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Capital IconMinnesota Legislature
Office of the Revisor of Statutes

SF 2934

4th Engrossment - 93rd Legislature (2023 - 2024) Posted on 10/25/2023 09:32am

KEY: stricken = removed, old language.
underscored = added, new language.
Version List Authors and Status
Pdf Rtf
Line numbers 1.1 1.2 1.3 1.4 1.5 1.6 1.7 1.8 1.9 1.10 1.11 1.12 1.13 1.14 1.15 1.16 1.17 1.18 1.19 1.20 1.21 1.22 1.23 1.24 1.25 1.26 1.27 1.28 1.29 1.30 1.31 1.32 1.33 1.34 1.35 1.36 1.37 1.38 2.1 2.2 2.3 2.4 2.5 2.6
2.7 2.8
2.9 2.10 2.11 2.12 2.13 2.14 2.15 2.16 2.17 2.18 2.19 2.20 2.21 2.22 2.23 2.24 2.25 2.26 2.27 2.28 2.29 2.30 2.31 2.32 2.33 3.1 3.2 3.3
3.4 3.5 3.6 3.7 3.8 3.9 3.10 3.11 3.12 3.13 3.14 3.15 3.16 3.17 3.18 3.19 3.20 3.21 3.22 3.23 3.24 3.25 3.26 3.27 3.28 3.29 3.30 3.31 3.32 3.33 3.34 4.1 4.2 4.3 4.4 4.5 4.6 4.7 4.8 4.9 4.10 4.11 4.12 4.13 4.14 4.15 4.16 4.17 4.18 4.19 4.20 4.21 4.22 4.23 4.24 4.25 4.26 4.27 4.28 4.29 4.30 4.31 4.32 4.33 4.34 5.1 5.2 5.3 5.4 5.5 5.6 5.7 5.8 5.9 5.10 5.11 5.12 5.13 5.14 5.15 5.16 5.17 5.18 5.19 5.20 5.21 5.22 5.23 5.24 5.25 5.26 5.27 5.28 5.29 5.30 5.31 5.32 5.33 5.34 5.35 6.1 6.2 6.3 6.4 6.5 6.6 6.7 6.8 6.9 6.10 6.11 6.12
6.13
6.14 6.15 6.16 6.17 6.18 6.19 6.20 6.21 6.22 6.23 6.24 6.25 6.26 6.27 6.28 6.29 6.30 6.31 6.32 6.33 7.1 7.2 7.3 7.4 7.5 7.6 7.7 7.8 7.9 7.10 7.11 7.12
7.13
7.14 7.15 7.16 7.17 7.18 7.19 7.20 7.21 7.22 7.23 7.24 7.25 7.26 7.27 7.28 7.29 7.30 7.31 7.32 7.33 8.1 8.2 8.3 8.4 8.5 8.6 8.7 8.8 8.9 8.10 8.11 8.12 8.13 8.14 8.15 8.16 8.17 8.18 8.19 8.20 8.21 8.22 8.23 8.24 8.25 8.26 8.27 8.28 8.29 8.30 8.31 9.1 9.2 9.3 9.4 9.5 9.6 9.7 9.8 9.9 9.10 9.11 9.12 9.13 9.14 9.15 9.16 9.17 9.18 9.19 9.20 9.21 9.22 9.23 9.24 9.25 9.26 9.27 9.28 9.29 9.30 9.31 9.32 9.33 9.34 10.1 10.2 10.3 10.4 10.5 10.6 10.7 10.8 10.9 10.10 10.11 10.12 10.13 10.14 10.15 10.16 10.17 10.18 10.19 10.20 10.21 10.22 10.23 10.24 10.25 10.26 10.27 10.28 10.29 10.30 10.31 10.32 11.1 11.2 11.3 11.4 11.5 11.6 11.7 11.8 11.9 11.10 11.11 11.12 11.13 11.14 11.15 11.16 11.17 11.18 11.19 11.20 11.21 11.22 11.23
11.24
11.25 11.26 11.27 11.28 11.29 11.30 11.31 11.32 11.33 12.1 12.2 12.3 12.4 12.5 12.6 12.7 12.8 12.9 12.10 12.11 12.12 12.13 12.14 12.15 12.16 12.17 12.18 12.19 12.20 12.21 12.22 12.23 12.24 12.25 12.26 12.27 12.28 12.29 12.30 12.31 12.32 13.1 13.2 13.3 13.4 13.5 13.6 13.7 13.8 13.9 13.10 13.11 13.12 13.13 13.14 13.15 13.16 13.17 13.18 13.19 13.20 13.21 13.22 13.23 13.24 13.25 13.26 13.27 13.28 13.29 13.30 13.31 14.1 14.2 14.3 14.4 14.5 14.6 14.7 14.8 14.9 14.10 14.11 14.12 14.13 14.14 14.15 14.16 14.17 14.18 14.19 14.20 14.21 14.22 14.23 14.24 14.25 14.26 14.27 14.28 14.29 14.30
15.1 15.2 15.3
15.4 15.5 15.6 15.7 15.8 15.9 15.10 15.11 15.12 15.13 15.14 15.15 15.16 15.17 15.18 15.19 15.20 15.21 15.22 15.23 15.24 15.25 15.26 15.27 15.28 15.29 15.30 15.31 16.1 16.2 16.3 16.4 16.5 16.6 16.7 16.8 16.9 16.10 16.11 16.12 16.13 16.14 16.15 16.16 16.17 16.18 16.19 16.20 16.21 16.22 16.23 16.24 16.25 16.26 16.27 16.28 16.29 16.30 16.31 16.32 16.33 17.1 17.2 17.3 17.4 17.5 17.6 17.7 17.8 17.9 17.10 17.11 17.12 17.13 17.14 17.15 17.16 17.17 17.18 17.19 17.20 17.21
17.22
17.23 17.24 17.25 17.26 17.27 17.28 17.29 17.30 17.31 18.1 18.2 18.3 18.4 18.5 18.6
18.7 18.8 18.9 18.10 18.11 18.12 18.13 18.14 18.15 18.16
18.17 18.18 18.19 18.20 18.21 18.22 18.23 18.24
18.25 18.26 18.27 18.28 18.29 18.30 18.31 19.1 19.2 19.3 19.4 19.5 19.6 19.7 19.8 19.9 19.10 19.11 19.12 19.13 19.14 19.15 19.16 19.17 19.18 19.19 19.20 19.21 19.22 19.23 19.24 19.25 19.26 19.27 19.28 19.29 20.1 20.2 20.3 20.4 20.5 20.6 20.7 20.8 20.9 20.10 20.11 20.12 20.13 20.14 20.15 20.16 20.17 20.18 20.19 20.20 20.21 20.22 20.23 20.24 20.25 20.26 20.27 20.28 20.29 20.30 20.31 21.1 21.2 21.3 21.4 21.5 21.6 21.7 21.8 21.9 21.10 21.11 21.12 21.13 21.14 21.15 21.16 21.17 21.18 21.19 21.20 21.21 21.22 21.23 21.24 21.25 21.26 21.27 21.28 21.29 21.30 21.31 22.1 22.2 22.3 22.4 22.5 22.6 22.7 22.8
22.9 22.10 22.11 22.12 22.13 22.14 22.15 22.16 22.17 22.18 22.19 22.20 22.21 22.22 22.23 22.24 22.25 22.26 22.27 22.28 22.29 22.30 22.31 22.32 23.1 23.2 23.3 23.4 23.5 23.6 23.7 23.8 23.9
23.10 23.11 23.12 23.13 23.14 23.15 23.16 23.17 23.18 23.19 23.20 23.21 23.22 23.23 23.24 23.25 23.26 23.27 23.28 23.29 23.30 23.31 24.1 24.2 24.3 24.4 24.5 24.6 24.7 24.8 24.9 24.10 24.11 24.12 24.13 24.14 24.15 24.16 24.17 24.18 24.19 24.20 24.21 24.22 24.23 24.24 24.25 24.26 24.27 24.28 24.29 24.30 24.31 24.32 25.1 25.2 25.3 25.4 25.5 25.6
25.7 25.8 25.9
25.10 25.11 25.12 25.13 25.14 25.15 25.16 25.17 25.18 25.19 25.20 25.21 25.22 25.23 25.24 25.25 25.26 25.27 25.28 25.29 25.30 25.31 26.1 26.2 26.3 26.4
26.5 26.6 26.7
26.8 26.9 26.10 26.11 26.12 26.13 26.14 26.15 26.16 26.17 26.18 26.19 26.20 26.21 26.22 26.23
26.24 26.25 26.26
26.27 26.28 26.29 26.30 26.31 27.1 27.2 27.3 27.4 27.5 27.6 27.7 27.8 27.9 27.10 27.11 27.12 27.13 27.14 27.15 27.16 27.17 27.18 27.19 27.20 27.21 27.22 27.23 27.24 27.25 27.26 27.27 27.28 27.29 27.30 27.31 28.1 28.2 28.3 28.4 28.5 28.6 28.7 28.8 28.9 28.10 28.11 28.12 28.13 28.14 28.15
28.16 28.17 28.18
28.19 28.20 28.21 28.22 28.23 28.24 28.25 28.26 28.27 28.28 28.29 29.1 29.2 29.3 29.4 29.5 29.6 29.7 29.8 29.9 29.10 29.11 29.12 29.13 29.14 29.15 29.16 29.17 29.18 29.19 29.20 29.21 29.22 29.23 29.24 29.25 29.26
29.27 29.28 29.29
30.1 30.2 30.3 30.4 30.5 30.6 30.7 30.8 30.9 30.10 30.11 30.12 30.13 30.14 30.15
30.16 30.17 30.18 30.19 30.20 30.21 30.22 30.23 30.24 30.25 30.26 30.27 30.28 30.29 30.30 31.1 31.2 31.3 31.4 31.5 31.6 31.7 31.8 31.9 31.10 31.11 31.12 31.13 31.14 31.15 31.16 31.17 31.18 31.19 31.20 31.21 31.22 31.23 31.24 31.25 31.26 31.27 31.28 31.29 31.30 31.31 31.32 32.1 32.2 32.3 32.4 32.5 32.6 32.7 32.8 32.9 32.10 32.11 32.12 32.13 32.14 32.15 32.16 32.17
32.18 32.19 32.20 32.21 32.22 32.23 32.24 32.25 32.26 32.27 32.28 32.29 32.30 32.31 32.32 32.33 33.1 33.2 33.3 33.4 33.5 33.6 33.7 33.8 33.9 33.10 33.11 33.12 33.13 33.14 33.15 33.16 33.17 33.18 33.19 33.20 33.21 33.22 33.23 33.24 33.25 33.26 33.27 33.28 33.29 33.30 33.31 33.32 34.1 34.2 34.3 34.4 34.5 34.6 34.7 34.8 34.9 34.10 34.11 34.12 34.13 34.14 34.15 34.16 34.17 34.18 34.19 34.20 34.21 34.22 34.23 34.24 34.25 34.26 34.27 34.28 34.29
34.30 34.31 34.32
35.1 35.2 35.3 35.4 35.5 35.6 35.7 35.8 35.9 35.10 35.11 35.12 35.13 35.14 35.15 35.16 35.17 35.18 35.19 35.20 35.21 35.22 35.23 35.24 35.25 35.26 35.27 35.28 35.29 35.30 35.31 36.1 36.2 36.3 36.4 36.5 36.6 36.7 36.8 36.9 36.10 36.11 36.12 36.13 36.14 36.15 36.16 36.17 36.18 36.19 36.20 36.21 36.22 36.23 36.24 36.25 36.26 36.27 36.28
36.29 36.30 36.31 36.32 36.33 37.1 37.2 37.3 37.4 37.5 37.6
37.7 37.8 37.9 37.10 37.11 37.12 37.13 37.14 37.15 37.16 37.17 37.18 37.19 37.20 37.21 37.22 37.23 37.24 37.25 37.26 37.27 37.28 37.29 37.30 37.31 38.1 38.2 38.3 38.4 38.5 38.6
38.7 38.8 38.9 38.10 38.11 38.12 38.13 38.14 38.15 38.16 38.17 38.18 38.19 38.20 38.21 38.22 38.23 38.24 38.25 38.26 38.27 38.28 38.29 39.1 39.2 39.3 39.4 39.5
39.6 39.7 39.8
39.9 39.10 39.11 39.12 39.13 39.14 39.15 39.16 39.17 39.18 39.19 39.20 39.21 39.22 39.23 39.24 39.25 39.26 39.27 39.28 39.29 39.30 39.31 39.32 39.33 40.1 40.2 40.3 40.4 40.5 40.6 40.7 40.8 40.9
40.10 40.11 40.12 40.13 40.14
40.15 40.16 40.17 40.18 40.19 40.20 40.21
40.22 40.23 40.24
40.25 40.26 40.27 40.28 40.29 40.30 40.31 41.1 41.2 41.3 41.4 41.5 41.6 41.7 41.8 41.9 41.10 41.11 41.12 41.13 41.14 41.15 41.16 41.17 41.18 41.19 41.20 41.21 41.22 41.23
41.24 41.25 41.26 41.27
42.1 42.2 42.3 42.4 42.5 42.6 42.7 42.8 42.9 42.10 42.11 42.12 42.13 42.14 42.15 42.16 42.17 42.18 42.19 42.20 42.21 42.22 42.23 42.24 42.25 42.26 42.27 42.28 42.29 42.30 42.31 43.1 43.2 43.3 43.4 43.5 43.6 43.7 43.8 43.9 43.10 43.11 43.12
43.13 43.14 43.15
43.16 43.17 43.18 43.19 43.20 43.21 43.22 43.23 43.24 43.25 43.26 43.27 43.28 43.29 43.30 43.31
44.1 44.2 44.3
44.4 44.5 44.6 44.7 44.8 44.9 44.10 44.11 44.12 44.13 44.14 44.15 44.16 44.17 44.18 44.19 44.20 44.21 44.22 44.23 44.24 44.25 44.26 44.27 44.28 44.29 44.30 44.31 45.1 45.2 45.3 45.4 45.5 45.6 45.7 45.8 45.9 45.10 45.11 45.12 45.13 45.14 45.15 45.16 45.17 45.18 45.19 45.20 45.21 45.22 45.23 45.24 45.25 45.26 45.27 45.28 45.29 45.30 45.31 45.32 46.1 46.2 46.3 46.4 46.5 46.6 46.7 46.8
46.9 46.10 46.11 46.12 46.13
46.14 46.15 46.16 46.17 46.18 46.19 46.20 46.21 46.22 46.23 46.24 46.25 46.26 46.27
46.28 46.29 46.30 46.31 46.32
47.1 47.2 47.3 47.4 47.5 47.6 47.7 47.8 47.9 47.10 47.11 47.12
47.13 47.14 47.15
47.16 47.17 47.18 47.19 47.20 47.21 47.22 47.23 47.24 47.25 47.26 47.27 47.28 47.29 47.30 48.1 48.2 48.3 48.4 48.5 48.6 48.7 48.8 48.9 48.10 48.11 48.12 48.13 48.14 48.15 48.16 48.17 48.18 48.19 48.20 48.21 48.22 48.23 48.24 48.25 48.26 48.27 48.28 48.29 48.30 48.31 48.32 49.1 49.2
49.3 49.4 49.5
49.6 49.7 49.8 49.9 49.10 49.11 49.12 49.13 49.14 49.15 49.16 49.17 49.18 49.19 49.20 49.21 49.22 49.23 49.24 49.25 49.26 49.27 49.28 49.29 49.30 50.1 50.2 50.3 50.4 50.5 50.6 50.7 50.8 50.9 50.10 50.11 50.12 50.13 50.14 50.15 50.16 50.17 50.18 50.19 50.20 50.21 50.22 50.23 50.24
50.25 50.26 50.27
50.28 50.29 50.30 50.31 51.1 51.2 51.3 51.4 51.5 51.6 51.7 51.8 51.9 51.10 51.11 51.12 51.13 51.14 51.15 51.16 51.17 51.18 51.19 51.20 51.21 51.22 51.23 51.24 51.25 51.26 51.27 51.28 51.29 51.30 51.31 52.1 52.2 52.3 52.4 52.5 52.6 52.7
52.8 52.9 52.10
52.11 52.12 52.13 52.14 52.15 52.16 52.17 52.18 52.19 52.20 52.21 52.22 52.23 52.24 52.25 52.26 52.27 52.28 53.1 53.2 53.3 53.4 53.5 53.6 53.7 53.8 53.9 53.10 53.11 53.12 53.13 53.14 53.15 53.16 53.17 53.18 53.19 53.20 53.21 53.22 53.23 53.24 53.25 53.26 53.27 53.28 53.29 53.30 53.31
54.1 54.2 54.3
54.4 54.5 54.6 54.7 54.8 54.9 54.10 54.11 54.12 54.13 54.14 54.15 54.16 54.17 54.18 54.19 54.20 54.21 54.22 54.23 54.24 54.25 54.26 54.27 54.28 54.29 55.1 55.2 55.3 55.4 55.5 55.6 55.7 55.8 55.9 55.10 55.11 55.12 55.13 55.14 55.15 55.16 55.17 55.18 55.19 55.20 55.21
55.22 55.23 55.24
55.25 55.26 55.27 55.28 55.29 55.30 56.1 56.2 56.3 56.4 56.5 56.6 56.7 56.8 56.9 56.10 56.11 56.12 56.13 56.14 56.15 56.16 56.17 56.18 56.19 56.20 56.21 56.22 56.23 56.24 56.25 56.26 56.27 56.28 56.29 56.30 56.31 57.1 57.2 57.3 57.4 57.5 57.6 57.7 57.8 57.9 57.10 57.11
57.12 57.13 57.14
57.15 57.16 57.17 57.18 57.19 57.20 57.21 57.22 57.23 57.24 57.25 57.26 57.27 57.28 57.29 57.30 58.1 58.2 58.3 58.4 58.5 58.6 58.7 58.8 58.9 58.10 58.11 58.12 58.13 58.14 58.15 58.16 58.17 58.18 58.19 58.20 58.21 58.22 58.23 58.24 58.25 58.26 58.27 58.28 58.29 58.30 58.31 59.1 59.2 59.3 59.4 59.5 59.6 59.7 59.8 59.9 59.10 59.11 59.12 59.13
59.14 59.15 59.16
59.17 59.18 59.19 59.20 59.21 59.22 59.23 59.24 59.25 59.26 59.27 59.28 59.29 59.30 60.1 60.2 60.3 60.4 60.5 60.6 60.7 60.8 60.9 60.10 60.11 60.12 60.13 60.14 60.15 60.16 60.17 60.18 60.19 60.20 60.21 60.22 60.23 60.24 60.25 60.26 60.27 60.28 60.29 60.30 61.1 61.2 61.3 61.4 61.5 61.6 61.7
61.8 61.9 61.10
61.11 61.12 61.13 61.14 61.15 61.16 61.17 61.18 61.19 61.20 61.21 61.22 61.23 61.24 61.25 61.26 61.27 61.28 61.29 61.30 61.31 62.1 62.2 62.3 62.4 62.5 62.6 62.7 62.8 62.9 62.10 62.11 62.12 62.13 62.14 62.15 62.16
62.17 62.18 62.19
62.20 62.21 62.22 62.23 62.24 62.25 62.26 62.27 62.28 62.29 62.30 62.31 63.1 63.2 63.3 63.4 63.5 63.6 63.7 63.8 63.9 63.10 63.11 63.12 63.13 63.14 63.15 63.16 63.17 63.18 63.19 63.20 63.21 63.22 63.23 63.24 63.25 63.26 63.27 63.28 63.29 63.30 63.31 63.32 64.1 64.2 64.3 64.4 64.5 64.6 64.7
64.8 64.9 64.10 64.11
64.12 64.13 64.14 64.15 64.16 64.17 64.18 64.19 64.20 64.21 64.22 64.23 64.24 64.25 64.26 64.27 64.28 64.29 64.30
64.31
65.1 65.2 65.3 65.4 65.5 65.6 65.7 65.8 65.9 65.10 65.11 65.12 65.13 65.14 65.15 65.16 65.17 65.18 65.19 65.20 65.21 65.22 65.23 65.24 65.25 65.26
65.27
66.1 66.2 66.3 66.4 66.5 66.6 66.7 66.8 66.9 66.10 66.11 66.12 66.13 66.14 66.15 66.16 66.17 66.18 66.19 66.20 66.21 66.22
66.23 66.24 66.25
66.26 66.27 66.28 66.29 66.30 66.31 67.1 67.2 67.3 67.4 67.5 67.6 67.7 67.8 67.9 67.10 67.11 67.12 67.13 67.14 67.15 67.16 67.17 67.18 67.19 67.20 67.21 67.22 67.23 67.24 67.25 67.26 67.27 67.28 67.29 67.30 67.31 67.32 68.1 68.2 68.3 68.4 68.5 68.6 68.7 68.8 68.9 68.10 68.11 68.12 68.13 68.14 68.15 68.16 68.17 68.18 68.19 68.20 68.21 68.22
68.23 68.24 68.25 68.26
68.27 68.28 68.29 68.30 68.31 68.32 68.33
69.1 69.2 69.3
69.4 69.5 69.6 69.7 69.8 69.9 69.10
69.11 69.12 69.13
69.14 69.15 69.16 69.17 69.18 69.19 69.20
69.21 69.22 69.23
69.24 69.25 69.26 69.27 69.28 69.29
70.1 70.2 70.3
70.4 70.5 70.6 70.7 70.8 70.9 70.10 70.11 70.12 70.13 70.14 70.15 70.16 70.17 70.18 70.19 70.20 70.21 70.22 70.23 70.24 70.25 70.26 70.27 70.28 70.29 70.30 70.31 71.1 71.2 71.3 71.4 71.5 71.6 71.7
71.8 71.9 71.10
71.11 71.12 71.13 71.14 71.15 71.16 71.17 71.18 71.19 71.20 71.21 71.22 71.23 71.24 71.25 71.26 71.27 71.28 71.29 71.30
72.1 72.2 72.3
72.4 72.5 72.6 72.7 72.8 72.9 72.10 72.11 72.12 72.13 72.14 72.15 72.16 72.17 72.18 72.19 72.20 72.21
72.22 72.23 72.24
72.25 72.26 72.27 72.28 72.29 72.30 72.31 73.1 73.2 73.3 73.4 73.5 73.6 73.7 73.8 73.9 73.10 73.11 73.12 73.13 73.14 73.15 73.16 73.17 73.18 73.19 73.20 73.21 73.22 73.23 73.24 73.25 73.26 73.27 73.28 73.29 73.30 74.1 74.2 74.3 74.4
74.5 74.6 74.7 74.8 74.9 74.10
74.11 74.12 74.13 74.14 74.15 74.16 74.17 74.18 74.19 74.20 74.21 74.22 74.23 74.24 74.25 74.26 74.27 74.28 74.29 74.30 74.31 75.1 75.2 75.3 75.4 75.5 75.6 75.7 75.8
75.9 75.10 75.11
75.12 75.13 75.14 75.15 75.16 75.17 75.18 75.19 75.20 75.21 75.22 75.23 75.24 75.25 75.26 75.27 75.28 75.29
75.30
76.1 76.2 76.3 76.4 76.5 76.6
76.7 76.8 76.9
76.10 76.11 76.12 76.13 76.14 76.15 76.16 76.17 76.18 76.19 76.20 76.21 76.22 76.23 76.24 76.25 76.26 76.27 76.28 76.29 76.30 77.1 77.2 77.3 77.4 77.5 77.6 77.7 77.8 77.9 77.10 77.11 77.12 77.13 77.14 77.15 77.16 77.17 77.18 77.19 77.20 77.21 77.22 77.23 77.24 77.25 77.26 77.27 77.28 77.29 77.30 77.31 77.32 77.33 78.1 78.2 78.3 78.4 78.5 78.6 78.7 78.8 78.9 78.10 78.11 78.12 78.13
78.14 78.15 78.16 78.17 78.18 78.19 78.20 78.21 78.22 78.23 78.24 78.25 78.26 78.27 78.28 78.29 78.30 78.31 78.32 79.1 79.2 79.3 79.4 79.5 79.6 79.7 79.8 79.9 79.10
79.11 79.12 79.13 79.14 79.15 79.16 79.17 79.18 79.19 79.20 79.21 79.22 79.23 79.24 79.25 79.26 79.27 79.28 79.29 79.30 79.31 80.1 80.2 80.3 80.4 80.5 80.6 80.7 80.8 80.9 80.10 80.11 80.12 80.13 80.14 80.15 80.16 80.17 80.18 80.19 80.20 80.21 80.22 80.23 80.24 80.25 80.26 80.27 80.28 80.29 80.30 80.31 80.32 81.1 81.2 81.3 81.4 81.5 81.6 81.7 81.8 81.9 81.10 81.11 81.12 81.13 81.14 81.15 81.16 81.17 81.18 81.19 81.20 81.21 81.22 81.23 81.24 81.25 81.26 81.27 81.28 81.29 82.1 82.2 82.3 82.4 82.5 82.6
82.7 82.8 82.9 82.10 82.11 82.12 82.13 82.14 82.15 82.16 82.17 82.18 82.19 82.20 82.21 82.22 82.23 82.24 82.25 82.26 82.27 82.28 82.29 82.30 82.31 82.32 83.1 83.2 83.3 83.4 83.5 83.6 83.7 83.8 83.9 83.10 83.11 83.12 83.13 83.14 83.15 83.16 83.17 83.18
83.19 83.20 83.21 83.22 83.23 83.24 83.25 83.26 83.27 83.28 83.29 83.30 83.31 83.32
83.33
84.1 84.2 84.3 84.4 84.5 84.6 84.7 84.8 84.9 84.10 84.11 84.12 84.13 84.14 84.15
84.16 84.17 84.18 84.19
84.20 84.21 84.22 84.23
84.24 84.25 84.26 84.27 84.28 84.29 84.30 84.31 85.1 85.2
85.3 85.4 85.5 85.6 85.7 85.8 85.9 85.10 85.11 85.12 85.13 85.14 85.15 85.16 85.17 85.18 85.19 85.20 85.21 85.22 85.23 85.24 85.25
85.26 85.27 85.28 85.29 85.30 85.31 85.32
86.1 86.2 86.3
86.4 86.5 86.6 86.7 86.8
86.9 86.10 86.11
86.12 86.13 86.14 86.15 86.16 86.17 86.18 86.19
86.20 86.21 86.22 86.23
86.24 86.25 86.26
87.1 87.2 87.3 87.4 87.5
87.6 87.7 87.8
87.9 87.10 87.11 87.12 87.13 87.14
87.15 87.16 87.17
87.18 87.19 87.20 87.21 87.22 87.23 87.24 87.25 87.26
87.27 87.28 87.29 87.30 87.31 88.1 88.2 88.3 88.4 88.5 88.6 88.7 88.8 88.9 88.10 88.11 88.12 88.13 88.14
88.15 88.16 88.17 88.18 88.19 88.20 88.21 88.22 88.23 88.24 88.25 88.26 88.27 88.28 88.29 88.30
89.1 89.2 89.3 89.4 89.5 89.6 89.7 89.8 89.9 89.10 89.11 89.12 89.13 89.14 89.15 89.16 89.17 89.18 89.19 89.20 89.21 89.22 89.23 89.24 89.25
89.26 89.27 89.28 89.29 89.30 89.31 90.1 90.2 90.3
90.4 90.5 90.6
90.7 90.8 90.9 90.10 90.11 90.12 90.13 90.14
90.15 90.16 90.17 90.18 90.19 90.20 90.21
90.22 90.23 90.24 90.25 90.26 90.27 90.28 90.29 90.30 91.1 91.2 91.3 91.4 91.5 91.6
91.7 91.8 91.9 91.10 91.11 91.12 91.13 91.14 91.15 91.16 91.17 91.18 91.19 91.20 91.21 91.22 91.23 91.24 91.25 91.26 91.27 91.28 91.29 92.1 92.2 92.3 92.4 92.5 92.6 92.7 92.8 92.9 92.10 92.11 92.12 92.13 92.14 92.15 92.16 92.17 92.18 92.19 92.20 92.21 92.22 92.23 92.24 92.25 92.26 92.27 92.28 92.29 92.30 92.31 93.1 93.2 93.3 93.4 93.5 93.6 93.7 93.8 93.9 93.10 93.11 93.12 93.13 93.14 93.15 93.16 93.17
93.18 93.19 93.20 93.21 93.22 93.23 93.24 93.25 93.26 93.27 93.28 93.29 93.30 93.31 93.32 94.1 94.2 94.3 94.4 94.5 94.6
94.7 94.8 94.9 94.10 94.11 94.12 94.13 94.14 94.15 94.16 94.17 94.18
94.19
94.20 94.21 94.22
94.23 94.24 94.25 94.26
95.1 95.2
95.3 95.4 95.5 95.6 95.7 95.8 95.9 95.10 95.11 95.12 95.13 95.14 95.15 95.16 95.17 95.18 95.19 95.20 95.21 95.22 95.23 95.24 95.25 95.26 95.27 95.28 95.29 95.30 96.1 96.2 96.3 96.4 96.5 96.6 96.7 96.8 96.9 96.10 96.11 96.12 96.13 96.14
96.15 96.16 96.17 96.18 96.19 96.20 96.21 96.22 96.23 96.24 96.25 96.26 96.27 96.28 96.29 96.30 96.31 96.32 97.1 97.2 97.3 97.4 97.5 97.6 97.7 97.8 97.9 97.10 97.11 97.12 97.13 97.14 97.15 97.16 97.17 97.18 97.19 97.20 97.21 97.22 97.23 97.24 97.25 97.26 97.27 97.28 97.29 97.30 97.31 98.1 98.2 98.3 98.4 98.5 98.6 98.7 98.8 98.9 98.10 98.11 98.12 98.13 98.14 98.15 98.16 98.17 98.18 98.19 98.20 98.21 98.22 98.23 98.24 98.25 98.26 98.27 98.28 98.29 98.30 98.31 98.32 98.33 98.34 99.1 99.2 99.3 99.4 99.5 99.6 99.7 99.8 99.9 99.10 99.11 99.12 99.13 99.14 99.15 99.16 99.17 99.18 99.19 99.20 99.21 99.22 99.23 99.24 99.25 99.26 99.27 99.28 99.29 100.1 100.2 100.3 100.4 100.5 100.6 100.7 100.8 100.9 100.10 100.11 100.12 100.13 100.14 100.15 100.16 100.17 100.18 100.19 100.20 100.21 100.22 100.23 100.24 100.25 100.26 100.27 100.28 100.29 100.30 100.31 100.32 101.1 101.2 101.3 101.4 101.5 101.6 101.7 101.8 101.9 101.10 101.11 101.12
101.13 101.14 101.15 101.16 101.17 101.18 101.19 101.20 101.21 101.22 101.23 101.24 101.25 101.26 101.27 101.28 101.29
102.1 102.2 102.3 102.4 102.5 102.6 102.7 102.8 102.9 102.10 102.11 102.12 102.13 102.14 102.15 102.16 102.17 102.18 102.19 102.20 102.21 102.22 102.23 102.24 102.25 102.26 102.27 102.28 102.29 102.30 102.31 102.32 103.1 103.2 103.3 103.4 103.5 103.6 103.7 103.8 103.9 103.10 103.11 103.12 103.13 103.14 103.15 103.16 103.17 103.18 103.19 103.20 103.21 103.22 103.23 103.24 103.25 103.26 103.27 103.28 103.29 103.30 103.31 103.32 103.33 104.1 104.2 104.3 104.4 104.5 104.6 104.7 104.8 104.9 104.10 104.11 104.12 104.13 104.14 104.15 104.16
104.17 104.18 104.19
104.20 104.21 104.22 104.23 104.24 104.25 104.26 104.27 104.28 104.29 104.30 104.31 105.1 105.2 105.3 105.4 105.5 105.6 105.7 105.8 105.9 105.10 105.11 105.12 105.13 105.14 105.15 105.16 105.17 105.18 105.19 105.20 105.21
105.22 105.23 105.24
105.25 105.26 105.27 105.28 105.29 105.30 105.31 106.1 106.2 106.3 106.4 106.5 106.6 106.7 106.8 106.9 106.10 106.11 106.12 106.13 106.14
106.15 106.16 106.17 106.18 106.19 106.20 106.21 106.22 106.23 106.24 106.25 106.26 106.27 106.28 106.29 106.30 106.31 106.32 106.33 107.1 107.2 107.3 107.4 107.5 107.6 107.7 107.8 107.9 107.10 107.11 107.12 107.13 107.14 107.15 107.16 107.17 107.18 107.19 107.20 107.21 107.22 107.23 107.24 107.25 107.26 107.27 107.28 107.29 107.30 107.31 107.32 108.1 108.2 108.3
108.4
108.5 108.6 108.7 108.8 108.9 108.10
108.11 108.12 108.13 108.14 108.15 108.16 108.17 108.18 108.19 108.20 108.21 108.22 108.23 108.24 108.25 108.26 108.27 108.28 108.29 108.30 109.1 109.2 109.3 109.4 109.5 109.6 109.7 109.8 109.9 109.10 109.11 109.12 109.13 109.14 109.15 109.16 109.17 109.18 109.19 109.20 109.21
109.22 109.23 109.24
109.25 109.26 109.27 109.28 109.29 109.30 109.31 109.32 110.1 110.2 110.3 110.4 110.5 110.6 110.7 110.8 110.9 110.10 110.11 110.12 110.13 110.14 110.15 110.16 110.17 110.18 110.19 110.20 110.21 110.22 110.23 110.24 110.25 110.26 110.27 110.28 110.29 110.30 110.31 110.32 110.33 111.1 111.2 111.3 111.4 111.5 111.6 111.7 111.8
111.9 111.10 111.11
111.12 111.13 111.14 111.15 111.16 111.17 111.18
111.19 111.20 111.21
111.22 111.23 111.24 111.25 111.26 111.27 111.28 111.29 111.30 111.31 111.32 112.1 112.2 112.3 112.4 112.5 112.6 112.7 112.8 112.9 112.10 112.11 112.12 112.13 112.14 112.15 112.16 112.17 112.18 112.19 112.20 112.21 112.22 112.23 112.24 112.25 112.26 112.27 112.28 112.29 112.30 112.31 112.32 112.33 113.1 113.2 113.3 113.4 113.5 113.6 113.7 113.8 113.9 113.10 113.11 113.12 113.13 113.14 113.15 113.16 113.17 113.18 113.19 113.20 113.21 113.22 113.23 113.24 113.25 113.26
113.27
113.28 113.29 113.30 113.31 114.1 114.2
114.3 114.4 114.5
114.6 114.7 114.8 114.9 114.10 114.11
114.12 114.13 114.14
114.15 114.16 114.17 114.18 114.19 114.20 114.21 114.22 114.23 114.24 114.25 114.26 114.27 114.28 114.29 114.30
115.1 115.2 115.3
115.4 115.5 115.6 115.7 115.8 115.9 115.10 115.11 115.12 115.13 115.14 115.15 115.16 115.17 115.18 115.19 115.20 115.21 115.22 115.23 115.24 115.25 115.26 115.27 115.28 115.29 115.30 116.1 116.2 116.3 116.4 116.5 116.6 116.7 116.8 116.9 116.10 116.11 116.12 116.13 116.14 116.15 116.16 116.17 116.18 116.19 116.20 116.21 116.22 116.23 116.24
116.25 116.26 116.27
117.1 117.2 117.3 117.4 117.5 117.6 117.7 117.8 117.9 117.10 117.11 117.12 117.13 117.14 117.15 117.16 117.17 117.18 117.19 117.20 117.21 117.22 117.23 117.24 117.25 117.26 117.27 117.28 117.29 117.30 117.31 117.32 118.1 118.2 118.3 118.4 118.5 118.6 118.7 118.8 118.9 118.10 118.11 118.12 118.13 118.14 118.15
118.16 118.17 118.18 118.19
118.20 118.21 118.22 118.23 118.24 118.25 118.26 118.27 118.28 118.29 118.30 118.31 118.32 118.33 119.1 119.2 119.3 119.4 119.5 119.6 119.7 119.8 119.9 119.10 119.11 119.12 119.13 119.14 119.15 119.16 119.17 119.18 119.19 119.20 119.21 119.22 119.23 119.24 119.25 119.26 119.27 119.28 119.29 119.30 119.31 119.32 119.33 119.34 120.1 120.2 120.3 120.4 120.5 120.6 120.7 120.8 120.9 120.10 120.11 120.12 120.13 120.14 120.15 120.16 120.17 120.18 120.19 120.20 120.21 120.22 120.23 120.24 120.25 120.26 120.27 120.28 120.29 120.30 120.31 120.32 120.33 120.34 121.1 121.2 121.3 121.4 121.5 121.6 121.7 121.8 121.9 121.10 121.11 121.12 121.13 121.14
121.15 121.16 121.17
121.18 121.19 121.20 121.21 121.22 121.23 121.24 121.25 121.26 121.27 121.28 121.29 121.30 121.31 121.32 122.1 122.2 122.3 122.4 122.5 122.6 122.7 122.8 122.9 122.10 122.11 122.12 122.13 122.14 122.15 122.16 122.17 122.18 122.19 122.20 122.21 122.22 122.23 122.24 122.25 122.26 122.27 122.28 122.29 122.30 123.1 123.2 123.3 123.4 123.5 123.6 123.7 123.8 123.9 123.10 123.11 123.12 123.13
123.14 123.15 123.16
123.17 123.18 123.19 123.20 123.21 123.22 123.23 123.24 123.25 123.26 123.27 123.28 124.1 124.2
124.3 124.4 124.5
124.6 124.7 124.8 124.9 124.10 124.11 124.12
124.13 124.14 124.15
124.16 124.17 124.18 124.19 124.20 124.21 124.22
124.23 124.24 124.25
124.26 124.27 124.28 125.1 125.2 125.3 125.4
125.5 125.6 125.7
125.8 125.9 125.10 125.11 125.12 125.13 125.14 125.15
125.16 125.17 125.18
125.19 125.20 125.21 125.22 125.23 125.24 125.25 125.26
125.27 125.28 125.29
126.1 126.2 126.3 126.4 126.5 126.6 126.7 126.8 126.9
126.10 126.11 126.12
126.13 126.14 126.15 126.16 126.17 126.18 126.19 126.20
126.21 126.22 126.23
126.24 126.25 126.26 126.27 126.28 126.29 127.1 127.2 127.3
127.4 127.5 127.6
127.7 127.8 127.9 127.10 127.11 127.12 127.13 127.14 127.15 127.16
127.17 127.18 127.19
127.20 127.21 127.22 127.23 127.24 127.25 127.26 127.27 127.28 127.29
128.1 128.2 128.3
128.4 128.5 128.6 128.7 128.8 128.9 128.10 128.11 128.12
128.13 128.14 128.15
128.16 128.17 128.18 128.19 128.20 128.21
128.22 128.23 128.24
128.25 128.26 128.27 128.28 128.29 128.30 129.1 129.2 129.3 129.4 129.5 129.6 129.7 129.8 129.9
129.10 129.11 129.12
129.13 129.14 129.15 129.16 129.17 129.18 129.19 129.20 129.21 129.22 129.23 129.24 129.25
129.26 129.27 129.28
130.1 130.2 130.3 130.4 130.5 130.6 130.7 130.8 130.9
130.10 130.11 130.12 130.13 130.14 130.15 130.16 130.17 130.18 130.19 130.20 130.21 130.22 130.23 130.24 130.25 130.26 130.27 130.28 130.29 130.30 131.1 131.2 131.3 131.4 131.5 131.6 131.7 131.8 131.9 131.10
131.11 131.12 131.13 131.14 131.15 131.16 131.17 131.18 131.19 131.20 131.21 131.22 131.23 131.24 131.25 131.26 131.27 131.28 131.29 131.30 131.31
132.1 132.2 132.3 132.4 132.5 132.6 132.7 132.8 132.9
132.10 132.11 132.12 132.13 132.14 132.15 132.16 132.17 132.18
132.19 132.20 132.21 132.22 132.23 132.24
132.25 132.26 132.27
132.28 132.29 132.30 132.31 133.1 133.2 133.3 133.4 133.5 133.6 133.7 133.8 133.9 133.10 133.11 133.12 133.13 133.14 133.15 133.16 133.17 133.18 133.19 133.20 133.21 133.22 133.23 133.24 133.25
133.26 133.27 133.28 133.29
134.1 134.2 134.3 134.4 134.5
134.6 134.7 134.8
134.9 134.10
134.11 134.12 134.13 134.14 134.15 134.16 134.17 134.18 134.19 134.20 134.21 134.22 134.23 134.24 134.25 134.26 134.27 134.28 134.29 134.30 134.31 135.1 135.2 135.3 135.4 135.5 135.6 135.7 135.8 135.9 135.10 135.11 135.12 135.13 135.14 135.15 135.16 135.17 135.18 135.19 135.20 135.21 135.22 135.23 135.24 135.25 135.26 135.27 135.28 135.29 135.30 135.31 135.32 135.33 135.34 136.1 136.2 136.3 136.4 136.5 136.6 136.7 136.8 136.9 136.10 136.11 136.12 136.13 136.14 136.15 136.16 136.17 136.18 136.19 136.20 136.21 136.22 136.23 136.24 136.25 136.26 136.27 136.28 136.29 136.30 136.31 137.1 137.2 137.3 137.4 137.5 137.6 137.7 137.8 137.9 137.10 137.11
137.12 137.13 137.14 137.15 137.16 137.17 137.18
137.19 137.20 137.21 137.22 137.23 137.24 137.25 137.26 137.27 137.28 137.29 137.30 137.31 137.32 138.1 138.2 138.3 138.4 138.5 138.6 138.7 138.8 138.9 138.10 138.11 138.12 138.13 138.14 138.15 138.16 138.17 138.18 138.19 138.20 138.21 138.22 138.23 138.24 138.25 138.26 138.27 138.28 138.29 138.30 138.31 138.32 138.33 139.1 139.2 139.3 139.4
139.5
139.6 139.7 139.8 139.9 139.10 139.11 139.12 139.13 139.14 139.15 139.16 139.17 139.18 139.19 139.20 139.21 139.22 139.23 139.24 139.25 139.26 139.27 139.28 139.29 139.30 139.31 140.1 140.2 140.3 140.4 140.5 140.6 140.7 140.8 140.9 140.10 140.11 140.12 140.13 140.14 140.15 140.16 140.17 140.18 140.19 140.20 140.21 140.22 140.23 140.24 140.25 140.26 140.27 140.28 140.29 140.30 140.31 140.32 141.1 141.2 141.3 141.4 141.5 141.6 141.7 141.8 141.9 141.10 141.11 141.12 141.13 141.14 141.15 141.16 141.17 141.18 141.19 141.20
141.21 141.22 141.23 141.24
141.25 141.26 141.27 141.28 141.29 141.30 141.31 141.32 142.1 142.2 142.3 142.4 142.5 142.6 142.7 142.8 142.9 142.10 142.11 142.12 142.13 142.14 142.15 142.16 142.17 142.18 142.19 142.20 142.21 142.22 142.23 142.24 142.25 142.26 142.27 142.28 142.29 142.30 143.1 143.2 143.3 143.4 143.5 143.6 143.7 143.8 143.9 143.10 143.11 143.12 143.13 143.14 143.15 143.16 143.17 143.18 143.19 143.20 143.21 143.22 143.23 143.24 143.25 143.26 143.27 143.28 143.29 143.30 143.31 143.32 143.33 144.1 144.2 144.3 144.4 144.5 144.6 144.7 144.8 144.9 144.10 144.11 144.12 144.13 144.14 144.15 144.16 144.17 144.18 144.19 144.20 144.21 144.22 144.23 144.24 144.25 144.26 144.27 144.28 144.29 144.30 144.31 144.32 145.1 145.2 145.3 145.4 145.5 145.6 145.7 145.8 145.9 145.10 145.11 145.12 145.13 145.14 145.15 145.16 145.17 145.18 145.19 145.20 145.21 145.22 145.23 145.24 145.25 145.26 145.27 145.28 145.29 145.30 145.31 145.32 146.1 146.2 146.3 146.4 146.5 146.6 146.7 146.8 146.9 146.10 146.11 146.12 146.13 146.14
146.15 146.16 146.17
146.18 146.19 146.20 146.21 146.22 146.23 146.24 146.25 146.26 146.27 146.28 146.29 146.30 146.31 146.32 146.33 147.1 147.2 147.3 147.4 147.5 147.6 147.7 147.8 147.9 147.10 147.11 147.12 147.13 147.14 147.15 147.16 147.17 147.18
147.19 147.20 147.21
147.22 147.23 147.24 147.25 147.26 147.27 147.28 147.29 147.30 147.31 147.32 147.33 148.1 148.2 148.3 148.4 148.5 148.6 148.7 148.8 148.9 148.10 148.11 148.12 148.13 148.14 148.15 148.16 148.17 148.18 148.19 148.20 148.21 148.22 148.23 148.24 148.25 148.26 148.27 148.28 148.29 148.30 148.31 148.32 149.1 149.2 149.3 149.4 149.5 149.6 149.7 149.8 149.9 149.10 149.11 149.12
149.13 149.14 149.15 149.16 149.17 149.18 149.19 149.20 149.21 149.22 149.23 149.24 149.25 149.26 149.27 149.28 149.29 149.30 149.31 150.1 150.2
150.3
150.4 150.5 150.6 150.7 150.8 150.9 150.10
150.11
150.12 150.13 150.14 150.15 150.16 150.17 150.18 150.19 150.20 150.21 150.22 150.23 150.24 150.25 150.26 150.27 150.28 150.29 150.30
150.31
151.1 151.2 151.3 151.4 151.5 151.6 151.7 151.8 151.9 151.10 151.11 151.12 151.13 151.14 151.15 151.16 151.17 151.18 151.19 151.20 151.21 151.22 151.23 151.24 151.25
151.26 151.27 151.28 151.29 151.30 152.1 152.2 152.3 152.4 152.5 152.6 152.7 152.8 152.9 152.10 152.11 152.12 152.13 152.14 152.15 152.16 152.17 152.18 152.19 152.20 152.21 152.22 152.23 152.24
152.25
152.26 152.27 152.28 152.29 152.30 152.31 152.32 153.1 153.2 153.3 153.4 153.5 153.6 153.7 153.8 153.9 153.10 153.11 153.12 153.13 153.14 153.15 153.16 153.17 153.18 153.19
153.20 153.21 153.22 153.23 153.24 153.25 153.26 153.27 153.28 153.29 153.30 153.31 153.32 153.33 153.34 154.1 154.2 154.3 154.4 154.5 154.6 154.7 154.8 154.9 154.10 154.11 154.12 154.13 154.14 154.15 154.16 154.17 154.18 154.19 154.20 154.21 154.22 154.23 154.24 154.25 154.26 154.27 154.28 154.29 154.30 154.31 154.32 154.33 154.34 155.1 155.2 155.3 155.4 155.5 155.6 155.7 155.8 155.9 155.10 155.11 155.12 155.13 155.14 155.15 155.16 155.17 155.18 155.19 155.20 155.21 155.22 155.23 155.24 155.25 155.26 155.27 155.28 155.29 155.30 155.31 155.32 155.33 155.34 156.1 156.2 156.3 156.4 156.5 156.6 156.7 156.8 156.9 156.10 156.11 156.12 156.13 156.14 156.15 156.16 156.17 156.18 156.19 156.20 156.21 156.22 156.23 156.24 156.25 156.26 156.27 156.28 156.29 156.30
157.1 157.2
157.3 157.4 157.5 157.6 157.7 157.8 157.9 157.10 157.11 157.12 157.13 157.14 157.15 157.16
157.17 157.18 157.19 157.20 157.21 157.22
157.23 157.24 157.25 157.26 157.27 157.28 157.29 157.30 157.31
158.1 158.2 158.3 158.4 158.5 158.6 158.7 158.8 158.9 158.10 158.11 158.12 158.13
158.14 158.15 158.16 158.17 158.18 158.19 158.20 158.21 158.22 158.23 158.24 158.25 158.26 158.27 158.28 158.29 158.30 158.31 158.32
159.1 159.2 159.3 159.4 159.5 159.6 159.7 159.8 159.9 159.10 159.11 159.12 159.13
159.14
159.15 159.16 159.17 159.18 159.19 159.20 159.21 159.22 159.23 159.24 159.25 159.26 159.27 159.28 159.29 159.30 159.31 160.1 160.2 160.3 160.4 160.5 160.6 160.7 160.8 160.9 160.10 160.11 160.12 160.13 160.14 160.15 160.16 160.17 160.18 160.19 160.20 160.21 160.22 160.23 160.24 160.25 160.26 160.27
160.28
160.29 160.30 160.31 160.32 160.33 161.1 161.2 161.3 161.4 161.5 161.6 161.7
161.8 161.9 161.10 161.11 161.12 161.13 161.14 161.15 161.16 161.17 161.18 161.19 161.20 161.21 161.22 161.23 161.24 161.25 161.26 161.27 161.28 161.29 161.30 161.31 161.32 162.1 162.2
162.3 162.4 162.5 162.6 162.7 162.8 162.9 162.10 162.11 162.12 162.13 162.14 162.15 162.16 162.17 162.18 162.19 162.20 162.21 162.22 162.23 162.24 162.25 162.26 162.27 162.28 162.29 162.30 163.1 163.2 163.3 163.4 163.5 163.6 163.7 163.8 163.9 163.10 163.11 163.12 163.13 163.14 163.15 163.16 163.17 163.18 163.19 163.20 163.21 163.22 163.23 163.24 163.25 163.26 163.27 163.28 163.29 163.30 164.1 164.2 164.3 164.4 164.5 164.6 164.7 164.8 164.9 164.10 164.11 164.12 164.13 164.14 164.15 164.16 164.17 164.18 164.19 164.20 164.21 164.22 164.23 164.24 164.25 164.26 164.27 164.28 164.29 164.30 164.31 164.32 165.1 165.2 165.3 165.4 165.5
165.6 165.7 165.8
165.9 165.10 165.11 165.12 165.13 165.14 165.15 165.16 165.17 165.18 165.19 165.20 165.21 165.22 165.23 165.24 165.25 165.26 165.27 165.28 165.29
165.30 165.31 165.32
166.1 166.2 166.3 166.4 166.5 166.6 166.7 166.8 166.9 166.10 166.11 166.12 166.13 166.14 166.15 166.16
166.17
166.18 166.19 166.20 166.21 166.22 166.23 166.24 166.25 166.26 166.27 166.28 166.29 166.30 167.1 167.2 167.3 167.4 167.5 167.6 167.7 167.8 167.9 167.10 167.11 167.12 167.13 167.14 167.15
167.16 167.17 167.18 167.19 167.20 167.21 167.22 167.23 167.24 167.25 167.26 167.27 167.28 167.29 167.30 167.31 168.1 168.2 168.3 168.4 168.5 168.6 168.7 168.8 168.9 168.10 168.11 168.12 168.13 168.14 168.15 168.16 168.17 168.18 168.19 168.20 168.21 168.22 168.23 168.24 168.25 168.26 168.27 168.28 168.29 168.30 169.1 169.2 169.3 169.4 169.5 169.6 169.7 169.8
169.9 169.10 169.11 169.12 169.13 169.14 169.15 169.16 169.17 169.18 169.19 169.20 169.21 169.22 169.23 169.24 169.25
169.26 169.27 169.28 169.29 169.30 170.1 170.2 170.3 170.4 170.5 170.6 170.7 170.8 170.9 170.10 170.11 170.12 170.13 170.14 170.15 170.16 170.17 170.18 170.19 170.20 170.21 170.22 170.23 170.24 170.25 170.26 170.27 170.28 170.29 170.30 170.31 170.32 170.33 170.34 171.1 171.2 171.3 171.4 171.5 171.6 171.7 171.8
171.9 171.10 171.11 171.12 171.13 171.14 171.15 171.16 171.17
171.18 171.19 171.20 171.21 171.22 171.23 171.24 171.25 171.26
171.27 171.28 171.29 171.30 171.31 171.32 172.1 172.2 172.3
172.4
172.5 172.6 172.7 172.8 172.9 172.10
172.11 172.12 172.13 172.14 172.15 172.16 172.17 172.18 172.19 172.20 172.21
172.22
172.23 172.24 172.25 172.26 172.27 172.28 172.29 173.1 173.2 173.3 173.4 173.5 173.6 173.7
173.8 173.9 173.10 173.11 173.12 173.13
173.14 173.15 173.16 173.17 173.18 173.19 173.20 173.21 173.22 173.23
173.24 173.25 173.26 173.27 173.28 173.29 173.30 173.31 173.32 174.1 174.2 174.3 174.4
174.5 174.6 174.7 174.8 174.9 174.10 174.11 174.12 174.13
174.14 174.15 174.16 174.17
174.18 174.19 174.20 174.21
174.22 174.23
174.24 174.25
174.26 174.27 174.28 174.29 175.1 175.2 175.3 175.4 175.5 175.6 175.7
175.8
175.9 175.10 175.11 175.12 175.13 175.14 175.15 175.16 175.17 175.18 175.19 175.20 175.21 175.22 175.23 175.24 175.25 175.26 175.27 175.28 175.29 175.30 175.31 176.1 176.2 176.3 176.4 176.5 176.6 176.7 176.8 176.9 176.10 176.11 176.12 176.13 176.14 176.15 176.16 176.17 176.18 176.19 176.20 176.21 176.22 176.23 176.24 176.25 176.26 176.27 176.28 176.29 176.30 176.31 177.1 177.2 177.3 177.4 177.5 177.6 177.7 177.8 177.9 177.10 177.11 177.12 177.13 177.14 177.15 177.16 177.17 177.18 177.19 177.20 177.21 177.22 177.23 177.24 177.25 177.26 177.27 177.28 177.29 177.30 177.31 177.32 177.33 177.34 178.1 178.2 178.3 178.4 178.5 178.6 178.7
178.8 178.9 178.10 178.11 178.12 178.13 178.14 178.15 178.16 178.17
178.18 178.19 178.20 178.21 178.22 178.23 178.24 178.25 178.26
178.27 178.28 178.29 178.30 178.31 179.1 179.2
179.3 179.4 179.5 179.6 179.7 179.8 179.9 179.10 179.11 179.12 179.13 179.14 179.15 179.16 179.17 179.18 179.19 179.20 179.21
179.22 179.23 179.24 179.25 179.26 179.27 179.28 179.29 179.30 179.31
180.1 180.2 180.3 180.4 180.5 180.6 180.7 180.8 180.9 180.10 180.11 180.12 180.13 180.14 180.15 180.16 180.17 180.18 180.19 180.20 180.21 180.22 180.23 180.24 180.25 180.26 180.27 180.28 180.29 180.30 180.31 180.32 181.1 181.2 181.3 181.4 181.5 181.6 181.7 181.8 181.9 181.10 181.11 181.12 181.13 181.14 181.15 181.16 181.17 181.18 181.19 181.20 181.21 181.22 181.23 181.24 181.25 181.26 181.27 181.28 181.29 181.30 181.31 181.32 181.33 181.34 182.1 182.2 182.3 182.4
182.5 182.6 182.7 182.8 182.9 182.10 182.11 182.12 182.13 182.14 182.15 182.16 182.17 182.18 182.19 182.20 182.21 182.22 182.23 182.24 182.25 182.26 182.27 182.28 182.29 182.30 182.31 182.32 183.1 183.2 183.3 183.4 183.5 183.6 183.7 183.8 183.9 183.10 183.11 183.12 183.13 183.14 183.15 183.16 183.17 183.18 183.19 183.20 183.21 183.22 183.23 183.24 183.25 183.26 183.27 183.28 183.29 183.30 183.31 183.32 184.1 184.2 184.3
184.4 184.5 184.6 184.7 184.8 184.9 184.10 184.11 184.12 184.13 184.14 184.15 184.16 184.17 184.18 184.19 184.20 184.21 184.22 184.23 184.24 184.25 184.26 184.27 184.28 184.29 184.30 185.1 185.2 185.3 185.4 185.5 185.6 185.7 185.8 185.9 185.10 185.11 185.12 185.13 185.14 185.15 185.16 185.17 185.18 185.19 185.20 185.21 185.22 185.23 185.24 185.25 185.26 185.27 185.28 185.29 185.30 185.31 185.32 185.33
185.34
186.1 186.2 186.3 186.4 186.5 186.6 186.7 186.8 186.9 186.10 186.11 186.12 186.13 186.14 186.15 186.16 186.17 186.18 186.19 186.20 186.21 186.22 186.23 186.24 186.25 186.26 186.27 186.28 186.29 186.30 186.31 186.32 186.33
187.1
187.2 187.3 187.4 187.5 187.6 187.7
187.8 187.9 187.10 187.11 187.12 187.13 187.14 187.15 187.16 187.17 187.18 187.19 187.20 187.21 187.22 187.23 187.24 187.25 187.26 187.27 187.28 187.29 187.30 187.31 188.1 188.2 188.3 188.4 188.5 188.6 188.7 188.8 188.9 188.10 188.11 188.12 188.13 188.14 188.15 188.16 188.17 188.18 188.19 188.20 188.21 188.22 188.23 188.24 188.25 188.26 188.27 188.28 188.29 188.30 188.31 188.32 188.33 189.1 189.2 189.3 189.4 189.5 189.6 189.7 189.8 189.9 189.10 189.11 189.12 189.13 189.14 189.15 189.16 189.17 189.18 189.19 189.20 189.21 189.22 189.23 189.24 189.25 189.26 189.27 189.28 189.29 189.30 189.31 189.32 190.1 190.2 190.3
190.4
190.5 190.6 190.7 190.8 190.9 190.10 190.11 190.12 190.13 190.14 190.15 190.16 190.17 190.18
190.19 190.20 190.21 190.22 190.23 190.24 190.25 190.26 190.27 190.28 190.29 190.30 190.31 190.32 191.1 191.2 191.3 191.4 191.5 191.6 191.7 191.8 191.9 191.10
191.11 191.12
191.13 191.14 191.15 191.16 191.17 191.18 191.19
191.20 191.21 191.22 191.23 191.24 191.25 191.26 191.27 191.28 191.29 192.1 192.2 192.3 192.4 192.5 192.6 192.7 192.8 192.9 192.10 192.11 192.12 192.13 192.14 192.15 192.16
192.17 192.18 192.19 192.20 192.21 192.22 192.23 192.24 192.25 192.26 192.27 192.28 192.29 192.30 192.31 193.1 193.2 193.3 193.4 193.5 193.6 193.7 193.8 193.9 193.10 193.11 193.12
193.13 193.14 193.15 193.16 193.17 193.18 193.19 193.20 193.21 193.22 193.23 193.24 193.25 193.26 193.27 193.28 193.29 193.30 193.31 193.32 194.1 194.2 194.3 194.4 194.5 194.6 194.7 194.8 194.9 194.10 194.11 194.12 194.13 194.14 194.15 194.16 194.17 194.18 194.19 194.20 194.21 194.22 194.23 194.24 194.25 194.26 194.27 194.28 194.29 194.30 194.31 194.32
195.1 195.2 195.3 195.4 195.5 195.6 195.7 195.8 195.9 195.10 195.11
195.12 195.13 195.14 195.15 195.16 195.17 195.18 195.19 195.20 195.21 195.22 195.23 195.24
195.25 195.26
195.27 195.28 195.29 195.30 195.31 195.32 196.1 196.2 196.3 196.4 196.5 196.6 196.7 196.8 196.9 196.10 196.11 196.12 196.13 196.14 196.15 196.16 196.17 196.18 196.19 196.20 196.21 196.22 196.23 196.24 196.25 196.26 196.27 196.28 196.29 196.30 197.1 197.2 197.3 197.4 197.5 197.6 197.7 197.8 197.9 197.10 197.11 197.12 197.13 197.14 197.15 197.16 197.17 197.18 197.19 197.20 197.21 197.22 197.23 197.24 197.25 197.26 197.27 197.28 197.29 197.30 197.31 197.32 197.33 197.34 198.1 198.2 198.3 198.4 198.5 198.6 198.7 198.8 198.9 198.10 198.11 198.12 198.13 198.14 198.15 198.16 198.17 198.18
198.19 198.20 198.21 198.22 198.23 198.24 198.25 198.26 198.27 198.28
198.29 198.30 198.31 198.32 198.33 199.1 199.2 199.3 199.4 199.5 199.6 199.7 199.8
199.9 199.10 199.11 199.12 199.13 199.14 199.15 199.16 199.17 199.18 199.19 199.20 199.21 199.22
199.23 199.24 199.25 199.26 199.27 199.28 199.29 199.30 199.31 199.32 199.33
200.1 200.2 200.3 200.4 200.5 200.6 200.7 200.8 200.9 200.10 200.11 200.12 200.13 200.14 200.15 200.16 200.17 200.18 200.19 200.20 200.21 200.22 200.23 200.24 200.25 200.26 200.27 200.28 200.29 200.30 200.31 200.32 200.33 201.1 201.2 201.3 201.4 201.5 201.6
201.7 201.8 201.9 201.10 201.11 201.12 201.13 201.14 201.15 201.16 201.17 201.18 201.19 201.20 201.21 201.22 201.23
201.24 201.25 201.26 201.27 201.28 201.29 201.30 201.31 201.32 202.1 202.2 202.3 202.4 202.5 202.6 202.7 202.8 202.9 202.10 202.11 202.12 202.13 202.14 202.15 202.16 202.17 202.18 202.19 202.20 202.21 202.22 202.23 202.24 202.25 202.26 202.27 202.28 202.29 202.30 202.31 202.32 202.33 202.34 203.1 203.2 203.3 203.4 203.5 203.6 203.7 203.8 203.9 203.10 203.11
203.12 203.13 203.14 203.15 203.16 203.17 203.18 203.19 203.20 203.21 203.22 203.23
203.24 203.25 203.26 203.27 203.28 203.29 203.30 203.31 203.32 204.1 204.2 204.3 204.4 204.5 204.6 204.7 204.8
204.9 204.10 204.11 204.12 204.13 204.14 204.15 204.16 204.17 204.18 204.19 204.20
204.21 204.22 204.23 204.24 204.25
204.26 204.27
204.28 204.29 204.30 204.31 205.1 205.2 205.3 205.4 205.5 205.6 205.7 205.8 205.9
205.10
205.11 205.12 205.13 205.14 205.15 205.16 205.17 205.18 205.19 205.20
205.21
205.22 205.23 205.24 205.25 205.26 205.27 205.28 205.29 205.30 205.31 205.32 206.1 206.2 206.3 206.4 206.5 206.6 206.7 206.8 206.9 206.10 206.11 206.12 206.13 206.14 206.15 206.16 206.17 206.18 206.19
206.20
206.21 206.22 206.23 206.24 206.25 206.26 206.27 206.28 206.29 206.30 206.31 207.1 207.2 207.3 207.4 207.5 207.6 207.7 207.8 207.9 207.10 207.11 207.12 207.13
207.14 207.15 207.16 207.17 207.18 207.19 207.20 207.21 207.22 207.23 207.24 207.25 207.26 207.27 207.28 207.29 207.30 207.31
208.1 208.2 208.3 208.4 208.5 208.6 208.7 208.8 208.9 208.10 208.11 208.12 208.13 208.14
208.15 208.16
208.17 208.18 208.19 208.20 208.21 208.22 208.23 208.24 208.25 208.26 208.27 208.28 208.29 208.30 208.31 208.32
209.1
209.2 209.3 209.4 209.5 209.6 209.7 209.8 209.9 209.10 209.11 209.12 209.13 209.14 209.15 209.16 209.17 209.18 209.19 209.20 209.21
209.22
209.23 209.24 209.25 209.26 209.27 209.28 209.29 209.30 209.31 210.1 210.2
210.3 210.4 210.5 210.6 210.7 210.8 210.9 210.10 210.11 210.12 210.13 210.14 210.15 210.16 210.17 210.18 210.19 210.20 210.21 210.22 210.23 210.24 210.25 210.26 210.27 210.28 210.29 210.30 210.31 210.32 211.1 211.2 211.3 211.4 211.5 211.6 211.7 211.8 211.9 211.10 211.11 211.12 211.13 211.14 211.15 211.16 211.17
211.18
211.19 211.20 211.21 211.22 211.23 211.24 211.25 211.26 211.27 211.28 211.29 211.30 211.31
212.1 212.2 212.3 212.4 212.5 212.6 212.7 212.8 212.9 212.10 212.11 212.12 212.13 212.14 212.15 212.16 212.17 212.18 212.19 212.20 212.21 212.22 212.23 212.24 212.25 212.26 212.27 212.28 212.29 212.30 213.1 213.2 213.3 213.4 213.5 213.6 213.7 213.8 213.9 213.10 213.11 213.12 213.13 213.14 213.15 213.16 213.17 213.18 213.19 213.20 213.21 213.22 213.23 213.24 213.25 213.26 213.27 213.28 213.29 213.30 214.1 214.2 214.3 214.4 214.5 214.6 214.7 214.8 214.9 214.10 214.11 214.12 214.13 214.14 214.15 214.16 214.17 214.18 214.19 214.20 214.21 214.22 214.23 214.24 214.25 214.26 214.27 214.28 214.29 214.30 214.31 214.32 214.33 215.1
215.2
215.3 215.4 215.5 215.6 215.7 215.8
215.9
215.10 215.11
215.12 215.13 215.14 215.15 215.16 215.17 215.18 215.19 215.20 215.21 215.22 215.23
215.24 215.25 215.26 215.27 215.28 215.29 215.30 215.31 216.1 216.2 216.3 216.4 216.5 216.6 216.7 216.8 216.9 216.10 216.11 216.12 216.13 216.14 216.15 216.16 216.17 216.18 216.19 216.20 216.21 216.22 216.23 216.24 216.25 216.26 216.27 216.28 216.29 216.30 216.31 216.32 216.33 217.1 217.2 217.3 217.4 217.5 217.6 217.7 217.8 217.9 217.10 217.11 217.12 217.13 217.14 217.15 217.16 217.17 217.18 217.19 217.20 217.21 217.22 217.23 217.24 217.25 217.26 217.27 217.28 217.29 217.30 217.31 217.32 217.33 217.34 217.35 218.1 218.2 218.3 218.4 218.5 218.6 218.7 218.8 218.9 218.10 218.11 218.12 218.13 218.14 218.15 218.16 218.17 218.18 218.19 218.20 218.21 218.22 218.23 218.24 218.25 218.26 218.27 218.28 218.29 218.30 218.31 218.32 218.33 218.34 219.1 219.2 219.3 219.4 219.5 219.6 219.7 219.8 219.9 219.10 219.11 219.12 219.13 219.14 219.15 219.16 219.17 219.18 219.19 219.20 219.21 219.22 219.23 219.24 219.25 219.26 219.27 219.28 219.29 219.30 219.31 219.32 220.1 220.2 220.3 220.4 220.5 220.6 220.7 220.8 220.9 220.10 220.11 220.12 220.13 220.14 220.15 220.16 220.17 220.18 220.19 220.20 220.21 220.22 220.23 220.24 220.25 220.26 220.27 220.28 220.29 220.30 220.31 220.32 220.33 220.34 220.35 221.1 221.2 221.3 221.4 221.5 221.6 221.7 221.8 221.9 221.10 221.11 221.12 221.13 221.14 221.15 221.16 221.17 221.18 221.19 221.20 221.21 221.22 221.23 221.24 221.25 221.26 221.27 221.28 221.29 221.30 221.31 221.32 221.33 221.34 221.35 222.1 222.2 222.3 222.4 222.5 222.6 222.7 222.8 222.9 222.10 222.11 222.12 222.13 222.14 222.15 222.16 222.17 222.18 222.19 222.20 222.21 222.22 222.23 222.24 222.25 222.26 222.27 222.28 222.29 222.30 222.31 222.32 222.33 222.34 223.1 223.2 223.3 223.4 223.5 223.6 223.7 223.8 223.9 223.10 223.11 223.12 223.13 223.14 223.15 223.16 223.17 223.18 223.19 223.20 223.21 223.22 223.23 223.24 223.25 223.26 223.27 223.28 223.29 223.30 223.31 223.32 223.33 224.1 224.2 224.3 224.4 224.5 224.6 224.7 224.8 224.9 224.10 224.11 224.12 224.13 224.14 224.15 224.16 224.17 224.18 224.19 224.20 224.21 224.22 224.23 224.24 224.25 224.26 224.27 224.28 224.29 224.30 224.31 224.32 224.33 224.34 224.35 225.1 225.2 225.3 225.4 225.5 225.6 225.7 225.8 225.9 225.10 225.11 225.12 225.13 225.14 225.15 225.16 225.17 225.18 225.19 225.20 225.21 225.22 225.23 225.24 225.25 225.26 225.27 225.28 225.29 225.30 225.31 225.32 225.33 225.34 225.35 226.1 226.2 226.3 226.4 226.5 226.6 226.7 226.8 226.9 226.10 226.11 226.12 226.13 226.14 226.15 226.16 226.17 226.18 226.19 226.20 226.21 226.22 226.23 226.24 226.25 226.26 226.27 226.28 226.29 226.30 226.31 226.32 226.33 226.34 226.35 227.1 227.2 227.3 227.4 227.5 227.6 227.7 227.8 227.9 227.10 227.11 227.12 227.13 227.14 227.15 227.16 227.17 227.18 227.19 227.20 227.21 227.22 227.23 227.24 227.25 227.26 227.27 227.28 227.29 227.30 227.31 227.32 228.1 228.2 228.3 228.4 228.5 228.6 228.7 228.8 228.9 228.10 228.11 228.12 228.13 228.14 228.15 228.16 228.17 228.18 228.19 228.20 228.21 228.22 228.23 228.24 228.25 228.26 228.27 228.28 228.29 228.30 228.31 228.32 228.33 228.34 229.1 229.2 229.3 229.4 229.5 229.6 229.7 229.8 229.9 229.10 229.11 229.12 229.13 229.14 229.15 229.16 229.17 229.18 229.19 229.20 229.21 229.22 229.23 229.24 229.25 229.26 229.27 229.28 229.29 229.30 229.31 229.32 229.33 229.34 229.35 230.1 230.2 230.3 230.4 230.5 230.6 230.7 230.8 230.9 230.10 230.11 230.12 230.13 230.14 230.15 230.16 230.17 230.18 230.19 230.20 230.21 230.22 230.23 230.24 230.25 230.26 230.27 230.28 230.29 230.30 230.31 230.32 230.33 230.34 230.35 231.1 231.2 231.3 231.4 231.5 231.6 231.7 231.8 231.9 231.10 231.11 231.12 231.13 231.14 231.15 231.16 231.17 231.18 231.19 231.20 231.21 231.22 231.23 231.24 231.25 231.26 231.27 231.28 231.29 231.30 231.31 231.32 231.33 232.1 232.2 232.3 232.4 232.5 232.6 232.7 232.8 232.9 232.10 232.11 232.12 232.13 232.14 232.15 232.16 232.17 232.18 232.19 232.20 232.21 232.22 232.23 232.24 232.25 232.26 232.27 232.28 232.29 232.30 232.31 232.32 232.33 232.34 232.35 233.1 233.2 233.3 233.4 233.5 233.6 233.7 233.8 233.9 233.10 233.11 233.12 233.13 233.14 233.15 233.16 233.17 233.18 233.19 233.20 233.21 233.22 233.23 233.24 233.25 233.26 233.27 233.28 233.29 233.30 233.31 233.32 233.33 233.34 234.1 234.2 234.3 234.4 234.5 234.6 234.7 234.8 234.9 234.10 234.11 234.12 234.13 234.14 234.15 234.16 234.17 234.18 234.19 234.20 234.21 234.22 234.23 234.24 234.25 234.26 234.27 234.28 234.29 234.30 234.31 234.32 234.33 234.34 234.35 235.1 235.2 235.3 235.4 235.5 235.6 235.7 235.8 235.9 235.10 235.11 235.12 235.13 235.14 235.15 235.16 235.17 235.18 235.19 235.20
235.21 235.22 235.23 235.24
235.25 235.26 235.27 235.28 235.29 235.30 235.31 235.32
235.33 235.34 236.1 236.2 236.3 236.4
236.5 236.6 236.7 236.8 236.9 236.10 236.11 236.12 236.13
236.14 236.15 236.16 236.17 236.18 236.19 236.20 236.21 236.22 236.23 236.24 236.25
236.26
236.27 236.28 236.29 236.30
237.1
237.2 237.3 237.4 237.5 237.6 237.7 237.8 237.9 237.10 237.11 237.12 237.13 237.14 237.15 237.16 237.17 237.18
237.19 237.20 237.21
237.22 237.23 237.24
237.25 237.26

A bill for an act
 relating to human services; modifying provisions governing disability services,
aging services, health care, behavioral health, substance use disorder, the Opioid
Prescribing Improvement Program, human services licensing, and direct care and
treatment; establishing the Department of Direct Care and Treatment; making
technical and conforming changes; establishing certain grants; requiring reports;
appropriating money; amending Minnesota Statutes 2022, sections 4.046,
subdivisions 6, 7; 15.01; 15.06, subdivision 1; 43A.08, subdivision 1a; 179A.54,
by adding a subdivision; 241.021, subdivision 1; 241.31, subdivision 5; 241.415;
245.037; 245.91, subdivision 4; 245A.03, subdivision 7; 245A.04, subdivision 7;
245A.07, by adding subdivisions; 245A.10, subdivision 6, by adding a subdivision;
245A.11, subdivisions 7, 7a; 245A.13, subdivisions 1, 2, 3, 5, 6, 7, 9; 245D.03,
subdivision 1; 245G.02, subdivision 2; 245G.08, subdivision 3; 245G.09,
subdivision 3; 245G.22, subdivision 15, as amended if enacted; 246.54, subdivisions
1a, 1b; 252.27, subdivision 2a; 252.50, subdivision 2; 253B.10, subdivision 1;
254B.01, by adding a subdivision; 254B.05, subdivisions 1, 5; 256.01, subdivision
19; 256.042, subdivisions 1, 2; 256.043, subdivisions 3, 3a; 256.975, subdivision
6; 256.9754; 256B.04, by adding a subdivision; 256B.056, subdivision 3; 256B.057,
subdivision 9; 256B.0625, subdivisions 17, 17a, 17b, 18h, 22, by adding a
subdivision; 256B.0638, subdivisions 1, 2, 4, 5, by adding a subdivision;
256B.0659, subdivisions 1, 12, 19, 24, by adding a subdivision; 256B.073,
subdivision 3, by adding a subdivision; 256B.0759, subdivision 2; 256B.0911,
subdivision 13; 256B.0913, subdivisions 4, 5; 256B.0917, subdivision 1b;
256B.092, subdivision 1a; 256B.0949, subdivision 15; 256B.14, subdivision 2;
256B.49, subdivision 13; 256B.4905, subdivision 4a; 256B.4911, by adding a
subdivision; 256B.4912, by adding subdivisions; 256B.4914, subdivisions 3, as
amended, 4, 5, 5a, 5b, 6, 6a, 6b, 6c, 7a, 7b, 7c, 8, 9, 10, 10a, 10c, 12, 14, by adding
subdivisions; 256B.5012, by adding subdivisions; 256B.766; 256B.85, subdivision
7, by adding a subdivision; 256B.851, subdivisions 3, 5, 6; 256D.425, subdivision
1; 256I.05, by adding subdivisions; 256M.42; 256R.17, subdivision 2; 256R.25;
256R.47; 256R.53, by adding a subdivision; 256S.15, subdivision 2; 256S.18, by
adding a subdivision; 256S.19, subdivision 3; 256S.21; 256S.2101, subdivision
1; 256S.211; 256S.212; 256S.213; 256S.214; 256S.215, subdivisions 2, 3, 4, 7, 8,
9, 10, 11, 12, 13, 14, 15, 16, 17; 268.19, subdivision 1; Laws 2019, chapter 63,
article 3, section 1, as amended; Laws 2021, chapter 30, article 12, section 5, as
amended; Laws 2021, First Special Session chapter 7, article 16, section 28, as
amended; article 17, sections 8; 16; proposing coding for new law in Minnesota
Statutes, chapters 121A; 245; 245A; 245D; 252; 254B; 256; 256B; 256I; 256R;
325F; proposing coding for new law as Minnesota Statutes, chapter 246C; repealing
Minnesota Statutes 2022, sections 245G.05, subdivision 2; 245G.06, subdivision
2; 246.18, subdivisions 2, 2a; 256B.0759, subdivision 6; 256B.0917, subdivisions
1a, 6, 7a, 13; 256B.4914, subdivisions 6b, 9a; 256S.19, subdivision 4; 256S.2101,
subdivision 2.

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

ARTICLE 1

DISABILITY SERVICES

Section 1.

Minnesota Statutes 2022, section 179A.54, is amended by adding a subdivision
to read:


new text begin Subd. 11. new text end

new text begin Home Care Orientation Trust. new text end

new text begin (a) The state and an exclusive representative
certified pursuant to this section may establish a joint labor and management trust, referred
to as the Home Care Orientation Trust, for the exclusive purpose of rendering voluntary
orientation training to individual providers of direct support services who are represented
by the exclusive representative.
 new text end

new text begin (b) Financial contributions by the state to the Home Care Orientation Trust must be
made by the state pursuant to a collective bargaining agreement negotiated under this section.
All such financial contributions by the state must be held in trust for the purpose of paying,
from principal, from income, or from both, the costs associated with developing, delivering,
and promoting voluntary orientation training for individual providers of direct support
services working under a collective bargaining agreement and providing services through
a covered program under section 256B.0711. The Home Care Orientation Trust must be
administered, managed, and otherwise controlled jointly by a board of trustees composed
of an equal number of trustees appointed by the state and trustees appointed by the exclusive
representative under this section. The trust shall not be an agent of either the state or of the
exclusive representative.
 new text end

new text begin (c) Trust administrative, management, legal, and financial services may be provided to
the board of trustees by a third-party administrator, financial management institution, other
appropriate entity, or any combination thereof, as designated by the board of trustees from
time to time, and those services must be paid from the money held in trust and created by
the state's financial contributions to the Home Care Orientation Trust.
 new text end

new text begin (d) The state is authorized to purchase liability insurance for members of the board of
trustees appointed by the state.
 new text end

new text begin (e) Financial contributions to or participation in the management or administration of
the Home Care Orientation Trust must not be considered an unfair labor practice under
section 179A.13, or a violation of Minnesota law.
 new text end

Sec. 2.

Minnesota Statutes 2022, section 245A.03, subdivision 7, is amended to read:


Subd. 7.

Licensing moratorium.

(a) The commissioner shall not issue an initial license
for child foster care licensed under Minnesota Rules, parts 2960.3000 to 2960.3340, or adult
foster care licensed under Minnesota Rules, parts 9555.5105 to 9555.6265, under this chapter
for a physical location that will not be the primary residence of the license holder for the
entire period of licensure. If a family child foster care home or family adult foster care home
license is issued during this moratorium, and the license holder changes the license holder's
primary residence away from the physical location of the foster care license, the
commissioner shall revoke the license according to section 245A.07. The commissioner
shall not issue an initial license for a community residential setting licensed under chapter
245D. When approving an exception under this paragraph, the commissioner shall consider
the resource need determination process in paragraph (h), the availability of foster care
licensed beds in the geographic area in which the licensee seeks to operate, the results of a
person's choices during their annual assessment and service plan review, and the
recommendation of the local county board. The determination by the commissioner is final
and not subject to appeal. Exceptions to the moratorium include:

(1) foster care settings where at least 80 percent of the residents are 55 years of age or
older;

(2) foster care licenses replacing foster care licenses in existence on May 15, 2009, or
community residential setting licenses replacing adult foster care licenses in existence on
December 31, 2013, and determined to be needed by the commissioner under paragraph
(b);

(3) new foster care licenses or community residential setting licenses determined to be
needed by the commissioner under paragraph (b) for the closure of a nursing facility, ICF/DD,
or regional treatment center; restructuring of state-operated services that limits the capacity
of state-operated facilities; or allowing movement to the community for people who no
longer require the level of care provided in state-operated facilities as provided under section
256B.092, subdivision 13, or 256B.49, subdivision 24;

(4) new foster care licenses or community residential setting licenses determined to be
needed by the commissioner under paragraph (b) for persons requiring hospital-level care;
or

(5) new foster care licenses or community residential setting licenses for people receiving
customized living or 24-hour customized living services under the brain injury or community
access for disability inclusion waiver plans under section 256B.49new text begin or elderly waiver plan
under chapter 256Snew text end and residing in the customized living setting deleted text begin before July 1, 2022,deleted text end for
which a license is required. A customized living service provider subject to this exception
may rebut the presumption that a license is required by seeking a reconsideration of the
commissioner's determination. The commissioner's disposition of a request for
reconsideration is final and not subject to appeal under chapter 14. The exception is available
until deleted text begin June 30deleted text end new text begin December 31new text end , 2023. This exception is available when:

(i) the person's customized living services are provided in a customized living service
setting serving four or fewer people deleted text begin under the brain injury or community access for disability
inclusion waiver plans under section 256B.49deleted text end in a single-family home operational on or
before June 30, 2021. Operational is defined in section 256B.49, subdivision 28;

(ii) the person's case manager provided the person with information about the choice of
service, service provider, and location of service, including in the person's home, to help
the person make an informed choice; and

(iii) the person's services provided in the licensed foster care or community residential
setting are less than or equal to the cost of the person's services delivered in the customized
living setting as determined by the lead agency.

(b) The commissioner shall determine the need for newly licensed foster care homes or
community residential settings as defined under this subdivision. As part of the determination,
the commissioner shall consider the availability of foster care capacity in the area in which
the licensee seeks to operate, and the recommendation of the local county board. The
determination by the commissioner must be final. A determination of need is not required
for a change in ownership at the same address.

(c) When an adult resident served by the program moves out of a foster home that is not
the primary residence of the license holder according to section 256B.49, subdivision 15,
paragraph (f), or the adult community residential setting, the county shall immediately
inform the Department of Human Services Licensing Division. The department may decrease
the statewide licensed capacity for adult foster care settings.

(d) Residential settings that would otherwise be subject to the decreased license capacity
established in paragraph (c) shall be exempt if the license holder's beds are occupied by
residents whose primary diagnosis is mental illness and the license holder is certified under
the requirements in subdivision 6a or section 245D.33.

(e) A resource need determination process, managed at the state level, using the available
data required by section 144A.351, and other data and information shall be used to determine
where the reduced capacity determined under section 256B.493 will be implemented. The
commissioner shall consult with the stakeholders described in section 144A.351, and employ
a variety of methods to improve the state's capacity to meet the informed decisions of those
people who want to move out of corporate foster care or community residential settings,
long-term service needs within budgetary limits, including seeking proposals from service
providers or lead agencies to change service type, capacity, or location to improve services,
increase the independence of residents, and better meet needs identified by the long-term
services and supports reports and statewide data and information.

(f) At the time of application and reapplication for licensure, the applicant and the license
holder that are subject to the moratorium or an exclusion established in paragraph (a) are
required to inform the commissioner whether the physical location where the foster care
will be provided is or will be the primary residence of the license holder for the entire period
of licensure. If the primary residence of the applicant or license holder changes, the applicant
or license holder must notify the commissioner immediately. The commissioner shall print
on the foster care license certificate whether or not the physical location is the primary
residence of the license holder.

(g) License holders of foster care homes identified under paragraph (f) that are not the
primary residence of the license holder and that also provide services in the foster care home
that are covered by a federally approved home and community-based services waiver, as
authorized under chapter 256S or section 256B.092 or 256B.49, must inform the human
services licensing division that the license holder provides or intends to provide these
waiver-funded services.

(h) The commissioner may adjust capacity to address needs identified in section
144A.351. Under this authority, the commissioner may approve new licensed settings or
delicense existing settings. Delicensing of settings will be accomplished through a process
identified in section 256B.493.

(i) The commissioner must notify a license holder when its corporate foster care or
community residential setting licensed beds are reduced under this section. The notice of
reduction of licensed beds must be in writing and delivered to the license holder by certified
mail or personal service. The notice must state why the licensed beds are reduced and must
inform the license holder of its right to request reconsideration by the commissioner. The
license holder's request for reconsideration must be in writing. If mailed, the request for
reconsideration must be postmarked and sent to the commissioner within 20 calendar days
after the license holder's receipt of the notice of reduction of licensed beds. If a request for
reconsideration is made by personal service, it must be received by the commissioner within
20 calendar days after the license holder's receipt of the notice of reduction of licensed beds.

(j) The commissioner shall not issue an initial license for children's residential treatment
services licensed under Minnesota Rules, parts 2960.0580 to 2960.0700, under this chapter
for a program that Centers for Medicare and Medicaid Services would consider an institution
for mental diseases. Facilities that serve only private pay clients are exempt from the
moratorium described in this paragraph. The commissioner has the authority to manage
existing statewide capacity for children's residential treatment services subject to the
moratorium under this paragraph and may issue an initial license for such facilities if the
initial license would not increase the statewide capacity for children's residential treatment
services subject to the moratorium under this paragraph.

new text begin EFFECTIVE DATE. new text end

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

Sec. 3.

Minnesota Statutes 2022, section 245A.11, subdivision 7, is amended to read:


Subd. 7.

Adult foster care; variance for alternate overnight supervision.

(a) The
commissioner may grant a variance under section 245A.04, subdivision 9, to rule parts
requiring a caregiver to be present in an adult foster care home during normal sleeping hours
to allow for alternative methods of overnight supervision. The commissioner may grant the
variance if the local county licensing agency recommends the variance and the county
recommendation includes documentation verifying that:

(1) the county has approved the license holder's plan for alternative methods of providing
overnight supervision and determined the plan protects the residents' health, safety, and
rights;

(2) the license holder has obtained written and signed informed consent from each
resident or each resident's legal representative documenting the resident's or legal
representative's agreement with the alternative method of overnight supervision; and

(3) the alternative method of providing overnight supervision, which may include the
use of technology, is specified for each resident in the resident's: (i) individualized plan of
care; (ii) individual service plan under section 256B.092, subdivision 1b, if required; or (iii)
individual resident placement agreement under Minnesota Rules, part 9555.5105, subpart
19, if required.

(b) To be eligible for a variance under paragraph (a), the adult foster care license holder
must not have had a conditional license issued under section 245A.06, or any other licensing
sanction issued under section 245A.07 during the prior 24 months based on failure to provide
adequate supervision, health care services, or resident safety in the adult foster care home.

(c) A license holder requesting a variance under this subdivision to utilize technology
as a component of a plan for alternative overnight supervision may request the commissioner's
review in the absence of a county recommendation. Upon receipt of such a request from a
license holder, the commissioner shall review the variance request with the county.

(d) deleted text begin A variance granted by the commissioner according to this subdivision before January
1, 2014, to a license holder for an adult foster care home must transfer with the license when
the license converts to a community residential setting license under chapter 245D. The
terms and conditions of the variance remain in effect as approved at the time the variance
was granteddeleted text end new text begin The variance requirements under this subdivision for alternative overnight
supervision do not apply to community residential settings licensed under chapter 245Dnew text end .

new text begin EFFECTIVE DATE. new text end

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

Sec. 4.

Minnesota Statutes 2022, section 245A.11, subdivision 7a, is amended to read:


Subd. 7a.

Alternate overnight supervision technology; adult foster care deleted text begin and
community residential settingdeleted text end licenses.

(a) The commissioner may grant an applicant or
license holder an adult foster care deleted text begin or community residential settingdeleted text end license for a residence
that does not have a caregiver in the residence during normal sleeping hours as required
under Minnesota Rules, part 9555.5105, subpart 37, item B, or section 245D.02, subdivision
33b, but uses monitoring technology to alert the license holder when an incident occurs that
may jeopardize the health, safety, or rights of a foster care recipient. The applicant or license
holder must comply with all other requirements under Minnesota Rules, parts 9555.5105
to 9555.6265, or applicable requirements under chapter 245D, and the requirements under
this subdivision. The license printed by the commissioner must state in bold and large font:

(1) that the facility is under electronic monitoring; and

(2) the telephone number of the county's common entry point for making reports of
suspected maltreatment of vulnerable adults under section 626.557, subdivision 9.

(b) Applications for a license under this section must be submitted directly to the
Department of Human Services licensing division. The licensing division must immediately
notify the county licensing agency. The licensing division must collaborate with the county
licensing agency in the review of the application and the licensing of the program.

(c) Before a license is issued by the commissioner, and for the duration of the license,
the applicant or license holder must establish, maintain, and document the implementation
of written policies and procedures addressing the requirements in paragraphs (d) through
(f).

(d) The applicant or license holder must have policies and procedures that:

(1) establish characteristics of target populations that will be admitted into the home,
and characteristics of populations that will not be accepted into the home;

(2) explain the discharge process when a resident served by the program requires
overnight supervision or other services that cannot be provided by the license holder due
to the limited hours that the license holder is on site;

(3) describe the types of events to which the program will respond with a physical
presence when those events occur in the home during time when staff are not on site, and
how the license holder's response plan meets the requirements in paragraph (e), clause (1)
or (2);

(4) establish a process for documenting a review of the implementation and effectiveness
of the response protocol for the response required under paragraph (e), clause (1) or (2).
The documentation must include:

(i) a description of the triggering incident;

(ii) the date and time of the triggering incident;

(iii) the time of the response or responses under paragraph (e), clause (1) or (2);

(iv) whether the response met the resident's needs;

(v) whether the existing policies and response protocols were followed; and

(vi) whether the existing policies and protocols are adequate or need modification.

When no physical presence response is completed for a three-month period, the license
holder's written policies and procedures must require a physical presence response drill to
be conducted for which the effectiveness of the response protocol under paragraph (e),
clause (1) or (2), will be reviewed and documented as required under this clause; and

(5) establish that emergency and nonemergency phone numbers are posted in a prominent
location in a common area of the home where they can be easily observed by a person
responding to an incident who is not otherwise affiliated with the home.

(e) The license holder must document and include in the license application which
response alternative under clause (1) or (2) is in place for responding to situations that
present a serious risk to the health, safety, or rights of residents served by the program:

(1) response alternative (1) requires only the technology to provide an electronic
notification or alert to the license holder that an event is underway that requires a response.
Under this alternative, no more than ten minutes will pass before the license holder will be
physically present on site to respond to the situation; or

(2) response alternative (2) requires the electronic notification and alert system under
alternative (1), but more than ten minutes may pass before the license holder is present on
site to respond to the situation. Under alternative (2), all of the following conditions are
met:

(i) the license holder has a written description of the interactive technological applications
that will assist the license holder in communicating with and assessing the needs related to
the care, health, and safety of the foster care recipients. This interactive technology must
permit the license holder to remotely assess the well being of the resident served by the
program without requiring the initiation of the foster care recipient. Requiring the foster
care recipient to initiate a telephone call does not meet this requirement;

(ii) the license holder documents how the remote license holder is qualified and capable
of meeting the needs of the foster care recipients and assessing foster care recipients' needs
under item (i) during the absence of the license holder on site;

(iii) the license holder maintains written procedures to dispatch emergency response
personnel to the site in the event of an identified emergency; and

(iv) each resident's individualized plan of care, support plan under sections 256B.0913,
subdivision 8; 256B.092, subdivision 1b; 256B.49, subdivision 15; and 256S.10, if required,
or individual resident placement agreement under Minnesota Rules, part 9555.5105, subpart
19, if required, identifies the maximum response time, which may be greater than ten minutes,
for the license holder to be on site for that resident.

(f) Each resident's placement agreement, individual service agreement, and plan must
clearly state that the adult foster care deleted text begin or community residential settingdeleted text end license category is
a program without the presence of a caregiver in the residence during normal sleeping hours;
the protocols in place for responding to situations that present a serious risk to the health,
safety, or rights of residents served by the program under paragraph (e), clause (1) or (2);
and a signed informed consent from each resident served by the program or the person's
legal representative documenting the person's or legal representative's agreement with
placement in the program. If electronic monitoring technology is used in the home, the
informed consent form must also explain the following:

(1) how any electronic monitoring is incorporated into the alternative supervision system;

(2) the backup system for any electronic monitoring in times of electrical outages or
other equipment malfunctions;

(3) how the caregivers or direct support staff are trained on the use of the technology;

(4) the event types and license holder response times established under paragraph (e);

(5) how the license holder protects each resident's privacy related to electronic monitoring
and related to any electronically recorded data generated by the monitoring system. A
resident served by the program may not be removed from a program under this subdivision
for failure to consent to electronic monitoring. The consent form must explain where and
how the electronically recorded data is stored, with whom it will be shared, and how long
it is retained; and

(6) the risks and benefits of the alternative overnight supervision system.

The written explanations under clauses (1) to (6) may be accomplished through
cross-references to other policies and procedures as long as they are explained to the person
giving consent, and the person giving consent is offered a copy.

(g) Nothing in this section requires the applicant or license holder to develop or maintain
separate or duplicative policies, procedures, documentation, consent forms, or individual
plans that may be required for other licensing standards, if the requirements of this section
are incorporated into those documents.

(h) The commissioner may grant variances to the requirements of this section according
to section 245A.04, subdivision 9.

(i) For the purposes of paragraphs (d) through (h), "license holder" has the meaning
under section 245A.02, subdivision 9, and additionally includes all staff, volunteers, and
contractors affiliated with the license holder.

(j) For the purposes of paragraph (e), the terms "assess" and "assessing" mean to remotely
determine what action the license holder needs to take to protect the well-being of the foster
care recipient.

(k) The commissioner shall evaluate license applications using the requirements in
paragraphs (d) to (f). The commissioner shall provide detailed application forms, including
a checklist of criteria needed for approval.

(l) To be eligible for a license under paragraph (a), the adult foster care deleted text begin or community
residential settingdeleted text end license holder must not have had a conditional license issued under section
245A.06 or any licensing sanction under section 245A.07 during the prior 24 months based
on failure to provide adequate supervision, health care services, or resident safety in the
adult foster care home deleted text begin or community residential settingdeleted text end .

(m) The commissioner shall review an application for an alternative overnight supervision
license within 60 days of receipt of the application. When the commissioner receives an
application that is incomplete because the applicant failed to submit required documents or
that is substantially deficient because the documents submitted do not meet licensing
requirements, the commissioner shall provide the applicant written notice that the application
is incomplete or substantially deficient. In the written notice to the applicant, the
commissioner shall identify documents that are missing or deficient and give the applicant
45 days to resubmit a second application that is substantially complete. An applicant's failure
to submit a substantially complete application after receiving notice from the commissioner
is a basis for license denial under section 245A.05. The commissioner shall complete
subsequent review within 30 days.

(n) Once the application is considered complete under paragraph (m), the commissioner
will approve or deny an application for an alternative overnight supervision license within
60 days.

(o) For the purposes of this subdivision, "supervision" means:

(1) oversight by a caregiver or direct support staff as specified in the individual resident's
place agreement or support plan and awareness of the resident's needs and activities; and

(2) the presence of a caregiver or direct support staff in a residence during normal sleeping
hours, unless a determination has been made and documented in the individual's support
plan that the individual does not require the presence of a caregiver or direct support staff
during normal sleeping hours.

new text begin EFFECTIVE DATE. new text end

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

Sec. 5.

Minnesota Statutes 2022, section 245D.03, subdivision 1, is amended to read:


Subdivision 1.

Applicability.

(a) The commissioner shall regulate the provision of home
and community-based services to persons with disabilities and persons age 65 and older
pursuant to this chapter. The licensing standards in this chapter govern the provision of
basic support services and intensive support services.

(b) Basic support services provide the level of assistance, supervision, and care that is
necessary to ensure the health and welfare of the person and do not include services that
are specifically directed toward the training, treatment, habilitation, or rehabilitation of the
person. Basic support services include:

(1) in-home and out-of-home respite care services as defined in section 245A.02,
subdivision 15, and under the brain injury, community alternative care, community access
for disability inclusion, developmental disabilities, and elderly waiver plans, excluding
out-of-home respite care provided to children in a family child foster care home licensed
under Minnesota Rules, parts 2960.3000 to 2960.3100, when the child foster care license
holder complies with the requirements under section 245D.06, subdivisions 5, 6, 7, and 8,
or successor provisions; and section 245D.061 or successor provisions, which must be
stipulated in the statement of intended use required under Minnesota Rules, part 2960.3000,
subpart 4;

(2) adult companion services as defined under the brain injury, community access for
disability inclusion, community alternative care, and elderly waiver plans, excluding adult
companion services provided under the Corporation for National and Community Services
Senior Companion Program established under the Domestic Volunteer Service Act of 1973,
Public Law 98-288;

(3) personal support as defined under the developmental disabilities waiver plan;

(4) 24-hour emergency assistance, personal emergency response as defined under the
community access for disability inclusion and developmental disabilities waiver plans;

(5) night supervision services as defined under the brain injury, community access for
disability inclusion, community alternative care, and developmental disabilities waiver
plans;

(6) homemaker services as defined under the community access for disability inclusion,
brain injury, community alternative care, developmental disabilities, and elderly waiver
plans, excluding providers licensed by the Department of Health under chapter 144A and
those providers providing cleaning services only;

(7) individual community living support under section 256S.13; and

(8) individualized home supports services as defined under the brain injury, community
alternative care, and community access for disability inclusion, and developmental disabilities
waiver plans.

(c) Intensive support services provide assistance, supervision, and care that is necessary
to ensure the health and welfare of the person and services specifically directed toward the
training, habilitation, or rehabilitation of the person. Intensive support services include:

(1) intervention services, including:

(i) positive support services as defined under the brain injury and community access for
disability inclusion, community alternative care, and developmental disabilities waiver
plans;

(ii) in-home or out-of-home crisis respite services as defined under the brain injury,
community access for disability inclusion, community alternative care, and developmental
disabilities waiver plans; and

(iii) specialist services as defined under the current brain injury, community access for
disability inclusion, community alternative care, and developmental disabilities waiver
plans;

(2) in-home support services, including:

(i) in-home family support and supported living services as defined under the
developmental disabilities waiver plan;

(ii) independent living services training as defined under the brain injury and community
access for disability inclusion waiver plans;

(iii) semi-independent living services;

(iv) individualized home support with training services as defined under the brain injury,
community alternative care, community access for disability inclusion, and developmental
disabilities waiver plans; and

(v) individualized home support with family training services as defined under the brain
injury, community alternative care, community access for disability inclusion, and
developmental disabilities waiver plans;

(3) residential supports and services, including:

(i) supported living services as defined under the developmental disabilities waiver plan
provided in a family or corporate child foster care residence, a family adult foster care
residence, a community residential setting, or a supervised living facility;

(ii) foster care services as defined in the brain injury, community alternative care, and
community access for disability inclusion waiver plans provided in a family or corporate
child foster care residence, a family adult foster care residence, or a community residential
setting;

(iii) community residential services as defined under the brain injury, community
alternative care, community access for disability inclusion, and developmental disabilities
waiver plans provided in a corporate child foster care residence, a community residential
setting, or a supervised living facility;

(iv) family residential services as defined in the brain injury, community alternative
care, community access for disability inclusion, and developmental disabilities waiver plans
provided in a family child foster care residence or a family adult foster care residence; deleted text begin and
deleted text end

(v) residential services provided to more than four persons with developmental disabilities
in a supervised living facility, including ICFs/DD;new text begin and
new text end

new text begin (vi) life sharing as defined in the brain injury, community alternative care, community
access for disability inclusion, and developmental disabilities waiver plans;
 new text end

(4) day services, including:

(i) structured day services as defined under the brain injury waiver plan;

(ii) day services under sections 252.41 to 252.46, and as defined under the brain injury,
community alternative care, community access for disability inclusion, and developmental
disabilities waiver plans;

(iii) day training and habilitation services under sections 252.41 to 252.46, and as defined
under the developmental disabilities waiver plan; and

(iv) prevocational services as defined under the brain injury, community alternative care,
community access for disability inclusion, and developmental disabilities waiver plans; and

(5) employment exploration services as defined under the brain injury, community
alternative care, community access for disability inclusion, and developmental disabilities
waiver plans;

(6) employment development services as defined under the brain injury, community
alternative care, community access for disability inclusion, and developmental disabilities
waiver plans;

(7) employment support services as defined under the brain injury, community alternative
care, community access for disability inclusion, and developmental disabilities waiver plans;
and

(8) integrated community support as defined under the brain injury and community
access for disability inclusion waiver plans beginning January 1, 2021, and community
alternative care and developmental disabilities waiver plans beginning January 1, 2023.

new text begin EFFECTIVE DATE. new text end

new text begin This section is effective January 1, 2026, or upon federal approval,
whichever is later. The commissioner of human services shall notify the revisor of statutes
when federal approval is obtained.
 new text end

Sec. 6.

new text begin [245D.261] COMMUNITY RESIDENTIAL SETTINGS; REMOTE
OVERNIGHT SUPERVISION.
 new text end

new text begin Subdivision 1. new text end

new text begin Definitions. new text end

new text begin (a) For purposes of this section, the following terms have
the meanings given, unless otherwise specified.
 new text end

new text begin (b) "Resident" means an adult residing in a community residential setting.
 new text end

new text begin (c) "Technology" means:
 new text end

new text begin (1) enabling technology, which is a device capable of live two-way communication or
engagement between a resident and direct support staff at a remote location; or
 new text end

new text begin (2) monitoring technology, which is the use of equipment to oversee, monitor, and
supervise an individual who receives medical assistance waiver or alternative care services
under section 256B.0913, 256B.092, or 256B.49 or chapter 256S.
 new text end

new text begin Subd. 2. new text end

new text begin Documentation of permissible remote overnight supervision. new text end

new text begin A license
holder providing remote overnight supervision in a community residential setting in lieu of
on-site direct support staff must comply with the requirements of this chapter, including
the requirement under section 245D.02, subdivision 33b, paragraph (a), clause (3), that the
absence of direct support staff from the community residential setting while services are
being delivered must be documented in the resident's support plan or support plan addendum.
 new text end

new text begin Subd. 3. new text end

new text begin Provider requirements for remote overnight supervision; commissioner
notification. new text end

new text begin (a) A license holder providing remote overnight supervision in a community
residential setting must:
 new text end

new text begin (1) use technology;
 new text end

new text begin (2) notify the commissioner of the community residential setting's intent to use technology
in lieu of on-site staff. The notification must:
 new text end

new text begin (i) indicate a start date for the use of technology; and
 new text end

new text begin (ii) attest that all requirements under this section are met and policies required under
subdivision 4 are available upon request;
 new text end

new text begin (3) clearly state in each person's support plan addendum that the community residential
setting is a program without the in-person presence of overnight direct support;
 new text end

new text begin (4) include with each person's support plan addendum the license holder's protocols for
responding to situations that present a serious risk to the health, safety, or rights of residents
served by the program; and
 new text end

new text begin (5) include in each person's support plan addendum the person's maximum permissible
response time as determined by the person's support team.
 new text end

new text begin (b) Upon being notified via technology that an incident has occurred that may jeopardize
the health, safety, or rights of a resident, the license holder must document an evaluation
of the need for the physical presence of a staff member. If a physical presence is needed, a
staff person, volunteer, or contractor must be on site to respond to the situation within the
resident's maximum permissible response time.
 new text end

new text begin (c) A license holder must notify the commissioner if remote overnight supervision
technology will no longer be used by the license holder.
 new text end

new text begin (d) Upon receipt of notification of use of remote overnight supervision or discontinuation
of use of remote overnight supervision by a license holder, the commissioner shall notify
the county licensing agency and update the license.
 new text end

new text begin Subd. 4. new text end

new text begin Required policies and procedures for remote overnight supervision. new text end

new text begin (a) A
license holder providing remote overnight supervision must have policies and procedures
that:
 new text end

new text begin (1) protect the residents' health, safety, and rights;
 new text end

new text begin (2) explain the discharge process if a person served by the program requires in-person
supervision or other services that cannot be provided by the license holder due to the limited
hours that direct support staff are on site, including information explaining that if a resident
provides informed consent to the use of monitoring technology but later revokes their
consent, the resident may be subject to a service termination in accordance with section
245D.10, subdivision 3a;
 new text end

new text begin (3) ensure that services may not be terminated for any person or resident currently served
by the program and receiving in-person services solely because the person declines to
provide informed consent to the initial change to the use of monitoring technology as required
under subdivision 5;
 new text end

new text begin (4) explain the backup system for technology in times of electrical outages or other
equipment malfunctions;
 new text end

new text begin (5) explain how the license holder trains the direct support staff on the use of the
technology; and
 new text end

new text begin (6) establish a plan for dispatching emergency response personnel to the site in the event
of an identified emergency.
 new text end

new text begin (b) Nothing in this section requires the license holder to develop or maintain separate
or duplicative policies, procedures, documentation, consent forms, or individual plans that
may be required for other licensing standards if the requirements of this section are
incorporated into those documents.
 new text end

new text begin (c) When no physical presence response is completed for a three-month period, the
license holder must conduct a physical presence response drill. The effectiveness of the
response protocol must be reviewed and documented.
 new text end

new text begin Subd. 5. new text end

new text begin Consent to use of monitoring technology. new text end

new text begin If a license holder uses monitoring
technology in a community residential setting, the license holder must obtain a signed
informed consent form from each resident served by the program or the resident's legal
representative documenting the resident's or legal representative's agreement to use of the
specific monitoring technology used in the setting. The informed consent form documenting
this agreement must also explain:
 new text end

new text begin (1) how the license holder uses monitoring technology to provide remote supervision;
 new text end

new text begin (2) the risks and benefits of using monitoring technology;
 new text end

new text begin (3) how the license holder protects each resident's privacy while monitoring technology
is being used in the setting; and
 new text end

new text begin (4) how the license holder protects each resident's privacy when the monitoring
technology system electronically records personally identifying data.
 new text end

new text begin EFFECTIVE DATE. new text end

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

Sec. 7.

new text begin [252.54] STATEWIDE DISABILITY EMPLOYMENT TECHNICAL
ASSISTANCE CENTER.
 new text end

new text begin The commissioner must establish a statewide technical assistance center to provide
resources and assistance to programs, people, and families to support individuals with
disabilities to achieve meaningful and competitive employment in integrated settings. Duties
of the technical assistance center include but are not limited to:
 new text end

new text begin (1) offering provider business model transition support to ensure ongoing access to
employment and day services;
 new text end

new text begin (2) identifying and providing training on innovative, promising, and emerging practices;
 new text end

new text begin (3) maintaining a resource clearinghouse to serve as a hub of information to ensure
programs, people, and families have access to high-quality materials and information;
 new text end

new text begin (4) fostering innovation and actionable progress by providing direct technical assistance
to programs; and
 new text end

new text begin (5) cultivating partnerships and mentorship across support programs, people, and families
in the exploration of and successful transition to competitive, integrated employment.
 new text end

Sec. 8.

new text begin [252.55] LEAD AGENCY EMPLOYMENT FIRST CAPACITY BUILDING
GRANTS.
 new text end

new text begin The commissioner shall establish a grant program to expand lead agency capacity to
support people with disabilities to contemplate, explore, and maintain competitive, integrated
employment options. Allowable uses of money include:
 new text end

new text begin (1) enhancing resources and staffing to support people and families in understanding
employment options and navigating service options;
 new text end

new text begin (2) implementing and testing innovative approaches to better support people with
disabilities and their families in achieving competitive, integrated employment; and
 new text end

new text begin (3) other activities approved by the commissioner.
 new text end

Sec. 9.

Minnesota Statutes 2022, section 256.01, subdivision 19, is amended to read:


Subd. 19.

Grants for deleted text begin case managementdeleted text end new text begin supportivenew text end services to persons with HIV or
AIDS.

The commissioner may award grants to eligible vendors for the development,
implementation, and evaluation of deleted text begin case managementdeleted text end new text begin supportivenew text end services for individuals
infected with the human immunodeficiency virus. HIV/AIDS deleted text begin case managementdeleted text end new text begin supportivenew text end
services will be provided to increase access to cost effective health care services, to reduce
the risk of HIV transmission, to ensure that basic client needs are met, and to increase client
access to needed community supports or services.

Sec. 10.

new text begin [256.4764] LONG-TERM SERVICES AND SUPPORTS WORKFORCE
INCENTIVE GRANTS.
 new text end

new text begin Subdivision 1. new text end

new text begin Grant program established. new text end

new text begin The commissioner of human services shall
establish grants for long-term services and supports providers and facilities to assist with
recruiting and retaining direct support professionals.
 new text end

new text begin Subd. 2. new text end

new text begin Definitions. new text end

new text begin (a) For purposes of this section, the following terms have the
meanings given.
 new text end

new text begin (b) "Commissioner" means the commissioner of human services.
 new text end

new text begin (c) "Eligible employer" means an organization enrolled in a Minnesota health care
program that is:
 new text end

new text begin (1) a provider of home and community-based services under Minnesota Statutes, chapter
245D;
 new text end

new text begin (2) a facility certified as an intermediate care facility for persons with developmental
disabilities;
 new text end

new text begin (3) a nursing facility under section 256R.02, subdivision 33;
 new text end

new text begin (4) a provider of personal care assistance services under section 256B.0659;
 new text end

new text begin (5) a provider of community first services and supports under section 256B.85;
 new text end

new text begin (6) a provider of early intensive developmental and behavioral intervention services
under section 256B.0949;
 new text end

new text begin (7) a provider of home care services as defined under section 256B.0651, subdivision
1, paragraph (d);
 new text end

new text begin (8) an eligible financial management services provider serving people through
consumer-directed community supports under chapter 256S and sections 256B.092 and
256B.49, or consumer support grants under section 256.476; or
 new text end

new text begin (9) a provider of customized living services as defined in section 256S.02.
 new text end

new text begin (d) "Eligible worker" means a worker who earns $30 per hour or less and is currently
employed or recruited to be employed by an eligible employer.
 new text end

new text begin Subd. 3. new text end

new text begin Allowable uses of grant money. new text end

new text begin (a) Grantees must use grant money to provide
payments to eligible workers for the following purposes:
 new text end

new text begin (1) retention, recruitment, and incentive payments;
 new text end

new text begin (2) postsecondary loan and tuition payments;
 new text end

new text begin (3) child care costs;
 new text end

new text begin (4) transportation-related costs;
 new text end

new text begin (5) personal care assistant background study costs; and
 new text end

new text begin (6) other costs associated with retaining and recruiting workers, as approved by the
commissioner.
 new text end

new text begin (b) Eligible workers may receive cumulative payments up to $1,000 per year from the
workforce incentive grant account and all other state money intended for the same purpose.
 new text end

new text begin (c) The commissioner must develop a grant cycle distribution plan that allows for
equitable distribution of money among eligible employers. The commissioner's determination
of the grant awards and amounts is final and is not subject to appeal.
 new text end

new text begin Subd. 4. new text end

new text begin Attestation. new text end

new text begin As a condition of obtaining grant payments under this section, an
eligible employer must attest and agree to the following:
 new text end

new text begin (1) the employer is an eligible employer;
 new text end

new text begin (2) the total number of eligible employees;
 new text end

new text begin (3) the employer will distribute the entire value of the grant to eligible workers allowed
under this section;
 new text end

new text begin (4) the employer will create and maintain records under subdivision 6;
 new text end

new text begin (5) the employer will not use the money appropriated under this section for any purpose
other than the purposes permitted under this section; and
 new text end

new text begin (6) the entire value of any grant amounts will be distributed to eligible workers identified
by the employer.
 new text end

new text begin Subd. 5. new text end

new text begin Distribution plan; report. new text end

new text begin (a) Each grantee shall prepare, and upon request
submit to the commissioner, a distribution plan that specifies the amount of money the
grantee expects to receive and how that money will be distributed for recruitment and
retention purposes for eligible employees. Within 60 days of receiving the grant, the grantee
must post the distribution plan and leave it posted for a period of at least six months in an
area of the grantee's operation to which all direct support professionals have access.
 new text end

new text begin (b) Within 12 months of receiving a grant under this section, each grantee that receives
a grant shall submit a report to the commissioner that includes the following information:
 new text end

new text begin (1) a description of how grant money was distributed to eligible employees; and
 new text end

new text begin (2) the total dollar amount distributed.
 new text end

new text begin (c) Failure to submit the report under paragraph (b) may result in recoupment of grant
money.
 new text end

new text begin Subd. 6. new text end

new text begin Audits and recoupment. new text end

new text begin (a) The commissioner may perform an audit under
this section up to six years after a grant is awarded to ensure:
 new text end

new text begin (1) the grantee used the money solely for allowable purposes under subdivision 3;
 new text end

new text begin (2) the grantee was truthful when making attestations under subdivision 4; and
 new text end

new text begin (3) the grantee complied with the conditions of receiving a grant under this section.
 new text end

new text begin (b) If the commissioner determines that a grantee used grant money for purposes not
authorized under this section, the commissioner must treat any amount used for a purpose
not authorized under this section as an overpayment. The commissioner must recover any
overpayment.
 new text end

new text begin Subd. 7. new text end

new text begin Grants not to be considered income. new text end

new text begin (a) Notwithstanding any law to the
contrary, grant awards under this section must not be considered income, assets, or personal
property for purposes of determining eligibility or recertifying eligibility for:
 new text end

new text begin (1) child care assistance programs under chapter 119B;
 new text end

new text begin (2) general assistance, Minnesota supplemental aid, and food support under chapter
256D;
 new text end

new text begin (3) housing support under chapter 256I;
 new text end

new text begin (4) the Minnesota family investment program and diversionary work program under
chapter 256J; and
 new text end

new text begin (5) economic assistance programs under chapter 256P.
 new text end

new text begin (b) The commissioner must not consider grant awards under this section as income or
assets under section 256B.056, subdivision 1a, paragraph (a), 3, or 3c, or for persons with
eligibility determined under section 256B.057, subdivision 3, 3a, 3b, 4, or 9.
 new text end

new text begin Subd. 8. new text end

new text begin Income tax subtractions. new text end

new text begin (a) For the purposes of this section, "subtraction"
has the meaning given in section 290.0132, subdivision 1, and the rules in that subdivision
apply for this section. The definitions in section 290.01 apply to this section.
 new text end

new text begin (b) The amount of a payment received under this section is a subtraction.
 new text end

new text begin (c) Payments under this section and Laws 2021, First Special Session chapter 7, article
17, section 20, as amended, are excluded from income as defined in sections 290.0674,
subdivision 2a, and 290A.03, subdivision 3.
 new text end

new text begin Subd. 9. new text end

new text begin Account created. new text end

new text begin A workforce incentive grant account is created in the special
revenue fund. Appropriations made for grants and payments administered under this section
may be transferred to this account. Amounts in the account are appropriated to the
commissioner of human services. Appropriations transferred to this account cancel and are
returned to the fund of origin on the date the original appropriations would have lapsed.
 new text end

new text begin Subd. 10. new text end

new text begin Nursing facilities; applicable credit. new text end

new text begin The commissioner must treat grant
payments awarded under this section as an applicable credit as defined under section 256R.10,
subdivision 6.
 new text end

new text begin Subd. 11. new text end

new text begin Self-directed services workforce. new text end

new text begin Payments administered under this section,
including reimbursements for paid family medical leave premiums, do not constitute a
change in a term or condition for individual providers as defined in section 256B.0711 in
covered programs and are not subject to the state's obligation to meet and negotiate under
chapter 179A.
 new text end

Sec. 11.

new text begin [256.4773] TECHNOLOGY FOR HOME GRANT.
 new text end

new text begin Subdivision 1. new text end

new text begin Establishment. new text end

new text begin The commissioner must establish a technology for home
grant program that provides assistive technology consultations and resources for people
with disabilities who want to stay in their own home, move to their own home, or remain
in a less restrictive residential setting. The grant program may be administered using a team
approach that allows multiple professionals to assess and meet a person's assistive technology
needs. The team may include but is not limited to occupational therapists, physical therapists,
speech therapists, nurses, and engineers.
 new text end

new text begin Subd. 2. new text end

new text begin Eligible applicants. new text end

new text begin An eligible applicant is a person who uses or is eligible
for home care services under section 256B.0651, home and community-based services under
section 256B.092 or 256B.49, personal care assistance under section 256B.0659, or
community first services and supports under section 256B.85, and who meets one of the
following conditions:
 new text end

new text begin (1) lives in the applicant's own home and may benefit from assistive technology for
safety, communication, community engagement, or independence;
 new text end

new text begin (2) is currently seeking to live in the applicant's own home and needs assistive technology
to meet that goal; or
 new text end

new text begin (3) resides in a residential setting under section 256B.4914, subdivision 3, and is seeking
to reduce reliance on paid staff to live more independently in the setting.
 new text end

new text begin Subd. 3. new text end

new text begin Allowable grant activities. new text end

new text begin The technology for home grant program must
provide at-home, in-person assistive technology consultation and technical assistance to
help people with disabilities live more independently. Allowable activities include but are
not limited to:
 new text end

new text begin (1) consultations in people's homes, workplaces, or community locations;
 new text end

new text begin (2) connecting people to resources to help them live in their own homes, transition to
their own homes, or live more independently in residential settings;
 new text end

new text begin (3) conducting training for and set up and installation of assistive technology; and
 new text end

new text begin (4) participating on a person's care team to develop a plan to ensure assistive technology
goals are met.
 new text end

new text begin Subd. 4. new text end

new text begin Data collection and outcomes. new text end

new text begin Grantees must provide data summaries to the
commissioner for the purpose of evaluating the effectiveness of the grant program. The
commissioner must identify outcome measures to evaluate program activities to assess
whether the grant programs help people transition to or remain in the least restrictive setting.
 new text end

Sec. 12.

Minnesota Statutes 2022, section 256B.0659, subdivision 1, is amended to read:


Subdivision 1.

Definitions.

(a) For the purposes of this section, the terms defined in
paragraphs (b) to (r) have the meanings given unless otherwise provided in text.

(b) "Activities of daily living" means grooming, dressing, bathing, transferring, mobility,
positioning, eating, and toileting.

(c) "Behavior," effective January 1, 2010, means a category to determine the home care
rating and is based on the criteria found in this section. "Level I behavior" means physical
aggression deleted text begin towardsdeleted text end new text begin towardnew text end self, others, or destruction of property that requires the immediate
response of another person.

(d) "Complex health-related needs," effective January 1, 2010, means a category to
determine the home care rating and is based on the criteria found in this section.

(e) "Critical activities of daily living," effective January 1, 2010, means transferring,
mobility, eating, and toileting.

(f) "Dependency in activities of daily living" means a person requires assistance to begin
and complete one or more of the activities of daily living.

(g) "Extended personal care assistance service" means personal care assistance services
included in a service plan under one of the home and community-based services waivers
authorized under chapter 256S and sections 256B.092, subdivision 5, and 256B.49, which
exceed the amount, duration, and frequency of the state plan personal care assistance services
for participants who:

(1) need assistance provided periodically during a week, but less than daily will not be
able to remain in their homes without the assistance, and other replacement services are
more expensive or are not available when personal care assistance services are to be reduced;
or

(2) need additional personal care assistance services beyond the amount authorized by
the state plan personal care assistance assessment in order to ensure that their safety, health,
and welfare are provided for in their homes.

(h) "Health-related procedures and tasks" means procedures and tasks that can be
delegated or assigned by a licensed health care professional under state law to be performed
by a personal care assistant.

(i) "Instrumental activities of daily living" means activities to include meal planning and
preparation; basic assistance with paying bills; shopping for food, clothing, and other
essential items; performing household tasks integral to the personal care assistance services;
communication by telephone and other media; and traveling, including to medical
appointments and to participate in the community.new text begin For purposes of this paragraph, traveling
includes driving and accompanying the recipient in the recipient's chosen mode of
transportation and according to the recipient's personal care assistance care plan.
new text end

(j) "Managing employee" has the same definition as Code of Federal Regulations, title
42, section 455.

(k) "Qualified professional" means a professional providing supervision of personal care
assistance services and staff as defined in section 256B.0625, subdivision 19c.

(l) "Personal care assistance provider agency" means a medical assistance enrolled
provider that provides or assists with providing personal care assistance services and includes
a personal care assistance provider organization, personal care assistance choice agency,
class A licensed nursing agency, and Medicare-certified home health agency.

(m) "Personal care assistant" or "PCA" means an individual employed by a personal
care assistance agency who provides personal care assistance services.

(n) "Personal care assistance care plan" means a written description of personal care
assistance services developed by the personal care assistance provider according to the
service plan.

(o) "Responsible party" means an individual who is capable of providing the support
necessary to assist the recipient to live in the community.

(p) "Self-administered medication" means medication taken orally, by injection, nebulizer,
or insertion, or applied topically without the need for assistance.

(q) "Service plan" means a written summary of the assessment and description of the
services needed by the recipient.

(r) "Wages and benefits" means wages and salaries, the employer's share of FICA taxes,
Medicare taxes, state and federal unemployment taxes, workers' compensation, mileage
reimbursement, health and dental insurance, life insurance, disability insurance, long-term
care insurance, uniform allowance, and contributions to employee retirement accounts.

new text begin EFFECTIVE DATE. new text end

new text begin This section is effective 90 days following federal approval. The
commissioner of human services shall notify the revisor of statutes when federal approval
is obtained.
 new text end

Sec. 13.

Minnesota Statutes 2022, section 256B.0659, subdivision 12, is amended to read:


Subd. 12.

Documentation of personal care assistance services provided.

(a) Personal
care assistance services for a recipient must be documented daily by each personal care
assistant, on a time sheet form approved by the commissioner. All documentation may be
web-based, electronic, or paper documentation. The completed form must be submitted on
a monthly basis to the provider and kept in the recipient's health record.

(b) The activity documentation must correspond to the personal care assistance care plan
and be reviewed by the qualified professional.

(c) The personal care assistant time sheet must be on a form approved by the
commissioner documenting time the personal care assistant provides services in the home.
The following criteria must be included in the time sheet:

(1) full name of personal care assistant and individual provider number;

(2) provider name and telephone numbers;

(3) full name of recipient and either the recipient's medical assistance identification
number or date of birth;

(4) consecutive dates, including month, day, and year, and arrival and departure times
with a.m. or p.m. notations;

(5) signatures of recipient or the responsible party;

(6) personal signature of the personal care assistant;

(7) any shared care provided, if applicable;

(8) a statement that it is a federal crime to provide false information on personal care
service billings for medical assistance payments; deleted text begin and
deleted text end

(9) dates and location of recipient stays in a hospital, care facility, or incarcerationnew text begin ; and
new text end

new text begin (10) any time spent traveling, as described in subdivision 1, paragraph (i), including
start and stop times with a.m. and p.m. designations, the origination site, and the destination
sitenew text end .

new text begin EFFECTIVE DATE. new text end

new text begin This section is effective 90 days following federal approval. The
commissioner of human services shall notify the revisor of statutes when federal approval
is obtained.
 new text end

Sec. 14.

Minnesota Statutes 2022, section 256B.0659, is amended by adding a subdivision
to read:


new text begin Subd. 14a. new text end

new text begin Qualified professional; remote supervision. new text end

new text begin (a) For recipients with chronic
health conditions or severely compromised immune systems, a qualified professional may
conduct the supervision required under subdivision 14 via two-way interactive audio and
visual telecommunication if, at the recipient's request, the recipient's primary health care
provider:
 new text end

new text begin (1) determines that remote supervision is appropriate; and
 new text end

new text begin (2) documents the determination under clause (1) in a statement of need or other document
that is subsequently included in the recipient's personal care assistance care plan.
 new text end

new text begin (b) Notwithstanding any other provision of law, a care plan developed or amended via
remote supervision may be executed by electronic signature.
 new text end

new text begin (c) A personal care assistance provider agency must not conduct its first supervisory
visit for a recipient or complete its initial personal care assistance care plan via a remote
visit.
 new text end

new text begin (d) A recipient may request to return to in-person supervisory visits at any time.
 new text end

new text begin EFFECTIVE DATE. new text end

new text begin This section is effective July 1, 2023, or upon federal approval,
whichever is later. The commissioner of human services shall notify the revisor of statutes
when federal approval is obtained.
 new text end

Sec. 15.

Minnesota Statutes 2022, section 256B.0659, subdivision 19, is amended to read:


Subd. 19.

Personal care assistance choice option; qualifications; duties.

(a) Under
personal care assistance choice, the recipient or responsible party shall:

(1) recruit, hire, schedule, and terminate personal care assistants according to the terms
of the written agreement required under subdivision 20, paragraph (a);

(2) develop a personal care assistance care plan based on the assessed needs and
addressing the health and safety of the recipient with the assistance of a qualified professional
as needed;

(3) orient and train the personal care assistant with assistance as needed from the qualified
professional;

(4) supervise and evaluate the personal care assistant with the qualified professional,
who is required to visit the recipient at least every 180 days;

(5) monitor and verify in writing and report to the personal care assistance choice agency
the number of hours worked by the personal care assistant and the qualified professional;

(6) engage in an annual reassessment as required in subdivision 3a to determine
continuing eligibility and service authorization; deleted text begin and
deleted text end

(7) use the same personal care assistance choice provider agency if shared personal
assistance care is being useddeleted text begin .deleted text end new text begin ; and
new text end

new text begin (8) ensure that a personal care assistant driving the recipient under subdivision 1,
paragraph (i), has a valid driver's license and the vehicle used is registered and insured
according to Minnesota law.
 new text end

(b) The personal care assistance choice provider agency shall:

(1) meet all personal care assistance provider agency standards;

(2) enter into a written agreement with the recipient, responsible party, and personal
care assistants;

(3) not be related as a parent, child, sibling, or spouse to the recipient or the personal
care assistant; and

(4) ensure arm's-length transactions without undue influence or coercion with the recipient
and personal care assistant.

(c) The duties of the personal care assistance choice provider agency are to:

(1) be the employer of the personal care assistant and the qualified professional for
employment law and related regulations including but not limited to purchasing and
maintaining workers' compensation, unemployment insurance, surety and fidelity bonds,
and liability insurance, and submit any or all necessary documentation including but not
limited to workers' compensation, unemployment insurance, and labor market data required
under section 256B.4912, subdivision 1a;

(2) bill the medical assistance program for personal care assistance services and qualified
professional services;

(3) request and complete background studies that comply with the requirements for
personal care assistants and qualified professionals;

(4) pay the personal care assistant and qualified professional based on actual hours of
services provided;

(5) withhold and pay all applicable federal and state taxes;

(6) verify and keep records of hours worked by the personal care assistant and qualified
professional;

(7) make the arrangements and pay taxes and other benefits, if any, and comply with
any legal requirements for a Minnesota employer;

(8) enroll in the medical assistance program as a personal care assistance choice agency;
and

(9) enter into a written agreement as specified in subdivision 20 before services are
provided.

new text begin EFFECTIVE DATE. new text end

new text begin This section is effective 90 days following federal approval. The
commissioner of human services shall notify the revisor of statutes when federal approval
is obtained.
 new text end

Sec. 16.

Minnesota Statutes 2022, section 256B.0659, subdivision 24, is amended to read:


Subd. 24.

Personal care assistance provider agency; general duties.

A personal care
assistance provider agency shall:

(1) enroll as a Medicaid provider meeting all provider standards, including completion
of the required provider training;

(2) comply with general medical assistance coverage requirements;

(3) demonstrate compliance with law and policies of the personal care assistance program
to be determined by the commissioner;

(4) comply with background study requirements;

(5) verify and keep records of hours worked by the personal care assistant and qualified
professional;

(6) not engage in any agency-initiated direct contact or marketing in person, by phone,
or other electronic means to potential recipients, guardians, or family members;

(7) pay the personal care assistant and qualified professional based on actual hours of
services provided;

(8) withhold and pay all applicable federal and state taxes;

(9) document that the agency uses a minimum of 72.5 percent of the revenue generated
by the medical assistance rate for personal care assistance services for employee personal
care assistant wages and benefits. The revenue generated by the qualified professional and
the reasonable costs associated with the qualified professional shall not be used in making
this calculation;

(10) make the arrangements and pay unemployment insurance, taxes, workers'
compensation, liability insurance, and other benefits, if any;

(11) enter into a written agreement under subdivision 20 before services are provided;

(12) report suspected neglect and abuse to the common entry point according to section
256B.0651;

(13) provide the recipient with a copy of the home care bill of rights at start of service;

(14) request reassessments at least 60 days prior to the end of the current authorization
for personal care assistance services, on forms provided by the commissioner;

(15) comply with the labor market reporting requirements described in section 256B.4912,
subdivision 1a; deleted text begin and
deleted text end

(16) document that the agency uses the additional revenue due to the enhanced rate under
subdivision 17a for the wages and benefits of the PCAs whose services meet the requirements
under subdivision 11, paragraph (d)new text begin ; and
new text end

new text begin (17) ensure that a personal care assistant driving a recipient under subdivision 1,
paragraph (i), has a valid driver's license and the vehicle used is registered and insured
according to Minnesota lawnew text end .

new text begin EFFECTIVE DATE. new text end

new text begin This section is effective 90 days following federal approval. The
commissioner of human services shall notify the revisor of statutes when federal approval
is obtained.
 new text end

Sec. 17.

Minnesota Statutes 2022, section 256B.0911, subdivision 13, is amended to read:


Subd. 13.

MnCHOICES assessor qualifications, training, and certification.

(a) The
commissioner shall develop and implement a curriculum and an assessor certification
process.

(b) MnCHOICES certified assessors must:

(1) either have a bachelor's degree in social work, nursing with a public health nursing
certificate, or other closely related field deleted text begin with at least one year of home and community-based
experiencedeleted text end or be a registered nurse with at least two years of home and community-based
experience; and

(2) have received training and certification specific to assessment and consultation for
long-term care services in the state.

(c) Certified assessors shall demonstrate best practices in assessment and support
planning, including person-centered planning principles, and have a common set of skills
that ensures consistency and equitable access to services statewide.

(d) Certified assessors must be recertified every three years.

Sec. 18.

Minnesota Statutes 2022, section 256B.092, subdivision 1a, is amended to read:


Subd. 1a.

Case management services.

(a) Each recipient of a home and community-based
waiver shall be provided case management services by qualified vendors as described in
the federally approved waiver application.

(b) Case management service activities provided to or arranged for a person include:

(1) development of the person-centered support plan under subdivision 1b;

(2) informing the individual or the individual's legal guardian or conservator, or parent
if the person is a minor, of service options, including all service options available under the
waiver plan;

(3) consulting with relevant medical experts or service providers;

(4) assisting the person in the identification of potential providers of chosen services,
including:

(i) providers of services provided in a non-disability-specific setting;

(ii) employment service providers;

(iii) providers of services provided in settings that are not controlled by a provider; and

(iv) providers of financial management services;

(5) assisting the person to access services and assisting in appeals under section 256.045;

(6) coordination of services, if coordination is not provided by another service provider;

(7) evaluation and monitoring of the services identified in the support plan, which must
incorporate at least one annual face-to-face visit by the case manager with each person; and

(8) reviewing support plans and providing the lead agency with recommendations for
service authorization based upon the individual's needs identified in the support plan.

(c) Case management service activities that are provided to the person with a
developmental disability shall be provided directly by county agencies or under contract.
If a county agency contracts for case management services, the county agency must provide
each recipient of home and community-based services who is receiving contracted case
management services with the contact information the recipient may use to file a grievance
with the county agency about the quality of the contracted services the recipient is receiving
from a county-contracted case manager. Case management services must be provided by a
public or private agency that is enrolled as a medical assistance provider determined by the
commissioner to meet all of the requirements in the approved federal waiver plans. Case
management services must not be provided to a recipient by a private agency that has a
financial interest in the provision of any other services included in the recipient's support
plan. For purposes of this section, "private agency" means any agency that is not identified
as a lead agency under section 256B.0911, subdivision 10.

(d) Case managers are responsible for service provisions listed in paragraphs (a) and
(b). Case managers shall collaborate with consumers, families, legal representatives, and
relevant medical experts and service providers in the development and annual review of the
person-centered support plan and habilitation plan.

(e) For persons who need a positive support transition plan as required in chapter 245D,
the case manager shall participate in the development and ongoing evaluation of the plan
with the expanded support team. At least quarterly, the case manager, in consultation with
the expanded support team, shall evaluate the effectiveness of the plan based on progress
evaluation data submitted by the licensed provider to the case manager. The evaluation must
identify whether the plan has been developed and implemented in a manner to achieve the
following within the required timelines:

(1) phasing out the use of prohibited procedures;

(2) acquisition of skills needed to eliminate the prohibited procedures within the plan's
timeline; and

(3) accomplishment of identified outcomes.

If adequate progress is not being made, the case manager shall consult with the person's
expanded support team to identify needed modifications and whether additional professional
support is required to provide consultation.

(f) The Department of Human Services shall offer ongoing education in case management
to case managers. Case managers shall receive no less than deleted text begin tendeleted text end new text begin 20new text end hours of case management
education and disability-related training each year. The education and training must include
person-centered planningnew text begin , informed choice, cultural competency, employment planning,
community living planning, self-direction options, and use of technology supportsnew text end . new text begin By
August 1, 2024, all case managers must complete an employment support training course
identified by the commissioner of human services. For case managers hired after August
1, 2024, this training must be completed within the first six months of providing case
management services.new text end For the purposes of this section, "person-centered planning" or
"person-centered" has the meaning given in section 256B.0911, subdivision 10.new text begin Case
managers must document completion of training in a system identified by the commissioner.
new text end

Sec. 19.

Minnesota Statutes 2022, section 256B.0949, subdivision 15, is amended to read:


Subd. 15.

EIDBI provider qualifications.

(a) A QSP must be employed by an agency
and be:

(1) a licensed mental health professional who has at least 2,000 hours of supervised
clinical experience or training in examining or treating people with ASD or a related condition
or equivalent documented coursework at the graduate level by an accredited university in
ASD diagnostics, ASD developmental and behavioral treatment strategies, and typical child
development; or

(2) a developmental or behavioral pediatrician who has at least 2,000 hours of supervised
clinical experience or training in examining or treating people with ASD or a related condition
or equivalent documented coursework at the graduate level by an accredited university in
the areas of ASD diagnostics, ASD developmental and behavioral treatment strategies, and
typical child development.

(b) A level I treatment provider must be employed by an agency and:

(1) have at least 2,000 hours of supervised clinical experience or training in examining
or treating people with ASD or a related condition or equivalent documented coursework
at the graduate level by an accredited university in ASD diagnostics, ASD developmental
and behavioral treatment strategies, and typical child development or an equivalent
combination of documented coursework or hours of experience; and

(2) have or be at least one of the following:

(i) a master's degree in behavioral health or child development or related fields including,
but not limited to, mental health, special education, social work, psychology, speech
pathology, or occupational therapy from an accredited college or university;

(ii) a bachelor's degree in a behavioral health, child development, or related field
including, but not limited to, mental health, special education, social work, psychology,
speech pathology, or occupational therapy, from an accredited college or university, and
advanced certification in a treatment modality recognized by the department;

(iii) a board-certified behavior analyst; or

(iv) a board-certified assistant behavior analyst with 4,000 hours of supervised clinical
experience that meets all registration, supervision, and continuing education requirements
of the certification.

(c) A level II treatment provider must be employed by an agency and must be:

(1) a person who has a bachelor's degree from an accredited college or university in a
behavioral or child development science or related field including, but not limited to, mental
health, special education, social work, psychology, speech pathology, or occupational
therapy; and meets at least one of the following:

(i) has at least 1,000 hours of supervised clinical experience or training in examining or
treating people with ASD or a related condition or equivalent documented coursework at
the graduate level by an accredited university in ASD diagnostics, ASD developmental and
behavioral treatment strategies, and typical child development or a combination of
coursework or hours of experience;

(ii) has certification as a board-certified assistant behavior analyst from the Behavior
Analyst Certification Board;

(iii) is a registered behavior technician as defined by the Behavior Analyst Certification
Board; or

(iv) is certified in one of the other treatment modalities recognized by the department;
or

(2) a person who has:

(i) an associate's degree in a behavioral or child development science or related field
including, but not limited to, mental health, special education, social work, psychology,
speech pathology, or occupational therapy from an accredited college or university; and

(ii) at least 2,000 hours of supervised clinical experience in delivering treatment to people
with ASD or a related condition. Hours worked as a mental health behavioral aide or level
III treatment provider may be included in the required hours of experience; or

(3) a person who has at least 4,000 hours of supervised clinical experience in delivering
treatment to people with ASD or a related condition. Hours worked as a mental health
behavioral aide or level III treatment provider may be included in the required hours of
experience; or

(4) a person who is a graduate student in a behavioral science, child development science,
or related field and is receiving clinical supervision by a QSP affiliated with an agency to
meet the clinical training requirements for experience and training with people with ASD
or a related condition; or

(5) a person who is at least 18 years of age and who:

(i) is fluent in a non-English languagenew text begin or is an individual certified by a Tribal Nationnew text end ;

(ii) completed the level III EIDBI training requirements; and

(iii) receives observation and direction from a QSP or level I treatment provider at least
once a week until the person meets 1,000 hours of supervised clinical experience.

(d) A level III treatment provider must be employed by an agency, have completed the
level III training requirement, be at least 18 years of age, and have at least one of the
following:

(1) a high school diploma or commissioner of education-selected high school equivalency
certification;

(2) fluency in a non-English languagenew text begin or Tribal Nation certificationnew text end ;

(3) one year of experience as a primary personal care assistant, community health worker,
waiver service provider, or special education assistant to a person with ASD or a related
condition within the previous five years; or

(4) completion of all required EIDBI training within six months of employment.

new text begin EFFECTIVE DATE. new text end

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

Sec. 20.

Minnesota Statutes 2022, section 256B.49, subdivision 13, is amended to read:


Subd. 13.

Case management.

(a) Each recipient of a home and community-based waiver
shall be provided case management services by qualified vendors as described in the federally
approved waiver application. The case management service activities provided must include:

(1) finalizing the person-centered written support plan within the timelines established
by the commissioner and section 256B.0911, subdivision 29;

(2) informing the recipient or the recipient's legal guardian or conservator of service
options, including all service options available under the waiver plans;

(3) assisting the recipient in the identification of potential service providers of chosen
services, including:

(i) available options for case management service and providers;

(ii) providers of services provided in a non-disability-specific setting;

(iii) employment service providers;

(iv) providers of services provided in settings that are not community residential settings;
and

(v) providers of financial management services;

(4) assisting the recipient to access services and assisting with appeals under section
256.045; and

(5) coordinating, evaluating, and monitoring of the services identified in the service
plan.

(b) The case manager may delegate certain aspects of the case management service
activities to another individual provided there is oversight by the case manager. The case
manager may not delegate those aspects which require professional judgment including:

(1) finalizing the person-centered support plan;

(2) ongoing assessment and monitoring of the person's needs and adequacy of the
approved person-centered support plan; and

(3) adjustments to the person-centered support plan.

(c) Case management services must be provided by a public or private agency that is
enrolled as a medical assistance provider determined by the commissioner to meet all of
the requirements in the approved federal waiver plans. Case management services must not
be provided to a recipient by a private agency that has any financial interest in the provision
of any other services included in the recipient's support plan. For purposes of this section,
"private agency" means any agency that is not identified as a lead agency under section
256B.0911, subdivision 10.

(d) For persons who need a positive support transition plan as required in chapter 245D,
the case manager shall participate in the development and ongoing evaluation of the plan
with the expanded support team. At least quarterly, the case manager, in consultation with
the expanded support team, shall evaluate the effectiveness of the plan based on progress
evaluation data submitted by the licensed provider to the case manager. The evaluation must
identify whether the plan has been developed and implemented in a manner to achieve the
following within the required timelines:

(1) phasing out the use of prohibited procedures;

(2) acquisition of skills needed to eliminate the prohibited procedures within the plan's
timeline; and

(3) accomplishment of identified outcomes.

If adequate progress is not being made, the case manager shall consult with the person's
expanded support team to identify needed modifications and whether additional professional
support is required to provide consultation.

(e) The Department of Human Services shall offer ongoing education in case management
to case managers. Case managers shall receive no less than deleted text begin tendeleted text end new text begin 20new text end hours of case management
education and disability-related training each year. The education and training must include
person-centered planningnew text begin , informed choice, cultural competency, employment planning,
community living planning, self-direction options, and use of technology supportsnew text end . new text begin By
August 1, 2024, all case managers must complete an employment support training course
identified by the commissioner of human services. For case managers hired after August
1, 2024, this training must be completed within the first six months of providing case
management services.new text end For the purposes of this section, "person-centered planning" or
"person-centered" has the meaning given in section 256B.0911, subdivision 10.new text begin Case
managers shall document completion of training in a system identified by the commissioner.
new text end

Sec. 21.

Minnesota Statutes 2022, section 256B.4905, subdivision 4a, is amended to read:


Subd. 4a.

Informed choice in employment policy.

It is the policy of this state that
working-age individuals who have disabilities:

(1) can work and achieve competitive integrated employment with appropriate services
and supports, as needed;

(2) make informed choices about their postsecondary education, work, and career goals;
deleted text begin and
deleted text end

(3) will be offered the opportunity to make an informed choice, at least annually, to
pursue postsecondary education or to work and earn a competitive wagedeleted text begin .deleted text end new text begin ; and
new text end

new text begin (4) will be offered benefits planning assistance and supports to understand available
work incentive programs and to understand the impact of work on benefits.
 new text end

Sec. 22.

new text begin [256B.4906] SUBMINIMUM WAGES IN HOME AND
COMMUNITY-BASED SERVICES REPORTING.
 new text end

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

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

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

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

new text begin (1) name;
 new text end

new text begin (2) date of birth;
 new text end

new text begin (3) identified race and ethnicity;
 new text end

new text begin (4) disability type;
 new text end

new text begin (5) key employment status measures as determined by the commissioner; and
 new text end

new text begin (6) key community-life engagement measures as determined by the commissioner.
 new text end

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

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

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

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

Sec. 23.

Minnesota Statutes 2022, section 256B.4911, is amended by adding a subdivision
to read:


new text begin Subd. 6. new text end

new text begin Services provided by parents and spouses. new text end

new text begin (a) This subdivision limits medical
assistance payments under the consumer-directed community supports option for personal
assistance services provided by a parent to the parent's minor child or by a participant's
spouse. This subdivision applies to the consumer-directed community supports option
available under all of the following:
 new text end

new text begin (1) alternative care program;
 new text end

new text begin (2) brain injury waiver;
 new text end

new text begin (3) community alternative care waiver;
 new text end

new text begin (4) community access for disability inclusion waiver;
 new text end

new text begin (5) developmental disabilities waiver; and
 new text end

new text begin (6) elderly waiver.
 new text end

new text begin (b) For the purposes of this subdivision, "parent" means a parent, stepparent, or legal
guardian of a minor.
 new text end

new text begin (c) If multiple parents are providing personal assistance services to their minor child or
children, each parent may provide up to 40 hours of personal assistance services in any
seven-day period regardless of the number of children served. The total number of hours
of medical assistance home and community-based services provided by all of the parents
must not exceed 80 hours in a seven-day period regardless of the number of children served.
 new text end

new text begin (d) If only one parent is providing personal assistance services to a minor child or
children, the parent may provide up to 60 hours of medical assistance home and
community-based services in a seven-day period regardless of the number of children served.
 new text end

new text begin (e) If a participant's spouse is providing personal assistance services, the spouse may
provide up to 60 hours of medical assistance home and community-based services in a
seven-day period.
 new text end

new text begin (f) This subdivision must not be construed to permit an increase in the total authorized
consumer-directed community supports budget for an individual.
 new text end

new text begin EFFECTIVE DATE. new text end

new text begin This section is effective July 1, 2023, or upon federal approval,
whichever is later. The commissioner of human services shall notify the revisor of statutes
when federal approval is obtained.
 new text end

Sec. 24.

Minnesota Statutes 2022, section 256B.4912, is amended by adding a subdivision
to read:


new text begin Subd. 1b. new text end

new text begin Direct support professional annual labor market survey. new text end

new text begin (a) The
commissioner shall develop and administer a survey of direct care staff who work for
organizations that provide services under the following programs:
 new text end

new text begin (1) home and community-based services for seniors under chapter 256S and section
256B.0913, home and community-based services for people with developmental disabilities
under section 256B.092, and home and community-based services for people with disabilities
under section 256B.49;
 new text end

new text begin (2) personal care assistance services under section 256B.0625, subdivision 19a;
community first services and supports under section 256B.85; nursing services and home
health services under section 256B.0625, subdivision 6a; home care nursing services under
section 256B.0625, subdivision 7; and
 new text end

new text begin (3) financial management services for participants who directly employ direct-care staff
through consumer support grants under section 256.476; the personal care assistance choice
program under section 256B.0659, subdivisions 18 to 20; community first services and
supports under section 256B.85; and the consumer-directed community supports option
available under the alternative care program, the brain injury waiver, the community
alternative care waiver, the community access for disability inclusion waiver, the
developmental disabilities waiver, the elderly waiver, and the Minnesota senior health
option, except financial management services providers are not required to submit the data
listed in subdivision 1a, clauses (7) to (11).
 new text end

new text begin (b) The survey must collect information about the individual experience of the direct-care
staff and any other information necessary to assess the overall economic viability and
well-being of the workforce.
 new text end

new text begin (c) For purposes of this subdivision, "direct-care staff" means employees, including
self-employed individuals and individuals directly employed by a participant in a
consumer-directed service delivery option, providing direct service to participants under
this section. Direct-care staff does not include executive, managerial, or administrative staff.
 new text end

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

new text begin (e) The commissioner shall analyze data submitted under this section annually to assess
the overall economic viability and well-being of the workforce and the impact of the state
of the workforce on access to services.
 new text end

Sec. 25.

Minnesota Statutes 2022, section 256B.4912, is amended by adding a subdivision
to read:


new text begin Subd. 1c. new text end

new text begin Annual labor market report. new text end

new text begin The commissioner shall publish annual reports
on provider and state-level labor market data, including but not limited to the data outlined
in subdivisions 1a and 1b.
 new text end

Sec. 26.

Minnesota Statutes 2022, section 256B.4912, is amended by adding a subdivision
to read:


new text begin Subd. 16. new text end

new text begin Rates established by the commissioner. new text end

new text begin For homemaker services eligible
for reimbursement under the developmental disabilities waiver, the brain injury waiver, the
community alternative care waiver, and the community access for disability inclusion waiver,
the commissioner must establish rates equal to the rates established under sections 256S.21
to 256S.215 for the corresponding homemaker services.
 new text end

new text begin EFFECTIVE DATE. new text end

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

Sec. 27.

Minnesota Statutes 2022, section 256B.4914, subdivision 3, is amended to read:


Subd. 3.

Applicable services.

new text begin (a) new text end Applicable services are those authorized under the
state's home and community-based services waivers under sections 256B.092 and 256B.49,
including the following, as defined in the federally approved home and community-based
services plan:

(1) 24-hour customized living;

(2) adult day services;

(3) adult day services bath;

(4) community residential services;

(5) customized living;

(6) day support services;

(7) employment development services;

(8) employment exploration services;

(9) employment support services;

(10) family residential services;

(11) individualized home supports;

(12) individualized home supports with family training;

(13) individualized home supports with training;

(14) integrated community supports;

new text begin (15) life sharing;
 new text end

deleted text begin (15)deleted text end new text begin (16)new text end night supervision;

deleted text begin (16)deleted text end new text begin (17)new text end positive support services;

deleted text begin (17)deleted text end new text begin (18)new text end prevocational services;

deleted text begin (18)deleted text end new text begin (19)new text end residential support services;

deleted text begin (19)deleted text end new text begin (20)new text end respite services;

deleted text begin (20)deleted text end new text begin (21)new text end transportation services; and

deleted text begin (21)deleted text end new text begin (22)new text end other services as approved by the federal government in the state home and
community-based services waiver plan.

new text begin (b) Effective January 1, 2024, or upon federal approval, whichever is later, respite
services under paragraph (a), clause (20), are not an applicable service under this section.
 new text end

new text begin EFFECTIVE DATE. new text end

new text begin This section is effective January 1, 2026, or upon federal approval,
whichever is later, except that paragraph (b) is effective the day following final enactment.
The commissioner of human services shall notify the revisor of statutes when federal approval
is obtained.
 new text end

Sec. 28.

Minnesota Statutes 2022, section 256B.4914, subdivision 4, is amended to read:


Subd. 4.

Data collection for rate determination.

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

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

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

(1) shared staffing hours;

(2) individual staffing hours;

(3) direct registered nurse hours;

(4) direct licensed practical nurse hours;

(5) staffing ratios;

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

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

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

(9) service hours provided through monitoring technology.

(d) Updates to individual data must include:

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

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

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

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

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

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

new text begin EFFECTIVE DATE. new text end

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

Sec. 29.

Minnesota Statutes 2022, section 256B.4914, subdivision 5, is amended to read:


Subd. 5.

Base wage index; establishment and updates.

(a) The base wage index is
established to determine staffing costs associated with providing services to individuals
receiving home and community-based services. For purposes of calculating the base wage,
Minnesota-specific wages taken from job descriptions and standard occupational
classification (SOC) codes from the Bureau of Labor Statistics as defined in the Occupational
Handbook must be used.

(b) The commissioner shall update the base wage index in subdivision 5a, publish these
updated values, and load them into the rate management system as follows:

(1) on January 1, 2022, based on wage data by SOC from the Bureau of Labor Statistics
available as of December 31, 2019;

(2) on deleted text begin Novemberdeleted text end new text begin Januarynew text end 1, 2024, based on wage data by SOC from the Bureau of Labor
Statistics deleted text begin available as of December 31, 2021deleted text end new text begin published in March 2022new text end ; and

(3) on deleted text begin Julydeleted text end new text begin Januarynew text end 1, 2026, and every two years thereafter, based on wage data by SOC
from the Bureau of Labor Statistics deleted text begin available 30 months and one daydeleted text end new text begin published in the spring
approximately 21 monthsnew text end prior to the scheduled update.

new text begin EFFECTIVE DATE. new text end

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

Sec. 30.

Minnesota Statutes 2022, section 256B.4914, subdivision 5a, is amended to read:


Subd. 5a.

Base wage index; calculations.

The base wage index must be calculated as
follows:

(1) for supervisory staff, 100 percent of the median wage for community and social
services specialist (SOC code 21-1099), with the exception of the supervisor of positive
supports professional, positive supports analyst, and positive supports specialist, which is
100 percent of the median wage for clinical counseling and school psychologist (SOC code
19-3031);

(2) for registered nurse staff, 100 percent of the median wage for registered nurses (SOC
code 29-1141);

(3) for licensed practical nurse staff, 100 percent of the median wage for licensed practical
nurses (SOC code 29-2061);

(4) for residential asleep-overnight staff, the minimum wage in Minnesota for large
employersdeleted text begin , with the exception of asleep-overnight staff for family residential services, which
is 36 percent of the minimum wage in Minnesota for large employersdeleted text end ;

(5) for residential direct care staff, the sum of:

(i) 15 percent of the subtotal of 50 percent of the median wage for home health and
personal care aide (SOC code 31-1120); 30 percent of the median wage for nursing assistant
(SOC code 31-1131); and 20 percent of the median wage for social and human services
aide (SOC code 21-1093); and

(ii) 85 percent of the subtotal of 40 percent of the median wage for home health and
personal care aide (SOC code 31-1120); 20 percent of the median wage for nursing assistant
(SOC code deleted text begin 31-1014deleted text end new text begin 31-1131new text end ); 20 percent of the median wage for psychiatric technician
(SOC code 29-2053); and 20 percent of the median wage for social and human services
aide (SOC code 21-1093);

(6) for adult day services staff, 70 percent of the median wage for nursing assistant (SOC
code 31-1131); and 30 percent of the median wage for home health and personal care aide
(SOC code 31-1120);

(7) for day support services staff and prevocational services staff, 20 percent of the
median wage for nursing assistant (SOC code 31-1131); 20 percent of the median wage for
psychiatric technician (SOC code 29-2053); and 60 percent of the median wage for social
and human services aide (SOC code 21-1093);

(8) for positive supports analyst staff, 100 percent of the median wage for substance
abuse, behavioral disorder, and mental health counselor (SOC code 21-1018);

(9) for positive supports professional staff, 100 percent of the median wage for clinical
counseling and school psychologist (SOC code 19-3031);

(10) for positive supports specialist staff, 100 percent of the median wage for psychiatric
technicians (SOC code 29-2053);

(11) for individualized home supports with family training staff, 20 percent of the median
wage for nursing aide (SOC code 31-1131); 30 percent of the median wage for community
social service specialist (SOC code 21-1099); 40 percent of the median wage for social and
human services aide (SOC code 21-1093); and ten percent of the median wage for psychiatric
technician (SOC code 29-2053);

(12) for individualized home supports with training services staff, 40 percent of the
median wage for community social service specialist (SOC code 21-1099); 50 percent of
the median wage for social and human services aide (SOC code 21-1093); and ten percent
of the median wage for psychiatric technician (SOC code 29-2053);

(13) for employment support services staff, 50 percent of the median wage for
rehabilitation counselor (SOC code 21-1015); and 50 percent of the median wage for
community and social services specialist (SOC code 21-1099);

(14) for employment exploration services staff, 50 percent of the median wage for
deleted text begin rehabilitation counselor (SOC code 21-1015)deleted text end new text begin education, guidance, school, and vocational
counselor (SOC code 21-1012)new text end ; and 50 percent of the median wage for community and
social services specialist (SOC code 21-1099);

(15) for employment development services staff, 50 percent of the median wage for
education, guidance, school, and vocational counselors (SOC code 21-1012); and 50 percent
of the median wage for community and social services specialist (SOC code 21-1099);

(16) for individualized home support without training staff, 50 percent of the median
wage for home health and personal care aide (SOC code 31-1120); and 50 percent of the
median wage for nursing assistant (SOC code 31-1131);new text begin and
new text end

(17) for night supervision staff, 40 percent of the median wage for home health and
personal care aide (SOC code 31-1120); 20 percent of the median wage for nursing assistant
(SOC code 31-1131); 20 percent of the median wage for psychiatric technician (SOC code
29-2053); and 20 percent of the median wage for social and human services aide (SOC code
21-1093)deleted text begin ; anddeleted text end new text begin .
new text end

deleted text begin (18) for respite staff, 50 percent of the median wage for home health and personal care
aide (SOC code 31-1131); and 50 percent of the median wage for nursing assistant (SOC
code 31-1014).
 deleted text end

new text begin EFFECTIVE DATE. new text end

new text begin The amendment to clause (5), item (ii), the amendment to clause
(14), and the amendment striking clause (18) are effective January 1, 2024, or upon federal
approval, whichever is later. The amendment to clause (4) is effective January 1, 2026, or
upon federal approval, whichever is later. The commissioner of human services shall notify
the revisor of statutes when federal approval is obtained.
 new text end

Sec. 31.

Minnesota Statutes 2022, section 256B.4914, subdivision 5b, is amended to read:


Subd. 5b.

Standard component value adjustments.

The commissioner shall update
the client and programming support, transportation, and program facility cost component
values as required in subdivisions 6 to deleted text begin 9adeleted text end new text begin 9 and the rates identified in subdivision 19new text end for
changes in the Consumer Price Index. The commissioner shall adjust these values higher
or lower, publish these updated values, and load them into the rate management system as
follows:

(1) on January 1, 2022, by the percentage change in the CPI-U from the date of the
previous update to the data available on December 31, 2019;

(2) on deleted text begin Novemberdeleted text end new text begin Januarynew text end 1, 2024, by the percentage change in the CPI-U from the date
of the previous update to the data available as of December 31, deleted text begin 2021deleted text end new text begin 2022new text end ; and

(3) on deleted text begin Julydeleted text end new text begin Januarynew text end 1, 2026, and every two years thereafter, by the percentage change
in the CPI-U from the date of the previous update to the data available deleted text begin 30deleted text end new text begin 24new text end months and
one day prior to the scheduled update.

new text begin EFFECTIVE DATE. new text end

new text begin This section is effective January 1, 2026, or upon federal approval,
whichever is later, except that the amendment striking the cross-reference to subdivision
9a and the amendments to clauses (2) and (3) are effective January 1, 2024, or upon federal
approval, whichever is later. The commissioner of human services shall notify the revisor
of statutes when federal approval is obtained.
 new text end

Sec. 32.

Minnesota Statutes 2022, section 256B.4914, subdivision 6, is amended to read:


Subd. 6.

Residential support services; generally.

(a) For purposes of this section,
residential support services includes 24-hour customized living services, community
residential services, customized living services, deleted text begin family residential services,deleted text end and integrated
community supports.

(b) A unit of service for residential support services is a day. Any portion of any calendar
day, within allowable Medicaid rules, where an individual spends time in a residential setting
is billable as a day. The number of days authorized for all individuals enrolling in residential
support services must include every day that services start and end.

(c) When the available shared staffing hours in a residential setting are insufficient to
meet the needs of an individual who enrolled in residential support services after January
1, 2014, then individual staffing hours shall be used.

new text begin EFFECTIVE DATE. new text end

new text begin This section is effective January 1, 2026, or upon federal approval,
whichever is later. The commissioner of human services shall notify the revisor of statutes
when federal approval is obtained.
 new text end

Sec. 33.

Minnesota Statutes 2022, section 256B.4914, subdivision 6a, is amended to read:


Subd. 6a.

Community residential services; component values and calculation of
payment rates.

(a) Component values for community residential services are:

(1) competitive workforce factor: deleted text begin 4.7deleted text end new text begin 6.7new text end percent;

(2) supervisory span of control ratio: 11 percent;

(3) employee vacation, sick, and training allowance ratio: 8.71 percent;

(4) employee-related cost ratio: 23.6 percent;

(5) general administrative support ratio: 13.25 percent;

(6) program-related expense ratio: 1.3 percent; and

(7) absence and utilization factor ratio: 3.9 percent.

(b) Payments for community residential services must be calculated as follows:

(1) determine the number of shared direct staffing and individual direct staffing hours
to meet a recipient's needs provided on site or through monitoring technology;

(2) determine the appropriate hourly staff wage rates derived by the commissioner as
provided in subdivisions 5 and 5a;

(3) except for subdivision 5a, clauses (1) to (4), multiply the result of clause (2) by the
product of one plus the competitive workforce factor;

(4) for a recipient requiring customization for deaf and hard-of-hearing language
accessibility under subdivision 12, add the customization rate provided in subdivision 12
to the result of clause (3);

(5) multiply the number of shared direct staffing and individual direct staffing hours
provided on site or through monitoring technology and nursing hours by the appropriate
staff wages;

(6) multiply the number of shared direct staffing and individual direct staffing hours
provided on site or through monitoring technology and nursing hours by the product of the
supervision span of control ratio and the appropriate supervisory staff wage in subdivision
5a, clause (1);

(7) combine the results of clauses (5) and (6), excluding any shared direct staffing and
individual direct staffing hours provided through monitoring technology, and multiply the
result by one plus the employee vacation, sick, and training allowance ratio. This is defined
as the direct staffing cost;

(8) for employee-related expenses, multiply the direct staffing cost, excluding any shared
direct staffing and individual hours provided through monitoring technology, by one plus
the employee-related cost ratio;

(9) for client programming and supports, add $2,260.21 divided by 365. The
commissioner shall update the amount in this clause as specified in subdivision 5b;

(10) for transportation, if provided, add $1,742.62 divided by 365, or $3,111.81 divided
by 365 if customized for adapted transport, based on the resident with the highest assessed
need. The commissioner shall update the amounts in this clause as specified in subdivision
5b;

(11) subtotal clauses (8) to (10) and the direct staffing cost of any shared direct staffing
and individual direct staffing hours provided through monitoring technology that was
excluded in clause (8);

(12) sum the standard general administrative support ratio, the program-related expense
ratio, and the absence and utilization factor ratio;

(13) divide the result of clause (11) by one minus the result of clause (12). This is the
total payment amount; and

(14) adjust the result of clause (13) by a factor to be determined by the commissioner
to adjust for regional differences in the cost of providing services.

new text begin EFFECTIVE DATE. new text end

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

Sec. 34.

Minnesota Statutes 2022, section 256B.4914, subdivision 6b, is amended to read:


Subd. 6b.

Family residential services; component values and calculation of payment
rates.

(a) Component values for family residential services are:

(1) competitive workforce factor: deleted text begin 4.7deleted text end new text begin 6.7new text end percent;

(2) supervisory span of control ratio: 11 percent;

(3) employee vacation, sick, and training allowance ratio: 8.71 percent;

(4) employee-related cost ratio: 23.6 percent;

(5) general administrative support ratio: 3.3 percent;

(6) program-related expense ratio: 1.3 percent; and

(7) absence factor: 1.7 percent.

(b) Payments for family residential services must be calculated as follows:

(1) determine the number of shared direct staffing and individual direct staffing hours
to meet a recipient's needs provided on site or through monitoring technology;

(2) determine the appropriate hourly staff wage rates derived by the commissioner as
provided in subdivisions 5 and 5a;

(3) except for subdivision 5a, clauses (1) to (4), multiply the result of clause (2) by the
product of one plus the competitive workforce factor;

(4) for a recipient requiring customization for deaf and hard-of-hearing language
accessibility under subdivision 12, add the customization rate provided in subdivision 12
to the result of clause (3);

(5) multiply the number of shared direct staffing and individual direct staffing hours
provided on site or through monitoring technology and nursing hours by the appropriate
staff wages;

(6) multiply the number of shared direct staffing and individual direct staffing hours
provided on site or through monitoring technology and nursing hours by the product of the
supervisory span of control ratio and the appropriate supervisory staff wage in subdivision
5a, clause (1);

(7) combine the results of clauses (5) and (6), excluding any shared direct staffing and
individual direct staffing hours provided through monitoring technology, and multiply the
result by one plus the employee vacation, sick, and training allowance ratio. This is defined
as the direct staffing cost;

(8) for employee-related expenses, multiply the direct staffing cost, excluding any shared
and individual direct staffing hours provided through monitoring technology, by one plus
the employee-related cost ratio;

(9) for client programming and supports, add $2,260.21 divided by 365. The
commissioner shall update the amount in this clause as specified in subdivision 5b;

(10) for transportation, if provided, add $1,742.62 divided by 365, or $3,111.81 divided
by 365 if customized for adapted transport, based on the resident with the highest assessed
need. The commissioner shall update the amounts in this clause as specified in subdivision
5b;

(11) subtotal clauses (8) to (10) and the direct staffing cost of any shared direct staffing
and individual direct staffing hours provided through monitoring technology that was
excluded in clause (8);

(12) sum the standard general administrative support ratio, the program-related expense
ratio, and the absence and utilization factor ratio;

(13) divide the result of clause (11) by one minus the result of clause (12). This is the
total payment rate; and

(14) adjust the result of clause (13) by a factor to be determined by the commissioner
to adjust for regional differences in the cost of providing services.

new text begin EFFECTIVE DATE. new text end

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

Sec. 35.

Minnesota Statutes 2022, section 256B.4914, subdivision 6c, is amended to read:


Subd. 6c.

Integrated community supports; component values and calculation of
payment rates.

(a) Component values for integrated community supports are:

(1) competitive workforce factor: deleted text begin 4.7deleted text end new text begin 6.7new text end percent;

(2) supervisory span of control ratio: 11 percent;

(3) employee vacation, sick, and training allowance ratio: 8.71 percent;

(4) employee-related cost ratio: 23.6 percent;

(5) general administrative support ratio: 13.25 percent;

(6) program-related expense ratio: 1.3 percent; and

(7) absence and utilization factor ratio: 3.9 percent.

(b) Payments for integrated community supports must be calculated as follows:

(1) determine the number of shared direct staffing and individual direct staffing hours
to meet a recipient's needs. The base shared direct staffing hours must be eight hours divided
by the number of people receiving support in the integrated community support setting, and
the individual direct staffing hours must be the average number of direct support hours
provided directly to the service recipient;

(2) determine the appropriate hourly staff wage rates derived by the commissioner as
provided in subdivisions 5 and 5a;

(3) except for subdivision 5a, clauses (1) to (4), multiply the result of clause (2) by the
product of one plus the competitive workforce factor;

(4) for a recipient requiring customization for deaf and hard-of-hearing language
accessibility under subdivision 12, add the customization rate provided in subdivision 12
to the result of clause (3);

(5) multiply the number of shared direct staffing and individual direct staffing hours in
clause (1) by the appropriate staff wages;

(6) multiply the number of shared direct staffing and individual direct staffing hours in
clause (1) by the product of the supervisory span of control ratio and the appropriate
supervisory staff wage in subdivision 5a, clause (1);

(7) combine the results of clauses (5) and (6) and multiply the result by one plus the
employee vacation, sick, and training allowance ratio. This is defined as the direct staffing
cost;

(8) for employee-related expenses, multiply the direct staffing cost by one plus the
employee-related cost ratio;

(9) for client programming and supports, add $2,260.21 divided by 365. The
commissioner shall update the amount in this clause as specified in subdivision 5b;

(10) add the results of clauses (8) and (9);

(11) add the standard general administrative support ratio, the program-related expense
ratio, and the absence and utilization factor ratio;

(12) divide the result of clause (10) by one minus the result of clause (11). This is the
total payment amount; and

(13) adjust the result of clause (12) by a factor to be determined by the commissioner
to adjust for regional differences in the cost of providing services.

new text begin EFFECTIVE DATE. new text end

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

Sec. 36.

Minnesota Statutes 2022, section 256B.4914, subdivision 7a, is amended to read:


Subd. 7a.

Adult day services; component values and calculation of payment rates.

(a)
Component values for adult day services are:

(1) competitive workforce factor: deleted text begin 4.7deleted text end new text begin 6.7new text end percent;

(2) supervisory span of control ratio: 11 percent;

(3) employee vacation, sick, and training allowance ratio: 8.71 percent;

(4) employee-related cost ratio: 23.6 percent;

(5) program plan support ratio: 5.6 percent;

(6) client programming and support ratio: 7.4 percent, updated as specified in subdivision
5b;

(7) general administrative support ratio: 13.25 percent;

(8) program-related expense ratio: 1.8 percent; and

(9) absence and utilization factor ratio: 9.4 percent.

(b) A unit of service for adult day services is either a day or 15 minutes. A day unit of
service is six or more hours of time spent providing direct service.

(c) Payments for adult day services must be calculated as follows:

(1) determine the number of units of service and the staffing ratio to meet a recipient's
needs;

(2) determine the appropriate hourly staff wage rates derived by the commissioner as
provided in subdivisions 5 and 5a;

(3) except for subdivision 5a, clauses (1) to (4), multiply the result of clause (2) by the
product of one plus the competitive workforce factor;

(4) for a recipient requiring customization for deaf and hard-of-hearing language
accessibility under subdivision 12, add the customization rate provided in subdivision 12
to the result of clause (3);

(5) multiply the number of day program direct staffing hours and nursing hours by the
appropriate staff wage;

(6) multiply the number of day program direct staffing hours by the product of the
supervisory span of control ratio and the appropriate supervisory staff wage in subdivision
5a, clause (1);

(7) combine the results of clauses (5) and (6), and multiply the result by one plus the
employee vacation, sick, and training allowance ratio. This is defined as the direct staffing
rate;

(8) for program plan support, multiply the result of clause (7) by one plus the program
plan support ratio;

(9) for employee-related expenses, multiply the result of clause (8) by one plus the
employee-related cost ratio;

(10) for client programming and supports, multiply the result of clause (9) by one plus
the client programming and support ratio;

(11) for program facility costs, add $19.30 per week with consideration of staffing ratios
to meet individual needs, updated as specified in subdivision 5b;

(12) for adult day bath services, add $7.01 per 15 minute unit;

(13) this is the subtotal rate;

(14) sum the standard general administrative rate support ratio, the program-related
expense ratio, and the absence and utilization factor ratio;

(15) divide the result of clause (13) by one minus the result of clause (14). This is the
total payment amount; and

(16) adjust the result of clause (15) by a factor to be determined by the commissioner
to adjust for regional differences in the cost of providing services.

new text begin EFFECTIVE DATE. new text end

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

Sec. 37.

Minnesota Statutes 2022, section 256B.4914, subdivision 7b, is amended to read:


Subd. 7b.

Day support services; component values and calculation of payment
rates.

(a) Component values for day support services are:

(1) competitive workforce factor: deleted text begin 4.7deleted text end new text begin 6.7new text end percent;

(2) supervisory span of control ratio: 11 percent;

(3) employee vacation, sick, and training allowance ratio: 8.71 percent;

(4) employee-related cost ratio: 23.6 percent;

(5) program plan support ratio: 5.6 percent;

(6) client programming and support ratio: 10.37 percent, updated as specified in
subdivision 5b;

(7) general administrative support ratio: 13.25 percent;

(8) program-related expense ratio: 1.8 percent; and

(9) absence and utilization factor ratio: 9.4 percent.

(b) A unit of service for day support services is 15 minutes.

(c) Payments for day support services must be calculated as follows:

(1) determine the number of units of service and the staffing ratio to meet a recipient's
needs;

(2) determine the appropriate hourly staff wage rates derived by the commissioner as
provided in subdivisions 5 and 5a;

(3) except for subdivision 5a, clauses (1) to (4), multiply the result of clause (2) by the
product of one plus the competitive workforce factor;

(4) for a recipient requiring customization for deaf and hard-of-hearing language
accessibility under subdivision 12, add the customization rate provided in subdivision 12
to the result of clause (3);

(5) multiply the number of day program direct staffing hours and nursing hours by the
appropriate staff wage;

(6) multiply the number of day program direct staffing hours by the product of the
supervisory span of control ratio and the appropriate supervisory staff wage in subdivision
5a, clause (1);

(7) combine the results of clauses (5) and (6), and multiply the result by one plus the
employee vacation, sick, and training allowance ratio. This is defined as the direct staffing
rate;

(8) for program plan support, multiply the result of clause (7) by one plus the program
plan support ratio;

(9) for employee-related expenses, multiply the result of clause (8) by one plus the
employee-related cost ratio;

(10) for client programming and supports, multiply the result of clause (9) by one plus
the client programming and support ratio;

(11) for program facility costs, add $19.30 per week with consideration of staffing ratios
to meet individual needs, updated as specified in subdivision 5b;

(12) this is the subtotal rate;

(13) sum the standard general administrative rate support ratio, the program-related
expense ratio, and the absence and utilization factor ratio;

(14) divide the result of clause (12) by one minus the result of clause (13). This is the
total payment amount; and

(15) adjust the result of clause (14) by a factor to be determined by the commissioner
to adjust for regional differences in the cost of providing services.

new text begin EFFECTIVE DATE. new text end

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

Sec. 38.

Minnesota Statutes 2022, section 256B.4914, subdivision 7c, is amended to read:


Subd. 7c.

Prevocational services; component values and calculation of payment
rates.

(a) Component values for prevocational services are:

(1) competitive workforce factor: deleted text begin 4.7deleted text end new text begin 6.7new text end percent;

(2) supervisory span of control ratio: 11 percent;

(3) employee vacation, sick, and training allowance ratio: 8.71 percent;

(4) employee-related cost ratio: 23.6 percent;

(5) program plan support ratio: 5.6 percent;

(6) client programming and support ratio: 10.37 percent, updated as specified in
subdivision 5b;

(7) general administrative support ratio: 13.25 percent;

(8) program-related expense ratio: 1.8 percent; and

(9) absence and utilization factor ratio: 9.4 percent.

(b) A unit of service for prevocational services is either a day or 15 minutes. A day unit
of service is six or more hours of time spent providing direct service.

(c) Payments for prevocational services must be calculated as follows:

(1) determine the number of units of service and the staffing ratio to meet a recipient's
needs;

(2) determine the appropriate hourly staff wage rates derived by the commissioner as
provided in subdivisions 5 and 5a;

(3) except for subdivision 5a, clauses (1) to (4), multiply the result of clause (2) by the
product of one plus the competitive workforce factor;

(4) for a recipient requiring customization for deaf and hard-of-hearing language
accessibility under subdivision 12, add the customization rate provided in subdivision 12
to the result of clause (3);

(5) multiply the number of day program direct staffing hours and nursing hours by the
appropriate staff wage;

(6) multiply the number of day program direct staffing hours by the product of the
supervisory span of control ratio and the appropriate supervisory staff wage in subdivision
5a, clause (1);

(7) combine the results of clauses (5) and (6), and multiply the result by one plus the
employee vacation, sick, and training allowance ratio. This is defined as the direct staffing
rate;

(8) for program plan support, multiply the result of clause (7) by one plus the program
plan support ratio;

(9) for employee-related expenses, multiply the result of clause (8) by one plus the
employee-related cost ratio;

(10) for client programming and supports, multiply the result of clause (9) by one plus
the client programming and support ratio;

(11) for program facility costs, add $19.30 per week with consideration of staffing ratios
to meet individual needs, updated as specified in subdivision 5b;

(12) this is the subtotal rate;

(13) sum the standard general administrative rate support ratio, the program-related
expense ratio, and the absence and utilization factor ratio;

(14) divide the result of clause (12) by one minus the result of clause (13). This is the
total payment amount; and

(15) adjust the result of clause (14) by a factor to be determined by the commissioner
to adjust for regional differences in the cost of providing services.

new text begin EFFECTIVE DATE. new text end

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

Sec. 39.

Minnesota Statutes 2022, section 256B.4914, subdivision 8, is amended to read:


Subd. 8.

Unit-based services with programming; component values and calculation
of payment rates.

(a) For the purpose of this section, unit-based services with programming
include employment exploration services, employment development services, employment
support services, individualized home supports with family training, individualized home
supports with training, and positive support services provided to an individual outside of
any service plan for a day program or residential support service.

(b) Component values for unit-based services with programming are:

(1) competitive workforce factor: deleted text begin 4.7deleted text end new text begin 6.7new text end percent;

(2) supervisory span of control ratio: 11 percent;

(3) employee vacation, sick, and training allowance ratio: 8.71 percent;

(4) employee-related cost ratio: 23.6 percent;

(5) program plan support ratio: 15.5 percent;

(6) client programming and support ratio: 4.7 percent, updated as specified in subdivision
5b;

(7) general administrative support ratio: 13.25 percent;

(8) program-related expense ratio: 6.1 percent; and

(9) absence and utilization factor ratio: 3.9 percent.

(c) A unit of service for unit-based services with programming is 15 minutes.

(d) Payments for unit-based services with programming must be calculated as follows,
unless the services are reimbursed separately as part of a residential support services or day
program payment rate:

(1) determine the number of units of service to meet a recipient's needs;

(2) determine the appropriate hourly staff wage rates derived by the commissioner as
provided in subdivisions 5 and 5a;

(3) except for subdivision 5a, clauses (1) to (4), multiply the result of clause (2) by the
product of one plus the competitive workforce factor;

(4) for a recipient requiring customization for deaf and hard-of-hearing language
accessibility under subdivision 12, add the customization rate provided in subdivision 12
to the result of clause (3);

(5) multiply the number of direct staffing hours by the appropriate staff wage;

(6) multiply the number of direct staffing hours by the product of the supervisory span
of control ratio and the appropriate supervisory staff wage in subdivision 5a, clause (1);

(7) combine the results of clauses (5) and (6), and multiply the result by one plus the
employee vacation, sick, and training allowance ratio. This is defined as the direct staffing
rate;

(8) for program plan support, multiply the result of clause (7) by one plus the program
plan support ratio;

(9) for employee-related expenses, multiply the result of clause (8) by one plus the
employee-related cost ratio;

(10) for client programming and supports, multiply the result of clause (9) by one plus
the client programming and support ratio;

(11) this is the subtotal rate;

(12) sum the standard general administrative support ratio, the program-related expense
ratio, and the absence and utilization factor ratio;

(13) divide the result of clause (11) by one minus the result of clause (12). This is the
total payment amount;

(14) for services provided in a shared manner, divide the total payment in clause (13)
as follows:

(i) for employment exploration services, divide by the number of service recipients, not
to exceed five;

(ii) for employment support services, divide by the number of service recipients, not to
exceed six; deleted text begin and
deleted text end

(iii) for individualized home supports with training and individualized home supports
with family training, divide by the number of service recipients, not to exceed deleted text begin twodeleted text end new text begin threenew text end ;
and

new text begin (iv) for night supervision, divide by the number of service recipients, not to exceed two;
and
 new text end

(15) adjust the result of clause (14) by a factor to be determined by the commissioner
to adjust for regional differences in the cost of providing services.

new text begin EFFECTIVE DATE. new text end

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

Sec. 40.

Minnesota Statutes 2022, section 256B.4914, subdivision 9, is amended to read:


Subd. 9.

Unit-based services without programming; component values and
calculation of payment rates.

(a) For the purposes of this section, unit-based services
without programming include individualized home supports without training and night
supervision provided to an individual outside of any service plan for a day program or
residential support service. Unit-based services without programming do not include respite.

(b) Component values for unit-based services without programming are:

(1) competitive workforce factor: deleted text begin 4.7deleted text end new text begin 6.7new text end percent;

(2) supervisory span of control ratio: 11 percent;

(3) employee vacation, sick, and training allowance ratio: 8.71 percent;

(4) employee-related cost ratio: 23.6 percent;

(5) program plan support ratio: 7.0 percent;

(6) client programming and support ratio: 2.3 percent, updated as specified in subdivision
5b;

(7) general administrative support ratio: 13.25 percent;

(8) program-related expense ratio: 2.9 percent; and

(9) absence and utilization factor ratio: 3.9 percent.

(c) A unit of service for unit-based services without programming is 15 minutes.

(d) Payments for unit-based services without programming must be calculated as follows
unless the services are reimbursed separately as part of a residential support services or day
program payment rate:

(1) determine the number of units of service to meet a recipient's needs;

(2) determine the appropriate hourly staff wage rates derived by the commissioner as
provided in subdivisions 5 to 5a;

(3) except for subdivision 5a, clauses (1) to (4), multiply the result of clause (2) by the
product of one plus the competitive workforce factor;

(4) for a recipient requiring customization for deaf and hard-of-hearing language
accessibility under subdivision 12, add the customization rate provided in subdivision 12
to the result of clause (3);

(5) multiply the number of direct staffing hours by the appropriate staff wage;

(6) multiply the number of direct staffing hours by the product of the supervisory span
of control ratio and the appropriate supervisory staff wage in subdivision 5a, clause (1);

(7) combine the results of clauses (5) and (6), and multiply the result by one plus the
employee vacation, sick, and training allowance ratio. This is defined as the direct staffing
rate;

(8) for program plan support, multiply the result of clause (7) by one plus the program
plan support ratio;

(9) for employee-related expenses, multiply the result of clause (8) by one plus the
employee-related cost ratio;

(10) for client programming and supports, multiply the result of clause (9) by one plus
the client programming and support ratio;

(11) this is the subtotal rate;

(12) sum the standard general administrative support ratio, the program-related expense
ratio, and the absence and utilization factor ratio;

(13) divide the result of clause (11) by one minus the result of clause (12). This is the
total payment amount;

(14) for individualized home supports without training provided in a shared manner,
divide the total payment amount in clause (13) by the number of service recipients, not to
exceed deleted text begin twodeleted text end new text begin threenew text end ; and

(15) adjust the result of clause (14) by a factor to be determined by the commissioner
to adjust for regional differences in the cost of providing services.

new text begin EFFECTIVE DATE. new text end

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

Sec. 41.

Minnesota Statutes 2022, section 256B.4914, subdivision 10, is amended to read:


Subd. 10.

Evaluation of information and data.

(a) The commissioner shall, within
available resources, conduct research and gather data and information from existing state
systems or other outside sources on the following items:

(1) differences in the underlying cost to provide services and care across the state;

(2) mileage, vehicle type, lift requirements, incidents of individual and shared rides, and
units of transportation for all day services, which must be collected from providers using
the rate management worksheet and entered into the rates management system; and

(3) the distinct underlying costs for services provided by a license holder under sections
245D.05, 245D.06, 245D.07, 245D.071, 245D.081, and 245D.09, and for services provided
by a license holder certified under section 245D.33.

(b) The commissioner, in consultation with stakeholders, shall review and evaluate the
following values already in subdivisions 6 to deleted text begin 9adeleted text end new text begin 9new text end , or issues that impact all services, including,
but not limited to:

(1) values for transportation rates;

(2) values for services where monitoring technology replaces staff time;

(3) values for indirect services;

(4) values for nursing;

(5) values for the facility use rate in day services, and the weightings used in the day
service ratios and adjustments to those weightings;

(6) values for workers' compensation as part of employee-related expenses;

(7) values for unemployment insurance as part of employee-related expenses;

(8) direct care workforce labor market measures;

(9) any changes in state or federal law with a direct impact on the underlying cost of
providing home and community-based services;

(10) outcome measures, determined by the commissioner, for home and community-based
services rates determined under this section; and

(11) different competitive workforce factors by service, as determined under subdivision
10b.

(c) The commissioner shall report to the chairs and the ranking minority members of
the legislative committees and divisions with jurisdiction over health and human services
policy and finance with the information and data gathered under paragraphs (a) and (b) on
January 15, 2021, with a full report, and a full report once every four years thereafter.

(d) Beginning July 1, 2022, the commissioner shall renew analysis and implement
changes to the regional adjustment factors once every six years. Prior to implementation,
the commissioner shall consult with stakeholders on the methodology to calculate the
adjustment.

new text begin EFFECTIVE DATE. new text end

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

Sec. 42.

Minnesota Statutes 2022, section 256B.4914, subdivision 10a, is amended to
read:


Subd. 10a.

Reporting and analysis of cost data.

(a) The commissioner must ensure
that wage values and component values in subdivisions 5 to deleted text begin 9adeleted text end new text begin 9new text end reflect the cost to provide
the service. As determined by the commissioner, in consultation with stakeholders identified
in subdivision 17, a provider enrolled to provide services with rates determined under this
section must submit requested cost data to the commissioner to support research on the cost
of providing services that have rates determined by the disability waiver rates system.
Requested cost data may include, but is not limited to:

(1) worker wage costs;

(2) benefits paid;

(3) supervisor wage costs;

(4) executive wage costs;

(5) vacation, sick, and training time paid;

(6) taxes, workers' compensation, and unemployment insurance costs paid;

(7) administrative costs paid;

(8) program costs paid;

(9) transportation costs paid;

(10) vacancy rates; and

(11) other data relating to costs required to provide services requested by the
commissioner.

(b) At least once in any five-year period, a provider must submit cost data for a fiscal
year that ended not more than 18 months prior to the submission date. The commissioner
shall provide each provider a 90-day notice prior to its submission due date. If a provider
fails to submit required reporting data, the commissioner shall provide notice to providers
that have not provided required data 30 days after the required submission date, and a second
notice for providers who have not provided required data 60 days after the required
submission date. The commissioner shall temporarily suspend payments to the provider if
cost data is not received 90 days after the required submission date. Withheld payments
shall be made once data is received by the commissioner.

(c) The commissioner shall conduct a random validation of data submitted under
paragraph (a) to ensure data accuracy.new text begin The commissioner shall analyze cost documentation
in paragraph (a) and provide recommendations for adjustments to cost components.
new text end

(d) The commissioner shall analyze cost data submitted under paragraph (a) and, in
consultation with stakeholders identified in subdivision 17, may submit recommendations
on component values and inflationary factor adjustments to the chairs and ranking minority
members of the legislative committees with jurisdiction over human services once every
four years beginning January 1, 2021. The commissioner shall make recommendations in
conjunction with reports submitted to the legislature according to subdivision 10, paragraph
(c).new text begin The commissioner shall release cost data in an aggregate form. Cost data from individual
providers must not be released except as provided for in current law.
new text end

(e) deleted text begin The commissioner shall release cost data in an aggregate form, and cost data from
individual providers shall not be released except as provided for in current law.deleted text end new text begin The
commissioner shall use data collected in paragraph (a) to determine the compliance with
requirements identified under subdivision 10d. The commissioner shall identify providers
who have not met the thresholds identified under subdivision 10d on the Department of
Human Services website for the year for which the providers reported their costs.
new text end

deleted text begin (f) The commissioner, in consultation with stakeholders identified in subdivision 17,
shall develop and implement a process for providing training and technical assistance
necessary to support provider submission of cost documentation required under paragraph
(a).
 deleted text end

new text begin EFFECTIVE DATE. new text end

new text begin This section is effective January 1, 2025, except that the
amendment striking the cross-reference to subdivision 9a is effective January 1, 2024, or
upon federal approval, whichever is later. The commissioner of human services shall notify
the revisor of statutes when federal approval is obtained.
 new text end

Sec. 43.

Minnesota Statutes 2022, section 256B.4914, subdivision 10c, is amended to
read:


Subd. 10c.

Reporting and analysis of competitive workforce factor.

(a) Beginning
February 1, deleted text begin 2021deleted text end new text begin 2025new text end , and every two years thereafter, the commissioner shall report to the
chairs and ranking minority members of the legislative committees and divisions with
jurisdiction over health and human services policy and finance an analysis of the competitive
workforce factor.

(b) The report must include deleted text begin recommendations to update the competitive workforce factor
usingdeleted text end :

(1) the most recently available wage data by SOC code for the weighted average wage
for direct care staff for residential services and direct care staff for day services;

(2) the most recently available wage data by SOC code of the weighted average wage
of comparable occupations; and

(3) workforce data as required under subdivision 10b.

(c) deleted text begin The commissioner shall not recommend an increase or decrease of the competitive
workforce factor from the current value by more than two percentage points. If, after a
biennial analysis for the next report, the competitive workforce factor is less than or equal
to zero, the commissioner shall recommend a competitive workforce factor of zero.deleted text end new text begin This
subdivision expires June 30, 2031.
new text end

new text begin EFFECTIVE DATE. new text end

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

Sec. 44.

Minnesota Statutes 2022, section 256B.4914, is amended by adding a subdivision
to read:


new text begin Subd. 10d. new text end

new text begin Direct care staff; compensation. new text end

new text begin (a) A provider paid with rates determined
under subdivision 6 must use a minimum of 66 percent of the revenue generated by rates
determined under that subdivision for direct care staff compensation.
 new text end

new text begin (b) A provider paid with rates determined under subdivision 7 must use a minimum of
45 percent of the revenue generated by rates determined under that subdivision for direct
care compensation.
 new text end

new text begin (c) A provider paid with rates determined under subdivision 8 or 9 must use a minimum
of 60 percent of the revenue generated by rates determined under those subdivisions for
direct care compensation.
 new text end

new text begin (d) Compensation under this subdivision includes:
 new text end

new text begin (1) wages;
 new text end

new text begin (2) taxes and workers' compensation;
 new text end

new text begin (3) health insurance;
 new text end

new text begin (4) dental insurance;
 new text end

new text begin (5) vision insurance;
 new text end

new text begin (6) life insurance;
 new text end

new text begin (7) short-term disability insurance;
 new text end

new text begin (8) long-term disability insurance;
 new text end

new text begin (9) retirement spending;
 new text end

new text begin (10) tuition reimbursement;
 new text end

new text begin (11) wellness programs;
 new text end

new text begin (12) paid vacation time;
 new text end

new text begin (13) paid sick time; or
 new text end

new text begin (14) other items of monetary value provided to direct care staff.
 new text end

new text begin EFFECTIVE DATE. new text end

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

Sec. 45.

Minnesota Statutes 2022, section 256B.4914, subdivision 12, is amended to read:


Subd. 12.

Customization of rates for individuals.

(a) For persons determined to have
higher needs based on being deaf or hard-of-hearing, the direct-care costs must be increased
by an adjustment factor prior to calculating the rate under subdivisions 6 to deleted text begin 9adeleted text end new text begin 9new text end . The
customization rate with respect to deaf or hard-of-hearing persons shall be $2.50 per hour
for waiver recipients who meet the respective criteria as determined by the commissioner.

(b) For the purposes of this section, "deaf and hard-of-hearing" means:

(1) the person has a developmental disability and:

(i) an assessment score which indicates a hearing impairment that is severe or that the
person has no useful hearing;

(ii) an expressive communications score that indicates the person uses single signs or
gestures, uses an augmentative communication aid, or does not have functional
communication, or the person's expressive communications is unknown; and

(iii) a communication score which indicates the person comprehends signs, gestures,
and modeling prompts or does not comprehend verbal, visual, or gestural communication,
or that the person's receptive communication score is unknown; or

(2) the person receives long-term care services and has an assessment score that indicates
the person hears only very loud sounds, the person has no useful hearing, or a determination
cannot be made; and the person receives long-term care services and has an assessment that
indicates the person communicates needs with sign language, symbol board, written
messages, gestures, or an interpreter; communicates with inappropriate content, makes
garbled sounds or displays echolalia, or does not communicate needs.

new text begin EFFECTIVE DATE. new text end

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

Sec. 46.

Minnesota Statutes 2022, section 256B.4914, subdivision 14, is amended to read:


Subd. 14.

Exceptions.

(a) In a format prescribed by the commissioner, lead agencies
must identify individuals with exceptional needs that cannot be met under the disability
waiver rate system. The commissioner shall use that information to evaluate and, if necessary,
approve an alternative payment rate for those individuals. Whether granted, denied, or
modified, the commissioner shall respond to all exception requests in writing. The
commissioner shall include in the written response the basis for the action and provide
notification of the right to appeal under paragraph (h).

(b) Lead agencies must act on an exception request within 30 days and notify the initiator
of the request of their recommendation in writing. A lead agency shall submit all exception
requests along with its recommendation to the commissioner.

(c) An application for a rate exception may be submitted for the following criteria:

(1) an individual has service needs that cannot be met through additional units of service;

(2) an individual's rate determined under subdivisions 6 to deleted text begin 9adeleted text end new text begin 9new text end is so insufficient that it
has resulted in an individual receiving a notice of discharge from the individual's provider;
or

(3) an individual's service needs, including behavioral changes, require a level of service
which necessitates a change in provider or which requires the current provider to propose
service changes beyond those currently authorized.

(d) Exception requests must include the following information:

(1) the service needs required by each individual that are not accounted for in subdivisions
6 to deleted text begin 9adeleted text end new text begin 9new text end ;

(2) the service rate requested and the difference from the rate determined in subdivisions
6 to deleted text begin 9adeleted text end new text begin 9new text end ;

(3) a basis for the underlying costs used for the rate exception and any accompanying
documentation; and

(4) any contingencies for approval.

(e) Approved rate exceptions shall be managed within lead agency allocations under
sections 256B.092 and 256B.49.

(f) Individual disability waiver recipients, an interested party, or the license holder that
would receive the rate exception increase may request that a lead agency submit an exception
request. A lead agency that denies such a request shall notify the individual waiver recipient,
interested party, or license holder of its decision and the reasons for denying the request in
writing no later than 30 days after the request has been made and shall submit its denial to
the commissioner in accordance with paragraph (b). The reasons for the denial must be
based on the failure to meet the criteria in paragraph (c).

(g) The commissioner shall determine whether to approve or deny an exception request
no more than 30 days after receiving the request. If the commissioner denies the request,
the commissioner shall notify the lead agency and the individual disability waiver recipient,
the interested party, and the license holder in writing of the reasons for the denial.

(h) The individual disability waiver recipient may appeal any denial of an exception
request by either the lead agency or the commissioner, pursuant to sections 256.045 and
256.0451. When the denial of an exception request results in the proposed demission of a
waiver recipient from a residential or day habilitation program, the commissioner shall issue
a temporary stay of demission, when requested by the disability waiver recipient, consistent
with the provisions of section 256.045, subdivisions 4a and 6, paragraph (c). The temporary
stay shall remain in effect until the lead agency can provide an informed choice of
appropriate, alternative services to the disability waiver.

(i) Providers may petition lead agencies to update values that were entered incorrectly
or erroneously into the rate management system, based on past service level discussions
and determination in subdivision 4, without applying for a rate exception.

(j) The starting date for the rate exception will be the later of the date of the recipient's
change in support or the date of the request to the lead agency for an exception.

(k) The commissioner shall track all exception requests received and their dispositions.
The commissioner shall issue quarterly public exceptions statistical reports, including the
number of exception requests received and the numbers granted, denied, withdrawn, and
pending. The report shall include the average amount of time required to process exceptions.

(l) Approved rate exceptions remain in effect in all cases until an individual's needs
change as defined in paragraph (c).

new text begin (m) Rates determined under subdivision 19 are ineligible for rate exceptions.
 new text end

new text begin EFFECTIVE DATE. new text end

new text begin This section is effective January 1, 2024, or upon federal approval,
whichever is later, except that paragraph (m) is effective January 1, 2026, or upon federal
approval, whichever is later. The commissioner of human services shall notify the revisor
of statutes when federal approval is obtained.
 new text end

Sec. 47.

Minnesota Statutes 2022, section 256B.4914, is amended by adding a subdivision
to read:


new text begin Subd. 19. new text end

new text begin Payments for family residential and life sharing services. new text end

new text begin The commissioner
shall establish rates for family residential services and life sharing services based on a
person's assessed need, as described in the federally-approved waiver plans. Rates for life
sharing services must be ten percent higher than the corresponding family residential services
rate.
 new text end

new text begin EFFECTIVE DATE. new text end

new text begin This section is effective January 1, 2026, or upon federal approval,
whichever is later. The commissioner of human services shall notify the revisor of statutes
when federal approval is obtained.
 new text end

Sec. 48.

Minnesota Statutes 2022, section 256B.5012, is amended by adding a subdivision
to read:


new text begin Subd. 19. new text end

new text begin ICF/DD rate increase effective January 1, 2024. new text end

new text begin (a) Effective January 1,
2024, the daily operating payment rate for a class A intermediate care facility for persons
with developmental disabilities is increased by $40.
 new text end

new text begin (b) Effective January 1, 2024, the daily operating payment rate for a class B intermediate
care facility for persons with developmental disabilities is increased by $40.
 new text end

new text begin EFFECTIVE DATE. new text end

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

Sec. 49.

Minnesota Statutes 2022, section 256B.5012, is amended by adding a subdivision
to read:


new text begin Subd. 20. new text end

new text begin ICF/DD minimum daily operating payment rates. new text end

new text begin (a) The minimum daily
operating payment rate for a class A intermediate care facility for persons with developmental
disabilities is $275.
 new text end

new text begin (b) The minimum daily operating payment rate for a class B intermediate care facility
for persons with developmental disabilities is $316.
 new text end

new text begin EFFECTIVE DATE. new text end

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

Sec. 50.

Minnesota Statutes 2022, section 256B.5012, is amended by adding a subdivision
to read:


new text begin Subd. 21. new text end

new text begin ICF/DD rate increases after January 1, 2025. new text end

new text begin Beginning January 1, 2025,
and every year thereafter, the rates under this section must be updated for the percentage
change in the Consumer Price Index (CPI-U) from the previous July 1 to the data available
12 months and one day prior.
 new text end

new text begin EFFECTIVE DATE. new text end

new text begin This section is effective January 1, 2025, or upon federal approval,
whichever is later. The commissioner of human services shall notify the revisor of statutes
when federal approval is obtained.
 new text end

Sec. 51.

Minnesota Statutes 2022, section 256B.85, subdivision 7, is amended to read:


Subd. 7.

Community first services and supports; covered services.

Services and
supports covered under CFSS include:

(1) assistance to accomplish activities of daily living (ADLs), instrumental activities of
daily living (IADLs), and health-related procedures and tasks through hands-on assistance
to accomplish the task or constant supervision and cueing to accomplish the task;

(2) assistance to acquire, maintain, or enhance the skills necessary for the participant to
accomplish activities of daily living, instrumental activities of daily living, or health-related
tasks;

(3) expenditures for items, services, supports, environmental modifications, or goods,
including assistive technology. These expenditures must:

(i) relate to a need identified in a participant's CFSS service delivery plan; and

(ii) increase independence or substitute for human assistance, to the extent that
expenditures would otherwise be made for human assistance for the participant's assessed
needs;

(4) observation and redirection for behavior or symptoms where there is a need for
assistance;

(5) back-up systems or mechanisms, such as the use of pagers or other electronic devices,
to ensure continuity of the participant's services and supports;

(6) services provided by a consultation services provider as defined under subdivision
17, that is under contract with the department and enrolled as a Minnesota health care
program provider;

(7) services provided by an FMS provider as defined under subdivision 13a, that is an
enrolled provider with the department;

(8) CFSS services provided by a support worker who is a parent, stepparent, or legal
guardian of a participant under age 18, or who is the participant's spouse. deleted text begin These support
workers shall not:deleted text end new text begin Covered services under this clause are subject to the limitations described
in subdivision 7b; and
new text end

deleted text begin (i) provide any medical assistance home and community-based services in excess of 40
hours per seven-day period regardless of the number of parents providing services,
combination of parents and spouses providing services, or number of children who receive
medical assistance services; and
 deleted text end

deleted text begin (ii) have a wage that exceeds the current rate for a CFSS support worker including the
wage, benefits, and payroll taxes; and
 deleted text end

(9) worker training and development services as described in subdivision 18a.

new text begin EFFECTIVE DATE. new text end

new text begin This section is effective July 1, 2023, or upon federal approval,
whichever is later. The commissioner of human services shall notify the revisor of statutes
when federal approval is obtained.
 new text end

Sec. 52.

Minnesota Statutes 2022, section 256B.85, is amended by adding a subdivision
to read:


new text begin Subd. 7b. new text end

new text begin Services provided by parents and spouses. new text end

new text begin (a) This subdivision applies to
services and supports described in subdivision 7, clause (8).
 new text end

new text begin (b) If multiple parents are support workers providing CFSS services to their minor child
or children, each parent may provide up to 40 hours of medical assistance home and
community-based services in any seven-day period regardless of the number of children
served. The total number of hours of medical assistance home and community-based services
provided by all of the parents must not exceed 80 hours in a seven-day period regardless of
the number of children served.
 new text end

new text begin (c) If only one parent is a support worker providing CFSS services to the parent's minor
child or children, the parent may provide up to 60 hours of medical assistance home and
community-based services in a seven-day period regardless of the number of children served.
 new text end

new text begin (d) If a participant's spouse is a support worker providing CFSS services, the spouse
may provide up to 60 hours of medical assistance home and community-based services in
a seven-day period.
 new text end

new text begin (e) Paragraphs (b) to (d) must not be construed to permit an increase in either the total
authorized service budget for an individual or the total number of authorized service units.
 new text end

new text begin (f) A parent or participant's spouse must not receive a wage that exceeds the current rate
for a CFSS support worker, including wages, benefits, and payroll taxes.
 new text end

new text begin EFFECTIVE DATE. new text end

new text begin This section is effective July 1, 2023, or upon federal approval,
whichever is later. The commissioner of human services shall notify the revisor of statutes
when federal approval is obtained.
 new text end

Sec. 53.

Minnesota Statutes 2022, section 256B.851, subdivision 3, is amended to read:


Subd. 3.

Payment rates; base wage index.

When initially establishing the base wage
component values, the commissioner must use the Minnesota-specific median wage for the
standard occupational classification (SOC) codes published by the Bureau of Labor Statistics
in the edition of the Occupational Handbook deleted text begin available January 1,deleted text end new text begin published in Marchnew text end 2021.
The commissioner must calculate the base wage component values as follows for:

(1) personal care assistance services, CFSS, extended personal care assistance services,
and extended CFSS. The base wage component value equals the median wage for personal
care aide (SOC code 31-1120);

(2) enhanced rate personal care assistance services and enhanced rate CFSS. The base
wage component value equals the product of median wage for personal care aide (SOC
code 31-1120) and the value of the enhanced rate under section 256B.0659, subdivision
17a; and

(3) qualified professional services and CFSS worker training and development. The base
wage component value equals the sum of 70 percent of the median wage for registered nurse
(SOC code 29-1141), 15 percent of the median wage for health care social worker (SOC
code 21-1099), and 15 percent of the median wage for social and human service assistant
(SOC code 21-1093).

new text begin EFFECTIVE DATE. new text end

new text begin This section is effective January 1, 2024, or 90 days after federal
approval, whichever is later. The commissioner of human services shall notify the revisor
of statutes when federal approval is obtained.
 new text end

Sec. 54.

Minnesota Statutes 2022, section 256B.851, subdivision 5, is amended to read:


Subd. 5.

Payment rates; component values.

(a) The commissioner must use the
following component values:

(1) employee vacation, sick, and training factor, 8.71 percent;

(2) employer taxes and workers' compensation factor, 11.56 percent;

(3) employee benefits factor, 12.04 percent;

(4) client programming and supports factor, 2.30 percent;

(5) program plan support factor, 7.00 percent;

(6) general business and administrative expenses factor, 13.25 percent;

(7) program administration expenses factor, 2.90 percent; and

(8) absence and utilization factor, 3.90 percent.

(b) For purposes of implementation, the commissioner shall use the following
implementation components:

(1) personal care assistance services and CFSS: deleted text begin 75.45deleted text end new text begin 88.19new text end percent;

(2) enhanced rate personal care assistance services and enhanced rate CFSS: deleted text begin 75.45deleted text end new text begin 88.19new text end
percent; and

(3) qualified professional services and CFSS worker training and development: deleted text begin 75.45deleted text end new text begin
88.19new text end percent.

new text begin (c) Effective January 1, 2025, for purposes of implementation, the commissioner shall
use the following implementation components:
 new text end

new text begin (1) personal care assistance services and CFSS: 92.08 percent;
 new text end

new text begin (2) enhanced rate personal care assistance services and enhanced rate CFSS: 92.08
percent; and
 new text end

new text begin (3) qualified professional services and CFSS worker training and development: 92.08
percent.
 new text end

new text begin (d) The commissioner shall use the following worker retention components:
 new text end

new text begin (1) for workers who have provided fewer than 1,001 cumulative hours in personal care
assistance services or CFSS, the worker retention component is zero percent;
 new text end

new text begin (2) for workers who have provided between 1,001 and 2,000 cumulative hours in personal
care assistance services or CFSS, the worker retention component is 2.17 percent;
 new text end

new text begin (3) for workers who have provided between 2,001 and 6,000 cumulative hours in personal
care assistance services or CFSS, the worker retention component is 4.36 percent;
 new text end

new text begin (4) for workers who have provided between 6,001 and 10,000 cumulative hours in
personal care assistance services or CFSS, the worker retention component is 7.35 percent;
and
 new text end

new text begin (5) for workers who have provided more than 10,000 cumulative hours in personal care
assistance services or CFSS, the worker retention component is 10.81 percent.
 new text end

new text begin (e) The commissioner shall define the appropriate worker retention component based
on the total number of units billed for services rendered by the individual provider since
July 1, 2017. The worker retention component must be determined by the commissioner
for each individual provider and is not subject to appeal.
 new text end

new text begin EFFECTIVE DATE. new text end

new text begin The amendments to paragraph (b) are effective January 1, 2024,
or 90 days after federal approval, whichever is later. Paragraph (b) expires January 1, 2025,
or 90 days after federal approval of paragraph (c), whichever is later. Paragraphs (c) to (e)
are effective January 1, 2025, or 90 days after federal approval, whichever is later. The
commissioner of human services shall notify the revisor of statutes when federal approval
is obtained.
 new text end

Sec. 55.

Minnesota Statutes 2022, section 256B.851, subdivision 6, is amended to read:


Subd. 6.

Payment rates; rate determination.

(a) The commissioner must determine
the rate for personal care assistance services, CFSS, extended personal care assistance
services, extended CFSS, enhanced rate personal care assistance services, enhanced rate
CFSS, qualified professional services, and CFSS worker training and development as
follows:

(1) multiply the appropriate total wage component value calculated in subdivision 4 by
one plus the employee vacation, sick, and training factor in subdivision 5;

(2) for program plan support, multiply the result of clause (1) by one plus the program
plan support factor in subdivision 5;

(3) for employee-related expenses, add the employer taxes and workers' compensation
factor in subdivision 5 and the employee benefits factor in subdivision 5. The sum is
employee-related expenses. Multiply the product of clause (2) by one plus the value for
employee-related expenses;

(4) for client programming and supports, multiply the product of clause (3) by one plus
the client programming and supports factor in subdivision 5;

(5) for administrative expenses, add the general business and administrative expenses
factor in subdivision 5, the program administration expenses factor in subdivision 5, and
the absence and utilization factor in subdivision 5;

(6) divide the result of clause (4) by one minus the result of clause (5). The quotient is
the hourly rate;

(7) multiply the hourly rate by the appropriate implementation component under
subdivision 5. This is the adjusted hourly rate; and

(8) divide the adjusted hourly rate by four. The quotient is the total adjusted payment
rate.

new text begin (b) In processing claims, the commissioner shall incorporate the worker retention
component specified in subdivision 5, by multiplying one plus the total adjusted payment
rate by the appropriate worker retention component under subdivision 5, paragraph (d).
 new text end

deleted text begin (b)deleted text end new text begin (c)new text end The commissioner must publish the total deleted text begin adjusteddeleted text end new text begin finalnew text end payment rates.

new text begin EFFECTIVE DATE. new text end

new text begin This section is effective January 1, 2025, or 90 days after federal
approval, whichever is later. The commissioner of human services shall notify the revisor
of statutes when federal approval is obtained.
 new text end

Sec. 56.

Minnesota Statutes 2022, section 256D.425, subdivision 1, is amended to read:


Subdivision 1.

Persons entitled to receive aid.

A person who is aged, blind, or 18 years
of age or older and disabled and who is receiving supplemental security benefits under Title
XVI on the basis of age, blindness, or disability (or would be eligible for such benefits
except for excess income) is eligible for a payment under the Minnesota supplemental aid
program, if the person's net income is less than the standards in section 256D.44. new text begin A person
who is receiving benefits under the Minnesota supplemental aid program in the month prior
to becoming eligible under section 1619(b) of the Social Security Act is eligible for a
payment under the Minnesota supplemental aid program while they remain in section 1619(b)
status. new text end Persons who are not receiving Supplemental Security Income benefits under Title
XVI of the Social Security Act or disability insurance benefits under Title II of the Social
Security Act due to exhausting time limited benefits are not eligible to receive benefits
under the MSA program. Persons who are not receiving Social Security or other maintenance
benefits for failure to meet or comply with the Social Security or other maintenance program
requirements are not eligible to receive benefits under the MSA program. Persons who are
found ineligible for Supplemental Security Income because of excess income, but whose
income is within the limits of the Minnesota supplemental aid program, must have blindness
or disability determined by the state medical review team.

new text begin EFFECTIVE DATE. new text end

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

Sec. 57.

Minnesota Statutes 2022, section 256S.2101, subdivision 1, is amended to read:


Subdivision 1.

Phase-in for disability waiver customized living rates.

All rates and
rate components for community access for disability inclusion customized living and brain
injury customized living under section 256B.4914 deleted text begin shalldeleted text end new text begin mustnew text end be the sum of deleted text begin tendeleted text end new text begin 29.6new text end percent
of the rates calculated under sections 256S.211 to 256S.215 and deleted text begin 90deleted text end new text begin 70.4new text end percent of the rates
calculated using the rate methodology in effect as of June 30, 2017.

new text begin EFFECTIVE DATE. new text end

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

Sec. 58.

Minnesota Statutes 2022, section 268.19, subdivision 1, is amended to read:


Subdivision 1.

Use of data.

(a) Except as provided by this section, data gathered from
any person under the administration of the Minnesota Unemployment Insurance Law are
private data on individuals or nonpublic data not on individuals as defined in section 13.02,
subdivisions 9 and 12, and may not be disclosed except according to a district court order
or section 13.05. A subpoena is not considered a district court order. These data may be
disseminated to and used by the following agencies without the consent of the subject of
the data:

(1) state and federal agencies specifically authorized access to the data by state or federal
law;

(2) any agency of any other state or any federal agency charged with the administration
of an unemployment insurance program;

(3) any agency responsible for the maintenance of a system of public employment offices
for the purpose of assisting individuals in obtaining employment;

(4) the public authority responsible for child support in Minnesota or any other state in
accordance with section 256.978;

(5) human rights agencies within Minnesota that have enforcement powers;

(6) the Department of Revenue to the extent necessary for its duties under Minnesota
laws;

(7) public and private agencies responsible for administering publicly financed assistance
programs for the purpose of monitoring the eligibility of the program's recipients;

(8) the Department of Labor and Industry and the Commerce Fraud Bureau in the
Department of Commerce for uses consistent with the administration of their duties under
Minnesota law;

(9) the Department of Human Services and the Office of Inspector General and its agents
within the Department of Human Services, including county fraud investigators, for
investigations related to recipient or provider fraud and employees of providers when the
provider is suspected of committing public assistance fraud;

new text begin (10) the Department of Human Services for the purpose of evaluating medical assistance
services and supporting program improvement;
 new text end

deleted text begin (10)deleted text end new text begin (11)new text end local and state welfare agencies for monitoring the eligibility of the data subject
for assistance programs, or for any employment or training program administered by those
agencies, whether alone, in combination with another welfare agency, or in conjunction
with the department or to monitor and evaluate the statewide Minnesota family investment
program and other cash assistance programs, the Supplemental Nutrition Assistance Program,
and the Supplemental Nutrition Assistance Program Employment and Training program by
providing data on recipients and former recipients of Supplemental Nutrition Assistance
Program (SNAP) benefits, cash assistance under chapter 256, 256D, 256J, or 256K, child
care assistance under chapter 119B, or medical programs under chapter 256B or 256L or
formerly codified under chapter 256D;

deleted text begin (11)deleted text end new text begin (12)new text end local and state welfare agencies for the purpose of identifying employment,
wages, and other information to assist in the collection of an overpayment debt in an
assistance program;

deleted text begin (12)deleted text end new text begin (13)new text end local, state, and federal law enforcement agencies for the purpose of ascertaining
the last known address and employment location of an individual who is the subject of a
criminal investigation;

deleted text begin (13)deleted text end new text begin (14)new text end the United States Immigration and Customs Enforcement has access to data
on specific individuals and specific employers provided the specific individual or specific
employer is the subject of an investigation by that agency;

deleted text begin (14)deleted text end new text begin (15)new text end the Department of Health for the purposes of epidemiologic investigations;

deleted text begin (15)deleted text end new text begin (16)new text end the Department of Corrections for the purposes of case planning and internal
research for preprobation, probation, and postprobation employment tracking of offenders
sentenced to probation and preconfinement and postconfinement employment tracking of
committed offenders;

deleted text begin (16)deleted text end new text begin (17)new text end the state auditor to the extent necessary to conduct audits of job opportunity
building zones as required under section 469.3201; and

deleted text begin (17)deleted text end new text begin (18)new text end the Office of Higher Education for purposes of supporting program
improvement, system evaluation, and research initiatives including the Statewide
Longitudinal Education Data System.

(b) Data on individuals and employers that are collected, maintained, or used by the
department in an investigation under section 268.182 are confidential as to data on individuals
and protected nonpublic data not on individuals as defined in section 13.02, subdivisions 3
and 13, and must not be disclosed except under statute or district court order or to a party
named in a criminal proceeding, administrative or judicial, for preparation of a defense.

(c) Data gathered by the department in the administration of the Minnesota unemployment
insurance program must not be made the subject or the basis for any suit in any civil
proceedings, administrative or judicial, unless the action is initiated by the department.

Sec. 59.

new text begin PROVIDER CAPACITY GRANTS FOR RURAL AND UNDERSERVED
COMMUNITIES.
 new text end

new text begin Subdivision 1. new text end

new text begin Establishment and authority. new text end

new text begin (a) The commissioner of human services
shall award grants to organizations that provide community-based services to rural or
underserved communities. The grants must be used to build organizational capacity to
provide home and community-based services in the state and to build new or expanded
infrastructure to access medical assistance reimbursement.
 new text end

new text begin (b) The commissioner shall conduct community engagement, provide technical assistance,
and establish a collaborative learning community related to the grants available under this
section and shall work with the commissioners of management and budget and administration
to mitigate barriers in accessing grant money.
 new text end

new text begin (c) The commissioner shall limit expenditures under this subdivision to the amount
appropriated for this purpose.
 new text end

new text begin (d) The commissioner shall give priority to organizations that provide culturally specific
and culturally responsive services or that serve historically underserved communities
throughout the state.
 new text end

new text begin Subd. 2. new text end

new text begin Eligibility. new text end

new text begin An eligible applicant for the capacity grants under subdivision 1 is
an organization or provider that serves, or will serve, rural or underserved communities
and:
 new text end

new text begin (1) provides, or will provide, home and community-based services in the state; or
 new text end

new text begin (2) serves, or will serve, as a connector for communities to available home and
community-based services.
 new text end

new text begin Subd. 3. new text end

new text begin Allowable grant activities. new text end

new text begin Grants under this section must be used by recipients
for the following activities:
 new text end

new text begin (1) expanding existing services;
 new text end

new text begin (2) increasing access in rural or underserved areas;
 new text end

new text begin (3) creating new home and community-based organizations;
 new text end

new text begin (4) connecting underserved communities to benefits and available services; or
 new text end

new text begin (5) building new or expanded infrastructure to access medical assistance reimbursement.
 new text end

Sec. 60. new text begin NEW AMERICAN LEGAL, SOCIAL SERVICES, AND LONG-TERM
CARE WORKFORCE GRANT PROGRAM.
new text end

new text begin Subdivision 1. new text end

new text begin Definition. new text end

new text begin "New American" means an individual born abroad and the
individual's children, irrespective of immigration status.
 new text end

new text begin Subd. 2. new text end

new text begin Grant program established. new text end

new text begin The commissioner of human services shall
establish a new American legal, social services, and long-term care workforce grant program
for organizations that serve and support new Americans:
 new text end

new text begin (1) in seeking or maintaining legal or citizenship status to legally obtain or retain
employment in any field or industry; or
 new text end

new text begin (2) to provide specialized services and supports to new Americans to enter the long-term
care workforce.
 new text end

new text begin Subd. 3. new text end

new text begin Eligible grantees. new text end

new text begin (a) The commissioner shall select grantees as provided in
this subdivision.
 new text end

new text begin (b) Eligible applicants for a grant under this section must demonstrate the qualifications,
legal or other expertise, cultural competency, and experience in working with new Americans
necessary to perform the activities required under subdivision 4 statewide or in discreet
portions of the state.
 new text end

new text begin (c) Eligible applicants seeking to provide services include governmental units, federally
recognized Tribal Nations, nonprofit organizations as defined under section 501(c)(3) of
the Internal Revenue Code, for-profit organizations, and legal services organizations
specializing in obtaining visas for health care workers.
 new text end

new text begin (d) Eligible applicants seeking to provide supports for new Americans to obtain or
maintain employment must demonstrate expertise and capacity to provide training, peer
mentoring, supportive services, workforce development, and other services to develop and
implement strategies for recruiting and retaining qualified employees.
 new text end

new text begin (e) The commissioner shall prioritize:
 new text end

new text begin (1) for applicants providing legal or social services, organizations that serve populations
in areas of the state where worker shortages are most acute or for whom existing legal
services and social services during the legal process or while seeking qualified legal
assistance are unavailable or insufficient; and
 new text end

new text begin (2) for applicants providing supports for new Americans to obtain or maintain
employment in the long-term care workforce, applications from joint labor management
programs.
 new text end

new text begin Subd. 4. new text end

new text begin Allowable uses of grant money. new text end

new text begin (a) Organizations receiving grant money
under this section must provide one or more of the following:
 new text end

new text begin (1) intake, assessment, referral, orientation, legal advice, or representation to new
Americans to seek or maintain legal or citizenship status and secure or maintain legal
authorization for employment in the United States;
 new text end

new text begin (2) social services designed to help eligible populations meet their immediate basic needs
during the process of seeking or maintaining legal status and legal authorization for
employment, including but not limited to accessing housing, food, employment or
employment training, education, course fees, community orientation, transportation, child
care, and medical care. Social services may also include navigation services to address
ongoing needs once immediate basic needs have been met; or
 new text end

new text begin (3) specialized activities targeted to individuals to support recruitment and connection
to long-term care employment opportunities including:
 new text end

new text begin (i) developing connections to employment with long-term care employers and potential
employees;
 new text end

new text begin (ii) providing recruitment, training, guidance, mentorship, and other support services
necessary to encourage employment, employee retention, and successful community
integration;
 new text end

new text begin (iii) providing career education, wraparound support services, and job skills training in
high-demand health care and long-term care fields;
 new text end

new text begin (iv) paying for program expenses related to long-term care professions, including but
not limited to hiring instructors and navigators, space rentals, and supportive services to
help participants attend classes. Allowable uses for supportive services include but are not
limited to:
 new text end

new text begin (A) course fees;
 new text end

new text begin (B) child care costs;
 new text end

new text begin (C) transportation costs;
 new text end

new text begin (D) tuition fees;
 new text end

new text begin (E) financial coaching fees;
 new text end

new text begin (F) mental health supports; and
 new text end

new text begin (G) uniform costs incurred as a direct result of participating in classroom instruction or
training; or
 new text end

new text begin (v) repaying student loan debt directly incurred as a result of pursuing a qualifying course
of study or training.
 new text end

new text begin Subd. 5. new text end

new text begin Reporting. new text end

new text begin (a) Grant recipients under this section must collect and report to
the commissioner information on program participation and program outcomes. The
commissioner shall determine the form and timing of reports.
 new text end

new text begin (b) Grant recipients providing immigration legal services under this section must collect
and report to the commissioner data that are consistent with the requirements established
for the advisory committee established by the supreme court under Minnesota Statutes,
section 480.242, subdivision 1.
 new text end

new text begin Subd. 6. new text end

new text begin Impact study and evaluation. new text end

new text begin (a) The commissioner shall conduct a study of
the long-term care workforce portion of the grant program under this section to assess the
impacts on new Americans served by the grant program and may evaluate the following:
 new text end

new text begin (1) employee retention;
 new text end

new text begin (2) employee compensation;
 new text end

new text begin (3) career advancement and mobility;
 new text end

new text begin (4) career satisfaction; and
 new text end

new text begin (5) safety in the workplace.
 new text end

new text begin (b) By June 30, 2027, the commissioner shall submit a report to the chairs and ranking
minority members of the legislative committees and divisions with jurisdiction over human
services finance and policy on the impacts on new Americans engaged in the grant program,
based on the results of the evaluation under paragraph (a). Where feasible, the report must
include recommendations to improve the experience of new Americans in the long-term
care workforce.
 new text end

Sec. 61.

new text begin SUPPORTED-DECISION-MAKING PROGRAMS.
 new text end

new text begin Subdivision 1. new text end

new text begin Authorization. new text end

new text begin The commissioner of human services shall award general
operating grants to public and private nonprofit organizations, counties, and Tribes to provide
and promote supported decision making.
 new text end

new text begin Subd. 2. new text end

new text begin Definitions. new text end

new text begin (a) For the purposes of this section, the terms in this section have
the meanings given.
 new text end

new text begin (b) "Supported decision making" has the meaning given in section 524.5-102, subdivision
16a.
 new text end

new text begin (c) "Supported-decision-making services" means services provided to help an individual
consider, access, or develop supported decision making, potentially as an alternative to
more restrictive forms of decision making, including guardianship and conservatorship.
The services may be provided to the individual, family members, or trusted support people.
The individual may currently be a person subject to guardianship or conservatorship, but
the services must not be used to help a person access a guardianship or conservatorship.
 new text end

new text begin Subd. 3. new text end

new text begin Grants. new text end

new text begin (a) The grants must be distributed as follows:
 new text end

new text begin (1) at least 75 percent of the grant money must be used to fund programs or organizations
that provide supported-decision-making services;
 new text end

new text begin (2) no more than 20 percent of the grant money may be used to fund county or Tribal
programs that provide supported-decision-making services; and
 new text end

new text begin (3) no more than five percent of the grant money may be used to fund programs or
organizations that do not provide supported-decision-making services but do promote the
use and advancement of supported decision making.
 new text end

new text begin (b) The grants must be distributed in a manner to promote racial and geographic diversity
in the populations receiving services as determined by the commissioner.
 new text end

new text begin Subd. 4. new text end

new text begin Evaluation and report. new text end

new text begin By December 1, 2024, the commissioner must submit
to the chairs and ranking minority members of the legislative committees with jurisdiction
over human services finance and policy an interim report on the impact and outcomes of
the grants, including the number of grants awarded and the organizations receiving the
grants. The interim report must include any available evidence of how grantees were able
to increase utilization of supported decision making and reduce or avoid more restrictive
forms of decision making such as guardianship and conservatorship. By December 1, 2025,
the commissioner must submit to the chairs and ranking minority members of the legislative
committees with jurisdiction over human services finance and policy a final report on the
impact and outcomes of the grants, including any updated information from the interim
report and the total number of people served by the grants. The final report must also detail
how the money was used to achieve the requirements in subdivision 3, paragraph (b).
 new text end

new text begin Subd. 5. new text end

new text begin Applications. new text end

new text begin Any public or private nonprofit agency may apply to the
commissioner for a grant under subdivision 3, paragraph (a), clause (1) or (3). Any county
or Tribal agency in Minnesota may apply to the commissioner for a grant under subdivision
3, paragraph (a), clause (2). The application must be submitted in a form approved by the
commissioner.
 new text end

new text begin Subd. 6. new text end

new text begin Duties of grantees. new text end

new text begin Every public or private nonprofit agency, county, or Tribal
agency that receives a grant to provide or promote supported decision making must comply
with rules related to the administration of the grants.
 new text end

Sec. 62. new text begin APPROVAL OF CORPORATE FOSTER CARE MORATORIUM
EXCEPTIONS.
new text end

new text begin (a) The commissioner of human services may approve or deny corporate foster care
moratorium exceptions requested under Minnesota Statutes, section 245A.03, subdivision
7, paragraph (a), clause (5), prior to approval of a service provider's home and
community-based services license under Minnesota Statutes, chapter 245D. Approval of
the moratorium exception must not be construed as final approval of a service provider's
home and community-based services or community residential setting license.
 new text end

new text begin (b) Approval under paragraph (a) must be available only for service providers that have
requested a home and community-based services license under Minnesota Statutes, chapter
245D.
 new text end

new text begin (c) Approval under paragraph (a) must be rescinded if the service provider's application
for a home and community-based services or community residential setting license is denied.
 new text end

new text begin (d) This section expires December 31, 2023.
 new text end

new text begin EFFECTIVE DATE. new text end

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

Sec. 63. new text begin EARLY INTENSIVE DEVELOPMENTAL AND BEHAVIORAL
INTERVENTION LICENSURE STUDY.
new text end

new text begin (a) The commissioner of human services must review the medical assistance early
intensive developmental and behavioral intervention (EIDBI) service and evaluate the need
for licensure or other regulatory modifications. At a minimum, the evaluation must include:
 new text end

new text begin (1) an examination of current Department of Human Services-licensed programs that
are similar to EIDBI;
 new text end

new text begin (2) an environmental scan of licensure requirements for Medicaid autism programs in
other states; and
 new text end

new text begin (3) consideration of health and safety needs for populations with autism and related
conditions.
 new text end

new text begin (b) The commissioner must consult with interested stakeholders, including self-advocates
who use EIDBI services, EIDBI providers, parents of youth who use EIDBI services, and
advocacy organizations. The commissioner must convene stakeholder meetings to obtain
feedback on licensure or regulatory recommendations.
 new text end

Sec. 64. new text begin MEMORANDUMS OF UNDERSTANDING.
new text end

new text begin The memorandums of understanding with Service Employees International Union
Healthcare Minnesota and Iowa, submitted by the commissioner of management and budget
on February 27, 2023, are ratified.
 new text end

Sec. 65. new text begin SELF-DIRECTED WORKER CONTRACT RATIFICATION.
new text end

new text begin The labor agreement between the state of Minnesota and the Service Employees
International Union Healthcare Minnesota and Iowa, submitted to the Legislative
Coordinating Commission on February 27, 2023, is ratified.
 new text end

Sec. 66. new text begin BUDGET INCREASE FOR CONSUMER-DIRECTED COMMUNITY
SUPPORTS.
new text end

new text begin (a) Effective January 1, 2024, or upon federal approval, whichever is later,
consumer-directed community support budgets identified in the waiver plans under Minnesota
Statutes, sections 256B.092 and 256B.49, and chapter 256S; and the alternative care program
under Minnesota Statutes, section 256B.0913, must be increased by 8.49 percent.
 new text end

new text begin (b) Effective January 1, 2025, or upon federal approval, whichever is later,
consumer-directed community support budgets identified in the waiver plans under Minnesota
Statutes, sections 256B.092 and 256B.49, and chapter 256S; and the alternative care program
under Minnesota Statutes, section 256B.0913, must be increased by 4.53 percent.
 new text end

Sec. 67. new text begin DIRECT CARE SERVICE CORPS PILOT PROJECT.
new text end

new text begin Subdivision 1. new text end

new text begin Establishment. new text end

new text begin The Metropolitan Center for Independent Living must
develop a pilot project establishing the Minnesota Direct Care Service Corps. The pilot
project must utilize financial incentives to attract postsecondary students to work as personal
care assistants or direct support professionals. The Metropolitan Center for Independent
Living must establish the financial incentives and minimum work requirements to be eligible
for incentive payments. The financial incentive must increase with each semester that the
student participates in the Minnesota Direct Care Service Corps.
 new text end

new text begin Subd. 2. new text end

new text begin Pilot sites. new text end

new text begin (a) Pilot sites must include one postsecondary institution in the
seven-county metropolitan area and at least one postsecondary institution outside of the
seven-county metropolitan area. If more than one postsecondary institution outside the
metropolitan area is selected, one must be located in northern Minnesota and the other must
be located in southern Minnesota.
 new text end

new text begin (b) After satisfactorily completing the work requirements for a semester, the pilot site
or its fiscal agent must pay students the financial incentive developed for the pilot project.
 new text end

new text begin Subd. 3. new text end

new text begin Evaluation and report. new text end

new text begin (a) The Metropolitan Center for Independent Living
must contract with a third party to evaluate the pilot project's impact on health care costs,
retention of personal care assistants, and patients' and providers' satisfaction of care. The
evaluation must include the number of participants, the hours of care provided by participants,
and the retention of participants from semester to semester.
 new text end

new text begin (b) By January 15, 2025, the Metropolitan Center for Independent Living must report
the findings under paragraph (a) to the chairs and ranking minority members of the legislative
committees with jurisdiction over human services finance and policy.
 new text end

Sec. 68. new text begin RATE INCREASE FOR HOME CARE SERVICES.
new text end

new text begin (a) The commissioner of human services shall increase payment rates for home health
agency services under Minnesota Statutes, section 256B.0653, by 14.99 percent from the
rates in effect on December 31, 2023.
 new text end

new text begin (b) The commissioner shall increase payment rates for home care nursing under
Minnesota Statutes, section 256B.0651, subdivision 2, clause (2), by 25 percent from the
rates in effect on December 31, 2023.
 new text end

new text begin EFFECTIVE DATE. new text end

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

Sec. 69. new text begin SPECIALIZED EQUIPMENT AND SUPPLIES LIMIT INCREASE.
new text end

new text begin Upon federal approval, the commissioner of human services must increase the annual
limit for specialized equipment and supplies under Minnesota's federally approved home
and community-based service waiver plans, alternative care, and essential community
supports to $10,000.
 new text end

new text begin EFFECTIVE DATE. new text end

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

Sec. 70. new text begin DIRECTION TO COMMISSIONER; APPLICATION OF INTERMEDIATE
CARE FACILITIES FOR PERSONS WITH DEVELOPMENTAL DISABILITIES
RATE INCREASES.
new text end

new text begin The commissioner of human services shall apply the rate increases under Minnesota
Statutes, section 256B.5012, subdivisions 19 and 20, as follows:
 new text end

new text begin (1) apply Minnesota Statutes, section 256B.5012, subdivision 19; and
 new text end

new text begin (2) apply any required rate increase as required under Minnesota Statutes, section
256B.5012, subdivision 20, to the results of clause (1).
 new text end

Sec. 71. new text begin RATE INCREASE FOR CERTAIN DISABILITY WAIVER SERVICES.
new text end

new text begin The commissioner of human services shall increase payment rates for chore services
and home-delivered meals provided under Minnesota Statutes, sections 256B.092 and
256B.49, by 14.99 percent from the rates in effect on December 31, 2023.
 new text end

new text begin EFFECTIVE DATE. new text end

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

Sec. 72. new text begin RATE INCREASE FOR EARLY INTENSIVE DEVELOPMENTAL AND
BEHAVIORAL INTERVENTION BENEFIT SERVICES.
new text end

new text begin The commissioner of human services shall increase payment rates for early intensive
developmental and behavioral intervention services under Minnesota Statutes, section
256B.0949, by 14.99 percent from the rates in effect on December 31, 2023.
 new text end

new text begin EFFECTIVE DATE. new text end

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

Sec. 73. new text begin RATE INCREASE FOR INTERMEDIATE CARE FACILITIES FOR
PERSONS WITH DEVELOPMENTAL DISABILITIES DAY TRAINING AND
HABILITATION SERVICES.
new text end

new text begin The commissioner of human services shall increase payment rates for day training and
habilitation services under Minnesota Statutes, section 252.46, by 14.99 percent from the
rates in effect on December 31, 2023.
 new text end

new text begin EFFECTIVE DATE. new text end

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

Sec. 74. new text begin STUDY TO EXPAND ACCESS TO SERVICES FOR PEOPLE WITH
CO-OCCURRING BEHAVIORAL HEALTH CONDITIONS AND DISABILITIES.
new text end

new text begin The commissioner of human services, in consultation with stakeholders, must evaluate
options to expand services authorized under Minnesota's federally approved home and
community-based waivers, including positive support, crisis respite, respite, and specialist
services. The evaluation may include surveying community providers as to the barriers to
meeting people's needs and options to authorize services under Minnesota's medical assistance
state plan and strategies to decrease the number of people who remain in hospitals, jails,
and other acute or crisis settings when they no longer meet medical or other necessity criteria.
 new text end

Sec. 75. new text begin TEMPORARY GRANT FOR SMALL CUSTOMIZED LIVING
PROVIDERS.
new text end

new text begin (a) The commissioner of human services must establish a temporary grant for:
 new text end

new text begin (1) customized living providers that serve six or fewer people in a single-family home;
and
 new text end

new text begin (2) community residential service providers and integrated community supports providers
who transitioned from providing customized living or 24-hour customized living on or after
June 30, 2021.
 new text end

new text begin (b) Allowable uses of grant money include physical plant updates required for community
residential services or integrated community supports licensure, technical assistance to adapt
business models and meet policy and regulatory guidance, and other uses approved by the
commissioner. Allowable uses of grant money also include reimbursement for eligible costs
incurred by a community residential service provider or integrated community supports
provider directly related to the provider's transition from providing customized living or
24-hour customized living. License holders of eligible settings must apply for grant money
using an application process determined by the commissioner. Grant money approved by
the commissioner is a onetime award of up to $50,000 per eligible setting. To be considered
for grant money, eligible license holders must submit a grant application by June 30, 2024.
The commissioner may approve grant applications on a rolling basis.
 new text end

Sec. 76. new text begin DIRECTION TO COMMISSIONER; SUPPORTED-DECISION-MAKING
REIMBURSEMENT STUDY.
new text end

new text begin By December 15, 2024, the commissioner shall issue a report to the governor and the
chairs and ranking minority members of the legislative committees with jurisdiction over
human services finance and policy detailing how medical assistance service providers could
be reimbursed for providing supported-decision-making services. The report must detail
recommendations for all medical assistance programs, including all home and
community-based programs, to provide for reimbursement for supported-decision-making
services. The report must develop detailed provider requirements for reimbursement,
including the criteria necessary to provide high-quality services. In developing provider
requirements, the commissioner shall consult with all relevant stakeholders, including
organizations currently providing supported-decision-making services. The report must also
include strategies to promote equitable access to supported-decision-making services to
individuals who are Black, Indigenous, or People of Color; people from culturally specific
communities; people from rural communities; and other people who may experience barriers
to accessing medical assistance home and community-based services.
 new text end

Sec. 77. new text begin DIRECTION TO COMMISSIONER; SHARED SERVICES.
new text end

new text begin (a) By December 31, 2023, the commissioner of human services shall seek any necessary
changes to home and community-based services waiver plans regarding sharing services in
order to:
 new text end

new text begin (1) permit shared services for chore, homemaker, and night supervision;
 new text end

new text begin (2) permit existing shared services at higher ratios, including individualized home
supports without training, individualized home supports with training, and individualized
home supports with family training at a ratio of one staff person to three recipients;
 new text end

new text begin (3) ensure that individuals who are seeking to share services permitted under the waiver
plans in an own-home setting are not required to live in a licensed setting in order to share
services so long as all other requirements are met; and
 new text end

new text begin (4) issue guidance for shared services, including:
 new text end

new text begin (i) informed choice for all individuals sharing the services;
 new text end

new text begin (ii) guidance on how lead agencies and individuals shall determine that shared service
is appropriate to meet the needs, health, and safety of each individual for whom the lead
agency provides case management or care coordination; and
 new text end

new text begin (iii) guidance clarifying that an individual's decision to share services does not reduce
any determination of the individual's overall or assessed needs for services.
 new text end

new text begin (b) The commissioner shall develop or provide guidance outlining:
 new text end

new text begin (1) instructions for shared services support planning;
 new text end

new text begin (2) person-centered approaches and informed choice in shared services support planning;
and
 new text end

new text begin (3) required contents of shared services agreements.
 new text end

new text begin (c) The commissioner shall seek and utilize stakeholder input for any proposed changes
to waiver plans and any shared services guidance.
 new text end

Sec. 78. new text begin DIRECTION TO COMMISSIONER; DISABILITY WAIVER SHARED
SERVICES RATES.
new text end

new text begin The commissioner of human services shall establish a rate system for shared homemaker
services and shared chore services provided under Minnesota Statutes, sections 256B.092
and 256B.49. For two persons sharing services, the rate paid to a provider must not exceed
1-1/2 times the rate paid for serving a single individual, and for three persons sharing
services, the rate paid to a provider must not exceed two times the rate paid for serving a
single individual. These rates apply only when all of the criteria for the shared service have
been met.
 new text end

new text begin EFFECTIVE DATE. new text end

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

Sec. 79. new text begin INTERAGENCY EMPLOYMENT SUPPORTS ALIGNMENT STUDY.
new text end

new text begin The commissioners of human services, employment and economic development, and
education must conduct an interagency alignment study on employment supports for people
with disabilities. The study must evaluate:
 new text end

new text begin (1) service rates;
 new text end

new text begin (2) provider enrollment and monitoring standards; and
 new text end

new text begin (3) eligibility processes and people's lived experience transitioning between employment
programs.
 new text end

Sec. 80. new text begin MONITORING EMPLOYMENT OUTCOMES.
new text end

new text begin By January 15, 2025, the Departments of Human Services, Employment and Economic
Development, and Education must provide the chairs and ranking minority members of the
legislative committees with jurisdiction over health, human services, and labor finance and
policy with a plan for tracking employment outcomes for people with disabilities served by
programs administered by the agencies. This plan must include any needed changes to state
law to track supports received and outcomes across programs.
 new text end

Sec. 81. new text begin STUDY ON PRESUMPTIVE ELIGIBILITY FOR LONG-TERM SERVICES
AND SUPPORTS.
new text end

new text begin (a) The commissioner of human services must study presumptive financial and functional
eligibility for people with disabilities and older adults in the following programs:
 new text end

new text begin (1) medical assistance, alternative care, and essential community supports; and
 new text end

new text begin (2) home and community-based services.
 new text end

new text begin (b) The commissioner must evaluate the following in the study of presumptive eligibility
within the programs listed in paragraph (a):
 new text end

new text begin (1) current eligibility processes;
 new text end

new text begin (2) barriers to timely eligibility determinations; and
 new text end

new text begin (3) strategies to enhance access to home and community-based services in the least
restrictive setting.
 new text end

new text begin (c) By January 1, 2025, the commissioner must report recommendations and draft
legislation to the chairs and ranking minority members of the legislative committees with
jurisdiction over health and human services finance and policy.
 new text end

Sec. 82. new text begin ACUTE CARE TRANSITIONS ADVISORY COUNCIL.
new text end

new text begin Subdivision 1. new text end

new text begin Establishment. new text end

new text begin The commissioner of human services shall establish an
Acute Care Transitions Advisory Council to advise and assist the commissioner in
establishing and implementing a statewide vision and systemic approach to acute care
transitions in Minnesota.
 new text end

new text begin Subd. 2. new text end

new text begin Membership. new text end

new text begin (a) The Acute Care Transitions Advisory Council consists of
the following members:
 new text end

new text begin (1) two individuals or their representatives who have lived experiences with acute care
transitions;
 new text end

new text begin (2) two members representing home and community-based services providers;
 new text end

new text begin (3) two members representing the Minnesota Hospital Association;
 new text end

new text begin (4) one member representing the Minnesota Association of County Social Service
Administrators;
 new text end

new text begin (5) one member representing the Local Public Health Association;
 new text end

new text begin (6) one member representing a Tribal government;
 new text end

new text begin (7) one member representing the University of Minnesota;
 new text end

new text begin (8) one member representing the State Advisory Council on Mental Health and
Subcommittee on Children's Mental Health;
 new text end

new text begin (9) one member representing a public sector labor union;
 new text end

new text begin (10) one member representing the Minnesota County Attorney's Association;
 new text end

new text begin (11) one individual who has had an acute hospital stay initiated during a crisis;
 new text end

new text begin (12) one parent of a child who has had an acute hospital stay initiated during a crisis;
 new text end

new text begin (13) one individual who meets the definition of a caring professional;
 new text end

new text begin (14) the commissioner of human services or a designee;
 new text end

new text begin (15) the commissioner of health or a designee; and
 new text end

new text begin (16) the commissioner of education or a designee.
 new text end

new text begin (b) To the extent possible, the advisory council members must represent diverse
populations and different areas of the state.
 new text end

new text begin (c) A member of the legislature may not serve as a member of the advisory council.
 new text end

new text begin Subd. 3. new text end

new text begin Cochairs; convening first meeting. new text end

new text begin The commissioner of human services shall
convene the first meeting. Advisory council members must select advisory council cochairs
at the first meeting.
 new text end

new text begin Subd. 4. new text end

new text begin Compensation; expenses; reimbursement. new text end

new text begin Advisory council members must
be compensated and reimbursed for expenses as provided in Minnesota Statutes, section
15.059, subdivision 3.
 new text end

new text begin Subd. 5. new text end

new text begin Administrative support. new text end

new text begin The commissioner of human services shall provide
meeting space and administrative support to the advisory council.
 new text end

new text begin Subd. 6. new text end

new text begin Public and community engagement. new text end

new text begin The commissioner of human services
shall conduct public and community engagement to obtain information about barriers and
potential solutions to transitioning patients from acute care settings to more appropriate
nonacute care settings and must provide the information collected through public and
community engagement to the advisory council.
 new text end

new text begin Subd. 7. new text end

new text begin Duties. new text end

new text begin (a) By October 1, 2024, the advisory council shall develop and present
to the chairs and ranking minority members of the legislative committees and divisions with
jurisdiction over health and human services finance and policy and the commissioner of
human services an action plan for creating a systemic approach to acute care transitions for
Minnesotans. The action plan must include but is not limited to the following:
 new text end

new text begin (1) recommendations to improve regional capacity for acute care transitions, including
examining the roles and experience of counties and Tribes in delivering services and
identifying any conflicting and duplicative roles and responsibilities among health and
human services agencies, counties, and Tribes;
 new text end

new text begin (2) recommendations to create a measurement and evaluation system using
implementation science to analyze regional and statewide data in transitions and make
ongoing recommendations for policy and program improvement; and
 new text end

new text begin (3) statewide strategies for improving access to transitioning from acute care settings
with a focus on addressing geographic, racial, and ethnic disparities.
 new text end

new text begin (b) The advisory council may contract with a private entity or consultant as necessary
to complete its duties under this section, and is exempt from state procurement process
requirements under Minnesota Statutes, chapter 16C.
 new text end

new text begin Subd. 8. new text end

new text begin Limitations. new text end

new text begin (a) In developing the action plan, the advisory council shall take
into consideration the impact of its recommendations on:
 new text end

new text begin (1) the existing capacity of state agencies, including staffing needs, technology resources,
and existing agency responsibilities; and
 new text end

new text begin (2) the capacity of county and Tribal partners.
 new text end

new text begin (b) The advisory council shall not include in the action plan recommendations that may
result in loss of benefits for the individuals eligible for state health and human services
public programs or exacerbate health disparities and inequities in access to health care and
human services.
 new text end

new text begin Subd. 9. new text end

new text begin Expiration. new text end

new text begin The Acute Care Transitions Advisory Council expires October 2,
2024, or the day after submitting the action plan required under subdivision 7, whichever
is earlier.
 new text end

Sec. 83. new text begin OVERPAYMENTS FOR DISABILITY WAIVER CUSTOMIZED LIVING
SERVICES.
new text end

new text begin (a) Notwithstanding Minnesota Statutes, section 256B.064, or any other law to the
contrary, providers that received ineligible payments for customized living services under
the community access for disability inclusion or brain injury waivers for people under age
55 who were not residing in the setting before January 11, 2021, must not be required to
repay ineligible payments related to the age restrictions for customized living services
delivered between January 11, 2021, and July 1, 2023. The state must not sanction providers
for receipt of these ineligible payments or otherwise seek recovery of these payments.
 new text end

new text begin (b) The state must repay with state money any amount owed to the Centers for Medicare
and Medicaid Services for the federal financial participation amount received by the state
for ineligible payments identified in paragraph (a).
 new text end

new text begin (c) Nothing in this section prohibits the commissioner from recouping past claims due
to false claims or for reasons other than ineligible payments related to age restrictions for
disability waiver customized living services for people who were not residing in the setting
between January 11, 2021, and July 1, 2023, or from recouping future ineligible payments
for disability customized living services, including from providers who received the ineligible
payments described in paragraph (a).
 new text end

new text begin (d) The commissioner must update guidance and communicate with lead agencies and
customized living service providers to ensure that lead agencies and providers understand
the requirements for medical assistance disability waiver customized living service payments.
 new text end

Sec. 84. new text begin PERSONAL CARE ASSISTANCE COMPENSATION FOR SERVICES
PROVIDED BY A PARENT OR SPOUSE.
new text end

new text begin (a) Notwithstanding Minnesota Statutes, section 256B.0659, subdivisions 3, paragraph
(a), clause (a); 11, paragraph (c); and 19, paragraph (b), clause (3), a parent, stepparent, or
legal guardian of a minor who is a personal care assistance recipient or the spouse of a
personal care assistance recipient may provide and be paid for providing personal care
assistance services under medical assistance. The commissioner shall seek federal approval
for these payments. If federal approval is not received, the commissioner shall make payments
for services rendered, prior to federal disapproval, without federal financial participation.
 new text end

new text begin (b) This section expires November 11, 2023, or upon the expiration of federal approval,
whichever is later. The commissioner of human services shall notify the revisor of statutes
when federal approval expires.
 new text end

new text begin EFFECTIVE DATE. new text end

new text begin This section is effective retroactively from May 12, 2023.
 new text end

Sec. 85. new text begin REPEALER.
new text end

new text begin (a) new text end new text begin Minnesota Statutes 2022, section 256B.4914, subdivision 9a, new text end new text begin is repealed.
 new text end

new text begin (b) new text end new text begin Minnesota Statutes 2022, section 256B.4914, subdivision 6b, new text end new text begin is repealed.
 new text end

new text begin EFFECTIVE DATE. new text end

new text begin Paragraph (a) is effective January 1, 2024, or upon federal
approval, whichever is later, and paragraph (b) is effective January 1, 2026, or upon federal
approval, whichever is later. The commissioner of human services shall notify the revisor
of statutes when federal approval is obtained.
 new text end

ARTICLE 2

AGING SERVICES

Section 1.

Minnesota Statutes 2022, section 256.975, subdivision 6, is amended to read:


Subd. 6.

deleted text begin Indiandeleted text end new text begin Native Americannew text end eldersnew text begin coordinatornew text end position.

new text begin (a) new text end The Minnesota
Board on Aging shall create deleted text begin an Indiandeleted text end new text begin a Native Americannew text end elders coordinator positiondeleted text begin ,deleted text end and
shall hire staff as appropriations permit for the purposes of deleted text begin coordinating efforts with the
National Indian Council on Aging and developingdeleted text end new text begin facilitating the coordination and
development ofnew text end a deleted text begin comprehensivedeleted text end statewidenew text begin Tribal-basednew text end service system for deleted text begin Indiandeleted text end new text begin Native
Americannew text end elders. deleted text begin An Indian elder is defined for purposes of this subdivision as an Indian
enrolled in a band or tribe who is 55 years or older.
deleted text end

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

new text begin (1) "Native American elder" means an individual enrolled in a federally recognized
Tribe and identified as an elder according to the requirements of the individual's home Tribe;
and
 new text end

new text begin (2) "Tribal government" means representatives of each of the 11 federally recognized
Native American Tribes located wholly or partially within the boundaries of the state of
Minnesota.
 new text end

new text begin (c)new text end The statewidenew text begin Tribal-basednew text end service system deleted text begin mustdeleted text end new text begin maynew text end include the following
components:

deleted text begin (1) an assessment of the program eligibility, examining the need to change the age-based
eligibility criteria to need-based eligibility criteria;
 deleted text end

deleted text begin (2)deleted text end new text begin (1)new text end a deleted text begin planning system that woulddeleted text end new text begin plan tonew text end grantnew text begin ,new text end or make recommendations for grantingnew text begin ,new text end
federal and state funding fornew text begin statewide Tribal-based Native American programs andnew text end services;

new text begin (2) a plan to develop business initiatives involving Tribal members that will qualify for
federal- and state-funded elder service contracts;
 new text end

(3) a plan fornew text begin statewide Tribal-basednew text end service focal pointsdeleted text begin , senior centers, or community
centersdeleted text end for socialization and service accessibility for deleted text begin Indiandeleted text end new text begin Native Americannew text end elders;

(4) a plan to develop and implementnew text begin statewidenew text end education and public awareness deleted text begin campaignsdeleted text end new text begin
promotions,new text end including deleted text begin awareness programs, sensitivitydeleted text end culturalnew text begin sensitivitynew text end trainingdeleted text begin ,deleted text end and
public education on deleted text begin Indian elder needsdeleted text end new text begin Native American eldersnew text end ;

(5) a plan fornew text begin statewide culturally appropriatenew text end information and referral services new text begin for Native
American elders, new text end includingnew text begin legal advice and counsel andnew text end trained advocates deleted text begin and an Indian
elder newsletterdeleted text end ;

(6) a plan for a coordinatednew text begin statewide Tribal-basednew text end health care system including health
deleted text begin promotion/preventiondeleted text end new text begin promotion and preventionnew text end , in-home service, long-term care service,
and health care services;

(7) a plan for ongoing deleted text begin research involving Indian elders including needs assessment and
needs analysis;deleted text end new text begin collection of significant data on Native American elders, including population,
health, socialization, mortality, homelessness, and economic status; and
new text end

deleted text begin (8) information and referral services for legal advice or legal counsel; and
 deleted text end

deleted text begin (9)deleted text end new text begin (8)new text end a plan to coordinate services with existing organizationsnew text begin ,new text end includingnew text begin but not limited
to the state of Minnesota,new text end the deleted text begin Council ofdeleted text end new text begin Minnesotanew text end Indian Affairsnew text begin Councilnew text end , deleted text begin the Minnesota
Indian Council of Elders,deleted text end the Minnesota Board on Aging, new text begin Wisdom Steps, new text end andnew text begin Minnesotanew text end
Tribal governments.

Sec. 2.

Minnesota Statutes 2022, section 256.9754, is amended to read:


256.9754 deleted text begin COMMUNITY SERVICES DEVELOPMENTdeleted text end new text begin LIVE WELL AT HOMEnew text end
GRANTS deleted text begin PROGRAMdeleted text end .

Subdivision 1.

Definitions.

For purposes of this section, the following terms have the
meanings given.

(a) "Community" means a town, township, city, or targeted neighborhood within a city,
or a consortium of towns, townships, cities, or targeted neighborhoods within cities.

new text begin (b) "Core home and community-based services provider" means a Faith in Action, Living
at Home/Block Nurse, congregational nurse, or similar community-based program governed
by a board, the majority of whose members reside within the program's service area, that
organizes and uses volunteers and paid staff to deliver nonmedical services intended to
assist older adults to identify and manage risks and to maintain the older adults' community
living and integration in the community.
 new text end

new text begin (c) "Long-term services and supports" means any service available under the elderly
waiver program or alternative care grant programs, nursing facility services, transportation
services, caregiver support and respite care services, and other home and community-based
services identified as necessary either to maintain lifestyle choices for older adults or to
support older adults to remain in their own home.
 new text end

deleted text begin (b)deleted text end new text begin (d)new text end "Older adult services" means any services available under the elderly waiver
program or alternative care grant programs; nursing facility services; transportation services;
respite services; and other community-based services identified as necessary either to
maintain lifestyle choices for older Minnesotans, or to promote independence.

deleted text begin (c)deleted text end new text begin (e)new text end "Older adult" refers to individuals 65 years of age and older.

Subd. 2.

Creationnew text begin ; purposenew text end .

new text begin (a) new text end The deleted text begin community services developmentdeleted text end new text begin live well at homenew text end
grants deleted text begin program isdeleted text end new text begin arenew text end created under the administration of the commissioner of human
services.

new text begin (b) The purpose of projects selected by the commissioner of human services under this
section is to make strategic changes in the long-term services and supports system for older
adults and people with dementia, including statewide capacity for local service development
and technical assistance and statewide availability of home and community-based services
for older adult services, caregiver support and respite care services, and other supports in
Minnesota. These projects are intended to create incentives for new and expanded home
and community-based services in Minnesota in order to:
 new text end

new text begin (1) reach older adults early in the progression of older adults' need for long-term services
and supports, providing them with low-cost, high-impact services that will prevent or delay
the use of more costly services;
 new text end

new text begin (2) support older adults to live in the most integrated, least restrictive community setting;
 new text end

new text begin (3) support the informal caregivers of older adults;
 new text end

new text begin (4) develop and implement strategies to integrate long-term services and supports with
health care services, in order to improve the quality of care and enhance the quality of life
of older adults and older adults' informal caregivers;
 new text end

new text begin (5) ensure cost-effective use of financial and human resources;
 new text end

new text begin (6) build community-based approaches and community commitment to delivering
long-term services and supports for older adults in their own homes;
 new text end

new text begin (7) achieve a broad awareness and use of lower-cost in-home services as an alternative
to nursing homes and other residential services;
 new text end

new text begin (8) strengthen and develop additional home and community-based services and
alternatives to nursing homes and other residential services; and
 new text end

new text begin (9) strengthen programs that use volunteers.
 new text end

new text begin (c) The services provided by these projects are available to older adults who are eligible
for medical assistance and the elderly waiver under chapter 256S, the alternative care
program under section 256B.0913, or the essential community supports grant under section
256B.0922, and to older adults who have their own money to pay for services.
 new text end

Subd. 3.

deleted text begin Provision ofdeleted text end new text begin Community services developmentnew text end grants.

The commissioner
shall makenew text begin community services developmentnew text end grants available to communities, providers of
older adult services deleted text begin identified in subdivision 1deleted text end , or deleted text begin todeleted text end a consortium of providers of older
adult servicesdeleted text begin ,deleted text end to establish older adult services. Grants may be provided for capital and other
costs including, but not limited to, start-up and training costs, equipment, and supplies
related to older adult services or other residential or service alternatives to nursing facility
care. Grants may also be made to renovate current buildings, provide transportation services,
fund programs that would allow older adults or individuals with a disability to stay in their
own homes by sharing a home, fund programs that coordinate and manage formal and
informal services to older adults in their homes to enable them to live as independently as
possible in their own homes as an alternative to nursing home care, or expand state-funded
programs in the area.

Subd. 3a.

Priority for other grants.

The commissioner of health shall give priority to
a grantee selected under subdivision 3 when awarding technology-related grants, if the
grantee is using technology as part of the proposal unless that priority conflicts with existing
state or federal guidance related to grant awards by the Department of Health. The
commissioner of transportation shall give priority to a grantee under subdivision 3 when
distributing transportation-related funds to create transportation options for older adults
unless that preference conflicts with existing state or federal guidance related to grant awards
by the Department of Transportation.

Subd. 3b.

State waivers.

The commissioner of health may waive applicable state laws
and rulesnew text begin for grantees under subdivision 3new text end on a time-limited basis if the commissioner of
health determines that a participating grantee requires a waiver in order to achieve
demonstration project goals.

new text begin Subd. 3c. new text end

new text begin Caregiver support and respite care projects. new text end

new text begin (a) The commissioner shall
establish projects to expand the availability of caregiver support and respite care services
for family and other caregivers. The commissioner shall use a request for proposals to select
nonprofit entities to administer the projects. Projects must:
 new text end

new text begin (1) establish a local coordinated network of volunteer and paid respite workers;
 new text end

new text begin (2) coordinate assignment of respite care services to caregivers of older adults;
 new text end

new text begin (3) assure the health and safety of the older adults;
 new text end

new text begin (4) identify at-risk caregivers;
 new text end

new text begin (5) provide information, education, and training for caregivers in the designated
community; and
 new text end

new text begin (6) demonstrate the need in the proposed service area, particularly where nursing facility
closures have occurred or are occurring or areas with service needs identified by section
144A.351. Preference must be given for projects that reach underserved populations.
 new text end

new text begin (b) Projects must clearly describe:
 new text end

new text begin (1) how they will achieve their purpose;
 new text end

new text begin (2) the process for recruiting, training, and retraining volunteers; and
 new text end

new text begin (3) a plan to promote the project in the designated community, including outreach to
older adults needing the services.
 new text end

new text begin (c) Money for all projects under this subdivision may be used to:
 new text end

new text begin (1) hire a coordinator to develop a coordinated network of volunteer and paid respite
care services and assign workers to clients;
 new text end

new text begin (2) recruit and train volunteer providers;
 new text end

new text begin (3) provide information, training, and education to caregivers;
 new text end

new text begin (4) advertise the availability of the caregiver support and respite care project; and
 new text end

new text begin (5) purchase equipment to maintain a system of assigning workers to clients.
 new text end

new text begin (d) Volunteer and caregiver training must include resources on how to support an
individual with dementia.
 new text end

new text begin (e) Project money may not be used to supplant existing funding sources.
 new text end

new text begin Subd. 3d. new text end

new text begin Core home and community-based services projects. new text end

new text begin The commissioner
shall select and contract with core home and community-based services providers for projects
to provide services and supports to older adults both with and without family and other
informal caregivers using a request for proposals process. Projects must:
 new text end

new text begin (1) have a credible public or private nonprofit sponsor providing ongoing financial
support;
 new text end

new text begin (2) have a specific, clearly defined geographic service area;
 new text end

new text begin (3) use a practice framework designed to identify high-risk older adults and help them
take action to better manage their chronic conditions and maintain their community living;
 new text end

new text begin (4) have a team approach to coordination and care, ensuring that the older adult
participants, participants families, and the formal and informal providers are all part of
planning and providing services;
 new text end

new text begin (5) provide information, support services, homemaking services, counseling, and training
for the older adults and family caregivers;
 new text end

new text begin (6) encourage service area or neighborhood residents and local organizations to
collaborate in meeting the needs of older adults in their geographic service areas;
 new text end

new text begin (7) recruit, train, and direct the use of volunteers to provide informal services and other
appropriate support to older adults and their caregivers; and
 new text end

new text begin (8) provide coordination and management of formal and informal services to older adults
and older adults families using less expensive alternatives.
 new text end

new text begin Subd. 3e. new text end

new text begin Community service grants. new text end

new text begin The commissioner shall award contracts for
grants to public and private nonprofit agencies to establish services that strengthen a
community's ability to provide a system of home and community-based services for elderly
persons. The commissioner shall use a request for proposals process.
 new text end

new text begin Subd. 3f. new text end

new text begin Live Well at Home grant extensions. new text end

new text begin (a) A current grantee under subdivision
3, 3c, 3d, or 3e may apply to the commissioner to receive on a noncompetitive basis up to
two years of additional funding.
 new text end

new text begin (b) To be eligible for a grant extension, a grant extension applicant must have been
awarded a grant under this section within the previous five years and provide at least one
eligible service in an underserved community. The grantee must submit to the commissioner
a letter of intent to continue providing the eligible service after the expiration of a grant
extension provided under this subdivision.
 new text end

new text begin (c) The commissioner of human services must give priority to submitted letters of intent
from grantees who have demonstrated success in providing chore services, homemaker
services, transportation services, grocery services, caregiver supports, service coordination,
or other home and community-based services to older adults in underserved communities.
 new text end

new text begin (d) Notwithstanding section 16B.98, subdivision 5, paragraph (b), the commissioner
may from within available appropriations extend a grant agreement up to two additional
years, not to exceed seven years, for grantees the commissioner determines can successfully
sustain the grantee's Live Well at Home project with the additional funds made available
through the grant agreement extension.
 new text end

Subd. 4.

Eligibility.

Grants may be awarded only to communities and providers or to a
consortium of providers that have a local match of 50 percent of the costs for the project in
the form of donations, local tax dollars, in-kind donations, fundraising, or other local matches.

Subd. 5.

Grant preference.

The commissioner of human services shall give preference
when awarding grants under this section to areas where nursing facility closures have
occurred or are occurring or areas with service needs identified by section 144A.351. The
commissioner may award grants to the extent grant funds are available and to the extent
applications are approved by the commissioner. Denial of approval of an application in one
year does not preclude submission of an application in a subsequent year. The maximum
grant amount is limited to $750,000.

Sec. 3.

new text begin [256.9756] CAREGIVER RESPITE SERVICES GRANTS.
 new text end

new text begin Subdivision 1. new text end

new text begin Caregiver respite services grant program established. new text end

new text begin The Minnesota
Board on Aging must establish a caregiver respite services grant program to increase the
availability of respite services for family caregivers of people with dementia and older adults
and to provide information, education, and training to respite caregivers and volunteers
regarding caring for people with dementia. From the money made available for this purpose,
the board must award grants on a competitive basis to respite service providers, giving
priority to areas of the state where there is a high need of respite services.
 new text end

new text begin Subd. 2. new text end

new text begin Eligible uses. new text end

new text begin Grant recipients awarded grant money under this section must
use a portion of the grant award as determined by the board to provide free or subsidized
respite services for family caregivers of people with dementia and older adults.
 new text end

new text begin Subd. 3. new text end

new text begin Report. new text end

new text begin By January 15, 2026, the board shall submit a progress report about
the caregiver respite services grants in this section to the chairs and ranking minority members
of the legislative committees and divisions with jurisdiction over human services finance
and policy. The progress report must include metrics of the use of grant program money.
This subdivision expires upon submission of the report. The board shall notify the revisor
of statutes when the report is submitted.
 new text end

Sec. 4.

Minnesota Statutes 2022, section 256B.0913, subdivision 4, is amended to read:


Subd. 4.

Eligibility for funding for services for nonmedical assistance recipients.

(a)
Funding for services under the alternative care program is available to persons who meet
the following criteria:

(1) the person is a citizen of the United States or a United States national;

(2) the person has been determined by a community assessment under section 256B.0911
to be a person who would require the level of care provided in a nursing facility, as
determined under section 256B.0911, subdivision 26, but for the provision of services under
the alternative care program;

(3) the person is age 65 or older;

(4) the person would be eligible for medical assistance within 135 days of admission to
a nursing facility;

(5) the person is not ineligible for the payment of long-term care services by the medical
assistance program due to an asset transfer penalty under section 256B.0595 or equity
interest in the home exceeding $500,000 as stated in section 256B.056;

(6) the person needs long-term care services that are not funded through other state or
federal funding, or other health insurance or other third-party insurance such as long-term
care insurance;

(7) except for individuals described in clause (8), the monthly cost of the alternative
care services funded by the program for this person does not exceed 75 percent of the
monthly limit described under section 256S.18. This monthly limit does not prohibit the
alternative care client from payment for additional services, but in no case may the cost of
additional services purchased under this section exceed the difference between the client's
monthly service limit defined under section 256S.04, and the alternative care program
monthly service limit defined in this paragraph. If care-related supplies and equipment or
environmental modifications and adaptations are or will be purchased for an alternative
care services recipient, the costs may be prorated on a monthly basis for up to 12 consecutive
months beginning with the month of purchase. If the monthly cost of a recipient's other
alternative care services exceeds the monthly limit established in this paragraph, the annual
cost of the alternative care services shall be determined. In this event, the annual cost of
alternative care services shall not exceed 12 times the monthly limit described in this
paragraph;

(8) for individuals assigned a case mix classification A as described under section
256S.18, with (i) no dependencies in activities of daily living, or (ii) up to two dependencies
in bathing, dressing, grooming, walking, and eating when the dependency score in eating
is three or greater as determined by an assessment performed under section 256B.0911, the
monthly cost of alternative care services funded by the program cannot exceed $593 per
month for all new participants enrolled in the program on or after July 1, 2011. This monthly
limit shall be applied to all other participants who meet this criteria at reassessment. This
monthly limit shall be increased annually as described in section 256S.18. This monthly
limit does not prohibit the alternative care client from payment for additional services, but
in no case may the cost of additional services purchased exceed the difference between the
client's monthly service limit defined in this clause and the limit described in clause (7) for
case mix classification A; deleted text begin and
deleted text end

(9) the person is making timely payments of the assessed monthly fee. A person is
ineligible if payment of the fee is over 60 days past due, unless the person agrees to:

(i) the appointment of a representative payee;

(ii) automatic payment from a financial account;

(iii) the establishment of greater family involvement in the financial management of
payments; or

(iv) another method acceptable to the lead agency to ensure prompt fee paymentsdeleted text begin .deleted text end new text begin ; and
new text end

new text begin (10) for a person participating in consumer-directed community supports, the person's
monthly service limit must be equal to the monthly service limits in clause (7), except that
a person assigned a case mix classification L must receive the monthly service limit for
case mix classification A.
 new text end

(b) The lead agency may extend the client's eligibility as necessary while making
arrangements to facilitate payment of past-due amounts and future premium payments.
Following disenrollment due to nonpayment of a monthly fee, eligibility shall not be
reinstated for a period of 30 days.

(c) Alternative care funding under this subdivision is not available for a person who is
a medical assistance recipient or who would be eligible for medical assistance without a
spenddown or waiver obligation. A person whose initial application for medical assistance
and the elderly waiver program is being processed may be served under the alternative care
program for a period up to 60 days. If the individual is found to be eligible for medical
assistance, medical assistance must be billed for services payable under the federally
approved elderly waiver plan and delivered from the date the individual was found eligible
for the federally approved elderly waiver plan. Notwithstanding this provision, alternative
care funds may not be used to pay for any service the cost of which: (i) is payable by medical
assistance; (ii) is used by a recipient to meet a waiver obligation; or (iii) is used to pay a
medical assistance income spenddown for a person who is eligible to participate in the
federally approved elderly waiver program under the special income standard provision.

(d) Alternative care funding is not available for a person who resides in a licensed nursing
home, certified boarding care home, hospital, or intermediate care facility, except for case
management services which are provided in support of the discharge planning process for
a nursing home resident or certified boarding care home resident to assist with a relocation
process to a community-based setting.

(e) Alternative care funding is not available for a person whose income is greater than
the maintenance needs allowance under section 256S.05, but equal to or less than 120 percent
of the federal poverty guideline effective July 1 in the fiscal year for which alternative care
eligibility is determined, who would be eligible for the elderly waiver with a waiver
obligation.

new text begin EFFECTIVE DATE. new text end

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

Sec. 5.

Minnesota Statutes 2022, section 256B.0913, subdivision 5, is amended to read:


Subd. 5.

Services covered under alternative care.

Alternative care funding may be
used for payment of costs of:

(1) adult day services and adult day services bath;

(2) home care;

(3) homemaker services;

(4) personal care;

(5) case management and conversion case management;

(6) respite care;

(7) specialized supplies and equipment;

(8) home-delivered meals;

(9) nonmedical transportation;

(10) nursing services;

(11) chore services;

(12) companion services;

(13) nutrition services;

(14) family caregiver training and education;

(15) coaching and counseling;

(16) telehome care to provide services in their own homes in conjunction with in-home
visits;

(17) consumer-directed community supports deleted text begin under the alternative care programs which
are available statewide and limited to the average monthly expenditures representative of
all alternative care program participants for the same case mix resident class assigned in
the most recent fiscal year for which complete expenditure data is availabledeleted text end ;

(18) environmental accessibility and adaptations; and

(19) discretionary services, for which lead agencies may make payment from their
alternative care program allocation for services not otherwise defined in this section or
section 256B.0625, following approval by the commissioner.

Total annual payments for discretionary services for all clients served by a lead agency
must not exceed 25 percent of that lead agency's annual alternative care program base
allocation, except that when alternative care services receive federal financial participation
under the 1115 waiver demonstration, funding shall be allocated in accordance with
subdivision 17.

new text begin EFFECTIVE DATE. new text end

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

Sec. 6.

Minnesota Statutes 2022, section 256B.0917, subdivision 1b, is amended to read:


Subd. 1b.

Definitions.

(a) For purposes of this section, the following terms have the
meanings given.

(b) deleted text begin "Community" means a town; township; city; or targeted neighborhood within a city;
or a consortium of towns, townships, cities, or specific neighborhoods within a city.
deleted text end

deleted text begin (c) "Core home and community-based services provider" means a Faith in Action, Living
at Home Block Nurse, Congregational Nurse, or similar community-based program governed
by a board, the majority of whose members reside within the program's service area, that
organizes and uses volunteers and paid staff to deliver nonmedical services intended to
assist older adults to identify and manage risks and to maintain their community living and
integration in the community.
 deleted text end

deleted text begin (d)deleted text end "Eldercare development partnership" means a team of representatives of county
social service and public health agencies, the area agency on aging, local nursing home
providers, local home care providers, and other appropriate home and community-based
providers in the area agency's planning and service area.

deleted text begin (e)deleted text end new text begin (c)new text end "Long-term services and supports" means any service available under the elderly
waiver program or alternative care grant programs, nursing facility services, transportation
services, caregiver support and respite care services, and other home and community-based
services identified as necessary either to maintain lifestyle choices for older adults or to
support them to remain in their own home.

deleted text begin (f)deleted text end new text begin (d)new text end "Older adult" refers to an individual who is 65 years of age or older.

Sec. 7.

Minnesota Statutes 2022, section 256M.42, is amended to read:


256M.42 ADULT PROTECTION GRANT ALLOCATIONS.

Subdivision 1.

Formula.

(a) The commissioner shall allocate state money appropriated
under this section new text begin on an annual basis new text end to each county board deleted text begin and tribal government approved
by the commissioner to assume county agency dutiesdeleted text end for adult deleted text begin protective services or as a
lead investigative agencydeleted text end new text begin protectionnew text end under section 626.557 deleted text begin on an annual basis in an amount
determineddeleted text end new text begin and to Tribal Nations that have voluntarily chosen by resolution of Tribal
government to participate in vulnerable adult protection programsnew text end according to the following
formulanew text begin after the award of the amounts in paragraph (c)new text end :

(1) 25 percent must be allocated new text begin to the responsible agency new text end on the basis of the number
of reports of suspected vulnerable adult maltreatment under sections 626.557 and 626.5572,
deleted text begin when the county or tribe is responsibledeleted text end as determined by the most recent data of the
commissioner; and

(2) 75 percent must be allocated new text begin to the responsible agency new text end on the basis of the number
of screened-in reports for adult protective services or vulnerable adult maltreatment
investigations under sections 626.557 and 626.5572, deleted text begin when the county or tribe is responsibledeleted text end
as determined by the most recent data of the commissioner.

(b) deleted text begin The commissioner is precluded from changing the formula under this subdivision
or recommending a change to the legislature without public review and input.deleted text end new text begin
Notwithstanding paragraph (a), the commissioner must not award a county less than a
minimum allocation established by the commissioner.
new text end

new text begin (c) To receive money under this subdivision, a participating Tribal Nation must apply
to the commissioner. Of the amount appropriated for purposes of this section, the
commissioner must award $100,000 to each federally recognized Tribal Nation that has
applied to the commissioner and has a Tribal resolution establishing a vulnerable adult
protection program. Money received by a Tribal Nation under this section must be used for
its vulnerable adult protection program.
 new text end

Subd. 2.

Payment.

The commissioner shall make allocations for the state fiscal year
starting July 1, deleted text begin 2019deleted text end new text begin 2023new text end , and to each county board or Tribal government on or before
October 10, deleted text begin 2019deleted text end new text begin 2023new text end . The commissioner shall make allocations under subdivision 1 to
each county board or Tribal government each year thereafter on or before July 10.

Subd. 3.

deleted text begin Prohibition on supplanting existing moneydeleted text end new text begin Purpose of expendituresnew text end .

Money
received under this section must be used deleted text begin for staffing for protection of vulnerable adults or deleted text end
new text begin to meet the agency's duties under section 626.557 andnew text end to expand adult protective servicesnew text begin
to stop, prevent, and reduce risks of maltreatment for adults accepted for services under
section 626.557, or for multidisciplinary teams under section 626.5571new text end . deleted text begin Money must not
be used to supplant current county or tribe expenditures for these purposes.
deleted text end

new text begin Subd. 4. new text end

new text begin Required expenditures. new text end

new text begin State money must be used to expand, not supplant,
county or Tribal expenditures for the fiscal year 2023 base for adult protection programs,
service interventions, or multidisciplinary teams. A county receiving money under this
section must maintain a level of yearly county expenditures for adult protection services
under chapter 626 at least equal to that county's average expenditures for those services for
calendar years 2022 and 2023.
 new text end

new text begin Subd. 5. new text end

new text begin County performance on adult protection measures. new text end

new text begin The commissioner must
set vulnerable adult protection measures and standards for money received under this section.
The commissioner must require an underperforming county to demonstrate that the county
designated money allocated under this section for the purpose required and implemented a
reasonable strategy to improve adult protection performance, including the development of
a performance improvement plan and additional remedies identified by the commissioner.
The commissioner may redirect up to 20 percent of an underperforming county's money
under this section toward the performance improvement plan.
 new text end

new text begin Subd. 6. new text end

new text begin American Indian adult protection. new text end

new text begin Tribal Nations receiving money under
this section must establish vulnerable adult protection measures and standards and report
annually to the commissioner on these outcomes and the number of adults served.
 new text end

new text begin EFFECTIVE DATE. new text end

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

Sec. 8.

Minnesota Statutes 2022, section 256R.17, subdivision 2, is amended to read:


Subd. 2.

Case mix indices.

(a) The commissioner shall assign a case mix index to each
case mix classification deleted text begin based on the Centers for Medicare and Medicaid Services staff time
measurement studydeleted text end new text begin as determined by the commissioner of health under section 144.0724new text end .

(b) An index maximization approach shall be used to classify residents. "Index
maximization" has the meaning given in section 144.0724, subdivision 2, paragraph (c).

Sec. 9.

Minnesota Statutes 2022, section 256R.25, is amended to read:


256R.25 EXTERNAL FIXED COSTS PAYMENT RATE.

(a) The payment rate for external fixed costs is the sum of the amounts in paragraphs
(b) to deleted text begin (o)deleted text end new text begin (p)new text end .

(b) For a facility licensed as a nursing home, the portion related to the provider surcharge
under section 256.9657 is equal to $8.86 per resident day. For a facility licensed as both a
nursing home and a boarding care home, the portion related to the provider surcharge under
section 256.9657 is equal to $8.86 per resident day multiplied by the result of its number
of nursing home beds divided by its total number of licensed beds.

(c) The portion related to the licensure fee under section 144.122, paragraph (d), is the
amount of the fee divided by the sum of the facility's resident days.

(d) The portion related to development and education of resident and family advisory
councils under section 144A.33 is $5 per resident day divided by 365.

(e) The portion related to scholarships is determined under section 256R.37.

(f) The portion related to planned closure rate adjustments is as determined under section
256R.40, subdivision 5, and Minnesota Statutes 2010, section 256B.436.

(g) The portion related to consolidation rate adjustments shall be as determined under
section 144A.071, subdivisions 4c, paragraph (a), clauses (5) and (6), and 4d.

(h) The portion related to single-bed room incentives is as determined under section
256R.41.

(i) The portions related to real estate taxes, special assessments, and payments made in
lieu of real estate taxes directly identified or allocated to the nursing facility are the allowable
amounts divided by the sum of the facility's resident days. Allowable costs under this
paragraph for payments made by a nonprofit nursing facility that are in lieu of real estate
taxes shall not exceed the amount which the nursing facility would have paid to a city or
township and county for fire, police, sanitation services, and road maintenance costs had
real estate taxes been levied on that property for those purposes.

(j) The portion related to employer health insurance costs is the allowable costs divided
by the sum of the facility's resident days.

(k) The portion related to the Public Employees Retirement Association is the allowable
costs divided by the sum of the facility's resident days.

(l) The portion related to quality improvement incentive payment rate adjustments is
the amount determined under section 256R.39.

(m) The portion related to performance-based incentive payments is the amount
determined under section 256R.38.

(n) The portion related to special dietary needs is the amount determined under section
256R.51.

(o) The portion related to the rate adjustments for border city facilities is the amount
determined under section 256R.481.

new text begin (p) The portion related to the rate adjustment for critical access nursing facilities is the
amount determined under section 256R.47.
 new text end

new text begin EFFECTIVE DATE. new text end

new text begin This section is effective July 1, 2023, or upon federal approval,
whichever is later. The commissioner of human services shall notify the revisor of statutes
when federal approval is obtained.
 new text end

Sec. 10.

Minnesota Statutes 2022, section 256R.47, is amended to read:


256R.47 RATE ADJUSTMENT FOR CRITICAL ACCESS NURSING
FACILITIES.

(a) The commissioner, in consultation with the commissioner of health, may designate
certain nursing facilities as critical access nursing facilities. The designation shall be granted
on a competitive basis, within the limits of funds appropriated for this purpose.

(b) The commissioner shall request proposals from nursing facilities every two years.
Proposals must be submitted in the form and according to the timelines established by the
commissioner. In selecting applicants to designate, the commissioner, in consultation with
the commissioner of health, and with input from stakeholders, shall develop criteria designed
to preserve access to nursing facility services in isolated areas, rebalance long-term care,
and improve quality. To the extent practicable, the commissioner shall ensure an even
distribution of designations across the state.

(c) deleted text begin The commissioner shall allow the benefits in clauses (1) to (5)deleted text end For nursing facilities
designated as critical access nursing facilitiesdeleted text begin :deleted text end new text begin , the commissioner shall allow a supplemental
payment above a facility's operating payment rate as determined to be necessary by the
commissioner to maintain access to nursing facility services in isolated areas identified in
paragraph (b). The commissioner must approve the amounts of supplemental payments
through a memorandum of understanding. Supplemental payments to facilities under this
section must be in the form of time-limited rate adjustments included in the external fixed
costs payment rate under section 256R.25.
new text end

deleted text begin (1) partial rebasing, with the commissioner allowing a designated facility operating
payment rates being the sum of up to 60 percent of the operating payment rate determined
in accordance with section 256R.21, subdivision 3, and at least 40 percent, with the sum of
the two portions being equal to 100 percent, of the operating payment rate that would have
been allowed had the facility not been designated. The commissioner may adjust these
percentages by up to 20 percent and may approve a request for less than the amount allowed;
 deleted text end

deleted text begin (2) enhanced payments for leave days. Notwithstanding section 256R.43, upon
designation as a critical access nursing facility, the commissioner shall limit payment for
leave days to 60 percent of that nursing facility's total payment rate for the involved resident,
and shall allow this payment only when the occupancy of the nursing facility, inclusive of
bed hold days, is equal to or greater than 90 percent;
 deleted text end

deleted text begin (3) two designated critical access nursing facilities, with up to 100 beds in active service,
may jointly apply to the commissioner of health for a waiver of Minnesota Rules, part
4658.0500, subpart 2, in order to jointly employ a director of nursing. The commissioner
of health shall consider each waiver request independently based on the criteria under
Minnesota Rules, part 4658.0040;
 deleted text end

deleted text begin (4) the minimum threshold under section 256B.431, subdivision 15, paragraph (e), shall
be 40 percent of the amount that would otherwise apply; and
 deleted text end

deleted text begin (5) the quality-based rate limits under section 256R.23, subdivisions 5 to 7, apply to
designated critical access nursing facilities.
 deleted text end

(d) Designation of a critical access nursing facility is for a new text begin maximum new text end period of new text begin up to
new text end two years, after which the deleted text begin benefitsdeleted text end new text begin benefitnew text end allowed under paragraph (c) shall be removed.
Designated facilities may apply for continued designation.

deleted text begin (e) This section is suspended and no state or federal funding shall be appropriated or
allocated for the purposes of this section from January 1, 2016, to December 31, 2019.
 deleted text end

new text begin (e) The memorandum of understanding required by paragraph (c) must state that the
designation of a critical access nursing facility must be removed if the facility undergoes a
change of ownership as defined in section 144A.06, subdivision 2.
 new text end

new text begin EFFECTIVE DATE. new text end

new text begin This section is effective July 1, 2023, or upon federal approval,
whichever is later. The commissioner of human services shall notify the revisor of statutes
when federal approval is obtained.
 new text end

Sec. 11.

Minnesota Statutes 2022, section 256R.53, is amended by adding a subdivision
to read:


new text begin Subd. 3. new text end

new text begin Nursing facility in Red Wing. new text end

new text begin (a) The operating payment rate for a facility
located in the city of Red Wing at 1412 West 4th Street is the sum of its direct care costs
per standardized day, its other care-related costs per resident day, and its other operating
costs per day.
 new text end

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

new text begin EFFECTIVE DATE. new text end

new text begin This section is effective July 1, 2023, or upon federal approval,
whichever is later. The commissioner of human services shall notify the revisor of statutes
when federal approval is obtained.
 new text end

Sec. 12.

new text begin [256R.55] FINANCIALLY DISTRESSED NURSING FACILITY LOAN
PROGRAM.
 new text end

new text begin Subdivision 1. new text end

new text begin Financially distressed nursing facility loans. new text end

new text begin The commissioner of
human services shall establish a competitive financially distressed nursing facility loan
program to provide operating loans to eligible nursing facilities. The commissioner shall
initiate the application process for the loan described in this section at least once annually.
A second application process may be initiated each year at the discretion of the commissioner.
 new text end

new text begin Subd. 2. new text end

new text begin Eligibility. new text end

new text begin To be an eligible applicant for a loan under this section, a nursing
facility must submit to the commissioner of human services a loan application in the form
and according to the timelines established by the commissioner. In its loan application, a
loan applicant must demonstrate that:
 new text end

new text begin (1) the total net income of the nursing facility is not generating sufficient revenue to
cover the nursing facility's operating expenses;
 new text end

new text begin (2) the nursing facility is at risk of closure; and
 new text end

new text begin (3) additional operating revenue is necessary to either preserve access to nursing facility
services within the community or support people with complex, high-acuity support needs.
 new text end

new text begin Subd. 3. new text end

new text begin Approving loans. new text end

new text begin The commissioner must evaluate all loan applications on a
competitive basis and award loans to successful applicants within available appropriations
for this purpose. The commissioner's decisions are final and not subject to appeal.
 new text end

new text begin Subd. 4. new text end

new text begin Disbursement schedule. new text end

new text begin Successful loan applicants under this section may
receive loan disbursements as a lump sum, on an agreed upon disbursement schedule, or as
a time-limited line of credit. The commissioner shall approve disbursements to successful
loan applicants through a memorandum of understanding. Memoranda of understanding
must specify the amount and schedule of loan disbursements.
 new text end

new text begin Subd. 5. new text end

new text begin Loan administration. new text end

new text begin The commissioner may contract with an independent
third party to administer the loan program under this section.
 new text end

new text begin Subd. 6. new text end

new text begin Loan payments. new text end

new text begin The commissioner shall negotiate the terms of the loan
repayment, including the start of the repayment plan, the due date of the repayment, and
the frequency of the repayment installments. Repayment installments must not begin until
at least 18 months after the first disbursement date. The memoranda of understanding must
specify the amount and schedule of loan payments. The repayment term must not exceed
72 months. If any loan payment to the commissioner is not paid within the time specified
by the memoranda of understanding, the late payment must be assessed a penalty rate of
0.01 percent of the original loan amount each month the payment is past due. This late fee
is not an allowable cost on the department's cost report. The commissioner shall have the
power to abate penalties when discrepancies occur resulting from but not limited to
circumstances of error and mail delivery.
 new text end

new text begin Subd. 7. new text end

new text begin Loan repayment. new text end

new text begin (a) If a borrower is more than 60 calendar days delinquent
in the timely payment of a contractual payment under this section, the provisions in
paragraphs (b) to (e) apply.
 new text end

new text begin (b) The commissioner may withhold some or all of the amount of the delinquent loan
payment, together with any penalties due and owing on those amounts, from any money
the department owes to the borrower. The commissioner may, at the commissioner's
discretion, also withhold future contractual payments from any money the commissioner
owes the provider as those contractual payments become due and owing. The commissioner
may continue this withholding until the commissioner determines there is no longer any
need to do so.
 new text end

new text begin (c) The commissioner shall give prior notice of the commissioner's intention to withhold
by mail, facsimile, or email at least ten business days before the date of the first payment
period for which the withholding begins. The notice must be deemed received as of the date
of mailing or receipt of the facsimile or electronic notice. The notice must:
 new text end

new text begin (1) state the amount of the delinquent contractual payment;
 new text end

new text begin (2) state the amount of the withholding per payment period;
 new text end

new text begin (3) state the date on which the withholding is to begin;
 new text end

new text begin (4) state whether the commissioner intends to withhold future installments of the
provider's contractual payments; and
 new text end

new text begin (5) state other contents as the commissioner deems appropriate.
 new text end

new text begin (d) The commissioner, or the commissioner's designee, may enter into written settlement
agreements with a provider to resolve disputes and other matters involving unpaid loan
contractual payments or future loan contractual payments.
 new text end

new text begin (e) Notwithstanding any law to the contrary, all unpaid loans, plus any accrued penalties,
are overpayments for the purposes of section 256B.0641, subdivision 1. The current owner
of a nursing home or boarding care home is liable for the overpayment amount owed by a
former owner for any facility sold, transferred, or reorganized.
 new text end

new text begin Subd. 8. new text end

new text begin Audit. new text end

new text begin Loan money allocated under this section are subject to audit to determine
whether the money was spent as authorized under this section.
 new text end

new text begin Subd. 9. new text end

new text begin Carryforward. new text end

new text begin Notwithstanding section 16A.28, subdivision 3, any
appropriation for the purposes under this section carry forward and do not lapse until the
close of the fiscal year in which this section expires.
 new text end

new text begin Subd. 10. new text end

new text begin Expiration. new text end

new text begin This section expires June 30, 2029.
 new text end

new text begin EFFECTIVE DATE. new text end

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

Sec. 13.

Minnesota Statutes 2022, section 256S.15, subdivision 2, is amended to read:


Subd. 2.

Foster care limit.

The elderly waiver payment for the foster care service in
combination with the payment for all other elderly waiver services, including case
management, must not exceed the monthly case mix budget cap for the participant as
specified in sections 256S.18, subdivision 3, and 256S.19, deleted text begin subdivisionsdeleted text end new text begin subdivisionnew text end 3 deleted text begin and
4deleted text end .

new text begin EFFECTIVE DATE. new text end

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

Sec. 14.

Minnesota Statutes 2022, section 256S.18, is amended by adding a subdivision
to read:


new text begin Subd. 3a. new text end

new text begin Monthly case mix budget caps for consumer-directed community
supports. new text end

new text begin The monthly case mix budget caps for each case mix classification for
consumer-directed community supports must be equal to the monthly case mix budget caps
in subdivision 3.
 new text end

new text begin EFFECTIVE DATE. new text end

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

Sec. 15.

Minnesota Statutes 2022, section 256S.19, subdivision 3, is amended to read:


Subd. 3.

Calculation of monthly conversion budget deleted text begin cap without consumer-directed
community supportsdeleted text end new text begin capsnew text end .

(a) The elderly waiver monthly conversion budget cap for the
cost of elderly waiver services deleted text begin without consumer-directed community supportsdeleted text end must be
based on the nursing facility case mix adjusted total payment rate of the nursing facility
where the elderly waiver applicant currently resides for the applicant's case mix classification
as determined according to section 256R.17.

(b) The elderly waiver monthly conversion budget cap for the cost of elderly waiver
services deleted text begin without consumer-directed community supports shalldeleted text end new text begin mustnew text end be calculated by
multiplying the applicable nursing facility case mix adjusted total payment rate by 365,
dividing by 12, and subtracting the participant's maintenance needs allowance.

(c) A participant's initially approved monthly conversion budget cap for elderly waiver
services deleted text begin without consumer-directed community supports shalldeleted text end new text begin mustnew text end be adjusted at least
annually as described in section 256S.18, subdivision 5.

new text begin (d) Conversion budget caps for individuals participating in consumer-directed community
supports must be set as described in paragraphs (a) to (c).
 new text end

new text begin EFFECTIVE DATE. new text end

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

Sec. 16.

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


256S.21 RATE SETTING; APPLICATIONnew text begin ; EVALUATIONnew text end .

new text begin Subdivision 1. new text end

new text begin Application of rate setting. new text end

The deleted text begin paymentdeleted text end new text begin ratenew text end methodologies in sections
256S.2101 to 256S.215 apply tonew text begin :
new text end

new text begin (1)new text end elderly waiver, elderly waiver customized living, and elderly waiver foster care under
this chapter;

new text begin (2)new text end alternative care under section 256B.0913;

new text begin (3)new text end essential community supports under section 256B.0922; and

new text begin (4)new text end community access for disability inclusion customized living and brain injury
customized living under section 256B.49.

new text begin Subd. 2. new text end

new text begin Evaluation of rate setting. new text end

new text begin (a) Beginning January 1, 2024, and every two years
thereafter, the commissioner, in consultation with stakeholders, shall use all available data
and resources to evaluate the following rate setting elements:
 new text end

new text begin (1) the base wage index;
 new text end

new text begin (2) the factors and supervision wage components; and
 new text end

new text begin (3) the formulas to calculate adjusted base wages and rates.
 new text end

new text begin (b) Beginning January 15, 2026, and every two years thereafter, the commissioner shall
report to the chairs and ranking minority members of the legislative committees and divisions
with jurisdiction over health and human services finance and policy with a full report on
the information and data gathered under paragraph (a).
 new text end

new text begin Subd. 3. new text end

new text begin Cost reporting. new text end

new text begin (a) As determined by the commissioner, in consultation with
stakeholders, a provider enrolled to provide services with rates determined under this chapter
must submit requested cost data to the commissioner to support evaluation of the rate
methodologies in this chapter. Requested cost data may include but are not limited to:
 new text end

new text begin (1) worker wage costs;
 new text end

new text begin (2) benefits paid;
 new text end

new text begin (3) supervisor wage costs;
 new text end

new text begin (4) executive wage costs;
 new text end

new text begin (5) vacation, sick, and training time paid;
 new text end

new text begin (6) taxes, workers' compensation, and unemployment insurance costs paid;
 new text end

new text begin (7) administrative costs paid;
 new text end

new text begin (8) program costs paid;
 new text end

new text begin (9) transportation costs paid;
 new text end

new text begin (10) vacancy rates; and
 new text end

new text begin (11) other data relating to costs required to provide services requested by the
commissioner.
 new text end

new text begin (b) At least once in any five-year period, a provider must submit cost data for a fiscal
year that ended not more than 18 months prior to the submission date. The commissioner
shall provide each provider a 90-day notice prior to the provider's submission due date. If
by 30 days after the required submission date a provider fails to submit required reporting
data, the commissioner shall provide notice to the provider, and if by 60 days after the
required submission date a provider has not provided the required data, the commissioner
shall provide a second notice. The commissioner shall temporarily suspend payments to the
provider if cost data is not received 90 days after the required submission date. Withheld
payments must be made once data is received by the commissioner.
 new text end

new text begin (c) The commissioner shall coordinate the cost reporting activities required under this
section with the cost reporting activities directed under section 256B.4914, subdivision 10a.
 new text end

new text begin (d) The commissioner shall analyze cost documentation in paragraph (a) and, in
consultation with stakeholders, may submit recommendations on rate methodologies in this
chapter, including ways to monitor and enforce the spending requirements directed in section
256S.2101, subdivision 3, through the reports directed by subdivision 2.
 new text end

new text begin EFFECTIVE DATE. new text end

new text begin Subdivisions 1 and 2 are effective January 1, 2024, or upon
federal approval, whichever is later. Subdivision 3 is effective January 1, 2025. The
commissioner of human services shall notify the revisor of statutes when approval is obtained.
 new text end

Sec. 17.

Minnesota Statutes 2022, section 256S.211, is amended to read:


256S.211 RATE SETTING; deleted text begin RATE ESTABLISHMENTdeleted text end new text begin UPDATING RATES;
SPENDING REQUIREMENTSnew text end .

Subdivision 1.

Establishing base wages.

When establishing new text begin and updating new text end the base wages
according to section 256S.212, the commissioner shall use standard occupational
classification (SOC) codes from the Bureau of Labor Statistics as defined in the edition of
the Occupational Handbook published immediately prior to January 1, 2019, using
Minnesota-specific wages taken from job descriptions.

Subd. 2.

deleted text begin Establishingdeleted text end new text begin Updatingnew text end rates.

deleted text begin By January 1 of each year,deleted text end new text begin On January 1, 2024,new text end
the commissioner shall deleted text begin establish factors,deleted text end new text begin updatenew text end component ratesdeleted text begin ,deleted text end and rates according to
sections deleted text begin 256S.213 anddeleted text end new text begin 256S.212 tonew text end 256S.215, using deleted text begin base wages established according to
section 256S.212deleted text end new text begin the data referenced in subdivision 1new text end .

new text begin Subd. 3. new text end

new text begin Updating home-delivered meals rate. new text end

new text begin On January 1 of each year, the
commissioner must update the home-delivered meals rate in section 256S.215, subdivision
15, by the percent increase in the nursing facility dietary per diem using the two most recently
available nursing facility cost reports.
 new text end

new text begin Subd. 4. new text end

new text begin Spending requirements. new text end

new text begin (a) Except for community access for disability
inclusion customized living and brain injury customized living under section 256B.49,
home-delivered meals, and designated disproportionate share facilities under section
256S.205, at least 80 percent of the marginal increase in revenue from the implementation
of any rate adjustments under this section must be used to increase compensation-related
costs for employees directly employed by the provider.
 new text end

new text begin (b) For the purposes of this subdivision, compensation-related costs include:
 new text end

new text begin (1) wages and salaries;
 new text end

new text begin (2) the employer's share of FICA taxes, Medicare taxes, state and federal unemployment
taxes, workers' compensation, and mileage reimbursement;
 new text end

new text begin (3) the employer's paid share of health and dental insurance, life insurance, disability
insurance, long-term care insurance, uniform allowance, pensions, and contributions to
employee retirement accounts; and
 new text end

new text begin (4) benefits that address direct support professional workforce needs above and beyond
what employees were offered prior to the implementation of any rate adjustments under
this section, including any concurrent or subsequent adjustments to the base wage indices.
 new text end

new text begin (c) Compensation-related costs for persons employed in the central office of a corporation
or entity that has an ownership interest in the provider or exercises control over the provider,
or for persons paid by the provider under a management contract, do not count toward the
80 percent requirement under this subdivision.
 new text end

new text begin (d) A provider agency or individual provider that receives additional revenue subject to
the requirements of this subdivision shall prepare, and upon request submit to the
commissioner, a distribution plan that specifies the amount of money the provider expects
to receive that is subject to the requirements of this subdivision, including how that money
was or will be distributed to increase compensation-related costs for employees. Within 60
days of final implementation of the new phase-in proportion or adjustment to the base wage
indices subject to the requirements of this subdivision, the provider must post the distribution
plan and leave it posted for a period of at least six months in an area of the provider's
operation to which all employees have access. The posted distribution plan must include
instructions regarding how to contact the commissioner, or the commissioner's representative,
if an employee has not received the compensation-related increase described in the plan.
 new text end

new text begin EFFECTIVE DATE. new text end

new text begin This section is effective January 1, 2024, or upon federal approval,
whichever is later, except that subdivision 3 is effective July 1, 2023, or upon federal
approval, whichever is later. The commissioner of human services shall notify the revisor
of statutes when federal approval is obtained.
 new text end

Sec. 18.

Minnesota Statutes 2022, section 256S.212, is amended to read:


256S.212 RATE SETTING; BASE WAGE INDEX.

Subdivision 1.

Updating SOC codes.

If any of the SOC codes and positions used in
this section are no longer available, the commissioner shall, in consultation with stakeholders,
select a new SOC code and position that is the closest match to the previously used SOC
position.

Subd. 2.

Home management and support services base wage.

For customized livingdeleted text begin ,deleted text end new text begin
andnew text end foster caredeleted text begin , and residential caredeleted text end component services, the home management and support
services base wage equals 33.33 percent of the Minneapolis-St. Paul-Bloomington, MN-WI
MetroSA average wage for new text begin home health and new text end personal deleted text begin and homedeleted text end care aide (SOC code deleted text begin 39-9021deleted text end new text begin
31-1120new text end ); 33.33 percent of the Minneapolis-St. Paul-Bloomington, MN-WI MetroSA average
wage for food preparation workers (SOC code 35-2021); and 33.34 percent of the
Minneapolis-St. Paul-Bloomington, MN-WI MetroSA average wage for maids and
housekeeping cleaners (SOC code 37-2012).

Subd. 3.

Home care aide base wage.

For customized livingdeleted text begin ,deleted text end new text begin andnew text end foster caredeleted text begin , and
residential caredeleted text end component services, the home care aide base wage equals deleted text begin 50deleted text end new text begin 75new text end percent of
the Minneapolis-St. Paul-Bloomington, MN-WI MetroSA average wage for home healthnew text begin
and personal carenew text end aides (SOC code deleted text begin 31-1011deleted text end new text begin 31-1120new text end ); and deleted text begin 50deleted text end new text begin 25new text end percent of the
Minneapolis-St. Paul-Bloomington, MN-WI MetroSA average wage for nursing assistants
(SOC code deleted text begin 31-1014deleted text end new text begin 31-1131new text end ).

Subd. 4.

Home health aide base wage.

For customized livingdeleted text begin ,deleted text end new text begin andnew text end foster caredeleted text begin , and
residential caredeleted text end component services, the home health aide base wage equals deleted text begin 20deleted text end new text begin 33.33new text end percent
of the Minneapolis-St. Paul-Bloomington, MN-WI MetroSA average wage for licensed
practical and licensed vocational nurses (SOC code 29-2061); deleted text begin and 80deleted text end new text begin 33.33new text end percent of the
Minneapolis-St. Paul-Bloomington, MN-WI MetroSA average wage for nursing assistants
(SOC code deleted text begin 31-1014deleted text end new text begin 31-1131new text end )new text begin ; and 33.34 percent of the Minneapolis-St. Paul-Bloomington,
MN-WI MetroSA average wage for home health and personal care aides (SOC code
31-1120)new text end .

Subd. 5.

Medication setups by licensed nurse base wage.

For customized livingdeleted text begin ,deleted text end new text begin andnew text end
foster caredeleted text begin , and residential caredeleted text end component services, the medication setups by licensed nurse
base wage equals deleted text begin tendeleted text end new text begin 25new text end percent of the Minneapolis-St. Paul-Bloomington, MN-WI MetroSA
average wage for licensed practical and licensed vocational nurses (SOC code 29-2061);
and deleted text begin 90deleted text end new text begin 75new text end percent of the Minneapolis-St. Paul-Bloomington, MN-WI MetroSA average
wage for registered nurses (SOC code 29-1141).

Subd. 6.

Chore services base wage.

The chore services base wage equals deleted text begin 100deleted text end new text begin 50new text end percent
of the Minneapolis-St. Paul-Bloomington, MN-WI MetroSA average wage for landscaping
and groundskeeping workers (SOC code 37-3011)new text begin ; and 50 percent of the Minneapolis-St.
Paul-Bloomington, MN-WI MetroSA average wage for maids and housekeeping cleaners
(SOC code 37-2012)new text end .

Subd. 7.

Companion services base wage.

The companion services base wage equals
deleted text begin 50deleted text end new text begin 80new text end percent of the Minneapolis-St. Paul-Bloomington, MN-WI MetroSA average wage
for new text begin home health and new text end personal deleted text begin and homedeleted text end care aides (SOC code deleted text begin 39-9021deleted text end new text begin 31-1120new text end ); and deleted text begin 50deleted text end new text begin
20new text end percent of the Minneapolis-St. Paul-Bloomington, MN-WI MetroSA average wage for
maids and housekeeping cleaners (SOC code 37-2012).

Subd. 8.

Homemaker deleted text begin services anddeleted text end assistance with personal care base wage.

The
homemaker deleted text begin services anddeleted text end assistance with personal care base wage equals deleted text begin 60deleted text end new text begin 50new text end percent of
the Minneapolis-St. Paul-Bloomington, MN-WI MetroSA average wage for new text begin home health
and new text end personal deleted text begin and homedeleted text end care deleted text begin aidedeleted text end new text begin aidesnew text end (SOC code deleted text begin 39-9021deleted text end new text begin 31-1120new text end ); deleted text begin 20deleted text end new text begin and 50new text end percent of
the Minneapolis-St. Paul-Bloomington, MN-WI MetroSA average wage for nursing assistants
(SOC code deleted text begin 31-1014deleted text end new text begin 31-1131new text end )deleted text begin ; and 20 percent of the Minneapolis-St. Paul-Bloomington,
MN-WI MetroSA average wage for maids and housekeeping cleaners (SOC code 37-2012)deleted text end .

Subd. 9.

Homemaker deleted text begin services anddeleted text end cleaning base wage.

The homemaker deleted text begin services anddeleted text end
cleaning base wage equals deleted text begin 60 percent of the Minneapolis-St. Paul-Bloomington, MN-WI
MetroSA average wage for personal and home care aide (SOC code 39-9021); 20 percent
of the Minneapolis-St. Paul-Bloomington, MN-WI MetroSA average wage for nursing
assistants (SOC code 31-1014); and 20deleted text end new text begin 100new text end percent of the Minneapolis-St. Paul-Bloomington,
MN-WI MetroSA average wage for maids and housekeeping cleaners (SOC code 37-2012).

Subd. 10.

Homemaker deleted text begin services anddeleted text end home management base wage.

The homemaker
deleted text begin services anddeleted text end home management base wage equals deleted text begin 60deleted text end new text begin 50new text end percent of the Minneapolis-St.
Paul-Bloomington, MN-WI MetroSA average wage for new text begin home health and new text end personal deleted text begin and homedeleted text end
care deleted text begin aidedeleted text end new text begin aidesnew text end (SOC code deleted text begin 39-9021deleted text end new text begin 31-1120new text end ); deleted text begin 20deleted text end new text begin and 50new text end percent of the Minneapolis-St.
Paul-Bloomington, MN-WI MetroSA average wage for nursing assistants (SOC code
deleted text begin 31-1014deleted text end new text begin 31-1131new text end )deleted text begin ; and 20 percent of the Minneapolis-St. Paul-Bloomington, MN-WI
MetroSA average wage for maids and housekeeping cleaners (SOC code 37-2012)deleted text end .

Subd. 11.

In-home respite care services base wage.

The in-home respite care services
base wage equals deleted text begin fivedeleted text end new text begin 15new text end percent of the Minneapolis-St. Paul-Bloomington, MN-WI MetroSA
average wage for registered nurses (SOC code 29-1141); 75 percent of the Minneapolis-St.
Paul-Bloomington, MN-WI MetroSA average wage for deleted text begin nursing assistantsdeleted text end new text begin home health and
personal care aidesnew text end (SOC code deleted text begin 31-1014deleted text end new text begin 31-1120new text end ); and deleted text begin 20deleted text end new text begin tennew text end percent of the Minneapolis-St.
Paul-Bloomington, MN-WI MetroSA average wage for licensed practical and licensed
vocational nurses (SOC code 29-2061).

Subd. 12.

Out-of-home respite care services base wage.

The out-of-home respite care
services base wage equals deleted text begin fivedeleted text end new text begin 15new text end percent of the Minneapolis-St. Paul-Bloomington, MN-WI
MetroSA average wage for registered nurses (SOC code 29-1141); 75 percent of the
Minneapolis-St. Paul-Bloomington, MN-WI MetroSA average wage for deleted text begin nursing assistantsdeleted text end new text begin
home health and personal care aidesnew text end (SOC code deleted text begin 31-1014deleted text end new text begin 31-1120new text end ); and deleted text begin 20deleted text end new text begin tennew text end percent of
the Minneapolis-St. Paul-Bloomington, MN-WI MetroSA average wage for licensed practical
and licensed vocational nurses (SOC code 29-2061).

Subd. 13.

Individual community living support base wage.

The individual community
living support base wage equals deleted text begin 20deleted text end new text begin 60new text end percent of the Minneapolis-St. Paul-Bloomington,
MN-WI MetroSA average wage for deleted text begin licensed practical and licensed vocational nursesdeleted text end new text begin social
and human services assistantsnew text end (SOC code deleted text begin 29-2061deleted text end new text begin 21-1093new text end ); and deleted text begin 80deleted text end new text begin 40new text end percent of the
Minneapolis-St. Paul-Bloomington, MN-WI MetroSA average wage for nursing assistants
(SOC code deleted text begin 31-1014deleted text end new text begin 31-1131new text end ).

Subd. 14.

Registered nurse base wage.

The registered nurse base wage equals 100
percent of the Minneapolis-St. Paul-Bloomington, MN-WI MetroSA average wage for
registered nurses (SOC code 29-1141).

Subd. 15.

deleted text begin Social workerdeleted text end new text begin Unlicensed supervisornew text end base wage.

The deleted text begin social workerdeleted text end new text begin
unlicensed supervisornew text end base wage equals 100 percent of the Minneapolis-St.
Paul-Bloomington, MN-WI MetroSA average wage for deleted text begin medical and public health socialdeleted text end new text begin
first-line supervisors of personal servicenew text end workers (SOC code deleted text begin 21-1022deleted text end new text begin 39-1022new text end ).

new text begin Subd. 16. new text end

new text begin Adult day services base wage. new text end

new text begin The adult day services base wage equals 75
percent of the Minneapolis-St. Paul-Bloomington, MN-WI MetroSA average wage for home
health and personal care aides (SOC code 31-1120); and 25 percent of the Minneapolis-St.
Paul-Bloomington, MN-WI MetroSA average wage for nursing assistants (SOC code
31-1131).
 new text end

new text begin EFFECTIVE DATE. new text end

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

Sec. 19.

Minnesota Statutes 2022, section 256S.213, is amended to read:


256S.213 RATE SETTING; FACTORS.

Subdivision 1.

Payroll taxes and benefits factor.

The payroll taxes and benefits factor
is the sum of net payroll taxes and benefits, divided by the sum of all salaries for all nursing
facilities on the most recent and available cost report.

Subd. 2.

General and administrative factor.

The general and administrative factor is
deleted text begin the difference of net general and administrative expenses and administrative salaries, divided
by total operating expenses for all nursing facilities on the most recent and available cost
reportdeleted text end new text begin 14.4 percentnew text end .

Subd. 3.

Program plan support factor.

new text begin (a) new text end The program plan support factor is deleted text begin 12.8deleted text end new text begin tennew text end
percent new text begin for the following services new text end to cover the cost of direct service staff needed to provide
support for deleted text begin home and community-baseddeleted text end new text begin thenew text end service when not engaged in direct contact with
participantsdeleted text begin .deleted text end new text begin :
new text end

new text begin (1) adult day services;
 new text end

new text begin (2) customized living; and
 new text end

new text begin (3) foster care.
 new text end

new text begin (b) The program plan support factor is 15.5 percent for the following services to cover
the cost of direct service staff needed to provide support for the service when not engaged
in direct contact with participants:
 new text end

new text begin (1) chore services;
 new text end

new text begin (2) companion services;
 new text end

new text begin (3) homemaker assistance with personal care;
 new text end

new text begin (4) homemaker cleaning;
 new text end

new text begin (5) homemaker home management;
 new text end

new text begin (6) in-home respite care;
 new text end

new text begin (7) individual community living support; and
 new text end

new text begin (8) out-of-home respite care.
 new text end

Subd. 4.

Registered nurse management and supervision deleted text begin factordeleted text end new text begin wage componentnew text end .

The
registered nurse management and supervision deleted text begin factordeleted text end new text begin wage componentnew text end equals 15 percent of
the registered nurse adjusted base wage as defined in section 256S.214.

Subd. 5.

deleted text begin Social workerdeleted text end new text begin Unlicensed supervisornew text end supervision deleted text begin factordeleted text end new text begin wage
componentnew text end .

The deleted text begin social workerdeleted text end new text begin unlicensed supervisornew text end supervision deleted text begin factordeleted text end new text begin wage componentnew text end
equals 15 percent of the deleted text begin social workerdeleted text end new text begin unlicensed supervisornew text end adjusted base wage as defined
in section 256S.214.

new text begin Subd. 6. new text end

new text begin Facility and equipment factor. new text end

new text begin The facility and equipment factor for adult
day services is 16.2 percent.
 new text end

new text begin Subd. 7. new text end

new text begin Food, supplies, and transportation factor. new text end

new text begin The food, supplies, and
transportation factor for adult day services is 24 percent.
 new text end

new text begin Subd. 8. new text end

new text begin Supplies and transportation factor. new text end

new text begin The supplies and transportation factor
for the following services is 1.56 percent:
 new text end

new text begin (1) chore services;
 new text end

new text begin (2) companion services;
 new text end

new text begin (3) homemaker assistance with personal care;
 new text end

new text begin (4) homemaker cleaning;
 new text end

new text begin (5) homemaker home management;
 new text end

new text begin (6) in-home respite care;
 new text end

new text begin (7) individual community support services; and
 new text end

new text begin (8) out-of-home respite care.
 new text end

new text begin Subd. 9. new text end

new text begin Absence factor. new text end

new text begin The absence factor for the following services is 4.5 percent:
 new text end

new text begin (1) adult day services;
 new text end

new text begin (2) chore services;
 new text end

new text begin (3) companion services;
 new text end

new text begin (4) homemaker assistance with personal care;
 new text end

new text begin (5) homemaker cleaning;
 new text end

new text begin (6) homemaker home management;
 new text end

new text begin (7) in-home respite care;
 new text end

new text begin (8) individual community living support; and
 new text end

new text begin (9) out-of-home respite care.
 new text end

new text begin EFFECTIVE DATE. new text end

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

Sec. 20.

Minnesota Statutes 2022, section 256S.214, is amended to read:


256S.214 RATE SETTING; ADJUSTED BASE WAGE.

new text begin (a) new text end For the purposes of section 256S.215, the adjusted base wage for each position equals
the position's base wage under section 256S.212 plus:

(1) the position's base wage multiplied by the payroll taxes and benefits factor under
section 256S.213, subdivision 1;

deleted text begin (2) the position's base wage multiplied by the general and administrative factor under
section 256S.213, subdivision 2; and
 deleted text end

deleted text begin (3)deleted text end new text begin (2)new text end the position's base wage multiplied by the new text begin applicable new text end program plan support factor
under section 256S.213, subdivision 3deleted text begin .deleted text end new text begin ; and
new text end

new text begin (3) the position's base wage multiplied by the absence factor under section 256S.213,
subdivision 9, if applicable.
 new text end

new text begin (b) If the base wage described in paragraph (a) is below $16.68, the base wage must
equal $16.68.
 new text end

new text begin EFFECTIVE DATE. new text end

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

Sec. 21.

Minnesota Statutes 2022, section 256S.215, subdivision 2, is amended to read:


Subd. 2.

Home management and support services component rate.

The component
rate for home management and support services is new text begin calculated as follows:
new text end

new text begin (1) sum new text end the home management and support services adjusted base wage deleted text begin plusdeleted text end new text begin andnew text end the
registered nurse management and supervision deleted text begin factor.deleted text end new text begin wage component;
new text end

new text begin (2) multiply the result of clause (1) by the general and administrative factor; and
 new text end

new text begin (3) sum the results of clauses (1) and (2).
 new text end

new text begin EFFECTIVE DATE. new text end

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

Sec. 22.

Minnesota Statutes 2022, section 256S.215, subdivision 3, is amended to read:


Subd. 3.

Home care aide services component rate.

The component rate for home care
aide services is new text begin calculated as follows:
new text end

new text begin (1) sum new text end the home health aide services adjusted base wage deleted text begin plusdeleted text end new text begin andnew text end the registered nurse
management and supervision deleted text begin factor.deleted text end new text begin wage component;
new text end

new text begin (2) multiply the result of clause (1) by the general and administrative factor; and
 new text end

new text begin (3) sum the results of clauses (1) and (2).
 new text end

new text begin EFFECTIVE DATE. new text end

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

Sec. 23.

Minnesota Statutes 2022, section 256S.215, subdivision 4, is amended to read:


Subd. 4.

Home health aide services component rate.

The component rate for home
health aide services is new text begin calculated as follows:
new text end

new text begin (1) sum new text end the home health aide services adjusted base wage deleted text begin plusdeleted text end new text begin andnew text end the registered nurse
management and supervision deleted text begin factor.deleted text end new text begin wage component;
new text end

new text begin (2) multiply the result of clause (1) by the general and administrative factor; and
 new text end

new text begin (3) sum the results of clauses (1) and (2).
 new text end

new text begin EFFECTIVE DATE. new text end

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

Sec. 24.

Minnesota Statutes 2022, section 256S.215, subdivision 7, is amended to read:


Subd. 7.

Chore services rate.

The 15-minute unit rate for chore services is calculated
as follows:

(1) sum the chore services adjusted base wage and the deleted text begin social workerdeleted text end new text begin unlicensed supervisornew text end
supervision deleted text begin factordeleted text end new text begin wage componentnew text end ; deleted text begin and
deleted text end

(2) new text begin multiply the result of clause (1) by the general and administrative factor;
new text end

new text begin (3) multiply the result of clause (1) by the supplies and transportation factor; and
 new text end

new text begin (4) sum the results of clauses (1) to (3) and new text end divide the result deleted text begin of clause (1)deleted text end by four.

new text begin EFFECTIVE DATE. new text end

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

Sec. 25.

Minnesota Statutes 2022, section 256S.215, subdivision 8, is amended to read:


Subd. 8.

Companion services rate.

The 15-minute unit rate for companion services is
calculated as follows:

(1) sum the companion services adjusted base wage and the deleted text begin social workerdeleted text end new text begin unlicensed
supervisornew text end supervision deleted text begin factordeleted text end new text begin wage componentnew text end ; deleted text begin and
deleted text end

(2) new text begin multiply the result of clause (1) by the general and administrative factor;
new text end

new text begin (3) multiply the result of clause (1) by the supplies and transportation factor; and
 new text end

new text begin (4) sum the results of clauses (1) to (3) and new text end divide the result deleted text begin of clause (1)deleted text end by four.

new text begin EFFECTIVE DATE. new text end

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

Sec. 26.

Minnesota Statutes 2022, section 256S.215, subdivision 9, is amended to read:


Subd. 9.

Homemaker deleted text begin services anddeleted text end assistance with personal care rate.

The 15-minute
unit rate for homemaker deleted text begin services anddeleted text end assistance with personal care is calculated as follows:

(1) sum the homemaker deleted text begin services anddeleted text end assistance with personal care adjusted base wage
and the deleted text begin registered nurse management anddeleted text end new text begin unlicensed supervisornew text end supervision deleted text begin factordeleted text end new text begin wage
componentnew text end ; deleted text begin and
deleted text end

(2) new text begin multiply the result of clause (1) by the general and administrative factor;
new text end

new text begin (3) multiply the result of clause (1) by the supplies and transportation factor; and
 new text end

new text begin (4) sum the results of clauses (1) to (3) and new text end divide the result deleted text begin of clause (1)deleted text end by four.

new text begin EFFECTIVE DATE. new text end

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

Sec. 27.

Minnesota Statutes 2022, section 256S.215, subdivision 10, is amended to read:


Subd. 10.

Homemaker deleted text begin services anddeleted text end cleaning rate.

The 15-minute unit rate for
homemaker deleted text begin services anddeleted text end cleaning is calculated as follows:

(1) sum the homemaker deleted text begin services anddeleted text end cleaning adjusted base wage and the deleted text begin registered
nurse management anddeleted text end new text begin unlicensed supervisornew text end supervision deleted text begin factordeleted text end new text begin wage componentnew text end ; deleted text begin and
deleted text end

(2) new text begin multiply the result of clause (1) by the general and administrative factor;
new text end

new text begin (3) multiply the result of clause (1) by the supplies and transportation factor; and
 new text end

new text begin (4) sum the results of clauses (1) to (3) and new text end divide the result deleted text begin of clause (1)deleted text end by four.

new text begin EFFECTIVE DATE. new text end

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

Sec. 28.

Minnesota Statutes 2022, section 256S.215, subdivision 11, is amended to read:


Subd. 11.

Homemaker deleted text begin services anddeleted text end home management rate.

The 15-minute unit rate
for homemaker deleted text begin services anddeleted text end home management is calculated as follows:

(1) sum the homemaker deleted text begin services anddeleted text end home management adjusted base wage and thedeleted text begin
registered nurse management anddeleted text end new text begin unlicensed supervisornew text end supervision deleted text begin factordeleted text end new text begin wage componentnew text end ;
deleted text begin and
deleted text end

(2) new text begin multiply the result of clause (1) by the general and administrative factor;
new text end

new text begin (3) multiply the result of clause (1) by the supplies and transportation factor; and
 new text end

new text begin (4) sum the results of clauses (1) to (3) and new text end divide the result deleted text begin of clause (1)deleted text end by four.

new text begin EFFECTIVE DATE. new text end

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

Sec. 29.

Minnesota Statutes 2022, section 256S.215, subdivision 12, is amended to read:


Subd. 12.

In-home respite care services rates.

(a) The 15-minute unit rate for in-home
respite care services is calculated as follows:

(1) sum the in-home respite care services adjusted base wage and the registered nurse
management and supervision deleted text begin factordeleted text end new text begin wage componentnew text end ; deleted text begin and
deleted text end

(2) new text begin multiply the result of clause (1) by the general and administrative factor;
new text end

new text begin (3) multiply the result of clause (1) by the supplies and transportation factor; and
 new text end

new text begin (4) sum the results of clauses (1) to (3) and new text end divide the result deleted text begin of clause (1)deleted text end by four.

(b) The in-home respite care services daily rate equals the in-home respite care services
15-minute unit rate multiplied by 18.

new text begin EFFECTIVE DATE. new text end

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

Sec. 30.

Minnesota Statutes 2022, section 256S.215, subdivision 13, is amended to read:


Subd. 13.

Out-of-home respite care services rates.

(a) The 15-minute unit rate for
out-of-home respite care is calculated as follows:

(1) sum the out-of-home respite care services adjusted base wage and the registered
nurse management and supervision deleted text begin factordeleted text end new text begin wage componentnew text end ; deleted text begin and
deleted text end

(2) new text begin multiply the result of clause (1) by the general and administrative factor;
new text end

new text begin (3) multiply the result of clause (1) by the supplies and transportation factor; and
 new text end

new text begin (4) sum the results of clauses (1) to (3) and new text end divide the result deleted text begin of clause (1)deleted text end by four.

(b) The out-of-home respite care services daily rate equals the 15-minute unit rate for
out-of-home respite care services multiplied by 18.

new text begin EFFECTIVE DATE. new text end

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

Sec. 31.

Minnesota Statutes 2022, section 256S.215, subdivision 14, is amended to read:


Subd. 14.

Individual community living support rate.

The individual community living
support rate is calculated as follows:

(1) sum the deleted text begin home care aidedeleted text end new text begin individual community living supportnew text end adjusted base wage
and the deleted text begin social workerdeleted text end new text begin registered nurse management andnew text end supervision deleted text begin factordeleted text end new text begin wage componentnew text end ;
deleted text begin and
deleted text end

(2) new text begin multiply the result of clause (1) by the general and administrative factor;
new text end

new text begin (3) multiply the result of clause (1) by the supplies and transportation factor; and
 new text end

new text begin (4) sum the results of clauses (1) to (3) and new text end divide the result deleted text begin of clause (1)deleted text end by four.

new text begin EFFECTIVE DATE. new text end

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

Sec. 32.

Minnesota Statutes 2022, section 256S.215, subdivision 15, is amended to read:


Subd. 15.

Home-delivered meals rate.

new text begin Effective January 1, 2024, new text end the home-delivered
meals rate deleted text begin equals $9.30deleted text end new text begin is $8.17, updated as directed in section 256S.211, subdivision 3new text end .
deleted text begin The commissioner shall increase the home delivered meals rate every July 1 by the percent
increase in the nursing facility dietary per diem using the two most recent and available
nursing facility cost reports.
deleted text end

new text begin EFFECTIVE DATE. new text end

new text begin This section is effective July 1, 2023, or upon federal approval,
whichever is later. The commissioner of human services shall notify the revisor of statutes
when approval is obtained.
 new text end

Sec. 33.

Minnesota Statutes 2022, section 256S.215, subdivision 16, is amended to read:


Subd. 16.

Adult day services rate.

The 15-minute unit rate for adult day servicesdeleted text begin , with
an assumed staffing ratio of one staff person to four participants, is the sum ofdeleted text end new text begin is calculated
as followsnew text end :

(1) deleted text begin one-sixteenth of the home care aidedeleted text end new text begin divide the adult daynew text end services adjusted base wagedeleted text begin ,
except that the general and administrative factor used to determine the home care aide
services adjusted base wage is 20 percentdeleted text end new text begin by five to reflect an assumed staffing ratio of one
to fivenew text end ;

(2) deleted text begin one-fourth of the registered nurse management and supervision factordeleted text end new text begin sum the result
of clause (1) and the registered nurse management and supervision wage componentnew text end ; deleted text begin and
deleted text end

(3) deleted text begin $0.63 to cover the cost of meals.deleted text end new text begin multiply the result of clause (2) by the general and
administrative factor;
new text end

new text begin (4) multiply the result of clause (2) by the facility and equipment factor;
 new text end

new text begin (5) multiply the result of clause (2) by the food, supplies, and transportation factor; and
 new text end

new text begin (6) sum the results of clauses (2) to (5) and divide the result by four.
 new text end

new text begin EFFECTIVE DATE. new text end

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

Sec. 34.

Minnesota Statutes 2022, section 256S.215, subdivision 17, is amended to read:


Subd. 17.

Adult day services bath rate.

The 15-minute unit rate for adult day services
bath is deleted text begin the sum ofdeleted text end new text begin calculated as followsnew text end :

(1) deleted text begin one-fourth of the home care aidedeleted text end new text begin sum the adult daynew text end services adjusted base wagedeleted text begin ,
except that the general and administrative factor used to determine the home care aide
services adjusted base wage is 20 percentdeleted text end new text begin and the nurse management and supervision wage
componentnew text end ;

(2) deleted text begin one-fourth of the registered nurse management and supervisiondeleted text end new text begin multiply the result
of clause (1) by the general and administrativenew text end factor; deleted text begin and
deleted text end

(3) deleted text begin $0.63 to cover the cost of meals.deleted text end new text begin multiply the result of clause (1) by the facility and
equipment factor;
new text end

new text begin (4) multiply the result of clause (1) by the food, supplies, and transportation factor; and
 new text end

new text begin (5) sum the results of clauses (1) to (4) and divide the result by four.
 new text end

new text begin EFFECTIVE DATE. new text end

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

Sec. 35.

Laws 2021, chapter 30, article 12, section 5, as amended by Laws 2021, First
Special Session chapter 7, article 17, section 2, is amended to read:


Sec. 5. GOVERNOR'S COUNCIL ON AN AGE-FRIENDLY MINNESOTA.

The Governor's Council on an Age-Friendly Minnesota, established in Executive Order
19-38, shall: (1) work to advance age-friendly policies; and (2) coordinate state, local, and
private partners' collaborative work on emergency preparedness, with a focus on older
adults, communities, and persons in zip codes most impacted by the COVID-19 pandemic.
The Governor's Council on an Age-Friendly Minnesota is extended and expires June 30,
deleted text begin 2024deleted text end new text begin 2027new text end .

Sec. 36.

Laws 2021, First Special Session chapter 7, article 17, section 8, is amended to
read:


Sec. 8. AGE-FRIENDLY MINNESOTA.

Subdivision 1.

Age-friendly community grants.

(a) This act includes $0 in fiscal year
2022 and $875,000 in fiscal year 2023 for age-friendly community grants. The commissioner
of human services, in collaboration with the Minnesota Board on Aging and the Governor's
Council on an Age-Friendly Minnesota, established in Executive Order 19-38, shall develop
the age-friendly community grant program to help communities, including cities, counties,
other municipalities, Tribes, and collaborative efforts, to become age-friendly communities,
with an emphasis on structures, services, and community features necessary to support older
adult residents over the next decade, including but not limited to:

(1) coordination of health and social services;

(2) transportation access;

(3) safe, affordable places to live;

(4) reducing social isolation and improving wellness;

(5) combating ageism and racism against older adults;

(6) accessible outdoor space and buildings;

(7) communication and information technology access; and

(8) opportunities to stay engaged and economically productive.

The general fund base in this act for this purpose is $875,000 in fiscal year 2024 and $0 in
fiscal year 2025.

(b) All grant activities must be completed by March 31, deleted text begin 2024deleted text end new text begin 2027new text end .

(c) This subdivision expires June 30, deleted text begin 2024deleted text end new text begin 2027new text end .

Subd. 2.

Technical assistance grants.

(a) This act includes $0 in fiscal year 2022 and
$575,000 in fiscal year 2023 for technical assistance grants. The commissioner of human
services, in collaboration with the Minnesota Board on Aging and the Governor's Council
on an Age-Friendly Minnesota, established in Executive Order 19-38, shall develop the
age-friendly technical assistance grant program. The general fund base in this act for this
purpose is $575,000 in fiscal year 2024 and $0 in fiscal year 2025.

(b) All grant activities must be completed by March 31, deleted text begin 2024deleted text end new text begin 2027new text end .

(c) This subdivision expires June 30, deleted text begin 2024deleted text end new text begin 2027new text end .

Sec. 37. new text begin DIRECTION TO COMMISSIONER; FUTURE PACE IMPLEMENTATION
FUNDING.
new text end

new text begin (a) The commissioner of human services shall work collaboratively with stakeholders
to undertake an actuarial analysis of Medicaid costs for nursing home eligible beneficiaries
for the purposes of establishing a monthly Medicaid capitation rate for the program of
all-inclusive care for the elderly (PACE). The analysis must include all sources of state
Medicaid expenditures for nursing home eligible beneficiaries, including but not limited to
capitation payments to plans and additional state expenditures to skilled nursing facilities
consistent with Code of Federal Regulations, chapter 42, part 447, and long-term care costs.
 new text end

new text begin (b) The commissioner shall also estimate the administrative costs associated with
implementing and monitoring PACE.
 new text end

new text begin (c) The commissioner shall provide a report to the chairs and ranking minority members
of the legislative committees with jurisdiction over health care finance on the actuarial
analysis, proposed capitation rate, and estimated administrative costs by March 1, 2024.
The commissioner shall recommend a financing mechanism and administrative framework
by September 1, 2024.
 new text end

new text begin (d) By September 1, 2024, the commissioner shall inform the chairs and ranking minority
members of the legislative committees with jurisdiction over health care finance on the
commissioner's progress toward developing a recommended financing mechanism. For
purposes of this section, the commissioner may issue or extend a request for proposal to an
outside vendor.
 new text end

Sec. 38. new text begin DIRECTION TO COMMISSIONER; CAREGIVER RESPITE SERVICES
GRANTS.
new text end

new text begin Beginning in fiscal year 2025, the commissioner of human services must continue the
respite services for older adults grant program established under Laws 2021, First Special
Session chapter 7, article 17, section 17, subdivision 3, under the authority granted under
Minnesota Statutes, section 256.9756. The commissioner may begin the grant application
process for awarding grants under Minnesota Statutes, section 256.9756, during fiscal year
2024 in order to facilitate the continuity of the grant program during the transition from a
temporary program to a permanent one.
 new text end

Sec. 39. new text begin DIRECTION TO COMMISSIONERS; SMALL PROVIDER REGULATORY
RELIEF.
new text end

new text begin The commissioners of human services and health must consult with assisted living
facility license holders who provide customized living and whose facilities are smaller than
11 beds to compile a list of regulatory requirements, compliance with which is particularly
difficult for small providers. The commissioners must provide the chairs and ranking minority
members of the legislative committees with jurisdiction over assisted living licensure and
customized living with recommendations, including draft legislation, to reduce the regulatory
burden on small providers.
 new text end

Sec. 40. new text begin RATE INCREASE FOR CERTAIN HOME AND COMMUNITY-BASED
SERVICES.
new text end

new text begin The commissioner of human services shall increase payment rates for community living
assistance and family caregiver services under Minnesota Statutes, sections 256B.0913 and
256B.0922, and chapter 256S by 14.99 percent from the rates in effect on December 31,
2023.
 new text end

new text begin EFFECTIVE DATE. new text end

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

Sec. 41. new text begin NURSING FACILITY RATE STUDY.
new text end

new text begin (a) The commissioner of human services shall contract with an independent organization
with subject matter expertise in nursing facility accounting to conduct a study of nursing
facility rates that includes:
 new text end

new text begin (1) a review of nursing facility rates of all states bordering Minnesota and the states
included in the Centers for Medicare and Medicaid Services Region V;
 new text end

new text begin (2) the data necessary to determine the total net income and the operating margin of a
nursing facility;
 new text end

new text begin (3) the data necessary to determine whether a nursing facility can generate sufficient
revenue to cover the nursing facility's operating expenses;
 new text end

new text begin (4) the average reimbursement rate per resident day in each state and the data used to
compute that rate;
 new text end

new text begin (5) facility-level data on all types of Medicaid payments to nursing facilities, including
but not limited to:
 new text end

new text begin (i) supplemental rate add-ons;
 new text end

new text begin (ii) rate components;
 new text end

new text begin (iii) data on the sources of the nonfederal share of spending necessary to determine the
net Medicaid payment at the facility level; and
 new text end

new text begin (iv) disclosure of transactions from a related party; and
 new text end

new text begin (6) any other information determined necessary by the commissioner to complete the
study.
 new text end

new text begin (b) Upon request, a nursing facility must provide information to the commissioner
pertaining to the nursing facility's financial operations.
 new text end

new text begin (c) By January 1, 2025, the commissioner shall submit a report to the chairs and ranking
minority members of the legislative committees and divisions with jurisdiction over human
services policy and finance recommending adjustments to the nursing facility rate
methodology under Minnesota Statutes, chapter 256R, based on the results of the study in
paragraph (a). The commissioner shall consult with the Office of the Legislative Auditor
Financial Audit Division and Program Evaluation Division on study design methods.
 new text end

Sec. 42. new text begin REVISOR INSTRUCTION.
new text end

new text begin The revisor of statutes shall change the headnote in Minnesota Statutes, section
256B.0917, from "HOME AND COMMUNITY-BASED SERVICES FOR OLDER
ADULTS" to "ELDERCARE DEVELOPMENT PARTNERSHIPS."
 new text end

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

new text begin (a) new text end new text begin Minnesota Statutes 2022, section 256B.0917, subdivisions 1a, 6, 7a, and 13, new text end new text begin are
repealed.
 new text end

new text begin (b) new text end new text begin Minnesota Statutes 2022, sections 256S.19, subdivision 4; and 256S.2101, subdivision
2, new text end new text begin are repealed.
 new text end

new text begin EFFECTIVE DATE. new text end

new text begin Paragraph (a) is effective July 1, 2023. Paragraph (b) is effective
January 1, 2024, or upon federal approval, whichever is later. The commissioner of human
services shall notify the revisor of statutes when approval is obtained.
 new text end

ARTICLE 3

HEALTH CARE

Section 1.

Minnesota Statutes 2022, section 252.27, subdivision 2a, is amended to read:


Subd. 2a.

Contribution amount.

(a) The natural or adoptive parents of a minor child,
new text begin not new text end including a child determined eligible for medical assistance without consideration of
parental incomenew text begin under the Tax Equity and Fiscal Responsibility Act (TEFRA) option or a
child accessing home and community-based waiver servicesnew text end , must contribute to the cost of
services used by making monthly payments on a sliding scale based on income, unless the
child is married or has been married, parental rights have been terminated, or the child's
adoption is subsidized according to chapter 259A or through title IV-E of the Social Security
Act. The parental contribution is a partial or full payment for medical services provided for
diagnostic, therapeutic, curing, treating, mitigating, rehabilitation, maintenance, and personal
care services as defined in United States Code, title 26, section 213, needed by the child
with a chronic illness or disability.

(b) For households with adjusted gross income equal to or greater than 275 percent of
federal poverty guidelines, the parental contribution shall be computed by applying the
following schedule of rates to the adjusted gross income of the natural or adoptive parents:

(1) if the adjusted gross income is equal to or greater than 275 percent of federal poverty
guidelines and less than or equal to 545 percent of federal poverty guidelines, the parental
contribution shall be determined using a sliding fee scale established by the commissioner
of human services which begins at 1.65 percent of adjusted gross income at 275 percent of
federal poverty guidelines and increases to 4.5 percent of adjusted gross income for those
with adjusted gross income up to 545 percent of federal poverty guidelines;

(2) if the adjusted gross income is greater than 545 percent of federal poverty guidelines
and less than 675 percent of federal poverty guidelines, the parental contribution shall be
4.5 percent of adjusted gross income;

(3) if the adjusted gross income is equal to or greater than 675 percent of federal poverty
guidelines and less than 975 percent of federal poverty guidelines, the parental contribution
shall be determined using a sliding fee scale established by the commissioner of human
services which begins at 4.5 percent of adjusted gross income at 675 percent of federal
poverty guidelines and increases to 5.99 percent of adjusted gross income for those with
adjusted gross income up to 975 percent of federal poverty guidelines; and

(4) if the adjusted gross income is equal to or greater than 975 percent of federal poverty
guidelines, the parental contribution shall be 7.49 percent of adjusted gross income.

If the child lives with the parent, the annual adjusted gross income is reduced by $2,400
prior to calculating the parental contribution. If the child resides in an institution specified
in section 256B.35, the parent is responsible for the personal needs allowance specified
under that section in addition to the parental contribution determined under this section.
The parental contribution is reduced by any amount required to be paid directly to the child
pursuant to a court order, but only if actually paid.

(c) The household size to be used in determining the amount of contribution under
paragraph (b) includes natural and adoptive parents and their dependents, including the
child receiving services. Adjustments in the contribution amount due to annual changes in
the federal poverty guidelines shall be implemented on the first day of July following
publication of the changes.

(d) For purposes of paragraph (b), "income" means the adjusted gross income of the
natural or adoptive parents determined according to the previous year's federal tax form,
except, effective retroactive to July 1, 2003, taxable capital gains to the extent the funds
have been used to purchase a home shall not be counted as income.

(e) The contribution shall be explained in writing to the parents at the time eligibility
for services is being determined. The contribution shall be made on a monthly basis effective
with the first month in which the child receives services. Annually upon redetermination
or at termination of eligibility, if the contribution exceeded the cost of services provided,
the local agency or the state shall reimburse that excess amount to the parents, either by
direct reimbursement if the parent is no longer required to pay a contribution, or by a
reduction in or waiver of parental fees until the excess amount is exhausted. All
reimbursements must include a notice that the amount reimbursed may be taxable income
if the parent paid for the parent's fees through an employer's health care flexible spending
account under the Internal Revenue Code, section 125, and that the parent is responsible
for paying the taxes owed on the amount reimbursed.

(f) The monthly contribution amount must be reviewed at least every 12 months; when
there is a change in household size; and when there is a loss of or gain in income from one
month to another in excess of ten percent. The local agency shall mail a written notice 30
days in advance of the effective date of a change in the contribution amount. A decrease in
the contribution amount is effective in the month that the parent verifies a reduction in
income or change in household size.

(g) Parents of a minor child who do not live with each other shall each pay the
contribution required under paragraph (a). An amount equal to the annual court-ordered
child support payment actually paid on behalf of the child receiving services shall be deducted
from the adjusted gross income of the parent making the payment prior to calculating the
parental contribution under paragraph (b).

(h) The contribution under paragraph (b) shall be increased by an additional five percent
if the local agency determines that insurance coverage is available but not obtained for the
child. For purposes of this section, "available" means the insurance is a benefit of employment
for a family member at an annual cost of no more than five percent of the family's annual
income. For purposes of this section, "insurance" means health and accident insurance
coverage, enrollment in a nonprofit health service plan, health maintenance organization,
self-insured plan, or preferred provider organization.

Parents who have more than one child receiving services shall not be required to pay
more than the amount for the child with the highest expenditures. There shall be no resource
contribution from the parents. The parent shall not be required to pay a contribution in
excess of the cost of the services provided to the child, not counting payments made to
school districts for education-related services. Notice of an increase in fee payment must
be given at least 30 days before the increased fee is due.

(i) The contribution under paragraph (b) shall be reduced by $300 per fiscal year if, in
the 12 months prior to July 1:

(1) the parent applied for insurance for the child;

(2) the insurer denied insurance;

(3) the parents submitted a complaint or appeal, in writing to the insurer, submitted a
complaint or appeal, in writing, to the commissioner of health or the commissioner of
commerce, or litigated the complaint or appeal; and

(4) as a result of the dispute, the insurer reversed its decision and granted insurance.

For purposes of this section, "insurance" has the meaning given in paragraph (h).

A parent who has requested a reduction in the contribution amount under this paragraph
shall submit proof in the form and manner prescribed by the commissioner or county agency,
includingdeleted text begin ,deleted text end but not limited todeleted text begin ,deleted text end the insurer's denial of insurance, the written letter or complaint
of the parents, court documents, and the written response of the insurer approving insurance.
The determinations of the commissioner or county agency under this paragraph are not rules
subject to chapter 14.

Sec. 2.

Minnesota Statutes 2022, section 256B.04, is amended by adding a subdivision to
read:


new text begin Subd. 26. new text end

new text begin Notice of employed persons with disabilities program. new text end

new text begin At the time of initial
enrollment and at least annually thereafter, the commissioner shall provide information on
the medical assistance program for employed persons with disabilities under section
256B.057, subdivision 9, to all medical assistance enrollees who indicate they have a
disability.
 new text end

Sec. 3.

Minnesota Statutes 2022, section 256B.056, subdivision 3, is amended to read:


Subd. 3.

Asset limitations for certain individuals.

(a) To be eligible for medical
assistance, a person must not individually own more than $3,000 in assets, or if a member
of a household with two family members, husband and wife, or parent and child, the
household must not own more than $6,000 in assets, plus $200 for each additional legal
dependent. In addition to these maximum amounts, an eligible individual or family may
accrue interest on these amounts, but they must be reduced to the maximum at the time of
an eligibility redetermination. The accumulation of the clothing and personal needs allowance
according to section 256B.35 must also be reduced to the maximum at the time of the
eligibility redetermination. The value of assets that are not considered in determining
eligibility for medical assistance is the value of those assets excluded under the Supplemental
Security Income program for aged, blind, and disabled persons, with the following
exceptions:

(1) household goods and personal effects are not considered;

(2) capital and operating assets of a trade or business that the local agency determines
are necessary to the person's ability to earn an income are not considered;

(3) motor vehicles are excluded to the same extent excluded by the Supplemental Security
Income program;

(4) assets designated as burial expenses are excluded to the same extent excluded by the
Supplemental Security Income program. Burial expenses funded by annuity contracts or
life insurance policies must irrevocably designate the individual's estate as contingent
beneficiary to the extent proceeds are not used for payment of selected burial expenses;

(5) for a person who no longer qualifies as an employed person with a disability due to
loss of earnings, assets allowed while eligible for medical assistance under section 256B.057,
subdivision 9, are not considered for 12 months, beginning with the first month of ineligibility
as an employed person with a disabilitydeleted text begin , to the extent that the person's total assets remain
within the allowed limits of section 256B.057, subdivision 9, paragraph (d)deleted text end ;

(6) a designated employment incentives asset account is disregarded when determining
eligibility for medical assistance for a person age 65 years or older under section 256B.055,
subdivision 7. An employment incentives asset account must only be designated by a person
who has been enrolled in medical assistance under section 256B.057, subdivision 9, for a
24-consecutive-month period. A designated employment incentives asset account contains
qualified assets owned by the person deleted text begin and the person's spousedeleted text end in the last month of enrollment
in medical assistance under section 256B.057, subdivision 9. Qualified assets include
retirement and pension accounts, medical expense accounts, and up to $17,000 of the person's
other nonexcluded new text begin liquid new text end assets. An employment incentives asset account is no longer
designated when a person loses medical assistance eligibility for a calendar month or more
before turning age 65. A person who loses medical assistance eligibility before age 65 can
establish a new designated employment incentives asset account by establishing a new
24-consecutive-month period of enrollment under section 256B.057, subdivision 9. deleted text begin The
deleted text end deleted text begin income of a spouse of a person enrolled in medical assistance under section 256B.057,
subdivision 9, during each of the 24 consecutive months before the person's 65th birthday
must be disregarded when determining eligibility for medical assistance under section
256B.055, subdivision 7.deleted text end Persons eligible under this clause are not subject to the provisions
in section 256B.059; and

(7) effective July 1, 2009, certain assets owned by American Indians are excluded as
required by section 5006 of the American Recovery and Reinvestment Act of 2009, Public
Law 111-5. For purposes of this clause, an American Indian is any person who meets the
definition of Indian according to Code of Federal Regulations, title 42, section 447.50.

(b) No asset limit shall apply to persons eligible under deleted text begin sectiondeleted text end new text begin sectionsnew text end 256B.055,
subdivision 15new text begin , and 256B.057, subdivision 9new text end .

new text begin EFFECTIVE DATE. new text end

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

Sec. 4.

Minnesota Statutes 2022, section 256B.057, subdivision 9, is amended to read:


Subd. 9.

Employed persons with disabilities.

(a) Medical assistance may be paid for
a person who is employed and who:

(1) but for excess earnings or assetsdeleted text begin ,deleted text end meets the definition of disabled under the
Supplemental Security Income program;new text begin and
new text end

(2) deleted text begin meets the asset limits in paragraph (d); and
deleted text end

deleted text begin (3)deleted text end pays a premium and other obligations under paragraph (e).

(b) For purposes of eligibility, there is a $65 earned income disregard. To be eligible
for medical assistance under this subdivision, a person must have more than $65 of earned
income. Earned income must have Medicare, Social Security, and applicable state and
federal taxes withheld. The person must document earned income tax withholding. Any
spousal income deleted text begin or assetsdeleted text end shall be disregarded for purposes of eligibility and premium
determinations.

(c) After the month of enrollment, a person enrolled in medical assistance under this
subdivision who:

(1) is temporarily unable to work and without receipt of earned income due to a medical
condition, as verified by a physician, advanced practice registered nurse, or physician
assistant; or

(2) loses employment for reasons not attributable to the enrollee, and is without receipt
of earned income may retain eligibility for up to four consecutive months after the month
of job loss. To receive a four-month extension, enrollees must verify the medical condition
or provide notification of job loss. All other eligibility requirements must be met and the
enrollee must pay all calculated premium costs for continued eligibility.

(d) deleted text begin For purposes of determining eligibility under this subdivision, a person's assets must
not exceed $20,000, excluding:
deleted text end

deleted text begin (1) all assets excluded under section 256B.056;
 deleted text end

deleted text begin (2) retirement accounts, including individual accounts, 401(k) plans, 403(b) plans, Keogh
plans, and pension plans;
 deleted text end

deleted text begin (3) medical expense accounts set up through the person's employer; and
 deleted text end

deleted text begin (4) spousal assets, including spouse's share of jointly held assets.
 deleted text end

deleted text begin (e)deleted text end All enrollees must pay a premium to be eligible for medical assistance under this
subdivision, except as provided under clause (5).

(1) An enrollee must pay the greater of a $35 premium or the premium calculated based
on the person's gross earned and unearned income and the applicable family size using a
sliding fee scale established by the commissioner, which begins at one percent of income
at 100 percent of the federal poverty guidelines and increases to 7.5 percent of income for
those with incomes at or above 300 percent of the federal poverty guidelines.

(2) Annual adjustments in the premium schedule based upon changes in the federal
poverty guidelines shall be effective for premiums due in July of each year.

(3) All enrollees who receive unearned income must pay one-half of one percent of
unearned income in addition to the premium amount, except as provided under clause (5).

(4) Increases in benefits under title II of the Social Security Act shall not be counted as
income for purposes of this subdivision until July 1 of each year.

(5) Effective July 1, 2009, American Indians are exempt from paying premiums as
required by section 5006 of the American Recovery and Reinvestment Act of 2009, Public
Law 111-5. For purposes of this clause, an American Indian is any person who meets the
definition of Indian according to Code of Federal Regulations, title 42, section 447.50.

deleted text begin (f)deleted text end new text begin (e)new text end A person's eligibility and premium shall be determined by the local county agency.
Premiums must be paid to the commissioner. All premiums are dedicated to the
commissioner.

deleted text begin (g)deleted text end new text begin (f)new text end Any required premium shall be determined at application and redetermined at the
enrollee's six-month income review or when a change in income or household size is reported.
Enrollees must report any change in income or household size within ten days of when the
change occurs. A decreased premium resulting from a reported change in income or
household size shall be effective the first day of the next available billing month after the
change is reported. Except for changes occurring from annual cost-of-living increases, a
change resulting in an increased premium shall not affect the premium amount until the
next six-month review.

deleted text begin (h)deleted text end new text begin (g)new text end Premium payment is due upon notification from the commissioner of the premium
amount required. Premiums may be paid in installments at the discretion of the commissioner.

deleted text begin (i)deleted text end new text begin (h)new text end Nonpayment of the premium shall result in denial or termination of medical
assistance unless the person demonstrates good cause for nonpayment. "Good cause" means
an excuse for the enrollee's failure to pay the required premium when due because the
circumstances were beyond the enrollee's control or not reasonably foreseeable. The
commissioner shall determine whether good cause exists based on the weight of the
supporting evidence submitted by the enrollee to demonstrate good cause. Except when an
installment agreement is accepted by the commissioner, all persons disenrolled for
nonpayment of a premium must pay any past due premiums as well as current premiums
due prior to being reenrolled. Nonpayment shall include payment with a returned, refused,
or dishonored instrument. The commissioner may require a guaranteed form of payment as
the only means to replace a returned, refused, or dishonored instrument.

deleted text begin (j)deleted text end new text begin (i)new text end For enrollees whose income does not exceed 200 percent of the federal poverty
guidelines and who are also enrolled in Medicare, the commissioner shall reimburse the
enrollee for Medicare part B premiums under section 256B.0625, subdivision 15, paragraph
(a).

new text begin (j) The commissioner is authorized to determine that a premium amount was calculated
or billed in error, make corrections to financial records and billing systems, and refund
premiums collected in error.
 new text end

new text begin EFFECTIVE DATE. new text end

new text begin This section is effective January 1, 2024, or upon federal approval,
whichever occurs later, except that paragraph (j) is effective the day following final
enactment. The commissioner of human services shall notify the revisor of statutes when
federal approval is obtained.
 new text end

Sec. 5.

Minnesota Statutes 2022, section 256B.0625, subdivision 17, is amended to read:


Subd. 17.

Transportation costs.

(a) "Nonemergency medical transportation service"
means motor vehicle transportation provided by a public or private person that serves
Minnesota health care program beneficiaries who do not require emergency ambulance
service, as defined in section 144E.001, subdivision 3, to obtain covered medical services.

(b) Medical assistance covers medical transportation costs incurred solely for obtaining
emergency medical care or transportation costs incurred by eligible persons in obtaining
emergency or nonemergency medical care when paid directly to an ambulance company,
nonemergency medical transportation company, or other recognized providers of
transportation services. Medical transportation must be provided by:

(1) nonemergency medical transportation providers who meet the requirements of this
subdivision;

(2) ambulances, as defined in section 144E.001, subdivision 2;

(3) taxicabs that meet the requirements of this subdivision;

(4) public transit, as defined in section 174.22, subdivision 7; or

(5) not-for-hire vehicles, including volunteer drivers, as defined in section 65B.472,
subdivision 1, paragraph (h).

(c) Medical assistance covers nonemergency medical transportation provided by
nonemergency medical transportation providers enrolled in the Minnesota health care
programs. All nonemergency medical transportation providers must comply with the
operating standards for special transportation service as defined in sections 174.29 to 174.30
and Minnesota Rules, chapter 8840, and all drivers must be individually enrolled with the
commissioner and reported on the claim as the individual who provided the service. All
nonemergency medical transportation providers shall bill for nonemergency medical
transportation services in accordance with Minnesota health care programs criteria. Publicly
operated transit systems, volunteers, and not-for-hire vehicles are exempt from the
requirements outlined in this paragraph.

(d) An organization may be terminated, denied, or suspended from enrollment if:

(1) the provider has not initiated background studies on the individuals specified in
section 174.30, subdivision 10, paragraph (a), clauses (1) to (3); or

(2) the provider has initiated background studies on the individuals specified in section
174.30, subdivision 10, paragraph (a), clauses (1) to (3), and:

(i) the commissioner has sent the provider a notice that the individual has been
disqualified under section 245C.14; and

(ii) the individual has not received a disqualification set-aside specific to the special
transportation services provider under sections 245C.22 and 245C.23.

(e) The administrative agency of nonemergency medical transportation must:

(1) adhere to the policies defined by the commissioner;

(2) pay nonemergency medical transportation providers for services provided to
Minnesota health care programs beneficiaries to obtain covered medical services;

(3) provide data monthly to the commissioner on appeals, complaints, no-shows, canceled
trips, and number of trips by mode; and

(4) by July 1, 2016, in accordance with subdivision 18e, utilize a web-based single
administrative structure assessment tool that meets the technical requirements established
by the commissioner, reconciles trip information with claims being submitted by providers,
and ensures prompt payment for nonemergency medical transportation services.

(f) Until the commissioner implements the single administrative structure and delivery
system under subdivision 18e, clients shall obtain their level-of-service certificate from the
commissioner or an entity approved by the commissioner that does not dispatch rides for
clients using modes of transportation under paragraph (i), clauses (4), (5), (6), and (7).

(g) The commissioner may use an order by the recipient's attending physician, advanced
practice registered nurse, physician assistant, or a medical or mental health professional to
certify that the recipient requires nonemergency medical transportation services.
Nonemergency medical transportation providers shall perform driver-assisted services for
eligible individuals, when appropriate. Driver-assisted service includes passenger pickup
at and return to the individual's residence or place of business, assistance with admittance
of the individual to the medical facility, and assistance in passenger securement or in securing
of wheelchairs, child seats, or stretchers in the vehicle.

Nonemergency medical transportation providers must take clients to the health care
provider using the most direct route, and must not exceed 30 miles for a trip to a primary
care provider or 60 miles for a trip to a specialty care provider, unless the client receives
authorization from the local agency.

Nonemergency medical transportation providers may not bill for separate base rates for
the continuation of a trip beyond the original destination. Nonemergency medical
transportation providers must maintain trip logs, which include pickup and drop-off times,
signed by the medical provider or client, whichever is deemed most appropriate, attesting
to mileage traveled to obtain covered medical services. Clients requesting client mileage
reimbursement must sign the trip log attesting mileage traveled to obtain covered medical
services.

(h) The administrative agency shall use the level of service process established by the
commissioner to determine the client's most appropriate mode of transportation. If public
transit or a certified transportation provider is not available to provide the appropriate service
mode for the client, the client may receive a onetime service upgrade.

(i) The covered modes of transportation are:

(1) client reimbursement, which includes client mileage reimbursement provided to
clients who have their own transportation, or to family or an acquaintance who provides
transportation to the client;

(2) volunteer transport, which includes transportation by volunteers using their own
vehicle;

(3) unassisted transport, which includes transportation provided to a client by a taxicab
or public transit. If a taxicab or public transit is not available, the client can receive
transportation from another nonemergency medical transportation provider;

(4) assisted transport, which includes transport provided to clients who require assistance
by a nonemergency medical transportation provider;

(5) lift-equipped/ramp transport, which includes transport provided to a client who is
dependent on a device and requires a nonemergency medical transportation provider with
a vehicle containing a lift or ramp;

(6) protected transport, which includes transport provided to a client who has received
a prescreening that has deemed other forms of transportation inappropriate and who requires
a provider: (i) with a protected vehicle that is not an ambulance or police car and has safety
locks, a video recorder, and a transparent thermoplastic partition between the passenger and
the vehicle driver; and (ii) who is certified as a protected transport provider; and

(7) stretcher transport, which includes transport for a client in a prone or supine position
and requires a nonemergency medical transportation provider with a vehicle that can transport
a client in a prone or supine position.

(j) The local agency shall be the single administrative agency and shall administer and
reimburse for modes defined in paragraph (i) according to paragraphs (m) and (n) when the
commissioner has developed, made available, and funded the web-based single administrative
structure, assessment tool, and level of need assessment under subdivision 18e. The local
agency's financial obligation is limited to funds provided by the state or federal government.

(k) The commissioner shall:

(1) verify that the mode and use of nonemergency medical transportation is appropriate;

(2) verify that the client is going to an approved medical appointment; and

(3) investigate all complaints and appeals.

(l) The administrative agency shall pay for the services provided in this subdivision and
seek reimbursement from the commissioner, if appropriate. As vendors of medical care,
local agencies are subject to the provisions in section 256B.041, the sanctions and monetary
recovery actions in section 256B.064, and Minnesota Rules, parts 9505.2160 to 9505.2245.

(m) Payments for nonemergency medical transportation must be paid based on the client's
assessed mode under paragraph (h), not the type of vehicle used to provide the service. The
medical assistance reimbursement rates for nonemergency medical transportation services
that are payable by or on behalf of the commissioner for nonemergency medical
transportation services are:

(1) $0.22 per mile for client reimbursement;

(2) up to 100 percent of the Internal Revenue Service business deduction rate for volunteer
transport;

(3) equivalent to the standard fare for unassisted transport when provided by public
transit, and deleted text begin $11deleted text end new text begin $12.10new text end for the base rate and deleted text begin $1.30deleted text end new text begin $1.43new text end per mile when provided by a
nonemergency medical transportation provider;

(4) deleted text begin $13deleted text end new text begin $14.30new text end for the base rate and deleted text begin $1.30deleted text end new text begin $1.43new text end per mile for assisted transport;

(5) deleted text begin $18deleted text end new text begin $19.80new text end for the base rate and deleted text begin $1.55deleted text end new text begin $1.70new text end per mile for lift-equipped/ramp transport;

(6) $75 for the base rate and $2.40 per mile for protected transport; and

(7) $60 for the base rate and $2.40 per mile for stretcher transport, and $9 per trip for
an additional attendant if deemed medically necessary.

(n) The base rate for nonemergency medical transportation services in areas defined
under RUCA to be super rural is equal to 111.3 percent of the respective base rate in
paragraph (m), clauses (1) to (7). The mileage rate for nonemergency medical transportation
services in areas defined under RUCA to be rural or super rural areas is:

(1) for a trip equal to 17 miles or less, equal to 125 percent of the respective mileage
rate in paragraph (m), clauses (1) to (7); and

(2) for a trip between 18 and 50 miles, equal to 112.5 percent of the respective mileage
rate in paragraph (m), clauses (1) to (7).

(o) For purposes of reimbursement rates for nonemergency medical transportation
services under paragraphs (m) and (n), the zip code of the recipient's place of residence
shall determine whether the urban, rural, or super rural reimbursement rate applies.

(p) For purposes of this subdivision, "rural urban commuting area" or "RUCA" means
a census-tract based classification system under which a geographical area is determined
to be urban, rural, or super rural.

(q) The commissioner, when determining reimbursement rates for nonemergency medical
transportation under paragraphs (m) and (n), shall exempt all modes of transportation listed
under paragraph (i) from Minnesota Rules, part 9505.0445, item R, subitem (2).

new text begin (r) Effective for the first day of each calendar quarter in which the price of gasoline as
posted publicly by the United States Energy Information Administration exceeds $3.00 per
gallon, the commissioner shall adjust the rate paid per mile in paragraph (m) by one percent
up or down for every increase or decrease of ten cents for the price of gasoline. The increase
or decrease must be calculated using a base gasoline price of $3.00. The percentage increase
or decrease must be calculated using the average of the most recently available price of all
grades of gasoline for Minnesota as posted publicly by the United States Energy Information
Administration.
 new text end

new text begin EFFECTIVE DATE. new text end

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

Sec. 6.

Minnesota Statutes 2022, section 256B.0625, subdivision 17a, is amended to read:


Subd. 17a.

Payment for ambulance services.

(a) Medical assistance covers ambulance
services. Providers shall bill ambulance services according to Medicare criteria.
Nonemergency ambulance services shall not be paid as emergencies. Effective for services
rendered on or after July 1, 2001, medical assistance payments for ambulance services shall
be paid at the Medicare reimbursement rate or at the medical assistance payment rate in
effect on July 1, 2000, whichever is greater.

(b) Effective for services provided on or after July 1, 2016, medical assistance payment
rates for ambulance services identified in this paragraph are increased by five percent.
Capitation payments made to managed care plans and county-based purchasing plans for
ambulance services provided on or after January 1, 2017, shall be increased to reflect this
rate increase. The increased rate described in this paragraph applies to ambulance service
providers whose base of operations as defined in section 144E.10 is located:

(1) outside the metropolitan counties listed in section 473.121, subdivision 4, and outside
the cities of Duluth, Mankato, Moorhead, St. Cloud, and Rochester; or

(2) within a municipality with a population of less than 1,000.

new text begin (c) Effective for the first day of each calendar quarter in which the price of gasoline as
posted publicly by the United States Energy Information Administration exceeds $3.00 per
gallon, the commissioner shall adjust the rate paid per mile in paragraph (a) by one percent
up or down for every increase or decrease of ten cents for the price of gasoline. The increase
or decrease must be calculated using a base gasoline price of $3.00. The percentage increase
or decrease must be calculated using the average of the most recently available price of all
grades of gasoline for Minnesota as posted publicly by the United States Energy Information
Administration.
 new text end

new text begin (d) Managed care plans and county-based purchasing plans must provide a fuel adjustment
for ambulance services rates when fuel exceeds $3 per gallon. If, for any contract year,
federal approval is not received for this paragraph, the commissioner must adjust the
capitation rates paid to managed care plans and county-based purchasing plans for that
contract year to reflect the removal of this provision. Contracts between managed care plans
and county-based purchasing plans and providers to whom this paragraph applies must
allow recovery of payments from those providers if capitation rates are adjusted in accordance
with this paragraph. Payment recoveries must not exceed the amount equal to any increase
in rates that results from this paragraph. This paragraph expires if federal approval is not
received for this paragraph at any time.
 new text end

new text begin EFFECTIVE DATE. new text end

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

Sec. 7.

Minnesota Statutes 2022, section 256B.0625, subdivision 17b, is amended to read:


Subd. 17b.

Documentation required.

(a) As a condition for payment, nonemergency
medical transportation providers must document each occurrence of a service provided to
a recipient according to this subdivision. Providers must maintain deleted text begin odometer and otherdeleted text end records
sufficient to distinguish individual trips with specific vehicles and drivers. The documentation
may be collected and maintained using electronic systems or software or in paper form but
must be made available and produced upon request. Program funds paid for transportation
that is not documented according to this subdivision deleted text begin shall be recovered by the departmentdeleted text end new text begin
may be subject to recovery by the commissioner pursuant to section 256B.064new text end .

(b) A nonemergency medical transportation provider must compile transportation new text begin trip
new text end recordsnew text begin that are written in English and legible according to the standard of a reasonable
person andnew text end that deleted text begin meetdeleted text end new text begin include each ofnew text end the following deleted text begin requirementsdeleted text end new text begin elementsnew text end :

deleted text begin (1) the record must be in English and must be legible according to the standard of a
reasonable person;
 deleted text end

deleted text begin (2)deleted text end new text begin (1)new text end the recipient's name deleted text begin must be on each page of the recorddeleted text end ; deleted text begin and
deleted text end

deleted text begin (3) each entry in the record must document:
 deleted text end

deleted text begin (i) the date on which the entry is made;
 deleted text end

deleted text begin (ii)deleted text end new text begin (2)new text end the date or dates the service is providednew text begin , if different than the date the entry was
madenew text end ;

deleted text begin (iii)deleted text end new text begin (3) eithernew text end the printed deleted text begin last name, first name, and middle initialdeleted text end new text begin name new text end of the drivernew text begin
sufficient to distinguish the driver of service or the driver's provider numbernew text end ;

deleted text begin (iv)deleted text end new text begin (4) the date andnew text end the signature of the driver attesting deleted text begin to the following: "I certify that
I have accurately reported in this record the trip miles I actually drove and the dates and
times I actually drove them. I understand that misreporting the miles driven and hours
worked is fraud for which I could face criminal prosecution or civil proceedings."deleted text end new text begin that the
record accurately represents the services provided and the actual miles driven, and
acknowledging that misreporting information that results in ineligible or excessive payments
may result in civil or criminal actionnew text end ;

deleted text begin (v)deleted text end new text begin (5) the date andnew text end the signature of the recipient or authorized party attesting deleted text begin to the
following: "I certify that I received the reported transportation service.", or the signature of
the provider of medical services certifying that the recipient was delivered to the providerdeleted text end new text begin
that transportation services were provided as indicated on the transportation trip record, or
the signature of the medical services provider certifying that the recipient was transported
to the medical services provider destination. In the event that both the medical services
provider and the recipient or authorized party refuse or are unable to provide signatures,
the driver must document on the transportation trip record that signatures were requested
and not providednew text end ;

deleted text begin (vi)deleted text end new text begin (6)new text end the address, or the description if the address is not available, of both the origin
and destination, and the mileage for the most direct route from the origin to the destination;

deleted text begin (vii)deleted text end new text begin (7)new text end the new text begin name or number of the new text end mode of transportation in which the service is
provided;

deleted text begin (viii)deleted text end new text begin (8)new text end the license plate number of the vehicle used to transport the recipient;

deleted text begin (ix) whether the service was ambulatory or nonambulatory;
 deleted text end

deleted text begin (x)deleted text end new text begin (9)new text end the time of the new text begin recipient new text end pickupnew text begin ;
new text end

deleted text begin anddeleted text end new text begin (10)new text end the time of the new text begin recipient new text end drop-off deleted text begin with "a.m." and "p.m." designationsdeleted text end ;

new text begin (11) the odometer reading of the vehicle used to transport the recipient taken at the time
of pickup;
 new text end

new text begin (12) the odometer reading of the vehicle used to transport the recipient taken at the time
of drop-off;
 new text end

deleted text begin (xi)deleted text end new text begin (13)new text end the name of the extra attendant when an extra attendant is used to provide
special transportation service; and

deleted text begin (xii)deleted text end new text begin (14)new text end the deleted text begin electronic sourcedeleted text end documentationnew text begin indicating the method that wasnew text end used to
deleted text begin calculate driving directions and mileagedeleted text end new text begin determine the most direct routenew text end .

new text begin (c) In determining whether the commissioner will seek recovery, the documentation
requirements in this section apply retroactively to audit findings beginning January 1, 2020,
and to all audit findings thereafter.
 new text end

Sec. 8.

Minnesota Statutes 2022, section 256B.0625, subdivision 18h, is amended to read:


Subd. 18h.

new text begin Nonemergency medical transportation provisions related to new text end managed
care.

(a) The following new text begin nonemergency medical transportation (NEMT) new text end subdivisions apply
to managed care plans and county-based purchasing plans:

(1) subdivision 17, paragraphs (a), (b), (i), and (n);

(2) subdivision 18; and

(3) subdivision 18a.

(b) A nonemergency medical transportation provider must comply with the operating
standards for special transportation service specified in sections 174.29 to 174.30 and
Minnesota Rules, chapter 8840. Publicly operated transit systems, volunteers, and not-for-hire
vehicles are exempt from the requirements in this paragraph.

new text begin (c) Managed care plans and county-based purchasing plans must provide a fuel adjustment
for NEMT rates when fuel exceeds $3 per gallon. If, for any contract year, federal approval
is not received for this paragraph, the commissioner must adjust the capitation rates paid to
managed care plans and county-based purchasing plans for that contract year to reflect the
removal of this provision. Contracts between managed care plans and county-based
purchasing plans and providers to whom this paragraph applies must allow recovery of
payments from those providers if capitation rates are adjusted in accordance with this
paragraph. Payment recoveries must not exceed the amount equal to any increase in rates
that results from this paragraph. This paragraph expires if federal approval is not received
for this paragraph at any time.
 new text end

new text begin EFFECTIVE DATE. new text end

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

Sec. 9.

Minnesota Statutes 2022, section 256B.0625, subdivision 22, is amended to read:


Subd. 22.

Hospice care.

Medical assistance covers hospice care services under Public
Law 99-272, section 9505, to the extent authorized by rule, except that a recipient age 21
or under who elects to receive hospice services does not waive coverage for services that
are related to the treatment of the condition for which a diagnosis of terminal illness has
been made.new text begin Hospice respite and end-of-life care under subdivision 22a are not hospice care
services under this subdivision.
new text end

new text begin EFFECTIVE DATE. new text end

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

Sec. 10.

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


new text begin Subd. 22a. new text end

new text begin Residential hospice facility; hospice respite and end-of-life care for
children. new text end

new text begin (a) Medical assistance covers hospice respite and end-of-life care if the care is
for children who elect to receive hospice care delivered in a facility that is licensed under
sections 144A.75 to 144A.755 and that is a residential hospice facility under section 144A.75,
subdivision 13, paragraph (a). Hospice care services under subdivision 22 are not hospice
respite or end-of-life care under this subdivision.
 new text end

new text begin (b) The payment rates for coverage under this subdivision must be 100 percent of the
Medicare rate for continuous home care hospice services as published in the Centers for
Medicare and Medicaid Services annual final rule updating payments and policies for hospice
care. Payment for hospice respite and end-of-life care under this subdivision must be made
from state money, though the commissioner must seek to obtain federal financial participation
for the payments. Payment for hospice respite and end-of-life care must be paid to the
residential hospice facility and are not included in any limit or cap amount applicable to
hospice services payments to the elected hospice services provider.
 new text end

new text begin (c) Certification of the residential hospice facility by the federal Medicare program must
not be a requirement of medical assistance payment for hospice respite and end-of-life care
under this subdivision.
 new text end

new text begin EFFECTIVE DATE. new text end

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

Sec. 11.

Minnesota Statutes 2022, section 256B.073, subdivision 3, is amended to read:


Subd. 3.

Requirements.

(a) In developing implementation requirements for electronic
visit verification, the commissioner shall ensure that the requirements:

(1) are minimally administratively and financially burdensome to a provider;

(2) are minimally burdensome to the service recipient and the least disruptive to the
service recipient in receiving and maintaining allowed services;

(3) consider existing best practices and use of electronic visit verification;

(4) are conducted according to all state and federal laws;

(5) are effective methods for preventing fraud when balanced against the requirements
of clauses (1) and (2); and

(6) are consistent with the Department of Human Services' policies related to covered
services, flexibility of service use, and quality assurance.

(b) The commissioner shall make training available to providers on the electronic visit
verification system requirements.

(c) The commissioner shall establish baseline measurements related to preventing fraud
and establish measures to determine the effect of electronic visit verification requirements
on program integrity.

(d) The commissioner shall make a state-selected electronic visit verification system
available to providers of services.

new text begin (e) The commissioner shall make available and publish on the agency website the name
and contact information for the vendor of the state-selected electronic visit verification
system and the other vendors that offer alternative electronic visit verification systems. The
information provided must state that the state-selected electronic visit verification system
is offered at no cost to the provider of services and that the provider may choose an alternative
system that may be at a cost to the provider.
 new text end

Sec. 12.

Minnesota Statutes 2022, section 256B.073, is amended by adding a subdivision
to read:


new text begin Subd. 5. new text end

new text begin Vendor requirements. new text end

new text begin (a) The vendor of the electronic visit verification system
selected by the commissioner and the vendor's affiliate must comply with the requirements
of this subdivision.
 new text end

new text begin (b) The vendor of the state-selected electronic visit verification system and the vendor's
affiliate must:
 new text end

new text begin (1) notify the provider of services that the provider may choose the state-selected
electronic visit verification system at no cost to the provider;
 new text end

new text begin (2) offer the state-selected electronic visit verification system to the provider of services
prior to offering any fee-based electronic visit verification system;
 new text end

new text begin (3) notify the provider of services that the provider may choose any fee-based electronic
visit verification system prior to offering the vendor's or its affiliate's fee-based electronic
visit verification system; and
 new text end

new text begin (4) when offering the state-selected electronic visit verification system, clearly
differentiate between the state-selected electronic visit verification system and the vendor's
or its affiliate's alternative fee-based system.
 new text end

new text begin (c) The vendor of the state-selected electronic visit verification system and the vendor's
affiliate must not use state data that are not available to other vendors of electronic visit
verification systems to promote or sell the vendor's or its affiliate's alternative electronic
visit verification system.
 new text end

new text begin (d) Upon request from the provider, the vendor of the state-selected electronic visit
verification system must provide proof of compliance with the requirements of paragraph
(b).
 new text end

new text begin (e) An agreement between the vendor of the state-selected electronic visit verification
system or its affiliate and a provider of services for an electronic visit verification system
that is not the state-selected system entered into on or after July 1, 2023, is subject to
immediate termination by the provider if the vendor violates any of the requirements of
paragraph (b).
 new text end

new text begin EFFECTIVE DATE. new text end

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

Sec. 13.

Minnesota Statutes 2022, section 256B.14, subdivision 2, is amended to read:


Subd. 2.

Actions to obtain payment.

The state agency shall promulgate rules to
determine the ability of responsible relatives to contribute partial or complete payment or
repayment of medical assistance furnished to recipients for whom they are responsible. All
medical assistance exclusions shall be allowed, and a resource limit of $10,000 for
nonexcluded resources shall be implemented. Above these limits, a contribution of one-third
of the excess resources shall be required. These rules shall not require payment or repayment
when payment would cause undue hardship to the responsible relative or that relative's
immediate family. These rules deleted text begin shall be consistent with the requirements of section 252.27
fordeleted text end new text begin do not apply tonew text end parents of children whose eligibility for medical assistance was determined
without deeming of the parents' resources and incomenew text begin under the Tax Equity and Fiscal
Responsibility Act (TEFRA) option or to parents of children accessing home and
community-based waiver servicesnew text end . The county agency shall give the responsible relative
notice of the amount of the payment or repayment. If the state agency or county agency
finds that notice of the payment obligation was given to the responsible relative, but that
the relative failed or refused to pay, a cause of action exists against the responsible relative
for that portion of medical assistance granted after notice was given to the responsible
relative, which the relative was determined to be able to pay.

The action may be brought by the state agency or the county agency in the county where
assistance was granted, for the assistance, together with the costs of disbursements incurred
due to the action.

In addition to granting the county or state agency a money judgment, the court may,
upon a motion or order to show cause, order continuing contributions by a responsible
relative found able to repay the county or state agency. The order shall be effective only
for the period of time during which the recipient receives medical assistance from the county
or state agency.

Sec. 14.

Minnesota Statutes 2022, section 256B.766, is amended to read:


256B.766 REIMBURSEMENT FOR BASIC CARE SERVICES.

(a) Effective for services provided on or after July 1, 2009, total payments for basic care
services, shall be reduced by three percent, except that for the period July 1, 2009, through
June 30, 2011, total payments shall be reduced by 4.5 percent for the medical assistance
and general assistance medical care programs, prior to third-party liability and spenddown
calculation. Effective July 1, 2010, the commissioner shall classify physical therapy services,
occupational therapy services, and speech-language pathology and related services as basic
care services. The reduction in this paragraph shall apply to physical therapy services,
occupational therapy services, and speech-language pathology and related services provided
on or after July 1, 2010.

(b) Payments made to managed care plans and county-based purchasing plans shall be
reduced for services provided on or after October 1, 2009, to reflect the reduction effective
July 1, 2009, and payments made to the plans shall be reduced effective October 1, 2010,
to reflect the reduction effective July 1, 2010.

(c) Effective for services provided on or after September 1, 2011, through June 30, 2013,
total payments for outpatient hospital facility fees shall be reduced by five percent from the
rates in effect on August 31, 2011.

(d) Effective for services provided on or after September 1, 2011, through June 30, 2013,
total payments for ambulatory surgery centers facility fees, medical supplies and durable
medical equipment not subject to a volume purchase contract, prosthetics and orthotics,
renal dialysis services, laboratory services, public health nursing services, physical therapy
services, occupational therapy services, speech therapy services, eyeglasses not subject to
a volume purchase contract, hearing aids not subject to a volume purchase contract, and
anesthesia services shall be reduced by three percent from the rates in effect on August 31,
2011.

(e) Effective for services provided on or after September 1, 2014, payments for
ambulatory surgery centers facility fees, hospice services, renal dialysis services, laboratory
services, public health nursing services, eyeglasses not subject to a volume purchase contract,
and hearing aids not subject to a volume purchase contract shall be increased by three percent
and payments for outpatient hospital facility fees shall be increased by three percent.
Payments made to managed care plans and county-based purchasing plans shall not be
adjusted to reflect payments under this paragraph.

(f) Payments for medical supplies and durable medical equipment not subject to a volume
purchase contract, and prosthetics and orthotics, provided on or after July 1, 2014, through
June 30, 2015, shall be decreased by .33 percent. Payments for medical supplies and durable
medical equipment not subject to a volume purchase contract, and prosthetics and orthotics,
provided on or after July 1, 2015, shall be increased by three percent from the rates as
determined under paragraphs (i) and (j).

(g) Effective for services provided on or after July 1, 2015, payments for outpatient
hospital facility fees, medical supplies and durable medical equipment not subject to a
volume purchase contract, prosthetics, and orthotics to a hospital meeting the criteria specified
in section 62Q.19, subdivision 1, paragraph (a), clause (4), shall be increased by 90 percent
from the rates in effect on June 30, 2015. Payments made to managed care plans and
county-based purchasing plans shall not be adjusted to reflect payments under this paragraph.

(h) This section does not apply to physician and professional services, inpatient hospital
services, family planning services, mental health services, dental services, prescription
drugs, medical transportation, federally qualified health centers, rural health centers, Indian
health services, and Medicare cost-sharing.

(i) Effective for services provided on or after July 1, 2015, the following categories of
medical supplies and durable medical equipment shall be individually priced items: deleted text begin enteral
nutrition and supplies,deleted text end customized and other specialized tracheostomy tubes and supplies,
electric patient lifts, and durable medical equipment repair and service. This paragraph does
not apply to medical supplies and durable medical equipment subject to a volume purchase
contract, products subject to the preferred diabetic testing supply program, and items provided
to dually eligible recipients when Medicare is the primary payer for the item. The
commissioner shall not apply any medical assistance rate reductions to durable medical
equipment as a result of Medicare competitive bidding.

(j) Effective for services provided on or after July 1, 2015, medical assistance payment
rates for durable medical equipment, prosthetics, orthotics, or supplies shall be increased
as follows:

(1) payment rates for durable medical equipment, prosthetics, orthotics, or supplies that
were subject to the Medicare competitive bid that took effect in January of 2009 shall be
increased by 9.5 percent; and

(2) payment rates for durable medical equipment, prosthetics, orthotics, or supplies on
the medical assistance fee schedule, whether or not subject to the Medicare competitive bid
that took effect in January of 2009, shall be increased by 2.94 percent, with this increase
being applied after calculation of any increased payment rate under clause (1).

This paragraph does not apply to medical supplies and durable medical equipment subject
to a volume purchase contract, products subject to the preferred diabetic testing supply
program, items provided to dually eligible recipients when Medicare is the primary payer
for the item, and individually priced items identified in paragraph (i). Payments made to
managed care plans and county-based purchasing plans shall not be adjusted to reflect the
rate increases in this paragraph.

(k) Effective for nonpressure support ventilators provided on or after January 1, 2016,
the rate shall be the lower of the submitted charge or the Medicare fee schedule rate. Effective
for pressure support ventilators provided on or after January 1, 2016, the rate shall be the
lower of the submitted charge or 47 percent above the Medicare fee schedule rate. For
payments made in accordance with this paragraph, if, and to the extent that, the commissioner
identifies that the state has received federal financial participation for ventilators in excess
of the amount allowed effective January 1, 2018, under United States Code, title 42, section
1396b(i)(27), the state shall repay the excess amount to the Centers for Medicare and
Medicaid Services with state funds and maintain the full payment rate under this paragraph.

(l) Payment rates for durable medical equipment, prosthetics, orthotics or supplies, that
are subject to the upper payment limit in accordance with section 1903(i)(27) of the Social
Security Act, shall be paid the Medicare rate. Rate increases provided in this chapter shall
not be applied to the items listed in this paragraph.

new text begin (m) For dates of service on or after July 1, 2023, through June 30, 2024, enteral nutrition
and supplies must be paid according to this paragraph. If sufficient data exists for a product
or supply, payment must be based upon the 50th percentile of the usual and customary
charges per product code submitted to the commissioner, using only charges submitted per
unit. Increases in rates resulting from the 50th percentile payment method must not exceed
150 percent of the previous fiscal year's rate per code and product combination. Data are
sufficient if: (1) the commissioner has at least 100 paid claim lines by at least ten different
providers for a given product or supply; or (2) in the absence of the data in clause (1), the
commissioner has at least 20 claim lines by at least five different providers for a product or
supply that does not meet the requirements of clause (1). If sufficient data are not available
to calculate the 50th percentile for enteral products or supplies, the payment rate must be
the payment rate in effect on June 30, 2023.
 new text end

new text begin (n) For dates of service on or after July 1, 2024, enteral nutrition and supplies must be
paid according to this paragraph and updated annually each January 1. If sufficient data
exists for a product or supply, payment must be based upon the 50th percentile of the usual
and customary charges per product code submitted to the commissioner for the previous
calendar year, using only charges submitted per unit. Increases in rates resulting from the
50th percentile payment method must not exceed 150 percent of the previous year's rate per
code and product combination. Data are sufficient if: (1) the commissioner has at least 100
paid claim lines by at least ten different providers for a given product or supply; or (2) in
the absence of the data in clause (1), the commissioner has at least 20 claim lines by at least
five different providers for a product or supply that does not meet the requirements of clause
(1). If sufficient data are not available to calculate the 50th percentile for enteral products
or supplies, the payment must be the manufacturer's suggested retail price of that product
or supply minus 20 percent. If the manufacturer's suggested retail price is not available,
payment must be the actual acquisition cost of that product or supply plus 20 percent.
 new text end

ARTICLE 4

BEHAVIORAL HEALTH

Section 1.

Minnesota Statutes 2022, section 4.046, subdivision 6, is amended to read:


Subd. 6.

new text begin Office of new text end Addiction and Recoverynew text begin ;new text end director.

new text begin The Office of Addiction and
Recovery is created in the Department of Management and Budget. new text end The governor must
appoint an addiction and recovery director, who shall serve as chair of the subcabinetnew text begin and
administer the Office of Addiction and Recoverynew text end . The director shall serve in the unclassified
service and shall report to the governor. The director must:

(1) make efforts to break down silos and work across agencies to better target the state's
role in addressing addiction, treatment, and recoverynew text begin for youth and adultsnew text end ;

(2) assist in leading the subcabinet and the advisory council toward progress on
measurable goals that track the state's efforts in combatting addictionnew text begin for youth and adults,
and preventing substance use and addiction among the state's youth populationnew text end ; and

(3) establish and manage external partnerships and build relationships with communities,
community leaders, and those who have direct experience with addiction to ensure that all
voices of recovery are represented in the work of the subcabinet and advisory council.

Sec. 2.

Minnesota Statutes 2022, section 4.046, subdivision 7, is amended to read:


Subd. 7.

Staff and administrative support.

The commissioner of deleted text begin human servicesdeleted text end new text begin
management and budgetnew text end , in coordination with other state agencies and boards as applicable,
must provide staffing and administrative support to thenew text begin Office of Addiction and Recovery,
thenew text end addiction and recovery director, the subcabinet, and the advisory council established in
this section.

Sec. 3.

Minnesota Statutes 2022, section 245.91, subdivision 4, is amended to read:


Subd. 4.

Facility or program.

"Facility" or "program" means a nonresidential or
residential program as defined in section 245A.02, subdivisions 10 and 14, and any agency,
facility, or program that provides services or treatment for mental illness, developmental
disability, substance use disorder, or emotional disturbance that is required to be licensed,
certified, or registered by the commissioner of human services, health, or education;new text begin a sober
home as defined in section 254B.01, subdivision 10;new text end and an acute care inpatient facility that
provides services or treatment for mental illness, developmental disability, substance use
disorder, or emotional disturbance.

Sec. 4.

Minnesota Statutes 2022, section 245G.02, subdivision 2, is amended to read:


Subd. 2.

Exemption from license requirement.

This chapter does not apply to a county
or recovery community organization that is providing a service for which the county or
recovery community organization is an eligible vendor under section 254B.05. This chapter
does not apply to an organization whose primary functions are information, referral,
diagnosis, case management, and assessment for the purposes of client placement, education,
support group services, or self-help programs. This chapter does not apply to the activities
of a licensed professional in private practice. A license holder providing the initial set of
substance use disorder services allowable under section 254A.03, subdivision 3, paragraph
(c), to an individual referred to a licensed nonresidential substance use disorder treatment
program after a positive screen for alcohol or substance misuse is exempt from sections
245G.05; 245G.06, subdivisions 1, deleted text begin 2deleted text end new text begin 1anew text end , and 4; 245G.07, subdivisions 1, paragraph (a),
clauses (2) to (4), and 2, clauses (1) to (7); and 245G.17.

Sec. 5.

Minnesota Statutes 2022, section 245G.09, subdivision 3, is amended to read:


Subd. 3.

Contents.

Client records must contain the following:

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

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

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

(4) an assessment summary completed according to section 245G.05, subdivision 2;

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

(6) an individual treatment plan according to section 245G.06, subdivisions 1 deleted text begin and 2deleted text end new text begin and
1anew text end ;

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

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

Sec. 6.

Minnesota Statutes 2022, section 245G.22, subdivision 15, as amended by 2023
H.F. No. 1403, article 1, section 17, if enacted, is amended to read:


Subd. 15.

Nonmedication treatment services; documentation.

(a) The program must
offer at least 50 consecutive minutes of individual or group therapy treatment services as
defined in section 245G.07, subdivision 1, paragraph (a), clause (1), per week, for the first
ten weeks following the day of service initiation, and at least 50 consecutive minutes per
month thereafter. As clinically appropriate, the program may offer these services cumulatively
and not consecutively in increments of no less than 15 minutes over the required time period,
and for a total of 60 minutes of treatment services over the time period, and must document
the reason for providing services cumulatively in the client's record. The program may offer
additional levels of service when deemed clinically necessary.

(b) Notwithstanding the requirements of comprehensive assessments in section 245G.05,
the assessment must be completed within 21 days from the day of service initiation.

new text begin EFFECTIVE DATE. new text end

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

Sec. 7.

Minnesota Statutes 2022, section 253B.10, subdivision 1, is amended to read:


Subdivision 1.

Administrative requirements.

(a) When a person is committed, the
court shall issue a warrant or an order committing the patient to the custody of the head of
the treatment facility, state-operated treatment program, or community-based treatment
program. The warrant or order shall state that the patient meets the statutory criteria for
civil commitment.

(b) The commissioner shall prioritize patients being admitted from jail or a correctional
institution who are:

(1) ordered confined in a state-operated treatment program for an examination under
Minnesota Rules of Criminal Procedure, rules 20.01, subdivision 4, paragraph (a), and
20.02, subdivision 2;

(2) under civil commitment for competency treatment and continuing supervision under
Minnesota Rules of Criminal Procedure, rule 20.01, subdivision 7;

(3) found not guilty by reason of mental illness under Minnesota Rules of Criminal
Procedure, rule 20.02, subdivision 8, and under civil commitment or are ordered to be
detained in a state-operated treatment program pending completion of the civil commitment
proceedings; or

(4) committed under this chapter to the commissioner after dismissal of the patient's
criminal charges.

Patients described in this paragraph must be admitted to a state-operated treatment program
within 48 hours. The commitment must be ordered by the court as provided in section
253B.09, subdivision 1, paragraph (d).

(c) Upon the arrival of a patient at the designated treatment facility, state-operated
treatment program, or community-based treatment program, the head of the facility or
program shall retain the duplicate of the warrant and endorse receipt upon the original
warrant or acknowledge receipt of the order. The endorsed receipt or acknowledgment must
be filed in the court of commitment. After arrival, the patient shall be under the control and
custody of the head of the facility or program.

(d) Copies of the petition for commitment, the court's findings of fact and conclusions
of law, the court order committing the patient, the report of the court examiners, and the
prepetition report, and any medical and behavioral information available shall be provided
at the time of admission of a patient to the designated treatment facility or program to which
the patient is committed. Upon a patient's referral to the commissioner of human services
for admission pursuant to subdivision 1, paragraph (b), any inpatient hospital, treatment
facility, jail, or correctional facility that has provided care or supervision to the patient in
the previous two years shall, when requested by the treatment facility or commissioner,
provide copies of the patient's medical and behavioral records to the Department of Human
Services for purposes of preadmission planning. This information shall be provided by the
head of the treatment facility to treatment facility staff in a consistent and timely manner
and pursuant to all applicable laws.

new text begin (e) Patients described in paragraph (b) must be admitted to a state-operated treatment
program within 48 hours of the Office of Medical Director, under section 246.018, or a
designee determining that a medically appropriate bed is available. This paragraph expires
on June 30, 2025.
 new text end

new text begin EFFECTIVE DATE. new text end

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

Sec. 8.

Minnesota Statutes 2022, section 254B.01, is amended by adding a subdivision to
read:


new text begin Subd. 10. new text end

new text begin Sober home. new text end

new text begin A sober home is a cooperative living residence, a room and
board residence, an apartment, or any other living accommodation that:
 new text end

new text begin (1) provides temporary housing to persons with substance use disorders;
 new text end

new text begin (2) stipulates that residents must abstain from using alcohol or other illicit drugs or
substances not prescribed by a physician;
 new text end

new text begin (3) charges a fee for living there;
 new text end

new text begin (4) does not provide counseling or treatment services to residents;
 new text end

new text begin (5) promotes sustained recovery from substance use disorders; and
 new text end

new text begin (6) follows the sober living guidelines published by the federal Substance Abuse and
Mental Health Services Administration.
 new text end

Sec. 9.

Minnesota Statutes 2022, section 254B.05, subdivision 1, is amended to read:


Subdivision 1.

Licensure required .

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

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

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

(d) A recovery community organization that meets certification requirements identified
by the commissioner is an eligible vendor of peer support services.

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

Sec. 10.

Minnesota Statutes 2022, section 254B.05, subdivision 5, is amended to read:


Subd. 5.

Rate requirements.

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

(b) Eligible substance use disorder treatment services include:

(1) outpatient treatment services that are licensed according to sections 245G.01 to
245G.17, or applicable tribal license;

(2) comprehensive assessments provided according to sections 245.4863, paragraph (a),
and 245G.05;

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

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

(5) on July 1, 2019, or upon federal approval, whichever is later, withdrawal management
services provided according to chapter 245F;

deleted text begin (6) substance use disorder treatment services with medications for opioid use disorder
that are licensed according to sections 245G.01 to 245G.17 and 245G.22, or applicable
tribal license;
 deleted text end

deleted text begin (7) substance use disorder treatment with medications for opioid use disorder plus
enhanced treatment services that meet the requirements of clause (6) and provide nine hours
of clinical services each week;
 deleted text end

deleted text begin (8)deleted text end new text begin (6)new text end high, medium, and low intensity residential treatment services that are licensed
according to sections 245G.01 to 245G.17 and 245G.21 or applicable tribal license which
provide, respectively, 30, 15, and five hours of clinical services each week;

deleted text begin (9)deleted text end new text begin (7)new text end hospital-based treatment services that are licensed according to sections 245G.01
to 245G.17 or applicable tribal license and licensed as a hospital under sections 144.50 to
144.56;

deleted text begin (10)deleted text end new text begin (8)new text end adolescent treatment programs that are licensed as outpatient treatment programs
according to sections 245G.01 to 245G.18 or as residential treatment programs according
to Minnesota Rules, parts 2960.0010 to 2960.0220, and 2960.0430 to 2960.0490, or
applicable tribal license;

deleted text begin (11)deleted text end new text begin (9)new text end high-intensity residential treatment services that are licensed according to sections
245G.01 to 245G.17 and 245G.21 or applicable tribal license, which provide 30 hours of
clinical services each week provided by a state-operated vendor or to clients who have been
civilly committed to the commissioner, present the most complex and difficult care needs,
and are a potential threat to the community; and

deleted text begin (12)deleted text end new text begin (10)new text end room and board facilities that meet the requirements of subdivision 1a.

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

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

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

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

(B) meets the licensure exclusion criteria of section 245A.03, subdivision 2, paragraph
(a), clause (6), and meets the requirements under section 245G.19, subdivision 4; or

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

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

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

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

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

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

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

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

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

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

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

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

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

(d) In order to be eligible for a higher rate under paragraph (c), clause (1), a program
that provides arrangements for off-site child care must maintain current documentation at
the substance use disorder facility of the child care provider's current licensure to provide
child care services. Programs that provide child care according to paragraph (c), clause (1),
must be deemed in compliance with the licensing requirements in section 245G.19.

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

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

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

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

new text begin EFFECTIVE DATE. new text end

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

Sec. 11.

new text begin [254B.121] RATE METHODOLOGY; SUBSTANCE USE DISORDER
TREATMENT SERVICES WITH MEDICATIONS FOR OPIOID USE DISORDER.
 new text end

new text begin Subdivision 1. new text end

new text begin Rates established. new text end

new text begin Notwithstanding sections 254B.03, subdivision 9,
paragraph (a), clause (2); 254B.05, subdivision 5, paragraph (a); and 254B.12, subdivision
1, the commissioner shall use the rates in this section for substance use disorder treatment
services with medications for opioid use disorder.
 new text end

new text begin Subd. 2. new text end

new text begin Rate updates. new text end

new text begin Effective each January 1, the commissioner must update the
rates for substance use disorder treatment services with medications for opioid use disorder
that are licensed according to sections 245G.01 to 245G.17 and 245G.22, or applicable
Tribal license, to equal the corresponding Minnesota-specific, locality-adjusted Medicare
rates for the same or comparable services in the calendar year in which the services are
provided. This rate does not apply to federally qualified health centers, rural health centers,
Indian health services, and certified community behavioral health centers.
 new text end

new text begin Subd. 3. new text end

new text begin Nondrug weekly bundle annual limit. new text end

new text begin No more than 30 weekly nondrug
bundle charges are eligible for coverage in the first calendar year that an enrollee is being
treated by an opioid treatment provider and no more than 15 weekly nondrug bundle charges
are eligible for coverage in subsequent calendar years. The commissioner may override the
coverage limitation on the number of weekly nondrug bundle charges for an enrollee if the
provider obtains authorization to exceed the limit and documents the medical necessity,
services to be provided, and rationale for requiring the enrollee to report to the provider's
facility for a face-to-face encounter more frequently.
 new text end

new text begin EFFECTIVE DATE. new text end

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

Sec. 12.

new text begin [254B.17] WITHDRAWAL MANAGEMENT START-UP AND
CAPACITY-BUILDING GRANTS.
 new text end

new text begin The commissioner must establish start-up and capacity-building grants for prospective
or new withdrawal management programs licensed under chapter 245F that will meet
medically monitored or clinically monitored levels of care. Grants may be used for expenses
that are not reimbursable under Minnesota health care programs, including but not limited
to:
 new text end

new text begin (1) costs associated with hiring staff;
 new text end

new text begin (2) costs associated with staff retention;
 new text end

new text begin (3) the purchase of office equipment and supplies;
 new text end

new text begin (4) the purchase of software;
 new text end

new text begin (5) costs associated with obtaining applicable and required licenses;
 new text end

new text begin (6) business formation costs;
 new text end

new text begin (7) costs associated with staff training; and
 new text end

new text begin (8) the purchase of medical equipment and supplies necessary to meet health and safety
requirements.
 new text end

new text begin EFFECTIVE DATE. new text end

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

Sec. 13.

new text begin [254B.18] SAFE RECOVERY SITES START-UP AND
CAPACITY-BUILDING GRANTS.
 new text end

new text begin (a) The commissioner of human services must establish start-up and capacity-building
grants for current or prospective harm reduction organizations to promote health, wellness,
safety, and recovery to people who are in active stages of substance use disorder. Grants
must be used to establish safe recovery sites that offer harm reduction services and supplies,
including but not limited to:
 new text end

new text begin (1) safe injection spaces;
 new text end

new text begin (2) sterile needle exchange;
 new text end

new text begin (3) opiate antagonist rescue kits;
 new text end

new text begin (4) fentanyl and other drug testing;
 new text end

new text begin (5) street outreach;
 new text end

new text begin (6) educational and referral services;
 new text end

new text begin (7) health, safety, and wellness services; and
 new text end

new text begin (8) access to hygiene and sanitation.
 new text end

new text begin (b) The commissioner must conduct local community outreach and engagement in
collaboration with newly established safe recovery sites. The commissioner must evaluate
the efficacy of safe recovery sites and collect data to measure health-related and public
safety outcomes.
 new text end

new text begin (c) The commissioner must prioritize grant applications for organizations that are
culturally specific or culturally responsive and that commit to serving individuals from
communities that are disproportionately impacted by the opioid epidemic, including:
 new text end

new text begin (1) Native American, American Indian, and Indigenous communities; and
 new text end

new text begin (2) Black, African American, and African-born communities.
 new text end

new text begin (d) For purposes of this section, a "culturally specific" or "culturally responsive"
organization is an organization that is designed to address the unique needs of individuals
who share a common language, racial, ethnic, or social background, and is governed with
significant input from individuals of that specific background.
 new text end

Sec. 14.

new text begin [254B.181] SOBER HOMES.
 new text end

new text begin Subdivision 1. new text end

new text begin Requirements. new text end

new text begin All sober homes must comply with applicable state laws
and regulations and local ordinances related to maximum occupancy, fire safety, and
sanitation. In addition, all sober homes must:
 new text end

new text begin (1) maintain a supply of an opiate antagonist in the home and post information on proper
use;
 new text end

new text begin (2) have written policies regarding access to all prescribed medications;
 new text end

new text begin (3) have written policies regarding evictions;
 new text end

new text begin (4) return all property and medications to a person discharged from the home and retain
the items for a minimum of 60 days if the person did not collect them upon discharge. The
owner must make an effort to contact persons listed as emergency contacts for the discharged
person so that the items are returned;
 new text end

new text begin (5) document the names and contact information for persons to contact in case of an
emergency or upon discharge and notification of a family member, or other emergency
contact designated by the resident under certain circumstances, including but not limited to
death due to an overdose;
 new text end

new text begin (6) maintain contact information for emergency resources in the community to address
mental health and health emergencies;
 new text end

new text begin (7) have policies on staff qualifications and prohibition against fraternization;
 new text end

new text begin (8) have a policy on whether the use of medications for opioid use disorder is permissible;
 new text end

new text begin (9) have a fee schedule and refund policy;
 new text end

new text begin (10) have rules for residents;
 new text end

new text begin (11) have policies that promote resident participation in treatment, self-help groups, or
other recovery supports;
 new text end

new text begin (12) have policies requiring abstinence from alcohol and illicit drugs; and
 new text end

new text begin (13) distribute the sober home bill of rights.
 new text end

new text begin Subd. 2. new text end

new text begin Bill of rights. new text end

new text begin An individual living in a sober home has the right to:
 new text end

new text begin (1) have access to an environment that supports recovery;
 new text end

new text begin (2) have access to an environment that is safe and free from alcohol and other illicit
drugs or substances;
 new text end

new text begin (3) be free from physical and verbal abuse, neglect, financial exploitation, and all forms
of maltreatment covered under the Vulnerable Adults Act, sections 626.557 to 626.5572;
 new text end

new text begin (4) be treated with dignity and respect and to have personal property treated with respect;
 new text end

new text begin (5) have personal, financial, and medical information kept private and to be advised of
the sober home's policies and procedures regarding disclosure of such information;
 new text end

new text begin (6) access, while living in the residence, to other community-based support services as
needed;
 new text end

new text begin (7) be referred to appropriate services upon leaving the residence, if necessary;
 new text end

new text begin (8) retain personal property that does not jeopardize safety or health;
 new text end

new text begin (9) assert these rights personally or have them asserted by the individual's representative
or by anyone on behalf of the individual without retaliation;
 new text end

new text begin (10) be provided with the name, address, and telephone number of the ombudsman for
mental health, substance use disorder, and developmental disabilities and information about
the right to file a complaint;
 new text end

new text begin (11) be fully informed of these rights and responsibilities, as well as program policies
and procedures; and
 new text end

new text begin (12) not be required to perform services for the residence that are not included in the
usual expectations for all residents.
 new text end

new text begin Subd. 3. new text end

new text begin Complaints; ombudsman for mental health and developmental
disabilities. new text end

new text begin Any complaints about a sober home may be made to and reviewed or
investigated by the ombudsman for mental health and developmental disabilities, pursuant
to sections 245.91 and 245.94.
 new text end

new text begin Subd. 4. new text end

new text begin Private right of action. new text end

new text begin In addition to pursuing other remedies, an individual
may bring an action to recover damages caused by a violation of this section.
 new text end

Sec. 15.

new text begin [254B.191] EVIDENCE-BASED TRAINING.
 new text end

new text begin The commissioner of human services must establish training opportunities for substance
use disorder treatment providers under Minnesota Statutes, chapters 245F and 245G, and
applicable Tribal licenses, to increase knowledge and develop skills to adopt evidence-based
and promising practices in substance use disorder treatment programs. Training opportunities
must support the transition to American Society of Addiction Medicine (ASAM) standards.
Training formats may include self or organizational assessments, virtual modules, one-to-one
coaching, self-paced courses, interactive hybrid courses, and in-person courses. Foundational
and skill-building training topics may include:
 new text end

new text begin (1) ASAM criteria;
 new text end

new text begin (2) person-centered and culturally responsive services;
 new text end

new text begin (3) medical and clinical decision making;
 new text end

new text begin (4) conducting assessments and appropriate level of care;
 new text end

new text begin (5) treatment and service planning;
 new text end

new text begin (6) identifying and overcoming systems challenges;
 new text end

new text begin (7) conducting clinical case reviews; and
 new text end

new text begin (8) appropriate and effective transfer and discharge.
 new text end

Sec. 16.

Minnesota Statutes 2022, section 256B.0759, subdivision 2, is amended to read:


Subd. 2.

Provider participation.

(a) deleted text begin Outpatientdeleted text end new text begin Programs licensed by the Department
of Human Services as nonresidentialnew text end substance use disorder treatment deleted text begin providers may elect
to participate in the demonstration project and meet the requirements of subdivision 3. To
participate, a provider must notify the commissioner of the provider's intent to participate
in a format required by the commissioner and enroll as a demonstration project providerdeleted text end new text begin
programs that receive payment under this chapter must enroll as demonstration project
providers and meet the requirements of subdivision 3 by January 1, 2025. Programs that do
not meet the requirements of this paragraph are ineligible for payment for services provided
under section 256B.0625new text end .

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

new text begin (c) Programs licensed by the Department of Human Services as residential treatment
programs according to section 245G.21 that receive payment under this chapter and are
licensed as a hospital under sections 144.50 to 144.581 must enroll as demonstration project
providers and meet the requirements of subdivision 3 by January 1, 2025.
 new text end

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

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

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

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

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

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

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

Sec. 17.

Minnesota Statutes 2022, section 256I.05, is amended by adding a subdivision
to read:


new text begin Subd. 1s. new text end

new text begin Supplemental rate; Douglas County. new text end

new text begin Notwithstanding the provisions of
subdivisions 1a and 1c, beginning July 1, 2023, a county agency shall negotiate a
supplementary rate in addition to the rate specified in subdivision 1, not to exceed $750 per
month, including any legislatively authorized inflationary adjustments, for a housing support
provider located in Douglas County that operates a long-term residential facility with a total
of 74 beds that serve chemically dependent men and provide 24-hour-a-day supervision
and other support services.
 new text end

Sec. 18.

Minnesota Statutes 2022, section 256I.05, is amended by adding a subdivision
to read:


new text begin Subd. 1t. new text end

new text begin Supplemental rate; Crow Wing County. new text end

new text begin Notwithstanding the provisions of
subdivisions 1a and 1c, beginning July 1, 2023, a county agency shall negotiate a
supplementary rate in addition to the rate specified in subdivision 1, not to exceed $750 per
month, including any legislatively authorized inflationary adjustments, for a housing support
provider located in Crow Wing County that operates a long-term residential facility with a
total of 90 beds that serves chemically dependent men and women and provides
24-hour-a-day supervision and other support services.
 new text end

Sec. 19.

Minnesota Statutes 2022, section 256I.05, is amended by adding a subdivision
to read:


new text begin Subd. 1u. new text end

new text begin Supplemental rate; Douglas County. new text end

new text begin Notwithstanding the provisions in this
section, beginning July 1, 2023, a county agency shall negotiate a supplemental rate for up
to 20 beds in addition to the rate specified in subdivision 1, not to exceed the maximum rate
allowed under subdivision 1a, including any legislatively authorized inflationary adjustments,
for a housing support provider located in Douglas County that operates two facilities and
provides room and board and supplementary services to adult males recovering from
substance use disorder, mental illness, or housing instability.
 new text end

new text begin EFFECTIVE DATE. new text end

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

Sec. 20.

new text begin [325F.725] SOBER HOME TITLE PROTECTION.
 new text end

new text begin No person or entity may use the phrase "sober home," whether alone or in combination
with other words and whether orally or in writing, to advertise, market, or otherwise describe,
offer, or promote itself, or any housing, service, service package, or program that it provides
within this state, unless the person or entity meets the definition of a sober home in section
254B.01, subdivision 10, and meets the requirements of section 254B.181.
 new text end

Sec. 21. new text begin CULTURALLY RESPONSIVE RECOVERY COMMUNITY GRANTS.
new text end

new text begin The commissioner must establish start-up and capacity-building grants for prospective
or new recovery community organizations serving or intending to serve culturally specific
or population-specific recovery communities. Grants may be used for expenses that are not
reimbursable under Minnesota health care programs, including but not limited to:
 new text end

new text begin (1) costs associated with hiring and retaining staff;
 new text end

new text begin (2) staff training, purchasing office equipment and supplies;
 new text end

new text begin (3) purchasing software and website services;
 new text end

new text begin (4) costs associated with establishing nonprofit status;
 new text end

new text begin (5) rental and lease costs and community outreach; and
 new text end

new text begin (6) education and recovery events.
 new text end

new text begin EFFECTIVE DATE. new text end

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

Sec. 22. new text begin FAMILY TREATMENT START-UP AND CAPACITY-BUILDING
GRANTS.
new text end

new text begin The commissioner of human services must establish start-up and capacity-building grants
for prospective or new substance use disorder treatment programs that serve parents with
their children. Grants must be used for expenses that are not reimbursable under Minnesota
health care programs, including but not limited to:
 new text end

new text begin (1) physical plant upgrades to support larger family units;
 new text end

new text begin (2) supporting the expansion or development of programs that provide holistic services,
including trauma supports, conflict resolution, and parenting skills;
 new text end

new text begin (3) increasing awareness, education, and outreach utilizing culturally responsive
approaches to develop relationships between culturally specific communities and clinical
treatment provider programs; and
 new text end

new text begin (4) expanding culturally specific family programs and accommodating diverse family
units.
 new text end

Sec. 23. new text begin MEDICAL ASSISTANCE BEHAVIORAL HEALTH SYSTEM
TRANSFORMATION STUDY.
new text end

new text begin The commissioner of human services, in consultation with stakeholders, must evaluate
the feasibility, potential design, and federal authorities needed to cover traditional healing,
behavioral health services in correctional facilities, and contingency management under the
medical assistance program.
 new text end

Sec. 24. new text begin OPIOID TREATMENT PROGRAM WORK GROUP.
new text end

new text begin The commissioner of human services must convene a work group of community partners
to evaluate the opioid treatment program model under Minnesota Statutes, section 245G.22,
and to make recommendations on overall service design; simplification or improvement of
regulatory oversight; increasing access to opioid treatment programs and improving the
quality of care; addressing geographic, racial, and justice-related disparities for individuals
who utilize or may benefit from medications for opioid use disorder; and other related topics,
as determined by the work group. The commissioner must report the work group's
recommendations to the chairs and ranking minority members of the legislative committees
with jurisdiction over health and human services by January 15, 2024.
 new text end

Sec. 25. new text begin ENROLLMENT AND REQUIREMENTS FOR PEER RECOVERY
SUPPORT SERVICES VENDORS.
new text end

new text begin The commissioner of human services must consult with providers, counties, Tribes,
recovery community organizations, and the recovery community at large to develop
recommendations on whether entities seeking vendor eligibility for medical assistance peer
recovery support services should be subject to additional provider enrollment and oversight
requirements. The commissioner must submit recommendations to the chairs and ranking
minority members of the committees with jurisdiction over health and human services by
February 1, 2024. Recommendations must include the additional requirements that may be
needed and specify which entities would be subject to the additional requirements.
Recommendations must balance the goals of fostering cultures of accountability, applying
supportive supervision models, and increasing access to high-quality, culturally responsive
medical assistance peer recovery support services.
 new text end

Sec. 26. new text begin SOBER HOME SCAN.
new text end

new text begin The commissioner of human services shall conduct a survey to identify sober home
settings across the state and to collect information about the services they provide, their
funding sources, whether they specialize in serving specific populations, and other
information needed to inform policies to strengthen sober housing in the state. The
commissioner must collaborate with the Minnesota Association of Sober Homes, sober
home operators, the recovery community, behavioral health providers that work directly
with sober housing, and recovery community organizations to provide input and data for
this survey.
 new text end

Sec. 27. new text begin REVISOR INSTRUCTION.
new text end

new text begin The revisor of statutes shall renumber Minnesota Statutes, section 245G.01, subdivision
20b, as Minnesota Statutes, section 245G.01, subdivision 20d, and make any necessary
changes to cross-references.
 new text end

Sec. 28. new text begin REPEALER.
new text end

new text begin (a) new text end new text begin Minnesota Statutes 2022, sections 245G.05, subdivision 2; 245G.06, subdivision 2;
and 256B.0759, subdivision 6, new text end new text begin are repealed.
 new text end

new text begin (b) new text end new text begin Minnesota Statutes 2022, section 246.18, subdivisions 2 and 2a, new text end new text begin are repealed.
 new text end

new text begin EFFECTIVE DATE. new text end

new text begin Paragraph (a) is effective January 1, 2024. Paragraph (b) is
effective July 1, 2023.
 new text end

ARTICLE 5

OPIOID EPIDEMIC RESPONSE AND OVERDOSE PREVENTION

Section 1.

new text begin [121A.224] OPIATE ANTAGONISTS.
 new text end

new text begin (a) A school district or charter school must maintain a supply of opiate antagonists, as
defined in section 604A.04, subdivision 1, at each school site to be administered in
compliance with section 151.37, subdivision 12.
 new text end

new text begin (b) Each school building must have at least two doses of a nasal opiate antagonist
available on site.
 new text end

new text begin (c) The commissioner of health shall identify resources, including at least one training
video, to help schools implement an opiate antagonist emergency response and make the
resources available for schools.
 new text end

new text begin (d) A school board may adopt a model plan for use, storage, and administration of opiate
antagonists.
 new text end

new text begin EFFECTIVE DATE. new text end

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

Sec. 2.

Minnesota Statutes 2022, section 241.021, subdivision 1, is amended to read:


Subdivision 1.

Correctional facilities; inspection; licensing.

(a) Except as provided
in paragraph (b), the commissioner of corrections shall inspect and license all correctional
facilities throughout the state, whether public or private, established and operated for the
detention and confinement of persons confined or incarcerated therein according to law
except to the extent that they are inspected or licensed by other state regulating agencies.
The commissioner shall promulgate pursuant to chapter 14, rules establishing minimum
standards for these facilities with respect to their management, operation, physical condition,
and the security, safety, health, treatment, and discipline of persons confined or incarcerated
therein. These minimum standards shall include but are not limited to specific guidance
pertaining to:

(1) screening, appraisal, assessment, and treatment for persons confined or incarcerated
in correctional facilities with mental illness or substance use disorders;

(2) a policy on the involuntary administration of medications;

(3) suicide prevention plans and training;

(4) verification of medications in a timely manner;

(5) well-being checks;

(6) discharge planning, including providing prescribed medications to persons confined
or incarcerated in correctional facilities upon release;

(7) a policy on referrals or transfers to medical or mental health care in a noncorrectional
institution;

(8) use of segregation and mental health checks;

(9) critical incident debriefings;

(10) clinical management of substance use disordersnew text begin and opioid overdose emergency
proceduresnew text end ;

(11) a policy regarding identification of persons with special needs confined or
incarcerated in correctional facilities;

(12) a policy regarding the use of telehealth;

(13) self-auditing of compliance with minimum standards;

(14) information sharing with medical personnel and when medical assessment must be
facilitated;

(15) a code of conduct policy for facility staff and annual training;

(16) a policy on death review of all circumstances surrounding the death of an individual
committed to the custody of the facility; and

(17) dissemination of a rights statement made available to persons confined or
incarcerated in licensed correctional facilities.

No individual, corporation, partnership, voluntary association, or other private
organization legally responsible for the operation of a correctional facility may operate the
facility unless it possesses a current license from the commissioner of corrections. Private
adult correctional facilities shall have the authority of section 624.714, subdivision 13, if
the Department of Corrections licenses the facility with the authority and the facility meets
requirements of section 243.52.

The commissioner shall review the correctional facilities described in this subdivision
at least once every two years, except as otherwise provided, to determine compliance with
the minimum standards established according to this subdivision or other Minnesota statute
related to minimum standards and conditions of confinement.

The commissioner shall grant a license to any facility found to conform to minimum
standards or to any facility which, in the commissioner's judgment, is making satisfactory
progress toward substantial conformity and the standards not being met do not impact the
interests and well-being of the persons confined or incarcerated in the facility. A limited
license under subdivision 1a may be issued for purposes of effectuating a facility closure.
The commissioner may grant licensure up to two years. Unless otherwise specified by
statute, all licenses issued under this chapter expire at 12:01 a.m. on the day after the
expiration date stated on the license.

The commissioner shall have access to the buildings, grounds, books, records, staff, and
to persons confined or incarcerated in these facilities. The commissioner may require the
officers in charge of these facilities to furnish all information and statistics the commissioner
deems necessary, at a time and place designated by the commissioner.

All facility administrators of correctional facilities are required to report all deaths of
individuals who died while committed to the custody of the facility, regardless of whether
the death occurred at the facility or after removal from the facility for medical care stemming
from an incident or need for medical care at the correctional facility, as soon as practicable,
but no later than 24 hours of receiving knowledge of the death, including any demographic
information as required by the commissioner.

All facility administrators of correctional facilities are required to report all other
emergency or unusual occurrences as defined by rule, including uses of force by facility
staff that result in substantial bodily harm or suicide attempts, to the commissioner of
corrections within ten days from the occurrence, including any demographic information
as required by the commissioner. The commissioner of corrections shall consult with the
Minnesota Sheriffs' Association and a representative from the Minnesota Association of
Community Corrections Act Counties who is responsible for the operations of an adult
correctional facility to define "use of force" that results in substantial bodily harm for
reporting purposes.

The commissioner may require that any or all such information be provided through the
Department of Corrections detention information system. The commissioner shall post each
inspection report publicly and on the department's website within 30 days of completing
the inspection. The education program offered in a correctional facility for the confinement
or incarceration of juvenile offenders must be approved by the commissioner of education
before the commissioner of corrections may grant a license to the facility.

(b) For juvenile facilities licensed by the commissioner of human services, the
commissioner may inspect and certify programs based on certification standards set forth
in Minnesota Rules. For the purpose of this paragraph, "certification" has the meaning given
it in section 245A.02.

(c) Any state agency which regulates, inspects, or licenses certain aspects of correctional
facilities shall, insofar as is possible, ensure that the minimum standards it requires are
substantially the same as those required by other state agencies which regulate, inspect, or
license the same aspects of similar types of correctional facilities, although at different
correctional facilities.

(d) Nothing in this section shall be construed to limit the commissioner of corrections'
authority to promulgate rules establishing standards of eligibility for counties to receive
funds under sections 401.01 to 401.16, or to require counties to comply with operating
standards the commissioner establishes as a condition precedent for counties to receive that
funding.

(e) The department's inspection unit must report directly to a division head outside of
the correctional institutions division.

Sec. 3.

Minnesota Statutes 2022, section 241.31, subdivision 5, is amended to read:


Subd. 5.

Minimum standards.

The commissioner of corrections shall establish minimum
standards for the size, area to be served, qualifications of staff, ratio of staff to client
population, and treatment programs for community corrections programs established pursuant
to this section. Plans and specifications for such programs, including proposed budgets must
first be submitted to the commissioner for approval prior to the establishment.new text begin Community
corrections programs must maintain a supply of opiate antagonists, as defined in section
604A.04, subdivision 1, at each correctional site to be administered in compliance with
section 151.37, subdivision 12. Each site must have at least two doses of an opiate antagonist
on site. Staff must be trained on how and when to administer opiate antagonists.
new text end

Sec. 4.

Minnesota Statutes 2022, section 241.415, is amended to read:


241.415 RELEASE PLANS; SUBSTANCE ABUSE.

The commissioner shall cooperate with community-based corrections agencies to
determine how best to address the substance abuse treatment needs of offenders who are
being released from prison. The commissioner shall ensure that an offender's prison release
plan adequately addresses the offender's needs for substance abuse assessment, treatment,
or other services following release, within the limits of available resources.new text begin The commissioner
must provide individuals with known or stated histories of opioid use disorder with
emergency opiate antagonist rescue kits upon release.
new text end

Sec. 5.

new text begin [245.891] OPIOID OVERDOSE SURGE ALERT SYSTEM.
 new text end

new text begin The commissioner must establish a voluntary, statewide opioid overdose surge text
message alert system, to prevent opioid overdose by cautioning people to refrain from
substance use or to use harm reduction strategies when there is an overdose surge in their
surrounding area. The alert system may include other forms of electronic alerts. The
commissioner may collaborate with local agencies, other state agencies, and harm reduction
organizations to promote and improve the surge alert system.
 new text end

Sec. 6.

new text begin [245A.242] EMERGENCY OVERDOSE TREATMENT.
 new text end

new text begin Subdivision 1. new text end

new text begin Applicability. new text end

new text begin This section applies to the following licenses issued under
this chapter:
 new text end

new text begin (1) substance use disorder treatment programs licensed according to chapter 245G;
 new text end

new text begin (2) children's residential facility substance use disorder treatment programs licensed
according to Minnesota Rules, parts 2960.0010 to 2960.0220 and 2960.0430 to 2960.0490;
 new text end

new text begin (3) detoxification programs licensed according to Minnesota Rules, parts 9530.6510 to
9530.6590;
 new text end

new text begin (4) withdrawal management programs licensed according to chapter 245F; and
 new text end

new text begin (5) intensive residential treatment services or residential crisis stabilization licensed
according to chapter 245I and section 245I.23.
 new text end

new text begin Subd. 2. new text end

new text begin Emergency overdose treatment. new text end

new text begin A license holder must maintain a supply of
opiate antagonists as defined in section 604A.04, subdivision 1, available for emergency
treatment of opioid overdose and must have a written standing order protocol by a physician
who is licensed under chapter 147, advanced practice registered nurse who is licensed under
chapter 148, or physician assistant who is licensed under chapter 147A, that permits the
license holder to maintain a supply of opiate antagonists on site. A license holder must
require staff to undergo training in the specific mode of administration used at the program,
which may include intranasal administration, intramuscular injection, or both.
 new text end

Sec. 7.

Minnesota Statutes 2022, section 245G.08, subdivision 3, is amended to read:


Subd. 3.

deleted text begin Standing order protocoldeleted text end new text begin Emergency overdose treatmentnew text end .

A license holder
deleted text begin that maintains a supply of naloxone available for emergency treatment of opioid overdose
must have a written standing order protocol by a physician who is licensed under chapter
deleted text end deleted text begin 147deleted text end deleted text begin , advanced practice registered nurse who is licensed under chapter deleted text end deleted text begin 148deleted text end deleted text begin , or physician
assistant who is licensed under chapter deleted text end deleted text begin 147Adeleted text end deleted text begin , that permits the license holder to maintain a
supply of naloxone on site. A license holder must require staff to undergo training in the
specific mode of administration used at the program, which may include intranasal
administration, intramuscular injection, or both.deleted text end new text begin must follow the emergency overdose
treatment requirements in section 245A.242.
new text end

Sec. 8.

Minnesota Statutes 2022, section 256.042, subdivision 1, is amended to read:


Subdivision 1.

Establishment of the advisory council.

(a) The Opiate Epidemic
Response Advisory Council is established to develop and implement a comprehensive and
effective statewide effort to address the opioid addiction and overdose epidemic in Minnesota.
The council shall focus on:

(1) prevention and education, including public education and awareness for adults and
youth, prescriber education, the development and sustainability of opioid overdose prevention
and education programs, the role of adult protective services in prevention and response,
and providing financial support to local law enforcement agencies for opiate antagonist
programs;

(2) training on the treatment of opioid addiction, including the use of all Food and Drug
Administration approved opioid addiction medications, detoxification, relapse prevention,
patient assessment, individual treatment planning, counseling, recovery supports, diversion
control, and other best practices;

(3) the expansion and enhancement of a continuum of care for opioid-related substance
use disorders, including primary prevention, early intervention, treatment, recovery, and
aftercare services; and

(4) the development of measures to assess and protect the ability of cancer patients and
survivors, persons battling life-threatening illnesses, persons suffering from severe chronic
pain, and persons at the end stages of life, who legitimately need prescription pain
medications, to maintain their quality of life by accessing these pain medications without
facing unnecessary barriers. The measures must also address the needs of individuals
described in this clause who are elderly or who reside in underserved or rural areas of the
state.

(b) The council shall:

(1) review local, state, and federal initiatives and activities related to education,
prevention, treatment, and services for individuals and families experiencing and affected
by opioid use disorder;

(2) establish priorities to address the state's opioid epidemic, for the purpose of
recommending initiatives to fund;

(3) recommend to the commissioner of human services specific projects and initiatives
to be funded;

(4) ensure that available funding is allocated to align with other state and federal funding,
to achieve the greatest impact and ensure a coordinated state effort;

(5) consult with the commissioners of human services, health, and management and
budget to develop measurable outcomes to determine the effectiveness of funds allocated;

(6) develop recommendations for an administrative and organizational framework for
the allocation, on a sustainable and ongoing basis, of any money deposited into the separate
account under section 16A.151, subdivision 2, paragraph (f), in order to address the opioid
abuse and overdose epidemic in Minnesota and the areas of focus specified in paragraph
(a);

(7) review reports, data, and performance measures submitted by municipalities under
subdivision 5; deleted text begin and
deleted text end

(8) consult with relevant stakeholders, including lead agencies and municipalities, to
review and provide recommendations for necessary revisions to the reporting requirements
under subdivision 5 to ensure that the required reporting accurately measures progress in
addressing the harms of the opioid epidemicdeleted text begin .deleted text end new text begin ; and
new text end

new text begin (9) meet with each of the 11 federally recognized Minnesota Tribal Nations individually
on an annual basis in order to collaborate and communicate on shared issues and priorities.
 new text end

(c) The council, in consultation with the commissioner of management and budget, and
within available appropriations, shall select from projects awarded grants under section
256.043, subdivisions 3 and 3a, and municipality projects funded by direct payments received
as part of a statewide opioid settlement agreement, that include promising practices or
theory-based activities for which the commissioner of management and budget shall conduct
evaluations using experimental or quasi-experimental design. Grant proposals and
municipality projects that include promising practices or theory-based activities and are
selected for an evaluation shall be administered to support the experimental or
quasi-experimental evaluation. Grantees and municipalities shall collect and report
information that is needed to complete the evaluation. The commissioner of management
and budget, under section 15.08, may obtain additional relevant data to support the
experimental or quasi-experimental evaluation studies.

(d) The council, in consultation with the commissioners of human services, health, public
safety, and management and budget, shall establish goals related to addressing the opioid
epidemic and determine a baseline against which progress shall be monitored and set
measurable outcomes, including benchmarks. The goals established must include goals for
prevention and public health, access to treatment, and multigenerational impacts. The council
shall use existing measures and data collection systems to determine baseline data against
which progress shall be measured. The council shall include the proposed goals, the
measurable outcomes, and proposed benchmarks to meet these goals in its initial report to
the legislature under subdivision 5, paragraph (a), due January 31, 2021.

Sec. 9.

Minnesota Statutes 2022, section 256.042, subdivision 2, is amended to read:


Subd. 2.

Membership.

(a) The council shall consist of the following deleted text begin 19deleted text end new text begin 20new text end voting
members, appointed by the commissioner of human services except as otherwise specified,
and three nonvoting members:

(1) two members of the house of representatives, appointed in the following sequence:
the first from the majority party appointed by the speaker of the house and the second from
the minority party appointed by the minority leader. Of these two members, one member
must represent a district outside of the seven-county metropolitan area, and one member
must represent a district that includes the seven-county metropolitan area. The appointment
by the minority leader must ensure that this requirement for geographic diversity in
appointments is met;

(2) two members of the senate, appointed in the following sequence: the first from the
majority party appointed by the senate majority leader and the second from the minority
party appointed by the senate minority leader. Of these two members, one member must
represent a district outside of the seven-county metropolitan area and one member must
represent a district that includes the seven-county metropolitan area. The appointment by
the minority leader must ensure that this requirement for geographic diversity in appointments
is met;

(3) one member appointed by the Board of Pharmacy;

(4) one member who is a physician appointed by the Minnesota Medical Association;

(5) one member representing opioid treatment programs, sober living programs, or
substance use disorder programs licensed under chapter 245G;

(6) one member appointed by the Minnesota Society of Addiction Medicine who is an
addiction psychiatrist;

(7) one member representing professionals providing alternative pain management
therapies, including, but not limited to, acupuncture, chiropractic, or massage therapy;

(8) one member representing nonprofit organizations conducting initiatives to address
the opioid epidemic, with the commissioner's initial appointment being a member
representing the Steve Rummler Hope Network, and subsequent appointments representing
this or other organizations;

(9) one member appointed by the Minnesota Ambulance Association who is serving
with an ambulance service as an emergency medical technician, advanced emergency
medical technician, or paramedic;

(10) one member representing the Minnesota courts who is a judge or law enforcement
officer;

(11) one public member who is a Minnesota resident and who is in opioid addiction
recovery;

(12) two members representing Indian tribes, one representing the Ojibwe tribes and
one representing the Dakota tribes;

new text begin (13) one member representing an urban American Indian community;
 new text end

deleted text begin (13)deleted text end new text begin (14)new text end one public member who is a Minnesota resident and who is suffering from
chronic pain, intractable pain, or a rare disease or condition;

deleted text begin (14)deleted text end new text begin (15)new text end one mental health advocate representing persons with mental illness;

deleted text begin (15)deleted text end new text begin (16)new text end one member appointed by the Minnesota Hospital Association;

deleted text begin (16)deleted text end new text begin (17)new text end one member representing a local health department; and

deleted text begin (17)deleted text end new text begin (18)new text end the commissioners of human services, health, and corrections, or their designees,
who shall be ex officio nonvoting members of the council.

(b) The commissioner of human services shall coordinate the commissioner's
appointments to provide geographic, racial, and gender diversity, and shall ensure that at
least deleted text begin one-halfdeleted text end new text begin one-thirdnew text end of council members appointed by the commissioner reside outside
of the seven-county metropolitan area. Of the members appointed by the commissioner, to
the extent practicable, at least one member must represent a community of color
disproportionately affected by the opioid epidemic.

(c) The council is governed by section 15.059, except that members of the council shall
serve three-year terms and shall receive no compensation other than reimbursement for
expenses. Notwithstanding section 15.059, subdivision 6, the council shall not expire.

(d) The chair shall convene the council at least quarterly, and may convene other meetings
as necessary. The chair shall convene meetings at different locations in the state to provide
geographic access, and shall ensure that at least one-half of the meetings are held at locations
outside of the seven-county metropolitan area.

(e) The commissioner of human services shall provide staff and administrative services
for the advisory council.

(f) The council is subject to chapter 13D.

Sec. 10.

Minnesota Statutes 2022, section 256.043, subdivision 3, is amended to read:


Subd. 3.

Appropriations from registration and license fee account.

(a) The
appropriations in paragraphs (b) to deleted text begin (h)deleted text end new text begin (n)new text end shall be made from the registration and license
fee account on a fiscal year basis in the order specified.

(b) The appropriations specified in Laws 2019, chapter 63, article 3, section 1, paragraphs
(b), (f), (g), and (h), as amended by Laws 2020, chapter 115, article 3, section 35, shall be
made accordingly.

new text begin (c) $100,000 is appropriated to the commissioner of human services for grants for opiate
antagonist distribution. Grantees may utilize funds for opioid overdose prevention,
community asset mapping, education, and opiate antagonist distribution.
 new text end

new text begin (d) $2,000,000 is appropriated to the commissioner of human services for grants to Tribal
nations and five urban Indian communities for traditional healing practices for American
Indians and to increase the capacity of culturally specific providers in the behavioral health
workforce.
 new text end

new text begin (e) $400,000 is appropriated to the commissioner of human services for competitive
grants for opioid-focused Project ECHO programs.
 new text end

new text begin (f) $277,000 in fiscal year 2024 and $321,000 each year thereafter is appropriated to the
commissioner of human services to administer the funding distribution and reporting
requirements in paragraph (o).
 new text end

new text begin (g) $3,000,000 in fiscal year 2025 and $3,000,000 each year thereafter is appropriated
to the commissioner of human services for safe recovery sites start-up and capacity building
grants under section 254B.18.
 new text end

new text begin (h) $395,000 in fiscal year 2024 and $415,000 each year thereafter is appropriated to
the commissioner of human services for the opioid overdose surge alert system under section
245.891.
 new text end

deleted text begin (c)deleted text end new text begin (i)new text end $300,000 is appropriated to the commissioner of management and budget for
evaluation activities under section 256.042, subdivision 1, paragraph (c).

deleted text begin (d)deleted text end new text begin (j)new text end deleted text begin $249,000 deleted text end new text begin $261,000 new text end is appropriated to the commissioner of human services for
the provision of administrative services to the Opiate Epidemic Response Advisory Council
and for the administration of the grants awarded under paragraph deleted text begin (h)deleted text end new text begin (n)new text end .

deleted text begin (e)deleted text end new text begin (k)new text end $126,000 is appropriated to the Board of Pharmacy for the collection of the
registration fees under section 151.066.

deleted text begin (f)deleted text end new text begin (l)new text end $672,000 is appropriated to the commissioner of public safety for the Bureau of
Criminal Apprehension. Of this amount, $384,000 is for drug scientists and lab supplies
and $288,000 is for special agent positions focused on drug interdiction and drug trafficking.

deleted text begin (g)deleted text end new text begin (m)new text end After the appropriations in paragraphs (b) to deleted text begin (f)deleted text end new text begin (l)new text end are made, 50 percent of the
remaining amount is appropriated to the commissioner of human services for distribution
to county social service agencies and Tribal social service agency initiative projects
authorized under section 256.01, subdivision 14b, to provide child protection services to
children and families who are affected by addiction. The commissioner shall distribute this
money proportionally to county social service agencies and Tribal social service agency
initiative projects based on out-of-home placement episodes where parental drug abuse is
the primary reason for the out-of-home placement using data from the previous calendar
year. County social service agencies and Tribal social service agency initiative projects
receiving funds from the opiate epidemic response fund must annually report to the
commissioner on how the funds were used to provide child protection services, including
measurable outcomes, as determined by the commissioner. County social service agencies
and Tribal social service agency initiative projects must not use funds received under this
paragraph to supplant current state or local funding received for child protection services
for children and families who are affected by addiction.

deleted text begin (h)deleted text end new text begin (n)new text end After the appropriations in paragraphs (b) to deleted text begin (g)deleted text end new text begin (m)new text end are made, the remaining
amount in the account is appropriated to the commissioner of human services to award
grants as specified by the Opiate Epidemic Response Advisory Council in accordance with
section 256.042, unless otherwise appropriated by the legislature.

deleted text begin (i)deleted text end new text begin (o)new text end Beginning in fiscal year 2022 and each year thereafter, funds for county social
service agencies and Tribal social service agency initiative projects under paragraph deleted text begin (g)deleted text end new text begin
(m)new text end and grant funds specified by the Opiate Epidemic Response Advisory Council under
paragraph deleted text begin (h)deleted text end new text begin (n)new text end may be distributed on a calendar year basis.

new text begin (p) Notwithstanding section 16A.28, subdivision 3, funds appropriated in paragraphs
(c), (d), (e), (g), (m), and (n) are available for three years after the funds are appropriated.
 new text end

new text begin EFFECTIVE DATE. new text end

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

Sec. 11.

Minnesota Statutes 2022, section 256.043, subdivision 3a, is amended to read:


Subd. 3a.

Appropriations from settlement account.

(a) The appropriations in paragraphs
(b) to (e) shall be made from the settlement account on a fiscal year basis in the order
specified.

(b) If the balance in the registration and license fee account is not sufficient to fully fund
the appropriations specified in subdivision 3, paragraphs (b) to deleted text begin (f)deleted text end new text begin (l)new text end , an amount necessary
to meet any insufficiency shall be transferred from the settlement account to the registration
and license fee account to fully fund the required appropriations.

(c) $209,000 in fiscal year 2023 and $239,000 in fiscal year 2024 and subsequent fiscal
years are appropriated to the commissioner of human services for the administration of
grants awarded under paragraph (e). $276,000 in fiscal year 2023 and $151,000 in fiscal
year 2024 and subsequent fiscal years are appropriated to the commissioner of human
services to collect, collate, and report data submitted and to monitor compliance with
reporting and settlement expenditure requirements by grantees awarded grants under this
section and municipalities receiving direct payments from a statewide opioid settlement
agreement as defined in section 256.042, subdivision 6.

(d) After any appropriations necessary under paragraphs (b) and (c) are made, an amount
equal to the calendar year allocation to Tribal social service agency initiative projects under
subdivision 3, paragraph deleted text begin (g)deleted text end new text begin (m)new text end , is appropriated from the settlement account to the
commissioner of human services for distribution to Tribal social service agency initiative
projects to provide child protection services to children and families who are affected by
addiction. The requirements related to proportional distribution, annual reporting, and
maintenance of effort specified in subdivision 3, paragraph deleted text begin (g)deleted text end new text begin (m)new text end , also apply to the
appropriations made under this paragraph.

(e) After making the appropriations in paragraphs (b), (c), and (d), the remaining amount
in the account is appropriated to the commissioner of human services to award grants as
specified by the Opiate Epidemic Response Advisory Council in accordance with section
256.042.

(f) Funds for Tribal social service agency initiative projects under paragraph (d) and
grant funds specified by the Opiate Epidemic Response Advisory Council under paragraph
(e) may be distributed on a calendar year basis.

new text begin (g) Notwithstanding section 16A.28, subdivision 3, funds appropriated in paragraphs
(d) and (e) are available for three years after the funds are appropriated.
 new text end

new text begin EFFECTIVE DATE. new text end

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

Sec. 12.

new text begin [256I.052] OPIATE ANTAGONISTS.
 new text end

new text begin (a) Site-based or group housing support settings must maintain a supply of opiate
antagonists as defined in section 604A.04, subdivision 1, at each housing site to be
administered in compliance with section 151.37, subdivision 12.
 new text end

new text begin (b) Each site must have at least two doses of an opiate antagonist on site.
 new text end

new text begin (c) Staff on site must have training on how and when to administer opiate antagonists.
 new text end

Sec. 13.

Laws 2019, chapter 63, article 3, section 1, as amended by Laws 2020, chapter
115, article 3, section 35, and Laws 2022, chapter 53, section 12, is amended to read:


Section 1. APPROPRIATIONS.

(a) Board of Pharmacy; administration. $244,000 in fiscal year 2020 is appropriated
from the general fund to the Board of Pharmacy for onetime information technology and
operating costs for administration of licensing activities under Minnesota Statutes, section
151.066. This is a onetime appropriation.

(b) Commissioner of human services; administration. $309,000 in fiscal year 2020
is appropriated from the general fund and $60,000 in fiscal year 2021 is appropriated from
the opiate epidemic response fund to the commissioner of human services for the provision
of administrative services to the Opiate Epidemic Response Advisory Council and for the
administration of the grants awarded under paragraphs (f), (g), and (h). The opiate epidemic
response fund base for this appropriation is $60,000 in fiscal year 2022, $60,000 in fiscal
year 2023, $60,000 in fiscal year 2024, and $0 in fiscal year 2025 .

(c) Board of Pharmacy; administration. $126,000 in fiscal year 2020 is appropriated
from the general fund to the Board of Pharmacy for the collection of the registration fees
under section 151.066.

(d) Commissioner of public safety; enforcement activities. $672,000 in fiscal year
2020 is appropriated from the general fund to the commissioner of public safety for the
Bureau of Criminal Apprehension. Of this amount, $384,000 is for drug scientists and lab
supplies and $288,000 is for special agent positions focused on drug interdiction and drug
trafficking.

(e) Commissioner of management and budget; evaluation activities. $300,000 in
fiscal year 2020 is appropriated from the general fund and $300,000 in fiscal year 2021 is
appropriated from the opiate epidemic response fund to the commissioner of management
and budget for evaluation activities under Minnesota Statutes, section 256.042, subdivision
1, paragraph (c).

(f) Commissioner of human services; grants for Project ECHO. $400,000 in fiscal
year 2020 is appropriated from the general fund and $400,000 in fiscal year 2021 is
appropriated from the opiate epidemic response fund to the commissioner of human services
for grants of $200,000 to CHI St. Gabriel's Health Family Medical Center for the
opioid-focused Project ECHO program and $200,000 to Hennepin Health Care for the
opioid-focused Project ECHO program. The opiate epidemic response fund base for this
appropriation is $400,000 in fiscal year 2022, $400,000 in fiscal year 2023, deleted text begin $400,000 in
fiscal year 2024,deleted text end and $0 in fiscal year deleted text begin 2025deleted text end new text begin 2024new text end .

(g) Commissioner of human services; opioid overdose prevention grant. $100,000
in fiscal year 2020 is appropriated from the general fund and $100,000 in fiscal year 2021
is appropriated from the opiate epidemic response fund to the commissioner of human
services for a grant to a nonprofit organization that has provided overdose prevention
programs to the public in at least 60 counties within the state, for at least three years, has
received federal funding before January 1, 2019, and is dedicated to addressing the opioid
epidemic. The grant must be used for opioid overdose prevention, community asset mapping,
education, and overdose antagonist distribution. The opiate epidemic response fund base
for this appropriation is $100,000 in fiscal year 2022, $100,000 in fiscal year 2023, deleted text begin $100,000deleted text end
deleted text begin in fiscal year 2024,deleted text end and $0 in fiscal year deleted text begin 2025deleted text end new text begin 2024new text end .

(h) Commissioner of human services; traditional healing. $2,000,000 in fiscal year
2020 is appropriated from the general fund and $2,000,000 in fiscal year 2021 is appropriated
from the opiate epidemic response fund to the commissioner of human services to award
grants to Tribal nations and five urban Indian communities for traditional healing practices
to American Indians and to increase the capacity of culturally specific providers in the
behavioral health workforce. The opiate epidemic response fund base for this appropriation
is $2,000,000 in fiscal year 2022, $2,000,000 in fiscal year 2023deleted text begin , $2,000,000 in fiscal year
2024deleted text end , and $0 in fiscal year deleted text begin 2025deleted text end new text begin 2024new text end .

(i) Board of Dentistry; continuing education. $11,000 in fiscal year 2020 is
appropriated from the state government special revenue fund to the Board of Dentistry to
implement the continuing education requirements under Minnesota Statutes, section 214.12,
subdivision 6.

(j) Board of Medical Practice; continuing education. $17,000 in fiscal year 2020 is
appropriated from the state government special revenue fund to the Board of Medical Practice
to implement the continuing education requirements under Minnesota Statutes, section
214.12, subdivision 6.

(k) Board of Nursing; continuing education. $17,000 in fiscal year 2020 is appropriated
from the state government special revenue fund to the Board of Nursing to implement the
continuing education requirements under Minnesota Statutes, section 214.12, subdivision
6.

(l) Board of Optometry; continuing education. $5,000 in fiscal year 2020 is
appropriated from the state government special revenue fund to the Board of Optometry to
implement the continuing education requirements under Minnesota Statutes, section 214.12,
subdivision 6.

(m) Board of Podiatric Medicine; continuing education. $5,000 in fiscal year 2020
is appropriated from the state government special revenue fund to the Board of Podiatric
Medicine to implement the continuing education requirements under Minnesota Statutes,
section 214.12, subdivision 6.

(n) Commissioner of health; nonnarcotic pain management and wellness. $1,250,000
is appropriated in fiscal year 2020 from the general fund to the commissioner of health, to
provide funding for:

(1) statewide mapping and assessment of community-based nonnarcotic pain management
and wellness resources; and

(2) up to five demonstration projects in different geographic areas of the state to provide
community-based nonnarcotic pain management and wellness resources to patients and
consumers.

The demonstration projects must include an evaluation component and scalability analysis.
The commissioner shall award the grant for the statewide mapping and assessment, and the
demonstration project grants, through a competitive request for proposal process. Grants
for statewide mapping and assessment and demonstration projects may be awarded
simultaneously. In awarding demonstration project grants, the commissioner shall give
preference to proposals that incorporate innovative community partnerships, are informed
and led by people in the community where the project is taking place, and are culturally
relevant and delivered by culturally competent providers. This is a onetime appropriation.

(o) Commissioner of health; administration. $38,000 in fiscal year 2020 is appropriated
from the general fund to the commissioner of health for the administration of the grants
awarded in paragraph (n).

new text begin EFFECTIVE DATE. new text end

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

Sec. 14.

new text begin PUBLIC AWARENESS CAMPAIGN.
 new text end

new text begin (a) The commissioner of human services must establish a multitiered public awareness
and educational campaign on substance use disorders. The campaign must include strategies
to prevent substance use disorder, reduce stigma, and ensure people know how to access
treatment, recovery, and harm reduction services.
 new text end

new text begin (b) The commissioner must consult with communities disproportionately impacted by
substance use disorder to ensure the campaign focuses on lived experience and equity. The
commissioner may also consult and establish relationships with media and communication
experts, behavioral health professionals, state and local agencies, and community
organizations to design and implement the campaign.
 new text end

new text begin (c) The campaign must include awareness-raising and educational information using
multichannel marketing strategies, social media, virtual events, press releases, reports, and
targeted outreach. The commissioner must evaluate the effectiveness of the campaign and
modify outreach and strategies as needed.
 new text end

Sec. 15. new text begin HARM REDUCTION AND CULTURALLY SPECIFIC GRANTS.
new text end

new text begin (a) The commissioner of human services must establish grants for Tribal Nations or
culturally specific organizations to enhance and expand capacity to address the impacts of
the opioid epidemic in their respective communities. Grants may be used to purchase and
distribute harm reduction supplies, develop organizational capacity, and expand culturally
specific services.
 new text end

new text begin (b) Harm reduction grant funds must be used to promote safer practices and reduce the
transmission of infectious disease. Allowable expenses include syringes, fentanyl testing
supplies, disinfectants, opiate antagonist rescue kits, safe injection kits, safe smoking kits,
sharps disposal, wound-care supplies, medication lock boxes, FDA-approved home testing
kits for viral hepatitis and HIV, written educational and resource materials, and other supplies
approved by the commissioner.
 new text end

new text begin (c) Culturally specific organizational capacity grant funds must be used to develop and
improve organizational infrastructure to increase access to culturally specific services and
community building. Allowable expenses include funds for organizations to hire staff or
consultants who specialize in fundraising, grant writing, business development, and program
integrity or other identified organizational needs as approved by the commissioner.
 new text end

new text begin (d) Culturally specific service grant funds must be used to expand culturally specific
outreach and services. Allowable expenses include hiring or consulting with cultural advisors,
resources to support cultural traditions, and education to empower individuals and providers,
develop a sense of community, and develop a connection to ancestral roots.
 new text end

new text begin (e) Opiate antagonist training grant funds may be used to provide information and training
on safe storage and use of opiate antagonists. Training may be conducted via multiple
modalities, including but not limited to in-person, virtual, written, and video recordings.
 new text end

ARTICLE 6

OPIOID PRESCRIBING IMPROVEMENT PROGRAM

Section 1.

Minnesota Statutes 2022, section 256B.0638, subdivision 1, is amended to read:


Subdivision 1.

Program established.

The commissioner of human services, in
conjunction with the commissioner of health, shall coordinate and implement an opioid
prescribing improvement program to reduce opioid dependency and substance use by
Minnesotans due to the prescribing of opioid analgesics by health care providersnew text begin and to
support patient-centered, compassionate care for Minnesotans who require treatment with
opioid analgesicsnew text end .

Sec. 2.

Minnesota Statutes 2022, section 256B.0638, subdivision 2, is amended to read:


Subd. 2.

Definitions.

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

(b) "Commissioner" means the commissioner of human services.

(c) "Commissioners" means the commissioner of human services and the commissioner
of health.

(d) "DEA" means the United States Drug Enforcement Administration.

(e) "Minnesota health care program" means a public health care program administered
by the commissioner of human services under this chapter and chapter 256L, and the
Minnesota restricted recipient program.

(f) "Opioid disenrollment standards" means parameters of opioid prescribing practices
that fall outside community standard thresholds for prescribing to such a degree that a
provider must be disenrolled as a deleted text begin medical assistancedeleted text end new text begin Minnesota health care programnew text end provider.

(g) "Opioid prescriber" means a licensed health care provider who prescribes opioids to
deleted text begin medical assistancedeleted text end new text begin Minnesota health care programnew text end and MinnesotaCare enrollees under the
fee-for-service system or under a managed care or county-based purchasing plan.

(h) "Opioid quality improvement standard thresholds" means parameters of opioid
prescribing practices that fall outside community standards for prescribing to such a degree
that quality improvement is required.

(i) "Program" means the statewide opioid prescribing improvement program established
under this section.

(j) "Provider group" means a clinic, hospital, or primary or specialty practice group that
employs, contracts with, or is affiliated with an opioid prescriber. Provider group does not
include a professional association supported by dues-paying members.

(k) "Sentinel measures" means measures of opioid use that identify variations in
prescribing practices during the prescribing intervals.

Sec. 3.

Minnesota Statutes 2022, section 256B.0638, subdivision 4, is amended to read:


Subd. 4.

Program components.

(a) The working group shall recommend to the
commissioners the components of the statewide opioid prescribing improvement program,
including, but not limited to, the following:

(1) developing criteria for opioid prescribing protocols, including:

(i) prescribing for the interval of up to four days immediately after an acute painful
event;

(ii) prescribing for the interval of up to 45 days after an acute painful event; and

(iii) prescribing for chronic pain, which for purposes of this program means pain lasting
longer than 45 days after an acute painful event;

(2) developing sentinel measures;

(3) developing educational resources for opioid prescribers about communicating with
patients about pain management and the use of opioids to treat pain;

(4) developing opioid quality improvement standard thresholds and opioid disenrollment
standards for opioid prescribers and provider groups. In developing opioid disenrollment
standards, the standards may be described in terms of the length of time in which prescribing
practices fall outside community standards and the nature and amount of opioid prescribing
that fall outside community standards; and

(5) addressing other program issues as determined by the commissioners.

(b) The opioid prescribing protocols shall not apply to opioids prescribed for patients
who are experiencing pain caused by a malignant condition or who are receiving hospice
carenew text begin or palliative carenew text end , or to opioids prescribed for substance use disorder treatment with
medications for opioid use disorder.

(c) All opioid prescribers who prescribe opioids to Minnesota health care program
enrollees must participate in the program in accordance with subdivision 5. Any other
prescriber who prescribes opioids may comply with the components of this program described
in paragraph (a) on a voluntary basis.

Sec. 4.

Minnesota Statutes 2022, section 256B.0638, subdivision 5, is amended to read:


Subd. 5.

Program implementation.

(a) The commissioner shall implement the deleted text begin programs
within the Minnesota health caredeleted text end new text begin quality improvementnew text end program to improve the health of
and quality of care provided to Minnesota health care program enrollees. new text begin The program must
be designed to support patient-centered care consistent with community standards of care.
The program must discourage unsafe tapering practices and patient abandonment by
providers. new text end The commissioner shall annually collect and report to provider groups the sentinel
measures of data showing individual opioid prescribers' opioid prescribing patterns compared
to their anonymized peers. Provider groups shall distribute data to their affiliated, contracted,
or employed opioid prescribers.

(b) The commissioner shall notify an opioid prescriber and all provider groups with
which the opioid prescriber is employed or affiliated when the opioid prescriber's prescribing
pattern exceeds the opioid quality improvement standard thresholds. An opioid prescriber
and any provider group that receives a notice under this paragraph shall submit to the
commissioner a quality improvement plan for review and approval by the commissioner
with the goal of bringing the opioid prescriber's prescribing practices into alignment with
community standards. A quality improvement plan must include:

(1) components of the program described in subdivision 4, paragraph (a);

(2) internal practice-based measures to review the prescribing practice of the opioid
prescriber and, where appropriate, any other opioid prescribers employed by or affiliated
with any of the provider groups with which the opioid prescriber is employed or affiliated;
and

(3) deleted text begin appropriate use of the prescription monitoring program under section 152.126deleted text end new text begin
demonstration of patient-centered care consistent with community standards of carenew text end .

(c) If, after a year from the commissioner's notice under paragraph (b), the opioid
prescriber's prescribing practicesnew text begin for treatment of acute or postacute painnew text end do not improve
so that they are consistent with community standards, the commissioner deleted text begin shalldeleted text end new text begin maynew text end take one
or more of the following steps:

(1) new text begin require the prescriber, the provider group, or both, to new text end monitor prescribing practices
more frequently than annually;

(2) monitor more aspects of the opioid prescriber's prescribing practices than the sentinel
measures; or

(3) require the opioid prescriber to participate in additional quality improvement effortsdeleted text begin ,
including but not limited to mandatory use of the prescription monitoring program established
under section 152.126deleted text end .

new text begin (d) Prescribers treating patients who are on chronic, high doses of opioids must meet
community standards of care, including performing regular assessments and addressing
unwarranted risks of opioid prescribing, but are not required to show measurable changes
in chronic pain prescribing thresholds within a certain period.
 new text end

new text begin (e) The commissioner shall dismiss a prescriber from participating in the opioid
prescribing quality improvement program on an annual basis when the prescriber
demonstrates that the prescriber's practices are patient-centered and reflect community
standards for safe and compassionate treatment of patients experiencing pain.
 new text end

deleted text begin (d)deleted text end new text begin (f)new text end The commissioner deleted text begin shall terminate from Minnesota health care programsdeleted text end new text begin may
investigate for possible disenrollmentnew text end all opioid prescribers and provider groups whose
prescribing practices fall within the applicable opioid disenrollment standards.

deleted text begin (e)deleted text end new text begin (g)new text end No physician, advanced practice registered nurse, or physician assistant, acting
in good faith based on the needs of the patient, may be disenrolled by the commissioner of
human services solely for prescribing a dosage that equates to an upward deviation from
morphine milligram equivalent dosage recommendations specified in state or federal opioid
prescribing guidelines or policies, or quality improvement thresholds established under this
section.

Sec. 5.

Minnesota Statutes 2022, section 256B.0638, is amended by adding a subdivision
to read:


new text begin Subd. 6a. new text end

new text begin Waiver for certain provider groups. new text end

new text begin (a) This section does not apply to
prescribers employed by, or under contract or affiliated with, a provider group for which
the commissioner has granted a waiver from the requirements of this section.
 new text end

new text begin (b) The commissioner, in consultation with opioid prescribers, shall develop waiver
criteria for provider groups, and shall make waivers available beginning July 1, 2023. In
granting waivers, the commissioner shall consider whether the medical director of the
provider group and a majority of the practitioners within a provider group have specialty
training, fellowship training, or experience in treating chronic pain. Waivers under this
subdivision must be granted on an annual basis.
 new text end

Sec. 6. new text begin DIRECTION TO COMMISSIONER OF HUMAN SERVICES; OPIOID
PRESCRIBING IMPROVEMENT PROGRAM SUNSET.
new text end

new text begin The commissioner of human services shall recommend criteria to provide for a sunset
of the opioid prescribing improvement program under Minnesota Statutes, section 256B.0638.
In developing sunset criteria, the commissioner shall consult with stakeholders including
but not limited to the Minnesota Medical Association, the Minnesota Society of Interventional
Pain Physicians, clinicians that practice pain management, addiction medicine, or mental
health, and either current or former Minnesota health care program enrollees who use or
have used opioid therapy to manage chronic pain. By January 15, 2024, the commissioner
shall submit recommended criteria to the chairs and ranking minority members of the
legislative committees with jurisdiction over health and human services finance and policy.
The opioid prescribing improvement program shall expire when the recommended criteria
developed according to this section are met, or on December 31, 2024, whichever is sooner.
 new text end

ARTICLE 7

LICENSING

Section 1.

Minnesota Statutes 2022, section 245A.04, subdivision 7, is amended to read:


Subd. 7.

Grant of license; license extension.

(a) If the commissioner determines that
the program complies with all applicable rules and laws, the commissioner shall issue a
license consistent with this section or, if applicable, a temporary change of ownership license
under section 245A.043. At minimum, the license shall state:

(1) the name of the license holder;

(2) the address of the program;

(3) the effective date and expiration date of the license;

(4) the type of license;

(5) the maximum number and ages of persons that may receive services from the program;
and

(6) any special conditions of licensure.

(b) The commissioner may issue a license for a period not to exceed two years if:

(1) the commissioner is unable to conduct the evaluation or observation required by
subdivision 4, paragraph (a), clause (4), because the program is not yet operational;

(2) certain records and documents are not available because persons are not yet receiving
services from the program; and

(3) the applicant complies with applicable laws and rules in all other respects.

(c) A decision by the commissioner to issue a license does not guarantee that any person
or persons will be placed or cared for in the licensed program.

(d) Except as provided in paragraphs deleted text begin (f) and (g)deleted text end new text begin (i) and (j)new text end , the commissioner shall not
issue deleted text begin or reissuedeleted text end a license if the applicant, license holder, or new text begin an affiliated new text end controlling individual
has:

(1) been disqualified and the disqualification was not set aside and no variance has been
granted;

(2) been denied a license under this chapter, within the past two years;

(3) had a license issued under this chapter revoked within the past five years;new text begin or
new text end

deleted text begin (4) an outstanding debt related to a license fee, licensing fine, or settlement agreement
for which payment is delinquent; or
 deleted text end

deleted text begin (5)deleted text end new text begin (4)new text end failed to submit the information required of an applicant under subdivision 1,
paragraph (f) or (g), after being requested by the commissioner.

When a license issued under this chapter is revoked deleted text begin under clause (1) or (3)deleted text end , the license
holder and new text begin each affiliated new text end controlling individual new text begin with a revoked license new text end may not hold any
license under chapter 245A for five years following the revocation, and other licenses held
by the applicantdeleted text begin ,deleted text end new text begin ornew text end license holderdeleted text begin ,deleted text end or new text begin licenses affiliated with each new text end controlling individual
shall also be revoked.

new text begin (e) Notwithstanding paragraph (d), the commissioner may elect not to revoke a license
affiliated with a license holder or controlling individual that had a license revoked within
the past five years if the commissioner determines that (1) the license holder or controlling
individual is operating the program in substantial compliance with applicable laws and rules,
and (2) the program's continued operation is in the best interests of the community being
served.
 new text end

new text begin (f) Notwithstanding paragraph (d), the commissioner may issue a new license in response
to an application that is affiliated with an applicant, license holder, or controlling individual
that had an application denied within the past two years or a license revoked within the past
five years if the commissioner determines that (1) the applicant or controlling individual
has operated one or more programs in substantial compliance with applicable laws and
rules, and (2) the program's operation would be in the best interests of the community to be
served.
 new text end

new text begin (g) In determining whether a program's operation would be in the best interests of the
community to be served, the commissioner shall consider factors such as the number of
persons served, the availability of alternative services available in the surrounding
community, the management structure of the program, whether the program provides
culturally specific services, and other relevant factors.
 new text end

deleted text begin (e)deleted text end new text begin (h)new text end The commissioner shall not issue or reissue a license under this chapter if an
individual living in the household where the services will be provided as specified under
section 245C.03, subdivision 1, has been disqualified and the disqualification has not been
set aside and no variance has been granted.

deleted text begin (f)deleted text end new text begin (i)new text end Pursuant to section 245A.07, subdivision 1, paragraph (b), when a license issued
under this chapter has been suspended or revoked and the suspension or revocation is under
appeal, the program may continue to operate pending a final order from the commissioner.
If the license under suspension or revocation will expire before a final order is issued, a
temporary provisional license may be issued provided any applicable license fee is paid
before the temporary provisional license is issued.

deleted text begin (g)deleted text end new text begin (j)new text end Notwithstanding paragraph deleted text begin (f)deleted text end new text begin (i)new text end , when a revocation is based on the
disqualification of a controlling individual or license holder, and the controlling individual
or license holder is ordered under section 245C.17 to be immediately removed from direct
contact with persons receiving services or is ordered to be under continuous, direct
supervision when providing direct contact services, the program may continue to operate
only if the program complies with the order and submits documentation demonstrating
compliance with the order. If the disqualified individual fails to submit a timely request for
reconsideration, or if the disqualification is not set aside and no variance is granted, the
order to immediately remove the individual from direct contact or to be under continuous,
direct supervision remains in effect pending the outcome of a hearing and final order from
the commissioner.

deleted text begin (h)deleted text end new text begin (k)new text end For purposes of reimbursement for meals only, under the Child and Adult Care
Food Program, Code of Federal Regulations, title 7, subtitle B, chapter II, subchapter A,
part 226, relocation within the same county by a licensed family day care provider, shall
be considered an extension of the license for a period of no more than 30 calendar days or
until the new license is issued, whichever occurs first, provided the county agency has
determined the family day care provider meets licensure requirements at the new location.

deleted text begin (i)deleted text end new text begin (l)new text end Unless otherwise specified by statute, all licenses issued under this chapter expire
at 12:01 a.m. on the day after the expiration date stated on the license. A license holder must
apply for and be granted a new license to operate the program or the program must not be
operated after the expiration date.

deleted text begin (j)deleted text end new text begin (m)new text end The commissioner shall not issue or reissue a license under this chapter if it has
been determined that a tribal licensing authority has established jurisdiction to license the
program or service.

Sec. 2.

Minnesota Statutes 2022, section 245A.07, is amended by adding a subdivision to
read:


new text begin Subd. 2b. new text end

new text begin Immediate suspension of residential programs. new text end

new text begin For suspensions issued to
a licensed residential program as defined in section 245A.02, subdivision 14, the effective
date of the order may be delayed for up to 30 calendar days to provide for the continuity of
care of service recipients. The license holder must cooperate with the commissioner to
ensure service recipients receive continued care during the period of the delay and to facilitate
the transition of service recipients to new providers. In these cases, the suspension order
takes effect when all service recipients have been transitioned to a new provider or 30 days
after the suspension order was issued, whichever comes first.
 new text end

Sec. 3.

Minnesota Statutes 2022, section 245A.07, is amended by adding a subdivision to
read:


new text begin Subd. 2c. new text end

new text begin Immediate suspension for programs with multiple licensed service sites. new text end

new text begin (a)
For license holders that operate more than one service site under a single license, the
suspension order must be specific to the service site or sites where the commissioner
determines an order is required under subdivision 2. The order must not apply to other
service sites operated by the same license holder unless the commissioner has included in
the order an articulable basis for applying the order to other service sites.
 new text end

new text begin (b) If the commissioner has issued more than one license to the license holder under this
chapter, the suspension imposed under this section must be specific to the license for the
program at which the commissioner determines an order is required under subdivision 2.
The order must not apply to other licenses held by the same license holder if those programs
are being operated in substantial compliance with applicable law and rules.
 new text end

Sec. 4.

Minnesota Statutes 2022, section 245A.10, subdivision 6, is amended to read:


Subd. 6.

License not issued until license or certification fee is paid.

The commissioner
shall not issue new text begin or reissue new text end a license or certification until the license or certification fee is paid.
The commissioner shall send a bill for the license or certification fee to the billing address
identified by the license holder. If the license holder does not submit the license or
certification fee payment by the due date, the commissioner shall send the license holder a
past due notice. If the license holder fails to pay the license or certification fee by the due
date on the past due notice, the commissioner shall send a final notice to the license holder
informing the license holder that the program license will expire on December 31 unless
the license fee is paid before December 31. If a license expires, the program is no longer
licensed and, unless exempt from licensure under section 245A.03, subdivision 2, must not
operate after the expiration date. After a license expires, if the former license holder wishes
to provide licensed services, the former license holder must submit a new license application
and application fee under subdivision 3.

Sec. 5.

Minnesota Statutes 2022, section 245A.10, is amended by adding a subdivision to
read:


new text begin Subd. 9. new text end

new text begin License not reissued until outstanding debt is paid. new text end

new text begin The commissioner shall
not reissue a license or certification until the license holder has paid all outstanding debts
related to a licensing fine or settlement agreement for which payment is delinquent. If the
payment is past due, the commissioner shall send a past due notice informing the license
holder that the program license will expire on December 31 unless the outstanding debt is
paid before December 31. If a license expires, the program is no longer licensed and must
not operate after the expiration date. After a license expires, if the former license holder
wishes to provide licensed services, the former license holder must submit a new license
application and application fee under subdivision 3.
 new text end

Sec. 6.

Minnesota Statutes 2022, section 245A.13, subdivision 1, is amended to read:


Subdivision 1.

Application.

new text begin (a) new text end In addition to any other remedy provided by law, the
commissioner may petition the district court in Ramsey County for an order directing the
controlling individuals of a residential or nonresidential program licensed or certified by
the commissioner to show cause why the commissioner should not be appointed receiver
to operate the program. The petition to the district court must contain proof by affidavitnew text begin that
one or more of the following circumstances existsnew text end : deleted text begin (1) that the commissioner has either
begun proceedings to suspend or revoke a license or certification, has suspended or revoked
a license or certification, or has decided to deny an application for licensure or certification
of the program; or (2) it appears to the commissioner that the health, safety, or rights of the
residents or persons receiving care from the program may be in jeopardy because of the
manner in which the program may close, the program's financial condition, or violations
committed by the program of federal or state laws or rules. If the license holder, applicant,
or controlling individual operates more than one program, the commissioner's petition must
specify and be limited to the program for which it seeks receivership. The affidavit submitted
by the commissioner must set forth alternatives to receivership that have been considered,
including rate adjustments. The order to show cause is returnable not less than five days
after service is completed and must provide for personal service of a copy to the program
administrator and to the persons designated as agents by the controlling individuals to accept
service on their behalf.
deleted text end

new text begin (1) the commissioner has commenced proceedings to suspend or revoke the program's
license or refused to renew the program's license;
 new text end

new text begin (2) there is a threat of imminent abandonment by the program or its controlling
individuals;
 new text end

new text begin (3) the program has shown a pattern of failure to meet ongoing financial obligations
such as failing to pay for food, pharmaceuticals, personnel costs, or required insurance;
 new text end

new text begin (4) the health, safety, or rights of the residents or persons receiving care from the program
appear to be in jeopardy due to the manner in which the program may close, the program's
financial condition, or violations of federal or state law or rules committed by the program;
or
 new text end

new text begin (5) the commissioner has notified the program or its controlling individuals that the
program's federal Medicare or Medicaid provider agreement will be terminated, revoked,
canceled, or not renewed.
 new text end

new text begin (b) If the license holder, applicant, or controlling individual operates more than one
program, the commissioner's petition must specify and be limited to the program for which
it seeks receivership.
 new text end

new text begin (c) The order to show cause shall be personally served on the program through its
authorized agent or, in the event the authorized agent cannot be located, on any controlling
individual for the program.
 new text end

Sec. 7.

Minnesota Statutes 2022, section 245A.13, subdivision 2, is amended to read:


Subd. 2.

Appointment of receiver.

new text begin (a) new text end If the court finds that involuntary receivership
is necessary as a means of protecting the health, safety, or rights of persons being served
by the program, the court shall appoint the commissioner as receiver to operate the program.
The commissioner as receiver may contract with another entity or group to act as the
managing agent during the receivership period. The managing agent will be responsible for
the day-to-day operations of the program subject at all times to the review and approval of
the commissioner.new text begin A managing agent shall not:
new text end

new text begin (1) be the license holder or controlling individual of the program;
 new text end

new text begin (2) have a financial interest in the program at the time of the receivership;
 new text end

new text begin (3) be otherwise affiliated with the program; or
 new text end

new text begin (4) have had a licensed program that has been ordered into receivership.
 new text end

new text begin (b) Notwithstanding state contracting requirements in chapter 16C, the commissioner
shall establish and maintain a list of qualified persons or entities with experience in delivering
services and with winding down programs under chapter 245A, 245D, or 245G, or other
service types licensed by the commissioner. The list shall be a resource for selecting a
managing agent, and the commissioner may update the list at any time.
 new text end

Sec. 8.

Minnesota Statutes 2022, section 245A.13, subdivision 3, is amended to read:


Subd. 3.

Powers and duties of receiver.

deleted text begin Within 36 months after the receivership order,
the receiver shall provide for the orderly transfer of the persons served by the program to
other programs or make other provisions to protect their health, safety, and rights. The
receiver or the managing agent shall correct or eliminate deficiencies in the program that
the commissioner determines endanger the health, safety, or welfare of the persons being
served by the program unless the correction or elimination of deficiencies at a residential
program involves major alteration in the structure of the physical plant. If the correction or
elimination of the deficiencies at a residential program requires major alterations in the
structure of the physical plant, the receiver shall take actions designed to result in the
immediate transfer of persons served by the residential program. During the period of the
receivership, the receiver and the managing agent shall operate the residential or
nonresidential program in a manner designed to preserve the health, safety, rights, adequate
care, and supervision of the persons served by the program. The receiver or the managing
agent may make contracts and incur lawful expenses. The receiver or the managing agent
shall collect incoming payments from all sources and apply them to the cost incurred in the
performance of the functions of the receivership including the fee set under subdivision 4.
No security interest in any real or personal property comprising the program or contained
within it, or in any fixture of the physical plant, shall be impaired or diminished in priority
by the receiver or the managing agent. deleted text end new text begin (a) A receiver appointed pursuant to this section
shall, within 18 months after the receivership order, determine whether to close the program
or to make other provisions with the intent to keep the program open. If the receiver
determines that program closure is appropriate, the commissioner shall provide for the
orderly transfer of individuals served by the program to other programs or make other
provisions to protect the health, safety, and rights of individuals served by the program.
 new text end

new text begin (b) During the receivership, the receiver or the managing agent shall correct or eliminate
deficiencies in the program that the commissioner determines endanger the health, safety,
or welfare of the persons being served by the program unless the correction or elimination
of deficiencies at a residential program involves major alteration in the structure of the
physical plant. If the correction or elimination of the deficiencies at a residential program
requires major alterations in the structure of the physical plant, the receiver shall take actions
designed to result in the immediate transfer of persons served by the residential program.
During the period of the receivership, the receiver and the managing agent shall operate the
residential or nonresidential program in a manner designed to preserve the health, safety,
rights, adequate care, and supervision of the persons served by the program.
 new text end

new text begin (c) The receiver or the managing agent may make contracts and incur lawful expenses.
 new text end

new text begin (d) The receiver or the managing agent shall use the building, fixtures, furnishings, and
any accompanying consumable goods in the provision of care and services to the clients
during the receivership period. The receiver shall take action as is reasonably necessary to
protect or conserve the tangible assets or property during receivership.
 new text end

new text begin (e) The receiver or the managing agent shall collect incoming payments from all sources
and apply them to the cost incurred in the performance of the functions of the receivership,
including the fee set under subdivision 4. No security interest in any real or personal property
comprising the program or contained within it, or in any fixture of the physical plant, shall
be impaired or diminished in priority by the receiver or the managing agent.
 new text end

new text begin (f) The receiver has authority to hire, direct, manage, and discharge any employees of
the program, including management level staff for the program.
 new text end

new text begin (g) The commissioner, as the receiver appointed by the court, may hire a managing agent
to work on the commissioner's behalf to operate the program during the receivership. The
managing agent is entitled to a reasonable fee. The receiver and managing agent shall be
liable only in an official capacity for injury to persons and property by reason of the
conditions of the program. The receiver and managing agent shall not be personally liable,
except for gross negligence or intentional acts. The commissioner shall assist the managing
agent in carrying out the managing agent's duties.
 new text end

Sec. 9.

Minnesota Statutes 2022, section 245A.13, subdivision 5, is amended to read:


Subd. 5.

Termination.

An involuntary receivership terminates deleted text begin 36deleted text end new text begin 18new text end months after the
date on which it was ordered or at any other time designated by the court or when any of
the following events occurs:

(1) the commissioner determines that the program's license or certification application
should be granted or should not be suspended or revoked;

(2) a new license or certification is granted to the program;

(3) the commissioner determines that all persons residing in a residential program have
been provided with alternative residential programs or that all persons receiving services
in a nonresidential program have been referred to other programs; or

(4) the court determines that the receivership is no longer necessary because the conditions
which gave rise to the receivership no longer exist.

Sec. 10.

Minnesota Statutes 2022, section 245A.13, subdivision 6, is amended to read:


Subd. 6.

Emergency procedure.

new text begin (a) new text end If it appears from the petition filed under subdivision
1, from an affidavit or affidavits filed with the petition, or from testimony of witnesses
under oath if the court determines it necessary, that there is probable cause to believe that
an emergency exists in a residential or nonresidential program, the court shall issue a
temporary order for appointment of a receiver within deleted text begin fivedeleted text end new text begin twonew text end days after receipt of the
petition. deleted text begin Notice of the petition must be served on the program administrator and on the
persons designated as agents by the controlling individuals to accept service on their behalf.
A hearing on the petition must be held within five days after notice is served unless the
administrator or authorized agent consents to a later date. After the hearing, the court may
continue, modify, or terminate the temporary order.
deleted text end

new text begin (b) Notice of the petition must be served on the authorized agent of the program that is
subject to the receivership petition or, if the authorized agent is not immediately available
for service, on at least one of the controlling individuals for the program. A hearing on the
petition must be held within five days after notice is served unless the authorized agent or
other controlling individual consents to a later date. After the hearing, the court may continue,
modify, or terminate the temporary order.
 new text end

Sec. 11.

Minnesota Statutes 2022, section 245A.13, subdivision 7, is amended to read:


Subd. 7.

Rate recommendation.

new text begin For any program receiving Medicaid funds and ordered
into receivership, new text end the commissioner of human services may review rates of a residential or
nonresidential program deleted text begin participating in the medical assistance program which is in
receivership anddeleted text end that has needs or deficiencies documented by the Department of Health
or the Department of Human Services. If the commissioner of human services determines
that a review of the rate established under sections 256B.5012 and 256B.5013 is needed,
the commissioner shall:

(1) review the order or determination that cites the deficiencies or needs; and

(2) determine the need for additional staff, additional annual hours by type of employee,
and additional consultants, services, supplies, equipment, repairs, or capital assets necessary
to satisfy the needs or deficiencies.

Sec. 12.

Minnesota Statutes 2022, section 245A.13, subdivision 9, is amended to read:


Subd. 9.

Receivership accounting.

The commissioner may deleted text begin usedeleted text end new text begin adjust Medicaid rates
and use Medicaid funds, including but not limited to waiver funds, andnew text end the medical assistance
account and funds for receivership cash flownew text begin , receivership administrative fees,new text end and accounting
purposesnew text begin , to the extent permitted by the state's approved Medicaid plannew text end .

ARTICLE 8

DIRECT CARE AND TREATMENT

Section 1.

Minnesota Statutes 2022, section 15.01, is amended to read:


15.01 DEPARTMENTS OF THE STATE.

The following agencies are designated as the departments of the state government: the
Department of Administrationdeleted text begin ;deleted text end new text begin ,new text end the Department of Agriculturedeleted text begin ;deleted text end new text begin ,new text end the Department of
Commercedeleted text begin ;deleted text end new text begin ,new text end the Department of Correctionsdeleted text begin ;deleted text end new text begin , the Department of Direct Care and Treatment,new text end
the Department of Educationdeleted text begin ;deleted text end new text begin ,new text end the Department of Employment and Economic Developmentdeleted text begin ;deleted text end new text begin ,new text end
the Department of Healthdeleted text begin ;deleted text end new text begin ,new text end the Department of Human Rightsdeleted text begin ;deleted text end new text begin , the Department of Human
Services,new text end the Department of Information Technology Servicesdeleted text begin ;deleted text end new text begin ,new text end the Department of Iron
Range Resources and Rehabilitationdeleted text begin ;deleted text end new text begin ,new text end the Department of Labor and Industrydeleted text begin ;deleted text end new text begin ,new text end the Department
of Management and Budgetdeleted text begin ;deleted text end new text begin ,new text end the Department of Military Affairsdeleted text begin ;deleted text end new text begin ,new text end the Department of Natural
Resourcesdeleted text begin ;deleted text end new text begin ,new text end the Department of Public Safetydeleted text begin ; the Department of Human Services;deleted text end new text begin ,new text end the
Department of Revenuedeleted text begin ;deleted text end new text begin ,new text end the Department of Transportationdeleted text begin ;deleted text end new text begin ,new text end the Department of Veterans
Affairsdeleted text begin ;deleted text end new text begin ,new text end and their successor departments.

new text begin EFFECTIVE DATE. new text end

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

Sec. 2.

Minnesota Statutes 2022, section 15.06, subdivision 1, is amended to read:


Subdivision 1.

Applicability.

This section applies to the following departments or
agencies: the Departments of Administration, Agriculture, Commerce, Corrections, new text begin Direct
Care and Treatment, new text end Education, Employment and Economic Development, Health, Human
Rights, new text begin Human Services, new text end Labor and Industry, Management and Budget, Natural Resources,
Public Safety, deleted text begin Human Services,deleted text end Revenue, Transportation, and Veterans Affairs; the Housing
Finance and Pollution Control Agencies; the Office of Commissioner of Iron Range
Resources and Rehabilitation; the Department of Information Technology Services; the
Bureau of Mediation Services; and their successor departments and agencies. The heads of
the foregoing departments or agencies are "commissioners."

new text begin EFFECTIVE DATE. new text end

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

Sec. 3.

Minnesota Statutes 2022, section 43A.08, subdivision 1a, is amended to read:


Subd. 1a.

Additional unclassified positions.

Appointing authorities for the following
agencies may designate additional unclassified positions according to this subdivision: the
Departments of Administrationdeleted text begin ;deleted text end new text begin ,new text end Agriculturedeleted text begin ;deleted text end new text begin ,new text end Commercedeleted text begin ;deleted text end new text begin ,new text end Correctionsdeleted text begin ;deleted text end new text begin , Direct Care and
Treatment,new text end Educationdeleted text begin ;deleted text end new text begin ,new text end Employment and Economic Developmentdeleted text begin ;deleted text end new text begin ,new text end Explore Minnesota
Tourismdeleted text begin ;deleted text end new text begin ,new text end Management and Budgetdeleted text begin ;deleted text end new text begin ,new text end Healthdeleted text begin ;deleted text end new text begin ,new text end Human Rightsdeleted text begin ;deleted text end new text begin , Human Services,new text end Labor and
Industrydeleted text begin ;deleted text end new text begin ,new text end Natural Resourcesdeleted text begin ;deleted text end new text begin ,new text end Public Safetydeleted text begin ;deleted text end new text begin ,new text end deleted text begin Human Services;deleted text end Revenuedeleted text begin ;deleted text end new text begin ,new text end Transportationdeleted text begin ;deleted text end new text begin ,new text end
and Veterans Affairs; the Housing Finance and Pollution Control Agencies; the State Lottery;
the State Board of Investment; the Office of Administrative Hearings; the Department of
Information Technology Services; the Offices of the Attorney General, Secretary of State,
and State Auditor; the Minnesota State Colleges and Universities; the Minnesota Office of
Higher Education; the Perpich Center for Arts Education; and the Minnesota Zoological
Board.

A position designated by an appointing authority according to this subdivision must
meet the following standards and criteria:

(1) the designation of the position would not be contrary to other law relating specifically
to that agency;

(2) the person occupying the position would report directly to the agency head or deputy
agency head and would be designated as part of the agency head's management team;

(3) the duties of the position would involve significant discretion and substantial
involvement in the development, interpretation, and implementation of agency policy;

(4) the duties of the position would not require primarily personnel, accounting, or other
technical expertise where continuity in the position would be important;

(5) there would be a need for the person occupying the position to be accountable to,
loyal to, and compatible with, the governor and the agency head, the employing statutory
board or commission, or the employing constitutional officer;

(6) the position would be at the level of division or bureau director or assistant to the
agency head; and

(7) the commissioner has approved the designation as being consistent with the standards
and criteria in this subdivision.

new text begin EFFECTIVE DATE. new text end

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

Sec. 4.

Minnesota Statutes 2022, section 245.037, is amended to read:


245.037 MONEY COLLECTED AS RENT; STATE PROPERTY.

new text begin (a) new text end Notwithstanding any law to the contrary, money collected as rent under section
16B.24, subdivision 5, for state property at any of the regional treatment centers or state
nursing home facilities administered by the commissioner of human services is dedicated
to the regional treatment center or state nursing home from which it is generated. Any
balance remaining at the end of the fiscal year shall not cancel and is available until expended.

new text begin (b) The commissioner may lease out any buildings or portions of buildings, units, or
lands acquired by the department that are not needed for the uses and purposes of the
department. Such authority to lease out buildings, units, and lands includes authority to
lease to employees of the department, notwithstanding section 16B.24, subdivision 5,
paragraph (c). The commissioner may set the prices and terms and conditions for leases
under this paragraph, and shall not make any such lease for a term of more than five years.
All money received from leases under this paragraph shall be credited to the fund from
which the property was acquired or through which the property is being maintained. Money
credited for leased property maintenance is appropriated to the commissioner for that purpose.
 new text end

new text begin (c) The commissioner may lease out any buildings or portions of buildings, units, or
lands acquired by the department to clients and employees of the department for the provision
of community-based services, notwithstanding section 16B.24, subdivision 5, paragraph
(c). The commissioner may set the prices and terms and conditions for leases under this
paragraph, and shall not make any such lease for a term of more than five years. All money
received from leases under this paragraph shall be credited to the fund from which the
property was acquired or through which the property is being maintained. Money credited
for leased property maintenance is appropriated to the commissioner for that purpose.
 new text end

Sec. 5.

Minnesota Statutes 2022, section 246.54, subdivision 1a, is amended to read:


Subd. 1a.

Anoka-Metro Regional Treatment Center.

(a) A county's payment of the
cost of care provided at Anoka-Metro Regional Treatment Center shall be according to the
following schedule:

(1) zero percent for the first 30 days;

(2) 20 percent for days 31 and over if the stay is determined to be clinically appropriate
for the client; and

(3) 100 percent for each day during the stay, including the day of admission, when the
facility determines that it is clinically appropriate for the client to be discharged.

(b) If payments received by the state under sections 246.50 to 246.53 exceed 80 percent
of the cost of care for days over 31 for clients who meet the criteria in paragraph (a), clause
(2), the county shall be responsible for paying the state only the remaining amount. The
county shall not be entitled to reimbursement from the client, the client's estate, or from the
client's relatives, except as provided in section 246.53.

new text begin (c) Between July 1, 2023, and June 30, 2025, the county is not responsible for the cost
of care under paragraph (a), clause (3), for a person who is committed as a person who has
a mental illness and is dangerous to the public under section 253B.18 and who is awaiting
transfer to another state-operated facility or program. This paragraph expires June 30, 2025.
 new text end

Sec. 6.

Minnesota Statutes 2022, section 246.54, subdivision 1b, is amended to read:


Subd. 1b.

Community behavioral health hospitals.

new text begin (a) new text end A county's payment of the cost
of care provided at state-operated community-based behavioral health hospitals for adults
and children shall be according to the following schedule:

(1) 100 percent for each day during the stay, including the day of admission, when the
facility determines that it is clinically appropriate for the client to be discharged; and

(2) the county shall not be entitled to reimbursement from the client, the client's estate,
or from the client's relatives, except as provided in section 246.53.

new text begin (b) Between July 1, 2023, and June 30, 2025, the county is not responsible for the cost
of care under paragraph (a), clause (1), for a person committed as a person who has a mental
illness and is dangerous to the public under section 253B.18 and who is awaiting transfer
to another state-operated facility or program. This paragraph expires June 30, 2025.
 new text end

new text begin (c) Notwithstanding any law to the contrary, the client is not responsible for payment
of the cost of care under this subdivision.
 new text end

Sec. 7.

new text begin [246C.01] TITLE.
 new text end

new text begin This chapter may be cited as the "Department of Direct Care & Treatment Act."
 new text end

Sec. 8.

new text begin [246C.02] DEPARTMENT OF DIRECT CARE AND TREATMENT;
ESTABLISHMENT.
 new text end

new text begin (a) The Department of Direct Care and Treatment is created. An executive board shall
head the Department of Direct Care and Treatment. The executive board shall develop and
maintain direct care and treatment in a manner consistent with applicable law, including
chapters 13, 245, 246, 246B, 252, 253, 253B, 253C, 253D, 254A, 254B, and 256. The
Department of Direct Care and Treatment shall provide direct care and treatment services
in coordination with counties and other vendors. Direct care and treatment services shall
include specialized inpatient programs at secure treatment facilities as defined in sections
253B.02, subdivision 18a, and 253D.02, subdivision 13; community preparation services;
regional treatment centers; enterprise services; consultative services; aftercare services;
community-based services and programs; transition services; nursing home services; and
other services consistent with the mission of the Department of Direct Care and Treatment.
 new text end

new text begin (b) "Community preparation services" means specialized inpatient or outpatient services
or programs operated outside of a secure environment but administered by a secure treatment
facility.
 new text end

new text begin EFFECTIVE DATE. new text end

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

Sec. 9.

new text begin [246C.03] TRANSITION OF AUTHORITY; DEVELOPMENT OF A BOARD.
 new text end

new text begin Subdivision 1. new text end

new text begin Authority until board is developed and powers defined. new text end

new text begin Upon the
effective date of this act, the commissioner of human services shall continue to exercise all
authorities and responsibilities under chapters 13, 245, 246, 246B, 252, 253, 253B, 253C,
253D, 254A, 254B, and 256, until legislation is effective that develops the Department of
Direct Care and Treatment executive board and defines the responsibilities and powers of
the Department of Direct Care and Treatment and its executive board.
 new text end

new text begin Subd. 2. new text end

new text begin Development of Department of Direct Care and Treatment Board. new text end

new text begin (a) The
commissioner of human services shall prepare legislation for introduction during the 2024
legislative session, with input from stakeholders the commissioner deems necessary,
proposing legislation for the creation and implementation of the Direct Care and Treatment
executive board and defining the responsibilities, powers, and function of the Department
of Direct Care and Treatment executive board.
 new text end

new text begin (b) The Department of Direct Care and Treatment executive board shall consist of no
more than five members, all appointed by the governor.
 new text end

new text begin (c) An executive board member's qualifications must be appropriate for overseeing a
complex behavioral health system, such as experience serving on a hospital or non-profit
board, serving as a public sector labor union representative, experience in delivery of
behavioral health services or care coordination, or working as a licensed health care provider,
in an allied health profession, or in health care administration.
 new text end

new text begin EFFECTIVE DATE. new text end

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

Sec. 10.

new text begin [246C.04] TRANSFER OF DUTIES.
 new text end

new text begin (a) Section 15.039 applies to the transfer of duties required by this chapter.
 new text end

new text begin (b) The commissioner of administration, with the governor's approval, shall issue
reorganization orders under section 16B.37 as necessary to carry out the transfer of duties
required by section 246C.03. The provision of section 16B.37, subdivision 1, stating that
transfers under section 16B.37 may only be to an agency that has existed for at least one
year does not apply to transfers to an agency created by this chapter.
 new text end

new text begin (c) The initial salary for the health systems chief executive officer of the Department of
Direct Care and Treatment is the same as the salary for the health systems chief executive
officer of direct care and treatment at the Department of Human Services immediately before
July 1, 2024.
 new text end

Sec. 11.

new text begin [246C.05] EMPLOYEE PROTECTIONS FOR ESTABLISHING THE NEW
DEPARTMENT OF DIRECT CARE AND TREATMENT.
 new text end

new text begin (a) Personnel whose duties relate to the functions assigned to the Department of Direct
Care and Treatment executive board in section 246C.03 are transferred to the Department
of Direct Care and Treatment effective 30 days after approval by the commissioner of direct
care and treatment.
 new text end

new text begin (b) Before the Department of Direct Care and Treatment executive board is appointed,
personnel whose duties relate to the functions in this section may be transferred beginning
July 1, 2024, with 30 days' notice from the commissioner of management and budget.
 new text end

new text begin (c) The following protections shall apply to employees who are transferred from the
Department of Human Services to the Department of Direct Care and Treatment:
 new text end

new text begin (1) No transferred employee shall have their employment status and job classification
altered as a result of the transfer.
 new text end

new text begin (2) Transferred employees who were represented by an exclusive representative prior
to the transfer shall continue to be represented by the same exclusive representative after
the transfer.
 new text end

new text begin (3) The applicable collective bargaining agreements with exclusive representatives shall
continue in full force and effect for such transferred employees after the transfer.
 new text end

new text begin (4) The state shall have the obligation to meet and negotiate with the exclusive
representatives of the transferred employees about any proposed changes affecting or relating
to the transferred employees' terms and conditions of employment to the extent such changes
are not addressed in the applicable collective bargaining agreement.
 new text end

new text begin (5) When an employee in a temporary unclassified position is transferred to the
Department of Direct Care and Treatment, the total length of time that the employee has
served in the appointment shall include all time served in the appointment at the transferring
agency and the time served in the appointment at the Department of Direct Care and
Treatment. An employee in a temporary unclassified position who was hired by a transferring
agency through an open competitive selection process in accordance with a policy enacted
by Minnesota Management and Budget shall be considered to have been hired through such
process after the transfer.
 new text end

new text begin (6) In the event that the state transfers ownership or control of any of the facilities,
services, or operations of the Department of Direct Care and Treatment to another entity,
whether private or public, by subcontracting, sale, assignment, lease, or other transfer, the
state shall require as a written condition of such transfer of ownership or control the following
provisions:
 new text end

new text begin (i) Employees who perform work in transferred facilities, services, or operations must
be offered employment with the entity acquiring ownership or control before the entity
offers employment to any individual who was not employed by the transferring agency at
the time of the transfer.
 new text end

new text begin (ii) The wage and benefit standards of such transferred employees must not be reduced
by the entity acquiring ownership or control through the expiration of the collective
bargaining agreement in effect at the time of the transfer or for a period of two years after
the transfer, whichever is longer.
 new text end

new text begin (d) There is no liability on the part of, and no cause of action arises against, the state of
Minnesota or its officers or agents for any action or inaction of any entity acquiring ownership
or control of any facilities, services, or operations of the Department of Direct Care and
Treatment.
 new text end

new text begin EFFECTIVE DATE. new text end

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

Sec. 12.

Minnesota Statutes 2022, section 252.50, subdivision 2, is amended to read:


Subd. 2.

Authorization to build or purchase.

Within the limits of available
appropriations, the commissioner may build, purchase, or lease suitable buildingsnew text begin , at least
a portion of which must be usednew text end for state-operated, community-based programs. The
commissioner must develop the state-operated community residential facilities authorized
in the worksheets of the house of representatives appropriations and senate finance
committees. If financing through state general obligation bonds is not available, the
commissioner shall finance the purchase or construction of state-operated, community-based
facilities with the Minnesota Housing Finance Agency. The commissioner shall make
payments through the Department of Administration to the Minnesota Housing Finance
Agency in repayment of mortgage loans granted for the purposes of this section. Programs
must be adaptable to the needs of persons with developmental disabilities and residential
programs must be homelike.

Sec. 13. new text begin TASK FORCE ON PRIORITY ADMISSIONS TO STATE-OPERATED
TREATMENT PROGRAMS.
new text end

new text begin Subdivision 1. new text end

new text begin Establishment; purpose. new text end

new text begin The Task Force on Priority Admissions to
State-Operated Treatment Programs is established to evaluate the impact of the requirements
for priority admissions under Minnesota Statutes, section 253B.10, subdivision 1, paragraph
(b) on:
 new text end

new text begin (1) the Department of Human Services;
 new text end

new text begin (2) individuals referred for admission and care at state-operated treatment programs,
including both individuals referred for priority admission under Minnesota Statutes, section
253B.10, subdivision 1, paragraph (b), and individuals not referred according to such priority
admissions requirements; and
 new text end

new text begin (3) the mental health system in Minnesota, including community hospitals.
 new text end

new text begin Subd. 2. new text end

new text begin Membership. new text end

new text begin (a) The task force shall consist of the following members,
appointed as follows:
 new text end

new text begin (1) a member appointed by the governor;
 new text end

new text begin (2) the commissioner of human services, or a designee;
 new text end

new text begin (3) a member representing Department of Human Services direct care and treatment
services who has experience with civil commitments, appointed by the commissioner of
human services;
 new text end

new text begin (4) the ombudsman for mental health and developmental disabilities;
 new text end

new text begin (5) a hospital representative, appointed by the Minnesota Hospital Association;
 new text end

new text begin (6) a county representative, appointed by the Association of Minnesota Counties;
 new text end

new text begin (7) a county social services representative, appointed by the Minnesota Association of
County Social Service Administrators;
 new text end

new text begin (8) a member appointed by the Minnesota Civil Commitment Defense Panel;
 new text end

new text begin (9) a county attorney, appointed by the Minnesota County Attorneys Association;
 new text end

new text begin (10) a county sheriff, appointed by the Minnesota Sheriffs' Association;
 new text end

new text begin (11) a member appointed by the Minnesota Psychiatric Society;
 new text end

new text begin (12) a member appointed by the Minnesota Association of Community Mental Health
Programs;
 new text end

new text begin (13) a member appointed by the National Alliance on Mental Illness Minnesota;
 new text end

new text begin (14) the Minnesota Attorney General;
 new text end

new text begin (15) three individuals from organizations representing racial and ethnic groups that are
overrepresented in the criminal justice system, appointed by the commissioner of corrections;
and
 new text end

new text begin (16) one member of the public with lived experience directly related to the task force's
purposes, appointed by the governor.
 new text end

new text begin (b) Appointments must be made no later than July 15, 2023.
 new text end

new text begin (c) Member compensation and reimbursement for expenses are governed by Minnesota
Statutes, section 15.059, subdivision 3.
 new text end

new text begin (d) A member of the legislature may not serve as a member of the task force.
 new text end

new text begin Subd. 3. new text end

new text begin Officers; meetings. new text end

new text begin (a) The commissioner of human services must convene
the first meeting of the task force no later than August 1, 2023.
 new text end

new text begin (b) The Attorney General and the commissioner of human services must serve as
co-chairs. The task force may elect other officers as necessary.
 new text end

new text begin (c) Task force meetings are subject to the Minnesota Open Meeting Law under Minnesota
Statutes, chapter 13D.
 new text end

new text begin Subd. 4. new text end

new text begin Administrative support. new text end

new text begin The commissioner of human services must provide
administrative support and staff assistance for the task force.
 new text end

new text begin Subd. 5. new text end

new text begin Data usage and privacy. new text end

new text begin Any data provided by executive agencies as part of
the work and report of the task force is subject to the requirements of the Minnesota
Government Data Practices Act under Minnesota Statutes, chapter 13, and all other applicable
data privacy laws.
 new text end

new text begin Subd. 6. new text end

new text begin Duties. new text end

new text begin The task force must:
 new text end

new text begin (1) evaluate the impact of the priority admissions required under Minnesota Statutes,
section 253B.10, subdivision 1, paragraph (b), on the ability of the state to serve all
individuals in need of care in state-operated treatment programs by analyzing:
 new text end

new text begin (i) the number of individuals admitted to state-operated treatment programs from jails
or correctional institutions according to the requirements of Minnesota Statutes, section
253B.10, subdivision 1, paragraph (b), since July 1, 2013;
 new text end

new text begin (ii) the number of individuals currently on waiting lists for admission to state-operated
treatment programs;
 new text end

new text begin (iii) the average length of time an individual admitted from a jail or correctional institution
waits for a medically appropriate bed in a state-operated treatment program, compared to
an individual admitted from another location, such as a community hospital or the individual's
home; and
 new text end

new text begin (iv) county-by-county trends over time for priority admissions under Minnesota Statutes,
section 253B.10, subdivision 1, paragraph (b);
 new text end

new text begin (2) analyze the impact of the priority admissions required under Minnesota Statutes,
section 253B.10, subdivision 1, paragraph (b), on the mental health system statewide,
including on community hospitals;
 new text end

new text begin (3) develop policy and funding recommendations for improvements or alternatives to
the current priority admissions requirement. Recommendations must ensure that
state-operated treatment programs have medical discretion to admit individuals with the
highest acuity and who may pose a risk to self and others, regardless of referral path; and
 new text end

new text begin (4) identify and recommend options for providing treatment to individuals referred
according to the priority admissions required under Minnesota Statutes, section 253B.10,
subdivision 1, paragraph (b), and other individuals in the community who require treatment
at state-operated treatment programs.
 new text end

new text begin Subd. 7. new text end

new text begin Report. new text end

new text begin No later than February 1, 2024, the task force must submit a written
report to the chairs and ranking minority members of the legislative committees with
jurisdiction over public safety and human services that includes recommendations on:
 new text end

new text begin (1) proposals to amend Minnesota Statutes, section 253B.10, subdivision 1, paragraph
(b), to improve the priority admissions requirements and process;
 new text end

new text begin (2) ways to ensure that state-operated treatment programs have medical discretion to
prioritize the admission of individuals with the most acute clinical and behavioral health
needs or who pose a risk to self and others, regardless of referral path;
 new text end

new text begin (3) additional ways to meet the treatment needs of individuals referred to state-operated
treatment programs according to the priority admissions required under Minnesota Statutes,
section 253B.10, subdivision 1, paragraph (b), and other individuals in the community who
require treatment at state-operated treatment programs; and
 new text end

new text begin (4) any other relevant findings, research, or analyses conducted or produced by the task
force under subdivision 6.
 new text end

new text begin Subd. 8. new text end

new text begin Expiration. new text end

new text begin The task force expires June 30, 2024.
 new text end

new text begin EFFECTIVE DATE. new text end

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

Sec. 14. new text begin REVISOR INSTRUCTION.
new text end

new text begin The revisor of statutes, in consultation with staff from the House Research Department;
House Fiscal Analysis; the Office of Senate Counsel, Research and Fiscal Analysis; and
the respective departments shall prepare legislation for introduction in the 2024 legislative
session proposing the statutory changes necessary to implement the transfers of duties that
this article requires.
 new text end

new text begin EFFECTIVE DATE. new text end

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

ARTICLE 9

APPROPRIATIONS

Section 1. new text begin HEALTH AND HUMAN SERVICES APPROPRIATIONS.
new text end

new text begin The sums shown in the columns marked "Appropriations" are appropriated to the agencies
and for the purposes specified in this article. The appropriations are from the general fund,
or another named fund, and are available for the fiscal years indicated for each purpose.
The figures "2024" and "2025" used in this article mean that the appropriations listed under
them are available for the fiscal year ending June 30, 2024, or June 30, 2025, respectively.
"The first year" is fiscal year 2024. "The second year" is fiscal year 2025. "The biennium"
is fiscal years 2024 and 2025.
 new text end

new text begin APPROPRIATIONS
 new text end
new text begin Available for the Year
 new text end
new text begin Ending June 30
 new text end
new text begin 2024
 new text end 		new text begin 2025
 new text end

Sec. 2. new text begin COMMISSIONER OF HUMAN
SERVICES
new text end

new text begin Subdivision 1. new text end

new text begin Total Appropriation
 new text end

new text begin $
 new text end 		new text begin 6,926,209,000
 new text end 		new text begin $
 new text end 		new text begin 7,181,099,000
 new text end
new text begin Appropriations by Fund
 new text end
new text begin 2024
 new text end 		new text begin 2025
 new text end
new text begin General
 new text end 		new text begin 6,924,445,000
 new text end 		new text begin 7,179,297,000
 new text end
new text begin Health Care Access
 new text end 		new text begin 31,000
 new text end 		new text begin 69,000
 new text end
new text begin Lottery Prize
 new text end 		new text begin 1,733,000
 new text end 		new text begin 1,733,000
 new text end

new text begin The amounts that may be spent for each
purpose are specified in the following
subdivisions.
 new text end

new text begin Subd. 2. new text end

new text begin Central Office; Operations
 new text end

new text begin 24,607,000
 new text end 		new text begin 17,725,000
 new text end

new text begin (a) Grant Administration Carryforward.
 new text end

new text begin (1) Of this amount, $714,000 in fiscal year
2024 is available until June 30, 2027.
 new text end

new text begin (2) Of this amount, $140,000 in fiscal year
2025 is available until June 30, 2027.
 new text end

new text begin (3) Of this amount, $640,000 in fiscal year
2024 is available until June 30, 2029.
 new text end

new text begin (b) Base Level Adjustment. The general fund
base is increased by $7,249,000 in fiscal year
2026 and increased by $6,999,000 in fiscal
year 2027.
 new text end

new text begin Subd. 3. new text end

new text begin Central Office; Children and Families
 new text end

new text begin 2,699,000
 new text end 		new text begin -0-
 new text end

new text begin new text begin Grant Administration Carryforward.new text end Of
this amount, $2,699,000 in fiscal year 2024 is
available until June 30, 2027.
 new text end

new text begin Subd. 4. new text end

new text begin Central Office; Health Care
 new text end

new text begin 2,468,000
 new text end 		new text begin 3,439,000
 new text end

new text begin (a) Initial PACE Implementation Funding.
$270,000 in fiscal year 2024 is to complete
the initial actuarial and administrative work
necessary to recommend a financing
mechanism for the operation of PACE under
Minnesota Statutes, section 256B.69,
subdivision 23, paragraph (e). This is a
onetime appropriation and is available until
June 30, 2025.
 new text end

new text begin (b) Base Level Adjustment. The general fund
base is increased by $3,322,000 in fiscal year
2026 and increased by $3,322,000 in fiscal
year 2027.
 new text end

new text begin Subd. 5. new text end

new text begin Central Office; Aging and Disability
Services
 new text end

new text begin 40,115,000
 new text end 		new text begin 11,995,000
 new text end

new text begin (a) Employment Supports Alignment Study.
$50,000 in fiscal year 2024 and $200,000 in
fiscal year 2025 are to conduct an interagency
employment supports alignment study. The
base for this appropriation is $150,000 in fiscal
year 2026 and $100,000 in fiscal year 2027.
 new text end

new text begin (b) Case Management Training
Curriculum. $377,000 in fiscal year 2024 and
$377,000 in fiscal year 2025 are to develop
and implement a curriculum and training plan
to ensure all lead agency assessors and case
managers have the knowledge and skills
necessary to fulfill support planning and
coordination responsibilities for individuals
who use home and community-based disability
services and live in own-home settings. This
is a onetime appropriation.
 new text end

new text begin (c) Office of Ombudsperson for Long-Term
Care. $875,000 in fiscal year 2024 and
$875,000 in fiscal year 2025 are for additional
staff and associated direct costs in the Office
of Ombudsperson for Long-Term Care.
 new text end

new text begin (d) Direct Care Services Corps Pilot Project.
$500,000 in fiscal year 2024 is from the
general fund for a grant to the Metropolitan
Center for Independent Living for the direct
care services corps pilot project. Up to $25,000
may be used by the Metropolitan Center for
Independent Living for administrative costs.
This is a onetime appropriation.
 new text end

new text begin (e) Research on Access to Long-Term Care
Services and Financing. Any unexpended
amount of the fiscal year 2023 appropriation
referenced in Laws 2021, First Special Session
chapter 7, article 17, section 16, estimated to
be $300,000, is canceled. The amount canceled
is appropriated in fiscal year 2024 for the same
purpose.
 new text end

new text begin (f) Native American Elder Coordinator.
$441,000 in fiscal year 2024 and $441,000 in
fiscal year 2025 are for the Native American
elder coordinator position under Minnesota
Statutes, section 256.975, subdivision 6.
 new text end

new text begin (g) Grant Administration Carryforward.
 new text end

new text begin (1) Of this amount, $8,154,000 in fiscal year
2024 is available until June 30, 2027.
 new text end

new text begin (2) Of this amount, $1,071,000 in fiscal year
2025 is available until June 30, 2027.
 new text end

new text begin (3) Of this amount, $19,000,000 in fiscal year
2024 is available until June 30, 2029.
 new text end

new text begin (h) Base Level Adjustment. The general fund
base is increased by $8,189,000 in fiscal year
2026 and increased by $8,093,000 in fiscal
year 2027.
 new text end

new text begin Subd. 6. new text end

new text begin Central Office; Behavioral Health,
Housing, and Deaf and Hard of Hearing
Services
 new text end

new text begin 9,573,000
 new text end 		new text begin 4,048,000
 new text end

new text begin (a) Evidence-Based Training for Substance
Use Disorder Provider Community.
$150,000 in fiscal year 2024 and $150,000 in
fiscal year 2025 are for provider participation
in clinical training for the transition to
American Society of Addiction Medicine
standards.
 new text end

new text begin (b) Substance Use Disorder Public
Awareness Campaign. $1,584,000 in fiscal
year 2024 is to develop and establish a public
awareness campaign targeting the stigma of
opioid use disorders with the goal of
prevention and education of youth on the
dangers of opioids and other substance use.
Notwithstanding Minnesota Statutes, section
16A.28, this appropriation is available until
June 30, 2027. This is a onetime appropriation.
 new text end

new text begin (c) Evaluation of Recovery Site Grants.
$100,000 in fiscal year 2025 is to provide
funding for evaluating the effectiveness of
recovery site grant efforts.
 new text end

new text begin (d) Grant Administration Carryforward.
 new text end

new text begin (1) Of this amount, $3,948,000 in fiscal year
2024 is available until June 30, 2027.
 new text end

new text begin (2) Of this amount, $1,183,000 in fiscal year
2024 is available until June 30, 2029.
 new text end

new text begin (e) Base Level Adjustment. The general fund
base is increased by $3,759,000 in fiscal year
2026 and increased by $3,659,000 in fiscal
year 2027.
 new text end

new text begin Subd. 7. new text end

new text begin Forecasted Programs; Housing Support
 new text end

new text begin 783,000
 new text end 		new text begin 1,592,000
 new text end

new text begin Subd. 8. new text end

new text begin Forecasted Programs; MinnesotaCare
 new text end

new text begin 31,000
 new text end 		new text begin 69,000
 new text end

new text begin This appropriation is from the health care
access fund.
 new text end

new text begin Subd. 9. new text end

new text begin Forecasted Programs; Medical
Assistance
 new text end

new text begin 5,672,632,000
 new text end 		new text begin 6,347,966,000
 new text end

new text begin Subd. 10. new text end

new text begin Forecasted Programs; Alternative
Care
 new text end

new text begin 48,042,000
 new text end 		new text begin 53,377,000
 new text end

new text begin Any money allocated to the alternative care
program that is not spent for the purposes
indicated does not cancel but must be
transferred to the medical assistance account.
 new text end

new text begin Subd. 11. new text end

new text begin Forecasted Programs; Behavioral
Health Fund
 new text end

new text begin 96,387,000
 new text end 		new text begin 98,417,000
 new text end

new text begin Subd. 12. new text end

new text begin Grant Programs; Refugee Services
Grants
 new text end

new text begin 7,000,000
 new text end 		new text begin -0-
 new text end

new text begin new text begin New American Legal, Social Services, and
Long-Term Care Workforce Grant
Program.new text end $7,000,000 in fiscal year 2024 is
for legal and social services grants.
Notwithstanding Minnesota Statutes, section
16A.28, this appropriation is available until
June 30, 2027. This is a onetime appropriation.
 new text end

new text begin Subd. 13. new text end

new text begin Grant Programs; Other Long-Term
Care Grants
 new text end

new text begin 152,387,000
 new text end 		new text begin 1,925,000
 new text end

new text begin (a) Provider Capacity Grant for Rural and
Underserved Communities. $17,148,000 in
fiscal year 2024 is for provider capacity grants
for rural and underserved communities.
Notwithstanding Minnesota Statutes, section
16A.28, this appropriation is available until
June 30, 2027. This is a onetime appropriation.
 new text end

new text begin (b) New American Legal, Social Services,
and Long-Term Care Grant Program.
$28,316,000 in fiscal year 2024 is for
long-term care workforce grants for new
Americans. Notwithstanding Minnesota
Statutes, section 16A.28, this appropriation is
available until June 30, 2027. This is a onetime
appropriation.
 new text end

new text begin (c) Supported Decision Making Programs.
$4,000,000 in fiscal year 2024 is for supported
decision making grants. This is a onetime
appropriation and is available until June 30,
2025.
 new text end

new text begin (d) Direct Support Professionals
Employee-Owned Cooperative Program.
$350,000 in fiscal year 2024 is for a grant to
the Metropolitan Consortium of Community
Developers for the Direct Support
Professionals Employee-Owned Cooperative
program. The grantee must use the grant
amount for outreach and engagement,
managing a screening and selection process,
providing one-on-one technical assistance,
developing and providing training curricula
related to cooperative development and home
and community-based waiver services,
administration, reporting, and program
evaluation. This is a onetime appropriation
and is available until June 30, 2025.
 new text end

new text begin (e) Long-Term Services and Supports
Workforce Incentive Grants. $83,560,000
in fiscal year 2024 is for long-term services
and supports workforce incentive grants
administered according to Minnesota Statutes,
section 256.4764. Notwithstanding Minnesota
Statutes, section 16A.28, this appropriation is
available until June 30, 2029. This is a onetime
appropriation.
 new text end

new text begin (f) Base Level Adjustment. The general fund
base is $3,949,000 in fiscal year 2026 and
$3,949,000 in fiscal year 2027. Of these
amounts, $2,024,000 in fiscal year 2026 and
$2,024,000 in fiscal year 2027 are for PCA
background study grants.
 new text end

new text begin Subd. 14. new text end

new text begin Grant Programs; Aging and Adult
Services Grants
 new text end

new text begin 164,626,000
 new text end 		new text begin 34,795,000
 new text end

new text begin (a) Vulnerable Adult Act Redesign Phase
Two. $17,129,000 in fiscal year 2024 is for
adult protection grants to counties and Tribes
under Minnesota Statutes, section 256M.42.
Notwithstanding Minnesota Statutes, section
16A.28, this appropriation is available until
June 30, 2027. The base for this appropriation
is $866,000 in fiscal year 2026 and $867,000
in fiscal year 2027.
 new text end

new text begin (b) Caregiver Respite Services Grants.
$1,800,000 in fiscal year 2025 is for caregiver
respite services grants under Minnesota
Statutes, section 256.9756. This is a onetime
appropriation.
 new text end

new text begin (c) Live Well at Home Grants. $4,575,000
in fiscal year 2024 is for live well at home
grants under Minnesota Statutes, section
256.9754, subdivision 3f. This is a onetime
appropriation and is available until June 30,
2025.
 new text end

new text begin (d) Senior Nutrition Program. $10,552,000
in fiscal year 2024 is for the senior nutrition
program. Notwithstanding Minnesota Statutes,
section 16A.28, this appropriation is available
until June 30, 2027. This is a onetime
appropriation.
 new text end

new text begin (e) Age-Friendly Community Grants.
$3,000,000 in fiscal year 2024 is for the
continuation of age-friendly community grants
under Laws 2021, First Special Session
chapter 7, article 17, section 8, subdivision 1.
Notwithstanding Minnesota Statutes, section
16A.28, this is a onetime appropriation and is
available until June 30, 2027.
 new text end

new text begin (f) Age-Friendly Technical Assistance
Grants. $1,725,000 in fiscal year 2024 is for
the continuation of age-friendly technical
assistance grants under Laws 2021, First
Special Session chapter 7, article 17, section
8, subdivision 2. Notwithstanding Minnesota
Statutes, section 16A.28, this is a onetime
appropriation and is available until June 30,
2027.
 new text end

new text begin (g) Financially Distressed Nursing Facility
Loan Program. $93,200,000 in fiscal year
2024 is for the financially distressed nursing
facility loan program under Minnesota
Statutes, section 256R.55, and is available as
provided therein.
 new text end

new text begin (h) Base Level Adjustment. The general fund
base is $33,861,000 in fiscal year 2026 and
$33,862,000 in fiscal year 2027.
 new text end

new text begin Subd. 15. new text end

new text begin Deaf and Hard-of-Hearing Grants
 new text end

new text begin 2,886,000
 new text end 		new text begin 2,886,000
 new text end

new text begin Subd. 16. new text end

new text begin Grant Programs; Disabilities Grants
 new text end

new text begin 113,684,000
 new text end 		new text begin 30,377,000
 new text end

new text begin (a) Temporary Grants for Small
Customized Living Providers. $5,450,000
in fiscal year 2024 is for grants to assist small
customized living providers to transition to
community residential services licensure or
integrated community supports licensure.
Notwithstanding Minnesota Statutes, section
16A.28, this appropriation is available until
June 30, 2027. This is a onetime appropriation.
 new text end

new text begin (b) Lead Agency Capacity Building Grants.
$444,000 in fiscal year 2024 and $2,396,000
in fiscal year 2025 are for grants to assist
organizations, counties, and Tribes to build
capacity for employment opportunities for
people with disabilities. The base for this
appropriation is $2,413,000 in fiscal year 2026
and $2,411,000 in fiscal year 2027.
 new text end

new text begin (c) Employment and Technical Assistance
Center Grants. $450,000 in fiscal year 2024
and $1,800,000 in fiscal year 2025 are for
employment and technical assistance grants
to assist organizations and employers in
promoting a more inclusive workplace for
people with disabilities.
 new text end

new text begin (d) Case Management Training Grants.
$37,000 in fiscal year 2024 and $123,000 in
fiscal year 2025 are for grants to provide case
management training to organizations and
employers to support the state's disability
employment supports system. The base for
this appropriation is $45,000 in fiscal year
2026 and $45,000 in fiscal year 2027.
 new text end

new text begin (e) Self-Directed Bargaining Agreement;
Electronic Visit Verification Stipends.
$6,095,000 in fiscal year 2024 is for onetime
stipends of $200 to bargaining members to
offset the potential costs related to people
using individual devices to access the
electronic visit verification system. Of this
amount, $5,600,000 is for stipends and
$495,000 is for administration. This is a
onetime appropriation and is available until
June 30, 2025.
 new text end

new text begin (f) Self-Directed Collective Bargaining
Agreement; Temporary Rate Increase
Memorandum of Understanding. $1,600,000
in fiscal year 2024 is for onetime stipends for
individual providers covered by the SEIU
collective bargaining agreement based on the
memorandum of understanding related to the
temporary rate increase in effect between
December 1, 2020, and February 7, 2021. Of
this amount, $1,400,000 of the appropriation
is for stipends and $200,000 is for
administration. This is a onetime
appropriation.
 new text end

new text begin (g) Self-Directed Collective Bargaining
Agreement; Retention Bonuses. $50,750,000
in fiscal year 2024 is for onetime retention
bonuses covered by the SEIU collective
bargaining agreement. Of this amount,
$50,000,000 is for retention bonuses and
$750,000 is for administration of the bonuses.
This is a onetime appropriation and is
available until June 30, 2025.
 new text end

new text begin (h) Self-Directed Bargaining Agreement;
Training Stipends. $2,100,000 in fiscal year
2024 and $100,000 in fiscal year 2025 are for
onetime stipends of $500 for collective
bargaining unit members who complete
designated, voluntary trainings made available
through or recommended by the State Provider
Cooperation Committee. Of this amount,
$2,000,000 in fiscal year 2024 is for stipends,
and $100,000 in fiscal year 2024 and $100,000
in fiscal year 2025 are for administration. This
is a onetime appropriation.
 new text end

new text begin (i) Self-Directed Bargaining Agreement;
Orientation Program. $2,000,000 in fiscal
year 2024 and $2,000,000 in fiscal year 2025
are for onetime $100 payments to collective
bargaining unit members who complete
voluntary orientation requirements. Of this
amount, $1,500,000 in fiscal year 2024 and
$1,500,000 in fiscal year 2025 are for the
onetime $100 payments, and $500,000 in
fiscal year 2024 and $500,000 in fiscal year
2025 are for orientation-related costs. This is
a onetime appropriation.
 new text end

new text begin (j) Self-Directed Bargaining Agreement;
Home Care Orientation Trust. $1,000,000
in fiscal year 2024 is for the Home Care
Orientation Trust under Minnesota Statutes,
section 179A.54, subdivision 11. The
commissioner shall disburse the appropriation
to the board of trustees of the Home Care
Orientation Trust for deposit into an account
designated by the board of trustees outside the
state treasury and state's accounting system.
This is a onetime appropriation.
 new text end

new text begin (k) HIV/AIDS Supportive Services.
$12,100,000 in fiscal year 2024 is for grants
to community-based HIV/AIDS supportive
services providers as defined in Minnesota
Statutes, section 256.01, subdivision 19, and
for payment of allowed health care costs as
defined in Minnesota Statutes, section
256.935. This is a onetime appropriation and
is available until June 30, 2025.
 new text end

new text begin (l) Motion Analysis Advancements Clinical
Study and Patient Care. $400,000 is fiscal
year 2024 is for a grant to the Mayo Clinic
Motion Analysis Laboratory and Limb Lab
for continued research in motion analysis
advancements and patient care. This is a
onetime appropriation and is available through
June 30, 2025.
 new text end

new text begin (m) Grant to Family Voices in Minnesota.
$75,000 in fiscal year 2024 and $75,000 in
fiscal year 2025 are for a grant to Family
Voices in Minnesota under Minnesota
Statutes, section 256.4776.
 new text end

new text begin (n) Parent-to-Parent Programs.
 new text end

new text begin (1) $550,000 in fiscal year 2024 and $550,000
in fiscal year 2025 are for grants to
organizations that provide services to
underserved communities with a high
prevalence of autism spectrum disorder. This
is a onetime appropriation and is available
until June 30, 2025.
 new text end

new text begin (2) The commissioner shall give priority to
organizations that provide culturally specific
and culturally responsive services.
 new text end

new text begin (3) Eligible organizations must:
 new text end

new text begin (i) conduct outreach and provide support to
newly identified parents or guardians of a child
with special health care needs;
 new text end

new text begin (ii) provide training to educate parents and
guardians in ways to support their child and
navigate the health, education, and human
services systems;
 new text end

new text begin (iii) facilitate ongoing peer support for parents
and guardians from trained volunteer support
parents; and
 new text end

new text begin (iv) communicate regularly with other
parent-to-parent programs and national
organizations to ensure that best practices are
implemented.
 new text end

new text begin (4) Grant recipients must use grant money for
the activities identified in clause (3).
 new text end

new text begin (5) For purposes of this paragraph, "special
health care needs" means disabilities, chronic
illnesses or conditions, health-related
educational or behavioral problems, or the risk
of developing disabilities, illnesses, conditions,
or problems.
 new text end

new text begin (6) Each grant recipient must report to the
commissioner of human services annually by
January 15 with measurable outcomes from
programs and services funded by this
appropriation the previous year including the
number of families served and the number of
volunteer support parents trained by the
organization's parent-to-parent program.
 new text end

new text begin (o) Self-Advocacy Grants for Persons with
Intellectual and Developmental Disabilities.
$323,000 in fiscal year 2024 and $323,000 in
fiscal year 2025 are for self-advocacy grants
under Minnesota Statutes, section 256.477.
Of these amounts, $218,000 in fiscal year
2024 and $218,000 in fiscal year 2025 are for
the activities under Minnesota Statutes, section
256.477, subdivision 1, paragraph (a), clauses
(5) to (7), and for administrative costs, and
$105,000 in fiscal year 2024 and $105,000 in
fiscal year 2025 are for the activities under
Minnesota Statutes, section 256.477,
subdivision 2.
 new text end

new text begin (p) Technology for Home Grants. $300,000
in fiscal year 2024 and $300,000 in fiscal year
2025 are for technology for home grants under
Minnesota Statutes, section 256.4773.
 new text end

new text begin (q) Community Residential Setting
Transition. $500,000 in fiscal year 2024 is
for a grant to Hennepin County to expedite
approval of community residential setting
licenses subject to the corporate foster care
moratorium exception under Minnesota
Statutes, section 245A.03, subdivision 7,
paragraph (a), clause (5).
 new text end

new text begin (r) Base Level Adjustment. The general fund
base is $27,343,000 in fiscal year 2026 and
$27,016,000 in fiscal year 2027.
 new text end

new text begin Subd. 17. new text end

new text begin Grant Programs; Adult Mental Health
Grants
 new text end

new text begin 4,400,000
 new text end 		new text begin -0-
 new text end

new text begin (a) Training for Peer Workforce. $4,000,000
in fiscal year 2024 is for peer workforce
training grants. Notwithstanding Minnesota
Statutes, section 16A.28, this is a onetime
appropriation and is available until June 30,
2027.
 new text end

new text begin (b) Family Enhancement Center Grant.
$400,000 in fiscal year 2024 is for a grant to
the Family Enhancement Center to develop,
maintain, and expand community-based social
engagement and connection programs to help
families dealing with trauma and mental health
issues develop connections with each other
and their communities, including the NEST
parent monitoring program, the cook to
connect program, and the call to movement
initiative. This appropriation is onetime and
is available until June 30, 2025.
 new text end

new text begin Subd. 18. new text end

new text begin Grant Programs; Chemical
Dependency Treatment Support Grants
 new text end

new text begin Appropriations by Fund
 new text end
new text begin General
 new text end 		new text begin 54,691,000
 new text end 		new text begin 5,342,000
 new text end
new text begin Lottery Prize
 new text end 		new text begin 1,733,000
 new text end 		new text begin 1,733,000
 new text end

new text begin (a) Culturally Specific Recovery
Community Organization Start-Up Grants.
$4,000,000 in fiscal year 2024 is for culturally
specific recovery community organization
start-up grants. Notwithstanding Minnesota
Statutes, section 16A.28, this appropriation is
available until June 30, 2027. This is a onetime
appropriation.
 new text end

new text begin (b) Safe Recovery Sites. $14,537,000 in fiscal
year 2024 is from the general fund for start-up
and capacity-building grants for organizations
to establish safe recovery sites.
Notwithstanding Minnesota Statutes, section
16A.28, this appropriation is onetime and is
available until June 30, 2029.
 new text end

new text begin (c) Technical Assistance for Culturally
Specific Organizations; Culturally Specific
Services Grants. $4,000,000 in fiscal year
2024 is for grants to culturally specific
providers for technical assistance navigating
culturally specific and responsive substance
use and recovery programs. Notwithstanding
Minnesota Statutes, section 16A.28, this
appropriation is available until June 30, 2027.
 new text end

new text begin (d) Technical Assistance for Culturally
Specific Organizations; Culturally Specific
Grant Development Training. $400,000 in
fiscal year 2024 is for grants for up to four
trainings for community members and
culturally specific providers for grant writing
training for substance use and recovery-related
grants. Notwithstanding Minnesota Statutes,
section 16A.28, this is a onetime appropriation
and is available until June 30, 2027.
 new text end

new text begin (e) Harm Reduction Supplies for Tribal and
Culturally Specific Programs. $7,597,000
in fiscal year 2024 is from the general fund to
provide sole source grants to culturally
specific communities to purchase syringes,
testing supplies, and opiate antagonists.
Notwithstanding Minnesota Statutes, section
16A.28, this appropriation is available until
June 30, 2027. This is a onetime appropriation.
 new text end

new text begin (f) Families and Family Treatment
Capacity-Building and Start-Up Grants.
$10,000,000 in fiscal year 2024 is from the
general fund for start-up and capacity-building
grants for family substance use disorder
treatment programs. Notwithstanding
Minnesota Statutes, section 16A.28, this
appropriation is available until June 30, 2029.
This is a onetime appropriation.
 new text end

new text begin (g) Start-Up and Capacity Building Grants
for Withdrawal Management. $500,000 in
fiscal year 2024 and $1,000,000 in fiscal year
2025 are for start-up and capacity building
grants for withdrawal management.
 new text end

new text begin (h) Recovery Community Organization
Grants. $4,300,000 in fiscal year 2024 is from
the general fund for grants to recovery
community organizations, as defined in
Minnesota Statutes, section 254B.01,
subdivision 8, that are current grantees as of
June 30, 2023. This is a onetime appropriation
and is available until June 30, 2025.
 new text end

new text begin (i) Opioid Overdose Prevention Grants.
 new text end

new text begin (1) $125,000 in fiscal year 2024 and $125,000
in fiscal year 2025 are from the general fund
for a grant to Ka Joog, a nonprofit organization
in Minneapolis, Minnesota, to be used for
collaborative outreach, education, and training
on opioid use and overdose, and distribution
of opiate antagonist kits in East African and
Somali communities in Minnesota. This is a
onetime appropriation.
 new text end

new text begin (2) $125,000 in fiscal year 2024 and $125,000
in fiscal year 2025 are from the general fund
for a grant to the Steve Rummler Hope
Network to be used for statewide outreach,
education, and training on opioid use and
overdose, and distribution of opiate antagonist
kits. This is a onetime appropriation.
 new text end

new text begin (3) $250,000 in fiscal year 2024 and $250,000
in fiscal year 2025 are from the general fund
for a grant to African Career Education and
Resource, Inc. to be used for collaborative
outreach, education, and training on opioid
use and overdose, and distribution of opiate
antagonist kits. This is a onetime
appropriation.
 new text end

new text begin (j) Problem Gambling. $225,000 in fiscal
year 2024 and $225,000 in fiscal year 2025
are from the lottery prize fund for a grant to a
state affiliate recognized by the National
Council on Problem Gambling. The affiliate
must provide services to increase public
awareness of problem gambling, education,
training for individuals and organizations that
provide effective treatment services to problem
gamblers and their families, and research
related to problem gambling.
 new text end

new text begin (k) Project ECHO. $1,310,000 in fiscal year
2024 and $1,295,000 in fiscal year 2025 are
from the general fund for a grant to Hennepin
Healthcare to expand the Project ECHO
program. The grant must be used to establish
at least four substance use disorder-focused
Project ECHO programs at Hennepin
Healthcare, expanding the grantee's capacity
to improve health and substance use disorder
outcomes for diverse populations of
individuals enrolled in medical assistance,
including but not limited to immigrants,
individuals who are homeless, individuals
seeking maternal and perinatal care, and other
underserved populations. The Project ECHO
programs funded under this section must be
culturally responsive, and the grantee must
contract with culturally and linguistically
appropriate substance use disorder service
providers who have expertise in focus areas,
based on the populations served. Grant funds
may be used for program administration,
equipment, provider reimbursement, and
staffing hours. This is a onetime appropriation.
 new text end

new text begin (l) White Earth Nation Substance Use
Disorder Digital Therapy Tool. $3,000,000
in fiscal year 2024 is from the general fund
for a grant to the White Earth Nation to
develop an individualized Native American
centric digital therapy tool with Pathfinder
Solutions. This is a onetime appropriation.
The grant must be used to:
 new text end

new text begin (1) develop a mobile application that is
culturally tailored to connecting substance use
disorder resources with White Earth Nation
members;
 new text end

new text begin (2) convene a planning circle with White Earth
Nation members to design the tool;
 new text end

new text begin (3) provide and expand White Earth
Nation-specific substance use disorder
services; and
 new text end

new text begin (4) partner with an academic research
institution to evaluate the efficacy of the
program.
 new text end

new text begin (m) Wellness in the Woods. $300,000 in
fiscal year 2024 and $300,000 in fiscal year
2025 are from the general fund for a grant to
Wellness in the Woods for daily peer support
and special sessions for individuals who are
in substance use disorder recovery, are
transitioning out of incarceration, or who have
experienced trauma. These are onetime
appropriations.
 new text end

new text begin (n) Base Level Adjustment. The general fund
base is $3,247,000 in fiscal year 2026 and
$3,247,000 in fiscal year 2027.
 new text end

new text begin Subd. 19. new text end

new text begin Direct Care and Treatment - Transfer
Authority
 new text end

new text begin (a) Money appropriated for budget activities
under subdivisions 20 to 24 may be transferred
between budget activities and between years
of the biennium with the approval of the
commissioner of management and budget.
 new text end

new text begin (b) Ending balances in obsolete accounts in
the special revenue fund and other dedicated
accounts within direct care and treatment may
be transferred to other dedicated and gift fund
accounts within direct care and treatment for
client use and other client activities, with
approval of the commissioner of management
and budget. These transactions must be
completed by August 1, 2023.
 new text end

new text begin Subd. 20. new text end

new text begin Direct Care and Treatment - Mental
Health and Substance Abuse
 new text end

new text begin 169,962,000
 new text end 		new text begin 177,152,000
 new text end

new text begin The commissioner responsible for operations
of direct care and treatment services, with the
approval of the commissioner of management
and budget, may transfer any balance in the
enterprise fund established for the community
addiction recovery enterprise program to the
general fund appropriation within this
subdivision. Any balance remaining after June
30, 2025, cancels to the general fund.
 new text end

new text begin Subd. 21. new text end

new text begin Direct Care and Treatment -
Community-Based Services
 new text end

new text begin 20,386,000
 new text end 		new text begin 21,164,000
 new text end

new text begin new text begin Base Level Adjustment.new text end The general fund
base is $20,116,000 in fiscal year 2026 and
$20,116,000 in fiscal year 2027.
 new text end

new text begin Subd. 22. new text end

new text begin Direct Care and Treatment - Forensic
Services
 new text end

new text begin 141,020,000
 new text end 		new text begin 148,513,000
 new text end

new text begin Subd. 23. new text end

new text begin Direct Care and Treatment - Sex
Offender Program
 new text end

new text begin 115,920,000
 new text end 		new text begin 121,726,000
 new text end

new text begin Subd. 24. new text end

new text begin Direct Care and Treatment -
Operations
 new text end

new text begin 80,177,000
 new text end 		new text begin 96,858,000
 new text end

new text begin The general fund base is $70,063,000 in fiscal
year 2026 and $70,161,000 in fiscal year 2027.
 new text end

Sec. 3. new text begin COUNCIL ON DISABILITY
new text end

new text begin $
 new text end 		new text begin 2,027,000
 new text end 		new text begin $
 new text end 		new text begin 2,407,000
 new text end

new text begin Base Level Adjustment. The general fund
base is $2,406,000 in fiscal year 2026 and
$2,407,000 in fiscal year 2027.
 new text end

Sec. 4. new text begin OFFICE OF THE OMBUDSMAN FOR
MENTAL HEALTH AND DEVELOPMENTAL
DISABILITIES
new text end

new text begin $
 new text end 		new text begin 3,441,000
 new text end 		new text begin $
 new text end 		new text begin 3,644,000
 new text end

new text begin Department of Psychiatry Monitoring.
$100,000 in fiscal year 2024 and $100,000 in
fiscal year 2025 are for monitoring the
Department of Psychiatry at the University of
Minnesota.
 new text end

Sec. 5. new text begin COMMISSIONER OF MANAGEMENT
AND BUDGET
new text end

new text begin $
 new text end 		new text begin 1,000,000
 new text end 		new text begin $
 new text end 		new text begin 1,000,000
 new text end

new text begin Office of Addiction and Recovery.
$1,000,000 in fiscal year 2024 and $1,000,000
in fiscal year 2025 are for the Office of
Addiction and Recovery.
 new text end

Sec. 6.

Laws 2021, First Special Session chapter 7, article 16, section 28, as amended by
Laws 2022, chapter 40, section 1, is amended to read:


Sec. 28. CONTINGENT APPROPRIATIONS.

Any appropriation in this act for a purpose included in Minnesota's initial state spending
plan as described in guidance issued by the Centers for Medicare and Medicaid Services
for implementation of section 9817 of the federal American Rescue Plan Act of 2021 is
contingent uponnew text begin the initialnew text end approval of that purpose by the Centers for Medicare and Medicaid
Services, except for the rate increases specified in article 11, sections 12 and 19. This section
expires June 30, 2024.

Sec. 7.

Laws 2021, First Special Session chapter 7, article 17, section 16, is amended to
read:


Sec. 16. RESEARCH ON ACCESS TO LONG-TERM CARE SERVICES AND
FINANCING.

new text begin (a) new text end This act includes $400,000 in fiscal year 2022 and $300,000 in fiscal year 2023 for
an actuarial research study of public and private financing options for long-term services
and supports reform to increase access across the state. The commissioner of human services
must conduct the study. Of this amount, the commissioner may transfer up to $100,000 to
the commissioner of commerce for costs related to the requirements of the study. The general
fund base included in this act for this purpose is $0 in fiscal year 2024 and $0 in fiscal year
2025.

new text begin (b) All activities must be completed by June 30, 2024.
 new text end

new text begin EFFECTIVE DATE. new text end

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

Sec. 8. new text begin DIRECT CARE AND TREATMENT FISCAL YEAR 2023
APPROPRIATION.
new text end

new text begin $4,829,000 is appropriated in fiscal year 2023 to the commissioner of human services
for direct care and treatment programs. This is a onetime appropriation.
 new text end

new text begin EFFECTIVE DATE. new text end

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

Sec. 9. new text begin TRANSFERS.
new text end

new text begin Subdivision 1. new text end

new text begin Grants. new text end

new text begin The commissioner of human services, with the approval of the
commissioner of management and budget, may transfer unencumbered appropriation balances
for the biennium ending June 30, 2025, within fiscal years among the MFIP; general
assistance; medical assistance; MinnesotaCare; MFIP child care assistance under Minnesota
Statutes, section 119B.05; Minnesota supplemental aid program; housing support program;
the entitlement portion of Northstar Care for Children under Minnesota Statutes, chapter
256N; and the entitlement portion of the behavioral health fund between fiscal years of the
biennium. The commissioner shall inform the chairs and ranking minority members of the
legislative committees with jurisdiction over health and human services quarterly about
transfers made under this subdivision.
 new text end

new text begin Subd. 2. new text end

new text begin Administration. new text end

new text begin Positions, salary money, and nonsalary administrative money
may be transferred within the Department of Human Services as the commissioner considers
necessary, with the advance approval of the commissioner of management and budget. The
commissioners shall inform the chairs and ranking minority members of the legislative
committees with jurisdiction over health and human services finance quarterly about transfers
made under this section.
 new text end

Sec. 10. new text begin APPROPRIATIONS GIVEN EFFECT ONCE.
new text end

new text begin If an appropriation or transfer in this article is enacted more than once during the 2023
regular session, the appropriation or transfer must be given effect once.
 new text end

Sec. 11. new text begin EXPIRATION OF UNCODIFIED LANGUAGE.
new text end

new text begin All uncodified language contained in this article expires on June 30, 2025, unless a
different expiration date is explicit.
 new text end

Sec. 12. new text begin EFFECTIVE DATE.
new text end

new text begin This article is effective July 1, 2023, unless a different effective date is specified.
 new text end

APPENDIX

Repealed Minnesota Statutes: S2934-4

245G.05 COMPREHENSIVE ASSESSMENT AND ASSESSMENT SUMMARY.

Subd. 2.

Assessment summary.

(a) An alcohol and drug counselor must complete an assessment summary within three calendar days from the day of service initiation for a residential program and within three calendar days on which a treatment session has been provided from the day of service initiation for a client in a nonresidential program. The comprehensive assessment summary is complete upon a qualified staff member's dated signature. If the comprehensive assessment is used to authorize the treatment service, the alcohol and drug counselor must prepare an assessment summary on the same date the comprehensive assessment is completed. If the comprehensive assessment and assessment summary are to authorize treatment services, the assessor must determine appropriate services for the client using the dimensions in Minnesota Rules, part 9530.6622, and document the recommendations.

(b) An assessment summary must include:

(1) a risk description according to section 245G.05 for each dimension listed in paragraph (c);

(2) a narrative summary supporting the risk descriptions; and

(3) a determination of whether the client has a substance use disorder.

(c) An assessment summary must contain information relevant to treatment service planning and recorded in the dimensions in clauses (1) to (6). The license holder must consider:

(1) Dimension 1, acute intoxication/withdrawal potential; the client's ability to cope with withdrawal symptoms and current state of intoxication;

(2) Dimension 2, biomedical conditions and complications; the degree to which any physical disorder of the client would interfere with treatment for substance use, and the client's ability to tolerate any related discomfort. The license holder must determine the impact of continued substance use on the unborn child, if the client is pregnant;

(3) Dimension 3, emotional, behavioral, and cognitive conditions and complications; the degree to which any condition or complication is likely to interfere with treatment for substance use or with functioning in significant life areas and the likelihood of harm to self or others;

(4) Dimension 4, readiness for change; the support necessary to keep the client involved in treatment service;

(5) Dimension 5, relapse, continued use, and continued problem potential; the degree to which the client recognizes relapse issues and has the skills to prevent relapse of either substance use or mental health problems; and

(6) Dimension 6, recovery environment; whether the areas of the client's life are supportive of or antagonistic to treatment participation and recovery.

245G.06 INDIVIDUAL TREATMENT PLAN.

Subd. 2.

Plan contents.

An individual treatment plan must be recorded in the six dimensions listed in section 245G.05, subdivision 2, paragraph (c), must address each issue identified in the assessment summary, prioritized according to the client's needs and focus, and must include:

(1) specific goals and methods to address each identified need in the comprehensive assessment summary, including amount, frequency, and anticipated duration of treatment service. The methods must be appropriate to the client's language, reading skills, cultural background, and strengths;

(2) resources to refer the client to when the client's needs are to be addressed concurrently by another provider; and

(3) goals the client must reach to complete treatment and terminate services.

246.18 DISPOSAL OF FUNDS.

Subd. 2.

Behavioral health fund.

Money received by a substance use disorder treatment facility operated by a regional treatment center or nursing home under the jurisdiction of the commissioner of human services must be deposited in the state treasury and credited to the behavioral health fund. Money in the behavioral health fund is appropriated to the commissioner to operate substance use disorder programs.

Subd. 2a.

Disposition of interest for the behavioral health fund.

Beginning July 1, 1991, interest earned on cash balances on deposit with the commissioner of management and budget derived from receipts from substance use disorder programs affiliated with state-operated facilities under the commissioner of human services must be deposited in the state treasury and credited to a substance use disorder account under subdivision 2. Any interest earned is appropriated to the commissioner to operate substance use disorder programs according to subdivision 2.

256B.0759 SUBSTANCE USE DISORDER DEMONSTRATION PROJECT.

Subd. 6.

Medium intensity residential program participation.

Medium intensity residential programs that qualify to participate in the demonstration project shall use the specified base payment rate of $132.90 per day, and shall be eligible for the rate increases specified in subdivision 4.

256B.0917 HOME AND COMMUNITY-BASED SERVICES FOR OLDER ADULTS.

Subd. 1a.

Home and community-based services for older adults.

(a) The purpose of projects selected by the commissioner of human services under this section is to make strategic changes in the long-term services and supports system for older adults including statewide capacity for local service development and technical assistance, and statewide availability of home and community-based services for older adult services, caregiver support and respite care services, and other supports in the state of Minnesota. These projects are intended to create incentives for new and expanded home and community-based services in Minnesota in order to:

(1) reach older adults early in the progression of their need for long-term services and supports, providing them with low-cost, high-impact services that will prevent or delay the use of more costly services;

(2) support older adults to live in the most integrated, least restrictive community setting;

(3) support the informal caregivers of older adults;

(4) develop and implement strategies to integrate long-term services and supports with health care services, in order to improve the quality of care and enhance the quality of life of older adults and their informal caregivers;

(5) ensure cost-effective use of financial and human resources;

(6) build community-based approaches and community commitment to delivering long-term services and supports for older adults in their own homes;

(7) achieve a broad awareness and use of lower-cost in-home services as an alternative to nursing homes and other residential services;

(8) strengthen and develop additional home and community-based services and alternatives to nursing homes and other residential services; and

(9) strengthen programs that use volunteers.

(b) The services provided by these projects are available to older adults who are eligible for medical assistance and the elderly waiver under chapter 256S, the alternative care program under section 256B.0913, or essential community supports grant under section 256B.0922, and to persons who have their own funds to pay for services.

Subd. 6.

Caregiver support and respite care projects.

(a) The commissioner shall establish projects to expand the availability of caregiver support and respite care services for family and other caregivers. The commissioner shall use a request for proposals to select nonprofit entities to administer the projects. Projects shall:

(1) establish a local coordinated network of volunteer and paid respite workers;

(2) coordinate assignment of respite care services to caregivers of older adults;

(3) assure the health and safety of the older adults;

(4) identify at-risk caregivers;

(5) provide information, education, and training for caregivers in the designated community; and

(6) demonstrate the need in the proposed service area particularly where nursing facility closures have occurred or are occurring or areas with service needs identified by section 144A.351. Preference must be given for projects that reach underserved populations.

(b) Projects must clearly describe:

(1) how they will achieve their purpose;

(2) the process for recruiting, training, and retraining volunteers; and

(3) a plan to promote the project in the designated community, including outreach to persons needing the services.

(c) Funds for all projects under this subdivision may be used to:

(1) hire a coordinator to develop a coordinated network of volunteer and paid respite care services and assign workers to clients;

(2) recruit and train volunteer providers;

(3) provide information, training, and education to caregivers;

(4) advertise the availability of the caregiver support and respite care project; and

(5) purchase equipment to maintain a system of assigning workers to clients.

(d) Project funds may not be used to supplant existing funding sources.

Subd. 7a.

Core home and community-based services.

The commissioner shall select and contract with core home and community-based services providers for projects to provide services and supports to older adults both with and without family and other informal caregivers using a request for proposals process. Projects must:

(1) have a credible, public, or private nonprofit sponsor providing ongoing financial support;

(2) have a specific, clearly defined geographic service area;

(3) use a practice framework designed to identify high-risk older adults and help them take action to better manage their chronic conditions and maintain their community living;

(4) have a team approach to coordination and care, ensuring that the older adult participants, their families, and the formal and informal providers are all part of planning and providing services;

(5) provide information, support services, homemaking services, counseling, and training for the older adults and family caregivers;

(6) encourage service area or neighborhood residents and local organizations to collaborate in meeting the needs of older adults in their geographic service areas;

(7) recruit, train, and direct the use of volunteers to provide informal services and other appropriate support to older adults and their caregivers; and

(8) provide coordination and management of formal and informal services to older adults and their families using less expensive alternatives.

Subd. 13.

Community service grants.

The commissioner shall award contracts for grants to public and private nonprofit agencies to establish services that strengthen a community's ability to provide a system of home and community-based services for elderly persons. The commissioner shall use a request for proposal process. The commissioner shall give preference when awarding grants under this section to areas where nursing facility closures have occurred or are occurring or to areas with service needs identified under section 144A.351.

256B.4914 HOME AND COMMUNITY-BASED SERVICES WAIVERS; RATE SETTING.

Subd. 6b.

Family residential services; component values and calculation of payment rates.

(a) Component values for family residential services are:

(1) competitive workforce factor: 4.7 percent;

(2) supervisory span of control ratio: 11 percent;

(3) employee vacation, sick, and training allowance ratio: 8.71 percent;

(4) employee-related cost ratio: 23.6 percent;

(5) general administrative support ratio: 3.3 percent;

(6) program-related expense ratio: 1.3 percent; and

(7) absence factor: 1.7 percent.

(b) Payments for family residential services must be calculated as follows:

(1) determine the number of shared direct staffing and individual direct staffing hours to meet a recipient's needs provided on site or through monitoring technology;

(2) determine the appropriate hourly staff wage rates derived by the commissioner as provided in subdivisions 5 and 5a;

(3) except for subdivision 5a, clauses (1) to (4), multiply the result of clause (2) by the product of one plus the competitive workforce factor;

(4) for a recipient requiring customization for deaf and hard-of-hearing language accessibility under subdivision 12, add the customization rate provided in subdivision 12 to the result of clause (3);

(5) multiply the number of shared direct staffing and individual direct staffing hours provided on site or through monitoring technology and nursing hours by the appropriate staff wages;

(6) multiply the number of shared direct staffing and individual direct staffing hours provided on site or through monitoring technology and nursing hours by the product of the supervisory span of control ratio and the appropriate supervisory staff wage in subdivision 5a, clause (1);

(7) combine the results of clauses (5) and (6), excluding any shared direct staffing and individual direct staffing hours provided through monitoring technology, and multiply the result by one plus the employee vacation, sick, and training allowance ratio. This is defined as the direct staffing cost;

(8) for employee-related expenses, multiply the direct staffing cost, excluding any shared and individual direct staffing hours provided through monitoring technology, by one plus the employee-related cost ratio;

(9) for client programming and supports, add $2,260.21 divided by 365. The commissioner shall update the amount in this clause as specified in subdivision 5b;

(10) for transportation, if provided, add $1,742.62 divided by 365, or $3,111.81 divided by 365 if customized for adapted transport, based on the resident with the highest assessed need. The commissioner shall update the amounts in this clause as specified in subdivision 5b;

(11) subtotal clauses (8) to (10) and the direct staffing cost of any shared direct staffing and individual direct staffing hours provided through monitoring technology that was excluded in clause (8);

(12) sum the standard general administrative support ratio, the program-related expense ratio, and the absence and utilization factor ratio;

(13) divide the result of clause (11) by one minus the result of clause (12). This is the total payment rate; and

(14) adjust the result of clause (13) by a factor to be determined by the commissioner to adjust for regional differences in the cost of providing services.

Subd. 9a.

Respite services; component values and calculation of payment rates.

(a) For the purposes of this section, respite services include respite services provided to an individual outside of any service plan for a day program or residential support service.

(b) Component values for respite services are:

(1) competitive workforce factor: 4.7 percent;

(2) supervisory span of control ratio: 11 percent;

(3) employee vacation, sick, and training allowance ratio: 8.71 percent;

(4) employee-related cost ratio: 23.6 percent;

(5) general administrative support ratio: 13.25 percent;

(6) program-related expense ratio: 2.9 percent; and

(7) absence and utilization factor ratio: 3.9 percent.

(c) A unit of service for respite services is 15 minutes.

(d) Payments for respite services must be calculated as follows unless the service is reimbursed separately as part of a residential support services or day program payment rate:

(1) determine the number of units of service to meet an individual's needs;

(2) determine the appropriate hourly staff wage rates derived by the commissioner as provided in subdivisions 5 and 5a;

(3) except for subdivision 5a, clauses (1) to (4), multiply the result of clause (2) by the product of one plus the competitive workforce factor;

(4) for a recipient requiring deaf and hard-of-hearing customization under subdivision 12, add the customization rate provided in subdivision 12 to the result of clause (3);

(5) multiply the number of direct staffing hours by the appropriate staff wage;

(6) multiply the number of direct staffing hours by the product of the supervisory span of control ratio and the appropriate supervisory staff wage in subdivision 5a, clause (1);

(7) combine the results of clauses (5) and (6), and multiply the result by one plus the employee vacation, sick, and training allowance ratio. This is defined as the direct staffing rate;

(8) for employee-related expenses, multiply the result of clause (7) by one plus the employee-related cost ratio;

(9) this is the subtotal rate;

(10) sum the standard general administrative support ratio, the program-related expense ratio, and the absence and utilization factor ratio;

(11) divide the result of clause (9) by one minus the result of clause (10). This is the total payment amount;

(12) for respite services provided in a shared manner, divide the total payment amount in clause (11) by the number of service recipients, not to exceed three; and

(13) adjust the result of clause (12) by a factor to be determined by the commissioner to adjust for regional differences in the cost of providing services.

256S.19 MONTHLY CASE MIX BUDGET CAPS; NURSING FACILITY RESIDENTS.

Subd. 4.

Calculation of monthly conversion budget cap with consumer-directed community supports.

For the elderly waiver monthly conversion budget cap for the cost of elderly waiver services with consumer-directed community supports, the nursing facility case mix adjusted total payment rate used under subdivision 3 to calculate the monthly conversion budget cap for elderly waiver services without consumer-directed community supports must be reduced by a percentage equal to the percentage difference between the consumer-directed community supports budget limit that would be assigned according to the elderly waiver plan and the corresponding monthly case mix budget cap under this chapter, but not to exceed 50 percent.

256S.2101 RATE SETTING; PHASE-IN.

Subd. 2.

Phase-in for elderly waiver rates.

Except for home-delivered meals as described in section 256S.215, subdivision 15, all rates and rate components for elderly waiver, elderly waiver customized living, and elderly waiver foster care under this chapter; alternative care under section 256B.0913; and essential community supports under section 256B.0922 shall be the sum of 18.8 percent of the rates calculated under sections 256S.211 to 256S.215, and 81.2 percent of the rates calculated using the rate methodology in effect as of June 30, 2017. The rate for home-delivered meals shall be the sum of the service rate in effect as of January 1, 2019, and the increases described in section 256S.215, subdivision 15.