HF4421 (Legislative Session 94 (2025-2026))
County cost-share requirements for economically distressed counties modified, and opiate epidemic response fund appropriation modified.
Related bill: SF4626
AI Generated Summary
Purpose
- This bill makes changes to how costs are shared for certain health services by counties, and it expands and reorganizes funding for addressing the opiate epidemic in Minnesota. It adjusts who pays for substance use disorder services, defines when counties are considered economically distressed, and sets up and allocates money through the Opiate Epidemic Response Fund for various programs and initiatives.
Main Provisions
Economic distress designation for counties
- Counties classified as economically distressed are exempt from paying certain costs.
- Criteria to be named economically distressed: more than 15% of the county’s population living in poverty and more than 70% of the county’s land area exempt from property taxation.
Cost sharing for substance use disorder (SUD) services
- Generally, counties must pay 22.95% of the cost of SUD services (with some exceptions).
- Exceptions include certain services covered under other programs (e.g., MA/Medicaid, room and board).
- Counties can use the indigent hospitalization levy to finance treatment and hospital payments.
- If a county is economically distressed, it is not responsible for its share of the cost of SUD services.
Revisions to funding and distribution in the Opiate Epidemic Response framework
- A series of appropriations from the registration and license fee account are specified for:
- Opiate antagonist distribution grants (for overdose prevention and related activities).
- Direct payments to Tribal nations and urban Indian communities for traditional healing practices and to bolster culturally specific behavioral health providers.
- Competitive grants for opioid-focused Project ECHO programs.
- Safe recovery sites startup and capacity-building grants.
- Opioid overdose surge alert system.
- Administrative and evaluation activities related to the program and advisory council.
- Funding for the Bureau of Criminal Apprehension within public safety (drug science/lab work and drug interdiction positions).
- Fees collection by the Board of Pharmacy.
- After other required allocations, 50% of the remaining funds go to county and Tribal social service agencies for prevention and child protection services related to families affected by addiction, distributed using a formula based on past intake and out-of-home placement data.
- Funds for prevention and child protection cannot be used to supplant existing state or local funding.
- Any remaining money after these allocations goes to grants as directed by the Opiate Epidemic Response Advisory Council.
- Beginning in 2022, some distributions may be calendar-year-based rather than fiscal-year-based.
- Funds remain available for up to three years after being appropriated.
Notable Changes to Law
- Explicit exemptions for economically distressed counties from certain cost-sharing obligations for care.
- A formal criteria-based method to classify counties as economically distressed (poverty rate and property tax exemptions).
- A structured, multi-source funding framework for opiate epidemic response activities, including grants, tribal funding, traditional healing, and public safety.
- Requirements for reporting and accountability to ensure funds support prevention and child protection services without duplicating or replacing existing funding.
- Clarified distribution timelines (calendar-year option) and multi-year availability of funds.
Who is Affected
- Counties, especially economically distressed counties, and the county social service system.
- Tribal nations and urban Indian communities, through direct funding and support for traditional healing and culturally specific providers.
- Individuals and communities affected by substance use disorders and opioid misuse, through changes in service funding and access.
- Agencies involved in public safety, health services, child protection, and addiction prevention and treatment programs.
Potential Impacts
- Financial relief for economically distressed counties by reducing or eliminating county cost-sharing for certain care.
- Expanded funding and targeted programs to combat opioid misuse, including overdose prevention, traditional healing, and capacity-building for treatment providers.
- Increased emphasis on prevention and child protection services related to addiction, supported by data-driven distribution of funds.
- Greater coordination among state agencies, tribes, and urban Indian communities in addressing the opiate epidemic.
Relevant Terms - economically distressed counties - poverty (more than 15 percent) - property tax exemptions (more than 70 percent) - cost sharing - substance use disorder services - 22.95 percent - indigent hospitalization levy - opiate antagonist distribution - Opiate Epidemic Response Fund - Opiate Epidemic Response Advisory Council - Tribal nations and urban Indian communities - traditional healing practices - Project ECHO programs - safe recovery sites - overdose surge alert system - administrative services - grants and distributions - prevention and child protection services - out-of-home placement - not to supplant existing funding - calendar year distribution - three-year availability of funds
Bill text versions
- Introduction PDF PDF file
Actions
| Date | Chamber | Where | Type | Name | Committee Name |
|---|---|---|---|---|---|
| March 18, 2026 | House | Action | Introduction and first reading, referred to | Health Finance and Policy |
Citations
[
{
"analysis": {
"added": [
"Adds explicit criteria for classifying a county as economically distressed (poverty rate > 15% and >70% of county land exempt from property tax)."
],
"removed": [
"Strikes or narrows previous cost-sharing rules by providing an explicit exemption for economically distressed counties."
],
"summary": "Modifies the exceptions and classification for county cost-sharing under the care provisions for economically distressed counties, defining criteria for distress and clarifying when counties are not responsible for certain costs.",
"modified": [
"Alters applicability of cost-sharing obligations under this section based on economic distress status."
]
},
"citation": "Minnesota Statutes 2024 section 246.54 subdivision 2",
"subdivision": "subdivision 2"
},
{
"analysis": {
"added": [
"Keeps 22.95% county share of the cost of substance use disorder services (with certain exceptions for MA enrollees).",
"Permits use of the indigent hospitalization levy for treatment and hospital payments under this section."
],
"removed": [
"Explicitly provides for distributions to counties from private or third-party payor collections (less 15%) for the cost of payment and collections."
],
"summary": "Revises how costs for substance use disorder services are divided between counties and the state.",
"modified": [
"Allows economically distressed counties to be treated as not responsible for the county share of costs under this section."
]
},
"citation": "Minnesota Statutes 2025 Supplement section 254B.03 subdivision 4",
"subdivision": "subdivision 4"
},
{
"analysis": {
"added": [
"Creates appropriations for opioid antagonist distribution, tribal and urban Indian community partnerships, and traditional healing practices.",
"Funds for Project ECHO programs focused on opioid-related education and outreach.",
"Funding for safe recovery sites startup and capacity-building grants."
],
"removed": [
"No explicit removals identified; the clause reorganizes or adds allocations rather than removing existing lines."
],
"summary": "Allocates funds from the registration and license fee account to various programs related to opiate response and behavioral health.",
"modified": [
"Reconfigures and expands the use of funds from the registration and license fee account toward opiate epidemic response and related workforce and community initiatives."
]
},
"citation": "Minnesota Statutes 2025 Supplement section 256.043 subdivision 3",
"subdivision": "subdivision 3"
},
{
"analysis": {
"added": [
"No substantive programmatic addition; cross-reference clarifies application of cost-sharing rules to certain services."
],
"removed": [
"No explicit removals identified."
],
"summary": "References the applicability of the cost-sharing framework under section 254B.09 in the context of the opioid and behavioral health funding provisions.",
"modified": [
"Maintains linkage between county contributions and state funding within the new opioid response funding framework."
]
},
"citation": "Minnesota Statutes 2025 Supplement section 254B.09 subdivision 1",
"subdivision": "subdivision 1"
},
{
"analysis": {
"added": [
"Specific funding lines or program support related to the opiate epidemic response are continued or expanded under this statute."
],
"removed": [
"No explicit removals identified."
],
"summary": "Allocations related to behavioral health or related services within the state’s budgeting framework.",
"modified": [
"Details of funding for related behavioral health services are adjusted in conjunction with the opiate epidemic response funds."
]
},
"citation": "Minnesota Statutes 2025 Supplement section 256B.69",
"subdivision": ""
},
{
"analysis": {
"added": [
"Includes funding for evaluation activities as part of program oversight."
],
"removed": [
"No explicit removals identified."
],
"summary": "Provides for evaluation activities related to the opiate epidemic response grants and programs.",
"modified": [
"Explicitly earmarks funds for evaluation in connection with the Opiate Epidemic Response Advisory Council initiatives."
]
},
"citation": "Minnesota Statutes 2025 Supplement section 256.042 subdivision 1",
"subdivision": "subdivision 1"
},
{
"analysis": {
"added": [
"Allocates or specifies funding related to the surge alert system."
],
"removed": [
"No explicit removals identified."
],
"summary": "Authorizes or funds the Opioid Overdose Surge Alert System as part of the opioid response.",
"modified": [
"Integrates surge alert system funding into the broader opiate epidemic response funding framework."
]
},
"citation": "Minnesota Statutes 2025 Supplement section 245.891",
"subdivision": ""
},
{
"analysis": {
"added": [
"Supports Project ECHO dissemination and related capacity building for opioid-related practice improvements."
],
"removed": [
"No explicit removals identified."
],
"summary": "Provides grants for opioid-focused Project ECHO programs and related capacity-building initiatives.",
"modified": [
"Expands and codifies funding for opioid-focused education and workforce development."
]
},
"citation": "Minnesota Statutes 2025 Supplement section 254B.18",
"subdivision": ""
},
{
"analysis": {
"added": [
"Directs funds to support fee collection activities by the Board of Pharmacy."
],
"removed": [
"No explicit removals identified."
],
"summary": "Allocates funds to the Board of Pharmacy for collection of registration fees under section 151.066.",
"modified": [
"Reaffirms or redirects funding related to pharmacy registration fee administration."
]
},
"citation": "Minnesota Statutes 2025 Supplement section 151.066",
"subdivision": ""
},
{
"analysis": {
"added": [
"Directs funds to prevention and child protection services based on intake data and prior placement episodes."
],
"removed": [
"No explicit removals identified."
],
"summary": "Allocates remaining fund balance to county and tribal social service agency initiatives related to addiction prevention and child protection services.",
"modified": [
"Implements formula-based distribution to counties and tribal agencies with reporting requirements."
]
},
"citation": "Minnesota Statutes 2025 Supplement section 254B.0505 subdivision 1",
"subdivision": "subdivision 1"
},
{
"analysis": {
"added": [
"Explicitly permits distribution to county and tribal agencies for prevention and child protection services tied to addiction."
],
"removed": [
"No explicit removals identified."
],
"summary": "Authorizes distribution of funds to county and tribal social service agency initiatives for addiction-affected children and families.",
"modified": [
"Uses a data-driven formula based on prior-year intake and out-of-home placement data."
]
},
"citation": "Minnesota Statutes 2025 Supplement section 256.01 subdivision 14b",
"subdivision": "subdivision 14b"
},
{
"analysis": {
"added": [
"No new code sections added; chapter reference remains as the basis for property tax exemptions."
],
"removed": [
"No explicit removals identified."
],
"summary": "References property tax law provisions within chapter 272 that inform county cost-sharing considerations.",
"modified": [
"Contextual basis for distressed-county property tax exemptions is maintained within the new funding framework."
]
},
"citation": "Minnesota Statutes chapter 272",
"subdivision": ""
}
]Progress through the legislative process
In Committee