Text of MN SF 2818 (2023)

Omnibus Human Services policy bill

Back to the bill page

Legislative text is a public record. Where LegiScan supplied it, the CC BY 4.0 credit applies.

Source: LegiScan. Bill data and text from LegiScan (legiscan.com), licensed CC BY 4.0 and used in modified form. LegiScan does not endorse the Trans Data Initiative. License: CC BY 4.0(opens another site). Source page(opens another site)

As introduced

565,805 characters

Open the printed bill (PDF)

1.1 A bill for an act​ 1.2 relating to human services; modifying and establishing laws regarding aging,​ 1.3 disability, behavioral health, substance use disorder, housing, economic assistance,​ 1.4 children and family services, health care, licensing, Department of Human Services​ 1.5 Office of Inspector General, and conversion therapy; requiring reports;​ 1.6 appropriating money; amending Minnesota Statutes 2022, sections 13.46,​ 1.7 subdivision 4; 62N.25, subdivision 5; 62Q.1055; 62Q.47; 62V.05, subdivision 4a;​ 1.8 122A.18, subdivision 8; 169A.70, subdivisions 3, 4; 245.462, subdivisions 3, 12;​ 1.9 245.4661, subdivision 9; 245.469, subdivision 3; 245.4711, subdivisions 3, 4;​ 1.10 245.477; 245.4835, subdivision 2; 245.4871, subdivisions 3, 19; 245.4873,​ 1.11 subdivision 4; 245.4881, subdivisions 3, 4; 245.4885, subdivision 1; 245.4887;​ 1.12 245.50, subdivision 5; 245A.02, subdivisions 5a, 10b; 245A.03, subdivision 7;​ 1.13 245A.04, subdivisions 1, 4, 7; 245A.041, by adding a subdivision; 245A.043,​ 1.14 subdivision 3; 245A.05; 245A.07, subdivisions 1, 2a, 3; 245A.10, subdivisions 3,​ 1.15 4; 245A.11, subdivision 7, by adding a subdivision; 245A.14, subdivision 4;​ 1.16 245A.1435; 245A.146, subdivision 3; 245A.16, subdivisions 1, 9, by adding a​ 1.17 subdivision; 245A.18, subdivision 2; 245A.52, subdivisions 1, 2, 3, 5, by adding​ 1.18 subdivisions; 245A.66, by adding a subdivision; 245C.02, subdivisions 6a, 11c,​ 1.19 by adding subdivisions; 245C.03, subdivisions 1, 1a, 4, 5, 5a; 245C.031,​ 1.20 subdivisions 1, 4; 245C.05, subdivisions 1, 5a, by adding a subdivision; 245C.07;​ 1.21 245C.08, subdivision 1; 245C.10, subdivision 4; 245C.15, subdivision 4a; 245C.30,​ 1.22 subdivision 2; 245C.31, subdivision 1; 245C.33, subdivision 4; 245D.03,​ 1.23 subdivision 1; 245E.06, subdivision 3; 245E.08; 245G.05, subdivision 2; 245G.07,​ 1.24 subdivision 3a; 245G.13, subdivision 2; 245G.22, subdivision 2; 245H.03, by​ 1.25 adding a subdivision; 245H.05; 245H.08, subdivisions 4, 5; 245H.13, subdivisions​ 1.26 3, 7, 9; 245I.20, subdivision 10; 246.0135; 254A.03, subdivision 3; 254A.035,​ 1.27 subdivision 2; 254A.19, subdivisions 1, 3, 4, by adding subdivisions; 254B.01,​ 1.28 subdivision 5, by adding subdivisions; 254B.03, subdivisions 1, 2, 5; 254B.04,​ 1.29 subdivisions 1, 2a, by adding subdivisions; 254B.05, subdivisions 1a, 5; 256.01,​ 1.30 by adding a subdivision; 256.478, by adding subdivisions; 256.9685, subdivisions​ 1.31 1a, 1b; 256.9686, by adding a subdivision; 256B.04, subdivision 15; 256B.056,​ 1.32 by adding a subdivision; 256B.0622, subdivision 8; 256B.0625, subdivisions 3a,​ 1.33 16, by adding a subdivision; 256B.064; 256B.0911, subdivision 23; 256B.092,​ 1.34 subdivision 10; 256B.093, subdivision 1; 256B.0946, subdivision 6; 256B.0947,​ 1.35 subdivision 7a; 256B.27, subdivision 3; 256B.439, subdivisions 3c, 3d; 256B.492;​ 1.36 256B.493, subdivisions 2a, 4; 256D.02, by adding a subdivision; 256D.07; 256D.09,​ 1.37 subdivision 2a; 256I.03, subdivision 15, by adding a subdivision; 256I.04,​ 1.38 subdivision 2; 256I.06, subdivision 3; 256I.09; 256J.08, subdivision 21; 256J.09,​ 1​ 23-00276 as introduced​ 01/26/23 REVISOR EB/HL​ SENATE​ STATE OF MINNESOTA​ S.F. No. 2818​ NINETY-THIRD SESSION​ (SENATE AUTHORS: WIKLUND)​ OFFICIAL STATUS​ D-PG​ DATE​ Introduction and first reading​ 03/13/2023​ Referred to Health and Human Services​ 2.1 subdivision 3; 256J.95, subdivision 5; 256L.03, subdivisions 1, 2; 256L.12,​ 2.2 subdivision 8; 256N.24, subdivision 12; 256P.01, by adding a subdivision; 256P.04,​ 2.3 by adding a subdivision; 256S.202, subdivision 1; 260B.157, subdivisions 1, 3;​ 2.4 260C.157, subdivision 3; 260C.221, subdivision 1; 260C.317, subdivision 3;​ 2.5 260E.20, subdivision 1; 299A.299, subdivision 1; 325F.69, by adding a subdivision;​ 2.6 518A.43, subdivision 1b; 524.5-104; 524.5-118, subdivision 2a; 524.5-313; Laws​ 2.7 2021, First Special Session chapter 7, article 2, section 17; article 6, section 12;​ 2.8 article 11, section 18; article 13, section 43; article 17, section 20; Laws 2022,​ 2.9 chapter 98, article 4, section 37; proposing coding for new law in Minnesota​ 2.10 Statutes, chapters 119B; 214; 245; 245A; repealing Minnesota Statutes 2022,​ 2.11 sections 169A.70, subdivision 6; 245A.144; 245A.175; 245A.22; 245C.02,​ 2.12 subdivision 9; 245C.301; 245G.22, subdivision 19; 254A.02, subdivision 8a;​ 2.13 254A.16, subdivision 6; 254A.19, subdivisions 1a, 2, 5; 254B.04, subdivisions​ 2.14 2b, 2c; 254B.041, subdivision 2; 254B.13, subdivisions 1, 2, 2a, 4, 5, 6, 7, 8;​ 2.15 254B.16; 256.9685, subdivisions 1c, 1d; 256B.49, subdivision 23; 256D.63,​ 2.16 subdivision 1; 256I.03, subdivision 6; 260.835, subdivision 2; 518A.59; Minnesota​ 2.17 Rules, parts 2960.3070; 2960.3210; 9502.0425, subparts 5, 10; 9505.0235;​ 2.18 9505.0505, subpart 18; 9505.0520, subpart 9b.​ 2.19 BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF MINNESOTA:​ 2.20 ARTICLE 1​ 2.21 AGING, DISABILITY, AND BEHAVIORAL HEALTH SERVICES​ 2.22 Section 1. Minnesota Statutes 2022, section 245.462, subdivision 3, is amended to read:​ 2.23 Subd. 3. Case management services. "Case management services" means activities​ 2.24 that are coordinated with the community support services program as defined in subdivision​ 2.25 6 and are designed to help adults with serious and persistent mental illness in gaining access​ 2.26 to needed medical, social, educational, vocational, and other necessary services as they​ 2.27 relate to the client's mental health needs. Case management services include developing a​ 2.28 functional assessment, an individual assessment summary community support plan, referring​ 2.29 and assisting the person to obtain needed mental health and other services, ensuring​ 2.30 coordination of services, and monitoring the delivery of services.​ 2.31 Sec. 2. Minnesota Statutes 2022, section 245.462, subdivision 12, is amended to read:​ 2.32 Subd. 12. Individual assessment summary community support plan. "Individual​ 2.33 assessment summary community support plan" means a written plan developed by a case​ 2.34 manager on the basis of a diagnostic assessment and functional assessment. The plan​ 2.35 identifies specific services needed by an adult with serious and persistent mental illness to​ 2.36 develop independence or improved functioning in daily living, health and medication​ 2.37 management, social functioning, interpersonal relationships, financial management, housing,​ 2.38 transportation, and employment.​ 2​ Article 1 Sec. 2.​ 23-00276 as introduced​ 01/26/23 REVISOR EB/HL​ 3.1 Sec. 3. Minnesota Statutes 2022, section 245.4661, subdivision 9, is amended to read:​ 3.2 Subd. 9. Services and programs. (a) The following three distinct grant programs are​ 3.3 funded under this section:​ 3.4 (1) mental health crisis services;​ 3.5 (2) housing with supports for adults with serious mental illness; and​ 3.6 (3) projects for assistance in transitioning from homelessness (PATH program).​ 3.7 (b) In addition, the following are eligible for grant funds:​ 3.8 (1) community education and prevention;​ 3.9 (2) client outreach;​ 3.10 (3) early identification and intervention;​ 3.11 (4) adult outpatient diagnostic assessment and psychological testing;​ 3.12 (5) peer support services;​ 3.13 (6) community support program services (CSP);​ 3.14 (7) adult residential crisis stabilization;​ 3.15 (8) supported employment;​ 3.16 (9) assertive community treatment (ACT);​ 3.17 (10) housing subsidies;​ 3.18 (11) basic living, social skills, and community intervention;​ 3.19 (12) emergency response services;​ 3.20 (13) adult outpatient psychotherapy;​ 3.21 (14) adult outpatient medication management;​ 3.22 (15) adult mobile crisis services;​ 3.23 (16) adult day treatment;​ 3.24 (17) partial hospitalization;​ 3.25 (18) adult residential treatment;​ 3.26 (19) adult mental health targeted case management; and​ 3.27 (20) intensive community rehabilitative services (ICRS); and​ 3​ Article 1 Sec. 3.​ 23-00276 as introduced​ 01/26/23 REVISOR EB/HL​ 4.1 (21) (20) transportation.​ 4.2 Sec. 4. Minnesota Statutes 2022, section 245.469, subdivision 3, is amended to read:​ 4.3 Subd. 3. Mental health crisis services. The commissioner of human services shall​ 4.4 increase access to mental health crisis services for children and adults. In order to increase​ 4.5 access, the commissioner must:​ 4.6 (1) develop a central phone number where calls can be routed to the appropriate crisis​ 4.7 services;​ 4.8 (2) provide telephone consultation 24 hours a day to mobile crisis teams who are serving​ 4.9 people with traumatic brain injury or intellectual disabilities who are experiencing a mental​ 4.10 health crisis;​ 4.11 (3) expand crisis services across the state, including rural areas of the state and examining​ 4.12 access per population;​ 4.13 (4) establish and implement state standards and requirements for crisis services as outlined​ 4.14 in section 256B.0624; and​ 4.15 (5) provide grants to adult mental health initiatives, counties, tribes, or community mental​ 4.16 health providers to establish new mental health crisis residential service capacity.​ 4.17 Priority will be given to regions that do not have a mental health crisis residential services​ 4.18 program, do not have an inpatient psychiatric unit within the region, do not have an inpatient​ 4.19 psychiatric unit within 90 miles, or have a demonstrated need based on the number of crisis​ 4.20 residential or intensive residential treatment beds available to meet the needs of the residents​ 4.21 in the region. At least 50 percent of the funds must be distributed to programs in rural​ 4.22 Minnesota. Grant funds may be used for start-up costs, including but not limited to​ 4.23 renovations, furnishings, and staff training. Grant applications shall provide details on how​ 4.24 the intended service will address identified needs and shall demonstrate collaboration with​ 4.25 crisis teams, other mental health providers, hospitals, and police.​ 4.26 EFFECTIVE DATE. This section is effective the day following final enactment.​ 4.27 Sec. 5. Minnesota Statutes 2022, section 245.4711, subdivision 3, is amended to read:​ 4.28 Subd. 3. Duties of case manager. Upon a determination of eligibility for case​ 4.29 management services, and if the adult consents to the services, the case manager shall​ 4.30 complete a written functional assessment according to section 245.462, subdivision 11a.​ 4.31 The case manager shall develop an individual assessment summary community support​ 4​ Article 1 Sec. 5.​ 23-00276 as introduced​ 01/26/23 REVISOR EB/HL​ 5.1 plan for the adult according to subdivision 4, paragraph (a), review the adult's progress, and​ 5.2 monitor the provision of services. If services are to be provided in a host county that is not​ 5.3 the county of financial responsibility, the case manager shall consult with the host county​ 5.4 and obtain a letter demonstrating the concurrence of the host county regarding the provision​ 5.5 of services.​ 5.6 Sec. 6. Minnesota Statutes 2022, section 245.4711, subdivision 4, is amended to read:​ 5.7 Subd. 4. Individual assessment summary community support plan. (a) The case​ 5.8 manager must develop an individual assessment summary community support plan for each​ 5.9 adult that incorporates the client's individual treatment plan. The individual treatment plan​ 5.10 may not be a substitute for the development of an individual assessment summary community​ 5.11 support plan. The individual assessment summary community support plan must be developed​ 5.12 within 30 days of client intake and reviewed at least every 180 days after it is developed,​ 5.13 unless the case manager receives a written request from the client or the client's family for​ 5.14 a review of the plan every 90 days after it is developed. The case manager is responsible​ 5.15 for developing the individual assessment summary community support plan based on a​ 5.16 diagnostic assessment and a functional assessment and for implementing and monitoring​ 5.17 the delivery of services according to the individual assessment summary community support​ 5.18 plan. To the extent possible, the adult with serious and persistent mental illness, the person's​ 5.19 family, advocates, service providers, and significant others must be involved in all phases​ 5.20 of development and implementation of the individual or family assessment summary​ 5.21 community support plan.​ 5.22 (b) The client's individual assessment summary community support plan must state:​ 5.23 (1) the goals of each service;​ 5.24 (2) the activities for accomplishing each goal;​ 5.25 (3) a schedule for each activity; and​ 5.26 (4) the frequency of face-to-face contacts by the case manager, as appropriate to client​ 5.27 need and the implementation of the individual assessment summary community support​ 5.28 plan.​ 5.29 Sec. 7. Minnesota Statutes 2022, section 245.477, is amended to read:​ 5.30 245.477 APPEALS.​ 5.31 Any adult who requests mental health services under sections 245.461 to 245.486 must​ 5.32 be advised of services available and the right to appeal at the time of the request and each​ 5​ Article 1 Sec. 7.​ 23-00276 as introduced​ 01/26/23 REVISOR EB/HL​ 6.1 time the individual assessment summary community support plan or individual treatment​ 6.2 plan is reviewed. Any adult whose request for mental health services under sections 245.461​ 6.3 to 245.486 is denied, not acted upon with reasonable promptness, or whose services are​ 6.4 suspended, reduced, or terminated by action or inaction for which the county board is​ 6.5 responsible under sections 245.461 to 245.486 may contest that action or inaction before​ 6.6 the state agency as specified in section 256.045. The commissioner shall monitor the nature​ 6.7 and frequency of administrative appeals under this section.​ 6.8 Sec. 8. Minnesota Statutes 2022, section 245.4835, subdivision 2, is amended to read:​ 6.9 Subd. 2. Failure to maintain expenditures. (a) If a county does not comply with​ 6.10 subdivision 1, the commissioner shall require the county to develop a corrective action plan​ 6.11 according to a format and timeline established by the commissioner. If the commissioner​ 6.12 determines that a county has not developed an acceptable corrective action plan within the​ 6.13 required timeline, or that the county is not in compliance with an approved corrective action​ 6.14 plan, the protections provided to that county under section 245.485 do not apply.​ 6.15 (b) The commissioner shall consider the following factors to determine whether to​ 6.16 approve a county's corrective action plan:​ 6.17 (1) the degree to which a county is maximizing revenues for mental health services from​ 6.18 noncounty sources;​ 6.19 (2) the degree to which a county is expanding use of alternative services that meet mental​ 6.20 health needs, but do not count as mental health services within existing reporting systems.​ 6.21 If approved by the commissioner, the alternative services must be included in the county's​ 6.22 base as well as subsequent years. The commissioner's approval for alternative services must​ 6.23 be based on the following criteria:​ 6.24 (i) the service must be provided to children with emotional disturbance or adults with​ 6.25 mental illness;​ 6.26 (ii) the services must be based on an individual treatment plan or individual assessment​ 6.27 summary community support plan as defined in the Comprehensive Mental Health Act;​ 6.28 and​ 6.29 (iii) the services must be supervised by a mental health professional and provided by​ 6.30 staff who meet the staff qualifications defined in sections 256B.0943, subdivision 7, and​ 6.31 256B.0623, subdivision 5.​ 6.32 (c) Additional county expenditures to make up for the prior year's underspending may​ 6.33 be spread out over a two-year period.​ 6​ Article 1 Sec. 8.​ 23-00276 as introduced​ 01/26/23 REVISOR EB/HL​ 7.1 Sec. 9. Minnesota Statutes 2022, section 245.4871, subdivision 3, is amended to read:​ 7.2 Subd. 3. Case management services. "Case management services" means activities​ 7.3 that are coordinated with the family community support services and are designed to help​ 7.4 the child with severe emotional disturbance and the child's family obtain needed mental​ 7.5 health services, social services, educational services, health services, vocational services,​ 7.6 recreational services, and related services in the areas of volunteer services, advocacy,​ 7.7 transportation, and legal services. Case management services include assisting in obtaining​ 7.8 a comprehensive diagnostic assessment, developing an individual family assessment summary​ 7.9 community support plan, and assisting the child and the child's family in obtaining needed​ 7.10 services by coordination with other agencies and assuring continuity of care. Case managers​ 7.11 must assess and reassess the delivery, appropriateness, and effectiveness of services over​ 7.12 time.​ 7.13 Sec. 10. Minnesota Statutes 2022, section 245.4871, subdivision 19, is amended to read:​ 7.14 Subd. 19. Individual family assessment summary community support​ 7.15 plan. "Individual family assessment summary community support plan" means a written​ 7.16 plan developed by a case manager in conjunction with the family and the child with severe​ 7.17 emotional disturbance on the basis of a diagnostic assessment and a functional assessment.​ 7.18 The plan identifies specific services needed by a child and the child's family to:​ 7.19 (1) treat the symptoms and dysfunctions determined in the diagnostic assessment;​ 7.20 (2) relieve conditions leading to emotional disturbance and improve the personal​ 7.21 well-being of the child;​ 7.22 (3) improve family functioning;​ 7.23 (4) enhance daily living skills;​ 7.24 (5) improve functioning in education and recreation settings;​ 7.25 (6) improve interpersonal and family relationships;​ 7.26 (7) enhance vocational development; and​ 7.27 (8) assist in obtaining transportation, housing, health services, and employment.​ 7.28 Sec. 11. Minnesota Statutes 2022, section 245.4873, subdivision 4, is amended to read:​ 7.29 Subd. 4. Individual case coordination. The case manager designated under section​ 7.30 245.4881 is responsible for ongoing coordination with any other person responsible for​ 7.31 planning, development, and delivery of social services, education, corrections, health, or​ 7​ Article 1 Sec. 11.​ 23-00276 as introduced​ 01/26/23 REVISOR EB/HL​ 8.1 vocational services for the individual child. The individual family assessment summary​ 8.2 community support plan developed by the case manager shall reflect the coordination among​ 8.3 the local service system providers.​ 8.4 Sec. 12. Minnesota Statutes 2022, section 245.4881, subdivision 3, is amended to read:​ 8.5 Subd. 3. Duties of case manager. (a) Upon a determination of eligibility for case​ 8.6 management services, the case manager shall develop an individual family assessment​ 8.7 summary community support plan for a child as specified in subdivision 4, review the child's​ 8.8 progress, and monitor the provision of services. If services are to be provided in a host​ 8.9 county that is not the county of financial responsibility, the case manager shall consult with​ 8.10 the host county and obtain a letter demonstrating the concurrence of the host county regarding​ 8.11 the provision of services.​ 8.12 (b) The case manager shall note in the child's record the services needed by the child​ 8.13 and the child's family, the services requested by the family, services that are not available,​ 8.14 and the unmet needs of the child and child's family. The case manager shall note this​ 8.15 provision in the child's record.​ 8.16 Sec. 13. Minnesota Statutes 2022, section 245.4881, subdivision 4, is amended to read:​ 8.17 Subd. 4. Individual family assessment summary community support plan. (a) For​ 8.18 each child, the case manager must develop an individual family assessment summary​ 8.19 community support plan that incorporates the child's individual treatment plan. The individual​ 8.20 treatment plan may not be a substitute for the development of an individual family assessment​ 8.21 summary community support plan. The case manager is responsible for developing the​ 8.22 individual family assessment summary community support plan within 30 days of intake​ 8.23 based on a diagnostic assessment and for implementing and monitoring the delivery of​ 8.24 services according to the individual family assessment summary community support plan.​ 8.25 The case manager must review the plan at least every 180 calendar days after it is developed,​ 8.26 unless the case manager has received a written request from the child's family or an advocate​ 8.27 for the child for a review of the plan every 90 days after it is developed. To the extent​ 8.28 appropriate, the child with severe emotional disturbance, the child's family, advocates,​ 8.29 service providers, and significant others must be involved in all phases of development and​ 8.30 implementation of the individual family assessment summary community support plan.​ 8.31 Notwithstanding the lack of an individual family assessment summary community support​ 8.32 plan, the case manager shall assist the child and child's family in accessing the needed​ 8.33 services listed in section 245.4884, subdivision 1.​ 8​ Article 1 Sec. 13.​ 23-00276 as introduced​ 01/26/23 REVISOR EB/HL​ 9.1 (b) The child's individual family assessment summary community support plan must​ 9.2 state:​ 9.3 (1) the goals and expected outcomes of each service and criteria for evaluating the​ 9.4 effectiveness and appropriateness of the service;​ 9.5 (2) the activities for accomplishing each goal;​ 9.6 (3) a schedule for each activity; and​ 9.7 (4) the frequency of face-to-face contacts by the case manager, as appropriate to client​ 9.8 need and the implementation of the individual family assessment summary community​ 9.9 support plan.​ 9.10 Sec. 14. Minnesota Statutes 2022, section 245.4885, subdivision 1, is amended to read:​ 9.11 Subdivision 1. Admission criteria. (a) Prior to admission or placement, except in the​ 9.12 case of an emergency, all children referred for treatment of severe emotional disturbance​ 9.13 in a treatment foster care setting, residential treatment facility, or informally admitted to a​ 9.14 regional treatment center shall undergo an assessment to determine the appropriate level of​ 9.15 care if county funds are used to pay for the child's services. An emergency includes when​ 9.16 a child is in need of and has been referred for crisis stabilization services under section​ 9.17 245.4882, subdivision 6. A child who has been referred to residential treatment for crisis​ 9.18 stabilization services in a residential treatment center is not required to undergo an assessment​ 9.19 under this section.​ 9.20 (b) The county board shall determine the appropriate level of care for a child when​ 9.21 county-controlled funds are used to pay for the child's residential treatment under this​ 9.22 chapter, including residential treatment provided in a qualified residential treatment program​ 9.23 as defined in section 260C.007, subdivision 26d. When a county board does not have​ 9.24 responsibility for a child's placement and the child is enrolled in a prepaid health program​ 9.25 under section 256B.69, the enrolled child's contracted health plan must determine the​ 9.26 appropriate level of care for the child. When Indian Health Services funds or funds of a​ 9.27 tribally owned facility funded under the Indian Self-Determination and Education Assistance​ 9.28 Act, Public Law 93-638, are used for the child, the Indian Health Services or 638 tribal​ 9.29 health facility must determine the appropriate level of care for the child. When more than​ 9.30 one entity bears responsibility for a child's coverage, the entities shall coordinate level of​ 9.31 care determination activities for the child to the extent possible.​ 9.32 (c) The child's level of care determination shall determine whether the proposed treatment:​ 9.33 (1) is necessary;​ 9​ Article 1 Sec. 14.​ 23-00276 as introduced​ 01/26/23 REVISOR EB/HL​ 10.1 (2) is appropriate to the child's individual treatment needs;​ 10.2 (3) cannot be effectively provided in the child's home; and​ 10.3 (4) provides a length of stay as short as possible consistent with the individual child's​ 10.4 needs.​ 10.5 (d) When a level of care determination is conducted, the county board or other entity​ 10.6 may not determine that a screening of a child, referral, or admission to a residential treatment​ 10.7 facility is not appropriate solely because services were not first provided to the child in a​ 10.8 less restrictive setting and the child failed to make progress toward or meet treatment goals​ 10.9 in the less restrictive setting. The level of care determination must be based on a diagnostic​ 10.10 assessment of a child that evaluates the child's family, school, and community living​ 10.11 situations; and an assessment of the child's need for care out of the home using a validated​ 10.12 tool which assesses a child's functional status and assigns an appropriate level of care to the​ 10.13 child. The validated tool must be approved by the commissioner of human services and​ 10.14 may be the validated tool approved for the child's assessment under section 260C.704 if the​ 10.15 juvenile treatment screening team recommended placement of the child in a qualified​ 10.16 residential treatment program. If a diagnostic assessment has been completed by a mental​ 10.17 health professional within the past 180 days, a new diagnostic assessment need not be​ 10.18 completed unless in the opinion of the current treating mental health professional the child's​ 10.19 mental health status has changed markedly since the assessment was completed. The child's​ 10.20 parent shall be notified if an assessment will not be completed and of the reasons. A copy​ 10.21 of the notice shall be placed in the child's file. Recommendations developed as part of the​ 10.22 level of care determination process shall include specific community services needed by​ 10.23 the child and, if appropriate, the child's family, and shall indicate whether these services​ 10.24 are available and accessible to the child and the child's family. The child and the child's​ 10.25 family must be invited to any meeting where the level of care determination is discussed​ 10.26 and decisions regarding residential treatment are made. The child and the child's family​ 10.27 may invite other relatives, friends, or advocates to attend these meetings.​ 10.28 (e) During the level of care determination process, the child, child's family, or child's​ 10.29 legal representative, as appropriate, must be informed of the child's eligibility for case​ 10.30 management services and family community support services and that an individual family​ 10.31 assessment summary community support plan is being developed by the case manager, if​ 10.32 assigned.​ 10​ Article 1 Sec. 14.​ 23-00276 as introduced​ 01/26/23 REVISOR EB/HL​ 11.1 (f) The level of care determination, placement decision, and recommendations for mental​ 11.2 health services must be documented in the child's record and made available to the child's​ 11.3 family, as appropriate.​ 11.4 Sec. 15. Minnesota Statutes 2022, section 245.4887, is amended to read:​ 11.5 245.4887 APPEALS.​ 11.6 A child or a child's family, as appropriate, who requests mental health services under​ 11.7 sections 245.487 to 245.4889 must be advised of services available and the right to appeal​ 11.8 as described in this section at the time of the request and each time the individual family​ 11.9 assessment summary community support plan or individual treatment plan is reviewed. A​ 11.10 child whose request for mental health services under sections 245.487 to 245.4889 is denied,​ 11.11 not acted upon with reasonable promptness, or whose services are suspended, reduced, or​ 11.12 terminated by action or inaction for which the county board is responsible under sections​ 11.13 245.487 to 245.4889 may contest that action or inaction before the state agency according​ 11.14 to section 256.045. The commissioner shall monitor the nature and frequency of​ 11.15 administrative appeals under this section.​ 11.16 Sec. 16. [245.4903] CULTURAL AND ETHNIC MINORITY INFRASTRUCTURE​ 11.17 GRANT PROGRAM.​ 11.18 Subdivision 1. Establishment. The commissioner of human services shall establish a​ 11.19 cultural and ethnic minority infrastructure grant program to ensure that mental health and​ 11.20 substance use disorder treatment supports and services are culturally specific and culturally​ 11.21 responsive to meet the cultural needs of the communities served.​ 11.22 Subd. 2. Eligible applicants. An eligible applicant is a licensed entity or provider from​ 11.23 a cultural or ethnic minority population who:​ 11.24 (1) provides mental health or substance use disorder treatment services and supports to​ 11.25 individuals from cultural and ethnic minority populations, including individuals who are​ 11.26 lesbian, gay, bisexual, transgender, or queer and from cultural and ethnic minority​ 11.27 populations;​ 11.28 (2) provides or is qualified and has the capacity to provide clinical supervision and​ 11.29 support to members of culturally diverse and ethnic minority communities to qualify as​ 11.30 mental health and substance use disorder treatment providers; or​ 11.31 (3) has the capacity and experience to provide training for mental health and substance​ 11.32 use disorder treatment providers on cultural competency and cultural humility.​ 11​ Article 1 Sec. 16.​ 23-00276 as introduced​ 01/26/23 REVISOR EB/HL​ 12.1 Subd. 2. Allowable grant activities. (a) The cultural and ethnic minority infrastructure​ 12.2 grant program grantees must engage in activities and provide supportive services to ensure​ 12.3 and increase equitable access to culturally specific and responsive care and to build​ 12.4 organizational and professional capacity for licensure and certification for the communities​ 12.5 served. Allowable grant activities include but are not limited to:​ 12.6 (1) workforce development activities focused on recruiting, supporting, training, and​ 12.7 supervision activities for mental health and substance use disorder practitioners and​ 12.8 professionals from diverse racial, cultural, and ethnic communities;​ 12.9 (2) supporting members of culturally diverse and ethnic minority communities to qualify​ 12.10 as mental health and substance use disorder professionals, practitioners, clinical supervisors,​ 12.11 recovery peer specialists, mental health certified peer specialists, and mental health certified​ 12.12 family peer specialists;​ 12.13 (3) culturally specific outreach, early intervention, trauma-informed services, and recovery​ 12.14 support in mental health and substance use disorder services;​ 12.15 (4) provision of trauma-informed, culturally responsive mental health and substance use​ 12.16 disorder supports and services for children and families, youth, or adults who are from​ 12.17 cultural and ethnic minority backgrounds and are uninsured or underinsured;​ 12.18 (5) mental health and substance use disorder service expansion and infrastructure​ 12.19 improvement activities, particularly in greater Minnesota;​ 12.20 (6) training for mental health and substance use disorder treatment providers on cultural​ 12.21 competency and cultural humility; and​ 12.22 (7) activities to increase the availability of culturally responsive mental health and​ 12.23 substance use disorder services for children and families, youth, or adults or to increase the​ 12.24 availability of substance use disorder services for individuals from cultural and ethnic​ 12.25 minorities in the state.​ 12.26 (b) The commissioner must assist grantees with meeting third-party credentialing​ 12.27 requirements, and grantees must obtain all available third-party reimbursement sources as​ 12.28 a condition of receiving grant funds. Grantees must serve individuals from cultural and​ 12.29 ethnic minority communities regardless of health coverage status or ability to pay.​ 12.30 Subd. 3. Data collection and outcomes. Grantees must provide regular data summaries​ 12.31 to the commissioner for purposes of evaluating the effectiveness of the cultural and ethnic​ 12.32 minority infrastructure grant program. The commissioner must use identified culturally​ 12​ Article 1 Sec. 16.​ 23-00276 as introduced​ 01/26/23 REVISOR EB/HL​ 13.1 appropriate outcome measures instruments to evaluate outcomes and must evaluate program​ 13.2 activities by analyzing whether the program:​ 13.3 (1) increased access to culturally specific services for individuals from cultural and​ 13.4 ethnic minority communities across the state;​ 13.5 (2) increased the number of individuals from cultural and ethnic minority communities​ 13.6 served by grantees;​ 13.7 (3) increased cultural responsiveness and cultural competency of mental health and​ 13.8 substance use disorder treatment providers;​ 13.9 (4) increased the number of mental health and substance use disorder treatment providers​ 13.10 and clinical supervisors from cultural and ethnic minority communities;​ 13.11 (5) increased the number of mental health and substance use disorder treatment​ 13.12 organizations owned, managed, or led by individuals who are Black, Indigenous, or people​ 13.13 of color;​ 13.14 (6) reduced health disparities through improved clinical and functional outcomes for​ 13.15 those accessing services; and​ 13.16 (7) led to an overall increase in culturally specific mental health and substance use​ 13.17 disorder service availability.​ 13.18 EFFECTIVE DATE. This section is effective the day following final enactment.​ 13.19 Sec. 17. [245.4906] MENTAL HEALTH CERTIFIED PEER SPECIALIST GRANT​ 13.20 PROGRAM.​ 13.21 Subdivision 1. Establishment. The mental health certified peer specialist grant program​ 13.22 is established in the Department of Human Services to provide funding for training for​ 13.23 mental health certified peer specialists who provide services to support individuals with​ 13.24 lived experience of mental illness under section 256B.0615. Certified peer specialists provide​ 13.25 services to individuals who are receiving assertive community treatment or intensive​ 13.26 residential treatment services under section 256B.0622, adult rehabilitative mental health​ 13.27 services under section 256B.0623, or crisis response services under section 256B.0624.​ 13.28 Mental health certified peer specialist qualifications are defined in section 245I.04,​ 13.29 subdivision 10, and mental health certified peer specialists' scope of practice is defined in​ 13.30 section 245I.04, subdivision 11.​ 13.31 Subd. 2. Activities. Grant funding may be used to provide training for mental health​ 13.32 certified peer specialists as specified in section 256B.0615, subdivision 5.​ 13​ Article 1 Sec. 17.​ 23-00276 as introduced​ 01/26/23 REVISOR EB/HL​ 14.1 Subd. 3. Outcomes. Evaluation includes the extent to which individuals receiving peer​ 14.2 services:​ 14.3 (1) experience progress on achieving treatment goals; and​ 14.4 (2) experience a reduction in hospital admissions.​ 14.5 EFFECTIVE DATE. This section is effective the day following final enactment.​ 14.6 Sec. 18. [245.4907] MENTAL HEALTH CERTIFIED FAMILY PEER SPECIALIST​ 14.7 GRANT PROGRAM.​ 14.8 Subdivision 1. Establishment. The mental health certified peer family specialist grant​ 14.9 program is established in the Department of Human Services to provide funding for training​ 14.10 for mental health certified peer family specialists who provide services to support individuals​ 14.11 with lived experience of mental illness under section 256B.0616. Certified family peer​ 14.12 specialists provide services to families who have a child with an emotional disturbance or​ 14.13 severe emotional disturbance under chapter 245. Certified family peer specialists provide​ 14.14 services to families whose children are receiving inpatient hospitalization under section​ 14.15 256B.0625, subdivision 1; partial hospitalization under Minnesota Rules, parts 9505.0370,​ 14.16 subpart 24, and 9505.0372, subpart 9; residential treatment under section 245.4882; children's​ 14.17 intensive behavioral health services under section 256B.0946; and day treatment, children's​ 14.18 therapeutic services and supports, or crisis response services under section 256B.0624.​ 14.19 Mental health certified family peer specialist qualifications are defined in section 245I.04,​ 14.20 subdivision 12, and mental health certified family peer specialists' scope of practice is​ 14.21 defined in section 245I.04, subdivision 13.​ 14.22 Subd. 2. Activities. Grant funding may be used to provide training for mental health​ 14.23 certified family peer specialists as specified in section 256B.0616, subdivision 5.​ 14.24 Subd. 3. Outcomes. Evaluation includes the extent to which individuals receiving family​ 14.25 peer services:​ 14.26 (1) progress on achieving treatment goals; and​ 14.27 (2) experience a reduction in hospital admissions.​ 14.28 EFFECTIVE DATE. This section is effective the day following final enactment.​ 14​ Article 1 Sec. 18.​ 23-00276 as introduced​ 01/26/23 REVISOR EB/HL​ 15.1 Sec. 19. [245.991] PROJECTS FOR ASSISTANCE IN TRANSITION FROM​ 15.2 HOMELESSNESS PROGRAM.​ 15.3 Subdivision 1. Establishment. The projects for assistance in transition from homelessness​ 15.4 program is established in the Department of Human Services to prevent or end homelessness​ 15.5 for people with serious mental illness or co-occurring substance use disorder and ensure​ 15.6 the commissioner may achieve the goals of the housing mission statement in section 245.461,​ 15.7 subdivision 4.​ 15.8 Subd. 2. Activities. All projects for assistance in transition from homelessness must​ 15.9 provide homeless outreach and case management services. Projects may provide clinical​ 15.10 assessment, habilitation and rehabilitation services, community mental health services,​ 15.11 substance use disorder treatment, housing transition and sustaining services, direct assistance​ 15.12 funding, and other activities as determined by the commissioner.​ 15.13 Subd. 3. Eligibility. Program activities must be provided to people with serious mental​ 15.14 illness, or with co-occurring substance use disorder, who meet homeless criteria determined​ 15.15 by the commissioner. People receiving homeless outreach may be presumed eligible until​ 15.16 serious mental illness can be verified.​ 15.17 Subd. 4. Outcomes. Evaluation of each project includes the extent to which:​ 15.18 (1) grantees contact individuals through homeless outreach services;​ 15.19 (2) grantees enroll individuals in case management services;​ 15.20 (3) individuals access behavioral health services; and​ 15.21 (4) individuals transition from homelessness to housing.​ 15.22 Subd. 5. Federal aid or grants. The commissioner of human services must comply with​ 15.23 all conditions and requirements necessary to receive federal aid or grants with respect to​ 15.24 homeless services or programs as specified in section 245.70.​ 15.25 EFFECTIVE DATE. This section is effective the day following final enactment.​ 15.26 Sec. 20. [245.992] HOUSING WITH SUPPORT FOR ADULTS WITH SERIOUS​ 15.27 MENTAL ILLNESS PROGRAM.​ 15.28 Subdivision 1. Creation. The housing with support for adults with serious mental illness​ 15.29 program is established in the Department of Human Services to prevent or end homelessness​ 15.30 for people with serious mental illness, increase the availability of housing with support, and​ 15.31 ensure the commissioner may achieve the goals of the housing mission statement in section​ 15.32 245.461, subdivision 4.​ 15​ Article 1 Sec. 20.​ 23-00276 as introduced​ 01/26/23 REVISOR EB/HL​ 16.1 Subd. 2. Activities. The housing with support for adults with serious mental illness​ 16.2 program may provide a range of activities and supportive services to assure that people​ 16.3 obtain and retain permanent supportive housing. Program activities may include case​ 16.4 management, site-based housing services, housing transition and sustaining services, outreach​ 16.5 services, community support services, direct assistance funding, and other activities as​ 16.6 determined by the commissioner.​ 16.7 Subd. 3. Eligibility. Program activities must be provided to people with serious mental​ 16.8 illness, or with co-occurring substance use disorder, who meet homeless criteria determined​ 16.9 by the commissioner.​ 16.10 Subd. 4. Outcomes. Evaluation of program activities must utilize evidence-based​ 16.11 practices and must include the extent to which:​ 16.12 (1) grantees' housing and activities utilize evidence-based practices;​ 16.13 (2) individuals transition from homelessness to housing;​ 16.14 (3) individuals retain housing; and​ 16.15 (4) individuals are satisfied with their housing.​ 16.16 EFFECTIVE DATE. This section is effective the day following final enactment.​ 16.17 Sec. 21. Minnesota Statutes 2022, section 245A.03, subdivision 7, is amended to read:​ 16.18 Subd. 7. Licensing moratorium. (a) The commissioner shall not issue an initial license​ 16.19 for child foster care licensed under Minnesota Rules, parts 2960.3000 to 2960.3340, or adult​ 16.20 foster care licensed under Minnesota Rules, parts 9555.5105 to 9555.6265, under this chapter​ 16.21 for a physical location that will not be the primary residence of the license holder for the​ 16.22 entire period of licensure. If a family child foster care home or family adult foster care home​ 16.23 license is issued during this moratorium, and the license holder changes the license holder's​ 16.24 primary residence away from the physical location of the foster care license, the​ 16.25 commissioner shall revoke the license according to section 245A.07. The commissioner​ 16.26 shall not issue an initial license for a community residential setting licensed under chapter​ 16.27 245D. When approving an exception under this paragraph, the commissioner shall consider​ 16.28 the resource need determination process in paragraph (h), the availability of foster care​ 16.29 licensed beds in the geographic area in which the licensee seeks to operate, the results of a​ 16.30 person's choices during their annual assessment and service plan review, and the​ 16.31 recommendation of the local county board. The determination by the commissioner is final​ 16.32 and not subject to appeal. Exceptions to the moratorium include:​ 16​ Article 1 Sec. 21.​ 23-00276 as introduced​ 01/26/23 REVISOR EB/HL​ 17.1 (1) foster care settings a license for a person in a foster care setting that is not the primary​ 17.2 residence of the license holder and where at least 80 percent of the residents are 55 years​ 17.3 of age or older;​ 17.4 (2) foster care licenses replacing foster care licenses in existence on May 15, 2009, or​ 17.5 community residential setting licenses replacing adult foster care licenses in existence on​ 17.6 December 31, 2013, and determined to be needed by the commissioner under paragraph​ 17.7 (b);​ 17.8 (3) new foster care licenses or community residential setting licenses determined to be​ 17.9 needed by the commissioner under paragraph (b) for the closure of a nursing facility, ICF/DD,​ 17.10 or regional treatment center; restructuring of state-operated services that limits the capacity​ 17.11 of state-operated facilities; or allowing movement to the community for people who no​ 17.12 longer require the level of care provided in state-operated facilities as provided under section​ 17.13 256B.092, subdivision 13, or 256B.49, subdivision 24;​ 17.14 (4) new foster care licenses or community residential setting licenses determined to be​ 17.15 needed by the commissioner under paragraph (b) for persons requiring hospital-level care;​ 17.16 or​ 17.17 (5) new foster care licenses or community residential setting licenses for people receiving​ 17.18 customized living or 24-hour customized living services under the brain injury or community​ 17.19 access for disability inclusion waiver plans under section 256B.49 and residing in the​ 17.20 customized living setting before July 1, 2022, for which a license is required. A customized​ 17.21 living service provider subject to this exception may rebut the presumption that a license​ 17.22 is required by seeking a reconsideration of the commissioner's determination. The​ 17.23 commissioner's disposition of a request for reconsideration is final and not subject to appeal​ 17.24 under chapter 14. The exception is available until June 30, 2023. This exception is available​ 17.25 when:​ 17.26 (i) the person's customized living services are provided in a customized living service​ 17.27 setting serving four or fewer people under the brain injury or community access for disability​ 17.28 inclusion waiver plans under section 256B.49 in a single-family home operational on or​ 17.29 before June 30, 2021. Operational is defined in section 256B.49, subdivision 28;​ 17.30 (ii) the person's case manager provided the person with information about the choice of​ 17.31 service, service provider, and location of service, including in the person's home, to help​ 17.32 the person make an informed choice; and​ 17​ Article 1 Sec. 21.​ 23-00276 as introduced​ 01/26/23 REVISOR EB/HL​ 18.1 (iii) the person's services provided in the licensed foster care or community residential​ 18.2 setting are less than or equal to the cost of the person's services delivered in the customized​ 18.3 living setting as determined by the lead agency.​ 18.4 (b) The commissioner shall determine the need for newly licensed foster care homes or​ 18.5 community residential settings as defined under this subdivision. As part of the determination,​ 18.6 the commissioner shall consider the availability of foster care capacity in the area in which​ 18.7 the licensee seeks to operate, and the recommendation of the local county board. The​ 18.8 determination by the commissioner must be final. A determination of need is not required​ 18.9 for a change in ownership at the same address.​ 18.10 (c) When an adult resident served by the program moves out of a foster home that is not​ 18.11 the primary residence of the license holder according to section 256B.49, subdivision 15,​ 18.12 paragraph (f), or the adult community residential setting, the county shall immediately​ 18.13 inform the Department of Human Services Licensing Division. The department may decrease​ 18.14 the statewide licensed capacity for adult foster care settings.​ 18.15 (d) Residential settings that would otherwise be subject to the decreased license capacity​ 18.16 established in paragraph (c) shall be exempt if the license holder's beds are occupied by​ 18.17 residents whose primary diagnosis is mental illness and the license holder is certified under​ 18.18 the requirements in subdivision 6a or section 245D.33.​ 18.19 (e) A resource need determination process, managed at the state level, using the available​ 18.20 data required by section 144A.351, and other data and information shall be used to determine​ 18.21 where the reduced capacity determined under section 256B.493 will be implemented. The​ 18.22 commissioner shall consult with the stakeholders described in section 144A.351, and employ​ 18.23 a variety of methods to improve the state's capacity to meet the informed decisions of those​ 18.24 people who want to move out of corporate foster care or community residential settings,​ 18.25 long-term service needs within budgetary limits, including seeking proposals from service​ 18.26 providers or lead agencies to change service type, capacity, or location to improve services,​ 18.27 increase the independence of residents, and better meet needs identified by the long-term​ 18.28 services and supports reports and statewide data and information.​ 18.29 (f) At the time of application and reapplication for licensure, the applicant and the license​ 18.30 holder that are subject to the moratorium or an exclusion established in paragraph (a) are​ 18.31 required to inform the commissioner whether the physical location where the foster care​ 18.32 will be provided is or will be the primary residence of the license holder for the entire period​ 18.33 of licensure. If the primary residence of the applicant or license holder changes, the applicant​ 18.34 or license holder must notify the commissioner immediately. The commissioner shall print​ 18​ Article 1 Sec. 21.​ 23-00276 as introduced​ 01/26/23 REVISOR EB/HL​ 19.1 on the foster care license certificate whether or not the physical location is the primary​ 19.2 residence of the license holder.​ 19.3 (g) License holders of foster care homes identified under paragraph (f) that are not the​ 19.4 primary residence of the license holder and that also provide services in the foster care home​ 19.5 that are covered by a federally approved home and community-based services waiver, as​ 19.6 authorized under chapter 256S or section 256B.092 or 256B.49, must inform the human​ 19.7 services licensing division that the license holder provides or intends to provide these​ 19.8 waiver-funded services.​ 19.9 (h) The commissioner may adjust capacity to address needs identified in section​ 19.10 144A.351. Under this authority, the commissioner may approve new licensed settings or​ 19.11 delicense existing settings. Delicensing of settings will be accomplished through a process​ 19.12 identified in section 256B.493.​ 19.13 (i) The commissioner must notify a license holder when its corporate foster care or​ 19.14 community residential setting licensed beds are reduced under this section. The notice of​ 19.15 reduction of licensed beds must be in writing and delivered to the license holder by certified​ 19.16 mail or personal service. The notice must state why the licensed beds are reduced and must​ 19.17 inform the license holder of its right to request reconsideration by the commissioner. The​ 19.18 license holder's request for reconsideration must be in writing. If mailed, the request for​ 19.19 reconsideration must be postmarked and sent to the commissioner within 20 calendar days​ 19.20 after the license holder's receipt of the notice of reduction of licensed beds. If a request for​ 19.21 reconsideration is made by personal service, it must be received by the commissioner within​ 19.22 20 calendar days after the license holder's receipt of the notice of reduction of licensed beds.​ 19.23 (j) The commissioner shall not issue an initial license for children's residential treatment​ 19.24 services licensed under Minnesota Rules, parts 2960.0580 to 2960.0700, under this chapter​ 19.25 for a program that Centers for Medicare and Medicaid Services would consider an institution​ 19.26 for mental diseases. Facilities that serve only private pay clients are exempt from the​ 19.27 moratorium described in this paragraph. The commissioner has the authority to manage​ 19.28 existing statewide capacity for children's residential treatment services subject to the​ 19.29 moratorium under this paragraph and may issue an initial license for such facilities if the​ 19.30 initial license would not increase the statewide capacity for children's residential treatment​ 19.31 services subject to the moratorium under this paragraph.​ 19.32 EFFECTIVE DATE. This section is effective the day following final enactment.​ 19​ Article 1 Sec. 21.​ 23-00276 as introduced​ 01/26/23 REVISOR EB/HL​ 20.1 Sec. 22. Minnesota Statutes 2022, section 245A.11, subdivision 7, is amended to read:​ 20.2 Subd. 7. Adult foster care and community residential settings; variance for alternate​ 20.3 overnight supervision. (a) The commissioner may grant a variance under section 245A.04,​ 20.4 subdivision 9, to statutes and rule parts requiring a caregiver to be present in an adult foster​ 20.5 care home or a community residential setting during normal sleeping hours to allow for​ 20.6 alternative methods of overnight supervision. The commissioner may grant the variance if​ 20.7 the local county licensing agency recommends the variance and the county recommendation​ 20.8 includes documentation verifying that:​ 20.9 (1) the county has approved the license holder's plan for alternative methods of providing​ 20.10 overnight supervision and determined the plan protects the residents' health, safety, and​ 20.11 rights;​ 20.12 (2) the license holder has obtained written and signed informed consent from each​ 20.13 resident or each resident's legal representative documenting the resident's or legal​ 20.14 representative's agreement with the alternative method of overnight supervision; and​ 20.15 (3) the alternative method of providing overnight supervision, which may include the​ 20.16 use of technology, is specified for each resident in the resident's: (i) individualized plan of​ 20.17 care; (ii) individual service support plan under section 256B.092, subdivision 1b, if required;​ 20.18 or (iii) individual resident placement agreement under Minnesota Rules, part 9555.5105,​ 20.19 subpart 19, if required.​ 20.20 (b) To be eligible for a variance under paragraph (a), the adult foster care or community​ 20.21 residential setting license holder must not have had a conditional license issued under section​ 20.22 245A.06, or any other licensing sanction issued under section 245A.07 during the prior 24​ 20.23 months based on failure to provide adequate supervision, health care services, or resident​ 20.24 safety in the adult foster care home or community residential setting.​ 20.25 (c) A license holder requesting a variance under this subdivision to utilize technology​ 20.26 as a component of a plan for alternative overnight supervision may request the commissioner's​ 20.27 review in the absence of a county recommendation. Upon receipt of such a request from a​ 20.28 license holder, the commissioner shall review the variance request with the county.​ 20.29 (d) A variance granted by the commissioner according to this subdivision before January​ 20.30 1, 2014, to a license holder for an adult foster care home must transfer with the license when​ 20.31 the license converts to a community residential setting license under chapter 245D. The​ 20.32 terms and conditions of the variance remain in effect as approved at the time the variance​ 20.33 was granted.​ 20​ Article 1 Sec. 22.​ 23-00276 as introduced​ 01/26/23 REVISOR EB/HL​ 21.1 EFFECTIVE DATE. This section is effective the day following final enactment.​ 21.2 Sec. 23. Minnesota Statutes 2022, section 245A.16, subdivision 1, is amended to read:​ 21.3 Subdivision 1. Delegation of authority to agencies. (a) County agencies and private​ 21.4 agencies that have been designated or licensed by the commissioner to perform licensing​ 21.5 functions and activities under section 245A.04 and background studies for family child care​ 21.6 under chapter 245C; to recommend denial of applicants under section 245A.05; to issue​ 21.7 correction orders, to issue variances, and recommend a conditional license under section​ 21.8 245A.06; or to recommend suspending or revoking a license or issuing a fine under section​ 21.9 245A.07, shall comply with rules and directives of the commissioner governing those​ 21.10 functions and with this section. The following variances are excluded from the delegation​ 21.11 of variance authority and may be issued only by the commissioner:​ 21.12 (1) dual licensure of family child care and child foster care, dual licensure of child foster​ 21.13 care and adult foster care or a community residential setting, and dual licensure of adult​ 21.14 foster care and family child care;​ 21.15 (2) adult foster care maximum capacity;​ 21.16 (3) adult foster care minimum age requirement;​ 21.17 (4) child foster care maximum age requirement;​ 21.18 (5) variances regarding disqualified individuals except that, before the implementation​ 21.19 of NETStudy 2.0, county agencies may issue variances under section 245C.30 regarding​ 21.20 disqualified individuals when the county is responsible for conducting a consolidated​ 21.21 reconsideration according to sections 245C.25 and 245C.27, subdivision 2, clauses (a) and​ 21.22 (b), of a county maltreatment determination and a disqualification based on serious or​ 21.23 recurring maltreatment;​ 21.24 (6) the required presence of a caregiver in the adult foster care residence during normal​ 21.25 sleeping hours;​ 21.26 (7) variances to requirements relating to chemical use problems of a license holder or a​ 21.27 household member of a license holder; and​ 21.28 (8) variances to section 245A.53 for a time-limited period. If the commissioner grants​ 21.29 a variance under this clause, the license holder must provide notice of the variance to all​ 21.30 parents and guardians of the children in care.​ 21​ Article 1 Sec. 23.​ 23-00276 as introduced​ 01/26/23 REVISOR EB/HL​ 22.1 Except as provided in section 245A.14, subdivision 4, paragraph (e), a county agency must​ 22.2 not grant a license holder a variance to exceed the maximum allowable family child care​ 22.3 license capacity of 14 children.​ 22.4 (b) A county agency that has been designated by the commissioner to issue family child​ 22.5 care variances must:​ 22.6 (1) publish the county agency's policies and criteria for issuing variances on the county's​ 22.7 public website and update the policies as necessary; and​ 22.8 (2) annually distribute the county agency's policies and criteria for issuing variances to​ 22.9 all family child care license holders in the county.​ 22.10 (c) Before the implementation of NETStudy 2.0, county agencies must report information​ 22.11 about disqualification reconsiderations under sections 245C.25 and 245C.27, subdivision​ 22.12 2, paragraphs (a) and (b), and variances granted under paragraph (a), clause (5), to the​ 22.13 commissioner at least monthly in a format prescribed by the commissioner.​ 22.14 (d) For family child care programs, the commissioner shall require a county agency to​ 22.15 conduct one unannounced licensing review at least annually.​ 22.16 (e) For family adult day services programs, the commissioner may authorize licensing​ 22.17 reviews every two years after a licensee has had at least one annual review.​ 22.18 (f) A license issued under this section may be issued for up to two years.​ 22.19 (g) During implementation of chapter 245D, the commissioner shall consider:​ 22.20 (1) the role of counties in quality assurance;​ 22.21 (2) the duties of county licensing staff; and​ 22.22 (3) the possible use of joint powers agreements, according to section 471.59, with counties​ 22.23 through which some licensing duties under chapter 245D may be delegated by the​ 22.24 commissioner to the counties.​ 22.25 Any consideration related to this paragraph must meet all of the requirements of the corrective​ 22.26 action plan ordered by the federal Centers for Medicare and Medicaid Services.​ 22.27 (h) Licensing authority specific to section 245D.06, subdivisions 5, 6, 7, and 8, or​ 22.28 successor provisions; and section 245D.061 or successor provisions, for family child foster​ 22.29 care programs providing out-of-home respite, as identified in section 245D.03, subdivision​ 22.30 1, paragraph (b), clause (1), is excluded from the delegation of authority to county and​ 22.31 private agencies.​ 22​ Article 1 Sec. 23.​ 23-00276 as introduced​ 01/26/23 REVISOR EB/HL​ 23.1 (i) A county agency shall report to the commissioner, in a manner prescribed by the​ 23.2 commissioner, the following information for a licensed family child care program:​ 23.3 (1) the results of each licensing review completed, including the date of the review, and​ 23.4 any licensing correction order issued;​ 23.5 (2) any death, serious injury, or determination of substantiated maltreatment; and​ 23.6 (3) any fires that require the service of a fire department within 48 hours of the fire. The​ 23.7 information under this clause must also be reported to the state fire marshal within two​ 23.8 business days of receiving notice from a licensed family child care provider.​ 23.9 EFFECTIVE DATE. This section is effective the day following final enactment.​ 23.10 Sec. 24. Minnesota Statutes 2022, section 245D.03, subdivision 1, is amended to read:​ 23.11 Subdivision 1. Applicability. (a) The commissioner shall regulate the provision of home​ 23.12 and community-based services to persons with disabilities and persons age 65 and older​ 23.13 pursuant to this chapter. The licensing standards in this chapter govern the provision of​ 23.14 basic support services and intensive support services.​ 23.15 (b) Basic support services provide the level of assistance, supervision, and care that is​ 23.16 necessary to ensure the health and welfare of the person and do not include services that​ 23.17 are specifically directed toward the training, treatment, habilitation, or rehabilitation of the​ 23.18 person. Basic support services include:​ 23.19 (1) in-home and out-of-home respite care services as defined in section 245A.02,​ 23.20 subdivision 15, and under the brain injury, community alternative care, community access​ 23.21 for disability inclusion, developmental disabilities, and elderly waiver plans, excluding​ 23.22 out-of-home respite care provided to children in a family child foster care home licensed​ 23.23 under Minnesota Rules, parts 2960.3000 to 2960.3100, when the child foster care license​ 23.24 holder complies with the requirements under section 245D.06, subdivisions 5, 6, 7, and 8,​ 23.25 or successor provisions; and section 245D.061 or successor provisions, which must be​ 23.26 stipulated in the statement of intended use required under Minnesota Rules, part 2960.3000,​ 23.27 subpart 4;​ 23.28 (2) adult companion services as defined under the brain injury, community access for​ 23.29 disability inclusion, community alternative care, and elderly waiver plans plan, excluding​ 23.30 adult companion services provided under the Corporation for National and Community​ 23.31 Services Senior Companion Program established under the Domestic Volunteer Service​ 23.32 Act of 1973, Public Law 98-288;​ 23​ Article 1 Sec. 24.​ 23-00276 as introduced​ 01/26/23 REVISOR EB/HL​ 24.1 (3) personal support as defined under the developmental disabilities waiver plan;​ 24.2 (4) (3) 24-hour emergency assistance, personal emergency response as defined under​ 24.3 the community access for disability inclusion and developmental disabilities waiver plans;​ 24.4 (5) (4) night supervision services as defined under the brain injury, community access​ 24.5 for disability inclusion, community alternative care, and developmental disabilities waiver​ 24.6 plans;​ 24.7 (6) (5) homemaker services as defined under the community access for disability​ 24.8 inclusion, brain injury, community alternative care, developmental disabilities, and elderly​ 24.9 waiver plans, excluding providers licensed by the Department of Health under chapter 144A​ 24.10 and those providers providing cleaning services only;​ 24.11 (7) (6) individual community living support under section 256S.13; and​ 24.12 (8) (7) individualized home supports without training services as defined under the brain​ 24.13 injury, community alternative care, and community access for disability inclusion, and​ 24.14 developmental disabilities waiver plans.​ 24.15 (c) Intensive support services provide assistance, supervision, and care that is necessary​ 24.16 to ensure the health and welfare of the person and services specifically directed toward the​ 24.17 training, habilitation, or rehabilitation of the person. Intensive support services include:​ 24.18 (1) intervention services, including:​ 24.19 (i) positive support services as defined under the brain injury and community access for​ 24.20 disability inclusion, community alternative care, and developmental disabilities waiver​ 24.21 plans;​ 24.22 (ii) in-home or out-of-home crisis respite services as defined under the brain injury,​ 24.23 community access for disability inclusion, community alternative care, and developmental​ 24.24 disabilities waiver plans; and​ 24.25 (iii) specialist services as defined under the current brain injury, community access for​ 24.26 disability inclusion, community alternative care, and developmental disabilities waiver​ 24.27 plans;​ 24.28 (2) in-home support services, including:​ 24.29 (i) in-home family support and supported living services as defined under the​ 24.30 developmental disabilities waiver plan;​ 24.31 (ii) independent living services training as defined under the brain injury and community​ 24.32 access for disability inclusion waiver plans;​ 24​ Article 1 Sec. 24.​ 23-00276 as introduced​ 01/26/23 REVISOR EB/HL​ 25.1 (iii) (i) semi-independent living services;​ 25.2 (iv) (ii) individualized home support with training services as defined under the brain​ 25.3 injury, community alternative care, community access for disability inclusion, and​ 25.4 developmental disabilities waiver plans; and​ 25.5 (v) (iii) individualized home support with family training services as defined under the​ 25.6 brain injury, community alternative care, community access for disability inclusion, and​ 25.7 developmental disabilities waiver plans;​ 25.8 (3) residential supports and services, including:​ 25.9 (i) supported living services as defined under the developmental disabilities waiver plan​ 25.10 provided in a family or corporate child foster care residence, a family adult foster care​ 25.11 residence, a community residential setting, or a supervised living facility;​ 25.12 (ii) foster care services as defined in the brain injury, community alternative care, and​ 25.13 community access for disability inclusion waiver plans provided in a family or corporate​ 25.14 child foster care residence, a family adult foster care residence, or a community residential​ 25.15 setting;​ 25.16 (iii) (i) community residential services as defined under the brain injury, community​ 25.17 alternative care, community access for disability inclusion, and developmental disabilities​ 25.18 waiver plans provided in a corporate child foster care residence, a community residential​ 25.19 setting, or a supervised living facility;​ 25.20 (iv) (ii) family residential services as defined in the brain injury, community alternative​ 25.21 care, community access for disability inclusion, and developmental disabilities waiver plans​ 25.22 provided in a family child foster care residence or a family adult foster care residence; and​ 25.23 (v) (iii) residential services provided to more than four persons with developmental​ 25.24 disabilities in a supervised living facility, including ICFs/DD;​ 25.25 (4) day services, including:​ 25.26 (i) structured day services as defined under the brain injury waiver plan;​ 25.27 (ii) (i) day services under sections 252.41 to 252.46, and as defined under the brain​ 25.28 injury, community alternative care, community access for disability inclusion, and​ 25.29 developmental disabilities waiver plans; and​ 25.30 (iii) day training and habilitation services under sections 252.41 to 252.46, and as defined​ 25.31 under the developmental disabilities waiver plan; and​ 25​ Article 1 Sec. 24.​ 23-00276 as introduced​ 01/26/23 REVISOR EB/HL​ 26.1 (iv) (ii) prevocational services as defined under the brain injury, community alternative​ 26.2 care, community access for disability inclusion, and developmental disabilities waiver plans;​ 26.3 and​ 26.4 (5) employment exploration services as defined under the brain injury, community​ 26.5 alternative care, community access for disability inclusion, and developmental disabilities​ 26.6 waiver plans;​ 26.7 (6) employment development services as defined under the brain injury, community​ 26.8 alternative care, community access for disability inclusion, and developmental disabilities​ 26.9 waiver plans;​ 26.10 (7) employment support services as defined under the brain injury, community alternative​ 26.11 care, community access for disability inclusion, and developmental disabilities waiver plans;​ 26.12 and​ 26.13 (8) integrated community support as defined under the brain injury and community​ 26.14 access for disability inclusion waiver plans beginning January 1, 2021, and community​ 26.15 alternative care and developmental disabilities waiver plans beginning January 1, 2023.​ 26.16 Sec. 25. Minnesota Statutes 2022, section 245G.07, subdivision 3a, is amended to read:​ 26.17 Subd. 3a. Use of guest speakers. (a) The license holder may allow a guest speaker to​ 26.18 present information to clients as part of a treatment service provided by an alcohol and drug​ 26.19 counselor, according to the requirements of this subdivision.​ 26.20 (b) An alcohol and drug counselor must visually observe and listen to the presentation​ 26.21 of information by a guest speaker the entire time the guest speaker presents information to​ 26.22 the clients. The alcohol and drug counselor is responsible for all information the guest​ 26.23 speaker presents to the clients.​ 26.24 (c) The presentation of information by a guest speaker constitutes a direct contact service,​ 26.25 as defined in section 245C.02, subdivision 11.​ 26.26 (d) The license holder must provide the guest speaker with all training required for staff​ 26.27 members. If the guest speaker provides direct contact services one day a month or less, the​ 26.28 license holder must only provide the guest speaker with orientation training on the following​ 26.29 subjects before the guest speaker provides direct contact services:​ 26.30 (1) mandatory reporting of maltreatment, as specified in sections 245A.65, 626.557, and​ 26.31 626.5572 and chapter 260E;​ 26.32 (2) applicable client confidentiality rules and regulations;​ 26​ Article 1 Sec. 25.​ 23-00276 as introduced​ 01/26/23 REVISOR EB/HL​ 27.1 (3) ethical standards for client interactions; and​ 27.2 (4) emergency procedures.​ 27.3 (e) For a treatment service that includes a guest speaker, in addition to the requirements​ 27.4 in section 245G.06, subdivision 2a, the alcohol and drug counselor that provides the service​ 27.5 must also document in the client record the name of the guest speaker, the start and stop​ 27.6 time of the presentation by the guest speaker, and the topic and summary of the guest speaker​ 27.7 presentation.​ 27.8 Sec. 26. Minnesota Statutes 2022, section 246.0135, is amended to read:​ 27.9 246.0135 OPERATION OF REGIONAL TREATMENT CENTERS.​ 27.10 (a) The commissioner of human services is prohibited from closing any regional treatment​ 27.11 center or state-operated nursing home or any program at any of the regional treatment centers​ 27.12 or state-operated nursing homes, without specific legislative authorization. For persons with​ 27.13 developmental disabilities who move from one regional treatment center to another regional​ 27.14 treatment center, the provisions of section 256B.092, subdivision 10, must be followed for​ 27.15 both the discharge from one regional treatment center and admission to another regional​ 27.16 treatment center, except that the move is not subject to the consensus requirement of section​ 27.17 256B.092, subdivision 10, paragraph (b).​ 27.18 (b) Prior to closing or downsizing a regional treatment center, the commissioner of​ 27.19 human services shall be responsible for assuring that community-based alternatives developed​ 27.20 in response are adequate to meet the program needs identified by each county within the​ 27.21 catchment area and do not require additional local county property tax expenditures.​ 27.22 (c) The nonfederal share of the cost of alternative treatment or care developed as the​ 27.23 result of the closure of a regional treatment center, including costs associated with fulfillment​ 27.24 of responsibilities under chapter 253B shall be paid from state funds appropriated for​ 27.25 purposes specified in section 246.013.​ 27.26 (d) The commissioner may not divert state funds used for providing for care or treatment​ 27.27 of persons residing in a regional treatment center for purposes unrelated to the care and​ 27.28 treatment of such persons.​ 27.29 Sec. 27. Minnesota Statutes 2022, section 254B.05, subdivision 1a, is amended to read:​ 27.30 Subd. 1a. Room and board provider requirements. (a) Effective January 1, 2000,​ 27.31 vendors of room and board are eligible for behavioral health fund payment if the vendor:​ 27​ Article 1 Sec. 27.​ 23-00276 as introduced​ 01/26/23 REVISOR EB/HL​ 28.1 (1) has rules prohibiting residents bringing chemicals into the facility or using chemicals​ 28.2 while residing in the facility and provide consequences for infractions of those rules;​ 28.3 (2) is determined to meet applicable health and safety requirements;​ 28.4 (3) is not a jail or prison;​ 28.5 (4) is not concurrently receiving funds under chapter 256I for the recipient;​ 28.6 (5) admits individuals who are 18 years of age or older;​ 28.7 (6) is registered as a board and lodging or lodging establishment according to section​ 28.8 157.17;​ 28.9 (7) has awake staff on site 24 hours per day whenever a client is present;​ 28.10 (8) has staff who are at least 18 years of age and meet the requirements of section​ 28.11 245G.11, subdivision 1, paragraph (b);​ 28.12 (9) has emergency behavioral procedures that meet the requirements of section 245G.16;​ 28.13 (10) meets the requirements of section 245G.08, subdivision 5, if administering​ 28.14 medications to clients;​ 28.15 (11) meets the abuse prevention requirements of section 245A.65, including a policy on​ 28.16 fraternization and the mandatory reporting requirements of section 626.557;​ 28.17 (12) documents coordination with the treatment provider to ensure compliance with​ 28.18 section 254B.03, subdivision 2;​ 28.19 (13) protects client funds and ensures freedom from exploitation by meeting the​ 28.20 provisions of section 245A.04, subdivision 13;​ 28.21 (14) has a grievance procedure that meets the requirements of section 245G.15,​ 28.22 subdivision 2; and​ 28.23 (15) has sleeping and bathroom facilities for men and women separated by a door that​ 28.24 is locked, has an alarm, or is supervised by awake staff.​ 28.25 (b) Programs licensed according to Minnesota Rules, chapter 2960, are exempt from​ 28.26 paragraph (a), clauses (5) to (15).​ 28.27 (c) Programs providing children's mental health crisis admissions and stabilization under​ 28.28 section 245.4882, subdivision 6, are eligible vendors of room and board.​ 28​ Article 1 Sec. 27.​ 23-00276 as introduced​ 01/26/23 REVISOR EB/HL​ 29.1 (d) Licensed programs providing intensive residential treatment services or residential​ 29.2 crisis stabilization services pursuant to section 256B.0622 or 256B.0624 are eligible vendors​ 29.3 of room and board and are exempt from paragraph (a), clauses (6) to (15).​ 29.4 (e) A vendor that is not licensed as a residential treatment program must have a policy​ 29.5 to address staffing coverage when a client may unexpectedly need to be present at the room​ 29.6 and board site.​ 29.7 Sec. 28. Minnesota Statutes 2022, section 254B.05, subdivision 5, is amended to read:​ 29.8 Subd. 5. Rate requirements. (a) The commissioner shall establish rates for substance​ 29.9 use disorder services and service enhancements funded under this chapter.​ 29.10 (b) Eligible substance use disorder treatment services include:​ 29.11 (1) outpatient treatment services that are licensed according to sections 245G.01 to​ 29.12 245G.17, or applicable tribal license;​ 29.13 (2) comprehensive assessments provided according to sections 245.4863, paragraph (a),​ 29.14 and 245G.05;​ 29.15 (3) care coordination services provided according to section 245G.07, subdivision 1,​ 29.16 paragraph (a), clause (5);​ 29.17 (4) peer recovery support services provided according to section 245G.07, subdivision​ 29.18 2, clause (8);​ 29.19 (5) on July 1, 2019, or upon federal approval, whichever is later, withdrawal management​ 29.20 services provided according to chapter 245F;​ 29.21 (6) substance use disorder treatment services with medications for opioid use disorder​ 29.22 that are licensed according to sections 245G.01 to 245G.17 and 245G.22, or applicable​ 29.23 tribal license;​ 29.24 (7) substance use disorder treatment with medications for opioid use disorder plus​ 29.25 enhanced treatment services that meet the requirements of clause (6) and provide nine hours​ 29.26 of clinical services each week;​ 29.27 (8) high, medium, and low intensity residential treatment services that are licensed​ 29.28 according to sections 245G.01 to 245G.17 and 245G.21 or applicable tribal license which​ 29.29 provide, respectively, 30, 15, and five hours of clinical services each week;​ 29​ Article 1 Sec. 28.​ 23-00276 as introduced​ 01/26/23 REVISOR EB/HL​ 30.1 (9) hospital-based treatment services that are licensed according to sections 245G.01 to​ 30.2 245G.17 or applicable tribal license and licensed as a hospital under sections 144.50 to​ 30.3 144.56;​ 30.4 (10) adolescent treatment programs that are licensed as outpatient treatment programs​ 30.5 according to sections 245G.01 to 245G.18 or as residential treatment programs according​ 30.6 to Minnesota Rules, parts 2960.0010 to 2960.0220, and 2960.0430 to 2960.0490, or​ 30.7 applicable tribal license;​ 30.8 (11) high-intensity residential treatment services that are licensed according to sections​ 30.9 245G.01 to 245G.17 and 245G.21 or applicable tribal license, which provide 30 hours of​ 30.10 clinical services each week provided by a state-operated vendor or to clients who have been​ 30.11 civilly committed to the commissioner, present the most complex and difficult care needs,​ 30.12 and are a potential threat to the community; and​ 30.13 (12) room and board facilities that meet the requirements of subdivision 1a.​ 30.14 (c) The commissioner shall establish higher rates for programs that meet the requirements​ 30.15 of paragraph (b) and one of the following additional requirements:​ 30.16 (1) programs that serve parents with their children if the program:​ 30.17 (i) provides on-site child care during the hours of treatment activity that:​ 30.18 (A) is licensed under chapter 245A as a child care center under Minnesota Rules, chapter​ 30.19 9503; or​ 30.20 (B) meets the licensure exclusion criteria of section 245A.03, subdivision 2, paragraph​ 30.21 (a), clause (6), and meets the requirements is licensed under section chapter 245A and​ 30.22 sections 245G.01 to 245G.19, subdivision 4; or​ 30.23 (ii) arranges for off-site child care during hours of treatment activity at a facility that is​ 30.24 licensed under chapter 245A as:​ 30.25 (A) a child care center under Minnesota Rules, chapter 9503; or​ 30.26 (B) a family child care home under Minnesota Rules, chapter 9502;​ 30.27 (2) culturally specific or culturally responsive programs as defined in section 254B.01,​ 30.28 subdivision 4a;​ 30.29 (3) disability responsive programs as defined in section 254B.01, subdivision 4b;​ 30.30 (4) programs that offer medical services delivered by appropriately credentialed health​ 30.31 care staff in an amount equal to two hours per client per week if the medical needs of the​ 30​ Article 1 Sec. 28.​ 23-00276 as introduced​ 01/26/23 REVISOR EB/HL​ 31.1 client and the nature and provision of any medical services provided are documented in the​ 31.2 client file; or​ 31.3 (5) programs that offer services to individuals with co-occurring mental health and​ 31.4 substance use disorder problems if:​ 31.5 (i) the program meets the co-occurring requirements in section 245G.20;​ 31.6 (ii) 25 percent of the counseling staff are licensed mental health professionals under​ 31.7 section 245I.04, subdivision 2, or are students or licensing candidates under the supervision​ 31.8 of a licensed alcohol and drug counselor supervisor and mental health professional under​ 31.9 section 245I.04, subdivision 2, except that no more than 50 percent of the mental health​ 31.10 staff may be students or licensing candidates with time documented to be directly related​ 31.11 to provisions of co-occurring services;​ 31.12 (iii) clients scoring positive on a standardized mental health screen receive a mental​ 31.13 health diagnostic assessment within ten days of admission;​ 31.14 (iv) the program has standards for multidisciplinary case review that include a monthly​ 31.15 review for each client that, at a minimum, includes a licensed mental health professional​ 31.16 and licensed alcohol and drug counselor, and their involvement in the review is documented;​ 31.17 (v) family education is offered that addresses mental health and substance use disorder​ 31.18 and the interaction between the two; and​ 31.19 (vi) co-occurring counseling staff shall receive eight hours of co-occurring disorder​ 31.20 training annually.​ 31.21 (d) In order to be eligible for a higher rate under paragraph (c), clause (1), a program​ 31.22 that provides arrangements for off-site child care must maintain current documentation at​ 31.23 the substance use disorder facility of the child care provider's current licensure to provide​ 31.24 child care services. Programs that provide child care according to paragraph (c), clause (1),​ 31.25 must be deemed in compliance with the licensing requirements in section 245G.19.​ 31.26 (e) Adolescent residential programs that meet the requirements of Minnesota Rules,​ 31.27 parts 2960.0430 to 2960.0490 and 2960.0580 to 2960.0690, are exempt from the requirements​ 31.28 in paragraph (c), clause (4), items (i) to (iv).​ 31.29 (f) Subject to federal approval, substance use disorder services that are otherwise covered​ 31.30 as direct face-to-face services may be provided via telehealth as defined in section 256B.0625,​ 31.31 subdivision 3b. The use of telehealth to deliver services must be medically appropriate to​ 31.32 the condition and needs of the person being served. Reimbursement shall be at the same​ 31.33 rates and under the same conditions that would otherwise apply to direct face-to-face services.​ 31​ Article 1 Sec. 28.​ 23-00276 as introduced​ 01/26/23 REVISOR EB/HL​ 32.1 (g) For the purpose of reimbursement under this section, substance use disorder treatment​ 32.2 services provided in a group setting without a group participant maximum or maximum​ 32.3 client to staff ratio under chapter 245G shall not exceed a client to staff ratio of 48 to one.​ 32.4 At least one of the attending staff must meet the qualifications as established under this​ 32.5 chapter for the type of treatment service provided. A recovery peer may not be included as​ 32.6 part of the staff ratio.​ 32.7 (h) Payment for outpatient substance use disorder services that are licensed according​ 32.8 to sections 245G.01 to 245G.17 is limited to six hours per day or 30 hours per week unless​ 32.9 prior authorization of a greater number of hours is obtained from the commissioner.​ 32.10 Sec. 29. Minnesota Statutes 2022, section 256.01, is amended by adding a subdivision to​ 32.11 read:​ 32.12 Subd. 12b. Department of Human Services systemic critical incident review team. (a)​ 32.13 The commissioner may establish a Department of Human Services systemic critical incident​ 32.14 review team to review critical incidents reported as required under section 626.557 for​ 32.15 which the Department of Human Services is responsible under section 626.5572, subdivision​ 32.16 13; chapter 245D; or Minnesota Rules, chapter 9544. When reviewing a critical incident,​ 32.17 the systemic critical incident review team shall identify systemic influences to the incident​ 32.18 rather than determine the culpability of any actors involved in the incident. The systemic​ 32.19 critical incident review may assess the entire critical incident process from the point of an​ 32.20 entity reporting the critical incident through the ongoing case management process.​ 32.21 Department staff shall lead and conduct the reviews and may utilize county staff as reviewers.​ 32.22 The systemic critical incident review process may include but is not limited to:​ 32.23 (1) data collection about the incident and actors involved. Data may include the relevant​ 32.24 critical services; the service provider's policies and procedures applicable to the incident;​ 32.25 the coordinated service and support plan as defined in section 245D.02, subdivision 4b, for​ 32.26 the person receiving services; or an interview of an actor involved in the critical incident​ 32.27 or the review of the critical incident. Actors may include:​ 32.28 (i) staff of the provider agency;​ 32.29 (ii) lead agency staff administering home and community-based services delivered by​ 32.30 the provider;​ 32.31 (iii) Department of Human Services staff with oversight of home and community-based​ 32.32 services;​ 32.33 (iv) Department of Health staff with oversight of home and community-based services;​ 32​ Article 1 Sec. 29.​ 23-00276 as introduced​ 01/26/23 REVISOR EB/HL​ 33.1 (v) members of the community including advocates, legal representatives, health care​ 33.2 providers, pharmacy staff, or others with knowledge of the incident or the actors in the​ 33.3 incident; and​ 33.4 (vi) staff from the Office of the Ombudsman for Mental Health and Developmental​ 33.5 Disabilities;​ 33.6 (2) systemic mapping of the critical incident. The team conducting the systemic mapping​ 33.7 of the incident may include any actors identified in clause (1), designated representatives​ 33.8 of other provider agencies, regional teams, and representatives of the local regional quality​ 33.9 council identified in section 256B.097; and​ 33.10 (3) analysis of the case for systemic influences.​ 33.11 Data collected by the critical incident review team shall be aggregated and provided to​ 33.12 regional teams, participating regional quality councils, and the commissioner. The regional​ 33.13 teams and quality councils shall analyze the data and make recommendations to the​ 33.14 commissioner regarding systemic changes that would decrease the number and severity of​ 33.15 critical incidents in the future or improve the quality of the home and community-based​ 33.16 service system.​ 33.17 (b) Cases selected for the systemic critical incident review process shall be selected by​ 33.18 a selection committee among the following critical incident categories:​ 33.19 (1) cases of caregiver neglect identified in section 626.5572, subdivision 17;​ 33.20 (2) cases involving financial exploitation identified in section 626.5572, subdivision 9;​ 33.21 (3) incidents identified in section 245D.02, subdivision 11;​ 33.22 (4) incidents identified in Minnesota Rules, part 9544.0110; and​ 33.23 (5) service terminations reported to the department in accordance with section 245D.10,​ 33.24 subdivision 3a.​ 33.25 (c) The systemic critical incident review under this section shall not replace the process​ 33.26 for screening or investigating cases of alleged maltreatment of an adult under section 626.557.​ 33.27 The department may select cases for systemic critical incident review, under the jurisdiction​ 33.28 of the commissioner, reported for suspected maltreatment and closed following initial or​ 33.29 final disposition.​ 33.30 (d) The proceedings and records of the review team are confidential data on individuals​ 33.31 or protected nonpublic data as defined in section 13.02, subdivisions 3 and 13. Data that​ 33.32 document a person's opinions formed as a result of the review are not subject to discovery​ 33​ Article 1 Sec. 29.​ 23-00276 as introduced​ 01/26/23 REVISOR EB/HL​ 34.1 or introduction into evidence in a civil or criminal action against a professional, the state,​ 34.2 or a county agency arising out of the matters that the team is reviewing. Information,​ 34.3 documents, and records otherwise available from other sources are not immune from​ 34.4 discovery or use in a civil or criminal action solely because the information, documents,​ 34.5 and records were assessed or presented during proceedings of the review team. A person​ 34.6 who presented information before the systemic critical incident review team or who is a​ 34.7 member of the team shall not be prevented from testifying about matters within the person's​ 34.8 knowledge. In a civil or criminal proceeding, a person shall not be questioned about opinions​ 34.9 formed by the person as a result of the review.​ 34.10 (e) By October 1 of each year, the commissioner shall prepare an annual public report​ 34.11 containing the following information:​ 34.12 (1) the number of cases reviewed under each critical incident category identified in​ 34.13 paragraph (b) and a geographical description of where cases under each category originated;​ 34.14 (2) an aggregate summary of the systemic themes from the critical incidents examined​ 34.15 by the critical incident review team during the previous year;​ 34.16 (3) a synopsis of the conclusions, incident analyses, or exploratory activities taken in​ 34.17 regard to the critical incidents examined by the critical incident review team; and​ 34.18 (4) recommendations made to the commissioner regarding systemic changes that could​ 34.19 decrease the number and severity of critical incidents in the future or improve the quality​ 34.20 of the home and community-based service system.​ 34.21 EFFECTIVE DATE. This section is effective the day following final enactment.​ 34.22 Sec. 30. Minnesota Statutes 2022, section 256.478, is amended by adding a subdivision​ 34.23 to read:​ 34.24 Subd. 3. Authorized uses of grant funds. Grant funds may be used for but are not​ 34.25 limited to the following:​ 34.26 (1) increasing access to home and community-based services for an individual;​ 34.27 (2) improving caregiver-child relationships and aiding progress toward treatment goals;​ 34.28 and​ 34.29 (3) reducing emergency department visits.​ 34.30 EFFECTIVE DATE. This section is effective the day following final enactment.​ 34​ Article 1 Sec. 30.​ 23-00276 as introduced​ 01/26/23 REVISOR EB/HL​ 35.1 Sec. 31. Minnesota Statutes 2022, section 256.478, is amended by adding a subdivision​ 35.2 to read:​ 35.3 Subd. 4. Outcomes. Program evaluation is based on but not limited to the following​ 35.4 criteria:​ 35.5 (1) expediting discharges for individuals who no longer need hospital level of care;​ 35.6 (2) individuals obtaining and retaining housing;​ 35.7 (3) individuals maintaining community living by diverting admission to Anoka Metro​ 35.8 Regional Treatment Center and Forensic Mental Health Program;​ 35.9 (4) reducing recidivism rates of individuals returning to state institutions; and​ 35.10 (5) individuals' ability to live in the least restrictive community setting.​ 35.11 EFFECTIVE DATE. This section is effective the day following final enactment.​ 35.12 Sec. 32. Minnesota Statutes 2022, section 256B.0911, subdivision 23, is amended to read:​ 35.13 Subd. 23. MnCHOICES reassessments; option for alternative and self-directed​ 35.14 waiver services. (a) At the time of reassessment, the certified assessor shall assess a person​ 35.15 receiving waiver residential supports and services and currently residing in a setting listed​ 35.16 in clauses (1) to (5) to determine if the person would prefer to be served in a​ 35.17 community-living setting as defined in section 256B.49, subdivision 23 256B.492,​ 35.18 subdivision 1, paragraph (b), or in a setting not controlled by a provider, or to receive​ 35.19 integrated community supports as described in section 245D.03, subdivision 1, paragraph​ 35.20 (c), clause (8). The certified assessor shall offer the person through a person-centered​ 35.21 planning process the option to receive alternative housing and service options. This paragraph​ 35.22 applies to those currently residing in a:​ 35.23 (1) community residential setting;​ 35.24 (2) licensed adult foster care home that is either not the primary residence of the license​ 35.25 holder or in which the license holder is not the primary caregiver;​ 35.26 (3) family adult foster care residence;​ 35.27 (4) customized living setting; or​ 35.28 (5) supervised living facility.​ 35.29 (b) At the time of reassessment, the certified assessor shall assess each person receiving​ 35.30 waiver day services to determine if that person would prefer to receive employment services​ 35.31 as described in section 245D.03, subdivision 1, paragraph (c), clauses (5) to (7). The certified​ 35​ Article 1 Sec. 32.​ 23-00276 as introduced​ 01/26/23 REVISOR EB/HL​ 36.1 assessor shall describe to the person through a person-centered planning process the option​ 36.2 to receive employment services.​ 36.3 (c) At the time of reassessment, the certified assessor shall assess each person receiving​ 36.4 non-self-directed waiver services to determine if that person would prefer an available​ 36.5 service and setting option that would permit self-directed services and supports. The certified​ 36.6 assessor shall describe to the person through a person-centered planning process the option​ 36.7 to receive self-directed services and supports.​ 36.8 EFFECTIVE DATE. This section is effective upon federal approval. The commissioner​ 36.9 of human services shall notify the revisor of statutes when federal approval is obtained.​ 36.10 Sec. 33. Minnesota Statutes 2022, section 256B.092, subdivision 10, is amended to read:​ 36.11 Subd. 10. Admission of persons to and discharge of persons from regional treatment​ 36.12 centers. (a) Prior to the admission of a person to a regional treatment center program for​ 36.13 persons with developmental disabilities, the case manager shall make efforts to secure​ 36.14 community-based alternatives. If these alternatives are rejected by the person, the person's​ 36.15 legal guardian or conservator, or the county agency in favor of a regional treatment center​ 36.16 placement, the case manager shall document the reasons why the alternatives were rejected.​ 36.17 (b) When discharge of a person from a regional treatment center to a community-based​ 36.18 service is proposed, the case manager shall convene the screening team and in addition to​ 36.19 members of the team identified in subdivision 7, the case manager shall invite to the meeting​ 36.20 the person's parents and near relatives, and the ombudsman established under section 245.92​ 36.21 if the person is under public guardianship. The meeting shall be convened at a time and​ 36.22 place that allows for participation of all team members and invited individuals who choose​ 36.23 to attend. The notice of the meeting shall inform the person's parents and near relatives​ 36.24 about the screening team process, and their right to request a review if they object to the​ 36.25 discharge, and shall provide the names and functions of advocacy organizations, and​ 36.26 information relating to assistance available to individuals interested in establishing private​ 36.27 guardianships under the provisions of section 252A.03. The screening team meeting shall​ 36.28 be conducted according to subdivisions 7 and 8. Discharge of the person shall not go forward​ 36.29 without consensus of the screening team.​ 36.30 (c) The results of the screening team meeting and individual service plan developed​ 36.31 according to subdivision 1b shall be used by the interdisciplinary team assembled in​ 36.32 accordance with Code of Federal Regulations, title 42, section 483.440, to evaluate and​ 36.33 make recommended modifications to the individual service plan as proposed. The individual​ 36​ Article 1 Sec. 33.​ 23-00276 as introduced​ 01/26/23 REVISOR EB/HL​ 37.1 service plan shall specify postplacement monitoring to be done by the case manager according​ 37.2 to section 253B.15, subdivision 1a.​ 37.3 (d) Notice of the meeting of the interdisciplinary team assembled in accordance with​ 37.4 Code of Federal Regulations, title 42, section 483.440, shall be sent to all team members​ 37.5 15 days prior to the meeting, along with a copy of the proposed individual service plan. The​ 37.6 case manager shall request that proposed providers visit the person and observe the person's​ 37.7 program at the regional treatment center prior to the discharge. Whenever possible,​ 37.8 preplacement visits by the person to proposed service sites should also be scheduled in​ 37.9 advance of the meeting. Members of the interdisciplinary team assembled for the purpose​ 37.10 of discharge planning shall include but not be limited to the case manager, the person, the​ 37.11 person's legal guardian or conservator, parents and near relatives, the person's advocate,​ 37.12 representatives of proposed community service providers, representatives of the regional​ 37.13 treatment center residential and training and habilitation services, a registered nurse if the​ 37.14 person has overriding medical needs that impact the delivery of services, and a qualified​ 37.15 developmental disability professional specializing in behavior management if the person​ 37.16 to be discharged has behaviors that may result in injury to self or others. The case manager​ 37.17 may also invite other service providers who have expertise in an area related to specific​ 37.18 service needs of the person to be discharged.​ 37.19 (e) The interdisciplinary team shall review the proposed plan to assure that it identifies​ 37.20 service needs, availability of services, including support services, and the proposed providers'​ 37.21 abilities to meet the service needs identified in the person's individual service plan. The​ 37.22 interdisciplinary team shall review the most recent licensing reports of the proposed providers​ 37.23 and corrective action taken by the proposed provider, if required. The interdisciplinary team​ 37.24 shall review the current individual program plans for the person and agree to an interim​ 37.25 individual program plan to be followed for the first 30 days in the person's new living​ 37.26 arrangement. The interdisciplinary team may suggest revisions to the service plan, and all​ 37.27 team suggestions shall be documented. If the person is to be discharged to a community​ 37.28 intermediate care facility for persons with developmental disabilities, the team shall give​ 37.29 preference to facilities with a licensed capacity of 15 or fewer beds. Thirty days prior to the​ 37.30 date of discharge, the case manager shall send a final copy of the service plan to all invited​ 37.31 members of the team, the ombudsman, if the person is under public guardianship, and the​ 37.32 advocacy system established under United States Code, title 42, section 6042.​ 37.33 (b) Assessment and support planning must be completed in accordance with requirements​ 37.34 identified in section 256B.0911.​ 37​ Article 1 Sec. 33.​ 23-00276 as introduced​ 01/26/23 REVISOR EB/HL​ 38.1 (f) (c) No discharge shall take place until disputes are resolved under section 256.045,​ 38.2 subdivision 4a, or until a review by the commissioner is completed upon request of the chief​ 38.3 executive officer or program director of the regional treatment center, or the county agency.​ 38.4 For persons under public guardianship, the ombudsman may request a review or hearing​ 38.5 under section 256.045. Notification schedules required under this subdivision may be waived​ 38.6 by members of the team when judged urgent and with agreement of the parents or near​ 38.7 relatives participating as members of the interdisciplinary team.​ 38.8 Sec. 34. Minnesota Statutes 2022, section 256B.439, subdivision 3c, is amended to read:​ 38.9 Subd. 3c. Contact and demographic information for consumer surveys for home​ 38.10 and community-based services. For purposes of conducting the consumer surveys under​ 38.11 subdivision 3a, the commissioner may request contact information of clients and associated​ 38.12 key representatives and aggregate, de-identified demographic information of clients served​ 38.13 by the provider. The commissioner may request the following demographic information:​ 38.14 (1) age; (2) race; (3) ethnicity; and (4) gender identity. Providers must furnish the contact​ 38.15 and demographic information available to the provider and must provide notice to clients​ 38.16 and associated key representatives that their contact information and aggregate demographic​ 38.17 information has been provided to the commissioner.​ 38.18 Sec. 35. Minnesota Statutes 2022, section 256B.439, subdivision 3d, is amended to read:​ 38.19 Subd. 3d. Resident experience survey and family survey for assisted living​ 38.20 facilities. The commissioner shall develop and administer a resident experience survey for​ 38.21 assisted living facility residents and a family survey for families of assisted living facility​ 38.22 residents. Money appropriated to the commissioner to administer the resident experience​ 38.23 survey and family survey is available in either fiscal year of the biennium in which it is​ 38.24 appropriated. Assisted living facilities licensed under chapter 144G must participate in the​ 38.25 surveys when the commissioner requests their participation.​ 38.26 Sec. 36. Minnesota Statutes 2022, section 256B.492, is amended to read:​ 38.27 256B.492 HOME AND COMMUNITY-BASED SETTINGS FOR PEOPLE WITH​ 38.28 DISABILITIES.​ 38.29 Subdivision 1. Definitions. (a) For the purposes of this section the following terms have​ 38.30 the meanings given.​ 38.31 (b) "Community-living setting" means a single-family home or multifamily dwelling​ 38.32 unit where a service recipient or a service recipient's family owns or rents and maintains​ 38​ Article 1 Sec. 36.​ 23-00276 as introduced​ 01/26/23 REVISOR EB/HL​ 39.1 control over the individual unit as demonstrated by a lease agreement. Community-living​ 39.2 setting does not include a home or dwelling unit that the service provider owns, operates,​ 39.3 or leases or in which the service provider has a direct or indirect financial interest.​ 39.4 (c) "Controlling individual" has the meaning given in section 245A.02, subdivision 5a.​ 39.5 (d) "License holder" has the meaning given in section 245A.02, subdivision 9.​ 39.6 Subd. 2. Home and community-based waiver settings. (a) Individuals receiving services​ 39.7 under a home and community-based waiver under section 256B.092 or 256B.49 may receive​ 39.8 services in the following settings:​ 39.9 (1) home and community-based settings that comply with all requirements identified by​ 39.10 the federal Centers for Medicare and Medicaid Services in the Code of Federal Regulations,​ 39.11 title 42, section 441.301(c), and with the requirements of the federally approved transition​ 39.12 plan and waiver plans for each home and community-based services waiver; and​ 39.13 (2) settings required by the Housing Opportunities for Persons with AIDS Program.​ 39.14 (b) The settings in paragraph (a) must not have the qualities of an institution which​ 39.15 include, but are not limited to: regimented meal and sleep times, limitations on visitors, and​ 39.16 lack of privacy. Restrictions agreed to and documented in the person's individual service​ 39.17 plan shall not result in a residence having the qualities of an institution as long as the​ 39.18 restrictions for the person are not imposed upon others in the same residence and are the​ 39.19 least restrictive alternative, imposed for the shortest possible time to meet the person's needs.​ 39.20 Subd. 3. Community-living settings. (a) Individuals receiving services under a home​ 39.21 and community-based waiver under section 256B.092 or 256B.49 may receive services in​ 39.22 community-living settings. Community-living settings must meet the requirements of​ 39.23 subdivision 2, paragraph (a), clause (1).​ 39.24 (b) For the purposes of this section, direct financial interest exists if payment passes​ 39.25 between the license holder or any controlling individual of a licensed program and the​ 39.26 service recipient or an entity acting on the service recipient's behalf for the purpose of​ 39.27 obtaining or maintaining a dwelling. For the purposes of this section, indirect financial​ 39.28 interest exists if the license holder or any controlling individual of a licensed program has​ 39.29 an ownership or investment interest in the entity that owns, operates, leases, or otherwise​ 39.30 receives payment from the service recipient or an entity acting on the service recipient's​ 39.31 behalf for the purpose of obtaining or maintaining a dwelling.​ 39​ Article 1 Sec. 36.​ 23-00276 as introduced​ 01/26/23 REVISOR EB/HL​ 40.1 (c) To ensure a service recipient or the service recipient's family maintains control over​ 40.2 the home or dwelling unit, community-living settings are subject to the following​ 40.3 requirements:​ 40.4 (1) service recipients must not be required to receive services or share services;​ 40.5 (2) service recipients must not be required to have a disability or specific diagnosis to​ 40.6 live in the community-living setting;​ 40.7 (3) service recipients may hire service providers of their choice;​ 40.8 (4) service recipients may choose whether to share their household and with whom;​ 40.9 (5) the home or multifamily dwelling unit must include living, sleeping, bathing, and​ 40.10 cooking areas;​ 40.11 (6) service recipients must have lockable access and egress;​ 40.12 (7) service recipients must be free to receive visitors and leave the settings at times and​ 40.13 for durations of their own choosing;​ 40.14 (8) leases must comply with chapter 504B;​ 40.15 (9) landlords must not charge different rents to tenants who are receiving home and​ 40.16 community-based services; and​ 40.17 (10) access to the greater community must be easily facilitated based on the service​ 40.18 recipient's needs and preferences.​ 40.19 (d) Nothing in this section prohibits a service recipient from having another person or​ 40.20 entity not affiliated with the service provider cosign a lease. Nothing in this section prohibits​ 40.21 a service recipient, during any period in which a service provider has cosigned the service​ 40.22 recipient's lease, from modifying services with an existing cosigning service provider and,​ 40.23 subject to the approval of the landlord, maintaining a lease cosigned by the service provider.​ 40.24 Nothing in this section prohibits a service recipient, during any period in which a service​ 40.25 provider has cosigned the service recipient's lease, from terminating services with the​ 40.26 cosigning service provider, receiving services from a new service provider, or, subject to​ 40.27 the approval of the landlord, maintaining a lease cosigned by the new service provider.​ 40.28 (e) A lease cosigned by a service provider meets the requirements of paragraph (b) if​ 40.29 the service recipient and service provider develop and implement a transition plan which​ 40.30 must provide that, within two years of cosigning the initial lease, the service provider shall​ 40.31 transfer the lease to the service recipient and other cosigners, if any.​ 40​ Article 1 Sec. 36.​ 23-00276 as introduced​ 01/26/23 REVISOR EB/HL​ 41.1 (f) In the event the landlord has not approved the transfer of the lease within two years​ 41.2 of the service provider cosigning the initial lease, the service provider must submit a​ 41.3 time-limited extension request to the commissioner of human services to continue the​ 41.4 cosigned lease arrangement. The extension request must include:​ 41.5 (1) the reason the landlord denied the transfer;​ 41.6 (2) the plan to overcome the denial to transfer the lease;​ 41.7 (3) the length of time needed to successfully transfer the lease, not to exceed an additional​ 41.8 two years;​ 41.9 (4) a description of how the transition plan was followed, what occurred that led to the​ 41.10 landlord denying the transfer, and what changes in circumstances or condition, if any, the​ 41.11 service recipient experienced; and​ 41.12 (5) a revised transition plan to transfer the cosigned lease between the service provider​ 41.13 and the service recipient to the service recipient.​ 41.14 (g) The commissioner must approve an extension under paragraph (f) within sufficient​ 41.15 time to ensure the continued occupancy by the service recipient.​ 41.16 EFFECTIVE DATE. This section is effective upon federal approval. The commissioner​ 41.17 of human services shall notify the revisor of statutes when federal approval is obtained.​ 41.18 Sec. 37. Minnesota Statutes 2022, section 256B.493, subdivision 2a, is amended to read:​ 41.19 Subd. 2a. Closure process. (a) The commissioner shall work with stakeholders to​ 41.20 establish a process for the application, review, approval, and implementation of setting​ 41.21 closures. Voluntary proposals from license holders for consolidation and closure of adult​ 41.22 foster care or community residential settings are encouraged. Whether voluntary or​ 41.23 involuntary, all closure plans must include:​ 41.24 (1) a description of the proposed closure plan, identifying the home or homes and​ 41.25 occupied beds;​ 41.26 (2) the proposed timetable for the proposed closure, including the proposed dates for​ 41.27 notification to people living there and the affected lead agencies, commencement of closure,​ 41.28 and completion of closure;​ 41.29 (3) the proposed relocation plan jointly developed by the counties of financial​ 41.30 responsibility, the people living there and their legal representatives, if any, who wish to​ 41.31 continue to receive services from the provider, and the providers for current residents of​ 41.32 any adult foster care home designated for closure; and​ 41​ Article 1 Sec. 37.​ 23-00276 as introduced​ 01/26/23 REVISOR EB/HL​ 42.1 (4) documentation from the provider in a format approved by the commissioner that all​ 42.2 the adult foster care homes or community residential settings receiving a planned closure​ 42.3 rate adjustment under the plan have accepted joint and severable for recovery of​ 42.4 overpayments under section 256B.0641, subdivision 2, for the facilities designated for​ 42.5 closure under this plan.​ 42.6 (b) The commissioner shall give first priority to closure plans which:​ 42.7 (1) target counties and geographic areas which have:​ 42.8 (i) need for other types of services;​ 42.9 (ii) need for specialized services;​ 42.10 (iii) higher than average per capita use of licensed corporate foster care or community​ 42.11 residential settings; or​ 42.12 (iv) residents not living in the geographic area of their choice;​ 42.13 (2) demonstrate savings of medical assistance expenditures; and​ 42.14 (3) demonstrate that alternative services are based on the recipient's choice of provider​ 42.15 and are consistent with federal law, state law, and federally approved waiver plans.​ 42.16 The commissioner shall also consider any information provided by people using services,​ 42.17 their legal representatives, family members, or the lead agency on the impact of the planned​ 42.18 closure on people and the services they need.​ 42.19 (c) For each closure plan approved by the commissioner, a contract must be established​ 42.20 between the commissioner, the counties of financial responsibility, and the participating​ 42.21 license holder.​ 42.22 Sec. 38. Minnesota Statutes 2022, section 256B.493, subdivision 4, is amended to read:​ 42.23 Subd. 4. Review and approval process. (a) To be considered for approval, an application​ 42.24 must include:​ 42.25 (1) a description of the proposed closure plan, which must identify the home or homes​ 42.26 and occupied beds for which a planned closure rate adjustment is requested;​ 42.27 (2) the proposed timetable for any proposed closure, including the proposed dates for​ 42.28 notification to residents and the affected lead agencies, commencement of closure, and​ 42.29 completion of closure;​ 42.30 (3) the proposed relocation plan jointly developed by the counties of financial​ 42.31 responsibility, the residents and their legal representatives, if any, who wish to continue to​ 42​ Article 1 Sec. 38.​ 23-00276 as introduced​ 01/26/23 REVISOR EB/HL​ 43.1 receive services from the provider, and the providers for current residents of any adult foster​ 43.2 care home designated for closure; and​ 43.3 (4) documentation in a format approved by the commissioner that all the adult foster​ 43.4 care homes receiving a planned closure rate adjustment under the plan have accepted joint​ 43.5 and several liability for recovery of overpayments under section 256B.0641, subdivision 2,​ 43.6 for the facilities designated for closure under this plan.​ 43.7 (b) In reviewing and approving closure proposals, the commissioner shall give first​ 43.8 priority to proposals that:​ 43.9 (1) target counties and geographic areas which have:​ 43.10 (i) need for other types of services;​ 43.11 (ii) need for specialized services;​ 43.12 (iii) higher than average per capita use of foster care settings where the license holder​ 43.13 does not reside; or​ 43.14 (iv) residents not living in the geographic area of their choice;​ 43.15 (2) demonstrate savings of medical assistance expenditures; and​ 43.16 (3) demonstrate that alternative services are based on the recipient's choice of provider​ 43.17 and are consistent with federal law, state law, and federally approved waiver plans.​ 43.18 The commissioner shall also consider any information provided by service recipients,​ 43.19 their legal representatives, family members, or the lead agency on the impact of the planned​ 43.20 closure on the recipients and the services they need.​ 43.21 (c) The commissioner shall select proposals that best meet the criteria established in this​ 43.22 subdivision for planned closure of adult foster care settings. The commissioner shall notify​ 43.23 license holders of the selections approved by the commissioner.​ 43.24 (d) For each proposal approved by the commissioner, a contract must be established​ 43.25 between the commissioner, the counties of financial responsibility, and the participating​ 43.26 license holder.​ 43.27 EFFECTIVE DATE. This section is effective the day following final enactment.​ 43.28 Sec. 39. Minnesota Statutes 2022, section 256S.202, subdivision 1, is amended to read:​ 43.29 Subdivision 1. Customized living monthly service rate limits. (a) Except for a​ 43.30 participant assigned to case mix classification L, as described in section 256S.18, subdivision​ 43.31 1, paragraph (b), the customized living monthly service rate limit shall not exceed 50 percent​ 43​ Article 1 Sec. 39.​ 23-00276 as introduced​ 01/26/23 REVISOR EB/HL​ 44.1 of the monthly case mix budget cap, less the maintenance needs allowance, adjusted at least​ 44.2 annually in the manner described under section 256S.18, subdivisions 5 and 6.​ 44.3 (b) The customized living monthly service rate limit for participants assigned to case​ 44.4 mix classification L must be the monthly service rate limit for participants assigned to case​ 44.5 mix classification A, reduced by 25 percent.​ 44.6 Sec. 40. Minnesota Statutes 2022, section 524.5-104, is amended to read:​ 44.7 524.5-104 FACILITY OF TRANSFER.​ 44.8 (a) A person who may transfer money or personal property to a minor may do so, as to​ 44.9 an amount or value not exceeding the amount allowable as a tax exclusion gift under section​ 44.10 2503(b) of the Internal Revenue Code or a different amount that is approved by the court,​ 44.11 by transferring it to:​ 44.12 (1) a person who has the care and custody of the minor and with whom the minor resides;​ 44.13 (2) a guardian of the minor;​ 44.14 (3) a custodian under the Uniform Transfers To Minors Act or custodial trustee under​ 44.15 the Uniform Custodial Trust Act;​ 44.16 (4) a financial institution as a deposit in an interest-bearing account or certificate in the​ 44.17 sole name of the minor and giving notice of the deposit to the minor; or​ 44.18 (5) an ABLE account. A guardian only has the authority to establish an ABLE account.​ 44.19 The guardian may not administer the ABLE account in the guardian's capacity as guardian.​ 44.20 The guardian may appoint or name a person to exercise signature authority over an ABLE​ 44.21 account, including the individual selected by the eligible individual or the eligible individual's​ 44.22 agent under a power of attorney, conservator, spouse, parent, sibling, grandparent, or​ 44.23 representative payee, whether an individual or organization, appointed by the Social Security​ 44.24 Administration, in that order.​ 44.25 (b) This section does not apply if the person making payment or delivery knows that a​ 44.26 conservator has been appointed or that a proceeding for appointment of a conservator of​ 44.27 the minor is pending.​ 44.28 (c) A person who transfers money or property in compliance with this section is not​ 44.29 responsible for its proper application.​ 44.30 (d) A guardian or other person who receives money or property for a minor under​ 44.31 paragraph (a), clause (1) or (2), may only apply it to the support, care, education, health,​ 44.32 and welfare of the minor, and may not derive a personal financial benefit except for​ 44​ Article 1 Sec. 40.​ 23-00276 as introduced​ 01/26/23 REVISOR EB/HL​ 45.1 reimbursement for necessary expenses. Any excess must be preserved for the future support,​ 45.2 care, education, health, and welfare of the minor and any balance must be transferred to the​ 45.3 minor upon emancipation or attaining majority.​ 45.4 EFFECTIVE DATE. This section is effective the day following final enactment.​ 45.5 Sec. 41. Minnesota Statutes 2022, section 524.5-313, is amended to read:​ 45.6 524.5-313 POWERS AND DUTIES OF GUARDIAN.​ 45.7 (a) A guardian shall be subject to the control and direction of the court at all times and​ 45.8 in all things.​ 45.9 (b) The court shall grant to a guardian only those powers necessary to provide for the​ 45.10 demonstrated needs of the person subject to guardianship.​ 45.11 (c) The court may appoint a guardian if it determines that all the powers and duties listed​ 45.12 in this section are needed to provide for the needs of the incapacitated person. The court​ 45.13 may also appoint a guardian if it determines that a guardian is needed to provide for the​ 45.14 needs of the incapacitated person through the exercise of some, but not all, of the powers​ 45.15 and duties listed in this section. The duties and powers of a guardian or those which the​ 45.16 court may grant to a guardian include, but are not limited to:​ 45.17 (1) the power to have custody of the person subject to guardianship and the power to​ 45.18 establish a place of abode within or outside the state, except as otherwise provided in this​ 45.19 clause. The person subject to guardianship or any interested person may petition the court​ 45.20 to prevent or to initiate a change in abode. A person subject to guardianship may not be​ 45.21 admitted to a regional treatment center by the guardian except:​ 45.22 (i) after a hearing under chapter 253B;​ 45.23 (ii) for outpatient services; or​ 45.24 (iii) for the purpose of receiving temporary care for a specific period of time not to​ 45.25 exceed 90 days in any calendar year;​ 45.26 (2) the duty to provide for the care, comfort, and maintenance needs of the person subject​ 45.27 to guardianship, including food, clothing, shelter, health care, social and recreational​ 45.28 requirements, and, whenever appropriate, training, education, and habilitation or​ 45.29 rehabilitation. The guardian has no duty to pay for these requirements out of personal funds.​ 45.30 Whenever possible and appropriate, the guardian should meet these requirements through​ 45.31 governmental benefits or services to which the person subject to guardianship is entitled,​ 45.32 rather than from the estate of the person subject to guardianship. Failure to satisfy the needs​ 45​ Article 1 Sec. 41.​ 23-00276 as introduced​ 01/26/23 REVISOR EB/HL​ 46.1 and requirements of this clause shall be grounds for removal of a private guardian, but the​ 46.2 guardian shall have no personal or monetary liability;​ 46.3 (3) the duty to take reasonable care of the clothing, furniture, vehicles, and other personal​ 46.4 effects of the person subject to guardianship, and, if other property requires protection, the​ 46.5 power to seek appointment of a conservator of the estate. The guardian must give notice by​ 46.6 mail to interested persons prior to the disposition of the clothing, furniture, vehicles, or​ 46.7 other personal effects of the person subject to guardianship. The notice must inform the​ 46.8 person of the right to object to the disposition of the property within ten days of the date of​ 46.9 mailing and to petition the court for a review of the guardian's proposed actions. Notice of​ 46.10 the objection must be served by mail or personal service on the guardian and the person​ 46.11 subject to guardianship unless the person subject to guardianship is the objector. The guardian​ 46.12 served with notice of an objection to the disposition of the property may not dispose of the​ 46.13 property unless the court approves the disposition after a hearing;​ 46.14 (4)(i) the power to give any necessary consent to enable the person subject to guardianship​ 46.15 to receive necessary medical or other professional care, counsel, treatment, or service, except​ 46.16 that no guardian may give consent for psychosurgery, electroshock, sterilization, or​ 46.17 experimental treatment of any kind unless the procedure is first approved by order of the​ 46.18 court as provided in this clause. The guardian shall not consent to any medical care for the​ 46.19 person subject to guardianship which violates the known conscientious, religious, or moral​ 46.20 belief of the person subject to guardianship;​ 46.21 (ii) a guardian who believes a procedure described in item (i) requiring prior court​ 46.22 approval to be necessary for the proper care of the person subject to guardianship, shall​ 46.23 petition the court for an order and, in the case of a public guardianship under chapter 252A,​ 46.24 obtain the written recommendation of the commissioner of human services. The court shall​ 46.25 fix the time and place for the hearing and shall give notice to the person subject to​ 46.26 guardianship in such manner as specified in section 524.5-308 and to interested persons.​ 46.27 The court shall appoint an attorney to represent the person subject to guardianship who is​ 46.28 not represented by counsel, provided that such appointment shall expire upon the expiration​ 46.29 of the appeal time for the order issued by the court under this section or the order dismissing​ 46.30 a petition, or upon such other time or event as the court may direct. In every case the court​ 46.31 shall determine if the procedure is in the best interest of the person subject to guardianship.​ 46.32 In making its determination, the court shall consider a written medical report which​ 46.33 specifically considers the medical risks of the procedure, whether alternative, less restrictive​ 46.34 methods of treatment could be used to protect the best interest of the person subject to​ 46​ Article 1 Sec. 41.​ 23-00276 as introduced​ 01/26/23 REVISOR EB/HL​ 47.1 guardianship, and any recommendation of the commissioner of human services for a public​ 47.2 person subject to guardianship. The standard of proof is that of clear and convincing evidence;​ 47.3 (iii) in the case of a petition for sterilization of a person with developmental disabilities​ 47.4 subject to guardianship, the court shall appoint a licensed physician, a psychologist who is​ 47.5 qualified in the diagnosis and treatment of developmental disability, and a social worker​ 47.6 who is familiar with the social history and adjustment of the person subject to guardianship​ 47.7 or the case manager for the person subject to guardianship to examine or evaluate the person​ 47.8 subject to guardianship and to provide written reports to the court. The reports shall indicate​ 47.9 why sterilization is being proposed, whether sterilization is necessary and is the least intrusive​ 47.10 method for alleviating the problem presented, and whether it is in the best interest of the​ 47.11 person subject to guardianship. The medical report shall specifically consider the medical​ 47.12 risks of sterilization, the consequences of not performing the sterilization, and whether​ 47.13 alternative methods of contraception could be used to protect the best interest of the person​ 47.14 subject to guardianship;​ 47.15 (iv) any person subject to guardianship whose right to consent to a sterilization has not​ 47.16 been restricted under this section or section 252A.101 may be sterilized only if the person​ 47.17 subject to guardianship consents in writing or there is a sworn acknowledgment by an​ 47.18 interested person of a nonwritten consent by the person subject to guardianship. The consent​ 47.19 must certify that the person subject to guardianship has received a full explanation from a​ 47.20 physician or registered nurse of the nature and irreversible consequences of the sterilization;​ 47.21 (v) a guardian or the public guardian's designee who acts within the scope of authority​ 47.22 conferred by letters of guardianship under section 252A.101, subdivision 7, and according​ 47.23 to the standards established in this chapter or in chapter 252A shall not be civilly or criminally​ 47.24 liable for the provision of any necessary medical care, including, but not limited to, the​ 47.25 administration of psychotropic medication or the implementation of aversive and deprivation​ 47.26 procedures to which the guardian or the public guardian's designee has consented;​ 47.27 (5) in the event there is no duly appointed conservator of the estate of the person subject​ 47.28 to guardianship, the guardian shall have the power to approve or withhold approval of any​ 47.29 contract, except for necessities, which the person subject to guardianship may make or wish​ 47.30 to make;​ 47.31 (6) the duty and power to exercise supervisory authority over the person subject to​ 47.32 guardianship in a manner which limits civil rights and restricts personal freedom only to​ 47.33 the extent necessary to provide needed care and services. A guardian may not restrict the​ 47.34 ability of the person subject to guardianship to communicate, visit, or interact with others,​ 47​ Article 1 Sec. 41.​ 23-00276 as introduced​ 01/26/23 REVISOR EB/HL​ 48.1 including receiving visitors or making or receiving telephone calls, personal mail, or​ 48.2 electronic communications including through social media, or participating in social activities,​ 48.3 unless the guardian has good cause to believe restriction is necessary because interaction​ 48.4 with the person poses a risk of significant physical, psychological, or financial harm to the​ 48.5 person subject to guardianship, and there is no other means to avoid such significant harm.​ 48.6 In all cases, the guardian shall provide written notice of the restrictions imposed to the court,​ 48.7 to the person subject to guardianship, and to the person subject to restrictions. The person​ 48.8 subject to guardianship or the person subject to restrictions may petition the court to remove​ 48.9 or modify the restrictions;​ 48.10 (7) if there is no acting conservator of the estate for the person subject to guardianship,​ 48.11 the guardian has the power to apply on behalf of the person subject to guardianship for any​ 48.12 assistance, services, or benefits available to the person subject to guardianship through any​ 48.13 unit of government;​ 48.14 (8) unless otherwise ordered by the court, the person subject to guardianship retains the​ 48.15 right to vote;​ 48.16 (9) the power to establish an ABLE account for a person subject to guardianship or​ 48.17 conservatorship. By this provision a guardian only has the authority to establish an ABLE​ 48.18 account, but may not administer the ABLE account in the guardian's capacity as guardian.​ 48.19 The guardian may appoint or name a person to exercise signature authority over an ABLE​ 48.20 account, including the individual selected by the eligible individual or the eligible individual's​ 48.21 agent under a power of attorney; conservator; spouse; parent; sibling; grandparent; or​ 48.22 representative payee, whether an individual or organization, appointed by the SSA, in that​ 48.23 order; and​ 48.24 (10) if there is no conservator appointed for the person subject to guardianship, the​ 48.25 guardian has the duty and power to institute suit on behalf of the person subject to​ 48.26 guardianship and represent the person subject to guardianship in expungement proceedings,​ 48.27 harassment proceedings, and all civil court proceedings, including but not limited to​ 48.28 restraining orders, orders for protection, name changes, conciliation court, housing court,​ 48.29 family court, probate court, and juvenile court, provided that a guardian may not settle or​ 48.30 compromise any claim or debt owed to the estate without court approval.​ 48.31 EFFECTIVE DATE. This section is effective the day following final enactment.​ 48​ Article 1 Sec. 41.​ 23-00276 as introduced​ 01/26/23 REVISOR EB/HL​ 49.1 Sec. 42. Laws 2021, First Special Session chapter 7, article 17, section 20, is amended to​ 49.2 read:​ 49.3 Sec. 20. HCBS WORKFORCE DEVELOPMENT GRANT.​ 49.4 (a) This act includes $0 in fiscal year 2022 and $5,588,000 in fiscal year 2023 to address​ 49.5 challenges related to attracting and maintaining direct care workers who provide home and​ 49.6 community-based services for people with disabilities and older adults. The general fund​ 49.7 base included in this act for this purpose is $5,588,000 in fiscal year 2024 and $0 in fiscal​ 49.8 year 2025.​ 49.9 (b) At least 90 percent of funding for this provision must be directed to workers who​ 49.10 earn 200 300 percent or less of the most current federal poverty level issued by the United​ 49.11 States Department of Health and Human Services.​ 49.12 (c) The commissioner must consult with stakeholders to finalize a report detailing the​ 49.13 final plan for use of the funds. The commissioner must publish the report by March 1, 2022,​ 49.14 and notify the chairs and ranking minority members of the legislative committees with​ 49.15 jurisdiction over health and human services policy and finance.​ 49.16 (d) For the purposes of this section, "subtraction" has the meaning given in Minnesota​ 49.17 Statutes, section 290.0132, subdivision 1, and the rules in that subdivision apply for this​ 49.18 section. The definitions in Minnesota Statutes, section 290.01, apply to this section.​ 49.19 (e) The amount of workforce development grant money received under this section is a​ 49.20 subtraction.​ 49.21 (f) Workforce development grant money under this section is excluded from income as​ 49.22 defined in Minnesota Statutes, sections 290.0674, subdivision 2a, and 290A.03, subdivision​ 49.23 3.​ 49.24 (g) Notwithstanding any law to the contrary, payments under this section must not be​ 49.25 considered income, assets, or personal property for purposes of determining eligibility or​ 49.26 recertifying eligibility for:​ 49.27 (1) child care assistance programs under Minnesota Statutes, chapter 119B;​ 49.28 (2) general assistance, Minnesota supplemental aid, and food support under Minnesota​ 49.29 Statutes, chapter 256D;​ 49.30 (3) housing support under Minnesota Statutes, chapter 256I;​ 49.31 (4) Minnesota family investment program and diversionary work program under​ 49.32 Minnesota Statutes, chapter 256J; and​ 49​ Article 1 Sec. 42.​ 23-00276 as introduced​ 01/26/23 REVISOR EB/HL​ 50.1 (5) economic assistance programs under Minnesota Statutes, chapter 256P.​ 50.2 (h) The commissioner of human services must not consider frontline worker payments​ 50.3 under this section as income or assets under Minnesota Statutes, section 256B.056,​ 50.4 subdivision 1a, paragraph (a); 3; or 3c, or for persons with eligibility determined under​ 50.5 Minnesota Statutes, section 256B.057, subdivision 3, 3a, or 3b.​ 50.6 Sec. 43. REVISOR INSTRUCTION.​ 50.7 The revisor of statutes shall renumber Minnesota Statutes, section 245D.03, and correct​ 50.8 all cross-references.​ 50.9 EFFECTIVE DATE. This section is effective the day following final enactment.​ 50.10 Sec. 44. REPEALER.​ 50.11 Subdivision 1. Minnesota Statutes 2022, section 256B.49, subdivision 23, is repealed.​ 50.12 Subd. 2. Minnesota Statutes 2022, sections 254B.13, subdivisions 1, 2, 2a, 4, 5, 6, 7,​ 50.13 and 8; and 254B.16, are repealed.​ 50.14 EFFECTIVE DATE. The repeal of the section in subdivision 1 is effective the day​ 50.15 following final enactment, and the repeal of the sections in subdivision 2 is effective upon​ 50.16 federal approval. The commissioner of human services shall notify the revisor of statutes​ 50.17 when federal approval is obtained.​ 50.18 ARTICLE 2​ 50.19 SUBSTANCE USE DISORDER DIRECT ACCESS​ 50.20 Section 1. Minnesota Statutes 2022, section 62N.25, subdivision 5, is amended to read:​ 50.21 Subd. 5. Benefits. Community integrated service networks must offer the health​ 50.22 maintenance organization benefit set, as defined in chapter 62D, and other laws applicable​ 50.23 to entities regulated under chapter 62D. Community networks and chemical dependency​ 50.24 facilities under contract with a community network shall use the assessment criteria in​ 50.25 Minnesota Rules, parts 9530.6600 to 9530.6655, section 245G.05 when assessing enrollees​ 50.26 for chemical dependency treatment.​ 50​ Article 2 Section 1.​ 23-00276 as introduced​ 01/26/23 REVISOR EB/HL​ 51.1 Sec. 2. Minnesota Statutes 2022, section 62Q.1055, is amended to read:​ 51.2 62Q.1055 CHEMICAL DEPENDENCY.​ 51.3 All health plan companies shall use the assessment criteria in Minnesota Rules, parts​ 51.4 9530.6600 to 9530.6655, section 245G.05 when assessing and placing treating enrollees​ 51.5 for chemical dependency treatment.​ 51.6 Sec. 3. Minnesota Statutes 2022, section 62Q.47, is amended to read:​ 51.7 62Q.47 ALCOHOLISM, MENTAL HEALTH, AND CHEMICAL DEPENDENCY​ 51.8 SERVICES.​ 51.9 (a) All health plans, as defined in section 62Q.01, that provide coverage for alcoholism,​ 51.10 mental health, or chemical dependency services, must comply with the requirements of this​ 51.11 section.​ 51.12 (b) Cost-sharing requirements and benefit or service limitations for outpatient mental​ 51.13 health and outpatient chemical dependency and alcoholism services, except for persons​ 51.14 placed in seeking chemical dependency services under Minnesota Rules, parts 9530.6600​ 51.15 to 9530.6655 section 245G.05, must not place a greater financial burden on the insured or​ 51.16 enrollee, or be more restrictive than those requirements and limitations for outpatient medical​ 51.17 services.​ 51.18 (c) Cost-sharing requirements and benefit or service limitations for inpatient hospital​ 51.19 mental health and inpatient hospital and residential chemical dependency and alcoholism​ 51.20 services, except for persons placed in seeking chemical dependency services under Minnesota​ 51.21 Rules, parts 9530.6600 to 9530.6655 section 245G.05, must not place a greater financial​ 51.22 burden on the insured or enrollee, or be more restrictive than those requirements and​ 51.23 limitations for inpatient hospital medical services.​ 51.24 (d) A health plan company must not impose an NQTL with respect to mental health and​ 51.25 substance use disorders in any classification of benefits unless, under the terms of the health​ 51.26 plan as written and in operation, any processes, strategies, evidentiary standards, or other​ 51.27 factors used in applying the NQTL to mental health and substance use disorders in the​ 51.28 classification are comparable to, and are applied no more stringently than, the processes,​ 51.29 strategies, evidentiary standards, or other factors used in applying the NQTL with respect​ 51.30 to medical and surgical benefits in the same classification.​ 51.31 (e) All health plans must meet the requirements of the federal Mental Health Parity Act​ 51.32 of 1996, Public Law 104-204; Paul Wellstone and Pete Domenici Mental Health Parity and​ 51​ Article 2 Sec. 3.​ 23-00276 as introduced​ 01/26/23 REVISOR EB/HL​ 52.1 Addiction Equity Act of 2008; the Affordable Care Act; and any amendments to, and federal​ 52.2 guidance or regulations issued under, those acts.​ 52.3 (f) The commissioner may require information from health plan companies to confirm​ 52.4 that mental health parity is being implemented by the health plan company. Information​ 52.5 required may include comparisons between mental health and substance use disorder​ 52.6 treatment and other medical conditions, including a comparison of prior authorization​ 52.7 requirements, drug formulary design, claim denials, rehabilitation services, and other​ 52.8 information the commissioner deems appropriate.​ 52.9 (g) Regardless of the health care provider's professional license, if the service provided​ 52.10 is consistent with the provider's scope of practice and the health plan company's credentialing​ 52.11 and contracting provisions, mental health therapy visits and medication maintenance visits​ 52.12 shall be considered primary care visits for the purpose of applying any enrollee cost-sharing​ 52.13 requirements imposed under the enrollee's health plan.​ 52.14 (h) By June 1 of each year, beginning June 1, 2021, the commissioner of commerce, in​ 52.15 consultation with the commissioner of health, shall submit a report on compliance and​ 52.16 oversight to the chairs and ranking minority members of the legislative committees with​ 52.17 jurisdiction over health and commerce. The report must:​ 52.18 (1) describe the commissioner's process for reviewing health plan company compliance​ 52.19 with United States Code, title 42, section 18031(j), any federal regulations or guidance​ 52.20 relating to compliance and oversight, and compliance with this section and section 62Q.53;​ 52.21 (2) identify any enforcement actions taken by either commissioner during the preceding​ 52.22 12-month period regarding compliance with parity for mental health and substance use​ 52.23 disorders benefits under state and federal law, summarizing the results of any market conduct​ 52.24 examinations. The summary must include: (i) the number of formal enforcement actions​ 52.25 taken; (ii) the benefit classifications examined in each enforcement action; and (iii) the​ 52.26 subject matter of each enforcement action, including quantitative and nonquantitative​ 52.27 treatment limitations;​ 52.28 (3) detail any corrective action taken by either commissioner to ensure health plan​ 52.29 company compliance with this section, section 62Q.53, and United States Code, title 42,​ 52.30 section 18031(j); and​ 52.31 (4) describe the information provided by either commissioner to the public about​ 52.32 alcoholism, mental health, or chemical dependency parity protections under state and federal​ 52.33 law.​ 52​ Article 2 Sec. 3.​ 23-00276 as introduced​ 01/26/23 REVISOR EB/HL​ 53.1 The report must be written in nontechnical, readily understandable language and must be​ 53.2 made available to the public by, among other means as the commissioners find appropriate,​ 53.3 posting the report on department websites. Individually identifiable information must be​ 53.4 excluded from the report, consistent with state and federal privacy protections.​ 53.5 Sec. 4. Minnesota Statutes 2022, section 169A.70, subdivision 3, is amended to read:​ 53.6 Subd. 3. Assessment report. (a) The assessment report must be on a form prescribed​ 53.7 by the commissioner and shall contain an evaluation of the convicted defendant concerning​ 53.8 the defendant's prior traffic and criminal record, characteristics and history of alcohol and​ 53.9 chemical use problems, and amenability to rehabilitation through the alcohol safety program.​ 53.10 The report is classified as private data on individuals as defined in section 13.02, subdivision​ 53.11 12.​ 53.12 (b) The assessment report must include:​ 53.13 (1) a diagnosis of the nature of the offender's chemical and alcohol involvement;​ 53.14 (2) an assessment of the severity level of the involvement;​ 53.15 (3) a recommended level of care for the offender in accordance with the criteria contained​ 53.16 in rules adopted by the commissioner of human services under section 254A.03, subdivision​ 53.17 3 (substance use disorder treatment rules) section 245G.05;​ 53.18 (4) an assessment of the offender's placement needs;​ 53.19 (5) recommendations for other appropriate remedial action or care, including aftercare​ 53.20 services in section 254B.01, subdivision 3, that may consist of educational programs,​ 53.21 one-on-one counseling, a program or type of treatment that addresses mental health concerns,​ 53.22 or a combination of them; and​ 53.23 (6) a specific explanation why no level of care or action was recommended, if applicable.​ 53.24 Sec. 5. Minnesota Statutes 2022, section 169A.70, subdivision 4, is amended to read:​ 53.25 Subd. 4. Assessor standards; rules; assessment time limits. A chemical use assessment​ 53.26 required by this section must be conducted by an assessor appointed by the court. The​ 53.27 assessor must meet the training and qualification requirements of rules adopted by the​ 53.28 commissioner of human services under section 254A.03, subdivision 3 (substance use​ 53.29 disorder treatment rules) section 245G.11, subdivisions 1 and 5. Notwithstanding section​ 53.30 13.82 (law enforcement data), the assessor shall have access to any police reports, laboratory​ 53.31 test results, and other law enforcement data relating to the current offense or previous​ 53​ Article 2 Sec. 5.​ 23-00276 as introduced​ 01/26/23 REVISOR EB/HL​ 54.1 offenses that are necessary to complete the evaluation. An assessor providing an assessment​ 54.2 under this section may not have any direct or shared financial interest or referral relationship​ 54.3 resulting in shared financial gain with a treatment provider, except as authorized under​ 54.4 section 254A.19, subdivision 3. If an independent assessor is not available, the court may​ 54.5 use the services of an assessor authorized to perform assessments for the county social​ 54.6 services agency under a variance granted under rules adopted by the commissioner of human​ 54.7 services under section 254A.03, subdivision 3. An appointment for the defendant to undergo​ 54.8 the assessment must be made by the court, a court services probation officer, or the court​ 54.9 administrator as soon as possible but in no case more than one week after the defendant's​ 54.10 court appearance. The assessment must be completed no later than three weeks after the​ 54.11 defendant's court appearance. If the assessment is not performed within this time limit, the​ 54.12 county where the defendant is to be sentenced shall perform the assessment. The county of​ 54.13 financial responsibility must be determined under chapter 256G.​ 54.14 Sec. 6. Minnesota Statutes 2022, section 245A.043, subdivision 3, is amended to read:​ 54.15 Subd. 3. Change of ownership process. (a) When a change in ownership is proposed​ 54.16 and the party intends to assume operation without an interruption in service longer than 60​ 54.17 days after acquiring the program or service, the license holder must provide the commissioner​ 54.18 with written notice of the proposed change on a form provided by the commissioner at least​ 54.19 60 days before the anticipated date of the change in ownership. For purposes of this​ 54.20 subdivision and subdivision 4, "party" means the party that intends to operate the service​ 54.21 or program.​ 54.22 (b) The party must submit a license application under this chapter on the form and in​ 54.23 the manner prescribed by the commissioner at least 30 days before the change in ownership​ 54.24 is complete, and must include documentation to support the upcoming change. The party​ 54.25 must comply with background study requirements under chapter 245C and shall pay the​ 54.26 application fee required under section 245A.10. A party that intends to assume operation​ 54.27 without an interruption in service longer than 60 days after acquiring the program or service​ 54.28 is exempt from the requirements of sections 245G.03, subdivision 2, paragraph (b), and​ 54.29 254B.03, subdivision 2, paragraphs (c) and (d) and (e).​ 54.30 (c) The commissioner may streamline application procedures when the party is an existing​ 54.31 license holder under this chapter and is acquiring a program licensed under this chapter or​ 54.32 service in the same service class as one or more licensed programs or services the party​ 54.33 operates and those licenses are in substantial compliance. For purposes of this subdivision,​ 54.34 "substantial compliance" means within the previous 12 months the commissioner did not​ 54​ Article 2 Sec. 6.​ 23-00276 as introduced​ 01/26/23 REVISOR EB/HL​ 55.1 (1) issue a sanction under section 245A.07 against a license held by the party, or (2) make​ 55.2 a license held by the party conditional according to section 245A.06.​ 55.3 (d) Except when a temporary change in ownership license is issued pursuant to​ 55.4 subdivision 4, the existing license holder is solely responsible for operating the program​ 55.5 according to applicable laws and rules until a license under this chapter is issued to the​ 55.6 party.​ 55.7 (e) If a licensing inspection of the program or service was conducted within the previous​ 55.8 12 months and the existing license holder's license record demonstrates substantial​ 55.9 compliance with the applicable licensing requirements, the commissioner may waive the​ 55.10 party's inspection required by section 245A.04, subdivision 4. The party must submit to the​ 55.11 commissioner (1) proof that the premises was inspected by a fire marshal or that the fire​ 55.12 marshal deemed that an inspection was not warranted, and (2) proof that the premises was​ 55.13 inspected for compliance with the building code or that no inspection was deemed warranted.​ 55.14 (f) If the party is seeking a license for a program or service that has an outstanding action​ 55.15 under section 245A.06 or 245A.07, the party must submit a letter as part of the application​ 55.16 process identifying how the party has or will come into full compliance with the licensing​ 55.17 requirements.​ 55.18 (g) The commissioner shall evaluate the party's application according to section 245A.04,​ 55.19 subdivision 6. If the commissioner determines that the party has remedied or demonstrates​ 55.20 the ability to remedy the outstanding actions under section 245A.06 or 245A.07 and has​ 55.21 determined that the program otherwise complies with all applicable laws and rules, the​ 55.22 commissioner shall issue a license or conditional license under this chapter. The conditional​ 55.23 license remains in effect until the commissioner determines that the grounds for the action​ 55.24 are corrected or no longer exist.​ 55.25 (h) The commissioner may deny an application as provided in section 245A.05. An​ 55.26 applicant whose application was denied by the commissioner may appeal the denial according​ 55.27 to section 245A.05.​ 55.28 (i) This subdivision does not apply to a licensed program or service located in a home​ 55.29 where the license holder resides.​ 55.30 Sec. 7. Minnesota Statutes 2022, section 245G.05, subdivision 2, is amended to read:​ 55.31 Subd. 2. Assessment summary. (a) An alcohol and drug counselor must complete an​ 55.32 assessment summary within three calendar days from the day of service initiation for a​ 55.33 residential program and within three calendar days on which a treatment session has been​ 55​ Article 2 Sec. 7.​ 23-00276 as introduced​ 01/26/23 REVISOR EB/HL​ 56.1 provided from the day of service initiation for a client in a nonresidential program. The​ 56.2 comprehensive assessment summary is complete upon a qualified staff member's dated​ 56.3 signature. If the comprehensive assessment is used to authorize the treatment service, the​ 56.4 alcohol and drug counselor must prepare an assessment summary on the same date the​ 56.5 comprehensive assessment is completed. If the comprehensive assessment and assessment​ 56.6 summary are to authorize treatment services, the assessor must determine appropriate level​ 56.7 of care and services for the client using the dimensions in Minnesota Rules, part 9530.6622,​ 56.8 criteria established in section 254B.04, subdivision 4, and document the recommendations.​ 56.9 (b) An assessment summary must include:​ 56.10 (1) a risk description according to section 245G.05 for each dimension listed in paragraph​ 56.11 (c);​ 56.12 (2) a narrative summary supporting the risk descriptions; and​ 56.13 (3) a determination of whether the client has a substance use disorder.​ 56.14 (c) An assessment summary must contain information relevant to treatment service​ 56.15 planning and recorded in the dimensions in clauses (1) to (6). The license holder must​ 56.16 consider:​ 56.17 (1) Dimension 1, acute intoxication/withdrawal potential; the client's ability to cope with​ 56.18 withdrawal symptoms and current state of intoxication;​ 56.19 (2) Dimension 2, biomedical conditions and complications; the degree to which any​ 56.20 physical disorder of the client would interfere with treatment for substance use, and the​ 56.21 client's ability to tolerate any related discomfort. The license holder must determine the​ 56.22 impact of continued substance use on the unborn child, if the client is pregnant;​ 56.23 (3) Dimension 3, emotional, behavioral, and cognitive conditions and complications;​ 56.24 the degree to which any condition or complication is likely to interfere with treatment for​ 56.25 substance use or with functioning in significant life areas and the likelihood of harm to self​ 56.26 or others;​ 56.27 (4) Dimension 4, readiness for change; the support necessary to keep the client involved​ 56.28 in treatment service;​ 56.29 (5) Dimension 5, relapse, continued use, and continued problem potential; the degree​ 56.30 to which the client recognizes relapse issues and has the skills to prevent relapse of either​ 56.31 substance use or mental health problems; and​ 56​ Article 2 Sec. 7.​ 23-00276 as introduced​ 01/26/23 REVISOR EB/HL​ 57.1 (6) Dimension 6, recovery environment; whether the areas of the client's life are​ 57.2 supportive of or antagonistic to treatment participation and recovery.​ 57.3 Sec. 8. Minnesota Statutes 2022, section 245G.22, subdivision 2, is amended to read:​ 57.4 Subd. 2. Definitions. (a) For purposes of this section, the terms defined in this subdivision​ 57.5 have the meanings given them.​ 57.6 (b) "Diversion" means the use of a medication for the treatment of opioid addiction being​ 57.7 diverted from intended use of the medication.​ 57.8 (c) "Guest dose" means administration of a medication used for the treatment of opioid​ 57.9 addiction to a person who is not a client of the program that is administering or dispensing​ 57.10 the medication.​ 57.11 (d) "Medical director" means a practitioner licensed to practice medicine in the​ 57.12 jurisdiction that the opioid treatment program is located who assumes responsibility for​ 57.13 administering all medical services performed by the program, either by performing the​ 57.14 services directly or by delegating specific responsibility to a practitioner of the opioid​ 57.15 treatment program.​ 57.16 (e) "Medication used for the treatment of opioid use disorder" means a medication​ 57.17 approved by the Food and Drug Administration for the treatment of opioid use disorder.​ 57.18 (f) "Minnesota health care programs" has the meaning given in section 256B.0636.​ 57.19 (g) "Opioid treatment program" has the meaning given in Code of Federal Regulations,​ 57.20 title 42, section 8.12, and includes programs licensed under this chapter.​ 57.21 (h) "Placing authority" has the meaning given in Minnesota Rules, part 9530.6605,​ 57.22 subpart 21a.​ 57.23 (i) (h) "Practitioner" means a staff member holding a current, unrestricted license to​ 57.24 practice medicine issued by the Board of Medical Practice or nursing issued by the Board​ 57.25 of Nursing and is currently registered with the Drug Enforcement Administration to order​ 57.26 or dispense controlled substances in Schedules II to V under the Controlled Substances Act,​ 57.27 United States Code, title 21, part B, section 821. Practitioner includes an advanced practice​ 57.28 registered nurse and physician assistant if the staff member receives a variance by the state​ 57.29 opioid treatment authority under section 254A.03 and the federal Substance Abuse and​ 57.30 Mental Health Services Administration.​ 57.31 (j) (i) "Unsupervised use" means the use of a medication for the treatment of opioid use​ 57.32 disorder dispensed for use by a client outside of the program setting.​ 57​ Article 2 Sec. 8.​ 23-00276 as introduced​ 01/26/23 REVISOR EB/HL​ 58.1 Sec. 9. Minnesota Statutes 2022, section 254A.03, subdivision 3, is amended to read:​ 58.2 Subd. 3. Rules for substance use disorder care. (a) The commissioner of human​ 58.3 services shall establish by rule criteria to be used in determining the appropriate level of​ 58.4 substance use disorder care for each recipient of public assistance seeking treatment for​ 58.5 substance misuse or substance use disorder. Upon federal approval of a comprehensive​ 58.6 assessment as a Medicaid benefit, or on July 1, 2018, whichever is later, and notwithstanding​ 58.7 the criteria in Minnesota Rules, parts 9530.6600 to 9530.6655, An eligible vendor of​ 58.8 comprehensive assessments under section 254B.05 may determine and approve the​ 58.9 appropriate level of substance use disorder treatment for a recipient of public assistance.​ 58.10 The process for determining an individual's financial eligibility for the behavioral health​ 58.11 fund or determining an individual's enrollment in or eligibility for a publicly subsidized​ 58.12 health plan is not affected by the individual's choice to access a comprehensive assessment​ 58.13 for placement.​ 58.14 (b) The commissioner shall develop and implement a utilization review process for​ 58.15 publicly funded treatment placements to monitor and review the clinical appropriateness​ 58.16 and timeliness of all publicly funded placements in treatment.​ 58.17 (c) If a screen result is positive for alcohol or substance misuse, a brief screening for​ 58.18 alcohol or substance use disorder that is provided to a recipient of public assistance within​ 58.19 a primary care clinic, hospital, or other medical setting or school setting establishes medical​ 58.20 necessity and approval for an initial set of substance use disorder services identified in​ 58.21 section 254B.05, subdivision 5. The initial set of services approved for a recipient whose​ 58.22 screen result is positive may include any combination of up to four hours of individual or​ 58.23 group substance use disorder treatment, two hours of substance use disorder treatment​ 58.24 coordination, or two hours of substance use disorder peer support services provided by a​ 58.25 qualified individual according to chapter 245G. A recipient must obtain an assessment​ 58.26 pursuant to paragraph (a) to be approved for additional treatment services. Minnesota Rules,​ 58.27 parts 9530.6600 to 9530.6655, and A comprehensive assessment pursuant to section 245G.05​ 58.28 are not applicable is not required to receive the initial set of services allowed under this​ 58.29 subdivision. A positive screen result establishes eligibility for the initial set of services​ 58.30 allowed under this subdivision.​ 58.31 (d) Notwithstanding Minnesota Rules, parts 9530.6600 to 9530.6655, An individual​ 58.32 may choose to obtain a comprehensive assessment as provided in section 245G.05.​ 58.33 Individuals obtaining a comprehensive assessment may access any enrolled provider that​ 58.34 is licensed to provide the level of service authorized pursuant to section 254A.19, subdivision​ 58.35 3, paragraph (d). If the individual is enrolled in a prepaid health plan, the individual must​ 58​ Article 2 Sec. 9.​ 23-00276 as introduced​ 01/26/23 REVISOR EB/HL​ 59.1 comply with any provider network requirements or limitations. This paragraph expires July​ 59.2 1, 2022.​ 59.3 (d) An individual may choose to obtain a comprehensive assessment as provided in​ 59.4 section 245G.05. Individuals obtaining a comprehensive assessment may access any enrolled​ 59.5 provider that is licensed to provide the level of service authorized pursuant to section​ 59.6 254A.19, subdivision 3. If the individual is enrolled in a prepaid health plan, the individual​ 59.7 must comply with any provider network requirements or limitations.​ 59.8 Sec. 10. Minnesota Statutes 2022, section 254A.19, subdivision 1, is amended to read:​ 59.9 Subdivision 1. Persons arrested outside of home county. When a chemical use​ 59.10 assessment is required under Minnesota Rules, parts 9530.6600 to 9530.6655, for a person​ 59.11 who is arrested and taken into custody by a peace officer outside of the person's county of​ 59.12 residence, the assessment must be completed by the person's county of residence no later​ 59.13 than three weeks after the assessment is initially requested. If the assessment is not performed​ 59.14 within this time limit, the county where the person is to be sentenced shall perform the​ 59.15 assessment county where the person is detained must give access to an assessor qualified​ 59.16 under section 254A.19, subdivision 3. The county of financial responsibility is determined​ 59.17 under chapter 256G.​ 59.18 Sec. 11. Minnesota Statutes 2022, section 254A.19, subdivision 3, is amended to read:​ 59.19 Subd. 3. Financial conflicts of interest. Comprehensive assessments. (a) Except as​ 59.20 provided in paragraph (b), (c), or (d), an assessor conducting a chemical use assessment​ 59.21 under Minnesota Rules, parts 9530.6600 to 9530.6655, may not have any direct or shared​ 59.22 financial interest or referral relationship resulting in shared financial gain with a treatment​ 59.23 provider.​ 59.24 (b) A county may contract with an assessor having a conflict described in paragraph (a)​ 59.25 if the county documents that:​ 59.26 (1) the assessor is employed by a culturally specific service provider or a service provider​ 59.27 with a program designed to treat individuals of a specific age, sex, or sexual preference;​ 59.28 (2) the county does not employ a sufficient number of qualified assessors and the only​ 59.29 qualified assessors available in the county have a direct or shared financial interest or a​ 59.30 referral relationship resulting in shared financial gain with a treatment provider; or​ 59.31 (3) the county social service agency has an existing relationship with an assessor or​ 59.32 service provider and elects to enter into a contract with that assessor to provide both​ 59​ Article 2 Sec. 11.​ 23-00276 as introduced​ 01/26/23 REVISOR EB/HL​ 60.1 assessment and treatment under circumstances specified in the county's contract, provided​ 60.2 the county retains responsibility for making placement decisions.​ 60.3 (c) The county may contract with a hospital to conduct chemical assessments if the​ 60.4 requirements in subdivision 1a are met.​ 60.5 An assessor under this paragraph may not place clients in treatment. The assessor shall​ 60.6 gather required information and provide it to the county along with any required​ 60.7 documentation. The county shall make all placement decisions for clients assessed by​ 60.8 assessors under this paragraph.​ 60.9 (d) An eligible vendor under section 254B.05 conducting a comprehensive assessment​ 60.10 for an individual seeking treatment shall approve the nature, intensity level, and duration​ 60.11 of treatment service if a need for services is indicated, but the individual assessed can access​ 60.12 any enrolled provider that is licensed to provide the level of service authorized, including​ 60.13 the provider or program that completed the assessment. If an individual is enrolled in a​ 60.14 prepaid health plan, the individual must comply with any provider network requirements​ 60.15 or limitations.​ 60.16 Sec. 12. Minnesota Statutes 2022, section 254A.19, subdivision 4, is amended to read:​ 60.17 Subd. 4. Civil commitments. A Rule 25 assessment, under Minnesota Rules, part​ 60.18 9530.6615, For the purposes of determining level of care, a comprehensive assessment does​ 60.19 not need to be completed for an individual being committed as a chemically dependent​ 60.20 person, as defined in section 253B.02, and for the duration of a civil commitment under​ 60.21 section 253B.065, 253B.09, or 253B.095 in order for a county to access the behavioral​ 60.22 health fund under section 254B.04. The county must determine if the individual meets the​ 60.23 financial eligibility requirements for the behavioral health fund under section 254B.04.​ 60.24 Nothing in this subdivision prohibits placement in a treatment facility or treatment program​ 60.25 governed under this chapter or Minnesota Rules, parts 9530.6600 to 9530.6655.​ 60.26 Sec. 13. Minnesota Statutes 2022, section 254A.19, is amended by adding a subdivision​ 60.27 to read:​ 60.28 Subd. 6. Assessments for detoxification programs. For detoxification programs licensed​ 60.29 under chapter 245A according to Minnesota Rules, parts 9530.6510 to 9530.6590, a​ 60.30 "chemical use assessment" is a comprehensive assessment and assessment summary​ 60.31 completed according to the requirements of section 245G.05 and a "chemical dependency​ 60.32 assessor" or "assessor" is an individual who meets the qualifications of section 245G.11,​ 60.33 subdivisions 1 and 5.​ 60​ Article 2 Sec. 13.​ 23-00276 as introduced​ 01/26/23 REVISOR EB/HL​ 61.1 Sec. 14. Minnesota Statutes 2022, section 254A.19, is amended by adding a subdivision​ 61.2 to read:​ 61.3 Subd. 7. Assessments for children's residential facilities. For children's residential​ 61.4 facilities licensed under chapter 245A according to Minnesota Rules, parts 2960.0010 to​ 61.5 2960.0220 and 2960.0430 to 2960.0490, a "chemical use assessment" is a comprehensive​ 61.6 assessment and assessment summary completed according to the requirements of section​ 61.7 245G.05 and must be completed by an individual who meets the qualifications of section​ 61.8 245G.11, subdivisions 1 and 5.​ 61.9 Sec. 15. Minnesota Statutes 2022, section 254B.01, is amended by adding a subdivision​ 61.10 to read:​ 61.11 Subd. 2a. Behavioral health fund. "Behavioral health fund" means money allocated​ 61.12 for payment of treatment services under chapter 254B.​ 61.13 Sec. 16. Minnesota Statutes 2022, section 254B.01, is amended by adding a subdivision​ 61.14 to read:​ 61.15 Subd. 2b. Client. "Client" means an individual who has requested substance use disorder​ 61.16 services or for whom substance use disorder services have been requested.​ 61.17 Sec. 17. Minnesota Statutes 2022, section 254B.01, is amended by adding a subdivision​ 61.18 to read:​ 61.19 Subd. 2c. Co-payment. "Co-payment" means:​ 61.20 (1) the amount an insured person is obligated to pay before the person's third-party​ 61.21 payment source is obligated to make a payment; or​ 61.22 (2) the amount an insured person is obligated to pay in addition to the amount the person's​ 61.23 third-party payment source is obligated to pay.​ 61.24 Sec. 18. Minnesota Statutes 2022, section 254B.01, is amended by adding a subdivision​ 61.25 to read:​ 61.26 Subd. 4c. Department. "Department" means the Department of Human Services.​ 61​ Article 2 Sec. 18.​ 23-00276 as introduced​ 01/26/23 REVISOR EB/HL​ 62.1 Sec. 19. Minnesota Statutes 2022, section 254B.01, is amended by adding a subdivision​ 62.2 to read:​ 62.3 Subd. 4d. Drug and Alcohol Abuse Normative Evaluation System or DAANES. "Drug​ 62.4 and Alcohol Abuse Normative Evaluation System" or "DAANES" means the reporting​ 62.5 system used to collect all substance use disorder treatment data across all levels of care and​ 62.6 providers.​ 62.7 Sec. 20. Minnesota Statutes 2022, section 254B.01, subdivision 5, is amended to read:​ 62.8 Subd. 5. Local agency. "Local agency" means the agency designated by a board of​ 62.9 county commissioners, a local social services agency, or a human services board to make​ 62.10 placements and submit state invoices according to Laws 1986, chapter 394, sections 8 to​ 62.11 20 authorized under section 254B.03, subdivision 1, to determine financial eligibility for​ 62.12 the behavioral health fund.​ 62.13 Sec. 21. Minnesota Statutes 2022, section 254B.01, is amended by adding a subdivision​ 62.14 to read:​ 62.15 Subd. 6a. Minor child. "Minor child" means an individual under the age of 18 years.​ 62.16 Sec. 22. Minnesota Statutes 2022, section 254B.01, is amended by adding a subdivision​ 62.17 to read:​ 62.18 Subd. 6b. Policyholder. "Policyholder" means a person who has a third-party payment​ 62.19 policy under which a third-party payment source has an obligation to pay all or part of a​ 62.20 client's treatment costs.​ 62.21 Sec. 23. Minnesota Statutes 2022, section 254B.01, is amended by adding a subdivision​ 62.22 to read:​ 62.23 Subd. 9. Responsible relative. "Responsible relative" means a person who is a member​ 62.24 of the client's household and is the client's spouse or the parent of a minor child who is a​ 62.25 client.​ 62.26 Sec. 24. Minnesota Statutes 2022, section 254B.01, is amended by adding a subdivision​ 62.27 to read:​ 62.28 Subd. 10. Third-party payment source "Third-party payment source" means a person,​ 62.29 entity, or public or private agency other than medical assistance or general assistance medical​ 62​ Article 2 Sec. 24.​ 23-00276 as introduced​ 01/26/23 REVISOR EB/HL​ 63.1 care that has a probable obligation to pay all or part of the costs of a client's substance use​ 63.2 disorder treatment.​ 63.3 Sec. 25. Minnesota Statutes 2022, section 254B.01, is amended by adding a subdivision​ 63.4 to read:​ 63.5 Subd. 11. Vendor. "Vendor" means a provider of substance use disorder treatment​ 63.6 services that meets the criteria established in section 254B.05, and that has applied to​ 63.7 participate as a provider in the medical assistance program according to Minnesota Rules,​ 63.8 part 9505.0195.​ 63.9 Sec. 26. Minnesota Statutes 2022, section 254B.03, subdivision 1, is amended to read:​ 63.10 Subdivision 1. Local agency duties. (a) Every local agency shall must determine financial​ 63.11 eligibility for substance use disorder services and provide substance use disorder services​ 63.12 to persons residing within its jurisdiction who meet criteria established by the commissioner​ 63.13 for placement in a substance use disorder residential or nonresidential treatment service.​ 63.14 Substance use disorder money must be administered by the local agencies according to law​ 63.15 and rules adopted by the commissioner under sections 14.001 to 14.69.​ 63.16 (b) In order to contain costs, the commissioner of human services shall select eligible​ 63.17 vendors of substance use disorder services who can provide economical and appropriate​ 63.18 treatment. Unless the local agency is a social services department directly administered by​ 63.19 a county or human services board, the local agency shall not be an eligible vendor under​ 63.20 section 254B.05. The commissioner may approve proposals from county boards to provide​ 63.21 services in an economical manner or to control utilization, with safeguards to ensure that​ 63.22 necessary services are provided. If a county implements a demonstration or experimental​ 63.23 medical services funding plan, the commissioner shall transfer the money as appropriate.​ 63.24 (c) A culturally specific vendor that provides assessments under a variance under​ 63.25 Minnesota Rules, part 9530.6610, shall be allowed to provide assessment services to persons​ 63.26 not covered by the variance.​ 63.27 (d) Notwithstanding Minnesota Rules, parts 9530.6600 to 9530.6655, (c) An individual​ 63.28 may choose to obtain a comprehensive assessment as provided in section 245G.05.​ 63.29 Individuals obtaining a comprehensive assessment may access any enrolled provider that​ 63.30 is licensed to provide the level of service authorized pursuant to section 254A.19, subdivision​ 63.31 3, paragraph (d). If the individual is enrolled in a prepaid health plan, the individual must​ 63.32 comply with any provider network requirements or limitations.​ 63​ Article 2 Sec. 26.​ 23-00276 as introduced​ 01/26/23 REVISOR EB/HL​ 64.1 (e) (d) Beginning July 1, 2022, local agencies shall not make placement location​ 64.2 determinations.​ 64.3 Sec. 27. Minnesota Statutes 2022, section 254B.03, subdivision 2, is amended to read:​ 64.4 Subd. 2. Behavioral health fund payment. (a) Payment from the behavioral health​ 64.5 fund is limited to payments for services identified in section 254B.05, other than​ 64.6 detoxification licensed under Minnesota Rules, parts 9530.6510 to 9530.6590, and​ 64.7 detoxification provided in another state that would be required to be licensed as a substance​ 64.8 use disorder program if the program were in the state. Out of state vendors must also provide​ 64.9 the commissioner with assurances that the program complies substantially with state licensing​ 64.10 requirements and possesses all licenses and certifications required by the host state to provide​ 64.11 substance use disorder treatment. Vendors receiving payments from the behavioral health​ 64.12 fund must not require co-payment from a recipient of benefits for services provided under​ 64.13 this subdivision. The vendor is prohibited from using the client's public benefits to offset​ 64.14 the cost of services paid under this section. The vendor shall not require the client to use​ 64.15 public benefits for room or board costs. This includes but is not limited to cash assistance​ 64.16 benefits under chapters 119B, 256D, and 256J, or SNAP benefits. Retention of SNAP​ 64.17 benefits is a right of a client receiving services through the behavioral health fund or through​ 64.18 state contracted managed care entities. Payment from the behavioral health fund shall be​ 64.19 made for necessary room and board costs provided by vendors meeting the criteria under​ 64.20 section 254B.05, subdivision 1a, or in a community hospital licensed by the commissioner​ 64.21 of health according to sections 144.50 to 144.56 to a client who is:​ 64.22 (1) determined to meet the criteria for placement in a residential substance use disorder​ 64.23 treatment program according to rules adopted under section 254A.03, subdivision 3; and​ 64.24 (2) concurrently receiving a substance use disorder treatment service in a program​ 64.25 licensed by the commissioner and reimbursed by the behavioral health fund.​ 64.26 (b) A county may, from its own resources, provide substance use disorder services for​ 64.27 which state payments are not made. A county may elect to use the same invoice procedures​ 64.28 and obtain the same state payment services as are used for substance use disorder services​ 64.29 for which state payments are made under this section if county payments are made to the​ 64.30 state in advance of state payments to vendors. When a county uses the state system for​ 64.31 payment, the commissioner shall make monthly billings to the county using the most recent​ 64.32 available information to determine the anticipated services for which payments will be made​ 64.33 in the coming month. Adjustment of any overestimate or underestimate based on actual​ 64​ Article 2 Sec. 27.​ 23-00276 as introduced​ 01/26/23 REVISOR EB/HL​ 65.1 expenditures shall be made by the state agency by adjusting the estimate for any succeeding​ 65.2 month.​ 65.3 (c) (b) The commissioner shall coordinate substance use disorder services and determine​ 65.4 whether there is a need for any proposed expansion of substance use disorder treatment​ 65.5 services. The commissioner shall deny vendor certification to any provider that has not​ 65.6 received prior approval from the commissioner for the creation of new programs or the​ 65.7 expansion of existing program capacity. The commissioner shall consider the provider's​ 65.8 capacity to obtain clients from outside the state based on plans, agreements, and previous​ 65.9 utilization history, when determining the need for new treatment services.​ 65.10 (d) (c) At least 60 days prior to submitting an application for new licensure under chapter​ 65.11 245G, the applicant must notify the county human services director in writing of the​ 65.12 applicant's intent to open a new treatment program. The written notification must include,​ 65.13 at a minimum:​ 65.14 (1) a description of the proposed treatment program; and​ 65.15 (2) a description of the target population to be served by the treatment program.​ 65.16 (e) (d) The county human services director may submit a written statement to the​ 65.17 commissioner, within 60 days of receiving notice from the applicant, regarding the county's​ 65.18 support of or opposition to the opening of the new treatment program. The written statement​ 65.19 must include documentation of the rationale for the county's determination. The commissioner​ 65.20 shall consider the county's written statement when determining whether there is a need for​ 65.21 the treatment program as required by paragraph (c).​ 65.22 Sec. 28. Minnesota Statutes 2022, section 254B.03, subdivision 5, is amended to read:​ 65.23 Subd. 5. Rules; appeal. The commissioner shall adopt rules as necessary to implement​ 65.24 this chapter. The commissioner shall establish an appeals process for use by recipients when​ 65.25 services certified by the county are disputed. The commissioner shall adopt rules and​ 65.26 standards for the appeal process to assure adequate redress for persons referred to​ 65.27 inappropriate services.​ 65.28 Sec. 29. Minnesota Statutes 2022, section 254B.04, subdivision 1, is amended to read:​ 65.29 Subdivision 1. Eligibility. Scope and applicability. (a) Persons eligible for benefits​ 65.30 under Code of Federal Regulations, title 25, part 20, who meet the income standards of​ 65.31 section 256B.056, subdivision 4, and are not enrolled in medical assistance, are entitled to​ 65​ Article 2 Sec. 29.​ 23-00276 as introduced​ 01/26/23 REVISOR EB/HL​ 66.1 behavioral health fund services. State money appropriated for this paragraph must be placed​ 66.2 in a separate account established for this purpose.​ 66.3 (b) Persons with dependent children who are determined to be in need of chemical​ 66.4 dependency treatment pursuant to an assessment under section 260E.20, subdivision 1, or​ 66.5 a case plan under section 260C.201, subdivision 6, or 260C.212, shall be assisted by the​ 66.6 local agency to access needed treatment services. Treatment services must be appropriate​ 66.7 for the individual or family, which may include long-term care treatment or treatment in a​ 66.8 facility that allows the dependent children to stay in the treatment facility. The county shall​ 66.9 pay for out-of-home placement costs, if applicable.​ 66.10 (c) Notwithstanding paragraph (a), persons enrolled in medical assistance are eligible​ 66.11 for room and board services under section 254B.05, subdivision 5, paragraph (b), clause​ 66.12 (12).​ 66.13 This section governs the administration of the behavioral health fund, establishes the​ 66.14 criteria to be applied by local agencies to determine a client's financial eligibility under the​ 66.15 behavioral health fund, and determines a client's obligation to pay for substance use disorder​ 66.16 treatment services.​ 66.17 Sec. 30. Minnesota Statutes 2022, section 254B.04, is amended by adding a subdivision​ 66.18 to read:​ 66.19 Subd. 1a. Client eligibility. (a) Persons eligible for benefits under Code of Federal​ 66.20 Regulations, title 25, part 20, who meet the income standards of section 256B.056,​ 66.21 subdivision 4, and are not enrolled in medical assistance, are entitled to behavioral health​ 66.22 fund services. State money appropriated for this paragraph must be placed in a separate​ 66.23 account established for this purpose.​ 66.24 (b) Persons with dependent children who are determined to be in need of chemical​ 66.25 dependency treatment pursuant to an assessment under section 260E.20, subdivision 1, or​ 66.26 a case plan under section 260C.201, subdivision 6, or 260C.212, shall be assisted by the​ 66.27 local agency to access needed treatment services. Treatment services must be appropriate​ 66.28 for the individual or family, which may include long-term care treatment or treatment in a​ 66.29 facility that allows the dependent children to stay in the treatment facility. The county shall​ 66.30 pay for out-of-home placement costs, if applicable.​ 66.31 (c) Notwithstanding paragraph (a), persons enrolled in medical assistance are eligible​ 66.32 for room and board services under section 254B.05, subdivision 5, paragraph (b), clause​ 66.33 (12).​ 66​ Article 2 Sec. 30.​ 23-00276 as introduced​ 01/26/23 REVISOR EB/HL​ 67.1 (d) A client is eligible to have substance use disorder treatment paid for with funds from​ 67.2 the behavioral health fund when the client:​ 67.3 (1) is eligible for MFIP as determined under chapter 256J;​ 67.4 (2) is eligible for medical assistance as determined under Minnesota Rules, parts​ 67.5 9505.0010 to 9505.0150;​ 67.6 (3) is eligible for general assistance, general assistance medical care, or work readiness​ 67.7 as determined under Minnesota Rules, parts 9500.1200 to 9500.1318; or​ 67.8 (4) has income that is within current household size and income guidelines for entitled​ 67.9 persons, as defined in this subdivision and subdivision 7.​ 67.10 (e) Clients who meet the financial eligibility requirement in paragraph (a) and who have​ 67.11 a third-party payment source are eligible for the behavioral health fund if the third-party​ 67.12 payment source pays less than 100 percent of the cost of treatment services for eligible​ 67.13 clients.​ 67.14 (f) A client is ineligible to have substance use disorder treatment services paid for with​ 67.15 behavioral health fund money if the client:​ 67.16 (1) has an income that exceeds current household size and income guidelines for entitled​ 67.17 persons as defined in this subdivision and subdivision 7; or​ 67.18 (2) has an available third-party payment source that will pay the total cost of the client's​ 67.19 treatment.​ 67.20 (g) A client who is disenrolled from a state prepaid health plan during a treatment episode​ 67.21 is eligible for continued treatment service that is paid for by the behavioral health fund until​ 67.22 the treatment episode is completed or the client is re-enrolled in a state prepaid health plan​ 67.23 if the client:​ 67.24 (1) continues to be enrolled in MinnesotaCare, medical assistance, or general assistance​ 67.25 medical care; or​ 67.26 (2) is eligible according to paragraphs (a) and (b) and is determined eligible by a local​ 67.27 agency under section 254B.04.​ 67.28 (h) When a county commits a client under chapter 253B to a regional treatment center​ 67.29 for substance use disorder services and the client is ineligible for the behavioral health fund,​ 67.30 the county is responsible for the payment to the regional treatment center according to​ 67.31 section 254B.05, subdivision 4.​ 67​ Article 2 Sec. 30.​ 23-00276 as introduced​ 01/26/23 REVISOR EB/HL​ 68.1 Sec. 31. Minnesota Statutes 2022, section 254B.04, subdivision 2a, is amended to read:​ 68.2 Subd. 2a. Eligibility for treatment in residential settings room and board services​ 68.3 for persons in outpatient substance use disorder treatment. Notwithstanding provisions​ 68.4 of Minnesota Rules, part 9530.6622, subparts 5 and 6, related to an assessor's discretion in​ 68.5 making placements to residential treatment settings, A person eligible for room and board​ 68.6 services under this section 254B.05, subdivision 5, paragraph (b), clause (12), must score​ 68.7 at level 4 on assessment dimensions related to readiness to change, relapse, continued use,​ 68.8 or recovery environment in order to be assigned to services with a room and board component​ 68.9 reimbursed under this section. Whether a treatment facility has been designated an institution​ 68.10 for mental diseases under United States Code, title 42, section 1396d, shall not be a factor​ 68.11 in making placements.​ 68.12 Sec. 32. Minnesota Statutes 2022, section 254B.04, is amended by adding a subdivision​ 68.13 to read:​ 68.14 Subd. 4. Assessment criteria and risk descriptions. (a) The level of care determination​ 68.15 must follow criteria approved by the commissioner.​ 68.16 (b) Dimension 1: Acute intoxication/withdrawal potential. A vendor must use the criteria​ 68.17 in Dimension 1 to determine a client's acute intoxication and withdrawal potential, the​ 68.18 client's ability to cope with withdrawal symptoms, and the client's current state of​ 68.19 intoxication.​ 68.20 "0" The client displays full functioning with good ability to tolerate and cope with​ 68.21 withdrawal discomfort, and the client shows no signs or symptoms of intoxication or​ 68.22 withdrawal or diminishing signs or symptoms.​ 68.23 "1" The client can tolerate and cope with withdrawal discomfort. The client displays​ 68.24 mild to moderate intoxication or signs and symptoms interfering with daily functioning but​ 68.25 does not immediately endanger self or others. The client poses a minimal risk of severe​ 68.26 withdrawal.​ 68.27 "2" The client has some difficulty tolerating and coping with withdrawal discomfort.​ 68.28 The client's intoxication may be severe but responds to support and treatment such that the​ 68.29 client does not immediately endanger self or others. The client displays moderate signs and​ 68.30 symptoms of withdrawal with moderate risk of severe withdrawal.​ 68.31 "3" The client tolerates and copes with withdrawal discomfort poorly. The client has​ 68.32 severe intoxication, such that the client endangers self or others, or intoxication has not​ 68.33 abated with less intensive services. The client displays severe signs and symptoms of​ 68​ Article 2 Sec. 32.​ 23-00276 as introduced​ 01/26/23 REVISOR EB/HL​ 69.1 withdrawal, has a risk of severe but manageable withdrawal, or has worsening withdrawal​ 69.2 despite detoxification at less intensive level.​ 69.3 "4" The client is incapacitated with severe signs and symptoms. The client displays​ 69.4 severe withdrawal and is a danger to self or others.​ 69.5 (c) Dimension 2: biomedical conditions and complications. The vendor must use the​ 69.6 criteria in Dimension 2 to determine a client's biomedical conditions and complications, the​ 69.7 degree to which any physical disorder of the client would interfere with treatment for​ 69.8 substance use, and the client's ability to tolerate any related discomfort. If the client is​ 69.9 pregnant, the provider must determine the impact of continued substance use on the unborn​ 69.10 child.​ 69.11 "0" The client displays full functioning with good ability to cope with physical discomfort.​ 69.12 "1" The client tolerates and copes with physical discomfort and is able to get the services​ 69.13 that the client needs.​ 69.14 "2" The client has difficulty tolerating and coping with physical problems or has other​ 69.15 biomedical problems that interfere with recovery and treatment. The client neglects or does​ 69.16 not seek care for serious biomedical problems.​ 69.17 "3" The client tolerates and copes poorly with physical problems or has poor general​ 69.18 health. The client neglects the client's medical problems without active assistance.​ 69.19 "4" The client is unable to participate in substance use disorder treatment and has severe​ 69.20 medical problems, a condition that requires immediate intervention, or is incapacitated.​ 69.21 (d) Dimension 3: Emotional, behavioral, and cognitive conditions and complications.​ 69.22 The vendor must use the criteria in Dimension 3 to determine a client's: emotional, behavioral,​ 69.23 and cognitive conditions and complications; the degree to which any condition or​ 69.24 complication is likely to interfere with treatment for substance use or with functioning in​ 69.25 significant life areas; and the likelihood of harm to self or others.​ 69.26 "0" The client has good impulse control and coping skills and presents no risk of harm​ 69.27 to self or others. The client functions in all life areas and displays no emotional, behavioral,​ 69.28 or cognitive problems or the problems are stable.​ 69.29 "1" The client has impulse control and coping skills. The client presents a mild to​ 69.30 moderate risk of harm to self or others or displays symptoms of emotional, behavioral, or​ 69.31 cognitive problems. The client has a mental health diagnosis and is stable. The client​ 69.32 functions adequately in significant life areas.​ 69​ Article 2 Sec. 32.​ 23-00276 as introduced​ 01/26/23 REVISOR EB/HL​ 70.1 "2" The client has difficulty with impulse control and lacks coping skills. The client has​ 70.2 thoughts of suicide or harm to others without means; however, the thoughts may interfere​ 70.3 with participation in some activities. The client has difficulty functioning in significant life​ 70.4 areas. The client has moderate symptoms of emotional, behavioral, or cognitive problems.​ 70.5 The client is able to participate in most treatment activities.​ 70.6 "3" The client has a severe lack of impulse control and coping skills. The client also has​ 70.7 frequent thoughts of suicide or harm to others including a plan and the means to carry out​ 70.8 the plan. In addition, the client is severely impaired in significant life areas and has severe​ 70.9 symptoms of emotional, behavioral, or cognitive problems that interfere with the client's​ 70.10 participation in treatment activities.​ 70.11 "4" The client has severe emotional or behavioral symptoms that place the client or​ 70.12 others at acute risk of harm. The client also has intrusive thoughts of harming self or others.​ 70.13 The client is unable to participate in treatment activities.​ 70.14 (e) Dimension 4: Readiness for change. The vendor must use the criteria in Dimension​ 70.15 4 to determine a client's readiness for change and the support necessary to keep the client​ 70.16 involved in treatment services.​ 70.17 "0" The client is cooperative, motivated, ready to change, admits problems, committed​ 70.18 to change, and engaged in treatment as a responsible participant.​ 70.19 "1" The client is motivated with active reinforcement to explore treatment and strategies​ 70.20 for change but ambivalent about illness or need for change.​ 70.21 "2" The client displays verbal compliance, but lacks consistent behaviors; has low​ 70.22 motivation for change; and is passively involved in treatment.​ 70.23 "3" The client displays inconsistent compliance, minimal awareness of either the client's​ 70.24 addiction or mental disorder, and is minimally cooperative.​ 70.25 "4" The client is:​ 70.26 (i) noncompliant with treatment and has no awareness of addiction or mental disorder​ 70.27 and does not want or is unwilling to explore change or is in total denial of the client's illness​ 70.28 and its implications; or​ 70.29 (ii) the client is dangerously oppositional to the extent that the client is a threat of​ 70.30 imminent harm to self and others.​ 70.31 (f) Dimension 5: Relapse, continued use, and continued problem potential. The vendor​ 70.32 must use the criteria in Dimension 5 to determine a client's relapse, continued use, and​ 70​ Article 2 Sec. 32.​ 23-00276 as introduced​ 01/26/23 REVISOR EB/HL​ 71.1 continued problem potential and the degree to which the client recognizes relapse issues​ 71.2 and has the skills to prevent relapse of either substance use or mental health problems.​ 71.3 "0" The client recognizes risk well and is able to manage potential problems.​ 71.4 "1" The client recognizes relapse issues and prevention strategies but displays some​ 71.5 vulnerability for further substance use or mental health problems.​ 71.6 "2" The client has:​ 71.7 (i) minimal recognition and understanding of relapse and recidivism issues and displays​ 71.8 moderate vulnerability for further substance use or mental health problems; or​ 71.9 (ii) some coping skills inconsistently applied.​ 71.10 "3" The client has poor recognition and understanding of relapse and recidivism issues​ 71.11 and displays moderately high vulnerability for further substance use or mental health​ 71.12 problems. The client has few coping skills and rarely applies coping skills.​ 71.13 "4" The client has no coping skills to arrest mental health or addiction illnesses or prevent​ 71.14 relapse. The client has no recognition or understanding of relapse and recidivism issues and​ 71.15 displays high vulnerability for further substance use disorder or mental health problems.​ 71.16 (g) Dimension 6: Recovery environment. The vendor must use the criteria in Dimension​ 71.17 6 to determine a client's recovery environment, whether the areas of the client's life are​ 71.18 supportive of or antagonistic to treatment participation and recovery.​ 71.19 "0" The client is engaged in structured meaningful activity and has a supportive significant​ 71.20 other, family, and living environment.​ 71.21 "1" The client has passive social network support, or family and significant other are​ 71.22 not interested in the client's recovery. The client is engaged in structured meaningful activity.​ 71.23 "2" The client is engaged in structured, meaningful activity, but peers, family, significant​ 71.24 other, and living environment are unsupportive, or there is criminal justice involvement by​ 71.25 the client or among the client's peers, significant other, or in the client's living environment.​ 71.26 "3" The client is not engaged in structured meaningful activity and the client's peers,​ 71.27 family, significant other, and living environment are unsupportive, or there is significant​ 71.28 criminal justice system involvement.​ 71.29 "4" The client has:​ 71​ Article 2 Sec. 32.​ 23-00276 as introduced​ 01/26/23 REVISOR EB/HL​ 72.1 (i) a chronically antagonistic significant other, living environment, family, peer group,​ 72.2 or long-term criminal justice involvement that is harmful to recovery or treatment progress;​ 72.3 or​ 72.4 (ii) the client has an actively antagonistic significant other, family, work, or living​ 72.5 environment that poses an immediate threat to the client's safety and well-being.​ 72.6 Sec. 33. Minnesota Statutes 2022, section 254B.04, is amended by adding a subdivision​ 72.7 to read:​ 72.8 Subd. 5. Local agency responsibility to provide services. The local agency may employ​ 72.9 individuals to conduct administrative activities and facilitate access to substance use disorder​ 72.10 treatment services.​ 72.11 Sec. 34. Minnesota Statutes 2022, section 254B.04, is amended by adding a subdivision​ 72.12 to read:​ 72.13 Subd. 6. Local agency to determine client financial eligibility. (a) The local agency​ 72.14 shall determine a client's financial eligibility for the behavioral health fund according to​ 72.15 section 254B.04, subdivision 1, with the income calculated prospectively for one year from​ 72.16 the date of comprehensive assessment. The local agency shall pay for eligible clients​ 72.17 according to chapter 256G. The local agency shall enter the financial eligibility span within​ 72.18 ten calendar days of request. Client eligibility must be determined using forms prescribed​ 72.19 by the department. To determine a client's eligibility, the local agency must determine the​ 72.20 client's income, the size of the client's household, the availability of a third-party payment​ 72.21 source, and a responsible relative's ability to pay for the client's substance use disorder​ 72.22 treatment.​ 72.23 (b) A client who is a minor child must not be deemed to have income available to pay​ 72.24 for substance use disorder treatment, unless the minor child is responsible for payment under​ 72.25 section 144.347 for substance use disorder treatment services sought under section 144.343,​ 72.26 subdivision 1.​ 72.27 (c) The local agency must determine the client's household size as follows:​ 72.28 (1) if the client is a minor child, the household size includes the following persons living​ 72.29 in the same dwelling unit:​ 72.30 (i) the client;​ 72.31 (ii) the client's birth or adoptive parents; and​ 72​ Article 2 Sec. 34.​ 23-00276 as introduced​ 01/26/23 REVISOR EB/HL​ 73.1 (iii) the client's siblings who are minors; and​ 73.2 (2) if the client is an adult, the household size includes the following persons living in​ 73.3 the same dwelling unit:​ 73.4 (i) the client;​ 73.5 (ii) the client's spouse;​ 73.6 (iii) the client's minor children; and​ 73.7 (iv) the client's spouse's minor children.​ 73.8 For purposes of this paragraph, household size includes a person listed in clauses (1) and​ 73.9 (2) who is in an out-of-home placement if a person listed in clause (1) or (2) is contributing​ 73.10 to the cost of care of the person in out-of-home placement.​ 73.11 (d) The local agency must determine the client's current prepaid health plan enrollment,​ 73.12 the availability of a third-party payment source, including the availability of total payment,​ 73.13 partial payment, and amount of co-payment.​ 73.14 (e) The local agency must provide the required eligibility information to the department​ 73.15 in the manner specified by the department.​ 73.16 (f) The local agency shall require the client and policyholder to conditionally assign to​ 73.17 the department the client and policyholder's rights and the rights of minor children to benefits​ 73.18 or services provided to the client if the department is required to collect from a third-party​ 73.19 pay source.​ 73.20 (g) The local agency must redetermine a client's eligibility for the behavioral health fund​ 73.21 every 12 months.​ 73.22 (h) A client, responsible relative, and policyholder must provide income or wage​ 73.23 verification, household size verification, and must make an assignment of third-party payment​ 73.24 rights under paragraph (f). If a client, responsible relative, or policyholder does not comply​ 73.25 with the provisions of this subdivision, the client is ineligible for behavioral health fund​ 73.26 payment for substance use disorder treatment, and the client and responsible relative must​ 73.27 be obligated to pay for the full cost of substance use disorder treatment services provided​ 73.28 to the client.​ 73​ Article 2 Sec. 34.​ 23-00276 as introduced​ 01/26/23 REVISOR EB/HL​ 74.1 Sec. 35. Minnesota Statutes 2022, section 254B.04, is amended by adding a subdivision​ 74.2 to read:​ 74.3 Subd. 7. Client fees. A client whose household income is within current household size​ 74.4 and income guidelines for entitled persons as defined in section 254B.04, subdivision 1a,​ 74.5 must pay no fee for care related to substance use disorder, including drug screens.​ 74.6 Sec. 36. Minnesota Statutes 2022, section 254B.04, is amended by adding a subdivision​ 74.7 to read:​ 74.8 Subd. 8. Vendor must participate in DAANES system. To be eligible for payment​ 74.9 under the behavioral health fund, a vendor must participate in the Drug and Alcohol Abuse​ 74.10 Normative Evaluation System (DAANES) or submit to the commissioner the information​ 74.11 required in the DAANES in the format specified by the commissioner.​ 74.12 Sec. 37. Minnesota Statutes 2022, section 256D.09, subdivision 2a, is amended to read:​ 74.13 Subd. 2a. Vendor payments for drug dependent persons. If, at the time of application​ 74.14 or at any other time, there is a reasonable basis for questioning whether a person applying​ 74.15 for or receiving financial assistance is drug dependent, as defined in section 254A.02,​ 74.16 subdivision 5, the person shall be referred for a chemical health assessment, and only​ 74.17 emergency assistance payments or general assistance vendor payments may be provided​ 74.18 until the assessment is complete and the results of the assessment made available to the​ 74.19 county agency. A reasonable basis for referring an individual for an assessment exists when:​ 74.20 (1) the person has required detoxification two or more times in the past 12 months;​ 74.21 (2) the person appears intoxicated at the county agency as indicated by two or more of​ 74.22 the following:​ 74.23 (i) the odor of alcohol;​ 74.24 (ii) slurred speech;​ 74.25 (iii) disconjugate gaze;​ 74.26 (iv) impaired balance;​ 74.27 (v) difficulty remaining awake;​ 74.28 (vi) consumption of alcohol;​ 74.29 (vii) responding to sights or sounds that are not actually present;​ 74.30 (viii) extreme restlessness, fast speech, or unusual belligerence;​ 74​ Article 2 Sec. 37.​ 23-00276 as introduced​ 01/26/23 REVISOR EB/HL​ 75.1 (3) the person has been involuntarily committed for drug dependency at least once in​ 75.2 the past 12 months; or​ 75.3 (4) the person has received treatment, including domiciliary care, for drug abuse or​ 75.4 dependency at least twice in the past 12 months.​ 75.5 The assessment and determination of drug dependency, if any, must be made by an​ 75.6 assessor qualified under Minnesota Rules, part 9530.6615, subpart 2 section 245G.11,​ 75.7 subdivisions 1 and 5, to perform an assessment of chemical use. The county shall only​ 75.8 provide emergency general assistance or vendor payments to an otherwise eligible applicant​ 75.9 or recipient who is determined to be drug dependent, except up to 15 percent of the grant​ 75.10 amount the person would otherwise receive may be paid in cash. Notwithstanding subdivision​ 75.11 1, the commissioner of human services shall also require county agencies to provide​ 75.12 assistance only in the form of vendor payments to all eligible recipients who assert substance​ 75.13 use disorder as a basis for eligibility under section 256D.05, subdivision 1, paragraph (a),​ 75.14 clauses (1) and (5).​ 75.15 The determination of drug dependency shall be reviewed at least every 12 months. If​ 75.16 the county determines a recipient is no longer drug dependent, the county may cease vendor​ 75.17 payments and provide the recipient payments in cash.​ 75.18 Sec. 38. Minnesota Statutes 2022, section 256L.03, subdivision 2, is amended to read:​ 75.19 Subd. 2. Substance use disorder. Beginning July 1, 1993, covered health services shall​ 75.20 include individual outpatient treatment of substance use disorder by a qualified health​ 75.21 professional or outpatient program.​ 75.22 Persons who may need substance use disorder services under the provisions of this​ 75.23 chapter shall be assessed by a local agency as defined under section 254B.01 must be​ 75.24 assessed by a qualified professional as defined in section 245G.11, subdivisions 1 and 5,​ 75.25 and under the assessment provisions of section 254A.03, subdivision 3. A local agency or​ 75.26 managed care plan under contract with the Department of Human Services must place offer​ 75.27 services to a person in need of substance use disorder services as provided in Minnesota​ 75.28 Rules, parts 9530.6600 to 9530.6655 based on the recommendations of section 245G.05.​ 75.29 Persons who are recipients of medical benefits under the provisions of this chapter and who​ 75.30 are financially eligible for behavioral health fund services provided under the provisions of​ 75.31 chapter 254B shall receive substance use disorder treatment services under the provisions​ 75.32 of chapter 254B only if:​ 75​ Article 2 Sec. 38.​ 23-00276 as introduced​ 01/26/23 REVISOR EB/HL​ 76.1 (1) they have exhausted the substance use disorder benefits offered under this chapter;​ 76.2 or​ 76.3 (2) an assessment indicates that they need a level of care not provided under the provisions​ 76.4 of this chapter.​ 76.5 Recipients of covered health services under the children's health plan, as provided in​ 76.6 Minnesota Statutes 1990, section 256.936, and as amended by Laws 1991, chapter 292,​ 76.7 article 4, section 17, and recipients of covered health services enrolled in the children's​ 76.8 health plan or the MinnesotaCare program after October 1, 1992, pursuant to Laws 1992,​ 76.9 chapter 549, article 4, sections 5 and 17, are eligible to receive substance use disorder​ 76.10 benefits under this subdivision.​ 76.11 Sec. 39. Minnesota Statutes 2022, section 256L.12, subdivision 8, is amended to read:​ 76.12 Subd. 8. Substance use disorder assessments. The managed care plan shall be​ 76.13 responsible for assessing the need and placement for provision of substance use disorder​ 76.14 services according to criteria set forth in Minnesota Rules, parts 9530.6600 to 9530.6655​ 76.15 section 245G.05.​ 76.16 Sec. 40. Minnesota Statutes 2022, section 260B.157, subdivision 1, is amended to read:​ 76.17 Subdivision 1. Investigation. Upon request of the court the local social services agency​ 76.18 or probation officer shall investigate the personal and family history and environment of​ 76.19 any minor coming within the jurisdiction of the court under section 260B.101 and shall​ 76.20 report its findings to the court. The court may order any minor coming within its jurisdiction​ 76.21 to be examined by a duly qualified physician, psychiatrist, or psychologist appointed by the​ 76.22 court.​ 76.23 The court shall order a chemical use assessment conducted when a child is (1) found to​ 76.24 be delinquent for violating a provision of chapter 152, or for committing a felony-level​ 76.25 violation of a provision of chapter 609 if the probation officer determines that alcohol or​ 76.26 drug use was a contributing factor in the commission of the offense, or (2) alleged to be​ 76.27 delinquent for violating a provision of chapter 152, if the child is being held in custody​ 76.28 under a detention order. The assessor's qualifications must comply with section 245G.11,​ 76.29 subdivisions 1 and 5, and the assessment criteria shall must comply with Minnesota Rules,​ 76.30 parts 9530.6600 to 9530.6655 section 245G.05. If funds under chapter 254B are to be used​ 76.31 to pay for the recommended treatment, the assessment and placement must comply with all​ 76.32 provisions of Minnesota Rules, parts 9530.6600 to 9530.6655 and 9530.7000 to 9530.7030​ 76​ Article 2 Sec. 40.​ 23-00276 as introduced​ 01/26/23 REVISOR EB/HL​ 77.1 sections 245G.05 and 254B.04. The commissioner of human services shall reimburse the​ 77.2 court for the cost of the chemical use assessment, up to a maximum of $100.​ 77.3 The court shall order a children's mental health screening conducted when a child is​ 77.4 found to be delinquent. The screening shall be conducted with a screening instrument​ 77.5 approved by the commissioner of human services and shall be conducted by a mental health​ 77.6 practitioner as defined in section 245.4871, subdivision 26, or a probation officer who is​ 77.7 trained in the use of the screening instrument. If the screening indicates a need for assessment,​ 77.8 the local social services agency, in consultation with the child's family, shall have a diagnostic​ 77.9 assessment conducted, including a functional assessment, as defined in section 245.4871.​ 77.10 With the consent of the commissioner of corrections and agreement of the county to pay​ 77.11 the costs thereof, the court may, by order, place a minor coming within its jurisdiction in​ 77.12 an institution maintained by the commissioner for the detention, diagnosis, custody and​ 77.13 treatment of persons adjudicated to be delinquent, in order that the condition of the minor​ 77.14 be given due consideration in the disposition of the case. Any funds received under the​ 77.15 provisions of this subdivision shall not cancel until the end of the fiscal year immediately​ 77.16 following the fiscal year in which the funds were received. The funds are available for use​ 77.17 by the commissioner of corrections during that period and are hereby appropriated annually​ 77.18 to the commissioner of corrections as reimbursement of the costs of providing these services​ 77.19 to the juvenile courts.​ 77.20 Sec. 41. Minnesota Statutes 2022, section 260B.157, subdivision 3, is amended to read:​ 77.21 Subd. 3. Juvenile treatment screening team. (a) The local social services agency shall​ 77.22 establish a juvenile treatment screening team to conduct screenings and prepare case plans​ 77.23 under this subdivision. The team, which may be the team constituted under section 245.4885​ 77.24 or 256B.092 or Minnesota Rules, parts 9530.6600 to 9530.6655 chapter 254B, shall consist​ 77.25 of social workers, juvenile justice professionals, and persons with expertise in the treatment​ 77.26 of juveniles who are emotionally disabled, chemically dependent, or have a developmental​ 77.27 disability. The team shall involve parents or guardians in the screening process as appropriate.​ 77.28 The team may be the same team as defined in section 260C.157, subdivision 3.​ 77.29 (b) If the court, prior to, or as part of, a final disposition, proposes to place a child:​ 77.30 (1) for the primary purpose of treatment for an emotional disturbance, and residential​ 77.31 placement is consistent with section 260.012, a developmental disability, or chemical​ 77.32 dependency in a residential treatment facility out of state or in one which is within the state​ 77.33 and licensed by the commissioner of human services under chapter 245A; or​ 77​ Article 2 Sec. 41.​ 23-00276 as introduced​ 01/26/23 REVISOR EB/HL​ 78.1 (2) in any out-of-home setting potentially exceeding 30 days in duration, including a​ 78.2 post-dispositional placement in a facility licensed by the commissioner of corrections or​ 78.3 human services, the court shall notify the county welfare agency. The county's juvenile​ 78.4 treatment screening team must either:​ 78.5 (i) screen and evaluate the child and file its recommendations with the court within 14​ 78.6 days of receipt of the notice; or​ 78.7 (ii) elect not to screen a given case, and notify the court of that decision within three​ 78.8 working days.​ 78.9 (c) If the screening team has elected to screen and evaluate the child, the child may not​ 78.10 be placed for the primary purpose of treatment for an emotional disturbance, a developmental​ 78.11 disability, or chemical dependency, in a residential treatment facility out of state nor in a​ 78.12 residential treatment facility within the state that is licensed under chapter 245A, unless one​ 78.13 of the following conditions applies:​ 78.14 (1) a treatment professional certifies that an emergency requires the placement of the​ 78.15 child in a facility within the state;​ 78.16 (2) the screening team has evaluated the child and recommended that a residential​ 78.17 placement is necessary to meet the child's treatment needs and the safety needs of the​ 78.18 community, that it is a cost-effective means of meeting the treatment needs, and that it will​ 78.19 be of therapeutic value to the child; or​ 78.20 (3) the court, having reviewed a screening team recommendation against placement,​ 78.21 determines to the contrary that a residential placement is necessary. The court shall state​ 78.22 the reasons for its determination in writing, on the record, and shall respond specifically to​ 78.23 the findings and recommendation of the screening team in explaining why the​ 78.24 recommendation was rejected. The attorney representing the child and the prosecuting​ 78.25 attorney shall be afforded an opportunity to be heard on the matter.​ 78.26 Sec. 42. Minnesota Statutes 2022, section 260C.157, subdivision 3, is amended to read:​ 78.27 Subd. 3. Juvenile treatment screening team. (a) The responsible social services agency​ 78.28 shall establish a juvenile treatment screening team to conduct screenings under this chapter​ 78.29 and chapter 260D, for a child to receive treatment for an emotional disturbance, a​ 78.30 developmental disability, or related condition in a residential treatment facility licensed by​ 78.31 the commissioner of human services under chapter 245A, or licensed or approved by a tribe.​ 78.32 A screening team is not required for a child to be in: (1) a residential facility specializing​ 78.33 in prenatal, postpartum, or parenting support; (2) a facility specializing in high-quality​ 78​ Article 2 Sec. 42.​ 23-00276 as introduced​ 01/26/23 REVISOR EB/HL​ 79.1 residential care and supportive services to children and youth who have been or are at risk​ 79.2 of becoming victims of sex trafficking or commercial sexual exploitation; (3) supervised​ 79.3 settings for youth who are 18 years of age or older and living independently; or (4) a licensed​ 79.4 residential family-based treatment facility for substance abuse consistent with section​ 79.5 260C.190. Screenings are also not required when a child must be placed in a facility due to​ 79.6 an emotional crisis or other mental health emergency.​ 79.7 (b) The responsible social services agency shall conduct screenings within 15 days of a​ 79.8 request for a screening, unless the screening is for the purpose of residential treatment and​ 79.9 the child is enrolled in a prepaid health program under section 256B.69, in which case the​ 79.10 agency shall conduct the screening within ten working days of a request. The responsible​ 79.11 social services agency shall convene the juvenile treatment screening team, which may be​ 79.12 constituted under section 245.4885, 254B.05, or 256B.092 or Minnesota Rules, parts​ 79.13 9530.6600 to 9530.6655. The team shall consist of social workers; persons with expertise​ 79.14 in the treatment of juveniles who are emotionally disturbed, chemically dependent, or have​ 79.15 a developmental disability; and the child's parent, guardian, or permanent legal custodian.​ 79.16 The team may include the child's relatives as defined in section 260C.007, subdivisions 26b​ 79.17 and 27, the child's foster care provider, and professionals who are a resource to the child's​ 79.18 family such as teachers, medical or mental health providers, and clergy, as appropriate,​ 79.19 consistent with the family and permanency team as defined in section 260C.007, subdivision​ 79.20 16a. Prior to forming the team, the responsible social services agency must consult with the​ 79.21 child's parents, the child if the child is age 14 or older, and, if applicable, the child's tribe​ 79.22 to obtain recommendations regarding which individuals to include on the team and to ensure​ 79.23 that the team is family-centered and will act in the child's best interests. If the child, child's​ 79.24 parents, or legal guardians raise concerns about specific relatives or professionals, the team​ 79.25 should not include those individuals. This provision does not apply to paragraph (c).​ 79.26 (c) If the agency provides notice to tribes under section 260.761, and the child screened​ 79.27 is an Indian child, the responsible social services agency must make a rigorous and concerted​ 79.28 effort to include a designated representative of the Indian child's tribe on the juvenile​ 79.29 treatment screening team, unless the child's tribal authority declines to appoint a​ 79.30 representative. The Indian child's tribe may delegate its authority to represent the child to​ 79.31 any other federally recognized Indian tribe, as defined in section 260.755, subdivision 12.​ 79.32 The provisions of the Indian Child Welfare Act of 1978, United States Code, title 25, sections​ 79.33 1901 to 1963, and the Minnesota Indian Family Preservation Act, sections 260.751 to​ 79.34 260.835, apply to this section.​ 79​ Article 2 Sec. 42.​ 23-00276 as introduced​ 01/26/23 REVISOR EB/HL​ 80.1 (d) If the court, prior to, or as part of, a final disposition or other court order, proposes​ 80.2 to place a child with an emotional disturbance or developmental disability or related condition​ 80.3 in residential treatment, the responsible social services agency must conduct a screening.​ 80.4 If the team recommends treating the child in a qualified residential treatment program, the​ 80.5 agency must follow the requirements of sections 260C.70 to 260C.714.​ 80.6 The court shall ascertain whether the child is an Indian child and shall notify the​ 80.7 responsible social services agency and, if the child is an Indian child, shall notify the Indian​ 80.8 child's tribe as paragraph (c) requires.​ 80.9 (e) When the responsible social services agency is responsible for placing and caring​ 80.10 for the child and the screening team recommends placing a child in a qualified residential​ 80.11 treatment program as defined in section 260C.007, subdivision 26d, the agency must: (1)​ 80.12 begin the assessment and processes required in section 260C.704 without delay; and (2)​ 80.13 conduct a relative search according to section 260C.221 to assemble the child's family and​ 80.14 permanency team under section 260C.706. Prior to notifying relatives regarding the family​ 80.15 and permanency team, the responsible social services agency must consult with the child's​ 80.16 parent or legal guardian, the child if the child is age 14 or older, and, if applicable, the child's​ 80.17 tribe to ensure that the agency is providing notice to individuals who will act in the child's​ 80.18 best interests. The child and the child's parents may identify a culturally competent qualified​ 80.19 individual to complete the child's assessment. The agency shall make efforts to refer the​ 80.20 assessment to the identified qualified individual. The assessment may not be delayed for​ 80.21 the purpose of having the assessment completed by a specific qualified individual.​ 80.22 (f) When a screening team determines that a child does not need treatment in a qualified​ 80.23 residential treatment program, the screening team must:​ 80.24 (1) document the services and supports that will prevent the child's foster care placement​ 80.25 and will support the child remaining at home;​ 80.26 (2) document the services and supports that the agency will arrange to place the child​ 80.27 in a family foster home; or​ 80.28 (3) document the services and supports that the agency has provided in any other setting.​ 80.29 (g) When the Indian child's tribe or tribal health care services provider or Indian Health​ 80.30 Services provider proposes to place a child for the primary purpose of treatment for an​ 80.31 emotional disturbance, a developmental disability, or co-occurring emotional disturbance​ 80.32 and chemical dependency, the Indian child's tribe or the tribe delegated by the child's tribe​ 80.33 shall submit necessary documentation to the county juvenile treatment screening team,​ 80.34 which must invite the Indian child's tribe to designate a representative to the screening team.​ 80​ Article 2 Sec. 42.​ 23-00276 as introduced​ 01/26/23 REVISOR EB/HL​ 81.1 (h) The responsible social services agency must conduct and document the screening in​ 81.2 a format approved by the commissioner of human services.​ 81.3 Sec. 43. Minnesota Statutes 2022, section 260E.20, subdivision 1, is amended to read:​ 81.4 Subdivision 1. General duties. (a) The local welfare agency shall offer services to​ 81.5 prevent future maltreatment, safeguarding and enhancing the welfare of the maltreated child,​ 81.6 and supporting and preserving family life whenever possible.​ 81.7 (b) If the report alleges a violation of a criminal statute involving maltreatment or child​ 81.8 endangerment under section 609.378, the local law enforcement agency and local welfare​ 81.9 agency shall coordinate the planning and execution of their respective investigation and​ 81.10 assessment efforts to avoid a duplication of fact-finding efforts and multiple interviews.​ 81.11 Each agency shall prepare a separate report of the results of the agency's investigation or​ 81.12 assessment.​ 81.13 (c) In cases of alleged child maltreatment resulting in death, the local agency may rely​ 81.14 on the fact-finding efforts of a law enforcement investigation to make a determination of​ 81.15 whether or not maltreatment occurred.​ 81.16 (d) When necessary, the local welfare agency shall seek authority to remove the child​ 81.17 from the custody of a parent, guardian, or adult with whom the child is living.​ 81.18 (e) In performing any of these duties, the local welfare agency shall maintain an​ 81.19 appropriate record.​ 81.20 (f) In conducting a family assessment or investigation, the local welfare agency shall​ 81.21 gather information on the existence of substance abuse and domestic violence.​ 81.22 (g) If the family assessment or investigation indicates there is a potential for abuse of​ 81.23 alcohol or other drugs by the parent, guardian, or person responsible for the child's care,​ 81.24 the local welfare agency shall conduct must coordinate a chemical use comprehensive​ 81.25 assessment pursuant to Minnesota Rules, part 9530.6615 section 245G.05.​ 81.26 (h) The agency may use either a family assessment or investigation to determine whether​ 81.27 the child is safe when responding to a report resulting from birth match data under section​ 81.28 260E.03, subdivision 23, paragraph (c). If the child subject of birth match data is determined​ 81.29 to be safe, the agency shall consult with the county attorney to determine the appropriateness​ 81.30 of filing a petition alleging the child is in need of protection or services under section​ 81.31 260C.007, subdivision 6, clause (16), in order to deliver needed services. If the child is​ 81.32 determined not to be safe, the agency and the county attorney shall take appropriate action​ 81.33 as required under section 260C.503, subdivision 2.​ 81​ Article 2 Sec. 43.​ 23-00276 as introduced​ 01/26/23 REVISOR EB/HL​ 82.1 Sec. 44. Minnesota Statutes 2022, section 299A.299, subdivision 1, is amended to read:​ 82.2 Subdivision 1. Establishment of team. A county, a multicounty organization of counties​ 82.3 formed by an agreement under section 471.59, or a city with a population of no more than​ 82.4 50,000, may establish a multidisciplinary chemical abuse prevention team. The chemical​ 82.5 abuse prevention team may include, but not be limited to, representatives of health, mental​ 82.6 health, public health, law enforcement, educational, social service, court service, community​ 82.7 education, religious, and other appropriate agencies, and parent and youth groups. For​ 82.8 purposes of this section, "chemical abuse" has the meaning given in Minnesota Rules, part​ 82.9 9530.6605, subpart 6 section 254A.02, subdivision 6a. When possible the team must​ 82.10 coordinate its activities with existing local groups, organizations, and teams dealing with​ 82.11 the same issues the team is addressing.​ 82.12 Sec. 45. REVISOR INSTRUCTION.​ 82.13 The revisor of statutes shall renumber the subdivisions in Minnesota Statutes, section​ 82.14 254B.01, in alphabetical order and correct any cross-reference changes that result.​ 82.15 Sec. 46. REPEALER.​ 82.16 Minnesota Statutes 2022, sections 169A.70, subdivision 6; 245G.22, subdivision 19;​ 82.17 254A.02, subdivision 8a; 254A.16, subdivision 6; 254A.19, subdivisions 1a, 2, and 5;​ 82.18 254B.04, subdivisions 2b and 2c; and 254B.041, subdivision 2, are repealed.​ 82.19 ARTICLE 3​ 82.20 HOUSING AND ECONOMIC ASSISTANCE​ 82.21 Section 1. Minnesota Statutes 2022, section 256D.02, is amended by adding a subdivision​ 82.22 to read:​ 82.23 Subd. 20. Date of application. "Date of application" has the meaning given in section​ 82.24 256P.01, subdivision 2b.​ 82.25 Sec. 2. Minnesota Statutes 2022, section 256D.07, is amended to read:​ 82.26 256D.07 TIME OF PAYMENT OF ASSISTANCE.​ 82.27 An applicant for general assistance shall be deemed eligible if the application and the​ 82.28 verification of the statement on that application demonstrate that the applicant is within the​ 82.29 eligibility criteria established by sections 256D.01 to 256D.21 and any applicable rules of​ 82.30 the commissioner. Any person requesting general assistance shall be permitted by the county​ 82​ Article 3 Sec. 2.​ 23-00276 as introduced​ 01/26/23 REVISOR EB/HL​ 83.1 agency to make an application for assistance as soon as administratively possible and in no​ 83.2 event later than the fourth day following the date on which assistance is first requested, and​ 83.3 no county agency shall require that a person requesting assistance appear at the offices of​ 83.4 the county agency more than once prior to the date on which the person is permitted to make​ 83.5 the application. The application shall be in writing in the manner and upon the form​ 83.6 prescribed by the commissioner and attested to by the oath of the applicant or in lieu thereof​ 83.7 shall contain the following declaration which shall be signed by the applicant: "I declare​ 83.8 that this application has been examined by me and to the best of my knowledge and belief​ 83.9 is a true and correct statement of every material point." Applications must be submitted​ 83.10 according to section 256P.04, subdivision 1a. On the date that general assistance is first​ 83.11 requested, the county agency shall inquire and determine whether the person requesting​ 83.12 assistance is in immediate need of food, shelter, clothing, assistance for necessary​ 83.13 transportation, or other emergency assistance pursuant to section 256D.06, subdivision 2.​ 83.14 A person in need of emergency assistance shall be granted emergency assistance immediately,​ 83.15 and necessary emergency assistance shall continue for up to 30 days following the date of​ 83.16 application. A determination of an applicant's eligibility for general assistance shall be made​ 83.17 by the county agency as soon as the required verifications are received by the county agency​ 83.18 and in no event later than 30 days following the date that the application is made. Any​ 83.19 verifications required of the applicant shall be reasonable, and the commissioner shall by​ 83.20 rule establish reasonable verifications. General assistance shall be granted to an eligible​ 83.21 applicant without the necessity of first securing action by the board of the county agency.​ 83.22 The first month's grant must be computed to cover the time period starting with the date a​ 83.23 signed application form is received by the county agency of application, as defined by​ 83.24 section 256P.01, subdivision 2b, or from the date that the applicant meets all eligibility​ 83.25 factors, whichever occurs later.​ 83.26 If upon verification and due investigation it appears that the applicant provided false​ 83.27 information and the false information materially affected the applicant's eligibility for general​ 83.28 assistance or the amount of the applicant's general assistance grant, the county agency may​ 83.29 refer the matter to the county attorney. The county attorney may commence a criminal​ 83.30 prosecution or a civil action for the recovery of any general assistance wrongfully received,​ 83.31 or both.​ 83.32 Sec. 3. Minnesota Statutes 2022, section 256I.03, subdivision 15, is amended to read:​ 83.33 Subd. 15. Supportive housing. "Supportive housing" means housing that is not​ 83.34 time-limited and, provides or coordinates services necessary for a resident to maintain​ 83.35 housing stability, and is not assisted living licensed under chapter 144G.​ 83​ Article 3 Sec. 3.​ 23-00276 as introduced​ 01/26/23 REVISOR EB/HL​ 84.1 Sec. 4. Minnesota Statutes 2022, section 256I.03, is amended by adding a subdivision to​ 84.2 read:​ 84.3 Subd. 16. Date of application. "Date of application" has the meaning given in section​ 84.4 256P.01, subdivision 2b.​ 84.5 Sec. 5. Minnesota Statutes 2022, section 256I.04, subdivision 2, is amended to read:​ 84.6 Subd. 2. Date of eligibility. An individual who has met the eligibility requirements of​ 84.7 subdivision 1, shall have a housing support payment made on the individual's behalf from​ 84.8 the first day of the month in which a signed of the date of application form is received by​ 84.9 a county agency, as defined by section 256P.01, subdivision 2b, or the first day of the month​ 84.10 in which all eligibility factors have been met, whichever is later.​ 84.11 Sec. 6. Minnesota Statutes 2022, section 256I.06, subdivision 3, is amended to read:​ 84.12 Subd. 3. Filing of application. The county agency must immediately provide an​ 84.13 application form to any person requesting housing support. Application for housing support​ 84.14 must be in writing on a form prescribed by the commissioner. Applications must be submitted​ 84.15 according to section 256P.04, subdivision 1a. The county agency must determine an​ 84.16 applicant's eligibility for housing support as soon as the required verifications are received​ 84.17 by the county agency and within 30 days after a signed application is received by the county​ 84.18 agency for the aged or blind or within 60 days for people with a disability.​ 84.19 Sec. 7. Minnesota Statutes 2022, section 256I.09, is amended to read:​ 84.20 256I.09 COMMUNITY LIVING INFRASTRUCTURE.​ 84.21 The commissioner shall award grants to agencies and multi-Tribal collaboratives through​ 84.22 an annual competitive process. Grants awarded under this section may be used for: (1)​ 84.23 outreach to locate and engage people who are homeless or residing in segregated settings​ 84.24 to screen for basic needs and assist with referral to community living resources; (2) building​ 84.25 capacity to provide technical assistance and consultation on housing and related support​ 84.26 service resources for persons with both disabilities and low income; or (3) streamlining the​ 84.27 administration and monitoring activities related to housing support funds. Agencies may​ 84.28 collaborate and submit a joint application for funding under this section.​ 84.29 Sec. 8. Minnesota Statutes 2022, section 256J.08, subdivision 21, is amended to read:​ 84.30 Subd. 21. Date of application. "Date of application" means the date on which the county​ 84.31 agency receives an applicant's application as a signed written application, an application​ 84​ Article 3 Sec. 8.​ 23-00276 as introduced​ 01/26/23 REVISOR EB/HL​ 85.1 submitted by telephone, or an application submitted through Internet telepresence has the​ 85.2 meaning given in section 256P.01, subdivision 2b.​ 85.3 Sec. 9. Minnesota Statutes 2022, section 256J.09, subdivision 3, is amended to read:​ 85.4 Subd. 3. Submitting application form. (a) A county agency must offer, in person or​ 85.5 by mail, the application forms prescribed by the commissioner as soon as a person makes​ 85.6 a written or oral inquiry. At that time, the county agency must:​ 85.7 (1) inform the person that assistance begins on the date that the of application is received​ 85.8 by the county agency either as a signed written application; an application submitted by​ 85.9 telephone; or an application submitted through Internet telepresence;, as defined in section​ 85.10 256P.01, subdivision 2b, or on the date that all eligibility criteria are met, whichever is later;​ 85.11 (2) inform a person that the person may submit the application by telephone or through​ 85.12 Internet telepresence;​ 85.13 (3) inform a person that when the person submits the application by telephone or through​ 85.14 Internet telepresence, the county agency must receive a signed written application within​ 85.15 30 days of the date that the person submitted the application by telephone or through Internet​ 85.16 telepresence of the application submission requirements in section 256P.04, subdivision​ 85.17 1a;​ 85.18 (4) inform the person that any delay in submitting the application will reduce the amount​ 85.19 of assistance paid for the month of application;​ 85.20 (5) inform a person that the person may submit the application before an interview;​ 85.21 (6) explain the information that will be verified during the application process by the​ 85.22 county agency as provided in section 256J.32;​ 85.23 (7) inform a person about the county agency's average application processing time and​ 85.24 explain how the application will be processed under subdivision 5;​ 85.25 (8) explain how to contact the county agency if a person's application information changes​ 85.26 and how to withdraw the application;​ 85.27 (9) inform a person that the next step in the application process is an interview and what​ 85.28 a person must do if the application is approved including, but not limited to, attending​ 85.29 orientation under section 256J.45 and complying with employment and training services​ 85.30 requirements in sections 256J.515 to 256J.57;​ 85​ Article 3 Sec. 9.​ 23-00276 as introduced​ 01/26/23 REVISOR EB/HL​ 86.1 (10) inform the person that an interview must be conducted. The interview may be​ 86.2 conducted face-to-face in the county office or at a location mutually agreed upon, through​ 86.3 Internet telepresence, or by telephone;​ 86.4 (11) explain the child care and transportation services that are available under paragraph​ 86.5 (c) to enable caregivers to attend the interview, screening, and orientation; and​ 86.6 (12) identify any language barriers and arrange for translation assistance during​ 86.7 appointments, including, but not limited to, screening under subdivision 3a, orientation​ 86.8 under section 256J.45, and assessment under section 256J.521.​ 86.9 (b) Upon receipt of a signed application, the county agency must stamp the date of receipt​ 86.10 on the face of the application. The county agency must process the application within the​ 86.11 time period required under subdivision 5. An applicant may withdraw the application at​ 86.12 any time by giving written or oral notice to the county agency. The county agency must​ 86.13 issue a written notice confirming the withdrawal. The notice must inform the applicant of​ 86.14 the county agency's understanding that the applicant has withdrawn the application and no​ 86.15 longer wants to pursue it. When, within ten days of the date of the agency's notice, an​ 86.16 applicant informs a county agency, in writing, that the applicant does not wish to withdraw​ 86.17 the application, the county agency must reinstate the application and finish processing the​ 86.18 application.​ 86.19 (c) Upon a participant's request, the county agency must arrange for transportation and​ 86.20 child care or reimburse the participant for transportation and child care expenses necessary​ 86.21 to enable participants to attend the screening under subdivision 3a and orientation under​ 86.22 section 256J.45.​ 86.23 Sec. 10. Minnesota Statutes 2022, section 256J.95, subdivision 5, is amended to read:​ 86.24 Subd. 5. Submitting application form. The eligibility date for the diversionary work​ 86.25 program begins on the date that the combined of application form (CAF) is received by the​ 86.26 county agency either as a signed written application; an application submitted by telephone;​ 86.27 or an application submitted through Internet telepresence;, as defined in section 256P.01,​ 86.28 subdivision 2b, or on the date that diversionary work program eligibility criteria are met,​ 86.29 whichever is later. The county agency must inform an applicant that when the applicant​ 86.30 submits the application by telephone or through Internet telepresence, the county agency​ 86.31 must receive a signed written application within 30 days of the date that the applicant​ 86.32 submitted the application by telephone or through Internet telepresence of the application​ 86.33 submission requirements in section 256P.04, subdivision 1a. The county agency must inform​ 86.34 the applicant that any delay in submitting the application will reduce the benefits paid for​ 86​ Article 3 Sec. 10.​ 23-00276 as introduced​ 01/26/23 REVISOR EB/HL​ 87.1 the month of application. The county agency must inform a person that an application may​ 87.2 be submitted before the person has an interview appointment. Upon receipt of a signed​ 87.3 application, the county agency must stamp the date of receipt on the face of the application.​ 87.4 The applicant may withdraw the application at any time prior to approval by giving written​ 87.5 or oral notice to the county agency. The county agency must follow the notice requirements​ 87.6 in section 256J.09, subdivision 3, when issuing a notice confirming the withdrawal.​ 87.7 Sec. 11. Minnesota Statutes 2022, section 256P.01, is amended by adding a subdivision​ 87.8 to read:​ 87.9 Subd. 2b. Date of application. "Date of application" means the date on which the agency​ 87.10 receives an applicant's application as a signed written application, an application submitted​ 87.11 by telephone, or an application submitted through Internet telepresence. The child care​ 87.12 assistance program under chapter 119B is exempt from this definition.​ 87.13 Sec. 12. Minnesota Statutes 2022, section 256P.04, is amended by adding a subdivision​ 87.14 to read:​ 87.15 Subd. 1a. Application submission. An agency must offer, in person or by mail, the​ 87.16 application forms prescribed by the commissioner as soon as a person makes a written or​ 87.17 oral inquiry about assistance. Applications must be received by the agency as a signed​ 87.18 written application, an application submitted by telephone, or an application submitted​ 87.19 through Internet telepresence. When a person submits an application by telephone or through​ 87.20 Internet telepresence, the agency must receive a signed written application within 30 days​ 87.21 of the date that the person submitted the application by telephone or through Internet​ 87.22 telepresence.​ 87.23 Sec. 13. REVISOR INSTRUCTION.​ 87.24 The revisor of statutes shall renumber the subdivisions in Minnesota Statutes, sections​ 87.25 256D.02 and 256I.03, in alphabetical order, excluding the first subdivision in each section,​ 87.26 and correct any cross-reference changes that result.​ 87.27 ARTICLE 4​ 87.28 CHILDREN AND FAMILY SERVICES​ 87.29 Section 1. Minnesota Statutes 2022, section 256N.24, subdivision 12, is amended to read:​ 87.30 Subd. 12. Approval of initial assessments, special assessments, and reassessments. (a)​ 87.31 Any agency completing initial assessments, special assessments, or reassessments must​ 87​ Article 4 Section 1.​ 23-00276 as introduced​ 01/26/23 REVISOR EB/HL​ 88.1 designate one or more supervisors or other staff to examine and approve assessments​ 88.2 completed by others in the agency under subdivision 2. The person approving an assessment​ 88.3 must not be the case manager or staff member completing that assessment.​ 88.4 (b) In cases where a special assessment or reassessment for Northstar kinship assistance​ 88.5 and adoption assistance is required under subdivision 8 or 11, the commissioner shall review​ 88.6 and approve the assessment as part of the eligibility determination process outlined in section​ 88.7 256N.22, subdivision 7, for Northstar kinship assistance, or section 256N.23, subdivision​ 88.8 7, for adoption assistance. The assessment determines the maximum of the negotiated​ 88.9 agreement amount under section 256N.25.​ 88.10 (c) The effective date of the new rate is effective the calendar month that the assessment​ 88.11 is approved, or the effective date of the agreement, whichever is later. determined as follows:​ 88.12 (1) for initial assessments of children in foster care, the new rate is effective based on​ 88.13 the emergency foster care rate for initial placement pursuant to section 256N.26, subdivision​ 88.14 6;​ 88.15 (2) for special assessments, the new rate is effective the date of the finalized adoption​ 88.16 decree or the date of the court order that transfers permanent legal and physical custody to​ 88.17 a relative;​ 88.18 (3) for postpermanency reassessments, the new rate is effective the date that the​ 88.19 commissioner signs the amendment to the Northstar Adoption Assistance or Northstar​ 88.20 Kinship Assistance benefit agreement.​ 88.21 Sec. 2. Minnesota Statutes 2022, section 260C.221, subdivision 1, is amended to read:​ 88.22 Subdivision 1. Relative search requirements. (a) The responsible social services agency​ 88.23 shall exercise due diligence to identify and notify adult relatives, as defined in section​ 88.24 260C.007, subdivision 27, and current caregivers of a child's sibling, prior to placement or​ 88.25 within 30 days after the child's removal from the parent, regardless of whether a child is​ 88.26 placed in a relative's home, as required under subdivision 2. The relative search required​ 88.27 by this section shall be comprehensive in scope.​ 88.28 (b) The relative search required by this section shall include both maternal and paternal​ 88.29 adult relatives of the child; all adult grandparents; all legal parents, guardians, or custodians​ 88.30 of the child's siblings; and any other adult relatives suggested by the child's parents, subject​ 88.31 to the exceptions due to family violence in subdivision 5, paragraph (b). The search shall​ 88.32 also include getting information from the child in an age-appropriate manner about who the​ 88.33 child considers to be family members and important friends with whom the child has resided​ 88​ Article 4 Sec. 2.​ 23-00276 as introduced​ 01/26/23 REVISOR EB/HL​ 89.1 or had significant contact. The relative search required under this section must fulfill the​ 89.2 agency's duties under the Indian Child Welfare Act regarding active efforts to prevent the​ 89.3 breakup of the Indian family under United States Code, title 25, section 1912(d), and to​ 89.4 meet placement preferences under United States Code, title 25, section 1915.​ 89.5 (c) The responsible social services agency has a continuing responsibility to search for​ 89.6 and identify relatives of a child and send the notice to relatives that is required under​ 89.7 subdivision 2, unless the court has relieved the agency of this duty under subdivision 5,​ 89.8 paragraph (e).​ 89.9 Sec. 3. Minnesota Statutes 2022, section 260C.317, subdivision 3, is amended to read:​ 89.10 Subd. 3. Order; retention of jurisdiction. (a) A certified copy of the findings and the​ 89.11 order terminating parental rights, and a summary of the court's information concerning the​ 89.12 child shall be furnished by the court to the commissioner or the agency to which guardianship​ 89.13 is transferred.​ 89.14 (b) The orders shall be on a document separate from the findings. The court shall furnish​ 89.15 the guardian a copy of the order terminating parental rights.​ 89.16 (c) When the court orders guardianship pursuant to this section, the guardian ad litem​ 89.17 and counsel for the child shall continue on the case until an adoption decree is entered. An​ 89.18 in-court appearance hearing must be held every 90 days following termination of parental​ 89.19 rights for the court to review progress toward an adoptive placement and the specific​ 89.20 recruitment efforts the agency has taken to find an adoptive family for the child and to​ 89.21 finalize the adoption or other permanency plan. Review of the progress toward adoption of​ 89.22 a child under guardianship of the commissioner of human services shall be conducted​ 89.23 according to section 260C.607.​ 89.24 (d) Upon terminating parental rights or upon a parent's consent to adoption under​ 89.25 Minnesota Statutes 2010, section 260C.201, subdivision 11, or section 260C.515, subdivision​ 89.26 5 3, resulting in an order for guardianship to the commissioner of human services, the court​ 89.27 shall retain jurisdiction:​ 89.28 (1) until the child is adopted;​ 89.29 (2) through the child's minority; or​ 89.30 (3) as long as the child continues in or reenters foster care, until the individual becomes​ 89.31 21 years of age according to sections 260C.193, subdivision 6, and 260C.451.​ 89​ Article 4 Sec. 3.​ 23-00276 as introduced​ 01/26/23 REVISOR EB/HL​ 90.1 Sec. 4. Minnesota Statutes 2022, section 518A.43, subdivision 1b, is amended to read:​ 90.2 Subd. 1b. Increase in income of custodial parent. In a modification of support under​ 90.3 section 518A.39, the court may deviate from the presumptive child support obligation under​ 90.4 section 518A.34 when the only change in circumstances is an increase to the custodial​ 90.5 parent's income and:,​ 90.6 (1) the basic support increases;, and:​ 90.7 (2) (1) the parties' combined gross income is $6,000 or less; or​ 90.8 (3) (2) the obligor's income is $2,000 or less.​ 90.9 EFFECTIVE DATE. This section is effective the day following final enactment.​ 90.10 Sec. 5. REPEALER.​ 90.11 Subdivision 1. Minnesota Statutes 2022, section 518A.59, is repealed.​ 90.12 Subd. 2. Minnesota Statutes 2022, section 256D.63, subdivision 1, is repealed.​ 90.13 EFFECTIVE DATE. The repeal of the section in subdivision 1 is effective the day​ 90.14 following final enactment.​ 90.15 ARTICLE 5​ 90.16 HEALTH CARE​ 90.17 Section 1. Minnesota Statutes 2022, section 256B.056, is amended by adding a subdivision​ 90.18 to read:​ 90.19 Subd. 5d. Medical assistance room and board rate. "Medical assistance room and​ 90.20 board rate" means an amount equal to 81 percent of the federal poverty guideline for a single​ 90.21 individual living alone in the community less the medical assistance personal needs allowance​ 90.22 under section 256B.35. The amount of the room and board rate, as defined in section 256I.03,​ 90.23 subdivision 2, that exceeds the medical assistance room and board rate is considered a​ 90.24 remedial care cost. A remedial care cost may be used to meet a spenddown obligation under​ 90.25 this section. The medical assistance room and board rate is to be adjusted on January 1 of​ 90.26 each year.​ 90.27 Sec. 2. Minnesota Statutes 2022, section 256B.0622, subdivision 8, is amended to read:​ 90.28 Subd. 8. Medical assistance payment for assertive community treatment and​ 90.29 intensive residential treatment services. (a) Payment for intensive residential treatment​ 90.30 services and assertive community treatment in this section shall be based on one daily rate​ 90​ Article 5 Sec. 2.​ 23-00276 as introduced​ 01/26/23 REVISOR EB/HL​ 91.1 per provider inclusive of the following services received by an eligible client in a given​ 91.2 calendar day: all rehabilitative services under this section, staff travel time to provide​ 91.3 rehabilitative services under this section, and nonresidential crisis stabilization services​ 91.4 under section 256B.0624.​ 91.5 (b) Except as indicated in paragraph (c), payment will not be made to more than one​ 91.6 entity for each client for services provided under this section on a given day. If services​ 91.7 under this section are provided by a team that includes staff from more than one entity, the​ 91.8 team must determine how to distribute the payment among the members.​ 91.9 (c) The commissioner shall determine one rate for each provider that will bill medical​ 91.10 assistance for residential services under this section and one rate for each assertive community​ 91.11 treatment provider. If a single entity provides both services, one rate is established for the​ 91.12 entity's residential services and another rate for the entity's nonresidential services under​ 91.13 this section. A provider is not eligible for payment under this section without authorization​ 91.14 from the commissioner. The commissioner shall develop rates using the following criteria:​ 91.15 (1) the provider's cost for services shall include direct services costs, other program​ 91.16 costs, and other costs determined as follows:​ 91.17 (i) the direct services costs must be determined using actual costs of salaries, benefits,​ 91.18 payroll taxes, and training of direct service staff and service-related transportation;​ 91.19 (ii) other program costs not included in item (i) must be determined as a specified​ 91.20 percentage of the direct services costs as determined by item (i). The percentage used shall​ 91.21 be determined by the commissioner based upon the average of percentages that represent​ 91.22 the relationship of other program costs to direct services costs among the entities that provide​ 91.23 similar services;​ 91.24 (iii) physical plant costs calculated based on the percentage of space within the program​ 91.25 that is entirely devoted to treatment and programming. This does not include administrative​ 91.26 or residential space;​ 91.27 (iv) assertive community treatment physical plant costs must be reimbursed as part of​ 91.28 the costs described in item (ii); and​ 91.29 (v) subject to federal approval, up to an additional five percent of the total rate may be​ 91.30 added to the program rate as a quality incentive based upon the entity meeting performance​ 91.31 criteria specified by the commissioner;​ 91.32 (2) actual cost is defined as costs which are allowable, allocable, and reasonable, and​ 91.33 consistent with federal reimbursement requirements under Code of Federal Regulations,​ 91​ Article 5 Sec. 2.​ 23-00276 as introduced​ 01/26/23 REVISOR EB/HL​ 92.1 title 48, chapter 1, part 31, relating to for-profit entities, and Office of Management and​ 92.2 Budget Circular Number A-122, relating to nonprofit entities;​ 92.3 (3) the number of service units;​ 92.4 (4) the degree to which clients will receive services other than services under this section;​ 92.5 and​ 92.6 (5) the costs of other services that will be separately reimbursed.​ 92.7 (d) The rate for intensive residential treatment services and assertive community treatment​ 92.8 must exclude the medical assistance room and board rate, as defined in section 256I.03,​ 92.9 subdivision 6 256B.056, subdivision 5d, and services not covered under this section, such​ 92.10 as partial hospitalization, home care, and inpatient services.​ 92.11 (e) Physician services that are not separately billed may be included in the rate to the​ 92.12 extent that a psychiatrist, or other health care professional providing physician services​ 92.13 within their scope of practice, is a member of the intensive residential treatment services​ 92.14 treatment team. Physician services, whether billed separately or included in the rate, may​ 92.15 be delivered by telehealth. For purposes of this paragraph, "telehealth" has the meaning​ 92.16 given to "mental health telehealth" in section 256B.0625, subdivision 46, when telehealth​ 92.17 is used to provide intensive residential treatment services.​ 92.18 (f) When services under this section are provided by an assertive community treatment​ 92.19 provider, case management functions must be an integral part of the team.​ 92.20 (g) The rate for a provider must not exceed the rate charged by that provider for the​ 92.21 same service to other payors.​ 92.22 (h) The rates for existing programs must be established prospectively based upon the​ 92.23 expenditures and utilization over a prior 12-month period using the criteria established in​ 92.24 paragraph (c). The rates for new programs must be established based upon estimated​ 92.25 expenditures and estimated utilization using the criteria established in paragraph (c).​ 92.26 (i) Entities who discontinue providing services must be subject to a settle-up process​ 92.27 whereby actual costs and reimbursement for the previous 12 months are compared. In the​ 92.28 event that the entity was paid more than the entity's actual costs plus any applicable​ 92.29 performance-related funding due the provider, the excess payment must be reimbursed to​ 92.30 the department. If a provider's revenue is less than actual allowed costs due to lower​ 92.31 utilization than projected, the commissioner may reimburse the provider to recover its actual​ 92.32 allowable costs. The resulting adjustments by the commissioner must be proportional to the​ 92​ Article 5 Sec. 2.​ 23-00276 as introduced​ 01/26/23 REVISOR EB/HL​ 93.1 percent of total units of service reimbursed by the commissioner and must reflect a difference​ 93.2 of greater than five percent.​ 93.3 (j) A provider may request of the commissioner a review of any rate-setting decision​ 93.4 made under this subdivision.​ 93.5 Sec. 3. Minnesota Statutes 2022, section 256B.0625, subdivision 3a, is amended to read:​ 93.6 Subd. 3a. Sex reassignment surgery Gender confirmation services. Sex reassignment​ 93.7 surgery is not covered Medical Assistance covers gender confirmation services.​ 93.8 Sec. 4. Minnesota Statutes 2022, section 256B.0625, subdivision 16, is amended to read:​ 93.9 Subd. 16. Abortion services. Medical assistance covers abortion services, but only if​ 93.10 one of the following conditions is met:​ 93.11 (a) The abortion is a medical necessity. "Medical necessity" means (1) the signed written​ 93.12 statement of two physicians indicating the abortion is medically necessary to prevent the​ 93.13 death of the mother, and (2) the patient has given her consent to the abortion in writing​ 93.14 unless the patient is physically or legally incapable of providing informed consent to the​ 93.15 procedure, in which case consent will be given as otherwise provided by law;​ 93.16 (b) The pregnancy is the result of criminal sexual conduct as defined in section 609.342,​ 93.17 subdivision 1, clauses (a), (b), (c)(i) and (ii), and (e), and subdivision 1a, clauses (a), (b),​ 93.18 (c)(i) and (ii), and (d), and the incident is reported within 48 hours after the incident occurs​ 93.19 to a valid law enforcement agency for investigation, unless the victim is physically unable​ 93.20 to report the criminal sexual conduct, in which case the report shall be made within 48 hours​ 93.21 after the victim becomes physically able to report the criminal sexual conduct; or​ 93.22 (c) The pregnancy is the result of incest, but only if the incident and relative are reported​ 93.23 to a valid law enforcement agency for investigation prior to the abortion.​ 93.24 (1) the person suffers from a physical disorder, physical injury, or physical illness,​ 93.25 including a life-endangering physical condition caused by or arising from the pregnancy​ 93.26 itself that would, as certified by a physician, place the person in danger of death unless the​ 93.27 abortion is performed;​ 93.28 (2) the pregnancy resulted from rape;​ 93.29 (3) the pregnancy resulted from incest; or​ 93.30 (4) the abortion is being done for other health or therapeutic reasons.​ 93.31 EFFECTIVE DATE. This section is effective the day following final enactment.​ 93​ Article 5 Sec. 4.​ 23-00276 as introduced​ 01/26/23 REVISOR EB/HL​ 94.1 Sec. 5. Minnesota Statutes 2022, section 256B.0946, subdivision 6, is amended to read:​ 94.2 Subd. 6. Excluded services. (a) Services in clauses (1) to (7) are not covered under this​ 94.3 section and are not eligible for medical assistance payment as components of children's​ 94.4 intensive behavioral health services, but may be billed separately:​ 94.5 (1) inpatient psychiatric hospital treatment;​ 94.6 (2) mental health targeted case management;​ 94.7 (3) partial hospitalization;​ 94.8 (4) medication management;​ 94.9 (5) children's mental health day treatment services;​ 94.10 (6) crisis response services under section 256B.0624;​ 94.11 (7) transportation; and​ 94.12 (8) mental health certified family peer specialist services under section 256B.0616.​ 94.13 (b) Children receiving intensive behavioral health services are not eligible for medical​ 94.14 assistance reimbursement for the following services while receiving children's intensive​ 94.15 behavioral health services:​ 94.16 (1) psychotherapy and skills training components of children's therapeutic services and​ 94.17 supports under section 256B.0943;​ 94.18 (2) mental health behavioral aide services as defined in section 256B.0943, subdivision​ 94.19 1, paragraph (l);​ 94.20 (3) home and community-based waiver services;​ 94.21 (4) mental health residential treatment; and​ 94.22 (5) medical assistance room and board costs rate, as defined in section 256I.03,​ 94.23 subdivision 6 256B.056, subdivision 5d.​ 94.24 Sec. 6. Minnesota Statutes 2022, section 256B.0947, subdivision 7a, is amended to read:​ 94.25 Subd. 7a. Noncovered services. (a) The rate for intensive rehabilitative mental health​ 94.26 services does not include medical assistance payment for services in clauses (1) to (7).​ 94.27 Services not covered under this paragraph may be billed separately:​ 94.28 (1) inpatient psychiatric hospital treatment;​ 94.29 (2) partial hospitalization;​ 94​ Article 5 Sec. 6.​ 23-00276 as introduced​ 01/26/23 REVISOR EB/HL​ 95.1 (3) children's mental health day treatment services;​ 95.2 (4) physician services outside of care provided by a psychiatrist serving as a member of​ 95.3 the treatment team;​ 95.4 (5) medical assistance room and board costs rate, as defined in section 256I.03,​ 95.5 subdivision 6 256B.056, subdivision 5d;​ 95.6 (6) home and community-based waiver services; and​ 95.7 (7) other mental health services identified in the child's individualized education program.​ 95.8 (b) The following services are not covered under this section and are not eligible for​ 95.9 medical assistance payment while youth are receiving intensive rehabilitative mental health​ 95.10 services:​ 95.11 (1) mental health residential treatment; and​ 95.12 (2) mental health behavioral aide services, as defined in section 256B.0943, subdivision​ 95.13 1, paragraph (l).​ 95.14 Sec. 7. Minnesota Statutes 2022, section 256L.03, subdivision 1, is amended to read:​ 95.15 Subdivision 1. Covered health services. (a) "Covered health services" means the health​ 95.16 services reimbursed under chapter 256B, with the exception of special education services,​ 95.17 home care nursing services, adult dental care services other than services covered under​ 95.18 section 256B.0625, subdivision 9, orthodontic services, nonemergency medical transportation​ 95.19 services, personal care assistance and case management services, community first services​ 95.20 and supports under section 256B.85, behavioral health home services under section​ 95.21 256B.0757, housing stabilization services under section 256B.051, and nursing home or​ 95.22 intermediate care facilities services.​ 95.23 (b) No public funds shall be used for coverage of abortion under MinnesotaCare except​ 95.24 where the life of the female would be endangered or substantial and irreversible impairment​ 95.25 of a major bodily function would result if the fetus were carried to term; or where the​ 95.26 pregnancy is the result of rape or incest.​ 95.27 (c) (b) Covered health services shall be expanded as provided in this section.​ 95.28 (d) (c) For the purposes of covered health services under this section, "child" means an​ 95.29 individual younger than 19 years of age.​ 95.30 EFFECTIVE DATE. This section is effective the day following final enactment.​ 95​ Article 5 Sec. 7.​ 23-00276 as introduced​ 01/26/23 REVISOR EB/HL​ 96.1 Sec. 8. REPEALER.​ 96.2 Subdivision 1. Minnesota Statutes 2022, section 256I.03, subdivision 6, is repealed.​ 96.3 Subd. 2. Minnesota Rules, part 9505.0235, is repealed.​ 96.4 EFFECTIVE DATE. The repeal of the subdivision in subdivision 2 is effective the​ 96.5 day following final enactment.​ 96.6 ARTICLE 6​ 96.7 HUMAN SERVICES LICENSING AND OFFICE OF INSPECTOR GENERAL​ 96.8 Section 1. Minnesota Statutes 2022, section 13.46, subdivision 4, is amended to read:​ 96.9 Subd. 4. Licensing data. (a) As used in this subdivision:​ 96.10 (1) "licensing data" are all data collected, maintained, used, or disseminated by the​ 96.11 welfare system pertaining to persons licensed or registered or who apply for licensure or​ 96.12 registration or who formerly were licensed or registered under the authority of the​ 96.13 commissioner of human services. "Licensing data" includes data pertaining to persons or​ 96.14 government entities certified under chapter 245H or section 245I.20. "License holder"​ 96.15 includes "certification holder" under section 245H.01, subdivision 4, and a person or​ 96.16 government entity issued a certification under section 245I.20;​ 96.17 (2) "client" means a person who is receiving services from a licensee or from an applicant​ 96.18 for licensure; and​ 96.19 (3) "personal and personal financial data" are Social Security numbers, identity of and​ 96.20 letters of reference, insurance information, reports from the Bureau of Criminal​ 96.21 Apprehension, health examination reports, and social/home studies.​ 96.22 (b)(1)(i) Except as provided in paragraph (c), the following data on applicants, license​ 96.23 holders, and former licensees are public: name, address, telephone number of licensees, the​ 96.24 public email address provided by nonfamily foster care license holder, date of receipt of a​ 96.25 completed application, dates of licensure, licensed capacity, type of client preferred, variances​ 96.26 granted, record of training and education in child care and child development, type of​ 96.27 dwelling, name and relationship of other family members, previous license history, class​ 96.28 of license, the existence and status of complaints, and the number of serious injuries to or​ 96.29 deaths of individuals in the licensed program as reported to the commissioner of human​ 96.30 services, the local social services agency, or any other county welfare agency. For purposes​ 96.31 of this clause, a serious injury is one that is treated by a physician.​ 96​ Article 6 Section 1.​ 23-00276 as introduced​ 01/26/23 REVISOR EB/HL​ 97.1 (ii) Except as provided in item (v), when a correction order, an order to forfeit a fine,​ 97.2 an order of license suspension, an order of temporary immediate suspension, an order of​ 97.3 license revocation, an order of license denial, or an order of conditional license has been​ 97.4 issued, or a complaint is resolved, the following data on current and former licensees and​ 97.5 applicants are public: the general nature of the complaint or allegations leading to the​ 97.6 temporary immediate suspension; the substance and investigative findings of the licensing​ 97.7 or maltreatment complaint, licensing violation, or substantiated maltreatment; the existence​ 97.8 of settlement negotiations; the record of informal resolution of a licensing violation; orders​ 97.9 of hearing; findings of fact; conclusions of law; specifications of the final correction order,​ 97.10 fine, suspension, temporary immediate suspension, revocation, denial, or conditional license​ 97.11 contained in the record of licensing action; whether a fine has been paid; and the status of​ 97.12 any appeal of these actions.​ 97.13 (iii) When a license denial under section 245A.05 or a sanction under section 245A.07​ 97.14 is based on a determination that a license holder, applicant, or controlling individual is​ 97.15 responsible for maltreatment under section 626.557 or chapter 260E, the identity of the​ 97.16 applicant, license holder, or controlling individual as the individual responsible for​ 97.17 maltreatment is public data at the time of the issuance of the license denial or sanction.​ 97.18 (iv) When a license denial under section 245A.05 or a sanction under section 245A.07​ 97.19 is based on a determination that a license holder, applicant, or controlling individual is​ 97.20 disqualified under chapter 245C, the identity of the license holder, applicant, or controlling​ 97.21 individual as the disqualified individual and the reason for the disqualification are public​ 97.22 data at the time of the issuance of the licensing sanction or denial. If the applicant, license​ 97.23 holder, or controlling individual requests reconsideration of the disqualification and the​ 97.24 disqualification is affirmed, the reason for the disqualification and the reason to not set aside​ 97.25 the disqualification are public data.​ 97.26 (v) A correction order or fine issued to a child care provider for a licensing violation is​ 97.27 private data on individuals under section 13.02, subdivision 12, or nonpublic data under​ 97.28 section 13.02, subdivision 9, if the correction order or fine is seven years old or older.​ 97.29 (2) For applicants who withdraw their application prior to licensure or denial of a license,​ 97.30 the following data are public: the name of the applicant, the city and county in which the​ 97.31 applicant was seeking licensure, the dates of the commissioner's receipt of the initial​ 97.32 application and completed application, the type of license sought, and the date of withdrawal​ 97.33 of the application.​ 97​ Article 6 Section 1.​ 23-00276 as introduced​ 01/26/23 REVISOR EB/HL​ 98.1 (3) For applicants who are denied a license, the following data are public: the name and​ 98.2 address of the applicant, the city and county in which the applicant was seeking licensure,​ 98.3 the dates of the commissioner's receipt of the initial application and completed application,​ 98.4 the type of license sought, the date of denial of the application, the nature of the basis for​ 98.5 the denial, the existence of settlement negotiations, the record of informal resolution of a​ 98.6 denial, orders of hearings, findings of fact, conclusions of law, specifications of the final​ 98.7 order of denial, and the status of any appeal of the denial.​ 98.8 (4) When maltreatment is substantiated under section 626.557 or chapter 260E and the​ 98.9 victim and the substantiated perpetrator are affiliated with a program licensed under chapter​ 98.10 245A, the commissioner of human services, local social services agency, or county welfare​ 98.11 agency may inform the license holder where the maltreatment occurred of the identity of​ 98.12 the substantiated perpetrator and the victim.​ 98.13 (5) Notwithstanding clause (1), for child foster care, only the name of the license holder​ 98.14 and the status of the license are public if the county attorney has requested that data otherwise​ 98.15 classified as public data under clause (1) be considered private data based on the best interests​ 98.16 of a child in placement in a licensed program.​ 98.17 (c) The following are private data on individuals under section 13.02, subdivision 12,​ 98.18 or nonpublic data under section 13.02, subdivision 9: personal and personal financial data​ 98.19 on family day care program and family foster care program applicants and licensees and​ 98.20 their family members who provide services under the license.​ 98.21 (d) The following are private data on individuals: the identity of persons who have made​ 98.22 reports concerning licensees or applicants that appear in inactive investigative data, and the​ 98.23 records of clients or employees of the licensee or applicant for licensure whose records are​ 98.24 received by the licensing agency for purposes of review or in anticipation of a contested​ 98.25 matter. The names of reporters of complaints or alleged violations of licensing standards​ 98.26 under chapters 245A, 245B, 245C, and 245D, and applicable rules and alleged maltreatment​ 98.27 under section 626.557 and chapter 260E, are confidential data and may be disclosed only​ 98.28 as provided in section 260E.21, subdivision 4; 260E.35; or 626.557, subdivision 12b.​ 98.29 (e) Data classified as private, confidential, nonpublic, or protected nonpublic under this​ 98.30 subdivision become public data if submitted to a court or administrative law judge as part​ 98.31 of a disciplinary proceeding in which there is a public hearing concerning a license which​ 98.32 has been suspended, immediately suspended, revoked, or denied.​ 98.33 (f) Data generated in the course of licensing investigations that relate to an alleged​ 98.34 violation of law are investigative data under subdivision 3.​ 98​ Article 6 Section 1.​ 23-00276 as introduced​ 01/26/23 REVISOR EB/HL​ 99.1 (g) Data that are not public data collected, maintained, used, or disseminated under this​ 99.2 subdivision that relate to or are derived from a report as defined in section 260E.03, or​ 99.3 626.5572, subdivision 18, are subject to the destruction provisions of sections 260E.35,​ 99.4 subdivision 6, and 626.557, subdivision 12b.​ 99.5 (h) Upon request, not public data collected, maintained, used, or disseminated under​ 99.6 this subdivision that relate to or are derived from a report of substantiated maltreatment as​ 99.7 defined in section 626.557 or chapter 260E may be exchanged with the Department of​ 99.8 Health for purposes of completing background studies pursuant to section 144.057 and with​ 99.9 the Department of Corrections for purposes of completing background studies pursuant to​ 99.10 section 241.021.​ 99.11 (i) Data on individuals collected according to licensing activities under chapters 245A​ 99.12 and 245C, data on individuals collected by the commissioner of human services according​ 99.13 to investigations under section 626.557 and chapters 245A, 245B, 245C, 245D, and 260E​ 99.14 may be shared with the Department of Human Rights, the Department of Health, the​ 99.15 Department of Corrections, the ombudsman for mental health and developmental disabilities,​ 99.16 and the individual's professional regulatory board when there is reason to believe that laws​ 99.17 or standards under the jurisdiction of those agencies may have been violated or the​ 99.18 information may otherwise be relevant to the board's regulatory jurisdiction. Background​ 99.19 study data on an individual who is the subject of a background study under chapter 245C​ 99.20 for a licensed service for which the commissioner of human services is the license holder​ 99.21 may be shared with the commissioner and the commissioner's delegate by the licensing​ 99.22 division. Unless otherwise specified in this chapter, the identity of a reporter of alleged​ 99.23 maltreatment or licensing violations may not be disclosed.​ 99.24 (j) In addition to the notice of determinations required under sections 260E.24,​ 99.25 subdivisions 5 and 7, and 260E.30, subdivision 6, paragraphs (b), (c), (d), (e), and (f), if the​ 99.26 commissioner or the local social services agency has determined that an individual is a​ 99.27 substantiated perpetrator of maltreatment of a child based on sexual abuse, as defined in​ 99.28 section 260E.03, and the commissioner or local social services agency knows that the​ 99.29 individual is a person responsible for a child's care in another facility, the commissioner or​ 99.30 local social services agency shall notify the head of that facility of this determination. The​ 99.31 notification must include an explanation of the individual's available appeal rights and the​ 99.32 status of any appeal. If a notice is given under this paragraph, the government entity making​ 99.33 the notification shall provide a copy of the notice to the individual who is the subject of the​ 99.34 notice.​ 99​ Article 6 Section 1.​ 23-00276 as introduced​ 01/26/23 REVISOR EB/HL​ 100.1 (k) All not public data collected, maintained, used, or disseminated under this subdivision​ 100.2 and subdivision 3 may be exchanged between the Department of Human Services, Licensing​ 100.3 Division, and the Department of Corrections for purposes of regulating services for which​ 100.4 the Department of Human Services and the Department of Corrections have regulatory​ 100.5 authority.​ 100.6 Sec. 2. Minnesota Statutes 2022, section 62V.05, subdivision 4a, is amended to read:​ 100.7 Subd. 4a. Background study required. (a) The board must initiate background studies​ 100.8 under section 245C.031 of:​ 100.9 (1) each navigator;​ 100.10 (2) each in-person assister; and​ 100.11 (3) each certified application counselor.​ 100.12 (b) The board may initiate the background studies required by paragraph (a) using the​ 100.13 online NETStudy 2.0 system operated by the commissioner of human services.​ 100.14 (c) The board shall not permit any individual to provide any service or function listed​ 100.15 in paragraph (a) until the board has received notification from the commissioner of human​ 100.16 services indicating that the individual:​ 100.17 (1) the board has evaluated any notification received from the commissioner of human​ 100.18 services indicating the individual's potential disqualifications and has determined that the​ 100.19 individual is not disqualified under chapter 245C; or​ 100.20 (2) the board has determined that the individual is disqualified, but has received granted​ 100.21 a set aside from the board of that disqualification according to sections 245C.22 and 245C.23.​ 100.22 (d) The board or its delegate shall review a reconsideration request of an individual in​ 100.23 paragraph (a), including granting a set aside, according to the procedures and criteria in​ 100.24 chapter 245C. The board shall notify the individual and the Department of Human Services​ 100.25 of the board's decision.​ 100.26 Sec. 3. [119B.162] RECONSIDERATION OF CORRECTION ORDERS.​ 100.27 (a) If a provider believes that the contents of the commissioner's correction order are in​ 100.28 error, the provider may ask the Department of Human Services to reconsider the parts of​ 100.29 the correction order that are alleged to be in error. The request for reconsideration must be​ 100.30 made in writing and must be postmarked and sent to the commissioner within 30 calendar​ 100.31 days from the date the correction order was mailed to the provider, and:​ 100​ Article 6 Sec. 3.​ 23-00276 as introduced​ 01/26/23 REVISOR EB/HL​ 101.1 (1) specify the parts of the correction order that are alleged to be in error;​ 101.2 (2) explain why they are in error; and​ 101.3 (3) include documentation to support the allegation of error.​ 101.4 (b) A request for reconsideration does not stay any provisions or requirements of the​ 101.5 correction order. The commissioner's disposition of a request for reconsideration is final​ 101.6 and not subject to appeal under chapter 14. The commissioner's decision is appealable by​ 101.7 petition for writ of certiorari under chapter 606.​ 101.8 Sec. 4. Minnesota Statutes 2022, section 122A.18, subdivision 8, is amended to read:​ 101.9 Subd. 8. Background studies. (a) The Professional Educator Licensing and Standards​ 101.10 Board and the Board of School Administrators must initiate criminal history background​ 101.11 studies of all first-time applicants for educator and administrator licenses under their​ 101.12 jurisdiction. Applicants must include with their licensure applications:​ 101.13 (1) an executed criminal history consent form, including fingerprints; and​ 101.14 (2) payment to conduct the background study. The Professional Educator Licensing and​ 101.15 Standards Board must deposit payments received under this subdivision in an account in​ 101.16 the special revenue fund. Amounts in the account are annually appropriated to the​ 101.17 Professional Educator Licensing and Standards Board to pay for the costs of background​ 101.18 studies on applicants for licensure.​ 101.19 (b) The background study for all first-time teaching applicants for educator licenses​ 101.20 must include a review of information from the Bureau of Criminal Apprehension, including​ 101.21 criminal history data as defined in section 13.87, and must also include a review of the​ 101.22 national criminal records repository. The superintendent of the Bureau of Criminal​ 101.23 Apprehension is authorized to exchange fingerprints with the Federal Bureau of Investigation​ 101.24 for purposes of the criminal history check.​ 101.25 (c) The Professional Educator Licensing and Standards Board may initiate criminal​ 101.26 history background studies through the commissioner of human services according to section​ 101.27 245C.031 to obtain background study data required under this chapter.​ 101.28 Sec. 5. Minnesota Statutes 2022, section 245A.02, subdivision 5a, is amended to read:​ 101.29 Subd. 5a. Controlling individual. (a) "Controlling individual" means an owner of a​ 101.30 program or service provider licensed under this chapter and the following individuals, if​ 101.31 applicable:​ 101​ Article 6 Sec. 5.​ 23-00276 as introduced​ 01/26/23 REVISOR EB/HL​ 102.1 (1) each officer of the organization, including the chief executive officer and chief​ 102.2 financial officer;​ 102.3 (2) the individual designated as the authorized agent under section 245A.04, subdivision​ 102.4 1, paragraph (b);​ 102.5 (3) the individual designated as the compliance officer under section 256B.04, subdivision​ 102.6 21, paragraph (g);​ 102.7 (4) each managerial official whose responsibilities include the direction of the​ 102.8 management or policies of a program; and​ 102.9 (5) the individual designated as the primary provider of care for a special family child​ 102.10 care program under section 245A.14, subdivision 4, paragraph (i).; and​ 102.11 (6) the president and treasurer of the board of directors of a nonprofit corporation.​ 102.12 (b) Controlling individual does not include:​ 102.13 (1) a bank, savings bank, trust company, savings association, credit union, industrial​ 102.14 loan and thrift company, investment banking firm, or insurance company unless the entity​ 102.15 operates a program directly or through a subsidiary;​ 102.16 (2) an individual who is a state or federal official, or state or federal employee, or a​ 102.17 member or employee of the governing body of a political subdivision of the state or federal​ 102.18 government that operates one or more programs, unless the individual is also an officer,​ 102.19 owner, or managerial official of the program, receives remuneration from the program, or​ 102.20 owns any of the beneficial interests not excluded in this subdivision;​ 102.21 (3) an individual who owns less than five percent of the outstanding common shares of​ 102.22 a corporation:​ 102.23 (i) whose securities are exempt under section 80A.45, clause (6); or​ 102.24 (ii) whose transactions are exempt under section 80A.46, clause (2);​ 102.25 (4) an individual who is a member of an organization exempt from taxation under section​ 102.26 290.05, unless the individual is also an officer, owner, or managerial official of the program​ 102.27 or owns any of the beneficial interests not excluded in this subdivision. This clause does​ 102.28 not exclude from the definition of controlling individual an organization that is exempt from​ 102.29 taxation; or​ 102.30 (5) an employee stock ownership plan trust, or a participant or board member of an​ 102.31 employee stock ownership plan, unless the participant or board member is a controlling​ 102.32 individual according to paragraph (a).​ 102​ Article 6 Sec. 5.​ 23-00276 as introduced​ 01/26/23 REVISOR EB/HL​ 103.1 (c) For purposes of this subdivision, "managerial official" means an individual who has​ 103.2 the decision-making authority related to the operation of the program, and the responsibility​ 103.3 for the ongoing management of or direction of the policies, services, or employees of the​ 103.4 program. A site director who has no ownership interest in the program is not considered to​ 103.5 be a managerial official for purposes of this definition.​ 103.6 Sec. 6. Minnesota Statutes 2022, section 245A.02, subdivision 10b, is amended to read:​ 103.7 Subd. 10b. Owner. "Owner" means an individual or organization that has a direct or​ 103.8 indirect ownership interest of five percent or more in a program licensed under this chapter.​ 103.9 For purposes of this subdivision, "direct ownership interest" means the possession of equity​ 103.10 in capital, stock, or profits of an organization, and "indirect ownership interest" means a​ 103.11 direct ownership interest in an entity that has a direct or indirect ownership interest in a​ 103.12 licensed program. For purposes of this chapter, "owner of a nonprofit corporation" means​ 103.13 the president and treasurer of the board of directors or, for an entity owned by an employee​ 103.14 stock ownership plan," means the president and treasurer of the entity. A government entity​ 103.15 or nonprofit corporation that is issued a license under this chapter shall be designated the​ 103.16 owner.​ 103.17 Sec. 7. Minnesota Statutes 2022, section 245A.04, subdivision 1, is amended to read:​ 103.18 Subdivision 1. Application for licensure. (a) An individual, organization, or government​ 103.19 entity that is subject to licensure under section 245A.03 must apply for a license. The​ 103.20 application must be made on the forms and in the manner prescribed by the commissioner.​ 103.21 The commissioner shall provide the applicant with instruction in completing the application​ 103.22 and provide information about the rules and requirements of other state agencies that affect​ 103.23 the applicant. An applicant seeking licensure in Minnesota with headquarters outside of​ 103.24 Minnesota must have a program office located within 30 miles of the Minnesota border.​ 103.25 An applicant who intends to buy or otherwise acquire a program or services licensed under​ 103.26 this chapter that is owned by another license holder must apply for a license under this​ 103.27 chapter and comply with the application procedures in this section and section 245A.03​ 103.28 245A.043.​ 103.29 The commissioner shall act on the application within 90 working days after a complete​ 103.30 application and any required reports have been received from other state agencies or​ 103.31 departments, counties, municipalities, or other political subdivisions. The commissioner​ 103.32 shall not consider an application to be complete until the commissioner receives all of the​ 103.33 required information.​ 103​ Article 6 Sec. 7.​ 23-00276 as introduced​ 01/26/23 REVISOR EB/HL​ 104.1 When the commissioner receives an application for initial licensure that is incomplete​ 104.2 because the applicant failed to submit required documents or that is substantially deficient​ 104.3 because the documents submitted do not meet licensing requirements, the commissioner​ 104.4 shall provide the applicant written notice that the application is incomplete or substantially​ 104.5 deficient. In the written notice to the applicant the commissioner shall identify documents​ 104.6 that are missing or deficient and give the applicant 45 days to resubmit a second application​ 104.7 that is substantially complete. An applicant's failure to submit a substantially complete​ 104.8 application after receiving notice from the commissioner is a basis for license denial under​ 104.9 section 245A.05.​ 104.10 (b) An application for licensure must identify all controlling individuals as defined in​ 104.11 section 245A.02, subdivision 5a, and must designate one individual to be the authorized​ 104.12 agent. The application must be signed by the authorized agent and must include the authorized​ 104.13 agent's first, middle, and last name; mailing address; and email address. By submitting an​ 104.14 application for licensure, the authorized agent consents to electronic communication with​ 104.15 the commissioner throughout the application process. The authorized agent must be​ 104.16 authorized to accept service on behalf of all of the controlling individuals. A government​ 104.17 entity that holds multiple licenses under this chapter may designate one authorized agent​ 104.18 for all licenses issued under this chapter or may designate a different authorized agent for​ 104.19 each license. Service on the authorized agent is service on all of the controlling individuals.​ 104.20 It is not a defense to any action arising under this chapter that service was not made on each​ 104.21 controlling individual. The designation of a controlling individual as the authorized agent​ 104.22 under this paragraph does not affect the legal responsibility of any other controlling individual​ 104.23 under this chapter.​ 104.24 (c) An applicant or license holder must have a policy that prohibits license holders,​ 104.25 employees, subcontractors, and volunteers, when directly responsible for persons served​ 104.26 by the program, from abusing prescription medication or being in any manner under the​ 104.27 influence of a chemical that impairs the individual's ability to provide services or care. The​ 104.28 license holder must train employees, subcontractors, and volunteers about the program's​ 104.29 drug and alcohol policy.​ 104.30 (d) An applicant and license holder must have a program grievance procedure that permits​ 104.31 persons served by the program and their authorized representatives to bring a grievance to​ 104.32 the highest level of authority in the program.​ 104.33 (e) The commissioner may limit communication during the application process to the​ 104.34 authorized agent or the controlling individuals identified on the license application and for​ 104.35 whom a background study was initiated under chapter 245C. The commissioner may require​ 104​ Article 6 Sec. 7.​ 23-00276 as introduced​ 01/26/23 REVISOR EB/HL​ 105.1 the applicant, except for child foster care, to demonstrate competence in the applicable​ 105.2 licensing requirements by successfully completing a written examination. The commissioner​ 105.3 may develop a prescribed written examination format.​ 105.4 (f) When an applicant is an individual, the applicant must provide:​ 105.5 (1) the applicant's taxpayer identification numbers including the Social Security number​ 105.6 or Minnesota tax identification number, and federal employer identification number if the​ 105.7 applicant has employees;​ 105.8 (2) at the request of the commissioner, a copy of the most recent filing with the secretary​ 105.9 of state that includes the complete business name, if any;​ 105.10 (3) if doing business under a different name, the doing business as (DBA) name, as​ 105.11 registered with the secretary of state;​ 105.12 (4) if applicable, the applicant's National Provider Identifier (NPI) number and Unique​ 105.13 Minnesota Provider Identifier (UMPI) number; and​ 105.14 (5) at the request of the commissioner, the notarized signature of the applicant or​ 105.15 authorized agent.; and​ 105.16 (6) except for family foster care providers, an email address that will be made public​ 105.17 subject to the requirements under section 13.46, subdivision 4, paragraph (b), clause (1),​ 105.18 item (i).​ 105.19 (g) When an applicant is an organization, the applicant must provide:​ 105.20 (1) the applicant's taxpayer identification numbers including the Minnesota tax​ 105.21 identification number and federal employer identification number;​ 105.22 (2) at the request of the commissioner, a copy of the most recent filing with the secretary​ 105.23 of state that includes the complete business name, and if doing business under a different​ 105.24 name, the doing business as (DBA) name, as registered with the secretary of state;​ 105.25 (3) the first, middle, and last name, and address for all individuals who will be controlling​ 105.26 individuals, including all officers, owners, and managerial officials as defined in section​ 105.27 245A.02, subdivision 5a, and the date that the background study was initiated by the applicant​ 105.28 for each controlling individual;​ 105.29 (4) if applicable, the applicant's NPI number and UMPI number;​ 105.30 (5) the documents that created the organization and that determine the organization's​ 105.31 internal governance and the relations among the persons that own the organization, have​ 105.32 an interest in the organization, or are members of the organization, in each case as provided​ 105​ Article 6 Sec. 7.​ 23-00276 as introduced​ 01/26/23 REVISOR EB/HL​ 106.1 or authorized by the organization's governing statute, which may include a partnership​ 106.2 agreement, bylaws, articles of organization, organizational chart, and operating agreement,​ 106.3 or comparable documents as provided in the organization's governing statute; and​ 106.4 (6) the notarized signature of the applicant or authorized agent.; and​ 106.5 (7) an email address that will be made public subject to the requirements under section​ 106.6 13.46, subdivision 4, paragraph (b), clause (1), item (i).​ 106.7 (h) When the applicant is a government entity, the applicant must provide:​ 106.8 (1) the name of the government agency, political subdivision, or other unit of government​ 106.9 seeking the license and the name of the program or services that will be licensed;​ 106.10 (2) the applicant's taxpayer identification numbers including the Minnesota tax​ 106.11 identification number and federal employer identification number;​ 106.12 (3) a letter signed by the manager, administrator, or other executive of the government​ 106.13 entity authorizing the submission of the license application; and​ 106.14 (4) if applicable, the applicant's NPI number and UMPI number.; and​ 106.15 (5) an email address that will be made public subject to the requirements under section​ 106.16 13.46, subdivision 4, paragraph (b), clause (1), item (i).​ 106.17 (i) At the time of application for licensure or renewal of a license under this chapter, the​ 106.18 applicant or license holder must acknowledge on the form provided by the commissioner​ 106.19 if the applicant or license holder elects to receive any public funding reimbursement from​ 106.20 the commissioner for services provided under the license that:​ 106.21 (1) the applicant's or license holder's compliance with the provider enrollment agreement​ 106.22 or registration requirements for receipt of public funding may be monitored by the​ 106.23 commissioner as part of a licensing investigation or licensing inspection; and​ 106.24 (2) noncompliance with the provider enrollment agreement or registration requirements​ 106.25 for receipt of public funding that is identified through a licensing investigation or licensing​ 106.26 inspection, or noncompliance with a licensing requirement that is a basis of enrollment for​ 106.27 reimbursement for a service, may result in:​ 106.28 (i) a correction order or a conditional license under section 245A.06, or sanctions under​ 106.29 section 245A.07;​ 106.30 (ii) nonpayment of claims submitted by the license holder for public program​ 106.31 reimbursement;​ 106​ Article 6 Sec. 7.​ 23-00276 as introduced​ 01/26/23 REVISOR EB/HL​ 107.1 (iii) recovery of payments made for the service;​ 107.2 (iv) disenrollment in the public payment program; or​ 107.3 (v) other administrative, civil, or criminal penalties as provided by law.​ 107.4 EFFECTIVE DATE. The change to paragraph (a) is effective the day following final​ 107.5 enactment.​ 107.6 Sec. 8. Minnesota Statutes 2022, section 245A.04, subdivision 4, is amended to read:​ 107.7 Subd. 4. Inspections; waiver. (a) Before issuing a license under this chapter, the​ 107.8 commissioner shall conduct an inspection of the program. The inspection must include but​ 107.9 is not limited to:​ 107.10 (1) an inspection of the physical plant;​ 107.11 (2) an inspection of records and documents;​ 107.12 (3) observation of the program in operation; and​ 107.13 (4) an inspection for the health, safety, and fire standards in licensing requirements for​ 107.14 a child care license holder.​ 107.15 (b) The observation in paragraph (a), clause (3), is not required prior to issuing a license​ 107.16 under subdivision 7. If the commissioner issues a license under this chapter, these​ 107.17 requirements must be completed within one year after the issuance of the license.​ 107.18 (c) Before completing a licensing inspection in a family child care program or child care​ 107.19 center, the licensing agency must offer the license holder an exit interview to discuss​ 107.20 violations or potential violations of law or rule observed during the inspection and offer​ 107.21 technical assistance on how to comply with applicable laws and rules. The commissioner​ 107.22 shall not issue a correction order or negative licensing action for violations of law or rule​ 107.23 not discussed in an exit interview, unless a license holder chooses not to participate in an​ 107.24 exit interview or not to complete the exit interview. If the license holder is unable to complete​ 107.25 the exit interview, the licensing agency must offer an alternate time for the license holder​ 107.26 to complete the exit interview.​ 107.27 (d) If a family child care license holder disputes a county licensor's interpretation of a​ 107.28 licensing requirement during a licensing inspection or exit interview, the license holder​ 107.29 may, within five business days after the exit interview or licensing inspection, request​ 107.30 clarification from the commissioner, in writing, in a manner prescribed by the commissioner.​ 107.31 The license holder's request must describe the county licensor's interpretation of the licensing​ 107.32 requirement at issue, and explain why the license holder believes the county licensor's​ 107​ Article 6 Sec. 8.​ 23-00276 as introduced​ 01/26/23 REVISOR EB/HL​ 108.1 interpretation is inaccurate. The commissioner and the county must include the license​ 108.2 holder in all correspondence regarding the disputed interpretation, and must provide an​ 108.3 opportunity for the license holder to contribute relevant information that may impact the​ 108.4 commissioner's decision. The county licensor must not issue a correction order related to​ 108.5 the disputed licensing requirement until the commissioner has provided clarification to the​ 108.6 license holder about the licensing requirement.​ 108.7 (e) The commissioner or the county shall inspect at least annually once each calendar​ 108.8 year a child care provider licensed under this chapter and Minnesota Rules, chapter 9502​ 108.9 or 9503, for compliance with applicable licensing standards.​ 108.10 (f) No later than November 19, 2017, the commissioner shall make publicly available​ 108.11 on the department's website the results of inspection reports of all child care providers​ 108.12 licensed under this chapter and under Minnesota Rules, chapter 9502 or 9503, and the​ 108.13 number of deaths, serious injuries, and instances of substantiated child maltreatment that​ 108.14 occurred in licensed child care settings each year.​ 108.15 EFFECTIVE DATE. This section is effective the day following final enactment.​ 108.16 Sec. 9. Minnesota Statutes 2022, section 245A.04, subdivision 7, is amended to read:​ 108.17 Subd. 7. Grant of license; license extension. (a) If the commissioner determines that​ 108.18 the program complies with all applicable rules and laws, the commissioner shall issue a​ 108.19 license consistent with this section or, if applicable, a temporary change of ownership license​ 108.20 under section 245A.043. At minimum, the license shall state:​ 108.21 (1) the name of the license holder;​ 108.22 (2) the address of the program;​ 108.23 (3) the effective date and expiration date of the license;​ 108.24 (4) the type of license;​ 108.25 (5) the maximum number and ages of persons that may receive services from the program;​ 108.26 and​ 108.27 (6) any special conditions of licensure.; and​ 108.28 (7) the public email address of the program.​ 108.29 (b) The commissioner may issue a license for a period not to exceed two years if:​ 108.30 (1) the commissioner is unable to conduct the evaluation or observation required by​ 108.31 subdivision 4, paragraph (a), clause (4) (3), because the program is not yet operational;​ 108​ Article 6 Sec. 9.​ 23-00276 as introduced​ 01/26/23 REVISOR EB/HL​ 109.1 (2) certain records and documents are not available because persons are not yet receiving​ 109.2 services from the program; and​ 109.3 (3) the applicant complies with applicable laws and rules in all other respects.​ 109.4 (c) A decision by the commissioner to issue a license does not guarantee that any person​ 109.5 or persons will be placed or cared for in the licensed program.​ 109.6 (d) Except as provided in paragraphs (f) and (g), the commissioner shall not issue or​ 109.7 reissue a license if the applicant, license holder, or controlling individual has:​ 109.8 (1) been disqualified and the disqualification was not set aside and no variance has been​ 109.9 granted;​ 109.10 (2) been denied a license under this chapter, within the past two years;​ 109.11 (3) had a license issued under this chapter revoked within the past five years;​ 109.12 (4) an outstanding debt related to a license fee, licensing fine, or settlement agreement​ 109.13 for which payment is delinquent; or​ 109.14 (5) failed to submit the information required of an applicant under subdivision 1,​ 109.15 paragraph (f) or, (g), or (h), after being requested by the commissioner.​ 109.16 When a license issued under this chapter is revoked under clause (1) or (3), the license​ 109.17 holder and controlling individual may not hold any license under chapter 245A for five​ 109.18 years following the revocation, and other licenses held by the applicant, license holder, or​ 109.19 controlling individual shall also be revoked.​ 109.20 (e) The commissioner shall not issue or reissue a license under this chapter if an individual​ 109.21 living in the household where the services will be provided as specified under section​ 109.22 245C.03, subdivision 1, has been disqualified and the disqualification has not been set aside​ 109.23 and no variance has been granted.​ 109.24 (f) Pursuant to section 245A.07, subdivision 1, paragraph (b), when a license issued​ 109.25 under this chapter has been suspended or revoked and the suspension or revocation is under​ 109.26 appeal, the program may continue to operate pending a final order from the commissioner.​ 109.27 If the license under suspension or revocation will expire before a final order is issued, a​ 109.28 temporary provisional license may be issued provided any applicable license fee is paid​ 109.29 before the temporary provisional license is issued.​ 109.30 (g) Notwithstanding paragraph (f), when a revocation is based on the disqualification​ 109.31 of a controlling individual or license holder, and the controlling individual or license holder​ 109.32 is ordered under section 245C.17 to be immediately removed from direct contact with​ 109​ Article 6 Sec. 9.​ 23-00276 as introduced​ 01/26/23 REVISOR EB/HL​ 110.1 persons receiving services or is ordered to be under continuous, direct supervision when​ 110.2 providing direct contact services, the program may continue to operate only if the program​ 110.3 complies with the order and submits documentation demonstrating compliance with the​ 110.4 order. If the disqualified individual fails to submit a timely request for reconsideration, or​ 110.5 if the disqualification is not set aside and no variance is granted, the order to immediately​ 110.6 remove the individual from direct contact or to be under continuous, direct supervision​ 110.7 remains in effect pending the outcome of a hearing and final order from the commissioner.​ 110.8 (h) For purposes of reimbursement for meals only, under the Child and Adult Care Food​ 110.9 Program, Code of Federal Regulations, title 7, subtitle B, chapter II, subchapter A, part 226,​ 110.10 relocation within the same county by a licensed family day care provider, shall be considered​ 110.11 an extension of the license for a period of no more than 30 calendar days or until the new​ 110.12 license is issued, whichever occurs first, provided the county agency has determined the​ 110.13 family day care provider meets licensure requirements at the new location.​ 110.14 (i) Unless otherwise specified by statute, all licenses issued under this chapter expire at​ 110.15 12:01 a.m. on the day after the expiration date stated on the license. A license holder must​ 110.16 apply for and be granted a new license to operate the program or the program must not be​ 110.17 operated after the expiration date.​ 110.18 (j) The commissioner shall not issue or reissue a license under this chapter if it has been​ 110.19 determined that a tribal licensing authority has established jurisdiction to license the program​ 110.20 or service.​ 110.21 EFFECTIVE DATE. The changes to paragraphs (b) and (d) are effective the day​ 110.22 following final enactment.​ 110.23 Sec. 10. Minnesota Statutes 2022, section 245A.041, is amended by adding a subdivision​ 110.24 to read:​ 110.25 Subd. 6. First date of direct contact; documentation requirements. Except for family​ 110.26 child care, family foster care for children, and family adult day services that the license​ 110.27 holder provides in the license holder's residence, license holders must document the first​ 110.28 date that a background study subject has direct contact, as defined in section 245C.02,​ 110.29 subdivision 11, with a person served by the license holder's program. Unless this chapter​ 110.30 otherwise requires, if the license holder does not maintain the documentation required by​ 110.31 this subdivision in the license holder's personnel files, the license holder must provide the​ 110.32 documentation to the commissioner upon the commissioner's request.​ 110.33 EFFECTIVE DATE. This section is effective January 1, 2024.​ 110​ Article 6 Sec. 10.​ 23-00276 as introduced​ 01/26/23 REVISOR EB/HL​ 111.1 Sec. 11. Minnesota Statutes 2022, section 245A.05, is amended to read:​ 111.2 245A.05 DENIAL OF APPLICATION.​ 111.3 (a) The commissioner may deny a license if an applicant or controlling individual:​ 111.4 (1) fails to submit a substantially complete application after receiving notice from the​ 111.5 commissioner under section 245A.04, subdivision 1;​ 111.6 (2) fails to comply with applicable laws or rules;​ 111.7 (3) knowingly withholds relevant information from or gives false or misleading​ 111.8 information to the commissioner in connection with an application for a license or during​ 111.9 an investigation;​ 111.10 (4) has a disqualification that has not been set aside under section 245C.22 and no​ 111.11 variance has been granted;​ 111.12 (5) has an individual living in the household who received a background study under​ 111.13 section 245C.03, subdivision 1, paragraph (a), clause (2), who has a disqualification that​ 111.14 has not been set aside under section 245C.22, and no variance has been granted;​ 111.15 (6) is associated with an individual who received a background study under section​ 111.16 245C.03, subdivision 1, paragraph (a), clause (6), who may have unsupervised access to​ 111.17 children or vulnerable adults, and who has a disqualification that has not been set aside​ 111.18 under section 245C.22, and no variance has been granted;​ 111.19 (7) fails to comply with section 245A.04, subdivision 1, paragraph (f) or (g);​ 111.20 (8) fails to demonstrate competent knowledge as required by section 245A.04, subdivision​ 111.21 6;​ 111.22 (9) has a history of noncompliance as a license holder or controlling individual with​ 111.23 applicable laws or rules, including but not limited to this chapter and chapters 119B and​ 111.24 245C;​ 111.25 (10) is prohibited from holding a license according to section 245.095; or​ 111.26 (11) for a family foster setting, has or has an individual who is living in the household​ 111.27 where the licensed services are provided or is otherwise subject to a background study who​ 111.28 has nondisqualifying background study information, as described in section 245C.05,​ 111.29 subdivision 4, that reflects on the individual's applicant's ability to safely provide care to​ 111.30 foster children.​ 111​ Article 6 Sec. 11.​ 23-00276 as introduced​ 01/26/23 REVISOR EB/HL​ 112.1 (b) An applicant whose application has been denied by the commissioner must be given​ 112.2 notice of the denial, which must state the reasons for the denial in plain language. Notice​ 112.3 must be given by certified mail or personal service. The notice must state the reasons the​ 112.4 application was denied and must inform the applicant of the right to a contested case hearing​ 112.5 under chapter 14 and Minnesota Rules, parts 1400.8505 to 1400.8612. The applicant may​ 112.6 appeal the denial by notifying the commissioner in writing by certified mail or personal​ 112.7 service. If mailed, the appeal must be postmarked and sent to the commissioner within 20​ 112.8 calendar days after the applicant received the notice of denial. If an appeal request is made​ 112.9 by personal service, it must be received by the commissioner within 20 calendar days after​ 112.10 the applicant received the notice of denial. Section 245A.08 applies to hearings held to​ 112.11 appeal the commissioner's denial of an application.​ 112.12 EFFECTIVE DATE. This section is effective the day following final enactment.​ 112.13 Sec. 12. Minnesota Statutes 2022, section 245A.07, subdivision 1, is amended to read:​ 112.14 Subdivision 1. Sanctions; appeals; license. (a) In addition to making a license conditional​ 112.15 under section 245A.06, the commissioner may suspend or revoke the license, impose a fine,​ 112.16 or secure an injunction against the continuing operation of the program of a license holder​ 112.17 who:​ 112.18 (1) does not comply with applicable law or rule, or who;​ 112.19 (2) has nondisqualifying background study information, as described in section 245C.05,​ 112.20 subdivision 4, that reflects on the license holder's ability to safely provide care to foster​ 112.21 children; or​ 112.22 (3) has an individual living in the household where the licensed services are provided​ 112.23 or is otherwise subject to a background study and the individual has nondisqualifying​ 112.24 background study information, as described in section 245C.05, subdivision 4, that reflects​ 112.25 on the license holder's ability to safely provide care to foster children.​ 112.26 When applying sanctions authorized under this section, the commissioner shall consider​ 112.27 the nature, chronicity, or severity of the violation of law or rule and the effect of the violation​ 112.28 on the health, safety, or rights of persons served by the program.​ 112.29 (b) If a license holder appeals the suspension or revocation of a license and the license​ 112.30 holder continues to operate the program pending a final order on the appeal, the commissioner​ 112.31 shall issue the license holder a temporary provisional license. Unless otherwise specified​ 112.32 by the commissioner, variances in effect on the date of the license sanction under appeal​ 112.33 continue under the temporary provisional license. If a license holder fails to comply with​ 112​ Article 6 Sec. 12.​ 23-00276 as introduced​ 01/26/23 REVISOR EB/HL​ 113.1 applicable law or rule while operating under a temporary provisional license, the​ 113.2 commissioner may impose additional sanctions under this section and section 245A.06, and​ 113.3 may terminate any prior variance. If a temporary provisional license is set to expire, a new​ 113.4 temporary provisional license shall be issued to the license holder upon payment of any fee​ 113.5 required under section 245A.10. The temporary provisional license shall expire on the date​ 113.6 the final order is issued. If the license holder prevails on the appeal, a new nonprovisional​ 113.7 license shall be issued for the remainder of the current license period.​ 113.8 (c) If a license holder is under investigation and the license issued under this chapter is​ 113.9 due to expire before completion of the investigation, the program shall be issued a new​ 113.10 license upon completion of the reapplication requirements and payment of any applicable​ 113.11 license fee. Upon completion of the investigation, a licensing sanction may be imposed​ 113.12 against the new license under this section, section 245A.06, or 245A.08.​ 113.13 (d) Failure to reapply or closure of a license issued under this chapter by the license​ 113.14 holder prior to the completion of any investigation shall not preclude the commissioner​ 113.15 from issuing a licensing sanction under this section or section 245A.06 at the conclusion​ 113.16 of the investigation.​ 113.17 EFFECTIVE DATE. This section is effective the day following final enactment.​ 113.18 Sec. 13. Minnesota Statutes 2022, section 245A.07, subdivision 2a, is amended to read:​ 113.19 Subd. 2a. Immediate suspension expedited hearing. (a) Within five working days of​ 113.20 receipt of the license holder's timely appeal, the commissioner shall request assignment of​ 113.21 an administrative law judge. The request must include a proposed date, time, and place of​ 113.22 a hearing. A hearing must be conducted by an administrative law judge within 30 calendar​ 113.23 days of the request for assignment, unless an extension is requested by either party and​ 113.24 granted by the administrative law judge for good cause. The commissioner shall issue a​ 113.25 notice of hearing by certified mail or personal service at least ten working days before the​ 113.26 hearing. The scope of the hearing shall be limited solely to the issue of whether the temporary​ 113.27 immediate suspension should remain in effect pending the commissioner's final order under​ 113.28 section 245A.08, regarding a licensing sanction issued under subdivision 3 following the​ 113.29 immediate suspension. For suspensions under subdivision 2, paragraph (a), clause (1), the​ 113.30 burden of proof in expedited hearings under this subdivision shall be limited to the​ 113.31 commissioner's demonstration that reasonable cause exists to believe that the license holder's​ 113.32 actions or failure to comply with applicable law or rule poses, or the actions of other​ 113.33 individuals or conditions in the program poses an imminent risk of harm to the health, safety,​ 113.34 or rights of persons served by the program. "Reasonable cause" means there exist specific​ 113​ Article 6 Sec. 13.​ 23-00276 as introduced​ 01/26/23 REVISOR EB/HL​ 114.1 articulable facts or circumstances which provide the commissioner with a reasonable​ 114.2 suspicion that there is an imminent risk of harm to the health, safety, or rights of persons​ 114.3 served by the program. When the commissioner has determined there is reasonable cause​ 114.4 to order the temporary immediate suspension of a license based on a violation of safe sleep​ 114.5 requirements, as defined in section 245A.1435, the commissioner is not required to​ 114.6 demonstrate that an infant died or was injured as a result of the safe sleep violations. For​ 114.7 suspensions under subdivision 2, paragraph (a), clause (2), the burden of proof in expedited​ 114.8 hearings under this subdivision shall be limited to the commissioner's demonstration by a​ 114.9 preponderance of the evidence that, since the license was revoked, the license holder​ 114.10 committed additional violations of law or rule which may adversely affect the health or​ 114.11 safety of persons served by the program.​ 114.12 (b) The administrative law judge shall issue findings of fact, conclusions, and a​ 114.13 recommendation within ten working days from the date of hearing. The parties shall have​ 114.14 ten calendar days to submit exceptions to the administrative law judge's report. The record​ 114.15 shall close at the end of the ten-day period for submission of exceptions. The commissioner's​ 114.16 final order shall be issued within ten working days from the close of the record. When an​ 114.17 appeal of a temporary immediate suspension is withdrawn or dismissed, the commissioner​ 114.18 shall issue a final order affirming the temporary immediate suspension within ten calendar​ 114.19 days of the commissioner's receipt of the withdrawal or dismissal. Within 90 calendar days​ 114.20 after an immediate suspension has been issued and the license holder has not submitted a​ 114.21 timely appeal under subdivision 2, paragraph (b), or within 90 calendar days after a final​ 114.22 order affirming an immediate suspension, the commissioner shall make a determination​ 114.23 regarding determine:​ 114.24 (1) whether a final licensing sanction shall be issued under subdivision 3, paragraph (a),​ 114.25 clauses (1) to (5). The license holder shall continue to be prohibited from operation of the​ 114.26 program during this 90-day period.; or​ 114.27 (2) whether the outcome of related, ongoing investigations or judicial proceedings are​ 114.28 necessary to determine if a final licensing sanction under subdivision 3, paragraph (a),​ 114.29 clauses (1) to (5), will be issued, and persons served by the program remain at an imminent​ 114.30 risk of harm during the investigation period or proceedings. If so, the commissioner shall​ 114.31 issue a suspension order under subdivision 3, paragraph (a), clause (6).​ 114.32 (c) When the final order under paragraph (b) affirms an immediate suspension or the​ 114.33 license holder does not submit a timely appeal of the immediate suspension, and a final​ 114.34 licensing sanction is issued under subdivision 3 and the license holder appeals that sanction,​ 114.35 the license holder continues to be prohibited from operation of the program pending a final​ 114​ Article 6 Sec. 13.​ 23-00276 as introduced​ 01/26/23 REVISOR EB/HL​ 115.1 commissioner's order under section 245A.08, subdivision 5, regarding the final licensing​ 115.2 sanction.​ 115.3 (d) The license holder shall continue to be prohibited from operation of the program​ 115.4 while a suspension order issued under paragraph (b), clause (2), remains in effect.​ 115.5 (d) (e) For suspensions under subdivision 2, paragraph (a), clause (3), the burden of​ 115.6 proof in expedited hearings under this subdivision shall be limited to the commissioner's​ 115.7 demonstration by a preponderance of the evidence that a criminal complaint and warrant​ 115.8 or summons was issued for the license holder that was not dismissed, and that the criminal​ 115.9 charge is an offense that involves fraud or theft against a program administered by the​ 115.10 commissioner.​ 115.11 Sec. 14. Minnesota Statutes 2022, section 245A.07, subdivision 3, is amended to read:​ 115.12 Subd. 3. License suspension, revocation, or fine. (a) The commissioner may suspend​ 115.13 or revoke a license, or impose a fine if:​ 115.14 (1) a license holder fails to comply fully with applicable laws or rules including but not​ 115.15 limited to the requirements of this chapter and chapter 245C;​ 115.16 (2) a license holder, a controlling individual, or an individual living in the household​ 115.17 where the licensed services are provided or is otherwise subject to a background study has​ 115.18 been disqualified and the disqualification was not set aside and no variance has been granted;​ 115.19 (3) a license holder knowingly withholds relevant information from or gives false or​ 115.20 misleading information to the commissioner in connection with an application for a license,​ 115.21 in connection with the background study status of an individual, during an investigation,​ 115.22 or regarding compliance with applicable laws or rules;​ 115.23 (4) a license holder is excluded from any program administered by the commissioner​ 115.24 under section 245.095; or​ 115.25 (5) revocation is required under section 245A.04, subdivision 7, paragraph (d).;​ 115.26 (6) suspension is necessary under subdivision 2a, paragraph (b), clause (2); or​ 115.27 (7) for a family foster setting, a license holder, or an individual living in the household​ 115.28 where the licensed services are provided or who is otherwise subject to a background study​ 115.29 has nondisqualifying background study information, as described in section 245C.05,​ 115.30 subdivision 4, that reflects on the license holder's ability to safely provide care to foster​ 115.31 children.​ 115​ Article 6 Sec. 14.​ 23-00276 as introduced​ 01/26/23 REVISOR EB/HL​ 116.1 A license holder who has had a license issued under this chapter suspended, revoked,​ 116.2 or has been ordered to pay a fine must be given notice of the action by certified mail or​ 116.3 personal service. If mailed, the notice must be mailed to the address shown on the application​ 116.4 or the last known address of the license holder. The notice must state in plain language the​ 116.5 reasons the license was suspended or revoked, or a fine was ordered.​ 116.6 (b) If the license was suspended or revoked, the notice must inform the license holder​ 116.7 of the right to a contested case hearing under chapter 14 and Minnesota Rules, parts​ 116.8 1400.8505 to 1400.8612. The license holder may appeal an order suspending or revoking​ 116.9 a license. The appeal of an order suspending or revoking a license must be made in writing​ 116.10 by certified mail or personal service. If mailed, the appeal must be postmarked and sent to​ 116.11 the commissioner within ten calendar days after the license holder receives notice that the​ 116.12 license has been suspended or revoked. If a request is made by personal service, it must be​ 116.13 received by the commissioner within ten calendar days after the license holder received the​ 116.14 order. Except as provided in subdivision 2a, paragraph (c), if a license holder submits a​ 116.15 timely appeal of an order suspending or revoking a license, the license holder may continue​ 116.16 to operate the program as provided in section 245A.04, subdivision 7, paragraphs (f) and​ 116.17 (g), until the commissioner issues a final order on the suspension or revocation.​ 116.18 (c)(1) If the license holder was ordered to pay a fine, the notice must inform the license​ 116.19 holder of the responsibility for payment of fines and the right to a contested case hearing​ 116.20 under chapter 14 and Minnesota Rules, parts 1400.8505 to 1400.8612. The appeal of an​ 116.21 order to pay a fine must be made in writing by certified mail or personal service. If mailed,​ 116.22 the appeal must be postmarked and sent to the commissioner within ten calendar days after​ 116.23 the license holder receives notice that the fine has been ordered. If a request is made by​ 116.24 personal service, it must be received by the commissioner within ten calendar days after​ 116.25 the license holder received the order.​ 116.26 (2) The license holder shall pay the fines assessed on or before the payment date specified.​ 116.27 If the license holder fails to fully comply with the order, the commissioner may issue a​ 116.28 second fine or suspend the license until the license holder complies. If the license holder​ 116.29 receives state funds, the state, county, or municipal agencies or departments responsible for​ 116.30 administering the funds shall withhold payments and recover any payments made while the​ 116.31 license is suspended for failure to pay a fine. A timely appeal shall stay payment of the fine​ 116.32 until the commissioner issues a final order.​ 116.33 (3) A license holder shall promptly notify the commissioner of human services, in writing,​ 116.34 when a violation specified in the order to forfeit a fine is corrected. If upon reinspection the​ 116.35 commissioner determines that a violation has not been corrected as indicated by the order​ 116​ Article 6 Sec. 14.​ 23-00276 as introduced​ 01/26/23 REVISOR EB/HL​ 117.1 to forfeit a fine, the commissioner may issue a second fine. The commissioner shall notify​ 117.2 the license holder by certified mail or personal service that a second fine has been assessed.​ 117.3 The license holder may appeal the second fine as provided under this subdivision.​ 117.4 (4) Fines shall be assessed as follows:​ 117.5 (i) the license holder shall forfeit $1,000 for each determination of maltreatment of a​ 117.6 child under chapter 260E or the maltreatment of a vulnerable adult under section 626.557​ 117.7 for which the license holder is determined responsible for the maltreatment under section​ 117.8 260E.30, subdivision 4, paragraphs (a) and (b), or 626.557, subdivision 9c, paragraph (c);​ 117.9 (ii) if the commissioner determines that a determination of maltreatment for which the​ 117.10 license holder is responsible is the result of maltreatment that meets the definition of serious​ 117.11 maltreatment as defined in section 245C.02, subdivision 18, the license holder shall forfeit​ 117.12 $5,000;​ 117.13 (iii) for a program that operates out of the license holder's home and a program licensed​ 117.14 under Minnesota Rules, parts 9502.0300 to 9502.0445, the fine assessed against the license​ 117.15 holder shall not exceed $1,000 for each determination of maltreatment;​ 117.16 (iv) the license holder shall forfeit $200 for each occurrence of a violation of law or rule​ 117.17 governing matters of health, safety, or supervision, including but not limited to the provision​ 117.18 of adequate staff-to-child or adult ratios, and failure to comply with background study​ 117.19 requirements under chapter 245C; and​ 117.20 (v) the license holder shall forfeit $100 for each occurrence of a violation of law or rule​ 117.21 other than those subject to a $5,000, $1,000, or $200 fine in items (i) to (iv).​ 117.22 For purposes of this section, "occurrence" means each violation identified in the​ 117.23 commissioner's fine order. Fines assessed against a license holder that holds a license to​ 117.24 provide home and community-based services, as identified in section 245D.03, subdivision​ 117.25 1, and a community residential setting or day services facility license under chapter 245D​ 117.26 where the services are provided, may be assessed against both licenses for the same​ 117.27 occurrence, but the combined amount of the fines shall not exceed the amount specified in​ 117.28 this clause for that occurrence.​ 117.29 (5) When a fine has been assessed, the license holder may not avoid payment by closing,​ 117.30 selling, or otherwise transferring the licensed program to a third party. In such an event, the​ 117.31 license holder will be personally liable for payment. In the case of a corporation, each​ 117.32 controlling individual is personally and jointly liable for payment.​ 117​ Article 6 Sec. 14.​ 23-00276 as introduced​ 01/26/23 REVISOR EB/HL​ 118.1 (d) Except for background study violations involving the failure to comply with an order​ 118.2 to immediately remove an individual or an order to provide continuous, direct supervision,​ 118.3 the commissioner shall not issue a fine under paragraph (c) relating to a background study​ 118.4 violation to a license holder who self-corrects a background study violation before the​ 118.5 commissioner discovers the violation. A license holder who has previously exercised the​ 118.6 provisions of this paragraph to avoid a fine for a background study violation may not avoid​ 118.7 a fine for a subsequent background study violation unless at least 365 days have passed​ 118.8 since the license holder self-corrected the earlier background study violation.​ 118.9 EFFECTIVE DATE. Paragraph (a), clause (7), is effective the day following final​ 118.10 enactment.​ 118.11 Sec. 15. Minnesota Statutes 2022, section 245A.10, subdivision 3, is amended to read:​ 118.12 Subd. 3. Application fee for initial license or certification. (a) For fees required under​ 118.13 subdivision 1, an applicant for an initial license or certification issued by the commissioner​ 118.14 shall submit a $500 application fee with each new application required under this subdivision.​ 118.15 An applicant for an initial day services facility license under chapter 245D shall submit a​ 118.16 $250 application fee with each new application. The application fee shall not be prorated,​ 118.17 is nonrefundable, and is in lieu of the annual license or certification fee that expires on​ 118.18 December 31. The commissioner shall not process an application until the application fee​ 118.19 is paid.​ 118.20 (b) Except as provided in clauses (1) to (3) and (2), an applicant shall apply for a license​ 118.21 to provide services at a specific location.​ 118.22 (1) For a license to provide home and community-based services to persons with​ 118.23 disabilities or age 65 and older under chapter 245D, an applicant shall submit an application​ 118.24 to provide services statewide. Notwithstanding paragraph (a), applications received by the​ 118.25 commissioner between July 1, 2013, and December 31, 2013, for licensure of services​ 118.26 provided under chapter 245D must include an application fee that is equal to the annual​ 118.27 license renewal fee under subdivision 4, paragraph (b), or $500, whichever is less.​ 118.28 Applications received by the commissioner after January 1, 2014, must include the application​ 118.29 fee required under paragraph (a). Applicants who meet the modified application criteria​ 118.30 identified in section 245A.042, subdivision 2, are exempt from paying an application fee.​ 118.31 (2) For a license to provide independent living assistance for youth under section 245A.22,​ 118.32 an applicant shall submit a single application to provide services statewide.​ 118​ Article 6 Sec. 15.​ 23-00276 as introduced​ 01/26/23 REVISOR EB/HL​ 119.1 (3) (2) For a license for a private agency to provide foster care or adoption services under​ 119.2 Minnesota Rules, parts 9545.0755 to 9545.0845, an applicant shall submit a single application​ 119.3 to provide services statewide.​ 119.4 (c) The initial application fee charged under this subdivision does not include the​ 119.5 temporary license surcharge under section 16E.22.​ 119.6 EFFECTIVE DATE. This section is effective the day following final enactment.​ 119.7 Sec. 16. Minnesota Statutes 2022, section 245A.10, subdivision 4, is amended to read:​ 119.8 Subd. 4. License or certification fee for certain programs. (a) Child care centers shall​ 119.9 pay an annual nonrefundable license fee based on the following schedule:​ 119.10 Child Care Center​ License Fee​ 119.11 Licensed Capacity​ $200​ 119.12 1 to 24 persons​ $300​ 119.13 25 to 49 persons​ $400​ 119.14 50 to 74 persons​ $500​ 119.15 75 to 99 persons​ $600​ 119.16 100 to 124 persons​ $700​ 119.17 125 to 149 persons​ $800​ 119.18 150 to 174 persons​ $900​ 119.19 175 to 199 persons​ $1,000​ 119.20 200 to 224 persons​ $1,100​ 119.21 225 or more persons​ 119.22 (b)(1) A program licensed to provide one or more of the home and community-based​ 119.23 services and supports identified under chapter 245D to persons with disabilities or age 65​ 119.24 and older, shall pay an annual nonrefundable license fee based on revenues derived from​ 119.25 the provision of services that would require licensure under chapter 245D during the calendar​ 119.26 year immediately preceding the year in which the license fee is paid, according to the​ 119.27 following schedule:​ License Fee​ 119.28 License Holder Annual Revenue​ $200​ 119.29 less than or equal to $10,000​ $300​ 119.30 greater than $10,000 but less than or​ 119.31 equal to $25,000​ $400​ 119.32 greater than $25,000 but less than or​ 119.33 equal to $50,000​ $500​ 119.34 greater than $50,000 but less than or​ 119.35 equal to $100,000​ 119​ Article 6 Sec. 16.​ 23-00276 as introduced​ 01/26/23 REVISOR EB/HL​ $600​ 120.1 greater than $100,000 but less than or​ 120.2 equal to $150,000​ $800​ 120.3 greater than $150,000 but less than or​ 120.4 equal to $200,000​ $1,000​ 120.5 greater than $200,000 but less than or​ 120.6 equal to $250,000​ $1,200​ 120.7 greater than $250,000 but less than or​ 120.8 equal to $300,000​ $1,400​ 120.9 greater than $300,000 but less than or​ 120.10 equal to $350,000​ $1,600​ 120.11 greater than $350,000 but less than or​ 120.12 equal to $400,000​ $1,800​ 120.13 greater than $400,000 but less than or​ 120.14 equal to $450,000​ $2,000​ 120.15 greater than $450,000 but less than or​ 120.16 equal to $500,000​ $2,250​ 120.17 greater than $500,000 but less than or​ 120.18 equal to $600,000​ $2,500​ 120.19 greater than $600,000 but less than or​ 120.20 equal to $700,000​ $2,750​ 120.21 greater than $700,000 but less than or​ 120.22 equal to $800,000​ $3,000​ 120.23 greater than $800,000 but less than or​ 120.24 equal to $900,000​ $3,250​ 120.25 greater than $900,000 but less than or​ 120.26 equal to $1,000,000​ $3,500​ 120.27 greater than $1,000,000 but less than or​ 120.28 equal to $1,250,000​ $3,750​ 120.29 greater than $1,250,000 but less than or​ 120.30 equal to $1,500,000​ $4,000​ 120.31 greater than $1,500,000 but less than or​ 120.32 equal to $1,750,000​ $4,250​ 120.33 greater than $1,750,000 but less than or​ 120.34 equal to $2,000,000​ $4,500​ 120.35 greater than $2,000,000 but less than or​ 120.36 equal to $2,500,000​ $4,750​ 120.37 greater than $2,500,000 but less than or​ 120.38 equal to $3,000,000​ $5,000​ 120.39 greater than $3,000,000 but less than or​ 120.40 equal to $3,500,000​ $5,500​ 120.41 greater than $3,500,000 but less than or​ 120.42 equal to $4,000,000​ $6,000​ 120.43 greater than $4,000,000 but less than or​ 120.44 equal to $4,500,000​ $6,500​ 120.45 greater than $4,500,000 but less than or​ 120.46 equal to $5,000,000​ 120​ Article 6 Sec. 16.​ 23-00276 as introduced​ 01/26/23 REVISOR EB/HL​ $7,000​ 121.1 greater than $5,000,000 but less than or​ 121.2 equal to $7,500,000​ $8,500​ 121.3 greater than $7,500,000 but less than or​ 121.4 equal to $10,000,000​ $10,000​ 121.5 greater than $10,000,000 but less than or​ 121.6 equal to $12,500,000​ $14,000​ 121.7 greater than $12,500,000 but less than or​ 121.8 equal to $15,000,000​ $18,000​ 121.9 greater than $15,000,000​ 121.10 (2) If requested, the license holder shall provide the commissioner information to verify​ 121.11 the license holder's annual revenues or other information as needed, including copies of​ 121.12 documents submitted to the Department of Revenue.​ 121.13 (3) At each annual renewal, a license holder may elect to pay the highest renewal fee,​ 121.14 and not provide annual revenue information to the commissioner.​ 121.15 (4) A license holder that knowingly provides the commissioner incorrect revenue amounts​ 121.16 for the purpose of paying a lower license fee shall be subject to a civil penalty in the amount​ 121.17 of double the fee the provider should have paid.​ 121.18 (5) Notwithstanding clause (1), a license holder providing services under one or more​ 121.19 licenses under chapter 245B that are in effect on May 15, 2013, shall pay an annual license​ 121.20 fee for calendar years 2014, 2015, and 2016, equal to the total license fees paid by the license​ 121.21 holder for all licenses held under chapter 245B for calendar year 2013. For calendar year​ 121.22 2017 and thereafter, the license holder shall pay an annual license fee according to clause​ 121.23 (1).​ 121.24 (c) A substance use disorder treatment program licensed under chapter 245G, to provide​ 121.25 substance use disorder treatment shall pay an annual nonrefundable license fee based on​ 121.26 the following schedule:​ License Fee​ 121.27 Licensed Capacity​ $600​ 121.28 1 to 24 persons​ $800​ 121.29 25 to 49 persons​ $1,000​ 121.30 50 to 74 persons​ $1,200​ 121.31 75 to 99 persons​ $1,400​ 121.32 100 or more persons​ 121.33 (d) A detoxification program licensed under Minnesota Rules, parts 9530.6510 to​ 121.34 9530.6590, or a withdrawal management program licensed under chapter 245F shall pay​ 121.35 an annual nonrefundable license fee based on the following schedule:​ 121​ Article 6 Sec. 16.​ 23-00276 as introduced​ 01/26/23 REVISOR EB/HL​ License Fee​ 122.1 Licensed Capacity​ $760​ 122.2 1 to 24 persons​ $960​ 122.3 25 to 49 persons​ $1,160​ 122.4 50 or more persons​ 122.5 A detoxification program that also operates a withdrawal management program at the same​ 122.6 location shall only pay one fee based upon the licensed capacity of the program with the​ 122.7 higher overall capacity.​ 122.8 (e) Except for child foster care, a residential facility licensed under Minnesota Rules,​ 122.9 chapter 2960, to serve children shall pay an annual nonrefundable license fee based on the​ 122.10 following schedule:​ License Fee​ 122.11 Licensed Capacity​ $1,000​ 122.12 1 to 24 persons​ $1,100​ 122.13 25 to 49 persons​ $1,200​ 122.14 50 to 74 persons​ $1,300​ 122.15 75 to 99 persons​ $1,400​ 122.16 100 or more persons​ 122.17 (f) A residential facility licensed under section 245I.23 or Minnesota Rules, parts​ 122.18 9520.0500 to 9520.0670, to serve persons with mental illness shall pay an annual​ 122.19 nonrefundable license fee based on the following schedule:​ License Fee​ 122.20 Licensed Capacity​ $2,525​ 122.21 1 to 24 persons​ $2,725​ 122.22 25 or more persons​ 122.23 (g) A residential facility licensed under Minnesota Rules, parts 9570.2000 to 9570.3400,​ 122.24 to serve persons with physical disabilities shall pay an annual nonrefundable license fee​ 122.25 based on the following schedule:​ License Fee​ 122.26 Licensed Capacity​ $450​ 122.27 1 to 24 persons​ $650​ 122.28 25 to 49 persons​ $850​ 122.29 50 to 74 persons​ $1,050​ 122.30 75 to 99 persons​ $1,250​ 122.31 100 or more persons​ 122.32 (h) A program licensed to provide independent living assistance for youth under section​ 122.33 245A.22 shall pay an annual nonrefundable license fee of $1,500.​ 122​ Article 6 Sec. 16.​ 23-00276 as introduced​ 01/26/23 REVISOR EB/HL​ 123.1 (i) (h) A private agency licensed to provide foster care and adoption services under​ 123.2 Minnesota Rules, parts 9545.0755 to 9545.0845, shall pay an annual nonrefundable license​ 123.3 fee of $875.​ 123.4 (j) (i) A program licensed as an adult day care center licensed under Minnesota Rules,​ 123.5 parts 9555.9600 to 9555.9730, shall pay an annual nonrefundable license fee based on the​ 123.6 following schedule:​ License Fee​ 123.7 Licensed Capacity​ $500​ 123.8 1 to 24 persons​ $700​ 123.9 25 to 49 persons​ $900​ 123.10 50 to 74 persons​ $1,100​ 123.11 75 to 99 persons​ $1,300​ 123.12 100 or more persons​ 123.13 (k) (j) A program licensed to provide treatment services to persons with sexual​ 123.14 psychopathic personalities or sexually dangerous persons under Minnesota Rules, parts​ 123.15 9515.3000 to 9515.3110, shall pay an annual nonrefundable license fee of $20,000.​ 123.16 (l) (k) A mental health clinic certified under section 245I.20 shall pay an annual​ 123.17 nonrefundable certification fee of $1,550. If the mental health clinic provides services at a​ 123.18 primary location with satellite facilities, the satellite facilities shall be certified with the​ 123.19 primary location without an additional charge.​ 123.20 EFFECTIVE DATE. This section is effective the day following final enactment.​ 123.21 Sec. 17. Minnesota Statutes 2022, section 245A.11, is amended by adding a subdivision​ 123.22 to read:​ 123.23 Subd. 12. License holder qualifications for child foster care. (a) Child foster care​ 123.24 license holders must maintain the ability to care for a foster child and ensure a safe home​ 123.25 environment for children placed in their care. License holders must immediately notify the​ 123.26 licensing agency of:​ 123.27 (1) any changes to the license holder or household member's physical or behavioral​ 123.28 health that may affect the license holder's ability to care for a foster child or pose a risk to​ 123.29 a foster child's health; or​ 123.30 (2) changes related to the care of a child or vulnerable adult for whom the license holder​ 123.31 is a parent or legally responsible, including living out of the home for treatment for physical​ 123.32 or behavioral health, modified parenting time arrangements, legal custody, or placement in​ 123.33 foster care.​ 123​ Article 6 Sec. 17.​ 23-00276 as introduced​ 01/26/23 REVISOR EB/HL​ 124.1 (b) The licensing agency may request a license holder or household member to undergo​ 124.2 an evaluation by a specialist in areas such as physical or behavioral health to evaluate the​ 124.3 license holder's ability to provide a safe environment for a foster child.​ 124.4 EFFECTIVE DATE. This section is effective January 1, 2024.​ 124.5 Sec. 18. Minnesota Statutes 2022, section 245A.14, subdivision 4, is amended to read:​ 124.6 Subd. 4. Special family child care homes. (a) Nonresidential child care programs​ 124.7 serving 14 or fewer children that are conducted at a location other than the license holder's​ 124.8 own residence shall be licensed under this section and the rules governing family child care​ 124.9 or group family child care if:​ 124.10 (a) (1) the license holder is the primary provider of care and the nonresidential child​ 124.11 care program is conducted in a dwelling that is located on a residential lot;​ 124.12 (b) (2) the license holder is an employer who may or may not be the primary provider​ 124.13 of care, and the purpose for the child care program is to provide child care services to​ 124.14 children of the license holder's employees;​ 124.15 (c) (3) the license holder is a church or religious organization;​ 124.16 (d) (4) the license holder is a community collaborative child care provider. For purposes​ 124.17 of this subdivision, a community collaborative child care provider is a provider participating​ 124.18 in a cooperative agreement with a community action agency as defined in section 256E.31;​ 124.19 (e) (5) the license holder is a not-for-profit agency that provides child care in a dwelling​ 124.20 located on a residential lot and the license holder maintains two or more contracts with​ 124.21 community employers or other community organizations to provide child care services.​ 124.22 The county licensing agency may grant a capacity variance to a license holder licensed​ 124.23 under this paragraph clause to exceed the licensed capacity of 14 children by no more than​ 124.24 five children during transition periods related to the work schedules of parents, if the license​ 124.25 holder meets the following requirements:​ 124.26 (1) (i) the program does not exceed a capacity of 14 children more than a cumulative​ 124.27 total of four hours per day;​ 124.28 (2) (ii) the program meets a one to seven staff-to-child ratio during the variance period;​ 124.29 (3) (iii) all employees receive at least an extra four hours of training per year than required​ 124.30 in the rules governing family child care each year;​ 124.31 (4) (iv) the facility has square footage required per child under Minnesota Rules, part​ 124.32 9502.0425;​ 124​ Article 6 Sec. 18.​ 23-00276 as introduced​ 01/26/23 REVISOR EB/HL​ 125.1 (5) (v) the program is in compliance with local zoning regulations;​ 125.2 (6) (vi) the program is in compliance with the applicable fire code as follows:​ 125.3 (i) (A) if the program serves more than five children older than 2-1/2 years of age, but​ 125.4 no more than five children 2-1/2 years of age or less, the applicable fire code is educational​ 125.5 occupancy, as provided in Group E Occupancy under the Minnesota State Fire Code 2015​ 125.6 2020, Section 202; or​ 125.7 (ii) (B) if the program serves more than five children 2-1/2 years of age or less, the​ 125.8 applicable fire code is Group I-4 Occupancies Occupancy, as provided in the Minnesota​ 125.9 State Fire Code 2015 2020, Section 202, unless the rooms in which the children 2-1/2 years​ 125.10 of age or younger are cared for are located on a level of exit discharge and each of these​ 125.11 child care rooms has an exit door directly to the exterior, then the applicable fire code is​ 125.12 Group E occupancies Occupancy, as provided in the Minnesota State Fire Code 2015 2020,​ 125.13 Section 202; and​ 125.14 (7) (vii) any age and capacity limitations required by the fire code inspection and square​ 125.15 footage determinations shall be printed on the license; or​ 125.16 (f) (6) the license holder is the primary provider of care and has located the licensed​ 125.17 child care program in a commercial space, if the license holder meets the following​ 125.18 requirements:​ 125.19 (1) (i) the program is in compliance with local zoning regulations;​ 125.20 (2) (ii) the program is in compliance with the applicable fire code as follows:​ 125.21 (i) (A) if the program serves more than five children older than 2-1/2 years of age, but​ 125.22 no more than five children 2-1/2 years of age or less, the applicable fire code is educational​ 125.23 occupancy, as provided in Group E Occupancy under the Minnesota State Fire Code 2015​ 125.24 2020, Section 202; or​ 125.25 (ii) (B) if the program serves more than five children 2-1/2 years of age or less, the​ 125.26 applicable fire code is Group I-4 Occupancies Occupancy, as provided under the Minnesota​ 125.27 State Fire Code 2015 2020, Section 202, unless the rooms in which the children 2-1/2 years​ 125.28 of age or younger are cared for are located on a level of exit discharge and each of these​ 125.29 child care rooms has an exit door directly to the exterior, then the applicable fire code is​ 125.30 Group E Occupancy, as provided in the Minnesota State Fire Code 2020, Section 202;​ 125.31 (3) (iii) any age and capacity limitations required by the fire code inspection and square​ 125.32 footage determinations are printed on the license; and​ 125​ Article 6 Sec. 18.​ 23-00276 as introduced​ 01/26/23 REVISOR EB/HL​ 126.1 (4) (iv) the license holder prominently displays the license issued by the commissioner​ 126.2 which contains the statement "This special family child care provider is not licensed as a​ 126.3 child care center."​ 126.4 (g) (b) Notwithstanding Minnesota Rules, part 9502.0335, subpart 12, the commissioner​ 126.5 may issue up to four licenses to an organization licensed under paragraph (b), (c), or (e) (a),​ 126.6 clause (2), (3), or (5). Each license must have its own primary provider of care as required​ 126.7 under paragraph (i) (d). Each license must operate as a distinct and separate program in​ 126.8 compliance with all applicable laws and regulations.​ 126.9 (h) (c) For licenses issued under paragraph (b), (c), (d), (e), or (f) (a), clause (2), (3),​ 126.10 (4), (5), or (6), the commissioner may approve up to four licenses at the same location or​ 126.11 under one contiguous roof if each license holder is able to demonstrate compliance with all​ 126.12 applicable rules and laws. Each licensed program must operate as a distinct program and​ 126.13 within the capacity, age, and ratio distributions of each license.​ 126.14 (i) (d) For a license issued under paragraph (b), (c), or (e) (a), clause (2), (3), or (5), the​ 126.15 license holder must designate a person to be the primary provider of care at the licensed​ 126.16 location on a form and in a manner prescribed by the commissioner. The license holder​ 126.17 shall notify the commissioner in writing before there is a change of the person designated​ 126.18 to be the primary provider of care. The primary provider of care:​ 126.19 (1) must be the person who will be the provider of care at the program and present during​ 126.20 the hours of operation;​ 126.21 (2) must operate the program in compliance with applicable laws and regulations under​ 126.22 chapter 245A and Minnesota Rules, chapter 9502;​ 126.23 (3) is considered a child care background study subject as defined in section 245C.02,​ 126.24 subdivision 6a, and must comply with background study requirements in chapter 245C;​ 126.25 (4) must complete the training that is required of license holders in section 245A.50;​ 126.26 and​ 126.27 (5) is authorized to communicate with the county licensing agency and the department​ 126.28 on matters related to licensing.​ 126.29 (j) (e) For any license issued under this subdivision, the license holder must ensure that​ 126.30 any other caregiver, substitute, or helper who assists in the care of children meets the training​ 126.31 requirements in section 245A.50 and background study requirements under chapter 245C.​ 126​ Article 6 Sec. 18.​ 23-00276 as introduced​ 01/26/23 REVISOR EB/HL​ 127.1 Sec. 19. Minnesota Statutes 2022, section 245A.1435, is amended to read:​ 127.2 245A.1435 REDUCTION OF RISK OF SUDDEN UNEXPECTED INFANT DEATH​ 127.3 IN LICENSED PROGRAMS.​ 127.4 (a) When a license holder is placing an infant to sleep, the license holder must place the​ 127.5 infant on the infant's back, unless the license holder has documentation from the infant's​ 127.6 physician, advanced practice registered nurse, or physician assistant directing an alternative​ 127.7 sleeping position for the infant. The physician, advanced practice registered nurse, or​ 127.8 physician assistant directive must be on a form approved developed by the commissioner​ 127.9 and must remain on file at the licensed location. An infant who independently rolls onto its​ 127.10 stomach after being placed to sleep on its back may be allowed to remain sleeping on its​ 127.11 stomach if the infant is at least six months of age or the license holder has a signed statement​ 127.12 from the parent indicating that the infant regularly rolls over at home.​ 127.13 (b) The license holder must place the infant in a crib directly on a firm mattress with a​ 127.14 fitted sheet that is appropriate to the mattress size, that fits tightly on the mattress, and​ 127.15 overlaps the underside of the mattress so it cannot be dislodged by pulling on the corner of​ 127.16 the sheet with reasonable effort. The license holder must not place anything in the crib with​ 127.17 the infant except for the infant's pacifier, as defined in Code of Federal Regulations, title​ 127.18 16, part 1511. The pacifier must be free from any sort of attachment. The requirements of​ 127.19 this section apply to license holders serving infants younger than one year of age. Licensed​ 127.20 child care providers must meet the crib requirements under section 245A.146. A correction​ 127.21 order shall not be issued under this paragraph unless there is evidence that a violation​ 127.22 occurred when an infant was present in the license holder's care.​ 127.23 (c) If an infant falls asleep before being placed in a crib, the license holder must move​ 127.24 the infant to a crib as soon as practicable, and must keep the infant within sight of the license​ 127.25 holder until the infant is placed in a crib. When an infant falls asleep while being held, the​ 127.26 license holder must consider the supervision needs of other children in care when determining​ 127.27 how long to hold the infant before placing the infant in a crib to sleep. The sleeping infant​ 127.28 must not be in a position where the airway may be blocked or with anything covering the​ 127.29 infant's face.​ 127.30 (d) When a license holder places an infant under one year of age down to sleep, the​ 127.31 infant's clothing or sleepwear must not have weighted materials, a hood, or a bib.​ 127.32 (e) A license holder may place an infant under one year of age down to sleep wearing​ 127.33 a helmet if the license holder has signed documentation by a physician, advanced practice​ 127​ Article 6 Sec. 19.​ 23-00276 as introduced​ 01/26/23 REVISOR EB/HL​ 128.1 registered nurse, physician assistant, licensed occupational therapist, or licensed physical​ 128.2 therapist on a form developed by the commissioner.​ 128.3 (d) (f) Placing a swaddled infant down to sleep in a licensed setting is not recommended​ 128.4 for an infant of any age and is prohibited for any infant who has begun to roll over​ 128.5 independently. However, with the written consent of a parent or guardian according to this​ 128.6 paragraph, a license holder may place the infant who has not yet begun to roll over on its​ 128.7 own down to sleep in a one-piece sleeper equipped with an attached system that fastens​ 128.8 securely only across the upper torso, with no constriction of the hips or legs, to create a​ 128.9 swaddle. A swaddle is defined as a one-piece sleepwear that wraps over the infant's arms,​ 128.10 fastens securely only across the infant's upper torso, and does not constrict the infant's hips​ 128.11 or legs. If a swaddle is used by a license holder, the license holder must ensure that it meets​ 128.12 the requirements of paragraph (d) and is not so tight that it restricts the infant's ability to​ 128.13 breathe or so loose that the fabric could cover the infant's nose and mouth. Prior to any use​ 128.14 of swaddling for sleep by a provider licensed under this chapter, the license holder must​ 128.15 obtain informed written consent for the use of swaddling from the parent or guardian of the​ 128.16 infant on a form provided developed by the commissioner and prepared in partnership with​ 128.17 the Minnesota Sudden Infant Death Center.​ 128.18 (g) A license holder may request a variance to this section to permit the use of a​ 128.19 cradleboard when requested by a parent or guardian for a cultural accommodation. A variance​ 128.20 for the use of a cradleboard may be issued only by the commissioner. The variance request​ 128.21 must be submitted on a form developed by the commissioner in partnership with Tribal​ 128.22 welfare agencies and the Department of Health.​ 128.23 EFFECTIVE DATE. This section is effective January 1, 2024.​ 128.24 Sec. 20. Minnesota Statutes 2022, section 245A.146, subdivision 3, is amended to read:​ 128.25 Subd. 3. License holder documentation of cribs. (a) Annually, from the date printed​ 128.26 on the license, all license holders shall check all their cribs' brand names and model numbers​ 128.27 against the United States Consumer Product Safety Commission website listing of unsafe​ 128.28 cribs.​ 128.29 (b) The license holder shall maintain written documentation to be reviewed on site for​ 128.30 each crib showing that the review required in paragraph (a) has been completed, and which​ 128.31 of the following conditions applies:​ 128.32 (1) the crib was not identified as unsafe on the United States Consumer Product Safety​ 128.33 Commission website;​ 128​ Article 6 Sec. 20.​ 23-00276 as introduced​ 01/26/23 REVISOR EB/HL​ 129.1 (2) the crib was identified as unsafe on the United States Consumer Product Safety​ 129.2 Commission website, but the license holder has taken the action directed by the United​ 129.3 States Consumer Product Safety Commission to make the crib safe; or​ 129.4 (3) the crib was identified as unsafe on the United States Consumer Product Safety​ 129.5 Commission website, and the license holder has removed the crib so that it is no longer​ 129.6 used by or accessible to children in care.​ 129.7 (c) Documentation of the review completed under this subdivision shall be maintained​ 129.8 by the license holder on site and made available to parents or guardians of children in care​ 129.9 and the commissioner.​ 129.10 (d) Notwithstanding Minnesota Rules, part 9502.0425, a family child care provider that​ 129.11 complies with this section may use a mesh-sided or fabric-sided play yard, pack and play,​ 129.12 or playpen or crib that has not been identified as unsafe on the United States Consumer​ 129.13 Product Safety Commission website for the care or sleeping of infants.​ 129.14 (e) On at least a monthly basis, the family child care license holder shall perform safety​ 129.15 inspections of every mesh-sided or fabric-sided play yard, pack and play, or playpen used​ 129.16 by or that is accessible to any child in care, and must document the following:​ 129.17 (1) there are no tears, holes, or loose or unraveling threads in mesh or fabric sides of​ 129.18 crib;​ 129.19 (2) the weave of the mesh on the crib is no larger than one-fourth of an inch;​ 129.20 (3) no mesh fabric is unsecure or unattached to top rail and floor plate of crib;​ 129.21 (4) no tears or holes to top rail of crib;​ 129.22 (5) the mattress floor board is not soft and does not exceed one inch thick;​ 129.23 (6) the mattress floor board has no rips or tears in covering;​ 129.24 (7) the mattress floor board in use is a waterproof an original mattress or replacement​ 129.25 mattress provided by the manufacturer of the crib;​ 129.26 (8) there are no protruding or loose rivets, metal nuts, or bolts on the crib;​ 129.27 (9) there are no knobs or wing nuts on outside crib legs;​ 129.28 (10) there are no missing, loose, or exposed staples; and​ 129.29 (11) the latches on top and side rails used to collapse crib are secure, they lock properly,​ 129.30 and are not loose.​ 129​ Article 6 Sec. 20.​ 23-00276 as introduced​ 01/26/23 REVISOR EB/HL​ 130.1 (f) If a cradleboard is used in a licensed setting, the license holder must check the​ 130.2 cradleboard not less than monthly to ensure the cradleboard is structurally sound and there​ 130.3 are no loose or protruding parts. The license holder shall maintain written documentation​ 130.4 of this review.​ 130.5 EFFECTIVE DATE. This section is effective January 1, 2024.​ 130.6 Sec. 21. Minnesota Statutes 2022, section 245A.16, subdivision 1, is amended to read:​ 130.7 Subdivision 1. Delegation of authority to agencies. (a) County agencies and private​ 130.8 agencies that have been designated or licensed by the commissioner to perform licensing​ 130.9 functions and activities under section 245A.04 and background studies for family child care​ 130.10 under chapter 245C; to recommend denial of applicants under section 245A.05; to issue​ 130.11 correction orders, to issue variances, and recommend a conditional license under section​ 130.12 245A.06; or to recommend suspending or revoking a license or issuing a fine under section​ 130.13 245A.07, shall comply with rules and directives of the commissioner governing those​ 130.14 functions and with this section. The following variances are excluded from the delegation​ 130.15 of variance authority and may be issued only by the commissioner:​ 130.16 (1) dual licensure of family child care and child foster care, dual licensure of child and​ 130.17 adult foster care, and adult foster care and family child care;​ 130.18 (2) adult foster care maximum capacity;​ 130.19 (3) adult foster care minimum age requirement;​ 130.20 (4) child foster care maximum age requirement;​ 130.21 (5) variances regarding disqualified individuals except that, before the implementation​ 130.22 of NETStudy 2.0, county agencies may issue variances under section 245C.30 regarding​ 130.23 disqualified individuals when the county is responsible for conducting a consolidated​ 130.24 reconsideration according to sections 245C.25 and 245C.27, subdivision 2, clauses (a) and​ 130.25 (b), of a county maltreatment determination and a disqualification based on serious or​ 130.26 recurring maltreatment;​ 130.27 (6) the required presence of a caregiver in the adult foster care residence during normal​ 130.28 sleeping hours;​ 130.29 (7) variances to requirements relating to chemical use problems of a license holder or a​ 130.30 household member of a license holder; and​ 130​ Article 6 Sec. 21.​ 23-00276 as introduced​ 01/26/23 REVISOR EB/HL​ 131.1 (8) variances to section 245A.53 for a time-limited period. If the commissioner grants​ 131.2 a variance under this clause, the license holder must provide notice of the variance to all​ 131.3 parents and guardians of the children in care.; and​ 131.4 (9) variances to section 245A.1435 for the use of a cradleboard for a cultural​ 131.5 accommodation.​ 131.6 Except as provided in section 245A.14, subdivision 4, paragraph (e), a county agency must​ 131.7 not grant a license holder a variance to exceed the maximum allowable family child care​ 131.8 license capacity of 14 children.​ 131.9 (b) A county agency that has been designated by the commissioner to issue family child​ 131.10 care variances must:​ 131.11 (1) publish the county agency's policies and criteria for issuing variances on the county's​ 131.12 public website and update the policies as necessary; and​ 131.13 (2) annually distribute the county agency's policies and criteria for issuing variances to​ 131.14 all family child care license holders in the county.​ 131.15 (c) Before the implementation of NETStudy 2.0, county agencies must report information​ 131.16 about disqualification reconsiderations under sections 245C.25 and 245C.27, subdivision​ 131.17 2, paragraphs (a) and (b), and variances granted under paragraph (a), clause (5), to the​ 131.18 commissioner at least monthly in a format prescribed by the commissioner.​ 131.19 (d) (c) For family child care programs, the commissioner shall require a county agency​ 131.20 to conduct one unannounced licensing review at least annually.​ 131.21 (e) (d) For family adult day services programs, the commissioner may authorize licensing​ 131.22 reviews every two years after a licensee has had at least one annual review.​ 131.23 (f) (e) A license issued under this section may be issued for up to two years.​ 131.24 (g) (f) During implementation of chapter 245D, the commissioner shall consider:​ 131.25 (1) the role of counties in quality assurance;​ 131.26 (2) the duties of county licensing staff; and​ 131.27 (3) the possible use of joint powers agreements, according to section 471.59, with counties​ 131.28 through which some licensing duties under chapter 245D may be delegated by the​ 131.29 commissioner to the counties.​ 131.30 Any consideration related to this paragraph must meet all of the requirements of the corrective​ 131.31 action plan ordered by the federal Centers for Medicare and Medicaid Services.​ 131​ Article 6 Sec. 21.​ 23-00276 as introduced​ 01/26/23 REVISOR EB/HL​ 132.1 (h) (g) Licensing authority specific to section 245D.06, subdivisions 5, 6, 7, and 8, or​ 132.2 successor provisions; and section 245D.061 or successor provisions, for family child foster​ 132.3 care programs providing out-of-home respite, as identified in section 245D.03, subdivision​ 132.4 1, paragraph (b), clause (1), is excluded from the delegation of authority to county and​ 132.5 private agencies.​ 132.6 (i) (h) A county agency shall report to the commissioner, in a manner prescribed by the​ 132.7 commissioner, the following information for a licensed family child care program:​ 132.8 (1) the results of each licensing review completed, including the date of the review, and​ 132.9 any licensing correction order issued;​ 132.10 (2) any death, serious injury, or determination of substantiated maltreatment; and​ 132.11 (3) any fires that require the service of a fire department within 48 hours of the fire. The​ 132.12 information under this clause must also be reported to the state fire marshal within two​ 132.13 business days of receiving notice from a licensed family child care provider.​ 132.14 EFFECTIVE DATE. This section is effective the day following final enactment, except​ 132.15 for the changes to paragraph (a), clauses (7) to (9), which are effective January 1, 2024.​ 132.16 Sec. 22. Minnesota Statutes 2022, section 245A.16, subdivision 9, is amended to read:​ 132.17 Subd. 9. Licensed family foster settings. (a) Before recommending to grant a license,​ 132.18 deny a license under section 245A.05, or revoke a license under section 245A.07 for​ 132.19 nondisqualifying background study information received under section 245C.05, subdivision​ 132.20 4, paragraph (a), clause (3), for a licensed family foster setting, a county agency or private​ 132.21 agency that has been designated or licensed by the commissioner must review the following​ 132.22 for the license holder, applicant, or an individual living in the household where the licensed​ 132.23 services are provided or who is otherwise subject to a background study:​ 132.24 (1) the type of offenses;​ 132.25 (2) the number of offenses;​ 132.26 (3) the nature of the offenses;​ 132.27 (4) the age of the individual at the time of the offenses;​ 132.28 (5) the length of time that has elapsed since the last offense;​ 132.29 (6) the relationship of the offenses and the capacity to care for a child;​ 132.30 (7) evidence of rehabilitation;​ 132​ Article 6 Sec. 22.​ 23-00276 as introduced​ 01/26/23 REVISOR EB/HL​ 133.1 (8) information or knowledge from community members regarding the individual's​ 133.2 capacity to provide foster care;​ 133.3 (9) any available information regarding child maltreatment reports or child in need of​ 133.4 protection or services petitions, or related cases, in which the individual has been involved​ 133.5 or implicated, and documentation that the individual has remedied issues or conditions​ 133.6 identified in child protection or court records that are relevant to safely caring for a child;​ 133.7 (10) a statement from the study subject;​ 133.8 (11) a statement from the license holder; and​ 133.9 (12) other aggravating and mitigating factors.​ 133.10 (b) For purposes of this section, "evidence of rehabilitation" includes but is not limited​ 133.11 to the following:​ 133.12 (1) maintaining a safe and stable residence;​ 133.13 (2) continuous, regular, or stable employment;​ 133.14 (3) successful participation in an education or job training program;​ 133.15 (4) positive involvement with the community or extended family;​ 133.16 (5) compliance with the terms and conditions of probation or parole following the​ 133.17 individual's most recent conviction;​ 133.18 (6) if the individual has had a substance use disorder, successful completion of a substance​ 133.19 use disorder assessment, substance use disorder treatment, and recommended continuing​ 133.20 care, if applicable, demonstrated abstinence from controlled substances, as defined in section​ 133.21 152.01, subdivision 4, or the establishment of a sober network;​ 133.22 (7) if the individual has had a mental illness or documented mental health issues,​ 133.23 demonstrated completion of a mental health evaluation, participation in therapy or other​ 133.24 recommended mental health treatment, or appropriate medication management, if applicable;​ 133.25 (8) if the individual's offense or conduct involved domestic violence, demonstrated​ 133.26 completion of a domestic violence or anger management program, and the absence of any​ 133.27 orders for protection or harassment restraining orders against the individual since the previous​ 133.28 offense or conduct;​ 133.29 (9) written letters of support from individuals of good repute, including but not limited​ 133.30 to employers, members of the clergy, probation or parole officers, volunteer supervisors,​ 133.31 or social services workers;​ 133​ Article 6 Sec. 22.​ 23-00276 as introduced​ 01/26/23 REVISOR EB/HL​ 134.1 (10) demonstrated remorse for convictions or conduct, or demonstrated positive behavior​ 134.2 changes; and​ 134.3 (11) absence of convictions or arrests since the previous offense or conduct, including​ 134.4 any convictions that were expunged or pardoned.​ 134.5 (c) An applicant for a family foster setting license must sign all releases of information​ 134.6 requested by the county or private licensing agency.​ 134.7 (d) When licensing a relative for a family foster setting, the commissioner shall also​ 134.8 consider the importance of maintaining the child's relationship with relatives as an additional​ 134.9 significant factor in determining whether an application will be denied.​ 134.10 (e) When recommending that the commissioner deny or revoke a license, the county or​ 134.11 private licensing agency must send a summary of the review completed according to​ 134.12 paragraph (a), on a form developed by the commissioner, to the commissioner and include​ 134.13 any recommendation for licensing action.​ 134.14 EFFECTIVE DATE. This section is effective the day following final enactment.​ 134.15 Sec. 23. Minnesota Statutes 2022, section 245A.16, is amended by adding a subdivision​ 134.16 to read:​ 134.17 Subd. 10. Electronic checklist use by family child care licensors. County staff who​ 134.18 perform family child care licensing functions must use the commissioner's electronic licensing​ 134.19 checklist in the manner prescribed by the commissioner.​ 134.20 EFFECTIVE DATE. This section is effective July 1, 2023.​ 134.21 Sec. 24. Minnesota Statutes 2022, section 245A.18, subdivision 2, is amended to read:​ 134.22 Subd. 2. Child passenger restraint systems; training requirement. (a) Programs​ 134.23 licensed by the Department of Human Services under this chapter and Minnesota Rules,​ 134.24 chapter 2960, that serve a child or children under eight years of age must document training​ 134.25 that fulfills the requirements in this subdivision. Sections 245A.60, subdivision 4, and​ 134.26 245A.61, subdivision 4, describe training requirements for family foster care and foster​ 134.27 residence settings.​ 134.28 (b) Before a license holder, staff person, or caregiver transports a child or children under​ 134.29 age eight in a motor vehicle, the person transporting the child must satisfactorily complete​ 134.30 training on the proper use and installation of child restraint systems in motor vehicles.​ 134​ Article 6 Sec. 24.​ 23-00276 as introduced​ 01/26/23 REVISOR EB/HL​ 135.1 Training completed under this section may be used to meet initial or ongoing training under​ 135.2 Minnesota Rules, part 2960.3070, subparts 1 and 2.​ 135.3 (c) Training required under this section must be completed at orientation or initial training​ 135.4 and repeated at least once every five years. At a minimum, the training must address the​ 135.5 proper use of child restraint systems based on the child's size, weight, and age, and the​ 135.6 proper installation of a car seat or booster seat in the motor vehicle used by the license​ 135.7 holder to transport the child or children.​ 135.8 (d) Training under paragraph (c) must be provided by individuals who are certified and​ 135.9 approved by the Department of Public Safety, Office of Traffic Safety within the Department​ 135.10 of Public Safety. License holders may obtain a list of certified and approved trainers through​ 135.11 the Department of Public Safety website or by contacting the agency.​ 135.12 (e) Notwithstanding paragraph (a), for an emergency relative placement under section​ 135.13 245A.035, the commissioner may grant a variance to the training required by this subdivision​ 135.14 for a relative who completes a child seat safety check up. The child seat safety check up​ 135.15 trainer must be approved by the Department of Public Safety, Office of Traffic Safety, and​ 135.16 must provide one-on-one instruction on placing a child of a specific age in the exact child​ 135.17 passenger restraint in the motor vehicle in which the child will be transported. Once granted​ 135.18 a variance, and if all other licensing requirements are met, the relative applicant may receive​ 135.19 a license and may transport a relative foster child younger than eight years of age. A child​ 135.20 seat safety check up must be completed each time a child requires a different size car seat​ 135.21 according to car seat and vehicle manufacturer guidelines. A relative license holder must​ 135.22 complete training that meets the other requirements of this subdivision prior to placement​ 135.23 of another foster child younger than eight years of age in the home or prior to the renewal​ 135.24 of the child foster care license.​ 135.25 EFFECTIVE DATE. This section is effective January 1, 2024.​ 135.26 Sec. 25. [245A.211] PRONE RESTRAINT PROHIBITION.​ 135.27 Subdivision 1. Applicability. This section applies to all programs licensed or certified​ 135.28 under this chapter, chapters 245D, 245F, 245G, 245H, and sections 245I.20 and 245I.23.​ 135.29 The requirements in this section are in addition to any applicable requirements for the use​ 135.30 of holds or restraints for each license or certification type.​ 135.31 Subd. 2. Definitions. (a) "Mechanical restraint" means a restraint device that limits the​ 135.32 voluntary movement of a person or the person's limbs.​ 135​ Article 6 Sec. 25.​ 23-00276 as introduced​ 01/26/23 REVISOR EB/HL​ 136.1 (b) "Prone restraint" means a restraint that places a person in a face-down position with​ 136.2 the person's chest in contact with the floor or other surface.​ 136.3 (c) "Restraint" means a physical hold, physical restraint, manual restraint, restraint​ 136.4 equipment, or mechanical restraint that holds a person immobile or limits the voluntary​ 136.5 movement of a person or the person's limbs.​ 136.6 Subd. 3. Prone restraint prohibition. (a) A license or certification holder must not use​ 136.7 a prone restraint on any person receiving services in a program, except in the instances​ 136.8 allowed by paragraphs (b) to (d).​ 136.9 (b) If a person rolls into a prone position during the use of a restraint, the person must​ 136.10 be restored to a nonprone position as quickly as possible.​ 136.11 (c) If the applicable licensing requirements allow a program to use mechanical restraints,​ 136.12 a person may be briefly held in a prone restraint for the purpose of applying mechanical​ 136.13 restraints if the person is restored to a nonprone position as quickly as possible.​ 136.14 (d) If the applicable licensing requirements allow a program to use seclusion, a person​ 136.15 may be briefly held in a prone restraint to allow staff to safely exit a seclusion room.​ 136.16 Subd. 4. Contraindicated physical restraints. A license or certification holder must​ 136.17 not implement a restraint on a person receiving services in a program in a way that is​ 136.18 contraindicated for any of the person's known medical or psychological conditions. Prior​ 136.19 to using restraints on a person, the license or certification holder must assess and document​ 136.20 a determination of any medical or psychological conditions that restraints are contraindicated​ 136.21 for and the type of restraints that will not be used on the person based on this determination.​ 136.22 Sec. 26. Minnesota Statutes 2022, section 245A.52, subdivision 1, is amended to read:​ 136.23 Subdivision 1. Means of escape. (a)(1) At least one emergency escape route separate​ 136.24 from the main exit from the space must be available in each room used for sleeping by​ 136.25 anyone receiving licensed care, and (2) a basement used for child care. One means of escape​ 136.26 must be a stairway or door leading to the floor of exit discharge. The other must be a door​ 136.27 or window leading directly outside. A window used as an emergency escape route must be​ 136.28 openable without special knowledge.​ 136.29 (b) In homes with construction that began before May 2, 2016 March 31, 2020, the​ 136.30 interior of the window leading directly outside must have a net clear opening area of not​ 136.31 less than 4.5 square feet or 648 square inches and have minimum clear opening dimensions​ 136.32 of 20 inches wide and 20 inches high. The net clear opening dimensions shall be the result​ 136.33 of normal operation of the opening. The opening must be no higher than 48 inches from the​ 136​ Article 6 Sec. 26.​ 23-00276 as introduced​ 01/26/23 REVISOR EB/HL​ 137.1 floor. The height to the window may be measured from a platform if a platform is located​ 137.2 below the window.​ 137.3 (c) In homes with construction that began on or after May 2, 2016 March 31, 2020, the​ 137.4 interior of the window leading directly outside must have minimum clear opening dimensions​ 137.5 of 20 inches wide and 24 inches high. The net clear opening dimensions shall be the result​ 137.6 of normal operation of the opening. The opening must be no higher than 44 inches from the​ 137.7 floor.​ 137.8 (d) Additional requirements are dependent on the distance of the openings from the ground​ 137.9 outside the window: (1) windows or other openings with a sill height not more than 44​ 137.10 inches above or below the finished ground level adjacent to the opening (grade-floor​ 137.11 emergency escape and rescue openings) must have a minimum opening of five square feet;​ 137.12 and (2) non-grade-floor emergency escape and rescue openings must have a minimum​ 137.13 opening of 5.7 square feet.​ 137.14 Sec. 27. Minnesota Statutes 2022, section 245A.52, subdivision 2, is amended to read:​ 137.15 Subd. 2. Door to attached garage. Notwithstanding Minnesota Rules, part 9502.0425,​ 137.16 subpart 5, day care residences with an attached garage are not required to have a self-closing​ 137.17 door to the residence. The door to the residence may be If there is an opening between an​ 137.18 attached garage and a day care residence, there must be a door that is:​ 137.19 (1) a solid wood bonded-core door at least 1-3/8 inches thick;​ 137.20 (2) a steel insulated door if the door is at least 1-3/8 inches thick.; or​ 137.21 (3) a door with a fire protection rating of 20 minutes.​ 137.22 The separation wall on the garage side between the residence and garage must consist of​ 137.23 1/2 inch thick gypsum wallboard or its equivalent.​ 137.24 Sec. 28. Minnesota Statutes 2022, section 245A.52, subdivision 3, is amended to read:​ 137.25 Subd. 3. Heating and venting systems. (a) Notwithstanding Minnesota Rules, part​ 137.26 9502.0425, subpart 7, item C, items that can be ignited and support combustion, including​ 137.27 but not limited to plastic, fabric, and wood products must not be located within:​ 137.28 (1) 18 inches of a gas or fuel-oil heater or furnace.; or​ 137.29 (2) 36 inches of a solid-fuel-burning appliance.​ 137​ Article 6 Sec. 28.​ 23-00276 as introduced​ 01/26/23 REVISOR EB/HL​ 138.1 (b) If a license holder produces manufacturer instructions listing a smaller distance, then​ 138.2 the manufacturer instructions control the distance combustible items must be from gas,​ 138.3 fuel-oil, or solid-fuel burning heaters or furnaces.​ 138.4 Sec. 29. Minnesota Statutes 2022, section 245A.52, subdivision 5, is amended to read:​ 138.5 Subd. 5. Carbon monoxide and smoke alarms. (a) All homes must have an approved​ 138.6 and operational carbon monoxide alarm installed within ten feet of each room used for​ 138.7 sleeping children in care.​ 138.8 (b) Smoke alarms that have been listed by the Underwriter Laboratory must be properly​ 138.9 installed and maintained on all levels including basements, but not including crawl spaces​ 138.10 and uninhabitable attics, and in hallways outside rooms used for sleeping children in care.​ 138.11 in hallways outside of rooms used for sleeping children and on all levels, including basements​ 138.12 but not including crawl spaces and uninhabitable attics.​ 138.13 (c) In homes with construction that began on or after May 2, 2016 March 31, 2020,​ 138.14 smoke alarms must be installed and maintained in each room used for sleeping children in​ 138.15 care.​ 138.16 Sec. 30. Minnesota Statutes 2022, section 245A.52, is amended by adding a subdivision​ 138.17 to read:​ 138.18 Subd. 7. Stairways. All stairways must meet the following conditions.​ 138.19 (1) Stairways of four or more steps must have handrails on at least one side.​ 138.20 (2) Any open area between the handrail and stair tread must be enclosed with a protective​ 138.21 guardrail as specified in the State Building Code. At open risers, openings located more​ 138.22 than 30 inches (762 mm), as measured vertically, to the floor or grade below shall not permit​ 138.23 the passage of a sphere four inches (102 mm) in diameter.​ 138.24 (3) Gates or barriers must be used when children between the ages of six and 18 months​ 138.25 are in care.​ 138.26 (4) Stairways must be well lit, in good repair, and free of clutter and obstructions.​ 138.27 Sec. 31. Minnesota Statutes 2022, section 245A.52, is amended by adding a subdivision​ 138.28 to read:​ 138.29 Subd. 8. Fire code variances. When a variance is requested of the standards contained​ 138.30 in subdivision 1, 2, 3, 4, or 5, an applicant or provider must submit written approval from​ 138​ Article 6 Sec. 31.​ 23-00276 as introduced​ 01/26/23 REVISOR EB/HL​ 139.1 the state fire marshal of the variance requested and the alternative measures identified to​ 139.2 ensure the safety of children in care.​ 139.3 Sec. 32. [245A.60] FAMILY CHILD FOSTER CARE TRAINING REQUIREMENTS.​ 139.4 Subdivision 1. Applicability. This section applies to programs licensed to provide foster​ 139.5 care for children in the license holder's residence. For the purposes of this section, "foster​ 139.6 parent" means a license holder under this chapter. For the purposes of this section, "caregiver"​ 139.7 means a person who provides services to a child according to the child's case plan in a setting​ 139.8 licensed under Minnesota Rules, parts 2960.3000 to 2960.3340.​ 139.9 Subd. 2. Orientation. (a) Each foster parent applicant must complete a minimum of six​ 139.10 hours of orientation before the commissioner will license the applicant. An applicant's​ 139.11 orientation training hours do not count toward yearly training hours. The commissioner​ 139.12 may grant a variance to the applicant regarding the number of orientation hours that this​ 139.13 subdivision requires.​ 139.14 (b) The foster parent's orientation must include training about the following:​ 139.15 (1) emergency procedures, including evacuation routes, emergency telephone numbers,​ 139.16 severe storm and tornado procedures, and the location of alarms and equipment;​ 139.17 (2) all relevant laws and rules, including this chapter; chapters 260, 260C, 260D, and​ 139.18 260E; Minnesota Rules, chapter 9560; and related legal issues and reporting requirements;​ 139.19 (3) cultural diversity, gender sensitivity, culturally specific services, cultural competence,​ 139.20 and information about discrimination and racial bias to ensure that caregivers are culturally​ 139.21 competent to care for foster children according to section 260C.212, subdivision 11;​ 139.22 (4) the foster parent's roles and responsibilities in developing and implementing the​ 139.23 child's case plan and involvement in court and administrative reviews of the child's placement;​ 139.24 (5) the licensing agency's requirements;​ 139.25 (6) one hour relating to reasonable and prudent parenting standards for the child's​ 139.26 participation in age-appropriate or developmentally appropriate extracurricular, social, or​ 139.27 cultural activities according to section 260C.212, subdivision 14;​ 139.28 (7) two hours relating to children's mental health issues according to subdivision 3;​ 139.29 (8) if subdivision 4 requires, the proper use and installation of child passenger restraint​ 139.30 systems in motor vehicles;​ 139​ Article 6 Sec. 32.​ 23-00276 as introduced​ 01/26/23 REVISOR EB/HL​ 140.1 (9) if subdivision 5 requires, at least one hour about reducing the risk of sudden​ 140.2 unexpected infant death and abusive head trauma from shaking infants and young children;​ 140.3 and​ 140.4 (10) if subdivision 6 requires, operating medical equipment.​ 140.5 Subd. 3. Mental health training. Each foster parent prior to licensure and each caregiver​ 140.6 prior to caring for a foster child must complete two hours of training that addresses the​ 140.7 causes, symptoms, and key warning signs of children's mental health disorders; cultural​ 140.8 considerations; and effective approaches to manage a child's behaviors. Each year, each​ 140.9 foster parent and caregiver must complete at least one hour of training about children's​ 140.10 mental health issues and treatment. A short-term substitute caregiver is exempt from this​ 140.11 subdivision. The commissioner of human services shall approve of a mental health training​ 140.12 curriculum that satisfies the requirements of this subdivision.​ 140.13 Subd. 4. Child passenger restraint systems. (a) Each foster parent and caregiver must​ 140.14 satisfactorily complete training about the proper use and installation of child passenger​ 140.15 restraint systems in motor vehicles before transporting a child younger than eight years of​ 140.16 age in a motor vehicle.​ 140.17 (b) An individual who is certified and approved by the Office of Traffic Safety within​ 140.18 the Department of Public Safety must provide training about the proper use and installation​ 140.19 of child passenger restraint systems in motor vehicles to each foster parent and caregiver​ 140.20 who transports a child. At a minimum, the training must address the proper use of child​ 140.21 passenger restraint systems based on a child's size, weight, and age, and the proper installation​ 140.22 of a car seat or booster seat in the motor vehicle that will be transporting the child. A foster​ 140.23 parent or caregiver who transports a child must repeat the training in this subdivision at​ 140.24 least once every five years.​ 140.25 (c) Notwithstanding paragraph (a), for an emergency relative placement under section​ 140.26 245A.035, the commissioner may grant a variance to the training required by this subdivision​ 140.27 to a child's relative who completes a child seat safety checkup. The Office of Traffic Safety​ 140.28 within the Department of Public Safety must approve of the child seat safety checkup trainer​ 140.29 and must provide one-on-one instruction to the child's relative applicant about placing a​ 140.30 child of a specific age in the exact child passenger restraint in the motor vehicle that will​ 140.31 be used to transport the child. Once the commissioner grants a variance to the child's relative,​ 140.32 the child's relative may transport a relative foster child younger than eight years of age, and​ 140.33 once the child's relative meets all other licensing requirements, the commissioner may​ 140.34 license the child's relative applicant. The child's relative must complete a child seat safety​ 140​ Article 6 Sec. 32.​ 23-00276 as introduced​ 01/26/23 REVISOR EB/HL​ 141.1 checkup each time that the child requires a different sized car seat according to car seat and​ 141.2 vehicle manufacturer guidelines. A relative license holder must complete training that meets​ 141.3 the other requirements of this subdivision prior to placement of another foster child younger​ 141.4 than eight years of age in the relative license holder's home or prior to the renewal of the​ 141.5 relative license holder's child foster care license.​ 141.6 Subd. 5. Training about the risk of sudden unexpected infant death and abusive​ 141.7 head trauma. (a) Each foster parent and caregiver who cares for an infant or a child five​ 141.8 years of age or younger must satisfactorily complete at least one hour of training about​ 141.9 reducing the risk of sudden unexpected infant death pursuant to section 245A.1435 and​ 141.10 abusive head trauma from shaking infants and young children. Each foster parent and​ 141.11 caregiver must complete this training prior to caring for an infant or a child five years of​ 141.12 age or younger. The county or private licensing agency monitoring the foster care provider​ 141.13 under section 245A.16 must approve of the training about reducing the risk of sudden​ 141.14 unexpected infant death and abusive head trauma from shaking infants and young children.​ 141.15 (b) At a minimum, the training must address the risk factors related to sudden unexpected​ 141.16 infant death and abusive head trauma, means of reducing the risk of sudden unexpected​ 141.17 infant death and abusive head trauma, and license holder communication with parents​ 141.18 regarding reducing the risk of sudden unexpected infant death and abusive head trauma.​ 141.19 (c) For emergency relative placements under section 245A.035, this training must be​ 141.20 completed before a license is issued. Each foster parent and caregiver must complete the​ 141.21 training in this subdivision at least once every five years.​ 141.22 Subd. 6. Training on use of medical equipment. (a) If caring for a child who relies on​ 141.23 medical equipment to sustain the child's life or monitor the child's medical condition, each​ 141.24 foster parent and caregiver must satisfactorily complete training to operate the child's​ 141.25 equipment with a health care professional or an individual who provides training on the​ 141.26 child's equipment.​ 141.27 (b) A foster parent or caregiver is exempt from this subdivision if:​ 141.28 (1) the foster parent or caregiver is currently caring for an individual who is using the​ 141.29 same equipment in the foster home; or​ 141.30 (2) the foster parent or caregiver has written documentation that the foster parent or​ 141.31 caregiver has cared for an individual who relied on the same equipment within the past six​ 141.32 months.​ 141​ Article 6 Sec. 32.​ 23-00276 as introduced​ 01/26/23 REVISOR EB/HL​ 142.1 Subd. 7. Fetal alcohol spectrum disorders training. Each foster parent and caregiver​ 142.2 must complete at least one hour of training yearly on fetal alcohol spectrum disorders. A​ 142.3 provider who is also licensed to provide home and community-based services under chapter​ 142.4 245D and the provider's staff are exempt from this subdivision. A short-term substitute​ 142.5 caregiver is exempt from this subdivision. The commissioner of human services shall approve​ 142.6 a fetal alcohol spectrum disorders training curriculum that satisfies the requirements of this​ 142.7 subdivision.​ 142.8 Subd. 8. Yearly training requirement. (a) Each foster parent must complete a minimum​ 142.9 of 12 hours of training per year. If a foster parent fails to complete the required yearly​ 142.10 training and does not show good cause why the foster parent did not complete the training,​ 142.11 the foster parent is prohibited from accepting a new foster child placement until the foster​ 142.12 parent completes the training. The commissioner may grant a variance to the required number​ 142.13 of yearly training hours.​ 142.14 (b) Each year, each foster parent and caregiver must complete one hour of training about​ 142.15 children's mental health issues according to subdivision 3, and one hour of training about​ 142.16 fetal alcohol spectrum disorders, if required by subdivision 7.​ 142.17 (c) Each year, each foster parent and caregiver must complete training about the reporting​ 142.18 requirements and definitions in chapter 260E, as section 245A.66 requires. Foster parents​ 142.19 and caregivers caring for youth 18 and older in extended foster care must complete training​ 142.20 about the reporting requirements and definitions in section 626.557, as section 245A.65,​ 142.21 subdivision 3 requires.​ 142.22 (d) At least once every five years, each foster parent and caregiver must complete one​ 142.23 hour of training about reducing the risk of sudden unexpected infant death and abusive head​ 142.24 trauma, if required by subdivision 5.​ 142.25 (e) At least once every five years, each foster parent and caregiver must complete training​ 142.26 regarding child passenger restraint systems, if required by subdivision 4.​ 142.27 (f) The commissioner may provide each foster parent with a nonexclusive list of eligible​ 142.28 training topics and resources that fulfill the remaining hours of required yearly training.​ 142.29 Subd. 9. Documentation of training. (a) The licensing agency must document the​ 142.30 trainings that this section requires on a form that the commissioner has developed.​ 142.31 (b) For training required under subdivision 6, the agency must retain a training and skills​ 142.32 form on file and update the form each year for each foster care provider who completes​ 142.33 training about caring for a child who relies on medical equipment to sustain the child's life​ 142​ Article 6 Sec. 32.​ 23-00276 as introduced​ 01/26/23 REVISOR EB/HL​ 143.1 or monitor the child's medical condition. The agency placing the child must obtain a copy​ 143.2 of the training and skills form from the foster parent or from the agency supervising the​ 143.3 foster parent. The agency must retain the form and any updated information on file for the​ 143.4 placement's duration. The form must be available to the parent or guardian and the child's​ 143.5 social worker for the social worker to make an informed placement decision. The agency​ 143.6 must use the training and skills form that the commissioner has developed.​ 143.7 EFFECTIVE DATE. This section is effective January 1, 2024.​ 143.8 Sec. 33. [245A.61] FOSTER RESIDENCE SETTING STAFF TRAINING​ 143.9 REQUIREMENTS.​ 143.10 Subdivision 1. Applicability. This section applies to foster residence settings, which is​ 143.11 defined as foster care that a license holder licensed under this chapter provides in a home​ 143.12 in which the license holder does not reside. Foster residence setting does not include any​ 143.13 program licensed or certified under Minnesota Rules, parts 2960.0010 to 2960.0710. For​ 143.14 the purposes of this section, "caregiver" means a person who provides services to a child​ 143.15 according to the child's case plan in a setting licensed under Minnesota Rules, parts​ 143.16 2960.3000 to 2960.3340.​ 143.17 Subd. 2. Orientation. The license holder must ensure that each staff person attends and​ 143.18 successfully completes at least six hours of orientation training before the staff person has​ 143.19 unsupervised contact with a foster child. Orientation training hours are not counted toward​ 143.20 the hours of yearly training. Orientation must include training about the following:​ 143.21 (1) emergency procedures including evacuation routes, emergency telephone numbers,​ 143.22 severe storm and tornado procedures, and the location of facility alarms and equipment;​ 143.23 (2) all relevant laws, rules, and legal issues, including reporting requirements for​ 143.24 maltreatment, abuse, and neglect specified in chapter 260E and section 626.557 and other​ 143.25 reporting requirements based on the children's ages;​ 143.26 (3) cultural diversity, gender sensitivity, culturally specific services, and information​ 143.27 about discrimination and racial bias to ensure that caregivers are culturally sensitive and​ 143.28 culturally competent to care for foster children according to section 260C.212, subdivision​ 143.29 11;​ 143.30 (4) general and special needs, including disability needs, of children and families served;​ 143.31 (5) operational policies and procedures of the license holder;​ 143.32 (6) data practices requirements and issues;​ 143​ Article 6 Sec. 33.​ 23-00276 as introduced​ 01/26/23 REVISOR EB/HL​ 144.1 (7) two hours of training about children's mental health disorders according to subdivision​ 144.2 3;​ 144.3 (8) if required by subdivision 4, the proper use and installation of child passenger restraint​ 144.4 systems in motor vehicles;​ 144.5 (9) if required by subdivision 5, at least one hour of training about reducing the risk of​ 144.6 sudden unexpected infant death and abusive head trauma from shaking infants and young​ 144.7 children; and​ 144.8 (10) if required by subdivision 6, caring for a child who relies on medical equipment to​ 144.9 sustain the child's life or monitor the child's medical condition.​ 144.10 Subd. 3. Mental health training. Prior to caring for a child, a staff person must complete​ 144.11 two hours of training that addresses the causes, symptoms, and key warning signs of mental​ 144.12 health disorders; cultural considerations; and effective approaches to manage a child's​ 144.13 behaviors. A foster residence staff person must complete at least one hour of the yearly​ 144.14 training requirement regarding children's mental health issues and treatment. The​ 144.15 commissioner of human services shall approve a mental health training curriculum that​ 144.16 satisfies the requirements of this subdivision.​ 144.17 Subd. 4. Child passenger restraint systems. Prior to transporting a child younger than​ 144.18 eight years of age in a motor vehicle, a license holder, staff person, or caregiver must​ 144.19 satisfactorily complete training about the proper use and installation of child restraint systems​ 144.20 in motor vehicles. An individual who is certified and approved by the Office of Traffic​ 144.21 Safety within the Department of Public Safety must provide training to a license holder,​ 144.22 staff person, or caregiver about the proper use and installation of child restraint systems in​ 144.23 motor vehicles.​ 144.24 At a minimum, the training must address the proper use of child passenger restraint​ 144.25 systems based on a child's size, weight, and age and the proper installation of a car seat or​ 144.26 booster seat in the motor vehicle transporting the child. Each license holder, staff person,​ 144.27 and caregiver transporting a child younger than eight years of age in a motor vehicle must​ 144.28 complete the training in this subdivision at least once every five years.​ 144.29 Subd. 5. Training about the risk of sudden unexpected infant death and abusive​ 144.30 head trauma. (a) A license holder who cares for an infant or a child five years of age or​ 144.31 younger must document that each staff person has satisfactorily completed at least one hour​ 144.32 of training about reducing the risk of sudden unexpected infant death pursuant to section​ 144.33 245A.1435 and abusive head trauma from shaking infants and young children. Each staff​ 144.34 person must complete the training in this subdivision prior to caring for an infant or a child​ 144​ Article 6 Sec. 33.​ 23-00276 as introduced​ 01/26/23 REVISOR EB/HL​ 145.1 five years of age or younger. The county or private licensing agency responsible for​ 145.2 monitoring the child foster care provider under section 245A.16 must approve of the training​ 145.3 about reducing the risk of sudden unexpected infant death and abusive head trauma from​ 145.4 shaking infants and young children.​ 145.5 (b) At a minimum, the training must address the risk factors related to sudden unexpected​ 145.6 infant death and abusive head trauma, means of reducing the risk of sudden unexpected​ 145.7 infant death and abusive head trauma, and license holder communication with parents​ 145.8 regarding reducing the risk of sudden unexpected infant death and abusive head trauma​ 145.9 from shaking infants and young children.​ 145.10 (c) Each staff person caring for an infant or a child five years of age or younger must​ 145.11 complete the training in this subdivision at least once every five years.​ 145.12 Subd. 6. Training on use of medical equipment. (a) If caring for a child who relies on​ 145.13 medical equipment to sustain the child's life or monitor a child's medical condition, the​ 145.14 license holder or staff person must complete training to operate the child's equipment. A​ 145.15 health care professional or an individual who provides training on the equipment must train​ 145.16 the license holder or staff person about how to operate the child's equipment.​ 145.17 (b) A license holder is exempt from this subdivision if:​ 145.18 (1) the license holder is currently caring for an individual who is using the same​ 145.19 equipment in the foster home and each staff person has received training to use the​ 145.20 equipment; or​ 145.21 (2) the license holder has written documentation that, within the past six months, the​ 145.22 license holder has cared for an individual who relied on the same equipment and each current​ 145.23 staff person has received training to use the same equipment.​ 145.24 Subd. 7. Fetal alcohol spectrum disorders training. (a) For each staff person, at least​ 145.25 one hour of their yearly training requirement in subdivision 9 must be about fetal alcohol​ 145.26 spectrum disorders. The commissioner of human services shall approve of a fetal alcohol​ 145.27 spectrum disorders training curriculum that satisfies the requirements of this subdivision.​ 145.28 (b) A provider who is also licensed to provide home and community-based services​ 145.29 under chapter 245D and the provider's staff are exempt from this subdivision.​ 145.30 Subd. 8. Prudent parenting standards training. The license holder must have at least​ 145.31 one on-site staff person who is trained regarding the reasonable and prudent parenting​ 145.32 standards in section 260C.212, subdivision 14, and authorized to apply the reasonable and​ 145.33 prudent parenting standards to decisions involving the approval of a foster child's​ 145​ Article 6 Sec. 33.​ 23-00276 as introduced​ 01/26/23 REVISOR EB/HL​ 146.1 participation in age-appropriate and developmentally appropriate extracurricular, social, or​ 146.2 cultural activities. The trained on-site staff person is not required to be available 24 hours​ 146.3 per day.​ 146.4 Subd. 9. Yearly training plan and hours. (a) A license holder must develop a yearly​ 146.5 training plan for staff and volunteers. The license holder must modify training for staff and​ 146.6 volunteers each year to meet each person's current needs and provide sufficient training to​ 146.7 accomplish each staff person's duties. To determine the type and amount of training for​ 146.8 each person, the license holder must consider the foster care program's target population,​ 146.9 the program's services, and expected outcomes from the services, as well as the employee's​ 146.10 job description, tasks, and the position's performance indicators.​ 146.11 (b) A full-time staff person who has direct contact with children must complete at least​ 146.12 18 hours of in-service training per year, including nine hours of skill development training.​ 146.13 (c) A part-time direct care staff person must complete sufficient training to competently​ 146.14 care for children. The amount of training must be at least one hour of training for each 60​ 146.15 hours that the part-time direct care staff person has worked, up to 18 hours of training per​ 146.16 part-time employee per year.​ 146.17 (d) Other foster residence staff and volunteers must complete in-service training​ 146.18 requirements each year that are consistent with the foster residence staff and volunteers'​ 146.19 duties.​ 146.20 (e) Section 245A.66 requires a license holder to ensure that all staff and volunteers have​ 146.21 training yearly about the reporting requirements and definitions in chapter 260E.​ 146.22 Subd. 10. Documentation of training. (a) For each staff person and volunteer, the​ 146.23 license holder must document the date, the number of training hours, and the name of the​ 146.24 entity that provided the training.​ 146.25 (b) For training required under subdivision 6, the agency supervising the foster care​ 146.26 provider must retain a training and skills form on file and update the form each year for​ 146.27 each staff person who completes training about caring for a child who relies on medical​ 146.28 equipment to sustain the child's life or monitor a child's medical condition. The agency​ 146.29 placing the child must obtain a copy of the training and skills form from the foster care​ 146.30 provider or the agency supervising the foster care provider. The placing agency must retain​ 146.31 the form and any updated information on file for the placement's duration. The form must​ 146.32 be available to the child's parent or the child's primary caregiver and the child's social worker​ 146.33 to make an informed placement decision. The agency must use the training and skills form​ 146.34 that the commissioner has developed.​ 146​ Article 6 Sec. 33.​ 23-00276 as introduced​ 01/26/23 REVISOR EB/HL​ 147.1 EFFECTIVE DATE. This section is effective January 1, 2024.​ 147.2 Sec. 34. Minnesota Statutes 2022, section 245A.66, is amended by adding a subdivision​ 147.3 to read:​ 147.4 Subd. 4. Ongoing training requirement. (a) In addition to the orientation training​ 147.5 required by the applicable licensing rules and statutes, children's residential facility, and​ 147.6 private child-placing agency, license holders must provide a training annually on the​ 147.7 maltreatment of minors reporting requirements and definitions in chapter 260E to each​ 147.8 mandatory reporter, as described in section 260E.06, subdivision 1.​ 147.9 (b) In addition to the orientation training required by the applicable licensing rules and​ 147.10 statutes, all family child foster care license holders and caregivers and foster residence​ 147.11 setting staff and volunteers that are mandatory reporters as described in section 260E.06,​ 147.12 subdivision 1, must complete training each year on the maltreatment of minors reporting​ 147.13 requirements and definitions in chapter 260E.​ 147.14 EFFECTIVE DATE. This section is effective January 1, 2024.​ 147.15 Sec. 35. Minnesota Statutes 2022, section 245C.02, subdivision 6a, is amended to read:​ 147.16 Subd. 6a. Child care background study subject. (a) "Child care background study​ 147.17 subject" means an individual who is affiliated with a licensed child care center, certified​ 147.18 license-exempt child care center, licensed family child care program, or legal nonlicensed​ 147.19 child care provider authorized under chapter 119B, and who is:​ 147.20 (1) employed by a child care provider for compensation;​ 147.21 (2) assisting in the care of a child for a child care provider;​ 147.22 (3) a person applying for licensure, certification, or enrollment;​ 147.23 (4) a controlling individual as defined in section 245A.02, subdivision 5a;​ 147.24 (5) an individual 13 years of age or older who lives in the household where the licensed​ 147.25 program will be provided and who is not receiving licensed services from the program;​ 147.26 (6) an individual ten to 12 years of age who lives in the household where the licensed​ 147.27 services will be provided when the commissioner has reasonable cause as defined in section​ 147.28 245C.02, subdivision 15;​ 147.29 (7) an individual who, without providing direct contact services at a licensed program,​ 147.30 certified program, or program authorized under chapter 119B, may have unsupervised access​ 147​ Article 6 Sec. 35.​ 23-00276 as introduced​ 01/26/23 REVISOR EB/HL​ 148.1 to a child receiving services from a program when the commissioner has reasonable cause​ 148.2 as defined in section 245C.02, subdivision 15; or​ 148.3 (8) a volunteer, contractor providing services for hire in the program, prospective​ 148.4 employee, or other individual who has unsupervised physical access to a child served by a​ 148.5 program and who is not under supervision by an individual listed in clause (1) or (5),​ 148.6 regardless of whether the individual provides program services.​ 148.7 (b) Notwithstanding paragraph (a), an individual who is providing services that are not​ 148.8 part of the child care program is not required to have a background study if:​ 148.9 (1) the child receiving services is signed out of the child care program for the duration​ 148.10 that the services are provided;​ 148.11 (2) the licensed child care center, certified license-exempt child care center, licensed​ 148.12 family child care program, or legal nonlicensed child care provider authorized under chapter​ 148.13 119B has obtained advanced written permission from the parent authorizing the child to​ 148.14 receive the services, which is maintained in the child's record;​ 148.15 (3) the licensed child care center, certified license-exempt child care center, licensed​ 148.16 family child care program, or legal nonlicensed child care provider authorized under chapter​ 148.17 119B maintains documentation on site that identifies the individual service provider and​ 148.18 the services being provided; and​ 148.19 (4) the licensed child care center, certified license-exempt child care center, licensed​ 148.20 family child care program, or legal nonlicensed child care provider authorized under chapter​ 148.21 119B ensures that the service provider does not have unsupervised access to a child not​ 148.22 receiving the provider's services.​ 148.23 Sec. 36. Minnesota Statutes 2022, section 245C.02, subdivision 11c, is amended to read:​ 148.24 Subd. 11c. Entity. "Entity" means any program, organization, license holder, government​ 148.25 agency, or agency initiating required to initiate a background study.​ 148.26 Sec. 37. Minnesota Statutes 2022, section 245C.02, is amended by adding a subdivision​ 148.27 to read:​ 148.28 Subd. 11f. Employee. "Employee" means an individual who provides services or seeks​ 148.29 to provide services for the entity with which they are required to be affiliated in NETStudy​ 148.30 2.0 and who is subject to oversight by the entity, which includes but is not limited to​ 148.31 continuous, direct supervision by the entity and being subject to immediate removal from​ 148.32 providing direct care services by the entity when required.​ 148​ Article 6 Sec. 37.​ 23-00276 as introduced​ 01/26/23 REVISOR EB/HL​ 149.1 Sec. 38. Minnesota Statutes 2022, section 245C.02, is amended by adding a subdivision​ 149.2 to read:​ 149.3 Subd. 22. Volunteer. "Volunteer" means an individual who provides or seeks to provide​ 149.4 services for an entity without direct compensation for services provided, is required to be​ 149.5 affiliated in NETStudy 2.0 and is subject to oversight by the entity, including but not limited​ 149.6 to continuous, direct supervision and immediate removal from providing direct care services​ 149.7 when required.​ 149.8 Sec. 39. Minnesota Statutes 2022, section 245C.03, subdivision 1, is amended to read:​ 149.9 Subdivision 1. Licensed programs. (a) The commissioner shall conduct a background​ 149.10 study on:​ 149.11 (1) the person or persons applying for a license;​ 149.12 (2) an individual age 13 and over living in the household where the licensed program​ 149.13 will be provided who is not receiving licensed services from the program;​ 149.14 (3) current or prospective employees or contractors of the applicant who will have direct​ 149.15 contact with persons served by the facility, agency, or program;​ 149.16 (4) volunteers or student volunteers who will have direct contact with persons served​ 149.17 by the program to provide program services if the contact is not under the continuous, direct​ 149.18 supervision by an individual listed in clause (1) or (3);​ 149.19 (5) an individual age ten to 12 living in the household where the licensed services will​ 149.20 be provided when the commissioner has reasonable cause as defined in section 245C.02,​ 149.21 subdivision 15;​ 149.22 (6) an individual who, without providing direct contact services at a licensed program,​ 149.23 may have unsupervised access to children or vulnerable adults receiving services from a​ 149.24 program, when the commissioner has reasonable cause as defined in section 245C.02,​ 149.25 subdivision 15;​ 149.26 (7) all controlling individuals as defined in section 245A.02, subdivision 5a;​ 149.27 (8) notwithstanding the other requirements in this subdivision, child care background​ 149.28 study subjects as defined in section 245C.02, subdivision 6a; and​ 149.29 (9) notwithstanding clause (3), for children's residential facilities and foster residence​ 149.30 settings, any adult working in the facility, whether or not the individual will have direct​ 149.31 contact with persons served by the facility.​ 149​ Article 6 Sec. 39.​ 23-00276 as introduced​ 01/26/23 REVISOR EB/HL​ 150.1 (b) For child foster care when the license holder resides in the home where foster care​ 150.2 services are provided, a short-term substitute caregiver providing direct contact services for​ 150.3 a child for less than 72 hours of continuous care is not required to receive a background​ 150.4 study under this chapter.​ 150.5 (c) This subdivision applies to the following programs that must be licensed under​ 150.6 chapter 245A:​ 150.7 (1) adult foster care;​ 150.8 (2) child foster care;​ 150.9 (3) children's residential facilities;​ 150.10 (4) family child care;​ 150.11 (5) licensed child care centers;​ 150.12 (6) licensed home and community-based services under chapter 245D;​ 150.13 (7) residential mental health programs for adults;​ 150.14 (8) substance use disorder treatment programs under chapter 245G;​ 150.15 (9) withdrawal management programs under chapter 245F;​ 150.16 (10) adult day care centers;​ 150.17 (11) family adult day services;​ 150.18 (12) independent living assistance for youth;​ 150.19 (13) (12) detoxification programs;​ 150.20 (14) (13) community residential settings; and​ 150.21 (15) (14) intensive residential treatment services and residential crisis stabilization under​ 150.22 chapter 245I.​ 150.23 EFFECTIVE DATE. This section is effective the day following final enactment, except​ 150.24 for the change to paragraph (a), clause (3), which is effective August 1, 2023.​ 150.25 Sec. 40. Minnesota Statutes 2022, section 245C.03, subdivision 1, is amended to read:​ 150.26 Subdivision 1. Licensed programs. (a) The commissioner shall conduct a background​ 150.27 study on:​ 150.28 (1) the person or persons applying for a license;​ 150​ Article 6 Sec. 40.​ 23-00276 as introduced​ 01/26/23 REVISOR EB/HL​ 151.1 (2) an individual age 13 and over living in the household where the licensed program​ 151.2 will be provided who is not receiving licensed services from the program;​ 151.3 (3) current or prospective employees or contractors of the applicant who will have direct​ 151.4 contact with persons served by the facility, agency, or program;​ 151.5 (4) volunteers or student volunteers who will have direct contact with persons served​ 151.6 by the program to provide program services if the contact is not under the continuous, direct​ 151.7 supervision by an individual listed in clause (1) or (3);​ 151.8 (5) an individual age ten to 12 living in the household where the licensed services will​ 151.9 be provided when the commissioner has reasonable cause as defined in section 245C.02,​ 151.10 subdivision 15;​ 151.11 (6) an individual who, without providing direct contact services at a licensed program,​ 151.12 may have unsupervised access to children or vulnerable adults receiving services from a​ 151.13 program, when the commissioner has reasonable cause as defined in section 245C.02,​ 151.14 subdivision 15;​ 151.15 (7) all controlling individuals as defined in section 245A.02, subdivision 5a;​ 151.16 (8) notwithstanding the other requirements in this subdivision, child care background​ 151.17 study subjects as defined in section 245C.02, subdivision 6a; and​ 151.18 (9) notwithstanding clause (3), for children's residential facilities and foster residence​ 151.19 settings, any adult working in the facility, whether or not the individual will have direct​ 151.20 contact with persons served by the facility.​ 151.21 (b) For child foster care when the license holder resides in the home where foster care​ 151.22 services are provided, a short-term substitute caregiver providing direct contact services for​ 151.23 a child for less than 72 hours of continuous care is not required to receive a background​ 151.24 study under this chapter.​ 151.25 (c) This subdivision applies to the following programs that must be licensed under​ 151.26 chapter 245A:​ 151.27 (1) adult foster care;​ 151.28 (2) child foster care;​ 151.29 (3) children's residential facilities;​ 151.30 (4) family child care;​ 151.31 (5) licensed child care centers;​ 151​ Article 6 Sec. 40.​ 23-00276 as introduced​ 01/26/23 REVISOR EB/HL​ 152.1 (6) licensed home and community-based services under chapter 245D;​ 152.2 (7) residential mental health programs for adults;​ 152.3 (8) substance use disorder treatment programs under chapter 245G;​ 152.4 (9) withdrawal management programs under chapter 245F;​ 152.5 (10) adult day care centers;​ 152.6 (11) family adult day services;​ 152.7 (12) independent living assistance for youth;​ 152.8 (13) detoxification programs;​ 152.9 (14) community residential settings; and​ 152.10 (15) intensive residential treatment services and residential crisis stabilization under​ 152.11 chapter 245I.​ 152.12 Sec. 41. Minnesota Statutes 2022, section 245C.03, subdivision 1a, is amended to read:​ 152.13 Subd. 1a. Procedure. (a) Individuals and organizations that are required under this​ 152.14 section to have or initiate background studies shall comply with the requirements of this​ 152.15 chapter.​ 152.16 (b) All studies conducted under this section shall be conducted according to sections​ 152.17 299C.60 to 299C.64, including the consent and self-disclosure required in section 299C.62,​ 152.18 subdivision 2. This requirement does not apply to subdivisions 1, paragraph (c), clauses (2)​ 152.19 to (5), and 6a.​ 152.20 Sec. 42. Minnesota Statutes 2022, section 245C.03, subdivision 4, is amended to read:​ 152.21 Subd. 4. Personnel pool agencies; temporary personnel agencies; educational​ 152.22 programs; professional services agencies. (a) The commissioner also may conduct studies​ 152.23 on individuals specified in subdivision 1, paragraph (a), clauses (3) and (4), when the studies​ 152.24 are initiated by:​ 152.25 (1) personnel pool agencies;​ 152.26 (2) temporary personnel agencies;​ 152.27 (3) educational programs that train individuals by providing direct contact services in​ 152.28 licensed programs; and​ 152​ Article 6 Sec. 42.​ 23-00276 as introduced​ 01/26/23 REVISOR EB/HL​ 153.1 (4) professional services agencies that are not licensed and which contract that work​ 153.2 with licensed programs to provide direct contact services or individuals who provide direct​ 153.3 contact services.​ 153.4 (b) Personnel pool agencies, temporary personnel agencies, and professional services​ 153.5 agencies must employ the individuals providing direct care services for children, people​ 153.6 with disabilities, or the elderly. Individuals must be affiliated in NETStudy 2.0 and subject​ 153.7 to oversight by the entity, which includes but is not limited to continuous, direct supervision​ 153.8 by the entity and being subject to immediate removal from providing direct care services​ 153.9 by the entity when required.​ 153.10 Sec. 43. Minnesota Statutes 2022, section 245C.03, subdivision 5, is amended to read:​ 153.11 Subd. 5. Other state agencies. The commissioner shall conduct background studies on​ 153.12 applicants and license holders under the jurisdiction of other state agencies who are required​ 153.13 in other statutory sections to initiate background studies under this chapter, including the​ 153.14 applicant's or license holder's employees, contractors, and volunteers when required under​ 153.15 other statutory sections.​ 153.16 Sec. 44. Minnesota Statutes 2022, section 245C.03, subdivision 5a, is amended to read:​ 153.17 Subd. 5a. Facilities serving children or adults licensed or regulated by the​ 153.18 Department of Health. (a) Except as specified in paragraph (b), the commissioner shall​ 153.19 conduct background studies of:​ 153.20 (1) individuals providing services who have direct contact, as defined under section​ 153.21 245C.02, subdivision 11, with patients and residents in hospitals, boarding care homes,​ 153.22 outpatient surgical centers licensed under sections 144.50 to 144.58; nursing homes and​ 153.23 home care agencies licensed under chapter 144A; assisted living facilities and assisted living​ 153.24 facilities with dementia care licensed under chapter 144G; and board and lodging​ 153.25 establishments that are registered to provide supportive or health supervision services under​ 153.26 section 157.17;​ 153.27 (2) individuals specified in subdivision 2 who provide direct contact services in a nursing​ 153.28 home or a home care agency licensed under chapter 144A; an assisted living facility or​ 153.29 assisted living facility with dementia care licensed under chapter 144G; or a boarding care​ 153.30 home licensed under sections 144.50 to 144.58. If the individual undergoing a study resides​ 153.31 outside of Minnesota, the study must include a check for substantiated findings of​ 153.32 maltreatment of adults and children in the individual's state of residence when the state​ 153.33 makes the information available;​ 153​ Article 6 Sec. 44.​ 23-00276 as introduced​ 01/26/23 REVISOR EB/HL​ 154.1 (3) all other employees in assisted living facilities or assisted living facilities with​ 154.2 dementia care licensed under chapter 144G, nursing homes licensed under chapter 144A,​ 154.3 and boarding care homes licensed under sections 144.50 to 144.58. A disqualification of​ 154.4 an individual in this section shall disqualify the individual from positions allowing direct​ 154.5 contact with or access to patients or residents receiving services. "Access" means physical​ 154.6 access to a client or the client's personal property without continuous, direct supervision as​ 154.7 defined in section 245C.02, subdivision 8, when the employee's employment responsibilities​ 154.8 do not include providing direct contact services;​ 154.9 (4) individuals employed by a supplemental nursing services agency, as defined under​ 154.10 section 144A.70, who are providing services in health care facilities;​ 154.11 (5) controlling persons of a supplemental nursing services agency, as defined by section​ 154.12 144A.70; and​ 154.13 (6) license applicants, owners, managerial officials, and controlling individuals who are​ 154.14 required under section 144A.476, subdivision 1, or 144G.13, subdivision 1, to undergo a​ 154.15 background study under this chapter, regardless of the licensure status of the license applicant,​ 154.16 owner, managerial official, or controlling individual.​ 154.17 (b) The commissioner of human services shall not conduct An entity shall not initiate a​ 154.18 background study on any individual identified in paragraph (a), clauses (1) to (5), if the​ 154.19 individual has a valid license issued by a health-related licensing board as defined in section​ 154.20 214.01, subdivision 2, and has completed the criminal background check as required in​ 154.21 section 214.075. An entity that is affiliated with individuals who meet the requirements of​ 154.22 this paragraph must separate those individuals from the entity's roster for NETStudy 2.0.​ 154.23 The Department of Human Services is not liable for conducting background studies that​ 154.24 have been submitted or not removed from the roster in violation of this provision.​ 154.25 (c) If a facility or program is licensed by the Department of Human Services and the​ 154.26 Department of Health and is subject to the background study provisions of this chapter, the​ 154.27 Department of Human Services is solely responsible for the background studies of individuals​ 154.28 in the jointly licensed program.​ 154.29 (d) The commissioner of health shall review and make decisions regarding reconsideration​ 154.30 requests, including whether to grant variances, according to the procedures and criteria in​ 154.31 this chapter. The commissioner of health shall inform the requesting individual and the​ 154.32 Department of Human Services of the commissioner of health's decision regarding the​ 154.33 reconsideration. The commissioner of health's decision to grant or deny a reconsideration​ 154.34 of a disqualification is a final administrative agency action.​ 154​ Article 6 Sec. 44.​ 23-00276 as introduced​ 01/26/23 REVISOR EB/HL​ 155.1 Sec. 45. Minnesota Statutes 2022, section 245C.031, subdivision 1, is amended to read:​ 155.2 Subdivision 1. Alternative background studies. (a) The commissioner shall conduct​ 155.3 an alternative background study of individuals listed in this section.​ 155.4 (b) Notwithstanding other sections of this chapter, all alternative background studies​ 155.5 except subdivision 12 shall be conducted according to this section and with sections 299C.60​ 155.6 to 299C.64, including the consent and self-disclosure required in section 299C.62, subdivision​ 155.7 2.​ 155.8 (c) All terms in this section shall have the definitions provided in section 245C.02.​ 155.9 (d) The entity that submits an alternative background study request under this section​ 155.10 shall submit the request to the commissioner according to section 245C.05.​ 155.11 (e) The commissioner shall comply with the destruction requirements in section 245C.051.​ 155.12 (f) Background studies conducted under this section are subject to the provisions of​ 155.13 section 245C.32.​ 155.14 (g) The commissioner shall forward all information that the commissioner receives under​ 155.15 section 245C.08 to the entity that submitted the alternative background study request under​ 155.16 subdivision 2. The commissioner shall not make any eligibility determinations regarding​ 155.17 background studies conducted under this section.​ 155.18 Sec. 46. Minnesota Statutes 2022, section 245C.031, subdivision 4, is amended to read:​ 155.19 Subd. 4. Applicants, licensees, and other occupations regulated by the commissioner​ 155.20 of health. The commissioner shall conduct an alternative background study, including a​ 155.21 check of state data, and a national criminal history records check of the following individuals.​ 155.22 For studies under this section, the following persons shall complete a consent form and​ 155.23 criminal history disclosure form:​ 155.24 (1) An applicant for initial licensure, temporary licensure, or relicensure after a lapse in​ 155.25 licensure as an audiologist or speech-language pathologist or an applicant for initial​ 155.26 certification as a hearing instrument dispenser who must submit to a background study​ 155.27 under section 144.0572.​ 155.28 (2) An applicant for a renewal license or certificate as an audiologist, speech-language​ 155.29 pathologist, or hearing instrument dispenser who was licensed or obtained a certificate​ 155.30 before January 1, 2018.​ 155​ Article 6 Sec. 46.​ 23-00276 as introduced​ 01/26/23 REVISOR EB/HL​ 156.1 Sec. 47. Minnesota Statutes 2022, section 245C.05, subdivision 1, is amended to read:​ 156.2 Subdivision 1. Individual studied. (a) The individual who is the subject of the​ 156.3 background study must provide the applicant, license holder, or other entity under section​ 156.4 245C.04 with sufficient information to ensure an accurate study, including:​ 156.5 (1) the individual's first, middle, and last name and all other names by which the​ 156.6 individual has been known;​ 156.7 (2) current home address, city, and state of residence;​ 156.8 (3) current zip code;​ 156.9 (4) sex;​ 156.10 (5) date of birth;​ 156.11 (6) driver's license number or state identification number or, for those without a driver's​ 156.12 license or state identification card, an acceptable form of identification as determined by​ 156.13 the commissioner; and​ 156.14 (7) upon implementation of NETStudy 2.0, the home address, city, county, and state of​ 156.15 residence for the past five years.​ 156.16 (b) Every subject of a background study conducted or initiated by counties or private​ 156.17 agencies under this chapter must also provide the home address, city, county, and state of​ 156.18 residence for the past five years.​ 156.19 (c) Every subject of a background study related to private agency adoptions or related​ 156.20 to child foster care licensed through a private agency, who is 18 years of age or older, shall​ 156.21 also provide the commissioner a signed consent for the release of any information received​ 156.22 from national crime information databases to the private agency that initiated the background​ 156.23 study.​ 156.24 (d) The subject of a background study who is 18 years of age or older shall provide​ 156.25 fingerprints and a photograph as required in subdivision 5. The subject of a background​ 156.26 study who is 17 years of age or younger shall provide fingerprints and a photograph only​ 156.27 as required in subdivision 5a.​ 156.28 (e) The subject of a background study shall submit a completed criminal and maltreatment​ 156.29 history records check consent form and criminal history disclosure form for applicable​ 156.30 national and state level record checks.​ 156​ Article 6 Sec. 47.​ 23-00276 as introduced​ 01/26/23 REVISOR EB/HL​ 157.1 Sec. 48. Minnesota Statutes 2022, section 245C.05, subdivision 5a, is amended to read:​ 157.2 Subd. 5a. Background study requirements for minors. (a) A background study​ 157.3 completed under this chapter on a subject who is required to be studied under section​ 157.4 245C.03, subdivision 1, and is 17 years of age or younger shall be completed by the​ 157.5 commissioner for:​ 157.6 (1) a legal nonlicensed child care provider authorized under chapter 119B;​ 157.7 (2) a licensed family child care program; or​ 157.8 (3) a licensed foster care home.​ 157.9 (b) The subject shall submit to the commissioner only the information under subdivision​ 157.10 1, paragraph (a).​ 157.11 (c) Notwithstanding paragraph (b), a subject who is 17 years of age or younger is required​ 157.12 to submit fingerprints and a photograph, and the commissioner shall conduct a national​ 157.13 criminal history record check must provide the commissioner with a set of the background​ 157.14 study subject's classifiable fingerprints and photograph, if:​ 157.15 (1) the commissioner has reasonable cause to require a national criminal history record​ 157.16 check defined in section 245C.02, subdivision 15a; or​ 157.17 (2) under paragraph (a), clauses (1) and (2), the subject is employed by the provider or​ 157.18 supervises children served by the program.​ 157.19 (d) A subject who is 17 years of age or younger is required to submit​ 157.20 non-fingerprint-based data according to section 245C.08, subdivision 1, paragraph (a),​ 157.21 clause (6), item (iii), and the commissioner shall conduct the check if:​ 157.22 (1) the commissioner has reasonable cause to require a national criminal history record​ 157.23 check defined in section 245C.02, subdivision 15a; or​ 157.24 (2) the subject is employed by the provider or supervises children served by the program​ 157.25 under paragraph (a), clauses (1) and (2).​ 157.26 Sec. 49. Minnesota Statutes 2022, section 245C.05, is amended by adding a subdivision​ 157.27 to read:​ 157.28 Subd. 8. Study submitted. The entity with which the background study subject is seeking​ 157.29 affiliation shall initiate the background study in the NETStudy 2.0 system.​ 157​ Article 6 Sec. 49.​ 23-00276 as introduced​ 01/26/23 REVISOR EB/HL​ 158.1 Sec. 50. Minnesota Statutes 2022, section 245C.07, is amended to read:​ 158.2 245C.07 STUDY SUBJECT AFFILIATED WITH MULTIPLE FACILITIES.​ 158.3 (a) Subject to the conditions in paragraph (d), when a license holder, applicant, or other​ 158.4 entity owns multiple programs or services that are licensed by the Department of Human​ 158.5 Services, Department of Health, or Department of Corrections, only one background study​ 158.6 is required for an individual who provides direct contact services in one or more of the​ 158.7 licensed programs or services if:​ 158.8 (1) the license holder designates one individual with one address and telephone number​ 158.9 as the person to receive sensitive background study information for the multiple licensed​ 158.10 programs or services that depend on the same background study; and​ 158.11 (2) the individual designated to receive the sensitive background study information is​ 158.12 capable of determining, upon request of the department, whether a background study subject​ 158.13 is providing direct contact services in one or more of the license holder's programs or services​ 158.14 and, if so, at which location or locations.​ 158.15 (b) When a license holder maintains background study compliance for multiple licensed​ 158.16 programs according to paragraph (a), and one or more of the licensed programs closes, the​ 158.17 license holder shall immediately notify the commissioner which staff must be transferred​ 158.18 to an active license so that the background studies can be electronically paired with the​ 158.19 license holder's active program.​ 158.20 (c) When a background study is being initiated by a licensed program or service or a​ 158.21 foster care provider that is also licensed under chapter 144G, a study subject affiliated with​ 158.22 multiple licensed programs or services may attach to the background study form a cover​ 158.23 letter indicating the additional names of the programs or services, addresses, and background​ 158.24 study identification numbers.​ 158.25 When the commissioner receives a notice, the commissioner shall notify each program​ 158.26 or service identified by the background study subject of the study results.​ 158.27 The background study notice the commissioner sends to the subsequent agencies shall​ 158.28 satisfy those programs' or services' responsibilities for initiating a background study on that​ 158.29 individual.​ 158.30 (d) If a background study was conducted on an individual related to child foster care​ 158.31 and the requirements under paragraph (a) are met, the background study is transferable​ 158.32 across all licensed programs. If a background study was conducted on an individual under​ 158​ Article 6 Sec. 50.​ 23-00276 as introduced​ 01/26/23 REVISOR EB/HL​ 159.1 a license other than child foster care and the requirements under paragraph (a) are met, the​ 159.2 background study is transferable to all licensed programs except child foster care.​ 159.3 (e) The provisions of this section that allow a single background study in one or more​ 159.4 licensed programs or services do not apply to background studies submitted by adoption​ 159.5 agencies, supplemental nursing services agencies, personnel pool agencies, educational​ 159.6 programs, professional services agencies, temporary personnel agencies, and unlicensed​ 159.7 personal care provider organizations.​ 159.8 (f) For an entity operating under NETStudy 2.0, the entity's active roster must be the​ 159.9 system used to document when a background study subject is affiliated with multiple entities.​ 159.10 For a background study to be transferable:​ 159.11 (1) the background study subject must be on and moving to a roster for which the person​ 159.12 designated to receive sensitive background study information is the same; and​ 159.13 (2) the same entity must own or legally control both the roster from which the transfer​ 159.14 is occurring and the roster to which the transfer is occurring. For an entity that holds or​ 159.15 controls multiple licenses, or unlicensed personal care provider organizations, there must​ 159.16 be a common highest level entity that has a legally identifiable structure that can be verified​ 159.17 through records available from the secretary of state.​ 159.18 Sec. 51. Minnesota Statutes 2022, section 245C.08, subdivision 1, is amended to read:​ 159.19 Subdivision 1. Background studies conducted by Department of Human Services. (a)​ 159.20 For a background study conducted by the Department of Human Services, the commissioner​ 159.21 shall review:​ 159.22 (1) information related to names of substantiated perpetrators of maltreatment of​ 159.23 vulnerable adults that has been received by the commissioner as required under section​ 159.24 626.557, subdivision 9c, paragraph (j);​ 159.25 (2) the commissioner's records relating to the maltreatment of minors in licensed​ 159.26 programs, and from findings of maltreatment of minors as indicated through the social​ 159.27 service information system;​ 159.28 (3) information from juvenile courts as required in subdivision 4 for individuals listed​ 159.29 in section 245C.03, subdivision 1, paragraph (a), when there is reasonable cause;​ 159.30 (4) information from the Bureau of Criminal Apprehension, including information​ 159.31 regarding a background study subject's registration in Minnesota as a predatory offender​ 159.32 under section 243.166;​ 159​ Article 6 Sec. 51.​ 23-00276 as introduced​ 01/26/23 REVISOR EB/HL​ 160.1 (5) except as provided in clause (6), information received as a result of submission of​ 160.2 fingerprints for a national criminal history record check, as defined in section 245C.02,​ 160.3 subdivision 13c, when the commissioner has reasonable cause for a national criminal history​ 160.4 record check as defined under section 245C.02, subdivision 15a, or as required under section​ 160.5 144.057, subdivision 1, clause (2);​ 160.6 (6) for a background study related to a child foster family setting application for licensure,​ 160.7 foster residence settings, children's residential facilities, a transfer of permanent legal and​ 160.8 physical custody of a child under sections 260C.503 to 260C.515, or adoptions, and for a​ 160.9 background study required for family child care, certified license-exempt child care, child​ 160.10 care centers, and legal nonlicensed child care authorized under chapter 119B, the​ 160.11 commissioner shall also review:​ 160.12 (i) information from the child abuse and neglect registry for any state in which the​ 160.13 background study subject has resided for the past five years;​ 160.14 (ii) when the background study subject is 18 years of age or older, or a minor under​ 160.15 section 245C.05, subdivision 5a, paragraph (c), information received following submission​ 160.16 of fingerprints for a national criminal history record check; and​ 160.17 (iii) when the background study subject is 18 years of age or older or a minor under​ 160.18 section 245C.05, subdivision 5a, paragraph (d), for licensed family child care, certified​ 160.19 license-exempt child care, licensed child care centers, and legal nonlicensed child care​ 160.20 authorized under chapter 119B, information obtained using non-fingerprint-based data​ 160.21 including information from the criminal and sex offender registries for any state in which​ 160.22 the background study subject resided for the past five years and information from the national​ 160.23 crime information database and the national sex offender registry; and​ 160.24 (7) for a background study required for family child care, certified license-exempt child​ 160.25 care centers, licensed child care centers, and legal nonlicensed child care authorized under​ 160.26 chapter 119B, the background study shall also include, to the extent practicable, a name​ 160.27 and date-of-birth search of the National Sex Offender Public website.​ 160.28 (b) Notwithstanding expungement by a court, the commissioner may consider information​ 160.29 obtained under paragraph (a), clauses (3) and (4), unless the commissioner received notice​ 160.30 of the petition for expungement and the court order for expungement is directed specifically​ 160.31 to the commissioner.​ 160.32 (c) The commissioner shall also review criminal case information received according​ 160.33 to section 245C.04, subdivision 4a, from the Minnesota court information system that relates​ 160​ Article 6 Sec. 51.​ 23-00276 as introduced​ 01/26/23 REVISOR EB/HL​ 161.1 to individuals who have already been studied under this chapter and who remain affiliated​ 161.2 with the agency that initiated the background study.​ 161.3 (d) When the commissioner has reasonable cause to believe that the identity of a​ 161.4 background study subject is uncertain, the commissioner may require the subject to provide​ 161.5 a set of classifiable fingerprints for purposes of completing a fingerprint-based record check​ 161.6 with the Bureau of Criminal Apprehension. Fingerprints collected under this paragraph​ 161.7 shall not be saved by the commissioner after they have been used to verify the identity of​ 161.8 the background study subject against the particular criminal record in question.​ 161.9 (e) The commissioner may inform the entity that initiated a background study under​ 161.10 NETStudy 2.0 of the status of processing of the subject's fingerprints.​ 161.11 Sec. 52. Minnesota Statutes 2022, section 245C.10, subdivision 4, is amended to read:​ 161.12 Subd. 4. Temporary personnel agencies, personnel pool agencies, educational​ 161.13 programs, and professional services agencies. The commissioner shall recover the cost​ 161.14 of the background studies initiated by temporary personnel agencies, personnel pool agencies,​ 161.15 educational programs, and professional services agencies that initiate background studies​ 161.16 under section 245C.03, subdivision 4, through a fee of no more than $42 per study charged​ 161.17 to the agency. The fees collected under this subdivision are appropriated to the commissioner​ 161.18 for the purpose of conducting background studies.​ 161.19 Sec. 53. Minnesota Statutes 2022, section 245C.15, subdivision 4a, is amended to read:​ 161.20 Subd. 4a. Licensed family foster setting disqualifications. (a) Notwithstanding​ 161.21 subdivisions 1 to 4, for a background study affiliated with a licensed family foster setting,​ 161.22 regardless of how much time has passed, an individual is disqualified under section 245C.14​ 161.23 if the individual committed an act that resulted in a felony-level conviction for sections:​ 161.24 609.185 (murder in the first degree); 609.19 (murder in the second degree); 609.195 (murder​ 161.25 in the third degree); 609.20 (manslaughter in the first degree); 609.205 (manslaughter in​ 161.26 the second degree); 609.2112 (criminal vehicular homicide); 609.221 (assault in the first​ 161.27 degree); 609.223, subdivision 2 (assault in the third degree, past pattern of child abuse);​ 161.28 609.223, subdivision 3 (assault in the third degree, victim under four); a felony offense​ 161.29 under sections 609.2242 and 609.2243 (domestic assault, spousal abuse, child abuse or​ 161.30 neglect, or a crime against children); 609.2247 (domestic assault by strangulation); 609.2325​ 161.31 (criminal abuse of a vulnerable adult resulting in the death of a vulnerable adult); 609.245​ 161.32 (aggravated robbery); 609.25 (kidnapping); 609.255 (false imprisonment); 609.2661 (murder​ 161.33 of an unborn child in the first degree); 609.2662 (murder of an unborn child in the second​ 161​ Article 6 Sec. 53.​ 23-00276 as introduced​ 01/26/23 REVISOR EB/HL​ 162.1 degree); 609.2663 (murder of an unborn child in the third degree); 609.2664 (manslaughter​ 162.2 of an unborn child in the first degree); 609.2665 (manslaughter of an unborn child in the​ 162.3 second degree); 609.267 (assault of an unborn child in the first degree); 609.2671 (assault​ 162.4 of an unborn child in the second degree); 609.268 (injury or death of an unborn child in the​ 162.5 commission of a crime); 609.322, subdivision 1 (solicitation, inducement, and promotion​ 162.6 of prostitution; sex trafficking in the first degree); 609.324, subdivision 1 (other prohibited​ 162.7 acts; engaging in, hiring, or agreeing to hire minor to engage in prostitution); 609.342​ 162.8 (criminal sexual conduct in the first degree); 609.343 (criminal sexual conduct in the second​ 162.9 degree); 609.344 (criminal sexual conduct in the third degree); 609.345 (criminal sexual​ 162.10 conduct in the fourth degree); 609.3451 (criminal sexual conduct in the fifth degree);​ 162.11 609.3453 (criminal sexual predatory conduct); 609.352 (solicitation of children to engage​ 162.12 in sexual conduct); 609.377 (malicious punishment of a child); 609.378 (neglect or​ 162.13 endangerment of a child); 609.561 (arson in the first degree); 609.582, subdivision 1 (burglary​ 162.14 in the first degree); 609.746 (interference with privacy); 617.23 (indecent exposure); 617.246​ 162.15 (use of minors in sexual performance prohibited); or 617.247 (possession of pictorial​ 162.16 representations of minors).​ 162.17 (b) Notwithstanding subdivisions 1 to 4, for the purposes of a background study affiliated​ 162.18 with a licensed family foster setting, an individual is disqualified under section 245C.14,​ 162.19 regardless of how much time has passed, if the individual:​ 162.20 (1) committed an action under paragraph (e) that resulted in death or involved sexual​ 162.21 abuse, as defined in section 260E.03, subdivision 20;, or 626.5572, subdivision 2, paragraph​ 162.22 (a), clause (4), or paragraph (c);​ 162.23 (2) committed an act that resulted in a gross misdemeanor-level conviction for section​ 162.24 609.3451 (criminal sexual conduct in the fifth degree);​ 162.25 (3) committed an act against or involving a minor that resulted in a felony-level conviction​ 162.26 for: section 609.222 (assault in the second degree); 609.223, subdivision 1 (assault in the​ 162.27 third degree); 609.2231 (assault in the fourth degree); or 609.224 (assault in the fifth degree);​ 162.28 or​ 162.29 (4) committed an act that resulted in a misdemeanor or gross misdemeanor-level​ 162.30 conviction for section 617.293 (dissemination and display of harmful materials to minors).​ 162.31 (c) Notwithstanding subdivisions 1 to 4, for a background study affiliated with a licensed​ 162.32 family foster setting, an individual is disqualified under section 245C.14 if fewer than 20​ 162.33 years have passed since the termination of the individual's parental rights under section​ 162.34 260C.301, subdivision 1, paragraph (b), or if the individual consented to a termination of​ 162​ Article 6 Sec. 53.​ 23-00276 as introduced​ 01/26/23 REVISOR EB/HL​ 163.1 parental rights under section 260C.301, subdivision 1, paragraph (a), to settle a petition to​ 163.2 involuntarily terminate parental rights. An individual is disqualified under section 245C.14​ 163.3 if fewer than 20 years have passed since the termination of the individual's parental rights​ 163.4 in any other state or country, where the conditions for the individual's termination of parental​ 163.5 rights are substantially similar to the conditions in section 260C.301, subdivision 1, paragraph​ 163.6 (b).​ 163.7 (d) Notwithstanding subdivisions 1 to 4, for a background study affiliated with a licensed​ 163.8 family foster setting, an individual is disqualified under section 245C.14 if fewer than five​ 163.9 years have passed since a felony-level violation for sections: 152.021 (controlled substance​ 163.10 crime in the first degree); 152.022 (controlled substance crime in the second degree); 152.023​ 163.11 (controlled substance crime in the third degree); 152.024 (controlled substance crime in the​ 163.12 fourth degree); 152.025 (controlled substance crime in the fifth degree); 152.0261 (importing​ 163.13 controlled substances across state borders); 152.0262, subdivision 1, paragraph (b)​ 163.14 (possession of substance with intent to manufacture methamphetamine); 152.027, subdivision​ 163.15 6, paragraph (c) (sale or possession of synthetic cannabinoids); 152.096 (conspiracies​ 163.16 prohibited); 152.097 (simulated controlled substances); 152.136 (anhydrous ammonia;​ 163.17 prohibited conduct; criminal penalties; civil liabilities); 152.137 (methamphetamine-related​ 163.18 crimes involving children or vulnerable adults); 169A.24 (felony first-degree driving while​ 163.19 impaired); 243.166 (violation of predatory offender registration requirements); 609.2113​ 163.20 (criminal vehicular operation; bodily harm); 609.2114 (criminal vehicular operation; unborn​ 163.21 child); 609.228 (great bodily harm caused by distribution of drugs); 609.2325 (criminal​ 163.22 abuse of a vulnerable adult not resulting in the death of a vulnerable adult); 609.233 (criminal​ 163.23 neglect); 609.235 (use of drugs to injure or facilitate a crime); 609.24 (simple robbery);​ 163.24 609.322, subdivision 1a (solicitation, inducement, and promotion of prostitution; sex​ 163.25 trafficking in the second degree); 609.498, subdivision 1 (tampering with a witness in the​ 163.26 first degree); 609.498, subdivision 1b (aggravated first-degree witness tampering); 609.562​ 163.27 (arson in the second degree); 609.563 (arson in the third degree); 609.582, subdivision 2​ 163.28 (burglary in the second degree); 609.66 (felony dangerous weapons); 609.687 (adulteration);​ 163.29 609.713 (terroristic threats); 609.749, subdivision 3, 4, or 5 (felony-level harassment or​ 163.30 stalking); 609.855, subdivision 5 (shooting at or in a public transit vehicle or facility); or​ 163.31 624.713 (certain people not to possess firearms).​ 163.32 (e) Notwithstanding subdivisions 1 to 4, except as provided in paragraph (a), for a​ 163.33 background study affiliated with a licensed family child foster care license, an individual​ 163.34 is disqualified under section 245C.14 if fewer than five years have passed since:​ 163​ Article 6 Sec. 53.​ 23-00276 as introduced​ 01/26/23 REVISOR EB/HL​ 164.1 (1) a felony-level violation for an act not against or involving a minor that constitutes:​ 164.2 section 609.222 (assault in the second degree); 609.223, subdivision 1 (assault in the third​ 164.3 degree); 609.2231 (assault in the fourth degree); or 609.224, subdivision 4 (assault in the​ 164.4 fifth degree);​ 164.5 (2) a violation of an order for protection under section 518B.01, subdivision 14;​ 164.6 (3) a determination or disposition of the individual's failure to make required reports​ 164.7 under section 260E.06 or 626.557, subdivision 3, for incidents in which the final disposition​ 164.8 under chapter 260E or section 626.557 was substantiated maltreatment and the maltreatment​ 164.9 was recurring or serious;​ 164.10 (4) a determination or disposition of the individual's substantiated serious or recurring​ 164.11 maltreatment of a minor under chapter 260E, a vulnerable adult under section 626.557, or​ 164.12 serious or recurring maltreatment in any other state, the elements of which are substantially​ 164.13 similar to the elements of maltreatment under chapter 260E or section 626.557 and meet​ 164.14 the definition of serious maltreatment or recurring maltreatment;​ 164.15 (5) a gross misdemeanor-level violation for sections: 609.224, subdivision 2 (assault in​ 164.16 the fifth degree); 609.2242 and 609.2243 (domestic assault); 609.233 (criminal neglect);​ 164.17 609.377 (malicious punishment of a child); 609.378 (neglect or endangerment of a child);​ 164.18 609.746 (interference with privacy); 609.749 (stalking); or 617.23 (indecent exposure); or​ 164.19 (6) committing an act against or involving a minor that resulted in a misdemeanor-level​ 164.20 violation of section 609.224, subdivision 1 (assault in the fifth degree).​ 164.21 (f) For purposes of this subdivision, the disqualification begins from:​ 164.22 (1) the date of the alleged violation, if the individual was not convicted;​ 164.23 (2) the date of conviction, if the individual was convicted of the violation but not​ 164.24 committed to the custody of the commissioner of corrections; or​ 164.25 (3) the date of release from prison, if the individual was convicted of the violation and​ 164.26 committed to the custody of the commissioner of corrections.​ 164.27 Notwithstanding clause (3), if the individual is subsequently reincarcerated for a violation​ 164.28 of the individual's supervised release, the disqualification begins from the date of release​ 164.29 from the subsequent incarceration.​ 164.30 (g) An individual's aiding and abetting, attempt, or conspiracy to commit any of the​ 164.31 offenses listed in paragraphs (a) and (b), as each of these offenses is defined in Minnesota​ 164.32 Statutes, permanently disqualifies the individual under section 245C.14. An individual is​ 164​ Article 6 Sec. 53.​ 23-00276 as introduced​ 01/26/23 REVISOR EB/HL​ 165.1 disqualified under section 245C.14 if fewer than five years have passed since the individual's​ 165.2 aiding and abetting, attempt, or conspiracy to commit any of the offenses listed in paragraphs​ 165.3 (d) and (e).​ 165.4 (h) An individual's offense in any other state or country, where the elements of the​ 165.5 offense are substantially similar to any of the offenses listed in paragraphs (a) and (b),​ 165.6 permanently disqualifies the individual under section 245C.14. An individual is disqualified​ 165.7 under section 245C.14 if fewer than five years have passed since an offense in any other​ 165.8 state or country, the elements of which are substantially similar to the elements of any​ 165.9 offense listed in paragraphs (d) and (e).​ 165.10 EFFECTIVE DATE. This section is effective the day following final enactment.​ 165.11 Sec. 54. Minnesota Statutes 2022, section 245C.30, subdivision 2, is amended to read:​ 165.12 Subd. 2. Disclosure of reason for disqualification. (a) The commissioner may not grant​ 165.13 a variance for a disqualified individual unless the applicant, license-exempt child care center​ 165.14 certification holder, or license holder requests the variance and the disqualified individual​ 165.15 provides written consent for the commissioner to disclose to the applicant, license-exempt​ 165.16 child care center certification holder, or license holder the reason for the disqualification.​ 165.17 (b) This subdivision does not apply to programs licensed to provide family child care​ 165.18 for children, foster care for children in the provider's own home, or foster care or day care​ 165.19 services for adults in the provider's own home. When the commissioner grants a variance​ 165.20 for a disqualified individual in connection with a license to provide the services specified​ 165.21 in this paragraph, the disqualified individual's consent is not required to disclose the reason​ 165.22 for the disqualification to the license holder in the variance issued under subdivision 1,​ 165.23 provided that the commissioner may not disclose the reason for the disqualification if the​ 165.24 disqualification is based on a felony-level conviction for a drug-related offense within the​ 165.25 past five years.​ 165.26 Sec. 55. Minnesota Statutes 2022, section 245C.31, subdivision 1, is amended to read:​ 165.27 Subdivision 1. Board determines disciplinary or corrective action. (a) The​ 165.28 commissioner shall notify a health-related licensing board as defined in section 214.01,​ 165.29 subdivision 2, if the commissioner determines that an individual who is licensed by the​ 165.30 health-related licensing board and who is included on the board's roster list provided in​ 165.31 accordance with subdivision 3a is responsible for substantiated maltreatment under section​ 165.32 626.557 or chapter 260E, in accordance with subdivision 2. Upon receiving notification,​ 165​ Article 6 Sec. 55.​ 23-00276 as introduced​ 01/26/23 REVISOR EB/HL​ 166.1 the health-related licensing board shall make a determination as to whether to impose​ 166.2 disciplinary or corrective action under chapter 214.​ 166.3 (b) This section does not apply to a background study of an individual regulated by a​ 166.4 health-related licensing board if the individual's study is related to child foster care, adult​ 166.5 foster care, or family child care licensure.​ 166.6 Sec. 56. Minnesota Statutes 2022, section 245C.33, subdivision 4, is amended to read:​ 166.7 Subd. 4. Information commissioner reviews. (a) The commissioner shall review the​ 166.8 following information regarding the background study subject:​ 166.9 (1) the information under section 245C.08, subdivisions 1, 3, and 4;​ 166.10 (2) information from the child abuse and neglect registry for any state in which the​ 166.11 subject has resided for the past five years; and​ 166.12 (3) information from national crime information databases, when required under section​ 166.13 245C.08.​ 166.14 (b) The commissioner shall provide any information collected under this subdivision to​ 166.15 the county or private agency that initiated the background study. The commissioner shall​ 166.16 also provide the agency:​ 166.17 (1) with a notice whether the information collected shows that the subject of the​ 166.18 background study has a conviction listed in United States Code, title 42, section​ 166.19 671(a)(20)(A); and.​ 166.20 (2) for background studies conducted under subdivision 1, paragraph (a), the date of all​ 166.21 adoption-related background studies completed on the subject by the commissioner after​ 166.22 June 30, 2007, and the name of the county or private agency that initiated the adoption-related​ 166.23 background study.​ 166.24 Sec. 57. Minnesota Statutes 2022, section 245E.06, subdivision 3, is amended to read:​ 166.25 Subd. 3. Appeal of department action. A provider's rights related to the department's​ 166.26 action taken under this chapter against a provider are established in sections 119B.16 and,​ 166.27 119B.161, and 119B.162.​ 166​ Article 6 Sec. 57.​ 23-00276 as introduced​ 01/26/23 REVISOR EB/HL​ 167.1 Sec. 58. Minnesota Statutes 2022, section 245E.08, is amended to read:​ 167.2 245E.08 REPORTING OF SUSPECTED FRAUDULENT ACTIVITY.​ 167.3 (a) A person who, in good faith, makes a report of or testifies in any action or proceeding​ 167.4 in which financial misconduct is alleged, and who is not involved in, has not participated​ 167.5 in, or has not aided and abetted, conspired, or colluded in the financial misconduct, shall​ 167.6 have immunity from any liability, civil or criminal, that results by reason of the person's​ 167.7 report or testimony. For the purpose of any proceeding, the good faith of any person reporting​ 167.8 or testifying under this provision shall be presumed.​ 167.9 (b) If a person that is or has been involved in, participated in, aided and abetted, conspired,​ 167.10 or colluded in the financial misconduct reports the financial misconduct, the department​ 167.11 may consider that person's report and assistance in investigating the misconduct as a​ 167.12 mitigating factor in the department's pursuit of civil, criminal, or administrative remedies.​ 167.13 (c) After an investigation is complete, the reporter's name must be kept confidential.​ 167.14 The subject of the report may compel disclosure of the reporter's name only with the consent​ 167.15 of the reporter or upon a written finding by a district court that the report was false and there​ 167.16 is evidence that the report was made in bad faith. This paragraph does not alter disclosure​ 167.17 responsibilities or obligations under the Rules of Criminal Procedure, except that when the​ 167.18 identity of the reporter is relevant to a criminal prosecution the district court shall conduct​ 167.19 an in-camera review before determining whether to order disclosure of the reporter's identity.​ 167.20 Sec. 59. Minnesota Statutes 2022, section 245G.13, subdivision 2, is amended to read:​ 167.21 Subd. 2. Staff development. (a) A license holder must ensure that each staff member​ 167.22 has the training described in this subdivision.​ 167.23 (b) Each staff member must be trained every two years in:​ 167.24 (1) client confidentiality rules and regulations and client ethical boundaries; and​ 167.25 (2) emergency procedures and client rights as specified in sections 144.651, 148F.165,​ 167.26 and 253B.03.​ 167.27 (c) Annually each staff member with direct contact must be trained on mandatory​ 167.28 reporting as specified in sections 245A.65, 626.557, and 626.5572, and chapter 260E,​ 167.29 including specific training covering the license holder's policies for obtaining a release of​ 167.30 client information.​ 167.31 (d) Upon employment and annually thereafter, each staff member with direct contact​ 167.32 must receive training on HIV minimum standards according to section 245A.19.​ 167​ Article 6 Sec. 59.​ 23-00276 as introduced​ 01/26/23 REVISOR EB/HL​ 168.1 (e) The license holder must ensure that each mandatory reporter, as described in section​ 168.2 260E.06, subdivision 1, is trained on the maltreatment of minors reporting requirements​ 168.3 and definitions in chapter 260E before the mandatory reporter has direct contact, as defined​ 168.4 in section 245C.02, subdivision 11, with a person served by the program.​ 168.5 (e) (f) A treatment director, supervisor, nurse, or counselor must have a minimum of 12​ 168.6 hours of training in co-occurring disorders that includes competencies related to philosophy,​ 168.7 trauma-informed care, screening, assessment, diagnosis and person-centered treatment​ 168.8 planning, documentation, programming, medication, collaboration, mental health​ 168.9 consultation, and discharge planning. A new staff member who has not obtained the training​ 168.10 must complete the training within six months of employment. A staff member may request,​ 168.11 and the license holder may grant, credit for relevant training obtained before employment,​ 168.12 which must be documented in the staff member's personnel file.​ 168.13 EFFECTIVE DATE. This section is effective January 1, 2024.​ 168.14 Sec. 60. Minnesota Statutes 2022, section 245H.03, is amended by adding a subdivision​ 168.15 to read:​ 168.16 Subd. 5. Notification required. (a) A certification holder must notify the commissioner,​ 168.17 in a manner prescribed by the commissioner, and obtain the commissioner's approval before​ 168.18 making any changes:​ 168.19 (1) to the certification holder as defined in section 245H.01, subdivision 4;​ 168.20 (2) to the certification holder contact person as defined in section 245H.01, subdivision​ 168.21 4a;​ 168.22 (3) to the certification holder information on file with the secretary of state or Department​ 168.23 of Revenue;​ 168.24 (4) in the location of the program certified under this chapter;​ 168.25 (5) to the ages of children served by the program; or​ 168.26 (6) to the certified center's schedule including its:​ 168.27 (i) yearly schedule;​ 168.28 (ii) hours of operation; or​ 168.29 (iii) days of the week it is open.​ 168.30 (b) When, for reasons beyond the certification holder's control, a certification holder​ 168.31 cannot provide the commissioner with prior notice of the changes in paragraph (a), the​ 168​ Article 6 Sec. 60.​ 23-00276 as introduced​ 01/26/23 REVISOR EB/HL​ 169.1 certification holder must notify the commissioner by the tenth business day after the change​ 169.2 and must provide any additional information requested by the commissioner.​ 169.3 (c) When a certification holder notifies the commissioner of a change to the certification​ 169.4 holder information on file with the secretary of state, the certification holder must provide​ 169.5 documentation of the change.​ 169.6 (d) Upon implementation of the provider licensing and reporting hub, certification holders​ 169.7 must enter and update information in the hub in a manner prescribed by the commissioner.​ 169.8 EFFECTIVE DATE. This section is effective August 1, 2023.​ 169.9 Sec. 61. Minnesota Statutes 2022, section 245H.05, is amended to read:​ 169.10 245H.05 MONITORING AND INSPECTIONS.​ 169.11 (a) The commissioner must conduct an on-site inspection of a certified license-exempt​ 169.12 child care center at least annually once each calendar year to determine compliance with​ 169.13 the health, safety, and fire standards specific to a certified license-exempt child care center.​ 169.14 (b) No later than November 19, 2017, the commissioner shall make publicly available​ 169.15 on the department's website the results of inspection reports for all certified centers including​ 169.16 the number of deaths, serious injuries, and instances of substantiated child maltreatment​ 169.17 that occurred in certified centers each year.​ 169.18 EFFECTIVE DATE. This section is effective the day following final enactment.​ 169.19 Sec. 62. Minnesota Statutes 2022, section 245H.08, subdivision 4, is amended to read:​ 169.20 Subd. 4. Maximum group size. (a) For a child six weeks old through 16 months old,​ 169.21 the maximum group size shall be no more than eight children.​ 169.22 (b) For a child 16 months old through 33 months old, the maximum group size shall be​ 169.23 no more than 14 children.​ 169.24 (c) For a child 33 months old through prekindergarten, a maximum group size shall be​ 169.25 no more than 20 children.​ 169.26 (d) For a child in kindergarten through 13 years old, a maximum group size shall be no​ 169.27 more than 30 children.​ 169.28 (e) The maximum group size applies at all times except during group activity coordination​ 169.29 time not exceeding 15 minutes, during a meal, outdoor activity, field trip, nap and rest, and​ 169​ Article 6 Sec. 62.​ 23-00276 as introduced​ 01/26/23 REVISOR EB/HL​ 170.1 special activity including a film, guest speaker, indoor large muscle activity, or holiday​ 170.2 program.​ 170.3 (f) Notwithstanding paragraph (d), a certified center may continue to serve a child 14​ 170.4 years of age or older if one of the following conditions is true:​ 170.5 (1) the child remains eligible for child care assistance under section 119B.09, subdivision​ 170.6 1, paragraph (e); or​ 170.7 (2) the certified center serves only school-age children in a setting that has students​ 170.8 enrolled in no grade higher than 8th grade.​ 170.9 Sec. 63. Minnesota Statutes 2022, section 245H.08, subdivision 5, is amended to read:​ 170.10 Subd. 5. Ratios. (a) The minimally acceptable staff-to-child ratios are:​ 1:4​ 170.11 six weeks old through 16 months old​ 1:7​ 170.12 16 months old through 33 months old​ 1:10​ 170.13 33 months old through prekindergarten​ 1:15​ 170.14 kindergarten through 13 years old​ 170.15 (b) Kindergarten includes a child of sufficient age to have attended the first day of​ 170.16 kindergarten or who is eligible to enter kindergarten within the next four months.​ 170.17 (c) For mixed groups, the ratio for the age group of the youngest child applies.​ 170.18 (d) Notwithstanding paragraph (a), a certified center may continue to serve a child 14​ 170.19 years of age or older if one of the following conditions is true:​ 170.20 (1) the child remains eligible for child care assistance under section 119B.09, subdivision​ 170.21 1, paragraph (e); or​ 170.22 (2) the certified center serves only school-age children in a setting that has students​ 170.23 enrolled in no grade higher than 8th grade.​ 170.24 EFFECTIVE DATE. This section is effective August 1, 2023.​ 170.25 Sec. 64. Minnesota Statutes 2022, section 245H.13, subdivision 3, is amended to read:​ 170.26 Subd. 3. Administration of medication. (a) A certified center that chooses to administer​ 170.27 medicine must meet the requirements in this subdivision.​ 170.28 (b) The certified center must obtain written permission from the child's parent or legal​ 170.29 guardian before administering prescription medicine, nonprescription medicine, diapering​ 170.30 product, sunscreen lotion, and insect repellent.​ 170​ Article 6 Sec. 64.​ 23-00276 as introduced​ 01/26/23 REVISOR EB/HL​ 171.1 (c) The certified center must administer nonprescription medicine, diapering product,​ 171.2 sunscreen lotion, and insect repellent according to the manufacturer's instructions unless​ 171.3 provided written instructions by a licensed health professional to use a product differently.​ 171.4 (d) The certified center must obtain and follow written instructions from the prescribing​ 171.5 health professional before administering prescription medicine. Medicine with the child's​ 171.6 first and last name and current prescription information on the label is considered written​ 171.7 instructions.​ 171.8 (e) The certified center must ensure all prescription and nonprescription medicine is:​ 171.9 (1) kept in the medicine's original container with a legible label stating the child's first​ 171.10 and last name;​ 171.11 (2) given only to the child whose name is on the label;​ 171.12 (3) not given after an expiration date on the label; and​ 171.13 (4) returned to the child's parent or legal guardian or destroyed, if unused.​ 171.14 (f) The certified center must document in the child's record the administration of​ 171.15 prescription and nonprescription medication, including the child's first and last name; the​ 171.16 name of the medication or prescription number; the date, time, and dosage; and the name​ 171.17 and signature of the person who administered the medicine. This documentation must be​ 171.18 available to the child's parent or legal guardian.​ 171.19 (g) The certified center must store prescription and nonprescription medicines, insect​ 171.20 repellents, and diapering products according to directions on the original container.​ 171.21 EFFECTIVE DATE. This section is effective August 1, 2023.​ 171.22 Sec. 65. Minnesota Statutes 2022, section 245H.13, subdivision 7, is amended to read:​ 171.23 Subd. 7. Risk reduction plan. (a) The certified center must develop a risk reduction​ 171.24 plan that identifies risks to children served by the child care center. The assessment of risk​ 171.25 must include risks presented by (1) the physical plant where the certified services are​ 171.26 provided, including electrical hazards; and (2) the environment, including the proximity to​ 171.27 busy roads and bodies of water.​ 171.28 (b) The certification holder must establish policies and procedures to minimize identified​ 171.29 risks. After any change to the risk reduction plan, the certification holder must inform staff​ 171.30 of the change in the risk reduction plan and document that staff were informed of the change.​ 171​ Article 6 Sec. 65.​ 23-00276 as introduced​ 01/26/23 REVISOR EB/HL​ 172.1 (c) If middle-school-age children are enrolled in the center and combined with elementary​ 172.2 children, the certification holder must establish policies and procedures to ensure adequate​ 172.3 supervision as defined in subdivision 10 when children are grouped together.​ 172.4 EFFECTIVE DATE. This section is effective August 1, 2023.​ 172.5 Sec. 66. Minnesota Statutes 2022, section 245H.13, subdivision 9, is amended to read:​ 172.6 Subd. 9. Behavior guidance. The certified center must ensure that staff and volunteers​ 172.7 use positive behavior guidance and do not subject children to:​ 172.8 (1) corporal punishment, including but not limited to rough handling, shoving, hair​ 172.9 pulling, ear pulling, shaking, slapping, kicking, biting, pinching, hitting, and spanking;​ 172.10 (2) humiliation;​ 172.11 (3) abusive language;​ 172.12 (4) the use of mechanical restraints, including tying;​ 172.13 (5) the use of physical restraints other than to physically hold a child when containment​ 172.14 is necessary to protect a child or others from harm; or​ 172.15 (6) prone restraints, as prohibited by section 245A.211; or​ 172.16 (6) (7) the withholding or forcing of food and other basic needs.​ 172.17 Sec. 67. Minnesota Statutes 2022, section 245I.20, subdivision 10, is amended to read:​ 172.18 Subd. 10. Application procedures. (a) The applicant for certification must submit any​ 172.19 documents that the commissioner requires on forms approved by the commissioner.​ 172.20 (b) Upon submitting an application for certification, an applicant must pay the application​ 172.21 fee required by section 245A.10, subdivision 3.​ 172.22 (c) The commissioner must act on an application within 90 working days of receiving​ 172.23 a completed application.​ 172.24 (d) When the commissioner receives an application for initial certification that is​ 172.25 incomplete because the applicant failed to submit required documents or is deficient because​ 172.26 the submitted documents do not meet certification requirements, the commissioner must​ 172.27 provide the applicant with written notice that the application is incomplete or deficient. In​ 172.28 the notice, the commissioner must identify the particular documents that are missing or​ 172.29 deficient and give the applicant 45 days to submit a second application that is complete. An​ 172​ Article 6 Sec. 67.​ 23-00276 as introduced​ 01/26/23 REVISOR EB/HL​ 173.1 applicant's failure to submit a complete application within 45 days after receiving notice​ 173.2 from the commissioner is a basis for certification denial.​ 173.3 (e) The commissioner must give notice of a denial to an applicant when the commissioner​ 173.4 has made the decision to deny the certification application. In the notice of denial, the​ 173.5 commissioner must state the reasons for the denial in plain language. The commissioner​ 173.6 must send or deliver the notice of denial to an applicant by certified mail or personal service.​ 173.7 In the notice of denial, the commissioner must state the reasons that the commissioner denied​ 173.8 the application and must inform the applicant of the applicant's right to request a contested​ 173.9 case hearing under chapter 14 and Minnesota Rules, parts 1400.8505 to 1400.8612. The​ 173.10 applicant may appeal the denial by notifying the commissioner in writing by certified mail​ 173.11 or personal service. If mailed, the appeal must be postmarked and sent to the commissioner​ 173.12 within 20 calendar days after the applicant received the notice of denial. If an applicant​ 173.13 delivers an appeal by personal service, the commissioner must receive the appeal within 20​ 173.14 calendar days after the applicant received the notice of denial.​ 173.15 (f) The commissioner may require the applicant or certification holder to provide an​ 173.16 email address for the certification holder that will be made public subject to the requirements​ 173.17 under section 13.46, subdivision 4, paragraph (b), clause (1), item (i).​ 173.18 Sec. 68. Minnesota Statutes 2022, section 256.9685, subdivision 1a, is amended to read:​ 173.19 Subd. 1a. Administrative reconsideration. Notwithstanding section 256B.04,​ 173.20 subdivision 15, the commissioner shall establish an administrative reconsideration process​ 173.21 for appeals of inpatient hospital services determined to be medically unnecessary. A​ 173.22 physician, advanced practice registered nurse, physician assistant, or hospital may request​ 173.23 a reconsideration of the decision that inpatient hospital services are not medically necessary​ 173.24 by submitting a written request for review to the commissioner within 30 calendar days​ 173.25 after receiving the date of the notice of the decision was mailed. The request for​ 173.26 reconsideration process shall take place prior to the procedures of subdivision 1b and shall​ 173.27 be conducted be reviewed by the at least one medical review agent that is independent of​ 173.28 the case under reconsideration. The medical review agent shall make a recommendation to​ 173.29 the commissioner. The commissioner's decision on reconsideration is final and not subject​ 173.30 to appeal under chapter 14.​ 173.31 Sec. 69. Minnesota Statutes 2022, section 256.9685, subdivision 1b, is amended to read:​ 173.32 Subd. 1b. Appeal of reconsideration. Notwithstanding section 256B.72, the​ 173.33 commissioner may recover inpatient hospital payments for services that have been determined​ 173​ Article 6 Sec. 69.​ 23-00276 as introduced​ 01/26/23 REVISOR EB/HL​ 174.1 to be medically unnecessary after the reconsideration and determinations. A physician,​ 174.2 advanced practice registered nurse, physician assistant, or hospital may appeal the result of​ 174.3 the reconsideration process by submitting a written request for review to the commissioner​ 174.4 within 30 days after receiving notice of the action. The commissioner shall review the​ 174.5 medical record and information submitted during the reconsideration process and the medical​ 174.6 review agent's basis for the determination that the services were not medically necessary​ 174.7 for inpatient hospital services. The commissioner shall issue an order upholding or reversing​ 174.8 the decision of the reconsideration process based on the review. The commissioner's decision​ 174.9 under subdivision 1a is appealable by petition for writ of certiorari under chapter 606.​ 174.10 Sec. 70. Minnesota Statutes 2022, section 256.9686, is amended by adding a subdivision​ 174.11 to read:​ 174.12 Subd. 7a. Medical review agent. "Medical review agent" means the representative of​ 174.13 the commissioner who is authorized by the commissioner to administer medical record​ 174.14 reviews; conduct administrative reconsiderations as defined by section 256.9685, subdivision​ 174.15 1a; and perform other functions as stipulated in the terms of the agent's contract with the​ 174.16 department. Medical records reviews and administrative reconsiderations will be performed​ 174.17 by medical professionals within their scope of expertise, including but not limited to​ 174.18 physicians, physician assistants, advanced practice registered nurses, and registered nurses.​ 174.19 The medical professional performing the review or reconsideration must be on staff with​ 174.20 the medical review agent, in good standing, and licensed to practice in the state where the​ 174.21 medical professional resides.​ 174.22 Sec. 71. Minnesota Statutes 2022, section 256B.04, subdivision 15, is amended to read:​ 174.23 Subd. 15. Utilization review. (a) Establish on a statewide basis a new program to​ 174.24 safeguard against unnecessary or inappropriate use of medical assistance services, against​ 174.25 excess payments, against unnecessary or inappropriate hospital admissions or lengths of​ 174.26 stay, and against underutilization of services in prepaid health plans, long-term care facilities​ 174.27 or any health care delivery system subject to fixed rate reimbursement. In implementing​ 174.28 the program, the state agency shall utilize both prepayment and postpayment review systems​ 174.29 to determine if utilization is reasonable and necessary. The determination of whether services​ 174.30 are reasonable and necessary shall be made by the commissioner in consultation with a​ 174.31 professional services advisory group or health care consultant appointed by the commissioner.​ 174.32 (b) Contracts entered into for purposes of meeting the requirements of this subdivision​ 174.33 shall not be subject to the set-aside provisions of chapter 16C.​ 174​ Article 6 Sec. 71.​ 23-00276 as introduced​ 01/26/23 REVISOR EB/HL​ 175.1 (c) A recipient aggrieved by the commissioner's termination of services or denial of​ 175.2 future services may appeal pursuant to section 256.045. Unless otherwise provided by law,​ 175.3 a vendor aggrieved by the commissioner's determination that services provided were not​ 175.4 reasonable or necessary may appeal pursuant to the contested case procedures of chapter​ 175.5 14. To appeal, the vendor shall notify the commissioner in writing within 30 days of receiving​ 175.6 the commissioner's notice. The appeal request shall specify each disputed item, the reason​ 175.7 for the dispute, an estimate of the dollar amount involved for each disputed item, the​ 175.8 computation that the vendor believes is correct, the authority in statute or rule upon which​ 175.9 the vendor relies for each disputed item, the name and address of the person or firm with​ 175.10 whom contacts may be made regarding the appeal, and other information required by the​ 175.11 commissioner.​ 175.12 (d) The commissioner may select providers to provide case management services to​ 175.13 recipients who use health care services inappropriately or to recipients who are eligible for​ 175.14 other managed care projects. The providers shall be selected based upon criteria that may​ 175.15 include a comparison with a peer group of providers related to the quality, quantity, or cost​ 175.16 of health care services delivered or a review of sanctions previously imposed by health care​ 175.17 services programs or the provider's professional licensing board.​ 175.18 Sec. 72. Minnesota Statutes 2022, section 256B.064, is amended to read:​ 175.19 256B.064 SANCTIONS; MONETARY RECOVERY.​ 175.20 Subdivision 1. Terminating payments to ineligible vendors individuals or entities. The​ 175.21 commissioner may terminate payments under this chapter to any person or facility that,​ 175.22 under applicable federal law or regulation, has been determined to be ineligible for payments​ 175.23 under title XIX of the Social Security Act.​ 175.24 Subd. 1a. Grounds for sanctions against vendors. (a) The commissioner may impose​ 175.25 sanctions against a vendor of medical care any individual or entity that receives payments​ 175.26 from medical assistance or provides goods or services for which payment is made from​ 175.27 medical assistance for any of the following: (1) fraud, theft, or abuse in connection with the​ 175.28 provision of medical care goods and services to recipients of public assistance for which​ 175.29 payment is made from medical assistance; (2) a pattern of presentment of false or duplicate​ 175.30 claims or claims for services not medically necessary; (3) a pattern of making false statements​ 175.31 of material facts for the purpose of obtaining greater compensation than that to which the​ 175.32 vendor individual or entity is legally entitled; (4) suspension or termination as a Medicare​ 175.33 vendor; (5) refusal to grant the state agency access during regular business hours to examine​ 175.34 all records necessary to disclose the extent of services provided to program recipients and​ 175​ Article 6 Sec. 72.​ 23-00276 as introduced​ 01/26/23 REVISOR EB/HL​ 176.1 appropriateness of claims for payment; (6) failure to repay an overpayment or a fine finally​ 176.2 established under this section; (7) failure to correct errors in the maintenance of health​ 176.3 service or financial records for which a fine was imposed or after issuance of a warning by​ 176.4 the commissioner; and (8) any reason for which a vendor an individual or entity could be​ 176.5 excluded from participation in the Medicare program under section 1128, 1128A, or​ 176.6 1866(b)(2) of the Social Security Act. For the purposes of this section, goods or services​ 176.7 for which payment is made from medical assistance includes but is not limited to care and​ 176.8 services identified in section 256B.0625 or provided pursuant to any federally approved​ 176.9 waiver.​ 176.10 (b) The commissioner may impose sanctions against a pharmacy provider for failure to​ 176.11 respond to a cost of dispensing survey under section 256B.0625, subdivision 13e, paragraph​ 176.12 (h).​ 176.13 Subd. 1b. Sanctions available. The commissioner may impose the following sanctions​ 176.14 for the conduct described in subdivision 1a: suspension or withholding of payments to a​ 176.15 vendor an individual or entity and suspending or terminating participation in the program,​ 176.16 or imposition of a fine under subdivision 2, paragraph (f). When imposing sanctions under​ 176.17 this section, the commissioner shall consider the nature, chronicity, or severity of the conduct​ 176.18 and the effect of the conduct on the health and safety of persons served by the vendor​ 176.19 individual or entity. The commissioner shall suspend a vendor's an individual's or entity's​ 176.20 participation in the program for a minimum of five years if the vendor individual or entity​ 176.21 is convicted of a crime, received a stay of adjudication, or entered a court-ordered diversion​ 176.22 program for an offense related to a provision of a health service under medical assistance,​ 176.23 including a federally approved waiver, or health care fraud. Regardless of imposition of​ 176.24 sanctions, the commissioner may make a referral to the appropriate state licensing board.​ 176.25 Subd. 1c. Grounds for and methods of monetary recovery. (a) The commissioner​ 176.26 may obtain monetary recovery from a vendor who an individual or entity that has been​ 176.27 improperly paid by the department either as a result of conduct described in subdivision 1a​ 176.28 or as a result of a vendor or department an error by the individual or entity submitting the​ 176.29 claim or by the department, regardless of whether the error was intentional. Patterns need​ 176.30 not be proven as a precondition to monetary recovery of erroneous or false claims, duplicate​ 176.31 claims, claims for services not medically necessary, or claims based on false statements.​ 176.32 (b) The commissioner may obtain monetary recovery using methods including but not​ 176.33 limited to the following: assessing and recovering money improperly paid and debiting from​ 176.34 future payments any money improperly paid. The commissioner shall charge interest on​ 176.35 money to be recovered if the recovery is to be made by installment payments or debits,​ 176​ Article 6 Sec. 72.​ 23-00276 as introduced​ 01/26/23 REVISOR EB/HL​ 177.1 except when the monetary recovery is of an overpayment that resulted from a department​ 177.2 error. The interest charged shall be the rate established by the commissioner of revenue​ 177.3 under section 270C.40.​ 177.4 Subd. 1d. Investigative costs. The commissioner may seek recovery of investigative​ 177.5 costs from any vendor of medical care or services who individual or entity that willfully​ 177.6 submits a claim for reimbursement for services that the vendor individual or entity knows,​ 177.7 or reasonably should have known, is a false representation and that results in the payment​ 177.8 of public funds for which the vendor individual or entity is ineligible. Billing errors that​ 177.9 result in unintentional overcharges shall not be grounds for investigative cost recoupment.​ 177.10 Subd. 2. Imposition of monetary recovery and sanctions. (a) The commissioner shall​ 177.11 determine any monetary amounts to be recovered and sanctions to be imposed upon a vendor​ 177.12 of medical care an individual or entity under this section. Except as provided in paragraphs​ 177.13 (b) and (d), neither a monetary recovery nor a sanction will be imposed by the commissioner​ 177.14 without prior notice and an opportunity for a hearing, according to chapter 14, on the​ 177.15 commissioner's proposed action, provided that the commissioner may suspend or reduce​ 177.16 payment to a vendor of medical care an individual or entity, except a nursing home or​ 177.17 convalescent care facility, after notice and prior to the hearing if in the commissioner's​ 177.18 opinion that action is necessary to protect the public welfare and the interests of the program.​ 177.19 (b) Except when the commissioner finds good cause not to suspend payments under​ 177.20 Code of Federal Regulations, title 42, section 455.23 (e) or (f), the commissioner shall​ 177.21 withhold or reduce payments to a vendor of medical care an individual or entity without​ 177.22 providing advance notice of such withholding or reduction if either of the following occurs:​ 177.23 (1) the vendor individual or entity is convicted of a crime involving the conduct described​ 177.24 in subdivision 1a; or​ 177.25 (2) the commissioner determines there is a credible allegation of fraud for which an​ 177.26 investigation is pending under the program. Allegations are considered credible when they​ 177.27 have an indicium of reliability and the state agency has reviewed all allegations, facts, and​ 177.28 evidence carefully and acts judiciously on a case-by-case basis. A credible allegation of​ 177.29 fraud is an allegation which has been verified by the state, from any source, including but​ 177.30 not limited to:​ 177.31 (i) fraud hotline complaints;​ 177.32 (ii) claims data mining; and​ 177​ Article 6 Sec. 72.​ 23-00276 as introduced​ 01/26/23 REVISOR EB/HL​ 178.1 (iii) patterns identified through provider audits, civil false claims cases, and law​ 178.2 enforcement investigations.​ 178.3 Allegations are considered to be credible when they have an indicia of reliability and​ 178.4 the state agency has reviewed all allegations, facts, and evidence carefully and acts​ 178.5 judiciously on a case-by-case basis.​ 178.6 (c) The commissioner must send notice of the withholding or reduction of payments​ 178.7 under paragraph (b) within five days of taking such action unless requested in writing by a​ 178.8 law enforcement agency to temporarily withhold the notice. The notice must:​ 178.9 (1) state that payments are being withheld according to paragraph (b);​ 178.10 (2) set forth the general allegations as to the nature of the withholding action, but need​ 178.11 not disclose any specific information concerning an ongoing investigation;​ 178.12 (3) except in the case of a conviction for conduct described in subdivision 1a, state that​ 178.13 the withholding is for a temporary period and cite the circumstances under which withholding​ 178.14 will be terminated;​ 178.15 (4) identify the types of claims to which the withholding applies; and​ 178.16 (5) inform the vendor individual or entity of the right to submit written evidence for​ 178.17 consideration by the commissioner.​ 178.18 (d) The withholding or reduction of payments will not continue after the commissioner​ 178.19 determines there is insufficient evidence of fraud by the vendor individual or entity, or after​ 178.20 legal proceedings relating to the alleged fraud are completed, unless the commissioner has​ 178.21 sent notice of intention to impose monetary recovery or sanctions under paragraph (a). Upon​ 178.22 conviction for a crime related to the provision, management, or administration of a health​ 178.23 service under medical assistance, a payment held pursuant to this section by the commissioner​ 178.24 or a managed care organization that contracts with the commissioner under section 256B.035​ 178.25 is forfeited to the commissioner or managed care organization, regardless of the amount​ 178.26 charged in the criminal complaint or the amount of criminal restitution ordered.​ 178.27 (d) (e) The commissioner shall suspend or terminate a vendor's an individual's or entity's​ 178.28 participation in the program without providing advance notice and an opportunity for a​ 178.29 hearing when the suspension or termination is required because of the vendor's individual's​ 178.30 or entity's exclusion from participation in Medicare. Within five days of taking such action,​ 178.31 the commissioner must send notice of the suspension or termination. The notice must:​ 178.32 (1) state that suspension or termination is the result of the vendor's individual's or entity's​ 178.33 exclusion from Medicare;​ 178​ Article 6 Sec. 72.​ 23-00276 as introduced​ 01/26/23 REVISOR EB/HL​ 179.1 (2) identify the effective date of the suspension or termination; and​ 179.2 (3) inform the vendor individual or entity of the need to be reinstated to Medicare before​ 179.3 reapplying for participation in the program.​ 179.4 (e) (f) Upon receipt of a notice under paragraph (a) that a monetary recovery or sanction​ 179.5 is to be imposed, a vendor an individual or entity may request a contested case, as defined​ 179.6 in section 14.02, subdivision 3, by filing with the commissioner a written request of appeal.​ 179.7 The appeal request must be received by the commissioner no later than 30 days after the​ 179.8 date the notification of monetary recovery or sanction was mailed to the vendor individual​ 179.9 or entity. The appeal request must specify:​ 179.10 (1) each disputed item, the reason for the dispute, and an estimate of the dollar amount​ 179.11 involved for each disputed item;​ 179.12 (2) the computation that the vendor individual or entity believes is correct;​ 179.13 (3) the authority in statute or rule upon which the vendor individual or entity relies for​ 179.14 each disputed item;​ 179.15 (4) the name and address of the person or entity with whom contacts may be made​ 179.16 regarding the appeal; and​ 179.17 (5) other information required by the commissioner.​ 179.18 (f) (g) The commissioner may order a vendor an individual or entity to forfeit a fine for​ 179.19 failure to fully document services according to standards in this chapter and Minnesota​ 179.20 Rules, chapter 9505. The commissioner may assess fines if specific required components​ 179.21 of documentation are missing. The fine for incomplete documentation shall equal 20 percent​ 179.22 of the amount paid on the claims for reimbursement submitted by the vendor individual or​ 179.23 entity, or up to $5,000, whichever is less. If the commissioner determines that a vendor an​ 179.24 individual or entity repeatedly violated this chapter, chapter 254B or 245G, or Minnesota​ 179.25 Rules, chapter 9505, related to the provision of services to program recipients and the​ 179.26 submission of claims for payment, the commissioner may order a vendor an individual or​ 179.27 entity to forfeit a fine based on the nature, severity, and chronicity of the violations, in an​ 179.28 amount of up to $5,000 or 20 percent of the value of the claims, whichever is greater. The​ 179.29 commissioner may issue fines under this paragraph in place of or in addition to full monetary​ 179.30 recovery of the value of the claims submitted under subdivision 1c.​ 179.31 (g) (h) The vendor individual or entity shall pay the fine assessed on or before the​ 179.32 payment date specified. If the vendor individual or entity fails to pay the fine, the​ 179​ Article 6 Sec. 72.​ 23-00276 as introduced​ 01/26/23 REVISOR EB/HL​ 180.1 commissioner may withhold or reduce payments and recover the amount of the fine. A​ 180.2 timely appeal shall stay payment of the fine until the commissioner issues a final order.​ 180.3 Subd. 3. Vendor Mandates on prohibited payments. (a) The commissioner shall​ 180.4 maintain and publish a list of each excluded individual and entity that was convicted of a​ 180.5 crime related to the provision, management, or administration of a medical assistance health​ 180.6 service, or suspended or terminated under subdivision 2. Medical assistance payments cannot​ 180.7 be made by a vendor an individual or entity for items or services furnished either directly​ 180.8 or indirectly by an excluded individual or entity, or at the direction of excluded individuals​ 180.9 or entities.​ 180.10 (b) The vendor entity must check the exclusion list on a monthly basis and document​ 180.11 the date and time the exclusion list was checked and the name and title of the person who​ 180.12 checked the exclusion list. The vendor entity must immediately terminate payments to an​ 180.13 individual or entity on the exclusion list.​ 180.14 (c) A vendor's An entity's requirement to check the exclusion list and to terminate​ 180.15 payments to individuals or entities on the exclusion list applies to each individual or entity​ 180.16 on the exclusion list, even if the named individual or entity is not responsible for direct​ 180.17 patient care or direct submission of a claim to medical assistance.​ 180.18 (d) A vendor An entity that pays medical assistance program funds to an individual or​ 180.19 entity on the exclusion list must refund any payment related to either items or services​ 180.20 rendered by an individual or entity on the exclusion list from the date the individual or entity​ 180.21 is first paid or the date the individual or entity is placed on the exclusion list, whichever is​ 180.22 later, and a vendor an entity may be subject to:​ 180.23 (1) sanctions under subdivision 2;​ 180.24 (2) a civil monetary penalty of up to $25,000 for each determination by the department​ 180.25 that the vendor employed or contracted with an individual or entity on the exclusion list;​ 180.26 and​ 180.27 (3) other fines or penalties allowed by law.​ 180.28 Subd. 4. Notice. (a) The department shall serve the notice required under subdivision 2​ 180.29 shall be served by certified mail at the address submitted to the department by the vendor​ 180.30 individual or entity. Service is complete upon mailing. The commissioner shall place an​ 180.31 affidavit of the certified mailing in the vendor's file as an indication of the address and the​ 180.32 date of mailing.​ 180​ Article 6 Sec. 72.​ 23-00276 as introduced​ 01/26/23 REVISOR EB/HL​ 181.1 (b) The department shall give notice in writing to a recipient placed in the Minnesota​ 181.2 restricted recipient program under section 256B.0646 and Minnesota Rules, part 9505.2200.​ 181.3 The department shall send the notice shall be sent by first class mail to the recipient's current​ 181.4 address on file with the department. A recipient placed in the Minnesota restricted recipient​ 181.5 program may contest the placement by submitting a written request for a hearing to the​ 181.6 department within 90 days of the notice being mailed.​ 181.7 Subd. 5. Immunity; good faith reporters. (a) A person who makes a good faith report​ 181.8 is immune from any civil or criminal liability that might otherwise arise from reporting or​ 181.9 participating in the investigation. Nothing in this subdivision affects a vendor's an individual's​ 181.10 or entity's responsibility for an overpayment established under this subdivision.​ 181.11 (b) A person employed by a lead investigative agency who is conducting or supervising​ 181.12 an investigation or enforcing the law according to the applicable law or rule is immune from​ 181.13 any civil or criminal liability that might otherwise arise from the person's actions, if the​ 181.14 person is acting in good faith and exercising due care.​ 181.15 (c) For purposes of this subdivision, "person" includes a natural person or any form of​ 181.16 a business or legal entity.​ 181.17 (d) After an investigation is complete, the reporter's name must be kept confidential.​ 181.18 The subject of the report may compel disclosure of the reporter's name only with the consent​ 181.19 of the reporter or upon a written finding by a district court that the report was false and there​ 181.20 is evidence that the report was made in bad faith. This subdivision does not alter disclosure​ 181.21 responsibilities or obligations under the Rules of Criminal Procedure, except that when the​ 181.22 identity of the reporter is relevant to a criminal prosecution the district court shall conduct​ 181.23 an in-camera review before determining whether to order disclosure of the reporter's identity.​ 181.24 Sec. 73. Minnesota Statutes 2022, section 256B.27, subdivision 3, is amended to read:​ 181.25 Subd. 3. Access to medical records. The commissioner of human services, with the​ 181.26 written consent of the recipient, on file with the local welfare agency, shall be allowed​ 181.27 access in the manner and within the time prescribed by the commissioner to all personal​ 181.28 medical records of medical assistance recipients solely for the purposes of investigating​ 181.29 whether or not: (a) a vendor of medical care has submitted a claim for reimbursement, a​ 181.30 cost report or a rate application which is duplicative, erroneous, or false in whole or in part,​ 181.31 or which results in the vendor obtaining greater compensation than the vendor is legally​ 181.32 entitled to; or (b) the medical care was medically necessary. When the commissioner is​ 181.33 investigating a possible overpayment of Medicaid funds, the commissioner must be given​ 181.34 immediate access without prior notice to the vendor's office during regular business hours​ 181​ Article 6 Sec. 73.​ 23-00276 as introduced​ 01/26/23 REVISOR EB/HL​ 182.1 and to documentation and records related to services provided and submission of claims​ 182.2 for services provided. The department shall document in writing the need for immediate​ 182.3 access to records related to a specific investigation. Denying the commissioner access to​ 182.4 records is cause for the vendor's immediate suspension of payment or termination according​ 182.5 to section 256B.064. All providers receiving medical assistance payments must make those​ 182.6 records available immediately to the commissioner upon request. Any records not provided​ 182.7 to the commissioner at the date and time of the request are inadmissible if offered as evidence​ 182.8 by the provider in any proceeding to contest sanctions against or monetary recovery from​ 182.9 the provider. The determination of provision of services not medically necessary shall be​ 182.10 made by the commissioner. Notwithstanding any other law to the contrary, a vendor of​ 182.11 medical care shall not be subject to any civil or criminal liability for providing access to​ 182.12 medical records to the commissioner of human services pursuant to this section.​ 182.13 Sec. 74. Minnesota Statutes 2022, section 524.5-118, subdivision 2a, is amended to read:​ 182.14 Subd. 2a. Procedure; state licensing agency data. (a) The court shall request the​ 182.15 commissioner of human services to provide the court within 25 working days of receipt of​ 182.16 the request with licensing agency data for licenses directly related to the responsibilities of​ 182.17 a professional fiduciary if the study subject indicates current or prior affiliation from the​ 182.18 following agencies in Minnesota:​ 182.19 (1) Lawyers Responsibility Board;​ 182.20 (2) State Board of Accountancy;​ 182.21 (3) Board of Social Work;​ 182.22 (4) Board of Psychology;​ 182.23 (5) Board of Nursing;​ 182.24 (6) Board of Medical Practice;​ 182.25 (7) Department of Education;​ 182.26 (8) (7) Department of Commerce;​ 182.27 (9) (8) Board of Chiropractic Examiners;​ 182.28 (10) (9) Board of Dentistry;​ 182.29 (11) (10) Board of Marriage and Family Therapy;​ 182.30 (12) (11) Department of Human Services;​ 182.31 (13) (12) Peace Officer Standards and Training (POST) Board; and​ 182​ Article 6 Sec. 74.​ 23-00276 as introduced​ 01/26/23 REVISOR EB/HL​ 183.1 (14) (13) Professional Educator Licensing and Standards Board.​ 183.2 (b) The commissioner shall enter into agreements with these agencies to provide the​ 183.3 commissioner with electronic access to the relevant licensing data, and to provide the​ 183.4 commissioner with a quarterly list of new sanctions issued by the agency.​ 183.5 (c) The commissioner shall provide to the court the electronically available data​ 183.6 maintained in the agency's database, including whether the proposed guardian or conservator​ 183.7 is or has been licensed by the agency, and if the licensing agency database indicates a​ 183.8 disciplinary action or a sanction against the individual's license, including a condition,​ 183.9 suspension, revocation, or cancellation.​ 183.10 (d) If the proposed guardian or conservator has resided in a state other than Minnesota​ 183.11 in the previous ten years, licensing agency data under this section shall also include the​ 183.12 licensing agency data from any other state where the proposed guardian or conservator​ 183.13 reported to have resided during the previous ten years if the study subject indicates current​ 183.14 or prior affiliation. If the proposed guardian or conservator has or has had a professional​ 183.15 license in another state that is directly related to the responsibilities of a professional fiduciary​ 183.16 from one of the agencies listed under paragraph (a), state licensing agency data shall also​ 183.17 include data from the relevant licensing agency of that state.​ 183.18 (e) The commissioner is not required to repeat a search for Minnesota or out-of-state​ 183.19 licensing data on an individual if the commissioner has provided this information to the​ 183.20 court within the prior five years.​ 183.21 (f) The commissioner shall review the information in paragraph (c) at least once every​ 183.22 four months to determine if an individual who has been studied within the previous five​ 183.23 years:​ 183.24 (1) has new disciplinary action or sanction against the individual's license; or​ 183.25 (2) did not disclose a prior or current affiliation with a Minnesota licensing agency.​ 183.26 (g) If the commissioner's review in paragraph (f) identifies new information, the​ 183.27 commissioner shall provide any new information to the court.​ 183.28 Sec. 75. REVISOR INSTRUCTION.​ 183.29 The revisor of statutes shall renumber the subdivisions in Minnesota Statutes, section​ 183.30 245C.02, in alphabetical order and correct any cross-reference changes that result.​ 183​ Article 6 Sec. 75.​ 23-00276 as introduced​ 01/26/23 REVISOR EB/HL​ 184.1 Sec. 76. REPEALER.​ 184.2 Subdivision 1. (a) Minnesota Statutes 2022, sections 245A.144; and 245A.175, are​ 184.3 repealed.​ 184.4 (b) Minnesota Rules, parts 2960.3070; and 2960.3210, are repealed.​ 184.5 (c) Minnesota Rules, part 9502.0425, subparts 5 and 10, are repealed.​ 184.6 Subd. 2. Minnesota Statutes 2022, section 245A.22, is repealed.​ 184.7 Subd. 3. (a) Minnesota Statutes 2022, sections 245C.02, subdivision 9; and 245C.301,​ 184.8 are repealed.​ 184.9 (b) Minnesota Statutes 2022, section 256.9685, subdivisions 1c and 1d, and Minnesota​ 184.10 Rules, parts 9505.0505, subpart 18; and 9505.0520, subpart 9b, are repealed.​ 184.11 EFFECTIVE DATE. Subdivision 1 is effective January 1, 2024; subdivision 2 is​ 184.12 effective the day following final enactment; and subdivision 3 is effective August 1, 2023.​ 184.13 ARTICLE 7​ 184.14 MISCELLANEOUS​ 184.15 Section 1. Minnesota Statutes 2022, section 245.50, subdivision 5, is amended to read:​ 184.16 Subd. 5. Special contracts; bordering states. (a) An individual who is detained,​ 184.17 committed, or placed on an involuntary basis under chapter 253B may be confined or treated​ 184.18 in a bordering state pursuant to a contract under this section. An individual who is detained,​ 184.19 committed, or placed on an involuntary basis under the civil law of a bordering state may​ 184.20 be confined or treated in Minnesota pursuant to a contract under this section. A peace or​ 184.21 health officer who is acting under the authority of the sending state may transport an​ 184.22 individual to a receiving agency that provides services pursuant to a contract under this​ 184.23 section and may transport the individual back to the sending state under the laws of the​ 184.24 sending state. Court orders valid under the law of the sending state are granted recognition​ 184.25 and reciprocity in the receiving state for individuals covered by a contract under this section​ 184.26 to the extent that the court orders relate to confinement for treatment or care of mental​ 184.27 illness, chemical dependency, or detoxification. Such treatment or care may address other​ 184.28 conditions that may be co-occurring with the mental illness or chemical dependency. These​ 184.29 court orders are not subject to legal challenge in the courts of the receiving state. Individuals​ 184.30 who are detained, committed, or placed under the law of a sending state and who are​ 184.31 transferred to a receiving state under this section continue to be in the legal custody of the​ 184.32 authority responsible for them under the law of the sending state. Except in emergencies,​ 184​ Article 7 Section 1.​ 23-00276 as introduced​ 01/26/23 REVISOR EB/HL​ 185.1 those individuals may not be transferred, removed, or furloughed from a receiving agency​ 185.2 without the specific approval of the authority responsible for them under the law of the​ 185.3 sending state.​ 185.4 (b) While in the receiving state pursuant to a contract under this section, an individual​ 185.5 shall be subject to the sending state's laws and rules relating to length of confinement,​ 185.6 reexaminations, and extensions of confinement. No individual may be sent to another state​ 185.7 pursuant to a contract under this section until the receiving state has enacted a law recognizing​ 185.8 the validity and applicability of this section.​ 185.9 (c) If an individual receiving services pursuant to a contract under this section leaves​ 185.10 the receiving agency without permission and the individual is subject to involuntary​ 185.11 confinement under the law of the sending state, the receiving agency shall use all reasonable​ 185.12 means to return the individual to the receiving agency. The receiving agency shall​ 185.13 immediately report the absence to the sending agency. The receiving state has the primary​ 185.14 responsibility for, and the authority to direct, the return of these individuals within its borders​ 185.15 and is liable for the cost of the action to the extent that it would be liable for costs of its​ 185.16 own resident.​ 185.17 (d) Responsibility for payment for the cost of care remains with the sending agency.​ 185.18 (e) This subdivision also applies to county contracts under subdivision 2 which include​ 185.19 emergency care and treatment provided to a county resident in a bordering state.​ 185.20 (f) If a Minnesota resident is admitted to a facility in a bordering state under this chapter,​ 185.21 a physician, a licensed psychologist who has a doctoral degree in psychology, or an advanced​ 185.22 practice registered nurse certified in mental health, an individual who is licensed in the​ 185.23 bordering state, may act as a court examiner under sections 253B.07, 253B.08, 253B.092,​ 185.24 253B.12, and 253B.17 subject to the same requirements and limitations in section 253B.02,​ 185.25 subdivision subdivisions 4d and 7. An examiner under section 253B.02, subdivision 7, may​ 185.26 initiate an emergency hold under section 253B.051 on a Minnesota resident who is in a​ 185.27 hospital that is under contract with a Minnesota governmental entity under this section​ 185.28 provided the resident, in the opinion of the examiner, meets the criteria in section 253B.051.​ 185.29 (g) This section shall apply to detoxification services that are unrelated to treatment​ 185.30 whether the services are provided on a voluntary or involuntary basis.​ 185.31 Sec. 2. Minnesota Statutes 2022, section 254A.035, subdivision 2, is amended to read:​ 185.32 Subd. 2. Membership terms, compensation, removal and expiration. The membership​ 185.33 of this council shall be composed of 17 persons who are American Indians and who are​ 185​ Article 7 Sec. 2.​ 23-00276 as introduced​ 01/26/23 REVISOR EB/HL​ 186.1 appointed by the commissioner. The commissioner shall appoint one representative from​ 186.2 each of the following groups: Red Lake Band of Chippewa Indians; Fond du Lac Band,​ 186.3 Minnesota Chippewa Tribe; Grand Portage Band, Minnesota Chippewa Tribe; Leech Lake​ 186.4 Band, Minnesota Chippewa Tribe; Mille Lacs Band, Minnesota Chippewa Tribe; Bois Forte​ 186.5 Band, Minnesota Chippewa Tribe; White Earth Band, Minnesota Chippewa Tribe; Lower​ 186.6 Sioux Indian Reservation; Prairie Island Sioux Indian Reservation; Shakopee Mdewakanton​ 186.7 Sioux Indian Reservation; Upper Sioux Indian Reservation; International Falls Northern​ 186.8 Range; Duluth Urban Indian Community; and two representatives from the Minneapolis​ 186.9 Urban Indian Community and two from the St. Paul Urban Indian Community. The terms,​ 186.10 compensation, and removal of American Indian Advisory Council members shall be as​ 186.11 provided in section 15.059. The council expires June 30, 2023.​ 186.12 Sec. 3. Minnesota Statutes 2022, section 256B.093, subdivision 1, is amended to read:​ 186.13 Subdivision 1. State traumatic brain injury program. (a) The commissioner of human​ 186.14 services shall:​ 186.15 (1) maintain a statewide traumatic brain injury program;​ 186.16 (2) supervise and coordinate services and policies for persons with traumatic brain​ 186.17 injuries;​ 186.18 (3) contract with qualified agencies or employ staff to provide statewide administrative​ 186.19 case management and consultation;​ 186.20 (4) maintain an advisory committee to provide recommendations in reports to the​ 186.21 commissioner regarding program and service needs of persons with brain injuries;​ 186.22 (5) investigate the need for the development of rules or statutes for the brain injury home​ 186.23 and community-based services waiver; and​ 186.24 (6) investigate present and potential models of service coordination which can be​ 186.25 delivered at the local level.​ 186.26 (b) The advisory committee required by paragraph (a), clause (4), must consist of no​ 186.27 fewer than ten members and no more than 30 members. The commissioner shall appoint​ 186.28 all advisory committee members to one- or two-year terms and appoint one member as​ 186.29 chair. The advisory committee expires on June 30, 2023.​ 186​ Article 7 Sec. 3.​ 23-00276 as introduced​ 01/26/23 REVISOR EB/HL​ 187.1 Sec. 4. Laws 2021, First Special Session chapter 7, article 2, section 17, the effective date,​ 187.2 is amended to read:​ 187.3 EFFECTIVE DATE. This section is effective July 1, 2021, except subdivision 6,​ 187.4 paragraph (b), is effective upon federal approval and subdivision 15 is effective the day​ 187.5 following final enactment. The commissioner of human services shall notify the revisor of​ 187.6 statutes when federal approval is obtained.​ 187.7 Sec. 5. Laws 2021, First Special Session chapter 7, article 6, section 12, the effective date,​ 187.8 is amended to read:​ 187.9 EFFECTIVE DATE. This section is effective July 1, 2021, or upon federal approval,​ 187.10 whichever is later. The commissioner of human services shall notify the revisor of statutes​ 187.11 when federal approval is obtained.​ 187.12 Sec. 6. Laws 2021, First Special Session chapter 7, article 11, section 18, the effective​ 187.13 date, is amended to read:​ 187.14 EFFECTIVE DATE. This section is effective July 1, 2021, or upon federal approval,​ 187.15 whichever is later, except paragraph (f) is effective the day following final enactment. The​ 187.16 commissioner shall notify the revisor of statutes when federal approval is obtained.​ 187.17 Sec. 7. Laws 2021, First Special Session chapter 7, article 13, section 43, the effective​ 187.18 date, is amended to read:​ 187.19 EFFECTIVE DATE. This section is effective January 1, 2022, or upon federal approval,​ 187.20 whichever is later, except the fifth sentence in paragraph (d) is effective January 1, 2022.​ 187.21 The commissioner of human services shall notify the revisor of statutes when federal approval​ 187.22 is obtained.​ 187.23 Sec. 8. Laws 2022, chapter 98, article 4, section 37, the effective date, is amended to read:​ 187.24 EFFECTIVE DATE. This section is effective July 1, 2022, or upon federal approval,​ 187.25 whichever is later. The commissioner of human services shall notify the revisor of statutes​ 187.26 when federal approval is obtained.​ 187.27 Sec. 9. REPEALER.​ 187.28 Minnesota Statutes 2022, section 260.835, subdivision 2, is repealed.​ 187​ Article 7 Sec. 9.​ 23-00276 as introduced​ 01/26/23 REVISOR EB/HL​ 188.1 ARTICLE 8​ 188.2 PROHIBITION ON CONVERSION THERAPY​ 188.3 Section 1. [214.078] PROTECTION FROM CONVERSION THERAPY.​ 188.4 Subdivision 1. Definition. "Conversion therapy" means any practice by a mental health​ 188.5 practitioner as defined in section 245I.04, subdivision 4, or mental health professional as​ 188.6 defined in section 245I.04, subdivision 2, that seeks to change an individual's sexual​ 188.7 orientation or gender identity, including efforts to change behaviors or gender expressions​ 188.8 or to eliminate or reduce sexual or romantic attractions or feelings toward individuals of​ 188.9 the same gender. Conversion therapy does not include counseling that provides assistance​ 188.10 to an individual undergoing gender transition, or counseling that provides acceptance,​ 188.11 support, and understanding of an individual or facilitates an individual's coping, social​ 188.12 support, and identity exploration and development, including sexual-orientation-neutral​ 188.13 interventions to prevent or address unlawful conduct or unsafe sexual practices, as long as​ 188.14 the counseling does not seek to change an individual's sexual orientation or gender identity.​ 188.15 Subd. 2. Prohibition. (a) No mental health practitioner or mental health professional​ 188.16 shall engage in conversion therapy with a client younger than 18 years of age or with a​ 188.17 vulnerable adult as defined in section 626.5572, subdivision 21.​ 188.18 (b) Conversion therapy attempted by a mental health practitioner or mental health​ 188.19 professional with a client younger than 18 years of age or with a vulnerable adult shall be​ 188.20 considered unprofessional conduct that may subject the mental health practitioner or mental​ 188.21 health professional to disciplinary action by the licensing board of the mental health​ 188.22 practitioner or mental health professional.​ 188.23 EFFECTIVE DATE. This section is effective the day following final enactment.​ 188.24 Sec. 2. Minnesota Statutes 2022, section 256B.0625, is amended by adding a subdivision​ 188.25 to read:​ 188.26 Subd. 5n. Conversion therapy. Conversion therapy, as defined in section 214.078,​ 188.27 subdivision 1, is not covered.​ 188.28 Sec. 3. Minnesota Statutes 2022, section 325F.69, is amended by adding a subdivision to​ 188.29 read:​ 188.30 Subd. 7. Advertisement and sales; misrepresentation of conversion therapy. (a) For​ 188.31 purposes of this subdivision, "conversion therapy" means services or products that are​ 188.32 intended to change an individual's sexual orientation or gender identity, including efforts​ 188​ Article 8 Sec. 3.​ 23-00276 as introduced​ 01/26/23 REVISOR EB/HL​ 189.1 to change behaviors and gender expressions or to eliminate or reduce sexual or romantic​ 189.2 attractions or feelings toward individuals of the same gender.​ 189.3 (b) No person or entity shall, while conducting any trade or commerce, use or employ​ 189.4 any fraud, false pretense, false promise, false guarantee, misrepresentation, false or​ 189.5 misleading statements, or deceptive practice by advertising or otherwise offering conversion​ 189.6 therapy services that could reasonably be interpreted or inferred as representing​ 189.7 homosexuality as a mental disease, disorder, or illness, or guaranteeing to change an​ 189.8 individual's sexual orientation or gender identity.​ 189​ Article 8 Sec. 3.​ 23-00276 as introduced​ 01/26/23 REVISOR EB/HL​ 169A.70 ALCOHOL SAFETY PROGRAMS; CHEMICAL USE ASSESSMENTS.​ Subd. 6. Method of assessment. (a) As used in this subdivision, "collateral contact" means an​ oral or written communication initiated by an assessor for the purpose of gathering information​ from an individual or agency, other than the offender, to verify or supplement information provided​ by the offender during an assessment under this section. The term includes contacts with family​ members and criminal justice agencies.​ (b) An assessment conducted under this section must include at least one personal interview​ with the offender designed to make a determination about the extent of the offender's past and​ present chemical and alcohol use or abuse. It must also include collateral contacts and a review of​ relevant records or reports regarding the offender including, but not limited to, police reports, arrest​ reports, driving records, chemical testing records, and test refusal records. If the offender has a​ probation officer, the officer must be the subject of a collateral contact under this subdivision. If​ an assessor is unable to make collateral contacts, the assessor shall specify why collateral contacts​ were not made.​ 245A.144 TRAINING ON RISK OF SUDDEN UNEXPECTED INFANT DEATH AND​ ABUSIVE HEAD TRAUMA FOR CHILD FOSTER CARE PROVIDERS.​ (a) Licensed child foster care providers that care for infants or children through five years of​ age must document that before staff persons and caregivers assist in the care of infants or children​ through five years of age, they are instructed on the standards in section 245A.1435 and receive​ training on reducing the risk of sudden unexpected infant death and abusive head trauma from​ shaking infants and young children. This section does not apply to emergency relative placement​ under section 245A.035. The training on reducing the risk of sudden unexpected infant death and​ abusive head trauma may be provided as:​ (1) orientation training to child foster care providers, who care for infants or children through​ five years of age, under Minnesota Rules, part 2960.3070, subpart 1; or​ (2) in-service training to child foster care providers, who care for infants or children through​ five years of age, under Minnesota Rules, part 2960.3070, subpart 2.​ (b) Training required under this section must be at least one hour in length and must be completed​ at least once every five years. At a minimum, the training must address the risk factors related to​ sudden unexpected infant death and abusive head trauma, means of reducing the risk of sudden​ unexpected infant death and abusive head trauma, and license holder communication with parents​ regarding reducing the risk of sudden unexpected infant death and abusive head trauma.​ (c) Training for child foster care providers must be approved by the county or private licensing​ agency that is responsible for monitoring the child foster care provider under section 245A.16. The​ approved training fulfills, in part, training required under Minnesota Rules, part 2960.3070.​ 245A.175 CHILD FOSTER CARE TRAINING REQUIREMENT; MENTAL HEALTH​ TRAINING; FETAL ALCOHOL SPECTRUM DISORDERS TRAINING.​ Prior to a nonemergency placement of a child in a foster care home, the child foster care license​ holder and caregivers in foster family and treatment foster care settings, and all staff providing care​ in foster residence settings must complete two hours of training that addresses the causes, symptoms,​ and key warning signs of mental health disorders; cultural considerations; and effective approaches​ for dealing with a child's behaviors. At least one hour of the annual training requirement for the​ foster family license holder and caregivers, and foster residence staff must be on children's mental​ health issues and treatment. Except for providers and services under chapter 245D, the annual​ training must also include at least one hour of training on fetal alcohol spectrum disorders, which​ must be counted toward the 12 hours of required in-service training per year. Short-term substitute​ caregivers are exempt from these requirements. Training curriculum shall be approved by the​ commissioner of human services.​ 245A.22 INDEPENDENT LIVING ASSISTANCE FOR YOUTH.​ Subdivision 1. Independent living assistance for youth. "Independent living assistance for​ youth" means a nonresidential program that provides a system of services that includes training,​ counseling, instruction, supervision, and assistance provided to youth according to the youth's​ independent living plan, when the placements in the program are made by the county agency.​ Services may include assistance in locating housing, budgeting, meal preparation, shopping, personal​ appearance, counseling, and related social support services needed to meet the youth's needs and​ improve the youth's ability to conduct such tasks independently. Such services shall not extend to​ 1R​ APPENDIX​ Repealed Minnesota Statutes: 23-00276​ youths needing 24-hour per day supervision and services. Youths needing a 24-hour per day program​ of supervision and services shall not be accepted or retained in an independent living assistance​ program.​ Subd. 2. Admission. (a) The license holder shall accept as clients in the independent living​ assistance program only youth ages 16 to 21 who are in out-of-home placement, leaving out-of-home​ placement, at risk of becoming homeless, or homeless.​ (b) Youth who have current drug or alcohol problems, a recent history of violent behaviors, or​ a mental health disorder or issue that is not being resolved through counseling or treatment are not​ eligible to receive the services described in subdivision 1.​ (c) Youth who are not employed, participating in employment training, or enrolled in an academic​ program are not eligible to receive transitional housing or independent living assistance.​ (d) The commissioner may grant a variance under section 245A.04, subdivision 9, to requirements​ in this section.​ Subd. 3. Independent living plan. (a) Unless an independent living plan has been developed​ by the local agency, the license holder shall develop a plan based on the client's individual needs​ that specifies objectives for the client. The services provided shall include those specified in this​ section. The plan shall identify the persons responsible for implementation of each part of the plan.​ The plan shall be reviewed as necessary, but at least annually.​ (b) The following services, or adequate access to referrals for the following services, must be​ made available to the targeted youth participating in the programs described in subdivision 1:​ (1) counseling services for the youth and their families, if appropriate, on site, to help with​ problems that contributed to the homelessness or could impede making the transition to independent​ living;​ (2) educational, vocational, or employment services;​ (3) health care;​ (4) transportation services including, where appropriate, assisting the child in obtaining a driver's​ license;​ (5) money management skills training;​ (6) planning for ongoing housing;​ (7) social and recreational skills training; and​ (8) assistance establishing and maintaining connections with the child's family and community.​ Subd. 4. Records. (a) The license holder shall maintain a record for each client.​ (b) For each client the record maintained by the license holder shall document the following:​ (1) admission information;​ (2) the independent living plan;​ (3) delivery of the services required of the license holder in the independent living plan;​ (4) the client's progress toward obtaining the objectives identified in the independent living​ plan; and​ (5) a termination summary after service is terminated.​ (c) If the license holder manages the client's money, the record maintained by the license holder​ shall also include the following:​ (1) written permission from the client or the client's legal guardian to manage the client's money;​ (2) the reasons the license holder is to manage the client's money; and​ (3) a complete record of the use of the client's money and reconciliation of the account.​ Subd. 5. Service termination plan. The license holder, in conjunction with the county agency,​ shall establish a service termination plan that specifies how independent living assistance services​ will be terminated and the actions to be performed by the involved agencies, including necessary​ referrals for other ongoing services.​ 2R​ APPENDIX​ Repealed Minnesota Statutes: 23-00276​ Subd. 6. Place of residence provided by program. When a client's place of residence is​ provided by the license holder as part of the independent living assistance program, the place of​ residence is not subject to separate licensure.​ Subd. 7. General licensing requirements apply. In addition to the requirements of this section,​ providers of independent living assistance are subject to general licensing requirements of this​ chapter.​ 245C.02 DEFINITIONS.​ Subd. 9. Contractor. "Contractor" means any individual, regardless of employer, who is​ providing program services for hire under the control of the provider.​ 245C.301 NOTIFICATION OF SET-ASIDE OR VARIANCE.​ (a) Except as provided under paragraphs (b) and (c), if required by the commissioner, family​ child care providers and child care centers must provide a written notification to parents considering​ enrollment of a child or parents of a child attending the family child care or child care center if the​ program employs or has living in the home any individual who is the subject of either a set-aside​ or variance.​ (b) Notwithstanding paragraph (a), family child care license holders are not required to disclose​ that the program has an individual living in the home who is the subject of a set-aside or variance​ if:​ (1) the household member resides in the residence where the family child care is provided;​ (2) the subject of the set-aside or variance is under the age of 18 years; and​ (3) the set-aside or variance relates to a disqualification under section 245C.15, subdivision 4,​ for a misdemeanor-level theft crime as defined in section 609.52.​ (c) The notice specified in paragraph (a) is not required when the period of disqualification in​ section 245C.15, subdivisions 2 to 4, has been exceeded.​ 245G.22 OPIOID TREATMENT PROGRAMS.​ Subd. 19. Placing authorities. A program must provide certain notification and client-specific​ updates to placing authorities for a client who is enrolled in Minnesota health care programs. At​ the request of the placing authority, the program must provide client-specific updates, including​ but not limited to informing the placing authority of positive drug testings and changes in medications​ used for the treatment of opioid use disorder ordered for the client.​ 254A.02 DEFINITIONS.​ Subd. 8a. Placing authority. "Placing authority" means a county, prepaid health plan, or tribal​ governing board governed by Minnesota Rules, parts 9530.6600 to 9530.6655.​ 254A.16 RESPONSIBILITIES OF THE COMMISSIONER.​ Subd. 6. Monitoring. The commissioner shall gather and placing authorities shall provide​ information to measure compliance with Minnesota Rules, parts 9530.6600 to 9530.6655. The​ commissioner shall specify the format for data collection to facilitate tracking, aggregating, and​ using the information.​ 254A.19 CHEMICAL USE ASSESSMENTS.​ Subd. 1a. Emergency room patients. A county may enter into a contract with a hospital to​ provide chemical use assessments under Minnesota Rules, parts 9530.6600 to 9530.6655, for patients​ admitted to an emergency room or inpatient hospital when:​ (1) an assessor is not available; and​ (2) detoxification services in the county are at full capacity.​ Subd. 2. Probation officer as contact. When a chemical use assessment is required under​ Minnesota Rules, parts 9530.6600 to 9530.6655, for a person who is on probation or under other​ correctional supervision, the assessor, either orally or in writing, shall contact the person's probation​ officer to verify or supplement the information provided by the person.​ 3R​ APPENDIX​ Repealed Minnesota Statutes: 23-00276​ Subd. 5. Assessment via telehealth. Notwithstanding Minnesota Rules, part 9530.6615, subpart​ 3, item A, a chemical use assessment may be conducted via telehealth as defined in section​ 256B.0625, subdivision 3b.​ 254B.04 ELIGIBILITY FOR BEHAVIORAL HEALTH FUND SERVICES.​ Subd. 2b. Eligibility for placement in opioid treatment programs. Prior to placement of an​ individual who is determined by the assessor to require treatment for opioid addiction, the assessor​ must provide educational information concerning treatment options for opioid addiction, including​ the use of a medication for the use of opioid addiction. The commissioner shall develop educational​ materials supported by research and updated periodically that must be used by assessors to comply​ with this requirement.​ Subd. 2c. Eligibility to receive peer recovery support and treatment service​ coordination. Notwithstanding Minnesota Rules, part 9530.6620, subpart 6, a placing authority​ may authorize peer recovery support and treatment service coordination for a person who scores a​ severity of one or more in dimension 4, 5, or 6, under Minnesota Rules, part 9530.6622. Authorization​ for peer recovery support and treatment service coordination under this subdivision does not need​ to be provided in conjunction with treatment services under Minnesota Rules, part 9530.6622,​ subpart 4, 5, or 6.​ 254B.041 SUBSTANCE USE DISORDER RULES.​ Subd. 2. Vendor collections; rule amendment. The commissioner may amend Minnesota​ Rules, parts 9530.7000 to 9530.7025, to require a vendor of substance use disorder transitional and​ extended care rehabilitation services to collect the cost of care received under a program from an​ eligible person who has been determined to be partially responsible for treatment costs, and to remit​ the collections to the commissioner. The commissioner shall pay to a vendor, for the collections,​ an amount equal to five percent of the collections remitted to the commissioner by the vendor.​ 254B.13 PILOT PROJECTS; CHEMICAL HEALTH CARE.​ Subdivision 1. Authorization for navigator pilot projects. The commissioner may approve​ and implement navigator pilot projects developed under the planning process required under Laws​ 2009, chapter 79, article 7, section 26, to provide alternatives to and enhance coordination of the​ delivery of chemical health services required under section 254B.03.​ Subd. 2. Program design and implementation. (a) The commissioner and counties participating​ in the navigator pilot projects shall continue to work in partnership to refine and implement the​ navigator pilot projects initiated under Laws 2009, chapter 79, article 7, section 26.​ (b) The commissioner and counties participating in the navigator pilot projects shall complete​ the planning phase and, if approved by the commissioner for implementation, enter into agreements​ governing the operation of the navigator pilot projects.​ Subd. 2a. Eligibility for navigator pilot program. (a) To be considered for participation in a​ navigator pilot program, an individual must:​ (1) be a resident of a county with an approved navigator program;​ (2) be eligible for behavioral health fund services;​ (3) be a voluntary participant in the navigator program;​ (4) satisfy one of the following items:​ (i) have at least one severity rating of three or above in dimension four, five, or six in a​ comprehensive assessment under section 245G.05, subdivision 2, paragraph (c), clauses (4) to (6);​ or​ (ii) have at least one severity rating of two or above in dimension four, five, or six in a​ comprehensive assessment under section 245G.05, subdivision 2, paragraph (c), clauses (4) to (6),​ and be currently participating in a Rule 31 treatment program under chapter 245G or be within 60​ days following discharge after participation in a Rule 31 treatment program; and​ (5) have had at least two treatment episodes in the past two years, not limited to episodes​ reimbursed by the behavioral health fund. An admission to an emergency room, a detoxification​ program, or a hospital may be substituted for one treatment episode if it resulted from the individual's​ substance use disorder.​ 4R​ APPENDIX​ Repealed Minnesota Statutes: 23-00276​ (b) New eligibility criteria may be added as mutually agreed upon by the commissioner and​ participating navigator programs.​ Subd. 4. Notice of navigator pilot project discontinuation. Each county's participation in the​ navigator pilot project may be discontinued for any reason by the county or the commissioner of​ human services after 30 days' written notice to the other party.​ Subd. 5. Duties of commissioner. (a) Notwithstanding any other provisions in this chapter, the​ commissioner may authorize navigator pilot projects to use the behavioral health fund to pay for​ nontreatment navigator pilot services:​ (1) in addition to those authorized under section 254B.03, subdivision 2, paragraph (a); and​ (2) by vendors in addition to those authorized under section 254B.05 when not providing​ substance use disorder treatment services.​ (b) For purposes of this section, "nontreatment navigator pilot services" include navigator​ services, peer support, family engagement and support, housing support, rent subsidies, supported​ employment, and independent living skills.​ (c) State expenditures for substance use disorder services and nontreatment navigator pilot​ services provided by or through the navigator pilot projects must not be greater than the behavioral​ health fund expected share of forecasted expenditures in the absence of the navigator pilot projects.​ The commissioner may restructure the schedule of payments between the state and participating​ counties under the local agency share and division of cost provisions under section 254B.03,​ subdivisions 3 and 4, as necessary to facilitate the operation of the navigator pilot projects.​ (d) The commissioner may waive administrative rule requirements that are incompatible with​ the implementation of the navigator pilot project, except that any substance use disorder treatment​ funded under this section must continue to be provided by a licensed treatment provider.​ (e) The commissioner shall not approve or enter into any agreement related to navigator pilot​ projects authorized under this section that puts current or future federal funding at risk.​ (f) The commissioner shall provide participating navigator pilot projects with transactional data,​ reports, provider data, and other data generated by county activity to assess and measure outcomes.​ This information must be transmitted or made available in an acceptable form to participating​ navigator pilot projects at least once every six months or within a reasonable time following the​ commissioner's receipt of information from the counties needed to comply with this paragraph.​ Subd. 6. Duties of county board. The county board, or other county entity that is approved to​ administer a navigator pilot project, shall:​ (1) administer the navigator pilot project in a manner consistent with the objectives described​ in subdivision 2 and the planning process in subdivision 5;​ (2) ensure that no one is denied substance use disorder treatment services for which they would​ otherwise be eligible under section 254A.03, subdivision 3; and​ (3) provide the commissioner with timely and pertinent information as negotiated in agreements​ governing operation of the navigator pilot projects.​ Subd. 7. Managed care. An individual who is eligible for the navigator pilot program under​ subdivision 2a is excluded from mandatory enrollment in managed care until these services are​ included in the health plan's benefit set.​ Subd. 8. Authorization for continuation of navigator pilots. The navigator pilot projects​ implemented pursuant to subdivision 1 are authorized to continue operation after July 1, 2013,​ under existing agreements governing operation of the pilot projects.​ 254B.16 PILOT PROJECTS; TREATMENT FOR PREGNANT AND POSTPARTUM​ WOMEN WITH SUBSTANCE USE DISORDER.​ Subdivision 1. Pilot projects established. (a) Within the limits of federal funds available​ specifically for this purpose, the commissioner of human services shall establish pilot projects to​ provide substance use disorder treatment and services to pregnant and postpartum women with a​ primary diagnosis of substance use disorder, including opioid use disorder. Pilot projects funded​ under this section must:​ (1) promote flexible uses of funds to provide treatment and services to pregnant and postpartum​ women with substance use disorders;​ 5R​ APPENDIX​ Repealed Minnesota Statutes: 23-00276​ (2) fund family-based treatment and services for pregnant and postpartum women with substance​ use disorders;​ (3) identify gaps in services along the continuum of care that are provided to pregnant and​ postpartum women with substance use disorders; and​ (4) encourage new approaches to service delivery and service delivery models.​ (b) A pilot project funded under this section must provide at least a portion of its treatment and​ services to women who receive services on an outpatient basis.​ Subd. 2. Federal funds. The commissioner shall apply for any available grant funds from the​ federal Center for Substance Abuse Treatment for these pilot projects.​ 256.9685 ESTABLISHMENT OF INPATIENT HOSPITAL PAYMENT SYSTEM.​ Subd. 1c. Judicial review. A hospital, physician, advanced practice registered nurse, or physician​ assistant aggrieved by an order of the commissioner under subdivision 1b may appeal the order to​ the district court of the county in which the physician, advanced practice registered nurse, physician​ assistant, or hospital is located by:​ (1) serving a written copy of a notice of appeal upon the commissioner within 30 days after the​ date the commissioner issued the order; and​ (2) filing the original notice of appeal and proof of service with the court administrator of the​ district court. The appeal shall be treated as a dispositive motion under the Minnesota General Rules​ of Practice, rule 115. The district court scope of review shall be as set forth in section 14.69.​ Subd. 1d. Transmittal of record. Within 30 days after being served with the notice of appeal,​ the commissioner shall transmit to the district court the original or certified copy of the entire record​ considered by the commissioner in making the final agency decision. The district court shall not​ consider evidence that was not included in the record before the commissioner.​ 256B.49 HOME AND COMMUNITY-BASED SERVICE WAIVERS FOR PERSONS​ WITH DISABILITIES.​ Subd. 23. Community-living settings. (a) For the purposes of this chapter, "community-living​ settings" means a single-family home or multifamily dwelling unit where a service recipient or a​ service recipient's family owns or rents, and maintains control over the individual unit as​ demonstrated by a lease agreement. Community-living settings does not include a home or dwelling​ unit that the service provider owns, operates, or leases or in which the service provider has a direct​ or indirect financial interest.​ (b) To ensure a service recipient or the service recipient's family maintains control over the​ home or dwelling unit, community-living settings are subject to the following requirements:​ (1) service recipients must not be required to receive services or share services;​ (2) service recipients must not be required to have a disability or specific diagnosis to live in​ the community-living setting;​ (3) service recipients may hire service providers of their choice;​ (4) service recipients may choose whether to share their household and with whom;​ (5) the home or multifamily dwelling unit must include living, sleeping, bathing, and cooking​ areas;​ (6) service recipients must have lockable access and egress;​ (7) service recipients must be free to receive visitors and leave the settings at times and for​ durations of their own choosing;​ (8) leases must comply with chapter 504B;​ (9) landlords must not charge different rents to tenants who are receiving home and​ community-based services; and​ (10) access to the greater community must be easily facilitated based on the service recipient's​ needs and preferences.​ (c) Nothing in this section prohibits a service recipient from having another person or entity​ not affiliated with the service provider cosign a lease. Nothing in this section prohibits a service​ 6R​ APPENDIX​ Repealed Minnesota Statutes: 23-00276​ recipient, during any period in which a service provider has cosigned the service recipient's lease,​ from modifying services with an existing cosigning service provider and, subject to the approval​ of the landlord, maintaining a lease cosigned by the service provider. Nothing in this section prohibits​ a service recipient, during any period in which a service provider has cosigned the service recipient's​ lease, from terminating services with the cosigning service provider, receiving services from a new​ service provider, and, subject to the approval of the landlord, maintaining a lease cosigned by the​ new service provider.​ (d) A lease cosigned by a service provider meets the requirements of paragraph (a) if the service​ recipient and service provider develop and implement a transition plan which must provide that,​ within two years of cosigning the initial lease, the service provider shall transfer the lease to the​ service recipient and other cosigners, if any.​ (e) In the event the landlord has not approved the transfer of the lease within two years of the​ service provider cosigning the initial lease, the service provider must submit a time-limited extension​ request to the commissioner of human services to continue the cosigned lease arrangement. The​ extension request must include:​ (1) the reason the landlord denied the transfer;​ (2) the plan to overcome the denial to transfer the lease;​ (3) the length of time needed to successfully transfer the lease, not to exceed an additional two​ years;​ (4) a description of how the transition plan was followed, what occurred that led to the landlord​ denying the transfer, and what changes in circumstances or condition, if any, the service recipient​ experienced; and​ (5) a revised transition plan to transfer the cosigned lease between the service provider and the​ service recipient to the service recipient.​ The commissioner must approve an extension within sufficient time to ensure the continued​ occupancy by the service recipient.​ 256D.63 EXPIRATION OF SUPPLEMENTAL NUTRITION ASSISTANCE PROGRAM​ BENEFITS AND REPORTING REQUIREMENTS.​ Subdivision 1. Expiration of SNAP benefits. Supplemental Nutrition Assistance Program​ (SNAP) benefits shall not be stored off line or expunged from a recipient's account unless the​ benefits have not been accessed for 12 months after the month they were issued.​ 256I.03 DEFINITIONS.​ Subd. 6. Medical assistance room and board rate. "Medical assistance room and board rate"​ means an amount equal to 81 percent of the federal poverty guideline for a single individual living​ alone in the community less the medical assistance personal needs allowance under section 256B.35.​ For the purposes of this section, the amount of the room and board rate that exceeds the medical​ assistance room and board rate is considered a remedial care cost. A remedial care cost may be​ used to meet a spenddown obligation under section 256B.056, subdivision 5. The medical assistance​ room and board rate is to be adjusted on the first day of January of each year.​ 260.835 AMERICAN INDIAN CHILD WELFARE ADVISORY COUNCIL.​ Subd. 2. Expiration. The American Indian Child Welfare Advisory Council expires June 30,​ 2023.​ 518A.59 NOTICE OF INTEREST ON LATE CHILD SUPPORT.​ Any judgment or decree of dissolution or legal separation containing a requirement of child​ support and any determination of parentage, order under chapter 518C, order under section 256.87,​ or order under section 260B.331 or 260C.331 must include a notice to the parties that section​ 548.091, subdivision 1a, provides for interest to begin accruing on a payment or installment of child​ support whenever the unpaid amount due is greater than the current support due.​ 7R​ APPENDIX​ Repealed Minnesota Statutes: 23-00276​ 2960.3070 FOSTER PARENT TRAINING.​ Subpart 1. Orientation. A nonrelative foster parent must complete a minimum of six​ hours of orientation before admitting a foster child. Orientation is required for relative foster​ parents who will be licensed as a child's foster parents. Orientation for relatives must be​ completed within 30 days following the initial placement. The foster parent's orientation​ must include items A to E:​ A. emergency procedures, including evacuation routes, emergency telephone​ numbers, severe storm and tornado procedures, and location of alarms and equipment;​ B. relevant laws and rules, including, but not limited to, chapter 9560 and​ Minnesota Statutes, chapters 245A, 260, 260C, and 260E, and legal issues and reporting​ requirements;​ C. cultural diversity, gender sensitivity, culturally specific services, cultural​ competence, and information about discrimination and racial bias issues to ensure that​ caregivers will be culturally competent to care for foster children according to Minnesota​ Statutes, section 260C.212, subdivision 11;​ D. information about the role and responsibilities of the foster parent in the​ development and implementation of the case plan and in court and administrative reviews​ of the child's placement; and​ E. requirements of the licensing agency.​ Subp. 2. In-service training. Each foster parent must complete a minimum of 12​ hours of training per year in one or more of the areas in this subpart or in other areas as​ agreed upon by the licensing agency and the foster parent. If the foster parent has not​ completed the required annual training at the time of relicensure and does not show good​ cause why the training was not completed, the foster parent may not accept new foster​ children until the training is completed. The nonexclusive list of topics in items A to Z​ provides examples of in-service training topics that could be useful to a foster parent:​ A. cultural competence and transcultural placements;​ B. adoption and permanency;​ C. crisis intervention, including suicide prevention;​ D. sexual offender behaviors;​ E. children's psychological, spiritual, cultural, sexual, emotional, intellectual, and​ social development;​ F. legal issues including liability;​ G. foster family relationships with placing agencies and other service providers;​ H. first aid and life-sustaining treatment such as cardiopulmonary resuscitation;​ I. preparing foster children for independent living;​ J. parenting children who suffered physical, emotional, or sexual abuse or domestic​ violence;​ K. chemical dependency, and signs or symptoms of alcohol and drug abuse;​ L. mental health and emotional disturbance issues;​ M. Americans with Disabilities Act and Individuals With Disabilities Education​ Act;​ N. caring for children with disabilities and disability-related issues regarding​ developmental disabilities, emotional and behavioral disorders, and specific learning​ disabilities;​ 8R​ APPENDIX​ Repealed Minnesota Rules: 23-00276​ O. privacy issues of foster children;​ P. physical and nonphysical behavior guidance, crisis de-escalation, and discipline​ techniques, including how to handle aggression for specific age groups and specific issues​ such as developmental disabilities, chemical dependency, emotional disturbances, learning​ disabilities, and past abuse;​ Q. birth families and reunification;​ R. effects of foster care on foster families;​ S. home safety;​ T. emergency procedures;​ U. child and family wellness;​ V. sexual orientation;​ W. disability bias and discrimination;​ X. management of sexual perpetration, violence, bullying, and exploitative​ behaviors;​ Y. medical technology-dependent or medically fragile conditions; and​ Z. separation, loss, and attachment.​ Subp. 3. Medical equipment training. Foster parents who care for children who rely​ on medical equipment to sustain life or monitor a medical condition must meet the​ requirements of Minnesota Statutes, section 245A.155.​ 2960.3210 STAFF TRAINING REQUIREMENTS.​ Subpart 1. Orientation. The license holder must ensure that all staff attend and​ successfully complete at least six hours of orientation training before having unsupervised​ contact with foster children. The number of hours of orientation training are not counted as​ part of the hours of annual training. Orientation training must include at least the topics in​ items A to F:​ A. emergency procedures, including evacuation routes, emergency telephone​ numbers, severe storm and tornado procedures, and location of facility alarms and equipment;​ B. relevant statutes and administrative rules and legal issues, including reporting​ requirements for abuse and neglect specified in Minnesota Statutes, chapter 260E and section​ 626.557, and other reporting requirements based on the ages of the children;​ C. cultural diversity and gender sensitivity, culturally specific services, and​ information about discrimination and racial bias issues to ensure that caregivers have cultural​ sensitivity and will be culturally competent to care for children according to Minnesota​ Statutes, section 260C.212, subdivision 11;​ D. general and special needs, including disability needs, of children and families​ served;​ E. operational policies and procedures of the license holder; and​ F. data practices regulations and issues.​ Subp. 2. Personnel training. The license holder must provide training for staff that​ is modified annually to meet the current needs of individual staff persons. The license holder​ must develop an annual training plan for employees that addresses items A to C.​ A. Full-time and part-time direct care staff and volunteers must have sufficient​ training to accomplish their duties. To determine the type and amount of training an employee​ needs, the license holder must consider the foster care program's target population, services​ the program delivers, and outcomes expected from the services, as well as the employee's​ 9R​ APPENDIX​ Repealed Minnesota Rules: 23-00276​ position description, tasks to be performed, and the performance indicators for the position.​ The license holder and staff who care for children who rely on medical equipment to sustain​ life or monitor a medical condition must meet the requirements of Minnesota Statutes,​ section 245A.155.​ B. Full-time staff who have direct contact with children must complete at least​ 18 hours of in-service training per year. One-half of the training must be skill development​ training. Other foster home staff and volunteers must complete in-service training​ requirements consistent with their duties.​ C. Part-time direct care staff must receive sufficient training to competently care​ for children. The amount of training must be provided at least at a ratio of one hour of​ training for each 60 hours worked, up to 18 hours of training per part-time employee per​ year.​ Subp. 3. Documentation of training. The license holder must document the date and​ number of hours of orientation and in-service training completed by each staff person in​ each topic area and the name of the entity that provided the training.​ 9502.0425 PHYSICAL ENVIRONMENT.​ Subp. 5. Occupancy separations. Day care residences with an attached garage must​ have a self-closing, tight fitting solid wood bonded core door at least 1-3/8 inch thick, or​ door with a fire protection rating of 20 minutes or greater and a separation wall consisting​ of 5/8 inch thick gypsum wallboard or its equivalent on the garage side between the residence​ and garage.​ Subp. 10. Stairways. All stairways must meet the following conditions.​ A. Stairways of three or more steps must have handrails.​ B. Any open area between the handrail and stair tread must be enclosed with a​ protective guardrail as specified in the State Building Code. The back of the stair risers must​ be enclosed.​ C. Gates or barriers must be used when children between the ages of 6 and 18​ months are in care.​ D. Stairways must be well-lighted, in good repair, and free of clutter and​ obstructions.​ 9505.0235 ABORTION SERVICES.​ Subpart 1. Definition. For purposes of this part, "abortion related services" means​ services provided in connection with an elective abortion except those services which would​ otherwise be provided in the course of a pregnancy. Examples of abortion related services​ include hospitalization when the abortion is performed in an inpatient setting, the use of a​ facility when the abortion is performed in an outpatient setting, counseling about the abortion,​ general and local anesthesia provided in connection with the abortion, and antibiotics​ provided directly after the abortion.​ Medically necessary services that are not considered to be abortion related include​ family planning services as defined in part 9505.0280, subpart 1, history and physical​ examination, tests for pregnancy and venereal disease, blood tests, rubella titer, ultrasound​ tests, rhoGAM(TM), pap smear, and laboratory examinations for the purpose of detecting​ fetal abnormalities.​ Treatment for infection or other complications of the abortion are covered services.​ Subp. 2. Payment limitation. Unless otherwise provided by law, an abortion related​ service provided to a recipient is eligible for medical assistance payment if the abortion​ meets the conditions in item A, B, or C.​ 10R​ APPENDIX​ Repealed Minnesota Rules: 23-00276​ A. The abortion must be necessary to prevent the death of a pregnant woman who​ has given her written consent to the abortion. If the pregnant woman is physically or legally​ incapable of giving her written consent to the procedure, authorization for the abortion must​ be obtained as specified in Minnesota Statutes, section 144.343. The necessity of the abortion​ to prevent the death of the pregnant woman must be certified in writing by two physicians​ before the abortion is performed.​ B. The pregnancy is the result of criminal sexual conduct as defined in Minnesota​ Statutes, section 609.342, paragraphs (c) to (f). The conduct must be reported to a law​ enforcement agency within 48 hours after its occurrence. If the victim is physically unable​ to report the criminal sexual conduct within 48 hours after its occurrence, the report must​ be made within 48 hours after the victim becomes physically able to report the criminal​ sexual conduct.​ C. The pregnancy is the result of incest. Before the abortion, the incest and the​ name of the relative allegedly committing the incest must be reported to a law enforcement​ agency.​ 9505.0505 DEFINITIONS.​ Subp. 18. Medical review agent. "Medical review agent" means the representative​ of the commissioner who is authorized by the commissioner to administer procedures for​ admission certifications, medical record reviews and reconsideration, and perform other​ functions as stipulated in the terms of the agent's contract with the department.​ 9505.0520 INPATIENT ADMISSION CERTIFICATION.​ Subp. 9b. Reconsideration; physician advisers appointed by medical review​ agent. Upon receipt of a request for reconsideration under subpart 9, the medical review​ agent shall appoint at least three physician advisers who did not take part in the decision to​ deny or withdraw all or part of the admission certification. Each physician adviser shall​ determine the medical necessity of the admission or the continued stay or, in the case of a​ readmission, determine whether the admission and readmission meet the criteria in part​ 9505.0540. The reconsideration decision must be the majority opinion of the physician​ advisers. In making the decision, the three physician advisers shall use the criteria of medical​ necessity set out in part 9505.0530.​ 11R​ APPENDIX​ Repealed Minnesota Rules: 23-00276​