1.1 A bill for an act
1.2 relating to human services; modifying provisions relating to aging and older adult
1.3 services, disability services, early intensive developmental and behavioral
1.4 intervention, direct care and treatment, and health care; establishing a patient driven
1.5 payment model phase-in, the Minnesota Caregiver Defined Contribution Retirement
1.6 Fund Trust, recovery residence certification, and a working group; requiring stipend
1.7 payments to certain collective bargaining unit members; requiring reports;
1.8 appropriating money; amending Minnesota Statutes 2024, sections 13.46,
1.9 subdivision 1; 144.0724, subdivision 11; 144A.071, subdivisions 4a, 4c, 4d;
1.10 144A.161, subdivision 10; 179A.54, by adding a subdivision; 245.4661,
1.11 subdivisions 2, 6, 7; 245.91, subdivision 4; 245C.16, subdivision 1; 245G.01,
1.12 subdivision 13b, by adding subdivisions; 245G.02, subdivision 2; 245G.07,
1.13 subdivisions 1, 3, 4, by adding subdivisions; 245G.11, subdivisions 6, 7, by adding
1.14 a subdivision; 245G.22, subdivisions 11, 15; 246B.10; 254A.19, subdivision 4;
1.15 254B.01, subdivisions 10, 11; 254B.02, subdivision 5; 254B.03, subdivisions 1,
1.16 3, 4; 254B.04, subdivisions 1a, 5, 6, 6a; 254B.05, subdivisions 1, 1a; 254B.06,
1.17 subdivision 2; 254B.09, subdivision 2; 254B.181, subdivisions 1, 2, 3, by adding
1.18 subdivisions; 254B.19, subdivision 1; 256.01, subdivisions 29, 34; 256.043,
1.19 subdivision 3; 256.9657, subdivision 1; 256B.04, subdivisions 12, 14; 256B.0625,
1.20 subdivisions 5m, 17, by adding a subdivision; 256B.0659, subdivision 17a;
1.21 256B.0757, subdivision 4c; 256B.0924, subdivision 6; 256B.0949, subdivisions
1.22 15, 16, by adding a subdivision; 256B.19, subdivision 1; 256B.431, subdivision
1.23 30; 256B.49, by adding a subdivision; 256B.4914, subdivisions 3, 5, 5a, 5b, 6a,
1.24 7a, 7b, 7c, 8, 9, by adding subdivisions; 256B.85, subdivisions 7a, 8, 16; 256B.851,
1.25 subdivisions 5, 6; 256G.01, subdivision 3; 256G.08, subdivisions 1, 2; 256G.09,
1.26 subdivisions 1, 2; 256I.04, subdivision 2a; 256R.02, subdivisions 18, 19, 22, by
1.27 adding subdivisions; 256R.10, subdivision 8; 256R.23, subdivisions 7, 8; 256R.24,
1.28 subdivision 3; 256R.25; 256R.26, subdivision 9; 256R.43; 260E.14, subdivision
1.29 1; 325F.725; 611.43, by adding a subdivision; 611.46, subdivision 1; 611.55, by
1.30 adding a subdivision; 626.5572, subdivision 13; proposing coding for new law in
1.31 Minnesota Statutes, chapters 245A; 254B; 256R; repealing Minnesota Statutes
1.32 2024, sections 144A.1888; 245G.01, subdivision 20d; 245G.07, subdivision 2;
1.33 254B.01, subdivision 5; 254B.04, subdivision 2a; 256B.0625, subdivisions 18b,
1.34 18e, 18h; 256B.434, subdivision 4; 256R.02, subdivision 38; 256R.12, subdivision
1.35 10; 256R.23, subdivision 6; 256R.36; 256R.40; 256R.41; 256R.481; 256R.53,
1.36 subdivision 1.
1
REVISOR AGW/AC 25-0033903/03/25
State of Minnesota
This Document can be made available
in alternative formats upon request
HOUSE OF REPRESENTATIVES
H. F. No. 2434
NINETY-FOURTH SESSION
Authored by Schomacker and Noor03/17/2025
The bill was read for the first time and referred to the Committee on Human Services Finance and Policy 2.1BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF MINNESOTA:
2.2 ARTICLE 1
2.3 AGING AND OLDER ADULT SERVICES
2.4 Section 1. Minnesota Statutes 2024, section 144A.071, subdivision 4a, is amended to read:
2.5 Subd. 4a.Exceptions for replacement beds.It is in the best interest of the state to
2.6ensure that nursing homes and boarding care homes continue to meet the physical plant
2.7licensing and certification requirements by permitting certain construction projects. Facilities
2.8should be maintained in condition to satisfy the physical and emotional needs of residents
2.9while allowing the state to maintain control over nursing home expenditure growth.
2.10 The commissioner of health in coordination with the commissioner of human services,
2.11may approve the renovation, replacement, upgrading, or relocation of a nursing home or
2.12boarding care home, under the following conditions:
2.13 (a) to license or certify beds in a new facility constructed to replace a facility or to make
2.14repairs in an existing facility that was destroyed or damaged after June 30, 1987, by fire,
2.15lightning, or other hazard provided:
2.16 (i) destruction was not caused by the intentional act of or at the direction of a controlling
2.17person of the facility;
2.18 (ii) at the time the facility was destroyed or damaged the controlling persons of the
2.19facility maintained insurance coverage for the type of hazard that occurred in an amount
2.20that a reasonable person would conclude was adequate;
2.21 (iii) the net proceeds from an insurance settlement for the damages caused by the hazard
2.22are applied to the cost of the new facility or repairs;
2.23 (iv) the number of licensed and certified beds in the new facility does not exceed the
2.24number of licensed and certified beds in the destroyed facility; and
2.25 (v) the commissioner determines that the replacement beds are needed to prevent an
2.26inadequate supply of beds.
2.27Project construction costs incurred for repairs authorized under this clause shall not be
2.28considered in the dollar threshold amount defined in subdivision 2;
2.29 (b) to license or certify beds that are moved from one location to another within a nursing
2.30home facility, provided the total costs of remodeling performed in conjunction with the
2.31relocation of beds does not exceed $1,000,000;
2Article 1 Section 1.
REVISOR AGW/AC 25-0033903/03/25 3.1 (c) to license or certify beds in a project recommended for approval under section
3.2144A.073;
3.3 (d) to license or certify beds that are moved from an existing state nursing home to a
3.4different state facility, provided there is no net increase in the number of state nursing home
3.5beds;
3.6 (e) to certify and license as nursing home beds boarding care beds in a certified boarding
3.7care facility if the beds meet the standards for nursing home licensure, or in a facility that
3.8was granted an exception to the moratorium under section 144A.073, and if the cost of any
3.9remodeling of the facility does not exceed $1,000,000. If boarding care beds are licensed
3.10as nursing home beds, the number of boarding care beds in the facility must not increase
3.11beyond the number remaining at the time of the upgrade in licensure. The provisions
3.12contained in section 144A.073 regarding the upgrading of the facilities do not apply to
3.13facilities that satisfy these requirements;
3.14 (f) to license and certify up to 40 beds transferred from an existing facility owned and
3.15operated by the Amherst H. Wilder Foundation in the city of St. Paul to a new unit at the
3.16same location as the existing facility that will serve persons with Alzheimer's disease and
3.17other related disorders. The transfer of beds may occur gradually or in stages, provided the
3.18total number of beds transferred does not exceed 40. At the time of licensure and certification
3.19of a bed or beds in the new unit, the commissioner of health shall delicense and decertify
3.20the same number of beds in the existing facility. As a condition of receiving a license or
3.21certification under this clause, the facility must make a written commitment to the
3.22commissioner of human services that it will not seek to receive an increase in its
3.23property-related payment rate as a result of the transfers allowed under this paragraph;
3.24 (g) to license and certify nursing home beds to replace currently licensed and certified
3.25boarding care beds which may be located either in a remodeled or renovated boarding care
3.26or nursing home facility or in a remodeled, renovated, newly constructed, or replacement
3.27nursing home facility within the identifiable complex of health care facilities in which the
3.28currently licensed boarding care beds are presently located, provided that the number of
3.29boarding care beds in the facility or complex are decreased by the number to be licensed as
3.30nursing home beds and further provided that, if the total costs of new construction,
3.31replacement, remodeling, or renovation exceed ten percent of the appraised value of the
3.32facility or $200,000, whichever is less, the facility makes a written commitment to the
3.33commissioner of human services that it will not seek to receive an increase in its
3.34property-related payment rate by reason of the new construction, replacement, remodeling,
3Article 1 Section 1.
REVISOR AGW/AC 25-0033903/03/25 4.1or renovation. The provisions contained in section 144A.073 regarding the upgrading of
4.2facilities do not apply to facilities that satisfy these requirements;
4.3 (h) to license as a nursing home and certify as a nursing facility a facility that is licensed
4.4as a boarding care facility but not certified under the medical assistance program, but only
4.5if the commissioner of human services certifies to the commissioner of health that licensing
4.6the facility as a nursing home and certifying the facility as a nursing facility will result in
4.7a net annual savings to the state general fund of $200,000 or more;
4.8 (i) to certify, after September 30, 1992, and prior to July 1, 1993, existing nursing home
4.9beds in a facility that was licensed and in operation prior to January 1, 1992;
4.10 (j) to license and certify new nursing home beds to replace beds in a facility acquired
4.11by the Minneapolis Community Development Agency as part of redevelopment activities
4.12in a city of the first class, provided the new facility is located within three miles of the site
4.13of the old facility. Operating and property costs for the new facility must be determined and
4.14allowed under section 256B.431 or 256B.434 or chapter 256R;
4.15 (k) to license and certify up to 20 new nursing home beds in a community-operated
4.16hospital and attached convalescent and nursing care facility with 40 beds on April 21, 1991,
4.17that suspended operation of the hospital in April 1986. The commissioner of human services
4.18shall provide the facility with the same per diem property-related payment rate for each
4.19additional licensed and certified bed as it will receive for its existing 40 beds;
4.20 (l) to license or certify beds in renovation, replacement, or upgrading projects as defined
4.21in section 144A.073, subdivision 1, so long as the cumulative total costs of the facility's
4.22remodeling projects do not exceed $1,000,000;
4.23 (m) to license and certify beds that are moved from one location to another for the
4.24purposes of converting up to five four-bed wards to single or double occupancy rooms in
4.25a nursing home that, as of January 1, 1993, was county-owned and had a licensed capacity
4.26of 115 beds;
4.27 (n) to allow a facility that on April 16, 1993, was a 106-bed licensed and certified nursing
4.28facility located in Minneapolis to layaway all of its licensed and certified nursing home
4.29beds. These beds may be relicensed and recertified in a newly constructed teaching nursing
4.30home facility affiliated with a teaching hospital upon approval by the legislature. The
4.31proposal must be developed in consultation with the interagency committee on long-term
4.32care planning. The beds on layaway status shall have the same status as voluntarily delicensed
4.33and decertified beds, except that beds on layaway status remain subject to the surcharge in
4.34section 256.9657. This layaway provision expires July 1, 1998;
4Article 1 Section 1.
REVISOR AGW/AC 25-0033903/03/25 5.1 (o) to allow a project which will be completed in conjunction with an approved
5.2moratorium exception project for a nursing home in southern Cass County and which is
5.3directly related to that portion of the facility that must be repaired, renovated, or replaced,
5.4to correct an emergency plumbing problem for which a state correction order has been
5.5issued and which must be corrected by August 31, 1993;
5.6 (p) to allow a facility that on April 16, 1993, was a 368-bed licensed and certified nursing
5.7facility located in Minneapolis to layaway, upon 30 days prior written notice to the
5.8commissioner, up to 30 of the facility's licensed and certified beds by converting three-bed
5.9wards to single or double occupancy. Beds on layaway status shall have the same status as
5.10voluntarily delicensed and decertified beds except that beds on layaway status remain subject
5.11to the surcharge in section 256.9657, remain subject to the license application and renewal
5.12fees under section 144A.07 and shall be subject to a $100 per bed reactivation fee. In
5.13addition, at any time within three years of the effective date of the layaway, the beds on
5.14layaway status may be:
5.15 (1) relicensed and recertified upon relocation and reactivation of some or all of the beds
5.16to an existing licensed and certified facility or facilities located in Pine River, Brainerd, or
5.17International Falls; provided that the total project construction costs related to the relocation
5.18of beds from layaway status for any facility receiving relocated beds may not exceed the
5.19dollar threshold provided in subdivision 2 unless the construction project has been approved
5.20through the moratorium exception process under section 144A.073;
5.21 (2) relicensed and recertified, upon reactivation of some or all of the beds within the
5.22facility which placed the beds in layaway status, if the commissioner has determined a need
5.23for the reactivation of the beds on layaway status.
5.24 The property-related payment rate of a facility placing beds on layaway status must be
5.25adjusted by the incremental change in its rental per diem after recalculating the rental per
5.26diem as provided in section 256B.431, subdivision 3a, paragraph (c). The property-related
5.27payment rate for a facility relicensing and recertifying beds from layaway status must be
5.28adjusted by the incremental change in its rental per diem after recalculating its rental per
5.29diem using the number of beds after the relicensing to establish the facility's capacity day
5.30divisor, which shall be effective the first day of the month following the month in which
5.31the relicensing and recertification became effective. Any beds remaining on layaway status
5.32more than three years after the date the layaway status became effective must be removed
5.33from layaway status and immediately delicensed and decertified;
5Article 1 Section 1.
REVISOR AGW/AC 25-0033903/03/25 6.1 (q) to license and certify beds in a renovation and remodeling project to convert 12
6.2four-bed wards into 24 two-bed rooms, expand space, and add improvements in a nursing
6.3home that, as of January 1, 1994, met the following conditions: the nursing home was located
6.4in Ramsey County; had a licensed capacity of 154 beds; and had been ranked among the
6.5top 15 applicants by the 1993 moratorium exceptions advisory review panel. The total
6.6project construction cost estimate for this project must not exceed the cost estimate submitted
6.7in connection with the 1993 moratorium exception process;
6.8 (r) to license and certify up to 117 beds that are relocated from a licensed and certified
6.9138-bed nursing facility located in St. Paul to a hospital with 130 licensed hospital beds
6.10located in South St. Paul, provided that the nursing facility and hospital are owned by the
6.11same or a related organization and that prior to the date the relocation is completed the
6.12hospital ceases operation of its inpatient hospital services at that hospital. After relocation,
6.13the nursing facility's status shall be the same as it was prior to relocation. The nursing
6.14facility's property-related payment rate resulting from the project authorized in this paragraph
6.15shall become effective no earlier than April 1, 1996. For purposes of calculating the
6.16incremental change in the facility's rental per diem resulting from this project, the allowable
6.17appraised value of the nursing facility portion of the existing health care facility physical
6.18plant prior to the renovation and relocation may not exceed $2,490,000;
6.19 (s) to license and certify two beds in a facility to replace beds that were voluntarily
6.20delicensed and decertified on June 28, 1991;
6.21 (t) to allow 16 licensed and certified beds located on July 1, 1994, in a 142-bed nursing
6.22home and 21-bed boarding care home facility in Minneapolis, notwithstanding the licensure
6.23and certification after July 1, 1995, of the Minneapolis facility as a 147-bed nursing home
6.24facility after completion of a construction project approved in 1993 under section 144A.073,
6.25to be laid away upon 30 days' prior written notice to the commissioner. Beds on layaway
6.26status shall have the same status as voluntarily delicensed or decertified beds except that
6.27they shall remain subject to the surcharge in section 256.9657. The 16 beds on layaway
6.28status may be relicensed as nursing home beds and recertified at any time within five years
6.29of the effective date of the layaway upon relocation of some or all of the beds to a licensed
6.30and certified facility located in Watertown, provided that the total project construction costs
6.31related to the relocation of beds from layaway status for the Watertown facility may not
6.32exceed the dollar threshold provided in subdivision 2 unless the construction project has
6.33been approved through the moratorium exception process under section 144A.073.
6.34 The property-related payment rate of the facility placing beds on layaway status must
6.35be adjusted by the incremental change in its rental per diem after recalculating the rental
6Article 1 Section 1.
REVISOR AGW/AC 25-0033903/03/25 7.1per diem as provided in section 256B.431, subdivision 3a, paragraph (c). The property-related
7.2payment rate for the facility relicensing and recertifying beds from layaway status must be
7.3adjusted by the incremental change in its rental per diem after recalculating its rental per
7.4diem using the number of beds after the relicensing to establish the facility's capacity day
7.5divisor, which shall be effective the first day of the month following the month in which
7.6the relicensing and recertification became effective. Any beds remaining on layaway status
7.7more than five years after the date the layaway status became effective must be removed
7.8from layaway status and immediately delicensed and decertified;
7.9 (u) to license and certify beds that are moved within an existing area of a facility or to
7.10a newly constructed addition which is built for the purpose of eliminating three- and four-bed
7.11rooms and adding space for dining, lounge areas, bathing rooms, and ancillary service areas
7.12in a nursing home that, as of January 1, 1995, was located in Fridley and had a licensed
7.13capacity of 129 beds;
7.14 (v) to relocate 36 beds in Crow Wing County and four beds from Hennepin County to
7.15a 160-bed facility in Crow Wing County, provided all the affected beds are under common
7.16ownership;
7.17 (w) to license and certify a total replacement project of up to 49 beds located in Norman
7.18County that are relocated from a nursing home destroyed by flood and whose residents were
7.19relocated to other nursing homes. The operating cost payment rates for the new nursing
7.20facility shall be determined based on the interim and settle-up payment provisions of section
7.21256R.27 and the reimbursement provisions of chapter 256R. Property-related reimbursement
7.22rates shall be determined under section 256R.26, taking into account any federal or state
7.23flood-related loans or grants provided to the facility;
7.24 (x) to license and certify to the licensee of a nursing home in Polk County that was
7.25destroyed by flood in 1997 replacement projects with a total of up to 129 beds, with at least
7.2625 beds to be located in Polk County and up to 104 beds distributed among up to three other
7.27counties. These beds may only be distributed to counties with fewer than the median number
7.28of age intensity adjusted beds per thousand, as most recently published by the commissioner
7.29of human services. If the licensee chooses to distribute beds outside of Polk County under
7.30this paragraph, prior to distributing the beds, the commissioner of health must approve the
7.31location in which the licensee plans to distribute the beds. The commissioner of health shall
7.32consult with the commissioner of human services prior to approving the location of the
7.33proposed beds. The licensee may combine these beds with beds relocated from other nursing
7.34facilities as provided in section 144A.073, subdivision 3c. The operating payment rates for
7.35the new nursing facilities shall be determined based on the interim and settle-up payment
7Article 1 Section 1.
REVISOR AGW/AC 25-0033903/03/25 8.1provisions of Minnesota Rules, parts 9549.0010 to 9549.0080. Property-related
8.2reimbursement rates shall be determined under section 256R.26. If the replacement beds
8.3permitted under this paragraph are combined with beds from other nursing facilities, the
8.4rates shall be calculated as the weighted average of rates determined as provided in this
8.5paragraph and section 256R.50;
8.6 (y) to license and certify beds in a renovation and remodeling project to convert 13
8.7three-bed wards into 13 two-bed rooms and 13 single-bed rooms, expand space, and add
8.8improvements in a nursing home that, as of January 1, 1994, met the following conditions:
8.9the nursing home was located in Ramsey County, was not owned by a hospital corporation,
8.10had a licensed capacity of 64 beds, and had been ranked among the top 15 applicants by
8.11the 1993 moratorium exceptions advisory review panel. The total project construction cost
8.12estimate for this project must not exceed the cost estimate submitted in connection with the
8.131993 moratorium exception process;
8.14 (z) to license and certify up to 150 nursing home beds to replace an existing 285 bed
8.15nursing facility located in St. Paul. The replacement project shall include both the renovation
8.16of existing buildings and the construction of new facilities at the existing site. The reduction
8.17in the licensed capacity of the existing facility shall occur during the construction project
8.18as beds are taken out of service due to the construction process. Prior to the start of the
8.19construction process, the facility shall provide written information to the commissioner of
8.20health describing the process for bed reduction, plans for the relocation of residents, and
8.21the estimated construction schedule. The relocation of residents shall be in accordance with
8.22the provisions of law and rule;
8.23 (aa) to allow the commissioner of human services to license an additional 36 beds to
8.24provide residential services for the physically disabled under Minnesota Rules, parts
8.259570.2000 to 9570.3400, in a 198-bed nursing home located in Red Wing, provided that
8.26the total number of licensed and certified beds at the facility does not increase;
8.27 (bb) to license and certify a new facility in St. Louis County with 44 beds constructed
8.28to replace an existing facility in St. Louis County with 31 beds, which has resident rooms
8.29on two separate floors and an antiquated elevator that creates safety concerns for residents
8.30and prevents nonambulatory residents from residing on the second floor. The project shall
8.31include the elimination of three- and four-bed rooms;
8.32 (cc) to license and certify four beds in a 16-bed certified boarding care home in
8.33Minneapolis to replace beds that were voluntarily delicensed and decertified on or before
8.34March 31, 1992. The licensure and certification is conditional upon the facility periodically
8Article 1 Section 1.
REVISOR AGW/AC 25-0033903/03/25 9.1assessing and adjusting its resident mix and other factors which may contribute to a potential
9.2institution for mental disease declaration. The commissioner of human services shall retain
9.3the authority to audit the facility at any time and shall require the facility to comply with
9.4any requirements necessary to prevent an institution for mental disease declaration, including
9.5delicensure and decertification of beds, if necessary;
9.6 (dd) to license and certify 72 beds in an existing facility in Mille Lacs County with 80
9.7beds as part of a renovation project. The renovation must include construction of an addition
9.8to accommodate ten residents with beginning and midstage dementia in a self-contained
9.9living unit; creation of three resident households where dining, activities, and support spaces
9.10are located near resident living quarters; designation of four beds for rehabilitation in a
9.11self-contained area; designation of 30 private rooms; and other improvements;
9.12 (ee) to license and certify beds in a facility that has undergone replacement or remodeling
9.13as part of a planned closure under section 256R.40;
9.14 (ff) (ee) to license and certify a total replacement project of up to 124 beds located in
9.15Wilkin County that are in need of relocation from a nursing home significantly damaged
9.16by flood. The operating cost payment rates for the new nursing facility shall be determined
9.17based on the interim and settle-up payment provisions of section 256R.27 and the
9.18reimbursement provisions of chapter 256R. Property-related reimbursement rates shall be
9.19determined under section 256R.26, taking into account any federal or state flood-related
9.20loans or grants provided to the facility;
9.21 (gg) (ff) to allow the commissioner of human services to license an additional nine beds
9.22to provide residential services for the physically disabled under Minnesota Rules, parts
9.239570.2000 to 9570.3400, in a 240-bed nursing home located in Duluth, provided that the
9.24total number of licensed and certified beds at the facility does not increase;
9.25 (hh) (gg) to license and certify up to 120 new nursing facility beds to replace beds in a
9.26facility in Anoka County, which was licensed for 98 beds as of July 1, 2000, provided the
9.27new facility is located within four miles of the existing facility and is in Anoka County.
9.28Operating and property rates shall be determined and allowed under chapter 256R and
9.29Minnesota Rules, parts 9549.0010 to 9549.0080; or
9.30 (ii) (hh) to transfer up to 98 beds of a 129-licensed bed facility located in Anoka County
9.31that, as of March 25, 2001, is in the active process of closing, to a 122-licensed bed nonprofit
9.32nursing facility located in the city of Columbia Heights or its affiliate. The transfer is effective
9.33when the receiving facility notifies the commissioner in writing of the number of beds
9.34accepted. The commissioner shall place all transferred beds on layaway status held in the
9Article 1 Section 1.
REVISOR AGW/AC 25-0033903/03/25 10.1name of the receiving facility. The layaway adjustment provisions of section 256B.431,
10.2subdivision 30, do not apply to this layaway. The receiving facility may only remove the
10.3beds from layaway for recertification and relicensure at the receiving facility's current site,
10.4or at a newly constructed facility located in Anoka County. The receiving facility must
10.5receive statutory authorization before removing these beds from layaway status, or may
10.6remove these beds from layaway status if removal from layaway status is part of a
10.7moratorium exception project approved by the commissioner under section 144A.073.
10.8 EFFECTIVE DATE.This section is effective the day following final enactment.
10.9 Sec. 2. Minnesota Statutes 2024, section 144A.071, subdivision 4c, is amended to read:
10.10 Subd. 4c.Exceptions for replacement beds after June 30, 2003.(a) The commissioner
10.11of health, in coordination with the commissioner of human services, may approve the
10.12renovation, replacement, upgrading, or relocation of a nursing home or boarding care home,
10.13under the following conditions:
10.14 (1) to license and certify an 80-bed city-owned facility in Nicollet County to be
10.15constructed on the site of a new city-owned hospital to replace an existing 85-bed facility
10.16attached to a hospital that is also being replaced. The threshold allowed for this project
10.17under section 144A.073 shall be the maximum amount available to pay the additional
10.18medical assistance costs of the new facility;
10.19 (2) to license and certify 29 beds to be added to an existing 69-bed facility in St. Louis
10.20County, provided that the 29 beds must be transferred from active or layaway status at an
10.21existing facility in St. Louis County that had 235 beds on April 1, 2003.
10.22The licensed capacity at the 235-bed facility must be reduced to 206 beds, but the payment
10.23rate at that facility shall not be adjusted as a result of this transfer. The operating payment
10.24rate of the facility adding beds after completion of this project shall be the same as it was
10.25on the day prior to the day the beds are licensed and certified. This project shall not proceed
10.26unless it is approved and financed under the provisions of section 144A.073;
10.27 (3) to license and certify a new 60-bed facility in Austin, provided that: (i) 45 of the new
10.28beds are transferred from a 45-bed facility in Austin under common ownership that is closed
10.29and 15 of the new beds are transferred from a 182-bed facility in Albert Lea under common
10.30ownership; (ii) the commissioner of human services is authorized by the 2004 legislature
10.31to negotiate budget-neutral planned nursing facility closures; and (iii) money is available
10.32from planned closures of facilities under common ownership to make implementation of
10.33this clause budget-neutral to the state. The bed capacity of the Albert Lea facility shall be
10Article 1 Sec. 2.
REVISOR AGW/AC 25-0033903/03/25 11.1reduced to 167 beds following the transfer. Of the 60 beds at the new facility, 20 beds shall
11.2be used for a special care unit for persons with Alzheimer's disease or related dementias;
11.3 (4) to license and certify up to 80 beds transferred from an existing state-owned nursing
11.4facility in Cass County to a new facility located on the grounds of the Ah-Gwah-Ching
11.5campus. The operating cost payment rates for the new facility shall be determined based
11.6on the interim and settle-up payment provisions of section 256R.27 and the reimbursement
11.7provisions of chapter 256R. The property payment rate for the first three years of operation
11.8shall be $35 per day. For subsequent years, the property payment rate of $35 per day shall
11.9be adjusted for inflation as provided in section 256B.434, subdivision 4, paragraph (c), as
11.10long as the facility has a contract under section 256B.434;
11.11 (5) (4) to initiate a pilot program to license and certify up to 80 beds transferred from
11.12an existing county-owned nursing facility in Steele County relocated to the site of a new
11.13acute care facility as part of the county's Communities for a Lifetime comprehensive plan
11.14to create innovative responses to the aging of its population. Upon relocation to the new
11.15site, the nursing facility shall delicense 28 beds. The payment rate for external fixed costs
11.16for the new facility shall be increased by an amount as calculated according to items (i) to
11.17(v):
11.18 (i) compute the estimated decrease in medical assistance residents served by the nursing
11.19facility by multiplying the decrease in licensed beds by the historical percentage of medical
11.20assistance resident days;
11.21 (ii) compute the annual savings to the medical assistance program from the delicensure
11.22of 28 beds by multiplying the anticipated decrease in medical assistance residents, determined
11.23in item (i), by the existing facility's weighted average payment rate multiplied by 365;
11.24 (iii) compute the anticipated annual costs for community-based services by multiplying
11.25the anticipated decrease in medical assistance residents served by the nursing facility,
11.26determined in item (i), by the average monthly elderly waiver service costs for individuals
11.27in Steele County multiplied by 12;
11.28 (iv) subtract the amount in item (iii) from the amount in item (ii);
11.29 (v) divide the amount in item (iv) by an amount equal to the relocated nursing facility's
11.30occupancy factor under section 256B.431, subdivision 3f, paragraph (c), multiplied by the
11.31historical percentage of medical assistance resident days; and
11.32 (6) (5) to consolidate and relocate nursing facility beds to a new site in Goodhue County
11.33and to integrate these services with other community-based programs and services under a
11Article 1 Sec. 2.
REVISOR AGW/AC 25-0033903/03/25 12.1communities for a lifetime pilot program and comprehensive plan to create innovative
12.2responses to the aging of its population. Two nursing facilities, one for 84 beds and one for
12.365 beds, in the city of Red Wing licensed on July 1, 2015, shall be consolidated into a newly
12.4renovated 64-bed nursing facility resulting in the delicensure of 85 beds. Notwithstanding
12.5the carryforward of the approval authority in section 144A.073, subdivision 11, the funding
12.6approved in April 2009 by the commissioner of health for a project in Goodhue County
12.7shall not carry forward. The closure of the 85 beds shall not be eligible for a planned closure
12.8rate adjustment under Minnesota Statutes 2024, section 256R.40. The construction project
12.9permitted in this clause shall not be eligible for a threshold project rate adjustment under
12.10section 256B.434, subdivision 4f. The payment rate for external fixed costs for the new
12.11facility shall be increased by an amount as calculated according to items (i) to (vi):
12.12 (i) compute the estimated decrease in medical assistance residents served by both nursing
12.13facilities by multiplying the difference between the occupied beds of the two nursing facilities
12.14for the reporting year ending September 30, 2009, and the projected occupancy of the facility
12.15at 95 percent occupancy by the historical percentage of medical assistance resident days;
12.16 (ii) compute the annual savings to the medical assistance program from the delicensure
12.17by multiplying the anticipated decrease in the medical assistance residents, determined in
12.18item (i), by the hospital-owned nursing facility weighted average payment rate multiplied
12.19by 365;
12.20 (iii) compute the anticipated annual costs for community-based services by multiplying
12.21the anticipated decrease in medical assistance residents served by the facilities, determined
12.22in item (i), by the average monthly elderly waiver service costs for individuals in Goodhue
12.23County multiplied by 12;
12.24 (iv) subtract the amount in item (iii) from the amount in item (ii);
12.25 (v) multiply the amount in item (iv) by 57.2 percent; and
12.26 (vi) divide the difference of the amount in item (iv) and the amount in item (v) by an
12.27amount equal to the relocated nursing facility's occupancy factor under section 256B.431,
12.28subdivision 3f, paragraph (c), multiplied by the historical percentage of medical assistance
12.29resident days.
12.30 (b) Projects approved under this subdivision shall be treated in a manner equivalent to
12.31projects approved under subdivision 4a.
12.32 EFFECTIVE DATE.This section is effective the day following final enactment.
12Article 1 Sec. 2.
REVISOR AGW/AC 25-0033903/03/25 13.1 Sec. 3. Minnesota Statutes 2024, section 144A.071, subdivision 4d, is amended to read:
13.2 Subd. 4d.Consolidation of nursing facilities.(a) The commissioner of health, in
13.3consultation with the commissioner of human services, may approve a request for
13.4consolidation of nursing facilities which includes the closure of one or more facilities and
13.5the upgrading of the physical plant of the remaining nursing facility or facilities, the costs
13.6of which exceed the threshold project limit under subdivision 2, clause (a). The
13.7commissioners shall consider the criteria in this section, section 144A.073, and Minnesota
13.8Statutes 2024, section 256R.40, in approving or rejecting a consolidation proposal. In the
13.9event the commissioners approve the request, the commissioner of human services shall
13.10calculate an external fixed costs rate adjustment according to clauses (1) to (3):
13.11 (1) the closure of beds shall not be eligible for a planned closure rate adjustment under
13.12Minnesota Statutes 2024, section 256R.40, subdivision 5;
13.13 (2) the construction project permitted in this clause shall not be eligible for a threshold
13.14project rate adjustment under section 256B.434, subdivision 4f, or a moratorium exception
13.15adjustment under section 144A.073; and
13.16 (3) the payment rate for external fixed costs for a remaining facility or facilities shall
13.17be increased by an amount equal to 65 percent of the projected net cost savings to the state
13.18calculated in paragraph (b), divided by the state's medical assistance percentage of medical
13.19assistance dollars, and then divided by estimated medical assistance resident days, as
13.20determined in paragraph (c), of the remaining nursing facility or facilities in the request in
13.21this paragraph. The rate adjustment is effective on the first day of the month of January or
13.22July, whichever date occurs first following both the completion of the construction upgrades
13.23in the consolidation plan and the complete closure of the facility or facilities designated for
13.24closure in the consolidation plan. If more than one facility is receiving upgrades in the
13.25consolidation plan, each facility's date of construction completion must be evaluated
13.26separately.
13.27 (b) For purposes of calculating the net cost savings to the state, the commissioner shall
13.28consider clauses (1) to (7):
13.29 (1) the annual savings from estimated medical assistance payments from the net number
13.30of beds closed taking into consideration only beds that are in active service on the date of
13.31the request and that have been in active service for at least three years;
13.32 (2) the estimated annual cost of increased case load of individuals receiving services
13.33under the elderly waiver;
13Article 1 Sec. 3.
REVISOR AGW/AC 25-0033903/03/25 14.1 (3) the estimated annual cost of elderly waiver recipients receiving support under housing
14.2support under chapter 256I;
14.3 (4) the estimated annual cost of increased case load of individuals receiving services
14.4under the alternative care program;
14.5 (5) the annual loss of license surcharge payments on closed beds;
14.6 (6) the savings from not paying planned closure rate adjustments that the facilities would
14.7otherwise be eligible for under Minnesota Statutes 2024, section 256R.40; and
14.8 (7) the savings from not paying external fixed costs payment rate adjustments from
14.9submission of renovation costs that would otherwise be eligible as threshold projects under
14.10section 256B.434, subdivision 4f.
14.11 (c) For purposes of the calculation in paragraph (a), clause (3), the estimated medical
14.12assistance resident days of the remaining facility or facilities shall be computed assuming
14.1395 percent occupancy multiplied by the historical percentage of medical assistance resident
14.14days of the remaining facility or facilities, as reported on the facility's or facilities' most
14.15recent nursing facility statistical and cost report filed before the plan of closure is submitted,
14.16multiplied by 365.
14.17 (d) For purposes of net cost of savings to the state in paragraph (b), the average occupancy
14.18percentages will be those reported on the facility's or facilities' most recent nursing facility
14.19statistical and cost report filed before the plan of closure is submitted, and the average
14.20payment rates shall be calculated based on the approved payment rates in effect at the time
14.21the consolidation request is submitted.
14.22 (e) To qualify for the external fixed costs payment rate adjustment under this subdivision,
14.23the closing facilities shall:
14.24 (1) submit an application for closure according to Minnesota Statutes 2024, section
14.25256R.40, subdivision 2; and
14.26 (2) follow the resident relocation provisions of section 144A.161.
14.27 (f) The county or counties in which a facility or facilities are closed under this subdivision
14.28shall not be eligible for designation as a hardship area under subdivision 3 for five years
14.29from the date of the approval of the proposed consolidation. The applicant shall notify the
14.30county of this limitation and the county shall acknowledge this in a letter of support.
14.31 (g) Projects approved on or after March 1, 2020, are not subject to paragraph (a), clauses
14.32(2) and (3), and paragraph (c). The 65 percent projected net cost savings to the state calculated
14Article 1 Sec. 3.
REVISOR AGW/AC 25-0033903/03/25 15.1in paragraph (b) must be applied to the moratorium cost of the project and the remainder
15.2must be added to the moratorium funding under section 144A.073, subdivision 11.
15.3 (h) Consolidation project applications not approved by the commissioner prior to March
15.41, 2020, are subject to the moratorium process under section 144A.073, subdivision 2. Upon
15.5request by the applicant, the commissioner may extend this deadline to August 1, 2020, so
15.6long as the facilities, bed numbers, and counties specified in the original application are not
15.7altered. Proposals from facilities seeking approval for a consolidation project prior to March
15.81, 2020, must be received by the commissioner no later than January 1, 2020. This paragraph
15.9expires August 1, 2020.
15.10 EFFECTIVE DATE.This section is effective the day following final enactment.
15.11Sec. 4. Minnesota Statutes 2024, section 144A.161, subdivision 10, is amended to read:
15.12 Subd. 10.Facility closure rate adjustment.Upon the request of a closing facility, the
15.13commissioner of human services must allow the facility a closure rate adjustment equal to
15.14a 50 percent payment rate increase to reimburse relocation costs or other costs related to
15.15facility closure. This rate increase is effective on the date the facility's occupancy decreases
15.16to 90 percent of capacity days after the written notice of closure is distributed under
15.17subdivision 5 and shall remain in effect for a period of up to 60 days. The commissioner
15.18shall delay the implementation of rate adjustments under section 256R.40, subdivisions 5
15.19and 6, to offset the cost of this rate adjustment.
15.20 EFFECTIVE DATE.This section is effective the day following final enactment.
15.21Sec. 5. Minnesota Statutes 2024, section 256.9657, subdivision 1, is amended to read:
15.22 Subdivision 1.Nursing home license surcharge.(a) Effective July 1, 1993, each
15.23non-state-operated nursing home licensed under chapter 144A shall pay to the commissioner
15.24an annual surcharge according to the schedule in subdivision 4. The surcharge shall be
15.25calculated as $620 per licensed bed. If the number of licensed beds is reduced, the surcharge
15.26shall be based on the number of remaining licensed beds the second month following the
15.27receipt of timely notice by the commissioner of human services that beds have been
15.28delicensed. The nursing home must notify the commissioner of health in writing when beds
15.29are delicensed. The commissioner of health must notify the commissioner of human services
15.30within ten working days after receiving written notification. If the notification is received
15.31by the commissioner of human services by the 15th of the month, the invoice for the second
15.32following month must be reduced to recognize the delicensing of beds. Beds on layaway
15.33status continue to be subject to the surcharge. The commissioner of human services must
15Article 1 Sec. 5.
REVISOR AGW/AC 25-0033903/03/25 16.1acknowledge a medical care surcharge appeal within 30 days of receipt of the written appeal
16.2from the provider.
16.3 (b) Effective July 1, 1994, the surcharge in paragraph (a) shall be increased to $625.
16.4 (c) Effective August 15, 2002, the surcharge under paragraph (b) shall be increased to
16.5$990.
16.6 (d) (b) Effective July 15, 2003, the surcharge under paragraph (c) this subdivision shall
16.7be increased to $2,815.
16.8 (e) (c) The commissioner may reduce, and may subsequently restore, the surcharge under
16.9paragraph (d) (b) based on the commissioner's determination of a permissible surcharge.
16.10 EFFECTIVE DATE.This section is effective the day following final enactment.
16.11Sec. 6. Minnesota Statutes 2024, section 256B.431, subdivision 30, is amended to read:
16.12 Subd. 30.Bed layaway and delicensure.(a) For rate years beginning on or after July
16.131, 2000, a nursing facility reimbursed under this section which has placed beds on layaway
16.14shall, for purposes of application of the downsizing incentive in subdivision 3a, paragraph
16.15(c), and calculation of the rental per diem, have those beds given the same effect as if the
16.16beds had been delicensed so long as the beds remain on layaway. At the time of a layaway,
16.17a facility may change its single bed election for use in calculating capacity days under
16.18Minnesota Rules, part 9549.0060, subpart 11. The property payment rate increase shall be
16.19effective the first day of the month of January or July, whichever occurs first following the
16.20date on which the layaway of the beds becomes effective under section 144A.071, subdivision
16.214b.
16.22 (b) For rate years beginning on or after July 1, 2000, notwithstanding any provision to
16.23the contrary under section 256B.434 or chapter 256R, a nursing facility reimbursed under
16.24that section or chapter that has placed beds on layaway shall, for so long as the beds remain
16.25on layaway, be allowed to:
16.26 (1) aggregate the applicable investment per bed limits based on the number of beds
16.27licensed immediately prior to entering the alternative payment system;
16.28 (2) retain or change the facility's single bed election for use in calculating capacity days
16.29under Minnesota Rules, part 9549.0060, subpart 11; and
16.30 (3) establish capacity days based on the number of beds immediately prior to the layaway
16.31and the number of beds after the layaway.
16Article 1 Sec. 6.
REVISOR AGW/AC 25-0033903/03/25 17.1 The commissioner shall increase the facility's property payment rate by the incremental
17.2increase in the rental per diem resulting from the recalculation of the facility's rental per
17.3diem applying only the changes resulting from the layaway of beds and clauses (1), (2), and
17.4(3). If a facility reimbursed under section 256B.434 or chapter 256R completes a moratorium
17.5exception project after its base year, the base year property rate shall be the moratorium
17.6project property rate. The base year rate shall be inflated by the factors in Minnesota Statutes
17.72024, section 256B.434, subdivision 4, paragraph (c). The property payment rate increase
17.8shall be effective the first day of the month of January or July, whichever occurs first
17.9following the date on which the layaway of the beds becomes effective.
17.10 (c) If a nursing facility removes a bed from layaway status in accordance with section
17.11144A.071, subdivision 4b, the commissioner shall establish capacity days based on the
17.12number of licensed and certified beds in the facility not on layaway and shall reduce the
17.13nursing facility's property payment rate in accordance with paragraph (b).
17.14 (d) For the rate years beginning on or after July 1, 2000, notwithstanding any provision
17.15to the contrary under section 256B.434 or chapter 256R, a nursing facility reimbursed under
17.16that section or chapter that has delicensed beds after July 1, 2000, by giving notice of the
17.17delicensure to the commissioner of health according to the notice requirements in section
17.18144A.071, subdivision 4b, shall be allowed to:
17.19 (1) aggregate the applicable investment per bed limits based on the number of beds
17.20licensed immediately prior to entering the alternative payment system;
17.21 (2) retain or change the facility's single bed election for use in calculating capacity days
17.22under Minnesota Rules, part 9549.0060, subpart 11; and
17.23 (3) establish capacity days based on the number of beds immediately prior to the
17.24delicensure and the number of beds after the delicensure.
17.25 The commissioner shall increase the facility's property payment rate by the incremental
17.26increase in the rental per diem resulting from the recalculation of the facility's rental per
17.27diem applying only the changes resulting from the delicensure of beds and clauses (1), (2),
17.28and (3). If a facility reimbursed under section 256B.434 completes a moratorium exception
17.29project after its base year, the base year property rate shall be the moratorium project property
17.30rate. The base year rate shall be inflated by the factors in Minnesota Statutes 2024, section
17.31256B.434, subdivision 4, paragraph (c). The property payment rate increase shall be effective
17.32the first day of the month of January or July, whichever occurs first following the date on
17.33which the delicensure of the beds becomes effective.
17Article 1 Sec. 6.
REVISOR AGW/AC 25-0033903/03/25 18.1 (e) For nursing facilities reimbursed under this section, section 256B.434, or chapter
18.2256R, any beds placed on layaway shall not be included in calculating facility occupancy
18.3as it pertains to leave days defined in Minnesota Rules, part 9505.0415.
18.4 (f) For nursing facilities reimbursed under this section, section 256B.434, or chapter
18.5256R, the rental rate calculated after placing beds on layaway may not be less than the rental
18.6rate prior to placing beds on layaway.
18.7 (g) A nursing facility receiving a rate adjustment as a result of this section shall comply
18.8with section 256R.06, subdivision 5.
18.9 (h) A facility that does not utilize the space made available as a result of bed layaway
18.10or delicensure under this subdivision to reduce the number of beds per room or provide
18.11more common space for nursing facility uses or perform other activities related to the
18.12operation of the nursing facility shall have its property rate increase calculated under this
18.13subdivision reduced by the ratio of the square footage made available that is not used for
18.14these purposes to the total square footage made available as a result of bed layaway or
18.15delicensure.
18.16 (i) The commissioner must not increase the property payment rates under this subdivision
18.17for beds placed in or removed from layaway on or after July 1, 2025.
18.18 EFFECTIVE DATE.This section is effective July 1, 2025.
18.19Sec. 7. Minnesota Statutes 2024, section 256R.02, subdivision 18, is amended to read:
18.20 Subd. 18.Employer health insurance costs."Employer health insurance costs" means:
18.21 (1) premium expenses for group coverage;
18.22 (2) actual expenses incurred for self-insured plans, including actual claims paid, stop-loss
18.23premiums, and plan fees. Actual expenses incurred for self-insured plans does not include
18.24allowances for future funding unless the plan meets the Medicare provider reimbursement
18.25manual requirements for reporting on a premium basis when the Medicare provider
18.26reimbursement manual regulations define the actual costs; and
18.27 (3) employer contributions to employer-sponsored individual coverage health
18.28reimbursement arrangements as provided by Code of Federal Regulations, title 45, section
18.29146.123, employee health reimbursement accounts, and health savings accounts.
18.30 EFFECTIVE DATE.This section is effective the day following final enactment.
18Article 1 Sec. 7.
REVISOR AGW/AC 25-0033903/03/25 19.1 Sec. 8. Minnesota Statutes 2024, section 256R.02, subdivision 19, is amended to read:
19.2 Subd. 19.External fixed costs."External fixed costs" means costs related to the nursing
19.3home surcharge under section 256.9657, subdivision 1; licensure fees under section 144.122;
19.4family advisory council fee under section 144A.33; scholarships under section 256R.37;
19.5planned closure rate adjustments under section 256R.40; consolidation rate adjustments
19.6under section 144A.071, subdivisions 4c, paragraph (a), clauses (5) and (6), and 4d;
19.7single-bed room incentives under section 256R.41; property taxes, special assessments, and
19.8payments in lieu of taxes; employer health insurance costs; quality improvement incentive
19.9payment rate adjustments under section 256R.39; performance-based incentive payments
19.10under section 256R.38; special dietary needs under section 256R.51; and Public Employees
19.11Retirement Association employer costs; and border city rate adjustments under section
19.12256R.481.
19.13 EFFECTIVE DATE.This section is effective January 1, 2026.
19.14Sec. 9. Minnesota Statutes 2024, section 256R.02, subdivision 22, is amended to read:
19.15 Subd. 22.Fringe benefit costs."Fringe benefit costs" means the costs for group life,;
19.16dental,; workers' compensation,; short- and long-term disability,; long-term care insurance,;
19.17accident insurance,; supplemental insurance,; legal assistance insurance,; profit sharing,;
19.18child care costs,; health insurance costs not covered under subdivision 18, including costs
19.19associated with eligible part-time employee family members or retirees,; and pension and
19.20retirement plan contributions, except for the Public Employees Retirement Association
19.21costs.
19.22 EFFECTIVE DATE.This section is effective the day following final enactment.
19.23Sec. 10. Minnesota Statutes 2024, section 256R.02, is amended by adding a subdivision
19.24to read:
19.25 Subd. 36a.Patient driven payment model or PDPM."Patient driven payment model"
19.26or "PDPM" has the meaning given in section 144.0724, subdivision 2.
19.27 EFFECTIVE DATE.This section is effective the day following final enactment.
19.28Sec. 11. Minnesota Statutes 2024, section 256R.02, is amended by adding a subdivision
19.29to read:
19.30 Subd. 45a.Resource utilization group or RUG."Resource utilization group" or "RUG"
19.31has the meaning given in section 144.0724, subdivision 2.
19Article 1 Sec. 11.
REVISOR AGW/AC 25-0033903/03/25 20.1 EFFECTIVE DATE.This section is effective the day following final enactment.
20.2 Sec. 12. Minnesota Statutes 2024, section 256R.10, subdivision 8, is amended to read:
20.3 Subd. 8.Employer health insurance costs.(a) Employer health insurance costs are
20.4allowable for (1) all nursing facility employees, and (2) the spouse and dependents of those
20.5employees who are employed on average at least 30 hours per week.
20.6 (b) Effective for the rate year beginning on January 1, 2026, the annual reimbursement
20.7cap for health insurance costs is $14,703, as adjusted according to paragraph (c). The
20.8allowable costs for health insurance must not exceed the reimbursement cap multiplied by
20.9the annual average month end number of allowed enrolled nursing facility employees from
20.10the applicable cost report period. For shared employees, the allowable number of enrolled
20.11employees includes only the nursing facility percentage of any shared allowed enrolled
20.12employees. The allowable number of enrolled employees must not include non-nursing
20.13facility employees or individuals who elect COBRA continuation coverage.
20.14 (c) Effective for rate years beginning on or after January 1, 2026, the commissioner shall
20.15adjust the annual reimbursement cap for employer health insurance costs by the previous
20.16year's cap plus an inflation adjustment. The commissioner must index for the inflation based
20.17on the change in the Consumer Price Index (all items-urban) (CPI-U) forecasted by the
20.18Reports and Forecast Division of the Department of Human Services in the fourth quarter
20.19of the calendar year preceding the rate year. The commissioner must base the inflation
20.20adjustment on the 12-month period from the second quarter of the previous cost report year
20.21to the second quarter of the cost report year for which the cap is being applied.
20.22 (b) (d) The commissioner must not treat employer contributions to employer-sponsored
20.23individual coverage health reimbursement arrangements as allowable costs if the facility
20.24does not provide the commissioner copies of the employer-sponsored individual coverage
20.25health reimbursement arrangement plan documents and documentation of any health
20.26insurance premiums and associated co-payments reimbursed under the arrangement.
20.27Documentation of reimbursements must denote any reimbursements for health insurance
20.28premiums or associated co-payments incurred by the spouses or dependents of nursing
20.29facility employees who work on average less than 30 hours per week.
20.30 EFFECTIVE DATE.This section is effective the day following final enactment.
20Article 1 Sec. 12.
REVISOR AGW/AC 25-0033903/03/25 21.1 Sec. 13. Minnesota Statutes 2024, section 256R.23, subdivision 7, is amended to read:
21.2 Subd. 7.Determination of direct care payment rates.A facility's direct care payment
21.3rate equals the lesser of (1) the facility's direct care costs per standardized day, or (2) the
21.4facility's direct care costs per standardized day divided by its cost to limit ratio, or (3) 102
21.5percent of the previous year's other care-related payment rate.
21.6 EFFECTIVE DATE.This section is effective January 1, 2026.
21.7 Sec. 14. Minnesota Statutes 2024, section 256R.23, subdivision 8, is amended to read:
21.8 Subd. 8.Determination of other care-related payment rates.A facility's other
21.9care-related payment rate equals the lesser of (1) the facility's other care-related cost per
21.10resident day, or (2) the facility's other care-related cost per resident day divided by its cost
21.11to limit ratio, or (3) 102 percent of the previous year's other care-related payment rate.
21.12 EFFECTIVE DATE.This section is effective January 1, 2026.
21.13Sec. 15. Minnesota Statutes 2024, section 256R.24, subdivision 3, is amended to read:
21.14 Subd. 3.Determination of the other operating payment rate.A facility's other
21.15operating payment rate equals 105 percent of the median other operating cost per day or
21.16102 percent of the previous year's other operating payment rate.
21.17 EFFECTIVE DATE.This section is effective January 1, 2026.
21.18Sec. 16. Minnesota Statutes 2024, section 256R.25, is amended to read:
21.19 256R.25 EXTERNAL FIXED COSTS PAYMENT RATE.
21.20 (a) The payment rate for external fixed costs is the sum of the amounts in paragraphs
21.21(b) to (p) (m).
21.22 (b) For a facility licensed as a nursing home, the portion related to the provider surcharge
21.23under section 256.9657 is equal to $8.86 per resident day. For a facility licensed as both a
21.24nursing home and a boarding care home, the portion related to the provider surcharge under
21.25section 256.9657 is equal to $8.86 per resident day multiplied by the result of its number
21.26of nursing home beds divided by its total number of licensed beds.
21.27 (c) The portion related to the licensure fee under section 144.122, paragraph (d), is the
21.28amount of the fee divided by the sum of the facility's resident days.
21.29 (d) The portion related to development and education of resident and family advisory
21.30councils under section 144A.33 is $5 per resident day divided by 365.
21Article 1 Sec. 16.
REVISOR AGW/AC 25-0033903/03/25 22.1 (e) The portion related to scholarships is determined under section 256R.37.
22.2 (f) The portion related to planned closure rate adjustments is as determined under section
22.3256R.40, subdivision 5, and Minnesota Statutes 2010, section 256B.436.
22.4 (g) (f) The portion related to consolidation rate adjustments shall be as determined under
22.5section 144A.071, subdivisions 4c, paragraph (a), clauses (5) and (6), and 4d.
22.6 (h) The portion related to single-bed room incentives is as determined under section
22.7256R.41.
22.8 (i) (g) The portions related to real estate taxes, special assessments, and payments made
22.9in lieu of real estate taxes directly identified or allocated to the nursing facility are the
22.10allowable amounts divided by the sum of the facility's resident days. Allowable costs under
22.11this paragraph for payments made by a nonprofit nursing facility that are in lieu of real
22.12estate taxes shall not exceed the amount which the nursing facility would have paid to a
22.13city or township and county for fire, police, sanitation services, and road maintenance costs
22.14had real estate taxes been levied on that property for those purposes.
22.15 (j) (h) The portion related to employer health insurance costs is the allowable costs
22.16divided by the sum of the facility's resident days.
22.17 (k) (i) The portion related to the Public Employees Retirement Association is the
22.18allowable costs divided by the sum of the facility's resident days.
22.19 (l) (j) The portion related to quality improvement incentive payment rate adjustments
22.20is the amount determined under section 256R.39.
22.21 (m) (k) The portion related to performance-based incentive payments is the amount
22.22determined under section 256R.38.
22.23 (n) (l) The portion related to special dietary needs is the amount determined under section
22.24256R.51.
22.25 (o) The portion related to the rate adjustments for border city facilities is the amount
22.26determined under section 256R.481.
22.27 (p) (m) The portion related to the rate adjustment for critical access nursing facilities is
22.28the amount determined under section 256R.47.
22.29 EFFECTIVE DATE.This section is effective January 1, 2026.
22Article 1 Sec. 16.
REVISOR AGW/AC 25-0033903/03/25 23.1 Sec. 17. Minnesota Statutes 2024, section 256R.26, subdivision 9, is amended to read:
23.2 Subd. 9.Transition period.(a) A facility's property payment rate is the property rate
23.3established for the facility under sections 256B.431 and 256B.434 until the facility's property
23.4rate is transitioned upon completion of any project authorized under section 144A.071,
23.5subdivision 3 or 4d; or 144A.073, subdivision 3, to the fair rental value property rate
23.6calculated under this chapter.
23.7 (b) Effective the first day of the first month of the calendar quarter after the completion
23.8of the project described in paragraph (a), the commissioner shall transition a facility to the
23.9property payment rate calculated under this chapter. The initial rate year ends on December
23.1031 and may be less than a full 12-month period. The commissioner shall schedule an appraisal
23.11within 90 days of the commissioner receiving notification from the facility that the project
23.12is completed. The commissioner shall apply the property payment rate determined after the
23.13appraisal retroactively to the first day of the first month of the calendar quarter after the
23.14completion of the project.
23.15 (c) Upon a facility's transition to the fair rental value property rates calculated under this
23.16chapter, the facility's total property payment rate under subdivision 8 shall be the only
23.17payment for costs related to capital assets, including depreciation, interest and lease expenses
23.18for all depreciable assets, including movable equipment, land improvements, and land.
23.19Facilities with property payment rates established under subdivisions 1 to 8 are not eligible
23.20for planned closure rate adjustments under Minnesota Statutes 2024, section 256R.40;
23.21consolidation rate adjustments under section 144A.071, subdivisions 4c, paragraph (a),
23.22clauses (5) and (6), and 4d; single-bed room incentives under Minnesota Statutes 2024,
23.23section 256R.41; and the property rate inflation adjustment under Minnesota Statutes 2024,
23.24section 256B.434, subdivision 4. The commissioner shall remove any of these incentives
23.25from the facility's existing rate upon the facility transitioning to the fair rental value property
23.26rates calculated under this chapter.
23.27 EFFECTIVE DATE.This section is effective January 1, 2026.
23.28Sec. 18. Minnesota Statutes 2024, section 256R.43, is amended to read:
23.29 256R.43 BED HOLDS.
23.30 The commissioner shall limit payment for leave days in a nursing facility to 30 percent
23.31of that nursing facility's total payment rate for the involved resident, and shall allow this
23.32payment only when the occupancy of the nursing facility, inclusive of bed hold days, is
23.33equal to or greater than 96 percent, notwithstanding Minnesota Rules, part 9505.0415. For
23Article 1 Sec. 18.
REVISOR AGW/AC 25-0033903/03/25 24.1the purpose of establishing leave day payments, the commissioner shall determine occupancy
24.2based on the number of licensed and certified beds in the facility that are not in layaway
24.3status.
24.4 EFFECTIVE DATE.This section is effective the day following final enactment.
24.5 Sec. 19. [256R.531] PATIENT DRIVEN PAYMENT MODEL PHASE-IN.
24.6 Subdivision 1.Model phase-in.From October 1, 2025, to December 31, 2028, the
24.7commissioner shall determine an adjustment to the total payment rate for each facility as
24.8determined under sections 256R.21 and 256R.27 to phase in the direct care payment rate
24.9from the RUG-IV case mix classification system to the patient driven payment model
24.10(PDPM) case mix classification system.
24.11 Subd. 2.RUG-IV standardized days and facility case mix index.(a) The commissioner
24.12must determine the RUG-IV standardized days and facility average case mix using the sum
24.13of the resident days by case mix classification for all payers on the Minnesota Statistical
24.14and Cost Report.
24.15 (b) For the rate year beginning January 1, 2028, to December 31, 2028:
24.16 (1) the commissioner must determine the RUG-IV facility average case mix using the
24.17sum of the resident days by the case mix classification for all payers on the September 30,
24.182025, Minnesota Statistical and Cost Report; and
24.19 (2) the commissioner must determine the RUG-IV standardized days by multiplying the
24.20resident days on the September 30, 2026, Minnesota Statistical and Cost Report by the
24.21RUG-IV facility case mix index determined under clause (1).
24.22 Subd. 3.RUG-IV medical assistance case mix adjusted direct care payment rate.The
24.23commissioner must determine a facility's RUG-IV blended medical assistance case mix
24.24adjusted direct care payment rate as the product of:
24.25 (1) the facility's RUG-IV direct care and payment rate determined in section 256R.23,
24.26subdivision 7, using the RUG-IV standardized days determined in subdivision 2; and
24.27 (2) the corresponding medical assistance facility average case mix index for medical
24.28assistance days determined in subdivision 2.
24.29 Subd. 4.PDPM medical assistance case mix adjusted direct care payment rate.The
24.30commissioner must determine a facility's PDPM medical assistance case mix adjusted direct
24.31care payment rate as the product of:
24Article 1 Sec. 19.
REVISOR AGW/AC 25-0033903/03/25 25.1 (1) the facility's direct care payment rate determined in section 256R.23, subdivision 7;
25.2and
25.3 (2) the corresponding medical assistance facility average case mix index for medical
25.4assistance days as defined in section 256R.02, subdivision 20.
25.5 Subd. 5.Blended medical assistance case mix adjusted direct care payment rate.The
25.6commissioner must determine a facility's blended medical assistance case mix adjusted
25.7direct care payment rate as the sum of:
25.8 (1) the RUG-IV medical assistance case mix adjusted direct care payment rate determined
25.9in subdivision 3 multiplied by the following percentages:
25.10 (i) from October 1, 2025, to December 31, 2026, 75 percent;
25.11 (ii) from January 1, 2027, to December 31, 2027, 50 percent; and
25.12 (iii) from January 1, 2028, to December 31, 2028, 25 percent; and
25.13 (2) the PDPM medical assistance case mix adjusted direct care payment rate determined
25.14in subdivision 4 multiplied by the following percentages:
25.15 (i) October 1, 2025, to December 31, 2026, 25 percent;
25.16 (ii) January 1, 2027, to December 31, 2027, 50 percent; and
25.17 (iii) January 1, 2028, to December 31, 2028, 75 percent.
25.18 Subd. 6.PDPM phase-in rate adjustment.The commissioner shall determine a facility's
25.19PDPM phase-in rate adjustment as the difference between:
25.20 (1) the blended medical assistance case mix adjusted direct care payment rate determined
25.21in subdivision 5; and
25.22 (2) the PDPM medical assistance case mix adjusted direct care payment rate determined
25.23in section 256R.23, subdivision 7.
25.24 EFFECTIVE DATE.This section is effective October 1, 2025.
25.25Sec. 20. [256R.532] NURSING FACILITY RATE ADD-ON FOR WORKFORCE
25.26STANDARDS.
25.27 (a) Effective for rate years beginning on and after January 1, 2028, or upon federal
25.28approval, whichever is later, the commissioner shall annually provide a rate add-on amount
25.29for nursing facilities reimbursed under this chapter for the initial standards for wages for
25.30nursing home workers adopted by the Nursing Home Workforce Standards Board in
25Article 1 Sec. 20.
REVISOR AGW/AC 25-0033903/03/25 26.1Minnesota Rules, parts 5200.2060 to 5200.2090, pursuant to section 181.213, subdivision
26.22, paragraph (c). The add-on amount is equal to:
26.3 (1) $3.97 per resident day, effective January 1, 2028; and
26.4 (2) $8.62 per resident day, effective January 1, 2029.
26.5 (b) Effective upon federal approval, the commissioner must determine the add-on amount
26.6for subsequent rate years in consultation with the commissioner of labor and industry.
26.7 EFFECTIVE DATE.This section is effective the day following final enactment.
26.8 Sec. 21. REPEALER.
26.9 (a) Minnesota Statutes 2024, sections 256B.434, subdivision 4; 256R.02, subdivision
26.1038; 256R.40; 256R.41; 256R.481; and 256R.53, subdivision 1, are repealed.
26.11 (b) Minnesota Statutes 2024, sections 144A.1888; 256R.12, subdivision 10; and 256R.36,
26.12are repealed.
26.13 (c) Minnesota Statutes 2024, section 256R.23, subdivision 6, is repealed.
26.14 EFFECTIVE DATE.Paragraph (a) is effective January 1, 2026. Paragraph (b) is
26.15effective the day following final enactment. Paragraph (c) is effective October 1, 2025.
26.16 ARTICLE 2
26.17 DISABILITY SERVICES
26.18Section 1. Minnesota Statutes 2024, section 179A.54, is amended by adding a subdivision
26.19to read:
26.20 Subd. 12.Minnesota Caregiver Defined Contribution Retirement Fund Trust.(a)
26.21The state and an exclusive representative certified pursuant to this section may establish a
26.22joint labor and management trust, referred to as the Minnesota Caregiver Defined
26.23Contribution Retirement Fund Trust, for the exclusive purpose of creating, implementing,
26.24and administering a retirement plan for individual providers of direct support services who
26.25are represented by the exclusive representative.
26.26 (b) The state must make financial contributions to the Minnesota Caregiver Defined
26.27Contribution Retirement Fund Trust pursuant to a collective bargaining agreement negotiated
26.28under this section. The financial contributions by the state must be held in trust for the
26.29purpose of paying, from principal, income, or both, the costs associated with creating,
26.30implementing, and administering a defined contribution retirement plan for individual
26.31providers of direct support services working under a collective bargaining agreement and
26Article 2 Section 1.
REVISOR AGW/AC 25-0033903/03/25 27.1providing services through a covered program under section 256B.0711. A board of trustees
27.2composed of an equal number of trustees appointed by the governor and trustees appointed
27.3by the exclusive representative under this section must administer, manage, and otherwise
27.4jointly control the Minnesota Caregiver Defined Contribution Retirement Fund Trust. The
27.5trust must not be an agent of either the state or the exclusive representative.
27.6 (c) A third-party administrator, financial management institution, other appropriate
27.7entity, or any combination thereof may provide trust administrative, management, legal,
27.8and financial services to the board of trustees as designated by the board of trustees from
27.9time to time. The services must be paid from the money held in trust and created by the
27.10state's financial contributions to the Minnesota Caregiver Defined Contribution Retirement
27.11Fund Trust.
27.12 (d) The state is authorized to purchase liability insurance for members of the board of
27.13trustees appointed by the governor.
27.14 (e) Financial contributions to or participation in the management or administration of
27.15the Minnesota Caregiver Defined Contribution Retirement Fund Trust must not be considered
27.16an unfair labor practice under section 179A.13, or a violation of Minnesota law.
27.17 EFFECTIVE DATE.This section is effective July 1, 2025.
27.18Sec. 2. [245A.142] EARLY INTENSIVE DEVELOPMENT AL AND BEHAVIORAL
27.19INTERVENTION PROVISIONAL LICENSURE.
27.20 Subdivision 1.Regulatory powers.The commissioner shall regulate early intensive
27.21developmental and behavioral intervention (EIDBI) agencies pursuant to this section.
27.22 Subd. 2.Provisional license.(a) The commissioner shall issue a provisional license to
27.23an agency providing EIDBI services as described in section 256B.0949 that meet the
27.24requirements of this section by .... A provisional license is effective for up to one year from
27.25the initial effective date of the license, except that a provisional license may be extended
27.26according to subdivisions ..., paragraph (b), and 3.
27.27 (b) Beginning ...., no agency providing EIDBI services may operate in Minnesota unless
27.28licensed under this section.
27.29 Subd. 3.Provisional license regulatory functions.The commissioner may:
27.30 (1) license, survey, and monitor without advance notice in accordance with this section;
27.31 (2) investigate reports of maltreatment;
27.32 (3) investigate complaints against EIDBI agencies;
27Article 2 Sec. 2.
REVISOR AGW/AC 25-0033903/03/25 28.1 (4) issue correction orders and assess monetary penalties; and
28.2 (5) take other action reasonably required to accomplish the purposes of this section.
28.3 Subd. 4.Provisional license requirements.(a) A provisional license holder must:
28.4 (1) identify all controlling individuals, as defined in section 245A.02, subdivision 5a,
28.5for the agency;
28.6 (2) provide documented disclosures surrounding the use of billing agencies or other
28.7consultants, available to the department upon request;
28.8 (3) establish provider policies and procedures related to staff training, staff qualifications,
28.9quality assurance, and service activities;
28.10 (4) document contracts with independent contractors for qualified supervising
28.11professionals, including the number of hours contracted and responsibilities, available to
28.12the department upon request; and
28.13 (5) comply with section 256B.0949, subdivisions 2, 3a, 6, 7, 14, 15, 16, and 16a.
28.14 (b) Provisional license holders must comply with this section within 90 calendar days
28.15from the effective date of the provisional license.
28.16 Subd. 5.Reporting of maltreatment.A provisional license holder must comply with
28.17the requirements of reporting of maltreatment of vulnerable adults and minors under section
28.18626.557 and chapter 260E.
28.19 Subd. 6.Background studies.A provisional license holder must initiate a background
28.20study through the commissioner's NETStudy system as provided under sections 245C.03,
28.21subdivision 15, and 245C.10, subdivision 17.
28.22 Subd. 7.Sanctions.If the provisional license holder is not in substantial compliance
28.23with the requirements of this section after 90 days following the effective date of the
28.24provisional license, the commissioner may either: (1) not renew or terminate the provisional
28.25license; or (2) extend the provisional license for a period not to exceed 90 calendar days
28.26and apply conditions necessary to bring the facility into substantial compliance. If the
28.27provisional license holder is not in substantial compliance within the time allowed by the
28.28extension or does not satisfy the license conditions, the commissioner may terminate the
28.29license.
28.30 Subd. 8.Reconsideration.(a) If a provisional license holder disagrees with a sanction
28.31under subdivision 7, the provisional license holder may request reconsideration by the
28Article 2 Sec. 2.
REVISOR AGW/AC 25-0033903/03/25 29.1commissioner. The reconsideration request process must be conducted internally by the
29.2commissioner and is not an administrative appeal under chapter 14 or section 256.045.
29.3 (b) The provisional licensee requesting the reconsideration must make the request in
29.4writing and list and describe the reasons why the provisional licensee disagrees with the
29.5sanction under subdivision 7.
29.6 (c) The reconsideration request and supporting documentation must be received by the
29.7commissioner within 15 calendar days after the date the provisional licensee receives notice
29.8of the sanction under subdivision 7.
29.9 Subd. 9.Continued operation.A provisional license holder may continue to operate
29.10after receiving notice of nonrenewal or termination:
29.11 (1) during the 15 calendar day reconsideration window;
29.12 (2) during the pendency of a reconsideration; or
29.13 (3) while in active negotiation with the commissioner for an extension of the provisional
29.14license with conditions, and the commissioner confirms the negotiation is active.
29.15 Subd. 10.Transition to nonprovisional EIDBI license; future licensure standards.(a)
29.16The commissioner must develop a process and transition plan for comprehensive EIDBI
29.17agency licensure by January 1, 2026.
29.18 (b) By December 1, 2026, the commissioner shall establish standards for nonprovisional
29.19EIDBI agency licensure and submit proposed legislation to the chairs and ranking minority
29.20members of the legislative committees with jurisdiction over human services licensing.
29.21 EFFECTIVE DATE.This section is effective July 1, 2025.
29.22Sec. 3. Minnesota Statutes 2024, section 245C.16, subdivision 1, is amended to read:
29.23 Subdivision 1.Determining immediate risk of harm.(a) If the commissioner determines
29.24that the individual studied has a disqualifying characteristic, the commissioner shall review
29.25the information immediately available and make a determination as to the subject's immediate
29.26risk of harm to persons served by the program where the individual studied will have direct
29.27contact with, or access to, people receiving services.
29.28 (b) The commissioner shall consider all relevant information available, including the
29.29following factors in determining the immediate risk of harm:
29.30 (1) the recency of the disqualifying characteristic;
29.31 (2) the recency of discharge from probation for the crimes;
29Article 2 Sec. 3.
REVISOR AGW/AC 25-0033903/03/25 30.1 (3) the number of disqualifying characteristics;
30.2 (4) the intrusiveness or violence of the disqualifying characteristic;
30.3 (5) the vulnerability of the victim involved in the disqualifying characteristic;
30.4 (6) the similarity of the victim to the persons served by the program where the individual
30.5studied will have direct contact;
30.6 (7) whether the individual has a disqualification from a previous background study that
30.7has not been set aside;
30.8 (8) if the individual has a disqualification which may not be set aside because it is a
30.9permanent bar under section 245C.24, subdivision 1, or the individual is a child care
30.10background study subject who has a felony-level conviction for a drug-related offense in
30.11the last five years, the commissioner may order the immediate removal of the individual
30.12from any position allowing direct contact with, or access to, persons receiving services from
30.13the program and from working in a children's residential facility or foster residence setting;
30.14and
30.15 (9) if the individual has a disqualification which may not be set aside because it is a
30.16permanent bar under section 245C.24, subdivision 2, or the individual is a child care
30.17background study subject who has a felony-level conviction for a drug-related offense during
30.18the last five years, the commissioner may order the immediate removal of the individual
30.19from any position allowing direct contact with or access to persons receiving services from
30.20the center and from working in a licensed child care center or certified license-exempt child
30.21care center.
30.22 (c) This section does not apply when the subject of a background study is regulated by
30.23a health-related licensing board as defined in chapter 214, and the subject is determined to
30.24be responsible for substantiated maltreatment under section 626.557 or chapter 260E.
30.25 (d) This section does not apply to a background study related to an initial application
30.26for a child foster family setting license.
30.27 (e) Except for paragraph (f), this section does not apply to a background study that is
30.28also subject to the requirements under section 256B.0659, subdivisions 11 and 13, for a
30.29personal care assistant or a qualified professional as defined in section 256B.0659,
30.30subdivision 1, or to a background study for an individual providing early intensive
30.31developmental and behavioral intervention services under section 245A.142 or 256B.0949.
30.32 (f) If the commissioner has reason to believe, based on arrest information or an active
30.33maltreatment investigation, that an individual poses an imminent risk of harm to persons
30Article 2 Sec. 3.
REVISOR AGW/AC 25-0033903/03/25 31.1receiving services, the commissioner may order that the person be continuously supervised
31.2or immediately removed pending the conclusion of the maltreatment investigation or criminal
31.3proceedings.
31.4 EFFECTIVE DATE.This section is effective .....
31.5 Sec. 4. Minnesota Statutes 2024, section 256B.0659, subdivision 17a, is amended to read:
31.6 Subd. 17a.Enhanced rate.(a) An enhanced rate of 107.5 percent of the rate paid for
31.7personal care assistance services shall be paid for services provided to persons who qualify
31.8for ten or more hours of personal care assistance services per day when provided by a
31.9personal care assistant who meets the requirements of subdivision 11, paragraph (d). This
31.10paragraph expires upon the effective date of paragraph (b).
31.11 (b) Effective January 1, 2026, or upon federal approval, whichever is later, an enhanced
31.12rate of 112.5 percent of the rate paid for personal care assistance services shall be paid for
31.13services provided to persons who qualify for ten or more hours of personal care assistance
31.14services per day when provided by a personal care assistant who meets the requirements of
31.15subdivision 11, paragraph (d).
31.16 (b) (c) A personal care assistance provider must use all additional revenue attributable
31.17to the rate enhancements under this subdivision for the wages and wage-related costs of the
31.18personal care assistants, including any corresponding increase in the employer's share of
31.19FICA taxes, Medicare taxes, state and federal unemployment taxes, and workers'
31.20compensation premiums. The agency must not use the additional revenue attributable to
31.21any enhanced rate under this subdivision to pay for mileage reimbursement, health and
31.22dental insurance, life insurance, disability insurance, long-term care insurance, uniform
31.23allowance, contributions to employee retirement accounts, or any other employee benefits.
31.24 (c) (d) Any change in the eligibility criteria for the enhanced rate for personal care
31.25assistance services as described in this subdivision and referenced in subdivision 11,
31.26paragraph (d), does not constitute a change in a term or condition for individual providers
31.27as defined in section 256B.0711, and is not subject to the state's obligation to meet and
31.28negotiate under chapter 179A.
31.29 EFFECTIVE DATE.This section is effective the day following final enactment.
31.30Sec. 5. Minnesota Statutes 2024, section 256B.0924, subdivision 6, is amended to read:
31.31 Subd. 6.Payment for targeted case management.(a) Medical assistance and
31.32MinnesotaCare payment for targeted case management shall be made on a monthly basis.
31Article 2 Sec. 5.
REVISOR AGW/AC 25-0033903/03/25 32.1In order to receive payment for an eligible adult, the provider must document at least one
32.2contact per month and not more than two consecutive months without a face-to-face contact
32.3either in person or by interactive video that meets the requirements in section 256B.0625,
32.4subdivision 20b, with the adult or the adult's legal representative, family, primary caregiver,
32.5or other relevant persons identified as necessary to the development or implementation of
32.6the goals of the personal service plan.
32.7 (b) Except as provided under paragraph (m), payment for targeted case management
32.8provided by county staff under this subdivision shall be based on the monthly rate
32.9methodology under section 256B.094, subdivision 6, paragraph (b), calculated as one
32.10combined average rate together with adult mental health case management under section
32.11256B.0625, subdivision 20, except for calendar year 2002. In calendar year 2002, the rate
32.12for case management under this section shall be the same as the rate for adult mental health
32.13case management in effect as of December 31, 2001. Billing and payment must identify the
32.14recipient's primary population group to allow tracking of revenues.
32.15 (c) Payment for targeted case management provided by county-contracted vendors shall
32.16be based on a monthly rate calculated in accordance with section 256B.076, subdivision 2.
32.17The rate must not exceed the rate charged by the vendor for the same service to other payers.
32.18If the service is provided by a team of contracted vendors, the team shall determine how to
32.19distribute the rate among its members. No reimbursement received by contracted vendors
32.20shall be returned to the county, except to reimburse the county for advance funding provided
32.21by the county to the vendor.
32.22 (d) If the service is provided by a team that includes contracted vendors and county staff,
32.23the costs for county staff participation on the team shall be included in the rate for
32.24county-provided services. In this case, the contracted vendor and the county may each
32.25receive separate payment for services provided by each entity in the same month. In order
32.26to prevent duplication of services, the county must document, in the recipient's file, the need
32.27for team targeted case management and a description of the different roles of the team
32.28members.
32.29 (e) Notwithstanding section 256B.19, subdivision 1, the nonfederal share of costs for
32.30targeted case management shall be provided by the recipient's county of responsibility, as
32.31defined in sections 256G.01 to 256G.12, from sources other than federal funds or funds
32.32used to match other federal funds.
32.33 (f) The commissioner may suspend, reduce, or terminate reimbursement to a provider
32.34that does not meet the reporting or other requirements of this section. The county of
32Article 2 Sec. 5.
REVISOR AGW/AC 25-0033903/03/25 33.1responsibility, as defined in sections 256G.01 to 256G.12, is responsible for any federal
33.2disallowances. The county may share this responsibility with its contracted vendors.
33.3 (g) The commissioner shall set aside five percent of the federal funds received under
33.4this section for use in reimbursing the state for costs of developing and implementing this
33.5section.
33.6 (h) Payments to counties for targeted case management expenditures under this section
33.7shall only be made from federal earnings from services provided under this section. Payments
33.8to contracted vendors shall include both the federal earnings and the county share.
33.9 (i) Notwithstanding section 256B.041, county payments for the cost of case management
33.10services provided by county staff shall not be made to the commissioner of management
33.11and budget. For the purposes of targeted case management services provided by county
33.12staff under this section, the centralized disbursement of payments to counties under section
33.13256B.041 consists only of federal earnings from services provided under this section.
33.14 (j) If the recipient is a resident of a nursing facility, intermediate care facility, or hospital,
33.15and the recipient's institutional care is paid by medical assistance, payment for targeted case
33.16management services under this subdivision is limited to the lesser of:
33.17 (1) the last 180 days of the recipient's residency in that facility; or
33.18 (2) the limits and conditions which apply to federal Medicaid funding for this service.
33.19 (k) Payment for targeted case management services under this subdivision shall not
33.20duplicate payments made under other program authorities for the same purpose.
33.21 (l) Any growth in targeted case management services and cost increases under this
33.22section shall be the responsibility of the counties.
33.23 (m) The commissioner may make payments for Tribes according to section 256B.0625,
33.24subdivision 34, or other relevant federally approved rate setting methodologies for vulnerable
33.25adult and developmental disability targeted case management provided by Indian health
33.26services and facilities operated by a Tribe or Tribal organization.
33.27 EFFECTIVE DATE.This section is effective July 1, 2025.
33.28Sec. 6. Minnesota Statutes 2024, section 256B.0949, subdivision 15, is amended to read:
33.29 Subd. 15.EIDBI provider qualifications.(a) A QSP must be employed by an employee
33.30of an agency and be:
33Article 2 Sec. 6.
REVISOR AGW/AC 25-0033903/03/25 34.1 (1) a licensed mental health professional who has at least 2,000 hours of supervised
34.2clinical experience or training in examining or treating people with ASD or a related condition
34.3or equivalent documented coursework at the graduate level by an accredited university in
34.4ASD diagnostics, ASD developmental and behavioral treatment strategies, and typical child
34.5development; or
34.6 (2) a developmental or behavioral pediatrician who has at least 2,000 hours of supervised
34.7clinical experience or training in examining or treating people with ASD or a related condition
34.8or equivalent documented coursework at the graduate level by an accredited university in
34.9the areas of ASD diagnostics, ASD developmental and behavioral treatment strategies, and
34.10typical child development.
34.11 (b) A level I treatment provider must be employed by an employee of an agency and:
34.12 (1) have at least 2,000 hours of supervised clinical experience or training in examining
34.13or treating people with ASD or a related condition or equivalent documented coursework
34.14at the graduate level by an accredited university in ASD diagnostics, ASD developmental
34.15and behavioral treatment strategies, and typical child development or an equivalent
34.16combination of documented coursework or hours of experience; and
34.17 (2) have or be at least one of the following:
34.18 (i) a master's degree in behavioral health or child development or related fields including,
34.19but not limited to, mental health, special education, social work, psychology, speech
34.20pathology, or occupational therapy from an accredited college or university;
34.21 (ii) a bachelor's degree in a behavioral health, child development, or related field
34.22including, but not limited to, mental health, special education, social work, psychology,
34.23speech pathology, or occupational therapy, from an accredited college or university, and
34.24advanced certification in a treatment modality recognized by the department;
34.25 (iii) a board-certified behavior analyst as defined by the Behavior Analyst Certification
34.26Board or a qualified behavior analyst as defined by the Qualified Applied Behavior Analysis
34.27Credentialing Board; or
34.28 (iv) a board-certified assistant behavior analyst with 4,000 hours of supervised clinical
34.29experience that meets all registration, supervision, and continuing education requirements
34.30of the certification.
34.31 (c) A level II treatment provider must be employed by an employee of an agency and
34.32must be:
34Article 2 Sec. 6.
REVISOR AGW/AC 25-0033903/03/25 35.1 (1) a person who has a bachelor's degree from an accredited college or university in a
35.2behavioral or child development science or related field including, but not limited to, mental
35.3health, special education, social work, psychology, speech pathology, or occupational
35.4therapy; and meets at least one of the following:
35.5 (i) has at least 1,000 hours of supervised clinical experience or training in examining or
35.6treating people with ASD or a related condition or equivalent documented coursework at
35.7the graduate level by an accredited university in ASD diagnostics, ASD developmental and
35.8behavioral treatment strategies, and typical child development or a combination of
35.9coursework or hours of experience;
35.10 (ii) has certification as a board-certified assistant behavior analyst from the Behavior
35.11Analyst Certification Board or a qualified autism service practitioner from the Qualified
35.12Applied Behavior Analysis Credentialing Board;
35.13 (iii) is a registered behavior technician as defined by the Behavior Analyst Certification
35.14Board or an applied behavior analysis technician as defined by the Qualified Applied
35.15Behavior Analysis Credentialing Board; or
35.16 (iv) is certified in one of the other treatment modalities recognized by the department;
35.17or
35.18 (2) a person who has:
35.19 (i) an associate's degree in a behavioral or child development science or related field
35.20including, but not limited to, mental health, special education, social work, psychology,
35.21speech pathology, or occupational therapy from an accredited college or university; and
35.22 (ii) at least 2,000 hours of supervised clinical experience in delivering treatment to people
35.23with ASD or a related condition. Hours worked as a mental health behavioral aide or level
35.24III treatment provider may be included in the required hours of experience; or
35.25 (3) a person who has at least 4,000 hours of supervised clinical experience in delivering
35.26treatment to people with ASD or a related condition. Hours worked as a mental health
35.27behavioral aide or level III treatment provider may be included in the required hours of
35.28experience; or
35.29 (4) a person who is a graduate student in a behavioral science, child development science,
35.30or related field and is receiving clinical supervision by a QSP affiliated with an agency to
35.31meet the clinical training requirements for experience and training with people with ASD
35.32or a related condition; or
35.33 (5) a person who is at least 18 years of age and who:
35Article 2 Sec. 6.
REVISOR AGW/AC 25-0033903/03/25 36.1 (i) is fluent in a non-English language or is an individual certified by a Tribal Nation;
36.2 (ii) completed the level III EIDBI training requirements; and
36.3 (iii) receives observation and direction from a QSP or level I treatment provider at least
36.4once a week until the person meets 1,000 hours of supervised clinical experience.
36.5 (d) A level III treatment provider must be employed by en employee of an agency, have
36.6completed the level III training requirement, be at least 18 years of age, and have at least
36.7one of the following:
36.8 (1) a high school diploma or commissioner of education-selected high school equivalency
36.9certification;
36.10 (2) fluency in a non-English language or Tribal Nation certification;
36.11 (3) one year of experience as a primary personal care assistant, community health worker,
36.12waiver service provider, or special education assistant to a person with ASD or a related
36.13condition within the previous five years; or
36.14 (4) completion of all required EIDBI training within six months of employment.
36.15 EFFECTIVE DATE.This section is effective the day following final enactment.
36.16Sec. 7. Minnesota Statutes 2024, section 256B.0949, subdivision 16, is amended to read:
36.17 Subd. 16.Agency duties.(a) An agency delivering an EIDBI service under this section
36.18must:
36.19 (1) enroll as a medical assistance Minnesota health care program provider according to
36.20Minnesota Rules, part 9505.0195, and section 256B.04, subdivision 21, and meet all
36.21applicable provider standards and requirements;
36.22 (2) demonstrate compliance with federal and state laws for EIDBI service;
36.23 (3) verify and maintain records of a service provided to the person or the person's legal
36.24representative as required under Minnesota Rules, parts 9505.2175 and 9505.2197;
36.25 (4) demonstrate that while enrolled or seeking enrollment as a Minnesota health care
36.26program provider the agency did not have a lead agency contract or provider agreement
36.27discontinued because of a conviction of fraud; or did not have an owner, board member, or
36.28manager fail a state or federal criminal background check or appear on the list of excluded
36.29individuals or entities maintained by the federal Department of Human Services Office of
36.30Inspector General;
36Article 2 Sec. 7.
REVISOR AGW/AC 25-0033903/03/25 37.1 (5) have established business practices including written policies and procedures, internal
37.2controls, and a system that demonstrates the organization's ability to deliver quality EIDBI
37.3services;
37.4 (6) have an office located in Minnesota or a border state;
37.5 (7) conduct a criminal background check on an individual who has direct contact with
37.6the person or the person's legal representative;
37.7 (8) report maltreatment according to section 626.557 and chapter 260E;
37.8 (9) comply with any data requests consistent with the Minnesota Government Data
37.9Practices Act, sections 256B.064 and 256B.27;
37.10 (10) provide training for all agency staff on the requirements and responsibilities listed
37.11in the Maltreatment of Minors Act, chapter 260E, and the Vulnerable Adult Protection Act,
37.12section 626.557, including mandated and voluntary reporting, nonretaliation, and the agency's
37.13policy for all staff on how to report suspected abuse and neglect;
37.14 (11) have a written policy to resolve issues collaboratively with the person and the
37.15person's legal representative when possible. The policy must include a timeline for when
37.16the person and the person's legal representative will be notified about issues that arise in
37.17the provision of services;
37.18 (12) provide the person's legal representative with prompt notification if the person is
37.19injured while being served by the agency. An incident report must be completed by the
37.20agency staff member in charge of the person. A copy of all incident and injury reports must
37.21remain on file at the agency for at least five years from the report of the incident; and
37.22 (13) before starting a service, provide the person or the person's legal representative a
37.23description of the treatment modality that the person shall receive, including the staffing
37.24certification levels and training of the staff who shall provide a treatment.;
37.25 (14) provide clinical supervision by a qualified supervising professional for a minimum
37.26of one hour of supervision for every ten hours of direct treatment per person that meets
37.27clinical licensure requirements for quality supervision and effective intervention; and
37.28 (15) provide clinical, in-person supervision sessions by a qualified supervising
37.29professional at least once per month for intervention, observation, and direction.
37.30 (b) When delivering the ITP, and annually thereafter, an agency must provide the person
37.31or the person's legal representative with:
37Article 2 Sec. 7.
REVISOR AGW/AC 25-0033903/03/25 38.1 (1) a written copy and a verbal explanation of the person's or person's legal
38.2representative's rights and the agency's responsibilities;
38.3 (2) documentation in the person's file the date that the person or the person's legal
38.4representative received a copy and explanation of the person's or person's legal
38.5representative's rights and the agency's responsibilities; and
38.6 (3) reasonable accommodations to provide the information in another format or language
38.7as needed to facilitate understanding of the person's or person's legal representative's rights
38.8and the agency's responsibilities.
38.9 Sec. 8. Minnesota Statutes 2024, section 256B.0949, is amended by adding a subdivision
38.10to read:
38.11 Subd. 18.Provisional licensure.Beginning on January 1, 2026, the commissioner shall
38.12begin issuing provisional licenses to enrolled EIDBI agencies while permanent licensing
38.13standards are developed. EIDBI agencies enrolled by December 31, 2025, have 60 calendar
38.14days to submit an application for provisional licensure on the forms and in the manner
38.15prescribed by the commissioner. The commissioner must act on an application within 90
38.16working days after receiving a complete application.
38.17Sec. 9. Minnesota Statutes 2024, section 256B.19, subdivision 1, is amended to read:
38.18 Subdivision 1.Division of cost.The state and county share of medical assistance costs
38.19not paid by federal funds shall be as follows:
38.20 (1) beginning January 1, 1992, 50 percent state funds and 50 percent county funds for
38.21the cost of placement of severely emotionally disturbed children in regional treatment
38.22centers;
38.23 (2) beginning January 1, 2003, 80 percent state funds and 20 percent county funds for
38.24the costs of nursing facility placements of persons with disabilities under the age of 65 that
38.25have exceeded 90 days. This clause shall be subject to chapter 256G and shall not apply to
38.26placements in facilities not certified to participate in medical assistance;
38.27 (3) beginning July 1, 2004, 90 percent state funds and ten percent county funds for the
38.28costs of placements that have exceeded 90 days in intermediate care facilities for persons
38.29with developmental disabilities that have seven or more beds. This provision includes
38.30pass-through payments made under section 256B.5015; and
38.31 (4) beginning July 1, 2004, when state funds are used to pay for a nursing facility
38.32placement due to the facility's status as an institution for mental diseases (IMD), the county
38Article 2 Sec. 9.
REVISOR AGW/AC 25-0033903/03/25 39.1shall pay 20 percent of the nonfederal share of costs that have exceeded 90 days. This clause
39.2is subject to chapter 256G.; and
39.3 (5) beginning July 1, 2026, or upon federal approval, whichever is later, 95 percent state
39.4funds and five percent county funds for the costs of services for all people receiving
39.5community residential services, family residential services, customized living services, or
39.6integrated community supports under section 256B.4914.
39.7 For counties that participate in a Medicaid demonstration project under sections 256B.69
39.8and 256B.71, the division of the nonfederal share of medical assistance expenses for
39.9payments made to prepaid health plans or for payments made to health maintenance
39.10organizations in the form of prepaid capitation payments, this division of medical assistance
39.11expenses shall be 95 percent by the state and five percent by the county of financial
39.12responsibility.
39.13 In counties where prepaid health plans are under contract to the commissioner to provide
39.14services to medical assistance recipients, the cost of court ordered treatment ordered without
39.15consulting the prepaid health plan that does not include diagnostic evaluation,
39.16recommendation, and referral for treatment by the prepaid health plan is the responsibility
39.17of the county of financial responsibility.
39.18 EFFECTIVE DATE.This section is effective the day following final enactment.
39.19Sec. 10. Minnesota Statutes 2024, section 256B.49, is amended by adding a subdivision
39.20to read:
39.21 Subd. 30.Customized living age limitation.Effective January 1, 2026, or upon federal
39.22approval, whichever is later, the commissioner must not authorize customized living services
39.23as defined under the brain injury and community access for disability inclusion waiver plans
39.24for persons under age 55 unless the person was authorized for customized living services
39.25at any time prior to January 1, 2026.
39.26 EFFECTIVE DATE.This section is effective the day following final enactment.
39.27Sec. 11. Minnesota Statutes 2024, section 256B.4914, subdivision 3, is amended to read:
39.28 Subd. 3.Applicable services.(a) Applicable services are those authorized under the
39.29state's home and community-based services waivers under sections 256B.092 and 256B.49,
39.30including the following, as defined in the federally approved home and community-based
39.31services plan:
39.32 (1) 24-hour customized living;
39Article 2 Sec. 11.
REVISOR AGW/AC 25-0033903/03/25 40.1 (2) adult day services;
40.2 (3) adult day services bath;
40.3 (4) community residential services;
40.4 (5) customized living;
40.5 (6) day support services;
40.6 (7) employment development services;
40.7 (8) employment exploration services;
40.8 (9) employment support services;
40.9 (10) family residential services;
40.10 (11) individualized home supports;
40.11 (12) individualized home supports with family training;
40.12 (13) individualized home supports with training;
40.13 (14) integrated community supports;
40.14 (15) life sharing;
40.15 (16) effective until the effective date of clauses (17) and (18), night supervision;
40.16 (17) effective January 1, 2026, or upon federal approval, whichever is later, awake night
40.17supervision;
40.18 (18) effective January 1, 2026, or upon federal approval, whichever is later, asleep night
40.19supervision;
40.20 (17) (19) positive support services;
40.21 (18) (20) prevocational services;
40.22 (19) (21) residential support services;
40.23 (20) (22) respite services;
40.24 (21) (23) transportation services; and
40.25 (22) (24) other services as approved by the federal government in the state home and
40.26community-based services waiver plan.
40Article 2 Sec. 11.
REVISOR AGW/AC 25-0033903/03/25 41.1 (b) Effective January 1, 2024, or upon federal approval, whichever is later, respite
41.2services under paragraph (a), clause (20) (22), are not an applicable service under this
41.3section.
41.4 EFFECTIVE DATE.This section is effective the day following final enactment, except
41.5that the amendments to paragraph (b) are effective January 1, 2026, or upon federal approval,
41.6whichever is later. The commissioner of human services shall notify the revisor of statutes
41.7when federal approval is obtained.
41.8 Sec. 12. Minnesota Statutes 2024, section 256B.4914, subdivision 5, is amended to read:
41.9 Subd. 5.Base wage index; establishment and updates.(a) The base wage index is
41.10established to determine staffing costs associated with providing services to individuals
41.11receiving home and community-based services. For purposes of calculating the base wage,
41.12Minnesota-specific wages taken from job descriptions and standard occupational
41.13classification (SOC) codes from the Bureau of Labor Statistics as defined in the Occupational
41.14Handbook must be used.
41.15 (b) The commissioner shall update the base wage index in subdivision 5a, publish these
41.16updated values, and load them into the rate management system as follows:
41.17 (1) on January 1, 2022, based on wage data by SOC from the Bureau of Labor Statistics
41.18available as of December 31, 2019;
41.19 (2) on January 1, 2024, based on wage data by SOC from the Bureau of Labor Statistics
41.20published in March 2022; and
41.21 (3) on January 1, 2026, and every two years thereafter, based on wage data by SOC from
41.22the Bureau of Labor Statistics published in the spring approximately 21 months prior to the
41.23scheduled update.
41.24 (c) Effective January 1, 2026, or upon federal approval, whichever is later, if the result
41.25of any base wage index update exceeds two percent, the commissioner must implement a
41.26change to the base wage index update of two percent. If the result of any base wage index
41.27is less than two percent, the commissioner must implement the full value of the change.
41.28 EFFECTIVE DATE.This section is effective the day following final enactment.
41.29Sec. 13. Minnesota Statutes 2024, section 256B.4914, subdivision 5a, is amended to read:
41.30 Subd. 5a.Base wage index; calculations.The base wage index must be calculated as
41.31follows:
41Article 2 Sec. 13.
REVISOR AGW/AC 25-0033903/03/25 42.1 (1) for supervisory staff, 100 percent of the median wage for community and social
42.2services specialist (SOC code 21-1099), with the exception of the supervisor of positive
42.3supports professional, positive supports analyst, and positive supports specialist, which is
42.4100 percent of the median wage for clinical counseling and school psychologist (SOC code
42.519-3031);
42.6 (2) for registered nurse staff, 100 percent of the median wage for registered nurses (SOC
42.7code 29-1141);
42.8 (3) for licensed practical nurse staff, 100 percent of the median wage for licensed practical
42.9nurses (SOC code 29-2061);
42.10 (4) for residential asleep-overnight staff, the minimum wage in Minnesota for large
42.11employers;
42.12 (5) for residential direct care staff, the sum of:
42.13 (i) 15 percent of the subtotal of 50 percent of the median wage for home health and
42.14personal care aide (SOC code 31-1120); 30 percent of the median wage for nursing assistant
42.15(SOC code 31-1131); and 20 percent of the median wage for social and human services
42.16aide (SOC code 21-1093); and
42.17 (ii) 85 percent of the subtotal of 40 percent of the median wage for home health and
42.18personal care aide (SOC code 31-1120); 20 percent of the median wage for nursing assistant
42.19(SOC code 31-1131); 20 percent of the median wage for psychiatric technician (SOC code
42.2029-2053); and 20 percent of the median wage for social and human services aide (SOC code
42.2121-1093);
42.22 (6) for adult day services staff, 70 percent of the median wage for nursing assistant (SOC
42.23code 31-1131); and 30 percent of the median wage for home health and personal care aide
42.24(SOC code 31-1120);
42.25 (7) for day support services staff and prevocational services staff, 20 percent of the
42.26median wage for nursing assistant (SOC code 31-1131); 20 percent of the median wage for
42.27psychiatric technician (SOC code 29-2053); and 60 percent of the median wage for social
42.28and human services aide (SOC code 21-1093);
42.29 (8) for positive supports analyst staff, 100 percent of the median wage for substance
42.30abuse, behavioral disorder, and mental health counselor (SOC code 21-1018);
42.31 (9) for positive supports professional staff, 100 percent of the median wage for clinical
42.32counseling and school psychologist (SOC code 19-3031);
42Article 2 Sec. 13.
REVISOR AGW/AC 25-0033903/03/25 43.1 (10) for positive supports specialist staff, 100 percent of the median wage for psychiatric
43.2technicians (SOC code 29-2053);
43.3 (11) for individualized home supports with family training staff, 20 percent of the median
43.4wage for nursing aide (SOC code 31-1131); 30 percent of the median wage for community
43.5social service specialist (SOC code 21-1099); 40 percent of the median wage for social and
43.6human services aide (SOC code 21-1093); and ten percent of the median wage for psychiatric
43.7technician (SOC code 29-2053);
43.8 (12) for individualized home supports with training services staff, 40 percent of the
43.9median wage for community social service specialist (SOC code 21-1099); 50 percent of
43.10the median wage for social and human services aide (SOC code 21-1093); and ten percent
43.11of the median wage for psychiatric technician (SOC code 29-2053);
43.12 (13) for employment support services staff, 50 percent of the median wage for
43.13rehabilitation counselor (SOC code 21-1015); and 50 percent of the median wage for
43.14community and social services specialist (SOC code 21-1099);
43.15 (14) for employment exploration services staff, 50 percent of the median wage for
43.16education, guidance, school, and vocational counselor (SOC code 21-1012); and 50 percent
43.17of the median wage for community and social services specialist (SOC code 21-1099);
43.18 (15) for employment development services staff, 50 percent of the median wage for
43.19education, guidance, school, and vocational counselors (SOC code 21-1012); and 50 percent
43.20of the median wage for community and social services specialist (SOC code 21-1099);
43.21 (16) for individualized home support without training staff, 50 percent of the median
43.22wage for home health and personal care aide (SOC code 31-1120); and 50 percent of the
43.23median wage for nursing assistant (SOC code 31-1131); and
43.24 (17) effective until the effective date of clauses (18) and (19), for night supervision staff,
43.2540 percent of the median wage for home health and personal care aide (SOC code 31-1120);
43.2620 percent of the median wage for nursing assistant (SOC code 31-1131); 20 percent of the
43.27median wage for psychiatric technician (SOC code 29-2053); and 20 percent of the median
43.28wage for social and human services aide (SOC code 21-1093).;
43.29 (18) effective January 1, 2026, or upon federal approval, whichever is later, for awake
43.30night supervision staff, 40 percent of the median wage for home health and personal care
43.31aide (SOC code 31-1120); 20 percent of the median wage for nursing assistant (SOC code
43.3231-1131); 20 percent the median wage for psychiatric technician (SOC code 29-2053); and
43.3320 percent of the median wage for social and human services aid (SOC code 21-1093); and
43Article 2 Sec. 13.
REVISOR AGW/AC 25-0033903/03/25 44.1 (19) effective January 1, 2026, or upon federal approval, whichever is later, for asleep
44.2night supervision staff, the minimum wage in Minnesota for large employers.
44.3 EFFECTIVE DATE.This section is effective the day following final enactment.
44.4 Sec. 14. Minnesota Statutes 2024, section 256B.4914, subdivision 5b, is amended to read:
44.5 Subd. 5b.Standard component value adjustments.The commissioner shall update
44.6the client and programming support, transportation, and program facility cost component
44.7values as required in subdivisions 6 to 9 and the rates identified in subdivision 19 for changes
44.8in the Consumer Price Index. If the result of this update exceeds two percent, the
44.9commissioner shall implement a change to these component values of two percent. If the
44.10result of this update is less than two percent, the commissioner shall implement the full
44.11value of the change. The commissioner shall adjust these values higher or lower, publish
44.12these updated values, and load them into the rate management system as follows:
44.13 (1) on January 1, 2022, by the percentage change in the CPI-U from the date of the
44.14previous update to the data available on December 31, 2019;
44.15 (2) on January 1, 2024, by the percentage change in the CPI-U from the date of the
44.16previous update to the data available as of December 31, 2022; and
44.17 (3) on January 1, 2026, and every two years thereafter, by the percentage change in the
44.18CPI-U from the date of the previous update to the data available 24 months and one day
44.19prior to the scheduled update.
44.20 EFFECTIVE DATE.This section is effective January 1, 2026, or upon federal approval,
44.21whichever is later. The commissioner shall notify the revisor of statutes when federal
44.22approval is obtained.
44.23Sec. 15. Minnesota Statutes 2024, section 256B.4914, subdivision 6a, is amended to read:
44.24 Subd. 6a.Community residential services; component values and calculation of
44.25payment rates.(a) Component values for community residential services are:
44.26 (1) competitive workforce factor: 6.7 percent;
44.27 (2) supervisory span of control ratio: 11 percent;
44.28 (3) employee vacation, sick, and training allowance ratio: 8.71 percent;
44.29 (4) employee-related cost ratio: 23.6 percent;
44.30 (5) general administrative support ratio: 13.25 percent;
44Article 2 Sec. 15.
REVISOR AGW/AC 25-0033903/03/25 45.1 (6) program-related expense ratio: 1.3 percent; and
45.2 (7) absence and utilization factor ratio: 3.9 percent.
45.3 (b) Payments for community residential services must be calculated as follows:
45.4 (1) determine the number of shared direct staffing and individual direct staffing hours
45.5to meet a recipient's needs provided on site or through monitoring technology;
45.6 (2) determine the appropriate hourly staff wage rates derived by the commissioner as
45.7provided in subdivisions 5 and 5a;
45.8 (3) except for subdivision 5a, clauses (1) to (4), multiply the result of clause (2) by the
45.9product of one plus the competitive workforce factor;
45.10 (4) for a recipient requiring customization for deaf and hard-of-hearing language
45.11accessibility under subdivision 12, add the customization rate provided in subdivision 12
45.12to the result of clause (3);
45.13 (5) multiply the number of shared direct staffing and individual direct staffing hours
45.14provided on site or through monitoring technology and nursing hours by the appropriate
45.15staff wages;
45.16 (6) multiply the number of shared direct staffing and individual direct staffing hours
45.17provided on site or through monitoring technology and nursing hours by the product of the
45.18supervision span of control ratio and the appropriate supervisory staff wage in subdivision
45.195a, clause (1);
45.20 (7) combine the results of clauses (5) and (6), excluding any shared direct staffing and
45.21individual direct staffing hours provided through monitoring technology, and multiply the
45.22result by one plus the employee vacation, sick, and training allowance ratio. This is defined
45.23as the direct staffing cost;
45.24 (8) for employee-related expenses, multiply the direct staffing cost, excluding any shared
45.25direct staffing and individual hours provided through monitoring technology, by one plus
45.26the employee-related cost ratio;
45.27 (9) for client programming and supports, add $2,260.21 divided by 365. The
45.28commissioner shall update the amount in this clause as specified in subdivision 5b;
45.29 (10) for transportation, if provided, add $1,742.62 divided by 365, or $3,111.81 divided
45.30by 365 if customized for adapted transport, based on the resident with the highest assessed
45.31need. The commissioner shall update the amounts in this clause as specified in subdivision
45.325b;
45Article 2 Sec. 15.
REVISOR AGW/AC 25-0033903/03/25 46.1 (11) subtotal clauses (8) to (10) and the direct staffing cost of any shared direct staffing
46.2and individual direct staffing hours provided through monitoring technology that was
46.3excluded in clause (8);
46.4 (12) sum the standard general administrative support ratio, the program-related expense
46.5ratio, and the absence and utilization factor ratio;
46.6 (13) divide the result of clause (11) by one minus the result of clause (12). This is the
46.7total payment amount; and
46.8 (14) adjust the result of clause (13) by a factor to be determined by the commissioner
46.9to adjust for regional differences in the cost of providing services.
46.10 (c) Effective January 1, 2026, or upon federal approval, whichever is later, community
46.11services under this section must be billed at a maximum of 351 days per year.
46.12 EFFECTIVE DATE.This section is effective the day following final enactment.
46.13Sec. 16. Minnesota Statutes 2024, section 256B.4914, subdivision 7a, is amended to read:
46.14 Subd. 7a.Adult day services; component values and calculation of payment rates.(a)
46.15Component values for adult day services are:
46.16 (1) competitive workforce factor: 6.7 percent;
46.17 (2) supervisory span of control ratio: 11 percent;
46.18 (3) employee vacation, sick, and training allowance ratio: 8.71 percent;
46.19 (4) employee-related cost ratio: 23.6 percent;
46.20 (5) program plan support ratio: 5.6 percent;
46.21 (6) client programming and support ratio: 7.4 percent, updated as specified in subdivision
46.225b;
46.23 (7) general administrative support ratio: 13.25 percent;
46.24 (8) program-related expense ratio: 1.8 percent; and
46.25 (9) absence and utilization factor ratio: 9.4 3.9 percent.
46.26 (b) A unit of service for adult day services is either a day or 15 minutes. A day unit of
46.27service is six or more hours of time spent providing direct service.
46.28 (c) Payments for adult day services must be calculated as follows:
46Article 2 Sec. 16.
REVISOR AGW/AC 25-0033903/03/25 47.1 (1) determine the number of units of service and the staffing ratio to meet a recipient's
47.2needs;
47.3 (2) determine the appropriate hourly staff wage rates derived by the commissioner as
47.4provided in subdivisions 5 and 5a;
47.5 (3) except for subdivision 5a, clauses (1) to (4), multiply the result of clause (2) by the
47.6product of one plus the competitive workforce factor;
47.7 (4) for a recipient requiring customization for deaf and hard-of-hearing language
47.8accessibility under subdivision 12, add the customization rate provided in subdivision 12
47.9to the result of clause (3);
47.10 (5) multiply the number of day program direct staffing hours and nursing hours by the
47.11appropriate staff wage;
47.12 (6) multiply the number of day program direct staffing hours by the product of the
47.13supervisory span of control ratio and the appropriate supervisory staff wage in subdivision
47.145a, clause (1);
47.15 (7) combine the results of clauses (5) and (6), and multiply the result by one plus the
47.16employee vacation, sick, and training allowance ratio. This is defined as the direct staffing
47.17rate;
47.18 (8) for program plan support, multiply the result of clause (7) by one plus the program
47.19plan support ratio;
47.20 (9) for employee-related expenses, multiply the result of clause (8) by one plus the
47.21employee-related cost ratio;
47.22 (10) for client programming and supports, multiply the result of clause (9) by one plus
47.23the client programming and support ratio;
47.24 (11) for program facility costs, add $19.30 per week with consideration of staffing ratios
47.25to meet individual needs, updated as specified in subdivision 5b;
47.26 (12) for adult day bath services, add $7.01 per 15 minute unit;
47.27 (13) this is the subtotal rate;
47.28 (14) sum the standard general administrative rate support ratio, the program-related
47.29expense ratio, and the absence and utilization factor ratio;
47.30 (15) divide the result of clause (13) by one minus the result of clause (14). This is the
47.31total payment amount; and
47Article 2 Sec. 16.
REVISOR AGW/AC 25-0033903/03/25 48.1 (16) adjust the result of clause (15) by a factor to be determined by the commissioner
48.2to adjust for regional differences in the cost of providing services.
48.3 EFFECTIVE DATE.This section is effective January 1, 2026.
48.4 Sec. 17. Minnesota Statutes 2024, section 256B.4914, subdivision 7b, is amended to read:
48.5 Subd. 7b.Day support services; component values and calculation of payment
48.6rates.(a) Component values for day support services are:
48.7 (1) competitive workforce factor: 6.7 percent;
48.8 (2) supervisory span of control ratio: 11 percent;
48.9 (3) employee vacation, sick, and training allowance ratio: 8.71 percent;
48.10 (4) employee-related cost ratio: 23.6 percent;
48.11 (5) program plan support ratio: 5.6 percent;
48.12 (6) client programming and support ratio: 10.37 percent, updated as specified in
48.13subdivision 5b;
48.14 (7) general administrative support ratio: 13.25 percent;
48.15 (8) program-related expense ratio: 1.8 percent; and
48.16 (9) absence and utilization factor ratio: 9.4 3.9 percent.
48.17 (b) A unit of service for day support services is 15 minutes.
48.18 (c) Payments for day support services must be calculated as follows:
48.19 (1) determine the number of units of service and the staffing ratio to meet a recipient's
48.20needs;
48.21 (2) determine the appropriate hourly staff wage rates derived by the commissioner as
48.22provided in subdivisions 5 and 5a;
48.23 (3) except for subdivision 5a, clauses (1) to (4), multiply the result of clause (2) by the
48.24product of one plus the competitive workforce factor;
48.25 (4) for a recipient requiring customization for deaf and hard-of-hearing language
48.26accessibility under subdivision 12, add the customization rate provided in subdivision 12
48.27to the result of clause (3);
48.28 (5) multiply the number of day program direct staffing hours and nursing hours by the
48.29appropriate staff wage;
48Article 2 Sec. 17.
REVISOR AGW/AC 25-0033903/03/25 49.1 (6) multiply the number of day program direct staffing hours by the product of the
49.2supervisory span of control ratio and the appropriate supervisory staff wage in subdivision
49.35a, clause (1);
49.4 (7) combine the results of clauses (5) and (6), and multiply the result by one plus the
49.5employee vacation, sick, and training allowance ratio. This is defined as the direct staffing
49.6rate;
49.7 (8) for program plan support, multiply the result of clause (7) by one plus the program
49.8plan support ratio;
49.9 (9) for employee-related expenses, multiply the result of clause (8) by one plus the
49.10employee-related cost ratio;
49.11 (10) for client programming and supports, multiply the result of clause (9) by one plus
49.12the client programming and support ratio;
49.13 (11) for program facility costs, add $19.30 per week with consideration of staffing ratios
49.14to meet individual needs, updated as specified in subdivision 5b;
49.15 (12) this is the subtotal rate;
49.16 (13) sum the standard general administrative rate support ratio, the program-related
49.17expense ratio, and the absence and utilization factor ratio;
49.18 (14) divide the result of clause (12) by one minus the result of clause (13). This is the
49.19total payment amount; and
49.20 (15) adjust the result of clause (14) by a factor to be determined by the commissioner
49.21to adjust for regional differences in the cost of providing services.
49.22 EFFECTIVE DATE.This section is effective January 1, 2026.
49.23Sec. 18. Minnesota Statutes 2024, section 256B.4914, subdivision 7c, is amended to read:
49.24 Subd. 7c.Prevocational services; component values and calculation of payment
49.25rates.(a) Component values for prevocational services are:
49.26 (1) competitive workforce factor: 6.7 percent;
49.27 (2) supervisory span of control ratio: 11 percent;
49.28 (3) employee vacation, sick, and training allowance ratio: 8.71 percent;
49.29 (4) employee-related cost ratio: 23.6 percent;
49.30 (5) program plan support ratio: 5.6 percent;
49Article 2 Sec. 18.
REVISOR AGW/AC 25-0033903/03/25 50.1 (6) client programming and support ratio: 10.37 percent, updated as specified in
50.2subdivision 5b;
50.3 (7) general administrative support ratio: 13.25 percent;
50.4 (8) program-related expense ratio: 1.8 percent; and
50.5 (9) absence and utilization factor ratio: 9.4 3.9 percent.
50.6 (b) A unit of service for prevocational services is either a day or 15 minutes. A day unit
50.7of service is six or more hours of time spent providing direct service.
50.8 (c) Payments for prevocational services must be calculated as follows:
50.9 (1) determine the number of units of service and the staffing ratio to meet a recipient's
50.10needs;
50.11 (2) determine the appropriate hourly staff wage rates derived by the commissioner as
50.12provided in subdivisions 5 and 5a;
50.13 (3) except for subdivision 5a, clauses (1) to (4), multiply the result of clause (2) by the
50.14product of one plus the competitive workforce factor;
50.15 (4) for a recipient requiring customization for deaf and hard-of-hearing language
50.16accessibility under subdivision 12, add the customization rate provided in subdivision 12
50.17to the result of clause (3);
50.18 (5) multiply the number of day program direct staffing hours and nursing hours by the
50.19appropriate staff wage;
50.20 (6) multiply the number of day program direct staffing hours by the product of the
50.21supervisory span of control ratio and the appropriate supervisory staff wage in subdivision
50.225a, clause (1);
50.23 (7) combine the results of clauses (5) and (6), and multiply the result by one plus the
50.24employee vacation, sick, and training allowance ratio. This is defined as the direct staffing
50.25rate;
50.26 (8) for program plan support, multiply the result of clause (7) by one plus the program
50.27plan support ratio;
50.28 (9) for employee-related expenses, multiply the result of clause (8) by one plus the
50.29employee-related cost ratio;
50.30 (10) for client programming and supports, multiply the result of clause (9) by one plus
50.31the client programming and support ratio;
50Article 2 Sec. 18.
REVISOR AGW/AC 25-0033903/03/25 51.1 (11) for program facility costs, add $19.30 per week with consideration of staffing ratios
51.2to meet individual needs, updated as specified in subdivision 5b;
51.3 (12) this is the subtotal rate;
51.4 (13) sum the standard general administrative rate support ratio, the program-related
51.5expense ratio, and the absence and utilization factor ratio;
51.6 (14) divide the result of clause (12) by one minus the result of clause (13). This is the
51.7total payment amount; and
51.8 (15) adjust the result of clause (14) by a factor to be determined by the commissioner
51.9to adjust for regional differences in the cost of providing services.
51.10 EFFECTIVE DATE.This section is effective January 1, 2026.
51.11Sec. 19. Minnesota Statutes 2024, section 256B.4914, subdivision 8, is amended to read:
51.12 Subd. 8. Unit-based services with programming; component values and calculation
51.13of payment rates.(a) For the purpose of this section, unit-based services with programming
51.14include employment exploration services, employment development services, employment
51.15support services, individualized home supports with family training, individualized home
51.16supports with training, and positive support services provided to an individual outside of
51.17any service plan for a day program or residential support service.
51.18 (b) Component values for unit-based services with programming are:
51.19 (1) competitive workforce factor: 6.7 percent;
51.20 (2) supervisory span of control ratio: 11 percent;
51.21 (3) employee vacation, sick, and training allowance ratio: 8.71 percent;
51.22 (4) employee-related cost ratio: 23.6 percent;
51.23 (5) program plan support ratio: 15.5 percent;
51.24 (6) client programming and support ratio: 4.7 percent, updated as specified in subdivision
51.255b;
51.26 (7) general administrative support ratio: 13.25 percent;
51.27 (8) program-related expense ratio: 6.1 percent; and
51.28 (9) absence and utilization factor ratio: 3.9 percent.
51.29 (c) A unit of service for unit-based services with programming is 15 minutes.
51Article 2 Sec. 19.
REVISOR AGW/AC 25-0033903/03/25 52.1 (d) Payments for unit-based services with programming must be calculated as follows,
52.2unless the services are reimbursed separately as part of a residential support services or day
52.3program payment rate:
52.4 (1) determine the number of units of service to meet a recipient's needs;
52.5 (2) determine the appropriate hourly staff wage rates derived by the commissioner as
52.6provided in subdivisions 5 and 5a;
52.7 (3) except for subdivision 5a, clauses (1) to (4), multiply the result of clause (2) by the
52.8product of one plus the competitive workforce factor;
52.9 (4) for a recipient requiring customization for deaf and hard-of-hearing language
52.10accessibility under subdivision 12, add the customization rate provided in subdivision 12
52.11to the result of clause (3);
52.12 (5) multiply the number of direct staffing hours by the appropriate staff wage;
52.13 (6) multiply the number of direct staffing hours by the product of the supervisory span
52.14of control ratio and the appropriate supervisory staff wage in subdivision 5a, clause (1);
52.15 (7) combine the results of clauses (5) and (6), and multiply the result by one plus the
52.16employee vacation, sick, and training allowance ratio. This is defined as the direct staffing
52.17rate;
52.18 (8) for program plan support, multiply the result of clause (7) by one plus the program
52.19plan support ratio;
52.20 (9) for employee-related expenses, multiply the result of clause (8) by one plus the
52.21employee-related cost ratio;
52.22 (10) for client programming and supports, multiply the result of clause (9) by one plus
52.23the client programming and support ratio;
52.24 (11) this is the subtotal rate;
52.25 (12) sum the standard general administrative support ratio, the program-related expense
52.26ratio, and the absence and utilization factor ratio;
52.27 (13) divide the result of clause (11) by one minus the result of clause (12). This is the
52.28total payment amount;
52.29 (14) for services provided in a shared manner, divide the total payment in clause (13)
52.30as follows:
52Article 2 Sec. 19.
REVISOR AGW/AC 25-0033903/03/25 53.1 (i) for employment exploration services, divide by the number of service recipients, not
53.2to exceed five;
53.3 (ii) for employment support services, divide by the number of service recipients, not to
53.4exceed six;
53.5 (iii) for individualized home supports with training and individualized home supports
53.6with family training, divide by the number of service recipients, not to exceed three; and
53.7 (iv) for night supervision, divide by the number of service recipients, not to exceed two;
53.8and
53.9 (15) adjust the result of clause (14) by a factor to be determined by the commissioner
53.10to adjust for regional differences in the cost of providing services.
53.11 (e) Effective January 1, 2026, or upon federal approval, whichever is later, the
53.12commissioner must bill individualized home supports with training and individualized home
53.13supports with family training at a maximum of eight hours per day.
53.14 EFFECTIVE DATE.This section is effective the day following final enactment.
53.15Sec. 20. Minnesota Statutes 2024, section 256B.4914, subdivision 9, is amended to read:
53.16 Subd. 9. Unit-based services without programming; component values and
53.17calculation of payment rates.(a) For the purposes of this section, unit-based services
53.18without programming include individualized home supports without training and night
53.19supervision provided to an individual outside of any service plan for a day program or
53.20residential support service. Unit-based services without programming do not include respite.
53.21This paragraph expires upon the effective date of paragraph (b).
53.22 (b) Effective January 1, 2026, or upon federal approval, whichever is later, for the
53.23purposes of this section, unit-based services without programming include individualized
53.24home supports without training, awake night supervision, and asleep night supervision
53.25provided to an individual outside of any service plan for a day program or residential support
53.26service.
53.27 (b) (c) Component values for unit-based services without programming are:
53.28 (1) competitive workforce factor: 6.7 percent;
53.29 (2) supervisory span of control ratio: 11 percent;
53.30 (3) employee vacation, sick, and training allowance ratio: 8.71 percent;
53.31 (4) employee-related cost ratio: 23.6 percent;
53Article 2 Sec. 20.
REVISOR AGW/AC 25-0033903/03/25 54.1 (5) program plan support ratio: 7.0 percent;
54.2 (6) client programming and support ratio: 2.3 percent, updated as specified in subdivision
54.35b;
54.4 (7) general administrative support ratio: 13.25 percent;
54.5 (8) program-related expense ratio: 2.9 percent; and
54.6 (9) absence and utilization factor ratio: 3.9 percent.
54.7 (c) (d) A unit of service for unit-based services without programming is 15 minutes.
54.8 (d) (e) Payments for unit-based services without programming must be calculated as
54.9follows unless the services are reimbursed separately as part of a residential support services
54.10or day program payment rate:
54.11 (1) determine the number of units of service to meet a recipient's needs;
54.12 (2) determine the appropriate hourly staff wage rates derived by the commissioner as
54.13provided in subdivisions 5 to 5a;
54.14 (3) except for subdivision 5a, clauses (1) to (4), multiply the result of clause (2) by the
54.15product of one plus the competitive workforce factor;
54.16 (4) for a recipient requiring customization for deaf and hard-of-hearing language
54.17accessibility under subdivision 12, add the customization rate provided in subdivision 12
54.18to the result of clause (3);
54.19 (5) multiply the number of direct staffing hours by the appropriate staff wage;
54.20 (6) multiply the number of direct staffing hours by the product of the supervisory span
54.21of control ratio and the appropriate supervisory staff wage in subdivision 5a, clause (1);
54.22 (7) combine the results of clauses (5) and (6), and multiply the result by one plus the
54.23employee vacation, sick, and training allowance ratio. This is defined as the direct staffing
54.24rate;
54.25 (8) for program plan support, multiply the result of clause (7) by one plus the program
54.26plan support ratio;
54.27 (9) for employee-related expenses, multiply the result of clause (8) by one plus the
54.28employee-related cost ratio;
54.29 (10) for client programming and supports, multiply the result of clause (9) by one plus
54.30the client programming and support ratio;
54Article 2 Sec. 20.
REVISOR AGW/AC 25-0033903/03/25 55.1 (11) this is the subtotal rate;
55.2 (12) sum the standard general administrative support ratio, the program-related expense
55.3ratio, and the absence and utilization factor ratio;
55.4 (13) divide the result of clause (11) by one minus the result of clause (12). This is the
55.5total payment amount;
55.6 (14) for individualized home supports without training provided in a shared manner,
55.7divide the total payment amount in clause (13) by the number of service recipients, not to
55.8exceed three; and
55.9 (15) adjust the result of clause (14) by a factor to be determined by the commissioner
55.10to adjust for regional differences in the cost of providing services.
55.11 EFFECTIVE DATE.This section is effective the day following final enactment.
55.12Sec. 21. Minnesota Statutes 2024, section 256B.4914, is amended by adding a subdivision
55.13to read:
55.14 Subd. 14a.Limitations on rate exceptions for residential services.(a) Effective July
55.151, 2026, the commissioner must implement limitations on the size and number of rate
55.16exceptions for community residential services, customized living services, family residential
55.17services, and integrated community supports.
55.18 (b) The commissioner must restrict rate exceptions to the absence and utilization factor
55.19ratio to people temporarily receiving hospital or crisis respite services. The commissioner
55.20must not grant an exception for more than 351 leave days per calendar year.
55.21 (c) For rate exceptions related to behavioral needs, the commissioner must include:
55.22 (1) a documented behavioral diagnosis; or
55.23 (2) determined assessed needs for behavioral supports as identified in the person's most
55.24recent assessment.
55.25 (d) Community residential services rate exceptions must not include positive supports
55.26costs.
55.27 (e) The commissioner must not approve rate exception requests related to increased
55.28community time or transportation.
55.29 (f) For the commissioner to approve a rate exception annual renewal, the person's most
55.30recent assessment must indicate continued extraordinary needs in the areas cited in the
55.31exception request. If a person's assessment continues to identify these extraordinary needs,
55Article 2 Sec. 21.
REVISOR AGW/AC 25-0033903/03/25 56.1lead agencies requesting an annual renewal of rate exceptions must submit provider-created
56.2documentation supporting the continuation of the exception, including but not limited to:
56.3 (1) payroll records for direct care wages cited in the request;
56.4 (2) payment records or receipts for other costs cited in the request; and
56.5 (3) documentation of expenses paid that were identified as necessary for the initial rate
56.6exception.
56.7 (g) The commissioner must not increase rate exception annual renewals that request an
56.8exception to direct care or supervision wages more than the most recently implemented
56.9base wage index determined under subdivision 5.
56.10 (h) The commissioner must publish online an annual report detailing the impact of the
56.11limitations under this subdivision on home and community-based services spending, including
56.12but not limited to:
56.13 (1) the number and percentage of rate exceptions granted and denied;
56.14 (2) total spending on community residential setting services and rate exceptions;
56.15 (3) trends in the percentage of spending attributable to rate exceptions; and
56.16 (4) an evaluation of the effectiveness of the limitations in controlling spending growth.
56.17 EFFECTIVE DATE.This section is effective January 1, 2026.
56.18Sec. 22. Minnesota Statutes 2024, section 256B.4914, is amended by adding a subdivision
56.19to read:
56.20 Subd. 20.Sanctions and monetary recovery.Payments under this section are subject
56.21to the sanctions and monetary recovery requirements under section 256B.064.
56.22Sec. 23. Minnesota Statutes 2024, section 256B.85, subdivision 7a, is amended to read:
56.23 Subd. 7a.Enhanced rate.(a) An enhanced rate of 107.5 percent of the rate paid for
56.24CFSS must be paid for services provided to persons who qualify for ten or more hours of
56.25CFSS per day when provided by a support worker who meets the requirements of subdivision
56.2616, paragraph (e). This paragraph expires upon the effective date of paragraph (b).
56.27 (b) Effective January 1, 2026, or upon federal approval, whichever is later, an enhanced
56.28rate of 112.5 percent of the rate paid for CFSS must be paid for services provided to persons
56.29who qualify for ten or more hours of CFSS per day when provided by a support worker
56.30who meets the requirements of subdivision 16, paragraph (e).
56Article 2 Sec. 23.
REVISOR AGW/AC 25-0033903/03/25 57.1 (b) (c) An agency provider must use all additional revenue attributable to the rate
57.2enhancements under this subdivision for the wages and wage-related costs of the support
57.3workers, including any corresponding increase in the employer's share of FICA taxes,
57.4Medicare taxes, state and federal unemployment taxes, and workers' compensation premiums.
57.5The agency provider must not use the additional revenue attributable to any enhanced rate
57.6under this subdivision to pay for mileage reimbursement, health and dental insurance, life
57.7insurance, disability insurance, long-term care insurance, uniform allowance, contributions
57.8to employee retirement accounts, or any other employee benefits.
57.9 (c) (d) Any change in the eligibility criteria for the enhanced rate for CFSS as described
57.10in this subdivision and referenced in subdivision 16, paragraph (e), does not constitute a
57.11change in a term or condition for individual providers as defined in section 256B.0711, and
57.12is not subject to the state's obligation to meet and negotiate under chapter 179A.
57.13 EFFECTIVE DATE.This section is effective the day following federal approval.
57.14Sec. 24. Minnesota Statutes 2024, section 256B.85, subdivision 8, is amended to read:
57.15 Subd. 8.Determination of CFSS service authorization amount.(a) All community
57.16first services and supports must be authorized by the commissioner or the commissioner's
57.17designee before services begin. The authorization for CFSS must be completed as soon as
57.18possible following an assessment but no later than 40 calendar days from the date of the
57.19assessment.
57.20 (b) The amount of CFSS authorized must be based on the participant's home care rating
57.21described in paragraphs (d) and (e) and any additional service units for which the participant
57.22qualifies as described in paragraph (f).
57.23 (c) The home care rating shall be determined by the commissioner or the commissioner's
57.24designee based on information submitted to the commissioner identifying the following for
57.25a participant:
57.26 (1) the total number of dependencies of activities of daily living;
57.27 (2) the presence of complex health-related needs; and
57.28 (3) the presence of Level I behavior.
57.29 (d) The methodology to determine the total service units for CFSS for each home care
57.30rating is based on the median paid units per day for each home care rating from fiscal year
57.312007 data for the PCA program.
57Article 2 Sec. 24.
REVISOR AGW/AC 25-0033903/03/25 58.1 (e) Each home care rating is designated by the letters P through Z and EN and has the
58.2following base number of service units assigned:
58.3 (1) P home care rating requires Level I behavior or one to three dependencies in ADLs
58.4and qualifies the person for five service units;
58.5 (2) Q home care rating requires Level I behavior and one to three dependencies in ADLs
58.6and qualifies the person for six service units;
58.7 (3) R home care rating requires a complex health-related need and one to three
58.8dependencies in ADLs and qualifies the person for seven service units;
58.9 (4) S home care rating requires four to six dependencies in ADLs and qualifies the person
58.10for ten service units;
58.11 (5) T home care rating requires four to six dependencies in ADLs and Level I behavior
58.12and qualifies the person for 11 service units;
58.13 (6) U home care rating requires four to six dependencies in ADLs and a complex
58.14health-related need and qualifies the person for 14 service units;
58.15 (7) V home care rating requires seven to eight dependencies in ADLs and qualifies the
58.16person for 17 service units;
58.17 (8) W home care rating requires seven to eight dependencies in ADLs and Level I
58.18behavior and qualifies the person for 20 service units;
58.19 (9) Z home care rating requires seven to eight dependencies in ADLs and a complex
58.20health-related need and qualifies the person for 30 service units; and
58.21 (10) EN home care rating includes ventilator dependency as defined in section 256B.0651,
58.22subdivision 1, paragraph (g). A person who meets the definition of ventilator-dependent
58.23and the EN home care rating and utilize a combination of CFSS and home care nursing
58.24services is limited to a total of 96 service units per day for those services in combination.
58.25Additional units may be authorized when a person's assessment indicates a need for two
58.26staff to perform activities. Additional time is limited to 16 service units per day.
58.27 (f) Additional service units are provided through the assessment and identification of
58.28the following:
58.29 (1) 30 additional minutes per day for a dependency in each critical activity of daily
58.30living;
58.31 (2) 30 additional minutes per day for each complex health-related need; and
58Article 2 Sec. 24.
REVISOR AGW/AC 25-0033903/03/25 59.1 (3) 30 additional minutes per day for each behavior under this clause that requires
59.2assistance at least four times per week:
59.3 (i) level I behavior that requires the immediate response of another person;
59.4 (ii) increased vulnerability due to cognitive deficits or socially inappropriate behavior;
59.5or
59.6 (iii) increased need for assistance for participants who are verbally aggressive or resistive
59.7to care so that the time needed to perform activities of daily living is increased.
59.8 (g) The service budget for budget model participants shall be based on:
59.9 (1) assessed units as determined by the home care rating; and
59.10 (2) an adjustment needed for administrative expenses. This paragraph expires upon the
59.11effective date of paragraph (h).
59.12 (h) Effective January 1, 2026, or upon federal approval, whichever is later, the service
59.13budget for budget model participants shall be based on:
59.14 (1) assessed units as determined by the home care rating and the payment methodologies
59.15under section 256B.851; and
59.16 (2) an adjustment needed for administrative expenses.
59.17 EFFECTIVE DATE.This section is effective the day following final approval.
59.18Sec. 25. Minnesota Statutes 2024, section 256B.85, subdivision 16, is amended to read:
59.19 Subd. 16.Support workers requirements.(a) Support workers shall:
59.20 (1) enroll with the department as a support worker after a background study under chapter
59.21245C has been completed and the support worker has received a notice from the
59.22commissioner that the support worker:
59.23 (i) is not disqualified under section 245C.14; or
59.24 (ii) is disqualified, but has received a set-aside of the disqualification under section
59.25245C.22;
59.26 (2) have the ability to effectively communicate with the participant or the participant's
59.27representative;
59.28 (3) have the skills and ability to provide the services and supports according to the
59.29participant's CFSS service delivery plan and respond appropriately to the participant's needs;
59Article 2 Sec. 25.
REVISOR AGW/AC 25-0033903/03/25 60.1 (4) complete the basic standardized CFSS training as determined by the commissioner
60.2before completing enrollment. The training must be available in languages other than English
60.3and to those who need accommodations due to disabilities. CFSS support worker training
60.4must include successful completion of the following training components: basic first aid,
60.5vulnerable adult, child maltreatment, OSHA universal precautions, basic roles and
60.6responsibilities of support workers including information about basic body mechanics,
60.7emergency preparedness, orientation to positive behavioral practices, orientation to
60.8responding to a mental health crisis, fraud issues, time cards and documentation, and an
60.9overview of person-centered planning and self-direction. Upon completion of the training
60.10components, the support worker must pass the certification test to provide assistance to
60.11participants;
60.12 (5) complete employer-directed training and orientation on the participant's individual
60.13needs;
60.14 (6) maintain the privacy and confidentiality of the participant; and
60.15 (7) not independently determine the medication dose or time for medications for the
60.16participant.
60.17 (b) The commissioner may deny or terminate a support worker's provider enrollment
60.18and provider number if the support worker:
60.19 (1) does not meet the requirements in paragraph (a);
60.20 (2) fails to provide the authorized services required by the employer;
60.21 (3) has been intoxicated by alcohol or drugs while providing authorized services to the
60.22participant or while in the participant's home;
60.23 (4) has manufactured or distributed drugs while providing authorized services to the
60.24participant or while in the participant's home; or
60.25 (5) has been excluded as a provider by the commissioner of human services, or by the
60.26United States Department of Health and Human Services, Office of Inspector General, from
60.27participation in Medicaid, Medicare, or any other federal health care program.
60.28 (c) A support worker may appeal in writing to the commissioner to contest the decision
60.29to terminate the support worker's provider enrollment and provider number.
60.30 (d) A support worker must not provide or be paid for more than 310 hours of CFSS per
60.31month, regardless of the number of participants the support worker serves or the number
60.32of agency-providers or participant employers by which the support worker is employed.
60Article 2 Sec. 25.
REVISOR AGW/AC 25-0033903/03/25 61.1The department shall not disallow the number of hours per day a support worker works
61.2unless it violates other law.
61.3 (e) CFSS qualify for an enhanced rate if the support worker providing the services:
61.4 (1) provides services, within the scope of CFSS described in subdivision 7, to a participant
61.5who qualifies for ten or more hours per day of CFSS; and
61.6 (2) satisfies the current requirements of Medicare for training and competency or
61.7competency evaluation of home health aides or nursing assistants, as provided in the Code
61.8of Federal Regulations, title 42, section 483.151 or 484.36, or alternative state-approved
61.9training or competency requirements. This paragraph expires upon the effective date of
61.10paragraph (f).
61.11 (f) Effective January 1, 2026, or upon federal approval, whichever is later, CFSS qualify
61.12for an enhanced rate or budget if the support worker providing the services:
61.13 (1) provides services, within the scope of CFSS described in subdivision 7, to a participant
61.14who qualifies for ten or more hours per day of CFSS; and
61.15 (2) satisfies the current requirements of Medicare for training and competency or
61.16competency evaluation of home health aides or nursing assistants, as provided in the Code
61.17of Federal Regulations, title 42, section 483.151 or 484.36, or alternative state-approved
61.18training or competency requirements.
61.19 EFFECTIVE DATE.This section is effective the day following federal approval.
61.20Sec. 26. Minnesota Statutes 2024, section 256B.851, subdivision 5, is amended to read:
61.21 Subd. 5.Payment rates; component values.(a) The commissioner must use the
61.22following component values:
61.23 (1) employee vacation, sick, and training factor, 8.71 percent;
61.24 (2) employer taxes and workers' compensation factor, 11.56 percent;
61.25 (3) employee benefits factor, 12.04 percent;
61.26 (4) client programming and supports factor, 2.30 percent;
61.27 (5) program plan support factor, 7.00 percent;
61.28 (6) general business and administrative expenses factor, 13.25 percent;
61.29 (7) program administration expenses factor, 2.90 percent; and
61.30 (8) absence and utilization factor, 3.90 percent.
61Article 2 Sec. 26.
REVISOR AGW/AC 25-0033903/03/25 62.1 (b) For purposes of implementation, the commissioner shall use the following
62.2implementation components:
62.3 (1) personal care assistance services and CFSS: 88.19 percent;
62.4 (2) enhanced rate personal care assistance services and enhanced rate CFSS: 88.19
62.5percent; and
62.6 (3) qualified professional services and CFSS worker training and development: 88.19
62.7percent. This paragraph expires upon the effective date of paragraph (c).
62.8 (c) Effective January 1, 2026, or upon federal approval, whichever is later, for purposes
62.9of implementation, the commissioner shall use the following implementation components:
62.10 (1) personal care assistance services and CFSS: 92.20 percent;
62.11 (2) enhanced rate personal care assistance services and enhanced rate CFSS: 92.20
62.12percent; and
62.13 (3) qualified professional services and CFSS worker training and development: 92.20
62.14percent.
62.15 (c) (d) Effective January 1, 2025, for purposes of implementation, the commissioner
62.16shall use the following implementation components:
62.17 (1) personal care assistance services and CFSS: 92.08 percent;
62.18 (2) enhanced rate personal care assistance services and enhanced rate CFSS: 92.08
62.19percent; and
62.20 (3) qualified professional services and CFSS worker training and development: 92.08
62.21percent. This paragraph expires upon the effective date of paragraph (c).
62.22 (d) (e) The commissioner shall use the following worker retention components:
62.23 (1) for workers who have provided fewer than 1,001 cumulative hours in personal care
62.24assistance services or CFSS, the worker retention component is zero percent;
62.25 (2) for workers who have provided between 1,001 and 2,000 cumulative hours in personal
62.26care assistance services or CFSS, the worker retention component is 2.17 percent;
62.27 (3) for workers who have provided between 2,001 and 6,000 cumulative hours in personal
62.28care assistance services or CFSS, the worker retention component is 4.36 percent;
62.29 (4) for workers who have provided between 6,001 and 10,000 cumulative hours in
62.30personal care assistance services or CFSS, the worker retention component is 7.35 percent;
62.31and
62Article 2 Sec. 26.
REVISOR AGW/AC 25-0033903/03/25 63.1 (5) for workers who have provided more than 10,000 cumulative hours in personal care
63.2assistance services or CFSS, the worker retention component is 10.81 percent. This paragraph
63.3expires upon the effective date of paragraph (f).
63.4 (f) Effective January 1, 2026, or upon federal approval, whichever is later, the
63.5commissioner shall use the following worker retention components:
63.6 (1) for workers who have provided fewer than 1,001 cumulative hours in personal care
63.7assistance services or CFSS, the worker retention component is zero percent;
63.8 (2) for workers who have provided between 1,001 and 2,000 cumulative hours in personal
63.9care assistance services or CFSS, the worker retention component is 4.05 percent;
63.10 (3) for workers who have provided between 2,001 and 6,000 cumulative hours in personal
63.11care assistance services or CFSS, the worker retention component is 6.24 percent;
63.12 (4) for workers who have provided between 6,001 and 10,000 cumulative hours in
63.13personal care assistance services or CFSS, the worker retention component is 9.23 percent;
63.14and
63.15 (5) for workers who have provided more than 10,000 cumulative hours in personal care
63.16assistance services or CFSS, the worker retention component is 12.69 percent.
63.17 (e) (g) The commissioner shall define the appropriate worker retention component based
63.18on the total number of units billed for services rendered by the individual provider since
63.19July 1, 2017. The worker retention component must be determined by the commissioner
63.20for each individual provider and is not subject to appeal.
63.21 (h) Effective January 1, 2027, or upon federal approval, whichever is later, for purposes
63.22of implementation, the commissioner shall use the following implementation components
63.23if a worker has completed either the orientation for individual providers offered through
63.24the Home Care Orientation Trust or an orientation defined and offered by the commissioner:
63.25 (1) for workers who have provided fewer than 1,001 cumulative hours in personal care
63.26assistance services or CFSS, the worker retention component is 1.88 percent;
63.27 (2) for workers who have provided between 1,001 and 2,000 cumulative hours in personal
63.28care assistance services or CFSS, the worker retention component is 5.92 percent;
63.29 (3) for workers who have provided between 2,001, and 6,000 cumulative hours in personal
63.30care assistance services or CFSS, the worker retention component is 8.11 percent;
63Article 2 Sec. 26.
REVISOR AGW/AC 25-0033903/03/25 64.1 (4) for workers who have provided between 6,001 and 10,000 cumulative hours in
64.2personal care assistance services or CFSS, the worker retention component is 11.10 percent;
64.3and
64.4 (5) for workers who have provided more than 10,000 cumulative hours in personal care
64.5assistance services or CFSS, the worker retention component is 14.56 percent.
64.6 EFFECTIVE DATE.This section is effective the day following final enactment.
64.7 Sec. 27. Minnesota Statutes 2024, section 256B.851, subdivision 6, is amended to read:
64.8 Subd. 6.Payment rates; rate determination.(a) The commissioner must determine
64.9the rate for personal care assistance services, CFSS, extended personal care assistance
64.10services, extended CFSS, enhanced rate personal care assistance services, enhanced rate
64.11CFSS, qualified professional services, and CFSS worker training and development as
64.12follows:
64.13 (1) multiply the appropriate total wage component value calculated in subdivision 4 by
64.14one plus the employee vacation, sick, and training factor in subdivision 5;
64.15 (2) for program plan support, multiply the result of clause (1) by one plus the program
64.16plan support factor in subdivision 5;
64.17 (3) for employee-related expenses, add the employer taxes and workers' compensation
64.18factor in subdivision 5 and the employee benefits factor in subdivision 5. The sum is
64.19employee-related expenses. Multiply the product of clause (2) by one plus the value for
64.20employee-related expenses;
64.21 (4) for client programming and supports, multiply the product of clause (3) by one plus
64.22the client programming and supports factor in subdivision 5;
64.23 (5) for administrative expenses, add the general business and administrative expenses
64.24factor in subdivision 5, the program administration expenses factor in subdivision 5, and
64.25the absence and utilization factor in subdivision 5;
64.26 (6) divide the result of clause (4) by one minus the result of clause (5). The quotient is
64.27the hourly rate;
64.28 (7) multiply the hourly rate by the appropriate implementation component under
64.29subdivision 5. This is the adjusted hourly rate; and
64.30 (8) divide the adjusted hourly rate by four. The quotient is the total adjusted payment
64.31rate.
64Article 2 Sec. 27.
REVISOR AGW/AC 25-0033903/03/25 65.1 (b) In processing personal care assistance provider agency and CFSS provider agency
65.2claims, the commissioner shall incorporate the worker retention component specified in
65.3subdivision 5, by multiplying one plus the total adjusted payment rate by the appropriate
65.4worker retention component under subdivision 5, paragraph (d).
65.5 (c) The commissioner must publish the total final payment rates.
65.6 (d) The commissioner shall increase the authorization for the CFSS budget model of
65.7those CFSS participant-employers employing individual providers who have provided more
65.8than 1,000 hours of services as well as individual providers who have completed the
65.9orientation offered by the Home Care Orientation Trust or an orientation defined and offered
65.10by the commissioner. The commissioner shall determine the amount and method of the
65.11authorization increase.
65.12 EFFECTIVE DATE.This section is effective January 1, 2026, or upon federal approval,
65.13whichever is later. The commissioner shall notify the revisor of statutes when federal
65.14approval is obtained.
65.15Sec. 28. Minnesota Statutes 2024, section 260E.14, subdivision 1, is amended to read:
65.16 Subdivision 1.Facilities and schools.(a) The local welfare agency is the agency
65.17responsible for investigating allegations of maltreatment in child foster care, family child
65.18care, legally nonlicensed child care, and reports involving children served by an unlicensed
65.19personal care provider organization under section 256B.0659. Copies of findings related to
65.20personal care provider organizations under section 256B.0659 must be forwarded to the
65.21Department of Human Services provider enrollment.
65.22 (b) The Department of Children, Youth, and Families is the agency responsible for
65.23screening and investigating allegations of maltreatment in juvenile correctional facilities
65.24listed under section 241.021 located in the local welfare agency's county and in facilities
65.25licensed or certified under chapters 245A and 245D.
65.26 (c) The Department of Health is the agency responsible for screening and investigating
65.27allegations of maltreatment in facilities licensed under sections 144.50 to 144.58 and 144A.43
65.28to 144A.482 or chapter 144H.
65.29 (d) The Department of Education is the agency responsible for screening and investigating
65.30allegations of maltreatment in a school as defined in section 120A.05, subdivisions 9, 11,
65.31and 13, and chapter 124E. The Department of Education's responsibility to screen and
65.32investigate includes allegations of maltreatment involving students 18 through 21 years of
65Article 2 Sec. 28.
REVISOR AGW/AC 25-0033903/03/25 66.1age, including students receiving special education services, up to and including graduation
66.2and the issuance of a secondary or high school diploma.
66.3 (e) The Department of Human Services is the agency responsible for screening and
66.4investigating allegations of maltreatment of minors in an EIDBI agency operating under a
66.5provisional license under section 245A.142.
66.6 (e) (f) A health or corrections agency receiving a report may request the local welfare
66.7agency to provide assistance pursuant to this section and sections 260E.20 and 260E.22.
66.8 (f) (g) The Department of Children, Youth, and Families is the agency responsible for
66.9screening and investigating allegations of maltreatment in facilities or programs not listed
66.10in paragraph (a) that are licensed or certified under chapters 142B and 142C.
66.11 EFFECTIVE DATE.This section is effective .....
66.12Sec. 29. Minnesota Statutes 2024, section 626.5572, subdivision 13, is amended to read:
66.13 Subd. 13.Lead investigative agency."Lead investigative agency" is the primary
66.14administrative agency responsible for investigating reports made under section 626.557.
66.15 (a) The Department of Health is the lead investigative agency for facilities or services
66.16licensed or required to be licensed as hospitals, home care providers, nursing homes, boarding
66.17care homes, hospice providers, residential facilities that are also federally certified as
66.18intermediate care facilities that serve people with developmental disabilities, or any other
66.19facility or service not listed in this subdivision that is licensed or required to be licensed by
66.20the Department of Health for the care of vulnerable adults. "Home care provider" has the
66.21meaning provided in section 144A.43, subdivision 4, and applies when care or services are
66.22delivered in the vulnerable adult's home.
66.23 (b) The Department of Human Services is the lead investigative agency for facilities or
66.24services licensed or required to be licensed as adult day care, adult foster care, community
66.25residential settings, programs for people with disabilities, family adult day services, mental
66.26health programs, mental health clinics, substance use disorder programs, the Minnesota Sex
66.27Offender Program, or any other facility or service not listed in this subdivision that is licensed
66.28or required to be licensed by the Department of Human Services, including EIDBI agencies
66.29operating under a provisional license under section 245A.142.
66.30 (c) The county social service agency or its designee is the lead investigative agency for
66.31all other reports, including, but not limited to, reports involving vulnerable adults receiving
66.32services from a personal care provider organization under section 256B.0659.
66Article 2 Sec. 29.
REVISOR AGW/AC 25-0033903/03/25 67.1 EFFECTIVE DATE.This section is effective .....
67.2 Sec. 30. TRANSITION TO NONPROVISIONAL EIDBI LICENSE; FUTURE
67.3LICENSURE STANDARDS.
67.4 (a) The commissioner must develop a process and transition plan for comprehensive
67.5EIDBI agency licensure by January 1, 2026.
67.6 (b) By December 1, 2026, in consultation with stakeholders the commissioner shall draft
67.7standards for nonprovisional EIDBI agency licensure and submit proposed legislation to
67.8the chairs and ranking minority members of the legislative committees with jurisdiction
67.9over human services licensing.
67.10 EFFECTIVE DATE.This section is effective August 1, 2025.
67.11Sec. 31. BUDGET INCREASE FOR CONSUMER-DIRECTED COMMUNITY
67.12SUPPORTS.
67.13 Effective January 1, 2026, or upon federal approval, whichever is later, the commissioner
67.14must increase the consumer-directed community support budgets identified in the waiver
67.15plans under Minnesota Statutes, sections 256B.092 and 256B.49, and chapter 256S; and
67.16the alternative care program under Minnesota Statutes, section 256B.0913, by 0.13 percent.
67.17 EFFECTIVE DATE.This section is effective the day following final enactment.
67.18Sec. 32. ENHANCED BUDGET INCREASE FOR CONSUMER-DIRECTED
67.19COMMUNITY SUPPORTS.
67.20 Effective January 1, 2026, or upon federal approval, whichever is later, the commissioner
67.21must increase the consumer-directed community supports budget exception percentage
67.22identified in the waiver plans under Minnesota Statutes, sections 256B.092 and 256B.49,
67.23and chapter 256S; and the alternative care program under Minnesota Statutes, section
67.24256B.0913, from 7.5 to 12.5.
67.25 EFFECTIVE DATE.This section is effective the day following final enactment.
67.26Sec. 33. STIPEND PAYMENTS TO SEIU HEALTHCARE MINNESOTA & IOWA
67.27BARGAINING UNIT MEMBERS.
67.28 (a) The commissioner of human services shall issue stipend payments to collective
67.29bargaining unit members as required by the labor agreement between the state of Minnesota
67Article 2 Sec. 33.
REVISOR AGW/AC 25-0033903/03/25 68.1and the Service Employees International Union (SEIU) Healthcare Minnesota & Iowa and
68.2as specified under article 7, section 16, subdivisions 3 and 5.
68.3 (b) The definitions in Minnesota Statutes, section 290.01, apply to this section.
68.4 (c) For the purposes of this section, "subtraction" has the meaning given in Minnesota
68.5Statutes, section 290.0132, subdivision 1, and the rules in that subdivision apply to this
68.6section.
68.7 (d) The amount of stipend payments received by SEIU Healthcare Minnesota & Iowa
68.8collective bargaining unit members under this section is a subtraction.
68.9 (e) The amount of stipend payments received by SEIU Healthcare Minnesota & Iowa
68.10collective bargaining unit members under this section is excluded from income as defined
68.11in Minnesota Statutes, section 290A.03, subdivision 3.
68.12 (f) Notwithstanding any law to the contrary, stipend payments under this section must
68.13not be considered income, assets, or personal property for purposes of determining or
68.14recertifying eligibility for:
68.15 (1) child care assistance programs under Minnesota Statutes, chapter 142E;
68.16 (2) general assistance, Minnesota supplemental aid, and food support under Minnesota
68.17Statutes, chapter 256D;
68.18 (3) housing support under Minnesota Statutes, chapter 256I;
68.19 (4) the Minnesota family investment program under Minnesota Statutes, chapter 142G;
68.20and
68.21 (5) economic assistance programs under Minnesota Statutes, chapter 256P.
68.22 (g) The commissioner of human services must not consider stipend payments under this
68.23section as income or assets under Minnesota Statutes, section 256B.056, subdivision 1a,
68.24paragraph (a); 3; or 3c, or for persons with eligibility determined under Minnesota Statutes,
68.25section 256B.057, subdivision 3, 3a, or 3b.
68.26 EFFECTIVE DATE.This section is effective the day following final enactment.
68.27Sec. 34. RESIDENTIAL OVERNIGHT STAFFING REFORM STUDY.
68.28 (a) The commissioner shall conduct a study of overnight supervision requirements in
68.29community residential services as defined in Minnesota Statutes, chapter 245D, to assess
68.30and determine the thresholds necessary for an individual to qualify for awake overnight
68.31supervision. The study may evaluate:
68Article 2 Sec. 34.
REVISOR AGW/AC 25-0033903/03/25 69.1 (1) individual safety needs and risk factors during overnight hours;
69.2 (2) the level of support required to address health, behavioral, and environmental risks;
69.3 (3) the cost-effectiveness and resource allocation of awake versus asleep overnight
69.4supervision models;
69.5 (4) staffing and workforce implications for providers of community residential services;
69.6and
69.7 (5) feedback and recommendations from stakeholders, including service recipients,
69.8families of service recipients, and providers.
69.9 (b) By June 30, 2027, the commissioner shall submit a report to the chairs and ranking
69.10minority members of the legislative committees and divisions with jurisdiction over human
69.11services finance and policy. The report must outline the findings from the study, including
69.12any identified thresholds for awake overnight supervision eligibility and recommendations
69.13for implementing evidence-based guidelines to enhance service delivery and individual
69.14safety.
69.15 ARTICLE 3
69.16 DIRECT CARE AND TREATMENT
69.17Section 1. Minnesota Statutes 2024, section 13.46, subdivision 1, is amended to read:
69.18 Subdivision 1.Definitions.As used in this section:
69.19 (a) "Individual" means an individual according to section 13.02, subdivision 8, but does
69.20not include a vendor of services.
69.21 (b) "Program" includes all programs for which authority is vested in a component of the
69.22welfare system according to statute or federal law, including but not limited to Native
69.23American Tribe programs that provide a service component of the welfare system, the
69.24Minnesota family investment program, medical assistance, general assistance, general
69.25assistance medical care formerly codified in chapter 256D, the child care assistance program,
69.26and child support collections.
69.27 (c) "Welfare system" includes the Department of Human Services; Direct Care and
69.28Treatment; the Department of Children, Youth, and Families; local social services agencies;
69.29county welfare agencies; county public health agencies; county veteran services agencies;
69.30county housing agencies; private licensing agencies; the public authority responsible for
69.31child support enforcement; human services boards; community mental health center boards,
69.32state hospitals, state nursing homes, the ombudsman for mental health and developmental
69Article 3 Section 1.
REVISOR AGW/AC 25-0033903/03/25 70.1disabilities; Native American Tribes to the extent a Tribe provides a service component of
70.2the welfare system; the Minnesota Competency Attainment Board and forensic navigators
70.3under chapter 611; and persons, agencies, institutions, organizations, and other entities
70.4under contract to any of the above agencies to the extent specified in the contract.
70.5 (d) "Mental health data" means data on individual clients and patients of community
70.6mental health centers, established under section 245.62, mental health divisions of counties
70.7and other providers under contract to deliver mental health services, Direct Care and
70.8Treatment mental health services, or the ombudsman for mental health and developmental
70.9disabilities.
70.10 (e) "Fugitive felon" means a person who has been convicted of a felony and who has
70.11escaped from confinement or violated the terms of probation or parole for that offense.
70.12 (f) "Private licensing agency" means an agency licensed by the commissioner of children,
70.13youth, and families under chapter 142B to perform the duties under section 142B.30.
70.14Sec. 2. Minnesota Statutes 2024, section 246B.10, is amended to read:
70.15 246B.10 LIABILITY OF COUNTY; REIMBURSEMENT .
70.16 (a) The civilly committed sex offender's county shall pay to the state a portion of the
70.17cost of care provided in the Minnesota Sex Offender Program to a civilly committed sex
70.18offender who has legally settled in that county.
70.19 (b) A county's payment must be made from the county's own sources of revenue and
70.20payments must:
70.21 (1) equal ten 40 percent of the cost of care, as determined by the executive board, for
70.22each day or portion of a day that the civilly committed sex offender spends at the facility
70.23for individuals admitted to the Minnesota Sex Offender Program before August 1, 2011; or
70.24 (2) equal 25 percent of the cost of care, as determined by the executive board, for each
70.25day or portion of a day that the civilly committed sex offender:
70.26 (i) spends at the facility for individuals admitted to the Minnesota Sex Offender Program
70.27on or after August 1, 2011; or
70.28 (ii) receives services within a program operated by the Minnesota Sex Offender Program
70.29while on provisional discharge.
70.30 (c) The county is responsible for paying the state the remaining amount if payments
70.31received by the state under this chapter exceed:
70Article 3 Sec. 2.
REVISOR AGW/AC 25-0033903/03/25 71.1 (1) 90 percent of the cost of care for individuals admitted to the Minnesota Sex Offender
71.2Program before August 1, 2011; or
71.3 (2) 75 60 percent of the cost of care for individuals:.
71.4 (i) admitted to the Minnesota Sex Offender Program on or after August 1, 2011; or
71.5 (ii) receiving services within a program operated by the Minnesota Sex Offender Program
71.6while on provisional discharge.
71.7 (d) The county is not entitled to reimbursement from the civilly committed sex offender,
71.8the civilly committed sex offender's estate, or from the civilly committed sex offender's
71.9relatives, except as provided in section 246B.07.
71.10Sec. 3. Minnesota Statutes 2024, section 256G.01, subdivision 3, is amended to read:
71.11 Subd. 3.Program coverage.This chapter applies to all social service programs
71.12administered by the commissioner of human services or the Direct Care and Treatment
71.13executive board in which residence is the determining factor in establishing financial
71.14responsibility. These include, but are not limited to: commitment proceedings, including
71.15voluntary admissions; emergency holds; competency proceedings under chapter 611; poor
71.16relief funded wholly through local agencies; social services, including title XX, IV-E and
71.17section 256K.10; social services programs funded wholly through the resources of county
71.18agencies; social services provided under the Minnesota Indian Family Preservation Act,
71.19sections 260.751 to 260.781; costs for delinquency confinement under section 393.07,
71.20subdivision 2; service responsibility for these programs; and housing support under chapter
71.21256I.
71.22Sec. 4. Minnesota Statutes 2024, section 256G.08, subdivision 1, is amended to read:
71.23 Subdivision 1.Commitment and competency proceedings.In cases of voluntary
71.24admission, or commitment to state or other institutions, or criminal orders for inpatient
71.25examination or participation in a competency attainment program under chapter 611, the
71.26committing county or the county from which the first criminal order for inpatient examination
71.27or order for participation in a competency attainment program under chapter 611 is issued
71.28shall initially pay for all costs. This includes the expenses of the taking into custody,
71.29confinement, emergency holds under sections 253B.051, subdivisions 1 and 2, and 253B.07,
71.30examination, commitment, conveyance to the place of detention, rehearing, and hearings
71.31under section sections 253B.092 and 611.47, including hearings held under that section
71Article 3 Sec. 4.
REVISOR AGW/AC 25-0033903/03/25 72.1which those sections that are venued outside the county of commitment or the county of
72.2the chapter 611 competency proceedings order.
72.3 Sec. 5. Minnesota Statutes 2024, section 256G.08, subdivision 2, is amended to read:
72.4 Subd. 2.Responsibility for nonresidents.If a person committed, or voluntarily admitted
72.5to a state institution, or ordered for inpatient examination or participation in a competency
72.6attainment program under chapter 611 has no residence in this state, financial responsibility
72.7belongs to the county of commitment or the county from which the first criminal order for
72.8inpatient examination or order for participation in a competency attainment program under
72.9chapter 611 was issued.
72.10Sec. 6. Minnesota Statutes 2024, section 256G.09, subdivision 1, is amended to read:
72.11 Subdivision 1.General procedures.If upon investigation the local agency decides that
72.12the application, or commitment, or first criminal order under chapter 611 was not filed in
72.13the county of financial responsibility as defined by this chapter, but that the applicant is
72.14otherwise eligible for assistance, it shall send a copy of the application, or commitment
72.15claim, or chapter 611 claim together with the record of any investigation it has made, to the
72.16county it believes is financially responsible. The copy and record must be sent within 60
72.17days of the date the application was approved or the claim was paid. The first local agency
72.18shall provide assistance to the applicant until financial responsibility is transferred under
72.19this section.
72.20 The county receiving the transmittal has 30 days to accept or reject financial
72.21responsibility. A failure to respond within 30 days establishes financial responsibility by
72.22the receiving county.
72.23Sec. 7. Minnesota Statutes 2024, section 256G.09, subdivision 2, is amended to read:
72.24 Subd. 2.Financial disputes.(a) If the county receiving the transmittal does not believe
72.25it is financially responsible, it should provide to the commissioner of human services and
72.26the initially responsible county a statement of all facts and documents necessary for the
72.27commissioner to make the requested determination of financial responsibility. The submission
72.28must clearly state the program area in dispute and must state the specific basis upon which
72.29the submitting county is denying financial responsibility.
72.30 (b) The initially responsible county then has 15 calendar days to submit its position and
72.31any supporting evidence to the commissioner. The absence of a submission by the initially
72.32responsible county does not limit the right of the commissioner of human services or Direct
72Article 3 Sec. 7.
REVISOR AGW/AC 25-0033903/03/25 73.1Care and Treatment executive board to issue a binding opinion based on the evidence actually
73.2submitted.
73.3 (c) A case must not be submitted until the local agency taking the application, or making
73.4the commitment, or residing in the county from which the first criminal order under chapter
73.5611 was issued has made an initial determination about eligibility and financial responsibility,
73.6and services have been initiated. This paragraph does not prohibit the submission of closed
73.7cases that otherwise meet the applicable statute of limitations.
73.8 Sec. 8. Minnesota Statutes 2024, section 611.43, is amended by adding a subdivision to
73.9read:
73.10 Subd. 5.Costs related to confined treatment.(a) When a defendant is ordered to
73.11participate in an examination in a treatment facility, a locked treatment facility, or a
73.12state-operated treatment facility under subdivision 1, paragraph (b), the facility shall bill
73.13the responsible health plan first. The county in which the criminal charges are filed is
73.14responsible to pay any charges not covered by the health plan, including co-pays and
73.15deductibles. If the defendant has health plan coverage and is confined in a hospital, but the
73.16hospitalization does not meet the criteria in section 62M.07, subdivision 2, clause (1);
73.1762Q.53; 62Q.535, subdivision 1; or 253B.045, subdivision 6, the county in which criminal
73.18charges are filed is responsible for payment.
73.19 (b) The Direct Care and Treatment executive board shall determine the cost of
73.20confinement in a state-operated treatment facility based on the executive board's
73.21determination of cost of care pursuant to section 246.50, subdivision 5.
73.22Sec. 9. Minnesota Statutes 2024, section 611.46, subdivision 1, is amended to read:
73.23 Subdivision 1.Order to competency attainment program.(a) If the court finds the
73.24defendant incompetent and the charges have not been dismissed, the court shall order the
73.25defendant to participate in a program to assist the defendant in attaining competency. The
73.26court may order participation in a competency attainment program provided outside of a
73.27jail, a jail-based competency attainment program, or an alternative program. The court must
73.28determine the least-restrictive program appropriate to meet the defendant's needs and public
73.29safety. In making this determination, the court must consult with the forensic navigator and
73.30consider any recommendations of the court examiner. The court shall not order a defendant
73.31to participate in a jail-based program or a state-operated treatment program if the highest
73.32criminal charge is a targeted misdemeanor.
73Article 3 Sec. 9.
REVISOR AGW/AC 25-0033903/03/25 74.1 (b) If the court orders the defendant to a locked treatment facility or jail-based program,
74.2the court must calculate the defendant's custody credit and cannot order the defendant to a
74.3locked treatment facility or jail-based program for a period that would cause the defendant's
74.4custody credit to exceed the maximum sentence for the underlying charge.
74.5 (c) The court may only order the defendant to participate in competency attainment at
74.6an inpatient or residential treatment program under this section if the head of the treatment
74.7program determines that admission to the program is clinically appropriate and consents to
74.8the defendant's admission. The court may only order the defendant to participate in
74.9competency attainment at a state-operated treatment facility under this section if the Direct
74.10Care and Treatment executive board or a designee determines that admission of the defendant
74.11is clinically appropriate and consents to the defendant's admission. The court may require
74.12a competency program that qualifies as a locked facility or a state-operated treatment program
74.13to notify the court in writing of the basis for refusing consent for admission of the defendant
74.14in order to ensure transparency and maintain an accurate record. The court may not require
74.15personal appearance of any representative of a competency program. The court shall send
74.16a written request for notification to the locked facility or state-operated treatment program
74.17and the locked facility or state-operated treatment program shall provide a written response
74.18to the court within ten days of receipt of the court's request.
74.19 (d) If the defendant is confined in jail and has not received competency attainment
74.20services within 30 days of the finding of incompetency, the court shall review the case with
74.21input from the prosecutor and defense counsel and may:
74.22 (1) order the defendant to participate in an appropriate competency attainment program
74.23that takes place outside of a jail;
74.24 (2) order a conditional release of the defendant with conditions that include but are not
74.25limited to a requirement that the defendant participate in a competency attainment program
74.26when one becomes available and accessible;
74.27 (3) make a determination as to whether the defendant is likely to attain competency in
74.28the reasonably foreseeable future and proceed under section 611.49; or
74.29 (4) upon a motion, dismiss the charges in the interest of justice.
74.30 (e) The court may order any hospital, treatment facility, or correctional facility that has
74.31provided care or supervision to a defendant in the previous two years to provide copies of
74.32the defendant's medical records to the competency attainment program or alternative program
74.33in which the defendant was ordered to participate. This information shall be provided in a
74.34consistent and timely manner and pursuant to all applicable laws.
74Article 3 Sec. 9.
REVISOR AGW/AC 25-0033903/03/25 75.1 (f) If at any time the defendant refuses to participate in a competency attainment program
75.2or an alternative program, the head of the program shall notify the court and any entity
75.3responsible for supervision of the defendant.
75.4 (g) At any time, the head of the program may discharge the defendant from the program
75.5or facility. The head of the program must notify the court, prosecutor, defense counsel, and
75.6any entity responsible for the supervision of the defendant prior to any planned discharge.
75.7Absent emergency circumstances, this notification shall be made five days prior to the
75.8discharge if the defendant is not being discharged to jail or a correctional facility. Upon the
75.9receipt of notification of discharge or upon the request of either party in response to
75.10notification of discharge, the court may order that a defendant who is subject to bail or
75.11unmet conditions of release be returned to jail upon being discharged from the program or
75.12facility. If the court orders a defendant returned to jail, the court shall notify the parties and
75.13head of the program at least one day before the defendant's planned discharge, except in
75.14the event of an emergency discharge where one day notice is not possible. The court must
75.15hold a review hearing within seven days of the defendant's return to jail. The forensic
75.16navigator must be given notice of the hearing and be allowed to participate.
75.17 (h) If the defendant is discharged from the program or facility under emergency
75.18circumstances, notification of emergency discharge shall include a description of the
75.19emergency circumstances and may include a request for emergency transportation. The
75.20court shall make a determination on a request for emergency transportation within 24 hours.
75.21Nothing in this section prohibits a law enforcement agency from transporting a defendant
75.22pursuant to any other authority.
75.23 (i) If the defendant is ordered to participate in an inpatient or residential competency
75.24attainment or alternative program, the program or facility must notify the court, prosecutor,
75.25defense counsel, and any entity responsible for the supervision of the defendant if the
75.26defendant is placed on a leave or elopement status from the program and if the defendant
75.27returns to the program from a leave or elopement status.
75.28 (j) Defense counsel and prosecutors must have access to information relevant to a
75.29defendant's participation and treatment in a competency attainment program or alternative
75.30program, including but not limited to discharge planning.
75.31Sec. 10. Minnesota Statutes 2024, section 611.55, is amended by adding a subdivision to
75.32read:
75.33 Subd. 5.Data access.Forensic navigators must have access to all data collected, created,
75.34or maintained by a competency attainment program or an alternative program regarding a
75Article 3 Sec. 10.
REVISOR AGW/AC 25-0033903/03/25 76.1defendant in order for navigators to carry out their duties under this section. A competency
76.2attainment program or alternative program may request a copy of the court order appointing
76.3the forensic navigator before disclosing any private information about a defendant.
76.4 ARTICLE 4
76.5 BEHAVIORAL HEALTH
76.6 Section 1. Minnesota Statutes 2024, section 245.4661, subdivision 2, is amended to read:
76.7 Subd. 2.Program design and implementation.Adult mental health initiatives shall
76.8be responsible for designing, planning, improving, and maintaining a mental health service
76.9delivery system for adults with serious and persistent mental illness that would:
76.10 (1) provide an expanded array of services from which clients can choose services
76.11appropriate to their needs;
76.12 (2) be based on purchasing strategies that improve access and coordinate services without
76.13cost shifting;
76.14 (3) prioritize evidence-based services and implement services that are promising practices
76.15or theory-based practices so that the service can be evaluated according to subdivision 5a;
76.16 (4) incorporate existing state facilities and resources into the community mental health
76.17infrastructure through creative partnerships with local vendors; and
76.18 (5) utilize existing categorical funding streams and reimbursement sources in combined
76.19and creative ways, except adult mental health initiative funding only after all other eligible
76.20funding sources have been applied. Appropriations and all funds that are attributable to the
76.21operation of state-operated services under the control of the Direct Care and Treatment
76.22executive board are excluded unless appropriated specifically by the legislature for a purpose
76.23consistent with this section.
76.24Sec. 2. Minnesota Statutes 2024, section 245.4661, subdivision 6, is amended to read:
76.25 Subd. 6.Duties of commissioner.(a) For purposes of adult mental health initiatives,
76.26the commissioner shall facilitate integration of funds or other resources as needed and
76.27requested by each adult mental health initiative. These resources may include:
76.28 (1) community support services funds administered under Minnesota Rules, parts
76.299535.1700 to 9535.1760;
76.30 (2) other mental health special project funds;
76Article 4 Sec. 2.
REVISOR AGW/AC 25-0033903/03/25 77.1 (3) medical assistance, MinnesotaCare, and housing support under chapter 256I if
77.2requested by the adult mental health initiative's managing entity and if the commissioner
77.3determines this would be consistent with the state's overall health care reform efforts; and
77.4 (4) regional treatment center resources, with consent from the Direct Care and Treatment
77.5executive board.
77.6 (b) The commissioner shall consider the following criteria in awarding grants for adult
77.7mental health initiatives:
77.8 (1) the ability of the initiatives to accomplish the objectives described in subdivision 2;
77.9 (2) the size of the target population to be served; and
77.10 (3) geographical distribution.
77.11 (c) (b) The commissioner shall review overall status of the initiatives at least every two
77.12years and recommend any legislative changes needed by January 15 of each odd-numbered
77.13year.
77.14 (d) (c) The commissioner may waive administrative rule requirements that are
77.15incompatible with the implementation of the adult mental health initiative.
77.16 (e) (d) The commissioner may exempt the participating counties from fiscal sanctions
77.17for noncompliance with requirements in laws and rules that are incompatible with the
77.18implementation of the adult mental health initiative.
77.19 (f) (e) The commissioner may award grants to an entity designated by a county board
77.20or group of county boards to pay for start-up and implementation costs of the adult mental
77.21health initiative.
77.22Sec. 3. Minnesota Statutes 2024, section 245.4661, subdivision 7, is amended to read:
77.23 Subd. 7.Duties of adult mental health initiative board.The adult mental health
77.24initiative board, or other entity which is approved to administer an adult mental health
77.25initiative, shall:
77.26 (1) administer the initiative in a manner that is consistent with the objectives described
77.27in subdivision 2 and the planning process described in subdivision 5;
77.28 (2) assure that no one is denied services that they would otherwise be eligible for; and
77.29 (3) provide the commissioner of human services with timely and pertinent information
77.30through the following methods:
77Article 4 Sec. 3.
REVISOR AGW/AC 25-0033903/03/25 78.1 (i) submission of mental health plans and plan amendments which are based on a format
78.2and timetable determined by the commissioner;
78.3 (ii) submission of social services expenditure and grant reconciliation reports, based on
78.4a coding format to be determined by mutual agreement between the initiative's managing
78.5entity and the commissioner; and
78.6 (iii) submission of data and participation in an evaluation of the adult mental health
78.7initiatives, to be designed cooperatively by the commissioner and the initiatives. For services
78.8provided to American Indians in Tribal nations or urban Indian communities, oral reports
78.9using a system designed in partnership between the commissioner and the reporting
78.10community satisfy the requirements of this clause.
78.11Sec. 4. Minnesota Statutes 2024, section 245.91, subdivision 4, is amended to read:
78.12 Subd. 4.Facility or program."Facility" or "program" means a nonresidential or
78.13residential program as defined in section 245A.02, subdivisions 10 and 14, and any agency,
78.14facility, or program that provides services or treatment for mental illness, developmental
78.15disability, substance use disorder, or emotional disturbance that is required to be licensed,
78.16certified, or registered by the commissioner of human services, health, or education; a sober
78.17home recovery residence as defined in section 254B.01, subdivision 11; peer recovery
78.18support services provided by a recovery community organization as defined in section
78.19254B.01, subdivision 8; and an acute care inpatient facility that provides services or treatment
78.20for mental illness, developmental disability, substance use disorder, or emotional disturbance.
78.21 EFFECTIVE DATE.This section is effective January 1, 2027.
78.22Sec. 5. Minnesota Statutes 2024, section 245G.01, subdivision 13b, is amended to read:
78.23 Subd. 13b.Guest speaker."Guest speaker" means an individual who is not an alcohol
78.24and drug counselor qualified according to section 245G.11, subdivision 5; is not qualified
78.25according to the commissioner's list of professionals under section 245G.07, subdivision 3,
78.26clause (1); and who works under the direct observation of an alcohol and drug counselor to
78.27present to clients on topics in which the guest speaker has expertise and that the license
78.28holder has determined to be beneficial to a client's recovery. Tribally licensed programs
78.29have autonomy to identify the qualifications of their guest speakers.
78Article 4 Sec. 5.
REVISOR AGW/AC 25-0033903/03/25 79.1 Sec. 6. Minnesota Statutes 2024, section 245G.01, is amended by adding a subdivision to
79.2read:
79.3 Subd. 13d.Individual counseling."Individual counseling" means professionally led
79.4psychotherapeutic treatment for substance use disorders that is delivered in a one-to-one
79.5setting or in a setting with the client and the client's family and other natural supports.
79.6 Sec. 7. Minnesota Statutes 2024, section 245G.01, is amended by adding a subdivision to
79.7read:
79.8 Subd. 20f.Psychoeducation."Psychoeducation" means the services described in section
79.9245G.07, subdivision 1a, clause (2).
79.10Sec. 8. Minnesota Statutes 2024, section 245G.01, is amended by adding a subdivision to
79.11read:
79.12 Subd. 20g.Psychosocial treatment services."Psychosocial treatment services" means
79.13the services described in section 245G.07, subdivision 1a.
79.14Sec. 9. Minnesota Statutes 2024, section 245G.01, is amended by adding a subdivision to
79.15read:
79.16 Subd. 20h.Recovery support services."Recovery support services" means the services
79.17described in section 245G.07, subdivision 2a, paragraph (b), clause (1).
79.18Sec. 10. Minnesota Statutes 2024, section 245G.01, is amended by adding a subdivision
79.19to read:
79.20 Subd. 26a.Treatment coordination."Treatment coordination" means the services
79.21described in section 245G.07, subdivision 1b.
79.22Sec. 11. Minnesota Statutes 2024, section 245G.02, subdivision 2, is amended to read:
79.23 Subd. 2.Exemption from license requirement.This chapter does not apply to a county
79.24or recovery community organization that is providing a service for which the county or
79.25recovery community organization is an eligible vendor under section 254B.05. This chapter
79.26does not apply to an organization whose primary functions are information, referral,
79.27diagnosis, case management, and assessment for the purposes of client placement, education,
79.28support group services, or self-help programs. This chapter does not apply to the activities
79.29of a licensed professional in private practice. A license holder providing the initial set of
79.30substance use disorder services allowable under section 254A.03, subdivision 3, paragraph
79Article 4 Sec. 11.
REVISOR AGW/AC 25-0033903/03/25 80.1(c), to an individual referred to a licensed nonresidential substance use disorder treatment
80.2program after a positive screen for alcohol or substance misuse is exempt from sections
80.3245G.05; 245G.06, subdivisions 1, 1a, and 4; 245G.07, subdivisions 1, paragraph (a), clauses
80.4(2) to (4), and 2, clauses (1) to (7) subdivision 1a, clause (2); and 245G.17.
80.5 EFFECTIVE DATE.This section is effective July 1, 2026.
80.6 Sec. 12. Minnesota Statutes 2024, section 245G.07, subdivision 1, is amended to read:
80.7 Subdivision 1.Treatment service.(a) A licensed residential treatment program must
80.8offer the treatment services in clauses (1) to (5) subdivisions 1a and 1b and may offer the
80.9treatment services in subdivision 2 to each client, unless clinically inappropriate and the
80.10justifying clinical rationale is documented. A nonresidential The treatment program must
80.11offer all treatment services in clauses (1) to (5) and document in the individual treatment
80.12plan the specific services for which a client has an assessed need and the plan to provide
80.13the services:.
80.14 (1) individual and group counseling to help the client identify and address needs related
80.15to substance use and develop strategies to avoid harmful substance use after discharge and
80.16to help the client obtain the services necessary to establish a lifestyle free of the harmful
80.17effects of substance use disorder;
80.18 (2) client education strategies to avoid inappropriate substance use and health problems
80.19related to substance use and the necessary lifestyle changes to regain and maintain health.
80.20Client education must include information on tuberculosis education on a form approved
80.21by the commissioner, the human immunodeficiency virus according to section 245A.19,
80.22other sexually transmitted diseases, drug and alcohol use during pregnancy, and hepatitis;
80.23 (3) a service to help the client integrate gains made during treatment into daily living
80.24and to reduce the client's reliance on a staff member for support;
80.25 (4) a service to address issues related to co-occurring disorders, including client education
80.26on symptoms of mental illness, the possibility of comorbidity, and the need for continued
80.27medication compliance while recovering from substance use disorder. A group must address
80.28co-occurring disorders, as needed. When treatment for mental health problems is indicated,
80.29the treatment must be integrated into the client's individual treatment plan; and
80.30 (5) treatment coordination provided one-to-one by an individual who meets the staff
80.31qualifications in section 245G.11, subdivision 7. Treatment coordination services include:
80.32 (i) assistance in coordination with significant others to help in the treatment planning
80.33process whenever possible;
80Article 4 Sec. 12.
REVISOR AGW/AC 25-0033903/03/25 81.1 (ii) assistance in coordination with and follow up for medical services as identified in
81.2the treatment plan;
81.3 (iii) facilitation of referrals to substance use disorder services as indicated by a client's
81.4medical provider, comprehensive assessment, or treatment plan;
81.5 (iv) facilitation of referrals to mental health services as identified by a client's
81.6comprehensive assessment or treatment plan;
81.7 (v) assistance with referrals to economic assistance, social services, housing resources,
81.8and prenatal care according to the client's needs;
81.9 (vi) life skills advocacy and support accessing treatment follow-up, disease management,
81.10and education services, including referral and linkages to long-term services and supports
81.11as needed; and
81.12 (vii) documentation of the provision of treatment coordination services in the client's
81.13file.
81.14 (b) A treatment service provided to a client must be provided according to the individual
81.15treatment plan and must consider cultural differences and special needs of a client.
81.16 (c) A supportive service alone does not constitute a treatment service. Supportive services
81.17include:
81.18 (1) milieu management or supervising or monitoring clients without also providing a
81.19treatment service identified in subdivision 1a, 1b, or 2a;
81.20 (2) transporting clients; and
81.21 (3) waiting with clients for appointments at social service agencies, court hearings, and
81.22similar activities.
81.23 (d) A treatment service provided in a group setting must be provided in a cohesive
81.24manner and setting that allows every client receiving the service to interact and receive the
81.25same service at the same time.
81.26Sec. 13. Minnesota Statutes 2024, section 245G.07, is amended by adding a subdivision
81.27to read:
81.28 Subd. 1a.Psychosocial treatment service.Psychosocial treatment services must be
81.29provided according to the hours identified in section 254B.19 for the ASAM level of care
81.30provided to the client. A license holder must provide the following psychosocial treatment
81.31services as a part of the client's individual treatment:
81Article 4 Sec. 13.
REVISOR AGW/AC 25-0033903/03/25 82.1 (1) counseling services that provide a client with professional assistance in managing
82.2substance use disorder and co-occurring conditions, either individually or in a group setting.
82.3Counseling must:
82.4 (i) utilization of evidence-based techniques to help a client modify behavior, overcome
82.5obstacles, and achieve and sustain recovery through techniques such as active listening,
82.6guidance, discussion, feedback, and clarification;
82.7 (ii) help for the client to identify and address needs related to substance use, develop
82.8strategies to avoid harmful substance use, and establish a lifestyle free of the harmful effects
82.9of substance use disorder; and
82.10 (iii) work to improve well-being and mental health, resolve or mitigate symptomatic
82.11behaviors, beliefs, compulsions, thoughts, and emotions, and enhance relationships and
82.12social skills, while addressing client-centered psychological and emotional needs; and
82.13 (2) psychoeducation services to provide a client with information about substance use
82.14and co-occurring conditions, either individually or in a group setting. Psychoeducation
82.15includes structured presentations, interactive discussions, and practical exercises to help
82.16clients understand and manage their conditions effectively. Topics include but are not limited
82.17to:
82.18 (i) the causes of substance use disorder and co-occurring disorders;
82.19 (ii) behavioral techniques that help a client change behaviors, thoughts, and feelings;
82.20 (iii) the importance of maintaining mental health, including understanding symptoms
82.21of mental illness;
82.22 (iv) medications for addiction and psychiatric disorders and the importance of medication
82.23adherence;
82.24 (v) the importance of maintaining physical health, health-related risk factors associated
82.25with substance use disorder, and specific health education on tuberculosis, HIV, other
82.26sexually transmitted diseases, drug and alcohol use during pregnancy, and hepatitis; and
82.27 (vi) harm-reduction strategies.
82.28Sec. 14. Minnesota Statutes 2024, section 245G.07, is amended by adding a subdivision
82.29to read:
82.30 Subd. 1b.Treatment coordination.(a) Treatment coordination must be provided
82.31one-to-one by an individual who meets the staff qualifications in section 245G.11, subdivision
82.327. Treatment coordination services include:
82Article 4 Sec. 14.
REVISOR AGW/AC 25-0033903/03/25 83.1 (1) coordinating directly with others involved in the client's treatment and recovery,
83.2including the referral source, family or natural supports, social services agencies, and external
83.3care providers;
83.4 (2) providing clients with training and facilitating connections to community resources
83.5that support recovery;
83.6 (3) assisting clients in obtaining necessary resources and services such as financial
83.7assistance, housing, food, clothing, medical care, education, harm reduction services,
83.8vocational support, and recreational services that promote recovery;
83.9 (4) helping clients connect and engage with self-help support groups and expand social
83.10support networks with family, friends, and organizations; and
83.11 (5) assisting clients in transitioning between levels of care, including providing direct
83.12connections to ensure continuity of care.
83.13 (b) Treatment coordination does not include coordinating services or communicating
83.14with staff members within the licensed program.
83.15 (c) Treatment coordination may be provided in a setting with the individual client and
83.16others involved in the client's treatment and recovery.
83.17Sec. 15. Minnesota Statutes 2024, section 245G.07, is amended by adding a subdivision
83.18to read:
83.19 Subd. 2a.Ancillary treatment service.(a) A license holder may provide ancillary
83.20services in addition to the hours of psychosocial treatment services identified in section
83.21254B.19 for the ASAM level of care provided to the client.
83.22 (b) A license holder may provide the following ancillary treatment services as a part of
83.23the client's individual treatment:
83.24 (1) recovery support services provided individually or in a group setting, that include:
83.25 (i) supporting clients in restoring daily living skills, such as health and health care
83.26navigation and self-care to enhance personal well-being;
83.27 (ii) providing resources and assistance to help clients restore life skills, including effective
83.28parenting, financial management, pro-social behavior, education, employment, and nutrition;
83.29 (iii) assisting clients in restoring daily functioning and routines affected by substance
83.30use and supporting them in developing skills for successful community integration; and
83Article 4 Sec. 15.
REVISOR AGW/AC 25-0033903/03/25 84.1 (iv) helping clients respond to or avoid triggers that threaten their community stability,
84.2assisting the client in identifying potential crises and developing a plan to address them,
84.3and providing support to restore the client's stability and functioning; and
84.4 (2) peer recovery support services provided according to sections 254B.05, subdivision
84.55, and 254B.052.
84.6 Sec. 16. Minnesota Statutes 2024, section 245G.07, subdivision 3, is amended to read:
84.7 Subd. 3.Counselors Treatment service providers.(a) All treatment services, except
84.8peer recovery support services and treatment coordination, must be provided by an alcohol
84.9and drug counselor qualified according to section 245G.11, subdivision 5, unless the
84.10individual providing the service is specifically qualified according to the accepted credential
84.11required to provide the service. The commissioner shall maintain a current list of
84.12professionals qualified to provide treatment services.
84.13 (b) Psychosocial treatment services must be provided by an alcohol and drug counselor
84.14qualified according to section 245G.11, subdivision 5, unless the individual providing the
84.15service is specifically qualified according to the accepted credential required to provide the
84.16service. The commissioner shall maintain a current list of professionals qualified to provide
84.17psychosocial treatment services.
84.18 (c) Treatment coordination must be provided by a treatment coordinator qualified
84.19according to section 245G.11, subdivision 7.
84.20 (d) Recovery support services must be provided by a behavioral health practitioner
84.21qualified according to section 245G.11, subdivision 12.
84.22 (e) Peer recovery support services must be provided by a recovery peer qualified
84.23according to section 245I.04, subdivision 18.
84.24Sec. 17. Minnesota Statutes 2024, section 245G.07, subdivision 4, is amended to read:
84.25 Subd. 4.Location of service provision.(a) The license holder must provide all treatment
84.26services a client receives at one of the license holder's substance use disorder treatment
84.27licensed locations or at a location allowed under paragraphs (b) to (f). If the services are
84.28provided at the locations in paragraphs (b) to (d), the license holder must document in the
84.29client record the location services were provided.
84.30 (b) The license holder may provide nonresidential individual treatment services at a
84.31client's home or place of residence.
84Article 4 Sec. 17.
REVISOR AGW/AC 25-0033903/03/25 85.1 (c) If the license holder provides treatment services by telehealth, the services must be
85.2provided according to this paragraph:
85.3 (1) the license holder must maintain a licensed physical location in Minnesota where
85.4the license holder must offer all treatment services in subdivision 1, paragraph (a), clauses
85.5(1) to (4), 1a physically in-person to each client;
85.6 (2) the license holder must meet all requirements for the provision of telehealth in sections
85.7254B.05, subdivision 5, paragraph (f), and 256B.0625, subdivision 3b. The license holder
85.8must document all items in section 256B.0625, subdivision 3b, paragraph (c), for each client
85.9receiving services by telehealth, regardless of payment type or whether the client is a medical
85.10assistance enrollee;
85.11 (3) the license holder may provide treatment services by telehealth to clients individually;
85.12 (4) the license holder may provide treatment services by telehealth to a group of clients
85.13that are each in a separate physical location;
85.14 (5) the license holder must not provide treatment services remotely by telehealth to a
85.15group of clients meeting together in person, unless permitted under clause (7);
85.16 (6) clients and staff may join an in-person group by telehealth if a staff member qualified
85.17to provide the treatment service is physically present with the group of clients meeting
85.18together in person; and
85.19 (7) the qualified professional providing a residential group treatment service by telehealth
85.20must be physically present on-site at the licensed residential location while the service is
85.21being provided. If weather conditions or short-term illness prohibit a qualified professional
85.22from traveling to the residential program and another qualified professional is not available
85.23to provide the service, a qualified professional may provide a residential group treatment
85.24service by telehealth from a location away from the licensed residential location. In such
85.25circumstances, the license holder must ensure that a qualified professional does not provide
85.26a residential group treatment service by telehealth from a location away from the licensed
85.27residential location for more than one day at a time, must ensure that a staff person who
85.28qualifies as a paraprofessional is physically present with the group of clients, and must
85.29document the reason for providing the remote telehealth service in the records of clients
85.30receiving the service. The license holder must document the dates that residential group
85.31treatment services were provided by telehealth from a location away from the licensed
85.32residential location in a central log and must provide the log to the commissioner upon
85.33request.
85Article 4 Sec. 17.
REVISOR AGW/AC 25-0033903/03/25 86.1 (d) The license holder may provide the additional ancillary treatment services under
86.2subdivision 2, clauses (2) to (6) and (8), 2a away from the licensed location at a suitable
86.3location appropriate to the treatment service.
86.4 (e) Upon written approval from the commissioner for each satellite location, the license
86.5holder may provide nonresidential treatment services at satellite locations that are in a
86.6school, jail, or nursing home. A satellite location may only provide services to students of
86.7the school, inmates of the jail, or residents of the nursing home. Schools, jails, and nursing
86.8homes are exempt from the licensing requirements in section 245A.04, subdivision 2a, to
86.9document compliance with building codes, fire and safety codes, health rules, and zoning
86.10ordinances.
86.11 (f) The commissioner may approve other suitable locations as satellite locations for
86.12nonresidential treatment services. The commissioner may require satellite locations under
86.13this paragraph to meet all applicable licensing requirements. The license holder may not
86.14have more than two satellite locations per license under this paragraph.
86.15 (g) The license holder must provide the commissioner access to all files, documentation,
86.16staff persons, and any other information the commissioner requires at the main licensed
86.17location for all clients served at any location under paragraphs (b) to (f).
86.18 (h) Notwithstanding sections 245A.65, subdivision 2, and 626.557, subdivision 14, a
86.19program abuse prevention plan is not required for satellite or other locations under paragraphs
86.20(b) to (e). An individual abuse prevention plan is still required for any client that is a
86.21vulnerable adult as defined in section 626.5572, subdivision 21.
86.22Sec. 18. Minnesota Statutes 2024, section 245G.11, subdivision 6, is amended to read:
86.23 Subd. 6.Paraprofessionals.A paraprofessional must have knowledge of client rights,
86.24according to section 148F.165, and staff member responsibilities. A paraprofessional may
86.25not make decisions to admit, transfer, or discharge a client but may perform tasks related
86.26to intake and orientation. A paraprofessional may be the responsible for the delivery of
86.27treatment service staff member according to section 245G.10, subdivision 3. A
86.28paraprofessional is not qualified to provide a treatment service according to section 245G.07,
86.29subdivisions 1a, 1b, and 2a.
86.30Sec. 19. Minnesota Statutes 2024, section 245G.11, subdivision 7, is amended to read:
86.31 Subd. 7.Treatment coordination provider qualifications.(a) Treatment coordination
86.32must be provided by qualified staff. An individual is qualified to provide treatment
86Article 4 Sec. 19.
REVISOR AGW/AC 25-0033903/03/25 87.1coordination if the individual meets the qualifications of an alcohol and drug counselor
87.2under subdivision 5 or if the individual:
87.3 (1) is skilled in the process of identifying and assessing a wide range of client needs;
87.4 (2) is knowledgeable about local community resources and how to use those resources
87.5for the benefit of the client;
87.6 (3) has successfully completed 30 hours of classroom instruction on treatment
87.7coordination for an individual with substance use disorder;
87.8 (4) has either: a high school diploma or equivalent; and
87.9 (i) a bachelor's degree in one of the behavioral sciences or related fields; or
87.10 (ii) current certification as an alcohol and drug counselor, level I, by the Upper Midwest
87.11Indian Council on Addictive Disorders; and
87.12 (5) has at least 2,000 1,000 hours of supervised experience working with individuals
87.13with substance use disorder.
87.14 (b) A treatment coordinator must receive at least one hour of supervision regarding
87.15individual service delivery from an alcohol and drug counselor, or a mental health
87.16professional who has substance use treatment and assessments within the scope of their
87.17practice, on a monthly basis.
87.18Sec. 20. Minnesota Statutes 2024, section 245G.11, is amended by adding a subdivision
87.19to read:
87.20 Subd. 12.Behavioral health practitioners.(a) A behavioral health practitioner must
87.21meet the qualifications in section 245I.04, subdivision 4.
87.22 (b) A behavioral health practitioner working within a substance use disorder treatment
87.23program licensed under this chapter has the following scope of practice:
87.24 (1) a behavioral health practitioner may provide clients with recovery support services,
87.25as defined in section 245G.07, subdivision 2a, paragraph (b), clause (1); and
87.26 (2) a behavioral health practitioner must not provide treatment supervision to other staff
87.27persons.
87.28 (c) A behavioral health practitioner working within a substance use disorder treatment
87.29program licensed under this chapter must receive at least one hour of supervision per month
87.30on individual service delivery from an alcohol and drug counselor or a mental health
87Article 4 Sec. 20.
REVISOR AGW/AC 25-0033903/03/25 88.1professional who has substance use treatment and assessments within the scope of their
88.2practice.
88.3 Sec. 21. Minnesota Statutes 2024, section 245G.22, subdivision 11, is amended to read:
88.4 Subd. 11.Waiting list.An opioid treatment program must have a waiting list system.
88.5If the person seeking admission cannot be admitted within 14 days of the date of application,
88.6each person seeking admission must be placed on the waiting list, unless the person seeking
88.7admission is assessed by the program and found ineligible for admission according to this
88.8chapter and Code of Federal Regulations, title 42, part 1, subchapter A, section 8.12 (e),
88.9and title 45, parts 160 to 164. The waiting list must assign a unique client identifier for each
88.10person seeking treatment while awaiting admission. A person seeking admission on a waiting
88.11list who receives no services under section 245G.07, subdivision 1 1a or 1b, must not be
88.12considered a client as defined in section 245G.01, subdivision 9.
88.13Sec. 22. Minnesota Statutes 2024, section 245G.22, subdivision 15, is amended to read:
88.14 Subd. 15.Nonmedication treatment services; documentation.(a) The program must
88.15offer at least 50 consecutive minutes of individual or group therapy treatment services as
88.16defined in section 245G.07, subdivision 1, paragraph (a) 1a, clause (1), per week, for the
88.17first ten weeks following the day of service initiation, and at least 50 consecutive minutes
88.18per month thereafter. As clinically appropriate, the program may offer these services
88.19cumulatively and not consecutively in increments of no less than 15 minutes over the required
88.20time period, and for a total of 60 minutes of treatment services over the time period, and
88.21must document the reason for providing services cumulatively in the client's record. The
88.22program may offer additional levels of service when deemed clinically necessary.
88.23 (b) Notwithstanding the requirements of comprehensive assessments in section 245G.05,
88.24the assessment must be completed within 21 days from the day of service initiation.
88.25Sec. 23. Minnesota Statutes 2024, section 254A.19, subdivision 4, is amended to read:
88.26 Subd. 4.Civil commitments.For the purposes of determining level of care, a
88.27comprehensive assessment does not need to be completed for an individual being committed
88.28as a chemically dependent person, as defined in section 253B.02, and for the duration of a
88.29civil commitment under section 253B.09 or 253B.095 in order for a county the individual
88.30to access be eligible for the behavioral health fund under section 254B.04. The county
88.31commissioner must determine if the individual meets the financial eligibility requirements
88.32for the behavioral health fund under section 254B.04.
88Article 4 Sec. 23.
REVISOR AGW/AC 25-0033903/03/25 89.1 EFFECTIVE DATE.This section is effective July 1, 2025.
89.2 Sec. 24. Minnesota Statutes 2024, section 254B.01, subdivision 10, is amended to read:
89.3 Subd. 10.Skilled Psychosocial treatment services."Skilled Psychosocial treatment
89.4services" includes the treatment services described in section 245G.07, subdivisions 1,
89.5paragraph (a), clauses (1) to (4), and 2, clauses (1) to (6). Skilled subdivision 1a. Psychosocial
89.6treatment services must be provided by qualified professionals as identified in section
89.7245G.07, subdivision 3, paragraph (b).
89.8 Sec. 25. Minnesota Statutes 2024, section 254B.01, subdivision 11, is amended to read:
89.9 Subd. 11.Sober home Recovery residence.A sober home recovery residence is a
89.10cooperative living residence, a room and board residence, an apartment, or any other living
89.11accommodation that:
89.12 (1) provides temporary housing to persons with substance use disorders;
89.13 (2) stipulates that residents must abstain from using alcohol or other illicit drugs or
89.14substances not prescribed by a physician;
89.15 (3) charges a fee for living there;
89.16 (4) does not provide counseling or treatment services to residents;
89.17 (5) promotes sustained recovery from substance use disorders; and
89.18 (6) follows the sober living guidelines published by the federal Substance Abuse and
89.19Mental Health Services Administration.
89.20 EFFECTIVE DATE.This section is effective January 1, 2027.
89.21Sec. 26. Minnesota Statutes 2024, section 254B.02, subdivision 5, is amended to read:
89.22 Subd. 5.Local agency Tribal allocation.The commissioner may make payments to
89.23local agencies Tribal Nation servicing agencies from money allocated under this section to
89.24support individuals with substance use disorders and determine eligibility for behavioral
89.25health fund payments. The payment must not be less than 133 percent of the local agency
89.26Tribal Nations payment for the fiscal year ending June 30, 2009, adjusted in proportion to
89.27the statewide change in the appropriation for this chapter.
89.28 EFFECTIVE DATE.This section is effective July 1, 2025.
89Article 4 Sec. 26.
REVISOR AGW/AC 25-0033903/03/25 90.1 Sec. 27. Minnesota Statutes 2024, section 254B.03, subdivision 1, is amended to read:
90.2 Subdivision 1.Local agency duties Financial eligibility determinations.(a) Every
90.3local agency The commissioner of human services or Tribal Nation servicing agencies must
90.4determine financial eligibility for substance use disorder services and provide substance
90.5use disorder services to persons residing within its jurisdiction who meet criteria established
90.6by the commissioner. Substance use disorder money must be administered by the local
90.7agencies according to law and rules adopted by the commissioner under sections 14.001 to
90.814.69.
90.9 (b) In order to contain costs, the commissioner of human services shall select eligible
90.10vendors of substance use disorder services who can provide economical and appropriate
90.11treatment. Unless the local agency is a social services department directly administered by
90.12a county or human services board, the local agency shall not be an eligible vendor under
90.13section 254B.05. The commissioner may approve proposals from county boards to provide
90.14services in an economical manner or to control utilization, with safeguards to ensure that
90.15necessary services are provided. If a county implements a demonstration or experimental
90.16medical services funding plan, the commissioner shall transfer the money as appropriate.
90.17 (c) An individual may choose to obtain a comprehensive assessment as provided in
90.18section 245G.05. Individuals obtaining a comprehensive assessment may access any enrolled
90.19provider that is licensed to provide the level of service authorized pursuant to section
90.20254A.19, subdivision 3. If the individual is enrolled in a prepaid health plan, the individual
90.21must comply with any provider network requirements or limitations.
90.22 (d) Beginning July 1, 2022, local agencies shall not make placement location
90.23determinations.
90.24 EFFECTIVE DATE.This section is effective July 1, 2025.
90.25Sec. 28. Minnesota Statutes 2024, section 254B.03, subdivision 3, is amended to read:
90.26 Subd. 3.Local agencies Counties to pay state for county share.Local agencies
90.27Counties shall pay the state for the county share of the services authorized by the local
90.28agency commissioner, except when the payment is made according to section 254B.09,
90.29subdivision 8.
90.30 EFFECTIVE DATE.This section is effective July 1, 2025.
90Article 4 Sec. 28.
REVISOR AGW/AC 25-0033903/03/25 91.1 Sec. 29. Minnesota Statutes 2024, section 254B.03, subdivision 4, is amended to read:
91.2 Subd. 4.Division of costs.(a) Except for services provided by a county under section
91.3254B.09, subdivision 1, or services provided under section 256B.69, the county shall, out
91.4of local money, pay the state for 22.95 50 percent of the cost of substance use disorder
91.5services, except for those individuals living in carceral settings. The county shall pay the
91.6state 22.95 percent of the cost of substance use disorder services for individuals in carceral
91.7settings. Services provided to persons enrolled in medical assistance under chapter 256B
91.8and room and board services under section 254B.05, subdivision 5, paragraph (b), are
91.9exempted from county contributions. Counties may use the indigent hospitalization levy
91.10for treatment and hospital payments made under this section.
91.11 (b) 22.95 50 percent of any state collections from private or third-party pay, less 15
91.12percent for the cost of payment and collections, must be distributed to the county that paid
91.13for a portion of the treatment under this section.
91.14 EFFECTIVE DATE.This section is effective July 1, 2025.
91.15Sec. 30. Minnesota Statutes 2024, section 254B.04, subdivision 1a, is amended to read:
91.16 Subd. 1a.Client eligibility.(a) Persons eligible for benefits under Code of Federal
91.17Regulations, title 25, part 20, who meet the income standards of section 256B.056,
91.18subdivision 4, and are not enrolled in medical assistance, are entitled to behavioral health
91.19fund services. State money appropriated for this paragraph must be placed in a separate
91.20account established for this purpose.
91.21 (b) Persons with dependent children who are determined to be in need of substance use
91.22disorder treatment pursuant to an assessment under section 260E.20, subdivision 1, or in
91.23need of chemical dependency treatment pursuant to a case plan under section 260C.201,
91.24subdivision 6, or 260C.212, shall be assisted by the local agency commissioner to access
91.25needed treatment services. Treatment services must be appropriate for the individual or
91.26family, which may include long-term care treatment or treatment in a facility that allows
91.27the dependent children to stay in the treatment facility. The county shall pay for out-of-home
91.28placement costs, if applicable.
91.29 (c) Notwithstanding paragraph (a), any person enrolled in medical assistance or
91.30MinnesotaCare is eligible for room and board services under section 254B.05, subdivision
91.315, paragraph (b), clause (9).
91.32 (d) A client is eligible to have substance use disorder treatment paid for with funds from
91.33the behavioral health fund when the client:
91Article 4 Sec. 30.
REVISOR AGW/AC 25-0033903/03/25 92.1 (1) is eligible for MFIP as determined under chapter 142G;
92.2 (2) is eligible for medical assistance as determined under Minnesota Rules, parts
92.39505.0010 to 9505.0150 9505.140;
92.4 (3) is eligible for general assistance, general assistance medical care, or work readiness
92.5as determined under Minnesota Rules, parts 9500.1200 to 9500.1318 9500.1272; or
92.6 (4) has income that is within current household size and income guidelines for entitled
92.7persons, as defined in this subdivision and subdivision 7.
92.8 (e) Clients who meet the financial eligibility requirement in paragraph (a) and who have
92.9a third-party payment source are eligible for the behavioral health fund if the third-party
92.10payment source pays less than 100 percent of the cost of treatment services for eligible
92.11clients.
92.12 (f) A client is ineligible to have substance use disorder treatment services paid for with
92.13behavioral health fund money if the client:
92.14 (1) has an income that exceeds current household size and income guidelines for entitled
92.15persons as defined in this subdivision and subdivision 7; or
92.16 (2) has an available third-party payment source that will pay the total cost of the client's
92.17treatment.
92.18 (g) A client who is disenrolled from a state prepaid health plan during a treatment episode
92.19is eligible for continued treatment service that is paid for by the behavioral health fund until
92.20the treatment episode is completed or the client is re-enrolled in a state prepaid health plan
92.21if the client:
92.22 (1) continues to be enrolled in MinnesotaCare, medical assistance, or general assistance
92.23medical care; or
92.24 (2) is eligible according to paragraphs (a) and (b) and is determined eligible by a local
92.25agency the commissioner under section 254B.04.
92.26 (h) When a county commits a client under chapter 253B to a regional treatment center
92.27for substance use disorder services and the client is ineligible for the behavioral health fund,
92.28the county is responsible for the payment to the regional treatment center according to
92.29section 254B.05, subdivision 4.
92.30 (i) Persons enrolled in MinnesotaCare are eligible for room and board services when
92.31provided through intensive residential treatment services and residential crisis services under
92.32section 256B.0622.
92Article 4 Sec. 30.
REVISOR AGW/AC 25-0033903/03/25 93.1 (j) A person is eligible for one 60-consecutive-calendar-day period per year. A person
93.2may submit a request for additional eligibility to the commissioner. A person denied
93.3additional eligibility under this paragraph may request a state agency hearing under section
93.4256.045.
93.5 EFFECTIVE DATE.This section is effective July 1, 2025.
93.6 Sec. 31. Minnesota Statutes 2024, section 254B.04, subdivision 5, is amended to read:
93.7 Subd. 5.Local agency Commissioner responsibility to provide administrative
93.8services.The local agency commissioner of human services may employ individuals to
93.9conduct administrative activities and facilitate access to substance use disorder treatment
93.10services.
93.11Sec. 32. Minnesota Statutes 2024, section 254B.04, subdivision 6, is amended to read:
93.12 Subd. 6.Local agency Commissioner to determine client financial eligibility.(a)
93.13The local agency commissioner shall determine a client's financial eligibility for the
93.14behavioral health fund according to section 254B.04, subdivision 1a, with the income
93.15calculated prospectively for one year from the date of request. The local agency commissioner
93.16shall pay for eligible clients according to chapter 256G. Client eligibility must be determined
93.17using only forms prescribed by the commissioner unless the local agency has a reasonable
93.18basis for believing that the information submitted on a form is false. To determine a client's
93.19eligibility, the local agency commissioner must determine the client's income, the size of
93.20the client's household, the availability of a third-party payment source, and a responsible
93.21relative's ability to pay for the client's substance use disorder treatment.
93.22 (b) A client who is a minor child must not be deemed to have income available to pay
93.23for substance use disorder treatment, unless the minor child is responsible for payment under
93.24section 144.347 for substance use disorder treatment services sought under section 144.343,
93.25subdivision 1.
93.26 (c) The local agency commissioner must determine the client's household size as follows:
93.27 (1) if the client is a minor child, the household size includes the following persons living
93.28in the same dwelling unit:
93.29 (i) the client;
93.30 (ii) the client's birth or adoptive parents; and
93.31 (iii) the client's siblings who are minors; and
93Article 4 Sec. 32.
REVISOR AGW/AC 25-0033903/03/25 94.1 (2) if the client is an adult, the household size includes the following persons living in
94.2the same dwelling unit:
94.3 (i) the client;
94.4 (ii) the client's spouse;
94.5 (iii) the client's minor children; and
94.6 (iv) the client's spouse's minor children.
94.7For purposes of this paragraph, household size includes a person listed in clauses (1) and
94.8(2) who is in an out-of-home placement if a person listed in clause (1) or (2) is contributing
94.9to the cost of care of the person in out-of-home placement.
94.10 (d) The local agency commissioner must determine the client's current prepaid health
94.11plan enrollment, the availability of a third-party payment source, including the availability
94.12of total payment, partial payment, and amount of co-payment.
94.13 (e) The local agency must provide the required eligibility information to the department
94.14in the manner specified by the department.
94.15 (f) (e) The local agency commissioner shall require the client and policyholder to
94.16conditionally assign to the department the client and policyholder's rights and the rights of
94.17minor children to benefits or services provided to the client if the department is required to
94.18collect from a third-party pay source.
94.19 (g) (f) The local agency commissioner must redetermine determine a client's eligibility
94.20for the behavioral health fund every 12 months for a 60-consecutive-calendar-day period
94.21per calendar year.
94.22 (h) (g) A client, responsible relative, and policyholder must provide income or wage
94.23verification, household size verification, and must make an assignment of third-party payment
94.24rights under paragraph (f) (e). If a client, responsible relative, or policyholder does not
94.25comply with the provisions of this subdivision, the client is ineligible for behavioral health
94.26fund payment for substance use disorder treatment, and the client and responsible relative
94.27must be obligated to pay for the full cost of substance use disorder treatment services
94.28provided to the client.
94.29Sec. 33. Minnesota Statutes 2024, section 254B.04, subdivision 6a, is amended to read:
94.30 Subd. 6a.Span of eligibility.The local agency commissioner must enter the financial
94.31eligibility span within five business days of a request. If the comprehensive assessment is
94.32completed within the timelines required under chapter 245G, then the span of eligibility
94Article 4 Sec. 33.
REVISOR AGW/AC 25-0033903/03/25 95.1must begin on the date services were initiated. If the comprehensive assessment is not
95.2completed within the timelines required under chapter 245G, then the span of eligibility
95.3must begin on the date the comprehensive assessment was completed.
95.4 Sec. 34. Minnesota Statutes 2024, section 254B.05, subdivision 1, is amended to read:
95.5 Subdivision 1.Licensure or certification required.(a) Programs licensed by the
95.6commissioner are eligible vendors. Hospitals may apply for and receive licenses to be
95.7eligible vendors, notwithstanding the provisions of section 245A.03. American Indian
95.8programs that provide substance use disorder treatment, extended care, transitional residence,
95.9or outpatient treatment services, and are licensed by tribal government are eligible vendors.
95.10 (b) A licensed professional in private practice as defined in section 245G.01, subdivision
95.1117, who meets the requirements of section 245G.11, subdivisions 1 and 4, is an eligible
95.12vendor of a comprehensive assessment provided according to section 254A.19, subdivision
95.133, and treatment services provided according to sections 245G.06 and 245G.07, subdivision
95.141, paragraphs (a), clauses (1) to (5), and (b); and subdivision 2, clauses (1) to (6). subdivisions
95.151, 1a, and 1b.
95.16 (c) A county is an eligible vendor for a comprehensive assessment when provided by
95.17an individual who meets the staffing credentials of section 245G.11, subdivisions 1 and 5,
95.18and completed according to the requirements of section 254A.19, subdivision 3. A county
95.19is an eligible vendor of care treatment coordination services when provided by an individual
95.20who meets the staffing credentials of section 245G.11, subdivisions 1 and 7, and provided
95.21according to the requirements of section 245G.07, subdivision 1, paragraph (a), clause (5)
95.221b. A county is an eligible vendor of peer recovery services when the services are provided
95.23by an individual who meets the requirements of section 245G.11, subdivision 8, and
95.24according to section 254B.052.
95.25 (d) A recovery community organization that meets the requirements of clauses (1) to
95.26(14) and meets certification or accreditation requirements of the Alliance for Recovery
95.27Centered Organizations, the Council on Accreditation of Peer Recovery Support Services,
95.28or a Minnesota statewide recovery organization identified by the commissioner is an eligible
95.29vendor of peer recovery support services. A Minnesota statewide recovery organization
95.30identified by the commissioner must update recovery community organization applicants
95.31for certification or accreditation on the status of the application within 45 days of receipt.
95.32If the approved statewide recovery organization denies an application, it must provide a
95.33written explanation for the denial to the recovery community organization. Eligible vendors
95.34under this paragraph must:
95Article 4 Sec. 34.
REVISOR AGW/AC 25-0033903/03/25 96.1 (1) be nonprofit organizations under section 501(c)(3) of the Internal Revenue Code, be
96.2free from conflicting self-interests, and be autonomous in decision-making, program
96.3development, peer recovery support services provided, and advocacy efforts for the purpose
96.4of supporting the recovery community organization's mission;
96.5 (2) be led and governed by individuals in the recovery community, with more than 50
96.6percent of the board of directors or advisory board members self-identifying as people in
96.7personal recovery from substance use disorders;
96.8 (3) have a mission statement and conduct corresponding activities indicating that the
96.9organization's primary purpose is to support recovery from substance use disorder;
96.10 (4) demonstrate ongoing community engagement with the identified primary region and
96.11population served by the organization, including individuals in recovery and their families,
96.12friends, and recovery allies;
96.13 (5) be accountable to the recovery community through documented priority-setting and
96.14participatory decision-making processes that promote the engagement of, and consultation
96.15with, people in recovery and their families, friends, and recovery allies;
96.16 (6) provide nonclinical peer recovery support services, including but not limited to
96.17recovery support groups, recovery coaching, telephone recovery support, skill-building,
96.18and harm-reduction activities, and provide recovery public education and advocacy;
96.19 (7) have written policies that allow for and support opportunities for all paths toward
96.20recovery and refrain from excluding anyone based on their chosen recovery path, which
96.21may include but is not limited to harm reduction paths, faith-based paths, and nonfaith-based
96.22paths;
96.23 (8) maintain organizational practices to meet the needs of Black, Indigenous, and people
96.24of color communities, LGBTQ+ communities, and other underrepresented or marginalized
96.25communities. Organizational practices may include board and staff training, service offerings,
96.26advocacy efforts, and culturally informed outreach and services;
96.27 (9) use recovery-friendly language in all media and written materials that is supportive
96.28of and promotes recovery across diverse geographical and cultural contexts and reduces
96.29stigma;
96.30 (10) establish and maintain a publicly available recovery community organization code
96.31of ethics and grievance policy and procedures;
96.32 (11) not classify or treat any recovery peer hired on or after July 1, 2024, as an
96.33independent contractor;
96Article 4 Sec. 34.
REVISOR AGW/AC 25-0033903/03/25 97.1 (12) not classify or treat any recovery peer as an independent contractor on or after
97.2January 1, 2025;
97.3 (13) provide an orientation for recovery peers that includes an overview of the consumer
97.4advocacy services provided by the Ombudsman for Mental Health and Developmental
97.5Disabilities and other relevant advocacy services; and
97.6 (14) provide notice to peer recovery support services participants that includes the
97.7following statement: "If you have a complaint about the provider or the person providing
97.8your peer recovery support services, you may contact the Minnesota Alliance of Recovery
97.9Community Organizations. You may also contact the Office of Ombudsman for Mental
97.10Health and Developmental Disabilities." The statement must also include:
97.11 (i) the telephone number, website address, email address, and mailing address of the
97.12Minnesota Alliance of Recovery Community Organizations and the Office of Ombudsman
97.13for Mental Health and Developmental Disabilities;
97.14 (ii) the recovery community organization's name, address, email, telephone number, and
97.15name or title of the person at the recovery community organization to whom problems or
97.16complaints may be directed; and
97.17 (iii) a statement that the recovery community organization will not retaliate against a
97.18peer recovery support services participant because of a complaint.
97.19 (e) A recovery community organization approved by the commissioner before June 30,
97.202023, must have begun the application process as required by an approved certifying or
97.21accrediting entity and have begun the process to meet the requirements under paragraph (d)
97.22by September 1, 2024, in order to be considered as an eligible vendor of peer recovery
97.23support services.
97.24 (f) A recovery community organization that is aggrieved by an accreditation, certification,
97.25or membership determination and believes it meets the requirements under paragraph (d)
97.26may appeal the determination under section 256.045, subdivision 3, paragraph (a), clause
97.27(14), for reconsideration as an eligible vendor. If the human services judge determines that
97.28the recovery community organization meets the requirements under paragraph (d), the
97.29recovery community organization is an eligible vendor of peer recovery support services.
97.30 (g) All recovery community organizations must be certified or accredited by an entity
97.31listed in paragraph (d) by June 30, 2025.
97.32 (h) Detoxification programs licensed under Minnesota Rules, parts 9530.6510 to
97.339530.6590, are not eligible vendors. Programs that are not licensed as a residential or
97Article 4 Sec. 34.
REVISOR AGW/AC 25-0033903/03/25 98.1nonresidential substance use disorder treatment or withdrawal management program by the
98.2commissioner or by tribal government or do not meet the requirements of subdivisions 1a
98.3and 1b are not eligible vendors.
98.4 (i) Hospitals, federally qualified health centers, and rural health clinics are eligible
98.5vendors of a comprehensive assessment when the comprehensive assessment is completed
98.6according to section 254A.19, subdivision 3, and by an individual who meets the criteria
98.7of an alcohol and drug counselor according to section 245G.11, subdivision 5. The alcohol
98.8and drug counselor must be individually enrolled with the commissioner and reported on
98.9the claim as the individual who provided the service.
98.10 (j) Any complaints about a recovery community organization or peer recovery support
98.11services may be made to and reviewed or investigated by the ombudsperson for behavioral
98.12health and developmental disabilities under sections 245.91 and 245.94.
98.13Sec. 35. Minnesota Statutes 2024, section 254B.05, subdivision 1a, is amended to read:
98.14 Subd. 1a.Room and board provider requirements.(a) Vendors of room and board
98.15are eligible for behavioral health fund payment if the vendor:
98.16 (1) has rules prohibiting residents bringing chemicals into the facility or using chemicals
98.17while residing in the facility and provide consequences for infractions of those rules;
98.18 (2) is determined to meet applicable health and safety requirements;
98.19 (3) is not a jail or prison;
98.20 (4) is not concurrently receiving funds under chapter 256I for the recipient;
98.21 (5) admits individuals who are 18 years of age or older;
98.22 (6) is registered as a board and lodging or lodging establishment according to section
98.23157.17;
98.24 (7) has awake staff on site whenever a client is present;
98.25 (8) has staff who are at least 18 years of age and meet the requirements of section
98.26245G.11, subdivision 1, paragraph (b);
98.27 (9) has emergency behavioral procedures that meet the requirements of section 245G.16;
98.28 (10) meets the requirements of section 245G.08, subdivision 5, if administering
98.29medications to clients;
98.30 (11) meets the abuse prevention requirements of section 245A.65, including a policy on
98.31fraternization and the mandatory reporting requirements of section 626.557;
98Article 4 Sec. 35.
REVISOR AGW/AC 25-0033903/03/25 99.1 (12) documents coordination with the treatment provider to ensure compliance with
99.2section 254B.03, subdivision 2;
99.3 (13) protects client funds and ensures freedom from exploitation by meeting the
99.4provisions of section 245A.04, subdivision 13;
99.5 (14) has a grievance procedure that meets the requirements of section 245G.15,
99.6subdivision 2; and
99.7 (15) has sleeping and bathroom facilities for men and women separated by a door that
99.8is locked, has an alarm, or is supervised by awake staff.
99.9 (b) Programs licensed according to Minnesota Rules, chapter 2960, are exempt from
99.10paragraph (a), clauses (5) to (15).
99.11 (c) Programs providing children's mental health crisis admissions and stabilization under
99.12section 245.4882, subdivision 6, are eligible vendors of room and board.
99.13 (d) Programs providing children's residential services under section 245.4882, except
99.14services for individuals who have a placement under chapter 260C or 260D, are eligible
99.15vendors of room and board.
99.16 (e) Licensed programs providing intensive residential treatment services or residential
99.17crisis stabilization services pursuant to section 256B.0622 or 256B.0624 are eligible vendors
99.18of room and board and are exempt from paragraph (a), clauses (6) to (15).
99.19 (f) A vendor that is not licensed as a residential treatment program must have a policy
99.20to address staffing coverage when a client may unexpectedly need to be present at the room
99.21and board site.
99.22 (g) No new vendors for room and board services may be approved after June 30, 2025,
99.23to receive payments from the behavioral health fund, under the provisions of section 254B.04,
99.24subdivision 2a. Room and board vendors that were approved and operating prior to July 1,
99.252025, may continue to receive payments from the behavioral health fund for services provided
99.26until June 30, 2027. Room and board vendors providing services in accordance with section
99.27254B.04, subdivision 2a, will no longer be eligible to claim reimbursement for room and
99.28board services provided on or after July 1, 2027.
99.29 EFFECTIVE DATE.This section is effective the day following final enactment.
99Article 4 Sec. 35.
REVISOR AGW/AC 25-0033903/03/25 100.1Sec. 36. Minnesota Statutes 2024, section 254B.06, subdivision 2, is amended to read:
100.2 Subd. 2.Allocation of collections.The commissioner shall allocate 77.05 50 percent
100.3of patient payments and third-party payments to the special revenue account and 22.95 50
100.4percent to the county financially responsible for the patient.
100.5 EFFECTIVE DATE.This section is effective July 1, 2025.
100.6Sec. 37. Minnesota Statutes 2024, section 254B.09, subdivision 2, is amended to read:
100.7 Subd. 2.American Indian agreements.The commissioner may enter into agreements
100.8with federally recognized Tribal units to pay for substance use disorder treatment services
100.9provided under Laws 1986, chapter 394, sections 8 to 20. The agreements must clarify how
100.10the governing body of the Tribal unit fulfills local agency the Tribal unit's responsibilities
100.11regarding the form and manner of invoicing.
100.12 EFFECTIVE DATE.This section is effective July 1, 2025.
100.13Sec. 38. Minnesota Statutes 2024, section 254B.181, subdivision 1, is amended to read:
100.14 Subdivision 1.Requirements.(a) All recovery residences must be certified by the
100.15commissioner in accordance with the standards of a National Alliance for Recovery
100.16Residences Level 1 or Level 2 recovery residence.
100.17 (b) All sober homes recovery residences must:
100.18 (1) comply with applicable state laws and regulations and local ordinances related to
100.19maximum occupancy, fire safety, and sanitation. In addition, all sober homes must:;
100.20 (2) have safety policies and procedures that at a minimum address:
100.21 (i) safety inspections requiring periodic verification of smoke detectors, carbon monoxide
100.22detectors, and fire extinguishers, and emergency evacuation drills;
100.23 (ii) exposure to bodily fluids and contagious diseases; and
100.24 (iii) emergency procedures posted in conspicuous locations in the residence;
100.25 (1) (3) maintain a supply of an opiate antagonist in the home in a conspicuous location
100.26and, post information on proper use, and train staff on how to administer the opiate
100.27antagonist;
100.28 (2) (4) have written policies regarding access to all prescribed medications and storage
100.29of medications when requested by a resident;
100Article 4 Sec. 38.
REVISOR AGW/AC 25-0033903/03/25 101.1 (3) (5) have written policies regarding evictions residency termination that include how
101.2length of stay is determined and eviction procedures;
101.3 (4) (6) return all property and medications to a person discharged from the home and
101.4retain the items for a minimum of 60 days if the person did not collect them upon discharge.
101.5The owner must make an effort to contact persons listed as emergency contacts for the
101.6discharged person so that the items are returned;
101.7 (7) ensure separation of funds of persons served by the program from funds of the
101.8program or program staff. The program and staff must not:
101.9 (i) borrow money from a person served by the program;
101.10 (ii) purchase personal items from a person served by the program;
101.11 (iii) sell merchandise or personal services to a person served by the program;
101.12 (iv) require a person served by the program to purchase items for which the program is
101.13eligible for reimbursement; or
101.14 (v) use funds of persons served by the program to purchase items for which the program
101.15is already receiving public or private payments;
101.16 (5) (8) document the names and contact information for persons to contact in case of an
101.17emergency or upon discharge and notification of a family member, or other emergency
101.18contact designated by the resident under certain circumstances, including but not limited to
101.19death due to an overdose;
101.20 (6) (9) maintain contact information for emergency resources in the community to address
101.21mental health and health emergencies;
101.22 (7) (10) have policies on staff qualifications and prohibition against fraternization;
101.23 (8) (11) permit residents to use, as directed by a licensed prescriber, legally prescribed
101.24and dispensed or administered pharmacotherapies approved by the United States Food and
101.25Drug Administration for the treatment of opioid use disorder;
101.26 (9) (12) permit residents to use, as directed by a licensed prescriber, legally prescribed
101.27and dispensed or administered pharmacotherapies approved by the United States Food and
101.28Drug Administration to treat co-occurring substance use disorders and mental health
101.29conditions;
101.30 (10) (13) have a fee schedule and refund policy;
101.31 (11) (14) have rules for residents, including on any prohibited items;
101Article 4 Sec. 38.
REVISOR AGW/AC 25-0033903/03/25 102.1 (12) (15) have policies that promote resident participation in treatment, self-help groups,
102.2or other recovery supports;
102.3 (13) (16) have policies requiring abstinence from alcohol and illicit drugs on the property.
102.4If the program utilizes drug screening or toxicology, the procedures must be included in
102.5policy; and
102.6 (14) (17) distribute and post in the common areas the sober home resident bill of rights.,
102.7resident rules, and grievance process;
102.8 (18) have policies and procedures on searches;
102.9 (19) have code of ethics policies and procedures that are aligned with the National
102.10Alliance for Recovery Residences code of ethics and document that the policies and
102.11procedures are read and signed by every individual associated with the operation of the
102.12recovery residence, including owners, operators, staff, and volunteers;
102.13 (20) have a description of how residents are involved with the governance of the
102.14residence, including decision-making procedures, how residents are involved in setting and
102.15implementing rules, and the role of peer leaders, if any; and
102.16 (21) have procedures to maintain a respectful environment, including appropriate action
102.17to stop intimidation, bullying, sexual harassment, or threatening behavior of residents, staff,
102.18and visitors within the residence. Programs must consider trauma-informed and
102.19resilience-promoting practices when determining action.
102.20Sec. 39. Minnesota Statutes 2024, section 254B.181, subdivision 2, is amended to read:
102.21 Subd. 2.Bill of rights.An individual living in a sober home recovery residence has the
102.22right to:
102.23 (1) have access to an environment that supports recovery;
102.24 (2) have access to an environment that is safe and free from alcohol and other illicit
102.25drugs or substances;
102.26 (3) be free from physical and verbal abuse, neglect, financial exploitation, and all forms
102.27of maltreatment covered under the Vulnerable Adults Act, sections 626.557 to 626.5572;
102.28 (4) be treated with dignity and respect and to have personal property treated with respect;
102.29 (5) have personal, financial, and medical information kept private and to be advised of
102.30the sober home's recovery residence's policies and procedures regarding disclosure of such
102.31information;
102Article 4 Sec. 39.
REVISOR AGW/AC 25-0033903/03/25 103.1 (6) access, while living in the residence, to other community-based support services as
103.2needed;
103.3 (7) be referred to appropriate services upon leaving the residence, if necessary;
103.4 (8) retain personal property that does not jeopardize safety or health;
103.5 (9) assert these rights personally or have them asserted by the individual's representative
103.6or by anyone on behalf of the individual without retaliation;
103.7 (10) be provided with the name, address, and telephone number of the ombudsman for
103.8mental health, substance use disorder, and developmental disabilities and the certifying
103.9designated state affiliate and information about the right to file a complaint;
103.10 (11) be fully informed of these rights and responsibilities, as well as program policies
103.11and procedures; and
103.12 (12) not be required to perform services for the residence that are not included in the
103.13usual expectations for all residents.
103.14Sec. 40. Minnesota Statutes 2024, section 254B.181, subdivision 3, is amended to read:
103.15 Subd. 3.Complaints; ombudsman for mental health and developmental
103.16disabilities.Any complaints about a sober home recovery residence may be made to and
103.17reviewed or investigated by the ombudsman for mental health and developmental disabilities,
103.18pursuant to sections 245.91 and 245.94, and the certifying designated state affiliate.
103.19Sec. 41. Minnesota Statutes 2024, section 254B.181, is amended by adding a subdivision
103.20to read:
103.21 Subd. 5.Resident records.(a) A recovery residence must maintain documentation for
103.22each resident of a written agreement prior to beginning residency that includes the following:
103.23 (1) the resident bill of rights;
103.24 (2) financial obligations and agreements, refund policy, and payments from third party
103.25payers for any fees paid on the resident's behalf;
103.26 (3) services provided;
103.27 (4) recovery goals;
103.28 (5) relapse policies; and
103.29 (6) policies on personal property.
103Article 4 Sec. 41.
REVISOR AGW/AC 25-0033903/03/25 104.1 (b) A recovery residence must maintain documentation for each resident demonstrating:
104.2 (1) completion of orientation on emergency procedures;
104.3 (2) completion of orientation on resident rules;
104.4 (3) that the resident is formally linked with the community, such as the resident
104.5maintaining or searching for a job, being enrolled in an education program, or working with
104.6family services or health and housing programs;
104.7 (4) that residents and staff engage in community relations and interactions to promote
104.8kinship with other recovery communities and goodwill for recovery services; and
104.9 (5) any referrals made for additional services.
104.10 (c) Resident records are private data on individuals as defined in section 13.02,
104.11subdivision 12.
104.12Sec. 42. Minnesota Statutes 2024, section 254B.181, is amended by adding a subdivision
104.13to read:
104.14 Subd. 6.Staff requirements.Certified level 2 programs must have staff to model and
104.15teach recovery skills and behaviors and must have the following policies and procedures:
104.16 (1) written job descriptions for each staff member position, including position
104.17responsibilities and qualifications;
104.18 (2) performance plans for development of staff in need of improvement;
104.19 (3) a staffing plan that demonstrates continuous development for all staff;
104.20 (4) background checks for all staff who will have direct and regular interaction with
104.21residents;
104.22 (5) expectations for staff to maintain clear personal and professional boundaries;
104.23 (6) annual trainings on emergency procedures, the resident bill of rights, grievance
104.24policies and procedures, and the code of ethics; and
104.25 (7) a prohibition on staff providing billable peer recovery support services to residents
104.26of the recovery residence.
104.27Sec. 43. [254B.182] RECOVERY RESIDENCE CERTIFICATION.
104.28 (a) Effective January 1, 2027, the commissioner of human services shall certify all
104.29recovery residences in Minnesota that are in compliance with section 254B.181. Beginning
104Article 4 Sec. 43.
REVISOR AGW/AC 25-0033903/03/25 105.1January 1, 2027, a recovery residence may not serve clients without a certification from the
105.2commissioner.
105.3 (b) The commissioner shall:
105.4 (1) publish a list of certified recovery residences, including any data related to date of
105.5certification, contact information, compliance reports, and the results of any investigations.
105.6The facts of any investigation that substantiates an adverse impact on an individual's health
105.7or safety is public information, except for any identifying information on a resident or
105.8complainant;
105.9 (2) make requirements for certification of recovery residences publicly accessible;
105.10 (3) review and recertify recovery residences every three years;
105.11 (4) compile an annual report on the number of recovery residences, the number of newly
105.12certified recovery residences in the last year, and the number of recovery residences that
105.13lost certification in the last year;
105.14 (5) review and make certification determinations for all recovery residences beginning
105.15on July 1, 2027; and
105.16 (6) make a certification determination for a recovery residence within 90 days of
105.17application.
105.18 (c) The commissioner may decertify a recovery residence with a 30-day notice.
105.19 (d) A recovery residence that is not certified or is decertified may request reconsideration.
105.20The recovery residence must appeal a denial or decertification in writing and send or deliver
105.21the reconsideration request to the commissioner by certified mail, by personal service, or
105.22through the provider licensing and reporting hub. If the recovery residence mails the
105.23reconsideration request, the reconsideration request must be postmarked and sent to the
105.24commissioner within ten calendar days after the recovery residence receives the order of
105.25certification denial or decertification. If the recovery residence delivers a reconsideration
105.26request by personal service, the commissioner must receive the reconsideration request
105.27within ten calendar days after the recovery residence received the order. If the order is issued
105.28through the provider hub, the request must be received by the commissioner within 20
105.29calendar days from the date the commissioner issued the order through the hub. If a recovery
105.30residence submits a timely reconsideration request of an order of certification denial or
105.31decertification, the recovery residence may continue to operate the program until the
105.32commissioner issues a final order. The commissioner's disposition of a request for
105.33reconsideration is final and not subject to appeal under chapter 14.
105Article 4 Sec. 43.
REVISOR AGW/AC 25-0033903/03/25 106.1Sec. 44. Minnesota Statutes 2024, section 254B.19, subdivision 1, is amended to read:
106.2 Subdivision 1.Level of care requirements.(a) For each client assigned an ASAM level
106.3of care, eligible vendors must implement the standards set by the ASAM for the respective
106.4level of care. Additionally, vendors must meet the following requirements:
106.5 (1) For ASAM level 0.5 early intervention targeting individuals who are at risk of
106.6developing a substance-related problem but may not have a diagnosed substance use disorder,
106.7early intervention services may include individual or group counseling, treatment
106.8coordination, peer recovery support, screening brief intervention, and referral to treatment
106.9provided according to section 254A.03, subdivision 3, paragraph (c).
106.10 (2) For ASAM level 1.0 outpatient clients, adults must receive up to eight hours per
106.11week of skilled psychosocial treatment services and adolescents must receive up to five
106.12hours per week. Services must be licensed according to section 245G.20 and meet
106.13requirements under section 256B.0759. Peer recovery Ancillary services and treatment
106.14coordination may be provided beyond the hourly skilled psychosocial treatment service
106.15hours allowable per week.
106.16 (3) For ASAM level 2.1 intensive outpatient clients, adults must receive nine to 19 hours
106.17per week of skilled psychosocial treatment services and adolescents must receive six or
106.18more hours per week. Vendors must be licensed according to section 245G.20 and must
106.19meet requirements under section 256B.0759. Peer recovery Ancillary services and treatment
106.20coordination may be provided beyond the hourly skilled psychosocial treatment service
106.21hours allowable per week. If clinically indicated on the client's treatment plan, this service
106.22may be provided in conjunction with room and board according to section 254B.05,
106.23subdivision 1a.
106.24 (4) For ASAM level 2.5 partial hospitalization clients, adults must receive 20 hours or
106.25more of skilled psychosocial treatment services. Services must be licensed according to
106.26section 245G.20 and must meet requirements under section 256B.0759. Level 2.5 is for
106.27clients who need daily monitoring in a structured setting, as directed by the individual
106.28treatment plan and in accordance with the limitations in section 254B.05, subdivision 5,
106.29paragraph (h). If clinically indicated on the client's treatment plan, this service may be
106.30provided in conjunction with room and board according to section 254B.05, subdivision
106.311a.
106.32 (5) For ASAM level 3.1 clinically managed low-intensity residential clients, programs
106.33must provide at least 5 hours of skilled psychosocial treatment services per week according
106.34to each client's specific treatment schedule, as directed by the individual treatment plan.
106Article 4 Sec. 44.
REVISOR AGW/AC 25-0033903/03/25 107.1Programs must be licensed according to section 245G.20 and must meet requirements under
107.2section 256B.0759.
107.3 (6) For ASAM level 3.3 clinically managed population-specific high-intensity residential
107.4clients, programs must be licensed according to section 245G.20 and must meet requirements
107.5under section 256B.0759. Programs must have 24-hour staffing coverage. Programs must
107.6be enrolled as a disability responsive program as described in section 254B.01, subdivision
107.74b, and must specialize in serving persons with a traumatic brain injury or a cognitive
107.8impairment so significant, and the resulting level of impairment so great, that outpatient or
107.9other levels of residential care would not be feasible or effective. Programs must provide,
107.10at a minimum, daily skilled psychosocial treatment services seven days a week according
107.11to each client's specific treatment schedule, as directed by the individual treatment plan.
107.12 (7) For ASAM level 3.5 clinically managed high-intensity residential clients, services
107.13must be licensed according to section 245G.20 and must meet requirements under section
107.14256B.0759. Programs must have 24-hour staffing coverage and provide, at a minimum,
107.15daily skilled psychosocial treatment services seven days a week according to each client's
107.16specific treatment schedule, as directed by the individual treatment plan.
107.17 (8) For ASAM level withdrawal management 3.2 clinically managed clients, withdrawal
107.18management must be provided according to chapter 245F.
107.19 (9) For ASAM level withdrawal management 3.7 medically monitored clients, withdrawal
107.20management must be provided according to chapter 245F.
107.21 (b) Notwithstanding the minimum daily skilled psychosocial treatment service
107.22requirements under paragraph (a), clauses (6) and (7), ASAM level 3.3 and 3.5 vendors
107.23must provide each client at least 30 hours of treatment services per week for the period
107.24between January 1, 2024, through June 30, 2024.
107.25Sec. 45. Minnesota Statutes 2024, section 256.043, subdivision 3, is amended to read:
107.26 Subd. 3.Appropriations from registration and license fee account.(a) The
107.27appropriations in paragraphs (b) to (n) shall be made from the registration and license fee
107.28account on a fiscal year basis in the order specified.
107.29 (b) The appropriations specified in Laws 2019, chapter 63, article 3, section 1, paragraphs
107.30(b), (f), (g), and (h), as amended by Laws 2020, chapter 115, article 3, section 35, shall be
107.31made accordingly.
107Article 4 Sec. 45.
REVISOR AGW/AC 25-0033903/03/25 108.1 (c) $100,000 is appropriated to the commissioner of human services for grants for opiate
108.2antagonist distribution. Grantees may utilize funds for opioid overdose prevention,
108.3community asset mapping, education, and opiate antagonist distribution.
108.4 (d) $2,000,000 is appropriated to the commissioner of human services for grants direct
108.5payments to Tribal nations and five urban Indian communities for traditional healing practices
108.6for American Indians and to increase the capacity of culturally specific providers in the
108.7behavioral health workforce. Any evaluations of practices under this paragraph must be
108.8designed cooperatively by the commissioner and Tribal nations or urban Indian communities.
108.9The commissioner must not require recipients to provide the details of specific ceremonies
108.10or identities of healers.
108.11 (e) $400,000 is appropriated to the commissioner of human services for competitive
108.12grants for opioid-focused Project ECHO programs.
108.13 (f) $277,000 in fiscal year 2024 and $321,000 each year thereafter is appropriated to the
108.14commissioner of human services to administer the funding distribution and reporting
108.15requirements in paragraph (o).
108.16 (g) $3,000,000 in fiscal year 2025 and $3,000,000 each year thereafter is appropriated
108.17to the commissioner of human services for safe recovery sites start-up and capacity building
108.18grants under section 254B.18.
108.19 (h) $395,000 in fiscal year 2024 and $415,000 each year thereafter is appropriated to
108.20the commissioner of human services for the opioid overdose surge alert system under section
108.21245.891.
108.22 (i) $300,000 is appropriated to the commissioner of management and budget for
108.23evaluation activities under section 256.042, subdivision 1, paragraph (c).
108.24 (j) $261,000 is appropriated to the commissioner of human services for the provision of
108.25administrative services to the Opiate Epidemic Response Advisory Council and for the
108.26administration of the grants awarded under paragraph (n).
108.27 (k) $126,000 is appropriated to the Board of Pharmacy for the collection of the registration
108.28fees under section 151.066.
108.29 (l) $672,000 is appropriated to the commissioner of public safety for the Bureau of
108.30Criminal Apprehension. Of this amount, $384,000 is for drug scientists and lab supplies
108.31and $288,000 is for special agent positions focused on drug interdiction and drug trafficking.
108.32 (m) After the appropriations in paragraphs (b) to (l) are made, 50 percent of the remaining
108.33amount is appropriated to the commissioner of children, youth, and families for distribution
108Article 4 Sec. 45.
REVISOR AGW/AC 25-0033903/03/25 109.1to county social service agencies and Tribal social service agency initiative projects
109.2authorized under section 256.01, subdivision 14b, to provide prevention and child protection
109.3services to children and families who are affected by addiction. The commissioner shall
109.4distribute this money proportionally to county social service agencies and Tribal social
109.5service agency initiative projects through a formula based on intake data from the previous
109.6three calendar years related to substance use and out-of-home placement episodes where
109.7parental drug abuse is a reason for the out-of-home placement. County social service agencies
109.8and Tribal social service agency initiative projects receiving funds from the opiate epidemic
109.9response fund must annually report to the commissioner on how the funds were used to
109.10provide prevention and child protection services, including measurable outcomes, as
109.11determined by the commissioner. County social service agencies and Tribal social service
109.12agency initiative projects must not use funds received under this paragraph to supplant
109.13current state or local funding received for child protection services for children and families
109.14who are affected by addiction.
109.15 (n) After the appropriations in paragraphs (b) to (m) are made, the remaining amount in
109.16the account is appropriated to the commissioner of human services to award grants as
109.17specified by the Opiate Epidemic Response Advisory Council in accordance with section
109.18256.042, unless otherwise appropriated by the legislature.
109.19 (o) Beginning in fiscal year 2022 and each year thereafter, funds for county social service
109.20agencies and Tribal social service agency initiative projects under paragraph (m) and grant
109.21funds specified by the Opiate Epidemic Response Advisory Council under paragraph (n)
109.22may be distributed on a calendar year basis.
109.23 (p) Notwithstanding section 16A.28, subdivision 3, funds appropriated in paragraphs
109.24(c), (d), (e), (g), (m), and (n) are available for three years after the funds are appropriated.
109.25Sec. 46. Minnesota Statutes 2024, section 256B.0625, subdivision 5m, is amended to read:
109.26 Subd. 5m.Certified community behavioral health clinic services.(a) Medical
109.27assistance covers services provided by a not-for-profit certified community behavioral health
109.28clinic (CCBHC) that meets the requirements of section 245.735, subdivision 3.
109.29 (b) The commissioner shall reimburse CCBHCs on a per-day basis for each day that an
109.30eligible service is delivered using the CCBHC daily bundled rate system for medical
109.31assistance payments as described in paragraph (c). The commissioner shall include a quality
109.32incentive payment in the CCBHC daily bundled rate system as described in paragraph (e).
109.33There is no county share for medical assistance services when reimbursed through the
109.34CCBHC daily bundled rate system.
109Article 4 Sec. 46.
REVISOR AGW/AC 25-0033903/03/25 110.1 (c) The commissioner shall ensure that the CCBHC daily bundled rate system for CCBHC
110.2payments under medical assistance meets the following requirements:
110.3 (1) the CCBHC daily bundled rate shall be a provider-specific rate calculated for each
110.4CCBHC, based on the daily cost of providing CCBHC services and the total annual allowable
110.5CCBHC costs divided by the total annual number of CCBHC visits. For calculating the
110.6payment rate, total annual visits include visits covered by medical assistance and visits not
110.7covered by medical assistance. Allowable costs include but are not limited to the salaries
110.8and benefits of medical assistance providers; the cost of CCBHC services provided under
110.9section 245.735, subdivision 3, paragraph (a), clauses (6) and (7); and other costs such as
110.10insurance or supplies needed to provide CCBHC services;
110.11 (2) payment shall be limited to one payment per day per medical assistance enrollee
110.12when an eligible CCBHC service is provided. A CCBHC visit is eligible for reimbursement
110.13if at least one of the CCBHC services listed under section 245.735, subdivision 3, paragraph
110.14(a), clause (6), is furnished to a medical assistance enrollee by a health care practitioner or
110.15licensed agency employed by or under contract with a CCBHC;
110.16 (3) initial CCBHC daily bundled rates for newly certified CCBHCs under section 245.735,
110.17subdivision 3, shall be established by the commissioner using a provider-specific rate based
110.18on the newly certified CCBHC's audited historical cost report data adjusted for the expected
110.19cost of delivering CCBHC services. Estimates are subject to review by the commissioner
110.20and must include the expected cost of providing the full scope of CCBHC services and the
110.21expected number of visits for the rate period;
110.22 (4) the commissioner shall rebase CCBHC rates once every two years following the last
110.23rebasing and no less than 12 months following an initial rate or a rate change due to a change
110.24in the scope of services. For CCBHCs certified after September 31, 2020, and before January
110.251, 2021, the commissioner shall rebase rates according to this clause for services provided
110.26on or after January 1, 2024;
110.27 (5) the commissioner shall provide for a 60-day appeals process after notice of the results
110.28of the rebasing;
110.29 (6) an entity that receives a CCBHC daily bundled rate that overlaps with another federal
110.30Medicaid rate is not eligible for the CCBHC rate methodology;
110.31 (7) payments for CCBHC services to individuals enrolled in managed care shall be
110.32coordinated with the state's phase-out of CCBHC wrap payments. The commissioner shall
110.33complete the phase-out of CCBHC wrap payments within 60 days of the implementation
110.34of the CCBHC daily bundled rate system in the Medicaid Management Information System
110Article 4 Sec. 46.
REVISOR AGW/AC 25-0033903/03/25 111.1(MMIS), for CCBHCs reimbursed under this chapter, with a final settlement of payments
111.2due made payable to CCBHCs no later than 18 months thereafter;
111.3 (8) the CCBHC daily bundled rate for each CCBHC shall be updated by trending each
111.4provider-specific rate by the Medicare Economic Index for primary care services. This
111.5update shall occur each year in between rebasing periods determined by the commissioner
111.6in accordance with clause (4). CCBHCs must provide data on costs and visits to the state
111.7annually using the CCBHC cost report established by the commissioner; and
111.8 (9) a CCBHC may request a rate adjustment for changes in the CCBHC's scope of
111.9services when such changes are expected to result in an adjustment to the CCBHC payment
111.10rate by 2.5 percent or more. The CCBHC must provide the commissioner with information
111.11regarding the changes in the scope of services, including the estimated cost of providing
111.12the new or modified services and any projected increase or decrease in the number of visits
111.13resulting from the change. Estimated costs are subject to review by the commissioner. Rate
111.14adjustments for changes in scope shall occur no more than once per year in between rebasing
111.15periods per CCBHC and are effective on the date of the annual CCBHC rate update.
111.16 (d) Managed care plans and county-based purchasing plans shall reimburse CCBHC
111.17providers at the CCBHC daily bundled rate. The commissioner shall monitor the effect of
111.18this requirement on the rate of access to the services delivered by CCBHC providers. If, for
111.19any contract year, federal approval is not received for this paragraph, the commissioner
111.20must adjust the capitation rates paid to managed care plans and county-based purchasing
111.21plans for that contract year to reflect the removal of this provision. Contracts between
111.22managed care plans and county-based purchasing plans and providers to whom this paragraph
111.23applies must allow recovery of payments from those providers if capitation rates are adjusted
111.24in accordance with this paragraph. Payment recoveries must not exceed the amount equal
111.25to any increase in rates that results from this provision. This paragraph expires if federal
111.26approval is not received for this paragraph at any time.
111.27 (e) The commissioner shall implement a quality incentive payment program for CCBHCs
111.28that meets the following requirements:
111.29 (1) a CCBHC shall receive a quality incentive payment upon meeting specific numeric
111.30thresholds for performance metrics established by the commissioner, in addition to payments
111.31for which the CCBHC is eligible under the CCBHC daily bundled rate system described in
111.32paragraph (c);
111.33 (2) a CCBHC must be certified and enrolled as a CCBHC for the entire measurement
111.34year to be eligible for incentive payments;
111Article 4 Sec. 46.
REVISOR AGW/AC 25-0033903/03/25 112.1 (3) each CCBHC shall receive written notice of the criteria that must be met in order to
112.2receive quality incentive payments at least 90 days prior to the measurement year; and
112.3 (4) a CCBHC must provide the commissioner with data needed to determine incentive
112.4payment eligibility within six months following the measurement year. The commissioner
112.5shall notify CCBHC providers of their performance on the required measures and the
112.6incentive payment amount within 12 months following the measurement year.
112.7 (f) All claims to managed care plans for CCBHC services as provided under this section
112.8shall be submitted directly to, and paid by, the commissioner on the dates specified no later
112.9than January 1 of the following calendar year, if:
112.10 (1) one or more managed care plans does not comply with the federal requirement for
112.11payment of clean claims to CCBHCs, as defined in Code of Federal Regulations, title 42,
112.12section 447.45(b), and the managed care plan does not resolve the payment issue within 30
112.13days of noncompliance; and
112.14 (2) the total amount of clean claims not paid in accordance with federal requirements
112.15by one or more managed care plans is 50 percent of, or greater than, the total CCBHC claims
112.16eligible for payment by managed care plans.
112.17If the conditions in this paragraph are met between January 1 and June 30 of a calendar
112.18year, claims shall be submitted to and paid by the commissioner beginning on January 1 of
112.19the following year. If the conditions in this paragraph are met between July 1 and December
112.2031 of a calendar year, claims shall be submitted to and paid by the commissioner beginning
112.21on July 1 of the following year.
112.22 (g) Peer services provided by a CCBHC certified under section 245.735 are a covered
112.23service under medical assistance when a licensed mental health professional or alcohol and
112.24drug counselor determines that peer services are medically necessary. Eligibility under this
112.25subdivision for peer services provided by a CCBHC supersede eligibility standards under
112.26sections 256B.0615, 256B.0616, and 245G.07, subdivision 2 2a, paragraph (b), clause (8)
112.27(2).
112.28Sec. 47. Minnesota Statutes 2024, section 256B.0757, subdivision 4c, is amended to read:
112.29 Subd. 4c.Behavioral health home services staff qualifications.(a) A behavioral health
112.30home services provider must maintain staff with required professional qualifications
112.31appropriate to the setting.
112Article 4 Sec. 47.
REVISOR AGW/AC 25-0033903/03/25 113.1 (b) If behavioral health home services are offered in a mental health setting, the
113.2integration specialist must be a licensed nurse, as defined in section 148.171, subdivision
113.39.
113.4 (c) If behavioral health home services are offered in a primary care setting, the integration
113.5specialist must be a mental health professional who is qualified according to section 245I.04,
113.6subdivision 2.
113.7 (d) If behavioral health home services are offered in either a primary care setting or
113.8mental health setting, the systems navigator must be a mental health practitioner who is
113.9qualified according to section 245I.04, subdivision 4, or a community health worker as
113.10defined in section 256B.0625, subdivision 49.
113.11 (e) If behavioral health home services are offered in either a primary care setting or
113.12mental health setting, the qualified health home specialist must be one of the following:
113.13 (1) a mental health certified peer specialist who is qualified according to section 245I.04,
113.14subdivision 10;
113.15 (2) a mental health certified family peer specialist who is qualified according to section
113.16245I.04, subdivision 12;
113.17 (3) a case management associate as defined in section 245.462, subdivision 4, paragraph
113.18(g), or 245.4871, subdivision 4, paragraph (j);
113.19 (4) a mental health rehabilitation worker who is qualified according to section 245I.04,
113.20subdivision 14;
113.21 (5) a community paramedic as defined in section 144E.28, subdivision 9;
113.22 (6) a peer recovery specialist as defined in section 245G.07, subdivision 1, clause (5)
113.23245G.11, subdivision 8; or
113.24 (7) a community health worker as defined in section 256B.0625, subdivision 49.
113.25Sec. 48. Minnesota Statutes 2024, section 256I.04, subdivision 2a, is amended to read:
113.26 Subd. 2a.License required; staffing qualifications.(a) Except as provided in paragraph
113.27(b) (c), an agency may not enter into an agreement with an establishment to provide housing
113.28support unless:
113.29 (1) the establishment is licensed by the Department of Health as a hotel and restaurant;
113.30a board and lodging establishment; a boarding care home before March 1, 1985; or a
113.31supervised living facility, and the service provider for residents of the facility is licensed
113Article 4 Sec. 48.
REVISOR AGW/AC 25-0033903/03/25 114.1under chapter 245A. However, an establishment licensed by the Department of Health to
114.2provide lodging need not also be licensed to provide board if meals are being supplied to
114.3residents under a contract with a food vendor who is licensed by the Department of Health;
114.4 (2) the residence is: (i) licensed by the commissioner of human services under Minnesota
114.5Rules, parts 9555.5050 to 9555.6265; (ii) certified by a county human services agency prior
114.6to July 1, 1992, using the standards under Minnesota Rules, parts 9555.5050 to 9555.6265;
114.7(iii) licensed by the commissioner under Minnesota Rules, parts 2960.0010 to 2960.0120,
114.8with a variance under section 245A.04, subdivision 9; or (iv) licensed under section 245D.02,
114.9subdivision 4a, as a community residential setting by the commissioner of human services;
114.10or
114.11 (3) the facility is licensed under chapter 144G and provides three meals a day.
114.12 (b) Effective January 1, 2027, the commissioner may enter into housing support
114.13agreements with a board and lodging establishment under section 256I.04, subdivision 2a,
114.14paragraph (a), clause (1), that is also certified by the commissioner as a recovery residence,
114.15subject to the requirements of section 256I.04, subdivisions 2a to 2f. When doing so, the
114.16department of human services serves as the lead agency for the agreement.
114.17 (b) (c) The requirements under paragraph (a) do not apply to establishments exempt
114.18from state licensure because they are:
114.19 (1) located on Indian reservations and subject to tribal health and safety requirements;
114.20or
114.21 (2) supportive housing establishments where an individual has an approved habitability
114.22inspection and an individual lease agreement.
114.23 (c) (d) Supportive housing establishments that serve individuals who have experienced
114.24long-term homelessness and emergency shelters must participate in the homeless management
114.25information system and a coordinated assessment system as defined by the commissioner.
114.26 (d) (e) Effective July 1, 2016, an agency shall not have an agreement with a provider of
114.27housing support unless all staff members who have direct contact with recipients:
114.28 (1) have skills and knowledge acquired through one or more of the following:
114.29 (i) a course of study in a health- or human services-related field leading to a bachelor
114.30of arts, bachelor of science, or associate's degree;
114.31 (ii) one year of experience with the target population served;
114Article 4 Sec. 48.
REVISOR AGW/AC 25-0033903/03/25 115.1 (iii) experience as a mental health certified peer specialist according to section 256B.0615;
115.2or
115.3 (iv) meeting the requirements for unlicensed personnel under sections 144A.43 to
115.4144A.483;
115.5 (2) hold a current driver's license appropriate to the vehicle driven if transporting
115.6recipients;
115.7 (3) complete training on vulnerable adults mandated reporting and child maltreatment
115.8mandated reporting, where applicable; and
115.9 (4) complete housing support orientation training offered by the commissioner.
115.10Sec. 49. Minnesota Statutes 2024, section 325F.725, is amended to read:
115.11 325F.725 SOBER HOME RECOVERY RESIDENCE TITLE PROTECTION.
115.12 No person or entity may use the phrase "sober home," "recovery residence," whether
115.13alone or in combination with other words and whether orally or in writing, to advertise,
115.14market, or otherwise describe, offer, or promote itself, or any housing, service, service
115.15package, or program that it provides within this state, unless the person or entity meets the
115.16definition of a sober home recovery residence in section 254B.01, subdivision 11, and meets
115.17the requirements of section 254B.181.
115.18 EFFECTIVE DATE.This section is effective the day following final enactment.
115.19Sec. 50. WORKING GROUP FOR RECOVERY RESIDENCES.
115.20 (a) The commissioner of human services must convene a working group on recovery
115.21residences.
115.22 (b) The working group must:
115.23 (1) produce a report that examines how other states fund recovery residences, identifying
115.24best practices and models that could be applicable to Minnesota;
115.25 (2) engage with communities to ensure meaningful collaboration with key external
115.26partners on the ideas being developed that will inform the final plan and recommendations;
115.27and
115.28 (3) develop an implementable plan addressing housing needs for individuals in outpatient
115.29substance use disorder treatment that includes:
115.30 (i) clear strategies for aligning housing models with individual treatment needs;
115Article 4 Sec. 50.
REVISOR AGW/AC 25-0033903/03/25 116.1 (ii) an assessment of funding streams, including potential federal funding sources;
116.2 (iii) a timeline for implementation, with key milestones and action steps;
116.3 (iv) recommendations for future resource allocation to ensure long-term housing stability
116.4for individuals in recovery; and
116.5 (v) specific recommendations for policy or legislative changes that may be required to
116.6support sustainable recovery housing solutions.
116.7 (c) The working group shall include but is not limited to:
116.8 (1) at least two designees from the Department of Human Services, at least one
116.9representing behavioral health policy and at least one representing homelessness, housing
116.10and support services policy;
116.11 (2) the commissioner of health or a designee;
116.12 (3) two people who have experience living in a recovery residence;
116.13 (4) representatives from at least three substance use disorder lodging facilities currently
116.14operating in Minnesota;
116.15 (5) three representatives from county social services agencies, at least one from within
116.16and one from outside the seven-county metropolitan area;
116.17 (6) a representative from a Tribal social services agency; and
116.18 (7) representatives from national or state organizations specializing in recovery residences
116.19and substance use disorder treatment.
116.20 (d) The working group shall meet at least monthly and as necessary to fulfill its
116.21responsibilities. The commissioner of human services shall provide administrative support
116.22and meeting space for the working group. The working group may conduct meetings
116.23remotely.
116.24 (e) The commissioner of human services shall make appointments to the working group
116.25by October 1, 2025, and convene the first meeting of the working group by January 15,
116.262026.
116.27 (f) The working group shall submit a final report with recommendations to the chairs
116.28and ranking minority members of the legislative committees with jurisdiction over health
116.29and human services policy and finance on or before January 1, 2027.
116Article 4 Sec. 50.
REVISOR AGW/AC 25-0033903/03/25 117.1Sec. 51. REVISOR INSTRUCTION.
117.2 The revisor of statutes shall change the terms "mental health practitioner" and "mental
117.3health practitioners" to "behavioral health practitioner" or "behavioral health practitioners"
117.4wherever they appear in Minnesota Statutes, chapter 245I.
117.5Sec. 52. REPEALER.
117.6 (a) Minnesota Statutes 2024, sections 245G.01, subdivision 20d; 245G.07, subdivision
117.72; and 254B.01, subdivision 5, are repealed.
117.8 (b) Minnesota Statutes 2024, section 254B.04, subdivision 2a, is repealed.
117.9 EFFECTIVE DATE.Paragraph (a) is effective July 1, 2025, and paragraph (b) is
117.10effective July 1, 2027.
117.11 ARTICLE 5
117.12 HEALTH CARE
117.13Section 1. Minnesota Statutes 2024, section 256.01, subdivision 29, is amended to read:
117.14 Subd. 29.State medical review team.(a) To ensure the timely processing of
117.15determinations of disability by the commissioner's state medical review team under sections
117.16256B.055, subdivisions 7, paragraph (b), and 12, and 256B.057, subdivision 9, the
117.17commissioner shall review all medical evidence and seek information from providers,
117.18applicants, and enrollees to support the determination of disability where necessary. Disability
117.19shall be determined according to the rules of title XVI and title XIX of the Social Security
117.20Act and pertinent rules and policies of the Social Security Administration.
117.21 (b) Medical assistance providers must grant the state medical review team access to
117.22electronic health records held by the medical assistance providers, when available, to support
117.23efficient and accurate disability determinations.
117.24 (b) (c) Prior to a denial or withdrawal of a requested determination of disability due to
117.25insufficient evidence, the commissioner shall (1) ensure that the missing evidence is necessary
117.26and appropriate to a determination of disability, and (2) assist applicants and enrollees to
117.27obtain the evidence, including, but not limited to, medical examinations and electronic
117.28medical records.
117.29 (c) (d) Any appeal made under section 256.045, subdivision 3, of a disability
117.30determination made by the state medical review team must be decided according to the
117.31timelines under section 256.0451, subdivision 22, paragraph (a). If a written decision is not
117Article 5 Section 1.
REVISOR AGW/AC 25-0033903/03/25 118.1issued within the timelines under section 256.0451, subdivision 22, paragraph (a), the appeal
118.2must be immediately reviewed by the chief human services judge.
118.3 EFFECTIVE DATE.This section is effective the day following final enactment.
118.4Sec. 2. Minnesota Statutes 2024, section 256B.04, subdivision 12, is amended to read:
118.5 Subd. 12.Limitation on services.(a) The commissioner shall place limits on the types
118.6of services covered by medical assistance, the frequency with which the same or similar
118.7services may be covered by medical assistance for an individual recipient, and the amount
118.8paid for each covered service. The state agency shall promulgate rules establishing maximum
118.9reimbursement rates for emergency and nonemergency transportation.
118.10 The rules shall provide:
118.11 (1) an opportunity for all recognized transportation providers to be reimbursed for
118.12nonemergency transportation consistent with the maximum rates established by the agency;
118.13and
118.14 (2) reimbursement of public and private nonprofit providers serving the population with
118.15a disability generally at reasonable maximum rates that reflect the cost of providing the
118.16service regardless of the fare that might be charged by the provider for similar services to
118.17individuals other than those receiving medical assistance or medical care under this chapter.
118.18This paragraph expires July 1, 2026, for medical assistance fee-for-service and January 1,
118.192027, for prepaid medical assistance.
118.20 (b) The commissioner shall encourage providers reimbursed under this chapter to
118.21coordinate their operation with similar services that are operating in the same community.
118.22To the extent practicable, the commissioner shall encourage eligible individuals to utilize
118.23less expensive providers capable of serving their needs. This paragraph expires July 1, 2026,
118.24for medical assistance fee-for-service and January 1, 2027, for prepaid medical assistance.
118.25 (c) For the purpose of this subdivision and section 256B.02, subdivision 8, and effective
118.26on January 1, 1981, "recognized provider of transportation services" means an operator of
118.27special transportation service as defined in section 174.29 that has been issued a current
118.28certificate of compliance with operating standards of the commissioner of transportation
118.29or, if those standards do not apply to the operator, that the agency finds is able to provide
118.30the required transportation in a safe and reliable manner. Until January 1, 1981, "recognized
118.31transportation provider" includes an operator of special transportation service that the agency
118.32finds is able to provide the required transportation in a safe and reliable manner. This
118Article 5 Sec. 2.
REVISOR AGW/AC 25-0033903/03/25 119.1paragraph expires July 1, 2026, for medical assistance fee-for-service and January 1, 2027,
119.2for prepaid medical assistance.
119.3 (d) Effective July 1, 2026, for medical assistance fee-for-service and January 1, 2027,
119.4for prepaid medical assistance, the commissioner shall place limits on the types of services
119.5covered by medical assistance, the frequency with which the same or similar services may
119.6be covered by medical assistance for an individual recipient, and the amount paid for each
119.7covered service.
119.8 EFFECTIVE DATE.This section is effective the day following final enactment.
119.9Sec. 3. Minnesota Statutes 2024, section 256B.04, subdivision 14, is amended to read:
119.10 Subd. 14.Competitive bidding.(a) When determined to be effective, economical, and
119.11feasible, the commissioner may utilize volume purchase through competitive bidding and
119.12negotiation under the provisions of chapter 16C, to provide items under the medical assistance
119.13program including but not limited to the following:
119.14 (1) eyeglasses;
119.15 (2) oxygen. The commissioner shall provide for oxygen needed in an emergency situation
119.16on a short-term basis, until the vendor can obtain the necessary supply from the contract
119.17dealer;
119.18 (3) hearing aids and supplies;
119.19 (4) durable medical equipment, including but not limited to:
119.20 (i) hospital beds;
119.21 (ii) commodes;
119.22 (iii) glide-about chairs;
119.23 (iv) patient lift apparatus;
119.24 (v) wheelchairs and accessories;
119.25 (vi) oxygen administration equipment;
119.26 (vii) respiratory therapy equipment;
119.27 (viii) electronic diagnostic, therapeutic and life-support systems; and
119.28 (ix) allergen-reducing products as described in section 256B.0625, subdivision 67,
119.29paragraph (c) or (d);
119Article 5 Sec. 3.
REVISOR AGW/AC 25-0033903/03/25 120.1 (5) nonemergency medical transportation level of need determinations, disbursement of
120.2public transportation passes and tokens, and volunteer and recipient mileage and parking
120.3reimbursements;
120.4 (6) drugs; and
120.5 (7) quitline services as described in section 256B.0625, subdivision 68, paragraph (c).
120.6This paragraph expires July 1, 2026, for medical assistance fee-for-service and January 1,
120.72027, for prepaid medical assistance.
120.8 (b) Effective July 1, 2026, for medical assistance fee-for-service and January 1, 2027,
120.9for prepaid medical assistance, when determined to be effective, economical, and feasible,
120.10the commissioner may utilize volume purchase through competitive bidding and negotiation
120.11under the provisions of chapter 16C to provide items under the medical assistance program,
120.12including but not limited to the following:
120.13 (1) eyeglasses;
120.14 (2) oxygen. The commissioner shall provide for oxygen needed in an emergency situation
120.15on a short-term basis, until the vendor can obtain the necessary supply from the contract
120.16dealer;
120.17 (3) hearing aids and supplies;
120.18 (4) durable medical equipment, including but not limited to:
120.19 (i) hospital beds;
120.20 (ii) commodes;
120.21 (iii) glide-about chairs;
120.22 (iv) patient lift apparatus;
120.23 (v) wheelchairs and accessories;
120.24 (vi) oxygen administration equipment;
120.25 (vii) respiratory therapy equipment; and
120.26 (viii) electronic diagnostic, therapeutic, and life-support systems;
120.27 (5) nonemergency medical transportation; and
120.28 (6) drugs.
120.29 (b) (c) Rate changes and recipient cost-sharing under this chapter and chapter 256L do
120.30not affect contract payments under this subdivision unless specifically identified.
120Article 5 Sec. 3.
REVISOR AGW/AC 25-0033903/03/25 121.1 (c) (d) The commissioner may not utilize volume purchase through competitive bidding
121.2and negotiation under the provisions of chapter 16C for special transportation services or
121.3incontinence products and related supplies. This paragraph expires July 1, 2026, for medical
121.4assistance fee-for-service and January 1, 2027, for prepaid medical assistance.
121.5 (e) Effective July 1, 2026, for medical assistance fee-for-service and January 1, 2027,
121.6for prepaid medical assistance, the commissioner may not utilize volume purchase through
121.7competitive bidding and negotiation under the provisions of chapter 16C for incontinence
121.8products and related supplies.
121.9 EFFECTIVE DATE.This section is effective the day following final enactment.
121.10Sec. 4. Minnesota Statutes 2024, section 256B.0625, subdivision 17, is amended to read:
121.11 Subd. 17.Transportation costs.(a) "Nonemergency medical transportation service"
121.12means motor vehicle transportation provided by a public or private person that serves
121.13Minnesota health care program beneficiaries who do not require emergency ambulance
121.14service, as defined in section 144E.001, subdivision 3, to obtain covered medical services.
121.15 (b) For purposes of this subdivision, "rural urban commuting area" or "RUCA" means
121.16a census-tract based classification system under which a geographical area is determined
121.17to be urban, rural, or super rural. This paragraph expires July 1, 2026, for medical assistance
121.18fee-for-service and January 1, 2027, for prepaid medical assistance.
121.19 (c) Medical assistance covers medical transportation costs incurred solely for obtaining
121.20emergency medical care or transportation costs incurred by eligible persons in obtaining
121.21emergency or nonemergency medical care when paid directly to an ambulance company,
121.22nonemergency medical transportation company, or other recognized providers of
121.23transportation services. Medical transportation must be provided by:
121.24 (1) nonemergency medical transportation providers who meet the requirements of this
121.25subdivision;
121.26 (2) ambulances, as defined in section 144E.001, subdivision 2;
121.27 (3) taxicabs that meet the requirements of this subdivision;
121.28 (4) public transportation, within the meaning of "public transportation" as defined in
121.29section 174.22, subdivision 7; or
121.30 (5) not-for-hire vehicles, including volunteer drivers, as defined in section 65B.472,
121.31subdivision 1, paragraph (p).
121Article 5 Sec. 4.
REVISOR AGW/AC 25-0033903/03/25 122.1 (d) Medical assistance covers nonemergency medical transportation provided by
122.2nonemergency medical transportation providers enrolled in the Minnesota health care
122.3programs. All nonemergency medical transportation providers must comply with the
122.4operating standards for special transportation service as defined in sections 174.29 to 174.30
122.5and Minnesota Rules, chapter 8840, and all drivers must be individually enrolled with the
122.6commissioner and reported on the claim as the individual who provided the service. All
122.7nonemergency medical transportation providers shall bill for nonemergency medical
122.8transportation services in accordance with Minnesota health care programs criteria. Publicly
122.9operated transit systems, volunteers, and not-for-hire vehicles are exempt from the
122.10requirements outlined in this paragraph.
122.11 (e) An organization may be terminated, denied, or suspended from enrollment if:
122.12 (1) the provider has not initiated background studies on the individuals specified in
122.13section 174.30, subdivision 10, paragraph (a), clauses (1) to (3); or
122.14 (2) the provider has initiated background studies on the individuals specified in section
122.15174.30, subdivision 10, paragraph (a), clauses (1) to (3), and:
122.16 (i) the commissioner has sent the provider a notice that the individual has been
122.17disqualified under section 245C.14; and
122.18 (ii) the individual has not received a disqualification set-aside specific to the special
122.19transportation services provider under sections 245C.22 and 245C.23.
122.20 (f) The administrative agency of nonemergency medical transportation must:
122.21 (1) adhere to the policies defined by the commissioner;
122.22 (2) pay nonemergency medical transportation providers for services provided to
122.23Minnesota health care programs beneficiaries to obtain covered medical services;
122.24 (3) provide data monthly to the commissioner on appeals, complaints, no-shows, canceled
122.25trips, and number of trips by mode; and
122.26 (4) by July 1, 2016, in accordance with subdivision 18e, utilize a web-based single
122.27administrative structure assessment tool that meets the technical requirements established
122.28by the commissioner, reconciles trip information with claims being submitted by providers,
122.29and ensures prompt payment for nonemergency medical transportation services. This
122.30paragraph expires July 1, 2026, for medical assistance fee-for-service and January 1, 2027,
122.31for prepaid medical assistance.
122Article 5 Sec. 4.
REVISOR AGW/AC 25-0033903/03/25 123.1 (g) Effective July 1, 2026, for medical fee-for-service and January 1, 2027, for prepaid
123.2medical assistance, the administrative agency of nonemergency medical transportation must:
123.3 (1) adhere to the policies defined by the commissioner;
123.4 (2) pay nonemergency medical transportation providers for services provided to
123.5Minnesota health care programs beneficiaries to obtain covered medical services; and
123.6 (3) provide data monthly to the commissioner on appeals, complaints, no-shows, canceled
123.7trips, and number of trips by mode.
123.8 (g) (h) Until the commissioner implements the single administrative structure and delivery
123.9system under subdivision 18e, clients shall obtain their level-of-service certificate from the
123.10commissioner or an entity approved by the commissioner that does not dispatch rides for
123.11clients using modes of transportation under paragraph (l) (n), clauses (4), (5), (6), and (7).
123.12This paragraph expires July 1, 2026, for medical assistance fee-for-service and January 1,
123.132027, for prepaid medical assistance.
123.14 (h) (i) The commissioner may use an order by the recipient's attending physician,
123.15advanced practice registered nurse, physician assistant, or a medical or mental health
123.16professional to certify that the recipient requires nonemergency medical transportation
123.17services. Nonemergency medical transportation providers shall perform driver-assisted
123.18services for eligible individuals, when appropriate. Driver-assisted service includes passenger
123.19pickup at and return to the individual's residence or place of business, assistance with
123.20admittance of the individual to the medical facility, and assistance in passenger securement
123.21or in securing of wheelchairs, child seats, or stretchers in the vehicle.
123.22 (i) (j) Nonemergency medical transportation providers must take clients to the health
123.23care provider using the most direct route, and must not exceed 30 miles for a trip to a primary
123.24care provider or 60 miles for a trip to a specialty care provider, unless the client receives
123.25authorization from the local agency. This paragraph expires July 1, 2026, for medical
123.26assistance fee-for-service and January 1, 2027, for prepaid medical assistance.
123.27 (k) Effective July 1, 2026, for medical assistance fee-for-service and January 1, 2027,
123.28for prepaid medical assistance, nonemergency medical transportation providers must take
123.29clients to the health care provider using the most direct route and must not exceed 30 miles
123.30for a trip to a primary care provider or 60 miles for a trip to a specialty care provider, unless
123.31the client receives authorization from the administrator.
123.32 (j) (l) Nonemergency medical transportation providers may not bill for separate base
123.33rates for the continuation of a trip beyond the original destination. Nonemergency medical
123Article 5 Sec. 4.
REVISOR AGW/AC 25-0033903/03/25 124.1transportation providers must maintain trip logs, which include pickup and drop-off times,
124.2signed by the medical provider or client, whichever is deemed most appropriate, attesting
124.3to mileage traveled to obtain covered medical services. Clients requesting client mileage
124.4reimbursement must sign the trip log attesting mileage traveled to obtain covered medical
124.5services.
124.6 (k) (m) The administrative agency shall use the level of service process established by
124.7the commissioner to determine the client's most appropriate mode of transportation. If public
124.8transit or a certified transportation provider is not available to provide the appropriate service
124.9mode for the client, the client may receive a onetime service upgrade.
124.10 (l) (n) The covered modes of transportation are:
124.11 (1) client reimbursement, which includes client mileage reimbursement provided to
124.12clients who have their own transportation, or to family or an acquaintance who provides
124.13transportation to the client;
124.14 (2) volunteer transport, which includes transportation by volunteers using their own
124.15vehicle;
124.16 (3) unassisted transport, which includes transportation provided to a client by a taxicab
124.17or public transit. If a taxicab or public transit is not available, the client can receive
124.18transportation from another nonemergency medical transportation provider;
124.19 (4) assisted transport, which includes transport provided to clients who require assistance
124.20by a nonemergency medical transportation provider;
124.21 (5) lift-equipped/ramp transport, which includes transport provided to a client who is
124.22dependent on a device and requires a nonemergency medical transportation provider with
124.23a vehicle containing a lift or ramp;
124.24 (6) protected transport, which includes transport provided to a client who has received
124.25a prescreening that has deemed other forms of transportation inappropriate and who requires
124.26a provider: (i) with a protected vehicle that is not an ambulance or police car and has safety
124.27locks, a video recorder, and a transparent thermoplastic partition between the passenger and
124.28the vehicle driver; and (ii) who is certified as a protected transport provider; and
124.29 (7) stretcher transport, which includes transport for a client in a prone or supine position
124.30and requires a nonemergency medical transportation provider with a vehicle that can transport
124.31a client in a prone or supine position.
124.32 (m) (o) The local agency shall be the single administrative agency and shall administer
124.33and reimburse for modes defined in paragraph (l) (n) according to paragraphs (p) and (q)
124Article 5 Sec. 4.
REVISOR AGW/AC 25-0033903/03/25 125.1(r) to (t) when the commissioner has developed, made available, and funded the web-based
125.2single administrative structure, assessment tool, and level of need assessment under
125.3subdivision 18e. The local agency's financial obligation is limited to funds provided by the
125.4state or federal government. This paragraph expires July 1, 2026, for medical assistance
125.5fee-for-service and January 1, 2027, for prepaid medical assistance.
125.6 (n) (p) The commissioner shall:
125.7 (1) verify that the mode and use of nonemergency medical transportation is appropriate;
125.8 (2) verify that the client is going to an approved medical appointment; and
125.9 (3) investigate all complaints and appeals.
125.10 (o) (q) The administrative agency shall pay for the services provided in this subdivision
125.11and seek reimbursement from the commissioner, if appropriate. As vendors of medical care,
125.12local agencies are subject to the provisions in section 256B.041, the sanctions and monetary
125.13recovery actions in section 256B.064, and Minnesota Rules, parts 9505.2160 to 9505.2245.
125.14This paragraph expires July 1, 2026, for medical assistance fee-for-service and January 1,
125.152027, for prepaid medical assistance.
125.16 (p) (r) Payments for nonemergency medical transportation must be paid based on the
125.17client's assessed mode under paragraph (k) (m), not the type of vehicle used to provide the
125.18service. The medical assistance reimbursement rates for nonemergency medical transportation
125.19services that are payable by or on behalf of the commissioner for nonemergency medical
125.20transportation services are:
125.21 (1) $0.22 per mile for client reimbursement;
125.22 (2) up to 100 percent of the Internal Revenue Service business deduction rate for volunteer
125.23transport;
125.24 (3) equivalent to the standard fare for unassisted transport when provided by public
125.25transit, and $12.10 for the base rate and $1.43 per mile when provided by a nonemergency
125.26medical transportation provider;
125.27 (4) $14.30 for the base rate and $1.43 per mile for assisted transport;
125.28 (5) $19.80 for the base rate and $1.70 per mile for lift-equipped/ramp transport;
125.29 (6) $75 for the base rate and $2.40 per mile for protected transport; and
125.30 (7) $60 for the base rate and $2.40 per mile for stretcher transport, and $9 per trip for
125.31an additional attendant if deemed medically necessary. This paragraph expires July 1, 2026,
125.32for medical assistance fee-for-service and January 1, 2027, for prepaid medical assistance.
125Article 5 Sec. 4.
REVISOR AGW/AC 25-0033903/03/25 126.1 (s) Effective July 1, 2026, for medical assistance fee-for-service and January 1, 2027,
126.2for prepaid medical assistance, payments for nonemergency medical transportation must
126.3be paid based on the client's assessed mode under paragraph (m), not the type of vehicle
126.4used to provide the service.
126.5 (q) (t) The base rate for nonemergency medical transportation services in areas defined
126.6under RUCA to be super rural is equal to 111.3 percent of the respective base rate in
126.7paragraph (p) (r), clauses (1) to (7). The mileage rate for nonemergency medical
126.8transportation services in areas defined under RUCA to be rural or super rural areas is:
126.9 (1) for a trip equal to 17 miles or less, equal to 125 percent of the respective mileage
126.10rate in paragraph (p) (r), clauses (1) to (7); and
126.11 (2) for a trip between 18 and 50 miles, equal to 112.5 percent of the respective mileage
126.12rate in paragraph (p) (r), clauses (1) to (7). This paragraph expires July 1, 2026, for medical
126.13assistance fee-for-service and January 1, 2027, for prepaid medical assistance.
126.14 (r) (u) For purposes of reimbursement rates for nonemergency medical transportation
126.15services under paragraphs (p) and (q) (r) to (t), the zip code of the recipient's place of
126.16residence shall determine whether the urban, rural, or super rural reimbursement rate applies.
126.17This paragraph expires July 1, 2026, for medical assistance fee-for-service and January 1,
126.182027, for prepaid medical assistance.
126.19 (s) (v) The commissioner, when determining reimbursement rates for nonemergency
126.20medical transportation under paragraphs (p) and (q), shall exempt all modes of transportation
126.21listed under paragraph (l) (n) from Minnesota Rules, part 9505.0445, item R, subitem (2).
126.22 (t) (w) Effective for the first day of each calendar quarter in which the price of gasoline
126.23as posted publicly by the United States Energy Information Administration exceeds $3.00
126.24per gallon, the commissioner shall adjust the rate paid per mile in paragraph (p) (r) by one
126.25percent up or down for every increase or decrease of ten cents for the price of gasoline. The
126.26increase or decrease must be calculated using a base gasoline price of $3.00. The percentage
126.27increase or decrease must be calculated using the average of the most recently available
126.28price of all grades of gasoline for Minnesota as posted publicly by the United States Energy
126.29Information Administration. This paragraph expires July 1, 2026, for medical assistance
126.30fee-for-service and January 1, 2027, for prepaid medical assistance.
126.31 EFFECTIVE DATE.This section is effective the day following final enactment.
126Article 5 Sec. 4.
REVISOR AGW/AC 25-0033903/03/25 127.1Sec. 5. Minnesota Statutes 2024, section 256B.0625, is amended by adding a subdivision
127.2to read:
127.3 Subd. 18i.Administration of nonemergency medical transportation.Effective July
127.41, 2026, for medical assistance fee-for-service and January 1, 2027, for prepaid medical
127.5assistance, the commissioner must contract either statewide or regionally for the
127.6administration of the nonemergency medical transportation program in compliance with
127.7the provisions of this chapter. The contract must include the administration of the
127.8nonemergency medical transportation benefit for those enrolled in managed care as described
127.9in section 256B.69.
127.10 EFFECTIVE DATE.This section is effective the day following final enactment.
127.11Sec. 6. REPEALER.
127.12 Minnesota Statutes 2024, section 256B.0625, subdivisions 18b, 18e, and 18h, are
127.13repealed.
127.14 EFFECTIVE DATE.This section is effective July 1, 2026, for medical assistance
127.15fee-for-service and January 1, 2027, for prepaid medical assistance.
127.16 ARTICLE 6
127.17 MISCELLANEOUS
127.18Section 1. Minnesota Statutes 2024, section 144.0724, subdivision 11, is amended to read:
127.19 Subd. 11.Nursing facility level of care.(a) For purposes of medical assistance payment
127.20of long-term care services, a recipient must be determined, using assessments defined in
127.21subdivision 4, to meet one of the following nursing facility level of care criteria:
127.22 (1) the person requires formal clinical monitoring at least once per day;
127.23 (2) the person needs the assistance of another person or constant supervision to begin
127.24and complete at least four of the following activities of living: bathing, bed mobility, dressing,
127.25eating, grooming, toileting, transferring, and walking;
127.26 (3) the person needs the assistance of another person or constant supervision to begin
127.27and complete toileting, transferring, or positioning and the assistance cannot be scheduled;
127.28 (4) the person has significant difficulty with memory, using information, daily decision
127.29making, or behavioral needs that require intervention;
127.30 (5) the person has had a qualifying nursing facility stay of at least 90 days;
127Article 6 Section 1.
REVISOR AGW/AC 25-0033903/03/25 128.1 (6) the person meets the nursing facility level of care criteria determined 90 days after
128.2admission or on the first quarterly assessment after admission, whichever is later; or
128.3 (7) the person is determined to be at risk for nursing facility admission or readmission
128.4through a face-to-face long-term care consultation assessment as specified in section
128.5256B.0911, subdivision 17 to 21, 23, 24, 27, or 28, by a county, tribe, or managed care
128.6organization under contract with the Department of Human Services. The person is
128.7considered at risk under this clause if the person currently lives alone or will live alone or
128.8be homeless without the person's current housing and also meets one of the following criteria:
128.9 (i) the person has experienced a fall resulting in a fracture;
128.10 (ii) the person has been determined to be at risk of maltreatment or neglect, including
128.11self-neglect; or
128.12 (iii) the person has a sensory impairment that substantially impacts functional ability
128.13and maintenance of a community residence.
128.14 (b) The assessment used to establish medical assistance payment for nursing facility
128.15services must be the most recent assessment performed under subdivision 4, paragraphs (b)
128.16and (c), that occurred no more than 90 calendar days before the effective date of medical
128.17assistance eligibility for payment of long-term care services. In no case shall medical
128.18assistance payment for long-term care services occur prior to the date of the determination
128.19of nursing facility level of care.
128.20 (c) The assessment used to establish medical assistance payment for long-term care
128.21services provided under chapter 256S and section 256B.49 and alternative care payment
128.22for services provided under section 256B.0913 must be the most recent face-to-face
128.23assessment performed under section 256B.0911, subdivisions 17 to 21, 23, 24, 27, or 28,
128.24that occurred no more than 60 one calendar days year before the effective date of medical
128.25assistance eligibility for payment of long-term care services.
128.26Sec. 2. Minnesota Statutes 2024, section 256.01, subdivision 34, is amended to read:
128.27 Subd. 34.Federal administrative reimbursement dedicated.Federal administrative
128.28reimbursement resulting from the following activities is appropriated to the commissioner
128.29for the designated purposes:
128.30 (1) reimbursement for the Minnesota senior health options project; and
128.31 (2) reimbursement related to prior authorization, review of medical necessity, and
128.32inpatient admission certification by a professional review organization. A portion of these
128Article 6 Sec. 2.
REVISOR AGW/AC 25-0033903/03/25 129.1funds must be used for activities to decrease unnecessary pharmaceutical costs in medical
129.2assistance.; and
129.3 (3) reimbursement for capacity building and implementation grant expenditures for the
129.4medical assistance reentry demonstration waiver under section 256B.0761.
129.5 ARTICLE 7
129.6 DEPARTMENT OF HUMAN SERVICES APPROPRIATIONS
129.7Section 1. HUMAN SERVICES APPROPRIATIONS.
129.8 The sums shown in the columns marked "Appropriations" are appropriated to the
129.9commissioner of human services and for the purposes specified in this article. The
129.10appropriations are from the general fund, or another named fund, and are available for the
129.11fiscal years indicated for each purpose. The figures "2026" and "2027" used in this article
129.12mean that the appropriations listed under them are available for the fiscal year ending June
129.1330, 2026, or June 30, 2027, respectively. "The first year" is fiscal year 2026. "The second
129.14year" is fiscal year 2027. "The biennium" is fiscal years 2026 and 2027.
129.15 APPROPRIATIONS
129.16 Available for the Year
129.17 Ending June 30
2027129.18 2026
5,133,590,000$5,225,959,000$129.19Sec. 2. TOTAL APPROPRIATION
129.20Subdivision 1.Appropriations by Fund
129.21 Appropriations by Fund
2027129.22 2026
5,131,732,0005,204,101,000129.23General
1,733,0001,733,000129.24Lottery Prize
125,000125,000
129.25State Government
129.26Special Revenue
-0-20,000,000
129.27Family and Medical
129.28Benefit Insurance
129.29The amounts that may be spent for each
129.30purpose are specified in the following sections.
129.31Subd. 2.Information Technology Appropriations
129.32(a) IT Appropriations Generally
129.33This appropriation includes funds for
129.34information technology projects, services, and
129Article 7 Sec. 2.
REVISOR AGW/AC 25-0033903/03/25 130.1support. Notwithstanding Minnesota Statutes,
130.2section 16E.0466, funding for information
130.3technology project costs must be incorporated
130.4into the service-level agreement and paid to
130.5Minnesota IT Services by the Department of
130.6Human Services under the rates and
130.7mechanism specified in that agreement.
130.8(b) Receipts for Systems Project
130.9Appropriations and federal receipts for
130.10information technology systems projects for
130.11MAXIS, PRISM, MMIS, ISDS, METS, and
130.12SSIS must be deposited in the state systems
130.13account authorized in Minnesota Statutes,
130.14section 256.014. Money appropriated for
130.15information technology projects approved by
130.16the commissioner of Minnesota IT Services,
130.17funded by the legislature, and approved by the
130.18commissioner of management and budget may
130.19be transferred from one project to another and
130.20from development to operations as the
130.21commissioner of human services deems
130.22necessary. Any unexpended balance in the
130.23appropriation for these projects does not
130.24cancel and is available for ongoing
130.25development and operations.
4,836,000$4,315,000$130.26Sec. 3. CENTRAL OFFICE; OPERATIONS
130.27The general fund base for this section is
130.28$3,196,000 in fiscal year 2028 and $3,010,000
130.29in fiscal year 2029.
3,871,000$3,358,000$130.30Sec. 4. CENTRAL OFFICE; HEALTH CARE
51,498,000$52,510,000$
130.31Sec. 5. CENTRAL OFFICE; AGING AND
130.32DISABILITY SERVICES
130.33Subdivision 1.Appropriations by Fund
130Article 7 Sec. 5.
REVISOR AGW/AC 25-0033903/03/25 2027131.1 2026
51,373,00052,385,000131.2General
125,000125,000
131.3State Government
131.4Special Revenue
131.5Subd. 2.Residential Overnight Staffing Reform
131.6Study
131.7$250,000 in fiscal year 2026 is to complete a
131.8study on residential overnight staffing reform.
131.9This is a onetime appropriation.
131.10Subd. 3.Base Level Adjustment
131.11The general fund base for this section is
131.12$50,701,000 in fiscal year 2028 and
131.13$50,701,000 in fiscal year 2029.
686,000$735,000$
131.14Sec. 6. CENTRAL OFFICE; BEHAVIORAL
131.15HEALTH
131.16$150,000 in fiscal year 2026 is for a
131.17workgroup on recovery residences. This is a
131.18onetime appropriation and is available until
131.19June 30, 2027.
276,000$-0-$
131.20Sec. 7. CENTRAL OFFICE; HOMELESSNESS,
131.21HOUSING, AND SUPPORT SERVICES
131.22The general fund base for this section is
131.23$321,000 in fiscal year 2028 and $321,000 in
131.24fiscal year 2029.
11,330,000$8,883,000$
131.25Sec. 8. CENTRAL OFFICE; OFFICE OF
131.26INSPECTOR GENERAL
131.27The general fund base for this section is
131.28$11,476,000 in fiscal year 2028 and
131.29$11,476,000 in fiscal year 2029.
1,800,000$-0-$
131.30Sec. 9. FORECASTED PROGRAMS;
131.31HOUSING SUPPORT
4,734,694,000$4,766,244,000$
131.32Sec. 10. FORECASTED PROGRAMS;
131.33MEDICAL ASSISTANCE
186,000$74,000$
131.34Sec. 11. FORECASTED PROGRAMS;
131.35ALTERNATIVE CARE
131Article 7 Sec. 11.
REVISOR AGW/AC 25-0033903/03/25 132.1Any money allocated to the alternative care
132.2program that is not spent for the purposes
132.3indicated does not cancel but must be
132.4transferred to the medical assistance account.
107,822,000$114,251,000$
132.5Sec. 12. FORECASTED PROGRAMS;
132.6BEHAVIORAL HEALTH FUND
1,925,000$22,747,000$
132.7Sec. 13. GRANT PROGRAMS; OTHER
132.8LONG-TERM CARE GRANTS
132.9Subdivision 1.Appropriations by Fund
2027132.10 2026
1,925,0002,747,000132.11General
.......20,000,000
132.12Family and Medical
132.13Benefit Insurance
132.14Subd. 2.Direct Care Provider Premiums
132.15Through HCBS Workforce Incentive Fund
132.16(a) $20,000,000 in fiscal year 2026 is from the
132.17family and medical benefit account to the
132.18commissioner of human services to provide
132.19reimbursement for premiums incurred for the
132.20paid family and medical leave program under
132.21this chapter. Funds must be administered
132.22through the home and community-based
132.23workforce incentive fund under Minnesota
132.24Statutes, section 256.4764.
132.25(b) The commissioner of employment and
132.26economic development shall share premium
132.27payment data collected under this chapter to
132.28assist the commissioner of human services in
132.29the verification process of premiums paid
132.30under this section.
132.31(c) The amount in this subdivision is for the
132.32purposes of Minnesota Statutes, section
132.33256.4764. This is a onetime appropriation and
132.34is available until June 30, 2027.
132Article 7 Sec. 13.
REVISOR AGW/AC 25-0033903/03/25 33,862,000$33,861,000$
133.1Sec. 14. GRANT PROGRAMS; AGING AND
133.2ADULT SERVICES GRANTS
2,886,000$2,886,000$
133.3Sec. 15. DEAF, DEAFBLIND, AND HARD OF
133.4HEARING GRANTS
25,853,000$64,030,000$
133.5Sec. 16. GRANT PROGRAMS; DISABILITY
133.6GRANTS
133.7Subdivision 1.Self-Directed Bargaining
133.8Agreement; Orientation Start-Up Funds
133.9$3,000,000 in fiscal year 2026 is for
133.10orientation program start-up costs as defined
133.11by the SEIU collective bargaining agreement.
133.12This is a onetime appropriation.
133.13Subd. 2.Self-Directed Bargaining Agreement;
133.14Orientation Ongoing Funds
133.15$2,000,000 in fiscal year 2026 and $500,000
133.16in fiscal year 2027 are for ongoing costs
133.17related to the orientation program as defined
133.18by the SEIU collective bargaining agreement.
133.19The base for this appropriation is $500,000 in
133.20fiscal year 2028 and $500,000 in fiscal year
133.212029.
133.22Subd. 3.Self-Directed Bargaining Agreement;
133.23Training Stipends
133.24$2,250,000 in fiscal year 2026 is for onetime
133.25stipends of $750 for collective bargaining unit
133.26members for training. This is a onetime
133.27appropriation.
133.28Subd. 4.Self-Directed Bargaining Agreement;
133.29Retirement Trust Funds
133.30$350,000 in fiscal year 2026 is for a vendor
133.31to create a retirement trust, as defined by the
133.32SEIU collective bargaining agreement. This
133.33is a onetime appropriation.
133Article 7 Sec. 16.
REVISOR AGW/AC 25-0033903/03/25 134.1Subd. 5.Self-Directed Bargaining Agreement;
134.2Health Care Stipends
134.3$30,750,000 in fiscal year 2026 is for stipends
134.4of $1,200 for collective bargaining unit
134.5members for retention and defraying any
134.6health insurance costs they may incur.
134.7Stipends are available once per fiscal year per
134.8member for fiscal year 2026 and fiscal year
134.92027. Of this amount, $30,000,000 in fiscal
134.10year 2026 is for stipends and $750,000 in
134.11fiscal year 2026 is for administration. This is
134.12a onetime appropriation and is available until
134.13June 30, 2027.
110,217,000$110,217,000$
134.14Sec. 17. GRANT PROGRAMS; ADULT
134.15MENTAL HEALTH GRANTS
34,648,000$34,648,000$
134.16Sec. 18. GRANT PROGRAMS; CHILDREN'S
134.17MENTAL HEALTH GRANTS
4,980,000$4,980,000$
134.18Sec. 19. GRANT PROGRAMS; CHEMICAL
134.19DEPENDENCY TREATMENT SUPPORT
134.20GRANTS
134.21 Appropriations by Fund
2027134.22 2026
3,247,0003,247,000134.23General
1,733,0001,733,000134.24Lottery Prize
2,220,000$2,220,000$134.25Sec. 20. GRANT PROGRAMS; HIV GRANTS
134.26Sec. 21. TRANSFERS.
134.27 Subdivision 1.Grants.The commissioner of human services, with the approval of the
134.28commissioner of management and budget, may transfer unencumbered appropriation balances
134.29for the biennium ending June 30, 2025, within fiscal years among general assistance, medical
134.30assistance, MinnesotaCare, the Minnesota supplemental aid program, the housing support
134.31program, and the entitlement portion of the behavioral health fund between fiscal years of
134.32the biennium. The commissioner shall report to the chairs and ranking minority members
134.33of the legislative committees with jurisdiction over health and human services quarterly
134.34about transfers made under this subdivision.
134Article 7 Sec. 21.
REVISOR AGW/AC 25-0033903/03/25 135.1 Subd. 2.Administration.Positions, salary money, and nonsalary administrative money
135.2may be transferred within the Department of Human Services as the commissioners deem
135.3necessary, with the advance approval of the commissioner of management and budget. The
135.4commissioners shall report to the chairs and ranking minority members of the legislative
135.5committees with jurisdiction over health and human services finance quarterly about transfers
135.6made under this section.
135.7 Subd. 3.Children, youth, and families.Administrative money may be transferred
135.8between the Department of Human Services and the Department of Children, Youth, and
135.9Families as the commissioners deem necessary, with the advance approval of the
135.10commissioner of management and budget. The commissioners shall report to the chairs and
135.11ranking minority members of the legislative committees with jurisdiction over children and
135.12families quarterly about transfers made under this section.
135.13 ARTICLE 8
135.14 DIRECT CARE AND TREATMENT APPROPRIATIONS
135.15Section 1. DIRECT CARE AND TREATMENT APPROPRIATIONS.
135.16 The sums shown in the columns marked "Appropriations" are appropriated to the
135.17executive board of direct care and treatment and for the purposes specified in this article.
135.18The appropriations are from the general fund, or another named fund, and are available for
135.19the fiscal years indicated for each purpose. The figures "2026" and "2027" used in this
135.20article mean that the appropriations listed under them are available for the fiscal year ending
135.21June 30, 2026, or June 30, 2027, respectively. "The first year" is fiscal year 2026. "The
135.22second year" is fiscal year 2027. "The biennium" is fiscal years 2026 and 2027.
135.23 APPROPRIATIONS
135.24 Available for the Year
135.25 Ending June 30
2027135.26 2026
602,021,000$577,328,000$
135.27Sec. 2. EXECUTIVE BOARD OF DIRECT
135.28CARE AND TREATMENT; TOTAL
135.29APPROPRIATION
135.30The amounts that may be spent for each
135.31purpose are specified in the following sections.
194,840,000$189,761,000$
135.32Sec. 3. MENTAL HEALTH AND SUBSTANCE
135.33ABUSE
14,170,000$13,927,000$135.34Sec. 4. COMMUNITY-BASED SERVICES
164,094,000$160,239,000$135.35Sec. 5. FORENSIC SERVICES
135Article 8 Sec. 5.
REVISOR AGW/AC 25-0033903/03/25 131,351,000$128,050,000$136.1Sec. 6. SEX OFFENDER PROGRAM
97,566,000$85,351,000$136.2Sec. 7. ADMINISTRATION
136.3Sec. 8. TRANSFER AUTHORITY.
136.4 (a) Money appropriated for budget programs in sections 3 to 7 may be transferred between
136.5budget programs and between years of the biennium with the approval of the commissioner
136.6of management and budget.
136.7 (b) The executive board of Direct Care and Treatment, with the approval of the
136.8commissioner of management and budget, may transfer money appropriated for Direct Care
136.9and Treatment administration into the special revenue account for security systems and
136.10information technology projects, services, and support.
136.11 (c) Positions, salary money, and nonsalary administrative money may be transferred
136.12within and between Direct Care and Treatment and the Department of Human Services as
136.13the executive board and commissioner consider necessary, with the advance approval of
136.14the commissioner of management and budget.
136.15 ARTICLE 9
136.16 OTHER AGENCY APPROPRIATIONS
136.17Section 1. HEALTH AND HUMAN SERVICES APPROPRIATIONS.
136.18 The sums shown in the columns marked "Appropriations" are appropriated to the agencies
136.19and for the purposes specified in this article. The appropriations are from the general fund,
136.20or another named fund, and are available for the fiscal years indicated for each purpose.
136.21The figures "2026" and "2027" used in this article mean that the appropriations listed under
136.22them are available for the fiscal year ending June 30, 2026, or June 30, 2027, respectively.
136.23"The first year" is fiscal year 2026. "The second year" is fiscal year 2027. "The biennium"
136.24is fiscal years 2026 and 2027.
136.25 APPROPRIATIONS
136.26 Available for the Year
136.27 Ending June 30
2027136.28 2026
2,457,000$2,432,000$136.29Sec. 2. COUNCIL ON DISABILITY
3,765,000$3,706,000$
136.30Sec. 3. OFFICE OF THE OMBUDSMAN FOR
136.31MENTAL HEALTH AND DEVELOPMENT AL
136.32DISABILITIES
136Article 9 Sec. 3.
REVISOR AGW/AC 25-0033903/03/25 Page.Ln 2.2AGING AND OLDER ADULT SERVICES..........................................ARTICLE 1
Page.Ln 26.16DISABILITY SERVICES......................................................................ARTICLE 2
Page.Ln 69.15DIRECT CARE AND TREATMENT....................................................ARTICLE 3
Page.Ln 76.4BEHAVIORAL HEALTH......................................................................ARTICLE 4
Page.Ln 117.11HEALTH CARE.....................................................................................ARTICLE 5
Page.Ln 127.16MISCELLANEOUS...............................................................................ARTICLE 6
Page.Ln 129.5DEPARTMENT OF HUMAN SERVICES APPROPRIATIONS..........ARTICLE 7
Page.Ln 135.13DIRECT CARE AND TREATMENT APPROPRIATIONS.................ARTICLE 8
Page.Ln 136.15OTHER AGENCY APPROPRIATIONS...............................................ARTICLE 9
1
APPENDIX
Article locations for 25-00339 144A.1888 REUSE OF FACILITIES.
Notwithstanding any local ordinance related to development, planning, or zoning to the contrary,
the conversion or reuse of a nursing home that closes or that curtails, reduces, or changes operations
shall be considered a conforming use permitted under local law, provided that the facility is converted
to another long-term care service approved by a regional planning group under section 256R.40
that serves a smaller number of persons than the number of persons served before the closure or
curtailment, reduction, or change in operations.
245G.01 DEFINITIONS.
Subd. 20d.Skilled treatment services."Skilled treatment services" has the meaning provided
in section 254B.01, subdivision 10.
245G.07 TREATMENT SERVICE.
Subd. 2.Additional treatment service.A license holder may provide or arrange the following
additional treatment service as a part of the client's individual treatment plan:
(1) relationship counseling provided by a qualified professional to help the client identify the
impact of the client's substance use disorder on others and to help the client and persons in the
client's support structure identify and change behaviors that contribute to the client's substance use
disorder;
(2) therapeutic recreation to allow the client to participate in recreational activities without the
use of mood-altering chemicals and to plan and select leisure activities that do not involve the
inappropriate use of chemicals;
(3) stress management and physical well-being to help the client reach and maintain an
appropriate level of health, physical fitness, and well-being;
(4) living skills development to help the client learn basic skills necessary for independent
living;
(5) employment or educational services to help the client become financially independent;
(6) socialization skills development to help the client live and interact with others in a positive
and productive manner;
(7) room, board, and supervision at the treatment site to provide the client with a safe and
appropriate environment to gain and practice new skills; and
(8) peer recovery support services must be provided by a recovery peer qualified according to
section 245I.04, subdivision 18. Peer recovery support services must be provided according to
sections 254B.05, subdivision 5, and 254B.052.
254B.01 DEFINITIONS.
Subd. 5.Local agency."Local agency" means the agency designated by a board of county
commissioners, a local social services agency, or a human services board authorized under section
254B.03, subdivision 1, to determine financial eligibility for the behavioral health fund.
254B.04 ELIGIBILITY FOR BEHAVIORAL HEALTH FUND SERVICES.
Subd. 2a.Eligibility for room and board services for persons in outpatient substance use
disorder treatment.A person eligible for room and board services under section 254B.05,
subdivision 5, paragraph (b), must score at level 4 on assessment dimensions related to readiness
to change, relapse, continued use, or recovery environment in order to be assigned to services with
a room and board component reimbursed under this section. Whether a treatment facility has been
designated an institution for mental diseases under United States Code, title 42, section 1396d, shall
not be a factor in making placements.
256B.0625 COVERED SERVICES.
Subd. 18b.Broker dispatching prohibition.Except for establishing level of service process,
the commissioner shall not use a broker or coordinator for any purpose related to nonemergency
medical transportation services under subdivision 18.
Subd. 18e.Single administrative structure and delivery system.The commissioner, in
coordination with the commissioner of transportation, shall implement a single administrative
structure and delivery system for nonemergency medical transportation, beginning the latter of the
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Repealed Minnesota Statutes: 25-00339 date the single administrative assessment tool required in this subdivision is available for use, as
determined by the commissioner or by July 1, 2016.
In coordination with the Department of Transportation, the commissioner shall develop and
authorize a web-based single administrative structure and assessment tool, which must operate 24
hours a day, seven days a week, to facilitate the enrollee assessment process for nonemergency
medical transportation services. The web-based tool shall facilitate the transportation eligibility
determination process initiated by clients and client advocates; shall include an accessible automated
intake and assessment process and real-time identification of level of service eligibility; and shall
authorize an appropriate and auditable mode of transportation authorization. The tool shall provide
a single framework for reconciling trip information with claiming and collecting complaints regarding
inappropriate level of need determinations, inappropriate transportation modes utilized, and
interference with accessing nonemergency medical transportation. The web-based single
administrative structure shall operate on a trial basis for one year from implementation and, if
approved by the commissioner, shall be permanent thereafter.
Subd. 18h.Nonemergency medical transportation provisions related to managed care.(a)
The following nonemergency medical transportation (NEMT) subdivisions apply to managed care
plans and county-based purchasing plans:
(1) subdivision 17, paragraphs (a), (b), (i), and (n);
(2) subdivision 18; and
(3) subdivision 18a.
(b) A nonemergency medical transportation provider must comply with the operating standards
for special transportation service specified in sections 174.29 to 174.30 and Minnesota Rules,
chapter 8840. Publicly operated transit systems, volunteers, and not-for-hire vehicles are exempt
from the requirements in this paragraph.
(c) Managed care plans and county-based purchasing plans must provide a fuel adjustment for
NEMT rates when fuel exceeds $3 per gallon. If, for any contract year, federal approval is not
received for this paragraph, the commissioner must adjust the capitation rates paid to managed care
plans and county-based purchasing plans for that contract year to reflect the removal of this provision.
Contracts between managed care plans and county-based purchasing plans and providers to whom
this paragraph applies must allow recovery of payments from those providers if capitation rates are
adjusted in accordance with this paragraph. Payment recoveries must not exceed the amount equal
to any increase in rates that results from this paragraph. This paragraph expires if federal approval
is not received for this paragraph at any time.
256B.434 PAYMENT RATES AND PROCEDURES; CONTRACTS AND AGREEMENTS.
Subd. 4.Alternate rates for nursing facilities.Effective for the rate years beginning on and
after January 1, 2019, a nursing facility's property payment rate for the second and subsequent years
of a facility's contract under this section are the previous rate year's property payment rate plus an
inflation adjustment. The index for the inflation adjustment must be based on the change in the
Consumer Price Index-All Items (United States City average) (CPI-U) forecasted by the Reports
and Forecasts Division of the Department of Human Services, as forecasted in the fourth quarter
of the calendar year preceding the rate year. The inflation adjustment must be based on the 12-month
period from the midpoint of the previous rate year to the midpoint of the rate year for which the
rate is being determined.
256R.02 DEFINITIONS.
Subd. 38.Prior system operating cost payment rate."Prior system operating cost payment
rate" means the operating cost payment rate in effect on December 31, 2015, under Minnesota Rules
and Minnesota Statutes, inclusive of health insurance, plus property insurance costs from external
fixed costs, minus any rate increases allowed under Minnesota Statutes 2015 Supplement, section
256B.441, subdivision 55a.
256R.12 COST ALLOCATION.
Subd. 10.Allocation of self-insurance costs.For the rate year beginning on July 1, 1998, a
group of nursing facilities related by common ownership that self-insures group health, dental, or
life insurance may allocate its directly identified costs of self-insuring its Minnesota nursing facility
workers among those nursing facilities in the group that are reimbursed under this chapter. The
method of cost allocation shall be based on the ratio of each nursing facility's total allowable salaries
and wages to that of the nursing facility group's total allowable salaries and wages, then similarly
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Repealed Minnesota Statutes: 25-00339 allocated within each nursing facility's operating cost categories. The costs associated with the
administration of the group's self-insurance plan must remain classified in the nursing facility's
administrative cost category. A written request of the nursing facility group's election to use this
alternate method of allocation of self-insurance costs must be received by the commissioner no
later than May 1, 1998, to take effect July 1, 1998, or those self-insurance costs shall continue to
be allocated under the existing cost allocation methods. Once a nursing facility group elects this
method of cost allocation for its group health, dental, or life insurance self-insurance costs, it shall
remain in effect until such time as the group no longer self-insures these costs.
256R.23 TOTAL CARE-RELATED PAYMENT RATES.
Subd. 6.Payment rate limit reduction.No facility shall be subject in any rate year to a
care-related payment rate limit reduction greater than five percent of the median determined in
subdivision 4.
256R.36 HOLD HARMLESS.
No nursing facility's operating payment rate, plus its employer health insurance costs portion
of the external fixed costs payment rate, will be less than its prior system operating cost payment
rate.
256R.40 NURSING FACILITY VOLUNTARY CLOSURE; ALTERNATIVES.
Subdivision 1.Definitions.(a) The definitions in this subdivision apply to this section.
(b) "Closure" means the cessation of operations of a nursing facility and delicensure and
decertification of all beds within the facility.
(c) "Closure plan" means a plan to close a nursing facility and reallocate a portion of the resulting
savings to provide planned closure rate adjustments at other facilities.
(d) "Commencement of closure" means the date on which residents and designated representatives
are notified of a planned closure as provided in section 144A.161, subdivision 5a, as part of an
approved closure plan.
(e) "Completion of closure" means the date on which the final resident of the nursing facility
designated for closure in an approved closure plan is discharged from the facility or the date that
beds from a partial closure are delicensed and decertified.
(f) "Partial closure" means the delicensure and decertification of a portion of the beds within
the facility.
(g) "Planned closure rate adjustment" means an increase in a nursing facility's operating rates
resulting from a planned closure or a planned partial closure of another facility.
Subd. 2.Applications for planned closure rate.(a) To be considered for approval of a planned
closure, an application must include:
(1) a description of the proposed closure plan, which must include identification of the facility
or facilities to receive a planned closure rate adjustment;
(2) the proposed timetable for any proposed closure, including the proposed dates for
announcement to residents, commencement of closure, and completion of closure;
(3) if available, the proposed relocation plan for current residents of any facility designated for
closure. If a relocation plan is not available, the application must include a statement agreeing to
develop a relocation plan designed to comply with section 144A.161;
(4) a description of the relationship between the nursing facility that is proposed for closure and
the nursing facility or facilities proposed to receive the planned closure rate adjustment. If these
facilities are not under common ownership, copies of any contracts, purchase agreements, or other
documents establishing a relationship or proposed relationship must be provided; and
(5) documentation, in a format approved by the commissioner, that all the nursing facilities
receiving a planned closure rate adjustment under the plan have accepted joint and several liability
for recovery of overpayments under section 256B.0641, subdivision 2, for the facilities designated
for closure under the plan.
(b) The application must also address the criteria listed in subdivision 3.
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Repealed Minnesota Statutes: 25-00339 Subd. 3.Criteria for review of application.In reviewing and approving closure proposals,
the commissioner shall consider, but not be limited to, the following criteria:
(1) improved quality of care and quality of life for consumers;
(2) closure of a nursing facility that has a poor physical plant;
(3) the existence of excess nursing facility beds, measured in terms of beds per thousand persons
aged 85 or older. The excess must be measured in reference to:
(i) the county in which the facility is located. A facility in a county that is in the lowest quartile
of counties with reference to beds per thousand persons aged 85 or older is not in an area of excess
capacity;
(ii) the county and all contiguous counties;
(iii) the region in which the facility is located; or
(iv) the facility's service area. The facility shall indicate in its application the service area it
believes is appropriate for this measurement;
(4) low-occupancy rates, provided that the unoccupied beds are not the result of a personnel
shortage. In analyzing occupancy rates, the commissioner shall examine waiting lists in the applicant
facility and at facilities in the surrounding area, as determined under clause (3);
(5) evidence of coordination between the community planning process and the facility application.
If the planning group does not support a level of nursing facility closures that the commissioner
considers to be reasonable, the commissioner may approve a planned closure proposal without its
support;
(6) proposed usage of funds available from a planned closure rate adjustment for care-related
purposes;
(7) innovative use planned for the closed facility's physical plant;
(8) evidence that the proposal serves the interests of the state; and
(9) evidence of other factors that affect the viability of the facility, including excessive nursing
pool costs.
Subd. 4.Review and approval of applications.(a) The commissioner, in consultation with
the commissioner of health, shall approve or deny an application within 30 days after receiving it.
The commissioner may appoint an advisory review panel composed of representatives of counties,
consumers, and providers to review proposals and provide comments and recommendations to the
committee. The commissioners of human services and health shall provide staff and technical
assistance to the committee for the review and analysis of proposals.
(b) Approval of a planned closure expires 18 months after approval by the commissioner unless
commencement of closure has begun.
(c) The commissioner may change any provision of the application to which the applicant, the
regional planning group, and the commissioner agree.
Subd. 5.Planned closure rate adjustment.(a) The commissioner shall calculate the amount
of the planned closure rate adjustment available under subdivision 6 according to clauses (1) to (4):
(1) the amount available is the net reduction of nursing facility beds multiplied by $2,080;
(2) the total number of beds in the nursing facility or facilities receiving the planned closure
rate adjustment must be identified;
(3) capacity days are determined by multiplying the number determined under clause (2) by
365; and
(4) the planned closure rate adjustment is the amount available in clause (1), divided by capacity
days determined under clause (3).
(b) A planned closure rate adjustment under this section is effective on the first day of the month
of January or July, whichever occurs immediately following completion of closure of the facility
designated for closure in the application and becomes part of the nursing facility's external fixed
payment rate.
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Repealed Minnesota Statutes: 25-00339 (c) Upon the request of a closing facility, the commissioner must allow the facility a closure
rate adjustment as provided under section 144A.161, subdivision 10.
(d) A facility that has received a planned closure rate adjustment may reassign it to another
facility that is under the same ownership at any time within three years of its effective date. The
amount of the adjustment is computed according to paragraph (a).
(e) If the per bed dollar amount specified in paragraph (a), clause (1), is increased, the
commissioner shall recalculate planned closure rate adjustments for facilities that delicense beds
under this section on or after July 1, 2001, to reflect the increase in the per bed dollar amount. The
recalculated planned closure rate adjustment is effective from the date the per bed dollar amount
is increased.
Subd. 6.Assignment of closure rate to another facility.A facility or facilities reimbursed
under this chapter with a closure plan approved by the commissioner under subdivision 4 may
assign a planned closure rate adjustment to another facility or facilities that are not closing or in
the case of a partial closure, to the facility undertaking the partial closure. A facility may also elect
to have a planned closure rate adjustment shared equally by the five nursing facilities with the
lowest total operating payment rates in the state development region designated under section
462.385, in which the facility that is closing is located. The planned closure rate adjustment must
be calculated under subdivision 5. Facilities that delicense beds without a closure plan, or whose
closure plan is not approved by the commissioner, are not eligible to assign a planned closure rate
adjustment under subdivision 5, unless they: (1) are delicensing five or fewer beds, or less than six
percent of their total licensed bed capacity, whichever is greater; (2) are located in a county in the
top three quartiles of beds per 1,000 persons aged 65 or older; and (3) have not delicensed beds in
the prior three months. Facilities meeting these criteria are eligible to assign the amount calculated
under subdivision 5 to themselves. If a facility is delicensing the greater of six or more beds, or six
percent or more of its total licensed bed capacity, and does not have an approved closure plan or is
not eligible for the adjustment under subdivision 5, the commissioner shall calculate the amount
the facility would have been eligible to assign under subdivision 5, and shall use this amount to
provide equal rate adjustments to the five nursing facilities with the lowest total operating payment
rates in the state development region designated under section 462.385, in which the facility that
delicensed beds is located.
Subd. 7.Other rate adjustments.Facilities receiving planned closure rate adjustments remain
eligible for any applicable rate adjustments provided under this chapter.
256R.41 SINGLE-BED ROOM INCENTIVE.
(a) Beginning July 1, 2005, the operating payment rate for nursing facilities reimbursed under
this chapter shall be increased by 20 percent multiplied by the ratio of the number of new single-bed
rooms created divided by the number of active beds on July 1, 2005, for each bed closure that results
in the creation of a single-bed room after July 1, 2005. The commissioner may implement rate
adjustments for up to 3,000 new single-bed rooms each year. For eligible bed closures for which
the commissioner receives a notice from a facility that a bed has been delicensed and a new single-bed
room has been established, the rate adjustment in this paragraph shall be effective on either the first
day of the month of January or July, whichever occurs first following the date of the bed delicensure.
(b) A nursing facility is prohibited from discharging residents for purposes of establishing
single-bed rooms. A nursing facility must submit documentation to the commissioner in a form
prescribed by the commissioner, certifying the occupancy status of beds closed to create single-bed
rooms. In the event that the commissioner determines that a facility has discharged a resident for
purposes of establishing a single-bed room, the commissioner shall not provide a rate adjustment
under paragraph (a).
256R.481 RATE ADJUSTMENTS FOR BORDER CITY FACILITIES.
(a) The commissioner shall allow each nonprofit nursing facility located within the boundaries
of the city of Breckenridge or Moorhead prior to January 1, 2015, to apply once annually for a rate
add-on to the facility's external fixed costs payment rate.
(b) A facility seeking an add-on to its external fixed costs payment rate under this section must
apply annually to the commissioner to receive the add-on. A facility must submit the application
within 60 calendar days of the effective date of any add-on under this section. The commissioner
may waive the deadlines required by this paragraph under extraordinary circumstances.
(c) The commissioner shall provide the add-on to each eligible facility that applies by the
application deadline.
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Repealed Minnesota Statutes: 25-00339 (d) The add-on to the external fixed costs payment rate is the difference on January 1 of the
median total payment rate for case mix classification PA1 of the nonprofit facilities located in an
adjacent city in another state and in cities contiguous to the adjacent city minus the eligible nursing
facility's total payment rate for case mix classification PA1 as determined under section 256R.22,
subdivision 4.
256R.53 FACILITY SPECIFIC EXEMPTIONS.
Subdivision 1.Nursing facility in Golden Valley.The operating payment rate for a facility
located in the city of Golden Valley at 3915 Golden Valley Road with 44 licensed rehabilitation
beds as of January 7, 2015, is the sum of its direct care costs per standardized day, its other
care-related costs per resident day, and its other operating costs per day.
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Repealed Minnesota Statutes: 25-00339