdeleted text begin ,deleted text end but does not include a placement based upon an act which if
committed by an adult would be deemed a crime, or upon an award of custody in a divorce
proceeding to one of the parents.
Sec. 6.
Minnesota Statutes 2023 Supplement, section 260.755, subdivision 3a, is amended
to read:
Subd. 3a.
Child-placing agency.
"Child-placing agency" means a public, private, or
nonprofit legal entity: (1) providing assistance to deleted text begin adeleted text end new text begin an Indiannew text end child and the new text begin Indian new text end child's
deleted text begin parent ordeleted text end parentsnew text begin or Indian custodiannew text end ; or (2) placing deleted text begin adeleted text end new text begin an Indiannew text end child in foster care or for
adoption on a voluntary or involuntary basis.
Sec. 7.
Minnesota Statutes 2022, section 260.755, subdivision 5, is amended to read:
Subd. 5.
Demand.
"Demand" means a written and notarized statement signed by a parent
or Indian custodian of deleted text begin adeleted text end new text begin an Indiannew text end child which requests the return of the new text begin Indian new text end child who
has been voluntarily placed in foster care.
Sec. 8.
Minnesota Statutes 2023 Supplement, section 260.755, subdivision 5b, is amended
to read:
Subd. 5b.
Extended family member.
"Extended family member" is as defined by the
law or custom of the Indian child's Tribe or, in the absence of any law or custom of the
Tribe, is a person who has reached the age of 18 and who is the Indian child's grandparent,
aunt or uncle, brother or sister, brother-in-law or sister-in-law, niece or nephew, first or
second cousin, or stepparent. new text begin For the purposes of provision of active efforts and foster care
and permanency placement decisions, the legal parent, guardian, or custodian of the Indian
child's sibling is not an extended family member or relative of an Indian child unless they
are independently related to the Indian child or recognized by the Indian child's Tribe as an
extended family member.
new text end
Sec. 9.
Minnesota Statutes 2022, section 260.755, subdivision 14, is amended to read:
Subd. 14.
Parent.
"Parent" means the biological parent of an Indian childdeleted text begin ,deleted text end or any deleted text begin Indiandeleted text end
person who has lawfully adopted an Indian child, including a person who has adopted deleted text begin adeleted text end new text begin an
Indiannew text end child by Tribal law or custom. Parent includes a father as defined by Tribal law or
custom. Parent does not include an unmarried father whose paternity has not been
acknowledged or established. Paternity has been acknowledged when an unmarried father
takes any action to hold himself out as the biological father of an Indian child.
Sec. 10.
Minnesota Statutes 2022, section 260.755, is amended by adding a subdivision
to read:
new text begin Subd. 15a. new text end
new text begin Petitioner. new text end
new text begin
"Petitioner" means one or more individuals other than a parent
or Indian custodian who has filed a petition or motion seeking a grant of temporary or
permanent guardianship, custody, or adoption of an Indian child.
new text end
Sec. 11.
Minnesota Statutes 2022, section 260.755, subdivision 17a, is amended to read:
Subd. 17a.
Qualified expert witness.
"Qualified expert witness" means an individual
who deleted text begin (1) has specific knowledge of the Indian child's tribe's culture and customs, ordeleted text end meets
the criteria in section 260.771, subdivision 6, paragraph (d), and deleted text begin (2)deleted text end provides testimony as
required by the Indian Child Welfare Act of 1978, United States Code, title 25, section
1912, new text begin and the Minnesota Indian Family Preservation Act, new text end regarding deleted text begin out-of-home placement
or termination of parental rightsdeleted text end new text begin child placement or permanency proceedingsnew text end relating to an
Indian child.
Sec. 12.
Minnesota Statutes 2023 Supplement, section 260.755, subdivision 20, is amended
to read:
Subd. 20.
Tribal court.
"Tribal court" means a court with jurisdiction over child custody
proceedings and which is either a court of Indian offenses, deleted text begin ordeleted text end a court established and operated
under the code or custom of an Indian Tribe, or any other administrative body of a Tribe
which is vested with authority over child custody proceedings.
Sec. 13.
Minnesota Statutes 2022, section 260.755, is amended by adding a subdivision
to read:
new text begin Subd. 20a. new text end
new text begin Tribal representative. new text end
new text begin
"Tribal representative" means a representative
designated by and acting on behalf of a Tribe in connection with an Indian child placement
proceeding as defined in subdivision 3. It is not required that the designated representative
be an attorney to represent the Tribe in these matters. An individual appearing as a Tribal
representative on behalf of a Tribe and participating in a court proceeding under this chapter
is not engaged in the unauthorized practice of law.
new text end
Sec. 14.
Minnesota Statutes 2023 Supplement, section 260.755, subdivision 22, is amended
to read:
Subd. 22.
Voluntary foster care placement.
"Voluntary foster care placement" means
a decision in which there has been participation by a child-placing agency resulting in the
temporary placement of an Indian child away from the home of the new text begin Indian new text end child's parents
or Indian custodian in a foster home, institution, or the home of a guardian, and the parent
or Indian custodian may have the new text begin Indian new text end child returned upon demand.
Sec. 15.
Minnesota Statutes 2023 Supplement, section 260.758, subdivision 2, is amended
to read:
Subd. 2.
Temporary emergency jurisdiction of state courts.
(a) The child-placing
agencynew text begin , petitioner,new text end or court shall ensure that the emergency removal or placement terminates
immediately when removal or placement is no longer necessary to prevent imminent physical
damage or harm to the Indian child. The child-placing agencynew text begin , petitioner,new text end or court shall
expeditiously initiate a child placement proceeding subject to the provisions of sections
260.751 to 260.835, transfer the new text begin Indian new text end child to the jurisdiction of the appropriate Indian
Tribe, or return the Indian child to the Indian child's parent or Indian custodian as may be
appropriate.
(b) If the Indian child is a resident of or is domiciled on a reservation but temporarily
located off the reservation, a court of this state has only temporary emergency jurisdiction
until the Indian child is transferred to the jurisdiction of the appropriate Indian Tribe unless
the Indian child's Tribe has expressly declined to exercise its jurisdiction, or the Indian child
is returned to the Indian child's parent or Indian custodian.
Sec. 16.
Minnesota Statutes 2023 Supplement, section 260.758, subdivision 4, is amended
to read:
Subd. 4.
Emergency proceeding requirements.
(a) The court shall hold a hearing no
later than 72 hours, excluding weekends and holidays, after the emergency removal of the
Indian child. The court shall determine whether the emergency removal continues to be
necessary to prevent imminent physical damage or harm to the Indian child.
(b) The court shall hold additional hearings whenever new information indicates that
the emergency situation has ended and new text begin must determine new text end at any court hearing during the
emergency proceeding deleted text begin to determinedeleted text end whether the emergency removal or placement is no
longer necessary to prevent imminent physical damage or harm to the Indian child.
Sec. 17.
Minnesota Statutes 2023 Supplement, section 260.758, subdivision 5, is amended
to read:
Subd. 5.
Termination of emergency removal or placement.
(a) An emergency removal
or placement of an Indian child must immediately terminate once the child-placing agency
or court possesses sufficient evidence to determine that the emergency removal or placement
is no longer necessary to prevent imminent physical damage or harm to the Indian child
and the Indian child shall be immediately returned to the custody of the Indian child's parent
or Indian custodian.
(b) An emergency removal or placement ends when the Indian child is transferred to
the jurisdiction of the Indian child's Tribe, or when the court orders, after service upon the
Indian child's parents, Indian custodian, and Indian child's Tribe, deleted text begin thatdeleted text end new text begin placement ofnew text end the
Indian child deleted text begin shall be placed in foster caredeleted text end upon a determination supported by clear and
convincing evidence, including testimony by a qualified expert witness, that custody of the
Indian child by the Indian child's parent or Indian custodian is likely to result in serious
emotional or physical damage to the Indian child.
(c) In no instance shall emergency removal or emergency placement of an Indian child
extend beyond 30 days unless the court finds by a showing of clear and convincing evidence
that: (1) continued emergency removal or placement is necessary to prevent imminent
physical damage or harm to the Indian child; (2) the court has been unable to transfer the
proceeding to the jurisdiction of the Indian child's Tribal court; and (3) it has not been
possible to initiate a child placement proceeding with all of the protections under sections
260.751 to 260.835, including obtaining the testimony of a qualified expert witness.
Sec. 18.
Minnesota Statutes 2023 Supplement, section 260.761, is amended to read:
260.761 INQUIRY OF TRIBAL LINEAGE; NOTICE TO TRIBES, PARENTS,
AND INDIAN CUSTODIANS; ACCESS TO FILES.
Subdivision 1.
Inquiry of Tribal lineage.
new text begin (a) new text end The child-placing agency or deleted text begin individualdeleted text end
petitioner shall inquire of the child, the child's parents and custodians, and other appropriate
persons whether there is any reason to believe that a child brought to the agency's attention
may have lineage to an Indian Tribe. This inquiry shall occur at the time the child comes
to the attention of the child-placing agency or deleted text begin individualdeleted text end petitioner and shall continue
throughout the involvement of the child-placing agency or deleted text begin individualdeleted text end petitioner.
new text begin
(b) In any child placement proceeding, the court shall inquire of the child, the child's
parents, custodian, and any person participating in the proceedings whether the child has
any American Indian heritage or lineage to an Indian Tribe. The inquiry shall be made at
the commencement of the proceeding and all responses must be on the record. The court
must instruct the parties to inform the court if they subsequently receive information that
provides reason to believe the child is an Indian child.
new text end
new text begin
(c) If there is reason to believe the child is an Indian child, but the court does not have
sufficient evidence to determine whether the child is an Indian child, the court shall:
new text end
new text begin
(1) confirm with a report, declaration, or testimony in the record that the child-placing
agency or petitioner used due diligence to identify and work with all of the Tribes for which
there is reason to believe the child may be a member of or eligible for membership to verify
whether the child is an Indian child; and
new text end
new text begin
(2) proceed with the case as if the child is an Indian child until it is determined on the
record that the child does not meet the definition of Indian child.
new text end
Subd. 2.
Notice deleted text begin to Tribesdeleted text end of services or court proceedings involving an Indian
child.
(a) When a child-placing agency new text begin or petitioner new text end has information that a family assessment,
investigation, or noncaregiver sex trafficking assessment being conducted may involve an
Indian child, the child-placing agency new text begin or petitioner new text end shall notify the Indian child's Tribe of
the family assessment, investigation, or noncaregiver sex trafficking assessment according
to section 260E.18. The child-placing agency new text begin or petitioner new text end shall provide initial notice 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 new text begin or petitioner new text end 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 new text begin or petitioner new text end 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 new text begin or petitioner new text end shall continue to include the Tribe in service
planning and updates as to the progress of the case.
(b) When a child-placing agency new text begin or petitioner new text end has information that a child receiving
services may be an Indian child, the child-placing agency new text begin or petitioner new text end 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 for the Tribe to determine if the child is a member or eligible for Tribal
membership, and the new text begin child-placing new text end agency new text begin or petitioner new text end must provide this notification to
the Tribe within seven days of receiving information that the child may be an Indian child.
If information regarding the child's grandparents or Indian custodian is not available within
the seven-day period, the child-placing agency new text begin or petitioner new text end 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 deleted text begin make efforts to allow
appearances by telephone or video conference for Tribal representatives, parents, and Indian
custodiansdeleted text end new text begin allow appearances by telephone, video conference, or other electronic medium
for Tribal representatives, the Indian child's parents, or the Indian custodiannew text end .
(d) new text begin In all child placement proceedings, except for adoptive or preadoptive placement
proceedings, when a court has reason to believe the child is an Indian child, new text end the child-placing
agency or deleted text begin individualdeleted text end petitioner shall deleted text begin effect service of any petition governed by sections
260.751 to 260.835deleted text end new text begin provide notice of the proceedings and a copy of any petition to the
Indian child's parents, Indian custodian, and the Indian child's Tribe and shall effect service
of any notice and petition governed by sections 260.751 to 260.835 upon the parent, Indian
custodian, and the Indian child's Tribenew text end by certified mail or registered mail, return receipt
requested deleted text begin upon the Indian child's parents, Indian custodian, and Indian child's Tribe at least
10 days before the admit-deny hearing is helddeleted text end . If the identity or location of the Indian child's
parents or Indian custodian deleted text begin anddeleted text end new text begin ornew text end Tribe cannot be determined, the child-placing agency new text begin or
petitioner new text end shall provide the notice required in this paragraph to the United States Secretary
of the Interior, Bureau of Indian Affairs by certified new text begin or registered new text end mail, return receipt
requested.new text begin Where service is only accomplished through the United States Secretary of the
Interior, Bureau of Indian Affairs, the initial hearing shall not be held until 20 days after
notice upon the Tribe or the Secretary of the Interior.
new text end
new text begin
(e) Notice under this subdivision must be in clear and understandable language and
include the following:
new text end
new text begin
(1) the child's name, date of birth, and birth place;
new text end
new text begin
(2) all names known for the parents and Indian custodian, including maiden, married,
former names, and aliases, correctly spelled;
new text end
new text begin
(3) the dates of birth, birth place, and Tribal enrollment numbers of the Indian child, the
Indian child's parents, and the Indian custodian, if known;
new text end
new text begin
(4) the full names, dates of birth, birth places, and Tribal enrollment or affiliation
information of direct lineal ancestors of the child, other extended family members, and
custodians of the child, if known;
new text end
new text begin
(5) the name of any and all Indian Tribes in which the child is or may be a member or
eligible for membership in; and
new text end
new text begin
(6) statements setting out:
new text end
new text begin
(i) the name of the petitioner and name and address of the petitioner's attorney;
new text end
new text begin
(ii) the right of any parent or Indian custodian of the Indian child, to intervene in the
child placement proceedings, if not already a party;
new text end
new text begin
(iii) the right of the Indian child's Tribe to intervene in the proceedings at any time;
new text end
new text begin
(iv) the right of the Indian child, the Indian child's parent, and the Indian custodian to
court-appointed counsel if they meet the requirements in section 611.17;
new text end
new text begin
(v) the right to be granted, upon request, up to 20 additional days to prepare for the
child-placement proceedings;
new text end
new text begin
(vi) the right of the Indian child's parent, the Indian custodian, and the Indian child's
Tribe to petition the court for transfer of the proceedings to Tribal court;
new text end
new text begin
(vii) the mailing addresses and telephone numbers of the court and information related
to all parental and custodial rights of the parent or Indian custodian; and
new text end
new text begin
(viii) that all parties must maintain confidentiality of all information contained in the
notice and must not provide the information to anyone other than their attorney.
new text end
deleted text begin (e)deleted text end new text begin (f)new text end A Tribe, the Indian child's parents, or the Indian custodian may request up to 20
additional days to prepare for the deleted text begin admit-denydeleted text end new text begin initialnew text end 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.
deleted text begin (f)deleted text end new text begin (g)new text end A child-placing agency or deleted text begin individualdeleted text end 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, deleted text begin individualdeleted text end 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 in a case at any time. At any stage of
the child-placing deleted text begin agency'sdeleted text end new text begin agency or petitioner'snew text end involvement with an Indian child, the
new text begin child-placing new text end agency new text begin or petitioner new text end 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 new text begin or petitioner new text end of satisfying the notice
requirements in state or federal law.
new text begin
(h) The court shall allow appearances by telephone, video conference, or other electronic
means for Tribal representatives at all hearings and trials. The court shall allow appearances
by telephone, video conference, or other electronic means for the Indian child's parents or
Indian custodian for all hearings, except that the court may require an in-person appearance
for trials or other evidentiary or contested hearings.
new text end
Subd. 3.
Notice of potential preadoptive or adoptive placement.
In any adoptive or
preadoptive placement proceeding, including voluntary proceedings, where any party or
participant has reason to believe that a child who is the subject of an adoptive or preadoptive
placement proceeding is or may be an "Indian child," as defined in section 260.755,
subdivision 8, and United States Code, title 25, section 1903(4), the child-placing agency
or deleted text begin individualdeleted text end petitioner shall notify the Indian child's Tribe by registered mail or certified
mail with return receipt requested of the pending proceeding and of the right of intervention
under subdivision 6. If the identity or location of the new text begin Indian new text end child's Tribe cannot be
determined, the notice must be given to the United States Secretary of Interior in like manner.
No preadoptive or adoptive placement proceeding may be held until at least 20 days after
receipt of the notice by the Tribe or the secretary. Upon request, the Tribe must be granted
up to 20 additional days to prepare for the proceeding. The child-placing agency or deleted text begin individualdeleted text end
petitioner shall include in the notice the identity of the birth parents andnew text begin Indiannew text end child absent
written objection by the birth parents. The child-placing agency new text begin or petitioner new text end shall inform
the birth parents of the Indian child of any services available to the Indian child through the
child's Tribal social services agency, including child placement services, and shall
additionally provide the birth parents of the Indian child with all information sent from the
Tribal social services agency in response to the notice.
Subd. 4.
Unknown father.
If the child-placing agency, deleted text begin individualdeleted text end petitioner, the court,
or any party has reason to believe that a child who is the subject of a child placement
proceeding is or may be an Indian child but the father of the child is unknown and has not
registered with the fathers' adoption registry pursuant to section 259.52, the child-placing
agency or deleted text begin individualdeleted text end petitioner shall provide to the Tribe believed to be the Indian child's
Tribe information sufficient to enable the Tribe to determine the child's eligibility for
membership in the Tribe, including, but not limited to, the legal and maiden name of the
birth mother, her date of birth, the names and dates of birth of her parents and grandparents,
and, if available, information pertaining to the possible identity, Tribal affiliation, or location
of the birth father. new text begin If the identity or location of the Indian child's Tribe cannot be determined,
the notice must be given to the United States Secretary of Interior in like manner.
new text end
Subd. 5.
Proof of service of notice upon Tribe or secretary.
In cases where a
child-placing agency or party to an adoptive placement knows or has reason to believe that
a child is or may be an Indian child, proof of service upon the new text begin Indian new text end child's Tribe or the
secretary of interior must be filed with the adoption petition.
Subd. 6.
Indian Tribe's right of intervention.
In any child placement proceeding under
sections 260.751 to 260.835, the Indian child's Tribe shall have a right to intervene at any
point in the proceeding.
Subd. 6a.
Indian Tribe's access to files.
At any stage of the child-placing deleted text begin agency'sdeleted text end new text begin
agency or petitioner'snew text end involvement with an Indian child, the child-placing agency new text begin or petitioner
new text end shall, upon request, give the Tribal social services agency full cooperation including access
to all files concerning the Indian child. If the files contain confidential or private data, the
child-placing agency new text begin or petitioner new text end may require execution of an agreement with the Tribal
social services agency to maintain the data according to statutory provisions applicable to
the data.
Sec. 19.
Minnesota Statutes 2023 Supplement, section 260.762, is amended to read:
260.762 DUTY TO PREVENT OUT-OF-HOMEnew text begin CHILDnew text end PLACEMENTnew text begin ,
PRESERVE THE CHILD'S FAMILY,new text end AND PROMOTE FAMILY REUNIFICATION;
ACTIVE EFFORTS.
Subdivision 1.
Active efforts.
Active efforts includes acknowledging traditional helping
and healing systems of an Indian child's Tribe and using these systems as the core to help
and heal the Indian child and familynew text begin regardless of whether the Indian child's Tribe has
intervened in the proceedingsnew text end . deleted text begin Active efforts are not required to prevent voluntary
out-of-home placement and to effect voluntary permanency for the Indian child.
deleted text end
deleted text begin Subd. 2. deleted text end
deleted text begin Requirements for child-placing agencies and individual petitioners. deleted text end
deleted text begin
A
child-placing agency or individual petitioner shall:
deleted text end
deleted text begin
(1) work with the Indian child's Tribe and family to develop an alternative plan to
out-of-home placement;
deleted text end
deleted text begin
(2) before making a decision that may affect an Indian child's safety and well-being or
when contemplating out-of-home placement of an Indian child, seek guidance from the
Indian child's Tribe on family structure, how the family can seek help, what family and
Tribal resources are available, and what barriers the family faces at that time that could
threaten its preservation; and
deleted text end
deleted text begin
(3) request participation of the Indian child's Tribe at the earliest possible time and
request the Tribe's active participation throughout the case.
deleted text end
new text begin Subd. 2a. new text end
new text begin Required findings that active efforts were provided. new text end
new text begin
(a) A court shall not
order a child placement, termination of parental rights, guardianship to the commissioner
of human services under section 260C.325, or temporary or permanent change in custody
of an Indian child unless the court finds that the child-placing agency or petitioner
demonstrated that active efforts were made to preserve the Indian child's family. Active
efforts to preserve the Indian child's family include efforts to prevent placement of the Indian
child to correct the conditions that led to the placement by ensuring remedial services and
rehabilitative programs designed to prevent the breakup of the family were provided in a
manner consistent with the prevailing social and cultural conditions of the Indian child's
Tribe and in partnership with the Indian child, the Indian child's parents, the Indian custodian,
extended family members, and Tribe, and that these efforts have proved unsuccessful.
new text end
new text begin
(b) The court, in determining whether active efforts were made to preserve the Indian
child's family for purposes of child placement or permanency, shall ensure the provision of
active efforts designed to correct the conditions that led to the placement of the Indian child
and shall make findings regarding whether the following activities were appropriate and
necessary, and whether the child-placing agency or petitioner ensured appropriate and
meaningful services were available based upon the family's specific needs, whether listed
in this paragraph or not:
new text end
new text begin
(1) whether active efforts were made at the earliest point possible to inquire into the
child's heritage, to identify any federally recognized Indian Tribe the child may be affiliated
with, to notify all potential Tribes at the earliest point possible, and to request participation
of the Indian child's Tribe;
new text end
new text begin
(2) whether a Tribally designated representative with substantial knowledge of the
prevailing social and cultural standards and child-rearing practices within the Tribal
community was provided an opportunity to consult with and be involved in any investigations
or assessments of the family's circumstances, participate in identifying the family's needs,
and participate in development of any plan to keep the Indian child safely in the home,
identify services designed to prevent the breakup of the Indian child's family, and to reunify
the Indian child's family as soon as safety can be assured if out-of-home placement has
occurred;
new text end
new text begin
(3) whether the Tribal representative was provided with all information available
regarding the proceeding, and whether it was requested that the Tribal representative assist
in identifying services designed to prevent the breakup of the Indian child's family and to
reunify the Indian child's family as soon as safety can be assured if out-of-home placement
has occurred;
new text end
new text begin
(4) whether, before making a decision that may affect an Indian child's safety and
well-being or when contemplating placement of an Indian child, guidance from the Indian
child's Tribe was sought regarding family structure, how the family can seek help, what
family and Tribal resources are available, and what barriers the family faces that could
threaten the family's preservation;
new text end
new text begin
(5) whether a Tribal representative was consulted to determine and arrange for visitation
in the most natural setting that ensures the Indian child's safety, when the Indian child's
safety requires supervised visitation;
new text end
new text begin
(6) whether early and ongoing efforts occurred to identify, locate, and include extended
family members as supports for the Indian child and the Indian child's family;
new text end
new text begin
(7) whether continued active efforts were made to identify and place the Indian child in
a home that is compliant with the placement preferences in sections 260.751 to 260.835,
including whether extended family members were consulted to provide support to the Indian
child and Indian child's parents; to inform the child-placing agency, petitioner, and court
as to cultural connections and family structure; to assist in identifying appropriate cultural
services and supports for the Indian child and Indian child's parents; and to identify and
serve as placement and permanency resources for the Indian child. If there was difficulty
contacting or engaging extended family members, whether assistance was sought from the
Tribe, the Department of Human Services, or other agencies with expertise in working with
Indian families;
new text end
new text begin
(8) whether services and resources were provided to extended family members who are
considered the primary placement option for an Indian child, as agreed upon by the
child-placing agency or petitioner and the Tribe, to overcome licensing and other barriers
to providing care to an Indian child. The need for services or resources shall not be a basis
to exclude an extended family member from consideration as a primary placement. Services
and resources include but are not limited to child care assistance, financial assistance,
housing resources, emergency resources, and foster care licensing assistance and resources;
new text end
new text begin
(9) whether concrete services and access to both Tribal and non-Tribal services were
provided to the Indian child's parents and Indian custodian and, where necessary, members
of the Indian child's extended family members who provide support to the Indian child and
the Indian child's parents; and whether these services were provided in an ongoing manner
throughout the child-placing agency or petitioner's involvement with the Indian family to
directly assist the Indian family in accessing and utilizing services to maintain the Indian
family, or to reunify the Indian family as soon as safety can be assured if out-of-home
placement has occurred. Services include but are not limited to financial assistance, food,
housing, health care, transportation, in-home services, community support services, and
specialized services; and
new text end
new text begin
(10) whether visitation occurred whenever possible in the home of the Indian child's
parent, Indian custodian, or extended family member or in another noninstitutional setting
in order to keep the Indian child in close contact with the Indian child's parents, siblings,
and other relatives regardless of the Indian child's age and to allow the Indian child and
those with whom the Indian child visits to have natural, unsupervised interaction when
consistent with protecting the child's safety.
new text end
new text begin Subd. 2b. new text end
new text begin Adoptions. new text end
new text begin
For adoptions under chapter 259, the court may find that active
efforts were made to prevent placement of an Indian child or to reunify the Indian child
with the Indian child's parents upon a finding that: (1) subdivision 2a, paragraph (b), clauses
(1) to (4), were met; (2) the Indian child's parent knowingly and voluntarily consented to
placement of the Indian child for adoption on the record as described in section 260.765,
subdivision 3a; (3) fraud was not present, and the Indian child's parent was not under duress;
(4) the Indian child's parent was offered and declined services that would enable the Indian
child's parent to maintain custody of the Indian child; and (5) the Indian child's parent was
counseled on alternatives to adoption, and adoption contact agreements.
new text end
deleted text begin Subd. 3. deleted text end
deleted text begin Required findings that active efforts were provided. deleted text end
deleted text begin
(a) Any party seeking
to affect a termination of parental rights, other permanency action, or a placement where
custody of an Indian child may be temporarily or permanently transferred to a person or
entity who is not the Indian child's parent or Indian custodian, and where the Indian child's
parent or Indian custodian cannot have the Indian child returned to their care upon demand,
must satisfy the court that active efforts have been made to provide remedial services and
rehabilitative programs designed to prevent the breakup of the Indian family and that these
efforts have proved unsuccessful.
deleted text end
deleted text begin
(b) A court shall not order an out-of-home or permanency placement for an Indian child
unless the court finds that the child-placing agency made active efforts to, as required by
section 260.012 and this section, provide remedial services and rehabilitative programs
designed to prevent the breakup of the Indian child's family, and that these efforts have
proved unsuccessful. To the extent possible, active efforts must be provided in a manner
consistent with the prevailing social and cultural conditions of the Indian child's Tribe and
in partnership with the Indian child, Indian parents, extended family, and Tribe.
deleted text end
deleted text begin
(c) Regardless of whether the Indian child's Tribe has intervened in the proceedings, the
court, in determining whether the child-placing agency made active efforts to preserve the
Indian child's family for purposes of out-of-home placement and permanency, shall ensure
the provision of active efforts designed to correct the conditions that led to the out-of-home
placement of the Indian child and shall make findings regarding whether the following
activities were appropriate and necessary, and whether the child-placing agency made
appropriate and meaningful services, whether listed in this paragraph or not, available to
the family based upon that family's specific needs:
deleted text end
deleted text begin
(1) whether the child-placing agency made efforts at the earliest point possible to (i)
identify whether a child may be an Indian child as defined in section 260.755, subdivision
8; and (ii) identify and request participation of the Indian child's Tribe at the earliest point
possible and throughout the investigation or assessment, case planning, provision of services,
and case completion;
deleted text end
deleted text begin
(2) whether the child-placing agency requested that a Tribally designated representative
with substantial knowledge of prevailing social and cultural standards and child-rearing
practices within the Tribal community evaluate the circumstances of the Indian child's
family, provided the Tribally designated representative with all information available
regarding the case, and requested that the Tribally designated representative assist in
developing a case plan that uses Tribal and Indian community resources;
deleted text end
deleted text begin
(3) whether the child-placing agency provided concrete services and access to both
Tribal and non-Tribal services to members of the Indian child's family, including but not
limited to financial assistance, food, housing, health care, transportation, in-home services,
community support services, and specialized services; and whether these services are being
provided in an ongoing manner throughout the agency's involvement with the family, to
directly assist the family in accessing and utilizing services to maintain the Indian family,
or reunify the Indian family as soon as safety can be assured if out-of-home placement has
occurred;
deleted text end
deleted text begin
(4) whether the child-placing agency made early and ongoing efforts to identify, locate,
and include extended family members;
deleted text end
deleted text begin
(5) whether the child-placing agency notified and consulted with the Indian child's
extended family members, as identified by the child, the child's parents, or the Tribe; whether
extended family members were consulted to provide support to the child and parents, to
inform the child-placing agency and court as to cultural connections and family structure,
to assist in identifying appropriate cultural services and supports for the child and parents,
and to identify and serve as a placement and permanency resource for the child; and if there
was difficulty contacting or engaging with extended family members, whether assistance
was sought from the Tribe, the Department of Human Services, or other agencies with
expertise in working with Indian families;
deleted text end
deleted text begin
(6) whether the child-placing agency provided services and resources to relatives who
are considered the primary placement option for an Indian child, as agreed by the
child-placing agency and the Tribe, to overcome barriers to providing care to an Indian
child. Services and resources shall include but are not limited to child care assistance,
financial assistance, housing resources, emergency resources, and foster care licensing
assistance and resources; and
deleted text end
deleted text begin
(7) whether the child-placing agency arranged for visitation to occur, whenever possible,
in the home of the Indian child's parent, Indian custodian, or other family member or in
another noninstitutional setting, in order to keep the child in close contact with parents,
siblings, and other relatives regardless of the child's age and to allow the child and those
with whom the child visits to have natural, unsupervised interaction when consistent with
protecting the child's safety; and whether the child-placing agency consulted with a Tribal
representative to determine and arrange for visitation in the most natural setting that ensures
the child's safety, when the child's safety requires supervised visitation.
deleted text end
Sec. 20.
Minnesota Statutes 2023 Supplement, section 260.763, subdivision 1, is amended
to read:
Subdivision 1.
Indian Tribe jurisdiction.
(a) An Indian Tribe has exclusive jurisdiction
over all child placement proceedings involving an Indian child who resides or is domiciled
within the reservation of the Tribe, except where jurisdiction is otherwise vested in the state
by existing federal law. new text begin The child-placing agencies and the courts shall defer to a Tribal
determination of the Tribe's exclusive jurisdiction when an Indian child resides or is
domiciled within the reservation of the Tribe.
new text end
(b) Where an Indian child is a ward of the Tribal court, the Indian Tribe retains exclusive
jurisdiction, notwithstanding the residence or domicile of the child unless the Tribe agrees
to allow concurrent jurisdiction with the state.
(c) An Indian Tribe and the state of Minnesota share concurrent jurisdiction over a child
placement proceeding involving an Indian child who resides or is domiciled outside of the
reservation of the Tribenew text begin , or if the Tribe agrees to concurrent jurisdictionnew text end .
Sec. 21.
Minnesota Statutes 2023 Supplement, section 260.763, subdivision 4, is amended
to read:
Subd. 4.
Transfer of proceedings.
In any child placement proceeding, new text begin upon a motion
or request by the Indian child's parent, Indian custodian, or Tribe, new text end the court, in the absence
of good cause to the contrary, shall transfer the proceeding to the jurisdiction of the Tribe
absent objection by either new text begin of the Indian child's new text end parentnew text begin or the Indian custodiannew text end . The deleted text begin petitiondeleted text end new text begin
motion or requestnew text end to transfer may be deleted text begin fileddeleted text end new text begin madenew text end by the Indian child's parent, the Indian
custodian, or the Indian child's Tribenew text begin at any stage in the proceedings by: (1) filing a written
motion with the court and serving the motion upon the other parties; or (2) making a request
on the record during the hearing, which shall be reflected in the court's findings. A request
or motion to transfer made by a Tribal representative of the Indian child's Tribe under this
subdivision shall not be considered the unauthorized practice of lawnew text end . The transfer is subject
to declination by the Tribal court of the Tribe.
Sec. 22.
Minnesota Statutes 2023 Supplement, section 260.763, subdivision 5, is amended
to read:
Subd. 5.
Good cause to deny transfer.
(a) Establishing good cause to deny transfer of
jurisdiction to a Tribal court is a fact-specific inquiry to be determined on a case-by-case
basis. Socioeconomic conditions and the perceived adequacy of Tribal or Bureau of Indian
Affairs social services or judicial systems must not be considered in a determination that
good cause exists. The party opposed to transfer of jurisdiction to a Tribal court has the
burden to prove by clear and convincing evidence that good cause to deny transfer exists.
Opposition to a motion to transfer jurisdiction to Tribal court must be in writing and must
be served upon all parties.
(b) new text begin Upon a motion or request by an Indian child's parent, Indian custodian, or Tribe, new text end the
court deleted text begin may find good cause to deny transfer to Tribal court ifdeleted text end new text begin shall transfer jurisdiction to a
Tribal court unless the court determines that there is good cause to deny transfer based on
the followingnew text end :
(1) the Indian child's Tribe does not have a Tribal court or any other administrative body
of a Tribe vested with authority over child placement proceedings, as defined in section
260.755, subdivision 3, to which the case can be transferred, and no other Tribal court has
been designated by the Indian child's Tribe; or
(2) the evidence necessary to decide the case could not be adequately presented in the
Tribal court without undue hardship to the parties or the witnesses and the Tribal court is
unable to mitigate the hardship by any means permitted in the Tribal court's rules. Without
evidence of undue hardship, travel distance alone is not a basis for denying a transfer.
Sec. 23.
Minnesota Statutes 2023 Supplement, section 260.765, subdivision 2, is amended
to read:
Subd. 2.
Notice.
When an Indian child is voluntarily placed deleted text begin in foster caredeleted text end new text begin out of the care
of the Indian child's parent or Indian custodiannew text end , the child-placing agency involved in the
decision to place the new text begin Indian new text end child shall give notice new text begin as described in section 260.761 new text end of the
placement to the new text begin Indian new text end child's parent, parents, Indian custodian, and the Tribal social
services agency within seven days of placement, excluding weekends and holidays.
If a child-placing agency makes a temporary voluntary deleted text begin foster caredeleted text end placement pending
a decision on adoption by deleted text begin adeleted text end new text begin an Indian child'snew text end parentnew text begin or Indian custodiannew text end , notice of the
placement shall be given to the new text begin Indian new text end child's parents, Tribal social services agency, and
the Indian custodian upon the filing of a petition for termination of parental rights or three
months following the temporary placement, whichever occurs first.
Sec. 24.
Minnesota Statutes 2023 Supplement, section 260.765, subdivision 3a, is amended
to read:
Subd. 3a.
Court requirements for consent.
Where any parent or Indian custodian
voluntarily consents to a deleted text begin foster caredeleted text end new text begin childnew text end placement or to termination of parental rightsnew text begin or
adoptionnew text end , the consent shall not be valid unless executed in writing and recorded before a
judge and accompanied by the presiding judge's finding that the terms and consequences
of the consent were fully explained in detail and were fully understood by the parent or
Indian custodian. The court shall also find that either the parent or Indian custodian fully
understood the explanation in English or that it was interpreted into a language the parent
or Indian custodian understood. Any consent given prior to, or within ten days after, the
birth of an Indian child shall not be valid.
Sec. 25.
Minnesota Statutes 2023 Supplement, section 260.765, subdivision 4b, is amended
to read:
Subd. 4b.
Collateral attack; vacation of decree and return of custody;
limitations.
After the entry of a final decree of adoption of an Indian child in any state
court, the new text begin Indian child's new text end parent may withdraw consent upon the grounds that consent was
obtained through fraud or duress and may petition the court to vacate the decree. Upon a
finding that consent was obtained through fraud or duress, the court shall vacate the decree
and return the new text begin Indian new text end child to the new text begin Indian child's new text end parent. No adoption that has been effective
for at least two years may be invalidated under the provisions of this subdivision unless
otherwise permitted under a provision of state law.
Sec. 26.
Minnesota Statutes 2023 Supplement, section 260.771, subdivision 1a, is amended
to read:
Subd. 1a.
Active efforts.
In any child placement proceeding, the child-placing agency
or deleted text begin individualdeleted text end petitioner shall ensure that appropriate active efforts as described in section
260.762 are provided to the Indian child's parent or parents, Indian custodian, and family
to support reunification and preservation of the new text begin Indian new text end child's placement with and relationship
to the Indian child's new text begin extended new text end family.
Sec. 27.
Minnesota Statutes 2023 Supplement, section 260.771, subdivision 1b, is amended
to read:
Subd. 1b.
Placement preference.
In any child placement proceeding, the child-placing
agency or deleted text begin individualdeleted text end petitioner shall follow the placement preferences described in section
260.773 or, where preferred placement is not available even with the provision of active
efforts, shall follow section 260.773, subdivisions 12 to 15.
Sec. 28.
Minnesota Statutes 2023 Supplement, section 260.771, subdivision 1c, is amended
to read:
Subd. 1c.
Identification of extended family members.
Any child-placing agency or
deleted text begin individualdeleted text end petitioner considering placement of an Indian child shall deleted text begin makedeleted text end new text begin ensurenew text end active
efforts new text begin are made new text end to identify and locate siblings and extended family members and to explore
placement with deleted text begin andeleted text end extended family deleted text begin member and facilitate continued involvement in the
Indian child's lifedeleted text end new text begin members and ensure the Indian child's relationship with the Indian child's
extended family and Tribenew text end .
Sec. 29.
Minnesota Statutes 2023 Supplement, section 260.771, subdivision 2b, is amended
to read:
Subd. 2b.
Appointment of counsel.
(a) In any state court child placement proceeding,
new text begin including but not limited to any proceeding where the petitioner or another party seeks to
temporarily or permanently remove an Indian child from new text end the new text begin Indian child's new text end parent or parents
or Indian custodiannew text begin , the Indian child's parent or parents or Indian custodiannew text end shall have the
right to be represented by an attorney. If the parent or parents or Indian custodian cannot
afford an attorney and meet the requirements of section 611.17, an attorney will be appointed
to represent them.
(b) In any state court child placement proceeding, any new text begin Indian new text end child ten years of age or
older shall have the right to court-appointed counsel.new text begin The court may appoint counsel for
any Indian child under ten years of age in any state court child placement proceeding if the
court determines that appointment is appropriate and in the best interest of the Indian child.
new text end
new text begin
(c) If the court appoints counsel to represent a person pursuant to this subdivision, the
court shall appoint counsel to represent the person prior to the first hearing on the petition,
but may appoint counsel at any stage of the proceeding if the court deems it necessary. The
court shall not appoint a public defender to represent the person unless such appointment
is authorized by section 611.14.
new text end
Sec. 30.
Minnesota Statutes 2023 Supplement, section 260.771, subdivision 2d, is amended
to read:
Subd. 2d.
Tribal access to files and other documents.
At any subsequent stage of the
child-placing agency new text begin or petitioner's new text end involvement with an Indian child, the child-placing
agency or deleted text begin individualdeleted text end new text begin petitionernew text end shall, upon request, give the Tribal social services agency
full cooperation including access to all files concerning the Indian child. If the files contain
confidential or private data, the child-placing agency or deleted text begin individualdeleted text end new text begin petitionernew text end may require
execution of an agreement with the Tribal social services agency specifying that the Tribal
social services agency shall maintain the data according to statutory provisions applicable
to the data.
Sec. 31.
Minnesota Statutes 2023 Supplement, section 260.771, is amended by adding a
subdivision to read:
new text begin Subd. 2e. new text end
new text begin Participation of Indian child's Tribe in court proceedings. new text end
new text begin
(a) In any child
placement proceeding that involves an Indian child, any Tribe that the Indian child may be
eligible for membership in, as determined by the Tribe, is a party to the proceedings without
the need to file a motion.
new text end
new text begin
(b) An Indian child's Tribe, Tribal representative, or attorney representing the Tribe:
new text end
new text begin
(1) may appear remotely at hearings by telephone, video conference, or other electronic
medium without prior request;
new text end
new text begin
(2) is not required to use the court's electronic filing and service system and may use
United States mail, facsimile, or other alternative method for filing and service;
new text end
new text begin
(3) may file documents with the court using an alternative method that the clerk of court
shall accept and file electronically;
new text end
new text begin
(4) is exempt from any filing fees required under section 357.021; and
new text end
new text begin
(5) is exempt from the pro hac vice requirements of Rule 5 of the Minnesota General
Rules of Practice.
new text end
Sec. 32.
Minnesota Statutes 2023 Supplement, section 260.771, subdivision 6, is amended
to read:
Subd. 6.
Qualified expert witness and evidentiary requirements.
(a) In deleted text begin andeleted text end new text begin anynew text end
involuntary deleted text begin foster caredeleted text end placement proceeding, the court must determine by clear and
convincing evidence, including testimony of a qualified expert witness, that continued
custody of the new text begin Indian new text end child by the parent or Indian custodian is likely to result in serious
emotional damage or serious physical damage to the new text begin Indian new text end child.
In a termination of parental rights proceeding, the court must determine by evidence
beyond a reasonable doubt, including testimony of a qualified expert witness, that continued
custody of the new text begin Indian new text end child by the parent or Indian custodian is likely to result in serious
emotional damage or serious physical damage to the new text begin Indian new text end child.
In an involuntary permanent transfer of legal and physical custody deleted text begin proceedingdeleted text end , permanent
custody to the agency deleted text begin proceedingdeleted text end , temporary custody to the agency, or other permanency
proceeding, the court must determine by clear and convincing evidence, including testimony
of a qualified expert witness, that the continued custody of the Indian child by the Indian
child's parent or parents or Indian custodian is likely to result in serious emotional damage
or serious physical damage to the new text begin Indian new text end child. Qualified expert witness testimony is not
required where custody is transferred to the Indian child's parent.
Testimony of a qualified expert witness shall be provided for involuntary deleted text begin foster caredeleted text end new text begin
childnew text end placement and permanency proceedings independently.
(b) The child-placing agency, deleted text begin individualdeleted text end petitioner, or any other party shall make diligent
efforts to locate and present to the court a qualified expert witness designated by the Indian
child's Tribe. The qualifications of a qualified expert witness designated by the Indian child's
Tribe are not subject to a challenge in Indian child placement proceedings.
(c) If a party cannot obtain testimony from a Tribally designated qualified expert witness,
the party shall submit to the court the diligent efforts made to obtain a Tribally designated
qualified expert witness.
(d) If clear and convincing evidence establishes that a party's diligent efforts cannot
produce testimony from a Tribally designated qualified expert witness, the party shall
demonstrate to the court that a proposed qualified expert witness is, in descending order of
preference:
(1) a member of the new text begin Indian new text end child's Tribe who is recognized by the Indian child's Tribal
community as knowledgeable in Tribal customs as they pertain to family organization and
child-rearing practices; or
(2) an Indian person from an Indian community who has substantial experience in the
delivery of child and family services to Indians and extensive knowledge of prevailing social
and cultural standards and contemporary and traditional child-rearing practices of the Indian
child's Tribe.
If clear and convincing evidence establishes that diligent efforts have been made to obtain
a qualified expert witness who meets the criteria in clause (1) or (2), but those efforts have
not been successful, a party may use an expert witness, as defined by the Minnesota Rules
of Evidence, rule 702, who has substantial experience in providing services to Indian families
and who has substantial knowledge of prevailing social and cultural standards and
child-rearing practices within the Indian community. The court or any party may request
the assistance of the Indian child's Tribe or the Bureau of Indian Affairs agency serving the
Indian child's Tribe in locating persons qualified to serve as expert witnesses.
(e) The court may allow alternative methods of participation and testimony in state court
proceedings by a qualified expert witness, such as participation or testimony by telephone,
deleted text begin videoconferencingdeleted text end new text begin video conferencenew text end , or other deleted text begin methodsdeleted text end new text begin electronic mediumnew text end .
Sec. 33.
Minnesota Statutes 2023 Supplement, section 260.773, subdivision 1, is amended
to read:
Subdivision 1.
Least restrictive setting.
In all proceedings where custody of the Indian
child may be removed from the new text begin Indian child's new text end parentnew text begin or Indian custodiannew text end , the Indian child
shall be placed in the least restrictive setting which most approximates a family and in which
the Indian child's special needs, if any, may be met. The Indian child shall also be placed
within reasonable proximity to the Indian child's home, taking into account any special
needs of the Indian child.
Sec. 34.
Minnesota Statutes 2023 Supplement, section 260.773, subdivision 2, is amended
to read:
Subd. 2.
Tribe's order of placement recognized.
In the case of a placement under
subdivision 3 or 4, if the Indian child's Tribe has established a different order of placement
preference by resolution, the child-placing agency new text begin or petitioner new text end and the court shall recognize
the Indian child's Tribe's order of placement in the form provided by the Tribe.
Sec. 35.
Minnesota Statutes 2023 Supplement, section 260.773, subdivision 3, is amended
to read:
Subd. 3.
Placement deleted text begin optionsdeleted text end new text begin preferences for temporary proceedingsnew text end .
Preference shall
be given, in the absence of good cause to the contrary, to a placement with:
(1) a noncustodial parent or Indian custodian;
(2) a member of thenew text begin Indiannew text end child's extended family;
(3) a foster home licensed, approved, or specified by the Indian child's Tribe;
(4) an Indian foster home licensed or approved by an authorized non-Indian licensing
authority; or
(5) an institution for children approved by an Indian Tribe or operated by an Indian
organization which has a program suitable to meet the Indian child's needs.
Sec. 36.
Minnesota Statutes 2023 Supplement, section 260.773, subdivision 4, is amended
to read:
Subd. 4.
Placement deleted text begin preferencedeleted text end new text begin preferences for permanent proceedingsnew text end .
In any
adoptive placement, transfer of custody placement, or other permanency placement of an
Indian child, a preference shall be given, in the absence of good cause to the contrary, to a
placement with:
(1) the Indian child's noncustodial parent or Indian custodian;
(2) a member of the new text begin Indian new text end child's extended family;
(3) other members of the Indian child's Tribe; or
(4) other persons or entities recognized as appropriate to be a permanency resource for
the Indian child, by the Indian child's parent or parents, Indian custodian, or Indian Tribe.
Sec. 37.
Minnesota Statutes 2023 Supplement, section 260.773, subdivision 5, is amended
to read:
Subd. 5.
Suitability of placement.
The deleted text begin countydeleted text end new text begin child-placing agency and petitionernew text end shall
defer to the judgment of the Indian child's Tribe as to the suitability of a placement.
Sec. 38.
Minnesota Statutes 2023 Supplement, section 260.773, subdivision 10, is amended
to read:
Subd. 10.
Exceptions to placement preferences.
The court shall follow the placement
preferences in subdivisions 1 to 9, except as follows:
(1) where a parent evidences a desire for anonymity, the child-placing agency new text begin or petitioner
new text end and the court shall give weight to the parent's desire for anonymity in applying the
preferences. A parent's desire for anonymity does not excuse the application of sections
260.751 to 260.835; or
(2) where the court determines there is good cause based on:
(i) the reasonable request of the Indian child's parents, if one or both parents attest that
they have reviewed the placement options that comply with the order of placement
preferences;
(ii) the reasonable request of the Indian child if the new text begin Indian new text end child is able to understand
and comprehend the decision that is being made;
(iii) the testimony of a qualified expert designated by the new text begin Indian new text end child's Tribe and, if
necessary, testimony from an expert witness who meets qualifications of section 260.771,
subdivision 6, paragraph (d), clause (2), that supports placement outside the order of
placement preferences due to extraordinary physical or emotional needs of the new text begin Indian new text end child
that require highly specialized services; or
(iv) the testimony by the child-placing agency new text begin or petitioner new text end that a diligent search has
been conducted that did not locate any available, suitable families for the new text begin Indian new text end child that
meet the placement preference criteria.
Sec. 39.
Minnesota Statutes 2023 Supplement, section 260.773, subdivision 11, is amended
to read:
Subd. 11.
Factors considered in determining placement.
Testimony of the new text begin Indian
new text end child's bonding or attachment to a foster family alone, without the existence of at least one
of the factors in subdivision 10, clause (2), shall not be considered good cause to keep an
Indian child in a lower preference or nonpreference placement. Ease of visitation and
facilitation of relationship with the Indian child's parents, Indian custodian, extended family,
or Tribe may be considered when determining placement.
Sec. 40.
Minnesota Statutes 2023 Supplement, section 260.774, subdivision 1, is amended
to read:
Subdivision 1.
Improper removal.
In any proceeding where custody of the Indian child
was improperly removed from the parent or deleted text begin parentsdeleted text end new text begin Indian custodiannew text end or where the petitioner
has improperly retained custody after a visit or other temporary relinquishment of custody,
the court shall decline jurisdiction over the petition and shall immediately return the Indian
child to the Indian child's parent deleted text begin or parentsdeleted text end or Indian custodian unless returning the Indian
child to the Indian child's parent deleted text begin or parentsdeleted text end or Indian custodian would subject the Indian
child to a substantial and immediate danger or threat of such danger.
Sec. 41.
Minnesota Statutes 2023 Supplement, section 260.774, subdivision 2, is amended
to read:
Subd. 2.
Invalidation.
(a) Any order for deleted text begin out-of-homedeleted text end new text begin childnew text end placement, transfer of custody,
termination of parental rights, or other permanent change in custody of an Indian child shall
be invalidated upon a showing, by a preponderance of the evidence, that a violation of any
one of the provisions in section 260.761, 260.762, 260.763, 260.765, 260.771, 260.773, or
260.7745 has occurred.
(b) The Indian child, the Indian child's parent or parents, guardian, Indian custodian, or
Indian Tribe may file a petition new text begin or motion new text end to invalidate under this subdivision.
(c) Upon a finding that a violation of one of the provisions in section 260.761, 260.762,
260.763, 260.765, 260.771, 260.773, or 260.7745 has occurred, the court shall:
(1) dismiss the petition without prejudice; deleted text begin and
deleted text end
(2) return the Indian child to the care, custody, and control of the parent or parents or
Indian custodian, unless the Indian child would be subjected to imminent new text begin physical new text end damage
or harmdeleted text begin .deleted text end new text begin ; and
new text end
new text begin
(3) determine whether the Indian child's parent or Indian custodian has been assessed
placement costs and order reimbursement of those costs.
new text end
new text begin
(d) Upon a finding that a willful, intentional, knowing, or reckless violation of one of
the provisions in section 260.761, 260.762, 260.763, 260.765, 260.771, 260.773, or 260.7745
has occurred, the court may consider whether sanctions, reasonable costs, and attorney fees
should be imposed against the offending party.
new text end
Sec. 42.
Minnesota Statutes 2023 Supplement, section 260.774, subdivision 3, is amended
to read:
Subd. 3.
Return of custody following adoption.
(a) Whenever a final decree of adoption
of an Indian child has been vacated, set aside, or there is a termination of the parental rights
of the adoptive parents to the new text begin Indian new text end child, a biological parent or prior Indian custodian may
petition for return of custody and the court shall grant the petition unless there is a showing,
in proceedings subject to the provision of sections 260.751 to 260.835, that the return of
custody is not in the best interests of the Indian child.
(b) The county attorney, Indian child, Indian child's Tribe,new text begin Indian custodian,new text end or deleted text begin adeleted text end new text begin an
Indian child'snew text end parent whose parental rights were terminated under a previous order of the
court may file a petition for the return of custody.
(c) A petition for return of custody may be filed in court when:
(1) the parent or Indian custodian has corrected the conditions that led to an order
terminating parental rights;
(2) the parent or Indian custodian is willing and has the capability to provide day-to-day
care and maintain the health, safety, and welfare of the Indian child; and
(3) the adoption has been vacated, set aside, or termination of the parental rights of the
adoptive parents to the Indian child has occurred.
(d) A petition for reestablishment of the legal parent and child relationship for deleted text begin adeleted text end new text begin an Indian
new text end child who has not been adopted must meet the requirements in section 260C.329.
Sec. 43.
Minnesota Statutes 2022, section 260.775, is amended to read:
260.775 PLACEMENT RECORDS.
(a) The commissioner of human services shall publish annually an inventory of all Indian
children in residential facilities. The inventory shall include, by county and statewide,
information on legal status, living arrangement, age, sex, Tribe in which the new text begin Indian new text end child is
a member or eligible for membership, accumulated length of time in foster care, and other
demographic information deemed appropriate concerning all Indian children in residential
facilities. The report must also state the extent to which authorized child-placing agencies
comply with the order of preference described in United States Code, title 25, section 1901,
et seq. The commissioner shall include the information required under this paragraph in the
annual report on child maltreatment and on children in deleted text begin out-of-homedeleted text end placement under section
257.0725.
(b) This section expires January 1, 2032.
Sec. 44.
Minnesota Statutes 2023 Supplement, section 260.781, subdivision 1, is amended
to read:
Subdivision 1.
Court decree information.
(a) A state court entering a final decree or
order in an Indian child adoptive placement shall provide the Department of Human Services
and the child's Tribal social services agency with a copy of the decree or order together with
such other information to show:
(1) the name and Tribal affiliation of the new text begin Indian new text end child;
(2) the names and addresses of the biological parentsnew text begin and Indian custodian, if anynew text end ;
(3) the names and addresses of the adoptive parents; and
(4) the identity of any agency having files or information relating to the adoptive
placement.
If the court records contain an affidavit of the biological or adoptive deleted text begin parent ordeleted text end parents
new text begin or Indian custodian new text end requesting anonymity, the court shall delete the name and address of
the biological or adoptive parents new text begin or Indian custodian new text end from the information sent to the new text begin Indian
new text end child's Tribal social services agency. The court shall include the affidavit with the other
information provided to the Minnesota Department of Human Services and the Secretary
of the Interior. The Minnesota Department of Human Services shall and the Secretary of
the Interior is requested to ensure that the confidentiality of the information is maintained
and the information shall not be subject to the Freedom of Information Act, United States
Code, title 5, section 552, as amended.
(b) For:
(1) disclosure of information for deleted text begin enrollmentdeleted text end new text begin membershipnew text end of an Indian child in the Tribe;
(2) determination of member rights or benefits; or
(3) certification of entitlement to membership upon the request of the adopted Indian
child over the age of eighteen, the adoptive or foster parents of an Indian child, or an Indian
Tribe,
the Secretary of the Interior is requested to disclose any other necessary information for the
membership of an Indian child in the Tribe in which the Indian child may be eligible for
membership or for determining any rights or benefits associated with that membership.
Where the documents relating to the Indian child contain an affidavit from the biological
parent or deleted text begin parentsdeleted text end new text begin Indian custodiannew text end requesting anonymity, the Secretary of the Interior is
requested to certify to the Indian child's Tribe, where the information warrants, that the
Indian child's parentage and other circumstances of birth entitle the Indian child to
membership under the criteria established by the Tribe.
Sec. 45.
Minnesota Statutes 2022, section 260.785, subdivision 1, is amended to read:
Subdivision 1.
Primary support grants.
The commissioner shall establish direct grants
to Indian Tribes, Indian organizations, and Tribal social services agency programs located
off-reservation that serve Indian children and their families to provide primary support for
Indian child welfare programs to implement the new text begin Minnesota new text end Indian Family Preservation Act.
Sec. 46.
Minnesota Statutes 2022, section 260.785, subdivision 3, is amended to read:
Subd. 3.
Compliance grants.
The commissioner shall establish direct grants to an Indian
child welfare defense corporation, as defined in Minnesota Statutes 1996, section 611.216,
subdivision 1a, to promote statewide compliance with the new text begin Minnesota new text end Indian Family
Preservation Act and the Indian Child Welfare Act, United States Code, title 25, section
1901, et seq. The commissioner shall give priority consideration to applicants with
demonstrated capability of providing legal advocacy services statewide.
Sec. 47.
Minnesota Statutes 2023 Supplement, section 260.786, subdivision 2, is amended
to read:
Subd. 2.
Purposes.
Money must be used to address staffing for responding to notifications
under the new text begin federal new text end Indian Child Welfare Act and the Minnesota Indian Family Preservation
Act, to the extent necessary, or to provide other child protection and child welfare services.
Money must not be used to supplant current Tribal expenditures for these purposes.
Sec. 48.
Minnesota Statutes 2023 Supplement, section 260.795, subdivision 1, is amended
to read:
Subdivision 1.
Types of services.
(a) Eligible Indian child welfare services provided
under primary support grants include:
(1) placement prevention and reunification services;
(2) family-based services;
(3) individual and family counseling;
(4) access to professional individual, group, and family counseling;
(5) crisis intervention and crisis counseling;
(6) development of foster and adoptive placement resources, including recruitment,
licensing, and support;
(7) court advocacy;
(8) training and consultation to county and private social services agencies regarding
the new text begin federal new text end Indian Child Welfare Act and the Minnesota Indian Family Preservation Act;
(9) advocacy in working with the county and private social services agencies, and
activities to help provide access to agency services, including but not limited to 24-hour
caretaker and homemaker services, day care, emergency shelter care up to 30 days in 12
months, access to emergency financial assistance, and arrangements to provide temporary
respite care to a family for up to 72 hours consecutively or 30 days in 12 months;
(10) transportation services to the child and parents to prevent placement or reunite the
family; and
(11) other activities and services approved by the commissioner that further the goals
of the new text begin federal new text end Indian Child Welfare Act and the new text begin Minnesota new text end Indian Family Preservation Act,
including but not limited to recruitment of Indian staff for child-placing agencies and licensed
child-placing agencies. The commissioner may specify the priority of an activity and service
based on its success in furthering these goals.
(b) Eligible services provided under special focus grants include:
(1) permanency planning activities that meet the special needs of Indian families;
(2) teenage pregnancy;
(3) independent living skills;
(4) family and community involvement strategies to combat child abuse and chronic
neglect of children;
(5) coordinated child welfare and mental health services to Indian families;
(6) innovative approaches to assist Indian youth to establish better self-image, decrease
isolation, and decrease the suicide rate;
(7) expanding or improving services by packaging and disseminating information on
successful approaches or by implementing models in Indian communities relating to the
development or enhancement of social structures that increase family self-reliance and links
with existing community resources;
(8) family retrieval services to help adopted individuals reestablish legal affiliation with
the Indian Tribe; and
(9) other activities and services approved by the commissioner that further the goals of
the new text begin federal new text end Indian Child Welfare Act and the new text begin Minnesota new text end Indian Family Preservation Act.
The commissioner may specify the priority of an activity and service based on its success
in furthering these goals.
(c) The commissioner shall give preference to programs that use Indian staff, contract
with Indian organizations or Tribes, or whose application is a joint effort between the Indian
and non-Indian community to achieve the goals of the new text begin federal new text end Indian Child Welfare Act
and the Minnesota Indian Family Preservation Act. Programs must have input and support
from the Indian community.
Sec. 49.
Minnesota Statutes 2022, section 260.810, subdivision 3, is amended to read:
Subd. 3.
Final report.
A final evaluation report must be submitted by each approved
programnew text begin to the commissionernew text end . It must include client outcomes, cost and effectiveness in
meeting the goals of the new text begin Minnesota new text end Indian Family Preservation Act and permanency planning
goals.new text begin The commissioner must compile the final reports into one document and provide a
copy to each Tribe.
new text end
Sec. 50.
Minnesota Statutes 2022, section 260C.007, subdivision 26b, is amended to read:
Subd. 26b.
Relative of an Indian child.
"Relative of an Indian child" means a person
who is a member of the Indian child's family as defined in the Indian Child Welfare Act of
1978, United States Code, title 25, section 1903, paragraphs (2), (6), and (9)new text begin , and who is an
extended family member as defined in section 260.755, subdivision 5b, of the Minnesota
Indian Family Preservation Act.
new text end
Sec. 51.
Minnesota Statutes 2022, section 260C.178, subdivision 1, as amended by Laws
2024, chapter 80, article 8, section 24, is amended to read:
Subdivision 1.
Hearing and release requirements.
(a) If a child was taken into custody
under section 260C.175, subdivision 1, clause (1) or (2), item (ii), the court shall hold a
hearing within 72 hours of the time that the child was taken into custody, excluding
Saturdays, Sundays, and holidays, to determine whether the child should continue to be in
custody.
(b) Unless there is reason to believe that the child would endanger self or others or not
return for a court hearing, or that the child's health or welfare would be immediately
endangered, the child shall be released to the custody of a parent, guardian, custodian, or
other suitable person, subject to reasonable conditions of release including, but not limited
to, a requirement that the child undergo a chemical use assessment as provided in section
260C.157, subdivision 1.
(c) If the court determines that there is reason to believe that the child would endanger
self or others or not return for a court hearing, or that the child's health or welfare would be
immediately endangered if returned to the care of the parent or guardian who has custody
and from whom the child was removed, the court shall order the child:
(1) into the care of the child's noncustodial parent and order the noncustodial parent to
comply with any conditions that the court determines appropriate to ensure the safety and
care of the child, including requiring the noncustodial parent to cooperate with paternity
establishment proceedings if the noncustodial parent has not been adjudicated the child's
father; or
(2) into foster care as defined in section 260C.007, subdivision 18, under the legal
responsibility of the responsible social services agency or responsible probation or corrections
agency for the purposes of protective care as that term is used in the juvenile court rules.
The court shall not give the responsible social services legal custody and order a trial home
visit at any time prior to adjudication and disposition under section 260C.201, subdivision
1, paragraph (a), clause (3), but may order the child returned to the care of the parent or
guardian who has custody and from whom the child was removed and order the parent or
guardian to comply with any conditions the court determines to be appropriate to meet the
safety, health, and welfare of the child.
(d) In determining whether the child's health or welfare would be immediately
endangered, the court shall consider whether the child would reside with a perpetrator of
domestic child abuse.
(e) The court, before determining whether a child should be placed in or continue in
foster care under the protective care of the responsible agency, shall also make a
determination, consistent with section 260.012 as to whether reasonable efforts were made
to prevent placement or whether reasonable efforts to prevent placement are not required.
In the case of an Indian child, the court shall determine whether active efforts, according
to section 260.762 and the Indian Child Welfare Act of 1978, United States Code, title 25,
section 1912(d), were made to prevent placement. The court shall enter a finding that the
responsible social services agency has made reasonable efforts to prevent placement when
the agency establishes either:
(1) that the agency has actually provided services or made efforts in an attempt to prevent
the child's removal but that such services or efforts have not proven sufficient to permit the
child to safely remain in the home; or
(2) that there are no services or other efforts that could be made at the time of the hearing
that could safely permit the child to remain home or to return home. The court shall not
make a reasonable efforts determination under this clause unless the court is satisfied that
the agency has sufficiently demonstrated to the court that there were no services or other
efforts that the agency was able to provide at the time of the hearing enabling the child to
safely remain home or to safely return home. When reasonable efforts to prevent placement
are required and there are services or other efforts that could be ordered that would permit
the child to safely return home, the court shall order the child returned to the care of the
parent or guardian and the services or efforts put in place to ensure the child's safety. When
the court makes a prima facie determination that one of the circumstances under paragraph
(g) exists, the court shall determine that reasonable efforts to prevent placement and to
return the child to the care of the parent or guardian are not required.
(f) If the court finds the social services agency's preventive or reunification efforts have
not been reasonable but further preventive or reunification efforts could not permit the child
to safely remain at home, the court may nevertheless authorize or continue the removal of
the child.
(g) The court may not order or continue the foster care placement of the child unless the
court makes explicit, individualized findings that continued custody of the child by the
parent or guardian would be contrary to the welfare of the child and that placement is in the
best interest of the child.
(h) At the emergency removal hearing, or at any time during the course of the proceeding,
and upon notice and request of the county attorney, the court shall determine whether a
petition has been filed stating a prima facie case that:
(1) the parent has subjected a child to egregious harm as defined in section 260C.007,
subdivision 14;
(2) the parental rights of the parent to another child have been involuntarily terminated;
(3) the child is an abandoned infant under section 260C.301, subdivision 2, paragraph
(a), clause (2);
(4) the parents' custodial rights to another child have been involuntarily transferred to a
relative under a juvenile protection proceeding or a similar process of another jurisdiction;
(5) the parent has committed sexual abuse as defined in section 260E.03, against the
child or another child of the parent;
(6) the parent has committed an offense that requires registration as a predatory offender
under section 243.166, subdivision 1b, paragraph (a) or (b); or
(7) the provision of services or further services for the purpose of reunification is futile
and therefore unreasonable.
(i) When a petition to terminate parental rights is required under section 260C.301,
subdivision 4, or 260C.503, subdivision 2, but the county attorney has determined not to
proceed with a termination of parental rights petition, and has instead filed a petition to
transfer permanent legal and physical custody to a relative under section 260C.507, the
court shall schedule a permanency hearing within 30 days of the filing of the petition.
(j) If the county attorney has filed a petition under section 260C.307, the court shall
schedule a trial under section 260C.163 within 90 days of the filing of the petition except
when the county attorney determines that the criminal case shall proceed to trial first under
section 260C.503, subdivision 2, paragraph (c).
(k) If the court determines the child should be ordered into foster care and the child's
parent refuses to give information to the responsible social services agency regarding the
child's father or relatives of the child, the court may order the parent to disclose the names,
addresses, telephone numbers, and other identifying information to the responsible social
services agency for the purpose of complying with sections 260C.150, 260C.151, 260C.212,
260C.215, 260C.219, and 260C.221.
(l) If a child ordered into foster care has siblings, whether full, half, or step, who are
also ordered into foster care, the court shall inquire of the responsible social services agency
of the efforts to place the children together as required by section 260C.212, subdivision 2,
paragraph (d), if placement together is in each child's best interests, unless a child is in
placement for treatment or a child is placed with a previously noncustodial parent who is
not a parent to all siblings. If the children are not placed together at the time of the hearing,
the court shall inquire at each subsequent hearing of the agency's reasonable efforts to place
the siblings together, as required under section 260.012. If any sibling is not placed with
another sibling or siblings, the agency must develop a plan to facilitate visitation or ongoing
contact among the siblings as required under section 260C.212, subdivision 1, unless it is
contrary to the safety or well-being of any of the siblings to do so.
(m) When the court has ordered the child into the care of a noncustodial parent or in
foster care, the court may order a chemical dependency evaluation, mental health evaluation,
medical examination, and parenting assessment for the parent as necessary to support the
development of a plan for reunification required under subdivision 7 and section 260C.212,
subdivision 1, or the child protective services plan under section 260E.26, and Minnesota
Rules, part 9560.0228.
new text begin
(n) When the court has ordered an Indian child into an emergency child placement, the
Indian child shall be placed according to the placement preferences in the Minnesota Indian
Family Preservation Act, section 260.773.
new text end
Sec. 52.
Minnesota Statutes 2022, section 260D.01, is amended to read:
260D.01 CHILD IN VOLUNTARY FOSTER CARE FOR TREATMENT.
(a) Sections 260D.01 to 260D.10, may be cited as the "child in voluntary foster care for
treatment" provisions of the Juvenile Court Act.
(b) The juvenile court has original and exclusive jurisdiction over a child in voluntary
foster care for treatment upon the filing of a report or petition required under this chapter.
All obligations of the responsible social services agency to a child and family in foster care
contained in chapter 260C not inconsistent with this chapter are also obligations of the
agency with regard to a child in foster care for treatment under this chapter.
(c) This chapter shall be construed consistently with the mission of the children's mental
health service system as set out in section 245.487, subdivision 3, and the duties of an agency
under sections 256B.092 and 260C.157 and Minnesota Rules, parts 9525.0004 to 9525.0016,
to meet the needs of a child with a developmental disability or related condition. This
chapter:
(1) establishes voluntary foster care through a voluntary foster care agreement as the
means for an agency and a parent to provide needed treatment when the child must be in
foster care to receive necessary treatment for an emotional disturbance or developmental
disability or related condition;
(2) establishes court review requirements for a child in voluntary foster care for treatment
due to emotional disturbance or developmental disability or a related condition;
(3) establishes the ongoing responsibility of the parent as legal custodian to visit the
child, to plan together with the agency for the child's treatment needs, to be available and
accessible to the agency to make treatment decisions, and to obtain necessary medical,
dental, and other care for the child;
(4) applies to voluntary foster care when the child's parent and the agency agree that the
child's treatment needs require foster care either:
(i) due to a level of care determination by the agency's screening team informed by the
child's diagnostic and functional assessment under section 245.4885; or
(ii) due to a determination regarding the level of services needed by the child by the
responsible social services agency's screening team under section 256B.092, and Minnesota
Rules, parts 9525.0004 to 9525.0016; and
(5) includes the requirements for a child's placement in sections 260C.70 to 260C.714,
when the juvenile treatment screening team recommends placing a child in a qualified
residential treatment program, except as modified by this chapter.
(d) This chapter does not apply when there is a current determination under chapter
260E that the child requires child protective services or when the child is in foster care for
any reason other than treatment for the child's emotional disturbance or developmental
disability or related condition. When there is a determination under chapter 260E that the
child requires child protective services based on an assessment that there are safety and risk
issues for the child that have not been mitigated through the parent's engagement in services
or otherwise, or when the child is in foster care for any reason other than the child's emotional
disturbance or developmental disability or related condition, the provisions of chapter 260C
apply.
(e) The paramount consideration in all proceedings concerning a child in voluntary foster
care for treatment is the safety, health, and the best interests of the child. The purpose of
this chapter is:
(1) to ensure that a child with a disability is provided the services necessary to treat or
ameliorate the symptoms of the child's disability;
(2) to preserve and strengthen the child's family ties whenever possible and in the child's
best interests, approving the child's placement away from the child's parents only when the
child's need for care or treatment requires out-of-home placement and the child cannot be
maintained in the home of the parent; and
(3) to ensure that the child's parent retains legal custody of the child and associated
decision-making authority unless the child's parent willfully fails or is unable to make
decisions that meet the child's safety, health, and best interests. The court may not find that
the parent willfully fails or is unable to make decisions that meet the child's needs solely
because the parent disagrees with the agency's choice of foster care facility, unless the
agency files a petition under chapter 260C, and establishes by clear and convincing evidence
that the child is in need of protection or services.
(f) The legal parent-child relationship shall be supported under this chapter by maintaining
the parent's legal authority and responsibility for ongoing planning for the child and by the
agency's assisting the parent, when necessary, to exercise the parent's ongoing right and
obligation to visit or to have reasonable contact with the child. Ongoing planning means:
(1) actively participating in the planning and provision of educational services, medical,
and dental care for the child;
(2) actively planning and participating with the agency and the foster care facility for
the child's treatment needs;
(3) planning to meet the child's need for safety, stability, and permanency, and the child's
need to stay connected to the child's family and community;
(4) engaging with the responsible social services agency to ensure that the family and
permanency team under section 260C.706 consists of appropriate family members. For
purposes of voluntary placement of a child in foster care for treatment under chapter 260D,
prior to forming the child's family and permanency team, the responsible social services
agency must consult with the child's parent or legal guardian, the child if the child is 14
years of age or older, and, if applicable, the child's Tribe to obtain recommendations regarding
which individuals to include on the team and to ensure that the team is family-centered and
will act in the child's best interests. If the child, child's parents, or legal guardians raise
concerns about specific relatives or professionals, the team should not include those
individuals unless the individual is a treating professional or an important connection to the
youth as outlined in the case or crisis plan; and
(5) for a voluntary placement under this chapter in a qualified residential treatment
program, as defined in section 260C.007, subdivision 26d, for purposes of engaging in a
relative search as provided in section 260C.221, the county agency must consult with the
child's parent or legal guardian, the child if the child is 14 years of age or older, and, if
applicable, the child's Tribe to obtain recommendations regarding which adult relatives the
county agency should notify. If the child, child's parents, or legal guardians raise concerns
about specific relatives, the county agency should not notify those relatives.
(g) The provisions of section 260.012 to ensure placement prevention, family
reunification, and all active and reasonable effort requirements of that section apply. deleted text begin This
deleted text end deleted text begin chapter shall be construed consistently with the requirements of the Indian Child Welfare
deleted text end deleted text begin Act of 1978, United States Code, title 25, section 1901, et al., and the provisions of the
deleted text end deleted text begin Minnesota Indian Family Preservation Act, sections 260.751 to 260.835.
deleted text end
Sec. 53.
new text begin
[260D.011] COMPLIANCE WITH FEDERAL INDIAN CHILD WELFARE
ACT AND MINNESOTA INDIAN FAMILY PRESERVATION ACT.
new text end
new text begin
Proceedings under this chapter concerning an Indian child are child custody proceedings
governed by the Indian Child Welfare Act, United States Code, title 25, sections 1901 to
1963; by the Minnesota Indian Family Preservation Act, sections 260.751 to 260.835; and
by this chapter when not inconsistent with the federal Indian Child Welfare Act or the
Minnesota Indian Family Preservation Act.
new text end
Sec. 54.
new text begin
[260E.015] COMPLIANCE WITH FEDERAL INDIAN CHILD WELFARE
ACT AND MINNESOTA INDIAN FAMILY PRESERVATION ACT.
new text end
new text begin
Proceedings under this chapter concerning an Indian child are child custody proceedings
governed by the Indian Child Welfare Act, United States Code, title 25, sections 1901 to
1963; by the Minnesota Indian Family Preservation Act, sections 260.751 to 260.835; and
by this chapter when not inconsistent with the federal Indian Child Welfare Act or the
Minnesota Indian Family Preservation Act.
new text end
Sec. 55.
new text begin
[524.5-2011] COMPLIANCE WITH FEDERAL INDIAN CHILD WELFARE
ACT AND MINNESOTA INDIAN FAMILY PRESERVATION ACT.
new text end
new text begin
Proceedings under this chapter concerning an Indian child are child custody proceedings
governed by the Indian Child Welfare Act, United States Code, title 25, sections 1901 to
1963; by the Minnesota Indian Family Preservation Act, sections 260.751 to 260.835; and
by this chapter when not inconsistent with the federal Indian Child Welfare Act or the
Minnesota Indian Family Preservation Act.
new text end
Sec. 56. new text begin DIRECTION TO COMMISSIONER OF HUMAN SERVICES; STUDY OF
CHILD PLACEMENT AND PERMANENCY; PRACTICE RECOMMENDATIONS.
new text end
new text begin Subdivision 1. new text end
new text begin Study parameters. new text end
new text begin
By September 1, 2024, the commissioner of human
services shall contract with an independent consultant to evaluate the effects of child
placement in foster care and out-of-home settings on the safety, permanency, and well-being
of the child. The study must be designed to evaluate the system overall for a child's placement
and permanency. The study shall identify and evaluate factors designed to ensure emotional
and physical safety of the child in the context of child placement and permanency dispositions
and shall include an analysis of structuring out-of-home placement decisions, reunification
timelines, and service provisions to best allow the parents to engage in positive parenting
of the child. The goal is to determine guidelines for when to place a child out-of-home, who
to place the child with, when and how to keep the child connected to family and community,
and what timelines support building a stable base for the child's parents to engage in necessary
treatment, including but not limited to substance use or mental health treatment, before
undertaking parenting responsibilities.
new text end
new text begin
(b) The study shall take into account the educational and behavioral development, mental
health functioning, and placement stability of the child. The study shall also take into
consideration the social, financial, and whole health of the family unit.
new text end
new text begin Subd. 2. new text end
new text begin Collaboration with interested parties. new text end
new text begin
The consultant shall design the study
with an advisory group consisting of:
new text end
new text begin
(1) the commissioner of human services, or a designee;
new text end
new text begin
(2) the commissioner of children, youth, and families, or a designee;
new text end
new text begin
(3) the ombudsperson for foster youth, or a designee;
new text end
new text begin
(4) a representative from the Association of Minnesota Counties appointed by the
association;
new text end
new text begin
(5) two members representing county social services agencies, one from the seven-county
metropolitan area and one from Greater Minnesota;
new text end
new text begin
(6) one member appointed by the Minnesota Council on Disability;
new text end
new text begin
(7) one member appointed by the Indian Child Welfare Advisory Council;
new text end
new text begin
(8) one member appointed by the Ombudsperson for American Indian Families;
new text end
new text begin
(9) one member appointed by the Children's Alliance;
new text end
new text begin
(10) up to four members appointed by the ombudsperson for families;
new text end
new text begin
(11) up to four members from the Children's Justice Task Force; and
new text end
new text begin
(12) members of the public appointed by the governor representing:
new text end
new text begin
(i) one member 18 years of age who has lived experience with the child welfare system;
new text end
new text begin
(ii) one member 18 years of age or older who has lived experience with the child welfare
system as a parent or caregiver;
new text end
new text begin
(iii) one member who is working with or advocating for children with disabilities;
new text end
new text begin
(iv) one member with experience working with or advocating for LGBTQ youth;
new text end
new text begin
(v) one member working with or advocating for Indigenous children;
new text end
new text begin
(vi) one member working with or advocating for black children or youth;
new text end
new text begin
(vii) one member working with or advocating for other children of color;
new text end
new text begin
(viii) one member who is an attorney representing children in child placement
proceedings;
new text end
new text begin
(ix) one member who is a Tribal attorney in child placement proceedings;
new text end
new text begin
(x) one member who is an attorney representing parents in child placement proceedings;
new text end
new text begin
(xi) one member with experience in children's mental health;
new text end
new text begin
(xii) one member with experience in adult mental health; and
new text end
new text begin
(xiii) one member who is a substance abuse professional.
new text end
new text begin Subd. 3. new text end
new text begin Report. new text end
new text begin
By September 1, 2027, the consultant shall submit a final report to the
commissioner of human services and to the chairs and ranking minority members of the
legislative committees with jurisdiction over health and human services. The final report
must include a recommendation on the optimal time frame for child placement in foster
care or out-of-home placement. The commissioner of human services shall include a report
on needed statutory changes as a result of the consultant's report.
new text end
Sec. 57. new text begin REPEALER.
new text end
new text begin
Minnesota Statutes 2022, section 260.755, subdivision 13,
new text end
new text begin
is repealed.
new text end
ARTICLE 16
MINNESOTA AFRICAN AMERICAN FAMILY PRESERVATION AND CHILD
WELFARE DISPROPORTIONALITY ACT
Section 1.
new text begin
[260.61] CITATION.
new text end
new text begin
Sections 260.61 to 260.695 may be cited as the "Minnesota African American Family
Preservation and Child Welfare Disproportionality Act."
new text end
new text begin EFFECTIVE DATE. new text end
new text begin
This section is effective July 1, 2026, except as provided under
section 19 of this article.
new text end
Sec. 2.
new text begin
[260.62] PURPOSES.
new text end
new text begin
(a) The purposes of the Minnesota African American Family Preservation and Child
Welfare Disproportionality Act are to:
new text end
new text begin
(1) protect the best interests of African American and disproportionately represented
children;
new text end
new text begin
(2) promote the stability and security of African American and disproportionately
represented children and their families by establishing minimum standards to prevent the
arbitrary and unnecessary removal of African American and disproportionately represented
children from their families; and
new text end
new text begin
(3) improve permanency outcomes, including family reunification, for African American
and disproportionately represented children.
new text end
new text begin
(b) Nothing in this legislation is intended to interfere with the protections of the Indian
Child Welfare Act of 1978, United States Code, title 25, sections 1901 to 1963.
new text end
new text begin EFFECTIVE DATE. new text end
new text begin
This section is effective July 1, 2026, except as provided under
section 19 of this article.
new text end
Sec. 3.
new text begin
[260.63] 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 260.61 to 260.695.
new text end
new text begin Subd. 2. new text end
new text begin Active efforts. new text end
new text begin
"Active efforts" means a rigorous and concerted level of effort
that the responsible social services agency must continuously make throughout the time
that the responsible social services agency is involved with an African American or a
disproportionately represented child and the child's family. To provide active efforts to
preserve an African American or a disproportionately represented child's family, the
responsible social services agency must continuously involve an African American or a
disproportionately represented child's family in all services for the family, including case
planning and choosing services and providers, and inform the family of the ability to request
a case review by the commissioner under section 260.694. When providing active efforts,
a responsible social services agency must consider an African American or a
disproportionately represented family's social and cultural values at all times while providing
services to the African American or disproportionately represented child and family. Active
efforts includes continuous efforts to preserve an African American or a disproportionately
represented child's family and to prevent the out-of-home placement of an African American
or a disproportionately represented child. If an African American or a disproportionately
represented child enters out-of-home placement, the responsible social services agency must
make active efforts to reunify the African American or disproportionately represented child
with the child's family as soon as possible. Active efforts sets a higher standard for the
responsible social services agency than reasonable efforts to preserve the child's family,
prevent the child's out-of-home placement, and reunify the child with the child's family.
Active efforts includes the provision of reasonable efforts as required by Title IV-E of the
Social Security Act, United States Code, title 42, sections 670 to 679c.
new text end
new text begin Subd. 3. new text end
new text begin Adoptive placement. new text end
new text begin
"Adoptive placement" means the permanent placement
of an African American or a disproportionately represented child made by the responsible
social services agency upon a fully executed adoption placement agreement, including the
signatures of the adopting parent, the responsible social services agency, and the
commissioner of human services according to section 260C.613, subdivision 1.
new text end
new text begin Subd. 4. new text end
new text begin African American child. new text end
new text begin
"African American child" means a child having
origins in Africa, including a child of two or more races who has at least one parent with
origins in Africa.
new text end
new text begin Subd. 5. new text end
new text begin
Best interests of the African American or disproportionately represented
child.
new text end
new text begin
The "best interests of the African American or disproportionately represented child"
means providing a culturally informed practice lens that acknowledges, utilizes, and embraces
the African American or disproportionately represented child's community and cultural
norms and allows the child to remain safely at home with the child's family. The best interests
of the African American or disproportionately represented child support the child's sense
of belonging to the child's family, extended family, kin, and cultural community.
new text end
new text begin Subd. 6. new text end
new text begin Child placement proceeding. new text end
new text begin
(a) "Child placement proceeding" means any
judicial proceeding that could result in:
new text end
new text begin
(1) an adoptive placement;
new text end
new text begin
(2) a foster care placement;
new text end
new text begin
(3) a preadoptive placement; or
new text end
new text begin
(4) a termination of parental rights.
new text end
new text begin
(b) Judicial proceedings under this subdivision include a child's placement based upon
a child's juvenile status offense but do not include a child's placement based upon:
new text end
new text begin
(1) an act which if committed by an adult would be deemed a crime; or
new text end
new text begin
(2) an award of child custody in a divorce proceeding to one of the child's parents.
new text end
new text begin Subd. 7. new text end
new text begin Commissioner. new text end
new text begin
"Commissioner" means the commissioner of human services
or the commissioner's designee.
new text end
new text begin Subd. 8. new text end
new text begin Custodian. new text end
new text begin
"Custodian" means any person who is under a legal obligation to
provide care and support for an African American or a disproportionately represented child,
or who is in fact providing daily care and support for an African American or a
disproportionately represented child. This subdivision does not impose a legal obligation
upon a person who is not otherwise legally obligated to provide a child with necessary food,
clothing, shelter, education, or medical care.
new text end
new text begin Subd. 9. new text end
new text begin Disproportionality. new text end
new text begin
"Disproportionality" means the overrepresentation of
African American children and other disproportionately represented children in Minnesota's
child welfare system population as compared to the representation of those children in
Minnesota's total child population.
new text end
new text begin Subd. 10. new text end
new text begin Disproportionately represented child. new text end
new text begin
"Disproportionately represented child"
means a child whose race, culture, ethnicity, or low-income socioeconomic status is
disproportionately encountered, engaged, or identified in the child welfare system as
compared to the representation in Minnesota's total child population.
new text end
new text begin Subd. 11. new text end
new text begin Egregious harm. new text end
new text begin
"Egregious harm" has the meaning given in section 260E.03,
subdivision 5.
new text end
new text begin Subd. 12. new text end
new text begin Foster care placement. new text end
new text begin
"Foster care placement" means the court-ordered
removal of an African American or a disproportionately represented child from the child's
home with the child's parent or legal custodian and the temporary placement of the child in
a foster home, in shelter care or a facility, or in the home of a guardian, when the parent or
legal custodian cannot have the child returned upon demand, but the parent's parental rights
have not been terminated. A foster care placement includes an order placing the child under
the guardianship of the commissioner, pursuant to section 260C.325, prior to an adoption
being finalized.
new text end
new text begin Subd. 13. new text end
new text begin Imminent physical damage or harm. new text end
new text begin
"Imminent physical damage or harm"
means that a child is threatened with immediate and present conditions that are
life-threatening or likely to result in abandonment, sexual abuse, or serious physical injury.
new text end
new text begin Subd. 14. new text end
new text begin Responsible social services agency. new text end
new text begin
"Responsible social services agency"
has the meaning given in section 260C.007, subdivision 27a.
new text end
new text begin Subd. 15. new text end
new text begin Parent. new text end
new text begin
"Parent" means the biological parent of an African American or a
disproportionately represented child or any person who has legally adopted an African
American or a disproportionately represented child who, prior to the adoption, was considered
a relative to the child, as defined in subdivision 16. Parent includes an unmarried father
whose paternity has been acknowledged or established and a putative father. Paternity has
been acknowledged when an unmarried father takes any action to hold himself out as the
biological father of a child.
new text end
new text begin Subd. 16. new text end
new text begin Preadoptive placement. new text end
new text begin
"Preadoptive placement" means a responsible social
services agency's placement of an African American or a disproportionately represented
child with the child's family or kin when the child is under the guardianship of the
commissioner for the purpose of adoption but an adoptive placement agreement for the
child has not been fully executed.
new text end
new text begin Subd. 17. new text end
new text begin Relative. new text end
new text begin
"Relative" means:
new text end
new text begin
(1) an individual related to the child by blood, marriage, or adoption;
new text end
new text begin
(2) a legal parent, guardian, or custodian of the child's sibling;
new text end
new text begin
(3) an individual who is an important friend of the child or child's family with whom
the child has resided or has had significant contact; or
new text end
new text begin
(4) an individual who the child or the child's family identify as related to the child's
family.
new text end
new text begin Subd. 18. new text end
new text begin Safety network. new text end
new text begin
"Safety network" means a group of individuals identified by
the parent and child, when appropriate, that is accountable for developing, implementing,
sustaining, supporting, or improving a safety plan to protect the safety and well-being of a
child.
new text end
new text begin Subd. 19. new text end
new text begin Sexual abuse. new text end
new text begin
"Sexual abuse" has the meaning given in section 260E.03,
subdivision 20.
new text end
new text begin Subd. 20. new text end
new text begin Termination of parental rights. new text end
new text begin
"Termination of parental rights" means an
action resulting in the termination of the parent-child relationship under section 260C.301.
new text end
new text begin EFFECTIVE DATE. new text end
new text begin
This section is effective July 1, 2026, except as provided under
section 19 of this article.
new text end
Sec. 4.
new text begin
[260.64] DUTY TO PREVENT OUT-OF-HOME PLACEMENT AND
PROMOTE FAMILY REUNIFICATION.
new text end
new text begin Subdivision 1. new text end
new text begin Active efforts. new text end
new text begin
A responsible social services agency shall make active
efforts to prevent the out-of-home placement of an African American or a disproportionately
represented child, eliminate the need for a child's removal from the child's home, and reunify
an African American or a disproportionately represented child with the child's family as
soon as practicable.
new text end
new text begin Subd. 2. new text end
new text begin Safety plan. new text end
new text begin
(a) Prior to petitioning the court to remove an African American
or a disproportionately represented child from the child's home, a responsible social services
agency must work with the child's family to allow the child to remain in the child's home
while implementing a safety plan based on the family's needs. The responsible social services
agency must:
new text end
new text begin
(1) make active efforts to engage the child's parent or custodian and the child, when
appropriate;
new text end
new text begin
(2) assess the family's cultural and economic needs;
new text end
new text begin
(3) hold a family group consultation meeting and connect the family with supports to
establish a safety network for the family; and
new text end
new text begin
(4) provide support, guidance, and input to assist the family and the family's safety
network with developing the safety plan.
new text end
new text begin
(b) The safety plan must:
new text end
new text begin
(1) address the specific allegations impacting the child's safety in the home. If neglect
is alleged, the safety plan must incorporate economic services and supports to address the
family's specific needs and prevent neglect;
new text end
new text begin
(2) incorporate family and community support to ensure the child's safety while keeping
the family intact; and
new text end
new text begin
(3) be adjusted as needed to address the child's and family's ongoing needs and support.
new text end
new text begin
(c) The responsible social services agency is not required to establish a safety plan in a
case with allegations of sexual abuse or egregious harm.
new text end
new text begin Subd. 3. new text end
new text begin Out-of-home placement prohibited. new text end
new text begin
Unless the court finds by clear and
convincing evidence that the child would be at risk of serious emotional damage or serious
physical damage if the child were to remain in the child's home, a court shall not order a
foster care or permanent out-of-home placement of an African American or a
disproportionately represented child alleged to be in need of protection or services. At each
hearing regarding an African American or a disproportionately represented child who is
alleged or adjudicated to be in need of child protective services, the court shall review
whether the responsible social services agency has provided active efforts to the child and
the child's family and shall require the responsible social services agency to provide evidence
and documentation that demonstrates that the agency is providing culturally informed,
strength-based, community-involved, and community-based services to the child and the
child's family.
new text end
new text begin Subd. 4. new text end
new text begin Required findings that active efforts were provided. new text end
new text begin
When determining
whether the responsible social services agency has made active efforts to preserve the child's
family, the court shall make findings regarding whether the responsible social services
agency made appropriate and meaningful services available to the child's family based upon
the family's specific needs. If a court determines that the responsible social services agency
did not make active efforts to preserve the family as required by this section, the court shall
order the responsible social services agency to immediately provide active efforts to the
child and child's family to preserve the family.
new text end
new text begin EFFECTIVE DATE. new text end
new text begin
This section is effective July 1, 2026, except as provided under
section 19 of this article.
new text end
Sec. 5.
new text begin
[260.641] ENSURING FREQUENT VISITATION FOR AFRICAN
AMERICAN AND DISPROPORTIONATELY REPRESENTED CHILDREN IN
OUT-OF-HOME PLACEMENT.
new text end
new text begin
A responsible social services agency must engage in best practices related to visitation
when an African American or a disproportionately represented child is in out-of-home
placement. When the child is in out-of-home placement, the responsible social services
agency shall make active efforts to facilitate regular and frequent visitation between the
child and the child's parents or custodians, the child's siblings, and the child's relatives. If
visitation is infrequent between the child and the child's parents, custodians, siblings, or
relatives, the responsible social services agency shall make active efforts to increase the
frequency of visitation and address any barriers to visitation.
new text end
new text begin EFFECTIVE DATE. new text end
new text begin
This section is effective July 1, 2026, except as provided under
section 19 of this article.
new text end
Sec. 6.
new text begin
[260.65] NONCUSTODIAL PARENTS; TEMPORARY OUT-OF-HOME
PLACEMENT.
new text end
new text begin Subdivision 1. new text end
new text begin Active efforts required; responsible social services agency. new text end
new text begin
Prior to
or within 48 hours of the removal of an African American or a disproportionately represented
child from the child's home, the responsible social services agency must make active efforts
to identify and locate the child's noncustodial or nonadjudicated parent and the child's
relatives to notify the child's parent and relatives that the child is or will be placed in foster
care and provide the child's parent and relatives with a list of legal resources. The notice to
the child's noncustodial or nonadjudicated parent and relatives must also include the
information required under section 260C.221, subdivision 2. The responsible social services
agency must maintain detailed records of the agency's efforts to notify parents and relatives
under this section.
new text end
new text begin Subd. 2. new text end
new text begin Placement with noncustodial or nonadjudicated parent. new text end
new text begin
(a) Notwithstanding
the provisions of section 260C.219, the responsible social services agency must assess an
African American or a disproportionately represented child's noncustodial or nonadjudicated
parent's ability to care for the child before placing the child in foster care. If a child's
noncustodial or nonadjudicated parent is willing and able to provide daily care for the
African American or disproportionately represented child temporarily or permanently, the
court shall order that the child be placed in the home of the noncustodial or nonadjudicated
parent pursuant to section 260C.178 or 260C.201, subdivision 1. The responsible social
services agency must make active efforts to assist a noncustodial or nonadjudicated parent
with remedying any issues that may prevent the child from being placed with the noncustodial
or nonadjudicated parent.
new text end
new text begin
(b) If an African American or a disproportionately represented child's noncustodial or
nonadjudicated parent is unwilling or unable to provide daily care for the child and the court
has determined that the child's continued placement in the home of the child's noncustodial
or nonadjudicated parent would endanger the child's health, safety, or welfare, the child's
parent, custodian, or the child, when appropriate, has the right to select one or more relatives
who may be willing and able to provide temporary care for the child. The responsible social
services agency must place the child with a selected relative after assessing the relative's
willingness and ability to provide daily care for the child. If selected relatives are not available
or there is a documented safety concern with the relative placement, the responsible social
services agency shall consider additional relatives for the child's placement.
new text end
new text begin Subd. 3. new text end
new text begin Informal kinship care agreement. new text end
new text begin
The responsible social services agency
must inform selected relatives and the child's parent or custodian of the difference between
informal kinship care arrangements and court-ordered foster care. If a selected relative and
the child's parent or custodian request an informal kinship care arrangement for a child's
placement instead of court-ordered foster care and such an arrangement will maintain the
child's safety and well-being, the responsible social services agency shall comply with the
request and inform the court of the plan for the child. The court shall honor the request to
forego a court-ordered foster care placement of the child in favor of an informal kinship
care arrangement, unless the court determines that the request is not in the best interests of
the African American or disproportionately represented child.
new text end
new text begin Subd. 4. new text end
new text begin Active efforts; child foster care licensure process. new text end
new text begin
The responsible social
services agency must make active efforts to support relatives with whom a child is placed
in completing the child foster care licensure process and addressing barriers, disqualifications,
or other issues affecting the relatives' licensure, including but not limited to assisting relatives
with requesting reconsideration of a disqualification under section 245C.21.
new text end
new text begin Subd. 5. new text end
new text begin Future placement not prohibited. new text end
new text begin
The decision by a relative not to be
considered as an African American or a disproportionately represented child's foster care
or temporary placement option shall not be a basis for the responsible social services agency
or the court to rule out the relative for placement in the future or for denying the relative's
request to be considered or selected as a foster care or permanent placement for the child.
new text end
new text begin EFFECTIVE DATE. new text end
new text begin
This section is effective July 1, 2026, except as provided under
section 19 of this article.
new text end
Sec. 7.
new text begin
[260.66] EMERGENCY REMOVAL.
new text end
new text begin Subdivision 1. new text end
new text begin Emergency removal or placement permitted. new text end
new text begin
Nothing in this section
shall be construed to prevent the emergency removal of an African American or a
disproportionately represented child's parent or custodian or the emergency placement of
the child in a foster setting in order to prevent imminent physical damage or harm to the
child.
new text end
new text begin Subd. 2. new text end
new text begin Petition for emergency removal; placement requirements. new text end
new text begin
A petition for a
court order authorizing the emergency removal or continued emergency placement of an
African American or a disproportionately represented child or the petition's accompanying
documents must contain a statement of the risk of imminent physical damage or harm to
the African American or disproportionately represented child and any evidence that the
emergency removal or placement continues to be necessary to prevent imminent physical
damage or harm to the child. The petition or its accompanying documents must also contain
the following information:
new text end
new text begin
(1) the name, age, and last known address of the child;
new text end
new text begin
(2) the name and address of the child's parents and custodians, or, if unknown, a detailed
explanation of efforts made to locate and contact them;
new text end
new text begin
(3) the steps taken to provide notice to the child's parents and custodians about the
emergency proceeding;
new text end
new text begin
(4) a specific and detailed account of the circumstances that led the agency responsible
for the emergency removal of the child to take that action; and
new text end
new text begin
(5) a statement of the efforts that have been taken to assist the child's parents or custodians
so that the child may safely be returned to their custody.
new text end
new text begin Subd. 3. new text end
new text begin Emergency proceeding requirements. new text end
new text begin
(a) The court shall hold a hearing no
later than 72 hours, excluding weekends and holidays, after the emergency removal of an
African American or a disproportionately represented child. The court shall determine
whether the emergency removal continues to be necessary to prevent imminent physical
damage or harm to the child.
new text end
new text begin
(b) The court shall hold additional hearings whenever new information indicates that
the emergency situation has ended. At any court hearing after the emergency proceeding,
the court must determine whether the emergency removal or placement is no longer necessary
to prevent imminent physical damage or harm to the child.
new text end
new text begin
(c) Notwithstanding section 260C.163, subdivision 3, and the provisions of Minnesota
Rules of Juvenile Protection Procedure, rule 25, a parent or custodian of an African American
or a disproportionately represented child who is subject to an emergency hearing under this
section and Minnesota Rules of Juvenile Protection Procedure, rule 30, must be represented
by counsel. The court must appoint qualified counsel to represent a parent if the parent
meets the eligibility requirements in section 611.17.
new text end
new text begin Subd. 4. new text end
new text begin Termination of emergency removal or placement. new text end
new text begin
(a) An emergency removal
or placement of an African American or a disproportionately represented child must
immediately terminate once the responsible social services agency or court possesses
sufficient evidence to determine that the emergency removal or placement is no longer
necessary to prevent imminent physical damage or harm to the child and the child shall be
immediately returned to the custody of the child's parent or custodian. The responsible social
services agency or court shall ensure that the emergency removal or placement terminates
immediately when the removal or placement is no longer necessary to prevent imminent
physical damage or harm to the African American or disproportionately represented child.
new text end
new text begin
(b) An emergency removal or placement ends when the court orders, after service upon
the African American or disproportionately represented child's parents or custodian, that
the child shall be placed in foster care upon a determination supported by clear and
convincing evidence that custody of the child by the child's parent or custodian is likely to
result in serious emotional or physical damage to the child.
new text end
new text begin
(c) In no instance shall emergency removal or emergency placement of an African
American or a disproportionately represented child extend beyond 30 days unless the court
finds by a showing of clear and convincing evidence that:
new text end
new text begin
(1) continued emergency removal or placement is necessary to prevent imminent physical
damage or harm to the child; and
new text end
new text begin
(2) it has not been possible to initiate a child placement proceeding with all of the
protections under sections 260.61 to 260.68.
new text end
new text begin EFFECTIVE DATE. new text end
new text begin
This section is effective July 1, 2026, except as provided under
section 19 of this article.
new text end
Sec. 8.
new text begin
[260.67] TRANSFER OF PERMANENT LEGAL AND PHYSICAL
CUSTODY; TERMINATION OF PARENTAL RIGHTS; CHILD PLACEMENT
PROCEEDINGS.
new text end
new text begin Subdivision 1. new text end
new text begin Preference for transfer of permanent legal and physical custody. new text end
new text begin
If
an African American or a disproportionately represented child cannot be returned to the
child's parent, the court shall, if possible, transfer permanent legal and physical custody of
the child to:
new text end
new text begin
(1) a noncustodial parent under section 260C.515, subdivision 4, if the child cannot
return to the care of the parent or custodian from whom the child was removed or who had
legal custody at the time that the child was placed in foster care; or
new text end
new text begin
(2) a willing and able relative, according to the requirements of section 260C.515,
subdivision 4, if the court determines that reunification with the child's family is not an
appropriate permanency option for the child. Prior to the court ordering a transfer of
permanent legal and physical custody to a relative who is not a parent, the responsible social
services agency must inform the relative of Northstar kinship assistance benefits and
eligibility requirements and of the relative's ability to apply for benefits on behalf of the
child under chapter 256N.
new text end
new text begin Subd. 2. new text end
new text begin Termination of parental rights restrictions. new text end
new text begin
(a) A court shall not terminate
the parental rights of a parent of an African American or a disproportionately represented
child based solely on the parent's failure to complete case plan requirements.
new text end
new text begin
(b) A court shall not terminate the parental rights of a parent of an African American or
a disproportionately represented child in a child placement proceeding unless the allegations
against the parent involve sexual abuse; egregious harm as defined in section 260C.007,
subdivision 14; murder in the first, second, or third degree under section 609.185, 609.19,
or 609.195; murder of an unborn child in the first, second, or third degree under section
609.2661, 609.2662, or 609.2663; manslaughter of an unborn child in the first or second
degree under section 609.2664 or 609.2665; domestic assault by strangulation under section
609.2247; felony domestic assault under section 609.2242 or 609.2243; kidnapping under
section 609.25; solicitation, inducement, and promotion of prostitution under section 609.322,
subdivision 1, and subdivision 1a if one or more aggravating factors are present; criminal
sexual conduct under sections 609.342 to 609.3451; engaging in, hiring, or agreeing to hire
a minor to engage in prostitution under section 609.324, subdivision 1; solicitation of children
to engage in sexual conduct under section 609.352; possession of pornographic work
involving minors under section 617.247; malicious punishment or neglect or endangerment
of a child under section 609.377 or 609.378; use of a minor in sexual performance under
section 617.246; or failing to protect a child from an overt act or condition that constitutes
egregious harm.
new text end
new text begin
(c) Nothing in this subdivision precludes the court from terminating the parental rights
of a parent of an African American or a disproportionately represented child if the parent
desires to voluntarily terminate the parent's own parental rights for good cause under section
260C.301, subdivision 1, paragraph (a).
new text end
new text begin Subd. 3. new text end
new text begin Appeals. new text end
new text begin
Notwithstanding the Minnesota Rules of Juvenile Protection Procedure,
rule 47.02, subdivision 2, a parent of an African American or a disproportionately represented
child whose parental rights have been terminated may appeal the decision within 90 days
of the service of notice by the court administrator of the filing of the court's order.
new text end
new text begin EFFECTIVE DATE. new text end
new text begin
This section is effective July 1, 2026, except as provided under
section 19 of this article.
new text end
Sec. 9.
new text begin
[260.68] RESPONSIBLE SOCIAL SERVICES AGENCY CONDUCT AND
CASE REVIEW.
new text end
new text begin Subdivision 1. new text end
new text begin Responsible social services agency conduct. new text end
new text begin
(a) A responsible social
services agency employee who has duties related to child protection shall not knowingly:
new text end
new text begin
(1) make untrue statements about any case involving a child alleged to be in need of
protection or services;
new text end
new text begin
(2) intentionally withhold any information that may be material to a case involving a
child alleged to be in need of protection or services; or
new text end
new text begin
(3) fabricate or falsify any documentation or evidence relating to a case involving a child
alleged to be in need of protection or services.
new text end
new text begin
(b) Any of the actions listed in paragraph (a) shall constitute grounds for adverse
employment action.
new text end
new text begin Subd. 2. new text end
new text begin Commissioner notification. new text end
new text begin
(a) When a responsible social services agency
makes a maltreatment determination involving an African American or a disproportionately
represented child or places an African American or a disproportionately represented child
in a foster care placement, the agency shall, within seven days of making a maltreatment
determination or initiating the child's foster care placement, notify the commissioner of the
maltreatment determination or foster care placement and of the steps that the agency has
taken to investigate and remedy the conditions that led to the maltreatment determination
or foster care placement. Upon receiving this notice, the commissioner shall review the
responsible social services agency's handling of the child's case to ensure that the case plan
and services address the unique needs of the child and the child's family and that the agency
is making active efforts to reunify and preserve the child's family. At all stages of a case
involving an African American or a disproportionately represented child, the responsible
social services agency shall, upon request, fully cooperate with the commissioner and, as
appropriate and as permitted under statute, provide access to all relevant case files.
new text end
new text begin
(b) In any adoptive or preadoptive placement proceeding involving an African American
or a disproportionately represented child under the guardianship of the commissioner, the
responsible social services agency shall notify the commissioner of the pending proceeding
and of the right of intervention. The notice must include the identity of the child and the
child's parents whose parental rights were terminated or who consented to the child's
adoption. Upon receipt of the notice, the commissioner shall review the case to ensure that
the requirements of this act have been met. When the responsible social services agency
has identified a nonrelative as an African American or a disproportionately represented
child's adoptive placement, no preadoptive or adoptive placement proceeding may be held
until at least 30 days after the commissioner receives the required notice or until an adoption
home study can be completed for a relative adoption, whichever occurs first. If the
commissioner requests additional time to prepare for the proceeding, the district court must
grant the commissioner up to 30 additional days to prepare for the proceeding. In cases in
which a responsible social services agency or party to a preadoptive or adoptive placement
knows or has reason to believe that a child is or may be African American or a
disproportionately represented child, proof of service upon the commissioner must be filed
with the adoption petition.
new text end
new text begin Subd. 3. new text end
new text begin Case review. new text end
new text begin
(a) Each responsible social services agency shall conduct a review
of all child protection cases handled by the agency every 24 months, after establishing a
2024 baseline. The responsible social services agency shall report the agency's findings to
the county board, related child welfare committees, the Children's Justice Initiative team,
the commissioner, and community stakeholders within six months of gathering the relevant
case data. The case review must include:
new text end
new text begin
(1) the number of African American and disproportionately represented children
represented in the county child welfare system;
new text end
new text begin
(2) the number and sources of maltreatment reports received and reports screened in for
investigation or referred for family assessment and the race of the children and parents or
custodians involved in each report;
new text end
new text begin
(3) the number and race of children and parents or custodians who receive in-home
preventive case management services;
new text end
new text begin
(4) the number and race of children whose parents or custodians are referred to
community-based, culturally appropriate, strength-based, or trauma-informed services;
new text end
new text begin
(5) the number and race of children removed from their homes;
new text end
new text begin
(6) the number and race of children reunified with their parents or custodians;
new text end
new text begin
(7) the number and race of children whose parents or custodians are offered family group
decision-making services;
new text end
new text begin
(8) the number and race of children whose parents or custodians are offered the parent
support outreach program;
new text end
new text begin
(9) the number and race of children in foster care or out-of-home placement at the time
that the data is gathered;
new text end
new text begin
(10) the number and race of children who achieve permanency through a transfer of
permanent legal and physical custody to a relative, a legal guardianship, or an adoption;
and
new text end
new text begin
(11) the number and race of children who are under the guardianship of the commissioner
or awaiting a permanency disposition.
new text end
new text begin
(b) The required case review must also:
new text end
new text begin
(1) identify barriers to reunifying children with their families;
new text end
new text begin
(2) identify the family conditions that led to the out-of-home placement;
new text end
new text begin
(3) identify any barriers to accessing culturally informed mental health or substance use
disorder treatment services for the parents or children;
new text end
new text begin
(4) document efforts to identify fathers and maternal and paternal relatives and to provide
services to custodial and noncustodial fathers, if appropriate; and
new text end
new text begin
(5) document and summarize court reviews of active efforts.
new text end
new text begin
(c) Any responsible social services agency that has a case review showing
disproportionality and disparities in child welfare outcomes for African American and other
disproportionately represented children and families, compared to the agency's overall
outcomes, must develop a remediation plan to be approved by the commissioner. The
responsible social services agency must develop the plan within 30 days of finding the
disproportionality or disparities and must make measurable improvements within 12 months
of the date that the commissioner approves the remediation plan. A responsible social
services agency may request assistance from the commissioner to develop a remediation
plan. The remediation plan must include measurable outcomes to identify, address, and
reduce the factors that led to the disproportionality and disparities in the agency's child
welfare outcomes and include information about how the responsible social services agency
will achieve and document trauma-informed, positive child well-being outcomes through
remediation efforts.
new text end
new text begin EFFECTIVE DATE. new text end
new text begin
This section is effective July 1, 2026, except as provided under
section 19 of this article.
new text end
Sec. 10.
new text begin
[260.69] CULTURAL COMPETENCY TRAINING FOR INDIVIDUALS
WORKING WITH AFRICAN AMERICAN AND DISPROPORTIONATELY
REPRESENTED CHILDREN.
new text end
new text begin Subdivision 1. new text end
new text begin Applicability. new text end
new text begin
The commissioner of human services must collaborate
with the Children's Justice Initiative to ensure that cultural competency training is given to
individuals working in the child welfare system, including child welfare workers, supervisors,
attorneys, juvenile court judges, and family law judges.
new text end
new text begin Subd. 2. new text end
new text begin Training. new text end
new text begin
(a) The commissioner must develop training content and establish
the frequency of trainings.
new text end
new text begin
(b) The cultural competency training under this section is required prior to or within six
months of beginning work with any African American or disproportionately represented
child and their family. A responsible social services agency staff person who is unable to
complete the cultural competency training prior to working with African American or
disproportionately represented children and their families must work with a qualified staff
person within the agency who has completed cultural competency training until the person
is able to complete the required training. The training must be available by January 1, 2027,
and must:
new text end
new text begin
(1) be provided by an African American individual or individual from a community that
is disproportionately represented in the child welfare system who is knowledgeable about
African American and other disproportionately represented social and cultural norms and
historical trauma;
new text end
new text begin
(2) raise awareness and increase a person's competency to value diversity, conduct a
self-assessment, manage the dynamics of difference, acquire cultural knowledge, and adapt
to diversity and the cultural contexts of communities served;
new text end
new text begin
(3) include instruction on effectively developing a safety plan and instruction on engaging
a safety network; and
new text end
new text begin
(4) be accessible and comprehensive and include the ability to ask questions.
new text end
new text begin
(c) The training may be provided in a series of segments, either in person or online.
new text end
new text begin Subd. 3. new text end
new text begin Update. new text end
new text begin
The commissioner must provide an update to the chairs and ranking
minority members of the legislative committees with jurisdiction over child protection by
July 1, 2027, on the rollout of the training under subdivision 1 and the content and
accessibility of the training under subdivision 2.
new text end
new text begin EFFECTIVE DATE. new text end
new text begin
This section is effective July 1, 2026, except as provided under
section 19 of this article.
new text end
Sec. 11.
new text begin
[260.691] AFRICAN AMERICAN CHILD WELL-BEING ADVISORY
COUNCIL.
new text end
new text begin Subdivision 1. new text end
new text begin Duties. new text end
new text begin
The African American Child Well-Being Advisory Council must:
new text end
new text begin
(1) review annual reports related to African American children involved in the child
welfare system. These reports may include, but are not limited to the maltreatment,
out-of-home placement, and permanency of African American children;
new text end
new text begin
(2) assist in and make recommendations to the commissioner for developing strategies
to reduce maltreatment determinations, prevent unnecessary out-of-home placement, promote
culturally appropriate foster care and shelter or facility placement decisions and settings for
African American children in need of out-of-home placement, ensure timely achievement
of permanency, and improve child welfare outcomes for African American children and
their families;
new text end
new text begin
(3) review summary reports on targeted case reviews prepared by the commissioner to
ensure that responsible social services agencies meet the needs of African American children
and their families. Based on data collected from those reviews, the council will assist the
commissioner with developing strategies needed to improve any identified child welfare
outcomes, including but not limited to maltreatment, out-of-home placement, and permanency
for African American children;
new text end
new text begin
(4) assist the Cultural and Ethnic Communities Leadership Council with making
recommendations to the commissioner and the legislature for public policy and statutory
changes that specifically consider the needs of African American children and their families
involved in the child welfare system;
new text end
new text begin
(5) advise the commissioner on stakeholder engagement strategies and actions that the
commissioner and responsible social services agencies may take to improve child welfare
outcomes for African American children and their families;
new text end
new text begin
(6) assist the commissioner with developing strategies for public messaging and
communication related to racial disproportionality and disparities in child welfare outcomes
for African American children and their families;
new text end
new text begin
(7) assist the commissioner with identifying and developing internal and external
partnerships to support adequate access to services and resources for African American
children and their families, including but not limited to housing assistance, employment
assistance, food and nutrition support, health care, child care assistance, and educational
support and training; and
new text end
new text begin
(8) assist the commissioner with developing strategies to promote the development of
a culturally diverse and representative child welfare workforce in Minnesota that includes
professionals who are reflective of the community served and who have been directly
impacted by lived experiences within the child welfare system. The council must also assist
the commissioner in exploring strategies and partnerships to address education and training
needs, hiring, recruitment, retention, and professional advancement practices.
new text end
new text begin Subd. 2. new text end
new text begin Annual report. new text end
new text begin
By January 1, 2026, and annually thereafter, the council shall
report to the chairs and ranking minority members of the legislative committees with
jurisdiction over child protection on the council's activities under subdivision 1 and other
issues on which the council chooses to report. The report may include recommendations
for statutory changes to improve the child protection system and child welfare outcomes
for African American children 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. 12.
new text begin
[260.692] AFRICAN AMERICAN CHILD WELL-BEING UNIT.
new text end
new text begin Subdivision 1. new text end
new text begin Duties. new text end
new text begin
The African American Child Well-Being Unit, currently
established by the commissioner, must:
new text end
new text begin
(1) assist with the development of African American cultural competency training and
review child welfare curriculum in the Minnesota Child Welfare Training Academy to
ensure that responsible social services agency staff and other child welfare professionals
are appropriately prepared to engage with African American children and their families and
to support family preservation and reunification;
new text end
new text begin
(2) provide technical assistance, including on-site technical assistance, and case
consultation to responsible social services agencies to assist agencies with implementing
and complying with the Minnesota African American Family Preservation and Child Welfare
Disproportionality Act;
new text end
new text begin
(3) monitor individual county and statewide disaggregated and nondisaggregated data
to identify trends and patterns in child welfare outcomes, including but not limited to
reporting, maltreatment, out-of-home placement, and permanency of African American
children and develop strategies to address disproportionality and disparities in the child
welfare system;
new text end
new text begin
(4) develop and implement a system for conducting case reviews when the commissioner
receives reports of noncompliance with the Minnesota African American Family Preservation
and Child Welfare Disproportionality Act or when requested by the parent or custodian of
an African American child. Case reviews may include but are not limited to a review of
placement prevention efforts, safety planning, case planning and service provision by the
responsible social services agency, relative placement consideration, and permanency
planning;
new text end
new text begin
(5) establish and administer a request for proposals process for African American and
disproportionately represented family preservation grants under section 260.693, monitor
grant activities, and provide technical assistance to grantees;
new text end
new text begin
(6) in coordination with the African American Child Well-Being Advisory Council,
coordinate services and create internal and external partnerships to support adequate access
to services and resources for African American children and their families, including but
not limited to housing assistance, employment assistance, food and nutrition support, health
care, child care assistance, and educational support and training; and
new text end
new text begin
(7) develop public messaging and communication to inform the public about racial
disparities in child welfare outcomes, current efforts and strategies to reduce racial disparities,
and resources available to African American children and their families involved in the
child welfare system.
new text end
new text begin Subd. 2. new text end
new text begin Case reviews. new text end
new text begin
(a) The African American Child Well-Being Unit must conduct
systemic case reviews to monitor targeted child welfare outcomes, including but not limited
to maltreatment, out-of-home placement, and permanency of African American children.
new text end
new text begin
(b) The reviews under this subdivision must be conducted using a random sampling of
representative child welfare cases stratified for certain case related factors, including but
not limited to case type, maltreatment type, if the case involves out-of-home placement,
and other demographic variables. In conducting the reviews, unit staff may use court records
and documents, information from the social services information system, and other available
case file information to complete the case reviews.
new text end
new text begin
(c) The frequency of the reviews and the number of cases, child welfare outcomes, and
selected counties reviewed will be determined by the unit in consultation with the African
American Child Well-Being Advisory Council, with consideration given to the availability
of unit resources needed to conduct the reviews.
new text end
new text begin
(d) The unit must monitor all case reviews and use the collective case review information
and data to generate summary case review reports, ensure compliance with the Minnesota
African American Family Preservation and Child Welfare Disproportionality Act, and
identify trends or patterns in child welfare outcomes for African American children.
new text end
new text begin Subd. 3. new text end
new text begin Reports. new text end
new text begin
The African American Child Well-Being Unit must provide regular
updates on unit activities, including summary reports of case reviews, to the African
American Child Well-Being Advisory Council, and must publish an annual census of African
American children in out-of-home placements statewide. The annual census must include
data on the types of placements, age and sex of the children, how long the children have
been in out-of-home placements, and other relevant demographic information.
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.
new text begin
[260.693] AFRICAN AMERICAN AND DISPROPORTIONATELY
REPRESENTED FAMILY PRESERVATION GRANTS.
new text end
new text begin Subdivision 1. new text end
new text begin Primary support grants. new text end
new text begin
The commissioner shall establish direct grants
to organizations, service providers, and programs owned and led by African Americans and
other individuals from communities disproportionately represented in the child welfare
system to provide services and support for African American and disproportionately
represented children and their families involved in Minnesota's child welfare system,
including supporting existing eligible services and facilitating the development of new
services and providers, to create a more expansive network of service providers available
for African American and disproportionately represented children and their families.
new text end
new text begin Subd. 2. new text end
new text begin Eligible services. new text end
new text begin
(a) Services eligible for grants under this section include but
are not limited to:
new text end
new text begin
(1) child out-of-home placement prevention and reunification services;
new text end
new text begin
(2) family-based services and reunification therapy;
new text end
new text begin
(3) culturally specific individual and family counseling;
new text end
new text begin
(4) court advocacy;
new text end
new text begin
(5) training and consultation to responsible social services agencies and private social
services agencies regarding this act;
new text end
new text begin
(6) development and promotion of culturally informed, affirming, and responsive
community-based prevention and family preservation services that target the children, youth,
families, and communities of African American and African heritage experiencing the
highest disparities, disproportionality, and overrepresentation in the Minnesota child welfare
system;
new text end
new text begin
(7) culturally affirming and responsive services that work with children and families in
their communities to address their needs and ensure child and family safety and well-being
within a culturally appropriate lens and framework;
new text end
new text begin
(8) services to support informal kinship care arrangements; and
new text end
new text begin
(9) other activities and services approved by the commissioner that further the goals of
the Minnesota African American Family Preservation and Child Welfare Disproportionality
Act, including but not limited to the recruitment of African American staff and staff from
other communities disproportionately represented in the child welfare system to work for
responsible social services agencies and licensed child-placing agencies.
new text end
new text begin
(b) The commissioner may specify the priority of an activity and service based on its
success in furthering these goals. The commissioner shall give preference to programs and
service providers that are located in or serve counties with the highest rates of child welfare
disproportionality for African American and other disproportionately represented children
and their families and employ staff who represent the population primarily served.
new text end
new text begin Subd. 3. new text end
new text begin Ineligible services. new text end
new text begin
Grant money may not be used to supplant funding for
existing services or for the following purposes:
new text end
new text begin
(1) child day care that is necessary solely because of the employment or training for
employment of a parent or another relative with whom the child is living;
new text end
new text begin
(2) foster care maintenance or difficulty of care payments;
new text end
new text begin
(3) residential treatment facility payments;
new text end
new text begin
(4) adoption assistance or Northstar kinship assistance payments under chapter 259A
or 256N;
new text end
new text begin
(5) public assistance payments for Minnesota family investment program assistance,
supplemental aid, medical assistance, general assistance, general assistance medical care,
or community health services; or
new text end
new text begin
(6) administrative costs for income maintenance staff.
new text end
new text begin Subd. 4. new text end
new text begin Requests for proposals. new text end
new text begin
The commissioner shall request proposals for grants
under subdivisions 1, 2, and 3 and specify the information and criteria required.
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 260C.329, subdivision 3, is amended to read:
Subd. 3.
Petition.
The county attorney deleted text begin ordeleted text end new text begin ,new text end a parent whose parental rights were terminated
under a previous order of the courtnew text begin , an African American or a disproportionately represented
child who is ten years of age or older, the responsible social services agency, or a guardian
ad litemnew text end may file a petition for the reestablishment of the legal parent and child relationship.
A parent filing a petition under this section shall pay a filing fee in the amount required
under section 357.021, subdivision 2, clause (1). The filing fee may be waived deleted text begin pursuant to
chapter 563deleted text end new text begin in cases of indigencynew text end . A petition for the reestablishment of the legal parent and
child relationship may be filed when:
deleted text begin
(1) in cases where the county attorney is the petitioning party, both the responsible social
services agency and the county attorney agree that reestablishment of the legal parent and
child relationship is in the child's best interests;
deleted text end
deleted text begin (2)deleted text end new text begin (1)new text end the parent has corrected the conditions that led to an order terminating parental
rights;
deleted text begin (3)deleted text end new text begin (2)new text end the parent is willing and has the capability to provide day-to-day care and maintain
the health, safety, and welfare of the child;
deleted text begin
(4) the child has been in foster care for at least 48 months after the court issued the order
terminating parental rights;
deleted text end
deleted text begin (5)deleted text end new text begin (3)new text end the child has not been adopted; and
deleted text begin (6)deleted text end new text begin (4)new text end the child is not the subject of a written adoption placement agreement between
the responsible social services agency and the prospective adoptive parent, as required under
Minnesota Rules, part 9560.0060, subpart 2.
new text begin EFFECTIVE DATE. new text end
new text begin
This section is effective July 1, 2026, except as provided under
section 19 of this article.
new text end
Sec. 15.
Minnesota Statutes 2022, section 260C.329, subdivision 8, is amended to read:
Subd. 8.
Hearing.
The court may grant the petition ordering the reestablishment of the
legal parent and child relationship only if it finds by clear and convincing evidence that:
(1) reestablishment of the legal parent and child relationship is in the child's best interests;
(2) the child has not been adopted;
(3) the child is not the subject of a written adoption placement agreement between the
responsible social services agency and the prospective adoptive parent, as required under
Minnesota Rules, part 9560.0060, subpart 2;
deleted text begin
(4) at least 48 months have elapsed following a final order terminating parental rights
and the child remains in foster care;
deleted text end
deleted text begin (5)deleted text end new text begin (4)new text end the child desires to reside with the parent;
deleted text begin (6)deleted text end new text begin (5)new text end the parent has corrected the conditions that led to an order terminating parental
rights; and
deleted text begin (7)deleted text end new text begin (6)new text end the parent is willing and has the capability to provide day-to-day care and maintain
the health, safety, and welfare of the child.
new text begin EFFECTIVE DATE. new text end
new text begin
This section is effective July 1, 2026, except as provided under
section 19 of this article.
new text end
Sec. 16. new text begin DIRECTION TO COMMISSIONER OF HUMAN SERVICES;
DISAGGREGATE DATA.
new text end
new text begin
The commissioner of human services must establish a process to improve the
disaggregation of data to monitor child welfare outcomes for African American and other
disproportionately represented children in the child welfare system. The commissioner must
begin disaggregating data by January 1, 2027.
new text end
new text begin EFFECTIVE DATE. new text end
new text begin
This section is effective July 1, 2026.
new text end
Sec. 17. new text begin CHILD WELFARE COMPLIANCE AND FEEDBACK PORTAL.
new text end
new text begin
The commissioner of human services shall develop, maintain, and administer a publicly
accessible online compliance and feedback portal to receive reports of noncompliance with
the Minnesota African American Family Preservation and Child Welfare Disproportionality
Act under Minnesota Statutes, sections 260.61 to 260.69, and other statutes related to child
maltreatment, safety, and placement. Reports received through the portal must be transferred
for review and further action to the appropriate unit or department within the Department
of Human Services, including but not limited to the African American Child Well-Being
Unit.
new text end
new text begin EFFECTIVE DATE. new text end
new text begin
This section is effective July 1, 2026, except as provided under
section 19 of this article.
new text end
Sec. 18. new text begin DIRECTION TO COMMISSIONER; MAINTAINING CONNECTIONS
IN FOSTER CARE BEST PRACTICES.
new text end
new text begin
The commissioner of human services shall develop and publish guidance on best practices
for ensuring that African American and disproportionately represented children in foster
care maintain connections and relationships with their parents, custodians, and extended
relative and kin network. The commissioner shall also develop and publish best practice
guidance on engaging and assessing noncustodial and nonadjudicated parents to care for
their African American or disproportionately represented children who cannot remain with
the children's custodial parents.
new text end
new text begin EFFECTIVE DATE. new text end
new text begin
This section is effective July 1, 2026, except as provided under
section 19 of this article.
new text end
Sec. 19. new text begin MINNESOTA AFRICAN AMERICAN FAMILY PRESERVATION AND
CHILD WELFARE DISPROPORTIONALITY ACT; PILOT PROGRAMS.
new text end
new text begin
(a) The commissioner of human services must establish a pilot program that implements
sections 1 to 17 in Hennepin and Ramsey Counties.
new text end
new text begin
(b) The commissioner of human services must report on the outcomes of the pilot
program, including the number of participating families, the rate of children in out-of-home
placement, and the measures taken to prevent out-of-home placement for each participating
family to the chairs and ranking minority members of the legislative committees with
jurisdiction over child welfare.
new text end
new text begin
(c) Sections 1 to 17 are effective July 1, 2024, for purposes of this pilot program.
new text end
new text begin
(d) This section expires July 1, 2027.
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. 20. new text begin MINNESOTA AFRICAN AMERICAN FAMILY PRESERVATION AND
CHILD WELFARE DISPROPORTIONALITY ACT; WORKING GROUP.
new text end
new text begin
(a) The commissioner of human services must establish a working group to provide
guidance and oversight for the Minnesota African American Family Preservation and Child
Welfare Disproportionality Act pilot programs in Hennepin and Ramsey Counties.
new text end
new text begin
(b) The members of the working group must include representatives from the Association
of Minnesota Counties, Hennepin County, Ramsey County, the Department of Human
Services, and community organizations with experience in child welfare.
new text end
new text begin
(c) The working group must provide oversight of the pilot programs and evaluate the
cost of the pilot program. The working group must also assess future costs of implementing
the Minnesota African American Family Preservation and Child Welfare Disproportionality
Act statewide.
new text end
new text begin
(d) By June 30, 2026, the working group must develop an implementation plan and best
practices for the Minnesota African American Family Preservation and Child Welfare
Disproportionality Act to go into effect statewide.
new text end
new text begin EFFECTIVE DATE. new text end
new text begin
This section is effective July 1, 2024.
new text end
Sec. 21. new text begin APPROPRIATIONS; MINNESOTA AFRICAN AMERICAN FAMILY
PRESERVATION AND CHILD WELFARE DISPROPORTIONALITY ACT.
new text end
new text begin
(a) $5,000,000 in fiscal year 2025 is appropriated from the general fund to the
commissioner of human services for grants to Hennepin and Ramsey Counties to implement
the Minnesota African American Family Preservation and Child Welfare Disproportionality
Act pilot programs. This is a onetime appropriation and is available through June 30, 2026.
new text end
new text begin
(b) $1,000,000 in fiscal year 2025 is appropriated from the general fund to the
commissioner of human services for the African American and disproportionately represented
family preservation grant program in Minnesota Statutes, section 260.693.
new text end
new text begin
(c) $1,029,000 in fiscal year 2025 is appropriated from the general fund to the
commissioner of human services for the African American Child Well-Being Unit to hire
full-time staff members.
new text end
ARTICLE 17
CHILDREN AND FAMILIES POLICY
Section 1.
Minnesota Statutes 2023 Supplement, section 119B.011, subdivision 15, is
amended to read:
Subd. 15.
Income.
"Income" means earned income as defined under section 256P.01,
subdivision 3deleted text begin ,deleted text end new text begin ;new text end unearned income as defined under section 256P.01, subdivision 8deleted text begin ,deleted text end new text begin ; income
under Minnesota Rules, part 3400.0170;new text end and public assistance cash benefits, including the
Minnesota family investment program, work benefit, Minnesota supplemental aid, general
assistance, refugee cash assistance, at-home infant child care subsidy payments, and child
support and maintenance distributed to the family under section 256.741, subdivision 2a.
The following are deducted from income: funds used to pay for health insurance
premiums for family members, and child or spousal support paid to or on behalf of a person
or persons who live outside of the household. Income sources not included in this subdivision
deleted text begin anddeleted text end new text begin ;new text end section 256P.06, subdivision 3deleted text begin ,deleted text end new text begin ; and Minnesota Rules, part 3400.0170,new text end are not counted
as income.
Sec. 2.
Minnesota Statutes 2023 Supplement, 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
to:
(i) an administrative review under section 119B.161; or
(ii) a contested case hearing or an administrative reconsideration under section 245.095;
(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);
new text begin
(5) ends a provider's rate differential under section 119B.13, subdivision 3a or 3b;
new text end
deleted text begin (5)deleted text end new text begin (6)new text end initiates an administrative fraud disqualification deleted text begin hearingdeleted text end ; or
deleted text begin (6)deleted text end new text begin (7)new text end 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
deleted text begin Department of Human Services, Appeals Divisiondeleted text end new text begin state agencynew text end . A provider's request must
be received by the deleted text begin Appeals Divisiondeleted text end new text begin state agencynew text end no later than 30 days after the date a
county or the commissioner deleted text begin mailsdeleted text end new text begin sendsnew text end the noticenew text begin under subdivision 1cnew text end .
(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.
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 2023 Supplement, 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), new text begin clauses (1) to (5), new text end a county agency or the commissioner must deleted text begin maildeleted text end new text begin sendnew text end
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 deleted text begin maildeleted text end new text begin sendnew text end the written notice at least 15 calendar days
before the adverse action's effective date.new text begin If the appealable action is a denial of an
authorization under subdivision 1a, paragraph (b), clause (1), the provider's notice is effective
on the date the notice is sent.
new text end
(b) The notice new text begin of adverse action in paragraph (a) new text end shall state (1) the factual basis for the
county agency or department's determination, (2) the action the county agency or 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
(c) Notice requirements for administrative fraud disqualifications under subdivision 1a,
paragraph (b), clause (6), are set forth in section 256.046, subdivision 3.
new text end
new text begin
(d) A provider must receive notices that include:
new text end
new text begin
(1) the right to appeal if a county issues a payment and the provider disagrees with the
amount of the payment under subdivision 1a, paragraph (b), clause (7), at the time of
authorization and reauthorization under section 119B.125, subdivision 1; and
new text end
new text begin
(2) the amount of each payment when a payment is issued.
new text end
new text begin
(e) A provider's request to appeal a payment amount must be received by the state agency
no later than 30 days after the date a county sends the notice informing the provider of its
payment amount.
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. 4.
Minnesota Statutes 2023 Supplement, section 119B.161, subdivision 2, is amended
to read:
Subd. 2.
Notice.
(a) The commissioner must deleted text begin maildeleted text end new text begin sendnew text end 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 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 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 August 1, 2024.
new text end
Sec. 5.
Minnesota Statutes 2022, section 121A.15, subdivision 3, is amended to read:
Subd. 3.
Exemptions from immunizations.
(a) If a person is at least seven years old
and has not been immunized against pertussis, the person must not be required to be
immunized against pertussis.
(b) If a person is at least 18 years old and has not completed a series of immunizations
against poliomyelitis, the person must not be required to be immunized against poliomyelitis.
(c) If a statement, signed by a physician, is submitted to the administrator or other person
having general control and supervision of the school or child care facility stating that an
immunization is contraindicated for medical reasons or that laboratory confirmation of the
presence of adequate immunity exists, the immunization specified in the statement need
not be required.
(d) If a notarized statement signed by the minor child's parent or guardian or by the
emancipated person is submitted to the administrator or other person having general control
and supervision of the school or child care facility stating that the person has not been
immunized as prescribed in subdivision 1 because of the conscientiously held beliefs of the
parent or guardian of the minor child or of the emancipated person, the immunizations
specified in the statement shall not be required. This statement must also be forwarded to
the commissioner of the Department of Health.new text begin This paragraph does not apply to a child
enrolling or enrolled in a child care center or family child care program that adopts a policy
under subdivision 3b.
new text end
(e) If the person is under 15 months, the person is not required to be immunized against
measles, rubella, or mumps.
(f) If a person is at least five years old and has not been immunized against haemophilus
influenzae type b, the person is not required to be immunized against haemophilus influenzae
type b.
(g) If a person who is not a Minnesota resident enrolls in a Minnesota school online
learning course or program that delivers instruction to the person only by computer and
does not provide any teacher or instructor contact time or require classroom attendance, the
person is not subject to the immunization, statement, and other requirements of this section.
Sec. 6.
Minnesota Statutes 2022, section 121A.15, is amended by adding a subdivision to
read:
new text begin Subd. 3b. new text end
new text begin Child care programs. new text end
new text begin
A child care center licensed under chapter 245A and
Minnesota Rules, chapter 9503, and a family child care provider licensed under chapter
245A and Minnesota Rules, chapter 9502, may adopt a policy prohibiting a child over two
months of age from enrolling or remaining enrolled in the child care center or family child
care program if the child:
new text end
new text begin
(1) has not been immunized in accordance with subdivision 1 or 2 and in accordance
with Minnesota Rules, chapter 4604; and
new text end
new text begin
(2) is not exempt from immunizations under subdivision 3, paragraph (a), (c), (e), or (f).
new text end
Sec. 7.
Minnesota Statutes 2023 Supplement, section 124D.142, subdivision 2, as amended
by Laws 2024, chapter 80, article 4, section 10, is amended to read:
Subd. 2.
System components.
(a) The standards-based voluntary quality rating and
improvement system includes:
(1) new text begin effective July 1, 2026, new text end at least a one-star rating for all programs licensed under
Minnesota Rules, chapter 9502 or 9503, or Tribally licensed that do not opt out of the system
under paragraph (b) and that are not:
(i) the subject of a finding of fraud for which the program or individual is currently
serving a penalty or exclusion;
(ii) prohibited from receiving public funds under section 245.095, regardless of whether
the action is under appeal;
(iii) under revocation, suspension, temporary immediate suspension, or decertification,
or is operating under a conditional license, regardless of whether the action is under appeal;
or
(iv) the subject of suspended, denied, or terminated payments to a provider under section
119B.13, subdivision 6, paragraph (d), clause (1) or (2); 245E.02, subdivision 4, paragraph
(c), clause (4); or 256.98, subdivision 1, regardless of whether the action is under appeal;
(2) quality opportunities in order to improve the educational outcomes of children so
that they are ready for school;
(3) a framework based on the Minnesota quality rating system rating tool and a common
set of child outcome and program standards informed by evaluation results;
(4) a tool to increase the number of publicly funded and regulated early learning and
care services in both public and private market programs that are high quality;
(5) voluntary participation ensuring that if a program or provider chooses to participate,
the program or provider will be rated and may receive public funding associated with the
rating; and
(6) tracking progress toward statewide access to high-quality early learning and care
programs, progress toward the number of low-income children whose parents can access
quality programs, and progress toward increasing the number of children who are fully
prepared to enter kindergarten.
(b) By July 1, 2026, the commissioner of children, youth, and families shall establish a
process by which a program may opt out of the rating under paragraph (a), clause (1). The
commissioner shall consult with Tribes to develop a process for rating Tribally licensed
programs that is consistent with the goal outlined in paragraph (a), clause (1).
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 2023 Supplement, section 144.2252, subdivision 2, is amended
to read:
Subd. 2.
Release of original birth record.
(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.
(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.
(c) 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.
(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 begin
(e) The state registrar may request assistance from the commissioner of human services
if needed to discharge duties under this section, as authorized under section 259.79.
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. 9.
Minnesota Statutes 2023 Supplement, section 144.2253, is amended to read:
144.2253 BIRTH PARENT CONTACT PREFERENCE FORM.
(a) The commissioner must make available to the public a contact preference form as
described in paragraph (b).
(b) The contact preference form must provide the following information to be completed
at the option of a birth parent:
(1) "I would like to be contacted."
(2) "I would prefer to be contacted only through an intermediary."
(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."
(c) A contact preference form must include space where the birth parent may include
information that the birth parent feels is important for the adopted person to know.
(d) If a birth parent of an adopted person submits a completed contact preference form
to the commissioner, the commissioner must:
(1) match the contact preference form to the adopted person's original birth recordnew text begin . The
commissioner may request assistance from the commissioner of human services if needed
to discharge duties under this clause, as authorized under section 259.79new text end ; and
(2) attach the contact preference form to the original birth record as required under
section 144.2252.
(e) A contact preference form submitted to the commissioner under this section is private
data on an individual as defined in section 13.02, subdivision 12, except that the contact
preference form may be released as provided under section 144.2252, subdivision 2.
new text begin EFFECTIVE DATE. new text end
new text begin
This section is effective August 1, 20...
new text end
Sec. 10.
Minnesota Statutes 2022, section 243.166, subdivision 7, as amended by Laws
2024, chapter 79, article 9, section 5, is amended to read:
Subd. 7.
Use of data.
(a) Except as otherwise provided in subdivision 4b or 7a or sections
244.052 and 299C.093, the data provided under this section is private data on individuals
under section 13.02, subdivision 12.
(b) The data may be used only by law enforcement and corrections agencies for law
enforcement and corrections purposes. Law enforcement or a corrections agent may disclose
the status of an individual as a predatory offender to a child protection worker with a local
welfare agency for purposes of doing a familynew text begin investigation ornew text end assessment under chapter
260E. A corrections agent may also disclose the status of an individual as a predatory
offender to comply with section 244.057.
(c) The commissioner of human services is authorized to have access to the data for
purposes of completing background studies under chapter 245C.
(d) The direct care and treatment executive board is authorized to have access to data
for any service, program, or facility owned or operated by the state of Minnesota and under
the programmatic direction and fiscal control of the executive board for purposes described
in section 246.13, subdivision 2, paragraph (b).
Sec. 11.
Minnesota Statutes 2023 Supplement, section 245A.03, subdivision 7, as amended
by Laws 2024, chapter 85, section 53, and Laws 2024, chapter 80, article 2, section 37, is
amended to read:
Subd. 7.
Licensing moratorium.
(a) The commissioner shall not issue an initial license
for child foster care licensed under Minnesota Rules, parts 2960.3000 to 2960.3340,new text begin which
does not include child foster residence settings with residential program certifications for
compliance with the Family First Prevention Services Act under section 245A.25, subdivision
1, paragraph (a),new text end or adult foster care licensed under Minnesota Rules, parts 9555.5105 to
9555.6265, under this chapter for a physical location that will not be the primary residence
of the license holder for the entire period of licensure. new text begin If a child foster residence setting that
was previously exempt from the licensing moratorium under this paragraph has its Family
First Prevention Services Act certification rescinded under section 245A.25, subdivision 9,
ornew text end new text begin new text end if a family adult foster care home license is issued during this moratorium, and the license
holder changes the license holder's primary residence away from the physical location of
the foster care license, the commissioner shall revoke the license according to section
245A.07. The commissioner shall not issue an initial license for a community residential
setting licensed under chapter 245D. When approving an exception under this paragraph,
the commissioner shall consider the resource need determination process in paragraph (h),
the availability of foster care licensed beds in the geographic area in which the licensee
seeks to operate, the results of a person's choices during their annual assessment and service
plan review, and the recommendation of the local county board. The determination by the
commissioner is final and not subject to appeal. Exceptions to the moratorium include:
(1) a license for a person in a foster care setting that is not the primary residence of the
license holder and where at least 80 percent of the residents are 55 years of age or older;
(2) foster care licenses replacing foster care licenses in existence on May 15, 2009, or
community residential setting licenses replacing adult foster care licenses in existence on
December 31, 2013, and determined to be needed by the commissioner under paragraph
(b);
(3) new foster care licenses or community residential setting licenses determined to be
needed by the commissioner under paragraph (b) for the closure of a nursing facility, ICF/DD,
or regional treatment center; restructuring of state-operated services that limits the capacity
of state-operated facilities; or allowing movement to the community for people who no
longer require the level of care provided in state-operated facilities as provided under section
256B.092, subdivision 13, or 256B.49, subdivision 24;
(4) new foster care licenses or community residential setting licenses determined to be
needed by the commissioner under paragraph (b) for persons requiring hospital-level care;
or
(5) new foster care licenses or community residential setting licenses for people receiving
customized living or 24-hour customized living services under the brain injury or community
access for disability inclusion waiver plans under section 256B.49 or elderly waiver plan
under chapter 256S and residing in the customized living setting for which a license is
required. A customized living service provider subject to this exception may rebut the
presumption that a license is required by seeking a reconsideration of the commissioner's
determination. The commissioner's disposition of a request for reconsideration is final and
not subject to appeal under chapter 14. The exception is available until December 31, 2023.
This exception is available when:
(i) the person's customized living services are provided in a customized living service
setting serving four or fewer people in a single-family home operational on or before June
30, 2021. Operational is defined in section 256B.49, subdivision 28;
(ii) the person's case manager provided the person with information about the choice of
service, service provider, and location of service, including in the person's home, to help
the person make an informed choice; and
(iii) the person's services provided in the licensed foster care or community residential
setting are less than or equal to the cost of the person's services delivered in the customized
living setting as determined by the lead agency.
(b) The commissioner shall determine the need for newly licensed foster care homes or
community residential settings as defined under this subdivision. As part of the determination,
the commissioner shall consider the availability of foster care capacity in the area in which
the licensee seeks to operate, and the recommendation of the local county board. The
determination by the commissioner must be final. A determination of need is not required
for a change in ownership at the same address.
(c) When an adult resident served by the program moves out of a foster home that is not
the primary residence of the license holder according to section 256B.49, subdivision 15,
paragraph (f), or the adult community residential setting, the county shall immediately
inform the Department of Human Services Licensing Division. The department may decrease
the statewide licensed capacity for adult foster care settings.
(d) Residential settings that would otherwise be subject to the decreased license capacity
established in paragraph (c) deleted text begin shalldeleted text end new text begin mustnew text end be exempt if the license holder's beds are occupied
by residents whose primary diagnosis is mental illness and the license holder is certified
under the requirements in subdivision 6a or section 245D.33.
(e) A resource need determination process, managed at the state level, using the available
data required by section 144A.351, and other data and information shall be used to determine
where the reduced capacity determined under section 256B.493 will be implemented. The
commissioner shall consult with the stakeholders described in section 144A.351, and employ
a variety of methods to improve the state's capacity to meet the informed decisions of those
people who want to move out of corporate foster care or community residential settings,
long-term service needs within budgetary limits, including seeking proposals from service
providers or lead agencies to change service type, capacity, or location to improve services,
increase the independence of residents, and better meet needs identified by the long-term
services and supports reports and statewide data and information.
(f) At the time of application and reapplication for licensure, the applicant and the license
holder that are subject to the moratorium or an exclusion established in paragraph (a) are
required to inform the commissioner whether the physical location where the foster care
will be provided is or will be the primary residence of the license holder for the entire period
of licensure. If the primary residence of the applicant or license holder changes, the applicant
or license holder must notify the commissioner immediately. The commissioner shall print
on the foster care license certificate whether or not the physical location is the primary
residence of the license holder.
(g) License holders of foster care homes identified under paragraph (f) that are not the
primary residence of the license holder and that also provide services in the foster care home
that are covered by a federally approved home and community-based services waiver, as
authorized under chapter 256S or section 256B.092 or 256B.49, must inform the human
services licensing division that the license holder provides or intends to provide these
waiver-funded services.
(h) The commissioner may adjust capacity to address needs identified in section
144A.351. Under this authority, the commissioner may approve new licensed settings or
delicense existing settings. Delicensing of settings will be accomplished through a process
identified in section 256B.493.
(i) The commissioner must notify a license holder when its corporate foster care or
community residential setting licensed beds are reduced under this section. The notice of
reduction of licensed beds must be in writing and delivered to the license holder by certified
mail or personal service. The notice must state why the licensed beds are reduced and must
inform the license holder of its right to request reconsideration by the commissioner. The
license holder's request for reconsideration must be in writing. If mailed, the request for
reconsideration must be postmarked and sent to the commissioner within 20 calendar days
after the license holder's receipt of the notice of reduction of licensed beds. If a request for
reconsideration is made by personal service, it must be received by the commissioner within
20 calendar days after the license holder's receipt of the notice of reduction of licensed beds.
(j) The commissioner shall not issue an initial license for children's residential treatment
services licensed under Minnesota Rules, parts 2960.0580 to 2960.0700, under this chapter
for a program that Centers for Medicare and Medicaid Services would consider an institution
for mental diseases. Facilities that serve only private pay clients are exempt from the
moratorium described in this paragraph. The commissioner has the authority to manage
existing statewide capacity for children's residential treatment services subject to the
moratorium under this paragraph and may issue an initial license for such facilities if the
initial license would not increase the statewide capacity for children's residential treatment
services subject to the moratorium under this paragraph.
Sec. 12.
Minnesota Statutes 2023 Supplement, 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 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, the commissioner must deleted text begin maildeleted text end new text begin sendnew text end
written notice deleted text begin by certified maildeleted text end new text begin using a signature-verified confirmed delivery methodnew text end to the
provider against whom the action is being taken. Unless otherwise specified under chapter
119B or 245E or Minnesota Rules, chapter 3400, the commissioner must deleted text begin maildeleted text end new text begin sendnew text end 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 deleted text begin Department of Human Services, Appeals Divisiondeleted text end new text begin state agencynew text end . A provider's
request must be received by the deleted text begin Appeals Divisiondeleted text end new text begin state agencynew text end no later than 30 days after
the date 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 deleted text begin shalldeleted text end new text begin mustnew text end 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 August 1, 2024.
new text end
Sec. 13.
Minnesota Statutes 2022, section 256J.08, subdivision 34a, is amended to read:
Subd. 34a.
Family violence.
(a) "Family violence" means the following, if committed
against a family or household member by a family or household member:
(1) physical harm, bodily injury, or assault;
(2) the infliction of fear of deleted text begin imminentdeleted text end physical harm, bodily injury, or assault; or
(3) terroristic threats, within the meaning of section 609.713, subdivision 1; criminal
sexual conduct, within the meaning of section 609.342, 609.343, 609.344, 609.345, or
609.3451; or interference with an emergency call within the meaning of section 609.78,
subdivision 2.
(b) For the purposes of family violence, "family or household member" means:
(1) spouses and former spouses;
(2) parents and children;
(3) persons related by blood;
(4) persons who are residing together or who have resided together in the past;
(5) persons who have a child in common regardless of whether they have been married
or have lived together at any time;
(6) a man and woman if the woman is pregnant and the man is alleged to be the father,
regardless of whether they have been married or have lived together at anytime; and
(7) persons involved in a current or past significant romantic or sexual relationship.
Sec. 14.
Minnesota Statutes 2022, section 256J.28, subdivision 1, is amended to read:
Subdivision 1.
Expedited issuance of the Supplemental Nutrition Assistance Program
(SNAP) benefits.
deleted text begin
The following households are entitled to expedited issuance of SNAP
benefits assistance:
deleted text end
deleted text begin
(1) households with less than $150 in monthly gross income provided their liquid assets
do not exceed $100;
deleted text end
deleted text begin
(2) migrant or seasonal farm worker households who are destitute as defined in Code
of Federal Regulations, title 7, subtitle B, chapter 2, subchapter C, part 273, section 273.10,
paragraph (e)(3), provided their liquid assets do not exceed $100; and
deleted text end
deleted text begin
(3) eligible households whose combined monthly gross income and liquid resources are
less than the household's monthly rent or mortgage and utilities.
deleted text end
For any month an individual receives expedited SNAP benefits, the individual is not
eligible for the MFIP food portion of assistance.
Sec. 15.
Minnesota Statutes 2022, section 256N.22, subdivision 10, is amended to read:
Subd. 10.
Assigning a successor relative custodian for a child's Northstar kinship
assistance.
(a) In the event of the death or incapacity of the relative custodian, eligibility
for Northstar kinship assistance and title IV-E assistance, if applicable, is not affected if the
relative custodian is replaced by a successor named in the Northstar kinship assistance
benefit agreement. Northstar kinship assistance deleted text begin shalldeleted text end new text begin mustnew text end be paid to a named successor
who is not the child's legal parent, biological parent or stepparent, or other adult living in
the home of the legal parent, biological parent, or stepparent.
(b) In order to receive Northstar kinship assistance, a named successor must:
(1) meet the background study requirements in subdivision 4;
(2) renegotiate the agreement consistent with section 256N.25, subdivision 2, including
cooperating with an assessment under section 256N.24;
(3) be ordered by the court to be the child's legal relative custodian in a modification
proceeding under section 260C.521, subdivision 2; and
(4) satisfy the requirements in this paragraph within one year of the relative custodian's
death or incapacity unless the commissioner certifies that the named successor made
reasonable attempts to satisfy the requirements within one year and failure to satisfy the
requirements was not the responsibility of the named successor.
(c) Payment of Northstar kinship assistance to the successor guardian may be temporarily
approved through the policies, procedures, requirements, and deadlines under section
256N.28, subdivision 2. Ongoing payment shall begin in the month when all the requirements
in paragraph (b) are satisfied.
(d) Continued payment of Northstar kinship assistance may occur in the event of the
death or incapacity of the relative custodian whennew text begin :
new text end
new text begin (1)new text end no successor has been named in the benefit agreement deleted text begin whendeleted text end new text begin or a named successor
is not able or willing to accept custody or guardianship of the child; and
new text end
new text begin (2)new text end the commissioner gives written consent to an individual who is a guardian or custodian
appointed by a court for the child upon the death of both relative custodians in the case of
assignment of custody to two individuals, or the sole relative custodian in the case of
assignment of custody to one individual, unless the child is under the custody of a county,
tribal, or child-placing agency.
(e) Temporary assignment of Northstar kinship assistance may be approved for a
maximum of six consecutive months from the death or incapacity of the relative custodian
or custodians as provided in paragraph (a) and must adhere to the policies, procedures,
requirements, and deadlines under section 256N.28, subdivision 2, that are prescribed by
the commissioner. If a court has not appointed a permanent legal guardian or custodian
within six months, the Northstar kinship assistance must terminate and must not be resumed.
(f) Upon assignment of assistance payments under paragraphs (d) and (e), assistance
must be provided from funds other than title IV-E.
Sec. 16.
Minnesota Statutes 2022, section 256N.24, subdivision 10, is amended to read:
Subd. 10.
Caregiver requests for reassessments.
(a) A caregiver may initiate a
reassessment request for an eligible child in writing to the financially responsible agency
or, if there is no financially responsible agency, the agency designated by the commissioner.
The written request must include the reason for the request and the name, address, and
contact information of the caregivers. The caregiver may request a reassessment if at least
six months have elapsed since any previous assessment or reassessment. For an eligible
foster child, a foster parent may request reassessment in less than six months with written
documentation that there have been significant changes in the child's needs that necessitate
an earlier reassessment.
(b) A caregiver may request a reassessment of an at-risk child for whom an adoption
assistance agreement has been executed if the caregiver has satisfied the commissioner with
written documentation from a qualified expert that the potential disability upon which
eligibility for the agreement was based has manifested itself, consistent with section 256N.25,
subdivision 3, paragraph (b).
(c) If the reassessment cannot be completed within 30 days of the caregiver's request,
the agency responsible for reassessment must notify the caregiver of the reason for the delay
and a reasonable estimate of when the reassessment can be completed.
(d) Notwithstanding any provision to the contrary in paragraph (a) or subdivision 9,
when a Northstar kinship assistance agreement or adoption assistance agreement under
section 256N.25 has been signed by all parties, no reassessment may be requested or
conducted until the court finalizes the transfer of permanent legal and physical custody or
finalizes the adoptiondeleted text begin , or the assistance agreement expires according to section 256N.25,
subdivision 1deleted text end .
Sec. 17.
Minnesota Statutes 2022, section 256N.26, subdivision 15, is amended to read:
Subd. 15.
Payments.
(a) Payments to caregivers new text begin or youth new text end under Northstar Care for
Children must be made monthly. Consistent with section 256N.24, subdivision 13, the
financially responsible agency must send the caregiver new text begin or youth new text end the required written notice
within 15 days of a completed assessment or reassessment.
(b) Unless paragraph (c) deleted text begin ordeleted text end new text begin ,new text end (d)new text begin , or (e)new text end applies, the financially responsible agency shall
pay foster parents directly for eligible children in foster care.
(c) When the legally responsible agency is different than the financially responsible
agency, the legally responsible agency may make the payments to the caregivernew text begin or youthnew text end ,
provided payments are made on a timely basis. The financially responsible agency must
pay the legally responsible agency on a timely basis. Caregivers must have access to the
financially and legally responsible agencies' records of the transaction, consistent with the
retention schedule for the payments.
(d) For eligible children in foster care, the financially responsible agency may pay the
foster parent's payment for a licensed child-placing agency instead of paying the foster
parents directly. The licensed child-placing agency must timely pay the foster parents and
maintain records of the transaction. Caregivers must have access to the financially responsible
agency's records of the transaction and the child-placing agency's records of the transaction,
consistent with the retention schedule for the payments.
new text begin
(e) If a foster youth aged 18 to 21 years old is placed in an unlicensed supervised
independent living setting, payments must be made directly to the youth or to a vendor if
the legally responsible agency determines it to be in the youth's best interests. If the legally
responsible agency has reason to believe that the youth is being financially exploited or at
risk of being financially exploited in the approved unlicensed supervised independent living
setting, the legally responsible agency shall advise the financially responsible agency to
make the payments to a vendor.
new text end
Sec. 18.
Minnesota Statutes 2022, section 256N.26, subdivision 16, is amended to read:
Subd. 16.
Effect of benefit on other aid.
Payments received under this section must
not be considered as income for child care assistance under chapter 119B or any other
financial benefit. Consistent with section 256J.24, a child new text begin or youth new text end receiving a maintenance
payment under Northstar Care for Children is excluded from any Minnesota family
investment program assistance unit.
Sec. 19.
Minnesota Statutes 2022, section 256N.26, subdivision 18, is amended to read:
Subd. 18.
Overpayments.
The commissioner has the authority to collect any amount
of foster care payment, adoption assistance, or Northstar kinship assistance paid to a caregiver
new text begin or youth new text end in excess of the payment due. Payments covered by this subdivision include basic
maintenance needs payments, supplemental difficulty of care payments, and reimbursement
of home and vehicle modifications under subdivision 10. Prior to any collection, the
commissioner or the commissioner's designee shall notify the caregiver new text begin or youth new text end in writing,
including:
(1) the amount of the overpayment and an explanation of the cause of overpayment;
(2) clarification of the corrected amount;
(3) a statement of the legal authority for the decision;
(4) information about how the caregiver can correct the overpayment;
(5) if repayment is required, when the payment is due and a person to contact to review
a repayment plan;
(6) a statement that the caregiver new text begin or youth new text end has a right to a fair hearing review by the
department; and
(7) the procedure for seeking a fair hearing review by the department.
Sec. 20.
Minnesota Statutes 2022, section 256N.26, subdivision 21, is amended to read:
Subd. 21.
Correct and true information.
The caregiver new text begin or youth new text end must be investigated
for fraud if the caregiver new text begin or youth new text end reports information the caregiver new text begin or youth new text end knows is untrue,
the caregiver new text begin or youth new text end fails to notify the commissioner of changes that may affect eligibility,
or the agency administering the program receives relevant information that the caregiver
new text begin or youth new text end did not report.
Sec. 21.
Minnesota Statutes 2022, section 256N.26, subdivision 22, is amended to read:
Subd. 22.
Termination notice for caregivernew text begin or youthnew text end .
The agency that issues the
maintenance payment shall provide the child's caregiver new text begin or the youth new text end with written notice of
termination of payment. Termination notices must be sent at least 15 days before the final
payment or, in the case of an unplanned termination, the notice is sent within three days of
the end of the payment. The written notice must minimally include the following:
(1) the date payment will end;
(2) the reason payments will end and the event that is the basis to terminate payment;
(3) a statement that the deleted text begin providerdeleted text end new text begin caregiver or youthnew text end has a right to a fair hearing review
by the department consistent with section 256.045, subdivision 3;
(4) the procedure to request a fair hearing; and
(5) the name, telephone number, and email address of a contact person at the agency.
Sec. 22.
Minnesota Statutes 2022, section 256P.05, is amended by adding a subdivision
to read:
new text begin Subd. 4. new text end
new text begin Rental income. new text end
new text begin
Rental income is subject to the requirements of this section.
new text end
Sec. 23.
Minnesota Statutes 2023 Supplement, 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) deleted text begin proceeds from rent anddeleted text end 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) for the purposes of programs under chapters 256D and 256I, retirement, survivors,
and disability insurance payments;
(ix) retirement benefits;
(x) cash assistance benefits, as defined by each program in chapters 119B, 256D, 256I,
and 256J;
(xi) income from members of the United States armed forces unless excluded from
income taxes according to federal or state law;
(xii) for the purposes of programs under chapters 119B, 256D, and 256I, all child support
payments;
(xiii) for the purposes of programs under chapter 256J, 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;
(xiv) spousal support;
(xv) workers' compensation; and
(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.
Sec. 24.
Minnesota Statutes 2022, section 259.37, subdivision 2, is amended to read:
Subd. 2.
Disclosure to birth parents and adoptive parents.
An agency shall provide
a disclosure statement written in clear, plain language to be signed by the prospective
adoptive parents and birth parents, except that in intercountry adoptions, the signatures of
birth parents are not required. The disclosure statement must contain the following
information:
(1) fees charged to the adoptive parent, including any policy on sliding scale fees or fee
waivers and an itemization of the amount that will be charged for the adoption study,
counseling, postplacement services, family of origin searches, birth parent expenses
authorized under section 259.55, or any other services;
(2) timeline for the adoptive parent to make fee payments;
(3) likelihood, given the circumstances of the prospective adoptive parent and any specific
program to which the prospective adoptive parent is applying, that an adoptive placement
may be made and the estimated length of time for making an adoptive placement. These
estimates must be based on adoptive placements made with prospective parents in similar
circumstances applying to a similar program with the agency during the immediately
preceding three to five years. If an agency has not been in operation for at least three years,
it must provide summary data based on whatever adoptive placements it has made and may
include a statement about the kind of efforts it will make to achieve an adoptive placement,
including a timetable it will follow in seeking a child. The estimates must include a statement
that the agency cannot guarantee placement of a child or a time by which a child will be
placed;
(4) a statement of the services the agency will provide the birth and adoptive parents;
(5) a statement prepared by the commissioner under section 259.39 that explains the
child placement and adoption process and the respective legal rights and responsibilities of
the birth parent and prospective adoptive parent during the process including a statement
that the prospective adoptive parent is responsible for filing an adoption petition not later
than 12 months after the child is placed in the prospective adoptive home;
(6) a statement regarding any information the agency may have about attorney referral
services, or about obtaining assistance with completing legal requirements for an adoption;
deleted text begin and
deleted text end
new text begin
(7) a statement regarding 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 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;
and
new text end
deleted text begin (7)deleted text end new text begin (8)new text end an acknowledgment to be signed by the birth parent and prospective adoptive
parent that they have received, read, and had the opportunity to ask questions of the agency
about the contents of the disclosure statement.
new text begin EFFECTIVE DATE. new text end
new text begin
This section is effective July 1, 2024.
new text end
Sec. 25.
Minnesota Statutes 2022, section 259.53, is amended by adding a subdivision to
read:
new text begin Subd. 7. new text end
new text begin Supportive parenting services for parents with disabilities. new text end
new text begin
(a) A court or
agency shall not deny a prospective parent the ability to proceed with an adoption due to
the prospective parent's disability. A person who raises a prospective parent's disability as
a basis for denying an adoption has the burden to prove by clear and convincing evidence
that specific behaviors of the prospective parent would endanger the health or safety of the
child. If the person meets the burden, the prospective parent with a disability shall have the
opportunity to demonstrate how implementing supportive services would alleviate any
concerns.
new text end
new text begin
(b) The court may require the agency that conducted the postplacement assessment and
filed the report with the court under subdivision 2 to provide the opportunity to use supportive
parenting services to a prospective parent, conduct a new postplacement assessment that is
inclusive of the prospective parent's use of supportive parenting services, and file a revised
report with the court under subdivision 2. This paragraph does not confer additional
responsibility to the agency to provide supportive parenting services directly to the
prospective parent. Within a reasonable period of time, the prospective parent has the right
to a court hearing to review the need for continuing services.
new text end
new text begin
(c) If a court denies or limits the ability of a prospective parent with a disability to adopt
a child, the court shall make specific written findings stating the basis for the determination
and why providing supportive parenting services is not a reasonable accommodation that
could prevent the denial or limitation.
new text end
new text begin
(d) For purposes of this subdivision, "disability" and "supportive parenting services"
have the meanings given in section 260C.201, subdivision 13.
new text end
new text begin EFFECTIVE DATE. new text end
new text begin
This section is effective August 1, 2024, and applies to pleadings
and motions pending on or after that date.
new text end
Sec. 26.
Minnesota Statutes 2022, section 259.79, subdivision 1, is amended to read:
Subdivision 1.
Content.
(a) The adoption records of the commissioner's agents and
licensed child-placing agencies shall contain copies of all relevant legal documents,
responsibly collected genetic, medical and social history of the child and the child's birth
parents, the child's placement record, copies of all pertinent agreements, contracts, and
correspondence relevant to the adoption, and copies of all reports and recommendations
made to the court.
(b) The commissioner of human services shall maintain a permanent record of all
adoptions granted in district court in Minnesota regarding children who are:
(1) under guardianship of the commissioner or a licensed child-placing agency according
to section 260C.317 or 260C.515, subdivision 3;
(2) placed by the commissioner, commissioner's agent, or licensed child-placing agency
after a consent to adopt according to section 259.24 or under an agreement conferring
authority to place for adoption according to section 259.25; or
(3) adopted after a direct adoptive placement approved by the district court under section
259.47.
Each record shall contain identifying information about the child, the birth or legal
parents, and adoptive parents, including race where such data is available. The record must
also contain: (1) the date the child was legally freed for adoption; (2) the date of the adoptive
placement; (3) the name of the placing agency; (4) the county where the adoptive placement
occurred; (5) the date that the petition to adopt was filed; (6) the county where the petition
to adopt was filed; and (7) the date and county where the adoption decree was granted.
(c) Identifying information contained in the adoption record deleted text begin shalldeleted text end new text begin mustnew text end be confidential
and deleted text begin shalldeleted text end new text begin mustnew text end be disclosed only pursuant to section 259.61new text begin or, for adoption records
maintained by the commissioner of human services, upon request from the commissioner
of health or state registrar pursuant to sections 144.2252 and 144.2253new text end .
Sec. 27.
Minnesota Statutes 2023 Supplement, section 259.83, subdivision 1, is amended
to read:
Subdivision 1.
Services provided.
(a) Agencies shall provide assistance and counseling
services upon receiving a request for current information from adoptive parents, birth parents,
deleted text begin ordeleted text end adopted persons aged 18 years of age and oldernew text begin , or adult siblings of adopted personsnew 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 deleted text begin 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 consentdeleted text end new text begin
complete the search request within six months of the request being made. If the agency is
unable to complete the search request within the specified time frame, the agency shall
inform the requester of the status of the request and include a reasonable estimate of when
the request can be completednew text end .
(b) Upon a request for assistance or services from an adoptive parent of a minor child,
birth parent, or an adopted person 18 years of age or older, the agency must inform the
person:
(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
(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.
deleted text begin Indeleted text end new text begin When making or supervising annew text end adoptive deleted text begin placementsdeleted text end new text begin placementnew text end , the agency must provide
in writing to the birth parents listed on the original birth record the information required
under this deleted text begin sectiondeleted text end new text begin paragraph and section 259.37, subdivision 2, clause (7)new text end .
Sec. 28.
Minnesota Statutes 2023 Supplement, section 259.83, subdivision 1b, is amended
to read:
Subd. 1b.
deleted text begin Geneticdeleted text end Siblings.
(a) A person who is at least 18 years of age who was adopted
ordeleted text begin , because of a termination of parental rights,deleted text end new text begin whonew text end was committed to the guardianship of
the commissioner of human servicesdeleted text begin , whether adopted ordeleted text end new text begin andnew text end notdeleted text begin ,deleted text end new text begin adoptednew text end 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) new text begin The agency must provide new text end assistance deleted text begin must be provided by the county or placing agency
ofdeleted text end new text begin tonew text end the person requesting information to the extent that information is available in the
deleted text begin existingdeleted text end records deleted text begin at the Department of Human Servicesdeleted text end new text begin required to be kept under section
259.79new text end . 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.
deleted text begin Upon the determination that parental rights with respect to another sibling were terminated,
identifying information and contact must be provided only upon mutual consent.deleted text end A reasonable
fee may be imposed by the deleted text begin county or placingdeleted text end agency.
Sec. 29.
Minnesota Statutes 2023 Supplement, section 259.83, subdivision 3a, is amended
to read:
Subd. 3a.
Birth parent identifying information.
(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 recordnew text begin , to the extent the information is availablenew text end :
(1) each of the birth parent's names; and
(2) each of the birth parent's birthdate and birthplace.
(b) The agency may charge a reasonable fee to the requester for providing the required
information under paragraph (a).
(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.
Sec. 30.
Minnesota Statutes 2022, section 259.83, subdivision 4, is amended to read:
Subd. 4.
Confidentiality.
Agencies shall provide adoptive parents, birth parents and
adult siblings, and adopted persons aged deleted text begin 19deleted text end new text begin 18new text end years and over reasonable assistance in a
manner consistent with state and federal laws, rules, and regulations regarding the
confidentiality and privacy of child welfare and adoption records.
Sec. 31.
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 care;
(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 custodiannew text begin . A child is not
considered to be without proper parental care based solely on the disability of the child's
parent, guardian, or custodiannew text end ;
(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. 32.
Minnesota Statutes 2022, section 260C.178, subdivision 7, is amended to read:
Subd. 7.
deleted text begin Out-of-home placementdeleted text end new text begin Casenew text end plan.
new text begin
(a) When the court has ordered the child
into the care of a parent under subdivision 1, paragraph (c), clause (1), the child protective
services plan under section 260E.26 must be filed within 30 days of the filing of the juvenile
protection petition under section 260C.141, subdivision 1.
new text end
deleted text begin (a)deleted text end new text begin (b) When the court orders the child into foster care under subdivision 1, paragraph
(c), clause (2), and not into the care of a parent,new text end an out-of-home placement plan required
under section 260C.212 deleted text begin shalldeleted text end new text begin mustnew text end be filed with the court within 30 days of the filing of a
juvenile protection petition under section 260C.141, subdivision 1, when the court orders
emergency removal of the child under this section, or filed with the petition if the petition
is a review of a voluntary placement under section 260C.141, subdivision 2.
deleted text begin (b)deleted text end new text begin (c)new text end Upon the filing of the new text begin child protective services plan under section 260E.26 or
new text end out-of-home placement plan deleted text begin whichdeleted text end new text begin thatnew text end has been developed jointly with the parent and in
consultation with others as required under section 260C.212, subdivision 1, the court may
approve implementation of the plan by the responsible social services agency based on the
allegations contained in the petition and any evaluations, examinations, or assessments
conducted under subdivision 1, paragraph deleted text begin (l)deleted text end new text begin (m)new text end . The court shall send written notice of the
approval of the new text begin child protective services plan or new text end out-of-home placement plan to all parties
and the county attorney or may state such approval on the record at a hearing. A parent may
agree to comply with the terms of the plan filed with the court.
deleted text begin (c)deleted text end new text begin (d)new text end The responsible social services agency shall make reasonable efforts to engage
both parents of the child in case planning. The responsible social service agency shall report
the results of its efforts to engage the child's parents in the new text begin child protective services plan or
new text end out-of-home placement plan filed with the court. The agency shall notify the court of the
services it will provide or efforts it will attempt under the plan notwithstanding the parent's
refusal to cooperate or disagreement with the services. The parent may ask the court to
modify the plan to require different or additional services requested by the parent, but which
the agency refused to provide. The court may approve the plan as presented by the agency
or may modify the plan to require services requested by the parent. The court's approval
deleted text begin shalldeleted text end new text begin mustnew text end be based on the content of the petition.
deleted text begin (d)deleted text end new text begin (e)new text end Unless the parent agrees to comply with the terms of the new text begin child protective services
plan or new text end out-of-home placement plan, the court may not order a parent to comply with the
provisions of the plan until the court finds the child is in need of protection or services and
orders disposition under section 260C.201, subdivision 1. However, the court may find that
the responsible social services agency has made reasonable efforts for reunification if the
agency makes efforts to implement the terms of deleted text begin andeleted text end new text begin the child protective services plan ornew text end
out-of-home placement plan approved under this section.
Sec. 33.
Minnesota Statutes 2022, section 260C.201, is amended by adding a subdivision
to read:
new text begin Subd. 13. new text end
new text begin Supportive parenting services. new text end
new text begin
(a) A person or agency shall not file a petition
alleging that a child is in need of protection or services on the basis of a parent's disability.
To make a prima facie showing that a child protection matter exists, the petitioner must
demonstrate in the petition that the child is in need of protection or services due to specific
behaviors of a parent or household member. The local agency or court must offer a parent
with a disability the opportunity to use supportive parenting services to assist the parent if
the petitioner makes a prima facie showing that through specific behaviors, a parent with a
disability cannot provide for the child's safety, health, or welfare. If a court removes a child
from a parent's home, the court shall make specific written findings stating the basis for
removing the child and why providing supportive parenting services is not a reasonable
accommodation that could prevent the child's out-of-home placement.
new text end
new text begin
(b) For purposes of this subdivision, "supportive parenting services" means services that
may assist a parent with a disability in the effective use of techniques and methods to enable
the parent to discharge the parent's responsibilities to a child as successfully as a parent who
does not have a disability, including nonvisual techniques for a parent who is blind.
new text end
new text begin
(c) For purposes of this subdivision, "disability" means:
new text end
new text begin
(1) physical or mental impairment that substantially limits one or more of a parent's
major life activities;
new text end
new text begin
(2) a record of having a physical or mental impairment that substantially limits one or
more of a parent's major life activities; or
new text end
new text begin
(3) being regarded as having a physical or mental impairment that substantially limits
one or more of a parent's major life activities.
new text end
new text begin
(d) The term "disability" must be construed in accordance with the ADA Amendments
Act of 2008, Public Law 110-325.
new text end
new text begin EFFECTIVE DATE. new text end
new text begin
This section is effective August 1, 2024, and applies to pleadings
and motions pending on or after that date.
new text end
Sec. 34.
Minnesota Statutes 2022, section 260C.202, is amended to read:
260C.202 COURT REVIEW OF deleted text begin FOSTER CAREdeleted text end new text begin DISPOSITIONnew text end .
new text begin Subdivision 1. new text end
new text begin
Court review for a child in the home of a parent under protective
supervision.
new text end
new text begin
If the court orders a child into the home of a parent under the protective
supervision of the responsible social services agency or child-placing agency under section
260C.201, subdivision 1, paragraph (a), clause (1), the court shall review the child protective
services plan under section 260E.26 at least every 90 days. The court shall notify the parents
of the provisions of sections 260C.503 to 260C.521, as required under juvenile court rules.
new text end
new text begin Subd. 2. new text end
new text begin Court review for a child placed in foster care. new text end
(a) If the court orders a child
placed in foster care, the court shall review the out-of-home placement plan and the child's
placement at least every 90 days as required in juvenile court rules to determine whether
continued out-of-home placement is necessary and appropriate or whether the child should
be returned home.
new text begin (b)new text end This review is not required if the court has returned the child home, ordered the child
permanently placed away from the parent under sections 260C.503 to 260C.521, or
terminated rights under section 260C.301. Court review for a child permanently placed
away from a parent, including where the child is under guardianship of the commissioner,
deleted text begin shall bedeleted text end new text begin isnew text end governed by section 260C.607.
new text begin (c)new text end When a child is placed in a qualified residential treatment program setting as defined
in section 260C.007, subdivision 26d, the responsible social services agency must submit
evidence to the court as specified in section 260C.712.
deleted text begin (b)deleted text end new text begin (d)new text end No later than three months after the child's placement in foster care, the court
shall review agency efforts to search for and notify relatives pursuant to section 260C.221,
and order that the agency's efforts begin immediately, or continue, if the agency has failed
to perform, or has not adequately performed, the duties under that section. The court must
order the agency to continue to appropriately engage relatives who responded to the notice
under section 260C.221 in placement and case planning decisions and to consider relatives
for foster care placement consistent with section 260C.221. Notwithstanding a court's finding
that the agency has made reasonable efforts to search for and notify relatives under section
260C.221, the court may order the agency to continue making reasonable efforts to search
for, notify, engage, and consider relatives who came to the agency's attention after sending
the initial notice under section 260C.221.
deleted text begin (c)deleted text end new text begin (e)new text end The court shall review the out-of-home placement plan and may modify the plan
as provided under section 260C.201, subdivisions 6 and 7.
deleted text begin (d)deleted text end new text begin (f)new text end When the court transfers the custody of a child to a responsible social services
agency resulting in foster care or protective supervision with a noncustodial parent under
subdivision 1, the court shall notify the parents of the provisions of sections 260C.204 and
260C.503 to 260C.521, as required under juvenile court rules.
deleted text begin (e)deleted text end new text begin (g)new text end When a child remains in or returns to foster care pursuant to section 260C.451
and the court has jurisdiction pursuant to section 260C.193, subdivision 6, paragraph (c),
the court shall at least annually conduct the review required under section 260C.203.
Sec. 35.
Minnesota Statutes 2022, section 260C.209, subdivision 1, is amended to read:
Subdivision 1.
Subjects.
The responsible social services agency may have access to the
criminal history and history of child and adult maltreatment on the following individuals:
(1) a noncustodial parent or nonadjudicated parent who is being assessed for purposes
of providing day-to-day care of a child temporarily or permanently under section 260C.219
and any member of the parent's household who is over the age of 13 when there is a
reasonable cause to believe that the parent or household member over age 13 has a criminal
history or a history of maltreatment of a child or vulnerable adult deleted text begin whichdeleted text end new text begin thatnew text end would endanger
the child's health, safety, or welfare;
(2) an individual deleted text begin whose suitability for relative placement under section 260C.221 is
being determineddeleted text end and any member of the deleted text begin relative'sdeleted text end new text begin individual'snew text end household who is over the
age of 13 when:
deleted text begin
(i) the relative must be licensed for foster care; or
deleted text end
new text begin
(i) the individual is being considered for relative placement under section 260C.221;
new text end
(ii) the background study is required under section 259.53, subdivision 2; or
(iii) deleted text begin the agency or the commissioner has reasonable cause to believe the relative or
household member over the age of 13 has a criminal history which would not makedeleted text end new text begin a petition
tonew text end transfer deleted text begin ofdeleted text end permanent legal and physical custody to the deleted text begin relative underdeleted text end new text begin individual has been
filed according tonew text end section 260C.515, subdivision 4, deleted text begin in the child's best interestdeleted text end new text begin paragraph (d),
and the individual is not pursuing Northstar kinship assistance eligibility for the child under
chapter 256Nnew text end ; and
(3) a parent, following an out-of-home placement, when the responsible social services
agency has reasonable cause to believe that the parent has been convicted of a crime directly
related to the parent's capacity to maintain the child's health, safety, or welfare or the parent
is the subject of an open investigation of, or has been the subject of a substantiated allegation
of, child or vulnerable-adult maltreatment within the past ten years.
"Reasonable cause" means that the agency has received information or a report from the
subject or a third person that creates an articulable suspicion that the individual has a history
that may pose a risk to the health, safety, or welfare of the child. The information or report
must be specific to the potential subject of the background check and deleted text begin shalldeleted text end new text begin mustnew text end not be
based on the race, religion, ethnic background, age, class, or lifestyle of the potential subject.
Sec. 36.
Minnesota Statutes 2022, section 260C.212, subdivision 1, is amended to read:
Subdivision 1.
Out-of-home placement; plan.
(a) An out-of-home placement plan shall
be prepared within 30 days after any child is placed in foster care by court order or a
voluntary placement agreement between the responsible social services agency and the
child's parent pursuant to section 260C.227 or chapter 260D.
(b) An out-of-home placement plan means a written document individualized to the
needs of the child and the child's parents or guardians that is prepared by the responsible
social services agency jointly with the child's parents or guardians and in consultation with
the child's guardian ad litem; the child's tribe, if the child is an Indian child; the child's foster
parent or representative of the foster care facility; and, when appropriate, the child. When
a child is age 14 or older, the child may include two other individuals on the team preparing
the child's out-of-home placement plan. The child may select one member of the case
planning team to be designated as the child's advisor and to advocate with respect to the
application of the reasonable and prudent parenting standards. The responsible social services
agency may reject an individual selected by the child if the agency has good cause to believe
that the individual would not act in the best interest of the child. For a child in voluntary
foster care for treatment under chapter 260D, preparation of the out-of-home placement
plan shall additionally include the child's mental health treatment provider. For a child 18
years of age or older, the responsible social services agency shall involve the child and the
child's parents as appropriate. As appropriate, the plan shall be:
(1) submitted to the court for approval under section 260C.178, subdivision 7;
(2) ordered by the court, either as presented or modified after hearing, under section
260C.178, subdivision 7, or 260C.201, subdivision 6; and
(3) signed by the parent or parents or guardian of the child, the child's guardian ad litem,
a representative of the child's tribe, the responsible social services agency, and, if possible,
the child.
(c) The out-of-home placement plan shall be explained by the responsible social services
agency to all persons involved in the plan's implementation, including the child who has
signed the plan, and shall set forth:
(1) a description of the foster care home or facility selected, including how the
out-of-home placement plan is designed to achieve a safe placement for the child in the
least restrictive, most family-like setting available that is in close proximity to the home of
the child's parents or guardians when the case plan goal is reunification; and how the
placement is consistent with the best interests and special needs of the child according to
the factors under subdivision 2, paragraph (b);
(2) the specific reasons for the placement of the child in foster care, and when
reunification is the plan, a description of the problems or conditions in the home of the
parent or parents that necessitated removal of the child from home and the changes the
parent or parents must make for the child to safely return home;
(3) a description of the services offered and provided to prevent removal of the child
from the home and to reunify the family including:
(i) the specific actions to be taken by the parent or parents of the child to eliminate or
correct the problems or conditions identified in clause (2), and the time period during which
the actions are to be taken; and
(ii) the reasonable efforts, or in the case of an Indian child, active efforts to be made to
achieve a safe and stable home for the child including social and other supportive services
to be provided or offered to the parent or parents or guardian of the child, the child, and the
residential facility during the period the child is in the residential facility;
(4) a description of any services or resources that were requested by the child or the
child's parent, guardian, foster parent, or custodian since the date of the child's placement
in the residential facility, and whether those services or resources were provided and if not,
the basis for the denial of the services or resources;
(5) the visitation plan for the parent or parents or guardian, other relatives as defined in
section 260C.007, subdivision 26b or 27, and siblings of the child if the siblings are not
placed together in foster care, and whether visitation is consistent with the best interest of
the child, during the period the child is in foster care;
(6) when a child cannot return to or be in the care of either parent, documentation of
steps to finalize adoption as the permanency plan for the child through reasonable efforts
to place the child for adoption pursuant to section 260C.605. At a minimum, the
documentation must include consideration of whether adoption is in the best interests of
the child and child-specific recruitment efforts such as a relative search, consideration of
relatives for adoptive placement, and the use of state, regional, and national adoption
exchanges to facilitate orderly and timely placements in and outside of the state. A copy of
this documentation shall be provided to the court in the review required under section
260C.317, subdivision 3, paragraph (b);
(7) when a child cannot return to or be in the care of either parent, documentation of
steps to finalize the transfer of permanent legal and physical custody to a relative as the
permanency plan for the child. This documentation must support the requirements of the
kinship placement agreement under section 256N.22 and must include the reasonable efforts
used to determine that it is not appropriate for the child to return home or be adopted, and
reasons why permanent placement with a relative through a Northstar kinship assistance
arrangement is in the child's best interest; how the child meets the eligibility requirements
for Northstar kinship assistance payments; agency efforts to discuss adoption with the child's
relative foster parent and reasons why the relative foster parent chose not to pursue adoption,
if applicable; and agency efforts to discuss with the child's parent or parents the permanent
transfer of permanent legal and physical custody or the reasons why these efforts were not
made;
(8) efforts to ensure the child's educational stability while in foster care for a child who
attained the minimum age for compulsory school attendance under state law and is enrolled
full time in elementary or secondary school, or instructed in elementary or secondary
education at home, or instructed in an independent study elementary or secondary program,
or incapable of attending school on a full-time basis due to a medical condition that is
documented and supported by regularly updated information in the child's case plan.
Educational stability efforts include:
(i) efforts to ensure that the child remains in the same school in which the child was
enrolled prior to placement or upon the child's move from one placement to another, including
efforts to work with the local education authorities to ensure the child's educational stability
and attendance; or
(ii) if it is not in the child's best interest to remain in the same school that the child was
enrolled in prior to placement or move from one placement to another, efforts to ensure
immediate and appropriate enrollment for the child in a new school;
(9) the educational records of the child including the most recent information available
regarding:
(i) the names and addresses of the child's educational providers;
(ii) the child's grade level performance;
(iii) the child's school record;
(iv) a statement about how the child's placement in foster care takes into account
proximity to the school in which the child is enrolled at the time of placement; and
(v) any other relevant educational information;
(10) the efforts by the responsible social services agency to ensure the oversight and
continuity of health care services for the foster child, including:
(i) the plan to schedule the child's initial health screens;
(ii) how the child's known medical problems and identified needs from the screens,
including any known communicable diseases, as defined in section 144.4172, subdivision
2, shall be monitored and treated while the child is in foster care;
(iii) how the child's medical information shall be updated and shared, including the
child's immunizations;
(iv) who is responsible to coordinate and respond to the child's health care needs,
including the role of the parent, the agency, and the foster parent;
(v) who is responsible for oversight of the child's prescription medications;
(vi) how physicians or other appropriate medical and nonmedical professionals shall be
consulted and involved in assessing the health and well-being of the child and determine
the appropriate medical treatment for the child; and
(vii) the responsibility to ensure that the child has access to medical care through either
medical insurance or medical assistance;
(11) the health records of the child including information available regarding:
(i) the names and addresses of the child's health care and dental care providers;
(ii) a record of the child's immunizations;
(iii) the child's known medical problems, including any known communicable diseases
as defined in section 144.4172, subdivision 2;
(iv) the child's medications; and
(v) any other relevant health care information such as the child's eligibility for medical
insurance or medical assistance;
(12) an independent living plan for a child 14 years of age or older, developed in
consultation with the child. The child may select one member of the case planning team to
be designated as the child's advisor and to advocate with respect to the application of the
reasonable and prudent parenting standards in subdivision 14. The plan should include, but
not be limited to, the following objectives:
(i) educational, vocational, or employment planning;
(ii) health care planning and medical coverage;
(iii) transportation including, where appropriate, assisting the child in obtaining a driver's
license;
(iv) money management, including the responsibility of the responsible social services
agency to ensure that the child annually receives, at no cost to the child, a consumer report
as defined under section 13C.001 and assistance in interpreting and resolving any inaccuracies
in the report;
(v) planning for housing;
(vi) social and recreational skills;
(vii) establishing and maintaining connections with the child's family and community;
and
(viii) regular opportunities to engage in age-appropriate or developmentally appropriate
activities typical for the child's age group, taking into consideration the capacities of the
individual child;
(13) for a child in voluntary foster care for treatment under chapter 260D, diagnostic
and assessment information, specific services relating to meeting the mental health care
needs of the child, and treatment outcomes;
(14) for a child 14 years of age or older, a signed acknowledgment that describes the
child's rights regarding education, health care, visitation, safety and protection from
exploitation, and court participation; receipt of the documents identified in section 260C.452;
and receipt of an annual credit report. The acknowledgment shall state that the rights were
explained in an age-appropriate manner to the child; and
(15) for a child placed in a qualified residential treatment program, the plan must include
the requirements in section 260C.708.
(d) The parent or parents or guardian and the child each shall have the right to legal
counsel in the preparation of the case plan and shall be informed of the right at the time of
placement of the child. The child shall also have the right to a guardian ad litem. If unable
to employ counsel from their own resources, the court shall appoint counsel upon the request
of the parent or parents or the child or the child's legal guardian. The parent or parents may
also receive assistance from any person or social services agency in preparation of the case
plan.
new text begin
(e) Before an out-of-home placement plan is signed by the parent or parents or guardian
of the child, the responsible social services agency must provide the parent or parents or
guardian with a one- to two-page summary of the plan using a form developed by the
commissioner. The out-of-home placement plan summary must clearly summarize the plan's
contents under paragraph (c) and list the requirements and responsibilities for the parent or
parents or guardian using plain language. The summary must be updated and provided to
the parent or parents or guardian when the out-of-home placement plan is updated under
subdivision 1a.
new text end
deleted text begin (e)deleted text end new text begin (f)new text end After the plan has been agreed upon by the parties involved or approved or ordered
by the court, the foster parents shall be fully informed of the provisions of the case plan and
shall be provided a copy of the plan.
deleted text begin (f)deleted text end new text begin (g)new text end Upon the child's discharge from foster care, the responsible social services agency
must provide the child's parent, adoptive parent, or permanent legal and physical custodian,
and the child, if the child is 14 years of age or older, with a current copy of the child's health
and education record. If a child meets the conditions in subdivision 15, paragraph (b), the
agency must also provide the child with the child's social and medical history. The responsible
social services agency may give a copy of the child's health and education record and social
and medical history to a child who is younger than 14 years of age, if it is appropriate and
if subdivision 15, paragraph (b), applies.
Sec. 37.
Minnesota Statutes 2022, section 260C.212, subdivision 2, is amended to read:
Subd. 2.
Placement decisions based on best interests of the child.
(a) The policy of
the state of Minnesota is to ensure that the child's best interests are met by requiring an
individualized determination of the needs of the child in consideration of paragraphs (a) to
(f), and of how the selected placement will serve the current and future needs of the child
being placed. The authorized child-placing agency shall place a child, released by court
order or by voluntary release by the parent or parents, in a family foster home selected by
considering placement with relatives in the following order:
(1) with an individual who is related to the child by blood, marriage, or adoption,
including the legal parent, guardian, or custodian of the child's sibling; or
(2) with an individual who is an important friend of the child or of the child's parent or
custodian, including an individual with whom the child has resided or had significant contact
or who has a significant relationship to the child or the child's parent or custodian.
For an Indian child, the agency shall follow the order of placement preferences in the Indian
Child Welfare Act of 1978, United States Code, title 25, section 1915.
(b) Among the factors the agency shall consider in determining the current and future
needs of the child are the following:
(1) the child's current functioning and behaviors;
(2) the medical needs of the child;
(3) the educational needs of the child;
(4) the developmental needs of the child;
(5) the child's history and past experience;
(6) the child's religious and cultural needs;
(7) the child's connection with a community, school, and faith community;
(8) the child's interests and talents;
(9) the child's current and long-term needs regarding relationships with parents, siblings,
relatives, and other caretakers;
(10) the reasonable preference of the child, if the court, or the child-placing agency in
the case of a voluntary placement, deems the child to be of sufficient age to express
preferences; and
(11) for an Indian child, the best interests of an Indian child as defined in section 260.755,
subdivision 2a.
When placing a child in foster care or in a permanent placement based on an individualized
determination of the child's needs, the agency must not use one factor in this paragraph to
the exclusion of all others, and the agency shall consider that the factors in paragraph (b)
may be interrelated.
(c) Placement of a child cannot be delayed or denied based on race, color, or national
origin of the foster parent or the child.
(d) Siblings should be placed together for foster care and adoption at the earliest possible
time unless it is documented that a joint placement would be contrary to the safety or
well-being of any of the siblings or unless it is not possible after reasonable efforts by the
responsible social services agency. In cases where siblings cannot be placed together, the
agency is required to provide frequent visitation or other ongoing interaction between
siblings unless the agency documents that the interaction would be contrary to the safety
or well-being of any of the siblings.
(e) deleted text begin Except for emergency placement as provided for in section 245A.035,deleted text end The following
requirements must be satisfied before the approval of a foster deleted text begin or adoptivedeleted text end placement in a
related or unrelated home: (1) a completed background study under section 245C.08; and
(2) a completed review of the written home study required under section 260C.215,
subdivision 4, clause (5), deleted text begin or 260C.611,deleted text end to assess the capacity of the prospective foster deleted text begin or
adoptivedeleted text end parent to ensure the placement will meet the needs of the individual child.new text begin For
adoptive placements in a related or unrelated home, the home must meet the requirements
of section 260C.611.
new text end
(f) The agency must determine whether colocation with a parent who is receiving services
in a licensed residential family-based substance use disorder treatment program is in the
child's best interests according to paragraph (b) and include that determination in the child's
case plan under subdivision 1. The agency may consider additional factors not identified
in paragraph (b). The agency's determination must be documented in the child's case plan
before the child is colocated with a parent.
(g) The agency must establish a juvenile treatment screening team under section 260C.157
to determine whether it is necessary and appropriate to recommend placing a child in a
qualified residential treatment program, as defined in section 260C.007, subdivision 26d.
new text begin
(h) A child in foster care must not be placed in an unlicensed emergency relative
placement under section 245A.035 or licensed family foster home when the responsible
social services agency is aware that a prospective foster parent, license applicant, license
holder, or adult household member has a permanent disqualification under section 245C.15,
subdivision 4a, paragraphs (a) and (b).
new text end
Sec. 38.
Minnesota Statutes 2022, section 260C.301, subdivision 1, as amended by Laws
2024, chapter 80, article 8, section 27, is amended to read:
Subdivision 1.
Voluntary and involuntary.
The juvenile court may upon petition,
terminate all rights of a parent to a child:
(a) with the written consent of a parent who for good cause desires to terminate parental
rights; or
(b) if it finds that one or more of the following conditions exist:
(1) that the parent has abandoned the child;
(2) that the parent has substantially, continuously, or repeatedly refused or neglected to
comply with the duties imposed upon that parent by the parent and child relationship,
including but not limited to providing the child with necessary food, clothing, shelter,
education, and other care and control necessary for the child's physical, mental, or emotional
health and development, if the parent is physically and financially able, and either reasonable
efforts by the social services agency have failed to correct the conditions that formed the
basis of the petition or reasonable efforts would be futile and therefore unreasonable;
deleted text begin
(3) that a parent has been ordered to contribute to the support of the child or financially
aid in the child's birth and has continuously failed to do so without good cause. This clause
shall not be construed to state a grounds for termination of parental rights of a noncustodial
parent if that parent has not been ordered to or cannot financially contribute to the support
of the child or aid in the child's birth;
deleted text end
deleted text begin (4)deleted text end new text begin (3)new text end that a parent is palpably unfit to be a party to the parent and child relationship
because of a consistent pattern of specific conduct before the child or of specific conditions
directly relating to the parent and child relationship either of which are determined by the
court to be of a duration or nature that renders the parent unable, for the reasonably
foreseeable future, to care appropriately for the ongoing physical, mental, or emotional
needs of the child. It is presumed that a parent is palpably unfit to be a party to the parent
and child relationship upon a showing that the parent's parental rights to one or more other
children were involuntarily terminated or that the parent's custodial rights to another child
have been involuntarily transferred to a relative under a juvenile protection proceeding or
a similar process of another jurisdiction;
deleted text begin (5)deleted text end new text begin (4)new text end that following the child's placement out of the home, reasonable efforts, under
the direction of the court, have failed to correct the conditions leading to the child's
placement. It is presumed that reasonable efforts under this clause have failed upon a showing
that:
(i) a child has resided out of the parental home under court order for a cumulative period
of 12 months within the preceding 22 months. In the case of a child under age eight at the
time the petition was filed alleging the child to be in need of protection or services, the
presumption arises when the child has resided out of the parental home under court order
for six months unless the parent has maintained regular contact with the child and the parent
is complying with the out-of-home placement plan;
(ii) the court has approved the out-of-home placement plan required under section
260C.212 and filed with the court under section 260C.178;
(iii) conditions leading to the out-of-home placement have not been corrected. It is
presumed that conditions leading to a child's out-of-home placement have not been corrected
upon a showing that the parent or parents have not substantially complied with the court's
orders and a reasonable case plan; and
(iv) reasonable efforts have been made by the social services agency to rehabilitate the
parent and reunite the family.
This clause does not prohibit the termination of parental rights prior to one year, or in
the case of a child under age eight, prior to six months after a child has been placed out of
the home.
It is also presumed that reasonable efforts have failed under this clause upon a showing
that:
(A) the parent has been diagnosed as chemically dependent by a professional certified
to make the diagnosis;
(B) the parent has been required by a case plan to participate in a chemical dependency
treatment program;
(C) the treatment programs offered to the parent were culturally, linguistically, and
clinically appropriate;
(D) the parent has either failed two or more times to successfully complete a treatment
program or has refused at two or more separate meetings with a caseworker to participate
in a treatment program; and
(E) the parent continues to abuse chemicals.
deleted text begin (6)deleted text end new text begin (5)new text end that a child has experienced egregious harm in the parent's care deleted text begin whichdeleted text end new text begin thatnew text end is of
a nature, duration, or chronicity that indicates a lack of regard for the child's well-being,
such that a reasonable person would believe it contrary to the best interest of the child or
of any child to be in the parent's care;
deleted text begin (7)deleted text end new text begin (6)new text end that in the case of a child born to a mother who was not married to the child's
father when the child was conceived nor when the child was born the person is not entitled
to notice of an adoption hearing under section 259.49 and the person has not registered with
the fathers' adoption registry under section 259.52;
deleted text begin (8)deleted text end new text begin (7)new text end that the child is neglected and in foster care; or
deleted text begin (9)deleted text end new text begin (8)new text end that the parent has been convicted of a crime listed in section 260.012, paragraph
(g), clauses (1) to (5).
In an action involving an American Indian child, sections 260.751 to 260.835 and the
Indian Child Welfare Act, United States Code, title 25, sections 1901 to 1923, control to
the extent that the provisions of this section are inconsistent with those laws.
Sec. 39.
Minnesota Statutes 2022, section 260C.515, subdivision 4, is amended to read:
Subd. 4.
new text begin Transfer of permanent legal and physical new text end custody deleted text begin to relativedeleted text end .
new text begin (a) new text end The court
may order new text begin a transfer of new text end permanent legal and physical custody tonew text begin :
new text end
new text begin
(1) a parent. The court must find that the parent understands a transfer of permanent
legal and physical custody includes permanent, ongoing responsibility for the protection,
education, care, and control of the child and decision making on behalf of the child until
adulthood; or
new text end
new text begin (2)new text end a fit and willing relative deleted text begin in the best interests of the childdeleted text end according to the deleted text begin followingdeleted text end
requirementsdeleted text begin :deleted text end new text begin in paragraph (b).
new text end
deleted text begin (1)deleted text end new text begin (b)new text end An order for transfer of permanent legal and physical custody to a relative deleted text begin shalldeleted text end new text begin
mustnew text end only be made after the court has reviewed the suitability of the prospective legal and
physical custodiandeleted text begin ;deleted text end new text begin , including a summary of information obtained from required background
studies under section 245C.33 or 260C.209, if the court finds the permanency disposition
to be in the child's best interests.
new text end
deleted text begin (2)deleted text end In transferring permanent legal and physical custody to a relative, the juvenile court
shall follow the standards applicable under this chapter and chapter 260, and the procedures
in the Minnesota Rules of Juvenile Protection Proceduredeleted text begin ;deleted text end new text begin . The court must issue written
findings that include the following:
new text end
new text begin
(1) the prospective legal and physical custodian understands that:
new text end
deleted text begin (3)deleted text end new text begin (i)new text end a transfer of new text begin permanent new text end legal and physical custody includes new text begin permanent, ongoing
new text end responsibility for the protection, education, care, and control of the child and decision
making on behalf of the childnew text begin until adulthoodnew text end ;new text begin and
new text end
deleted text begin (4)deleted text end new text begin (ii)new text end a permanent legal and physical custodian deleted text begin maydeleted text end new text begin shallnew text end not return a child to the
permanent care of a parent from whom the court removed custody without the court's
approval and without notice to the responsible social services agency;
new text begin
(2) transfer of permanent legal and physical custody and receipt of Northstar kinship
assistance under chapter 256N, when requested and the child is eligible, are in the child's
best interests;
new text end
new text begin
(3) when the agency files the petition under paragraph (c) or supports the petition filed
under paragraph (d), adoption is not in the child's best interests based on the determinations
in the kinship placement agreement required under section 256N.22, subdivision 2;
new text end
new text begin
(4) the agency made efforts to discuss adoption with the child's parent or parents, or the
agency did not make efforts to discuss adoption and the reasons why efforts were not made;
and
new text end
new text begin
(5) there are reasons to separate siblings during placement, if applicable.
new text end
deleted text begin (5)deleted text end new text begin (c)new text end The new text begin responsible new text end social services agency may file a petition naming a fit and willing
relative as a proposed permanent legal and physical custodian. A petition for transfer of
permanent legal and physical custody to a relative deleted text begin who is not a parentdeleted text end shall new text begin include facts
upon which the court can determine suitability of the proposed custodian, including a
summary of results from required background studies completed under section 245C.33.
The petition must new text end be accompanied by a kinship placement agreement under section 256N.22,
subdivision 2, between the agency and proposed permanent legal and physical custodiandeleted text begin ;deleted text end new text begin .
new text end
deleted text begin (6)deleted text end new text begin (d)new text end Another party to the permanency proceeding regarding the child may file a petition
to transfer permanent legal and physical custody to a relative. The petition must include
facts upon which the court can make the deleted text begin determinationdeleted text end new text begin determinationsnew text end required under deleted text begin clause
(7) anddeleted text end new text begin paragraph (b), including suitability of the proposed custodian and, if completed, a
summary of results from required background studies completed under section 245C.33 or
260C.209. If background studies have not been completed at the time of filing the petition,
they must be completed and a summary of results provided to the court prior to the court
granting the petition or finalizing the order according to paragraph (e). The petitionnew text end must
be filed deleted text begin notdeleted text end new text begin nonew text end later than the date for the required admit-deny hearing under section 260C.507;
or if the agency's petition is filed under section 260C.503, subdivision 2, the petition must
be filed not later than 30 days prior to the trial required under section 260C.509deleted text begin ;deleted text end new text begin .
new text end
deleted text begin
(7) where a petition is for transfer of permanent legal and physical custody to a relative
who is not a parent, the court must find that:
deleted text end
deleted text begin
(i) transfer of permanent legal and physical custody and receipt of Northstar kinship
assistance under chapter 256N, when requested and the child is eligible, are in the child's
best interests;
deleted text end
deleted text begin
(ii) adoption is not in the child's best interests based on the determinations in the kinship
placement agreement required under section 256N.22, subdivision 2;
deleted text end
deleted text begin
(iii) the agency made efforts to discuss adoption with the child's parent or parents, or
the agency did not make efforts to discuss adoption and the reasons why efforts were not
made; and
deleted text end
deleted text begin
(iv) there are reasons to separate siblings during placement, if applicable;
deleted text end
deleted text begin (8)deleted text end new text begin (e)new text end The court maynew text begin :
new text end
new text begin (1)new text end defer finalization of an order transferring permanent legal and physical custody to a
relative when deferring finalization is necessary to determine eligibility for Northstar kinship
assistance under chapter 256N;
deleted text begin (9) the court maydeleted text end new text begin (2)new text end finalize a deleted text begin permanentdeleted text end transfer of new text begin permanent legal and new text end physical deleted text begin and
legaldeleted text end custody to a relative regardless of eligibility for Northstar kinship assistance under
chapter 256Nnew text begin , provided that the court has reviewed the suitability of the proposed custodian,
including the summary of background study results, consistent with paragraph (b)new text end ; and
deleted text begin (10) the juvenile court maydeleted text end new text begin (3) following a transfer of permanent legal and physical
custody to a relative,new text end maintain jurisdiction over the responsible social services agency, the
parents or guardian of the child, the child, and the permanent legal and physical custodian
for purposes of ensuring appropriate services are delivered to the child and permanent legal
custodian for the purpose of ensuring conditions ordered by the court related to the care and
custody of the child are met.
Sec. 40.
Minnesota Statutes 2022, section 260C.607, subdivision 1, is amended to read:
Subdivision 1.
Review hearings.
(a) The court shall conduct a review of the responsible
social services agency's reasonable efforts to finalize adoption for any child under the
guardianship of the commissioner and of the progress of the case toward adoption at least
every 90 days after the court issues an order that the commissioner is the guardian of the
child.
(b) The review of progress toward adoption shall continue notwithstanding that an appeal
is made of the order for guardianshipnew text begin or termination of parental rightsnew text end .
(c) The agency's reasonable efforts to finalize the adoption must continue during the
pendency of the appeal new text begin under paragraph (b) or subdivision 6, paragraph (h), new text end and all progress
toward adoption shall continue except that the court may not finalize an adoption while the
appeal is pending.
Sec. 41.
Minnesota Statutes 2022, section 260C.607, subdivision 6, is amended to read:
Subd. 6.
Motion and hearing to order adoptive placement.
(a) At any time after the
district court orders the child under the guardianship of the commissioner of human services,
but not later than 30 days after receiving notice required under section 260C.613, subdivision
1, paragraph (c), that the agency has made an adoptive placement, a relative or the child's
foster parent may file a motion for an order for adoptive placement of a child who is under
the guardianship of the commissioner if the relative or the child's foster parent:
(1) has an adoption home study under section 259.41 or 260C.611 approving the relative
or foster parent for adoption. If the relative or foster parent does not have an adoption home
study, an affidavit attesting to efforts to complete an adoption home study may be filed with
the motion instead. The affidavit must be signed by the relative or foster parent and the
responsible social services agency or licensed child-placing agency completing the adoption
home study. The relative or foster parent must also have been a resident of Minnesota for
at least six months before filing the motion; the court may waive the residency requirement
for the moving party if there is a reasonable basis to do so; or
(2) is not a resident of Minnesota, but has an approved adoption home study by an agency
licensed or approved to complete an adoption home study in the state of the individual's
residence and the study is filed with the motion for adoptive placement. If the relative or
foster parent does not have an adoption home study in the relative or foster parent's state
of residence, an affidavit attesting to efforts to complete an adoption home study may be
filed with the motion instead. The affidavit must be signed by the relative or foster parent
and the agency completing the adoption home study.
(b) The motion deleted text begin shalldeleted text end new text begin mustnew text end be filed with the court conducting reviews of the child's
progress toward adoption under this section. The motion and supporting documents must
make a prima facie showing that the agency has been unreasonable in failing to make the
requested adoptive placement. The motion must be served according to the requirements
for motions under the Minnesota Rules of Juvenile Protection Procedure and deleted text begin shalldeleted text end new text begin mustnew text end be
made on all individuals and entities listed in subdivision 2.
(c) If the motion and supporting documents do not make a prima facie showing for the
court to determine whether the agency has been unreasonable in failing to make the requested
adoptive placement, the court shall dismiss the motion. If the court determines a prima facie
basis is made, the court shall set the matter for evidentiary hearing.
(d) At the evidentiary hearing, the responsible social services agency shall proceed first
with evidence about the reason for not making the adoptive placement proposed by the
moving party. When the agency presents evidence regarding the child's current relationship
with the identified adoptive placement resource, the court must consider the agency's efforts
to support the child's relationship with the moving party consistent with section 260C.221.
The moving party then has the burden of proving by a preponderance of the evidence that
the agency has been unreasonable in failing to make the adoptive placement.
(e) The court shall review and enter findings regarding whether the agency, in making
an adoptive placement decision for the child:
(1) considered relatives for adoptive placement in the order specified under section
260C.212, subdivision 2, paragraph (a); and
(2) assessed how the identified adoptive placement resource and the moving party are
each able to meet the child's current and future needs, based on an individualized
determination of the child's needs, as required under sections 260C.212, subdivision 2, and
260C.613, subdivision 1, paragraph (b).
(f) At the conclusion of the evidentiary hearing, if the court finds that the agency has
been unreasonable in failing to make the adoptive placement and that the moving party is
the most suitable adoptive home to meet the child's needs using the factors in section
260C.212, subdivision 2, paragraph (b), the court may:
(1) order the responsible social services agency to make an adoptive placement in the
home of the moving party if the moving party has an approved adoption home study; or
(2) order the responsible social services agency to place the child in the home of the
moving party upon approval of an adoption home study. The agency must promote and
support the child's ongoing visitation and contact with the moving party until the child is
placed in the moving party's home. The agency must provide an update to the court after
90 days, including progress and any barriers encountered. If the moving party does not have
an approved adoption home study within 180 days, the moving party and the agency must
inform the court of any barriers to obtaining the approved adoption home study during a
review hearing under this section. If the court finds that the moving party is unable to obtain
an approved adoption home study, the court must dismiss the order for adoptive placement
under this subdivision and order the agency to continue making reasonable efforts to finalize
the adoption of the child as required under section 260C.605.
(g) If, in order to ensure that a timely adoption may occur, the court orders the responsible
social services agency to make an adoptive placement under this subdivision, the agency
shall:
(1) make reasonable efforts to obtain a fully executed adoption placement agreement,
including assisting the moving party with the adoption home study process;
(2) work with the moving party regarding eligibility for adoption assistance as required
under chapter 256N; and
(3) if the moving party is not a resident of Minnesota, timely refer the matter for approval
of the adoptive placement through the Interstate Compact on the Placement of Children.
(h) Denial or granting of a motion for an order for adoptive placement after an evidentiary
hearing is an order deleted text begin whichdeleted text end new text begin thatnew text end may be appealed by the responsible social services agency,
the moving party, the child, when age ten or over, the child's guardian ad litem, and any
individual who had a fully executed adoption placement agreement regarding the child at
the time the motion was filed if the court's order has the effect of terminating the adoption
placement agreement. An appeal deleted text begin shalldeleted text end new text begin mustnew text end be conducted according to the requirements of
the Rules of Juvenile Protection Procedure.new text begin Pursuant to subdivision 1, paragraph (c), the
court shall not finalize an adoption while an appeal is pending.
new text end
Sec. 42.
Minnesota Statutes 2022, section 260C.611, is amended to read:
260C.611 ADOPTION STUDY REQUIRED.
(a) An adoption study under section 259.41 approving placement of the child in the
home of the prospective adoptive parent deleted text begin shalldeleted text end new text begin mustnew text end be completed before placing any child
under the guardianship of the commissioner in a home for adoption. If a prospective adoptive
parent has a current child foster care license under chapter 245A and is seeking to adopt a
foster child who is placed in the prospective adoptive parent's home and is under the
guardianship of the commissioner according to section 260C.325, subdivision 1, the child
foster care home study meets the requirements of this section for an approved adoption
home study if:
(1) the written home study on which the foster care license was based is completed in
the commissioner's designated format, consistent with the requirements in sections 259.41,
subdivision 2; and 260C.215, subdivision 4, clause (5); and Minnesota Rules, part 2960.3060,
subpart 4;
(2) the background studies on each prospective adoptive parent and all required household
members were completed according to section 245C.33;
(3) the commissioner has not issueddeleted text begin , within the last three years,deleted text end a sanction on the license
under section 245A.07 or an order of a conditional license under section 245A.06new text begin within
the last three years, or the commissioner has determined it to be in the child's best interests
to allow the child foster care home study to meet requirements of an approved adoption
home study upon review of the legally responsible agency's adoptive placement decisionnew text end ;
and
(4) the legally responsible agency determines that the individual needs of the child are
being met by the prospective adoptive parent through an assessment under section 256N.24,
subdivision 2, or a documented placement decision consistent with section 260C.212,
subdivision 2.
(b) If a prospective adoptive parent has previously held a foster care license or adoptive
home study, any update necessary to the foster care license, or updated or new adoptive
home study, if not completed by the licensing authority responsible for the previous license
or home study, shall include collateral information from the previous licensing or approving
agency, if available.
Sec. 43.
Minnesota Statutes 2022, section 260C.613, subdivision 1, is amended to read:
Subdivision 1.
Adoptive placement decisions.
(a) The responsible social services agency
has exclusive authority to make an adoptive placement deleted text begin ofdeleted text end new text begin decision fornew text end a child under the
guardianship of the commissioner. The child deleted text begin shall be considereddeleted text end new text begin is legallynew text end placed for adoption
when the adopting parent, the agency, and the commissioner have fully executed an adoption
placement agreement on the form prescribed by the commissioner.
(b) The responsible social services agency shall use an individualized determination of
the child's current and future needs, pursuant to section 260C.212, subdivision 2, paragraph
(b), to determine the most suitable adopting parent for the child in the child's best interests.
The responsible social services agency must consider adoptive placement of the child with
relatives in the order specified in section 260C.212, subdivision 2, paragraph (a).
(c) The responsible social services agency shall notify the court and parties entitled to
notice under section 260C.607, subdivision 2, when there is a fully executed adoption
placement agreement for the child.
new text begin
(d) Pursuant to section 260C.615, subdivision 1, paragraph (b), clause (4), the responsible
social services agency shall immediately notify the commissioner if the agency learns of
any new or previously undisclosed criminal or maltreatment information involving an
adoptive placement of a child under guardianship of the commissioner.
new text end
deleted text begin (d)deleted text end new text begin (e)new text end In the event new text begin a party to new text end an adoption placement agreement terminatesnew text begin the agreementnew text end ,
the responsible social services agency shall notify the court, the parties entitled to notice
under section 260C.607, subdivision 2, and the commissioner that the agreement and the
adoptive placement have terminated.
Sec. 44.
Minnesota Statutes 2022, section 260C.615, subdivision 1, is amended to read:
Subdivision 1.
Duties.
(a) For any child who is under the guardianship of the
commissioner, the commissioner has the exclusive rights to consent to:
(1) the medical care plan for the treatment of a child who is at imminent risk of death
or who has a chronic disease that, in a physician's judgment, will result in the child's death
in the near future including a physician's order not to resuscitate or intubate the child; and
(2) the child donating a part of the child's body to another person while the child is living;
the decision to donate a body part under this clause shall take into consideration the child's
wishes and the child's culture.
(b) In addition to the exclusive rights under paragraph (a), the commissioner has a duty
to:
(1) process any complete and accurate request for home study and placement through
the Interstate Compact on the Placement of Children under section 260.851;
(2) process any complete and accurate application for adoption assistance forwarded by
the responsible social services agency according to chapter 256N;
(3) review and process an adoption placement agreement forwarded to the commissioner
by the responsible social services agency and return it to the agency in a timely fashion;
deleted text begin and
deleted text end
new text begin
(4) review new or previously undisclosed information received from the agency or other
individuals or entities that may impact the health, safety, or well-being of a child who is
the subject of a fully executed adoption placement agreement; and
new text end
deleted text begin (4)deleted text end new text begin (5)new text end maintain records as required in chapter 259.
Sec. 45.
Minnesota Statutes 2022, section 260E.03, subdivision 23, as amended by Laws
2024, chapter 80, article 8, section 33, is amended to read:
Subd. 23.
Threatened injury.
(a) "Threatened injury" means a statement, overt act,
condition, or status that represents a substantial risk of physical or sexual abuse or mental
injury.
(b) Threatened injury includes, but is not limited to, exposing a child to a person
responsible for the child's care, as defined in subdivision 17, who has:
(1) subjected a child to, or failed to protect a child from, an overt act or condition that
constitutes egregious harm under subdivision 5 or a similar law of another jurisdiction;
(2) been found to be palpably unfit under section 260C.301, subdivision 1, paragraph
(b), clause (4), or a similar law of another jurisdiction;
(3) committed an act that resulted in an involuntary termination of parental rights under
section 260C.301, or a similar law of another jurisdiction; or
(4) committed an act that resulted in the involuntary transfer of permanent legal and
physical custody of a child to a relativenew text begin or parentnew text end under section 260C.515, subdivision 4,
or a similar law of another jurisdiction.
(c) A child is the subject of a report of threatened injury when the local welfare agency
receives birth match data under section 260E.14, subdivision 4, from the Department of
Human Services.
Sec. 46.
Minnesota Statutes 2022, section 393.07, subdivision 10a, is amended to read:
Subd. 10a.
Expedited issuance of SNAP benefits.
The commissioner of human services
shall continually monitor the expedited issuance of SNAP benefits to ensure that each county
complies with federal regulations and that households eligible for expedited issuance of
SNAP benefits are identified, processed, and certified within the time frames prescribed in
federal regulations.
deleted text begin
County SNAP benefits offices shall screen applicants on the day of application.
Applicants who meet the federal criteria for expedited issuance and have an immediate need
for food assistance shall receive within five working days the issuance of SNAP benefits.
deleted text end
deleted text begin
The local SNAP agency shall conspicuously post in each SNAP office a notice of the
availability of and the procedure for applying for expedited issuance and verbally advise
each applicant of the availability of the expedited process.
deleted text end
Sec. 47.
Minnesota Statutes 2022, section 518.17, is amended by adding a subdivision to
read:
new text begin Subd. 2a. new text end
new text begin Parents with disabilities. new text end
new text begin
(a) A court shall not deny nor restrict a parent's
parenting time or custody due to the parent's disability. A party raising disability as a basis
for denying or restricting parenting time has the burden to prove by clear and convincing
evidence that a parent's specific behaviors during parenting time would endanger the health
or safety of the child. If the party meets the burden, a parent with a disability shall have the
opportunity to demonstrate how implementing supportive services can alleviate any concerns.
The court may require a parent with a disability to use supportive parenting services to
facilitate parenting time.
new text end
new text begin
(b) If a court denies or limits the right of a parent with a disability to custody of a child
or visitation with a child, the court shall make specific written findings stating the basis for
the denial or limitation and why providing supportive parenting services is not a reasonable
accommodation that could prevent denying or limiting the parent's custody or parenting
time.
new text end
new text begin
(c) For purposes of this subdivision, "disability" and "supportive parenting services"
have the meanings given in section 260C.201, subdivision 13.
new text end
new text begin EFFECTIVE DATE. new text end
new text begin
This section is effective August 1, 2024, and applies to pleadings
and motions pending on or after that date.
new text end
ARTICLE 18
DEPARTMENT OF HUMAN SERVICES POLICY
Section 1.
Minnesota Statutes 2023 Supplement, section 13.46, subdivision 4, as amended
by Laws 2024, chapter 80, article 8, section 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,new text begin certification holders,new text end and former licensees are public: name, address, telephone
number of licensees,new text begin email addresses except for family child foster care,new text end 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 commissioner of children, youth, and families; 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 142A.15 or 245A.05 or a sanction under section
142B.18 or 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 142A.15 or 245A.05 or a sanction under section
142B.18 or 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 is 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
private 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
142B or 245A; the commissioner of human services; commissioner of children, youth, and
families; 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 142B, 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 142B,
245A, and 245C, data on individuals collected by the commissioner of human services
according to investigations under section 626.557 and chapters 142B, 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 or children, youth,
and families 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 of children, youth, and families 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.
new text begin EFFECTIVE DATE. new text end
new text begin
This section is effective January 1, 2025.
new text end
Sec. 2.
Minnesota Statutes 2023 Supplement, section 245A.02, subdivision 2c, is amended
to read:
Subd. 2c.
Annual or annually; family child carenew text begin and family child foster carenew text end .
For
the purposes of new text begin family child care under new text end sections 245A.50 to 245A.53new text begin and family child foster
care trainingnew text end , "annual" or "annually" means each calendar year.
new text begin EFFECTIVE DATE. new text end
new text begin
This section is effective January 1, 2025.
new text end
Sec. 3.
Minnesota Statutes 2023 Supplement, section 245A.03, subdivision 2, as amended
by Laws 2024, chapter 85, section 52, and Laws 2024, chapter 80, article 2, section 35, is
amended to read:
Subd. 2.
Exclusion from licensure.
(a) This chapter does not apply to:
(1) residential or nonresidential programs that are provided to a person by an individual
who is related;
(2) nonresidential programs that are provided by an unrelated individual to persons from
a single related family;
(3) residential or nonresidential programs that are provided to adults who do not misuse
substances or have a substance use disorder, a mental illness, a developmental disability, a
functional impairment, or a physical disability;
(4) sheltered workshops or work activity programs that are certified by the commissioner
of employment and economic development;
(5) programs operated by a public school for children 33 months or older;
(6) nonresidential programs primarily for children that provide care or supervision for
periods of less than three hours a day while the child's parent or legal guardian is in the
same building as the nonresidential program or present within another building that is
directly contiguous to the building in which the nonresidential program is located;
(7) nursing homes or hospitals licensed by the commissioner of health except as specified
under section 245A.02;
(8) board and lodge facilities licensed by the commissioner of health that do not provide
children's residential services under Minnesota Rules, chapter 2960, mental health or
substance use disorder treatment;
(9) programs licensed by the commissioner of corrections;
(10) recreation programs for children or adults that are operated or approved by a park
and recreation board whose primary purpose is to provide social and recreational activities;
(11) noncertified boarding care homes unless they provide services for five or more
persons whose primary diagnosis is mental illness or a developmental disability;
(12) programs for children such as scouting, boys clubs, girls clubs, and sports and art
programs, and nonresidential programs for children provided for a cumulative total of less
than 30 days in any 12-month period;
(13) residential programs for persons with mental illness, that are located in hospitals;
(14) camps licensed by the commissioner of health under Minnesota Rules, chapter
4630;
(15) mental health outpatient services for adults with mental illness or children with
emotional disturbance;
(16) residential programs serving school-age children whose sole purpose is cultural or
educational exchange, until the commissioner adopts appropriate rules;
(17) community support services programs as defined in section 245.462, subdivision
6, and family community support services as defined in section 245.4871, subdivision 17;
(18) deleted text begin settings registered under chapter deleted text end deleted text begin 144Ddeleted text end deleted text begin which provide home care services licensed
by the commissioner of health to fewer than seven adultsdeleted text end new text begin assisted living facilities licensed
by the commissioner of health under chapter 144Gnew text end ;
(19) substance use disorder treatment activities of licensed professionals in private
practice as defined in section 245G.01, subdivision 17;
(20) consumer-directed community support service funded under the Medicaid waiver
for persons with developmental disabilities when the individual who provided the service
is:
(i) the same individual who is the direct payee of these specific waiver funds or paid by
a fiscal agent, fiscal intermediary, or employer of record; and
(ii) not otherwise under the control of a residential or nonresidential program that is
required to be licensed under this chapter when providing the service;
(21) a county that is an eligible vendor under section 254B.05 to provide care coordination
and comprehensive assessment services;
(22) a recovery community organization that is an eligible vendor under section 254B.05
to provide peer recovery support services; or
(23) programs licensed by the commissioner of children, youth, and families in chapter
142B.
(b) For purposes of paragraph (a), clause (6), a building is directly contiguous to a
building in which a nonresidential program is located if it shares a common wall with the
building in which the nonresidential program is located or is attached to that building by
skyway, tunnel, atrium, or common roof.
deleted text begin (b)deleted text end new text begin (c)new text end Except for the home and community-based services identified in section 245D.03,
subdivision 1, nothing in this chapter shall be construed to require licensure for any services
provided and funded according to an approved federal waiver plan where licensure is
specifically identified as not being a condition for the services and funding.
Sec. 4.
Minnesota Statutes 2022, section 245A.04, is amended by adding a subdivision to
read:
new text begin Subd. 7b. new text end
new text begin
Notification to commissioner of changes in key staff positions; children's
residential facilities and detoxification programs.
new text end
new text begin
(a) A license holder must notify the
commissioner within five business days of a change or vacancy in a key staff position under
paragraphs (b) or (c). The license holder must notify the commissioner of the staffing change
or vacancy on a form approved by the commissioner and include the name of the staff person
now assigned to the key staff position and the staff person's qualifications for the position.
new text end
new text begin
(b) The key staff position for a children's residential facility licensed according to
Minnesota Rules, parts 2960.0130 to 2960.0220, is a program director; and
new text end
new text begin
(c) The key staff positions for a detoxification program licensed according to Minnesota
Rules, parts 9530.6510 to 9530.6590, are:
new text end
new text begin
(1) a program director as required by Minnesota Rules, part 9530.6560, subpart 1;
new text end
new text begin
(2) a registered nurse as required by Minnesota Rules, part 9530.6560, subpart 4; and
new text end
new text begin
(3) a medical director as required by Minnesota Rules, part 9530.6560, subpart 5.
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. 5.
Minnesota Statutes 2022, section 245A.04, subdivision 10, is amended to read:
Subd. 10.
Adoption agency; additional requirements.
In addition to the other
requirements of this section, an individual or organization applying for a license to place
children for adoption must:
(1) incorporate as a nonprofit corporation under chapter 317A;
(2) file with the application for licensure a copy of the disclosure form required under
section 259.37, subdivision 2;
(3) provide evidence that a bond has been obtained and will be continuously maintained
throughout the entire operating period of the agency, to cover the cost of transfer of records
to and storage of records by the agency which has agreed, according to rule established by
the commissioner, to receive the applicant agency's records if the applicant agency voluntarily
or involuntarily ceases operation and fails to provide for proper transfer of the records. The
bond must be made in favor of the agency which has agreed to receive the records; and
(4) submit a deleted text begin certified auditdeleted text end new text begin financial review completed by an accountantnew text end to the
commissioner each year the license is renewed as required under section 245A.03, subdivision
1.
new text begin EFFECTIVE DATE. new text end
new text begin
This section is effective January 1, 2025.
new text end
Sec. 6.
Minnesota Statutes 2022, section 245A.043, subdivision 2, is amended to read:
Subd. 2.
Change in ownership.
(a) If the commissioner determines that there is a change
in ownership, the commissioner shall require submission of a new license application. This
subdivision does not apply to a licensed program or service located in a home where the
license holder resides. A change in ownership occurs when:
(1) new text begin except as provided in paragraph (b), new text end the license holder sells or transfers 100 percent
of the property, stock, or assets;
(2) the license holder merges with another organization;
(3) the license holder consolidates with two or more organizations, resulting in the
creation of a new organization;
(4) there is a change to the federal tax identification number associated with the license
holder; or
(5) new text begin except as provided in paragraph (b), new text end all controlling individuals deleted text begin associated withdeleted text end new text begin fornew text end
the original deleted text begin applicationdeleted text end new text begin licensenew text end have changed.
(b) deleted text begin Notwithstandingdeleted text end new text begin For changes undernew text end paragraph (a), clauses (1) deleted text begin anddeleted text end new text begin ornew text end (5), no change
in ownership has occurred new text begin and a new license application is not required new text end if at least one
controlling individual has been deleted text begin listeddeleted text end new text begin affiliatednew text end as a controlling individual for the license
for at least the previous 12 monthsnew text begin immediately preceding the changenew text end .
Sec. 7.
Minnesota Statutes 2023 Supplement, section 245A.043, subdivision 3, is amended
to read:
Subd. 3.
new text begin Standard new text end change of ownership process.
(a) When a change in ownership is
proposed and the party intends to assume operation without an interruption in service longer
than 60 days after acquiring the program or service, the license holder must provide the
commissioner with written notice of the proposed change on a form provided by the
commissioner at least deleted text begin 60deleted text end new text begin 90new text end days before the anticipated date of the change in ownership.
For purposes of this deleted text begin subdivision and subdivision 4deleted text end new text begin sectionnew text end , "party" means the party that
intends to operate the service or program.
(b) The party must submit a license application under this chapter on the form and in
the manner prescribed by the commissioner at least deleted text begin 30deleted text end new text begin 90new text end days before the change in
ownership is new text begin anticipated to be new text end completedeleted text begin ,deleted text end and must include documentation to support the
upcoming change. The party must comply with background study requirements under chapter
245C and shall pay the application fee required under section 245A.10.
new text begin (c)new text end A party that intends to assume operation without an interruption in service longer
than 60 days after acquiring the program or service is exempt from the requirements of
sections 245G.03, subdivision 2, paragraph (b), and 254B.03, subdivision 2, paragraphs (c)
and (d).
deleted text begin (c)deleted text end new text begin (d)new text end The commissioner may streamline application procedures when the party is an
existing license holder under this chapter and is acquiring a program licensed under this
chapter or service in the same service class as one or more licensed programs or services
the party operates and those licenses are in substantial compliance. For purposes of this
subdivision, "substantial compliance" means within the previous 12 months the commissioner
did not (1) issue a sanction under section 245A.07 against a license held by the party, or
(2) make a license held by the party conditional according to section 245A.06.
deleted text begin (d) Except when a temporary change in ownership license is issued pursuant to
subdivision 4deleted text end new text begin (e) While the standard change of ownership process is pendingnew text end , the existing
license holder deleted text begin is solelydeleted text end new text begin remainsnew text end responsible for operating the program according to applicable
laws and rules until a license under this chapter is issued to the party.
deleted text begin (e)deleted text end new text begin (f)new text end If a licensing inspection of the program or service was conducted within the
previous 12 months and the existing license holder's license record demonstrates substantial
compliance with the applicable licensing requirements, the commissioner may waive the
party's inspection required by section 245A.04, subdivision 4. The party must submit to the
commissioner (1) proof that the premises was inspected by a fire marshal or that the fire
marshal deemed that an inspection was not warranted, and (2) proof that the premises was
inspected for compliance with the building code or that no inspection was deemed warranted.
deleted text begin (f)deleted text end new text begin (g)new text end If the party is seeking a license for a program or service that has an outstanding
action under section 245A.06 or 245A.07, the party must submit a deleted text begin letterdeleted text end new text begin written plannew text end as part
of the application process identifying how the party has or will come into full compliance
with the licensing requirements.
deleted text begin (g)deleted text end new text begin (h)new text end The commissioner shall evaluate the party's application according to section
245A.04, subdivision 6. If the commissioner determines that the party has remedied or
demonstrates the ability to remedy the outstanding actions under section 245A.06 or 245A.07
and has determined that the program otherwise complies with all applicable laws and rules,
the commissioner shall issue a license or conditional license under this chapter. new text begin A conditional
license issued under this section is final and not subject to reconsideration under section
245A.06, subdivision 4. new text end The conditional license remains in effect until the commissioner
determines that the grounds for the action are corrected or no longer exist.
deleted text begin (h)deleted text end new text begin (i)new text end The commissioner may deny an application as provided in section 245A.05. An
applicant whose application was denied by the commissioner may appeal the denial according
to section 245A.05.
deleted text begin (i)deleted text end new text begin (j)new text end This subdivision does not apply to a licensed program or service located in a home
where the license holder resides.
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 2022, section 245A.043, is amended by adding a subdivision
to read:
new text begin Subd. 3a. new text end
new text begin Emergency change in ownership process. new text end
new text begin
(a) In the event of a death of a
license holder or sole controlling individual or a court order or other event that results in
the license holder being inaccessible or unable to operate the program or service, a party
may submit a request to the commissioner to allow the party to assume operation of the
program or service under an emergency change in ownership process to ensure persons
continue to receive services while the commissioner evaluates the party's license application.
new text end
new text begin
(b) To request the emergency change of ownership process, the party must immediately:
new text end
new text begin
(1) notify the commissioner of the event resulting in the inability of the license holder
to operate the program and of the party's intent to assume operations; and
new text end
new text begin
(2) provide the commissioner with documentation that demonstrates the party has a legal
or legitimate ownership interest in the program or service if applicable and is able to operate
the program or service.
new text end
new text begin
(c) If the commissioner approves the party to continue operating the program or service
under an emergency change in ownership process, the party must:
new text end
new text begin
(1) request to be added as a controlling individual or license holder to the existing license;
new text end
new text begin
(2) notify persons receiving services of the emergency change in ownership in a manner
approved by the commissioner;
new text end
new text begin
(3) submit an application for a new license within 30 days of approval;
new text end
new text begin
(4) comply with the background study requirements under chapter 245C; and
new text end
new text begin
(5) pay the application fee required under section 245A.10.
new text end
new text begin
(d) While the emergency change of ownership process is pending, a party approved
under this subdivision is responsible for operating the program under the existing license
according to applicable laws and rules until a new license under this chapter is issued.
new text end
new text begin
(e) The provisions in subdivision 3, paragraphs (c), (d), and (f) to (i) apply to this
subdivision.
new text end
new text begin
(f) Once a party is issued a new license or has decided not to seek a new license, the
commissioner must close the existing license.
new text end
new text begin
(g) This subdivision applies to any program or service licensed under this chapter.
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. 9.
Minnesota Statutes 2022, section 245A.043, subdivision 4, is amended to read:
Subd. 4.
Temporary deleted text begin change in ownershipdeleted text end new text begin transitionalnew text end license.
deleted text begin
(a) After receiving the
party's application pursuant to subdivision 3, upon the written request of the existing license
holder and the party, the commissioner may issue a temporary change in ownership license
to the party while the commissioner evaluates the party's application. Until a decision is
made to grant or deny a license under this chapter, the existing license holder and the party
shall both be responsible for operating the program or service according to applicable laws
and rules, and the sale or transfer of the existing license holder's ownership interest in the
licensed program or service does not terminate the existing license.
deleted text end
deleted text begin
(b) The commissioner may issue a temporary change in ownership license when a license
holder's death, divorce, or other event affects the ownership of the program and an applicant
seeks to assume operation of the program or service to ensure continuity of the program or
service while a license application is evaluated.
deleted text end
deleted text begin
(c) This subdivision applies to any program or service licensed under this chapter.
deleted text end
new text begin
If a party's application under subdivision 2 is for a satellite license for a community
residential setting under section 245D.23 or day services facility under 245D.27 and if the
party already holds an active license to provide services under chapter 245D, the
commissioner may issue a temporary transitional license to the party for the community
residential setting or day services facility while the commissioner evaluates the party's
application. Until a decision is made to grant or deny a community residential setting or
day services facility satellite license, the party must be solely responsible for operating the
program according to applicable laws and rules, and the existing license must be closed.
The temporary transitional license expires after 12 months from the date it was issued or
upon issuance of the community residential setting or day services facility satellite license,
whichever occurs first.
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. 10.
Minnesota Statutes 2022, section 245A.043, is amended by adding a subdivision
to read:
new text begin Subd. 5. new text end
new text begin Failure to comply. new text end
new text begin
If the commissioner finds that the applicant or license holder
has not fully complied with this section, the commissioner may impose a licensing sanction
under section 245A.05, 245A.06, or 245A.07.
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. 11.
Minnesota Statutes 2023 Supplement, section 245A.07, subdivision 1, as amended
by Laws 2024, chapter 80, article 2, section 44, is amended to read:
Subdivision 1.
Sanctions; appeals; license.
(a) In addition to making a license conditional
under section 245A.06, the commissioner may suspend or revoke the license, impose a fine,
or secure an injunction against the continuing operation of the program of a license holder
who does not comply with applicable law or rule.
When applying sanctions authorized under this section, the commissioner shall consider
the nature, chronicity, or severity of the violation of law or rule and the effect of the violation
on the health, safety, or rights of persons served by the program.
(b) If a license holder appeals the suspension or revocation of a license and the license
holder continues to operate the program pending a final order on the appeal, the commissioner
shall issue the license holder a temporary provisional license. new text begin The commissioner may include
terms the license holder must follow pending a final order on the appeal.new text end new text begin new text end Unless otherwise
specified by the commissioner, variances in effect on the date of the license sanction under
appeal continue under the temporary provisional license. If a license holder fails to comply
with applicable law or rule while operating under a temporary provisional license, the
commissioner may impose additional sanctions under this section and section 245A.06, and
may terminate any prior variance. If a temporary provisional license is set to expire, a new
temporary provisional license shall be issued to the license holder upon payment of any fee
required under section 245A.10. The temporary provisional license shall expire on the date
the final order is issued. If the license holder prevails on the appeal, a new nonprovisional
license shall be issued for the remainder of the current license period.
(c) If a license holder is under investigation and the license issued under this chapter is
due to expire before completion of the investigation, the program shall be issued a new
license upon completion of the reapplication requirements and payment of any applicable
license fee. Upon completion of the investigation, a licensing sanction may be imposed
against the new license under this section, section 245A.06, or 245A.08.
(d) Failure to reapply or closure of a license issued under this chapter by the license
holder prior to the completion of any investigation shall not preclude the commissioner
from issuing a licensing sanction under this section or section 245A.06 at the conclusion
of the investigation.
new text begin EFFECTIVE DATE. new text end
new text begin
This section is effective January 1, 2025.
new text end
Sec. 12.
Minnesota Statutes 2022, section 245A.07, subdivision 6, is amended to read:
Subd. 6.
Appeal of multiple sanctions.
(a) When the license holder appeals more than
one licensing action or sanction that were simultaneously issued by the commissioner, the
license holder shall specify the actions or sanctions that are being appealed.
(b) If there are different timelines prescribed in statutes for the licensing actions or
sanctions being appealed, the license holder must submit the appeal within the longest of
those timelines specified in statutes.
(c) The appeal 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 the prescribed timeline with the first day beginning
the day after the license holder receives the certified letter. If a request is made by personal
service, it must be received by the commissioner within the prescribed timeline with the
first day beginning the day after the license holder receives the certified letter.new text begin If the appeal
is made through the provider licensing and reporting hub, it must be received by the
commissioner within the prescribed timeline with the first day beginning the day after the
commissioner issued the order through the hub.
new text end
(d) When there are different timelines prescribed in statutes for the appeal of licensing
actions or sanctions simultaneously issued by the commissioner, the commissioner shall
specify in the notice to the license holder the timeline for appeal as specified under paragraph
(b).
Sec. 13.
Minnesota Statutes 2023 Supplement, section 245A.11, subdivision 7, is amended
to read:
Subd. 7.
Adult foster carenew text begin and community residential settingnew text end ; variance for alternate
overnight supervision.
(a) The commissioner may grant a variance under section 245A.04,
subdivision 9, to new text begin statute or new text end rule parts requiring a caregiver to be present in an adult foster
care home new text begin or a community residential setting new text end during normal sleeping hours to allow for
alternative methods of overnight supervision. The commissioner may grant the variance if
the local county licensing agency recommends the variance and the county recommendation
includes documentation verifying that:
(1) the county has approved the license holder's plan for alternative methods of providing
overnight supervision and determined the plan protects the residents' health, safety, and
rights;
(2) the license holder has obtained written and signed informed consent from each
resident or each resident's legal representative documenting the resident's or legal
representative's agreement with the alternative method of overnight supervision; and
(3) the alternative method of providing overnight supervision, which may include the
use of technology, is specified for each resident in the resident's: (i) individualized plan of
care; (ii) deleted text begin individual servicedeleted text end new text begin supportnew text end plan under section 256B.092, subdivision 1b, if required;
or (iii) individual resident placement agreement under Minnesota Rules, part 9555.5105,
subpart 19, if required.
(b) To be eligible for a variance under paragraph (a), the adult foster care new text begin or community
residential setting new text end license holder must not have had a conditional license issued under section
245A.06, or any other licensing sanction issued under section 245A.07 during the prior 24
months based on failure to provide adequate supervision, health care services, or resident
safety in the adult foster care homenew text begin or a community residential settingnew text end .
(c) A license holder requesting a variance under this subdivision to utilize technology
as a component of a plan for alternative overnight supervision may request the commissioner's
review in the absence of a county recommendation. Upon receipt of such a request from a
license holder, the commissioner shall review the variance request with the county.
deleted text begin
(d) The variance requirements under this subdivision for alternative overnight supervision
do not apply to community residential settings licensed under chapter
deleted text end
deleted text begin
245D
deleted text end
deleted text begin
.
deleted text end
new text begin EFFECTIVE DATE. new text end
new text begin
This section is effective the day following final enactment.
new text end
Sec. 14.
Minnesota Statutes 2022, section 245A.14, subdivision 17, is amended to read:
Subd. 17.
Reusable water bottles or cups.
Notwithstanding any law to the contrary, a
licensed child care center may provide drinking water to a child in a reusable water bottle
or reusable cup if the center develops and ensures implementation of a written policy that
at a minimum includes the following procedures:
(1) each day the water bottle or cup is used, the child care center cleans and sanitizes
the water bottle or cup using procedures that comply with the Food Code under Minnesota
Rules, chapter 4626new text begin , or allows the child's parent or legal guardian to bring the water bottle
or cup homenew text end ;
(2) a water bottle or cup is assigned to a specific child and labeled with the child's first
and last name;
(3) water bottles and cups are stored in a manner that reduces the risk of a child using
the wrong water bottle or cup; and
(4) a water bottle or cup is used only for water.
Sec. 15.
Minnesota Statutes 2023 Supplement, section 245A.16, subdivision 1, as amended
by Laws 2024, chapter 80, article 2, section 65, is amended to read:
Subdivision 1.
Delegation of authority to agencies.
(a) County agencies that have been
designated by the commissioner to perform licensing functions and activities under section
245A.04; to recommend denial of applicants under section 245A.05; to issue correction
orders, to issue variances, and recommend a conditional license under section 245A.06; or
to recommend suspending or revoking a license or issuing a fine under section 245A.07,
shall comply with rules and directives of the commissioner governing those functions and
with this section. The following variances are excluded from the delegation of variance
authority and may be issued only by the commissioner:
(1) dual licensure of family child foster care and family adult foster care, dual licensure
of child foster residence setting and community residential setting, and dual licensure of
family adult foster care and family child care;
(2) adult foster care new text begin or community residential settingnew text end new text begin new text end maximum capacity;
(3) adult foster care new text begin or community residential settingnew text end new text begin new text end minimum age requirement;
(4) child foster care maximum age requirement;
(5) variances regarding disqualified individuals;
(6) the required presence of a caregiver in the adult foster care residence during normal
sleeping hours;
(7) variances to requirements relating to chemical use problems of a license holder or a
household member of a license holder; and
(8) variances to section 142B.46 for the use of a cradleboard for a cultural
accommodation.
(b) For family adult day services programs, the commissioner may authorize licensing
reviews every two years after a licensee has had at least one annual review.
(c) A license issued under this section may be issued for up to two years.
(d) During implementation of chapter 245D, the commissioner shall consider:
(1) the role of counties in quality assurance;
(2) the duties of county licensing staff; and
(3) the possible use of joint powers agreements, according to section 471.59, with counties
through which some licensing duties under chapter 245D may be delegated by the
commissioner to the counties.
Any consideration related to this paragraph must meet all of the requirements of the corrective
action plan ordered by the federal Centers for Medicare and Medicaid Services.
(e) Licensing authority specific to section 245D.06, subdivisions 5, 6, 7, and 8, or
successor provisions; and section 245D.061 or successor provisions, for family child foster
care programs providing out-of-home respite, as identified in section 245D.03, subdivision
1, paragraph (b), clause (1), is excluded from the delegation of authority to county agencies.
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 2023 Supplement, section 245A.16, subdivision 11, is amended
to read:
Subd. 11.
Electronic checklist use deleted text begin by family child care licensorsdeleted text end .
County new text begin and private
agency new text end staff who perform deleted text begin family child caredeleted text end new text begin delegatednew text end licensing functions must use the
commissioner's electronic licensing checklist in the manner prescribed by the commissioner.
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 2023 Supplement, section 245A.211, subdivision 4, is amended
to read:
Subd. 4.
Contraindicated physical restraints.
A license or certification holder must
not implement a restraint on a person receiving services in a program in a way that is
contraindicated for any of the person's known medical or psychological conditions. Prior
to using restraints on a persondeleted text begin , the license or certification holder must assess and document
a determination of anydeleted text end new text begin with a knownnew text end medical or psychological conditions that restraints are
contraindicated fornew text begin , the license or certification holder must document the contraindicationnew text end
and the type of restraints that will not be used on the person based on this determination.
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 2023 Supplement, section 245A.242, subdivision 2, is amended
to read:
Subd. 2.
Emergency overdose treatment.
new text begin (a) new text end A license holder must maintain a supply
of opiate antagonists as defined in section 604A.04, subdivision 1, available for emergency
treatment of opioid overdose and must have a written standing order protocol by a physician
who is licensed under chapter 147, advanced practice registered nurse who is licensed under
chapter 148, or physician assistant who is licensed under chapter 147A, that permits the
license holder to maintain a supply of opiate antagonists on site. A license holder must
require staff to undergo training in the specific mode of administration used at the program,
which may include intranasal administration, intramuscular injection, or both.
new text begin
(b) Notwithstanding any requirements to the contrary in Minnesota Rules, chapters 2960
and 9530, and Minnesota Statutes, chapters 245F, 245G, and 245I:
new text end
new text begin
(1) emergency opiate antagonist medications are not required to be stored in a locked
area and staff and adult clients may carry this medication on them and store it in an unlocked
location;
new text end
new text begin
(2) staff persons who only administer emergency opiate antagonist medications only
require the training required by paragraph (a), which any knowledgeable trainer may provide.
The trainer is not required to be a registered nurse or part of an accredited educational
institution; and
new text end
new text begin
(3) nonresidential substance use disorder treatment programs that do not administer
client medications beyond emergency opiate antagonist medications are not required to
have the policies and procedures required in section 245G.08, subdivisions 5 and 6, and
must instead describe the program's procedures for administering opiate antagonist
medications in the license holder's description of health care services under section 245G.08,
subdivision 1.
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. 19.
Minnesota Statutes 2022, section 245A.52, subdivision 2, is amended to read:
Subd. 2.
Door to attached garage.
deleted text begin
Notwithstanding Minnesota Rules, part 9502.0425,
subpart 5, day care residences with an attached garage are not required to have a self-closing
door to the residence. The door to the residence may be
deleted text end
new text begin
(a) If there is an opening between
an attached garage and a day care residence, there must be a door that is:
new text end
new text begin
(1) a solid wood bonded-core door at least 1-3/8 inches thick;
new text end
new text begin (2)new text end a steel insulated door deleted text begin if the door isdeleted text end at least 1-3/8 inches thickdeleted text begin .deleted text end new text begin ; or
new text end
new text begin
(3) a door with a fire protection rating of 20 minutes.
new text end
new text begin
(b) The separation wall on the garage side between the residence and garage must consist
of 1/2-inch-thick gypsum wallboard or its equivalent.
new text end
Sec. 20.
Minnesota Statutes 2022, section 245A.52, is amended by adding a subdivision
to read:
new text begin Subd. 8. new text end
new text begin Stairways. new text end
new text begin
(a) All stairways must meet the requirements in this subdivision.
new text end
new text begin
(b) Stairways of four or more steps must have handrails on at least one side.
new text end
new text begin
(c) Any open area between the handrail and stair tread must be enclosed with a protective
guardrail as specified in the State Building Code. At open risers, openings located more
than 30 inches or 762 millimeters as measured vertically to the floor or grade below must
not permit the passage of a sphere four inches or 102 millimeters in diameter.
new text end
new text begin
(d) Gates or barriers must be used when children aged six to 18 months are in care.
new text end
new text begin
(e) Stairways must be well lit, in good repair, and free of clutter and obstructions.
new text end
Sec. 21.
Minnesota Statutes 2022, section 245A.66, subdivision 2, is amended to read:
Subd. 2.
Child care centers; risk reduction plan.
(a) Child care centers licensed under
this chapter and Minnesota Rules, chapter 9503, must develop a risk reduction plan that
identifies the general risks to children served by the child care center. The license holder
must establish procedures to minimize identified risks, train staff on the procedures, and
annually review the procedures.
(b) The risk reduction plan must include an assessment of risk to children the center
serves or intends to serve and identify specific risks based on the outcome of the assessment.
The assessment of risk must be based on the following:
(1) an assessment of the risks presented by the physical plant where the licensed services
are provided, including an evaluation of the following factors: the condition and design of
the facility and its outdoor space, bathrooms, storage areas, and accessibility of medications
and cleaning products that are harmful to children when children are not supervised and the
existence of areas that are difficult to supervise; and
(2) an assessment of the risks presented by the environment for each facility and for
each site, including an evaluation of the following factors: the type of grounds and terrain
surrounding the building and the proximity to hazards, busy roads, and publicly accessed
businesses.
(c) The risk reduction plan must include a statement of measures that will be taken to
minimize the risk of harm presented to children for each risk identified in the assessment
required under paragraph (b) related to the physical plant and environment. At a minimum,
the stated measures must include the development and implementation of specific policies
and procedures or reference to existing policies and procedures that minimize the risks
identified.
(d) In addition to any program-specific risks identified in paragraph (b), the plan must
include development and implementation of specific policies and procedures or refer to
existing policies and procedures that minimize the risk of harm or injury to children,
including:
(1) closing children's fingers in doors, including cabinet doors;
(2) leaving children in the community without supervision;
(3) children leaving the facility without supervision;
(4) caregiver dislocation of children's elbows;
(5) burns from hot food or beverages, whether served to children or being consumed by
caregivers, and the devices used to warm food and beverages;
(6) injuries from equipment, such as scissors and glue guns;
(7) sunburn;
(8) feeding children foods to which they are allergic;
(9) children falling from changing tables; and
(10) children accessing dangerous items or chemicals or coming into contact with residue
from harmful cleaning products.
(e) The plan shall prohibit the accessibility of hazardous items to children.
(f) The plan must include specific policies and procedures to ensure adequate supervision
of children at all times as defined under section 245A.02, subdivision 18, with particular
emphasis on:
(1) times when children are transitioned from one area within the facility to another;
(2) nap-time supervision, including infant crib rooms as specified under section 245A.02,
subdivision 18, which requires that when an infant is placed in a crib to sleep, supervision
occurs when a staff person is within sight or hearing of the infant. When supervision of a
crib room is provided by sight or hearing, the center must have a plan to address the other
supervision components;
(3) child drop-off and pick-up times;
(4) supervision during outdoor play and on community activities, including but not
limited to field trips and neighborhood walks;
(5) supervision of children in hallways; deleted text begin and
deleted text end
(6) supervision of school-age children when using the restroom and visiting the child's
personal storage spacedeleted text begin .deleted text end new text begin ; and
new text end
new text begin
(7) supervision of preschool children when using an individual, private restroom within
the classroom.
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. 22.
Minnesota Statutes 2023 Supplement, section 245C.02, subdivision 6a, is amended
to read:
Subd. 6a.
Child care background study subject.
(a) "Child care background study
subject" means an individual who is affiliated with a licensed child care center, certified
license-exempt child care center, licensed family child care program, or legal nonlicensed
child care provider authorized under chapter 119B, and who is:
(1) employed by a child care provider for compensation;
(2) assisting in the care of a child for a child care provider;
(3) a person applying for licensure, certification, or enrollment;
(4) a controlling individual as defined in section 245A.02, subdivision 5a;
(5) an individual 13 years of age or older who lives in the household where the licensed
program will be provided and who is not receiving licensed services from the program;
(6) an individual ten to 12 years of age who lives in the household where the licensed
services will be provided when the commissioner has reasonable cause as defined in section
245C.02, subdivision 15;
(7) an individual who, without providing direct contact services at a licensed program,
certified program, or program authorized under chapter 119B, may have unsupervised access
to a child receiving services from a program when the commissioner has reasonable cause
as defined in section 245C.02, subdivision 15; deleted text begin or
deleted text end
(8) a volunteer, contractor providing services for hire in the program, prospective
employee, or other individual who has unsupervised physical access to a child served by a
program and who is not under supervision by an individual listed in clause (1) or (5),
regardless of whether the individual provides program servicesdeleted text begin .deleted text end new text begin ; or
new text end
new text begin
(9) an authorized agent in a license-exempt certified child care center as defined in
section 245H.01, subdivision 2a.
new text end
(b) Notwithstanding paragraph (a), an individual who is providing services that are not
part of the child care program is not required to have a background study if:
(1) the child receiving services is signed out of the child care program for the duration
that the services are provided;
(2) the licensed child care center, certified license-exempt child care center, licensed
family child care program, or legal nonlicensed child care provider authorized under chapter
119B has obtained advanced written permission from the parent authorizing the child to
receive the services, which is maintained in the child's record;
(3) the licensed child care center, certified license-exempt child care center, licensed
family child care program, or legal nonlicensed child care provider authorized under chapter
119B maintains documentation on site that identifies the individual service provider and
the services being provided; and
(4) the licensed child care center, certified license-exempt child care center, licensed
family child care program, or legal nonlicensed child care provider authorized under chapter
119B ensures that the service provider does not have unsupervised access to a child not
receiving the provider's services.
new text begin EFFECTIVE DATE. new text end
new text begin
This section is effective October 1, 2024.
new text end
Sec. 23.
Minnesota Statutes 2023 Supplement, section 245C.02, subdivision 13e, is
amended to read:
Subd. 13e.
NETStudy 2.0.
new text begin (a) new text end "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;
(5) issuing immediate verification of subjects' eligibility to provide services as more
studies are completed under the NETStudy 2.0 system; and
(6) providing electronic access to certain notices for entities and background study
subjects.
new text begin
(b) Information obtained by entities from public web-based data through NETStudy 2.0
under paragraph (a), clause (1), or any other source that is not direct correspondence from
the commissioner is not a notice of disqualification from the commissioner under this
chapter.
new text end
Sec. 24.
Minnesota Statutes 2022, section 245C.03, is amended by adding a subdivision
to read:
new text begin Subd. 16. new text end
new text begin Individuals affiliated with a Head Start program. new text end
new text begin
When initiated by the
Head Start program, including Tribal Head Start programs, the commissioner shall conduct
a background study on any individual who is affiliated with a Head Start program.
new text end
Sec. 25.
Minnesota Statutes 2023 Supplement, section 245C.033, subdivision 3, is amended
to read:
Subd. 3.
Procedure; maltreatment and state licensing agency data.
new text begin (a) For requests
paid directly by the guardian or conservator, new text end 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 begin
(b) For requests paid by the court based on the in forma pauperis status of the guardian
or conservator, requests for maltreatment and state licensing agency data checks must be
submitted by the court to the commissioner on the form or in the manner prescribed by the
commissioner. The form will serve as certification that the individual has been granted in
forma pauperis status. Upon receipt of a signed data request consent form from the court,
the commissioner shall initiate 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
Sec. 26.
new text begin
[245C.041] EMERGENCY WAIVER TO TEMPORARILY MODIFY
BACKGROUND STUDY REQUIREMENTS.
new text end
new text begin
(a) In the event of an emergency identified by the commissioner, the commissioner may
temporarily waive or modify provisions in this chapter, except that the commissioner shall
not waive or modify:
new text end
new text begin
(1) disqualification standards in section 245C.14 or 245C.15; or
new text end
new text begin
(2) any provision regarding the scope of individuals required to be subject to a background
study conducted under this chapter.
new text end
new text begin
(b) For the purposes of this section, an emergency may include, but is not limited to a
public health emergency, environmental emergency, natural disaster, or other unplanned
event that the commissioner has determined prevents the requirements in this chapter from
being met. This authority shall not exceed the amount of time needed to respond to the
emergency and reinstate the requirements of this chapter. The commissioner has the authority
to establish the process and time frame for returning to full compliance with this chapter.
The commissioner shall determine the length of time an emergency study is valid.
new text end
new text begin
(c) At the conclusion of the emergency, entities must submit a new, compliant background
study application and fee for each individual who was the subject of background study
affected by the powers created in this section, referred to as an "emergency study" to have
a new study that fully complies with this chapter within a time frame and notice period
established 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. 27.
Minnesota Statutes 2022, section 245C.05, subdivision 5, is amended to read:
Subd. 5.
Fingerprints and photograph.
(a) Notwithstanding paragraph deleted text begin (b)deleted text end new text begin (c)new text end , for
background studies conducted by the commissioner for child foster care, children's residential
facilities, adoptions, or a transfer of permanent legal and physical custody of a child, the
subject of the background study, who is 18 years of age or older, shall provide the
commissioner with a set of classifiable fingerprints obtained from an authorized agency for
a national criminal history record check.
new text begin
(b) Notwithstanding paragraph (c), for background studies conducted by the commissioner
for Head Start programs, the subject of the background study shall provide the commissioner
with a set of classifiable fingerprints obtained from an authorized agency for a national
criminal history record check.
new text end
deleted text begin (b)deleted text end new text begin (c)new text end For background studies initiated on or after the implementation of NETStudy
2.0, except as provided under subdivision 5a, every subject of a background study must
provide the commissioner with a set of the background study subject's classifiable fingerprints
and photograph. The photograph and fingerprints must be recorded at the same time by the
authorized fingerprint collection vendor or vendors and sent to the commissioner through
the commissioner's secure data system described in section 245C.32, subdivision 1a,
paragraph (b).
deleted text begin (c)deleted text end new text begin (d)new text end The fingerprints shall be submitted by the commissioner to the Bureau of Criminal
Apprehension and, when specifically required by law, submitted to the Federal Bureau of
Investigation for a national criminal history record check.
deleted text begin (d)deleted text end new text begin (e)new text end The fingerprints must not be retained by the Department of Public Safety, Bureau
of Criminal Apprehension, or the commissioner. The Federal Bureau of Investigation will
not retain background study subjects' fingerprints.
deleted text begin (e)deleted text end new text begin (f)new text end 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
name and date and time the subject's fingerprints were recorded and sent, only as necessary
for auditing and billing activities.
deleted text begin (f)deleted text end new text begin (g)new text end For any background study conducted under this chapter, the subject shall provide
the commissioner with a set of classifiable fingerprints when the commissioner has reasonable
cause to require a national criminal history record check as defined in section 245C.02,
subdivision 15a.
Sec. 28.
Minnesota Statutes 2023 Supplement, 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 deleted text begin in subdivision 4 for individuals listed
in section 245C.03, subdivision 1, paragraph (a),deleted text end new text begin for studies under this chapternew text end 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;
(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 website; and
(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).
(b) Except as otherwise provided in this paragraph, notwithstanding expungement by a
court, the commissioner may consider information obtained under paragraph (a), clauses
(3) and (4), unless:
(1) the commissioner received notice of the petition for expungement and the court order
for expungement is directed specifically to the commissioner; or
(2) the commissioner received notice of the expungement order issued pursuant to section
609A.017, 609A.025, or 609A.035, and the order for expungement is directed specifically
to the commissioner.
The commissioner may not consider information obtained under paragraph (a), clauses (3)
and (4), or from any other source that identifies a violation of chapter 152 without
determining if the offense involved the possession of marijuana or tetrahydrocannabinol
and, if so, whether the person received a grant of expungement or order of expungement,
or the person was resentenced to a lesser offense. If the person received a grant of
expungement or order of expungement, the commissioner may not consider information
related to that violation but may consider any other relevant information arising out of the
same incident.
(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. 29.
Minnesota Statutes 2022, section 245C.08, subdivision 4, is amended to read:
Subd. 4.
Juvenile court records.
(a) For a background study conducted by the
Department of Human Services, the commissioner shall review records from the juvenile
courts for an individual studied under deleted text begin section 245C.03, subdivision 1, paragraph (a),deleted text end new text begin this
chapternew text end when the commissioner has reasonable cause.
deleted text begin
(b) For a background study conducted by a county agency for family child care before
the implementation of NETStudy 2.0, the commissioner shall review records from the
juvenile courts for individuals listed in section 245C.03, subdivision 1, who are ages 13
through 23 living in the household where the licensed services will be provided. The
commissioner shall also review records from juvenile courts for any other individual listed
under section 245C.03, subdivision 1, when the commissioner has reasonable cause.
deleted text end
deleted text begin (c)deleted text end new text begin (b)new text end The juvenile courts shall help with the study by giving the commissioner existing
juvenile court records relating to delinquency proceedings held on individuals deleted text begin described in
section 245C.03, subdivision 1, paragraph (a),deleted text end new text begin who are subjects of studies under this chapternew text end
when requested pursuant to this subdivision.
deleted text begin (d)deleted text end new text begin (c)new text end For purposes of this chapter, a finding that a delinquency petition is proven in
juvenile court shall be considered a conviction in state district court.
deleted text begin (e)deleted text end new text begin (d)new text end Juvenile courts shall provide orders of involuntary and voluntary termination of
parental rights under section 260C.301 to the commissioner upon request for purposes of
conducting a background study under this chapter.
Sec. 30.
Minnesota Statutes 2023 Supplement, section 245C.10, subdivision 15, is amended
to read:
Subd. 15.
Guardians and conservators.
new text begin (a) new text end The commissioner shall recover the cost
of conducting maltreatment and state licensing agency checks for guardians and conservators
under section 245C.033 through a fee of no more than $50. The fees collected under this
subdivision are appropriated to the commissioner for the purpose of conducting maltreatment
and state licensing agency checks.
new text begin (b)new text end The fee must be paid directly to and in the manner prescribed by the commissioner
before any maltreatment and state licensing agency checks under section 245C.033 may be
conducted.
new text begin
(c) Notwithstanding paragraph (b), the court shall pay the fee for an applicant who has
been granted in forma pauperis status upon receipt of the invoice from the commissioner.
new text end
Sec. 31.
Minnesota Statutes 2022, section 245C.10, subdivision 18, is amended to read:
Subd. 18.
Applicants, licensees, and other occupations regulated by commissioner
of health.
The applicant or license holder is responsible for paying to the Department of
Human Services all fees associated with the preparation of the fingerprints, the criminal
records check consent form, andnew text begin , through a fee of no more than $44 per study,new text end the criminal
background check.
Sec. 32.
Minnesota Statutes 2022, section 245C.14, subdivision 1, is amended to read:
Subdivision 1.
Disqualification from direct contact.
(a) The commissioner shall
disqualify an individual who is the subject of a background study from any position allowing
direct contact with persons receiving services from the license holder or entity identified in
section 245C.03, upon receipt of information showing, or when a background study
completed under this chapter shows any of the following:
(1) a conviction of, admission to, or Alford plea to one or more crimes listed in section
245C.15, regardless of whether the conviction or admission is a felony, gross misdemeanor,
or misdemeanor level crime;
(2) a preponderance of the evidence indicates the individual has committed an act or
acts that meet the definition of any of the crimes listed in section 245C.15, regardless of
whether the preponderance of the evidence is for a felony, gross misdemeanor, or
misdemeanor level crime; deleted text begin or
deleted text end
(3) an investigation results in an administrative determination listed under section
245C.15, subdivision 4, paragraph (b)deleted text begin .deleted text end new text begin ; or
new text end
new text begin
(4) the individual's parental rights have been terminated under section 260C.301,
subdivision 1, paragraph (b), or section 260C.301, subdivision 3.
new text end
(b) No individual who is disqualified following a background study under section
245C.03, subdivisions 1 and 2, may be retained in a position involving direct contact with
persons served by a program or entity identified in section 245C.03, unless the commissioner
has provided written notice under section 245C.17 stating that:
(1) the individual may remain in direct contact during the period in which the individual
may request reconsideration as provided in section 245C.21, subdivision 2;
(2) the commissioner has set aside the individual's disqualification for that program or
entity identified in section 245C.03, as provided in section 245C.22, subdivision 4; or
(3) the license holder has been granted a variance for the disqualified individual under
section 245C.30.
(c) Notwithstanding paragraph (a), for the purposes of a background study affiliated
with a licensed family foster setting, the commissioner shall disqualify an individual who
is the subject of a background study from any position allowing direct contact with persons
receiving services from the license holder or entity identified in section 245C.03, upon
receipt of information showing or when a background study completed under this chapter
shows reason for disqualification under section 245C.15, subdivision 4a.
Sec. 33.
Minnesota Statutes 2022, section 245C.14, is amended by adding a subdivision
to read:
new text begin Subd. 5. new text end
new text begin Basis for disqualification. new text end
new text begin
Information obtained by entities from public
web-based data through NETStudy 2.0 or any other source that is not direct correspondence
from the commissioner is not a notice of disqualification from the commissioner under this
chapter.
new text end
Sec. 34.
Minnesota Statutes 2023 Supplement, 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 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 begin 152.0263, subdivision 1 (possession of cannabis in the first
degree); 152.0264, subdivision 1 (sale of cannabis in the first degree); 152.0265, subdivision
1 (cultivation of cannabis in the first degree);new text end new text begin 169A.24 (first-degree driving while impaired);
new text end 256.98 (wrongfully obtaining assistance); new text begin 260B.425 (criminal jurisdiction for contributing
to status as a juvenile petty offender or delinquency); 260C.425 (criminal jurisdiction for
contributing to need for protection or services); new text end 268.182 (fraud); 393.07, subdivision 10,
paragraph (c) (federal SNAP fraud); new text begin 518B.01, subdivision 14 (violation of an order for
protection); new text end 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); 609.247, subdivision 4 (carjacking in
the third degree); 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); new text begin 609.522 (organized retail theft); new text end 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); new text begin 609.746 (interference with privacy); new text end 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); or 624.713 (certain persons not to possess firearms).
(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)new text begin or since the termination of parental rights in any other state or country, the elements of
which are substantially similar to the elements listed in paragraph (c)new text end .
(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.
Sec. 35.
Minnesota Statutes 2022, section 245C.15, subdivision 3, is amended to read:
Subd. 3.
Ten-year disqualification.
(a) An individual is disqualified under section
245C.14 if: (1) less than ten years have passed since the discharge of the sentence imposed,
if any, for the offense; and (2) the individual has committed a gross misdemeanor-level
violation of any of the following offenses: sections 256.98 (wrongfully obtaining assistance);
new text begin 260B.425 (criminal jurisdiction for contributing to status as a juvenile petty offender or
delinquency); 260C.425 (criminal jurisdiction for contributing to need for protection or
services); new text end 268.182 (fraud); 393.07, subdivision 10, paragraph (c) (federal SNAP fraud);
609.2112, 609.2113, or 609.2114 (criminal vehicular homicide or injury); 609.221 or 609.222
(assault in the first or second degree); 609.223 or 609.2231 (assault in the third or fourth
degree); 609.224 (assault in the fifth degree); 609.224, subdivision 2, paragraph (c) (assault
in the fifth degree by a caregiver against a vulnerable adult); 609.2242 and 609.2243
(domestic assault); 609.23 (mistreatment of persons confined); 609.231 (mistreatment of
residents or patients); 609.2325 (criminal abuse of a vulnerable adult); 609.233 (criminal
neglect of a vulnerable adult); 609.2335 (financial exploitation of a vulnerable adult);
609.234 (failure to report maltreatment of a vulnerable adult); 609.265 (abduction); 609.275
(attempt to coerce); 609.324, subdivision 1a (other prohibited acts; minor engaged in
prostitution); 609.33 (disorderly house); 609.377 (malicious punishment of a child); 609.378
(neglect or endangerment of a child); 609.466 (medical assistance fraud); 609.52 (theft);
new text begin 609.522 (organized retail theft); new text end 609.525 (bringing stolen goods into Minnesota); 609.527
(identity theft); 609.53 (receiving stolen property); 609.535 (issuance of dishonored checks);
609.582 (burglary); 609.59 (possession of burglary tools); 609.611 (insurance fraud); 609.631
(check forgery; offering a forged check); 609.66 (dangerous weapons); 609.71 (riot); 609.72,
subdivision 3 (disorderly conduct against a vulnerable adult); deleted text begin repeat offenses under
(interference with privacy);deleted text end 609.749, subdivision 2 (harassment); 609.82 (fraud in obtaining
credit); 609.821 (financial transaction card fraud); 617.23 (indecent exposure), not involving
a minor; 617.241 (obscene materials and performances); 617.243 (indecent literature,
distribution); 617.293 (harmful materials; dissemination and display to minors prohibited);
or Minnesota Statutes 2012, section 609.21; or violation of an order for protection under
section 518B.01, subdivision 14.
(b) An individual is disqualified under section 245C.14 if less than ten 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 ten 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 any of the offenses listed in
paragraph (a).
(d) If the individual studied commits one of the offenses listed in paragraph (a), but the
sentence or level of offense is a misdemeanor disposition, the individual is disqualified but
the disqualification lookback period for the offense is the period applicable to misdemeanors.
(e) 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.
Sec. 36.
Minnesota Statutes 2022, section 245C.15, subdivision 4, is amended to read:
Subd. 4.
Seven-year disqualification.
(a) An individual is disqualified under section
245C.14 if: (1) less than seven years has passed since the discharge of the sentence imposed,
if any, for the offense; and (2) the individual has committed a misdemeanor-level violation
of any of the following offenses: sections 256.98 (wrongfully obtaining assistance); new text begin 260B.425
(criminal jurisdiction for contributing to status as a juvenile petty offender or delinquency);
260C.425 (criminal jurisdiction for contributing to need for protection or services); new text end 268.182
(fraud); 393.07, subdivision 10, paragraph (c) (federal SNAP fraud); 609.2112, 609.2113,
or 609.2114 (criminal vehicular homicide or injury); 609.221 (assault in the first degree);
609.222 (assault in the second degree); 609.223 (assault in the third degree); 609.2231
(assault in the fourth degree); 609.224 (assault in the fifth degree); 609.2242 (domestic
assault); 609.2335 (financial exploitation of a vulnerable adult); 609.234 (failure to report
maltreatment of a vulnerable adult); 609.2672 (assault of an unborn child in the third degree);
609.27 (coercion); violation of an order for protection under 609.3232 (protective order
authorized; procedures; penalties); 609.466 (medical assistance fraud); 609.52 (theft);
new text begin 609.522 (organized retail theft); new text end 609.525 (bringing stolen goods into Minnesota); 609.527
(identity theft); 609.53 (receiving stolen property); 609.535 (issuance of dishonored checks);
609.611 (insurance fraud); 609.66 (dangerous weapons); 609.665 (spring guns); 609.746
(interference with privacy); 609.79 (obscene or harassing telephone calls); 609.795 (letter,
telegram, or package; opening; harassment); 609.82 (fraud in obtaining credit); 609.821
(financial transaction card fraud); 617.23 (indecent exposure), not involving a minor; 617.293
(harmful materials; dissemination and display to minors prohibited); or Minnesota Statutes
2012, section 609.21; or violation of an order for protection under section 518B.01 (Domestic
Abuse Act).
(b) An individual is disqualified under section 245C.14 if less than seven years has
passed since a determination or disposition of the individual's:
(1) failure to make required reports under section 260E.06 or 626.557, subdivision 3,
for incidents in which: (i) the final disposition under section 626.557 or chapter 260E was
substantiated maltreatment, and (ii) the maltreatment was recurring or serious; or
(2) substantiated serious or recurring maltreatment of a minor under chapter 260E, a
vulnerable adult under section 626.557, or serious or recurring maltreatment in any other
state, the elements of which are substantially similar to the elements of maltreatment under
section 626.557 or chapter 260E for which: (i) there is a preponderance of evidence that
the maltreatment occurred, and (ii) the subject was responsible for the maltreatment.
(c) An individual is disqualified under section 245C.14 if less than seven years has
passed since the individual's aiding and abetting, attempt, or conspiracy to commit any of
the offenses listed in paragraphs (a) and (b), as each of these offenses is defined in Minnesota
Statutes.
(d) An individual is disqualified under section 245C.14 if less than seven 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 any of the offenses
listed in paragraphs (a) and (b).
(e) 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.
(f) An individual is disqualified under section 245C.14 if less than seven years has passed
since the individual was disqualified under section 256.98, subdivision 8.
Sec. 37.
Minnesota Statutes 2023 Supplement, section 245C.15, subdivision 4a, is amended
to read:
Subd. 4a.
Licensed family foster setting disqualifications.
(a) Notwithstanding
subdivisions 1 to 4, for a background study affiliated with a licensed family foster setting,
regardless of how much time has passed, an individual is disqualified under section 245C.14
if the individual committed an act that resulted in a felony-level conviction for sections:
609.185 (murder in the first degree); 609.19 (murder in the second degree); 609.195 (murder
in the third degree); 609.20 (manslaughter in the first degree); 609.205 (manslaughter in
the second degree); 609.2112 (criminal vehicular homicide); 609.221 (assault in the first
degree); 609.223, subdivision 2 (assault in the third degree, past pattern of child abuse);
609.223, subdivision 3 (assault in the third degree, victim under four); a felony offense
under sections 609.2242 and 609.2243 (domestic assault, spousal abuse, child abuse or
neglect, or a crime against children); 609.2247 (domestic assault by strangulation); 609.2325
(criminal abuse of a vulnerable adult resulting in the death of a vulnerable adult); 609.245
(aggravated robbery); 609.247, subdivision 2 or 3 (carjacking in the first or second degree);
609.25 (kidnapping); 609.255 (false imprisonment); 609.2661 (murder of an unborn child
in the first degree); 609.2662 (murder of an unborn child in the second degree); 609.2663
(murder of an unborn child in the third degree); 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); 609.322, subdivision 1 (solicitation, inducement, and promotion of prostitution; sex
trafficking in the first degree); 609.324, subdivision 1 (other prohibited acts; engaging in,
hiring, or agreeing to hire minor to engage in prostitution); 609.342 (criminal sexual conduct
in the first degree); 609.343 (criminal sexual conduct in the second degree); 609.344 (criminal
sexual conduct in the third degree); 609.345 (criminal sexual conduct in the fourth degree);
609.3451 (criminal sexual conduct in the fifth degree); 609.3453 (criminal sexual predatory
conduct); new text begin 609.3458 (sexual extortion); new text end 609.352 (solicitation of children to engage in sexual
conduct); 609.377 (malicious punishment of a child); 609.378 (neglect or endangerment of
a child); 609.561 (arson in the first degree); 609.582, subdivision 1 (burglary in the first
degree); 609.746 (interference with privacy); 617.23 (indecent exposure); 617.246 (use of
minors in sexual performance prohibited); or 617.247 (possession of pictorial representations
of minors).
(b) Notwithstanding subdivisions 1 to 4, for the purposes of a background study affiliated
with a licensed family foster setting, an individual is disqualified under section 245C.14,
regardless of how much time has passed, if the individual:
(1) committed an action under paragraph (e) that resulted in death or involved sexual
abuse, as defined in section 260E.03, subdivision 20;
(2) committed an act that resulted in a gross misdemeanor-level conviction for section
609.3451 (criminal sexual conduct in the fifth degree);
(3) committed an act against or involving a minor that resulted in a felony-level conviction
for: section 609.222 (assault in the second degree); 609.223, subdivision 1 (assault in the
third degree); 609.2231 (assault in the fourth degree); or 609.224 (assault in the fifth degree);
or
(4) committed an act that resulted in a misdemeanor or gross misdemeanor-level
conviction for section 617.293 (dissemination and display of harmful materials to minors).
(c) Notwithstanding subdivisions 1 to 4, for a background study affiliated with a licensed
family foster setting, an individual is disqualified under section 245C.14 if fewer than 20
years have passed since the termination of the individual's parental rights under section
260C.301, subdivision 1, paragraph (b), or if the individual consented to a termination of
parental rights under section 260C.301, subdivision 1, paragraph (a), to settle a petition to
involuntarily terminate parental rights. An individual is disqualified under section 245C.14
if fewer than 20 years have passed since the termination of the individual's parental rights
in any other state or country, where the conditions for the individual's termination of parental
rights are substantially similar to the conditions in section 260C.301, subdivision 1, paragraph
(b).
(d) Notwithstanding subdivisions 1 to 4, for a background study affiliated with a licensed
family foster setting, an individual is disqualified under section 245C.14 if fewer than five
years have passed since a felony-level violation for sections: 152.021 (controlled substance
crime in the first degree); 152.022 (controlled substance crime in the second degree); 152.023
(controlled substance crime in the third degree); 152.024 (controlled substance crime in the
fourth degree); 152.025 (controlled substance crime in the fifth degree); 152.0261 (importing
controlled substances across state borders); 152.0262, subdivision 1, paragraph (b)
(possession of substance with intent to manufacture methamphetamine); new text begin 152.0263,
subdivision 1 (possession of cannabis in the first degree); 152.0264, subdivision 1 (sale of
cannabis in the first degree); 152.0265, subdivision 1 (cultivation of cannabis in the first
degree);new text end 152.027, subdivision 6, paragraph (c) (sale or possession of synthetic cannabinoids);
152.096 (conspiracies prohibited); 152.097 (simulated controlled substances); 152.136
(anhydrous ammonia; prohibited conduct; criminal penalties; civil liabilities); 152.137
(methamphetamine-related crimes involving children or vulnerable adults); 169A.24 (felony
first-degree driving while impaired); 243.166 (violation of predatory offender registration
requirements); 609.2113 (criminal vehicular operation; bodily harm); 609.2114 (criminal
vehicular operation; unborn child); 609.228 (great bodily harm caused by distribution of
drugs); 609.2325 (criminal abuse of a vulnerable adult not resulting in the death of a
vulnerable adult); 609.233 (criminal neglect); 609.235 (use of drugs to injure or facilitate
a crime); 609.24 (simple robbery); 609.247, subdivision 4 (carjacking in the third degree);
609.322, subdivision 1a (solicitation, inducement, and promotion of prostitution; sex
trafficking in the second degree); 609.498, subdivision 1 (tampering with a witness in the
first degree); 609.498, subdivision 1b (aggravated first-degree witness tampering); 609.562
(arson in the second degree); 609.563 (arson in the third degree); 609.582, subdivision 2
(burglary in the second degree); 609.66 (felony dangerous weapons); 609.687 (adulteration);
609.713 (terroristic threats); 609.749, subdivision 3, 4, or 5 (felony-level harassment or
stalking); 609.855, subdivision 5 (shooting at or in a public transit vehicle or facility); or
624.713 (certain people not to possess firearms).
(e) Notwithstanding subdivisions 1 to 4, except as provided in paragraph (a), for a
background study affiliated with a licensed family child foster care license, an individual
is disqualified under section 245C.14 if fewer than five years have passed since:
(1) a felony-level violation for an act not against or involving a minor that constitutes:
section 609.222 (assault in the second degree); 609.223, subdivision 1 (assault in the third
degree); 609.2231 (assault in the fourth degree); or 609.224, subdivision 4 (assault in the
fifth degree);
(2) a violation of an order for protection under section 518B.01, subdivision 14;
(3) a determination or disposition of the individual's failure to make required reports
under section 260E.06 or 626.557, subdivision 3, for incidents in which the final disposition
under chapter 260E or section 626.557 was substantiated maltreatment and the maltreatment
was recurring or serious;
(4) a determination or disposition of the individual's substantiated serious or recurring
maltreatment of a minor under chapter 260E, a vulnerable adult under section 626.557, or
serious or recurring maltreatment in any other state, the elements of which are substantially
similar to the elements of maltreatment under chapter 260E or section 626.557 and meet
the definition of serious maltreatment or recurring maltreatment;
(5) a gross misdemeanor-level violation for sections: 609.224, subdivision 2 (assault in
the fifth degree); 609.2242 and 609.2243 (domestic assault); 609.233 (criminal neglect);
609.377 (malicious punishment of a child); 609.378 (neglect or endangerment of a child);
609.746 (interference with privacy); 609.749 (stalking); or 617.23 (indecent exposure); or
(6) committing an act against or involving a minor that resulted in a misdemeanor-level
violation of section 609.224, subdivision 1 (assault in the fifth degree).
(f) For purposes of this subdivision, the disqualification begins from:
(1) the date of the alleged violation, if the individual was not convicted;
(2) the date of conviction, if the individual was convicted of the violation but not
committed to the custody of the commissioner of corrections; or
(3) the date of release from prison, if the individual was convicted of the violation and
committed to the custody of the commissioner of corrections.
Notwithstanding clause (3), if the individual is subsequently reincarcerated for a violation
of the individual's supervised release, the disqualification begins from the date of release
from the subsequent incarceration.
(g) An individual's aiding and abetting, attempt, or conspiracy to commit any of the
offenses listed in paragraphs (a) and (b), as each of these offenses is defined in Minnesota
Statutes, permanently disqualifies the individual under section 245C.14. An individual is
disqualified under section 245C.14 if fewer than five years have passed since the individual's
aiding and abetting, attempt, or conspiracy to commit any of the offenses listed in paragraphs
(d) and (e).
(h) An individual's offense in any other state or country, where the elements of the
offense are substantially similar to any of the offenses listed in paragraphs (a) and (b),
permanently disqualifies the individual under section 245C.14. An individual is disqualified
under section 245C.14 if fewer than five years have passed since an offense in any other
state or country, the elements of which are substantially similar to the elements of any
offense listed in paragraphs (d) and (e).
Sec. 38.
Minnesota Statutes 2022, section 245C.22, subdivision 4, is amended to read:
Subd. 4.
Risk of harm; set aside.
(a) The commissioner may set aside the disqualification
if the commissioner finds that the individual has submitted sufficient information to
demonstrate that the individual does not pose a risk of harm to any person served by the
applicant, license holder, or other entities as provided in this chapter.
(b) In determining whether the individual has met the burden of proof by demonstrating
the individual does not pose a risk of harm, the commissioner shall consider:
(1) the nature, severity, and consequences of the event or events that led to the
disqualification;
(2) whether there is more than one disqualifying event;
(3) the age and vulnerability of the victim at the time of the event;
(4) the harm suffered by the victim;
(5) vulnerability of persons served by the program;
(6) the similarity between the victim and persons served by the program;
(7) the time elapsed without a repeat of the same or similar event;
(8) documentation of successful completion by the individual studied of training or
rehabilitation pertinent to the event; and
(9) any other information relevant to reconsideration.
new text begin
(c) For an individual seeking a child foster care license who is a relative of the child,
the commissioner shall consider the importance of maintaining the child's relationship with
relatives as an additional significant factor in determining whether a background study
disqualification should be set aside.
new text end
deleted text begin (c)deleted text end new text begin (d)new text end If the individual requested reconsideration on the basis that the information relied
upon to disqualify the individual was incorrect or inaccurate and the commissioner determines
that the information relied upon to disqualify the individual is correct, the commissioner
must also determine if the individual poses a risk of harm to persons receiving services in
accordance with paragraph (b).
deleted text begin (d)deleted text end new text begin (e)new text end For an individual seeking employment in the substance use disorder treatment
field, the commissioner shall set aside the disqualification if the following criteria are met:
(1) the individual is not disqualified for a crime of violence as listed under section
624.712, subdivision 5, except for the following crimes: crimes listed under section 152.021,
subdivision 2 or 2a; 152.022, subdivision 2; 152.023, subdivision 2; 152.024; or 152.025;
(2) the individual is not disqualified under section 245C.15, subdivision 1;
(3) the individual is not disqualified under section 245C.15, subdivision 4, paragraph
(b);
(4) the individual provided documentation of successful completion of treatment, at least
one year prior to the date of the request for reconsideration, at a program licensed under
chapter 245G, and has had no disqualifying crimes or conduct under section 245C.15 after
the successful completion of treatment;
(5) the individual provided documentation demonstrating abstinence from controlled
substances, as defined in section 152.01, subdivision 4, for the period of one year prior to
the date of the request for reconsideration; and
(6) the individual is seeking employment in the substance use disorder treatment field.
Sec. 39.
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) In connection with foster residence settings and children's residential facilities, 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, paragraph
(a) or (b).
new text end
Sec. 40.
Minnesota Statutes 2022, section 245C.24, subdivision 5, is amended to read:
Subd. 5.
Five-year bar to set aside new text begin or variance new text end disqualification; children's residential
facilitiesnew text begin , foster residence settingsnew text end .
The commissioner shall not set aside new text begin or grant a variance
for new text end the disqualification of an individual in connection with a license for a children's residential
facility new text begin or foster residence setting new text end who was convicted of a felony within the past five years
for: (1) physical assault or battery; or (2) a drug-related offense.
Sec. 41.
Minnesota Statutes 2022, section 245C.30, is amended by adding a subdivision
to read:
new text begin Subd. 1b. new text end
new text begin Child foster care variances. new text end
new text begin
For an individual seeking a child foster care
license who is a relative of the child, the commissioner shall consider the importance of
maintaining the child's relationship with relatives as an additional significant factor in
determining whether the individual should be granted a variance.
new text end
Sec. 42.
Minnesota Statutes 2022, section 245E.08, is amended to read:
245E.08 REPORTING OF SUSPECTED FRAUDULENT ACTIVITY.
(a) A person who, in good faith, makes a report of or testifies in any action or proceeding
in which financial misconduct is alleged, and who is not involved in, has not participated
in, or has not aided and abetted, conspired, or colluded in the financial misconduct, shall
have immunity from any liability, civil or criminal, that results by reason of the person's
report or testimony. For the purpose of any proceeding, the good faith of any person reporting
or testifying under this provision shall be presumed.
(b) If a person that is or has been involved in, participated in, aided and abetted, conspired,
or colluded in the financial misconduct reports the financial misconduct, the department
may consider that person's report and assistance in investigating the misconduct as a
mitigating factor in the department's pursuit of civil, criminal, or administrative remedies.
new text begin
(c) After an investigation is complete, the reporter's name must be kept confidential.
The subject of the report may compel disclosure of the reporter's name only with the consent
of the reporter or upon a written finding by a district court that the report was false and there
is evidence that the report was made in bad faith. This paragraph does not alter disclosure
responsibilities or obligations under the Rules of Criminal Procedure, except that when the
identity of the reporter is relevant to a criminal prosecution the district court shall conduct
an in-camera review before determining whether to order disclosure of the reporter's identity.
new text end
Sec. 43.
Minnesota Statutes 2022, section 245F.09, subdivision 2, is amended to read:
Subd. 2.
Protective procedures plan.
A license holder must have a written policy and
procedure that establishes the protective procedures that program staff must follow when
a patient is in imminent danger of harming self or others. The policy must be appropriate
to the type of facility and the level of staff training. The protective procedures policy must
include:
(1) an approval signed and dated by the program director and medical director prior to
implementation. Any changes to the policy must also be approved, signed, and dated by the
current program director and the medical director prior to implementation;
(2) which protective procedures the license holder will use to prevent patients from
imminent danger of harming self or others;
(3) the emergency conditions under which the protective procedures are permitted to be
used, if any;
(4) the patient's health conditions that limit the specific procedures that may be used and
alternative means of ensuring safety;
(5) emergency resources the program staff must contact when a patient's behavior cannot
be controlled by the procedures established in the policy;
(6) the training that staff must have before using any protective procedure;
(7) documentation of approved therapeutic holds;
(8) the use of law enforcement personnel as described in subdivision 4;
(9) standards governing emergency use of seclusion. Seclusion must be used only when
less restrictive measures are ineffective or not feasible. The standards in items (i) to (vii)
must be met when seclusion is used with a patient:
(i) seclusion must be employed solely for the purpose of preventing a patient from
imminent danger of harming self or others;
(ii) seclusion rooms must be equipped in a manner that prevents patients from self-harm
using projections, windows, electrical fixtures, or hard objects, and must allow the patient
to be readily observed without being interrupted;
(iii) seclusion must be authorized by the program director, a licensed physician, a
registered nurse, or a licensed physician assistant. If one of these individuals is not present
in the facility, the program director or a licensed physician, registered nurse, or physician
assistant must be contacted and authorization must be obtained within 30 minutes of initiating
seclusion, according to written policies;
(iv) patients must not be placed in seclusion for more than 12 hours at any one time;
(v) once the condition of a patient in seclusion has been determined to be safe enough
to end continuous observation, a patient in seclusion must be observed at a minimum of
every 15 minutes for the duration of seclusion and must always be within hearing range of
program staff;
(vi) a process for program staff to use to remove a patient to other resources available
to the facility if seclusion does not sufficiently assure patient safety; and
(vii) a seclusion area may be used for other purposes, such as intensive observation, if
the room meets normal standards of care for the purpose and if the room is not locked; and
(10) physical holds may only be used when less restrictive measures are not feasible.
The standards in items (i) to (iv) must be met when physical holds are used with a patient:
(i) physical holds must be employed solely for preventing a patient from imminent
danger of harming self or others;
(ii) physical holds must be authorized by the program director, a licensed physician, a
registered nurse, or a physician assistant. If one of these individuals is not present in the
facility, the program director or a licensed physician, registered nurse, or physician assistant
must be contacted and authorization must be obtained within 30 minutes of initiating a
physical hold, according to written policies;
(iii) the patient's health concerns must be considered in deciding whether to use physical
holds and which holds are appropriate for the patient; and
(iv) only approved holds may be utilized. Pronenew text begin and contraindicatednew text end holds are not allowed
new text begin according to section 245A.211 new text end and must not be authorized.
new text begin EFFECTIVE DATE. new text end
new text begin
This section is effective the day following final enactment.
new text end
Sec. 44.
Minnesota Statutes 2022, section 245F.14, is amended by adding a subdivision
to read:
new text begin Subd. 8. new text end
new text begin Notification to commissioner of changes in key staff positions. new text end
new text begin
A license
holder must notify the commissioner within five business days of a change or vacancy in a
key staff position. The key positions are a program director as required by subdivision 1, a
registered nurse as required by subdivision 4, and a medical director as required by
subdivision 5. The license holder must notify the commissioner of the staffing change or
vacancy on a form approved by the commissioner and include the name of the staff person
now assigned to the key staff position and the staff person's qualifications for the position.
new text end
new text begin EFFECTIVE DATE. new text end
new text begin
This section is effective January 1, 2025.
new text end
Sec. 45.
Minnesota Statutes 2022, section 245F.17, is amended to read:
245F.17 PERSONNEL FILES.
A license holder must maintain a separate personnel file for each staff member. At a
minimum, the file must contain:
(1) a completed application for employment signed by the staff member that contains
the staff member's qualifications for employment and documentation related to the applicant's
background study data, as defined in chapter 245C;
(2) documentation of the staff member's current professional license or registration, if
relevant;
(3) documentation of orientation and subsequent training;new text begin and
new text end
(4) deleted text begin documentation of a statement of freedom from substance use problems; and
deleted text end
deleted text begin (5)deleted text end an annual job performance evaluation.
new text begin EFFECTIVE DATE. new text end
new text begin
This section is effective the day following final enactment.
new text end
Sec. 46.
Minnesota Statutes 2022, section 245G.07, subdivision 4, is amended to read:
Subd. 4.
Location of service provision.
deleted text begin
The license holder may provide services at any
of the license holder's licensed locations or at another suitable location including a school,
government building, medical or behavioral health facility, or social service organization,
upon notification and approval of the commissioner. If services are provided off site from
the licensed site, the reason for the provision of services remotely must be documented.
The license holder may provide additional services under subdivision 2, clauses (2) to (5),
off-site if the license holder includes a policy and procedure detailing the off-site location
as a part of the treatment service description and the program abuse prevention plan.
deleted text end
new text begin
(a) The license holder must provide all treatment services a client receives at one of the
license holder's substance use disorder treatment licensed locations or at a location allowed
under paragraphs (b) to (f). If the services are provided at the locations in paragraphs (b) to
(d), the license holder must document in the client record the location services were provided.
new text end
new text begin
(b) The license holder may provide nonresidential individual treatment services at a
client's home or place of residence.
new text end
new text begin
(c) If the license holder provides treatment services by telehealth, the services must be
provided according to this paragraph:
new text end
new text begin
(1) the license holder must maintain a licensed physical location in Minnesota where
the license holder must offer all treatment services in subdivision 1, paragraph (a), clauses
(1) to (4), physically in person to each client;
new text end
new text begin
(2) the license holder must meet all requirements for the provision of telehealth in sections
254B.05, subdivision 5, paragraph (f), and 256B.0625, subdivision 3b. The license holder
must document all items in section 256B.0625, subdivision 3b, paragraph (c), for each client
receiving services by telehealth, regardless of payment type or whether the client is a medical
assistance enrollee;
new text end
new text begin
(3) the license holder may provide treatment services by telehealth to clients individually;
new text end
new text begin
(4) the license holder may provide treatment services by telehealth to a group of clients
that are each in a separate physical location;
new text end
new text begin
(5) the license holder must not provide treatment services remotely by telehealth to a
group of clients meeting together in person;
new text end
new text begin
(6) clients and staff may join an in-person group by telehealth if a staff qualified to
provide the treatment service is physically present with the group of clients meeting together
in person; and
new text end
new text begin
(7) the qualified professional providing a residential group treatment service by telehealth
must be physically present on-site at the licensed residential location while the service is
being provided.
new text end
new text begin
(d) The license holder may provide the additional treatment services under subdivision
2, clauses (2) to (5) and (8), away from the licensed location at a suitable location appropriate
to the treatment service.
new text end
new text begin
(e) Upon written approval from the commissioner for each satellite location, the license
holder may provide nonresidential treatment services at satellite locations that are in a
school, jail, or nursing home. A satellite location may only provide services to students of
the school, inmates of the jail, or residents of the nursing home. Schools, jails, and nursing
homes are exempt from the licensing requirements in section 245A.04, subdivision 2a, to
document compliance with building codes, fire and safety codes, health rules, and zoning
ordinances.
new text end
new text begin
(f) The commissioner may approve other suitable locations as satellite locations for
nonresidential treatment services. The commissioner may require satellite locations under
this paragraph to meet all applicable licensing requirements. The license holder may not
have more than two satellite locations per license under this paragraph.
new text end
new text begin
(g) The license holder must provide the commissioner access to all files, documentation,
staff persons, and any other information the commissioner requires at the main licensed
location for all clients served at any location under paragraphs (b) to (f).
new text end
new text begin
(h) Notwithstanding sections 245A.65, subdivision 2, and 626.557, subdivision 14, a
program abuse prevention plan is not required for satellite or other locations under paragraphs
(b) to (e). An individual abuse prevention plan is still required for any client that is a
vulnerable adult as defined in section 626.5572, subdivision 21.
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. 47.
Minnesota Statutes 2022, section 245G.08, subdivision 5, is amended to read:
Subd. 5.
Administration of medication and assistance with self-medication.
(a) A
license holder must meet the requirements in this subdivision if a service provided includes
the administration of medication.
(b) A staff member, other than a licensed practitioner or nurse, who is delegated by a
licensed practitioner or a registered nurse the task of administration of medication or assisting
with self-medication, must:
(1) successfully complete a medication administration training program for unlicensed
personnel through an accredited Minnesota postsecondary educational institution. A staff
member's completion of the course must be documented in writing and placed in the staff
member's personnel file;
(2) be trained according to a formalized training program that is taught by a registered
nurse and offered by the license holder. deleted text begin The training must include the process for
administration of naloxone, if naloxone is kept on site.deleted text end A staff member's completion of the
training must be documented in writing and placed in the staff member's personnel records;
or
(3) demonstrate to a registered nurse competency to perform the delegated activity. A
registered nurse must be employed or contracted to develop the policies and procedures for
administration of medication or assisting with self-administration of medication, or both.
(c) A registered nurse must provide supervision as defined in section 148.171, subdivision
23. The registered nurse's supervision must include, at a minimum, monthly on-site
supervision or more often if warranted by a client's health needs. The policies and procedures
must include:
(1) a provision that a delegation of administration of medication is limited to a method
a staff member has been trained to administer and limited to:
(i) a medication that is administered orally, topically, or as a suppository, an eye drop,
an ear drop, an inhalant, or an intranasal; and
(ii) an intramuscular injection of deleted text begin naloxonedeleted text end new text begin an opiate antagonist as defined in section
604A.04, subdivision 1,new text end or epinephrine;
(2) a provision that each client's file must include documentation indicating whether
staff must conduct the administration of medication or the client must self-administer
medication, or both;
(3) a provision that a client may carry emergency medication such as nitroglycerin as
instructed by the client's physician, advanced practice registered nurse, or physician assistant;
(4) a provision for the client to self-administer medication when a client is scheduled to
be away from the facility;
(5) a provision that if a client self-administers medication when the client is present in
the facility, the client must self-administer medication under the observation of a trained
staff member;
(6) a provision that when a license holder serves a client who is a parent with a child,
the parent may only administer medication to the child under a staff member's supervision;
(7) requirements for recording the client's use of medication, including staff signatures
with date and time;
(8) guidelines for when to inform a nurse of problems with self-administration of
medication, including a client's failure to administer, refusal of a medication, adverse
reaction, or error; and
(9) procedures for acceptance, documentation, and implementation of a prescription,
whether written, verbal, telephonic, or electronic.
new text begin EFFECTIVE DATE. new text end
new text begin
This section is effective the day following final enactment.
new text end
Sec. 48.
Minnesota Statutes 2022, section 245G.08, subdivision 6, is amended to read:
Subd. 6.
Control of drugs.
A license holder must have and implement written policies
and procedures developed by a registered nurse that contain:
(1) a requirement that each drug must be stored in a locked compartment. A Schedule
II drug, as defined by section 152.02, subdivision 3, must be stored in a separately locked
compartment, permanently affixed to the physical plant or medication cart;
(2) a system which accounts for all scheduled drugs each shift;
(3) a procedure for recording the client's use of medication, including the signature of
the staff member who completed the administration of the medication with the time and
date;
(4) a procedure to destroy a discontinued, outdated, or deteriorated medication;
(5) a statement that only authorized personnel are permitted access to the keys to a locked
compartment;
(6) a statement that no legend drug supply for one client shall be given to another client;
and
(7) a procedure for monitoring the available supply of deleted text begin naloxonedeleted text end new text begin an opiate antagonist as
defined in section 604A.04, subdivision 1,new text end on sitedeleted text begin ,deleted text end new text begin andnew text end replenishing the deleted text begin naloxonedeleted text end supply
when neededdeleted text begin , and destroying naloxone according to clause (4)deleted text end .
new text begin EFFECTIVE DATE. new text end
new text begin
This section is effective the day following final enactment.
new text end
Sec. 49.
Minnesota Statutes 2022, section 245G.10, is amended by adding a subdivision
to read:
new text begin Subd. 6. new text end
new text begin Notification to commissioner of changes in key staff positions. new text end
new text begin
A license
holder must notify the commissioner within five business days of a change or vacancy in a
key staff position. The key positions are a treatment director as required by subdivision 1,
an alcohol and drug counselor supervisor as required by subdivision 2, and a registered
nurse as required by section 245G.08, subdivision 5, paragraph (c). The license holder must
notify the commissioner of the staffing change or vacancy on a form approved by the
commissioner and include the name of the staff person now assigned to the key staff position
and the staff person's qualifications for the position.
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. 50.
Minnesota Statutes 2023 Supplement, section 245G.22, 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 them.
(b) "Diversion" means the use of a medication for the treatment of opioid addiction being
diverted from intended use of the medication.
(c) "Guest dose" means administration of a medication used for the treatment of opioid
addiction to a person who is not a client of the program that is administering or dispensing
the medication.
(d) "Medical director" means a practitioner licensed to practice medicine in the
jurisdiction that the opioid treatment program is located who assumes responsibility for
administering all medical services performed by the program, either by performing the
services directly or by delegating specific responsibility to a practitioner of the opioid
treatment program.
(e) "Medication used for the treatment of opioid use disorder" means a medication
approved by the Food and Drug Administration for the treatment of opioid use disorder.
(f) "Minnesota health care programs" has the meaning given in section 256B.0636.
(g) "Opioid treatment program" has the meaning given in Code of Federal Regulations,
title 42, section 8.12, and includes programs licensed under this chapter.
(h) "Practitioner" means a staff member holding a current, unrestricted license to practice
medicine issued by the Board of Medical Practice or nursing issued by the Board of Nursing
and is currently registered with the Drug Enforcement Administration to order or dispense
controlled substances in Schedules II to V under the Controlled Substances Act, United
States Code, title 21, part B, section 821. deleted text begin Practitioner includes an advanced practice registered
nurse and physician assistant if the staff member receives a variance by the state opioid
treatment authority under section 254A.03 and the federal Substance Abuse and Mental
Health Services Administration.
deleted text end
(i) "Unsupervised usenew text begin " or "take-homenew text end " means the use of a medication for the treatment
of opioid use disorder dispensed for use by a client outside of the program setting.
new text begin EFFECTIVE DATE. new text end
new text begin
This section is effective the day following final enactment.
new text end
Sec. 51.
Minnesota Statutes 2022, section 245G.22, subdivision 6, is amended to read:
Subd. 6.
Criteria for unsupervised use.
(a) To limit the potential for diversion of
medication used for the treatment of opioid use disorder to the illicit market, medication
dispensed to a client for unsupervised use shall be subject to the requirements of this
subdivision. Any client in an opioid treatment program may receive deleted text begin a single unsupervised
use dose for a day that the clinic is closed for business, including Sundays and state and
federal holidaysdeleted text end new text begin their individualized take-home doses as ordered for days that the clinic is
closed for business, on one weekend day (e.g., Sunday) and state and federal holidays, no
matter their length of time in treatment, as allowed under Code of Federal Regulations, title
42, part 8.12 (i)(1)new text end .
(b) new text begin For take-home doses beyond those allowed by paragraph (a), new text end a practitioner deleted text begin withdeleted text end
deleted text begin authority to prescribedeleted text end must review and document the criteria in deleted text begin this paragraph and paragraph
(c)deleted text end new text begin the Code of Federal Regulations, title 42, part 8.12 (i)(2),new text end when determining whether
dispensing medication for a client's unsupervised use is new text begin safe and it is new text end appropriate to
implement, increase, or extend the amount of time between visits to the program. deleted text begin The criteria
are:
deleted text end
deleted text begin
(1) absence of recent abuse of drugs including but not limited to opioids, non-narcotics,
and alcohol;
deleted text end
deleted text begin
(2) regularity of program attendance;
deleted text end
deleted text begin
(3) absence of serious behavioral problems at the program;
deleted text end
deleted text begin
(4) absence of known recent criminal activity such as drug dealing;
deleted text end
deleted text begin
(5) stability of the client's home environment and social relationships;
deleted text end
deleted text begin
(6) length of time in comprehensive maintenance treatment;
deleted text end
deleted text begin
(7) reasonable assurance that unsupervised use medication will be safely stored within
the client's home; and
deleted text end
deleted text begin
(8) whether the rehabilitative benefit the client derived from decreasing the frequency
of program attendance outweighs the potential risks of diversion or unsupervised use.
deleted text end
(c) The determination, including the basis of the determination must be documented new text begin by
a practitioner new text end in the client's medical record.
new text begin EFFECTIVE DATE. new text end
new text begin
This section is effective the day following final enactment.
new text end
Sec. 52.
Minnesota Statutes 2022, section 245G.22, subdivision 7, is amended to read:
Subd. 7.
Restrictions for unsupervised use of methadone hydrochloride.
(a) If a
deleted text begin medical director or prescribingdeleted text end practitioner assesses deleted text begin anddeleted text end new text begin ,new text end determinesnew text begin , and documentsnew text end that
a client meets the criteria in subdivision 6 deleted text begin and may be dispensed a medication used for the
treatment of opioid addiction, the restrictions in this subdivision must be followed when
the medication to be dispensed is methadone hydrochloride. The results of the assessment
must be contained in the client file. The number of unsupervised use medication doses per
week in paragraphs (b) to (d) is in addition to the number of unsupervised use medication
doses a client may receive for days the clinic is closed for business as allowed by subdivision
6, paragraph (a)deleted text end new text begin and that a patient is safely able to manage unsupervised doses of methadone,
the number of take-home doses the client receives must be limited by the number allowed
by the Code of Federal Regulations, title 42, part 8.12 (i)(3)new text end .
deleted text begin
(b) During the first 90 days of treatment, the unsupervised use medication supply must
be limited to a maximum of a single dose each week and the client shall ingest all other
doses under direct supervision.
deleted text end
deleted text begin
(c) In the second 90 days of treatment, the unsupervised use medication supply must be
limited to two doses per week.
deleted text end
deleted text begin
(d) In the third 90 days of treatment, the unsupervised use medication supply must not
exceed three doses per week.
deleted text end
deleted text begin
(e) In the remaining months of the first year, a client may be given a maximum six-day
unsupervised use medication supply.
deleted text end
deleted text begin
(f) After one year of continuous treatment, a client may be given a maximum two-week
unsupervised use medication supply.
deleted text end
deleted text begin
(g) After two years of continuous treatment, a client may be given a maximum one-month
unsupervised use medication supply, but must make monthly visits to the program.
deleted text end
new text begin EFFECTIVE DATE. new text end
new text begin
This section is effective the day following final enactment.
new text end
Sec. 53.
Minnesota Statutes 2023 Supplement, section 245G.22, subdivision 17, is amended
to read:
Subd. 17.
Policies and procedures.
(a) A license holder must develop and maintain the
policies and procedures required in this subdivision.
(b) For a program that is not open every day of the year, the license holder must maintain
a policy and procedure that covers requirements under section 245G.22, subdivisions 6 and
7. Unsupervised use of medication used for the treatment of opioid use disorder for days
that the program is closed for businessdeleted text begin , including but not limited to Sundaysdeleted text end new text begin on one weekend
daynew text end and state and federal holidays, must meet the requirements under section 245G.22,
subdivisions 6 and 7.
(c) The license holder must maintain a policy and procedure that includes specific
measures to reduce the possibility of diversion. The policy and procedure must:
(1) specifically identify and define the responsibilities of the medical and administrative
staff for performing diversion control measures; and
(2) include a process for contacting no less than five percent of clients who have
unsupervised use of medication, excluding clients approved solely under subdivision 6,
paragraph (a), to require clients to physically return to the program each month. The system
must require clients to return to the program within a stipulated time frame and turn in all
unused medication containers related to opioid use disorder treatment. The license holder
must document all related contacts on a central log and the outcome of the contact for each
client in the client's record. The medical director must be informed of each outcome that
results in a situation in which a possible diversion issue was identified.
(d) Medication used for the treatment of opioid use disorder must be ordered,
administered, and dispensed according to applicable state and federal regulations and the
standards set by applicable accreditation entities. If a medication order requires assessment
by the person administering or dispensing the medication to determine the amount to be
administered or dispensed, the assessment must be completed by an individual whose
professional scope of practice permits an assessment. For the purposes of enforcement of
this paragraph, the commissioner has the authority to monitor the person administering or
dispensing the medication for compliance with state and federal regulations and the relevant
standards of the license holder's accreditation agency and may issue licensing actions
according to sections 245A.05, 245A.06, and 245A.07, based on the commissioner's
determination of noncompliance.
(e) A counselor in an opioid treatment program must not supervise more than 50 clients.
(f) Notwithstanding paragraph (e), from July 1, 2023, to June 30, 2024, a counselor in
an opioid treatment program may supervise up to 60 clients. The license holder may continue
to serve a client who was receiving services at the program on June 30, 2024, at a counselor
to client ratio of up to one to 60 and is not required to discharge any clients in order to return
to the counselor to client ratio of one to 50. The license holder may not, however, serve a
new client after June 30, 2024, unless the counselor who would supervise the new client is
supervising fewer than 50 existing clients.
new text begin EFFECTIVE DATE. new text end
new text begin
This section is effective the day following final enactment.
new text end
Sec. 54.
Minnesota Statutes 2022, section 245H.01, is amended by adding a subdivision
to read:
new text begin Subd. 6a. new text end
new text begin Infant. new text end
new text begin
"Infant" means a child who is at least six weeks old but less than 16
months old.
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. 55.
Minnesota Statutes 2022, section 245H.01, is amended by adding a subdivision
to read:
new text begin Subd. 6b. new text end
new text begin Preschooler. new text end
new text begin
"Preschooler" means a child who is at least 33 months old but
who has not yet attended the first day of kindergarten.
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. 56.
Minnesota Statutes 2022, section 245H.01, is amended by adding a subdivision
to read:
new text begin Subd. 6c. new text end
new text begin School-age child. new text end
new text begin
"School-age child" means a child who is of sufficient age
to have attended the first day of kindergarten or is eligible to enter kindergarten within four
months and:
new text end
new text begin
(1) is no more than 13 years old;
new text end
new text begin
(2) remains eligible for child care assistance under section 119B.09, subdivision 1,
paragraph (e); or
new text end
new text begin
(3) attends a certified center that serves only school-age children in a setting that has
students enrolled in no grade higher than grade 8.
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. 57.
Minnesota Statutes 2022, section 245H.01, is amended by adding a subdivision
to read:
new text begin Subd. 8a. new text end
new text begin Toddler. new text end
new text begin
"Toddler" means a child who is at least 16 months old but less than
33 months old.
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. 58.
Minnesota Statutes 2023 Supplement, section 245H.06, subdivision 1, is amended
to read:
Subdivision 1.
Correction order new text begin and conditional certification new text end requirements.
(a) If
the applicant or certification holder deleted text begin faileddeleted text end new text begin failsnew text end 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.
(b) deleted text begin The commissioner may issue a correction order to the applicant or certification holder
through the provider licensing and reporting hub.deleted text end new text begin If the certification holder fails to comply
with a law or rule, the commissioner may issue a conditional certification. When issuing a
conditional certification, 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 conditional order must state:
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;
new text end
new text begin
(3) the time allowed to correct each violation; and
new text end
new text begin
(4) the length and terms of the conditional certification, and the reasons for making the
certification conditional.
new text end
new text begin
(c) Nothing in this section prohibits the commissioner from decertifying a center under
section 245H.07 before issuing a correction order or conditional certification.
new text end
new text begin
(d) The commissioner may issue a correction order or conditional certification 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 October 1, 2024.
new text end
Sec. 59.
Minnesota Statutes 2023 Supplement, 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 new text begin or conditional certification new text end is erroneous, the applicant
or certification holder may ask the commissioner to reconsider the part of the correction
order new text begin or conditional certification new text end that is allegedly erroneous. A request for reconsideration
must be made in writing and postmarked or submitted through the provider licensing and
reporting hub and sent to the commissioner within 20 calendar days after the applicant or
certification holder received the correction ordernew text begin or conditional certificationnew text end , and must:
(1) specify the part of the correction order new text begin or conditional certification new text end 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 new text begin of a correction order new text end 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) A timely request for reconsideration of a conditional certification shall stay imposition
of the terms of the conditional certification until the commissioner issues a decision on the
request for reconsideration.
new text end
deleted text begin (c)deleted text end new text begin (d)new text end 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 begin EFFECTIVE DATE. new text end
new text begin
This section is effective October 1, 2024.
new text end
Sec. 60.
Minnesota Statutes 2022, section 245H.08, subdivision 1, is amended to read:
Subdivision 1.
Staffing requirements.
new text begin (a) Except as provided in paragraph (b), new text end during
hours of operation, a certified center must have a director deleted text begin or designeedeleted text end on site who is
responsible for overseeing implementation of written policies relating to the management
and control of the daily activities of the program, ensuring the health and safety of program
participants, and supervising staff and volunteers.
new text begin
(b) When the director is absent, a certified center must designate a staff person who is
at least 18 years old to fulfill the director's responsibilities under this subdivision to ensure
continuity of program oversight. The designee does not have to meet the director
qualifications in subdivision 2 but must be aware of their designation and responsibilities
under this subdivision.
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. 61.
Minnesota Statutes 2023 Supplement, section 245H.08, subdivision 4, is amended
to read:
Subd. 4.
Maximum group size.
(a) For deleted text begin a child six weeks old through 16 months olddeleted text end new text begin an
infantnew text end , the maximum group size shall be no more than eight children.
(b) For a deleted text begin child 16 months old through 33 months olddeleted text end new text begin toddlernew text end , the maximum group size
shall be no more than 14 children.
(c) For a deleted text begin child 33 months old through prekindergartendeleted text end new text begin preschoolernew text end , deleted text begin adeleted text end new text begin thenew text end maximum
group size shall be no more than 20 children.
(d) For a deleted text begin child in kindergarten through 13 years olddeleted text end new text begin school-age childnew text end , deleted text begin adeleted text end new text begin thenew text end maximum
group size shall be no more than 30 children.
(e) The maximum group size applies at all times except during group activity coordination
time not exceeding 15 minutes, during a meal, outdoor activity, field trip, nap and rest, and
special activity including a film, guest speaker, indoor large muscle activity, or holiday
program.
deleted text begin
(f) Notwithstanding paragraph (d), a certified center may continue to serve a child 14
years of age or older if one of the following conditions is true:
deleted text end
deleted text begin
(1) the child remains eligible for child care assistance under section 119B.09, subdivision
1, paragraph (e); or
deleted text end
deleted text begin
(2) the certified center serves only school-age children in a setting that has students
enrolled in no grade higher than 8th grade.
deleted text end
new text begin EFFECTIVE DATE. new text end
new text begin
This section is effective October 1, 2024.
new text end
Sec. 62.
Minnesota Statutes 2023 Supplement, section 245H.08, subdivision 5, is amended
to read:
Subd. 5.
Ratios.
(a) The minimally acceptable staff-to-child ratios are:
|
deleted text begin
six weeks old through 16 months old
deleted text end
new text begin
infants new text end |
1:4 |
|
deleted text begin
16 months old through 33 months old
deleted text end
new text begin
toddlers new text end |
1:7 |
|
deleted text begin
33 months old through prekindergarten
deleted text end
new text begin
preschoolers new text end |
1:10 |
|
deleted text begin
kindergarten through 13 years old
deleted text end
new text begin
school-age children new text end |
1:15 |
deleted text begin
(b) Kindergarten includes a child of sufficient age to have attended the first day of
kindergarten or who is eligible to enter kindergarten within the next four months.
deleted text end
deleted text begin (c)deleted text end new text begin (b)new text end For deleted text begin mixeddeleted text end new text begin mixed-agenew text end groups, the ratio for the age group of the youngest child
applies.
deleted text begin
(d) Notwithstanding paragraph (a), a certified center may continue to serve a child 14
years of age or older if one of the following conditions is true:
deleted text end
deleted text begin
(1) the child remains eligible for child care assistance under section 119B.09, subdivision
1, paragraph (e); or
deleted text end
deleted text begin
(2) the certified center serves only school-age children in a setting that has students
enrolled in no grade higher than 8th grade.
deleted text end
new text begin EFFECTIVE DATE. new text end
new text begin
This section is effective October 1, 2024.
new text end
Sec. 63.
Minnesota Statutes 2022, section 245H.14, subdivision 1, is amended to read:
Subdivision 1.
First aid and cardiopulmonary resuscitation.
(a) Before having
unsupervised direct contact with a child, but within deleted text begin the firstdeleted text end 90 days deleted text begin of employment fordeleted text end new text begin
after the first date of direct contact with a child,new text end the director deleted text begin anddeleted text end new text begin ,new text end all staff persons, deleted text begin and within
90 days after the first date of direct contact with a child fordeleted text end substitutesnew text begin ,new text end and unsupervised
volunteersdeleted text begin , each persondeleted text end must successfully complete pediatric first aid and pediatric
cardiopulmonary resuscitation (CPR) training, unless the training has been completed within
the previous two calendar years. Staff must complete the pediatric first aid and pediatric
CPR training at least every other calendar year and the center must document the training
in the staff person's personnel record.
(b) Training completed under this subdivision may be used to meet the in-service training
requirements under subdivision 6.
new text begin EFFECTIVE DATE. new text end
new text begin
This section is effective October 1, 2024.
new text end
Sec. 64.
Minnesota Statutes 2022, section 245H.14, subdivision 4, is amended to read:
Subd. 4.
Child development.
deleted text begin The certified center must ensure that the director and all
staff persons complete child development and learning training within 90 days of employment
and every second calendar year thereafter. Substitutes and unsupervised volunteers must
complete child development and learning training within 90 days after the first date of direct
contact with a child and every second calendar year thereafter.deleted text end new text begin Before having unsupervised
direct contact with a child, but within 90 days after the first date of direct contact with a
child, the director, all staff persons, substitutes, and unsupervised volunteers must complete
child development and learning training. Child development and learning training must be
repeated every second calendar year thereafter.new text end The director and staff persons not including
substitutes must complete at least two hours of training on child development. The training
for substitutes and unsupervised volunteers is not required to be of a minimum length. For
purposes of this subdivision, "child development and learning training" means how a child
develops physically, cognitively, emotionally, and socially and learns as part of the child's
family, culture, and community.
new text begin EFFECTIVE DATE. new text end
new text begin
This section is effective October 1, 2024.
new text end
Sec. 65.
new text begin
[245H.19] CHILDREN'S RECORDS.
new text end
new text begin
(a) A certification holder must maintain a record for each child enrolled in the certification
holder's program. The record must contain:
new text end
new text begin
(1) the child's full name, birth date, and home address;
new text end
new text begin
(2) the name and telephone number of the child's parents or legal guardians;
new text end
new text begin
(3) the name and telephone number of at least one emergency contact person other than
the child's parents who can be reached in an emergency or when there is an injury requiring
medical attention and who is authorized to pick up the child; and
new text end
new text begin
(4) the names and telephone numbers of any additional persons authorized by the parents
or legal guardians to pick up the child from the center.
new text end
new text begin
(b) The certification holder must maintain in the child's record and ensure that during
all hours of operation staff can access the following information:
new text end
new text begin
(1) immunization information as required under section 245H.13, subdivision 2;
new text end
new text begin
(2) medication administration documentation as required under section 245H.13,
subdivision 3; and
new text end
new text begin
(3) documentation of any known allergy as required under section 245H.13, subdivision
4.
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. 66.
Minnesota Statutes 2023 Supplement, section 256B.064, subdivision 4, is amended
to read:
Subd. 4.
Notice.
(a) The department shall serve the notice required under subdivision 2
deleted text begin by certified mail atdeleted text end new text begin using a signature-verified confirmed delivery method tonew text end the address
submitted to the department by the individual or entity. Service is complete upon mailing.
(b) The department shall give notice in writing to a recipient placed in the Minnesota
restricted recipient program under section 256B.0646 and Minnesota Rules, part 9505.2200.
The department shall send the notice by first class mail to the recipient's current address on
file with the department. A recipient placed in the Minnesota restricted recipient program
may contest the placement by submitting a written request for a hearing to the department
within 90 days of the notice being mailed.
Sec. 67.
Minnesota Statutes 2022, section 256B.0757, subdivision 4a, is amended to read:
Subd. 4a.
Behavioral health home services provider requirements.
A behavioral
health home services provider must:
(1) be an enrolled Minnesota Health Care Programs provider;
(2) provide a medical assistance covered primary care or behavioral health service;
(3) utilize an electronic health record;
(4) utilize an electronic patient registry that contains data elements required by the
commissioner;
(5) demonstrate the organization's capacity to administer screenings approved by the
commissioner for substance use disorder or alcohol and tobacco use;
(6) demonstrate the organization's capacity to refer an individual to resources appropriate
to the individual's screening results;
(7) have policies and procedures to track referrals to ensure that the referral met the
individual's needs;
(8) conduct a brief needs assessment when an individual begins receiving behavioral
health home services. The brief needs assessment must be completed with input from the
individual and the individual's identified supports. The brief needs assessment must address
the individual's immediate safety and transportation needs and potential barriers to
participating in behavioral health home services;
(9) conduct a health wellness assessment within 60 days after intake that contains all
required elements identified by the commissioner;
(10) conduct a health action plan that contains all required elements identified by the
commissioner. The plan must be completed within 90 days after intake and must be updated
at least once every six months, or more frequently if significant changes to an individual's
needs or goals occur;
(11) agree to cooperate with and participate in the state's monitoring and evaluation of
behavioral health home services; and
(12) obtain the individual's deleted text begin writtendeleted text end consent to begin receiving behavioral health home
services using a form approved by the commissioner.
new text begin EFFECTIVE DATE. new text end
new text begin
This section is effective the day following final enactment.
new text end
Sec. 68.
Minnesota Statutes 2022, section 256B.0757, subdivision 4d, is amended to read:
Subd. 4d.
Behavioral health home services delivery standards.
(a) A behavioral health
home services provider must meet the following service delivery standards:
(1) establish and maintain processes to support the coordination of an individual's primary
care, behavioral health, and dental care;
(2) maintain a team-based model of care, including regular coordination and
communication between behavioral health home services team members;
(3) use evidence-based practices that recognize and are tailored to the medical, social,
economic, behavioral health, functional impairment, cultural, and environmental factors
affecting the individual's health and health care choices;
(4) use person-centered planning practices to ensure the individual's health action plan
accurately reflects the individual's preferences, goals, resources, and optimal outcomes for
the individual and the individual's identified supports;
(5) use the patient registry to identify individuals and population subgroups requiring
specific levels or types of care and provide or refer the individual to needed treatment,
intervention, or services;
(6) deleted text begin utilize the Department of Human Services Partner Portal todeleted text end identify past and current
treatment or services and identify potential gaps in carenew text begin using a tool approved by the
commissionernew text end ;
(7) deliver services consistent with the standards for frequency and face-to-face contact
required by the commissioner;
(8) ensure that a diagnostic assessment is completed for each individual receiving
behavioral health home services within six months of the start of behavioral health home
services;
(9) deliver services in locations and settings that meet the needs of the individual;
(10) provide a central point of contact to ensure that individuals and the individual's
identified supports can successfully navigate the array of services that impact the individual's
health and well-being;
(11) have capacity to assess an individual's readiness for change and the individual's
capacity to integrate new health care or community supports into the individual's life;
(12) offer or facilitate the provision of wellness and prevention education on
evidenced-based curriculums specific to the prevention and management of common chronic
conditions;
(13) help an individual set up and prepare for medical, behavioral health, social service,
or community support appointments, including accompanying the individual to appointments
as appropriate, and providing follow-up with the individual after these appointments;
(14) offer or facilitate the provision of health coaching related to chronic disease
management and how to navigate complex systems of care to the individual, the individual's
family, and identified supports;
(15) connect an individual, the individual's family, and identified supports to appropriate
support services that help the individual overcome access or service barriers, increase
self-sufficiency skills, and improve overall health;
(16) provide effective referrals and timely access to services; and
(17) establish a continuous quality improvement process for providing behavioral health
home services.
(b) The behavioral health home services provider must also create a plan, in partnership
with the individual and the individual's identified supports, to support the individual after
discharge from a hospital, residential treatment program, or other setting. The plan must
include protocols for:
(1) maintaining contact between the behavioral health home services team member, the
individual, and the individual's identified supports during and after discharge;
(2) linking the individual to new resources as needed;
(3) reestablishing the individual's existing services and community and social supports;
and
(4) following up with appropriate entities to transfer or obtain the individual's service
records as necessary for continued care.
(c) If the individual is enrolled in a managed care plan, a behavioral health home services
provider must:
(1) notify the behavioral health home services contact designated by the managed care
plan within 30 days of when the individual begins behavioral health home services; and
(2) adhere to the managed care plan communication and coordination requirements
described in the behavioral health home services manual.
(d) Before terminating behavioral health home services, the behavioral health home
services provider must:
(1) provide a 60-day notice of termination of behavioral health home services to all
individuals receiving behavioral health home services, the commissioner, and managed care
plans, if applicable; and
(2) refer individuals receiving behavioral health home services to a new behavioral
health home services provider.
new text begin EFFECTIVE DATE. new text end
new text begin
This section is effective the day following final enactment.
new text end
Sec. 69.
Minnesota Statutes 2023 Supplement, 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 2b, 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 standard of assistance for an assistance unit consisting of a 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 custodian, or consisting of a childless couple, is $350 per month
effective October 1, 2024, and must be adjusted by a percentage equal to the change in the
consumer price index as of January 1 every year, beginning October 1, 2025.
(c) For an assistance unit consisting of a single adult who lives with a parent or parents,
the general assistance standard of assistance is $350 per month effective October 1, deleted text begin 2023deleted text end new text begin
2024new text end , and must be adjusted by a percentage equal to the change in the consumer price index
as of January 1 every year, beginning October 1, 2025. 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.
new text begin EFFECTIVE DATE. new text end
new text begin
This section is effective the day following final enactment.
new text end
Sec. 70.
Minnesota Statutes 2022, section 256I.04, subdivision 2f, is amended to read:
Subd. 2f.
Required services.
(a) In deleted text begin licensed and registereddeleted text end new text begin authorizednew text end settings under
subdivision 2a, providers shall ensure that participants have at a minimum:
(1) food preparation and service for three nutritional meals a day on site;
(2) a bed, clothing storage, linen, bedding, laundering, and laundry supplies or service;
(3) housekeeping, including cleaning and lavatory supplies or service; and
(4) maintenance and operation of the building and grounds, including heat, water, garbage
removal, electricity, telephone for the site, cooling, supplies, and parts and tools to repair
and maintain equipment and facilities.
(b) In addition, when providers serve participants described in subdivision 1, paragraph
(c), the providers are required to assist the participants in applying for continuing housing
support payments before the end of the eligibility period.
Sec. 71.
Minnesota Statutes 2023 Supplement, section 256I.05, subdivision 1a, is amended
to read:
Subd. 1a.
Supplementary service rates.
(a) Subject to the provisions of section 256I.04,
subdivision 3, the agency may negotiate a payment not to exceed $494.91 for other services
necessary to provide room and board if the residence is licensed by or registered by the
Department of Health, or licensed by the Department of Human Services to provide services
in addition to room and board, and if the provider of services is not also concurrently
receiving funding for services for a recipient in the residence under the following programs
or funding sources: (1) home and community-based waiver services under chapter 256S or
section 256B.0913, 256B.092, or 256B.49; (2) personal care assistance under section
256B.0659; (3) community first services and supports under section 256B.85; or (4) services
for adults with mental illness grants under section 245.73. If funding is available for other
necessary services through a home and community-based waiver under chapter 256S, or
section 256B.0913, 256B.092, or 256B.49; personal care assistance services under section
256B.0659; community first services and supports under section 256B.85; or services for
adults with mental illness grants under section 245.73, then the housing support rate is
limited to the rate set in subdivision 1. Unless otherwise provided in law, in no case may
the supplementary service rate exceed $494.91. The registration and licensure requirement
does not apply to establishments which are exempt from state licensure because they are
located on Indian reservations and for which the tribe has prescribed health and safety
requirements. Service payments under this section may be prohibited under rules to prevent
the supplanting of federal funds with state funds.
deleted text begin
(b) The commissioner is authorized to make cost-neutral transfers from the housing
support fund for beds under this section to other funding programs administered by the
department after consultation with the agency in which the affected beds are located. The
commissioner may also make cost-neutral transfers from the housing support fund to agencies
for beds permanently removed from the housing support census under a plan submitted by
the agency and approved by the commissioner. The commissioner shall report the amount
of any transfers under this provision annually to the legislature.
deleted text end
deleted text begin (c)deleted text end new text begin (b)new text end Agencies must not negotiate supplementary service rates with providers of housing
support that are licensed as board and lodging with special services and that do not encourage
a policy of sobriety on their premises and make referrals to available community services
for volunteer and employment opportunities for residents.
Sec. 72.
Minnesota Statutes 2023 Supplement, section 256I.05, subdivision 11, is amended
to read:
Subd. 11.
deleted text begin Transfer of emergency shelter fundsdeleted text end new text begin Cost-neutral transfers from the
housing support fundnew text end .
new text begin
(a) The commissioner is authorized to make cost-neutral transfers
from the housing support fund for beds under this section to other funding programs
administered by the department after consultation with the agency in which the affected
beds are located.
new text end
new text begin
(b) The commissioner may also make cost-neutral transfers from the housing support
fund to agencies for beds removed from the housing support census under a plan submitted
by the agency and approved by the commissioner.
new text end
deleted text begin (a)deleted text end new text begin (c)new text end The commissioner shall make a cost-neutral transfer of funding from the housing
support fund to the agency for emergency shelter beds removed from the housing support
census under a deleted text begin biennialdeleted text end plan submitted by the agency and approved by the commissioner.new text begin
Plans submitted under this paragraph must include anticipated and actual outcomes for
persons experiencing homelessness in emergency shelters.
new text end
deleted text begin The plandeleted text end new text begin (d) Plans submitted under paragraph (b) or (c)new text end must describe: (1) deleted text begin anticipated
and actual outcomes for persons experiencing homelessness in emergency shelters; (2)deleted text end
improved efficiencies in administration; deleted text begin (3)deleted text end new text begin (2)new text end requirements for individual eligibility; and
deleted text begin (4)deleted text end new text begin (3)new text end plans for quality assurance monitoring and quality assurance outcomes. The
commissioner shall review deleted text begin thedeleted text end agency deleted text begin plandeleted text end new text begin plansnew text end to monitor implementation and outcomes
at least biennially, and more frequently if the commissioner deems necessary.
deleted text begin (b) Thedeleted text end new text begin (e)new text end Funding under paragraph deleted text begin (a)deleted text end new text begin (b), (c), or (d)new text end may be used for the provision
of room and board or supplemental services according to section 256I.03, subdivisions 14a
and 14b. Providers must meet the requirements of section 256I.04, subdivisions 2a to 2f.
Funding must be allocated annually, and the room and board portion of the allocation shall
be adjusted according to the percentage change in the housing support room and board rate.
deleted text begin The room and board portion of the allocation shall be determined at the time of transfer.deleted text end
The commissioner or agency may return beds to the housing support fund with 180 days'
notice, including financial reconciliation.
Sec. 73.
Minnesota Statutes 2022, section 260E.30, subdivision 3, as amended by Laws
2024, chapter 80, article 8, section 41, is amended to read:
Subd. 3.
Nonmaltreatment mistake.
(a) If paragraph (b) applies, rather than making a
determination of substantiated maltreatment by the individual, the commissioner of children,
youth, and families shall determine that the individual made a nonmaltreatment mistake.
(b) A nonmaltreatment mistake occurs when:
deleted text begin
(1) at the time of the incident, the individual was performing duties identified in the
facility's child care program plan required under Minnesota Rules, part 9503.0045;
deleted text end
deleted text begin (2)deleted text end new text begin (1)new text end the individual has not been determined responsible for a similar incident that
resulted in a finding of maltreatment for at least seven years;
deleted text begin (3)deleted text end new text begin (2)new text end the individual has not been determined to have committed a similar
nonmaltreatment mistake under this paragraph for at least four years;
deleted text begin (4)deleted text end new text begin (3)new text end any injury to a child resulting from the incident, if treated, is treated only with
remedies that are available over the counter, whether ordered by a medical professional or
not; and
deleted text begin (5)deleted text end new text begin (4)new text end except for the period when the incident occurred, the facility and the individual
providing services were both in compliance with all licensing new text begin and certification new text end requirements
relevant to the incident.
(c) This subdivision only applies to child care centers new text begin certified under chapter 245H and
new text end licensed under Minnesota Rules, chapter 9503.
new text begin EFFECTIVE DATE. new text end
new text begin
This section is effective October 1, 2024.
new text end
Sec. 74.
Minnesota Statutes 2022, section 260E.33, subdivision 2, as amended by Laws
2024, chapter 80, article 8, section 44, is amended to read:
Subd. 2.
Request for reconsideration.
(a) Except as provided under subdivision 5, an
individual or facility that the commissioner of human services; commissioner of children,
youth, and families; a local welfare agency; or the commissioner of education determines
has maltreated a child, an interested person acting on behalf of the child, regardless of the
determination, who contests the investigating agency's final determination regarding
maltreatment may request the investigating agency to reconsider its final determination
regarding maltreatment. The request for reconsideration must be submitted in writingnew text begin or
submitted in the provider licensing and reporting hubnew text end to the investigating agency within 15
calendar days after receipt of notice of the final determination regarding maltreatment or,
if the request is made by an interested person who is not entitled to notice, within 15 days
after receipt of the notice by the parent or guardian of the child. If mailed, the request for
reconsideration must be postmarked and sent to the investigating agency within 15 calendar
days of the individual's or facility's receipt of the final determination. If the request for
reconsideration is made by personal service, it must be received by the investigating agency
within 15 calendar days after the individual's or facility's receipt of the final determination.new text begin
Upon implementation of the provider licensing and reporting hub, the individual or facility
must use the hub to request reconsideration. The reconsideration must be received by the
commissioner within 15 calendar days of the individual's receipt of the notice of
disqualification.
new text end
(b) An individual who was determined to have maltreated a child under this chapter and
who was disqualified on the basis of serious or recurring maltreatment under sections
245C.14 and 245C.15 may request reconsideration of the maltreatment determination and
the disqualification. The request for reconsideration of the maltreatment determination and
the disqualification must be submitted within 30 calendar days of the individual's receipt
of the notice of disqualification under sections 245C.16 and 245C.17. If mailed, the request
for reconsideration of the maltreatment determination and the disqualification must be
postmarked and sent to the investigating agency within 30 calendar days of the individual's
receipt of the maltreatment determination and notice of disqualification. If the request for
reconsideration is made by personal service, it must be received by the investigating agency
within 30 calendar days after the individual's receipt of the notice of disqualification.
Sec. 75.
Laws 2024, chapter 80, article 2, section 5, is amended by adding a subdivision
to read:
new text begin Subd. 23. new text end
new text begin Family child foster care annual program evaluation. new text end
new text begin
Upon implementation
of a continuous license process for family child foster care, the annual program evaluation
required under Minnesota Rules, part 2960.3100, subpart 1, item G, must be conducted
utilizing the electronic licensing inspection checklist information and the provider licensing
and reporting hub in a manner prescribed by the commissioner.
new text end
Sec. 76.
Laws 2024, chapter 80, article 2, section 6, subdivision 2, is amended to read:
Subd. 2.
Change in ownership.
(a) If the commissioner determines that there is a change
in ownership, the commissioner shall require submission of a new license application. This
subdivision does not apply to a licensed program or service located in a home where the
license holder resides. A change in ownership occurs when:
(1) new text begin except as provided in paragraph (b), new text end the license holder sells or transfers 100 percent
of the property, stock, or assets;
(2) the license holder merges with another organization;
(3) the license holder consolidates with two or more organizations, resulting in the
creation of a new organization;
(4) there is a change to the federal tax identification number associated with the license
holder; or
(5) new text begin except as provided in paragraph (b),new text end new text begin new text end all controlling individuals deleted text begin associated withdeleted text end new text begin fornew text end
the original deleted text begin applicationdeleted text end new text begin licensenew text end have changed.
(b) deleted text begin Notwithstandingdeleted text end new text begin For changes undernew text end paragraph (a), deleted text begin clauses (1) and (5)deleted text end new text begin clause (1) or
(5)new text end , no change in ownership has occurrednew text begin and a new license application is not requirednew text end if
at least one controlling individual has been deleted text begin listeddeleted text end new text begin affiliatednew text end as a controlling individual for
the license for at least the previous 12 monthsnew text begin immediately preceding the changenew text end .
new text begin EFFECTIVE DATE. new text end
new text begin
This section is effective January 1, 2025.
new text end
Sec. 77.
Laws 2024, chapter 80, article 2, section 6, subdivision 3, is amended to read:
Subd. 3.
new text begin Standard new text end change of ownership process.
(a) When a change in ownership is
proposed and the party intends to assume operation without an interruption in service longer
than 60 days after acquiring the program or service, the license holder must provide the
commissioner with written notice of the proposed change on a form provided by the
commissioner at least deleted text begin 60deleted text end new text begin 90new text end days before the anticipated date of the change in ownership.
For purposes of this deleted text begin subdivision and subdivision 4deleted text end new text begin sectionnew text end , "party" means the party that
intends to operate the service or program.
(b) The party must submit a license application under this chapter on the form and in
the manner prescribed by the commissioner at least deleted text begin 30deleted text end new text begin 90new text end days before the change in
ownership is new text begin anticipated to be new text end complete and must include documentation to support the
upcoming change. The party must comply with background study requirements under chapter
245C and shall pay the application fee required under section 245A.10.
(c) The commissioner may streamline application procedures when the party is an existing
license holder under this chapter and is acquiring a program licensed under this chapter or
service in the same service class as one or more licensed programs or services the party
operates and those licenses are in substantial compliance. For purposes of this subdivision,
"substantial compliance" means within the previous 12 months the commissioner did not
(1) issue a sanction under section 245A.07 against a license held by the party, or (2) make
a license held by the party conditional according to section 245A.06.
(d) deleted text begin Except when a temporary change in ownership license is issued pursuant to
subdivision 4deleted text end new text begin While the standard change of ownership process is pendingnew text end , the existing
license holder deleted text begin is solelydeleted text end new text begin remainsnew text end responsible for operating the program according to applicable
laws and rules until a license under this chapter is issued to the party.
(e) If a licensing inspection of the program or service was conducted within the previous
12 months and the existing license holder's license record demonstrates substantial
compliance with the applicable licensing requirements, the commissioner may waive the
party's inspection required by section 245A.04, subdivision 4. The party must submit to the
commissioner (1) proof that the premises was inspected by a fire marshal or that the fire
marshal deemed that an inspection was not warranted, and (2) proof that the premises was
inspected for compliance with the building code or that no inspection was deemed warranted.
(f) If the party is seeking a license for a program or service that has an outstanding action
under section 245A.06 or 245A.07, the party must submit a letter as part of the application
process identifying how the party has or will come into full compliance with the licensing
requirements.
(g) The commissioner shall evaluate the party's application according to section 245A.04,
subdivision 6. If the commissioner determines that the party has remedied or demonstrates
the ability to remedy the outstanding actions under section 245A.06 or 245A.07 and has
determined that the program otherwise complies with all applicable laws and rules, the
commissioner shall issue a license or conditional license under this chapter.new text begin A conditional
license issued under this section is final and not subject to reconsideration under section
new text end new text begin 142B.16, subdivision 4.new text end The conditional license remains in effect until the commissioner
determines that the grounds for the action are corrected or no longer exist.
(h) The commissioner may deny an application as provided in section 245A.05. An
applicant whose application was denied by the commissioner may appeal the denial according
to section 245A.05.
(i) This subdivision does not apply to a licensed program or service located in a home
where the license holder resides.
new text begin EFFECTIVE DATE. new text end
new text begin
This section is effective January 1, 2025.
new text end
Sec. 78.
Laws 2024, chapter 80, article 2, section 6, is amended by adding a subdivision
to read:
new text begin Subd. 3a. new text end
new text begin Emergency change in ownership process. new text end
new text begin
(a) In the event of a death of a
license holder or sole controlling individual or a court order or other event that results in
the license holder being inaccessible or unable to operate the program or service, a party
may submit a request to the commissioner to allow the party to assume operation of the
program or service under an emergency change in ownership process to ensure persons
continue to receive services while the commissioner evaluates the party's license application.
new text end
new text begin
(b) To request the emergency change of ownership process, the party must immediately:
new text end
new text begin
(1) notify the commissioner of the event resulting in the inability of the license holder
to operate the program and of the party's intent to assume operations; and
new text end
new text begin
(2) provide the commissioner with documentation that demonstrates the party has a legal
or legitimate ownership interest in the program or service if applicable and is able to operate
the program or service.
new text end
new text begin
(c) If the commissioner approves the party to continue operating the program or service
under an emergency change in ownership process, the party must:
new text end
new text begin
(1) request to be added as a controlling individual or license holder to the existing license;
new text end
new text begin
(2) notify persons receiving services of the emergency change in ownership in a manner
approved by the commissioner;
new text end
new text begin
(3) submit an application for a new license within 30 days of approval;
new text end
new text begin
(4) comply with the background study requirements under chapter 245C; and
new text end
new text begin
(5) pay the application fee required under section 142B.12.
new text end
new text begin
(d) While the emergency change of ownership process is pending, a party approved
under this subdivision is responsible for operating the program under the existing license
according to applicable laws and rules until a new license under this chapter is issued.
new text end
new text begin
(e) The provisions in subdivision 3, paragraphs (c) and (g) to (h), apply to this subdivision.
new text end
new text begin
(f) Once a party is issued a new license or has decided not to seek a new license, the
commissioner must close the existing license.
new text end
new text begin
(g) This subdivision applies to any program or service licensed under this chapter.
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. 79.
Laws 2024, chapter 80, article 2, section 6, is amended by adding a subdivision
to read:
new text begin Subd. 5. new text end
new text begin Failure to comply. new text end
new text begin
If the commissioner finds that the applicant or license holder
has not fully complied with this section, the commissioner may impose a licensing sanction
under section 142B.15, 142B.16, or 142B.18.
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. 80.
Laws 2024, chapter 80, article 2, section 10, subdivision 1, is amended to read:
Subdivision 1.
Sanctions; appeals; license.
(a) In addition to making a license conditional
under section 142B.16, the commissioner may suspend or revoke the license, impose a fine,
or secure an injunction against the continuing operation of the program of a license holder
who:
(1) does not comply with applicable law or rule;
(2) has nondisqualifying background study information, as described in section 245C.05,
subdivision 4, that reflects on the license holder's ability to safely provide care to foster
children; or
(3) has an individual living in the household where the licensed services are provided
or is otherwise subject to a background study, and the individual has nondisqualifying
background study information, as described in section 245C.05, subdivision 4, that reflects
on the license holder's ability to safely provide care to foster children.
When applying sanctions authorized under this section, the commissioner shall consider
the nature, chronicity, or severity of the violation of law or rule and the effect of the violation
on the health, safety, or rights of persons served by the program.
(b) If a license holder appeals the suspension or revocation of a license and the license
holder continues to operate the program pending a final order on the appeal, the commissioner
shall issue the license holder a temporary provisional license. Unless otherwise specified
by the commissioner, variances in effect on the date of the license sanction under appeal
continue under the temporary provisional license. new text begin The commissioner may include terms the
license holder must follow pending a final order on the appeal.new text end new text begin new text end If a license holder fails to
comply with applicable law or rule while operating under a temporary provisional license,
the commissioner may impose additional sanctions under this section and section 142B.16
and may terminate any prior variance. If a temporary provisional license is set to expire, a
new temporary provisional license shall be issued to the license holder upon payment of
any fee required under section 142B.12. The temporary provisional license shall expire on
the date the final order is issued. If the license holder prevails on the appeal, a new
nonprovisional license shall be issued for the remainder of the current license period.
(c) If a license holder is under investigation and the license issued under this chapter is
due to expire before completion of the investigation, the program shall be issued a new
license upon completion of the reapplication requirements and payment of any applicable
license fee. Upon completion of the investigation, a licensing sanction may be imposed
against the new license under this section or section 142B.16 or 142B.20.
(d) Failure to reapply or closure of a license issued under this chapter by the license
holder prior to the completion of any investigation shall not preclude the commissioner
from issuing a licensing sanction under this section or section 142B.16 at the conclusion of
the investigation.
new text begin EFFECTIVE DATE. new text end
new text begin
This section is effective January 1, 2025.
new text end
Sec. 81.
Laws 2024, chapter 80, article 2, section 10, subdivision 6, is amended to read:
Subd. 6.
Appeal of multiple sanctions.
(a) When the license holder appeals more than
one licensing action or sanction that were simultaneously issued by the commissioner, the
license holder shall specify the actions or sanctions that are being appealed.
(b) If there are different timelines prescribed in statutes for the licensing actions or
sanctions being appealed, the license holder must submit the appeal within the longest of
those timelines specified in statutes.
(c) The appeal must be made in writing by certified mail deleted text begin ordeleted text end new text begin ,new 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 the prescribed timeline with the first day beginning the day after
the license holder receives the certified letter. If a request is made by personal service, it
must be received by the commissioner within the prescribed timeline with the first day
beginning the day after the license holder receives the certified letter.new text begin If the appeal is made
through the provider hub, the appeal must be received by the commissioner within the
prescribed timeline with the first day beginning the day after the commissioner issued the
order through the hub.
new text end
(d) When there are different timelines prescribed in statutes for the appeal of licensing
actions or sanctions simultaneously issued by the commissioner, the commissioner shall
specify in the notice to the license holder the timeline for appeal as specified under paragraph
(b).
Sec. 82.
Laws 2024, chapter 80, article 2, section 16, is amended by adding a subdivision
to read:
new text begin Subd. 9. new text end
new text begin Licensed child-placing agency personnel requirements. new text end
new text begin
(a) A licensed
child-placing agency must have an individual designated on staff or contract who supervises
the agency's casework. Supervising an agency's casework includes but is not limited to:
new text end
new text begin
(1) reviewing and approving each written home study the agency completes on
prospective foster parents or applicants to adopt;
new text end
new text begin
(2) ensuring ongoing compliance with licensing requirements; and
new text end
new text begin
(3) overseeing staff and ensuring they have the training and resources needed to perform
their responsibilities.
new text end
new text begin
(b) The individual who supervises the agency's casework must meet at least one of the
following qualifications:
new text end
new text begin
(1) is a licensed social worker, licensed graduate social worker, licensed independent
social worker, or licensed independent clinical social worker;
new text end
new text begin
(2) is a trained culturally competent professional with experience in a relevant field; or
new text end
new text begin
(3) is a licensed clinician with experience in a related field, including a clinician licensed
by a health-related licensing board under section 214.01, subdivision 2.
new text end
new text begin
(c) The commissioner may grant a variance under section 142B.10, subdivision 16, to
the requirements in this section.
new text end
Sec. 83. new text begin DIRECTION TO COMMISSIONER OF HUMAN SERVICES; FAMILY
CHILD FOSTER CARE CONTINUOUS LICENSES.
new text end
new text begin
The commissioner of human services shall develop a continuous license process for
family child foster care licenses. The continuous license process shall be incorporated into
the development of the electronic licensing inspection checklist information and provider
licensing and reporting hub for family child foster care.
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. 84. new text begin REVISOR INSTRUCTION.
new text end
new text begin
The revisor of statutes shall renumber Minnesota Statutes, section 256D.21, as Minnesota
Statutes, section 261.004.
new text end
Sec. 85. new text begin REPEALER.
new text end
new text begin
(a)
new text end
new text begin
Minnesota Statutes 2022, sections 245C.125; 256D.19, subdivisions 1 and 2; 256D.20,
subdivisions 1, 2, 3, and 4; and 256D.23, subdivisions 1, 2, and 3,
new text end
new text begin
are repealed.
new text end
new text begin
(b)
new text end
new text begin
Minnesota Statutes 2023 Supplement, section 245C.08, subdivision 2,
new text end
new text begin
is repealed.
new text end
new text begin
(c)
new text end
new text begin
Minnesota Rules, parts 9502.0425, subparts 5 and 10; and 9545.0805, subpart 1,
new text end
new text begin
are
repealed.
new text end
new text begin
(d)
new text end
new text begin
Laws 2024, chapter 80, article 2, section 6, subdivision 4,
new text end
new text begin
is repealed.
new text end
new text begin EFFECTIVE DATE. new text end
new text begin
The repeal of Minnesota Rules, part 9545.0805, subpart 1, is
effective July 1, 2024. Except for the repeal of Minnesota Statutes 2022, section 245C.125,
paragraph (a) is effective the day following final enactment.
new text end
ARTICLE 19
MISCELLANEOUS
Section 1.
Minnesota Statutes 2022, section 16A.055, subdivision 1a, is amended to read:
Subd. 1a.
deleted text begin Additional dutiesdeleted text end new text begin Program evaluation and organizational development
servicesnew text end .
The commissioner may assist state agencies by providing analytical, statistical,
program evaluation using experimental or quasi-experimental design, and organizational
development services to state agencies in order to assist the agency to achieve the agency's
mission and to operate efficiently and effectively. For purposes of this section, "experimental
design" means a method of evaluating the impact of a service that uses random assignment
to assign participants into groups that respectively receive the studied service and those that
receive service as usual, so that any difference in outcomes found at the end of the evaluation
can be attributed to the studied service; and "quasi-experimental design" means a method
of evaluating the impact of a service that uses strategies other than random assignment to
establish statistically similar groups that respectively receive the service and those that
receive service as usual, so that any difference in outcomes found at the end of the evaluation
can be attributed to the studied service.
Sec. 2.
Minnesota Statutes 2022, section 16A.055, is amended by adding a subdivision to
read:
new text begin Subd. 1b. new text end
new text begin Consultation to develop performance measures for grants. new text end
new text begin
(a) The
commissioner must, in consultation with the commissioners of health, human services, and
children, youth, and families, develop an ongoing consultation schedule to create, review,
and revise, as necessary, performance measures, data collection, and program evaluation
plans for all state-funded grants administered by the commissioners of health, human
services, and children, youth, and families that distribute at least $1,000,000 annually.
new text end
new text begin
(b) Following the development of the ongoing consultation schedule under paragraph
(a), the commissioner and the commissioner of the administering agency must conduct a
grant program consultation in accordance with the ongoing consultation schedule. Each
grant program consultation must include a review of performance measures, data collection,
program evaluation plans, and reporting for each grant program. Following each consultation,
the commissioner and the commissioner of the administering agency may revise evaluation
metrics of a grant program. The commissioner may provide continuing support to the grant
program in accordance with subdivision 1a.
new text end
Sec. 3.
new text begin
[137.095] EVIDENCE IN SUPPORT OF APPROPRIATION.
new text end
new text begin Subdivision 1. new text end
new text begin Written report. new text end
new text begin
Prior to the introduction of a bill proposing to appropriate
money to the Board of Regents of the University of Minnesota to benefit the University of
Minnesota's health sciences programs, the proponents of the bill must submit a written
report to the chairs and ranking minority members of the legislative committees with
jurisdiction over higher education and health and human services policy and finance setting
out the information required by this section. The University of Minnesota's health sciences
programs include the schools of medicine, nursing, public health, pharmacy, dentistry, and
veterinary medicine.
new text end
new text begin Subd. 2. new text end
new text begin Contents of report. new text end
new text begin
The report required under this section must include the
following information as specifically as possible:
new text end
new text begin
(1) the dollar amount requested;
new text end
new text begin
(2) how the requested dollar amount was calculated;
new text end
new text begin
(3) the necessity for the appropriation's purpose to be funded by public funds;
new text end
new text begin
(4) a funds flow analysis supporting the necessity analysis required by clause (3);
new text end
new text begin
(5) University of Minnesota budgeting considerations and decisions impacting the
necessity analysis required by clause (3);
new text end
new text begin
(6) all goals, outcomes, and purposes of the appropriation;
new text end
new text begin
(7) performance measures as defined by the University of Minnesota that the University
of Minnesota will utilize to ensure the funds are dedicated to the successful achievement
of the goals, outcomes, and purposes identified in clause (6); and
new text end
new text begin
(8) the extent to which the appropriation advances recruitment from, and training for
and retention of, health professionals from and in greater Minnesota and from underserved
communities in metropolitan areas.
new text end
new text begin Subd. 3. new text end
new text begin Certifications for academic health. new text end
new text begin
A report submitted under this section
must include, in addition to the information listed in subdivision 2, a certification, by the
University of Minnesota Vice President and Budget Director, that:
new text end
new text begin
(1) the appropriation will not be used to cover academic health clinical revenue deficits;
new text end
new text begin
(2) the goals, outcomes, and purposes of the appropriation are aligned with state goals
for population health improvement; and
new text end
new text begin
(3) the appropriation is aligned with the University of Minnesota's strategic plan for its
health sciences programs, including but not limited to shared goals and strategies for the
health professional schools.
new text end
new text begin Subd. 4. new text end
new text begin Right to request. new text end
new text begin
The chair of a standing committee in either house of the
legislature may request and obtain the reports required under this section from the chair of
a legislative committee with jurisdiction over higher education or health and human services
policy and finance.
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. 4.
Minnesota Statutes 2023 Supplement, section 142A.03, is amended by adding a
subdivision to read:
new text begin Subd. 2a. new text end
new text begin Grant consultation. new text end
new text begin
The commissioner must consult with the commissioner
of management and budget to create, review, and revise grant program performance measures
and to evaluate grant programs administered by the commissioner in accordance with section
16A.055, subdivisions 1a and 1b.
new text end
Sec. 5.
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 consultation. new text end
new text begin
The commissioner must consult with the commissioner
of management and budget to create, review, and revise grant program performance measures
and to evaluate grant programs administered by the commissioner in accordance with section
16A.055, subdivisions 1a and 1b.
new text end
Sec. 6.
Minnesota Statutes 2022, section 144.292, subdivision 6, is amended to read:
Subd. 6.
Cost.
(a) When a patient requests a copy of the patient's record for purposes of
reviewing current medical care, the provider must not charge a fee.
(b) When a provider or its representative makes copies of patient records upon a patient's
request under this section, the provider or its representative may charge the patient or the
patient's representative no more than deleted text begin 75 cents per page, plus $10 for time spent retrieving
and copying the records, unless other law or a rule or contract provide for a lower maximum
charge. This limitation does not apply to x-rays. The provider may charge a patient no more
than the actual cost of reproducing x-rays, plus no more than $10 for the time spent retrieving
and copying the x-raysdeleted text end new text begin the following amount, unless other law or a rule or contract provide
for a lower maximum charge:
new text end
new text begin
(1) for paper copies, $1 per page, plus $10 for time spent retrieving and copying the
records;
new text end
new text begin
(2) for x-rays, a total of $30 for retrieving and reproducing x-rays; and
new text end
new text begin (3) for electronic copies, a total of $20 for retrieving the recordsnew text end .
(c) deleted text begin The respective maximum charges of 75 cents per page and $10 for time provided in
this subdivision are in effect for calendar year 1992 and may be adjusted annually each
calendar year as provided in this subdivision. The permissible maximum charges shall
change each year by an amount that reflects the change, as compared to the previous year,
in the Consumer Price Index for all Urban Consumers, Minneapolis-St. Paul (CPI-U),
published by the Department of Labor.deleted text end new text begin For any copies of paper records provided under
paragraph (b), clause (1), a provider or the provider's representative may not charge more
than a total of:
new text end
new text begin
(1) $10 if there are no records available;
new text end
new text begin
(2) $30 for copies of records of up to 25 pages;
new text end
new text begin
(3) $50 for copies of records of up to 100 pages;
new text end
new text begin
(4) $50, plus an additional 20 cents per page for pages 101 and above; or
new text end
new text begin
(5) $500 for any request.
new text end
(d) A provider or its representative may charge deleted text begin thedeleted text end new text begin anew text end $10 retrieval fee, but must not
charge a per page feenew text begin or x-ray feenew text end to provide copies of records requested by a patient or the
patient's authorized representative if the request for copies of records is for purposes of
appealing a denial of Social Security disability income or Social Security disability benefits
under title II or title XVI of the Social Security Actdeleted text begin ; except that no fee shall be charged to
a patient who is receiving public assistance, or to a patient who is represented by an attorney
on behalf of a civil legal services program or a volunteer attorney program based on
indigencydeleted text end . new text begin Notwithstanding the foregoing, a provider or its representative must not charge
a fee, including a retrieval fee, to provide copies of records requested by a patient or the
patient's authorized representative if the request for copies of records is for purposes of
appealing a denial of Social Security disability income or Social Security disability benefits
under title II or title XVI of the Social Security Act when the patient is receiving public
assistance, represented by an attorney on behalf of a civil legal services program, or
represented by a volunteer attorney program based on indigency. The patient or the patient's
representative must submit one of the following to show that they are entitled to receive
records without charge under this paragraph:
new text end
new text begin
(1) a public assistance statement from the county or state administering assistance;
new text end
new text begin
(2) a request for records on the letterhead of the civil legal services program or volunteer
attorney program based on indigency; or
new text end
new text begin
(3) a benefits statement from the Social Security Administration.
new text end
For the purpose of further appeals, a patient may receive no more than two medical record
updates without charge, but only for medical record information previously not provided.
For purposes of this paragraph, a patient's authorized representative does not include units
of state government engaged in the adjudication of Social Security disability claims.
new text begin EFFECTIVE DATE. new text end
new text begin
This section is effective January 1, 2025.
new text end
Sec. 7.
new text begin
[144.2925] CONSTRUCTION.
new text end
new text begin
Sections 144.291 to 144.298 shall be construed to protect the privacy of a patient's health
records in a more stringent manner than provided in Code of Federal Regulations, title 45,
part 164. For purposes of this section, "more stringent" has the meaning given to that term
in Code of Federal Regulations, title 45, section 160.202, with respect to a use or disclosure
or the need for express legal permission from an individual to disclose individually
identifiable health information.
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 144.293, subdivision 2, is amended to read:
Subd. 2.
Patient consent to release of records.
A provider, or a person who receives
health records from a provider, may not release a patient's health records to a person without:
(1) a signed and dated consent from the patient or the patient's legally authorized
representative authorizing the release;
(2) specific authorization in new text begin Minnesota new text end law; or
(3) a representation from a provider that holds a signed and dated consent from the
patient authorizing the release.
new text begin EFFECTIVE DATE. new text end
new text begin
This section is effective the day following final enactment and
applies to health records released on or after that date.
new text end
Sec. 9.
Minnesota Statutes 2022, section 144.293, subdivision 4, is amended to read:
Subd. 4.
Duration of consent.
Except as provided in this section, a consent is valid for
one year or for a period specified in the consent or for a different period provided by
new text begin Minnesota new text end law.
new text begin EFFECTIVE DATE. new text end
new text begin
This section is effective the day following final enactment and
applies to health records released on or after that date.
new text end
Sec. 10.
Minnesota Statutes 2022, section 144.293, subdivision 9, is amended to read:
Subd. 9.
Documentation of release.
(a) In cases where a provider releases health records
without patient consent as authorized by new text begin Minnesota new text end law, the release must be documented
in the patient's health record. In the case of a release under section 144.294, subdivision 2,
the documentation must include the date and circumstances under which the release was
made, the person or agency to whom the release was made, and the records that were released.
(b) When a health record is released using a representation from a provider that holds a
consent from the patient, the releasing provider shall document:
(1) the provider requesting the health records;
(2) the identity of the patient;
(3) the health records requested; and
(4) the date the health records were requested.
new text begin EFFECTIVE DATE. new text end
new text begin
This section is effective the day following final enactment and
applies to health records released on or after that date.
new text end
Sec. 11.
Minnesota Statutes 2022, section 144.293, subdivision 10, is amended to read:
Subd. 10.
Warranties regarding consents, requests, and disclosures.
(a) When
requesting health records using consent, a person warrants that the consent:
(1) contains no information known to the person to be false; and
(2) accurately states the patient's desire to have health records disclosed or that there is
specific authorization in new text begin Minnesota new text end law.
(b) When requesting health records using consent, or a representation of holding a
consent, a provider warrants that the request:
(1) contains no information known to the provider to be false;
(2) accurately states the patient's desire to have health records disclosed or that there is
specific authorization in new text begin Minnesota new text end law; and
(3) does not exceed any limits imposed by the patient in the consent.
(c) When disclosing health records, a person releasing health records warrants that the
person:
(1) has complied with the requirements of this section regarding disclosure of health
records;
(2) knows of no information related to the request that is false; and
(3) has complied with the limits set by the patient in the consent.
new text begin EFFECTIVE DATE. new text end
new text begin
This section is effective the day following final enactment and
applies to health records released on or after that date.
new text end
Sec. 12.
Minnesota Statutes 2022, section 152.22, subdivision 14, is amended to read:
Subd. 14.
Qualifying medical condition.
"Qualifying medical condition" means a
diagnosis of any of the following conditions:
(1) cancer, if the underlying condition or treatment produces one or more of the following:
(i) severe or chronic pain;
(ii) nausea or severe vomiting; or
(iii) cachexia or severe wasting;
(2) glaucoma;
(3) human immunodeficiency virus or acquired immune deficiency syndrome;
(4) Tourette's syndrome;
(5) amyotrophic lateral sclerosis;
(6) seizures, including those characteristic of epilepsy;
(7) severe and persistent muscle spasms, including those characteristic of multiple
sclerosis;
(8) inflammatory bowel disease, including Crohn's disease;
(9) terminal illness, with a probable life expectancy of under one year, if the illness or
its treatment produces one or more of the following:
(i) severe or chronic pain;
(ii) nausea or severe vomiting; or
(iii) cachexia or severe wasting; or
(10) any other medical condition deleted text begin or its treatment approved by the commissionerdeleted text end new text begin that is:
new text end
new text begin
(i) approved by a patient's health care practitioner; or
new text end
new text begin (ii) if the patient is a veteran receiving care from the United States Department of Veterans
Affairs, certified under section 152.27, subdivision 3anew 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 152.27, subdivision 2, is amended to read:
Subd. 2.
Commissioner duties.
(a) The commissioner shall:
(1) give notice of the program to health care practitioners in the state who are eligible
to serve as health care practitioners and explain the purposes and requirements of the
program;
(2) allow each health care practitioner who meets or agrees to meet the program's
requirements and who requests to participate, to be included in the registry program to
collect data for the patient registry;
(3) provide explanatory information and assistance to each health care practitioner in
understanding the nature of therapeutic use of medical cannabis within program requirements;
(4) create and provide a certification to be used by a health care practitioner for the
practitioner to certify whether a patient has been diagnosed with a qualifying medical
condition and include in the certification an option for the practitioner to certify whether
the patient, in the health care practitioner's medical opinion, is developmentally or physically
disabled and, as a result of that disability, the patient requires assistance in administering
medical cannabis or obtaining medical cannabis from a distribution facility;
(5) supervise the participation of the health care practitioner in conducting patient
treatment and health records reporting in a manner that ensures stringent security and
record-keeping requirements and that prevents the unauthorized release of private data on
individuals as defined by section 13.02;
(6) develop safety criteria for patients with a qualifying medical condition as a
requirement of the patient's participation in the program, to prevent the patient from
undertaking any task under the influence of medical cannabis that would constitute negligence
or professional malpractice on the part of the patient; and
(7) conduct research and studies based on data from health records submitted to the
registry program and submit reports on intermediate or final research results to the legislature
and major scientific journals. The commissioner may contract with a third party to complete
the requirements of this clause. Any reports submitted must comply with section 152.28,
subdivision 2.
(b) The commissioner may add a delivery method under section 152.22, subdivision 6,
deleted text begin or add, remove, or modify a qualifying medical condition under section 152.22, subdivision
14,deleted text end upon a petition from a member of the public or the task force on medical cannabis
therapeutic research or as directed by law. deleted text begin The commissioner shall evaluate all petitions to
add a qualifying medical condition or to remove or modify an existing qualifying medical
condition submitted by the task force on medical cannabis therapeutic research or as directed
by law and may make the addition, removal, or modification if the commissioner determines
the addition, removal, or modification is warranted based on the best available evidence
and research.deleted text end If the commissioner wishes to add a delivery method under section 152.22,
subdivision 6, or add or remove a qualifying medical condition under section 152.22,
subdivision 14, the commissioner must notify the chairs and ranking minority members of
the legislative policy committees having jurisdiction over health and public safety of the
addition or removal and the reasons for its addition or removal, including any written
comments received by the commissioner from the public and any guidance received from
the task force on medical cannabis research, by January 15 of the year in which the
commissioner wishes to make the change. The change shall be effective on August 1 of that
year, unless the legislature by law provides otherwise.
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 152.27, is amended by adding a subdivision to
read:
new text begin Subd. 3a. new text end
new text begin Application procedure for veterans. new text end
new text begin
(a) Beginning July 1, 2024, the
commissioner shall establish an alternative certification procedure for veterans to enroll in
the patient registry program.
new text end
new text begin
(b) A patient who is a veteran receiving care from the United States Department of
Veterans Affairs and is seeking to enroll in the registry program must submit a copy of the
patient's veteran health identification card issued by the United States Department of Veterans
Affairs and an application established by the commissioner to confirm that veteran has been
diagnosed with a condition that may benefit from the therapeutic use of medical cannabis.
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.
Minnesota Statutes 2022, section 152.27, subdivision 6, is amended to read:
Subd. 6.
Patient enrollment.
(a) After receipt of a patient's application, application fees,
and signed disclosure, the commissioner shall enroll the patient in the registry program and
issue the patient and patient's registered designated caregiver or parent, legal guardian, or
spouse, if applicable, a registry verification. The commissioner shall approve or deny a
patient's application for participation in the registry program within 30 days after the
commissioner receives the patient's application and application fee. The commissioner may
approve applications up to 60 days after the receipt of a patient's application and application
fees until January 1, 2016. A patient's enrollment in the registry program shall only be
denied if the patient:
(1) does not have certification from a health care practitionernew text begin or, if the patient is a veteran
receiving care from the United States Department of Veterans Affairs, the documentation
required under subdivision 3anew text end that the patient has been diagnosed with a qualifying medical
condition;
(2) has not signed and returned the disclosure form required under subdivision 3,
paragraph (c), to the commissioner;
(3) does not provide the information required;
(4) has previously been removed from the registry program for violations of section
152.30 or 152.33; or
(5) provides false information.
(b) The commissioner shall give written notice to a patient of the reason for denying
enrollment in the registry program.
(c) Denial of enrollment into the registry program is considered a final decision of the
commissioner and is subject to judicial review under the Administrative Procedure Act
pursuant to chapter 14.
(d) A patient's enrollment in the registry program may only be revoked upon the death
of the patient or if a patient violates a requirement under section 152.30 or 152.33.
(e) The commissioner shall develop a registry verification to provide to the patient, the
health care practitioner identified in the patient's application, and to the manufacturer. The
registry verification shall include:
(1) the patient's name and date of birth;
(2) the patient registry number assigned to the patient; and
(3) the name and date of birth of the patient's registered designated caregiver, if any, or
the name of the patient's parent, legal guardian, or spouse if the parent, legal guardian, or
spouse will be acting as a caregiver.
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 245.096, is amended to read:
245.096 CHANGES TO GRANT PROGRAMS.
Prior to implementing any deleted text begin substantialdeleted text end changes to a grant funding formula disbursed
through allocations administered by the commissioner, the commissioner must provide a
report on the nature of the changes, the effect the changes will have, whether any funding
will change, and other relevant information, to the chairs and ranking minority members of
the legislative committees with jurisdiction over human services. The report must be provided
prior to the start of a regular session, and the proposed changes cannot be implemented until
after the adjournment of that regular session.
Sec. 17.
Minnesota Statutes 2023 Supplement, section 245C.31, subdivision 1, is amended
to read:
Subdivision 1.
Board determines disciplinary or corrective action.
new text begin (a)new text end The
commissioner shall notify a health-related licensing board as defined in section 214.01,
subdivision 2, if the commissioner determines that an individual who is licensed by the
health-related licensing board and who is included on the board's roster list provided in
accordance with subdivision 3a is responsible for substantiated maltreatment under section
626.557 or chapter 260E, in accordance with subdivision 2. deleted text begin Upon receiving notificationdeleted text end new text begin
Except as provided in paragraph (b), instead of the commissioner making a decision regarding
disqualification based on maltreatment for any study subject who is regulated by a
health-related licensing boardnew text end , the health-related licensing board shall make a determination
as to whether to impose disciplinary or corrective action under chapter 214.
new text begin
(b) The prohibition on disqualification in paragraph (a) does not apply to a background
study of an individual regulated by a health-related licensing board if the individual's study
is related to child foster care, adult foster care, or family child care licensure.
new text end
Sec. 18.
Minnesota Statutes 2022, section 256.01, is amended by adding a subdivision to
read:
new text begin Subd. 2c. new text end
new text begin Grant consultation. new text end
new text begin
The commissioner must consult with the commissioner
of management and budget to create, review, and revise grant program performance measures
and to evaluate grant programs administered by the commissioner in accordance with section
16A.055, subdivisions 1a and 1b.
new text end
Sec. 19.
Minnesota Statutes 2022, section 256.01, subdivision 41, is amended to read:
Subd. 41.
Reports on interagency agreements and intra-agency transfers.
new text begin (a)
Beginning July 1, 2024, new text end the commissioner of human services shall provide quarterly reports
to the chairs and ranking minority members of the legislative committees with jurisdiction
over health and human services policy and finance on:
(1) interagency agreements or service-level agreements and any renewals or extensions
of existing interagency or service-level agreements with a state department under section
15.01, state agency under section 15.012, or the Department of Information Technology
Services, with a value of more than $100,000, or related agreements with the same department
or agency with a cumulative value of more than $100,000; and
(2) transfers of appropriations of more than $100,000 between accounts within or between
agencies.
The report must include the statutory citation authorizing the agreement, transfer or dollar
amount, purpose, and effective date of the agreement, the duration of the agreement, and a
copy of the agreement.
new text begin
(b) This subdivision expires December 31, 2034.
new text end
Sec. 20.
Minnesota Statutes 2022, section 256B.79, subdivision 6, is amended to read:
Subd. 6.
Report.
new text begin (a) new text end By January 31, deleted text begin 2021deleted text end new text begin 2025new text end , and every two years thereafter, the
commissioner shall report to the chairs and ranking minority members of the legislative
committees with jurisdiction over health and human services policy and finance on the
status and outcomes of the grant program. The report must:
(1) describe the capacity of collaboratives receiving grants under this section;
(2) contain aggregate information about enrollees served within targeted populations;
(3) describe the utilization of enhanced prenatal services;
(4) for enrollees identified with maternal substance use disorders, describe the utilization
of substance use treatment and dispositions of any child protection cases;
(5) contain data on outcomes within targeted populations and compare these outcomes
to outcomes statewide, using standard categories of race and ethnicity; and
(6) include recommendations for continuing the program or sustaining improvements
through other means.
new text begin
(b) This subdivision expires December 31, 2034.
new text end
Sec. 21.
Minnesota Statutes 2022, section 256K.45, subdivision 2, is amended to read:
Subd. 2.
Homeless youth report.
new text begin (a) new text end The commissioner shall prepare a biennial report,
beginning deleted text begin in February 2015deleted text end new text begin January 1, 2025new text end , which provides meaningful information to
the new text begin chairs and ranking minority members of the new text end legislative committees deleted text begin havingdeleted text end new text begin withnew text end
jurisdiction over deleted text begin the issue ofdeleted text end homeless youth, that includes, but is not limited to: (1) a list
of the areas of the state with the greatest need for services and housing for homeless youth,
and the level and nature of the needs identified; (2) details about grants made, including
shelter-linked youth mental health grants under section 256K.46; (3) the distribution of
funds throughout the state based on population need; (4) follow-up information, if available,
on the status of homeless youth and whether they have stable housing two years after services
are provided; and (5) any other outcomes for populations served to determine the
effectiveness of the programs and use of funding.
new text begin
(b) This subdivision expires December 31, 2034.
new text end
Sec. 22.
Minnesota Statutes 2023 Supplement, section 342.01, subdivision 63, is amended
to read:
Subd. 63.
Qualifying medical condition.
"Qualifying medical condition" means a
diagnosis of any of the following conditions:
(1) Alzheimer's disease;
(2) autism spectrum disorder that meets the requirements of the fifth edition of the
Diagnostic and Statistical Manual of Mental Disorders published by the American Psychiatric
Association;
(3) cancer, if the underlying condition or treatment produces one or more of the following:
(i) severe or chronic pain;
(ii) nausea or severe vomiting; or
(iii) cachexia or severe wasting;
(4) chronic motor or vocal tic disorder;
(5) chronic pain;
(6) glaucoma;
(7) human immunodeficiency virus or acquired immune deficiency syndrome;
(8) intractable pain as defined in section 152.125, subdivision 1, paragraph (c);
(9) obstructive sleep apnea;
(10) post-traumatic stress disorder;
(11) Tourette's syndrome;
(12) amyotrophic lateral sclerosis;
(13) seizures, including those characteristic of epilepsy;
(14) severe and persistent muscle spasms, including those characteristic of multiple
sclerosis;
(15) inflammatory bowel disease, including Crohn's disease;
(16) irritable bowel syndrome;
(17) obsessive-compulsive disorder;
(18) sickle cell disease;
(19) terminal illness, with a probable life expectancy of under one year, if the illness or
its treatment produces one or more of the following:
(i) severe or chronic pain;
(ii) nausea or severe vomiting; or
(iii) cachexia or severe wasting; or
(20) any other medical condition deleted text begin or its treatment approved by the officedeleted text end new text begin that is:
new text end
new text begin
(i) approved by a patient's health care practitioner; or
new text end
new text begin (ii) if the patient is a veteran receiving care from the United States Department of Veterans
Affairs, certified under section 342.52, subdivision 3new 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 2023 Supplement, section 342.52, subdivision 3, is amended
to read:
Subd. 3.
Application procedure for veterans.
(a) The deleted text begin Division of Medical Cannabisdeleted text end new text begin
officenew text end shall establish an alternative certification procedure for veterans who receive care
from the United States Department of Veterans Affairs to deleted text begin confirm that the veteran has been
diagnosed with a qualifying medical conditiondeleted text end new text begin enroll in the patient registry programnew text end .
(b) A patient who is deleted text begin alsodeleted text end a veteran new text begin receiving care from the United States Department of
Veterans Affairs new text end and is seeking to enroll in the registry program must submit to the deleted text begin Division
of Medical Cannabisdeleted text end new text begin office a copy of the patient's veteran health identification card issued
by the United States Department of Veterans Affairs andnew text end an application established by the
deleted text begin Division of Medical Cannabis that includes the information identified in subdivision 2,
paragraph (a), and the additional information required by the Division of Medical Cannabis
to certify that the patient has been diagnosed with a qualifying medical conditiondeleted text end new text begin office to
confirm that veteran has been diagnosed with a condition that may benefit from the
therapeutic use of medical cannabisnew text end .
new text begin EFFECTIVE DATE. new text end
new text begin
This section is effective March 1, 2025.
new text end
Sec. 24.
Minnesota Statutes 2023 Supplement, section 342.53, is amended to read:
342.53 DUTIES OF OFFICE OF CANNABIS MANAGEMENT; REGISTRY
PROGRAM.
The office may add an allowable form of medical cannabinoid productdeleted text begin , and may add or
modify a qualifying medical condition upon its own initiative,deleted text end upon a petition from a member
of the public or from the Cannabis Advisory Council or as directed by law. The office must
evaluate all petitions and must make the addition or modification if the office determines
that the addition or modification is warranted by the best available evidence and research.
If the office wishes to add an allowable form or add or modify a qualifying medical condition,
the office must notify the chairs and ranking minority members of the legislative committees
and divisions with jurisdiction over health finance and policy by January 15 of the year in
which the change becomes effective. In this notification, the office must specify the proposed
addition or modification, the reasons for the addition or modification, any written comments
received by the office from the public about the addition or modification, and any guidance
received from the Cannabis Advisory Council. An addition or modification by the office
under this subdivision becomes effective on August 1 of that year unless the legislature by
law provides otherwise.
new text begin EFFECTIVE DATE. new text end
new text begin
This section is effective March 1, 2025.
new text end
Sec. 25.
Laws 2023, chapter 70, article 11, section 13, subdivision 8, is amended to read:
Subd. 8.
Expiration.
This section expires June 30, deleted text begin 2027deleted text end new text begin 2028new text end .
Sec. 26. new text begin ANNUAL REPORT TO LEGISLATURE; USE OF APPROPRIATION
FUNDS.
new text end
new text begin
By December 15, 2025, and every year thereafter, the Board of Regents of the University
of Minnesota must submit a report to the chairs and ranking minority members of the
legislative committees with primary jurisdiction over higher education and health and human
services policy and finance on the use of all appropriations for the benefit of the University
of Minnesota's health sciences programs, including:
new text end
new text begin
(1) material changes to the funds flow analysis required by Minnesota Statutes, section
137.095, subdivision 2, clause (4);
new text end
new text begin
(2) changes to the University of Minnesota's anticipated uses of each appropriation;
new text end
new text begin
(3) the results of the performance measures required by Minnesota Statutes, section
137.095, subdivision 2, clause (7); and
new text end
new text begin
(4) current and anticipated achievement of the goals, outcomes, and purposes of each
appropriation.
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. 27. new text begin DIRECTION TO COMMISSIONER OF HEALTH; HEALTH
PROFESSIONS WORKFORCE ADVISORY COUNCIL.
new text end
new text begin Subdivision 1. new text end
new text begin Health professions workforce advisory council. new text end
new text begin
The commissioner of
health, in consultation with the University of Minnesota and the Minnesota State HealthForce
Center of Excellence, shall provide recommendations to the legislature for the creation of
a health professions workforce advisory council to:
new text end
new text begin
(1) research and advise the legislature and the Minnesota Office of Higher Education
on the status of the health workforce who are in training and on the need for additional or
different training opportunities;
new text end
new text begin
(2) provide information and analysis on health workforce needs and trends, upon request,
to the legislature, any state department, or any other entity the advisory council deems
appropriate;
new text end
new text begin
(3) review and comment on legislation relevant to Minnesota's health workforce; and
new text end
new text begin
(4) study and provide recommendations regarding the following:
new text end
new text begin
(i) health workforce supply, including:
new text end
new text begin
(A) employment trends and demand;
new text end
new text begin
(B) strategies that entities in Minnesota are using or may use to address health workforce
shortages, recruitment, and retention; and
new text end
new text begin
(C) future investments to increase the supply of health care professionals, with particular
focus on critical areas of need within Minnesota;
new text end
new text begin
(ii) options for training and educating the health workforce, including:
new text end
new text begin
(A) increasing the diversity of health professions workers to reflect Minnesota's
communities;
new text end
new text begin
(B) addressing the maldistribution of primary, mental health, nursing, and dental providers
in greater Minnesota and in underserved communities in metropolitan areas;
new text end
new text begin
(C) increasing interprofessional training and clinical practice;
new text end
new text begin
(D) addressing the need for increased quality faculty to train an increased workforce;
and
new text end
new text begin
(E) developing advancement paths or career ladders for health care professionals;
new text end
new text begin
(iii) increasing funding for strategies to diversify and address gaps in the health workforce,
including:
new text end
new text begin
(A) increasing access to financing for graduate medical education;
new text end
new text begin
(B) expanding pathway programs to increase awareness of the health care professions
among high school, undergraduate, and community college students and engaging the current
health workforce in those programs;
new text end
new text begin
(C) reducing or eliminating tuition for entry-level health care positions that offer
opportunities for future advancement in high-demand settings and expanding other existing
financial support programs such as loan forgiveness and scholarship programs;
new text end
new text begin
(D) incentivizing recruitment from greater Minnesota and recruitment and retention for
providers practicing in greater Minnesota and in underserved communities in metropolitan
areas; and
new text end
new text begin
(E) expanding existing programs, or investing in new programs, that provide wraparound
support services to the existing health care workforce, especially people of color and
professionals from other underrepresented identities, to acquire training and advance within
the health care workforce; and
new text end
new text begin
(iv) other Minnesota health workforce priorities as determined by the advisory council.
new text end
new text begin Subd. 2. new text end
new text begin Report to the legislature. new text end
new text begin
On or before February 1, 2025, the commissioner
of health shall submit a report to the chairs and ranking minority members of the legislative
committees with jurisdiction over health and human services and higher education finance
and policy with recommendations for the creation of a health professions workforce advisory
council as described in subdivision 1. The report must include recommendations regarding:
new text end
new text begin
(1) membership of the advisory council;
new text end
new text begin
(2) funding sources and estimated costs for the advisory council;
new text end
new text begin
(3) existing sources of workforce data for the advisory council to perform its duties;
new text end
new text begin
(4) necessity for and options to obtain new data for the advisory council to perform its
duties;
new text end
new text begin
(5) additional duties of the advisory council;
new text end
new text begin
(6) proposed legislation to establish the advisory council;
new text end
new text begin
(7) similar health workforce advisory councils in other states; and
new text end
new text begin
(8) advisory council reporting requirements.
new text end
Sec. 28. new text begin REQUEST FOR INFORMATION; EVALUATION OF STATEWIDE
HEALTH CARE NEEDS AND CAPACITY AND PROJECTIONS OF FUTURE
HEALTH CARE NEEDS.
new text end
new text begin
(a) By November 1, 2024, the commissioner of health must publish a request for
information to assist the commissioner in a future comprehensive evaluation of current
health care needs and capacity in Minnesota and projections of future health care needs in
Minnesota based on population and provider characteristics. The request for information:
new text end
new text begin
(1) must provide guidance on defining the scope of the study and assist in answering
methodological questions that will inform the development of a request for proposals to
contract for performance of the study; and
new text end
new text begin
(2) may address topics that include but are not limited to how to define health care
capacity, expectations for capacity by geography or service type, how to consider health
centers that have areas of particular expertise or services that generally have a higher margin,
how hospital-based services should be considered as compared with evolving
nonhospital-based services, the role of technology in service delivery, health care workforce
supply issues, and other issues related to data or methods.
new text end
new text begin
(b) By February 1, 2025, the commissioner must submit a report to the chairs and ranking
minority members of the legislative committees with jurisdiction over health care, with the
results of the request for information and recommendations regarding conducting a
comprehensive evaluation of current health care needs and capacity in Minnesota and
projections of future health care needs in the state.
new text end
ARTICLE 20
FORECAST ADJUSTMENTS
Section 1. new text begin HUMAN SERVICES FORECAST ADJUSTMENTS.
|
new text begin
The sums shown in the columns marked "Appropriations" are added to or, if shown in
parentheses, subtracted from the appropriations in Laws 2023, chapter 61, article 9, and
Laws 2023, chapter 70, article 20, to the commissioner of human services from the general
fund or other named fund for the purposes specified in section 2 and are available for the
fiscal years indicated for each purpose. The figures "2024" and "2025" used in this article
mean that the addition to or subtraction from the appropriation listed under them is available
for the fiscal year ending June 30, 2024, or June 30, 2025, respectively.
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
137,604,000 new text end |
new text begin
$ new text end |
new text begin
329,432,000 new text end |
||
|
new text begin
Appropriations by Fund new text end |
||
|
new text begin
General Fund new text end |
new text begin
139,746,000 new text end |
new text begin
325,606,000 new text end |
|
new text begin
Health Care Access Fund new text end |
new text begin
10,542,000 new text end |
new text begin
6,224,000 new text end |
|
new text begin
Federal TANF new text end |
new text begin
(12,684,000) new text end |
new text begin
(2,398,000) new text end |
new text begin Subd. 2. new text end
new text begin
Forecasted Programs
|
||||||
|
new text begin
(a) MFIP/DWP new text end |
||||||
|
new text begin
Appropriations by Fund new text end |
||
|
new text begin
General Fund new text end |
new text begin
(5,990,000) new text end |
new text begin
(2,793,000) new text end |
|
new text begin
Federal TANF new text end |
new text begin
(12,684,000) new text end |
new text begin
(2,398,000) new text end |
|
new text begin
(b) MFIP Child Care Assistance new text end |
new text begin
(36,726,000) new text end |
new text begin
(26,004,000) new text end |
||||
|
new text begin
(c) General Assistance new text end |
new text begin
(567,000) new text end |
new text begin
292,000 new text end |
||||
|
new text begin
(d) Minnesota Supplemental Aid new text end |
new text begin
1,424,000 new text end |
new text begin
1,500,000 new text end |
||||
|
new text begin
(e) Housing Support new text end |
new text begin
11,200,000 new text end |
new text begin
14,667,000 new text end |
||||
|
new text begin
(f) Northstar Care for Children new text end |
new text begin
(3,697,000) new text end |
new text begin
(11,309,000) new text end |
||||
|
new text begin
(g) MinnesotaCare new text end |
new text begin
10,542,000 new text end |
new text begin
6,224,000 new text end |
||||
new text begin
These appropriations are from the health care
access fund.
new text end
|
new text begin
(h) Medical Assistance new text end |
new text begin
180,321,000 new text end |
new text begin
352,357,000 new text end |
||||
|
new text begin
(i) Behavioral Health Fund new text end |
new text begin
(6,219,000) new text end |
new text begin
(3,104,000) 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 21
APPROPRIATIONS
Section 1. new text begin HEALTH AND HUMAN SERVICES APPROPRIATIONS.
|
new text begin
The sums shown in the columns marked "Appropriations" are added to or, if shown in
parentheses, subtracted from the appropriations in Laws 2023, chapter 61, article 9; Laws
2023, chapter 70, article 20; and Laws 2023, chapter 74, section 6, to the agencies and for
the purposes specified in this article. The appropriations are from the general fund or other
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 addition to or subtraction from the
appropriation listed under them is available for the fiscal year ending June 30, 2024, or June
30, 2025, respectively. Base adjustments mean the addition to or subtraction from the base
level adjustment set in Laws 2023, chapter 61, article 9; Laws 2023, chapter 70, article 20;
and Laws 2023, chapter 74, section 6. Supplemental appropriations and reductions to
appropriations for the fiscal year ending June 30, 2024, are effective the day following final
enactment unless a different effective date is explicit.
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
(9,587,000) new text end |
new text begin
$ new text end |
new text begin
43,057,000 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
(7,912,000) new text end |
new text begin
41,682,000 new text end |
|
new text begin
Health Care Access new text end |
new text begin
(1,675,000) new text end |
new text begin
1,375,000 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
Central Office; Operations
|
||||||
|
new text begin
Appropriations by Fund new text end |
||
|
new text begin
General new text end |
new text begin
2,369,000 new text end |
new text begin
8,039,000 new text end |
|
new text begin
Health Care Access new text end |
new text begin
-0- new text end |
new text begin
572,000 new text end |
|
new text begin
Federal TANF new text end |
new text begin
(990,000) new text end |
new text begin
(1,094,000) new text end |
new text begin
(a) Social Services Information System
(SSIS). $10,084,000 in fiscal year 2025 is for
information technology improvements to the
SSIS. This is a onetime appropriation.
new text end
new text begin
(b) Extended Availability. $136,000 of the
general fund appropriation in fiscal year 2025
is available until June 30, 2027.
new text end
new text begin
(c) Base Level Adjustment. The general fund
base is increased by $4,569,000 in fiscal year
2026 and $4,511,000 in fiscal year 2027. The
health care access fund base is increased by
$115,000 in fiscal year 2026 and $115,000 in
fiscal year 2027.
new text end
new text begin Subd. 3. 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
2,598,000 new text end |
new text begin
7,665,000 new text end |
|
new text begin
Federal TANF new text end |
new text begin
990,000 new text end |
new text begin
1,094,000 new text end |
new text begin
(a) new text begin Child Protection Advisory Council.new text end
$466,000 in fiscal year 2025 is from the
general fund for the Child Protection Advisory
Council under Minnesota Statutes, section
260E.021. This is a onetime appropriation and
is available through June 30, 2027.
new text end
new text begin
(b) Pregnant and Parenting Homeless
Youth Study. $150,000 in fiscal year 2025 is
from the general fund for a grant to the Wilder
Foundation to study the statewide numbers
and unique needs of pregnant and parenting
youth experiencing homelessness and best
practices in supporting those youth within
programming, emergency shelter, and housing
settings. This is a onetime appropriation and
is available until June 30, 2026.
new text end
new text begin
(c) new text begin Minnesota African American Family
Preservation and Child Welfare
Disproportionality.new text end $1,132,000 in fiscal year
2025 is for the African American Child
Well-Being Unit to hire full-time staff
members. This is a onetime appropriation.
new text end
new text begin
(d) Base Level Adjustment. The general fund
base is increased by $5,208,000 in fiscal year
2026 and $5,208,000 in fiscal year 2027.
new text end
new text begin Subd. 4. 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
(3,216,000) new text end |
new text begin
3,752,000 new text end |
|
new text begin
Health Care Access new text end |
new text begin
(1,675,000) new text end |
new text begin
1,675,000 new text end |
new text begin
Base Level Adjustment. The general fund
base is increased by $154,000 in fiscal year
2026 and $96,000 in fiscal year 2027.
new text end
new text begin Subd. 5. new text end
new text begin
Central Office; Behavioral Health, Deaf
|
new text begin
(136,000) new text end |
new text begin
1,863,000 new text end |
||||
new text begin
new text begin Medical Assistance Mental Health Benefit
Development.new text end $1,727,000 in fiscal year 2025
is to: (1) conduct an analysis to identify
existing or pending Medicaid Clubhouse
benefits in other states, federal authorities
used, populations served, service and
reimbursement design, and accreditation
standards; (2) consult with providers,
advocates, Tribal Nations, counties, people
with lived experience as or with a child
experiencing mental health conditions, and
other interested community members to
develop a medical assistance state plan
covered benefit to provide intensive residential
mental health services for children and youth;
(3) consult with providers, advocates, Tribal
Nations, counties, people with lived
experience as or with a child in a mental health
crisis, and other interested community
members to develop a covered benefit under
medical assistance to provide residential
mental health crisis stabilization for children;
and (4) develop a First Episode Psychosis
Coordinated Specialty Care (FEP-CSC)
medical assistance benefit. This is a onetime
appropriation and is available until June 30,
2027.
new text end
new text begin Subd. 6. new text end
new text begin
Forecasted Programs; MinnesotaCare
|
new text begin
-0- new text end |
new text begin
144,000 new text end |
||||
new text begin
(a) This appropriation is from the health care
access fund.
new text end
new text begin
(b) Base Level Adjustment. The health care
access fund base is increased by $696,000 in
fiscal year 2026 and $1,189,000 in fiscal year
2027.
new text end
new text begin Subd. 7. 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
-0- new text end |
new text begin
7,059,000 new text end |
|
new text begin
Health Care Access new text end |
new text begin
-0- new text end |
new text begin
(1,016,000) new text end |
new text begin
Base Level Adjustment. The health care
access fund base is decreased by $1,111,000
in fiscal year 2026 and $1,604,000 in fiscal
year 2027.
new text end
new text begin Subd. 8. new text end
new text begin
Forecasted Programs; Behavioral
|
new text begin
-0- new text end |
new text begin
127,000 new text end |
||||
new text begin Subd. 9. new text end
new text begin
Grant Programs; Child Care
|
new text begin
-0- new text end |
new text begin
1,000,000 new text end |
||||
new text begin
(a) Professional Development for Child
Care Provider Associate Credential
Coursework. $500,000 in fiscal year 2025 is
for distribution to child care resource and
referral programs to coordinate professional
development opportunities for child care
providers under Minnesota Statutes, section
119B.19, subdivision 7, clause (5), for training
related to obtaining a child development
associate credential. This is a onetime
appropriation and is available through June
30, 2027. Notwithstanding Minnesota Statutes,
section 16B.98, subdivision 14, the amount
for administrative costs under this paragraph
is $0.
new text end
new text begin
(b) Child Care Improvement Grants.
$500,000 in fiscal year 2025 is for the child
care improvement grant program under
Minnesota Statutes, section 119B.25,
subdivision 3, paragraph (a), clause (7). This
is a onetime appropriation. Notwithstanding
Minnesota Statutes, section 16B.98,
subdivision 14, the amount for administrative
costs under this paragraph is $0.
new text end
new text begin Subd. 10. new text end
new text begin
Grant Programs; Children's Services
|
new text begin
-0- new text end |
new text begin
550,000 new text end |
||||
new text begin
Kinship Navigation Grant Program.
$550,000 in fiscal year 2025 is for the kinship
navigator grant program under Minnesota
Statutes, section 256E.40. This is a onetime
appropriation. Notwithstanding Minnesota
Statutes, section 16B.98, subdivision 14, the
amount for administrative costs under this
paragraph is $0.
new text end
new text begin Subd. 11. new text end
new text begin
Grant Programs; Children and
|
new text begin
-0- new text end |
new text begin
(1,704,000) new text end |
||||
new text begin
new text begin Minnesota African American Family
Preservation and Child Welfare
Disproportionality.new text end $1,000,000 in fiscal year
2025 is for the African American and
disproportionately represented family
preservation grant program under Minnesota
Statutes, section 260.693. This is a onetime
appropriation. Notwithstanding Minnesota
Statutes, section 16B.98, subdivision 14, the
amount for administrative costs under this
paragraph is $0.
new text end
new text begin Subd. 12. new text end
new text begin
Grant Programs; Children and
|
new text begin
-0- new text end |
new text begin
6,111,000 new text end |
||||
new text begin
(a) American Indian Food Sovereignty
Funding Program. $1,000,000 in fiscal year
2025 is for the American Indian food
sovereignty funding program under Minnesota
Statutes, section 256E.342. This is a onetime
appropriation and is available until June 30,
2026. Notwithstanding Minnesota Statutes,
section 16B.98, subdivision 14, the amount
for administrative costs under this paragraph
is $0.
new text end
new text begin
(b) Minnesota Food Bank Program.
$4,000,000 in fiscal year 2025 is for the
Minnesota food bank program under
Minnesota Statutes, section 256D.66. This is
a onetime appropriation. Notwithstanding
Minnesota Statutes, section 16B.98,
subdivision 14, the amount for administrative
costs under this paragraph is $0.
new text end
new text begin
(c) new text begin Emergency Services Program.new text end
$1,000,000 in fiscal year 2025 is for
emergency services grants under Minnesota
Statutes, section 256E.36. The commissioner
must distribute grants under this paragraph to
eligible entities to meet emerging, critical, and
immediate homelessness response needs that
have arisen since receiving an emergency
services grant award for fiscal years 2024 and
2025, including: (1) supporting overnight
emergency shelter or daytime service capacity
with a demonstrated and significant increase
in the number of persons served in fiscal year
2024 compared to the prior fiscal year; or (2)
maintaining existing overnight emergency
shelter bed or daytime service capacity with
a demonstrated and significant risk of closure
before April 30, 2025. This is a onetime
appropriation and is available until June 30,
2027. Notwithstanding Minnesota Statutes,
section 16B.98, subdivision 14, the amount
for administrative costs under this paragraph
is $0.
new text end
new text begin
(d) Base Level Adjustment. The general fund
base is decreased by $2,593,000 in fiscal year
2026 and $2,593,000 in fiscal year 2027.
new text end
new text begin Subd. 13. new text end
new text begin
Grant Programs; Fraud Prevention
|
new text begin
-0- new text end |
new text begin
3,018,000 new text end |
||||
new text begin Subd. 14. new text end
new text begin
Grant Programs; Health Care Grants
|
new text begin
-0- new text end |
new text begin
1,500,000 new text end |
||||
new text begin
new text begin Comunidades Latinas Unidas En Servercio
Certified Community Behavioral Health
Clinic Services.new text end $1,500,000 in fiscal year
2025 is for a payment to Comunidades Latinas
Unidas En Servercio (CLUES) to provide
comprehensive integrated health care through
the certified community behavioral health
clinic (CCBHC) model of service delivery as
required under Minnesota Statutes, section
245.735. Funds must be used to provide
evidence-based services under the CCBHC
service model and must not be used to
supplant available medical assistance funding.
By June 30, 2026, CLUES must report to the
commissioner of human services on:
new text end
new text begin
(1) the number of people served;
new text end
new text begin
(2) outcomes for people served; and
new text end
new text begin
(3) whether the funding reduced behavioral
health racial and ethnic disparities.
new text end
new text begin
This is a onetime appropriation and is
available until June 30, 2026. Notwithstanding
Minnesota Statutes, section 16B.98,
subdivision 14, the amount for administrative
costs under this paragraph is $0.
new text end
new text begin Subd. 15. new text end
new text begin
Grant Programs; Adult Mental Health
|
new text begin
(9,527,000) new text end |
new text begin
311,000 new text end |
||||
new text begin
Youable Emotional Health. $311,000 in
fiscal year 2025 is for a grant to Youable
Emotional Health 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. In accordance
with Minnesota Statutes, section 16B.98,
subdivision 14, the commissioner may use
$11,000 of this appropriation for
administrative costs.
new text end
new text begin Subd. 16. new text end
new text begin
Grant Programs; Child Mental Health
|
new text begin
-0- new text end |
new text begin
8,500,000 new text end |
||||
new text begin
(a)
new text end
new text begin
Ramsey County Youth Mental Health
Urgency Room.
new text end
new text begin
$1,500,000 in fiscal year
2025 is for a grant to Ramsey County for the
ongoing operation of the youth mental health
urgency room established in Laws 2022,
chapter 99, article 1, section 44. This is a
onetime appropriation. Notwithstanding
Minnesota Statutes, section 16B.98,
subdivision 14, the amount for administrative
costs under this paragraph is $0.
new text end
new text begin
(b) new text begin School-Linked Behavioral Health
Grants.new text end $3,000,000 in fiscal year 2025 is for
school-linked behavioral health grants under
Minnesota Statutes, section 245.4901. This is
a onetime appropriation. Notwithstanding
Minnesota Statutes, section 16B.98,
subdivision 14, the amount for administrative
costs under this paragraph is $0.
new text end
new text begin
(c)
new text end
new text begin
Early Childhood Mental Health
Consultation Grants.
new text end
new text begin
$1,000,000 in fiscal
year 2025 is for early childhood mental health
consultation grants under Minnesota Statutes,
section 245.4889, subdivision 1, paragraph
(b), clause (15). This is a onetime
appropriation. Notwithstanding Minnesota
Statutes, section 16B.98, subdivision 14, the
amount for administrative costs is $0.
new text end
new text begin
(d) new text begin Respite Care Services.new text end $3,000,000 in
fiscal year 2025 is for respite care services
under Minnesota Statutes, section 245.4889,
subdivision 1, paragraph (b), clause (3). This
is a onetime appropriation and is available
until June 30, 2027. Notwithstanding
Minnesota Statutes, section 16B.98,
subdivision 14, the amount for administrative
costs under this paragraph is $0.
new text end
new text begin Subd. 17. new text end
new text begin
Direct Care and Treatment; Mental
|
new text begin
-0- new text end |
new text begin
(6,109,000) new text end |
||||
new text begin
Base Level Adjustments. The general fund
base is decreased by $7,566,000 in fiscal year
2026 and $7,566,000 in fiscal year 2027.
new text end
new text begin EFFECTIVE DATE. new text end
new text begin
This section is effective the day following final enactment.
new text end
Sec. 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
(541,000) new text end |
new text begin
$ new text end |
new text begin
(469,000) 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
(545,000) new text end |
new text begin
2,267,000 new text end |
|
new text begin
State Government Special Revenue new text end |
new text begin
4,000 new text end |
new text begin
(2,736,000) new text end |
new text begin
The amount that may be spent for each
purpose is specified in the following
subdivision.
new text end
new text begin Subd. 2. new text end
new text begin
Health Improvement
|
new text begin
(545,000) new text end |
new text begin
1,415,000 new text end |
||||
new text begin
(a) new text begin Stillbirth Prevention Grant.new text end $210,000 in
fiscal year 2025 is for a grant to Healthy Birth
Day, Inc., to operate a stillbirth prevention
through tracking fetal movement pilot
program. This is a onetime appropriation and
is available until June 30, 2028. In accordance
with Minnesota Statutes, section 16B.98,
subdivision 14, the commissioner may use
$10,000 of this appropriation for
administrative costs.
new text end
new text begin
(b) new text begin Grant to Minnesota Medical Association
to Address Health Care Worker
Well-Being.new text end $526,000 in fiscal year 2025 is
for a grant to the Minnesota Medical
Association to: (1) create and conduct an
awareness and education campaign focused
on burnout and well-being of health care
workers, designed to reduce the stigma of
receiving mental health services; (2) encourage
health care workers who are experiencing
workplace-related fatigue to receive the care
they need; and (3) normalize the process for
seeking help. The Minnesota Medical
Association's campaign under this paragraph
must be targeted to health care professionals,
including physicians, nurses, and other
members of the health care team, and must
include resources for health care professionals
seeking to address burnout and well-being.
This is a onetime appropriation. In accordance
with Minnesota Statutes, section 16B.98,
subdivision 14, the commissioner may use
$26,000 of this appropriation for
administrative costs.
new text end
new text begin
(c) new text begin Grant to Chosen Vessels Midwifery
Services.new text end $263,000 in fiscal year 2025 is for
a grant to Chosen Vessels Midwifery Services
for a program to provide education, support,
and encouragement for African American
mothers to breastfeed their infants for the first
year of life or longer. Chosen Vessel
Midwifery Services must combine the midwife
model of care with the cultural tradition of
mutual aid to inspire African American
women to breastfeed their infants and to
provide support to those that do. This is a
onetime appropriation and is available until
June 30, 2026. In accordance with Minnesota
Statutes, section 16B.98, subdivision 14, the
commissioner may use $13,000 of this
appropriation for administrative costs.
new text end
new text begin
(d) new text begin American Indian Birth Center Planning
Grant.new text end $368,000 in fiscal year 2025 is for a
grant to the Birth Justice Collaborative to plan
for and engage the community in the
development of an American Indian-focused
birth center to improve access to culturally
centered prenatal and postpartum care with
the goal of improving maternal and child
health outcomes. The Birth Justice
Collaborative must report to the commissioner
on the plan to develop an American
Indian-focused birth center. This is a onetime
appropriation. In accordance with Minnesota
Statutes, section 16B.98, subdivision 14, the
commissioner may use $18,000 of this
appropriation for administrative costs.
new text end
new text begin
(e) new text begin Grant to Birth Justice Collaborative for
African American-Focused Homeplace
Model.new text end $263,000 in fiscal year 2025 is for a
grant to the Birth Justice Collaborative for
planning and community engagement to
develop a replicable African
American-focused Homeplace model. The
model's purpose must be to improve access to
culturally centered healing and care during
pregnancy and the postpartum period, with
the goal of improving maternal and child
health outcomes. The Birth Justice
Collaborative must report to the commissioner
on the needs of and plan to develop an African
American-focused Homeplace model in
Hennepin County. The report must outline
potential state and public partnerships and
financing strategies and must provide a
timeline for development. This is a onetime
appropriation. In accordance with Minnesota
Statutes, section 16B.98, subdivision 14, the
commissioner may use $13,000 of this
appropriation for administrative costs.
new text end
new text begin
(f) Hospital Nursing Loan Forgiveness.
$5,317,000 in fiscal year 2025 is for the
hospital nursing educational loan forgiveness
program under Minnesota Statutes, section
144.1512.
new text end
new text begin
(g)
new text end
new text begin
Base Level Adjustment.
new text end
new text begin
The general fund
base is decreased by $220,000 in fiscal year
2026 and $50,000 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
-0- new text end |
new text begin
852,000 new text end |
|
new text begin
State Government Special Revenue new text end |
new text begin
4,000 new text end |
new text begin
(2,736,000) new text end |
new text begin
(a) Translation of Competency Evaluation
for Nursing Assistant Registry. $20,000
from the general fund in fiscal year 2025 is
for translation of competency evaluation
materials for the nursing assistant registry.
This is a onetime appropriation.
new text end
new text begin
(b) Medication Training Program Review
for Graduates of Foreign Nursing Schools.
$451,000 from the general fund in fiscal year
2025 is for medication training program
review for medication training programs and
graduates of foreign nursing schools. This
appropriation is available until June 30, 2027.
The general fund base for this appropriation
is $49,000 in fiscal year 2026 and $49,000 in
fiscal year 2027.
new text end
new text begin
(c)
new text end
new text begin
Base Level Adjustment.
new text end
new text begin
The general fund
base is increased by $430,000 in fiscal year
2026 and $225,000 in fiscal year 2027. The
state government special revenue fund base is
decreased by $2,791,000 in fiscal year 2026
and $2,860,000 in fiscal year 2027.
new text end
Sec. 4. 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
600,000 new text end |
new text begin
-0- new text end |
|
new text begin
State Government Special Revenue new text end |
new text begin
-0- new text end |
new text begin
49,000 new text end |
new text begin
(a) Legal Costs. $600,000 in fiscal year 2024
is from the general fund for legal costs. This
is a onetime appropriation.
new text end
new text begin
(b) Base Level Adjustment. The state
government special revenue fund base is
increased by $27,000 in fiscal year 2026 and
$27,000 in fiscal year 2027.
new text end
Sec. 5. new text begin RARE DISEASE ADVISORY
|
new text begin
$ new text end |
new text begin
-0- new text end |
new text begin
$ new text end |
new text begin
342,000 new text end |
||
new text begin
This is a onetime appropriation and is
available until June 30, 2027.
new text end
Sec. 6. new text begin COMMISSIONER OF EDUCATION
|
new text begin
$ new text end |
new text begin
1,882,000 new text end |
new text begin
$ new text end |
new text begin
1,715,000 new text end |
||
new text begin
(a) Summer EBT. $1,882,000 in fiscal year
2024 and $1,542,000 in fiscal year 2025 are
for administration of the summer electronic
benefits transfer program under Public Law
117-328. Any unexpended amount in fiscal
year 2024 does not cancel and is available in
fiscal year 2025. The base for this
appropriation is $572,000 in fiscal year 2026
and $572,000 in fiscal year 2027.
new text end
new text begin
(b) Base Level Adjustment. The general fund
base is increased by $917,000 in fiscal year
2026 and $917,000 in fiscal year 2027.
new text end
Sec. 7. new text begin COMMISSIONER OF MANAGEMENT
|
||||||
|
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
-0- new text end |
new text begin
(232,000) new text end |
|
new text begin
Health Care Access new text end |
new text begin
-0- new text end |
new text begin
300,000 new text end |
new text begin
(a) Insulin safety net program. $300,000 in
fiscal year 2025 is from the health care access
fund for the insulin safety net program in
Minnesota Statutes, section 151.74.
new text end
new text begin
(b) Transfer. The commissioner must transfer
from the health care access fund to the insulin
safety net program account in the special
revenue fund the amount certified by the
commissioner of administration under
Minnesota Statutes, section 151.741,
subdivision 5, paragraph (b), estimated to be
$300,000 in fiscal year 2025, for
reimbursement to manufacturers for insulin
dispensed under the insulin safety net program
in Minnesota Statutes, section 151.74. The
base for this transfer is estimated to be
$300,000 in fiscal year 2026 and $300,000 in
fiscal year 2027.
new text end
new text begin
(c) Base Level Adjustment. The health care
access fund base is increased by $300,000 in
fiscal year 2026 and $300,000 in fiscal year
2027.
new text end
Sec. 8. new text begin COMMISSIONER OF CHILDREN,
|
new text begin
$ new text end |
new text begin
-0- new text end |
new text begin
$ new text end |
new text begin
3,279,000 new text end |
||
new text begin
new text begin Base Level Adjustment.new text end The general fund
base is increased by $7,183,000 in fiscal year
2026 and $6,833,000 in fiscal year 2027.
new text end
Sec. 9. new text begin COMMISSIONER OF COMMERCE
|
||||||
new text begin
(a) Defrayal of Costs for Mandated
Coverage of Prosthetic Devices. The general
fund base is increased by $558,000 in fiscal
year 2026 and $539,000 in fiscal year 2027.
The base includes $520,000 in fiscal year 2026
and $540,000 in fiscal year 2027 for defrayal
costs for mandated coverage of prosthetic
devices and $38,000 in fiscal year 2026 and
$19,000 in fiscal year 2027 for administrative
costs to implement mandated coverage of
prosthetic devices.
new text end
new text begin
(b) Defrayal of Costs for Mandated
Coverage of Abortions and
Abortion-Related Services. The general fund
base is increased by $338,000 in fiscal year
2026 and $319,000 in fiscal year 2027. The
base includes $300,000 in fiscal year 2026 and
$300,000 in fiscal year 2027 for defrayal costs
for mandated coverage of abortions and
abortion-related services and $38,000 in fiscal
year 2026 and $19,000 in fiscal year 2027 for
administrative costs to implement mandated
coverage of abortions and abortion-related
services.
new text end
Sec. 10. new text begin OFFICE OF THE OMBUDSPERSON
|
||||||
new text begin
new text begin Child Care and Development Block Grant
Allocation.new text end The commissioner of human
services must allocate $350,000 in fiscal year
2025, and each fiscal year thereafter from the
child care and development block grant to the
Ombudsperson for Family Child Care
Providers under Minnesota Statutes, section
245.975.
new text end
Sec. 11. new text begin CHILD PROTECTION ADVISORY
|
new text begin
$ new text end |
new text begin
-0- new text end |
new text begin
$ new text end |
new text begin
464,000 new text end |
||
new text begin
new text begin Child Protection Advisory Council.new text end
$464,000 in fiscal year 2025 is for the Child
Protection Advisory Council under Minnesota
Statutes, section 260E.021. This is a onetime
appropriation and is available through June
30, 2027.
new text end
Sec. 12. new text begin ATTORNEY GENERAL.
|
new text begin
$ new text end |
new text begin
-0- new text end |
new text begin
$ new text end |
new text begin
73,000 new text end |
||
new text begin
(a) Health Maintenance Organization
Regulatory Requirements. $73,000 in fiscal
year 2025 is for transaction review and related
investigatory and enforcement actions for
filings required under Minnesota Statutes,
section 317A.811, subdivision 1.
new text end
new text begin
(b) Base Level Adjustment. The general fund
base is increased by $73,000 in fiscal year
2026 and $73,000 in fiscal year 2027.
new text end
Sec. 13.
Laws 2023, chapter 22, section 4, subdivision 2, is amended to read:
Subd. 2.
Grants to navigators.
(a) $1,936,000 in fiscal year 2024 is
appropriated from the health care access fund
to the commissioner of human services for
grants to organizations with a MNsure grant
services navigator assister contract in good
standing as of the date of enactment. The grant
payment to each organization must be in
proportion to the number of medical assistance
and MinnesotaCare enrollees each
organization assisted that resulted in a
successful enrollment in the second quarter of
fiscal years 2020 and 2023, as determined by
MNsure's navigator payment process. This is
a onetime appropriation and is available until
June 30, 2025.
(b) $3,000,000 in fiscal year 2024 is
appropriated from the health care access fund
to the commissioner of human services for
grants to organizations with a MNsure grant
services navigator assister contract for
successful enrollments in medical assistance
and MinnesotaCare. This is a onetime
appropriationnew text begin and is available until June 30,
2025new text end .
new text begin EFFECTIVE DATE. new text end
new text begin
This section is effective the day following final enactment.
new text end
Sec. 14.
Laws 2023, chapter 57, article 1, section 6, is amended to read:
Sec. 6. PREMIUM SECURITY ACCOUNT TRANSFER; OUT.
deleted text begin $275,775,000deleted text end new text begin $284,605,000new text end in fiscal year 2026 is transferred from the premium security
plan account under Minnesota Statutes, section 62E.25, subdivision 1, to the general fund.
This is a onetime transfer.
Sec. 15.
Laws 2023, chapter 70, article 20, section 2, subdivision 5, is amended to read:
Subd. 5.Central Office; Health Care
|
||||||
| Appropriations by Fund |
||
| General |
35,807,000 |
31,349,000 |
| Health Care Access |
30,668,000 |
50,168,000 |
(a) Medical assistance and MinnesotaCare
accessibility improvements. deleted text begin $4,000,000deleted text end new text begin
$784,000new text end in fiscal year 2024 deleted text begin isdeleted text end new text begin and $3,216,000
in fiscal year 2025 arenew text end from the general fund
for interactive voice response upgrades and
translation services for medical assistance and
MinnesotaCare enrollees with limited English
proficiency. This appropriation is available
until June 30, deleted text begin 2025deleted text end new text begin 2027new text end .
(b) 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.
(c) Improving the Minnesota eligibility
technology system functionality. $1,604,000
in fiscal year 2024 and $711,000 in fiscal year
2025 are from the general fund for improving
the Minnesota eligibility technology system
functionality. The base for this appropriation
is $1,421,000 in fiscal year 2026 and $0 in
fiscal year 2027.
(d) Actuarial and economic analyses.
deleted text begin $2,500,000deleted text end new text begin $825,000 in fiscal year 2024new text end is
from the health care access fund for actuarial
and economic analyses andnew text begin $1,675,000 in
fiscal year 2025 is from the health care access
fundnew text end to prepare and submit a state innovation
waiver under section 1332 of the federal
Affordable Care Act for a Minnesota public
option health care plannew text begin ; community
engagement; project management; information
technology consultation for eligibility and
enrollment processes; updating the actuarial
and economic analyses completed in 2023;
and consultation to develop strategies for
outreach and communication with populations
ineligible for the existing MinnesotaCare
programnew text end . This is a onetime appropriation and
is available until June 30, deleted text begin 2025deleted text end new text begin 2027new text end .
(e) Contingent appropriation for Minnesota
public option health care plan. $22,000,000
in fiscal year 2025 is from the health care
access fund to implement a Minnesota public
option health care plan. This is a onetime
appropriation and is available upon approval
of a state innovation waiver under section
1332 of the federal Affordable Care Act. This
appropriation is available until deleted text begin June 30deleted text end new text begin
December 31new text end , 2027.
(f) Carryforward authority. Notwithstanding
Minnesota Statutes, section 16A.28,
subdivision 3, $2,367,000 of the appropriation
in fiscal year 2024 is available until June 30,
2027.
(g) Base level adjustment. The general fund
base is $32,315,000 in fiscal year 2026 and
$27,536,000 in fiscal year 2027. The health
care access fund base is $28,168,000 in fiscal
year 2026 and $28,168,000 in fiscal year 2027.
Sec. 16.
Laws 2023, chapter 70, article 20, section 2, subdivision 22, is amended to read:
Subd. 22.Grant Programs; Children's Services
|
||||||
| Appropriations by Fund |
||
| General |
86,212,000 |
85,063,000 |
| Federal TANF |
140,000 |
140,000 |
(a) Title IV-E Adoption Assistance. The
commissioner shall allocate funds from the
state's savings from the Fostering Connections
to Success and Increasing Adoptions Act's
expanded eligibility for Title IV-E adoption
assistance as required in Minnesota Statutes,
section 256N.261, and as allowable under
federal law. Additional savings to the state as
a result of the Fostering Connections to
Success and Increasing Adoptions Act's
expanded eligibility for Title IV-E adoption
assistance is for postadoption, foster care,
adoption, and kinship services, including a
parent-to-parent support network and as
allowable under federal law.
(b) 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.
(c) Leech Lake Band of Ojibwe American
Indian child welfare initiative. $1,848,000
in fiscal year 2024 and $1,848,000 in fiscal
year 2025 are from the general fund for the
Leech Lake Band of Ojibwe to participate in
the American Indian child welfare initiative.
(d) Red Lake Band of Chippewa American
Indian child welfare initiative. $3,000,000
in fiscal year 2024 and $3,000,000 in fiscal
year 2025 are from the general fund for the
Red Lake Band of Chippewa to participate in
the American Indian child welfare initiative.
(e) White Earth Nation American Indian
child welfare initiative. $3,776,000 in fiscal
year 2024 and $3,776,000 in fiscal year 2025
are from the general fund for the White Earth
Nation to participate in the American Indian
child welfare initiative.
(f) Indian Child welfare grants. $4,405,000
in fiscal year 2024 and $4,405,000 in fiscal
year 2025 are from the general fund for Indian
child welfare grants under Minnesota Statutes,
section 260.785. The base for this
appropriation is $4,640,000 in fiscal year 2026
and $4,640,000 in fiscal year 2027.
(g) Child welfare staff allocation for Tribes.
$799,000 in fiscal year 2024 and $799,000 in
fiscal year 2025 are from the general fund for
grants to Tribes for child welfare staffing
under Minnesota Statutes, section 260.786.
(h) 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 under Minnesota Statutes, section
256.4794. The base for this appropriation is
$506,000 in fiscal year 2026 and $507,000 in
fiscal year 2027.
(i) Family first prevention and early
intervention assessment response grants.
$4,000,000 in fiscal year 2024 and $6,112,000
in fiscal year 2025 are from the general fund
for family assessment response grants under
Minnesota Statutes, section 260.014. The base
for this appropriation is $6,000,000 in fiscal
year 2026 and $6,000,000 in fiscal year 2027.
(j) Grants for evidence-based prevention
and early intervention services. $4,329,000
in fiscal year 2024 and $4,100,000 in fiscal
year 2025 are from the general fund for grants
to support evidence-based prevention and early
intervention services under Minnesota
Statutes, section 256.4793.
(k) Grant to administer pool of qualified
individuals for assessments. $250,000 in
fiscal year 2024 and $250,000 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.
(l) 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.
(m) STAY in the community grants.
$1,579,000 in fiscal year 2024 and $2,247,000
in fiscal year 2025 are from the general fund
for the STAY in the community program
under Minnesota Statutes, section 260C.452.
This is a onetime appropriation and is
available until June 30, 2027.
(n) Grants for community resource centers.
$5,657,000 in fiscal year 2024 is from the
general fund for grants to establish a network
of community resource centers. This is a
onetime appropriation and is available until
June 30, 2027.
deleted text begin
(o) Family assets for independence in
Minnesota. $1,405,000 in fiscal year 2024
and $1,391,000 in fiscal year 2025 are from
the general fund for the family assets for
independence in Minnesota program, under
Minnesota Statutes, section 256E.35. This is
a onetime appropriation and is available until
June 30, 2027.
deleted text end
deleted text begin (p)deleted text end new text begin (o)new text end Base level adjustment. The general
fund base is $85,280,000 in fiscal year 2026
and $85,281,000 in fiscal year 2027.
Sec. 17.
Laws 2023, chapter 70, article 20, section 2, subdivision 24, is amended to read:
Subd. 24.Grant Programs; Children and
|
212,877,000 |
78,333,000 |
||||
(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.
(b) American Indian food sovereignty
funding program. $3,000,000 in fiscal year
2024 and $3,000,000 in fiscal year 2025 are
for Minnesota Statutes, section 256E.342. This
appropriation is available until June 30, 2025.
The base for this appropriation is $2,000,000
in fiscal year 2026 and $2,000,000 in fiscal
year 2027.
(c) Hennepin County grants to provide
services to people experiencing
homelessness. $11,432,000 in fiscal year 2024
is for grants to maintain capacity for shelters
and services provided to persons experiencing
homelessness in Hennepin County. Of this
amount:
(1) $4,500,000 is for a grant to Avivo Village;
(2) $2,000,000 is for a grant to the American
Indian Community Development Corporation
Homeward Bound shelter;
(3) $1,650,000 is for a grant to the Salvation
Army Harbor Lights shelter;
(4) $500,000 is for a grant to Agate Housing
and Services;
(5) $1,400,000 is for a grant to Catholic
Charities of St. Paul and Minneapolis;
(6) $450,000 is for a grant to Simpson
Housing; and
(7) $932,000 is for a grant to Hennepin
County.
Nothing shall preclude an eligible organization
receiving funding under this paragraph from
applying for and receiving funding under
Minnesota Statutes, section 256E.33, 256E.36,
256K.45, or 256K.47, nor does receiving
funding under this paragraph count against
any eligible organization in the competitive
processes related to those grant programs
under Minnesota Statutes, section 256E.33,
256E.36, 256K.45, or 256K.47.
(d) Diaper distribution grant program.
$545,000 in fiscal year 2024 and $553,000 in
fiscal year 2025 are for a grant to the Diaper
Bank of Minnesota under Minnesota Statutes,
section 256E.38.
(e) Prepared meals food relief. $1,654,000
in fiscal year 2024 and $1,638,000 in fiscal
year 2025 are for prepared meals food relief
grants. This is a onetime appropriation.
(f) Emergency shelter facilities. $98,456,000
in fiscal year 2024 is for grants to eligible
applicants for emergency shelter facilities.
This is a onetime appropriation and is
available until June 30, 2028.
(g) Homeless youth cash stipend pilot
project. $5,302,000 in fiscal year 2024 is 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. This is a onetime
appropriation and is available until June 30,
2028.
(h) Heading Home Ramsey County
continuum of care grants. $11,432,000 in
fiscal year 2024 is for grants to maintain
capacity for shelters and services provided to
people experiencing homelessness in Ramsey
County. Of this amount:
(1) $2,286,000 is for a grant to Catholic
Charities of St. Paul and Minneapolis;
(2) $1,498,000 is for a grant to More Doors;
(3) $1,734,000 is for a grant to Interfaith
Action Project Home;
(4) $2,248,000 is for a grant to Ramsey
County;
(5) $689,000 is for a grant to Radias Health;
(6) $493,000 is for a grant to The Listening
House;
(7) $512,000 is for a grant to Face to Face;
and
(8) $1,972,000 is for a grant to the city of St.
Paul.
Nothing shall preclude an eligible organization
receiving funding under this paragraph from
applying for and receiving funding under
Minnesota Statutes, section 256E.33, 256E.36,
256K.45, or 256K.47, nor does receiving
funding under this paragraph count against
any eligible organization in the competitive
processes related to those grant programs
under Minnesota Statutes, section 256E.33,
256E.36, 256K.45, or 256K.47.
(i) Capital for emergency food distribution
facilities. $7,000,000 in fiscal year 2024 is for
improving and expanding the infrastructure
of food shelf facilities. Grant money must be
made available to nonprofit organizations,
federally recognized Tribes, and local units of
government. This is a onetime appropriation
and is available until June 30, 2027.
(j) Emergency services program grants.
$15,250,000 in fiscal year 2024 and
$14,750,000 in fiscal year 2025 are for
emergency services grants under Minnesota
Statutes, section 256E.36. Any unexpended
amount in the first year does not cancel and
is available in the second year. The base for
this appropriation is $25,000,000 in fiscal year
2026 and $30,000,000 in fiscal year 2027.
(k) Homeless Youth Act grants. $15,136,000
in fiscal year 2024 and $15,136,000 in fiscal
year 2025 are for grants under Minnesota
Statutes, section 256K.45, subdivision 1. Any
unexpended amount in the first year does not
cancel and is available in the second year.
(l) Transitional housing programs.
$3,000,000 in fiscal year 2024 and $3,000,000
in fiscal year 2025 are for transitional housing
programs under Minnesota Statutes, section
256E.33. Any unexpended amount in the first
year does not cancel and is available in the
second year.
(m) Safe harbor shelter and housing grants.
$2,125,000 in fiscal year 2024 and $2,125,000
in fiscal year 2025 are for grants under
Minnesota Statutes, section 256K.47. Any
unexpended amount in the first year does not
cancel and is available in the second year. The
base for this appropriation is $1,250,000 in
fiscal year 2026 and $1,250,000 in fiscal year
2027.
(n) Supplemental nutrition assistance
program (SNAP) outreach. $1,000,000 in
fiscal year 2024 and $1,000,000 in fiscal year
2025 are for the SNAP outreach program
under Minnesota Statutes, section 256D.65.
The base for this appropriation is $500,000 in
fiscal year 2026 and $500,000 in fiscal year
2027.
new text begin
(o) Family Assets for Independence in
Minnesota. $1,405,000 in fiscal year 2024
and $1,391,000 in fiscal year 2025 are from
the general fund for the family assets for
independence in Minnesota program, under
Minnesota Statutes, section 256E.35. This is
a onetime appropriation and is available until
June 30, 2027.
new text end
new text begin
(p) Minnesota Food Assistance Program.
Unexpended funds for the Minnesota food
assistance program for fiscal year 2024 are
available until June 30, 2025.
new text end
deleted text begin (o)deleted text end new text begin (q)new text end Base level adjustment. The general
fund base is $83,179,000 in fiscal year 2026
and $88,179,000 in fiscal year 2027.
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.
Laws 2023, chapter 70, article 20, section 2, subdivision 29, is amended to read:
Subd. 29.Grant Programs; Adult Mental Health
|
132,327,000 |
121,270,000 |
||||
(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 deleted text begin sectiondeleted text end new text begin , sectionsnew text end
245.4661, subdivision 9, paragraph (b), clause
(15),new text begin and 245.4889, subdivision 1, paragraph
(b), clause (4),new text end to Tribal Nations.
(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.
(c) 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 and is available until
June 30, 2027.
(d) White Earth Nation; adult mental health
initiative. $300,000 in fiscal year 2024 and
$300,000 in fiscal year 2025 are for adult
mental health initiative grants to the White
Earth Nation. This is a onetime appropriation.
(e) Mobile crisis grants. $8,472,000 in fiscal
year 2024 and $8,380,000 in fiscal year 2025
are for the mobile crisis grants under
Minnesota Statutes, deleted text begin sectiondeleted text end new text begin sectionsnew text end 245.4661,
subdivision 9, paragraph (b), clause (15)new text begin , and
245.4889, subdivision 1, paragraph (b), clause
(4)new text end . This is a onetime appropriation and is
available until June 30, 2027.
(f) Base level adjustment. The general fund
base is $121,980,000 in fiscal year 2026 and
$121,980,000 in fiscal year 2027.
Sec. 19.
Laws 2023, chapter 70, article 20, section 2, subdivision 31, as amended by Laws
2023, chapter 75, section 12, is amended to read:
Subd. 31.Direct Care and Treatment - Mental
|
-0- |
6,109,000 |
||||
deleted text begin
(a) Keeping Nurses at the Bedside Act;
contingent appropriation. The appropriation
in this subdivision is contingent upon
legislative enactment by the 93rd Legislature
of provisions substantially similar to 2023 S.F.
No. 1561, the second engrossment, article 2.
deleted text end
deleted text begin (b)deleted text end Base level adjustment. The general fund
base is increased by $7,566,000 in fiscal year
2026 and increased by $7,566,000 in fiscal
year 2027.
Sec. 20.
Laws 2023, chapter 70, article 20, section 3, subdivision 2, is amended to read:
Subd. 2.Health Improvement
|
||||||
| Appropriations by Fund |
||
| General |
229,600,000 |
210,030,000 |
| State Government Special Revenue |
12,392,000 |
12,682,000 |
| Health Care Access |
49,051,000 |
53,290,000 |
| Federal TANF |
11,713,000 |
11,713,000 |
(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.
(b) Advancing equity through capacity
building and resource allocation grant
program. $916,000 in fiscal year 2024 and
$916,000 in fiscal year 2025 are from the
general fund for grants under Minnesota
Statutes, section 144.9821. This is a onetime
appropriation.
(c) Grant to Minnesota Community Health
Worker Alliance. $971,000 in fiscal year
2024 and $971,000 in fiscal year 2025 are
from the general fund for Minnesota Statutes,
section 144.1462.
(d) Community solutions for healthy child
development grants. $2,730,000 in fiscal year
2024 and $2,730,000 in fiscal year 2025 are
from the general fund for grants under
Minnesota Statutes, section 145.9257. The
base for this appropriation is $2,415,000 in
fiscal year 2026 and $2,415,000 in fiscal year
2027.
(e) Comprehensive Overdose and Morbidity
Prevention Act. $9,794,000 in fiscal year
2024 and $10,458,000 in fiscal year 2025 are
from the general fund for comprehensive
overdose and morbidity prevention strategies
under Minnesota Statutes, section 144.0528.
The base for this appropriation is $10,476,000
in fiscal year 2026 and $10,476,000 in fiscal
year 2027.
(f) Emergency preparedness and response.
$10,486,000 in fiscal year 2024 and
$14,314,000 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. The base for
this appropriation is $11,438,000 in fiscal year
2026 and $11,362,000 in fiscal year 2027.
(g) Healthy Beginnings, Healthy Families.
(1) $8,440,000 in fiscal year 2024 and
$7,305,000 in fiscal year 2025 are from the
general fund for grants under Minnesota
Statutes, sections 145.9571 to 145.9576. The
base for this appropriation is $1,500,000 in
fiscal year 2026 and $1,500,000 in fiscal year
2027. (2) Of the amount in clause (1),
$400,000 in fiscal year 2024 is to support the
transition from implementation of activities
under Minnesota Statutes, section 145.4235,
to implementation of activities under
Minnesota Statutes, sections 145.9571 to
145.9576. The commissioner shall award four
sole-source grants of $100,000 each to Face
to Face, Cradle of Hope, Division of Indian
Work, and Minnesota Prison Doula Project.
The amount in this clause is a onetime
appropriation.
(h) 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.
(i) Home visiting. $2,000,000 in fiscal year
2024 and $2,000,000 in fiscal year 2025 are
from the general fund for home visiting under
Minnesota Statutes, section 145.87, to provide
home visiting to priority populations under
Minnesota Statutes, section 145.87,
subdivision 1, paragraph (e).
(j) 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 an assessment of the feasibility
of 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.
(k) 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.
(l) 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.
(m) 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).
(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 2b.
(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.
(n) Health care workforce. (1) $1,010,000
in fiscal year 2024 and $2,550,000 in fiscal
year 2025 are from the health care access fund
for rural training tracks and rural clinicals
grants under Minnesota Statutes, sections
144.1505 and 144.1507. The base for this
appropriation is $4,060,000 in fiscal year 2026
and $3,600,000 in fiscal year 2027.
(2) $420,000 in fiscal year 2024 and $420,000
in fiscal year 2025 are from the health care
access fund for immigrant international
medical graduate training grants under
Minnesota Statutes, section 144.1911.
(3) $5,654,000 in fiscal year 2024 and
$5,550,000 in fiscal year 2025 are from the
health care access fund for site-based clinical
training grants under Minnesota Statutes,
section 144.1508. The base for this
appropriation is $4,657,000 in fiscal year 2026
and $3,451,000 in fiscal year 2027.
(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 for
health care professional grants. This is a
onetime appropriation and is available until
June 30, 2027.
(5) $502,000 in fiscal year 2024 and $502,000
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.
(o) School health. $800,000 in fiscal year
2024 and $1,300,000 in fiscal year 2025 are
from the general fund for grants under
Minnesota Statutes, section 145.903. The base
for this appropriation is $2,300,000 in fiscal
year 2026 and $2,300,000 in fiscal year 2027.
(p) 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.
(q) Workplace safety grants. $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,
2027. The commissioner may use up to ten
percent of this appropriation for
administration.
(r) 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.
(s) 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.
(t) Center for health care affordability.
$2,752,000 in fiscal year 2024 and $3,989,000
in fiscal year 2025 are from the general fund
to establish a center for health care
affordability and to implement Minnesota
Statutes, section 62J.312. The general fund
base for this appropriation is $3,988,000 in
fiscal year 2026 and $3,988,000 in fiscal year
2027.
(u) Federally qualified health centers
apprenticeship program. $690,000 in fiscal
year 2024 and $690,000 in fiscal year 2025
are from the general fund for grants under
Minnesota Statutes, section 145.9272.
(v) 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.
(w) deleted text begin Keeping Nurses at the Bedside Act;
contingent appropriationdeleted text end new text begin Nurse and Patient
Safety Actnew text end . deleted text begin The appropriations in this
paragraph are contingent upon legislative
enactment of 2023 Senate File 1384 by the
93rd Legislature.deleted text end The appropriations in this
paragraph are available until June 30, 2027.
(1) $5,317,000 in fiscal year 2024 deleted text begin and
$5,317,000 in fiscal year 2025 aredeleted text end new text begin isnew text end from the
general fund for loan forgiveness under
Minnesota Statutes, section 144.1501, for
eligible nurses who have agreed to work as
hospital nurses in accordance with Minnesota
Statutes, section 144.1501, subdivision 2,
paragraph (a), clause (7).
(2) $66,000 in fiscal year 2024 and $66,000
in fiscal year 2025 are from the general fund
for loan forgiveness under Minnesota Statutes,
section 144.1501, for eligible nurses who have
agreed to teach in accordance with Minnesota
Statutes, section 144.1501, subdivision 2,
paragraph (a), clause (3).
deleted text begin
(3) $545,000 in fiscal year 2024 and $879,000
in fiscal year 2025 are from the general fund
to administer Minnesota Statutes, section
144.7057; to perform the evaluation duties
described in Minnesota Statutes, section
144.7058; to continue prevention of violence
in health care program activities; to analyze
potential links between adverse events and
understaffing; to convene stakeholder groups
and create a best practices toolkit; and for a
report on the current status of the state's
nursing workforce employed by hospitals. The
base for this appropriation is $624,000 in fiscal
year 2026 and $454,000 in fiscal year 2027.
deleted text end
(x) Supporting healthy development of
babies. $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 the African American
Babies Coalition initiative. The base for this
appropriation is $520,000 in fiscal year 2026
and $0 in fiscal year 2027. Any appropriation
in fiscal year 2026 is available until June 30,
2027. This paragraph expires on June 30,
2027.
(y) Health professional education loan
forgiveness. $2,780,000 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. The commissioner
may use up to ten percent of this appropriation
for administration.
(z) Primary care residency expansion grant
program. $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.
(aa) Pediatric primary care mental health
training grant program. $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 144.1509. The
commissioner may use up to ten percent of
this appropriation for administration.
(bb) Mental health cultural community
continuing education 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
144.1511. The commissioner may use up to
ten percent of this appropriation for
administration.
(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.
(dd) Palliative Care Advisory Council.
deleted text begin $40,000deleted text end new text begin $44,000new text end in fiscal year 2024 and
deleted text begin $40,000deleted text end new text begin $44,000new text end in fiscal year 2025 are from
the general fund for deleted text begin grants underdeleted text end Minnesota
Statutes, section 144.059.
(ee) Analysis of a universal health care
financing system. $1,815,000 in fiscal year
2024 and $580,000 in fiscal year 2025 are
from the general fund to the commissioner to
contract for 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. The base for this appropriation is
$580,000 in fiscal year 2026 and $0 in fiscal
year 2027. This appropriation is available until
June 30, 2027.
(ff) Charitable assets public interest review.
(1) The appropriations under this paragraph
are contingent upon legislative enactment of
2023 House File 402 by the 93rd Legislature.
(2) $1,584,000 in fiscal year 2024 and
$769,000 in fiscal year 2025 are from the
general fund to review certain health care
entity transactions; to conduct analyses of the
impacts of health care transactions on health
care cost, quality, and competition; and to
issue public reports on health care transactions
in Minnesota and their impacts. The base for
this appropriation is $710,000 in fiscal year
2026 and $710,000 in fiscal year 2027.
(gg) Study of the development of a statewide
registry for provider orders for
life-sustaining treatment. $365,000 in fiscal
year 2024 deleted text begin and $365,000 in fiscal year 2025
aredeleted text end new text begin isnew text end 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.
(hh) Task Force on Pregnancy Health and
Substance Use Disorders. $199,000 in fiscal
year 2024 and $100,000 in fiscal year 2025
are from the general fund for the Task Force
on Pregnancy Health and Substance Use
Disorders. This is a onetime appropriation and
is available until June 30, 2025.
(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.
(jj) 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.
(kk) Psychedelic Medicine Task Force.
$338,000 in fiscal year 2024 and $171,000 in
fiscal year 2025 are from the general fund for
the Psychedelic Medicine Task Force. This is
a onetime appropriation.
(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.
(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 to offer
programming and culturally specific and
specialized assistance to support the health
and well-being of Special Guerilla Unit
Veterans. The base for this appropriation is
$500,000 in fiscal year 2026 and $0 in fiscal
year 2027. Any amount appropriated in fiscal
year 2026 is available until June 30, 2027.
This paragraph expires June 30, 2027.
(nn) Safe harbor regional navigator.
$300,000 in fiscal year 2024 and $300,000 in
fiscal year 2025 are for a regional navigator
in northwestern Minnesota. The commissioner
may use up to ten percent of this appropriation
for administration.
(oo) Network adequacy. $798,000 in fiscal
year 2024 and $491,000 in fiscal year 2025
are from the general fund for reviews of
provider networks under Minnesota Statutes,
section 62K.10, to determine network
adequacy.
new text begin
(pp) Grant to Minnesota Alliance for
Volunteer Advancement. $278,000 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. Subgrants must be used to
support the ongoing efforts of selected
organizations 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
deleted text begin (pp)deleted text end new text begin (qq)new text end (1) TANF Appropriations. TANF
funds must be used as follows:
(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;
(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;
(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;
(iv) $1,156,000 in fiscal year 2024 and
$1,156,000 in fiscal year 2025 are from the
TANF fund for sexual and reproductive health
services grants under Minnesota Statutes,
section 145.925; and
(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.
(2) TANF Carryforward. Any unexpended
balance of the TANF appropriation in the first
year does not cancel but is available in the
second year.
deleted text begin (qq)deleted text end new text begin (rr)new text end Base level adjustments. The general
fund base is $197,644,000 in fiscal year 2026
and $195,714,000 in fiscal year 2027. The
health care access fund base is $53,354,000
in fiscal year 2026 and $50,962,000 in fiscal
year 2027.
Sec. 21.
Laws 2023, chapter 70, article 20, section 12, as amended by Laws 2023, chapter
75, section 13, is amended to read:
Sec. 12. COMMISSIONER OF
|
$ |
12,932,000 |
$ |
3,412,000 |
||
(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.
(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.
deleted text begin
(c) Keeping Nurses at the Bedside Act
impact evaluation; contingent
appropriation. $232,000 in fiscal year 2025
is for the Keeping Nurses at the Bedside Act
impact evaluation. This appropriation is
contingent upon legislative enactment by the
93rd Legislature of a provision substantially
similar to the impact evaluation provision in
2023 S.F. No. 2995, the third engrossment,
article 3, section 22. This is a onetime
appropriation and is available until June 30,
2029.
deleted text end
deleted text begin (d)deleted text end new text begin (c)new text end Health care subcabinet. $551,000 in
fiscal year 2024 and $664,000 in fiscal year
2025 are to hire an executive director for the
health care subcabinet and to provide staffing
and administrative support for the health care
subcabinet.
deleted text begin (e)deleted text end new text begin (d)new text end Base level adjustment. The general
fund base is $1,114,000 in fiscal year 2026
and $1,114,000 in fiscal year 2027.
Sec. 22.
Laws 2023, chapter 70, article 20, section 23, is amended to read:
Sec. 23. TRANSFERS.
Subdivision 1.
Grants.
The commissioner of human servicesnew text begin and commissioner of
children, youth, and familiesnew text end , 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 MFIP; general assistance; medical assistance;
MinnesotaCare; MFIP child care assistance under Minnesota Statutes, section 119B.05;
Minnesota supplemental aid program; housing support 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 report to the chairs and ranking minority members of the legislative committees with
jurisdiction over health and human services quarterly about transfers made under this
subdivision.
Subd. 2.
Administration.
Positions, salary money, and nonsalary administrative money
may be transferred withinnew text begin and betweennew text end the Department of Human Servicesnew text begin and the
Department of Children, Youth, and Familiesnew text end as the commissioners consider necessary,
with the advance approval of the commissioner of management and budget. The
commissioners shall report to 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.
Sec. 23. 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 the commissioner is responsible.
new text end
Sec. 24. 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
APPENDIX
Repealed Minnesota Statutes: S4699-1
62A.041 MATERNITY BENEFITS.
Subd. 3.
Abortion.
For the purposes of this section, the term "maternity benefits" shall not include elective, induced abortion whether performed in a hospital, other abortion facility, or the office of a physician.
This section applies to policies and contracts issued, delivered, or renewed after August 1, 1985, that cover Minnesota residents.
62J.312 CENTER FOR HEALTH CARE AFFORDABILITY.
Subd. 6.
340B covered entity report.
(a) Beginning April 1, 2024, each 340B covered entity, as defined by section 340B(a)(4) of the Public Health Service Act, must report to the commissioner of health by April 1 of each year the following information related to its participation in the federal 340B program for the previous calendar year:
(1) the National Provider Identification (NPI) number;
(2) the name of the 340B covered entity;
(3) the servicing address of the 340B covered entity;
(4) the classification of the 340B covered entity;
(5) the aggregated acquisition cost for prescription drugs obtained under the 340B program;
(6) the aggregated payment amount received for drugs obtained under the 340B program and dispensed to patients;
(7) the aggregated payment made to pharmacies under contract to dispense drugs obtained under the 340B program; and
(8) the number of claims for prescription drugs described in clause (6).
(b) The information required under paragraph (a) must be reported by payer type, including commercial insurance, medical assistance and MinnesotaCare, and Medicare, in the form and manner defined by the commissioner. For covered entities that are hospitals, the information required under paragraph (a), clauses (5) to (8), must also be reported at the national drug code level for the 50 most frequently dispensed drugs by the facility under the 340B program.
(c) Data submitted under paragraph (a) must include prescription drugs dispensed by outpatient facilities that are identified as child facilities under the federal 340B program based on their inclusion on the hospital's Medicare cost report.
(d) Data submitted to the commissioner under paragraph (a) must be classified as nonpublic data as defined in section 13.02, subdivision 9.
(e) Beginning November 15, 2024, and by November 15 of each year thereafter, the commissioner shall prepare a report that aggregates the data submitted under paragraph (a). The commissioner shall submit this report to the chairs and ranking minority members of the legislative committees with jurisdiction over health care finance and policy.
62Q.522 COVERAGE OF CONTRACEPTIVE METHODS AND SERVICES.
Subd. 3.
Exemption.
(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:
(1) an employee enrolls in the health plan; or
(2) the effective date of the health plan, whichever occurs first.
(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.
Subd. 4.
Accommodation for eligible organizations.
(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.
(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.
(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:
(1) an employee enrolls in the health plan; or
(2) the effective date of the health plan, whichever occurs first.
(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:
(1) expressly exclude coverage for those contraceptive methods or services identified in the notice under paragraph (a) from the health plan; and
(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.
(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.
(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.
144.0528 COMPREHENSIVE DRUG OVERDOSE AND MORBIDITY PREVENTION ACT.
Subd. 5.
Promotion; administration.
In fiscal years 2026 and beyond, the commissioner may spend up to 25 percent of the total funding appropriated for the comprehensive drug overdose and morbidity program in each fiscal year to promote, administer, support, and evaluate the programs authorized under this section and to provide technical assistance to program grantees.
144.218 REPLACEMENT BIRTH RECORDS.
Subd. 3.
Subsequent marriage of birth parents.
If, in cases in which a record of birth has been registered pursuant to section 144.215 and the birth parents of the child marry after the birth of the child, a replacement record of birth shall be registered upon presentation of a certified copy of the marriage certificate of the birth parents, and either a recognition of parentage or court adjudication of paternity. The original record of birth is confidential, pursuant to section 13.02, subdivision 3, and shall not be disclosed except pursuant to court order.
144.497 ST ELEVATION MYOCARDIAL INFARCTION.
The commissioner of health shall assess and report on the quality of care provided in the state for ST elevation myocardial infarction response and treatment. The commissioner shall:
(1) utilize and analyze data provided by ST elevation myocardial infarction receiving centers to the ACTION Registry-Get with the guidelines or an equivalent data platform that does not identify individuals or associate specific ST elevation myocardial infarction heart attack events with an identifiable individual;
(2) annually post a summary report of the data in aggregate form on the Department of Health website; and
(3) coordinate to the extent possible with national voluntary health organizations involved in ST elevation myocardial infarction heart attack quality improvement to encourage ST elevation myocardial infarction receiving centers to report data consistent with nationally recognized guidelines on the treatment of individuals with confirmed ST elevation myocardial infarction heart attacks within the state and encourage sharing of information among health care providers on ways to improve the quality of care of ST elevation myocardial infarction patients in Minnesota.
144E.001 DEFINITIONS.
Subd. 5.
Board.
"Board" means the Emergency Medical Services Regulatory Board.
144E.01 EMERGENCY MEDICAL SERVICES REGULATORY BOARD.
Subdivision 1.
Membership.
(a) The Emergency Medical Services Regulatory Board consists of the following members, all of whom must work in Minnesota, except for the person listed in clause (14):
(1) an emergency physician certified by the American Board of Emergency Physicians;
(2) a representative of Minnesota hospitals;
(3) a representative of fire chiefs;
(4) a full-time firefighter who serves as an emergency medical responder on or within a nontransporting or nonregistered agency and who is a member of a professional firefighter's union;
(5) a volunteer firefighter who serves as an emergency medical responder on or within a nontransporting or nonregistered agency;
(6) an attendant currently practicing on a licensed ambulance service who is a paramedic or an emergency medical technician;
(7) an ambulance director for a licensed ambulance service;
(8) a representative of sheriffs;
(9) a member of a community health board to represent community health services;
(10) two representatives of regional emergency medical services programs, one of whom must be from the metropolitan regional emergency medical services program;
(11) a registered nurse currently practicing in a hospital emergency department;
(12) a pediatrician, certified by the American Board of Pediatrics, with experience in emergency medical services;
(13) a family practice physician who is currently involved in emergency medical services;
(14) a public member who resides in Minnesota; and
(15) the commissioners of health and public safety or their designees.
(b) The governor shall appoint members under paragraph (a). Appointments under paragraph (a), clauses (1) to (9) and (11) to (13), are subject to the advice and consent of the senate. In making appointments under paragraph (a), clauses (1) to (9) and (11) to (13), the governor shall consider recommendations of the American College of Emergency Physicians, the Minnesota Hospital Association, the Minnesota and State Fire Chief's Association, the Minnesota Ambulance Association, the Minnesota Emergency Medical Services Association, the Minnesota State Sheriff's Association, the Association of Minnesota Counties, the Minnesota Nurses Association, and the Minnesota chapter of the Academy of Pediatrics.
(c) At least seven members appointed under paragraph (a) must reside outside of the seven-county metropolitan area, as defined in section 473.121.
Subd. 2.
Ex officio members.
The speaker of the house and the Committee on Rules and Administration of the senate shall appoint one representative and one senator to serve as ex officio, nonvoting members.
Subd. 3.
Chair.
The governor shall designate one of the members appointed under subdivision 1 as chair of the board.
Subd. 4.
Compensation; terms.
Membership terms, compensation, and removal of members appointed under subdivision 1, are governed by section 15.0575.
Subd. 5.
Staff.
The board shall appoint an executive director who shall serve in the unclassified service and may appoint other staff. The service of the executive director shall be subject to the terms described in section 214.04, subdivision 2a.
Subd. 6.
Duties of board.
(a) The Emergency Medical Services Regulatory Board shall:
(1) administer and enforce the provisions of this chapter and other duties as assigned to the board;
(2) advise applicants for state or federal emergency medical services funds, review and comment on such applications, and approve the use of such funds unless otherwise required by federal law;
(3) make recommendations to the legislature on improving the access, delivery, and effectiveness of the state's emergency medical services delivery system; and
(4) establish procedures for investigating, hearing, and resolving complaints against emergency medical services providers.
(b) The Emergency Medical Services Board may prepare an initial work plan, which may be updated biennially. The work plan may include provisions to:
(1) prepare an emergency medical services assessment which addresses issues affecting the statewide delivery system;
(2) establish a statewide public information and education system regarding emergency medical services;
(3) create, in conjunction with the Department of Public Safety, a statewide injury and trauma prevention program; and
(4) designate an annual emergency medical services personnel recognition day.
Subd. 7.
Conflict of interest.
No member of the Emergency Medical Services Board may participate or vote in board proceedings in which the member has a direct conflict of interest, financial or otherwise.
144E.123 PREHOSPITAL CARE DATA.
Subd. 5.
Working group.
By October 1, 2011, the board must convene a working group composed of six members, three of which must be appointed by the board and three of which must be appointed by the Minnesota Ambulance Association, to redesign the board's policies related to collection of data from licenses. The issues to be considered include, but are not limited to, the following: user-friendly reporting requirements; data sets; improved accuracy of reported information; appropriate use of information gathered through the reporting system; and methods for minimizing the financial impact of data reporting on licenses, particularly for rural volunteer services. The working group must report its findings and recommendations to the board no later than July 1, 2012.
144E.27 EDUCATION PROGRAMS; BOARD APPROVAL.
Subdivision 1.
Education program instructor.
An education program instructor must be an emergency medical responder, EMT, AEMT, paramedic, physician, physician assistant, or registered nurse.
Subd. 1a.
Approval required.
(a) All education programs for an emergency medical responder must be approved by the board.
(b) To be approved by the board, an education program must:
(1) submit an application prescribed by the board that includes:
(i) type and length of course to be offered;
(ii) names, addresses, and qualifications of the program medical director, program education coordinator, and instructors;
(iii) admission criteria for students; and
(iv) materials and equipment to be used;
(2) for each course, implement the most current version of the United States Department of Transportation EMS Education Standards, or its equivalent as determined by the board applicable to Emergency Medical Responder registration education;
(3) have a program medical director and a program coordinator;
(4) have at least one instructor for every ten students at the practical skill stations;
(5) retain documentation of program approval by the board, course outline, and student information; and
(6) submit the appropriate fee as required under section 144E.29.
(c) The National EMS Education Standards by the NHTSA, United States Department of Transportation contains the minimal entry level of knowledge and skills for emergency medical responders. Medical directors of emergency medical responder groups may expand the knowledge and skill set.
144E.50 EMERGENCY MEDICAL SERVICES FUND.
Subd. 3.
Definition.
For purposes of this section, "board" means the Emergency Medical Services Regulatory Board.
245A.065 CHILD CARE FIX-IT TICKET.
(a) In lieu of a correction order under section 245A.06, the commissioner shall issue a fix-it ticket to a family child care or child care center license holder if the commissioner finds that:
(1) the license holder has failed to comply with a requirement in this chapter or Minnesota Rules, chapter 9502 or 9503, that the commissioner determines to be eligible for a fix-it ticket;
(2) the violation does not imminently endanger the health, safety, or rights of the persons served by the program;
(3) the license holder did not receive a fix-it ticket or correction order for the violation at the license holder's last licensing inspection;
(4) the violation can be corrected at the time of inspection or within 48 hours, excluding Saturdays, Sundays, and holidays; and
(5) the license holder corrects the violation at the time of inspection or agrees to correct the violation within 48 hours, excluding Saturdays, Sundays, and holidays.
(b) The fix-it ticket must state:
(1) the conditions that constitute a violation of the law or rule;
(2) the specific law or rule violated; and
(3) that the violation was corrected at the time of inspection or must be corrected within 48 hours, excluding Saturdays, Sundays, and holidays.
(c) The commissioner shall not publicly publish a fix-it ticket on the department's website.
(d) Within 48 hours, excluding Saturdays, Sundays, and holidays, of receiving a fix-it ticket, the license holder must correct the violation and within one week submit evidence to the licensing agency that the violation was corrected.
(e) If the violation is not corrected at the time of inspection or within 48 hours, excluding Saturdays, Sundays, and holidays, or the evidence submitted is insufficient to establish that the license holder corrected the violation, the commissioner must issue a correction order for the violation of Minnesota law or rule identified in the fix-it ticket according to section 245A.06.
245C.08 BACKGROUND STUDY; COMMISSIONER REVIEWS.
Subd. 2.
Background studies conducted by a county agency for family child care.
(a) Before the implementation of NETStudy 2.0, for a background study conducted by a county agency for family child care services, the commissioner shall review:
(1) information from the county agency's record of substantiated maltreatment of adults and the maltreatment of minors;
(2) information from juvenile courts as required in subdivision 4 for:
(i) individuals listed in section 245C.03, subdivision 1, paragraph (a), who are ages 13 through 23 living in the household where the licensed services will be provided; and
(ii) any other individual listed under section 245C.03, subdivision 1, when there is reasonable cause; and
(3) information from the Bureau of Criminal Apprehension.
(b) If the individual has resided in the county for less than five years, the study shall include the records specified under paragraph (a) for the previous county or counties of residence for the past five years.
(c) Notwithstanding expungement by a court, the county agency may consider information obtained under paragraph (a), clause (3), unless:
(1) the commissioner received notice of the petition for expungement and the court order for expungement is directed specifically to the commissioner; or
(2) the commissioner received notice of the expungement order issued pursuant to section 609A.017, 609A.025, or 609A.035, and the order for expungement is directed specifically to the commissioner.
245C.125 BACKGROUND STUDY; HEAD START PROGRAMS.
(a) Head Start programs that receive funds under section 119A.52 may contract with the commissioner to:
(1) conduct background studies on individuals affiliated with a Head Start program; and
(2) obtain background study data on individuals affiliated with a Head Start program.
(b) The commissioner must include a national criminal history record check in a background study conducted under paragraph (a).
(c) A Head Start program site that does not contract with the commissioner, is not licensed, and is not registered to receive payments under chapter 119B is exempt from the relevant requirements in this chapter. Nothing in this section supersedes requirements for background studies in this chapter or chapter 119B or 245H that relate to licensed child care programs or programs registered to receive payments under chapter 119B. For a background study conducted under this section to be transferable to other child care entities, the study must include all components of studies for a certified license-exempt child care center under this chapter.
256.01 COMMISSIONER OF HUMAN SERVICES; POWERS, DUTIES.
Subd. 12.
Child mortality review panel.
(a) The commissioner shall establish a child mortality review panel to review deaths of children in Minnesota, including deaths attributed to maltreatment or in which maltreatment may be a contributing cause and to review near fatalities as defined in section 260E.35. The commissioners of health, education, and public safety and the attorney general shall each designate a representative to the child mortality review panel. Other panel members shall be appointed by the commissioner, including a board-certified pathologist and a physician who is a coroner or a medical examiner. The purpose of the panel shall be to make recommendations to the state and to county agencies for improving the child protection system, including modifications in statute, rule, policy, and procedure.
(b) The commissioner may require a county agency to establish a local child mortality review panel. The commissioner may establish procedures for conducting local reviews and may require that all professionals with knowledge of a child mortality case participate in the local review. In this section, "professional" means a person licensed to perform or a person performing a specific service in the child protective service system. "Professional" includes law enforcement personnel, social service agency attorneys, educators, and social service, health care, and mental health care providers.
(c) If the commissioner of human services has reason to believe that a child's death was caused by maltreatment or that maltreatment was a contributing cause, the commissioner has access to not public data under chapter 13 maintained by state agencies, statewide systems, or political subdivisions that are related to the child's death or circumstances surrounding the care of the child. The commissioner shall also have access to records of private hospitals as necessary to carry out the duties prescribed by this section. Access to data under this paragraph is limited to police investigative data; autopsy records and coroner or medical examiner investigative data; hospital, public health, or other medical records of the child; hospital and other medical records of the child's parent that relate to prenatal care; and records created by social service agencies that provided services to the child or family within three years preceding the child's death. A state agency, statewide system, or political subdivision shall provide the data upon request of the commissioner. Not public data may be shared with members of the state or local child mortality review panel in connection with an individual case.
(d) Notwithstanding the data's classification in the possession of any other agency, data acquired by a local or state child mortality review panel in the exercise of its duties is protected nonpublic or confidential data as defined in section 13.02, but may be disclosed as necessary to carry out the purposes of the review panel. The data is not subject to subpoena or discovery. The commissioner may disclose conclusions of the review panel, but shall not disclose data that was classified as confidential or private data on decedents, under section 13.10, or private, confidential, or protected nonpublic data in the disseminating agency, except that the commissioner may disclose local social service agency data as provided in section 260E.35, on individual cases involving a fatality or near fatality of a person served by the local social service agency prior to the date of death.
(e) A person attending a child mortality review panel meeting shall not disclose what transpired at the meeting, except to carry out the purposes of the mortality review panel. The proceedings and records of the mortality review panel are protected nonpublic data as defined in section 13.02, subdivision 13, and are not subject to discovery or introduction into evidence in a civil or criminal action against a professional, the state or a county agency, arising out of the matters the panel is reviewing. Information, documents, and records otherwise available from other sources are not immune from discovery or use in a civil or criminal action solely because they were presented during proceedings of the review panel. A person who presented information before the review panel or who is a member of the panel shall not be prevented from testifying about matters within the person's knowledge. However, in a civil or criminal proceeding a person shall not be questioned about the person's presentation of information to the review panel or opinions formed by the person as a result of the review meetings.
Subd. 12a.
Department of Human Services child fatality and near fatality review team.
(a) The commissioner shall establish a Department of Human Services child fatality and near fatality review team to review child fatalities and near fatalities due to child maltreatment and child fatalities and near fatalities that occur in licensed facilities and are not due to natural causes. The review team shall assess the entire child protection services process from the point of a mandated reporter reporting the alleged maltreatment through the ongoing case management process. Department staff shall lead and conduct on-site local reviews and utilize supervisors from local county and tribal child welfare agencies as peer reviewers. The review process must focus on critical elements of the case and on the involvement of the child and family with the county or tribal child welfare agency. The review team shall identify necessary program improvement planning to address any practice issues identified and training and technical assistance needs of the local agency. Summary reports of each review shall be provided to the state child mortality review panel when completed.
(b) A member of the child fatality and near fatality review team shall not disclose what transpired during the review, except to carry out the duties of the child fatality and near fatality review team. The proceedings and records of the child fatality and near fatality review team are protected nonpublic data as defined in section 13.02, subdivision 13, and are not subject to discovery or introduction into evidence in a civil or criminal action against a professional, the state, or a county agency arising out of the matters the team is reviewing. Information, documents, and records otherwise available from other sources are not immune from discovery or use in a civil or criminal action solely because they were assessed or presented during proceedings of the review team. A person who presented information before the review team or who is a member of the team shall not be prevented from testifying about matters within the person's knowledge. In a civil or criminal proceeding a person shall not be questioned about the person's presentation of information to the review team or opinions formed by the person as a result of the review.
256D.19 ABOLITION OF TOWNSHIP SYSTEM OF POOR RELIEF.
Subdivision 1.
Town system abolished.
The town system for caring for the poor in each of the counties in which it is in effect is hereby abolished. The local social services agency of each county shall administer general assistance under the provisions of Laws 1973, chapter 650, article 21.
Subd. 2.
Local social services agencies duty.
All local social services agencies affected by Laws 1973, chapter 650, article 21 are hereby authorized to take over for the county as of January 1, 1974, the ownership of all case records relating to the administration of poor relief.
256D.20 TRANSFER OF TOWN EMPLOYEES.
Subdivision 1.
Rules for merit system.
The term "merit system" as used herein shall mean the rules for a merit system of personnel administration for employees of local social services agencies adopted by the commissioner of human services in accordance with the provisions of section 393.07, including the merit system established for Hennepin County pursuant to Laws 1965, chapter 855, as amended, the federal Social Security article as amended, and merit system standards and regulations issued by the federal Social Security Board and the United States Children's Bureau.
Subd. 2.
Designation of employees.
All employees of any municipality or town who are engaged full time in poor relief work therein on January 1, 1974 shall be retained as employees of the county and placed under the jurisdiction of its local social services agency.
All transferred employees shall be blanketed into the merit system with comparable status, classification, longevity, and seniority, and subject to the administrative requirements of the local social services agency. Employees with permanent status under any civil service provision on January 1, 1974, shall be granted permanent status under the merit system at comparable classifications and in accordance with work assignments made under the authority of the local social services agency as provided by the merit system rules.
The determination of proper job allocation shall be the responsibility of the personnel officer or director as provided under merit system rules applicable to the county involved with the right of appeal of allocation to the Merit System Council or personnel board by any employee affected by this transfer.
All transferred employees shall receive salaries for the classification to which they are allocated in accordance with the schedule in effect for local social services agency employees and at a salary step which they normally would have received had they been employed by the local social services agency for the same period of service they had previously served under the civil service provisions of any municipality or town; provided, however, that no salary shall be reduced as a result of the transfer.
All accumulated sick leave of transferred employees in the amount of 60 days or less shall be transferred to the records of the local social services agency and such accumulated sick leave shall be the legal liability of the local social services agency. All accumulated sick leave in excess of 60 days shall be paid in cash to transferred employees by the municipality or town by which they were employed prior to their transfer, at the time of transfer. In lieu of the cash payment, the municipality or town shall, at the option of the employee concerned, allow a leave of absence with pay, prior to transfer, for all or part of the accumulated sick leave.
Subd. 3.
Merit system transfer.
Employees of municipalities and towns engaged in the work of administering poor relief who are not covered by civil service provisions shall be blanketed into the merit system subject to a qualifying examination. Employees with one year or more service shall be subject to a qualifying examination and those with less than one year's service shall be subject to an open competitive examination.
Subd. 4.
Disbursement of vacation time.
All vacation leave of employees referred to in subdivision 2, accumulated prior to their transfer to county employment shall be paid in cash to them by the municipality or town by which they were employed prior to their transfer, and at the time of their transfer. In lieu of the cash payment, the municipality or town shall, at the option of the employee concerned, allow a leave of absence with pay, prior to such transfer, for all or part of the accumulated vacation time.
256D.23 TEMPORARY COUNTY ASSISTANCE PROGRAM.
Subdivision 1.
Program established.
Minnesota residents who meet the income and resource standards of section 256D.01, subdivision 1a, but do not qualify for cash benefits under sections 256D.01 to 256D.21, may qualify for a county payment under this section.
Subd. 2.
Payment amount, duration, and method.
(a) A county may make a payment of up to $203 for a single individual and up to $260 for a married couple under the terms of this subdivision.
(b) Payments to an individual or married couple may only be made once in a calendar year. If the applicant qualifies for a payment as a result of an emergency, as defined by the county, the payment shall be made within ten working days of the date of application. If the applicant does not qualify under the county definition of emergency, the payment shall be made at the beginning of the second month following the month of application, and the applicant must receive the payment in person at the local agency office.
(c) Payments may be made in the form of cash or as vendor payments for rent and utilities. If vendor payments are made, they shall be equal to $203 for a single individual or $260 for a married couple, or the actual amount of rent and utilities, whichever is less.
(d) Each county must develop policies and procedures as necessary to implement this section.
(e) Payments under this section are not an entitlement. No county is required to make a payment in excess of the amount available to the county under subdivision 3.
Subd. 3.
State allocation to counties.
The commissioner shall allocate to each county on an annual basis the amount specifically appropriated for payments under this section. The allocation shall be based on each county's proportionate share of state fiscal year 1994 work readiness expenditures.
256R.02 DEFINITIONS.
Subd. 46.
Resource utilization group.
"Resource utilization groups" or "RUG" has the meaning given in section 144.0724, subdivision 2, paragraph (f).
260.755 DEFINITIONS.
Subd. 13.
Local social services agency.
"Local social services agency" means the local agency under the authority of the county welfare or human services board or county board of commissioners which is responsible for human services.
Repealed Minnesota Session Laws: S4699-1
Laws 2023, chapter 25, section 190, subdivision 10
Sec. 190. new text begin REPEALER.new text end
new text begin Subd. 10. new text end
new text begin Obsolete subdivision. new text end
new text begin Minnesota Statutes 2022, section 256B.051, subdivision 7, new text end new text begin is repealed. new text end
Laws 2024, chapter 80, article 1, section 38 Subdivisions 3, 4, 11,
Sec. 38.
new text begin [142A.20] ADMINISTRATIVE AND JUDICIAL REVIEW OF CHILDREN, YOUTH, AND FAMILIES MATTERS. new text end
new text begin Subd. 3. new text end
new text begin Standard of evidence for maltreatment and disqualification hearings. new text end
new text begin (a) The state children, youth, and families judge shall determine that maltreatment has occurred if a preponderance of evidence exists to support the final disposition under chapter 260E or section 626.557. For purposes of hearings regarding disqualification, the state children, youth, and families judge shall affirm the proposed disqualification in an appeal under subdivision 2, paragraph (a), clause (5), if a preponderance of the evidence shows the individual has: new text end
new text begin (1) committed maltreatment under section 626.557 or chapter 260E that is serious or recurring; new text end
new text begin (2) committed an act or acts meeting the definition of any of the crimes listed in section 245C.15, subdivisions 1 to 4; or new text end
new text begin (3) failed to make required reports under section 626.557 or chapter 260E, for incidents in which the final disposition under section 626.557 or chapter 260E was substantiated maltreatment that was serious or recurring. new text end
new text begin (b) If the disqualification is affirmed, the state children, youth, and families judge shall determine whether the individual poses a risk of harm in accordance with the requirements of section 245C.22, and whether the disqualification should be set aside or not set aside. In determining whether the disqualification should be set aside, the children, youth, and families judge shall consider all of the characteristics that cause the individual to be disqualified, including those characteristics that were not subject to review under paragraph (a), in order to determine whether the individual poses a risk of harm. A decision to set aside a disqualification that is the subject of the hearing constitutes a determination that the individual does not pose a risk of harm and that the individual may provide direct contact services in the individual program specified in the set aside. new text end
new text begin (c) If a disqualification is based solely on a conviction or is conclusive for any reason under section 245C.29, the disqualified individual does not have a right to a hearing under this section. new text end
new text begin (d) The state children, youth, and families judge shall recommend an order to the commissioner of health; education; children, youth, and families; or human services, as applicable, who shall issue a final order. The commissioner shall affirm, reverse, or modify the final disposition. Any order of the commissioner issued in accordance with this subdivision is conclusive upon the parties unless appeal is taken in the manner provided in subdivision 7. In any licensing appeal under chapters 142B and 245C and sections 144.50 to 144.58 and 144A.02 to 144A.482, the commissioner's determination as to maltreatment is conclusive, as provided under section 245C.29. new text end
new text begin Subd. 4. new text end
new text begin Conduct of hearings. new text end
new text begin (a) All hearings held pursuant to subdivision 2 or 3 shall be conducted according to the provisions of the federal Social Security Act and the regulations implemented in accordance with that act to enable this state to qualify for federal grants-in-aid and according to the rules and written policies of the commissioner. County agencies shall install equipment necessary to conduct telephone hearings. A state children, youth, and families judge may schedule a telephone conference hearing when the distance or time required to travel to the county agency offices will cause a delay in the issuance of an order, or to promote efficiency, or at the mutual request of the parties. Hearings may be conducted by telephone conferences unless the applicant, recipient, former recipient, person, or facility contesting maltreatment objects. A children, youth, and families judge may grant a request for a hearing in person by holding the hearing by interactive video technology or in person. The children, youth, and families judge must hear the case in person if the person asserts that either the person or a witness has a physical or mental disability that would impair the person's or witness's ability to fully participate in a hearing held by interactive video technology. The hearing shall not be held earlier than five days after filing of the required notice with the county or state agency. The state children, youth, and families judge shall notify all interested persons of the time, date, and location of the hearing at least five days before the date of the hearing. Interested persons may be represented by legal counsel or other representative of their choice, including a provider of therapy services, at the hearing and may appear personally, testify and offer evidence, and examine and cross-examine witnesses. The applicant, recipient, former recipient, person, or facility contesting maltreatment shall have the opportunity to examine the contents of the case file and all documents and records to be used by the county or state agency at the hearing at a reasonable time before the date of the hearing and during the hearing. In hearings under subdivision 2, paragraph (a), clauses (4) and (5), either party may subpoena the private data relating to the investigation prepared by the agency under section 626.557 or chapter 260E that are not otherwise accessible under section 13.04, provided the identity of the reporter may not be disclosed. new text end
new text begin (b) The private data obtained by subpoena in a hearing under subdivision 2, paragraph (a), clause (2), must be subject to a protective order that prohibits its disclosure for any other purpose outside the hearing provided for in this section without prior order of the district court. Disclosure without court order is punishable by a sentence of not more than 90 days imprisonment or a fine of not more than $1,000, or both. These restrictions on the use of private data do not prohibit access to the data under section 13.03, subdivision 6. Except for appeals under subdivision 2, paragraph (a), clause (2), upon request, the county agency shall provide reimbursement for transportation, child care, photocopying, medical assessment, witness fee, and other necessary and reasonable costs incurred by the applicant, recipient, or former recipient in connection with the appeal. All evidence, except that privileged by law, commonly accepted by reasonable people in the conduct of their affairs as having probative value with respect to the issues, shall be submitted at the hearing and the hearing shall not be "a contested case" within the meaning of section 14.02, subdivision 3. The agency must present its evidence prior to or at the hearing and may not submit evidence after the hearing except by agreement of the parties at the hearing, provided the petitioner has the opportunity to respond. new text end
new text begin (c) In hearings under subdivision 2, paragraph (a), clauses (2) and (5), involving determinations of maltreatment or disqualification made by more than one county agency, by a county agency and a state agency, or by more than one state agency, the hearings may be consolidated into a single fair hearing upon the consent of all parties and the state children, youth, and families judge. new text end
new text begin Subd. 11. new text end
new text begin Interagency agreement with DHS. new text end
new text begin The commissioner of children, youth, and families may enter into an agreement with the commissioner of human services so that the commissioner of human services may conduct hearings and recommend and issue orders on behalf of the commissioner of children, youth, and families in accordance with this section. new text end
Laws 2024, chapter 80, article 1, section 39
Sec. 39.
new text begin [142A.21] HEARING PROCEDURES. new text end
new text begin Subdivision 1. new text end
new text begin Scope. new text end
new text begin (a) The requirements in this section apply to all fair hearings and appeals under section 142A.20, subdivision 2, paragraph (a), clauses (1), (2), (3), and (6). Except as provided in subdivisions 3 and 19, the requirements under this section apply to fair hearings and appeals under section 142A.20, subdivision 2, paragraph (a), clause (2). new text end
new text begin (b) For purposes of this section, "person" means an individual who, on behalf of themselves or their household, is appealing, disputing, or challenging an action, a decision, or a failure to act by an agency in the children, youth, and families system. When a person involved in a proceeding under this section is represented by an attorney or by an authorized representative, the term "person" also means the person's attorney or authorized representative. Any notice sent to the person involved in the hearing must also be sent to the person's attorney or authorized representative. new text end
new text begin (c) For purposes of this section, "agency" means the county human services agency, the Department of Children, Youth, and Families, and, where applicable, any entity involved under a contract, subcontract, grant, or subgrant with the state agency or with a county agency, that provides or operates programs or services in which appeals are governed by section 142A.20. new text end
new text begin Subd. 2. new text end
new text begin Access to files. new text end
new text begin A person involved in a fair hearing appeal has the right of access to the person's complete case files and to examine all private welfare data on the person that has been generated, collected, stored, or disseminated by the agency. A person involved in a fair hearing appeal has the right to a free copy of all documents in the case file involved in a fair hearing appeal. For purposes of this section, "case file" means the information, documents, and data, in whatever form, that have been generated, collected, stored, or disseminated by the agency in connection with the person and the program or service involved. new text end
new text begin Subd. 3. new text end
new text begin Agency appeal summary. new text end
new text begin (a) Except in fair hearings and appeals under section 142A.20, subdivision 2, paragraph (a), clauses (4) and (5), the agency involved in an appeal must prepare a state agency appeal summary for each fair hearing appeal. The state agency appeal summary shall be mailed or otherwise delivered to the person who is involved in the appeal at least three working days before the date of the hearing. The state agency appeal summary must also be mailed or otherwise delivered to the department's Appeals Office at least three working days before the date of the fair hearing appeal. new text end
new text begin (b) In addition, the children, youth, and families judge shall confirm that the state agency appeal summary is mailed or otherwise delivered to the person involved in the appeal as required under paragraph (a). The person involved in the fair hearing should be provided, through the state agency appeal summary or other reasonable methods, appropriate information about the procedures for the fair hearing and an adequate opportunity to prepare. These requirements apply equally to the state agency or an entity under contract when involved in the appeal. new text end
new text begin (c) The contents of the state agency appeal summary must be adequate to inform the person involved in the appeal of the evidence on which the agency relies and the legal basis for the agency's action or determination. new text end
new text begin Subd. 4. new text end
new text begin Enforcing access to files. new text end
new text begin A person involved in a fair hearing appeal may enforce the right of access to data and copies of the case file by making a request to the children, youth, and families judge. The children, youth, and families judge will make an appropriate order enforcing the person's rights under the Minnesota Government Data Practices Act, including but not limited to, ordering access to files, data, and documents; continuing a hearing to allow adequate time for access to data; or prohibiting use by the agency of files, data, or documents that have been generated, collected, stored, or disseminated without compliance with the Minnesota Government Data Practices Act and that have not been provided to the person involved in the appeal. new text end
new text begin Subd. 5. new text end
new text begin Prehearing conferences. new text end
new text begin (a) The children, youth, and families judge prior to a fair hearing appeal may hold a prehearing conference to further the interests of justice or efficiency and must include the person involved in the appeal. A person involved in a fair hearing appeal or the agency may request a prehearing conference. The prehearing conference may be conducted by telephone, in person, or in writing. The prehearing conference may address the following: new text end
new text begin (1) disputes regarding access to files, evidence, subpoenas, or testimony; new text end
new text begin (2) the time required for the hearing or any need for expedited procedures or decision; new text end
new text begin (3) identification or clarification of legal or other issues that may arise at the hearing; new text end
new text begin (4) identification of and possible agreement to factual issues; and new text end
new text begin (5) scheduling and any other matter that will aid in the proper and fair functioning of the hearing. new text end
new text begin (b) The children, youth, and families judge shall make a record or otherwise contemporaneously summarize the prehearing conference in writing, which shall be sent to both the person involved in the hearing, the person's attorney or authorized representative, and the agency. A children, youth, and families judge may make and issue rulings and orders while the appeal is pending. During the pendency of the appeal, these rulings and orders are not subject to a request for reconsideration or appeal. These rulings and orders are subject to review under subdivision 24 and section 142A.20, subdivision 7. new text end
new text begin Subd. 6. new text end
new text begin Appeal request for emergency assistance or urgent matter. new text end
new text begin (a) When an appeal involves an application for emergency assistance, the agency involved shall mail or otherwise deliver the state agency appeal summary to the department's Appeals Office within two working days of receiving the request for an appeal. A person may also request that a fair hearing be held on an emergency basis when the issue requires an immediate resolution. The children, youth, and families judge shall schedule the fair hearing on the earliest available date according to the urgency of the issue involved. Issuance of the recommended decision after an emergency hearing shall be expedited. new text end
new text begin (b) The commissioner shall issue a written decision within five working days of receiving the recommended decision, shall immediately inform the parties of the outcome by telephone, and shall mail the decision no later than two working days following the date of the decision. new text end
new text begin Subd. 7. new text end
new text begin Continuance, rescheduling, or adjourning a hearing. new text end
new text begin (a) A person involved in a fair hearing, or the agency, may request a continuance, a rescheduling, or an adjournment of a hearing for a reasonable period of time. The grounds for granting a request for a continuance, a rescheduling, or adjournment of a hearing include, but are not limited to, the following: new text end
new text begin (1) to reasonably accommodate the appearance of a witness; new text end
new text begin (2) to ensure that the person has adequate opportunity for preparation and for presentation of evidence and argument; new text end
new text begin (3) to ensure that the person or the agency has adequate opportunity to review, evaluate, and respond to new evidence, or where appropriate, to require that the person or agency review, evaluate, and respond to new evidence; new text end
new text begin (4) to permit the person involved and the agency to negotiate toward resolution of some or all of the issues where both agree that additional time is needed; new text end
new text begin (5) to permit the agency to reconsider a previous action or determination; new text end
new text begin (6) to permit or to require the performance of actions not previously taken; and new text end
new text begin (7) to provide additional time or to permit or require additional activity by the person or agency as the interests of fairness may require. new text end
new text begin (b) Requests for continuances or for rescheduling may be made orally or in writing. The person or agency requesting the continuance or rescheduling must first make reasonable efforts to contact the other participants in the hearing or their representatives and seek to obtain an agreement on the request. Requests for continuance or rescheduling should be made no later than three working days before the scheduled date of the hearing, unless there is a good cause as specified in subdivision 13. Granting a continuance or rescheduling may be conditioned upon a waiver by the requester of applicable time limits but should not cause unreasonable delay. new text end
new text begin Subd. 8. new text end
new text begin Subpoenas. new text end
new text begin (a) A person involved in a fair hearing or the agency may request a subpoena for a witness, for evidence, or for both. A reasonable number of subpoenas shall be issued to require the attendance and the testimony of witnesses, and the production of evidence relating to any issue of fact in the appeal hearing. The request for a subpoena must show a need for the subpoena and the general relevance to the issues involved. The subpoena shall be issued in the name of the department and shall be served and enforced as provided in section 357.22 and the Minnesota Rules of Civil Procedure. new text end
new text begin (b) An individual or entity served with a subpoena may petition the children, youth, and families judge in writing to vacate or modify a subpoena. The children, youth, and families judge shall resolve such a petition in a prehearing conference involving all parties and shall make a written decision. A subpoena may be vacated or modified if the children, youth, and families judge determines that the testimony or evidence sought does not relate with reasonable directness to the issues of the fair hearing appeal; that the subpoena is unreasonable, over broad, or oppressive; that the evidence sought is repetitious or cumulative; or that the subpoena has not been served reasonably in advance of the time when the appeal hearing will be held. new text end
new text begin Subd. 9. new text end
new text begin No ex parte contact. new text end
new text begin The children, youth, and families judge shall not have ex parte contact on substantive issues with the agency or with any person or witness in a fair hearing appeal. No employee of the department or agency shall review, interfere with, change, or attempt to influence the recommended decision of the children, youth, and families judge in any fair hearing appeal, except through the procedure allowed in subdivision 18. The limitations in this subdivision do not affect the commissioner's authority to review or reconsider decisions or make final decisions. new text end
new text begin Subd. 10. new text end
new text begin Telephone or face-to-face hearing. new text end
new text begin A fair hearing appeal may be conducted by telephone, by other electronic media, or by an in-person, face-to-face hearing. At the request of the person involved in a fair hearing appeal or their representative, a face-to-face hearing shall be conducted with all participants personally present before the children, youth, and families judge. new text end
new text begin Subd. 11. new text end
new text begin Hearing facilities and equipment. new text end
new text begin The children, youth, and families judge shall conduct the hearing in the county where the person involved resides, unless an alternate location is mutually agreed upon before the hearing, or unless the person has agreed to a hearing by telephone. Hearings under section 142A.20, subdivision 2, paragraph (a), clauses (4) and (5), must be conducted in the county where the determination was made, unless an alternate location is mutually agreed upon before the hearing. The hearing room shall be of sufficient size and layout to adequately accommodate both the number of individuals participating in the hearing and any identified special needs of any individual participating in the hearing. The children, youth, and families judge shall ensure that all communication and recording equipment that is necessary to conduct the hearing and to create an adequate record is present and functioning properly. If any necessary communication or recording equipment fails or ceases to operate effectively, the children, youth, and families judge shall take any steps necessary, including stopping or adjourning the hearing, until the necessary equipment is present and functioning properly. All reasonable efforts shall be undertaken to prevent and avoid any delay in the hearing process caused by defective communication or recording equipment. new text end
new text begin Subd. 12. new text end
new text begin Interpreter and translation services. new text end
new text begin The children, youth, and families judge has a duty to inquire and to determine whether any participant in the hearing needs the services of an interpreter or translator in order to participate in or to understand the hearing process. Necessary interpreter or translation services must be provided at no charge to the person involved in the hearing. If it appears that interpreter or translation services are needed but are not available for the scheduled hearing, the children, youth, and families judge shall continue or postpone the hearing until appropriate services can be provided. new text end
new text begin Subd. 13. new text end
new text begin Failure to appear; good cause. new text end
new text begin If a person involved in a fair hearing appeal fails to appear at the hearing, the children, youth, and families judge may dismiss the appeal. The children, youth, and families judge may reopen the appeal if within ten working days after the date of the dismissal the person files information in writing with the children, youth, and families judge to show good cause for not appearing. Good cause can be shown when there is: new text end
new text begin (1) a death or serious illness in the person's family; new text end
new text begin (2) a personal injury or illness that reasonably prevents the person from attending the hearing; new text end
new text begin (3) an emergency, crisis, or unforeseen event that reasonably prevents the person from attending the hearing; new text end
new text begin (4) an obligation or responsibility of the person that a reasonable person, in the conduct of one's affairs, could reasonably determine takes precedence over attending the hearing; new text end
new text begin (5) lack of or failure to receive timely notice of the hearing in the preferred language of the person involved in the hearing; and new text end
new text begin (6) excusable neglect, excusable inadvertence, excusable mistake, or other good cause as determined by the children, youth, and families judge. new text end
new text begin Subd. 14. new text end
new text begin Commencement of hearing. new text end
new text begin The children, youth, and families judge shall begin each hearing by describing the process to be followed in the hearing, including the swearing in of witnesses, how testimony and evidence are presented, the order of examining and cross-examining witnesses, and the opportunity for an opening statement and a closing statement. The children, youth, and families judge shall identify for the participants the issues to be addressed at the hearing and shall explain to the participants the burden of proof that applies to the person involved and the agency. The children, youth, and families judge shall confirm, prior to proceeding with the hearing, that the state agency appeal summary, if required under subdivision 3, has been properly completed and provided to the person involved in the hearing, and that the person has been provided documents and an opportunity to review the case file, as provided in this section. new text end
new text begin Subd. 15. new text end
new text begin Conduct of the hearing. new text end
new text begin The children, youth, and families judge shall act in a fair and impartial manner at all times. At the beginning of the hearing the agency must designate one person as their representative who shall be responsible for presenting the agency's evidence and questioning any witnesses. The children, youth, and families judge shall make sure that the person and the agency are provided sufficient time to present testimony and evidence, to confront and cross-examine all adverse witnesses, and to make any relevant statement at the hearing. The children, youth, and families judge shall make reasonable efforts to explain the hearing process to persons who are not represented and shall ensure that the hearing is conducted fairly and efficiently. Upon the reasonable request of the person or the agency involved, the children, youth, and families judge may direct witnesses to remain outside the hearing room, except during their individual testimony. The children, youth, and families judge shall not terminate the hearing before affording the person and the agency a complete opportunity to submit all admissible evidence and reasonable opportunity for oral or written statement. If a hearing lasts longer than anticipated, the hearing shall be rescheduled or continued from day-to-day until completion. Hearings that have been continued shall be timely scheduled to minimize delay in the disposition of the appeal. new text end
new text begin Subd. 16. new text end
new text begin Scope of issues addressed at the hearing. new text end
new text begin The hearing shall address the correctness and legality of the agency's action and shall not be limited simply to a review of the propriety of the agency's action. The person involved may raise and present evidence on all legal claims or defenses arising under state or federal law as a basis for appealing or disputing an agency action but not constitutional claims beyond the jurisdiction of the fair hearing. The children, youth, and families judge may take official notice of adjudicative facts. new text end
new text begin Subd. 17. new text end
new text begin Burden of persuasion. new text end
new text begin The burden of persuasion is governed by specific state or federal law and regulations that apply to the subject of the hearing. If there is no specific law, then the participant in the hearing who asserts the truth of a claim is under the burden to persuade the children, youth, and families judge that the claim is true. new text end
new text begin Subd. 18. new text end
new text begin Inviting comment by department. new text end
new text begin The children, youth, and families judge or the commissioner may determine that a written comment by the department about the policy implications of a specific legal issue could help resolve a pending appeal. Such a written policy comment from the department shall be obtained only by a written request that is also sent to the person involved and to the agency or its representative. When such a written comment is received, both the person involved in the hearing and the agency shall have adequate opportunity to review, evaluate, and respond to the written comment, including submission of additional testimony or evidence, and cross-examination concerning the written comment. new text end
new text begin Subd. 19. new text end
new text begin Developing the record. new text end
new text begin The children, youth, and families judge shall accept all evidence, except evidence privileged by law, that is commonly accepted by reasonable people in the conduct of their affairs as having probative value on the issues to be addressed at the hearing. Except in fair hearings and appeals under section 142A.20, subdivision 2, paragraph (a), clauses (4) and (5), in cases involving medical issues such as a diagnosis, a physician's report, or a review team's decision, the children, youth, and families judge shall consider whether it is necessary to have a medical assessment other than that of the individual making the original decision. When necessary, the children, youth, and families judge shall require an additional assessment be obtained at agency expense and made part of the hearing record. The children, youth, and families judge shall ensure for all cases that the record is sufficiently complete to make a fair and accurate decision. new text end
new text begin Subd. 20. new text end
new text begin Unrepresented persons. new text end
new text begin In cases involving unrepresented persons, the children, youth, and families judge shall take appropriate steps to identify and develop in the hearing relevant facts necessary for making an informed and fair decision. These steps may include, but are not limited to, asking questions of witnesses and referring the person to a legal services office. An unrepresented person shall be provided an adequate opportunity to respond to testimony or other evidence presented by the agency at the hearing. The children, youth, and families judge shall ensure that an unrepresented person has a full and reasonable opportunity at the hearing to establish a record for appeal. new text end
new text begin Subd. 21. new text end
new text begin Closing of the record. new text end
new text begin The agency must present its evidence prior to or at the hearing. The agency shall not be permitted to submit evidence after the hearing except by agreement at the hearing between the person involved, the agency, and the children, youth, and families judge. If evidence is submitted after the hearing, based on such an agreement, the person involved and the agency must be allowed sufficient opportunity to respond to the evidence. When necessary, the record shall remain open to permit a person to submit additional evidence on the issues presented at the hearing. new text end
new text begin Subd. 22. new text end
new text begin Decisions. new text end
new text begin (a) A timely, written decision must be issued in every appeal. Each decision must contain a clear ruling on the issues presented in the appeal hearing and should contain a ruling only on questions directly presented by the appeal and the arguments raised in the appeal. new text end
new text begin (b) A written decision must be issued within 90 days of the date the person involved requested the appeal unless a shorter time is required by law. An additional 30 days is provided in those cases where the commissioner refuses to accept the recommended decision. In appeals of maltreatment determinations or disqualifications filed pursuant to section 142A.20, subdivision 2, paragraph (a), clause (4) or (5), that also give rise to possible licensing actions, the 90-day period for issuing final decisions does not begin until the later of the date that the licensing authority provides notice to the appeals division that the authority has made the final determination in the matter or the date the appellant files the last appeal in the consolidated matters. new text end
new text begin (c) The decision must contain both findings of fact and conclusions of law, clearly separated and identified. The findings of fact must be based on the entire record. Each finding of fact made by the children, youth, and families judge shall be supported by a preponderance of the evidence unless a different standard is required under the regulations of a particular program. The "preponderance of the evidence" means, in light of the record as a whole, the evidence leads the children, youth, and families judge to believe that the finding of fact is more likely to be true than not true. The legal claims or arguments of a participant do not constitute either a finding of fact or a conclusion of law, except to the extent the children, youth, and families judge adopts an argument as a finding of fact or conclusion of law. new text end
new text begin (d) The decision shall contain at least the following: new text end
new text begin (1) a listing of the date and place of the hearing and the participants at the hearing; new text end
new text begin (2) a clear and precise statement of the issues, including the dispute under consideration and the specific points that must be resolved in order to decide the case; new text end
new text begin (3) a listing of the material, including exhibits, records, reports, placed into evidence at the hearing, and upon which the hearing decision is based; new text end
new text begin (4) the findings of fact based upon the entire hearing record. The findings of fact must be adequate to inform the participants and any interested person in the public of the basis of the decision. If the evidence is in conflict on an issue that must be resolved, the findings of fact must state the reasoning used in resolving the conflict; new text end
new text begin (5) conclusions of law that address the legal authority for the hearing and the ruling and give appropriate attention to the claims of the participants to the hearing; new text end
new text begin (6) a clear and precise statement of the decision made resolving the dispute under consideration in the hearing; and new text end
new text begin (7) written notice of the right to appeal to district court or to request reconsideration, and of the actions required and the time limits for taking appropriate action to appeal to district court or to request a reconsideration. new text end
new text begin (e) The children, youth, and families judge shall not independently investigate facts or otherwise rely on information not presented at the hearing. The children, youth, and families judge may not contact other agency personnel, except as provided in subdivision 18. The children, youth, and families judge's recommended decision must be based exclusively on the testimony and evidence presented at the hearing, and legal arguments presented, and the children, youth, and families judge's research and knowledge of the law. new text end
new text begin (f) The commissioner will review the recommended decision and accept or refuse to accept the decision according to section 142A.20, subdivision 5. new text end
new text begin Subd. 23. new text end
new text begin Refusal to accept recommended orders. new text end
new text begin (a) If the commissioner refuses to accept the recommended order from the children, youth, and families judge, the person involved, the person's attorney or authorized representative, and the agency shall be sent a copy of the recommended order, a detailed explanation of the basis for refusing to accept the recommended order, and the proposed modified order. new text end
new text begin (b) The person involved and the agency shall have at least ten business days to respond to the proposed modification of the recommended order. The person involved and the agency may submit a legal argument concerning the proposed modification, and may propose to submit additional evidence that relates to the proposed modified order. new text end
new text begin Subd. 24. new text end
new text begin Reconsideration. new text end
new text begin (a) Reconsideration may be requested within 30 days of the date of the commissioner's final order. If reconsideration is requested under section 142A.20, subdivision 5, the other participants in the appeal shall be informed of the request. The person seeking reconsideration has the burden to demonstrate why the matter should be reconsidered. The request for reconsideration may include legal argument and may include proposed additional evidence supporting the request. The other participants shall be sent a copy of all material submitted in support of the request for reconsideration and must be given ten days to respond. new text end
new text begin (b) When the requesting party raises a question as to the appropriateness of the findings of fact, the commissioner shall review the entire record. new text end
new text begin (c) When the requesting party questions the appropriateness of a conclusion of law, the commissioner shall consider the recommended decision, the decision under reconsideration, and the material submitted in connection with the reconsideration. The commissioner shall review the remaining record as necessary to issue a reconsidered decision. new text end
new text begin (d) The commissioner shall issue a written decision on reconsideration in a timely fashion. The decision must clearly inform the parties that this constitutes the final administrative decision, advise the participants of the right to seek judicial review, and the deadline for doing so. new text end
new text begin Subd. 25. new text end
new text begin Access to appeal decisions. new text end
new text begin Appeal decisions must be maintained in a manner so that the public has ready access to previous decisions on particular topics, subject to appropriate procedures for safeguarding names, personal identifying information, and other private data on the individual persons involved in the appeal. new text end
Laws 2024, chapter 80, article 1, section 43, subdivision 2
Sec. 43.
new text begin [142A.27] ADMINISTRATIVE FRAUD DISQUALIFICATION HEARINGS. new text end
new text begin Subd. 2. new text end
new text begin Combined hearing. new text end
new text begin The children, youth, and families judge may combine a fair hearing under section 142A.20 and administrative fraud disqualification hearing under this section into a single hearing if the factual issues arise out of the same, or related, circumstances and the individual receives prior notice that the hearings will be combined. If the administrative fraud disqualification hearing and fair hearing are combined, the time frames for administrative fraud disqualification hearings specified in Code of Federal Regulations, title 7, section 273.16, apply. If the individual accused of wrongfully obtaining assistance is charged under section 142A.25 or 256.98 for the same act or acts that are the subject of the hearing, the individual may request that the hearing be delayed until the criminal charge is decided by the court or withdrawn. new text end
new text begin (b) A human services judge may combine a fair hearing and administrative fraud disqualification hearing pursuant to section 142A.27, subdivision 2, or 256.046, subdivision 2, if either is under the jurisdiction of the commissioner of human services or the commissioner of children, youth, and families. new text end
Laws 2024, chapter 80, article 2, section 1, subdivision 11
Section 1.
new text begin [142B.01] DEFINITIONS. new text end
new text begin Subd. 11. new text end
new text begin Foster residence setting. new text end
new text begin "Foster residence setting" has the meaning given in Minnesota Rules, part 2960.3010, subpart 26, and includes settings licensed by the commissioner of children, youth, and families or the commissioner of corrections. new text end
Laws 2024, chapter 80, article 2, section 10, subdivision 4
Sec. 10.
new text begin [142B.18] SANCTIONS. new text end
new text begin Subd. 4. new text end
new text begin Immediate suspension of residential programs. new text end
new text begin For suspensions issued to a licensed residential program as defined in section 142B.01, subdivision 24, the effective date of the order may be delayed for up to 30 calendar days to provide for the continuity of care of service recipients. The license holder must cooperate with the commissioner to ensure service recipients receive continued care during the period of the delay and to facilitate the transition of service recipients to new providers. In these cases, the suspension order takes effect when all service recipients have been transitioned to a new provider or 30 days after the suspension order was issued, whichever comes first. new text end
Laws 2024, chapter 80, article 2, section 3, subdivision 3
Sec. 3.
new text begin [142B.03] SYSTEMS AND RECORDS. new text end
new text begin Subd. 3. new text end
new text begin First date of working in a setting; documentation requirements. new text end
new text begin Foster residence setting license holders must document the first date that a person who is a background study subject begins working in the license holder's setting. If the license holder does not maintain documentation of each background study subject's first date of working in the setting in the license holder's personnel files, the license holder must provide documentation to the commissioner that contains the first date that each background study subject began working in the license holder's program upon the commissioner's request. new text end
Laws 2024, chapter 80, article 2, section 33
Sec. 33.
Minnesota Statutes 2022, section 245A.02, subdivision 6e, is amended to read:
Subd. 6e.
Foster residence setting.
"Foster residence setting" has the meaning given in Minnesota Rules, part 2960.3010, subpart 26, and includes settings licensed by the commissioner of deleted text begin human servicesdeleted text end new text begin children, youth, and familiesnew text end or the commissioner of corrections.
Laws 2024, chapter 80, article 2, section 4, subdivision 4
Sec. 4.
new text begin [142B.05] WHO MUST BE LICENSED. new text end
new text begin Subd. 4. new text end
new text begin Licensing moratorium. new text end
new text begin (a) The commissioner shall not issue an initial license for child foster care licensed under Minnesota Rules, parts 2960.3000 to 2960.3340, under this chapter for a physical location that will not be the primary residence of the license holder for the entire period of licensure. If a family child foster care home license is issued during this moratorium and the license holder changes the license holder's primary residence away from the physical location of the foster care license, the commissioner shall revoke the license according to section 142B.18. When approving an exception under this paragraph, the commissioner shall consider the resource need determination process in paragraph (e), the availability of foster care licensed beds in the geographic area in which the licensee seeks to operate, the results of a person's choices during their annual assessment and service plan review, and the recommendation of the local county board. The determination by the commissioner is final and not subject to appeal. Exceptions to the moratorium include: new text end
new text begin (1) foster care licenses replacing foster care licenses in existence on May 15, 2009, and determined to be needed by the commissioner under paragraph (b); and new text end
new text begin (2) new foster care licenses determined to be needed by the commissioner under paragraph (b) for persons requiring hospital-level care. new text end
new text begin (b) The commissioner shall determine the need for newly licensed foster care homes. As part of the determination, the commissioner shall consider the availability of foster care capacity in the area in which the licensee seeks to operate, and the recommendation of the local county board. The determination by the commissioner must be final. A determination of need is not required for a change in ownership at the same address. new text end
new text begin (c) At the time of application and reapplication for licensure, the applicant and the license holder that are subject to the moratorium or an exclusion established in paragraph (a) are required to inform the commissioner whether the physical location where the foster care will be provided is or will be the primary residence of the license holder for the entire period of licensure. If the primary residence of the applicant or license holder changes, the applicant or license holder must notify the commissioner immediately. The commissioner shall print on the foster care license certificate whether or not the physical location is the primary residence of the license holder. new text end
new text begin (d) License holders of foster care homes identified under paragraph (c) that are not the primary residence of the license holder and that also provide services in the foster care home that are covered by a federally approved home and community-based services waiver, as authorized under chapter 256S or section 256B.092 or 256B.49, must inform the children, youth, and families licensing division that the license holder provides or intends to provide these waiver-funded services. new text end
new text begin (e) The commissioner may adjust capacity to address needs identified in section 144A.351. Under this authority, the commissioner may approve new licensed settings or delicense existing settings. Delicensing of settings will be accomplished through a process identified in section 256B.493. new text end
Laws 2024, chapter 80, article 2, section 6, subdivision 4
Sec. 6.
new text begin [142B.11] LICENSE APPLICATION AFTER CHANGE OF OWNERSHIP. new text end
new text begin Subd. 4. new text end
new text begin Temporary change in ownership license. new text end
new text begin (a) After receiving the party's application pursuant to subdivision 3, upon the written request of the existing license holder and the party, the commissioner may issue a temporary change in ownership license to the party while the commissioner evaluates the party's application. Until a decision is made to grant or deny a license under this chapter, the existing license holder and the party shall both be responsible for operating the program or service according to applicable laws and rules, and the sale or transfer of the existing license holder's ownership interest in the licensed program or service does not terminate the existing license. new text end
new text begin (b) The commissioner may issue a temporary change in ownership license when a license holder's death, divorce, or other event affects the ownership of the program and an applicant seeks to assume operation of the program or service to ensure continuity of the program or service while a license application is evaluated. new text end
new text begin (c) This subdivision applies to any program or service licensed under this chapter. new text end
Laws 2024, chapter 80, article 2, section 69
Sec. 69.
Minnesota Statutes 2022, section 245A.25, subdivision 1, is amended to read:
Subdivision 1.
Certification scope and applicability.
(a) This section establishes the requirements that a children's residential facility or child foster residence setting must meet to be certified for the purposes of Title IV-E funding requirements as:
(1) a qualified residential treatment program;
(2) a residential setting specializing in providing care and supportive services for youth who have been or are at risk of becoming victims of sex trafficking or commercial sexual exploitation;
(3) a residential setting specializing in providing prenatal, postpartum, or parenting support for youth; or
(4) a supervised independent living setting for youth who are 18 years of age or older.
(b) This section does not apply to a foster family setting in which the license holder resides in the foster home.
(c) Children's residential facilities licensed as detention settings according to Minnesota Rules, parts 2960.0230 to 2960.0290, or secure programs according to Minnesota Rules, parts 2960.0300 to 2960.0420, may not be certified under this section.
(d) For purposes of this section, "license holder" means an individual, organization, or government entity that was issued a children's residential facility or foster residence setting license by the commissioner of human services under this chapternew text begin ; by the commissioner of children, youth, and families under chapter 142B;new text end or by the commissioner of corrections under chapter 241.
(e) Certifications issued under this section for foster residence settings may only be issued by the commissioner of human services and are not delegated to county or private licensing agencies under section 245A.16.
Laws 2024, chapter 80, article 7, section 3
Sec. 3.
Minnesota Statutes 2022, section 256J.08, subdivision 32, is amended to read:
Subd. 32.
Fair hearing or hearing.
"Fair hearing" or "hearing" means the evidentiary hearing conducted by the department deleted text begin human servicesdeleted text end new text begin of children, youth, and familiesnew text end judge to resolve disputes as specified in section 256J.40, or if not applicable, section 256.045.
Laws 2024, chapter 80, article 7, section 9
Sec. 9.
Minnesota Statutes 2023 Supplement, section 256J.40, is amended to read:
256J.40 FAIR HEARINGS.
Caregivers receiving a notice of intent to sanction or a notice of adverse action that includes a sanction, reduction in benefits, suspension of benefits, denial of benefits, or termination of benefits may request a fair hearing. A request for a fair hearing must be submitted in writing to the county agency or to the commissioner and must be mailed within 30 days after a participant or former participant receives written notice of the agency's action or within 90 days when a participant or former participant shows good cause for not submitting the request within 30 days. A former participant who receives a notice of adverse action due to an overpayment may appeal the adverse action according to the requirements in this section. Issues that may be appealed are:
(1) the amount of the assistance payment;
(2) a suspension, reduction, denial, or termination of assistance;
(3) the basis for an overpayment, the calculated amount of an overpayment, and the level of recoupment;
(4) the eligibility for an assistance payment; and
(5) the use of protective or vendor payments under section 256J.39, subdivision 2, clauses (1) to (3).
A county agency must not reduce, suspend, or terminate payment when an aggrieved participant requests a fair hearing prior to the effective date of the adverse action or within ten days of the mailing of the notice of adverse action, whichever is later, unless the participant requests in writing not to receive continued assistance pending a hearing decision. Assistance issued pending a fair hearing is subject to recovery under section 256P.08 when as a result of the fair hearing decision the participant is determined ineligible for assistance or the amount of the assistance received. A county agency may increase or reduce an assistance payment while an appeal is pending when the circumstances of the participant change and are not related to the issue on appeal. The commissioner's order is binding on a county agency. No additional notice is required to enforce the commissioner's order.
A county agency shall reimburse appellants for reasonable and necessary expenses of attendance at the hearing, such as child care and transportation costs and for the transportation expenses of the appellant's witnesses and representatives to and from the hearing. Reasonable and necessary expenses do not include legal fees. Fair hearings must be conducted at a reasonable time and date by an impartial deleted text begin human servicesdeleted text end new text begin children, youth, and familiesnew text end judge employed by the department. The hearing may be conducted by telephone or at a site that is readily accessible to persons with disabilities.
The appellant may introduce new or additional evidence relevant to the issues on appeal. Recommendations of the deleted text begin human servicesdeleted text end new text begin children, youth, and familiesnew text end judge and decisions of the commissioner must be based on evidence in the hearing record and are not limited to a review of the county agency action.
Repealed Minnesota Rule: S4699-1
2960.0620 USE OF PSYCHOTROPIC MEDICATIONS.
Subp. 3.
Monitoring for tardive dyskinesia.
The license holder, under the direction of a medically licensed person, must monitor for tardive dyskinesia at least every three months if a resident is prescribed antipsychotic medication or amoxapine and must document the monitoring. A resident prescribed antipsychotic medication or amoxapine for more than 90 days must be checked for tardive dyskinesia at least 30 and 60 days after discontinuation of the antipsychotic medication or amoxapine. Monitoring must include use of a standardized rating scale and examination procedure. The license holder must provide the assessments to the physician for review if the results meet criteria that require physician review.
9502.0425 PHYSICAL ENVIRONMENT.
Subp. 5.
Occupancy separations.
Day care residences with an attached garage must have a self-closing, tight fitting solid wood bonded core door at least 1-3/8 inch thick, or door with a fire protection rating of 20 minutes or greater and a separation wall consisting of 5/8 inch thick gypsum wallboard or its equivalent on the garage side between the residence and garage.
9545.0805 PERSONNEL.
Subpart 1.
Supervision by a licensed independent social worker or independent clinical social worker.
An independent social worker or independent clinical social worker as defined in Minnesota Statutes, section 148B.21, must supervise an agency's case work. Supervising an agency's case work includes reviewing and approving each written home study the agency completes on prospective foster parents or applicants to adopt. An agency can meet the supervision requirement by complying with item A, B, C, or D.
A.
The agency's chief executive officer is a licensed independent social worker or independent clinical social worker and supervises staff members providing case work.
B.
The person who does the case work is licensed as an independent social worker or independent clinical social worker.
C.
The agency contracts with a licensed independent social worker or independent clinical social worker to supervise staff members' case work.
9545.0845 PLAN FOR TRANSFER OF RECORDS.
An applicant for initial or continuing licensure must submit a written plan indicating how the agency will provide for the transfer of records on both open and closed cases if the agency closes. The plan must provide for managing private and confidential information on agency clients, according to Minnesota Statutes, section 259.79. A controlling individual of the agency must sign the plan.
A.
Plans for the transfer of open cases and case records must specify arrangements the agency will make to transfer clients to another agency or county for continuation of services and to transfer the case record with the client.
B.
Plans for the transfer of closed adoption records must be accompanied by a signed agreement or other documentation indicating that a county or licensed child placing agency has agreed to accept and maintain the agency's closed case records and to provide follow-up services to affected clients.
9560.0232 ADMINISTRATIVE REQUIREMENTS.
Subp. 5.
Child mortality review panel.
A.
For purposes of this subpart, "local review panel" means a local multidisciplinary child mortality review panel.
B.
Under the commissioner's authority in Minnesota Statutes, section 256.01, subdivision 12, paragraph (b), each county shall establish a local review panel and shall participate on the local review panel. The local agency's child protection team may serve as the local review panel. The local review panel shall require participation by professional representatives, including professionals with knowledge of the child mortality case being reviewed.
C.
The local review panel shall:
(1)
have access to not public data under Minnesota Statutes, section 256.01, subdivision 12, paragraph (c), maintained by state agencies, statewide systems, or political subdivisions that are related to a child's death or circumstances surrounding the care of the child;
(2)
conduct a local review of the case within 60 days of the death of a child if:
(b)
the manner of death was due to sudden infant death syndrome or was other than by natural causes, and the child was a member of a family receiving social services from a local agency, a member of a family that received social services during the year before the child's death, or a member of a family that was the subject of a child protection assessment; or
(c)
the death occurred in a facility licensed by the department if the manner of death was by other than natural causes; and
(3)
submit a report of the review to the department within 30 days of completing subitem (2).
A review may be delayed if there is pending litigation or an active assessment or investigation.
D.
Under Minnesota Statutes, section 256.01, subdivision 12, paragraph (d):
(1)
data acquired by the local review panel in the exercise of its duty is protected nonpublic or confidential data as defined in Minnesota Statutes, section 13.02, but may be disclosed as necessary to carry out the purposes of the local review panel. The data is not subject to subpoena or discovery; and
E.
Persons attending the local review panel meeting, members of the local review panel, persons who presented information to the local review panel, and all data, information, documents, and records pertaining to the local review panel must comply with the requirements under Minnesota Statutes, section 256.01, subdivision 12, paragraph (e).