SF 5042

04/06/26  REVISOR  DTT/CH  26-08138      as introduced
  SENATE
  STATE OF MINNESOTA
  NINETY-FOURTH SESSION  S.F. No. 5042
       (SENATE AUTHORS: HOFFMAN)
  DATE       D-PG  OFFICIAL STATUS
       04/09/2026      7938 Introduction and first reading
  Referred to Human Services
  See SF4476
1.1A bill for an act
1.2relating to human services; modifying human services provisions on aging and
1.3disability services, behavioral health, licensing and program integrity, mental
1.4health licensing, background studies, and forecasted program appropriations
1.5adjustments; requiring reports; appropriating money; amending Minnesota Statutes
1.62024, sections 62D.04, subdivision 5; 142B.15; 142B.79; 144.057, subdivision 1;
1.7144.0724, by adding a subdivision; 245.4661, subdivision 10, by adding
1.8subdivisions; 245.735, subdivision 6; 245A.03, subdivision 7; 245A.10, by adding
1.9a subdivision; 245A.65, subdivision 1a; 245C.03, subdivisions 1, 2, 3, 4, 5a, 5b,
1.10      7, 9, 10, 12, by adding subdivisions; 245C.04, subdivisions 1, 4a; 245C.10,
1.11      subdivisions 4, 5, 8, 17; 245C.14, subdivisions 1, 2; 245C.24, subdivision 2;
1.12      245D.09, subdivisions 6, 7; 245G.03, subdivision 1; 245I.011, subdivisions 3, 5,
1.13      by adding a subdivision; 245I.02, subdivisions 33, 39, by adding subdivisions;
1.14      245I.03, subdivision 4, by adding a subdivision; 245I.06, subdivisions 1, 2; 245I.07;
1.15      245I.10, subdivisions 6, 8, by adding a subdivision; 254A.03, subdivision 2;
1.16      254B.06, subdivision 2; 256.975, subdivision 7b; 256B.04, by adding a subdivision;
1.17      256B.05, subdivision 1; 256B.0623, subdivisions 1, 3, 12, by adding a subdivision;
1.18      256B.0624, subdivisions 1, 4, by adding a subdivision; 256B.0625, subdivisions
1.19      3c, 3d, 17b, by adding subdivisions; 256B.073, subdivisions 1, 2, 3, 5, by adding
1.20      subdivisions; 256B.0761, subdivision 2; 256B.0911, subdivisions 26, 32;
1.21      256B.0943, subdivisions 2, 5a; 256B.4905, subdivisions 11, 12; 256B.4912, by
1.22      adding subdivisions; 256B.4914, subdivisions 6, 6a, 6b, 6d, 7a, 7b, 7c, by adding
1.23      subdivisions; 256B.492, by adding a subdivision; 256B.69, subdivision 1; 256R.10,
1.24      subdivision 8; 256R.23, subdivision 5; 256S.21, by adding subdivisions; 297E.02,
1.25      subdivision 3; Minnesota Statutes 2025 Supplement, sections 142A.09, subdivision
1.26      1; 142B.05, subdivision 3; 142B.10, subdivision 14; 144.0724, subdivisions 2, 11;
1.27      245.4661, subdivision 9; 245A.03, subdivision 2; 245A.04, subdivision 7; 245A.05;
1.28      245A.07, subdivision 3; 245A.10, subdivisions 3, 4; 245C.02, subdivision 15a;
1.29      245C.05, subdivisions 5, 5a; 245C.08, subdivision 1; 245C.10, subdivisions 9, 22;
1.30      245C.13, subdivision 2; 245C.16, subdivision 1; 245C.22, subdivision 5; 245I.04,
1.31      subdivisions 5, 17; 254B.02, subdivision 5; 254B.03, subdivision 4; 254B.0503,
1.32      subdivision 1; 254B.0509, subdivision 2; 256.01, subdivision 2; 256.4792,
1.33      subdivisions 1, 7, by adding a subdivision; 256B.04, subdivision 21; 256B.0625,
1.34      subdivisions 5m, 17; 256B.0632, by adding a subdivision; 256B.0911, subdivision
1.35      14; 256B.0943, subdivisions 3, 12; 256B.4914, subdivisions 3, 5a, 5b; 256I.04,
1.36      subdivision 2c; 256R.23, subdivisions 7, 8; 256R.24, subdivision 3; 256R.38;
1.37      256S.205, subdivisions 2, 3, 5, 7; 260E.14, subdivision 1; 626.5572, subdivision
1.38      13; Laws 2024, chapter 125, article 8, section 2, subdivisions 4, 14, as amended;
1
       04/06/26  REVISOR      DTT/CH  26-08138  as introduced
2.1Laws 2025, First Special Session chapter 9, article 4, sections 2; 23; 38; 39; 40;
2.241; 42; 43; 44; 50; 51; proposing coding for new law in Minnesota Statutes, chapters
2.3245A; 245I; 256B; repealing Minnesota Statutes 2024, sections 245.735,
2.4subdivisions 1a, 2a, 3a, 3b, 3c, 3d, 3e, 3f, 3g, 3h, 4a, 4b, 4c, 4e, 7, 8; 245A.70;
2.5245A.71; 245A.72; 245A.73; 245A.74; 245A.75; 245C.03, subdivisions 3a, 3b,
2.65, 6a, 7, 9a; 245C.04, subdivisions 2, 3, 4, 5, 7, 8, 9, 10, 11; 245D.261; 245I.20,
2.7subdivision 9; 245I.23, subdivision 23; 256.975, subdivision 7d; 256B.0371,
2.8subdivisions 1, 2, 4; 256B.055, subdivision 14; 256B.0623, subdivisions 2, 4, 5,
2.96, 9; 256B.0624, subdivisions 2, 3, 4a, 5, 6, 6a, 6b, 7, 8, 9, 11; 256B.073,
2.10      subdivision 4; 256B.0911, subdivision 21; 256B.0921; 256B.0943, subdivisions
2.11      4, 5, 5a, 6, 7, 11; 256B.4914, subdivision 6c; 256R.40, subdivisions 1, 2, 3, 4, 6,
2.12      7; 256R.42; 256S.205, subdivision 4; Minnesota Statutes 2025 Supplement, sections
2.13      245.735, subdivisions 3, 4d; 245C.04, subdivisions 6, 12, 13; 256B.0371,
2.14      subdivision 3; 256B.0943, subdivisions 1, 9; 256B.695; 256B.696; 256R.25,
2.15      subdivision 6; 256R.40, subdivision 5; Laws 2025, First Special Session chapter
2.16      9, article 2, section 68.
2.17 BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF MINNESOTA:
2.18ARTICLE 1
2.19AGING AND DISABILITY SERVICES
2.20   Section 1. Minnesota Statutes 2025 Supplement, section 144.0724, subdivision 2, is
2.21 amended to read:
2.22     Subd. 2. Definitions. For purposes of this section, the following terms have the meanings
2.23 given.
2.24     (a) "Assessment reference date" or "ARD" means the specific end point for look-back
2.25 periods in the MDS assessment process. This look-back period is also called the observation
2.26 or assessment period.
2.27     (b) "Case mix index" means the weighting factors assigned to the case mix reimbursement
2.28 classifications determined by an assessment.
2.29     (c) "Index maximization" means classifying a resident who could be assigned to more
2.30 than one category, to the category with the highest case mix index.
2.31     (d) "Minimum Data Set" or "MDS" means a core set of screening, clinical assessment,
2.32 and functional status elements, that include common definitions and coding categories
2.33 specified by the Centers for Medicare and Medicaid Services and designated by the
2.34 Department of Health.
2.35     (e) "Representative" means a person who is the resident's guardian or conservator, the
2.36 person authorized to pay the nursing home expenses of the resident, a representative of the
2.37 Office of Ombudsman for Long-Term Care whose assistance has been requested, or any
2.38 other individual designated by the resident.
       Article 1 Section 1.  2
       04/06/26  REVISOR      DTT/CH  26-08138  as introduced
3.1      (f) "Activities of daily living" or "ADL" includes personal hygiene, dressing, bathing,
3.2  transferring, bed mobility, locomotion, eating, and toileting.
3.3      (g) "Nursing facility level of care determination" means the assessment process that
3.4  results in a determination of a resident's or prospective resident's need for nursing facility
3.5  level of care as established in subdivision 11 for purposes of medical assistance payment
3.6  of long-term care services for:
3.7      (1) nursing facility services under chapter 256R;
3.8      (2) elderly waiver services under chapter 256S;
3.9      (3) CADI and BI waiver services under section 256B.49; and
3.10     (4) state payment of alternative care services under section 256B.0913.
3.11 This paragraph expires upon the effective date of paragraph (h).
3.12     (h) Effective January 1, 2027, or upon federal approval, whichever is later, "nursing
3.13 facility level of care determination" means the assessment process that results in a
3.14 determination of a resident's or prospective resident's need for nursing facility level of care:
3.15     (1) as established in subdivision 11 for purposes of medical assistance payment of
3.16 long-term care services for:
3.17     (i) nursing facility services under chapter 256R;
3.18     (ii) elderly waiver services under chapter 256S; and
3.19     (iii) state payment of alternative care services under section 256B.0913; and
3.20     (2) as established in subdivision 11a for purposes of medical assistance payment of
3.21 long-term care services for brain injury and community access for disability and inclusion
3.22 waivers under section 256B.49.
3.23     (h) (i) "Patient Driven Payment Model" or "PDPM" means the case mix reimbursement
3.24 classification system for residents in nursing facilities based on the resident's condition,
3.25 diagnosis, and the care the resident received at the time of the MDS assessment with an
3.26 ARD on or after October 1, 2025.
3.27     (i) (j) "Resource utilization group" or "RUG" means the case mix reimbursement
3.28 classification system for residents in nursing facilities according to the resident's clinical
3.29 and functional status as reflected in data supplied by the facility's MDS with an ARD on or
3.30 before September 30, 2025.
3.31     EFFECTIVE DATE. This section is effective the day following final enactment.
       Article 1 Section 1.  3
       04/06/26  REVISOR  DTT/CH  26-08138  as introduced
4.1    Sec. 2. Minnesota Statutes 2025 Supplement, section 144.0724, subdivision 11, is amended
4.2  to read:
4.3      Subd. 11. Nursing facility level of care. (a) For purposes of medical assistance payment
4.4  of long-term care services, a recipient must be determined, using assessments defined in
4.5  subdivision 4, to meet one of the following nursing facility level of care criteria:
4.6      (1) the person requires formal clinical monitoring at least once per day;
4.7      (2) the person needs the assistance of another person or constant supervision to begin
4.8  and complete at least four of the following activities of living: bathing, bed mobility, dressing,
4.9  eating, grooming, toileting, transferring, and walking;
4.10     (3) the person needs the assistance of another person or constant supervision to begin
4.11 and complete toileting, transferring, or positioning and the assistance cannot be scheduled;
4.12     (4) the person has significant difficulty with memory, using information, daily decision
4.13 making, or behavioral needs that require intervention;
4.14     (5) the person has had a qualifying nursing facility stay of at least 90 days;
4.15     (6) the person meets the nursing facility level of care criteria determined 90 days after
4.16 admission or on the first quarterly assessment after admission, whichever is later; or
4.17     (7) the person is determined to be at risk for nursing facility admission or readmission
4.18 through a face-to-face long-term care consultation assessment as specified in section
4.19 256B.0911, subdivision 17 to 21, 23, 24, 27, or 28, by a county, Tribe, or managed care
4.20 organization under contract with the Department of Human Services. The person is
4.21 considered at risk under this clause if the person currently lives alone or will live alone or
4.22 be homeless without the person's current housing and also meets one of the following criteria:
4.23     (i) the person has experienced a fall resulting in a fracture;
4.24     (ii) the person has been determined to be at risk of maltreatment or neglect, including
4.25 self-neglect; or
4.26     (iii) the person has a sensory impairment that substantially impacts functional ability
4.27 and maintenance of a community residence.
4.28     (b) The assessment used to establish medical assistance payment for nursing facility
4.29 services must be the most recent assessment performed under subdivision 4, paragraph (b),
4.30 that occurred no more than 90 calendar days before the effective date of medical assistance
4.31 eligibility for payment of long-term care services. In no case shall medical assistance payment
       Article 1 Sec. 2.  4
       04/06/26  REVISOR  DTT/CH  26-08138  as introduced
5.1  for long-term care services occur prior to the date of the determination of nursing facility
5.2  level of care.
5.3(c) The assessment used to establish medical assistance payment for long-term care
5.4  services provided under chapter 256S and section 256B.49 and alternative care payment
5.5  for services provided under section 256B.0913 must be the most recent face-to-face
5.6  assessment performed under section 256B.0911, subdivision 17 to 21, 23, 24, 27, or 28,
5.7  that occurred no more than one calendar year before the effective date of medical assistance
5.8  eligibility for payment of long-term care services.
5.9EFFECTIVE DATE. This section is effective January 1, 2027.
5.10   Sec. 3. Minnesota Statutes 2024, section 144.0724, is amended by adding a subdivision
5.11 to read:
5.12Subd. 11a. Nursing facility level of care; BI and CADI waivers. (a) Effective January
5.13 1, 2027, or upon federal approval, whichever is later, a determination of need for nursing
5.14 facility level of care for brain injury and community access for disability and inclusion
5.15 waivers under section 256B.49 must meet one of the following criteria:
5.16(1) the person needs the assistance of another person or constant supervision to begin
5.17 and complete at least four of the following activities of living: bathing, bed mobility, dressing,
5.18 eating, grooming, toileting, transferring, and walking;
5.19(2) the person needs the assistance of another person or constant supervision to begin
5.20 and complete toileting, transferring, or positioning and the assistance cannot be scheduled;
5.21 or
5.22(3) the person has significant difficulty with memory, using information, daily decision
5.23 making, or behavioral needs that require intervention.
5.24(b) Nursing facility level of care determinations for purposes of initial and ongoing
5.25 access to brain injury and community access for disability inclusion waiver programs must
5.26 be conducted by a MnCHOICES certified assessor in a manner determined by the
5.27 commissioner.
5.28EFFECTIVE DATE. This section is effective the day following final enactment.
5.29   Sec. 4. Minnesota Statutes 2024, section 245A.03, subdivision 7, is amended to read:
5.30Subd. 7. Licensing moratorium. (a) The commissioner shall not issue an initial license
5.31 for child foster care licensed under Minnesota Rules, parts 2960.3000 to 2960.3340, which
       Article 1 Sec. 4.  5
       04/06/26  REVISOR  DTT/CH  26-08138  as introduced
6.1  does not include child foster residence settings with residential program certifications for
6.2  compliance with the Family First Prevention Services Act under section 245A.25, subdivision
6.3  1, paragraph (a), or adult foster care licensed under Minnesota Rules, parts 9555.5105 to
6.4  9555.6265, under this chapter for a physical location that will not be the primary residence
6.5  of the license holder for the entire period of licensure. If a child foster residence setting that
6.6  was previously exempt from the licensing moratorium under this paragraph has its Family
6.7  First Prevention Services Act certification rescinded under section 245A.25, subdivision 9,
6.8  or if a family adult foster care home license is issued during this moratorium, and the license
6.9  holder changes the license holder's primary residence away from the physical location of
6.10 the foster care license, the commissioner shall revoke the license according to section
6.11 245A.07. The commissioner shall not issue an initial license for a community residential
6.12 setting licensed under chapter 245D. When approving an exception under this paragraph,
6.13 the commissioner shall consider the resource need determination process in paragraph (h),
6.14 the availability of foster care licensed beds in the geographic area in which the licensee
6.15 seeks to operate, the results of a person's choices during their annual assessment and service
6.16 plan review, and the recommendation of the local county board. The determination by the
6.17 commissioner is final and not subject to appeal. Exceptions to the moratorium include:
6.18(1) a license for a person in a foster care setting that is not the primary residence of the
6.19 license holder and where at least 80 percent of the residents are 55 years of age or older;
6.20(2) foster care licenses replacing foster care licenses in existence on May 15, 2009, or
6.21 community residential setting licenses replacing adult foster care licenses in existence on
6.22 December 31, 2013, and determined to be needed by the commissioner under paragraph
6.23 (b);
6.24(3) new foster care licenses or community residential setting licenses determined to be
6.25 needed by the commissioner under paragraph (b) for the closure of a nursing facility, ICF/DD,
6.26 or regional treatment center; restructuring of state-operated services that limits the capacity
6.27 of state-operated facilities; or allowing movement to the community for people who no
6.28 longer require the level of care provided in state-operated facilities as provided under section
6.29 256B.092, subdivision 13, or 256B.49, subdivision 24;
6.30(4) new foster care licenses or community residential setting licenses determined to be
6.31 needed by the commissioner under paragraph (b) for persons requiring hospital-level care;
6.32 or
6.33(5) new community residential setting licenses determined necessary by the commissioner
6.34 for people affected by the closure of homes with a capacity of five or six beds currently
       Article 1 Sec. 4.  6
       04/06/26  REVISOR  DTT/CH  26-08138  as introduced
7.1  licensed as supervised living facilities licensed under Minnesota Rules, chapter 4665, but
7.2  not designated as intermediate care facilities. This exception is available until June 30, 2025.
7.3      (b) The commissioner shall determine the need for newly licensed foster care homes or
7.4  community residential settings as defined under this subdivision. As part of the determination,
7.5  the commissioner shall consider the availability of foster care capacity in the area in which
7.6  the licensee seeks to operate, and the recommendation of the local county board. The
7.7  determination by the commissioner must be final. A determination of need is not required
7.8  for a change in ownership at the same address.
7.9      (c) When an adult resident served by the program moves out of a foster home that is not
7.10 the primary residence of the license holder according to section 256B.49, subdivision 15,
7.11 paragraph (f), or the adult community residential setting, the county shall immediately
7.12 inform the Department of Human Services Licensing Division. The department may decrease
7.13 the statewide licensed capacity for adult foster care settings.
7.14     (d) Residential settings that would otherwise be subject to the decreased license capacity
7.15 established in paragraph (c) must be exempt if the license holder's beds are occupied by
7.16 residents whose primary diagnosis is mental illness and the license holder is certified under
7.17 the requirements in subdivision 6a or section 245D.33.
7.18     (e) A resource need determination process, managed at the state level, using the available
7.19 data required by section 144A.351, and other data and information must be used to determine
7.20 where the reduced capacity determined under section 256B.493 will be implemented. The
7.21 commissioner shall consult with the stakeholders described in section 144A.351, and employ
7.22 a variety of methods to improve the state's capacity to meet the informed decisions of those
7.23 people who want to move out of corporate foster care or community residential settings,
7.24 long-term service needs within budgetary limits, including seeking proposals from service
7.25 providers or lead agencies to change service type, capacity, or location to improve services,
7.26 increase the independence of residents, and better meet needs identified by the long-term
7.27 services and supports reports and statewide data and information.
7.28     (f) At the time of application and reapplication for licensure, the applicant and the license
7.29 holder that are subject to the moratorium or an exclusion established in paragraph (a) are
7.30 required to inform the commissioner whether the physical location where the foster care
7.31 will be provided is or will be the primary residence of the license holder for the entire period
7.32 of licensure. If the primary residence of the applicant or license holder changes, the applicant
7.33 or license holder must notify the commissioner immediately. The commissioner shall print
       Article 1 Sec. 4.  7
       04/06/26  REVISOR  DTT/CH  26-08138  as introduced
8.1  on the foster care license certificate whether or not the physical location is the primary
8.2  residence of the license holder.
8.3      (g) License holders of foster care homes identified under paragraph (f) that are not the
8.4  primary residence of the license holder and that also provide services in the foster care home
8.5  that are covered by a federally approved home and community-based services waiver, as
8.6  authorized under chapter 256S or section 256B.092 or 256B.49, must inform the human
8.7  services licensing division that the license holder provides or intends to provide these
8.8  waiver-funded services.
8.9      (h) The commissioner may adjust capacity to address needs identified in section
8.10 144A.351. Under this authority, the commissioner may approve new licensed settings or
8.11 delicense existing settings. Delicensing of settings will be accomplished through a process
8.12 identified in section 256B.493.
8.13     (i) The commissioner must notify a license holder when its corporate foster care or
8.14 community residential setting licensed beds are reduced under this section. The notice of
8.15 reduction of licensed beds must be in writing and delivered to the license holder by certified
8.16 mail or personal service. The notice must state why the licensed beds are reduced and must
8.17 inform the license holder of its right to request reconsideration by the commissioner. The
8.18 license holder's request for reconsideration must be in writing. If mailed, the request for
8.19 reconsideration must be postmarked and sent to the commissioner within 20 calendar days
8.20 after the license holder's receipt of the notice of reduction of licensed beds. If a request for
8.21 reconsideration is made by personal service, it must be received by the commissioner within
8.22 20 calendar days after the license holder's receipt of the notice of reduction of licensed beds.
8.23     (j) The commissioner shall not issue an initial license for children's residential treatment
8.24 services licensed under Minnesota Rules, parts 2960.0580 to 2960.0700, under this chapter
8.25 for a program that Centers for Medicare and Medicaid Services would consider an institution
8.26 for mental diseases. Facilities that serve only private pay clients are exempt from the
8.27 moratorium described in this paragraph. The commissioner has the authority to manage
8.28 existing statewide capacity for children's residential treatment services subject to the
8.29 moratorium under this paragraph and may issue an initial license for such facilities if the
8.30 initial license would not increase the statewide capacity for children's residential treatment
8.31 services subject to the moratorium under this paragraph.
8.32     (k) Except as permitted in this paragraph, the commissioner must not issue an initial
8.33 license under chapter 245D authorizing integrated community supports under section
8.34 245D.03, subdivision 1, paragraph (c), clause (8), and must not approve a license change
       Article 1 Sec. 4.  8
       04/06/26  REVISOR  DTT/CH  26-08138  as introduced
9.1  adding integrated community supports to an existing license under chapter 245D. The
9.2  commissioner may approve an exception to the moratorium only when the applicant or
9.3  licensee meets all requirements under section 245D.12, the request is not superseded by
9.4  temporary moratoriums under section 245A.03, subdivision 7a, and the applicant submits
9.5  documentation demonstrating compliance with:
9.6      (1) federal and state home and community-based services requirements for
9.7  provider-controlled settings;
9.8      (2) the prohibition on the use of Medicaid money for room and board under section
9.9  256B.4912, subdivision 17, including the requirement that the provider not pay, subsidize,
9.10 offset, or otherwise financially contribute to rent, utilities, or other housing costs; and
9.11     (3) all licensing requirements applicable to integrated community supports under chapter
9.12 245D. In determining whether to approve an exception, the commissioner must consider
9.13 statewide and regional capacity for integrated community supports based on
9.14 needs-determination processes under paragraph (e). A determination under this paragraph
9.15 is final and not subject to appeal.
9.16     EFFECTIVE DATE. This section is effective January 1, 2027.
9.17   Sec. 5. Minnesota Statutes 2025 Supplement, section 256.4792, subdivision 1, is amended
9.18 to read:
9.19     Subdivision 1. Long-term services and supports loan program. The commissioner
9.20 of human services shall establish a loan program to provide operating loans to eligible
9.21 long-term services and supports providers. The commissioner shall initiate the application
9.22 process for the loan described in this section on an ongoing basis. The commissioner must
9.23 not issue any new loans under this program after July 1, 2026.
9.24   Sec. 6. Minnesota Statutes 2025 Supplement, section 256.4792, subdivision 7, is amended
9.25 to read:
9.26     Subd. 7. Loan repayment. (a) If a borrower is more than 60 calendar days delinquent
9.27 in the timely payment of a contractual payment under this section, the provisions in
9.28 paragraphs (b) to (e) apply.
9.29     (b) The commissioner may withhold some or all of the amount of the delinquent loan
9.30 payment, together with any penalties due and owing on those amounts, from any money
9.31 the department owes to the borrower. The commissioner may, at the commissioner's
9.32 discretion, also withhold future contractual payments from any money the commissioner
       Article 1 Sec. 6.  9
04/06/26  REVISOR  DTT/CH  26-08138  as introduced
10.1  owes the provider as those contractual payments become due and owing. The commissioner
10.2  may continue this withholding until the commissioner determines there is no longer any
10.3  need to do so.
10.4      (c) The commissioner shall give prior notice of the commissioner's intention to withhold
10.5  by mail, facsimile, or email at least ten business days before the date of the first payment
10.6  period for which the withholding begins. The notice must be deemed received as of the date
10.7  of mailing or receipt of the facsimile or electronic notice. The notice must state:
10.8      (1) the amount of the delinquent contractual payment;
10.9      (2) the amount of the withholding per payment period;
10.10     (3) the date on which the withholding is to begin;
10.11     (4) whether the commissioner intends to withhold future installments of the provider's
10.12 contractual payments; and
10.13     (5) other contents as the commissioner deems appropriate.
10.14     (d) The commissioner, or the commissioner's designee, may enter into written settlement
10.15 agreements with a provider to resolve disputes and other matters involving unpaid loan
10.16 contractual payments or future loan contractual payments.
10.17     (e) Notwithstanding any law to the contrary, all unpaid loans, plus any accrued penalties,
10.18 are overpayments for the purposes of section 256B.0641, subdivision 1. The current long-term
10.19 services and supports provider is liable for the overpayment amount owed by a former owner
10.20 for any provider sold, transferred, or reorganized.
10.21     (f) By January 15 each year, the commissioner must provide a report to the chairs and
10.22 ranking minority members of the legislative committees with jurisdiction over nursing
10.23 facilities of all facilities that are delinquent in their repayments. The reporting required
10.24 under this paragraph expires upon notification by the commissioner to the committees that
10.25 there are no outstanding balances from loan awards issued under this subdivision.
10.26   Sec. 7. Minnesota Statutes 2025 Supplement, section 256.4792, is amended by adding a
10.27 subdivision to read:
10.28     Subd. 11. Loan program expiration. After the commissioner collects all loan repayments
10.29 incurred on or before July 1, 2026, this section expires. The commissioner must notify the
10.30 revisor of statutes once all loan repayments under this section are collected.
Article 1 Sec. 7.  10
04/06/26  REVISOR  DTT/CH  26-08138  as introduced
11.1    Sec. 8. Minnesota Statutes 2024, section 256.975, subdivision 7b, is amended to read:
11.2      Subd. 7b. Exemptions and emergency admissions. (a) Exemptions from the federal
11.3  screening requirements outlined in subdivision 7a, paragraphs (b) and (c), are limited to:
11.4      (1) a person who, having entered an acute care facility from a certified nursing facility,
11.5  is returning to a certified nursing facility; or
11.6      (2) a person transferring from one certified nursing facility in Minnesota to another
11.7  certified nursing facility in Minnesota.
11.8      (b) Persons who are exempt from preadmission screening for purposes of level of care
11.9  determination include:
11.10     (1) persons described in paragraph (a);
11.11     (2) an individual who has a contractual right to have nursing facility care paid for
11.12 indefinitely by the Veterans Administration; and
11.13     (3) an individual enrolled in a demonstration project under section 256B.69, subdivision
11.14 8, at the time of application to a nursing facility; and.
11.15     (4) an individual currently being served under the alternative care program or under a
11.16 home and community-based services waiver authorized under section 1915(c) of the federal
11.17 Social Security Act.
11.18     (c) Persons admitted to a Medicaid-certified nursing facility from the community on an
11.19 emergency basis as described in paragraph (d) or from an acute care facility on a nonworking
11.20 day must be screened the first working day after admission.
11.21     (d) Emergency admission to a nursing facility prior to screening is permitted when all
11.22 of the following conditions are met:
11.23     (1) a person is admitted from the community to a certified nursing or certified boarding
11.24 care facility during Senior LinkAge Line nonworking hours;
11.25     (2) a physician, advanced practice registered nurse, or physician assistant has determined
11.26 that delaying admission until preadmission screening is completed would adversely affect
11.27 the person's health and safety;
11.28     (3) there is a recent precipitating event that precludes the client from living safely in the
11.29 community, such as sustaining an injury, sudden onset of acute illness, or a caregiver's
11.30 inability to continue to provide care;
Article 1 Sec. 8.  11
04/06/26  REVISOR  DTT/CH  26-08138  as introduced
12.1      (4) the attending physician, advanced practice registered nurse, or physician assistant
12.2  has authorized the emergency placement and has documented the reason that the emergency
12.3  placement is recommended; and
12.4      (5) the Senior LinkAge Line is contacted on the first working day following the
12.5  emergency admission.
12.6      (e) Transfer of a patient from an acute care hospital to a nursing facility is not considered
12.7  an emergency except for a person who has received hospital services in the following
12.8  situations: hospital admission for observation, care in an emergency room without hospital
12.9  admission, or following hospital 24-hour bed care and from whom admission is being sought
12.10 on a nonworking day.
12.11     (f) A nursing facility must provide written information to all persons admitted regarding
12.12 the person's right to request and receive long-term care consultation services as defined in
12.13 section 256B.0911, subdivision 11. The information must be provided prior to the person's
12.14 discharge from the facility and in a format specified by the commissioner.
12.15     EFFECTIVE DATE. This section is effective January 1, 2027.
12.16   Sec. 9. Minnesota Statutes 2024, section 256B.0623, is amended by adding a subdivision
12.17 to read:
12.18     Subd. 15. Billing limits. The maximum billable units for adult rehabilitation mental
12.19 health services under this section without authorization from the commissioner are:
12.20     (1) four hours per week per recipient combined total of H2017, H2017 HM, and H2017
12.21 HQ;
12.22     (2) 18 hours per month per recipient combined total of H2017, H2017 HM, and H2017
12.23 HQ; or
12.24     (3) 200 hours per year per recipient combined total of H2017, H2017 HM, and H2017
12.25 HQ.
12.26   Sec. 10. Minnesota Statutes 2025 Supplement, section 256B.0625, subdivision 17, is
12.27 amended to read:
12.28     Subd. 17. Transportation costs. (a) "Nonemergency medical transportation service"
12.29 means motor vehicle transportation provided by a public or private person that serves
12.30 Minnesota health care program beneficiaries who do not require emergency ambulance
12.31 service, as defined in section 144E.001, subdivision 3, to obtain covered medical services.
Article 1 Sec. 10.  12
04/06/26  REVISOR        DTT/CH  26-08138  as introduced
13.1      (b) For purposes of this subdivision, "rural urban commuting area" or "RUCA" means
13.2  a census-tract based classification system under which a geographical area is determined
13.3  to be urban, rural, or super rural. This paragraph expires July 1, 2026, for medical assistance
13.4  fee-for-service and January 1, 2027, for prepaid medical assistance.
13.5      (c) Medical assistance covers medical transportation costs incurred solely for obtaining
13.6  emergency medical care or transportation costs incurred by eligible persons in obtaining
13.7  emergency or nonemergency medical care when paid directly to an ambulance company,
13.8  nonemergency medical transportation company, or other recognized providers of
13.9  transportation services. Medical transportation must be provided by:
13.10     (1) nonemergency medical transportation providers who meet the requirements of this
13.11 subdivision;
13.12     (2) ambulances, as defined in section 144E.001, subdivision 2;
13.13     (3) taxicabs that meet the requirements of this subdivision;
13.14     (4) public transportation, within the meaning of "public transportation" as defined in
13.15 section 174.22, subdivision 7; or
13.16     (5) not-for-hire vehicles, including volunteer drivers, as defined in section 65B.472,
13.17 subdivision 1, paragraph (p).
13.18     (d) Medical assistance covers nonemergency medical transportation provided by
13.19 nonemergency medical transportation providers enrolled in the Minnesota health care
13.20 programs. All nonemergency medical transportation providers must comply with the
13.21 operating standards for special transportation service as defined in sections 174.29 to 174.30
13.22 and Minnesota Rules, chapter 8840, and all drivers must be individually enrolled with the
13.23 commissioner and reported on the claim as the individual who provided the service. All
13.24 nonemergency medical transportation providers shall bill for nonemergency medical
13.25 transportation services in accordance with Minnesota health care programs criteria. Publicly
13.26 operated transit systems, volunteers, and not-for-hire vehicles are exempt from the
13.27 requirements outlined in this paragraph. This paragraph expires upon the effective date of
13.28 paragraph (e).
13.29     (e) Effective January 1, 2027, or upon federal approval, whichever is later, medical
13.30 assistance covers nonemergency medical transportation provided by nonemergency medical
13.31 transportation providers enrolled in the Minnesota health care programs. All nonemergency
13.32 medical transportation providers must comply with the operating standards for special
13.33 transportation service as defined in sections 174.29 to 174.30 and Minnesota Rules, chapter
Article 1 Sec. 10.  13
04/06/26  REVISOR        DTT/CH  26-08138  as introduced
14.1  8840, and all drivers must be individually enrolled with the commissioner and reported on
14.2  the claim as the individual who provided the service. All nonemergency medical
14.3  transportation providers shall bill for nonemergency medical transportation services in
14.4  accordance with Minnesota health care programs criteria and comply with the requirements
14.5  of section 256B.073. Publicly operated transit systems, volunteers, and not-for-hire vehicles
14.6  are exempt from the requirements outlined in this paragraph.
14.7      (e) (f) An organization may be terminated, denied, or suspended from enrollment if:
14.8      (1) the provider has not initiated background studies on the individuals specified in
14.9  section 174.30, subdivision 10, paragraph (a), clauses (1) to (3); or
14.10     (2) the provider has initiated background studies on the individuals specified in section
14.11 174.30, subdivision 10, paragraph (a), clauses (1) to (3), and:
14.12     (i) the commissioner has sent the provider a notice that the individual has been
14.13 disqualified under section 245C.14; and
14.14     (ii) the individual has not received a disqualification set-aside specific to the special
14.15 transportation services provider under sections 245C.22 and 245C.23.
14.16     (f) (g) The administrative agency of nonemergency medical transportation must:
14.17     (1) adhere to the policies defined by the commissioner;
14.18     (2) pay nonemergency medical transportation providers for services provided to
14.19 Minnesota health care programs beneficiaries to obtain covered medical services;
14.20     (3) provide data monthly to the commissioner on appeals, complaints, no-shows, canceled
14.21 trips, and number of trips by mode; and
14.22     (4) by July 1, 2016, in accordance with subdivision 18e, utilize a web-based single
14.23 administrative structure assessment tool that meets the technical requirements established
14.24 by the commissioner, reconciles trip information with claims being submitted by providers,
14.25 and ensures prompt payment for nonemergency medical transportation services. This
14.26 paragraph expires July 1, 2026, for medical assistance fee-for-service and January 1, 2027,
14.27 for prepaid medical assistance.
14.28     (g) (h) Effective July 1, 2026, for medical fee-for-service and January 1, 2027, for prepaid
14.29 medical assistance, the administrative agency of nonemergency medical transportation must:
14.30     (1) adhere to the policies defined by the commissioner;
14.31     (2) pay nonemergency medical transportation providers for services provided to
14.32 Minnesota health care program beneficiaries to obtain covered medical services; and
Article 1 Sec. 10.  14
04/06/26  REVISOR  DTT/CH  26-08138  as introduced
15.1      (3) provide data monthly to the commissioner on appeals, complaints, no-shows, canceled
15.2  trips, and number of trips by mode.
15.3      (h) (i) Until the commissioner implements the single administrative structure and delivery
15.4  system under subdivision 18e, clients shall obtain their level-of-service certificate from the
15.5  commissioner or an entity approved by the commissioner that does not dispatch rides for
15.6  clients using modes of transportation under paragraph (n) (o), clauses (4), (5), (6), and (7).
15.7  This paragraph expires July 1, 2026, for medical assistance fee-for-service and January 1,
15.8  2027, for prepaid medical assistance.
15.9      (i) (j) The commissioner may use an order by the recipient's attending physician, advanced
15.10 practice registered nurse, physician assistant, or a medical or mental health professional to
15.11 certify that the recipient requires nonemergency medical transportation services.
15.12 Nonemergency medical transportation providers shall perform driver-assisted services for
15.13 eligible individuals, when appropriate. Driver-assisted service includes passenger pickup
15.14 at and return to the individual's residence or place of business, assistance with admittance
15.15 of the individual to the medical facility, and assistance in passenger securement or in securing
15.16 of wheelchairs, child seats, or stretchers in the vehicle.
15.17     (j) (k) Nonemergency medical transportation providers must take clients to the health
15.18 care provider using the most direct route, and must not exceed 30 miles for a trip to a primary
15.19 care provider or 60 miles for a trip to a specialty care provider, unless the client receives
15.20 authorization from the local agency. This paragraph expires July 1, 2026, for medical
15.21 assistance fee-for-service and January 1, 2027, for prepaid medical assistance.
15.22     (k) (l) Effective July 1, 2026, for medical assistance fee-for-service and January 1, 2027,
15.23 for prepaid medical assistance, nonemergency medical transportation providers must take
15.24 clients to the health care provider using the most direct route and must not exceed 30 miles
15.25 for a trip to a primary care provider or 60 miles for a trip to a specialty care provider, unless
15.26 the client receives authorization from the administrator.
15.27     (l) (m) Nonemergency medical transportation providers may not bill for separate base
15.28 rates for the continuation of a trip beyond the original destination. Nonemergency medical
15.29 transportation providers must maintain trip logs, which include pickup and drop-off times,
15.30 signed by the medical provider or client, whichever is deemed most appropriate, attesting
15.31 to mileage traveled to obtain covered medical services. Clients requesting client mileage
15.32 reimbursement must sign the trip log attesting mileage traveled to obtain covered medical
15.33 services.
Article 1 Sec. 10.  15
04/06/26  REVISOR  DTT/CH  26-08138  as introduced
16.1      (m) (n) The administrative agency shall use the level of service process established by
16.2  the commissioner to determine the client's most appropriate mode of transportation. If public
16.3  transit or a certified transportation provider is not available to provide the appropriate service
16.4  mode for the client, the client may receive a onetime service upgrade.
16.5      (n) (o) The covered modes of transportation are:
16.6      (1) client reimbursement, which includes client mileage reimbursement provided to
16.7  clients who have their own transportation, or to family or an acquaintance who provides
16.8  transportation to the client;
16.9      (2) volunteer transport, which includes transportation by volunteers using their own
16.10 vehicle;
16.11     (3) unassisted transport, which includes transportation provided to a client by a taxicab
16.12 or public transit. If a taxicab or public transit is not available, the client can receive
16.13 transportation from another nonemergency medical transportation provider;
16.14     (4) assisted transport, which includes transport provided to clients who require assistance
16.15 by a nonemergency medical transportation provider;
16.16     (5) lift-equipped/ramp transport, which includes transport provided to a client who is
16.17 dependent on a device and requires a nonemergency medical transportation provider with
16.18 a vehicle containing a lift or ramp;
16.19     (6) protected transport, which includes transport provided to a client who has received
16.20 a prescreening that has deemed other forms of transportation inappropriate and who requires
16.21 a provider: (i) with a protected vehicle that is not an ambulance or police car and has safety
16.22 locks, a video recorder, and a transparent thermoplastic partition between the passenger and
16.23 the vehicle driver; and (ii) who is certified as a protected transport provider; and
16.24     (7) stretcher transport, which includes transport for a client in a prone or supine position
16.25 and requires a nonemergency medical transportation provider with a vehicle that can transport
16.26 a client in a prone or supine position.
16.27     (o) (p) The local agency shall be the single administrative agency and shall administer
16.28 and reimburse for modes defined in paragraph (n) (o) according to paragraphs (r) (s) to (t)
16.29 (u) when the commissioner has developed, made available, and funded the web-based single
16.30 administrative structure, assessment tool, and level of need assessment under subdivision
16.31 18e. The local agency's financial obligation is limited to funds provided by the state or
16.32 federal government. This paragraph expires July 1, 2026, for medical assistance
16.33 fee-for-service and January 1, 2027, for prepaid medical assistance.
Article 1 Sec. 10.  16
04/06/26  REVISOR        DTT/CH  26-08138  as introduced
17.1      (p) (q) The commissioner shall:
17.2      (1) verify that the mode and use of nonemergency medical transportation is appropriate;
17.3      (2) verify that the client is going to an approved medical appointment; and
17.4      (3) investigate all complaints and appeals.
17.5      (q) (r) The administrative agency shall pay for the services provided in this subdivision
17.6  and seek reimbursement from the commissioner, if appropriate. As vendors of medical care,
17.7  local agencies are subject to the provisions in section 256B.041, the sanctions and monetary
17.8  recovery actions in section 256B.064, and Minnesota Rules, parts 9505.2160 to 9505.2245.
17.9  This paragraph expires July 1, 2026, for medical assistance fee-for-service and January 1,
17.10 2027, for prepaid medical assistance.
17.11     (r) (s) Payments for nonemergency medical transportation must be paid based on the
17.12 client's assessed mode under paragraph (m) (n), not the type of vehicle used to provide the
17.13 service. The medical assistance reimbursement rates for nonemergency medical transportation
17.14 services that are payable by or on behalf of the commissioner for nonemergency medical
17.15 transportation services are:
17.16     (1) $0.22 per mile for client reimbursement;
17.17     (2) up to 100 percent of the Internal Revenue Service business deduction rate for volunteer
17.18 transport;
17.19     (3) equivalent to the standard fare for unassisted transport when provided by public
17.20 transit, and $12.10 for the base rate and $1.43 per mile when provided by a nonemergency
17.21 medical transportation provider;
17.22     (4) $14.30 for the base rate and $1.43 per mile for assisted transport;
17.23     (5) $19.80 for the base rate and $1.70 per mile for lift-equipped/ramp transport;
17.24     (6) $75 for the base rate and $2.40 per mile for protected transport; and
17.25     (7) $60 for the base rate and $2.40 per mile for stretcher transport, and $9 per trip for
17.26 an additional attendant if deemed medically necessary. This paragraph expires July 1, 2026,
17.27 for medical assistance fee-for-service and January 1, 2027, for prepaid medical assistance.
17.28     (s) (t) Effective July 1, 2026, for medical assistance fee-for-service and January 1, 2027,
17.29 for prepaid medical assistance, payments for nonemergency medical transportation must
17.30 be paid based on the client's assessed mode under paragraph (m) (n), not the type of vehicle
17.31 used to provide the service.
Article 1 Sec. 10.  17
04/06/26  REVISOR  DTT/CH  26-08138  as introduced
18.1      (t) (u) The base rate for nonemergency medical transportation services in areas defined
18.2  under RUCA to be super rural is equal to 111.3 percent of the respective base rate in
18.3  paragraph (r) (s), clauses (1) to (7). The mileage rate for nonemergency medical transportation
18.4  services in areas defined under RUCA to be rural or super rural areas is:
18.5      (1) for a trip equal to 17 miles or less, equal to 125 percent of the respective mileage
18.6  rate in paragraph (r) (s), clauses (1) to (7); and
18.7      (2) for a trip between 18 and 50 miles, equal to 112.5 percent of the respective mileage
18.8  rate in paragraph (r) (s), clauses (1) to (7). This paragraph expires July 1, 2026, for medical
18.9  assistance fee-for-service and January 1, 2027, for prepaid medical assistance.
18.10     (u) (v) For purposes of reimbursement rates for nonemergency medical transportation
18.11 services under paragraphs (r) (s) to (t) (u), the zip code of the recipient's place of residence
18.12 shall determine whether the urban, rural, or super rural reimbursement rate applies. This
18.13 paragraph expires July 1, 2026, for medical assistance fee-for-service and January 1, 2027,
18.14 for prepaid medical assistance.
18.15     (v) (w) The commissioner, when determining reimbursement rates for nonemergency
18.16 medical transportation, shall exempt all modes of transportation listed under paragraph (n)
18.17 (o) from Minnesota Rules, part 9505.0445, item R, subitem (2).
18.18     (w) (x) Effective for the first day of each calendar quarter in which the price of gasoline
18.19 as posted publicly by the United States Energy Information Administration exceeds $3.00
18.20 per gallon, the commissioner shall adjust the rate paid per mile in paragraph (r) (s) by one
18.21 percent up or down for every increase or decrease of ten cents for the price of gasoline. The
18.22 increase or decrease must be calculated using a base gasoline price of $3.00. The percentage
18.23 increase or decrease must be calculated using the average of the most recently available
18.24 price of all grades of gasoline for Minnesota as posted publicly by the United States Energy
18.25 Information Administration. This paragraph expires July 1, 2026, for medical assistance
18.26 fee-for-service and January 1, 2027, for prepaid medical assistance.
18.27     EFFECTIVE DATE. This section is effective the day following final enactment.
18.28   Sec. 11. Minnesota Statutes 2024, section 256B.0625, subdivision 17b, is amended to
18.29 read:
18.30     Subd. 17b. Documentation required. (a) As a condition for payment, nonemergency
18.31 medical transportation providers must document each occurrence of a service provided to
18.32 a recipient according to this subdivision. Providers must maintain records sufficient to
18.33 distinguish individual trips with specific vehicles and drivers. The documentation may be
Article 1 Sec. 11.  18
04/06/26  REVISOR  DTT/CH  26-08138  as introduced
19.1  collected and maintained using electronic systems or software or in paper form but must be
19.2  made available and produced upon request. Program funds paid for transportation that is
19.3  not documented according to this subdivision may be subject to recovery by the commissioner
19.4  pursuant to section 256B.064.
19.5      (b) A nonemergency medical transportation provider must compile transportation trip
19.6  records that are written in English and legible according to the standard of a reasonable
19.7  person and that include each of the following elements:
19.8      (1) the recipient's name;
19.9      (2) the date or dates the service is provided, if different than the date the entry was made;
19.10     (3) either the printed name of the driver sufficient to distinguish the driver of service or
19.11 the driver's provider number;
19.12     (4) the date and the signature of the driver attesting that the record accurately represents
19.13 the services provided and the actual miles driven, and acknowledging that misreporting
19.14 information that results in ineligible or excessive payments may result in civil or criminal
19.15 action;
19.16     (5) the date and the signature of the recipient or authorized party attesting that
19.17 transportation services were provided as indicated on the transportation trip record, or the
19.18 signature of the medical services provider certifying that the recipient was transported to
19.19 the medical services provider destination. In the event that both the medical services provider
19.20 and the recipient or authorized party refuse or are unable to provide signatures, the driver
19.21 must document on the transportation trip record that signatures were requested and not
19.22 provided;
19.23     (6) the address, or the description if the address is not available, of both the origin and
19.24 destination, and the mileage for the most direct route from the origin to the destination;
19.25     (7) the name or number of the mode of transportation in which the service is provided;
19.26     (8) the license plate number of the vehicle used to transport the recipient;
19.27     (9) the time of the recipient pickup;
19.28     (10) the time of the recipient drop-off;
19.29     (11) the odometer reading of the vehicle used to transport the recipient taken at the time
19.30 of pickup;
19.31     (12) the odometer reading of the vehicle used to transport the recipient taken at the time
19.32 of drop-off;
Article 1 Sec. 11.  19
04/06/26  REVISOR  DTT/CH  26-08138  as introduced
20.1      (13) the name of the extra attendant when an extra attendant is used to provide special
20.2  transportation service; and
20.3      (14) the documentation indicating the method that was used to determine the most direct
20.4  route.
20.5      (c) In determining whether the commissioner will seek recovery, the documentation
20.6  requirements in this section apply retroactively to audit findings beginning January 1, 2020,
20.7  and to all audit findings thereafter.
20.8      (d) Effective January 1, 2027, or upon federal approval, whichever is later, records that
20.9  comply with section 256B.073 may be used to meet the requirements of this subdivision if
20.10 all required elements are included in the record.
20.11     EFFECTIVE DATE. This section is effective the day following final enactment.
20.12   Sec. 12. Minnesota Statutes 2025 Supplement, section 256B.0632, is amended by adding
20.13 a subdivision to read:
20.14     Subd. 3a. Billing limits. An individual client must not receive more than 30 days of
20.15 services under this section without prior authorization from the commissioner.
20.16   Sec. 13. Minnesota Statutes 2024, section 256B.073, subdivision 1, is amended to read:
20.17     Subdivision 1. Documentation; establishment and operation. The commissioner of
20.18 human services shall establish implementation requirements and standards for and maintain
20.19 the requirements and standards for the ongoing operation of electronic visit verification to
20.20 comply with the 21st Century Cures Act, Public Law 114-255. Within available
20.21 appropriations, the commissioner shall take steps to comply with the electronic visit
20.22 verification requirements in the 21st Century Cures Act, Public Law 114-255.
20.23   Sec. 14. Minnesota Statutes 2024, section 256B.073, subdivision 2, is amended to read:
20.24     Subd. 2. Definitions. (a) For purposes of this section, the terms in this subdivision have
20.25 the meanings given them.
20.26     (b) "Electronic visit verification" or "EVV" means the electronic documentation of the
20.27 process required under United States Code, title 42, section 1396b(l), and this section used
20.28 to electronically verify:
20.29     (1) type of service performed;
20.30     (2) individual receiving the service;
Article 1 Sec. 14.  20
04/06/26  REVISOR  DTT/CH  26-08138  as introduced
21.1(3) date of the service;
21.2(4) location of the service delivery;
21.3(5) individual providing the service; and
21.4(6) time the service begins and ends.
21.5(c) "Electronic visit verification system" means a system that provides electronic
21.6  verification of services used to collect, verify, and transmit EVV data to the commissioner
21.7  or the commissioner's designated data aggregator that complies with the 21st Century Cures
21.8  Act, Public Law 114-255, and the requirements of subdivision 3.
21.9(d) "Managed care organization" means a public or private organization that contracts
21.10 with the commissioner under section 256B.69 or other applicable law to deliver health care
21.11 services to individuals eligible for medical assistance or MinnesotaCare.
21.12(e) "Provider" means an individual or organization that meets one or more of the following
21.13 conditions:
21.14(1) is enrolled as a Minnesota health care programs provider;
21.15(2) provides services through a managed care organization under contract with the
21.16 commissioner under section 256B.69;
21.17(3) is a financial management services provider; or
21.18(4) is a participant employer under section 256B.85, subdivision 7, or an employer of
21.19 record directing services under section 256B.49, subdivision 16.
21.20(d) (f) "Service" means one of the following:
21.21(1) personal care assistance services as defined in section 256B.0625, subdivision 19a,
21.22 and provided according to section 256B.0659;
21.23(2) community first services and supports under section 256B.85;
21.24(3) home health services under section 256B.0625, subdivision 6a; or
21.25(4) other medical supplies and equipment or home and community-based services that
21.26 are required to be electronically verified by the 21st Century Cures Act, Public Law 114-255.;
21.27 or
21.28(5) other services determined by the commissioner.
21.29(g) "Financial management services provider" means an entity enrolled with the
21.30 commissioner to provide financial management services under section 256B.85 or other
Article 1 Sec. 14.  21
04/06/26  REVISOR  DTT/CH  26-08138  as introduced
22.1  applicable law and responsible for fiscal, payroll, and reporting functions on behalf of
22.2  participant employers.
22.3      (h) "Home health agency" means a home care provider agency that is Medicare certified
22.4  under Code of Federal Regulations, title 42, part 484, and licensed as a home care provider
22.5  under chapter 144A.
22.6      (i) "Worker" means an individual who provides personal care assistance services,
22.7  community first services and supports, home health services, consumer-directed community
22.8  supports, or other services identified by the commissioner as subject to electronic visit
22.9  verification.
22.10     (j) "Individual" means a person who receives services subject to electronic visit
22.11 verification under the medical assistance program.
22.12     (k) "Electronic visit verification data" means information collected through an electronic
22.13 visit verification system, including data elements required under United States Code, title
22.14 42, section 1396b(l), and any additional data elements specified by the commissioner under
22.15 this section.
22.16     (l) "Visit" means a single occurrence of service delivery subject to electronic visit
22.17 verification.
22.18     (m) "Verification method" means the electronic process used to capture and verify visit
22.19 information, including telephone, fixed visit verification devices, or mobile applications,
22.20 as approved by the commissioner.
22.21     (n) "Data aggregator" means the entity designated by the commissioner to collect, store,
22.22 and transmit electronic visit verification data from providers and third-party systems to the
22.23 commissioner in accordance with the standards and requirements established under this
22.24 section.
22.25     (o) "Third-party electronic visit verification system" means an electronic visit verification
22.26 system purchased or operated by a provider or vendor other than the state-provided system
22.27 designated by the commissioner.
22.28     (p) "State-provided electronic visit verification system" means the electronic visit
22.29 verification system made available by the commissioner to providers at no cost for services
22.30 subject to federal electronic visit verification requirements.
22.31     (q) "Electronic visit verification vendor" means any entity that develops, provides, or
22.32 supports an electronic visit verification system, including the state-provided vendor and
22.33 any third-party vendor.
Article 1 Sec. 14.  22
04/06/26  REVISOR  DTT/CH  26-08138  as introduced
23.1    Sec. 15. Minnesota Statutes 2024, section 256B.073, subdivision 3, is amended to read:
23.2      Subd. 3. Requirements. (a) In developing implementation requirements for administering
23.3  electronic visit verification, the commissioner shall must ensure that the system and related
23.4  requirements:
23.5      (1) are minimally administratively and financially burdensome to a provider reasonable
23.6  for providers;
23.7      (2) are minimally burdensome support continued access to the services and are designed
23.8  to avoid disruption to service recipient and the least disruptive to the service recipient in
23.9  receiving and maintaining allowed services delivery or receipt;
23.10     (3) consider existing best practices and use of electronic visit verification;
23.11     (4) are conducted according to all state and federal laws;
23.12     (5) are effective methods for preventing fraud when balanced against the requirements
23.13 of clauses (1) and (2); and
23.14     (6) are consistent with the Department of Human Services' policies related to covered
23.15 services, flexibility of service use, and quality assurance.
23.16     (b) The commissioner shall must make training and guidance available to providers on
23.17 the electronic visit verification system requirements and system use.
23.18     (c) The commissioner shall must establish baseline measurements related to preventing
23.19 fraud and establish measures to determine the effect of electronic visit verification
23.20 requirements on program integrity.
23.21     (d) The commissioner shall must make a state-selected electronic visit verification system
23.22 available to providers of services.
23.23     (e) The commissioner shall must make available and publish on the agency website the
23.24 name and contact information for the vendor of the state-selected electronic visit verification
23.25 system and the other vendors that offer alternative electronic visit verification systems. The
23.26 information provided must state that the state-selected electronic visit verification system
23.27 is offered at no cost to the provider of services and that the provider may choose an alternative
23.28 system that may be at a cost to the provider.
23.29     (f) The commissioner may establish implementation dates and implementation schedules
23.30 for services or system functions subject to electronic visit verification under this section,
23.31 including but not limited to the phased addition of new services, verification methods, or
23.32 technical requirements.
Article 1 Sec. 15.  23
04/06/26  REVISOR        DTT/CH  26-08138  as introduced
24.1      (g) The commissioner may waive the requirements of this section for any service
24.2  component or setting when the application of electronic visit verification is contrary to
24.3  paragraph (a).
24.4    Sec. 16. Minnesota Statutes 2024, section 256B.073, is amended by adding a subdivision
24.5  to read:
24.6      Subd. 4a. Electronic visit verification system options. (a) A provider must use an
24.7  electronic visit verification system that complies with the requirements established by the
24.8  commissioner. A provider may use either the state-provided system or a third-party system.
24.9  All systems used for compliance must provide data to the commissioner in the format and
24.10 frequency required by the commissioner.
24.11     (b) The commissioner must make a state-provided electronic visit verification system
24.12 available at no cost to providers of services. The commissioner must provide training on
24.13 the system to all providers.
24.14     (c) The commissioner must allow providers of services to utilize a third-party electronic
24.15 visit verification system that the commissioner determines meets the requirements of this
24.16 section.
24.17     (d) A provider using a third-party electronic visit verification system that meets all
24.18 technical specifications and federal and state laws must:
24.19     (1) collect and submit all data for each visit to the commissioner, including but not
24.20 limited to manual entries;
24.21     (2) maintain compliance identified by the commissioner, including but not limited to
24.22 incorporating into the system any changes in data requirements that must be transmitted to
24.23 the state EVV system; and
24.24     (3) integrate the system with the state's designated data aggregator to accurately send
24.25 data.
24.26     (e) The state-designated data aggregator must be available at no cost to a provider for
24.27 purposes of transmitting electronic visit verification data from approved third-party systems
24.28 to the commissioner. Any costs associated with the development and use of a third-party
24.29 system are the responsibility of the provider.
24.30     (f) If a provider is unable to integrate a third-party system with the designated state
24.31 aggregator, the provider must use the state EVV system.
Article 1 Sec. 16.  24
04/06/26  REVISOR  DTT/CH  26-08138  as introduced
25.1      (g) The commissioner must provide training on reviewing and correcting imported data
25.2  in the state's designated data aggregator to providers.
25.3    Sec. 17. Minnesota Statutes 2024, section 256B.073, is amended by adding a subdivision
25.4  to read:
25.5      Subd. 4b. Provider responsibilities. A provider must:
25.6      (1) use an electronic visit verification system that meets all technical and data submission
25.7  requirements established by the commissioner;
25.8      (2) enroll with the state-provided electronic visit verification system or the commissioner's
25.9  designated data aggregator, as applicable;
25.10     (3) provide all information requested by the commissioner for enrollment, access, and
25.11 data submission and ensure that such information remains accurate and up to date;
25.12     (4) maintain records for each individual receiving services subject to electronic visit
25.13 verification, including but not limited to all required data elements;
25.14     (5) maintain a current list of workers providing services subject to electronic visit
25.15 verification to individuals receiving services under medical assistance;
25.16     (6) provide the commissioner and any managed care organization under contract with
25.17 the commissioner under section 256B.69 with immediate, direct, and on-site or remote
25.18 access to the electronic visit verification system;
25.19     (7) at the request of the commissioner or a managed care organization, allow review or
25.20 copying of electronic visit verification documentation at no cost;
25.21     (8) ensure that electronic visit verification systems and related processes meet accessibility
25.22 and confidentiality requirements under state and federal law;
25.23     (9) comply with all policies, procedures, and technical specifications issued by the
25.24 commissioner under this section; and
25.25     (10) ensure that workers, participants, and other individuals using electronic visit
25.26 verification are trained and comply with all documentation and data entry requirements
25.27 established by the commissioner.
Article 1 Sec. 17.  25
04/06/26  REVISOR  DTT/CH  26-08138  as introduced
26.1    Sec. 18. Minnesota Statutes 2024, section 256B.073, subdivision 5, is amended to read:
26.2      Subd. 5. Vendor requirements. (a) The vendor of the electronic visit verification system
26.3  selected by the commissioner and the vendor's affiliate must comply with the requirements
26.4  of this subdivision.
26.5      (b) The vendor of the state-selected state-provided electronic visit verification system
26.6  and the vendor's affiliate must:
26.7      (1) notify the provider of services that the provider may choose the state-selected
26.8  state-provided electronic visit verification system at no cost to the provider;
26.9      (2) offer the state-selected state-provided electronic visit verification system to the
26.10 provider of services prior to offering any fee-based electronic visit verification system;
26.11     (3) notify the provider of services that the provider may choose any fee-based electronic
26.12 visit verification system prior to offering the vendor's or its affiliate's fee-based electronic
26.13 visit verification system; and
26.14     (4) when offering the state-selected state-provided electronic visit verification system,
26.15 clearly differentiate between the state-selected state-provided electronic visit verification
26.16 system and the vendor's or its affiliate's alternative fee-based system.
26.17     (c) The vendor of the state-selected state-provided electronic visit verification system
26.18 and the vendor's affiliate must not use state data that are not available to other vendors of
26.19 electronic visit verification systems to promote or sell the vendor's or its affiliate's alternative
26.20 electronic visit verification system.
26.21     (d) Upon request from the provider, the vendor of the state-selected state-provided
26.22 electronic visit verification system must provide proof of compliance with the requirements
26.23 of paragraph (b).
26.24     (e) An agreement between the vendor of the state-selected state-provided electronic visit
26.25 verification system or its affiliate and a provider of services for an electronic visit verification
26.26 system that is not the state-selected state-provided system entered into on or after July 1,
26.27 2023, is subject to immediate termination by the provider if the vendor violates any of the
26.28 requirements of paragraph (b).
26.29   Sec. 19. Minnesota Statutes 2024, section 256B.073, is amended by adding a subdivision
26.30 to read:
26.31     Subd. 6. Data and documentation. (a) A provider must submit electronic visit
26.32 verification data to the commissioner or the commissioner's designated data aggregator in
Article 1 Sec. 19.  26
04/06/26  REVISOR  DTT/CH  26-08138  as introduced
27.1  accordance with the technical standards, format, and frequency established under this section.
27.2  The commissioner may use integrated electronic visit verification data for oversight, quality
27.3  assurance, and program integrity purposes consistent with state and federal law.
27.4      (b) The commissioner and managed care organizations must use electronic visit
27.5  verification data to validate claims for payment under medical assistance. Claims that cannot
27.6  be validated in accordance with electronic visit verification requirements may be subject
27.7  to actions by the commissioner as authorized under state and federal law, including actions
27.8  related to payment, program integrity, or provider compliance.
27.9      (c) A provider must record all required electronic visit verification data at the time of
27.10 service delivery using an approved verification method. To be compliant with electronic
27.11 visit verification requirements, a provider must document a visit with all required data
27.12 elements recorded at the time of service delivery.
27.13     (d) A manual visit is a visit:
27.14     (1) entered administratively and not by the caregiver at the time of service delivery; or
27.15     (2) where data elements are edited after the time of service delivery.
27.16     (e) A manual visit does not comply with electronic visit verification requirements. A
27.17 manual visit must be confirmed and verified according to processes established by the
27.18 commissioner before being used to validate or support a claim for payment.
27.19     (f) A worker providing services subject to electronic visit verification must record the
27.20 start and end times of each visit at the time the service is delivered using an approved
27.21 verification method. A worker must complete and verify all time documentation, including
27.22 but not limited to verification of service type, date, and duration, on the date the service
27.23 occurs and be consistent with documentation requirements under sections 256B.0659,
27.24 subdivision 12; 256B.85, subdivision 15; 256B.49, subdivision 16; and 256B.0625,
27.25 subdivision 6a. A provider of services must maintain documentation demonstrating
27.26 compliance with this subdivision and make the documentation available to the commissioner
27.27 or a managed care organization under contract with the commissioner under section 256B.69
27.28 upon request.
27.29   Sec. 20. Minnesota Statutes 2024, section 256B.073, is amended by adding a subdivision
27.30 to read:
27.31     Subd. 7. Third-party system responsibilities. (a) This section is effective for Early
27.32 Intensive Developmental and Behavioral Intervention services beginning July 1, 2027, or
27.33 upon federal approval, whichever is later. This section is effective for all other services
Article 1 Sec. 20.  27
04/06/26  REVISOR  DTT/CH  26-08138  as introduced
28.1  subject to this subdivision beginning January 1, 2027, or upon federal approval, whichever
28.2  is later.
28.3      (b) A provider that uses a third-party electronic visit verification system must ensure
28.4  that the system meets all technical, functional, and data-exchange requirements established
28.5  by the commissioner and transmits data to the commissioner or the commissioner's designated
28.6  data aggregator in the format and frequency required by the commissioner.
28.7      (c) A third-party electronic visit verification vendor must:
28.8      (1) comply with all technical, contractual, privacy, and security standards established
28.9  by the commissioner;
28.10     (2) not use or disclose state data for any purpose other than fulfilling the requirements
28.11 of this section or federal law;
28.12     (3) provide the commissioner access to system documentation, data mapping, and audit
28.13 records upon request; and
28.14     (4) immediately report to the commissioner any data transmission failure, breach, or
28.15 interruption affecting the state's ability to receive required electronic visit verification data.
28.16     (d) A provider remains responsible for ensuring compliance with this section even when
28.17 using a third-party electronic visit verification system.
28.18     (e) The third-party vendor must ensure training on the system is available to providers.
28.19     EFFECTIVE DATE. This section is effective the day following final enactment.
28.20   Sec. 21. Minnesota Statutes 2024, section 256B.0911, subdivision 26, is amended to read:
28.21     Subd. 26. Determination of institutional level of care. (a) The determination of need
28.22 for hospital and intermediate care facility levels of care must be made according to criteria
28.23 developed by the commissioner, and in section 256B.092, using forms developed by the
28.24 commissioner.
28.25     (b) The determination of need for nursing facility level of care must be made based on
28.26 criteria in section 144.0724, subdivision 11. This paragraph expires upon the effective date
28.27 of paragraph (c).
28.28     (c) Effective January 1, 2027, or upon federal approval, whichever is later, the
28.29 determination of need for nursing facility level of care must be made based on criteria in
28.30 section 144.0724, subdivision 11, or criteria in section 144.0724, subdivision 11a, for brain
Article 1 Sec. 21.  28
04/06/26  REVISOR  DTT/CH  26-08138  as introduced
29.1  injury and community access for disability inclusion waiver services provided under section
29.2  256B.49.
29.3      EFFECTIVE DATE. This section is effective the day following final enactment.
29.4    Sec. 22. Minnesota Statutes 2024, section 256B.0911, subdivision 32, is amended to read:
29.5      Subd. 32. Administrative activity. (a) The commissioner shall:
29.6      (1) streamline the processes, including timelines for when assessments need to be
29.7  completed;
29.8      (2) provide the services in this section; and
29.9      (3) implement integrated solutions to automate the business processes to the extent
29.10 necessary for support plan approval, reimbursement, program planning, evaluation, and
29.11 policy development.; and
29.12     (4) grant limited role-based access to a person's support plan in the MnCHOICES system
29.13 to home and community-based service providers who have been designated as a provider
29.14 for that person by a lead agency for the purpose of signing the person's support plan
29.15 electronically and demonstrating that the provider has reviewed, understood, and agrees to
29.16 deliver services as outlined in the plan.
29.17     (b) The commissioner shall work with lead agencies responsible for conducting long-term
29.18 care consultation services to:
29.19     (1) modify the MnCHOICES application and assessment policies to create efficiencies
29.20 while ensuring federal compliance with medical assistance and long-term services and
29.21 supports eligibility criteria; and
29.22     (2) develop a set of measurable benchmarks sufficient to demonstrate quarterly
29.23 improvement in the average time per assessment and other mutually agreed upon measures
29.24 of increasing efficiency.
29.25     (c) The commissioner shall collect data on the benchmarks developed under paragraph
29.26 (b) and provide to the lead agencies an annual trend analysis of the data in order to
29.27 demonstrate the commissioner's compliance with the requirements of this subdivision.
29.28   Sec. 23. Minnesota Statutes 2024, section 256B.4905, subdivision 11, is amended to read:
29.29     Subd. 11. Informed choice in technology policy. It is the policy of this state that all
29.30 adults who have disabilities and children who have disabilities:
Article 1 Sec. 23.  29
04/06/26  REVISOR        DTT/CH  26-08138  as introduced
30.1      (1) can use assistive technology, remote supports, or a combination of both to enhance
30.2  the adult's or child's independence and quality of life; and
30.3      (2) have the right, at least annually, to make an informed choice about the adult's or
30.4  child's use of assistive technology and remote supports when permitted under the individual's
30.5  federally approved waiver plan, service authorization, and applicable service standards.
30.6      EFFECTIVE DATE. This section is effective the day following final enactment.
30.7    Sec. 24. Minnesota Statutes 2024, section 256B.4905, subdivision 12, is amended to read:
30.8      Subd. 12. Informed choice and technology prioritization in implementation for
30.9  disability waiver services. (a) The commissioner of human services shall ensure that:
30.10     (1) disability waivers under sections 256B.092 and 256B.49 support the presumption
30.11 that all adults who have disabilities and children who have disabilities may use assistive
30.12 technology, remote supports, or both to enhance the adult's or child's independence and
30.13 quality of life; and
30.14     (2) each individual accessing waiver services is offered, after an informed
30.15 decision-making process and during a person-centered planning process, the opportunity
30.16 to choose assistive technology, remote support, or both prior to the commissioner offering
30.17 or reauthorizing services that utilize direct support staff to ensure equitable access.; and
30.18     (3) policies and procedures related to the use of technology, including but not limited
30.19 to remote support, promote informed choice and protect the health and safety of individuals
30.20 receiving services consistent with federal law and the terms of approved waiver plans.
30.21     (b) Nothing in this subdivision authorizes the use of remote support as a method of
30.22 service delivery unless expressly permitted under the applicable service definition, waiver
30.23 plan, and service standards approved by the Centers for Medicare and Medicaid Services.
30.24     EFFECTIVE DATE. This section is effective the day following final enactment.
30.25   Sec. 25. Minnesota Statutes 2024, section 256B.4912, is amended by adding a subdivision
30.26 to read:
30.27     Subd. 17. Prohibition on room and board payments. (a) The provider must not use
30.28 medical assistance money to pay for room and board, including but not limited to rent,
30.29 mortgage payments, utilities, property taxes, homeowners association fees, or any other
30.30 housing-related cost, in accordance with federal home and community-based services waiver
Article 1 Sec. 25.  30
04/06/26  REVISOR        DTT/CH  26-08138  as introduced
31.1  requirements under United States Code, title 42, section 1396n(c), and Code of Federal
31.2  Regulations, title 42, section 441.310.
31.3      (b) A provider of home and community-based services, including but not limited to
31.4  integrated community supports under section 245D.03, subdivision 1, paragraph (c), clause
31.5  (8), must not:
31.6      (1) use, allocate, or apply any payment for home and community-based services to cover,
31.7  subsidize, discount, or otherwise contribute to any room and board expenses for a person
31.8  receiving services;
31.9      (2) apply agency operating margins, reserves, or profits derived from home and
31.10 community-based services to pay for rent or pay other housing costs for persons receiving
31.11 services; or
31.12     (3) enter into any financial arrangement, discount, concession, or reimbursement structure
31.13 that has the effect of using medical assistance service revenue to offset the housing costs
31.14 of a person receiving services.
31.15     (c) Nothing in this subdivision prohibits a provider from charging a person for room
31.16 and board in accordance with chapter 504B or applicable housing support laws, provided
31.17 the charge is independent of medical assistance payments and complies with all federal
31.18 home and community-based services setting requirements, including but not limited to
31.19 tenancy protections under Code of Federal Regulations, title 42, section 441.301(c)(4)(vi)(A).
31.20     (d) The commissioner may pursue corrective action, payment recovery, sanctions under
31.21 section 256B.064, and licensing action under chapter 245A or 245D for a violation of this
31.22 subdivision.
31.23     EFFECTIVE DATE. This section is effective January 1, 2027.
31.24   Sec. 26. Minnesota Statutes 2024, section 256B.4912, is amended by adding a subdivision
31.25 to read:
31.26     Subd. 19. Billing limits. (a) The limits in this subdivision establish the maximum amounts
31.27 of authorized units for each service within a service day, week, or month.
31.28     (b) Effective January 1, 2027, or upon federal approval, whichever is later, to ensure
31.29 fiscal accountability and consistency across home and community-based services authorized
31.30 under sections 256B.092, 256B.49, 256B.0913, 256B.0922, and 256B.0949 and chapter
31.31 256S, the following billing limits apply:
Article 1 Sec. 26.  31
04/06/26  REVISOR        DTT/CH  26-08138  as introduced
32.1      (1) adult companion services: up to six hours per day per recipient with a maximum of
32.2  963 hours annually;
32.3      (2) chore services: up to six hours per week per recipient for 15-minute units;
32.4      (3) homemaking services, cleaning: up to 16 hours per week per recipient;
32.5      (4) homemaking services, home management: up to 16 hours per week per recipient;
32.6      (5) day support services: up to eight hours per day per recipient;
32.7      (6) family training and counseling under a disability waiver: up to two hours per week
32.8  per recipient or family unit;
32.9      (7) community residential services one-to-one staffing: the maximum daily hours
32.10 permitted under the applicable service tier under section 256B.4914, as published by the
32.11 commissioner;
32.12     (8) independent living skills: up to six hours per day per recipient;
32.13     (9) individualized home supports with training and individualized home supports with
32.14 family training: three consecutive hours in a day or six total hours per day;
32.15     (10) home-delivered meals: up to two meals per day per recipient;
32.16     (11) individualized home supports: up to 16 hours per day per recipient, inclusive of all
32.17 staffing ratios;
32.18     (12) personal emergency response system: one unit per month per recipient, inclusive
32.19 of installation, monitoring, and maintenance;
32.20     (13) respite services provided in the recipient's home: 30 consecutive days per occurrence;
32.21     (14) overnight supervision services: ten hours per day per recipient, with no more than
32.22 eight hours asleep; and
32.23     (15) transportation services: 28 one-way trips per week per participant.
32.24     (c) Effective July 1, 2027, or upon federal approval, whichever is later, to ensure fiscal
32.25 accountability and consistency across home and community-based services authorized under
32.26 sections 256B.092, 256B.49, 256B.0913, 256B.0922, and 256B.0949 and chapter 256S,
32.27 the following billing limits apply to early intensive development and behavioral intervention
32.28 services:
32.29     (1) intensive services: 40 hours per week per recipient;
32.30     (2) travel: two hours per day per recipient;
Article 1 Sec. 26.  32
04/06/26  REVISOR  DTT/CH  26-08138  as introduced
33.1      (3) observation and direction: 20 hours per week per recipient; and
33.2      (4) individual treatment and planning: 300 units per year per recipient.
33.3      (d) For personal emergency response system billing units under paragraph (b), clause
33.4  (12), lead agency staff must end service lines for any inactive providers to prevent duplicate
33.5  billing.
33.6      (e) The limits in this subdivision do not limit a person's use of other waiver services.
33.7  Billing limits under this subdivision apply only to the individual service listed and do not
33.8  prohibit the recipient from accessing other services for which they are eligible on the same
33.9  day, week, or month, subject to other applicable requirements.
33.10     EFFECTIVE DATE. This section is effective the day following final enactment.
33.11   Sec. 27. Minnesota Statutes 2025 Supplement, section 256B.4914, subdivision 3, is
33.12 amended to read:
33.13     Subd. 3. Applicable services. (a) Applicable services are those authorized under the
33.14 state's home and community-based services waivers under sections 256B.092 and 256B.49,
33.15 including the following, as defined in the federally approved home and community-based
33.16 services plan:
33.17     (1) 24-hour customized living;
33.18     (2) adult day services;
33.19     (3) adult day services bath;
33.20     (4) community residential services;
33.21     (5) customized living;
33.22     (6) day support services;
33.23     (7) employment development services;
33.24     (8) employment exploration services;
33.25     (9) employment support services;
33.26     (10) family residential services;
33.27     (11) individualized home supports;
33.28     (12) individualized home supports with family training;
33.29     (13) individualized home supports with training;
Article 1 Sec. 27.  33
04/06/26  REVISOR        DTT/CH  26-08138  as introduced
34.1      (14) integrated community supports;
34.2      (15) life sharing;
34.3      (16) effective until the effective date of clauses (17) and (18) (19), night supervision;
34.4      (17) effective January 1, 2026, or upon federal approval, whichever is later, awake night
34.5  supervision;
34.6      (18) effective January 1, 2027, or upon federal approval, whichever is later, awake night
34.7  supervision only if documentation for an exception is provided and approved by the
34.8  commissioner;
34.9      (18) (19) effective January 1, 2026, or upon federal approval, whichever is later, asleep
34.10 night supervision;
34.11     (19) (20) positive support services;
34.12     (20) (21) prevocational services;
34.13     (21) (22) residential support services;
34.14     (22) (23) transportation services; and
34.15     (23) (24) other services as approved by the federal government in the state home and
34.16 community-based services waiver plan.
34.17     (b) Paragraph (a), clause (17), expires upon the effective date of paragraph (a), clause
34.18 (18).
34.19     EFFECTIVE DATE. This section is effective the day following final enactment.
34.20   Sec. 28. Minnesota Statutes 2025 Supplement, section 256B.4914, subdivision 5a, is
34.21 amended to read:
34.22     Subd. 5a. Base wage index; calculations. The base wage index must be calculated as
34.23 follows:
34.24     (1) for supervisory staff, 100 percent of the median wage for community and social
34.25 services specialist (SOC code 21-1099), with the exception of the supervisor of positive
34.26 supports professional, positive supports analyst, and positive supports specialist, which is
34.27 100 percent of the median wage for clinical counseling and school psychologist (SOC code
34.28 19-3031);
34.29     (2) for registered nurse staff, 100 percent of the median wage for registered nurses (SOC
34.30 code 29-1141);
Article 1 Sec. 28.  34
04/06/26  REVISOR  DTT/CH  26-08138  as introduced
35.1      (3) for licensed practical nurse staff, 100 percent of the median wage for licensed practical
35.2  nurses (SOC code 29-2061);
35.3      (4) for residential asleep-overnight staff, the minimum wage in Minnesota for large
35.4  employers;
35.5      (5) for residential direct care staff, the sum of:
35.6      (i) 15 percent of the subtotal of 50 percent of the median wage for home health and
35.7  personal care aide (SOC code 31-1120); 30 percent of the median wage for nursing assistant
35.8  (SOC code 31-1131); and 20 percent of the median wage for social and human services
35.9  aide (SOC code 21-1093); and
35.10     (ii) 85 percent of the subtotal of 40 percent of the median wage for home health and
35.11 personal care aide (SOC code 31-1120); 20 percent of the median wage for nursing assistant
35.12 (SOC code 31-1131); 20 percent of the median wage for psychiatric technician (SOC code
35.13 29-2053); and 20 percent of the median wage for social and human services aide (SOC code
35.14 21-1093);
35.15     (6) for adult day services staff, 70 percent of the median wage for nursing assistant (SOC
35.16 code 31-1131); and 30 percent of the median wage for home health and personal care aide
35.17 (SOC code 31-1120);
35.18     (7) for day support services staff and prevocational services staff, 20 percent of the
35.19 median wage for nursing assistant (SOC code 31-1131); 20 percent of the median wage for
35.20 psychiatric technician (SOC code 29-2053); and 60 percent of the median wage for social
35.21 and human services aide (SOC code 21-1093);
35.22     (8) for positive supports analyst staff, 100 percent of the median wage for substance
35.23 abuse, behavioral disorder, and mental health counselor (SOC code 21-1018);
35.24     (9) for positive supports professional staff, 100 percent of the median wage for clinical
35.25 counseling and school psychologist (SOC code 19-3031);
35.26     (10) for positive supports specialist staff, 100 percent of the median wage for psychiatric
35.27 technicians (SOC code 29-2053);
35.28     (11) for individualized home supports with family training staff, 20 percent of the median
35.29 wage for nursing aide (SOC code 31-1131); 30 percent of the median wage for community
35.30 social service specialist (SOC code 21-1099); 40 percent of the median wage for social and
35.31 human services aide (SOC code 21-1093); and ten percent of the median wage for psychiatric
35.32 technician (SOC code 29-2053);
Article 1 Sec. 28.  35
04/06/26  REVISOR  DTT/CH  26-08138  as introduced
36.1      (12) for individualized home supports with training services staff, 40 percent of the
36.2  median wage for community social service specialist (SOC code 21-1099); 50 percent of
36.3  the median wage for social and human services aide (SOC code 21-1093); and ten percent
36.4  of the median wage for psychiatric technician (SOC code 29-2053);
36.5      (13) for employment support services staff, 50 percent of the median wage for
36.6  rehabilitation counselor (SOC code 21-1015); and 50 percent of the median wage for
36.7  community and social services specialist (SOC code 21-1099);
36.8      (14) for employment exploration services staff, 50 percent of the median wage for
36.9  education, guidance, school, and vocational counselor (SOC code 21-1012); and 50 percent
36.10 of the median wage for community and social services specialist (SOC code 21-1099);
36.11     (15) for employment development services staff, 50 percent of the median wage for
36.12 education, guidance, school, and vocational counselors (SOC code 21-1012); and 50 percent
36.13 of the median wage for community and social services specialist (SOC code 21-1099);
36.14     (16) for individualized home support without training staff, 50 percent of the median
36.15 wage for home health and personal care aide (SOC code 31-1120); and 50 percent of the
36.16 median wage for nursing assistant (SOC code 31-1131);
36.17     (17) effective until the effective date of clauses (18) and (19), for night supervision staff,
36.18 40 percent of the median wage for home health and personal care aide (SOC code 31-1120);
36.19 20 percent of the median wage for nursing assistant (SOC code 31-1131); 20 percent of the
36.20 median wage for psychiatric technician (SOC code 29-2053); and 20 percent of the median
36.21 wage for social and human services aide (SOC code 21-1093);
36.22     (18) effective January 1, 2026, or upon federal approval, whichever is later, for awake
36.23 night supervision staff, 40 percent of the median wage for home health and personal care
36.24 aide (SOC code 31-1120); 20 percent of the median wage for nursing assistant (SOC code
36.25 31-1131); 20 of percent the median wage for psychiatric technician (SOC code 29-2053);
36.26 and 20 percent of the median wage for social and human services aid (SOC code 21-1093);
36.27 and
36.28     (19) effective January 1, 2026, or upon federal approval, whichever is later, for asleep
36.29 night supervision staff, the minimum wage in Minnesota for large employers.; and
36.30     (20) for integrated community support staff, 40 percent of the median wage for
36.31 community social service specialist (SOC code 21-1099); 50 percent of the median wage
36.32 for social and human services aide (SOC code 21-1093); and ten percent of the median
36.33 wage for psychiatric technician (SOC code 29-2053).
Article 1 Sec. 28.  36
04/06/26  REVISOR       DTT/CH  26-08138  as introduced
37.1      EFFECTIVE DATE. This section is effective January 1, 2027.
37.2    Sec. 29. Minnesota Statutes 2025 Supplement, section 256B.4914, subdivision 5b, is
37.3  amended to read:
37.4      Subd. 5b. Standard component value adjustments. (a) The commissioner shall update
37.5  the base wage index under subdivision 5a; client and programming support, transportation,
37.6  and program facility cost component values as required in subdivisions 6 to 9; and the rates
37.7  identified in subdivision 19 for changes in the Consumer Price Index. If the result of this
37.8  update exceeds eight percent, the commissioner shall implement a change to the base wage
37.9  index, component values, and rates under subdivision 19 of eight percent. If the result of
37.10 this update is less than eight percent, the commissioner shall implement the full value of
37.11 the change. The commissioner shall adjust these values higher or lower, publish these
37.12 updated values, and load them into the rate management system on January 1, 2026, and
37.13 every two years thereafter, by the percentage change in the CPI-U from the date of the
37.14 previous update to the data available 24 months and one day prior to the scheduled update.
37.15 This paragraph expires upon the effective date of paragraph (b).
37.16     (b) Effective January 1, 2028, or upon federal approval, whichever is later, the
37.17 commissioner shall update the base wage index under subdivision 5a; client and programming
37.18 support, transportation, and program facility cost component values as required in
37.19 subdivisions 6 to 9; and the rates identified in subdivision 19 for changes in the Consumer
37.20 Price Index. If the result of this update exceeds four percent, the commissioner shall
37.21 implement a change to the base wage index, component values, and rates under subdivision
37.22 19 of four percent. If the result of this update is less than four percent, the commissioner
37.23 shall implement the full value of the change. The commissioner shall adjust these values
37.24 higher or lower, publish these updated values, and load them into the rate management
37.25 system on January 1, 2028, and every two years thereafter, by the percentage change in the
37.26 CPI-U from the date of the previous update to the data available 24 months and one day
37.27 prior to the scheduled update.
37.28     EFFECTIVE DATE. This section is effective the day following final enactment.
37.29   Sec. 30. Minnesota Statutes 2024, section 256B.4914, subdivision 6, is amended to read:
37.30     Subd. 6. Residential support services; generally. (a) For purposes of this section,
37.31 residential support services includes 24-hour customized living services, community
37.32 residential services, and customized living services, and integrated community supports.
Article 1 Sec. 30.  37
04/06/26  REVISOR  DTT/CH  26-08138  as introduced
38.1      (b) A unit of service for residential support services is a day. Any portion of any calendar
38.2  day, within allowable Medicaid rules, where an individual spends time in a residential setting
38.3  is billable as a day. The number of days authorized for all individuals enrolling in residential
38.4  support services must include every day that services start and end.
38.5      (c) When the available shared staffing hours in a residential setting are insufficient to
38.6  meet the needs of an individual who enrolled in residential support services after January
38.7  1, 2014, then individual staffing hours shall be used.
38.8      EFFECTIVE DATE. This section is effective January 1, 2027.
38.9    Sec. 31. Minnesota Statutes 2024, section 256B.4914, subdivision 6a, is amended to read:
38.10     Subd. 6a. Community residential services; component values and calculation of
38.11 payment rates. (a) Component values for community residential services are:
38.12     (1) competitive workforce factor: 6.7 percent;
38.13     (2) supervisory span of control ratio: 11 percent;
38.14     (3) employee vacation, sick, and training allowance ratio: 8.71 percent;
38.15     (4) employee-related cost ratio: 23.6 percent;
38.16     (5) general administrative support ratio: 13.25 percent;
38.17     (6) program-related expense ratio: 1.3 percent; and
38.18     (7) absence and utilization factor ratio: 3.9 percent.
38.19     (b) Payments for community residential services must be calculated as follows:
38.20     (1) determine the number of shared direct staffing and individual direct staffing hours
38.21 to meet a recipient's needs provided on site or through monitoring technology;
38.22     (2) determine the appropriate hourly staff wage rates derived by the commissioner as
38.23 provided in subdivisions 5 and 5a;
38.24     (3) except for subdivision 5a, clauses (1) to (4), multiply the result of clause (2) by the
38.25 product of one plus the competitive workforce factor;
38.26     (4) for a recipient requiring customization for deaf and hard-of-hearing language
38.27 accessibility under subdivision 12, add the customization rate provided in subdivision 12
38.28 to the result of clause (3);
Article 1 Sec. 31.  38
04/06/26  REVISOR  DTT/CH  26-08138  as introduced
39.1(5) multiply the number of shared direct staffing and individual direct staffing hours
39.2  provided on site or through monitoring technology and nursing hours by the appropriate
39.3  staff wages;
39.4(6) multiply the number of shared direct staffing and individual direct staffing hours
39.5  provided on site or through monitoring technology and nursing hours by the product of the
39.6  supervision span of control ratio and the appropriate supervisory staff wage in subdivision
39.7  5a, clause (1);
39.8(7) combine the results of clauses (5) and (6), excluding any shared direct staffing and
39.9  individual direct staffing hours provided through monitoring technology, and multiply the
39.10 result by one plus the employee vacation, sick, and training allowance ratio. This is defined
39.11 as the direct staffing cost;
39.12(8) for employee-related expenses, multiply the direct staffing cost, excluding any shared
39.13 direct staffing and individual hours provided through monitoring technology, by one plus
39.14 the employee-related cost ratio;
39.15(9) for client programming and supports, add $2,260.21 divided by 365. The
39.16 commissioner shall update the amount in this clause as specified in subdivision 5b;
39.17(10) for transportation, if provided, add $1,742.62 divided by 365, or $3,111.81 divided
39.18 by 365 if customized for adapted transport, based on the resident with the highest assessed
39.19 need. The commissioner shall update the amounts in this clause as specified in subdivision
39.20 5b;
39.21(11) subtotal clauses (8) to (10) and the direct staffing cost of any shared direct staffing
39.22 and individual direct staffing hours provided through monitoring technology that was
39.23 excluded in clause (8);
39.24(12) sum the standard general administrative support ratio, the program-related expense
39.25 ratio, and the absence and utilization factor ratio;
39.26(13) divide the result of clause (11) by one minus the result of clause (12). This is the
39.27 total payment amount; and
39.28(14) adjust the result of clause (13) by a factor to be determined by the commissioner
39.29 to adjust for regional differences in the cost of providing services.
39.30(c) Effective January 1, 2026, or upon federal approval, whichever is later, community
39.31 residential services under this section must be billed at a maximum of 351 days per year.
39.32EFFECTIVE DATE. This section is effective the day following final enactment.
Article 1 Sec. 31.  39
04/06/26  REVISOR  DTT/CH  26-08138  as introduced
40.1    Sec. 32. Minnesota Statutes 2024, section 256B.4914, subdivision 6a, is amended to read:
40.2      Subd. 6a. Community residential services; component values and calculation of
40.3  payment rates. (a) Component values for community residential services are:
40.4      (1) competitive workforce factor: 6.7 percent;
40.5      (2) supervisory span of control ratio: 11 percent;
40.6      (3) employee vacation, sick, and training allowance ratio: 8.71 percent;
40.7      (4) employee-related cost ratio: 23.6 percent;
40.8      (5) general administrative support ratio: 13.25 percent;
40.9      (6) program-related expense ratio: 1.3 percent; and
40.10     (7) absence and utilization factor ratio: 3.9 percent.
40.11     (b) Payments for community residential services must be calculated as follows:
40.12     (1) determine the number of shared direct staffing and individual direct staffing hours
40.13 to meet a recipient's needs provided on site or through monitoring technology;
40.14     (2) determine the appropriate hourly staff wage rates derived by the commissioner as
40.15 provided in subdivisions 5 and 5a;
40.16     (3) except for subdivision 5a, clauses (1) to (4), multiply the result of clause (2) by the
40.17 product of one plus the competitive workforce factor;
40.18     (4) for a recipient requiring customization for deaf and hard-of-hearing language
40.19 accessibility under subdivision 12, add the customization rate provided in subdivision 12
40.20 to the result of clause (3);
40.21     (5) multiply the number of shared direct staffing and individual direct staffing hours
40.22 provided on site or through monitoring technology and nursing hours by the appropriate
40.23 staff wages;
40.24     (6) multiply the number of shared direct staffing and individual direct staffing hours
40.25 provided on site or through monitoring technology and nursing hours by the product of the
40.26 supervision span of control ratio and the appropriate supervisory staff wage in subdivision
40.27 5a, clause (1);
40.28     (7) combine the results of clauses (5) and (6), excluding any shared direct staffing and
40.29 individual direct staffing hours provided through monitoring technology, and multiply the
40.30 result by one plus the employee vacation, sick, and training allowance ratio. This is defined
40.31 as the direct staffing cost;
Article 1 Sec. 32.  40
04/06/26  REVISOR  DTT/CH  26-08138  as introduced
41.1(8) for employee-related expenses, multiply the direct staffing cost, excluding any shared
41.2  direct staffing and individual hours provided through monitoring technology, by one plus
41.3  the employee-related cost ratio;
41.4(9) for client programming and supports, add $2,260.21 divided by 365. The
41.5  commissioner shall update the amount in this clause as specified in subdivision 5b;
41.6(10) for transportation, if provided, add $1,742.62 divided by 365, or $3,111.81 divided
41.7  by 365 if customized for adapted transport, based on the resident with the highest assessed
41.8  need. The commissioner shall update the amounts in this clause as specified in subdivision
41.9  5b;
41.10(11) subtotal clauses (8) to (10) and the direct staffing cost of any shared direct staffing
41.11 and individual direct staffing hours provided through monitoring technology that was
41.12 excluded in clause (8);
41.13(12) sum the standard general administrative support ratio, the program-related expense
41.14 ratio, and the absence and utilization factor ratio;
41.15(13) divide the result of clause (11) by one minus the result of clause (12). This is the
41.16 total payment amount; and
41.17(14) adjust the result of clause (13) by a factor to be determined by the commissioner
41.18 to adjust for regional differences in the cost of providing services.
41.19EFFECTIVE DATE. This section is effective January 1, 2027, or upon federal approval,
41.20 whichever is later.
41.21   Sec. 33. Minnesota Statutes 2024, section 256B.4914, subdivision 6b, is amended to read:
41.22Subd. 6b. Family residential services; component values and calculation of payment
41.23 rates. (a) Component values for family residential services are:
41.24(1) competitive workforce factor: 6.7 percent;
41.25(2) supervisory span of control ratio: 11 percent;
41.26(3) employee vacation, sick, and training allowance ratio: 8.71 percent;
41.27(4) employee-related cost ratio: 23.6 percent;
41.28(5) general administrative support ratio: 3.3 percent;
41.29(6) program-related expense ratio: 1.3 percent; and
41.30(7) absence factor: 1.7 percent.
Article 1 Sec. 33.  41
04/06/26  REVISOR  DTT/CH  26-08138  as introduced
42.1(b) Payments for family residential services must be calculated as follows:
42.2(1) determine the number of shared direct staffing and individual direct staffing hours
42.3  to meet a recipient's needs provided on site or through monitoring technology;
42.4(2) determine the appropriate hourly staff wage rates derived by the commissioner as
42.5  provided in subdivisions 5 and 5a;
42.6(3) except for subdivision 5a, clauses (1) to (4), multiply the result of clause (2) by the
42.7  product of one plus the competitive workforce factor;
42.8(4) for a recipient requiring customization for deaf and hard-of-hearing language
42.9  accessibility under subdivision 12, add the customization rate provided in subdivision 12
42.10 to the result of clause (3);
42.11(5) multiply the number of shared direct staffing and individual direct staffing hours
42.12 provided on site or through monitoring technology and nursing hours by the appropriate
42.13 staff wages;
42.14(6) multiply the number of shared direct staffing and individual direct staffing hours
42.15 provided on site or through monitoring technology and nursing hours by the product of the
42.16 supervisory span of control ratio and the appropriate supervisory staff wage in subdivision
42.17 5a, clause (1);
42.18(7) combine the results of clauses (5) and (6), excluding any shared direct staffing and
42.19 individual direct staffing hours provided through monitoring technology, and multiply the
42.20 result by one plus the employee vacation, sick, and training allowance ratio. This is defined
42.21 as the direct staffing cost;
42.22(8) for employee-related expenses, multiply the direct staffing cost, excluding any shared
42.23 and individual direct staffing hours provided through monitoring technology, by one plus
42.24 the employee-related cost ratio;
42.25(9) for client programming and supports, add $2,260.21 divided by 365. The
42.26 commissioner shall update the amount in this clause as specified in subdivision 5b;
42.27(10) for transportation, if provided, add $1,742.62 divided by 365, or $3,111.81 divided
42.28 by 365 if customized for adapted transport, based on the resident with the highest assessed
42.29 need. The commissioner shall update the amounts in this clause as specified in subdivision
42.30 5b;
Article 1 Sec. 33.  42
04/06/26  REVISOR        DTT/CH  26-08138  as introduced
43.1      (11) subtotal clauses (8) to (10) and the direct staffing cost of any shared direct staffing
43.2  and individual direct staffing hours provided through monitoring technology that was
43.3  excluded in clause (8);
43.4      (12) sum the standard general administrative support ratio, the program-related expense
43.5  ratio, and the absence and utilization factor ratio;
43.6      (13) divide the result of clause (11) by one minus the result of clause (12). This is the
43.7  total payment rate; and
43.8      (14) adjust the result of clause (13) by a factor to be determined by the commissioner
43.9  to adjust for regional differences in the cost of providing services.
43.10     EFFECTIVE DATE. This section is effective January 1, 2027, or upon federal approval,
43.11 whichever is later.
43.12   Sec. 34. Minnesota Statutes 2024, section 256B.4914, subdivision 6d, is amended to read:
43.13     Subd. 6d. Payment for customized living. (a) The payment methodology for customized
43.14 living and 24-hour customized living must be the customized living tool. The commissioner
43.15 shall revise the customized living tool to reflect the services and activities unique to
43.16 disability-related recipient needs and adjust for regional differences in the cost of providing
43.17 services.
43.18     (b) The rate adjustments described in section 256S.205 do not apply to rates paid under
43.19 this section.
43.20     (c) Customized living and 24-hour customized living rates determined under this section
43.21 shall not include more than 24 hours of support in a daily unit.
43.22     (d) The commissioner shall establish the following acuity-based customized living tool
43.23 input limits, based on case mix, for customized living and 24-hour customized living rates
43.24 determined under this section:
43.25     (1) no more than two hours of mental health management per day for people assessed
43.26 for case mixes A, D, and G;
43.27     (2) no more than four hours of activities of daily living assistance per day for people
43.28 assessed for case mix B; and
43.29     (3) no more than six hours of activities of daily living assistance per day for people
43.30 assessed for case mix D.
Article 1 Sec. 34.  43
04/06/26  REVISOR  DTT/CH  26-08138  as introduced
44.1(e) Customized living monthly service rate limits must align with monthly service rate
44.2  limits determined under section 256S.202, subdivisions 1 and 2.
44.3    Sec. 35. Minnesota Statutes 2024, section 256B.4914, subdivision 7a, is amended to read:
44.4Subd. 7a. Adult day services; component values and calculation of payment rates. (a)
44.5  Component values for adult day services are:
44.6(1) competitive workforce factor: 6.7 percent;
44.7(2) supervisory span of control ratio: 11 percent;
44.8(3) employee vacation, sick, and training allowance ratio: 8.71 percent;
44.9(4) employee-related cost ratio: 23.6 percent;
44.10(5) program plan support ratio: 5.6 percent;
44.11(6) client programming and support ratio: 7.4 percent, updated as specified in subdivision
44.12 5b;
44.13(7) general administrative support ratio: 13.25 percent;
44.14(8) program-related expense ratio: 1.8 percent; and
44.15(9) absence and utilization factor ratio: 9.4 3.9 percent.
44.16(b) A unit of service for adult day services is either a day or 15 minutes. A day unit of
44.17 service is six or more hours of time spent providing direct service.
44.18(c) Payments for adult day services must be calculated as follows:
44.19(1) determine the number of units of service and the staffing ratio to meet a recipient's
44.20 needs;
44.21(2) determine the appropriate hourly staff wage rates derived by the commissioner as
44.22 provided in subdivisions 5 and 5a;
44.23(3) except for subdivision 5a, clauses (1) to (4), multiply the result of clause (2) by the
44.24 product of one plus the competitive workforce factor;
44.25(4) for a recipient requiring customization for deaf and hard-of-hearing language
44.26 accessibility under subdivision 12, add the customization rate provided in subdivision 12
44.27 to the result of clause (3);
44.28(5) multiply the number of day program direct staffing hours and nursing hours by the
44.29 appropriate staff wage;
Article 1 Sec. 35.  44
04/06/26  REVISOR  DTT/CH  26-08138  as introduced
45.1      (6) multiply the number of day program direct staffing hours by the product of the
45.2  supervisory span of control ratio and the appropriate supervisory staff wage in subdivision
45.3  5a, clause (1);
45.4      (7) combine the results of clauses (5) and (6), and multiply the result by one plus the
45.5  employee vacation, sick, and training allowance ratio. This is defined as the direct staffing
45.6  rate;
45.7      (8) for program plan support, multiply the result of clause (7) by one plus the program
45.8  plan support ratio;
45.9      (9) for employee-related expenses, multiply the result of clause (8) by one plus the
45.10 employee-related cost ratio;
45.11     (10) for client programming and supports, multiply the result of clause (9) by one plus
45.12 the client programming and support ratio;
45.13     (11) for program facility costs, add $19.30 per week with consideration of staffing ratios
45.14 to meet individual needs, updated as specified in subdivision 5b;
45.15     (12) for adult day bath services, add $7.01 per 15 minute unit;
45.16     (13) this is the subtotal rate;
45.17     (14) sum the standard general administrative rate support ratio, the program-related
45.18 expense ratio, and the absence and utilization factor ratio;
45.19     (15) divide the result of clause (13) by one minus the result of clause (14). This is the
45.20 total payment amount; and
45.21     (16) adjust the result of clause (15) by a factor to be determined by the commissioner
45.22 to adjust for regional differences in the cost of providing services.
45.23     EFFECTIVE DATE. This section is effective January 1, 2027.
45.24   Sec. 36. Minnesota Statutes 2024, section 256B.4914, subdivision 7b, is amended to read:
45.25     Subd. 7b. Day support services; component values and calculation of payment
45.26 rates. (a) Component values for day support services are:
45.27     (1) competitive workforce factor: 6.7 percent;
45.28     (2) supervisory span of control ratio: 11 percent;
45.29     (3) employee vacation, sick, and training allowance ratio: 8.71 percent;
45.30     (4) employee-related cost ratio: 23.6 percent;
Article 1 Sec. 36.  45
04/06/26  REVISOR  DTT/CH  26-08138  as introduced
46.1      (5) program plan support ratio: 5.6 percent;
46.2      (6) client programming and support ratio: 10.37 percent, updated as specified in
46.3  subdivision 5b;
46.4      (7) general administrative support ratio: 13.25 percent;
46.5      (8) program-related expense ratio: 1.8 percent; and
46.6      (9) absence and utilization factor ratio: 9.4 3.9 percent.
46.7      (b) A unit of service for day support services is 15 minutes.
46.8      (c) Payments for day support services must be calculated as follows:
46.9      (1) determine the number of units of service and the staffing ratio to meet a recipient's
46.10 needs;
46.11     (2) determine the appropriate hourly staff wage rates derived by the commissioner as
46.12 provided in subdivisions 5 and 5a;
46.13     (3) except for subdivision 5a, clauses (1) to (4), multiply the result of clause (2) by the
46.14 product of one plus the competitive workforce factor;
46.15     (4) for a recipient requiring customization for deaf and hard-of-hearing language
46.16 accessibility under subdivision 12, add the customization rate provided in subdivision 12
46.17 to the result of clause (3);
46.18     (5) multiply the number of day program direct staffing hours and nursing hours by the
46.19 appropriate staff wage;
46.20     (6) multiply the number of day program direct staffing hours by the product of the
46.21 supervisory span of control ratio and the appropriate supervisory staff wage in subdivision
46.22 5a, clause (1);
46.23     (7) combine the results of clauses (5) and (6), and multiply the result by one plus the
46.24 employee vacation, sick, and training allowance ratio. This is defined as the direct staffing
46.25 rate;
46.26     (8) for program plan support, multiply the result of clause (7) by one plus the program
46.27 plan support ratio;
46.28     (9) for employee-related expenses, multiply the result of clause (8) by one plus the
46.29 employee-related cost ratio;
46.30     (10) for client programming and supports, multiply the result of clause (9) by one plus
46.31 the client programming and support ratio;
Article 1 Sec. 36.  46
04/06/26  REVISOR  DTT/CH  26-08138  as introduced
47.1      (11) for program facility costs, add $19.30 per week with consideration of staffing ratios
47.2  to meet individual needs, updated as specified in subdivision 5b;
47.3      (12) this is the subtotal rate;
47.4      (13) sum the standard general administrative rate support ratio, the program-related
47.5  expense ratio, and the absence and utilization factor ratio;
47.6      (14) divide the result of clause (12) by one minus the result of clause (13). This is the
47.7  total payment amount; and
47.8      (15) adjust the result of clause (14) by a factor to be determined by the commissioner
47.9  to adjust for regional differences in the cost of providing services.
47.10     EFFECTIVE DATE. This section is effective January 1, 2027.
47.11   Sec. 37. Minnesota Statutes 2024, section 256B.4914, subdivision 7c, is amended to read:
47.12     Subd. 7c. Prevocational services; component values and calculation of payment
47.13 rates. (a) Component values for prevocational services are:
47.14     (1) competitive workforce factor: 6.7 percent;
47.15     (2) supervisory span of control ratio: 11 percent;
47.16     (3) employee vacation, sick, and training allowance ratio: 8.71 percent;
47.17     (4) employee-related cost ratio: 23.6 percent;
47.18     (5) program plan support ratio: 5.6 percent;
47.19     (6) client programming and support ratio: 10.37 percent, updated as specified in
47.20 subdivision 5b;
47.21     (7) general administrative support ratio: 13.25 percent;
47.22     (8) program-related expense ratio: 1.8 percent; and
47.23     (9) absence and utilization factor ratio: 9.4 3.9 percent.
47.24     (b) A unit of service for prevocational services is either a day or 15 minutes. A day unit
47.25 of service is six or more hours of time spent providing direct service.
47.26     (c) Payments for prevocational services must be calculated as follows:
47.27     (1) determine the number of units of service and the staffing ratio to meet a recipient's
47.28 needs;
Article 1 Sec. 37.  47
04/06/26  REVISOR  DTT/CH  26-08138  as introduced
48.1      (2) determine the appropriate hourly staff wage rates derived by the commissioner as
48.2  provided in subdivisions 5 and 5a;
48.3      (3) except for subdivision 5a, clauses (1) to (4), multiply the result of clause (2) by the
48.4  product of one plus the competitive workforce factor;
48.5      (4) for a recipient requiring customization for deaf and hard-of-hearing language
48.6  accessibility under subdivision 12, add the customization rate provided in subdivision 12
48.7  to the result of clause (3);
48.8      (5) multiply the number of day program direct staffing hours and nursing hours by the
48.9  appropriate staff wage;
48.10     (6) multiply the number of day program direct staffing hours by the product of the
48.11 supervisory span of control ratio and the appropriate supervisory staff wage in subdivision
48.12 5a, clause (1);
48.13     (7) combine the results of clauses (5) and (6), and multiply the result by one plus the
48.14 employee vacation, sick, and training allowance ratio. This is defined as the direct staffing
48.15 rate;
48.16     (8) for program plan support, multiply the result of clause (7) by one plus the program
48.17 plan support ratio;
48.18     (9) for employee-related expenses, multiply the result of clause (8) by one plus the
48.19 employee-related cost ratio;
48.20     (10) for client programming and supports, multiply the result of clause (9) by one plus
48.21 the client programming and support ratio;
48.22     (11) for program facility costs, add $19.30 per week with consideration of staffing ratios
48.23 to meet individual needs, updated as specified in subdivision 5b;
48.24     (12) this is the subtotal rate;
48.25     (13) sum the standard general administrative rate support ratio, the program-related
48.26 expense ratio, and the absence and utilization factor ratio;
48.27     (14) divide the result of clause (12) by one minus the result of clause (13). This is the
48.28 total payment amount; and
48.29     (15) adjust the result of clause (14) by a factor to be determined by the commissioner
48.30 to adjust for regional differences in the cost of providing services.
48.31     EFFECTIVE DATE. This section is effective January 1, 2027.
Article 1 Sec. 37.  48
04/06/26  REVISOR  DTT/CH  26-08138  as introduced
49.1    Sec. 38. Minnesota Statutes 2024, section 256B.4914, is amended by adding a subdivision
49.2  to read:
49.3      Subd. 8a. Integrated community supports unit-based services with programming;
49.4  component values and calculation of payment rates. (a) Component values for integrated
49.5  community supports unit-based services with programming are:
49.6      (1) competitive workforce factor: 6.7 percent;
49.7      (2) supervisory span of control ratio: 11 percent;
49.8      (3) employee vacation, sick, and training allowance ratio: 8.71 percent;
49.9      (4) employee-related cost ratio: 23.6 percent;
49.10     (5) program plan support ratio: 27 percent;
49.11     (6) client programming and support ratio: 9.2 percent;
49.12     (7) general administrative support ratio: 13.25 percent;
49.13     (8) program-related expense ratio: 6.1 percent; and
49.14     (9) absence and utilization factor ratio: 3.9 percent.
49.15     (b) A unit of integrated community supports unit-based services with programming is
49.16 15 minutes.
49.17     (c) Payments for integrated community supports must be calculated as follows:
49.18     (1) determine the number of units of service to meet a recipient's needs;
49.19     (2) determine the appropriate hourly staff wage rates derived by the commissioner as
49.20 provided in subdivisions 5 and 5a;
49.21     (3) except for subdivision 5a, clauses (1) to (4), multiply the result of clause (2) by the
49.22 product of one plus the competitive workforce factor;
49.23     (4) for a recipient requiring customization for deaf and hard-of-hearing language
49.24 accessibility under subdivision 12, add the customization rate provided in subdivision 12
49.25 to the result of clause (3);
49.26     (5) multiply the number of direct staffing hours by the appropriate staff wage;
49.27     (6) multiply the number of direct staffing hours by the product of the supervisory span
49.28 of control ratio and the appropriate supervisory staff wage in subdivision 5a, clause (1);
Article 1 Sec. 38.  49
04/06/26  REVISOR  DTT/CH  26-08138  as introduced
50.1      (7) combine the results of clauses (5) and (6), and multiply the result by one plus the
50.2  employee vacation, sick, and training allowance ratio. This is defined as the direct staffing
50.3  rate;
50.4      (8) for program plan support, multiply the result of clause (7) by one plus the program
50.5  plan support ratio divided by the approved capacity for the integrated community supports
50.6  setting;
50.7      (9) for employee-related expenses, multiply the result of clause (8) by one plus the
50.8  employee-related cost ratio;
50.9      (10) for client programming and supports, multiply the result of clause (9) by one plus
50.10 the client programming and support ratio;
50.11     (11) this is the subtotal rate;
50.12     (12) sum the standard general administrative support ratio, the program-related expense
50.13 ratio, and the absence and utilization factor ratio; and
50.14     (13) divide the result of clause (11) by one minus the result of clause (12). This is the
50.15 total payment amount.
50.16     (d) The commissioner must establish maximum allowable in-person and remote service
50.17 hours used in the rate methodology for integrated community supports based on the recipient's
50.18 case-mix classification. The total number of service hours entered into the rate framework
50.19 must not exceed the following limits:
50.20     (1) for case mix classifications A, C, and L, a maximum of two hours per day;
50.21     (2) for case mix classifications B, D, and F, a maximum of four hours per day;
50.22     (3) for case mix classifications E, G, I, J, and K, a maximum of six hours per day; and
50.23     (4) for case mix classification H, a maximum of eight hours per day.
50.24     (e) The daily limit in paragraph (d) does not limit a person's use of other disability waiver
50.25 services, which may be provided on the same day by the same provider providing integrated
50.26 community supports. Nothing in paragraph (d) prohibits approval of a rate exception for
50.27 individuals with exceptional or complex needs.
50.28     EFFECTIVE DATE. This section is effective January 1, 2027.
Article 1 Sec. 38.  50
04/06/26  REVISOR  DTT/CH  26-08138  as introduced
51.1    Sec. 39. Minnesota Statutes 2024, section 256B.4914, is amended by adding a subdivision
51.2  to read:
51.3      Subd. 10e. Documentation of staffing; auditing and rate review. (a) Effective for
51.4  services provided on or after January 1, 2029, a provider enrolled to provide residential
51.5  services under subdivision 6 must maintain documentation of direct staffing hours provided
51.6  to each person receiving services, including but not limited to documentation identifying:
51.7      (1) the name, role, and unique identifier for each staff person who provided services to
51.8  match records to payroll, time and attendance systems, and any other source documentation;
51.9      (2) the date services were provided;
51.10     (3) the total number of hours of direct support provided;
51.11     (4) awake overnight staffing hours provided, if applicable;
51.12     (5) asleep overnight staffing hours provided, if applicable; and
51.13     (6) any other staffing information required by the commissioner.
51.14     (b) A provider must maintain documentation in a manner and format determined by the
51.15 commissioner for at least six years. If a provider changes payroll vendors, merges operations,
51.16 or changes staffing identifiers, the provider must maintain a documented link between prior
51.17 and current staffing identifiers sufficient to allow tracking of hours worked, turnover, and
51.18 role classification for each staff person.
51.19     (c) A provider must submit the documentation required under paragraph (a) to the
51.20 commissioner annually, in a manner and format determined by the commissioner. The
51.21 commissioner must establish multiple submission windows throughout the calendar year
51.22 and may assign providers to a submission window for administrative efficiency and system
51.23 capacity. Documentation must reflect staffing provided during the prior calendar year and
51.24 must be submitted no later than the final business day of the provider's assigned submission
51.25 window. The commissioner may conduct random or targeted validations and audits of
51.26 submitted data and may require supplemental documentation as necessary to verify accuracy
51.27 and compliance.
51.28     (d) The commissioner must conduct periodic analysis of documentation submitted under
51.29 this subdivision and may validate staffing data through random audits or other verification
51.30 methods.
51.31     (e) Based on the analysis under paragraph (d), the commissioner may provide
51.32 recommendations to lead agencies regarding modifications to the rate of a person receiving
Article 1 Sec. 39.  51
04/06/26  REVISOR  DTT/CH  26-08138  as introduced
52.1  services, including increases or decreases necessary to align the rate with staffing provided
52.2  to the person as demonstrated by the submitted historical staffing documentation.
52.3  Recommendations must be based on the requirements of this section and applicable federal
52.4  and state requirements governing rate setting.
52.5      (f) If a provider fails to submit documentation requested within the submission window
52.6  in paragraph (c), the commissioner must issue a written notice of noncompliance. If
52.7  documentation is not received within 60 days following the notice of noncompliance, the
52.8  commissioner may temporarily suspend payments to the provider until the required
52.9  documentation is submitted. The commissioner must make withheld payments to the provider
52.10 once the required documentation is received. If such noncompliance persists, the
52.11 commissioner may adjust future rate payments, require the provider to submit a corrective
52.12 action plan, or pursue other enforcement actions as authorized by law.
52.13     (g) The commissioner must publish annual aggregate reports summarizing audit findings
52.14 and trends related to staffing provided under this section.
52.15     EFFECTIVE DATE. This section is effective the day following final enactment.
52.16   Sec. 40. Minnesota Statutes 2024, section 256B.4914, is amended by adding a subdivision
52.17 to read:
52.18     Subd. 21. Administrative fees charged by providers and vendors. Effective July 1,
52.19 2027, or upon federal approval, whichever is later, the commissioner must limit
52.20 administrative fees charged by enrolled providers and vendors approved by lead agencies
52.21 to no more than six percent of the total cost of the service or purchased goods. This limit
52.22 applies to the following services and other new market rate services as determined by the
52.23 commissioner:
52.24     (1) 24-hour emergency assistance;
52.25     (2) assistive technology;
52.26     (3) caregiver living expenses;
52.27     (4) chore services;
52.28     (5) crisis respite;
52.29     (6) environmental accessibility adaptations;
52.30     (7) family training and counseling;
52.31     (8) respite, billed daily or in 15-minute units;
Article 1 Sec. 40.  52
04/06/26  REVISOR  DTT/CH  26-08138  as introduced
53.1      (9) specialist services;
53.2      (10) transitional services; and
53.3      (11) transportation.
53.4      EFFECTIVE DATE. This section is effective the day following final enactment.
53.5    Sec. 41. Minnesota Statutes 2024, section 256B.492, is amended by adding a subdivision
53.6  to read:
53.7      Subd. 4. Integrated community supports setting approval moratorium and
53.8  exception. (a) The commissioner must not approve a new integrated community supports
53.9  setting or approve an expansion of an existing integrated community supports setting except
53.10 as provided in this subdivision.
53.11     (b) The commissioner may approve an exception to the moratorium only when the
53.12 applicant demonstrates indirect control of the setting and compliance with:
53.13     (1) the federal home and community-based services requirements under Code of Federal
53.14 Regulations, title 42, section 441.301(c);
53.15     (2) the prohibition on the use of medical assistance money for room and board under
53.16 section 256B.4912, subdivision 17;
53.17     (3) independent lease requirements consistent with chapter 504B; and
53.18     (4) all documentation requirements under section 245D.12.
53.19     (c) To approve an exception, the commissioner must determine that the lead agency has
53.20 requested the additional capacity to meet the specific disability-related needs of the person.
53.21 Priority must be given to geographic regions with insufficient integrated community supports
53.22 capacity based on statewide or regional needs determination processes.
53.23     (d) For purposes of this subdivision, "integrated community supports setting" means a
53.24 multifamily housing building where a provider delivers integrated community supports
53.25 under section 245D.03, subdivision 1, paragraph (c), clause (8), and for which a provider
53.26 has a provider-controlled or provider-associated financial interest as defined under section
53.27 245A.02, subdivision 10b.
53.28     (e) A determination under this subdivision is final and not subject to appeal.
53.29     EFFECTIVE DATE. This section is effective January 1, 2027.
Article 1 Sec. 41.  53
04/06/26  REVISOR       DTT/CH  26-08138  as introduced
54.1    Sec. 42. Minnesota Statutes 2024, section 256R.10, subdivision 8, is amended to read:
54.2      Subd. 8. Employer health insurance costs. (a) Employer health insurance costs are
54.3  allowable for (1) all nursing facility employees and (2) the spouse and dependents of those
54.4  nursing facility employees who are employed on average at least 30 hours per week.
54.5      (b) The commissioner must not treat employer contributions to employer-sponsored
54.6  individual coverage health reimbursement arrangements as allowable costs if the facility
54.7  does not provide the commissioner copies of the employer-sponsored individual coverage
54.8  health reimbursement arrangement plan documents and documentation of any health
54.9  insurance premiums and associated co-payments reimbursed under the arrangement.
54.10 Documentation of reimbursements must denote any reimbursements for health insurance
54.11 premiums or associated co-payments incurred by the spouses or dependents of nursing
54.12 facility employees who work on average less than 30 hours per week.
54.13     (c) Effective for the rate year beginning January 1, 2027, the annual reimbursement cap
54.14 for health insurance costs is $15,000 as adjusted according to paragraph (d). The allowable
54.15 costs for health insurance must not exceed the reimbursement cap multiplied by the annual
54.16 average month-end number of allowed enrolled nursing facility employees from the
54.17 applicable cost report period. For shared employees, the allowable number of enrolled
54.18 employees includes only the nursing facility percentage of any shared allowed enrolled
54.19 employees. The allowable number of enrolled employees must not include nonnursing
54.20 facility employees or individuals who elect COBRA continuation coverage.
54.21     (d) Effective for rate years beginning on or after January 1, 2028, the commissioner
54.22 shall adjust the annual reimbursement cap for employer health insurance costs by the previous
54.23 year's cap plus an adjustment for CPI-U inflation as defined in section 256R.02, subdivision
54.24 14a.
54.25     EFFECTIVE DATE. This section is effective the day following final enactment.
54.26   Sec. 43. Minnesota Statutes 2024, section 256R.23, subdivision 5, is amended to read:
54.27     Subd. 5. Determination of total care-related payment rate limits. (a) Effective until
54.28 December 31, 2027, the commissioner must determine each facility's total care-related
54.29 payment rate limit by:
54.30     (1) multiplying the facility's quality score, as determined under section 256R.16,
54.31 subdivision 1, by 0.5625;
54.32     (2) adding 89.375 to the amount determined in clause (1), and dividing the total by 100;
54.33 and
Article 1 Sec. 43.  54
04/06/26  REVISOR  DTT/CH  26-08138  as introduced
55.1      (3) multiplying the amount determined in clause (2) by the median total care-related
55.2  cost per day.
55.3      (b) Effective January 1, 2028, the commissioner must determine each facility's total
55.4  care-related payment rate limit by:
55.5      (1) multiplying the facility's quality score, as determined under section 256R.16,
55.6  subdivision 1, by two;
55.7      (2) subtracting 40 from the amount determined in clause (1), and dividing the total by
55.8  100; and
55.9      (3) multiplying the amount determined in clause (2) by the median total care-related
55.10 cost per day.
55.11     EFFECTIVE DATE. This section is effective the day following final enactment.
55.12   Sec. 44. Minnesota Statutes 2025 Supplement, section 256R.23, subdivision 7, is amended
55.13 to read:
55.14     Subd. 7. Determination of direct care payment rates. (a) A facility's direct care
55.15 payment rate equals the lesser of (1) the facility's direct care costs per standardized day, (2)
55.16 the facility's direct care costs per standardized day divided by its cost to limit ratio, (3) the
55.17 previous year's direct care payment rate times one plus CPI-U inflation, or (4) 104 percent
55.18 of the previous year's direct care payment rate. This paragraph expires upon the effective
55.19 date of paragraph (b).
55.20     (b) Effective January 1, 2027, or upon federal approval, whichever is later, a facility's
55.21 direct care payment rate equals the lesser of (1) the facility's direct care costs per standardized
55.22 day, (2) the facility's direct care costs per standardized day divided by its cost to limit ratio,
55.23 (3) the previous year's direct care payment rate times one plus CPI-U inflation, or (4) 102
55.24 percent of the previous year's direct care payment rate.
55.25     EFFECTIVE DATE. This section is effective the day following final enactment.
55.26   Sec. 45. Minnesota Statutes 2025 Supplement, section 256R.23, subdivision 8, is amended
55.27 to read:
55.28     Subd. 8. Determination of other care-related payment rates. (a) A facility's other
55.29 care-related payment rate equals the lesser of (1) the facility's other care-related cost per
55.30 resident day, (2) the facility's other care-related cost per resident day divided by its cost to
55.31 limit ratio, (3) the previous year's other care-related rate times one plus CPI-U inflation, or
Article 1 Sec. 45.  55
04/06/26  REVISOR  DTT/CH  26-08138  as introduced
56.1  (4) 104 percent of the previous year's other care-related payment rate. This paragraph expires
56.2  upon the effective date of paragraph (b).
56.3      (b) Effective January 1, 2027, or upon federal approval, whichever is later, a facility's
56.4  other care-related payment rate equals the lesser of (1) the facility's other care-related cost
56.5  per resident day, (2) the facility's other care-related cost per resident day divided by its cost
56.6  to limit ratio, (3) the previous year's other care-related rate times one plus CPI-U inflation,
56.7  or (4) 102 percent of the previous year's other care-related payment rate.
56.8      EFFECTIVE DATE. This section is effective the day following final enactment.
56.9    Sec. 46. Minnesota Statutes 2025 Supplement, section 256R.24, subdivision 3, is amended
56.10 to read:
56.11     Subd. 3. Determination of the other operating payment rate. (a) Effective until
56.12 December 31, 2027, a facility's other operating payment rate equals the lesser of (1) 105
56.13 percent of the median other operating cost per day, (2) the previous year's other operating
56.14 payment rate times one plus CPI-U inflation, or (3) 104 percent of the previous year's other
56.15 operating payment rate.
56.16     (b) Effective January 1, 2028, a facility's other operating payment rate equals the lesser
56.17 of (1) 100 percent of the median other operating cost per day, (2) the previous year's other
56.18 operating payment rate times one plus CPI-U inflation, or (3) 104 percent of the previous
56.19 year's other operating payment rate.
56.20     EFFECTIVE DATE. This section is effective the day following final enactment.
56.21   Sec. 47. Minnesota Statutes 2025 Supplement, section 256R.24, subdivision 3, is amended
56.22 to read:
56.23     Subd. 3. Determination of the other operating payment rate. (a) A facility's other
56.24 operating payment rate equals the lesser of (1) 105 percent of the median other operating
56.25 cost per day, (2) the previous year's other operating payment rate times one plus CPI-U
56.26 inflation, or (3) 104 percent of the previous year's other operating payment rate. This
56.27 paragraph expires upon the effective date of paragraph (b).
56.28     (b) Effective January 1, 2027, or upon federal approval, whichever is later, a facility's
56.29 other operating payment rate equals the lesser of (1) 105 percent of the median other
56.30 operating cost per day, (2) the previous year's other operating payment rate times one plus
56.31 CPI-U inflation, or (3) 102 percent of the previous year's other operating payment rate.
56.32     EFFECTIVE DATE. This section is effective the day following final enactment.
Article 1 Sec. 47.  56
04/06/26  REVISOR        DTT/CH  26-08138  as introduced
57.1    Sec. 48. Minnesota Statutes 2025 Supplement, section 256R.38, is amended to read:
57.2      256R.38 PERFORMANCE-BASED INCENTIVE PAYMENTS.
57.3      The commissioner shall develop additional incentive-based payments of up to five
57.4  percent above a facility's operating payment rate for achieving outcomes specified in a
57.5  contract. The commissioner may solicit proposals and select those which, on a competitive
57.6  basis, best meet the state's policy objectives. The commissioner shall limit the amount of
57.7  any incentive payment and the number of contract amendments under this section to operate
57.8  the incentive payments within funds appropriated for this purpose. The commissioner shall
57.9  approve proposals through a memorandum of understanding which shall specify various
57.10 levels of payment for various levels of performance. Incentive payments to facilities under
57.11 this section shall be in the form of are time-limited rate adjustments which shall be included
57.12 in the external fixed costs payment rate under section 256R.25. In establishing the specified
57.13 outcomes and related criteria, the commissioner shall consider the following state policy
57.14 objectives: that must only be paid if approved by the commissioner before the effective date
57.15 of this section. This section expires January 1, 2028.
57.16     (1) successful diversion or discharge of residents to the residents' prior home or other
57.17 community-based alternatives;
57.18     (2) adoption of new technology to improve quality or efficiency;
57.19     (3) improved quality as measured in the Minnesota Nursing Home Report Card;
57.20     (4) reduced acute care costs; and
57.21     (5) any additional outcomes proposed by a nursing facility that the commissioner finds
57.22 desirable.
57.23     EFFECTIVE DATE. This section is effective the day following final enactment.
57.24   Sec. 49. Minnesota Statutes 2025 Supplement, section 256S.205, subdivision 2, is amended
57.25 to read:
57.26     Subd. 2. Rate adjustment application. (a) Effective through September 30, 2023, a
57.27 facility may apply to the commissioner for an initial designation as a disproportionate share
57.28 facility. Applications must be submitted annually between September 1 and September 30.
57.29 The applying facility must apply in a manner determined by the commissioner. The applying
57.30 facility must document each of the following on the application:
57.31     (1) the number of customized living residents in the facility on September 1 of the
57.32 application year, broken out by specific waiver program; and
Article 1 Sec. 49.  57
04/06/26  REVISOR  DTT/CH  26-08138  as introduced
58.1      (2) the total number of people residing in the facility on September 1 of the application
58.2  year.
58.3      (b) Effective October 1, 2023, the commissioner must not process any new initial
58.4  applications for disproportionate share facilities.
58.5      (c) A facility that received rate floor payments in rate year 2024 may submit an annual
58.6  application under this subdivision to maintain its designation as a disproportionate share
58.7  facility.
58.8      (d) The commissioner must not process applications for disproportionate share facilities
58.9  after the September 1 through September 30, 2025, application period.
58.10   Sec. 50. Minnesota Statutes 2025 Supplement, section 256S.205, subdivision 3, is amended
58.11 to read:
58.12     Subd. 3. Rate adjustment eligibility criteria. (a) Only facilities satisfying all of the
58.13 following conditions on September 1 of the application year are eligible for designation as
58.14 a disproportionate share facility:
58.15     (1) at least 83.5 percent of the residents of the facility are customized living residents;
58.16 and
58.17     (2) at least 70 percent of the customized living residents are elderly waiver participants.
58.18     (b) A facility determined eligible for the disproportionate share rate adjustment in
58.19 application year 2023 and receiving payments in rate year 2024 is eligible to receive payments
58.20 in rate years beginning on or after January 1, 2025, only if the commissioner determines
58.21 that the facility continues to meet the eligibility requirements under this subdivision as
58.22 determined by the application process under subdivision 2, paragraph (c).
58.23     A facility is eligible to apply for the program in calendar year 2025 to receive payments
58.24 in 2026 if the facility was determined eligible for the disproportionate share rate adjustment
58.25 in 2023 and received payments in calendar year 2024.
58.26   Sec. 51. Minnesota Statutes 2025 Supplement, section 256S.205, subdivision 5, is amended
58.27 to read:
58.28     Subd. 5. Rate adjustment; rate floor. (a) Notwithstanding the 24-hour customized
58.29 living monthly service rate limits under section 256S.202, subdivision 2, and the component
58.30 service rates established under section 256S.201, subdivision 4, the commissioner must
58.31 establish a rate floor equal to $141 per resident per day for 24-hour customized living
Article 1 Sec. 51.  58
04/06/26  REVISOR  DTT/CH  26-08138  as introduced
59.1  services provided to an elderly waiver participant in a designated disproportionate share
59.2  facility.
59.3      (b) The commissioner must apply the rate floor to the services described in paragraph
59.4  (a) provided during the rate year.
59.5      The commissioner must not implement any adjustments to the disproportionate share
59.6  rate floor amount after January 1, 2027.
59.7    Sec. 52. Minnesota Statutes 2025 Supplement, section 256S.205, subdivision 7, is amended
59.8  to read:
59.9      Subd. 7. Expiration. This section expires May 31, 2028 January 1, 2027.
59.10   Sec. 53. Minnesota Statutes 2024, section 256S.21, is amended by adding a subdivision
59.11 to read:
59.12     Subd. 4. Documentation of staffing; auditing and rate review for residential support
59.13 services. (a) For purposes of this subdivision, residential support services include 24-hour
59.14 customized living services, customized living services, family adult foster care, and corporate
59.15 adult foster care.
59.16     (b) Effective January 1, 2029, a provider enrolled to provide residential services under
59.17 this subdivision must maintain documentation of direct staffing hours provided to each
59.18 person receiving services, including but not limited to documentation identifying:
59.19     (1) the name, role, and unique identifier for each staff person who provided services to
59.20 match records to payroll, time and attendance systems, and any other source documentation;
59.21     (2) the date services were provided;
59.22     (3) the total number of hours of direct support provided;
59.23     (4) awake overnight staffing hours provided, if applicable;
59.24     (5) asleep overnight staffing hours provided, if applicable; and
59.25     (6) any other staffing information required by the commissioner.
59.26     (c) A provider must maintain documentation in a manner and format determined by the
59.27 commissioner for at least six years. If a provider changes payroll vendors, merges operations,
59.28 or changes staffing identifiers, the provider must maintain a documented link between prior
59.29 and current staffing identifiers sufficient to allow tracking of hours worked, turnover, and
59.30 role classification for each staff person.
Article 1 Sec. 53.  59
04/06/26  REVISOR       DTT/CH  26-08138  as introduced
60.1      (d) A provider must submit the documentation required under paragraph (b) to the
60.2  commissioner annually, in a manner and format determined by the commissioner. The
60.3  commissioner must establish multiple submission windows throughout the calendar year
60.4  and may assign providers to a submission window for administrative efficiency and system
60.5  capacity. Documentation must reflect staffing provided during the prior calendar year and
60.6  must be submitted no later than the final business day of the provider's assigned submission
60.7  window. The commissioner may conduct random or targeted validations and audits of
60.8  submitted data and may require supplemental documentation as necessary to verify accuracy
60.9  and compliance.
60.10     (e) The commissioner must conduct periodic analysis of documentation submitted under
60.11 this subdivision and may validate staffing data through random audits or other verification
60.12 methods.
60.13     (f) Based on the analysis under paragraph (e), the commissioner may provide
60.14 recommendations to lead agencies regarding modifications to the rate of the person receiving
60.15 services, including increases or decreases necessary to align the rate with staffing provided
60.16 to the person as demonstrated by the submitted historical staffing documentation.
60.17 Recommendations must be based on the requirements of this section and applicable federal
60.18 and state requirements governing rate setting.
60.19     (g) If a provider fails to submit documentation requested within the submission window
60.20 under paragraph (c), the commissioner must issue a written notice of noncompliance. If
60.21 documentation is not received within 60 days following the notice of noncompliance, the
60.22 commissioner may temporarily suspend payments to the provider until the required
60.23 documentation is submitted. The commissioner must make withheld payments to the provider
60.24 once the required documentation is received. If such noncompliance persists, the
60.25 commissioner may adjust future rate payments, require the provider to submit a corrective
60.26 action plan, or pursue other enforcement actions as authorized by law.
60.27     (h) The commissioner must publish annual aggregate reports summarizing audit findings
60.28 and trends related to staffing provided under this section.
60.29     EFFECTIVE DATE. This section is effective the day following final enactment.
60.30   Sec. 54. Minnesota Statutes 2024, section 256S.21, is amended by adding a subdivision
60.31 to read:
60.32     Subd. 5. Administrative fees charged by providers or vendors. The commissioner
60.33 must limit administrative fees charged by enrolled providers or vendors approved by lead
Article 1 Sec. 54.  60
04/06/26  REVISOR  DTT/CH  26-08138  as introduced
61.1  agencies to no more than six percent of the total cost of the service or purchased goods.
61.2  This limit applies to the following services but allows for the addition of other services
61.3  determined by the commissioner:
61.4      (1) chore services;
61.5      (2) environmental accessibility adaptations;
61.6      (3) transitional services;
61.7      (4) transportation; and
61.8      (5) specialized equipment and supplies.
61.9      EFFECTIVE DATE. This section is effective January 1, 2027.
61.10   Sec. 55. MARKET RATE STUDY FOR HOME AND COMMUNITY-BASED
61.11 SERVICES.
61.12     (a) The commissioner of human services must conduct a market rate study to evaluate
61.13 the adequacy, sustainability, and equity of payment rates for specific home and
61.14 community-based services under the home and community-based services waivers authorized
61.15 under Minnesota Statutes, sections 256B.092 and 256B.49.
61.16     (b) The study must include, at minimum, an analysis of the following services:
61.17     (1) employment support services delivered in remote or virtual settings;
61.18     (2) 24-hour emergency assistance;
61.19     (3) assistive technology;
61.20     (4) environmental accessibility adaptations;
61.21     (5) chore services;
61.22     (6) transitional services;
61.23     (7) independent living skills training; and
61.24     (8) specialist services, including positive support services and orientation and mobility
61.25 services.
61.26     (c) In planning and conducting the market rate study, the commissioner must consult
61.27 with interested parties, including but not limited to service providers, people with disabilities,
61.28 lead agencies, Tribal Nations, culturally specific and community-based providers, and
61.29 disability advocacy organizations. The consultation process must be designed to ensure
Article 1 Sec. 55.  61
04/06/26  REVISOR        DTT/CH  26-08138  as introduced
62.1  meaningful participation from providers in greater Minnesota and from providers serving
62.2  communities of color and Tribal Nations.
62.3      (d) In conducting the study, the commissioner must analyze provider costs, workforce
62.4  availability, wage competitiveness, regional market conditions, inflationary impacts, and
62.5  access issues. The commissioner must also evaluate whether current reimbursement
62.6  methodologies reflect actual costs of providing services and support long-term access to
62.7  qualified providers.
62.8      (e) By February 15, 2027, the commissioner must submit a report with findings and
62.9  recommendations, including but not limited to any proposed statutory changes, to the chairs
62.10 and ranking minority members of the legislative committees with jurisdiction over health
62.11 and human services policy and finance.
62.12     EFFECTIVE DATE. This section is effective the day following final enactment.
62.13   Sec. 56. WAIVER AMENDMENTS; REMOTE SUPPORTS.
62.14     (a) The commissioner of human services must seek federal approval from the Centers
62.15 for Medicare and Medicaid Services to amend the state's home and community-based
62.16 services waiver plans under United States Code, title 42, section 1396n(c), to remove
62.17 authorization for the use of remote supports as a method of service delivery or supervision
62.18 for the following services:
62.19     (1) adult day services;
62.20     (2) community residential services;
62.21     (3) day support services;
62.22     (4) family residential services; and
62.23     (5) integrated community supports.
62.24     (b) Until federal approval is obtained, the commissioner must continue to allow the use
62.25 of remote support only to the extent permitted under the terms of the state's federally
62.26 approved waiver plans in effect on the effective date of this section.
62.27     EFFECTIVE DATE. This section is effective the day following final enactment.
62.28   Sec. 57. REPEALER.
62.29     Subdivision 1. Repealer. Minnesota Statutes 2024, section 256S.205, subdivision 4, is
62.30 repealed.
Article 1 Sec. 57.  62
04/06/26  REVISOR      DTT/CH  26-08138  as introduced
63.1      Subd. 2. Repealer. (a) Minnesota Statutes 2024, sections 256.975, subdivision 7d;
63.2  256B.073, subdivision 4; 256B.0921; and 256R.40, subdivisions 1, 2, 3, 4, 6, and 7, are
63.3  repealed.
63.4      (b) Minnesota Statutes 2025 Supplement, sections 256R.25, subdivision 6; and 256R.40,
63.5  subdivision 5, are repealed.
63.6      (c) Laws 2025, First Special Session chapter 9, article 2, section 68, is repealed.
63.7      Subd. 3. Repealer. Minnesota Statutes 2024, sections 256B.0911, subdivision 21; and
63.8  256B.4914, subdivision 6c, are repealed.
63.9      Subd. 4. Repealer. Minnesota Statutes 2024, sections 245A.70; 245A.71; 245A.72;
63.10 245A.73; 245A.74; 245A.75; and 245D.261, are repealed.
63.11     Subd. 5. Repealer. Minnesota Statutes 2024, section 256R.42, is repealed.
63.12     EFFECTIVE DATE. Subdivision 1 is effective the day following final enactment.
63.13 Subdivision 2 is effective July 1, 2026. Subdivision 3 is effective January 1, 2027.
63.14 Subdivision 4 is effective January 1, 2027, or upon federal approval, whichever is later.
63.15 Subdivision 5 is effective July 1, 2028.
63.16ARTICLE 2
63.17BEHAVIORAL HEALTH
63.18   Section 1. Minnesota Statutes 2024, section 245.4661, is amended by adding a subdivision
63.19 to read:
63.20     Subd. 1a. Direct payment. For purposes of this section, "direct payment" means a
63.21 funding mechanism used by the commissioner to distribute state appropriations to a county,
63.22 Tribe, or other eligible governmental entity for the purpose of carrying out duties, services,
63.23 or activities authorized under this section. A direct payment is not a grant under section
63.24 16B.97 and is not subject to statewide grant-making policies and laws, including but not
63.25 limited to sections 16A.15 and 16C.05, except as specifically required by the commissioner.
63.26 A direct payment must be used for the purposes and allowable activities established by the
63.27 commissioner and is subject to financial oversight, reporting, and monitoring requirements
63.28 under subdivision 11.
63.29     EFFECTIVE DATE. This section is effective the day following final enactment.
Article 2 Section 1.  63
04/06/26  REVISOR  DTT/CH  26-08138  as introduced
64.1    Sec. 2. Minnesota Statutes 2024, section 245.4661, is amended by adding a subdivision
64.2  to read:
64.3      Subd. 3a. Authority and rulemaking. The commissioner may distribute money under
64.4  this section through direct payments when the commissioner determines that a direct payment
64.5  is the most effective and efficient method to support the delivery of adult mental health
64.6  services, Tribal government activities, or county responsibilities under this section. The
64.7  commissioner shall establish eligibility criteria, allowable uses, documentation standards,
64.8  and reporting requirements for recipients of direct payments. The commissioner is authorized
64.9  to engage in rulemaking to fulfill the requirements of this subdivision.
64.10     EFFECTIVE DATE. This section is effective the day following final enactment.
64.11   Sec. 3. Minnesota Statutes 2025 Supplement, section 245.4661, subdivision 9, is amended
64.12 to read:
64.13     Subd. 9. Programs and eligible services and programs. (a) The following three distinct
64.14 grant programs are funded may receive direct payments under this section:
64.15     (1) mental health crisis services;
64.16     (2) housing with supports for adults with serious mental illness; and
64.17     (3) projects for assistance in transitioning from homelessness (PATH program).
64.18     (b) In addition, The following services are eligible for grant funds funding as direct
64.19 payments under this section as the payor of last resort:
64.20     (1) community education and prevention;
64.21     (2) client outreach;
64.22     (3) early identification and intervention;
64.23     (4) adult outpatient diagnostic assessment and psychological testing;
64.24     (5) peer support services;
64.25     (6) community support program services (CSP);
64.26     (7) adult residential crisis stabilization;
64.27     (8) supported employment;
64.28     (9) assertive community treatment (ACT);
64.29     (10) housing subsidies;
Article 2 Sec. 3.  64
04/06/26  REVISOR  DTT/CH  26-08138  as introduced
65.1      (11) basic living, social skills, and community intervention;
65.2      (12) emergency response services;
65.3      (13) adult outpatient psychotherapy;
65.4      (14) adult outpatient medication management;
65.5      (15) adult mobile crisis services, including the purchase and renovation of vehicles by
65.6  mobile crisis teams in order to provide protected transport under section 256B.0625,
65.7  subdivision 17, paragraph (l), clause (6);
65.8      (16) adult day treatment;
65.9      (17) partial hospitalization;
65.10     (18) adult residential treatment;
65.11     (19) adult mental health targeted case management; and
65.12     (20) transportation.
65.13     EFFECTIVE DATE. This section is effective the day following final enactment.
65.14   Sec. 4. Minnesota Statutes 2024, section 245.4661, subdivision 10, is amended to read:
65.15     Subd. 10. Commissioner duty to report on use of grant funds biennially. (a) By
65.16 November 1, 2016, and biennially thereafter, the commissioner of human services shall
65.17 provide sufficient information to the members of the legislative committees having
65.18 jurisdiction over mental health funding and policy issues to evaluate the use of funds
65.19 appropriated under this section. The commissioner shall provide, at a minimum, the following
65.20 information:
65.21     (1) the amount of funding to adult mental health initiatives, what programs and services
65.22 were funded in the previous two years, gaps in services that each initiative brought to the
65.23 attention of the commissioner, and outcome data for the programs and services that were
65.24 funded; and
65.25     (2) the amount of funding for other targeted services and the location of services.
65.26     (b) This subdivision expires January 1, 2032.
65.27     EFFECTIVE DATE. This section is effective the day following final enactment.
Article 2 Sec. 4.  65
04/06/26  REVISOR  DTT/CH  26-08138  as introduced
66.1    Sec. 5. Minnesota Statutes 2024, section 245.4661, is amended by adding a subdivision
66.2  to read:
66.3Subd. 12. Oversight of direct payments. (a) The commissioner shall develop and
66.4  maintain monitoring, financial review, and accountability procedures for all direct payments
66.5  issued under this section.
66.6(b) Recipients of direct payments must comply with all documentation, reporting, and
66.7  expenditure requirements established by the commissioner.
66.8(c) The commissioner may require corrective action, suspend payments, or recover funds
66.9  if a recipient fails to comply with requirements established under this subdivision.
66.10(d) The commissioner shall develop a direct payment acknowledgment process to ensure
66.11 that recipients understand the terms, conditions, and oversight requirements associated with
66.12 direct payments.
66.13(e) The commissioner is authorized to engage in rulemaking to fulfill the requirements
66.14 of this subdivision.
66.15EFFECTIVE DATE. This section is effective the day following final enactment.
66.16   Sec. 6. Minnesota Statutes 2024, section 245I.011, subdivision 5, is amended to read:
66.17Subd. 5. Programs certified under chapter 256B. (a) An individual, organization, or
66.18 government entity certified under the following sections must comply with all of the
66.19 responsibilities assigned to a license holder under this chapter except subdivision 1:
66.20(1) an assertive community treatment provider under section 256B.0622, subdivision
66.21 3a;
66.22(2) an adult rehabilitative mental health services provider under section 256B.0623;
66.23(3) a mobile crisis team under section 256B.0624;
66.24(4) a children's therapeutic services and supports provider under section 256B.0943;
66.25(5) a children's intensive behavioral health services provider under section 256B.0946;
66.26 and
66.27(6) an intensive nonresidential rehabilitative mental health services provider under section
66.28 256B.0947.; and
66.29(7) effective July 1, 2027, or upon federal approval, whichever is later, a coordinated
66.30 specialty care team under section 256B.0672.
Article 2 Sec. 6.  66
04/06/26  REVISOR  DTT/CH  26-08138  as introduced
67.1      (b) An individual, organization, or government entity certified under the sections listed
67.2  in paragraph (a), clauses (1) to (6) (7), must obtain a criminal background study for each
67.3  staff person and volunteer providing direct contact services to a client.
67.4      EFFECTIVE DATE. This section is effective the day following final enactment.
67.5    Sec. 7. Minnesota Statutes 2024, section 254A.03, subdivision 2, is amended to read:
67.6      Subd. 2. American Indian programs. There is hereby created a section of American
67.7  Indian programs, within the Alcohol and Drug Abuse Section of the Department of Human
67.8  Services, to be headed by a special assistant for American Indian programs on substance
67.9  misuse and substance use disorder and two assistants to that position. The section shall be
67.10 staffed with all personnel necessary to fully administer programming for substance misuse
67.11 and substance use disorder services for American Indians in the state. The special assistant
67.12 position shall be filled by a person with considerable practical experience in and
67.13 understanding of substance misuse and substance use disorder in the American Indian
67.14 community, who shall be responsible to the director of the Alcohol and Drug Abuse Section
67.15 created in subdivision 1 and shall be in the unclassified service. The special assistant shall
67.16 meet and consult with the American Indian Advisory Council as described in section
67.17 254A.035 and serve as a liaison to the Minnesota Indian Affairs Council and tribes to report
67.18 on the status of substance misuse and substance use disorder among American Indians in
67.19 the state of Minnesota. The special assistant with the approval of the director shall:
67.20     (1) administer direct payments using funds appropriated for American Indian groups,
67.21 organizations and reservations within the state for American Indian substance misuse and
67.22 substance use disorder programs;
67.23     (2) establish policies and procedures for such American Indian programs with the
67.24 assistance of the American Indian Advisory Board; and
67.25     (3) hire and supervise staff to assist in the administration of the American Indian program
67.26 section within the Alcohol and Drug Abuse Section of the Department of Human Services.
67.27     EFFECTIVE DATE. This section is effective January 1, 2027.
67.28   Sec. 8. Minnesota Statutes 2025 Supplement, section 254B.02, subdivision 5, is amended
67.29 to read:
67.30     Subd. 5. Tribal allocation. The commissioner may make direct payments to Tribal
67.31 Nation servicing agencies from money allocated under this section to support individuals
67.32 with substance use disorders and determine eligibility for behavioral health fund payments.
Article 2 Sec. 8.  67
04/06/26  REVISOR        DTT/CH  26-08138  as introduced
68.1  The payment must not be less than 133 percent of the Tribal Nations payment for the fiscal
68.2  year ending June 30, 2009, adjusted in proportion to the statewide change in the appropriation
68.3  for this chapter.
68.4      EFFECTIVE DATE. This section is effective January 1, 2027.
68.5    Sec. 9. Minnesota Statutes 2025 Supplement, section 254B.03, subdivision 4, is amended
68.6  to read:
68.7      Subd. 4. Division of costs. (a) Except for services provided by a county under section
68.8  254B.09, subdivision 1, or services provided under section 256B.69, the county shall, out
68.9  of local money, pay the state for 22.95 50 percent of the cost of substance use disorder
68.10 services, except for those services provided to persons enrolled in medical assistance under
68.11 chapter 256B and room and board services under section 254B.0505, subdivision 1. Counties
68.12 may use the indigent hospitalization levy for treatment and hospital payments made under
68.13 this section.
68.14     (b) 22.95 50 percent of any state collections from private or third-party pay, less 15
68.15 percent for the cost of payment and collections, must be distributed to the county that paid
68.16 for a portion of the treatment under this section.
68.17     EFFECTIVE DATE. This section is effective July 1, 2026.
68.18   Sec. 10. Minnesota Statutes 2025 Supplement, section 254B.0503, subdivision 1, is
68.19 amended to read:
68.20     Subdivision 1. Eligible vendor requirements. (a) Vendors of room and board are
68.21 eligible for behavioral health fund payment if the vendor:
68.22     (1) has rules prohibiting residents bringing chemicals into the facility or using chemicals
68.23 while residing in the facility and provide consequences for infractions of those rules;
68.24     (2) is determined to meet applicable health and safety requirements;
68.25     (3) is not a jail or prison;
68.26     (4) is not concurrently receiving funds under chapter 256I for the recipient;
68.27     (5) admits individuals who are 18 years of age or older;
68.28     (6) is registered as a board and lodging or lodging establishment according to section
68.29 157.17;
68.30     (7) has awake staff on site whenever a client is present;
Article 2 Sec. 10.  68
04/06/26  REVISOR       DTT/CH  26-08138  as introduced
69.1      (8) has staff who are at least 18 years of age and meet the requirements of section
69.2  245G.11, subdivision 1, paragraph (b);
69.3      (9) has emergency behavioral procedures that meet the requirements of section 245G.16;
69.4      (10) meets the requirements of section 245G.08, subdivision 5, if administering
69.5  medications to clients;
69.6      (11) meets the abuse prevention requirements of section 245A.65, including a policy on
69.7  fraternization and the mandatory reporting requirements of section 626.557;
69.8      (12) documents coordination with the treatment provider to ensure compliance with
69.9  section 254B.03, subdivision 2;
69.10     (13) protects client funds and ensures freedom from exploitation by meeting the
69.11 provisions of section 245A.04, subdivision 13;
69.12     (14) has a grievance procedure that meets the requirements of section 245G.15,
69.13 subdivision 2; and
69.14     (15) has sleeping and bathroom facilities for men and women separated by a door that
69.15 is locked, has an alarm, or is supervised by awake staff.
69.16     (b) Programs providing children's mental health crisis admissions and stabilization under
69.17 section 245.4882, subdivision 6, are eligible vendors of room and board.
69.18     (c) Programs providing children's residential services under section 245.4882, except
69.19 services for individuals who have a placement under chapter 260C or 260D, are eligible
69.20 vendors of room and board.
69.21     (d) A vendor that is not licensed as a residential treatment program must have a policy
69.22 to address staffing coverage when a client may unexpectedly need to be present at the room
69.23 and board site.
69.24     (e) No new vendors for room and board services may be approved after June 30, 2025,
69.25 to receive payments from the behavioral health fund, under the provisions of section 254B.04,
69.26 subdivision 2a. Room and board vendors that were approved and operating prior to July 1,
69.27 2025, may continue to receive payments from the behavioral health fund for services provided
69.28 until June 30, 2027 December 31, 2026. Room and board vendors providing services in
69.29 accordance with section 254B.04, subdivision 2a, will no longer be eligible to claim
69.30 reimbursement for room and board services provided on or after July January 1, 2027.
69.31     EFFECTIVE DATE. This section is effective the day following final enactment.
Article 2 Sec. 10.  69
04/06/26  REVISOR        DTT/CH  26-08138  as introduced
70.1    Sec. 11. Minnesota Statutes 2025 Supplement, section 254B.0509, subdivision 2, is
70.2  amended to read:
70.3      Subd. 2. Annual adjustments. Effective January 1, 2027, and annually thereafter, the
70.4  commissioner of human services must adjust the payment rates under subdivision 1 according
70.5  to the change from the midpoint of the previous rate year to the midpoint of the rate year
70.6  for which the rate is being determined using the Centers for Medicare and Medicaid Services
70.7  Medicare Economic Index as forecasted in the fourth quarter of the calendar year before
70.8  the rate year. Notwithstanding this subdivision, rates must not be adjusted lower than those
70.9  established on January 1, 2026.
70.10     EFFECTIVE DATE. This section is effective the day following final enactment.
70.11   Sec. 12. Minnesota Statutes 2024, section 254B.06, subdivision 2, is amended to read:
70.12     Subd. 2. Allocation of collections. The commissioner shall allocate 77.05 50 percent
70.13 of patient payments and third-party payments to the special revenue account and 22.95 50
70.14 percent to the county financially responsible for the patient.
70.15     EFFECTIVE DATE. This section is effective July 1, 2026.
70.16   Sec. 13. [256B.0618] COVERAGE FOR DETAINED INDIVIDUALS.
70.17     (a) An inmate of a correctional facility who is conditionally released under section
70.18 241.26, 244.065, or 631.425 is eligible for medical assistance if the individual:
70.19     (1) does not require the security of a public detention facility and is housed:
70.20     (i) in a halfway house or community correction center; or
70.21     (ii) under house arrest and monitored by electronic surveillance in a residence approved
70.22 by the commissioner of corrections; and
70.23     (2) meets all other eligibility requirements of this chapter.
70.24     (b) An individual, regardless of age, who is considered an inmate of a public institution
70.25 as defined in Code of Federal Regulations, title 42, section 435.1010, and who meets the
70.26 eligibility requirements in section 256B.056 is not eligible for medical assistance, except
70.27 for covered medical assistance services received:
70.28     (1) while an inpatient in a medical institution as defined in Code of Federal Regulations,
70.29 title 42, section 435.1010;
Article 2 Sec. 13.  70
04/06/26  REVISOR        DTT/CH  26-08138  as introduced
71.1      (2) by an eligible juvenile in accordance with the Consolidated Appropriations Act,
71.2  2023, Public Law 117-328, part 5121; and
71.3      (3) by an eligible individual under with section 256B.0761.
71.4      (c) Security logistics and costs related to the inpatient treatment of an inmate are the
71.5  responsibility of the entity with jurisdiction over the inmate.
71.6      EFFECTIVE DATE. This section is effective January 1, 2027.
71.7    Sec. 14. [256B.0619] CARCERAL TARGETED CASE MANAGEMENT SERVICES.
71.8      Subdivision 1. Generally. Effective January 1, 2027, or upon federal approval, whichever
71.9  is later, medical assistance covers carceral targeted case management services in accordance
71.10 with section 256B.0761 and United States Code, title 42, sections 1396a(a)(84); 1396d(a)(32);
71.11 1397bb(d); and 1397jj(b)(2) and (7).
71.12     Subd. 2. Definitions. (a) For purposes of this section, the following terms have the
71.13 meanings given.
71.14     (b) "Comprehensive care plan" means a person-centered plan that includes goals, tasks,
71.15 and services identified through screening and assessments and agreed upon by all parties.
71.16 This includes but is not limited to identifying resources and services necessary to meet the
71.17 individual's physical, behavioral health, and health-related social needs prerelease and
71.18 postrelease.
71.19     (c) "Consultation" means communication from a carceral targeted case manager to other
71.20 providers working with the same individual to inform, inquire, and instruct regarding the
71.21 individual's symptoms, strategies for effective engagement, care and intervention needs,
71.22 and treatment expectations across service settings, including but not limited to the education
71.23 services, social services, probation, home, primary care, medication prescribers, disabilities
71.24 services, and other mental health providers and to direct and coordinate clinical service
71.25 components provided to the justice-involved individual.
71.26     (d) "Targeted case management for justice-involved individuals" means the provision
71.27 of both county targeted case management and public or private vendor service coordination
71.28 services for the purpose of bridging prerelease and postrelease medical assistance services
71.29 to support the physical, behavioral health, and health-related social needs of justice-involved
71.30 individuals.
71.31     (e) "Targeted case management services" means services that assist medical assistance
71.32 eligible persons to gain access to needed medical, social, educational, and other services.
Article 2 Sec. 14.  71
04/06/26  REVISOR  DTT/CH  26-08138  as introduced
72.1Subd. 3. Eligibility. The following individuals are eligible for carceral targeted case
72.2  management services:
72.3(1) individuals eligible for medical assistance who meet all eligibility requirements under
72.4  United States Code, title 42, section 1396a(nn);
72.5(2) individuals eligible for medical assistance who meet eligibility requirements for the
72.6  Children's Health Insurance Program under United States Code, title 42, section 1397jj(b)(7);
72.7  or
72.8(3) individuals eligible for medical assistance who are currently incarcerated at a section
72.9  1115 reentry demonstration pilot facility and meet the participation requirements in section
72.10 256B.0761, subdivision 2.
72.11Subd. 4. Carceral targeted case management services. (a) For individuals eligible for
72.12 services under subdivision 3, clause (1) or (2), carceral targeted case management care
72.13 coordination is available for 30 days before release and up to 180 days postrelease. For
72.14 individuals eligible for services under subdivision 3, clause (3), carceral targeted case
72.15 management care coordination is available for up to 90 days before release and up to 180
72.16 days postrelease.
72.17(b) Carceral targeted case management care coordination includes:
72.18(1) comprehensive assessment and periodic reassessment addressing physical, behavioral,
72.19 and health-related social needs in accordance with section 256B.0761 and United States
72.20 Code, title 42, sections 1396a(nn) and 1397jj(b)(7).
72.21(2) comprehensive care plans including but not limited to;
72.22(i) the desired goals of the individual;
72.23(ii) the individual's preferences for services and supports;
72.24(iii) formal and informal services and supports based on areas of assessment, such as
72.25 social health, mental health, residence, family, education and vocation, safety, legal,
72.26 self-determination, financial, and chemical health; and
72.27(iv) housing arrangements postrelease.
72.28(3) regular review and revision of the comprehensive care plan with the individual to
72.29 ensure needs are adequately met by referrals and supports;
72.30(4) coordination of referrals, which must contain more than just a list of resources, to
72.31 bridge prerelease to postrelease medical assistance services, including but not limited to
72.32 referrals to community-based services identified as a need on the comprehensive care plan;
Article 2 Sec. 14.  72
04/06/26  REVISOR  DTT/CH  26-08138  as introduced
73.1      (5) warm handoffs and follow-up post release;
73.2      (6) monitoring and evaluation of services identified in the comprehensive care plan to
73.3  ensure personal outcomes are met and to ensure satisfaction with services and service
73.4  delivery;
73.5      (7) consultation with other professionals, including but not limited to community-based
73.6  mental health providers; and
73.7      (8) completion and maintenance of necessary documentation that supports and verifies
73.8  the activities in this section.
73.9      Subd. 5. Carceral targeted case management provider standards. Providers eligible
73.10 to receive medical assistance reimbursement under this section must enroll as a Minnesota
73.11 Health Care Programs provider. To qualify as a provider of carceral targeted case
73.12 management services, a provider must:
73.13     (1) have a minimum of a bachelor's degree or a license in a health or human services
73.14 field, comparable training and two years of experience in human services, or credentials
73.15 from an American Indian Tribe under section 256B.02, subdivision 7;
73.16     (2) demonstrate the capacity and experience to provide targeted case management
73.17 activities for justice-involved individuals as defined in subdivision 2;
73.18     (3) be able to coordinate and connect community resources needed by the recipient;
73.19     (4) demonstrate administrative capacity and experience to serve the justice-involved
73.20 population for which the provider will provide services and ensure quality of services under
73.21 state and federal requirements;
73.22     (5) have a financial management system that provides accurate documentation of services
73.23 and costs under state and federal requirements;
73.24     (6) demonstrate capacity to document and maintain individual case records under state
73.25 and federal requirements;
73.26     (7) demonstrate the capacity to coordinate with county administrative functions;
73.27     (8) be able to coordinate with health care providers to ensure access to necessary health
73.28 care services;
73.29     (9) have a procedure that (i) notifies the recipient of any conflict of interest if the targeted
73.30 case management service provider also provides the recipient's services and supports, (ii)
73.31 provides information on all potential conflicts of interest, (iii) obtains the recipient's informed
73.32 consent, and (iv) provides the recipient with alternatives; and
Article 2 Sec. 14.  73
04/06/26  REVISOR  DTT/CH  26-08138  as introduced
74.1      (10) demonstrate the capacity to achieve the following performance outcomes: (i) access;
74.2  (ii) quality; and (iii) consumer satisfaction.
74.3      Subd. 6. Medical assistance payment and rate setting. (a) Carceral targeted case
74.4  management rates are equal to rates authorized by the commissioner for relocation targeted
74.5  case management under section 256B.0621, subdivision 10.
74.6      (b) The carceral targeted case management rate only includes eligible services delivered
74.7  to an eligible recipient by an eligible provider.
74.8      EFFECTIVE DATE. This section is effective the day following final enactment.
74.9    Sec. 15. Minnesota Statutes 2024, section 256B.0625, is amended by adding a subdivision
74.10 to read:
74.11     Subd. 77. Carceral targeted case management. Effective January 1, 2027, or upon
74.12 federal approval, whichever is later, medical assistance covers carceral targeted case
74.13 management services under 256B.0619.
74.14     EFFECTIVE DATE. This section is effective January 1, 2027, or upon federal approval,
74.15 whichever is later.
74.16   Sec. 16. Minnesota Statutes 2024, section 256B.0625, is amended by adding a subdivision
74.17 to read:
74.18     Subd. 78. Coordinated specialty care services. Effective July 1, 2027, or upon federal
74.19 approval, whichever is later, medical assistance covers coordinated specialty care services
74.20 according to section 256B.0672.
74.21     EFFECTIVE DATE. This section is effective the day following final enactment.
74.22   Sec. 17. [256B.0672] COORDINATED SPECIALTY CARE FOR THE TREATMENT
74.23 OF EARLY EPISODE PSYCHOSIS.
74.24     Subdivision 1. Coverage. (a) Effective July 1, 2027, or upon federal approval, whichever
74.25 is later, medical assistance covers medically necessary coordinated specialty care services
74.26 when the services are provided by an entity certified under and meeting the standards in
74.27 this section.
74.28     (b) The provider entity must report individual client outcomes to the commissioner using
74.29 instruments and protocols approved by the commissioner.
Article 2 Sec. 17.  74
04/06/26  REVISOR  DTT/CH  26-08138  as introduced
75.1      Subd. 2. Definitions. (a) For purposes of this section, the following terms have the
75.2  meanings given.
75.3      (b) "Coordinated specialty care services" means rehabilitative services that include six
75.4  core activities: (1) cognitive or behavioral psychotherapy; (2) medication management; (3)
75.5  family education and support; (4) service coordination; (5) case management; and (6)
75.6  supported employment and education.
75.7      (c) "Coordinated specialty care team" means a group of interdisciplinary mental health
75.8  staff who work as a team to provide coordinated specialty care.
75.9      (d) "Early psychosis" means clinical high-risk stage or early-stage psychotic symptoms
75.10 or psychotic episodes present in Attenuated Psychosis Syndrome and first-episode psychosis.
75.11 Psychotic symptoms may include but are not limited to combinations of confused thinking,
75.12 delusions, hallucinations, changed feelings, and changed behavior.
75.13     (e) "Mental health professional" means a staff person who is qualified according to
75.14 section 245I.04, subdivision 2.
75.15     Subd. 3. Eligibility. An individual who is experiencing early psychosis with a duration
75.16 of onset of less than two years and has been on antipsychotic medications for less than a
75.17 total of 12 months is eligible for coordinated specialty care services.
75.18     Subd. 4. Eligibility exclusion. An individual is not eligible for coordinated specialty
75.19 care services under this section if it is determined that the individual's psychotic symptoms
75.20 are attributable primarily to a:
75.21     (1) substance-induced psychotic disorder;
75.22     (2) major medical condition;
75.23     (3) neurocognitive disorder; or
75.24     (4) developmental disorder.
75.25     Subd. 5. Provider certification requirements. (a) The commissioner must establish a
75.26 process for the certification of coordinated specialty care teams. The certification process
75.27 must determine if a team meets the standards for coordinated specialty care services under
75.28 this section and the standards in section 245I.011, subdivision 5. The provider certification
75.29 process must include ongoing review of required program fidelity standards under subdivision
75.30 13. Recertification may occur at any time and must occur at least every three years.
75.31     (b) The coordinated specialty care services provider must have at least one team. Each
75.32 team must be certified.
Article 2 Sec. 17.  75
04/06/26  REVISOR  DTT/CH  26-08138  as introduced
76.1      (c) To be certified under this section, a coordinated specialty care team must:
76.2      (1) demonstrate capacity to recruit, hire, manage, and train required team members;
76.3      (2) demonstrate adequate administrative ability to ensure availability of services;
76.4      (3) demonstrate flexibility in service delivery to respond to the changing and intermittent
76.5  care needs of a client as identified by the client and the individual treatment plan as defined
76.6  in section 245I.10, subdivisions 7 and 8;
76.7      (4) keep all necessary records required by law;
76.8      (5) be an enrolled medical assistance provider; and
76.9      (6) meet all treatment team staff requirements outlined in subdivision 7.
76.10     (d) The commissioner must establish a process for decertification of a coordinated
76.11 specialty care team and must require corrective action, medical assistance repayment, or
76.12 decertification of a coordinated specialty care team that no longer meets the requirements
76.13 in this section or that fails to meet the clinical quality standards or administrative standards
76.14 provided by the commissioner in the application and certification process. The commissioner
76.15 may decertify a coordinated specialty care team with cause at any time. The decertification
76.16 is subject to appeal to the state.
76.17     Subd. 6. Covered coordinated specialty care services. Coordinated specialty care
76.18 teams must offer and have the capacity to directly provide:
76.19     (1) assertive outreach and engagement strategies to encourage involvement in services;
76.20     (2) assessment for underlying and contributing factors to eligibility;
76.21     (3) person-centered care, delivered in a home and community, extending beyond typical
76.22 hours of operation, including evenings and weekends;
76.23     (4) crisis assessment, planning, and mobile crisis response services under section
76.24 256B.0624;
76.25     (5) team leadership from a mental health professional who provides ongoing consultation
76.26 to the team members, coordinates admission screening, and leads the weekly team meetings
76.27 to facilitate case review and entry to the program;
76.28     (6) employment and education services designed to enable individuals to retain or
76.29 rehabilitate function in workplace and educational settings consistent with individual
76.30 preferences;
Article 2 Sec. 17.  76
04/06/26  REVISOR  DTT/CH  26-08138  as introduced
77.1      (7) family psychoeducation and support provided to the client's family and other natural
77.2  supports to restore and strengthen the client's unique social and family relationships;
77.3      (8) individual and group psychotherapy, including but not limited to cognitive behavioral
77.4  therapies;
77.5      (9) care coordination services in clinic, community, and home settings;
77.6      (10) pharmacotherapy;
77.7      (11) medication management; and
77.8      (12) primary care coordination provided by a mental health professional authorized to
77.9  prescribe psychiatric medications.
77.10     Subd. 7. Team members. (a) Each coordinated specialty care team must have a program
77.11 director, psychiatric care provider, supported employment and education specialist, and
77.12 case manager.
77.13     (b) Coordinated specialty care teams may have a certified peer specialist, a certified peer
77.14 recovery specialist, and a certified family peer specialist.
77.15     Subd. 8. Program director. The program director must be a mental health professional
77.16 or a clinical trainee qualified according to section 245I.04, subdivision 6, and a single
77.17 full-time staff member. The program director must be dedicated to the coordinated specialty
77.18 care team, responsible for overseeing the administrative operations of the team, and
77.19 responsible for supervising team members to ensure delivery of best and ethical practices.
77.20 The program director is responsible for:
77.21     (1) serving as the primary liaison for referrals to the program;
77.22     (2) performing assessment and intake interviews for potential coordinated specialty care
77.23 services clients;
77.24     (3) ensuring medical necessity has been established to support all services delivered;
77.25     (4) engaging clients and family members in treatment and during treatment;
77.26     (5) actively participating in the coordinated specialty care team and providing direct
77.27 services to clients; and
77.28     (6) ensuring that overall treatment supervision for the coordinated specialty care team
77.29 is available after regular business hours and on weekends and holidays and that services
77.30 are provided by a qualified member of the team.
77.31     Subd. 9. Psychiatric care provider. (a) The psychiatric care provider must:
Article 2 Sec. 17.  77
04/06/26  REVISOR  DTT/CH  26-08138  as introduced
78.1      (1) be a mental health professional qualified according to section 245I.04, subdivision
78.2  2, clause (1) or (4), who is authorized to prescribe psychiatric medications as part of the
78.3  mental health professional's scope of practice. The psychiatric care provider must have
78.4  demonstrated clinical experience working with individuals and families, including but not
78.5  limited to the population served and specifically persons experiencing psychosis.
78.6      (2) fulfill the following functions for coordinated specialty care clients:
78.7      (i) provide assessment and treatment of clients' symptoms and response to medications,
78.8  including but not limited to side effects;
78.9      (ii) provide brief therapy to clients;
78.10     (iii) provide diagnostic and medication education to clients, with medication decisions
78.11 based on shared decision making;
78.12     (iv) monitor clients' nonpsychiatric medical conditions and nonpsychiatric medications;
78.13 and
78.14     (v) conduct home and community visits;
78.15     (3) be employed at no less than 0.20 full-time equivalent and comply with the staffing
78.16 requirements in paragraph (b); and
78.17     (4) provide psychiatric backup to the program after regular business hours and on
78.18 weekends and holidays. The psychiatric care provider may delegate this duty to another
78.19 qualified psychiatric provider.
78.20     (b) Psychiatric care providers must have designated hours to work on the coordinated
78.21 specialty care team with sufficient blocks of time on consistent days to carry out the provider's
78.22 clinical, supervisory, and administrative responsibilities. No more than two psychiatric care
78.23 providers may share the psychiatric care provider role on any one team. Backup coverage
78.24 must be arranged when the psychiatric care provider is on vacation or is unavailable for any
78.25 reason. If an individual is receiving care from a medication prescriber who is an ad hoc
78.26 member of the team or a primary care provider, the psychiatric care provider is responsible
78.27 for providing continuity of care with other medical providers, including but not limited to
78.28 the ad hoc psychiatrist, primary care provider, or advanced practice registered nurse, in the
78.29 team meetings and treatment planning.
78.30     Subd. 10. Individual and group psychotherapy provider. An individual or group
78.31 psychotherapy provider must:
Article 2 Sec. 17.  78
04/06/26  REVISOR  DTT/CH  26-08138  as introduced
79.1(1) be a mental health professional qualified under section 245I.04, subdivision 2; a
79.2  clinical trainee qualified under section 245I.04, subdivision 6; or a mental health practitioner
79.3  qualified under section 245I.04, subdivision 4, who has prior experience with providing
79.4  mental health services to individuals and families, particularly persons experiencing
79.5  psychosis; and
79.6(2) be responsible for:
79.7(i) providing individual and group therapy or skills training; and
79.8(ii) working with clients to identify goals, learn about symptoms and symptom
79.9  management through social and coping skills training, receive psychoeducation, learn
79.10 relaxation techniques, and engage in behavioral activation and other therapeutic techniques
79.11 in both an individual and group setting.
79.12Subd. 11. Case manager. A case manager must be a case management service provider
79.13 as defined in section 245.462, subdivision 4, or 245.4871, subdivision 4, and be responsible
79.14 for providing case management and family community support services as established in
79.15 section 245.4711 or 245.4881.
79.16Subd. 12. Mental health certified peer specialist and certified family peer
79.17 specialist. (a) A coordinated specialty care team may have:
79.18(1) a mental health certified peer specialist qualified under section 245I.04, subdivision
79.19 10;
79.20(2) a mental health certified family peer specialist qualified under section 245I.04,
79.21 subdivision 12; or
79.22(3) a certified rehabilitation specialist qualified under section 245I.04, subdivision 8.
79.23Subd. 13. Compliance with evidence-based practice and data reporting. (a) A
79.24 coordinated specialty care team must remain in compliance with fidelity standards as
79.25 measured by a fidelity tool for the treatment of early episode psychosis approved by the
79.26 commissioner. A team must submit data necessary to ensure fidelity with evidence-based
79.27 practice models in a form and manner prescribed by the commissioner.
79.28(b) A team must submit quality and outcomes data, including but not limited to client
79.29 satisfaction data, to the commissioner on a timeline and in a form and manner prescribed
79.30 by the commissioner.
79.31Subd. 14. Coordinated specialty care team variances. The commissioner may grant
79.32 a variance to specific requirements under this section for a coordinated specialty care team
Article 2 Sec. 17.  79
04/06/26  REVISOR  DTT/CH  26-08138  as introduced
80.1  when the coordinated specialty care team demonstrates an inability to meet the specific
80.2  requirement and how the team will ensure that the variance does not negatively impact
80.3  outcomes for clients. The commissioner may require a plan of action for the coordinated
80.4  specialty care team to come into compliance with the specific variance requirement and
80.5  establish specific time limits for the variance. A decision to grant or deny a variance request
80.6  is final and not subject to appeal.
80.7Subd. 15. Concurrent services. (a) The rate for coordinated specialty care services does
80.8  not include medical assistance payment for the following services:
80.9(1) inpatient psychiatric hospital treatment;
80.10(2) partial hospitalization;
80.11(3) child or adult mental health day treatment services;
80.12(4) physician services outside of care provided by a psychiatrist serving as a member of
80.13 the treatment team;
80.14(5) medical assistance room and board rate as defined in section 256B.056, subdivision
80.15 5d;
80.16(6) home and community-based waiver services;
80.17(7) mental health services identified in a child's individualized education program;
80.18(8) child and family psychoeducation services as defined in section 256B.0671,
80.19 subdivision 5;
80.20(9) dialectical behavior therapy as defined in section 256B.0671, subdivision 6;
80.21(10) neuropsychological assessments as defined in section 256B.0671, subdivision 8;
80.22(11) neuropsychological testing as defined in section 256B.0671, subdivision 9; and
80.23(12) psychological testing as defined in section 256B.0671, subdivision 10.
80.24(b) The services in paragraph (a) may be billed separately.
80.25Subd. 16. Excluded services. The following services are not covered under this section
80.26 and are not eligible for medical assistance payment while an individual is receiving
80.27 coordinated specialty care services:
80.28(1) mental health residential treatment, except during the last 30 days of residential
80.29 treatment to support discharge planning;
Article 2 Sec. 17.  80
04/06/26  REVISOR  DTT/CH  26-08138  as introduced
81.1(2) children's therapeutic services and supports as defined in section 256B.0943, except
81.2  for children's day treatment;
81.3(3) intensive rehabilitative mental health services as defined in section 256B.0947;
81.4(4) assertive community treatment services as defined in section 256B.0622;
81.5(5) mental health targeted case management under section 245.4881; and
81.6(6) mental health clinical care consultation as defined in section 256B.0671, subdivision
81.7  7.
81.8Subd. 17. Payments. The commissioner must make payments to each designated provider
81.9  for the provision of coordinated specialty care services under subdivision 6 to each eligible
81.10 individual under subdivision 3.
81.11EFFECTIVE DATE. This section is effective the day following final enactment.
81.12   Sec. 18. Minnesota Statutes 2024, section 256B.0761, subdivision 2, is amended to read:
81.13Subd. 2. Eligible individuals. Notwithstanding section 256B.055, subdivision 14,
81.14 Individuals are eligible to receive services under this demonstration if they are eligible under
81.15 section 256B.055, subdivision 3a, 6, 7, 7a, 9, 15, 16, or 17, as determined by the
81.16 commissioner in collaboration with correctional facilities, local governments, and Tribal
81.17 governments.
81.18   Sec. 19. Minnesota Statutes 2024, section 297E.02, subdivision 3, is amended to read:
81.19Subd. 3. Collection; disposition. (a) Taxes imposed by this section are due and payable
81.20 to the commissioner when the gambling tax return is required to be filed. Distributors must
81.21 file their monthly sales figures with the commissioner on a form prescribed by the
81.22 commissioner. Returns covering the taxes imposed under this section must be filed with
81.23 the commissioner on or before the 20th day of the month following the close of the previous
81.24 calendar month. The commissioner shall prescribe the content, format, and manner of returns
81.25 or other documents pursuant to section 270C.30. The proceeds, along with the revenue
81.26 received from all license fees and other fees under sections 349.11 to 349.191, 349.211,
81.27 and 349.213, must be paid to the commissioner of management and budget for deposit in
81.28 the general fund.
81.29(b) The sales tax imposed by chapter 297A on the sale of pull-tabs and tipboards by the
81.30 distributor is imposed on the retail sales price. The retail sale of pull-tabs or tipboards by
Article 2 Sec. 19.  81
04/06/26  REVISOR        DTT/CH  26-08138  as introduced
82.1  the organization is exempt from taxes imposed by chapter 297A and is exempt from all
82.2  local taxes and license fees except a fee authorized under section 349.16, subdivision 8.
82.3      (c) One-half of one percent of the revenue deposited in the general fund under paragraph
82.4  (a), is appropriated to the commissioner of human services for the compulsive gambling
82.5  treatment program established under section 245.98. One-half of one percent of the revenue
82.6  deposited in the general fund under paragraph (a), is appropriated to the commissioner of
82.7  human services for a grant to the state affiliate recognized by the National Council on
82.8  Problem Gambling to increase public awareness of problem gambling, education and training
82.9  for individuals and organizations providing effective treatment services to problem gamblers
82.10 and their families, and research relating to problem gambling. Money appropriated by this
82.11 paragraph must supplement and must not replace existing state funding for these programs.
82.12     (d) The commissioner of human services must provide to the state affiliate recognized
82.13 by the National Council on Problem Gambling a monthly statement of the amounts deposited
82.14 under paragraph (c). Beginning January 1, 2022, the commissioner of human services must
82.15 provide to the chairs and ranking minority members of the legislative committees with
82.16 jurisdiction over treatment for problem gambling and to the state affiliate recognized by the
82.17 National Council on Problem Gambling an annual reconciliation of the amounts deposited
82.18 under paragraph (c). The annual reconciliation under this paragraph must include the amount
82.19 allocated to the commissioner of human services for the compulsive gambling treatment
82.20 program established under section 245.98, and the amount allocated to the state affiliate
82.21 recognized by the National Council on Problem Gambling. The annual reconciliation must
82.22 also include any rollover amounts from the previous fiscal year and the utilization of those
82.23 amounts during the current reporting period.
82.24   Sec. 20. Laws 2025, First Special Session chapter 9, article 4, section 2, the effective date,
82.25 is amended to read:
82.26     EFFECTIVE DATE. This section is effective January July 1, 2027 2026.
82.27     EFFECTIVE DATE. This section is effective the day following final enactment.
82.28   Sec. 21. Laws 2025, First Special Session chapter 9, article 4, section 23, the effective
82.29 date, is amended to read:
82.30     EFFECTIVE DATE. This section is effective January July 1, 2027 2026.
82.31     EFFECTIVE DATE. This section is effective the day following final enactment.
Article 2 Sec. 21.  82
04/06/26  REVISOR       DTT/CH  26-08138  as introduced
83.1    Sec. 22. Laws 2025, First Special Session chapter 9, article 4, section 38, the effective
83.2  date, is amended to read:
83.3      EFFECTIVE DATE. This section is effective January July 1, 2027 2026.
83.4      EFFECTIVE DATE. This section is effective the day following final enactment.
83.5    Sec. 23. Laws 2025, First Special Session chapter 9, article 4, section 39, the effective
83.6  date, is amended to read:
83.7      EFFECTIVE DATE. This section is effective January July 1, 2027 2026.
83.8      EFFECTIVE DATE. This section is effective the day following final enactment.
83.9    Sec. 24. Laws 2025, First Special Session chapter 9, article 4, section 40, the effective
83.10 date, is amended to read:
83.11     EFFECTIVE DATE. This section is effective January July 1, 2027 2026.
83.12     EFFECTIVE DATE. This section is effective the day following final enactment.
83.13   Sec. 25. Laws 2025, First Special Session chapter 9, article 4, section 41, the effective
83.14 date, is amended to read:
83.15     EFFECTIVE DATE. This section is effective January July 1, 2027 2026.
83.16     EFFECTIVE DATE. This section is effective the day following final enactment.
83.17   Sec. 26. Laws 2025, First Special Session chapter 9, article 4, section 42, the effective
83.18 date, is amended to read:
83.19     EFFECTIVE DATE. This section is effective January July 1, 2027 2026.
83.20     EFFECTIVE DATE. This section is effective the day following final enactment.
83.21   Sec. 27. Laws 2025, First Special Session chapter 9, article 4, section 43, the effective
83.22 date, is amended to read:
83.23     EFFECTIVE DATE. This section is effective January July 1, 2027 2026.
83.24     EFFECTIVE DATE. This section is effective the day following final enactment.
83.25   Sec. 28. Laws 2025, First Special Session chapter 9, article 4, section 44, the effective
83.26 date, is amended to read:
83.27     EFFECTIVE DATE. This section is effective January July 1, 2027 2026.
Article 2 Sec. 28.  83
04/06/26  REVISOR       DTT/CH  26-08138  as introduced
84.1      EFFECTIVE DATE. This section is effective the day following final enactment.
84.2    Sec. 29. Laws 2025, First Special Session chapter 9, article 4, section 50, the effective
84.3  date, is amended to read:
84.4      EFFECTIVE DATE. This section is effective January July 1, 2027 2026.
84.5      EFFECTIVE DATE. This section is effective the day following final enactment.
84.6    Sec. 30. Laws 2025, First Special Session chapter 9, article 4, section 51, is amended to
84.7  read:
84.8    Sec. 51. RECOVERY RESIDENCE WORK GROUP.
84.9      (a) The commissioner of human services must convene a work group to develop
84.10 recommendations specific to recovery residences. The work group must:
84.11     (1) produce a report that examines how other states fund recovery residences, identifying
84.12 best practices and models that could be applicable to Minnesota;
84.13     (2) engage with stakeholders to ensure meaningful collaboration with key external
84.14 stakeholders on the ideas being developed that will inform the final plan and
84.15 recommendations; and
84.16     (3) create an implementable plan addressing housing needs for individuals in outpatient
84.17 substance use disorder treatment that includes:
84.18     (i) clear strategies for aligning housing models with individual treatment needs;
84.19     (ii) an assessment of funding streams, including potential federal funding sources;
84.20     (iii) a timeline for implementation with key milestones and action steps;
84.21     (iv) recommendations for future resource allocation to ensure long-term housing stability
84.22 for individuals in recovery;
84.23     (v) specific recommendations for policy or legislative changes that may be required to
84.24 support sustainable recovery housing solutions, including challenges faced by recovery
84.25 residences resulting from state and local housing regulations and ordinances; and
84.26     (vi) recommendations for potentially delegating the commissioner's recovery residence
84.27 certification duties under Minnesota Statutes, sections 254B.21 to 254B.216 to a third-party
84.28 organization.
84.29     (b) The work group must include but is not limited to:
Article 2 Sec. 30.  84
04/06/26  REVISOR        DTT/CH  26-08138  as introduced
85.1      (1) at least two designees from the Department of Human Services representing: (i)
85.2  behavioral health; and (ii) homelessness and housing and support services;
85.3      (2) the commissioner of health or a designee;
85.4      (3) two people who have experience living in a recovery residence;
85.5      (4) representatives from at least three substance use disorder lodging facilities currently
85.6  operating in Minnesota;
85.7      (5) three representatives from county social services agencies, at least one from inside
85.8  the seven-county metropolitan area and one from outside the seven-county metropolitan
85.9  area;
85.10     (6) a representative from a Tribal social services agency;
85.11     (7) representatives from the state affiliate of the National Alliance for Recovery
85.12 Residences; and
85.13     (8) representatives from state mental health advocacy and adult mental health provider
85.14 organizations.
85.15     (c) The work group must meet at least monthly and as necessary to fulfill its
85.16 responsibilities. The commissioner of human services must provide administrative support
85.17 and meeting space for the work group. The work group may conduct meetings remotely.
85.18     (d) The commissioner of human services must make appointments to the work group
85.19 by October 1, 2025, and convene the first meeting of the work group by January 15, 2026.
85.20     (e) The work group must submit a final report with recommendations to the chairs and
85.21 ranking minority members of the legislative committees with jurisdiction over health and
85.22 human services policy and finance on or before January July 1, 2027 2026.
85.23   Sec. 31. DIRECTION TO COMMISSIONER; CARCERAL TARGETED CASE
85.24 MANAGEMENT SERVICES BILLING UNITS.
85.25     The commissioner of human services must establish a new billing code for carceral
85.26 targeted case management services. The commissioner must identify reimbursement rates
85.27 for the newly defined codes, as required under Minnesota Statutes, section 256B.0619,
85.28 subdivision 6. The new billing codes must correspond to a 15-minute unit. The new billing
85.29 codes must be available for 180 days postrelease.
85.30     EFFECTIVE DATE. This section is effective January 1, 2027, or upon federal approval,
85.31 whichever is later.
Article 2 Sec. 31.  85
04/06/26  REVISOR  DTT/CH  26-08138  as introduced
86.1    Sec. 32. REPEALER.
86.2      Minnesota Statutes 2024, section 256B.055, subdivision 14, is repealed.
86.3      EFFECTIVE DATE. This section is effective January 1, 2027, or upon federal approval,
86.4  whichever is later.
86.5ARTICLE 3
86.6   DEPARTMENT OF HUMAN SERVICES OFFICE OF INSPECTOR GENERAL
86.7    Section 1. [245A.034] LICENSEE CONDUCT TOWARD PUBLIC OFFICIALS.
86.8      (a) Applicants, license holders, certification holders, and controlling individuals must
86.9  refrain from engaging in conduct that threatens the safety or well-being of Department of
86.10 Human Services staff, county employees, or other individuals acting under the authority of
86.11 the commissioner for duties authorized under this chapter, chapter 260E, and section 626.557.
86.12 Prohibited conduct includes but is not limited to:
86.13     (1) assault, including attempts, under sections 609.221, 609.222, 609.223, 609.2231,
86.14 and 609.224, regardless of whether there is a criminal proceeding or conviction;
86.15     (2) threats of violence under section 609.713, regardless of whether there is a criminal
86.16 proceeding or conviction;
86.17     (3) harassment or stalking under section 609.749, regardless of whether there is a criminal
86.18 proceeding or conviction;
86.19     (4) damage to property under section 609.595, regardless of whether there is a criminal
86.20 proceeding or conviction; or
86.21     (5) any other act with the intent to cause harm to personal safety.
86.22     (b) If the commissioner determines that conduct prohibited by paragraph (a) occurred
86.23 to an individual engaged in licensing, certification, investigation, or compliance activities,
86.24 the commissioner may take action under sections 245A.05, 245A.06, or 245A.07.
86.25     EFFECTIVE DATE. This section is effective the day following final enactment.
86.26   Sec. 2. Minnesota Statutes 2025 Supplement, section 245A.07, subdivision 3, is amended
86.27 to read:
86.28     Subd. 3. License suspension, revocation, or fine. (a) The commissioner may suspend
86.29 or revoke a license, or impose a fine if:
Article 3 Sec. 2.  86
04/06/26  REVISOR  DTT/CH  26-08138  as introduced
87.1      (1) a license holder fails to comply fully with applicable laws or rules including but not
87.2  limited to the requirements of this chapter and chapter 245C;
87.3      (2) a license holder, a controlling individual, or an individual living in the household
87.4  where the licensed services are provided or is otherwise subject to a background study has
87.5  been disqualified and the disqualification was not set aside and no variance has been granted;
87.6      (3) a license holder knowingly withholds relevant information from or gives false or
87.7  misleading information to the commissioner in connection with an application for a license,
87.8  in connection with the background study status of an individual, during an investigation,
87.9  or regarding compliance with applicable laws or rules;
87.10     (4) a license holder is excluded from any program administered by the commissioner
87.11 under section 245.095;
87.12     (5) revocation is required under section 245A.04, subdivision 7, paragraph (d); or
87.13     (6) suspension is necessary under subdivision 2a, paragraph (b), clause (2).
87.14     A license holder who has had a license issued under this chapter suspended, revoked,
87.15 or has been ordered to pay a fine must be given notice of the action by certified mail, by
87.16 personal service, or through the provider licensing and reporting hub. If mailed, the notice
87.17 must be mailed to the address shown on the application or the last known address of the
87.18 license holder. The notice must state in plain language the reasons the license was suspended
87.19 or revoked, or a fine was ordered.
87.20     (b) If the license was suspended or revoked, the notice must inform the license holder
87.21 of the right to a contested case hearing under chapter 14 and Minnesota Rules, parts
87.22 1400.8505 to 1400.8612. The license holder may appeal an order suspending or revoking
87.23 a license. The appeal of an order suspending or revoking a license must be made in writing
87.24 by certified mail, by personal service, or through the provider licensing and reporting hub.
87.25 If mailed, the appeal must be postmarked and sent to the commissioner within ten calendar
87.26 days after the license holder receives notice that the license has been suspended or revoked.
87.27 If a request is made by personal service, it must be received by the commissioner within
87.28 ten calendar days after the license holder received the order. If the order is issued through
87.29 the provider hub, the appeal must be received by the commissioner within ten calendar days
87.30 from the date the commissioner issued the order through the hub. Except as provided in
87.31 subdivision 2a, paragraph (c), if a license holder submits a timely appeal of an order
87.32 suspending or revoking a license, the license holder may continue to operate the program
87.33 as provided in section 245A.04, subdivision 7, paragraphs (i) and (j), until the commissioner
87.34 issues a final order on the suspension or revocation.
Article 3 Sec. 2.  87
04/06/26  REVISOR  DTT/CH  26-08138  as introduced
88.1      (c)(1) If the license holder was ordered to pay a fine, the notice must inform the license
88.2  holder of the responsibility for payment of fines and the right to a contested case hearing
88.3  under chapter 14 and Minnesota Rules, parts 1400.8505 to 1400.8612. The appeal of an
88.4  order to pay a fine must be made in writing by certified mail, by personal service, or through
88.5  the provider licensing and reporting hub. If mailed, the appeal must be postmarked and sent
88.6  to the commissioner within ten calendar days after the license holder receives notice that
88.7  the fine has been ordered. If a request is made by personal service, it must be received by
88.8  the commissioner within ten calendar days after the license holder received the order. If the
88.9  order is issued through the provider hub, the appeal must be received by the commissioner
88.10 within ten calendar days from the date the commissioner issued the order through the hub.
88.11     (2) The license holder shall pay the fines assessed on or before the payment date specified.
88.12 If the license holder fails to fully comply with the order, the commissioner may issue a
88.13 second fine or suspend the license until the license holder complies. If the license holder
88.14 receives state funds, the state, county, or municipal agencies or departments responsible for
88.15 administering the funds shall withhold payments and recover any payments made while the
88.16 license is suspended for failure to pay a fine. A timely appeal shall stay payment of the fine
88.17 until the commissioner issues a final order.
88.18     (3) A license holder shall promptly notify the commissioner of human services, in writing,
88.19 when a violation specified in the order to forfeit a fine is corrected. If upon reinspection the
88.20 commissioner determines that a violation has not been corrected as indicated by the order
88.21 to forfeit a fine, the commissioner may issue a second fine. The commissioner shall notify
88.22 the license holder by certified mail, by personal service, or through the provider licensing
88.23 and reporting hub that a second fine has been assessed. The license holder may appeal the
88.24 second fine as provided under this subdivision.
88.25     (4) Fines shall be assessed as follows:
88.26     (i) the license holder shall forfeit $1,000 for each determination of maltreatment of a
88.27 child under chapter 260E or the maltreatment of a vulnerable adult under section 626.557
88.28 for which the license holder is determined responsible for the maltreatment under section
88.29 260E.30, subdivision 4, paragraphs (a) and (b), or 626.557, subdivision 9c, paragraph (c);
88.30     (ii) if the commissioner determines that a determination of maltreatment for which the
88.31 license holder is responsible is the result of maltreatment that meets the definition of serious
88.32 maltreatment as defined in section 245C.02, subdivision 18, the license holder shall forfeit
88.33 $5,000;
Article 3 Sec. 2.  88
04/06/26  REVISOR  DTT/CH  26-08138  as introduced
89.1      (iii) the license holder shall forfeit $200 $500 for each occurrence of a violation of law
89.2  or rule governing matters of health, safety, or supervision, including but not limited to the
89.3  provision of adequate staff-to-child or adult ratios, and failure to comply with background
89.4  study requirements under chapter 245C; and
89.5      (iv) the license holder shall forfeit $100 $300 for each occurrence of a violation of law
89.6  or rule other than those subject to a $5,000, $1,000, or $200 fine in items (i) to (iii).
89.7      For purposes of this section, "occurrence" means each violation identified in the
89.8  commissioner's fine order. Fines assessed against a license holder that holds a license to
89.9  provide home and community-based services, as identified in section 245D.03, subdivision
89.10 1, and a community residential setting or day services facility license under chapter 245D
89.11 where the services are provided, may be assessed against both licenses for the same
89.12 occurrence, but the combined amount of the fines shall not exceed the amount specified in
89.13 this clause for that occurrence.
89.14     (5) When a fine has been assessed, the license holder may not avoid payment by closing,
89.15 selling, or otherwise transferring the licensed program to a third party. In such an event, the
89.16 license holder will be personally liable for payment. In the case of a corporation, each
89.17 controlling individual is personally and jointly liable for payment.
89.18     (d) Except for background study violations involving the failure to comply with an order
89.19 to immediately remove an individual or an order to provide continuous, direct supervision,
89.20 the commissioner shall not issue a fine under paragraph (c) relating to a background study
89.21 violation to a license holder who self-corrects a background study violation before the
89.22 commissioner discovers the violation. A license holder who has previously exercised the
89.23 provisions of this paragraph to avoid a fine for a background study violation may not avoid
89.24 a fine for a subsequent background study violation unless at least 365 days have passed
89.25 since the license holder self-corrected the earlier background study violation.
89.26   Sec. 3. Minnesota Statutes 2025 Supplement, section 256.01, subdivision 2, is amended
89.27 to read:
89.28     Subd. 2. Specific powers. Subject to the provisions of section 241.021, subdivision 2,
89.29 the commissioner of human services shall carry out the specific duties in paragraphs (a)
89.30 through (z):
89.31     (a) Administer and supervise the forms of public assistance provided for by state law
89.32 and other welfare activities or services that are vested in the commissioner. Administration
89.33 and supervision of human services activities or services includes, but is not limited to,
Article 3 Sec. 3.  89
04/06/26  REVISOR  DTT/CH  26-08138  as introduced
90.1  assuring timely and accurate distribution of benefits, completeness of service, and quality
90.2  program management. In addition to administering and supervising human services activities
90.3  vested by law in the department, the commissioner shall have the authority to:
90.4      (1) require county agency participation in training and technical assistance programs to
90.5  promote compliance with statutes, rules, federal laws, regulations, and policies governing
90.6  human services;
90.7      (2) monitor, on an ongoing basis, the performance of county agencies in the operation
90.8  and administration of human services, enforce compliance with statutes, rules, federal laws,
90.9  regulations, and policies governing welfare services and promote excellence of administration
90.10 and program operation;
90.11     (3) develop a quality control program or other monitoring program to review county
90.12 performance and accuracy of benefit determinations;
90.13     (4) require county agencies to make an adjustment to the public assistance benefits issued
90.14 to any individual consistent with federal law and regulation and state law and rule and to
90.15 issue or recover benefits as appropriate;
90.16     (5) delay or deny payment of all or part of the state and federal share of benefits and
90.17 administrative reimbursement according to the procedures set forth in section 256.017;
90.18     (6) make contracts with and grants to public and private agencies and organizations,
90.19 both profit and nonprofit, and individuals, using appropriated funds; and
90.20     (7) enter into contractual agreements with federally recognized Indian Tribes with a
90.21 reservation in Minnesota to the extent necessary for the Tribe to operate a federally approved
90.22 family assistance program or any other program under the supervision of the commissioner.
90.23 The commissioner shall consult with the affected county or counties in the contractual
90.24 agreement negotiations, if the county or counties wish to be included, in order to avoid the
90.25 duplication of county and Tribal assistance program services. The commissioner may
90.26 establish necessary accounts for the purposes of receiving and disbursing funds as necessary
90.27 for the operation of the programs.
90.28 The commissioner shall work in conjunction with the commissioner of children, youth, and
90.29 families to carry out the duties of this paragraph when necessary and feasible.
90.30     (b) Inform county agencies, on a timely basis, of changes in statute, rule, federal law,
90.31 regulation, and policy necessary to county agency administration of the programs.
90.32     (c) Administer and supervise all noninstitutional service to persons with disabilities,
90.33 including persons who have vision impairments, and persons who are deaf, deafblind, and
Article 3 Sec. 3.  90
04/06/26  REVISOR  DTT/CH  26-08138  as introduced
91.1  hard-of-hearing or with other disabilities. The commissioner may provide and contract for
91.2  the care and treatment of qualified indigent children in facilities other than those located
91.3  and available at state hospitals operated by the executive board when it is not feasible to
91.4  provide the service in state hospitals operated by the executive board.
91.5      (d) Assist and actively cooperate with other departments, agencies and institutions, local,
91.6  state, and federal, by performing services in conformity with the purposes of Laws 1939,
91.7  chapter 431.
91.8      (e) Act as the agent of and cooperate with the federal government in matters of mutual
91.9  concern relative to and in conformity with the provisions of Laws 1939, chapter 431,
91.10 including the administration of any federal funds granted to the state to aid in the performance
91.11 of any functions of the commissioner as specified in Laws 1939, chapter 431, and including
91.12 the promulgation of rules making uniformly available medical care benefits to all recipients
91.13 of public assistance, at such times as the federal government increases its participation in
91.14 assistance expenditures for medical care to recipients of public assistance, the cost thereof
91.15 to be borne in the same proportion as are grants of aid to said recipients.
91.16     (f) Establish and maintain any administrative units reasonably necessary for the
91.17 performance of administrative functions common to all divisions of the department.
91.18     (g) Act as designated guardian of both the estate and the person of all the wards of the
91.19 state of Minnesota, whether by operation of law or by an order of court, without any further
91.20 act or proceeding whatever, except as to persons committed as developmentally disabled.
91.21     (h) Act as coordinating referral and informational center on requests for service for
91.22 newly arrived immigrants coming to Minnesota.
91.23     (i) The specific enumeration of powers and duties as hereinabove set forth shall in no
91.24 way be construed to be a limitation upon the general transfer of powers herein contained.
91.25     (j) Establish county, regional, or statewide schedules of maximum fees and charges
91.26 which may be paid by county agencies for medical, dental, surgical, hospital, nursing and
91.27 nursing home care and medicine and medical supplies under all programs of medical care
91.28 provided by the state and for congregate living care under the income maintenance programs.
91.29     (k) Have the authority to conduct and administer experimental projects to test methods
91.30 and procedures of administering assistance and services to recipients or potential recipients
91.31 of public welfare. To carry out such experimental projects, it is further provided that the
91.32 commissioner of human services is authorized to waive the enforcement of existing specific
91.33 statutory program requirements, rules, and standards in one or more counties. The order
Article 3 Sec. 3.  91
04/06/26  REVISOR  DTT/CH  26-08138  as introduced
92.1  establishing the waiver shall provide alternative methods and procedures of administration,
92.2  shall not be in conflict with the basic purposes, coverage, or benefits provided by law, and
92.3  in no event shall the duration of a project exceed four years. It is further provided that no
92.4  order establishing an experimental project as authorized by the provisions of this section
92.5  shall become effective until the following conditions have been met:
92.6      (1) the United States Secretary of Health and Human Services has agreed, for the same
92.7  project, to waive state plan requirements relative to statewide uniformity; and
92.8      (2) a comprehensive plan, including estimated project costs, shall be approved by the
92.9  Legislative Advisory Commission and filed with the commissioner of administration.
92.10     (l) According to federal requirements and in coordination with the commissioner of
92.11 children, youth, and families, establish procedures to be followed by local welfare boards
92.12 in creating citizen advisory committees, including procedures for selection of committee
92.13 members.
92.14     (m) Allocate federal fiscal disallowances or sanctions which are based on quality control
92.15 error rates for medical assistance in the following manner:
92.16     (1) one-half of the total amount of the disallowance shall be borne by the county boards
92.17 responsible for administering the programs. Disallowances shall be shared by each county
92.18 board in the same proportion as that county's expenditures for the sanctioned program are
92.19 to the total of all counties' expenditures for medical assistance. Each county shall pay its
92.20 share of the disallowance to the state of Minnesota. When a county fails to pay the amount
92.21 due hereunder, the commissioner may deduct the amount from reimbursement otherwise
92.22 due the county, or the attorney general, upon the request of the commissioner, may institute
92.23 civil action to recover the amount due; and
92.24     (2) notwithstanding the provisions of clause (1), if the disallowance results from knowing
92.25 noncompliance by one or more counties with a specific program instruction, and that knowing
92.26 noncompliance is a matter of official county board record, the commissioner may require
92.27 payment or recover from the county or counties, in the manner prescribed in clause (1), an
92.28 amount equal to the portion of the total disallowance which resulted from the noncompliance,
92.29 and may distribute the balance of the disallowance according to clause (1).
92.30     (n) Develop and implement special projects that maximize reimbursements and result
92.31 in the recovery of money to the state. For the purpose of recovering state money, the
92.32 commissioner may enter into contracts with third parties. Any recoveries that result from
92.33 projects or contracts entered into under this paragraph shall be deposited in the state treasury
92.34 and credited to a special account until the balance in the account reaches $1,000,000. When
Article 3 Sec. 3.  92
04/06/26  REVISOR  DTT/CH  26-08138  as introduced
93.1  the balance in the account exceeds $1,000,000, the excess shall be transferred and credited
93.2  to the general fund. All money in the account is appropriated to the commissioner for the
93.3  purposes of this paragraph.
93.4      (o) Have the authority to establish and enforce the following county reporting
93.5  requirements:
93.6      (1) the commissioner shall establish fiscal and statistical reporting requirements necessary
93.7  to account for the expenditure of funds allocated to counties for human services programs.
93.8  When establishing financial and statistical reporting requirements, the commissioner shall
93.9  evaluate all reports, in consultation with the counties, to determine if the reports can be
93.10 simplified or the number of reports can be reduced;
93.11     (2) the county board shall submit monthly or quarterly reports to the department as
93.12 required by the commissioner. Monthly reports are due no later than 15 working days after
93.13 the end of the month. Quarterly reports are due no later than 30 calendar days after the end
93.14 of the quarter, unless the commissioner determines that the deadline must be shortened to
93.15 20 calendar days to avoid jeopardizing compliance with federal deadlines or risking a loss
93.16 of federal funding. Only reports that are complete, legible, and in the required format shall
93.17 be accepted by the commissioner;
93.18     (3) if the required reports are not received by the deadlines established in clause (2), the
93.19 commissioner may delay payments and withhold funds from the county board until the next
93.20 reporting period. When the report is needed to account for the use of federal funds and the
93.21 late report results in a reduction in federal funding, the commissioner shall withhold from
93.22 the county boards with late reports an amount equal to the reduction in federal funding until
93.23 full federal funding is received;
93.24     (4) a county board that submits reports that are late, illegible, incomplete, or not in the
93.25 required format for two out of three consecutive reporting periods is considered
93.26 noncompliant. When a county board is found to be noncompliant, the commissioner shall
93.27 notify the county board of the reason the county board is considered noncompliant and
93.28 request that the county board develop a corrective action plan stating how the county board
93.29 plans to correct the problem. The corrective action plan must be submitted to the
93.30 commissioner within 45 days after the date the county board received notice of
93.31 noncompliance;
93.32     (5) the final deadline for fiscal reports or amendments to fiscal reports is one year after
93.33 the date the report was originally due. If the commissioner does not receive a report by the
93.34 final deadline, the county board forfeits the funding associated with the report for that
Article 3 Sec. 3.  93
04/06/26  REVISOR  DTT/CH  26-08138  as introduced
94.1  reporting period and the county board must repay any funds associated with the report
94.2  received for that reporting period;
94.3      (6) the commissioner may not delay payments, withhold funds, or require repayment
94.4  under clause (3) or (5) if the county demonstrates that the commissioner failed to provide
94.5  appropriate forms, guidelines, and technical assistance to enable the county to comply with
94.6  the requirements. If the county board disagrees with an action taken by the commissioner
94.7  under clause (3) or (5), the county board may appeal the action according to sections 14.57
94.8  to 14.69; and
94.9      (7) counties subject to withholding of funds under clause (3) or forfeiture or repayment
94.10 of funds under clause (5) shall not reduce or withhold benefits or services to clients to cover
94.11 costs incurred due to actions taken by the commissioner under clause (3) or (5).
94.12     (p) Allocate federal fiscal disallowances or sanctions for audit exceptions when federal
94.13 fiscal disallowances or sanctions are based on a statewide random sample in direct proportion
94.14 to each county's claim for that period.
94.15     (q) Be responsible for ensuring the detection, prevention, investigation, and resolution
94.16 of fraudulent activities or behavior by applicants, recipients, and other participants in the
94.17 human services programs administered by the department, including but not limited to a
94.18 preenrollment risk assessment. A preenrollment risk assessment under this paragraph must
94.19 be conducted in accordance with the procedures and criteria established in section 256B.04,
94.20 subdivision 21a.
94.21     (r) Require county agencies to identify overpayments, establish claims, and utilize all
94.22 available and cost-beneficial methodologies to collect and recover these overpayments in
94.23 the human services programs administered by the department.
94.24     (s) Have the authority to administer the federal drug rebate program for drugs purchased
94.25 under the medical assistance program as allowed by section 1927 of title XIX of the Social
94.26 Security Act and according to the terms and conditions of section 1927. Rebates shall be
94.27 collected for all drugs that have been dispensed or administered in an outpatient setting and
94.28 that are from manufacturers who have signed a rebate agreement with the United States
94.29 Department of Health and Human Services.
94.30     (t) Have the authority to administer a supplemental drug rebate program for drugs
94.31 purchased under the medical assistance program. The commissioner may enter into
94.32 supplemental rebate contracts with pharmaceutical manufacturers and may require prior
94.33 authorization for drugs that are from manufacturers that have not signed a supplemental
Article 3 Sec. 3.  94
04/06/26  REVISOR        DTT/CH  26-08138  as introduced
95.1  rebate contract. Prior authorization of drugs shall be subject to the provisions of section
95.2  256B.0625, subdivision 13.
95.3      (u) Operate the department's communication systems account established in Laws 1993,
95.4  First Special Session chapter 1, article 1, section 2, subdivision 2, to manage shared
95.5  communication costs necessary for the operation of the programs the commissioner
95.6  supervises. Each account must be used to manage shared communication costs necessary
95.7  for the operations of the programs the commissioner supervises. The commissioner may
95.8  distribute the costs of operating and maintaining communication systems to participants in
95.9  a manner that reflects actual usage. Costs may include acquisition, licensing, insurance,
95.10 maintenance, repair, staff time and other costs as determined by the commissioner. Nonprofit
95.11 organizations and state, county, and local government agencies involved in the operation
95.12 of programs the commissioner supervises may participate in the use of the department's
95.13 communications technology and share in the cost of operation. The commissioner may
95.14 accept on behalf of the state any gift, bequest, devise or personal property of any kind, or
95.15 money tendered to the state for any lawful purpose pertaining to the communication activities
95.16 of the department. Any money received for this purpose must be deposited in the department's
95.17 communication systems accounts. Money collected by the commissioner for the use of
95.18 communication systems must be deposited in the state communication systems account and
95.19 is appropriated to the commissioner for purposes of this section.
95.20     (v) Receive any federal matching money that is made available through the medical
95.21 assistance program for the consumer satisfaction survey. Any federal money received for
95.22 the survey is appropriated to the commissioner for this purpose. The commissioner may
95.23 expend the federal money received for the consumer satisfaction survey in either year of
95.24 the biennium.
95.25     (w) Designate community information and referral call centers and incorporate cost
95.26 reimbursement claims from the designated community information and referral call centers
95.27 into the federal cost reimbursement claiming processes of the department according to
95.28 federal law, rule, and regulations. Existing information and referral centers provided by
95.29 Greater Twin Cities United Way or existing call centers for which Greater Twin Cities
95.30 United Way has legal authority to represent, shall be included in these designations upon
95.31 review by the commissioner and assurance that these services are accredited and in
95.32 compliance with national standards. Any reimbursement is appropriated to the commissioner
95.33 and all designated information and referral centers shall receive payments according to
95.34 normal department schedules established by the commissioner upon final approval of
Article 3 Sec. 3.  95
04/06/26  REVISOR  DTT/CH  26-08138  as introduced
96.1  allocation methodologies from the United States Department of Health and Human Services
96.2  Division of Cost Allocation or other appropriate authorities.
96.3      (x) Develop recommended standards for adult foster care homes that address the
96.4  components of specialized therapeutic services to be provided by adult foster care homes
96.5  with those services.
96.6      (y) Authorize the method of payment to or from the department as part of the human
96.7  services programs administered by the department. This authorization includes the receipt
96.8  or disbursement of funds held by the department in a fiduciary capacity as part of the human
96.9  services programs administered by the department.
96.10     (z) Designate the agencies that operate the Senior LinkAge Line under section 256.975,
96.11 subdivision 7, and the Disability Hub under subdivision 24 as the state of Minnesota Aging
96.12 and Disability Resource Center under United States Code, title 42, section 3001, the Older
96.13 Americans Act Amendments of 2006, and incorporate cost reimbursement claims from the
96.14 designated centers into the federal cost reimbursement claiming processes of the department
96.15 according to federal law, rule, and regulations. Any reimbursement must be appropriated
96.16 to the commissioner and treated consistent with section 256.011. All Aging and Disability
96.17 Resource Center designated agencies shall receive payments of grant funding that supports
96.18 the activity and generates the federal financial participation according to Board on Aging
96.19 administrative granting mechanisms.
96.20   Sec. 4. Minnesota Statutes 2025 Supplement, section 256B.04, subdivision 21, is amended
96.21 to read:
96.22     Subd. 21. Provider enrollment. (a) The commissioner shall enroll providers and conduct
96.23 screening activities as required by Code of Federal Regulations, title 42, section 455, subpart
96.24 E. A provider must enroll each provider-controlled location where direct services are
96.25 provided. The commissioner may deny a provider's incomplete application if a provider
96.26 fails to respond to the commissioner's request for additional information within 60 days of
96.27 the request. The commissioner must conduct a background study under chapter 245C,
96.28 including a review of databases in section 245C.08, subdivision 1, paragraph (a), clauses
96.29 (1) to (5), for a provider described in this paragraph. The background study requirement
96.30 may be satisfied if the commissioner conducted a fingerprint-based background study on
96.31 the provider that includes a review of databases in section 245C.08, subdivision 1, paragraph
96.32 (a), clauses (1) to (5).
96.33     (b) The commissioner shall revalidate:
Article 3 Sec. 4.  96
04/06/26  REVISOR  DTT/CH  26-08138  as introduced
97.1      (1) each provider under this subdivision at least once every five years;
97.2      (2) each personal care assistance agency, CFSS provider-agency, and CFSS financial
97.3  management services provider under this subdivision at least once every three years;
97.4      (3) each EIDBI agency under this subdivision at least once every three years; and
97.5      (4) at the commissioner's discretion, any medical-assistance-only provider type the
97.6  commissioner deems "high-risk" under this subdivision.
97.7      (c) The commissioner shall conduct revalidation as follows:
97.8      (1) provide 30-day notice of the revalidation due date including instructions for
97.9  revalidation and a list of materials the provider must submit; and
97.10     (2) if a provider fails to submit all required materials by the due date, notify the provider
97.11 of the deficiency within 30 days after the due date and allow the provider an additional 30
97.12 days from the notification date to comply; and
97.13     (3) (2) if a provider fails to respond or remedy a deficiency within the 30-day time period,
97.14 give 60-day notice of termination and immediately suspend the provider's ability to bill.
97.15 The provider does not have the right to appeal suspension of ability to bill.
97.16     (d) If a provider fails to comply with any individual provider requirement or condition
97.17 of participation, the commissioner may suspend the provider's ability to bill until the provider
97.18 comes into compliance. The commissioner's decision to suspend the provider is not subject
97.19 to an administrative appeal.
97.20     (e) Correspondence and notifications, including notifications of termination and other
97.21 actions, may be delivered electronically to a provider's MN-ITS mailbox. This paragraph
97.22 does not apply to correspondences and notifications related to background studies.
97.23     (f) If the commissioner or the Centers for Medicare and Medicaid Services determines
97.24 that a provider is designated "high-risk," the commissioner may withhold payment from
97.25 providers within that category upon initial enrollment for a 90-day period. The withholding
97.26 for each provider must begin on the date of the first submission of a claim.
97.27     (g) An enrolled provider that is also licensed by the commissioner under chapter 245A,
97.28 is licensed as a home care provider by the Department of Health under chapter 144A, or is
97.29 licensed as an assisted living facility under chapter 144G and has a home and
97.30 community-based services designation on the home care license under section 144A.484,
97.31 must designate an individual as the entity's compliance officer. The compliance officer
97.32 must:
Article 3 Sec. 4.  97
04/06/26  REVISOR  DTT/CH  26-08138  as introduced
98.1      (1) develop policies and procedures to assure adherence to medical assistance laws and
98.2  regulations and to prevent inappropriate claims submissions;
98.3      (2) train the employees of the provider entity, and any agents or subcontractors of the
98.4  provider entity including billers, on the policies and procedures under clause (1);
98.5      (3) respond to allegations of improper conduct related to the provision or billing of
98.6  medical assistance services, and implement action to remediate any resulting problems;
98.7      (4) use evaluation techniques to monitor compliance with medical assistance laws and
98.8  regulations;
98.9      (5) promptly report to the commissioner any identified violations of medical assistance
98.10 laws or regulations; and
98.11     (6) within 60 days of discovery by the provider of a medical assistance reimbursement
98.12 overpayment, report the overpayment to the commissioner and make arrangements with
98.13 the commissioner for the commissioner's recovery of the overpayment.
98.14 The commissioner may require, as a condition of enrollment in medical assistance, that a
98.15 provider within a particular industry sector or category establish a compliance program that
98.16 contains the core elements established by the Centers for Medicare and Medicaid Services.
98.17     (h) The commissioner may revoke the enrollment of an ordering or rendering provider
98.18 for a period of not more than one year, if the provider fails to maintain and, upon request
98.19 from the commissioner, provide access to documentation relating to written orders or requests
98.20 for payment for durable medical equipment, certifications for home health services, or
98.21 referrals for other items or services written or ordered by such provider, when the
98.22 commissioner has identified a pattern of a lack of documentation. A pattern means a failure
98.23 to maintain documentation or provide access to documentation on more than one occasion.
98.24 Nothing in this paragraph limits the authority of the commissioner to sanction a provider
98.25 under the provisions of section 256B.064.
98.26     (i) The commissioner shall terminate or deny the enrollment of any individual or entity
98.27 if the individual or entity has been terminated from participation in Medicare or under the
98.28 Medicaid program or Children's Health Insurance Program of any other state. The
98.29 commissioner may exempt a rehabilitation agency from termination or denial that would
98.30 otherwise be required under this paragraph, if the agency:
98.31     (1) is unable to retain Medicare certification and enrollment solely due to a lack of billing
98.32 to the Medicare program;
Article 3 Sec. 4.  98
04/06/26  REVISOR  DTT/CH  26-08138  as introduced
99.1      (2) meets all other applicable Medicare certification requirements based on an on-site
99.2  review completed by the commissioner of health; and
99.3      (3) serves primarily a pediatric population.
99.4      (j) As a condition of enrollment in medical assistance, the commissioner shall require
99.5  that a provider designated "moderate" or "high-risk" by the Centers for Medicare and
99.6  Medicaid Services or the commissioner permit the Centers for Medicare and Medicaid
99.7  Services, its agents, or its designated contractors and the state agency, its agents, or its
99.8  designated contractors to conduct unannounced on-site inspections of any provider location.
99.9  The commissioner shall publish in the Minnesota Health Care Program Provider Manual a
99.10 list of provider types designated "limited," "moderate," or "high-risk," based on the criteria
99.11 and standards used to designate Medicare providers in Code of Federal Regulations, title
99.12 42, section 424.518. The list and criteria are not subject to the requirements of chapter 14.
99.13 The commissioner's designations are not subject to administrative appeal.
99.14     (k) As a condition of enrollment in medical assistance, the commissioner shall require
99.15 that a high-risk provider, or a person with a direct or indirect ownership interest in the
99.16 provider of five percent or higher, consent to criminal background checks, including
99.17 fingerprinting, when required to do so under state law or by a determination by the
99.18 commissioner or the Centers for Medicare and Medicaid Services that a provider is designated
99.19 high-risk for fraud, waste, or abuse.
99.20     (l)(1) Upon initial enrollment, reenrollment, and notification of revalidation, all durable
99.21 medical equipment, prosthetics, orthotics, and supplies (DMEPOS) medical suppliers
99.22 meeting the durable medical equipment provider and supplier definition in clause (3),
99.23 operating in Minnesota and receiving Medicaid funds must purchase a surety bond that is
99.24 annually renewed and designates the Minnesota Department of Human Services as the
99.25 obligee, and must be submitted in a form approved by the commissioner. For purposes of
99.26 this clause, the following medical suppliers are not required to obtain a surety bond: a
99.27 federally qualified health center, a home health agency, the Indian Health Service, a
99.28 pharmacy, and a rural health clinic.
99.29     (2) At the time of initial enrollment or reenrollment, durable medical equipment providers
99.30 and suppliers defined in clause (3) must purchase a surety bond of $50,000. If a revalidating
99.31 provider's Medicaid revenue in the previous calendar year is up to and including $300,000,
99.32 the provider agency must purchase a surety bond of $50,000. If a revalidating provider's
99.33 Medicaid revenue in the previous calendar year is over $300,000, the provider agency must
99.34 purchase a surety bond of $100,000. The surety bond must allow for recovery of costs and
Article 3 Sec. 4.  99
  04/06/26  REVISOR  DTT/CH  26-08138  as introduced
100.1  fees in pursuing a claim on the bond. Any action to obtain monetary recovery or sanctions
100.2  from a surety bond must occur within six years from the date the debt is affirmed by a final
100.3  agency decision. An agency decision is final when the right to appeal the debt has been
100.4  exhausted or the time to appeal has expired under section 256B.064.
100.5      (3) "Durable medical equipment provider or supplier" means a medical supplier that can
100.6  purchase medical equipment or supplies for sale or rental to the general public and is able
100.7  to perform or arrange for necessary repairs to and maintenance of equipment offered for
100.8  sale or rental.
100.9      (m) The Department of Human Services may require a provider to purchase a surety
100.10 bond as a condition of initial enrollment, reenrollment, reinstatement, or continued enrollment
100.11 if: (1) the provider fails to demonstrate financial viability, (2) the department determines
100.12 there is significant evidence of or potential for fraud and abuse by the provider, or (3) the
100.13 provider or category of providers is designated high-risk pursuant to paragraph (f) and as
100.14 per Code of Federal Regulations, title 42, section 455.450. The surety bond must be in an
100.15 amount of $100,000 or ten percent of the provider's payments from Medicaid during the
100.16 immediately preceding 12 months, whichever is greater. The surety bond must name the
100.17 Department of Human Services as an obligee and must allow for recovery of costs and fees
100.18 in pursuing a claim on the bond. This paragraph does not apply if the provider currently
100.19 maintains a surety bond under the requirements in section 256B.051, 256B.0659, 256B.0701,
100.20 or 256B.85.
100.21   Sec. 5. Minnesota Statutes 2024, section 256B.04, is amended by adding a subdivision to
100.22 read:
100.23     Subd. 21a. Preenrollment assessment. (a) Before enrolling a provider or agency, the
100.24 commissioner may complete a preenrollment risk assessment of the provider or agency
100.25 seeking to enroll to confirm the provider or agency's eligibility and the provider or agency's
100.26 ability to meet the requirements of this chapter. The commissioner must utilize a risk-score
100.27 framework as a component of the assessment that identifies service-specific fraud risk
100.28 indicators, including but not limited to organizational readiness, financial stability,
100.29 compliance history, and addressing service necessity.
100.30     (b) Based on the assessment of fraud risk indicators described in paragraph (a), the
100.31 commissioner may deem the applicant ineligible and deny or rescind enrollment. The
100.32 decision to deny or rescind enrollment must be made in writing and sent using a
100.33 signature-verified confirmed delivery method. An applicant may request reconsideration
100.34 of the decision regarding the applicant's eligibility in writing within 30 business days after
  Article 3 Sec. 5.  100
  04/06/26  REVISOR  DTT/CH  26-08138  as introduced
101.1  the date the notice was issued. The commissioner must notify each applicant of the
101.2  commissioner's final decision regarding the applicant's eligibility.
101.3      (c) This subdivision is effective July 1, 2026. A provider enrolled before July 1, 2026,
101.4  that billed for services on or after January 1, 2025, must receive a positive preenrollment
101.5  risk assessment no later than July 1, 2027, to remain eligible. A provider or agency enrolled
101.6  before July 1, 2026, that has not billed for services on or after January 1, 2025, must receive
101.7  a positive preenrollment risk assessment no later than July 1, 2026, to remain eligible. A
101.8  provider that becomes ineligible under this paragraph regains eligibility after receiving a
101.9  positive assessment under this subdivision if the provider remains otherwise eligible.
101.10   Sec. 6. [256B.0647] REMITTANCE ADVICE MONETARY RECOVERY.
101.11     (a) The commissioner may use the remittance advice process under Code of Federal
101.12 Regulations, title 45, part 162.1601, as the notice to a vendor or provider when seeking
101.13 monetary recovery using a department-administered information technology system for
101.14 programmatically processed claims. The remittance advice must be delivered electronically
101.15 and constitutes the sole notice to the provider. The commissioner must withhold the payments
101.16 at issue when using the remittance advice as the notice.
101.17     (b) Providers may seek reconsideration of a remittance under this section by mailing a
101.18 request to the commissioner. The reconsideration request must be received no later than 30
101.19 calendar days from the posting of the remittance advice. A request for reconsideration does
101.20 not stay the withholding of payments. The commissioner's disposition of a request for
101.21 reconsideration is final and not subject to appeal under chapter 14. The request for
101.22 reconsideration must include:
101.23     (1) each disputed item, the reason for the dispute, and an estimate of the dollar amount
101.24 involved for each disputed item;
101.25     (2) the calculation that the individual or entity believes is correct;
101.26     (3) the authority in statute or rule upon which the individual or entity relies for each
101.27 disputed item;
101.28     (4) the name and address of the person or entity with whom contacts may be made
101.29 regarding the appeal; and
101.30     (5) other information required by the commissioner.
  Article 3 Sec. 6.  101
  04/06/26  REVISOR        DTT/CH  26-08138  as introduced
102.1ARTICLE 4
102.2UNIFORM SERVICE STANDARDS
102.3    Section 1. Minnesota Statutes 2024, section 245.735, subdivision 6, is amended to read:
102.4      Subd. 6. Section 223 of the Protecting Access to Medicare Act entities. (a) The
102.5  commissioner must request federal approval to participate in the demonstration program
102.6  established by section 223 of the Protecting Access to Medicare Act and, if approved, to
102.7  continue to participate in the demonstration program as long as federal funding for the
102.8  demonstration program remains available from the United States Department of Health and
102.9  Human Services. To the extent practicable, the commissioner shall align the requirements
102.10 of the demonstration program with the requirements under this section for CCBHCs receiving
102.11 medical assistance reimbursement under the authority of the state's Medicaid state plan. A
102.12 CCBHC may not apply to participate as a billing provider in both the CCBHC federal
102.13 demonstration and the benefit for CCBHCs under the medical assistance program.
102.14     (b) The commissioner must follow federal payment guidance, including payment of the
102.15 CCBHC daily bundled rate for services rendered by CCBHCs to individuals who are dually
102.16 eligible for Medicare and medical assistance when Medicare is the primary payer for the
102.17 service. Services provided by a CCBHC operating under the authority of the state's Medicaid
102.18 state plan will not receive the prospective payment system rate for services rendered by
102.19 CCBHCs to individuals who are dually eligible for Medicare and medical assistance when
102.20 Medicare is the primary payer for the service.
102.21     (c) Payment for services rendered by CCBHCs to individuals who have commercial
102.22 insurance as the primary payer and medical assistance as secondary payer is subject to the
102.23 requirements under section 256B.37. Services provided by a CCBHC operating under the
102.24 authority of the 223 demonstration or the state's Medicaid state plan will not receive the
102.25 prospective payment system rate for services rendered by CCBHCs to individuals who have
102.26 commercial insurance as the primary payer and medical assistance as the secondary payer.
102.27   Sec. 2. Minnesota Statutes 2025 Supplement, section 245A.03, subdivision 2, is amended
102.28 to read:
102.29     Subd. 2. Exclusion from licensure. (a) This chapter does not apply to:
102.30     (1) residential or nonresidential programs that are provided to a person by an individual
102.31 who is related;
102.32     (2) nonresidential programs that are provided by an unrelated individual to persons from
102.33 a single related family;
  Article 4 Sec. 2.  102
  04/06/26  REVISOR  DTT/CH  26-08138  as introduced
103.1      (3) residential or nonresidential programs that are provided to adults who do not misuse
103.2  substances or have a substance use disorder, a mental illness, a developmental disability, a
103.3  functional impairment, or a physical disability;
103.4      (4) sheltered workshops or work activity programs that are certified by the commissioner
103.5  of employment and economic development;
103.6      (5) programs operated by a public school for children 33 months or older;
103.7      (6) nonresidential programs primarily for children that provide care or supervision for
103.8  periods of less than three hours a day while the child's parent or legal guardian is in the
103.9  same building as the nonresidential program or present within another building that is
103.10 directly contiguous to the building in which the nonresidential program is located;
103.11     (7) nursing homes or hospitals licensed by the commissioner of health except as specified
103.12 under section 245A.02;
103.13     (8) board and lodge facilities licensed by the commissioner of health that do not provide
103.14 children's residential services under Minnesota Rules, chapter 2960, mental health or
103.15 substance use disorder treatment;
103.16     (9) programs licensed by the commissioner of corrections;
103.17     (10) recreation programs for children or adults that are operated or approved by a park
103.18 and recreation board whose primary purpose is to provide social and recreational activities;
103.19     (11) noncertified boarding care homes unless they provide services for five or more
103.20 persons whose primary diagnosis is mental illness or a developmental disability;
103.21     (12) programs for children such as scouting, boys clubs, girls clubs, and sports and art
103.22 programs, and nonresidential programs for children provided for a cumulative total of less
103.23 than 30 days in any 12-month period;
103.24     (13) residential programs for persons with mental illness, that are located in hospitals;
103.25     (14) camps licensed by the commissioner of health under Minnesota Rules, chapter
103.26 4630;
103.27     (15) mental health outpatient services for adults with mental illness or children with
103.28 mental illness, except for programs under section 245A.044;
103.29     (16) residential programs serving school-age children whose sole purpose is cultural or
103.30 educational exchange, until the commissioner adopts appropriate rules;
  Article 4 Sec. 2.  103
  04/06/26  REVISOR  DTT/CH  26-08138  as introduced
104.1(17) community support services programs as defined in section 245.462, subdivision
104.2  6, and family community support services as defined in section 245.4871, subdivision 17;
104.3(18) assisted living facilities licensed by the commissioner of health under chapter 144G;
104.4(19) substance use disorder treatment activities of licensed professionals in private
104.5  practice as defined in section 245G.01, subdivision 17;
104.6(20) consumer-directed community support service funded under the Medicaid waiver
104.7  for persons with developmental disabilities when the individual who provided the service
104.8  is:
104.9(i) the same individual who is the direct payee of these specific waiver funds or paid by
104.10 a fiscal agent, fiscal intermediary, or employer of record; and
104.11(ii) not otherwise under the control of a residential or nonresidential program that is
104.12 required to be licensed under this chapter when providing the service;
104.13(21) a county that is an eligible vendor under section 254B.0501 to provide care
104.14 coordination and comprehensive assessment services;
104.15(22) a recovery community organization that is an eligible vendor under section
104.16 254B.0501 to provide peer recovery support services; or
104.17(23) programs licensed by the commissioner of children, youth, and families in chapter
104.18 142B.
104.19(b) For purposes of paragraph (a), clause (6), a building is directly contiguous to a
104.20 building in which a nonresidential program is located if it shares a common wall with the
104.21 building in which the nonresidential program is located or is attached to that building by
104.22 skyway, tunnel, atrium, or common roof.
104.23(c) Except for the home and community-based services identified in section 245D.03,
104.24 subdivision 1, nothing in this chapter shall be construed to require licensure for any services
104.25 provided and funded according to an approved federal waiver plan where licensure is
104.26 specifically identified as not being a condition for the services and funding.
104.27EFFECTIVE DATE. This section is effective January 1, 2028.
104.28   Sec. 3. [245A.044] LICENSED NONRESIDENTIAL BEHAVIORAL HEALTH
104.29 SERVICES.
104.30Subdivision 1. License required for certain nonresidential behavioral health
104.31 services. (a) Beginning January 1, 2028, behavioral health service providers providing
  Article 4 Sec. 3.  104
  04/06/26  REVISOR  DTT/CH  26-08138  as introduced
105.1  mental health and substance use disorder services must obtain a license under this chapter
105.2  to provide:
105.3      (1) adult rehabilitative mental health services under section 245I.22;
105.4      (2) children's therapeutic services and supports in the community under section 245I.30
105.5  and children's day treatment under section 245I.31;
105.6      (3) crisis response services under section 245I.24; and
105.7      (4) certified community behavioral health clinic services under section 245I.17.
105.8      (b) As a condition of licensure, an applicant or license holder must demonstrate and
105.9  maintain verification of compliance with:
105.10     (1) licensing requirements under this chapter and chapter 245I; and
105.11     (2) applicable health care program requirements under Minnesota Rules, parts 9505.0170
105.12 to 9505.0475 and 9505.2160 to 9505.2245.
105.13     Subd. 2. Implementation. (a) Beginning July 1, 2027, the commissioner shall begin
105.14 issuing licenses to behavioral health service providers listed in subdivision 1. The
105.15 commissioner shall transition certified providers listed in subdivision 1 into licensure with
105.16 a phased-in schedule determined by the commissioner. The commissioner shall communicate
105.17 the schedule of implementation to providers certified under section 245I.011 at least three
105.18 months before the application is made available.
105.19     (b) Applicants for licensure must have an approved certification under section 245I.011
105.20 at least 90 days before the date of application.
105.21     (c) A provider's certification under section 245I.011, subdivision 5, paragraph (a), clauses
105.22 (2) to (4), or 6, paragraph (b), expires when the commissioner issues a decision on the
105.23 provider's license application.
105.24     (d) Upon licensure, a license holder must notify clients and staff of policies and
105.25 procedures outlined in the application.
105.26     (e) Notwithstanding paragraphs (a) and (c), subdivision 1, and sections 245I.17, 245I.22,
105.27 245I.24, 245I.30, and 245I.31, a provider listed under subdivision 1, paragraph (a), clauses
105.28 (1) to (4), and certified under section 245I.011 may continue operating past January 1, 2028,
105.29 until the commissioner issues a licensing decision if the provider submitted an application
105.30 before January 1, 2028.
  Article 4 Sec. 3.  105
  04/06/26  REVISOR  DTT/CH  26-08138  as introduced
106.1      (f) The commissioner must disenroll a provider from reimbursement for nonresidential
106.2  behavioral health services under the following sections if the provider fails to submit an
106.3  application for licensure within the time frame in paragraph (b):
106.4      (1) adult rehabilitative mental health services under section 256B.0623;
106.5      (2) crisis response services under section 256B.0624;
106.6      (3) children's therapeutic services and supports under section 256B.0943; and
106.7      (4) certified community behavioral health clinics under section 256B.0625, subdivision
106.8  5m.
106.9      (g) The commissioner must disenroll a provider listed in paragraph (f) from medical
106.10 assistance if:
106.11     (1) the application has been denied or the license has been suspended or revoked; and
106.12     (2) the provider appealed the application denial or the license suspension or revocation,
106.13 and the commissioner issued a final order on the appeal affirming the action.
106.14     EFFECTIVE DATE. This section is effective July 1, 2026.
106.15   Sec. 4. Minnesota Statutes 2025 Supplement, section 245A.10, subdivision 3, is amended
106.16 to read:
106.17     Subd. 3. Application fee for initial license or certification. (a) Except as provided in
106.18 paragraphs (c) and, (d), and (f), for fees required under subdivision 1, an applicant for an
106.19 initial license or certification issued by the commissioner shall submit a $2,100 application
106.20 fee with each new application required under this subdivision. The application fee shall not
106.21 be prorated, is nonrefundable, and is in lieu of the annual license or certification fee that
106.22 expires on December 31. The commissioner shall not process an application until the
106.23 application fee is paid.
106.24     (b) Except as provided in paragraph (c), an applicant shall apply for a license to provide
106.25 services at a specific location.
106.26     (c) For a license to provide home and community-based services to persons with
106.27 disabilities or age 65 and older under chapter 245D, an applicant shall submit an application
106.28 to provide services statewide. For fees required under subdivision 1, an applicant for an
106.29 initial license issued by the commissioner to provide home and community-based services
106.30 under chapter 245D shall submit a $4,200 application fee with each new application.
  Article 4 Sec. 4.  106
  04/06/26  REVISOR  DTT/CH  26-08138  as introduced
107.1      (d) For fees required under subdivision 1, an applicant for an initial license or certification
107.2  issued by the commissioner for children's residential facility or mental health clinic licensure
107.3  or certification shall submit a $500 application fee with each new application required under
107.4  this subdivision.
107.5      (e) For fees required under subdivision 1, an applicant for an initial certification issued
107.6  by the commissioner for mental health clinic certification shall submit a $2,100 application
107.7  fee with each new application required under this subdivision.
107.8      (f) For fees required under subdivision 1, an applicant for an initial license issued by
107.9  the commissioner to provide services at a certified community behavioral health clinic under
107.10 section 245I.17 shall submit a $4,200 application fee with each new application.
107.11   Sec. 5. Minnesota Statutes 2025 Supplement, section 245A.10, subdivision 4, is amended
107.12 to read:
107.13     Subd. 4. License or certification fee for certain programs. (a)(1) A program licensed
107.14 to provide one or more of the home and community-based services and supports identified
107.15 under chapter 245D to persons with disabilities or age 65 and older, shall pay an annual
107.16 nonrefundable license fee based on revenues derived from the provision of services that
107.17 would require licensure under chapter 245D during the calendar year immediately preceding
107.18 the year in which the license fee is paid, according to the following schedule:
107.19 License Holder Annual Revenue  License Fee
107.20 less than or equal to $10,000  $250
107.21 greater than $10,000 but less than or
107.22 equal to $25,000  $375
107.23 greater than $25,000 but less than or
107.24 equal to $50,000  $500
107.25 greater than $50,000 but less than or
107.26 equal to $100,000  $625
107.27 greater than $100,000 but less than or
107.28 equal to $150,000  $750
107.29 greater than $150,000 but less than or
107.30 equal to $200,000  $1,000
107.31 greater than $200,000 but less than or
107.32 equal to $250,000  $1,250
107.33 greater than $250,000 but less than or
107.34 equal to $300,000  $1,500
107.35 greater than $300,000 but less than or
107.36 equal to $350,000  $1,750
107.37 greater than $350,000 but less than or
107.38 equal to $400,000  $2,000
  Article 4 Sec. 5.  107
  04/06/26  REVISOR        DTT/CH  26-08138   as introduced
108.1  greater than $400,000 but less than or
108.2  equal to $450,000  $2,250
108.3  greater than $450,000 but less than or
108.4  equal to $500,000  $2,500
108.5  greater than $500,000 but less than or
108.6  equal to $600,000  $2,850
108.7  greater than $600,000 but less than or
108.8  equal to $700,000  $3,200
108.9  greater than $700,000 but less than or
108.10 equal to $800,000  $3,600
108.11 greater than $800,000 but less than or
108.12 equal to $900,000  $3,900
108.13 greater than $900,000 but less than or
108.14 equal to $1,000,000  $4,250
108.15 greater than $1,000,000 but less than or
108.16 equal to $1,250,000  $4,550
108.17 greater than $1,250,000 but less than or
108.18 equal to $1,500,000  $4,900
108.19 greater than $1,500,000 but less than or
108.20 equal to $1,750,000  $5,200
108.21 greater than $1,750,000 but less than or
108.22 equal to $2,000,000  $5,500
108.23 greater than $2,000,000 but less than or
108.24 equal to $2,500,000  $5,900
108.25 greater than $2,500,000 but less than or
108.26 equal to $3,000,000  $6,200
108.27 greater than $3,000,000 but less than or
108.28 equal to $3,500,000  $6,500
108.29 greater than $3,500,000 but less than or
108.30 equal to $4,000,000  $7,200
108.31 greater than $4,000,000 but less than or
108.32 equal to $4,500,000  $7,800
108.33 greater than $4,500,000 but less than or
108.34 equal to $5,000,000  $9,000
108.35 greater than $5,000,000 but less than or
108.36 equal to $7,500,000  $10,000
108.37 greater than $7,500,000 but less than or
108.38 equal to $10,000,000  $14,000
108.39 greater than $10,000,000 but less than or
108.40 equal to $12,500,000  $18,000
108.41 greater than $12,500,000 but less than or
108.42 equal to $15,000,000  $25,000
108.43 greater than $15,000,000 but less than or
108.44 equal to $17,500,000  $28,000
108.45 greater than $17,500,000 but less than
108.46 $20,000,000  $32,000
  Article 4 Sec. 5.  108
  04/06/26  REVISOR  DTT/CH  26-08138        as introduced
109.1  greater than $20,000,000 but less than
109.2  $25,000,000  $36,000
109.3  greater than $25,000,000 but less than
109.4  $30,000,000  $45,000
109.5  greater than $30,000,000 but less than
109.6  $35,000,000  $55,000
109.7  greater than $35,000,000  $75,000
109.8      (2) If requested, the license holder shall provide the commissioner information to verify
109.9  the license holder's annual revenues or other information as needed, including copies of
109.10 documents submitted to the Department of Revenue.
109.11     (3) At each annual renewal, a license holder may elect to pay the highest renewal fee,
109.12 and not provide annual revenue information to the commissioner.
109.13     (4) A license holder that knowingly provides the commissioner incorrect revenue amounts
109.14 for the purpose of paying a lower license fee shall be subject to a civil penalty in the amount
109.15 of double the fee the provider should have paid.
109.16     (b) A substance use disorder treatment program licensed under chapter 245G, to provide
109.17 substance use disorder treatment shall pay an annual nonrefundable license fee based on
109.18 the following schedule:
109.19Licensed Capacity  License Fee
109.201 to 24 persons  $2,600
109.2125 to 49 persons  $3,000
109.2250 to 74 persons  $5,000
109.2375 to 99 persons  $10,000
109.24100 to 199 persons  $15,000
109.25200 or more persons  $20,000
109.26     (c) A detoxification program licensed under Minnesota Rules, parts 9530.6510 to
109.27 9530.6590, or a withdrawal management program licensed under chapter 245F shall pay
109.28 an annual nonrefundable license fee based on the following schedule:
109.29Licensed Capacity  License Fee
109.301 to 24 persons  $2,600
109.3125 to 49 persons  $3,000
109.3250 or more persons  $5,000
109.33 A detoxification program that also operates a withdrawal management program at the same
109.34 location shall only pay one fee based upon the licensed capacity of the program with the
109.35 higher overall capacity.
  Article 4 Sec. 5.  109
  04/06/26  REVISOR  DTT/CH  26-08138     as introduced
110.1      (d) A children's residential facility licensed under Minnesota Rules, chapter 2960, to
110.2  serve children shall pay an annual nonrefundable license fee based on the following schedule:
110.3Licensed Capacity  License Fee
110.41 to 24 persons  $1,000
110.525 to 49 persons  $1,100
110.650 to 74 persons  $1,200
110.775 to 99 persons  $1,300
110.8100 or more persons  $1,400
110.9      (e) A residential facility licensed under section 245I.23 or Minnesota Rules, parts
110.10 9520.0500 to 9520.0670, to serve persons with mental illness shall pay an annual
110.11 nonrefundable license fee based on the following schedule:
110.12Licensed Capacity  License Fee
110.131 to 24 persons  $2,600
110.1425 to 49 persons  $3,000
110.1550 or more persons  $20,000
110.16     (f) A residential facility licensed under Minnesota Rules, parts 9570.2000 to 9570.3400,
110.17 to serve persons with physical disabilities shall pay an annual nonrefundable license fee
110.18 based on the following schedule:
110.19Licensed Capacity  License Fee
110.201 to 24 persons  $450
110.2125 to 49 persons  $650
110.2250 to 74 persons  $850
110.2375 to 99 persons  $1,050
110.24100 or more persons  $1,250
110.25     (g) A program licensed as an adult day care center licensed under Minnesota Rules,
110.26 parts 9555.9600 to 9555.9730, shall pay an annual nonrefundable license fee based on the
110.27 following schedule:
110.28Licensed Capacity  License Fee
110.291 to 24 persons  $2,600
110.3025 to 49 persons  $3,000
110.3150 to 74 persons  $5,000
110.3275 to 99 persons  $10,000
110.33100 to 199 persons  $15,000
110.34200 or more persons  $20,000
  Article 4 Sec. 5.  110
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111.1      (h) A program licensed to provide treatment services to persons with sexual psychopathic
111.2  personalities or sexually dangerous persons under Minnesota Rules, parts 9515.3000 to
111.3  9515.3110, shall pay an annual nonrefundable license fee of $20,000.
111.4      (i) A mental health clinic certified under section 245I.20 shall pay an annual
111.5  nonrefundable certification fee of $1,550 $3,000. If the mental health clinic provides services
111.6  at a primary location with satellite facilities, the satellite facilities shall be certified with the
111.7  primary location without an additional charge.
111.8      (j) If a program subject to annual fees under paragraph (b) provides services at a primary
111.9  location with satellite facilities, the satellite facilities must be licensed with the primary
111.10 location and must be subject to an additional $500 annual nonrefundable license fee per
111.11 satellite facility.
111.12     (j) A program licensed to provide behavioral health treatment services licensed under
111.13 section 245I.22, 245I.24, 245I.30, or 245I.31 shall pay an annual nonrefundable license fee
111.14 of $3,000 for each license.
111.15     (k) Certified community behavioral health clinics licensed under section 245I.17 shall
111.16 pay an annual nonrefundable license fee of $7,800.
111.17   Sec. 6. Minnesota Statutes 2024, section 245A.10, is amended by adding a subdivision to
111.18 read:
111.19     Subd. 4a. Fees for satellite locations. (a) If a program subject to annual fees under
111.20 subdivision 4, paragraph (b), provides services at a primary location with satellite facilities,
111.21 the satellite facilities are licensed with the primary location and are subject to an additional
111.22 $500 annual nonrefundable license fee per satellite facility.
111.23     (b) If a program subject to annual fees under subdivision 4, paragraph (j), provides
111.24 services at a primary location with satellite sites or facilities, the satellite locations must be
111.25 licensed with the primary location and shall pay an additional annual nonrefundable fee
111.26 according to the following schedule:
111.27     (1) one to five satellite locations: $1,500;
111.28     (2) six to 19 satellite locations: $3,500; or
111.29     (3) 20 or more satellite locations: $5,000.
  Article 4 Sec. 6.  111
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112.1    Sec. 7. Minnesota Statutes 2024, section 245A.65, subdivision 1a, is amended to read:
112.2      Subd. 1a. Determination of vulnerable adult status. (a) A license holder that provides
112.3  services to adults who are excluded from the definition of vulnerable adult under section
112.4  626.5572, subdivision 21, paragraph (a), clause (2), must determine whether the person is
112.5  a vulnerable adult under section 626.5572, subdivision 21, paragraph (a), clause (4). This
112.6  determination must be made within 24 hours of:
112.7      (1) admission to the licensed program; and
112.8      (2) any incident that:
112.9      (i) was reported under section 626.557; or
112.10     (ii) would have been required to be reported under section 626.557, if one or more of
112.11 the adults involved in the incident had been vulnerable adults.
112.12     (b) Upon determining that a person receiving services is a vulnerable adult under section
112.13 626.5572, subdivision 21, paragraph (a), clause (4), all requirements relative to vulnerable
112.14 adults under this chapter and section 626.557 must be met by the license holder.
112.15     (c) Notwithstanding paragraph (a), clause (1), a license holder providing mobile crisis
112.16 services must make a determination within 24 hours of first receiving crisis stabilization
112.17 services under section 245I.24, subdivision 9.
112.18   Sec. 8. Minnesota Statutes 2024, section 245C.03, subdivision 1, is amended to read:
112.19     Subdivision 1. Programs licensed by the commissioner. (a) The commissioner shall
112.20 conduct a background study on:
112.21     (1) the person or persons applying for a license;
112.22     (2) an individual age 13 and over living in the household where the licensed program
112.23 will be provided who is not receiving licensed services from the program;
112.24     (3) current or prospective employees of the applicant or license holder who will have
112.25 direct contact with persons served by the facility, agency, or program;
112.26     (4) volunteers or student volunteers who will have direct contact with persons served
112.27 by the program to provide program services if the contact is not under the continuous, direct
112.28 supervision by an individual listed in clause (1) or (3);
112.29     (5) an individual age ten to 12 living in the household where the licensed services will
112.30 be provided when the commissioner has reasonable cause as defined in section 245C.02,
112.31 subdivision 15;
  Article 4 Sec. 8.  112
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113.1      (6) an individual who, without providing direct contact services at a licensed program,
113.2  may have unsupervised access to children or vulnerable adults receiving services from a
113.3  program, when the commissioner has reasonable cause as defined in section 245C.02,
113.4  subdivision 15; and
113.5      (7) all controlling individuals as defined in section 245A.02, subdivision 5a;
113.6      (8) notwithstanding clause (3), for children's residential facilities and foster residence
113.7  settings, any adult working in the facility, whether or not the individual will have direct
113.8  contact with persons served by the facility.
113.9      (b) For child foster care when the license holder resides in the home where foster care
113.10 services are provided, a short-term substitute caregiver providing direct contact services for
113.11 a child for less than 72 hours of continuous care is not required to receive a background
113.12 study under this chapter.
113.13     (c) This subdivision applies to the following programs that must be licensed under
113.14 chapter 245A:
113.15     (1) adult foster care;
113.16     (2) children's residential facilities;
113.17     (3) licensed home and community-based services under chapter 245D;
113.18     (4) residential mental health programs for adults;
113.19     (5) substance use disorder treatment programs under chapter 245G;
113.20     (6) withdrawal management programs under chapter 245F;
113.21     (7) adult day care centers;
113.22     (8) family adult day services;
113.23     (9) detoxification programs;
113.24     (10) community residential settings;
113.25     (11) intensive residential treatment services and residential crisis stabilization under
113.26 chapter 245I; and
113.27     (12) treatment programs for persons with sexual psychopathic personality or sexually
113.28 dangerous persons, licensed under chapter 245A and according to Minnesota Rules, parts
113.29 9515.3000 to 9515.3110.;
113.30     (13) adult rehabilitative mental health services under chapter 245I;
  Article 4 Sec. 8.  113
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114.1      (14) certified community behavioral health clinic services under chapter 245I;
114.2      (15) children's therapeutic services and supports under chapter 245I; and
114.3      (16) crisis response services under chapter 245I.
114.4    Sec. 9. Minnesota Statutes 2025 Supplement, section 245C.13, subdivision 2, is amended
114.5  to read:
114.6      Subd. 2. Activities pending completion of background study. The subject of a
114.7  background study may not perform any activity requiring a background study under
114.8  paragraph (c) until the commissioner has issued one of the notices under paragraph (a).
114.9      (a) Notices from the commissioner required prior to activity under paragraph (c) include:
114.10     (1) a notice of the study results under section 245C.17 stating that:
114.11     (i) the individual is not disqualified; or
114.12     (ii) more time is needed to complete the study but the individual is not required to be
114.13 removed from direct contact or access to people receiving services prior to completion of
114.14 the study as provided under section 245C.17, subdivision 1, paragraph (b) or (c). The notice
114.15 that more time is needed to complete the study must also indicate whether the individual is
114.16 required to be under continuous direct supervision prior to completion of the background
114.17 study. When more time is necessary to complete a background study of an individual
114.18 affiliated with a Title IV-E eligible children's residential facility or foster residence setting,
114.19 the individual may not work in the facility or setting regardless of whether or not the
114.20 individual is supervised;
114.21     (2) a notice that a disqualification has been set aside under section 245C.23; or
114.22     (3) a notice that a variance has been granted related to the individual under section
114.23 245C.30.
114.24     (b) For a background study affiliated with a licensed child care center or certified
114.25 license-exempt child care center, the notice sent under paragraph (a), clause (1), item (ii),
114.26 must not be issued until the commissioner receives a qualifying result for the individual for
114.27 the fingerprint-based national criminal history record check or the fingerprint-based criminal
114.28 history information from the Bureau of Criminal Apprehension. The notice must require
114.29 the individual to be under continuous direct supervision prior to completion of the remainder
114.30 of the background study except as permitted in subdivision 3.
114.31     (c) Activities prohibited prior to receipt of notice under paragraph (a) include:
  Article 4 Sec. 9.  114
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115.1(1) being issued a license;
115.2(2) living in the household where the licensed program will be provided;
115.3(3) providing direct contact services to persons served by a program unless the subject
115.4  is under continuous direct supervision;
115.5(4) having access to persons receiving services if the background study was completed
115.6  under section 144.057, subdivision 1, or 245C.03, subdivision 1, paragraph (a), clause (2),
115.7  (5), or (6), unless the subject is under continuous direct supervision;
115.8(5) for licensed child care centers and certified license-exempt child care centers,
115.9  providing direct contact services to persons served by the program;
115.10(6) for children's residential facilities or foster residence settings, working in the facility
115.11 or setting;
115.12(7) for background studies affiliated with a personal care provider organization, except
115.13 as provided in section 245C.03, subdivision 3b, early intensive developmental and behavioral
115.14 intervention provider, or adult rehabilitative mental health services provider, before a
115.15 personal care assistant an individual provides services, the personal care assistance provider
115.16 agency entity must initiate a background study of the personal care assistant individual
115.17 under this chapter and the personal care assistance provider agency entity must have received
115.18 a notice from the commissioner that the personal care assistant individual is:
115.19(i) not disqualified under section 245C.14; or
115.20(ii) disqualified, but the personal care assistant has received a set aside of the
115.21 disqualification under section 245C.22; or
115.22(8) for background studies affiliated with an early intensive developmental and behavioral
115.23 intervention provider, before an individual provides services, the early intensive
115.24 developmental and behavioral intervention provider must initiate a background study for
115.25 the individual under this chapter and the early intensive developmental and behavioral
115.26 intervention provider must have received a notice from the commissioner that the individual
115.27 is:
115.28(i) not disqualified under section 245C.14; or
115.29(ii) disqualified, but the individual has received a set-aside of the disqualification under
115.30 section 245C.22.
  Article 4 Sec. 9.  115
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116.1    Sec. 10. Minnesota Statutes 2025 Supplement, section 245C.16, subdivision 1, is amended
116.2  to read:
116.3      Subdivision 1. Determining immediate risk of harm. (a) If the commissioner determines
116.4  that the individual studied has a disqualifying characteristic, the commissioner shall review
116.5  the information immediately available and make a determination as to the subject's immediate
116.6  risk of harm to persons served by the program where the individual studied will have direct
116.7  contact with, or access to, people receiving services.
116.8      (b) The commissioner shall consider all relevant information available, including the
116.9  following factors in determining the immediate risk of harm:
116.10     (1) the recency of the disqualifying characteristic;
116.11     (2) the recency of discharge from probation for the crimes;
116.12     (3) the number of disqualifying characteristics;
116.13     (4) the intrusiveness or violence of the disqualifying characteristic;
116.14     (5) the vulnerability of the victim involved in the disqualifying characteristic;
116.15     (6) the similarity of the victim to the persons served by the program where the individual
116.16 studied will have direct contact;
116.17     (7) whether the individual has a disqualification from a previous background study that
116.18 has not been set aside;
116.19     (8) if the individual has a disqualification which may not be set aside because it is a
116.20 permanent bar under section 245C.24, subdivision 1, or the individual is a child care
116.21 background study subject who has a felony-level conviction for a drug-related offense in
116.22 the last five years, the commissioner may order the immediate removal of the individual
116.23 from any position allowing direct contact with, or access to, persons receiving services from
116.24 the program and from working in a children's residential facility or foster residence setting;
116.25 and
116.26     (9) if the individual has a disqualification which may not be set aside because it is a
116.27 permanent bar under section 245C.24, subdivision 2, or the individual is a child care
116.28 background study subject who has a felony-level conviction for a drug-related offense during
116.29 the last five years, the commissioner may order the immediate removal of the individual
116.30 from any position allowing direct contact with or access to persons receiving services from
116.31 the center and from working in a licensed child care center or certified license-exempt child
116.32 care center.
  Article 4 Sec. 10.  116
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117.1      (c) This section does not apply when the subject of a background study is regulated by
117.2  a health-related licensing board as defined in chapter 214, and the subject is determined to
117.3  be responsible for substantiated maltreatment under section 626.557 or chapter 260E.
117.4      (d) This section does not apply to a background study related to an initial application
117.5  for a child foster family setting license.
117.6      (e) Except for paragraph (f), this section does not apply to a background study that is
117.7  also subject to the requirements under section 256B.0659, subdivisions 11 and 13, for a
117.8  personal care assistant or a qualified professional as defined in section 256B.0659,
117.9  subdivision 1, or to a background study for an individual providing early intensive
117.10 developmental and behavioral intervention services under section 256B.0949 245C.13,
117.11 subdivision 2, paragraph (c), clause (7).
117.12     (f) If the commissioner has reason to believe, based on arrest information or an active
117.13 maltreatment investigation, that an individual poses an imminent risk of harm to persons
117.14 receiving services, the commissioner may order that the person be continuously supervised
117.15 or immediately removed pending the conclusion of the maltreatment investigation or criminal
117.16 proceedings.
117.17   Sec. 11. Minnesota Statutes 2024, section 245G.03, subdivision 1, is amended to read:
117.18     Subdivision 1. License requirements. (a) An applicant for a license to provide substance
117.19 use disorder treatment must comply with the general requirements in section 626.557;
117.20 chapters 245A, 245C, and 260E; and Minnesota Rules, chapter 9544.
117.21     (b) The commissioner may grant variances to the requirements in this chapter that do
117.22 not affect the client's health or safety if the conditions in section 245A.04, subdivision 9,
117.23 are met.
117.24     (c) If a program is licensed according to this chapter and is part of a certified community
117.25 behavioral health clinic under section 245.735 245I.17, the license holder must comply with
117.26 the requirements in section 245.735 245I.17, subdivisions 4b to 4e 12 and 13, as part of the
117.27 licensing requirements under this chapter.
117.28   Sec. 12. Minnesota Statutes 2024, section 245I.011, subdivision 3, is amended to read:
117.29     Subd. 3. Certification required. (a) An individual, organization, or government entity
117.30 that is exempt from licensure under section 245A.03, subdivision 2, paragraph (a), clause
117.31 (12) (15), and chooses to be identified as a certified mental health clinic must:
117.32     (1) be a mental health clinic that is certified under section 245I.20;
  Article 4 Sec. 12.  117
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118.1(2) comply with all of the responsibilities assigned to a license holder by this chapter
118.2  except subdivision 1; and
118.3(3) comply with all of the responsibilities assigned to a certification holder by chapter
118.4  245A.
118.5(b) An individual, organization, or government entity described by this subdivision must
118.6  obtain a criminal background study for each staff person or volunteer who provides direct
118.7  contact services to clients.
118.8(c) If a clinic is certified according to this chapter and is part of a certified community
118.9  behavioral health clinic under section 245.735, the license holder must comply with the
118.10 requirements in section 245.735, subdivisions 4b to 4e, as part of the licensing requirements
118.11 under this chapter.
118.12EFFECTIVE DATE. This section is effective the day following final enactment, except
118.13 the amendment striking paragraph (c) is effective January 1, 2028.
118.14   Sec. 13. Minnesota Statutes 2024, section 245I.011, subdivision 5, is amended to read:
118.15Subd. 5. Programs certified under chapter 256B. (a) An individual, organization, or
118.16 government entity certified under the following sections must comply with all of the
118.17 responsibilities assigned to a license holder under this chapter except subdivision 1:
118.18(1) an assertive community treatment provider under section 256B.0622, subdivision
118.19 3a;
118.20(2) an adult rehabilitative mental health services provider under section 256B.0623;
118.21(3) a mobile crisis team under section 256B.0624;
118.22(4) a children's therapeutic services and supports provider under section 256B.0943;
118.23(5) (2) a children's intensive behavioral health services provider under section 256B.0946;
118.24 and
118.25(6) (3) an intensive nonresidential rehabilitative mental health services provider under
118.26 section 256B.0947.
118.27(b) An individual, organization, or government entity certified under the sections listed
118.28 in paragraph (a), clauses (1) to (6), must obtain a criminal background study for each staff
118.29 person and volunteer providing direct contact services to a client.
118.30EFFECTIVE DATE. This section is effective January 1, 2028.
  Article 4 Sec. 13.  118
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119.1    Sec. 14. Minnesota Statutes 2024, section 245I.011, is amended by adding a subdivision
119.2  to read:
119.3      Subd. 6. License required for nonresidential programs. (a) Beginning January 1,
119.4  2028, an individual, organization, or government entity must have a license under this
119.5  chapter to provide the following services:
119.6      (1) adult rehabilitative mental health services, as defined in section 256B.0623;
119.7      (2) mobile crisis services, as defined in section 256B.0624;
119.8      (3) children's therapeutic services and supports, as defined in section 256B.0943; or
119.9      (4) certified community behavioral health clinic services, as defined in sections 245I.17
119.10 and 256B.0625, subdivision 5m.
119.11     (b) An individual, organization, or government entity certified as any of the following
119.12 programs shall remain certified according to subdivision 5 until the commissioner issues a
119.13 license, the commissioner denies the license application, or the certification expires according
119.14 to chapter 245A:
119.15     (1) an adult rehabilitative mental health services provider under section 256B.0623;
119.16     (2) a mobile crisis team under section 256B.0624;
119.17     (3) a children's therapeutic services and supports provider under section 256B.0943; or
119.18     (4) a certified community behavioral health clinic under section 245.735.
119.19   Sec. 15. Minnesota Statutes 2024, section 245I.02, is amended by adding a subdivision
119.20 to read:
119.21     Subd. 1a. Alcohol and drug counselor "Alcohol and drug counselor" means an individual
119.22 qualified under section 245G.11, subdivision 5.
119.23   Sec. 16. Minnesota Statutes 2024, section 245I.02, is amended by adding a subdivision
119.24 to read:
119.25     Subd. 10a. Comprehensive evaluation. "Comprehensive evaluation" means a
119.26 person-centered, family-centered, and trauma-informed evaluation conducted according to
119.27 section 245I.17, subdivision 12.
  Article 4 Sec. 16.  119
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120.1    Sec. 17. Minnesota Statutes 2024, section 245I.02, is amended by adding a subdivision
120.2  to read:
120.3      Subd. 18a. Initial evaluation. "Initial evaluation" means the assessment and preliminary
120.4  diagnosis necessary to begin client services and conducted according to section 245I.17.
120.5    Sec. 18. Minnesota Statutes 2024, section 245I.02, is amended by adding a subdivision
120.6  to read:
120.7      Subd. 31a. Psychotherapy. "Psychotherapy" has the meaning given in section 256B.0671,
120.8  subdivision 11.
120.9    Sec. 19. Minnesota Statutes 2024, section 245I.02, subdivision 33, is amended to read:
120.10     Subd. 33. Rehabilitative mental health services. "Rehabilitative mental health services"
120.11 means mental health services provided to an adult a client that enable the client to develop
120.12 and achieve psychiatric stability, social competencies, personal and emotional adjustment,
120.13 independent living skills, family roles, and community skills when symptoms of mental
120.14 illness has impaired any of the client's abilities in these areas. Rehabilitation mental health
120.15 services include interventions that allow a client to self-monitor, compensate for, counteract,
120.16 or replace psychosocial skills deficits or maladaptive skills acquired over the course of a
120.17 mental illness. For a child client, rehabilitation includes intervention to restore a child or
120.18 adolescent to an age-appropriate developmental trajectory that had been disrupted by a
120.19 mental illness.
120.20   Sec. 20. Minnesota Statutes 2024, section 245I.02, subdivision 39, is amended to read:
120.21     Subd. 39. Treatment plan. "Treatment plan" means services that a license holder
120.22 formulates to respond to a client's needs and goals. A treatment plan includes individual
120.23 treatment plans under section 245I.10, subdivisions 7 and 8; initial treatment plans under
120.24 section 245I.23, subdivision 7; and crisis treatment plans under sections 245I.23, subdivision
120.25 8, and 256B.0624, subdivision 11. For a license holder under section 245I.17, treatment
120.26 plan refers to the integrated treatment plan developed according to section 245I.17,
120.27 subdivision 13.
120.28   Sec. 21. Minnesota Statutes 2024, section 245I.03, subdivision 4, is amended to read:
120.29     Subd. 4. Behavioral emergencies. (a) A license holder must have procedures that each
120.30 staff person follows when responding to a client who exhibits behavior that threatens the
  Article 4 Sec. 21.  120
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121.1  immediate safety of the client or others. A license holder's behavioral emergency procedures
121.2  must incorporate person-centered planning and trauma-informed care.
121.3      (b) A license holder's behavioral emergency procedures must include:
121.4      (1) a plan designed to prevent the client from inflicting self-harm and harming others;
121.5      (2) contact information for emergency resources that a staff person must use when the
121.6  license holder's behavioral emergency procedures are unsuccessful in controlling a client's
121.7  behavior;
121.8      (3) the types of behavioral emergency procedures that a staff person may use;
121.9      (4) the specific circumstances under which the program may use behavioral emergency
121.10 procedures; and
121.11     (5) the staff persons whom the license holder authorizes to implement behavioral
121.12 emergency procedures.; and
121.13     (6) the contact information for the local crisis team.
121.14     (c) The license holder's behavioral emergency procedures must not include secluding
121.15 or restraining a client except as allowed under section 245.8261.
121.16     (d) Staff persons must not use behavioral emergency procedures to enforce program
121.17 rules or for the convenience of staff persons. Behavioral emergency procedures must not
121.18 be part of any client's treatment plan. A staff person may not use behavioral emergency
121.19 procedures except in response to a client's current behavior that threatens the immediate
121.20 safety of the client or others.
121.21   Sec. 22. Minnesota Statutes 2024, section 245I.03, is amended by adding a subdivision
121.22 to read:
121.23     Subd. 11. Quality assurance and improvement plan. (a) At a minimum, a license
121.24 holder must develop a written quality assurance and improvement plan that includes plans
121.25 for:
121.26     (1) encouraging ongoing consultation among members of the treatment team;
121.27     (2) obtaining and evaluating feedback about services from clients, family and other
121.28 natural supports, referral sources, and staff persons;
121.29     (3) measuring and evaluating client outcomes;
121.30     (4) reviewing client suicide deaths and suicide attempts;
  Article 4 Sec. 22.  121
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122.1      (5) examining the quality of clinical service delivery to clients; and
122.2      (6) self-monitoring of compliance with this chapter.
122.3      (b) At least annually, a license holder must review, evaluate, and update the quality
122.4  assurance and improvement plan. The review must:
122.5      (1) include documentation of the actions that the certification holder will take as a result
122.6  of information obtained from monitoring activities in the plan; and
122.7      (2) establish goals for improved service delivery to clients for the next year.
122.8    Sec. 23. Minnesota Statutes 2025 Supplement, section 245I.04, subdivision 5, is amended
122.9  to read:
122.10     Subd. 5. Behavioral health practitioner scope of practice. (a) A behavioral health
122.11 practitioner under the treatment supervision of a mental health professional or certified
122.12 rehabilitation specialist may provide an adult client with client education, rehabilitative
122.13 mental health services, functional assessments, level of care assessments, crisis planning,
122.14 and treatment plans. A behavioral health practitioner under the treatment supervision of a
122.15 mental health professional may provide skill-building services to a child client, crisis
122.16 planning, and complete treatment plans for a child client.
122.17     (b) A behavioral health practitioner must not provide treatment supervision to other staff
122.18 persons. A behavioral health practitioner may provide direction to mental health rehabilitation
122.19 workers and mental health behavioral aides.
122.20     (c) A behavioral health practitioner who provides services to clients according to section
122.21 256B.0624 may perform crisis assessments and interventions for a client.
122.22   Sec. 24. Minnesota Statutes 2025 Supplement, section 245I.04, subdivision 17, is amended
122.23 to read:
122.24     Subd. 17. Mental health behavioral aide scope of practice. While under the treatment
122.25 supervision of a mental health professional, a mental health behavioral aide may practice
122.26 psychosocial skills with provide skill-building services to a child client according to the
122.27 child's treatment plan and individual behavior plan that a mental health professional, clinical
122.28 trainee, or behavioral health practitioner has previously taught to the child.
122.29   Sec. 25. Minnesota Statutes 2024, section 245I.06, subdivision 1, is amended to read:
122.30     Subdivision 1. Generally. (a) A license holder must ensure that a mental health
122.31 professional or certified rehabilitation specialist provides treatment supervision to each staff
  Article 4 Sec. 25.  122
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123.1  person who provides services to a client and who is not a mental health professional or
123.2  certified rehabilitation specialist. When providing treatment supervision, a treatment
123.3  supervisor must follow a staff person's written treatment supervision plan.
123.4      (b) Treatment supervision must focus on each client's treatment needs and the ability of
123.5  the staff person under treatment supervision to provide services to each client, including
123.6  the following topics related to the staff person's current caseload:
123.7      (1) a review and evaluation of the interventions that the staff person delivers to each
123.8  client;
123.9      (2) instruction on alternative strategies if a client is not achieving treatment goals;
123.10     (3) a review and evaluation of each client's assessments, treatment plans, and progress
123.11 notes for accuracy and appropriateness;
123.12     (4) instruction on the cultural norms or values of the clients and communities that the
123.13 license holder serves and the impact that a client's culture has on providing treatment;
123.14     (5) evaluation of and feedback regarding a direct service staff person's areas of
123.15 competency; and
123.16     (6) coaching, teaching, and practicing skills with a staff person.; and
123.17     (7) modeling service practices that respect the recipient, include the recipient in planning
123.18 and implementation of the individual treatment plan, recognize the recipient's strengths,
123.19 and coordinate with other involved parties and providers.
123.20     (c) A treatment supervisor must provide treatment supervision to a staff person using
123.21 methods that allow for immediate feedback, including in-person, telephone, and interactive
123.22 video supervision.
123.23     (d) A treatment supervisor's responsibility for a staff person receiving treatment
123.24 supervision is limited to the services provided by the associated license holder. If a staff
123.25 person receiving treatment supervision is employed by multiple license holders, each license
123.26 holder is responsible for providing treatment supervision related to the treatment of the
123.27 license holder's clients.
123.28   Sec. 26. Minnesota Statutes 2024, section 245I.06, subdivision 2, is amended to read:
123.29     Subd. 2. Treatment supervision planning. (a) A treatment supervisor and the staff
123.30 person supervised by the treatment supervisor must develop a written treatment supervision
123.31 plan. The license holder must ensure that a new staff person's treatment supervision plan is
123.32 completed, approved by the staff person, and implemented by a treatment supervisor and
  Article 4 Sec. 26.  123
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124.1  the new staff person within 30 days of the new staff person's first day of employment. The
124.2  license holder must review and update each staff person's treatment supervision plan annually.
124.3(b) Each staff person's treatment supervision plan must include:
124.4(1) the name and qualifications of the staff person receiving treatment supervision;
124.5(2) the names and licensures of the treatment supervisors who are supervising the staff
124.6  person;
124.7(3) how frequently the treatment supervisors must provide treatment supervision to the
124.8  staff person; and
124.9(4) the staff person's authorized scope of practice, including a description of the client
124.10 population ages that the staff person serves, and a description of the treatment methods and
124.11 modalities that the staff person may use to provide services to clients.
124.12   Sec. 27. Minnesota Statutes 2024, section 245I.07, is amended to read:
124.13245I.07 PERSONNEL FILES.
124.14(a) For each staff person, a license holder must maintain a personnel file that includes:
124.15(1) verification of the staff person's qualifications required for the position including
124.16 training, education, practicum or internship agreement, licensure, and any other required
124.17 qualifications;
124.18(2) documentation related to the staff person's background study;
124.19(3) the hiring date of the staff person;
124.20(4) a description of the staff person's job responsibilities with the license holder;
124.21(5) the date that the staff person's specific duties and responsibilities became effective,
124.22 including the date that the staff person began having direct contact with clients;
124.23(6) documentation of the staff person's training as required by section 245I.05, subdivision
124.24 2;
124.25(7) a verification copy of license renewals that the staff person completed during the
124.26 staff person's employment;
124.27(8) annual job performance evaluations; and
124.28(9) if applicable, the staff person's alleged and substantiated violations of the license
124.29 holder's policies under section 245I.03, subdivision 8, clauses (3) to (7), and the license
124.30 holder's response.
  Article 4 Sec. 27.  124
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125.1      (b) The license holder must ensure that all personnel files are readily accessible for the
125.2  commissioner's review. The license holder is not required to keep personnel files in a single
125.3  location.
125.4      (c) For a license holder under section 245I.17, a personnel file for staff who provide
125.5  substance use disorder treatment services must include records of training required under
125.6  section 245G.13, subdivision 2.
125.7    Sec. 28. Minnesota Statutes 2024, section 245I.10, is amended by adding a subdivision
125.8  to read:
125.9      Subd. 2a. Evaluation, treatment authorization, and planning in a certified community
125.10 behavioral health clinic. Notwithstanding subdivisions 2 and 7, a license holder under
125.11 section 245I.17 must meet the requirements of section 245I.17, subdivisions 11 and 12, for
125.12 assessments and section 245I.17, subdivision 13, for treatment planning. Service planning
125.13 and authorization for services delivered by a certified community behavioral health clinic
125.14 must be done pursuant to the standards in section 245I.17.
125.15   Sec. 29. Minnesota Statutes 2024, section 245I.10, subdivision 6, is amended to read:
125.16     Subd. 6. Standard diagnostic assessment; required elements. (a) Only a mental health
125.17 professional or a clinical trainee may complete a standard diagnostic assessment of a client.
125.18 A standard diagnostic assessment of a client must include a face-to-face interview with a
125.19 client and a written evaluation of the client. The assessor must complete a client's standard
125.20 diagnostic assessment within the client's cultural context. An alcohol and drug counselor
125.21 may gather and document the information in paragraphs (b) and (c) when completing a
125.22 comprehensive assessment according to section 245G.05.
125.23     (b) When completing a standard diagnostic assessment of a client, the assessor must
125.24 gather and document information about the client's current life situation, including the
125.25 following information:
125.26     (1) the client's age;
125.27     (2) the client's current living situation, including the client's housing status and household
125.28 members;
125.29     (3) the status of the client's basic needs;
125.30     (4) the client's education level and employment status;
125.31     (5) the client's current medications;
  Article 4 Sec. 29.  125
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126.1      (6) any immediate risks to the client's health and safety, including withdrawal symptoms,
126.2  medical conditions, and behavioral and emotional symptoms;
126.3      (7) the client's perceptions of the client's condition;
126.4      (8) the client's description of the client's symptoms, including the reason for the client's
126.5  referral;
126.6      (9) the client's history of mental health and substance use disorder treatment;
126.7      (10) cultural influences on the client; and
126.8      (11) substance use history, if applicable, including:
126.9      (i) amounts and types of substances, frequency and duration, route of administration,
126.10 periods of abstinence, and circumstances of relapse; and
126.11     (ii) the impact to functioning when under the influence of substances, including legal
126.12 interventions.
126.13     (c) If the assessor cannot obtain the information that this paragraph requires without
126.14 retraumatizing the client or harming the client's willingness to engage in treatment, the
126.15 assessor must identify which topics will require further assessment during the course of the
126.16 client's treatment. The assessor must gather and document information related to the following
126.17 topics:
126.18     (1) the client's relationship with the client's family and other significant personal
126.19 relationships, including the client's evaluation of the quality of each relationship;
126.20     (2) the client's strengths and resources, including the extent and quality of the client's
126.21 social networks;
126.22     (3) important developmental incidents in the client's life;
126.23     (4) maltreatment, trauma, potential brain injuries, and abuse that the client has suffered;
126.24     (5) the client's history of or exposure to alcohol and drug usage and treatment; and
126.25     (6) the client's health history and the client's family health history, including the client's
126.26 physical, chemical, and mental health history.
126.27     (d) When completing a standard diagnostic assessment of a client, an assessor must use
126.28 a recognized diagnostic framework.
126.29     (1) When completing a standard diagnostic assessment of a client who is five years of
126.30 age or younger, the assessor must use the current edition of the DC: 0-5 Diagnostic
  Article 4 Sec. 29.  126
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127.1  Classification of Mental Health and Development Disorders of Infancy and Early Childhood
127.2  published by Zero to Three.
127.3      (2) When completing a standard diagnostic assessment of a client who is six years of
127.4  age or older, the assessor must use the current edition of the Diagnostic and Statistical
127.5  Manual of Mental Disorders published by the American Psychiatric Association.
127.6      (3) When completing a standard diagnostic assessment of a client who is 12 to 17 years
127.7  of age, an assessor must use either the CRAFFT Questionnaire or the criteria in the most
127.8  recent edition of the Diagnostic and Statistical Manual of Mental Disorders published by
127.9  the American Psychiatric Association to screen and assess the client for a substance use
127.10 disorder.
127.11     (3) (4) When completing a standard diagnostic assessment of a client who is 18 years
127.12 of age or older, an assessor must use either (i) the CAGE-AID Questionnaire or (ii) the
127.13 criteria in the most recent edition of the Diagnostic and Statistical Manual of Mental
127.14 Disorders published by the American Psychiatric Association to screen and assess the client
127.15 for a substance use disorder.
127.16     (e) When completing a standard diagnostic assessment of a client, the assessor must
127.17 include and document the following components of the assessment:
127.18     (1) the client's mental status examination;
127.19     (2) the client's baseline measurements; symptoms; behavior; skills; abilities; resources;
127.20 vulnerabilities; safety needs, including client information that supports the assessor's findings
127.21 after applying a recognized diagnostic framework from paragraph (d); and any differential
127.22 diagnosis of the client; and
127.23     (3) an explanation of: (i) how the assessor diagnosed the client using the information
127.24 from the client's interview, assessment, psychological testing, and collateral information
127.25 about the client; (ii) the client's needs; (iii) the client's risk factors; (iv) the client's strengths;
127.26 and (v) the client's responsivity factors.
127.27     (f) When completing a standard diagnostic assessment of a client, the assessor must
127.28 consult the client and the client's family about which services that the client and the family
127.29 prefer to treat the client. The assessor must make referrals for the client as to services required
127.30 by law.
127.31     (g) Information from other providers and prior assessments may be used to complete
127.32 the diagnostic assessment if the source of the information is documented in the diagnostic
127.33 assessment.
  Article 4 Sec. 29.  127
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128.1      (h) If the client screens positive for a need for substance use disorder services, the assessor
128.2  must document what actions will be taken to address the client's co-occurring conditions.
128.3      (i) The assessor must determine if the client is eligible for targeted case management
128.4  services according to section 245.462, subdivision 20, or 245.4871, subdivision 6, and refer
128.5  the client to the county or contracted provider as appropriate.
128.6    Sec. 30. Minnesota Statutes 2024, section 245I.10, subdivision 8, is amended to read:
128.7      Subd. 8. Individual treatment plan; required elements. (a) After completing a client's
128.8  diagnostic assessment or reviewing a client's diagnostic assessment received from a different
128.9  provider and before providing services to the client beyond those permitted under subdivision
128.10 7, the license holder must complete the client's individual treatment plan. The license holder
128.11 must:
128.12     (1) base the client's individual treatment plan on the client's diagnostic assessment and
128.13 baseline measurements;
128.14     (2) for a child client, use a child-centered, family-driven, and culturally appropriate
128.15 planning process that allows the child's parents and guardians to observe and participate in
128.16 the child's individual and family treatment services, assessments, and treatment planning;
128.17     (3) for an adult client, use a person-centered, culturally appropriate planning process
128.18 that allows the client's family and other natural supports to observe and participate in the
128.19 client's treatment services, assessments, and treatment planning;
128.20     (4) identify the client's treatment goals, measureable treatment objectives, a schedule
128.21 for accomplishing the client's treatment goals and objectives, a treatment strategy, and the
128.22 individuals responsible for providing treatment services and supports to the client. The
128.23 license holder must have a treatment strategy to engage the client in treatment if the client:
128.24     (i) has a history of not engaging in treatment; and
128.25     (ii) is ordered by a court to participate in treatment services or to take neuroleptic
128.26 medications;
128.27     (5) identify the participants involved in the client's treatment planning. The client must
128.28 be a participant in the client's treatment planning. If applicable, the license holder must
128.29 document the reasons that the license holder did not involve the client's family, case manager,
128.30 or other natural supports in the client's treatment planning; and
128.31     (6) review the client's individual treatment plan every 180 days and update the client's
128.32 individual treatment plan with the client's treatment progress, new treatment objectives and
  Article 4 Sec. 30.  128
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129.1  goals or, if the client has not made treatment progress, changes in the license holder's
129.2  approach to treatment; and
129.3      (7) (6) ensure that the client approves of the client's individual treatment plan unless a
129.4  court orders the client's treatment plan under chapter 253B.
129.5      (b) If the client disagrees with the client's treatment plan, the license holder must
129.6  document in the client file the reasons why the client does not agree with the treatment plan.
129.7  If the license holder cannot obtain the client's approval of the treatment plan, a mental health
129.8  professional must make efforts to obtain approval from a person who is authorized to consent
129.9  on the client's behalf within 30 days after the client's previous individual treatment plan
129.10 expired. A license holder may not deny a client service during this time period solely because
129.11 the license holder could not obtain the client's approval of the client's individual treatment
129.12 plan. A license holder may continue to bill for the client's otherwise eligible services when
129.13 the client re-engages in services.
129.14     (c) The individual treatment plan must be updated as necessary to reflect the changing
129.15 needs of the client, including offering assistance in accessing necessary crisis services when
129.16 the license holder is aware of client need for the services. The license holder must review
129.17 the client's individual treatment plan every 180 days and update the client's individual
129.18 treatment plan with the client's treatment progress, new treatment objectives and goals, or,
129.19 if the client has not made treatment progress, changes in the license holder's approach to
129.20 treatment.
129.21   Sec. 31. [245I.17] CERTIFIED COMMUNITY BEHAVIORAL HEALTH CLINIC
129.22 LICENSURE.
129.23     Subdivision 1. Definitions. (a) For the purposes of this section, the terms in this
129.24 subdivision have the meanings given.
129.25     (b) "Care coordination" means the activities required to coordinate care across settings
129.26 and providers for an individual served to ensure seamless transitions across the full spectrum
129.27 of health services. Care coordination includes outreach and engagement; documenting a
129.28 plan of care for medical, behavioral health, and social services and supports in the integrated
129.29 treatment plan; assisting with obtaining appointments; confirming appointments are kept;
129.30 developing a crisis plan; tracking medication; and implementing care coordination agreements
129.31 with external providers. Care coordination may include psychiatric consultation with primary
129.32 care practitioners and with mental health clinical care practitioners.
  Article 4 Sec. 31.  129
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130.1      (c) "CCBHC client" means an individual who has participated in a preliminary screening
130.2  and risk assessment and who has received at least one of the nine required services from a
130.3  CCBHC.
130.4      (d) "Certified community behavioral health clinic" or "CCBHC" means a provider of
130.5  integrated behavioral health services that is licensed under this section and compliant with
130.6  federal CCBHC requirements.
130.7      (e) "Community needs assessment" means an assessment to identify community needs
130.8  and determine the community behavioral health clinic's capacity to address the needs of the
130.9  population being served.
130.10     (f) "Designated collaborating organization" means an entity meeting the requirements
130.11 of subdivision 5 with a formal agreement with a CCBHC to furnish CCBHC services.
130.12     (g) "Federal CCBHC criteria" means the most recently issued Certified Community
130.13 Behavioral Health Clinic Certification Criteria published by the Substance Abuse and Mental
130.14 Health Services Administration.
130.15     (h) "Needs assessment" means the community needs assessment described in federal
130.16 criteria for CCBHC.
130.17     (i) "Preliminary screening and risk assessment" means a mandatory screening and risk
130.18 assessment that is completed at the time of first contact, whether that contact is in person,
130.19 by telephone, or using other remote communication.
130.20     Subd. 2. Establishment of licensure. (a) The certified community behavioral health
130.21 clinic model is an integrated service delivery model that uses evidence-based behavioral
130.22 health practices to achieve better outcomes for individuals experiencing behavioral health
130.23 concerns while achieving sustainable rates through cost-based reimbursement for providers
130.24 and economic efficiencies for payors.
130.25     (b) Beginning January 1, 2028, a CCBHC must be licensed under this section and chapter
130.26 245A.
130.27     (c) A CCBHC must meet the requirements of this section and the federal CCBHC criteria.
130.28 The commissioner may require a CCBHC applicant or license holder to submit documentation
130.29 of compliance with state licensing requirements and federal CCBHC criteria. When permitted
130.30 by the Substance Abuse and Mental Health Services Administration, the commissioner may
130.31 select a transition date on which revisions to the federal CCBHC criteria become required
130.32 as licensing conditions for CCBHCs.
  Article 4 Sec. 31.  130
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131.1      Subd. 3. License extension. (a) The commissioner shall extend a compliant license
131.2  holder's license under this section for 36 months.
131.3      (b) The commissioner must complete a licensing review that includes an on-site inspection
131.4  within six months before the expiration of the CCBHC's current license.
131.5      (c) Within 180 days of license expiration, a CCBHC license holder must submit to the
131.6  commissioner all documentation required by the commissioner under subdivision 2,
131.7  paragraph (b).
131.8      Subd. 4. Required services and scope of licensure. Within a declared service area, the
131.9  CCBHC must be able to offer:
131.10     (1) mobile crisis services, directly or through a designated collaborating organization
131.11 under subdivision 4;
131.12     (2) outpatient mental health and substance use disorder services under subdivisions 9
131.13 and 10;
131.14     (3) screening, diagnosis, and risk assessment under subdivision 11;
131.15     (4) person- and family-centered treatment planning;
131.16     (5) psychiatric rehabilitation services under subdivision 14;
131.17     (6) community-based mental health care for veterans under subdivision 15;
131.18     (7) outpatient primary care screening and monitoring under subdivision 16;
131.19     (8) peer services under subdivision 17; and
131.20     (9) targeted case management under subdivision 18.
131.21     Subd. 5. Designated collaborating organization. (a) If a CCBHC is unable to provide
131.22 mobile crisis services, the CCBHC may contract with another entity that is licensed to
131.23 provide mobile crisis services under section 245I.24 and that meets the requirements of the
131.24 federal CCBHC criteria.
131.25     (b) The CCBHC must submit a designated collaborating organization arrangement for
131.26 approval to the commissioner as part of the licensing process.
131.27     Subd. 6. Exemptions to host county approval. Notwithstanding any other law that
131.28 requires a county contract or other form of county approval for a service listed in subdivision
131.29 4, a CCBHC that meets the requirements of this section may receive the prospective payment
131.30 under section 256B.0625, subdivision 5m, for that service without a county contract or
131.31 county approval.
  Article 4 Sec. 31.  131
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132.1      Subd. 7. Variances. When the standards listed in this section or other applicable standards
132.2  conflict or address similar issues in duplicative or incompatible ways, the commissioner
132.3  may grant variances to state requirements if the variances do not conflict with federal
132.4  requirements for services reimbursed under medical assistance. If standards overlap, the
132.5  commissioner may substitute all or a part of a licensure or certification that is substantially
132.6  the same as another licensure or certification. The commissioner shall consult with
132.7  stakeholders before granting variances under this provision. For a CCBHC that is licensed
132.8  but not approved for prospective payment under section 256B.0625, subdivision 5m, the
132.9  commissioner may grant a variance under this paragraph if the variance does not increase
132.10 the state share of costs.
132.11     Subd. 8. Evidence-based practices. The commissioner shall issue a list of required
132.12 evidence-based practices to be delivered by CCBHCs and may also provide a list of
132.13 recommended evidence-based practices. The commissioner may update the list to reflect
132.14 advances in outcomes research and medical services for persons living with mental illnesses
132.15 or substance use disorders. The commissioner shall take into consideration the adequacy
132.16 of evidence to support the efficacy of the practice across cultures and ages, the workforce
132.17 available, and the current availability of the practice in the state. At least 30 days before
132.18 issuing the initial list or issuing any revisions, the commissioner shall provide stakeholders
132.19 with an opportunity to comment.
132.20     Subd. 9. Outpatient mental health services. (a) A license holder must provide outpatient
132.21 mental health services that comply with the federal CCBHC criteria and applicable state
132.22 standards in this chapter, except as provided in this subdivision.
132.23     (b) An initial or comprehensive evaluation fulfills the requirements to perform a
132.24 diagnostic assessment in accordance with section 245I.10, subdivisions 2 and 6.
132.25     (c) An integrated treatment plan under this section fulfills the requirements to perform
132.26 treatment planning in accordance with section 245I.10, subdivisions 7 and 8.
132.27     (d) A license holder under this section is exempt from certification as a mental health
132.28 clinic under section 245I.20.
132.29     Subd. 10. Outpatient substance use disorder care. (a) When a license holder provides
132.30 substance use disorder treatment services to an individual with a substance use disorder
132.31 diagnosis, the license holder must comply with the requirements for substance use disorder
132.32 services in chapter 245G, except as provided in this subdivision.
132.33     (b) A preliminary screening and risk assessment under this section fulfills the
132.34 requirements to perform an initial services plan under section 245G.04, subdivision 1.
  Article 4 Sec. 31.  132
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133.1      (c) A comprehensive evaluation under this section fulfills the requirements to perform
133.2  a comprehensive assessment under section 245G.05.
133.3      (d) An integrated treatment plan under this section and containing a six-dimension
133.4  analysis of the client's needs according to the third edition of ASAM criteria, as defined in
133.5  section 254B.01, subdivision 2a, fulfills the requirements to provide an individual treatment
133.6  plan under section 245G.06.
133.7      (e) A license holder under this section fulfills the requirement to document personnel
133.8  files under section 245G.13, subdivision 3, by complying with the requirements of this
133.9  chapter.
133.10     (f) A license holder under this section fulfills the requirement to protect client rights
133.11 under section 245G.15 by complying with the requirements of section 245I.12.
133.12     (g) A license holder under this section fulfills the requirements to respond to behavioral
133.13 emergencies under section 245G.16 by complying with the requirements of section 245I.03,
133.14 subdivision 4.
133.15     (h) A license holder under this section is exempt from licensure under chapter 245G.
133.16     Subd. 11. Initial triage and risk assessment. (a) A license holder must have policies
133.17 and procedures on:
133.18     (1) how staff will implement the requirements of this subdivision;
133.19     (2) staff positions authorized to complete triage and risk assessments;
133.20     (3) documenting the results of the risk screenings; and
133.21     (4) ensuring the client is offered timely services according to the federal CCBHC criteria.
133.22     (b) A license holder must conduct an initial triage and risk assessment when a new client
133.23 requests services or is referred to services. A license holder may conduct an initial triage
133.24 and risk assessment in person, by telephone, or other remote communication. Based on the
133.25 acuity of needs as assessed in the initial triage and risk assessment, the client must be
133.26 categorized as having emergency, urgent, or routine needs.
133.27     (c) Based on these categorizations, the license holder must offer services that meet the
133.28 relevant timelines under the federal CCBHC criteria.
133.29     (d) The license holder must provide training that addresses:
133.30     (1) when a prospective client requires intervention from qualified staff;
133.31     (2) use of standardized measures that screen for significant risks;
  Article 4 Sec. 31.  133
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134.1      (3) other factors that indicate a client has urgent needs besides the Columbia Suicide
134.2  Severity Rating Scale or a self-harm screening; and
134.3      (4) overdose and substance use disorder risks.
134.4      Subd. 12. Initial and comprehensive evaluation. (a) A license holder under this section
134.5  must provide initial and comprehensive evaluations according to this section and federal
134.6  CCBHC criteria.
134.7      (b) An initial evaluation is necessary to authorize the provision of all medically necessary
134.8  CCBHC services until the completion of a comprehensive evaluation. A comprehensive
134.9  evaluation is necessary to authorize the provision of all medically necessary CCBHC services
134.10 on an ongoing basis. A license holder must ensure that each client's comprehensive evaluation
134.11 reflects the needs and assessments for all services provided.
134.12     Subd. 13. Integrated treatment plan. (a) A license holder under this section must
134.13 complete an integrated treatment plan for each client following the comprehensive evaluation
134.14 and no later than 60 calendar days after the date of the first request for services.
134.15     (b) A license holder must reflect all required services under subdivision 9 within the
134.16 integrated treatment plan according to the client's needs.
134.17     (c) A license hold must review and update a client's treatment plan as necessary to reflect
134.18 the changing needs of the client and progress made in treatment. If the client has not made
134.19 treatment progress, the revision of the treatment plan must indicate changes in the license
134.20 holder's approach to treatment to better meet the needs of the client. A license holder must
134.21 review and update the treatment plan at least every 180 days or as clinically indicated.
134.22     Subd. 14. Psychiatric rehabilitation services. (a) For children, a license holder under
134.23 this section must provide children's therapeutic services and supports according to sections
134.24 245I.30 and 245I.31, except that an initial or comprehensive assessment under this section
134.25 fulfills the requirement to perform a standard diagnostic assessment.
134.26     (b) For adults, a license holder under this section must provide adult rehabilitative mental
134.27 health services according to section 245I.22, except that:
134.28     (1) the license holder is exempt from the requirement to perform a level of care
134.29 assessment under section 245I.22, subdivision 6, paragraph (b); and
134.30     (2) an initial or comprehensive assessment under this section fulfills the requirement to
134.31 perform a standard diagnostic assessment.
  Article 4 Sec. 31.  134
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135.1      Subd. 15. Community-based care for veterans. (a) The license holder must provide
135.2  services according to federal requirements for eligibility and coordination with TRICARE
135.3  and the United States Department of Veterans Affairs.
135.4      (b) The license holder must assign and document a principal behavioral health provider
135.5  for every veteran receiving services.
135.6      Subd. 16. Primary care screening and monitoring. To fulfill the requirements for
135.7  primary care screening, a license holder under this section must have policies and procedures
135.8  detailing the screenings to be performed with specific populations at the clinic. The policies
135.9  and procedures must be approved by the medical director.
135.10     Subd. 17. Peer services. A license holder must be able to provide peer services as
135.11 described by federal CCBHC criteria and sections 245G.07, subdivision 2, clause (8),
135.12 256B.0615, and 256B.0616.
135.13     Subd. 18. Targeted case management. (a) A license holder must provide mental health
135.14 targeted case management as described by federal CCBHC criteria and section 256B.0625,
135.15 subdivision 20.
135.16     (b) An initial or comprehensive evaluation under this section fulfills any requirement
135.17 to perform a standard diagnostic assessment.
135.18     Subd. 19. Community needs assessment. (a) The community needs assessment must
135.19 be a collaborative document that reflects the engagement of the applicant or license holder
135.20 with current clients, other social and medical services agencies, community groups,
135.21 underserved populations, and government agencies. An applicant or license holder must
135.22 document an outreach plan within the community needs assessment to demonstrate how
135.23 stakeholder feedback was solicited and reflected in the plan.
135.24     (b) The applicant or license holder must publicly post a draft community needs assessment
135.25 on the organization's website for 30 days and submit a summary of public comments and
135.26 recommendations from the comment period to the commissioner.
135.27     (c) In the draft community needs assessment, the applicant or license holder must declare
135.28 a planned geographic service delivery area in which the CCBHC will be capable of providing
135.29 all nine required services. An applicant must show an analysis of how CCBHC status will
135.30 make a significant improvement in the availability and quality of the services. An existing
135.31 license holder must include analysis of which needs from prior needs assessments have
135.32 been improved by the operation of the CCBHC. A clinic that has not made and demonstrated
  Article 4 Sec. 31.  135
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136.1  substantial progress in addressing the identified needs must specify what changes will occur
136.2  to address the lack of progress.
136.3      (d) The commissioner must provide feedback and technical assistance if the needs
136.4  assessment must be revised.
136.5      Subd. 20. Staffing plan. (a) Based on an accepted community needs assessment, the
136.6  applicant or license holder must complete a staffing plan. The staffing plan must include
136.7  analysis of the extent to which identified staffing levels will be capable of meeting the needs
136.8  identified in the community needs assessment.
136.9      (b) The commissioner must provide feedback and technical assistance if the needs
136.10 assessment must be revised.
136.11     Subd. 21. Data and evaluation. A provider must submit documentation that establishes
136.12 the ability of the clinic to complete the required data collection as a CCBHC, as determined
136.13 by the commissioner. For an applicant that is an existing provider, the commissioner must
136.14 review and evaluate data submitted related to claims, grants, and other reporting to ensure
136.15 the data meets reporting requirements.
136.16     Subd. 22. Cost reporting. A provider must submit a cost report on the forms and in the
136.17 manner required in section 256B.0625, subdivision 5m.
136.18   Sec. 32. [245I.22] ADULT REHABILITATIVE MENTAL HEALTH SERVICES.
136.19     Subdivision 1. Generally. Beginning January 1, 2028, a provider of adult mental health
136.20 rehabilitative services must be licensed under this section and chapter 245A.
136.21     Subd. 2. Definitions. (a) For the purposes of this section, the terms in this subdivision
136.22 have the meanings given.
136.23     (b) "Adult mental health rehabilitative services" or "ARMHS" has the meaning given
136.24 in section 245I.02, subdivision 33.
136.25     (c) "Basic living skills" means rehabilitative interventions that instruct, assist, and support
136.26 the client in areas, including interpersonal communication skills, community resource
136.27 utilization and integration skills, crisis planning, relapse prevention skills, health care
136.28 directives, budgeting and shopping skills, healthy lifestyle skills and practices, cooking and
136.29 nutrition skills, transportation skills, mental illness symptom management skills, household
136.30 management skills, employment-related skills, and parenting skills.
136.31     (d) "Community intervention" means a client's community assisting in the client's
136.32 rehabilitation and includes consultation with relatives, guardians, friends, employers,
  Article 4 Sec. 32.  136
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137.1  treatment providers, and other significant individuals. Community intervention is appropriate
137.2  when directed exclusively to the treatment of the client.
137.3(e) "Medication education services" means services provided individually or in groups
137.4  that focus on educating the client about mental illness and symptoms, the role and effects
137.5  of medications in treating symptoms of mental illness, and the side effects of medications.
137.6  Medication education must be coordinated with medication management services and not
137.7  duplicate it. Medication education services must be provided by physicians, advanced
137.8  practice registered nurses, pharmacists, physician assistants, or registered nurses.
137.9(f) "Transition to community living" means services that maintain continuity of contact
137.10 between the rehabilitation services provider and the client and facilitate discharge from a
137.11 hospital, residential treatment program, board and lodging facility, or nursing home.
137.12 Transition to community living services must not be used to provide other areas of adult
137.13 rehabilitative mental health services.
137.14Subd. 3. Service components. An ARMHS provider must be capable of providing:
137.15(1) basic living skills;
137.16(2) medication education;
137.17(3) community intervention; and
137.18(4) transition to community living.
137.19Subd. 4. Provider requirements. An ARMHS license holder must be enrolled with
137.20 medical assistance and comply with standards in section 256B.0623.
137.21Subd. 5. Qualifications. ARMHS must be provided by:
137.22(1) a mental health professional qualified under section 245I.04, subdivision 2;
137.23(2) a certified rehabilitation specialist qualified under section 245I.04, subdivision 8;
137.24(3) a clinical trainee qualified under section 245I.04, subdivision 6;
137.25(4) a behavioral health practitioner qualified under section 245I.04, subdivision 4;
137.26(5) a mental health certified peer specialist qualified under section 245I.04, subdivision
137.27 12; or
137.28(6) a mental health rehabilitation worker qualified under section 245I.04, subdivision
137.29 14.
137.30Subd. 6. Service planning. (a) A provider of ARMHS must complete a written functional
137.31 assessment according to section 245I.10, subdivision 9, for each client.
  Article 4 Sec. 32.  137
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138.1(b) When a provider of ARMHS completes a written functional assessment, the provider
138.2  must also complete a level of care assessment, as defined in section 245I.02, subdivision
138.3  19, for the client.
138.4Subd. 7. Group modality. ARMHS may be provided in group settings if appropriate
138.5  to each participating client's needs and treatment plan. A group is defined as two to ten
138.6  clients, at least one of whom is concurrently receiving ARMHS. The service and group
138.7  must be specified in the client's individual treatment plan.
138.8    Sec. 33. [245I.24] MOBILE CRISIS RESPONSE SERVICES.
138.9Subdivision 1. Generally. (a) Mobile crisis response services provide short-term,
138.10 face-to-face mental health care for adults and children experiencing crisis in community
138.11 settings to help the individual maintain safety and return to a baseline level of functioning.
138.12(b) Beginning January 1, 2028, a provider of mobile crisis response services must be
138.13 licensed under this section and chapter 245A.
138.14Subd. 2. Definitions. (a) For the purposes of this section, the terms in this subdivision
138.15 have the meanings given.
138.16(b) "Crisis assessment" means an immediate face-to-face assessment by a physician, a
138.17 mental health professional, or a qualified member of a crisis team, as described in subdivision
138.18 5.
138.19(c) "Crisis intervention" means face-to-face, short-term intensive mental health services
138.20 initiated during a mental health crisis to help the individual cope with immediate stressors,
138.21 identify and utilize available resources and strengths, engage in voluntary treatment, and
138.22 begin to return to the individual's baseline level of functioning.
138.23(d) "Crisis screening" means a screening of a client's potential mental health crisis
138.24 situation under subdivision 6.
138.25(e) "Crisis stabilization" means individualized mental health services provided to an
138.26 individual that are designed to restore the individual to the individual's baseline level of
138.27 functioning. Crisis stabilization services may be provided in the individual's home, the home
138.28 of a family member or friend of the individual, another community setting, a short-term
138.29 supervised licensed residential program, or an emergency department. Crisis stabilization
138.30 services include family psychoeducation.
138.31(f) "Crisis team" means the staff of a provider entity who are supervised and prepared
138.32 to provide mobile crisis services to a client in a potential mental health crisis situation.
  Article 4 Sec. 33.  138
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139.1      (g) "Mental health crisis" is a behavioral, emotional, or psychiatric situation that, without
139.2  the provision of crisis response services, would likely result in significantly reducing the
139.3  individual's levels of functioning in primary activities of daily living, the individual needing
139.4  emergency services under section 62Q.55, or the individual being placed in a more restrictive
139.5  setting, including but not limited to inpatient hospitalization.
139.6      (h) "Mobile crisis services" means screening, assessment, intervention, and
139.7  community-based stabilization that is provided to an individual client. Mobile crisis services
139.8  does not include residential crisis stabilization.
139.9      Subd. 3. Eligibility. (a) An individual is eligible for crisis assessment services when the
139.10 person has screened positive for a potential mental health crisis during a crisis screening.
139.11     (b) An individual is eligible for crisis intervention services and crisis stabilization services
139.12 when the individual has been assessed during a crisis assessment to be experiencing a mental
139.13 health crisis.
139.14     Subd. 4. Policies, procedures, and practices specified. (a) In addition to the policies
139.15 and procedures required by section 245I.03, the license holder must establish, enforce, and
139.16 maintain policies and procedures to:
139.17     (1) ensure that crisis screenings, assessments, and intervention services are available 24
139.18 hours per day, seven days per week;
139.19     (2) respond to a call for services in a designated service area or according to a written
139.20 agreement with the local mental health authority for an adjacent area;
139.21     (3) have at least one mental health professional on staff at all times and at least one
139.22 additional staff member capable of leading a crisis response in the community; and
139.23     (4) respond to clients in the community according to the requirements and priorities in
139.24 subdivision 6.
139.25     (b) The license holder must provide the commissioner with information about the number
139.26 of requests for service, the number of clients that the provider serves face-to-face, and client
139.27 outcomes a minimum of every six months.
139.28     (c) The license holder must:
139.29     (1) provide support for an individual's family and natural supports by enabling the
139.30 individual's family and natural supports to observe and participate in the individual's
139.31 treatment, assessments, and planning services;
  Article 4 Sec. 33.  139
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140.1(2) implement culturally specific treatment identified in the crisis treatment plan that is
140.2  meaningful and appropriate as determined by the individual's culture, beliefs, values, and
140.3  language;
140.4(3) respond to the changing intervention and care needs of an individual as identified
140.5  by the individual or a family member; and
140.6(4) have the communication tools and procedures to communicate and consult promptly
140.7  about crisis assessment and interventions as services occur.
140.8(d) The license holder must coordinate services with:
140.9(1) county emergency services under section 245.469, community hospitals, ambulance,
140.10 transportation services, social services, law enforcement, engagement services, and mental
140.11 health crisis services through regularly scheduled interagency meetings;
140.12(2) other behavioral health service providers, county mental health authorities, or federally
140.13 recognized American Indian authorities and others as necessary, with the consent of the
140.14 individual or parent or guardian;
140.15(3) detoxification, withdrawal management services, and medical stabilization services
140.16 as required by clients; and
140.17(4) the individual's case manager if the individual is receiving case management services.
140.18Subd. 5. Crisis assessment and intervention staff qualifications. (a) Crisis assessment
140.19 and intervention services must be provided by:
140.20(1) a mental health professional qualified under section 245I.04, subdivision 2;
140.21(2) a clinical trainee qualified under section 245I.04, subdivision 6;
140.22(3) a behavioral health practitioner qualified under section 245I.04, subdivision 4;
140.23(4) a mental health certified family peer specialist qualified under section 245I.04,
140.24 subdivision 12; or
140.25(5) a mental health certified peer specialist qualified under section 245I.04, subdivision
140.26 10.
140.27(b) When crisis assessment and intervention services are provided to an individual in
140.28 the community, a mental health professional, clinical trainee, or mental health practitioner
140.29 must lead the response.
140.30(c) For providers under this section, the 30 hours of ongoing training required by section
140.31 245I.05, subdivision 4, paragraph (b), must be specific to providing crisis services to children
  Article 4 Sec. 33.  140
  04/06/26  REVISOR  DTT/CH  26-08138  as introduced
141.1  and adults and include training about evidence-based practices identified by the commissioner
141.2  of health to reduce the individual's risk of suicide and self-injurious behavior.
141.3      (d) At least six hours of the ongoing training under paragraph (c) must be specific to
141.4  working with families and providing crisis stabilization services to children and include the
141.5  following topics:
141.6      (1) developmental tasks of childhood and adolescence;
141.7      (2) family relationships;
141.8      (3) child and youth engagement and motivation, including motivational interviewing;
141.9      (4) culturally responsive care, including care for lesbian, gay, bisexual, transgender, and
141.10 queer youth;
141.11     (5) positive behavior support;
141.12     (6) crisis intervention for youth with developmental disabilities;
141.13     (7) child traumatic stress, trauma-informed care, and trauma-focused cognitive behavioral
141.14 therapy; and
141.15     (8) youth substance use.
141.16     (e) Individual providers must be experienced in crisis assessment, crisis intervention
141.17 techniques, treatment engagement strategies, working with families, and clinical decision
141.18 making under emergency conditions and have knowledge of local services and resources.
141.19     Subd. 6. Crisis screening. (a) A license holder may use the resources of emergency
141.20 services under section 245.469 for crisis screening. The crisis screening must gather
141.21 information, determine whether a mental health crisis situation exists, identify parties
141.22 involved, and determine an appropriate response.
141.23     (b) When conducting a crisis screening, a provider must:
141.24     (1) employ evidence-based practices to reduce the individual's risk of suicide and
141.25 self-injurious behavior;
141.26     (2) work with the individual to establish a plan and time frame for responding to the
141.27 individual's mental health crisis, including responding to the individual's immediate need
141.28 for support by telephone or text message until the provider can respond to the individual
141.29 face-to-face;
141.30     (3) document significant factors in determining whether the individual is experiencing
141.31 a mental health crisis, including prior requests for crisis services, an individual's recent
  Article 4 Sec. 33.  141
  04/06/26  REVISOR  DTT/CH  26-08138  as introduced
142.1  presentation at an emergency department, known calls to 911 or law enforcement, or
142.2  information from third parties with knowledge of an individual's history or current needs;
142.3      (4) accept calls from interested third parties and consider the additional needs or potential
142.4  mental health crises that the third parties may be experiencing;
142.5      (5) provide psychoeducation, including means reduction, to relevant third parties
142.6  including family members or other persons living with the individual; and
142.7      (6) consider other available services to determine which service intervention would best
142.8  address the individual's needs and circumstances.
142.9      (c) For the purposes of this section, the following situations indicate a positive screen
142.10 for a potential mental health crisis and the provider must prioritize providing a face-to-face
142.11 crisis assessment of the individual, unless a provider documents specific evidence to show
142.12 why the face-to-face assessment was not possible, including insufficient staffing resources,
142.13 concerns for staff or individual safety, or other clinical factors:
142.14     (1) the individual presents at an emergency department or urgent care setting and the
142.15 health care team at that location requested crisis services; or
142.16     (2) a peace officer requested crisis services for an individual who is potentially subject
142.17 to transportation under section 253B.051.
142.18     (d) A provider is not required to have direct contact with the individual to determine
142.19 that the individual is experiencing a potential mental health crisis. A mobile crisis provider
142.20 may gather relevant information about the individual from a third party to establish the
142.21 individual's need for services and potential safety factors.
142.22     Subd. 7. Crisis assessment. (a) If an individual screens positive for a potential mental
142.23 health crisis, a crisis assessment must be completed. A crisis assessment must evaluate any
142.24 immediate needs for which services are needed and, as time permits, the individual's:
142.25     (1) current life situation;
142.26     (2) health information, including current medications;
142.27     (3) sources of stress;
142.28     (4) mental health problems and symptoms;
142.29     (5) strengths;
142.30     (6) cultural considerations;
142.31     (7) support network;
  Article 4 Sec. 33.  142
  04/06/26  REVISOR  DTT/CH  26-08138  as introduced
143.1      (8) vulnerabilities;
143.2      (9) current functioning; and
143.3      (10) preferences as communicated directly by the individual or as communicated in a
143.4  health care directive as described in chapters 145C and 253B, the crisis treatment plan
143.5  described in subdivision 11, a crisis prevention plan, or a wellness recovery action plan.
143.6      (b) A provider must conduct a crisis assessment at the individual's location when
143.7  appropriate and, when not appropriate, document the reasons.
143.8      (c) Whenever possible, the assessor must attempt to include input from the individual
143.9  and the individual's family and other natural supports to assess whether a crisis exists.
143.10     (d) A crisis assessment includes determining whether the individual is willing to
143.11 voluntarily engage in treatment, whether the individual has an advance directive, and
143.12 gathering the individual's information and history from involved family or other natural
143.13 supports.
143.14     (e) If the individual does not need an acute level of care, a team must serve an otherwise
143.15 eligible individual who has a co-occurring substance use disorder.
143.16     (f) If after completing a crisis assessment of an individual, a provider refers the individual
143.17 to an intensive setting, including an emergency department, inpatient hospitalization, or
143.18 residential crisis stabilization, one of the crisis team members who completed or conferred
143.19 about the individual's crisis assessment must immediately contact the referral entity and
143.20 consult with the triage nurse or other staff responsible for intake at the referral entity. During
143.21 the consultation, the crisis team member must convey key findings or concerns that led to
143.22 the individual's referral. Following the consultation, the provider must also send written
143.23 documentation to the referral entity upon completion. The provider must document if the
143.24 individual or the individual's legal guardian signed releases for health records or if an
143.25 exception under section 144.293, subdivision 5, exists.
143.26     Subd. 8. Crisis intervention services. (a) If the crisis assessment determines an individual
143.27 needs mobile crisis intervention services, the license holder must provide crisis intervention
143.28 services promptly. As opportunity presents during the intervention, at least two members
143.29 of the mobile crisis intervention team must confer directly or by telephone about the crisis
143.30 assessment, crisis treatment plan, and actions taken and needed. At least one of the team
143.31 members must be providing face-to-face crisis intervention services. If providing crisis
143.32 intervention services, a clinical trainee or mental health practitioner must seek treatment
143.33 supervision as required in subdivision 10.
  Article 4 Sec. 33.  143
  04/06/26  REVISOR  DTT/CH  26-08138  as introduced
144.1      (b) If a provider delivers crisis intervention services while the individual is absent, the
144.2  provider must document the reason for delivering services while the individual is absent.
144.3      (c) The mobile crisis intervention team must develop a crisis treatment plan according
144.4  to subdivision 11.
144.5      (d) The mobile crisis intervention team must document which crisis treatment plan goals
144.6  and objectives have been met and when no further crisis intervention services are required.
144.7      (e) If the individual's mental health crisis is stabilized, but the individual needs a referral
144.8  to other services, the team must provide referrals to these services. If the individual is unable
144.9  to follow up on the referral, the team must link the individual to the service and follow up
144.10 to ensure the individual is receiving the service.
144.11     Subd. 9. Crisis stabilization services. (a) Crisis stabilization services must be provided
144.12 by qualified staff of a crisis stabilization services provider entity which must:
144.13     (1) develop a crisis treatment plan that meets the criteria in subdivision 11;
144.14     (2) complete a vulnerable adult determination in accordance with section 245A.65,
144.15 subdivision 1a;
144.16     (3) deliver crisis stabilization services according to the crisis treatment plan and include
144.17 face-to-face contact with the individual receiving services by qualified staff for further
144.18 assessment, help with referrals, updating of the crisis treatment plan, skills training, and
144.19 collaboration with other service providers in the community;
144.20     (4) if the provider delivers crisis stabilization services while the individual is absent,
144.21 document the reason for delivering services while the individual is absent; and
144.22     (5) if the individual's mental health crisis is stabilized and the individual does not have
144.23 a health care directive or psychiatric declaration, as defined in chapter 145C or section
144.24 253B.03, subdivision 6d, offer to work with the individual to develop a directive or
144.25 declaration.
144.26     (b) A staff member providing crisis stabilization services must be:
144.27     (1) a mental health professional qualified under section 245I.04, subdivision 2;
144.28     (2) a certified rehabilitation specialist qualified under section 245I.04, subdivision 8;
144.29     (3) a clinical trainee qualified under section 245I.04, subdivision 6;
144.30     (4) a behavioral health practitioner qualified under section 245I.04, subdivision 4;
  Article 4 Sec. 33.  144
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145.1(5) a mental health certified family peer specialist qualified under section 245I.04,
145.2  subdivision 12;
145.3(6) a mental health certified peer specialist qualified under section 245I.04, subdivision
145.4  10; or
145.5(7) a mental health rehabilitation worker qualified under section 245I.04, subdivision
145.6  14.
145.7(c) For providers under this section, the 30 hours of ongoing training required in section
145.8  245I.05, subdivision 4, paragraph (b), must be specific to providing crisis services to children
145.9  and adults and include training about evidence-based practices identified by the commissioner
145.10 of health to reduce an individual's risk of suicide and self-injurious behavior.
145.11(d) For providers who deliver care to children 21 years of age or younger, at least six
145.12 hours of the ongoing training under this subdivision must be specific to working with families
145.13 and providing crisis stabilization services to children, including the following topics:
145.14(1) developmental tasks of childhood and adolescence;
145.15(2) family relationships;
145.16(3) child and youth engagement and motivation, including motivational interviewing;
145.17(4) culturally responsive care, including care for lesbian, gay, bisexual, transgender, and
145.18 queer youth;
145.19(5) positive behavior support;
145.20(6) crisis intervention for youth with developmental disabilities;
145.21(7) child traumatic stress, trauma-informed care, and trauma-focused cognitive behavioral
145.22 therapy; and
145.23(8) youth substance use.
145.24 This paragraph does not apply to adult residential crisis stabilization services providers
145.25 licensed under section 245I.23 or providing services pursuant to section 256B.0624,
145.26 subdivision 7a.
145.27Subd. 10. Supervision. Clinical trainees and mental health practitioners may provide
145.28 crisis assessment and crisis intervention services if the following treatment supervision
145.29 requirements are met:
145.30(1) the license holder must accept full responsibility for the services provided;
  Article 4 Sec. 33.  145
  04/06/26  REVISOR  DTT/CH  26-08138  as introduced
146.1      (2) a mental health professional working for the license holder must be immediately
146.2  available by telephone or in person for treatment supervision;
146.3      (3) a mental health professional must be consulted, in person or by telephone, during
146.4  the first three hours when a clinical trainee or mental health practitioner provides crisis
146.5  assessment or crisis intervention services; and
146.6      (4) a mental health professional must:
146.7      (i) review and approve, as defined in section 245I.02, subdivision 2, the tentative crisis
146.8  assessment and crisis treatment plan within 24 hours of first providing services to the
146.9  individual, notwithstanding section 245I.08, subdivision 3; and
146.10     (ii) document the consultation required in clause (3).
146.11     Subd. 11. Crisis treatment plan. (a) Within 24 hours of an individual's admission, the
146.12 license holder must complete the individual's crisis treatment plan. The license holder must:
146.13     (1) base the individual's crisis treatment plan on the individual's crisis assessment;
146.14     (2) consider crisis assistance strategies that have been effective for the individual in the
146.15 past;
146.16     (3) for a child, use a child-centered, family-driven, and culturally appropriate planning
146.17 process that allows the child's parents and guardians to observe or participate in the child's
146.18 individual and family treatment services, assessment, and treatment planning;
146.19     (4) for an adult, use a person-centered, culturally appropriate planning process that allows
146.20 the individual's family and other natural supports to observe or participate in treatment
146.21 services, assessment, and treatment planning;
146.22     (5) identify the participants involved in the individual's treatment planning. The individual
146.23 must be a participant if possible;
146.24     (6) identify the individual's initial treatment goals, measurable treatment objectives, and
146.25 specific interventions that the license holder will use to help the person engage in treatment;
146.26     (7) include documentation of referral to and scheduling of services, including specific
146.27 providers where applicable;
146.28     (8) ensure that the individual or the individual's legal guardian approves under section
146.29 245I.02, subdivision 2, of the individual's crisis treatment plan unless a court orders the
146.30 individual's treatment plan under chapter 253B. If the individual or the individual's legal
146.31 guardian disagrees with the crisis treatment plan, the license holder must document in the
146.32 client file the reasons why the individual disagrees with the crisis treatment plan; and
  Article 4 Sec. 33.  146
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147.1      (9) ensure that a treatment supervisor approves, as defined in section 245I.02, subdivision
147.2  2, of the individual's treatment plan within 24 hours of the individual's admission if a mental
147.3  health practitioner or clinical trainee completes the crisis treatment plan, notwithstanding
147.4  section 245I.08, subdivision 3.
147.5      (b) The provider entity must provide the individual and the individual's legal guardian
147.6  with a copy of the crisis treatment plan.
147.7      Subd. 12. Application requirements. In an application made under this section and
147.8  section 245A.04, the applicant must demonstrate that the applicant is:
147.9      (1) enrolled as a medical assistance provider; and
147.10     (2) in compliance with the provider type requirements under section 256B.0624,
147.11 subdivision 4, as determined by the commissioner.
147.12   Sec. 34. [245I.30] CHILDREN'S THERAPEUTIC SERVICES AND SUPPORTS IN
147.13 THE COMMUNITY.
147.14     Subdivision 1. Generally. (a) "Children's therapeutic services and supports" means the
147.15 flexible package of mental health services for children who require varying therapeutic and
147.16 rehabilitative levels of intervention to treat a diagnosed mental illness. The services are
147.17 interventions that are delivered using various treatment modalities and combinations of
147.18 services designed to reach treatment outcomes identified in the individual treatment plan.
147.19 Children's therapeutic services and supports include development and rehabilitative services
147.20 that support a child's developmental treatment needs.
147.21     (b) Beginning January 1, 2028, a provider of children's therapeutic services and supports
147.22 in the community must be licensed under this section and chapter 245A.
147.23     Subd. 2. Service components. (a) A children's therapeutic services and supports license
147.24 holder must be capable of providing:
147.25     (1) individual and family psychotherapy, psychotherapy for crises, and group
147.26 psychotherapy;
147.27     (2) individual, family, or group skills training; and
147.28     (3) crisis planning.
147.29     (b) Crisis planning that meets the standards in section 245.4871, subdivision 9a, must
147.30 be offered to each client's family.
  Article 4 Sec. 34.  147
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148.1      Subd. 3. Provider requirements. A children's therapeutic services and supports license
148.2  holder must be enrolled with medical assistance and comply with the requirements in section
148.3  256B.0943.
148.4      Subd. 4. Qualifications of provider staff. Children's therapeutic services and supports
148.5  must be provided by:
148.6      (1) a mental health professional qualified under section 245I.04, subdivision 2;
148.7      (2) a clinical trainee qualified under section 245I.04, subdivision 6;
148.8      (3) a behavioral health practitioner qualified under section 245I.04, subdivision 4;
148.9      (4) a mental health certified family peer specialist qualified under section 245I.04,
148.10 subdivision 12; or
148.11     (5) a mental health behavioral aide qualified under section 245I.04, subdivision 16.
148.12     Subd. 5. Group modality. Group skills training may be provided to multiple clients
148.13 who, because of the nature of the clients' emotional, behavioral, or social dysfunction, can
148.14 derive mutual benefit from interaction in a group setting. A group is defined as two to ten
148.15 clients, at least one of whom is a client and is concurrently receiving a service under this
148.16 section. The service and group must be specified in the client's individual treatment plan.
148.17   Sec. 35. [245I.31] CHILDREN'S DAY TREATMENT.
148.18     Subdivision 1. Generally. (a) For the purposes of this section, "children's day treatment
148.19 program" means a site-based structured mental health program consisting of psychotherapy
148.20 and individual or group skills training provided by a team under the treatment supervision
148.21 of a mental health professional.
148.22     (b) Children's day treatment programs are licensed for a specific location of operation
148.23 and are not part of inpatient or residential treatment services.
148.24     (c) A children's day treatment program must stabilize a client's mental health status while
148.25 developing and improving the client's independent living and socialization skills. The goal
148.26 of the day treatment program must be to reduce or relieve the effects of mental illness and
148.27 provide training to enable the client to live in the community.
148.28     (d) Beginning January 1, 2028, a provider of children's day services must be licensed
148.29 under this section and chapter 245A.
148.30     Subd. 2. Service components. A children's day treatment program must be capable of
148.31 providing the services in section 245I.30, subdivision 2.
  Article 4 Sec. 35.  148
  04/06/26  REVISOR        DTT/CH  26-08138  as introduced
149.1      Subd. 3. Provider requirements. A children's day treatment license holder must:
149.2      (1) be enrolled as a provider with medical assistance;
149.3      (2) maintain a policy regarding the use of restrictive procedures and meet the requirements
149.4  of section 245.8261;
149.5      (3) maintain a policy on medications in accordance with section 245I.11, subdivision
149.6  6; and
149.7      (4) meet group modality requirements in section 245I.30, subdivision 5.
149.8      Subd. 4. Qualifications of provider staff. Children's day treatment services must be
149.9  provided by:
149.10     (1) a mental health professional qualified under section 245I.04, subdivision 2;
149.11     (2) a clinical trainee qualified under section 245I.04, subdivision 6; or
149.12     (3) a behavioral health practitioner qualified under section 245I.04, subdivision 4.
149.13   Sec. 36. Minnesota Statutes 2024, section 256B.0623, subdivision 1, is amended to read:
149.14     Subdivision 1. Scope. Subject to federal approval, Medical assistance covers medically
149.15 necessary adult rehabilitative mental health services when the services are provided by an
149.16 entity meeting the standards in this section licensed under section 245I.24. The provider
149.17 entity must make reasonable and good faith efforts to report individual client outcomes to
149.18 the commissioner, using instruments and protocols approved by the commissioner.
149.19     EFFECTIVE DATE. This section is effective January 1, 2028.
149.20   Sec. 37. Minnesota Statutes 2024, section 256B.0623, subdivision 3, is amended to read:
149.21     Subd. 3. Eligibility. An eligible recipient is an individual who:
149.22     (1) is age 18 or older;
149.23     (2) is diagnosed with a medical condition, such as mental illness or traumatic brain
149.24 injury, for which adult rehabilitative mental health services are needed;
149.25     (3) has substantial disability and functional impairment in three or more of the areas
149.26 listed in section 245I.10, subdivision 9, paragraph (a), clause (4), so that self-sufficiency is
149.27 markedly reduced; and
149.28     (4) has had a recent standard diagnostic assessment pursuant to section 245I.10,
149.29 subdivision 6, by a qualified professional that documents adult rehabilitative mental health
  Article 4 Sec. 37.  149
  04/06/26  REVISOR  DTT/CH  26-08138  as introduced
150.1  services are medically necessary to address identified disability and functional impairments
150.2  and individual recipient goals.
150.3      EFFECTIVE DATE. This section is effective January 1, 2028.
150.4    Sec. 38. Minnesota Statutes 2024, section 256B.0623, subdivision 12, is amended to read:
150.5      Subd. 12. Additional requirements. (a) Providers of adult rehabilitative mental health
150.6  services must comply with the requirements relating to referrals for case management in
150.7  section 245.467, subdivision 4.
150.8      (b) Adult rehabilitative mental health services are provided for most recipients in the
150.9  recipient's home and community. Services may also be provided at the home of a relative
150.10 or significant other, job site, psychosocial clubhouse, drop-in center, social setting, classroom,
150.11 or other places in the community. (a) Except for "transition to community services," the
150.12 place of service does not include a regional treatment center, nursing home, residential
150.13 treatment facility licensed under Minnesota Rules, parts 9520.0500 to 9520.0670 (Rule 36),
150.14 or section 245I.23, or an acute care hospital.
150.15     (c) Adult rehabilitative mental health services may be provided in group settings if
150.16 appropriate to each participating recipient's needs and individual treatment plan. A group
150.17 is defined as two to ten clients, at least one of whom is a recipient, who is concurrently
150.18 receiving a service which is identified in this section. The service and group must be specified
150.19 in the recipient's individual treatment plan. (b) No more than two qualified staff may bill
150.20 Medicaid for services provided to the same group of recipients. If two adult rehabilitative
150.21 mental health workers bill for recipients in the same group session, they must each bill for
150.22 different recipients.
150.23     (d) (c) Adult rehabilitative mental health services are appropriate if provided to enable
150.24 a recipient to retain stability and functioning, when the recipient is at risk of significant
150.25 functional decompensation or requiring more restrictive service settings without these
150.26 services.
150.27     (e) Adult rehabilitative mental health services instruct, assist, and support the recipient
150.28 in areas including: interpersonal communication skills, community resource utilization and
150.29 integration skills, crisis planning, relapse prevention skills, health care directives, budgeting
150.30 and shopping skills, healthy lifestyle skills and practices, cooking and nutrition skills,
150.31 transportation skills, medication education and monitoring, mental illness symptom
150.32 management skills, household management skills, employment-related skills, parenting
150.33 skills, and transition to community living services.
  Article 4 Sec. 38.  150
  04/06/26  REVISOR        DTT/CH  26-08138  as introduced
151.1      (f) Community intervention, including consultation with relatives, guardians, friends,
151.2  employers, treatment providers, and other significant individuals, is appropriate when
151.3  directed exclusively to the treatment of the client.
151.4      EFFECTIVE DATE. This section is effective January 1, 2028.
151.5    Sec. 39. Minnesota Statutes 2024, section 256B.0624, subdivision 1, is amended to read:
151.6      Subdivision 1. Scope. (a) Subject to federal approval, Medical assistance covers medically
151.7  necessary crisis response services when the services are provided according to the standards
151.8  in this section 245I.24.
151.9      (b) Subject to federal approval, Medical assistance covers medically necessary residential
151.10 crisis stabilization for adults when the services are provided by an entity licensed under and
151.11 meeting the standards in section 245I.23 or an entity with an adult foster care license meeting
151.12 the standards in this section subdivision 7a.
151.13     (c) The provider entity must make reasonable and good faith efforts to report individual
151.14 client outcomes to the commissioner using instruments and protocols approved by the
151.15 commissioner.
151.16     EFFECTIVE DATE. This section is effective January 1, 2028.
151.17   Sec. 40. Minnesota Statutes 2024, section 256B.0624, subdivision 4, is amended to read:
151.18     Subd. 4. Provider entity standards. (a) A mobile crisis provider must be:
151.19     (1) a county board operated entity;
151.20     (2) an Indian health services facility or facility owned and operated by a tribe or Tribal
151.21 organization operating under United States Code, title 325, section 450f; or
151.22     (3) a provider entity that is under contract with the county board in the county where
151.23 the potential crisis or emergency is occurring. To provide services under this section, the
151.24 provider entity must directly provide the services; or if services are subcontracted, the
151.25 provider entity must maintain responsibility for services and billing.
151.26     (b) A mobile crisis provider must meet the following standards:
151.27     (1) ensure that crisis screenings, crisis assessments, and crisis intervention services are
151.28 available to a recipient 24 hours a day, seven days a week;
151.29     (2) be able to respond to a call for services in a designated service area or according to
151.30 a written agreement with the local mental health authority for an adjacent area;
  Article 4 Sec. 40.  151
  04/06/26  REVISOR  DTT/CH  26-08138  as introduced
152.1      (3) have at least one mental health professional on staff at all times and at least one
152.2  additional staff member capable of leading a crisis response in the community; and
152.3      (4) provide the commissioner with information about the number of requests for service,
152.4  the number of people that the provider serves face-to-face, outcomes, and the protocols that
152.5  the provider uses when deciding when to respond in the community.
152.6      (c) A provider entity that provides crisis stabilization services in a residential setting
152.7  under subdivision 7 is not required to meet the requirements of paragraphs (a) and (b), but
152.8  must meet all other requirements of this subdivision.
152.9      (d) A crisis services provider must have the capacity to meet and carry out the standards
152.10 in section 245I.011, subdivision 5, and the following standards:
152.11     (1) ensures that staff persons provide support for a recipient's family and natural supports,
152.12 by enabling the recipient's family and natural supports to observe and participate in the
152.13 recipient's treatment, assessments, and planning services;
152.14     (2) has adequate administrative ability to ensure availability of services;
152.15     (3) is able to ensure that staff providing these services are skilled in the delivery of
152.16 mental health crisis response services to recipients;
152.17     (4) is able to ensure that staff are implementing culturally specific treatment identified
152.18 in the crisis treatment plan that is meaningful and appropriate as determined by the recipient's
152.19 culture, beliefs, values, and language;
152.20     (5) is able to ensure enough flexibility to respond to the changing intervention and care
152.21 needs of a recipient as identified by the recipient or family member during the service
152.22 partnership between the recipient and providers;
152.23     (6) is able to ensure that staff have the communication tools and procedures to
152.24 communicate and consult promptly about crisis assessment and interventions as services
152.25 occur;
152.26     (7) is able to coordinate these services with county emergency services, community
152.27 hospitals, ambulance, transportation services, social services, law enforcement, engagement
152.28 services, and mental health crisis services through regularly scheduled interagency meetings;
152.29     (8) is able to ensure that services are coordinated with other behavioral health service
152.30 providers, county mental health authorities, or federally recognized American Indian
152.31 authorities and others as necessary, with the consent of the recipient or parent or guardian.
  Article 4 Sec. 40.  152
  04/06/26  REVISOR  DTT/CH  26-08138  as introduced
153.1  Services must also be coordinated with the recipient's case manager if the recipient is
153.2  receiving case management services;
153.3      (9) is able to ensure that crisis intervention services are provided in a manner consistent
153.4  with sections 245.461 to 245.486 and 245.487 to 245.4879;
153.5      (10) is able to coordinate detoxification services for the recipient according to Minnesota
153.6  Rules, parts 9530.6605 to 9530.6655, or withdrawal management according to chapter 245F;
153.7      (11) is able to establish and maintain a quality assurance and evaluation plan to evaluate
153.8  the outcomes of services and recipient satisfaction; and
153.9      (12) is an enrolled medical assistance provider.
153.10     (b) A mobile crisis provider must ensure services are provided consistent with section
153.11 245.469, subdivisions 1 and 2.
153.12     EFFECTIVE DATE. This section is effective January 1, 2028.
153.13   Sec. 41. Minnesota Statutes 2024, section 256B.0624, is amended by adding a subdivision
153.14 to read:
153.15     Subd. 7a. Residential crisis stabilization services in adult foster care settings. (a) If
153.16 crisis stabilization services are provided in a supervised, licensed residential setting that
153.17 serves no more than four adult residents and one or more individuals are present at the
153.18 setting to receive residential crisis stabilization, the residential staff must include, for at
153.19 least eight hours per day, at least one mental health professional, clinical trainee, certified
153.20 rehabilitation specialist, or mental health practitioner. The commissioner must establish a
153.21 statewide per diem rate for crisis stabilization services provided under this paragraph to
153.22 medical assistance enrollees. The rate for a provider must not exceed the rate charged by
153.23 that provider for the same service to other payers. Payment must not be made to more than
153.24 one entity for each individual for services provided under this paragraph on a given day.
153.25 The commissioner must set rates prospectively for the annual rate period. The commissioner
153.26 must require providers to submit annual cost reports on a uniform cost reporting form and
153.27 use submitted cost reports to inform the rate-setting process. The commissioner must
153.28 recalculate the statewide per diem every year.
153.29     (b) A provider under this subdivision must follow the requirements under section 245I.24,
153.30 subdivisions 4, paragraphs (c) and (d), and 9.
153.31     EFFECTIVE DATE. This section is effective January 1, 2028.
  Article 4 Sec. 41.  153
  04/06/26  REVISOR        DTT/CH  26-08138  as introduced
154.1    Sec. 42. Minnesota Statutes 2025 Supplement, section 256B.0625, subdivision 5m, is
154.2  amended to read:
154.3      Subd. 5m. Certified community behavioral health clinic services. (a) Medical
154.4  assistance covers services provided by a not-for-profit certified community behavioral health
154.5  clinic (CCBHC) that meets the requirements of section 245.735, subdivision 3 245I.17.
154.6      (b) The commissioner shall reimburse CCBHCs on a per-day basis for each day that an
154.7  eligible service is delivered using the CCBHC daily bundled rate system for medical
154.8  assistance payments as described in paragraph (c). The commissioner shall include a quality
154.9  incentive payment in the CCBHC daily bundled rate system as described in paragraph (e).
154.10 There is no county share for medical assistance services when reimbursed through the
154.11 CCBHC daily bundled rate system.
154.12     (c) The commissioner shall ensure that the CCBHC daily bundled rate system for CCBHC
154.13 payments under medical assistance meets the following requirements:
154.14     (1) the CCBHC daily bundled rate shall be a provider-specific rate calculated for each
154.15 CCBHC, based on the daily cost of providing CCBHC services and the total annual allowable
154.16 CCBHC costs divided by the total annual number of CCBHC visits. For calculating the
154.17 payment rate, total annual visits include visits covered by medical assistance and visits not
154.18 covered by medical assistance. Allowable costs include but are not limited to the salaries
154.19 and benefits of medical assistance providers; the cost of CCBHC services provided under
154.20 section 245.735, subdivision 3, paragraph (a), clauses (6) and (7) 245I.17, subdivision 4;
154.21 and other costs such as insurance or supplies needed to provide CCBHC services;
154.22     (2) payment shall be limited to one payment per day per medical assistance enrollee
154.23 when an eligible CCBHC service is provided. A CCBHC visit is eligible for reimbursement
154.24 if at least one of the CCBHC services listed under section 245.735, subdivision 3, paragraph
154.25 (a), clause (6) 245I.17, subdivision 4, is furnished to a medical assistance enrollee by a
154.26 health care practitioner or licensed agency employed by or under contract with a CCBHC;
154.27     (3) initial CCBHC daily bundled rates for newly certified licensed CCBHCs under
154.28 section 245.735, subdivision 3 245I.17, shall be established by the commissioner using a
154.29 provider-specific rate based on the newly certified licensed CCBHC's audited historical
154.30 cost report data adjusted for the expected cost of delivering CCBHC services. Estimates
154.31 are subject to review by the commissioner and must include the expected cost of providing
154.32 the full scope of CCBHC services and the expected number of visits for the rate period;
154.33     (4) the commissioner shall rebase CCBHC rates once every two years following the last
154.34 rebasing and no less than 12 months following an initial rate or a rate change due to a change
  Article 4 Sec. 42.  154
  04/06/26  REVISOR        DTT/CH  26-08138  as introduced
155.1  in the scope of services. For CCBHCs certified after September 30, 2020, and before January
155.2  1, 2021, the commissioner shall rebase rates according to this clause for services provided
155.3  on or after January 1, 2024;
155.4      (5) the commissioner shall provide for a 60-day appeals process after notice of the results
155.5  of the rebasing;
155.6      (6) an entity that receives a CCBHC daily bundled rate that overlaps with another federal
155.7  Medicaid rate is not eligible for the CCBHC rate methodology;
155.8      (7) payments for CCBHC services to individuals enrolled in managed care shall be
155.9  coordinated with the state's phase-out of CCBHC wrap payments. The commissioner shall
155.10 complete the phase-out of CCBHC wrap payments within 60 days of the implementation
155.11 of the CCBHC daily bundled rate system in the Medicaid Management Information System
155.12 (MMIS), for CCBHCs reimbursed under this chapter, with a final settlement of payments
155.13 due made payable to CCBHCs no later than 18 months thereafter;
155.14     (8) the CCBHC daily bundled rate for each CCBHC shall be updated by trending each
155.15 provider-specific rate by the Medicare Economic Index for primary care services. This
155.16 update shall occur each year in between rebasing periods determined by the commissioner
155.17 in accordance with clause (4). CCBHCs must provide data on costs and visits to the state
155.18 annually using the CCBHC cost report established by the commissioner; and
155.19     (9) a CCBHC may request a rate adjustment for changes in the CCBHC's scope of
155.20 services when such changes are expected to result in an adjustment to the CCBHC payment
155.21 rate by 2.5 percent or more. The CCBHC must provide the commissioner with information
155.22 regarding the changes in the scope of services, including the estimated cost of providing
155.23 the new or modified services and any projected increase or decrease in the number of visits
155.24 resulting from the change. Estimated costs are subject to review by the commissioner. Rate
155.25 adjustments for changes in scope shall occur no more than once per year in between rebasing
155.26 periods per CCBHC and are effective on the date of the annual CCBHC rate update.
155.27     (d) Managed care plans and county-based purchasing plans shall reimburse CCBHC
155.28 providers at the CCBHC daily bundled rate. The commissioner shall monitor the effect of
155.29 this requirement on the rate of access to the services delivered by CCBHC providers. If, for
155.30 any contract year, federal approval is not received for this paragraph, the commissioner
155.31 must adjust the capitation rates paid to managed care plans and county-based purchasing
155.32 plans for that contract year to reflect the removal of this provision. Contracts between
155.33 managed care plans and county-based purchasing plans and providers to whom this paragraph
155.34 applies must allow recovery of payments from those providers if capitation rates are adjusted
  Article 4 Sec. 42.  155
  04/06/26  REVISOR        DTT/CH  26-08138  as introduced
156.1  in accordance with this paragraph. Payment recoveries must not exceed the amount equal
156.2  to any increase in rates that results from this provision. This paragraph expires if federal
156.3  approval is not received for this paragraph at any time.
156.4      (e) The commissioner shall implement a quality incentive payment program for CCBHCs
156.5  that meets the following requirements:
156.6      (1) a CCBHC shall receive a quality incentive payment upon meeting specific numeric
156.7  thresholds for performance metrics established by the commissioner, in addition to payments
156.8  for which the CCBHC is eligible under the CCBHC daily bundled rate system described in
156.9  paragraph (c);
156.10     (2) a CCBHC must be certified licensed and enrolled as a CCBHC for the entire
156.11 measurement year to be eligible for incentive payments;
156.12     (3) each CCBHC shall receive written notice of the criteria that must be met in order to
156.13 receive quality incentive payments at least 90 days prior to the measurement year; and
156.14     (4) a CCBHC must provide the commissioner with data needed to determine incentive
156.15 payment eligibility within six months following the measurement year. The commissioner
156.16 shall notify CCBHC providers of their performance on the required measures and the
156.17 incentive payment amount within 12 months following the measurement year.
156.18     (f) All claims to managed care plans for CCBHC services as provided under this section
156.19 shall be submitted directly to, and paid by, the commissioner on the dates specified no later
156.20 than January 1 of the following calendar year, if:
156.21     (1) one or more managed care plans does not comply with the federal requirement for
156.22 payment of clean claims to CCBHCs, as defined in Code of Federal Regulations, title 42,
156.23 section 447.45(b), and the managed care plan does not resolve the payment issue within 30
156.24 days of noncompliance; and
156.25     (2) the total amount of clean claims not paid in accordance with federal requirements
156.26 by one or more managed care plans is 50 percent of, or greater than, the total CCBHC claims
156.27 eligible for payment by managed care plans.
156.28 If the conditions in this paragraph are met between January 1 and June 30 of a calendar
156.29 year, claims shall be submitted to and paid by the commissioner beginning on January 1 of
156.30 the following year. If the conditions in this paragraph are met between July 1 and December
156.31 31 of a calendar year, claims shall be submitted to and paid by the commissioner beginning
156.32 on July 1 of the following year.
  Article 4 Sec. 42.  156
  04/06/26  REVISOR  DTT/CH  26-08138  as introduced
157.1      (g) Peer services provided by a CCBHC certified licensed under section 245.735 245I.17
157.2  are a covered service under medical assistance when a licensed mental health professional
157.3  or alcohol and drug counselor determines that peer services are medically necessary.
157.4  Eligibility under this subdivision for peer services provided by a CCBHC supersede eligibility
157.5  standards under sections 256B.0615, 256B.0616, and 245G.07, subdivision 2a, paragraph
157.6  (b), clause (2).
157.7      EFFECTIVE DATE. This section is effective January 1, 2028.
157.8    Sec. 43. Minnesota Statutes 2024, section 256B.0943, subdivision 2, is amended to read:
157.9      Subd. 2. Covered service components of children's therapeutic services and
157.10 supports. (a) Subject to federal approval, medical assistance covers medically necessary
157.11 children's therapeutic services and supports when the services are provided by an eligible
157.12 provider entity certified under and meeting the standards in this section licensed under
157.13 section 245I.30 or children's day treatment services licensed under section 245I.31. The
157.14 provider entity must make reasonable and good faith efforts to report individual client
157.15 outcomes to the commissioner, using instruments and protocols approved by the
157.16 commissioner.
157.17     (b) The covered service components of children's therapeutic services and supports are:
157.18     (1) patient and/or family psychotherapy, family psychotherapy, psychotherapy for crisis,
157.19 and group psychotherapy;
157.20     (2) individual, family, or group skills training provided by a mental health professional,
157.21 clinical trainee, or mental health practitioner;
157.22     (3) crisis planning;
157.23     (4) mental health behavioral aide services;
157.24     (1) the services described in section 245I.30, subdivision 2, by providers licensed under
157.25 section 245I.30 or 245I.31;
157.26     (2) administration of standardized measures;
157.27     (5) (3) direction of a mental health behavioral aide; and
157.28     (6) (4) mental health service plan development; and.
157.29     (7) children's day treatment.
157.30     (c) In delivering services under this section, a licensed provider entity must ensure that
157.31 psychotherapy to address a child's underlying mental health disorder is documented as part
  Article 4 Sec. 43.  157
  04/06/26  REVISOR  DTT/CH  26-08138  as introduced
158.1  of the child's ongoing treatment. A provider must deliver or arrange for medically necessary
158.2  psychotherapy unless the child's parent or caregiver chooses not to receive the psychotherapy
158.3  or the provider determines that psychotherapy is no longer medically necessary. When a
158.4  provider determines that psychotherapy is no longer medically necessary, the provider must
158.5  update required documentation, including but not limited to the individual treatment plan,
158.6  the child's medical record, or other authorizations, to include the determination. When a
158.7  provider determines that a child needs psychotherapy but psychotherapy cannot be delivered
158.8  due to a shortage of licensed mental health professionals in the child's community, the
158.9  provider must document the lack of access in the child's medical record.
158.10     (d) Medical assistance covers service plan development before completion of a child's
158.11 individual treatment plan. Service plan development consists of development, review, and
158.12 revision of the individual treatment plan by face-to-face or electronic communication,
158.13 including time spent gathering client history from other key figures or providers. The provider
158.14 must document events, including the time spent with the family and other key participants
158.15 in the child's life to approve the individual treatment plan. Service plan development is
158.16 covered only if a treatment plan is completed or for work already completed at the time the
158.17 client voluntarily chooses to disengage with services for the child. If it is determined upon
158.18 review that a treatment plan was not completed for the child, the commissioner shall recover
158.19 the payment for the service plan development.
158.20     (e) Medical assistance covers time spent administering and reporting standardized
158.21 measures approved by the commissioner.
158.22     EFFECTIVE DATE. This section is effective January 1, 2028.
158.23   Sec. 44. Minnesota Statutes 2025 Supplement, section 256B.0943, subdivision 3, is
158.24 amended to read:
158.25     Subd. 3. Determination of client eligibility. (a) A client's eligibility to receive children's
158.26 therapeutic services and supports under this section shall be determined based on a standard
158.27 diagnostic assessment by a mental health professional or a clinical trainee that is performed
158.28 within one year before the initial start of service and updated as required under section
158.29 245I.10, subdivision 2. The standard diagnostic assessment must:
158.30     (1) determine whether a child under age 18 has a diagnosis of mental illness or, if the
158.31 person is between the ages of 18 and 21, whether the person has a mental illness; and
  Article 4 Sec. 44.  158
  04/06/26  REVISOR  DTT/CH  26-08138  as introduced
159.1      (2) document children's therapeutic services and supports as medically necessary to
159.2  address an identified disability, functional impairment, and the individual client's needs and
159.3  goals; and.
159.4      (3) be used in the development of the individual treatment plan.
159.5      (b) Notwithstanding paragraph (a), a client may be determined to be eligible for up to
159.6  five days of day treatment under this section based on a hospital's medical history and
159.7  presentation examination of the client.
159.8      (c) Children's therapeutic services and supports include development and rehabilitative
159.9  services that support a child's developmental treatment needs.
159.10   Sec. 45. Minnesota Statutes 2025 Supplement, section 256B.0943, subdivision 12, is
159.11 amended to read:
159.12     Subd. 12. Excluded services. (a) The following services are not eligible for medical
159.13 assistance payment as children's therapeutic services and supports:
159.14     (1) service components of children's therapeutic services and supports simultaneously
159.15 provided by more than one provider entity unless prior authorization is obtained;
159.16     (2) treatment by multiple providers within the same agency at the same clock time,
159.17 unless one service is delivered to the child and the other service is delivered to the child's
159.18 family or treatment team without the child present;
159.19     (3) children's therapeutic services and supports provided in violation of medical assistance
159.20 policy in Minnesota Rules, part 9505.0220;
159.21     (4) mental health behavioral aide services provided by a personal care assistant who is
159.22 not qualified as a mental health behavioral aide and employed by a certified children's
159.23 therapeutic services and supports provider entity;
159.24     (5) service components of CTSS that are the responsibility of a residential or program
159.25 license holder, including foster care providers under the terms of a service agreement or
159.26 administrative rules governing licensure; and
159.27     (6) adjunctive activities that may be offered by a provider entity but are not otherwise
159.28 covered by medical assistance, including:
159.29     (i) a service that is primarily recreation oriented or that is provided in a setting that is
159.30 not medically supervised. This includes sports activities, exercise groups, activities such as
159.31 craft hours, leisure time, social hours, meal or snack time, trips to community activities,
159.32 and tours;
  Article 4 Sec. 45.  159
  04/06/26  REVISOR        DTT/CH  26-08138  as introduced
160.1      (ii) a social or educational service that does not have or cannot reasonably be expected
160.2  to have a therapeutic outcome related to the client's mental illness;
160.3      (iii) prevention or education programs provided to the community; and
160.4      (iv) treatment for clients with primary diagnoses of alcohol or other drug abuse.
160.5      (b) Time spent doing work before and after providing direct services, including scheduling
160.6  or maintaining clinical records, is included in CTSS payments and may not be separately
160.7  billed as additional clock hours of service.
160.8    Sec. 46. Minnesota Statutes 2025 Supplement, section 260E.14, subdivision 1, is amended
160.9  to read:
160.10     Subdivision 1. Facilities and schools. (a) The local welfare agency is the agency
160.11 responsible for investigating allegations of maltreatment in child foster care, family child
160.12 care, legally nonlicensed child care, and reports involving children served by an unlicensed
160.13 personal care provider organization under section 256B.0659. Copies of findings related to
160.14 personal care provider organizations under section 256B.0659 must be forwarded to the
160.15 Department of Human Services provider enrollment.
160.16     (b) The Department of Human Services is the agency responsible for screening and
160.17 investigating allegations of maltreatment in juvenile correctional facilities listed under
160.18 section 241.021 located in the local welfare agency's county and in facilities licensed or
160.19 certified under chapters 245A and 245D.
160.20     (c) The Department of Health is the agency responsible for screening and investigating
160.21 allegations of maltreatment in facilities licensed under sections 144.50 to 144.58 and 144A.43
160.22 to 144A.482 or chapter 144H.
160.23     (d) The Department of Education is the agency responsible for screening and investigating
160.24 allegations of maltreatment in a school as defined in section 120A.05, subdivisions 9, 11,
160.25 and 13, and chapter 124E. The Department of Education's responsibility to screen and
160.26 investigate includes allegations of maltreatment involving students 18 through 21 years of
160.27 age, including students receiving special education services, up to and including graduation
160.28 and the issuance of a secondary or high school diploma.
160.29     (e) The Department of Human Services is the agency responsible for screening and
160.30 investigating allegations of maltreatment of minors in an EIDBI agency operating under
160.31 sections 245A.142 and 256B.0949.
  Article 4 Sec. 46.  160
  04/06/26  REVISOR  DTT/CH  26-08138  as introduced
161.1      (f) A health or corrections agency receiving a report may request the local welfare agency
161.2  to provide assistance pursuant to this section and sections 260E.20 and 260E.22.
161.3      (g) The Department of Children, Youth, and Families is the agency responsible for
161.4  screening and investigating allegations of maltreatment in facilities or programs not listed
161.5  in paragraph (a) that are licensed or certified under chapters 142B and 142C.
161.6      (h) The Department of Human Services is the agency responsible for screening and
161.7  investigating allegations of maltreatment of minors for mobile crisis response services and
161.8  children's therapeutic services and supports programs licensed under chapter 245I.
161.9    Sec. 47. Minnesota Statutes 2025 Supplement, section 626.5572, subdivision 13, is amended
161.10 to read:
161.11     Subd. 13. Lead investigative agency. "Lead investigative agency" is the primary
161.12 administrative agency responsible for investigating reports made under section 626.557.
161.13     (a) The Department of Health is the lead investigative agency for facilities or services
161.14 licensed or required to be licensed as hospitals, home care providers, nursing homes, boarding
161.15 care homes, hospice providers, residential facilities that are also federally certified as
161.16 intermediate care facilities that serve people with developmental disabilities, or any other
161.17 facility or service not listed in this subdivision that is licensed or required to be licensed by
161.18 the Department of Health for the care of vulnerable adults. "Home care provider" has the
161.19 meaning provided in section 144A.43, subdivision 4, and applies when care or services are
161.20 delivered in the vulnerable adult's home.
161.21     (b) The Department of Human Services is the lead investigative agency for facilities or
161.22 services licensed or required to be licensed as adult day care, adult foster care, community
161.23 residential settings, programs for people with disabilities, EIDBI agencies, family adult day
161.24 services, mental health programs licensed under chapter 245I, mental health clinics, substance
161.25 use disorder programs, the Minnesota Sex Offender Program, or any other facility or service
161.26 not listed in this subdivision that is licensed or required to be licensed by the Department
161.27 of Human Services. The Department of Human Services is also the lead investigative agency
161.28 for unlicensed EIDBI agencies under section 256B.0949. The Department of Human Services
161.29 is the lead investigative agency for adult rehabilitative mental health services under section
161.30 245I.22, mobile crisis response services under section 245I.24, and certified community
161.31 behavioral health clinics under section 245I.17.
  Article 4 Sec. 47.  161
  04/06/26  REVISOR      DTT/CH  26-08138  as introduced
162.1      (c) The county social service agency or its designee is the lead investigative agency for
162.2  all other reports, including but not limited to reports involving vulnerable adults receiving
162.3  services from a personal care provider organization under section 256B.0659.
162.4      EFFECTIVE DATE. This section is effective January 1, 2028.
162.5    Sec. 48. REVISOR INSTRUCTION.
162.6      The revisor of statutes shall renumber Minnesota Statutes, section 245.735, subdivisions
162.7  5 and 6, as Minnesota Statutes, section 245I.17, subdivisions 23 and 24.
162.8    Sec. 49. REPEALER.
162.9      (a) Minnesota Statutes 2024, sections 245.735, subdivisions 1a, 2a, 3a, 3b, 3c, 3d, 3e,
162.10 3f, 3g, 3h, 4a, 4b, 4c, 4e, 7, and 8; 245C.03, subdivision 7; 245I.20, subdivision 9; 245I.23,
162.11 subdivision 23; 256B.0623, subdivisions 2, 4, 5, 6, and 9; 256B.0624, subdivisions 2, 3,
162.12 4a, 5, 6, 6a, 6b, 7, 8, 9, and 11; and 256B.0943, subdivisions 4, 5, 5a, 6, 7, and 11, are
162.13 repealed.
162.14     (b) Minnesota Statutes 2025 Supplement, sections 245.735, subdivisions 3 and 4d; and
162.15 256B.0943, subdivisions 1 and 9, are repealed.
162.16     EFFECTIVE DATE. This section is effective January 1, 2028.
162.17ARTICLE 5
162.18BACKGROUND STUDIES
162.19   Section 1. Minnesota Statutes 2025 Supplement, section 142A.09, subdivision 1, is
162.20 amended to read:
162.21     Subdivision 1. Background studies required. The commissioner of human services
162.22 shall conduct background studies of individuals specified in section 245C.03, subdivision
162.23 5c, affiliated with:
162.24     (1) a facility or program licensed or seeking a license under chapter 142B;
162.25     (2) a license-exempt child care center certified under chapter 142C; or
162.26     (3) a legal nonlicensed child care provider authorized under chapter 142E.
  Article 5 Section 1.  162
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163.1    Sec. 2. Minnesota Statutes 2025 Supplement, section 142B.05, subdivision 3, is amended
163.2  to read:
163.3      Subd. 3. Foster care by an individual who is related to a child; license required. (a)
163.4  Notwithstanding subdivision 2, paragraph (a), clause (1), in order to provide foster care for
163.5  a child, an individual who is related to the child, other than a parent, or legal guardian, must
163.6  be licensed by the commissioner except as provided by section 142B.06.
163.7      (b) If an individual who is related to a child is seeking licensure to provide foster care
163.8  for the child and the individual has a domestic partner but is not married to the domestic
163.9  partner, only the individual related to the child must be licensed to provide foster care. The
163.10 commissioner must conduct background studies on household members according to section
163.11 245C.03, subdivision 1.
163.12   Sec. 3. Minnesota Statutes 2025 Supplement, section 142B.10, subdivision 14, is amended
163.13 to read:
163.14     Subd. 14. Grant of license; license extension. (a) If the commissioner determines that
163.15 the program complies with all applicable rules and laws, the commissioner shall issue a
163.16 license consistent with this section or, if applicable, a temporary change of ownership license
163.17 under section 142B.11. At minimum, the license shall state:
163.18     (1) the name of the license holder;
163.19     (2) the address of the program;
163.20     (3) the effective date and expiration date of the license;
163.21     (4) the type of license;
163.22     (5) the maximum number and ages of persons that may receive services from the program;
163.23 and
163.24     (6) any special conditions of licensure.
163.25     (b) The commissioner may issue a license for a period not to exceed two years if:
163.26     (1) the commissioner is unable to conduct the observation required by subdivision 11,
163.27 paragraph (a), clause (3), because the program is not yet operational;
163.28     (2) certain records and documents are not available because persons are not yet receiving
163.29 services from the program; and
163.30     (3) the applicant complies with applicable laws and rules in all other respects.
  Article 5 Sec. 3.  163
  04/06/26  REVISOR  DTT/CH  26-08138  as introduced
164.1      (c) A decision by the commissioner to issue a license does not guarantee that any person
164.2  or persons will be placed or cared for in the licensed program.
164.3      (d) Except as provided in paragraphs (i) and (j), the commissioner shall not issue a
164.4  license if the applicant, license holder, or an affiliated controlling individual has:
164.5      (1) been disqualified and the disqualification was not set aside and no variance has been
164.6  granted;
164.7      (2) been denied a license under this chapter or chapter 245A within the past two years;
164.8      (3) had a license issued under this chapter or chapter 245A revoked within the past five
164.9  years; or
164.10     (4) failed to submit the information required of an applicant under subdivision 1,
164.11 paragraph (f), (g), or (h), after being requested by the commissioner.
164.12     When a license issued under this chapter or chapter 245A is revoked, the license holder
164.13 and each affiliated controlling individual with a revoked license may not hold any license
164.14 under chapter 142B for five years following the revocation, and other licenses held by the
164.15 applicant or license holder or licenses affiliated with each controlling individual shall also
164.16 be revoked.
164.17     (e) Notwithstanding paragraph (d), the commissioner may elect not to revoke a license
164.18 affiliated with a license holder or controlling individual that had a license revoked within
164.19 the past five years if the commissioner determines that (1) the license holder or controlling
164.20 individual is operating the program in substantial compliance with applicable laws and rules
164.21 and (2) the program's continued operation is in the best interests of the community being
164.22 served.
164.23     (f) Notwithstanding paragraph (d), the commissioner may issue a new license in response
164.24 to an application that is affiliated with an applicant, license holder, or controlling individual
164.25 that had an application denied within the past two years or a license revoked within the past
164.26 five years if the commissioner determines that (1) the applicant or controlling individual
164.27 has operated one or more programs in substantial compliance with applicable laws and rules
164.28 and (2) the program's operation would be in the best interests of the community to be served.
164.29     (g) In determining whether a program's operation would be in the best interests of the
164.30 community to be served, the commissioner shall consider factors such as the number of
164.31 persons served, the availability of alternative services available in the surrounding
164.32 community, the management structure of the program, whether the program provides
164.33 culturally specific services, and other relevant factors.
  Article 5 Sec. 3.  164
  04/06/26  REVISOR  DTT/CH  26-08138  as introduced
165.1      (h) The commissioner shall not issue or reissue a license under this chapter if an individual
165.2  living in the household where the services will be provided as specified under section
165.3  245C.03, subdivision 1, has been disqualified and the disqualification has not been set aside
165.4  and no variance has been granted.
165.5      (i) Pursuant to section 142B.18, subdivision 1, paragraph (b), when a license issued
165.6  under this chapter has been suspended or revoked and the suspension or revocation is under
165.7  appeal, the program may continue to operate pending a final order from the commissioner.
165.8  If the license under suspension or revocation will expire before a final order is issued, a
165.9  temporary provisional license may be issued provided any applicable license fee is paid
165.10 before the temporary provisional license is issued.
165.11     (j) Notwithstanding paragraph (i), when a revocation is based on the disqualification of
165.12 a controlling individual or license holder, and the controlling individual or license holder
165.13 is ordered under section 245C.17 to be immediately removed from direct contact with
165.14 persons receiving services or is ordered to be under continuous, direct supervision when
165.15 providing direct contact services, the program may continue to operate only if the program
165.16 complies with the order and submits documentation demonstrating compliance with the
165.17 order. If the disqualified individual fails to submit a timely request for reconsideration, or
165.18 if the disqualification is not set aside and no variance is granted, the order to immediately
165.19 remove the individual from direct contact or to be under continuous, direct supervision
165.20 remains in effect pending the outcome of a hearing and final order from the commissioner.
165.21     (k) For purposes of reimbursement for meals only, under the Child and Adult Care Food
165.22 Program, Code of Federal Regulations, title 7, subtitle B, chapter II, subchapter A, part 226,
165.23 relocation within the same county by a licensed family day care provider, shall be considered
165.24 an extension of the license for a period of no more than 30 calendar days or until the new
165.25 license is issued, whichever occurs first, provided the county agency has determined the
165.26 family day care provider meets licensure requirements at the new location.
165.27     (l) Unless otherwise specified by statute, all licenses issued under this chapter expire at
165.28 12:01 a.m. on the day after the expiration date stated on the license. A license holder must
165.29 comply with the requirements in section 142B.12 and be reissued a new license to operate
165.30 the program or the program must not be operated after the expiration date. Child foster care
165.31 license holders must apply for and be granted a new license to operate the program or the
165.32 program must not be operated after the expiration date. Upon implementation of the provider
165.33 licensing and reporting hub, licenses may be issued each calendar year.
  Article 5 Sec. 3.  165
  04/06/26  REVISOR  DTT/CH  26-08138  as introduced
166.1(m) The commissioner shall not issue or reissue a license under this chapter if it has
166.2  been determined that a tribal licensing authority has established jurisdiction to license the
166.3  program or service.
166.4(n) The commissioner of children, youth, and families shall coordinate and share data
166.5  with the commissioner of human services to enforce this section.
166.6    Sec. 4. Minnesota Statutes 2024, section 142B.15, is amended to read:
166.7142B.15 DENIAL OF APPLICATION.
166.8(a) The commissioner may deny a license if an applicant or controlling individual:
166.9(1) fails to submit a substantially complete application after receiving notice from the
166.10 commissioner under section 142B.10, subdivision 1;
166.11(2) fails to comply with applicable laws or rules;
166.12(3) knowingly withholds relevant information from or gives false or misleading
166.13 information to the commissioner in connection with an application for a license or during
166.14 an investigation;
166.15(4) has a disqualification that has not been set aside under section 245C.22 and no
166.16 variance has been granted;
166.17(5) has an individual living in the household who received a background study under
166.18 section 245C.03, subdivision 1, paragraph (a), clause (2), and who has a disqualification
166.19 that has not been set aside under section 245C.22, and no variance has been granted;
166.20(6) is associated with an individual who received a background study under section
166.21 245C.03, subdivision 1, paragraph (a), clause (6), who may have unsupervised access to
166.22 children or vulnerable adults, and who has a disqualification that has not been set aside
166.23 under section 245C.22, and no variance has been granted;
166.24(7) fails to comply with section 142B.10, subdivision 1, paragraph (f) or (g);
166.25(8) fails to demonstrate competent knowledge as required by section 142B.10, subdivision
166.26 13;
166.27(9) has a history of noncompliance as a license holder or controlling individual with
166.28 applicable laws or rules, including but not limited to this chapter and chapters 142E, 245A,
166.29 and 245C;
166.30(10) is prohibited from holding a license according to section 142A.12 or 245.095; or
  Article 5 Sec. 4.  166
  04/06/26  REVISOR  DTT/CH  26-08138  as introduced
167.1      (11) for a family foster setting, has or has an individual who is living in the household
167.2  where the licensed services are provided or is otherwise subject to a background study who
167.3  has nondisqualifying background study information, as described in section 245C.05,
167.4  subdivision 4, that reflects on the applicant's ability to safely provide care to foster children.
167.5      (b) An applicant whose application has been denied by the commissioner must be given
167.6  notice of the denial, which must state the reasons for the denial in plain language. Notice
167.7  must be given by certified mail, by personal service, or through the provider licensing and
167.8  reporting hub. The notice must state the reasons the application was denied and must inform
167.9  the applicant of the right to a contested case hearing under chapter 14 and Minnesota Rules,
167.10 parts 1400.8505 to 1400.8612. The applicant may appeal the denial by notifying the
167.11 commissioner in writing by certified mail, by personal service, or through the provider
167.12 licensing and reporting hub. If mailed, the appeal must be postmarked and sent to the
167.13 commissioner within 20 calendar days after the applicant received the notice of denial. If
167.14 an appeal request is made by personal service, it must be received by the commissioner
167.15 within 20 calendar days after the applicant received the notice of denial. If the order is issued
167.16 through the provider hub, the appeal must be received by the commissioner within 20
167.17 calendar days from the date the commissioner issued the order through the hub. Section
167.18 142B.20 applies to hearings held to appeal the commissioner's denial of an application.
167.19   Sec. 5. Minnesota Statutes 2024, section 142B.79, is amended to read:
167.20     142B.79 CONTRACTORS SERVING MULTIPLE FAMILY CHILD CARE
167.21 LICENSE HOLDERS.
167.22     Contractors who serve multiple family child care license holders may request that the
167.23 county agency maintain a record of:
167.24     (1) the contractor's background study results as required in section 245C.04, subdivision
167.25 8, to verify that the contractor does not have a disqualification or a disqualification that has
167.26 not been set aside, and is eligible to provide direct contact services in a licensed program;
167.27 and
167.28     (2) the contractor's compliance with training requirements.
167.29   Sec. 6. Minnesota Statutes 2024, section 144.057, subdivision 1, is amended to read:
167.30     Subdivision 1. Background studies required. (a) Except as specified in paragraph (b),
167.31 the commissioner of health shall contract with the commissioner of human services to
167.32 conduct background studies of:
  Article 5 Sec. 6.  167
  04/06/26  REVISOR  DTT/CH  26-08138  as introduced
168.1      (1) individuals providing services that have direct contact, as defined under section
168.2  245C.02, subdivision 11, with patients and residents in hospitals, boarding care homes,
168.3  outpatient surgical centers licensed under sections 144.50 to 144.58; nursing homes and
168.4  home care agencies licensed under chapter 144A; assisted living facilities and assisted living
168.5  facilities with dementia care licensed under chapter 144G; and board and lodging
168.6  establishments that are registered to provide supportive or health supervision services under
168.7  section 157.17;
168.8      (2) individuals specified in section 245C.03, subdivision 1, who perform direct contact
168.9  services in a nursing home or a home care agency licensed under chapter 144A; an assisted
168.10 living facility or assisted living facility with dementia care licensed under chapter 144G;
168.11 or a boarding care home licensed under sections 144.50 to 144.58. If the individual under
168.12 study resides outside Minnesota, the study must include a check for substantiated findings
168.13 of maltreatment of adults and children in the individual's state of residence when the
168.14 information is made available by that state, and must include a check of the National Crime
168.15 Information Center database;
168.16     (3) all other employees in assisted living facilities or assisted living facilities with
168.17 dementia care licensed under chapter 144G, nursing homes licensed under chapter 144A,
168.18 and boarding care homes licensed under sections 144.50 to 144.58. A disqualification of
168.19 an individual in this section shall disqualify the individual from positions allowing direct
168.20 contact or access to patients or residents receiving services. "Access" means physical access
168.21 to a client or the client's personal property without continuous, direct supervision as defined
168.22 in section 245C.02, subdivision 8, when the employee's employment responsibilities do not
168.23 include providing direct contact services;
168.24     (4) individuals employed by a supplemental nursing services agency, as defined under
168.25 section 144A.70, who are providing services in health care facilities;
168.26     (5) controlling persons of a supplemental nursing services agency, as defined under
168.27 section 144A.70; and
168.28     (6) license applicants, owners, managerial officials, and controlling individuals who are
168.29 required under section 144A.476, subdivision 1, or 144G.13, subdivision 1, to undergo a
168.30 background study under chapter 245C, regardless of the licensure status of the license
168.31 applicant, owner, managerial official, or controlling individual.
168.32     (b) The commissioner of human services shall not conduct a background study on any
168.33 individual identified in paragraph (a), clauses (1) to (5), if the individual has a valid license
168.34 issued by a health-related licensing board as defined in section 214.01, subdivision 2, and
  Article 5 Sec. 6.  168
  04/06/26  REVISOR  DTT/CH  26-08138  as introduced
169.1  has completed the criminal background check as required in section 214.075. An entity that
169.2  is affiliated with individuals who meet the requirements of this paragraph must separate
169.3  those individuals from the entity's roster for NETStudy 2.0.
169.4      (c) If a facility or program is licensed by the Department of Human Services and subject
169.5  to the background study provisions of chapter 245C and is also licensed by the Department
169.6  of Health, the Department of Human Services is solely responsible for the background
169.7  studies of individuals in the jointly licensed programs.
169.8    Sec. 7. Minnesota Statutes 2025 Supplement, section 245A.04, subdivision 7, is amended
169.9  to read:
169.10     Subd. 7. Grant of license; license extension. (a) If the commissioner determines that
169.11 the program complies with all applicable rules and laws, the commissioner shall issue a
169.12 license consistent with this section or, if applicable, a temporary change of ownership license
169.13 under section 245A.043. At minimum, the license shall state:
169.14     (1) the name of the license holder;
169.15     (2) the address of the program;
169.16     (3) the effective date and expiration date of the license;
169.17     (4) the type of license and the specific service the license holder is licensed to provide;
169.18     (5) the maximum number and ages of persons that may receive services from the program;
169.19 and
169.20     (6) any special conditions of licensure.
169.21     (b) The commissioner may issue a license for a period not to exceed two years if:
169.22     (1) the commissioner is unable to conduct the observation required by subdivision 4,
169.23 paragraph (a), clause (3), because the program is not yet operational;
169.24     (2) certain records and documents are not available because persons are not yet receiving
169.25 services from the program; and
169.26     (3) the applicant complies with applicable laws and rules in all other respects.
169.27     (c) A decision by the commissioner to issue a license does not guarantee that any person
169.28 or persons will be placed or cared for in the licensed program.
169.29     (d) Except as provided in paragraphs (i) and (j), the commissioner shall not issue a
169.30 license if the applicant, license holder, or an affiliated controlling individual has:
  Article 5 Sec. 7.  169
  04/06/26  REVISOR  DTT/CH  26-08138  as introduced
170.1      (1) been disqualified and the disqualification was not set aside and no variance has been
170.2  granted;
170.3      (2) been denied a license under this chapter or chapter 142B within the past two years;
170.4      (3) had a license issued under this chapter or chapter 142B revoked within the past five
170.5  years; or
170.6      (4) failed to submit the information required of an applicant under subdivision 1,
170.7  paragraph (f), (g), or (h), after being requested by the commissioner.
170.8      When a license issued under this chapter or chapter 142B is revoked, the license holder
170.9  and each affiliated controlling individual with a revoked license may not hold any license
170.10 under chapter 245A for five years following the revocation, and other licenses held by the
170.11 applicant or license holder or licenses affiliated with each controlling individual shall also
170.12 be revoked.
170.13     (e) Notwithstanding paragraph (d), the commissioner may elect not to revoke a license
170.14 affiliated with a license holder or controlling individual that had a license revoked within
170.15 the past five years if the commissioner determines that (1) the license holder or controlling
170.16 individual is operating the program in substantial compliance with applicable laws and rules
170.17 and (2) the program's continued operation is in the best interests of the community being
170.18 served.
170.19     (f) Notwithstanding paragraph (d), the commissioner may issue a new license in response
170.20 to an application that is affiliated with an applicant, license holder, or controlling individual
170.21 that had an application denied within the past two years or a license revoked within the past
170.22 five years if the commissioner determines that (1) the applicant or controlling individual
170.23 has operated one or more programs in substantial compliance with applicable laws and rules
170.24 and (2) the program's operation would be in the best interests of the community to be served.
170.25     (g) In determining whether a program's operation would be in the best interests of the
170.26 community to be served, the commissioner shall consider factors such as the number of
170.27 persons served, the availability of alternative services available in the surrounding
170.28 community, the management structure of the program, whether the program provides
170.29 culturally specific services, and other relevant factors.
170.30     (h) The commissioner shall not issue or reissue a license under this chapter if an individual
170.31 living in the household where the services will be provided as specified under section
170.32 245C.03, subdivision 1, has been disqualified and the disqualification has not been set aside
170.33 and no variance has been granted.
  Article 5 Sec. 7.  170
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171.1      (i) Pursuant to section 245A.07, subdivision 1, paragraph (b), when a license issued
171.2  under this chapter has been suspended or revoked and the suspension or revocation is under
171.3  appeal, the program may continue to operate pending a final order from the commissioner.
171.4  If the license under suspension or revocation will expire before a final order is issued, a
171.5  temporary provisional license may be issued provided any applicable license fee is paid
171.6  before the temporary provisional license is issued.
171.7      (j) Notwithstanding paragraph (i), when a revocation is based on the disqualification of
171.8  a controlling individual or license holder, and the controlling individual or license holder
171.9  is ordered under section 245C.17 to be immediately removed from direct contact with
171.10 persons receiving services or is ordered to be under continuous, direct supervision when
171.11 providing direct contact services, the program may continue to operate only if the program
171.12 complies with the order and submits documentation demonstrating compliance with the
171.13 order. If the disqualified individual fails to submit a timely request for reconsideration, or
171.14 if the disqualification is not set aside and no variance is granted, the order to immediately
171.15 remove the individual from direct contact or to be under continuous, direct supervision
171.16 remains in effect pending the outcome of a hearing and final order from the commissioner.
171.17     (k) Unless otherwise specified by statute, all licenses issued under this chapter expire
171.18 at 12:01 a.m. on the day after the expiration date stated on the license. A license holder must
171.19 comply with the requirements in section 245A.10 and be reissued a new license to operate
171.20 the program or the program must not be operated after the expiration date. Adult foster care,
171.21 family adult day services, child foster residence setting, and community residential services
171.22 license holders must apply for and be granted a new license to operate the program or the
171.23 program must not be operated after the expiration date. Upon implementation of the provider
171.24 licensing and reporting hub, licenses may be issued each calendar year.
171.25     (l) The commissioner shall not issue or reissue a license under this chapter if it has been
171.26 determined that a Tribal licensing authority has established jurisdiction to license the program
171.27 or service.
171.28     (m) The commissioner of human services may coordinate and share data with the
171.29 commissioner of children, youth, and families to enforce this section.
171.30     (n) For substance use disorder treatment programs, for the purposes of paragraph (a),
171.31 clause (5), the maximum number of persons who may receive services from the program
171.32 includes persons served at satellite locations.
  Article 5 Sec. 7.  171
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172.1    Sec. 8. Minnesota Statutes 2025 Supplement, section 245A.05, is amended to read:
172.2245A.05 DENIAL OF APPLICATION.
172.3(a) The commissioner may deny a license if an applicant or controlling individual:
172.4(1) fails to submit a substantially complete application after receiving notice from the
172.5  commissioner under section 245A.04, subdivision 1;
172.6(2) fails to comply with applicable laws or rules;
172.7(3) knowingly withholds relevant information from or gives false or misleading
172.8  information to the commissioner in connection with an application for a license or during
172.9  an investigation;
172.10(4) has a disqualification that has not been set aside under section 245C.22 and no
172.11 variance has been granted;
172.12(5) has an individual living in the household who received a background study under
172.13 section 245C.03, subdivision 1, paragraph (a), clause (2), and who has a disqualification
172.14 that has not been set aside under section 245C.22, and no variance has been granted;
172.15(6) is associated with an individual who received a background study under section
172.16 245C.03, subdivision 1, paragraph (a), clause (6), who may have unsupervised access to
172.17 children or vulnerable adults, and who has a disqualification that has not been set aside
172.18 under section 245C.22, and no variance has been granted;
172.19(7) fails to comply with section 245A.04, subdivision 1, paragraph (f) or (g);
172.20(8) fails to demonstrate competent knowledge as required by section 245A.04, subdivision
172.21 6;
172.22(9) has a history of noncompliance as a license holder or controlling individual with
172.23 applicable laws or rules, including but not limited to this chapter and chapters 142E and
172.24 245C;
172.25(10) is prohibited from holding a license according to section 245.095; or
172.26(11) is the subject of a pending administrative, civil, or criminal investigation.
172.27(b) An applicant whose application has been denied by the commissioner must be given
172.28 notice of the denial, which must state the reasons for the denial in plain language. Notice
172.29 must be given by certified mail, by personal service, or through the provider licensing and
172.30 reporting hub. The notice must state the reasons the application was denied and must inform
172.31 the applicant of the right to a contested case hearing under chapter 14 and Minnesota Rules,
  Article 5 Sec. 8.  172
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173.1  parts 1400.8505 to 1400.8612. The applicant may appeal the denial by notifying the
173.2  commissioner in writing by certified mail, by personal service, or through the provider
173.3  licensing and reporting hub. If mailed, the appeal must be postmarked and sent to the
173.4  commissioner within 20 calendar days after the applicant received the notice of denial. If
173.5  an appeal request is made by personal service, it must be received by the commissioner
173.6  within 20 calendar days after the applicant received the notice of denial. If the order is issued
173.7  through the provider hub, the appeal must be received by the commissioner within 20
173.8  calendar days from the date the commissioner issued the order through the hub. Section
173.9  245A.08 applies to hearings held to appeal the commissioner's denial of an application.
173.10   Sec. 9. Minnesota Statutes 2025 Supplement, section 245C.02, subdivision 15a, is amended
173.11 to read:
173.12     Subd. 15a. Reasonable cause to require a national criminal history record check. (a)
173.13 "Reasonable cause to require a national criminal history record check" means information
173.14 or circumstances exist that provide the commissioner with articulable suspicion that further
173.15 pertinent information may exist concerning a background study subject that merits conducting
173.16 a national criminal history record check on that subject. The commissioner has reasonable
173.17 cause to require a national criminal history record check when:
173.18     (1) information from the Bureau of Criminal Apprehension indicates that the subject is
173.19 a multistate offender;
173.20     (2) information from the Bureau of Criminal Apprehension indicates that multistate
173.21 offender status is undetermined;
173.22     (3) the commissioner has received a report from the subject or a third party indicating
173.23 that the subject has a criminal history in a jurisdiction other than Minnesota; or
173.24     (4) information from the Bureau of Criminal Apprehension for a state-based name and
173.25 date of birth background study in which the subject is a minor that indicates that the subject
173.26 has a criminal history.
173.27     (b) In addition to the circumstances described in paragraph (a), the commissioner has
173.28 reasonable cause to require a national criminal history record check if the subject is not
173.29 currently residing in Minnesota or resided in a jurisdiction other than Minnesota during the
173.30 previous five years.
173.31     (c) Reasonable cause to require a national criminal history check does not apply to family
173.32 child foster care or, adoption, adult day services, or adult foster care studies.
173.33     EFFECTIVE DATE. This section is effective January 25, 2028.
  Article 5 Sec. 9.  173
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174.1    Sec. 10. Minnesota Statutes 2024, section 245C.03, subdivision 1, is amended to read:
174.2      Subdivision 1. Programs licensed by the commissioner. (a) The commissioner shall
174.3  conduct a background study when initiated on the following individuals affiliated with
174.4  programs licensed by the commissioner:
174.5      (1) the person or persons applying for a license;
174.6      (2) an individual age 13 and over living in the household where the licensed program
174.7  will be provided who is not receiving licensed services from the program;
174.8      (3) current or prospective employees of the applicant or license holder who will have
174.9  direct contact with persons served by the facility, agency, or program;
174.10     (4) volunteers or student volunteers who will have direct contact with persons served
174.11 by the program to provide program services if the contact is not under the continuous, direct
174.12 supervision by an individual listed in clause (1) or (3);
174.13     (5) an individual age ten to 12 living in the household where the licensed services will
174.14 be provided when the commissioner has reasonable cause as defined in section 245C.02,
174.15 subdivision 15;
174.16     (6) an individual who, without providing direct contact services at a licensed program,
174.17 may have unsupervised access to children or vulnerable adults receiving services from a
174.18 program, when the commissioner has reasonable cause as defined in section 245C.02,
174.19 subdivision 15; and
174.20     (7) all controlling individuals as defined in section 245A.02, subdivision 5a;
174.21     (8) notwithstanding clause (3), for children's residential facilities and foster residence
174.22 settings, any adult working in the facility, whether or not the individual will have direct
174.23 contact with persons served by the facility.
174.24     (b) For child foster care when the license holder resides in the home where foster care
174.25 services are provided, a short-term substitute caregiver providing direct contact services for
174.26 a child for less than 72 hours of continuous care is not required to receive a background
174.27 study under this chapter.
174.28     (c) This subdivision applies to the following programs that must be licensed under
174.29 chapter 245A:
174.30     (1) adult foster care;
174.31     (2) children's residential facilities;
  Article 5 Sec. 10.  174
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175.1      (3) licensed home and community-based services under chapter 245D;
175.2      (4) residential mental health programs for adults;
175.3      (5) substance use disorder treatment programs under chapter 245G;
175.4      (6) withdrawal management programs under chapter 245F;
175.5      (7) adult day care centers;
175.6      (8) family adult day services;
175.7      (9) detoxification programs;
175.8      (10) community residential settings;
175.9      (11) intensive residential treatment services and residential crisis stabilization under
175.10 chapter 245I; and
175.11     (12) treatment programs for persons with sexual psychopathic personality or sexually
175.12 dangerous persons, licensed under chapter 245A and according to Minnesota Rules, parts
175.13 9515.3000 to 9515.3110.
175.14   Sec. 11. Minnesota Statutes 2024, section 245C.03, subdivision 2, is amended to read:
175.15     Subd. 2. Personal care provider organizations. The commissioner shall conduct
175.16 background studies on any individual required under sections 256B.0651 to 256B.0654 and
175.17 256B.0659 to have a background study completed under this chapter with at least a five
175.18 percent ownership stake in, an operator of, or an employee or volunteer who provides direct
175.19 contact services for a personal care provider organization under section 256B.0659. For the
175.20 purposes of this subdivision, operator includes board members or other individuals who
175.21 oversee the billing, management, or policies of the services provided.
175.22   Sec. 12. Minnesota Statutes 2024, section 245C.03, subdivision 3, is amended to read:
175.23     Subd. 3. Supplemental nursing services agencies. The commissioner shall conduct all
175.24 background studies required under this chapter and initiated by on any individual who is
175.25 an owner with at least a five percent ownership stake in, an operator of, or an employee or
175.26 volunteer who provides direct contact services for a supplemental nursing services agencies
175.27 registered agency under section 144A.71, subdivision 1. For the purposes of this subdivision,
175.28 operator includes board members or other individuals who oversee the billing, management,
175.29 or policies of the services provided.
  Article 5 Sec. 12.  175
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176.1    Sec. 13. Minnesota Statutes 2024, section 245C.03, subdivision 4, is amended to read:
176.2      Subd. 4. Personnel pool agencies; temporary personnel agencies; educational
176.3  programs; professional services agencies. (a) The commissioner also may shall conduct
176.4  studies on individuals specified in subdivision 1, paragraph (a), clauses (3) and (4), employees
176.5  or volunteers seeking to provide direct contact services for programs licensed by the
176.6  commissioner of human services or health when the studies are initiated by:
176.7      (1) personnel pool agencies;
176.8      (2) temporary personnel agencies;
176.9      (3) educational programs that train individuals by providing direct contact services in
176.10 licensed programs; and
176.11     (4) professional services agencies that are not licensed and that work with licensed
176.12 programs to provide direct contact services or individuals who provide direct contact services.
176.13     (b) Personnel pool agencies, temporary personnel agencies, and professional services
176.14 agencies must employ the individuals providing direct care services for children, people
176.15 with disabilities, or the elderly. Individuals must be affiliated in NETStudy 2.0 and subject
176.16 to oversight by the entity, which includes but is not limited to continuous, direct supervision
176.17 by the entity and being subject to immediate removal from providing direct care services
176.18 when required.
176.19   Sec. 14. Minnesota Statutes 2024, section 245C.03, subdivision 5a, is amended to read:
176.20     Subd. 5a. Facilities Programs serving children or adults licensed or regulated by
176.21 the Department of Health. (a) Except as specified in paragraph (b), the commissioner shall
176.22 conduct background studies under this chapter of:
176.23     (1) individuals providing services who have direct contact, as defined under section
176.24 245C.02, subdivision 11, with patients and residents in any individual with at least a five
176.25 percent ownership stake in, an operator of, or an employee or volunteer who provides direct
176.26 contact services for hospitals, boarding care homes, outpatient surgical centers licensed
176.27 under sections 144.50 to 144.58; nursing homes and home care agencies licensed under
176.28 chapter 144A; assisted living facilities and assisted living facilities with dementia care
176.29 licensed under chapter 144G; and board and lodging establishments that are registered to
176.30 provide supportive or health supervision services under section 157.17;
176.31     (2) individuals specified in subdivision 2 who provide direct contact services in a any
176.32 individual with at least a five percent ownership stake in, an operator of, or an employee or
  Article 5 Sec. 14.  176
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177.1  volunteer who provides direct contact services for nursing home or a home care agency
177.2  licensed under chapter 144A; an assisted living facility or assisted living facility with
177.3  dementia care licensed under chapter 144G; or a boarding care home licensed under sections
177.4  144.50 to 144.58. If the individual undergoing a study resides outside of Minnesota, the
177.5  study must include a check for substantiated findings of maltreatment of adults and children
177.6  in the individual's state of residence when the state makes the information available; and
177.7      (3) all other employees in any individual with at least a five percent ownership stake in,
177.8  an operator of, or an employee or volunteer who provides direct contact services for assisted
177.9  living facilities or assisted living facilities with dementia care licensed under chapter 144G,
177.10 nursing homes licensed under chapter 144A, and boarding care homes licensed under sections
177.11 144.50 to 144.58. A disqualification of an individual in this section shall disqualify the
177.12 individual from positions allowing direct contact with or access to patients or residents
177.13 receiving services. "Access" means physical access to a client or the client's personal property
177.14 without continuous, direct supervision as defined in section 245C.02, subdivision 8, when
177.15 the employee's employment responsibilities do not include providing direct contact services;
177.16     (4) individuals employed by a supplemental nursing services agency, as defined under
177.17 section 144A.70, who are providing services in health care facilities;
177.18     (5) controlling persons of a supplemental nursing services agency, as defined by section
177.19 144A.70; and
177.20     (6) license applicants, owners, managerial officials, and controlling individuals who are
177.21 required under section 144A.476, subdivision 1, or 144G.13, subdivision 1, to undergo a
177.22 background study under this chapter, regardless of the licensure status of the license applicant,
177.23 owner, managerial official, or controlling individual.
177.24     (b) An entity shall not initiate a background study on any individual identified in
177.25 paragraph (a), clauses (1) to (5) (3), if the individual has a valid license issued by a
177.26 health-related licensing board as defined in section 214.01, subdivision 2, and has completed
177.27 the criminal background check as required in section 214.075. An entity that is affiliated
177.28 with individuals who meet the requirements of this paragraph must separate those individuals
177.29 from the entity's roster for NETStudy 2.0. The Department of Human Services is not liable
177.30 for conducting background studies that have been submitted or not removed from the roster
177.31 in violation of this provision.
177.32     (c) If a facility or program is licensed by the Department of Human Services and the
177.33 Department of Health and is subject to the background study provisions of this chapter, the
  Article 5 Sec. 14.  177
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178.1  Department of Human Services is solely responsible for the background studies of individuals
178.2  in the jointly licensed program.
178.3      (d) The commissioner of health shall review and make decisions regarding reconsideration
178.4  requests, including whether to grant variances, according to the procedures and criteria in
178.5  this chapter. The commissioner of health shall inform the requesting individual and the
178.6  Department of Human Services of the commissioner of health's decision regarding the
178.7  reconsideration. The commissioner of health's decision to grant or deny a reconsideration
178.8  of a disqualification is a final administrative agency action.
178.9    Sec. 15. Minnesota Statutes 2024, section 245C.03, subdivision 5b, is amended to read:
178.10     Subd. 5b. Facilities serving children or youth licensed by the Department of
178.11 Corrections. (a) The commissioner shall conduct background studies of individuals any
178.12 individual with at least a five percent ownership stake in, an operator of, or an employee
178.13 working in secure and nonsecure children's residential facilities, juvenile detention facilities,
178.14 and foster residence settings, whether or not the individual will have direct contact, as
178.15 defined under section 245C.02, subdivision 11, with persons served in the facilities or
178.16 settings.
178.17     (b) A clerk or administrator of any court, the Bureau of Criminal Apprehension, a
178.18 prosecuting attorney, a county sheriff, or a chief of a local police department shall assist in
178.19 conducting background studies by providing the commissioner of human services or the
178.20 commissioner's representative all criminal conviction data available from local and state
178.21 criminal history record repositories related to applicants, operators, all persons living in a
178.22 household, and all staff of any facility subject to background studies under this subdivision.
178.23     (c) (b) For the purpose of this subdivision, the term "secure and nonsecure residential
178.24 facility and detention facility" includes programs licensed or certified under section 241.021,
178.25 subdivision 2.
178.26     (d) If an individual is disqualified, the Department of Human Services shall notify the
178.27 disqualified individual and the facility in which the disqualified individual provides services
178.28 of the disqualification and shall inform the disqualified individual of the right to request a
178.29 reconsideration of the disqualification by submitting the request to the Department of
178.30 Corrections.
178.31     (e) The commissioner of corrections shall review and make decisions regarding
178.32 reconsideration requests, including whether to grant variances, according to the procedures
178.33 and criteria in this chapter. The commissioner of corrections shall inform the requesting
  Article 5 Sec. 15.  178
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179.1  individual and the Department of Human Services of the commissioner of corrections'
179.2  decision regarding the reconsideration. The commissioner of corrections' decision to grant
179.3  or deny a reconsideration of a disqualification is the final administrative agency action.
179.4    Sec. 16. Minnesota Statutes 2024, section 245C.03, subdivision 7, is amended to read:
179.5      Subd. 7. Children's therapeutic services and supports providers. The commissioner
179.6  shall conduct background studies of all direct service providers and volunteers any individual
179.7  with at least a five percent ownership stake in, an operator of, or an employee or volunteer
179.8  for children's therapeutic services and supports providers under section 256B.0943.
179.9    Sec. 17. Minnesota Statutes 2024, section 245C.03, subdivision 9, is amended to read:
179.10     Subd. 9. Community first services and supports and financial management services
179.11 organizations. Individuals affiliated with Community First Services and Supports (CFSS)
179.12 agency-providers and Financial Management Services (FMS) providers enrolled to provide
179.13 CFSS services under the medical assistance program must meet the following requirements:
179.14     (1) owners who have a five percent interest or more and all managing employees are
179.15 subject to a background study under this chapter. This requirement applies to currently
179.16 enrolled providers and agencies seeking enrollment. "Managing employee" has the meaning
179.17 given in Code of Federal Regulations, title 42, section 455.101. An organization is barred
179.18 from enrollment if:
179.19     (i) the organization has not initiated background studies of owners and managing
179.20 employees; or
179.21     (ii) the organization has initiated background studies of owners and managing employees
179.22 and the commissioner has sent the organization a notice that an owner or managing employee
179.23 of the organization has been disqualified under section 245C.14 and the owner or managing
179.24 employee has not received a set aside of the disqualification under section 245C.22;
179.25     (2) a background study must be initiated and completed for all staff who will have direct
179.26 contact with the participant to provide worker training and development; and
179.27     (3) a background study must be initiated and completed for all support workers.
179.28     The commissioner shall conduct background studies of any individual with at least a
179.29 five percent ownership stake in, an operator of, or an employee or volunteer for Community
179.30 First Services and Supports (CFSS) agency-providers and Financial Management Services
179.31 providers enrolled to provide CFSS services under section 256B.85. For the purposes of
  Article 5 Sec. 17.  179
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180.1  this subdivision, operator includes board members or other individuals who oversee the
180.2  billing, management, or policies of the services provided.
180.3    Sec. 18. Minnesota Statutes 2024, section 245C.03, subdivision 10, is amended to read:
180.4      Subd. 10. Providers of housing support or supplementary services. (a) The
180.5  commissioner shall conduct background studies of the following individuals who provide
180.6  services under section 256I.04:
180.7      (1) controlling individuals as defined in section 245A.02;
180.8      (2) managerial officials as defined in section 245A.02; and
180.9      (3) all employees and volunteers of the establishment who have direct contact with
180.10 recipients or who have unsupervised access to recipients, recipients' personal property, or
180.11 recipients' private data.
180.12     (b) The provider of housing support must comply with all requirements for entities
180.13 initiating background studies under this chapter.
180.14     (c) A provider of housing support must demonstrate that all individuals who are required
180.15 to have a background study according to paragraph (a) have a notice stating that:
180.16     (1) the individual is not disqualified under section 245C.14; or
180.17     (2) the individual is disqualified and the individual has been issued a set aside of the
180.18 disqualification for the setting under section 245C.22.
180.19   Sec. 19. Minnesota Statutes 2024, section 245C.03, subdivision 12, is amended to read:
180.20     Subd. 12. Providers of special transportation service. (a) The commissioner shall
180.21 conduct background studies of the following individuals who provide special transportation
180.22 services under section 174.30:
180.23     (1) each person with a direct or indirect ownership interest of five percent or higher in
180.24 a transportation service provider;
180.25     (2) each controlling individual as defined under section 245A.02;
180.26     (3) a managerial official as defined in section 245A.02;
180.27     (4) each driver employed by the transportation service provider;
180.28     (5) each individual employed by the transportation service provider to assist a passenger
180.29 during transport; and
  Article 5 Sec. 19.  180
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181.1      (6) each employee of the transportation service agency who provides administrative
181.2  support, including an employee who:
181.3      (i) may have face-to-face contact with or access to passengers, passengers' personal
181.4  property, or passengers' private data;
181.5      (ii) performs any scheduling or dispatching tasks; or
181.6      (iii) performs any billing activities.
181.7      (b) When a local or contracted agency is authorizing a ride under section 256B.0625,
181.8  subdivision 17, by a volunteer driver, and the agency authorizing the ride has a reason to
181.9  believe that the volunteer driver has a history that would disqualify the volunteer driver or
181.10 that may pose a risk to the health or safety of passengers, the agency may initiate a
181.11 background study that shall be completed according to this chapter using the commissioner
181.12 of human services' online NETStudy system, or by contacting the Department of Human
181.13 Services background study division for assistance. The agency that initiates the background
181.14 study under this paragraph shall be responsible for providing the volunteer driver with the
181.15 privacy notice required by section 245C.05, subdivision 2c, and with the payment for the
181.16 background study required by section 245C.10 before the background study is completed.
181.17   Sec. 20. Minnesota Statutes 2024, section 245C.03, is amended by adding a subdivision
181.18 to read:
181.19     Subd. 17. Providers of adult rehabilitative mental health services. The commissioner
181.20 shall conduct background studies on any individual with an ownership stake of at least five
181.21 percent in an adult rehabilitative mental health services provider, an operator of an adult
181.22 rehabilitative mental health services provider, or an employee or volunteer who has direct
181.23 contact with people receiving adult rehabilitative mental health services under section
181.24 256B.0623.
181.25   Sec. 21. Minnesota Statutes 2024, section 245C.03, is amended by adding a subdivision
181.26 to read:
181.27     Subd. 18. Providers of peer recovery services. The commissioner shall conduct
181.28 background studies on any individual with an ownership stake of at least five percent in a
181.29 peer recovery services provider, an operator of a peer recovery service provider, or an
181.30 employee or volunteer who has direct contact with people receiving peer recovery services
181.31 under section 254B.052.
  Article 5 Sec. 21.  181
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182.1    Sec. 22. Minnesota Statutes 2024, section 245C.03, is amended by adding a subdivision
182.2  to read:
182.3      Subd. 19. Providers of adult assertive community treatment services. The
182.4  commissioner shall conduct background studies on any individual with an ownership stake
182.5  of at least five percent in an adult assertive community treatment services provider, an
182.6  operator of an adult assertive community treatment services provider, or an employee or
182.7  volunteer who has direct contact with people receiving adult assertive community treatment
182.8  services under section 256B.0622.
182.9    Sec. 23. Minnesota Statutes 2024, section 245C.04, subdivision 1, is amended to read:
182.10     Subdivision 1. Licensed programs; other child care programs When studies are
182.11 initiated. (a) The commissioner shall conduct a background study of an individual required
182.12 to be studied For all studies required under section 245C.03, subdivision 1, the entity shall
182.13 initiate the study using the electronic system known as NETStudy 2.0 at least upon
182.14 application for initial license for all license types or enrollment and before owning, operating,
182.15 or providing direct contact services.
182.16     (b) The commissioner shall conduct a background study of an individual required to be
182.17 studied under section 245C.03, subdivision 1, including a child care background study
182.18 subject as defined in section 245C.02, subdivision 6a, in a family child care program, licensed
182.19 child care center, certified license-exempt child care center, or legal nonlicensed child care
182.20 provider, on a schedule determined by the commissioner. Except as provided in section
182.21 245C.05, subdivision 5a, a child care background study must include submission of
182.22 fingerprints for a national criminal history record check and a review of the information
182.23 under section 245C.08. A background study for a child care program must be repeated
182.24 within five years from the most recent study conducted under this paragraph.
182.25     (c) At reauthorization or when a new background study is needed under section 142E.16,
182.26 subdivision 2, for a legal nonlicensed child care provider authorized under chapter 142E:
182.27     (1) for a background study affiliated with a legal nonlicensed child care provider, the
182.28 individual shall provide information required under section 245C.05, subdivision 1,
182.29 paragraphs (a), (b), and (d), to the commissioner and be fingerprinted and photographed
182.30 under section 245C.05, subdivision 5; and
182.31     (2) the commissioner shall verify the information received under clause (1) and submit
182.32 the request in NETStudy 2.0 to complete the background study.
182.33     (d) At reapplication for a family child care license:
  Article 5 Sec. 23.  182
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183.1      (1) for a background study affiliated with a licensed family child care center, the
183.2  individual shall provide information required under section 245C.05, subdivision 1,
183.3  paragraphs (a), (b), and (d), to the county agency, and be fingerprinted and photographed
183.4  under section 245C.05, subdivision 5;
183.5      (2) the county agency shall verify the information received under clause (1) and forward
183.6  the information to the commissioner and submit the request in NETStudy 2.0 to complete
183.7  the background study; and
183.8      (3) the background study conducted by the commissioner under this paragraph must
183.9  include a review of the information required under section 245C.08.
183.10     (e) The commissioner is not required to conduct a study of an individual at the time of
183.11 reapplication for a license if the individual's background study was completed by the
183.12 commissioner of human services and the following conditions are met:
183.13     (1) a study of the individual was conducted either at the time of initial licensure or when
183.14 the individual became affiliated with the license holder;
183.15     (2) the individual has been continuously affiliated with the license holder since the last
183.16 study was conducted; and
183.17     (3) the last study of the individual was conducted on or after October 1, 1995.
183.18     (f) The commissioner of human services shall conduct a background study of an
183.19 individual specified under section 245C.03, subdivision 1, paragraph (a), clauses (2) to (6),
183.20 who is newly affiliated with a child foster family setting license holder:
183.21     (1) the county or private agency shall collect and forward to the commissioner the
183.22 information required under section 245C.05, subdivisions 1 and 5, when the child foster
183.23 family setting applicant or license holder resides in the home where child foster care services
183.24 are provided; and
183.25     (2) the background study conducted by the commissioner of human services under this
183.26 paragraph must include a review of the information required under section 245C.08,
183.27 subdivisions 1, 3, and 4.
183.28     (g) The commissioner shall conduct a background study of an individual specified under
183.29 section 245C.03, subdivision 1, paragraph (a), clauses (2) to (6), who is newly affiliated
183.30 with an adult foster care or family adult day services and with a family child care license
183.31 holder or a legal nonlicensed child care provider authorized under chapter 142E and:
  Article 5 Sec. 23.  183
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184.1      (1) except as provided in section 245C.05, subdivision 5a, the county shall collect and
184.2  forward to the commissioner the information required under section 245C.05, subdivision
184.3  1, paragraphs (a) and (b), and subdivision 5, paragraph (b), for background studies conducted
184.4  by the commissioner for all family adult day services, for adult foster care when the adult
184.5  foster care license holder resides in the adult foster care residence, and for family child care
184.6  and legal nonlicensed child care authorized under chapter 142E;
184.7      (2) the license holder shall collect and forward to the commissioner the information
184.8  required under section 245C.05, subdivisions 1, paragraphs (a) and (b); and 5, paragraphs
184.9  (a) and (b), for background studies conducted by the commissioner for adult foster care
184.10 when the license holder does not reside in the adult foster care residence; and
184.11     (3) the background study conducted by the commissioner under this paragraph must
184.12 include a review of the information required under section 245C.08, subdivision 1, paragraph
184.13 (a), and subdivisions 3 and 4.
184.14     (h) Applicants for licensure, license holders, and other entities as provided in this chapter
184.15 must submit completed background study requests to the commissioner using the electronic
184.16 system known as NETStudy before individuals specified in section 245C.03, subdivision
184.17 1, begin positions allowing direct contact in any licensed program.
184.18     (i) For an individual who is not on the entity's active roster, the entity must initiate a
184.19 new background study through NETStudy when:
184.20     (1) an individual returns to a position requiring a background study following an absence
184.21 of 120 or more consecutive days; or
184.22     (2) a program that discontinued providing licensed direct contact services for 120 or
184.23 more consecutive days begins to provide direct contact licensed services again.
184.24     The license holder shall maintain a copy of the notification provided to the commissioner
184.25 under this paragraph in the program's files. If the individual's disqualification was previously
184.26 set aside for the license holder's program and the new background study results in no new
184.27 information that indicates the individual may pose a risk of harm to persons receiving
184.28 services from the license holder, the previous set-aside shall remain in effect.
184.29     (j) For purposes of this section, a physician licensed under chapter 147, advanced practice
184.30 registered nurse licensed under chapter 148, or physician assistant licensed under chapter
184.31 147A is considered to be continuously affiliated upon the license holder's receipt from the
184.32 commissioner of health or human services of the physician's, advanced practice registered
184.33 nurse's, or physician assistant's background study results.
  Article 5 Sec. 23.  184
  04/06/26  REVISOR        DTT/CH  26-08138  as introduced
185.1      (k) For purposes of family child care, a substitute caregiver must receive repeat
185.2  background studies at the time of each license renewal.
185.3      (l) A repeat background study at the time of license renewal is not required if the family
185.4  child care substitute caregiver's background study was completed by the commissioner on
185.5  or after October 1, 2017, and the substitute caregiver is on the license holder's active roster
185.6  in NETStudy 2.0.
185.7      (m) Before and after school programs authorized under chapter 142E, are exempt from
185.8  the background study requirements under section 123B.03, for an employee for whom a
185.9  background study under this chapter has been completed.
185.10   Sec. 24. Minnesota Statutes 2024, section 245C.04, subdivision 4a, is amended to read:
185.11     Subd. 4a. Agency background studies; electronic criminal case information updates;
185.12 rosters; and criteria for eliminating repeat background studies. (a) The commissioner
185.13 shall develop and implement an electronic process as a part of NETStudy 2.0 for the regular
185.14 transfer of new criminal case information that is added to the Minnesota court information
185.15 system. The commissioner's system must include for review only information that relates
185.16 to individuals who are on the master roster. Entities initiating studies under section 245C.03
185.17 are exempt from any requirement to initiate repeat studies as long as the individual remains
185.18 continually affiliated with the roster; the individual has a final determination of eligibility,
185.19 a set aside, or a variance granted; and the individual's legal name does not change.
185.20     (b) The commissioner shall develop and implement an online system as a part of
185.21 NETStudy 2.0 for agencies that initiate background studies under this chapter to access and
185.22 maintain records of background studies initiated by that agency. The system must show all
185.23 active background study subjects affiliated with that agency and the status of each individual's
185.24 background study. Each agency that initiates background studies must use this system to
185.25 notify the commissioner of discontinued affiliation for purposes of the processes required
185.26 under paragraph (a). Notwithstanding paragraph (a), every individual continuously affiliated
185.27 with a child care provider must have a new background study initiated every five years.
185.28     (c) After an entity initiating a background study has paid the applicable fee for the study
185.29 and has provided the individual with the privacy notice required under section 245C.05,
185.30 subdivision 2c, NETStudy 2.0 shall immediately inform the entity whether the individual
185.31 requires a background study or whether the individual is immediately eligible to provide
185.32 services based on a previous background study. If the individual is immediately eligible,
185.33 the entity initiating the background study shall be able to view the information previously
185.34 supplied by the individual who is the subject of a background study as required under section
  Article 5 Sec. 24.  185
  04/06/26  REVISOR        DTT/CH  26-08138  as introduced
186.1  245C.05, subdivision 1, including the individual's photograph taken at the time the
186.2  individual's fingerprints were recorded. The commissioner shall not provide any entity
186.3  initiating a subsequent background study with information regarding the other entities that
186.4  initiated background studies on the subject.
186.5      (d) Verification that an individual is eligible to provide services based on a previous
186.6  background study is dependent on the individual voluntarily providing the individual's
186.7  Social Security number to the commissioner at the time each background study is initiated.
186.8  When an individual does not provide the individual's Social Security number for the
186.9  background study, that study is not transferable and a repeat background study on that
186.10 individual is required if the individual seeks a position requiring a background study under
186.11 this chapter with another entity.
186.12   Sec. 25. Minnesota Statutes 2025 Supplement, section 245C.05, subdivision 5, is amended
186.13 to read:
186.14     Subd. 5. Fingerprints and photograph. (a) Notwithstanding paragraph (c), for
186.15 background studies conducted by the commissioner for current or prospective child foster
186.16 or adoptive parents, and for any adult working in a children's residential facility, the subject
186.17 of the background study shall provide the commissioner with a set of classifiable fingerprints
186.18 obtained from an authorized agency for a national criminal history record check.
186.19     (b) Notwithstanding paragraph (c), for background studies conducted by the commissioner
186.20 for Head Start programs, the subject of the background study shall provide the commissioner
186.21 with a set of classifiable fingerprints obtained from an authorized agency for a national
186.22 criminal history record check.
186.23     (c) For background studies initiated on or after the implementation of NETStudy 2.0,
186.24 except as provided under subdivision 5a, every subject of a background study must provide
186.25 the commissioner with a set of the background study subject's classifiable fingerprints and
186.26 photograph. The photograph and fingerprints must be recorded at the same time by the
186.27 authorized fingerprint collection vendor or vendors and sent to the commissioner through
186.28 the commissioner's secure data system described in section 245C.32, subdivision 1a,
186.29 paragraph (b).
186.30     (d) The fingerprints shall be submitted by the commissioner to the Bureau of Criminal
186.31 Apprehension and, when specifically required by law, submitted to the Federal Bureau of
186.32 Investigation for a national criminal history record check.
  Article 5 Sec. 25.  186
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187.1      (e) The fingerprints must not be retained by the Department of Public Safety, Bureau
187.2  of Criminal Apprehension, or the commissioner. The Federal Bureau of Investigation will
187.3  not retain background study subjects' fingerprints.
187.4      (f) The authorized fingerprint collection vendor or vendors shall, for purposes of verifying
187.5  the identity of the background study subject, be able to view the identifying information
187.6  entered into NETStudy 2.0 by the entity that initiated the background study, but shall not
187.7  retain the subject's fingerprints, photograph, or information from NETStudy 2.0. The
187.8  authorized fingerprint collection vendor or vendors shall retain no more than the name and
187.9  date and time the subject's fingerprints were recorded and sent, only as necessary for auditing
187.10 and billing activities.
187.11     (g) For any background study conducted under this chapter, except for family child
187.12 foster care or, adoption, adult day services, or adult foster care studies, the subject shall
187.13 provide the commissioner with a set of classifiable fingerprints when the commissioner has
187.14 reasonable cause to require a national criminal history record check as defined in section
187.15 245C.02, subdivision 15a.
187.16     EFFECTIVE DATE. This section is effective January 25, 2028.
187.17   Sec. 26. Minnesota Statutes 2025 Supplement, section 245C.05, subdivision 5a, is amended
187.18 to read:
187.19     Subd. 5a. Background study requirements for minors. (a) A background study
187.20 completed under this chapter on a subject who is required to be studied under section
187.21 245C.03, subdivision 1, and is 17 years of age or younger shall be completed by the
187.22 commissioner for:
187.23     (1) a legal nonlicensed child care provider authorized under chapter 142E;
187.24     (2) a licensed family child care program; or
187.25     (3) a licensed foster care home.
187.26     (b) The subject shall submit to the commissioner only the information under subdivision
187.27 1, paragraph (a).
187.28     (c) For child care studies, a subject who is 17 years of age or younger is required to
187.29 submit fingerprints and a photograph, and the commissioner shall conduct a national criminal
187.30 history record check, if:
187.31     (1) the commissioner has reasonable cause to require a national criminal history record
187.32 check defined in section 245C.02, subdivision 15a; or
  Article 5 Sec. 26.  187
  04/06/26  REVISOR  DTT/CH  26-08138  as introduced
188.1      (2) under paragraph (a), clauses (1) and (2), the subject is employed by the provider or
188.2  supervises children served by the program.
188.3      (d) For child care studies, a subject who is 17 years of age or younger is required to
188.4  submit non-fingerprint-based data according to section 245C.08, subdivision 1, paragraph
188.5  (a), clause (6), item (iii), and the commissioner shall conduct the check if:
188.6      (1) the commissioner has reasonable cause to require a national criminal history record
188.7  check defined in section 245C.02, subdivision 15a; or
188.8      (2) the subject is employed by the provider or supervises children served by the program
188.9  under paragraph (a), clauses (1) and (2).
188.10   Sec. 27. Minnesota Statutes 2025 Supplement, section 245C.08, subdivision 1, is amended
188.11 to read:
188.12     Subdivision 1. Background studies conducted by Department of Human Services. (a)
188.13 For a background study conducted by the Department of Human Services, the commissioner
188.14 shall review:
188.15     (1) information related to names of substantiated perpetrators of maltreatment of
188.16 vulnerable adults that has been received by the commissioner as required under section
188.17 626.557, subdivision 9c, paragraph (j);
188.18     (2) the commissioner's records relating to the maltreatment of minors in licensed
188.19 programs, and from findings of maltreatment of minors as indicated through the social
188.20 service information system;
188.21     (3) information from juvenile courts as required for studies under this chapter when
188.22 there is reasonable cause;
188.23     (4) information from the Bureau of Criminal Apprehension, including information
188.24 regarding a background study subject's registration in Minnesota as a predatory offender
188.25 under section 243.166;
188.26     (5) except as provided in clause (6), information received as a result of submission of
188.27 fingerprints for a national criminal history record check, as defined in section 245C.02,
188.28 subdivision 13c, when the commissioner has reasonable cause for a national criminal history
188.29 record check as defined under section 245C.02, subdivision 15a, or as required under section
188.30 144.057, subdivision 1, clause (2);
188.31     (6) for a background study related to a child foster family setting application for licensure,
188.32 foster residence settings, children's residential facilities, a transfer of permanent legal and
  Article 5 Sec. 27.  188
  04/06/26  REVISOR        DTT/CH  26-08138  as introduced
189.1  physical custody of a child under sections 260C.503 to 260C.515, or adoptions, and for a
189.2  background study required for family child care, certified license-exempt child care, child
189.3  care centers, and legal nonlicensed child care authorized under chapter 142E, the
189.4  commissioner shall also review:
189.5      (i) information from the child abuse and neglect registry for any state in which the
189.6  background study subject has resided for the past five years;
189.7      (ii) information received from a national criminal history record check, if authorized for
189.8  the study; and
189.9      (iii) when the background study subject is 18 years of age or older or a minor under
189.10 section 245C.05, subdivision 5a, paragraph (d), for licensed family child care, certified
189.11 license-exempt child care, licensed child care centers, and legal nonlicensed child care
189.12 authorized under chapter 142E, information obtained using non-fingerprint-based data
189.13 including information from the criminal and sex offender registries for any state in which
189.14 the background study subject resided for the past five years and information from the national
189.15 crime information database and the national sex offender registry;
189.16     (7) for a background study required for family child care, certified license-exempt child
189.17 care centers, licensed child care centers, and legal nonlicensed child care authorized under
189.18 chapter 142E, the background study shall also include, to the extent practicable, a name and
189.19 date-of-birth search of the National Sex Offender Public website; and
189.20     (8) for a background study required for treatment programs for sexual psychopathic
189.21 personalities or sexually dangerous persons, the background study shall only include a
189.22 review of the information required under paragraph (a), clauses (1) to (4).
189.23     (b) Except as otherwise provided in this paragraph, notwithstanding expungement by a
189.24 court, the commissioner may consider information obtained under paragraph (a), clauses
189.25 (3) and (4), unless:
189.26     (1) the commissioner received notice of the petition for expungement and the court order
189.27 for expungement is directed specifically to the commissioner; or
189.28     (2) the commissioner received notice of the expungement order issued pursuant to section
189.29 609A.017, 609A.025, or 609A.035, and the order for expungement is directed specifically
189.30 to the commissioner.
189.31 The commissioner may not consider information obtained under paragraph (a), clauses (3)
189.32 and (4), or from any other source that identifies a violation of chapter 152 without
189.33 determining if the offense involved the possession of marijuana or tetrahydrocannabinol
  Article 5 Sec. 27.  189
  04/06/26  REVISOR        DTT/CH  26-08138  as introduced
190.1  and, if so, whether the person received a grant of expungement or order of expungement,
190.2  or the person was resentenced to a lesser offense. If the person received a grant of
190.3  expungement or order of expungement, the commissioner may not consider information
190.4  related to that violation but may consider any other relevant information arising out of the
190.5  same incident.
190.6      (c) The commissioner shall also review criminal case information received according
190.7  to section 245C.04, subdivision 4a, from the Minnesota court information system that relates
190.8  to individuals who have already been studied under this chapter and who remain affiliated
190.9  with the agency that initiated the background study.
190.10     (d) When the commissioner has reasonable cause to believe that the identity of a
190.11 background study subject is uncertain, the commissioner may require the subject to provide
190.12 a set of classifiable fingerprints for purposes of completing a fingerprint-based record check
190.13 with the Bureau of Criminal Apprehension. Fingerprints collected under this paragraph
190.14 shall not be saved by the commissioner after they have been used to verify the identity of
190.15 the background study subject against the particular criminal record in question.
190.16     (e) The commissioner may inform the entity that initiated a background study under
190.17 NETStudy 2.0 of the status of processing of the subject's fingerprints.
190.18   Sec. 28. Minnesota Statutes 2024, section 245C.10, subdivision 4, is amended to read:
190.19     Subd. 4. Temporary personnel agencies, personnel pool agencies, educational
190.20 programs, and professional services agencies. The commissioner shall recover the cost
190.21 of the background studies initiated by temporary personnel agencies, personnel pool agencies,
190.22 educational programs, and professional services agencies that initiate background studies
190.23 under section 245C.03, subdivision 4, through a fee of no more than $44 per study charged
190.24 to the agency. The fees collected under this subdivision are appropriated to the commissioner
190.25 for the purpose of conducting background studies.
190.26   Sec. 29. Minnesota Statutes 2024, section 245C.10, subdivision 5, is amended to read:
190.27     Subd. 5. Adult foster care and family adult day services. The commissioner shall
190.28 recover the cost of background studies required under section 245C.03, subdivision 1, for
190.29 the purposes of adult foster care and family adult day services licensing, through a fee of
190.30 no more than $44 per study charged to the license holder. The fees collected under this
190.31 subdivision are appropriated to the commissioner for the purpose of conducting background
190.32 studies.
  Article 5 Sec. 29.  190
  04/06/26  REVISOR       DTT/CH  26-08138  as introduced
191.1    Sec. 30. Minnesota Statutes 2024, section 245C.10, subdivision 8, is amended to read:
191.2      Subd. 8. Children's therapeutic services and supports providers. The commissioner
191.3  shall recover the cost of background studies required under section 245C.03, subdivision
191.4  7, for the purposes of children's therapeutic services and supports under section 256B.0943,
191.5  through a fee of no more than $44 per study charged to the license holder. The fees collected
191.6  under this subdivision are appropriated to the commissioner for the purpose of conducting
191.7  background studies.
191.8    Sec. 31. Minnesota Statutes 2025 Supplement, section 245C.10, subdivision 9, is amended
191.9  to read:
191.10     Subd. 9. Human services licensed programs. The commissioner shall recover the cost
191.11 of background studies required under section 245C.03, subdivision 1, for all programs that
191.12 are licensed by the commissioner through a fee of no more than $44 per study charged to
191.13 the license holder. The fees collected under this subdivision are appropriated to the
191.14 commissioner for the purpose of conducting background studies.
191.15   Sec. 32. Minnesota Statutes 2024, section 245C.10, subdivision 17, is amended to read:
191.16     Subd. 17. Early intensive developmental and behavioral intervention providers. The
191.17 commissioner shall recover the cost of background studies required under section 245C.03,
191.18 subdivision 15, for the purposes of early intensive developmental and behavioral intervention
191.19 under section 256B.0949, through a fee of no more than $44 per study charged to the enrolled
191.20 agency. The fees collected under this subdivision are appropriated to the commissioner for
191.21 the purpose of conducting background studies.
191.22   Sec. 33. Minnesota Statutes 2025 Supplement, section 245C.10, subdivision 22, is amended
191.23 to read:
191.24     Subd. 22. Recuperative care providers. The commissioner shall recover the cost of
191.25 background studies required under section 245C.03, subdivision 16, for recuperative care
191.26 under section 256B.0701, through a fee of no more than $44 per study charged to the enrolled
191.27 provider. The fees collected under this subdivision are appropriated to the commissioner
191.28 for the purpose of conducting background studies.
  Article 5 Sec. 33.  191
  04/06/26  REVISOR  DTT/CH  26-08138  as introduced
192.1    Sec. 34. Minnesota Statutes 2025 Supplement, section 245C.13, subdivision 2, is amended
192.2  to read:
192.3      Subd. 2. Activities pending completion of background study. The subject of a
192.4  background study may not perform any activity requiring a background study under
192.5  paragraph (c) until the commissioner has issued one of the notices under paragraph (a).
192.6      (a) Notices from the commissioner required prior to activity under paragraph (c) include:
192.7      (1) a notice of the study results under section 245C.17 stating that:
192.8      (i) the individual is not disqualified; or
192.9      (ii) more time is needed to complete the study but the individual is not required to be
192.10 removed from direct contact or access to people receiving services prior to completion of
192.11 the study as provided under section 245C.17, subdivision 1, paragraph (b) or (c). The notice
192.12 that more time is needed to complete the study must also indicate whether the individual is
192.13 required to be under continuous direct supervision prior to completion of the background
192.14 study. When more time is necessary to complete a background study of an individual
192.15 affiliated with a Title IV-E eligible children's residential facility or foster residence setting,
192.16 the individual may not work in the facility or setting regardless of whether or not the
192.17 individual is supervised;
192.18     (2) a notice that a disqualification has been set aside under section 245C.23; or
192.19     (3) a notice that a variance has been granted related to the individual under section
192.20 245C.30.
192.21     (b) For a background study affiliated with a licensed child care center or certified
192.22 license-exempt child care center, the notice sent under paragraph (a), clause (1), item (ii),
192.23 must not be issued until the commissioner receives a qualifying result for the individual for
192.24 the fingerprint-based national criminal history record check or the fingerprint-based criminal
192.25 history information from the Bureau of Criminal Apprehension. The notice must require
192.26 the individual to be under continuous direct supervision prior to completion of the remainder
192.27 of the background study except as permitted in subdivision 3.
192.28     (c) Activities prohibited prior to receipt of notice under paragraph (a) include:
192.29     (1) being issued a license;
192.30     (2) living in the household where the licensed program will be provided;
192.31     (3) providing direct contact services to persons served by a program unless the subject
192.32 is under continuous direct supervision;
  Article 5 Sec. 34.  192
  04/06/26  REVISOR  DTT/CH  26-08138  as introduced
193.1(4) having access to persons receiving services if the background study was completed
193.2  under section 144.057, subdivision 1, or 245C.03, subdivision 1, paragraph (a), clause (2),
193.3  (5), or (6), unless the subject is under continuous direct supervision;
193.4(5) for licensed child care centers and certified license-exempt child care centers,
193.5  providing direct contact services to persons served by the program;
193.6(6) for children's residential facilities or foster residence settings, working in the facility
193.7  or setting; or
193.8(7) for background studies affiliated with a personal care provider organization, except
193.9  as provided in section 245C.03, subdivision 3b, early intensive developmental and behavioral
193.10 intervention provider, housing support or supplementary services provider, special
193.11 transportation services provider, or community first services and supports provider before
193.12 a personal care assistant an individual provides services, the personal care assistance provider
193.13 agency entity must initiate a background study of the personal care assistant individual
193.14 under this chapter and the personal care assistance provider agency entity must have received
193.15 a notice from the commissioner that the personal care assistant individual is:
193.16(i) not disqualified under section 245C.14; or
193.17(ii) disqualified, but the personal care assistant individual has received a set aside of the
193.18 disqualification under section 245C.22; or.
193.19(8) for background studies affiliated with an early intensive developmental and behavioral
193.20 intervention provider, before an individual provides services, the early intensive
193.21 developmental and behavioral intervention provider must initiate a background study for
193.22 the individual under this chapter and the early intensive developmental and behavioral
193.23 intervention provider must have received a notice from the commissioner that the individual
193.24 is:
193.25(i) not disqualified under section 245C.14; or
193.26(ii) disqualified, but the individual has received a set-aside of the disqualification under
193.27 section 245C.22.
193.28   Sec. 35. Minnesota Statutes 2024, section 245C.14, subdivision 1, is amended to read:
193.29Subdivision 1. Disqualification from direct contact. (a) The commissioner shall
193.30 disqualify an individual who is the subject of a background study from any position allowing
193.31 direct contact with persons receiving services from the license holder or entity identified in
  Article 5 Sec. 35.  193
  04/06/26  REVISOR       DTT/CH  26-08138  as introduced
194.1  section 245C.03, upon receipt of information showing, or when a background study
194.2  completed under this chapter shows any of the following:
194.3      (1) a conviction of, admission to, or Alford plea to one or more crimes listed in section
194.4  245C.15, regardless of whether the conviction or admission is a felony, gross misdemeanor,
194.5  or misdemeanor level crime;
194.6      (2) a preponderance of the evidence indicates the individual has committed an act or
194.7  acts that meet the definition of any of the crimes listed in section 245C.15, regardless of
194.8  whether the preponderance of the evidence is for a felony, gross misdemeanor, or
194.9  misdemeanor level crime;
194.10     (3) an investigation results in an administrative determination listed under section
194.11 245C.15, subdivision 4, paragraph (b); or
194.12     (4) the individual's parental rights have been terminated under section 260C.301,
194.13 subdivision 1, paragraph (b), or section 260C.301, subdivision 3.
194.14     (b) No individual who is disqualified following a background study under section
194.15 245C.03, subdivisions 1 and 2, may be retained in a position involving direct contact with
194.16 persons served by a program or entity identified in section 245C.03, unless the commissioner
194.17 has provided written notice under section 245C.17 stating that:
194.18     (1) the individual may remain in direct contact during the period in which the individual
194.19 may request reconsideration as provided in section 245C.21, subdivision 2;
194.20     (2) the commissioner has set aside the individual's disqualification for that program or
194.21 entity identified in section 245C.03, as provided in section 245C.22, subdivision 4; or
194.22     (3) the license holder has been granted a variance for the disqualified individual under
194.23 section 245C.30.
194.24     (c) Notwithstanding paragraph (a), for the purposes of a background study affiliated
194.25 with a licensed family foster setting, the commissioner shall disqualify an individual who
194.26 is the subject of a background study from any position allowing direct contact with persons
194.27 receiving services from the license holder or entity identified in section 245C.03, upon
194.28 receipt of information showing or when a background study completed under this chapter
194.29 shows reason for disqualification under section 245C.15, subdivision 4a.
194.30   Sec. 36. Minnesota Statutes 2024, section 245C.14, subdivision 2, is amended to read:
194.31     Subd. 2. Disqualification from access. (a) If an individual who is studied under section
194.32 245C.03, subdivision 1, paragraph (a), clauses (2), (5), and (6), is disqualified from direct
  Article 5 Sec. 36.  194
  04/06/26  REVISOR        DTT/CH  26-08138  as introduced
195.1  contact under subdivision 1, the commissioner shall also disqualify the individual from
195.2  access to a person receiving services from the license holder.
195.3      (b) No individual who is disqualified following a background study under section
195.4  245C.03, subdivision 1, paragraph (a), clauses (2), (5), and (6), or as provided elsewhere
195.5  in statute who is disqualified as a result of this section, may be allowed access to persons
195.6  served by the program unless the commissioner has provided written notice under section
195.7  245C.17 stating that:
195.8      (1) the individual may remain in direct contact during the period in which the individual
195.9  may request reconsideration as provided in section 245C.21, subdivision 2;
195.10     (2) the commissioner has set aside the individual's disqualification for that licensed
195.11 program or entity identified in section 245C.03 as provided in section 245C.22, subdivision
195.12 4; or
195.13     (3) the license holder has been granted a variance for the disqualified individual under
195.14 section 245C.30.
195.15   Sec. 37. Minnesota Statutes 2025 Supplement, section 245C.16, subdivision 1, is amended
195.16 to read:
195.17     Subdivision 1. Determining immediate risk of harm. (a) If the commissioner determines
195.18 that the individual studied has a disqualifying characteristic, the commissioner shall review
195.19 the information immediately available and make a determination as to the subject's immediate
195.20 risk of harm to persons served by the program where the individual studied will have direct
195.21 contact with, or access to, people receiving services.
195.22     (b) The commissioner shall consider all relevant information available, including the
195.23 following factors in determining the immediate risk of harm:
195.24     (1) the recency of the disqualifying characteristic;
195.25     (2) the recency of discharge from probation for the crimes;
195.26     (3) the number of disqualifying characteristics;
195.27     (4) the intrusiveness or violence of the disqualifying characteristic;
195.28     (5) the vulnerability of the victim involved in the disqualifying characteristic;
195.29     (6) the similarity of the victim to the persons served by the program where the individual
195.30 studied will have direct contact;
  Article 5 Sec. 37.  195
  04/06/26  REVISOR  DTT/CH  26-08138  as introduced
196.1      (7) whether the individual has a disqualification from a previous background study that
196.2  has not been set aside;
196.3      (8) if the individual has a disqualification which may not be set aside because it is a
196.4  permanent bar under section 245C.24, subdivision 1, or the individual is a child care
196.5  background study subject who has a felony-level conviction for a drug-related offense in
196.6  the last five years, the commissioner may order the immediate removal of the individual
196.7  from any position allowing direct contact with, or access to, persons receiving services from
196.8  the program and from working in a children's residential facility or foster residence setting;
196.9  and
196.10     (9) if the individual has a disqualification which may not be set aside because it is a
196.11 permanent bar under section 245C.24, subdivision 2, or the individual is a child care
196.12 background study subject who has a felony-level conviction for a drug-related offense during
196.13 the last five years, the commissioner may order the immediate removal of the individual
196.14 from any position allowing direct contact with or access to persons receiving services from
196.15 the center and from working in a licensed child care center or certified license-exempt child
196.16 care center.
196.17     (c) This section does not apply when the subject of a background study is regulated by
196.18 a health-related licensing board as defined in chapter 214, and the subject is determined to
196.19 be responsible for substantiated maltreatment under section 626.557 or chapter 260E.
196.20     (d) This section does not apply to a background study related to an initial application
196.21 for a child foster family setting license.
196.22     (e) Except for paragraph (f), this section does not apply to a background study that is
196.23 also subject to the requirements under section 256B.0659, subdivisions 11 and 13, for a
196.24 personal care assistant or a qualified professional as defined in section 256B.0659,
196.25 subdivision 1, or to a background study for an individual providing early intensive
196.26 developmental and behavioral intervention services under section 256B.0949 245C.13,
196.27 subdivision 2, paragraph (c), clause (7).
196.28     (f) If the commissioner has reason to believe, based on arrest information or an active
196.29 maltreatment investigation, that an individual poses an imminent risk of harm to persons
196.30 receiving services, the commissioner may order that the person be continuously supervised
196.31 or immediately removed pending the conclusion of the maltreatment investigation or criminal
196.32 proceedings.
  Article 5 Sec. 37.  196
  04/06/26  REVISOR        DTT/CH  26-08138  as introduced
197.1    Sec. 38. Minnesota Statutes 2025 Supplement, section 245C.22, subdivision 5, is amended
197.2  to read:
197.3      Subd. 5. Scope of set-aside. (a) If the commissioner sets aside a disqualification under
197.4  this section, the disqualified individual remains disqualified, but may hold a license and
197.5  have direct contact with or access to persons receiving services. Except as provided in
197.6  paragraph (b), the commissioner's set-aside of a disqualification is limited solely to the
197.7  licensed program, applicant, or agency specified in the set aside notice under section 245C.23.
197.8  For personal care provider organizations, financial management services organizations,
197.9  community first services and supports organizations, unlicensed home and community-based
197.10 organizations, and consumer-directed community supports organizations, the commissioner's
197.11 set-aside may further be limited to a specific individual who is receiving services. For new
197.12 background studies required under section 245C.04, subdivision 1, paragraph (h), if an
197.13 individual's disqualification was previously set aside for the license holder's program and
197.14 the new background study results in no new information that indicates the individual may
197.15 pose a risk of harm to persons receiving services from the license holder, the previous
197.16 set-aside shall remain in effect.
197.17     (b) If the commissioner has previously set aside an individual's disqualification for one
197.18 or more programs or agencies, and the individual is the subject of a subsequent background
197.19 study for a different program or agency, the commissioner shall determine whether the
197.20 disqualification is set aside for the program or agency that initiated the subsequent
197.21 background study. A notice of a set-aside under paragraph (c) shall be issued within 15
197.22 working days if all of the following criteria are met:
197.23     (1) the subsequent background study was initiated in connection with a program licensed
197.24 or regulated under the same provisions of law and rule for at least one program for which
197.25 the individual's disqualification was previously set aside by the commissioner;
197.26     (2) the individual is not disqualified for an offense specified in section 245C.15,
197.27 subdivision 1 or 2;
197.28     (3) the commissioner has received no new information to indicate that the individual
197.29 may pose a risk of harm to any person served by the program; and
197.30     (4) the previous set-aside was not limited to a specific person receiving services.
197.31     (c) Notwithstanding paragraph (b), clause (2), for an individual who is employed in the
197.32 substance use disorder field, if the commissioner has previously set aside an individual's
197.33 disqualification for one or more programs or agencies in the substance use disorder treatment
197.34 field, and the individual is the subject of a subsequent background study for a different
  Article 5 Sec. 38.  197
  04/06/26  REVISOR  DTT/CH  26-08138  as introduced
198.1  program or agency in the substance use disorder treatment field, the commissioner shall set
198.2  aside the disqualification for the program or agency in the substance use disorder treatment
198.3  field that initiated the subsequent background study when the criteria under paragraph (b),
198.4  clauses (1), (3), and (4), are met and the individual is not disqualified for an offense specified
198.5  in section 245C.15, subdivision 1. A notice of a set-aside under paragraph (d) shall be issued
198.6  within 15 working days.
198.7(d) When a disqualification is set aside under paragraph (b), the notice of background
198.8  study results issued under section 245C.17, in addition to the requirements under section
198.9  245C.17, shall state that the disqualification is set aside for the program or agency that
198.10 initiated the subsequent background study. The notice must inform the individual that the
198.11 individual may request reconsideration of the disqualification under section 245C.21 on the
198.12 basis that the information used to disqualify the individual is incorrect.
198.13   Sec. 39. Minnesota Statutes 2024, section 245C.24, subdivision 2, is amended to read:
198.14Subd. 2. Permanent bar to set aside a disqualification. (a) Except as provided in
198.15 paragraphs (b) to (g), the commissioner may not set aside the disqualification of any
198.16 individual disqualified pursuant to this chapter, regardless of how much time has passed,
198.17 if the individual was disqualified for a crime or conduct listed in section 245C.15, subdivision
198.18 1.
198.19(b) For an individual in the substance use disorder or corrections field who was
198.20 disqualified for a crime or conduct listed under section 245C.15, subdivision 1, and whose
198.21 disqualification was set aside prior to July 1, 2005, the commissioner must consider granting
198.22 a variance pursuant to section 245C.30 for the license holder for a program dealing primarily
198.23 with adults. A request for reconsideration evaluated under this paragraph must include a
198.24 letter of recommendation from the license holder that was subject to the prior set-aside
198.25 decision addressing the individual's quality of care to children or vulnerable adults and the
198.26 circumstances of the individual's departure from that service.
198.27(c) If an individual who requires a background study for nonemergency medical
198.28 transportation services under section 245C.03, subdivision 12, was disqualified for a crime
198.29 or conduct listed under section 245C.15, subdivision 1, and if more than 40 years have
198.30 passed since the discharge of the sentence imposed, the commissioner may consider granting
198.31 a set-aside pursuant to section 245C.22. A request for reconsideration evaluated under this
198.32 paragraph must include a letter of recommendation from the employer. This paragraph does
198.33 not apply to a person disqualified based on a violation of sections 243.166; 609.185 to
  Article 5 Sec. 39.  198
  04/06/26  REVISOR  DTT/CH  26-08138  as introduced
199.1  609.205; 609.25; 609.342 to 609.3453; 609.352; 617.23, subdivision 2, clause (1), or 3,
199.2  clause (1); 617.246; or 617.247.
199.3      (d) When a licensed foster care provider adopts an individual who had received foster
199.4  care services from the provider for over six months, and the adopted individual is required
199.5  to receive a background study under section 245C.03, subdivision 1, paragraph (a), clause
199.6  (2) or (6), the commissioner may grant a variance to the license holder under section 245C.30
199.7  to permit the adopted individual with a permanent disqualification to remain affiliated with
199.8  the license holder under the conditions of the variance when the variance is recommended
199.9  by the county of responsibility for each of the remaining individuals in placement in the
199.10 home and the licensing agency for the home.
199.11     (e) For an individual 18 years of age or older affiliated with a licensed family foster
199.12 setting, the commissioner must not set aside or grant a variance for the disqualification of
199.13 any individual disqualified pursuant to this chapter, regardless of how much time has passed,
199.14 if the individual was disqualified for a crime or conduct listed in section 245C.15, subdivision
199.15 4a, paragraphs (a) and (b).
199.16     (f) In connection with a family foster setting license, the commissioner may grant a
199.17 variance to the disqualification for an individual who is under 18 years of age at the time
199.18 the background study is submitted.
199.19     (g) In connection with foster residence settings and children's residential facilities, the
199.20 commissioner must not set aside or grant a variance for the disqualification of any individual
199.21 disqualified pursuant to this chapter, regardless of how much time has passed, if the individual
199.22 was disqualified for a crime or conduct listed in section 245C.15, subdivision 4a, paragraph
199.23 (a) or (b).
199.24   Sec. 40. Minnesota Statutes 2024, section 245D.09, subdivision 6, is amended to read:
199.25     Subd. 6. Subcontractors and temporary staff. If the license holder uses a subcontractor
199.26 or temporary staff to perform services licensed under this chapter on the license holder's
199.27 behalf, the license holder must ensure that the subcontractor or temporary staff meets and
199.28 maintains compliance with all requirements under this chapter that apply to the services to
199.29 be provided, including training, orientation, and supervision necessary to fulfill their
199.30 responsibilities. The license holder must ensure that a background study has been completed
199.31 according to the requirements in sections 245C.03, subdivision 1, and 245C.04.
199.32 Subcontractors and temporary staff hired by the license holder must meet the Minnesota
199.33 licensing requirements applicable to the disciplines in which they are providing services.
  Article 5 Sec. 40.  199
  04/06/26  REVISOR        DTT/CH  26-08138  as introduced
200.1  The license holder must maintain documentation that the applicable requirements have been
200.2  met.
200.3    Sec. 41. Minnesota Statutes 2024, section 245D.09, subdivision 7, is amended to read:
200.4      Subd. 7. Volunteers. The license holder must ensure that volunteers who provide direct
200.5  support services to persons served by the program receive the training, orientation, and
200.6  supervision necessary to fulfill their responsibilities. The license holder must ensure that a
200.7  background study has been completed according to the requirements in sections 245C.03,
200.8  subdivision 1, and 245C.04. The license holder must maintain documentation that the
200.9  applicable requirements have been met.
200.10   Sec. 42. Minnesota Statutes 2024, section 256B.0943, subdivision 5a, is amended to read:
200.11     Subd. 5a. Background studies. The requirements for background studies under section
200.12 245I.011, subdivision 5, paragraph (b), may be met by a children's therapeutic services and
200.13 supports services agency through the commissioner's NETStudy system as provided under
200.14 sections 245C.03, subdivision 7, and 245C.10, subdivision 8.
200.15   Sec. 43. Minnesota Statutes 2025 Supplement, section 256I.04, subdivision 2c, is amended
200.16 to read:
200.17     Subd. 2c. Background study requirements. (a) A provider of housing support must
200.18 initiate background studies in accordance with section 245C.03, subdivision 10.
200.19     (b) A provider initiating a background study pursuant to chapter 245C is not required
200.20 to initiate a background study in accordance with sections 299C.66 to 299C.71 or chapter
200.21 364.
200.22   Sec. 44. REPEALER.
200.23     (a) Minnesota Statutes 2024, sections 245C.03, subdivisions 3a, 3b, 5, 6a, and 9a; and
200.24 245C.04, subdivisions 2, 3, 4, 5, 7, 8, 9, 10, and 11, are repealed.
200.25     (b) Minnesota Statutes 2025 Supplement, section 245C.04, subdivisions 6, 12, and 13,
200.26 are repealed.
  Article 5 Sec. 44.  200
  04/06/26  REVISOR      DTT/CH  26-08138  as introduced
201.1ARTICLE 6
201.2MISCELLANEOUS
201.3    Section 1. Minnesota Statutes 2024, section 62D.04, subdivision 5, is amended to read:
201.4      Subd. 5. Participation; government programs. (a) Health maintenance organizations
201.5  that are a nonprofit corporation organized under chapter 317A or a local governmental unit
201.6  shall, as a condition of receiving and retaining a certificate of authority, participate in the
201.7  medical assistance and MinnesotaCare programs. A health maintenance organization
201.8  governed by this subdivision is required to submit proposals in good faith that meet the
201.9  requirements of the request for proposal provided that the requirements can be reasonably
201.10 met by a health maintenance organization to serve individuals eligible for the above programs
201.11 in a geographic region of the state if, at the time of publication of a request for proposal,
201.12 the percentage of recipients in the public programs in the region who are enrolled in the
201.13 health maintenance organization is less than the health maintenance organization's percentage
201.14 of the total number of individuals enrolled in health maintenance organizations in the same
201.15 region. Geographic regions shall be defined by the commissioner of human services in the
201.16 request for proposals. This paragraph expires upon the effective date of paragraph (b).
201.17     (b) Effective January 1, 2029, or upon the date the administrative service organization
201.18 begins administering medical assistance under section 256B.697, whichever is later, a health
201.19 maintenance organization that is a nonprofit corporation organized under chapter 317A or
201.20 a local governmental unit shall, as a condition of receiving and retaining a certificate of
201.21 authority, participate in the integrated medical assistance and MinnesotaCare programs. A
201.22 health maintenance organization governed by this subdivision is required to submit proposals
201.23 in good faith that meet the requirements of the request for proposal provided that the
201.24 requirements can be reasonably met by a health maintenance organization. A health
201.25 maintenance organization must serve individuals eligible for the integrated medical assistance
201.26 and MinnesotaCare programs in a geographic region of the state if, at the time of publication
201.27 of a request for proposal, the percentage of recipients in the public programs in the region
201.28 who are enrolled in the health maintenance organization is less than the health maintenance
201.29 organization's percentage of the total number of individuals enrolled in health maintenance
201.30 organizations in the same region. The commissioner of human services must define
201.31 geographic regions in the request for proposals.
201.32     (c) The commissioner of human services must notify the revisor of statutes when the
201.33 administrative service organization begins administering medical assistance.
  Article 6 Section 1.  201
  04/06/26  REVISOR        DTT/CH  26-08138  as introduced
202.1    Sec. 2. Minnesota Statutes 2024, section 256B.05, subdivision 1, is amended to read:
202.2      Subdivision 1. Administration of medical assistance. (a) The county agencies shall
202.3  administer medical assistance in their respective counties under the supervision of the state
202.4  agency and the commissioner of human services as specified in section 256.01, and shall
202.5  make such reports, prepare such statistics, and keep such records and accounts in relation
202.6  to medical assistance as the state agency may require under section 256.01, subdivision 2,
202.7  paragraph (o).
202.8      (b) The commissioner must administer specific duties related to determining medical
202.9  assistance eligibility on behalf of a county agency administration to ensure compliance with
202.10 federal and state requirements for the medical assistance program. The commissioner must
202.11 undertake the specific duties on a statewide and uniform administrative and operational
202.12 basis.
202.13   Sec. 3. Minnesota Statutes 2024, section 256B.0625, subdivision 3c, is amended to read:
202.14     Subd. 3c. Health Services Advisory Council. (a) The commissioner, after receiving
202.15 recommendations from professional physician associations, professional associations
202.16 representing licensed nonphysician health care professionals, and consumer groups, shall
202.17 establish a 14-member Health Services Advisory Council, which consists of 13 voting
202.18 members and one nonvoting member. The Health Services Advisory Council shall advise
202.19 the commissioner regarding (1) health services pertaining to the administration of health
202.20 care benefits covered under Minnesota health care programs (MHCP); and (2) evidence-based
202.21 decision-making and health care benefit and coverage policies for MHCP. The Health
202.22 Services Advisory Council shall consider available evidence regarding quality, safety, and
202.23 cost-effectiveness when advising the commissioner. The Health Services Advisory Council
202.24 shall meet at least quarterly. The Health Services Advisory Council shall annually select a
202.25 chair from among its members who shall work directly with the commissioner's medical
202.26 director to establish the agenda for each meeting. The Health Services Advisory Council
202.27 may recommend criteria for verifying centers of excellence for specific aspects of medical
202.28 care where a specific set of combined services, a volume of patients necessary to maintain
202.29 a high level of competency, or a specific level of technical capacity is associated with
202.30 improved health outcomes.
202.31     (b) The commissioner shall establish a dental subcouncil to operate under the Health
202.32 Services Advisory Council. The dental subcouncil consists of general dentists, dental
202.33 specialists, safety net providers, dental hygienists, health plan company entities under
202.34 contract to serve MHCP and county and public health representatives, health researchers,
  Article 6 Sec. 3.  202
  04/06/26  REVISOR  DTT/CH  26-08138  as introduced
203.1  consumers, and a designee of the commissioner of health. The dental subcouncil shall advise
203.2  the commissioner regarding:
203.3      (1) the critical access dental program under section 256B.76, subdivision 4, including
203.4  but not limited to criteria for designating and terminating critical access dental providers;
203.5      (2) any changes to the critical access dental provider program necessary to comply with
203.6  program expenditure limits;
203.7      (3) dental coverage policy based on evidence, quality, continuity of care, and best
203.8  practices;
203.9      (4) the development of dental delivery models; and
203.10     (5) dental services to be added or eliminated from subdivision 9.
203.11     (c) The Health Services Advisory Council may monitor and track the practice patterns
203.12 of health care providers who serve MHCP recipients under fee-for-service, managed care,
203.13 and county-based purchasing. The monitoring and tracking shall focus on services or
203.14 specialties for which there is a high variation in utilization or quality across providers, or
203.15 which are associated with high medical costs. The commissioner, based upon the findings
203.16 of the Health Services Advisory Council, may notify providers whose practice patterns
203.17 indicate below average quality or higher than average utilization or costs. Managed care
203.18 and county-based purchasing plans Entities contracted to administer MHCP programs shall
203.19 provide the commissioner with utilization and cost data necessary to implement this
203.20 paragraph, and the commissioner shall make these data available to the Health Services
203.21 Advisory Council.
203.22   Sec. 4. Minnesota Statutes 2024, section 256B.0625, subdivision 3d, is amended to read:
203.23     Subd. 3d. Health Services Advisory Council members. (a) The Health Services
203.24 Advisory Council consists of:
203.25     (1) six voting members who are licensed physicians actively engaged in the practice of
203.26 medicine in Minnesota, three of whom must represent health plans entities currently under
203.27 contract to serve MHCP recipients, including but not limited to integrated health partnerships,
203.28 health plans, and county-based purchasing plans;
203.29     (2) two voting members who are licensed physician specialists actively practicing their
203.30 specialty in Minnesota and providing care to MHCP recipients;
  Article 6 Sec. 4.  203
  04/06/26  REVISOR  DTT/CH  26-08138  as introduced
204.1      (3) two voting members who are nonphysician health care professionals licensed or
204.2  registered in their profession and actively engaged in their practice of their profession in
204.3  Minnesota and providing care to MHCP recipients;
204.4      (4) one voting member who is a health care or mental health professional licensed or
204.5  registered in the member's profession, actively engaged in the practice of the member's
204.6  profession in Minnesota, and actively engaged in the treatment of persons with mental
204.7  illness, and providing care to MHCP recipients;
204.8      (5) two consumers who are enrolled in MHCP programs directly or are caregivers for
204.9  MHCP recipients who shall serve as voting members; and
204.10     (6) the commissioner's medical director who shall serve as a nonvoting member.
204.11     (b) Members of the Health Services Advisory Council shall not be employed by the state
204.12 of Minnesota, except for the medical director. A quorum shall comprise a simple majority
204.13 of the voting members. Vacant seats shall not count toward a quorum.
204.14   Sec. 5. Minnesota Statutes 2025 Supplement, section 256B.0911, subdivision 14, is
204.15 amended to read:
204.16     Subd. 14. Use of MnCHOICES certified assessors required. (a) Each lead agency
204.17 shall use MnCHOICES certified assessors who have completed MnCHOICES training and
204.18 the certification process determined by the commissioner in subdivision 13.
204.19     (b) Each lead agency must ensure that the lead agency has sufficient numbers of certified
204.20 assessors to provide long-term consultation assessment and support planning within the
204.21 timelines and parameters of the service.
204.22     (c) A lead agency may choose, according to departmental policies, to contract with a
204.23 qualified, certified assessor to conduct assessments and reassessments on behalf of the lead
204.24 agency.
204.25     (d) Tribes and health plans under contract with the commissioner must provide long-term
204.26 care consultation services as specified in the contract.
204.27     (e) A lead agency must provide the commissioner with an administrative contact for
204.28 communication purposes.
204.29     (f) A lead agency may contract under this subdivision with any hospital licensed under
204.30 sections 144.50 to 144.56 to conduct assessments of patients in the hospital on behalf of
204.31 the lead agency when the lead agency has failed to meet its obligations under subdivision
204.32 17. The contracted assessment must be conducted by a hospital employee who is a qualified,
  Article 6 Sec. 5.  204
  04/06/26  REVISOR        DTT/CH  26-08138  as introduced
205.1  certified assessor. The hospital employees who perform assessments under the contract
205.2  between the hospital and the lead agency may perform assessments in addition to other
205.3  duties assigned to the employee by the hospital, except the hospital employees who perform
205.4  the assessments under contract with the lead agency must not perform any waiver-related
205.5  tasks other than assessments. Hospitals are not eligible for reimbursement under subdivision
205.6  33. The lead agency that enters into a contract with a hospital under this paragraph is
205.7  responsible for oversight, compliance, and quality assurance for all assessments performed
205.8  under the contract.
205.9      (g) The commissioner must employ certified assessors within the department to conduct
205.10 assessments on behalf of lead agencies under conditions and circumstances determined by
205.11 the commissioner. Certified assessors employed by the department may conduct assessments
205.12 in addition to other duties as assigned, except the certified assessors employed by the
205.13 department must not perform any responsibilities of a lead agency described in this section
205.14 other than assessments. Nothing in this paragraph creates an obligation for the department
205.15 to provide the department's certified assessors to conduct assessments on behalf of a lead
205.16 agency.
205.17   Sec. 6. Minnesota Statutes 2024, section 256B.69, subdivision 1, is amended to read:
205.18     Subdivision 1. Purpose. (a) The commissioner of human services shall establish a
205.19 medical assistance demonstration project to determine whether prepayment combined with
205.20 better management of health care services is an effective mechanism to ensure that all
205.21 eligible individuals receive necessary health care in a coordinated fashion while containing
205.22 costs. For the purposes of this project, waiver of certain statutory provisions is necessary
205.23 in accordance with this section.
205.24     (b) Effective January 1, 2029, or upon the date the administrative service organization
205.25 begins administering medical assistance under section 256B.697, whichever is later, this
205.26 section applies only to medical assistance members enrolled in integrated Medicare products
205.27 for individuals with disabilities and seniors and MinnesotaCare. The commissioner of human
205.28 services must notify the revisor of statutes when the administrative service organization
205.29 begins administering medical assistance.
205.30   Sec. 7. [256B.697] MEDICAL ASSISTANCE ADMINISTRATIVE SERVICE
205.31 ORGANIZATION.
205.32     (a) Effective January 1, 2029, the commissioner must contract with an administrative
205.33 service organization to administer the medical assistance program on a statewide basis. The
  Article 6 Sec. 7.  205
  04/06/26  REVISOR  DTT/CH  26-08138  as introduced
206.1  administrator is responsible for the administration of all populations within medical assistance
206.2  except individuals enrolled in integrated Medicare products, including but not limited to
206.3  Minnesota Senior Health Options and Special Needs BasicCare.
206.4      (b) Services performed by the administrator may include but are not limited to:
206.5      (1) claims processing for all covered services;
206.6      (2) coordination of care for members;
206.7      (3) program integrity initiatives;
206.8      (4) management of third-party liability requirements;
206.9      (5) development, execution, and maintenance of a claims processing system compliant
206.10 with all applicable state and federal laws and regulations;
206.11     (6) assistance and outreach to recipients to manage and access needed care;
206.12     (7) assistance and outreach to enrolled providers;
206.13     (8) utilization management and medical necessity review of services; and
206.14     (9) quality improvement and program evaluation initiatives.
206.15     (c) Rates paid to providers under this section must be the same rates paid to providers
206.16 under this chapter and chapter 256.
206.17     (d) The administrator may, with the approval of the commissioner, elect to subcontract
206.18 with other entities to assist in the delivery and administration of services.
206.19     (e) The commissioner may elect to contract separately from the administrative services
206.20 organization for care coordination if the commissioner determines additional support is
206.21 needed for members to access medically necessary care.
206.22   Sec. 8. DIRECTION TO COMMISSIONER; ADMINISTRATIVE SERVICE
206.23 ORGANIZATION TRANSFER ASSESSMENT.
206.24     (a) The commissioner of human services must procure a contract with a vendor to assess
206.25 the current status and plan for the transfer of administration of medical assistance to the
206.26 commissioner's administrative service organization under Minnesota Statutes, section
206.27 256B.697, by January 1, 2033. The commissioner must submit the assessment to the chairs
206.28 and ranking minority members of the legislative committees with jurisdiction over human
206.29 services and health care policy and finance by October 1, 2028.
206.30     (b) The assessment must include:
  Article 6 Sec. 8.  206
  04/06/26  REVISOR  DTT/CH  26-08138  as introduced
207.1      (1) a comprehensive assessment of medical assistance eligibility functions performed
207.2  by counties and Tribal governments, including identification of handoffs between county
207.3  and Tribal eligibility workers and state eligibility workers, and a catalog of eligibility
207.4  functions performed by state eligibility workers;
207.5      (2) examination of current expenditures, administrative budgets, and federal financial
207.6  participation in county and Tribal administrative work related to medical assistance eligibility
207.7  activities;
207.8      (3) eligibility system review, mapping, and recommended updates; and
207.9      (4) recommendations for a successful transition of centralized eligibility functions based
207.10 on consultation with stakeholders, review of information provided by county and Tribal
207.11 governments, review of other states' best practices for maximizing federal dollars, a feasible
207.12 timeline of activities, and required legislative changes and actions.
207.13     (c) The commissioner must consult with the Tribal Nations, the Association of Minnesota
207.14 Counties, and the Minnesota Association of County Social Service Administrators on the
207.15 final deliverables included in the assessment.
207.16   Sec. 9. MNCHOICES REDESIGN WORKING GROUP.
207.17     Subdivision 1. Establishment. The commissioner of human services shall convene a
207.18 MnCHOICES Redesign Working Group to develop recommendations related to state
207.19 provision of MnCHOICES assessments under Minnesota Statutes, section 256B.0911,
207.20 subdivision 14, paragraph (g).
207.21     Subd. 2. Membership. At a minimum, the working group must include the following
207.22 members:
207.23     (1) two individuals receiving waiver services or the individuals' family members or
207.24 advocates, appointed by the commissioner in consultation with organizations representing
207.25 individuals with lived experience of disability and waiver services;
207.26     (2) three county representatives, appointed by the Minnesota Association of County
207.27 Social Service Administrators, including;
207.28     (i) at least one representative of a lead agency located in a metropolitan county, as defined
207.29 in Minnesota Statutes, section 473.121, subdivision 4; and
207.30     (ii) at least two representatives of lead agencies located outside of a metropolitan county,
207.31 as defined in Minnesota Statutes, section 473.121, subdivision 4;
  Article 6 Sec. 9.  207
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208.1      (3) one staff member from the Minnesota Social Service Association, appointed by the
208.2  Minnesota Social Service Association;
208.3      (4) at least three representatives from Tribal Nations, appointed by the commissioner;
208.4      (5) two representatives of disability advocacy organizations, appointed by the
208.5  commissioner; and
208.6      (6) additional nonvoting participants as determined by the commissioner, which may
208.7  include staff from the Department of Human Services and other interested parties.
208.8      Subd. 3. Duties. The working group shall make recommendations to shift the
208.9  responsibility and administration of conducting MnCHOICES assessments to the state.
208.10 Recommendations must include:
208.11     (1) defined roles and responsibilities between county, Tribal Nation, and state functions;
208.12     (2) revised payment methodologies and financing of duties;
208.13     (3) efficient workflows between local and state functions;
208.14     (4) service continuity for people seeking and receiving long-term services and supports;
208.15 and
208.16     (5) methods for gathering public feedback and providing public awareness.
208.17     Subd. 4. Terms, compensation, and removal. The terms, compensation, and removal
208.18 of the working group members are governed by Minnesota Statutes, section 15.059,
208.19 subdivision 3.
208.20     Subd. 5. Meetings; administrative support. (a) The first meeting of the working group
208.21 must be convened no later than August 1, 2026. The working group must meet at least
208.22 monthly. The working group may meet by telephone or interactive technology consistent
208.23 with Minnesota Statutes, section 13D.015.
208.24     (b) The Department of Human Services shall provide staff and administrative support
208.25 to convene the working group, facilitate working group meetings, and prepare the final
208.26 report.
208.27     Subd. 6. Report. By September 1, 2027, the commissioner must submit a report of the
208.28 working group's findings and recommendations, including but not limited to any legislative
208.29 changes necessary to implement the recommendations, to the chairs and ranking minority
208.30 members of the legislative committees with jurisdiction over human services policy and
208.31 finance.
  Article 6 Sec. 9.  208
  04/06/26  REVISOR        DTT/CH  26-08138  as introduced
209.1      Subd. 7. Expiration. The working group expires upon submission of the report required
209.2  under subdivision 6.
209.3    Sec. 10. DIRECTION TO COMMISSIONER; WAIVER CASE MANAGEMENT
209.4  REQUIREMENTS AND COSTS STUDY.
209.5      (a) The commissioner of human services must analyze and provide recommendations
209.6  on waiver case management services. The commissioner must develop a request for proposals
209.7  for a contract with a third party to conduct a study. The study and recommendations must
209.8  include:
209.9      (1) definition of roles and responsibilities for waiver case management services, including
209.10 but not limited to oversight functions and requirements of waiver case management services;
209.11     (2) an assessment of providing waiver case management in acute care settings to ensure
209.12 continuity of care; and
209.13     (3) an update to the rate methodology to ensure payments reflect the costs of providing
209.14 waiver case management services.
209.15     (b) The commissioner must consult with lead agencies, providers across the spectrum
209.16 of services and regions of the state, and culturally responsive providers in the development
209.17 of the request for proposals for the study and for the duration of the contract.
209.18     (c) By June 30, 2027, the commissioner must submit a final report to the chairs and
209.19 ranking minority members of the legislative committees with jurisdiction over human
209.20 services policy and finance that includes the results of the analysis and the recommendations
209.21 required under this section.
209.22   Sec. 11. DIRECTION TO COMMISSIONER; ASSESSMENT OF
209.23 ADMINISTRATION ROLES.
209.24     (a) The commissioner of human services, in consultation with Tribal Nations and counties,
209.25 must conduct a study to assess and recommend improvements to the roles and responsibilities
209.26 of the state agency, counties, and Tribal Nations in administering human services programs.
209.27     (b) The study must include a comprehensive review of programs administered by the
209.28 department, including but not limited to medical assistance, MinnesotaCare, behavioral
209.29 health services, long-term services and supports, housing and homelessness programs,
209.30 Minnesota supplemental aid, general assistance, and licensing and oversight functions.
209.31     (c) The study must evaluate the:
  Article 6 Sec. 11.  209
  04/06/26  REVISOR  DTT/CH  26-08138  as introduced
210.1      (1) current roles and responsibilities held by the state agency, counties, and Tribal Nations
210.2  in administering human services programs, including but not limited to the challenges and
210.3  benefits of the current delegation of roles and responsibilities;
210.4      (2) lived experience of people accessing human services programs related to the
210.5  delegation of administrative duties;
210.6      (3) financing of human services program administration across the state agency, counties,
210.7  and Tribal Nations; and
210.8      (4) administration of human services programs in other states, focusing on the roles and
210.9  responsibilities of the local governments versus the state Medicaid or human services agency,
210.10 and identifying the benefits, challenges, and financing of the delegation of duties.
210.11     (d) The study must focus on the goals of transforming the human services system to
210.12 ensure a transparent, accessible, accountable, equitable, and effective human services system.
210.13     (e) The study must provide recommendations for the optimal delegation of duties between
210.14 the state agency, counties, and Tribal Nations in the delivery of human services.
210.15 Recommendations must include:
210.16     (1) how the delegation of duties will improve the experience of people accessing human
210.17 services;
210.18     (2) implementation and timing considerations to ensure continuity of services;
210.19     (3) systems technology adaptations required;
210.20     (4) workforce considerations; and
210.21     (5) financing strategies and the estimated fiscal impact to the state budget.
210.22     (f) By October 1, 2028, the commissioner must submit a report on the study and
210.23 recommendations to the chairs and ranking minority members of the legislative committees
210.24 with jurisdiction over health and human services policy and finance.
210.25   Sec. 12. REPEALER.
210.26     (a) Minnesota Statutes 2024, section 256B.0371, subdivisions 1, 2, and 4, are repealed.
210.27     (b) Minnesota Statutes 2025 Supplement, sections 256B.0371, subdivision 3; and
210.28 256B.696, are repealed.
210.29     (c) Minnesota Statutes 2025 Supplement, section 256B.695, is repealed.
  Article 6 Sec. 12.  210
  04/06/26  REVISOR  DTT/CH  26-08138  as introduced
211.1      EFFECTIVE DATE. Paragraphs (a) and (b) are effective the day following final
211.2  enactment. Paragraph (c) is effective January 1, 2029, or upon the date the administrative
211.3  service organization begins administering medical assistance under Minnesota Statutes,
211.4  section 256B.697, whichever is later. The commissioner of human services must notify the
211.5  revisor of statutes when the administrative service organization begins administering medical
211.6  assistance.
211.7ARTICLE 7
211.8HUMAN SERVICES FORECAST ADJUSTMENTS
211.9  Section 1. HUMAN SERVICES FORECAST ADJUSTMENTS.
211.10     The sums shown in the columns marked "Appropriations" are added to or, if shown in
211.11 parentheses, subtracted from the appropriations in Laws 2025, First Special Session chapter
211.12 3, article 20, and Laws 2025, First Special Session chapter 9, article 12, to the commissioner
211.13 of human services from the general fund or other named fund for the purposes specified in
211.14 section 2 and are available for the fiscal years indicated for each purpose. The figures "2026"
211.15 and "2027" used in this article mean that the addition to or subtraction from the appropriation
211.16 listed under them is available for the fiscal year ending June 30, 2026, or June 30, 2027,
211.17 respectively.
211.18APPROPRIATIONS
211.19Available for the Year
211.20Ending June 30
211.212026  2027
211.22 Sec. 2. COMMISSIONER OF HUMAN
211.23 SERVICES.
211.24 Subdivision 1. Total Appropriation  $   739,634,000 $    775,035,000
211.25Appropriations by Fund
211.26 General Fund  652,953,000      615,407,000
211.27 Health Care Access
211.28 Fund  86,681,000      159,628,000
211.29 Subd. 2. Forecasted Programs
211.30 (a) General Assistance  7,909,000  9,653,000
211.31 (b) Minnesota Supplemental Aid  2,976,000  3,233,000
211.32 (c) Housing Support  29,593,000        44,727,000
211.33 (d) MinnesotaCare  86,681,000       159,628,000
  Article 7 Sec. 2.  211
  04/06/26  REVISOR  DTT/CH  26-08138  as introduced
212.1  These appropriations are from the health care
212.2  access fund.
212.3  (e) Medical Assistance  589,777,000  525,140,000
212.4  (f) Behavioral Health Fund  22,698,000  32,654,000
212.5    Sec. 3. EFFECTIVE DATE.
212.6      This article is effective the day following final enactment.
212.7ARTICLE 8
212.8DEPARTMENT OF HUMAN SERVICES APPROPRIATIONS
212.9  Section 1. HUMAN SERVICES APPROPRIATIONS.
212.10     The dollar amounts shown in the columns marked "Appropriations" are added to or, if
212.11 shown in parentheses, are subtracted from the appropriations in Laws 2025, First Special
212.12 Session chapter 9, article 12, from the general fund or any fund named for the purposes
212.13 specified in this article, to be available for the fiscal year indicated for each purpose. The
212.14 figures "2026" and "2027" used in this article mean that the appropriations listed under them
212.15 are available for the fiscal years ending June 30, 2026, or June 30, 2027, respectively. "The
212.16 first year" is fiscal year 2026. "The second year" is fiscal year 2027. "The biennium" is
212.17 fiscal years 2026 and 2027.
212.18APPROPRIATIONS
212.19Available for the Year
212.20Ending June 30
212.212026  2027
212.22 Sec. 2. TOTAL APPROPRIATION  $     (822,000) $      (145,196,000)
212.23Appropriations by Fund
212.242026  2027
212.25 General  (822,000)     (147,209,000)
212.26 Special Government
212.27 Revenue Fund  -0-  2,013,000
212.28 Sec. 3. CENTRAL OFFICE; OPERATIONS  $  -0- $     30,851,000
212.29 Subdivision 1. Evaluation of DHS Structure and
212.30 Processes
212.31 $500,000 in fiscal year 2027 is for a
212.32 comprehensive evaluation of the Department
212.33 of Human Service's structure and processes.
  Article 8 Sec. 3.  212
  04/06/26  REVISOR  DTT/CH  26-08138  as introduced
213.1  This is a onetime appropriation and is
213.2  available until June 30, 2028.
213.3  Subd. 2. Base Level Adjustment
213.4  The general fund base is increased by
213.5  $21,665,000 in fiscal year 2028 and increased
213.6  by $19,895,000 in fiscal year 2029.
213.7  Sec. 4. CENTRAL OFFICE; HEALTH CARE $  -0- $   34,186,000
213.8  Subdivision 1. Medical Assistance Eligibility
213.9  Study
213.10 $2,000,000 in fiscal year 2027 is for a study
213.11 on the transfer of eligibility functions of the
213.12 medical assistance program performed by
213.13 county and Tribal governments to the
213.14 Department of Human Services. This is a
213.15 onetime appropriation and is available until
213.16 June 30, 2029.
213.17 Subd. 2. Base Level Adjustment
213.18 The general fund base is increased by
213.19 $70,976,000 in fiscal year 2028 and increased
213.20 by $86,272,000 in fiscal year 2029.
213.21 Sec. 5. CENTRAL OFFICE; AGING AND
213.22 DISABILITY SERVICES  $  -0- $    7,589,000
213.23 Subdivision 1. Market Rate and Homemaking
213.24 Services Rate Study
213.25 $500,000 in fiscal year 2027 is for a study on
213.26 rate setting methodologies for services
213.27 currently offered under market rate
213.28 methodologies and homemaking services. This
213.29 is onetime appropriation and is available until
213.30 June 30, 2028.
213.31 Subd. 2. Waiver Case Management Study
213.32 $300,000 in fiscal year 2027 is for a study on
213.33 waiver case management services. This is a
  Article 8 Sec. 5.  213
  04/06/26  REVISOR  DTT/CH  26-08138  as introduced
214.1  onetime appropriation and is available until
214.2  June 30, 2028.
214.3  Subd. 3. Base Level Adjustment
214.4  The general fund base is increased by
214.5  $15,839,000 in fiscal year 2028 and increased
214.6  by $17,129,000 in fiscal year 2029.
214.7  Sec. 6. CENTRAL OFFICE; BEHAVIORAL
214.8  HEALTH  $  -0- $      568,000
214.9  Subdivision 1. Coordinated Specialty Care
214.10 Evaluation
214.11 $250,000 in fiscal year 2027 is for evaluation,
214.12 provider training, capacity building, and
214.13 outcome reporting related to the
214.14 implementation of coordinated specialty care.
214.15 The base for this appropriation is $250,000 in
214.16 fiscal year 2028 and $150,000 in fiscal year
214.17 2029.
214.18 Subd. 2. Access to Services for Incarcerated
214.19 Individuals Evaluation
214.20 $150,000 in fiscal year 2027 is for community
214.21 engagement and evaluation related reentry
214.22 services.
214.23 Subd. 3. Base Level Adjustment
214.24 The general fund base is increased by
214.25 $993,000 in fiscal year 2028 and increased by
214.26 $858,000 in fiscal year 2029.
214.27 Sec. 7. CENTRAL OFFICE; OFFICE OF
214.28 INSPECTOR GENERAL  $  -0- $   37,841,000
214.29 Subdivision 1. Appropriations by Fund
214.30Appropriations by Fund
214.312026  2027
214.32 General Fund  -0-  35,828,000
214.33 Special Government
214.34 Revenue Fund  -0-  2,013,000
  Article 8 Sec. 7.  214
  04/06/26  REVISOR        DTT/CH  26-08138  as introduced
215.1  Subd. 2. Base Level Adjustment
215.2  The general fund base is increased by
215.3  $36,259,000 in fiscal year 2028 and increased
215.4  by $36,259,000 in fiscal year 2029. The
215.5  special revenue government fund base is
215.6  increased by $2,352,000 in fiscal year 2028
215.7  and increased by $2,352,000 in fiscal year
215.8  2029.
215.9  Sec. 8. FORECASTED PROGRAMS;
215.10 HOUSING SUPPORT  $  -0- $     12,524,000
215.11 Sec. 9. FORECASTED PROGRAMS;
215.12 MEDICAL ASSISTANCE  $  -0- $   (250,391,000)
215.13 Base Level Adjustment. The general fund
215.14 base for this section is increased by
215.15 $8,883,000 in fiscal year 2029 for increases
215.16 in Medical Assistance payment rates for the
215.17 implementation of the Administrative Service
215.18 Organization model.
215.19 Sec. 10. FORECASTED PROGRAMS;
215.20 ALTERNATIVE CARE  $  -0- $       (160,000)
215.21 Sec. 11. FORECASTED PROGRAMS;
215.22 BEHAVIORAL HEALTH FUND  $  -0- $    (26,259,000)
215.23 Sec. 12. REFUGEE SERVICE GRANTS  $  -0- $     10,000,000
215.24 This is a onetime appropriation.
215.25 Sec. 13. HOUSING SUPPORT GRANTS  $  -0- $       1,442,000
215.26 Subdivision 1. Housing Support Agreements
215.27 Grants
215.28 $1,250,000 in fiscal year 2027 is for grants to
215.29 utilize a collaborative model whereby a
215.30 housing support provider operating under
215.31 section 256I.04 connects eligible individuals
215.32 receiving integrated community supports with
215.33 housing support assistance. This is a onetime
215.34 appropriation and is available until June 30,
215.35 2028.
  Article 8 Sec. 13.  215
  04/06/26  REVISOR        DTT/CH  26-08138  as introduced
216.1  Subd. 2. Base Level Adjustment
216.2  The general fund base is increased by
216.3  $192,000 in fiscal year 2028 and increased by
216.4  $192,000 in fiscal year 2029.
216.5  Sec. 14. GRANT PROGRAMS; ADULT
216.6  MENTAL HEALTH GRANTS  $  -0- $   (1,317,000)
216.7  Sec. 15. GRANT PROGRAMS; CHILDREN'S
216.8  MENTAL HEALTH GRANTS  $  -0- $       361,000
216.9  Sec. 16. GRANT PROGRAMS; CHEMICAL
216.10 DEPENDENCY TREATMENT SUPPORT
216.11 GRANTS  $  -0- $     (361,000)
216.12   Sec. 17. Laws 2024, chapter 125, article 8, section 2, subdivision 4, is amended to read:
216.13 Subd. 4. Central Office; Aging and Disability
216.14 Services  (2,664,000)  4,164,000
216.15 (a) Tribal Vulnerable Adult and
216.16 Developmental Disabilities Targeted Case
216.17 Management Medical Assistance Benefit.
216.18 $200,000 in fiscal year 2025 is for a contract
216.19 to develop a Tribal vulnerable adult and
216.20 developmental disabilities targeted case
216.21 management medical assistance benefit under
216.22 Minnesota Statutes, section 256B.0924. This
216.23 is a onetime appropriation. Notwithstanding
216.24 Minnesota Statutes, section 16A.28,
216.25 subdivision 3, this appropriation is available
216.26 until June 30, 2027.
216.27 (b) Disability Services Person-Centered
216.28 Engagement and Navigation Study.
216.29 $600,000 in fiscal year 2025 is for the
216.30 disability services person-centered engagement
216.31 and navigation study. This is a onetime
216.32 appropriation. Notwithstanding Minnesota
216.33 Statutes, section 16A.28, subdivision 3, this
216.34 appropriation is available until June 30, 2026.
  Article 8 Sec. 17.  216
  04/06/26  REVISOR  DTT/CH  26-08138  as introduced
217.1  (c) Pediatric Hospital-to-Home Transition
217.2  Pilot Program Administration. $300,000 in
217.3  fiscal year 2025 is for a contract related to the
217.4  pediatric hospital-to-home transition pilot
217.5  program. This is a onetime appropriation.
217.6  Notwithstanding Minnesota Statutes, section
217.7  16A.28, subdivision 3, this appropriation is
217.8  available until June 30, 2027 2028.
217.9  (d) Reimbursement for Community-First
217.10 Services and Supports Workers Report.
217.11 $250,000 in fiscal year 2025 is for a contract
217.12 related to the reimbursement for
217.13 community-first services and supports workers
217.14 report. This is a onetime appropriation.
217.15 Notwithstanding Minnesota Statutes, section
217.16 16A.28, subdivision 3, this appropriation is
217.17 available until June 30, 2026.
217.18 (e) Carryforward Authority.
217.19 Notwithstanding Minnesota Statutes, section
217.20 16A.28, subdivision 3, $758,000 in fiscal year
217.21 2025 is available until June 30, 2026, and
217.22 $2,687,000 in fiscal year 2025 is available
217.23 until June 30, 2027.
217.24 (f) Base Level Adjustment. The general fund
217.25 base is increased by $340,000 in fiscal year
217.26 2026 and increased by $340,000 in fiscal year
217.27 2027.
217.28   Sec. 18. Laws 2024, chapter 125, article 8, section 2, subdivision 14, as amended by Laws
217.29 2025, First Special Session chapter 9, article 12, section 29, is amended to read:
217.30 Subd. 14. Grant Programs; Disabilities Grants  1,650,000  9,574,000
217.31 (a) Capital Improvement for Accessibility.
217.32 $400,000 in fiscal year 2025 is for a payment
217.33 to Anoka County to make capital
217.34 improvements to existing space in the Anoka
  Article 8 Sec. 18.  217
  04/06/26  REVISOR  DTT/CH  26-08138   as introduced
218.1  County Human Services building in the city
218.2  of Blaine, including making bathrooms fully
218.3  compliant with the Americans with Disabilities
218.4  Act with adult changing tables and ensuring
218.5  barrier-free access for the purposes of
218.6  improving and expanding the services an
218.7  existing building tenant can provide to adults
218.8  with developmental disabilities. This is a
218.9  onetime appropriation.
218.10 (b) Dakota County Disability Services
218.11 Workforce Shortage Pilot Project. $500,000
218.12 in fiscal year 2025 is for a grant to Dakota
218.13 County for innovative solutions to the
218.14 disability services workforce shortage. Up to
218.15 $250,000 of this amount must be used to
218.16 develop and test an online application for
218.17 matching requests for services from people
218.18 with disabilities to available staff, and up to
218.19 $250,000 of this amount must be used to
218.20 develop a communities-for-all program that
218.21 engages businesses, community organizations,
218.22 neighbors, and informal support systems to
218.23 promote community inclusion of people with
218.24 disabilities. By October 1, 2026, the
218.25 commissioner shall report the outcomes and
218.26 recommendations of these pilot projects to the
218.27 chairs and ranking minority members of the
218.28 legislative committees with jurisdiction over
218.29 human services finance and policy. This is a
218.30 onetime appropriation. Notwithstanding
218.31 Minnesota Statutes, section 16A.28,
218.32 subdivision 3, this appropriation is available
218.33 until June 30, 2027.
218.34 (c) Pediatric Hospital-to-Home Transition
218.35 Pilot Program. $1,040,000 in fiscal year 2025
  Article 8 Sec. 18.  218
  04/06/26  REVISOR  DTT/CH  26-08138   as introduced
219.1  is for the pediatric hospital-to-home pilot
219.2  program. This is a onetime appropriation.
219.3  Notwithstanding Minnesota Statutes, section
219.4  16A.28, subdivision 3, this appropriation is
219.5  available until June 30, 2027 2028.
219.6  (d) Artists With Disabilities Support.
219.7  $690,000 in fiscal year 2025 is for a payment
219.8  to a nonprofit organization licensed under
219.9  Minnesota Statutes, chapter 245D, located on
219.10 Minnehaha Avenue West in Saint Paul, and
219.11 that supports artists with disabilities in creating
219.12 visual and performing art that challenges
219.13 society's views of persons with disabilities.
219.14 This is a onetime appropriation.
219.15 Notwithstanding Minnesota Statutes, section
219.16 16A.28, subdivision 3, this appropriation is
219.17 available until June 30, 2027.
219.18 (e) Emergency Relief Grants for Rural
219.19 EIDBI Providers. $600,000 in fiscal year
219.20 2025 is for emergency relief grants for EIDBI
219.21 providers. This is a onetime appropriation.
219.22 Notwithstanding Minnesota Statutes, section
219.23 16A.28, subdivision 3, this appropriation is
219.24 available until June 30, 2027.
219.25 (f) Self-Advocacy Grants for Persons with
219.26 Intellectual and Developmental Disabilities.
219.27 $250,000 in fiscal year 2025 is for
219.28 self-advocacy grants under Minnesota Statutes,
219.29 section 256.477, subdivision 1, paragraph (a),
219.30 clauses (5) to (7), and for administrative costs.
219.31 This is a onetime appropriation and is
219.32 available until June 30, 2027.
219.33 (g) Electronic Visit Verification
219.34 Implementation Grants. $864,000 in fiscal
219.35 year 2025 is for electronic visit verification
  Article 8 Sec. 18.  219
  04/06/26  REVISOR  DTT/CH  26-08138   as introduced
220.1  implementation grants. This is a onetime
220.2  appropriation. Notwithstanding Minnesota
220.3  Statutes, section 16A.28, subdivision 3, this
220.4  appropriation is available until June 30, 2027.
220.5  (h) Aging and Disability Services for
220.6  Immigrant and Refugee Communities.
220.7  $250,000 in fiscal year 2025 is for a payment
220.8  to SEWA-AIFW to address aging, disability,
220.9  and mental health needs for immigrant and
220.10 refugee communities. This is a onetime
220.11 appropriation and is available until June 30,
220.12 2027.
220.13 (i) License Transition Support for Small
220.14 Disability Waiver Providers. $3,150,000 in
220.15 fiscal year 2025 is for license transition
220.16 payments to small disability waiver providers.
220.17 This is a onetime appropriation.
220.18 Notwithstanding Minnesota Statutes, section
220.19 16A.28, subdivision 3, this appropriation is
220.20 available until June 30, 2027.
220.21 (j) Own home services provider
220.22 capacity-building grants. $1,519,000 in fiscal
220.23 year 2025 is for the own home services
220.24 provider capacity-building grant program.
220.25 Notwithstanding Minnesota Statutes, section
220.26 16A.28, subdivision 3, this appropriation is
220.27 available until June 30, 2027. This is a onetime
220.28 appropriation.
220.29 (k) Continuation of Centers for
220.30 Independent Living HCBS Access Grants.
220.31 $311,000 in fiscal year 2024 is for continued
220.32 funding of grants awarded under Laws 2021,
220.33 First Special Session chapter 7, article 17,
220.34 section 19, as amended by Laws 2022, chapter
220.35 98, article 15, section 15. This is a onetime
  Article 8 Sec. 18.  220
  04/06/26  REVISOR        DTT/CH  26-08138  as introduced
221.1  appropriation and is available until June 30,
221.2  2025.
221.3  (l) Base Level Adjustment. The general fund
221.4  base is increased by $811,000 in fiscal year
221.5  2026 and increased by $811,000 in fiscal year
221.6  2027.
221.7    Sec. 19. TRANSFERS AND CANCELLATIONS.
221.8      Subdivision 1. MnCHOICES modification grants. The fiscal year 2027 general fund
221.9  base appropriation for MnCHOICES modifications is reduced from $125,000 to $0 first
221.10 established under Laws 2023, chapter 61, article 9, section 2, subdivision 16. The general
221.11 fund base for this purpose is $0 in fiscal year 2028 and $0 in fiscal year 2029.
221.12     Subd. 2. Day training and habilitation facility grants. The fiscal year 2028 and fiscal
221.13 year 2029 general fund base appropriations for grant allocations to counties for day training
221.14 and habilitation services for adults with developmental disabilities when provided as a social
221.15 service under Minnesota Statutes, sections 252.41 to 252.46, are reduced from $811,000 to
221.16 $0. The general fund base for this purpose is also reduced to $0.
221.17     Subd. 3. Innovation grants. The fiscal year 2027 general fund base appropriations for
221.18 the innovation grants program under Minnesota Statutes, section 256B.0921, are reduced
221.19 from $1,925,000 to $0. The general fund base for this purpose is also reduced to $0.
221.20     Subd. 4. Preadmission screening grant program. The fiscal year 2027 general fund
221.21 base appropriation for the preadmission screening grant program under Minnesota Statutes,
221.22 section 256.975, subdivision 7d, paragraph (b), is reduced from $20,000 to $0. The general
221.23 fund base for this purpose is also reduced to $0.
221.24     Subd. 5. 2023 long-term services and supports loan program. Any unencumbered
221.25 and unexpended amount of the long-term services and supports program under Minnesota
221.26 Statutes, section 256.4792, subdivision 8a, estimated to be $70,854,000, is transferred from
221.27 the special revenue fund to the general fund and is canceled.
221.28     Subd. 6. 2024 long-term services and supports loan program. The fiscal year 2026
221.29 general fund base appropriations for the long-term services and supports loan program first
221.30 established under Laws 2024, chapter 125, article 8, section 1, subdivision 12, paragraph
221.31 (e), are reduced from $822,000 to $0.
  Article 8 Sec. 19.  221
  04/06/26  REVISOR  DTT/CH  26-08138  as introduced
222.1ARTICLE 9
222.2OTHER AGENCY APPROPRIATIONS
222.3  Section 1. OTHER AGENCY APPROPRIATIONS.
222.4      The dollar amounts shown in the columns marked "Appropriations" are added to or, if
222.5  shown in parentheses, are subtracted from the appropriations in Laws 2025, First Special
222.6  Session chapter 9, article 14, from the general fund or any fund named for the purposes
222.7  specified in this article, to be available for the fiscal year indicated for each purpose. The
222.8  figures "2026" and "2027" used in this article mean that the appropriations listed under them
222.9  are available for the fiscal years ending June 30, 2026, or June 30, 2027, respectively. "The
222.10 first year" is fiscal year 2026. "The second year" is fiscal year 2027. "The biennium" is
222.11 fiscal years 2026 and 2027.
222.12APPROPRIATIONS
222.13Available for the Year
222.14Ending June 30
222.152026  2027
222.16 Sec. 2. COMMISSIONER OF HEALTH;
222.17 TOTAL APPROPRIATION  $  -0- $      1,125,000
222.18 The amounts that may be spent for each
222.19 purpose are specified in the following sections.
222.20 Sec. 3. HEALTH IMPROVEMENT  $  -0- $      1,125,000
222.21   Sec. 4. DEPARTMENT OF CHILDREN, YOUTH, AND FAMILIES
222.22 APPROPRIATION; LOCAL ADMINISTRATION ASSESSMENT.
222.23     $2,500,000 in fiscal year 2027 is appropriated from the general fund to the commissioner
222.24 of children, youth, and families for an assessment of state, county, and Tribal Nation roles
222.25 in administering human services programs. This is a onetime appropriation and is available
222.26 until June 30, 2029.
  Article 9 Sec. 4.  222
  APPENDIX
  Article locations for 26-08138
ARTICLE 1   AGING AND DISABILITY SERVICES............................................... Page.Ln 2.18
ARTICLE 2   BEHAVIORAL HEALTH...................................................................... Page.Ln 63.16
  DEPARTMENT OF HUMAN SERVICES OFFICE OF INSPECTOR
ARTICLE 3   GENERAL.............................................................................................. Page.Ln 86.5
ARTICLE 4   UNIFORM SERVICE STANDARDS.................................................... Page.Ln 102.1
ARTICLE 5   BACKGROUND STUDIES................................................................... Page.Ln 162.17
ARTICLE 6   MISCELLANEOUS............................................................................... Page.Ln 201.1
ARTICLE 7   HUMAN SERVICES FORECAST ADJUSTMENTS........................... Page.Ln 211.7
ARTICLE 8   DEPARTMENT OF HUMAN SERVICES APPROPRIATIONS.......... Page.Ln 212.7
ARTICLE 9   OTHER AGENCY APPROPRIATIONS............................................... Page.Ln 222.1
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  APPENDIX
  Repealed Minnesota Statutes: 26-08138
    245.735 CERTIFIED COMMUNITY BEHAVIORAL HEALTH CLINIC SERVICES.
    Subd. 1a. Definitions. (a) For the purposes of this section, the terms in this subdivision have
the meanings given.
    (b) "Alcohol and drug counselor" has the meaning given in section 245G.11, subdivision 5.
    (c) "Care coordination" means the activities required to coordinate care across settings and
providers for a person served to ensure seamless transitions across the full spectrum of health
services. Care coordination includes outreach and engagement; documenting a plan of care for
medical, behavioral health, and social services and supports in the integrated treatment plan; assisting
with obtaining appointments; confirming appointments are kept; developing a crisis plan; tracking
medication; and implementing care coordination agreements with external providers. Care
coordination may include psychiatric consultation with primary care practitioners and with mental
health clinical care practitioners.
    (d) "Community needs assessment" means an assessment to identify community needs and
determine the community behavioral health clinic's capacity to address the needs of the population
being served.
    (e) "Comprehensive evaluation" means a person-centered, family-centered, and trauma-informed
evaluation meeting the requirements of subdivision 4b completed for the purposes of diagnosis and
treatment planning.
   (f) "Designated collaborating organization" means an entity meeting the requirements of
subdivision 3a with a formal agreement with a CCBHC to furnish CCBHC services.
    (g) "Functional assessment" means an assessment of a client's current level of functioning
relative to functioning that is appropriate for someone the client's age and that meets the requirements
of subdivision 4a.
    (h) "Initial evaluation" means an evaluation completed by a mental health professional that
gathers and documents information necessary to formulate a preliminary diagnosis and begin client
services.
   (i) "Integrated treatment plan" means a documented plan of care that is person- and
family-centered and formulated to respond to a client's needs and goals.
    (j) "Mental health professional" has the meaning given in section 245I.04, subdivision 2.
    (k) "Mobile crisis services" has the meaning given in section 256B.0624, subdivision 2.
    (l) "Preliminary screening and risk assessment" means a mandatory screening and risk assessment
that is completed at the first contact with the prospective CCBHC service recipient and determines
the acuity of client need.
    Subd. 2a. Establishment. The certified community behavioral health clinic model is an integrated
payment and service delivery model that uses evidence-based behavioral health practices to achieve
better outcomes for individuals experiencing behavioral health concerns while achieving sustainable
rates for providers and economic efficiencies for payors.
    Subd. 3. Certified community behavioral health clinics. (a) The commissioner shall establish
state certification and recertification processes for certified community behavioral health clinics
(CCBHCs) that satisfy all federal requirements necessary for CCBHCs certified under this section
to be eligible for reimbursement under medical assistance, without service area limits based on
geographic area or region. The commissioner shall consult with CCBHC stakeholders before
establishing and implementing changes in the certification or recertification process and requirements.
Any changes to the certification or recertification process or requirements must be consistent with
the most recently issued Certified Community Behavioral Health Clinic Certification Criteria
published by the Substance Abuse and Mental Health Services Administration. The commissioner
must allow a transition period for CCBHCs to meet the revised criteria on or before January 1,
2025. The commissioner is authorized to amend the state's Medicaid state plan or the terms of the
demonstration to comply with federal requirements.
    (b) As part of the state CCBHC certification and recertification processes, the commissioner
shall provide to entities applying for certification or requesting recertification the standard
requirements of the community needs assessment and the staffing plan that are consistent with the
most recently issued Certified Community Behavioral Health Clinic Certification Criteria published
by the Substance Abuse and Mental Health Services Administration.
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  Repealed Minnesota Statutes: 26-08138
    (c) The commissioner shall schedule a certification review that includes a site visit within 90
calendar days of receipt of an application for certification or recertification.
       (d) Entities that choose to be CCBHCs must:
    (1) complete a community needs assessment and complete a staffing plan that is responsive to
the needs identified in the community needs assessment and update both the community needs
assessment and the staffing plan no less frequently than every 36 months;
       (2) comply with state licensing requirements and other requirements issued by the commissioner;
    (3) employ or contract with a medical director. A medical director must be a physician licensed
under chapter 147 and either certified by the American Board of Psychiatry and Neurology, certified
by the American Osteopathic Board of Neurology and Psychiatry, or eligible for board certification
in psychiatry. A registered nurse who is licensed under sections 148.171 to 148.285 and is certified
as a nurse practitioner in adult or family psychiatric and mental health nursing by a national nurse
certification organization may serve as the medical director when a CCBHC is unable to employ
or contract a qualified physician;
    (4) employ or contract for clinic staff who have backgrounds in diverse disciplines, including
licensed mental health professionals and licensed alcohol and drug counselors, and staff who are
culturally and linguistically trained to meet the needs of the population the clinic serves;
    (5) ensure that clinic services are available and accessible to individuals and families of all ages
and genders with access on evenings and weekends and that crisis management services are available
24 hours per day;
    (6) establish fees for clinic services for individuals who are not enrolled in medical assistance
using a sliding fee scale that ensures that services to patients are not denied or limited due to an
individual's inability to pay for services;
    (7) comply with quality assurance reporting requirements and other reporting requirements
included in the most recently issued Certified Community Behavioral Health Clinic Certification
Criteria published by the Substance Abuse and Mental Health Services Administration;
    (8) provide crisis mental health and substance use services, withdrawal management services,
emergency crisis intervention services, and stabilization services through existing mobile crisis
services; screening, assessment, and diagnosis services, including risk assessments and level of
care determinations; person- and family-centered treatment planning; outpatient mental health and
substance use services; targeted case management; psychiatric rehabilitation services; peer support
and counselor services and family support services; and intensive community-based mental health
services, including mental health services for members of the armed forces and veterans. CCBHCs
must directly provide the majority of these services to enrollees, but may coordinate some services
with another entity through a collaboration or agreement, pursuant to subdivision 3a;
    (9) provide coordination of care across settings and providers to ensure seamless transitions for
individuals being served across the full spectrum of health services, including acute, chronic, and
behavioral needs;
       (10) be certified as a mental health clinic under section 245I.20;
    (11) comply with standards established by the commissioner relating to CCBHC screenings,
assessments, and evaluations that are consistent with this section;
       (12) be licensed to provide substance use disorder treatment under chapter 245G;
       (13) be certified to provide children's therapeutic services and supports under section 256B.0943;
       (14) be certified to provide adult rehabilitative mental health services under section 256B.0623;
       (15) be enrolled to provide mental health crisis response services under section 256B.0624;
   (16) be enrolled to provide mental health targeted case management under section 256B.0625,
subdivision 20;
       (17) provide services that comply with the evidence-based practices described in subdivision
3d;
   (18) provide peer services as defined in sections 256B.0615, 256B.0616, and 245G.07,
subdivision 2a, paragraph (b), clause (2), as applicable when peer services are provided; and
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  (19) inform all clients upon initiation of care of the full array of services available under the
CCBHC model.
   Subd. 3a. Designated collaborating organizations. If a certified CCBHC is unable to provide
one or more of the services listed in subdivision 3, paragraph (d), clauses (8) to (19), the CCBHC
may contract with another entity that has the required authority to provide that service and that
meets the requirements of the most recently issued Certified Community Behavioral Health Clinic
Certification Criteria published by the Substance Abuse and Mental Health Services Administration.
    Subd. 3b. Exemptions to host county approval. Notwithstanding any other law that requires
a county contract or other form of county approval for a service listed in subdivision 3, paragraph
(d), clause (8), a CCBHC that meets the requirements of this section may receive the prospective
payment under section 256B.0625, subdivision 5m, for that service without a county contract or
county approval.
    Subd. 3c. Variances. When the standards listed in this section or other applicable standards
conflict or address similar issues in duplicative or incompatible ways, the commissioner may grant
variances to state requirements if the variances do not conflict with federal requirements for services
reimbursed under medical assistance. If standards overlap, the commissioner may substitute all or
a part of a licensure or certification that is substantially the same as another licensure or certification.
The commissioner shall consult with stakeholders before granting variances under this provision.
For a CCBHC that is certified but not approved for prospective payment under section 256B.0625,
subdivision 5m, the commissioner may grant a variance under this paragraph if the variance does
not increase the state share of costs.
    Subd. 3d. Evidence-based practices. The commissioner shall issue a list of required
evidence-based practices to be delivered by CCBHCs and may also provide a list of recommended
evidence-based practices. The commissioner may update the list to reflect advances in outcomes
research and medical services for persons living with mental illnesses or substance use disorders.
The commissioner shall take into consideration the adequacy of evidence to support the efficacy
of the practice across cultures and ages, the workforce available, and the current availability of the
practice in the state. At least 30 days before issuing the initial list or issuing any revisions, the
commissioner shall provide stakeholders with an opportunity to comment.
    Subd. 3e. Recertification. A CCBHC must apply for recertification every 36 months.
    Subd. 3f. Notice and opportunity for correction. (a) The commissioner shall provide a formal
written notice to an applicant for CCBHC certification outlining the determination of the application
and process for applicable and necessary corrective action required of the applicant signed by the
commissioner or appropriate division director to applicant entities within 45 calendar days of the
site visit.
    (b) The commissioner may reject an application if the applicant entity does not take all corrective
actions specified in the notice and notify the commissioner that the applicant entity has done so
within 60 calendar days.
    (c) The commissioner must send the applicant entity a final decision on the corrected application
within 45 calendar days of the applicant entity's notice to the commissioner that the applicant has
taken the required corrective actions.
    Subd. 3g. Decertification process. The commissioner must establish a process for decertification.
The commissioner must require corrective action, medical assistance repayment, or decertification
of a CCBHC that no longer meets the requirements in this section or that fails to meet the standards
provided by the commissioner in the application, certification, or recertification process.
    Subd. 3h. Minimum staffing standards. A CCBHC must meet minimum staffing requirements
required by the most recently issued Certified Community Behavioral Health Clinic Certification
Criteria published by the Substance Abuse and Mental Health Services Administration.
    Subd. 4a. Functional assessment requirements. (a) For adults, a functional assessment may
be completed using a Daily Living Activities-20 tool.
    (b) Notwithstanding any law to the contrary, a functional assessment performed by a CCBHC
that meets the requirements of this subdivision satisfies the requirements in:
    (1) section 256B.0623, subdivision 9;
    (2) section 245.4711, subdivision 3; and
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  Repealed Minnesota Statutes: 26-08138
   (3) Minnesota Rules, part 9520.0914, subpart 2.
   Subd. 4b. Requirements for comprehensive evaluations. (a) A comprehensive evaluation
must be completed for all new clients within 60 calendar days following the preliminary screening
and risk assessment.
    (b) Only a mental health professional may complete a comprehensive evaluation. The mental
health professional must consult with an alcohol and drug counselor when substance use disorder
services are deemed clinically appropriate.
    (c) The comprehensive evaluation must consist of the synthesis of existing information including
but not limited to an external diagnostic assessment, crisis assessment, preliminary screening and
risk assessment, initial evaluation, and primary care screenings.
   (d) A comprehensive evaluation must be completed in the cultural context of the client and
updated to reflect changes in the client's conditions and at the client's request or when the client's
condition no longer meets the existing diagnosis.
    (e) The psychiatric evaluation and management service fulfills requirements for the
comprehensive evaluation when a client of a CCBHC is receiving exclusively psychiatric evaluation
and management services. The CCBHC shall complete the comprehensive evaluation within 60
calendar days of a client's referral for additional CCBHC services.
    (f) For clients engaging exclusively in substance use disorder services at the CCBHC, a substance
use disorder comprehensive assessment as defined in section 245G.05, subdivision 2, that is
completed within 60 calendar days of service initiation shall fulfill requirements of the comprehensive
evaluation.
    (g) Notwithstanding any law to the contrary, a comprehensive evaluation performed by a CCBHC
that meets the requirements of this subdivision satisfies the requirements in:
   (1) section 245.462, subdivision 20, paragraph (c);
   (2) section 245.4711, subdivision 2, paragraph (b);
   (3) section 245.4871, subdivision 6;
   (4) section 245.4881, subdivision 2, paragraph (c);
   (5) section 245G.04, subdivision 1;
   (6) section 245G.05, subdivision 1;
   (7) section 245I.10, subdivisions 4 to 6;
   (8) section 256B.0623, subdivisions 3, clause (4), 8, and 10;
   (9) section 256B.0943, subdivisions 3 and 6, paragraph (b), clause (1);
   (10) Minnesota Rules, part 9520.0909, subpart 1;
   (11) Minnesota Rules, part 9520.0910, subparts 1 and 2; and
   (12) Minnesota Rules, part 9520.0914, subpart 2.
   Subd. 4c. Requirements for initial evaluations. (a) A CCBHC must complete either an initial
evaluation or a comprehensive evaluation as required by the most recently issued Certified
Community Behavioral Health Clinic Certification Criteria published by the Substance Abuse and
Mental Health Services Administration.
   (b) Notwithstanding any law to the contrary, an initial evaluation performed by a CCBHC that
meets the requirements of this subdivision satisfies the requirements in:
   (1) section 245.4711, subdivision 4;
   (2) section 245.4881, subdivisions 3 and 4;
   (3) section 245I.10, subdivision 5;
   (4) section 256B.0623, subdivisions 3, clause (4), 8, and 10;
   (5) section 256B.0943, subdivisions 3 and 6, paragraph (b), clauses (1) and (2);
   (6) Minnesota Rules, part 9520.0909, subpart 1;
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  Repealed Minnesota Statutes: 26-08138
   (7) Minnesota Rules, part 9520.0910, subpart 1;
   (8) Minnesota Rules, part 9520.0914, subpart 2;
   (9) Minnesota Rules, part 9520.0918, subparts 1 and 2; and
   (10) Minnesota Rules, part 9520.0919, subpart 2.
   Subd. 4d. Requirements for integrated treatment plans. (a) An integrated treatment plan
must be completed within 60 calendar days following the preliminary screening and risk assessment
and updated no less frequently than every six months or when the client's circumstances change.
    (b) Only a mental health professional may complete an integrated treatment plan. The mental
health professional must consult with an alcohol and drug counselor when substance use disorder
services are deemed clinically appropriate. An alcohol and drug counselor may approve the integrated
treatment plan. The integrated treatment plan must be developed through a shared decision-making
process with the client, the client's support system if the client chooses, or, for children, with the
family or caregivers.
   (c) The integrated treatment plan must:
   (1) use the ASAM 6 dimensional framework; and
   (2) incorporate prevention, medical and behavioral health needs, and service delivery.
    (d) The psychiatric evaluation and management service fulfills requirements for the integrated
treatment plan when a client of a CCBHC is receiving exclusively psychiatric evaluation and
management services. The CCBHC must complete an integrated treatment plan within 60 calendar
days of a client's referral for additional CCBHC services.
    (e) Notwithstanding any law to the contrary, an integrated treatment plan developed by a CCBHC
that meets the requirements of this subdivision satisfies the requirements in:
   (1) section 245G.06, subdivision 1;
   (2) section 245G.09, subdivision 3, paragraph (a), clause (6);
   (3) section 245I.10, subdivisions 7 and 8; and
   (4) section 256B.0943, subdivision 6, paragraph (b), clause (2).
    Subd. 4e. Additional licensing and certification requirements. (a) This subdivision applies
to programs and clinics that are a part of a CCBHC.
    (b) The requirements for initial evaluations under subdivision 4c, comprehensive evaluations
under subdivision 4b, and integrated treatment plans under subdivision 4d are incorporated into the
licensing requirements for substance use disorder treatment programs under chapter 245G.
    (c) The requirements for initial evaluations under subdivision 4c, comprehensive evaluations
under subdivision 4b, and integrated treatment plans under subdivision 4d are incorporated into the
certification requirements for mental health clinics under section 245I.20.
    (d) The Department of Human Services licensing division will review, inspect, and investigate
for compliance with the requirements in subdivisions 4b to 4d for programs or clinics subject to
this subdivision.
    Subd. 7. Addition of CCBHCs to section 223 state demonstration programs. (a) If the
commissioner's request under subdivision 6 to reenter the demonstration program established by
section 223 of the Protecting Access to Medicare Act is approved, upon reentry the commissioner
must follow all federal guidance on the addition of CCBHCs to section 223 state demonstration
programs.
    (b) Prior to participating in the demonstration, a CCBHC must meet the demonstration
certification criteria and prospective payment system guidance in effect at that time and be certified
as a CCBHC by the state. The Substance Abuse and Mental Health Services Administration
attestation process for CCBHC expansion grants is not sufficient to constitute state certification.
CCBHCs newly added to the demonstration must participate in all aspects of the state demonstration
program, including but not limited to quality measurement and reporting, evaluation activities, and
state CCBHC demonstration program requirements, such as use of state-specified evidence-based
practices. A newly added CCBHC must report on quality measures before its first full demonstration
year if it joined the demonstration program in calendar year 2023 out of alignment with the state's
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  Repealed Minnesota Statutes: 26-08138
demonstration year cycle. A CCBHC may provide services in multiple locations and in
community-based settings subject to federal rules of the 223 demonstration authority or Medicaid
state plan authority.
   (c) If a CCBHC meets the definition of a satellite facility, as defined by the Substance Abuse
and Mental Health Services Administration, and was established after April 1, 2014, the CCBHC
cannot receive payment as a part of the demonstration program.
   Subd. 8. Grievance procedures required. CCBHCs and designated collaborating organizations
must allow all service recipients access to grievance procedures, which must satisfy the minimum
requirements of medical assistance and other grievance requirements such as those that may be
mandated by relevant accrediting entities.
   245A.70 REMOTE ADULT DAY SERVICES.
    (a) For the purposes of sections 245A.70 to 245A.75, the following terms have the meanings
given.
   (b) "Adult day care" and "adult day services" have the meanings given in section 245A.02,
subdivision 2a.
    (c) "Remote adult day services" means an individualized and coordinated set of services provided
via live two-way communication by an adult day care or adult day services center.
    (d) "Live two-way communication" means real-time audio or audio and video transmission of
information between a participant and an actively involved staff member.
   245A.71 APPLICABILITY AND SCOPE.
    Subdivision 1. Licensing requirements. Adult day care centers or adult day services centers
that provide remote adult day services must be licensed under this chapter and comply with the
requirements set forth in this section.
    Subd. 2. Standards for licensure. License holders seeking to provide remote adult day services
must submit a request in the manner prescribed by the commissioner. Remote adult day services
must not be delivered until approved by the commissioner. The designation to provide remote
services is voluntary for license holders. Upon approval, the designation of approval for remote
adult day services must be printed on the center's license and identified on the commissioner's public
website.
    Subd. 3. Federal requirements. Adult day care centers or adult day services centers that provide
remote adult day services to participants receiving alternative care under section 256B.0913, essential
community supports under section 256B.0922, or home and community-based services waivers
under chapter 256S or section 256B.092 or 256B.49 must comply with federally approved waiver
plans.
   Subd. 4. Service limitations. Remote adult day services must be provided during the days and
hours of in-person services specified on the license of the adult day care center or adult day services
center.
   245A.72 RECORD REQUIREMENTS.
    Adult day care centers and adult day services centers providing remote adult day services must
comply with participant record requirements set forth in Minnesota Rules, part 9555.9660. The
center must document how remote services will help a participant reach the short- and long-term
objectives in the participant's plan of care.
   245A.73 REMOTE ADULT DAY SERVICES STAFF.
   Subdivision 1. Staff ratios. (a) A staff person who provides remote adult day services without
two-way interactive video must only provide services to one participant at a time.
   (b) A staff person who provides remote adult day services through two-way interactive video
must not provide services to more than eight participants at one time.
   Subd. 2. Staff training. A center licensed under section 245A.71 must document training
provided to each staff person regarding the provision of remote services in the staff person's record.
The training must be provided prior to a staff person delivering remote adult day services without
supervision. The training must include:
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  Repealed Minnesota Statutes: 26-08138
    (1) how to use the equipment, technology, and devices required to provide remote adult day
services via live two-way communication;
   (2) orientation and training on each participant's plan of care as directly related to remote adult
day services; and
   (3) direct observation by a manager or supervisor of the staff person while providing supervised
remote service delivery sufficient to assess staff competency.
      245A.74 INDIVIDUAL SERVICE PLANNING.
    Subdivision 1. Eligibility. (a) A person must be eligible for and receiving in-person adult day
services to receive remote adult day services from the same provider. The same provider must
deliver both in-person adult day services and remote adult day services to a participant.
    (b) The license holder must update the participant's plan of care according to Minnesota Rules,
part 9555.9700.
    (c) For a participant who chooses to receive remote adult day services, the license holder must
document in the participant's plan of care the participant's proposed schedule and frequency for
receiving both in-person and remote services. The license holder must also document in the
participant's plan of care that remote services:
    (1) are chosen as a service delivery method by the participant or the participant's legal
representative;
      (2) will meet the participant's assessed needs;
      (3) are provided within the scope of adult day services; and
   (4) will help the participant achieve identified short- and long-term objectives specific to the
provision of remote adult day services.
      Subd. 2. Participant daily service limitations. In a 24-hour period, a participant may receive:
   (1) a combination of in-person adult day services and remote adult day services on the same
day but not at the same time;
    (2) a combination of in-person and remote adult day services that does not exceed 12 hours in
total; and
      (3) up to six hours of remote adult day services.
    Subd. 3. Minimum in-person requirement. A participant who receives remote services must
receive services in-person as assigned in the participant's plan of care at least quarterly.
      245A.75 SERVICE AND PROGRAM REQUIREMENTS.
   Remote adult day services must be in the scope of adult day services provided in Minnesota
Rules, part 9555.9710, subparts 3 to 7.
      245C.03 BACKGROUND STUDY; INDIVIDUALS TO BE STUDIED.
    Subd. 3a. Personal care assistance provider agency; background studies. Personal care
assistance provider agencies enrolled to provide personal care assistance services under the medical
assistance program must meet the following requirements:
    (1) owners who have a five percent interest or more and all managing employees are subject to
a background study as provided in this chapter. This requirement applies to currently enrolled
personal care assistance provider agencies and agencies seeking enrollment as a personal care
assistance provider agency. "Managing employee" has the same meaning as in Code of Federal
Regulations, title 42, section 455.101. An organization is barred from enrollment if:
      (i) the organization has not initiated background studies of owners and managing employees;
or
    (ii) the organization has initiated background studies of owners and managing employees and
the commissioner has sent the organization a notice that an owner or managing employee of the
organization has been disqualified under section 245C.14, and the owner or managing employee
has not received a set aside of the disqualification under section 245C.22; and
      (2) a background study must be initiated and completed for all qualified professionals.
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  Repealed Minnesota Statutes: 26-08138
    Subd. 3b. Exception to personal care assistant; requirements. The personal care assistant
for a recipient may be allowed to enroll with a different personal care assistance provider agency
upon initiation of a new background study according to this chapter if:
    (1) the commissioner determines that a change in enrollment or affiliation of the personal care
assistant is needed in order to ensure continuity of services and protect the health and safety of the
recipient;
   (2) the chosen agency has been continuously enrolled as a personal care assistance provider
agency for at least two years;
    (3) the recipient chooses to transfer to the personal care assistance provider agency;
    (4) the personal care assistant has been continuously enrolled with the former personal care
assistance provider agency since the last background study was completed; and
    (5) the personal care assistant continues to meet requirements of section 256B.0659, subdivision
11, notwithstanding paragraph (a), clause (3).
    Subd. 5. Other state agencies. The commissioner shall conduct background studies on applicants
and license holders under the jurisdiction of other state agencies who are required in other statutory
sections to initiate background studies under this chapter, including the applicant's or license holder's
employees and volunteers when required under other statutory sections.
   Subd. 6a. Legal nonlicensed and certified child care programs. The commissioner shall
conduct background studies for each child care background study subject as defined in section
245C.02, subdivision 6a, as required by sections 142C.09 and 142E.16.
    Subd. 7. Children's therapeutic services and supports providers. The commissioner shall
conduct background studies of all direct service providers and volunteers for children's therapeutic
services and supports providers under section 256B.0943.
   Subd. 9a. Exception to support worker requirements for continuity of services. The support
worker for a participant may enroll with a different Community First Services and Supports (CFSS)
agency-provider or Financial Management Services (FMS) provider upon initiation, rather than
completion, of a new background study according to this chapter if:
    (1) the commissioner determines that the support worker's change in enrollment or affiliation
is necessary to ensure continuity of services and to protect the health and safety of the participant;
   (2) the chosen agency-provider or FMS provider has been continuously enrolled as a CFSS
agency-provider or FMS provider for at least two years or since the inception of the CFSS program,
whichever is shorter;
    (3) the participant served by the support worker chooses to transfer to the CFSS agency-provider
or the FMS provider to which the support worker is transferring;
    (4) the support worker has been continuously enrolled with the former CFSS agency-provider
or FMS provider since the support worker's last background study was completed; and
   (5) the support worker continues to meet the requirements of section 256B.85, subdivision 16,
notwithstanding paragraph (a), clause (1).
    245C.04 WHEN BACKGROUND STUDY MUST OCCUR.
    Subd. 2. Other state agencies. Applicants and license holders under the jurisdiction of other
state agencies who are required in other statutory sections to initiate background studies under this
chapter must submit completed background study forms to the commissioner before the background
study subject begins in a position allowing direct contact in the licensed program or, where applicable,
prior to being employed.
    Subd. 3. Personal care provider organizations. (a) The commissioner shall conduct a
background study of an individual required to be studied under section 245C.03, subdivision 2, at
least upon application for initial enrollment under sections 256B.0651 to 256B.0654 and 256B.0659.
   (b) Organizations required to initiate background studies under sections 256B.0651 to 256B.0654
and 256B.0659 for individuals described in section 245C.03, subdivision 2, must submit a completed
background study request to the commissioner using the electronic system known as NETStudy
before those individuals begin a position allowing direct contact with persons served by the
organization.
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    (c) Organizations required to initiate background studies under sections 256B.0651 to 256B.0654
and 256B.0659 for individuals described in section 245C.03, subdivision 2, must initiate a new
background study through NETStudy when an individual returns to a position requiring a background
study following an absence of 120 or more consecutive days.
    Subd. 4. Supplemental nursing services agencies. (a) The commissioner shall conduct a
background study of an individual required to be studied under section 245C.03, subdivision 3, at
least upon application for registration under section 144A.71, subdivision 1.
    (b) Each supplemental nursing services agency must initiate background studies using the
electronic system known as NETStudy before an individual begins a position allowing direct contact
with persons served by the agency and annually thereafter.
    (c) A supplemental nursing services agency that initiates background studies through NETStudy
2.0 is exempt from the requirement to initiate annual background studies under paragraph (b) for
individuals who are on the agency's active roster.
   Subd. 5. Personnel agencies; educational programs; professional services agencies. (a)
Agencies, programs, and individuals who initiate background studies under section 245C.03,
subdivision 4, must initiate the studies annually using the electronic system known as NETStudy.
    (b) Agencies, programs, and individuals who initiate background studies through NETStudy
2.0 are exempt from the requirement to initiate annual background studies under paragraph (a) for
individuals who are on the agency's or program's active roster.
    Subd. 6. Unlicensed home and community-based waiver providers of service to seniors
and individuals with disabilities and providers of housing stabilization services. (a) Providers
required to initiate background studies under section 245C.03, subdivision 6, must initiate a study
using the electronic system known as NETStudy 2.0 before the individual begins in a position
allowing direct contact with persons served by the provider. New providers must initiate a study
under this subdivision before initial enrollment if the provider has not already initiated background
studies as part of the service licensure requirements.
    (b) Except as provided in paragraph (c), the providers must initiate a background study annually
of an individual required to be studied under section 245C.03, subdivision 6.
   (c) After an initial background study under this subdivision is initiated on an individual by a
provider of both services licensed by the commissioner and the unlicensed services under this
subdivision, a repeat annual background study is not required if:
    (1) the provider maintains compliance with the requirements of section 245C.07, paragraph (a),
regarding one individual with one address and telephone number as the person to receive sensitive
background study information for the multiple programs that depend on the same background study,
and that the individual who is designated to receive the sensitive background information is capable
of determining, upon the request of the commissioner, whether a background study subject is
providing direct contact services in one or more of the provider's programs or services and, if so,
at which location or locations; and
    (2) the individual who is the subject of the background study provides direct contact services
under the provider's licensed program for at least 40 hours per year so the individual will be
recognized by a probation officer or corrections agent to prompt a report to the commissioner
regarding criminal convictions as required under section 245C.05, subdivision 7.
    Subd. 7. New study required with legal name change. (a) For a background study completed
on an individual required to be studied under section 245C.03, the license holder or other entity
that initiated the background study must initiate a new background study using the electronic system
known as NETStudy when an individual who is affiliated with the license holder or other entity
undergoes a legal name change.
     (b) For background studies subject to a fee paid through the NETStudy system, the entity that
initiated the study may initiate a new study under paragraph (a) or notify the commissioner of the
name change through a notice to the commissioner.
    Subd. 8. Current or prospective contractors serving multiple family child care license
holders. (a) Before the implementation of NETStudy 2.0, current or prospective contractors who
are required to have a background study under section 245C.03, subdivision 1, who provide services
for multiple family child care license holders in a single county, and will have direct contact with
children served in the family child care setting are required to have only one background study
which is transferable to all family child care programs in that county if:
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    (1) the county agency maintains a record of the contractor's background study results which
verify the contractor is approved to have direct contact with children receiving services;
     (2) the license holder contacts the county agency and obtains notice that the current or prospective
contractor is in compliance with background study requirements and approved to have direct contact;
and
    (3) the contractor's background study is repeated every two years.
    (b) For a family child care license holder operating under NETStudy 2.0, the license holder's
active roster shall be the system used to document when a background study subject is affiliated
with the license holder.
   Subd. 9. Community first services and supports organizations. (a) The commissioner shall
conduct a background study of an individual required to be studied under section 245C.03,
subdivision 9, at least upon application for initial enrollment under section 256B.85.
    (b) Before an individual described in section 245C.03, subdivision 9, begins a position allowing
direct contact with a person served by an organization required to initiate a background study under
section 256B.85, the organization must receive a notice from the commissioner that the support
worker is:
    (1) not disqualified under section 245C.14; or
   (2) disqualified, but the individual has received a set-aside of the disqualification under section
245C.22.
    Subd. 10. Child protection workers or social services staff having responsibility for child
protective duties. The commissioner shall conduct background studies of employees of county
social services and local welfare agencies having responsibility for child protection duties when
the background study is initiated according to section 260E.36, subdivision 3.
    Subd. 11. Children's residential facilities and foster residence settings. Applicants and license
holders for children's residential facilities and foster residence settings must submit a background
study request to the commissioner using the electronic system known as NETStudy 2.0:
    (1) before the commissioner issues a license to an applicant;
    (2) before an individual age 13 or older, who is not currently receiving services from the licensed
facility or setting, may live in the licensed program or setting;
    (3) before a volunteer has unsupervised direct contact with persons that the program serves;
   (4) before an individual becomes a controlling individual as defined in section 245A.02,
subdivision 5a;
    (5) before an adult, regardless of whether or not the individual will have direct contact with
persons served by the facility, begins working in the facility or setting;
   (6) when directed to by the commissioner for an individual who resides in the household as
described in section 245C.03, subdivision 1, paragraph (a), clause (5); and
      (7) when directed to by the commissioner for an individual who may have unsupervised access
to children or vulnerable adults as described in section 245C.03, subdivision 1, paragraph (a), clause
(6).
    Subd. 12. Early intensive developmental and behavioral intervention providers. Providers
required to initiate background studies under section 245C.03, subdivision 15, must initiate a study
using the electronic system known as NETStudy 2.0 before the individual begins in a position
allowing direct contact with persons served by the provider or before the individual becomes an
operator or acquires five percent or more ownership.
    Subd. 13. Recuperative care providers. Providers required to initiate background studies under
section 245C.03, subdivision 16, must initiate a study using the electronic system known as
NETStudy 2.0 before the individual begins in a position allowing direct contact with persons served
by the provider, before the individual becomes an operator of the provider, or before the individual
acquires an ownership interest of at least five percent in the provider.
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  245D.261 COMMUNITY RESIDENTIAL SETTINGS; REMOTE OVERNIGHT
SUPERVISION.
   Subdivision 1. Definitions. (a) For purposes of this section, the following terms have the
meanings given, unless otherwise specified.
    (b) "Resident" means an adult residing in a community residential setting.
    (c) "Technology" means:
   (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
    (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.
    Subd. 2. Documentation of permissible remote overnight supervision. 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.
    Subd. 3. Provider requirements for remote overnight supervision; commissioner
notification. (a) A license holder providing remote overnight supervision in a community residential
setting must:
    (1) use technology;
    (2) notify the commissioner of the community residential setting's intent to use technology in
lieu of on-site staff. The notification must:
    (i) indicate a start date for the use of technology; and
    (ii) attest that all requirements under this section are met and policies required under subdivision
4 are available upon request;
     (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;
    (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
   (5) include in each person's support plan addendum the person's maximum permissible response
time as determined by the person's support team.
    (b) Upon being notified via technology that an incident has occurred that jeopardizes 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 and determine whether a physical presence is needed in a time
that is less than the maximum permissible response time under paragraph (a), clause (5). If it is
determined that a physical presence is needed that requires a response time less than the maximum
response time under paragraph (a), clause (5), the plan under subdivision 4, paragraph (a), clause
(6), must be deployed.
    (c) A license holder must notify the commissioner if remote overnight supervision technology
will no longer be used by the license holder.
    (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.
   Subd. 4. Required policies and procedures for remote overnight supervision. (a) A license
holder providing remote overnight supervision must have policies and procedures that:
    (1) protect the residents' health, safety, and rights;
    (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
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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;
    (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;
   (4) explain the backup system for technology in times of electrical outages or other equipment
malfunctions;
       (5) explain how the license holder trains the direct support staff on the use of the technology;
and
    (6) establish a plan for dispatching emergency response personnel to the site in the event of an
identified emergency.
   (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.
   (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.
    Subd. 5. Consent to use of monitoring technology. 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:
       (1) how the license holder uses monitoring technology to provide remote supervision;
       (2) the risks and benefits of using monitoring technology;
   (3) how the license holder protects each resident's privacy while monitoring technology is being
used in the setting; and
    (4) how the license holder protects each resident's privacy when the monitoring technology
system electronically records personally identifying data.
       245I.20 MENTAL HEALTH CLINIC.
   Subd. 9. Quality assurance and improvement plan. (a) At a minimum, a certification holder
must develop a written quality assurance and improvement plan that includes a plan for:
       (1) encouraging ongoing consultation among members of the treatment team;
   (2) obtaining and evaluating feedback about services from clients, family and other natural
supports, referral sources, and staff persons;
       (3) measuring and evaluating client outcomes;
       (4) reviewing client suicide deaths and suicide attempts;
       (5) examining the quality of clinical service delivery to clients; and
       (6) self-monitoring of compliance with this chapter.
    (b) At least annually, the certification holder must review, evaluate, and update the quality
assurance and improvement plan. The review must: (1) include documentation of the actions that
the certification holder will take as a result of information obtained from monitoring activities in
the plan; and (2) establish goals for improved service delivery to clients for the next year.
  245I.23 INTENSIVE RESIDENTIAL TREATMENT SERVICES AND RESIDENTIAL
CRISIS STABILIZATION.
    Subd. 23. Quality assurance and improvement plan. (a) A license holder must develop a
written quality assurance and improvement plan that includes a plan to:
       (1) encourage ongoing consultation between members of the treatment team;
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    (2) obtain and evaluate feedback about services from clients, family and other natural supports,
referral sources, and staff persons;
   (3) measure and evaluate client outcomes in the program;
   (4) review critical incidents in the program;
   (5) examine the quality of clinical services in the program; and
   (6) self-monitor the license holder's compliance with this chapter.
   (b) At least annually, the license holder must review, evaluate, and update the license holder's
quality assurance and improvement plan. The license holder's review must:
    (1) document the actions that the license holder will take in response to the information that the
license holder obtains from the monitoring activities in the plan; and
   (2) establish goals for improving the license holder's services to clients during the next year.
   256.975 MINNESOTA BOARD ON AGING.
    Subd. 7d. Payment for preadmission screening. (a) The Department of Human Services shall
provide funding for preadmission screening to the Minnesota Board on Aging to cover screener
salaries and expenses to provide the services described in subdivisions 7a to 7c. The Minnesota
Board on Aging shall:
     (1) employ, or contract with other agencies to employ, within the limits of available funding,
sufficient personnel to provide preadmission screening and level of care determination services;
and
    (2) seek to maximize federal funding for the service as provided under section 256.01, subdivision
2, paragraph (aa).
    (b) The Department of Human Services shall provide funding for preadmission screening
follow-up to the Disability Hub for the under-60 population to cover options counseling salaries
and expenses to provide the services described in subdivisions 7a to 7c. The Disability Hub shall:
    (1) employ, or contract with other agencies to employ, within the limits of available funding,
sufficient personnel to provide preadmission screening follow-up services; and
    (2) seek to maximize federal funding for the service as provided under section 256.01, subdivision
2, paragraph (aa).
  256B.0371 PERFORMANCE BENCHMARKS FOR DENTAL ACCESS; CONTINGENT
DENTAL ADMINISTRATOR.
    Subdivision 1. Benchmark for dental access. For coverage years 2022 to 2024, the
commissioner shall establish a performance benchmark under which at least 55 percent of children
and adults who were continuously enrolled for at least 11 months in either medical assistance or
MinnesotaCare through a managed care or county-based purchasing plan received at least one dental
visit during the coverage year.
    Subd. 2. Corrective action plan. For coverage years 2022 to 2024, if a managed care or
county-based purchasing plan under contract with the commissioner to provide dental services
under this chapter or chapter 256L has a rate of dental utilization that is ten percent or more below
the performance benchmark specified in subdivision 1, the commissioner shall require the managed
care or county-based purchasing plan to submit a corrective action plan to the commissioner
describing how the entity intends to increase dental utilization to meet the performance benchmark.
The managed care or county-based purchasing plan must:
   (1) provide a written corrective action plan to the commissioner for approval;
   (2) implement the plan; and
   (3) provide the commissioner with documentation of each corrective action taken.
    Subd. 3. Contingent contract with dental administrator. (a) The commissioner shall determine
the extent to which managed care and county-based purchasing plans in the aggregate meet the
performance benchmark specified in subdivision 1 for coverage year 2024. If managed care and
county-based purchasing plans in the aggregate fail to meet the performance benchmark, the
commissioner, after issuing a request for information followed by a request for proposals, shall
contract with a dental administrator to administer dental services beginning January 1, 2028, for
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recipients of medical assistance and MinnesotaCare who are served under fee-for-service and
persons receiving services through managed care plans.
   (b) The dental administrator must provide administrative services, including but not limited to:
   (1) provider recruitment, contracting, and assistance;
   (2) recipient outreach and assistance;
   (3) utilization management and reviews of medical necessity for dental services;
   (4) dental claims processing;
   (5) coordination of dental care with other services;
   (6) management of fraud and abuse;
   (7) monitoring access to dental services statewide;
   (8) performance measurement;
   (9) quality improvement and evaluation;
   (10) management of third-party liability requirements; and
   (11) establishment of grievance and appeals processes for providers and enrollees that the
commissioner can monitor.
    (c) Dental administrator payments to contracted dental providers must be based on rates
recommended by the dental access working group. If the recommended rates are not established in
law prior to July 1, 2027, dental administrator payments to contracted dental providers must be at
the rates established under sections 256B.76 and 256L.11.
   (d) Recipients must be given a choice of dental provider, including any provider who agrees to
provider participation requirements and payment rates established by the commissioner and dental
administrator. The dental administrator must comply with the network adequacy and geographic
access requirements that apply to managed care plans for dental services under section 62K.14.
   (e) The contract with the dental administrator must include performance benchmarks,
accountability measures, and progress rewards based on the recommendations from the dental
access working group.
    (f) Notwithstanding the contract term limits under section 16C.06, subdivision 3b, the
commissioner may extend the implementation contract for the single dental administrator under
paragraph (a) up to three years from the date of execution and may contract with the same contractor
as the single dental administrator for up to five years, beginning in 2028.
    Subd. 4. Dental utilization report. (a) The commissioner shall submit an annual report beginning
March 15, 2022, and ending March 15, 2026, to the chairs and ranking minority members of the
legislative committees with jurisdiction over health and human services policy and finance that
includes the percentage for adults and children one through 20 years of age for the most recent
complete calendar year receiving at least one dental visit for both fee-for-service and the prepaid
medical assistance program. The report must include:
   (1) statewide utilization for both fee-for-service and for the prepaid medical assistance program;
   (2) utilization by county;
   (3) utilization by children receiving dental services through fee-for-service and through a
managed care plan or county-based purchasing plan; and
    (4) utilization by adults receiving dental services through fee-for-service and through a managed
care plan or county-based purchasing plan.
   (b) The report must also include a description of any corrective action plans required to be
submitted under subdivision 2.
    (c) The initial report due on March 15, 2022, must include the utilization metrics described in
paragraph (a) for each of the following calendar years: 2017, 2018, 2019, and 2020.
   (d) In the annual report due on March 15, 2023, and in each report due thereafter, the
commissioner shall include the following:
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   (1) the number of dentists enrolled with the commissioner as a medical assistance dental provider
and the congressional district or districts in which the dentist provides services;
    (2) the number of enrolled dentists who provided fee-for-service dental services to medical
assistance or MinnesotaCare patients within the previous calendar year in the following increments:
one to nine patients, ten to 100 patients, and over 100 patients;
   (3) the number of enrolled dentists who provided dental services to medical assistance or
MinnesotaCare patients through a managed care plan or county-based purchasing plan within the
previous calendar year in the following increments: one to nine patients, ten to 100 patients, and
over 100 patients; and
   (4) the number of dentists who provided dental services to a new patient who was enrolled in
medical assistance or MinnesotaCare within the previous calendar year.
   (e) The report due on March 15, 2023, must include the metrics described in paragraph (d) for
each of the following years: 2017, 2018, 2019, 2020, and 2021.
   256B.055 ELIGIBILITY CATEGORIES.
     Subd. 14. Persons detained by law. (a) Medical assistance may be paid for an inmate of a
correctional facility who is conditionally released as authorized under section 241.26, 244.065, or
631.425, if the individual does not require the security of a public detention facility and is housed
in a halfway house or community correction center, or under house arrest and monitored by electronic
surveillance in a residence approved by the commissioner of corrections, and if the individual meets
the other eligibility requirements of this chapter.
    (b) An individual who is enrolled in medical assistance, and who is charged with a crime and
incarcerated for less than 12 months shall be suspended from eligibility at the time of incarceration
until the individual is released. Upon release, medical assistance eligibility is reinstated without
reapplication using a reinstatement process and form, if the individual is otherwise eligible.
    (c) An individual, regardless of age, who is considered an inmate of a public institution as
defined in Code of Federal Regulations, title 42, section 435.1010, and who meets the eligibility
requirements in section 256B.056, is not eligible for medical assistance, except for covered services
received while an inpatient in a medical institution as defined in Code of Federal Regulations, title
42, section 435.1010. Security issues, including costs, related to the inpatient treatment of an inmate
are the responsibility of the entity with jurisdiction over the inmate.
   256B.0623 ADULT REHABILITATIVE MENTAL HEALTH SERVICES COVERED.
   Subd. 2. Definitions. For purposes of this section, the following terms have the meanings given
them.
   (a) "Adult rehabilitative mental health services" means the services described in section 245I.02,
subdivision 33.
   (b) "Medication education services" means services provided individually or in groups which
focus on educating the recipient about mental illness and symptoms; the role and effects of
medications in treating symptoms of mental illness; and the side effects of medications. Medication
education is coordinated with medication management services and does not duplicate it. Medication
education services are provided by physicians, advanced practice registered nurses, pharmacists,
physician assistants, or registered nurses.
    (c) "Transition to community living services" means services which maintain continuity of
contact between the rehabilitation services provider and the recipient and which facilitate discharge
from a hospital, residential treatment program, board and lodging facility, or nursing home. Transition
to community living services are not intended to provide other areas of adult rehabilitative mental
health services.
    Subd. 4. Provider entity standards. (a) The provider entity must be certified by the state
following the certification process and procedures developed by the commissioner.
    (b) The certification process is a determination as to whether the entity meets the standards in
this section and chapter 245I, as required in section 245I.011, subdivision 5. The certification must
specify which adult rehabilitative mental health services the entity is qualified to provide.
   (c) State-level recertification must occur at least every three years.
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   (d) The commissioner may intervene at any time and decertify providers with cause. The
decertification is subject to appeal to the state. A county board may recommend that the state
decertify a provider for cause.
    (e) The adult rehabilitative mental health services provider entity must meet the following
standards:
      (1) have capacity to recruit, hire, manage, and train qualified staff;
      (2) have adequate administrative ability to ensure availability of services;
    (3) ensure that staff are skilled in the delivery of the specific adult rehabilitative mental health
services provided to the individual eligible recipient;
    (4) ensure enough flexibility in service delivery to respond to the changing and intermittent
care needs of a recipient as identified by the recipient and the individual treatment plan;
    (5) assist the recipient in arranging needed crisis assessment, intervention, and stabilization
services;
    (6) ensure that services are coordinated with other recipient mental health services providers
and the county mental health authority and the federally recognized American Indian authority and
necessary others after obtaining the consent of the recipient. Services must also be coordinated with
the recipient's case manager or care coordinator if the recipient is receiving case management or
care coordination services;
      (7) keep all necessary records required by law;
      (8) deliver services as required by section 245.461;
      (9) be an enrolled Medicaid provider; and
    (10) maintain a quality assurance plan to determine specific service outcomes and the recipient's
satisfaction with services.
    Subd. 5. Qualifications of provider staff. Adult rehabilitative mental health services must be
provided by qualified individual provider staff of a certified provider entity. Individual provider
staff must be qualified as:
      (1) a mental health professional who is qualified according to section 245I.04, subdivision 2;
      (2) a certified rehabilitation specialist who is qualified according to section 245I.04, subdivision
8;
      (3) a clinical trainee who is qualified according to section 245I.04, subdivision 6;
      (4) a mental health practitioner qualified according to section 245I.04, subdivision 4;
   (5) a mental health certified peer specialist who is qualified according to section 245I.04,
subdivision 10;
   (6) a mental health rehabilitation worker who is qualified according to section 245I.04,
subdivision 14; or
      (7) a licensed occupational therapist, as defined in section 148.6402, subdivision 14.
   Subd. 6. Required supervision. (a) A treatment supervisor providing treatment supervision
required by section 245I.06 must:
    (1) meet with staff receiving treatment supervision at least monthly to discuss treatment topics
of interest and treatment plans of recipients; and
    (2) meet at least monthly with the directing clinical trainee or mental health practitioner, if there
is one, to review needs of the adult rehabilitative mental health services program, review staff
on-site observations and evaluate mental health rehabilitation workers, plan staff training, review
program evaluation and development, and consult with the directing clinical trainee or mental health
practitioner.
   (b) An adult rehabilitative mental health services provider entity must have a treatment director
who is a mental health professional, clinical trainee, certified rehabilitation specialist, or mental
health practitioner. The treatment director must:
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   (1) ensure the direct observation of mental health rehabilitation workers required by section
245I.06, subdivision 3, is provided;
    (2) ensure immediate availability by phone or in person for consultation by a mental health
professional, certified rehabilitation specialist, clinical trainee, or a mental health practitioner to
the mental health rehabilitation worker during service provision;
   (3) model service practices which: respect the recipient, include the recipient in planning and
implementation of the individual treatment plan, recognize the recipient's strengths, collaborate and
coordinate with other involved parties and providers;
     (4) ensure that clinical trainees, mental health practitioners, and mental health rehabilitation
workers are able to effectively communicate with the recipients, significant others, and providers;
and
    (5) oversee the record of the results of direct observation, progress note evaluation, and corrective
actions taken to modify the work of the clinical trainees, mental health practitioners, and mental
health rehabilitation workers.
   (c) A clinical trainee or mental health practitioner who is providing treatment direction for a
provider entity must receive treatment supervision at least monthly to:
      (1) identify and plan for general needs of the recipient population served;
      (2) identify and plan to address provider entity program needs and effectiveness;
      (3) identify and plan provider entity staff training and personnel needs and issues; and
      (4) plan, implement, and evaluate provider entity quality improvement programs.
    Subd. 9. Functional assessment. (a) Providers of adult rehabilitative mental health services
must complete a written functional assessment according to section 245I.10, subdivision 9, for each
recipient.
    (b) When a provider of adult rehabilitative mental health services completes a written functional
assessment, the provider must also complete a level of care assessment as defined in section 245I.02,
subdivision 19, for the recipient.
      256B.0624 CRISIS RESPONSE SERVICES COVERED.
   Subd. 2. Definitions. For purposes of this section, the following terms have the meanings given
them.
   (a) "Certified rehabilitation specialist" means a staff person who is qualified under section
245I.04, subdivision 8.
      (b) "Clinical trainee" means a staff person who is qualified under section 245I.04, subdivision
6.
   (c) "Crisis assessment" means an immediate face-to-face assessment by a physician, a mental
health professional, or a qualified member of a crisis team, as described in subdivision 6a.
    (d) "Crisis intervention" means face-to-face, short-term intensive mental health services initiated
during a mental health crisis to help the recipient cope with immediate stressors, identify and utilize
available resources and strengths, engage in voluntary treatment, and begin to return to the recipient's
baseline level of functioning.
   (e) "Crisis screening" means a screening of a client's potential mental health crisis situation
under subdivision 6.
    (f) "Crisis stabilization" means individualized mental health services provided to a recipient
that are designed to restore the recipient to the recipient's prior functional level. Crisis stabilization
services may be provided in the recipient's home, the home of a family member or friend of the
recipient, another community setting, a short-term supervised, licensed residential program, or an
emergency department. Crisis stabilization services includes family psychoeducation.
  (g) "Crisis team" means the staff of a provider entity who are supervised and prepared to provide
mobile crisis services to a client in a potential mental health crisis situation.
    (h) "Mental health certified family peer specialist" means a staff person who is qualified under
section 245I.04, subdivision 12.
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   (i) "Mental health certified peer specialist" means a staff person who is qualified under section
245I.04, subdivision 10.
    (j) "Mental health crisis" is a behavioral, emotional, or psychiatric situation that, without the
provision of crisis response services, would likely result in significantly reducing the recipient's
levels of functioning in primary activities of daily living, in an emergency situation under section
62Q.55, or in the placement of the recipient in a more restrictive setting, including but not limited
to inpatient hospitalization.
   (k) "Mental health practitioner" means a staff person who is qualified under section 245I.04,
subdivision 4.
   (l) "Mental health professional" means a staff person who is qualified under section 245I.04,
subdivision 2.
   (m) "Mental health rehabilitation worker" means a staff person who is qualified under section
245I.04, subdivision 14.
    (n) "Mobile crisis services" means screening, assessment, intervention, and community-based
stabilization, excluding residential crisis stabilization, that is provided to a recipient.
    Subd. 3. Eligibility. (a) A recipient is eligible for crisis assessment services when the recipient
has screened positive for a potential mental health crisis during a crisis screening.
    (b) A recipient is eligible for crisis intervention services and crisis stabilization services when
the recipient has been assessed during a crisis assessment to be experiencing a mental health crisis.
    Subd. 4a. Alternative provider standards. If a county or Tribe demonstrates that, due to
geographic or other barriers, it is not feasible to provide mobile crisis intervention services according
to the standards in subdivision 4, paragraph (b), the commissioner may approve an alternative plan
proposed by a county or Tribe. The alternative plan must:
    (1) result in increased access and a reduction in disparities in the availability of mobile crisis
services;
   (2) provide mobile crisis services outside of the usual nine-to-five office hours and on weekends
and holidays; and
    (3) comply with standards for emergency mental health services in section 245.469.
    Subd. 5. Crisis assessment and intervention staff qualifications. (a) Qualified individual
staff of a qualified provider entity must provide crisis assessment and intervention services to a
recipient. A staff member providing crisis assessment and intervention services to a recipient must
be qualified as a:
    (1) mental health professional;
    (2) clinical trainee;
    (3) mental health practitioner;
    (4) mental health certified family peer specialist; or
    (5) mental health certified peer specialist.
   (b) When crisis assessment and intervention services are provided to a recipient in the community,
a mental health professional, clinical trainee, or mental health practitioner must lead the response.
    (c) The 30 hours of ongoing training required by section 245I.05, subdivision 4, paragraph (b),
must be specific to providing crisis services to children and adults and include training about
evidence-based practices identified by the commissioner of health to reduce the recipient's risk of
suicide and self-injurious behavior.
   (d) At least six hours of the ongoing training under paragraph (c) must be specific to working
with families and providing crisis stabilization services to children and include the following topics:
    (1) developmental tasks of childhood and adolescence;
    (2) family relationships;
    (3) child and youth engagement and motivation, including motivational interviewing;
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   (4) culturally responsive care, including care for lesbian, gay, bisexual, transgender, and queer
youth;
    (5) positive behavior support;
    (6) crisis intervention for youth with developmental disabilities;
    (7) child traumatic stress, trauma-informed care, and trauma-focused cognitive behavioral
therapy; and
    (8) youth substance use.
    (e) Team members must be experienced in crisis assessment, crisis intervention techniques,
treatment engagement strategies, working with families, and clinical decision-making under
emergency conditions and have knowledge of local services and resources.
    Subd. 6. Crisis screening. (a) The crisis screening may use the resources of emergency services
as defined in section 245.469, subdivisions 1 and 2. The crisis screening must gather information,
determine whether a mental health crisis situation exists, identify parties involved, and determine
an appropriate response.
    (b) When conducting the crisis screening of a recipient, a provider must:
   (1) employ evidence-based practices to reduce the recipient's risk of suicide and self-injurious
behavior;
    (2) work with the recipient to establish a plan and time frame for responding to the recipient's
mental health crisis, including responding to the recipient's immediate need for support by telephone
or text message until the provider can respond to the recipient face-to-face;
   (3) document significant factors in determining whether the recipient is experiencing a mental
health crisis, including prior requests for crisis services, a recipient's recent presentation at an
emergency department, known calls to 911 or law enforcement, or information from third parties
with knowledge of a recipient's history or current needs;
   (4) accept calls from interested third parties and consider the additional needs or potential mental
health crises that the third parties may be experiencing;
   (5) provide psychoeducation, including means reduction, to relevant third parties including
family members or other persons living with the recipient; and
    (6) consider other available services to determine which service intervention would best address
the recipient's needs and circumstances.
    (c) For the purposes of this section, the following situations indicate a positive screen for a
potential mental health crisis and the provider must prioritize providing a face-to-face crisis
assessment of the recipient, unless a provider documents specific evidence to show why this was
not possible, including insufficient staffing resources, concerns for staff or recipient safety, or other
clinical factors:
   (1) the recipient presents at an emergency department or urgent care setting and the health care
team at that location requested crisis services; or
    (2) a peace officer requested crisis services for a recipient who is potentially subject to
transportation under section 253B.051.
    (d) A provider is not required to have direct contact with the recipient to determine that the
recipient is experiencing a potential mental health crisis. A mobile crisis provider may gather
relevant information about the recipient from a third party to establish the recipient's need for
services and potential safety factors.
    Subd. 6a. Crisis assessment. (a) If a recipient screens positive for a potential mental health
crisis, a crisis assessment must be completed. A crisis assessment evaluates any immediate needs
for which services are needed and, as time permits, the recipient's current life situation, health
information, including current medications, sources of stress, mental health problems and symptoms,
strengths, cultural considerations, support network, vulnerabilities, current functioning, and the
recipient's preferences as communicated directly by the recipient, or as communicated in a health
care directive as described in chapters 145C and 253B, the crisis treatment plan described under
subdivision 11, a crisis prevention plan, or a wellness recovery action plan.
    (b) A provider must conduct a crisis assessment at the recipient's location whenever possible.
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    (c) Whenever possible, the assessor must attempt to include input from the recipient and the
recipient's family and other natural supports to assess whether a crisis exists.
    (d) A crisis assessment includes: (1) determining (i) whether the recipient is willing to voluntarily
engage in treatment, or (ii) whether the recipient has an advance directive, and (2) gathering the
recipient's information and history from involved family or other natural supports.
    (e) A crisis assessment must include coordinated response with other health care providers if
the assessment indicates that a recipient needs detoxification, withdrawal management, or medical
stabilization in addition to crisis response services. If the recipient does not need an acute level of
care, a team must serve an otherwise eligible recipient who has a co-occurring substance use disorder.
    (f) If, after completing a crisis assessment of a recipient, a provider refers a recipient to an
intensive setting, including an emergency department, inpatient hospitalization, or residential crisis
stabilization, one of the crisis team members who completed or conferred about the recipient's crisis
assessment must immediately contact the referral entity and consult with the triage nurse or other
staff responsible for intake at the referral entity. During the consultation, the crisis team member
must convey key findings or concerns that led to the recipient's referral. Following the immediate
consultation, the provider must also send written documentation upon completion. The provider
must document if these releases occurred with authorization by the recipient, the recipient's legal
guardian, or as allowed by section 144.293, subdivision 5.
    Subd. 6b. Crisis intervention services. (a) If the crisis assessment determines mobile crisis
intervention services are needed, the crisis intervention services must be provided promptly. As
opportunity presents during the intervention, at least two members of the mobile crisis intervention
team must confer directly or by telephone about the crisis assessment, crisis treatment plan, and
actions taken and needed. At least one of the team members must be providing face-to-face crisis
intervention services. If providing crisis intervention services, a clinical trainee or mental health
practitioner must seek treatment supervision as required in subdivision 9.
   (b) If a provider delivers crisis intervention services while the recipient is absent, the provider
must document the reason for delivering services while the recipient is absent.
   (c) The mobile crisis intervention team must develop a crisis treatment plan according to
subdivision 11.
    (d) The mobile crisis intervention team must document which crisis treatment plan goals and
objectives have been met and when no further crisis intervention services are required.
    (e) If the recipient's mental health crisis is stabilized, but the recipient needs a referral to other
services, the team must provide referrals to these services. If the recipient has a case manager,
planning for other services must be coordinated with the case manager. If the recipient is unable to
follow up on the referral, the team must link the recipient to the service and follow up to ensure the
recipient is receiving the service.
    (f) If the recipient's mental health crisis is stabilized and the recipient does not have an advance
directive, the case manager or crisis team shall offer to work with the recipient to develop one.
   Subd. 7. Crisis stabilization services. (a) Crisis stabilization services must be provided by
qualified staff of a crisis stabilization services provider entity and must meet the following standards:
    (1) a crisis treatment plan must be developed that meets the criteria in subdivision 11;
    (2) staff must be qualified as defined in subdivision 8;
    (3) crisis stabilization services must be delivered according to the crisis treatment plan and
include face-to-face contact with the recipient by qualified staff for further assessment, help with
referrals, updating of the crisis treatment plan, skills training, and collaboration with other service
providers in the community; and
   (4) if a provider delivers crisis stabilization services while the recipient is absent, the provider
must document the reason for delivering services while the recipient is absent.
    (b) If crisis stabilization services are provided in a supervised, licensed residential setting that
serves no more than four adult residents, and one or more individuals are present at the setting to
receive residential crisis stabilization, the residential staff must include, for at least eight hours per
day, at least one mental health professional, clinical trainee, certified rehabilitation specialist, or
mental health practitioner. The commissioner shall establish a statewide per diem rate for crisis
stabilization services provided under this paragraph to medical assistance enrollees. The rate for a
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provider shall not exceed the rate charged by that provider for the same service to other payers.
Payment shall not be made to more than one entity for each individual for services provided under
this paragraph on a given day. The commissioner shall set rates prospectively for the annual rate
period. The commissioner shall require providers to submit annual cost reports on a uniform cost
reporting form and shall use submitted cost reports to inform the rate-setting process. The
commissioner shall recalculate the statewide per diem every year.
    Subd. 8. Crisis stabilization staff qualifications. (a) Mental health crisis stabilization services
must be provided by qualified individual staff of a qualified provider entity. A staff member providing
crisis stabilization services to a recipient must be qualified as a:
   (1) mental health professional;
   (2) certified rehabilitation specialist;
   (3) clinical trainee;
   (4) mental health practitioner;
   (5) mental health certified family peer specialist;
   (6) mental health certified peer specialist; or
   (7) mental health rehabilitation worker.
    (b) The 30 hours of ongoing training required in section 245I.05, subdivision 4, paragraph (b),
must be specific to providing crisis services to children and adults and include training about
evidence-based practices identified by the commissioner of health to reduce a recipient's risk of
suicide and self-injurious behavior.
    (c) For providers who deliver care to children 21 years of age and younger, at least six hours
of the ongoing training under this subdivision must be specific to working with families and providing
crisis stabilization services to children and include the following topics:
   (1) developmental tasks of childhood and adolescence;
   (2) family relationships;
   (3) child and youth engagement and motivation, including motivational interviewing;
   (4) culturally responsive care, including care for lesbian, gay, bisexual, transgender, and queer
youth;
   (5) positive behavior support;
   (6) crisis intervention for youth with developmental disabilities;
    (7) child traumatic stress, trauma-informed care, and trauma-focused cognitive behavioral
therapy; and
   (8) youth substance use.
This paragraph does not apply to adult residential crisis stabilization service providers licensed
according to section 245I.23.
    Subd. 9. Supervision. Clinical trainees and mental health practitioners may provide crisis
assessment and crisis intervention services if the following treatment supervision requirements are
met:
   (1) the mental health provider entity must accept full responsibility for the services provided;
    (2) the mental health professional of the provider entity must be immediately available by phone
or in person for treatment supervision;
    (3) the mental health professional is consulted, in person or by phone, during the first three
hours when a clinical trainee or mental health practitioner provides crisis assessment or crisis
intervention services; and
   (4) the mental health professional must:
    (i) review and approve, as defined in section 245I.02, subdivision 2, of the tentative crisis
assessment and crisis treatment plan within 24 hours of first providing services to the recipient,
notwithstanding section 245I.08, subdivision 3; and
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    (ii) document the consultation required in clause (3).
    Subd. 11. Crisis treatment plan. (a) Within 24 hours of the recipient's admission, the provider
entity must complete the recipient's crisis treatment plan. The provider entity must:
    (1) base the recipient's crisis treatment plan on the recipient's crisis assessment;
    (2) consider crisis assistance strategies that have been effective for the recipient in the past;
    (3) for a child recipient, use a child-centered, family-driven, and culturally appropriate planning
process that allows the recipient's parents and guardians to observe or participate in the recipient's
individual and family treatment services, assessment, and treatment planning;
    (4) for an adult recipient, use a person-centered, culturally appropriate planning process that
allows the recipient's family and other natural supports to observe or participate in treatment services,
assessment, and treatment planning;
   (5) identify the participants involved in the recipient's treatment planning. The recipient, if
possible, must be a participant;
    (6) identify the recipient's initial treatment goals, measurable treatment objectives, and specific
interventions that the license holder will use to help the recipient engage in treatment;
   (7) include documentation of referral to and scheduling of services, including specific providers
where applicable;
    (8) ensure that the recipient or the recipient's legal guardian approves under section 245I.02,
subdivision 2, of the recipient's crisis treatment plan unless a court orders the recipient's treatment
plan under chapter 253B. If the recipient or the recipient's legal guardian disagrees with the crisis
treatment plan, the license holder must document in the client file the reasons why the recipient
disagrees with the crisis treatment plan; and
    (9) ensure that a treatment supervisor approves under section 245I.02, subdivision 2, of the
recipient's treatment plan within 24 hours of the recipient's admission if a mental health practitioner
or clinical trainee completes the crisis treatment plan, notwithstanding section 245I.08, subdivision
3.
    (b) The provider entity must provide the recipient and the recipient's legal guardian with a copy
of the recipient's crisis treatment plan.
    256B.073 ELECTRONIC VISIT VERIFICATION.
    Subd. 4. Provider requirements. (a) A provider of services may select any electronic visit
verification system that meets the requirements established by the commissioner.
    (b) All electronic visit verification systems used by providers to comply with the requirements
established by the commissioner must provide data to the commissioner in a format and at a
frequency to be established by the commissioner.
    (c) Providers must implement the electronic visit verification systems required under this section
by a date established by the commissioner to be set after the state-selected electronic visit verification
systems for personal care services and home health services are in production. For purposes of this
paragraph, "personal care services" and "home health services" have the meanings given in United
States Code, title 42, section 1396b(l)(5). Reimbursement rates for providers must not be reduced
as a result of federal action to reduce the federal medical assistance percentage under the 21st
Century Cures Act, Public Law 114-255.
    256B.0911 LONG-TERM CARE CONSULTATION SERVICES.
    Subd. 21. MnCHOICES assessments; exceptions following institutional stay. (a) A person
receiving home and community-based waiver services under section 256B.0913, 256B.092, or
256B.49 or chapter 256S may return to a community with home and community-based waiver
services under the same waiver without being assessed or reassessed under this section if the person
temporarily entered one of the following for 121 or fewer days:
    (1) a hospital;
    (2) an institution of mental disease;
    (3) a nursing facility;
    (4) an intensive residential treatment services program;
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      (5) a transitional care unit; or
      (6) an inpatient substance use disorder treatment setting.
    (b) Nothing in paragraph (a) changes annual long-term care consultation reassessment
requirements, payment for institutional or treatment services, medical assistance financial eligibility,
or any other law.
      256B.0921 HOME AND COMMUNITY-BASED SERVICES INNOVATION POOL.
    The commissioner of human services shall develop an initiative to provide incentives for
innovation in: (1) achieving integrated competitive employment; (2) achieving integrated competitive
employment for youth under age 25 upon their graduation from school; (3) living in the most
integrated setting; and (4) other outcomes determined by the commissioner. The commissioner
shall seek requests for proposals and shall contract with one or more entities to provide incentive
payments for meeting identified outcomes.
      256B.0943 CHILDREN'S THERAPEUTIC SERVICES AND SUPPORTS.
   Subdivision 1. Definitions. (a) For purposes of this section, the following terms have the
meanings given them.
    (b) "Children's therapeutic services and supports" means the flexible package of mental health
services for children who require varying therapeutic and rehabilitative levels of intervention to
treat a diagnosed mental illness, as defined in section 245.462, subdivision 20, or 245.4871,
subdivision 15. The services are time-limited interventions that are delivered using various treatment
modalities and combinations of services designed to reach treatment outcomes identified in the
individual treatment plan.
   (c) "Clinical trainee" means a staff person who is qualified according to section 245I.04,
subdivision 6.
      (d) "Crisis planning" has the meaning given in section 245.4871, subdivision 9a.
    (e) "Culturally competent provider" means a provider who understands and can utilize to a
client's benefit the client's culture when providing services to the client. A provider may be culturally
competent because the provider is of the same cultural or ethnic group as the client or the provider
has developed the knowledge and skills through training and experience to provide services to
culturally diverse clients.
   (f) "Day treatment program" for children means a site-based structured mental health program
consisting of psychotherapy for three or more individuals and individual or group skills training
provided by a team, under the treatment supervision of a mental health professional.
    (g) "Direct service time" means the time that a mental health professional, clinical trainee,
mental health practitioner, or mental health behavioral aide spends face-to-face with a client and
the client's family or providing covered services through telehealth as defined under section
256B.0625, subdivision 3b. Direct service time includes time in which the provider obtains a client's
history, develops a client's treatment plan, records individual treatment outcomes, or provides
service components of children's therapeutic services and supports. Direct service time does not
include time doing work before and after providing direct services, including scheduling or
maintaining clinical records.
    (h) "Direction of mental health behavioral aide" means the activities of a mental health
professional, clinical trainee, or mental health practitioner in guiding the mental health behavioral
aide in providing services to a client. The direction of a mental health behavioral aide must be based
on the client's individual treatment plan and meet the requirements in subdivision 6, paragraph (b),
clause (7).
      (i) "Individual treatment plan" means the plan described in section 245I.10, subdivisions 7 and
8.
    (j) "Mental health behavioral aide services" means medically necessary one-on-one activities
performed by a mental health behavioral aide qualified according to section 245I.04, subdivision
16, to assist a child retain or generalize psychosocial skills as previously trained by a mental health
professional, clinical trainee, or mental health practitioner and as described in the child's individual
treatment plan and individual behavior plan. Activities involve working directly with the child or
child's family as provided in subdivision 9, paragraph (b), clause (4).
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   (k) "Mental health certified family peer specialist" means a staff person who is qualified
according to section 245I.04, subdivision 12.
   (l) "Mental health practitioner" means a staff person who is qualified according to section
245I.04, subdivision 4.
   (m) "Mental health professional" means a staff person who is qualified according to section
245I.04, subdivision 2.
    (n) "Mental health service plan development" includes:
    (1) development and revision of a child's individual treatment plan; and
   (2) administering and reporting standardized outcome measurements approved by the
commissioner, as periodically needed to evaluate the effectiveness of treatment.
    (o) "Mental illness" has the meaning given in section 245.462, subdivision 20, paragraph (a),
for persons at least 18 years of age but under 21 years of age, and has the meaning given in section
245.4871, subdivision 15, for children under 18 years of age.
    (p) "Psychotherapy" means the treatment described in section 256B.0671, subdivision 11.
    (q) "Rehabilitative services" or "psychiatric rehabilitation services" means interventions to: (1)
restore a child or adolescent to an age-appropriate developmental trajectory that had been disrupted
by a psychiatric illness; or (2) enable the child to self-monitor, compensate for, cope with, counteract,
or replace psychosocial skills deficits or maladaptive skills acquired over the course of a psychiatric
illness. Psychiatric rehabilitation services for children combine coordinated psychotherapy to address
internal psychological, emotional, and intellectual processing deficits, and skills training to restore
personal and social functioning. Psychiatric rehabilitation services establish a progressive series of
goals with each achievement building upon a prior achievement.
    (r) "Skills training" means individual, family, or group training, delivered by or under the
supervision of a mental health professional, designed to facilitate the acquisition of psychosocial
skills that are medically necessary to rehabilitate the child to an age-appropriate developmental
trajectory heretofore disrupted by a psychiatric illness or to enable the child to self-monitor,
compensate for, cope with, counteract, or replace skills deficits or maladaptive skills acquired over
the course of a psychiatric illness. Skills training is subject to the service delivery requirements
under subdivision 9, paragraph (b), clause (2).
   (s) "Standard diagnostic assessment" means the assessment described in section 245I.10,
subdivision 6.
    (t) "Treatment supervision" means the supervision described in section 245I.06.
     Subd. 4. Provider entity certification. (a) The commissioner shall establish an initial provider
entity application and certification process and recertification process to determine whether a
provider entity has an administrative and clinical infrastructure that meets the requirements in
subdivisions 5 and 6. A provider entity must be certified for the three core rehabilitation services
of psychotherapy, skills training, and crisis planning. The commissioner shall recertify a provider
entity every three years using the individual provider's certification anniversary or the calendar year
end, whichever is later. The commissioner may approve a recertification extension, in the interest
of sustaining services, when a certain date for recertification is identified. The commissioner shall
establish a process for decertification of a provider entity and shall require corrective action, medical
assistance repayment, or decertification of a provider entity that no longer meets the requirements
in this section or that fails to meet the clinical quality standards or administrative standards provided
by the commissioner in the application and certification process.
   (b) The commissioner must provide the following to providers for the certification, recertification,
and decertification processes:
    (1) a structured listing of required provider certification criteria;
    (2) a formal written letter with a determination of certification, recertification, or decertification,
signed by the commissioner or the appropriate division director; and
    (3) a formal written communication outlining the process for necessary corrective action and
follow-up by the commissioner, if applicable.
   (c) For purposes of this section, a provider entity must meet the standards in this section and
chapter 245I, as required under section 245I.011, subdivision 5, and be:
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   (1) an Indian health services facility or a facility owned and operated by a tribe or tribal
organization operating as a 638 facility under Public Law 93-638 certified by the state;
    (2) a county-operated entity certified by the state; or
    (3) a noncounty entity certified by the state.
    Subd. 5. Provider entity administrative infrastructure requirements. (a) An eligible provider
entity shall demonstrate the availability, by means of employment or contract, of at least one backup
mental health professional in the event of the primary mental health professional's absence.
   (b) In addition to the policies and procedures required under section 245I.03, the policies and
procedures must include:
    (1) fiscal procedures, including internal fiscal control practices and a process for collecting
revenue that is compliant with federal and state laws; and
   (2) a client-specific treatment outcomes measurement system, including baseline measures, to
measure a client's progress toward achieving mental health rehabilitation goals.
    (c) A provider entity that uses a restrictive procedure with a client must meet the requirements
of section 245.8261.
   Subd. 5a. Background studies. The requirements for background studies under section 245I.011,
subdivision 5, paragraph (b), may be met by a children's therapeutic services and supports services
agency through the commissioner's NETStudy system as provided under sections 245C.03,
subdivision 7, and 245C.10, subdivision 8.
    Subd. 6. Provider entity clinical infrastructure requirements. (a) To be an eligible provider
entity under this section, a provider entity must have a clinical infrastructure that utilizes diagnostic
assessment, individual treatment plans, service delivery, and individual treatment plan review that
are culturally competent, child-centered, and family-driven to achieve maximum benefit for the
client. The provider entity must review, and update as necessary, the clinical policies and procedures
every three years, must distribute the policies and procedures to staff initially and upon each
subsequent update, and must train staff accordingly.
   (b) The clinical infrastructure written policies and procedures must include policies and
procedures for meeting the requirements in this subdivision:
    (1) providing or obtaining a client's standard diagnostic assessment, including a standard
diagnostic assessment. When required components of the standard diagnostic assessment are not
provided in an outside or independent assessment or cannot be attained immediately, the provider
entity must determine the missing information within 30 days and amend the child's standard
diagnostic assessment or incorporate the information into the child's individual treatment plan;
    (2) developing an individual treatment plan;
    (3) providing treatment supervision plans for staff according to section 245I.06. Treatment
supervision does not include the authority to make or terminate court-ordered placements of the
child. A treatment supervisor must be available for urgent consultation as required by the individual
client's needs or the situation;
   (4) requiring a mental health professional to determine the level of supervision for a behavioral
health aide and to document and sign the supervision determination in the behavioral health aide's
supervision plan;
   (5) ensuring the immediate accessibility of a mental health professional, clinical trainee, or
mental health practitioner to the behavioral aide during service delivery;
   (6) providing service delivery that implements the individual treatment plan and meets the
requirements under subdivision 9; and
    (7) individual treatment plan review. The review must determine the extent to which the services
have met each of the goals and objectives in the treatment plan. The review must assess the client's
progress and ensure that services and treatment goals continue to be necessary and appropriate to
the client and the client's family or foster family.
    Subd. 7. Qualifications of individual and team providers. (a) An individual or team provider
working within the scope of the provider's practice or qualifications may provide service components
of children's therapeutic services and supports that are identified as medically necessary in a client's
individual treatment plan.
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    (b) An individual provider must be qualified as a:
    (1) mental health professional;
    (2) clinical trainee;
    (3) mental health practitioner;
    (4) mental health certified family peer specialist; or
    (5) mental health behavioral aide.
    (c) A day treatment team must include one mental health professional or clinical trainee.
   Subd. 9. Service delivery criteria. (a) In delivering services under this section, a certified
provider entity must ensure that:
    (1) the provider's caseload size should reasonably enable the provider to play an active role in
service planning, monitoring, and delivering services to meet the client's and client's family's needs,
as specified in each client's individual treatment plan;
   (2) site-based programs, including day treatment programs, provide staffing and facilities to
ensure the client's health, safety, and protection of rights, and that the programs are able to implement
each client's individual treatment plan; and
     (3) a day treatment program is provided to a group of clients by a team under the treatment
supervision of a mental health professional. The day treatment program must be provided in and
by: (i) an outpatient hospital accredited by the Joint Commission on Accreditation of Health
Organizations and licensed under sections 144.50 to 144.55; (ii) a community mental health center
under section 245.62; or (iii) an entity that is certified under subdivision 4 to operate a program
that meets the requirements of section 245.4884, subdivision 2, and Minnesota Rules, parts 9505.0170
to 9505.0475. The day treatment program must stabilize the client's mental health status while
developing and improving the client's independent living and socialization skills. The goal of the
day treatment program must be to reduce or relieve the effects of mental illness and provide training
to enable the client to live in the community. The remainder of the structured treatment program
may include patient and/or family or group psychotherapy, and individual or group skills training,
if included in the client's individual treatment plan. Day treatment programs are not part of inpatient
or residential treatment services. When a day treatment group that meets the minimum group size
requirement temporarily falls below the minimum group size because of a member's temporary
absence, medical assistance covers a group session conducted for the group members in attendance.
A day treatment program may provide fewer than the minimally required hours for a particular
child during a billing period in which the child is transitioning into, or out of, the program.
   (b) To be eligible for medical assistance payment, a provider entity must deliver the service
components of children's therapeutic services and supports in compliance with the following
requirements:
    (1) psychotherapy to address the child's underlying mental health disorder must be documented
as part of the child's ongoing treatment. A provider must deliver or arrange for medically necessary
psychotherapy unless the child's parent or caregiver chooses not to receive it or the provider
determines that psychotherapy is no longer medically necessary. When a provider determines that
psychotherapy is no longer medically necessary, the provider must update required documentation,
including but not limited to the individual treatment plan, the child's medical record, or other
authorizations, to include the determination. When a provider determines that a child needs
psychotherapy but psychotherapy cannot be delivered due to a shortage of licensed mental health
professionals in the child's community, the provider must document the lack of access in the child's
medical record;
    (2) individual, family, or group skills training is subject to the following requirements:
    (i) a mental health professional, clinical trainee, or mental health practitioner shall provide skills
training;
    (ii) skills training delivered to a child or the child's family must be targeted to the specific deficits
or maladaptations of the child's mental health disorder and must be prescribed in the child's individual
treatment plan;
    (iii) group skills training may be provided to multiple recipients who, because of the nature of
their emotional, behavioral, or social dysfunction, can derive mutual benefit from interaction in a
group setting, which must be staffed as follows:
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   (A) one mental health professional, clinical trainee, or mental health practitioner must work
with a group of three to eight clients; or
    (B) any combination of two mental health professionals, clinical trainees, or mental health
practitioners must work with a group of nine to 12 clients;
     (iv) a mental health professional, clinical trainee, or mental health practitioner must have taught
the psychosocial skill before a mental health behavioral aide may practice that skill with the client;
and
    (v) for group skills training, when a skills group that meets the minimum group size requirement
temporarily falls below the minimum group size because of a group member's temporary absence,
the provider may conduct the session for the group members in attendance;
    (3) crisis planning to a child and family must include development of a written plan that
anticipates the particular factors specific to the child that may precipitate a psychiatric crisis for the
child in the near future. The written plan must document actions that the family should be prepared
to take to resolve or stabilize a crisis, such as advance arrangements for direct intervention and
support services to the child and the child's family. Crisis planning must include preparing resources
designed to address abrupt or substantial changes in the functioning of the child or the child's family
when sudden change in behavior or a loss of usual coping mechanisms is observed, or the child
begins to present a danger to self or others;
    (4) mental health behavioral aide services must be medically necessary treatment services,
identified in the child's individual treatment plan.
To be eligible for medical assistance payment, mental health behavioral aide services must be
delivered to a child who has been diagnosed with a mental illness, as provided in subdivision 1,
paragraph (a). The mental health behavioral aide must document the delivery of services in written
progress notes. Progress notes must reflect implementation of the treatment strategies, as performed
by the mental health behavioral aide and the child's responses to the treatment strategies; and
    (5) mental health service plan development must be performed in consultation with the child's
family and, when appropriate, with other key participants in the child's life by the child's treating
mental health professional or clinical trainee or by a mental health practitioner and approved by
the treating mental health professional. Treatment plan drafting consists of development, review,
and revision by face-to-face or electronic communication. The provider must document events,
including the time spent with the family and other key participants in the child's life to approve the
individual treatment plan. Medical assistance covers service plan development before completion
of the child's individual treatment plan. Service plan development is covered only if a treatment
plan is completed for the child. If upon review it is determined that a treatment plan was not
completed for the child, the commissioner shall recover the payment for the service plan
development.
    Subd. 11. Documentation and billing. (a) A provider entity must document the services it
provides under this section. The provider entity must ensure that documentation complies with
Minnesota Rules, parts 9505.2175 and 9505.2197. Services billed under this section that are not
documented according to this subdivision shall be subject to monetary recovery by the commissioner.
Billing for covered service components under subdivision 2, paragraph (b), must not include anything
other than direct service time.
    (b) Required documentation must be completed for each individual provider and service modality
for each day a child receives a service under subdivision 2, paragraph (b).
    256B.4914 HOME AND COMMUNITY-BASED SERVICES WAIVERS; RATE SETTING.
    Subd. 6c. Integrated community supports; component values and calculation of payment
rates. (a) Component values for integrated community supports are:
    (1) competitive workforce factor: 6.7 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: 1.3 percent; and
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   (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.
   256B.695 COUNTY-ADMINISTERED RURAL MEDICAL ASSISTANCE PROGRAM.
   Subdivision 1. Definitions. (a) For the purposes of this section, the following terms have the
meanings given.
   (b) "CARMA" means the county-administered rural medical assistance program established
under this section.
   (c) "Commissioner" means the commissioner of human services.
   (d) "Eligible individual" means an individual who is:
   (1) residing in a county administering CARMA; and
   (2) eligible for medical assistance, MinnesotaCare, Minnesota Senior Health Options (MSHO),
Minnesota Senior Care Plus (MSC+), or Special Needs Basic Care (SNBC).
   (e) "Enrollee" means an individual enrolled in CARMA.
   (f) "PMAP" means the prepaid medical assistance program under section 256B.69.
    (g) "Rural county" has the meaning given to "rural area" in Code of Federal Regulations, title
42, section 438.52.
   Subd. 2. Program established. CARMA is established to:
   (1) provide a county-owned and county-administered alternative to PMAP;
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    (2) facilitate integration of health care, public health, and social services to address health-related
social needs in rural communities;
    (3) account for the fewer enrollees and local providers of health care and community services
in rural communities; and
    (4) promote accountability for health outcomes, health equity, customer service, community
outreach, and cost of care.
   Subd. 3. County participation. Each county or group of counties authorized under section
256B.692 may administer CARMA for any or all eligible individuals as an alternative to PMAP,
MinnesotaCare, MSHO, MSC+, or SNBC programs. Counties choosing and authorized to administer
CARMA are exempt from the procurement process as required under section 256B.69.
    Subd. 4. Oversight and regulation. CARMA is governed by sections 256B.69 and 256B.692,
unless otherwise provided for under this section. The commissioner must develop and implement
a procurement process requiring applications from county-based purchasing plans interested in
offering CARMA. The procurement process must require county-based purchasing plans to
demonstrate compliance with federal and state regulatory requirements and the ability to meet the
goals of the program set forth in subdivision 2. The commissioner must review and approve or
disapprove applications.
    Subd. 5. CARMA enrollment. (a) Subject to paragraphs (d) and (e), eligible individuals must
be automatically enrolled in CARMA, but may decline enrollment. Eligible individuals may enroll
in fee-for-service medical assistance. Eligible individuals may change their CARMA elections on
an annual basis.
   (b) Eligible individuals must be able to enroll in CARMA through the selection process in
accordance with the election period established in section 256B.69, subdivision 4, paragraph (e).
    (c) Enrollees who were not previously enrolled in the medical assistance program or
MinnesotaCare can change their selection once within the first year after enrollment in CARMA.
Enrollees who were not previously enrolled in CARMA have 90 days to make a change and changes
are allowed for additional special circumstances.
    (d) The commissioner may offer a second health plan other than, and in addition to, CARMA
to eligible individuals when another health plan is required by federal law or rule. The commissioner
may offer a replacement plan to eligible individuals, as determined by the commissioner, when
counties administering CARMA have their contract terminated for cause.
    (e) The commissioner may, on a county-by-county basis, offer a health plan other than, and in
addition to, CARMA to individuals who are eligible for both Medicare and medical assistance due
to age or disability if the commissioner deems it necessary for enrollees to have another choice of
health plan. Factors the commissioner must consider when determining if the other health plan is
necessary include the number of available Medicare Advantage Plan options that are not special
needs plans in the county, the size of the enrolling population, the additional administrative burden
placed on providers and counties by multiple health plan options in a county, the need to ensure
the viability and success of the CARMA program, and the impact to the medical assistance program.
    (f) In counties where the commissioner is required by federal law or elects to offer a second
health plan other than CARMA pursuant to paragraphs (d) and (e), eligible enrollees who do not
select a health plan at the time of enrollment must automatically be enrolled in CARMA.
    (g) This subdivision supersedes section 256B.694.
   Subd. 6. Benefits and services. (a) Counties or groups of counties administering CARMA must
cover all benefits and services required to be covered by medical assistance under section 256B.0625.
    (b) Counties or groups of counties administering CARMA may reimburse enrollees directly for
out-of-pocket costs incurred obtaining assessed HRSN services provided by nontraditional providers
who are unable to accept payment via traditional health insurance methods. Enrollees must not be
reimbursed for out-of-pocket costs paid to providers eligible to enroll.
    Subd. 7. Payment. (a) The commissioner, in consultation with counties and groups of counties
administering CARMA, must develop a mechanism for making payments to counties and groups
of counties that administer CARMA. The payment mechanism must:
    (1) be governed by contracts with terms, including but not limited to payment rates, amended
on an as-needed basis;
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    (2) pay a full-risk monthly capitation payment for services included in CARMA, including the
cost for administering CARMA benefits and services;
   (3) include risk corridors based on minimum loss ratio, total cost of care, or other metrics;
    (4) include a settle-up process tied to the risk corridor arrangement allowing a county or group
of counties administering CARMA to retain savings for reinvestment in health care activities and
operations to protect against significant losses that a county or group of counties administering
CARMA or the state might realize, beginning no sooner than after a county's or group of counties'
third year of CARMA operations;
   (5) include a collaborative rate-setting process accounting for CARMA experience, regional
experience, and the Department of Human Services fee-for-service experience; and
    (6) be exempt from section 256B.69, subdivisions 5a, paragraphs (c) and (f), and 5d, and payment
for Medicaid services provided under section 256B.69, subdivision 28, paragraph (b), no sooner
than three years after CARMA implementation.
   (b) Payments for benefits and services under subdivision 6, paragraph (a), must not exceed
payments that otherwise would have been paid to health plans under medical assistance for that
county or region.
    Subd. 8. Quality measures. (a) The commissioner and counties and groups of counties
administering CARMA must collaborate to establish quality measures for CARMA not to exceed
the extent of quality measures required under sections 256B.69 and 256B.692. The measures must
include:
   (1) enrollee experience and outcomes;
   (2) population health;
   (3) health equity; and
   (4) the value of health care spending.
    (b) The commissioner and counties and groups of counties administering CARMA must
collaborate to define a quality improvement model for CARMA. The model must include a focus
on locally specified measures based on counties' unique needs. The locally specified measures for
the county or group of counties administering CARMA must be determined before the commissioner
enters into any contract with a county or group of counties.
   Subd. 9. Data and systems integration. The commissioner and counties and groups of counties
administering CARMA must collaborate to:
    (1) identify and address barriers that prevent counties and groups of counties administering
CARMA from reviewing individual enrollee eligibility information to identify eligibility and to
help enrollees apply for other appropriate programs and resources;
    (2) identify and address barriers preventing counties and groups of counties administering
CARMA from more readily communicating with and educating potential and current enrollees
regarding other program opportunities, including helping enrollees apply for those programs and
navigate transitions between programs;
    (3) develop and test, in counties participating in CARMA, a universal public assistance
application form to reduce the administrative barriers associated with applying for and participating
in various public programs;
    (4) identify and address regulatory and system barriers that may prohibit counties and groups
of counties administering CARMA, agencies, and other partners from working together to identify
and address an individual's needs;
   (5) facilitate greater interoperability between counties and groups of counties administering
CARMA, agencies, and other partners to send and receive the data necessary to support CARMA,
counties, and local health system efforts to improve the health and welfare of prospective and
enrolled populations;
    (6) support efforts of counties and groups of counties administering CARMA to incorporate
the necessary automation and interoperability to eliminate manual processes when related to the
data exchanged; and
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    (7) support the creation and maintenance by counties and groups of counties administering
CARMA of an updated electronic inventory of community resources available to assist the enrollee
in the enrollee's HRSN, including an electronic closed-loop referral system.
   256B.696 PRESCRIPTION DRUGS; STATE PHARMACY BENEFIT MANAGER.
   Subdivision 1. Definitions. (a) For purposes of this section, the following terms have the
meanings given.
   (b) "Managed care enrollees" means medical assistance and MinnesotaCare enrollees receiving
coverage from managed care plans.
   (c) "Managed care organizations" means health plan companies and county-based purchasing
organizations providing coverage to medical assistance and MinnesotaCare enrollees under the
managed care delivery system.
    (d) "State pharmacy benefit manager" means the pharmacy benefit manager selected pursuant
to the procurement process in subdivision 2.
     Subd. 2. Procurement process. (a) The commissioner must, through a competitive procurement
process in compliance with paragraph (b), select a state pharmacy benefit manager to comply with
the requirements set forth in subdivision 3. The state pharmacy benefit manager selected under this
subdivision must be a prepaid ambulatory health plan, as defined in Code of Federal Regulations,
title 42, section 438.2.
   (b) When selecting the state pharmacy benefit manager, the commissioner must:
   (1) accept applications for entities seeking to become the state pharmacy benefit manager;
   (2) establish eligibility criteria an entity must meet in order to become the state pharmacy benefit
manager; and
   (3) enter into a master contract with a single pharmacy benefit manager.
    (c) Applicants for the state pharmacy benefit manager must disclose to the commissioner the
following during the procurement process:
    (1) any activity, policy, practice, contract, or arrangement of the pharmacy benefit manager that
may directly or indirectly present any conflict of interest with the pharmacy benefit manager's
relationship with or obligation to the Department of Human Services or a managed care organization;
   (2) all common ownership, members of a board of directors, managers, or other control of the
pharmacy benefit manager or any of the pharmacy benefit manager's affiliated companies with:
   (i) a managed care organization administering medical assistance or MinnesotaCare benefits in
Minnesota or an affiliate of the managed care organization;
   (ii) an entity that contracts on behalf of a pharmacy or any pharmacy services administration
organization and its affiliates;
   (iii) a drug wholesaler or distributor and its affiliates;
   (iv) a third-party payer and its affiliates; or
   (v) a pharmacy and its affiliates;
    (3) any direct or indirect fees, charges, or any kind of assessments imposed by the pharmacy
benefit manager on pharmacies licensed in the state with which the pharmacy benefit manager
shares common ownership, management, or control, or that are owned, managed, or controlled by
any of the pharmacy benefit manager's affiliated companies;
   (4) any direct or indirect fees, charges, or any kind of assessments imposed by the pharmacy
benefit manager on pharmacies licensed in the state; and
    (5) any financial terms and arrangements between the pharmacy benefit manager and a
prescription drug manufacturer or labeler, including formulary management, drug substitution
programs, educational support claims processing, or data sales fees.
    Subd. 3. Contract requirements. The master contract required under subdivision 2, paragraph
(b), clause (3), must include provisions that prohibit the state pharmacy benefit manager from:
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    (1) requiring, enticing, or coercing an enrollee to obtain pharmacy services, including a
prescription drug, from a pharmacy owned or otherwise affiliated with the state pharmacy benefit
manager;
    (2) communicating to an enrollee, in any manner, that the enrollee is required to obtain pharmacy
services or have a prescription dispensed at, or pharmacy services provided by, a particular pharmacy
owned or affiliated with the state pharmacy benefit manager if there are other nonaffiliated
pharmacies that have the ability to dispense the medication or provide the services and are also in
network;
    (3) requiring an enrollee to obtain pharmacy services, including a prescription drug, exclusively
through a mail order pharmacy;
    (4) directly or indirectly retroactively denying or reducing a claim or aggregate of claims for
pharmacy services, including prescription drugs, after adjudication of the claim or aggregation of
claims; and
   (5) paying a rate for pharmacy services, including the prescription drug, that is less than the
sum of the following:
   (i) the amount of the professional dispensing fee if it were determined pursuant to section
256B.0625, subdivision 13e; and
   (ii) either:
    (A) the lower of the national average drug acquisition cost or the Minnesota actual acquisition
cost under section 256B.0625, subdivision 13e, paragraph (i);
   (B) the maximum allowable cost, as described in section 62W.08, if the national average drug
acquisition cost and the Minnesota actual acquisition cost are unreported; or
    (C) the wholesale acquisition cost minus two percent at the time the drug is administered or
dispensed if the costs of subitems (A) and (B) are unreported or unavailable.
     Subd. 4. Prescription drug coverage requirements. (a) The state pharmacy benefit manager
is responsible for processing all point of sale outpatient pharmacy claims under the managed care
delivery system. Managed care and county-based purchasing plans must use the state pharmacy
benefit manager pursuant to the terms of the master contract required under subdivision 2, paragraph
(b), clause (3). The state pharmacy benefit manager selected is the exclusive pharmacy benefit
manager used by managed care and county-based purchasing plans when providing coverage to
enrollees. The commissioner may require the managed care and county-based purchasing plans and
state pharmacy benefit manager to directly exchange data and files for members enrolled with the
plans.
    (b) The commissioner may require the state pharmacy benefit manager to modify utilization
review limitations, requirements, and strategies imposed on prescription drug coverage.
   (c) All payment arrangements between the Department of Human Services, managed care plans,
county-based purchasing plans, and the state pharmacy benefit manager must comply with state
and federal statutes, regulations adopted by the Centers for Medicare and Medicaid Services, and
any other agreement between the department and the Centers for Medicare and Medicaid Services.
The commissioner may change a payment arrangement to comply with this paragraph.
   (d) The commissioner must administer and oversee this section to:
   (1) ensure proper administration of prescription drug benefits for managed care enrollees; and
    (2) increase the transparency of prescription drug prices and other information for the benefit
of pharmacies.
    Subd. 5. Reporting requirements. (a) The state pharmacy benefit manager must, on request
from the commissioner, disclose to the commissioner all sources of payment the state pharmacy
benefit manager receives for prescribed drugs, including drug rebates, discounts, credits, clawbacks,
fees, grants, chargebacks, reimbursements, or other financial benefits or payments related to services
provided for a managed care or county-based purchasing plan.
    (b) Each managed care and county-based purchasing plan must disclose to the commissioner,
in the format specified by the commissioner, the entity's administrative costs associated with
providing pharmacy services under the managed care delivery system.
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   (c) The state pharmacy benefit manager must provide a written quarterly report to the
commissioner containing the following information from the immediately preceding quarter:
   (1) the prices the state pharmacy benefit manager negotiated for prescribed drugs under the
managed care delivery system. The prices must include any rebates the state pharmacy benefit
manager received from drug manufacturers;
   (2) unredacted copies of contracts between the state pharmacy benefit manager and enrolled
pharmacies;
   (3) any rebate amounts the state pharmacy benefit manager passed on to individual pharmacies;
    (4) any changes to the information previously disclosed in accordance with subdivision 2,
paragraph (c); and
   (5) any other information required by the commissioner.
    (d) Data submitted pursuant to paragraph (c), clause (3), are nonpublic data, as defined in section
13.02, subdivision 9.
    (e) The commissioner may request and collect additional information and clinical data from the
state pharmacy benefit manager.
    (f) At the time of contract execution, renewal, or modification, the commissioner must modify
the reporting requirements under its managed care contracts as necessary to meet the requirements
of this subdivision.
    Subd. 6. Commissioner's program authority. (a) To accomplish the requirements of subdivision
4, paragraph (d), the commissioner, in consultation with the Formulary Committee established
under section 256B.0625, subdivision 13c, has the authority to:
   (1) adopt or develop a preferred drug list for managed care plans;
     (2) at the commissioner's discretion, engage in price negotiations with prescription drug
manufacturers, wholesalers, or group purchasing organizations in place of the state pharmacy benefit
manager to obtain price discounts and rebates for prescription drugs for managed care enrollees;
and
   (3) develop and manage a drug formulary for managed care and county-based purchasing plans.
   (b) The commissioner may contract with one or more entities to perform any of the functions
described in paragraph (a).
    Subd. 7. Contracts with pharmacies. (a) The commissioner may review contracts between
the state pharmacy benefit manager and pharmacies for compliance with this section and the master
contract required under subdivision 2, paragraph (b), clause (3). The commissioner may amend any
term or condition of a contract that does not comply with this section or the master contract.
    (b) A master contract and a contract between a state pharmacy benefit manager and a pharmacy
are nonpublic data, as defined in section 13.02, subdivision 9.
    Subd. 8. Federal approval. (a) The commissioner must seek any necessary federal approval
to implement this section.
     (b) The commissioner shall monitor the effect of state directed payments under this section on
access to pharmaceutical services in rural and underserved areas of Minnesota. If, for any contract
year, federal approval is not received for a state directed payment under this section, the
commissioner must adjust payments made to the managed care entity for that contract year to reflect
removal of the payment. Contracts between the state pharmacy benefit manager and providers to
whom this section applies must allow recovery of payments from those providers if rates are adjusted
in accordance with this paragraph. Payment recoveries must not exceed the amount equal to any
increase in rates that results from state directed payments under this section. This paragraph expires
if federal approval is not received for state directed payments under this section at any time.
   256R.25 EXTERNAL FIXED COSTS PAYMENT RATE.
    Subd. 6. Planned closures. The portion related to planned closure rate adjustments is as
determined under section 256R.40, subdivision 5, and Minnesota Statutes 2010, section 256B.436.
   256R.40 NURSING FACILITY VOLUNTARY CLOSURE; ALTERNATIVES.
   Subdivision 1. Definitions. (a) The definitions in this subdivision apply to this section.
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   (b) "Closure" means the cessation of operations of a nursing facility and delicensure and
decertification of all beds within the facility.
    (c) "Closure plan" means a plan to close a nursing facility and reallocate a portion of the resulting
savings to provide planned closure rate adjustments at other facilities.
    (d) "Commencement of closure" means the date on which residents and designated representatives
are notified of a planned closure as provided in section 144A.161, subdivision 5a, as part of an
approved closure plan.
    (e) "Completion of closure" means the date on which the final resident of the nursing facility
designated for closure in an approved closure plan is discharged from the facility or the date that
beds from a partial closure are delicensed and decertified.
    (f) "Partial closure" means the delicensure and decertification of a portion of the beds within
the facility.
    (g) "Planned closure rate adjustment" means an increase in a nursing facility's operating rates
resulting from a planned closure or a planned partial closure of another facility.
    Subd. 2. Applications for planned closure rate. (a) To be considered for approval of a planned
closure, an application must include:
    (1) a description of the proposed closure plan, which must include identification of the facility
or facilities to receive a planned closure rate adjustment;
   (2) the proposed timetable for any proposed closure, including the proposed dates for
announcement to residents, commencement of closure, and completion of closure;
    (3) if available, the proposed relocation plan for current residents of any facility designated for
closure. If a relocation plan is not available, the application must include a statement agreeing to
develop a relocation plan designed to comply with section 144A.161;
    (4) a description of the relationship between the nursing facility that is proposed for closure and
the nursing facility or facilities proposed to receive the planned closure rate adjustment. If these
facilities are not under common ownership, copies of any contracts, purchase agreements, or other
documents establishing a relationship or proposed relationship must be provided; and
    (5) documentation, in a format approved by the commissioner, that all the nursing facilities
receiving a planned closure rate adjustment under the plan have accepted joint and several liability
for recovery of overpayments under section 256B.0641, subdivision 2, for the facilities designated
for closure under the plan.
    (b) The application must also address the criteria listed in subdivision 3.
    Subd. 3. Criteria for review of application. In reviewing and approving closure proposals,
the commissioner shall consider, but not be limited to, the following criteria:
    (1) improved quality of care and quality of life for consumers;
    (2) closure of a nursing facility that has a poor physical plant;
   (3) the existence of excess nursing facility beds, measured in terms of beds per thousand persons
aged 85 or older. The excess must be measured in reference to:
    (i) the county in which the facility is located. A facility in a county that is in the lowest quartile
of counties with reference to beds per thousand persons aged 85 or older is not in an area of excess
capacity;
    (ii) the county and all contiguous counties;
    (iii) the region in which the facility is located; or
    (iv) the facility's service area. The facility shall indicate in its application the service area it
believes is appropriate for this measurement;
    (4) low-occupancy rates, provided that the unoccupied beds are not the result of a personnel
shortage. In analyzing occupancy rates, the commissioner shall examine waiting lists in the applicant
facility and at facilities in the surrounding area, as determined under clause (3);
     (5) evidence of coordination between the community planning process and the facility application.
If the planning group does not support a level of nursing facility closures that the commissioner
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considers to be reasonable, the commissioner may approve a planned closure proposal without its
support;
   (6) proposed usage of funds available from a planned closure rate adjustment for care-related
purposes;
    (7) innovative use planned for the closed facility's physical plant;
    (8) evidence that the proposal serves the interests of the state; and
   (9) evidence of other factors that affect the viability of the facility, including excessive nursing
pool costs.
    Subd. 4. Review and approval of applications. (a) The commissioner, in consultation with
the commissioner of health, shall approve or deny an application within 30 days after receiving it.
The commissioner may appoint an advisory review panel composed of representatives of counties,
consumers, and providers to review proposals and provide comments and recommendations to the
committee. The commissioners of human services and health shall provide staff and technical
assistance to the committee for the review and analysis of proposals.
   (b) Approval of a planned closure expires 18 months after approval by the commissioner unless
commencement of closure has begun.
    (c) The commissioner may change any provision of the application to which the applicant, the
regional planning group, and the commissioner agree.
    Subd. 5. Planned closure rate adjustment. (a) The commissioner shall calculate the amount
of the planned closure rate adjustment available under subdivision 6 according to clauses (1) to (4):
    (1) the amount available is the net reduction of nursing facility beds multiplied by $2,080;
    (2) the total number of beds in the nursing facility or facilities receiving the planned closure
rate adjustment must be identified;
   (3) capacity days are determined by multiplying the number determined under clause (2) by
365; and
   (4) the planned closure rate adjustment is the amount available in clause (1), divided by capacity
days determined under clause (3).
    (b) A planned closure rate adjustment under this section is effective on the first day of the month
of January or July, whichever occurs immediately following completion of closure of the facility
designated for closure in the application and becomes part of the nursing facility's external fixed
costs payment rate.
    (c) Upon the request of a closing facility, the commissioner must allow the facility a closure
rate adjustment as provided under section 144A.161, subdivision 10.
    (d) A facility that has received a planned closure rate adjustment may reassign it to another
facility that is under the same ownership at any time within three years of its effective date. The
amount of the adjustment is computed according to paragraph (a).
     (e) If the per bed dollar amount specified in paragraph (a), clause (1), is increased, the
commissioner shall recalculate planned closure rate adjustments for facilities that delicense beds
under this section on or after July 1, 2001, to reflect the increase in the per bed dollar amount. The
recalculated planned closure rate adjustment is effective from the date the per bed dollar amount
is increased.
    Subd. 6. Assignment of closure rate to another facility. A facility or facilities reimbursed
under this chapter with a closure plan approved by the commissioner under subdivision 4 may
assign a planned closure rate adjustment to another facility or facilities that are not closing or in
the case of a partial closure, to the facility undertaking the partial closure. A facility may also elect
to have a planned closure rate adjustment shared equally by the five nursing facilities with the
lowest total operating payment rates in the state development region designated under section
462.385, in which the facility that is closing is located. The planned closure rate adjustment must
be calculated under subdivision 5. Facilities that delicense beds without a closure plan, or whose
closure plan is not approved by the commissioner, are not eligible to assign a planned closure rate
adjustment under subdivision 5, unless they: (1) are delicensing five or fewer beds, or less than six
percent of their total licensed bed capacity, whichever is greater; (2) are located in a county in the
top three quartiles of beds per 1,000 persons aged 65 or older; and (3) have not delicensed beds in
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  APPENDIX
  Repealed Minnesota Statutes: 26-08138
the prior three months. Facilities meeting these criteria are eligible to assign the amount calculated
under subdivision 5 to themselves. If a facility is delicensing the greater of six or more beds, or six
percent or more of its total licensed bed capacity, and does not have an approved closure plan or is
not eligible for the adjustment under subdivision 5, the commissioner shall calculate the amount
the facility would have been eligible to assign under subdivision 5, and shall use this amount to
provide equal rate adjustments to the five nursing facilities with the lowest total operating payment
rates in the state development region designated under section 462.385, in which the facility that
delicensed beds is located.
    Subd. 7. Other rate adjustments. Facilities receiving planned closure rate adjustments remain
eligible for any applicable rate adjustments provided under this chapter.
   256R.42 RATE ADJUSTMENT FOR THE FIRST 30 DAYS.
    (a) During the first 30 calendar days after admission, the total payment rate for a case mix
classification must be increased by 20 percent. Beginning with the 31st calendar day after admission,
the total payment rate is the rate otherwise determined under this chapter.
    (b) The enhanced rates under this section shall not be allowed if a resident has resided during
the previous 30 calendar days in:
   (1) the same nursing facility;
   (2) a nursing facility owned or operated by a related party; or
   (3) a nursing facility or part of a facility that closed or was in the process of closing.
  256S.205 CUSTOMIZED LIVING SERVICES; DISPROPORTIONATE SHARE RATE
ADJUSTMENTS.
    Subd. 4. Designation as a disproportionate share facility. (a) By October 15 of each application
year, the commissioner must designate as a disproportionate share facility a facility that complies
with the application requirements of subdivision 2 and meets the eligibility criteria of subdivision
3.
   (b) An annual designation is effective for one rate year.
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  APPENDIX
  Repealed Minnesota Session Laws: 26-08138
Laws 2025, First Special Session chapter 9, article 2, section 68
 Sec. 68. DIRECTION TO THE COMMISSIONER OF HUMAN SERVICES; INCREASE
TO PAYMENTS FOR FAMILY RESIDENTIAL AND LIFE SHARING SERVICES.
    Effective January 1, 2026, or upon federal approval, whichever is later, the commissioner of
human services must increase by 25.84 percent payment rates previously established under Minnesota
Statutes, section 256B.4914, subdivision 19, for family residential services. Rates for life sharing
services must be ten percent higher than the corresponding family residential services rate established
under this section.
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