sh2725a-3

1.1Senator Draheim moved to amend H.F. No. 2725 as follows:
1.2Delete everything after the enacting clause and insert:

1.3"ARTICLE 1

1.4MENTAL HEALTH POLICY

1.5    Section 1. Minnesota Statutes 2020, section 144.55, subdivision 4, is amended to read:
1.6    Subd. 4. Routine inspections; presumption. Any hospital surveyed and accredited
1.7under the standards of the hospital accreditation program of an approved accrediting
1.8organization that submits to the commissioner within a reasonable time copies of (a) its
1.9currently valid accreditation certificate and accreditation letter, together with accompanying
1.10recommendations and comments and (b) any further recommendations, progress reports
1.11and correspondence directly related to the accreditation is presumed to comply with
1.12application requirements of subdivision 1 and the standards requirements of subdivision 3
1.13and no further routine inspections or accreditation information shall be required by the
1.14commissioner to determine compliance. Notwithstanding the provisions of sections 144.54
1.15and 144.653, subdivisions 2 and 4, hospitals shall be inspected only as provided in this
1.16section. The provisions of section 144.653 relating to the assessment and collection of fines
1.17shall not apply to any hospital. The commissioner of health shall annually conduct, with
1.18notice, validation inspections of a selected sample of the number of hospitals accredited by
1.19an approved accrediting organization, not to exceed ten percent of accredited hospitals, for
1.20the purpose of determining compliance with the provisions of subdivision 3. If a validation
1.21survey discloses a failure to comply with subdivision 3, the provisions of section 144.653
1.22relating to correction orders, reinspections, and notices of noncompliance shall apply. The
1.23commissioner shall also conduct any inspection necessary to determine whether hospital
1.24construction, addition, or remodeling projects comply with standards for construction
1.25promulgated in rules pursuant to subdivision 3. The commissioner may also conduct
1.26inspections to determine whether a hospital or hospital corporate system continues to satisfy
1.27the conditions on which a hospital construction moratorium exception was granted under
1.28section 144.551, subdivision 1a. Pursuant to section 144.653, the commissioner shall inspect
1.29any hospital that does not have a currently valid hospital accreditation certificate from an
1.30approved accrediting organization. Nothing in this subdivision shall be construed to limit
1.31the investigative powers of the Office of Health Facility Complaints as established in sections
1.32144A.51 to 144A.54.
1.33EFFECTIVE DATE.This section is effective the day following final enactment.

2.1    Sec. 2. Minnesota Statutes 2020, section 144.55, subdivision 6, is amended to read:
2.2    Subd. 6. Suspension, revocation, and refusal to renew. (a) The commissioner may
2.3refuse to grant or renew, or may suspend or revoke, a license on any of the following grounds:
2.4(1) violation of any of the provisions of sections 144.50 to 144.56 or the rules or standards
2.5issued pursuant thereto, or Minnesota Rules, chapters 4650 and 4675;
2.6(2) permitting, aiding, or abetting the commission of any illegal act in the institution;
2.7(3) conduct or practices detrimental to the welfare of the patient; or
2.8(4) obtaining or attempting to obtain a license by fraud or misrepresentation; or
2.9(5) with respect to hospitals and outpatient surgical centers, if the commissioner
2.10determines that there is a pattern of conduct that one or more physicians or advanced practice
2.11registered nurses who have a "financial or economic interest," as defined in section 144.6521,
2.12subdivision 3, in the hospital or outpatient surgical center, have not provided the notice and
2.13disclosure of the financial or economic interest required by section 144.6521.
2.14(b) The commissioner shall not renew a license for a boarding care bed in a resident
2.15room with more than four beds.
2.16(c) The commissioner shall not renew licenses for hospital beds issued to a hospital or
2.17hospital corporate system pursuant to a hospital construction moratorium exception under
2.18section 144.551, subdivision 1a, if the commissioner determines the hospital or hospital
2.19corporate system is not satisfying the conditions on which the exception was granted.
2.20EFFECTIVE DATE.This section is effective the day following final enactment.

2.21    Sec. 3. Minnesota Statutes 2021 Supplement, section 144.551, subdivision 1, is amended
2.22to read:
2.23    Subdivision 1. Restricted construction or modification. (a) The following construction
2.24or modification may not be commenced:
2.25(1) any erection, building, alteration, reconstruction, modernization, improvement,
2.26extension, lease, or other acquisition by or on behalf of a hospital that increases the bed
2.27capacity of a hospital, relocates hospital beds from one physical facility, complex, or site
2.28to another, or otherwise results in an increase or redistribution of hospital beds within the
2.29state; and
2.30(2) the establishment of a new hospital.
2.31(b) This section does not apply to:
3.1(1) construction or relocation within a county by a hospital, clinic, or other health care
3.2facility that is a national referral center engaged in substantial programs of patient care,
3.3medical research, and medical education meeting state and national needs that receives more
3.4than 40 percent of its patients from outside the state of Minnesota;
3.5(2) a project for construction or modification for which a health care facility held an
3.6approved certificate of need on May 1, 1984, regardless of the date of expiration of the
3.7certificate;
3.8(3) a project for which a certificate of need was denied before July 1, 1990, if a timely
3.9appeal results in an order reversing the denial;
3.10(4) a project exempted from certificate of need requirements by Laws 1981, chapter 200,
3.11section 2;
3.12(5) a project involving consolidation of pediatric specialty hospital services within the
3.13Minneapolis-St. Paul metropolitan area that would not result in a net increase in the number
3.14of pediatric specialty hospital beds among the hospitals being consolidated;
3.15(6) a project involving the temporary relocation of pediatric-orthopedic hospital beds to
3.16an existing licensed hospital that will allow for the reconstruction of a new philanthropic,
3.17pediatric-orthopedic hospital on an existing site and that will not result in a net increase in
3.18the number of hospital beds. Upon completion of the reconstruction, the licenses of both
3.19hospitals must be reinstated at the capacity that existed on each site before the relocation;
3.20(7) the relocation or redistribution of hospital beds within a hospital building or
3.21identifiable complex of buildings provided the relocation or redistribution does not result
3.22in: (i) an increase in the overall bed capacity at that site; (ii) relocation of hospital beds from
3.23one physical site or complex to another; or (iii) redistribution of hospital beds within the
3.24state or a region of the state;
3.25(8) relocation or redistribution of hospital beds within a hospital corporate system that
3.26involves the transfer of beds from a closed facility site or complex to an existing site or
3.27complex provided that: (i) no more than 50 percent of the capacity of the closed facility is
3.28transferred; (ii) the capacity of the site or complex to which the beds are transferred does
3.29not increase by more than 50 percent; (iii) the beds are not transferred outside of a federal
3.30health systems agency boundary in place on July 1, 1983; (iv) the relocation or redistribution
3.31does not involve the construction of a new hospital building; and (v) the transferred beds
3.32are used first to replace within the hospital corporate system the total number of beds
3.33previously used in the closed facility site or complex for mental health services and substance
3.34use disorder services. Only after the hospital corporate system has fulfilled the requirements
4.1of this item may the remainder of the available capacity of the closed facility site or complex
4.2be transferred for any other purpose;
4.3(9) a construction project involving up to 35 new beds in a psychiatric hospital in Rice
4.4County that primarily serves adolescents and that receives more than 70 percent of its
4.5patients from outside the state of Minnesota;
4.6(10) a project to replace a hospital or hospitals with a combined licensed capacity of
4.7130 beds or less if: (i) the new hospital site is located within five miles of the current site;
4.8and (ii) the total licensed capacity of the replacement hospital, either at the time of
4.9construction of the initial building or as the result of future expansion, will not exceed 70
4.10licensed hospital beds, or the combined licensed capacity of the hospitals, whichever is less;
4.11(11) the relocation of licensed hospital beds from an existing state facility operated by
4.12the commissioner of human services to a new or existing facility, building, or complex
4.13operated by the commissioner of human services; from one regional treatment center site
4.14to another; or from one building or site to a new or existing building or site on the same
4.15campus;
4.16(12) the construction or relocation of hospital beds operated by a hospital having a
4.17statutory obligation to provide hospital and medical services for the indigent that does not
4.18result in a net increase in the number of hospital beds, notwithstanding section 144.552, 27
4.19beds, of which 12 serve mental health needs, may be transferred from Hennepin County
4.20Medical Center to Regions Hospital under this clause;
4.21(13) a construction project involving the addition of up to 31 new beds in an existing
4.22nonfederal hospital in Beltrami County;
4.23(14) a construction project involving the addition of up to eight new beds in an existing
4.24nonfederal hospital in Otter Tail County with 100 licensed acute care beds;
4.25(15) a construction project involving the addition of 20 new hospital beds in an existing
4.26hospital in Carver County serving the southwest suburban metropolitan area;
4.27(16) a project for the construction or relocation of up to 20 hospital beds for the operation
4.28of up to two psychiatric facilities or units for children provided that the operation of the
4.29facilities or units have received the approval of the commissioner of human services;
4.30(17) a project involving the addition of 14 new hospital beds to be used for rehabilitation
4.31services in an existing hospital in Itasca County;
4.32(18) a project to add 20 licensed beds in existing space at a hospital in Hennepin County
4.33that closed 20 rehabilitation beds in 2002, provided that the beds are used only for
5.1rehabilitation in the hospital's current rehabilitation building. If the beds are used for another
5.2purpose or moved to another location, the hospital's licensed capacity is reduced by 20 beds;
5.3(19) a critical access hospital established under section 144.1483, clause (9), and section
5.41820 of the federal Social Security Act, United States Code, title 42, section 1395i-4, that
5.5delicensed beds since enactment of the Balanced Budget Act of 1997, Public Law 105-33,
5.6to the extent that the critical access hospital does not seek to exceed the maximum number
5.7of beds permitted such hospital under federal law;
5.8(20) notwithstanding section 144.552, a project for the construction of a new hospital
5.9in the city of Maple Grove with a licensed capacity of up to 300 beds provided that:
5.10(i) the project, including each hospital or health system that will own or control the entity
5.11that will hold the new hospital license, is approved by a resolution of the Maple Grove City
5.12Council as of March 1, 2006;
5.13(ii) the entity that will hold the new hospital license will be owned or controlled by one
5.14or more not-for-profit hospitals or health systems that have previously submitted a plan or
5.15plans for a project in Maple Grove as required under section 144.552, and the plan or plans
5.16have been found to be in the public interest by the commissioner of health as of April 1,
5.172005;
5.18(iii) the new hospital's initial inpatient services must include, but are not limited to,
5.19medical and surgical services, obstetrical and gynecological services, intensive care services,
5.20orthopedic services, pediatric services, noninvasive cardiac diagnostics, behavioral health
5.21services, and emergency room services;
5.22(iv) the new hospital:
5.23(A) will have the ability to provide and staff sufficient new beds to meet the growing
5.24needs of the Maple Grove service area and the surrounding communities currently being
5.25served by the hospital or health system that will own or control the entity that will hold the
5.26new hospital license;
5.27(B) will provide uncompensated care;
5.28(C) will provide mental health services, including inpatient beds;
5.29(D) will be a site for workforce development for a broad spectrum of health-care-related
5.30occupations and have a commitment to providing clinical training programs for physicians
5.31and other health care providers;
5.32(E) will demonstrate a commitment to quality care and patient safety;
6.1(F) will have an electronic medical records system, including physician order entry;
6.2(G) will provide a broad range of senior services;
6.3(H) will provide emergency medical services that will coordinate care with regional
6.4providers of trauma services and licensed emergency ambulance services in order to enhance
6.5the continuity of care for emergency medical patients; and
6.6(I) will be completed by December 31, 2009, unless delayed by circumstances beyond
6.7the control of the entity holding the new hospital license; and
6.8(v) as of 30 days following submission of a written plan, the commissioner of health
6.9has not determined that the hospitals or health systems that will own or control the entity
6.10that will hold the new hospital license are unable to meet the criteria of this clause;
6.11(21) a project approved under section 144.553;
6.12(22) a project for the construction of a hospital with up to 25 beds in Cass County within
6.13a 20-mile radius of the state Ah-Gwah-Ching facility, provided the hospital's license holder
6.14is approved by the Cass County Board;
6.15(23) a project for an acute care hospital in Fergus Falls that will increase the bed capacity
6.16from 108 to 110 beds by increasing the rehabilitation bed capacity from 14 to 16 and closing
6.17a separately licensed 13-bed skilled nursing facility;
6.18(24) notwithstanding section 144.552, a project for the construction and expansion of a
6.19specialty psychiatric hospital in Hennepin County for up to 50 beds, exclusively for patients
6.20who are under 21 years of age on the date of admission. The commissioner conducted a
6.21public interest review of the mental health needs of Minnesota and the Twin Cities
6.22metropolitan area in 2008. No further public interest review shall be conducted for the
6.23construction or expansion project under this clause;
6.24(25) a project for a 16-bed psychiatric hospital in the city of Thief River Falls, if the
6.25commissioner finds the project is in the public interest after the public interest review
6.26conducted under section 144.552 is complete;
6.27(26)(i) a project for a 20-bed psychiatric hospital, within an existing facility in the city
6.28of Maple Grove, exclusively for patients who are under 21 years of age on the date of
6.29admission, if the commissioner finds the project is in the public interest after the public
6.30interest review conducted under section 144.552 is complete;
7.1(ii) this project shall serve patients in the continuing care benefit program under section
7.2256.9693. The project may also serve patients not in the continuing care benefit program;
7.3and
7.4(iii) if the project ceases to participate in the continuing care benefit program, the
7.5commissioner must complete a subsequent public interest review under section 144.552. If
7.6the project is found not to be in the public interest, the license must be terminated six months
7.7from the date of that finding. If the commissioner of human services terminates the contract
7.8without cause or reduces per diem payment rates for patients under the continuing care
7.9benefit program below the rates in effect for services provided on December 31, 2015, the
7.10project may cease to participate in the continuing care benefit program and continue to
7.11operate without a subsequent public interest review;
7.12(27) a project involving the addition of 21 new beds in an existing psychiatric hospital
7.13in Hennepin County that is exclusively for patients who are under 21 years of age on the
7.14date of admission;
7.15(28) a project to add 55 licensed beds in an existing safety net, level I trauma center
7.16hospital in Ramsey County as designated under section 383A.91, subdivision 5, of which
7.1715 beds are to be used for inpatient mental health and 40 are to be used for other services.
7.18In addition, five unlicensed observation mental health beds shall be added;
7.19(29) upon submission of a plan to the commissioner for public interest review under
7.20section 144.552 and the addition of the 15 inpatient mental health beds specified in clause
7.21(28), to its bed capacity, a project to add 45 licensed beds in an existing safety net, level I
7.22trauma center hospital in Ramsey County as designated under section 383A.91, subdivision
7.235. Five of the 45 additional beds authorized under this clause must be designated for use
7.24for inpatient mental health and must be added to the hospital's bed capacity before the
7.25remaining 40 beds are added. Notwithstanding section 144.552, the hospital may add licensed
7.26beds under this clause prior to completion of the public interest review, provided the hospital
7.27submits its plan by the 2021 deadline and adheres to the timelines for the public interest
7.28review described in section 144.552; or
7.29(30) upon submission of a plan to the commissioner for public interest review under
7.30section 144.552, a project to add up to 30 licensed beds in an existing psychiatric hospital
7.31in Hennepin County that exclusively provides care to patients who are under 21 years of
7.32age on the date of admission. Notwithstanding section 144.552, the psychiatric hospital
7.33may add licensed beds under this clause prior to completion of the public interest review,
8.1provided the hospital submits its plan by the 2021 deadline and adheres to the timelines for
8.2the public interest review described in section 144.552; or
8.3(31) a project for a 144-bed psychiatric hospital on the site of the former Bethesda
8.4hospital in the city of Saint Paul, Ramsey County, if the commissioner finds the project is
8.5in the public interest after the public interest review conducted under section 144.552 is
8.6complete. Following the completion of the construction project, the commissioner of health
8.7shall monitor the hospital, including by assessing the hospital's case mix and payer mix,
8.8patient transfers, and patient diversions. The hospital must have an intake and assessment
8.9area. The hospital must accommodate patients with acute mental health needs, whether they
8.10walk up to the facility, are delivered by ambulances or law enforcement, or are transferred
8.11from other facilities. The hospital must comply with subdivision 1a, paragraph (b). The
8.12hospital must annually submit de-identified data to the department in the format and manner
8.13defined by the commissioner.

8.14    Sec. 4. Minnesota Statutes 2020, section 144.551, is amended by adding a subdivision to
8.15read:
8.16    Subd. 1a. Exception for increased mental health bed capacity. (a) From August 1,
8.172022, to July 31, 2027, subdivision 1, paragraph (a), and sections 144.552 and 144.553, do
8.18not apply to:
8.19(1) those portions of any erection, building, alteration, reconstruction, modernization,
8.20improvement, extension, lease, or other acquisition by or on behalf of a hospital that increase
8.21the mental health bed capacity of a hospital; or
8.22(2) the establishment of a new psychiatric hospital.
8.23(b) Any hospital that increases its bed capacity or is established under this subdivision
8.24must:
8.25(1) use all the newly licensed beds exclusively for mental health services;
8.26(2) accept medical assistance and MinnesotaCare enrollees;
8.27(3) abide by the terms of the Minnesota Attorney General Hospital Agreement;
8.28(4) have an arrangement with a tertiary care facility or a sufficient number of medical
8.29specialists to determine and arrange appropriate treatment of medical conditions; and
8.30(5) submit to the commissioner requested information the commissioner deems necessary
8.31for the commissioner to conduct the study of inpatient mental health access and quality
8.32described in paragraph (e).
9.1(c) The commissioner shall monitor the implementation of exceptions under this
9.2subdivision. Each hospital or hospital corporate system granted an exception under this
9.3subdivision shall submit to the commissioner each year a report on how the hospital or
9.4hospital corporate system continues to satisfy the conditions on which the exception was
9.5granted.
9.6(d) Any hospital found to be in violation of this subdivision is subject to sanction under
9.7section 144.55, subdivision 6, paragraph (c).
9.8(e) By January 15, 2027, the commissioner of health shall submit to the chairs and
9.9ranking minority members of the legislative committees and divisions with jurisdiction over
9.10health a report containing the result of a study of inpatient mental health access and quality.
9.11The report must contain:
9.12(1) the location of every hospital that has expanded its capacity or been established under
9.13this subdivision;
9.14(2) summary data by location of the patient population served in the newly licensed
9.15beds, including age, duration of stay, and county of residence; and
9.16(3) an analysis of the change in access and quality of inpatient mental health care in
9.17Minnesota resulting from the enactment of this subdivision.
9.18A hospital that expands its capacity or is established under this subdivision must provide
9.19the information and data the commissioner requests to fulfill the requirements of this
9.20paragraph. For the purposes of section 144.55, subdivision 6, paragraph (c), a hospital's
9.21failure to provide data requested by the commissioner is a failure to satisfy the conditions
9.22on which an exception is granted under this subdivision.
9.23(f) The commissioner may request from other hospitals information that the commissioner
9.24deems necessary to perform the analysis required under paragraph (e).
9.25(g) No psychiatric hospital may be established on the site of the former Bethesda hospital
9.26in Saint Paul, Ramsey County, unless the commissioner determines that establishment of
9.27the hospital is in the public interest after completing a public interest review under section
9.28144.552.
9.29EFFECTIVE DATE.This section is effective the day following final enactment.

9.30    Sec. 5. [245.096] CHANGES TO GRANT PROGRAMS.
9.31Prior to implementing any substantial changes to a grant funding formula disbursed
9.32through allocations administered by the commissioner, the commissioner must provide a
10.1report on the nature of the changes, the effect the changes will have, whether any funding
10.2will change, and other relevant information, to the chairs and ranking minority members of
10.3the legislative committees with jurisdiction over human services. The report must be provided
10.4prior to the start of a regular session and the proposed changes cannot be implemented until
10.5after the adjournment of that regular session.

10.6    Sec. 6. Minnesota Statutes 2020, section 245.4661, as amended by Laws 2021, chapter
10.730, article 17, section 21, is amended to read:
10.8245.4661 ~~PILOT PROJECTS;~~ ADULT MENTAL HEALTH INITIATIVE
10.9SERVICES.
10.10    Subdivision 1. ~~Authorization for pilot projects~~ Adult mental health initiative
10.11services. ~~The commissioner of human services may approve pilot projects to provide~~
10.12~~alternatives to or enhance coordination of~~ Each county board, county boards acting jointly,
10.13or tribal government must provide or contract for sufficient infrastructure for the delivery
10.14of mental health services ~~required~~ under the Minnesota Comprehensive Adult Mental Health
10.15Act, sections 245.461 to 245.486.
10.16    Subd. 2. Program design and implementation. ~~The pilot projects~~ Adult mental health
10.17initiatives shall be ~~established to design, plan, and improve the~~ responsible for designing,
10.18planning, improving, and maintaining a mental health service delivery system for adults
10.19with serious and persistent mental illness that would:
10.20(1) provide an expanded array of services from which clients can choose services
10.21appropriate to their needs;
10.22(2) be based on purchasing strategies that improve access and coordinate services without
10.23cost shifting;
10.24(3) prioritize evidence-based services and implement services that are promising practices
10.25or theory-based practices so that the service can be evaluated according to subdivision 5a;
10.26~~(3)~~ (4) incorporate existing state facilities and resources into the community mental
10.27health infrastructure through creative partnerships with local vendors; and
10.28~~(4)~~ (5) utilize existing categorical funding streams and reimbursement sources in
10.29combined and creative ways, except appropriations to regional treatment centers and all
10.30funds that are attributable to the operation of state-operated services are excluded unless
10.31appropriated specifically by the legislature for a purpose consistent with this section or
10.32section 246.0136, subdivision 1.
11.1    Subd. 3. ~~Program~~ Adult mental health initiative evaluation. Evaluation of each ~~project~~
11.2adult mental health initiative will be based on outcome evaluation criteria ~~negotiated with~~
11.3~~each project prior to implementation~~ determined by the commissioners of human services
11.4and management and budget after consultation with stakeholders.
11.5    Subd. 4. Notice of ~~project~~ adult mental health initiative discontinuation. Each ~~project~~
11.6adult mental health initiative may be discontinued for any reason by the ~~project's~~ managing
11.7entity or the commissioner of human services, after 90 days' written notice to the other
11.8party.
11.9    Subd. 5. Planning for ~~pilot projects~~ adult mental health initiatives. ~~(a)~~ Each local
11.10plan for ~~a pilot project, with the exception of the placement of a Minnesota specialty treatment~~
11.11~~facility as defined in paragraph (c),~~ adult mental health initiative services must be developed
11.12under the direction of the county board, or multiple county boards acting jointly, as the local
11.13mental health authority. The planning process for each ~~pilot~~ adult mental health initiative
11.14shall include, but not be limited to, mental health consumers, families, advocates, local
11.15mental health advisory councils, local and state providers, representatives of state and local
11.16public employee bargaining units, and the department of human services. As part of the
11.17planning process, the county board or boards shall designate a managing entity responsible
11.18for receipt of funds and management of ~~the pilot project~~ adult mental health initiatives.
11.19~~(b) For Minnesota specialty treatment facilities, the commissioner shall issue a request~~
11.20~~for proposal for regions in which a need has been identified for services.~~
11.21~~(c) For purposes of this section, "Minnesota specialty treatment facility" is defined as~~
11.22~~an intensive residential treatment service licensed under chapter 245I.~~
11.23    Subd. 5a. Evaluations. The commissioner of management and budget, in consultation
11.24with the commissioner of human services, and within available appropriations, shall create
11.25and maintain an inventory of adult mental health initiative services administered by the
11.26county boards, identifying evidence-based services and services that are theory-based or
11.27promising practices. The commissioner of management and budget, in consultation with
11.28the commissioner of human services, shall select adult mental health initiative services that
11.29are promising practices or theory-based activities for which the commissioner of management
11.30and budget shall conduct evaluations using experimental or quasi-experimental design. The
11.31commissioner of human services, in consultation with the commissioner of management
11.32and budget, shall encourage county boards to administer adult mental health initiative
11.33services to support experimental or quasi-experimental evaluation and shall require county
11.34boards to collect and report information that is needed to complete the inventory and
12.1evaluation for any adult mental health initiative service that is selected for an evaluation.
12.2The commissioner of management and budget, under section 15.08, may obtain additional
12.3relevant data to support the inventory and the experimental or quasi experimental evaluation
12.4studies.
12.5    Subd. 6. Duties of commissioner. (a) For purposes of ~~the pilot projects~~ adult mental
12.6health initiatives, the commissioner shall facilitate integration of funds or other resources
12.7as needed and requested by each ~~project~~ adult mental health initiative. These resources may
12.8include:
12.9(1) community support services funds administered under Minnesota Rules, parts
12.109535.1700 to 9535.1760;
12.11(2) other mental health special project funds;
12.12(3) medical assistance, MinnesotaCare, and housing support under chapter 256I if
12.13requested by the ~~project's~~ adult mental health initiative's managing entity, and if the
12.14commissioner determines this would be consistent with the state's overall health care reform
12.15efforts; and
12.16(4) regional treatment center resources consistent with section 246.0136, subdivision 1.
12.17(b) The commissioner shall consider the following criteria in awarding ~~start-up and~~
12.18~~implementation~~ grants for ~~the pilot projects~~ adult mental health initiatives:
12.19(1) the ability of the ~~proposed projects~~ initiatives to accomplish the objectives described
12.20in subdivision 2;
12.21(2) the size of the target population to be served; and
12.22(3) geographical distribution.
12.23(c) The commissioner shall review overall status of the ~~projects~~ initiatives at least every
12.24two years and recommend any legislative changes needed by January 15 of each
12.25odd-numbered year.
12.26(d) The commissioner may waive administrative rule requirements ~~which~~ that are
12.27incompatible with the implementation of the ~~pilot project~~ adult mental health initiative.
12.28(e) The commissioner may exempt the participating counties from fiscal sanctions for
12.29noncompliance with requirements in laws and rules ~~which~~ that are incompatible with the
12.30implementation of the ~~pilot project~~ adult mental health initiative.
13.1(f) The commissioner may award grants to an entity designated by a county board or
13.2group of county boards to pay for start-up and implementation costs of the ~~pilot project~~
13.3adult mental health initiative.
13.4    Subd. 7. Duties of ~~county~~ adult mental health initiative board. The ~~county~~ adult
13.5mental health initiative board, or other entity which is approved to administer ~~a pilot project~~
13.6an adult mental health initiative, shall:
13.7(1) administer the ~~project~~ initiative in a manner ~~which~~ that is consistent with the objectives
13.8described in subdivision 2 and the planning process described in subdivision 5;
13.9(2) assure that no one is denied services ~~for which~~ that they would otherwise be eligible
13.10for; and
13.11(3) provide the commissioner of human services with timely and pertinent information
13.12through the following methods:
13.13(i) submission of mental health plans and plan amendments which are based on a format
13.14and timetable determined by the commissioner;
13.15(ii) submission of social services expenditure and grant reconciliation reports, based on
13.16a coding format to be determined by mutual agreement between the ~~project's~~ initiative's
13.17managing entity and the commissioner; and
13.18(iii) submission of data and participation in an evaluation of the ~~pilot projects~~ adult
13.19mental health initiatives, to be designed cooperatively by the commissioner and the ~~projects~~
13.20initiatives.
13.21    Subd. 8. Budget flexibility. The commissioner may make budget transfers that do not
13.22increase the state share of costs to effectively implement the restructuring of adult mental
13.23health services.
13.24    Subd. 9. Services and programs. (a) The following three distinct grant programs are
13.25funded under this section:
13.26(1) mental health crisis services;
13.27(2) housing with supports for adults with serious mental illness; and
13.28(3) projects for assistance in transitioning from homelessness (PATH program).
13.29(b) In addition, the following are eligible for grant funds:
13.30(1) community education and prevention;
13.31(2) client outreach;
14.1(3) early identification and intervention;
14.2(4) adult outpatient diagnostic assessment and psychological testing;
14.3(5) peer support services;
14.4(6) community support program services (CSP);
14.5(7) adult residential crisis stabilization;
14.6(8) supported employment;
14.7(9) assertive community treatment (ACT);
14.8(10) housing subsidies;
14.9(11) basic living, social skills, and community intervention;
14.10(12) emergency response services;
14.11(13) adult outpatient psychotherapy;
14.12(14) adult outpatient medication management;
14.13(15) adult mobile crisis services;
14.14(16) adult day treatment;
14.15(17) partial hospitalization;
14.16(18) adult residential treatment;
14.17(19) adult mental health targeted case management;
14.18(20) intensive community rehabilitative services (ICRS); and
14.19(21) transportation.
14.20    Subd. 10. Commissioner duty to report on use of grant funds biennially. By November
14.211, 2016, and biennially thereafter, the commissioner of human services shall provide
14.22sufficient information to the members of the legislative committees having jurisdiction over
14.23mental health funding and policy issues to evaluate the use of funds appropriated under this
14.24section ~~of law~~. The commissioner shall provide, at a minimum, the following information:
14.25    (1) the amount of funding to adult mental health initiatives, what programs and services
14.26were funded in the previous two years, gaps in services that each initiative brought to the
14.27attention of the commissioner, and outcome data for the programs and services that were
14.28funded; and
14.29    (2) the amount of funding for other targeted services and the location of services.
15.1    Subd. 11. Adult mental health initiative funding. When implementing the funding
15.2formula to distribute adult mental health initiative funds, the commissioner shall ensure that
15.3no adult mental health initiative region receives less than the amount the region received
15.4in fiscal year 2022 in combined adult mental health initiative funding.

15.5    Sec. 7. [245.4663] MENTAL HEALTH PROVIDER SUPERVISION GRANT
15.6PROGRAM.
15.7    Subdivision 1. Grant program established. The commissioner shall award grants to
15.8licensed or certified mental health providers who meet the criteria in subdivision 2 to fund
15.9supervision of interns and clinical trainees who are working toward becoming a mental
15.10health professional and to subsidize the costs of licensing applications and examination fees
15.11for clinical trainees.
15.12    Subd. 2. Eligible providers. In order to be eligible for a grant under this section, a mental
15.13health provider must:
15.14(1) provide at least 25 percent of the provider's yearly patient encounters to state public
15.15program enrollees or patients receiving sliding fee schedule discounts through a formal
15.16sliding fee schedule meeting the standards established by the United States Department of
15.17Health and Human Services under Code of Federal Regulations, title 42, section 51c.303;
15.18or
15.19(2) primarily serve underrepresented communities as defined in section 148E.101,
15.20subdivision 20.
15.21    Subd. 3. Application; grant award. A mental health provider seeking a grant under
15.22this section must apply to the commissioner at a time and in a manner specified by the
15.23commissioner. The commissioner shall review each application to determine if the application
15.24is complete, the mental health provider is eligible for a grant, and the proposed project is
15.25an allowable use of grant funds. The commissioner must determine the grant amount awarded
15.26to applicants that the commissioner determines will receive a grant.
15.27    Subd. 4. Allowable uses of grant funds. A mental health provider must use grant funds
15.28received under this section for one or more of the following:
15.29(1) to pay for direct supervision hours for interns and clinical trainees, in an amount up
15.30to $7,500 per intern or clinical trainee;
15.31(2) to establish a program to provide supervision to multiple interns or clinical trainees;
15.32or
16.1(3) to pay licensing application and examination fees for clinical trainees.
16.2    Subd. 5. Program oversight. During the grant period, the commissioner may require
16.3grant recipients to provide the commissioner with information necessary to evaluate the
16.4program.

16.5    Sec. 8. Minnesota Statutes 2020, section 245.4882, is amended by adding a subdivision
16.6to read:
16.7    Subd. 2a. Assessment requirements. (a) A residential treatment service provider must
16.8complete a diagnostic assessment of a child within ten calendar days of the child's admission.
16.9If a diagnostic assessment has been completed by a mental health professional within the
16.10past 180 days, a new diagnostic assessment need not be completed unless in the opinion of
16.11the current treating mental health professional the child's mental health status has changed
16.12markedly since the assessment was completed.
16.13(b) Notwithstanding the timeline requirements under Minnesota Rules, part 2960.0070,
16.14subpart 5, item C, subitems (1) and (2), the license holder must complete the screenings
16.15required by Minnesota Rules, part 2960.0070, subpart 5, item A, subitems (2), (3), (4), and
16.16(6), within ten calendar days. The license holder must complete the screenings required
16.17under Minnesota Rules, part 2960.0070, subpart 5, item A, subitems (1) and (5), according
16.18to the timelines in Minnesota Rules, part 2960.0070, subpart 5, item C, subitems (1) to (3).
16.19EFFECTIVE DATE.This section is effective January 1, 2023, or upon federal approval,
16.20whichever is later.

16.21    Sec. 9. Minnesota Statutes 2020, section 245.4882, is amended by adding a subdivision
16.22to read:
16.23    Subd. 6. Crisis admissions and stabilization. (a) A child may be referred for residential
16.24treatment services under this section for the purpose of crisis stabilization by:
16.25(1) a mental health professional as defined in section 245I.04, subdivision 2;
16.26(2) a physician licensed under chapter 147 who is assessing a child in an emergency
16.27department; or
16.28(3) a member of a mobile crisis team who meets the qualifications under section
16.29256B.0624, subdivision 5.
17.1(b) A provider making a referral under paragraph (a) must conduct an assessment of the
17.2child's mental health needs and make a determination that the child is experiencing a mental
17.3health crisis and is in need of residential treatment services under this section.
17.4(c) A child may receive services under this subdivision for up to 30 days and must be
17.5subject to the screening and admissions criteria and processes under section 245.4885
17.6thereafter.
17.7EFFECTIVE DATE.This section is effective January 1, 2023, or upon federal approval,
17.8whichever is later. The commissioner of human services shall notify the revisor of statutes
17.9when federal approval is obtained.

17.10    Sec. 10. Minnesota Statutes 2021 Supplement, section 245.4885, subdivision 1, is amended
17.11to read:
17.12    Subdivision 1. Admission criteria. (a) Prior to admission or placement, except in the
17.13case of an emergency, all children referred for treatment of severe emotional disturbance
17.14in a treatment foster care setting, residential treatment facility, or informally admitted to a
17.15regional treatment center shall undergo an assessment to determine the appropriate level of
17.16care if county funds are used to pay for the child's services. An emergency includes when
17.17a child is in need of and has been referred for crisis stabilization services under section
17.18245.4882, subdivision 6. A child who has been referred to residential treatment for crisis
17.19stabilization services in a residential treatment center is not required to undergo an assessment
17.20under this section.
17.21(b) The county board shall determine the appropriate level of care for a child when
17.22county-controlled funds are used to pay for the child's residential treatment under this
17.23chapter, including residential treatment provided in a qualified residential treatment program
17.24as defined in section 260C.007, subdivision 26d. When a county board does not have
17.25responsibility for a child's placement and the child is enrolled in a prepaid health program
17.26under section 256B.69, the enrolled child's contracted health plan must determine the
17.27appropriate level of care for the child. When Indian Health Services funds or funds of a
17.28tribally owned facility funded under the Indian Self-Determination and Education Assistance
17.29Act, Public Law 93-638, are used for the child, the Indian Health Services or 638 tribal
17.30health facility must determine the appropriate level of care for the child. When more than
17.31one entity bears responsibility for a child's coverage, the entities shall coordinate level of
17.32care determination activities for the child to the extent possible.
17.33(c) The child's level of care determination shall determine whether the proposed treatment:
18.1(1) is necessary;
18.2(2) is appropriate to the child's individual treatment needs;
18.3(3) cannot be effectively provided in the child's home; and
18.4(4) provides a length of stay as short as possible consistent with the individual child's
18.5needs.
18.6(d) When a level of care determination is conducted, the county board or other entity
18.7may not determine that a screening of a child, referral, or admission to a residential treatment
18.8facility is not appropriate solely because services were not first provided to the child in a
18.9less restrictive setting and the child failed to make progress toward or meet treatment goals
18.10in the less restrictive setting. The level of care determination must be based on a diagnostic
18.11assessment of a child that evaluates the child's family, school, and community living
18.12situations; and an assessment of the child's need for care out of the home using a validated
18.13tool which assesses a child's functional status and assigns an appropriate level of care to the
18.14child. The validated tool must be approved by the commissioner of human services and
18.15may be the validated tool approved for the child's assessment under section 260C.704 if the
18.16juvenile treatment screening team recommended placement of the child in a qualified
18.17residential treatment program. If a diagnostic assessment has been completed by a mental
18.18health professional within the past 180 days, a new diagnostic assessment need not be
18.19completed unless in the opinion of the current treating mental health professional the child's
18.20mental health status has changed markedly since the assessment was completed. The child's
18.21parent shall be notified if an assessment will not be completed and of the reasons. A copy
18.22of the notice shall be placed in the child's file. Recommendations developed as part of the
18.23level of care determination process shall include specific community services needed by
18.24the child and, if appropriate, the child's family, and shall indicate whether these services
18.25are available and accessible to the child and the child's family. The child and the child's
18.26family must be invited to any meeting where the level of care determination is discussed
18.27and decisions regarding residential treatment are made. The child and the child's family
18.28may invite other relatives, friends, or advocates to attend these meetings.
18.29(e) During the level of care determination process, the child, child's family, or child's
18.30legal representative, as appropriate, must be informed of the child's eligibility for case
18.31management services and family community support services and that an individual family
18.32community support plan is being developed by the case manager, if assigned.
19.1(f) The level of care determination, placement decision, and recommendations for mental
19.2health services must be documented in the child's record and made available to the child's
19.3family, as appropriate.
19.4EFFECTIVE DATE.This section is effective January 1, 2023, or upon federal approval,
19.5whichever is later. The commissioner of human services shall notify the revisor of statutes
19.6when federal approval is obtained.

19.7    Sec. 11. [245.4905] FIRST EPISODE OF PSYCHOSIS GRANT PROGRAM.
19.8    Subdivision 1. Creation. The first episode of psychosis grant program is established in
19.9the Department of Human Services to fund evidence-based interventions for youth at risk
19.10of developing or experiencing a first episode of psychosis and a public awareness campaign
19.11on the signs and symptoms of psychosis. First episode of psychosis services are eligible for
19.12children's mental health grants as specified in section 245.4889, subdivision 1, paragraph
19.13(b), clause (15).
19.14    Subd. 2. Activities. (a) All first episode of psychosis grant programs must:
19.15(1) provide intensive treatment and support for adolescents and adults experiencing or
19.16at risk of experiencing a first psychotic episode. Intensive treatment and support includes
19.17medication management, psychoeducation for an individual and an individual's family, case
19.18management, employment support, education support, cognitive behavioral approaches,
19.19social skills training, peer support, crisis planning, and stress management;
19.20(2) conduct outreach and provide training and guidance to mental health and health care
19.21professionals, including postsecondary health clinicians, on early psychosis symptoms,
19.22screening tools, and best practices;
19.23(3) ensure access for individuals to first psychotic episode services under this section,
19.24including access for individuals who live in rural areas; and
19.25(4) use all available funding streams.
19.26(b) Grant money may also be used to pay for housing or travel expenses for individuals
19.27receiving services or to address other barriers preventing individuals and their families from
19.28participating in first psychotic episode services.
19.29    Subd. 3. Eligibility. Program activities must be provided to people 15 to 40 years old
19.30with early signs of psychosis.
19.31    Subd. 4. Outcomes. Evaluation of program activities must utilize evidence-based
19.32practices and must include the following outcome evaluation criteria:
20.1(1) whether individuals experience a reduction in psychotic symptoms;
20.2(2) whether individuals experience a decrease in inpatient mental health hospitalizations;
20.3and
20.4(3) whether individuals experience an increase in educational attainment.
20.5    Subd. 5. Federal aid or grants. The commissioner of human services must comply with
20.6all conditions and requirements necessary to receive federal aid or grants.

20.7    Sec. 12. [245A.26] CHILDREN'S RESIDENTIAL FACILITY CRISIS
20.8STABILIZATION SERVICES.
20.9    Subdivision 1. Definitions. (a) For the purposes of this section, the terms defined in this
20.10subdivision have the meanings given.
20.11(b) "Clinical trainee" means a staff person who is qualified under section 245I.04,
20.12subdivision 6.
20.13(c) "License holder" means an individual, organization, or government entity that was
20.14issued a license by the commissioner of human services under this chapter for residential
20.15mental health treatment for children with emotional disturbance according to Minnesota
20.16Rules, parts 2960.0010 to 2960.0220 and 2960.0580 to 2960.0700, or shelter care services
20.17according to Minnesota Rules, parts 2960.0010 to 2960.0120 and 2960.0510 to 2960.0530.
20.18(d) "Mental health professional" means an individual who is qualified under section
20.19245I.04, subdivision 2.
20.20    Subd. 2. Scope and applicability. (a) This section establishes additional licensing
20.21requirements for a children's residential facility to provide children's residential crisis
20.22stabilization services to a client who is experiencing a mental health crisis and is in need of
20.23residential treatment services.
20.24(b) A children's residential facility may provide residential crisis stabilization services
20.25only if the facility is licensed to provide:
20.26(1) residential mental health treatment for children with emotional disturbance according
20.27to Minnesota Rules, parts 2960.0010 to 2960.0220 and 2960.0580 to 2960.0700; or
20.28(2) shelter care services according to Minnesota Rules, parts 2960.0010 to 2960.0120
20.29and 2960.0510 to 2960.0530.
20.30(c) If a client receives residential crisis stabilization services for 35 days or fewer in a
20.31facility licensed according to paragraph (b), clause (1), the facility is not required to complete
21.1a diagnostic assessment or treatment plan under Minnesota Rules, part 2960.0180, subpart
21.22, and part 2960.0600.
21.3(d) If a client receives residential crisis stabilization services for 35 days or fewer in a
21.4facility licensed according to paragraph (b), clause (2), the facility is not required to develop
21.5a plan for meeting the client's immediate needs under Minnesota Rules, part 2960.0520,
21.6subpart 3.
21.7    Subd. 3. Eligibility for services. An individual is eligible for children's residential crisis
21.8stabilization services if the individual is under 21 years of age and meets the eligibility
21.9criteria for crisis services under section 256B.0624, subdivision 3.
21.10    Subd. 4. Required services; providers. (a) A license holder providing residential crisis
21.11stabilization services must continually follow a client's individual crisis treatment plan to
21.12improve the client's functioning.
21.13(b) The license holder must offer and have the capacity to directly provide the following
21.14treatment services to a client:
21.15(1) crisis stabilization services as described in section 256B.0624, subdivision 7;
21.16(2) mental health services as specified in the client's individual crisis treatment plan,
21.17according to the client's treatment needs;
21.18(3) health services and medication administration, if applicable; and
21.19(4) referrals for the client to community-based treatment providers and support services
21.20for the client's transition from residential crisis stabilization to another treatment setting.
21.21(c) Children's residential crisis stabilization services must be provided by a qualified
21.22staff person listed in section 256B.0624, subdivision 8, according to the scope of practice
21.23for the individual staff person's position.
21.24    Subd. 5. Assessment and treatment planning. (a) Within 12 hours of a client's admission
21.25for residential crisis stabilization, the license holder must assess the client and document
21.26the client's immediate needs, including the client's:
21.27(1) health and safety, including the need for crisis assistance;
21.28(2) need for connection to family and other natural supports;
21.29(3) if applicable, housing and legal issues; and
21.30(4) if applicable, responsibilities for children, family, and other natural supports, and
21.31employers.
22.1(b) Within 24 hours of a client's admission for residential crisis stabilization, the license
22.2holder must complete a crisis treatment plan for the client, according to the requirements
22.3for a crisis treatment plan under section 256B.0624, subdivision 11. The license holder must
22.4base the client's crisis treatment plan on the client's referral information and the assessment
22.5of the client's immediate needs under paragraph (a). A mental health professional or a clinical
22.6trainee under the supervision of a mental health professional must complete the crisis
22.7treatment plan. A crisis treatment plan completed by a clinical trainee must contain
22.8documentation of approval, as defined in section 245I.02, subdivision 2, by a mental health
22.9professional within five business days of initial completion by the clinical trainee.
22.10(c) A mental health professional must review a client's crisis treatment plan each week
22.11and document the weekly reviews in the client's client file.
22.12(d) For a client receiving children's residential crisis stabilization services who is 18
22.13years of age or older, the license holder must complete an individual abuse prevention plan
22.14for the client, pursuant to section 245A.65, subdivision 2, as part of the client's crisis
22.15treatment plan.
22.16    Subd. 6. Staffing requirements. Staff members of facilities providing services under
22.17this section must have access to a mental health professional or clinical trainee within 30
22.18minutes, either in person or by telephone. The license holder must maintain a current schedule
22.19of available mental health professionals or clinical trainees and include contact information
22.20for each mental health professional or clinical trainee. The schedule must be readily available
22.21to all staff members.

22.22    Sec. 13. Minnesota Statutes 2021 Supplement, section 245I.23, is amended by adding a
22.23subdivision to read:
22.24    Subd. 19a. Additional requirements for locked program facility. (a) A license holder
22.25that prohibits clients from leaving the facility by locking exit doors or other permissible
22.26methods must meet the additional requirements of this subdivision.
22.27(b) The license holder must meet all applicable building and fire codes to operate a
22.28building with locked exit doors. The license holder must have the appropriate license from
22.29the Department of Health, as determined by the Department of Health, for operating a
22.30program with locked exit doors.
22.31(c) The license holder's policies and procedures must clearly describe the types of court
22.32orders that authorize the license holder to prohibit clients from leaving the facility.
23.1(d) For each client present in the facility under a court order, the license holder must
23.2maintain documentation of the court order authorizing the license holder to prohibit the
23.3client from leaving the facility.
23.4(e) Upon a client's admission to a locked program facility, the license holder must
23.5document in the client file that the client was informed:
23.6(1) that the client has the right to leave the facility according to the client's rights under
23.7section 144.651, subdivision 21, if the client is not subject to a court order authorizing the
23.8license holder to prohibit the client from leaving the facility; or
23.9(2) that the client cannot leave the facility due to a court order authorizing the license
23.10holder to prohibit the client from leaving the facility.
23.11(f) If the license holder prohibits a client from leaving the facility, the client's treatment
23.12plan must reflect this restriction.

23.13    Sec. 14. Minnesota Statutes 2020, section 253B.07, subdivision 2a, is amended to read:
23.14    Subd. 2a. Petition originating from criminal proceedings. (a) If criminal charges are
23.15pending against a defendant, the court shall order simultaneous competency and civil
23.16commitment examinations in accordance with Minnesota Rules of Criminal Procedure, rule
23.1720.04, when the following conditions are met:
23.18(1) the prosecutor or defense counsel doubts the defendant's competency and a motion
23.19is made challenging competency, or the court on its initiative raises the issue under section
23.20611.42 or Rules of Criminal Procedure, rule 20.01; and
23.21(2) the prosecutor and defense counsel agree simultaneous examinations are appropriate.
23.22No additional examination under subdivision 3 is required in a subsequent civil commitment
23.23proceeding unless a second examination is requested by defense counsel appointed following
23.24the filing of any petition for commitment.
23.25(b) Only a court examiner may conduct an assessment as described in section 611.43 or
23.26Minnesota Rules of Criminal Procedure, rules 20.01, subdivision 4, and 20.02, subdivision
23.272.
23.28(c) Where a county is ordered to consider civil commitment following a determination
23.29of incompetency under section 611.45 or Minnesota Rules of Criminal Procedure, rule
23.3020.01, the county in which the criminal matter is pending is responsible to conduct prepetition
23.31screening and, if statutory conditions for commitment are satisfied, to file the commitment
23.32petition in that county. By agreement between county attorneys, prepetition screening and
24.1filing the petition may be handled in the county of financial responsibility or the county
24.2where the proposed patient is present.
24.3(d) Following an acquittal of a person of a criminal charge under section 611.026, the
24.4petition shall be filed by the county attorney of the county in which the acquittal took place
24.5and the petition shall be filed with the court in which the acquittal took place, and that court
24.6shall be the committing court for purposes of this chapter. When a petition is filed pursuant
24.7to subdivision 2 with the court in which acquittal of a criminal charge took place, the court
24.8shall assign the judge before whom the acquittal took place to hear the commitment
24.9proceedings unless that judge is unavailable.

24.10    Sec. 15. Minnesota Statutes 2021 Supplement, section 254B.05, subdivision 1a, is amended
24.11to read:
24.12    Subd. 1a. Room and board provider requirements. (a) Effective January 1, 2000,
24.13vendors of room and board are eligible for behavioral health fund payment if the vendor:
24.14(1) has rules prohibiting residents bringing chemicals into the facility or using chemicals
24.15while residing in the facility and provide consequences for infractions of those rules;
24.16(2) is determined to meet applicable health and safety requirements;
24.17(3) is not a jail or prison;
24.18(4) is not concurrently receiving funds under chapter 256I for the recipient;
24.19(5) admits individuals who are 18 years of age or older;
24.20(6) is registered as a board and lodging or lodging establishment according to section
24.21157.17;
24.22(7) has awake staff on site 24 hours per day;
24.23(8) has staff who are at least 18 years of age and meet the requirements of section
24.24245G.11, subdivision 1, paragraph (b);
24.25(9) has emergency behavioral procedures that meet the requirements of section 245G.16;
24.26(10) meets the requirements of section 245G.08, subdivision 5, if administering
24.27medications to clients;
24.28(11) meets the abuse prevention requirements of section 245A.65, including a policy on
24.29fraternization and the mandatory reporting requirements of section 626.557;
24.30(12) documents coordination with the treatment provider to ensure compliance with
24.31section 254B.03, subdivision 2;
25.1(13) protects client funds and ensures freedom from exploitation by meeting the
25.2provisions of section 245A.04, subdivision 13;
25.3(14) has a grievance procedure that meets the requirements of section 245G.15,
25.4subdivision 2; and
25.5(15) has sleeping and bathroom facilities for men and women separated by a door that
25.6is locked, has an alarm, or is supervised by awake staff.
25.7(b) Programs licensed according to Minnesota Rules, chapter 2960, are exempt from
25.8paragraph (a), clauses (5) to (15).
25.9(c) Programs providing children's mental health crisis admissions and stabilization under
25.10section 245.4882, subdivision 6, are eligible vendors of room and board.
25.11~~(c)~~ (d) Licensed programs providing intensive residential treatment services or residential
25.12crisis stabilization services pursuant to section 256B.0622 or 256B.0624 are eligible vendors
25.13of room and board and are exempt from paragraph (a), clauses (6) to (15).

25.14    Sec. 16. Minnesota Statutes 2021 Supplement, section 256B.0625, subdivision 56a, is
25.15amended to read:
25.16    Subd. 56a. Officer-involved community-based care coordination. (a) Medical
25.17assistance covers officer-involved community-based care coordination for an individual
25.18who:
25.19(1) has screened positive for benefiting from treatment for a mental illness or substance
25.20use disorder using a tool approved by the commissioner;
25.21(2) does not require the security of a public detention facility and is not considered an
25.22inmate of a public institution as defined in Code of Federal Regulations, title 42, section
25.23435.1010;
25.24(3) meets the eligibility requirements in section 256B.056; and
25.25(4) has agreed to participate in officer-involved community-based care coordination.
25.26(b) Officer-involved community-based care coordination means navigating services to
25.27address a client's mental health, chemical health, social, economic, and housing needs, or
25.28any other activity targeted at reducing the incidence of jail utilization and connecting
25.29individuals with existing covered services available to them, including, but not limited to,
25.30targeted case management, waiver case management, or care coordination.
26.1(c) Officer-involved community-based care coordination must be provided by an
26.2individual who is an employee of or is under contract with a county, or is an employee of
26.3or under contract with an Indian health service facility or facility owned and operated by a
26.4tribe or a tribal organization operating under Public Law 93-638 as a 638 facility to provide
26.5officer-involved community-based care coordination and is qualified under one of the
26.6following criteria:
26.7(1) a mental health professional;
26.8(2) a clinical trainee qualified according to section 245I.04, subdivision 6, working under
26.9the treatment supervision of a mental health professional according to section 245I.06;
26.10(3) a mental health practitioner qualified according to section 245I.04, subdivision 4,
26.11working under the treatment supervision of a mental health professional according to section
26.12245I.06;
26.13(4) a mental health certified peer specialist qualified according to section 245I.04,
26.14subdivision 10, working under the treatment supervision of a mental health professional
26.15according to section 245I.06;
26.16(5) an individual qualified as an alcohol and drug counselor under section 245G.11,
26.17subdivision 5; or
26.18(6) a recovery peer qualified under section 245G.11, subdivision 8, working under the
26.19supervision of an individual qualified as an alcohol and drug counselor under section
26.20245G.11, subdivision 5.
26.21(d) Reimbursement is allowed for up to 60 days following the initial determination of
26.22eligibility.
26.23(e) Providers of officer-involved community-based care coordination shall annually
26.24report to the commissioner on the number of individuals served, and number of the
26.25community-based services that were accessed by recipients. The commissioner shall ensure
26.26that services and payments provided under officer-involved community-based care
26.27coordination do not duplicate services or payments provided under section 256B.0625,
26.28subdivision 20, 256B.0753, 256B.0755, or 256B.0757.
26.29~~(f) Notwithstanding section~~ ~~256B.19, subdivision 1, the nonfederal share of cost for~~
26.30~~officer-involved community-based care coordination services shall be provided by the~~
26.31~~county providing the services, from sources other than federal funds or funds used to match~~
26.32~~other federal funds.~~
27.1EFFECTIVE DATE.This section is effective January 1, 2023, or upon federal approval,
27.2whichever is later.

27.3    Sec. 17. Minnesota Statutes 2021 Supplement, section 256B.0946, subdivision 1, is
27.4amended to read:
27.5    Subdivision 1. Required covered service components. (a) Subject to federal approval,
27.6medical assistance covers medically necessary intensive behavioral health treatment services
27.7when the services are provided by a provider entity certified under and meeting the standards
27.8in this section. The provider entity must make reasonable and good faith efforts to report
27.9individual client outcomes to the commissioner, using instruments and protocols approved
27.10by the commissioner.
27.11(b) Intensive behavioral health treatment services to children with mental illness residing
27.12in foster family settings or with legal guardians that comprise specific required service
27.13components provided in clauses (1) to (6) are reimbursed by medical assistance when they
27.14meet the following standards:
27.15(1) psychotherapy provided by a mental health professional or a clinical trainee;
27.16(2) crisis planning;
27.17(3) individual, family, and group psychoeducation services provided by a mental health
27.18professional or a clinical trainee;
27.19(4) clinical care consultation provided by a mental health professional or a clinical
27.20trainee;
27.21(5) individual treatment plan development as defined in Minnesota Rules, part 9505.0371,
27.22subpart 7; and
27.23(6) service delivery payment requirements as provided under subdivision 4.
27.24EFFECTIVE DATE.This section is effective July 1, 2023, or upon federal approval,
27.25whichever is later. The commissioner of human services shall notify the revisor of statutes
27.26when federal approval is obtained.

27.27    Sec. 18. Minnesota Statutes 2021 Supplement, section 256B.0946, subdivision 1a, is
27.28amended to read:
27.29    Subd. 1a. Definitions. For the purposes of this section, the following terms have the
27.30meanings given them.
28.1(a) "At risk" means the child has experienced severe difficulty in managing mental health
28.2and behavior in multiple settings; has received a diagnosis of mental illness within the past
28.3180 days; and meets one of the following criteria:
28.4(1) has previously been in a residential or inpatient mental health treatment program,
28.5including a program licensed under Minnesota Rules, chapter 2960, for mental health issues
28.6within the past six months;
28.7(2) has a history of threatening harm to self or others and has actively engaged in
28.8self-harming or threatening behavior in the past 30 days;
28.9(3) has experienced interventions from mental health service programs, social services,
28.10mobile crisis programs, or law enforcement, or experienced the use of seclusion and restraints
28.11in school, to maintain safety in the child's home, community, or school within the past 60
28.12days; or
28.13(4) has a history of repeated intervention from mental health programs, social services,
28.14mobile crisis programs, or law enforcement to maintain safety in the child's home,
28.15community, or school within the past 60 days.
28.16~~(a)~~ (b) "Clinical care consultation" means communication from a treating clinician to
28.17other providers working with the same client to inform, inquire, and instruct regarding the
28.18client's symptoms, strategies for effective engagement, care and intervention needs, and
28.19treatment expectations across service settings, including but not limited to the client's school,
28.20social services, day care, probation, home, primary care, medication prescribers, disabilities
28.21services, and other mental health providers and to direct and coordinate clinical service
28.22components provided to the client and family.
28.23~~(b)~~ (c) "Clinical trainee" means a staff person who is qualified according to section
28.24245I.04, subdivision 6.
28.25~~(c)~~ (d) "Crisis planning" has the meaning given in section 245.4871, subdivision 9a.
28.26~~(d)~~ (e) "Culturally appropriate" means providing mental health services in a manner that
28.27incorporates the child's cultural influences into interventions as a way to maximize resiliency
28.28factors and utilize cultural strengths and resources to promote overall wellness.
28.29~~(e)~~ (f) "Culture" means the distinct ways of living and understanding the world that are
28.30used by a group of people and are transmitted from one generation to another or adopted
28.31by an individual.
28.32~~(f)~~ (g) "Standard diagnostic assessment" means the assessment described in section
28.33245I.10, subdivision 6.
29.1~~(g)~~ (h) "Family" means a person who is identified by the client or the client's parent or
29.2guardian as being important to the client's mental health treatment. Family may include,
29.3but is not limited to, parents, foster parents, children, spouse, committed partners, former
29.4spouses, persons related by blood or adoption, persons who are a part of the client's
29.5permanency plan, or persons who are presently residing together as a family unit.
29.6~~(h)~~ (i) "Foster care" has the meaning given in section 260C.007, subdivision 18.
29.7~~(i)~~ (j) "Foster family setting" means the foster home in which the license holder resides.
29.8~~(j)~~ (k) "Individual treatment plan" means the plan described in section 245I.10,
29.9subdivisions 7 and 8.
29.10~~(k)~~ (l) "Mental health certified family peer specialist" means a staff person who is
29.11qualified according to section 245I.04, subdivision 12.
29.12~~(l)~~ (m) "Mental health professional" means a staff person who is qualified according to
29.13section 245I.04, subdivision 2.
29.14~~(m)~~ (n) "Mental illness" has the meaning given in section 245I.02, subdivision 29.
29.15~~(n)~~ (o) "Parent" has the meaning given in section 260C.007, subdivision 25.
29.16~~(o)~~ (p) "Psychoeducation services" means information or demonstration provided to an
29.17individual, family, or group to explain, educate, and support the individual, family, or group
29.18in understanding a child's symptoms of mental illness, the impact on the child's development,
29.19and needed components of treatment and skill development so that the individual, family,
29.20or group can help the child to prevent relapse, prevent the acquisition of comorbid disorders,
29.21and achieve optimal mental health and long-term resilience.
29.22~~(p)~~ (q) "Psychotherapy" means the treatment described in section 256B.0671, subdivision
29.2311.
29.24~~(q)~~ (r) "Team consultation and treatment planning" means the coordination of treatment
29.25plans and consultation among providers in a group concerning the treatment needs of the
29.26child, including disseminating the child's treatment service schedule to all members of the
29.27service team. Team members must include all mental health professionals working with the
29.28child, a parent, the child unless the team lead or parent deem it clinically inappropriate, and
29.29at least two of the following: an individualized education program case manager; probation
29.30agent; children's mental health case manager; child welfare worker, including adoption or
29.31guardianship worker; primary care provider; foster parent; and any other member of the
29.32child's service team.
30.1~~(r)~~ (s) "Trauma" has the meaning given in section 245I.02, subdivision 38.
30.2~~(s)~~ (t) "Treatment supervision" means the supervision described under section 245I.06.
30.3EFFECTIVE DATE.This section is effective July 1, 2023, or upon federal approval,
30.4whichever is later. The commissioner of human services shall notify the revisor of statutes
30.5when federal approval is obtained.

30.6    Sec. 19. Minnesota Statutes 2021 Supplement, section 256B.0946, subdivision 2, is
30.7amended to read:
30.8    Subd. 2. Determination of client eligibility. An eligible recipient is an individual, from
30.9birth through age 20, who is currently placed in a foster home licensed under Minnesota
30.10Rules, parts 2960.3000 to 2960.3340, or placed in a foster home licensed under the
30.11regulations established by a federally recognized Minnesota Tribe, or who is residing in the
30.12legal guardian's home and is at risk, and has received: (1) a standard diagnostic assessment
30.13within 180 days before the start of service that documents that intensive behavioral health
30.14treatment services are medically necessary ~~within a foster family setting~~ to ameliorate
30.15identified symptoms and functional impairments; and (2) a level of care assessment as
30.16defined in section 245I.02, subdivision 19, that demonstrates that the individual requires
30.17intensive intervention without 24-hour medical monitoring, and a functional assessment as
30.18defined in section 245I.02, subdivision 17. The level of care assessment and the functional
30.19assessment must include information gathered from the placing county, Tribe, or case
30.20manager.
30.21EFFECTIVE DATE.This section is effective July 1, 2023, or upon federal approval,
30.22whichever is later. The commissioner of human services shall notify the revisor of statutes
30.23when federal approval is obtained.

30.24    Sec. 20. Minnesota Statutes 2021 Supplement, section 256B.0946, subdivision 3, is
30.25amended to read:
30.26    Subd. 3. Eligible mental health services providers. (a) Eligible providers for children's
30.27intensive ~~children's mental health~~ behavioral health services ~~in a foster family setting~~ must
30.28be certified by the state ~~and have a service provision contract with a county board or a~~
30.29~~reservation tribal council~~ and must be able to demonstrate the ability to provide all of the
30.30services required in this section and meet the standards in chapter 245I, as required in section
30.31245I.011, subdivision 5.
30.32(b) For purposes of this section, a provider agency must be:
31.1(1) a county-operated entity certified by the state;
31.2(2) an Indian Health Services facility operated by a Tribe or Tribal organization under
31.3funding authorized by United States Code, title 25, sections 450f to 450n, or title 3 of the
31.4Indian Self-Determination Act, Public Law 93-638, section 638 (facilities or providers); or
31.5(3) a noncounty entity.
31.6(c) Certified providers that do not meet the service delivery standards required in this
31.7section shall be subject to a decertification process.
31.8(d) For the purposes of this section, all services delivered to a client must be provided
31.9by a mental health professional or a clinical trainee.
31.10EFFECTIVE DATE.This section is effective July 1, 2023, or upon federal approval,
31.11whichever is later. The commissioner of human services shall notify the revisor of statutes
31.12when federal approval is obtained.

31.13    Sec. 21. Minnesota Statutes 2021 Supplement, section 256B.0946, subdivision 4, is
31.14amended to read:
31.15    Subd. 4. Service delivery payment requirements. (a) To be eligible for payment under
31.16this section, a provider must develop and practice written policies and procedures for
31.17children's intensive ~~treatment in foster care~~ behavioral health services, consistent with
31.18subdivision 1, paragraph (b), and comply with the following requirements in paragraphs
31.19(b) to (n).
31.20(b) Each previous and current mental health, school, and physical health treatment
31.21provider must be contacted to request documentation of treatment and assessments that the
31.22eligible client has received. This information must be reviewed and incorporated into the
31.23standard diagnostic assessment and team consultation and treatment planning review process.
31.24(c) Each client receiving treatment must be assessed for a trauma history, and the client's
31.25treatment plan must document how the results of the assessment will be incorporated into
31.26treatment.
31.27(d) The level of care assessment as defined in section 245I.02, subdivision 19, and
31.28functional assessment as defined in section 245I.02, subdivision 17, must be updated at
31.29least every 90 days or prior to discharge from the service, whichever comes first.
31.30(e) Each client receiving treatment services must have an individual treatment plan that
31.31is reviewed, evaluated, and approved every 90 days using the team consultation and treatment
31.32planning process.
32.1(f) Clinical care consultation must be provided in accordance with the client's individual
32.2treatment plan.
32.3(g) Each client must have a crisis plan within ten days of initiating services and must
32.4have access to clinical phone support 24 hours per day, seven days per week, during the
32.5course of treatment. The crisis plan must demonstrate coordination with the local or regional
32.6mobile crisis intervention team.
32.7(h) Services must be delivered and documented at least three days per week, equaling
32.8at least six hours of treatment per week. If the mental health professional, client, and family
32.9agree, service units may be temporarily reduced for a period of no more than 60 days in
32.10order to meet the needs of the client and family, or as part of transition or on a discharge
32.11plan to another service or level of care. The reasons for service reduction must be identified,
32.12documented, and included in the treatment plan. Billing and payment are prohibited for
32.13days on which no services are delivered and documented.
32.14(i) Location of service delivery must be in the client's home, day care setting, school, or
32.15other community-based setting that is specified on the client's individualized treatment plan.
32.16(j) Treatment must be developmentally and culturally appropriate for the client.
32.17(k) Services must be delivered in continual collaboration and consultation with the
32.18client's medical providers and, in particular, with prescribers of psychotropic medications,
32.19including those prescribed on an off-label basis. Members of the service team must be aware
32.20of the medication regimen and potential side effects.
32.21(l) Parents, siblings, foster parents, legal guardians, and members of the child's
32.22permanency plan must be involved in treatment and service delivery unless otherwise noted
32.23in the treatment plan.
32.24(m) Transition planning for the child must be conducted starting with the first treatment
32.25plan and must be addressed throughout treatment to support the child's permanency plan
32.26and postdischarge mental health service needs.
32.27(n) In order for a provider to receive the daily per-client encounter rate, at least one of
32.28the services listed in subdivision 1, paragraph (b), clauses (1) to (3), must be provided. The
32.29services listed in subdivision 1, paragraph (b), clauses (4) and (5), may be included as part
32.30of the daily per-client encounter rate.
32.31EFFECTIVE DATE.This section is effective July 1, 2023, or upon federal approval,
32.32whichever is later. The commissioner of human services shall notify the revisor of statutes
32.33when federal approval is obtained.

33.1    Sec. 22. Minnesota Statutes 2021 Supplement, section 256B.0946, subdivision 6, is
33.2amended to read:
33.3    Subd. 6. Excluded services. (a) Services in clauses (1) to (7) are not covered under this
33.4section and are not eligible for medical assistance payment as components of children's
33.5intensive ~~treatment in foster care~~ behavioral health services, but may be billed separately:
33.6(1) inpatient psychiatric hospital treatment;
33.7(2) mental health targeted case management;
33.8(3) partial hospitalization;
33.9(4) medication management;
33.10(5) children's mental health day treatment services;
33.11(6) crisis response services under section 256B.0624;
33.12(7) transportation; and
33.13(8) mental health certified family peer specialist services under section 256B.0616.
33.14(b) Children receiving intensive ~~treatment in foster care~~ behavioral health services are
33.15not eligible for medical assistance reimbursement for the following services while receiving
33.16children's intensive ~~treatment in foster care~~ behavioral health services:
33.17(1) psychotherapy and skills training components of children's therapeutic services and
33.18supports under section 256B.0943;
33.19(2) mental health behavioral aide services as defined in section 256B.0943, subdivision
33.201, paragraph (l);
33.21(3) home and community-based waiver services;
33.22(4) mental health residential treatment; and
33.23(5) room and board costs as defined in section 256I.03, subdivision 6.
33.24EFFECTIVE DATE.This section is effective July 1, 2023, or upon federal approval,
33.25whichever is later. The commissioner of human services shall notify the revisor of statutes
33.26when federal approval is obtained.

33.27    Sec. 23. Minnesota Statutes 2020, section 256B.0946, subdivision 7, is amended to read:
33.28    Subd. 7. Medical assistance payment and rate setting. The commissioner shall establish
33.29a single daily per-client encounter rate for children's intensive ~~treatment in foster care~~
33.30behavioral health services. The rate must be constructed to cover only eligible services
34.1delivered to an eligible recipient by an eligible provider, as prescribed in subdivision 1,
34.2paragraph (b).
34.3EFFECTIVE DATE.This section is effective July 1, 2023, or upon federal approval,
34.4whichever is later. The commissioner of human services shall notify the revisor of statutes
34.5when federal approval is obtained.

34.6    Sec. 24. Minnesota Statutes 2021 Supplement, section 256B.763, is amended to read:
34.7256B.763 CRITICAL ACCESS MENTAL HEALTH RATE INCREASE.
34.8    (a) For services defined in paragraph (b) and rendered on or after July 1, 2007, payment
34.9rates shall be increased by 23.7 percent over the rates in effect on January 1, 2006, for:
34.10    (1) psychiatrists and advanced practice registered nurses with a psychiatric specialty;
34.11    (2) community mental health centers under section 256B.0625, subdivision 5; and
34.12    (3) mental health clinics certified under section 245I.20, or hospital outpatient psychiatric
34.13departments that are designated as essential community providers under section 62Q.19.
34.14    (b) This increase applies to group skills training when provided as a component of
34.15children's therapeutic services and support, psychotherapy, medication management,
34.16evaluation and management, diagnostic assessment, explanation of findings, psychological
34.17testing, neuropsychological services, direction of behavioral aides, and inpatient consultation.
34.18    (c) This increase does not apply to rates that are governed by section 256B.0625,
34.19subdivision 30, or 256B.761, paragraph (b), other cost-based rates, rates that are negotiated
34.20with the county, rates that are established by the federal government, or rates that increased
34.21between January 1, 2004, and January 1, 2005.
34.22    (d) ~~The commissioner shall adjust rates paid to prepaid health plans under contract with~~
34.23~~the commissioner to reflect the rate increases provided in paragraphs (a), (e), and (f). The~~
34.24~~prepaid health plan must pass this rate increase to the providers identified in paragraphs (a),~~
34.25~~(e), (f), and (g).~~
34.26    ~~(e)~~ Payment rates shall be increased by 23.7 percent over the rates in effect on December
34.2731, 2007, for:
34.28    (1) medication education services provided on or after January 1, 2008, by adult
34.29rehabilitative mental health services providers certified under section 256B.0623; and
34.30    (2) mental health behavioral aide services provided on or after January 1, 2008, by
34.31children's therapeutic services and support providers certified under section 256B.0943.
35.1    ~~(f)~~ (e) For services defined in paragraph (b) and rendered on or after January 1, 2008,
35.2by children's therapeutic services and support providers certified under section 256B.0943
35.3and not already included in paragraph (a), payment rates shall be increased by 23.7 percent
35.4over the rates in effect on December 31, 2007.
35.5    ~~(g)~~ (f) Payment rates shall be increased by 2.3 percent over the rates in effect on
35.6December 31, 2007, for individual and family skills training provided on or after January
35.71, 2008, by children's therapeutic services and support providers certified under section
35.8256B.0943.
35.9~~(h)~~ (g) For services described in paragraphs (b), ~~(e)~~ (d), and ~~(g)~~ (f) and rendered on or
35.10after July 1, 2017, payment rates for mental health clinics certified under section 245I.20
35.11that are not designated as essential community providers under section 62Q.19 shall be
35.12equal to payment rates for mental health clinics certified under section 245I.20 that are
35.13designated as essential community providers under section 62Q.19. In order to receive
35.14increased payment rates under this paragraph, a provider must demonstrate a commitment
35.15to serve low-income and underserved populations by:
35.16(1) charging for services on a sliding-fee schedule based on current poverty income
35.17guidelines; and
35.18(2) not restricting access or services because of a client's financial limitation.
35.19(i) For services identified under this section that are rendered by providers identified
35.20under this section, managed care plans and county-based purchasing plans shall reimburse
35.21the providers at a rate that is at least equal to the fee-for-service payment rate. The
35.22commissioner shall monitor the effect of this requirement on the rate of access to the services
35.23delivered by mental health providers.
35.24EFFECTIVE DATE.This section is effective January 1, 2023.

35.25    Sec. 25. Minnesota Statutes 2020, section 480.182, is amended to read:
35.26480.182 STATE ASSUMPTION OF CERTAIN COURT COSTS.
35.27Notwithstanding any law to the contrary, the state courts will pay for the following
35.28court-related programs and costs:
35.29(1) court interpreter program costs, including the costs of hiring court interpreters;
35.30(2) guardian ad litem program and personnel costs;
35.31(3) examination costs, not including hospitalization or treatment costs, for mental
35.32commitments and related proceedings under chapter 253B;
36.1(4) examination costs under chapter 611 or rule 20 of the Rules of Criminal Procedure;
36.2(5) in forma pauperis costs;
36.3(6) costs for transcripts mandated by statute, except in appeal cases and postconviction
36.4cases handled by the Board of Public Defense;
36.5(7) jury program costs; and
36.6(8) witness fees and mileage fees specified in sections 253B.23, subdivision 1; 260B.152,
36.7subdivision 2; 260B.331, subdivision 3, clause (1); 260C.152, subdivision 2; 260C.331,
36.8subdivision 3, clause (1); 357.24; 357.32; and 627.02.

36.9    Sec. 26. [611.40] APPLICABILITY.
36.10Notwithstanding Rules of Criminal Procedure, rule 20.01, sections 611.40 to 611.59
36.11shall govern the proceedings for adults when competency to stand trial is at issue. This
36.12section does not apply to juvenile courts. A competency examination ordered under Rules
36.13of Criminal Procedure, rule 20.04, must follow the procedure in section 611.43.

36.14    Sec. 27. [611.41] DEFINITIONS.
36.15    Subdivision 1. Definitions. For the purposes of sections 611.40 to 611.58, the following
36.16terms have the meanings given.
36.17    Subd. 2. Alternative program. "Alternative program" means any mental health or
36.18substance use disorder treatment or program that is not a certified competency restoration
36.19program but may assist a defendant in attaining competency.
36.20    Subd. 3. Cognitive impairment. "Cognitive impairment" means a condition that impairs
36.21a person's memory, perception, communication, learning, or other ability to think. Cognitive
36.22impairment may be caused by any factor including traumatic, developmental, acquired,
36.23infectious, and degenerative processes.
36.24    Subd. 4. Community-based treatment program. "Community-based treatment program"
36.25means treatment and services provided at the community level, including but not limited
36.26to community support services programs as defined in section 245.462, subdivision 6; day
36.27treatment services as defined in section 245.462, subdivision 8; mental health crisis services
36.28as defined in section 245.462, subdivision 14c; outpatient services as defined in section
36.29245.462, subdivision 21; residential treatment services as defined in section 245.462,
36.30subdivision 23; assertive community treatment services provided under section 256B.0622;
36.31adult rehabilitation mental health services provided under section 256B.0623; home and
37.1community-based waivers; and supportive housing. Community-based treatment program
37.2does not include services provided by a state-operated treatment program.
37.3    Subd. 5. Competency restoration program. "Competency restoration program" means
37.4a structured program of clinical and educational services that is certified and designed to
37.5identify and address barriers to a defendant's ability to understand the criminal proceedings,
37.6consult with counsel, and participate in the defense.
37.7    Subd. 6. Competency restoration services. "Competency restoration services" means
37.8education provided by certified individuals to defendants found incompetent to proceed.
37.9Educational services must use the curriculum certified by the State Competency Restoration
37.10Board as the foundation for delivering competency restoration education. Competency
37.11restoration services does not include housing assistance or programs, social services, or
37.12treatment that must be provided by a licensed professional including mental health treatment,
37.13substance use disorder treatment, or co-occurring disorders treatment.
37.14    Subd. 7. Court examiner. "Court examiner" means a person appointed to serve the
37.15court, and who is a physician or licensed psychologist who has a doctoral degree in
37.16psychology.
37.17    Subd. 8. Forensic navigator. "Forensic navigator" means a person who meets the
37.18certification and continuing education requirements under section 611.55, subdivision 4,
37.19and provides the services under section 611.55, subdivision 2.
37.20    Subd. 9. Head of the program. "Head of the program" means the head of the competency
37.21restoration program or the head of the facility or program where the defendant is being
37.22served.
37.23    Subd. 10. Jail-based program. "Jail-based program" means a competency restoration
37.24program that operates within a correctional facility licensed by the commissioner of
37.25corrections under section 241.021 that meets the capacity standards governing jail facilities.
37.26A jail-based program may not be granted a variance to exceed its operational capacity.
37.27    Subd. 11. Locked treatment facility. "Locked treatment facility" means a
37.28community-based treatment program, treatment facility, or state-operated treatment program
37.29that is locked and is licensed by the Department of Health or Department of Human Services.
37.30    Subd. 12. Mental illness. "Mental illness" means an organic disorder of the brain or a
37.31clinically significant disorder of thought, mood, perception, orientation, or memory, that
37.32grossly impairs judgment, behavior, capacity to recognize reality, or to reason or understand,
37.33that is manifested by instances of grossly disturbed behavior or faulty perceptions. Mental
38.1illness does not include disorders defined as cognitive impairments in subdivision 3; epilepsy;
38.2antisocial personality disorder; brief periods of intoxication caused by alcohol, drugs, or
38.3other mind-altering substances; or repetitive or problematic patterns of using any alcohol,
38.4drugs, or other mind-altering substances.
38.5    Subd. 13. State-operated treatment program. "State-operated treatment program"
38.6means any state-operated program, including community behavioral health hospitals, crisis
38.7centers, residential facilities, outpatient services, and other community-based services
38.8developed and operated by the state and under the control of the commissioner of human
38.9services, for a person who has a mental illness, developmental disability, or chemical
38.10dependency.
38.11    Subd. 14. Suspend the criminal proceedings. "Suspend the criminal proceedings"
38.12means nothing can be heard or decided on the merits of the criminal charges except that the
38.13court retains jurisdiction in all other matters, including but not limited to bail, conditions
38.14of release, probation conditions, no contact orders, and appointment of counsel.
38.15    Subd. 15. Targeted misdemeanor. "Targeted misdemeanor" has the meaning given in
38.16section 299C.10, subdivision 1, paragraph (e).
38.17    Subd. 16. Treatment facility. "Treatment facility" means a non-state-operated hospital,
38.18residential treatment provider, crisis residential withdrawal management center, or corporate
38.19foster care home qualified to provide care and treatment for persons who have a mental
38.20illness, developmental disability, or chemical dependency.

38.21    Sec. 28. [611.42] COMPETENCY MOTION PROCEDURES.
38.22    Subdivision 1. Competency to stand trial. A defendant is incompetent and shall not
38.23plead, be tried, or be sentenced if, due to a mental illness or cognitive impairment, the
38.24defendant lacks the ability to:
38.25(1) rationally consult with counsel;
38.26(2) understand the proceedings; or
38.27(3) participate in the defense.
38.28    Subd. 2. Waiver of counsel in competency proceedings. (a) A defendant must not be
38.29allowed to waive counsel if the defendant lacks ability to:
38.30(1) knowingly, voluntarily, and intelligently waive the right to counsel;
38.31(2) appreciate the consequences of proceeding without counsel;
39.1(3) comprehend the nature of the charge;
39.2(4) comprehend the nature of the proceedings;
39.3(5) comprehend the possible punishment; or
39.4(6) comprehend any other matters essential to understanding the case.
39.5(b) The court must not proceed under this law before a lawyer consults with the defendant
39.6and has an opportunity to be heard.
39.7    Subd. 3. Competency motion. (a) At any time, the prosecutor or defense counsel may
39.8make a motion challenging the defendant's competency, or the court on its initiative may
39.9raise the issue. The defendant's consent is not required to bring a competency motion. The
39.10motion shall be supported by specific facts but shall not include communications between
39.11the defendant and defense counsel if disclosure would violate attorney-client privilege. By
39.12bringing the motion, the defendant does not waive attorney-client privilege.
39.13(b) If competency is at issue, the court shall appoint a forensic navigator to provide the
39.14forensic navigator services described in section 611.55 for the defendant, including
39.15development of a specific plan to identify appropriate housing and services if the defendant
39.16is released from custody or any charges are dismissed.
39.17(c) In felony, gross misdemeanor, and targeted misdemeanor cases, if the court determines
39.18there is a reasonable basis to doubt the defendant's competence and there is probable cause
39.19for the charge, the court must suspend the criminal proceedings and order an examination
39.20of the defendant under section 611.43.
39.21(d) In misdemeanor cases, other than cases involving a targeted misdemeanor, if the
39.22court determines there is a reasonable basis to doubt the defendant's competence and there
39.23is probable cause for the charge, the court must suspend the criminal proceedings. The court
39.24may order an examination of the defendant under section 611.43 if the examination is in
39.25the public interest. For purposes of this paragraph, an examination is in the public interest
39.26when it is necessary to assess whether the defendant has a cognitive impairment or mental
39.27illness; determine whether a defendant has the ability to access housing, food, income,
39.28disability verification, medications, and treatment for medical conditions; or whether a
39.29defendant has the ability to otherwise address any basic needs. The court shall order the
39.30forensic navigator to complete a bridge plan as described in section 611.55, subdivision 3
39.31and submit it to the court. The court may dismiss the charge upon receipt of the bridge plan
39.32without holding a hearing unless either party objects.
40.1    Subd. 4. Dismissal, referrals for services, and collaboration. (a) Except as provided
40.2in this subdivision, when the court determines there is a reasonable basis to doubt the
40.3defendant's competence and orders an examination of the defendant, a forensic navigator
40.4must complete a bridge plan with the defendant as described in section 611.55, subdivision
40.53, submit the bridge plan to the court, and provide a written copy to the defendant before
40.6the court or prosecutor dismisses any charges based on a belief or finding that the defendant
40.7is incompetent.
40.8(b) If for any reason a forensic navigator has not been appointed, the court must make
40.9every reasonable effort to coordinate with any resources available to the court and refer the
40.10defendant for possible assessment and social services, including but not limited to services
40.11for engagement under section 253B.041, before dismissing any charges based on a finding
40.12that the defendant is incompetent.
40.13(c) If working with the forensic navigator or coordinating a referral to services would
40.14cause an unreasonable delay in the release of a defendant being held in custody, the court
40.15may release the defendant. If a defendant has not been engaged for assessment and referral
40.16before release, the court may coordinate with the forensic navigator or any resources available
40.17to the court to engage the defendant for up to 90 days after release.
40.18(d) Courts may partner and collaborate with county social services, community-based
40.19programs, jails, and any other resource available to the court to provide referrals to services
40.20when a defendant's competency is at issue or a defendant has been found incompetent to
40.21proceed.
40.22(e) Counsel for the defendant may bring a motion to dismiss the proceedings in the
40.23interest of justice at any stage of the proceedings.

40.24    Sec. 29. [611.43] COMPETENCY EXAMINATION AND REPORT.
40.25    Subdivision 1. Competency examination. (a) If the court orders an examination pursuant
40.26to section 611.42, subdivision 3, the court shall appoint a court examiner to examine the
40.27defendant and report to the court on the defendant's competency to proceed. A court examiner
40.28may obtain from court administration and review the report of any prior or subsequent
40.29examination under this section or under Rules of Criminal Procedure, rule 20.
40.30(b) If the defendant is not entitled to release, the court shall order the defendant to
40.31participate in an examination where the defendant is being held, or the court may order that
40.32the defendant be confined in a treatment facility, locked treatment facility, or a state-operated
40.33treatment facility until the examination is completed.
41.1(c) If the defendant is entitled to release, the court shall order the defendant to appear
41.2for an examination. If the defendant fails to appear at an examination, the court may amend
41.3the conditions of release and bail pursuant to the Rules of Criminal Procedure, rule 6.
41.4(d) A competency examination ordered under Rules of Criminal Procedure, rule 20.04,
41.5shall proceed under subdivision 2.
41.6    Subd. 2. Report of examination. (a) The court-appointed examiner's written report shall
41.7be filed with the court and served on the prosecutor and defense counsel by the court. The
41.8report shall be filed no more than 30 days after the order for examination of a defendant in
41.9custody unless extended by the court for good cause. If the defendant is out of custody or
41.10confined in a noncorrectional program or treatment facility, the report shall be filed no more
41.11than 60 days after the order for examination, unless extended by the court for good cause.
41.12The report shall not include opinions concerning the defendant's mental condition at the
41.13time of the alleged offense or any statements made by the defendant regarding the alleged
41.14criminal conduct, unless necessary to support the examiner's opinion regarding competence
41.15or incompetence.
41.16(b) The report shall include an evaluation of the defendant's mental health, cognition,
41.17and the factual basis for opinions about:
41.18(1) any diagnoses made, and the results of any testing conducted with the defendant;
41.19(2) the defendant's competency to stand trial;
41.20(3) the level of care and education required for the defendant to attain, be restored to,
41.21or maintain competency;
41.22(4) a recommendation of the least restrictive setting appropriate to meet the defendant's
41.23needs for restoration and immediate safety;
41.24(5) the impact of any substance use disorder on the defendant, including the defendant's
41.25competency, and any recommendations for treatment;
41.26(6) the likelihood the defendant will attain competency in the reasonably foreseeable
41.27future;
41.28(7) whether the defendant poses a substantial likelihood of physical harm to self or
41.29others; and
41.30(8) if the court examiner's opinion is that the defendant is incompetent to proceed, the
41.31report must include an opinion as to whether the defendant possesses capacity to make
41.32decisions regarding neuroleptic medication unless the examiner is unable to render an
42.1opinion on capacity. If the examiner is unable to render an opinion on capacity, the report
42.2must document the reasons why the examiner is unable to render that opinion.
42.3(c) If the court examiner determines that the defendant presents an imminent risk of
42.4serious danger to another, is imminently suicidal, or otherwise needs emergency intervention,
42.5the examiner must promptly notify the court, prosecutor, defense counsel, and those
42.6responsible for the care and custody of the defendant.
42.7(d) If the defendant appears for the examination but does not participate, the court
42.8examiner shall submit a report and, if sufficient information is available, may render an
42.9opinion on competency and an opinion as to whether the unwillingness to participate resulted
42.10from a mental illness, cognitive impairment, or other factors.
42.11(e) If the court examiner determines the defendant would benefit from services for
42.12engagement in mental health treatment under section 253B.041 or any other referral to
42.13social services, the court examiner may recommend referral of the defendant to services
42.14where available.
42.15    Subd. 3. Additional examination. If either the prosecutor or defense counsel intends
42.16to retain an independent examiner, the party shall provide notice to the court and opposing
42.17counsel no later than ten days after the date of receipt of the court-appointed examiner's
42.18report. If an independent examiner is retained, the independent examiner's report shall be
42.19filed no more than 30 days after the date a party files notice of intent to retain an independent
42.20examiner, unless extended by the court for good cause.
42.21    Subd. 4. Admissibility of defendant's statements. When a defendant is examined under
42.22this section, any statement made by the defendant for the purpose of the examination and
42.23any evidence derived from the examination is admissible in the competency proceedings,
42.24but not in the criminal proceedings.

42.25    Sec. 30. [611.44] CONTESTED HEARING PROCEDURES.
42.26    Subdivision 1. Request for hearing. (a) The prosecutor or defense counsel may request
42.27a hearing on the court-appointed examiner's competency report by filing a written objection
42.28no later than ten days after the report is filed.
42.29(b) A hearing shall be held as soon as possible but no longer than 30 days after the
42.30request, unless extended by agreement of the prosecutor and defense counsel, or by the
42.31court for good cause.
43.1(c) If an independent court examiner is retained, the hearing may be continued up to 14
43.2days after the date the independent court examiner's report is filed. The court may continue
43.3the hearing for good cause.
43.4    Subd. 2. Competency hearing. (a) The court may admit all relevant and reliable evidence
43.5at the competency hearing. The court-appointed examiner is considered the court's witness
43.6and may be called and questioned by the court, prosecutor, or defense counsel. The report
43.7of the court-appointed examiner shall be admitted into evidence without further foundation.
43.8(b) Defense counsel may testify, subject to the prosecutor's cross-examination, but shall
43.9not violate attorney-client privilege. Testifying does not automatically disqualify defense
43.10counsel from continuing to represent the defendant. The court may inquire of defense counsel
43.11regarding the attorney-client relationship and the defendant's ability to communicate with
43.12counsel. The court shall not require counsel to divulge communications protected by
43.13attorney-client privilege, and the prosecutor shall not cross-examine defense counsel
43.14concerning responses to the court's inquiry.
43.15    Subd. 3. Determination without hearing. If neither party files an objection, the court
43.16shall determine the defendant's competency based on the reports of all examiners.
43.17    Subd. 4. Burden of proof and decision. The defendant is presumed incompetent unless
43.18the court finds by a preponderance of the evidence that the defendant is competent.

43.19    Sec. 31. [611.45] COMPETENCY FINDINGS.
43.20    Subdivision 1. Findings. (a) The court must rule on the defendant's competency to stand
43.21trial no more than 14 days after the examiner's report is submitted to the court. If there is a
43.22contested hearing, the court must rule no more than 30 days after the date of the hearing.
43.23(b) If the court finds the defendant competent, the court shall enter an order and the
43.24criminal proceedings shall resume.
43.25(c) If the court finds the defendant incompetent, the court shall enter a written order and
43.26suspend the criminal proceedings. The matter shall proceed under section 611.46.
43.27    Subd. 2. Appeal. Appeals under this chapter are governed by Rules of Criminal
43.28Procedure, rule 28. A verbatim record shall be made in all competency proceedings.
43.29    Subd. 3. Dismissal of criminal charge. (a) If the court finds the defendant incompetent,
43.30and the charge is a misdemeanor other than a targeted misdemeanor, the charge must be
43.31dismissed.
44.1(b) In targeted misdemeanor and gross misdemeanor cases, the charges must be dismissed
44.230 days after the date of the finding of incompetence, unless the prosecutor, before the
44.3expiration of the 30-day period, files a written notice of intent to prosecute when the
44.4defendant regains competency. If a notice has been filed and the charge is a targeted
44.5misdemeanor, charges must be dismissed within one year after the finding of incompetency.
44.6If a notice has been filed and the charge is a gross misdemeanor, charges must be dismissed
44.7within two years after the finding of incompetency.
44.8(c) In felony cases, except as provided in paragraph (d), the charges must be dismissed
44.9three years after the date of the finding of incompetency, unless the prosecutor, before the
44.10expiration of the three-year period, files a written notice of intent to prosecute when the
44.11defendant regains competency. If a notice has been filed, charges must be dismissed within
44.12five years after the finding of incompetency or ten years if the maximum sentence for the
44.13crime with which the defendant is charged is ten years or more.
44.14(d) The requirement that felony charges be dismissed under paragraph (c) does not apply
44.15if:
44.16(1) the court orders continuing supervision pursuant to section 611.49, subdivision 3;
44.17or
44.18(2) the defendant is charged with a violation of sections 609.185 (murder in the first
44.19degree); 609.19 (murder in the second degree); 609.195 (murder in the third degree); 609.20
44.20(manslaughter in the first degree); 609.205 (manslaughter in the second degree); 609.2112
44.21(criminal vehicular homicide); 609.2114, subdivision 1 (criminal vehicular operation, death
44.22to an unborn child); 609.2661 (murder of an unborn child in the first degree); 609.2662
44.23(murder of an unborn child in the second degree); 609.2663 (murder of an unborn child in
44.24the third degree); 609.2664 (manslaughter of an unborn child in the first degree); or 609.2665
44.25(manslaughter of an unborn child in the second degree); or a crime of violence as defined
44.26in section 624.712, subdivision 5, except for a violation of chapter 152.

44.27    Sec. 32. [611.46] INCOMPETENT TO STAND TRIAL AND CONTINUING
44.28SUPERVISION.
44.29    Subdivision 1. Order to competency restoration. (a) If the court finds the defendant
44.30incompetent and the charges have not been dismissed, the court shall order the defendant
44.31to participate in a competency restoration program to restore the defendant's competence.
44.32The court may order participation in a competency restoration program provided outside
44.33of a jail, a jail-based competency restoration program, or an alternative program. The court
44.34must determine the least-restrictive program appropriate to meet the defendant's needs and
45.1public safety. In making this determination, the court must consult with the forensic navigator
45.2and consider any recommendations of the court examiner. The court shall not order a
45.3defendant to participate in a jail-based program or a state-operated treatment program if the
45.4highest criminal charge is a misdemeanor or targeted misdemeanor.
45.5(b) The court may only order the defendant to participate in competency restoration at
45.6an inpatient or residential treatment program under this section if the head of the treatment
45.7program determines that admission to the program is clinically appropriate and consents to
45.8the defendant's admission. The court may only order the defendant to participate in
45.9competency restoration at a state-operated treatment facility under this section if the
45.10commissioner of human services or a designee determines that admission of the defendant
45.11is clinically appropriate and consents to the defendant's admission. The court may require
45.12a certified competency program that qualifies as a locked facility or a state-operated treatment
45.13program to notify the court in writing of the basis for refusing consent for admission of the
45.14defendant in order to ensure transparency and maintain an accurate record. The court may
45.15not require personal appearance of any representative of a certified competency program.
45.16The court shall send a written request for notification to the locked facility or state-operated
45.17treatment program and the locked facility or state-operated treatment program shall provide
45.18a written response to the court within ten days of receipt of the court's request.
45.19(c) If the defendant is confined in jail and has not received competency restoration
45.20services within 30 days of the finding of incompetency, the court shall review the case with
45.21input from the prosecutor and defense counsel and may:
45.22(1) order the defendant to participate in an appropriate competency restoration program
45.23that takes place outside of a jail;
45.24(2) conditionally release the defendant, including but not limited to conditions that the
45.25defendant participate in a competency restoration program when one becomes available
45.26and accessible;
45.27(3) make a determination as to whether the defendant is likely to attain competency in
45.28the reasonably foreseeable future and proceed under section 611.49; or
45.29(4) upon a motion, dismiss the charges in the interest of justice.
45.30(d) Upon the order to a competency restoration program or alternative program, the court
45.31may order any hospital, treatment facility, or correctional facility that has provided care or
45.32supervision to the defendant in the previous two years to provide copies of the defendant's
45.33medical records to the competency restoration program or alternative program. This
46.1information shall be provided in a consistent and timely manner and pursuant to all applicable
46.2laws.
46.3(e) If at any time the defendant refuses to participate in a competency restoration program
46.4or an alternative program, the head of the program shall notify the court and any entity
46.5responsible for supervision of the defendant.
46.6(f) At any time, the head of the program may discharge the defendant from the program
46.7or facility. The head of the program must notify the court, prosecutor, defense counsel, and
46.8any entity responsible for the supervision of the defendant prior to any planned discharge.
46.9Absent emergency circumstances, this notification shall be made five days prior to the
46.10discharge if the defendant is not being discharged to jail or a correctional facility. Upon the
46.11receipt of notification of discharge or upon the request of either party in response to
46.12notification of discharge, the court may order that a defendant who is subject to bail or
46.13unmet conditions of release be returned to jail upon being discharged from the program or
46.14facility. If the court orders a defendant returned to jail, the court shall notify the parties and
46.15head of the program at least one day before the defendant's planned discharge, except in
46.16the event of an emergency discharge where one day notice is not possible. The court must
46.17hold a review hearing within seven days of the defendant's return to jail. The forensic
46.18navigator must be given notice of the hearing and be allowed to participate.
46.19(g) If the defendant is discharged from the program or facility under emergency
46.20circumstances, notification of emergency discharge shall include a description of the
46.21emergency circumstances and may include a request for emergency transportation. The
46.22court shall make a determination on a request for emergency transportation within 24 hours.
46.23Nothing in this section prohibits a law enforcement agency from transporting a defendant
46.24pursuant to any other authority.
46.25    Subd. 2. Supervision. (a) Upon a finding of incompetency, if the defendant is entitled
46.26to release, the court must determine whether the defendant requires pretrial supervision.
46.27The court must weigh public safety risks against the defendant's interests in remaining free
46.28from supervision while presumed innocent in the criminal proceedings. The court may use
46.29a validated and equitable risk assessment tool to determine whether supervision is necessary.
46.30(b) If the court determines that the defendant requires pretrial supervision, the court shall
46.31direct the forensic navigator to conduct pretrial supervision and report violations to the
46.32court. The forensic navigator shall be responsible for the supervision of the defendant until
46.33ordered otherwise by the court.
47.1(c) Upon application by the prosecutor, the entity or its designee assigned to supervise
47.2the defendant, or court services alleging that the defendant violated a condition of release
47.3and is a risk to public safety, the court shall follow the procedures under Rules of Criminal
47.4Procedure, rule 6. Any hearing on the alleged violation of release conditions shall be held
47.5no more than 15 days after the date of issuance of a summons or within 72 hours if the
47.6defendant is apprehended on a warrant.
47.7(d) If the court finds a violation, the court may revise the conditions of release and bail
47.8as appropriate pursuant to the Rules of Criminal Procedure, including but not limited to
47.9consideration of the defendant's need for ongoing access to a competency restoration program
47.10or alternative program under this section.
47.11(e) The court must review conditions of release and bail on request of any party and may
47.12amend the conditions of release or make any other reasonable order upon receipt of
47.13information that the pretrial detention of a defendant has interfered with the defendant
47.14attaining competency.
47.15    Subd. 3. Certified competency restoration programs; procedure. (a) If the court
47.16orders a defendant to participate in a competency restoration program that takes place outside
47.17of a jail, or an alternative program that the court has determined is providing appropriate
47.18competency restoration services to the defendant, the court shall specify whether the program
47.19is a community-based treatment program or provided in a locked treatment facility.
47.20(b) If the court finds that the defendant continues to be incompetent at a review hearing
47.21held after the initial determination of competency, the court must hold a review hearing
47.22pursuant to section 611.49 and consider any changes to the defendant's conditions of release
47.23or competency restoration programming to restore the defendant's competency in the least
47.24restrictive program appropriate.
47.25(c) If the court orders the defendant to a locked treatment facility or jail-based program,
47.26the court must calculate the defendant's custody credit and cannot order the defendant to a
47.27locked treatment facility or jail-based program for a period that would cause the defendant's
47.28custody credit to exceed the maximum sentence for the underlying charge.
47.29    Subd. 4. Jail-based competency restoration programs; procedure. (a) A defendant
47.30is eligible to participate in a jail-based competency restoration program when the underlying
47.31charge is a gross misdemeanor or felony and either:
47.32(1) the defendant has been found incompetent, the defendant has not met the conditions
47.33of release ordered pursuant to rule 6.02 of the Rules of Criminal Procedure, including posting
47.34bail, and either a court-appointed examiner has recommended jail-based competency
48.1restoration as the least restrictive setting to meet the person's needs, or the court finds that
48.2after a reasonable effort by the forensic navigator, there has not been consent by another
48.3secure setting to the defendant's placement; or
48.4(2) the defendant is in custody and is ordered to a certified competency restoration
48.5program that takes place outside of a jail, a jail-based competency restoration program is
48.6available within a reasonable distance to the county where the defendant is being held, and
48.7the court ordered a time-limited placement in a jail-based program until transfer to a certified
48.8competency restoration program that takes place outside of a jail.
48.9(b) A defendant may not be ordered to participate in a jail-based competency restoration
48.10program for more than 90 days without a review hearing. If after 90 days of the order to a
48.11jail-based program the defendant has not attained competency, the court must review the
48.12case with input from the prosecutor and defense counsel and may:
48.13(1) order the defendant to participate in an appropriate certified competency restoration
48.14program that takes place outside of a locked facility; or
48.15(2) determine whether, after a reasonable effort by the forensic navigator, there is consent
48.16to the defendant's placement by another locked facility. If court determines that a locked
48.17facility is the least restrictive program appropriate and no appropriate locked facility is
48.18available, it may order the defendant to the jail-based program for an additional 90 days.
48.19(c) Nothing in this section prohibits the court from ordering the defendant transferred
48.20to a certified competency restoration program that takes place outside of a jail if the court
48.21determines that transition is appropriate, or the defendant satisfies the conditions of release
48.22or bail. Before the defendant is transitioned to a certified competency restoration program
48.23that takes place outside of a jail or an alternative program, the court shall notify the prosecutor
48.24and the defense counsel, and the provisions of subdivision 2 shall apply.
48.25(d) The court may require a certified competency program that qualifies as a locked
48.26facility to notify the court in writing of the basis for refusing consent of the defendant in
48.27order to ensure transparency and maintain an accurate record. The court may not require
48.28personal appearance of any representative of a certified competency program.
48.29    Subd. 5. Alternative programs; procedure. (a) A defendant is eligible to participate
48.30in an alternative program if the defendant has been found incompetent, the defendant is
48.31entitled to release, and a certified competency restoration program outside of a jail is not
48.32available.
49.1(b) As soon as the forensic navigator has reason to believe that no certified competency
49.2restoration program outside of a jail will be available within a reasonable time, the forensic
49.3navigator shall determine if there are available alternative programs that are likely to assist
49.4the defendant in attaining competency. Upon notification by the forensic navigator, the
49.5court may order the defendant to participate in an appropriate alternative program and notify
49.6the prosecutor and the defense counsel.
49.7(c) If at any time while the defendant is participating in an alternative program, an
49.8appropriate certified competency restoration program that takes place outside of a jail
49.9becomes available, the forensic navigator must notify the court. The court must notify the
49.10prosecutor and the defense counsel and must order the defendant to participate in an
49.11appropriate certified competency restoration program, unless the court determines that the
49.12defendant is receiving appropriate competency restoration services in the alternative program.
49.13If appropriate and in the public interest, the court may order the defendant to participate in
49.14the certified competency restoration program and an alternative program.
49.15(d) At any time, the head of the alternative program or the forensic navigator may notify
49.16the court that the defendant is receiving appropriate competency restoration services in the
49.17alternative program, and recommend that remaining in the alternative program is in the best
49.18interest of the defendant and the defendant's progress in attaining competency. The court
49.19may order the defendant to continue programming in the alternative program and proceed
49.20under subdivision 3.
49.21(e) If after 90 days of the order to an alternative program the defendant has not attained
49.22competency and the defendant is not participating in a certified competency restoration
49.23program, the court must hold a review hearing pursuant to section 611.49.
49.24    Subd. 6. Reporting to the court. (a) The court examiner must provide an updated report
49.25to the court at least once every six months, unless the court and the parties agree to a longer
49.26period that is not more than 12 months, as to the defendant's competency and a description
49.27of the efforts made to restore the defendant to competency.
49.28(b) At any time, the head of the program may notify the court and recommend that a
49.29court examiner provide an updated competency examination and report.
49.30(c) The court shall furnish copies of the report to the prosecutor, defense counsel, and
49.31the facility or program where the defendant is being served.
49.32(d) The report may make recommendations for continued services to ensure continued
49.33competency. If the defendant is found guilty, these recommendations may be considered
49.34by the court in imposing a sentence, including any conditions of probation.
50.1    Subd. 7. Contested hearings. The prosecutor or defense counsel may request a hearing
50.2on the court examiner's competency opinion by filing written objections to the competency
50.3report no later than ten days after receiving the report. All parties are entitled to notice before
50.4the hearing. If the hearing is held, it shall conform with the procedures of section 611.44.
50.5    Subd. 8. Competency determination. (a) The court must determine whether the
50.6defendant is competent based on the updated report from the court examiner no more than
50.714 days after receiving the report.
50.8(b) If the court finds the defendant competent, the court must enter an order and the
50.9criminal proceedings shall resume.
50.10(c) If the court finds the defendant incompetent, the court may order the defendant to
50.11continue participating in a program as provided in this section.
50.12(d) Counsel for the defendant may bring a motion to dismiss the proceedings in the
50.13interest of justice at any stage of the proceedings.

50.14    Sec. 33. [611.47] ADMINISTRATION OF MEDICATION.
50.15    Subdivision 1. Motion. When a court finds that a defendant is incompetent or any time
50.16thereafter, upon the motion of the prosecutor or treating medical provider, the court shall
50.17hear and determine whether the defendant lacks capacity to make decisions regarding the
50.18administration of neuroleptic medication.
50.19    Subd. 2. Certification report. (a) If the defendant's treating medical practitioner is of
50.20the opinion that the defendant lacks capacity to make decisions regarding neuroleptic
50.21medication, the treating medical practitioner shall certify in a report that the lack of capacity
50.22exists and which conditions under subdivision 3 are applicable. The certification report shall
50.23contain an assessment of the current mental status of the defendant and the opinion of the
50.24treating medical practitioner that involuntary neuroleptic medication has become medically
50.25necessary and appropriate under subdivision 3, paragraph (b), clause (1) or (2), or in the
50.26patient's best medical interest under subdivision 3, paragraph (b), clause (3). The certification
50.27report shall be filed with the court when a motion for a hearing is made under this section.
50.28(b) A certification report made pursuant to this section shall include a description of the
50.29neuroleptic medication proposed to be administered to the defendant and its likely effects
50.30and side effects, including effects on the defendant's condition or behavior that would affect
50.31the defendant's ability to understand the nature of the criminal proceedings or to assist
50.32counsel in the conduct of a defense in a reasonable manner.
51.1(c) Any defendant subject to an order under subdivision 3 of this section or the state
51.2may request review of that order.
51.3(d) The court may appoint a court examiner to examine the defendant and report to the
51.4court and parties as to whether the defendant lacks capacity to make decisions regarding
51.5the administration of neuroleptic medication. If the patient refuses to participate in an
51.6examination, the court examiner may rely on the patient's clinically relevant medical records
51.7in reaching an opinion.
51.8(e) The defendant is entitled to a second court examiner under this section, if requested
51.9by the defendant.
51.10    Subd. 3. Determination. (a) The court shall consider opinions in the reports prepared
51.11under subdivision 2 as applicable to the issue of whether the defendant lacks capacity to
51.12make decisions regarding the administration of neuroleptic medication and shall proceed
51.13under paragraph (b).
51.14(b) The court shall hear and determine whether any of the following is true:
51.15(1) the defendant lacks capacity to make decisions regarding neuroleptic medication, as
51.16defined in section 253B.092, subdivision 5, the defendant's mental illness requires medical
51.17treatment with neuroleptic medication, and, if the defendant's mental illness is not treated
51.18with neuroleptic medication, it is probable that serious harm to the physical or mental health
51.19of the patient will result. Probability of serious harm to the physical or mental health of the
51.20defendant requires evidence that the defendant is presently suffering adverse effects to the
51.21defendant's physical or mental health, or the defendant has previously suffered these effects
51.22as a result of a mental illness and the defendant's condition is substantially deteriorating or
51.23likely to deteriorate without administration of neuroleptic medication. The fact that a
51.24defendant has a diagnosis of a mental illness does not alone establish probability of serious
51.25harm to the physical or mental health of the defendant;
51.26(2) the defendant lacks capacity to make decisions regarding neuroleptic medication, as
51.27defined in section 253B.092, subdivision 5, neuroleptic medication is medically necessary,
51.28and the defendant is a danger to others, in that the defendant has inflicted, attempted to
51.29inflict, or made a serious threat of inflicting substantial bodily harm on another while in
51.30custody, or the defendant had inflicted, attempted to inflict, or made a serious threat of
51.31inflicting substantial bodily harm on another that resulted in being taken into custody, and
51.32the defendant presents, as a result of mental illness or cognitive impairment, a demonstrated
51.33danger of inflicting substantial bodily harm on others. Demonstrated danger may be based
52.1on an assessment of the defendant's present mental condition, including a consideration of
52.2past behavior of the defendant and other relevant information; or
52.3(3) the defendant lacks capacity to make decisions regarding neuroleptic medication, as
52.4defined in section 253B.092, subdivision 5, and the state has shown by clear and convincing
52.5evidence that:
52.6(i) the state has charged the defendant with a serious crime against the person or property;
52.7(ii) involuntary administration of neuroleptic medication is substantially likely to render
52.8the defendant competent to stand trial;
52.9(iii) the medication is unlikely to have side effects that interfere with the defendant's
52.10ability to understand the nature of the criminal proceedings or to assist counsel in the conduct
52.11of a defense in a reasonable manner;
52.12(iv) less intrusive treatments are unlikely to have substantially the same results and
52.13involuntary medication is necessary; and
52.14(v) neuroleptic medication is in the patient's best medical interest in light of the patient's
52.15medical condition.
52.16(c) In ruling on a petition under this section, the court shall also take into consideration
52.17any evidence on:
52.18(1) what the patient would choose to do in the situation if the patient had capacity,
52.19including evidence such as a durable power of attorney for health care under chapter 145C;
52.20(2) the defendant's family, community, moral, religious, and social values;
52.21(3) the medical risks, benefits, and alternatives to the proposed treatment;
52.22(4) past efficacy and any extenuating circumstances of past use of neuroleptic
52.23medications; and
52.24(5) any other relevant factors.
52.25(d) In determining whether the defendant possesses capacity to consent to neuroleptic
52.26medications, the court:
52.27(1) must apply a rebuttable presumption that a defendant has the capacity to make
52.28decisions regarding administration of neuroleptic medication;
52.29(2) must find that a defendant has the capacity to make decisions regarding the
52.30administration of neuroleptic medication if the defendant:
53.1(i) has an awareness of the nature of the defendant's situation and the possible
53.2consequences of refusing treatment with neuroleptic medications;
53.3(ii) has an understanding of treatment with neuroleptic medications and the risks, benefits,
53.4and alternatives; and
53.5(iii) communicates verbally or nonverbally a clear choice regarding treatment with
53.6neuroleptic medications that is a reasoned one not based on a symptom of the defendant's
53.7mental illness, even though it may not be in the defendant's best interests; and
53.8(3) must not conclude that a defendant's decision is unreasonable based solely on a
53.9disagreement with the medical practitioner's recommendation.
53.10(e) If consideration of the evidence presented on the factors in paragraph (c) weighs in
53.11favor of authorizing involuntary administration of neuroleptic medication, and the court
53.12finds any of the conditions described in paragraph (b) to be true, the court shall issue an
53.13order authorizing involuntary administration of neuroleptic medication to the defendant
53.14when and as prescribed by the defendant's medical practitioner, including administration
53.15by a treatment facility or correctional facility. The court order shall specify which medications
53.16are authorized and may limit the maximum dosage of neuroleptic medication that may be
53.17administered. The order shall be valid for no more than one year. An order may be renewed
53.18by filing another petition under this section and following the process in this section. The
53.19order shall terminate no later than the closure of the criminal case in which it is issued. The
53.20court shall not order involuntary administration of neuroleptic medication under paragraph
53.21(b), clause (3), unless the court has first found that the defendant does not meet the criteria
53.22for involuntary administration of neuroleptic medication under paragraph (b), clause (1),
53.23and does not meet the criteria under paragraph (b), clause (2).
53.24(f) A copy of the order must be given to the defendant, the defendant's attorney, the
53.25county attorney, and the treatment facility or correctional facility where the defendant is
53.26being served. The treatment facility, correctional facility, or treating medical practitioner
53.27may not begin administration of the neuroleptic medication until it notifies the patient of
53.28the court's order authorizing the treatment.
53.29    Subd. 4. Emergency administration. A treating medical practitioner may administer
53.30neuroleptic medication to a defendant who does not have capacity to make a decision
53.31regarding administration of the medication if the defendant is in an emergency situation.
53.32Medication may be administered for so long as the emergency continues to exist, up to 14
53.33days, if the treating medical practitioner determines that the medication is necessary to
53.34prevent serious, immediate physical harm to the patient or to others. If a request for
54.1authorization to administer medication is made to the court within the 14 days, the treating
54.2medical practitioner may continue the medication through the date of the first court hearing,
54.3if the emergency continues to exist. The treating medical practitioner shall document the
54.4emergency in the defendant's medical record in specific behavioral terms.
54.5    Subd. 5. Administration without judicial review. Neuroleptic medications may be
54.6administered without judicial review under this subdivision if:
54.7(1) the defendant has been prescribed neuroleptic medication prior to admission to a
54.8facility or program, but lacks the present capacity to consent to the administration of that
54.9neuroleptic medication; continued administration of the medication is in the patient's best
54.10interest; and the defendant does not refuse administration of the medication. In this situation,
54.11the previously prescribed neuroleptic medication may be continued for up to 14 days while
54.12the treating medical practitioner is requesting a court order authorizing administering
54.13neuroleptic medication or an amendment to a current court order authorizing administration
54.14of neuroleptic medication. If the treating medical practitioner requests a court order under
54.15this section within 14 days, the treating medical practitioner may continue administering
54.16the medication to the patient through the hearing date or until the court otherwise issues an
54.17order; or
54.18(2) the defendant does not have the present capacity to consent to the administration of
54.19neuroleptic medication, but prepared a health care power of attorney or a health care directive
54.20under chapter 145C requesting treatment or authorizing an agent or proxy to request
54.21treatment, and the agent or proxy has requested the treatment.
54.22    Subd. 6. Defendants with capacity to make informed decision. If the court finds that
54.23the defendant has the capacity to decide whether to take neuroleptic medication, a facility
54.24or program may not administer medication without the patient's informed written consent
54.25or without the declaration of an emergency, or until further review by the court.
54.26    Subd. 7. Procedure when patient defendant refuses medication. If physical force is
54.27required to administer the neuroleptic medication, the facility or program may only use
54.28injectable medications. If physical force is needed to administer the medication, medication
54.29may only be administered in a setting where the person's condition can be reassessed and
54.30medical personnel qualified to administer medication are available, including in the
54.31community or a correctional facility. The facility or program may not use a nasogastric tube
54.32to administer neuroleptic medication involuntarily.

55.1    Sec. 34. [611.48] REVIEW HEARINGS.
55.2The prosecutor or defense counsel may apply to the court for a hearing to review the
55.3defendant's competency restoration programming. All parties are entitled to notice before
55.4the hearing. The hearing shall be held no later than 30 days after the date of the request,
55.5unless extended upon agreement of the prosecutor and defense counsel or by the court for
55.6good cause.

55.7    Sec. 35. [611.49] LIKELIHOOD TO ATTAIN COMPETENCY.
55.8    Subdivision 1. Applicability. (a) The court may hold a hearing on its own initiative or
55.9upon request of either party to determine whether the defendant is likely to attain competency
55.10in the foreseeable future when the most recent court examiner's report states that the defendant
55.11is unlikely to attain competency in the foreseeable future, and either:
55.12(1) defendant has not been restored to competence after participating and cooperating
55.13with court ordered competency restoration programming for at least one year; or
55.14(2) the defendant has not received timely competency restoration services under section
55.15611.46 after one year.
55.16(b) The court cannot find a defendant unlikely to attain competency based upon a
55.17defendant's refusal to cooperate with or remain at a certified competency program or
55.18cooperate with an examination.
55.19(c) The parties are entitled to 30 days of notice prior to the hearing and, unless the parties
55.20agree to a longer time period, the court must determine within 30 days after the hearing
55.21whether there is a substantial probability that the defendant will attain competency within
55.22the foreseeable future.
55.23    Subd. 2. Procedure. (a) If the court finds that there is a substantial probability that the
55.24defendant will attain competency within the reasonably foreseeable future, the court shall
55.25find the defendant incompetent and proceed under section 611.46.
55.26(b) If the court finds that there is not a substantial probability the defendant will attain
55.27competency within the reasonably foreseeable future, the court may not order the defendant
55.28to participate in or continue to participate in a competency restoration program in a locked
55.29treatment facility. The court must release the defendant from any custody holds pertaining
55.30to the underlying criminal case and require the forensic navigator to develop a bridge plan.
55.31(c) If the court finds that there is not a substantial probability the defendant will attain
55.32competency within the foreseeable future, the court may issue an order to the designated
56.1agency in the county of financial responsibility or the county where the defendant is present
56.2to conduct a prepetition screening pursuant to section 253B.07.
56.3(d) If a hearing is held under this subdivision and the criteria pursuant to subdivision 1,
56.4paragraphs (a) and (b) are satisfied, a party attempting to demonstrate that there is a
56.5substantial probability that the defendant will attain competency within the foreseeable
56.6future must prove by a preponderance of the evidence.
56.7(e) If the court finds that there is not a substantial probability that the defendant will
56.8attain competency within the foreseeable future, the court must dismiss the case unless:
56.9(1) the person is charged with a violation of section 609.185 (murder in the first degree);
56.10609.19 (murder in the second degree); 609.195 (murder in the third degree); 609.20
56.11(manslaughter in the first degree); 609.205 (manslaughter in the second degree); 609.2112
56.12(criminal vehicular homicide); 609.2114, subdivision 1 (criminal vehicular operation, death
56.13to an unborn child); 609.2661 (murder of an unborn child in the first degree); 609.2662
56.14(murder of an unborn child in the second degree); 609.2663 (murder of an unborn child in
56.15the third degree); 609.2664 (manslaughter of an unborn child in the first degree); or 609.2665
56.16(manslaughter of an unborn child in the second degree); or a crime of violence as defined
56.17in section 624.712, subdivision 5, except for a violation of chapter 152; or
56.18(2) there is a showing of a danger to public safety if the matter is dismissed.
56.19(f) If the court does not dismiss the charges, the court must order continued supervision
56.20under subdivision 3.
56.21    Subd. 3. Continued supervision. (a) If the court orders the continued supervision of a
56.22defendant, any party may request a hearing on the issue of continued supervision by filing
56.23a notice no more than ten days after the order for continued supervision.
56.24(b) When continued supervision is ordered, the court must identify the supervisory
56.25agency responsible for the supervision of the defendant, including but not limited to directing
56.26a forensic navigator as the responsible entity.
56.27(c) Notwithstanding the reporting requirements of section 611.46, subdivision 5, the
56.28court examiner must provide an updated report to the court one year after the initial order
56.29for continued supervision as to the defendant's competency and a description of the efforts
56.30made to restore the defendant to competency. The court shall hold a review hearing within
56.3130 days of receipt of the report.
56.32(d) If continued supervision is ordered at the review hearing under paragraph (c), the
56.33court must set a date for a review hearing no later than two years after the most recent order
57.1for continuing supervision. The court must order review of the defendant's status, including
57.2an updated competency examination and report by the court examiner. The court examiner
57.3must submit the updated report to the court. At the review hearing, the court must determine
57.4if the defendant has attained competency, whether there is a substantial probability that the
57.5defendant will attain competency within the foreseeable future, and whether the absence of
57.6continuing supervision of the defendant is a danger to public safety. Notwithstanding
57.7subdivision 2, paragraph (e), the court may hear any motions to dismiss pursuant to the
57.8interest of justice at the review hearing.
57.9(e) The court may not order continued supervision for more than ten years unless the
57.10defendant is charged with a violation of section 609.185 (murder in the first degree); 609.19
57.11(murder in the second degree); 609.195 (murder in the third degree); 609.20 (manslaughter
57.12in the first degree); 609.205 (manslaughter in the second degree); 609.2112 (criminal
57.13vehicular homicide); 609.2114, subdivision 1 (criminal vehicular operation, death to an
57.14unborn child); 609.2661 (murder of an unborn child in the first degree); 609.2662 (murder
57.15of an unborn child in the second degree); 609.2663 (murder of an unborn child in the third
57.16degree); 609.2664 (manslaughter of an unborn child in the first degree); or 609.2665
57.17(manslaughter of an unborn child in the second degree); or a crime of violence as defined
57.18in section 624.712, subdivision 5, except for a violation of chapter 152.
57.19(f) At any time, the head of the program may discharge the defendant from the program
57.20or facility. The head of the program must notify the court, prosecutor, defense counsel,
57.21forensic navigator, and any entity responsible for the supervision of the defendant prior to
57.22any planned discharge. Absent emergency circumstances, this notification shall be made
57.23five days prior to the discharge. If the defendant is discharged from the program or facility
57.24under emergency circumstances, notification of emergency discharge shall include a
57.25description of the emergency circumstances and may include a request for emergency
57.26transportation. The court shall make a determination on a request for emergency
57.27transportation within 24 hours. Nothing in this section prohibits a law enforcement agency
57.28from transporting a defendant pursuant to any other authority.
57.29(g) The court may provide, partner, or contract for pretrial supervision services or
57.30continued supervision if the defendant is found incompetent and unlikely to attain competency
57.31in the foreseeable future.

58.1    Sec. 36. [611.50] DEFENDANT'S PARTICIPATION AND CONDUCT OF
58.2HEARINGS.
58.3    Subdivision 1. Place of hearing. Upon request of the prosecutor, defense counsel, or
58.4head of the treatment facility and approval by the court and the treatment facility, a hearing
58.5may be held at a treatment facility. A hearing may be conducted by interactive video
58.6conference consistent with the Rules of Criminal Procedure.
58.7    Subd. 2. Absence permitted. When a medical professional treating the defendant submits
58.8a written report stating that participating in a hearing under this statute is not in the best
58.9interest of the defendant and would be detrimental to the defendant's mental or physical
58.10health, the court shall notify the defense counsel and the defendant and allow the hearing
58.11to proceed without the defendant's participation.
58.12    Subd. 3. Disruption of hearing. At any hearing required under this section, the court,
58.13on its motion or on the motion of any party, may exclude or excuse a defendant who is
58.14seriously disruptive, refuses to participate, or who is incapable of comprehending and
58.15participating in the proceedings. In such instances, the court shall, with specificity on the
58.16record, state the behavior of the defendant or other circumstances which justify proceeding
58.17in the absence of the defendant.
58.18    Subd. 4. Issues not requiring defendant's participation. The defendant's incompetence
58.19does not preclude the defense counsel from making an objection or defense before trial that
58.20can be fairly determined without the defendant's participation.

58.21    Sec. 37. [611.51] CREDIT FOR CONFINEMENT.
58.22If the defendant is convicted, any time spent confined in a secured setting while being
58.23assessed and restored to competency must be credited as time served.

58.24    Sec. 38. [611.55] FORENSIC NAVIGATOR SERVICES.
58.25    Subdivision 1. Definition. As used in this section, "board" means the State Competency
58.26Restoration Board established in section 611.56.
58.27    Subd. 2. Availability of forensic navigator services. The board must provide or contract
58.28for enough forensic navigator services to meet the needs of adult defendants in each judicial
58.29district who are found incompetent to proceed.
58.30    Subd. 3. Duties. (a) Forensic navigators shall be impartial in all legal matters relating
58.31to the criminal case. Nothing shall be construed to permit the forensic navigator to provide
58.32legal counsel as a representative of the court, prosecutor, or defense counsel. Forensic
59.1navigators shall be required to report compliance and noncompliance with pretrial supervision
59.2and any orders of the court.
59.3(b) Forensic navigators shall provide services to assist defendants with mental illnesses
59.4and cognitive impairments. Services may include, but are not limited to:
59.5(1) developing bridge plans;
59.6(2) assisting defendants in participating in court-ordered examinations and hearings;
59.7(3) coordinating timely placement in court-ordered competency restoration programs;
59.8(4) providing competency restoration education;
59.9(5) reporting to the court on the progress of defendants found incompetent to stand trial;
59.10(6) providing coordinating services to help defendants access needed mental health,
59.11medical, housing, financial, social, transportation, precharge and pretrial diversion, and
59.12other necessary services provided by other programs and community service providers;
59.13(7) communicating with and offering supportive resources to defendants and family
59.14members of defendants; and
59.15(8) providing consultation and education to court officials on emerging issues and
59.16innovations in serving defendants with mental illnesses in the court system.
59.17(c) If a defendant's charges are dismissed, the appointed forensic navigator may continue
59.18assertive outreach with the individual for up to 90 days to assist in attaining stability in the
59.19community.
59.20    Subd. 4. Bridge plans. (a) The forensic navigator must prepare bridge plans with the
59.21defendant and submit them to the court. Bridge plans must be submitted before the time the
59.22court makes a competency finding pursuant to section 611.45. The bridge plan must include:
59.23(1) a confirmed housing address the defendant will use upon release, including but not
59.24limited to emergency shelters;
59.25(2) if possible, the dates, times, locations, and contact information for any appointments
59.26made to further coordinate support and assistance for the defendant in the community,
59.27including but not limited to mental health and substance use disorder treatment, or a list of
59.28referrals to services; and
59.29(3) any other referrals, resources, or recommendations the forensic navigator or court
59.30deems necessary.
60.1(b) Bridge plans and any supporting records or other data submitted with those plans
60.2are not accessible to the public.

60.3    Sec. 39. [611.56] STATE COMPETENCY RESTORATION BOARD.
60.4    Subdivision 1. Establishment; membership. (a) The State Competency Restoration
60.5Board is established in the judicial branch. The board is not subject to the administrative
60.6control of the judiciary. The board shall consist of seven members, including:
60.7(1) three members appointed by the supreme court, at least one of whom must be a
60.8defense attorney, one a county attorney, and one public member; and
60.9(2) four members appointed by the governor, at least one of whom must be a mental
60.10health professional with experience in competency restoration.
60.11(b) The appointing authorities may not appoint an active judge to be a member of the
60.12board, but may appoint a retired judge.
60.13(c) All members must demonstrate an interest in maintaining a high quality, independent
60.14forensic navigator program and a thorough process for certification of competency restoration
60.15programs. Members shall be familiar with the Minnesota Rules of Criminal Procedure,
60.16particularly rule 20; chapter 253B; and sections 611.40 to 611.59. Following the initial
60.17terms of appointment, at least one member appointed by the supreme court must have
60.18previous experience working as a forensic navigator. At least three members of the board
60.19shall live outside the First, Second, Fourth, and Tenth Judicial Districts. The terms,
60.20compensation, and removal of members shall be as provided in section 15.0575. The members
60.21shall elect the chair from among the membership for a term of two years.
60.22    Subd. 2. Duties and responsibilities. (a) The board shall create and administer a
60.23statewide, independent competency restoration system that certifies competency restoration
60.24programs and uses forensic navigators to promote prevention and diversion of people with
60.25mental illnesses and cognitive impairments from entering the legal system, support defendants
60.26with mental illness and cognitive impairments, support defendants in the competency process,
60.27and assist courts and partners in coordinating competency restoration services.
60.28(b) The board shall:
60.29(1) approve and recommend to the legislature a budget for the board and the forensic
60.30navigator program;
60.31(2) establish procedures for distribution of funding under this section to the forensic
60.32navigator program;
61.1(3) establish forensic navigator standards, administrative policies, procedures, and rules
61.2consistent with statute, rules of court, and laws that affect a forensic navigator's work;
61.3(4) establish certification requirements for competency restoration programs; and
61.4(5) carry out the programs under sections 611.57, 611.58, and 611.59.
61.5(c) The board may:
61.6(1) adopt standards, policies, or procedures necessary to ensure quality assistance for
61.7defendants found incompetent to stand trial and charged with a felony, gross misdemeanor,
61.8or targeted misdemeanor, or for defendants found incompetent to stand trial who have
61.9recurring incidents;
61.10(2) establish district forensic navigator offices as provided in subdivision 4; and
61.11(3) propose statutory changes to the legislature and rule changes to the supreme court
61.12that would facilitate the effective operation of the forensic navigator program.
61.13    Subd. 3. Administrator. The board shall appoint a program administrator who serves
61.14at the pleasure of the board. The program administrator shall attend all meetings of the board
61.15and the Certification Advisory Committee, but may not vote, and shall:
61.16(1) carry out all administrative functions necessary for the efficient and effective operation
61.17of the board and the program, including but not limited to hiring, supervising, and disciplining
61.18program staff and forensic navigators;
61.19(2) implement, as necessary, resolutions, standards, rules, regulations, and policies of
61.20the board;
61.21(3) keep the board fully advised as to its financial condition, and prepare and submit to
61.22the board the annual program and budget and other financial information as requested by
61.23the board;
61.24(4) recommend to the board the adoption of rules and regulations necessary for the
61.25efficient operation of the board and the program; and
61.26(5) perform other duties prescribed by the board.
61.27    Subd. 4. District offices. The board may establish district forensic navigator offices in
61.28counties, judicial districts, or other areas where the number of defendants receiving
61.29competency restoration services requires more than one full-time forensic navigator and
61.30establishment of an office is fiscally responsible and in the best interest of defendants found
61.31to be incompetent.
62.1    Subd. 5. Administration. The board may contract with the Office of State Court
62.2Administrator for administrative support services for the fiscal years following fiscal year
62.32022.
62.4    Subd. 6. Fees and costs; civil actions on contested case. Sections 15.039 and 15.471
62.5to 15.474 apply to the State Competency Restoration Board.
62.6    Subd. 7. Access to records. Access to records of the board is subject to the Rules of
62.7Public Access for Records of the Judicial Branch. The board may propose amendments for
62.8supreme court consideration.

62.9    Sec. 40. [611.57] CERTIFICATION ADVISORY COMMITTEE.
62.10    Subdivision 1. Establishment. The Certification Advisory Committee is established to
62.11provide the State Competency Restoration Board with advice and expertise related to the
62.12certification of competency restoration programs, including jail-based programs.
62.13    Subd. 2. Membership. (a) The Certification Advisory Committee consists of the
62.14following members:
62.15(1) a mental health professional, as defined in section 245I.02, subdivision 27, with
62.16community behavioral health experience, appointed by the governor;
62.17(2) a board-certified forensic psychiatrist with experience in competency evaluations,
62.18providing competency restoration services, or both, appointed by the governor;
62.19(3) a board-certified forensic psychologist with experience in competency evaluations,
62.20providing competency restoration services, or both, appointed by the governor;
62.21(4) the president of the Minnesota Corrections Association or a designee;
62.22(5) the direct care and treatment deputy commissioner or a designee;
62.23(6) the president of the Minnesota Association of County Social Service Administrators
62.24or a designee;
62.25(7) the president of the Minnesota Association of Community Mental Health Providers
62.26or a designee;
62.27(8) the president of the Minnesota Sheriffs' Association or a designee; and
62.28(9) the executive director of the National Alliance on Mental Illness Minnesota or a
62.29designee.
63.1(b) Members of the advisory committee serve without compensation and at the pleasure
63.2of the appointing authority. Vacancies shall be filled by the appointing authority consistent
63.3with the qualifications of the vacating member required by this subdivision.
63.4    Subd. 3. Meetings. At its first meeting, the advisory committee shall elect a chair and
63.5may elect a vice-chair. The advisory committee shall meet at least monthly or upon the call
63.6the chair. The advisory committee shall meet sufficiently enough to accomplish the tasks
63.7identified in this section.
63.8    Subd. 4. Duties. The Certification Advisory Committee shall consult with the Department
63.9of Human Services, the Department of Health, and the Department of Corrections; make
63.10recommendations to the State Competency Restoration Board regarding competency
63.11restoration curriculum, certification requirements for competency restoration programs
63.12including jail-based programs, and certification of individuals to provide competency
63.13restoration services; and provide information and recommendations on other issues relevant
63.14to competency restoration as requested by the board.

63.15    Sec. 41. [611.58] COMPETENCY RESTORATION CURRICULUM AND
63.16CERTIFICATION.
63.17    Subdivision 1. Curriculum. (a) By January 1, 2023, the board must recommend a
63.18competency restoration curriculum to educate and assist defendants found incompetent in
63.19attaining the ability to:
63.20(1) rationally consult with counsel;
63.21(2) understand the proceedings; and
63.22(3) participate in the defense.
63.23(b) The curriculum must be flexible enough to be delivered in community and correctional
63.24settings by individuals with various levels of education and qualifications, including but
63.25not limited to professionals in criminal justice, health care, mental health care, and social
63.26services. The board must review and update the curriculum as needed.
63.27    Subd. 2. Certification and distribution. By January 1, 2023, the board must develop
63.28a process for certifying individuals to deliver the competency restoration curriculum and
63.29make the curriculum available to every certified competency restoration program and forensic
63.30navigator in the state. Each competency restoration program in the state must use the
63.31competency restoration curriculum under this section as the foundation for delivering
63.32competency restoration education and must not substantially alter the content.

64.1    Sec. 42. [611.59] COMPETENCY RESTORATION PROGRAMS.
64.2    Subdivision 1. Availability and certification. The board must provide or contract for
64.3enough competency restoration services to meet the needs of adult defendants in each judicial
64.4district who are found incompetent to proceed and do not have access to competency
64.5restoration services as a part of any other programming in which they are ordered to
64.6participate. The board, in consultation with the Certification Advisory Committee, shall
64.7develop procedures to certify that the standards in this section are met, including procedures
64.8for regular recertification of competency restoration programs. The board shall maintain a
64.9list of certified competency restoration programs on the board's website to be updated at
64.10least once every year.
64.11    Subd. 2. Competency restoration provider standards. Except for jail-based programs,
64.12a competency restoration provider must:
64.13(1) be able to provide the appropriate mental health or substance use disorder treatment
64.14ordered by the court, including but not limited to treatment in inpatient, residential, and
64.15home-based settings;
64.16(2) ensure that competency restoration education certified by the board is provided to
64.17defendants and that regular assessments of defendants' progress in attaining competency
64.18are documented;
64.19(3) designate a head of the program knowledgeable in the processes and requirements
64.20of the competency to stand trial procedures; and
64.21(4) develop staff procedures or designate a person responsible to ensure timely
64.22communication with the court system.
64.23    Subd. 3. Jail-based competency restoration standards. Jail-based competency
64.24restoration programs must be housed in correctional facilities licensed by the Department
64.25of Corrections under section 241.021 and must:
64.26(1) have a designated program director who meets minimum qualification standards set
64.27by the board, including understanding the requirements of competency to stand trial
64.28procedures;
64.29(2) provide minimum mental health services including:
64.30(i) multidisciplinary staff sufficient to monitor defendants and provide timely assessments,
64.31treatment, and referrals as needed, including at least one medical professional licensed to
64.32prescribe psychiatric medication;
65.1(ii) prescribing, dispensing, and administering any medication deemed clinically
65.2appropriate by qualified medical professionals; and
65.3(iii) policies and procedures for the administration of involuntary medication;
65.4(3) ensure that competency restoration education certified by the board is provided to
65.5defendants and regular assessments of defendants' progress in attaining competency to stand
65.6trial are documented;
65.7(4) develop staff procedures or designate a person responsible to ensure timely
65.8communication with the court system; and
65.9(5) designate a space in the correctional facility for the program.
65.10    Subd. 2. Program evaluations. (a) The board shall collect the following data:
65.11(1) the total number of competency examinations ordered in each judicial district
65.12separated by county;
65.13(2) the age, race, and number of unique defendants and for whom at least one competency
65.14examination was ordered in each judicial district separated by county;
65.15(3) the age, race, and number of unique defendants found incompetent at least once in
65.16each judicial district separated by county; and
65.17(4) all available data on the level of charge and adjudication of cases with a defendant
65.18found incompetent and whether a forensic navigator was assigned to the case.
65.19(b) By February 15 of each year, the board must report to the legislative committees and
65.20divisions with jurisdiction over human services, public safety, and the judiciary on the data
65.21collected under this subdivision and may include recommendations for statutory or funding
65.22changes related to competency restoration.

65.23    Sec. 43. Laws 2021, First Special Session chapter 7, article 17, section 12, is amended to
65.24read:
65.25    Sec. 12. ~~PSYCHIATRIC RESIDENTIAL TREATMENT FACILITY AND CHILD~~
65.26~~AND ADOLESCENT~~ ADULT AND CHILDREN'S MOBILE TRANSITION ~~UNIT~~
65.27UNITS.
65.28(a) This act includes $2,500,000 in fiscal year 2022 and $2,500,000 in fiscal year 2023
65.29for the commissioner of human services to create adult and children's mental health transition
65.30and support teams to facilitate transition back to the community ~~of children~~ or to the least
65.31restrictive level of care from inpatient psychiatric settings, emergency departments, residential
66.1treatment facilities, and child and adolescent behavioral health hospitals. The general fund
66.2base included in this act for this purpose is $1,875,000 in fiscal year 2024 and $0 in fiscal
66.3year 2025.
66.4(b) Beginning April 1, 2024, counties may fund and continue conducting activities
66.5funded under this section.
66.6(c) This section expires March 31, 2024.

66.7    Sec. 44. MENTAL HEALTH URGENCY ROOM PILOT PROJECT.
66.8    Subdivision 1. Establishment. (a) The commissioner of human services shall establish
66.9a pilot project that addresses emergency mental health needs by creating urgency rooms to
66.10be used as a first contact resource for youths under the age of 26 who are experiencing a
66.11mental health crisis.
66.12(b) The commissioner shall provide Ramsey County with the first opportunity to operate
66.13the pilot project. If Ramsey County declines or fails to respond by January 1, 2023, the
66.14commissioner shall issue a request for proposals for the operation of the pilot project. Eligible
66.15applicants shall include counties, medical providers, and nonprofit organizations as specified
66.16in subdivision 2, paragraph (a). An applicant must have the capabilities specified in
66.17subdivision 2, paragraphs (b) through (d), and must provide the commissioner as part of
66.18the request for proposal process the information specified in subdivision 3.
66.19    Subd. 2. Eligibility. (a) To participate in the pilot project, the county or applicant may
66.20partner with:
66.21(1) a medical provider, including hospitals or emergency rooms;
66.22(2) a nonprofit organization that provides mental health services; or
66.23(3) a nonprofit organization serving an underserved or rural community if applicable
66.24that will partner with an existing medical provider or nonprofit organization that provides
66.25mental health services.
66.26(b) The partnering entity or entities must have the capability to:
66.27(1) perform a medical evaluation and mental health evaluation upon a youth's admittance
66.28to an urgency room;
66.29(2) accommodate a youth's stay for up to 14 days;
66.30(3) conduct a substance use disorder screening;
66.31(4) conduct a mental health crisis assessment;
67.1(5) provide peer support services;
67.2(6) provide crisis stabilization services;
67.3(7) provide access to crisis psychiatry; and
67.4(8) provide access to care planning and case management.
67.5(c) The entity or entities must have staff who are licensed mental health professionals
67.6as defined under Minnesota Statutes, section 245I.02, subdivision 27, and must have a
67.7connection to inpatient and outpatient mental health services, including the ability to provide
67.8physical health screenings.
67.9(d) The entity or entities must agree to accept patients regardless of their insurance status
67.10or their ability to pay.
67.11    Subd. 3. Application. (a) The county or applicant must provide the commissioner with
67.12the following:
67.13(1) a detailed service plan, including the services that will be provided, and the staffing
67.14requirements needed for these services;
67.15(2) an estimated cost of operating the project; and
67.16(3) verification of financial sustainability by detailing sufficient funding sources and the
67.17capacity to obtain third-party payments for services provided, including private insurance
67.18and federal Medicaid and Medicare financial participation;
67.19(b) The county or applicant and partnering entities must demonstrate an ability and
67.20willingness to build on existing resources in the community, and must agree to an evaluation
67.21of services and financial viability by the commissioner
67.22    Subd. 4. Grant activities. Grant funds from the pilot project may be used for:
67.23(1) expanding current space to create an urgency room;
67.24(2) performing medical or mental health evaluations;
67.25(3) developing a care plan for the youth; and
67.26(4) providing recommendations for further care, either at an inpatient or outpatient
67.27facility.
67.28    Subd. 5. Reporting. (a) The county or grantee must submit a report to the commissioner
67.29in a manner and on a timeline specified by the commissioner on the following:
67.30(1) how grant funds were spent;
68.1(2) how many youths were served; and
68.2(3) how the county or grantee met the goal of the pilot project.
68.3(b) The commissioner shall submit a report to the chairs and ranking minority members
68.4of the legislative committees with jurisdiction over human services regarding pilot project
68.5activities no later than January 15, 2026, on the results of the pilot project, including the
68.6information specified in paragraph (a).

68.7    Sec. 45. ONLINE MUSIC INSTRUCTION GRANT PROGRAM.
68.8(a) The commissioner of health shall award a grant to a community music education
68.9and performance center to partner with schools and early childhood centers to provide online
68.10music instruction to students and children for the purpose of increasing student
68.11self-confidence, providing students with a sense of community, and reducing individual
68.12stress. In applying for the grant, an applicant must commit to providing at least a 30 percent
68.13match of any grant funds received. The applicant must also include in the application the
68.14measurable outcomes the applicant intends to accomplish with the grant funds.
68.15(b) The grantee shall use grant funds to partner with schools or early childhood centers
68.16that are designated Title I schools or centers or are located in rural Minnesota, and may use
68.17the funds in consultation with the music or early childhood educators in each school or early
68.18childhood center to provide individual or small group music instruction, sectional ensembles,
68.19or other group music activities, music workshops, or early childhood music activities. At
68.20least half of the online music programs must be in partnership with schools or early childhood
68.21centers located in rural Minnesota. A grantee may use the funds awarded to supplement or
68.22enhance an existing online music program within a school or early childhood center that
68.23meets the criteria described in this paragraph.
68.24(c) The grantee must contract with a third-party entity to evaluate the success of the
68.25online music program. The evaluation must include interviews with the music educators
68.26and students at the schools and early childhood centers where an online music program was
68.27established. The results of the evaluation must be submitted to the commissioner of health
68.28and to the chairs and ranking minority members of the legislative committees with jurisdiction
68.29over mental health policy and finance by December 15, 2025.

68.30    Sec. 46. MENTAL HEALTH GRANTS FOR HEALTH CARE PROFESSIONALS.
68.31    Subdivision 1. Grants authorized. (a) The commissioner of health shall develop a grant
68.32program to award grants to health care entities, including but not limited to health care
69.1systems, hospitals, nursing facilities, community health clinics or consortium of clinics,
69.2federally qualified health centers, rural health clinics, or health professional associations
69.3for the purpose of establishing or expanding programs focused on improving the mental
69.4health of health care professionals.
69.5(b) Grants shall be awarded for programs that are evidenced-based or evidenced-informed
69.6and are focused on addressing the mental health of health care professionals by:
69.7(1) identifying and addressing the barriers to and stigma among health care professionals
69.8associated with seeking self-care, including mental health and substance use disorder services;
69.9(2) encouraging health care professionals to seek support and care for mental health and
69.10substance use disorder concerns;
69.11(3) identifying risk factors associated with suicide and other mental health conditions;
69.12or
69.13(4) developing and making available resources to support health care professionals with
69.14self-care and resiliency.
69.15    Subd. 2. Allocation of grants. (a) To receive a grant, a health care entity must submit
69.16an application to the commissioner by the deadline established by the commissioner. An
69.17application must be on a form and contain information as specified by the commissioner
69.18and at a minimum must contain:
69.19(1) a description of the purpose of the program for which the grant funds will be used;
69.20(2) a description of the achievable objectives of the program and how these objectives
69.21will be met; and
69.22(3) a process for documenting and evaluating the results of the program.
69.23(b) The commissioner shall give priority to programs that involve peer-to-peer support.
69.24    Subd. 3. Evaluation. The commissioner shall evaluate the overall effectiveness of the
69.25grant program by conducting a periodic evaluation of the impact and outcomes of the grant
69.26program on health care professional burnout and retention. The commissioner shall submit
69.27the results of the evaluation and any recommendations for improving the grant program to
69.28the chairs and ranking minority members of the legislative committees with jurisdiction
69.29over health care policy and finance by October 15, 2024.

70.1    Sec. 47. DIRECTION TO COMMISSIONER.
70.2The commissioner must update the behavioral health fund room and board rate schedule
70.3to include programs providing children's mental health crisis admissions and stabilization
70.4under Minnesota Statutes, section 245.4882, subdivision 6. The commissioner must establish
70.5room and board rates commensurate with current room and board rates for adolescent
70.6programs licensed under Minnesota Statutes, section 245G.18.

70.7    Sec. 48. REVISOR INSTRUCTION.
70.8The revisor of statutes shall change the term "intensive treatment in foster care" or similar
70.9terms to "children's intensive behavioral health services" wherever they appear in Minnesota
70.10Statutes and Minnesota Rules when referring to those providers and services regulated under
70.11Minnesota Statutes, section 256B.0946. The revisor shall make technical and grammatical
70.12changes related to the changes in terms.

70.13    Sec. 49. REPEALER.
70.14Minnesota Statutes 2020, section 245.4661, subdivision 8, is repealed.

70.15    Sec. 50. EFFECTIVE DATE.
70.16Section 23 to 34 are effective July 1, 2023, and apply to competency determinations
70.17initiated on or after that date.

70.18ARTICLE 2

70.19BOARD OF MEDICAL PRACTICE; TEMPORARY PERMITS

70.20    Section 1. Minnesota Statutes 2020, section 147.01, subdivision 7, is amended to read:
70.21    Subd. 7. Physician application and license fees. (a) The board may charge the following
70.22nonrefundable application and license fees processed pursuant to sections 147.02, 147.03,
70.23147.037, 147.0375, and 147.38:
70.24(1) physician application fee, $200;
70.25(2) physician annual registration renewal fee, $192;
70.26(3) physician endorsement to other states, $40;
70.27(4) physician emeritus license, $50;
70.28~~(5) physician temporary license, $60;~~
70.29~~(6)~~ (5) physician late fee, $60;
71.1~~(7)~~ (6) duplicate license fee, $20;
71.2~~(8)~~ (7) certification letter fee, $25;
71.3~~(9)~~ (8) education or training program approval fee, $100;
71.4~~(10)~~ (9) report creation and generation fee, $60 per hour;
71.5~~(11)~~ (10) examination administration fee (half day), $50;
71.6~~(12)~~ (11) examination administration fee (full day), $80;
71.7~~(13)~~ (12) fees developed by the Interstate Commission for determining physician
71.8qualification to register and participate in the interstate medical licensure compact, as
71.9established in rules authorized in and pursuant to section 147.38, not to exceed $1,000; and
71.10~~(14)~~ (13) verification fee, $25.
71.11(b) The board may prorate the initial annual license fee. All licensees are required to
71.12pay the full fee upon license renewal. The revenue generated from the fee must be deposited
71.13in an account in the state government special revenue fund.
71.14EFFECTIVE DATE.This section is effective the day following final enactment.

71.15    Sec. 2. Minnesota Statutes 2020, section 147.03, subdivision 1, is amended to read:
71.16    Subdivision 1. Endorsement; reciprocity. (a) The board may issue a license to practice
71.17medicine to any person who satisfies the requirements in paragraphs (b) to (e).
71.18    (b) The applicant shall satisfy all the requirements established in section 147.02,
71.19subdivision 1, paragraphs (a), (b), (d), (e), and (f), or section 147.037, subdivision 1,
71.20paragraphs (a) to (e).
71.21    (c) The applicant shall:
71.22    (1) have passed an examination prepared and graded by the Federation of State Medical
71.23Boards, the National Board of Medical Examiners, or the United States Medical Licensing
71.24Examination (USMLE) program in accordance with section 147.02, subdivision 1, paragraph
71.25(c), clause (2); the National Board of Osteopathic Medical Examiners; or the Medical Council
71.26of Canada; and
71.27    (2) have a current license from the equivalent licensing agency in another state or Canada
71.28and, if the examination in clause (1) was passed more than ten years ago, either:
71.29    (i) pass the Special Purpose Examination of the Federation of State Medical Boards with
71.30a score of 75 or better within three attempts; or
72.1    (ii) have a current certification by a specialty board of the American Board of Medical
72.2Specialties, of the American Osteopathic Association, the Royal College of Physicians and
72.3Surgeons of Canada, or of the College of Family Physicians of Canada; or
72.4    (3) if the applicant fails to meet the requirement established in section 147.02, subdivision
72.51, paragraph (c), clause (2), because the applicant failed to pass each of steps one, two, and
72.6three of the USMLE within the required three attempts, the applicant may be granted a
72.7license provided the applicant:
72.8    (i) has passed each of steps one, two, and three with passing scores as recommended by
72.9the USMLE program within no more than four attempts for any of the three steps;
72.10    (ii) is currently licensed in another state; and
72.11    (iii) has current certification by a specialty board of the American Board of Medical
72.12Specialties, the American Osteopathic Association Bureau of Professional Education, the
72.13Royal College of Physicians and Surgeons of Canada, or the College of Family Physicians
72.14of Canada.
72.15    (d) The applicant must not be under license suspension or revocation by the licensing
72.16board of the state or jurisdiction in which the conduct that caused the suspension or revocation
72.17occurred.
72.18    (e) The applicant must not have engaged in conduct warranting disciplinary action against
72.19a licensee, or have been subject to disciplinary action other than as specified in paragraph
72.20(d). If an applicant does not satisfy the requirements stated in this paragraph, the board may
72.21issue a license only on the applicant's showing that the public will be protected through
72.22issuance of a license with conditions or limitations the board considers appropriate.
72.23    (f) Upon the request of an applicant, the board may conduct the final interview of the
72.24applicant by teleconference.
72.25EFFECTIVE DATE.This section is effective the day following final enactment.

72.26    Sec. 3. Minnesota Statutes 2020, section 147.03, subdivision 2, is amended to read:
72.27    Subd. 2. Temporary permit. (a) An applicant for licensure under this section may
72.28request the board to issue a temporary permit in accordance with this subdivision. Upon
72.29receipt of the application for licensure, a request for a temporary permit, and a nonrefundable
72.30physician application fee specified under section 147.01, subdivision 7, the board may issue
72.31a temporary permit to practice medicine to as a physician ~~eligible for licensure under this~~
73.1~~section only if the application for licensure is complete, all requirements in subdivision 1~~
73.2~~have been met, and a nonrefundable fee set by the board has been paid~~ if the applicant is:
73.3(1) currently licensed in good standing to practice medicine as a physician in another
73.4state, territory, or Canadian province; and
73.5(2) not the subject of a pending investigation or disciplinary action in any state, territory,
73.6or Canadian province.
73.7~~The permit remains~~ (b) A temporary permit issued under this subdivision is nonrenewable
73.8and shall be valid ~~only~~ until ~~the meeting of the board at which~~ a decision is made on the
73.9physician's application for licensure or for 90 days, whichever occurs first.
73.10(c) The board may revoke a temporary permit that has been issued under this subdivision
73.11if the physician is the subject of an investigation or disciplinary action, or is disqualified
73.12for licensure for any other reason.
73.13(d) Notwithstanding section 13.41, subdivision 2, the board may release information
73.14regarding action taken by the board pursuant to this subdivision.
73.15EFFECTIVE DATE.This section is effective the day following final enactment.

73.16    Sec. 4. Minnesota Statutes 2020, section 147.037, is amended to read:
73.17147.037 LICENSING OF FOREIGN MEDICAL SCHOOL GRADUATES;
73.18~~TEMPORARY PERMIT~~.
73.19    Subdivision 1. Requirements. The board shall issue a license to practice medicine to
73.20any person who satisfies the requirements in paragraphs (a) to (g).
73.21    (a) The applicant shall satisfy all the requirements established in section 147.02,
73.22subdivision 1, paragraphs (a), (e), (f), (g), and (h).
73.23    (b) The applicant shall present evidence satisfactory to the board that the applicant is a
73.24graduate of a medical or osteopathic school approved by the board as equivalent to accredited
73.25United States or Canadian schools based upon its faculty, curriculum, facilities, accreditation,
73.26or other relevant data. If the applicant is a graduate of a medical or osteopathic program
73.27that is not accredited by the Liaison Committee for Medical Education or the American
73.28Osteopathic Association, the applicant may use the Federation of State Medical Boards'
73.29Federation Credentials Verification Service (FCVS) or its successor. If the applicant uses
73.30this service as allowed under this paragraph, the physician application fee may be less than
73.31$200 but must not exceed the cost of administering this paragraph.
74.1    (c) The applicant shall present evidence satisfactory to the board that the applicant has
74.2been awarded a certificate by the Educational Council for Foreign Medical Graduates, and
74.3the applicant has a working ability in the English language sufficient to communicate with
74.4patients and physicians and to engage in the practice of medicine.
74.5    (d) The applicant shall present evidence satisfactory to the board of the completion of
74.6one year of graduate, clinical medical training in a program accredited by a national
74.7accrediting organization approved by the board or other graduate training approved in
74.8advance by the board as meeting standards similar to those of a national accrediting
74.9organization. This requirement does not apply:
74.10    (1) to an applicant who is admitted as a permanent immigrant to the United States on or
74.11before October 1, 1991, as a person of exceptional ability in the sciences according to Code
74.12of Federal Regulations, title 20, section 656.22(d); or
74.13    (2) to an applicant holding a valid license to practice medicine in another country and
74.14issued a permanent immigrant visa after October 1, 1991, as a person of extraordinary ability
74.15in the field of science or as an outstanding professor or researcher according to Code of
74.16Federal Regulations, title 8, section 204.5(h) and (i), or a temporary nonimmigrant visa as
74.17a person of extraordinary ability in the field of science according to Code of Federal
74.18Regulations, title 8, section 214.2(o),
74.19provided that a person under clause (1) or (2) is admitted pursuant to rules of the United
74.20States Department of Labor.
74.21    (e) The applicant must:
74.22    (1) have passed an examination prepared and graded by the Federation of State Medical
74.23Boards, the United States Medical Licensing Examination program in accordance with
74.24section 147.02, subdivision 1, paragraph (c), clause (2), or the Medical Council of Canada;
74.25and
74.26    (2) if the examination in clause (1) was passed more than ten years ago, either:
74.27    (i) pass the Special Purpose Examination of the Federation of State Medical Boards with
74.28a score of 75 or better within three attempts; or
74.29    (ii) have a current certification by a specialty board of the American Board of Medical
74.30Specialties, of the American Osteopathic Association, of the Royal College of Physicians
74.31and Surgeons of Canada, or of the College of Family Physicians of Canada; or
74.32    (3) if the applicant fails to meet the requirement established in section 147.02, subdivision
74.331, paragraph (c), clause (2), because the applicant failed to pass each of steps one, two, and
75.1three of the USMLE within the required three attempts, the applicant may be granted a
75.2license provided the applicant:
75.3    (i) has passed each of steps one, two, and three with passing scores as recommended by
75.4the USMLE program within no more than four attempts for any of the three steps;
75.5    (ii) is currently licensed in another state; and
75.6    (iii) has current certification by a specialty board of the American Board of Medical
75.7Specialties, the American Osteopathic Association, the Royal College of Physicians and
75.8Surgeons of Canada, or the College of Family Physicians of Canada.
75.9    (f) The applicant must not be under license suspension or revocation by the licensing
75.10board of the state or jurisdiction in which the conduct that caused the suspension or revocation
75.11occurred.
75.12    (g) The applicant must not have engaged in conduct warranting disciplinary action
75.13against a licensee, or have been subject to disciplinary action other than as specified in
75.14paragraph (f). If an applicant does not satisfy the requirements stated in this paragraph, the
75.15board may issue a license only on the applicant's showing that the public will be protected
75.16through issuance of a license with conditions or limitations the board considers appropriate.
75.17    ~~Subd. 1a.~~ ~~Temporary permit.~~ ~~The board may issue a temporary permit to practice~~
75.18~~medicine to a physician eligible for licensure under this section only if the application for~~
75.19~~licensure is complete, all requirements in subdivision 1 have been met, and a nonrefundable~~
75.20~~fee set by the board has been paid. The permit remains valid only until the meeting of the~~
75.21~~board at which a decision is made on the physician's application for licensure.~~
75.22    Subd. 2. Medical school review. The board may contract with any qualified person or
75.23organization for the performance of a review or investigation, including site visits if
75.24necessary, of any medical or osteopathic school prior to approving the school under section
75.25147.02, subdivision 1, paragraph (b), or subdivision 1, paragraph (b), of this section. To the
75.26extent possible, the board shall require the school being reviewed to pay the costs of the
75.27review or investigation.
75.28EFFECTIVE DATE.This section is effective the day following final enactment.

75.29    Sec. 5. [147A.025] TEMPORARY PERMIT.
75.30(a) An applicant for licensure under section 147A.02, may request the board to issue a
75.31temporary permit in accordance with this section. Upon receipt of the application for
75.32licensure, a request for a temporary permit, and a nonrefundable physician assistant
76.1application fee as specified under section 147A.28, the board may issue a temporary permit
76.2to practice as a physician assistant if the applicant is:
76.3(1) currently licensed in good standing to practice as a physician assistant in another
76.4state, territory, or Canadian province; and
76.5(2) not subject to a pending investigation or disciplinary action in any state, territory, or
76.6Canadian province.
76.7(b) A temporary permit issued under this section is nonrenewable and shall be valid until
76.8a decision is made on the physician assistant's application for licensure or for 90 days,
76.9whichever occurs first.
76.10(c) The board may revoke the temporary permit that has been issued under this section
76.11if the applicant is the subject of an investigation or disciplinary action or is disqualified for
76.12licensure for any other reason.
76.13(d) Notwithstanding section 13.41, subdivision 2, the board may release information
76.14regarding any action taken by the board pursuant to this section.
76.15EFFECTIVE DATE.This section is effective the day following final enactment.

76.16    Sec. 6. Minnesota Statutes 2020, section 147A.28, is amended to read:
76.17147A.28 PHYSICIAN ASSISTANT APPLICATION AND LICENSE FEES.
76.18(a) The board may charge the following nonrefundable fees:
76.19(1) physician assistant application fee, $120;
76.20~~(2) physician assistant annual registration renewal fee (prescribing authority), $135;~~
76.21~~(3)~~ (2) physician assistant annual ~~registration~~ license renewal fee ~~(no prescribing~~
76.22~~authority)~~, $115;
76.23~~(4) physician assistant temporary registration, $115;~~
76.24~~(5) physician assistant temporary permit, $60;~~
76.25~~(6)~~ (3) physician assistant locum tenens permit, $25;
76.26~~(7)~~ (4) physician assistant late fee, $50;
76.27~~(8)~~ (5) duplicate license fee, $20;
76.28~~(9)~~ (6) certification letter fee, $25;
76.29~~(10)~~ (7) education or training program approval fee, $100;
77.1~~(11)~~ (8) report creation and generation fee, $60 per hour; and
77.2~~(12)~~ (9) verification fee, $25.
77.3(b) The board may prorate the initial annual license fee. All licensees are required to
77.4pay the full fee upon license renewal. The revenue generated from the fees must be deposited
77.5in an account in the state government special revenue fund.
77.6EFFECTIVE DATE.This section is effective the day following final enactment.

77.7    Sec. 7. Minnesota Statutes 2020, section 147C.40, subdivision 5, is amended to read:
77.8    Subd. 5. Respiratory therapist application and license fees. (a) The board may charge
77.9the following nonrefundable fees:
77.10(1) respiratory therapist application fee, $100;
77.11(2) respiratory therapist annual registration renewal fee, $90;
77.12(3) respiratory therapist inactive status fee, $50;
77.13(4) respiratory therapist temporary registration fee, $90;
77.14~~(5) respiratory therapist temporary permit, $60;~~
77.15~~(6)~~ (5) respiratory therapist late fee, $50;
77.16~~(7)~~ (6) duplicate license fee, $20;
77.17~~(8)~~ (7) certification letter fee, $25;
77.18~~(9)~~ (8) education or training program approval fee, $100;
77.19~~(10)~~ (9) report creation and generation fee, $60 per hour; and
77.20~~(11)~~ (10) verification fee, $25.
77.21(b) The board may prorate the initial annual license fee. All licensees are required to
77.22pay the full fee upon license renewal. The revenue generated from the fees must be deposited
77.23in an account in the state government special revenue fund.
77.24EFFECTIVE DATE.This section is effective the day following final enactment.

77.25    Sec. 8. REPEALER.
77.26Minnesota Statutes 2020, section 147.02, subdivision 2a, is repealed.
77.27EFFECTIVE DATE.This section is effective the day following final enactment.

78.1ARTICLE 3

78.2APPROPRIATIONS

78.3    Section 1. APPROPRIATION BASE ESTABLISHED; COMPETENCY
78.4RESTORATION.
78.5    Subdivision 1. Department of Corrections. The general fund appropriation base for
78.6the commissioner of corrections is $202,000 in fiscal year 2024 and $202,000 in fiscal year
78.72025 for correctional facilities inspectors.
78.8    Subd. 2. District courts. The general fund appropriation base for the district courts is
78.9$5,042,000 in fiscal year 2024 and $5,042,000 in fiscal year 2025 for costs associated with
78.10additional competency examination costs.
78.11    Subd. 3. State Competency Restoration Board. The general fund appropriation base
78.12for the State Competency Restoration Board is $11,350,000 in fiscal year 2024 and
78.13$10,900,000 in fiscal year 2025 for staffing and other costs needed to establish and perform
78.14the duties of the State Competency Restoration Board, including providing educational
78.15services necessary to restore defendants to competency, or contracting or partnering with
78.16other organizations to provide those services.

78.17    Sec. 2. APPROPRIATION; ADULT MENTAL HEALTH INITIATIVE GRANTS.
78.18(a) The general fund base for adult mental health initiative services under Minnesota
78.19Statutes, section 245.4661, is increased by $10,233,000 in fiscal year 2025 and thereafter,
78.20and is increased by an additional $10,140,000 in fiscal year 2026 and thereafter.
78.21(b) The general fund base for administration of adult mental health initiative services
78.22grants is increased by $135,000 in fiscal year 2025.
78.23(c) $400,000 in fiscal year 2023 is appropriated from the general fund to the commissioner
78.24of management and budget to create and maintain an inventory of adult mental health
78.25initiative services and to conduct evaluations of adult mental health initiative services that
78.26are promising practices or theory-based activities under Minnesota Statutes, section 245.4661,
78.27subdivision 5a.

78.28    Sec. 3. APPROPRIATION; AFRICAN AMERICAN COMMUNITY MENTAL
78.29HEALTH CENTER.
78.30(a) $1,000,000 in fiscal year 2023 is appropriated from the general fund to the
78.31commissioner of human services for a grant to an African American mental health service
78.32provider that is a licensed community mental health center specializing in services for
79.1African American children and families. The mental health center must offer culturally
79.2specific, comprehensive, trauma-informed, practice- and evidence-based, person- and
79.3family-centered mental health and substance use disorder services; supervision and training;
79.4and care coordination to all ages, regardless of ability to pay or place of residence. Upon
79.5request, the commissioner shall make information regarding the use of this grant funding
79.6available to the chairs and ranking minority members of the legislative committees with
79.7jurisdiction over health and human services. This is a onetime appropriation and is available
79.8until June 30, 2025.
79.9(b) The general fund base for this appropriation for administration of the grant in
79.10paragraph (a) is $104,000 in fiscal year 2024, $104,000 in fiscal year 2025, and $0 in fiscal
79.11year 2026 and thereafter.

79.12    Sec. 4. APPROPRIATION; CHILDREN'S FIRST EPISODE OF PSYCHOSIS.
79.13(a) $6,000 in fiscal year 2023 is appropriated from the general fund to the commissioner
79.14of human services to implement a children's first episode of psychosis grant under Minnesota
79.15Statutes, section 245.4905. The base for this appropriation is $480,000 in fiscal year 2024
79.16and $480,000 in fiscal year 2025.
79.17(b) Of this appropriation, $6,000 in fiscal year 2023 is for grants for children's first
79.18episode of psychosis.
79.19(c) The general fund base for administration is $119,000 in fiscal year 2024 and $119,000
79.20in fiscal year 2025. The general fund base for grants for children's first episode of psychosis
79.21is $361,000 in fiscal year 2024 and $361,000 in fiscal year 2025.

79.22    Sec. 5. APPROPRIATION; CHILDREN'S INTENSIVE BEHAVIORAL HEALTH
79.23TREATMENT SERVICES.
79.24(a) $101,000 in fiscal year 2023 is appropriated from the general fund to the commissioner
79.25of human services for children's intensive behavioral health treatment services. The base
79.26for this appropriation is $474,000 in fiscal year 2024 and $3,204,000 in fiscal year 2025.
79.27(b) Of this appropriation, $101,000 in fiscal year 2023 is for administration.
79.28(c) The general fund base for administration is $228,000 in fiscal year 2024 and $228,000
79.29in fiscal year 2025. The general fund base for children's intensive behavioral health treatment
79.30services is $246,000 in fiscal year 2024 and $2,976,000 in fiscal year 2025.

80.1    Sec. 6. APPROPRIATION; CHILDREN'S RESIDENTIAL FACILITY CRISIS
80.2STABILIZATION SERVICES.
80.3(a) $203,000 in fiscal year 2023 is appropriated from the general fund to the commissioner
80.4of human services for children's residential facility crisis stabilization services under
80.5Minnesota Statutes, section 245A.26. The general fund base for this appropriation is $495,000
80.6in fiscal year 2024 and $559,000 in fiscal year 2025.
80.7(b) Of this appropriation, $53,000 in fiscal year 2023 is for children's residential facility
80.8crisis stabilization services, $105,000 in fiscal year 2023 is for administration, and $45,000
80.9in fiscal year 2023 is for systems costs.
80.10(c) The general fund base for children's residential facility crisis stabilization services
80.11is $367,000 in fiscal year 2024 and $431,000 in fiscal year 2025. The general fund base for
80.12administration is $119,000 in fiscal year 2024 and $119,000 in fiscal year 2025. The general
80.13fund base for systems is $9,000 in fiscal year 2024 and $9,000 in fiscal year 2025.

80.14    Sec. 7. APPROPRIATION; INTENSIVE RESIDENTIAL TREATMENT SERVICES.
80.15(a) $2,914,000 in fiscal year 2023 is appropriated from the general fund to the
80.16commissioner of human services to provide start-up funds to intensive residential treatment
80.17service providers to provide treatment in locked facilities for patients who have been
80.18transferred from a jail or who have been deemed incompetent to stand trial and a judge has
80.19determined that the patient needs to be in a secure facility. The base for this appropriation
80.20is $180,000 in fiscal year 2024 and $0 in fiscal year 2025.
80.21(b) Of this appropriation, $115,000 in fiscal year 2023 is for administration and $3,000
80.22in fiscal year 2023 is for systems costs.
80.23(c) The base for administration is $179,000 in fiscal year 2024 and is available until
80.24June 30, 2025. The base for systems costs is $1,000 in fiscal year 2024 and $0 in fiscal year
80.252025.

80.26    Sec. 8. APPROPRIATION; MANAGED CARE MINIMUM RATE FOR MENTAL
80.27HEALTH SERVICES.
80.28$28,000 in fiscal year 2023 is appropriated from the general fund to the commissioner
80.29of human services to monitor the mental health services rate paid to providers under
80.30Minnesota Statutes, section 256B.763. The general fund base for this appropriation is
80.31$32,000 in fiscal year 2024 and $32,000 in fiscal year 2025.

81.1    Sec. 9. APPROPRIATION; MENTAL HEALTH GRANTS FOR HEALTH CARE
81.2PROFESSIONALS.
81.3$1,000,000 in fiscal year 2023 is appropriated from the general fund to the commissioner
81.4of health for the health care professionals mental health grant program. This is a onetime
81.5appropriation.

81.6    Sec. 10. APPROPRIATION; MENTAL HEALTH PROFESSIONAL LOAN
81.7FORGIVENESS.
81.8Notwithstanding the priorities and distribution requirements under Minnesota Statutes,
81.9section 144.1501, $1,600,000 is appropriated in fiscal year 2023 from the general fund to
81.10the commissioner of health for the health professional loan forgiveness program to be used
81.11for loan forgiveness only for individuals who are eligible mental health professionals under
81.12Minnesota Statutes, section 144.1501. Notwithstanding Minnesota Statutes, section 144.1501,
81.13subdivision 2, paragraph (b), if the commissioner of health does not receive enough qualified
81.14applicants within each biennium, the remaining funds shall be carried over to the next
81.15biennium and allocated proportionally among the other eligible professions in accordance
81.16with Minnesota Statutes, section 144.1501, subdivision 2.

81.17    Sec. 11. APPROPRIATION; MENTAL HEALTH PROVIDER SUPERVISION
81.18GRANT PROGRAM.
81.19$2,500,000 is appropriated in fiscal year 2023 from the general fund to the commissioner
81.20of human services for the mental health provider supervision grant program under Minnesota
81.21Statutes, section 245.4663.

81.22    Sec. 12. APPROPRIATION; MENTAL HEALTH URGENCY ROOM PILOT
81.23PROJECT.
81.24(a) $1,215,000 in fiscal year 2023 is appropriated from the general fund to the
81.25commissioner of human services for a mental health urgency room pilot project. The general
81.26fund base for this appropriation is $247,000 in fiscal year 2024, $247,000 in fiscal year
81.272025, and $0 in fiscal year 2026 and thereafter.
81.28(b) Of this appropriation, $1,000,000 in fiscal year 2023 is for a grant for a mental health
81.29urgency room pilot project and $215,000 in fiscal year 2023 is for administration.
81.30(c) The general fund base for administration is $247,000 in fiscal year 2024, $247,000
81.31in fiscal year 2025, and $0 in fiscal year 2026 and thereafter.
82.1(d) Any amount of this appropriation that is not encumbered on January 1, 2024, shall
82.2cancel and be added to the base amount in fiscal year 2024 for mobile crisis grants.

82.3    Sec. 13. APPROPRIATION; MOBILE CRISIS SERVICES.
82.4The general fund base for grants for adult mobile crisis services under Minnesota Statutes,
82.5section 245.4661, subdivision 9, paragraph (b), clause (15), is increased by $4,000,000 in
82.6fiscal year 2024 and increased by $5,600,000 in fiscal year 2025.

82.7    Sec. 14. APPROPRIATION; MOBILE TRANSITION UNITS AND PERSON
82.8CENTERED DISCHARGE PLANNING.
82.9(a) $796,000 in fiscal year 2023 is appropriated from the general fund to the commissioner
82.10of human services for a person-centered discharge planning process for adults and children
82.11being discharged from psychiatric residential treatment facilities, child and adolescent
82.12behavioral health hospitals, and hospital settings. The base for this appropriation is
82.13$1,010,000 in fiscal year 2024 and $1,010,000 in fiscal year 2025.
82.14(b) Of this appropriation, $546,000 in fiscal year 2023 is for administration and $250,000
82.15is for a grants to develop and support a person-centered discharge planning process for
82.16adults and children being discharged from psychiatric residential treatment facilities, child
82.17and adolescent behavioral health hospitals, and hospital settings.
82.18(c) The general fund base for administration is $760,000 in fiscal year 2024 and $760,000
82.19in fiscal year 2025. The general fund base is $250,000 in fiscal year 2024 and $250,000 in
82.20fiscal year 2025 for grants to develop and support a person-centered discharge planning
82.21process for adults and children being discharged from psychiatric residential treatment
82.22facilities, child and adolescent behavioral health hospitals, and hospital settings.

82.23    Sec. 15. APPROPRIATION; MONITORING OF A PSYCHIATRIC HOSPITAL.
82.24$15,000 in fiscal year 2023 is appropriated from the state government special revenue
82.25fund to the commissioner of health for collecting data and monitoring the 144-bed psychiatric
82.26hospital in the city of Saint Paul, Ramsey County, per Minnesota Statutes, described in
82.27section 144.551, subdivision 1, paragraph (b), clause (31).

82.28    Sec. 16. APPROPRIATION; OFFICER-INVOLVED COMMUNITY-BASED CARE
82.29COORDINATION.
82.30$11,000 in fiscal year 2023 is appropriated from the general fund to the commissioner
82.31of human services for medical assistance expenditures for officer-involved community-based
83.1care coordination. The general fund base for this appropriation is $10,000 in fiscal year
83.22024 and $15,000 in fiscal year 2025.

83.3    Sec. 17. APPROPRIATION; ONLINE MUSIC INSTRUCTION GRANT.
83.4$300,000 in fiscal year 2023 is appropriated from the general fund to the commissioner
83.5of health for a grant for the online music instruction grant program. This is a onetime
83.6appropriation and is available until June 30, 2025.

83.7    Sec. 18. APPROPRIATION; SCHOOL-LINKED BEHAVIORAL HEALTH
83.8GRANTS.
83.9$2,000,000 in fiscal year 2023 is appropriated from the general fund to the commissioner
83.10of human services for school-linked behavioral health grants under Minnesota Statutes,
83.11section 245.4901.

83.12    Sec. 19. APPROPRIATION; SHELTER-LINKED MENTAL HEALTH GRANTS.
83.13$2,000,000 in fiscal year 2023 is appropriated from the general fund to the commissioner
83.14of human services for shelter-linked youth mental health grants under Minnesota Statutes,
83.15section 256K.46."
83.16Renumber the sections in sequence and correct the internal references
83.17Amend the title accordingly
83.18The motion prevailed. #did not prevail. So the amendment was #not adopted.