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Capital IconMinnesota Legislature

SF 1028

1st Engrossment - 92nd Legislature (2021 - 2022) Posted on 03/16/2021 09:38am

KEY: stricken = removed, old language.
underscored = added, new language.

Current Version - 1st Engrossment

Line numbers 1.1 1.2 1.3 1.4 1.5 1.6 1.7 1.8 1.9 1.10 1.11 1.12 1.13 1.14 1.15 1.16 1.17 1.18 1.19 1.20 1.21 1.22 1.23 1.24 1.25 1.26 1.27 1.28 1.29 1.30 1.31 1.32 1.33 2.1
2.2 2.3
2.4 2.5 2.6 2.7 2.8 2.9 2.10 2.11 2.12
2.13 2.14 2.15 2.16 2.17 2.18 2.19 2.20 2.21 2.22 2.23 2.24 2.25 2.26 2.27 2.28 2.29 2.30 2.31 3.1 3.2 3.3 3.4 3.5 3.6 3.7 3.8 3.9 3.10 3.11 3.12 3.13 3.14 3.15 3.16 3.17 3.18 3.19 3.20 3.21 3.22 3.23 3.24 3.25 3.26 3.27 3.28 3.29 3.30 3.31 3.32 4.1 4.2 4.3 4.4 4.5
4.6 4.7
4.8 4.9 4.10 4.11 4.12 4.13 4.14 4.15 4.16 4.17 4.18 4.19 4.20 4.21 4.22 4.23 4.24 4.25 4.26 4.27 4.28 4.29 4.30 4.31 4.32 5.1 5.2 5.3 5.4 5.5 5.6 5.7 5.8 5.9 5.10 5.11 5.12 5.13 5.14 5.15 5.16 5.17 5.18 5.19 5.20 5.21 5.22 5.23 5.24 5.25 5.26 5.27 5.28 5.29 5.30 5.31 5.32 5.33 5.34 6.1 6.2 6.3 6.4 6.5 6.6 6.7 6.8 6.9 6.10 6.11 6.12 6.13 6.14 6.15 6.16 6.17 6.18 6.19 6.20 6.21 6.22 6.23 6.24 6.25 6.26 6.27 6.28 6.29 6.30 6.31 6.32 7.1 7.2 7.3 7.4 7.5 7.6 7.7 7.8 7.9 7.10 7.11 7.12 7.13 7.14 7.15 7.16 7.17 7.18 7.19 7.20 7.21 7.22 7.23 7.24 7.25 7.26 7.27 7.28 7.29 7.30 7.31 7.32 7.33 8.1 8.2 8.3 8.4 8.5 8.6 8.7 8.8 8.9 8.10 8.11 8.12 8.13 8.14 8.15 8.16 8.17 8.18
8.19 8.20 8.21 8.22 8.23 8.24 8.25 8.26 8.27 8.28 8.29 8.30 8.31 9.1 9.2 9.3 9.4 9.5 9.6 9.7 9.8 9.9 9.10 9.11 9.12 9.13 9.14 9.15 9.16 9.17 9.18 9.19 9.20 9.21 9.22 9.23 9.24 9.25 9.26 9.27 9.28 9.29 9.30 9.31 10.1 10.2 10.3 10.4 10.5 10.6 10.7 10.8 10.9 10.10 10.11 10.12 10.13 10.14 10.15 10.16 10.17 10.18 10.19 10.20 10.21 10.22 10.23 10.24 10.25 10.26 10.27 10.28 10.29 10.30 10.31 11.1 11.2 11.3 11.4 11.5 11.6 11.7 11.8
11.9 11.10 11.11 11.12 11.13 11.14 11.15 11.16 11.17 11.18 11.19 11.20 11.21 11.22 11.23 11.24 11.25 11.26 11.27 11.28 11.29 11.30 11.31 12.1 12.2 12.3 12.4 12.5 12.6 12.7 12.8 12.9 12.10 12.11 12.12 12.13 12.14 12.15 12.16 12.17 12.18 12.19 12.20 12.21 12.22 12.23 12.24 12.25 12.26 12.27 12.28 12.29 13.1 13.2 13.3 13.4 13.5 13.6 13.7 13.8 13.9 13.10 13.11 13.12 13.13 13.14 13.15 13.16 13.17 13.18 13.19 13.20 13.21 13.22 13.23 13.24 13.25 13.26 13.27 13.28 13.29 13.30 13.31 13.32 13.33 13.34 14.1 14.2 14.3 14.4 14.5 14.6 14.7 14.8 14.9 14.10 14.11 14.12 14.13 14.14 14.15 14.16 14.17 14.18 14.19 14.20 14.21 14.22 14.23 14.24 14.25 14.26 14.27 14.28 14.29 14.30 14.31 15.1 15.2 15.3 15.4 15.5 15.6 15.7 15.8 15.9 15.10 15.11 15.12 15.13 15.14 15.15 15.16 15.17 15.18 15.19 15.20 15.21 15.22 15.23 15.24 15.25 15.26 15.27 15.28 15.29 15.30 16.1 16.2 16.3 16.4 16.5 16.6 16.7 16.8 16.9 16.10 16.11 16.12 16.13 16.14 16.15 16.16 16.17 16.18 16.19 16.20 16.21 16.22 16.23 16.24 16.25 16.26 16.27 16.28 16.29 16.30 16.31
17.1 17.2 17.3 17.4 17.5 17.6 17.7 17.8 17.9 17.10 17.11 17.12 17.13 17.14 17.15 17.16 17.17 17.18 17.19 17.20 17.21 17.22 17.23 17.24 17.25 17.26 17.27 17.28 17.29 17.30 17.31 18.1 18.2 18.3 18.4 18.5 18.6 18.7 18.8 18.9 18.10 18.11 18.12 18.13 18.14 18.15 18.16 18.17 18.18 18.19 18.20 18.21 18.22 18.23 18.24 18.25 18.26 18.27 18.28 18.29 18.30 19.1 19.2 19.3 19.4 19.5 19.6 19.7 19.8 19.9 19.10 19.11 19.12 19.13 19.14 19.15 19.16 19.17 19.18 19.19 19.20 19.21 19.22 19.23 19.24 19.25 19.26 19.27 19.28 19.29 19.30 19.31 20.1 20.2 20.3 20.4 20.5 20.6 20.7
20.8 20.9 20.10 20.11 20.12 20.13 20.14 20.15 20.16 20.17 20.18 20.19 20.20 20.21 20.22 20.23 20.24 20.25 20.26 20.27 20.28 20.29 20.30 20.31 20.32 21.1 21.2 21.3 21.4 21.5 21.6 21.7 21.8 21.9 21.10 21.11 21.12 21.13 21.14 21.15 21.16 21.17 21.18 21.19 21.20 21.21 21.22 21.23 21.24 21.25 21.26 21.27 21.28 21.29 21.30
21.31 21.32 22.1 22.2 22.3 22.4 22.5 22.6 22.7 22.8 22.9 22.10 22.11 22.12 22.13 22.14 22.15 22.16 22.17 22.18 22.19
22.20 22.21 22.22 22.23 22.24 22.25 22.26 22.27 22.28 22.29 22.30 23.1 23.2 23.3 23.4 23.5 23.6 23.7 23.8 23.9 23.10 23.11 23.12 23.13 23.14 23.15 23.16 23.17 23.18 23.19 23.20 23.21 23.22 23.23 23.24 23.25 23.26 23.27 23.28 23.29 23.30 23.31 24.1 24.2 24.3 24.4 24.5 24.6 24.7 24.8
24.9 24.10 24.11 24.12 24.13 24.14 24.15 24.16 24.17 24.18 24.19 24.20 24.21 24.22 24.23 24.24 24.25 24.26 24.27 24.28 24.29 24.30 24.31 24.32 25.1 25.2 25.3 25.4 25.5 25.6 25.7 25.8 25.9 25.10 25.11 25.12 25.13 25.14 25.15
25.16 25.17 25.18 25.19 25.20 25.21 25.22 25.23 25.24 25.25 25.26 25.27 25.28 25.29 25.30 25.31 26.1 26.2 26.3 26.4 26.5 26.6 26.7 26.8 26.9 26.10 26.11 26.12 26.13 26.14 26.15 26.16 26.17 26.18 26.19 26.20 26.21 26.22 26.23 26.24 26.25 26.26 26.27 26.28 26.29 26.30 26.31 26.32 27.1 27.2 27.3 27.4 27.5 27.6 27.7 27.8 27.9 27.10 27.11 27.12 27.13 27.14 27.15 27.16 27.17 27.18 27.19 27.20 27.21 27.22 27.23 27.24 27.25 27.26 27.27 27.28 27.29 27.30 27.31 27.32 27.33 28.1 28.2 28.3 28.4 28.5 28.6 28.7 28.8 28.9 28.10 28.11 28.12 28.13 28.14 28.15 28.16 28.17 28.18 28.19 28.20 28.21 28.22 28.23 28.24 28.25 28.26 28.27 28.28 28.29 28.30 28.31 29.1 29.2 29.3 29.4 29.5 29.6 29.7 29.8 29.9 29.10 29.11 29.12 29.13 29.14 29.15 29.16 29.17 29.18 29.19 29.20 29.21 29.22 29.23 29.24 29.25 29.26 29.27 29.28 29.29 29.30 30.1 30.2 30.3 30.4 30.5 30.6 30.7 30.8 30.9 30.10 30.11 30.12 30.13 30.14 30.15 30.16 30.17 30.18 30.19 30.20 30.21 30.22 30.23 30.24 30.25 30.26 30.27 30.28 30.29 30.30 30.31 30.32 31.1 31.2 31.3 31.4 31.5 31.6 31.7 31.8 31.9 31.10 31.11 31.12 31.13 31.14 31.15 31.16 31.17 31.18 31.19 31.20 31.21 31.22 31.23 31.24 31.25 31.26 31.27 31.28 31.29 31.30 31.31 31.32 32.1 32.2 32.3 32.4 32.5 32.6 32.7 32.8 32.9 32.10 32.11 32.12 32.13 32.14 32.15 32.16 32.17 32.18 32.19 32.20 32.21 32.22 32.23 32.24 32.25 32.26 32.27 32.28 33.1 33.2 33.3
33.4 33.5 33.6 33.7 33.8 33.9 33.10 33.11 33.12 33.13 33.14 33.15 33.16 33.17 33.18 33.19 33.20 33.21 33.22 33.23 33.24 33.25 33.26 33.27 33.28 33.29 33.30 34.1 34.2 34.3 34.4 34.5 34.6 34.7 34.8 34.9 34.10 34.11 34.12 34.13 34.14 34.15 34.16 34.17 34.18 34.19 34.20 34.21 34.22 34.23 34.24 34.25 34.26 34.27 34.28 34.29 34.30 34.31 35.1 35.2 35.3 35.4 35.5 35.6 35.7 35.8 35.9 35.10 35.11 35.12 35.13 35.14 35.15 35.16 35.17
35.18 35.19 35.20 35.21 35.22 35.23 35.24 35.25 35.26 35.27 35.28 35.29 35.30 35.31 36.1 36.2 36.3 36.4 36.5 36.6 36.7 36.8 36.9 36.10 36.11 36.12 36.13 36.14 36.15 36.16 36.17 36.18 36.19 36.20 36.21 36.22 36.23 36.24 36.25 36.26 36.27 36.28 36.29 36.30 36.31 36.32 37.1 37.2 37.3 37.4 37.5 37.6 37.7 37.8 37.9 37.10 37.11 37.12 37.13 37.14 37.15 37.16 37.17 37.18
37.19 37.20 37.21 37.22 37.23 37.24
37.25 37.26 37.27 37.28 37.29 37.30 37.31 38.1 38.2 38.3 38.4 38.5 38.6 38.7 38.8 38.9 38.10 38.11 38.12 38.13 38.14 38.15 38.16 38.17 38.18 38.19 38.20 38.21 38.22 38.23 38.24 38.25 38.26 38.27 38.28 38.29 38.30 38.31 38.32 38.33 39.1 39.2 39.3 39.4 39.5 39.6 39.7 39.8 39.9 39.10 39.11 39.12 39.13 39.14 39.15 39.16 39.17 39.18 39.19 39.20 39.21 39.22 39.23 39.24 39.25 39.26 39.27 39.28 39.29 39.30 39.31 39.32 40.1 40.2 40.3 40.4 40.5 40.6 40.7 40.8 40.9 40.10 40.11 40.12 40.13 40.14 40.15 40.16 40.17 40.18 40.19 40.20 40.21 40.22 40.23 40.24 40.25 40.26 40.27 40.28 40.29 40.30 40.31 40.32 41.1 41.2 41.3 41.4 41.5 41.6 41.7 41.8 41.9 41.10 41.11 41.12 41.13 41.14 41.15 41.16 41.17 41.18 41.19 41.20 41.21 41.22 41.23 41.24 41.25 41.26 41.27 41.28 41.29 41.30 41.31 42.1 42.2 42.3 42.4 42.5 42.6 42.7 42.8 42.9 42.10 42.11 42.12 42.13 42.14 42.15 42.16 42.17 42.18 42.19 42.20 42.21 42.22 42.23 42.24 42.25 42.26 42.27 42.28 42.29 42.30 42.31 42.32 43.1 43.2 43.3 43.4 43.5 43.6 43.7 43.8 43.9 43.10 43.11 43.12 43.13 43.14 43.15 43.16 43.17 43.18 43.19 43.20 43.21 43.22 43.23 43.24 43.25 43.26 43.27 43.28 43.29 43.30 43.31 44.1 44.2 44.3 44.4 44.5 44.6 44.7 44.8 44.9 44.10 44.11 44.12 44.13 44.14 44.15 44.16 44.17 44.18 44.19 44.20 44.21 44.22 44.23 44.24 44.25 44.26 44.27 44.28 44.29 44.30 44.31 44.32 44.33 44.34 45.1 45.2 45.3 45.4 45.5 45.6 45.7 45.8 45.9 45.10 45.11 45.12 45.13
45.14 45.15 45.16 45.17 45.18 45.19 45.20 45.21 45.22 45.23 45.24 45.25 45.26 45.27 45.28 45.29 45.30 45.31 45.32 45.33 46.1 46.2 46.3 46.4 46.5 46.6 46.7 46.8 46.9 46.10 46.11 46.12 46.13 46.14 46.15 46.16 46.17 46.18 46.19 46.20 46.21 46.22 46.23 46.24 46.25 46.26 46.27 46.28 46.29 46.30 46.31 47.1 47.2 47.3 47.4 47.5 47.6 47.7 47.8 47.9 47.10 47.11 47.12 47.13 47.14 47.15 47.16 47.17 47.18 47.19 47.20 47.21 47.22 47.23 47.24 47.25 47.26 47.27 47.28 47.29 48.1 48.2 48.3 48.4 48.5 48.6 48.7 48.8 48.9 48.10 48.11 48.12 48.13 48.14 48.15 48.16 48.17 48.18 48.19 48.20 48.21 48.22 48.23 48.24 48.25 48.26 48.27 48.28 48.29 48.30 48.31 48.32 48.33 48.34 49.1 49.2 49.3 49.4 49.5 49.6 49.7 49.8 49.9 49.10 49.11 49.12 49.13 49.14 49.15 49.16 49.17 49.18 49.19 49.20 49.21 49.22 49.23 49.24 49.25 49.26 49.27 49.28 49.29 49.30 49.31 49.32 49.33 50.1 50.2 50.3 50.4 50.5 50.6 50.7 50.8 50.9 50.10 50.11 50.12 50.13 50.14 50.15 50.16 50.17 50.18 50.19 50.20 50.21 50.22 50.23 50.24 50.25 50.26 50.27 50.28 50.29 50.30 50.31 51.1 51.2 51.3 51.4 51.5 51.6 51.7 51.8 51.9 51.10 51.11 51.12 51.13 51.14 51.15 51.16 51.17 51.18 51.19 51.20 51.21 51.22 51.23 51.24 51.25 51.26 51.27 51.28 51.29 51.30 51.31 51.32 51.33 51.34 52.1 52.2 52.3 52.4 52.5 52.6 52.7 52.8 52.9 52.10 52.11 52.12 52.13 52.14 52.15 52.16 52.17 52.18 52.19 52.20 52.21 52.22 52.23 52.24 52.25 52.26 52.27 52.28 52.29 52.30 52.31 52.32 53.1 53.2 53.3 53.4 53.5 53.6 53.7 53.8 53.9 53.10 53.11 53.12 53.13 53.14 53.15 53.16 53.17 53.18 53.19 53.20 53.21 53.22 53.23 53.24 53.25 53.26 53.27 53.28 53.29 53.30 53.31 54.1 54.2 54.3 54.4 54.5 54.6 54.7 54.8 54.9 54.10 54.11 54.12 54.13 54.14 54.15 54.16 54.17 54.18 54.19 54.20 54.21 54.22 54.23 54.24 54.25 54.26 54.27 54.28 54.29 54.30 54.31 55.1 55.2 55.3 55.4 55.5 55.6 55.7 55.8 55.9 55.10 55.11 55.12 55.13 55.14 55.15 55.16 55.17 55.18 55.19 55.20 55.21 55.22 55.23 55.24 55.25 55.26 55.27 55.28 55.29 55.30 55.31 55.32 56.1 56.2 56.3 56.4 56.5 56.6 56.7 56.8 56.9 56.10 56.11 56.12 56.13 56.14 56.15 56.16 56.17 56.18 56.19 56.20 56.21 56.22 56.23 56.24 56.25 56.26 56.27 56.28 56.29 56.30 56.31 57.1 57.2 57.3 57.4 57.5 57.6 57.7 57.8 57.9 57.10 57.11 57.12 57.13 57.14 57.15 57.16 57.17 57.18 57.19 57.20 57.21 57.22 57.23 57.24 57.25 57.26 57.27
57.28 57.29 57.30 58.1 58.2 58.3 58.4 58.5 58.6 58.7 58.8 58.9 58.10 58.11 58.12 58.13 58.14 58.15 58.16 58.17 58.18 58.19 58.20 58.21 58.22 58.23 58.24 58.25 58.26 58.27 58.28 58.29 58.30 58.31 58.32 59.1 59.2 59.3 59.4 59.5 59.6 59.7 59.8 59.9 59.10 59.11 59.12 59.13 59.14 59.15 59.16 59.17 59.18 59.19 59.20 59.21 59.22 59.23 59.24 59.25 59.26 59.27 59.28 59.29 59.30 59.31 59.32 60.1 60.2 60.3 60.4 60.5 60.6 60.7 60.8 60.9 60.10 60.11 60.12 60.13 60.14 60.15 60.16 60.17 60.18 60.19 60.20 60.21 60.22 60.23 60.24 60.25 60.26 60.27 60.28 60.29 60.30 60.31 61.1 61.2 61.3 61.4 61.5 61.6 61.7 61.8 61.9 61.10 61.11 61.12 61.13 61.14 61.15 61.16 61.17 61.18 61.19 61.20 61.21 61.22 61.23 61.24 61.25 61.26 61.27 61.28 61.29 61.30 61.31 61.32 61.33 62.1 62.2 62.3 62.4 62.5 62.6 62.7 62.8 62.9 62.10 62.11 62.12 62.13 62.14 62.15 62.16 62.17 62.18 62.19 62.20 62.21 62.22 62.23 62.24 62.25 62.26 62.27 62.28 62.29 62.30 63.1 63.2 63.3 63.4 63.5 63.6 63.7 63.8 63.9 63.10 63.11 63.12 63.13 63.14 63.15 63.16 63.17 63.18 63.19 63.20 63.21 63.22 63.23 63.24 63.25 63.26 63.27 63.28 63.29 63.30 63.31 63.32 64.1 64.2 64.3 64.4 64.5 64.6 64.7 64.8 64.9 64.10 64.11 64.12 64.13 64.14 64.15 64.16 64.17 64.18 64.19 64.20 64.21 64.22 64.23 64.24 64.25 64.26 64.27 64.28 64.29 64.30 64.31 64.32 65.1 65.2 65.3 65.4 65.5 65.6 65.7 65.8 65.9 65.10 65.11 65.12 65.13 65.14 65.15 65.16 65.17 65.18 65.19 65.20 65.21 65.22 65.23 65.24 65.25 65.26 65.27 65.28 65.29 65.30 66.1 66.2 66.3 66.4 66.5 66.6 66.7 66.8 66.9 66.10 66.11 66.12 66.13 66.14 66.15 66.16 66.17 66.18 66.19 66.20 66.21 66.22 66.23 66.24 66.25 66.26 66.27 66.28 66.29 67.1 67.2 67.3 67.4 67.5 67.6 67.7 67.8 67.9 67.10 67.11 67.12 67.13 67.14 67.15 67.16 67.17 67.18 67.19 67.20 67.21 67.22 67.23 67.24 67.25 67.26 67.27 67.28 67.29 67.30 67.31 67.32 68.1 68.2 68.3 68.4 68.5 68.6 68.7 68.8 68.9 68.10 68.11 68.12 68.13 68.14 68.15 68.16 68.17 68.18 68.19 68.20 68.21 68.22 68.23 68.24 68.25 68.26 68.27 68.28 68.29 68.30 68.31 68.32 68.33 68.34 68.35 69.1 69.2 69.3 69.4 69.5 69.6 69.7 69.8 69.9 69.10 69.11 69.12 69.13 69.14 69.15 69.16 69.17
69.18 69.19 69.20 69.21 69.22 69.23 69.24 69.25 69.26 69.27
69.28 69.29
69.30 69.31 69.32 70.1 70.2 70.3 70.4 70.5 70.6 70.7 70.8 70.9 70.10 70.11 70.12 70.13 70.14 70.15 70.16 70.17 70.18 70.19 70.20
70.21 70.22 70.23 70.24 70.25 70.26 70.27 70.28 70.29 70.30 70.31 71.1 71.2 71.3 71.4 71.5 71.6 71.7 71.8 71.9 71.10 71.11 71.12 71.13 71.14 71.15 71.16 71.17 71.18 71.19 71.20 71.21 71.22 71.23 71.24 71.25 71.26 71.27
71.28 71.29 71.30 71.31 71.32 72.1 72.2 72.3 72.4 72.5 72.6 72.7 72.8 72.9 72.10 72.11 72.12 72.13 72.14 72.15
72.16 72.17 72.18 72.19 72.20 72.21 72.22 72.23 72.24 72.25 72.26 72.27 72.28 72.29 72.30 72.31 73.1 73.2 73.3 73.4 73.5 73.6 73.7 73.8 73.9 73.10 73.11 73.12 73.13 73.14 73.15 73.16 73.17 73.18 73.19 73.20 73.21 73.22 73.23 73.24 73.25 73.26 73.27 73.28 73.29 73.30 73.31 74.1 74.2 74.3 74.4 74.5 74.6 74.7 74.8 74.9 74.10 74.11 74.12 74.13 74.14 74.15 74.16 74.17 74.18 74.19 74.20 74.21 74.22 74.23 74.24 74.25 74.26 74.27 74.28 74.29 74.30 74.31 74.32 75.1 75.2 75.3 75.4 75.5 75.6 75.7 75.8 75.9 75.10 75.11 75.12 75.13 75.14 75.15 75.16 75.17 75.18 75.19 75.20 75.21 75.22 75.23 75.24 75.25 75.26 75.27 75.28 75.29 75.30 76.1 76.2 76.3 76.4 76.5 76.6 76.7 76.8 76.9 76.10 76.11 76.12 76.13 76.14 76.15 76.16 76.17 76.18 76.19 76.20 76.21 76.22 76.23 76.24 76.25 76.26 76.27 76.28 76.29 76.30 76.31 76.32 77.1 77.2 77.3 77.4 77.5 77.6 77.7 77.8 77.9 77.10 77.11 77.12 77.13 77.14 77.15 77.16 77.17 77.18 77.19 77.20 77.21 77.22 77.23 77.24 77.25 77.26 77.27 77.28 77.29 77.30 77.31 77.32 78.1 78.2 78.3 78.4 78.5 78.6 78.7 78.8 78.9 78.10 78.11 78.12 78.13 78.14 78.15 78.16 78.17 78.18 78.19 78.20 78.21 78.22 78.23 78.24 78.25 78.26 78.27 78.28 78.29 78.30 78.31 78.32 79.1 79.2 79.3 79.4 79.5 79.6 79.7 79.8 79.9 79.10 79.11 79.12 79.13 79.14 79.15 79.16 79.17 79.18 79.19 79.20 79.21 79.22 79.23 79.24 79.25 79.26 79.27 79.28 79.29 79.30 79.31 79.32 79.33 80.1 80.2 80.3 80.4 80.5 80.6 80.7 80.8 80.9 80.10 80.11 80.12 80.13 80.14 80.15 80.16 80.17 80.18 80.19 80.20 80.21 80.22 80.23 80.24 80.25 80.26 80.27 80.28 80.29 80.30 80.31 80.32 80.33 80.34 81.1 81.2 81.3 81.4 81.5 81.6 81.7 81.8 81.9 81.10 81.11 81.12 81.13 81.14 81.15 81.16 81.17 81.18 81.19 81.20 81.21 81.22 81.23 81.24 81.25 81.26 81.27 81.28 81.29 81.30 81.31 81.32 81.33 82.1 82.2 82.3 82.4 82.5 82.6 82.7 82.8 82.9 82.10 82.11 82.12 82.13 82.14 82.15 82.16 82.17 82.18 82.19 82.20 82.21 82.22 82.23 82.24 82.25 82.26 82.27 82.28 82.29 82.30 82.31 82.32 83.1 83.2 83.3 83.4 83.5 83.6 83.7 83.8 83.9 83.10 83.11 83.12 83.13 83.14 83.15 83.16 83.17 83.18 83.19 83.20 83.21 83.22 83.23 83.24 83.25 83.26 83.27 83.28 83.29 83.30 83.31 83.32 84.1 84.2 84.3 84.4 84.5 84.6 84.7 84.8 84.9 84.10 84.11 84.12 84.13 84.14 84.15 84.16 84.17 84.18 84.19 84.20 84.21 84.22 84.23 84.24 84.25 84.26 84.27 84.28 84.29 84.30 85.1 85.2 85.3 85.4 85.5 85.6 85.7 85.8 85.9 85.10 85.11 85.12 85.13 85.14 85.15 85.16 85.17 85.18 85.19 85.20 85.21 85.22 85.23 85.24 85.25 85.26 85.27 85.28 85.29 85.30 85.31 86.1 86.2 86.3 86.4 86.5 86.6 86.7 86.8 86.9 86.10 86.11 86.12 86.13 86.14 86.15 86.16 86.17 86.18 86.19 86.20 86.21 86.22 86.23 86.24 86.25 86.26 86.27 86.28 86.29 86.30 87.1 87.2 87.3 87.4 87.5
87.6 87.7
87.8 87.9 87.10 87.11 87.12 87.13 87.14 87.15 87.16 87.17 87.18
87.19 87.20 87.21 87.22 87.23 87.24 87.25 87.26 87.27 87.28 87.29 87.30 87.31 88.1 88.2
88.3 88.4 88.5 88.6 88.7 88.8 88.9 88.10 88.11 88.12 88.13 88.14 88.15 88.16
88.17 88.18 88.19 88.20 88.21 88.22 88.23 88.24 88.25 88.26 88.27 88.28 88.29 88.30 88.31 88.32 89.1 89.2 89.3
89.4 89.5 89.6 89.7 89.8 89.9 89.10 89.11 89.12 89.13 89.14 89.15 89.16 89.17 89.18 89.19 89.20 89.21 89.22 89.23 89.24 89.25 89.26 89.27 89.28 89.29 89.30 90.1 90.2 90.3 90.4 90.5
90.6 90.7 90.8 90.9 90.10 90.11 90.12 90.13 90.14 90.15 90.16 90.17 90.18 90.19 90.20 90.21 90.22 90.23 90.24 90.25 90.26 90.27 90.28 90.29 90.30 91.1 91.2 91.3 91.4 91.5 91.6 91.7 91.8 91.9 91.10 91.11 91.12 91.13 91.14 91.15 91.16
91.17 91.18 91.19 91.20 91.21 91.22 91.23 91.24 91.25 91.26 91.27 91.28 91.29 91.30 91.31 91.32 91.33 92.1 92.2 92.3 92.4 92.5 92.6 92.7 92.8
92.9 92.10 92.11 92.12 92.13 92.14 92.15 92.16 92.17 92.18 92.19 92.20 92.21 92.22 92.23 92.24 92.25 92.26 92.27 92.28 92.29 92.30 92.31 93.1 93.2 93.3 93.4 93.5 93.6 93.7 93.8 93.9 93.10 93.11 93.12
93.13 93.14 93.15 93.16 93.17 93.18 93.19 93.20 93.21 93.22 93.23 93.24 93.25 93.26 93.27 93.28 93.29 93.30 93.31 93.32 94.1 94.2 94.3 94.4 94.5 94.6 94.7 94.8
94.9 94.10 94.11
94.12 94.13 94.14 94.15 94.16 94.17 94.18 94.19 94.20 94.21 94.22 94.23 94.24 94.25 94.26 94.27
94.28 94.29 94.30 95.1 95.2 95.3 95.4 95.5 95.6 95.7 95.8 95.9 95.10 95.11 95.12 95.13 95.14 95.15 95.16 95.17
95.18 95.19 95.20 95.21 95.22 95.23 95.24 95.25 95.26 95.27 95.28 95.29 95.30 95.31 95.32 95.33 96.1 96.2 96.3 96.4 96.5 96.6 96.7 96.8 96.9 96.10 96.11 96.12 96.13 96.14 96.15 96.16 96.17
96.18 96.19 96.20 96.21 96.22 96.23 96.24 96.25 96.26
96.27 96.28 96.29 96.30 96.31
97.1 97.2 97.3 97.4 97.5 97.6 97.7 97.8 97.9 97.10 97.11 97.12 97.13 97.14 97.15 97.16 97.17 97.18 97.19 97.20 97.21 97.22 97.23 97.24 97.25 97.26 97.27 97.28 97.29 97.30 97.31 97.32 98.1 98.2 98.3 98.4 98.5 98.6 98.7 98.8 98.9 98.10 98.11 98.12 98.13 98.14 98.15 98.16 98.17 98.18 98.19 98.20 98.21 98.22 98.23 98.24 98.25 98.26 98.27 98.28 98.29 98.30 98.31 98.32 99.1 99.2 99.3 99.4 99.5 99.6 99.7 99.8 99.9 99.10 99.11 99.12
99.13 99.14 99.15 99.16 99.17 99.18 99.19 99.20 99.21 99.22 99.23 99.24 99.25 99.26 99.27 99.28 99.29 99.30 99.31 100.1 100.2 100.3 100.4 100.5 100.6 100.7 100.8 100.9 100.10 100.11 100.12 100.13 100.14 100.15
100.16 100.17 100.18 100.19 100.20 100.21 100.22
100.23 100.24 100.25 100.26 100.27 100.28 100.29
101.1 101.2 101.3 101.4
101.5 101.6 101.7 101.8 101.9 101.10 101.11 101.12 101.13 101.14 101.15 101.16 101.17 101.18 101.19
101.20 101.21 101.22 101.23 101.24 101.25 101.26 101.27 101.28 101.29 101.30 101.31
102.1 102.2 102.3 102.4 102.5 102.6 102.7 102.8 102.9 102.10 102.11 102.12 102.13 102.14 102.15
102.16 102.17 102.18 102.19 102.20 102.21 102.22 102.23 102.24 102.25 102.26 102.27 102.28 102.29 102.30 102.31 102.32 102.33 102.34
103.1 103.2 103.3 103.4 103.5 103.6 103.7 103.8 103.9 103.10 103.11 103.12 103.13 103.14 103.15 103.16 103.17 103.18 103.19 103.20 103.21 103.22 103.23 103.24
103.25 103.26 103.27 103.28 103.29 103.30 103.31 104.1 104.2 104.3 104.4 104.5 104.6 104.7 104.8 104.9 104.10 104.11 104.12 104.13 104.14 104.15 104.16 104.17 104.18 104.19 104.20 104.21 104.22
104.23 104.24 104.25 104.26 104.27 104.28 104.29 104.30 104.31
105.1 105.2 105.3 105.4 105.5 105.6 105.7 105.8 105.9 105.10 105.11 105.12 105.13 105.14 105.15 105.16 105.17 105.18 105.19 105.20 105.21 105.22 105.23 105.24 105.25 105.26 105.27 105.28 105.29
105.30 105.31 105.32 106.1 106.2 106.3 106.4 106.5 106.6 106.7 106.8 106.9 106.10 106.11 106.12 106.13
106.14 106.15 106.16 106.17 106.18 106.19 106.20 106.21 106.22 106.23 106.24 106.25 106.26 106.27 106.28 106.29 106.30 106.31 106.32 106.33 107.1 107.2 107.3 107.4 107.5 107.6
107.7 107.8 107.9 107.10 107.11 107.12 107.13 107.14 107.15 107.16 107.17 107.18 107.19 107.20 107.21 107.22 107.23 107.24 107.25 107.26 107.27 107.28 107.29 107.30 107.31 108.1 108.2 108.3 108.4 108.5
108.6 108.7 108.8 108.9 108.10 108.11 108.12 108.13 108.14 108.15 108.16 108.17 108.18 108.19 108.20 108.21 108.22 108.23 108.24 108.25
108.26 108.27 108.28 108.29 108.30 109.1 109.2 109.3 109.4 109.5 109.6
109.7 109.8 109.9 109.10
109.11 109.12 109.13 109.14 109.15 109.16 109.17 109.18 109.19 109.20 109.21 109.22 109.23 109.24 109.25 109.26 109.27 109.28 109.29 109.30 109.31 109.32 110.1 110.2 110.3 110.4 110.5 110.6 110.7 110.8 110.9 110.10 110.11 110.12 110.13 110.14 110.15 110.16 110.17
110.18 110.19 110.20 110.21 110.22 110.23 110.24
110.25 110.26 110.27 110.28 110.29 110.30 110.31 110.32 110.33 111.1 111.2 111.3 111.4 111.5 111.6 111.7
111.8 111.9 111.10 111.11 111.12 111.13 111.14
111.15 111.16 111.17 111.18 111.19 111.20 111.21
111.22 111.23 111.24 111.25
111.26 111.27 111.28 111.29 111.30 111.31 112.1 112.2 112.3 112.4 112.5 112.6 112.7 112.8 112.9
112.10 112.11 112.12 112.13 112.14 112.15 112.16 112.17 112.18 112.19 112.20 112.21 112.22 112.23 112.24 112.25 112.26 112.27 112.28 112.29 112.30 112.31 112.32
113.1 113.2 113.3 113.4 113.5 113.6 113.7 113.8 113.9 113.10 113.11 113.12 113.13 113.14 113.15 113.16 113.17 113.18 113.19 113.20 113.21 113.22 113.23 113.24 113.25
113.26 113.27 113.28 113.29 113.30 113.31 114.1 114.2 114.3 114.4 114.5 114.6 114.7 114.8 114.9
114.10 114.11 114.12 114.13
114.14 114.15 114.16 114.17 114.18 114.19 114.20 114.21 114.22 114.23 114.24 114.25 114.26 114.27 114.28 114.29 114.30 114.31 115.1 115.2 115.3 115.4 115.5 115.6 115.7 115.8 115.9 115.10 115.11 115.12 115.13 115.14 115.15 115.16 115.17 115.18 115.19 115.20 115.21 115.22 115.23 115.24 115.25 115.26 115.27 115.28 115.29 115.30 115.31 115.32 115.33 116.1 116.2 116.3 116.4 116.5 116.6 116.7 116.8 116.9 116.10 116.11 116.12 116.13 116.14 116.15 116.16 116.17 116.18 116.19 116.20 116.21 116.22 116.23 116.24 116.25 116.26 116.27 116.28 116.29 116.30 116.31 116.32 116.33 116.34 117.1 117.2 117.3 117.4 117.5 117.6 117.7 117.8 117.9 117.10 117.11
117.12 117.13 117.14 117.15 117.16 117.17 117.18 117.19 117.20 117.21 117.22 117.23 117.24 117.25 117.26 117.27 117.28 117.29 117.30 117.31 117.32 118.1 118.2 118.3 118.4
118.5 118.6 118.7 118.9 118.8 118.10 118.11 118.12 118.13 118.14 118.15 118.16 118.17 118.18 118.19 118.20 118.21 118.22 118.23 118.24 118.25 118.26 118.27 118.28 118.29 118.30 118.31 118.32 118.33 118.34 118.35 118.36 118.37 119.1 119.2 119.3 119.4 119.5 119.6 119.7 119.8 119.9 119.10 119.11 119.12 119.13 119.14 119.15 119.16 119.17 119.18 119.19 119.20 119.21 119.22 119.23 119.24 119.25 119.26 119.27 119.28 119.29 119.30 119.31 119.32 119.33 119.34 119.35 119.36 119.37 119.38 119.39 119.40 119.41 119.42 119.43 119.44 119.45 119.46 120.1 120.2 120.3 120.4 120.5 120.6 120.7 120.8 120.9 120.10 120.11 120.12 120.13 120.14 120.15 120.16 120.17 120.18 120.19 120.20 120.21 120.22 120.23 120.24 120.25 120.26 120.27 120.28 120.29 120.30 120.31 120.32 120.33 120.34 120.35 121.1 121.2 121.3 121.4 121.5 121.6 121.7 121.8 121.9 121.10 121.11 121.12 121.13 121.14 121.15 121.16 121.17 121.18 121.19 121.20 121.21 121.22 121.23 121.24 121.25 121.26 121.27 121.28 121.29 121.30 121.31 121.32 121.33 121.34 122.1 122.2 122.3 122.4 122.5 122.6 122.7 122.8 122.9 122.10 122.11 122.12
122.13 122.14 122.15 122.16 122.17 122.18 122.19 122.20 122.21 122.22 122.23 122.24 122.25 122.26 122.27 122.28 122.29 122.30 122.31 122.32 123.1 123.2 123.3 123.4 123.5 123.6 123.7 123.8 123.9 123.10 123.11 123.12 123.13 123.14 123.15 123.16 123.17 123.18 123.19 123.20 123.21 123.22 123.23 123.24 123.25 123.26 123.27 123.28 123.29 123.30 123.31 123.32 123.33 123.34 124.1 124.2 124.3
124.4 124.5 124.6 124.7 124.8
124.9 124.10 124.11 124.12 124.13 124.14 124.15 124.16 124.17 124.18 124.19 124.20 124.21 124.22 124.23 124.24 124.25 124.26 124.27 124.28 124.29 125.1 125.2 125.3 125.4 125.5 125.6 125.7 125.8 125.9 125.10 125.11 125.12 125.13 125.14 125.15 125.16 125.17 125.18 125.19 125.20 125.21 125.22 125.23 125.24 125.25 125.26 125.27 125.28 125.29 125.30 125.31 126.1 126.2 126.3 126.4 126.5 126.6 126.7 126.8 126.9 126.10 126.11 126.12 126.13 126.14 126.15 126.16 126.17 126.18 126.19 126.20 126.21 126.22 126.23 126.24 126.25 126.26 126.27 126.28 126.29 126.30 126.31 126.32 126.33 127.1 127.2 127.3 127.4 127.5 127.6 127.7 127.8 127.9 127.10 127.11 127.12 127.13 127.14 127.15 127.16
127.17 127.18 127.19 127.20 127.21 127.22
127.23 127.24 127.25 127.26 127.27 127.28 127.29 127.30 127.31 127.32
128.1 128.2 128.3 128.4 128.5 128.6 128.7 128.8
128.9 128.10 128.11 128.12
128.13 128.14 128.15 128.16 128.17 128.18 128.19 128.20 128.21 128.22 128.23
128.24 128.25 128.26 128.27 128.28 128.29 128.30 128.31 129.1 129.2 129.3
129.4 129.5 129.6 129.7 129.8 129.9 129.10 129.11 129.12 129.13 129.14 129.15 129.16 129.17 129.18 129.19 129.20 129.21 129.22 129.23 129.24 129.25 129.26 129.27 129.28 129.29 129.30 129.31 129.32 129.33 130.1 130.2 130.3 130.4 130.5 130.6 130.7 130.8 130.9 130.10 130.11 130.12 130.13 130.14 130.15 130.16 130.17 130.18 130.19 130.20 130.21 130.22 130.23 130.24 130.25 130.26 130.27 130.28 130.29 130.30 130.31 130.32 130.33 130.34 130.35 131.1 131.2 131.3 131.4 131.5 131.6 131.7 131.8 131.9 131.10 131.11 131.12 131.13 131.14 131.15 131.16 131.17 131.18 131.19 131.20 131.21 131.22 131.23 131.24 131.25 131.26 131.27 131.28 131.29 131.30 131.31 131.32 132.1 132.2 132.3 132.4 132.5 132.6 132.7 132.8 132.9 132.10 132.11 132.12 132.13 132.14 132.15 132.16 132.17 132.18 132.19 132.20 132.21 132.22 132.23 132.24 132.25 132.26
132.27 132.28 132.29 132.30 132.31 133.1 133.2 133.3 133.4 133.5 133.6 133.7 133.8 133.9 133.10 133.11 133.12 133.13 133.14 133.15 133.16 133.17 133.18 133.19 133.20 133.21 133.22 133.23 133.24 133.25 133.26 133.27 133.28 133.29 133.30 133.31
134.1 134.2 134.3 134.4 134.5 134.6 134.7 134.8 134.9 134.10 134.11 134.12 134.13 134.14 134.15 134.16 134.17 134.18 134.19 134.20 134.21 134.22
134.23 134.24 134.25 134.26 134.27 134.28 134.29 134.30 134.31 134.32 135.1 135.2 135.3 135.4 135.5 135.6 135.7 135.8 135.9 135.10 135.11 135.12 135.13 135.14 135.15 135.16 135.17 135.18 135.19 135.20 135.21 135.22 135.23 135.24 135.25 135.26 135.27 135.28 135.29 135.30 135.31 135.32 135.33 136.1 136.2 136.3 136.4 136.5 136.6 136.7 136.8 136.9 136.10 136.11 136.12 136.13 136.14 136.15 136.16 136.17 136.18 136.19 136.20 136.21 136.22 136.23 136.24 136.25 136.26 136.27 136.28
136.29 136.30 136.31 136.32 137.1 137.2 137.3 137.4 137.5 137.6 137.7 137.8 137.9 137.10 137.11 137.12 137.13 137.14 137.15 137.16 137.17 137.18 137.19 137.20 137.21 137.22 137.23 137.24 137.25 137.26 137.27 137.28 137.29 137.30 137.31 137.32 137.33 138.1 138.2 138.3 138.4 138.5 138.6 138.7 138.8 138.9 138.10 138.11 138.12 138.13 138.14 138.15 138.16 138.17 138.18 138.19 138.20 138.21 138.22 138.23 138.24 138.25 138.26 138.27 138.28 138.29 138.30 138.31 138.32 138.33 139.1 139.2 139.3 139.4 139.5 139.6 139.7 139.8 139.9 139.10 139.11 139.12 139.13 139.14 139.15 139.16 139.17 139.18 139.19 139.20 139.21 139.22 139.23 139.24 139.25 139.26 139.27 139.28 139.29 139.30 139.31 139.32 140.1 140.2 140.3 140.4 140.5 140.6 140.7 140.8 140.9 140.10 140.11 140.12 140.13 140.14 140.15 140.16 140.17 140.18 140.19 140.20 140.21 140.22 140.23 140.24 140.25 140.26 140.27 140.28
140.29 140.30 140.31 140.32 141.1 141.2 141.3 141.4 141.5 141.6 141.7 141.8 141.9 141.10 141.11 141.12 141.13 141.14 141.15 141.16 141.17 141.18 141.19 141.20 141.21 141.22 141.23 141.24 141.25 141.26 141.27 141.28 141.29 141.30 141.31 141.32 141.33 142.1 142.2 142.3 142.4 142.5 142.6 142.7 142.8 142.9 142.10 142.11 142.12 142.13 142.14 142.15 142.16 142.17 142.18 142.19 142.20 142.21 142.22 142.23 142.24 142.25 142.26 142.27 142.28 142.29 142.30 142.31 142.32 143.1 143.2 143.3 143.4 143.5 143.6 143.7 143.8 143.9 143.10 143.11 143.12 143.13 143.14 143.15 143.16 143.17 143.18 143.19
143.20 143.21 143.22 143.23 143.24 143.25 143.26 143.27 143.28 143.29 143.30 144.1 144.2 144.3 144.4 144.5 144.6 144.7 144.8 144.9 144.10 144.11 144.12 144.13 144.14 144.15 144.16 144.17 144.18 144.19 144.20 144.21 144.22 144.23 144.24 144.25 144.26 144.27 144.28 144.29 144.30 144.31 144.32 144.33 145.1 145.2 145.3 145.4 145.5 145.6 145.7 145.8 145.9 145.10 145.11 145.12 145.13 145.14 145.15 145.16 145.17 145.18 145.19 145.20 145.21 145.22 145.23 145.24 145.25 145.26 145.27 145.28
145.29 145.30 145.31 145.32 145.33 146.1 146.2 146.3 146.4 146.5 146.6
146.7 146.8 146.9 146.10 146.11 146.12 146.13 146.14 146.15 146.16 146.17 146.18 146.19 146.20 146.21 146.22 146.23 146.24 146.25 146.26 146.27 146.28 146.29 146.30 146.31 146.32 147.1 147.2 147.3 147.4 147.5
147.6 147.7 147.8 147.9 147.10 147.11 147.12 147.13 147.14 147.15 147.16 147.17
147.18 147.19 147.20 147.21 147.22 147.23 147.24 147.25 147.26 147.27 147.28 147.29 147.30 147.31 148.1 148.2 148.3 148.4 148.5 148.6 148.7 148.8 148.9 148.10 148.11 148.12 148.13 148.14 148.15 148.16 148.17 148.18 148.19 148.20 148.21 148.22 148.23 148.24 148.25 148.26 148.27 148.28 148.29 148.30 148.31 149.1 149.2 149.3 149.4 149.5 149.6 149.7 149.8 149.9 149.10
149.11 149.12 149.13 149.14 149.15 149.16 149.17 149.18 149.19 149.20 149.21 149.22 149.23 149.24 149.25 149.26 149.27 149.28 149.29 149.30 149.31 150.1 150.2 150.3 150.4 150.5 150.6 150.7 150.8 150.9 150.10 150.11 150.12 150.13 150.14 150.15 150.16 150.17 150.18 150.19 150.20 150.21 150.22 150.23 150.24 150.25 150.26 150.27 150.28 150.29 150.30 151.1 151.2 151.3 151.4 151.5 151.6 151.7 151.8 151.9 151.10 151.11 151.12 151.13 151.14 151.15 151.16 151.17 151.18 151.19
151.20 151.21 151.22 151.23 151.24 151.25 151.26 151.27 151.28 151.29 151.30 151.31 151.32 152.1 152.2 152.3 152.4 152.5 152.6 152.7 152.8 152.9 152.10 152.11 152.12 152.13 152.14 152.15 152.16 152.17 152.18 152.19 152.20 152.21 152.22 152.23 152.24 152.25 152.26 152.27 152.28 152.29 152.30 152.31 152.32 152.33 153.1 153.2 153.3 153.4 153.5 153.6 153.7 153.8 153.9 153.10 153.11 153.12 153.13 153.14 153.15 153.16 153.17 153.18 153.19 153.20 153.21 153.22 153.23 153.24 153.25
153.26 153.27 153.28 153.29 153.30 153.31 153.32 154.1 154.2 154.3 154.4 154.5 154.6 154.7
154.8 154.9 154.10 154.11 154.12 154.13 154.14 154.15 154.16 154.17 154.18 154.19 154.20 154.21 154.22 154.23 154.24 154.25 154.26 154.27 154.28 154.29 154.30 154.31 154.32 154.33 155.1 155.2 155.3 155.4 155.5 155.6 155.7
155.8 155.9 155.10 155.11 155.12 155.13 155.14 155.15 155.16 155.17 155.18 155.19 155.20 155.21 155.22 155.23 155.24 155.25 155.26 155.27 155.28 155.29 155.30 155.31 155.32 156.1 156.2 156.3 156.4 156.5 156.6 156.7 156.8 156.9 156.10 156.11 156.12 156.13 156.14 156.15 156.16 156.17 156.18 156.19 156.20 156.21 156.22 156.23 156.24 156.25 156.26 156.27 156.28 156.29 156.30 156.31 156.32 156.33 157.1 157.2 157.3
157.4 157.5 157.6 157.7 157.8 157.9 157.10 157.11 157.12 157.13 157.14 157.15 157.16 157.17 157.18 157.19 157.20 157.21 157.22 157.23 157.24 157.25 157.26 157.27 157.28 157.29 157.30 157.31 157.32 158.1 158.2 158.3 158.4 158.5 158.6 158.7 158.8 158.9 158.10 158.11 158.12
158.13 158.14 158.15 158.16 158.17 158.18 158.19 158.20 158.21 158.22 158.23 158.24
158.25 158.26 158.27 158.28 158.29 158.30 158.31 158.32 159.1 159.2 159.3 159.4 159.5 159.6
159.7 159.8 159.9 159.10 159.11 159.12
159.13 159.14 159.15 159.16 159.17 159.18 159.19 159.20 159.21 159.22 159.23 159.24 159.25
159.26 159.27 159.28 159.29 159.30 159.31 160.1 160.2 160.3 160.4 160.5 160.6 160.7 160.8 160.9 160.10 160.11 160.12 160.13 160.14 160.15
160.16 160.17 160.18 160.19 160.20 160.21 160.22 160.23 160.24 160.25 160.26 160.27 160.28 160.29 160.30 160.31 160.32 161.1 161.2 161.3 161.4 161.5 161.6 161.7 161.8 161.9 161.10 161.11 161.12 161.13 161.14 161.15 161.16 161.17 161.18 161.19 161.20 161.21 161.22 161.23 161.24 161.25 161.26 161.27 161.28 161.29 161.30 161.31 161.32 161.33
162.1 162.2 162.3 162.4 162.5 162.6 162.7 162.8 162.9 162.10 162.11 162.12 162.13 162.14 162.15 162.16 162.17 162.18 162.19 162.20 162.21 162.22 162.23 162.24 162.25 162.26 162.27 162.28 162.29
163.1 163.2 163.3 163.4 163.5 163.6 163.7 163.8 163.9 163.10 163.11 163.12 163.13 163.14 163.15 163.16 163.17 163.18 163.19 163.20 163.21 163.22 163.23 163.24 163.25 163.26 163.27 163.28 163.29 163.30 163.31
164.1 164.2 164.3 164.4 164.5 164.6 164.7 164.8 164.9 164.10 164.11 164.12 164.13 164.14 164.15 164.16 164.17 164.18 164.19 164.20 164.21 164.22 164.23 164.24 164.25 164.26 164.27 164.28 164.29 164.30 164.31 164.32 165.1 165.2 165.3 165.4 165.5 165.6 165.7 165.8 165.9 165.10 165.11 165.12 165.13 165.14 165.15 165.16 165.17 165.18 165.19 165.20 165.21 165.22 165.23 165.24 165.25 165.26 165.27 165.28 165.29 165.30 165.31 165.32 165.33 165.34 166.1 166.2 166.3 166.4 166.5 166.6 166.7 166.8 166.9 166.10 166.11 166.12 166.13 166.14 166.15 166.16 166.17 166.18 166.19 166.20 166.21 166.22 166.23 166.24 166.25 166.26 166.27 166.28 166.29 166.30 166.31 166.32 166.33 167.1 167.2 167.3 167.4 167.5 167.6 167.7 167.8 167.9 167.10 167.11 167.12 167.13 167.14 167.15 167.16 167.17 167.18 167.19 167.20 167.21 167.22 167.23 167.24 167.25 167.26 167.27 167.28 167.29 167.30 167.31 167.32
168.1 168.2 168.3 168.4 168.5 168.6 168.7 168.8 168.9 168.10 168.11 168.12 168.13 168.14 168.15 168.16 168.17 168.18
168.19 168.20 168.21 168.22 168.23 168.24 168.25 168.26 168.27 168.28 168.29 168.30 168.31 168.32 169.1 169.2 169.3 169.4 169.5 169.6 169.7 169.8 169.9 169.10 169.11 169.12 169.13 169.14
169.15 169.16 169.17 169.18 169.19 169.20 169.21 169.22 169.23 169.24 169.25 169.26 169.27 169.28 169.29 169.30 169.31 169.32
170.1 170.2 170.3 170.4 170.5 170.6 170.7 170.8 170.9 170.10 170.11 170.12 170.13 170.14 170.15 170.16 170.17 170.18 170.19 170.20 170.21 170.22 170.23 170.24 170.25 170.26 170.27 170.28 170.29 170.30 170.31 170.32 170.33 171.1 171.2 171.3 171.4 171.5 171.6 171.7 171.8 171.9
171.10 171.11 171.12 171.13 171.14
171.15 171.16 171.17 171.18 171.19 171.20 171.21 171.22 171.23 171.24 171.25 171.26 171.27 171.28 171.29 171.30 171.31 172.1 172.2 172.3 172.4 172.5 172.6 172.7 172.8 172.9 172.10 172.11 172.12 172.13 172.14 172.15 172.16 172.17 172.18 172.19 172.20 172.21 172.22 172.23 172.24 172.25 172.26 172.27 172.28 172.29 172.30 172.31 173.1 173.2 173.3 173.4 173.5 173.6 173.7 173.8 173.9 173.10 173.11 173.12 173.13 173.14 173.15 173.16 173.17 173.18 173.19 173.20 173.21 173.22 173.23 173.24 173.25 173.26 173.27 173.28 173.29 173.30 173.31 173.32 173.33 174.1 174.2 174.3 174.4 174.5 174.6 174.7 174.8 174.9 174.10 174.11 174.12 174.13 174.14 174.15 174.16 174.17 174.18 174.19 174.20 174.21 174.22 174.23 174.24 174.25 174.26 174.27 174.28 174.29 174.30 174.31 174.32 174.33 175.1 175.2 175.3 175.4 175.5 175.6 175.7 175.8 175.9 175.10 175.11 175.12 175.13 175.14 175.15 175.16 175.17 175.18 175.19
175.20 175.21 175.22 175.23 175.24 175.25 175.26 175.27 175.28 175.29 175.30 176.1 176.2 176.3 176.4 176.5 176.6 176.7 176.8 176.9 176.10 176.11 176.12 176.13 176.14 176.15 176.16 176.17 176.18
176.19 176.20 176.21 176.22 176.23 176.24 176.25 176.26 176.27 176.28 176.29 176.30 176.31 177.1 177.2 177.3 177.4 177.5 177.6 177.7 177.8 177.9 177.10 177.11 177.12 177.13 177.14 177.15 177.16 177.17 177.18 177.19 177.20 177.21 177.22 177.23 177.24 177.25 177.26 177.27 177.28 177.29 177.30 177.31 177.32 177.33 177.34 177.35 178.1 178.2 178.3 178.4 178.5 178.6 178.7 178.8 178.9 178.10 178.11 178.12 178.13 178.14 178.15 178.16 178.17 178.18 178.19 178.20 178.21 178.22 178.23 178.24 178.25 178.26 178.27 178.28 178.29 178.30 178.31 178.32 179.1 179.2 179.3 179.4 179.5 179.6 179.7 179.8 179.9 179.10 179.11 179.12 179.13 179.14 179.15 179.16 179.17 179.18 179.19 179.20 179.21 179.22 179.23 179.24 179.25 179.26 179.27 179.28 179.29 179.30 179.31 179.32 179.33 180.1 180.2 180.3 180.4 180.5 180.6 180.7 180.8 180.9 180.10 180.11 180.12 180.13 180.14 180.15 180.16 180.17 180.18 180.19 180.20 180.21 180.22 180.23 180.24 180.25 180.26 180.27
180.28 180.29 180.30 180.31 180.32 181.1 181.2 181.3 181.4 181.5 181.6 181.7 181.8 181.9 181.10 181.11 181.12 181.13 181.14 181.15 181.16 181.17
181.18 181.19 181.20 181.21 181.22 181.23 181.24 181.25 181.26 181.27 181.28 181.29 181.30 182.1 182.2 182.3 182.4 182.5 182.6 182.7 182.8 182.9 182.10
182.11 182.12 182.13 182.14 182.15 182.16 182.17 182.18 182.19 182.20 182.21 182.22 182.23 182.24 182.25 182.26 182.27 182.28 182.29 182.30 183.1 183.2 183.3 183.4 183.5 183.6 183.7 183.8 183.9 183.10 183.11 183.12 183.13 183.14 183.15 183.16 183.17 183.18 183.19 183.20 183.21 183.22 183.23 183.24 183.25 183.26 183.27 183.28 183.29 183.30 183.31 183.32 184.1 184.2 184.3 184.4 184.5 184.6 184.7 184.8 184.9 184.10 184.11 184.12 184.13 184.14 184.15 184.16 184.17 184.18 184.19
184.20 184.21 184.22 184.23 184.24 184.25 184.26 184.27 184.28 184.29 184.30 184.31 184.32 184.33 185.1 185.2 185.3 185.4 185.5 185.6 185.7 185.8 185.9 185.10 185.11 185.12 185.13 185.14 185.15 185.16 185.17 185.18
185.19 185.20 185.21 185.22 185.23 185.24 185.25 185.26 185.27 185.28 185.29 185.30 186.1 186.2 186.3 186.4
186.5 186.6 186.7 186.8 186.9 186.10 186.11 186.12 186.13 186.14 186.15 186.16 186.17 186.18 186.19 186.20 186.21 186.22 186.23 186.24 186.25 186.26 186.27 186.28 186.29 186.30 186.31 186.32 187.1 187.2 187.3 187.4 187.5 187.6 187.7 187.8 187.9 187.10 187.11 187.12 187.13 187.14 187.15 187.16 187.17 187.18 187.19 187.20 187.21 187.22
187.23 187.24 187.25 187.26 187.27 187.28 187.29 187.30 187.31 188.1 188.2 188.3 188.4 188.5 188.6 188.7 188.8 188.9 188.10 188.11 188.12 188.13
188.14 188.15 188.16 188.17 188.18 188.19 188.20
188.21 188.22 188.23 188.24 188.25 188.26 188.27 188.28 188.29 188.30 188.31 189.1 189.2 189.3 189.4 189.5 189.6 189.7 189.8 189.9 189.10 189.11 189.12 189.13 189.14 189.15 189.16 189.17 189.18 189.19 189.20 189.21 189.22 189.23 189.24 189.25 189.26 189.27 189.28 189.29 189.30 189.31 189.32 190.1 190.2 190.3 190.4 190.5 190.6 190.7 190.8 190.9 190.10 190.11 190.12 190.13 190.14 190.15 190.16 190.17 190.18 190.19 190.20 190.21 190.22 190.23 190.24 190.25 190.26 190.27 190.28 190.29 190.30 191.1 191.2 191.3 191.4 191.5 191.6 191.7 191.8 191.9 191.10 191.11 191.12 191.13 191.14
191.15 191.16 191.17 191.18 191.19 191.20 191.21 191.22 191.23 191.24 191.25 191.26 191.27 191.28 191.29 191.30 191.31 192.1 192.2
192.3 192.4 192.5 192.6 192.7 192.8 192.9 192.10 192.11 192.12 192.13 192.14 192.15 192.16 192.17 192.18 192.19 192.20 192.21 192.22 192.23 192.24 192.25 192.26 192.27 192.28 192.29 192.30 193.1 193.2 193.3 193.4 193.5 193.6 193.7 193.8 193.9 193.10 193.11 193.12 193.13 193.14 193.15 193.16 193.17 193.18 193.19 193.20 193.21
193.22 193.23 193.24 193.25 193.26 193.27 193.28 193.29 193.30 193.31 194.1 194.2 194.3 194.4 194.5 194.6 194.7 194.8 194.9 194.10 194.11 194.12 194.13 194.14 194.15 194.16 194.17 194.18 194.19 194.20 194.21 194.22 194.23 194.24 194.25 194.26 194.27 194.28 194.29 194.30 194.31 195.1 195.2 195.3 195.4 195.5 195.6 195.7 195.8 195.9 195.10 195.11 195.12 195.13 195.14 195.15 195.16 195.17 195.18 195.19 195.20 195.21 195.22 195.23 195.24 195.25 195.26 195.27 195.28 195.29 195.30 195.31 195.32 196.1 196.2 196.3
196.4 196.5 196.6 196.7 196.8 196.9 196.10 196.11 196.12 196.13 196.14 196.15 196.16 196.17 196.18 196.19 196.20 196.21 196.22 196.23 196.24 196.25 196.26 196.27 196.28 196.29 196.30 197.1 197.2 197.3 197.4 197.5 197.6 197.7 197.8 197.9 197.10 197.11 197.12 197.13 197.14 197.15 197.16 197.17 197.18 197.19 197.20 197.21 197.22 197.23 197.24 197.25 197.26 197.27 197.28 197.29 197.30 197.31 197.32 198.1 198.2 198.3 198.4 198.5 198.6 198.7 198.8 198.9 198.10 198.11 198.12
198.13 198.14 198.15 198.16 198.17 198.18 198.19 198.20 198.21 198.22 198.23 198.24 198.25 198.26 198.27 198.28 198.29 198.30 198.31 199.1 199.2
199.3 199.4 199.5 199.6 199.7 199.8 199.9 199.10 199.11 199.12 199.13 199.14 199.15 199.16 199.17 199.18 199.19 199.20 199.21 199.22 199.23 199.24 199.25 199.26 199.27 199.28 199.29 199.30 200.1 200.2 200.3 200.4 200.5 200.6 200.7 200.8 200.9 200.10 200.11 200.12 200.13 200.14 200.15 200.16 200.17 200.18 200.19 200.20 200.21 200.22 200.23 200.24 200.25 200.26 200.27 200.28 200.29 200.30 200.31 201.1 201.2 201.3 201.4 201.5 201.6 201.7 201.8 201.9 201.10 201.11
201.12 201.13 201.14 201.15 201.16 201.17 201.18 201.19 201.20 201.21 201.22 201.23 201.24
201.25 201.26 201.27 201.28 201.29 201.30 202.1 202.2 202.3 202.4 202.5 202.6 202.7 202.8
202.9 202.10 202.11 202.12 202.13 202.14 202.15 202.16 202.17 202.18 202.19 202.20
202.21 202.22 202.23 202.24 202.25 202.26 202.27 202.28 202.29 202.30 202.31 203.1 203.2 203.3 203.4 203.5 203.6 203.7 203.8 203.9 203.10 203.11 203.12 203.13 203.14 203.15 203.16 203.17 203.18 203.19
203.20 203.21 203.22 203.23 203.24 203.25 203.26 203.27 203.28 203.29 203.30 203.31 203.32 204.1 204.2 204.3 204.4 204.5 204.6 204.7 204.8 204.9 204.10 204.11 204.12 204.13 204.14 204.15 204.16 204.17 204.18 204.19 204.20 204.21 204.22 204.23 204.24 204.25 204.26 204.27 204.28 204.29 204.30 204.31 204.32
205.1 205.2 205.3 205.4 205.5 205.6 205.7 205.8 205.9 205.10 205.11 205.12 205.13 205.14 205.15 205.16
205.17 205.18 205.19 205.20 205.21 205.22 205.23 205.24 205.25 205.26 205.27 205.28 205.29 205.30 206.1 206.2 206.3 206.4 206.5 206.6 206.7 206.8 206.9 206.10 206.11 206.12 206.13 206.14 206.15 206.16 206.17 206.18 206.19 206.20 206.21 206.22 206.23 206.24 206.25 206.26 206.27 206.28 206.29 206.30 206.31 206.32 207.1 207.2
207.3 207.4 207.5 207.6 207.7 207.8 207.9 207.10 207.11 207.12 207.13 207.14 207.15 207.16 207.17 207.18 207.19 207.20 207.21 207.22 207.23 207.24 207.25 207.26 207.27 207.28 207.29 207.30 207.31 208.1 208.2 208.3 208.4 208.5 208.6 208.7 208.8 208.9 208.10 208.11 208.12 208.13 208.14 208.15 208.16 208.17 208.18 208.19 208.20 208.21 208.22 208.23 208.24 208.25
208.26 208.27 208.28 208.29 208.30 208.31 209.1 209.2 209.3 209.4 209.5 209.6

A bill for an act
relating to human services; modifying mental health services provisions; amending
Minnesota Statutes 2020, sections 62A.152, subdivision 3; 62A.3094, subdivision
1; 62Q.096; 144.651, subdivision 2; 144D.01, subdivision 4; 144G.08, subdivision
7, as amended; 148B.5301, subdivision 2; 148E.120, subdivision 2; 148F.11,
subdivision 1; 245.462, subdivisions 1, 6, 8, 9, 14, 16, 17, 18, 21, 23, by adding
a subdivision; 245.4661, subdivision 5; 245.4662, subdivision 1; 245.467,
subdivisions 2, 3; 245.469, subdivisions 1, 2; 245.470, subdivision 1; 245.4712,
subdivision 2; 245.472, subdivision 2; 245.4863; 245.4871, subdivisions 9a, 10,
11a, 17, 21, 26, 27, 29, 31, 32, 34, by adding a subdivision; 245.4876, subdivisions
2, 3; 245.4879, subdivision 1; 245.488, subdivision 1; 245.4901, subdivision 2;
245.62, subdivision 2; 245.735, subdivision 3; 245A.04, subdivision 5; 245A.10,
subdivision 4; 245A.65, subdivision 2; 245D.02, subdivision 20; 254B.05,
subdivision 5; 256B.0615, subdivisions 1, 5; 256B.0616, subdivisions 1, 3, 5;
256B.0622, subdivisions 1, 2, 3a, 4, 7, 7a, 7b, 7d; 256B.0623, subdivisions 1, 2,
3, 4, 5, 6, 9, 12; 256B.0624; 256B.0625, subdivisions 3b, 5, 19c, 28a, 42, 48, 49,
56a; 256B.0757, subdivision 4c; 256B.0941, subdivision 1; 256B.0943,
subdivisions 1, 2, 3, 4, 5, 5a, 6, 7, 9, 11; 256B.0946, subdivisions 1, 1a, 2, 3, 4, 6;
256B.0947, subdivisions 1, 2, 3, 3a, 5, 6, 7; 256B.0949, subdivisions 2, 4, 5a;
256B.25, subdivision 3; 256B.761; 256B.763; 256P.01, subdivision 6a; 295.50,
subdivision 9b; 325F.721, subdivision 1; proposing coding for new law in
Minnesota Statutes, chapter 256B; proposing coding for new law as Minnesota
Statutes, chapter 245I; repealing Minnesota Statutes 2020, sections 245.462,
subdivision 4a; 245.4879, subdivision 2; 245.62, subdivisions 3, 4; 245.69,
subdivision 2; 256B.0615, subdivision 2; 256B.0616, subdivision 2; 256B.0622,
subdivisions 3, 5a; 256B.0623, subdivisions 7, 8, 10, 11; 256B.0625, subdivisions
5l, 35a, 35b, 61, 62, 65; 256B.0943, subdivisions 8, 10; 256B.0944; 256B.0946,
subdivision 5; Minnesota Rules, parts 9505.0370; 9505.0371; 9505.0372;
9520.0010; 9520.0020; 9520.0030; 9520.0040; 9520.0050; 9520.0060; 9520.0070;
9520.0080; 9520.0090; 9520.0100; 9520.0110; 9520.0120; 9520.0130; 9520.0140;
9520.0150; 9520.0160; 9520.0170; 9520.0180; 9520.0190; 9520.0200; 9520.0210;
9520.0230; 9520.0750; 9520.0760; 9520.0770; 9520.0780; 9520.0790; 9520.0800;
9520.0810; 9520.0820; 9520.0830; 9520.0840; 9520.0850; 9520.0860; 9520.0870.

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

ARTICLE 1

MENTAL HEALTH UNIFORM SERVICE STANDARDS

Section 1.

new text begin [245I.01] PURPOSE AND CITATION.
new text end

new text begin Subdivision 1. new text end

new text begin Citation. new text end

new text begin This chapter may be cited as the "Mental Health Uniform
Service Standards Act."
new text end

new text begin Subd. 2. new text end

new text begin Purpose. new text end

new text begin In accordance with sections 245.461 and 245.487, the purpose of this
chapter is to create a system of mental health care that is unified, accountable, and
comprehensive, and to promote the recovery and resiliency of Minnesotans who have mental
illnesses. The state's public policy is to support Minnesotans' access to quality outpatient
and residential mental health services. Further, the state's public policy is to protect the
health and safety, rights, and well-being of Minnesotans receiving mental health services.
new text end

Sec. 2.

new text begin [245I.011] APPLICABILITY.
new text end

new text begin Subdivision 1. new text end

new text begin License requirements. new text end

new text begin A license holder under this chapter must comply
with the requirements in chapters 245A, 245C, and 260E; section 626.557; and Minnesota
Rules, chapter 9544.
new text end

new text begin Subd. 2. new text end

new text begin Variances. new text end

new text begin (a) The commissioner may grant a variance to an applicant, license
holder, or certification holder as long as the variance does not affect the staff qualifications
or the health or safety of any person in a licensed or certified program and the applicant,
license holder, or certification holder meets the following conditions:
new text end

new text begin (1) an applicant, license holder, or certification holder must request the variance on a
form approved by the commissioner and in a manner prescribed by the commissioner;
new text end

new text begin (2) the request for a variance must include the:
new text end

new text begin (i) reasons that the applicant, license holder, or certification holder cannot comply with
a requirement as stated in the law; and
new text end

new text begin (ii) alternative equivalent measures that the applicant, license holder, or certification
holder will follow to comply with the intent of the law; and
new text end

new text begin (3) the request for a variance must state the period of time when the variance is requested.
new text end

new text begin (b) The commissioner may grant a permanent variance when the conditions under which
the applicant, license holder, or certification holder requested the variance do not affect the
health or safety of any person whom the licensed or certified program serves, and when the
conditions of the variance do not compromise the qualifications of staff who provide services
to clients. A permanent variance expires when the conditions that warranted the variance
change in any way. Any applicant, license holder, or certification holder must inform the
commissioner of any changes to the conditions that warranted the permanent variance. If
an applicant, license holder, or certification holder fails to advise the commissioner of
changes to the conditions that warranted the variance, the commissioner must revoke the
permanent variance and may impose other sanctions under sections 245A.06 and 245A.07.
new text end

new text begin (c) The commissioner's decision to grant or deny a variance request is final and not
subject to appeal under the provisions of chapter 14.
new text end

new text begin Subd. 3. new text end

new text begin Certification required. new text end

new text begin (a) An individual, organization, or government entity
that is exempt from licensure under section 245A.03, subdivision 2, paragraph (a), clause
(19), and chooses to be identified as a certified mental health clinic must:
new text end

new text begin (1) be a mental health clinic that is certified under section 245I.20;
new text end

new text begin (2) comply with all of the responsibilities assigned to a license holder by this chapter
except subdivision 1; and
new text end

new text begin (3) comply with all of the responsibilities assigned to a certification holder by chapter
245A.
new text end

new text begin (b) An individual, organization, or government entity described by this subdivision must
obtain a criminal background study for each staff person or volunteer who provides direct
contact services to clients.
new text end

new text begin Subd. 4. new text end

new text begin License required. new text end

new text begin An individual, organization, or government entity providing
intensive residential treatment services or residential crisis stabilization to adults must be
licensed under section 245I.23.
new text end

new text begin Subd. 5. new text end

new text begin Programs certified under chapter 256B. new text end

new text begin (a) An individual, organization, or
government entity certified under the following sections must comply with all of the
responsibilities assigned to a license holder under this chapter except subdivision 1:
new text end

new text begin (1) an assertive community treatment provider under section 256B.0622, subdivision
3a;
new text end

new text begin (2) an adult rehabilitative mental health services provider under section 256B.0623;
new text end

new text begin (3) a mobile crisis team under section 256B.0624;
new text end

new text begin (4) a children's therapeutic services and supports provider under section 256B.0943;
new text end

new text begin (5) an intensive treatment in foster care provider under section 256B.0946; and
new text end

new text begin (6) an intensive nonresidential rehabilitative mental health services provider under section
256B.0947.
new text end

new text begin (b) An individual, organization, or government entity certified under the sections listed
in paragraph (a), clauses (1) to (6), must obtain a criminal background study for each staff
person and volunteer providing direct contact services to a client.
new text end

new text begin EFFECTIVE DATE. new text end

new text begin This section is effective upon federal approval or July 1, 2022,
whichever is later.
new text end

Sec. 3.

new text begin [245I.02] DEFINITIONS.
new text end

new text begin Subdivision 1. new text end

new text begin Scope. new text end

new text begin For purposes of this chapter, the terms in this section have the
meanings given.
new text end

new text begin Subd. 2. new text end

new text begin Approval. new text end

new text begin "Approval" means the documented review of, opportunity to request
changes to, and agreement with a treatment document. An individual may demonstrate
approval with a written signature, secure electronic signature, or documented oral approval.
new text end

new text begin Subd. 3. new text end

new text begin Behavioral sciences or related fields. new text end

new text begin "Behavioral sciences or related fields"
means an education from an accredited college or university in social work, psychology,
sociology, community counseling, family social science, child development, child
psychology, community mental health, addiction counseling, counseling and guidance,
special education, nursing, and other similar fields approved by the commissioner.
new text end

new text begin Subd. 4. new text end

new text begin Business day. new text end

new text begin "Business day" means a weekday on which government offices
are open for business. Business day does not include state or federal holidays, Saturdays,
or Sundays.
new text end

new text begin Subd. 5. new text end

new text begin Case manager. new text end

new text begin "Case manager" means a client's case manager according to
section 256B.0596; 256B.0621; 256B.0625, subdivision 20; 256B.092, subdivision 1a;
256B.0924; 256B.093, subdivision 3a; 256B.094; or 256B.49.
new text end

new text begin Subd. 6. new text end

new text begin Certified rehabilitation specialist. new text end

new text begin "Certified rehabilitation specialist" means
a staff person who meets the qualifications of section 245I.04, subdivision 8.
new text end

new text begin Subd. 7. new text end

new text begin Child. new text end

new text begin "Child" means a client under the age of 18.
new text end

new text begin Subd. 8. new text end

new text begin Client. new text end

new text begin "Client" means a person who is seeking or receiving services regulated
by this chapter. For the purpose of a client's consent to services, client includes a parent,
guardian, or other individual legally authorized to consent on behalf of a client to services.
new text end

new text begin Subd. 9. new text end

new text begin Clinical trainee. new text end

new text begin "Clinical trainee" means a staff person who is qualified
according to section 245I.04, subdivision 6.
new text end

new text begin Subd. 10. new text end

new text begin Commissioner. new text end

new text begin "Commissioner" means the commissioner of human services
or the commissioner's designee.
new text end

new text begin Subd. 11. new text end

new text begin Co-occurring substance use disorder treatment. new text end

new text begin "Co-occurring substance
use disorder treatment" means the treatment of a person who has a co-occurring mental
illness and substance use disorder. Co-occurring substance use disorder treatment is
characterized by stage-wise comprehensive treatment, treatment goal setting, and flexibility
for clients at each stage of treatment. Co-occurring substance use disorder treatment includes
assessing and tracking each client's stage of change readiness and treatment using a treatment
approach based on a client's stage of change, such as motivational interviewing when working
with a client at an earlier stage of change readiness and a cognitive behavioral approach
and relapse prevention to work with a client at a later stage of change; and facilitating a
client's access to community supports.
new text end

new text begin Subd. 12. new text end

new text begin Crisis plan. new text end

new text begin "Crisis plan" means a plan to prevent and de-escalate a client's
future crisis situation, with the goal of preventing future crises for the client and the client's
family and other natural supports. Crisis plan includes a crisis plan developed according to
section 245.4871, subdivision 9a.
new text end

new text begin Subd. 13. new text end

new text begin Critical incident. new text end

new text begin "Critical incident" means an occurrence involving a client
that requires a license holder to respond in a manner that is not part of the license holder's
ordinary daily routine. Critical incident includes a client's suicide, attempted suicide, or
homicide; a client's death; an injury to a client or other person that is life-threatening or
requires medical treatment; a fire that requires a fire department's response; alleged
maltreatment of a client; an assault of a client; an assault by a client; or other situation that
requires a response by law enforcement, the fire department, an ambulance, or another
emergency response provider.
new text end

new text begin Subd. 14. new text end

new text begin Diagnostic assessment. new text end

new text begin "Diagnostic assessment" means the evaluation and
report of a client's potential diagnoses that a mental health professional or clinical trainee
completes under section 245I.10, subdivisions 4 to 6.
new text end

new text begin Subd. 15. new text end

new text begin Direct contact. new text end

new text begin "Direct contact" has the meaning given in section 245C.02,
subdivision 11.
new text end

new text begin Subd. 16. new text end

new text begin Family and other natural supports. new text end

new text begin "Family and other natural supports"
means the people whom a client identifies as having a high degree of importance to the
client. Family and other natural supports also means people that the client identifies as being
important to the client's mental health treatment, regardless of whether the person is related
to the client or lives in the same household as the client.
new text end

new text begin Subd. 17. new text end

new text begin Functional assessment. new text end

new text begin "Functional assessment" means the assessment of a
client's current level of functioning relative to functioning that is appropriate for someone
the client's age. For a client five years of age or younger, a functional assessment is the
Early Childhood Service Intensity Instrument (ESCII). For a client six to 17 years of age,
a functional assessment is the Child and Adolescent Service Intensity Instrument (CASII).
For a client 18 years of age or older, a functional assessment is the functional assessment
described in section 245I.10, subdivision 9.
new text end

new text begin Subd. 18. new text end

new text begin Individual abuse prevention plan. new text end

new text begin "Individual abuse prevention plan" means
a plan according to section 245A.65, subdivision 2, paragraph (b), and section 626.557,
subdivision 14.
new text end

new text begin Subd. 19. new text end

new text begin Level of care assessment. new text end

new text begin "Level of care assessment" means the level of care
decision support tool appropriate to the client's age. For a client five years of age or younger,
a level of care assessment is the Early Childhood Service Intensity Instrument (ESCII). For
a client six to 17 years of age, a level of care assessment is the Child and Adolescent Service
Intensity Instrument (CASII). For a client 18 years of age or older, a level of care assessment
is the Level of Care Utilization System for Psychiatric and Addiction Services (LOCUS).
new text end

new text begin Subd. 20. new text end

new text begin License. new text end

new text begin "License" has the meaning given in section 245A.02, subdivision 8.
new text end

new text begin Subd. 21. new text end

new text begin License holder. new text end

new text begin "License holder" has the meaning given in section 245A.02,
subdivision 9.
new text end

new text begin Subd. 22. new text end

new text begin Licensed prescriber. new text end

new text begin "Licensed prescriber" means an individual who is
authorized to prescribe legend drugs under section 151.37.
new text end

new text begin Subd. 23. new text end

new text begin Mental health behavioral aide. new text end

new text begin "Mental health behavioral aide" means a
staff person who is qualified under section 245I.04, subdivision 16.
new text end

new text begin Subd. 24. new text end

new text begin Mental health certified family peer specialist. new text end

new text begin "Mental health certified
family peer specialist" means a staff person who is qualified under section 245I.04,
subdivision 12.
new text end

new text begin Subd. 25. new text end

new text begin Mental health certified peer specialist. new text end

new text begin "Mental health certified peer
specialist" means a staff person who is qualified under section 245I.04, subdivision 10.
new text end

new text begin Subd. 26. new text end

new text begin Mental health practitioner. new text end

new text begin "Mental health practitioner" means a staff person
who is qualified under section 245I.04, subdivision 4.
new text end

new text begin Subd. 27. new text end

new text begin Mental health professional. new text end

new text begin "Mental health professional" means a staff person
who is qualified under section 245I.04, subdivision 2.
new text end

new text begin Subd. 28. new text end

new text begin Mental health rehabilitation worker. new text end

new text begin "Mental health rehabilitation worker"
means a staff person who is qualified under section 245I.04, subdivision 14.
new text end

new text begin Subd. 29. new text end

new text begin Mental illness. new text end

new text begin "Mental illness" means any of the conditions included in the
most recent editions of the DC: 0-5 Diagnostic Classification of Mental Health and
Development Disorders of Infancy and Early Childhood published by Zero to Three or the
Diagnostic and Statistical Manual of Mental Disorders published by the American Psychiatric
Association.
new text end

new text begin Subd. 30. new text end

new text begin Organization. new text end

new text begin "Organization" has the meaning given in section 245A.02,
subdivision 10c.
new text end

new text begin Subd. 31. new text end

new text begin Personnel file. new text end

new text begin "Personnel file" means a set of records under section 245I.07,
paragraph (a). Personnel files excludes information related to a person's employment that
is not included in section 245I.07.
new text end

new text begin Subd. 32. new text end

new text begin Registered nurse. new text end

new text begin "Registered nurse" means a staff person who is qualified
under section 148.171, subdivision 20.
new text end

new text begin Subd. 33. new text end

new text begin Rehabilitative mental health services. new text end

new text begin "Rehabilitative mental health services"
means mental health services provided to an adult client that enable the client to develop
and achieve psychiatric stability, social competencies, personal and emotional adjustment,
independent living skills, family roles, and community skills when symptoms of mental
illness has impaired any of the client's abilities in these areas.
new text end

new text begin Subd. 34. new text end

new text begin Residential program. new text end

new text begin "Residential program" has the meaning given in section
245A.02, subdivision 14.
new text end

new text begin Subd. 35. new text end

new text begin Signature. new text end

new text begin "Signature" means a written signature or an electronic signature
defined in section 325L.02, paragraph (h).
new text end

new text begin Subd. 36. new text end

new text begin Staff person. new text end

new text begin "Staff person" means an individual who works under a license
holder's direction or under a contract with a license holder. Staff person includes an intern,
consultant, contractor, individual who works part-time, and an individual who does not
provide direct contact services to clients. Staff person includes a volunteer who provides
treatment services to a client or a volunteer whom the license holder regards as a staff person
for the purpose of meeting staffing or service delivery requirements. A staff person must
be 18 years of age or older.
new text end

new text begin Subd. 37. new text end

new text begin Strengths. new text end

new text begin "Strengths" means a person's inner characteristics, virtues, external
relationships, activities, and connections to resources that contribute to a client's resilience
and core competencies. A person can build on strengths to support recovery.
new text end

new text begin Subd. 38. new text end

new text begin Trauma. new text end

new text begin "Trauma" means an event, series of events, or set of circumstances
that is experienced by an individual as physically or emotionally harmful or life-threatening
that has lasting adverse effects on the individual's functioning and mental, physical, social,
emotional, or spiritual well-being. Trauma includes group traumatic experiences. Group
traumatic experiences are emotional or psychological harm that a group experiences. Group
traumatic experiences can be transmitted across generations within a community and are
often associated with racial and ethnic population groups who suffer major intergenerational
losses.
new text end

new text begin Subd. 39. new text end

new text begin Treatment plan. new text end

new text begin "Treatment plan" means services that a license holder
formulates to respond to a client's needs and goals. A treatment plan includes individual
treatment plans under section 245I.10, subdivisions 7 and 8; initial treatment plans under
section 245I.23, subdivision 7; and crisis treatment plans under sections 245I.23, subdivision
8, and 256B.0624, subdivision 11.
new text end

new text begin Subd. 40. new text end

new text begin Treatment supervision. new text end

new text begin "Treatment supervision" means a mental health
professional's or certified rehabilitation specialist's oversight, direction, and evaluation of
a staff person providing services to a client according to section 245I.06.
new text end

new text begin Subd. 41. new text end

new text begin Volunteer. new text end

new text begin "Volunteer" means an individual who, under the direction of the
license holder, provides services to or facilitates an activity for a client without compensation.
new text end

Sec. 4.

new text begin [245I.03] REQUIRED POLICIES AND PROCEDURES.
new text end

new text begin Subdivision 1. new text end

new text begin Generally. new text end

new text begin A license holder must establish, enforce, and maintain policies
and procedures to comply with the requirements of this chapter and chapters 245A, 245C,
and 260E; sections 626.557 and 626.5572; and Minnesota Rules, chapter 9544. The license
holder must make all policies and procedures available in writing to each staff person. The
license holder must complete and document a review of policies and procedures every two
years and update policies and procedures as necessary. Each policy and procedure must
identify the date that it was initiated and the dates of all revisions. The license holder must
clearly communicate any policy and procedural change to each staff person and provide
necessary training to each staff person to implement any policy and procedural change.
new text end

new text begin Subd. 2. new text end

new text begin Health and safety. new text end

new text begin A license holder must have policies and procedures to
ensure the health and safety of each staff person and client during the provision of services,
including policies and procedures for services based in community settings.
new text end

new text begin Subd. 3. new text end

new text begin Client rights. new text end

new text begin A license holder must have policies and procedures to ensure
that each staff person complies with the client rights and protections requirements in section
245I.12.
new text end

new text begin Subd. 4. new text end

new text begin Behavioral emergencies. new text end

new text begin (a) A license holder must have procedures that each
staff person follows when responding to a client who exhibits behavior that threatens the
immediate safety of the client or others. A license holder's behavioral emergency procedures
must incorporate person-centered planning and trauma-informed care.
new text end

new text begin (b) A license holder's behavioral emergency procedures must include:
new text end

new text begin (1) a plan designed to prevent the client from inflicting self-harm and harming others;
new text end

new text begin (2) contact information for emergency resources that a staff person must use when the
license holder's behavioral emergency procedures are unsuccessful in controlling a client's
behavior;
new text end

new text begin (3) the types of behavioral emergency procedures that a staff person may use;
new text end

new text begin (4) the specific circumstances under which the program may use behavioral emergency
procedures; and
new text end

new text begin (5) the staff persons whom the license holder authorizes to implement behavioral
emergency procedures.
new text end

new text begin (c) The license holder's behavioral emergency procedures must not include secluding
or restraining a client except as allowed under section 245.8261.
new text end

new text begin (d) Staff persons must not use behavioral emergency procedures to enforce program
rules or for the convenience of staff persons. Behavioral emergency procedures must not
be part of any client's treatment plan. A staff person may not use behavioral emergency
procedures except in response to a client's current behavior that threatens the immediate
safety of the client or others.
new text end

new text begin Subd. 5. new text end

new text begin Health services and medications. new text end

new text begin If a license holder is licensed as a residential
program, stores or administers client medications, or observes clients self-administer
medications, the license holder must ensure that a staff person who is a registered nurse or
licensed prescriber reviews and approves of the license holder's policies and procedures to
comply with the health services and medications requirements in section 245I.11, the training
requirements in section 245I.05, subdivision 6, and the documentation requirements in
section 245I.08, subdivision 5.
new text end

new text begin Subd. 6. new text end

new text begin Reporting maltreatment. new text end

new text begin A license holder must have policies and procedures
for reporting a staff person's suspected maltreatment, abuse, or neglect of a client according
to chapter 260E and section 626.557.
new text end

new text begin Subd. 7. new text end

new text begin Critical incidents. new text end

new text begin If a license holder is licensed as a residential program, the
license holder must have policies and procedures for reporting and maintaining records of
critical incidents according to section 245I.13.
new text end

new text begin Subd. 8. new text end

new text begin Personnel. new text end

new text begin A license holder must have personnel policies and procedures that:
new text end

new text begin (1) include a chart or description of the organizational structure of the program that
indicates positions and lines of authority;
new text end

new text begin (2) ensure that it will not adversely affect a staff person's retention, promotion, job
assignment, or pay when a staff person communicates in good faith with the Department
of Human Services, the Office of Ombudsman for Mental Health and Developmental
Disabilities, the Department of Health, a health-related licensing board, a law enforcement
agency, or a local agency investigating a complaint regarding a client's rights, health, or
safety;
new text end

new text begin (3) prohibit a staff person from having sexual contact with a client in violation of chapter
604, sections 609.344 or 609.345;
new text end

new text begin (4) prohibit a staff person from neglecting, abusing, or maltreating a client as described
in chapter 260E and sections 626.557 and 626.5572;
new text end

new text begin (5) include the drug and alcohol policy described in section 245A.04, subdivision 1,
paragraph (c);
new text end

new text begin (6) describe the process for disciplinary action, suspension, or dismissal of a staff person
for violating a policy provision described in clauses (3) to (5);
new text end

new text begin (7) describe the license holder's response to a staff person who violates other program
policies or who has a behavioral problem that interferes with providing treatment services
to clients; and
new text end

new text begin (8) describe each staff person's position that includes the staff person's responsibilities,
authority to execute the responsibilities, and qualifications for the position.
new text end

new text begin Subd. 9. new text end

new text begin Volunteers. new text end

new text begin A license holder must have policies and procedures for using
volunteers, including when a license holder must submit a background study for a volunteer,
and the specific tasks that a volunteer may perform.
new text end

new text begin Subd. 10. new text end

new text begin Data privacy. new text end

new text begin (a) A license holder must have policies and procedures that
comply with all applicable state and federal law. A license holder's use of electronic record
keeping or electronic signatures does not alter a license holder's obligations to comply with
applicable state and federal law.
new text end

new text begin (b) A license holder must have policies and procedures for a staff person to promptly
document a client's revocation of consent to disclose the client's health record. The license
holder must verify that the license holder has permission to disclose a client's health record
before releasing any client data.
new text end

Sec. 5.

new text begin [245I.04] PROVIDER QUALIFICATIONS AND SCOPE OF PRACTICE.
new text end

new text begin Subdivision 1. new text end

new text begin Tribal providers. new text end

new text begin For purposes of this section, a tribal entity may
credential an individual according to section 256B.02, subdivision 7, paragraphs (b) and
(c).
new text end

new text begin Subd. 2. new text end

new text begin Mental health professional qualifications. new text end

new text begin The following individuals may
provide services to a client as a mental health professional:
new text end

new text begin (1) a registered nurse who is licensed under sections 148.171 to 148.285 and is certified
as a: (i) clinical nurse specialist in child or adolescent, family, or adult psychiatric and
mental health nursing by a national certification organization; or (ii) nurse practitioner in
adult or family psychiatric and mental health nursing by a national nurse certification
organization;
new text end

new text begin (2) a licensed independent clinical social worker as defined in section 148E.050,
subdivision 5;
new text end

new text begin (3) a psychologist licensed by the Board of Psychology under sections 148.88 to 148.98;
new text end

new text begin (4) a physician licensed under chapter 147 if the physician is: (i) certified by the American
Board of Psychiatry and Neurology; (ii) certified by the American Osteopathic Board of
Neurology and Psychiatry; or (iii) eligible for board certification in psychiatry;
new text end

new text begin (5) a marriage and family therapist licensed under sections 148B.29 to 148B.392; or
new text end

new text begin (6) a licensed professional clinical counselor licensed under section 148B.5301.
new text end

new text begin Subd. 3. new text end

new text begin Mental health professional scope of practice. new text end

new text begin A mental health professional
must maintain a valid license with the mental health professional's governing health-related
licensing board and must only provide services to a client within the scope of practice
determined by the applicable health-related licensing board.
new text end

new text begin Subd. 4. new text end

new text begin Mental health practitioner qualifications. new text end

new text begin (a) An individual who is qualified
in at least one of the ways described in paragraph (b) to (d) may serve as a mental health
practitioner.
new text end

new text begin (b) An individual is qualified as a mental health practitioner through relevant coursework
if the individual completes at least 30 semester hours or 45 quarter hours in behavioral
sciences or related fields and:
new text end

new text begin (1) has at least 2,000 hours of experience providing services to individuals with:
new text end

new text begin (i) a mental illness or a substance use disorder; or
new text end

new text begin (ii) a traumatic brain injury or a developmental disability, and completes the additional
training described in section 245I.05, subdivision 3, paragraph (c), before providing direct
contact services to a client;
new text end

new text begin (2) is fluent in the non-English language of the ethnic group to which at least 50 percent
of the individual's clients belong, and completes the additional training described in section
245I.05, subdivision 3, paragraph (c), before providing direct contact services to a client;
new text end

new text begin (3) is working in a day treatment program under section 256B.0671, subdivision 3, or
256B.0943; or
new text end

new text begin (4) has completed a practicum or internship that (i) required direct interaction with adult
clients or child clients, and (ii) was focused on behavioral sciences or related fields.
new text end

new text begin (c) An individual is qualified as a mental health practitioner through work experience
if the individual:
new text end

new text begin (1) has at least 4,000 hours of experience in the delivery of services to individuals with:
new text end

new text begin (i) a mental illness or a substance use disorder; or
new text end

new text begin (ii) a traumatic brain injury or a developmental disability, and completes the additional
training described in section 245I.05, subdivision 3, paragraph (c), before providing direct
contact services to clients; or
new text end

new text begin (2) receives treatment supervision at least once per week until meeting the requirement
in clause (1) of 4,000 hours of experience and has at least 2,000 hours of experience providing
services to individuals with:
new text end

new text begin (i) a mental illness or a substance use disorder; or
new text end

new text begin (ii) a traumatic brain injury or a developmental disability, and completes the additional
training described in section 245I.05, subdivision 3, paragraph (c), before providing direct
contact services to clients.
new text end

new text begin (d) An individual is qualified as a mental health practitioner if the individual has a
master's or other graduate degree in behavioral sciences or related fields.
new text end

new text begin Subd. 5. new text end

new text begin Mental health practitioner scope of practice. new text end

new text begin (a) A mental health practitioner
under the treatment supervision of a mental health professional or certified rehabilitation
specialist may provide an adult client with client education, rehabilitative mental health
services, functional assessments, level of care assessments, and treatment plans. A mental
health practitioner under the treatment supervision of a mental health professional may
provide skill-building services to a child client and complete treatment plans for a child
client.
new text end

new text begin (b) A mental health practitioner must not provide treatment supervision to other staff
persons. A mental health practitioner may provide direction to mental health rehabilitation
workers and mental health behavioral aides.
new text end

new text begin (c) A mental health practitioner who provides services to clients according to section
256B.0624 or 256B.0944 may perform crisis assessments and interventions for a client.
new text end

new text begin Subd. 6. new text end

new text begin Clinical trainee qualifications. new text end

new text begin (a) A clinical trainee is a staff person who: (1)
is enrolled in an accredited graduate program of study to prepare the staff person for
independent licensure as a mental health professional and who is participating in a practicum
or internship with the license holder through the individual's graduate program; or (2) has
completed an accredited graduate program of study to prepare the staff person for independent
licensure as a mental health professional and who is in compliance with the requirements
of the applicable health-related licensing board, including requirements for supervised
practice.
new text end

new text begin (b) A clinical trainee is responsible for notifying and applying to a health-related licensing
board to ensure that the trainee meets the requirements of the health-related licensing board.
As permitted by a health-related licensing board, treatment supervision under this chapter
may be integrated into a plan to meet the supervisory requirements of the health-related
licensing board but does not supersede those requirements.
new text end

new text begin Subd. 7. new text end

new text begin Clinical trainee scope of practice. new text end

new text begin (a) A clinical trainee under the treatment
supervision of a mental health professional may provide a client with psychotherapy, client
education, rehabilitative mental health services, diagnostic assessments, functional
assessments, level of care assessments, and treatment plans.
new text end

new text begin (b) A clinical trainee must not provide treatment supervision to other staff persons. A
clinical trainee may provide direction to mental health behavioral aides and mental health
rehabilitation workers.
new text end

new text begin (c) A psychological clinical trainee under the treatment supervision of a psychologist
may perform psychological testing of clients.
new text end

new text begin (d) A clinical trainee must not provide services to clients that violate any practice act of
a health-related licensing board, including failure to obtain licensure if licensure is required.
new text end

new text begin Subd. 8. new text end

new text begin Certified rehabilitation specialist qualifications. new text end

new text begin A certified rehabilitation
specialist must have:
new text end

new text begin (1) a master's degree from an accredited college or university in behavioral sciences or
related fields;
new text end

new text begin (2) at least 4,000 hours of post-master's supervised experience providing mental health
services to clients; and
new text end

new text begin (3) a valid national certification as a certified rehabilitation counselor or certified
psychosocial rehabilitation practitioner.
new text end

new text begin Subd. 9. new text end

new text begin Certified rehabilitation specialist scope of practice. new text end

new text begin (a) A certified
rehabilitation specialist may provide an adult client with client education, rehabilitative
mental health services, functional assessments, level of care assessments, and treatment
plans.
new text end

new text begin (b) A certified rehabilitation specialist may provide treatment supervision to a mental
health certified peer specialist, mental health practitioner, and mental health rehabilitation
worker.
new text end

new text begin Subd. 10. new text end

new text begin Mental health certified peer specialist qualifications. new text end

new text begin A mental health
certified peer specialist must:
new text end

new text begin (1) have been diagnosed with a mental illness;
new text end

new text begin (2) be a current or former mental health services client; and
new text end

new text begin (3) have a valid certification as a mental health certified peer specialist under section
256B.0615.
new text end

new text begin Subd. 11. new text end

new text begin Mental health certified peer specialist scope of practice. new text end

new text begin A mental health
certified peer specialist under the treatment supervision of a mental health professional or
certified rehabilitation specialist must:
new text end

new text begin (1) provide individualized peer support to each client;
new text end

new text begin (2) promote a client's recovery goals, self-sufficiency, self-advocacy, and development
of natural supports; and
new text end

new text begin (3) support a client's maintenance of skills that the client has learned from other services.
new text end

new text begin Subd. 12. new text end

new text begin Mental health certified family peer specialist qualifications. new text end

new text begin A mental
health certified family peer specialist must:
new text end

new text begin (1) have raised or be currently raising a child with a mental illness;
new text end

new text begin (2) have experience navigating the children's mental health system; and
new text end

new text begin (3) have a valid certification as a mental health certified family peer specialist under
section 256B.0616.
new text end

new text begin Subd. 13. new text end

new text begin Mental health certified family peer specialist scope of practice. new text end

new text begin A mental
health certified family peer specialist under the treatment supervision of a mental health
professional must provide services to increase the child's ability to function in the child's
home, school, and community. The mental health certified family peer specialist must:
new text end

new text begin (1) provide family peer support to build on a client's family's strengths and help the
family achieve desired outcomes;
new text end

new text begin (2) provide nonadversarial advocacy to a child client and the child's family that
encourages partnership and promotes the child's positive change and growth;
new text end

new text begin (3) support families in advocating for culturally appropriate services for a child in each
treatment setting;
new text end

new text begin (4) promote resiliency, self-advocacy, and development of natural supports;
new text end

new text begin (5) support maintenance of skills learned from other services;
new text end

new text begin (6) establish and lead parent support groups;
new text end

new text begin (7) assist parents in developing coping and problem-solving skills; and
new text end

new text begin (8) educate parents about mental illnesses and community resources, including resources
that connect parents with similar experiences to one another.
new text end

new text begin Subd. 14. new text end

new text begin Mental health rehabilitation worker qualifications. new text end

new text begin (a) A mental health
rehabilitation worker must:
new text end

new text begin (1) have a high school diploma or equivalent; and
new text end

new text begin (2) meet one of the following qualification requirements:
new text end

new text begin (i) be fluent in the non-English language or competent in the culture of the ethnic group
to which at least 20 percent of the mental health rehabilitation worker's clients belong;
new text end

new text begin (ii) have an associate of arts degree;
new text end

new text begin (iii) have two years of full-time postsecondary education or a total of 15 semester hours
or 23 quarter hours in behavioral sciences or related fields;
new text end

new text begin (iv) be a registered nurse;
new text end

new text begin (v) have, within the previous ten years, three years of personal life experience with
mental illness;
new text end

new text begin (vi) have, within the previous ten years, three years of life experience as a primary
caregiver to an adult with a mental illness, traumatic brain injury, substance use disorder,
or developmental disability; or
new text end

new text begin (vii) have, within the previous ten years, 2,000 hours of work experience providing
health and human services to individuals.
new text end

new text begin (b) A mental health rehabilitation worker who is scheduled as an overnight staff person
and works alone is exempt from the additional qualification requirements in paragraph (a),
clause (2).
new text end

new text begin Subd. 15. new text end

new text begin Mental health rehabilitation worker scope of practice. new text end

new text begin A mental health
rehabilitation worker under the treatment supervision of a mental health professional or
certified rehabilitation specialist may provide rehabilitative mental health services to an
adult client according to the client's treatment plan.
new text end

new text begin Subd. 16. new text end

new text begin Mental health behavioral aide qualifications. new text end

new text begin (a) A level 1 mental health
behavioral aide must have: (1) a high school diploma or equivalent; or (2) two years of
experience as a primary caregiver to a child with mental illness within the previous ten
years.
new text end

new text begin (b) A level 2 mental health behavioral aide must: (1) have an associate or bachelor's
degree; or (2) be certified by a program under section 256B.0943, subdivision 8a.
new text end

new text begin Subd. 17. new text end

new text begin Mental health behavioral aide scope of practice. new text end

new text begin While under the treatment
supervision of a mental health professional, a mental health behavioral aide may practice
psychosocial skills with a child client according to the child's treatment plan and individual
behavior plan that a mental health professional, clinical trainee, or mental health practitioner
has previously taught to the child.
new text end

Sec. 6.

new text begin [245I.05] TRAINING REQUIRED.
new text end

new text begin Subdivision 1. new text end

new text begin Training plan. new text end

new text begin A license holder must develop a training plan to ensure
that staff persons receive ongoing training according to this section. The training plan must
include:
new text end

new text begin (1) a formal process to evaluate the training needs of each staff person. An annual
performance evaluation of a staff person satisfies this requirement;
new text end

new text begin (2) a description of how the license holder conducts ongoing training of each staff person,
including whether ongoing training is based on a staff person's hire date or a specified annual
cycle determined by the program;
new text end

new text begin (3) a description of how the license holder verifies and documents each staff person's
previous training experience. A license holder may consider a staff person to have met a
training requirement in subdivision 3, paragraph (d) or (e), if the staff person has received
equivalent postsecondary education in the previous four years or training experience in the
previous two years; and
new text end

new text begin (4) a description of how the license holder determines when a staff person needs
additional training, including when the license holder will provide additional training.
new text end

new text begin Subd. 2. new text end

new text begin Documentation of training. new text end

new text begin (a) The license holder must provide training to
each staff person according to the training plan and must document that the license holder
provided the training to each staff person. The license holder must document the following
information for each staff person's training:
new text end

new text begin (1) the topics of the training;
new text end

new text begin (2) the name of the trainee;
new text end

new text begin (3) the name and credentials of the trainer;
new text end

new text begin (4) the license holder's method of evaluating the trainee's competency upon completion
of training;
new text end

new text begin (5) the date of the training; and
new text end

new text begin (6) the length of training in hours and minutes.
new text end

new text begin (b) Documentation of a staff person's continuing education credit accepted by the
governing health-related licensing board is sufficient to document training for purposes of
this subdivision.
new text end

new text begin Subd. 3. new text end

new text begin Initial training. new text end

new text begin (a) A staff person must receive training about:
new text end

new text begin (1) vulnerable adult maltreatment under section 245A.65, subdivision 3; and
new text end

new text begin (2) the maltreatment of minor reporting requirements and definitions in chapter 260E
within 72 hours of first providing direct contact services to a client.
new text end

new text begin (b) Before providing direct contact services to a client, a staff person must receive training
about:
new text end

new text begin (1) client rights and protections under section 245I.12;
new text end

new text begin (2) the Minnesota Health Records Act, including client confidentiality, family engagement
under section 144.294, and client privacy;
new text end

new text begin (3) emergency procedures that the staff person must follow when responding to a fire,
inclement weather, a report of a missing person, and a behavioral or medical emergency;
new text end

new text begin (4) specific activities and job functions for which the staff person is responsible, including
the license holder's program policies and procedures applicable to the staff person's position;
new text end

new text begin (5) professional boundaries that the staff person must maintain; and
new text end

new text begin (6) specific needs of each client to whom the staff person will be providing direct contact
services, including each client's developmental status, cognitive functioning, physical and
mental abilities.
new text end

new text begin (c) Before providing direct contact services to a client, a mental health rehabilitation
worker, mental health behavioral aide, or mental health practitioner qualified under section
245I.04, subdivision 4, must receive 30 hours of training about:
new text end

new text begin (1) mental illnesses;
new text end

new text begin (2) client recovery and resiliency;
new text end

new text begin (3) mental health de-escalation techniques;
new text end

new text begin (4) co-occurring mental illness and substance use disorders; and
new text end

new text begin (5) psychotropic medications and medication side effects.
new text end

new text begin (d) Within 90 days of first providing direct contact services to an adult client, a clinical
trainee, mental health practitioner, mental health certified peer specialist, or mental health
rehabilitation worker must receive training about:
new text end

new text begin (1) trauma-informed care and secondary trauma;
new text end

new text begin (2) person-centered individual treatment plans, including seeking partnerships with
family and other natural supports;
new text end

new text begin (3) co-occurring substance use disorders; and
new text end

new text begin (4) culturally responsive treatment practices.
new text end

new text begin (e) Within 90 days of first providing direct contact services to a child client, a clinical
trainee, mental health practitioner, mental health certified family peer specialist, mental
health certified peer specialist, or mental health behavioral aide must receive training about
the topics in clauses (1) to (5). This training must address the developmental characteristics
of each child served by the license holder and address the needs of each child in the context
of the child's family, support system, and culture. Training topics must include:
new text end

new text begin (1) trauma-informed care and secondary trauma, including adverse childhood experiences
(ACEs);
new text end

new text begin (2) family-centered treatment plan development, including seeking partnership with a
child client's family and other natural supports;
new text end

new text begin (3) mental illness and co-occurring substance use disorders in family systems;
new text end

new text begin (4) culturally responsive treatment practices; and
new text end

new text begin (5) child development, including cognitive functioning, and physical and mental abilities.
new text end

new text begin (f) For a mental health behavioral aide, the training under paragraph (e) must include
parent team training using a curriculum approved by the commissioner.
new text end

new text begin Subd. 4. new text end

new text begin Ongoing training. new text end

new text begin (a) A license holder must ensure that staff persons who
provide direct contact services to clients receive annual training about the topics in
subdivision 3, paragraphs (a) and (b), clauses (1) to (3).
new text end

new text begin (b) A license holder must ensure that each staff person who is qualified under section
245I.04 who is not a mental health professional receives 30 hours of training every two
years. The training topics must be based on the program's needs and the staff person's areas
of competency.
new text end

new text begin Subd. 5. new text end

new text begin Additional training for medication administration. new text end

new text begin (a) Prior to administering
medications to a client under delegated authority or observing a client self-administer
medications, a staff person who is not a licensed prescriber, registered nurse, or licensed
practical nurse qualified under section 148.171, subdivision 8, must receive training about
psychotropic medications, side effects, and medication management.
new text end

new text begin (b) Prior to administering medications to a client under delegated authority, a staff person
must successfully complete a:
new text end

new text begin (1) medication administration training program for unlicensed personnel through an
accredited Minnesota postsecondary educational institution with completion of the course
documented in writing and placed in the staff person's personnel file; or
new text end

new text begin (2) formalized training program taught by a registered nurse or licensed prescriber that
is offered by the license holder. A staff person's successful completion of the formalized
training program must include direct observation of the staff person to determine the staff
person's areas of competency.
new text end

Sec. 7.

new text begin [245I.06] TREATMENT SUPERVISION.
new text end

new text begin Subdivision 1. new text end

new text begin Generally. new text end

new text begin (a) A license holder must ensure that a mental health
professional or certified rehabilitation specialist provides treatment supervision to each staff
person who provides services to a client and who is not a mental health professional or
certified rehabilitation specialist. When providing treatment supervision, a treatment
supervisor must follow a staff person's written treatment supervision plan.
new text end

new text begin (b) Treatment supervision must focus on each client's treatment needs and the ability of
the staff person under treatment supervision to provide services to each client, including
the following topics related to the staff person's current caseload:
new text end

new text begin (1) a review and evaluation of the interventions that the staff person delivers to each
client;
new text end

new text begin (2) instruction on alternative strategies if a client is not achieving treatment goals;
new text end

new text begin (3) a review and evaluation of each client's assessments, treatment plans, and progress
notes for accuracy and appropriateness;
new text end

new text begin (4) instruction on the cultural norms or values of the clients and communities that the
license holder serves and the impact that a client's culture has on providing treatment;
new text end

new text begin (5) evaluation of and feedback regarding a direct service staff person's areas of
competency; and
new text end

new text begin (6) coaching, teaching, and practicing skills with a staff person.
new text end

new text begin (c) A treatment supervisor must provide treatment supervision to a staff person using
methods that allow for immediate feedback, including in-person, telephone, and interactive
video supervision.
new text end

new text begin (d) A treatment supervisor's responsibility for a staff person receiving treatment
supervision is limited to the services provided by the associated license holder. If a staff
person receiving treatment supervision is employed by multiple license holders, each license
holder is responsible for providing treatment supervision related to the treatment of the
license holder's clients.
new text end

new text begin Subd. 2. new text end

new text begin Treatment supervision planning. new text end

new text begin (a) A treatment supervisor and the staff
person supervised by the treatment supervisor must develop a written treatment supervision
plan. The license holder must ensure that a new staff person's treatment supervision plan is
completed and implemented by a treatment supervisor and the new staff person within 30
days of the new staff person's first day of employment. The license holder must review and
update each staff person's treatment supervision plan annually.
new text end

new text begin (b) Each staff person's treatment supervision plan must include:
new text end

new text begin (1) the name and qualifications of the staff person receiving treatment supervision;
new text end

new text begin (2) the names and licensures of the treatment supervisors who are supervising the staff
person;
new text end

new text begin (3) how frequently the treatment supervisors must provide treatment supervision to the
staff person; and
new text end

new text begin (4) the staff person's authorized scope of practice, including a description of the client
population that the staff person serves, and a description of the treatment methods and
modalities that the staff person may use to provide services to clients.
new text end

new text begin Subd. 3. new text end

new text begin Treatment supervision and direct observation of mental health
rehabilitation workers and mental health behavioral aides.
new text end

new text begin (a) A mental health behavioral
aide or a mental health rehabilitation worker must receive direct observation from a mental
health professional, clinical trainee, certified rehabilitation specialist, or mental health
practitioner while the mental health behavioral aide or mental health rehabilitation worker
provides treatment services to clients, no less than twice per month for the first six months
of employment and once per month thereafter. The staff person performing the direct
observation must approve of the progress note for the observed treatment service.
new text end

new text begin (b) For a mental health rehabilitation worker qualified under section 245I.04, subdivision
14, paragraph (a), clause (2), item (i), treatment supervision in the first 2,000 hours of work
must at a minimum consist of:
new text end

new text begin (1) monthly individual supervision; and
new text end

new text begin (2) direct observation twice per month.
new text end

Sec. 8.

new text begin [245I.07] PERSONNEL FILES.
new text end

new text begin (a) For each staff person, a license holder must maintain a personnel file that includes:
new text end

new text begin (1) verification of the staff person's qualifications required for the position including
training, education, practicum or internship agreement, licensure, and any other required
qualifications;
new text end

new text begin (2) documentation related to the staff person's background study;
new text end

new text begin (3) the hiring date of the staff person;
new text end

new text begin (4) a description of the staff person's job responsibilities with the license holder;
new text end

new text begin (5) the date that the staff person's specific duties and responsibilities became effective,
including the date that the staff person began having direct contact with clients;
new text end

new text begin (6) documentation of the staff person's training as required by section 245I.05, subdivision
2;
new text end

new text begin (7) a verification copy of license renewals that the staff person completed during the
staff person's employment;
new text end

new text begin (8) annual job performance evaluations; and
new text end

new text begin (9) if applicable, the staff person's alleged and substantiated violations of the license
holder's policies under section 245I.03, subdivision 8, clauses (3) to (7), and the license
holder's response.
new text end

new text begin (b) The license holder must ensure that all personnel files are readily accessible for the
commissioner's review. The license holder is not required to keep personnel files in a single
location.
new text end

Sec. 9.

new text begin [245I.08] DOCUMENTATION STANDARDS.
new text end

new text begin Subdivision 1. new text end

new text begin Generally. new text end

new text begin A license holder must ensure that all documentation required
by this chapter complies with this section.
new text end

new text begin Subd. 2. new text end

new text begin Documentation standards. new text end

new text begin A license holder must ensure that all documentation
required by this chapter:
new text end

new text begin (1) is legible;
new text end

new text begin (2) identifies the applicable client and staff person on each page; and
new text end

new text begin (3) is signed and dated by the staff persons who provided services to the client or
completed the documentation, including the staff persons' credentials.
new text end

new text begin Subd. 3. new text end

new text begin Documenting approval. new text end

new text begin A license holder must ensure that all diagnostic
assessments, functional assessments, level of care assessments, and treatment plans completed
by a clinical trainee or mental health practitioner contain documentation of approval by a
treatment supervisor within five business days of initial completion by the staff person under
treatment supervision.
new text end

new text begin Subd. 4. new text end

new text begin Progress notes. new text end

new text begin A license holder must use a progress note to document each
occurrence of a mental health service that a staff person provides to a client. A progress
note must include the following:
new text end

new text begin (1) the type of service;
new text end

new text begin (2) the date of service;
new text end

new text begin (3) the start and stop time of the service unless the license holder is licensed as a
residential program;
new text end

new text begin (4) the location of the service;
new text end

new text begin (5) the scope of the service, including: (i) the targeted goal and objective; (ii) the
intervention that the staff person provided to the client and the methods that the staff person
used; (iii) the client's response to the intervention; (iv) the staff person's plan to take future
actions, including changes in treatment that the staff person will implement if the intervention
was ineffective; and (v) the service modality;
new text end

new text begin (6) the signature, printed name, and credentials of the staff person who provided the
service to the client;
new text end

new text begin (7) the mental health provider travel documentation required by section 256B.0625, if
applicable; and
new text end

new text begin (8) significant observations by the staff person, if applicable, including: (i) the client's
current risk factors; (ii) emergency interventions by staff persons; (iii) consultations with
or referrals to other professionals, family, or significant others; and (iv) changes in the
client's mental or physical symptoms.
new text end

new text begin Subd. 5. new text end

new text begin Medication administration record. new text end

new text begin If a license holder administers or observes
a client self-administer medications, the license holder must maintain a medication
administration record for each client that contains the following, as applicable:
new text end

new text begin (1) the client's date of birth;
new text end

new text begin (2) the client's allergies;
new text end

new text begin (3) all medication orders for the client, including client-specific orders for
over-the-counter medications and approved condition-specific protocols;
new text end

new text begin (4) the name of each ordered medication, date of each medication's expiration, each
medication's dosage frequency, method of administration, and time;
new text end

new text begin (5) the licensed prescriber's name and telephone number;
new text end

new text begin (6) the date of initiation;
new text end

new text begin (7) the signature, printed name, and credentials of the staff person who administered the
medication or observed the client self-administer the medication; and
new text end

new text begin (8) the reason that the license holder did not administer the client's prescribed medication
or observe the client self-administer the client's prescribed medication.
new text end

Sec. 10.

new text begin [245I.09] CLIENT FILES.
new text end

new text begin Subdivision 1. new text end

new text begin Generally. new text end

new text begin (a) A license holder must maintain a file for each client that
contains the client's current and accurate records. The license holder must store each client
file on the premises where the license holder provides or coordinates services for the client.
The license holder must ensure that all client files are readily accessible for the
commissioner's review. The license holder is not required to keep client files in a single
location.
new text end

new text begin (b) The license holder must protect client records against loss, tampering, or unauthorized
disclosure of confidential client data according to the Minnesota Government Data Practices
Act, chapter 13; the privacy provisions of the Minnesota health care programs provider
agreement; the Health Insurance Portability and Accountability Act of 1996 (HIPAA),
Public Law 104-191; and the Minnesota Health Records Act, sections 144.291 to 144.298.
new text end

new text begin Subd. 2. new text end

new text begin Record retention. new text end

new text begin A license holder must retain client records of a discharged
client for a minimum of five years from the date of the client's discharge. A license holder
who ceases to provide treatment services to a client must retain the client's records for a
minimum of five years from the date that the license holder stopped providing services to
the client and must notify the commissioner of the location of the client records and the
name of the individual responsible for storing and maintaining the client records.
new text end

new text begin Subd. 3. new text end

new text begin Contents. new text end

new text begin A license holder must retain a clear and complete record of the
information that the license holder receives regarding a client, and of the services that the
license holder provides to the client. If applicable, each client's file must include the following
information:
new text end

new text begin (1) the client's screenings, assessments, and testing;
new text end

new text begin (2) the client's treatment plans and reviews of the client's treatment plan;
new text end

new text begin (3) the client's individual abuse prevention plans;
new text end

new text begin (4) the client's health care directive under section 145C.01, subdivision 5a, and the
client's emergency contacts;
new text end

new text begin (5) the client's crisis plans;
new text end

new text begin (6) the client's consents for releases of information and documentation of the client's
releases of information;
new text end

new text begin (7) the client's significant medical and health-related information;
new text end

new text begin (8) a record of each communication that a staff person has with the client's other mental
health providers and persons interested in the client, including the client's case manager,
family members, primary caregiver, legal representatives, court representatives,
representatives from the correctional system, or school administration;
new text end

new text begin (9) written information by the client that the client requests to include in the client's file;
and
new text end

new text begin (10) the date of the client's discharge from the license holder's program, the reason that
the license holder discontinued services for the client, and the client's discharge summaries.
new text end

Sec. 11.

new text begin [245I.10] ASSESSMENT AND TREATMENT PLANNING.
new text end

new text begin Subdivision 1. new text end

new text begin Definitions. new text end

new text begin (a) "Diagnostic formulation" means a written analysis and
explanation of a client's clinical assessment to develop a hypothesis about the cause and
nature of a client's presenting problems and to identify the most suitable approach for treating
the client.
new text end

new text begin (b) "Responsivity factors" means the factors other than the diagnostic formulation that
may modify a client's treatment needs. This includes a client's learning style, abilities,
cognitive functioning, cultural background, and personal circumstances. When documenting
a client's responsivity factors a mental health professional or clinical trainee must include
an analysis of how a client's strengths are reflected in the license holder's plan to deliver
services to the client.
new text end

new text begin Subd. 2. new text end

new text begin Generally. new text end

new text begin (a) A license holder must use a client's diagnostic assessment or
crisis assessment to determine a client's eligibility for mental health services, except as
provided in this section.
new text end

new text begin (b) Prior to completing a client's initial diagnostic assessment, a license holder may
provide a client with the following services:
new text end

new text begin (1) an explanation of findings;
new text end

new text begin (2) neuropsychological testing, neuropsychological assessment, and psychological
testing;
new text end

new text begin (3) any combination of psychotherapy sessions, family psychotherapy sessions, and
family psychoeducation sessions not to exceed three sessions;
new text end

new text begin (4) crisis assessment services according to section 256B.0624; and
new text end

new text begin (5) ten days of intensive residential treatment services according to the assessment and
treatment planning standards in section 245.23, subdivision 7.
new text end

new text begin (c) Based on the client's needs that a crisis assessment identifies under section 256B.0624,
a license holder may provide a client with the following services:
new text end

new text begin (1) crisis intervention and stabilization services under section 245I.23 or 256B.0624;
and
new text end

new text begin (2) any combination of psychotherapy sessions, group psychotherapy sessions, family
psychotherapy sessions, and family psychoeducation sessions not to exceed ten sessions
within a 12-month period without prior authorization.
new text end

new text begin (d) Based on the client's needs in the client's brief diagnostic assessment, a license holder
may provide a client with any combination of psychotherapy sessions, group psychotherapy
sessions, family psychotherapy sessions, and family psychoeducation sessions not to exceed
ten sessions within a 12-month period without prior authorization for any new client or for
an existing client who the license holder projects will need fewer than ten sessions during
the next 12 months.
new text end

new text begin (e) Based on the client's needs that a hospital's medical history and presentation
examination identifies, a license holder may provide a client with:
new text end

new text begin (1) any combination of psychotherapy sessions, group psychotherapy sessions, family
psychotherapy sessions, and family psychoeducation sessions not to exceed ten sessions
within a 12-month period without prior authorization for any new client or for an existing
client who the license holder projects will need fewer than ten sessions during the next 12
months; and
new text end

new text begin (2) up to five days of day treatment services or partial hospitalization.
new text end

new text begin (f) A license holder must complete a new standard diagnostic assessment of a client:
new text end

new text begin (1) when the client requires services of a greater number or intensity than the services
that paragraphs (b) to (e) describe;
new text end

new text begin (2) at least annually following the client's initial diagnostic assessment if the client needs
additional mental health services and the client does not meet the criteria for a brief
assessment;
new text end

new text begin (3) when the client's mental health condition has changed markedly since the client's
most recent diagnostic assessment; or
new text end

new text begin (4) when the client's current mental health condition does not meet the criteria of the
client's current diagnosis.
new text end

new text begin (g) For an existing client, the license holder must ensure that a new standard diagnostic
assessment includes a written update containing all significant new or changed information
about the client, and an update regarding what information has not significantly changed,
including a discussion with the client about changes in the client's life situation, functioning,
presenting problems, and progress with achieving treatment goals since the client's last
diagnostic assessment was completed.
new text end

new text begin Subd. 3. new text end

new text begin Continuity of services. new text end

new text begin (a) For any client with a diagnostic assessment
completed under Minnesota Rules, parts 9505.0370 to 9505.0372, before the effective date
of this section, the diagnostic assessment is valid for authorizing the client's treatment and
billing for one calendar year after the date that the assessment was completed.
new text end

new text begin (b) For any client with an individual treatment plan completed under section 256B.0622,
256B.0623, 256B.0943, 256B.0946, or 256B.0947 or Minnesota Rules, parts 9505.0370 to
9505.0372, the client's treatment plan is valid for authorizing treatment and billing until the
treatment plan's expiration date.
new text end

new text begin (c) This subdivision expires July 1, 2023.
new text end

new text begin Subd. 4. new text end

new text begin Diagnostic assessment. new text end

new text begin A client's diagnostic assessment must: (1) identify at
least one mental health diagnosis for which the client meets the diagnostic criteria and
recommend mental health services to develop the client's mental health services and treatment
plan; or (2) include a finding that the client does not meet the criteria for a mental health
disorder.
new text end

new text begin Subd. 5. new text end

new text begin Brief diagnostic assessment; required elements. new text end

new text begin (a) Only a mental health
professional or clinical trainee may complete a brief diagnostic assessment of a client. A
license holder may only use a brief diagnostic assessment for a client who is six years of
age or older.
new text end

new text begin (b) When conducting a brief diagnostic assessment of a client, the assessor must complete
a face-to-face interview with the client and a written evaluation of the client. The assessor
must gather and document initial components of the client's standard diagnostic assessment,
including the client's:
new text end

new text begin (1) age;
new text end

new text begin (2) description of symptoms, including the reason for the client's referral;
new text end

new text begin (3) history of mental health treatment;
new text end

new text begin (4) cultural influences on the client; and
new text end

new text begin (5) mental status examination.
new text end

new text begin (c) Based on the initial components of the assessment, the assessor must develop a
provisional diagnostic formulation about the client. The assessor may use the client's
provisional diagnostic formulation to address the client's immediate needs and presenting
problems.
new text end

new text begin (d) A mental health professional or clinical trainee may use treatment sessions with the
client authorized by a brief diagnostic assessment to gather additional information about
the client to complete the client's standard diagnostic assessment if the number of sessions
will exceed the coverage limits in subdivision 2.
new text end

new text begin Subd. 6. new text end

new text begin Standard diagnostic assessment; required elements. new text end

new text begin (a) Only a mental health
professional or a clinical trainee may complete a standard diagnostic assessment of a client.
A standard diagnostic assessment of a client must include a face-to-face interview with a
client and a written evaluation of the client. The assessor must complete a client's standard
diagnostic assessment within the client's cultural context.
new text end

new text begin (b) When completing a standard diagnostic assessment of a client, the assessor must
gather and document information about the client's current life situation, including the
following information:
new text end

new text begin (1) the client's age;
new text end

new text begin (2) the client's current living situation, including the client's housing status and household
members;
new text end

new text begin (3) the status of the client's basic needs;
new text end

new text begin (4) the client's education level and employment status;
new text end

new text begin (5) the client's current medications;
new text end

new text begin (6) any immediate risks to the client's health and safety;
new text end

new text begin (7) the client's perceptions of the client's condition;
new text end

new text begin (8) the client's description of the client's symptoms, including the reason for the client's
referral;
new text end

new text begin (9) the client's history of mental health treatment; and
new text end

new text begin (10) cultural influences on the client.
new text end

new text begin (c) If the assessor cannot obtain the information that this subdivision requires without
retraumatizing the client or harming the client's willingness to engage in treatment, the
assessor must identify which topics will require further assessment during the course of the
client's treatment. The assessor must gather and document information related to the following
topics:
new text end

new text begin (1) the client's relationship with the client's family and other significant personal
relationships, including the client's evaluation of the quality of each relationship;
new text end

new text begin (2) the client's strengths and resources, including the extent and quality of the client's
social networks;
new text end

new text begin (3) important developmental incidents in the client's life;
new text end

new text begin (4) maltreatment, trauma, potential brain injuries, and abuse that the client has suffered;
new text end

new text begin (5) the client's history of or exposure to alcohol and drug usage and treatment; and
new text end

new text begin (6) the client's health history and the client's family health history, including the client's
physical, chemical, and mental health history.
new text end

new text begin (d) When completing a standard diagnostic assessment of a client, an assessor must use
a recognized diagnostic framework.
new text end

new text begin (1) When completing a standard diagnostic assessment of a client who is five years of
age or younger, the assessor must use the current edition of the DC: 0-5 Diagnostic
Classification of Mental Health and Development Disorders of Infancy and Early Childhood
published by Zero to Three.
new text end

new text begin (2) When completing a standard diagnostic assessment of a client who is six years of
age or older, the assessor must use the current edition of the Diagnostic and Statistical
Manual of Mental Disorders published by the American Psychiatric Association.
new text end

new text begin (3) When completing a standard diagnostic assessment of a client who is five years of
age or younger, an assessor must administer the Early Childhood Service Intensity Instrument
(ECSII) to the client and include the results in the client's assessment.
new text end

new text begin (4) When completing a standard diagnostic assessment of a client who is six to 17 years
of age, an assessor must administer the Child and Adolescent Service Intensity Instrument
(CASII) to the client and include the results in the client's assessment.
new text end

new text begin (5) When completing a standard diagnostic assessment of a client who is 18 years of
age or older, an assessor must use either (i) the CAGE-AID Questionnaire or (ii) the criteria
in the most recent edition of the Diagnostic and Statistical Manual of Mental Disorders
published by the American Psychiatric Association to screen and assess the client for a
substance use disorder.
new text end

new text begin (e) When completing a standard diagnostic assessment of a client, the assessor must
include and document the following components of the assessment:
new text end

new text begin (1) the client's mental status examination;
new text end

new text begin (2) the client's baseline measurements; symptoms; behavior; skills; abilities; resources;
vulnerabilities; safety needs, including client information that supports the assessor's findings
after applying a recognized diagnostic framework from paragraph (d); and any differential
diagnosis of the client;
new text end

new text begin (3) an explanation of: (i) how the assessor diagnosed the client using the information
from the client's interview, assessment, psychological testing, and collateral information
about the client; (ii) the client's needs; (iii) the client's risk factors; (iv) the client's strengths;
and (v) the client's responsivity factors.
new text end

new text begin (f) When completing a standard diagnostic assessment of a client, the assessor must
consult the client and the client's family about which services that the client and the family
prefer to treat the client. The assessor must make referrals for the client as to services required
by law.
new text end

new text begin Subd. 7. new text end

new text begin Individual treatment plan. new text end

new text begin A license holder must follow each client's written
individual treatment plan when providing services to the client with the following exceptions:
new text end

new text begin (1) services that do not require that a license holder completes a standard diagnostic
assessment of a client before providing services to the client;
new text end

new text begin (2) when developing a service plan; and
new text end

new text begin (3) when a client re-engages in services under subdivision 8, paragraph (b).
new text end

new text begin Subd. 8. new text end

new text begin Individual treatment plan; required elements. new text end

new text begin (a) After completing a client's
diagnostic assessment and before providing services to the client, the license holder must
complete the client's individual treatment plan. The license holder must:
new text end

new text begin (1) base the client's individual treatment plan on the client's diagnostic assessment and
baseline measurements;
new text end

new text begin (2) for a child client, use a child-centered, family-driven, and culturally appropriate
planning process that allows the child's parents and guardians to observe and participate in
the child's individual and family treatment services, assessments, and treatment planning;
new text end

new text begin (3) for an adult client, use a person-centered, culturally appropriate planning process
that allows the client's family and other natural supports to observe and participate in the
client's treatment services, assessments, and treatment planning;
new text end

new text begin (4) identify the client's treatment goals, measureable treatment objectives, a schedule
for accomplishing the client's treatment goals and objectives, a treatment strategy, and the
individuals responsible for providing treatment services and supports to the client. The
license holder must have a treatment strategy to engage the client in treatment if the client:
new text end

new text begin (i) has a history of not engaging in treatment; and
new text end

new text begin (ii) is ordered by a court to participate in treatment services or to take neuroleptic
medications;
new text end

new text begin (5) identify the participants involved in the client's treatment planning. The client must
be a participant in the client's treatment planning. If applicable, the license holder must
document the reasons that the license holder did not involve the client's family or other
natural supports in the client's treatment planning;
new text end

new text begin (6) review the client's individual treatment plan every 180 days and update the client's
individual treatment plan with the client's treatment progress, new treatment objectives and
goals or, if the client has not made treatment progress, changes in the license holder's
approach to treatment; and
new text end

new text begin (7) ensure that the client approves of the client's individual treatment plan unless a court
orders the client's treatment plan under chapter 253B.
new text end

new text begin (b) If the client disagrees with the client's treatment plan, the license holder must
document in the client file the reasons why the client does not agree with the treatment plan.
If the license holder cannot obtain the client's approval of the treatment plan, a mental health
professional must make efforts to obtain approval from a person who is authorized to consent
on the client's behalf within 30 days after the client's previous individual treatment plan
expired. A license holder may not deny a client service during this time period solely because
the license holder could not obtain the client's approval of the client's individual treatment
plan. A license holder may continue to bill for the client's otherwise eligible services when
the client re-engages in services.
new text end

new text begin Subd. 9. new text end

new text begin Functional assessment; required elements. new text end

new text begin When a license holder is
completing a functional assessment for an adult client, the license holder must:
new text end

new text begin (1) complete a functional assessment of the client after completing the client's diagnostic
assessment;
new text end

new text begin (2) use a collaborative process that allows the client and the client's family and other
natural supports, the client's referral sources, and the client's providers to provide information
about how the client's symptoms of mental illness impact the client's functioning;
new text end

new text begin (3) if applicable, document the reasons that the license holder did not contact the client's
family and other natural supports;
new text end

new text begin (4) assess and document how the client's symptoms of mental illness impact the client's
functioning in the following areas:
new text end

new text begin (i) the client's mental health symptoms;
new text end

new text begin (ii) the client's mental health service needs;
new text end

new text begin (iii) the client's substance use;
new text end

new text begin (iv) the client's vocational and educational functioning;
new text end

new text begin (v) the client's social functioning, including the use of leisure time;
new text end

new text begin (vi) the client's interpersonal functioning, including relationships with the client's family
and other natural supports;
new text end

new text begin (vii) the client's ability to provide self-care and live independently;
new text end

new text begin (viii) the client's medical and dental health;
new text end

new text begin (ix) the client's financial assistance needs; and
new text end

new text begin (x) the client's housing and transportation needs;
new text end

new text begin (5) include a narrative summarizing the client's strengths, resources, and all areas of
functional impairment;
new text end

new text begin (6) complete the client's functional assessment before the client's initial individual
treatment plan unless a service specifies otherwise; and
new text end

new text begin (7) update the client's functional assessment with the client's current functioning whenever
there is a significant change in the client's functioning or at least every 180 days, unless a
service specifies otherwise.
new text end

Sec. 12.

new text begin [245I.11] HEALTH SERVICES AND MEDICATIONS.
new text end

new text begin Subdivision 1. new text end

new text begin Generally. new text end

new text begin If a license holder is licensed as a residential program, stores
or administers client medications, or observes clients self-administer medications, the license
holder must ensure that a staff person who is a registered nurse or licensed prescriber is
responsible for overseeing storage and administration of client medications and observing
as a client self-administers medications, including training according to section 245I.05,
subdivision 6, and documenting the occurrence according to section 245I.08, subdivision
5.
new text end

new text begin Subd. 2. new text end

new text begin Health services. new text end

new text begin If a license holder is licensed as a residential program, the
license holder must:
new text end

new text begin (1) ensure that a client is screened for health issues within 72 hours of the client's
admission;
new text end

new text begin (2) monitor the physical health needs of each client on an ongoing basis;
new text end

new text begin (3) offer referrals to clients and coordinate each client's care with psychiatric and medical
services;
new text end

new text begin (4) identify circumstances in which a staff person must notify a registered nurse or
licensed prescriber of any of a client's health concerns and the process for providing
notification of client health concerns; and
new text end

new text begin (5) identify the circumstances in which the license holder must obtain medical care for
a client and the process for obtaining medical care for a client.
new text end

new text begin Subd. 3. new text end

new text begin Storing and accounting for medications. new text end

new text begin (a) If a license holder stores client
medications, the license holder must:
new text end

new text begin (1) store client medications in original containers in a locked location;
new text end

new text begin (2) store refrigerated client medications in special trays or containers that are separate
from food;
new text end

new text begin (3) store client medications marked "for external use only" in a compartment that is
separate from other client medications;
new text end

new text begin (4) store Schedule II to IV drugs listed in section 152.02, subdivisions 3 to 5, in a
compartment that is locked separately from other medications;
new text end

new text begin (5) ensure that only authorized staff persons have access to stored client medications;
new text end

new text begin (6) follow a documentation procedure on each shift to account for all scheduled drugs;
and
new text end

new text begin (7) record each incident when a staff person accepts a supply of client medications and
destroy discontinued, outdated, or deteriorated client medications.
new text end

new text begin (b) If a license holder is licensed as a residential program, the license holder must allow
clients who self-administer medications to keep a private medication supply. The license
holder must ensure that the client stores all private medication in a locked container in the
client's private living area, unless the private medication supply poses a health and safety
risk to any clients. A client must not maintain a private medication supply of a prescription
medication without a written medication order from a licensed prescriber and a prescription
label that includes the client's name.
new text end

new text begin Subd. 4. new text end

new text begin Medication orders. new text end

new text begin (a) If a license holder stores, prescribes, or administers
medications or observes a client self-administer medications, the license holder must:
new text end

new text begin (1) ensure that a licensed prescriber writes all orders to accept, administer, or discontinue
client medications;
new text end

new text begin (2) accept nonwritten orders to administer client medications in emergency circumstances
only;
new text end

new text begin (3) establish a timeline and process for obtaining a written order with the licensed
prescriber's signature when the license holder accepts a nonwritten order to administer client
medications;
new text end

new text begin (4) obtain prescription medication renewals from a licensed prescriber for each client
every 90 days for psychotropic medications and annually for all other medications; and
new text end

new text begin (5) maintain the client's right to privacy and dignity.
new text end

new text begin (b) If a license holder employs a licensed prescriber, the license holder must inform the
client about potential medication effects and side effects and obtain and document the client's
informed consent before the licensed prescriber prescribes a medication.
new text end

new text begin Subd. 5. new text end

new text begin Medication administration. new text end

new text begin If a license holder is licensed as a residential
program, the license holder must:
new text end

new text begin (1) assess and document each client's ability to self-administer medication. In the
assessment, the license holder must evaluate the client's ability to: (i) comply with prescribed
medication regimens; and (ii) store the client's medications safely and in a manner that
protects other individuals in the facility. Through the assessment process, the license holder
must assist the client in developing the skills necessary to safely self-administer medication;
new text end

new text begin (2) monitor the effectiveness of medications, side effects of medications, and adverse
reactions to medications for each client. The license holder must address and document any
concerns about a client's medications;
new text end

new text begin (3) ensure that no staff person or client gives a legend drug supply for one client to
another client;
new text end

new text begin (4) have policies and procedures for: (i) keeping a record of each client's medication
orders; (ii) keeping a record of any incident of deferring a client's medications; (iii)
documenting any incident when a client's medication is omitted; and (iv) documenting when
a client refuses to take medications as prescribed; and
new text end

new text begin (5) document and track medication errors, document whether the license holder notified
anyone about the medication error, determine if the license holder must take any follow-up
actions, and identify the staff persons who are responsible for taking follow-up actions.
new text end

Sec. 13.

new text begin [245I.12] CLIENT RIGHTS AND PROTECTIONS.
new text end

new text begin Subdivision 1. new text end

new text begin Client rights. new text end

new text begin A license holder must ensure that all clients have the
following rights:
new text end

new text begin (1) the rights listed in the health care bill of rights in section 144.651;
new text end

new text begin (2) the right to be free from discrimination based on age, race, color, creed, religion,
national origin, gender, marital status, disability, sexual orientation, and status with regard
to public assistance. The license holder must follow all applicable state and federal laws
including the Minnesota Human Rights Act, chapter 363A; and
new text end

new text begin (3) the right to be informed prior to a photograph or audio or video recording being made
of the client. The client has the right to refuse to allow any recording or photograph of the
client that is not for the purposes of identification or supervision by the license holder.
new text end

new text begin Subd. 2. new text end

new text begin Restrictions to client rights. new text end

new text begin If the license holder restricts a client's right, the
license holder must document in the client file a mental health professional's approval of
the restriction and the reasons for the restriction.
new text end

new text begin Subd. 3. new text end

new text begin Notice of rights. new text end

new text begin The license holder must give a copy of the client's rights
according to this section to each client on the day of the client's admission. The license
holder must document that the license holder gave a copy of the client's rights to each client
on the day of the client's admission according to this section. The license holder must post
a copy of the client rights in an area visible or accessible to all clients. The license holder
must include the client rights in Minnesota Rules, chapter 9544, for applicable clients.
new text end

new text begin Subd. 4. new text end

new text begin Client property. new text end

new text begin (a) The license holder must meet the requirements of section
245A.04, subdivision 13.
new text end

new text begin (b) If the license holder is unable to obtain a client's signature acknowledging the receipt
or disbursement of the client's funds or property required by section 245A.04, subdivision
13, paragraph (c), clause (1), two staff persons must sign documentation acknowledging
that the staff persons witnessed the client's receipt or disbursement of the client's funds or
property.
new text end

new text begin (c) The license holder must return all of the client's funds and other property to the client
except for the following items:
new text end

new text begin (1) illicit drugs, drug paraphernalia, and drug containers that are subject to forfeiture
under section 609.5316. The license holder must give illicit drugs, drug paraphernalia, and
drug containers to a local law enforcement agency or destroy the items; and
new text end

new text begin (2) weapons, explosives, and other property that may cause serious harm to the client
or others. The license holder may give a client's weapons and explosives to a local law
enforcement agency. The license holder must notify the client that a local law enforcement
agency has the client's property and that the client has the right to reclaim the property if
the client has a legal right to possess the item.
new text end

new text begin (d) If a client leaves the license holder's program but abandons the client's funds or
property, the license holder must retain and store the client's funds or property, including
medications, for a minimum of 30 days after the client's discharge from the program.
new text end

new text begin Subd. 5. new text end

new text begin Client grievances. new text end

new text begin (a) The license holder must have a grievance procedure
that:
new text end

new text begin (1) describes to clients how the license holder will meet the requirements in this
subdivision; and
new text end

new text begin (2) contains the current telephone numbers, e-mail addresses, and mailing addresses of
the Department of Human Services, Licensing Division; the Office of Ombudsman for
Mental Health and Developmental Disabilities; the Department of Health, Office of Health
Facilities Complaints; and all applicable health-related licensing boards.
new text end

new text begin (b) On the day of each client's admission, the license holder must explain the grievance
procedure to the client.
new text end

new text begin (c) The license holder must:
new text end

new text begin (1) post the grievance procedure in a place visible to clients and provide a copy of the
grievance procedure upon request;
new text end

new text begin (2) allow clients, former clients, and their authorized representatives to submit a grievance
to the license holder;
new text end

new text begin (3) within three business days of receiving a client's grievance, acknowledge in writing
that the license holder received the client's grievance. If applicable, the license holder must
include a notice of the client's separate appeal rights for a managed care organization's
reduction, termination, or denial of a covered service;
new text end

new text begin (4) within 15 business days of receiving a client's grievance, provide a written final
response to the client's grievance containing the license holder's official response to the
grievance; and
new text end

new text begin (5) allow the client to bring a grievance to the person with the highest level of authority
in the program.
new text end

Sec. 14.

new text begin [245I.13] CRITICAL INCIDENTS.
new text end

new text begin If a license holder is licensed as a residential program, the license holder must report all
critical incidents to the commissioner within ten days of learning of the incident on a form
approved by the commissioner. The license holder must keep a record of critical incidents
in a central location that is readily accessible to the commissioner for review upon the
commissioner's request for a minimum of two licensing periods.
new text end

Sec. 15.

new text begin [245I.20] MENTAL HEALTH CLINIC.
new text end

new text begin Subdivision 1. new text end

new text begin Purpose. new text end

new text begin Certified mental health clinics provide clinical services for the
treatment of mental illnesses with a treatment team that reflects multiple disciplines and
areas of expertise.
new text end

new text begin Subd. 2. new text end

new text begin Definitions. new text end

new text begin (a) "Clinical services" means services provided to a client to
diagnose, describe, predict, and explain the client's status relative to a condition or problem
as described in the: (1) current edition of the Diagnostic and Statistical Manual of Mental
Disorders published by the American Psychiatric Association; or (2) current edition of the
DC: 0-5 Diagnostic Classification of Mental Health and Development Disorders of Infancy
and Early Childhood published by Zero to Three. Where necessary, clinical services includes
services to treat a client to reduce the client's impairment due to the client's condition.
Clinical services also includes individual treatment planning, case review, record-keeping
required for a client's treatment, and treatment supervision. For the purposes of this section,
clinical services excludes services delivered to a client under a separate license and services
listed under section 245I.011, subdivision 5.
new text end

new text begin (b) "Competent" means having professional education, training, continuing education,
consultation, supervision, experience, or a combination thereof necessary to demonstrate
sufficient knowledge of and proficiency in a specific clinical service.
new text end

new text begin (c) "Discipline" means a branch of professional knowledge or skill acquired through a
specific course of study, training, and supervised practice. Discipline is usually documented
by a specific educational degree, licensure, or certification of proficiency. Examples of the
mental health disciplines include but are not limited to psychiatry, psychology, clinical
social work, marriage and family therapy, clinical counseling, and psychiatric nursing.
new text end

new text begin (d) "Treatment team" means the mental health professionals, mental health practitioners,
and clinical trainees who provide clinical services to clients.
new text end

new text begin Subd. 3. new text end

new text begin Organizational structure. new text end

new text begin (a) A mental health clinic location must be an entire
facility or a clearly identified unit within a facility that is administratively and clinically
separate from the rest of the facility. The mental health clinic location may provide services
other than clinical services to clients, including medical services, substance use disorder
services, social services, training, and education.
new text end

new text begin (b) The certification holder must notify the commissioner of all mental health clinic
locations. If there is more than one mental health clinic location, the certification holder
must designate one location as the main location and all of the other locations as satellite
locations. The main location as a unit and the clinic as a whole must comply with the
minimum staffing standards in subdivision 4.
new text end

new text begin (c) The certification holder must ensure that each satellite location:
new text end

new text begin (1) adheres to the same policies and procedures as the main location;
new text end

new text begin (2) provides treatment team members with face-to-face or telephone access to a mental
health professional for the purposes of supervision whenever the satellite location is open.
The certification holder must maintain a schedule of the mental health professionals who
will be available and the contact information for each available mental health professional.
The schedule must be current and readily available to treatment team members; and
new text end

new text begin (3) enables clients to access all of the mental health clinic's clinical services and treatment
team members, as needed.
new text end

new text begin Subd. 4. new text end

new text begin Minimum staffing standards. new text end

new text begin (a) A certification holder's treatment team must
consist of at least four mental health professionals. At least two of the mental health
professionals must be employed by or under contract with the mental health clinic for a
minimum of 35 hours per week each. Each of the two mental health professionals must
specialize in a different mental health discipline.
new text end

new text begin (b) The treatment team must include:
new text end

new text begin (1) a physician qualified as a mental health professional according to section 245I.04,
subdivision 2, clause (4), or a nurse qualified as a mental health professional according to
section 245I.04, subdivision 2, clause (1); and
new text end

new text begin (2) a psychologist qualified as a mental health professional according to section 245I.04,
subdivision 2, clause (3).
new text end

new text begin (c) The staff persons fulfilling the requirement in paragraph (b) must provide clinical
services at least:
new text end

new text begin (1) eight hours every two weeks if the mental health clinic has over 25.0 full-time
equivalent treatment team members;
new text end

new text begin (2) eight hours each month if the mental health clinic has 15.1 to 25.0 full-time equivalent
treatment team members;
new text end

new text begin (3) four hours each month if the mental health clinic has 5.1 to 15.0 full-time equivalent
treatment team members; or
new text end

new text begin (4) two hours each month if the mental health clinic has 2.0 to 5.0 full-time equivalent
treatment team members or only provides in-home services to clients.
new text end

new text begin (d) The certification holder must maintain a record that demonstrates compliance with
this subdivision.
new text end

new text begin Subd. 5. new text end

new text begin Treatment supervision specified. new text end

new text begin (a) A mental health professional must remain
responsible for each client's case. The certification holder must document the name of the
mental health professional responsible for each case and the dates that the mental health
professional is responsible for the client's case from beginning date to end date. The
certification holder must assign each client's case for assessment, diagnosis, and treatment
services to a treatment team member who is competent in the assigned clinical service, the
recommended treatment strategy, and in treating the client's characteristics.
new text end

new text begin (b) Treatment supervision of mental health practitioners and clinical trainees required
by section 245I.06 must include case reviews as described in this paragraph. Every two
months, a mental health professional must complete a case review of each client assigned
to the mental health professional when the client is receiving clinical services from a mental
health practitioner or clinical trainee. The case review must include a consultation process
that thoroughly examines the client's condition and treatment, including: (1) a review of the
client's reason for seeking treatment, diagnoses and assessments, and the individual treatment
plan; (2) a review of the appropriateness, duration, and outcome of treatment provided to
the client; and (3) treatment recommendations.
new text end

new text begin Subd. 6. new text end

new text begin Additional policy and procedure requirements. new text end

new text begin (a) In addition to the policies
and procedures required by section 245I.03, the certification holder must establish, enforce,
and maintain the policies and procedures required by this subdivision.
new text end

new text begin (b) The certification holder must have a clinical evaluation procedure to identify and
document each treatment team member's areas of competence.
new text end

new text begin (c) The certification holder must have policies and procedures for client intake and case
assignment that:
new text end

new text begin (1) outline the client intake process;
new text end

new text begin (2) describe how the mental health clinic determines the appropriateness of accepting a
client into treatment by reviewing the client's condition and need for treatment, the clinical
services that the mental health clinic offers to clients, and other available resources; and
new text end

new text begin (3) contain a process for assigning a client's case to a mental health professional who is
responsible for the client's case and other treatment team members.
new text end

new text begin Subd. 7. new text end

new text begin Referrals. new text end

new text begin If necessary treatment for a client or treatment desired by a client
is not available at the mental health clinic, the certification holder must facilitate appropriate
referrals for the client. When making a referral for a client, the treatment team member must
document a discussion with the client that includes: (1) the reason for the client's referral;
(2) potential treatment resources for the client; and (3) the client's response to receiving a
referral.
new text end

new text begin Subd. 8. new text end

new text begin Emergency service. new text end

new text begin For the certification holder's telephone numbers that clients
regularly access, the certification holder must include the contact information for the area's
mental health crisis services as part of the certification holder's message when a live operator
is not available to answer clients' calls.
new text end

new text begin Subd. 9. new text end

new text begin Quality assurance and improvement plan. new text end

new text begin (a) At a minimum, a certification
holder must develop a written quality assurance and improvement plan that includes a plan
for:
new text end

new text begin (1) encouraging ongoing consultation among members of the treatment team;
new text end

new text begin (2) obtaining and evaluating feedback about services from clients, family and other
natural supports, referral sources, and staff persons;
new text end

new text begin (3) measuring and evaluating client outcomes;
new text end

new text begin (4) reviewing client suicide deaths and suicide attempts;
new text end

new text begin (5) examining the quality of clinical service delivery to clients; and
new text end

new text begin (6) self-monitoring of compliance with this chapter.
new text end

new text begin (b) At least annually, the certification holder must review, evaluate, and update the
quality assurance and improvement plan. The review must: (1) include documentation of
the actions that the certification holder will take as a result of information obtained from
monitoring activities in the plan; and (2) establish goals for improved service delivery to
clients for the next year.
new text end

new text begin Subd. 10. new text end

new text begin Application procedures. new text end

new text begin (a) The applicant for certification must submit any
documents that the commissioner requires on forms approved by the commissioner.
new text end

new text begin (b) Upon submitting an application for certification, an applicant must pay the application
fee required by section 245A.10, subdivision 3.
new text end

new text begin (c) The commissioner must act on an application within 90 working days of receiving
a completed application.
new text end

new text begin (d) When the commissioner receives an application for initial certification that is
incomplete because the applicant failed to submit required documents or is deficient because
the submitted documents do not meet certification requirements, the commissioner must
provide the applicant with written notice that the application is incomplete or deficient. In
the notice, the commissioner must identify the particular documents that are missing or
deficient and give the applicant 45 days to submit a second application that is complete. An
applicant's failure to submit a complete application within 45 days after receiving notice
from the commissioner is a basis for certification denial.
new text end

new text begin (e) The commissioner must give notice of a denial to an applicant when the commissioner
has made the decision to deny the certification application. In the notice of denial, the
commissioner must state the reasons for the denial in plain language. The commissioner
must send or deliver the notice of denial to an applicant by certified mail or personal service.
In the notice of denial, the commissioner must state the reasons that the commissioner denied
the application and must inform the applicant of the applicant's right to request a contested
case hearing under chapter 14 and Minnesota Rules, parts 1400.8505 to 1400.8612. The
applicant may appeal the denial by notifying the commissioner in writing by certified mail
or personal service. If mailed, the appeal must be postmarked and sent to the commissioner
within 20 calendar days after the applicant received the notice of denial. If an applicant
delivers an appeal by personal service, the commissioner must receive the appeal within 20
calendar days after the applicant received the notice of denial.
new text end

new text begin Subd. 11. new text end

new text begin Commissioner's right of access. new text end

new text begin (a) When the commissioner is exercising
the powers conferred to the commissioner by this chapter, if the mental health clinic is in
operation and the information is relevant to the commissioner's inspection or investigation,
the certification holder must provide the commissioner access to:
new text end

new text begin (1) the physical facility and grounds where the program is located;
new text end

new text begin (2) documentation and records, including electronically maintained records;
new text end

new text begin (3) clients served by the mental health clinic;
new text end

new text begin (4) staff persons of the mental health clinic; and
new text end

new text begin (5) personnel records of current and former staff of the mental health clinic.
new text end

new text begin (b) The certification holder must provide the commissioner with access to the facility
and grounds, documentation and records, clients, and staff without prior notice and as often
as the commissioner considers necessary if the commissioner is investigating alleged
maltreatment or a violation of a law or rule, or conducting an inspection. When conducting
an inspection, the commissioner may request and must receive assistance from other state,
county, and municipal governmental agencies and departments. The applicant or certification
holder must allow the commissioner, at the commissioner's expense, to photocopy,
photograph, and make audio and video recordings during an inspection.
new text end

new text begin Subd. 12. new text end

new text begin Monitoring and inspections. new text end

new text begin (a) The commissioner may conduct a certification
review of the certified mental health clinic every two years to determine the certification
holder's compliance with applicable rules and statutes.
new text end

new text begin (b) The commissioner must offer the certification holder a choice of dates for an
announced certification review. A certification review must occur during the clinic's normal
working hours.
new text end

new text begin (c) The commissioner must make the results of certification reviews and investigations
publicly available on the department's website.
new text end

new text begin Subd. 13. new text end

new text begin Correction orders. new text end

new text begin (a) If the applicant or certification holder fails to comply
with a law or rule, the commissioner may issue a correction order. The correction order
must state:
new text end

new text begin (1) the condition that constitutes a violation of the law or rule;
new text end

new text begin (2) the specific law or rule that the applicant or certification holder has violated; and
new text end

new text begin (3) the time that the applicant or certification holder is allowed to correct each violation.
new text end

new text begin (b) If the applicant or certification holder believes that the commissioner's correction
order is erroneous, the applicant or certification holder may ask the commissioner to
reconsider the part of the correction order that is allegedly erroneous. An applicant or
certification holder must make a request for reconsideration in writing. The request must
be postmarked and sent to the commissioner within 20 calendar days after the applicant or
certification holder received the correction order; and the request must:
new text end

new text begin (1) specify the part of the correction order that is allegedly erroneous;
new text end

new text begin (2) explain why the specified part is erroneous; and
new text end

new text begin (3) include documentation to support the allegation of error.
new text end

new text begin (c) A request for reconsideration does not stay any provision or requirement of the
correction order. The commissioner's disposition of a request for reconsideration is final
and not subject to appeal.
new text end

new text begin (d) If the commissioner finds that the applicant or certification holder failed to correct
the violation specified in the correction order, the commissioner may decertify the certified
mental health clinic according to subdivision 14.
new text end

new text begin (e) Nothing in this subdivision prohibits the commissioner from decertifying a mental
health clinic according to subdivision 14.
new text end

new text begin Subd. 14. new text end

new text begin Decertification. new text end

new text begin (a) The commissioner may decertify a mental health clinic
if a certification holder:
new text end

new text begin (1) failed to comply with an applicable law or rule; or
new text end

new text begin (2) knowingly withheld relevant information from or gave false or misleading information
to the commissioner in connection with an application for certification, during an
investigation, or regarding compliance with applicable laws or rules.
new text end

new text begin (b) When considering decertification of a mental health clinic, the commissioner must
consider the nature, chronicity, or severity of the violation of law or rule and the effect of
the violation on the health, safety, or rights of clients.
new text end

new text begin (c) If the commissioner decertifies a mental health clinic, the order of decertification
must inform the certification holder of the right to have a contested case hearing under
chapter 14 and Minnesota Rules, parts 1400.8505 to 1400.8612. The certification holder
may appeal the decertification. The certification holder must appeal a decertification in
writing and send or deliver the appeal to the commissioner by certified mail or personal
service. If the certification holder mails the appeal, the appeal must be postmarked and sent
to the commissioner within ten calendar days after the certification holder receives the order
of decertification. If the certification holder delivers an appeal by personal service, the
commissioner must receive the appeal within ten calendar days after the certification holder
received the order. If a certification holder submits a timely appeal of an order of
decertification, the certification holder may continue to operate the program until the
commissioner issues a final order on the decertification.
new text end

new text begin (d) If the commissioner decertifies a mental health clinic pursuant to paragraph (a),
clause (1), based on a determination that the mental health clinic was responsible for
maltreatment, and if the certification holder appeals the decertification according to paragraph
(c), and appeals the maltreatment determination under section 260E.33, the final
decertification determination is stayed until the commissioner issues a final decision regarding
the maltreatment appeal.
new text end

new text begin Subd. 15. new text end

new text begin Transfer prohibited. new text end

new text begin A certification issued under this chapter is only valid
for the premises and the individual, organization, or government entity identified by the
commissioner on the certification. A certification is not transferable or assignable.
new text end

new text begin Subd. 16. new text end

new text begin Notifications required and noncompliance. new text end

new text begin (a) A certification holder must
notify the commissioner, in a manner prescribed by the commissioner, and obtain the
commissioner's approval before making any change to the name of the certification holder
or the location of the mental health clinic.
new text end

new text begin (b) Changes in mental health clinic organization, staffing, treatment, or quality assurance
procedures that affect the ability of the certification holder to comply with the minimum
standards of section 245I.20 must be reported in writing by the certification holder to the
commissioner within 15 days of the occurrence. Review of the change must be conducted
by the commissioner. A certification holder with changes resulting in noncompliance in
minimum standards must receive written notice and may have up to 180 days to correct the
areas of noncompliance before being decertified. Interim procedures to resolve the
noncompliance on a temporary basis must be developed and submitted in writing to the
commissioner for approval within 30 days of the commissioner's determination of the
noncompliance. Not reporting an occurrence of a change that results in noncompliance
within 15 days, failure to develop an approved interim procedure within 30 days of the
determination of the noncompliance, or nonresolution of the noncompliance within 180
days will result in immediate decertification.
new text end

new text begin (c) The mental health clinic may be required to submit written information to the
department to document that the mental health clinic has maintained compliance with the
rule and mental health clinic procedures.
new text end

Sec. 16.

new text begin [245I.23] INTENSIVE RESIDENTIAL TREATMENT SERVICES AND
RESIDENTIAL CRISIS STABILIZATION.
new text end

new text begin Subdivision 1. new text end

new text begin Purpose. new text end

new text begin (a) Intensive residential treatment services is a community-based
medically monitored level of care for an adult client that uses established rehabilitative
principles to promote a client's recovery and to develop and achieve psychiatric stability,
personal and emotional adjustment, self-sufficiency, and other skills that help a client
transition to a more independent setting.
new text end

new text begin (b) Residential crisis stabilization provides structure and support to an adult client in a
community living environment when a client has experienced a mental health crisis and
needs short-term services to ensure that the client can safely return to the client's home or
precrisis living environment with additional services and supports identified in the client's
crisis assessment.
new text end

new text begin Subd. 2. new text end

new text begin Definitions. new text end

new text begin (a) "Program location" means a set of rooms that are each physically
self-contained and have defining walls extending from floor to ceiling. Program location
includes bedrooms, living rooms or lounge areas, bathrooms, and connecting areas.
new text end

new text begin (b) "Treatment team" means a group of staff persons who provide intensive residential
treatment services or residential crisis stabilization to clients. The treatment team includes
mental health professionals, mental health practitioners, clinical trainees, certified
rehabilitation specialists, mental health rehabilitation workers, and mental health certified
peer specialists.
new text end

new text begin Subd. 3. new text end

new text begin Treatment services description. new text end

new text begin The license holder must describe in writing
all treatment services that the license holder provides. The license holder must have the
description readily available for the commissioner upon the commissioner's request.
new text end

new text begin Subd. 4. new text end

new text begin Required intensive residential treatment services. new text end

new text begin (a) On a daily basis, the
license holder must follow a client's treatment plan to provide intensive residential treatment
services to the client to improve the client's functioning.
new text end

new text begin (b) The license holder must offer and have the capacity to directly provide the following
treatment services to each client:
new text end

new text begin (1) rehabilitative mental health services;
new text end

new text begin (2) crisis prevention planning to assist a client with:
new text end

new text begin (i) identifying and addressing patterns in the client's history and experience of the client's
mental illness; and
new text end

new text begin (ii) developing crisis prevention strategies that include de-escalation strategies that have
been effective for the client in the past;
new text end

new text begin (3) health services and administering medication;
new text end

new text begin (4) co-occurring substance use disorder treatment;
new text end

new text begin (5) engaging the client's family and other natural supports in the client's treatment and
educating the client's family and other natural supports to strengthen the client's social and
family relationships; and
new text end

new text begin (6) making referrals for the client to other service providers in the community and
supporting the client's transition from intensive residential treatment services to another
setting.
new text end

new text begin (c) The license holder must include Illness Management and Recovery (IMR), Enhanced
Illness Management and Recovery (E-IMR), or other similar interventions in the license
holder's programming as approved by the commissioner.
new text end

new text begin Subd. 5. new text end

new text begin Required residential crisis stabilization services. new text end

new text begin (a) On a daily basis, the
license holder must follow a client's individual crisis treatment plan to provide services to
the client in residential crisis stabilization to improve the client's functioning.
new text end

new text begin (b) The license holder must offer and have the capacity to directly provide the following
treatment services to the client:
new text end

new text begin (1) crisis stabilization services as described in section 256B.0624, subdivision 7;
new text end

new text begin (2) rehabilitative mental health services;
new text end

new text begin (3) health services and administering the client's medications; and
new text end

new text begin (4) making referrals for the client to other service providers in the community and
supporting the client's transition from residential crisis stabilization to another setting.
new text end

new text begin Subd. 6. new text end

new text begin Optional treatment services. new text end

new text begin (a) If the license holder offers additional treatment
services to a client, the treatment service must be:
new text end

new text begin (1) approved by the commissioner; and
new text end

new text begin (2)(i) a mental health evidence-based practice that the federal Department of Health and
Human Services Substance Abuse and Mental Health Service Administration has adopted;
new text end

new text begin (ii) a nationally recognized mental health service that substantial research has validated
as effective in helping individuals with serious mental illness achieve treatment goals; or
new text end

new text begin (iii) developed under state-sponsored research of publicly funded mental health programs
and validated to be effective for individuals, families, and communities.
new text end

new text begin (b) Before providing an optional treatment service to a client, the license holder must
provide adequate training to a staff person about providing the optional treatment service
to a client.
new text end

new text begin Subd. 7. new text end

new text begin Intensive residential treatment services assessment and treatment
planning.
new text end

new text begin (a) Within 12 hours of a client's admission, the license holder must evaluate and
document the client's immediate needs, including the client's:
new text end

new text begin (1) health and safety, including the client's need for crisis assistance;
new text end

new text begin (2) responsibilities for children, family and other natural supports, and employers; and
new text end

new text begin (3) housing and legal issues.
new text end

new text begin (b) Within 24 hours of the client's admission, the license holder must complete an initial
treatment plan for the client. The license holder must:
new text end

new text begin (1) base the client's initial treatment plan on the client's referral information and an
assessment of the client's immediate needs;
new text end

new text begin (2) consider crisis assistance strategies that have been effective for the client in the past;
new text end

new text begin (3) identify the client's initial treatment goals, measurable treatment objectives, and
specific interventions that the license holder will use to help the client engage in treatment;
new text end

new text begin (4) identify the participants involved in the client's treatment planning. The client must
be a participant; and
new text end

new text begin (5) ensure that a treatment supervisor approves of the client's initial treatment plan if a
mental health practitioner or clinical trainee completes the client's treatment plan,
notwithstanding section 245I.08, subdivision 3.
new text end

new text begin (c) According to section 245A.65, subdivision 2, paragraph (b), the license holder must
complete an individual abuse prevention plan as part of a client's initial treatment plan.
new text end

new text begin (d) Within five days of the client's admission and again within 60 days after the client's
admission, the license holder must complete a level of care assessment of the client. If the
license holder determines that a client does not need a medically monitored level of service,
a treatment supervisor must document how the client's admission to and continued services
in intensive residential treatment services are medically necessary for the client.
new text end

new text begin (e) Within ten days of a client's admission, the license holder must complete or review
and update the client's standard diagnostic assessment.
new text end

new text begin (f) Within ten days of a client's admission, the license holder must complete the client's
individual treatment plan, notwithstanding section 245I.10, subdivision 8. Within 40 days
after the client's admission and again within 70 days after the client's admission, the license
holder must update the client's individual treatment plan. The license holder must focus the
client's treatment planning on preparing the client for a successful transition from intensive
residential treatment services to another setting. In addition to the required elements of an
individual treatment plan under section 245I.10, subdivision 8, the license holder must
identify the following information in the client's individual treatment plan: (1) the client's
referrals and resources for the client's health and safety; and (2) the staff persons who are
responsible for following up with the client's referrals and resources. If the client does not
receive a referral or resource that the client needs, the license holder must document the
reason that the license holder did not make the referral or did not connect the client to a
particular resource. The license holder is responsible for determining whether additional
follow-up is required on behalf of the client.
new text end

new text begin (g) Within 30 days of the client's admission, the license holder must complete a functional
assessment of the client. Within 60 days after the client's admission, the license holder must
update the client's functional assessment to include any changes in the client's functioning
and symptoms.
new text end

new text begin (h) For a client with a current substance use disorder diagnosis and for a client whose
substance use disorder screening in the client's standard diagnostic assessment indicates the
possibility that the client has a substance use disorder, the license holder must complete a
written assessment of the client's substance use within 30 days of the client's admission. In
the substance use assessment, the license holder must: (1) evaluate the client's history of
substance use, relapses, and hospitalizations related to substance use; (2) assess the effects
of the client's substance use on the client's relationships including with family member and
others; (3) identify financial problems, health issues, housing instability, and unemployment;
(4) assess the client's legal problems, past and pending incarceration, violence, and
victimization; and (5) evaluate the client's suicide attempts, noncompliance with taking
prescribed medications, and noncompliance with psychosocial treatment.
new text end

new text begin (i) On a weekly basis, a mental health professional or certified rehabilitation specialist
must review each client's treatment plan and individual abuse prevention plan. The license
holder must document in the client's file each weekly review of the client's treatment plan
and individual abuse prevention plan.
new text end

new text begin Subd. 8. new text end

new text begin Residential crisis stabilization assessment and treatment planning. new text end

new text begin (a)
Within 12 hours of a client's admission, the license holder must evaluate the client and
document the client's immediate needs, including the client's:
new text end

new text begin (1) health and safety, including the client's need for crisis assistance;
new text end

new text begin (2) responsibilities for children, family and other natural supports, and employers; and
new text end

new text begin (3) housing and legal issues.
new text end

new text begin (b) Within 24 hours of a client's admission, the license holder must complete a crisis
treatment plan for the client under section 256B.0624, subdivision 11. The license holder
must base the client's crisis treatment plan on the client's referral information and an
assessment of the client's immediate needs.
new text end

new text begin (c) Section 245A.65, subdivision 2, paragraph (b), requires the license holder to complete
an individual abuse prevention plan for a client as part of the client's crisis treatment plan.
new text end

new text begin Subd. 9. new text end

new text begin Key staff positions. new text end

new text begin (a) The license holder must have a staff person assigned
to each of the following key staff positions at all times:
new text end

new text begin (1) a program director who qualifies as a mental health practitioner. The license holder
must designate the program director as responsible for all aspects of the operation of the
program and the program's compliance with all applicable requirements. The program
director must know and understand the implications of this chapter; chapters 245A, 245C,
and 260E; sections 626.557 and 626.5572; Minnesota Rules, chapter 9544; and all other
applicable requirements. The license holder must document in the program director's
personnel file how the program director demonstrates knowledge of these requirements.
The program director may also serve as the treatment director of the program, if qualified;
new text end

new text begin (2) a treatment director who qualifies as a mental health professional. The treatment
director must be responsible for overseeing treatment services for clients and the treatment
supervision of all staff persons; and
new text end

new text begin (3) a registered nurse who qualifies as a mental health practitioner. The registered nurse
must:
new text end

new text begin (i) work at the program location a minimum of eight hours per week;
new text end

new text begin (ii) provide monitoring and supervision of staff persons as defined in section 148.171,
subdivisions 8a and 23;
new text end

new text begin (iii) be responsible for the review and approval of health service and medication policies
and procedures under section 245I.03, subdivision 5; and
new text end

new text begin (iv) oversee the license holder's provision of health services to clients, medication storage,
and medication administration to clients.
new text end

new text begin (b) Within five business days of a change in a key staff position, the license holder must
notify the commissioner of the staffing change. The license holder must notify the
commissioner of the staffing change on a form approved by the commissioner and include
the name of the staff person now assigned to the key staff position and the staff person's
qualifications.
new text end

new text begin Subd. 10. new text end

new text begin Minimum treatment team staffing levels and ratios. new text end

new text begin (a) The license holder
must maintain a treatment team staffing level sufficient to:
new text end

new text begin (1) provide continuous daily coverage of all shifts;
new text end

new text begin (2) follow each client's treatment plan and meet each client's needs as identified in the
client's treatment plan;
new text end

new text begin (3) implement program requirements; and
new text end

new text begin (4) safely monitor and guide the activities of each client, taking into account the client's
level of behavioral and psychiatric stability, cultural needs, and vulnerabilities.
new text end

new text begin (b) The license holder must ensure that treatment team members:
new text end

new text begin (1) remain awake during all work hours; and
new text end

new text begin (2) are available to monitor and guide the activities of each client whenever clients are
present in the program.
new text end

new text begin (c) On each shift, the license holder must maintain a treatment team staffing ratio of at
least one treatment team member to nine clients. If the license holder is serving nine or
fewer clients, at least one treatment team member on the day shift must be a mental health
professional, clinical trainee, certified rehabilitation specialist, or mental health practitioner.
If the license holder is serving more than nine clients, at least one of the treatment team
members working during both the day and evening shifts must be a mental health
professional, clinical trainee, certified rehabilitation specialist, or mental health practitioner.
new text end

new text begin (d) If the license holder provides residential crisis stabilization to clients and is serving
at least one client in residential crisis stabilization and more than four clients in residential
crisis stabilization and intensive residential treatment services, the license holder must
maintain a treatment team staffing ratio on each shift of at least two treatment team members
during the client's first 48 hours in residential crisis stabilization.
new text end

new text begin Subd. 11. new text end

new text begin Shift exchange. new text end

new text begin A license holder must ensure that treatment team members
working on different shifts exchange information about a client as necessary to effectively
care for the client and to follow and update a client's treatment plan and individual abuse
prevention plan.
new text end

new text begin Subd. 12. new text end

new text begin Daily documentation. new text end

new text begin (a) For each day that a client is present in the program,
the license holder must provide a daily summary in the client's file that includes observations
about the client's behavior and symptoms, including any critical incidents in which the client
was involved.
new text end

new text begin (b) For each day that a client is not present in the program, the license holder must
document the reason for a client's absence in the client's file.
new text end

new text begin Subd. 13. new text end

new text begin Access to a mental health professional, clinical trainee, certified
rehabilitation specialist, or mental health practitioner.
new text end

new text begin Treatment team members must
have access in person or by telephone to a mental health professional, clinical trainee,
certified rehabilitation specialist, or mental health practitioner within 30 minutes. The license
holder must maintain a schedule of mental health professionals, clinical trainees, certified
rehabilitation specialists, or mental health practitioners who will be available and contact
information to reach them. The license holder must keep the schedule current and make the
schedule readily available to treatment team members.
new text end

new text begin Subd. 14. new text end

new text begin Weekly team meetings. new text end

new text begin (a) The license holder must hold weekly team meetings
and ancillary meetings according to this subdivision.
new text end

new text begin (b) A mental health professional or certified rehabilitation specialist must hold at least
one team meeting each calendar week and be physically present at the team meeting. All
treatment team members, including treatment team members who work on a part-time or
intermittent basis, must participate in a minimum of one team meeting during each calendar
week when the treatment team member is working for the license holder. The license holder
must document all weekly team meetings, including the names of meeting attendees.
new text end

new text begin (c) If a treatment team member cannot participate in a weekly team meeting, the treatment
team member must participate in an ancillary meeting. A mental health professional, certified
rehabilitation specialist, clinical trainee, or mental health practitioner who participated in
the most recent weekly team meeting may lead the ancillary meeting. During the ancillary
meeting, the treatment team member leading the ancillary meeting must review the
information that was shared at the most recent weekly team meeting, including revisions
to client treatment plans and other information that the treatment supervisors exchanged
with treatment team members. The license holder must document all ancillary meetings,
including the names of meeting attendees.
new text end

new text begin Subd. 15. new text end

new text begin Intensive residential treatment services admission criteria. new text end

new text begin (a) An eligible
client for intensive residential treatment services is an individual who:
new text end

new text begin (1) is age 18 or older;
new text end

new text begin (2) is diagnosed with a mental illness;
new text end

new text begin (3) because of a mental illness, has a substantial disability and functional impairment
in three or more areas listed in section 245I.10, subdivision 9, clause (4), that markedly
reduce the individual's self-sufficiency;
new text end

new text begin (4) has one or more of the following: a history of recurring or prolonged inpatient
hospitalizations during the past year, significant independent living instability, homelessness,
or very frequent use of mental health and related services with poor outcomes for the
individual; and
new text end

new text begin (5) in the written opinion of a mental health professional, needs mental health services
that available community-based services cannot provide, or is likely to experience a mental
health crisis or require a more restrictive setting if the individual does not receive intensive
rehabilitative mental health services.
new text end

new text begin (b) The license holder must not limit or restrict intensive residential treatment services
to a client based solely on:
new text end

new text begin (1) the client's substance use;
new text end

new text begin (2) the county in which the client resides; or
new text end

new text begin (3) whether the client elects to receive other services for which the client may be eligible,
including case management services.
new text end

new text begin (c) This subdivision does not prohibit the license holder from restricting admissions of
individuals who present an imminent risk of harm or danger to themselves or others.
new text end

new text begin Subd. 16. new text end

new text begin Residential crisis stabilization services admission criteria. new text end

new text begin An eligible client
for residential crisis stabilization is an individual who is age 18 or older and meets the
eligibility criteria in section 256B.0624, subdivision 3.
new text end

new text begin Subd. 17. new text end

new text begin Admissions referrals and determinations. new text end

new text begin (a) The license holder must
identify the information that the license holder needs to make a determination about a
person's admission referral.
new text end

new text begin (b) The license holder must:
new text end

new text begin (1) always be available to receive referral information about a person seeking admission
to the license holder's program;
new text end

new text begin (2) respond to the referral source within eight hours of receiving a referral and, within
eight hours, communicate with the referral source about what information the license holder
needs to make a determination concerning the person's admission;
new text end

new text begin (3) consider the license holder's staffing ratio and the areas of treatment team members'
competency when determining whether the license holder is able to meet the needs of a
person seeking admission; and
new text end

new text begin (4) determine whether to admit a person within 72 hours of receiving all necessary
information from the referral source.
new text end

new text begin Subd. 18. new text end

new text begin Discharge standards. new text end

new text begin (a) When a license holder discharges a client from a
program, the license holder must categorize the discharge as a successful discharge,
program-initiated discharge, or non-program-initiated discharge according to the criteria in
this subdivision. The license holder must meet the standards associated with the type of
discharge according to this subdivision.
new text end

new text begin (b) To successfully discharge a client from a program, the license holder must ensure
that the following criteria are met:
new text end

new text begin (1) the client must substantially meet the client's documented treatment plan goals and
objectives;
new text end

new text begin (2) the client must complete discharge planning with the treatment team; and
new text end

new text begin (3) the client and treatment team must arrange for the client to receive continuing care
at a less intensive level of care after discharge.
new text end

new text begin (c) Prior to successfully discharging a client from a program, the license holder must
complete the client's discharge summary and provide the client with a copy of the client's
discharge summary in plain language that includes:
new text end

new text begin (1) a brief review of the client's problems and strengths during the period that the license
holder provided services to the client;
new text end

new text begin (2) the client's response to the client's treatment plan;
new text end

new text begin (3) the goals and objectives that the license holder recommends that the client addresses
during the first three months following the client's discharge from the program;
new text end

new text begin (4) the recommended actions, supports, and services that will assist the client with a
successful transition from the program to another setting;
new text end

new text begin (5) the client's crisis plan; and
new text end

new text begin (6) the client's forwarding address and telephone number.
new text end

new text begin (d) For a non-program-initiated discharge of a client from a program, the following
criteria must be met:
new text end

new text begin (1)(i) the client has withdrawn the client's consent for treatment; (ii) the license holder
has determined that the client has the capacity to make an informed decision; and (iii) the
client does not meet the criteria for an emergency hold under section 253B.051, subdivision
2;
new text end

new text begin (2) the client has left the program against staff person advice;
new text end

new text begin (3) an entity with legal authority to remove the client has decided to remove the client
from the program; or
new text end

new text begin (4) a source of payment for the services is no longer available.
new text end

new text begin (e) Within ten days of a non-program-initiated discharge of a client from a program, the
license holder must complete the client's discharge summary in plain language that includes:
new text end

new text begin (1) the reasons for the client's discharge;
new text end

new text begin (2) a description of attempts by staff persons to enable the client to continue treatment
or to consent to treatment; and
new text end

new text begin (3) recommended actions, supports, and services that will assist the client with a
successful transition from the program to another setting.
new text end

new text begin (f) For a program-initiated discharge of a client from a program, the following criteria
must be met:
new text end

new text begin (1) the client is competent but has not participated in treatment or has not followed the
program rules and regulations and the client has not participated to such a degree that the
program's level of care is ineffective or unsafe for the client, despite multiple, documented
attempts that the license holder has made to address the client's lack of participation in
treatment;
new text end

new text begin (2) the client has not made progress toward the client's treatment goals and objectives
despite the license holder's persistent efforts to engage the client in treatment, and the license
holder has no reasonable expectation that the client will make progress at the program's
level of care nor does the client require the program's level of care to maintain the current
level of functioning;
new text end

new text begin (3) a court order or the client's legal status requires the client to participate in the program
but the client has left the program against staff person advice; or
new text end

new text begin (4) the client meets criteria for a more intensive level of care and a more intensive level
of care is available to the client.
new text end

new text begin (g) Prior to a program-initiated discharge of a client from a program, the license holder
must consult the client, the client's family and other natural supports, and the client's case
manager, if applicable, to review the issues involved in the program's decision to discharge
the client from the program. During the discharge review process, which must not exceed
five working days, the license holder must determine whether the license holder, treatment
team, and any interested persons can develop additional strategies to resolve the issues
leading to the client's discharge and to permit the client to have an opportunity to continue
receiving services from the license holder. The license holder may temporarily remove a
client from the program facility during the five-day discharge review period. The license
holder must document the client's discharge review in the client's file.
new text end

new text begin (h) Prior to a program-initiated discharge of a client from the program, the license holder
must complete the client's discharge summary and provide the client with a copy of the
discharge summary in plain language that includes:
new text end

new text begin (1) the reasons for the client's discharge;
new text end

new text begin (2) the alternatives to discharge that the license holder considered or attempted to
implement;
new text end

new text begin (3) the names of each individual who is involved in the decision to discharge the client
and a description of each individual's involvement; and
new text end

new text begin (4) recommended actions, supports, and services that will assist the client with a
successful transition from the program to another setting.
new text end

new text begin Subd. 19. new text end

new text begin Program facility. new text end

new text begin (a) The license holder must be licensed or certified as a
board and lodging facility, supervised living facility, or a boarding care home by the
Department of Health.
new text end

new text begin (b) The license holder must have a capacity of five to 16 beds and the program must not
be declared as an institution for mental disease.
new text end

new text begin (c) The license holder must furnish each program location to meet the psychological,
emotional, and developmental needs of clients.
new text end

new text begin (d) The license holder must provide one living room or lounge area per program location.
There must be space available to provide services according to each client's treatment plan,
such as an area for learning recreation time skills and areas for learning independent living
skills, such as laundering clothes and preparing meals.
new text end

new text begin (e) The license holder must ensure that each program location allows each client to have
privacy. Each client must have privacy during assessment interviews and counseling sessions.
Each client must have a space designated for the client to see outside visitors at the program
facility.
new text end

new text begin Subd. 20. new text end

new text begin Physical separation of services. new text end

new text begin If the license holder offers services to
individuals who are not receiving intensive residential treatment services or residential
stabilization at the program location, the license holder must inform the commissioner and
submit a plan for approval to the commissioner about how and when the license holder will
provide services. The license holder must only provide services to clients who are not
receiving intensive residential treatment services or residential crisis stabilization in an area
that is physically separated from the area in which the license holder provides clients with
intensive residential treatment services or residential crisis stabilization.
new text end

new text begin Subd. 21. new text end

new text begin Dividing staff time between locations. new text end

new text begin A license holder must obtain approval
from the commissioner prior to providing intensive residential treatment services or
residential crisis stabilization to clients in more than one program location under one license
and dividing one staff person's time between program locations during the same work period.
new text end

new text begin Subd. 22. new text end

new text begin Additional policy and procedure requirements. new text end

new text begin (a) In addition to the policies
and procedures in section 245I.03, the license holder must establish, enforce, and maintain
the policies and procedures in this subdivision.
new text end

new text begin (b) The license holder must have policies and procedures for receiving referrals and
making admissions determinations about referred persons under subdivisions 14 to 16.
new text end

new text begin (c) The license holder must have policies and procedures for discharging clients under
subdivision 17. In the policies and procedures, the license holder must identify the staff
persons who are authorized to discharge clients from the program.
new text end

new text begin Subd. 23. new text end

new text begin Quality assurance and improvement plan. new text end

new text begin (a) A license holder must develop
a written quality assurance and improvement plan that includes a plan to:
new text end

new text begin (1) encourage ongoing consultation between members of the treatment team;
new text end

new text begin (2) obtain and evaluate feedback about services from clients, family and other natural
supports, referral sources, and staff persons;
new text end

new text begin (3) measure and evaluate client outcomes in the program;
new text end

new text begin (4) review critical incidents in the program;
new text end

new text begin (5) examine the quality of clinical services in the program; and
new text end

new text begin (6) self-monitor the license holder's compliance with this chapter.
new text end

new text begin (b) At least annually, the license holder must review, evaluate, and update the license
holder's quality assurance and improvement plan. The license holder's review must:
new text end

new text begin (1) document the actions that the license holder will take in response to the information
that the license holder obtains from the monitoring activities in the plan; and
new text end

new text begin (2) establish goals for improving the license holder's services to clients during the next
year.
new text end

new text begin Subd. 24. new text end

new text begin Application. new text end

new text begin When an applicant requests licensure to provide intensive
residential treatment services, residential crisis stabilization, or both to clients, the applicant
must submit, on forms that the commissioner provides, any documents that the commissioner
requires.
new text end

Sec. 17.

new text begin [256B.0671] COVERED MENTAL HEALTH SERVICES.
new text end

new text begin Subdivision 1. new text end

new text begin Definitions. new text end

new text begin (a) "Clinical trainee" means a staff person who is qualified
under section 245I.04, subdivision 6.
new text end

new text begin (b) "Mental health practitioner" means a staff person who is qualified under section
245I.04, subdivision 4.
new text end

new text begin (c) "Mental health professional" means a staff person who is qualified under section
245I.04, subdivision 2.
new text end

new text begin Subd. 2. new text end

new text begin Generally. new text end

new text begin (a) An individual, organization, or government entity providing
mental health services to a client under this section must obtain a criminal background study
of each staff person or volunteer who is providing direct contact services to a client.
new text end

new text begin (b) An individual, organization, or government entity providing mental health services
to a client under this section must comply with all responsibilities that chapter 245I assigns
to a license holder, except section 245I.011, subdivision 1, unless all of the individual's,
organization's, or government entity's treatment staff are qualified as mental health
professionals.
new text end

new text begin (c) An individual, organization, or government entity providing mental health services
to a client under this section must comply with the following requirements if all of the
license holder's treatment staff are qualified as mental health professionals:
new text end

new text begin (1) provider qualifications and scopes of practice under section 245I.04;
new text end

new text begin (2) maintaining and updating personnel files under section 245I.07;
new text end

new text begin (3) documenting under section 245I.08;
new text end

new text begin (4) maintaining and updating client files under section 245I.09;
new text end

new text begin (5) completing client assessments and treatment planning under section 245I.10;
new text end

new text begin (6) providing clients with health services and medications under section 245I.11; and
new text end

new text begin (7) respecting and enforcing client rights under section 245I.12.
new text end

new text begin Subd. 3. new text end

new text begin Adult day treatment services. new text end

new text begin (a) Subject to federal approval, medical
assistance covers adult day treatment (ADT) services that are provided under contract with
the county board. Adult day treatment payment is subject to the conditions in paragraphs
(b) to (e). The provider must make reasonable and good faith efforts to report individual
client outcomes to the commissioner using instruments, protocols, and forms approved by
the commissioner.
new text end

new text begin (b) Adult day treatment is an intensive psychotherapeutic treatment to reduce or relieve
the effects of mental illness on a client to enable the client to benefit from a lower level of
care and to live and function more independently in the community. Adult day treatment
services must be provided to a client to stabilize the client's mental health and to improve
the client's independent living and socialization skills. Adult day treatment must consist of
at least one hour of group psychotherapy and must include group time focused on
rehabilitative interventions or other therapeutic services that a multidisciplinary team provides
to each client. Adult day treatment services are not a part of inpatient or residential treatment
services. The following providers may apply to become adult day treatment providers:
new text end

new text begin (1) a hospital accredited by the Joint Commission on Accreditation of Health
Organizations and licensed under sections 144.50 to 144.55;
new text end

new text begin (2) a community mental health center under section 256B.0625, subdivision 5; or
new text end

new text begin (3) an entity that is under contract with the county board to operate a program that meets
the requirements of section 245.4712, subdivision 2, and Minnesota Rules, parts 9505.0170
to 9505.0475.
new text end

new text begin (c) An adult day treatment (ADT) services provider must:
new text end

new text begin (1) ensure that the commissioner has approved of the organization as an adult day
treatment provider organization;
new text end

new text begin (2) ensure that a multidisciplinary team provides ADT services to a group of clients. A
mental health professional must supervise each multidisciplinary staff person who provides
ADT services;
new text end

new text begin (3) make ADT services available to the client at least two days a week for at least three
consecutive hours per day. ADT services may be longer than three hours per day, but medical
assistance may not reimburse a provider for more than 15 hours per week;
new text end

new text begin (4) provide ADT services to each client that includes group psychotherapy by a mental
health professional or clinical trainee and daily rehabilitative interventions by a mental
health professional, clinical trainee, or mental health practitioner; and
new text end

new text begin (5) include ADT services in the client's individual treatment plan, when appropriate.
The adult day treatment provider must:
new text end

new text begin (i) complete a functional assessment of each client under section 245I.10, subdivision
9;
new text end

new text begin (ii) notwithstanding section 245I.10, subdivision 8, review the client's progress and
update the individual treatment plan at least every 90 days until the client is discharged
from the program; and
new text end

new text begin (iii) include a discharge plan for the client in the client's individual treatment plan.
new text end

new text begin (d) To be eligible for adult day treatment, a client must:
new text end

new text begin (1) be 18 years of age or older;
new text end

new text begin (2) not reside in a nursing facility, hospital, institute of mental disease, or state-operated
treatment center unless the client has an active discharge plan that indicates a move to an
independent living setting within 180 days;
new text end

new text begin (3) have the capacity to engage in rehabilitative programming, skills activities, and
psychotherapy in the structured, therapeutic setting of an adult day treatment program and
demonstrate measurable improvements in functioning resulting from participation in the
adult day treatment program;
new text end

new text begin (4) have a level of care assessment under section 245I.02, subdivision 19, recommending
that the client participate in services with the level of intensity and duration of an adult day
treatment program; and
new text end

new text begin (5) have the recommendation of a mental health professional for adult day treatment
services. The mental health professional must find that adult day treatment services are
medically necessary for the client.
new text end

new text begin (e) Medical assistance does not cover the following services as adult day treatment
services:
new text end

new text begin (1) services that are primarily recreational or that are provided in a setting that is not
under medical supervision, including sports activities, exercise groups, craft hours, leisure
time, social hours, meal or snack time, trips to community activities, and tours;
new text end

new text begin (2) social or educational services that do not have or cannot reasonably be expected to
have a therapeutic outcome related to the client's mental illness;
new text end

new text begin (3) consultations with other providers or service agency staff persons about the care or
progress of a client;
new text end

new text begin (4) prevention or education programs that are provided to the community;
new text end

new text begin (5) day treatment for clients with a primary diagnosis of a substance use disorder;
new text end

new text begin (6) day treatment provided in the client's home;
new text end

new text begin (7) psychotherapy for more than two hours per day; and
new text end

new text begin (8) participation in meal preparation and eating that is not part of a clinical treatment
plan to address the client's eating disorder.
new text end

new text begin Subd. 4. new text end

new text begin Explanation of findings. new text end

new text begin (a) Subject to federal approval, medical assistance
covers an explanation of findings that a mental health professional or clinical trainee provides
when the provider has obtained the authorization from the client or the client's representative
to release the information.
new text end

new text begin (b) A mental health professional or clinical trainee provides an explanation of findings
to assist the client or related parties in understanding the results of the client's testing or
diagnostic assessment and the client's mental illness, and provides professional insight that
the client or related parties need to carry out a client's treatment plan. Related parties may
include the client's family and other natural supports and other service providers working
with the client.
new text end

new text begin (c) An explanation of findings is not paid for separately when a mental health professional
or clinical trainee explains the results of psychological testing or a diagnostic assessment
to the client or the client's representative as part of the client's psychological testing or a
diagnostic assessment.
new text end

new text begin Subd. 5. new text end

new text begin Family psychoeducation services. new text end

new text begin (a) Subject to federal approval, medical
assistance covers family psychoeducation services provided to a child up to age 21 with a
diagnosed mental health condition when identified in the child's individual treatment plan
and provided by a mental health professional or a clinical trainee who has determined it
medically necessary to involve family members in the child's care.
new text end

new text begin (b) "Family psychoeducation services" means information or demonstration provided
to an individual or family as part of an individual, family, multifamily group, or peer group
session to explain, educate, and support the child and family in understanding a child's
symptoms of mental illness, the impact on the child's development, and needed components
of treatment and skill development so that the individual, family, or group can help the child
to prevent relapse, prevent the acquisition of comorbid disorders, and achieve optimal mental
health and long-term resilience.
new text end

new text begin Subd. 6. new text end

new text begin Dialectical behavior therapy. new text end

new text begin (a) Subject to federal approval, medical assistance
covers intensive mental health outpatient treatment for dialectical behavior therapy for
adults. A dialectical behavior therapy provider must make reasonable and good faith efforts
to report individual client outcomes to the commissioner using instruments and protocols
that are approved by the commissioner.
new text end

new text begin (b) "Dialectical behavior therapy" means an evidence-based treatment approach that a
mental health professional or clinical trainee provides to a client or a group of clients in an
intensive outpatient treatment program using a combination of individualized rehabilitative
and psychotherapeutic interventions. A dialectical behavior therapy program involves:
individual dialectical behavior therapy, group skills training, telephone coaching, and team
consultation meetings.
new text end

new text begin (c) To be eligible for dialectical behavior therapy, a client must:
new text end

new text begin (1) be 18 years of age or older;
new text end

new text begin (2) have mental health needs that available community-based services cannot meet or
that the client must receive concurrently with other community-based services;
new text end

new text begin (3) have either:
new text end

new text begin (i) a diagnosis of borderline personality disorder; or
new text end

new text begin (ii) multiple mental health diagnoses, exhibit behaviors characterized by impulsivity or
intentional self-harm, and be at significant risk of death, morbidity, disability, or severe
dysfunction in multiple areas of the client's life;
new text end

new text begin (4) be cognitively capable of participating in dialectical behavior therapy as an intensive
therapy program and be able and willing to follow program policies and rules to ensure the
safety of the client and others; and
new text end

new text begin (5) be at significant risk of one or more of the following if the client does not receive
dialectical behavior therapy:
new text end

new text begin (i) having a mental health crisis;
new text end

new text begin (ii) requiring a more restrictive setting such as hospitalization;
new text end

new text begin (iii) decompensating; or
new text end

new text begin (iv) engaging in intentional self-harm behavior.
new text end

new text begin (d) Individual dialectical behavior therapy combines individualized rehabilitative and
psychotherapeutic interventions to treat a client's suicidal and other dysfunctional behaviors
and to reinforce a client's use of adaptive skillful behaviors. A mental health professional
or clinical trainee must provide individual dialectical behavior therapy to a client. A mental
health professional or clinical trainee providing dialectical behavior therapy to a client must:
new text end

new text begin (1) identify, prioritize, and sequence the client's behavioral targets;
new text end

new text begin (2) treat the client's behavioral targets;
new text end

new text begin (3) assist the client in applying dialectical behavior therapy skills to the client's natural
environment through telephone coaching outside of treatment sessions;
new text end

new text begin (4) measure the client's progress toward dialectical behavior therapy targets;
new text end

new text begin (5) help the client manage mental health crises and life-threatening behaviors; and
new text end

new text begin (6) help the client learn and apply effective behaviors when working with other treatment
providers.
new text end

new text begin (e) Group skills training combines individualized psychotherapeutic and psychiatric
rehabilitative interventions conducted in a group setting to reduce the client's suicidal and
other dysfunctional coping behaviors and restore function. Group skills training must teach
the client adaptive skills in the following areas: (1) mindfulness; (2) interpersonal
effectiveness; (3) emotional regulation; and (4) distress tolerance.
new text end

new text begin (f) Group skills training must be provided by two mental health professionals or by a
mental health professional co-facilitating with a clinical trainee or a mental health practitioner.
Individual skills training must be provided by a mental health professional, a clinical trainee,
or a mental health practitioner.
new text end

new text begin (g) Before a program provides dialectical behavior therapy to a client, the commissioner
must certify the program as a dialectical behavior therapy provider. To qualify for
certification as a dialectical behavior therapy provider, a provider must:
new text end

new text begin (1) allow the commissioner to inspect the provider's program;
new text end

new text begin (2) provide evidence to the commissioner that the program's policies, procedures, and
practices meet the requirements of this subdivision and chapter 245I;
new text end

new text begin (3) be enrolled as a MHCP provider; and
new text end

new text begin (4) have a manual that outlines the program's policies, procedures, and practices that
meet the requirements of this subdivision.
new text end

new text begin Subd. 7. new text end

new text begin Mental health clinical care consultation. new text end

new text begin (a) Subject to federal approval,
medical assistance covers clinical care consultation for a person up to age 21 who is
diagnosed with a complex mental health condition or a mental health condition that co-occurs
with other complex and chronic conditions, when described in the person's individual
treatment plan and provided by a mental health professional or a clinical trainee.
new text end

new text begin (b) "Clinical care consultation" means communication from a treating mental health
professional to other providers or educators not under the treatment supervision of the
treating mental health professional who are working with the same client to inform, inquire,
and instruct regarding the client's symptoms; strategies for effective engagement, care, and
intervention needs; and treatment expectations across service settings and to direct and
coordinate clinical service components provided to the client and family.
new text end

new text begin Subd. 8. new text end

new text begin Neuropsychological assessment. new text end

new text begin (a) Subject to federal approval, medical
assistance covers a client's neuropsychological assessment.
new text end

new text begin (b) Neuropsychological assessment" means a specialized clinical assessment of the
client's underlying cognitive abilities related to thinking, reasoning, and judgment that is
conducted by a qualified neuropsychologist. A neuropsychological assessment must include
a face-to-face interview with the client, interpretation of the test results, and preparation
and completion of a report.
new text end

new text begin (c) A client is eligible for a neuropsychological assessment if the client meets at least
one of the following criteria:
new text end

new text begin (1) the client has a known or strongly suspected brain disorder based on the client's
medical history or the client's prior neurological evaluation, including a history of significant
head trauma, brain tumor, stroke, seizure disorder, multiple sclerosis, neurodegenerative
disorder, significant exposure to neurotoxins, central nervous system infection, metabolic
or toxic encephalopathy, fetal alcohol syndrome, or congenital malformation of the brain;
or
new text end

new text begin (2) the client has cognitive or behavioral symptoms that suggest that the client has an
organic condition that cannot be readily attributed to functional psychopathology or suspected
neuropsychological impairment in addition to functional psychopathology. The client's
symptoms may include:
new text end

new text begin (i) having a poor memory or impaired problem solving;
new text end

new text begin (ii) experiencing change in mental status evidenced by lethargy, confusion, or
disorientation;
new text end

new text begin (iii) experiencing a deteriorating level of functioning;
new text end

new text begin (iv) displaying a marked change in behavior or personality;
new text end

new text begin (v) in a child or an adolescent, having significant delays in acquiring academic skill or
poor attention relative to peers;
new text end

new text begin (vi) in a child or an adolescent, having reached a significant plateau in expected
development of cognitive, social, emotional, or physical functioning relative to peers; and
new text end

new text begin (vii) in a child or an adolescent, significant inability to develop expected knowledge,
skills, or abilities to adapt to new or changing cognitive, social, emotional, or physical
demands.
new text end

new text begin (d) The neuropsychological assessment must be completed by a neuropsychologist who:
new text end

new text begin (1) was awarded a diploma by the American Board of Clinical Neuropsychology, the
American Board of Professional Neuropsychology, or the American Board of Pediatric
Neuropsychology;
new text end

new text begin (2) earned a doctoral degree in psychology from an accredited university training program
and:
new text end

new text begin (i) completed an internship or its equivalent in a clinically relevant area of professional
psychology;
new text end

new text begin (ii) completed the equivalent of two full-time years of experience and specialized training,
at least one of which is at the postdoctoral level, supervised by a clinical neuropsychologist
in the study and practice of clinical neuropsychology and related neurosciences; and
new text end

new text begin (iii) holds a current license to practice psychology independently according to sections
144.88 to 144.98;
new text end

new text begin (3) is licensed or credentialed by another state's board of psychology examiners in the
specialty of neuropsychology using requirements equivalent to requirements specified by
one of the boards named in clause (1); or
new text end

new text begin (4) was approved by the commissioner as an eligible provider of neuropsychological
assessments prior to December 31, 2010.
new text end

new text begin Subd. 9. new text end

new text begin Neuropsychological testing. new text end

new text begin (a) Subject to federal approval, medical assistance
covers neuropsychological testing for clients.
new text end

new text begin (b) "Neuropsychological testing" means administering standardized tests and measures
designed to evaluate the client's ability to attend to, process, interpret, comprehend,
communicate, learn, and recall information and use problem solving and judgment.
new text end

new text begin (c) Medical assistance covers neuropsychological testing of a client when the client:
new text end

new text begin (1) has a significant mental status change that is not a result of a metabolic disorder and
that has failed to respond to treatment;
new text end

new text begin (2) is a child or adolescent with a significant plateau in expected development of
cognitive, social, emotional, or physical function relative to peers;
new text end

new text begin (3) is a child or adolescent with a significant inability to develop expected knowledge,
skills, or abilities to adapt to new or changing cognitive, social, physical, or emotional
demands; or
new text end

new text begin (4) has a significant behavioral change, memory loss, or suspected neuropsychological
impairment in addition to functional psychopathology, or other organic brain injury or one
of the following:
new text end

new text begin (i) traumatic brain injury;
new text end

new text begin (ii) stroke;
new text end

new text begin (iii) brain tumor;
new text end

new text begin (iv) substance use disorder;
new text end

new text begin (v) cerebral anoxic or hypoxic episode;
new text end

new text begin (vi) central nervous system infection or other infectious disease;
new text end

new text begin (vii) neoplasms or vascular injury of the central nervous system;
new text end

new text begin (viii) neurodegenerative disorders;
new text end

new text begin (ix) demyelinating disease;
new text end

new text begin (x) extrapyramidal disease;
new text end

new text begin (xi) exposure to systemic or intrathecal agents or cranial radiation known to be associated
with cerebral dysfunction;
new text end

new text begin (xii) systemic medical conditions known to be associated with cerebral dysfunction,
including renal disease, hepatic encephalopathy, cardiac anomaly, sickle cell disease, and
related hematologic anomalies, and autoimmune disorders, including lupus, erythematosus,
or celiac disease;
new text end

new text begin (xiii) congenital genetic or metabolic disorders known to be associated with cerebral
dysfunction, including phenylketonuria, craniofacial syndromes, or congenital hydrocephalus;
new text end

new text begin (xiv) severe or prolonged nutrition or malabsorption syndromes; or
new text end

new text begin (xv) a condition presenting in a manner difficult for a clinician to distinguish between
the neurocognitive effects of a neurogenic syndrome, including dementia or encephalopathy;
and a major depressive disorder when adequate treatment for major depressive disorder has
not improved the client's neurocognitive functioning; or another disorder, including autism,
selective mutism, anxiety disorder, or reactive attachment disorder.
new text end

new text begin (d) Neuropsychological testing must be administered or clinically supervised by a
qualified neuropsychologist under subdivision 8, paragraph (c).
new text end

new text begin (e) Medical assistance does not cover neuropsychological testing of a client when the
testing is:
new text end

new text begin (1) primarily for educational purposes;
new text end

new text begin (2) primarily for vocational counseling or training;
new text end

new text begin (3) for personnel or employment testing;
new text end

new text begin (4) a routine battery of psychological tests given to the client at the client's inpatient
admission or during a client's continued inpatient stay; or
new text end

new text begin (5) for legal or forensic purposes.
new text end

new text begin Subd. 10. new text end

new text begin Psychological testing. new text end

new text begin (a) Subject to federal approval, medical assistance
covers psychological testing of a client.
new text end

new text begin (b) "Psychological testing" means the use of tests or other psychometric instruments to
determine the status of a client's mental, intellectual, and emotional functioning.
new text end

new text begin (c) The psychological testing must:
new text end

new text begin (1) be administered or supervised by a licensed psychologist qualified under section
245I.04, subdivision 2, clause (3), who is competent in the area of psychological testing;
and
new text end

new text begin (2) be validated in a face-to-face interview between the client and a licensed psychologist
or a clinical trainee in psychology under the treatment supervision of a licensed psychologist
under section 245I.06.
new text end

new text begin (d) A licensed psychologist must supervise the administration, scoring, and interpretation
of a client's psychological tests when a clinical psychology trainee, technician, psychometrist,
or psychological assistant or a computer-assisted psychological testing program completes
the psychological testing of the client. The report resulting from the psychological testing
must be signed by the licensed psychologist who conducts the face-to-face interview with
the client. The licensed psychologist or a staff person who is under treatment supervision
must place the client's psychological testing report in the client's record and release one
copy of the report to the client and additional copies to individuals authorized by the client
to receive the report.
new text end

new text begin Subd. 11. new text end

new text begin Psychotherapy. new text end

new text begin (a) Subject to federal approval, medical assistance covers
psychotherapy for a client.
new text end

new text begin (b) "Psychotherapy" means treatment of a client with mental illness that applies to the
most appropriate psychological, psychiatric, psychosocial, or interpersonal method that
conforms to prevailing community standards of professional practice to meet the mental
health needs of the client. Medical assistance covers psychotherapy if a mental health
professional or a clinical trainee provides psychotherapy to a client.
new text end

new text begin (c) "Individual psychotherapy" means psychotherapy that a mental health professional
or clinical trainee designs for a client.
new text end

new text begin (d) "Family psychotherapy" means psychotherapy that a mental health professional or
clinical trainee designs for a client and one or more and the client's family members or
primary caregiver whose participation is necessary to accomplish the client's treatment
goals. Family members or primary caregivers participating in a therapy session do not need
to be eligible for medical assistance for medical assistance to cover family psychotherapy.
For purposes of this paragraph, "primary caregiver whose participation is necessary to
accomplish the client's treatment goals" excludes shift or facility staff persons who work at
the client's residence. Medical assistance payments for family psychotherapy are limited to
face-to-face sessions during which the client is present throughout the session, unless the
mental health professional or clinical trainee believes that the client's exclusion from the
family psychotherapy session is necessary to meet the goals of the client's individual
treatment plan. If the client is excluded from a family psychotherapy session, a mental health
professional or clinical trainee must document the reason for the client's exclusion and the
length of time that the client is excluded. The mental health professional must also document
any reason that a member of the client's family is excluded from a psychotherapy session.
new text end

new text begin (e) Group psychotherapy is appropriate for a client who, because of the nature of the
client's emotional, behavioral, or social dysfunctions, can benefit from treatment in a group
setting. For a group of three to eight clients, at least one mental health professional or clinical
trainee must provide psychotherapy to the group. For a group of nine to 12 clients, a team
of at least two mental health professionals or two clinical trainees or one mental health
professional and one clinical trainee must provide psychotherapy to the group. Medical
assistance will cover group psychotherapy for a group of no more than 12 persons.
new text end

new text begin (f) A multiple-family group psychotherapy session is eligible for medical assistance if
a mental health professional or clinical trainee designs the psychotherapy session for at least
two but not more than five families. A mental health professional or clinical trainee must
design multiple-family group psychotherapy sessions to meet the treatment needs of each
client. If the client is excluded from a psychotherapy session, the mental health professional
or clinical trainee must document the reason for the client's exclusion and the length of time
that the client was excluded. The mental health professional or clinical trainee must document
any reason that a member of the client's family was excluded from a psychotherapy session.
new text end

new text begin Subd. 12. new text end

new text begin Partial hospitalization. new text end

new text begin (a) Subject to federal approval, medical assistance
covers a client's partial hospitalization.
new text end

new text begin (b) "Partial hospitalization" means a provider's time-limited, structured program of
psychotherapy and other therapeutic services, as defined in United States Code, title 42,
chapter 7, subchapter XVIII, part E, section 1395x(ff), that a multidisciplinary staff person
provides in an outpatient hospital facility or community mental health center that meets
Medicare requirements to provide partial hospitalization services to a client.
new text end

new text begin (c) Partial hospitalization is an appropriate alternative to inpatient hospitalization for a
client who is experiencing an acute episode of mental illness who meets the criteria for an
inpatient hospital admission under Minnesota Rules, part 9505.0520, subpart 1, and who
has family and community resources that support the client's residence in the community.
Partial hospitalization consists of multiple intensive short-term therapeutic services for a
client that a multidisciplinary staff person provides to a client to treat the client's mental
illness.
new text end

new text begin Subd. 13. new text end

new text begin Diagnostic assessments. new text end

new text begin Subject to federal approval, medical assistance covers
a client's diagnostic assessments that a mental health professional or clinical trainee completes
under section 245I.10.
new text end

Sec. 18. new text beginDIRECTION TO COMMISSIONER; SINGLE COMPREHENSIVE
LICENSE STRUCTURE.
new text end

new text begin The commissioner of human services, in consultation with stakeholders including
counties, tribes, managed care organizations, provider organizations, advocacy groups, and
clients and clients' families, shall develop recommendations to develop a single
comprehensive licensing structure for mental health service programs, including outpatient
and residential services for adults and children. The recommendations must prioritize
program integrity, the welfare of clients and clients' families, improved integration of mental
health and substance use disorder services, and the reduction of administrative burden on
providers.
new text end

ARTICLE 2

CRISIS RESPONSE SERVICES

Section 1.

Minnesota Statutes 2020, section 245.469, subdivision 1, is amended to read:


Subdivision 1.

Availability of emergency services.

deleted text beginBy July 1, 1988,deleted text end new text begin(a)new text end County boards
must provide or contract for enough emergency services within the county to meet the needs
of adultsnew text begin, children, and familiesnew text end in the county who are experiencing an emotional crisis or
mental illness. Clients may be required to pay a fee according to section 245.481. new text beginEmergency
service providers must not delay the timely provision of emergency services to a client
because of delays in determining the fee under section 245.481 or because of the
unwillingness or inability of the client to pay the fee.
new text endEmergency services must include
assessment, crisis intervention, and appropriate case disposition. Emergency services must:

(1) promote the safety and emotional stability of deleted text beginadults with mental illness or emotional
crises
deleted text endnew text begin each clientnew text end;

(2) minimize further deterioration of deleted text beginadults with mental illness or emotional crisesdeleted text endnew text begin each
client
new text end;

(3) help deleted text beginadults with mental illness or emotional crisesdeleted text endnew text begin each clientnew text end to obtain ongoing care
and treatment; deleted text beginand
deleted text end

(4) prevent placement in settings that are more intensive, costly, or restrictive than
necessary and appropriate to meet client needsdeleted text begin.deleted text endnew text begin; and
new text end

new text begin (5) provide support, psychoeducation, and referrals to each client's family members,
service providers, and other third parties on behalf of the client in need of emergency
services.
new text end

new text begin (b) If a county provides engagement services under section 253B.041, the county's
emergency service providers must refer clients to engagement services when the client
meets the criteria for engagement services.
new text end

Sec. 2.

Minnesota Statutes 2020, section 245.469, subdivision 2, is amended to read:


Subd. 2.

Specific requirements.

(a) The county board shall require that all service
providers of emergency services to adults with mental illness provide immediate direct
access to a mental health professional during regular business hours. For evenings, weekends,
and holidays, the service may be by direct toll-free telephone access to a mental health
professional, deleted text beginadeleted text endnew text begin clinical trainee, ornew text end mental health practitionerdeleted text begin, or until January 1, 1991, a
designated person with training in human services who receives clinical supervision from
a mental health professional
deleted text end.

(b) The commissioner may waive the requirement in paragraph (a) that the evening,
weekend, and holiday service be provided by a mental health professionalnew text begin, clinical trainee,new text end
or mental health practitioner deleted text beginafter January 1, 1991,deleted text end if the county documents that:

(1) mental health professionalsnew text begin, clinical trainees,new text end or mental health practitioners are
unavailable to provide this service;

(2) services are provided by a designated person with training in human services who
receives deleted text beginclinicaldeleted text endnew text begin treatmentnew text end supervision from a mental health professional; and

(3) the service provider is not also the provider of fire and public safety emergency
services.

(c) The commissioner may waive the requirement in paragraph (b), clause (3), that the
evening, weekend, and holiday service not be provided by the provider of fire and public
safety emergency services if:

(1) every person who will be providing the first telephone contact has received at least
eight hours of training on emergency mental health services deleted text beginreviewed by the state advisory
council on mental health and then
deleted text end approved by the commissioner;

(2) every person who will be providing the first telephone contact will annually receive
at least four hours of continued training on emergency mental health services deleted text beginreviewed by
the state advisory council on mental health and then
deleted text end approved by the commissioner;

(3) the local social service agency has provided public education about available
emergency mental health services and can assure potential users of emergency services that
their calls will be handled appropriately;

(4) the local social service agency agrees to provide the commissioner with accurate
data on the number of emergency mental health service calls received;

(5) the local social service agency agrees to monitor the frequency and quality of
emergency services; and

(6) the local social service agency describes how it will comply with paragraph (d).

(d) Whenever emergency service during nonbusiness hours is provided by anyone other
than a mental health professional, a mental health professional must be available on call for
an emergency assessment and crisis intervention services, and must be available for at least
telephone consultation within 30 minutes.

Sec. 3.

Minnesota Statutes 2020, section 245.4879, subdivision 1, is amended to read:


Subdivision 1.

Availability of emergency services.

County boards must provide or
contract for deleted text beginenoughdeleted text end mental health emergency services deleted text beginwithin the county to meet the needs
of children, and children's families when clinically appropriate, in the county who are
experiencing an emotional crisis or emotional disturbance. The county board shall ensure
that parents, providers, and county residents are informed about when and how to access
emergency mental health services for children. A child or the child's parent may be required
to pay a fee according to section 245.481. Emergency service providers shall not delay the
timely provision of emergency service because of delays in determining this fee or because
of the unwillingness or inability of the parent to pay the fee. Emergency services must
include assessment, crisis intervention, and appropriate case disposition. Emergency services
must:
deleted text endnew text begin according to section 245.469.
new text end

deleted text begin (1) promote the safety and emotional stability of children with emotional disturbances
or emotional crises;
deleted text end

deleted text begin (2) minimize further deterioration of the child with emotional disturbance or emotional
crisis;
deleted text end

deleted text begin (3) help each child with an emotional disturbance or emotional crisis to obtain ongoing
care and treatment; and
deleted text end

deleted text begin (4) prevent placement in settings that are more intensive, costly, or restrictive than
necessary and appropriate to meet the child's needs.
deleted text end

Sec. 4.

Minnesota Statutes 2020, section 256B.0624, is amended to read:


256B.0624 deleted text beginADULTdeleted text end CRISIS RESPONSE SERVICES COVERED.

Subdivision 1.

Scope.

deleted text beginMedical assistance covers adult mental health crisis response
services as defined in subdivision 2, paragraphs (c) to (e),
deleted text end new text begin(a) new text endSubject to federal approval,
deleted text begin if provided to a recipient as defined in subdivision 3 and provided by a qualified provider
entity as defined in this section and by a qualified individual provider working within the
provider's scope of practice and as defined in this subdivision and identified in the recipient's
individual crisis treatment plan as defined in subdivision 11 and if determined to be medically
necessary
deleted text endnew text begin medical assistance covers medically necessary crisis response services when the
services are provided according to the standards in this section
new text end.

new text begin (b) Subject to federal approval, medical assistance covers medically necessary residential
crisis stabilization for adults when the services are provided by an entity licensed under and
meeting the standards in section 245I.23.
new text end

new text begin (c) The provider entity must make reasonable and good faith efforts to report individual
client outcomes to the commissioner using instruments and protocols approved by the
commissioner.
new text end

Subd. 2.

Definitions.

For purposes of this section, the following terms have the meanings
given them.

deleted text begin (a) "Mental health crisis" is an adult behavioral, emotional, or psychiatric situation
which, but for the provision of crisis response services, would likely result in significantly
reduced levels of functioning in primary activities of daily living, or in an emergency
situation, or in the placement of the recipient in a more restrictive setting, including, but
not limited to, inpatient hospitalization.
deleted text end

deleted text begin (b) "Mental health emergency" is an adult behavioral, emotional, or psychiatric situation
which causes an immediate need for mental health services and is consistent with section
62Q.55.
deleted text end

deleted text begin A mental health crisis or emergency is determined for medical assistance service
reimbursement by a physician, a mental health professional, or crisis mental health
practitioner with input from the recipient whenever possible.
deleted text end

new text begin (a) "Certified rehabilitation specialist" means a staff person who is qualified under section
245I.04, subdivision 8.
new text end

new text begin (b) "Clinical trainee" means a staff person who is qualified under section 245I.04,
subdivision 6.
new text end

(c) "deleted text beginMental healthdeleted text end Crisis assessment" means an immediate face-to-face assessment by
a physician, a mental health professional, or deleted text beginmental health practitioner under the clinical
supervision of a mental health professional, following a screening that suggests that the
adult may be experiencing a mental health crisis or mental health emergency situation. It
includes, when feasible, assessing whether the person might be willing to voluntarily accept
treatment, determining whether the person has an advance directive, and obtaining
information and history from involved family members or caretakers
deleted text endnew text begin a qualified member
of a crisis team, as described in subdivision 6a
new text end.

(d) "deleted text beginMental health mobiledeleted text end Crisis intervention deleted text beginservicesdeleted text end" means face-to-face, short-term
intensive mental health services initiated during a mental health crisis deleted text beginor mental health
emergency
deleted text end to help the recipient cope with immediate stressors, identify and utilize available
resources and strengths, engage in voluntary treatment, and begin to return to the recipient's
baseline level of functioning. deleted text beginThe services, including screening and treatment plan
recommendations, must be culturally and linguistically appropriate.
deleted text end

deleted text begin (1) This service is provided on site by a mobile crisis intervention team outside of an
inpatient hospital setting. Mental health mobile crisis intervention services must be available
24 hours a day, seven days a week.
deleted text end

deleted text begin (2) The initial screening must consider other available services to determine which
service intervention would best address the recipient's needs and circumstances.
deleted text end

deleted text begin (3) The mobile crisis intervention team must be available to meet promptly face-to-face
with a person in mental health crisis or emergency in a community setting or hospital
emergency room.
deleted text end

deleted text begin (4) The intervention must consist of a mental health crisis assessment and a crisis
treatment plan.
deleted text end

deleted text begin (5) The team must be available to individuals who are experiencing a co-occurring
substance use disorder, who do not need the level of care provided in a detoxification facility.
deleted text end

deleted text begin (6) The treatment plan must include recommendations for any needed crisis stabilization
services for the recipient, including engagement in treatment planning and family
psychoeducation.
deleted text end

new text begin (e) "Crisis screening" means a screening of a client's potential mental health crisis
situation under subdivision 6.
new text end

deleted text begin (e)deleted text endnew text begin (f)new text end "deleted text beginMental healthdeleted text end Crisis stabilization deleted text beginservicesdeleted text end" means individualized mental health
services provided to a recipient deleted text beginfollowing crisis intervention servicesdeleted text end which are designed
to restore the recipient to the recipient's prior functional level. deleted text beginMental healthdeleted text end Crisis
stabilization services may be provided in the recipient's home, the home of a family member
or friend of the recipient, another community setting, or a short-term supervised, licensed
residential program. deleted text beginMental health crisis stabilization does not include partial hospitalization
or day treatment. Mental health
deleted text end Crisis stabilization services includes family psychoeducation.

new text begin (g) "Crisis team" means the staff of a provider entity who are supervised and prepared
to provide mobile crisis services to a client in a potential mental health crisis situation.
new text end

new text begin (h) "Mental health certified family peer specialist" means a staff person who is qualified
under section 245I.04, subdivision 12.
new text end

new text begin (i) "Mental health certified peer specialist" means a staff person who is qualified under
section 245I.04, subdivision 10.
new text end

new text begin (j) "Mental health crisis" is a behavioral, emotional, or psychiatric situation that, without
the provision of crisis response services, would likely result in significantly reducing the
recipient's levels of functioning in primary activities of daily living, in an emergency situation
under section 62Q.55, or in the placement of the recipient in a more restrictive setting,
including but not limited to inpatient hospitalization.
new text end

new text begin (k) "Mental health practitioner" means a staff person who is qualified under section
245I.04, subdivision 4.
new text end

new text begin (l) "Mental health professional" means a staff person who is qualified under section
245I.04, subdivision 2.
new text end

new text begin (m) "Mental health rehabilitation worker" means a staff person who is qualified under
section 245I.04, subdivision 14.
new text end

new text begin (n) "Mobile crisis services" means screening, assessment, intervention, and community
based stabilization, excluding residential crisis stabilization, that is provided to a recipient.
new text end

Subd. 3.

Eligibility.

deleted text begin An eligible recipient is an individual who:
deleted text end

deleted text begin (1) is age 18 or older;
deleted text end

deleted text begin (2) is screened as possibly experiencing a mental health crisis or emergency where a
mental health crisis assessment is needed; and
deleted text end

deleted text begin (3) is assessed as experiencing a mental health crisis or emergency, and mental health
crisis intervention or crisis intervention and stabilization services are determined to be
medically necessary.
deleted text end

new text begin (a) A recipient is eligible for crisis assessment services when the recipient has screened
positive for a potential mental health crisis during a crisis screening.
new text end

new text begin (b) A recipient is eligible for crisis intervention services and crisis stabilization services
when the recipient has been assessed during a crisis assessment to be experiencing a mental
health crisis.
new text end

Subd. 4.

Provider entity standards.

(a) A deleted text beginprovider entity is an entity that meets the
standards listed in paragraph (c) and
deleted text endnew text begin mobile crisis provider must benew text end:

(1) deleted text beginisdeleted text end a county board operated entity; deleted text beginor
deleted text end

new text begin (2) an Indian health services facility or facility owned and operated by a tribe or tribal
organization operating under United States Code, title 325, section 450f; or
new text end

deleted text begin (2) isdeleted text endnew text begin (3)new text end a provider entity that is under contract with the county board in the county
where the potential crisis or emergency is occurring. To provide services under this section,
the provider entity must directly provide the services; or if services are subcontracted, the
provider entity must maintain responsibility for services and billing.

new text begin (b) A mobile crisis provider must meet the following standards:
new text end

new text begin (1) must ensure that crisis screenings, crisis assessments, and crisis intervention services
are available to a recipient 24 hours a day, seven days a week;
new text end

new text begin (2) must be able to respond to a call for services in a designated service area or according
to a written agreement with the local mental health authority for an adjacent area;
new text end

new text begin (3) must have at least one mental health professional on staff at all times and at least
one additional staff member capable of leading a crisis response in the community; and
new text end

new text begin (4) must provide the commissioner with information about the number of requests for
service, the number of people that the provider serves face-to-face, outcomes, and the
protocols that the provider uses when deciding when to respond in the community.
new text end

deleted text begin (b)deleted text endnew text begin (c)new text end A provider entity that provides crisis stabilization services in a residential setting
under subdivision 7 is not required to meet the requirements of deleted text beginparagraphdeleted text endnew text begin paragraphsnew text end (a)deleted text begin,
clauses (1) and (2)
deleted text endnew text begin to (b)new text end, but must meet all other requirements of this subdivision.

deleted text begin (c) The adult mental healthdeleted text endnew text begin (d) Anew text end crisis deleted text beginresponsedeleted text end services provider deleted text beginentitydeleted text end must have the
capacity to meet and carry out the new text beginstandards in section 245I.011, subdivision 5, and the
new text end following standards:

(1) deleted text beginhas the capacity to recruit, hire, and manage and train mental health professionals,
practitioners, and rehabilitation workers
deleted text endnew text begin ensures that staff persons provide support for a
recipient's family and natural supports, by enabling the recipient's family and natural supports
to observe and participate in the recipient's treatment, assessments, and planning services
new text end;

(2) has adequate administrative ability to ensure availability of services;

deleted text begin (3) is able to ensure adequate preservice and in-service training;
deleted text end

deleted text begin (4)deleted text endnew text begin (3)new text end is able to ensure that staff providing these services are skilled in the delivery of
mental health crisis response services to recipients;

deleted text begin (5)deleted text endnew text begin (4)new text end is able to ensure that staff are deleted text begincapable ofdeleted text end implementing culturally specific treatment
identified in the deleted text beginindividualdeleted text endnew text begin crisisnew text end treatment plan that is meaningful and appropriate as
determined by the recipient's culture, beliefs, values, and language;

deleted text begin (6)deleted text endnew text begin (5)new text end is able to ensure enough flexibility to respond to the changing intervention and
care needs of a recipient as identified by the recipient new text beginor family membernew text end during the service
partnership between the recipient and providers;

deleted text begin (7)deleted text endnew text begin (6)new text end is able to ensure that deleted text beginmental health professionals and mental health practitionersdeleted text endnew text begin
staff
new text end have the communication tools and procedures to communicate and consult promptly
about crisis assessment and interventions as services occur;

deleted text begin (8)deleted text endnew text begin (7)new text end is able to coordinate these services with county emergency services, community
hospitals, ambulance, transportation services, social services, law enforcementnew text begin, engagement
services
new text end, and mental health crisis services through regularly scheduled interagency meetings;

deleted text begin (9) is able to ensure that mental health crisis assessment and mobile crisis intervention
services are available 24 hours a day, seven days a week;
deleted text end

deleted text begin (10)deleted text endnew text begin (8)new text end is able to ensure that services are coordinated with other deleted text beginmentaldeleted text endnew text begin behavioralnew text end
health service providers, county mental health authorities, or federally recognized American
Indian authorities and others as necessary, with the consent of the deleted text beginadultdeleted text endnew text begin recipient or parent
or guardian
new text end. Services must also be coordinated with the recipient's case manager if the deleted text beginadultdeleted text endnew text begin
recipient
new text end is receiving case management services;

deleted text begin (11)deleted text endnew text begin (9)new text end is able to ensure that crisis intervention services are provided in a manner
consistent with sections 245.461 to 245.486new text begin and 245.487 to 245.4879new text end;

deleted text begin (12) is able to submit information as required by the state;
deleted text end

deleted text begin (13) maintains staff training and personnel files;
deleted text end

new text begin (10) is able to coordinate detoxification services for the recipient according to Minnesota
Rules, parts 9530.6605 to 9530.6655, or withdrawal management according to chapter 245F;
new text end

deleted text begin (14)deleted text endnew text begin (11)new text end is able to establish and maintain a quality assurance and evaluation plan to
evaluate the outcomes of services and recipient satisfaction;new text begin and
new text end

deleted text begin (15) is able to keep records as required by applicable laws;
deleted text end

deleted text begin (16) is able to comply with all applicable laws and statutes;
deleted text end

deleted text begin (17)deleted text endnew text begin (12)new text end is an enrolled medical assistance providerdeleted text begin; anddeleted text endnew text begin.
new text end

deleted text begin (18) develops and maintains written policies and procedures regarding service provision
and administration of the provider entity, including safety of staff and recipients in high-risk
situations.
deleted text end

Subd. 4a.

Alternative provider standards.

If a county new text beginor tribe new text enddemonstrates that, due
to geographic or other barriers, it is not feasible to provide mobile crisis intervention services
according to the standards in subdivision 4, paragraph deleted text begin(c), clause (9)deleted text endnew text begin (b)new text end, the commissioner
may approve deleted text begina crisis response provider based ondeleted text end an alternative plan proposed by a county
or deleted text begingroup of countiesdeleted text endnew text begin tribenew text end. The alternative plan must:

(1) result in increased access and a reduction in disparities in the availability of new text beginmobile
new text end crisis services;

(2) provide mobile new text begincrisis new text endservices outside of the usual nine-to-five office hours and on
weekends and holidays; and

(3) comply with standards for emergency mental health services in section 245.469.

Subd. 5.

deleted text beginMobiledeleted text end Crisis new text beginassessment and new text endintervention staff qualifications.

deleted text beginFor provision
of adult mental health mobile crisis intervention services, a mobile crisis intervention team
is comprised of at least two mental health professionals as defined in section 245.462,
subdivision 18
, clauses (1) to (6), or a combination of at least one mental health professional
and one mental health practitioner as defined in section 245.462, subdivision 17, with the
required mental health crisis training and under the clinical supervision of a mental health
professional on the team. The team must have at least two people with at least one member
providing on-site crisis intervention services when needed.
deleted text end new text begin(a) Qualified individual staff of
a qualified provider entity must provide crisis assessment and intervention services to a
recipient. A staff member providing crisis assessment and intervention services to a recipient
must be qualified as a:
new text end

new text begin (1) mental health professional;
new text end

new text begin (2) clinical trainee;
new text end

new text begin (3) mental health practitioner;
new text end

new text begin (4) mental health certified family peer specialist; or
new text end

new text begin (5) mental health certified peer specialist.
new text end

new text begin (b) When crisis assessment and intervention services are provided to a recipient in the
community, a mental health professional, clinical trainee, or mental health practitioner must
lead the response.
new text end

new text begin (c) The 30 hours of ongoing training required by section 245I.05, subdivision 4, paragraph
(b), must be specific to providing crisis services to children and adults and include training
about evidence-based practices identified by the commissioner of health to reduce the
recipient's risk of suicide and self-injurious behavior.
new text end

new text begin (d) new text endTeam members must be experienced in deleted text beginmental healthdeleted text endnew text begin crisisnew text end assessment, crisis
intervention techniques, treatment engagement strategies, working with families, and clinical
decision-making under emergency conditions and have knowledge of local services and
resources. deleted text beginThe team must recommend and coordinate the team's services with appropriate
local resources such as the county social services agency, mental health services, and local
law enforcement when necessary.
deleted text end

Subd. 6.

Crisis deleted text beginassessment and mobile intervention treatment planningdeleted text endnew text begin screeningnew text end.

(a)
deleted text begin Prior to initiating mobile crisis intervention services, a screening of the potential crisis
situation must be conducted.
deleted text end The new text begincrisis new text endscreening may use the resources of deleted text begincrisis assistance
and
deleted text end emergency services as defined in deleted text beginsections 245.462, subdivision 6, anddeleted text endnew text begin sectionnew text end 245.469,
subdivisions 1 and 2. The new text begincrisis new text endscreening must gather information, determine whether a
new text begin mental health new text endcrisis situation exists, identify parties involved, and determine an appropriate
response.

new text begin (b) When conducting the crisis screening of a recipient, a provider must:
new text end

new text begin (1) employ evidence-based practices to reduce the recipient's risk of suicide and
self-injurious behavior;
new text end

new text begin (2) work with the recipient to establish a plan and time frame for responding to the
recipient's mental health crisis, including responding to the recipient's immediate need for
support by telephone or text message until the provider can respond to the recipient
face-to-face;
new text end

new text begin (3) document significant factors in determining whether the recipient is experiencing a
mental health crisis, including prior requests for crisis services, a recipient's recent
presentation at an emergency department, known calls to 911 or law enforcement, or
information from third parties with knowledge of a recipient's history or current needs;
new text end

new text begin (4) accept calls from interested third parties and consider the additional needs or potential
mental health crises that the third parties may be experiencing;
new text end

new text begin (5) provide psychoeducation, including means reduction, to relevant third parties
including family members or other persons living with the recipient; and
new text end

new text begin (6) consider other available services to determine which service intervention would best
address the recipient's needs and circumstances.
new text end

new text begin (c) For the purposes of this section, the following situations indicate a positive screen
for a potential mental health crisis and the provider must prioritize providing a face-to-face
crisis assessment of the recipient, unless a provider documents specific evidence to show
why this was not possible, including insufficient staffing resources, concerns for staff or
recipient safety, or other clinical factors:
new text end

new text begin (1) the recipient presents at an emergency department or urgent care setting and the
health care team at that location requested crisis services; or
new text end

new text begin (2) a peace officer requested crisis services for a recipient who is potentially subject to
transportation under section 253B.051.
new text end

new text begin (d) A provider is not required to have direct contact with the recipient to determine that
the recipient is experiencing a potential mental health crisis. A mobile crisis provider may
gather relevant information about the recipient from a third party at the scene to establish
the recipient's need for services and potential safety factors.
new text end

new text begin Subd. 6a. new text end

new text begin Crisis assessment. new text end

deleted text begin(b)deleted text endnew text begin (a)new text end If a deleted text begincrisis existsdeleted text endnew text begin recipient screens positive for
potential mental health crisis
new text end, a crisis assessment must be completed. A crisis assessment
evaluates any immediate needs for which deleted text beginemergencydeleted text end services are needed and, as time
permits, the recipient's current life situation, new text beginhealth information, including current
medications,
new text endsources of stress, mental health problems and symptoms, strengths, cultural
considerations, support network, vulnerabilities, current functioning, and the recipient's
preferences as communicated directly by the recipient, or as communicated in a health care
directive as described in chapters 145C and 253B, the new text begincrisis new text endtreatment plan described under
deleted text begin paragraph (d)deleted text endnew text begin subdivision 11new text end, a crisis prevention plan, or a wellness recovery action plan.

new text begin (b) A provider must conduct a crisis assessment at the recipient's location whenever
possible.
new text end

new text begin (c) Whenever possible, the assessor must attempt to include input from the recipient and
the recipient's family and other natural supports to assess whether a crisis exists.
new text end

new text begin (d) A crisis assessment includes determining: (1) whether the recipient is willing to
voluntarily engage in treatment or (2) has an advance directive and (3) gathering the
recipient's information and history from involved family or other natural supports.
new text end

new text begin (e) A crisis assessment must include coordinated response with other health care providers
if the assessment indicates that a recipient needs detoxification, withdrawal management,
or medical stabilization in addition to crisis response services. If the recipient does not need
an acute level of care, a team must serve an otherwise eligible recipient who has a
co-occurring substance use disorder.
new text end

new text begin (f) If, after completing a crisis assessment of a recipient, a provider refers a recipient to
an intensive setting, including an emergency department, inpatient hospitalization, or
residential crisis stabilization, one of the crisis team members who completed or conferred
about the recipient's crisis assessment must immediately contact the referral entity and
consult with the triage nurse or other staff responsible for intake at the referral entity. During
the consultation, the crisis team member must convey key findings or concerns that led to
the recipient's referral. Following the immediate consultation, the provider must also send
written documentation upon completion. The provider must document if these releases
occurred with authorization by the recipient, the recipient's legal guardian, or as allowed
by section 144.293, subdivision 5.
new text end

new text begin Subd. 6b. new text end

new text begin Crisis intervention services. new text end

deleted text begin(c)deleted text endnew text begin (a)new text end If the crisis assessment determines mobile
crisis intervention services are needed, the new text begincrisis new text endintervention services must be provided
promptly. As opportunity presents during the intervention, at least two members of the
mobile crisis intervention team must confer directly or by telephone about the new text begincrisis
new text end assessment, new text begincrisis new text endtreatment plan, and actions taken and needed. At least one of the team
members must be deleted text beginon sitedeleted text end providing new text beginface-to-face new text endcrisis intervention services. If providing
deleted text begin on-sitedeleted text end crisis intervention services, a new text beginclinical trainee or new text endmental health practitioner must seek
deleted text begin clinicaldeleted text endnew text begin treatmentnew text end supervision as required in subdivision 9.

new text begin (b) If a provider delivers crisis intervention services while the recipient is absent, the
provider must document the reason for delivering services while the recipient is absent.
new text end

deleted text begin (d)deleted text endnew text begin (c)new text end The mobile crisis intervention team must develop deleted text beginan initial, briefdeleted text endnew text begin anew text end crisis treatment
plan deleted text beginas soon as appropriate but no later than 24 hours after the initial face-to-face interventiondeleted text endnew text begin
according to subdivision 11
new text end. deleted text beginThe plan must address the needs and problems noted in the
crisis assessment and include
deleted text enddeleted text beginmeasurable short-term goals, cultural considerations, and
frequency and type of services to be provided to achieve the goals and reduce or eliminate
the crisis. The treatment plan must be updated as needed to reflect current goals and services.
deleted text end

deleted text begin (e)deleted text endnew text begin (d)new text end The new text beginmobile crisis intervention new text endteam must document which deleted text beginshort-term goalsdeleted text endnew text begin crisis
treatment plan goals and objectives
new text end have been met and when no further crisis intervention
services are required.

deleted text begin (f)deleted text endnew text begin (e)new text end If the recipient's new text beginmental health new text endcrisis is stabilized, but the recipient needs a referral
to other services, the team must provide referrals to these services. If the recipient has a
case manager, planning for other services must be coordinated with the case manager. If
the recipient is unable to follow up on the referral, the team must link the recipient to the
service and follow up to ensure the recipient is receiving the service.

deleted text begin (g)deleted text endnew text begin (f)new text end If the recipient's new text beginmental health new text endcrisis is stabilized and the recipient does not have
an advance directive, the case manager or crisis team shall offer to work with the recipient
to develop one.

Subd. 7.

Crisis stabilization services.

(a) Crisis stabilization services must be provided
by qualified staff of a crisis stabilization services provider entity and must meet the following
standards:

(1) a crisis deleted text beginstabilizationdeleted text end treatment plan must be developed deleted text beginwhichdeleted text endnew text begin thatnew text end meets the criteria
in subdivision 11;

(2) staff must be qualified as defined in subdivision 8; deleted text beginand
deleted text end

(3) new text begincrisis stabilization new text endservices must be delivered according to the new text begincrisis new text endtreatment plan
and include face-to-face contact with the recipient by qualified staff for further assessment,
help with referrals, updating of the crisis deleted text beginstabilizationdeleted text end treatment plan, deleted text beginsupportive counseling,deleted text end
skills training, and collaboration with other service providers in the communitydeleted text begin.deleted text endnew text begin; and
new text end

new text begin (4) if a provider delivers crisis stabilization services while the recipient is absent, the
provider must document the reason for delivering services while the recipient is absent.
new text end

deleted text begin (b) If crisis stabilization services are provided in a supervised, licensed residential setting,
the recipient must be contacted face-to-face daily by a qualified mental health practitioner
or mental health professional. The program must have 24-hour-a-day residential staffing
which may include staff who do not meet the qualifications in subdivision 8. The residential
staff must have 24-hour-a-day immediate direct or telephone access to a qualified mental
health professional or practitioner.
deleted text end

deleted text begin (c)deleted text endnew text begin (b)new text end If crisis stabilization services are provided in a supervised, licensed residential
setting that serves no more than four adult residents, and one or more individuals are present
at the setting to receive residential crisis stabilization deleted text beginservicesdeleted text end, the residential staff must
include, for at least eight hours per day, at least one deleted text beginindividual who meets the qualifications
in subdivision 8, paragraph (a), clause (1) or (2)
deleted text endnew text begin mental health professional, clinical trainee,
certified rehabilitation specialist, or mental health practitioner
new text end.

deleted text begin (d) If crisis stabilization services are provided in a supervised, licensed residential setting
that serves more than four adult residents, and one or more are recipients of crisis stabilization
services, the residential staff must include, for 24 hours a day, at least one individual who
meets the qualifications in subdivision 8. During the first 48 hours that a recipient is in the
residential program, the residential program must have at least two staff working 24 hours
a day. Staffing levels may be adjusted thereafter according to the needs of the recipient as
specified in the crisis stabilization treatment plan.
deleted text end

Subd. 8.

deleted text beginAdultdeleted text end Crisis stabilization staff qualifications.

(a) deleted text beginAdultdeleted text end Mental health crisis
stabilization services must be provided by qualified individual staff of a qualified provider
entity. deleted text beginIndividual provider staff must have the following qualificationsdeleted text endnew text begin A staff member
providing crisis stabilization services to a recipient must be qualified as a
new text end:

(1) deleted text beginbe adeleted text end mental health professional deleted text beginas defined in section 245.462, subdivision 18, clauses
(1) to (6)
deleted text end;

(2) deleted text beginbe adeleted text endnew text begin certified rehabilitation specialist;
new text end

new text begin (3) clinical trainee;
new text end

new text begin (4)new text end mental health practitioner deleted text beginas defined in section 245.462, subdivision 17. The mental
health practitioner must work under the clinical supervision of a mental health professional
deleted text end;

new text begin (5) mental health certified family peer specialist;
new text end

deleted text begin (3) be adeleted text endnew text begin (6) mental healthnew text end certified peer specialist deleted text beginunder section 256B.0615. The certified
peer specialist must work under the clinical supervision of a mental health professional
deleted text end; or

deleted text begin (4) be adeleted text endnew text begin (7)new text end mental health rehabilitation worker deleted text beginwho meets the criteria in section
256B.0623, subdivision 5, paragraph (a), clause (4); works under the direction of a mental
health practitioner as defined in section 245.462, subdivision 17, or under direction of a
mental health professional; and works under the clinical supervision of a mental health
professional
deleted text end.

(b) deleted text beginMental health practitioners and mental health rehabilitation workers must have
completed at least 30 hours of training in crisis intervention and stabilization during the
past two years.
deleted text endnew text begin The 30 hours of ongoing training required in section 245I.05, subdivision
4, paragraph (b), must be specific to providing crisis services to children and adults and
include training about evidence-based practices identified by the commissioner of health
to reduce a recipient's risk of suicide and self-injurious behavior.
new text end

Subd. 9.

Supervision.

new text beginClinical trainees and new text endmental health practitioners may provide
crisis assessment and deleted text beginmobiledeleted text end crisis intervention services if the following deleted text beginclinicaldeleted text endnew text begin treatmentnew text end
supervision requirements are met:

(1) the mental health provider entity must accept full responsibility for the services
provided;

(2) the mental health professional of the provider entitydeleted text begin, who is an employee or under
contract with the provider entity,
deleted text end must be immediately available by phone or in person for
deleted text begin clinicaldeleted text endnew text begin treatmentnew text end supervision;

(3) the mental health professional is consulted, in person or by phone, during the first
three hours when a new text beginclinical trainee or new text endmental health practitioner provides deleted text beginon-site servicedeleted text endnew text begin
crisis assessment or crisis intervention services
new text end;new text begin and
new text end

(4) the mental health professional must:

(i) review and approvenew text begin, as defined in section 245I.02, subdivision 2,new text end of the tentative
crisis assessment and crisis treatment plannew text begin within 24 hours of first providing services to the
recipient, notwithstanding section 245I.08, subdivision 3
new text end;new text begin and
new text end

(ii) document the consultationnew text begin required in clause (3).new text enddeleted text begin; and
deleted text end

deleted text begin (iii) sign the crisis assessment and treatment plan within the next business day;
deleted text end

deleted text begin (5) if the mobile crisis intervention services continue into a second calendar day, a mental
health professional must contact the recipient face-to-face on the second day to provide
services and update the crisis treatment plan; and
deleted text end

deleted text begin (6) the on-site observation must be documented in the recipient's record and signed by
the mental health professional.
deleted text end

deleted text begin Subd. 10. deleted text end

deleted text begin Recipient file. deleted text end

deleted text begin Providers of mobile crisis intervention or crisis stabilization
services must maintain a file for each recipient containing the following information:
deleted text end

deleted text begin (1) individual crisis treatment plans signed by the recipient, mental health professional,
and mental health practitioner who developed the crisis treatment plan, or if the recipient
refused to sign the plan, the date and reason stated by the recipient as to why the recipient
would not sign the plan;
deleted text end

deleted text begin (2) signed release forms;
deleted text end

deleted text begin (3) recipient health information and current medications;
deleted text end

deleted text begin (4) emergency contacts for the recipient;
deleted text end

deleted text begin (5) case records which document the date of service, place of service delivery, signature
of the person providing the service, and the nature, extent, and units of service. Direct or
telephone contact with the recipient's family or others should be documented;
deleted text end

deleted text begin (6) required clinical supervision by mental health professionals;
deleted text end

deleted text begin (7) summary of the recipient's case reviews by staff;
deleted text end

deleted text begin (8) any written information by the recipient that the recipient wants in the file; and
deleted text end

deleted text begin (9) an advance directive, if there is one available.
deleted text end

deleted text begin Documentation in the file must comply with all requirements of the commissioner.
deleted text end

Subd. 11.

new text beginCrisis new text endtreatment plan.

deleted text begin The individual crisis stabilization treatment plan must
include, at a minimum:
deleted text end

deleted text begin (1) a list of problems identified in the assessment;
deleted text end

deleted text begin (2) a list of the recipient's strengths and resources;
deleted text end

deleted text begin (3) concrete, measurable short-term goals and tasks to be achieved, including time frames
for achievement;
deleted text end

deleted text begin (4) specific objectives directed toward the achievement of each one of the goals;
deleted text end

deleted text begin (5) documentation of the participants involved in the service planning. The recipient, if
possible, must be a participant. The recipient or the recipient's legal guardian must sign the
service plan or documentation must be provided why this was not possible. A copy of the
plan must be given to the recipient and the recipient's legal guardian. The plan should include
services arranged, including specific providers where applicable;
deleted text end

deleted text begin (6) planned frequency and type of services initiated;
deleted text end

deleted text begin (7) a crisis response action plan if a crisis should occur;
deleted text end

deleted text begin (8) clear progress notes on outcome of goals;
deleted text end

deleted text begin (9) a written plan must be completed within 24 hours of beginning services with the
recipient; and
deleted text end

deleted text begin (10) a treatment plan must be developed by a mental health professional or mental health
practitioner under the clinical supervision of a mental health professional. The mental health
professional must approve and sign all treatment plans.
deleted text end

new text begin (a) Within 24 hours of the recipient's admission, the provider entity must complete the
recipient's crisis treatment plan. The provider entity must:
new text end

new text begin (1) base the recipient's crisis treatment plan on the recipient's crisis assessment;
new text end

new text begin (2) consider crisis assistance strategies that have been effective for the recipient in the
past;
new text end

new text begin (3) for a child recipient, use a child-centered, family-driven, and culturally appropriate
planning process that allows the recipient's parents and guardians to observe or participate
in the recipient's individual and family treatment services, assessment, and treatment
planning;
new text end

new text begin (4) for an adult recipient, use a person-centered, culturally appropriate planning process
that allows the recipient's family and other natural supports to observe or participate in
treatment services, assessment, and treatment planning;
new text end

new text begin (5) identify the participants involved in the recipient's treatment planning. The recipient,
if possible, must be a participant;
new text end

new text begin (6) identify the recipient's initial treatment goals, measurable treatment objectives, and
specific interventions that the license holder will use to help the recipient engage in treatment;
new text end

new text begin (7) include documentation of referral to and scheduling of services, including specific
providers where applicable;
new text end

new text begin (8) ensure that the recipient or the recipient's legal guardian approves under section
245I.02, subdivision 2, of the recipient's crisis treatment plan unless a court orders the
recipient's treatment plan under chapter 253B. If the recipient or the recipient's legal guardian
disagrees with the crisis treatment plan, the license holder must document in the client file
the reasons why the recipient disagrees with the crisis treatment plan; and
new text end

new text begin (9) ensure that a treatment supervisor approves under section 245I.02, subdivision 2, of
the recipient's treatment plan within 24 hours of the recipient's admission if a mental health
practitioner or clinical trainee completes the crisis treatment plan, notwithstanding section
245I.08, subdivision 3.
new text end

new text begin (b) The provider entity must provide the recipient and the recipient's legal guardian with
a copy of the recipient's crisis treatment plan.
new text end

Subd. 12.

Excluded services.

The following services are excluded from reimbursement
under this section:

(1) room and board services;

(2) services delivered to a recipient while admitted to an inpatient hospital;

(3) recipient transportation costs may be covered under other medical assistance
provisions, but transportation services are not an adult mental health crisis response service;

(4) services provided and billed by a provider who is not enrolled under medical
assistance to provide adult mental health crisis response services;

(5) services performed by volunteers;

(6) direct billing of time spent "on call" when not delivering services to a recipient;

(7) provider service time included in case management reimbursement. When a provider
is eligible to provide more than one type of medical assistance service, the recipient must
have a choice of provider for each service, unless otherwise provided for by law;

(8) outreach services to potential recipients; deleted text beginand
deleted text end

(9) a mental health service that is not medically necessarydeleted text begin.deleted text endnew text begin;
new text end

new text begin (10) services that a residential treatment center licensed under Minnesota Rules, chapter
2960, provides to a client;
new text end

new text begin (11) partial hospitalization or day treatment; and
new text end

new text begin (12) a crisis assessment that a residential provider completes when a daily rate is paid
for the recipient's crisis stabilization.
new text end

ARTICLE 3

UNIFORM SERVICE STANDARDS; CONFORMING CHANGES

Section 1.

Minnesota Statutes 2020, section 62A.152, subdivision 3, is amended to read:


Subd. 3.

Provider discrimination prohibited.

All group policies and group subscriber
contracts that provide benefits for mental or nervous disorder treatments in a hospital must
provide direct reimbursement for those services if performed by a mental health professionaldeleted text begin,
as defined in sections 245.462, subdivision 18, clauses (1) to (5); and 245.4871, subdivision
27
, clauses (1) to (5)
deleted text endnew text begin qualified according to section 245I.04, subdivision 2new text end, to the extent that
the services and treatment are within the scope of mental health professional licensure.

This subdivision is intended to provide payment of benefits for mental or nervous disorder
treatments performed by a licensed mental health professional in a hospital and is not
intended to change or add benefits for those services provided in policies or contracts to
which this subdivision applies.

Sec. 2.

Minnesota Statutes 2020, section 62A.3094, subdivision 1, is amended to read:


Subdivision 1.

Definitions.

(a) For purposes of this section, the terms defined in
paragraphs (b) to (d) have the meanings given.

(b) "Autism spectrum disorders" means the conditions as determined by criteria set forth
in the most recent edition of the Diagnostic and Statistical Manual of Mental Disorders of
the American Psychiatric Association.

(c) "Medically necessary care" means health care services appropriate, in terms of type,
frequency, level, setting, and duration, to the enrollee's condition, and diagnostic testing
and preventative services. Medically necessary care must be consistent with generally
accepted practice parameters as determined by physicians and licensed psychologists who
typically manage patients who have autism spectrum disorders.

(d) "Mental health professional" means a mental health professional deleted text beginas defined in section
245.4871, subdivision 27
deleted text endnew text begin qualified according to section 245I.04, subdivision 2new text end, clause (1),
(2), (3), (4), or (6), who has training and expertise in autism spectrum disorder and child
development.

Sec. 3.

Minnesota Statutes 2020, section 62Q.096, is amended to read:


62Q.096 CREDENTIALING OF PROVIDERS.

If a health plan company has initially credentialed, as providers in its provider network,
individual providers employed by or under contract with an entity that:

(1) is authorized to bill under section 256B.0625, subdivision 5;

(2) deleted text beginmeets the requirements of Minnesota Rules, parts 9520.0750 to 9520.0870deleted text endnew text begin is a mental
health clinic certified under section 245I.20
new text end;

(3) is designated an essential community provider under section 62Q.19; and

(4) is under contract with the health plan company to provide mental health services,
the health plan company must continue to credential at least the same number of providers
from that entity, as long as those providers meet the health plan company's credentialing
standards.

A health plan company shall not refuse to credential these providers on the grounds that
their provider network has a sufficient number of providers of that type.

Sec. 4.

Minnesota Statutes 2020, section 144.651, subdivision 2, is amended to read:


Subd. 2.

Definitions.

For the purposes of this section, "patient" means a person who is
admitted to an acute care inpatient facility for a continuous period longer than 24 hours, for
the purpose of diagnosis or treatment bearing on the physical or mental health of that person.
For purposes of subdivisions 4 to 9, 12, 13, 15, 16, and 18 to 20, "patient" also means a
person who receives health care services at an outpatient surgical center or at a birth center
licensed under section 144.615. "Patient" also means a minor who is admitted to a residential
program as defined in section 253C.01. For purposes of subdivisions 1, 3 to 16, 18, 20 and
30, "patient" also means any person who is receiving mental health treatment on an outpatient
basis or in a community support program or other community-based program. "Resident"
means a person who is admitted to a nonacute care facility including extended care facilities,
nursing homes, and boarding care homes for care required because of prolonged mental or
physical illness or disability, recovery from injury or disease, or advancing age. For purposes
of all subdivisions except subdivisions 28 and 29, "resident" also means a person who is
admitted to a facility licensed as a board and lodging facility under Minnesota Rules, parts
4625.0100 to 4625.2355, new text begina boarding care home under sections 144.50 to 144.56, new text endor a
supervised living facility under Minnesota Rules, parts 4665.0100 to 4665.9900, and which
operates a rehabilitation program licensed under chapter 245G new text beginor 245I, new text endor Minnesota Rules,
parts 9530.6510 to 9530.6590.

Sec. 5.

Minnesota Statutes 2020, section 144D.01, subdivision 4, is amended to read:


Subd. 4.

Housing with services establishment or establishment.

(a) "Housing with
services establishment" or "establishment" means:

(1) an establishment providing sleeping accommodations to one or more adult residents,
at least 80 percent of which are 55 years of age or older, and offering or providing, for a
fee, one or more regularly scheduled health-related services or two or more regularly
scheduled supportive services, whether offered or provided directly by the establishment
or by another entity arranged for by the establishment; or

(2) an establishment that registers under section 144D.025.

(b) Housing with services establishment does not include:

(1) a nursing home licensed under chapter 144A;

(2) a hospital, certified boarding care home, or supervised living facility licensed under
sections 144.50 to 144.56;

(3) a board and lodging establishment licensed under chapter 157 and Minnesota Rules,
parts 9520.0500 to 9520.0670, or under chapter 245D deleted text beginordeleted text endnew text begin,new text end 245Gnew text begin, or 245Inew text end;

(4) a board and lodging establishment which serves as a shelter for battered women or
other similar purpose;

(5) a family adult foster care home licensed by the Department of Human Services;

(6) private homes in which the residents are related by kinship, law, or affinity with the
providers of services;

(7) residential settings for persons with developmental disabilities in which the services
are licensed under chapter 245D;

(8) a home-sharing arrangement such as when an elderly or disabled person or
single-parent family makes lodging in a private residence available to another person in
exchange for services or rent, or both;

(9) a duly organized condominium, cooperative, common interest community, or owners'
association of the foregoing where at least 80 percent of the units that comprise the
condominium, cooperative, or common interest community are occupied by individuals
who are the owners, members, or shareholders of the units;

(10) services for persons with developmental disabilities that are provided under a license
under chapter 245D; or

(11) a temporary family health care dwelling as defined in sections 394.307 and 462.3593.

Sec. 6.

Minnesota Statutes 2020, section 144G.08, subdivision 7, as amended by Laws
2020, Seventh Special Session chapter 1, article 6, section 5, is amended to read:


Subd. 7.

Assisted living facility.

"Assisted living facility" means a facility that provides
sleeping accommodations and assisted living services to one or more adults. Assisted living
facility includes assisted living facility with dementia care, and does not include:

(1) emergency shelter, transitional housing, or any other residential units serving
exclusively or primarily homeless individuals, as defined under section 116L.361;

(2) a nursing home licensed under chapter 144A;

(3) a hospital, certified boarding care, or supervised living facility licensed under sections
144.50 to 144.56;

(4) a lodging establishment licensed under chapter 157 and Minnesota Rules, parts
9520.0500 to 9520.0670, or under chapter 245D deleted text beginordeleted text endnew text begin,new text end 245Gnew text begin, or 245Inew text end;

(5) services and residential settings licensed under chapter 245A, including adult foster
care and services and settings governed under the standards in chapter 245D;

(6) a private home in which the residents are related by kinship, law, or affinity with the
provider of services;

(7) a duly organized condominium, cooperative, and common interest community, or
owners' association of the condominium, cooperative, and common interest community
where at least 80 percent of the units that comprise the condominium, cooperative, or
common interest community are occupied by individuals who are the owners, members, or
shareholders of the units;

(8) a temporary family health care dwelling as defined in sections 394.307 and 462.3593;

(9) a setting offering services conducted by and for the adherents of any recognized
church or religious denomination for its members exclusively through spiritual means or
by prayer for healing;

(10) housing financed pursuant to sections 462A.37 and 462A.375, units financed with
low-income housing tax credits pursuant to United States Code, title 26, section 42, and
units financed by the Minnesota Housing Finance Agency that are intended to serve
individuals with disabilities or individuals who are homeless, except for those developments
that market or hold themselves out as assisted living facilities and provide assisted living
services;

(11) rental housing developed under United States Code, title 42, section 1437, or United
States Code, title 12, section 1701q;

(12) rental housing designated for occupancy by only elderly or elderly and disabled
residents under United States Code, title 42, section 1437e, or rental housing for qualifying
families under Code of Federal Regulations, title 24, section 983.56;

(13) rental housing funded under United States Code, title 42, chapter 89, or United
States Code, title 42, section 8011;

(14) a covered setting as defined in section 325F.721, subdivision 1, paragraph (b); or

(15) any establishment that exclusively or primarily serves as a shelter or temporary
shelter for victims of domestic or any other form of violence.

Sec. 7.

Minnesota Statutes 2020, section 148B.5301, subdivision 2, is amended to read:


Subd. 2.

Supervision.

(a) To qualify as a LPCC, an applicant must have completed
4,000 hours of post-master's degree supervised professional practice in the delivery of
clinical services in the diagnosis and treatment of mental illnesses and disorders in both
children and adults. The supervised practice shall be conducted according to the requirements
in paragraphs (b) to (e).

(b) The supervision must have been received under a contract that defines clinical practice
and supervision from a mental health professional deleted text beginas defined in section 245.462, subdivision
18, clauses (1) to (6), or 245.4871, subdivision 27, clauses (1) to (6)
deleted text endnew text begin qualified according to
section 245I.04, subdivision 2
new text end, or by a board-approved supervisor, who has at least two
years of postlicensure experience in the delivery of clinical services in the diagnosis and
treatment of mental illnesses and disorders. All supervisors must meet the supervisor
requirements in Minnesota Rules, part 2150.5010.

(c) The supervision must be obtained at the rate of two hours of supervision per 40 hours
of professional practice. The supervision must be evenly distributed over the course of the
supervised professional practice. At least 75 percent of the required supervision hours must
be received in person. The remaining 25 percent of the required hours may be received by
telephone or by audio or audiovisual electronic device. At least 50 percent of the required
hours of supervision must be received on an individual basis. The remaining 50 percent
may be received in a group setting.

(d) The supervised practice must include at least 1,800 hours of clinical client contact.

(e) The supervised practice must be clinical practice. Supervision includes the observation
by the supervisor of the successful application of professional counseling knowledge, skills,
and values in the differential diagnosis and treatment of psychosocial function, disability,
or impairment, including addictions and emotional, mental, and behavioral disorders.

Sec. 8.

Minnesota Statutes 2020, section 148E.120, subdivision 2, is amended to read:


Subd. 2.

Alternate supervisors.

(a) The board may approve an alternate supervisor as
determined in this subdivision. The board shall approve up to 25 percent of the required
supervision hours by a deleted text beginlicenseddeleted text end mental health professional who is competent and qualified
to provide supervision according to the mental health professional's respective licensing
board, as established by section deleted text begin245.462, subdivision 18, clauses (1) to (6), or 245.4871,
subdivision 27
, clauses (1) to (6)
deleted text endnew text begin 245I.04, subdivision 2new text end.

(b) The board shall approve up to 100 percent of the required supervision hours by an
alternate supervisor if the board determines that:

(1) there are five or fewer supervisors in the county where the licensee practices social
work who meet the applicable licensure requirements in subdivision 1;

(2) the supervisor is an unlicensed social worker who is employed in, and provides the
supervision in, a setting exempt from licensure by section 148E.065, and who has
qualifications equivalent to the applicable requirements specified in sections 148E.100 to
148E.115;

(3) the supervisor is a social worker engaged in authorized social work practice in Iowa,
Manitoba, North Dakota, Ontario, South Dakota, or Wisconsin, and has the qualifications
equivalent to the applicable requirements in sections 148E.100 to 148E.115; or

(4) the applicant or licensee is engaged in nonclinical authorized social work practice
outside of Minnesota and the supervisor meets the qualifications equivalent to the applicable
requirements in sections 148E.100 to 148E.115, or the supervisor is an equivalent mental
health professional, as determined by the board, who is credentialed by a state, territorial,
provincial, or foreign licensing agency; or

(5) the applicant or licensee is engaged in clinical authorized social work practice outside
of Minnesota and the supervisor meets qualifications equivalent to the applicable
requirements in section 148E.115, or the supervisor is an equivalent mental health
professional as determined by the board, who is credentialed by a state, territorial, provincial,
or foreign licensing agency.

(c) In order for the board to consider an alternate supervisor under this section, the
licensee must:

(1) request in the supervision plan and verification submitted according to section
148E.125 that an alternate supervisor conduct the supervision; and

(2) describe the proposed supervision and the name and qualifications of the proposed
alternate supervisor. The board may audit the information provided to determine compliance
with the requirements of this section.

Sec. 9.

Minnesota Statutes 2020, section 148F.11, subdivision 1, is amended to read:


Subdivision 1.

Other professionals.

(a) Nothing in this chapter prevents members of
other professions or occupations from performing functions for which they are qualified or
licensed. This exception includes, but is not limited to: licensed physicians; registered nurses;
licensed practical nurses; licensed psychologists and licensed psychological practitioners;
members of the clergy provided such services are provided within the scope of regular
ministries; American Indian medicine men and women; licensed attorneys; probation officers;
licensed marriage and family therapists; licensed social workers; social workers employed
by city, county, or state agencies; licensed professional counselors; licensed professional
clinical counselors; licensed school counselors; registered occupational therapists or
occupational therapy assistants; Upper Midwest Indian Council on Addictive Disorders
(UMICAD) certified counselors when providing services to Native American people; city,
county, or state employees when providing assessments or case management under Minnesota
Rules, chapter 9530; and individuals defined in section 256B.0623, subdivision 5, paragraph
(a), clauses (1) deleted text beginand (2)deleted text endnew text begin to (6)new text end, providing deleted text beginintegrated dual diagnosisdeleted text endnew text begin co-occurring substance
use disorder
new text end treatment in adult mental health rehabilitative programs certified new text beginor licensed
new text end by the Department of Human Services under section new text begin245I.23, new text end256B.0622new text begin,new text end or 256B.0623.

(b) Nothing in this chapter prohibits technicians and resident managers in programs
licensed by the Department of Human Services from discharging their duties as provided
in Minnesota Rules, chapter 9530.

(c) Any person who is exempt from licensure under this section must not use a title
incorporating the words "alcohol and drug counselor" or "licensed alcohol and drug
counselor" or otherwise hold himself or herself out to the public by any title or description
stating or implying that he or she is engaged in the practice of alcohol and drug counseling,
or that he or she is licensed to engage in the practice of alcohol and drug counseling, unless
that person is also licensed as an alcohol and drug counselor. Persons engaged in the practice
of alcohol and drug counseling are not exempt from the board's jurisdiction solely by the
use of one of the titles in paragraph (a).

Sec. 10.

Minnesota Statutes 2020, section 245.462, subdivision 1, is amended to read:


Subdivision 1.

Definitions.

The definitions in this section apply to sections 245.461 to
deleted text begin 245.486deleted text endnew text begin 245.4863new text end.

Sec. 11.

Minnesota Statutes 2020, section 245.462, subdivision 6, is amended to read:


Subd. 6.

Community support services program.

"Community support services program"
means services, other than inpatient or residential treatment services, provided or coordinated
by an identified program and staff under the deleted text beginclinicaldeleted text endnew text begin treatmentnew text end supervision of a mental health
professional designed to help adults with serious and persistent mental illness to function
and remain in the community. A community support services program includes:

(1) client outreach,

(2) medication monitoring,

(3) assistance in independent living skills,

(4) development of employability and work-related opportunities,

(5) crisis assistance,

(6) psychosocial rehabilitation,

(7) help in applying for government benefits, and

(8) housing support services.

The community support services program must be coordinated with the case management
services specified in section 245.4711.

Sec. 12.

Minnesota Statutes 2020, section 245.462, subdivision 8, is amended to read:


Subd. 8.

Day treatment services.

"Day treatment," "day treatment services," or "day
treatment program" means deleted text begina structured program of treatment and care provided to an adult
in or by: (1) a hospital accredited by the joint commission on accreditation of health
organizations and licensed under sections 144.50 to 144.55; (2) a community mental health
center under section 245.62; or (3) an entity that is under contract with the county board to
operate a program that meets the requirements of section 245.4712, subdivision 2, and
Minnesota Rules, parts 9505.0170 to 9505.0475. Day treatment consists of group
psychotherapy and other intensive therapeutic services that are provided at least two days
a week by a multidisciplinary staff under the clinical supervision of a mental health
professional. Day treatment may include education and consultation provided to families
and other individuals as part of the treatment process. The services are aimed at stabilizing
the adult's mental health status, providing mental health services, and developing and
improving the adult's independent living and socialization skills. The goal of day treatment
is to reduce or relieve mental illness and to enable the adult to live in the community. Day
treatment services are not a part of inpatient or residential treatment services. Day treatment
services are distinguished from day care by their structured therapeutic program of
psychotherapy services. The commissioner may limit medical assistance reimbursement
for day treatment to 15 hours per week per person
deleted text endnew text begin the treatment services described under
section 256B.0671, subdivision 3
new text end.

Sec. 13.

Minnesota Statutes 2020, section 245.462, subdivision 9, is amended to read:


Subd. 9.

Diagnostic assessment.

deleted text begin(a)deleted text end "Diagnostic assessment" has the meaning given in
deleted text begin Minnesota Rules, part 9505.0370, subpart 11, and is delivered as provided in Minnesota
Rules, part 9505.0372, subpart 1, items A, B, C, and E. Diagnostic assessment includes a
standard, extended, or brief diagnostic assessment, or an adult update
deleted text endnew text begin section 245I.10,
subdivisions 4 to 6
new text end.

deleted text begin (b) A brief diagnostic assessment must include a face-to-face interview with the client
and a written evaluation of the client by a mental health professional or a clinical trainee,
as provided in Minnesota Rules, part 9505.0371, subpart 5, item C. The professional or
clinical trainee must gather initial components of a standard diagnostic assessment, including
the client's:
deleted text end

deleted text begin (1) age;
deleted text end

deleted text begin (2) description of symptoms, including reason for referral;
deleted text end

deleted text begin (3) history of mental health treatment;
deleted text end

deleted text begin (4) cultural influences and their impact on the client; and
deleted text end

deleted text begin (5) mental status examination.
deleted text end

deleted text begin (c) On the basis of the initial components, the professional or clinical trainee must draw
a provisional clinical hypothesis. The clinical hypothesis may be used to address the client's
immediate needs or presenting problem.
deleted text end

deleted text begin (d) Treatment sessions conducted under authorization of a brief assessment may be used
to gather additional information necessary to complete a standard diagnostic assessment or
an extended diagnostic assessment.
deleted text end

deleted text begin (e) Notwithstanding Minnesota Rules, part 9505.0371, subpart 2, item A, subitem (1),
unit (b), prior to completion of a client's initial diagnostic assessment, a client is eligible
for psychological testing as part of the diagnostic process.
deleted text end

deleted text begin (f) Notwithstanding Minnesota Rules, part 9505.0371, subpart 2, item A, subitem (1),
unit (c), prior to completion of a client's initial diagnostic assessment, but in conjunction
with the diagnostic assessment process, a client is eligible for up to three individual or family
psychotherapy sessions or family psychoeducation sessions or a combination of the above
sessions not to exceed three sessions.
deleted text end

deleted text begin (g) Notwithstanding Minnesota Rules, part 9505.0371, subpart 2, item B, subitem (3),
unit (a), a brief diagnostic assessment may be used for a client's family who requires a
language interpreter to participate in the assessment.
deleted text end

Sec. 14.

Minnesota Statutes 2020, section 245.462, subdivision 14, is amended to read:


Subd. 14.

Individual treatment plan.

"Individual treatment plan" means deleted text begina written plan
of intervention, treatment, and services for an adult with mental illness that is developed
by a service provider under the clinical supervision of a mental health professional on the
basis of a diagnostic assessment. The plan identifies goals and objectives of treatment,
treatment strategy, a schedule for accomplishing treatment goals and objectives, and the
individual responsible for providing treatment to the adult with mental illness
deleted text endnew text begin the formulation
of planned services that are responsive to the needs and goals of a client. An individual
treatment plan must be completed according to section 245I.10, subdivisions 7 and 8
new text end.

Sec. 15.

Minnesota Statutes 2020, section 245.462, subdivision 16, is amended to read:


Subd. 16.

Mental health funds.

"Mental health funds" are funds expended under sections
245.73 and 256E.12, federal mental health block grant funds, and funds expended under
section 256D.06 to facilities licensed under new text beginsection 245I.23 or new text endMinnesota Rules, parts
9520.0500 to 9520.0670.

Sec. 16.

Minnesota Statutes 2020, section 245.462, subdivision 17, is amended to read:


Subd. 17.

Mental health practitioner.

deleted text begin(a)deleted text end "Mental health practitioner" means a new text beginstaff
new text end person deleted text beginproviding services to adults with mental illness or children with emotional disturbance
who is qualified in at least one of the ways described in paragraphs (b) to (g). A mental
health practitioner for a child client must have training working with children. A mental
health practitioner for an adult client must have training working with adults
deleted text endnew text begin qualified
according to section 245I.04, subdivision 4
new text end.

deleted text begin (b) For purposes of this subdivision, a practitioner is qualified through relevant
coursework if the practitioner completes at least 30 semester hours or 45 quarter hours in
behavioral sciences or related fields and:
deleted text end

deleted text begin (1) has at least 2,000 hours of supervised experience in the delivery of services to adults
or children with:
deleted text end

deleted text begin (i) mental illness, substance use disorder, or emotional disturbance; or
deleted text end

deleted text begin (ii) traumatic brain injury or developmental disabilities and completes training on mental
illness, recovery from mental illness, mental health de-escalation techniques, co-occurring
mental illness and substance abuse, and psychotropic medications and side effects;
deleted text end

deleted text begin (2) is fluent in the non-English language of the ethnic group to which at least 50 percent
of the practitioner's clients belong, completes 40 hours of training in the delivery of services
to adults with mental illness or children with emotional disturbance, and receives clinical
supervision from a mental health professional at least once a week until the requirement of
2,000 hours of supervised experience is met;
deleted text end

deleted text begin (3) is working in a day treatment program under section 245.4712, subdivision 2; or
deleted text end

deleted text begin (4) has completed a practicum or internship that (i) requires direct interaction with adults
or children served, and (ii) is focused on behavioral sciences or related fields.
deleted text end

deleted text begin (c) For purposes of this subdivision, a practitioner is qualified through work experience
if the person:
deleted text end

deleted text begin (1) has at least 4,000 hours of supervised experience in the delivery of services to adults
or children with:
deleted text end

deleted text begin (i) mental illness, substance use disorder, or emotional disturbance; or
deleted text end

deleted text begin (ii) traumatic brain injury or developmental disabilities and completes training on mental
illness, recovery from mental illness, mental health de-escalation techniques, co-occurring
mental illness and substance abuse, and psychotropic medications and side effects; or
deleted text end

deleted text begin (2) has at least 2,000 hours of supervised experience in the delivery of services to adults
or children with:
deleted text end

deleted text begin (i) mental illness, emotional disturbance, or substance use disorder, and receives clinical
supervision as required by applicable statutes and rules from a mental health professional
at least once a week until the requirement of 4,000 hours of supervised experience is met;
or
deleted text end

deleted text begin (ii) traumatic brain injury or developmental disabilities; completes training on mental
illness, recovery from mental illness, mental health de-escalation techniques, co-occurring
mental illness and substance abuse, and psychotropic medications and side effects; and
receives clinical supervision as required by applicable statutes and rules at least once a week
from a mental health professional until the requirement of 4,000 hours of supervised
experience is met.
deleted text end

deleted text begin (d) For purposes of this subdivision, a practitioner is qualified through a graduate student
internship if the practitioner is a graduate student in behavioral sciences or related fields
and is formally assigned by an accredited college or university to an agency or facility for
clinical training.
deleted text end

deleted text begin (e) For purposes of this subdivision, a practitioner is qualified by a bachelor's or master's
degree if the practitioner:
deleted text end

deleted text begin (1) holds a master's or other graduate degree in behavioral sciences or related fields; or
deleted text end

deleted text begin (2) holds a bachelor's degree in behavioral sciences or related fields and completes a
practicum or internship that (i) requires direct interaction with adults or children served,
and (ii) is focused on behavioral sciences or related fields.
deleted text end

deleted text begin (f) For purposes of this subdivision, a practitioner is qualified as a vendor of medical
care if the practitioner meets the definition of vendor of medical care in section 256B.02,
subdivision 7, paragraphs (b) and (c), and is serving a federally recognized tribe.
deleted text end

deleted text begin (g) For purposes of medical assistance coverage of diagnostic assessments, explanations
of findings, and psychotherapy under section 256B.0625, subdivision 65, a mental health
practitioner working as a clinical trainee means that the practitioner's clinical supervision
experience is helping the practitioner gain knowledge and skills necessary to practice
effectively and independently. This may include supervision of direct practice, treatment
team collaboration, continued professional learning, and job management. The practitioner
must also:
deleted text end

deleted text begin (1) comply with requirements for licensure or board certification as a mental health
professional, according to the qualifications under Minnesota Rules, part 9505.0371, subpart
5, item A, including supervised practice in the delivery of mental health services for the
treatment of mental illness; or
deleted text end

deleted text begin (2) be a student in a bona fide field placement or internship under a program leading to
completion of the requirements for licensure as a mental health professional according to
the qualifications under Minnesota Rules, part 9505.0371, subpart 5, item A.
deleted text end

deleted text begin (h) For purposes of this subdivision, "behavioral sciences or related fields" has the
meaning given in section 256B.0623, subdivision 5, paragraph (d).
deleted text end

deleted text begin (i) Notwithstanding the licensing requirements established by a health-related licensing
board, as defined in section 214.01, subdivision 2, this subdivision supersedes any other
statute or rule.
deleted text end

Sec. 17.

Minnesota Statutes 2020, section 245.462, subdivision 18, is amended to read:


Subd. 18.

Mental health professional.

"Mental health professional" means a new text beginstaff new text endperson
deleted text begin providing clinical services in the treatment of mental illness who is qualified in at least one
of the following ways:
deleted text endnew text begin qualified according to section 245I.04, subdivision 2.
new text end

deleted text begin (1) in psychiatric nursing: a registered nurse who is licensed under sections 148.171 to
148.285; and:
deleted text end

deleted text begin (i) 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
deleted text end

deleted text begin (ii) 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 in the treatment
of mental illness;
deleted text end

deleted text begin (2) in clinical social work: a person 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 treatment of mental illness;
deleted text end

deleted text begin (3) in psychology: an individual licensed by the Board of Psychology under sections
148.88 to 148.98 who has stated to the Board of Psychology competencies in the diagnosis
and treatment of mental illness;
deleted text end

deleted text begin (4) in psychiatry: a physician licensed under chapter 147 and certified by the American
Board of Psychiatry and Neurology or eligible for board certification in psychiatry, or an
osteopathic physician licensed under chapter 147 and certified by the American Osteopathic
Board of Neurology and Psychiatry or eligible for board certification in psychiatry;
deleted text end

deleted text begin (5) in marriage and family therapy: the mental health professional must be a marriage
and family therapist licensed under sections 148B.29 to 148B.39 with at least two years of
post-master's supervised experience in the delivery of clinical services in the treatment of
mental illness;
deleted text end

deleted text begin (6) in licensed professional clinical counseling, the mental health professional shall be
a licensed professional clinical counselor under section 148B.5301 with at least 4,000 hours
of post-master's supervised experience in the delivery of clinical services in the treatment
of mental illness; or
deleted text end

deleted text begin (7) in allied fields: a 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 in the treatment of mental illness.
deleted text end

Sec. 18.

Minnesota Statutes 2020, section 245.462, subdivision 21, is amended to read:


Subd. 21.

Outpatient services.

"Outpatient services" means mental health services,
excluding day treatment and community support services programs, provided by or under
the deleted text beginclinicaldeleted text endnew text begin treatmentnew text end supervision of a mental health professional to adults with mental
illness who live outside a hospital. Outpatient services include clinical activities such as
individual, group, and family therapy; individual treatment planning; diagnostic assessments;
medication management; and psychological testing.

Sec. 19.

Minnesota Statutes 2020, section 245.462, subdivision 23, is amended to read:


Subd. 23.

Residential treatment.

"Residential treatment" means a 24-hour-a-day program
under the deleted text beginclinicaldeleted text endnew text begin treatmentnew text end supervision of a mental health professional, in a community
residential setting other than an acute care hospital or regional treatment center inpatient
unit, that must be licensed as a residential treatment program for adults with mental illness
under new text beginchapter 245I, new text endMinnesota Rules, parts 9520.0500 to 9520.0670new text begin,new text end or other rules adopted
by the commissioner.

Sec. 20.

Minnesota Statutes 2020, section 245.462, is amended by adding a subdivision
to read:


new text begin Subd. 27. new text end

new text begin Treatment supervision. new text end

new text begin "Treatment supervision" means the treatment
supervision described under section 245I.06.
new text end

Sec. 21.

Minnesota Statutes 2020, section 245.4661, subdivision 5, is amended to read:


Subd. 5.

Planning for pilot projects.

(a) Each local plan for a pilot project, with the
exception of the placement of a Minnesota specialty treatment facility as defined in paragraph
(c), must be developed under the direction of the county board, or multiple county boards
acting jointly, as the local mental health authority. The planning process for each pilot shall
include, but not be limited to, mental health consumers, families, advocates, local mental
health advisory councils, local and state providers, representatives of state and local public
employee bargaining units, and the department of human services. As part of the planning
process, the county board or boards shall designate a managing entity responsible for receipt
of funds and management of the pilot project.

(b) For Minnesota specialty treatment facilities, the commissioner shall issue a request
for proposal for regions in which a need has been identified for services.

(c) For purposes of this section, "Minnesota specialty treatment facility" is defined as
an intensive residential treatment service new text beginlicensed new text endunder deleted text beginsection 256B.0622, subdivision 2,
paragraph (b)
deleted text endnew text begin chapter 245Inew text end.

Sec. 22.

Minnesota Statutes 2020, section 245.4662, subdivision 1, is amended to read:


Subdivision 1.

Definitions.

(a) For purposes of this section, the following terms have
the meanings given them.

(b) "Community partnership" means a project involving the collaboration of two or more
eligible applicants.

(c) "Eligible applicant" means an eligible county, Indian tribe, mental health service
provider, hospital, or community partnership. Eligible applicant does not include a
state-operated direct care and treatment facility or program under chapter 246.

(d) "Intensive residential treatment services" has the meaning given in section 256B.0622deleted text begin,
subdivision 2
deleted text end.

(e) "Metropolitan area" means the seven-county metropolitan area, as defined in section
473.121, subdivision 2.

Sec. 23.

Minnesota Statutes 2020, section 245.467, subdivision 2, is amended to read:


Subd. 2.

Diagnostic assessment.

deleted text begin All providers of residential, acute care hospital inpatient,
and regional treatment centers must complete a diagnostic assessment for each of their
clients within five days of admission. Providers of day treatment services must complete a
diagnostic assessment within five days after the adult's second visit or within 30 days after
intake, whichever occurs first. In cases where a diagnostic assessment is available and has
been completed within three years preceding admission, only an adult diagnostic assessment
update is necessary. An "adult diagnostic assessment update" means a written summary by
a mental health professional of the adult's current mental health status and service needs
and includes a face-to-face interview with the adult. If the adult's mental health status has
changed markedly since the adult's most recent diagnostic assessment, a new diagnostic
assessment is required. Compliance with the provisions of this subdivision does not ensure
eligibility for medical assistance reimbursement under chapter 256B.
deleted text end new text begin Providers of services
governed by this section must complete a diagnostic assessment according to the standards
of section 245I.10, subdivisions 4 to 6.
new text end

Sec. 24.

Minnesota Statutes 2020, section 245.467, subdivision 3, is amended to read:


Subd. 3.

Individual treatment plans.

deleted text begin All providers of outpatient services, day treatment
services, residential treatment, acute care hospital inpatient treatment, and all regional
treatment centers must develop an individual treatment plan for each of their adult clients.
The individual treatment plan must be based on a diagnostic assessment. To the extent
possible, the adult client shall be involved in all phases of developing and implementing
the individual treatment plan. Providers of residential treatment and acute care hospital
inpatient treatment, and all regional treatment centers must develop the individual treatment
plan within ten days of client intake and must review the individual treatment plan every
90 days after intake. Providers of day treatment services must develop the individual
treatment plan before the completion of five working days in which service is provided or
within 30 days after the diagnostic assessment is completed or obtained, whichever occurs
first. Providers of outpatient services must develop the individual treatment plan within 30
days after the diagnostic assessment is completed or obtained or by the end of the second
session of an outpatient service, not including the session in which the diagnostic assessment
was provided, whichever occurs first. Outpatient and day treatment services providers must
review the individual treatment plan every 90 days after intake.
deleted text end new text begin Providers of services
governed by this section must complete an individual treatment plan according to the
standards of section 245I.10, subdivisions 7 and 8.
new text end

Sec. 25.

Minnesota Statutes 2020, section 245.470, subdivision 1, is amended to read:


Subdivision 1.

Availability of outpatient services.

(a) County boards must provide or
contract for enough outpatient services within the county to meet the needs of adults with
mental illness residing in the county. Services may be provided directly by the county
through county-operated deleted text beginmental health centers ordeleted text end mental health clinics deleted text beginapproved by the
commissioner under section 245.69, subdivision 2
deleted text endnew text begin meeting the standards of chapter 245Inew text end;
by contract with privately operated deleted text beginmental health centers ordeleted text end mental health clinics deleted text beginapproved
by the commissioner under section 245.69, subdivision 2
deleted text endnew text begin meeting the standards of chapter
245I
new text end; by contract with hospital mental health outpatient programs certified by the Joint
Commission on Accreditation of Hospital Organizations; or by contract with a deleted text beginlicenseddeleted text end
mental health professional deleted text beginas defined in section 245.462, subdivision 18, clauses (1) to (6)deleted text end.
Clients may be required to pay a fee according to section 245.481. Outpatient services
include:

(1) conducting diagnostic assessments;

(2) conducting psychological testing;

(3) developing or modifying individual treatment plans;

(4) making referrals and recommending placements as appropriate;

(5) treating an adult's mental health needs through therapy;

(6) prescribing and managing medication and evaluating the effectiveness of prescribed
medication; and

(7) preventing placement in settings that are more intensive, costly, or restrictive than
necessary and appropriate to meet client needs.

(b) County boards may request a waiver allowing outpatient services to be provided in
a nearby trade area if it is determined that the client can best be served outside the county.

Sec. 26.

Minnesota Statutes 2020, section 245.4712, subdivision 2, is amended to read:


Subd. 2.

Day treatment services provided.

(a) Day treatment services must be developed
as a part of the community support services available to adults with serious and persistent
mental illness residing in the county. Adults may be required to pay a fee according to
section 245.481. Day treatment services must be designed to:

(1) provide a structured environment for treatment;

(2) provide support for residing in the community;

(3) prevent placement in settings that are more intensive, costly, or restrictive than
necessary and appropriate to meet client need;

(4) coordinate with or be offered in conjunction with a local education agency's special
education program; and

(5) operate on a continuous basis throughout the year.

(b) deleted text beginFor purposes of complying with medical assistance requirements, an adult day
treatment program must comply with the method of clinical supervision specified in
Minnesota Rules, part 9505.0371, subpart 4. The clinical supervision must be performed
by a qualified supervisor who satisfies the requirements of Minnesota Rules, part 9505.0371,
subpart 5.
deleted text endnew text begin An adult day treatment program must comply with medical assistance requirements
in section 256B.0671, subdivision 3.
new text end

deleted text begin A day treatment program must demonstrate compliance with this clinical supervision
requirement by the commissioner's review and approval of the program according to
Minnesota Rules, part 9505.0372, subpart 8.
deleted text end

(c) County boards may request a waiver from including day treatment services if they
can document that:

(1) an alternative plan of care exists through the county's community support services
for clients who would otherwise need day treatment services;

(2) day treatment, if included, would be duplicative of other components of the
community support services; and

(3) county demographics and geography make the provision of day treatment services
cost ineffective and infeasible.

Sec. 27.

Minnesota Statutes 2020, section 245.472, subdivision 2, is amended to read:


Subd. 2.

Specific requirements.

Providers of residential services must be licensed under
new text begin chapter 245I or new text endapplicable rules adopted by the commissioner deleted text beginand must be clinically
supervised by a mental health professional. Persons employed in facilities licensed under
Minnesota Rules, parts 9520.0500 to 9520.0670, in the capacity of program director as of
July 1, 1987, in accordance with Minnesota Rules, parts 9520.0500 to 9520.0670, may be
allowed to continue providing clinical supervision within a facility, provided they continue
to be employed as a program director in a facility licensed under Minnesota Rules, parts
9520.0500 to 9520.0670
deleted text end.new text begin Residential services must be provided under treatment supervision.
new text end

Sec. 28.

Minnesota Statutes 2020, section 245.4863, is amended to read:


245.4863 INTEGRATED CO-OCCURRING DISORDER TREATMENT.

(a) The commissioner shall require individuals who perform chemical dependency
assessments to screen clients for co-occurring mental health disorders, and staff who perform
mental health diagnostic assessments to screen for co-occurring substance use disorders.
Screening tools must be approved by the commissioner. If a client screens positive for a
co-occurring mental health or substance use disorder, the individual performing the screening
must document what actions will be taken in response to the results and whether further
assessments must be performed.

(b) Notwithstanding paragraph (a), screening is not required when:

(1) the presence of co-occurring disorders was documented for the client in the past 12
months;

(2) the client is currently receiving co-occurring disorders treatment;

(3) the client is being referred for co-occurring disorders treatment; or

(4) a mental health professionaldeleted text begin, as defined in Minnesota Rules, part 9505.0370, subpart
18,
deleted text end who is competent to perform diagnostic assessments of co-occurring disorders is
performing a diagnostic assessment deleted text beginthat meets the requirements in Minnesota Rules, part
9533.0090, subpart 5,
deleted text end to identify whether the client may have co-occurring mental health
and chemical dependency disorders. If an individual is identified to have co-occurring
mental health and substance use disorders, the assessing mental health professional must
document what actions will be taken to address the client's co-occurring disorders.

(c) The commissioner shall adopt rules as necessary to implement this section. The
commissioner shall ensure that the rules are effective on July 1, 2013, thereby establishing
a certification process for integrated dual disorder treatment providers and a system through
which individuals receive integrated dual diagnosis treatment if assessed as having both a
substance use disorder and either a serious mental illness or emotional disturbance.

(d) The commissioner shall apply for any federal waivers necessary to secure, to the
extent allowed by law, federal financial participation for the provision of integrated dual
diagnosis treatment to persons with co-occurring disorders.

Sec. 29.

Minnesota Statutes 2020, section 245.4871, subdivision 9a, is amended to read:


Subd. 9a.

Crisis deleted text beginassistancedeleted text endnew text begin planningnew text end.

"Crisis deleted text beginassistancedeleted text endnew text begin planningnew text end" means deleted text beginassistance to
the child, the child's family, and all providers of services to the child to: recognize factors
precipitating a mental health crisis, identify behaviors related to the crisis, and be informed
of available resources to resolve the crisis. Crisis assistance requires the development of a
plan which addresses prevention and intervention strategies to be used in a potential crisis.
Other interventions include: (1) arranging for admission to acute care hospital inpatient
treatment
deleted text endnew text begin the development of a written plan to assist a child and the child's family in
preventing and addressing a potential crisis and is distinct from mobile crisis services as
defined in section 256B.0624. The plan must address prevention, deescalation, and
intervention strategies to be used in a crisis. The plan identifies factors that might precipitate
a crisis, behaviors or symptoms related to the emergence of a crisis, and the resources
available to resolve a crisis. The plan must address the following potential needs: (1) acute
care
new text end; (2) crisis placement; (3) community resources for follow-up; and (4) emotional support
to the family during crisis. Crisis deleted text beginassistancedeleted text endnew text begin planningnew text end does not include services designed to
secure the safety of a child who is at risk of abuse or neglect or necessary emergency services.

Sec. 30.

Minnesota Statutes 2020, section 245.4871, subdivision 10, is amended to read:


Subd. 10.

Day treatment services.

"Day treatment," "day treatment services," or "day
treatment program" means a structured program of treatment and care provided to a child
in:

(1) an outpatient hospital accredited by the Joint Commission on Accreditation of Health
Organizations and licensed under sections 144.50 to 144.55;

(2) a community mental health center under section 245.62;

(3) an entity that is under contract with the county board to operate a program that meets
the requirements of section 245.4884, subdivision 2, and Minnesota Rules, parts 9505.0170
to 9505.0475; deleted text beginor
deleted text end

(4) an entity that operates a program that meets the requirements of section 245.4884,
subdivision 2
, and Minnesota Rules, parts 9505.0170 to 9505.0475, that is under contract
with an entity that is under contract with a county boarddeleted text begin.deleted text endnew text begin; or
new text end

new text begin (5) a program certified under section 256B.0943.
new text end

Day treatment consists of group psychotherapy and other intensive therapeutic services
that are provided for a minimum two-hour time block by a multidisciplinary staff under the
deleted text begin clinicaldeleted text endnew text begin treatmentnew text end supervision of a mental health professional. Day treatment may include
education and consultation provided to families and other individuals as an extension of the
treatment process. The services are aimed at stabilizing the child's mental health status, and
developing and improving the child's daily independent living and socialization skills. Day
treatment services are distinguished from day care by their structured therapeutic program
of psychotherapy services. Day treatment services are not a part of inpatient hospital or
residential treatment services.

A day treatment service must be available to a child up to 15 hours a week throughout
the year and must be coordinated with, integrated with, or part of an education program
offered by the child's school.

Sec. 31.

Minnesota Statutes 2020, section 245.4871, subdivision 11a, is amended to read:


Subd. 11a.

Diagnostic assessment.

deleted text begin(a)deleted text end "Diagnostic assessment" has the meaning given
in deleted text beginMinnesota Rules, part 9505.0370, subpart 11, and is delivered as provided in Minnesota
Rules, part 9505.0372, subpart 1, items A, B, C, and E. Diagnostic assessment includes a
standard, extended, or brief diagnostic assessment, or an adult update
deleted text endnew text begin section 245I.10,
subdivisions 4 to 6
new text end.

deleted text begin (b) A brief diagnostic assessment must include a face-to-face interview with the client
and a written evaluation of the client by a mental health professional or a clinical trainee,
as provided in Minnesota Rules, part 9505.0371, subpart 5, item C. The professional or
clinical trainee must gather initial components of a standard diagnostic assessment, including
the client's:
deleted text end

deleted text begin (1) age;
deleted text end

deleted text begin (2) description of symptoms, including reason for referral;
deleted text end

deleted text begin (3) history of mental health treatment;
deleted text end

deleted text begin (4) cultural influences and their impact on the client; and
deleted text end

deleted text begin (5) mental status examination.
deleted text end

deleted text begin (c) On the basis of the brief components, the professional or clinical trainee must draw
a provisional clinical hypothesis. The clinical hypothesis may be used to address the client's
immediate needs or presenting problem.
deleted text end

deleted text begin (d) Treatment sessions conducted under authorization of a brief assessment may be used
to gather additional information necessary to complete a standard diagnostic assessment or
an extended diagnostic assessment.
deleted text end

deleted text begin (e) Notwithstanding Minnesota Rules, part 9505.0371, subpart 2, item A, subitem (1),
unit (b), prior to completion of a client's initial diagnostic assessment, a client is eligible
for psychological testing as part of the diagnostic process.
deleted text end

deleted text begin (f) Notwithstanding Minnesota Rules, part 9505.0371, subpart 2, item A, subitem (1),
unit (c), prior to completion of a client's initial diagnostic assessment, but in conjunction
with the diagnostic assessment process, a client is eligible for up to three individual or family
psychotherapy sessions or family psychoeducation sessions or a combination of the above
sessions not to exceed three sessions.
deleted text end

Sec. 32.

Minnesota Statutes 2020, section 245.4871, subdivision 17, is amended to read:


Subd. 17.

Family community support services.

"Family community support services"
means services provided under the deleted text beginclinicaldeleted text endnew text begin treatmentnew text end supervision of a mental health
professional and designed to help each child with severe emotional disturbance to function
and remain with the child's family in the community. Family community support services
do not include acute care hospital inpatient treatment, residential treatment services, or
regional treatment center services. Family community support services include:

(1) client outreach to each child with severe emotional disturbance and the child's family;

(2) medication monitoring where necessary;

(3) assistance in developing independent living skills;

(4) assistance in developing parenting skills necessary to address the needs of the child
with severe emotional disturbance;

(5) assistance with leisure and recreational activities;

(6) crisis deleted text beginassistancedeleted text endnew text begin planningnew text end, including crisis placement and respite care;

(7) professional home-based family treatment;

(8) foster care with therapeutic supports;

(9) day treatment;

(10) assistance in locating respite care and special needs day care; and

(11) assistance in obtaining potential financial resources, including those benefits listed
in section 245.4884, subdivision 5.

Sec. 33.

Minnesota Statutes 2020, section 245.4871, subdivision 21, is amended to read:


Subd. 21.

Individual treatment plan.

"Individual treatment plan" means deleted text begina written plan
of intervention, treatment, and services for a child with an emotional disturbance that is
developed by a service provider under the clinical supervision of a mental health professional
on the basis of a diagnostic assessment. An individual treatment plan for a child must be
developed in conjunction with the family unless clinically inappropriate. The plan identifies
goals and objectives of treatment, treatment strategy, a schedule for accomplishing treatment
goals and objectives, and the individuals responsible for providing treatment to the child
with an emotional disturbance
deleted text endnew text begin the formulation of planned services that are responsive to
the needs and goals of a client. An individual treatment plan must be completed according
to section 245I.10, subdivisions 7 and 8
new text end.

Sec. 34.

Minnesota Statutes 2020, section 245.4871, subdivision 26, is amended to read:


Subd. 26.

Mental health practitioner.

"Mental health practitioner" deleted text beginhas the meaning
given in section 245.462, subdivision 17
deleted text endnew text begin means a staff person who is qualified according
to section 245I.04, subdivision 4
new text end.

Sec. 35.

Minnesota Statutes 2020, section 245.4871, subdivision 27, is amended to read:


Subd. 27.

Mental health professional.

"Mental health professional" means a new text beginstaff new text endperson
deleted text begin providing clinical services in the diagnosis and treatment of children's emotional disorders.
A mental health professional must have training and experience in working with children
consistent with the age group to which the mental health professional is assigned. A mental
health professional must be qualified in at least one of the following ways:
deleted text endnew text begin qualified according
to section 245I.04, subdivision 2.
new text end

deleted text begin (1) in psychiatric nursing, the mental health professional must be a registered nurse who
is licensed under sections 148.171 to 148.285 and who is certified as a clinical specialist in
child and adolescent psychiatric or 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 in the
treatment of mental illness;
deleted text end

deleted text begin (2) in clinical social work, the mental health professional must be a person 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 treatment of
mental disorders;
deleted text end

deleted text begin (3) in psychology, the mental health professional must be an individual licensed by the
board of psychology under sections 148.88 to 148.98 who has stated to the board of
psychology competencies in the diagnosis and treatment of mental disorders;
deleted text end

deleted text begin (4) in psychiatry, the mental health professional must be a physician licensed under
chapter 147 and certified by the American Board of Psychiatry and Neurology or eligible
for board certification in psychiatry or an osteopathic physician licensed under chapter 147
and certified by the American Osteopathic Board of Neurology and Psychiatry or eligible
for board certification in psychiatry;
deleted text end

deleted text begin (5) in marriage and family therapy, the mental health professional must be a marriage
and family therapist licensed under sections 148B.29 to 148B.39 with at least two years of
post-master's supervised experience in the delivery of clinical services in the treatment of
mental disorders or emotional disturbances;
deleted text end

deleted text begin (6) in licensed professional clinical counseling, the mental health professional shall be
a licensed professional clinical counselor under section 148B.5301 with at least 4,000 hours
of post-master's supervised experience in the delivery of clinical services in the treatment
of mental disorders or emotional disturbances; or
deleted text end

deleted text begin (7) in allied fields, the mental health professional must be a 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 in the treatment of emotional disturbances.
deleted text end

Sec. 36.

Minnesota Statutes 2020, section 245.4871, subdivision 29, is amended to read:


Subd. 29.

Outpatient services.

"Outpatient services" means mental health services,
excluding day treatment and community support services programs, provided by or under
the deleted text beginclinicaldeleted text endnew text begin treatmentnew text end supervision of a mental health professional to children with emotional
disturbances who live outside a hospital. Outpatient services include clinical activities such
as individual, group, and family therapy; individual treatment planning; diagnostic
assessments; medication management; and psychological testing.

Sec. 37.

Minnesota Statutes 2020, section 245.4871, subdivision 31, is amended to read:


Subd. 31.

Professional home-based family treatment.

"Professional home-based family
treatment" means intensive mental health services provided to children because of an
emotional disturbance (1) who are at risk of out-of-home placement; (2) who are in
out-of-home placement; or (3) who are returning from out-of-home placement. Services
are provided to the child and the child's family primarily in the child's home environment.
Services may also be provided in the child's school, child care setting, or other community
setting appropriate to the child. Services must be provided on an individual family basis,
must be child-oriented and family-oriented, and must be designed using information from
diagnostic and functional assessments to meet the specific mental health needs of the child
and the child's family. Examples of services are: (1) individual therapy; (2) family therapy;
(3) client outreach; (4) assistance in developing individual living skills; (5) assistance in
developing parenting skills necessary to address the needs of the child; (6) assistance with
leisure and recreational services; (7) crisis deleted text beginassistancedeleted text endnew text begin planningnew text end, including crisis respite care
and arranging for crisis placement; and (8) assistance in locating respite and child care.
Services must be coordinated with other services provided to the child and family.

Sec. 38.

Minnesota Statutes 2020, section 245.4871, subdivision 32, is amended to read:


Subd. 32.

Residential treatment.

"Residential treatment" means a 24-hour-a-day program
under the deleted text beginclinicaldeleted text endnew text begin treatmentnew text end supervision of a mental health professional, in a community
residential setting other than an acute care hospital or regional treatment center inpatient
unit, that must be licensed as a residential treatment program for children with emotional
disturbances under Minnesota Rules, parts 2960.0580 to 2960.0700, or other rules adopted
by the commissioner.

Sec. 39.

Minnesota Statutes 2020, section 245.4871, subdivision 34, is amended to read:


Subd. 34.

Therapeutic support of foster care.

"Therapeutic support of foster care"
means the mental health training and mental health support services and deleted text beginclinicaldeleted text endnew text begin treatmentnew text end
supervision provided by a mental health professional to foster families caring for children
with severe emotional disturbance to provide a therapeutic family environment and support
for the child's improved functioning.new text begin Therapeutic support of foster care includes services
provided under section 256B.0946.
new text end

Sec. 40.

Minnesota Statutes 2020, section 245.4871, is amended by adding a subdivision
to read:


new text begin Subd. 36. new text end

new text begin Treatment supervision. new text end

new text begin "Treatment supervision" means the treatment
supervision described under section 245I.06.
new text end

Sec. 41.

Minnesota Statutes 2020, section 245.4876, subdivision 2, is amended to read:


Subd. 2.

Diagnostic assessment.

deleted text begin All residential treatment facilities and acute care
hospital inpatient treatment facilities that provide mental health services for children must
complete a diagnostic assessment for each of their child clients within five working days
of admission. Providers of day treatment services for children must complete a diagnostic
assessment within five days after the child's second visit or 30 days after intake, whichever
occurs first. In cases where a diagnostic assessment is available and has been completed
within 180 days preceding admission, only updating is necessary. "Updating" means a
written summary by a mental health professional of the child's current mental health status
and service needs. If the child's mental health status has changed markedly since the child's
most recent diagnostic assessment, a new diagnostic assessment is required. Compliance
with the provisions of this subdivision does not ensure eligibility for medical assistance
reimbursement under chapter 256B.
deleted text end new text begin Providers of services governed by this section shall
complete a diagnostic assessment according to the standards of section 245I.10, subdivisions
4 to 6.
new text end

Sec. 42.

Minnesota Statutes 2020, section 245.4876, subdivision 3, is amended to read:


Subd. 3.

Individual treatment plans.

deleted text begin All providers of outpatient services, day treatment
services, professional home-based family treatment, residential treatment, and acute care
hospital inpatient treatment, and all regional treatment centers that provide mental health
services for children must develop an individual treatment plan for each child client. The
individual treatment plan must be based on a diagnostic assessment. To the extent appropriate,
the child and the child's family shall be involved in all phases of developing and
implementing the individual treatment plan. Providers of residential treatment, professional
home-based family treatment, and acute care hospital inpatient treatment, and regional
treatment centers must develop the individual treatment plan within ten working days of
client intake or admission and must review the individual treatment plan every 90 days after
intake, except that the administrative review of the treatment plan of a child placed in a
residential facility shall be as specified in sections 260C.203 and 260C.212, subdivision 9.
Providers of day treatment services must develop the individual treatment plan before the
completion of five working days in which service is provided or within 30 days after the
diagnostic assessment is completed or obtained, whichever occurs first. Providers of
outpatient services must develop the individual treatment plan within 30 days after the
diagnostic assessment is completed or obtained or by the end of the second session of an
outpatient service, not including the session in which the diagnostic assessment was provided,
whichever occurs first. Providers of outpatient and day treatment services must review the
individual treatment plan every 90 days after intake.
deleted text end new text begin Providers of services governed by this
section shall complete an individual treatment plan according to the standards of section
245I.10, subdivisions 7 and 8.
new text end

Sec. 43.

Minnesota Statutes 2020, section 245.488, subdivision 1, is amended to read:


Subdivision 1.

Availability of outpatient services.

(a) County boards must provide or
contract for enough outpatient services wit