HF 2911

as introduced - 90th Legislature (2017 - 2018) Posted on 03/15/2018 04:35pm

A bill for an act
relating to human services; modifying adult foster care and community residential
setting license capacity; modifying home and community-based services plan
review and evaluation and intervention services; amending Minnesota Statutes
2016, sections 245D.071, subdivision 5; 245D.091, subdivisions 2, 3, 4; Minnesota
Statutes 2017 Supplement, section 245A.11, subdivision 2a.

BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF MINNESOTA:

Section 1.

Minnesota Statutes 2017 Supplement, section 245A.11, subdivision 2a, is
amended to read:

Subd. 2a.

Adult foster care and community residential setting license capacity.

(a)
The commissioner shall issue adult foster care and community residential setting licenses
with a maximum licensed capacity of four beds, including nonstaff roomers and boarders,
except that the commissioner may issue a license with a capacity of five beds, including
roomers and boarders, according to paragraphs (b) to (g).

(b) The license holder may have a maximum license capacity of five if all persons in
care are age 55 or over and do not have a serious and persistent mental illness or a
developmental disability.

(c) The commissioner may grant variances to paragraph (b) to allow a facility with a
licensed capacity of up to five persons to admit an individual under the age of 55 if the
variance complies with section 245A.04, subdivision 9, and approval of the variance is
recommended by the county in which the licensed facility is located.

(d) The commissioner may grant variances to paragraph (a) to allow the use of an
additional bed, up to five, for emergency crisis services for a person with serious and
persistent mental illness or a developmental disability, regardless of age, if the variance
complies with section 245A.04, subdivision 9, and approval of the variance is recommended
by the county in which the licensed facility is located.

(e) The commissioner may grant a variance to paragraph (b) to allow for the use of an
additional bed, up to five, for respite services, as defined in section 245A.02, for persons
with disabilities, regardless of age, if the variance complies with sections 245A.03,
subdivision 7, and 245A.04, subdivision 9, and approval of the variance is recommended
by the county in which the licensed facility is located. Respite care may be provided under
the following conditions:

(1) staffing ratios cannot be reduced below the approved level for the individuals being
served in the home on a permanent basis;

(2) no more than two different individuals can be accepted for respite services in any
calendar month and the total respite days may not exceed 120 days per program in any
calendar year;

(3) the person receiving respite services must have his or her own bedroom, which could
be used for alternative purposes when not used as a respite bedroom, and cannot be the
room of another person who lives in the facility; and

(4) individuals living in the facility must be notified when the variance is approved. The
provider must give 60 days' notice in writing to the residents and their legal representatives
prior to accepting the first respite placement. Notice must be given to residents at least two
days prior to service initiation, or as soon as the license holder is able if they receive notice
of the need for respite less than two days prior to initiation, each time a respite client will
be served, unless the requirement for this notice is waived by the resident or legal guardian.

(f) The commissioner may issue an adult foster care or community residential setting
license with a capacity of five adults if the fifth bed does not increase the overall statewide
capacity of licensed adult foster care or community residential setting beds in homes that
are not the primary residence of the license holder, as identified in a plan submitted to the
commissioner by the county, when the capacity is recommended by the county licensing
agency of the county in which the facility is located and if the recommendation verifies
that:

(1) the facility meets the physical environment requirements in the adult foster care
licensing rule;

(2) the five-bed living arrangement is specified for each resident in the resident's:

(i) individualized plan of care;

(ii) individual service plan under section 256B.092, subdivision 1b, if required; or

(iii) individual resident placement agreement under Minnesota Rules, part 9555.5105,
subpart 19, if required;

(3) the license holder obtains written and signed informed consent from each resident
or resident's legal representative documenting the resident's informed choice to remain
living in the home and that the resident's refusal to consent would not have resulted in
service termination; and

(4) the facility was licensed for adult foster care before deleted text begin March 1, 2011 deleted text end new text begin June 30, 2021 new text end .

(g) The commissioner shall not issue a new adult foster care license under paragraph (f)
after June 30, deleted text begin 2019 deleted text end new text begin 2021 new text end . The commissioner shall allow a facility with an adult foster care
license issued under paragraph (f) before June 30, deleted text begin 2019 deleted text end new text begin 2021 new text end , to continue with a capacity
of five adults if the license holder continues to comply with the requirements in paragraph
(f).

Sec. 2.

Minnesota Statutes 2016, section 245D.071, subdivision 5, is amended to read:

Subd. 5.

Service plan review and evaluation.

(a) The license holder must give the
person or the person's legal representative and case manager an opportunity to participate
in the ongoing review and development of the service plan and the methods used to support
the person and accomplish outcomes identified in subdivisions 3 and 4. new text begin At least once per
year, or within 30 days of a written request by the person, the person's legal representative,
or the case manager, new text end the license holder, in coordination with the person's support team or
expanded support team, must meet with the person, the person's legal representative, and
the case manager, and participate in service plan review meetings following stated timelines
established in the person's coordinated service and support plan or coordinated service and
support plan addendum deleted text begin or within 30 days of a written request by the person, the person's
legal representative, or the case manager, at a minimum of once per year deleted text end . The purpose of
the service plan review is to determine whether changes are needed to the service plan based
on the assessment information, the license holder's evaluation of progress towards
accomplishing outcomes, or other information provided by the support team or expanded
support team.

new text begin (b) At least once per year, the license holder, in coordination with the person's support
team or expanded support team, must meet with the person, the person's legal representative,
and the case manager to discuss how technology might be used to meet the person's desired
outcomes. The coordinated service and support plan or support plan addendum must include
a summary of this discussion. The summary must include a statement regarding any decision
made related to the use of technology and a description of any further research that must
be completed before a decision regarding the use of technology can be made. Nothing in
this paragraph requires the coordinated service and support plan to include the use of
technology for the provision of services.
new text end

deleted text begin (b) deleted text end new text begin (c) new text end The license holder must summarize the person's status and progress toward
achieving the identified outcomes and make recommendations and identify the rationale
for changing, continuing, or discontinuing implementation of supports and methods identified
in subdivision 4 in a report available at the time of the progress review meeting. The report
must be sent at least five working days prior to the progress review meeting if requested by
the team in the coordinated service and support plan or coordinated service and support
plan addendum.

deleted text begin (c) deleted text end new text begin (d) new text end The license holder must send the coordinated service and support plan addendum
to the person, the person's legal representative, and the case manager by mail within ten
working days of the progress review meeting. Within ten working days of the mailing of
the coordinated service and support plan addendum, the license holder must obtain dated
signatures from the person or the person's legal representative and the case manager to
document approval of any changes to the coordinated service and support plan addendum.

deleted text begin (d) deleted text end new text begin (e) new text end If, within ten working days of submitting changes to the coordinated service and
support plan and coordinated service and support plan addendum, the person or the person's
legal representative or case manager has not signed and returned to the license holder the
coordinated service and support plan or coordinated service and support plan addendum or
has not proposed written modifications to the license holder's submission, the submission
is deemed approved and the coordinated service and support plan addendum becomes
effective and remains in effect until the legal representative or case manager submits a
written request to revise the coordinated service and support plan addendum.

Sec. 3.

Minnesota Statutes 2016, section 245D.091, subdivision 2, is amended to read:

Subd. 2.

Behavior professional qualifications.

A behavior professional providing
behavioral support services as identified in section 245D.03, subdivision 1, paragraph (c),
clause (1), item (i), must have competencies in the following areas as required under the
brain injury and community access for disability inclusion waiver plans or successor plans:

(1) ethical considerations;

(2) functional assessment;

(3) functional analysis;

(4) measurement of behavior and interpretation of data;

(5) selecting intervention outcomes and strategies;

(6) behavior reduction and elimination strategies that promote least restrictive approved
alternatives;

(7) data collection;

(8) staff and caregiver training;

(9) support plan monitoring;

(10) co-occurring mental disorders or neurocognitive disorder;

(11) demonstrated expertise with populations being served; and

(12) must be a:

(i) psychologist licensed under sections 148.88 to 148.98, who has stated to the Board
of Psychology competencies in the above identified areas;

(ii) clinical social worker licensed as an independent clinical social worker under chapter
148D, or a person with a master's degree in social work from an accredited college or
university, with at least 4,000 hours of post-master's supervised experience in the delivery
of clinical services in the areas identified in clauses (1) to (11);

(iii) physician licensed under chapter 147 and certified by the American Board of
Psychiatry and Neurology or eligible for board certification in psychiatry with competencies
in the areas identified in clauses (1) to (11);

(iv) licensed professional clinical counselor licensed under sections 148B.29 to 148B.39
with at least 4,000 hours of post-master's supervised experience in the delivery of clinical
services who has demonstrated competencies in the areas identified in clauses (1) to (11);

(v) person with a master's degree from an accredited college or university in one of the
behavioral sciences or related fields, with at least 4,000 hours of post-master's supervised
experience in the delivery of clinical services with demonstrated competencies in the areas
identified in clauses (1) to (11); deleted text begin or
deleted text end

new text begin (vi) person with a master's degree from an accredited college or university in one of the
behavioral sciences or related fields, who is receiving post-master's clinical supervision as
part of a board-approved supervision plan; or
new text end

deleted text begin (vi) deleted text end new text begin (vii) new text end registered nurse who is licensed under sections 148.171 to 148.285, and who
is certified as a clinical specialist or as a nurse practitioner in adult or family psychiatric
and mental health nursing by a national nurse certification organization, or who has a master's
degree in nursing or one of the behavioral sciences or related fields from an accredited
college or university or its equivalent, with at least 4,000 hours of post-master's supervised
experience in the delivery of clinical services.

Sec. 4.

Minnesota Statutes 2016, section 245D.091, subdivision 3, is amended to read:

Subd. 3.

Behavior analyst qualifications.

(a) A behavior analyst providing behavioral
support services as identified in section 245D.03, subdivision 1, paragraph (c), clause (1),
item (i), must have competencies in the following areas as required under the brain injury
and community access for disability inclusion waiver plans or successor plans:

(1) have obtained a baccalaureate degree, master's degree, or PhD in a social services
discipline; or

(2) meet the qualifications of a mental health practitioner as defined in section 245.462,
subdivision 17.

(b) In addition, a behavior analyst must:

(1) have four years of supervised experience working with individuals who exhibit
challenging behaviors as well as co-occurring mental disorders or neurocognitive disorder new text begin ,
or a master's degree or higher new text end ;

(2) have received deleted text begin ten hours of instruction in functional assessment and functional analysis; deleted text end new text begin
training prior to hire or within 90 calendar days of hire that includes:
new text end

new text begin (i) ten hours of instruction in functional assessment and functional analysis;
new text end

new text begin (ii) 20 hours of instruction in the understanding of the function of behavior;
new text end

new text begin (iii) ten hours of instruction on design of positive practices behavior support strategies;
and
new text end

new text begin (iv) 20 hours of instruction on the use of behavior reduction approved strategies used
only in combination with behavior positive practices strategies;
new text end

deleted text begin (3) have received 20 hours of instruction in the understanding of the function of behavior;
deleted text end

deleted text begin (4) have received ten hours of instruction on design of positive practices behavior support
strategies;
deleted text end

deleted text begin (5) have received 20 hours of instruction on the use of behavior reduction approved
strategies used only in combination with behavior positive practices strategies;
deleted text end

deleted text begin (6) deleted text end new text begin (3) new text end be determined by a behavior professional to have the training and prerequisite
skills required to provide positive practice strategies as well as behavior reduction approved
and permitted intervention to the person who receives behavioral support; and

deleted text begin (7) deleted text end new text begin (4) new text end be under the direct supervision of a behavior professional.

new text begin (c) Meeting the qualifications for a behavior professional under subdivision 2 shall
substitute for meeting the qualifications listed in paragraph (b).
new text end

Sec. 5.

Minnesota Statutes 2016, section 245D.091, subdivision 4, is amended to read:

Subd. 4.

Behavior specialist qualifications.

(a) A behavior specialist providing
behavioral support services as identified in section 245D.03, subdivision 1, paragraph (c),
clause (1), item (i), must have competencies in the following areas as required under the
brain injury and community access for disability inclusion waiver plans or successor plans:

(1) have an associate's degree in a social services discipline; or

(2) have two years of supervised experience working with individuals who exhibit
challenging behaviors as well as co-occurring mental disorders or neurocognitive disorder.

(b) In addition, a behavior specialist must:

new text begin (1) have received training prior to hire or within 90 calendar days of hire that includes:
new text end

deleted text begin (1) have received deleted text end new text begin (i) new text end a minimum of four hours of training in functional assessment;

deleted text begin (2) have received deleted text end new text begin (ii) new text end 20 hours of instruction in the understanding of the function of
behavior; new text begin and
new text end

deleted text begin (3) have received deleted text end new text begin (iii) new text end ten hours of instruction on design of positive practices behavioral
support strategies;

deleted text begin (4) deleted text end new text begin (2) new text end be determined by a behavior professional to have the training and prerequisite
skills required to provide positive practices strategies as well as behavior reduction approved
intervention to the person who receives behavioral support; and

deleted text begin (5) deleted text end new text begin (3) new text end be under the direct supervision of a behavior professional.

new text begin (c) Meeting the qualifications for a behavior professional under subdivision 2 shall
substitute for meeting the qualifications listed in paragraphs (a) and (b).
new text end