1.1 	CONFERENCE COMMITTEE REPORT ON S.F. No. 4399
1.2 	A bill for an act
1.3 	relating to human services; modifying and establishing laws regarding disability 
1.4 	services, aging services, and substance use disorder treatment services; modifying 
1.5 	assisted living facility licensing standards; modernizing language in Deaf and 
1.6 	Hard-of-Hearing Services Act; expanding application of bloodborne pathogen 
1.7 	testing to nonsecure direct care and treatment programming; making technical 
1.8 	corrections and repealing obsolete language; limiting rent increases in certain 
1.9 	low-income rental projects receiving low-income housing tax credits;amending 
1.10 	Minnesota Statutes 2022, sections 144A.20, subdivision 4; 144G.30, subdivision 
1.11 	5; 144G.45, subdivision 3; 148F.025, subdivision 2; 245A.11, subdivision 2; 
1.12 	245D.071, subdivisions 3, 4; 245D.081, subdivisions 2, 3; 245D.09, subdivision 
1.13 	3; 245D.091, subdivisions 3, 4; 245D.10, subdivision 1; 245F.02, subdivisions 17, 
1.14 	21; 245F.08, subdivision 3; 245F.15, subdivision 7; 245G.031, subdivision 2; 
1.15 	245G.04, by adding a subdivision; 245G.22, subdivision 6; 246.71, subdivisions 
1.16 	3, 4, 5; 246.711; 246.712, subdivisions 1, 2; 246.713; 246.714; 246.715, 
1.17 	subdivisions 1, 2, 3; 246.716, subdivisions 1, 2, as amended; 246.717; 246.721, 
1.18 	as amended; 246.722; 254A.03, subdivision 1; 256.975, subdivision 7e; 256B.0659, 
1.19 	subdivision 17a; 256B.0759, subdivision 4; 256B.0911, subdivision 24; 256B.092, 
1.20 	by adding a subdivision; 256B.49, by adding a subdivision; 256B.4905, subdivision 
1.21 	12; 256B.69, subdivision 5k, by adding a subdivision; 256B.85, subdivisions 2, 
1.22 	6, 6a, 7a, 11, 17, 20, by adding a subdivision; 256C.21; 256C.23, subdivisions 1a, 
1.23 	2, 2a, 2b, 2c, 6, 7, by adding a subdivision; 256C.233, subdivisions 1, 2; 256C.24, 
1.24 	subdivisions 1, 2, 3; 256C.26; 256C.261; 256C.28, subdivision 1; 256R.08, 
1.25 	subdivision 1, by adding a subdivision; 256S.205, subdivision 5, by adding a 
1.26 	subdivision; 402A.16, subdivision 2; Minnesota Statutes 2023 Supplement, sections 
1.27 	245G.05, subdivision 3; 245G.09, subdivision 3; 245G.11, subdivision 10; 245G.22, 
1.28 	subdivisions 2, 17; 254A.19, subdivision 3; 254B.04, subdivision 6, by adding a 
1.29 	subdivision; 254B.05, subdivisions 1, 5; 254B.181, subdivision 1; 254B.19, 
1.30 	subdivision 1; 256B.057, subdivision 9; 256B.0659, subdivision 24; 256B.0759, 
1.31 	subdivision 2; 256B.4914, subdivisions 4, 10, 10a; 256B.85, subdivision 13a; 
1.32 	Laws 2021, First Special Session chapter 7, article 11, section 38, as amended; 
1.33 	article 13, section 75; Laws 2023, chapter 61, article 8, section 13, subdivision 2; 
1.34 	repealing Minnesota Statutes 2022, sections 245G.011, subdivision 5; 245G.22, 
1.35 	subdivisions 4, 7; 252.34; 256.01, subdivision 39; 256.975, subdivisions 7f, 7g; 
1.36 	256R.18.
1.37 	May 3, 2024
1.38 	The Honorable Bobby Joe Champion
1.39 	President of the Senate
1.40 	The Honorable Melissa Hortman
1.41 	Speaker of the House of Representatives
2.1 	We, the undersigned conferees for S.F. No. 4399 report that we have agreed upon the 
2.2 	items in dispute and recommend as follows:
2.3 	That the House recede from its amendments and that S.F. No. 4399 be further amended 
2.4 	as follows:
2.5 	Delete everything after the enacting clause and insert:

2.6 	ARTICLE 1
2.7 	DISABILITY SERVICES

2.8 	Section 1. Minnesota Statutes 2022, section 144G.45, subdivision 3, is amended to read:
2.9 		Subd. 3.Local laws apply. Assisted living facilities shall comply with all applicable 
2.10 	state and local governing laws, regulations, standards, ordinances, and codes for fire safety, 
2.11 	building, and zoning requirements, except a facility with a licensed resident capacity of six 
2.12 	or fewer is exempt from rental licensing regulations imposed by any town, municipality, 
2.13 	or county.

2.14 	EFFECTIVE DATE. This section is effective the day following final enactment.

2.15 	Sec. 2. Minnesota Statutes 2022, section 245A.11, subdivision 2, as amended by Laws 
2.16 	2024, chapter 85, section 55, is amended to read:
2.17 		Subd. 2.Permitted single-family residential use. (a) Residential programs with a 
2.18 	licensed capacity of six or fewer persons shall be considered a permitted single-family 
2.19 	residential use of property for the purposes of zoning and other land use regulations, except 
2.20 	that a residential program whose primary purpose is to treat juveniles who have violated 
2.21 	criminal statutes relating to sex offenses or have been adjudicated delinquent on the basis 
2.22 	of conduct in violation of criminal statutes relating to sex offenses shall not be considered 
2.23 	a permitted use. This exception shall not apply to residential programs licensed before July 
2.24 	1, 1995. Programs otherwise allowed under this subdivision shall not be prohibited by 
2.25 	operation of restrictive covenants or similar restrictions, regardless of when entered into, 
2.26 	which cannot be met because of the nature of the licensed program, including provisions 
2.27 	which require the home's occupants be related, and that the home must be occupied by the 
2.28 	owner, or similar provisions.
2.29 	(b) A community residential setting as defined in section 245D.02, subdivision 4a, with 
2.30 	a licensed capacity of six or fewer persons that is actively serving residents for which it is 
2.31 	licensed is exempt from rental licensing regulations imposed by any town, municipality, or 
2.32 	county.

3.1 	EFFECTIVE DATE. This section is effective the day following final enactment.

3.2 	Sec. 3. Minnesota Statutes 2022, section 245D.071, subdivision 3, is amended to read:
3.3 		Subd. 3.Assessment and initial service planning. (a) Within 15 days of service initiation 
3.4 	the license holder must complete a preliminary support plan addendum based on the support 
3.5 	plan.
3.6 	(b) Within the scope of services, the license holder must, at a minimum, complete 
3.7 	assessments in the following areas before the 45-day planning meeting providing 45 days 
3.8 	of service or within 60 calendar days of service initiation, whichever is shorter:
3.9 	(1) the person's ability to self-manage health and medical needs to maintain or improve 
3.10 	physical, mental, and emotional well-being, including, when applicable, allergies, seizures, 
3.11 	choking, special dietary needs, chronic medical conditions, self-administration of medication 
3.12 	or treatment orders, preventative screening, and medical and dental appointments;
3.13 	(2) the person's ability to self-manage personal safety to avoid injury or accident in the 
3.14 	service setting, including, when applicable, risk of falling, mobility, regulating water 
3.15 	temperature, community survival skills, water safety skills, and sensory disabilities; and
3.16 	(3) the person's ability to self-manage symptoms or behavior that may otherwise result 
3.17 	in an incident as defined in section 245D.02, subdivision 11, clauses (4) to (7), suspension 
3.18 	or termination of services by the license holder, or other symptoms or behaviors that may 
3.19 	jeopardize the health and welfare of the person or others.
3.20 	Assessments must produce information about the person that describes the person's overall 
3.21 	strengths, functional skills and abilities, and behaviors or symptoms. Assessments must be 
3.22 	based on the person's status within the last 12 months at the time of service initiation. 
3.23 	Assessments based on older information must be documented and justified. Assessments 
3.24 	must be conducted annually at a minimum or within 30 days of a written request from the 
3.25 	person or the person's legal representative or case manager. The results must be reviewed 
3.26 	by the support team or expanded support team as part of a service plan review.
3.27 	(c) Before providing 45 days of service or within 60 calendar days of service initiation, 
3.28 	whichever is shorter, the license holder must meethold an initial planning meeting with the 
3.29 	person, the person's legal representative, the case manager, other members of the support 
3.30 	team or expanded support team, and other people as identified by the person or the person's 
3.31 	legal representative to determine the following based on information obtained from the 
3.32 	assessments identified in paragraph (b), the person's identified needs in the support plan, 
3.33 	and the requirements in subdivision 4 and section 245D.07, subdivision 1a:
4.1 	(1) the scope of the services to be provided to support the person's daily needs and 
4.2 	activities;
4.3 	(2) the person's desired outcomes and the supports necessary to accomplish the person's 
4.4 	desired outcomes;
4.5 	(3) the person's preferences for how services and supports are provided, including how 
4.6 	the provider will support the person to have control of the person's schedule;
4.7 	(4) whether the current service setting is the most integrated setting available and 
4.8 	appropriate for the person;
4.9 	(5) opportunities to develop and maintain essential and life-enriching skills, abilities, 
4.10 	strengths, interests, and preferences;
4.11 	(6) opportunities for community access, participation, and inclusion in preferred 
4.12 	community activities;
4.13 	(7) opportunities to develop and strengthen personal relationships with other persons of 
4.14 	the person's choice in the community;
4.15 	(8) opportunities to seek competitive employment and work at competitively paying 
4.16 	jobs in the community; and
4.17 	(9) how services must be coordinated across other providers licensed under this chapter 
4.18 	serving the person and members of the support team or expanded support team to ensure 
4.19 	continuity of care and coordination of services for the person.
4.20 	(d) A discussion of how technology might be used to meet the person's desired outcomes 
4.21 	must be included in the 45-day initial planning meeting. The support plan or support plan 
4.22 	addendum must include a summary of this discussion. The summary must include a statement 
4.23 	regarding any decision that is made regarding the use of technology and a description of 
4.24 	any further research that needs to be completed before a decision regarding the use of 
4.25 	technology can be made. Nothing in this paragraph requires that the support plan include 
4.26 	the use of technology for the provision of services.

4.27 	Sec. 4. Minnesota Statutes 2022, section 245D.071, subdivision 4, is amended to read:
4.28 		Subd. 4.Service outcomes and supports. (a) Within ten working days of the 45-day
4.29 	initial planning meeting, the license holder must develop a service plan that documents the 
4.30 	service outcomes and supports based on the assessments completed under subdivision 3 
4.31 	and the requirements in section 245D.07, subdivision 1a. The outcomes and supports must 
4.32 	be included in the support plan addendum.
5.1 	(b) The license holder must document the supports and methods to be implemented to 
5.2 	support the person and accomplish outcomes related to acquiring, retaining, or improving 
5.3 	skills and physical, mental, and emotional health and well-being. The documentation must 
5.4 	include:
5.5 	(1) the methods or actions that will be used to support the person and to accomplish the 
5.6 	service outcomes, including information about:
5.7 	(i) any changes or modifications to the physical and social environments necessary when 
5.8 	the service supports are provided;
5.9 	(ii) any equipment and materials required; and
5.10 	(iii) techniques that are consistent with the person's communication mode and learning 
5.11 	style;
5.12 	(2) the measurable and observable criteria for identifying when the desired outcome has 
5.13 	been achieved and how data will be collected;
5.14 	(3) the projected starting date for implementing the supports and methods and the date 
5.15 	by which progress towards accomplishing the outcomes will be reviewed and evaluated; 
5.16 	and
5.17 	(4) the names of the staff or position responsible for implementing the supports and 
5.18 	methods.
5.19 	(c) Within 20 working days of the 45-day initial planning meeting, the license holder 
5.20 	must submit to and obtain dated signatures from the person or the person's legal representative 
5.21 	and case manager to document completion and approval of the assessment and support plan 
5.22 	addendum. If, within ten working days of the submission of the assessment or support plan 
5.23 	addendum, the person or the person's legal representative or case manager has not signed 
5.24 	and returned to the license holder the assessment and support plan addendum or has not 
5.25 	proposed written modifications to the license holder's submission, the submission is deemed 
5.26 	approved and the assessment and support plan addendum become effective and remain in 
5.27 	effect until the legal representative or case manager submits a written request to revise the 
5.28 	assessment or support plan addendum.

5.29 	Sec. 5. Minnesota Statutes 2022, section 245D.081, subdivision 2, is amended to read:
5.30 		Subd. 2.Coordination and evaluation of individual service delivery. (a) Delivery 
5.31 	and evaluation of services provided by the license holder must be coordinated by a designated 
6.1 	staff person. Except as provided in clause (3), the designated coordinator must provide 
6.2 	supervision, support, and evaluation of activities that include:
6.3 	(1) oversight of the license holder's responsibilities assigned in the person's support plan 
6.4 	and the support plan addendum;
6.5 	(2) taking the action necessary to facilitate the accomplishment of the outcomes according 
6.6 	to the requirements in section 245D.07;
6.7 	(3) instruction and assistance to direct support staff implementing the support plan and 
6.8 	the service outcomes, including direct observation of service delivery sufficient to assess 
6.9 	staff competency. The designated coordinator may delegate the direct observation and 
6.10 	competency assessment of the service delivery activities of direct support staff to an 
6.11 	individual whom the designated coordinator has previously deemed competent in those 
6.12 	activities; and
6.13 	(4) evaluation of the effectiveness of service delivery, methodologies, and progress on 
6.14 	the person's outcomes based on the measurable and observable criteria for identifying when 
6.15 	the desired outcome has been achieved according to the requirements in section 245D.07.
6.16 	(b) The license holder must ensure that the designated coordinator is competent to 
6.17 	perform the required duties identified in paragraph (a) through education, training, and work 
6.18 	experience relevant to the primary disability of persons served by the license holder and 
6.19 	the individual persons for whom the designated coordinator is responsible. The designated 
6.20 	coordinator must have the skills and ability necessary to develop effective plans and to 
6.21 	design and use data systems to measure effectiveness of services and supports. The license 
6.22 	holder must verify and document competence according to the requirements in section 
6.23 	245D.09, subdivision 3. The designated coordinator must minimally have:
6.24 	(1) a baccalaureate degree in a field related to human services, education, or health and 
6.25 	one year of full-time work experience providing direct care services to persons with 
6.26 	disabilities or persons age 65 and older, or equivalent work experience providing care or 
6.27 	education to vulnerable adults or children;
6.28 	(2) an associate degree in a field related to human services, education, or health and two 
6.29 	years of full-time work experience providing direct care services to persons with disabilities 
6.30 	or persons age 65 and older, or equivalent work experience providing care or education to 
6.31 	vulnerable adults or children;
6.32 	(3) a diploma in a field related to human services, education, or health from an accredited 
6.33 	postsecondary institution and three years of full-time work experience providing direct care 
7.1 	services to persons with disabilities or persons age 65 and older or equivalent work experience 
7.2 	providing care or education to vulnerable adults or children; or
7.3 	(4) a minimum of 50 hours of education and training related to human services and 
7.4 	disabilities; and
7.5 	(5) four years of full-time work experience providing direct care services to persons 
7.6 	with disabilities or persons age 65 and older under the supervision of a staff person who 
7.7 	meets the qualifications identified in clauses (1) to (3).

7.8 	Sec. 6. Minnesota Statutes 2022, section 245D.081, subdivision 3, is amended to read:
7.9 		Subd. 3.Program management and oversight. (a) The license holder must designate 
7.10 	a managerial staff person or persons to provide program management and oversight of the 
7.11 	services provided by the license holder. The designated manager is responsible for the 
7.12 	following:
7.13 	(1) maintaining a current understanding of the licensing requirements sufficient to ensure 
7.14 	compliance throughout the program as identified in section 245A.04, subdivision 1, paragraph 
7.15 	(e), and when applicable, as identified in section 256B.04, subdivision 21, paragraph (g);
7.16 	(2) ensuring the duties of the designated coordinator are fulfilled according to the 
7.17 	requirements in subdivision 2;
7.18 	(3) ensuring the program implements corrective action identified as necessary by the 
7.19 	program following review of incident and emergency reports according to the requirements 
7.20 	in section 245D.11, subdivision 2, clause (7). An internal review of incident reports of 
7.21 	alleged or suspected maltreatment must be conducted according to the requirements in 
7.22 	section 245A.65, subdivision 1, paragraph (b);
7.23 	(4) evaluation of satisfaction of persons served by the program, the person's legal 
7.24 	representative, if any, and the case manager, with the service delivery and progress toward 
7.25 	accomplishing outcomes identified in sections 245D.07 and 245D.071, and ensuring and 
7.26 	protecting each person's rights as identified in section 245D.04;
7.27 	(5) ensuring staff competency requirements are met according to the requirements in 
7.28 	section 245D.09, subdivision 3, and ensuring staff orientation and training is provided 
7.29 	according to the requirements in section 245D.09, subdivisions 4, 4a, and 5;
7.30 	(6) ensuring corrective action is taken when ordered by the commissioner and that the 
7.31 	terms and conditions of the license and any variances are met; and
8.1 	(7) evaluating the information identified in clauses (1) to (6) to develop, document, and 
8.2 	implement ongoing program improvements.
8.3 	(b) The designated manager must be competent to perform the duties as required and 
8.4 	must minimally meet the education and training requirements identified in subdivision 2, 
8.5 	paragraph (b), and have a minimum of three years of supervisory level experience in a 
8.6 	program providing direct support services to persons with disabilities or persons age 65 and 
8.7 	older that provides care or education to vulnerable adults or children.

8.8 	Sec. 7. Minnesota Statutes 2022, section 245D.09, subdivision 3, is amended to read:
8.9 		Subd. 3.Staff qualifications. (a) The license holder must ensure that staff providing 
8.10 	direct support, or staff who have responsibilities related to supervising or managing the 
8.11 	provision of direct support service, are competent as demonstrated through skills and 
8.12 	knowledge training, experience, and education relevant to the primary disability of the 
8.13 	person and to meet the person's needs and additional requirements as written in the support 
8.14 	plan or support plan addendum, or when otherwise required by the case manager or the 
8.15 	federal waiver plan. The license holder must verify and maintain evidence of staff 
8.16 	competency, including documentation of:
8.17 	(1) education and experience qualifications relevant to the job responsibilities assigned 
8.18 	to the staff and to the primary disability of persons served by the program, including a valid 
8.19 	degree and transcript, or a current license, registration, or certification, when a degree or 
8.20 	licensure, registration, or certification is required by this chapter or in the support plan or 
8.21 	support plan addendum;
8.22 	(2) demonstrated competency in the orientation and training areas required under this 
8.23 	chapter, and when applicable, completion of continuing education required to maintain 
8.24 	professional licensure, registration, or certification requirements. Competency in these areas 
8.25 	is determined by the license holder through knowledge testing or observed skill assessment 
8.26 	conducted by the trainer or instructor or by an individual who has been previously deemed 
8.27 	competent by the trainer or instructor in the area being assessed; and
8.28 	(3) except for a license holder who is the sole direct support staff, periodic performance 
8.29 	evaluations completed by the license holder of the direct support staff person's ability to 
8.30 	perform the job functions based on direct observation.
8.31 	(b) Staff under 18 years of age may not perform overnight duties or administer 
8.32 	medication.

9.1 	Sec. 8. Minnesota Statutes 2022, section 245D.091, subdivision 3, is amended to read:
9.2 		Subd. 3.Positive support analyst qualifications. (a) A positive support analyst providing 
9.3 	positive support services as identified in section 245D.03, subdivision 1, paragraph (c), 
9.4 	clause (1), item (i), must have competencies in one of the following areas as required under 
9.5 	the brain injury, community access for disability inclusion, community alternative care, and 
9.6 	developmental disabilities waiver plans or successor plans:
9.7 	(1) have obtained a baccalaureate degree, master's degree, or PhD in either a social 
9.8 	services discipline or nursing;
9.9 	(2) meet the qualifications of a mental health practitioner as defined in section 245.462, 
9.10 	subdivision 17; or
9.11 	(3) be a board-certified behavior analyst or board-certified assistant behavior analyst by 
9.12 	the Behavior Analyst Certification Board, Incorporated.
9.13 	(b) In addition, a positive support analyst must:
9.14 	(1) have four two years of supervised experience conducting functional behavior 
9.15 	assessments and designing, implementing, and evaluating effectiveness of positive practices 
9.16 	behavior support strategies for people who exhibit challenging behaviors as well as 
9.17 	co-occurring mental disorders and neurocognitive disorder;
9.18 	(2) have received training prior to hire or within 90 calendar days of hire that includes:
9.19 	(i) ten hours of instruction in functional assessment and functional analysis;
9.20 	(ii) 20 hours of instruction in the understanding of the function of behavior;
9.21 	(iii) ten hours of instruction on design of positive practices behavior support strategies;
9.22 	(iv) 20 hours of instruction preparing written intervention strategies, designing data 
9.23 	collection protocols, training other staff to implement positive practice strategies, 
9.24 	summarizing and reporting program evaluation data, analyzing program evaluation data to 
9.25 	identify design flaws in behavioral interventions or failures in implementation fidelity, and 
9.26 	recommending enhancements based on evaluation data; and
9.27 	(v) eight hours of instruction on principles of person-centered thinking;
9.28 	(3) be determined by a positive support professional to have the training and prerequisite 
9.29 	skills required to provide positive practice strategies as well as behavior reduction approved 
9.30 	and permitted intervention to the person who receives positive support; and
9.31 	(4) be under the direct supervision of a positive support professional.
10.1 	(c) Meeting the qualifications for a positive support professional under subdivision 2 
10.2 	shall substitute for meeting the qualifications listed in paragraph (b).

10.3 	EFFECTIVE DATE. This section is effective July 1, 2024, or upon federal approval, 
10.4 	whichever occurs later. The commissioner of human services shall inform the revisor of 
10.5 	statutes when federal approval is obtained.

10.6 	Sec. 9. Minnesota Statutes 2022, section 245D.091, subdivision 4, is amended to read:
10.7 		Subd. 4.Positive support specialist qualifications. (a) A positive support specialist 
10.8 	providing positive support services as identified in section 245D.03, subdivision 1, paragraph 
10.9 	(c), clause (1), item (i), must have competencies in one of the following areas as required 
10.10 	under the brain injury, community access for disability inclusion, community alternative 
10.11 	care, and developmental disabilities waiver plans or successor plans:
10.12 	(1) have an associate's degree in either a social services discipline or nursing; or
10.13 	(2) have two years of supervised experience working with individuals who exhibit 
10.14 	challenging behaviors as well as co-occurring mental disorders or neurocognitive disorder.
10.15 	(b) In addition, a behavior specialist must:
10.16 	(1) have received training prior to hire or within 90 calendar days of hire that includes:
10.17 	(i) a minimum of four hours of training in functional assessment;
10.18 	(ii) 20 hours of instruction in the understanding of the function of behavior;
10.19 	(iii) ten hours of instruction on design of positive practices behavioral support strategies; 
10.20 	and
10.21 	(iv) eight hours of instruction on principles of person-centered thinking;
10.22 	(2) be determined by a positive support professional to have the training and prerequisite 
10.23 	skills required to provide positive practices strategies as well as behavior reduction approved 
10.24 	intervention to the person who receives positive support; and
10.25 	(3) be under the direct supervision of a positive support professional.
10.26 	(c) Meeting the qualifications for a positive support professional under subdivision 2 
10.27 	shall substitute for meeting the qualifications listed in paragraphs (a) and (b).

10.28 	EFFECTIVE DATE. This section is effective July 1, 2024, or upon federal approval, 
10.29 	whichever occurs later. The commissioner of human services shall inform the revisor of 
10.30 	statutes when federal approval is obtained.

11.1 	Sec. 10. Minnesota Statutes 2022, section 245D.10, subdivision 1, is amended to read:
11.2 		Subdivision 1.Policy and procedure requirements.  A license holder providing either 
11.3 	basic or intensive supports and services must establish, enforce, and maintain policies and 
11.4 	procedures as required in this chapter, chapter 245A, and other applicable state and federal 
11.5 	laws and regulations governing the provision of home and community-based services 
11.6 	licensed according to this chapter. A license holder must use forms provided by the 
11.7 	commissioner to report service suspensions and service terminations under subdivisions 3 
11.8 	and 3a.

11.9 	EFFECTIVE DATE. This section is effective August 1, 2024.

11.10 	Sec. 11. Minnesota Statutes 2023 Supplement, section 256B.057, subdivision 9, is amended 
11.11 	to read:
11.12 		Subd. 9.Employed persons with disabilities. (a) Medical assistance may be paid for 
11.13 	a person who is employed and who:
11.14 	(1) but for excess earnings or assets meets the definition of disabled under the 
11.15 	Supplemental Security Income program; and
11.16 	(2) pays a premium and other obligations under paragraph (e) (d).
11.17 	(b) For purposes of eligibility, there is a $65 earned income disregard. To be eligible 
11.18 	for medical assistance under this subdivision, a person must have more than $65 of earned 
11.19 	income, be receiving an unemployment insurance benefit under chapter 268 that the person 
11.20 	began receiving while eligible under this subdivision, or be receiving family and medical 
11.21 	leave benefits under chapter 268B that the person began receiving while eligible under this 
11.22 	subdivision. Earned income must have Medicare, Social Security, and applicable state and 
11.23 	federal taxes withheld. The person must document earned income tax withholding. A person 
11.24 	who is self-employed must file and pay all applicable taxes. Any spousal income shall be 
11.25 	disregarded for purposes of eligibility and premium determinations.
11.26 	(c) After the month of enrollment, a person enrolled in medical assistance under this 
11.27 	subdivision who would otherwise be ineligible and be disenrolled due to one of the following 
11.28 	circumstances may retain eligibility for up to four consecutive months after a month of job 
11.29 	loss if the person:
11.30 	(1) is temporarily unable to work and without receipt of earned income due to a medical 
11.31 	condition, as verified by a physician, advanced practice registered nurse, or physician 
11.32 	assistant; or
12.1 	(2) loses employment for reasons not attributable to the enrollee, and is without receipt 
12.2 	of earned income.
12.3 	To receive a four-month extension of continued eligibility under this paragraph, enrollees 
12.4 	must verify the medical condition or provide notification of job loss, continue to meet all 
12.5 	other eligibility requirements, and continue to pay all calculated premium costs.
12.6 	(d) All enrollees must pay a premium to be eligible for medical assistance under this 
12.7 	subdivision, except as provided under clause (5).
12.8 	(1) An enrollee must pay the greater of a $35 premium or the premium calculated based 
12.9 	on the person's gross earned and unearned income and the applicable family size using a 
12.10 	sliding fee scale established by the commissioner, which begins at one percent of income 
12.11 	at 100 percent of the federal poverty guidelines and increases to 7.5 percent of income for 
12.12 	those with incomes at or above 300 percent of the federal poverty guidelines.
12.13 	(2) Annual adjustments in the premium schedule based upon changes in the federal 
12.14 	poverty guidelines shall be effective for premiums due in July of each year.
12.15 	(3) All enrollees who receive unearned income must pay one-half of one percent of 
12.16 	unearned income in addition to the premium amount, except as provided under clause (5).
12.17 	(4) Increases in benefits under title II of the Social Security Act shall not be counted as 
12.18 	income for purposes of this subdivision until July 1 of each year.
12.19 	(5) Effective July 1, 2009, American Indians are exempt from paying premiums as 
12.20 	required by section 5006 of the American Recovery and Reinvestment Act of 2009, Public 
12.21 	Law 111-5. For purposes of this clause, an American Indian is any person who meets the 
12.22 	definition of Indian according to Code of Federal Regulations, title 42, section 447.50.
12.23 	(e) A person's eligibility and premium shall be determined by the local county agency. 
12.24 	Premiums must be paid to the commissioner. All premiums are dedicated to the 
12.25 	commissioner.
12.26 	(f) Any required premium shall be determined at application and redetermined at the 
12.27 	enrollee's six-month 12-month income review or when a change in income or household 
12.28 	size is reported. Enrollees must report any change in income or household size within ten
12.29 	30 days of when the change occurs. A decreased premium resulting from a reported change 
12.30 	in income or household size shall be effective the first day of the next available billing 
12.31 	month after the change is reported. Except for changes occurring from annual cost-of-living 
12.32 	increases, a change resulting in an increased premium shall not affect the premium amount 
12.33 	until the next six-month 12-month review.
13.1 	(g) Premium payment is due upon notification from the commissioner of the premium 
13.2 	amount required. Premiums may be paid in installments at the discretion of the commissioner.
13.3 	(h) Nonpayment of the premium shall result in denial or termination of medical assistance 
13.4 	unless the person demonstrates good cause for nonpayment. "Good cause" means an excuse 
13.5 	for the enrollee's failure to pay the required premium when due because the circumstances 
13.6 	were beyond the enrollee's control or not reasonably foreseeable. The commissioner shall 
13.7 	determine whether good cause exists based on the weight of the supporting evidence 
13.8 	submitted by the enrollee to demonstrate good cause. Except when an installment agreement 
13.9 	is accepted by the commissioner, all persons disenrolled for nonpayment of a premium must 
13.10 	pay any past due premiums as well as current premiums due prior to being reenrolled. 
13.11 	Nonpayment shall include payment with a returned, refused, or dishonored instrument. The 
13.12 	commissioner may require a guaranteed form of payment as the only means to replace a 
13.13 	returned, refused, or dishonored instrument.
13.14 	(i) For enrollees whose income does not exceed 200 percent of the federal poverty 
13.15 	guidelines and who are also enrolled in Medicare, the commissioner shall reimburse the 
13.16 	enrollee for Medicare part B premiums under section 256B.0625, subdivision 15, paragraph 
13.17 	(a).
13.18 	(j) The commissioner is authorized to determine that a premium amount was calculated 
13.19 	or billed in error, make corrections to financial records and billing systems, and refund 
13.20 	premiums collected in error.

13.21 	Sec. 12. Minnesota Statutes 2022, section 256B.0659, subdivision 17a, is amended to 
13.22 	read:
13.23 		Subd. 17a.Enhanced rate. (a) An enhanced rate of 107.5 percent of the rate paid for 
13.24 	personal care assistance services shall be paid for services provided to persons who qualify 
13.25 	for ten or more hours of personal care assistance services per day when provided by a 
13.26 	personal care assistant who meets the requirements of subdivision 11, paragraph (d).
13.27 	(b) A personal care assistance provider must use all additional revenue attributable to 
13.28 	the rate enhancements under this subdivision for the wages and wage-related costs of the 
13.29 	personal care assistants, including any corresponding increase in the employer's share of 
13.30 	FICA taxes, Medicare taxes, state and federal unemployment taxes, and workers' 
13.31 	compensation premiums. The agency must not use the additional revenue attributable to 
13.32 	any enhanced rate under this subdivision to pay for mileage reimbursement, health and 
13.33 	dental insurance, life insurance, disability insurance, long-term care insurance, uniform 
13.34 	allowance, contributions to employee retirement accounts, or any other employee benefits.
14.1 	(c) Any change in the eligibility criteria for the enhanced rate for personal care assistance 
14.2 	services as described in this subdivision and referenced in subdivision 11, paragraph (d), 
14.3 	does not constitute a change in a term or condition for individual providers as defined in 
14.4 	section 256B.0711, and is not subject to the state's obligation to meet and negotiate under 
14.5 	chapter 179A.

14.6 	EFFECTIVE DATE. This section is effective July 1, 2024.

14.7 	Sec. 13. Minnesota Statutes 2023 Supplement, section 256B.0659, subdivision 24, is 
14.8 	amended to read:
14.9 		Subd. 24.Personal care assistance provider agency; general duties. A personal care 
14.10 	assistance provider agency shall:
14.11 	(1) enroll as a Medicaid provider meeting all provider standards, including completion 
14.12 	of the required provider training;
14.13 	(2) comply with general medical assistance coverage requirements;
14.14 	(3) demonstrate compliance with law and policies of the personal care assistance program 
14.15 	to be determined by the commissioner;
14.16 	(4) comply with background study requirements;
14.17 	(5) verify and keep records of hours worked by the personal care assistant and qualified 
14.18 	professional;
14.19 	(6) not engage in any agency-initiated direct contact or marketing in person, by phone, 
14.20 	or other electronic means to potential recipients, guardians, or family members;
14.21 	(7) pay the personal care assistant and qualified professional based on actual hours of 
14.22 	services provided;
14.23 	(8) withhold and pay all applicable federal and state taxes;
14.24 	(9) document that the agency uses a minimum of 72.5 percent of the revenue generated 
14.25 	by the medical assistance rate for personal care assistance services for employee personal 
14.26 	care assistant wages and benefits. The revenue generated by the qualified professional and 
14.27 	the reasonable costs associated with the qualified professional shall not be used in making 
14.28 	this calculation;
14.29 	(10) make the arrangements and pay unemployment insurance, taxes, workers' 
14.30 	compensation, liability insurance, and other benefits, if any;
14.31 	(11) enter into a written agreement under subdivision 20 before services are provided;
15.1 	(12) report suspected neglect and abuse to the common entry point according to section 
15.2 	256B.0651;
15.3 	(13) provide the recipient with a copy of the home care bill of rights at start of service;
15.4 	(14) request reassessments at least 60 days prior to the end of the current authorization 
15.5 	for personal care assistance services, on forms provided by the commissioner;
15.6 	(15) comply with the labor market reporting requirements described in section 256B.4912, 
15.7 	subdivision 1a;
15.8 	(16) document that the agency uses the additional revenue due to the enhanced rate under 
15.9 	subdivision 17a for the wages and benefitsand any corresponding increase in the employer's 
15.10 	share of FICA taxes, Medicare taxes, state and federal unemployment taxes, and workers' 
15.11 	compensation premiums of the PCAs whose services meet the requirements under subdivision 
15.12 	11, paragraph (d); and
15.13 	(17) ensure that a personal care assistant driving a recipient under subdivision 1, 
15.14 	paragraph (i), has a valid driver's license and the vehicle used is registered and insured 
15.15 	according to Minnesota law.

15.16 	EFFECTIVE DATE. This section is effective July 1, 2024.

15.17 	Sec. 14. Minnesota Statutes 2022, section 256B.0911, subdivision 24, is amended to read:
15.18 		Subd. 24.Remote reassessments. (a) Assessments performed according to subdivisions 
15.19 	17 to 20 and 23 must be in person unless the assessment is a reassessment meeting the 
15.20 	requirements of this subdivision. Remote reassessments conducted by interactive video or 
15.21 	telephone may substitute for in-person reassessments.
15.22 	(b) For services provided by the developmental disabilities waiver under section 
15.23 	256B.092, and the community access for disability inclusion, community alternative care, 
15.24 	and brain injury waiver programs under section 256B.49, remote reassessments may be 
15.25 	substituted for two consecutive reassessments if followed by an in-person reassessment.
15.26 	(c) For services provided by alternative care under section 256B.0913, essential 
15.27 	community supports under section 256B.0922, and the elderly waiver under chapter 256S, 
15.28 	remote reassessments may be substituted for one reassessment if followed by an in-person 
15.29 	reassessment.
15.30 	(d) For personal care assistance provided under section 256B.0659 and community first 
15.31 	services and supports provided under section 256B.85, remote reassessments may be 
15.32 	substituted for two consecutive reassessments if followed by an in-person reassessment.
16.1 	(d) (e) A remote reassessment is permitted only if the lead agency provides informed 
16.2 	choice and the person being reassessed or the person's legal representative provides informed 
16.3 	consent for a remote assessment. Lead agencies must document that informed choice was 
16.4 	offered.
16.5 	(e) (f) The person being reassessed, or the person's legal representative, may refuse a 
16.6 	remote reassessment at any time.
16.7 	(f) (g) During a remote reassessment, if the certified assessor determines an in-person 
16.8 	reassessment is necessary in order to complete the assessment, the lead agency shall schedule 
16.9 	an in-person reassessment.
16.10 	(g) (h) All other requirements of an in-person reassessment apply to a remote 
16.11 	reassessment, including updates to a person's support plan.

16.12 	EFFECTIVE DATE. This section is effective upon federal approval. The commissioner 
16.13 	of human services shall notify the revisor of statutes when federal approval is obtained.

16.14 	Sec. 15. Minnesota Statutes 2022, section 256B.092, is amended by adding a subdivision 
16.15 	to read:
16.16 		Subd. 3a.Authorization of technology services. (a) Lead agencies must not implement 
16.17 	additional requirements, in addition to those required by the commissioner, that could result 
16.18 	in the delay of approval or implementation of technology.
16.19 	(b) For individuals receiving waiver services under this section, approval or denial of 
16.20 	technology must occur within 30 business days of the receipt of the initial request. If denied, 
16.21 	the lead agency must submit a notice of action form clearly stating the reason for the denial, 
16.22 	including information describing why the technology is not appropriate to meet the 
16.23 	individual's assessed need.

16.24 	Sec. 16. Minnesota Statutes 2022, section 256B.49, is amended by adding a subdivision 
16.25 	to read:
16.26 		Subd. 16b.Authorization of technology services. (a) Lead agencies must not implement 
16.27 	additional requirements, in addition to those required by the commissioner, that could result 
16.28 	in the delay of approval or implementation of technology.
16.29 	(b) For individuals receiving waiver services under this section, approval or denial of 
16.30 	technology must occur within 30 business days of the receipt of the initial request. If denied, 
16.31 	the lead agency must submit a notice of action form clearly stating the reason for the denial, 
17.1 	including information describing why the technology is not appropriate to meet the 
17.2 	individual's assessed need.

17.3 	Sec. 17. Minnesota Statutes 2022, section 256B.4905, subdivision 12, is amended to read:
17.4 		Subd. 12.Informed choice in and technology prioritization in implementation for 
17.5 	disability waiver services. The commissioner of human services shall ensure that:
17.6 	(1) disability waivers under sections 256B.092 and 256B.49 support the presumption 
17.7 	that all adults who have disabilities and children who have disabilities may use assistive 
17.8 	technology, remote supports, or both to enhance the adult's or child's independence and 
17.9 	quality of life; and
17.10 	(2) each individual accessing waiver services is offered, after an informed 
17.11 	decision-making process and during a person-centered planning process, the opportunity 
17.12 	to choose assistive technology, remote support, or both prior to the commissioner offering 
17.13 	or reauthorizing services that utilize direct support staff to ensure equitable access.

17.14 	Sec. 18. Minnesota Statutes 2023 Supplement, section 256B.4914, subdivision 4, is 
17.15 	amended to read:
17.16 		Subd. 4.Data collection for rate determination. (a) Rates for applicable home and 
17.17 	community-based waivered services, including customized rates under subdivision 12, are 
17.18 	set by the rates management system.
17.19 	(b) Data and information in the rates management system must be used to calculate an 
17.20 	individual's rate.
17.21 	(c) Service providers, with information from the support plan and oversight by lead 
17.22 	agencies, shall provide values and information needed to calculate an individual's rate in 
17.23 	the rates management system. Lead agencies must use forms provided by the commissioner 
17.24 	to collect this information. The determination of service levels must be part of a discussion 
17.25 	with members of the support team as defined in section 245D.02, subdivision 34. This 
17.26 	discussion must occur prior to the final establishment of each individual's rate. The values 
17.27 	and information include:
17.28 	(1) shared staffing hours;
17.29 	(2) individual staffing hours;
17.30 	(3) direct registered nurse hours;
17.31 	(4) direct licensed practical nurse hours;
18.1 	(5) staffing ratios;
18.2 	(6) information to document variable levels of service qualification for variable levels 
18.3 	of reimbursement in each framework;
18.4 	(7) shared or individualized arrangements for unit-based services, including the staffing 
18.5 	ratio;
18.6 	(8) number of trips and miles for transportation services; and
18.7 	(9) service hours provided through monitoring technology.
18.8 	(d) Updates to individual data must include:
18.9 	(1) data for each individual that is updated annually when renewing service plans; and
18.10 	(2) requests by individuals or lead agencies to update a rate whenever there is a change 
18.11 	in an individual's service needs, with accompanying documentation.
18.12 	(e) Lead agencies shall review and approve all services reflecting each individual's needs, 
18.13 	and the values to calculate the final payment rate for services with variables under 
18.14 	subdivisions 6 to 9 for each individual. Lead agencies must notify the individual and the 
18.15 	service provider of the final agreed-upon values and rate, and provide information that is 
18.16 	identical to what was entered into the rates management system. If a value used was 
18.17 	mistakenly or erroneously entered and used to calculate a rate, a provider may petition lead 
18.18 	agencies to correct it. Lead agencies must respond to these requests. When responding to 
18.19 	the request, the lead agency must consider:
18.20 	(1) meeting the health and welfare needs of the individual or individuals receiving 
18.21 	services by service site, identified in their support plan under section 245D.02, subdivision 
18.22 	4b, and any addendum under section 245D.02, subdivision 4c;
18.23 	(2) meeting the requirements for staffing under subdivision 2, paragraphs (h), (n), and 
18.24 	(o); and meeting or exceeding the licensing standards for staffing required under section 
18.25 	245D.09, subdivision 1; and
18.26 	(3) meeting the staffing ratio requirements under subdivision 2, paragraph (o), and 
18.27 	meeting or exceeding the licensing standards for staffing required under section 245D.31.

18.28 	EFFECTIVE DATE. This section is effective January 1, 2025.

18.29 	Sec. 19. Minnesota Statutes 2022, section 256B.85, subdivision 2, is amended to read:
18.30 		Subd. 2.Definitions. (a) For the purposes of this section and section 256B.851, the terms 
18.31 	defined in this subdivision have the meanings given.
19.1 	(b) "Activities of daily living" or "ADLs" means:
19.2 	(1) dressing, including assistance with choosing, applying, and changing clothing and 
19.3 	applying special appliances, wraps, or clothing;
19.4 	(2) grooming, including assistance with basic hair care, oral care, shaving, applying 
19.5 	cosmetics and deodorant, and care of eyeglasses and hearing aids. Grooming includes nail 
19.6 	care, except for recipients who are diabetic or have poor circulation;
19.7 	(3) bathing, including assistance with basic personal hygiene and skin care;
19.8 	(4) eating, including assistance with hand washing and applying orthotics required for 
19.9 	eating, transfers, or feeding;
19.10 	(5) transfers, including assistance with transferring the participant from one seating or 
19.11 	reclining area to another;
19.12 	(6) mobility, including assistance with ambulation and use of a wheelchair. Mobility 
19.13 	does not include providing transportation for a participant;
19.14 	(7) positioning, including assistance with positioning or turning a participant for necessary 
19.15 	care and comfort; and
19.16 	(8) toileting, including assistance with bowel or bladder elimination and care, transfers, 
19.17 	mobility, positioning, feminine hygiene, use of toileting equipment or supplies, cleansing 
19.18 	the perineal area, inspection of the skin, and adjusting clothing.
19.19 	(c) "Agency-provider model" means a method of CFSS under which a qualified agency 
19.20 	provides services and supports through the agency's own employees and policies. The agency 
19.21 	must allow the participant to have a significant role in the selection and dismissal of support 
19.22 	workers of their choice for the delivery of their specific services and supports.
19.23 	(d) "Behavior" means a description of a need for services and supports used to determine 
19.24 	the home care rating and additional service units. The presence of Level I behavior is used 
19.25 	to determine the home care rating.
19.26 	(e) "Budget model" means a service delivery method of CFSS that allows the use of a 
19.27 	service budget and assistance from a financial management services (FMS) provider for a 
19.28 	participant to directly employ support workers and purchase supports and goods.
19.29 	(f) "Complex health-related needs" means an intervention listed in clauses (1) to (8) that 
19.30 	has been ordered by a physician, advanced practice registered nurse, or physician's assistant 
19.31 	and is specified in an assessment summary, including:
19.32 	(1) tube feedings requiring:
20.1 	(i) a gastrojejunostomy tube; or
20.2 	(ii) continuous tube feeding lasting longer than 12 hours per day;
20.3 	(2) wounds described as:
20.4 	(i) stage III or stage IV;
20.5 	(ii) multiple wounds;
20.6 	(iii) requiring sterile or clean dressing changes or a wound vac; or
20.7 	(iv) open lesions such as burns, fistulas, tube sites, or ostomy sites that require specialized 
20.8 	care;
20.9 	(3) parenteral therapy described as:
20.10 	(i) IV therapy more than two times per week lasting longer than four hours for each 
20.11 	treatment; or
20.12 	(ii) total parenteral nutrition (TPN) daily;
20.13 	(4) respiratory interventions, including:
20.14 	(i) oxygen required more than eight hours per day;
20.15 	(ii) respiratory vest more than one time per day;
20.16 	(iii) bronchial drainage treatments more than two times per day;
20.17 	(iv) sterile or clean suctioning more than six times per day;
20.18 	(v) dependence on another to apply respiratory ventilation augmentation devices such 
20.19 	as BiPAP and CPAP; and
20.20 	(vi) ventilator dependence under section 256B.0651;
20.21 	(5) insertion and maintenance of catheter, including:
20.22 	(i) sterile catheter changes more than one time per month;
20.23 	(ii) clean intermittent catheterization, and including self-catheterization more than six 
20.24 	times per day; or
20.25 	(iii) bladder irrigations;
20.26 	(6) bowel program more than two times per week requiring more than 30 minutes to 
20.27 	perform each time;
20.28 	(7) neurological intervention, including:
21.1 	(i) seizures more than two times per week and requiring significant physical assistance 
21.2 	to maintain safety; or
21.3 	(ii) swallowing disorders diagnosed by a physician, advanced practice registered nurse, 
21.4 	or physician's assistant and requiring specialized assistance from another on a daily basis; 
21.5 	and
21.6 	(8) other congenital or acquired diseases creating a need for significantly increased direct 
21.7 	hands-on assistance and interventions in six to eight activities of daily living.
21.8 	(g) "Community first services and supports" or "CFSS" means the assistance and supports 
21.9 	program under this section needed for accomplishing activities of daily living, instrumental 
21.10 	activities of daily living, and health-related tasks through hands-on assistance to accomplish 
21.11 	the task or constant supervision and cueing to accomplish the task, or the purchase of goods 
21.12 	as defined in subdivision 7, clause (3), that replace the need for human assistance.
21.13 	(h) "Community first services and supports service delivery plan" or "CFSS service 
21.14 	delivery plan" means a written document detailing the services and supports chosen by the 
21.15 	participant to meet assessed needs that are within the approved CFSS service authorization, 
21.16 	as determined in subdivision 8. Services and supports are based on the support plan identified 
21.17 	in sections 256B.092, subdivision 1b, and 256S.10.
21.18 	(i) "Consultation services" means a Minnesota health care program enrolled provider 
21.19 	organization that provides assistance to the participant in making informed choices about 
21.20 	CFSS services in general and self-directed tasks in particular, and in developing a 
21.21 	person-centered CFSS service delivery plan to achieve quality service outcomes.
21.22 	(j) "Critical activities of daily living" means transferring, mobility, eating, and toileting.
21.23 	(k) "Dependency" in activities of daily living means a person requires hands-on assistance 
21.24 	or constant supervision and cueing to accomplish one or more of the activities of daily living 
21.25 	every day or on the days during the week that the activity is performed; however, a child 
21.26 	must not be found to be dependent in an activity of daily living if, because of the child's 
21.27 	age, an adult would either perform the activity for the child or assist the child with the 
21.28 	activity and the assistance needed is the assistance appropriate for a typical child of the 
21.29 	same age.
21.30 	(l) "Extended CFSS" means CFSS services and supports provided under CFSS that are 
21.31 	included in the CFSS service delivery plan through one of the home and community-based 
21.32 	services waivers and as approved and authorized under chapter 256S and sections 256B.092, 
22.1 	subdivision 5, and 256B.49, which exceed the amount, duration, and frequency of the state 
22.2 	plan CFSS services for participants. Extended CFSS excludes the purchase of goods.
22.3 	(m) "Financial management services provider" or "FMS provider" means a qualified 
22.4 	organization required for participants using the budget model under subdivision 13 that is 
22.5 	an enrolled provider with the department to provide vendor fiscal/employer agent financial 
22.6 	management services (FMS).
22.7 	(n) "Health-related procedures and tasks" means procedures and tasks related to the 
22.8 	specific assessed health needs of a participant that can be taught or assigned by a 
22.9 	state-licensed health care or mental health professional and performed by a support worker.
22.10 	(o) "Instrumental activities of daily living" means activities related to living independently 
22.11 	in the community, including but not limited to: meal planning, preparation, and cooking; 
22.12 	shopping for food, clothing, or other essential items; laundry; housecleaning; assistance 
22.13 	with medications; managing finances; communicating needs and preferences during activities; 
22.14 	arranging supports; and assistance with traveling around and participating in the community, 
22.15 	including traveling to medical appointments. For purposes of this paragraph, traveling 
22.16 	includes driving and accompanying the recipient in the recipient's chosen mode of 
22.17 	transportation and according to the individual CFSS service delivery plan.
22.18 	(p) "Lead agency" has the meaning given in section 256B.0911, subdivision 10.
22.19 	(q) "Legal representative" means parent of a minor, a court-appointed guardian, or 
22.20 	another representative with legal authority to make decisions about services and supports 
22.21 	for the participant. Other representatives with legal authority to make decisions include but 
22.22 	are not limited to a health care agent or an attorney-in-fact authorized through a health care 
22.23 	directive or power of attorney.
22.24 	(r) "Level I behavior" means physical aggression toward self or others or destruction of 
22.25 	property that requires the immediate response of another person.
22.26 	(s) "Medication assistance" means providing verbal or visual reminders to take regularly 
22.27 	scheduled medication, and includes any of the following supports listed in clauses (1) to 
22.28 	(3) and other types of assistance, except that a support worker must not determine medication 
22.29 	dose or time for medication or inject medications into veins, muscles, or skin:
22.30 	(1) under the direction of the participant or the participant's representative, bringing 
22.31 	medications to the participant including medications given through a nebulizer, opening a 
22.32 	container of previously set-up medications, emptying the container into the participant's 
23.1 	hand, opening and giving the medication in the original container to the participant, or 
23.2 	bringing to the participant liquids or food to accompany the medication;
23.3 	(2) organizing medications as directed by the participant or the participant's representative; 
23.4 	and
23.5 	(3) providing verbal or visual reminders to perform regularly scheduled medications.
23.6 	(t) "Participant" means a person who is eligible for CFSS.
23.7 	(u) "Participant's representative" means a parent, family member, advocate, or other 
23.8 	adult authorized by the participant or participant's legal representative, if any, to serve as a 
23.9 	representative in connection with the provision of CFSS. If the participant is unable to assist 
23.10 	in the selection of a participant's representative, the legal representative shall appoint one.
23.11 	(v) "Person-centered planning process" means a process that is directed by the participant 
23.12 	to plan for CFSS services and supports.
23.13 	(w) "Service budget" means the authorized dollar amount used for the budget model or 
23.14 	for the purchase of goods.
23.15 	(x) "Shared services" means the provision of CFSS services by the same CFSS support 
23.16 	worker to two or three participants who voluntarily enter into a written agreement to receive 
23.17 	services at the same time, in the same setting, and through the same agency-provider or 
23.18 	FMS provider.
23.19 	(y) "Support worker" means a qualified and trained employee of the agency-provider 
23.20 	as required by subdivision 11b or of the participant employer under the budget model as 
23.21 	required by subdivision 14 who has direct contact with the participant and provides services 
23.22 	as specified within the participant's CFSS service delivery plan.
23.23 	(z) "Unit" means the increment of service based on hours or minutes identified in the 
23.24 	service agreement.
23.25 	(aa) "Vendor fiscal employer agent" means an agency that provides financial management 
23.26 	services.
23.27 	(bb) "Wages and benefits" means the hourly wages and salaries, the employer's share 
23.28 	of FICA taxes, Medicare taxes, state and federal unemployment taxes, workers' compensation, 
23.29 	mileage reimbursement, health and dental insurance, life insurance, disability insurance, 
23.30 	long-term care insurance, uniform allowance, contributions to employee retirement accounts, 
23.31 	or other forms of employee compensation and benefits.
24.1 	(cc) "Worker training and development" means services provided according to subdivision 
24.2 	18a for developing workers' skills as required by the participant's individual CFSS service 
24.3 	delivery plan that are arranged for or provided by the agency-provider or purchased by the 
24.4 	participant employer. These services include training, education, direct observation and 
24.5 	supervision, and evaluation and coaching of job skills and tasks, including supervision of 
24.6 	health-related tasks or behavioral supports.

24.7 	Sec. 20. Minnesota Statutes 2022, section 256B.85, subdivision 6, is amended to read:
24.8 		Subd. 6.Community first services and supports service delivery plan. (a) The CFSS 
24.9 	service delivery plan must be developed and evaluated through a person-centered planning 
24.10 	process by the participant, or the participant's representative or legal representative who 
24.11 	may be assisted by a consultation services provider. The CFSS service delivery plan must 
24.12 	reflect the services and supports that are important to the participant and for the participant 
24.13 	to meet the needs assessed by the certified assessor and identified in the support plan 
24.14 	identified in sections 256B.092, subdivision 1b, and 256S.10. The CFSS service delivery 
24.15 	plan must be reviewed by the participant, the consultation services provider, and the 
24.16 	agency-provider or FMS provider prior to starting services and at least annually upon 
24.17 	reassessment, or when there is a significant change in the participant's condition, or a change 
24.18 	in the need for services and supports.
24.19 	(b) The commissioner shall establish the format and criteria for the CFSS service delivery 
24.20 	plan.
24.21 	(c) The CFSS service delivery plan must be person-centered and:
24.22 	(1) specify the consultation services provider, agency-provider, or FMS provider selected 
24.23 	by the participant;
24.24 	(2) reflect the setting in which the participant resides that is chosen by the participant;
24.25 	(3) reflect the participant's strengths and preferences;
24.26 	(4) include the methods and supports used to address the needs as identified through an 
24.27 	assessment of functional needs;
24.28 	(5) include the participant's identified goals and desired outcomes;
24.29 	(6) reflect the services and supports, paid and unpaid, that will assist the participant to 
24.30 	achieve identified goals, including the costs of the services and supports, and the providers 
24.31 	of those services and supports, including natural supports;
25.1 	(7) identify the amount and frequency of face-to-face supports and amount and frequency 
25.2 	of remote supports and technology that will be used;
25.3 	(8) identify risk factors and measures in place to minimize them, including individualized 
25.4 	backup plans;
25.5 	(9) be understandable to the participant and the individuals providing support;
25.6 	(10) identify the individual or entity responsible for monitoring the plan;
25.7 	(11) be finalized and agreed to in writing by the participant and signed by individuals 
25.8 	and providers responsible for its implementation;
25.9 	(12) be distributed to the participant and other people involved in the plan;
25.10 	(13) prevent the provision of unnecessary or inappropriate care;
25.11 	(14) include a detailed budget for expenditures for budget model participants or 
25.12 	participants under the agency-provider model if purchasing goods; and
25.13 	(15) include a plan for worker training and development provided according to 
25.14 	subdivision 18a detailing what service components will be used, when the service components 
25.15 	will be used, how they will be provided, and how these service components relate to the 
25.16 	participant's individual needs and CFSS support worker services.
25.17 	(d) The CFSS service delivery plan must describe the units or dollar amount available 
25.18 	to the participant. The total units of agency-provider services or the service budget amount 
25.19 	for the budget model include both annual totals and a monthly average amount that cover 
25.20 	the number of months of the service agreement. The amount used each month may vary, 
25.21 	but additional funds must not be provided above the annual service authorization amount, 
25.22 	determined according to subdivision 8, unless a change in condition is assessed and 
25.23 	authorized by the certified assessor and documented in the support plan and CFSS service 
25.24 	delivery plan.
25.25 	(e) In assisting with the development or modification of the CFSS service delivery plan 
25.26 	during the authorization time period, the consultation services provider shall:
25.27 	(1) consult with the FMS provider on the spending budget when applicable; and
25.28 	(2) consult with the participant or participant's representative, agency-provider, and case 
25.29 	manager or care coordinator.
25.30 	(f) The CFSS service delivery plan must be approved by the consultation services provider
25.31 	lead agency for participants without a case manager or care coordinator who is responsible 
26.1 	for authorizing services. A case manager or care coordinator must approve the plan for a 
26.2 	waiver or alternative care program participant.

26.3 	Sec. 21. Minnesota Statutes 2022, section 256B.85, subdivision 6a, is amended to read:
26.4 		Subd. 6a.Person-centered planning process. The person-centered planning process 
26.5 	must:
26.6 	(1) include people chosen by the participant;
26.7 	(2) provide necessary information and support to ensure that the participant directs the 
26.8 	process to the maximum extent possible, and is enabled to make informed choices and 
26.9 	decisions;
26.10 	(3) be timely and occur at times and locations convenient to the participant;
26.11 	(4) reflect cultural considerations of the participant;
26.12 	(5) include within the process strategies for solving conflict or disagreement, including 
26.13 	clear conflict-of-interest guidelines as identified in Code of Federal Regulations, title 42, 
26.14 	section 441.500 441.540, for all planning;
26.15 	(6) provide the participant choices of the services and supports the participant receives 
26.16 	and the staff providing those services and supports;
26.17 	(7) include a method for the participant to request updates to the plan; and
26.18 	(8) record the alternative home and community-based settings that were considered by 
26.19 	the participant.

26.20 	Sec. 22. Minnesota Statutes 2022, section 256B.85, subdivision 7a, is amended to read:
26.21 		Subd. 7a.Enhanced rate. (a) An enhanced rate of 107.5 percent of the rate paid for 
26.22 	CFSS must be paid for services provided to persons who qualify for ten or more hours of 
26.23 	CFSS per day when provided by a support worker who meets the requirements of subdivision 
26.24 	16, paragraph (e).
26.25 	(b) An agency provider must use all additional revenue attributable to the rate 
26.26 	enhancements under this subdivision for the wages and wage-related costs of the support 
26.27 	workers, including any corresponding increase in the employer's share of FICA taxes, 
26.28 	Medicare taxes, state and federal unemployment taxes, and workers' compensation premiums. 
26.29 	The agency provider must not use the additional revenue attributable to any enhanced rate 
26.30 	under this subdivision to pay for mileage reimbursement, health and dental insurance, life 
27.1 	insurance, disability insurance, long-term care insurance, uniform allowance, contributions 
27.2 	to employee retirement accounts, or any other employee benefits.
27.3 	(c) Any change in the eligibility criteria for the enhanced rate for CFSS as described in 
27.4 	this subdivision and referenced in subdivision 16, paragraph (e), does not constitute a change 
27.5 	in a term or condition for individual providers as defined in section 256B.0711, and is not 
27.6 	subject to the state's obligation to meet and negotiate under chapter 179A.

27.7 	EFFECTIVE DATE. This section is effective July 1, 2024.

27.8 	Sec. 23. Minnesota Statutes 2022, section 256B.85, subdivision 11, is amended to read:
27.9 		Subd. 11.Agency-provider model. (a) The agency-provider model includes services 
27.10 	provided by support workers and staff providing worker training and development services 
27.11 	who are employed by an agency-provider that meets the criteria established by the 
27.12 	commissioner, including required training.
27.13 	(b) The agency-provider shall allow the participant to have a significant role in the 
27.14 	selection and dismissal of the support workers for the delivery of the services and supports 
27.15 	specified in the participant's CFSS service delivery plan. The agency must make a reasonable 
27.16 	effort to fulfill the participant's request for the participant's preferred support worker.
27.17 	(c) A participant may use authorized units of CFSS services as needed within a service 
27.18 	agreement that is not greater than 12 months. Using authorized units in a flexible manner 
27.19 	in either the agency-provider model or the budget model does not increase the total amount 
27.20 	of services and supports authorized for a participant or included in the participant's CFSS 
27.21 	service delivery plan.
27.22 	(d) A participant may share CFSS services. Two or three CFSS participants may share 
27.23 	services at the same time provided by the same support worker.
27.24 	(e) The agency-provider must use a minimum of 72.5 percent of the revenue generated 
27.25 	by the medical assistance payment for CFSS for support worker wages and benefits, except 
27.26 	all of the revenue generated by a medical assistance rate increase due to a collective 
27.27 	bargaining agreement under section 179A.54 must be used for support worker wages and 
27.28 	benefits. The agency-provider must document how this requirement is being met. The 
27.29 	revenue generated by the worker training and development services and the reasonable costs 
27.30 	associated with the worker training and development services must not be used in making 
27.31 	this calculation.
28.1 	(f) The agency-provider model must be used by participants who are restricted by the 
28.2 	Minnesota restricted recipient program under Minnesota Rules, parts 9505.2160 to 
28.3 	9505.2245.
28.4 	(g) Participants purchasing goods under this model, along with support worker services, 
28.5 	must:
28.6 	(1) specify the goods in the CFSS service delivery plan and detailed budget for 
28.7 	expenditures that must be approved by the consultation services provider lead agency, case 
28.8 	manager, or care coordinator; and
28.9 	(2) use the FMS provider for the billing and payment of such goods.
28.10 	(h) The agency provider is responsible for ensuring that any worker driving a participant 
28.11 	under subdivision 2, paragraph (o), has a valid driver's license and the vehicle used is 
28.12 	registered and insured according to Minnesota law.

28.13 	Sec. 24. Minnesota Statutes 2023 Supplement, section 256B.85, subdivision 13a, is 
28.14 	amended to read:
28.15 		Subd. 13a.Financial management services. (a) Services provided by an FMS provider 
28.16 	include but are not limited to: filing and payment of federal and state payroll taxes and 
28.17 	premiums on behalf of the participant; initiating and complying with background study 
28.18 	requirements under chapter 245C and maintaining documentation of background study 
28.19 	requests and results; billing for approved CFSS services with authorized funds; monitoring 
28.20 	expenditures; accounting for and disbursing CFSS funds; providing assistance in obtaining 
28.21 	and filing for liability, workers' compensation, family and medical benefit insurance, and 
28.22 	unemployment coverage; and providing participant instruction and technical assistance to 
28.23 	the participant in fulfilling employer-related requirements in accordance with section 3504 
28.24 	of the Internal Revenue Code and related regulations and interpretations, including Code 
28.25 	of Federal Regulations, title 26, section 31.3504-1.
28.26 	(b) Agency-provider services shall not be provided by the FMS provider.
28.27 	(c) The FMS provider shall provide service functions as determined by the commissioner 
28.28 	for budget model participants that include but are not limited to:
28.29 	(1) assistance with the development of the detailed budget for expenditures portion of 
28.30 	the CFSS service delivery plan as requested by the consultation services provider or 
28.31 	participant;
28.32 	(2) data recording and reporting of participant spending;
29.1 	(3) other duties established by the department, including with respect to providing 
29.2 	assistance to the participant, participant's representative, or legal representative in performing 
29.3 	employer responsibilities regarding support workers. The support worker shall not be 
29.4 	considered the employee of the FMS provider; and
29.5 	(4) billing, payment, and accounting of approved expenditures for goods.
29.6 	(d) The FMS provider shall obtain an assurance statement from the participant employer 
29.7 	agreeing to follow state and federal regulations and CFSS policies regarding employment 
29.8 	of support workers.
29.9 	(e) The FMS provider shall:
29.10 	(1) not limit or restrict the participant's choice of service or support providers or service 
29.11 	delivery models consistent with any applicable state and federal requirements;
29.12 	(2) provide the participant, consultation services provider, and case manager or care 
29.13 	coordinator, if applicable, with a monthly written summary of the spending for services and 
29.14 	supports that were billed against the spending budget;
29.15 	(3) be knowledgeable of state and federal employment regulations, including those under 
29.16 	the Fair Labor Standards Act of 1938, and comply with the requirements under chapter 
29.17 	268B and section 3504 of the Internal Revenue Code and related regulations and 
29.18 	interpretations, including Code of Federal Regulations, title 26, section 31.3504-1, regarding 
29.19 	agency employer tax liability for vendor fiscal/employer agent, and any requirements 
29.20 	necessary to process employer and employee deductions, provide appropriate and timely 
29.21 	submission of employer tax liabilities, and maintain documentation to support medical 
29.22 	assistance claims;
29.23 	(4) have current and adequate liability insurance and bonding and sufficient cash flow 
29.24 	as determined by the commissioner and have on staff or under contract a certified public 
29.25 	accountant or an individual with a baccalaureate degree in accounting;
29.26 	(5) assume fiscal accountability for state funds designated for the program and be held 
29.27 	liable for any overpayments or violations of applicable statutes or rules, including but not 
29.28 	limited to the Minnesota False Claims Act, chapter 15C;
29.29 	(6) maintain documentation of receipts, invoices, and bills to track all services and 
29.30 	supports expenditures for any goods purchased and maintain time records of support workers. 
29.31 	The documentation and time records must be maintained for a minimum of five years from 
29.32 	the claim date and be available for audit or review upon request by the commissioner. Claims 
29.33 	submitted by the FMS provider to the commissioner for payment must correspond with 
30.1 	services, amounts, and time periods as authorized in the participant's service budget and 
30.2 	service plan and must contain specific identifying information as determined by the 
30.3 	commissioner; and
30.4 	(7) provide written notice to the participant or the participant's representative at least 30 
30.5 	calendar days before a proposed service termination becomes effective, except in cases 
30.6 	where:
30.7 	(i) the participant engages in conduct that significantly alters the terms of the CFSS 
30.8 	service delivery plan with the FMS;
30.9 	(ii) the participant or other persons at the setting where services are being provided 
30.10 	engage in conduct that creates an imminent risk of harm to the support worker or other staff; 
30.11 	or
30.12 	(iii) an emergency or a significant change in the participant's condition occurs within a 
30.13 	24-hour period that results in the participant's service needs exceeding the participant's 
30.14 	identified needs in the current CFSS service delivery plan so that the plan cannot safely 
30.15 	meet the participant's needs.
30.16 	(f) The commissioner shall:
30.17 	(1) establish rates and payment methodology for the FMS provider;
30.18 	(2) identify a process to ensure quality and performance standards for the FMS provider 
30.19 	and ensure statewide access to FMS providers; and
30.20 	(3) establish a uniform protocol for delivering and administering CFSS services to be 
30.21 	used by eligible FMS providers.

30.22 	Sec. 25. Minnesota Statutes 2022, section 256B.85, subdivision 17, is amended to read:
30.23 		Subd. 17.Consultation services duties.  Consultation services is a required service that 
30.24 	includes:
30.25 	(1) entering into a written agreement with the participant, participant's representative, 
30.26 	or legal representative that includes but is not limited to the details of services, service 
30.27 	delivery methods, dates of services, and contact information;
30.28 	(2) providing an initial and annual orientation to CFSS information and policies, including 
30.29 	selecting a service model;
30.30 	(3) assisting with accessing FMS providers or agency-providers;
31.1 	(4) providing assistance with the development, implementation, management, 
31.2 	documentation, and evaluation of the person-centered CFSS service delivery plan;
31.3 	(5) approving the CFSS service delivery plan for a participant without a case manager 
31.4 	or care coordinator who is responsible for authorizing services;
31.5 	(6) (5) maintaining documentation of the approved CFSS service delivery plan;
31.6 	(7) (6) distributing copies of the final CFSS service delivery plan to the participant and 
31.7 	to the agency-provider or FMS provider, case manager or care coordinator, and other 
31.8 	designated parties;
31.9 	(8) (7) assisting to fulfill responsibilities and requirements of CFSS, including modifying 
31.10 	CFSS service delivery plans and changing service models;
31.11 	(9) (8) if requested, providing consultation on recruiting, selecting, training, managing, 
31.12 	directing, supervising, and evaluating support workers;
31.13 	(10) (9) evaluating services upon receiving information from an FMS provider indicating 
31.14 	spending or participant employer concerns;
31.15 	(11) (10) reviewing the use of and access to informal and community supports, goods, 
31.16 	or resources;
31.17 	(12) (11) a semiannual review of services if the participant does not have a case manager 
31.18 	or care coordinator and when the support worker is a paid parent of a minor participant or 
31.19 	the participant's spouse;
31.20 	(13) (12) collecting and reporting of data as required by the department;
31.21 	(14) (13) providing the participant with a copy of the participant protections under 
31.22 	subdivision 20 at the start of consultation services;
31.23 	(15) (14) providing assistance to resolve issues of noncompliance with the requirements 
31.24 	of CFSS;
31.25 	(16) (15) providing recommendations to the commissioner for changes to services when 
31.26 	support to participants to resolve issues of noncompliance have been unsuccessful; and
31.27 	(17) (16) other duties as assigned by the commissioner.

31.28 	Sec. 26. Minnesota Statutes 2022, section 256B.85, is amended by adding a subdivision 
31.29 	to read:
31.30 		Subd. 18b.Worker training and development services; remote visits. (a) Except as 
31.31 	provided in paragraph (b), the worker training and development services specified in 
32.1 	subdivision 18a, paragraph (c), clauses (3) and (4), may be provided to recipients with 
32.2 	chronic health conditions or severely compromised immune systems via two-way interactive 
32.3 	audio and visual telecommunications if, at the recipient's request, the recipient's primary 
32.4 	health care provider:
32.5 	(1) determines that remote worker training and development services are appropriate; 
32.6 	and
32.7 	(2) documents the determination under clause (1) in a statement of need or other document 
32.8 	that is subsequently included in the recipient's CFSS service delivery plan.
32.9 	(b) The worker training and development services specified in subdivision 18a, paragraph 
32.10 	(c), clause (3), provided at the start of services or the start of employment of a new support 
32.11 	worker must not be conducted via two-way interactive audio and visual telecommunications.
32.12 	(c) Notwithstanding any other provision of law, a CFSS service delivery plan developed 
32.13 	or amended via remote worker training and development services may be executed by 
32.14 	electronic signature.
32.15 	(d) A recipient may request to return to in-person worker training and development 
32.16 	services at any time.

32.17 	EFFECTIVE DATE. This section is effective upon community first services and 
32.18 	supports implementation. The commissioner of human services shall notify the revisor of 
32.19 	statutes upon CFSS implementation.

32.20 	Sec. 27. Minnesota Statutes 2022, section 256B.85, subdivision 20, is amended to read:
32.21 		Subd. 20.Participant protections. (a) All CFSS participants have the protections 
32.22 	identified in this subdivision.
32.23 	(b) Participants or participant's representatives must be provided with adequate 
32.24 	information, counseling, training, and assistance, as needed, to ensure that the participant 
32.25 	is able to choose and manage services, models, and budgets. This information must be 
32.26 	provided by the consultation services provider at the time of the initial or annual orientation 
32.27 	to CFSS, at the time of reassessment, or when requested by the participant or participant's 
32.28 	representative. This information must explain:
32.29 	(1) person-centered planning;
32.30 	(2) the range and scope of participant choices, including the differences between the 
32.31 	agency-provider model and the budget model, available CFSS providers, and other services 
32.32 	available in the community to meet the participant's needs;
33.1 	(3) the process for changing plans, services, and budgets;
33.2 	(4) identifying and assessing appropriate services; and
33.3 	(5) risks to and responsibilities of the participant under the budget model.
33.4 	(c) The consultation services provider must ensure that the participant chooses freely 
33.5 	between the agency-provider model and the budget model and among available 
33.6 	agency-providers and that the participant may change agency-providers after services have 
33.7 	begun.
33.8 	(d) A participant who appeals a reduction in previously authorized CFSS services may 
33.9 	continue previously authorized services pending an appeal in accordance with section 
33.10 	256.045.
33.11 	(e) If the units of service or budget allocation for CFSS are reduced, denied, or terminated, 
33.12 	the commissioner must provide notice of the reasons for the reduction in the participant's 
33.13 	notice of denial, termination, or reduction.
33.14 	(f) If all or part of a CFSS service delivery plan is denied approval by the consultation 
33.15 	services provider lead agency, the consultation services provider lead agency must provide 
33.16 	a notice that describes the basis of the denial.

33.17 	Sec. 28. Laws 2021, First Special Session chapter 7, article 13, section 75, is amended to 
33.18 	read:
33.19 	Sec. 75. DIRECTION TO COMMISSIONER OF HUMAN SERVICES; WAIVER 
33.20 	REIMAGINE AND INFORMED CHOICE STAKEHOLDER CONSULTATION.
 33.21 		Subdivision 1.Stakeholder consultation; generally. (a) The commissioner of human 
33.22 	services must consult with and seek input and assistance from stakeholders concerning 
33.23 	potential adjustments to the streamlined service menu from waiver reimagine phase I and 
33.24 	to the existing rate exemption criteria and process.
33.25 	(b) The commissioner of human services must consult with and, seek input and assistance 
33.26 	from, and collaborate with stakeholders concerning the development and implementation 
33.27 	of waiver reimagine phase II, including criteria and a process for individualized budget 
33.28 	exemptions, and how waiver reimagine phase II can support and expand informed choice 
33.29 	and informed decision making, including integrated employment, independent living, and 
33.30 	self-direction, consistent with Minnesota Statutes, section 256B.4905.
34.1 	(c) The commissioner of human services must consult with, seek input and assistance 
34.2 	from, and collaborate with stakeholders concerning the implementation and revisions of 
34.3 	the MnCHOICES 2.0 assessment tool.
34.4 		Subd. 2.Public stakeholder engagement. The commissioner must offer a public method 
34.5 	to regularly receive input and concerns from people with disabilities and their families about 
34.6 	waiver reimagine phase II. The commissioner shall provide regular quarterly public updates 
34.7 	on policy development and on how recent stakeholder input was used throughout the is 
34.8 	being incorporated into the current development and implementation of waiver reimagine 
34.9 	phase II.
34.10 		Subd. 3.Waiver Reimagine Advisory Committee. (a) The commissioner must convene, 
34.11 	at regular intervals throughout the development and implementation of waiver reimagine 
34.12 	phase II, a Waiver Reimagine Advisory Committee that consists of a group of diverse, 
34.13 	representative stakeholders. The commissioner must solicit and endeavor to include racially, 
34.14 	ethnically, and geographically diverse membership from each of the following groups:
34.15 	(1) people with disabilities who use waiver services;
34.16 	(2) family members of people who use waiver services;
34.17 	(3) disability and behavioral health advocates;
34.18 	(4) lead agency representatives; and
34.19 	(5) waiver service providers.
34.20 	(b) The assistant commissioner of aging and disability services must attend and participate 
34.21 	in meetings of the Waiver Reimagine Advisory Committee.
34.22 	(c) The Waiver Reimagine Advisory Committee must have the opportunity to assist
34.23 	collaborate in a meaningful way in developing and providing feedback on proposed plans 
34.24 	for waiver reimagine components, including an individual budget methodology, criteria 
34.25 	and a process for individualized budget exemptions, the consolidation of the four current 
34.26 	home and community-based waiver service programs into two-waiver programs, the role 
34.27 	of assessments and the MnCHOICES 2.0 assessment tool in determining service needs and 
34.28 	individual budgets, and other aspects of waiver reimagine phase II.
34.29 	(c) (d) The Waiver Reimagine Advisory Committee must have an opportunity to assist 
34.30 	in the development of and provide feedback on proposed adjustments and modifications to 
34.31 	the streamlined menu of services and the existing rate exception criteria and process.
35.1 		Subd. 4.Required report. Prior to seeking federal approval for any aspect of waiver 
35.2 	reimagine phase II and in consultation collaboration with the Waiver Reimagine Advisory 
35.3 	Committee, the commissioner must submit to the chairs and ranking minority members of 
35.4 	the legislative committees and divisions with jurisdiction over health and human services 
35.5 	a report on plans for waiver reimagine phase II. The report must also include any plans to 
35.6 	adjust or modify the streamlined menu of services or, the existing rate exemption criteria 
35.7 	or process, the proposed individual budget ranges, and the role of MnCHOICES 2.0 
35.8 	assessment tool in determining service needs and individual budget ranges.
35.9 		Subd. 5.Transition process. (a) Prior to implementation of wavier reimagine phase II, 
35.10 	the commissioner must establish a process to assist people who use waiver services and 
35.11 	lead agencies transition to a two-waiver system with an individual budget methodology.
35.12 	(b) The commissioner must ensure that the new waiver service menu and individual 
35.13 	budgets allow people to live in their own home, family home, or any home and 
35.14 	community-based setting of their choice. The commissioner must ensure, within available 
35.15 	resources and subject to state and federal regulations and law, that waiver reimagine does 
35.16 	not result in unintended service disruptions.
35.17 		Subd. 6.Online support planning tool. The commissioner must develop an online 
35.18 	support planning and tracking tool for people using disability waiver services that allows 
35.19 	access to the total budget available to the person, the services for which they are eligible, 
35.20 	and the services they have chosen and used. The commissioner must explore operability 
35.21 	options that would facilitate real-time tracking of a person's remaining available budget 
35.22 	throughout the service year. The online support planning tool must provide information in 
35.23 	an accessible format to support the person's informed choice. The commissioner must seek 
35.24 	input from people with disabilities about the online support planning tool prior to its 
35.25 	implementation.
35.26 		Subd. 7.Curriculum and training. The commissioner must develop and implement a 
35.27 	curriculum and training plan to ensure all lead agency assessors and case managers have 
35.28 	the knowledge and skills necessary to comply with informed decision making for people 
35.29 	who used home and community-based disability waivers. Training and competency 
35.30 	evaluations must be completed annually by all staff responsible for case management as 
35.31 	described in Minnesota Statutes, sections 256B.092, subdivision 1a, paragraph (f), and 
35.32 	256B.49, subdivision 13, paragraph (e).

36.1 	Sec. 29. COMMUNITY ACCESS FOR DISABILITY INCLUSION WAIVER 
36.2 	CUSTOMIZED LIVING SERVICES PROVIDERS LOCATED IN HENNEPIN 
36.3 	COUNTY.
 36.4 	The community access for disability inclusion (CADI) waiver customized living and 
36.5 	24-hour customized living size and age limitation does not apply to two housing settings 
36.6 	located in the city of Minneapolis that are financed by low-income housing tax credits 
36.7 	created in calendar years 2005 and 2011 and in which 24-hour customized living services 
36.8 	are provided to residents enrolled in the CADI waiver by Clare Housing.

36.9 	ARTICLE 2
36.10 	DEAF, DEAFBLIND, AND HARD-OF-HEARING SERVICES

36.11 	Section 1. Minnesota Statutes 2022, section 256C.21, is amended to read:
36.12 	256C.21 DEAF, DEAFBLIND, AND HARD-OF-HEARING SERVICES ACT; 
36.13 	CITATION.
36.14 	Sections 256C.21 to 256C.26 256C.261 may be cited as the "Deaf, DeafBlind, and 
36.15 	Hard-of-Hearing Services Act."

36.16 	EFFECTIVE DATE. This section is effective August 1, 2024.

36.17 	Sec. 2. Minnesota Statutes 2022, section 256C.23, subdivision 1a, is amended to read:
36.18 		Subd. 1a.Culturally affirmative. "Culturally affirmative" describes services that are 
36.19 	designed and delivered within the context of the culture, identity, language, communication, 
36.20 	and life experiences of a person persons who isare deaf, a person persons who isare 
36.21 	deafblind, and a person persons who is are hard-of-hearing.

36.22 	EFFECTIVE DATE. This section is effective August 1, 2024.

36.23 	Sec. 3. Minnesota Statutes 2022, section 256C.23, is amended by adding a subdivision to 
36.24 	read:
36.25 		Subd. 1b.Linguistically affirmative. "Linguistically affirmative" describes services 
36.26 	that are designed and delivered within the context of the language and communication 
36.27 	experiences of persons who are deaf, persons who are deafblind, and persons who are 
36.28 	hard-of-hearing.

36.29 	EFFECTIVE DATE. This section is effective August 1, 2024.

37.1 	Sec. 4. Minnesota Statutes 2022, section 256C.23, subdivision 2, is amended to read:
37.2 		Subd. 2.Deaf. "Deaf" means a hearing loss of such severity that the individual must 
37.3 	depend where the person communicates primarily on visual communication such as through
37.4 	American Sign Language or other another signed language, visual and manual means of 
37.5 	communication such as signing systems in English or, Cued Speech, reading and writing, 
37.6 	speech reading, and gestures or other visual communication.

37.7 	EFFECTIVE DATE. This section is effective August 1, 2024.

37.8 	Sec. 5. Minnesota Statutes 2022, section 256C.23, subdivision 2a, is amended to read:
37.9 		Subd. 2a.Hard-of-hearing. "Hard-of-hearing" means a hearing loss resulting in a 
37.10 	functional loss of hearing, but not to the extent that the individual must depend where the 
37.11 	person does not communicate primarily upon through visual communication.

37.12 	EFFECTIVE DATE. This section is effective August 1, 2024.

37.13 	Sec. 6. Minnesota Statutes 2022, section 256C.23, subdivision 2b, is amended to read:
37.14 		Subd. 2b.Deafblind. "Deafblind" means any combination of vision and hearing loss 
37.15 	which interferes with acquiring information from the environment to the extent that 
37.16 	compensatory where the person uses visual, auditory, or tactile strategies and skills are 
37.17 	necessary such as the use of a tactile form of a visual or spoken language to access that
37.18 	communication, information from the environment, or other information.

37.19 	EFFECTIVE DATE. This section is effective August 1, 2024.

37.20 	Sec. 7. Minnesota Statutes 2022, section 256C.23, subdivision 2c, is amended to read:
37.21 		Subd. 2c.Interpreting services. "Interpreting services" means services that include:
37.22 	(1) interpreting between a spoken language, such as English, and a visual language, such 
37.23 	as American Sign Language or another signed language;
37.24 	(2) interpreting between a spoken language and a visual representation of a spoken 
37.25 	language, such as Cued Speech and or signing systems in English;
37.26 	(3) interpreting within one language where the interpreter uses natural gestures and
37.27 	silently repeats the spoken message, replacing some words or phrases to give higher visibility 
37.28 	on the lips make the message more readable;
37.29 	(4) interpreting using low vision or tactile methods, signing systems, or signed languages
37.30 	for persons who have a combined hearing and vision loss or are deafblind; and
38.1 	(5) interpreting from one communication mode or language into another communication 
38.2 	mode or language that is linguistically and culturally appropriate for the participants in the 
38.3 	communication exchange.

38.4 	EFFECTIVE DATE. This section is effective August 1, 2024.

38.5 	Sec. 8. Minnesota Statutes 2022, section 256C.23, subdivision 6, is amended to read:
38.6 		Subd. 6.Real-time captioning. "Real-time captioning" means a method of captioning 
38.7 	in which a caption is captions are simultaneously prepared and displayed or transmitted at 
38.8 	the time of origination by specially trained real-time captioners.

38.9 	EFFECTIVE DATE. This section is effective August 1, 2024.

38.10 	Sec. 9. Minnesota Statutes 2022, section 256C.23, subdivision 7, is amended to read:
38.11 		Subd. 7.Family and community intervener. "Family and community intervener" 
38.12 	means a paraprofessional,person who is specifically trained in deafblindness, who and
38.13 	works one-on-one with a child who is deafblind to provide critical connections access to 
38.14 	language, communication, people, and the environment.

38.15 	EFFECTIVE DATE. This section is effective August 1, 2024.

38.16 	Sec. 10. Minnesota Statutes 2022, section 256C.233, subdivision 1, is amended to read:
38.17 		Subdivision 1.Deaf, DeafBlind, and Hard-of-Hearing Hard of Hearing State Services 
38.18 	Division. The commissioners of commerce, education, employment and economic 
38.19 	development, and health shall advise partner with the commissioner of human services on 
38.20 	the interagency activities of the Deaf, DeafBlind, and Hard-of-Hearing Hard of Hearing 
38.21 	State Services Division. This division addresses the developmental and social-emotional 
38.22 	needs of provides services for persons who are deaf, persons who are deafblind, and persons 
38.23 	who are hard-of-hearing through a statewide network of programs, services, and supports. 
38.24 	This division also advocates on behalf of and provides information and training about how 
38.25 	to best serve persons who are deaf, persons who are deafblind, and persons who are 
38.26 	hard-of-hearing. The commissioner of human services shall coordinate the work of the 
38.27 	interagency advisers and partners, receive legislative appropriations for the division, and 
38.28 	provide grants through the division for programs, services, and supports for persons who 
38.29 	are deaf, persons who are deafblind, and persons who are hard-of-hearing in identified areas 
38.30 	of need such as deafblind services, family services, interpreting services, and mental health 
38.31 	services.

39.1 	EFFECTIVE DATE. This section is effective August 1, 2024.

39.2 	Sec. 11. Minnesota Statutes 2022, section 256C.233, subdivision 2, is amended to read:
39.3 		Subd. 2.Responsibilities. The Deaf, DeafBlind, and Hard-of-Hearing Hard of Hearing 
39.4 	State Services Division shall:
39.5 	(1) establish and maintain a statewide network of regional culturally and linguistically 
39.6 	affirmative services for Minnesotans who are deaf, Minnesotans who are deafblind, and 
39.7 	Minnesotans who are hard-of-hearing;
39.8 	(2) work across divisions within the Department of Human Services, as well as with 
39.9 	other agencies and counties, to ensure that there is an understanding of:
39.10 	(i) the communication access challenges faced by persons who are deaf, persons who 
39.11 	are deafblind, and persons who are hard-of-hearing;
39.12 	(ii) the best practices for accommodating and mitigating addressing communication 
39.13 	access challenges; and
39.14 	(iii) the legal requirements for providing access to and effective communication with 
39.15 	persons who are deaf, persons who are deafblind, and persons who are hard-of-hearing;
39.16 	(3) assess the supply and demand statewide for interpreter interpreting services and 
39.17 	real-time captioning services, implement strategies to provide greater access to these services 
39.18 	in areas without sufficient supply, and build the base of partner with interpreting service 
39.19 	providers and real-time captioning service providers across the state;
39.20 	(4) maintain a statewide information resource that includes contact information and 
39.21 	professional certification credentials certifications of interpreting service providers and 
39.22 	real-time captioning service providers;
39.23 	(5) provide culturally and linguistically affirmative mental health services to persons 
39.24 	who are deaf, persons who are deafblind, and persons who are hard-of-hearing who:
39.25 	(i) use a visual language such as American Sign Language, another sign language, or a 
39.26 	tactile form of a visual language; or
39.27 	(ii) otherwise need culturally and linguistically affirmative therapeutic mental health
39.28 	services;
39.29 	(6) research and develop best practices and recommendations for emerging issues; and
39.30 	(7) provide as much information as practicable on the division's stand-alone website in 
39.31 	American Sign Language; and.
40.1 	(8) report to the chairs and ranking minority members of the legislative committees with 
40.2 	jurisdiction over human services biennially, beginning on January 1, 2019, on the following:
40.3 	(i) the number of regional service center staff, the location of the office of each staff 
40.4 	person, other service providers with which they are colocated, the number of people served 
40.5 	by each staff person and a breakdown of whether each person was served on-site or off-site, 
40.6 	and for those served off-site, a list of locations where services were delivered and the number 
40.7 	who were served in-person and the number who were served via technology;
40.8 	(ii) the amount and percentage of the division budget spent on reasonable 
40.9 	accommodations for staff;
40.10 	(iii) the number of people who use demonstration equipment and consumer evaluations 
40.11 	of the experience;
40.12 	(iv) the number of training sessions provided by division staff, the topics covered, the 
40.13 	number of participants, and consumer evaluations, including a breakdown by delivery 
40.14 	method such as in-person or via technology;
40.15 	(v) the number of training sessions hosted at a division location provided by another 
40.16 	service provider, the topics covered, the number of participants, and consumer evaluations, 
40.17 	including a breakdown by delivery method such as in-person or via technology;
40.18 	(vi) for each grant awarded, the amount awarded to the grantee and a summary of the 
40.19 	grantee's results, including consumer evaluations of the services or products provided;
40.20 	(vii) the number of people on waiting lists for any services provided by division staff 
40.21 	or for services or equipment funded through grants awarded by the division;
40.22 	(viii) the amount of time staff spent driving to appointments to deliver direct one-to-one 
40.23 	client services in locations outside of the regional service centers; and
40.24 	(ix) the regional needs and feedback on addressing service gaps identified by the advisory 
40.25 	committees.

40.26 	EFFECTIVE DATE. This section is effective August 1, 2024.

40.27 	Sec. 12. Minnesota Statutes 2022, section 256C.24, subdivision 1, is amended to read:
40.28 		Subdivision 1.Location. The Deaf, DeafBlind, and Hard-of-Hearing Hard of Hearing 
40.29 	State Services Division shall establish at least six regional service centers for persons who 
40.30 	are deaf, persons who are deafblind, and persons who are hard-of-hearing. The centers shall 
40.31 	be distributed regionally to provide access for persons who are deaf, persons who are 
40.32 	deafblind, and persons who are hard-of-hearing in all parts of the state.

41.1 	EFFECTIVE DATE. This section is effective August 1, 2024.

41.2 	Sec. 13. Minnesota Statutes 2022, section 256C.24, subdivision 2, is amended to read:
41.3 		Subd. 2.Responsibilities. Each regional service center shall:
41.4 	(1) employ qualified staff to work with persons who are deaf, persons who are deafblind, 
41.5 	and persons who are hard-of-hearing;
41.6 	(1) (2) establish connections and collaborations and explore colocating with other public 
41.7 	and private entities providing services to persons who are deaf, persons who are deafblind, 
41.8 	and persons who are hard-of-hearing in the region;
41.9 	(2) (3) for those in need of services, assist in coordinating services between service 
41.10 	providers and persons who are deaf, persons who are deafblind, and persons who are 
41.11 	hard-of-hearing, and the persons' families, and make referrals to the services needed;
41.12 	(3) employ staff trained to work with persons who are deaf, persons who are deafblind, 
41.13 	and persons who are hard-of-hearing;
41.14 	(4) if adequate or accessible services are not available from another public or private 
41.15 	service provider in the region, provide individual culturally and linguistically affirmative 
41.16 	assistance with service supports and solutions to persons who are deaf, persons who are 
41.17 	deafblind, and persons who are hard-of-hearing, and the persons' families. Individual 
41.18 	culturally affirmative assistance may be provided using technology only in areas of the state 
41.19 	where a person has access to sufficient quality telecommunications or broadband services 
41.20 	to allow effective communication. When a person who is deaf, a person who is deafblind, 
41.21 	or a person who is hard-of-hearing does not have access to sufficient telecommunications 
41.22 	or broadband service, individual assistance shall be available in person;
41.23 	(5) identify regional training and resource needs, work with deaf and hard-of-hearing 
41.24 	services training staff, and collaborate with others to and deliver training and resources for 
41.25 	persons who are deaf, persons who are deafblind, and persons who are hard-of-hearing, and 
41.26 	the persons' families, and other service providers about subjects including the persons' rights 
41.27 	under the law, American Sign Language, and the impact of hearing loss and options for 
41.28 	accommodating it;
41.29 	(6) have a mobile or permanent lab where persons who are deaf, persons who are 
41.30 	deafblind, and persons who are hard-of-hearing can try a selection of modern assistive 
41.31 	technology, telecommunications equipment, and other technology and equipment to 
41.32 	determine what would best meet the persons' needs;
42.1 	(7) collaborate with the Resource Center for the Deaf and Hard-of-Hearing Persons, 
42.2 	other divisions of the Department of Education and local school districts to develop and 
42.3 	deliver programs and services for provide information and resources to families with children 
42.4 	who are deaf, children who are deafblind, or children who are hard-of-hearing and to support
42.5 	school personnel serving these children;
42.6 	(8) provide training, resources, and consultation to the social service or income 
42.7 	maintenance staff employed by counties or by organizations with whom counties contract 
42.8 	for services to ensure that human services providers about communication barriers which 
42.9 	prevent access and other needs of persons who are deaf, persons who are deafblind, and 
42.10 	persons who are hard-of-hearing from using services are removed;
42.11 	(9) provide training to human service agencies in the region regarding program access 
42.12 	for persons who are deaf, persons who are deafblind, and persons who are hard-of-hearing;
42.13 	(10) (9) assess the ongoing need and supply of services for persons who are deaf, persons 
42.14 	who are deafblind, and persons who are hard-of-hearing in all parts of the state,; annually 
42.15 	consult with the division's advisory committees to identify regional needs and solicit feedback 
42.16 	on addressing service gaps,; and cooperate collaborate with public and private service 
42.17 	providers to develop these services on service solutions;
42.18 	(11) (10) provide culturally and linguistically affirmative mental health services to 
42.19 	persons who are deaf, persons who are deafblind, and persons who are hard-of-hearing who:
42.20 	(i) use a visual language such as American Sign Language, another sign language, or a 
42.21 	tactile form of a visual language; or
42.22 	(ii) otherwise need culturally and linguistically affirmative therapeutic mental health
42.23 	services; and
42.24 	(12) (11) establish partnerships with state and regional entities statewide that have the 
42.25 	technological capacity to provide Minnesotans with virtual access to the division's services 
42.26 	and division-sponsored training via through technology.

42.27 	EFFECTIVE DATE. This section is effective August 1, 2024.

42.28 	Sec. 14. Minnesota Statutes 2022, section 256C.24, subdivision 3, is amended to read:
42.29 		Subd. 3.Advisory committee. The director of the Deaf, DeafBlind, and Hard-of-Hearing
42.30 	Hard of Hearing State Services Division shall appoint eight advisory committees of up to 
42.31 	nine persons per advisory committee. Each committee shall represent a specific region of 
42.32 	the state. The director shall determine the boundaries of each advisory committee region. 
43.1 	The committees shall advise the director on the needs of persons who are deaf, persons who 
43.2 	are deafblind, and persons who are hard-of-hearing and service gaps in the region of the 
43.3 	state the committee represents. Members shall include persons who are deaf, persons who 
43.4 	are deafblind, and persons who are hard-of-hearing, persons who have communication 
43.5 	disabilities, parents of children who are deaf, parents of children who are deafblind, and 
43.6 	parents of children who are hard-of-hearing, parents of children who have communication 
43.7 	disabilities, and representatives of county and regional human services, including 
43.8 	representatives of private service providers. At least 50 percent of the members must be 
43.9 	deaf or deafblind or hard-of-hearing or have a communication disability. Committee members 
43.10 	shall serve for a three-year term, and may be appointed to. Committee members shall serve 
43.11 	no more than three consecutive terms and no more than nine years in total. Each advisory 
43.12 	committee shall elect a chair. The director of the Deaf, DeafBlind, and Hard-of-Hearing
43.13 	Hard of Hearing State Services Division shall may assign staff to serve as nonvoting members 
43.14 	of the committee. Members shall not receive a per diem. Otherwise, the compensation, 
43.15 	removal of members, and filling of vacancies on the committee shall be as provided in 
43.16 	section 15.0575.

43.17 	EFFECTIVE DATE. This section is effective August 1, 2024.

43.18 	Sec. 15. Minnesota Statutes 2022, section 256C.26, is amended to read:
43.19 	256C.26 EMPLOYMENT SERVICES.
43.20 	The commissioner of employment and economic development shall work with the Deaf, 
43.21 	DeafBlind, and Hard-of-Hearing Hard of Hearing State Services Division to develop and 
43.22 	implement a plan to deal with the underemployment of persons who are deaf, persons who 
43.23 	are deafblind, and persons who are hard-of-hearing persons.

43.24 	EFFECTIVE DATE. This section is effective August 1, 2024.

43.25 	Sec. 16. Minnesota Statutes 2022, section 256C.261, is amended to read:
43.26 	256C.261 SERVICES FOR PERSONS WHO ARE DEAFBLIND.
43.27 	(a) The commissioner of human services shall use at least 35 60 percent of the deafblind 
43.28 	services biennial base level grant funding for programs, services, and other supports for a 
43.29 	child adults who are deafblind and for children who is are deafblind and the child's family
43.30 	children's families. The commissioner shall use at least 25 percent of the deafblind services 
43.31 	biennial base level grant funding for services and other supports for an adult who is deafblind.
43.32 	(b) The commissioner shall award grants for the purposes of:
44.1 	(1) providing programs, services, and supports to persons who are deafblind; and.
44.2 	(2) developing and providing training to counties and the network of senior citizen 
44.3 	service providers. The purpose of the training grants is to teach counties how to use existing 
44.4 	programs that capture federal financial participation to meet the needs of eligible persons 
44.5 	who are deafblind and to build capacity of senior service programs to meet the needs of 
44.6 	seniors with a dual sensory hearing and vision loss.
44.7 	(b) (c) The commissioner may make grants:
44.8 	(1) for services and training provided by organizations to persons who are deafblind; 
44.9 	and
44.10 	(2) to develop and administer consumer-directed services. for persons who are deafblind; 
44.11 	and
44.12 	(3) to develop and provide training to counties and service providers on how to meet 
44.13 	the needs of persons who are deafblind.
44.14 	(c) (d) Consumer-directed services shall must be provided in whole by grant-funded 
44.15 	providers. The Deaf and Hard-of-Hearing Services Division's regional service centers shall 
44.16 	not provide any aspect of a grant-funded consumer-directed services program.
44.17 	(d) Any entity that is able to satisfy the grant criteria is eligible to receive a grant under 
44.18 	paragraph (a).
44.19 	(e) Deafblind service providers may, but are not required to, provide intervenor intervener
44.20 	services as part of the service package provided with grant funds under this section. Intervener 
44.21 	services include services provided by a family and community intervener as described in 
44.22 	paragraph (f).
44.23 	(f) The family and community intervener, as defined in section 256C.23, subdivision 7, 
44.24 	provides services to open channels of communication between the child and others; facilitates 
44.25 	the development or use of receptive and expressive communication skills by the child; and 
44.26 	develops and maintains a trusting, interactive relationship that promotes social and emotional 
44.27 	well-being. The family and community intervener also provides access to information and 
44.28 	the environment, and facilitates opportunities for learning and development. A family and 
44.29 	community intervener must have specific training in deafblindness, building language and 
44.30 	communication skills, and intervention strategies.

44.31 	EFFECTIVE DATE. This section is effective August 1, 2024.

45.1 	Sec. 17. Minnesota Statutes 2022, section 256C.28, subdivision 1, is amended to read:
45.2 		Subdivision 1.Membership. (a) The Commission of the Deaf, DeafBlind and Hard of 
45.3 	Hearing consists of seven ten members appointed at large and one member each from each
45.4 	up to five advisory committee committees established under section 256C.24, subdivision 
45.5 	3. At least 50 percent of the voting members must be deaf or deafblind or hard-of-hearing. 
45.6 	Members shall include persons who are deaf, deafblind, and hard-of-hearing, parents at 
45.7 	least one parent or guardian of children a person who are is deaf, deafblind, and or
45.8 	hard-of-hearing, and representatives of county and regional human services, including 
45.9 	representatives of private service providers. The commissioners of education, health, and 
45.10 	employment and economic development and the director of the Deaf, DeafBlind, and Hard 
45.11 	of Hearing State Services Division in the Department of Human Services, or their designees, 
45.12 	shall serve as ex officio, nonvoting members of the commission. The commission may 
45.13 	appoint additional ex officio members from other bureaus, divisions, or sections of state 
45.14 	departments directly concerned with the provision of services to persons who are deaf, 
45.15 	deafblind, or hard-of-hearing.
45.16 	Commission (b) Voting members of the commission are appointed by the governor for 
45.17 	a four-year term and until successors are appointed and qualify. Commission Voting members
45.18 	of the commission shall serve no more than three consecutive full terms, and no more than 
45.19 	12 years in total.
45.20 	(c) Annually, by January 31, the commission shall select one member as chair and one 
45.21 	member as vice-chair to serve until January 31 of the following year or until the commission 
45.22 	selects a new chair or vice-chair, whichever occurs later.

45.23 	ARTICLE 3
45.24 	AGING SERVICES

45.25 	Section 1. Minnesota Statutes 2022, section 144A.20, subdivision 4, is amended to read:
45.26 		Subd. 4.Assisted living director qualifications; ongoing training. (a) The Board of 
45.27 	Executives for Long Term Services and Supports may issue licenses to qualified persons 
45.28 	as an assisted living director and shall approve training and examinations. No license shall 
45.29 	be issued to a person as an assisted living director unless that person:
45.30 	(1) is eligible for licensure;
45.31 	(2) has applied for licensure under this subdivision within six months 30 days of hire as 
45.32 	an assisted living director; and
46.1 	(3) has satisfactorily met standards set by the board or is scheduled to complete the 
46.2 	training in paragraph (b) within one year of hire. The standards shall be designed to assure 
46.3 	that assisted living directors are individuals who, by training or experience, are qualified to 
46.4 	serve as assisted living directors.
46.5 	(b) In order to be qualified to serve as an assisted living director, an individual must:
46.6 	(1) have completed an approved training course and passed an examination approved 
46.7 	by the board that is designed to test for competence and that includes assisted living facility 
46.8 	laws in Minnesota; or
46.9 	(2)(i) currently be licensed in the state of Minnesota as a nursing home administrator or 
46.10 	have been validated as a qualified health services executive by the National Association of 
46.11 	Long Term Care Administrator Boards; and
46.12 	(ii) have core knowledge of assisted living facility laws; or.
46.13 	(3) apply for licensure by July 1, 2021, and satisfy one of the following:
46.14 	(i) have a higher education degree in nursing, social services, or mental health, or another 
46.15 	professional degree with training specific to management and regulatory compliance;
46.16 	(ii) have at least three years of supervisory, management, or operational experience and 
46.17 	higher education training applicable to an assisted living facility;
46.18 	(iii) have completed at least 1,000 hours of an executive in training program provided 
46.19 	by an assisted living director licensed under this subdivision; or
46.20 	(iv) have managed a housing with services establishment operating under assisted living 
46.21 	title protection for at least three years.
46.22 	(c) An assisted living director must receive at least 30 hours of training continuing 
46.23 	education every two years on topics relevant to the operation of an assisted living facility 
46.24 	and the needs of its residents. An assisted living director must maintain records of the 
46.25 	training continuing education required by this paragraph for at least the most recent three-year 
46.26 	period and must provide these records to Department of Health surveyors upon request. 
46.27 	Continuing education earned to maintain another professional license, such as a nursing 
46.28 	home administrator license, nursing license, social worker license, mental health professional 
46.29 	license, or real estate license, may be used to satisfy this requirement when the continuing 
46.30 	education is relevant to the assisted living services offered and residents served at the assisted 
46.31 	living facility.

47.1 	Sec. 2. Minnesota Statutes 2022, section 144G.30, subdivision 5, is amended to read:
47.2 		Subd. 5.Correction orders. (a) A correction order may be issued whenever the 
47.3 	commissioner finds upon survey or during a complaint investigation that a facility, a 
47.4 	managerial official, an agent of the facility, or an employee of the facility is not in compliance 
47.5 	with this chapter. The correction order shall cite the specific statute and document areas of 
47.6 	noncompliance and the time allowed for correction.
47.7 	(b) The commissioner shall mail or email copies of any correction order to the facility 
47.8 	within 30 calendar days after the survey exit date. A copy of each correction order and 
47.9 	copies of any documentation supplied to the commissioner shall be kept on file by the 
47.10 	facility and public documents shall be made available for viewing by any person upon 
47.11 	request. Copies may be kept electronically.
47.12 	(c) By the correction order date, the facility must:
47.13 	(1) document in the facility's records any action taken to comply with the correction 
47.14 	order. The commissioner may request a copy of this documentation and the facility's action 
47.15 	to respond to the correction order in future surveys, upon a complaint investigation, and as 
47.16 	otherwise needed.; and
47.17 	(2) make available, in a manner readily accessible to residents and others, including 
47.18 	provision of a paper copy upon request, the most recent plan of correction documenting the 
47.19 	actions taken by the facility to comply with the correction order.
47.20 	(d) After the plan of correction is made available under paragraph (c), clause (2), the 
47.21 	facility must provide a copy of the facility's most recent plan of correction to any individual 
47.22 	who requests it. A copy of the most recent plan of correction must be provided within 30 
47.23 	days after the request and in a format determined by the facility, except the facility must 
47.24 	make reasonable accommodations in providing the plan of correction in another format, 
47.25 	including a paper copy, upon request.

47.26 	EFFECTIVE DATE. This section is effective August 1, 2024, and applies to correction 
47.27 	orders issued on or after that date.

47.28 	Sec. 3. Minnesota Statutes 2022, section 256.975, subdivision 7e, is amended to read:
47.29 		Subd. 7e.Long-term care options counseling for assisted living at critical care 
47.30 	transitions. (a) The purpose of long-term care options counseling for assisted living is to 
47.31 	support persons with current or anticipated long-term care needs in making informed choices 
47.32 	among options that include the most cost-effective and least restrictive settings. Prospective 
47.33 	residents maintain the right to choose assisted living if that option is their preference.
48.1 	Reaching people before a crisis and during care transitions is important to ensure quality 
48.2 	of care and life, prevent unnecessary hospitalizations and readmissions, reduce the burden 
48.3 	on the health care system, reduce costs, and support personal preferences.
48.4 	(b) Licensed assisted living facilities shall inform each prospective resident or the 
48.5 	prospective resident's designated or legal representative of the availability of long-term care 
48.6 	options counseling for assisted living and the need to receive and verify the counseling prior 
48.7 	to signing a contract. Long-term care options counseling for assisted living is provided as 
48.8 	determined by the commissioner of human services. The service is delivered under a 
48.9 	partnership between lead agencies as defined in subdivision 10, paragraph (g), and the Area 
48.10 	Agencies on Aging, and is a point of entry to a combination of telephone-based long-term 
48.11 	care options counseling provided by Senior LinkAge Line and in-person long-term care 
48.12 	consultation provided by lead agencies. The point of entry service must be provided within 
48.13 	five working days of the request of the prospective resident as follows Counseling must be 
48.14 	delivered by Senior LinkAge Line either by telephone or in-person. Counseling must:
48.15 	(1) the counseling shall be conducted with the prospective resident, or in the alternative, 
48.16 	the resident's designated or legal representative, if:
48.17 	(i) the resident verbally requests; or
48.18 	(ii) the assisted living facility has documentation of the designated or legal representative's 
48.19 	authority to enter into a lease or contract on behalf of the prospective resident and accepts 
48.20 	the documentation in good faith;
48.21 	(2) the counseling shall (1) be performed in a manner that provides objective and complete 
48.22 	information;
48.23 	(3) the counseling must (2) include a review of the prospective resident's reasons for 
48.24 	considering assisted living services, the prospective resident's person's personal goals, a
48.25 	discussion of the prospective resident's person's immediate and projected long-term care 
48.26 	needs, and alternative community services or settings that may meet the prospective resident's
48.27 	person's needs; and
48.28 	(4) the prospective resident must be informed of the availability of an in-person visit 
48.29 	from a long-term care consultation team member at no charge to the prospective resident 
48.30 	to assist the prospective resident in assessment and planning to meet the prospective resident's 
48.31 	long-term care needs; and
49.1 	(5) verification of counseling shall be generated and provided to the prospective resident 
49.2 	by Senior LinkAge Line upon completion of the telephone-based counseling (3) include 
49.3 	the counseling and referral protocols in subdivision 7, paragraph (b), clauses (11) to (13).
49.4 	(c) An assisted living facility licensed under chapter 144G shall:
49.5 	(1) must inform each prospective resident or the prospective resident's designated or 
49.6 	legal representative of the availability of and contact information for long-term care options 
49.7 	counseling services under this subdivision; by providing Senior LinkAge Line information 
49.8 	at the facility tour.
49.9 	(2) receive a copy of the verification of counseling prior to executing a contract with 
49.10 	the prospective resident; and
49.11 	(3) retain a copy of the verification of counseling as part of the resident's file.
49.12 	(d) Emergency admissions to licensed assisted living facilities prior to consultation under 
49.13 	paragraph (b) are permitted according to policies established by the commissioner. Prior to 
49.14 	discharge, hospitals must refer older adults who are at risk of nursing home placement to 
49.15 	the Senior LinkAge Line for long-term care options counseling. Hospitals must make these 
49.16 	referrals using referral protocols and processes developed under subdivision 7.

49.17 	EFFECTIVE DATE. This section is effective August 1, 2024.

49.18 	Sec. 4. Minnesota Statutes 2022, section 256B.69, is amended by adding a subdivision to 
49.19 	read:
49.20 		Subd. 6h.Continuity of care for seniors receiving personal assistance. (a) If an 
49.21 	individual 65 years of age or older is receiving personal assistance from the same agency 
49.22 	continuously during the six months prior to being newly enrolled with any managed care 
49.23 	or county-based purchasing plan, the managed care or county-based purchasing plan with 
49.24 	which the individual is newly enrolled must offer the agency a contract for the purposes of 
49.25 	allowing the enrollee to receive any personal assistance covered under the terms of the plan 
49.26 	from the enrollee's current agency, provided the enrollee continues to live in the service 
49.27 	area of the enrollee's current agency.
49.28 	(b) For the purposes of this subdivision, the following terms have the meanings given:
49.29 	(1) "agency" means any of the following:
49.30 	(i) a personal care assistance provider agency as defined under section 256B.0659, 
49.31 	subdivision 1, paragraph (l);
50.1 	(ii) an agency provider as described in section 256B.85, subdivision 2, paragraph (c); 
50.2 	or
50.3 	(iii) a financial management services provider for an enrollee who directly employs 
50.4 	direct care staff through the community first services and supports budget model or through 
50.5 	the consumer-directed community supports option available under the elderly waiver; and
50.6 	(2) "personal assistance" means any of the following:
50.7 	(i) personal care assistance services, extended personal care assistance services, or 
50.8 	enhanced rate personal care assistance services under section 256B.0659;
50.9 	(ii) community first services and supports, extended community first services and 
50.10 	supports, or enhanced rate community first services and supports under section 256B.85; 
50.11 	or
50.12 	(iii) personal assistance provided through the consumer-directed community supports 
50.13 	option available under the elderly waiver.
50.14 	(c) This subdivision applies only if the enrollee's current agency agrees to accept as 
50.15 	payment in full the managed care plan's or county-based purchasing plan's in-network 
50.16 	reimbursement rate for the same covered service at the time the service is provided, and 
50.17 	agrees to enter into a managed care plan's or county-based purchasing plan's contract for 
50.18 	services of like kind.

50.19 	EFFECTIVE DATE. This section is effective January 1, 2025.

50.20 	Sec. 5. Minnesota Statutes 2022, section 256R.08, subdivision 1, is amended to read:
50.21 		Subdivision 1.Reporting of financial statements. (a) No later than February 1 of each 
50.22 	year, a nursing facility must:
50.23 	(1) provide the state agency with a copy of its audited financial statements or its working 
50.24 	trial balance;
50.25 	(2) provide the state agency with a copy of its audited financial statements for each year 
50.26 	an audit is conducted;
50.27 	(2) (3) provide the state agency with a statement of ownership for the facility;
50.28 	(3) (4) provide the state agency with separate, audited financial statements or and working 
50.29 	trial balances for every other facility owned in whole or in part by an individual or entity 
50.30 	that has an ownership interest in the facility;
51.1 	(5) provide the state agency with information regarding whether the licensee or a general 
51.2 	partner, director, or officer of the licensee controls or has an ownership interest of five 
51.3 	percent or more in a related organization that provides any services, facilities, or supplies 
51.4 	to the nursing facility;
51.5 	(4) (6) upon request, provide the state agency with separate, audited financial statements 
51.6 	or and working trial balances for every organization with which the facility conducts business 
51.7 	and which is owned in whole or in part by an individual or entity which has an ownership 
51.8 	interest in the facility;
51.9 	(5) (7) provide the state agency with copies of leases, purchase agreements, and other 
51.10 	documents related to the lease or purchase of the nursing facility; and
51.11 	(6) (8) upon request, provide the state agency with copies of leases, purchase agreements, 
51.12 	and other documents related to the acquisition of equipment, goods, and services which are 
51.13 	claimed as allowable costs.
51.14 	(b) If the licensee or the general partner, director, or officer of the licensee controls or 
51.15 	has an interest as described in paragraph (a), clause (5), the licensee must disclose all services, 
51.16 	facilities, or supplies provided to the nursing facility; the number of individuals who provide 
51.17 	services, facilities, or supplies at the nursing facility; and any other information requested 
51.18 	by the state agency.
51.19 	(b) (c) Audited financial statements submitted under paragraph paragraphs (a) and (b) 
51.20 	must include a balance sheet, income statement, statement of the rate or rates charged to 
51.21 	private paying residents, statement of retained earnings, statement of cash flows, notes to 
51.22 	the financial statements, audited applicable supplemental information, and the public 
51.23 	accountant's report. Public accountants must conduct audits in accordance with chapter 
51.24 	326A. The cost of an audit must not be an allowable cost unless the nursing facility submits 
51.25 	its audited financial statements in the manner otherwise specified in this subdivision. A 
51.26 	nursing facility must permit access by the state agency to the public accountant's audit work 
51.27 	papers that support the audited financial statements submitted under paragraph paragraphs
51.28 	(a) and (b).
51.29 	(c) (d) Documents or information provided to the state agency pursuant to this subdivision 
51.30 	must be public unless prohibited by the Health Insurance Portability and Accountability 
51.31 	Act or any other federal or state regulation. Data, notes, and preliminary drafts of reports 
51.32 	created, collected, and maintained by the audit offices of government entities, or persons 
51.33 	performing audits for government entities, and relating to an audit or investigation are 
51.34 	confidential data on individuals or protected nonpublic data until the final report has been 
52.1 	published or the audit or investigation is no longer being pursued actively, except that the 
52.2 	data must be disclosed as required to comply with section 6.67 or 609.456.
52.3 	(d) (e) If the requirements of paragraphs (a) and, (b), and (c) are not met, the 
52.4 	reimbursement rate may be reduced to 80 percent of the rate in effect on the first day of the 
52.5 	fourth calendar month after the close of the reporting period and the reduction must continue 
52.6 	until the requirements are met.
52.7 	(f) Licensees must provide the information required in this section to the commissioner 
52.8 	in a manner prescribed by the commissioner.
52.9 	(g) For purposes of this section, "related organization" and "control" have the meanings 
52.10 	given in section 256R.02, subdivision 43.

52.11 	EFFECTIVE DATE. This section is effective August 1, 2024.

52.12 	Sec. 6. Minnesota Statutes 2022, section 256R.08, is amended by adding a subdivision to 
52.13 	read:
52.14 		Subd. 5.Notice of costs associated with leases, rent, and use of land or other real 
52.15 	property by nursing homes. (a) Nursing homes must annually report to the commissioner, 
52.16 	in a manner determined by the commissioner, their cost associated with leases, rent, and 
52.17 	use of land or other real property and any other related information requested by the state 
52.18 	agency.
52.19 	(b) A nursing facility that violates this subdivision is subject to the penalties and 
52.20 	procedures under section 256R.04, subdivision 7.

52.21 	EFFECTIVE DATE. This section is effective August 1, 2024.

52.22 	Sec. 7. REPEALER.
 52.23 	(a) Minnesota Statutes 2022, section 256.975, subdivisions 7f and 7g, are repealed.
52.24 	(b) Minnesota Statutes 2022, section 256R.18, is repealed.

52.25 	EFFECTIVE DATE. Paragraph (a) is effective August 1, 2024. Paragraph (b) is effective 
52.26 	July 1, 2024.

53.1 	ARTICLE 4
53.2 	SUBSTANCE USE DISORDER SERVICES

53.3 	Section 1. Minnesota Statutes 2022, section 148F.025, subdivision 2, is amended to read:
53.4 		Subd. 2.Education requirements for licensure. An applicant for licensure must submit 
53.5 	evidence satisfactory to the board that the applicant has:
53.6 	(1) received a bachelor's or master's degree from an accredited school or educational 
53.7 	program; and
53.8 	(2) received 18 semester credits or 270 clock hours of academic course work and 880 
53.9 	clock hours of supervised alcohol and drug counseling practicum from an accredited school 
53.10 	or education program. The course work and practicum do not have to be part of the bachelor's 
53.11 	degree earned under clause (1). The academic course work must be in the following areas:
53.12 	(i) an overview of the transdisciplinary foundations of alcohol and drug counseling, 
53.13 	including theories of chemical dependency, the continuum of care, and the process of change;
53.14 	(ii) pharmacology of substance abuse disorders and the dynamics of addiction, including 
53.15 	substance use disorder treatment with medications for opioid use disorder;
53.16 	(iii) professional and ethical responsibilities;
53.17 	(iv) multicultural aspects of chemical dependency;
53.18 	(v) co-occurring disorders; and
53.19 	(vi) the core functions defined in section 148F.01, subdivision 10.

53.20 	Sec. 2. Minnesota Statutes 2022, section 245F.02, subdivision 17, is amended to read:
53.21 		Subd. 17.Peer recovery support services. "Peer recovery support services" means 
53.22 	mentoring and education, advocacy, and nonclinical recovery support provided by a recovery 
53.23 	peer services provided according to section 245F.08, subdivision 3.

53.24 	EFFECTIVE DATE. This section is effective the day following final enactment.

53.25 	Sec. 3. Minnesota Statutes 2022, section 245F.02, subdivision 21, is amended to read:
53.26 		Subd. 21.Recovery peer. "Recovery peer" means a person who has progressed in the 
53.27 	person's own recovery from substance use disorder and is willing to serve as a peer to assist 
53.28 	others in their recovery and is qualified according to section 245F.15, subdivision 7.

53.29 	EFFECTIVE DATE. This section is effective the day following final enactment.

54.1 	Sec. 4. Minnesota Statutes 2022, section 245F.08, subdivision 3, is amended to read:
54.2 		Subd. 3.Peer recovery support services. (a) Peers in recovery serve as mentors or 
54.3 	recovery-support partners for individuals in recovery, and may provide encouragement, 
54.4 	self-disclosure of recovery experiences, transportation to appointments, assistance with 
54.5 	finding resources that will help locate housing, job search resources, and assistance finding 
54.6 	and participating in support groups.
54.7 	(b) Peer recovery support services are provided by a recovery peer and must be supervised 
54.8 	by the responsible staff person.
54.9 	Peer recovery support services must meet the requirements in section 245G.07, 
54.10 	subdivision 2, clause (8), and must be provided by a person who is qualified according to 
54.11 	the requirements in section 245F.15, subdivision 7.

54.12 	EFFECTIVE DATE. This section is effective the day following final enactment.

54.13 	Sec. 5. Minnesota Statutes 2022, section 245F.15, subdivision 7, is amended to read:
54.14 		Subd. 7.Recovery peer qualifications. Recovery peers must:
54.15 	(1) be at least 21 years of age and have a high school diploma or its equivalent;
54.16 	(2) have a minimum of one year in recovery from substance use disorder;
54.17 	(3) have completed a curriculum designated by the commissioner that teaches specific 
54.18 	skills and training in the domains of ethics and boundaries, advocacy, mentoring and 
54.19 	education, and recovery and wellness support; and
54.20 	(4) receive supervision in areas specific to the domains of their role by qualified 
54.21 	supervisory staff.
54.22 	(1) meet the qualifications in section 245I.04, subdivision 18; and
54.23 	(2) provide services according to the scope of practice established in section 245I.04, 
54.24 	subdivision 19, under the supervision of an alcohol and drug counselor.

54.25 	EFFECTIVE DATE. This section is effective the day following final enactment.

54.26 	Sec. 6. Minnesota Statutes 2022, section 245G.031, subdivision 2, is amended to read:
54.27 		Subd. 2.Qualifying accreditation; determination of same and similar standards. (a) 
54.28 	The commissioner must accept a qualifying accreditation from an accrediting body listed 
54.29 	in paragraph (c) after determining, in consultation with the accrediting body and license 
54.30 	holders, which of the accrediting body's standards that are the same as or similar to the 
55.1 	licensing requirements in this chapter. In determining whether standards of an accrediting 
55.2 	body are the same as or similar to licensing requirements under this chapter, the commissioner 
55.3 	shall give due consideration to the existence of a standard that aligns in whole or in part to 
55.4 	a licensing standard.
55.5 	(b) Upon request by a license holder, the commissioner may allow the accrediting body 
55.6 	to monitor for compliance with licensing requirements under this chapter that are determined 
55.7 	to be neither the same as nor similar to those of the accrediting body.
55.8 	(c) For purposes of this section, "accrediting body" means The Joint Commission.
55.9 	(d) Qualifying accreditation only applies to the license holder's licensed programs that 
55.10 	are included in the accrediting body's survey during each survey period.

55.11 	Sec. 7. Minnesota Statutes 2022, section 245G.04, is amended by adding a subdivision to 
55.12 	read:
55.13 		Subd. 3.Opioid educational material. The license holder must provide opioid 
55.14 	educational material to the client on the day of service initiation. The license holder must 
55.15 	use the opioid educational material approved by the commissioner that contains information 
55.16 	on:
55.17 	(1) risks for opioid use disorder and dependence;
55.18 	(2) treatment options, including the use of a medication for opioid use disorder;
55.19 	(3) the risk and recognition of opioid overdose; and
55.20 	(4) the use, availability, and administration of an opiate antagonist to respond to opioid 
55.21 	overdose.

55.22 	EFFECTIVE DATE. This section is effective January 1, 2025.

55.23 	Sec. 8. Minnesota Statutes 2023 Supplement, section 245G.05, subdivision 3, is amended 
55.24 	to read:
55.25 		Subd. 3.Comprehensive assessment requirements. (a) A comprehensive assessment 
55.26 	must meet the requirements under section 245I.10, subdivision 6, paragraphs (b) and (c). 
55.27 	It must also include:
55.28 	(1) a diagnosis of a substance use disorder or a finding that the client does not meet the 
55.29 	criteria for a substance use disorder;
56.1 	(2) a determination of whether the individual screens positive for co-occurring mental 
56.2 	health disorders using a screening tool approved by the commissioner pursuant to section 
56.3 	245.4863;
56.4 	(3) a risk rating and summary to support the risk ratings within each of the dimensions 
56.5 	listed in section 254B.04, subdivision 4; and
56.6 	(4) a recommendation for the ASAM level of care identified in section 254B.19, 
56.7 	subdivision 1.
56.8 	(b) If the individual is assessed for opioid use disorder, the program must provide 
56.9 	educational material to the client within 24 hours of service initiation on:
56.10 	(1) risks for opioid use disorder and dependence;
56.11 	(2) treatment options, including the use of a medication for opioid use disorder;
56.12 	(3) the risk and recognition of opioid overdose; and
56.13 	(4) the use, availability, and administration of an opiate antagonist to respond to opioid 
56.14 	overdose.
56.15 	If the client is identified as having opioid use disorder at a later point, the required educational 
56.16 	material must be provided at that point. The license holder must use the educational materials 
56.17 	that are approved by the commissioner to comply with this requirement.

56.18 	EFFECTIVE DATE. This section is effective January 1, 2025.

56.19 	Sec. 9. Minnesota Statutes 2023 Supplement, section 245G.09, subdivision 3, is amended 
56.20 	to read:
56.21 		Subd. 3.Contents. Client records must contain the following:
56.22 	(1) documentation that the client was given information on client rights and 
56.23 	responsibilities, grievance procedures, tuberculosis, and HIV, and that the client was provided 
56.24 	an orientation to the program abuse prevention plan required under section 245A.65, 
56.25 	subdivision 2, paragraph (a), clause (4). If the client has an opioid use disorder, the record 
56.26 	must contain documentation that the client was provided educational information according 
56.27 	to section 245G.05 245G.04, subdivision 3, paragraph (b);
56.28 	(2) an initial services plan completed according to section 245G.04;
56.29 	(3) a comprehensive assessment completed according to section 245G.05;
56.30 	(4) an individual abuse prevention plan according to sections 245A.65, subdivision 2, 
56.31 	and 626.557, subdivision 14, when applicable;
57.1 	(5) an individual treatment plan according to section 245G.06, subdivisions 1 and 1a;
57.2 	(6) documentation of treatment services, significant events, appointments, concerns, and 
57.3 	treatment plan reviews according to section 245G.06, subdivisions 2a, 2b, 3, and 3a; and
57.4 	(7) a summary at the time of service termination according to section 245G.06, 
57.5 	subdivision 4.

57.6 	EFFECTIVE DATE. This section is effective January 1, 2025.

57.7 	Sec. 10. Minnesota Statutes 2023 Supplement, section 245G.11, subdivision 10, is amended 
57.8 	to read:
57.9 		Subd. 10.Student interns and former students. (a) A qualified staff member must 
57.10 	supervise and be responsible for a treatment service performed by a student intern and must 
57.11 	review and sign each assessment, individual treatment plan, and treatment plan review 
57.12 	prepared by a student intern.
57.13 	(b) An alcohol and drug counselor must supervise and be responsible for a treatment 
57.14 	service performed by a former student and must review and sign each assessment, individual 
57.15 	treatment plan, and treatment plan review prepared by the former student.
57.16 	(c) A student intern or former student must receive the orientation and training required 
57.17 	in section 245G.13, subdivisions 1, clause (7), and 2. No more than 50 percent of the 
57.18 	treatment staff may be students, student interns or former students, or licensing candidates
57.19 	with time documented to be directly related to the provision of treatment services for which 
57.20 	the staff are authorized.

57.21 	Sec. 11. Minnesota Statutes 2023 Supplement, section 245G.22, subdivision 2, is amended 
57.22 	to read:
57.23 		Subd. 2.Definitions. (a) For purposes of this section, the terms defined in this subdivision 
57.24 	have the meanings given them.
57.25 	(b) "Diversion" means the use of a medication for the treatment of opioid addiction being 
57.26 	diverted from intended use of the medication.
57.27 	(c) "Guest dose" means administration of a medication used for the treatment of opioid 
57.28 	addiction to a person who is not a client of the program that is administering or dispensing 
57.29 	the medication.
57.30 	(d) "Medical director" means a practitioner licensed to practice medicine in the 
57.31 	jurisdiction that the opioid treatment program is located who assumes responsibility for 
58.1 	administering all medical services performed by the program, either by performing the 
58.2 	services directly or by delegating specific responsibility to a practitioner of the opioid 
58.3 	treatment program.
58.4 	(e) "Medication used for the treatment of opioid use disorder" means a medication 
58.5 	approved by the Food and Drug Administration for the treatment of opioid use disorder.
58.6 	(f) "Minnesota health care programs" has the meaning given in section 256B.0636.
58.7 	(g) "Opioid treatment program" has the meaning given in Code of Federal Regulations, 
58.8 	title 42, section 8.12, and includes programs licensed under this chapter.
58.9 	(h) "Practitioner" means a staff member holding a current, unrestricted license to practice 
58.10 	medicine issued by the Board of Medical Practice or nursing issued by the Board of Nursing 
58.11 	and is currently registered with the Drug Enforcement Administration to order or dispense 
58.12 	controlled substances in Schedules II to V under the Controlled Substances Act, United 
58.13 	States Code, title 21, part B, section 821. Practitioner includes an advanced practice registered 
58.14 	nurse and physician assistant if the staff member receives a variance by the state opioid 
58.15 	treatment authority under section 254A.03 and the federal Substance Abuse and Mental 
58.16 	Health Services Administration.
58.17 	(i) "Unsupervised use" or "take-home dose" means the use of a medication for the 
58.18 	treatment of opioid use disorder dispensed for use by a client outside of the program setting.

58.19 	EFFECTIVE DATE. This section is effective the day following final enactment.

58.20 	Sec. 12. Minnesota Statutes 2022, section 245G.22, subdivision 6, is amended to read:
58.21 		Subd. 6.Criteria for unsupervised use. (a) To limit the potential for diversion of 
58.22 	medication used for the treatment of opioid use disorder to the illicit market, medication 
58.23 	dispensed to a client for unsupervised use shall be subject to the requirements of this 
58.24 	subdivision. Any client in an opioid treatment program may receive a single unsupervised 
58.25 	use dose for a day that the clinic is closed for business, including Sundays and state and 
58.26 	federal holidays individualized take-home doses as ordered for days that the clinic is closed 
58.27 	for business on one weekend day and state and federal holidays, no matter the client's length 
58.28 	of time in treatment, as allowed under Code of Federal Regulations, title 42, section 
58.29 	8.12(i)(1).
58.30 	(b) For take-home doses beyond those allowed in paragraph (a), a practitioner with 
58.31 	authority to prescribe must review and document the criteria in this paragraph and paragraph 
58.32 	(c)Code of Federal Regulations, title 42, section 8.12(i)(2), when determining whether 
58.33 	dispensing medication for a client's unsupervised use is safe and when it is appropriate to 
59.1 	implement, increase, or extend the amount of time between visits to the program. The criteria 
59.2 	are:
59.3 	(1) absence of recent abuse of drugs including but not limited to opioids, non-narcotics, 
59.4 	and alcohol;
59.5 	(2) regularity of program attendance;
59.6 	(3) absence of serious behavioral problems at the program;
59.7 	(4) absence of known recent criminal activity such as drug dealing;
59.8 	(5) stability of the client's home environment and social relationships;
59.9 	(6) length of time in comprehensive maintenance treatment;
59.10 	(7) reasonable assurance that unsupervised use medication will be safely stored within 
59.11 	the client's home; and
59.12 	(8) whether the rehabilitative benefit the client derived from decreasing the frequency 
59.13 	of program attendance outweighs the potential risks of diversion or unsupervised use.
59.14 	(c) The determination, including the basis of the determination must be documented by 
59.15 	a practitioner in the client's medical record.

59.16 	EFFECTIVE DATE. This section is effective the day following final enactment.

59.17 	Sec. 13. Minnesota Statutes 2022, section 245G.22, subdivision 7, is amended to read:
59.18 		Subd. 7.Restrictions for unsupervised use of methadone hydrochloride. (a) If a 
59.19 	medical director or prescribing practitioner assesses and, determines, and documents that 
59.20 	a client meets the criteria in subdivision 6 and may be dispensed a medication used for the 
59.21 	treatment of opioid addiction, the restrictions in this subdivision must be followed when 
59.22 	the medication to be dispensed is methadone hydrochloride. The results of the assessment 
59.23 	must be contained in the client file. The number of unsupervised use medication doses per 
59.24 	week in paragraphs (b) to (d) is in addition to the number of unsupervised use medication 
59.25 	doses a client may receive for days the clinic is closed for business as allowed by subdivision 
59.26 	6, paragraph (a) and that a patient is safely able to manage unsupervised doses of methadone, 
59.27 	the number of take-home doses the client receives must be limited by the number allowed 
59.28 	by Code of Federal Regulations, title 42, section 8.12(i)(3).
59.29 	(b) During the first 90 days of treatment, the unsupervised use medication supply must 
59.30 	be limited to a maximum of a single dose each week and the client shall ingest all other 
59.31 	doses under direct supervision.
60.1 	(c) In the second 90 days of treatment, the unsupervised use medication supply must be 
60.2 	limited to two doses per week.
60.3 	(d) In the third 90 days of treatment, the unsupervised use medication supply must not 
60.4 	exceed three doses per week.
60.5 	(e) In the remaining months of the first year, a client may be given a maximum six-day 
60.6 	unsupervised use medication supply.
60.7 	(f) After one year of continuous treatment, a client may be given a maximum two-week 
60.8 	unsupervised use medication supply.
60.9 	(g) After two years of continuous treatment, a client may be given a maximum one-month 
60.10 	unsupervised use medication supply, but must make monthly visits to the program.

60.11 	EFFECTIVE DATE. This section is effective the day following final enactment.

60.12 	Sec. 14. Minnesota Statutes 2023 Supplement, section 245G.22, subdivision 17, is amended 
60.13 	to read:
60.14 		Subd. 17.Policies and procedures. (a) A license holder must develop and maintain the 
60.15 	policies and procedures required in this subdivision.
60.16 	(b) For a program that is not open every day of the year, the license holder must maintain 
60.17 	a policy and procedure that covers requirements under section 245G.22, subdivisions 6 and 
60.18 	7. Unsupervised use of medication used for the treatment of opioid use disorder for days 
60.19 	that the program is closed for business, including but not limited to Sundayson one weekend 
60.20 	day and state and federal holidays, must meet the requirements under section 245G.22,
60.21 	subdivisions 6 and 7.
60.22 	(c) The license holder must maintain a policy and procedure that includes specific 
60.23 	measures to reduce the possibility of diversion. The policy and procedure must:
60.24 	(1) specifically identify and define the responsibilities of the medical and administrative 
60.25 	staff for performing diversion control measures; and
60.26 	(2) include a process for contacting no less than five percent of clients who have 
60.27 	unsupervised use of medication, excluding clients approved solely under subdivision 6, 
60.28 	paragraph (a), to require clients to physically return to the program each month. The system 
60.29 	must require clients to return to the program within a stipulated time frame and turn in all 
60.30 	unused medication containers related to opioid use disorder treatment. The license holder 
60.31 	must document all related contacts on a central log and the outcome of the contact for each 
61.1 	client in the client's record. The medical director must be informed of each outcome that 
61.2 	results in a situation in which a possible diversion issue was identified.
61.3 	(d) Medication used for the treatment of opioid use disorder must be ordered, 
61.4 	administered, and dispensed according to applicable state and federal regulations and the 
61.5 	standards set by applicable accreditation entities. If a medication order requires assessment 
61.6 	by the person administering or dispensing the medication to determine the amount to be 
61.7 	administered or dispensed, the assessment must be completed by an individual whose 
61.8 	professional scope of practice permits an assessment. For the purposes of enforcement of 
61.9 	this paragraph, the commissioner has the authority to monitor the person administering or 
61.10 	dispensing the medication for compliance with state and federal regulations and the relevant 
61.11 	standards of the license holder's accreditation agency and may issue licensing actions 
61.12 	according to sections 245A.05, 245A.06, and 245A.07, based on the commissioner's 
61.13 	determination of noncompliance.
61.14 	(e) A counselor in an opioid treatment program must not supervise more than 50 clients.
61.15 	The license holder must maintain a ratio of one full-time equivalent alcohol and drug 
61.16 	counselor for every 60 clients enrolled in the program. The license holder must determine 
61.17 	the appropriate number of clients for which each counselor is responsible based on the needs 
61.18 	of each client. The license holder must maintain documentation of the clients assigned to 
61.19 	each counselor to demonstrate compliance with this paragraph. For the purpose of this 
61.20 	paragraph, "full-time equivalent" means working at least 32 hours each week.
61.21 	(f) Notwithstanding paragraph (e), From July 1, 2023, to June 30, 2024, a counselor in 
61.22 	an opioid treatment program may supervise up to 60 clients. The license holder may continue 
61.23 	to serve a client who was receiving services at the program on June 30, 2024, at a counselor 
61.24 	to client ratio of up to one to 60 and is not required to discharge any clients in order to return 
61.25 	to the counselor to client ratio of one to 50. The license holder may not, however, serve a 
61.26 	new client after June 30, 2024, unless the counselor who would supervise the new client is 
61.27 	supervising fewer than 50 existing clients.

61.28 	EFFECTIVE DATE. This section is effective July 1, 2024, except the amendments to 
61.29 	paragraph (b) are effective the day following final enactment.

61.30 	Sec. 15. Minnesota Statutes 2023 Supplement, section 245I.04, subdivision 18, is amended 
61.31 	to read:
61.32 		Subd. 18.Recovery peer qualifications. (a) A recovery peer must:
61.33 	(1) have a minimum of one year in recovery from substance use disorder; and
62.1 	(2) hold a current credential from the Minnesota Certification Board, the Upper Midwest 
62.2 	Indian Council on Addictive Disorders, or the National Association for Alcoholism and 
62.3 	Drug Abuse Counselors that demonstrates skills and training in the domains of ethics and 
62.4 	boundaries, advocacy, mentoring and education, and recovery and wellness support.
62.5 	(b) A recovery peer who receives a credential from a Tribal Nation when providing peer 
62.6 	recovery support services in a tribally licensed program satisfies the requirement in paragraph 
62.7 	(a), clause (2).
62.8 	(c) A recovery peer hired on or after July 1, 2024, must not be classified or treated as 
62.9 	an independent contractor. Beginning January 1, 2025, a recovery peer must not be classified 
62.10 	or treated as an independent contractor.

62.11 	EFFECTIVE DATE. This section is effective July 1, 2024.

62.12 	Sec. 16. Minnesota Statutes 2023 Supplement, section 254A.19, subdivision 3, is amended 
62.13 	to read:
62.14 		Subd. 3.Comprehensive assessments.  (a) An eligible vendor under section 254B.05
62.15 	conducting a comprehensive assessment for an individual seeking treatment shall approve
62.16 	recommend the nature, intensity level, and duration of treatment service if a need for services 
62.17 	is indicated, but the individual assessed can access any enrolled provider that is licensed to 
62.18 	provide the level of service authorized, including the provider or program that completed 
62.19 	the assessment. If an individual is enrolled in a prepaid health plan, the individual must 
62.20 	comply with any provider network requirements or limitations.
62.21 	(b) When a comprehensive assessment is completed while the individual is in a substance 
62.22 	use disorder treatment program, the comprehensive assessment must meet the requirements 
62.23 	of section 245G.05.
62.24 	(c) When a comprehensive assessment is completed while the individual is in a 
62.25 	withdrawal management program, the comprehensive assessment must meet the requirements 
62.26 	of section 245F.06.
62.27 	(d) When a comprehensive assessment is completed for purposes of payment under 
62.28 	section 254B.05, subdivision 1, paragraph (b), (c), or (i), or if the assessment is completed 
62.29 	prior to service initiation by a licensed substance use disorder treatment program licensed 
62.30 	under chapter 245G or applicable Tribal license, the assessor must:
62.31 	(1) include all components under section 245G.05, subdivision 3;
63.1 	(2) provide the assessment within five days or at a later date upon the client's request, 
63.2 	or refer the individual to other locations where they may access this service sooner;
63.3 	(3) provide information on payment options for substance use disorder services when 
63.4 	the individual is uninsured or underinsured;
63.5 	(4) provide the individual with a notice of privacy practices;
63.6 	(5) provide a copy of the completed comprehensive assessment, upon request;
63.7 	(6) provide resources and contact information for the level of care being recommended; 
63.8 	and
63.9 	(7) provide an individual diagnosed with an opioid use disorder with educational material 
63.10 	approved by the commissioner that contains information on:
63.11 	(i) risks for opioid use disorder and opioid dependence;
63.12 	(ii) treatment options, including the use of a medication for opioid use disorder;
63.13 	(iii) the risk and recognition of opioid overdose; and
63.14 	(iv) the use, availability, and administration of an opiate antagonist to respond to opioid 
63.15 	overdose.

63.16 	Sec. 17. Minnesota Statutes 2022, section 254B.03, subdivision 4, is amended to read:
63.17 		Subd. 4.Division of costs. (a) Except for services provided by a county under section 
63.18 	254B.09, subdivision 1, or services provided under section 256B.69, the county shall, out 
63.19 	of local money, pay the state for 22.95 percent of the cost of substance use disorder services, 
63.20 	except for those services provided to persons enrolled in medical assistance under chapter 
63.21 	256B and room and board services under section 254B.05, subdivision 5, paragraph (b), 
63.22 	clause (12). Counties may use the indigent hospitalization levy for treatment and hospital 
63.23 	payments made under this section.
63.24 	(b) 22.95 percent of any state collections from private or third-party pay, less 15 percent 
63.25 	for the cost of payment and collections, must be distributed to the county that paid for a 
63.26 	portion of the treatment under this section.

63.27 	Sec. 18. Minnesota Statutes 2023 Supplement, section 254B.04, subdivision 1a, is amended 
63.28 	to read:
63.29 		Subd. 1a.Client eligibility. (a) Persons eligible for benefits under Code of Federal 
63.30 	Regulations, title 25, part 20, who meet the income standards of section 256B.056, 
64.1 	subdivision 4, and are not enrolled in medical assistance, are entitled to behavioral health 
64.2 	fund services. State money appropriated for this paragraph must be placed in a separate 
64.3 	account established for this purpose.
64.4 	(b) Persons with dependent children who are determined to be in need of substance use 
64.5 	disorder treatment pursuant to an assessment under section 260E.20, subdivision 1, or in 
64.6 	need of chemical dependency treatment pursuant to a case plan under section 260C.201, 
64.7 	subdivision 6, or 260C.212, shall be assisted by the local agency to access needed treatment 
64.8 	services. Treatment services must be appropriate for the individual or family, which may 
64.9 	include long-term care treatment or treatment in a facility that allows the dependent children 
64.10 	to stay in the treatment facility. The county shall pay for out-of-home placement costs, if 
64.11 	applicable.
64.12 	(c) Notwithstanding paragraph (a), persons enrolled in medical assistance are eligible 
64.13 	for room and board services under section 254B.05, subdivision 5, paragraph (b), clause 
64.14 	(12).
64.15 	(d) A client is eligible to have substance use disorder treatment paid for with funds from 
64.16 	the behavioral health fund when the client:
64.17 	(1) is eligible for MFIP as determined under chapter 256J;
64.18 	(2) is eligible for medical assistance as determined under Minnesota Rules, parts 
64.19 	9505.0010 to 9505.0150;
64.20 	(3) is eligible for general assistance, general assistance medical care, or work readiness 
64.21 	as determined under Minnesota Rules, parts 9500.1200 to 9500.1318; or
64.22 	(4) has income that is within current household size and income guidelines for entitled 
64.23 	persons, as defined in this subdivision and subdivision 7.
64.24 	(e) Clients who meet the financial eligibility requirement in paragraph (a) and who have 
64.25 	a third-party payment source are eligible for the behavioral health fund if the third-party 
64.26 	payment source pays less than 100 percent of the cost of treatment services for eligible 
64.27 	clients.
64.28 	(f) A client is ineligible to have substance use disorder treatment services paid for with 
64.29 	behavioral health fund money if the client:
64.30 	(1) has an income that exceeds current household size and income guidelines for entitled 
64.31 	persons as defined in this subdivision and subdivision 7; or
65.1 	(2) has an available third-party payment source that will pay the total cost of the client's 
65.2 	treatment.
65.3 	(g) A client who is disenrolled from a state prepaid health plan during a treatment episode 
65.4 	is eligible for continued treatment service that is paid for by the behavioral health fund until 
65.5 	the treatment episode is completed or the client is re-enrolled in a state prepaid health plan 
65.6 	if the client:
65.7 	(1) continues to be enrolled in MinnesotaCare, medical assistance, or general assistance 
65.8 	medical care; or
65.9 	(2) is eligible according to paragraphs (a) and (b) and is determined eligible by a local 
65.10 	agency under section 254B.04.
65.11 	(h) When a county commits a client under chapter 253B to a regional treatment center 
65.12 	for substance use disorder services and the client is ineligible for the behavioral health fund, 
65.13 	the county is responsible for the payment to the regional treatment center according to 
65.14 	section 254B.05, subdivision 4.

65.15 	Sec. 19. Minnesota Statutes 2023 Supplement, section 254B.04, subdivision 2a, is amended 
65.16 	to read:
65.17 		Subd. 2a.Eligibility for room and board services for persons in outpatient substance 
65.18 	use disorder treatment.  A person eligible for room and board services under section 
65.19 	254B.05, subdivision 5, paragraph (b), clause (12), must score at level 4 on assessment 
65.20 	dimensions related to readiness to change, relapse, continued use, or recovery environment 
65.21 	in order to be assigned to services with a room and board component reimbursed under this 
65.22 	section. Whether a treatment facility has been designated an institution for mental diseases 
65.23 	under United States Code, title 42, section 1396d, shall not be a factor in making placements.

65.24 	Sec. 20. Minnesota Statutes 2023 Supplement, section 254B.04, subdivision 6, is amended 
65.25 	to read:
65.26 		Subd. 6.Local agency to determine client financial eligibility. (a) The local agency 
65.27 	shall determine a client's financial eligibility for the behavioral health fund according to 
65.28 	section 254B.04, subdivision 1a, with the income calculated prospectively for one year from 
65.29 	the date of comprehensive assessment request. The local agency shall pay for eligible clients 
65.30 	according to chapter 256G. The local agency shall enter the financial eligibility span within 
65.31 	ten calendar days of request. Client eligibility must be determined using only forms prescribed 
65.32 	by the departmentcommissioner unless the local agency has a reasonable basis for believing 
66.1 	that the information submitted on a form is false. To determine a client's eligibility, the local 
66.2 	agency must determine the client's income, the size of the client's household, the availability 
66.3 	of a third-party payment source, and a responsible relative's ability to pay for the client's 
66.4 	substance use disorder treatment.
66.5 	(b) A client who is a minor child must not be deemed to have income available to pay 
66.6 	for substance use disorder treatment, unless the minor child is responsible for payment under 
66.7 	section 144.347 for substance use disorder treatment services sought under section 144.343, 
66.8 	subdivision 1.
66.9 	(c) The local agency must determine the client's household size as follows:
66.10 	(1) if the client is a minor child, the household size includes the following persons living 
66.11 	in the same dwelling unit:
66.12 	(i) the client;
66.13 	(ii) the client's birth or adoptive parents; and
66.14 	(iii) the client's siblings who are minors; and
66.15 	(2) if the client is an adult, the household size includes the following persons living in 
66.16 	the same dwelling unit:
66.17 	(i) the client;
66.18 	(ii) the client's spouse;
66.19 	(iii) the client's minor children; and
66.20 	(iv) the client's spouse's minor children.
66.21 	For purposes of this paragraph, household size includes a person listed in clauses (1) and 
66.22 	(2) who is in an out-of-home placement if a person listed in clause (1) or (2) is contributing 
66.23 	to the cost of care of the person in out-of-home placement.
66.24 	(d) The local agency must determine the client's current prepaid health plan enrollment, 
66.25 	the availability of a third-party payment source, including the availability of total payment, 
66.26 	partial payment, and amount of co-payment.
66.27 	(e) The local agency must provide the required eligibility information to the department 
66.28 	in the manner specified by the department.
66.29 	(f) The local agency shall require the client and policyholder to conditionally assign to 
66.30 	the department the client and policyholder's rights and the rights of minor children to benefits 
67.1 	or services provided to the client if the department is required to collect from a third-party 
67.2 	pay source.
67.3 	(g) The local agency must redetermine a client's eligibility for the behavioral health fund 
67.4 	every 12 months.
67.5 	(h) A client, responsible relative, and policyholder must provide income or wage 
67.6 	verification, household size verification, and must make an assignment of third-party payment 
67.7 	rights under paragraph (f). If a client, responsible relative, or policyholder does not comply 
67.8 	with the provisions of this subdivision, the client is ineligible for behavioral health fund 
67.9 	payment for substance use disorder treatment, and the client and responsible relative must 
67.10 	be obligated to pay for the full cost of substance use disorder treatment services provided 
67.11 	to the client.

67.12 	Sec. 21. Minnesota Statutes 2023 Supplement, section 254B.04, is amended by adding a 
67.13 	subdivision to read:
67.14 		Subd. 6a.Span of eligibility. The local agency must enter the financial eligibility span 
67.15 	within five business days of a request. If the comprehensive assessment is completed within 
67.16 	the timelines required under chapter 245G, then the span of eligibility must begin on the 
67.17 	date services were initiated. If the comprehensive assessment is not completed within the 
67.18 	timelines required under chapter 245G, then the span of eligibility must begin on the date 
67.19 	the comprehensive assessment was completed.

67.20 	Sec. 22. Minnesota Statutes 2023 Supplement, section 254B.05, subdivision 1, is amended 
67.21 	to read:
67.22 		Subdivision 1.Licensure or certification required. (a) Programs licensed by the 
67.23 	commissioner are eligible vendors. Hospitals may apply for and receive licenses to be 
67.24 	eligible vendors, notwithstanding the provisions of section 245A.03. American Indian 
67.25 	programs that provide substance use disorder treatment, extended care, transitional residence, 
67.26 	or outpatient treatment services, and are licensed by Tribal government are eligible vendors.
67.27 	(b) A licensed professional in private practice as defined in section 245G.01, subdivision 
67.28 	17, who meets the requirements of section 245G.11, subdivisions 1 and 4, is an eligible 
67.29 	vendor of a comprehensive assessment and assessment summary provided according to 
67.30 	section 245G.05254A.19, subdivision 3, and treatment services provided according to 
67.31 	sections 245G.06 and 245G.07, subdivision 1, paragraphs (a), clauses (1) to (5), and (b); 
67.32 	and subdivision 2, clauses (1) to (6).
68.1 	(c) A county is an eligible vendor for a comprehensive assessment and assessment
68.2 	summary when provided by an individual who meets the staffing credentials of section 
68.3 	245G.11, subdivisions 1 and 5, and completed according to the requirements of section 
68.4 	245G.05254A.19, subdivision 3. A county is an eligible vendor of care coordination services 
68.5 	when provided by an individual who meets the staffing credentials of section 245G.11, 
68.6 	subdivisions 1 and 7, and provided according to the requirements of section 245G.07, 
68.7 	subdivision 1, paragraph (a), clause (5). A county is an eligible vendor of peer recovery 
68.8 	services when the services are provided by an individual who meets the requirements of 
68.9 	section 245G.11, subdivision 8.
68.10 	(d) A recovery community organization that meets the requirements of clauses (1) to 
68.11 	(10) and meets membership certification or accreditation requirements of the Association 
68.12 	of Recovery Community Organizations,Alliance for Recovery Centered Organizations, the 
68.13 	Council on Accreditation of Peer Recovery Support Services, or a Minnesota statewide 
68.14 	recovery community organization identified by the commissioner is an eligible vendor of 
68.15 	peer support services. Eligible vendors under this paragraph must:
68.16 	(1) be nonprofit organizations;
68.17 	(2) be led and governed by individuals in the recovery community, with more than 50 
68.18 	percent of the board of directors or advisory board members self-identifying as people in 
68.19 	personal recovery from substance use disorders;
68.20 	(3) primarily focus on recovery from substance use disorders, with missions and visions 
68.21 	that support this primary focus;
68.22 	(4) be grassroots and reflective of and engaged with the community served;
68.23 	(5) be accountable to the recovery community through processes that promote the 
68.24 	involvement and engagement of, and consultation with, people in recovery and their families, 
68.25 	friends, and recovery allies;
68.26 	(6) provide nonclinical peer recovery support services, including but not limited to 
68.27 	recovery support groups, recovery coaching, telephone recovery support, skill-building 
68.28 	groups, and harm-reduction activities;
68.29 	(7) allow for and support opportunities for all paths toward recovery and refrain from 
68.30 	excluding anyone based on their chosen recovery path, which may include but is not limited 
68.31 	to harm reduction paths, faith-based paths, and nonfaith-based paths;
69.1 	(8) be purposeful in meeting the diverse needs of Black, Indigenous, and people of color 
69.2 	communities, including board and staff development activities, organizational practices, 
69.3 	service offerings, advocacy efforts, and culturally informed outreach and service plans;
69.4 	(9) be stewards of recovery-friendly language that is supportive of and promotes recovery 
69.5 	across diverse geographical and cultural contexts and reduces stigma; and
69.6 	(10) maintain an employee and volunteer code of ethics and easily accessible grievance 
69.7 	procedures posted in physical spaces, on websites, or on program policies or forms.;
69.8 	(11) not classify or treat any recovery peer hired on or after July 1, 2024, as an 
69.9 	independent contractor; and
69.10 	(12) not classify or treat any recovery peer as an independent contractor on or after 
69.11 	January 1, 2025.
69.12 	(e) Recovery community organizations approved by the commissioner before June 30, 
69.13 	2023, shall retain their designation as recovery community organizations.
69.14 	(f) A recovery community organization that is aggrieved by an accreditation or 
69.15 	membership determination and believes it meets the requirements under paragraph (d) may 
69.16 	appeal the determination under section 256.045, subdivision 3, paragraph (a), clause (15), 
69.17 	for reconsideration as an eligible vendor.
69.18 	(g) All recovery community organizations must be certified or accredited by an entity 
69.19 	listed in paragraph (d) by June 30, 2025.
69.20 	(g) (h) Detoxification programs licensed under Minnesota Rules, parts 9530.6510 to 
69.21 	9530.6590, are not eligible vendors. Programs that are not licensed as a residential or 
69.22 	nonresidential substance use disorder treatment or withdrawal management program by the 
69.23 	commissioner or by Tribal government or do not meet the requirements of subdivisions 1a 
69.24 	and 1b are not eligible vendors.
69.25 	(h) (i) Hospitals, federally qualified health centers, and rural health clinics are eligible 
69.26 	vendors of a comprehensive assessment when the comprehensive assessment is completed 
69.27 	according to section 245G.05254A.19, subdivision 3 and by an individual who meets the 
69.28 	criteria of an alcohol and drug counselor according to section 245G.11, subdivision 5. The 
69.29 	alcohol and drug counselor must be individually enrolled with the commissioner and reported 
69.30 	on the claim as the individual who provided the service.

69.31 	EFFECTIVE DATE. This section is effective August 1, 2024, except that paragraph 
69.32 	(d), clauses (11) and (12), are effective July 1, 2024.

70.1 	Sec. 23. Minnesota Statutes 2023 Supplement, section 254B.05, subdivision 5, is amended 
70.2 	to read:
70.3 		Subd. 5.Rate requirements. (a) The commissioner shall establish rates for substance 
70.4 	use disorder services and service enhancements funded under this chapter.
70.5 	(b) Eligible substance use disorder treatment services include:
70.6 	(1) those licensed, as applicable, according to chapter 245G or applicable Tribal license 
70.7 	and provided according to the following ASAM levels of care:
70.8 	(i) ASAM level 0.5 early intervention services provided according to section 254B.19, 
70.9 	subdivision 1, clause (1);
70.10 	(ii) ASAM level 1.0 outpatient services provided according to section 254B.19, 
70.11 	subdivision 1, clause (2);
70.12 	(iii) ASAM level 2.1 intensive outpatient services provided according to section 254B.19, 
70.13 	subdivision 1, clause (3);
70.14 	(iv) ASAM level 2.5 partial hospitalization services provided according to section 
70.15 	254B.19, subdivision 1, clause (4);
70.16 	(v) ASAM level 3.1 clinically managed low-intensity residential services provided 
70.17 	according to section 254B.19, subdivision 1, clause (5). The commissioner shall use the 
70.18 	base payment rate of $79.84 per day for services provided under this item;
70.19 	(vi) ASAM level 3.1 clinically managed low-intensity residential services according to 
70.20 	section 254B.19, subdivision 1, clause (5), provided at 15 or more hours of skilled treatment 
70.21 	services each week. The commissioner shall use the base payment rate of $166.13 per day 
70.22 	for services provided under this item;
70.23 	(vii) ASAM level 3.3 clinically managed population-specific high-intensity residential 
70.24 	services provided according to section 254B.19, subdivision 1, clause (6). The commissioner 
70.25 	shall use the specified base payment rate of $224.06 per day for services provided under 
70.26 	this item; and
70.27 	(vii) (viii) ASAM level 3.5 clinically managed high-intensity residential services provided 
70.28 	according to section 254B.19, subdivision 1, clause (7). The commissioner shall use the 
70.29 	specified base payment rate of $224.06 per day for services provided under this item;
70.30 	(2) comprehensive assessments provided according to sections 245.4863, paragraph (a), 
70.31 	and 245G.05 section 254A.19, subdivision 3;
71.1 	(3) treatment coordination services provided according to section 245G.07, subdivision 
71.2 	1, paragraph (a), clause (5);
71.3 	(4) peer recovery support services provided according to section 245G.07, subdivision 
71.4 	2, clause (8);
71.5 	(5) withdrawal management services provided according to chapter 245F;
71.6 	(6) hospital-based treatment services that are licensed according to sections 245G.01 to 
71.7 	245G.17 or applicable Tribal license and licensed as a hospital under sections 144.50 to 
71.8 	144.56;
71.9 	(7) substance use disorder treatment services with medications for opioid use disorder 
71.10 	provided in an opioid treatment program licensed according to sections 245G.01 to 245G.17 
71.11 	and 245G.22, or under an applicable Tribal license;
71.12 	(8) medium-intensity residential treatment services that provide 15 hours of skilled 
71.13 	treatment services each week and are licensed according to sections 245G.01 to 245G.17 
71.14 	and 245G.21 or applicable Tribal license;
71.15 	(7) (9) adolescent treatment programs that are licensed as outpatient treatment programs 
71.16 	according to sections 245G.01 to 245G.18 or as residential treatment programs according 
71.17 	to Minnesota Rules, parts 2960.0010 to 2960.0220, and 2960.0430 to 2960.0490, or 
71.18 	applicable Tribal license;
71.19 	(8) (10) ASAM 3.5 clinically managed high-intensity residential services that are licensed 
71.20 	according to sections 245G.01 to 245G.17 and 245G.21 or applicable Tribal license, which 
71.21 	provide ASAM level of care 3.5 according to section 254B.19, subdivision 1, clause (7), 
71.22 	and are provided by a state-operated vendor or to clients who have been civilly committed 
71.23 	to the commissioner, present the most complex and difficult care needs, and are a potential 
71.24 	threat to the community; and
71.25 	(9) (11) room and board facilities that meet the requirements of subdivision 1a.
71.26 	(c) The commissioner shall establish higher rates for programs that meet the requirements 
71.27 	of paragraph (b) and one of the following additional requirements:
71.28 	(1) programs that serve parents with their children if the program:
71.29 	(i) provides on-site child care during the hours of treatment activity that:
71.30 	(A) is licensed under chapter 245A as a child care center under Minnesota Rules, chapter 
71.31 	9503; or
71.32 	(B) is licensed under chapter 245A and sections 245G.01 to 245G.19; or
72.1 	(ii) arranges for off-site child care during hours of treatment activity at a facility that is 
72.2 	licensed under chapter 245A as:
72.3 	(A) a child care center under Minnesota Rules, chapter 9503; or
72.4 	(B) a family child care home under Minnesota Rules, chapter 9502;
72.5 	(2) culturally specific or culturally responsive programs as defined in section 254B.01, 
72.6 	subdivision 4a;
72.7 	(3) disability responsive programs as defined in section 254B.01, subdivision 4b;
72.8 	(4) programs that offer medical services delivered by appropriately credentialed health 
72.9 	care staff in an amount equal to two hoursone hour per client per week if the medical needs 
72.10 	of the client and the nature and provision of any medical services provided are documented 
72.11 	in the client file; or
72.12 	(5) programs that offer services to individuals with co-occurring mental health and 
72.13 	substance use disorder problems if:
72.14 	(i) the program meets the co-occurring requirements in section 245G.20;
72.15 	(ii) 25 percent of the counseling staff are licensed mental health professionals under 
72.16 	section 245I.04, subdivision 2, or are students or licensing candidates under the supervision 
72.17 	of a licensed alcohol and drug counselor supervisor and mental health professional under 
72.18 	section 245I.04, subdivision 2, except that no more than 50 percent of the mental health 
72.19 	staff may be students or licensing candidates with time documented to be directly related 
72.20 	to provisions of co-occurring services;(ii) the program employs a mental health professional 
72.21 	as defined in section 245I.04, subdivision 2;
72.22 	(iii) clients scoring positive on a standardized mental health screen receive a mental 
72.23 	health diagnostic assessment within ten days of admission;
72.24 	(iv) the program has standards for multidisciplinary case review that include a monthly 
72.25 	review for each client that, at a minimum, includes a licensed mental health professional 
72.26 	and licensed alcohol and drug counselor, and their involvement in the review is documented;
72.27 	(v) family education is offered that addresses mental health and substance use disorder 
72.28 	and the interaction between the two; and
72.29 	(vi) co-occurring counseling staff shall receive eight hours of co-occurring disorder 
72.30 	training annually.
72.31 	(d) In order to be eligible for a higher rate under paragraph (c), clause (1), a program 
72.32 	that provides arrangements for off-site child care must maintain current documentation at 
73.1 	the substance use disorder facility of the child care provider's current licensure to provide 
73.2 	child care services.
73.3 	(e) Adolescent residential programs that meet the requirements of Minnesota Rules, 
73.4 	parts 2960.0430 to 2960.0490 and 2960.0580 to 2960.0690, are exempt from the requirements 
73.5 	in paragraph (c), clause (4), items (i) to (iv).
73.6 	(f) Subject to federal approval, substance use disorder services that are otherwise covered 
73.7 	as direct face-to-face services may be provided via telehealth as defined in section 256B.0625, 
73.8 	subdivision 3b. The use of telehealth to deliver services must be medically appropriate to 
73.9 	the condition and needs of the person being served. Reimbursement shall be at the same 
73.10 	rates and under the same conditions that would otherwise apply to direct face-to-face services.
73.11 	(g) For the purpose of reimbursement under this section, substance use disorder treatment 
73.12 	services provided in a group setting without a group participant maximum or maximum 
73.13 	client to staff ratio under chapter 245G shall not exceed a client to staff ratio of 48 to one. 
73.14 	At least one of the attending staff must meet the qualifications as established under this 
73.15 	chapter for the type of treatment service provided. A recovery peer may not be included as 
73.16 	part of the staff ratio.
73.17 	(h) Payment for outpatient substance use disorder services that are licensed according 
73.18 	to sections 245G.01 to 245G.17 is limited to six hours per day or 30 hours per week unless 
73.19 	prior authorization of a greater number of hours is obtained from the commissioner.
73.20 	(i) Payment for substance use disorder services under this section must start from the 
73.21 	day of service initiation, when the comprehensive assessment is completed within the 
73.22 	required timelines.
73.23 	(j) A license holder that is unable to provide all residential treatment services because 
73.24 	a client missed services remains eligible to bill for the client's intensity level of services 
73.25 	under this paragraph if the license holder can document the reason the client missed services 
73.26 	and the interventions done to address the client's absence.
73.27 	(k) Hours in a treatment week may be reduced in observance of federally recognized 
73.28 	holidays.

73.29 	EFFECTIVE DATE. This section is effective August 1, 2024, except the amendments 
73.30 	to paragraph (b), clauses (1) and (8), which are effective retroactively from January 1, 2024, 
73.31 	with federal approval or retroactively from a later federally approved date. The commissioner 
73.32 	of human services shall inform the revisor of statutes of the effective date upon federal 
73.33 	approval.

74.1 	Sec. 24. Minnesota Statutes 2023 Supplement, section 254B.181, subdivision 1, is amended 
74.2 	to read:
74.3 		Subdivision 1.Requirements. All sober homes must comply with applicable state laws 
74.4 	and regulations and local ordinances related to maximum occupancy, fire safety, and 
74.5 	sanitation. In addition, all sober homes must:
74.6 	(1) maintain a supply of an opiate antagonist in the home in a conspicuous location and 
74.7 	post information on proper use;
74.8 	(2) have written policies regarding access to all prescribed medications;
74.9 	(3) have written policies regarding evictions;
74.10 	(4) return all property and medications to a person discharged from the home and retain 
74.11 	the items for a minimum of 60 days if the person did not collect them upon discharge. The 
74.12 	owner must make an effort to contact persons listed as emergency contacts for the discharged 
74.13 	person so that the items are returned;
74.14 	(5) document the names and contact information for persons to contact in case of an 
74.15 	emergency or upon discharge and notification of a family member, or other emergency 
74.16 	contact designated by the resident under certain circumstances, including but not limited to 
74.17 	death due to an overdose;
74.18 	(6) maintain contact information for emergency resources in the community to address 
74.19 	mental health and health emergencies;
74.20 	(7) have policies on staff qualifications and prohibition against fraternization;
74.21 	(8) have a policy on whether the use of medications for opioid use disorder is permissible
74.22 	permit residents to use, as directed by a licensed prescriber, legally prescribed and dispensed 
74.23 	or administered pharmacotherapies approved by the United States Food and Drug 
74.24 	Administration for the treatment of opioid use disorder;
74.25 	(9) permit residents to use, as directed by a licensed prescriber, legally prescribed and 
74.26 	dispensed or administered pharmacotherapies approved by the United States Food and Drug 
74.27 	Administration to treat co-occurring substance use disorders and mental health conditions;
74.28 	(9) (10) have a fee schedule and refund policy;
74.29 	(10) (11) have rules for residents;
74.30 	(11) (12) have policies that promote resident participation in treatment, self-help groups, 
74.31 	or other recovery supports;
75.1 	(12) (13) have policies requiring abstinence from alcohol and illicit drugs; and
75.2 	(13) (14) distribute the sober home bill of rights.

75.3 	EFFECTIVE DATE. This section is effective January 1, 2025, except clause (9) is 
75.4 	effective June 1, 2026.

75.5 	Sec. 25. Minnesota Statutes 2023 Supplement, section 256B.0759, subdivision 2, is 
75.6 	amended to read:
75.7 		Subd. 2.Provider participation. (a) Programs licensed by the Department of Human 
75.8 	Services as nonresidential substance use disorder treatment programs that receive payment 
75.9 	under this chapter must enroll as demonstration project providers and meet the requirements 
75.10 	of subdivision 3 by January 1, 2025. Programs that do not meet the requirements of this 
75.11 	paragraph are ineligible for payment for services provided under section 256B.0625.
75.12 	(b) Programs licensed by the Department of Human Services as residential treatment 
75.13 	programs according to section 245G.21 that receive payment under this chapter must enroll 
75.14 	as demonstration project providers and meet the requirements of subdivision 3 by January 
75.15 	1, 2024. Programs that do not meet the requirements of this paragraph are ineligible for 
75.16 	payment for services provided under section 256B.0625.
75.17 	(c) Programs licensed by the Department of Human Services as residential treatment 
75.18 	programs according to section 245G.21 that receive payment under this chapter and, are 
75.19 	licensed as a hospital under sections 144.50 to 144.581must, and provide only ASAM 3.7 
75.20 	medically monitored inpatient level of care are not required to enroll as demonstration 
75.21 	project providers and meet the requirements of subdivision 3 by January 1, 2025. Programs 
75.22 	meeting these criteria must submit evidence of providing the required level of care to the 
75.23 	commissioner to be exempt from enrolling in the demonstration.
75.24 	(d) Programs licensed by the Department of Human Services as withdrawal management 
75.25 	programs according to chapter 245F that receive payment under this chapter must enroll as 
75.26 	demonstration project providers and meet the requirements of subdivision 3 by January 1, 
75.27 	2024. Programs that do not meet the requirements of this paragraph are ineligible for payment 
75.28 	for services provided under section 256B.0625.
75.29 	(e) Out-of-state residential substance use disorder treatment programs that receive 
75.30 	payment under this chapter must enroll as demonstration project providers and meet the 
75.31 	requirements of subdivision 3 by January 1, 2024. Programs that do not meet the requirements 
75.32 	of this paragraph are ineligible for payment for services provided under section 256B.0625.
76.1 	(f) Tribally licensed programs may elect to participate in the demonstration project and 
76.2 	meet the requirements of subdivision 3. The Department of Human Services must consult 
76.3 	with Tribal Nations to discuss participation in the substance use disorder demonstration 
76.4 	project.
76.5 	(g) The commissioner shall allow providers enrolled in the demonstration project before 
76.6 	July 1, 2021, to receive applicable rate enhancements authorized under subdivision 4 for 
76.7 	all services provided on or after the date of enrollment, except that the commissioner shall 
76.8 	allow a provider to receive applicable rate enhancements authorized under subdivision 4 
76.9 	for services provided on or after July 22, 2020, to fee-for-service enrollees, and on or after 
76.10 	January 1, 2021, to managed care enrollees, if the provider meets all of the following 
76.11 	requirements:
76.12 	(1) the provider attests that during the time period for which the provider is seeking the 
76.13 	rate enhancement, the provider took meaningful steps in their plan approved by the 
76.14 	commissioner to meet the demonstration project requirements in subdivision 3; and
76.15 	(2) the provider submits attestation and evidence, including all information requested 
76.16 	by the commissioner, of meeting the requirements of subdivision 3 to the commissioner in 
76.17 	a format required by the commissioner.
76.18 	(h) The commissioner may recoup any rate enhancements paid under paragraph (g) to 
76.19 	a provider that does not meet the requirements of subdivision 3 by July 1, 2021.

76.20 	Sec. 26. Minnesota Statutes 2022, section 256B.0759, subdivision 4, is amended to read:
76.21 		Subd. 4.Provider payment rates. (a) Payment rates for participating providers must 
76.22 	be increased for services provided to medical assistance enrollees. To receive a rate increase, 
76.23 	participating providers must meet demonstration project requirements and provide evidence 
76.24 	of formal referral arrangements with providers delivering step-up or step-down levels of 
76.25 	care. Providers that have enrolled in the demonstration project but have not met the provider 
76.26 	standards under subdivision 3 as of July 1, 2022, are not eligible for a rate increase under 
76.27 	this subdivision until the date that the provider meets the provider standards in subdivision 
76.28 	3. Services provided from July 1, 2022, to the date that the provider meets the provider 
76.29 	standards under subdivision 3 shall be reimbursed at rates according to section 254B.05, 
76.30 	subdivision 5, paragraph (b). Rate increases paid under this subdivision to a provider for 
76.31 	services provided between July 1, 2021, and July 1, 2022, are not subject to recoupment 
76.32 	when the provider is taking meaningful steps to meet demonstration project requirements 
76.33 	that are not otherwise required by law, and the provider provides documentation to the 
76.34 	commissioner, upon request, of the steps being taken.
77.1 	(b) The commissioner may temporarily suspend payments to the provider according to 
77.2 	section 256B.04, subdivision 21, paragraph (d), if the provider does not meet the requirements 
77.3 	in paragraph (a). Payments withheld from the provider must be made once the commissioner 
77.4 	determines that the requirements in paragraph (a) are met.
77.5 	(c) For substance use disorder services under section 254B.05, subdivision 5, paragraph 
77.6 	(b), clause (8), provided on or after July 1, 2020, payment rates must be increased by 25 
77.7 	percent over the rates in effect on December 31, 2019.
77.8 	(d) (c) For outpatient individual and group substance use disorder services under section 
77.9 	254B.05, subdivision 5, paragraph (b), clauses clause (1), (6), and (7), and adolescent 
77.10 	treatment programs that are licensed as outpatient treatment programs according to sections 
77.11 	245G.01 to 245G.18, provided on or after January 1, 2021, payment rates must be increased 
77.12 	by 20 percent over the rates in effect on December 31, 2020.
77.13 	(e) (d) Effective January 1, 2021, and contingent on annual federal approval, managed 
77.14 	care plans and county-based purchasing plans must reimburse providers of the substance 
77.15 	use disorder services meeting the criteria described in paragraph (a) who are employed by 
77.16 	or under contract with the plan an amount that is at least equal to the fee-for-service base 
77.17 	rate payment for the substance use disorder services described in paragraphs paragraph (c) 
77.18 	and (d). The commissioner must monitor the effect of this requirement on the rate of access 
77.19 	to substance use disorder services and residential substance use disorder rates. Capitation 
77.20 	rates paid to managed care organizations and county-based purchasing plans must reflect 
77.21 	the impact of this requirement. This paragraph expires if federal approval is not received 
77.22 	at any time as required under this paragraph.
77.23 	(f) (e) Effective July 1, 2021, contracts between managed care plans and county-based 
77.24 	purchasing plans and providers to whom paragraph (e) (d) applies must allow recovery of 
77.25 	payments from those providers if, for any contract year, federal approval for the provisions 
77.26 	of paragraph (e) (d) is not received, and capitation rates are adjusted as a result. Payment 
77.27 	recoveries must not exceed the amount equal to any decrease in rates that results from this 
77.28 	provision.
77.29 	(f) For substance use disorder services with medications for opioid use disorder under 
77.30 	section 254B.05, subdivision 5, clause (7), provided on or after January 1, 2021, payment 
77.31 	rates must be increased by 20 percent over the rates in effect on December 31, 2020. Upon 
77.32 	implementation of new rates according to section 254B.121, the 20 percent increase will 
77.33 	no longer apply.

77.34 	EFFECTIVE DATE. This section is effective the day following final enactment.

78.1 	Sec. 27. Laws 2021, First Special Session chapter 7, article 11, section 38, as amended 
78.2 	by Laws 2022, chapter 98, article 4, section 50, is amended to read:
78.3 	Sec. 38. DIRECTION TO THE COMMISSIONER; SUBSTANCE USE DISORDER 
78.4 	TREATMENT PAPERWORK REDUCTION.
 78.5 	(a) The commissioner of human services, in consultation with counties, tribes, managed 
78.6 	care organizations, substance use disorder treatment professional associations, and other 
78.7 	relevant stakeholders, shall develop, assess, and recommend systems improvements to 
78.8 	minimize regulatory paperwork and improve systems for substance use disorder programs 
78.9 	licensed under Minnesota Statutes, chapter 245A, and regulated under Minnesota Statutes, 
78.10 	chapters 245F and 245G, and Minnesota Rules, chapters 2960 and 9530. The commissioner 
78.11 	of human services shall make available any resources needed from other divisions within 
78.12 	the department to implement systems improvements.
78.13 	(b) The commissioner of health shall make available needed information and resources 
78.14 	from the Division of Health Policy.
78.15 	(c) The Office of MN.IT Services shall provide advance consultation and implementation 
78.16 	of the changes needed in data systems.
78.17 	(d) The commissioner of human services shall contract with a vendor that has experience 
78.18 	with developing statewide system changes for multiple states at the payer and provider 
78.19 	levels. If the commissioner, after exercising reasonable diligence, is unable to secure a 
78.20 	vendor with the requisite qualifications, the commissioner may select the best qualified 
78.21 	vendor available. When developing recommendations, the commissioner shall consider 
78.22 	input from all stakeholders. The commissioner's recommendations shall maximize benefits 
78.23 	for clients and utility for providers, regulatory agencies, and payers.
78.24 	(e) The commissioner of human services and the contracted vendor shall follow the 
78.25 	recommendations from the report issued in response to Laws 2019, First Special Session 
78.26 	chapter 9, article 6, section 76.
78.27 	(f) Within two years of contracting with a qualified vendor according to paragraph (d)
78.28 	By December 15, 2024, the commissioner of human services shall take steps to implement 
78.29 	paperwork reductions and systems improvements within the commissioner's authority and 
78.30 	submit to the chairs and ranking minority members of the legislative committees with 
78.31 	jurisdiction over health and human services a report that includes recommendations for 
78.32 	changes in statutes that would further enhance systems improvements to reduce paperwork. 
78.33 	The report shall include a summary of the approaches developed and assessed by the 
79.1 	commissioner of human services and stakeholders and the results of any assessments 
79.2 	conducted.

79.3 	Sec. 28. REPEALER.
 79.4 	Minnesota Statutes 2022, section 245G.22, subdivision 4, is repealed.

79.5 	ARTICLE 5
79.6 	DIRECT CARE AND TREATMENT

79.7 	Section 1. Minnesota Statutes 2022, section 246.71, subdivision 3, is amended to read:
79.8 		Subd. 3.Patient. "Patient" means any person who is receiving treatment from or 
79.9 	committed to a secure state-operated treatment facility program, including the Minnesota 
79.10 	Sex Offender Program.

79.11 	Sec. 2. Minnesota Statutes 2022, section 246.71, subdivision 4, is amended to read:
79.12 		Subd. 4.Employee of a secure treatment facility state-operated treatment program
79.13 	or employee. "Employee of a secure treatment facility state-operated treatment program" 
79.14 	or "employee" means an employee of the Minnesota Security Hospital or a secure treatment 
79.15 	facility operated by the Minnesota Sex Offender Program any state-operated treatment 
79.16 	program.

79.17 	Sec. 3. Minnesota Statutes 2022, section 246.71, subdivision 5, is amended to read:
79.18 		Subd. 5.Secure treatment facility State-operated treatment program. "Secure 
79.19 	treatment facility State-operated treatment program" means the Minnesota Security Hospital 
79.20 	and the Minnesota Sex Offender Program facility in Moose Lake and any portion of the 
79.21 	Minnesota Sex Offender Program operated by the Minnesota Sex Offender Program at the 
79.22 	Minnesota Security Hospital any state-operated treatment program under the jurisdiction 
79.23 	of the executive board, including the Minnesota Sex Offender Program, community 
79.24 	behavioral health hospitals, crisis centers, residential facilities, outpatient services, and other 
79.25 	community-based services under the executive board's control.

79.26 	Sec. 4. Minnesota Statutes 2022, section 246.711, is amended to read:
79.27 	246.711 CONDITIONS FOR APPLICABILITY OF PROCEDURES.
79.28 		Subdivision 1.Request for procedures. An employee of a secure treatment facility
79.29 	state-operated treatment program may request that the procedures of sections 246.71 to 
80.1 	246.722 be followed when the employee may have experienced a significant exposure to a 
80.2 	patient.
80.3 		Subd. 2.Conditions. The secure treatment facility state-operated treatment program
80.4 	shall follow the procedures in sections 246.71 to 246.722 when all of the following conditions 
80.5 	are met:
80.6 	(1) a licensed physician, advanced practice registered nurse, or physician assistant 
80.7 	determines that a significant exposure has occurred following the protocol under section 
80.8 	246.721;
80.9 	(2) the licensed physician, advanced practice registered nurse, or physician assistant for 
80.10 	the employee needs the patient's blood-borne pathogens test results to begin, continue, 
80.11 	modify, or discontinue treatment in accordance with the most current guidelines of the 
80.12 	United States Public Health Service, because of possible exposure to a blood-borne pathogen; 
80.13 	and
80.14 	(3) the employee consents to providing a blood sample for testing for a blood-borne 
80.15 	pathogen.

80.16 	Sec. 5. Minnesota Statutes 2022, section 246.712, subdivision 1, is amended to read:
80.17 		Subdivision 1.Information to patient. (a) Before seeking any consent required by the 
80.18 	procedures under sections 246.71 to 246.722, a secure treatment facility state-operated 
80.19 	treatment program shall inform the patient that the patient's blood-borne pathogen test 
80.20 	results, without the patient's name or other uniquely identifying information, shall be reported 
80.21 	to the employee if requested and that test results collected under sections 246.71 to 246.722
80.22 	are for medical purposes as set forth in section 246.718 and may not be used as evidence 
80.23 	in any criminal proceedings or civil proceedings, except for procedures under sections 
80.24 	144.4171 to 144.4186.
80.25 	(b) The secure treatment facility state-operated treatment program shall inform the patient 
80.26 	of the insurance protections in section 72A.20, subdivision 29.
80.27 	(c) The secure treatment facility state-operated treatment program shall inform the patient 
80.28 	that the patient may refuse to provide a blood sample and that the patient's refusal may result 
80.29 	in a request for a court order to require the patient to provide a blood sample.
80.30 	(d) The secure treatment facility state-operated treatment program shall inform the patient 
80.31 	that the secure treatment facility state-operated treatment program will advise the employee 
80.32 	of a secure treatment facility state-operated treatment program of the confidentiality 
81.1 	requirements and penalties before the employee's health care provider discloses any test 
81.2 	results.

81.3 	Sec. 6. Minnesota Statutes 2022, section 246.712, subdivision 2, is amended to read:
81.4 		Subd. 2.Information to secure treatment facility state-operated treatment program
81.5 	employee. (a) Before disclosing any information about the patient, the secure treatment 
81.6 	facility state-operated treatment program shall inform the employee of a secure treatment 
81.7 	facility state-operated treatment program of the confidentiality requirements of section 
81.8 	246.719 and that the person may be subject to penalties for unauthorized release of test 
81.9 	results about the patient under section 246.72.
81.10 	(b) The secure treatment facility state-operated treatment program shall inform the 
81.11 	employee of the insurance protections in section 72A.20, subdivision 29.

81.12 	Sec. 7. Minnesota Statutes 2022, section 246.713, is amended to read:
81.13 	246.713 DISCLOSURE OF POSITIVE BLOOD-BORNE PATHOGEN TEST 
81.14 	RESULTS.
81.15 	If the conditions of sections 246.711 and 246.712 are met, the secure treatment facility
81.16 	state-operated treatment program shall ask the patient if the patient has ever had a positive 
81.17 	test for a blood-borne pathogen. The secure treatment facility state-operated treatment 
81.18 	program must attempt to get existing test results under this section before taking any steps 
81.19 	to obtain a blood sample or to test for blood-borne pathogens. The secure treatment facility
81.20 	state-operated treatment program shall disclose the patient's blood-borne pathogen test 
81.21 	results to the employee without the patient's name or other uniquely identifying information.

81.22 	Sec. 8. Minnesota Statutes 2022, section 246.714, is amended to read:
81.23 	246.714 CONSENT PROCEDURES GENERALLY.
81.24 	(a) For purposes of sections 246.71 to 246.722, whenever the secure treatment facility
81.25 	state-operated treatment program is required to seek consent, the secure treatment facility
81.26 	state-operated treatment program shall obtain consent from a patient or a patient's 
81.27 	representative consistent with other law applicable to consent.
81.28 	(b) Consent is not required if the secure treatment facility state-operated treatment 
81.29 	program has made reasonable efforts to obtain the representative's consent and consent 
81.30 	cannot be obtained within 24 hours of a significant exposure.
82.1 	(c) If testing of available blood occurs without consent because the patient is unconscious 
82.2 	or unable to provide consent, and a representative cannot be located, the secure treatment 
82.3 	facility state-operated treatment program shall provide the information required in section 
82.4 	246.712 to the patient or representative whenever it is possible to do so.
82.5 	(d) If a patient dies before an opportunity to consent to blood collection or testing under 
82.6 	sections 246.71 to 246.722, the secure treatment facility state-operated treatment program
82.7 	does not need consent of the patient's representative for purposes of sections 246.71 to 
82.8 	246.722.

82.9 	Sec. 9. Minnesota Statutes 2022, section 246.715, subdivision 1, is amended to read:
82.10 		Subdivision 1.Procedures with consent. If a sample of the patient's blood is available, 
82.11 	the secure treatment facility state-operated treatment program shall ensure that blood is 
82.12 	tested for blood-borne pathogens with the consent of the patient, provided the conditions 
82.13 	in sections 246.711 and 246.712 are met.

82.14 	Sec. 10. Minnesota Statutes 2022, section 246.715, subdivision 2, is amended to read:
82.15 		Subd. 2.Procedures without consent. If the patient has provided a blood sample, but 
82.16 	does not consent to blood-borne pathogens testing, the secure treatment facility state-operated 
82.17 	treatment program shall ensure that the blood is tested for blood-borne pathogens if the 
82.18 	employee requests the test, provided all of the following criteria are met:
82.19 	(1) the employee and secure treatment facility state-operated treatment program have 
82.20 	documented exposure to blood or body fluids during performance of the employee's work 
82.21 	duties;
82.22 	(2) a licensed physician, advanced practice registered nurse, or physician assistant has 
82.23 	determined that a significant exposure has occurred under section 246.711 and has 
82.24 	documented that blood-borne pathogen test results are needed for beginning, modifying, 
82.25 	continuing, or discontinuing medical treatment for the employee as recommended by the 
82.26 	most current guidelines of the United States Public Health Service;
82.27 	(3) the employee provides a blood sample for testing for blood-borne pathogens as soon 
82.28 	as feasible;
82.29 	(4) the secure treatment facility state-operated treatment program asks the patient to 
82.30 	consent to a test for blood-borne pathogens and the patient does not consent;
82.31 	(5) the secure treatment facility state-operated treatment program has provided the patient 
82.32 	and the employee with all of the information required by section 246.712; and
83.1 	(6) the secure treatment facility state-operated treatment program has informed the 
83.2 	employee of the confidentiality requirements of section 246.719 and the penalties for 
83.3 	unauthorized release of patient information under section 246.72.

83.4 	Sec. 11. Minnesota Statutes 2022, section 246.715, subdivision 3, is amended to read:
83.5 		Subd. 3.Follow-up. The secure treatment facility state-operated treatment program shall 
83.6 	inform the patient whose blood was tested of the results. The secure treatment facility
83.7 	state-operated treatment program shall inform the employee's health care provider of the 
83.8 	patient's test results without the patient's name or other uniquely identifying information.

83.9 	Sec. 12. Minnesota Statutes 2022, section 246.716, subdivision 1, is amended to read:
83.10 		Subdivision 1.Procedures with consent. (a) If a blood sample is not otherwise available, 
83.11 	the secure treatment facility state-operated treatment program shall obtain consent from the 
83.12 	patient before collecting a blood sample for testing for blood-borne pathogens. The consent 
83.13 	process shall include informing the patient that the patient may refuse to provide a blood 
83.14 	sample and that the patient's refusal may result in a request for a court order under subdivision 
83.15 	2 to require the patient to provide a blood sample.
83.16 	(b) If the patient consents to provide a blood sample, the secure treatment facility
83.17 	state-operated treatment program shall collect a blood sample and ensure that the sample 
83.18 	is tested for blood-borne pathogens.
83.19 	(c) The secure treatment facility state-operated treatment program shall inform the 
83.20 	employee's health care provider about the patient's test results without the patient's name 
83.21 	or other uniquely identifying information. The secure treatment facility state-operated 
83.22 	treatment program shall inform the patient of the test results.
83.23 	(d) If the patient refuses to provide a blood sample for testing, the secure treatment 
83.24 	facility state-operated treatment program shall inform the employee of the patient's refusal.

83.25 	Sec. 13. Minnesota Statutes 2022, section 246.716, subdivision 2, as amended by Laws 
83.26 	2024, chapter 79, article 2, section 58, is amended to read:
83.27 		Subd. 2.Procedures without consent. (a) A secure treatment facility state-operated 
83.28 	treatment program or an employee of a secure treatment facility state-operated treatment 
83.29 	program may bring a petition for a court order to require a patient to provide a blood sample 
83.30 	for testing for blood-borne pathogens. The petition shall be filed in the district court in the 
83.31 	county where the patient is receiving treatment from the secure treatment facility
83.32 	state-operated treatment program. The secure treatment facility state-operated treatment 
84.1 	program shall serve the petition on the patient three days before a hearing on the petition. 
84.2 	The petition shall include one or more affidavits attesting that:
84.3 	(1) the secure treatment facility state-operated treatment program followed the procedures 
84.4 	in sections 246.71 to 246.722 and attempted to obtain blood-borne pathogen test results 
84.5 	according to those sections;
84.6 	(2) a licensed physician, advanced practice registered nurse, or physician assistant 
84.7 	knowledgeable about the most current recommendations of the United States Public Health 
84.8 	Service has determined that a significant exposure has occurred to the employee of a secure 
84.9 	treatment facility state-operated treatment program under section 246.721; and
84.10 	(3) a physician, advanced practice registered nurse, or physician assistant has documented 
84.11 	that the employee has provided a blood sample and consented to testing for blood-borne 
84.12 	pathogens and blood-borne pathogen test results are needed for beginning, continuing, 
84.13 	modifying, or discontinuing medical treatment for the employee under section 246.721.
84.14 	(b) Secure treatment facilitiesState-operated treatment programs shall cooperate with 
84.15 	petitioners in providing any necessary affidavits to the extent that facility staff can attest 
84.16 	under oath to the facts in the affidavits.
84.17 	(c) The court may order the patient to provide a blood sample for blood-borne pathogen 
84.18 	testing if:
84.19 	(1) there is probable cause to believe the employee of a secure treatment facility
84.20 	state-operated treatment program has experienced a significant exposure to the patient;
84.21 	(2) the court imposes appropriate safeguards against unauthorized disclosure that must 
84.22 	specify the persons who have access to the test results and the purposes for which the test 
84.23 	results may be used;
84.24 	(3) a licensed physician, advanced practice registered nurse, or physician assistant for 
84.25 	the employee of a secure treatment facility state-operated treatment program needs the test 
84.26 	results for beginning, continuing, modifying, or discontinuing medical treatment for the 
84.27 	employee; and
84.28 	(4) the court finds a compelling need for the test results. In assessing compelling need, 
84.29 	the court shall weigh the need for the court-ordered blood collection and test results against 
84.30 	the interests of the patient, including, but not limited to, privacy, health, safety, or economic 
84.31 	interests. The court shall also consider whether involuntary blood collection and testing 
84.32 	would serve the public interests.
85.1 	(d) The court shall conduct the proceeding in camera unless the petitioner or the patient 
85.2 	requests a hearing in open court and the court determines that a public hearing is necessary 
85.3 	to the public interest and the proper administration of justice.
85.4 	(e) The patient may arrange for counsel in any proceeding brought under this subdivision.

85.5 	Sec. 14. Minnesota Statutes 2022, section 246.717, is amended to read:
85.6 	246.717 NO DISCRIMINATION.
85.7 	A secure treatment facility state-operated treatment program shall not withhold care or 
85.8 	treatment on the requirement that the patient consent to blood-borne pathogen testing under 
85.9 	sections 246.71 to 246.722.

85.10 	Sec. 15. Minnesota Statutes 2022, section 246.721, as amended by Laws 2024, chapter 
85.11 	79, article 2, section 60, is amended to read:
85.12 	246.721 PROTOCOL FOR EXPOSURE TO BLOOD-BORNE PATHOGENS.
85.13 	(a) A secure treatment facility state-operated treatment program shall follow applicable 
85.14 	Occupational Safety and Health Administration guidelines under Code of Federal 
85.15 	Regulations, title 29, part 1910.1030, for blood-borne pathogens.
85.16 	(b) Every secure treatment facility state-operated treatment program shall adopt and 
85.17 	follow a postexposure protocol for employees at a secure treatment facility state-operated 
85.18 	treatment program who have experienced a significant exposure. The postexposure protocol 
85.19 	must adhere to the most current recommendations of the United States Public Health Service 
85.20 	and include, at a minimum, the following:
85.21 	(1) a process for employees to report an exposure in a timely fashion;
85.22 	(2) a process for an infectious disease specialist, or a licensed physician, advanced 
85.23 	practice registered nurse, or physician assistant who is knowledgeable about the most current 
85.24 	recommendations of the United States Public Health Service in consultation with an infectious 
85.25 	disease specialist, (i) to determine whether a significant exposure to one or more blood-borne 
85.26 	pathogens has occurred, and (ii) to provide, under the direction of a licensed physician, 
85.27 	advanced practice registered nurse, or physician assistant, a recommendation or 
85.28 	recommendations for follow-up treatment appropriate to the particular blood-borne pathogen 
85.29 	or pathogens for which a significant exposure has been determined;
85.30 	(3) if there has been a significant exposure, a process to determine whether the patient 
85.31 	has a blood-borne pathogen through disclosure of test results, or through blood collection 
85.32 	and testing as required by sections 246.71 to 246.722;
86.1 	(4) a process for providing appropriate counseling prior to and following testing for a 
86.2 	blood-borne pathogen regarding the likelihood of blood-borne pathogen transmission and 
86.3 	follow-up recommendations according to the most current recommendations of the United 
86.4 	States Public Health Service for testing and treatment;
86.5 	(5) a process for providing appropriate counseling under clause (4) to the employee of 
86.6 	a secure treatment facility state-operated treatment program and to the patient; and
86.7 	(6) compliance with applicable state and federal laws relating to data practices, 
86.8 	confidentiality, informed consent, and the patient bill of rights.

86.9 	Sec. 16. Minnesota Statutes 2022, section 246.722, is amended to read:
86.10 	246.722 IMMUNITY.
86.11 	A secure treatment facility state-operated treatment program, licensed physician, advanced 
86.12 	practice registered nurse, physician assistant, and designated health care personnel are 
86.13 	immune from liability in any civil, administrative, or criminal action relating to the disclosure 
86.14 	of test results of a patient to an employee of a secure treatment facility state-operated 
86.15 	treatment program and the testing of a blood sample from the patient for blood-borne 
86.16 	pathogens if a good faith effort has been made to comply with sections 246.71 to 246.722.

86.17 	Sec. 17. Laws 2023, chapter 61, article 8, section 13, subdivision 2, is amended to read:
86.18 		Subd. 2.Membership. (a) The task force shall consist of the following members, 
86.19 	appointed as follows:
86.20 	(1) a member appointed by the governor;
86.21 	(2) the commissioner of human services, or a designee;
86.22 	(3) a member representing Department of Human Services direct care and treatment 
86.23 	services who has experience with civil commitments, appointed by the commissioner of 
86.24 	human services;
86.25 	(4) the ombudsman for mental health and developmental disabilities;
86.26 	(5) a hospital representative, appointed by the Minnesota Hospital Association;
86.27 	(6) a county representative, appointed by the Association of Minnesota Counties;
86.28 	(7) a county social services representative, appointed by the Minnesota Association of 
86.29 	County Social Service Administrators;
87.1 	(8) a member appointed by the Minnesota Civil Commitment Defense Panel Hennepin 
87.2 	County Commitment Defense Project;
87.3 	(9) a county attorney, appointed by the Minnesota County Attorneys Association;
87.4 	(10) a county sheriff, appointed by the Minnesota Sheriffs' Association;
87.5 	(11) a member appointed by the Minnesota Psychiatric Society;
87.6 	(12) a member appointed by the Minnesota Association of Community Mental Health 
87.7 	Programs;
87.8 	(13) a member appointed by the National Alliance on Mental Illness Minnesota;
87.9 	(14) the Minnesota Attorney General;
87.10 	(15) three individuals from organizations representing racial and ethnic groups that are 
87.11 	overrepresented in the criminal justice system, appointed by the commissioner of corrections; 
87.12 	and
87.13 	(16) one member of the public with lived experience directly related to the task force's 
87.14 	purposes, appointed by the governor.
87.15 	(b) Appointments must be made no later than July 15, 2023.
87.16 	(c) Member compensation and reimbursement for expenses are governed by Minnesota 
87.17 	Statutes, section 15.059, subdivision 3.
87.18 	(d) A member of the legislature may not serve as a member of the task force.

87.19 	ARTICLE 6
87.20 	MISCELLANEOUS

87.21 	Section 1. Minnesota Statutes 2022, section 254A.03, subdivision 1, is amended to read:
87.22 		Subdivision 1.Alcohol and Other Drug Abuse Section. There is hereby created an 
87.23 	Alcohol and Other Drug Abuse Section in the Department of Human Services. This section 
87.24 	shall be headed by a director. The commissioner may place the director's position in the 
87.25 	unclassified service if the position meets the criteria established in section 43A.08, 
87.26 	subdivision 1a. The section shall:
87.27 	(1) conduct and foster basic research relating to the cause, prevention and methods of 
87.28 	diagnosis, treatment and recovery of persons with substance misuse and substance use 
87.29 	disorder;
88.1 	(2) coordinate and review all activities and programs of all the various state departments 
88.2 	as they relate to problems associated with substance misuse and substance use disorder;
88.3 	(3) develop, demonstrate, and disseminate new methods and techniques for prevention, 
88.4 	early intervention, treatment and recovery support for substance misuse and substance use 
88.5 	disorder;
88.6 	(4) gather facts and information about substance misuse and substance use disorder, and 
88.7 	about the efficiency and effectiveness of prevention, treatment, and recovery support services 
88.8 	from all comprehensive programs, including programs approved or licensed by the 
88.9 	commissioner of human services or the commissioner of health or accredited by the Joint 
88.10 	Commission on Accreditation of Hospitals. The state authority is authorized to require 
88.11 	information from comprehensive programs which is reasonable and necessary to fulfill 
88.12 	these duties. When required information has been previously furnished to a state or local 
88.13 	governmental agency, the state authority shall collect the information from the governmental 
88.14 	agency. The state authority shall disseminate facts and summary information about problems 
88.15 	associated with substance misuse and substance use disorder to public and private agencies, 
88.16 	local governments, local and regional planning agencies, and the courts for guidance to and 
88.17 	assistance in prevention, treatment and recovery support;
88.18 	(5) inform and educate the general public on substance misuse and substance use disorder;
88.19 	(6) serve as the state authority concerning substance misuse and substance use disorder 
88.20 	by monitoring the conduct of diagnosis and referral services, research and comprehensive 
88.21 	programs. The state authority shall submit a biennial report to the governor and the legislature
88.22 	containing a description of public services delivery and recommendations concerning 
88.23 	increase of coordination and quality of services, and decrease of service duplication and 
88.24 	cost;
88.25 	(7) establish a state plan which shall set forth goals and priorities for a comprehensive 
88.26 	continuum of care for substance misuse and substance use disorder for Minnesota. All state 
88.27 	agencies operating substance misuse or substance use disorder programs or administering 
88.28 	state or federal funds for such programs shall annually set their program goals and priorities 
88.29 	in accordance with the state plan. Each state agency shall annually submit its plans and 
88.30 	budgets to the state authority for review. The state authority shall certify whether proposed 
88.31 	services comply with the comprehensive state plan and advise each state agency of review 
88.32 	findings;
88.33 	(8) make contracts with and grants to public and private agencies and organizations, 
88.34 	both profit and nonprofit, and individuals, using federal funds, and state funds as authorized 
89.1 	to pay for costs of state administration, including evaluation, statewide programs and services, 
89.2 	research and demonstration projects, and American Indian programs;
89.3 	(9) receive and administer money available for substance misuse and substance use 
89.4 	disorder programs under the alcohol, drug abuse, and mental health services block grant, 
89.5 	United States Code, title 42, sections 300X to 300X-9;
89.6 	(10) solicit and accept any gift of money or property for purposes of Laws 1973, chapter 
89.7 	572, and any grant of money, services, or property from the federal government, the state, 
89.8 	any political subdivision thereof, or any private source;
89.9 	(11) with respect to substance misuse and substance use disorder programs serving the 
89.10 	American Indian community, establish guidelines for the employment of personnel with 
89.11 	considerable practical experience in substance misuse and substance use disorder, and 
89.12 	understanding of social and cultural problems related to substance misuse and substance 
89.13 	use disorder, in the American Indian community.

89.14 	Sec. 2. Minnesota Statutes 2023 Supplement, section 256B.4914, subdivision 10, is 
89.15 	amended to read:
89.16 		Subd. 10.Evaluation of information and data. (a) The commissioner shall, within 
89.17 	available resources, conduct research and gather data and information from existing state 
89.18 	systems or other outside sources on the following items:
89.19 	(1) differences in the underlying cost to provide services and care across the state;
89.20 	(2) mileage, vehicle type, lift requirements, incidents of individual and shared rides, and 
89.21 	units of transportation for all day services, which must be collected from providers using 
89.22 	the rate management worksheet and entered into the rates management system; and
89.23 	(3) the distinct underlying costs for services provided by a license holder under sections 
89.24 	245D.05, 245D.06, 245D.07, 245D.071, 245D.081, and 245D.09, and for services provided 
89.25 	by a license holder certified under section 245D.33.
89.26 	(b) The commissioner, in consultation with stakeholders, shall review and evaluate the 
89.27 	following values already in subdivisions 6 to 9, or issues that impact all services, including, 
89.28 	but not limited to:
89.29 	(1) values for transportation rates;
89.30 	(2) values for services where monitoring technology replaces staff time;
89.31 	(3) values for indirect services;
90.1 	(4) values for nursing;
90.2 	(5) values for the facility use rate in day services, and the weightings used in the day 
90.3 	service ratios and adjustments to those weightings;
90.4 	(6) values for workers' compensation as part of employee-related expenses;
90.5 	(7) values for unemployment insurance as part of employee-related expenses;
90.6 	(8) direct care workforce labor market measures;
90.7 	(9) any changes in state or federal law with a direct impact on the underlying cost of 
90.8 	providing home and community-based services;
90.9 	(10) outcome measures, determined by the commissioner, for home and community-based 
90.10 	services rates determined under this section; and
90.11 	(11) different competitive workforce factors by service, as determined under subdivision 
90.12 	10b.
90.13 	(c) The commissioner shall report to the chairs and the ranking minority members of 
90.14 	the legislative committees and divisions with jurisdiction over health and human services 
90.15 	policy and finance with the information and data gathered under paragraphs (a) and (b) on 
90.16 	January 15, 2021, with a full report, and a full report once every four years thereafter.
90.17 	(d) (c) Beginning July 1, 2022, the commissioner shall renew analysis and implement 
90.18 	changes to the regional adjustment factors once every six years. Prior to implementation, 
90.19 	the commissioner shall consult with stakeholders on the methodology to calculate the 
90.20 	adjustment.

90.21 	Sec. 3. Minnesota Statutes 2023 Supplement, section 256B.4914, subdivision 10a, is 
90.22 	amended to read:
90.23 		Subd. 10a.Reporting and analysis of cost data. (a) The commissioner must ensure 
90.24 	that wage values and component values in subdivisions 5 to 9 reflect the cost to provide the 
90.25 	service. As determined by the commissioner, in consultation with stakeholders identified 
90.26 	in subdivision 17, a provider enrolled to provide services with rates determined under this 
90.27 	section must submit requested cost data to the commissioner to support research on the cost 
90.28 	of providing services that have rates determined by the disability waiver rates system. 
90.29 	Requested cost data may include, but is not limited to:
90.30 	(1) worker wage costs;
90.31 	(2) benefits paid;
91.1 	(3) supervisor wage costs;
91.2 	(4) executive wage costs;
91.3 	(5) vacation, sick, and training time paid;
91.4 	(6) taxes, workers' compensation, and unemployment insurance costs paid;
91.5 	(7) administrative costs paid;
91.6 	(8) program costs paid;
91.7 	(9) transportation costs paid;
91.8 	(10) vacancy rates; and
91.9 	(11) other data relating to costs required to provide services requested by the 
91.10 	commissioner.
91.11 	(b) At least once in any five-year period, a provider must submit cost data for a fiscal 
91.12 	year that ended not more than 18 months prior to the submission date. The commissioner 
91.13 	shall provide each provider a 90-day notice prior to its submission due date. If a provider 
91.14 	fails to submit required reporting data, the commissioner shall provide notice to providers 
91.15 	that have not provided required data 30 days after the required submission date, and a second 
91.16 	notice for providers who have not provided required data 60 days after the required 
91.17 	submission date. The commissioner shall temporarily suspend payments to the provider if 
91.18 	cost data is not received 90 days after the required submission date. Withheld payments 
91.19 	shall be made once data is received by the commissioner.
91.20 	(c) The commissioner shall conduct a random validation of data submitted under 
91.21 	paragraph (a) to ensure data accuracy. The commissioner shall analyze cost documentation 
91.22 	in paragraph (a) and provide recommendations for adjustments to cost components.
91.23 	(d) The commissioner shall analyze cost data submitted under paragraph (a) and, in 
91.24 	consultation with stakeholders identified in subdivision 17, may submit recommendations 
91.25 	on component values and inflationary factor adjustments to the chairs and ranking minority 
91.26 	members of the legislative committees with jurisdiction over human services once every 
91.27 	four years beginning January 1, 2021. The commissioner shall make recommendations in 
91.28 	conjunction with reports submitted to the legislature according to subdivision 10, paragraph 
91.29 	(c). The commissioner shall release cost data in an aggregate form. Cost data from individual 
91.30 	providers must not be released except as provided for in current law.
91.31 	(e) The commissioner shall use data collected in paragraph (a) to determine the 
91.32 	compliance with requirements identified under subdivision 10d. The commissioner shall 
92.1 	identify providers who have not met the thresholds identified under subdivision 10d on the 
92.2 	Department of Human Services website for the year for which the providers reported their 
92.3 	costs.

92.4 	Sec. 4. Minnesota Statutes 2022, section 256B.69, subdivision 5k, is amended to read:
92.5 		Subd. 5k.Actuarial soundness. (a) Rates paid to managed care plans and county-based 
92.6 	purchasing plans shall satisfy requirements for actuarial soundness. In order to comply with 
92.7 	this subdivision, the rates must:
92.8 	(1) be neither inadequate nor excessive;
92.9 	(2) satisfy federal requirements;
92.10 	(3) in the case of contracts with incentive arrangements, not exceed 105 percent of the 
92.11 	approved capitation payments attributable to the enrollees or services covered by the incentive 
92.12 	arrangement;
92.13 	(4) be developed in accordance with generally accepted actuarial principles and practices;
92.14 	(5) be appropriate for the populations to be covered and the services to be furnished 
92.15 	under the contract; and
92.16 	(6) be certified as meeting the requirements of federal regulations by actuaries who meet 
92.17 	the qualification standards established by the American Academy of Actuaries and follow 
92.18 	the practice standards established by the Actuarial Standards Board.
92.19 	(b) Each year within 30 days of the establishment of plan rates the commissioner shall 
92.20 	report to the chairs and ranking minority members of the senate Health and Human Services 
92.21 	Budget Division and the house of representatives Health Care and Human Services Finance 
92.22 	Division to certify how each of these conditions have been met by the new payment rates.

92.23 	Sec. 5. Minnesota Statutes 2022, section 402A.16, subdivision 2, is amended to read:
92.24 		Subd. 2.Duties. The Human Services Performance Council shall:
92.25 	(1) hold meetings at least quarterly that are in compliance with Minnesota's Open Meeting 
92.26 	Law under chapter 13D;
92.27 	(2) annually review the annual performance data submitted by counties or service delivery 
92.28 	authorities;
93.1 	(3) review and advise the commissioner on department procedures related to the 
93.2 	implementation of the performance management system and system process requirements 
93.3 	and on barriers to process improvement in human services delivery;
93.4 	(4) advise the commissioner on the training and technical assistance needs of county or 
93.5 	service delivery authority and department personnel;
93.6 	(5) review instances in which a county or service delivery authority has not made adequate 
93.7 	progress on a performance improvement plan and make recommendations to the 
93.8 	commissioner under section 402A.18;
93.9 	(6) consider appeals from counties or service delivery authorities that are in the remedies 
93.10 	process and make recommendations to the commissioner on resolving the issue;
93.11 	(7) convene working groups to update and develop outcomes, measures, and performance 
93.12 	thresholds for the performance management system and, on an annual basis, present these 
93.13 	recommendations to the commissioner, including recommendations on when a particular 
93.14 	essential human services program has a balanced set of program measures in place;
93.15 	(8) make recommendations on human services administrative rules or statutes that could 
93.16 	be repealed in order to improve service delivery; and
93.17 	(9) provide information to stakeholders on the council's role and regularly collect 
93.18 	stakeholder input on performance management system performance; and.
93.19 	(10) submit an annual report to the legislature and the commissioner, which includes a 
93.20 	comprehensive report on the performance of individual counties or service delivery 
93.21 	authorities as it relates to system measures; a list of counties or service delivery authorities 
93.22 	that have been required to create performance improvement plans and the areas identified 
93.23 	for improvement as part of the remedies process; a summary of performance improvement 
93.24 	training and technical assistance activities offered to the county personnel by the department; 
93.25 	recommendations on administrative rules or state statutes that could be repealed in order to 
93.26 	improve service delivery; recommendations for system improvements, including updates 
93.27 	to system outcomes, measures, and thresholds; and a response from the commissioner.

93.28 	Sec. 6. REPEALER.
 93.29 	Minnesota Statutes 2022, sections 245G.011, subdivision 5; 252.34; and 256.01, 
93.30 	subdivision 39, are repealed.
93.31 	Delete the title and insert:
94.1 	A bill for an act
94.2 	relating to human services; modifying and establishing laws regarding disability 
94.3 	services, aging services, and substance use disorder treatment services; modernizing 
94.4 	language in the Deaf and Hard-of-Hearing Services Act; expanding application 
94.5 	of bloodborne pathogen testing to nonsecure direct care and treatment programming; 
94.6 	making technical corrections and repealing obsolete language;amending Minnesota Statutes 2022, sections 144A.20, subdivision 4; 144G.30, subdivision 5; 144G.45, subdivision 3; 148F.025, subdivision 2; 245A.11, subdivision 2, as amended; 245D.071, subdivisions 3, 4; 245D.081, subdivisions 2, 3; 245D.09, subdivision 3; 245D.091, subdivisions 3, 4; 245D.10, subdivision 1; 245F.02, subdivisions 17, 21; 245F.08, subdivision 3; 245F.15, subdivision 7; 245G.031, subdivision 2; 245G.04, by adding a subdivision; 245G.22, subdivisions 6, 7; 246.71, subdivisions 3, 4, 5; 246.711; 246.712, subdivisions 1, 2; 246.713; 246.714; 246.715, subdivisions 1, 2, 3; 246.716, subdivisions 1, 2, as amended; 246.717; 246.721, as amended; 246.722; 254A.03, subdivision 1; 254B.03, subdivision 4; 256.975, subdivision 7e; 256B.0659, subdivision 17a; 256B.0759, subdivision 4; 256B.0911, subdivision 24; 256B.092, by adding a subdivision; 256B.49, by adding a subdivision; 256B.4905, subdivision 12; 256B.69, subdivision 5k, by adding a subdivision; 256B.85, subdivisions 2, 6, 6a, 7a, 11, 17, 20, by adding a subdivision; 256C.21; 256C.23, subdivisions 1a, 2, 2a, 2b, 2c, 6, 7, by adding a subdivision; 256C.233, subdivisions 1, 2; 256C.24, subdivisions 1, 2, 3; 256C.26; 256C.261; 256C.28, subdivision 1; 256R.08, subdivision 1, by adding a subdivision; 402A.16, subdivision 2; Minnesota Statutes 2023 Supplement, sections 245G.05, subdivision 3; 245G.09, subdivision 3; 245G.11, subdivision 10; 245G.22, subdivisions 2, 17; 245I.04, subdivision 18; 254A.19, subdivision 3; 254B.04, subdivisions 1a, 2a, 6, by adding a subdivision; 254B.05, subdivisions 1, 5; 254B.181, subdivision 1; 256B.057, subdivision 9; 256B.0659, subdivision 24; 256B.0759, subdivision 2; 256B.4914, subdivisions 4, 10, 10a; 256B.85, subdivision 13a; Laws 2021, First Special Session chapter 7, article 11, section 38, as amended; article 13, section 75; Laws 2023, chapter 61, article 8, section 13, subdivision 2; repealing Minnesota Statutes 2022, sections 245G.011, subdivision 5; 245G.22, subdivision 4; 252.34; 256.01, subdivision 39; 256.975, subdivisions 7f, 7g; 256R.18.
95.1	We request the adoption of this report and repassage of the bill.
	
95.2	Senate Conferees:
........			
95.3	........
		........
	
95.4	John Hoffman
		Alice Mann
	
95.5	........
			
95.6	Paul Utke
			
95.7	House Conferees:
........			
95.8	........
		........
	
95.9	Peter Fischer
		Luke Frederick
	
95.10	........
			
95.11	Dave Baker