SF 1591

as introduced - 90th Legislature (2017 - 2018) Posted on 03/02/2017 09:44am

A bill for an act
relating to human services; modifying provisions governing chemical and mental
health services; amending Minnesota Statutes 2016, sections 245A.03, subdivision
2; 245A.191; 254A.01; 254A.02, subdivisions 2, 3, 5, 6, 8, 10, by adding
subdivisions; 254A.03; 254A.035, subdivision 1; 254A.04; 254A.08; 254A.09;
254A.19, subdivision 3; 254B.01, subdivision 3, by adding a subdivision; 254B.03,
subdivision 2; 254B.04, subdivisions 1, 2b; 254B.05, subdivisions 1, 1a, 5;
254B.051; 254B.07; 254B.08; 254B.09; 254B.12, subdivision 2; 254B.13,
subdivision 2a; proposing coding for new law as Minnesota Statutes, chapter 245G;
repealing Minnesota Statutes 2016, sections 245A.1915; 245A.192; 254A.02,
subdivision 4; Minnesota Rules, parts 9530.6405, subparts 1, 1a, 2, 3, 4, 5, 6, 7,
7a, 8, 9, 10, 11, 12, 13, 14, 14a, 15, 15a, 16, 17, 17a, 17b, 17c, 18, 20, 21;
9530.6410; 9530.6415; 9530.6420; 9530.6422; 9530.6425; 9530.6430; 9530.6435;
9530.6440; 9530.6445; 9530.6450; 9530.6455; 9530.6460; 9530.6465; 9530.6470;
9530.6475; 9530.6480; 9530.6485; 9530.6490; 9530.6495; 9530.6500; 9530.6505.

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

Section 1.

Minnesota Statutes 2016, section 245A.03, subdivision 2, is amended to read:

Subd. 2.

Exclusion from licensure.

(a) This chapter does not apply to:

(1) residential or nonresidential programs that are provided to a person by an individual
who is related unless the residential program is a child foster care placement made by a
local social services agency or a licensed child-placing agency, except as provided in
subdivision 2a;

(2) nonresidential programs that are provided by an unrelated individual to persons from
a single related family;

(3) residential or nonresidential programs that are provided to adults who do not deleted text begin abuse
chemicals or who do not have a chemical dependency deleted text end new text begin misuse substances or have a substance
use disorder new text end , a mental illness, a developmental disability, a functional impairment, or a
physical disability;

(4) sheltered workshops or work activity programs that are certified by the commissioner
of employment and economic development;

(5) programs operated by a public school for children 33 months or older;

(6) nonresidential programs primarily for children that provide care or supervision for
periods of less than three hours a day while the child's parent or legal guardian is in the
same building as the nonresidential program or present within another building that is
directly contiguous to the building in which the nonresidential program is located;

(7) nursing homes or hospitals licensed by the commissioner of health except as specified
under section 245A.02;

(8) board and lodge facilities licensed by the commissioner of health that do not provide
children's residential services under Minnesota Rules, chapter 2960, mental health or chemical
dependency treatment;

(9) homes providing programs for persons placed by a county or a licensed agency for
legal adoption, unless the adoption is not completed within two years;

(10) programs licensed by the commissioner of corrections;

(11) recreation programs for children or adults that are operated or approved by a park
and recreation board whose primary purpose is to provide social and recreational activities;

(12) programs operated by a school as defined in section 120A.22, subdivision 4; YMCA
as defined in section 315.44; YWCA as defined in section 315.44; or JCC as defined in
section 315.51, whose primary purpose is to provide child care or services to school-age
children;

(13) Head Start nonresidential programs which operate for less than 45 days in each
calendar year;

(14) noncertified boarding care homes unless they provide services for five or more
persons whose primary diagnosis is mental illness or a developmental disability;

(15) programs for children such as scouting, boys clubs, girls clubs, and sports and art
programs, and nonresidential programs for children provided for a cumulative total of less
than 30 days in any 12-month period;

(16) residential programs for persons with mental illness, that are located in hospitals;

(17) the religious instruction of school-age children; Sabbath or Sunday schools; or the
congregate care of children by a church, congregation, or religious society during the period
used by the church, congregation, or religious society for its regular worship;

(18) camps licensed by the commissioner of health under Minnesota Rules, chapter
4630;

(19) mental health outpatient services for adults with mental illness or children with
emotional disturbance;

(20) residential programs serving school-age children whose sole purpose is cultural or
educational exchange, until the commissioner adopts appropriate rules;

(21) community support services programs as defined in section 245.462, subdivision
6, and family community support services as defined in section 245.4871, subdivision 17;

(22) the placement of a child by a birth parent or legal guardian in a preadoptive home
for purposes of adoption as authorized by section 259.47;

(23) settings registered under chapter 144D which provide home care services licensed
by the commissioner of health to fewer than seven adults;

(24) deleted text begin chemical dependency or deleted text end substance deleted text begin abuse deleted text end new text begin use disorder new text end treatment activities of licensed
professionals in private practice as defined in deleted text begin Minnesota Rules, part 9530.6405, subpart 15,
when the treatment activities are not paid for by the consolidated chemical dependency
treatment fund deleted text end new text begin section 245G.01, subdivision 17 new text end ;

(25) consumer-directed community support service funded under the Medicaid waiver
for persons with developmental disabilities when the individual who provided the service
is:

(i) the same individual who is the direct payee of these specific waiver funds or paid by
a fiscal agent, fiscal intermediary, or employer of record; and

(ii) not otherwise under the control of a residential or nonresidential program that is
required to be licensed under this chapter when providing the service;

(26) a program serving only children who are age 33 months or older, that is operated
by a nonpublic school, for no more than four hours per day per child, with no more than 20
children at any one time, and that is accredited by:

(i) an accrediting agency that is formally recognized by the commissioner of education
as a nonpublic school accrediting organization; or

(ii) an accrediting agency that requires background studies and that receives and
investigates complaints about the services provided.

A program that asserts its exemption from licensure under item (ii) shall, upon request
from the commissioner, provide the commissioner with documentation from the accrediting
agency that verifies: that the accreditation is current; that the accrediting agency investigates
complaints about services; and that the accrediting agency's standards require background
studies on all people providing direct contact services; or

(27) a program operated by a nonprofit organization incorporated in Minnesota or another
state that serves youth in kindergarten through grade 12; provides structured, supervised
youth development activities; and has learning opportunities take place before or after
school, on weekends, or during the summer or other seasonal breaks in the school calendar.
A program exempt under this clause is not eligible for child care assistance under chapter
119B. A program exempt under this clause must:

(i) have a director or supervisor on site who is responsible for overseeing written policies
relating to the management and control of the daily activities of the program, ensuring the
health and safety of program participants, and supervising staff and volunteers;

(ii) have obtained written consent from a parent or legal guardian for each youth
participating in activities at the site; and

(iii) have provided written notice to a parent or legal guardian for each youth at the site
that the program is not licensed or supervised by the state of Minnesota and is not eligible
to receive child care assistance payments.

(b) For purposes of paragraph (a), clause (6), a building is directly contiguous to a
building in which a nonresidential program is located if it shares a common wall with the
building in which the nonresidential program is located or is attached to that building by
skyway, tunnel, atrium, or common roof.

(c) Except for the home and community-based services identified in section 245D.03,
subdivision 1, nothing in this chapter shall be construed to require licensure for any services
provided and funded according to an approved federal waiver plan where licensure is
specifically identified as not being a condition for the services and funding.

new text begin EFFECTIVE DATE. new text end

new text begin This section is effective July 1, 2017.
new text end

Sec. 2.

Minnesota Statutes 2016, section 245A.191, is amended to read:

245A.191 PROVIDER ELIGIBILITY FOR PAYMENTS FROM THE CHEMICAL
DEPENDENCY CONSOLIDATED TREATMENT FUND.

(a) When a deleted text begin chemical dependency deleted text end new text begin substance use disorder new text end treatment provider licensed
under new text begin chapter 245G or new text end Minnesota Rules, parts 2960.0430 to 2960.0490 deleted text begin or 9530.6405 to
9530.6505 deleted text end , agrees to meet the applicable requirements under section 254B.05, subdivision
5, deleted text begin paragraphs (b), clauses (1) to (4) and (6), (c), and (e), deleted text end to be eligible for enhanced funding
from the chemical dependency consolidated treatment fund, the applicable requirements
under section 254B.05 are also licensing requirements that may be monitored for compliance
through licensing investigations and licensing inspections.

(b) Noncompliance with the requirements identified under paragraph (a) may result in:

(1) a correction order or a conditional license under section 245A.06, or sanctions under
section 245A.07;

(2) nonpayment of claims submitted by the license holder for public program
reimbursement;

(3) recovery of payments made for the service;

(4) disenrollment in the public payment program; or

(5) other administrative, civil, or criminal penalties as provided by law.

new text begin EFFECTIVE DATE. new text end

new text begin This section is effective July 1, 2017.
new text end

Sec. 3.

new text begin [245G.01] DEFINITIONS.
new text end

new text begin Subdivision 1. new text end

new text begin Scope. new text end

new text begin The terms used in this chapter have the meanings given them.
new text end

new text begin Subd. 2. new text end

new text begin Administration of medication. new text end

new text begin "Administration of medication" means providing
a medication to a client, and includes the following tasks, performed in the following order:
new text end

new text begin (1) checking the client's medication record;
new text end

new text begin (2) preparing the medication for administration;
new text end

new text begin (3) administering the medication to the client;
new text end

new text begin (4) documenting the administration of the medication, or the reason for not administering
a medication as prescribed; and
new text end

new text begin (5) reporting information to a licensed practitioner or a nurse regarding a problem with
the administration of medication or the client's refusal to take the medication, if applicable.
new text end

new text begin Subd. 3. new text end

new text begin Adolescent. new text end

new text begin "Adolescent" means an individual under 18 years of age.
new text end

new text begin Subd. 4. new text end

new text begin Alcohol and drug counselor. new text end

new text begin "Alcohol and drug counselor" has the meaning
given in section 148F.01, subdivision 5.
new text end

new text begin Subd. 5. new text end

new text begin Applicant. new text end

new text begin "Applicant" means an individual, corporation, partnership, voluntary
association, controlling individual, or other organization that applied for a license under
this chapter.
new text end

new text begin Subd. 6. new text end

new text begin Capacity management system. new text end

new text begin "Capacity management system" means a
database maintained by the department to compile and make information available to the
public about the waiting list status and current admission capability of each opioid treatment
program.
new text end

new text begin Subd. 7. new text end

new text begin Central registry. new text end

new text begin "Central registry" means a database maintained by the
department to collect identifying information from two or more programs about an individual
applying for maintenance treatment or detoxification treatment for opioid addiction to
prevent an individual's concurrent enrollment in more than one program.
new text end

new text begin Subd. 8. new text end

new text begin Client. new text end

new text begin "Client" means an individual accepted by a license holder for assessment
or treatment of a substance use disorder. An individual remains a client until the license
holder no longer provides or intends to provide the individual with treatment service.
new text end

new text begin Subd. 9. new text end

new text begin Commissioner. new text end

new text begin "Commissioner" means the commissioner of human services.
new text end

new text begin Subd. 10. new text end

new text begin Co-occurring disorders. new text end

new text begin "Co-occurring disorders" means a diagnosis of both
a substance use disorder and a mental health disorder.
new text end

new text begin Subd. 11. new text end

new text begin Department. new text end

new text begin "Department" means the Department of Human Services.
new text end

new text begin Subd. 12. new text end

new text begin Direct contact. new text end

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

new text begin Subd. 13. new text end

new text begin Face-to-face. new text end

new text begin "Face-to-face" means two-way, real-time, interactive and visual
communication between a client and a treatment service provider and includes services
delivered via telemedicine.
new text end

new text begin Subd. 14. new text end

new text begin License. new text end

new text begin "License" means a certificate issued by the commissioner authorizing
the license holder to provide a specific program for a specified period of time according to
the terms of the license and the rules of the commissioner.
new text end

new text begin Subd. 15. new text end

new text begin License holder. new text end

new text begin "License holder" means an individual, corporation, partnership,
voluntary organization, or other organization that is legally responsible for the operation of
the program, was granted a license by the commissioner under this chapter, and is a
controlling individual.
new text end

new text begin Subd. 16. new text end

new text begin Licensed practitioner. new text end

new text begin "Licensed practitioner" means an individual who is
authorized to prescribe medication as defined in section 151.01, subdivision 23.
new text end

new text begin Subd. 17. new text end

new text begin Licensed professional in private practice. new text end

new text begin "Licensed professional in private
practice" means an individual who:
new text end

new text begin (1) is licensed under chapter 148F, or is exempt from licensure under that chapter but
is otherwise licensed to provide alcohol and drug counseling services;
new text end

new text begin (2) practices solely within the permissible scope of the individual's license as defined
in the law authorizing licensure; and
new text end

new text begin (3) does not affiliate with other licensed or unlicensed professionals to provide alcohol
and drug counseling services. Affiliation does not include conferring with another
professional or making a client referral.
new text end

new text begin Subd. 18. new text end

new text begin Nurse. new text end

new text begin "Nurse" means an individual licensed and currently registered to
practice professional or practical nursing as defined in section 148.171, subdivisions 14 and
15.
new text end

new text begin Subd. 19. new text end

new text begin Opioid treatment program. new text end

new text begin "Opioid treatment program" or "OTP" means a
program or practitioner engaged in opioid treatment of an individual that provides dispensing
of an opioid agonist treatment medication, along with a comprehensive range of medical
and rehabilitative services, when clinically necessary, to an individual to alleviate the adverse
medical, psychological, or physical effects of an opioid addiction. OTP includes
detoxification treatment, short-term detoxification treatment, long-term detoxification
treatment, maintenance treatment, comprehensive maintenance treatment, and interim
maintenance treatment.
new text end

new text begin Subd. 20. new text end

new text begin Paraprofessional. new text end

new text begin "Paraprofessional" means an employee, agent, or
independent contractor of the license holder who performs tasks to support treatment service.
A paraprofessional may be referred to by a variety of titles including but not limited to
technician, case aide, or counselor assistant. If currently a client of the license holder, the
client cannot be a paraprofessional for the license holder.
new text end

new text begin Subd. 21. new text end

new text begin Student intern. new text end

new text begin "Student intern" means an individual who is authorized by a
licensing board to provide services under supervision of a licensed professional.
new text end

new text begin Subd. 22. new text end

new text begin Substance. new text end

new text begin "Substance" means alcohol, solvents, controlled substances as
defined in section 152.01, subdivision 4, and other mood-altering substances.
new text end

new text begin Subd. 23. new text end

new text begin Substance use disorder. new text end

new text begin "Substance use disorder" has the meaning given in
the current Diagnostic and Statistical Manual of Mental Disorders.
new text end

new text begin Subd. 24. new text end

new text begin Substance use disorder treatment. new text end

new text begin "Substance use disorder treatment" means
treatment of a substance use disorder, including the process of assessment of a client's needs,
development of planned methods, including interventions or services to address a client's
needs, provision of services, facilitation of services provided by other service providers,
and ongoing reassessment by a qualified professional when indicated. The goal of substance
use disorder treatment is to assist or support the client's efforts to recover from a substance
use disorder.
new text end

new text begin Subd. 25. new text end

new text begin Target population. new text end

new text begin "Target population" means individuals with a substance
use disorder and the specified characteristics that a license holder proposes to serve.
new text end

new text begin Subd. 26. new text end

new text begin Telemedicine. new text end

new text begin "Telemedicine" means the delivery of a substance use disorder
treatment service while the client is at an originating site and the licensed health care provider
is at a distant site as specified in section 254B.05, subdivision 5, paragraph (f).
new text end

new text begin Subd. 27. new text end

new text begin Treatment director. new text end

new text begin "Treatment director" means an individual who meets
the qualifications specified in section 245G.11, subdivisions 1 and 3, and is designated by
the license holder to be responsible for all aspects of the delivery of treatment service.
new text end

new text begin EFFECTIVE DATE. new text end

new text begin This section is effective July 1, 2017.
new text end

Sec. 4.

new text begin [245G.02] APPLICABILITY.
new text end

new text begin Subdivision 1. new text end

new text begin Applicability. new text end

new text begin Except as provided in subdivisions 2 and 3, no person,
corporation, partnership, voluntary association, controlling individual, or other organization
may provide a substance use disorder treatment service to an individual with a substance
use disorder unless licensed by the commissioner.
new text end

new text begin Subd. 2. new text end

new text begin Exemption from license requirement. new text end

new text begin This chapter does not apply to a county
or recovery community organization that is a vendor under section 254B.05 or to an
organization whose primary functions are information, referral, diagnosis, case management,
and assessment for the purposes of client placement, education, support group services, or
self-help programs. This chapter does not apply to the activities of a licensed professional
in private practice.
new text end

new text begin Subd. 3. new text end

new text begin Excluded hospitals. new text end

new text begin This chapter does not apply to substance use disorder
treatment provided by a hospital licensed under chapter 62J, or under sections 144.50 to
144.56, unless the hospital accepts funds for substance use disorder treatment from the
consolidated chemical dependency treatment fund under chapter 254B, medical assistance
under chapter 256B, or MinnesotaCare or health care cost containment under chapter 256L,
or general assistance medical care formerly codified in chapter 256D.
new text end

new text begin Subd. 4. new text end

new text begin Applicability of Minnesota Rules, chapter 2960. new text end

new text begin A residential adolescent
substance use disorder treatment program serving an individual younger than 16 years of
age must be licensed according to Minnesota Rules, chapter 2960.
new text end

new text begin EFFECTIVE DATE. new text end

new text begin This section is effective July 1, 2017.
new text end

Sec. 5.

new text begin [245G.03] LICENSING REQUIREMENTS.
new text end

new text begin Subdivision 1. new text end

new text begin License requirements. new text end

new text begin (a) An applicant for a license to provide substance
use disorder treatment must comply with the general requirements in chapters 245A and
245C, sections 626.556 and 626.557, and Minnesota Rules, chapter 9544.
new text end

new text begin (b) The commissioner may grant variances to the requirements in this chapter that do
not affect the client's health or safety if the conditions in section 245A.04, subdivision 9,
are met.
new text end

new text begin Subd. 2. new text end

new text begin Application. new text end

new text begin Before the commissioner issues a license, an applicant must
submit, on forms provided by the commissioner, any documents the commissioner requires
to demonstrate the following:
new text end

new text begin (1) compliance with this chapter;
new text end

new text begin (2) compliance with applicable building, fire and safety codes, health rules, zoning
ordinances, and other applicable rules and regulations or documentation that a waiver was
granted. An applicant's receipt of a waiver does not constitute modification of any
requirement in this chapter; and
new text end

new text begin (3) insurance coverage, including bonding, sufficient to cover all client funds, property,
and interests.
new text end

new text begin Subd. 3. new text end

new text begin Change in license terms. new text end

new text begin (a) The commissioner must determine whether a
new license is needed when a change in clauses (1) to (4) occurs. A license holder must
notify the commissioner before a change in one of the following occurs:
new text end

new text begin (1) the Department of Health's licensure of the program;
new text end

new text begin (2) whether the license holder provides services specified in sections 245G.18 to 245G.22;
new text end

new text begin (3) location; or
new text end

new text begin (4) capacity if the license holder meets the requirements of section 245G.21.
new text end

new text begin (b) A license holder must notify the commissioner and must apply for a new license if
there is a change in program ownership.
new text end

new text begin EFFECTIVE DATE. new text end

new text begin This section is effective July 1, 2017.
new text end

Sec. 6.

new text begin [245G.04] INITIAL SERVICES PLAN.
new text end

new text begin (a) The license holder must complete an initial services plan on the day of service
initiation. The plan must address the client's immediate health and safety concerns, identify
the needs to be addressed in the first treatment session, and make treatment suggestions for
the client during the time between intake and completion of the individual treatment plan.
new text end

new text begin (b) The initial services plan must include a determination of whether a client is a
vulnerable adult as defined in section 626.5572, subdivision 21. An adult client of a
residential program is a vulnerable adult. An individual abuse prevention plan, according
to sections 245A.65, subdivision 2, paragraph (b), and 626.557, subdivision 14, paragraph
(b), is required for a client who meets the definition of vulnerable adult.
new text end

new text begin EFFECTIVE DATE. new text end

new text begin This section is effective July 1, 2017.
new text end

Sec. 7.

new text begin [245G.05] COMPREHENSIVE ASSESSMENT AND ASSESSMENT
SUMMARY.
new text end

new text begin Subdivision 1. new text end

new text begin Comprehensive assessment. new text end

new text begin (a) A comprehensive assessment of the
client's substance use disorder must be administered face-to-face by an alcohol and drug
counselor within three calendar days after service initiation for a residential program or
during the initial session for all other programs. If the comprehensive assessment is not
completed during the initial session, the client-centered reason for the delay must be
documented in the client's file and the planned completion date. If the client received a
comprehensive assessment that authorized the treatment service, an alcohol and drug
counselor must review the assessment to determine compliance with this subdivision,
including applicable timelines. If available, the alcohol and drug counselor may use current
information provided by a referring agency or other source as a supplement. Information
gathered more than 45 days before the date of admission is not considered current. If the
comprehensive assessment cannot be completed in the time specified, the treatment plan
must indicate a person-centered reason for the delay, and how and when the comprehensive
assessment will be completed. The comprehensive assessment must include sufficient
information to complete the assessment summary according to subdivision 2 and the
individual treatment plan according to section 245G.06. The comprehensive assessment
must include information about the client's needs that relate to substance use and personal
strengths that support recovery, including:
new text end

new text begin (1) age, sex, cultural background, sexual orientation, living situation, economic status,
and level of education;
new text end

new text begin (2) circumstances of service initiation;
new text end

new text begin (3) previous attempts at treatment for substance misuse or substance use disorder,
compulsive gambling, or mental illness;
new text end

new text begin (4) substance use history including amounts and types of substances used, frequency
and duration of use, periods of abstinence, and circumstances of relapse, if any. For each
substance used within the previous 30 days, the information must include the date and time
of the most recent use and previous withdrawal symptoms;
new text end

new text begin (5) specific problem behaviors exhibited by the client when under the influence of
substances;
new text end

new text begin (6) family status, family history, including history or presence of physical or sexual
abuse, level of family support, and substance misuse or substance use disorder of a family
member or significant other;
new text end

new text begin (7) physical concerns or diagnoses, the severity of the concerns, and whether the concerns
are being addressed by a health care professional;
new text end

new text begin (8) mental health history and psychiatric status, including symptoms, disability, current
treatment supports, and psychotropic medication needed to maintain stability; the assessment
must utilize screening tools approved by the commissioner pursuant to section 245.4863 to
identify whether the client screens positive for co-occurring disorders;
new text end

new text begin (9) arrests and legal interventions related to substance use;
new text end

new text begin (10) ability to function appropriately in work and educational settings;
new text end

new text begin (11) ability to understand written treatment materials, including rules and the client's
rights;
new text end

new text begin (12) risk-taking behavior, including behavior that puts the client at risk of exposure to
blood-borne or sexually transmitted diseases;
new text end

new text begin (13) social network in relation to expected support for recovery and leisure time activities
that are associated with substance use;
new text end

new text begin (14) whether the client is pregnant and, if so, the health of the unborn child and the
client's current involvement in prenatal care;
new text end

new text begin (15) whether the client recognizes problems related to substance use and is willing to
follow treatment recommendations; and
new text end

new text begin (16) collateral information. If the assessor gathered sufficient information from the
referral source or the client to apply the criteria in parts 9530.6620 and 9530.6622, a collateral
contact is not required.
new text end

new text begin (b) If the client is identified as having opioid use disorder or seeking treatment for opioid
use disorder, the program must provide educational information to the client concerning:
new text end

new text begin (1) risks for opioid use disorder and dependence;
new text end

new text begin (2) treatment options, including the use of a medication for opioid use disorder;
new text end

new text begin (3) the risk of and recognizing opioid overdose; and
new text end

new text begin (4) the use, availability, and administration of naloxone to respond to opioid overdose.
new text end

new text begin (c) The commissioner shall develop educational materials that are supported by research
and updated periodically. The license holder must use the educational materials that are
approved by the commissioner to comply with this requirement.
new text end

new text begin (d) If the comprehensive assessment is completed to authorize treatment service for the
client, at the earliest opportunity during the assessment interview the assessor shall determine
if:
new text end

new text begin (1) the client is in severe withdrawal and likely to be a danger to self or others;
new text end

new text begin (2) the client has severe medical problems that require immediate attention; or
new text end

new text begin (3) the client has severe emotional or behavioral symptoms that place the client or others
at risk of harm.
new text end

new text begin If one or more of the conditions in clauses (1) to (3) are present, the assessor must end the
assessment interview and follow the procedures in the program's medical services plan
under section 245G.08, subdivision 2, to help the client obtain the appropriate services. The
assessment interview may resume when the condition is resolved.
new text end

new text begin Subd. 2. new text end

new text begin Assessment summary. new text end

new text begin (a) An alcohol and drug counselor must complete an
assessment summary within three calendar days after service initiation for a residential
program and within three sessions for all other programs. If the comprehensive assessment
is used to authorize the treatment service, the alcohol and drug counselor must prepare an
assessment summary on the same date the comprehensive assessment is completed. If the
comprehensive assessment and assessment summary are to authorize treatment services,
the assessor must determine appropriate services for the client using the dimensions in
Minnesota Rules, part 9530.6622, and document the recommendations.
new text end

new text begin (b) An assessment summary must include:
new text end

new text begin (1) a risk description according to section 245G.05 for each dimension listed in paragraph
(c);
new text end

new text begin (2) a narrative summary supporting the risk descriptions; and
new text end

new text begin (3) a determination of whether the client has a substance use disorder.
new text end

new text begin (c) An assessment summary must contain information relevant to treatment service
planning and recorded in the dimensions in clauses (1) to (6). The license holder must
consider:
new text end

new text begin (1) Dimension 1, acute intoxication/withdrawal potential; the client's ability to cope with
withdrawal symptoms and current state of intoxication;
new text end

new text begin (2) Dimension 2, biomedical conditions and complications; the degree to which any
physical disorder of the client would interfere with treatment for substance use, and the
client's ability to tolerate any related discomfort. The license holder must determine the
impact of continued chemical use on the unborn child, if the client is pregnant;
new text end

new text begin (3) Dimension 3, emotional, behavioral, and cognitive conditions and complications;
the degree to which any condition or complication is likely to interfere with treatment for
substance use or with functioning in significant life areas and the likelihood of harm to self
or others;
new text end

new text begin (4) Dimension 4, readiness for change; the support necessary to keep the client involved
in treatment service;
new text end

new text begin (5) Dimension 5, relapse, continued use, and continued problem potential; the degree
to which the client recognizes relapse issues and has the skills to prevent relapse of either
substance use or mental health problems; and
new text end

new text begin (6) Dimension 6, recovery environment; whether the areas of the client's life are
supportive of or antagonistic to treatment participation and recovery.
new text end

new text begin EFFECTIVE DATE. new text end

new text begin This section is effective July 1, 2017.
new text end

Sec. 8.

new text begin [245G.06] INDIVIDUAL TREATMENT PLAN.
new text end

new text begin Subdivision 1. new text end

new text begin General. new text end

new text begin Each client must have an individual treatment plan developed
by an alcohol and drug counselor within seven days of service initiation for a residential
program and within three sessions for all other programs. The client must have active, direct
involvement in selecting the anticipated outcomes of the treatment process and developing
the treatment plan. The individual treatment plan must be signed by the client and the alcohol
and drug counselor and document the client's involvement in the development of the plan.
The plan may be a continuation of the initial services plan required in section 245G.04.
Treatment planning must include ongoing assessment of client needs. An individual treatment
plan must be updated based on new information gathered about the client's condition and
on whether methods identified have the intended effect. A change to the plan must be signed
by the client and the alcohol and drug counselor. The plan must provide for the involvement
of the client's family and people selected by the client as important to the success of treatment
at the earliest opportunity, consistent with the client's treatment needs and written consent.
new text end

new text begin Subd. 2. new text end

new text begin Plan contents. new text end

new text begin An individual treatment plan must be recorded in the six
dimensions listed in section 245G.05, subdivision 2, paragraph (c), must address each issue
identified in the assessment summary, prioritized according to the client's needs and focus,
and must include:
new text end

new text begin (1) specific methods to address each identified need, including amount, frequency, and
anticipated duration of treatment service. The methods must be appropriate to the client's
language, reading skills, cultural background, and strengths;
new text end

new text begin (2) resources to refer the client to when the client's needs are to be addressed concurrently
by another provider; and
new text end

new text begin (3) goals the client must reach to complete treatment and terminate services.
new text end

new text begin Subd. 3. new text end

new text begin Documentation of treatment services; treatment plan review. new text end

new text begin (a) A review
of all treatment services must be documented weekly and include a review of:
new text end

new text begin (1) care coordination activities;
new text end

new text begin (2) medical and other appointments the client attended;
new text end

new text begin (3) issues related to medications that are not documented in the medication administration
record; and
new text end

new text begin (4) issues related to attendance for treatment services, including the reason for any client
absence from a treatment service.
new text end

new text begin (b) A note must be entered immediately following any significant event. A significant
event is an event that impacts the client's relationship with other clients, staff, the client's
family, or the client's treatment plan.
new text end

new text begin (c) A treatment plan review must be entered in a client's file weekly or after each treatment
service, whichever is less frequent, by the staff member providing the service. The review
must indicate the span of time covered by the review and each of the six dimensions listed
in section 245G.05, subdivision 2, paragraph (c). The review must:
new text end

new text begin (1) indicate the date, type, and amount of each treatment service provided and the client's
response to each service;
new text end

new text begin (2) address each goal in the treatment plan and whether the methods to address the goals
are effective;
new text end

new text begin (3) include monitoring of any physical and mental health problems;
new text end

new text begin (4) document the participation of others;
new text end

new text begin (5) document staff recommendations for changes in the methods identified in the treatment
plan and whether the client agrees with the change; and
new text end

new text begin (6) include a review and evaluation of the individual abuse prevention plan according
to section 245A.65.
new text end

new text begin (d) Each entry in a client's record must be accurate, legible, signed, and dated. A late
entry must be clearly labeled "late entry." A correction to an entry must be made in a way
in which the original entry can still be read.
new text end

new text begin Subd. 4. new text end

new text begin Service discharge summary. new text end

new text begin (a) An alcohol and drug counselor must write a
service discharge summary for each client. For a planned discharge, the service discharge
summary must be completed within 24 hours before the client's discharge and provided to
the client at discharge. For an unplanned discharge, the service discharge summary must
be completed and provided to the client at discharge or within five days following the client's
discharge, or document why providing the discharge summary was not possible.
new text end

new text begin (b) The service discharge summary must be recorded in the six dimensions listed in
section 245G.05, subdivision 2, paragraph (c), and include the following information:
new text end

new text begin (1) the client's issues, strengths, and needs while participating in treatment, including
services provided;
new text end

new text begin (2) the client's progress toward achieving each goal identified in the individual treatment
plan;
new text end

new text begin (3) a risk description according to section 245G.05; and
new text end

new text begin (4) the reasons for and circumstances of service termination. If a program discharges a
client at staff request, the reason for discharge and the procedure followed for the decision
to discharge must be documented and comply with the program's policies on staff-initiated
client discharge. If a client is discharged at staff request, the program must give the client
crisis and other referrals appropriate for the client's needs and offer assistance to the client
to access the services.
new text end

new text begin (c) For a client who successfully completes treatment, the summary must also include:
new text end

new text begin (1) the client's living arrangements at service termination;
new text end

new text begin (2) continuing care recommendations, including transitions between more or less intense
services, or more frequent to less frequent services, and referrals made with specific attention
to continuity of care for mental health, as needed;
new text end

new text begin (3) service termination diagnosis; and
new text end

new text begin (4) the client's prognosis.
new text end

new text begin EFFECTIVE DATE. new text end

new text begin This section is effective July 1, 2017.
new text end

Sec. 9.

new text begin [245G.07] TREATMENT SERVICE.
new text end

new text begin Subdivision 1. new text end

new text begin Treatment service. new text end

new text begin (a) A license holder must offer the following treatment
services, unless clinically inappropriate and the justifying clinical rationale is documented:
new text end

new text begin (1) individual and group counseling to help the client identify and address needs related
to substance use and develop strategies to avoid harmful substance use after discharge and
to help the client obtain the services necessary to establish a lifestyle free of the harmful
effects of substance use disorder;
new text end

new text begin (2) client education strategies to avoid inappropriate substance use and health problems
related to substance use and the necessary lifestyle changes to regain and maintain health.
Client education must include information on tuberculosis education on a form approved
by the commissioner, the human immunodeficiency virus according to Minnesota Statutes,
section 245A.19, other sexually transmitted diseases, drug and alcohol use during pregnancy,
and hepatitis;
new text end

new text begin (3) a service to help the client integrate gains made during treatment into daily living
and to reduce the client's reliance on a staff member for support;
new text end

new text begin (4) a service to address issues related to co-occurring disorders, including client education
on symptoms of mental illness, the possibility of comorbidity, and the need for continued
medication compliance while recovering from substance use disorder. A group must address
co-occurring disorders, as needed. When treatment for mental health problems is indicated,
the treatment must be integrated into the client's individual treatment plan;
new text end

new text begin (5) on July 1, 2018, or upon federal approval, whichever is later, peer recovery support
services provided one-to-one by an individual in recovery. Peer support services include
education, advocacy, mentoring through self-disclosure of personal recovery experiences,
attending recovery and other support groups with a client, accompanying the client to
appointments that support recovery, assistance accessing resources to obtain housing,
employment, education, and advocacy services, and nonclinical recovery support to assist
the transition from treatment into the recovery community; and
new text end

new text begin (6) on July 1, 2018, or upon federal approval, whichever is later, care coordination
provided by an individual who meets the staff qualifications in section 245G.11, subdivision
7. Care coordination services include:
new text end

new text begin (i) assistance in coordination with significant others to help in the treatment planning
process whenever possible;
new text end

new text begin (ii) assistance in coordination with and follow up for medical services as identified in
the treatment plan;
new text end

new text begin (iii) facilitation of referrals to substance use disorder services as indicated by a client's
medical provider, comprehensive assessment, or treatment plan;
new text end

new text begin (iv) facilitation of referrals to mental health services as identified by a client's
comprehensive assessment or treatment plan;
new text end

new text begin (v) assistance with referrals to economic assistance, social services, housing resources,
and prenatal care according to the client's needs;
new text end

new text begin (vi) life skills advocacy and support accessing treatment follow-up, disease management,
and education services, including referral and linkages to long-term services and supports
as needed; and
new text end

new text begin (vii) documentation of the provision of care coordination services in the client's file.
new text end

new text begin (b) A treatment service provided to a client must be provided according to the individual
treatment plan and must consider cultural differences and special needs of a client.
new text end

new text begin Subd. 2. new text end

new text begin Additional treatment service. new text end

new text begin A license holder may provide or arrange the
following additional treatment service as a part of the client's individual treatment plan:
new text end

new text begin (1) relationship counseling provided by a qualified professional to help the client identify
the impact of the client's substance use disorder on others and to help the client and persons
in the client's support structure identify and change behaviors that contribute to the client's
substance use disorder;
new text end

new text begin (2) therapeutic recreation to allow the client to participate in recreational activities
without the use of mood-altering chemicals and to plan and select leisure activities that do
not involve the inappropriate use of chemicals;
new text end

new text begin (3) stress management and physical well-being to help the client reach and maintain an
appropriate level of health, physical fitness, and well-being;
new text end

new text begin (4) living skills development to help the client learn basic skills necessary for independent
living;
new text end

new text begin (5) employment or educational services to help the client become financially independent;
new text end

new text begin (6) socialization skills development to help the client live and interact with others in a
positive and productive manner; and
new text end

new text begin (7) room, board, and supervision at the treatment site to provide the client with a safe
and appropriate environment to gain and practice new skills.
new text end

new text begin Subd. 3. new text end

new text begin Counselors. new text end

new text begin A treatment service, including therapeutic recreation, must be
provided by an alcohol and drug counselor according to section 245G.11, unless the
individual providing the service is specifically qualified according to the accepted credential
required to provide the service. Therapeutic recreation does not include planned leisure
activities.
new text end

new text begin Subd. 4. new text end

new text begin Location of service provision. new text end

new text begin The license holder may provide services at any
of the license holder's licensed locations or at another suitable location including a school,
government building, medical or behavioral health facility, or social service organization.
If services are provided off site from the licensed site, the reason for the provision of services
remotely must be documented.
new text end

new text begin EFFECTIVE DATE. new text end

new text begin This section is effective July 1, 2017.
new text end

Sec. 10.

new text begin [245G.08] MEDICAL SERVICES.
new text end

new text begin Subdivision 1. new text end

new text begin Health care services. new text end

new text begin An applicant or license holder must maintain a
complete description of the health care services, nursing services, dietary services, and
emergency physician services offered by the applicant or license holder.
new text end

new text begin Subd. 2. new text end

new text begin Procedures. new text end

new text begin The applicant or license holder must have written procedures for
obtaining a medical intervention for a client, that are approved in writing by a physician
who is licensed under chapter 147, unless:
new text end

new text begin (1) the license holder does not provide a service under section 245G.21; and
new text end

new text begin (2) a medical intervention is referred to 911, the emergency telephone number, or the
client's physician.
new text end

new text begin Subd. 3. new text end

new text begin Standing order protocol. new text end

new text begin A license holder that maintains a supply of naloxone
available for emergency treatment of opioid overdose must have a written standing order
protocol by a physician who is licensed under chapter 147, that permits the license holder
to maintain a supply of naloxone on site, and must require staff to undergo specific training
in administration of naloxone.
new text end

new text begin Subd. 4. new text end

new text begin Consultation services. new text end

new text begin The license holder must have access to and document
the availability of a licensed mental health professional to provide diagnostic assessment
and treatment planning assistance.
new text end

new text begin Subd. 5. new text end

new text begin Administration of medication and assistance with self-medication. new text end

new text begin (a) A
license holder must meet the requirements in this subdivision if a service provided includes
the administration of medication.
new text end

new text begin (b) A staff member, other than a licensed practitioner or nurse, who is delegated by a
licensed practitioner or a registered nurse the task of administration of medication or assisting
with self-medication, must:
new text end

new text begin (1) successfully complete a medication administration training program for unlicensed
personnel through an accredited Minnesota postsecondary educational institution. A staff
member's completion of the course must be documented in writing and placed in the staff
member's personnel file;
new text end

new text begin (2) be trained according to a formalized training program that is taught by a registered
nurse and offered by the license holder. The training must include the process for
administration of naloxone, if naloxone is kept on site. A staff member's completion of the
training must be documented in writing and placed in the staff member's personnel records;
or
new text end

new text begin (3) demonstrate to a registered nurse competency to perform the delegated activity. A
registered nurse must be employed or contracted to develop the policies and procedures for
administration of medication or assisting with self-administration of medication, or both.
new text end

new text begin (c) A registered nurse must provide supervision as defined in section 148.171, subdivision
23. The registered nurse's supervision must include, at a minimum, monthly on-site
supervision or more often if warranted by a client's health needs. The policies and procedures
must include:
new text end

new text begin (1) a provision that a delegation of administration of medication is limited to the
administration of a medication that is administered orally, topically, or as a suppository, an
eye drop, an ear drop, or an inhalant;
new text end

new text begin (2) a provision that each client's file must include documentation indicating whether
staff must conduct the administration of medication or the client must self-administer
medication, or both;
new text end

new text begin (3) a provision that a client may carry emergency medication such as nitroglycerin as
instructed by the client's physician;
new text end

new text begin (4) a provision for the client to self-administer medication when a client is scheduled to
be away from the facility;
new text end

new text begin (5) a provision that if a client self-administers medication when the client is present in
the facility, the client must self-administer medication under the observation of a trained
staff member;
new text end

new text begin (6) a provision that when a license holder serves a client who is a parent with a child,
the parent may only administer medication to the child under a staff member's supervision;
new text end

new text begin (7) requirements for recording the client's use of medication, including staff signatures
with date and time;
new text end

new text begin (8) guidelines for when to inform a nurse of problems with self-administration of
medication, including a client's failure to administer, refusal of a medication, adverse
reaction, or error; and
new text end

new text begin (9) procedures for acceptance, documentation, and implementation of a prescription,
whether written, verbal, telephonic, or electronic.
new text end

new text begin Subd. 6. new text end

new text begin Control of drugs. new text end

new text begin A license holder must have and implement written policies
and procedures developed by a registered nurse that contain:
new text end

new text begin (1) a requirement that each drug must be stored in a locked compartment. A Schedule
II drug, as defined by section 152.02, subdivision 3, must be stored in a separately locked
compartment, permanently affixed to the physical plant or medication cart;
new text end

new text begin (2) a system which accounts for all scheduled drugs each shift;
new text end

new text begin (3) a procedure for recording the client's use of medication, including the signature of
the staff member who completed the administration of the medication with the time and
date;
new text end

new text begin (4) a procedure to destroy a discontinued, outdated, or deteriorated medication;
new text end

new text begin (5) a statement that only authorized personnel are permitted access to the keys to a locked
compartment;
new text end

new text begin (6) a statement that no legend drug supply for one client shall be given to another client;
and
new text end

new text begin (7) a procedure for monitoring the available supply of naloxone on site, replenishing
the naloxone supply when needed, and destroying naloxone according to clause (4).
new text end

new text begin EFFECTIVE DATE. new text end

new text begin This section is effective July 1, 2017.
new text end

Sec. 11.

new text begin [245G.09] CLIENT RECORDS.
new text end

new text begin Subdivision 1. new text end

new text begin Client records required. new text end

new text begin (a) A license holder must maintain a file of
current and accurate client records on the premises where the treatment service is provided
or coordinated. For services provided off site, client records must be available at the program
and adhere to the same clinical and administrative policies and procedures as services
provided on site. A program using an electronic health record must maintain virtual access
to client records on the premises where the treatment service is delivered. The content and
format of client records must be uniform and entries in each record must be signed and
dated by the staff member making the entry. Client records must be protected against loss,
tampering, or unauthorized disclosure according to section 254A.09, chapter 13, and Code
of Federal Regulations, title 42, chapter 1, part 2, subpart B, sections 2.1 to 2.67, and title
45, parts 160 to 164.
new text end

new text begin (b) The program must have a policy and procedure that identifies how the program will
track and record client attendance at treatment activities, including the date, duration, and
nature of each treatment service provided to the client.
new text end

new text begin Subd. 2. new text end

new text begin Record retention. new text end

new text begin The client records of a discharged client must be retained
by a license holder for seven years. A license holder that ceases to provide treatment service
must retain client records for seven years from the date of facility closure and must notify
the commissioner of the location of the client records and the name of the individual
responsible for maintaining the client's records.
new text end

new text begin Subd. 3. new text end

new text begin Contents. new text end

new text begin Client records must contain the following:
new text end

new text begin (1) documentation that the client was given information on client rights and
responsibilities, grievance procedures, tuberculosis, and HIV, and that the client was provided
an orientation to the program abuse prevention plan required under section 245A.65,
subdivision 2, paragraph (a), clause (4);
new text end

new text begin (2) an initial services plan completed according to section 245G.04;
new text end

new text begin (3) a comprehensive assessment completed according to section 245G.05;
new text end

new text begin (4) an assessment summary completed according to section 245G.05, subdivision 2;
new text end

new text begin (5) an individual abuse prevention plan according to sections 245A.65, subdivision 2,
and 626.557, subdivision 14, when applicable;
new text end

new text begin (6) an individual treatment plan according to section 245G.06, subdivisions 1 and 2;
new text end

new text begin (7) documentation of treatment services and treatment plan review according to section
245G.06, subdivision 3; and
new text end

new text begin (8) a summary at the time of service termination according to section 245G.06,
subdivision 4.
new text end

new text begin EFFECTIVE DATE. new text end

new text begin This section is effective July 1, 2017.
new text end

Sec. 12.

new text begin [245G.10] STAFF REQUIREMENTS.
new text end

new text begin Subdivision 1. new text end

new text begin Treatment director. new text end

new text begin A license holder must have a treatment director.
new text end

new text begin Subd. 2. new text end

new text begin Alcohol and drug counselor supervisor. new text end

new text begin A license holder must employ an
alcohol and drug counselor supervisor who meets the requirements of section 245G.11,
subdivision 4. An individual may be simultaneously employed as a treatment director,
alcohol and drug counselor supervisor, and an alcohol and drug counselor if the individual
meets the qualifications for each position. If an alcohol and drug counselor is simultaneously
employed as an alcohol and drug counselor supervisor or treatment director, that individual
must be considered a 0.5 full-time equivalent alcohol and drug counselor for staff
requirements under subdivision 4.
new text end

new text begin Subd. 3. new text end

new text begin Responsible staff member. new text end

new text begin A treatment director must designate a staff member
who, when present in the facility, is responsible for the delivery of treatment service. A
license holder must have a designated staff member during all hours of operation. A license
holder providing room and board and treatment at the same site must have a responsible
staff member on duty 24 hours a day. The designated staff member must know and understand
the implications of this chapter and sections 245A.65, 626.556, 626.557, and 626.5572.
new text end

new text begin Subd. 4. new text end

new text begin Staff requirement. new text end

new text begin It is the responsibility of the license holder to determine
an acceptable group size based on each client's needs except that treatment services provided
in a group shall not exceed 16 clients. A counselor in an opioid treatment program must not
supervise more than 50 clients. The license holder must maintain a record that documents
compliance with this subdivision.
new text end

new text begin Subd. 5. new text end

new text begin Medical emergency. new text end

new text begin When a client is present, a license holder must have at
least one staff member on the premises who has a current American Red Cross standard
first aid certificate or an equivalent certificate and at least one staff member on the premises
who has a current American Red Cross community, American Heart Association, or
equivalent CPR certificate. A single staff member with both certifications satisfies this
requirement.
new text end

new text begin EFFECTIVE DATE. new text end

new text begin This section is effective July 1, 2017.
new text end

Sec. 13.

new text begin [245G.11] STAFF QUALIFICATIONS.
new text end

new text begin Subdivision 1. new text end

new text begin General qualifications. new text end

new text begin (a) All staff members who have direct contact
must be 18 years of age or older. At the time of employment, each staff member must meet
the qualifications in this subdivision. For purposes of this subdivision, "problematic substance
use" means a behavior or incident listed by the license holder in the personnel policies and
procedures according to section 245G.13, subdivision 1, clause (5).
new text end

new text begin (b) A treatment director, supervisor, nurse, counselor, student intern, or other professional
must be free of problematic substance use for at least the two years immediately preceding
employment and must sign a statement attesting to that fact.
new text end

new text begin (c) A paraprofessional, recovery peer, or any other staff member with direct contact
must be free of problematic substance use for at least one year immediately preceding
employment and must sign a statement attesting to that fact.
new text end

new text begin Subd. 2. new text end

new text begin Employment; prohibition on problematic substance use. new text end

new text begin A staff member
with direct contact must be free from problematic substance use as a condition of
employment, but is not required to sign additional statements. A staff member with direct
contact who is not free from problematic substance use must be removed from any
responsibilities that include direct contact for the time period specified in subdivision 1.
The time period begins to run on the date of the last incident of problematic substance use
as described in the facility's policies and procedures according to section 245G.13,
subdivision 1, clause (5).
new text end

new text begin Subd. 3. new text end

new text begin Treatment directors. new text end

new text begin A treatment director must:
new text end

new text begin (1) have at least one year of work experience in direct service to an individual with
substance use disorder or one year of work experience in the management or administration
of direct service to an individual with substance use disorder;
new text end

new text begin (2) have a baccalaureate degree or three years of work experience in administration or
personnel supervision in human services; and
new text end

new text begin (3) know and understand the implications of this chapter, chapter 245A, and sections
626.556, 626.557, and 626.5572. Demonstration of the treatment director's knowledge must
be documented in the personnel record.
new text end

new text begin Subd. 4. new text end

new text begin Alcohol and drug counselor supervisors. new text end

new text begin An alcohol and drug counselor
supervisor must:
new text end

new text begin (1) meet the qualification requirements in subdivision 5;
new text end

new text begin (2) have three or more years of experience providing individual and group counseling
to individuals with substance use disorder; and
new text end

new text begin (3) know and understand the implications of this chapter and sections 245A.65, 626.556,
626.557, and 626.5572.
new text end

new text begin Subd. 5. new text end

new text begin Alcohol and drug counselor qualifications. new text end

new text begin (a) An alcohol and drug counselor
must either be: (1) licensed under chapter 148F; or (2) exempt from licensure under chapter
148F and be a mental health professional as defined in section 245.462, subdivision 18.
new text end

new text begin (b) An alcohol and drug counselor must document competence in screening for and
working with clients with mental health disorders through education, training, and experience,
according to section 245G.13, subdivision 2, clause (5). For the purposes of enforcing this
section, the commissioner has the authority to monitor a service provider's compliance with
the relevant standards of a service provider's profession and may issue licensing actions
according to sections 245A.05, 245A.06, and 245A.07 based on the commissioner's
determination of noncompliance.
new text end

new text begin (c) A mental health professional identified in section 245.462, subdivision 18, must meet
one of the following criteria:
new text end

new text begin (1) completion of 270 hours of alcohol and drug counselor training that covers each of
the core functions listed in section 148F.01, subdivision 10, and successful completion of
880 hours of supervised experience as an alcohol and drug counselor, either as a student or
as a staff member; or
new text end

new text begin (2) current certification as an alcohol and drug counselor or alcohol and drug counselor
reciprocal, through the evaluation process established by the International Certification and
Reciprocity Consortium Alcohol and Other Drug Abuse, Inc.
new text end

new text begin (d) An individual who is currently certified as an alcohol and drug counselor by the
Upper Midwest Indian Council on Addictive Disorders meets the qualifications of an alcohol
and drug counselor when providing services to Native American people.
new text end

new text begin Subd. 6. new text end

new text begin Paraprofessionals. new text end

new text begin A paraprofessional must have knowledge of client rights,
according to section 148F.165, and staff member responsibilities. A paraprofessional may
not admit, transfer, or discharge a client but may be responsible for the delivery of treatment
service according to section 245G.10, subdivision 3.
new text end

new text begin Subd. 7. new text end

new text begin Care coordination provider qualifications. new text end

new text begin (a) Care coordination must be
provided by qualified staff. An individual is qualified to provide care coordination if the
individual:
new text end

new text begin (1) is skilled in the process of identifying and assessing a wide range of client needs;
new text end

new text begin (2) is knowledgeable about local community resources and how to use those resources
for the benefit of the client;
new text end

new text begin (3) has successfully completed 30 hours of classroom instruction on care coordination
for an individual with substance use disorder;
new text end

new text begin (4) has either:
new text end

new text begin (i) a bachelor's degree in one of the behavioral sciences or related fields; or
new text end

new text begin (ii) current certification as an alcohol and drug counselor, level I, by the Upper Midwest
Indian Council on Addictive Disorders; and
new text end

new text begin (5) has at least 2,000 hours of supervised experience working with individuals with
substance use disorder.
new text end

new text begin (b) A care coordinator must receive at least one hour of supervision regarding individual
service delivery from an alcohol and drug counselor weekly.
new text end

new text begin Subd. 8. new text end

new text begin Recovery peer qualifications. new text end

new text begin A recovery peer must:
new text end

new text begin (1) be at least 21 years of age and have a high school diploma or its equivalent;
new text end

new text begin (2) have a minimum of one year in recovery from substance use disorder;
new text end

new text begin (3) hold a current credential from a certification body approved by the commissioner
that demonstrates skills and training in the domains of ethics and boundaries, advocacy,
mentoring and education, and recovery and wellness support; and
new text end

new text begin (4) receive ongoing supervision in areas specific to the domains of the recovery peer's
role by an alcohol and drug counselor or an individual with a certification approved by the
commissioner.
new text end

new text begin Subd. 9. new text end

new text begin Volunteers. new text end

new text begin A volunteer may provide treatment service when the volunteer is
supervised and can be seen or heard by a staff member meeting the criteria in subdivision
4 or 5, but may not practice alcohol and drug counseling unless qualified under subdivision
5.
new text end

new text begin Subd. 10. new text end

new text begin Student interns. new text end

new text begin A qualified staff member must supervise and be responsible
for a treatment service performed by a student intern and must review and sign each
assessment, progress note, and individual treatment plan prepared by a student intern. A
student intern must receive the orientation and training required in section 245G.13,
subdivisions 1, clause (7), and 2. No more than 50 percent of the treatment staff may be
students or licensing candidates with time documented to be directly related to the provision
of treatment services for which the staff are authorized.
new text end

new text begin Subd. 11. new text end

new text begin Individuals with temporary permit. new text end

new text begin (a) An individual with a temporary
permit from the Board of Behavioral Health and Therapy may provide chemical dependency
treatment service according to this subdivision.
new text end

new text begin (b) An individual with a temporary permit must be supervised by a licensed alcohol and
drug counselor assigned by the license holder. The supervising licensed alcohol and drug
counselor must document the amount and type of supervision provided at least on a weekly
basis. The supervision must relate to the clinical practice.
new text end

new text begin (c) An individual with a temporary permit must be supervised by a clinical supervisor
approved by the Board of Behavioral Health and Therapy. The supervision must be
documented and meet the requirements of section 148F.04, subdivision 4.
new text end

new text begin EFFECTIVE DATE. new text end

new text begin This section is effective July 1, 2017.
new text end

Sec. 14.

new text begin [245G.12] PROVIDER POLICIES AND PROCEDURES.
new text end

new text begin A license holder must develop a written policies and procedures manual, indexed
according to section 245A.04, subdivision 14, paragraph (c), that provides staff members
immediate access to all policies and procedures and provides a client and other authorized
parties access to all policies and procedures. The manual must contain the following
materials:
new text end

new text begin (1) assessment and treatment planning policies, including screening for mental health
concerns and treatment objectives related to the client's identified mental health concerns
in the client's treatment plan;
new text end

new text begin (2) policies and procedures regarding HIV according to section 245A.19;
new text end

new text begin (3) the license holder's methods and resources to provide information on tuberculosis
and tuberculosis screening to each client and to report a known tuberculosis infection
according to section 144.4804;
new text end

new text begin (4) personnel policies according to section 245G.13;
new text end

new text begin (5) policies and procedures that protect a client's rights according to section 245G.15;
new text end

new text begin (6) a medical services plan according to section 245G.08;
new text end

new text begin (7) emergency procedures according to section 245G.16;
new text end

new text begin (8) policies and procedures for maintaining client records according to section 245G.09;
new text end

new text begin (9) procedures for reporting the maltreatment of minors according to section 626.556,
and vulnerable adults according to sections 245A.65, 626.557, and 626.5572;
new text end

new text begin (10) a description of treatment services, including the amount and type of services
provided;
new text end

new text begin (11) the methods used to achieve desired client outcomes;
new text end

new text begin (12) the hours of operation; and
new text end

new text begin (13) the target population served.
new text end

new text begin EFFECTIVE DATE. new text end

new text begin This section is effective July 1, 2017.
new text end

Sec. 15.

new text begin [245G.13] PROVIDER PERSONNEL POLICIES.
new text end

new text begin Subdivision 1. new text end

new text begin Personnel policy requirements. new text end

new text begin A license holder must have written
personnel policies that are available to each staff member. The personnel policies must:
new text end

new text begin (1) ensure that staff member retention, promotion, job assignment, or pay are not affected
by a good faith communication between a staff member and the department, the Department
of Health, the ombudsman for mental health and developmental disabilities, law enforcement,
or a local agency for the investigation of a complaint regarding a client's rights, health, or
safety;
new text end

new text begin (2) contain a job description for each staff member position specifying responsibilities,
degree of authority to execute job responsibilities, and qualification requirements;
new text end

new text begin (3) provide for a job performance evaluation based on standards of job performance
conducted on a regular and continuing basis, including a written annual review;
new text end

new text begin (4) describe behavior that constitutes grounds for disciplinary action, suspension, or
dismissal, including policies that address staff member problematic substance use and the
requirements of section 245G.11, subdivision 1, policies prohibiting personal involvement
with a client in violation of chapter 604, and policies prohibiting client abuse described in
sections 245A.65, 626.556, 626.557, and 626.5572;
new text end

new text begin (5) identify how the program will identify whether behaviors or incidents are problematic
substance use, including a description of how the facility must address:
new text end

new text begin (i) receiving treatment for substance use within the period specified for the position in
the staff qualification requirements, including medication-assisted treatment;
new text end

new text begin (ii) substance use that negatively impacts the staff member's job performance;
new text end

new text begin (iii) chemical use that affects the credibility of treatment services with a client, referral
source, or other member of the community;
new text end

new text begin (iv) symptoms of intoxication or withdrawal on the job; and
new text end

new text begin (v) the circumstances under which an individual who participates in monitoring by the
health professional services program for a substance use or mental health disorder is able
to provide services to the program's clients;
new text end

new text begin (6) include a chart or description of the organizational structure indicating lines of
authority and responsibilities;
new text end

new text begin (7) include orientation within 24 working hours of starting for each new staff member
based on a written plan that, at a minimum, must provide training related to the staff member's
specific job responsibilities, policies and procedures, client confidentiality, HIV minimum
standards, and client needs; and
new text end

new text begin (8) include policies outlining the license holder's response to a staff member with a
behavior problem that interferes with the provision of treatment service.
new text end

new text begin Subd. 2. new text end

new text begin Staff development. new text end

new text begin (a) A license holder must ensure that each staff member
has the training described in this subdivision.
new text end

new text begin (b) Each staff member must be trained every two years in:
new text end

new text begin (1) client confidentiality rules and regulations and client ethical boundaries; and
new text end

new text begin (2) emergency procedures and client rights as specified in sections 144.651, 148F.165,
and 253B.03.
new text end

new text begin (c) Annually each staff member with direct contact must be trained on mandatory
reporting as specified in sections 245A.65, 626.556, 626.5561, 626.557, and 626.5572,
including specific training covering the license holder's policies for obtaining a release of
client information.
new text end

new text begin (d) Upon employment and annually thereafter, each staff member with direct contact
must receive training on HIV minimum standards according to section 245A.19.
new text end

new text begin (e) A treatment director, supervisor, nurse, or counselor must have a minimum of 12
hours of training in co-occurring disorders that includes competencies related to philosophy,
trauma-informed care, screening, assessment, diagnosis and person-centered treatment
planning, documentation, programming, medication, collaboration, mental health
consultation, and discharge planning. A new staff member who has not obtained the training
must complete the training within six months of employment. A staff member may request,
and the license holder may grant, credit for relevant training obtained before employment,
which must be documented in the staff member's personnel file.
new text end

new text begin Subd. 3. new text end

new text begin Personnel files. new text end

new text begin The license holder must maintain a separate personnel file for
each staff member. At a minimum, the personnel file must conform to the requirements of
this chapter. A personnel file must contain the following:
new text end

new text begin (1) a completed application for employment signed by the staff member and containing
the staff member's qualifications for employment;
new text end

new text begin (2) documentation related to the staff member's background study data, according to
chapter 245C;
new text end

new text begin (3) for a staff member who provides psychotherapy services, employer names and
addresses for the past five years for which the staff member provided psychotherapy services,
and documentation of an inquiry required by sections 604.20 to 604.205 made to the staff
member's former employer regarding substantiated sexual contact with a client;
new text end

new text begin (4) documentation that the staff member completed orientation and training;
new text end

new text begin (5) documentation that the staff member meets the requirements in section 245G.11;
new text end

new text begin (6) documentation demonstrating the staff member's compliance with section 245G.08,
subdivision 3, for a staff member who conducts administration of medication; and
new text end

new text begin (7) documentation demonstrating the staff member's compliance with section 245G.18,
subdivision 2, for a staff member that treats an adolescent client.
new text end

new text begin EFFECTIVE DATE. new text end

new text begin This section is effective July 1, 2017.
new text end

Sec. 16.

new text begin [245G.14] SERVICE INITIATION AND TERMINATION POLICIES.
new text end

new text begin Subdivision 1. new text end

new text begin Service initiation policy. new text end

new text begin A license holder must have a written service
initiation policy containing service initiation preferences that comply with this section and
Code of Federal Regulations, title 45, part 96.131, and specific service initiation criteria.
The license holder must not initiate services for an individual who does not meet the service
initiation criteria. The service initiation criteria must be either posted in the area of the
facility where services for a client are initiated, or given to each interested person upon
request. Titles of each staff member authorized to initiate services for a client must be listed
in the services initiation and termination policies.
new text end

new text begin Subd. 2. new text end

new text begin License holder responsibilities. new text end

new text begin (a) The license holder must have and comply
with a written protocol for (1) assisting a client in need of care not provided by the license
holder, and (2) a client who poses a substantial likelihood of harm to the client or others, if
the behavior is beyond the behavior management capabilities of the staff members.
new text end

new text begin (b) A service termination and denial of service initiation that poses an immediate threat
to the health of any individual or requires immediate medical intervention must be referred
to a medical facility capable of admitting the client.
new text end

new text begin (c) A service termination policy and a denial of service initiation that involves the
commission of a crime against a license holder's staff member or on a license holder's
premises, as provided under Code of Federal Regulations, title 42, section 2.12(c)(5), and
title 45, parts 160 to 164, must be reported to a law enforcement agency with jurisdiction.
new text end

new text begin Subd. 3. new text end

new text begin Service termination policies. new text end

new text begin A license holder must have a written policy
specifying the conditions when a client must be terminated from service. The service
termination policy must include:
new text end

new text begin (1) procedures for a client whose services were terminated under subdivision 2;
new text end

new text begin (2) a description of client behavior that constitutes reason for a staff-requested service
termination and a process for providing this information to a client;
new text end

new text begin (3) a requirement that before discharging a client from a residential setting, for not
reaching treatment plan goals, the license holder must confer with other interested persons
to review the issues involved in the decision. The documentation requirements for a
staff-requested service termination must describe why the decision to discharge is warranted,
the reasons for the discharge, and the alternatives considered or attempted before discharging
the client;
new text end

new text begin (4) procedures consistent with section 253B.16, subdivision 2, that staff members must
follow when a client admitted under chapter 253B is to have services terminated;
new text end

new text begin (5) procedures a staff member must follow when a client leaves against staff or medical
advice and when the client may be dangerous to the client or others, including a policy that
requires a staff member to assist the client with assessing needs of care or other resources;
new text end

new text begin (6) procedures for communicating staff-approved service termination criteria to a client,
including the expectations in the client's individual treatment plan according to section
245G.06; and
new text end

new text begin (7) titles of each staff member authorized to terminate a client's service must be listed
in the service initiation and service termination policies.
new text end

new text begin EFFECTIVE DATE. new text end

new text begin This section is effective July 1, 2017.
new text end

Sec. 17.

new text begin [245G.15] CLIENT RIGHTS PROTECTION.
new text end

new text begin Subdivision 1. new text end

new text begin Explanation. new text end

new text begin A client has the rights identified in sections 144.651,
148F.165, 253B.03, and 254B.02, subdivision 2, as applicable. The license holder must
give each client at service initiation a written statement of the client's rights and
responsibilities. A staff member must review the statement with a client at that time.
new text end

new text begin Subd. 2. new text end

new text begin Grievance procedure. new text end

new text begin At service initiation, the license holder must explain
the grievance procedure to the client or the client's representative. The grievance procedure
must be posted in a place visible to clients, and made available upon a client's or former
client's request. The grievance procedure must require that:
new text end

new text begin (1) a staff member helps the client develop and process a grievance;
new text end

new text begin (2) current telephone numbers and 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 the Board
of Behavioral Health and Therapy, when applicable, be made available to a client; and
new text end

new text begin (3) a license holder responds to the client's grievance within three days of a staff member's
receipt of the grievance, and the client may bring the grievance to the highest level of
authority in the program if not resolved by another staff member.
new text end

new text begin Subd. 3. new text end

new text begin Photographs of client. new text end

new text begin (a) A photograph, video, or motion picture of a client
taken in the provision of treatment service is considered client records. A photograph for
identification and a recording by video or audio technology to enhance either therapy or
staff member supervision may be required of a client, but may only be available for use as
communications within a program. A client must be informed when the client's actions are
being recorded by camera or other technology, and the client must have the right to refuse
any recording or photography, except as authorized by this subdivision.
new text end

new text begin (b) A license holder must have a written policy regarding the use of any personal
electronic device that can record, transmit, or make images of another client. A license
holder must inform each client of this policy and the client's right to refuse being
photographed or recorded.
new text end

new text begin EFFECTIVE DATE. new text end

new text begin This section is effective July 1, 2017.
new text end

Sec. 18.

new text begin [245G.16] BEHAVIORAL EMERGENCY PROCEDURES.
new text end

new text begin (a) A license holder or applicant must have written behavioral emergency procedures
that staff must follow when responding to a client who exhibits behavior that is threatening
to the safety of the client or others. Programs must incorporate person-centered planning
and trauma-informed care in the program's behavioral emergency procedure policies. The
procedures must include:
new text end

new text begin (1) a plan designed to prevent a client from hurting themselves or others;
new text end

new text begin (2) contact information for emergency resources that staff must consult when a client's
behavior cannot be controlled by the behavioral emergency procedures;
new text end

new text begin (3) types of procedures that may be used;
new text end

new text begin (4) circumstances under which behavioral emergency procedures may be used; and
new text end

new text begin (5) staff members authorized to implement behavioral emergency procedures.
new text end

new text begin (b) Behavioral emergency procedures must not be used to enforce facility rules or for
the convenience of staff. Behavioral emergency procedures must not be part of any client's
treatment plan, or used at any time for any reason except in response to specific current
behavior that threatens the safety of the client or others. Behavioral emergency procedures
may not include the use of seclusion or restraint.
new text end

new text begin EFFECTIVE DATE. new text end

new text begin This section is effective July 1, 2017.
new text end

Sec. 19.

new text begin [245G.17] EVALUATION.
new text end

new text begin A license holder must participate in the drug and alcohol abuse normative evaluation
system by submitting information about each client to the commissioner in a manner
prescribed by the commissioner. A license holder must submit additional information
requested by the commissioner that is necessary to meet statutory or federal funding
requirements.
new text end

new text begin EFFECTIVE DATE. new text end

new text begin This section is effective July 1, 2017.
new text end

Sec. 20.

new text begin [245G.18] LICENSE HOLDERS SERVING ADOLESCENTS.
new text end

new text begin Subdivision 1. new text end

new text begin License. new text end

new text begin A residential treatment program that serves an adolescent younger
than 16 years of age must be licensed as a residential program for a child in out-of-home
placement by the department unless the license holder is exempt under section 245A.03,
subdivision 2.
new text end

new text begin Subd. 2. new text end

new text begin Alcohol and drug counselor qualifications. new text end

new text begin In addition to the requirements
specified in section 245G.11, subdivisions 1 and 5, an alcohol and drug counselor providing
treatment service to an adolescent must have:
new text end

new text begin (1) an additional 30 hours of classroom instruction or one three-credit semester college
course in adolescent development. This training need only be completed one time; and
new text end

new text begin (2) at least 150 hours of supervised experience as an adolescent counselor, either as a
student or as a staff member.
new text end

new text begin Subd. 3. new text end

new text begin Staff ratios. new text end

new text begin At least 25 percent of a counselor's scheduled work hours must
be allocated to indirect services, including documentation of client services, coordination
of services with others, treatment team meetings, and other duties. A counseling group
consisting entirely of adolescents must not exceed 16 adolescents. It is the responsibility of
the license holder to determine an acceptable group size based on the needs of the clients.
new text end

new text begin Subd. 4. new text end

new text begin Academic program requirements. new text end

new text begin A client who is required to attend school
must be enrolled and attending an educational program that was approved by the Department
of Education.
new text end

new text begin Subd. 5. new text end

new text begin Program requirements. new text end

new text begin In addition to the requirements specified in the client's
treatment plan under section 245G.06, programs serving an adolescent must include:
new text end

new text begin (1) coordination with the school system to address the client's academic needs;
new text end

new text begin (2) when appropriate, a plan that addresses the client's leisure activities without chemical
use; and
new text end

new text begin (3) a plan that addresses family involvement in the adolescent's treatment.
new text end

new text begin EFFECTIVE DATE. new text end

new text begin This section is effective July 1, 2017.
new text end

Sec. 21.

new text begin [245G.19] LICENSE HOLDERS SERVING CLIENTS WITH CHILDREN.
new text end

new text begin Subdivision 1. new text end

new text begin Health license requirements. new text end

new text begin In addition to the requirements of sections
245G.01 to 245G.17, a license holder that offers supervision of a child of a client is subject
to the requirements of this section. A license holder providing room and board for a client
and the client's child must have an appropriate facility license from the Department of
Health.
new text end

new text begin Subd. 2. new text end

new text begin Supervision of a child. new text end

new text begin "Supervision of a child" means a caregiver is within
sight or hearing of an infant, toddler, or preschooler at all times so that the caregiver can
intervene to protect the child's health and safety. For a school-age child it means a caregiver
is available to help and care for the child to protect the child's health and safety.
new text end

new text begin Subd. 3. new text end

new text begin Policy and schedule required. new text end

new text begin A license holder must meet the following
requirements:
new text end

new text begin (1) have a policy and schedule delineating the times and circumstances when the license
holder is responsible for supervision of a child in the program and when the child's parents
are responsible for supervision of a child. The policy must explain how the program will
communicate its policy about supervision of a child responsibility to the parent; and
new text end

new text begin (2) have written procedures addressing the actions a staff member must take if a child
is neglected or abused, including while the child is under the supervision of the child's
parent.
new text end

new text begin Subd. 4. new text end

new text begin Additional licensing requirements. new text end

new text begin During the times the license holder is
responsible for the supervision of a child, the license holder must meet the following
standards:
new text end

new text begin (1) child and adult ratios in Minnesota Rules, part 9502.0367;
new text end

new text begin (2) day care training in section 245A.50;
new text end

new text begin (3) behavior guidance in Minnesota Rules, part 9502.0395;
new text end

new text begin (4) activities and equipment in Minnesota Rules, part 9502.0415;
new text end

new text begin (5) physical environment in Minnesota Rules, part 9502.0425; and
new text end

new text begin (6) water, food, and nutrition in Minnesota Rules, part 9502.0445, unless the license
holder has a license from the Department of Health.
new text end

new text begin EFFECTIVE DATE. new text end

new text begin This section is effective July 1, 2017.
new text end

Sec. 22.

new text begin [245G.20] LICENSE HOLDERS SERVING PERSONS WITH
CO-OCCURRING DISORDERS.
new text end

new text begin A license holder specializing in the treatment of a person with co-occurring disorders
must:
new text end

new text begin (1) demonstrate that staff levels are appropriate for treating a client with a co-occurring
disorder, and that there are adequate staff members with mental health training;
new text end

new text begin (2) have continuing access to a medical provider with appropriate expertise in prescribing
psychotropic medication;
new text end

new text begin (3) have a mental health professional available for staff member supervision and
consultation;
new text end

new text begin (4) determine group size, structure, and content considering the special needs of a client
with a co-occurring disorder;
new text end

new text begin (5) have documentation of active interventions to stabilize mental health symptoms
present in the individual treatment plans and progress notes;
new text end

new text begin (6) have continuing documentation of collaboration with continuing care mental health
providers, and involvement of the providers in treatment planning meetings;
new text end

new text begin (7) have available program materials adapted to a client with a mental health problem;
new text end

new text begin (8) have policies that provide flexibility for a client who may lapse in treatment or may
have difficulty adhering to established treatment rules as a result of a mental illness, with
the goal of helping a client successfully complete treatment; and
new text end

new text begin (9) have individual psychotherapy and case management available during treatment
service.
new text end

new text begin EFFECTIVE DATE. new text end

new text begin This section is effective July 1, 2017.
new text end

Sec. 23.

new text begin [245G.21] REQUIREMENTS FOR LICENSED RESIDENTIAL
TREATMENT.
new text end

new text begin Subdivision 1. new text end

new text begin Applicability. new text end

new text begin A license holder who provides supervised room and board
at the licensed program site as a treatment component is defined as a residential program
according to section 245A.02, subdivision 14, and is subject to this section.
new text end

new text begin Subd. 2. new text end

new text begin Visitors. new text end

new text begin A client must be allowed to receive visitors at times prescribed by
the license holder. The license holder must set and post a notice of visiting rules and hours,
including both day and evening times. A client's right to receive visitors other than a personal
physician, religious adviser, county case manager, parole or probation officer, or attorney
may be subject to visiting hours established by the license holder for all clients. The treatment
director or designee may impose limitations as necessary for the welfare of a client provided
the limitation and the reasons for the limitation are documented in the client's file. A client
must be allowed to receive visits at all reasonable times from the client's personal physician,
religious adviser, county case manager, parole or probation officer, and attorney.
new text end

new text begin Subd. 3. new text end

new text begin Client property management. new text end

new text begin A license holder who provides room and board
and treatment services to a client in the same facility, and any license holder that accepts
client property must meet the requirements for handling client funds and property in section
245A.04, subdivision 13. License holders:
new text end

new text begin (1) may establish policies regarding the use of personal property to ensure that treatment
activities and the rights of other clients are not infringed upon;
new text end

new text begin (2) may take temporary custody of a client's property for violation of a facility policy;
new text end

new text begin (3) must retain the client's property for a minimum of seven days after the client's service
termination if the client does not reclaim property upon service termination, or for a minimum
of 30 days if the client does not reclaim property upon service termination and has received
room and board services from the license holder; and
new text end

new text begin (4) must return all property held in trust to the client at service termination regardless
of the client's service termination status, except that:
new text end

new text begin (i) a drug, drug paraphernalia, or drug container that is subject to forfeiture under section
609.5316, must be given to the custody of a local law enforcement agency. If giving the
property to the custody of a local law enforcement agency violates Code of Federal
Regulations, title 42, sections 2.1 to 2.67, or title 45, parts 160 to 164, a drug, drug
paraphernalia, or drug container must be destroyed by a staff member designated by the
program director; and
new text end

new text begin (ii) a weapon, explosive, and other property that can cause serious harm to the client or
others must be given to the custody of a local law enforcement agency, and the client must
be notified of the transfer and of the client's right to reclaim any lawful property transferred;
and
new text end

new text begin (iii) a medication that was determined by a physician to be harmful after examining the
client must be destroyed, except when the client's personal physician approves the medication
for continued use.
new text end

new text begin Subd. 4. new text end

new text begin Health facility license. new text end

new text begin A license holder who provides room and board and
treatment services in the same facility must have the appropriate license from the Department
of Health.
new text end

new text begin Subd. 5. new text end

new text begin Facility abuse prevention plan. new text end

new text begin A license holder must establish and enforce
an ongoing facility abuse prevention plan consistent with sections 245A.65 and 626.557,
subdivision 14.
new text end

new text begin Subd. 6. new text end

new text begin Individual abuse prevention plan. new text end

new text begin A license holder must prepare an individual
abuse prevention plan for each client as specified under sections 245A.65, subdivision 2,
and 626.557, subdivision 14.
new text end

new text begin Subd. 7. new text end

new text begin Health services. new text end

new text begin A license holder must have written procedures for assessing
and monitoring a client's health, including a standardized data collection tool for collecting
health-related information about each client. The policies and procedures must be approved
and signed by a registered nurse.
new text end

new text begin Subd. 8. new text end

new text begin Administration of medication. new text end

new text begin A license holder must meet the administration
of medications requirements of section 245G.08, subdivision 5, if services include medication
administration.
new text end

new text begin EFFECTIVE DATE. new text end

new text begin This section is effective July 1, 2017.
new text end

Sec. 24.

new text begin [245G.22] OPIOID TREATMENT PROGRAMS.
new text end

new text begin Subdivision 1. new text end

new text begin Additional requirements. new text end

new text begin (a) An opioid treatment program licensed
under this chapter must also comply with the requirements of this section and Code of
Federal Regulations, title 42, part 8. When federal guidance or interpretations are issued on
federal standards or requirements also required under this section, the federal guidance or
interpretations shall apply.
new text end

new text begin (b) Where a standard in this section differs from a standard in an otherwise applicable
administrative rule or statute, the standard of this section applies.
new text end

new text begin Subd. 2. new text end

new text begin Definitions. new text end

new text begin (a) For purposes of this section, the terms defined in this subdivision
have the meanings given them.
new text end

new text begin (b) "Diversion" means the use of a medication for the treatment of opioid addiction being
diverted from intended use of the medication.
new text end

new text begin (c) "Guest dose" means administration of a medication used for the treatment of opioid
addiction to a person who is not a client of the program that is administering or dispensing
the medication.
new text end

new text begin (d) "Medical director" means a physician licensed to practice medicine in the jurisdiction
that the opioid treatment program is located who assumes responsibility for administering
all medical services performed by the program, either by performing the services directly
or by delegating specific responsibility to authorized program physicians and health care
professionals functioning under the medical director's direct supervision.
new text end

new text begin (e) "Medication used for the treatment of opioid use disorder" means a medication
approved by the Food and Drug Administration for the treatment of opioid use disorder.
new text end

new text begin (f) "Minnesota health care programs" has the meaning given in section 256B.0636.
new text end

new text begin (g) "Opioid treatment program" has the meaning given in Code of Federal Regulations,
title 42, section 8.12, and includes programs licensed under this chapter.
new text end

new text begin (h) "Placing authority" has the meaning given in Minnesota Rules, part 9530.6605,
subpart 21a.
new text end

new text begin (i) "Unsupervised use" means the use of a medication for the treatment of opioid use
disorder dispensed for use by a client outside of the program setting.
new text end

new text begin Subd. 3. new text end

new text begin Medication orders. new text end

new text begin Before the program may administer or dispense a medication
used for the treatment of opioid use disorder:
new text end

new text begin (1) a client-specific order must be received from an appropriately credentialed physician
who is enrolled as a Minnesota health care programs provider and meets all applicable
provider standards;
new text end

new text begin (2) the signed order must be documented in the client's record; and
new text end

new text begin (3) if the physician that issued the order is not able to sign the order when issued, the
unsigned order must be entered in the client record at the time it was received, and the
physician must review the documentation and sign the order in the client's record within 72
hours of the medication being ordered. The license holder must report to the commissioner
any medication error that endangers a client's health, as determined by the medical director.
new text end

new text begin Subd. 4. new text end

new text begin High dose requirements. new text end

new text begin A client being administered or dispensed a dose
beyond that set forth in subdivision 6, paragraph (a), clause (1), that exceeds 150 milligrams
of methadone or 24 milligrams of buprenorphine daily, and for each subsequent increase,
must meet face-to-face with a prescribing physician. The meeting must occur before the
administration or dispensing of the increased medication dose.
new text end

new text begin Subd. 5. new text end

new text begin Drug testing. new text end

new text begin Each client enrolled in the program must receive a minimum of
eight random drug abuse tests per 12 months of treatment. Drug abuse tests must be
reasonably disbursed over the 12-month period. A license holder may elect to conduct more
drug abuse tests.
new text end

new text begin Subd. 6. new text end

new text begin Criteria for unsupervised use. new text end

new text begin (a) To limit the potential for diversion of
medication used for the treatment of opioid use disorder to the illicit market, medication
dispensed to a client for unsupervised use shall be subject to the following requirements:
new text end

new text begin (1) any client in an opioid treatment program may receive a single unsupervised use
dose for a day that the clinic is closed for business, including Sundays and state and federal
holidays; and
new text end

new text begin (2) other treatment program decisions on dispensing medications used for the treatment
of opioid use disorder to a client for unsupervised use shall be determined by the medical
director.
new text end

new text begin (b) In determining whether a client may be permitted unsupervised use of medications,
a physician with authority to prescribe must consider the criteria in this paragraph. The
criteria in this paragraph must also be considered when determining whether dispensing
medication for a client's unsupervised use is appropriate to increase or to extend the amount
of time between visits to the program. The criteria are:
new text end

new text begin (1) absence of recent abuse of drugs including but not limited to opioids, nonnarcotics,
and alcohol;
new text end

new text begin (2) regularity of program attendance;
new text end

new text begin (3) absence of serious behavioral problems at the program;
new text end

new text begin (4) absence of known recent criminal activity such as drug dealing;
new text end

new text begin (5) stability of the client's home environment and social relationships;
new text end

new text begin (6) length of time in comprehensive maintenance treatment;
new text end

new text begin (7) reasonable assurance that unsupervised use medication will be safely stored within
the client's home; and
new text end

new text begin (8) whether the rehabilitative benefit the client derived from decreasing the frequency
of program attendance outweighs the potential risks of diversion or unsupervised use.
new text end

new text begin (c) The determination, including the basis of the determination must be documented in
the client's medical record.
new text end

new text begin Subd. 7. new text end

new text begin Restrictions for unsupervised use of methadone hydrochloride. new text end

new text begin (a) If a
physician with authority to prescribe determines that a client meets the criteria in subdivision
6 and may be dispensed a medication used for the treatment of opioid addiction, the
restrictions in this subdivision must be followed when the medication to be dispensed is
methadone hydrochloride.
new text end

new text begin (b) During the first 90 days of treatment, the unsupervised use medication supply must
be limited to a maximum of a single dose each week and the client shall ingest all other
doses under direct supervision.
new text end

new text begin (c) In the second 90 days of treatment, the unsupervised use medication supply must be
limited to two doses per week.
new text end

new text begin (d) In the third 90 days of treatment, the unsupervised use medication supply must not
exceed three doses per week.
new text end

new text begin (e) In the remaining months of the first year, a client may be given a maximum six-day
unsupervised use medication supply.
new text end

new text begin (f) After one year of continuous treatment, a client may be given a maximum two-week
unsupervised use medication supply.
new text end

new text begin (g) After two years of continuous treatment, a client may be given a maximum one-month
unsupervised use medication supply, but must make monthly visits to the program.
new text end

new text begin Subd. 8. new text end

new text begin Restriction exceptions. new text end

new text begin When a license holder has reason to accelerate the
number of unsupervised use doses of methadone hydrochloride, the license holder must
comply with the requirements of Code of Federal Regulations, title 42, section 8.12, the
criteria for unsupervised use and must use the exception process provided by the federal
Center for Substance Abuse Treatment Division of Pharmacologic Therapies. For the
purposes of enforcement of this subdivision, the commissioner has the authority to monitor
a program for compliance with federal regulations and may issue licensing actions according
to sections 245A.05, 245A.06, and 245A.07 based on the commissioner's determination of
noncompliance.
new text end

new text begin Subd. 9. new text end

new text begin Guest dose. new text end

new text begin To receive a guest dose, the client must be enrolled in an opioid
treatment program elsewhere in the state or country and be receiving the medication on a
temporary basis because the client is not able to receive the medication at the program in
which the client is enrolled. Such arrangements shall not exceed 30 consecutive days in any
one program and must not be for the convenience or benefit of either program. A guest dose
may also occur when the client's primary clinic is not open and the client is not receiving
unsupervised use doses.
new text end

new text begin Subd. 10. new text end

new text begin Capacity management and waiting list system compliance. new text end

new text begin An opioid
treatment program must notify the department within seven days of the program reaching
both 90 and 100 percent of the program's capacity to care for clients. Each week, the program
must report its capacity, currently enrolled dosing clients, and any waiting list. A program
reporting 90 percent of capacity must also notify the department when the program's census
increases or decreases from the 90 percent level.
new text end

new text begin Subd. 11. new text end

new text begin Waiting list. new text end

new text begin An opioid treatment program must have a waiting list system.
If the person seeking admission cannot be admitted within 14 days of the date of application,
each person seeking admission must be placed on the waiting list, unless the person seeking
admission is assessed by the program and found ineligible for admission according to this
chapter and Code of Federal Regulations, title 42, part 1, subchapter A, section 8.12(e), and
title 45, parts 160 to 164. The waiting list must assign a unique client identifier for each
person seeking treatment while awaiting admission. A person seeking admission on a waiting
list who receives no services under section 245G.07, subdivision 1, must not be considered
a "client" as defined in section 245G.01, subdivision 9.
new text end

new text begin Subd. 12. new text end

new text begin Client referral. new text end

new text begin An opioid treatment program must consult the capacity
management system to ensure that a person on a waiting list is admitted at the earliest time
to a program providing appropriate treatment within a reasonable geographic area. If the
client was referred through a public payment system and if the program is not able to serve
the client within 14 days of the date of application for admission, the program must contact
and inform the referring agency of any available treatment capacity listed in the state capacity
management system.
new text end

new text begin Subd. 13. new text end

new text begin Outreach. new text end

new text begin An opioid treatment program must carry out activities to encourage
an individual in need of treatment to undergo treatment. The program's outreach model
must:
new text end

new text begin (1) select, train, and supervise outreach workers;
new text end

new text begin (2) contact, communicate, and follow up with individuals with high-risk substance
misuse, individuals with high-risk substance misuse associates, and neighborhood residents
within the constraints of federal and state confidentiality requirements;
new text end

new text begin (3) promote awareness among individuals who engage in substance misuse by injection
about the relationship between injecting substances and communicable diseases such as
HIV; and
new text end

new text begin (4) recommend steps to prevent HIV transmission.
new text end

new text begin Subd. 14. new text end

new text begin Central registry. new text end

new text begin (a) A license holder must comply with requirements to
submit information and necessary consents to the state central registry for each client
admitted, as specified by the commissioner. The license holder must submit data concerning
medication used for the treatment of opioid use disorder. The data must be submitted in a
method determined by the commissioner and the original information must be kept in the
client's record. The information must be submitted for each client at admission and discharge.
The program must document the date the information was submitted. The client's failure to
provide the information shall prohibit participation in an opioid treatment program. The
information submitted must include the client's:
new text end

new text begin (1) full name and all aliases;
new text end

new text begin (2) date of admission;
new text end

new text begin (3) date of birth;
new text end

new text begin (4) Social Security number or Alien Registration Number, if any;
new text end

new text begin (5) current or previous enrollment status in another opioid treatment program;
new text end

new text begin (6) government-issued photo identification card number; and
new text end

new text begin (7) driver's license number, if any.
new text end

new text begin (b) The requirements in paragraph (a) are effective upon the commissioner's
implementation of changes to the drug and alcohol abuse normative evaluation system or
development of an electronic system by which to submit the data.
new text end

new text begin Subd. 15. new text end

new text begin Nonmedication treatment services; documentation. new text end

new text begin (a) The program must
offer at least 50 consecutive minutes of individual or group therapy treatment services as
defined in section 245G.07, subdivision 1, paragraph (a), clause (1), per week, for the first
ten weeks following admission, and at least 50 consecutive minutes per month thereafter.
As clinically appropriate, the program may offer these services cumulatively and not
consecutively in increments of no less than 15 minutes over the required time period, and
for a total of 60 minutes of treatment services over the time period, and must document the
reason for providing services cumulatively in the client's record. The program may offer
additional levels of service when deemed clinically necessary.
new text end

new text begin (b) Notwithstanding the requirements of comprehensive assessments in section 245G.05,
the assessment must be completed within 21 days of service initiation.
new text end

new text begin (c) Notwithstanding the requirements of individual treatment plans set forth in section
245G.06:
new text end

new text begin (1) treatment plan contents for a maintenance client are not required to include goals
the client must reach to complete treatment and have services terminated;
new text end

new text begin (2) treatment plans for a client in a taper or detox status must include goals the client
must reach to complete treatment and have services terminated;
new text end

new text begin (3) for the initial ten weeks after admission for all new admissions, readmissions, and
transfers, progress notes must be entered in a client's file at least weekly and be recorded
in each of the six dimensions upon the development of the treatment plan and thereafter.
Subsequently, the counselor must document progress in the six dimensions at least once
monthly or, when clinical need warrants, more frequently; and
new text end

new text begin (4) upon the development of the treatment plan and thereafter, treatment plan reviews
must occur weekly, or after each treatment service, whichever is less frequent, for the first
ten weeks after the treatment plan is developed. Following the first ten weeks of treatment
plan reviews, reviews may occur monthly, unless the client's needs warrant more frequent
revisions or documentation.
new text end

new text begin Subd. 16. new text end

new text begin Prescription monitoring program. new text end

new text begin (a) The program must develop and
maintain a policy and procedure that requires the ongoing monitoring of the data from the
prescription monitoring program (PMP) for each client. The policy and procedure must
include how the program meets the requirements in paragraph (b).
new text end

new text begin (b) If a medication used for the treatment of substance use disorder is administered or
dispensed to a client, the license holder shall be subject to the following requirements:
new text end

new text begin (1) upon admission to a methadone clinic outpatient treatment program, a client must
be notified in writing that the commissioner of human services and the medical director
must monitor the PMP to review the prescribed controlled drugs a client received;
new text end

new text begin (2) the medical director or the medical director's delegate must review the data from the
PMP described in section 152.126 before the client is ordered any controlled substance, as
defined under section 152.126, subdivision 1, paragraph (c), including medications used
for the treatment of opioid addiction, and the medical director's or the medical director's
delegate's subsequent reviews of the PMP data must occur at least every 90 days;
new text end

new text begin (3) a copy of the PMP data reviewed must be maintained in the client's file;
new text end

new text begin (4) when the PMP data contains a recent history of multiple prescribers or multiple
prescriptions for controlled substances, the physician's review of the data and subsequent
actions must be documented in the client's file within 72 hours and must contain the medical
director's determination of whether or not the prescriptions place the client at risk of harm
and the actions to be taken in response to the PMP findings. The provider must conduct
subsequent reviews of the PMP on a monthly basis; and
new text end

new text begin (5) if at any time the medical director believes the use of the controlled substances places
the client at risk of harm, the program must seek the client's consent to discuss the client's
opioid treatment with other prescribers and must seek the client's consent for the other
prescriber to disclose to the opioid treatment program's medical director the client's condition
that formed the basis of the other prescriptions. If the information is not obtained within
seven days, the medical director must document whether or not changes to the client's
medication dose or number of unsupervised use doses are necessary until the information
is obtained.
new text end

new text begin (c) The commissioner shall collaborate with the Minnesota Board of Pharmacy to develop
and implement an electronic system for the commissioner to routinely access the PMP data
to determine whether any client enrolled in an opioid addiction treatment program licensed
according to this section was prescribed or dispensed a controlled substance in addition to
that administered or dispensed by the opioid addiction treatment program. When the
commissioner determines there have been multiple prescribers or multiple prescriptions of
controlled substances for a client, the commissioner shall:
new text end

new text begin (1) inform the medical director of the opioid treatment program only that the
commissioner determined the existence of multiple prescribers or multiple prescriptions of
controlled substances; and
new text end

new text begin (2) direct the medical director of the opioid treatment program to access the data directly,
review the effect of the multiple prescribers or multiple prescriptions, and document the
review.
new text end

new text begin (d) If determined necessary, the commissioner shall seek a federal waiver of, or exception
to, any applicable provision of Code of Federal Regulations, title 42, section 2.34(c), before
implementing this subdivision.
new text end

new text begin Subd. 17. new text end

new text begin Policies and procedures. new text end

new text begin (a) A license holder must develop and maintain the
policies and procedures required in this subdivision.
new text end

new text begin (b) For a program that is not open every day of the year, the license holder must maintain
a policy and procedure that permits a client to receive a single unsupervised use of medication
used for the treatment of opioid use disorder for days that the program is closed for business,
including, but not limited to, Sundays and state and federal holidays as required under
subdivision 6, paragraph (a), clause (1).
new text end

new text begin (c) The license holder must maintain a policy and procedure that includes specific
measures to reduce the possibility of diversion. The policy and procedure must:
new text end

new text begin (1) specifically identify and define the responsibilities of the medical and administrative
staff for performing diversion control measures; and
new text end

new text begin (2) include a process for contacting no less than five percent of clients who have
unsupervised use of medication, excluding clients approved solely under subdivision 6,
paragraph (a), clause (1), to require clients to physically return to the program each month.
The system must require clients to return to the program within a stipulated time frame and
turn in all unused medication containers related to opioid use disorder treatment. The license
holder must document all related contacts on a central log and the outcome of the contact
for each client in the client's record.
new text end

new text begin (d) Medication used for the treatment of opioid use disorder must be ordered,
administered, and dispensed according to applicable state and federal regulations and the
standards set by applicable accreditation entities. If a medication order requires assessment
by the person administering or dispensing the medication to determine the amount to be
administered or dispensed, the assessment must be completed by an individual whose
professional scope of practice permits an assessment. For the purposes of enforcement of
this paragraph, the commissioner has the authority to monitor the person administering or
dispensing the medication for compliance with state and federal regulations and the relevant
standards of the license holder's accreditation agency and may issue licensing actions
according to sections 245A.05, 245A.06, and 245A.07, based on the commissioner's
determination of noncompliance.
new text end

new text begin Subd. 18. new text end

new text begin Quality improvement plan. new text end

new text begin The license holder must develop and maintain
a quality improvement plan that:
new text end

new text begin (1) includes evaluation of the services provided to clients to identify issues that may
improve service delivery and client outcomes;
new text end

new text begin (2) includes goals for the program to accomplish based on the evaluation;
new text end

new text begin (3) is reviewed annually by the management of the program to determine whether the
goals were met and, if not, whether additional action is required;
new text end

new text begin (4) is updated at least annually to include new or continued goals based on an updated
evaluation of services; and
new text end

new text begin (5) identifies two specific goal areas, in addition to others identified by the program,
including:
new text end

new text begin (i) a goal concerning oversight and monitoring of the premises around and near the
exterior of the program to reduce the possibility of medication used for the treatment of
opioid use disorder being inappropriately used by a client, including but not limited to the
sale or transfer of the medication to others; and
new text end

new text begin (ii) a goal concerning community outreach, including but not limited to communications
with local law enforcement and county human services agencies, to increase coordination
of services and identification of areas of concern to be addressed in the plan.
new text end

new text begin Subd. 19. new text end

new text begin Placing authorities. new text end

new text begin A program must provide certain notification and
client-specific updates to placing authorities for a client who is enrolled in Minnesota health
care programs. At the request of the placing authority, the program must provide
client-specific updates, including but not limited to informing the placing authority of
positive drug screenings and changes in medications used for the treatment of opioid use
disorder ordered for the client.
new text end

new text begin Subd. 20. new text end

new text begin Duty to report suspected drug diversion. new text end

new text begin (a) To the fullest extent permitted
under Code of Federal Regulations, title 42, sections 2.1 to 2.67, a program shall report to
law enforcement any credible evidence that the program or its personnel knows, or reasonably
should know, that is directly related to a diversion crime on the premises of the program,
or a threat to commit a diversion crime.
new text end

new text begin (b) "Diversion crime," for the purposes of this section, means diverting, attempting to
divert, or conspiring to divert Schedule I, II, III, or IV drugs, as defined in section 152.02,
on the program's premises.
new text end

new text begin (c) The program must document the program's compliance with the requirement in
paragraph (a) in either a client's record or an incident report. A program's failure to comply
with paragraph (a) may result in sanctions as provided in sections 245A.06 and 245A.07.
new text end

new text begin EFFECTIVE DATE. new text end

new text begin This section is effective July 1, 2017.
new text end

Sec. 25.

Minnesota Statutes 2016, section 254A.01, is amended to read:

254A.01 PUBLIC POLICY.

It is hereby declared to be the public policy of this state that new text begin scientific evidence shows
that addiction to alcohol or other drugs is a chronic brain disorder with potential for
recurrence, and as with many other chronic conditions, people with substance use disorders
can be effectively treated and can enter recovery. new text end The interests of society are best served
by new text begin reducing the stigma of substance use disorder and new text end providing persons who are dependent
upon alcohol or other drugs with a comprehensive range of rehabilitative and social services new text begin
that span intensity levels and are not restricted to a particular point in time new text end . Further, it is
declared that treatment under these services shall be voluntary when possible: treatment
shall not be denied on the basis of prior treatment; treatment shall be based on an individual
treatment plan for each person undergoing treatment; treatment shall include a continuum
of services available for a person leaving a program of treatment; treatment shall include
all family members at the earliest possible phase of the treatment process.

new text begin EFFECTIVE DATE. new text end

new text begin This section is effective July 1, 2017.
new text end

Sec. 26.

Minnesota Statutes 2016, section 254A.02, subdivision 2, is amended to read:

Subd. 2.

Approved treatment program.

"Approved treatment program" means care
and treatment services provided by any individual, organization or association to deleted text begin drug
dependent deleted text end persons new text begin with a substance use disorder new text end , which meets the standards established by
the commissioner of human services.

new text begin EFFECTIVE DATE. new text end

new text begin This section is effective July 1, 2017.
new text end

Sec. 27.

Minnesota Statutes 2016, section 254A.02, subdivision 3, is amended to read:

Subd. 3.

Comprehensive program.

"Comprehensive program" means the range of
services which are to be made available for the purpose of prevention, care and treatment
of deleted text begin alcohol and drug abuse deleted text end new text begin substance misuse and substance use disorder new text end .

new text begin EFFECTIVE DATE. new text end

new text begin This section is effective July 1, 2017.
new text end

Sec. 28.

Minnesota Statutes 2016, section 254A.02, subdivision 5, is amended to read:

Subd. 5.

Drug dependent person.

"Drug dependent person" means any deleted text begin inebriate person
or any deleted text end person incapable of self-management or management of personal affairs or unable
to function physically or mentally in an effective manner because of the abuse of a drug,
including alcohol.

new text begin EFFECTIVE DATE. new text end

new text begin This section is effective July 1, 2017.
new text end

Sec. 29.

Minnesota Statutes 2016, section 254A.02, subdivision 6, is amended to read:

Subd. 6.

Facility.

"Facility" means any treatment facility administered under an approved
treatment program deleted text begin established under Laws 1973, chapter 572 deleted text end .

new text begin EFFECTIVE DATE. new text end

new text begin This section is effective July 1, 2017.
new text end

Sec. 30.

Minnesota Statutes 2016, section 254A.02, is amended by adding a subdivision
to read:

new text begin Subd. 6a. new text end

new text begin Substance misuse. new text end

new text begin "Substance misuse" means the use of any psychoactive
or mood-altering substance, without compelling medical reason, in a manner that results in
mental, emotional, or physical impairment and causes socially dysfunctional or socially
disordering behavior and that results in psychological dependence or physiological addiction
as a function of continued use. Substance misuse has the same meaning as "drug abuse" or
"abuse of drugs."
new text end

new text begin EFFECTIVE DATE. new text end

new text begin This section is effective July 1, 2017.
new text end

Sec. 31.

Minnesota Statutes 2016, section 254A.02, subdivision 8, is amended to read:

Subd. 8.

Other drugs.

"Other drugs" means any psychoactive deleted text begin chemical deleted text end new text begin substance new text end other
than alcohol.

new text begin EFFECTIVE DATE. new text end

new text begin This section is effective July 1, 2017.
new text end

Sec. 32.

Minnesota Statutes 2016, section 254A.02, subdivision 10, is amended to read:

Subd. 10.

State authority.

"State authority" is a division established within the
Department of Human Services for the purpose of relating the authority of state government
in the area of deleted text begin alcohol and drug abuse deleted text end new text begin substance misuse and substance use disorder new text end to the
deleted text begin alcohol and drug abuse deleted text end new text begin substance misuse and substance use disorder-related new text end activities within
the state.

new text begin EFFECTIVE DATE. new text end

new text begin This section is effective July 1, 2017.
new text end

Sec. 33.

Minnesota Statutes 2016, section 254A.02, is amended by adding a subdivision
to read:

new text begin Subd. 10a. new text end

new text begin Substance use disorder. new text end

new text begin "Substance use disorder" has the meaning given
in the current Diagnostic and Statistical Manual of Mental Disorders.
new text end

new text begin EFFECTIVE DATE. new text end

new text begin This section is effective July 1, 2017.
new text end

Sec. 34.

Minnesota Statutes 2016, section 254A.03, is amended to read:

254A.03 STATE AUTHORITY ON ALCOHOL AND DRUG ABUSE.

Subdivision 1.

Alcohol and Other Drug Abuse Section.

There is hereby created an
Alcohol and Other Drug Abuse Section in the Department of Human Services. This section
shall be headed by a director. The commissioner may place the director's position in the
unclassified service if the position meets the criteria established in section 43A.08,
subdivision 1a. The section shall:

(1) conduct and foster basic research relating to the cause, prevention and methods of
diagnosis, treatment and rehabilitation of deleted text begin alcoholic and other drug dependent deleted text end persons new text begin with
substance misuse and substance use disorder new text end ;

(2) coordinate and review all activities and programs of all the various state departments
as they relate to deleted text begin alcohol and other drug dependency and abuse deleted text end problems new text begin associated with
substance misuse and substance use disorder new text end ;

(3) develop, demonstrate, and disseminate new methods and techniques for deleted text begin the deleted text end prevention,
new text begin early intervention, new text end treatment and deleted text begin rehabilitation of alcohol and other drug abuse and
dependency problems deleted text end new text begin recovery support for substance misuse and substance use disorder new text end ;

(4) gather facts and information about deleted text begin alcoholism and other drug dependency and abuse deleted text end new text begin
substance misuse and substance use disorder new text end , and about the efficiency and effectiveness of
prevention, treatment, and deleted text begin rehabilitation deleted text end new text begin recovery support services new text end from all comprehensive
programs, including programs approved or licensed by the commissioner of human services
or the commissioner of health or accredited by the Joint Commission on Accreditation of
Hospitals. The state authority is authorized to require information from comprehensive
programs which is reasonable and necessary to fulfill these duties. When required information
has been previously furnished to a state or local governmental agency, the state authority
shall collect the information from the governmental agency. The state authority shall
disseminate facts and summary information about deleted text begin alcohol and other drug abuse dependency deleted text end
problems new text begin associated with substance misuse and substance use disorder new text end to public and private
agencies, local governments, local and regional planning agencies, and the courts for guidance
to and assistance in prevention, treatment and deleted text begin rehabilitation deleted text end new text begin recovery support new text end ;

(5) inform and educate the general public on deleted text begin alcohol and other drug dependency and
abuse problems deleted text end new text begin substance misuse and substance use disorder new text end ;

(6) serve as the state authority concerning deleted text begin alcohol and other drug dependency and abuse deleted text end new text begin
substance misuse and substance use disorder new text end by monitoring the conduct of diagnosis and
referral services, research and comprehensive programs. The state authority shall submit a
biennial report to the governor and the legislature containing a description of public services
delivery and recommendations concerning increase of coordination and quality of services,
and decrease of service duplication and cost;

(7) establish a state plan which shall set forth goals and priorities for a comprehensive
deleted text begin alcohol and other drug dependency and abuse program deleted text end new text begin continuum of care for substance
misuse and substance use disorder new text end for Minnesota. All state agencies operating deleted text begin alcohol and
other drug abuse or dependency deleted text end new text begin substance misuse or substance use disorder new text end programs or
administering state or federal funds for such programs shall annually set their program goals
and priorities in accordance with the state plan. Each state agency shall annually submit its
plans and budgets to the state authority for review. The state authority shall certify whether
proposed services comply with the comprehensive state plan and advise each state agency
of review findings;

(8) make contracts with and grants to public and private agencies and organizations,
both profit and nonprofit, and individuals, using federal funds, and state funds as authorized
to pay for costs of state administration, including evaluation, statewide programs and services,
research and demonstration projects, and American Indian programs;

(9) receive and administer deleted text begin monies deleted text end new text begin money new text end available for deleted text begin alcohol and drug abuse deleted text end new text begin substance
misuse and substance use disorder new text end programs under the alcohol, drug abuse, and mental
health services block grant, United States Code, title 42, sections 300X to 300X-9;

(10) solicit and accept any gift of money or property for purposes of Laws 1973, chapter
572, and any grant of money, services, or property from the federal government, the state,
any political subdivision thereof, or any private source;

(11) with respect to deleted text begin alcohol and other drug abuse deleted text end new text begin substance misuse and substance use
disorder new text end programs serving the American Indian community, establish guidelines for the
employment of personnel with considerable practical experience in deleted text begin alcohol and other drug
abuse problems deleted text end new text begin substance misuse and substance use disorder new text end , and understanding of social
and cultural problems related to deleted text begin alcohol and other drug abuse deleted text end new text begin substance misuse and substance
use disorder new text end , in the American Indian community.

Subd. 2.

American Indian programs.

There is hereby created a section of American
Indian programs, within the Alcohol and Drug Abuse Section of the Department of Human
Services, to be headed by a special assistant for American Indian programs on deleted text begin alcoholism
and drug abuse deleted text end new text begin substance misuse and substance use disorder new text end and two assistants to that
position. The section shall be staffed with all personnel necessary to fully administer
programming for deleted text begin alcohol and drug abuse deleted text end new text begin substance misuse and substance use disorder
services new text end for American Indians in the state. The special assistant position shall be filled by
a person with considerable practical experience in and understanding of deleted text begin alcohol and other
drug abuse problems deleted text end new text begin substance misuse and substance use disorder new text end in the American Indian
community, who shall be responsible to the director of the Alcohol and Drug Abuse Section
created in subdivision 1 and shall be in the unclassified service. The special assistant shall
meet and consult with the American Indian Advisory Council as described in section
254A.035 and serve as a liaison to the Minnesota Indian Affairs Council and tribes to report
on the status of deleted text begin alcohol and other drug abuse deleted text end new text begin substance misuse and substance use disorder new text end
among American Indians in the state of Minnesota. The special assistant with the approval
of the director shall:

(1) administer funds appropriated for American Indian groups, organizations and
reservations within the state for American Indian deleted text begin alcoholism and drug abuse deleted text end new text begin substance
misuse and substance use disorder new text end programs;

(2) establish policies and procedures for such American Indian programs with the
assistance of the American Indian Advisory Board; and

(3) hire and supervise staff to assist in the administration of the American Indian program
section within the Alcohol and Drug Abuse Section of the Department of Human Services.

Subd. 3.

Rules for deleted text begin chemical dependency deleted text end new text begin substance use disorder new text end care.

new text begin (a) new text end The
commissioner of human services shall establish by rule criteria to be used in determining
the appropriate level of chemical dependency care for each recipient of public assistance
seeking treatment for deleted text begin alcohol or other drug dependency and abuse problems. deleted text end new text begin substance
misuse or substance use disorder. On July 1, 2018, or upon federal approval, whichever is
later, of comprehensive assessment as a Medicaid benefit and notwithstanding the criteria
in Minnesota Rules, parts 9530 6600 to 9530.6655, an eligible vendor of comprehensive
assessments under section 254B.05 may determine and approve the appropriate level of
substance use disorder treatment for a recipient of public assistance. The process for
determining an individual's financial eligibility for the consolidated chemical dependency
treatment fund or determining an individual's enrollment in or eligibility for a publicly
subsidized health plan is not affected by the individual's choice to access a comprehensive
assessment for placement.
new text end

new text begin (b) The commissioner shall develop and implement a utilization review process for
publicly funded treatment placements to monitor and review the clinical appropriateness
and timeliness of all publicly funded placements in treatment.
new text end

new text begin EFFECTIVE DATE. new text end

new text begin This section is effective July 1, 2017.
new text end

Sec. 35.

Minnesota Statutes 2016, section 254A.035, subdivision 1, is amended to read:

Subdivision 1.

Establishment.

There is created an American Indian Advisory Council
to assist the state authority on deleted text begin alcohol and drug abuse deleted text end new text begin substance misuse and substance use
disorder new text end in proposal review and formulating policies and procedures relating to deleted text begin chemical
dependency and the abuse of alcohol and other drugs deleted text end new text begin substance misuse and substance use
disorder new text end by American Indians.

new text begin EFFECTIVE DATE. new text end

new text begin This section is effective July 1, 2017.
new text end

Sec. 36.

Minnesota Statutes 2016, section 254A.04, is amended to read:

254A.04 CITIZENS ADVISORY COUNCIL.

There is hereby created an Alcohol and Other Drug Abuse Advisory Council to advise
the Department of Human Services concerning the problems of deleted text begin alcohol and other drug
dependency and abuse deleted text end new text begin substance misuse and substance use disorder new text end , composed of ten
members. Five members shall be individuals whose interests or training are in the field of
deleted text begin alcohol dependency deleted text end new text begin alcohol-specific substance use disorder new text end and deleted text begin abuse deleted text end new text begin alcohol misuse new text end ; and
five members whose interests or training are in the field of deleted text begin dependency deleted text end new text begin substance use
disorder new text end and deleted text begin abuse of drugs deleted text end new text begin misuse of substances new text end other than alcohol. The terms, compensation
and removal of members shall be as provided in section 15.059. The council expires June
30, 2018. The commissioner of human services shall appoint members whose terms end in
even-numbered years. The commissioner of health shall appoint members whose terms end
in odd-numbered years.

new text begin EFFECTIVE DATE. new text end

new text begin This section is effective July 1, 2017.
new text end

Sec. 37.

Minnesota Statutes 2016, section 254A.08, is amended to read:

254A.08 DETOXIFICATION CENTERS.

Subdivision 1.

Detoxification services.

Every county board shall provide detoxification
services for deleted text begin drug dependent persons deleted text end new text begin any person incapable of self-management or management
of personal affairs or unable to function physically or mentally in an effective manner
because of the use of a drug, including alcohol new text end . The board may utilize existing treatment
programs and other agencies to meet this responsibility.

Subd. 2.

Program requirements.

For the purpose of this section, a detoxification
program means a social rehabilitation program new text begin licensed by the Department of Human
Services under Minnesota Rules, parts 9530.6510 to 9530.6590, and new text end established for the
purpose of facilitating access into care and treatment by detoxifying and evaluating the
person and providing entrance into a comprehensive program. Evaluation of the person
shall include verification by a professional, after preliminary examination, that the person
is intoxicated or has symptoms of deleted text begin chemical dependency deleted text end new text begin substance misuse or substance use
disorder new text end and appears to be in imminent danger of harming self or others. A detoxification
program shall have available the services of a licensed physician for medical emergencies
and routine medical surveillance. A detoxification program licensed by the Department of
Human Services to serve both adults and minors at the same site must provide for separate
sleeping areas for adults and minors.

new text begin EFFECTIVE DATE. new text end

new text begin This section is effective July 1, 2017.
new text end

Sec. 38.

Minnesota Statutes 2016, section 254A.09, is amended to read:

254A.09 CONFIDENTIALITY OF RECORDS.

The Department of Human Services shall assure confidentiality to individuals who are
the subject of research by the state authority or are recipients of deleted text begin alcohol or drug abuse deleted text end new text begin
substance misuse or substance use disorder new text end information, assessment, or treatment from a
licensed or approved program. The commissioner shall withhold from all persons not
connected with the conduct of the research the names or other identifying characteristics
of a subject of research unless the individual gives written permission that information
relative to treatment and recovery may be released. Persons authorized to protect the privacy
of subjects of research may not be compelled in any federal, state or local, civil, criminal,
administrative or other proceeding to identify or disclose other confidential information
about the individuals. Identifying information and other confidential information related to
deleted text begin alcohol or drug abuse deleted text end new text begin substance misuse or substance use disorder new text end information, assessment,
treatment, or aftercare services may be ordered to be released by the court for the purpose
of civil or criminal investigations or proceedings if, after review of the records considered
for disclosure, the court determines that the information is relevant to the purpose for which
disclosure is requested. The court shall order disclosure of only that information which is
determined relevant. In determining whether to compel disclosure, the court shall weigh
the public interest and the need for disclosure against the injury to the patient, to the treatment
relationship in the program affected and in other programs similarly situated, and the actual
or potential harm to the ability of programs to attract and retain patients if disclosure occurs.
This section does not exempt any person from the reporting obligations under section
626.556, nor limit the use of information reported in any proceeding arising out of the abuse
or neglect of a child. Identifying information and other confidential information related to
deleted text begin alcohol or drug abuse information deleted text end new text begin substance misuse or substance use disorder new text end , assessment,
treatment, or aftercare services may be ordered to be released by the court for the purpose
of civil or criminal investigations or proceedings. No information may be released pursuant
to this section that would not be released pursuant to section 595.02, subdivision 2.

new text begin EFFECTIVE DATE. new text end

new text begin This section is effective July 1, 2017.
new text end

Sec. 39.

Minnesota Statutes 2016, section 254A.19, subdivision 3, is amended to read:

Subd. 3.

Financial conflicts of interest.

(a) Except as provided in paragraph (b) or (c),
an assessor conducting a chemical use assessment under Minnesota Rules, parts 9530.6600
to 9530.6655, may not have any direct or shared financial interest or referral relationship
resulting in shared financial gain with a treatment provider.

(b) A county may contract with an assessor having a conflict described in paragraph (a)
if the county documents that:

(1) the assessor is employed by a culturally specific service provider or a service provider
with a program designed to treat individuals of a specific age, sex, or sexual preference;

(2) the county does not employ a sufficient number of qualified assessors and the only
qualified assessors available in the county have a direct or shared financial interest or a
referral relationship resulting in shared financial gain with a treatment provider; or

(3) the county social service agency has an existing relationship with an assessor or
service provider and elects to enter into a contract with that assessor to provide both
assessment and treatment under circumstances specified in the county's contract, provided
the county retains responsibility for making placement decisions.

(c) The county may contract with a hospital to conduct chemical assessments if the
requirements in subdivision 1a are met.

An assessor under this paragraph may not place clients in treatment. The assessor shall
gather required information and provide it to the county along with any required
documentation. The county shall make all placement decisions for clients assessed by
assessors under this paragraph.

new text begin (d) An eligible vendor under section 254B.05 conducting a comprehensive assessment
for an individual seeking treatment shall approve the nature, intensity level, and duration
of treatment service if a need for services is indicated, but the individual assessed can access
any enrolled provider that is licensed to provide the level of service authorized, including
the provider or program that completed the assessment. If an individual is enrolled in a
prepaid health plan, the individual must comply with any provider network requirements
or limitations.
new text end

new text begin EFFECTIVE DATE. new text end

new text begin This section is effective July 1, 2017.
new text end

Sec. 40.

Minnesota Statutes 2016, section 254B.01, subdivision 3, is amended to read:

Subd. 3.

deleted text begin Chemical dependency deleted text end new text begin Substance use disorder treatment new text end services.

" deleted text begin Chemical
dependency deleted text end new text begin Substance use disorder treatment new text end services" means a planned program of care
for the treatment of deleted text begin chemical dependency deleted text end new text begin substance misuse new text end or deleted text begin chemical abuse deleted text end new text begin substance
use disorder new text end to minimize or prevent further deleted text begin chemical abuse deleted text end new text begin substance misuse new text end by the person.
Diagnostic, evaluation, prevention, referral, detoxification, and aftercare services that are
not part of a program of care licensable as a residential or nonresidential deleted text begin chemical dependency deleted text end new text begin
substance use disorder new text end treatment program are not deleted text begin chemical dependency deleted text end new text begin substance use
disorder new text end services for purposes of this section. For pregnant and postpartum women, deleted text begin chemical
dependency deleted text end new text begin substance use disorder new text end services include halfway house services, aftercare
services, psychological services, and case management.

new text begin EFFECTIVE DATE. new text end

new text begin This section is effective July 1, 2017.
new text end

Sec. 41.

Minnesota Statutes 2016, section 254B.01, is amended by adding a subdivision
to read:

new text begin Subd. 8. new text end

new text begin Recovery community organization. new text end

new text begin "Recovery community organization"
means a community-based organization that promotes a recovery-orientation as an underlying
concept of healthy communities. A key role of a recovery community organization is the
training of recovery peers, who provide mentorship and ongoing support to persons dealing
with a substance use disorder, connecting them with the resources that can support that
person's recovery.
new text end

new text begin EFFECTIVE DATE. new text end

new text begin This section is effective July 1, 2017.
new text end

Sec. 42.

Minnesota Statutes 2016, section 254B.03, subdivision 2, is amended to read:

Subd. 2.

Chemical dependency fund payment.

(a) Payment from the chemical
dependency fund is limited to payments for services other than detoxification new text begin licensed under
Minnesota Rules, parts 9530.6510 to 9530.6590, new text end that, if located outside of federally
recognized tribal lands, would be required to be licensed by the commissioner as a chemical
dependency treatment or rehabilitation program under sections 245A.01 to 245A.16, and
services other than detoxification provided in another state that would be required to be
licensed as a chemical dependency program if the program were in the state. Out of state
vendors must also provide the commissioner with assurances that the program complies
substantially with state licensing requirements and possesses all licenses and certifications
required by the host state to provide chemical dependency treatment. deleted text begin Except for chemical
dependency transitional rehabilitation programs, deleted text end Vendors receiving payments from the
chemical dependency fund must not require co-payment from a recipient of benefits for
services provided under this subdivision. new text begin This includes but is not limited to cash or SNAP
benefits. Retention of SNAP benefits is a right of a client receiving services through the
consolidated chemical dependency treatment fund or through state contracted managed care
entities. new text end Payment from the chemical dependency fund shall be made for necessary room
and board costs provided by vendors certified according to section 254B.05, or in a
community hospital licensed by the commissioner of health according to sections 144.50
to 144.56 to a client who is:

(1) determined to meet the criteria for placement in a residential chemical dependency
treatment program according to rules adopted under section 254A.03, subdivision 3; and

(2) concurrently receiving a chemical dependency treatment service in a program licensed
by the commissioner and reimbursed by the chemical dependency fund.

(b) A county may, from its own resources, provide chemical dependency services for
which state payments are not made. A county may elect to use the same invoice procedures
and obtain the same state payment services as are used for chemical dependency services
for which state payments are made under this section if county payments are made to the
state in advance of state payments to vendors. When a county uses the state system for
payment, the commissioner shall make monthly billings to the county using the most recent
available information to determine the anticipated services for which payments will be made
in the coming month. Adjustment of any overestimate or underestimate based on actual
expenditures shall be made by the state agency by adjusting the estimate for any succeeding
month.

(c) The commissioner shall coordinate chemical dependency services and determine
whether there is a need for any proposed expansion of chemical dependency treatment
services. The commissioner shall deny vendor certification to any provider that has not
received prior approval from the commissioner for the creation of new programs or the
expansion of existing program capacity. The commissioner shall consider the provider's
capacity to obtain clients from outside the state based on plans, agreements, and previous
utilization history, when determining the need for new treatment services.

new text begin EFFECTIVE DATE. new text end

new text begin This section is effective July 1, 2017.
new text end

Sec. 43.

Minnesota Statutes 2016, section 254B.04, subdivision 1, is amended to read:

Subdivision 1.

Eligibility.

deleted text begin (a) deleted text end Persons eligible for benefits under Code of Federal
Regulations, title 25, part 20, and persons eligible for medical assistance benefits under
sections 256B.055, 256B.056, and 256B.057, subdivisions 1, 5, and 6, or who meet the
income standards of section 256B.056, subdivision 4, are entitled to chemical dependency
fund services. State money appropriated for this paragraph must be placed in a separate
account established for this purpose.

Persons with dependent children who are determined to be in need of chemical
dependency treatment pursuant to an assessment under section 626.556, subdivision 10, or
a case plan under section 260C.201, subdivision 6, or 260C.212, shall be assisted by the
local agency to access needed treatment services. Treatment services must be appropriate
for the individual or family, which may include long-term care treatment or treatment in a
facility that allows the dependent children to stay in the treatment facility. The county shall
pay for out-of-home placement costs, if applicable.

deleted text begin (b) A person not entitled to services under paragraph (a), but with family income that
is less than 215 percent of the federal poverty guidelines for the applicable family size, shall
be eligible to receive chemical dependency fund services within the limit of funds
appropriated for this group for the fiscal year. If notified by the state agency of limited
funds, a county must give preferential treatment to persons with dependent children who
are in need of chemical dependency treatment pursuant to an assessment under section
626.556, subdivision 10, or a case plan under section 260C.201, subdivision 6, or 260C.212.
A county may spend money from its own sources to serve persons under this paragraph.
State money appropriated for this paragraph must be placed in a separate account established
for this purpose.
deleted text end

deleted text begin (c) Persons whose income is between 215 percent and 412 percent of the federal poverty
guidelines for the applicable family size shall be eligible for chemical dependency services
on a sliding fee basis, within the limit of funds appropriated for this group for the fiscal
year. Persons eligible under this paragraph must contribute to the cost of services according
to the sliding fee scale established under subdivision 3. A county may spend money from
its own sources to provide services to persons under this paragraph. State money appropriated
for this paragraph must be placed in a separate account established for this purpose.
deleted text end

new text begin EFFECTIVE DATE. new text end

new text begin This section is effective July 1, 2017.
new text end

Sec. 44.

Minnesota Statutes 2016, section 254B.04, subdivision 2b, is amended to read:

Subd. 2b.

Eligibility for placement in opioid treatment programs.

deleted text begin (a) Notwithstanding
provisions of Minnesota Rules, part 9530.6622, subpart 5, related to a placement authority's
requirement to authorize services or service coordination in a program that complies with
Minnesota Rules, part 9530.6500, or Code of Federal Regulations, title 42, part 8, and after
taking into account an individual's preference for placement in an opioid deleted text end deleted text begin treatment program,
a placement authority may, but is not required to, authorize services or service coordination
or otherwise place an individual in an opioid treatment program. Prior to making a
determination of placement for an individual, the placing authority must consult with the
current treatment provider, if any.
deleted text end

deleted text begin (b) deleted text end Prior to placement of an individual who is determined by the assessor to require
treatment for opioid addiction, the assessor must provide educational information concerning
treatment options for opioid addiction, including the use of a medication for the use of
opioid addiction. The commissioner shall develop educational materials supported by
research and updated periodically that must be used by assessors to comply with this
requirement.

new text begin EFFECTIVE DATE. new text end

new text begin This section is effective July 1, 2017.
new text end

Sec. 45.

Minnesota Statutes 2016, section 254B.05, subdivision 1, is amended to read:

Subdivision 1.

Licensure required.

new text begin (a) new text end Programs licensed by the commissioner are
eligible vendors. Hospitals may apply for and receive licenses to be eligible vendors,
notwithstanding the provisions of section 245A.03. American Indian programs that provide
deleted text begin chemical dependency primary deleted text end new text begin substance use disorder new text end treatment, extended care, transitional
residence, or outpatient treatment services, and are licensed by tribal government are eligible
vendors.

new text begin (b) On July 1, 2018, or upon federal approval, whichever is later, a licensed professional
in private practice who meets the requirements of section 245G.11, subdivisions 1 and 4,
is an eligible vendor of a comprehensive assessment and assessment summary provided
according to section 245G.05, and treatment services provided according to sections 245G.06
and 245G.07, subdivision 1, paragraphs (a), clauses (1) to (5), and (b); and subdivision 2.
new text end

new text begin (c) On July 1, 2018, or upon federal approval, whichever is later, a county is an eligible
vendor for a comprehensive assessment and assessment summary when provided by an
individual who meets the staffing credentials of section 245G.11, subdivisions 1 and 4, and
completed according to the requirements of section 245G.05. A county is an eligible vendor
of care coordination services when provided by an individual who meets the staffing
credentials of section 245G.11, subdivisions 1 and 7, and provided according to the
requirements of section 245G.07, subdivision 1, clause (7).
new text end

new text begin (d) On July 1, 2018, or upon federal approval, whichever is later, a recovery community
organization that meets certification requirements identified by the commissioner is an
eligible vendor of peer support services.
new text end

new text begin (e) new text end Detoxification programs new text begin licensed under Minnesota Rules, parts 9530.6510 to
9530.6590, new text end are not eligible vendors. Programs that are not licensed as a deleted text begin chemical dependency deleted text end
residential or nonresidential new text begin substance use disorder new text end treatment new text begin or withdrawal management
new text end program by the commissioner or by tribal government or do not meet the requirements of
subdivisions 1a and 1b are not eligible vendors.

new text begin EFFECTIVE DATE. new text end

new text begin This section is effective July 1, 2017.
new text end

Sec. 46.

Minnesota Statutes 2016, section 254B.05, subdivision 1a, is amended to read:

Subd. 1a.

Room and board provider requirements.

(a) Effective January 1, 2000,
vendors of room and board are eligible for chemical dependency fund payment if the vendor:

(1) has rules prohibiting residents bringing chemicals into the facility or using chemicals
while residing in the facility and provide consequences for infractions of those rules;

(2) is determined to meet applicable health and safety requirements;

(3) is not a jail or prison;

(4) is not concurrently receiving funds under chapter 256I for the recipient;

(5) admits individuals who are 18 years of age or older;

(6) is registered as a board and lodging or lodging establishment according to section
157.17;

(7) has awake staff on site 24 hours per day;

(8) has staff who are at least 18 years of age and meet the requirements of deleted text begin Minnesota
Rules, part 9530.6450, subpart 1, item A deleted text end new text begin section 245G.11, subdivision 1, paragraph (a) new text end ;

(9) has emergency behavioral procedures that meet the requirements of deleted text begin Minnesota Rules,
part 9530.6475 deleted text end new text begin section 245G.16 new text end ;

(10) meets the requirements of deleted text begin Minnesota Rules, part 9530.6435, subparts 3 and 4, items
A and B deleted text end new text begin section 245G.08, subdivision 5 new text end , if administering medications to clients;

(11) meets the abuse prevention requirements of section 245A.65, including a policy on
fraternization and the mandatory reporting requirements of section 626.557;

(12) documents coordination with the treatment provider to ensure compliance with
section 254B.03, subdivision 2;

(13) protects client funds and ensures freedom from exploitation by meeting the
provisions of section 245A.04, subdivision 13;

(14) has a grievance procedure that meets the requirements of deleted text begin Minnesota Rules, part
9530.6470, subpart 2 deleted text end new text begin section 245G.15, subdivision 2 new text end ; and

(15) has sleeping and bathroom facilities for men and women separated by a door that
is locked, has an alarm, or is supervised by awake staff.

(b) Programs licensed according to Minnesota Rules, chapter 2960, are exempt from
paragraph (a), clauses (5) to (15).

new text begin EFFECTIVE DATE. new text end

new text begin This section is effective July 1, 2017.
new text end

Sec. 47.

Minnesota Statutes 2016, section 254B.05, subdivision 5, is amended to read:

Subd. 5.

Rate requirements.

(a) The commissioner shall establish rates for deleted text begin chemical
dependency deleted text end new text begin substance use disorder new text end services and service enhancements funded under this
chapter.

(b) Eligible deleted text begin chemical dependency deleted text end new text begin substance use disorder new text end treatment services include:

(1) outpatient treatment services that are licensed according to deleted text begin Minnesota Rules, parts
9530.6405 to 9530.6480 deleted text end new text begin sections 245G.01 to 245G.17 new text end , or applicable tribal license;

new text begin (2) on July 1, 2018, or upon federal approval, whichever is later, comprehensive
assessments provided according to sections 245.4863, paragraph (a), and 245G.05, and
Minnesota Rules, part 9530.6422;
new text end

new text begin (3) on July 1, 2018, or upon federal approval, whichever is later, care coordination
services provided according to section 245G.07, subdivision 1, paragraph (a), clause (6);
new text end

new text begin (4) on July 1, 2018, or upon federal approval, whichever is later, peer recovery support
services provided according to section 245G.07, subdivision 1, paragraph (a), clause (5);
new text end

new text begin (5) on July 1, 2018, or upon federal approval, whichever is later, withdrawal management
services provided according to chapter 245F;
new text end

deleted text begin (2) deleted text end new text begin (6) new text end medication-assisted therapy services that are licensed according to deleted text begin Minnesota
Rules, parts 9530.6405 to 9530.6480 and 9530.6500 deleted text end new text begin section 245G.07, subdivision 1 new text end , or
applicable tribal license;

deleted text begin (3) deleted text end new text begin (7) new text end medication-assisted therapy plus enhanced treatment services that meet the
requirements of clause deleted text begin (2) deleted text end new text begin (6) new text end and provide nine hours of clinical services each week;

deleted text begin (4) deleted text end new text begin (8) new text end high, medium, and low intensity residential treatment services that are licensed
according to deleted text begin Minnesota Rules, parts 9530.6405 to 9530.6480 and 9530.6505, deleted text end new text begin sections
245G.01 to 245G.17 and 245G.22 new text end or applicable tribal license which provide, respectively,
30, 15, and five hours of clinical services each week;

deleted text begin (5) deleted text end new text begin (9) new text end hospital-based treatment services that are licensed according to deleted text begin Minnesota Rules,
parts 9530.6405 to 9530.6480, deleted text end new text begin sections 245G.01 to 245G.17 new text end or applicable tribal license and
licensed as a hospital under sections 144.50 to 144.56;

deleted text begin (6) deleted text end new text begin (10) new text end adolescent treatment programs that are licensed as outpatient treatment programs
according to deleted text begin Minnesota Rules, parts 9530.6405 to 9530.6485, deleted text end new text begin sections 245G.01 to 245G.18 new text end
or as residential treatment programs according to Minnesota Rules, parts 2960.0010 to
2960.0220, and 2960.0430 to 2960.0490, or applicable tribal license;

deleted text begin (7) deleted text end new text begin (11) new text end high-intensity residential treatment services that are licensed according to
deleted text begin Minnesota Rules, parts 9530.6405 to 9530.6480 and 9530.6505, deleted text end new text begin sections 245G.01 to 245G.17
and 245G.21 new text end or applicable tribal license, which provide 30 hours of clinical services each
week provided by a state-operated vendor or to clients who have been civilly committed to
the commissioner, present the most complex and difficult care needs, and are a potential
threat to the community; and

deleted text begin (8) deleted text end new text begin (12) new text end room and board facilities that meet the requirements of subdivision 1a.

(c) The commissioner shall establish higher rates for programs that meet the requirements
of paragraph (b) and one of the following additional requirements:

(1) programs that serve parents with their children if the program:

(i) provides on-site child care during the hours of treatment activity that:

(A) is licensed under chapter 245A as a child care center under Minnesota Rules, chapter
9503; or

(B) meets the licensure exclusion criteria of section 245A.03, subdivision 2, paragraph
(a), clause (6), and meets the requirements under deleted text begin Minnesota Rules, part 9530.6490, subpart
4 deleted text end new text begin section 245G.19, subdivision 4 new text end ; or

(ii) arranges for off-site child care during hours of treatment activity at a facility that is
licensed under chapter 245A as:

(A) a child care center under Minnesota Rules, chapter 9503; or

(B) a family child care home under Minnesota Rules, chapter 9502;

(2) culturally specific programs as defined in section 254B.01, subdivision 4a, or
programs or subprograms serving special populations, if the program or subprogram meets
the following requirements:

(i) is designed to address the unique needs of individuals who share a common language,
racial, ethnic, or social background;

(ii) is governed with significant input from individuals of that specific background; and

(iii) employs individuals to provide individual or group therapy, at least 50 percent of
whom are of that specific background, except when the common social background of the
individuals served is a traumatic brain injury or cognitive disability and the program employs
treatment staff who have the necessary professional training, as approved by the
commissioner, to serve clients with the specific disabilities that the program is designed to
serve;

(3) programs that offer medical services delivered by appropriately credentialed health
care staff in an amount equal to two hours per client per week if the medical needs of the
client and the nature and provision of any medical services provided are documented in the
client file; and

(4) programs that offer services to individuals with co-occurring mental health and
chemical dependency problems if:

(i) the program meets the co-occurring requirements in deleted text begin Minnesota Rules, part 9530.6495 deleted text end new text begin
section 245G.20 new text end ;

(ii) 25 percent of the counseling staff are licensed mental health professionals, as defined
in section 245.462, subdivision 18, clauses (1) to (6), or are students or licensing candidates
under the supervision of a licensed alcohol and drug counselor supervisor and licensed
mental health professional, except that no more than 50 percent of the mental health staff
may be students or licensing candidates with time documented to be directly related to
provisions of co-occurring services;

(iii) clients scoring positive on a standardized mental health screen receive a mental
health diagnostic assessment within ten days of admission;

(iv) the program has standards for multidisciplinary case review that include a monthly
review for each client that, at a minimum, includes a licensed mental health professional
and licensed alcohol and drug counselor, and their involvement in the review is documented;

(v) family education is offered that addresses mental health and substance abuse disorders
and the interaction between the two; and

(vi) co-occurring counseling staff shall receive eight hours of co-occurring disorder
training annually.

(d) In order to be eligible for a higher rate under paragraph (c), clause (1), a program
that provides arrangements for off-site child care must maintain current documentation at
the chemical dependency facility of the child care provider's current licensure to provide
child care services. Programs that provide child care according to paragraph (c), clause (1),
must be deemed in compliance with the licensing requirements in deleted text begin Minnesota Rules, part
9530.6490 deleted text end new text begin section 245G.19 new text end .

(e) Adolescent residential programs that meet the requirements of Minnesota Rules,
parts 2960.0430 to 2960.0490 and 2960.0580 to 2960.0690, are exempt from the requirements
in paragraph (c), clause (4), items (i) to (iv).

(f) Subject to federal approval, chemical dependency services that are otherwise covered
as direct face-to-face services may be provided via two-way interactive video. The use of
two-way interactive video must be medically appropriate to the condition and needs of the
person being served. Reimbursement shall be at the same rates and under the same conditions
that would otherwise apply to direct face-to-face services. The interactive video equipment
and connection must comply with Medicare standards in effect at the time the service is
provided.

new text begin EFFECTIVE DATE. new text end

new text begin This section is effective July 1, 2017.
new text end

Sec. 48.

Minnesota Statutes 2016, section 254B.051, is amended to read:

254B.051 SUBSTANCE deleted text begin ABUSE deleted text end new text begin USE DISORDER new text end TREATMENT
EFFECTIVENESS.

In addition to the substance deleted text begin abuse deleted text end new text begin use disorder new text end treatment program performance outcome
measures that the commissioner of human services collects annually from treatment providers,
the commissioner shall request additional data from programs that receive appropriations
from the consolidated chemical dependency treatment fund. This data shall include number
of client readmissions six months after release from inpatient treatment, and the cost of
treatment per person for each program receiving consolidated chemical dependency treatment
funds. The commissioner may post this data on the department Web site.

new text begin EFFECTIVE DATE. new text end

new text begin This section is effective July 1, 2017.
new text end

Sec. 49.

Minnesota Statutes 2016, section 254B.07, is amended to read:

254B.07 THIRD-PARTY LIABILITY.

The state agency provision and payment of, or liability for, deleted text begin chemical dependency deleted text end new text begin
substance use disorder new text end medical care is the same as in section 256B.042.

new text begin EFFECTIVE DATE. new text end

new text begin This section is effective July 1, 2017.
new text end

Sec. 50.

Minnesota Statutes 2016, section 254B.08, is amended to read:

254B.08 FEDERAL WAIVERS.

The commissioner shall apply for any federal waivers necessary to secure, to the extent
allowed by law, federal financial participation for the provision of services to persons who
need deleted text begin chemical dependency deleted text end new text begin substance use disorder new text end services. The commissioner may seek
amendments to the waivers or apply for additional waivers to contain costs. The
commissioner shall ensure that payment for the cost of providing deleted text begin chemical dependency deleted text end new text begin
substance use disorder new text end services under the federal waiver plan does not exceed the cost of
deleted text begin chemical dependency deleted text end new text begin substance use disorder new text end services that would have been provided without
the waivered services.

new text begin EFFECTIVE DATE. new text end

new text begin This section is effective July 1, 2017.
new text end

Sec. 51.

Minnesota Statutes 2016, section 254B.09, is amended to read:

254B.09 INDIAN RESERVATION ALLOCATION OF CHEMICAL
DEPENDENCY FUND.

Subdivision 1.

Vendor payments.

The commissioner shall pay eligible vendors for
deleted text begin chemical dependency deleted text end new text begin substance use disorder new text end services to American Indians on the same
basis as other payments, except that no local match is required when an invoice is submitted
by the governing authority of a federally recognized American Indian tribal body or a county
if the tribal governing body has not entered into an agreement under subdivision 2 on behalf
of a current resident of the reservation under this section.

Subd. 2.

American Indian agreements.

The commissioner may enter into agreements
with federally recognized tribal units to pay for deleted text begin chemical dependency deleted text end new text begin substance use disorder new text end
treatment services provided under Laws 1986, chapter 394, sections 8 to 20. The agreements
must clarify how the governing body of the tribal unit fulfills local agency responsibilities
regarding:

(1) the form and manner of invoicing; and

(2) provide that only invoices for eligible vendors according to section 254B.05 will be
included in invoices sent to the commissioner for payment, to the extent that money allocated
under subdivisions 4 and 5 is used.

Subd. 6.

American Indian tribal placements.

After entering into an agreement under
subdivision 2, the governing authority of each reservation may submit invoices to the state
for the cost of providing deleted text begin chemical dependency deleted text end new text begin substance use disorder new text end services to residents
of the reservation according to the placement rules governing county placements, except
that local match requirements are waived. The governing body may designate an agency to
act on its behalf to provide placement services and manage invoices by written notice to
the commissioner and evidence of agreement by the agency designated.

Subd. 8.

Payments to improve services to American Indians.

The commissioner may
set rates for deleted text begin chemical dependency deleted text end new text begin substance use disorder new text end services to American Indians
according to the American Indian Health Improvement Act, Public Law 94-437, for eligible
vendors. These rates shall supersede rates set in county purchase of service agreements
when payments are made on behalf of clients eligible according to Public Law 94-437.

new text begin EFFECTIVE DATE. new text end

new text begin This section is effective July 1, 2017.
new text end

Sec. 52.

Minnesota Statutes 2016, section 254B.12, subdivision 2, is amended to read:

Subd. 2.

Payment methodology for highly specialized vendors.

Notwithstanding
subdivision 1, the commissioner shall seek federal authority to develop separate payment
methodologies for deleted text begin chemical dependency deleted text end new text begin substance use disorder new text end treatment services provided
under the consolidated chemical dependency treatment fund: (1) by a state-operated vendor;
or (2) for persons who have been civilly committed to the commissioner, present the most
complex and difficult care needs, and are a potential threat to the community. A payment
methodology under this subdivision is effective for services provided on or after October
1, 2015, or on or after the receipt of federal approval, whichever is later.

new text begin EFFECTIVE DATE. new text end

new text begin This section is effective July 1, 2017.
new text end

Sec. 53.

Minnesota Statutes 2016, section 254B.13, subdivision 2a, is amended to read:

Subd. 2a.

Eligibility for navigator pilot program.

(a) To be considered for participation
in a navigator pilot program, an individual must:

(1) be a resident of a county with an approved navigator program;

(2) be eligible for consolidated chemical dependency treatment fund services;

(3) be a voluntary participant in the navigator program;

(4) satisfy one of the following items:

(i) have at least one severity rating of three or above in dimension four, five, or six in a
comprehensive assessment under deleted text begin Minnesota Rules, part 9530.6422 deleted text end new text begin section 245G.05,
paragraph (c), clauses (4) to (6) new text end ; or

(ii) have at least one severity rating of two or above in dimension four, five, or six in a
comprehensive assessment under deleted text begin Minnesota Rules, part 9530.6422, deleted text end new text begin section 245G.05,
paragraph (c), clauses (4) to (6), new text end and be currently participating in a Rule 31 treatment program
under deleted text begin Minnesota Rules, parts 9530.6405 to 9530.6505, deleted text end new text begin chapter 245G new text end or be within 60 days
following discharge after participation in a Rule 31 treatment program; and

(5) have had at least two treatment episodes in the past two years, not limited to episodes
reimbursed by the consolidated chemical dependency treatment funds. An admission to an
emergency room, a detoxification program, or a hospital may be substituted for one treatment
episode if it resulted from the individual's substance use disorder.

(b) New eligibility criteria may be added as mutually agreed upon by the commissioner
and participating navigator programs.

new text begin EFFECTIVE DATE. new text end

new text begin This section is effective July 1, 2017.
new text end

Sec. 54. new text begin RESIDENTIAL TREATMENT AND PAYMENT RATE REFORM.
new text end

new text begin The commissioner shall contract with an outside expert to identify recommendations
for the development of a substance use disorder residential treatment program model and
payment structure that is not subject to the federal institutions for mental diseases exclusion
and that is financially sustainable for providers, while incentivizing best practices and
improved treatment outcomes. The analysis and report must include recommendations and
a timeline for supporting providers to transition to the new models of care delivery. No later
than December 15, 2018, a report with recommendations must be delivered to members of
the legislative committees in the house of representatives and senate with jurisdiction over
health and human services policy and finance.
new text end

new text begin EFFECTIVE DATE. new text end

new text begin This section is effective July 1, 2017.
new text end

Sec. 55. new text begin REVISOR'S INSTRUCTION.
new text end

new text begin In Minnesota Statutes and Minnesota Rules, the revisor of statutes, in consultation with
the with the Department of Human Services, shall make necessary cross-reference changes
that are needed as a result of the enactment of sections 5 to 26 and 56. The revisor shall
make any necessary technical and grammatical changes to preserve the meaning of the text.
new text end

new text begin EFFECTIVE DATE. new text end

new text begin This section is effective the day following final enactment.
new text end

Sec. 56. new text begin REPEALER.
new text end

new text begin (a) new text end new text begin Minnesota Statutes 2016, sections 245A.1915; 245A.192; and 254A.02, subdivision
4, new text end new text begin are repealed.
new text end

new text begin (b) new text end new text begin Minnesota Rules, parts 9530.6405, subparts 1, 1a, 2, 3, 4, 5, 6, 7, 7a, 8, 9, 10, 11,
12, 13, 14, 14a, 15, 15a, 16, 17, 17a, 17b, 17c, 18, 20, and 21; 9530.6410; 9530.6415;
9530.6420; 9530.6422; 9530.6425; 9530.6430; 9530.6435; 9530.6440; 9530.6445;
9530.6450; 9530.6455; 9530.6460; 9530.6465; 9530.6470; 9530.6475; 9530.6480;
9530.6485; 9530.6490; 9530.6495; 9530.6500; and 9530.6505, new text end new text begin are repealed.
new text end

new text begin EFFECTIVE DATE. new text end

new text begin This section is effective July 1, 2017.
new text end

APPENDIX

Repealed Minnesota Statutes: 17-2900

245A.1915 OPIOID ADDICTION TREATMENT EDUCATION REQUIREMENT FOR PROVIDERS LICENSED TO PROVIDE CHEMICAL DEPENDENCY TREATMENT SERVICES.

All programs serving persons with substance use issues licensed by the commissioner must provide educational information concerning: treatment options for opioid addiction, including the use of a medication for the use of opioid addiction; and recognition of and response to opioid overdose and the use and administration of naloxone, to clients identified as having or seeking treatment for opioid addiction. The commissioner shall develop educational materials that are supported by research and updated periodically that must be used by programs to comply with this requirement.

245A.192 PROVIDERS LICENSED TO PROVIDE TREATMENT OF OPIOID ADDICTION.

Subdivision 1.

Scope.

(a) This section applies to services licensed under this chapter to provide treatment for opioid addiction. In addition to the requirements under Minnesota Rules, parts 9530.6405 to 9530.6505, a program licensed to provide treatment of opioid addiction must meet the requirements in this section.

(b) Where a standard in this section differs from a standard in an otherwise applicable administrative rule, the standards of this section apply.

(c) When federal guidance or interpretations have been issued on federal standards or requirements also required under this section, the federal guidance or interpretations shall apply.

Subd. 2.

Definitions.

(a) For purposes of this section, the terms defined in this subdivision have the meanings given them.

(b) "Diversion" means the use of a medication for the treatment of opioid addiction being diverted from its intended use.

(c) "Guest dose or dosing" means the practice of administering a medication used for the treatment of opioid addiction to a person who is not a client of the program that is administering or dispensing the medication.

(d) "Medical director" means a physician, licensed to practice medicine in the jurisdiction in which the opioid treatment program is located, who assumes responsibility for administering all medical services performed by the program, either by performing them directly or by delegating specific responsibility to authorized program physicians and health care professionals functioning under the medical director's direct supervision.

(e) "Medication used for the treatment of opioid addiction" means a medication approved by the Food and Drug Administration for the treatment of opioid addiction.

(f) "Opioid treatment program" has the meaning given in Code of Federal Regulations, title 42, section 8.12, and includes programs licensed under Minnesota Rules, part 9530.6500.

(g) "Program" means an entity that is licensed under Minnesota Rules, part 9530.6500.

(h) "Unsupervised use" means the use of a medication for the treatment of opioid addiction dispensed for use by a client outside of the program setting. This is also referred to as a "take-home" dose.

(i) "Placing authority" has the meaning given in Minnesota Rules, part 9530.6605, subpart 21a.

(j) "Minnesota health care programs" has the meaning given in section 256B.0636.

Subd. 3.

Medication orders.

Prior to the program administering or dispensing a medication used for the treatment of opioid addiction:

(1) a client-specific order must be received from an appropriately credentialed physician who is enrolled as a Minnesota health care programs provider and meets all applicable provider standards;

(2) the signed order must be documented in the client's record; and

(3) if the physician that issued the order is not able to sign the order when issued, the unsigned order must be entered in the client record at the time it was received, and the physician must review the documentation and sign the order in the client's record within 72 hours of the medication being ordered. The license holder must report to the commissioner any medication error that endangers a patient's health, as determined by the medical director.

Subd. 3a.

High dose requirements.

A client being administered or dispensed a dose beyond that set forth in subdivision 5, paragraph (a), clause (1), that exceeds 150 milligrams of methadone or 24 milligrams of buprenorphine daily, and for each subsequent increase, must meet face-to-face with a prescribing physician. The meeting must occur before the administering or dispensing of the increased dose.

Subd. 4.

Drug testing.

Each client enrolled in the program must receive a minimum of eight random drug abuse tests per 12 months of treatment. These tests must be reasonably disbursed over the 12-month period. A license holder may elect to conduct more drug abuse tests.

Subd. 5.

Criteria for unsupervised use.

(a) To limit the potential for diversion of medication used for the treatment of opioid addiction to the illicit market, any such medications dispensed to patients for unsupervised use shall be subject to the following requirements:

(1) any patient in an opioid treatment program may receive a single take-home dose for a day that the clinic is closed for business, including Sundays and state and federal holidays; and

(2) treatment program decisions on dispensing medications used to treat opioid addiction to patients for unsupervised use beyond that set forth in clause (1) shall be determined by the medical director.

(b) A physician with authority to prescribe must consider the criteria in this subdivision in determining whether a client may be permitted unsupervised or take-home use of such medications. The criteria must also be considered when determining whether dispensing medication for a client's unsupervised use is appropriate to increase or to extend the amount of time between visits to the program. The criteria include:

(1) absence of recent abuse of drugs including but not limited to opioids, nonnarcotics, and alcohol;

(2) regularity of program attendance;

(3) absence of serious behavioral problems at the program;

(4) absence of known recent criminal activity such as drug dealing;

(5) stability of the client's home environment and social relationships;

(6) length of time in comprehensive maintenance treatment;

(7) reasonable assurance that take-home medication will be safely stored within the client's home; and

(8) whether the rehabilitative benefit the client derived from decreasing the frequency of program attendance outweighs the potential risks of diversion or unsupervised use.

(c) The determination, including the basis of the determination, must be consistent with the criteria in this subdivision and must be documented in the client's medical record.

Subd. 6.

Restrictions for unsupervised or take-home use of methadone hydrochloride.

(a) In cases where it is determined that a client meets the criteria in subdivision 5 and may be dispensed a medication used for the treatment of opioid addiction, the restrictions in paragraphs (b) to (g) must be followed when the medication to be dispensed is methadone hydrochloride.

(b) During the first 90 days of treatment, the take-home supply must be limited to a maximum of a single dose each week and the client shall ingest all other doses under direct supervision.

(c) In the second 90 days of treatment, the take-home supply must be limited to two doses per week.

(d) In the third 90 days of treatment, the take-home supply must not exceed three doses per week.

(e) In the remaining months of the first year, a client may be given a maximum six-day supply of take-home medication.

(f) After one year of continuous treatment, a client may be given a maximum two-week supply of take-home medication.

(g) After two years of continuous treatment, a client may be given a maximum one-month supply of take-home medication, but must make monthly visits.

Subd. 7.

Restriction exceptions.

When a license holder has reason to accelerate the number of unsupervised or take-home doses of methadone hydrochloride, the license holder must comply with the requirements of Code of Federal Regulations, title 42, section 8.12, the criteria for unsupervised use in subdivision 5, and must use the exception process provided by the federal Center for Substance Abuse Treatment Division of Pharmacologic Therapies. For the purposes of enforcement of this subdivision, the commissioner has the authority to monitor for compliance with these federal regulations and may issue licensing actions according to sections 245A.05, 245A.06, and 245A.07 based on the commissioner's determination of noncompliance.

Subd. 8.

Guest dosing.

In order to receive a guest dose, the client must be enrolled in an opioid treatment program elsewhere in the state or country and be receiving the medication on a temporary basis because the client is not able to receive the medication at the program in which the client is enrolled. Such arrangements shall not exceed 30 consecutive days in any one program and must not be for the convenience or benefit of either program. Guest dosing may also occur when the client's primary clinic is not open and the client is not receiving take-home doses.

Subd. 9.

Data and reporting.

The license holder must submit data concerning medication used for the treatment of opioid addiction to a central registry. The data must be submitted in a method determined by the commissioner and must be submitted for each client at the time of admission and discharge. The program must document the date the information was submitted. This requirement is effective upon implementation of changes to the Drug and Alcohol Abuse Normative Evaluation System (DAANES) or development of an electronic system by which to submit the data.

Subd. 10.

Nonmedication treatment services; documentation.

(a) The program must offer at least 50 consecutive minutes of individual or group therapy treatment services as defined in Minnesota Rules, part 9530.6430, subpart 1, item A, subitem (1), per week, for the first ten weeks following admission, and at least 50 consecutive minutes per month thereafter. As clinically appropriate, the program may offer these services cumulatively and not consecutively in increments of no less than 15 minutes over the required time period, and for a total of 60 minutes of treatment services over the time period, and must document the reason for providing services cumulatively in the client's record. The program may offer additional levels of service when deemed clinically necessary.

(b) Notwithstanding the requirements of comprehensive assessments in Minnesota Rules, part 9530.6422, the assessment must be completed within 21 days of service initiation.

(c) Notwithstanding the requirements of individual treatment plans set forth in Minnesota Rules, part 9530.6425:

(1) treatment plan contents for maintenance clients are not required to include goals the client must reach to complete treatment and have services terminated;

(2) treatment plans for clients in a taper or detox status must include goals the client must reach to complete treatment and have services terminated;

(3) for the initial ten weeks after admission for all new admissions, readmissions, and transfers, progress notes must be entered in a client's file at least weekly and be recorded in each of the six dimensions upon the development of the treatment plan and thereafter. Subsequently, the counselor must document progress no less than one time monthly, recorded in the six dimensions or when clinical need warrants more frequent notations; and

(4) upon the development of the treatment plan and thereafter, treatment plan reviews must occur weekly, or after each treatment service, whichever is less frequent, for the first ten weeks after the treatment plan is developed. Following the first ten weeks of treatment plan reviews, reviews may occur monthly, unless the client has needs that warrant more frequent revisions or documentation.

Subd. 11.

Prescription monitoring program.

(a) The program must develop and maintain a policy and procedure that requires the ongoing monitoring of the data from the prescription monitoring program for each client. The policy and procedure must include how the program will meet the requirements in paragraph (b).

(b) If a medication used for the treatment of opioid addiction is administered or dispensed to a client, the license holder shall be subject to the following requirements:

(1) upon admission to a methadone clinic outpatient treatment program, clients must be notified in writing that the commissioner of human services and the medical director will monitor the prescription monitoring program to review the prescribed controlled drugs the clients have received;

(2) the medical director or the medical director's delegate must review the data from the Minnesota Board of Pharmacy prescription monitoring program (PMP) established under section 152.126 prior to the client being ordered any controlled substance, as defined under section 152.126, subdivision 1, paragraph (c), including medications used for the treatment of opioid addiction, and subsequent reviews of the PMP data must occur at least every 90 days;

(3) a copy of the PMP data reviewed must be maintained in the client file;

(4) when the PMP data contains a recent history of multiple prescribers or multiple prescriptions for controlled substances, the physician's review of the data and subsequent actions must be documented in the client's individual file within 72 hours and must contain the medical director's determination of whether or not the prescriptions place the client at risk of harm and the actions to be taken in response to the PMP findings. In addition, the provider must conduct subsequent reviews of the PMP on a monthly basis; and

(5) if at any time the medical director believes the use of the controlled substances places the client at risk of harm, the program must seek the client's consent to discuss the client's opioid treatment with other prescribers and must seek consent for the other prescriber to disclose to the opioid treatment program's medical director the client's condition that formed the basis of the other prescriptions. If the information is not obtained within seven days, the medical director must document whether or not changes to the client's medication dose or number of take-home doses are necessary until the information is obtained.

(c) The commissioner shall collaborate with the Minnesota Board of Pharmacy to develop and implement an electronic system through which the commissioner shall routinely access the data from the Minnesota Board of Pharmacy prescription monitoring program established under section 152.126 for the purpose of determining whether any client enrolled in an opioid addiction treatment program licensed according to this section has also been prescribed or dispensed a controlled substance in addition to that administered or dispensed by the opioid addiction treatment program. When the commissioner determines there have been multiple prescribers or multiple prescriptions of controlled substances, the commissioner shall:

(1) inform the medical director of the opioid treatment program only that the commissioner determined the existence of multiple prescribers or multiple prescriptions of controlled substances; and

(2) direct the medical director of the opioid treatment program to access the data directly, review the effect of the multiple prescribers or multiple prescriptions, and document the review.

(d) If determined necessary, the commissioner shall seek a federal waiver of, or exception to, any applicable provision of Code of Federal Regulations, title 42, section 2.34(c), prior to implementing this subdivision.

Subd. 12.

Policies and procedures.

(a) License holders must develop and maintain the policies and procedures required in this subdivision.

(b) For programs that are not open every day of the year, the license holder must maintain a policy and procedure that permits clients to receive a single unsupervised use of medication used for the treatment of opioid addiction for days that the program is closed for business, including, but not limited to, Sundays and state and federal holidays as required under subdivision 5, paragraph (a), clause (1).

(c) The license holder must maintain a policy and procedure that includes specific measures to reduce the possibility of medication used for the treatment of opioid addiction being diverted from its intended treatment use. The policy and procedure must:

(1) specifically identify and define the responsibilities of the medical and administrative staff for carrying out diversion control measures; and

(2) include a process for contacting no less than five percent of clients who have unsupervised use of medication used for the treatment of opioid addiction, excluding those approved solely under subdivision 5, paragraph (a), clause (1), to require them to physically return to the program each month. The system must require clients to return to the program within a stipulated time frame and turn in all unused medication containers related to opioid addiction treatment. The license holder must document all related contacts on a central log and the outcome of the contact for each client in the individual client's record.

(d) Medications used for the treatment of opioid addictions must be ordered, administered, and dispensed according to applicable state and federal regulations and the standards set by applicable accreditation entities. In addition, when an order requires assessment by the person administering or dispensing the medication to determine the amount to be administered or dispensed, the assessment must be completed by an individual whose professional scope of practice permits such assessment. For the purposes of enforcement of this paragraph, the commissioner has the authority to monitor for compliance with these state and federal regulations and the relevant standards of the license holder's accreditation agency and may issue licensing actions according to sections 245A.05, 245A.06, and 245A.07 based on the commissioner's determination of noncompliance.

Subd. 13.

Quality improvement plan.

The license holder must develop and maintain a quality improvement process and plan. The plan must:

(1) include evaluation of the services provided to clients with the goal of identifying issues that may improve service delivery and client outcomes;

(2) include goals for the program to accomplish based on the evaluation;

(3) be reviewed annually by the management of the program to determine whether the goals were met and, if not, whether additional action is required;

(4) be updated at least annually to include new or continued goals based on an updated evaluation of services; and

(5) identify two specific goal areas, in addition to others identified by the program, including:

(i) a goal concerning oversight and monitoring of the premises around and near the exterior of the program to reduce the possibility of medication used for the treatment of opioid addiction being inappropriately used by clients, including but not limited to the sale or transfer of the medication to others; and

(ii) a goal concerning community outreach, including but not limited to communications with local law enforcement and county human services agencies, with the goal of increasing coordination of services and identification of areas of concern to be addressed in the plan.

Subd. 14.

Placing authorities.

Programs must provide certain notification and client-specific updates to placing authorities for clients who are enrolled in Minnesota health care programs. At the request of the placing authority, the program must provide client-specific updates, including but not limited to informing the placing authority of positive drug screenings and changes in medications used for the treatment of opioid addiction ordered for the client.

Subd. 15.

A program's duty to report suspected drug diversion.

(a) To the fullest extent permitted under Code of Federal Regulations, title 42, sections 2.1 to 2.67, a program shall report to law enforcement any credible evidence that the program or its personnel knows, or reasonably should know, that is directly related to a diversion crime on the premises of the program, or a threat to commit a diversion crime.

(b) "Diversion crime," for the purposes of this section, means diverting, attempting to divert, or conspiring to divert Schedule I, II, III, or IV drugs, as defined in section 152.02, on the program's premises.

(c) The program must document its compliance with the requirement in paragraph (a) in either a client's record or an incident report.

(d) Failure to comply with the duty in paragraph (a) may result in sanctions as provided in sections 245A.06 and 245A.07.

Subd. 16.

Variance.

The commissioner may grant a variance to the requirements of this section.

254A.02 DEFINITIONS.

Subd. 4.

Drug abuse or abuse of drugs.

"Drug abuse or abuse of drugs" is the use of any psychoactive or mood altering chemical substance, without compelling medical reason, in such a manner as to induce mental, emotional or physical impairment and cause socially dysfunctional or socially disordering behavior and which results in psychological or physiological dependency as a function of continued use.

Repealed Minnesota Rule: 17-2900

9530.6405 DEFINITIONS.

Subpart 1.

Scope.

As used in parts 9530.6405 to 9530.6505, the following terms have the meanings given to them.

9530.6405 DEFINITIONS.

Subp. 1a.

Administration of medications.

"Administration of medications" means performing a task to provide medications to a client, and includes the following tasks, performed in the following order:

A.

checking the client's medication record;

B.

preparing the medication for administration;

C.

administering the medication to the client;

D.

documenting the administration, or the reason for not administering medications as prescribed; and

E.

reporting information to a licensed practitioner or a nurse regarding problems with the administration of the medication or the client's refusal to take the medication.

9530.6405 DEFINITIONS.

Subp. 2.

Adolescent.

"Adolescent" means an individual under 18 years of age.

9530.6405 DEFINITIONS.

Subp. 3.

Alcohol and drug counselor.

"Alcohol and drug counselor" has the meaning given in Minnesota Statutes, section 148C.01, subdivision 2.

9530.6405 DEFINITIONS.

Subp. 4.

Applicant.

"Applicant" means an individual, corporation, partnership, voluntary association, controlling individual, or other organization that has applied for licensure under this chapter.

9530.6405 DEFINITIONS.

Subp. 5.

Capacity management system.

"Capacity management system" means a database operated by the Department of Human Services to compile and make information available to the public about the waiting list status and current admission capability of each program serving intravenous drug abusers.

9530.6405 DEFINITIONS.

Subp. 6.

Central registry.

"Central registry" means a database maintained by the department that collects identifying information from two or more programs about individuals applying for maintenance treatment or detoxification treatment for addiction to opiates for the purpose of avoiding an individual's concurrent enrollment in more than one program.

9530.6405 DEFINITIONS.

Subp. 7.

Chemical.

"Chemical" means alcohol, solvents, controlled substances as defined by Minnesota Statutes, section 152.01, subdivision 4, and other mood altering substances.

9530.6405 DEFINITIONS.

Subp. 7a.

Chemical dependency treatment.

"Chemical dependency treatment" means treatment of a substance use disorder, including the process of assessment of a client's needs, development of planned interventions or services to address those needs, provision of services, facilitation of services provided by other service providers, and reassessment by a qualified professional. The goal of treatment is to assist or support the client's efforts to recover from substance use disorder.

9530.6405 DEFINITIONS.

Subp. 8.

Client.

"Client" means an individual accepted by a license holder for assessment or treatment of a substance use disorder. An individual remains a client until the license holder no longer provides or plans to provide the individual with treatment services.

9530.6405 DEFINITIONS.

Subp. 9.

Commissioner.

"Commissioner" means the commissioner of the Department of Human Services or the commissioner's designee.

9530.6405 DEFINITIONS.

Subp. 10.

Co-occurring or co-occurring client.

"Co-occurring" or "co-occurring client" means a diagnosis that indicates a client suffers from a substance use disorder and a mental health problem.

9530.6405 DEFINITIONS.

Subp. 11.

Department.

"Department" means the Department of Human Services.

9530.6405 DEFINITIONS.

Subp. 12.

Direct client contact.

"Direct client contact" has the meaning given for "direct contact" in Minnesota Statutes, section 245C.02, subdivision 11.

9530.6405 DEFINITIONS.

Subp. 13.

License.

"License" means a certificate issued by the commissioner authorizing the license holder to provide a specific program for a specified period of time in accordance with the terms of the license and the rules of the commissioner.

9530.6405 DEFINITIONS.

Subp. 14.

License holder.

"License holder" means an individual, corporation, partnership, voluntary organization, or other organization that is legally responsible for the operation of the program, has been granted a license by the commissioner under this chapter, and is a controlling individual.

9530.6405 DEFINITIONS.

Subp. 14a.

Licensed practitioner.

"Licensed practitioner" means a person who is authorized to prescribe as defined in Minnesota Statutes, section 151.01, subdivision 23.

9530.6405 DEFINITIONS.

Subp. 15.

Licensed professional in private practice.

"Licensed professional in private practice" means an individual who meets the following criteria:

A.

is licensed under Minnesota Statutes, chapter 148C, or is exempt from licensure under that chapter but is otherwise licensed to provide alcohol and drug counseling services;

B.

practices solely within the permissible scope of the individual's license as defined in the law authorizing licensure; and

C.

does not affiliate with other licensed or unlicensed professionals for the purpose of providing alcohol and drug counseling services. Affiliation does not include conferring with other professionals or making client referrals.

9530.6405 DEFINITIONS.

Subp. 15a.

Nurse.

"Nurse" means a person licensed and currently registered to practice professional or practical nursing as defined in Minnesota Statutes, section 148.171, subdivisions 14 and 15.

9530.6405 DEFINITIONS.

Subp. 16.

Paraprofessional.

"Paraprofessional" means an employee, agent, or independent contractor of the license holder who performs tasks in support of the provision of treatment services. Paraprofessionals may be referred to by a variety of titles including technician, case aide, or counselor assistant. An individual may not be a paraprofessional employed by the license holder if the individual is a client of the license holder.

9530.6405 DEFINITIONS.

Subp. 17.

Program serving intravenous drug abusers.

"Program serving intravenous drug abusers" means a program whose primary purpose is providing agonist medication-assisted therapy to clients who are narcotic dependent, regardless of whether the client's narcotic use was intravenous or by other means.

9530.6405 DEFINITIONS.

Subp. 17a.

Student intern.

"Student intern" means a person who is enrolled in an alcohol and drug counselor education program at an accredited school or educational program and is earning a minimum of nine semester credits per calendar year toward the completion of an associate's, bachelor's, master's, or doctorate degree requirements. Degree requirements must include an additional 18 semester credits or 270 hours of alcohol and drug counseling related course work and 440 hours of practicum.

9530.6405 DEFINITIONS.

Subp. 17b.

Substance.

"Substance" means a "chemical" as defined in subpart 7.

9530.6405 DEFINITIONS.

Subp. 17c.

Substance use disorder.

"Substance use disorder" means a pattern of substance use as defined in the Diagnostic and Statistical Manual of Mental Disorders-IV-TR (DSM), et seq. The DSM-IV-TR is incorporated by reference. The DSM was published by the American Psychiatric Association in 1994, in Washington D.C., and is not subject to frequent change. The DSM-IV-TR is available through the Minitex interlibrary loan system.

9530.6405 DEFINITIONS.

Subp. 18.

Target population.

"Target population" means individuals experiencing problems with a substance use disorder having the specified characteristics that a license holder proposes to serve.

9530.6405 DEFINITIONS.

Subp. 20.

Treatment director.

"Treatment director" means an individual who meets the qualifications specified under part 9530.6450, subparts 1 and 3, and is designated by the license holder to be responsible for all aspects of the delivery of treatment services.

9530.6405 DEFINITIONS.

Subp. 21.

Treatment service.

"Treatment service" means a therapeutic intervention or series of interventions.

9530.6410 APPLICABILITY.

Subpart 1.

Applicability.

Except as provided in subparts 2 and 3, no person, corporation, partnership, voluntary association, controlling individual, or other organization may provide chemical dependency treatment services to an individual who has a substance use disorder unless licensed by the commissioner.

Subp. 2.

Activities exempt from license requirement.

Parts 9530.6405 to 9530.6505 do not apply to organizations whose primary functions are information, referral, diagnosis, case management, and assessment for the purposes of placement, education, support group services, or self-help programs. Parts 9530.6405 to 9530.6505do not apply to the activities of licensed professionals in private practice which are not paid for by the consolidated chemical dependency treatment fund.

Subp. 3.

Certain hospitals excluded from license requirement.

Parts 9530.6405 to 9530.6505 do not apply to chemical dependency treatment provided by hospitals licensed under Minnesota Statutes, chapter 62J, or under Minnesota Statutes, sections 144.50 to 144.56, unless the hospital accepts funds for chemical dependency treatment under the consolidated chemical dependency treatment fund under Minnesota Statutes, chapter 254B, medical assistance under Minnesota Statutes, chapter 256B, MinnesotaCare or health care cost containment under Minnesota Statutes, chapter 256L, or general assistance medical care under Minnesota Statutes, chapter 256D.

Subp. 4.

Applicability of chapter 2960.

Beginning July 1, 2005, residential adolescent chemical dependency treatment programs must be licensed according to chapter 2960.

9530.6415 LICENSING REQUIREMENTS.

Subpart 1.

General application and license requirements.

An applicant for a license to provide treatment must comply with the general requirements in Minnesota Statutes, chapters 245A and 245C, and Minnesota Statutes, sections 626.556 and 626.557.

Subp. 2.

Contents of application.

Prior to issuance of a license, an applicant must submit, on forms provided by the commissioner, any documents the commissioner requires to demonstrate the following:

A.

compliance with parts 9530.6405 to 9530.6505;

B.

compliance with applicable building, fire and safety codes, health rules, zoning ordinances, and other applicable rules and regulations or documentation that a waiver has been granted. The granting of a waiver does not constitute modification of any requirement of parts 9530.6405 to 9530.6505;

C.

completion of an assessment of need for a new or expanded program according to part 9530.6800; and

D.

insurance coverage, including bonding, sufficient to cover all client funds, property, and interests.

Subp. 3.

Changes in license terms.

A.

A license holder must notify the commissioner before one of the following occurs and the commissioner must determine the need for a new license:

(1)

a change in the Department of Health's licensure of the program;

(2)

a change in whether the license holder provides services specified in parts 9530.6485 to 9530.6505;

(3)

a change in location; or

(4)

a change in capacity if the license holder meets the requirements of part 9530.6505.

B.

A license holder must notify the commissioner and must apply for a new license if there is a change in program ownership.

9530.6420 INITIAL SERVICES PLAN.

The license holder must complete an initial services plan during or immediately following the intake interview. The plan must address the client's immediate health and safety concerns, identify the issues to be addressed in the first treatment sessions, and make treatment suggestions for the client during the time between intake and completion of the treatment plan. The initial services plan must include a determination whether a client is a vulnerable adult as defined in Minnesota Statutes, section 626.5572, subdivision 21. All adult clients of a residential program are vulnerable adults. An individual abuse prevention plan, according to Minnesota Statutes, sections 245A.65, subdivision 2, paragraph (b), and 626.557, subdivision 14, paragraph (b), is required for all clients who meet the definition of "vulnerable adult."

9530.6422 COMPREHENSIVE ASSESSMENT.

Subpart 1.

Comprehensive assessment of substance use disorder.

A comprehensive assessment of the client's substance use disorder must be coordinated by an alcohol and drug counselor and completed within three calendar days after service initiation for a residential program or three sessions of the client's initiation to services for all other programs. The alcohol and drug counselor may rely on current information provided by a referring agency or other sources as a supplement when information is available. Information gathered more than 45 days before the date of admission is not current. If the comprehensive assessment cannot be completed in the time specified, the treatment plan must indicate how and when it will be completed. The assessment must include sufficient information to complete the assessment summary according to subpart 2 and part 9530.6425. The comprehensive assessment must include information about the client's problems that relate to chemical use and personal strengths that support recovery, including:

A.

age, sex, cultural background, sexual orientation, living situation, economic status, and level of education;

B.

circumstances of service initiation;

C.

previous attempts at treatment for chemical use or dependency, compulsive gambling, or mental illness;

D.

chemical use history including amounts and types of chemicals used, frequency and duration of use, periods of abstinence, and circumstances of relapse, if any. For each chemical used within the previous 30 days, the information must include the date and time of the most recent use and any previous experience with withdrawal;

E.

specific problem behaviors exhibited by the client when under the influence of chemicals;

F.

current family status, family history, including history or presence of physical or sexual abuse, level of family support, and chemical use, abuse, or dependency among family members and significant others;

G.

physical concerns or diagnoses, the severity of the concerns, and whether or not the concerns are being addressed by a health care professional;

H.

mental health history and current psychiatric status, including symptoms, disability, current treatment supports, and psychotropic medication needed to maintain stability;

I.

arrests and legal interventions related to chemical use;

J.

ability to function appropriately in work and educational settings;

K.

ability to understand written treatment materials, including rules and client rights;

L.

risk-taking behavior, including behavior that puts the client at risk of exposure to blood borne or sexually transmitted diseases;

M.

social network in relation to expected support for recovery and leisure time activities that have been associated with chemical use;

N.

whether the client is pregnant and if so, the health of the unborn child and current involvement in prenatal care; and

O.

whether the client recognizes problems related to substance use and is willing to follow treatment recommendations.

Subp. 2.

Assessment summary.

An alcohol and drug counselor must prepare an assessment summary within three calendar days for a residential program or within three treatment sessions of service initiation. The narrative summary of the comprehensive assessment results must meet the requirements of items A and B:

A.

An assessment summary must be prepared by an alcohol and drug counselor and include:

(1)

a risk description according to part 9530.6622 for each dimension listed in item B;

(2)

narrative supporting the risk descriptions; and

(3)

a determination of whether the client meets the DSM criteria for a person with a substance use disorder.

B.

Contain information relevant to treatment planning and recorded in the dimensions in subitems (1) to (6):

(1)

Dimension 1, acute intoxication/withdrawal potential. The license holder must consider the client's ability to cope with withdrawal symptoms and current state of intoxication.

(2)

Dimension 2, biomedical conditions and complications. The license holder must consider the degree to which any physical disorder would interfere with treatment for substance abuse, and the client's ability to tolerate any related discomfort. The license holder must determine the impact of continued chemical use on the unborn child if the client is pregnant.

(3)

Dimension 3, emotional, behavioral, and cognitive conditions and complications. The license holder must determine the degree to which any condition or complications are likely to interfere with treatment for substance abuse or with functioning in significant life areas and the likelihood of risk of harm to self or others.

(4)

Dimension 4, readiness for change. The license holder must also consider the amount of support and encouragement necessary to keep the client involved in treatment.

(5)

Dimension 5, relapse, continued use, and continued problem potential. The license holder must consider the degree to which the client recognizes relapse issues and has the skills to prevent relapse of either substance use or mental health problems.

(6)

Dimension 6, recovery environment. The license holder must consider the degree to which key areas of the client's life are supportive of or antagonistic to treatment participation and recovery.

9530.6425 INDIVIDUAL TREATMENT PLANS.

Subpart 1.

General.

Individual treatment plans for clients in treatment must be completed within seven calendar days of completion of the assessment summary. Treatment plans must continually be updated, based on new information gathered about the client's condition and on whether planned treatment interventions have had the intended effect. Treatment planning must include ongoing assessment in each of the six dimensions according to part 9530.6422, subpart 2. The plan must provide for the involvement of the client's family and those people selected by the client as being important to the success of the treatment experience at the earliest opportunity, consistent with the client's treatment needs and written consent. The plan must be developed after completion of the comprehensive assessment and is subject to amendment until services to the client are terminated. The client must have an opportunity to have active, direct involvement in selecting the anticipated outcomes of the treatment process and in developing the individual treatment plan. The individual treatment plan must be signed by the client and the alcohol and drug counselor. The individual treatment plan may be a continuation of the initial services plan required in part 9530.6420.

Subp. 2.

Plan contents.

An individual treatment plan must be recorded in the six dimensions listed in part 9530.6422, subpart 2, item B, and address each problem identified in the assessment summary, and include:

A.

specific methods to be used to address identified problems, including amount, frequency, and anticipated duration of treatment service. The methods must be appropriate to the client's language, reading skills, cultural background, and strengths;

B.

resources to which the client is being referred for problems when problems are to be addressed concurrently by another provider; and

C.

goals the client must reach to complete treatment and have services terminated.

Subp. 3.

Progress notes and plan review.

A.

Progress notes must be entered in a client's file weekly or after each treatment service, whichever is less frequent, by the staff person providing the service. The note must reference the treatment plan. Progress notes must be recorded and address each of the six dimensions listed in part 9530.6422, subpart 2, item B. Progress notes must:

(1)

be entered immediately following any significant event. Significant events include those events which have an impact on the client's relationship with other clients, staff, the client's family, or the client's treatment plan;

(2)

indicate the type and amount of each treatment service the client has received;

(3)

include monitoring of any physical and mental health problems and the participation of others in the treatment plan;

(4)

document the participation of others; and

(5)

document that the client has been notified of each treatment plan change and that the client either does or does not agree with the change.

B.

Treatment plan review must:

(1)

occur weekly or after each treatment service, whichever is less frequent;

(2)

address each goal in the treatment plan that has been worked on since the last review;

(3)

address whether the strategies to address the goals are effective, and if not, must include changes to the treatment plan; and

(4)

include a review and evaluation of the individual abuse prevention plan according to Minnesota Statutes, section 245A.65.

C.

All entries in a client's record must be legible, signed, and dated. Late entries must be clearly labeled "late entry." Corrections to an entry must be made in a way in which the original entry can still be read.

Subp. 3a.

Documentation.

Progress notes and plan review do not require separate documentation if the information in the client file meets the requirements of subpart 3, items A and B.

Subp. 4.

Summary at termination of services.

An alcohol and drug counselor must write a discharge summary for each client. The summary must be completed within five days of the client's service termination or within five days from the client's or program's decision to terminate services, whichever is earlier.

A.

The summary at termination of services must be recorded in the six dimensions listed in part 9530.6422, subpart 2, item B, and include the following information:

(1)

client's problems, strengths, and needs while participating in treatment, including services provided;

(2)

client's progress toward achieving each of the goals identified in the individual treatment plan;

(3)

reasons for and circumstances of service termination; and

(4)

risk description according to part 9530.6622.

B.

For clients who successfully complete treatment, the summary must also include:

(1)

living arrangements upon discharge;

(2)

continuing care recommendations, including referrals made with specific attention to continuity of care for mental health problems, as needed;

(3)

service termination diagnosis; and

(4)

client's prognosis.

9530.6430 TREATMENT SERVICES.

Subpart 1.

Treatment services offered by license holder.

A.

A license holder must offer the following treatment services unless clinically inappropriate and the justifying clinical rationale is documented:

(1)

individual and group counseling to help the client identify and address problems related to chemical use and develop strategies to avoid inappropriate chemical use after discharge;

(2)

client education strategies to avoid inappropriate chemical use and health problems related to chemical use and the necessary changes in lifestyle to regain and maintain health. Client education must include information concerning the human immunodeficiency virus, according to Minnesota Statutes, section 245A.19, other sexually transmitted diseases, drug and alcohol use during pregnancy, hepatitis, and tuberculosis;

(3)

transition services to help the client integrate gains made during treatment into daily living and to reduce reliance on the license holder's staff for support;

(4)

services to address issues related to co-occurring mental illness, including education for clients on basic symptoms of mental illness, the possibility of comorbidity, and the need for continued medication compliance while working on recovery from substance use disorder. Groups must address co-occurring mental illness issues, as needed. When treatment for mental health problems is indicated, it is integrated into the client's treatment plan; and

(5)

service coordination to help the client obtain the services and to support the client's need to establish a lifestyle free of the harmful effects of substance use disorder.

B.

Treatment services provided to individual clients must be provided according to the individual treatment plan and must address cultural differences and special needs of all clients.

Subp. 2.

Additional treatment services.

A license holder may provide or arrange the following additional treatment services as a part of the individual treatment plan:

A.

relationship counseling provided by a qualified professional to help the client identify the impact of the client's substance use disorder on others and to help the client and persons in the client's support structure identify and change behaviors that contribute to the client's substance use disorder;

B.

therapeutic recreation to provide the client with an opportunity to participate in recreational activities without the use of mood-altering chemicals and to learn to plan and select leisure activities that do not involve the inappropriate use of chemicals;

C.

stress management and physical well-being to help the client reach and maintain an acceptable level of health, physical fitness, and well-being;

D.

living skills development to help the client learn basic skills necessary for independent living;

E.

employment or educational services to help the client become financially independent;

F.

socialization skills development to help the client live and interact with others in a positive and productive manner; and

G.

room, board, and supervision provided at the treatment site to give the client a safe and appropriate environment in which to gain and practice new skills.

Subp. 3.

Counselors to provide treatment services.

Treatment services, including therapeutic recreation, must be provided by alcohol and drug counselors qualified according to part 9530.6450, unless the individual providing the service is specifically qualified according to the accepted standards of that profession. Therapeutic recreation does not include planned leisure activities.

Subp. 4.

Location of service provision.

A client of a license holder may only receive services at any of the license holder's licensed locations or at the client's home, except that services under subpart 1, item A, subitems (3) and (5), and subpart 2, items B and E, may be provided in another suitable location.

9530.6435 MEDICAL SERVICES.

Subpart 1.

Health care services description.

An applicant or license holder must maintain a complete description of the health care services, nursing services, dietary services, and emergency physician services offered by the license holder.

Subp. 1a.

Procedures.

The applicant or license holder must have written procedures for obtaining medical interventions when needed for a client, that are approved in writing by a physician who is licensed under Minnesota Statutes, chapter 147, unless:

A.

the license holder does not provide services under part 9530.6505; and

B.

all medical interventions are referred to 911, the emergency telephone number, or the client's physician.

Subp. 2.

Consultation services.

The license holder must have access to and document the availability of a licensed mental health professional to provide diagnostic assessment and treatment planning assistance.

Subp. 3.

Administration of medications and assistance with self-medication.

A license holder must meet the requirements in items A and B if services include medication administration.

A.

A staff member, other than a licensed practitioner or nurse, who is delegated by a licensed practitioner or a registered nurse the task of administration of medication or assistance with self-medication must:

(1)

document that the staff member has successfully completed a medication administration training program for unlicensed personnel through an accredited Minnesota postsecondary educational institution. Completion of the course must be documented in writing and placed in the staff member's personnel file; or

(2)

be trained according to a formalized training program which is taught by a registered nurse and offered by the license holder. Completion of the course must be documented in writing and placed in the staff member's personnel records; or

(3)

demonstrate to a registered nurse competency to perform the delegated activity.

B.

A registered nurse must be employed or contracted to develop the policies and procedures for medication administration or assistance with self-administration of medication or both. A registered nurse must provide supervision as defined in part 6321.0100. The registered nurse supervision must include monthly on-site supervision or more often as warranted by client health needs. The policies and procedures must include:

(1)

a provision that delegations of administration of medication are limited to administration of those medications which are oral, suppository, eye drops, ear drops, inhalant, or topical;

(2)

a provision that each client's file must include documentation indicating whether staff will be administering medication or the client will be doing self-administration or a combination of both;

(3)

a provision that clients may carry emergency medication such as nitroglycerin as instructed by their physician;

(4)

a provision for medication to be self-administered when a client is scheduled not to be at the facility;

(5)

a provision that if medication is to be self-administered at a time when the client is present in the facility, medication will be self-administered under observation of a trained staff person;

(6)

a provision that when a license holder serves clients who are parents with children, the parent may only administer medication to the child under staff supervision;

(7)

requirements for recording the client's use of medication, including staff signatures with date and time;

(8)

guidelines for when to inform a registered nurse of problems with self-administration, including failure to administer, client refusal of a medication, adverse reactions, or errors; and

(9)

procedures for acceptance, documentation, and implementation of prescriptions, whether written, verbal, telephonic, or electronic.

Subp. 4.

Control of drugs.

A license holder must have in place and implement written policies and procedures developed by a registered nurse that contains the following provisions:

A.

a requirement that all drugs must be stored in a locked compartment. Schedule II drugs, as defined by Minnesota Statutes, section 152.02, must be stored in a separately locked compartment, permanently affixed to the physical plant or medication cart;

B.

a system which accounts for all scheduled drugs each shift;

C.

a procedure for recording the client's use of medication, including the signature of the administrator of the medication with the time and date;

D.

a procedure for destruction of discontinued, outdated, or deteriorated medications;

E.

a statement that only authorized personnel are permitted to have access to the keys to the locked drug compartments; and

F.

a statement that no legend drug supply for one client will be given to another client.

9530.6440 CLIENT RECORDS.

Subpart 1.

Client records required.

A license holder must maintain a file of current client records on the premises where the treatment services are provided or coordinated. The content and format of client records must be uniform and entries in each case must be signed and dated by the staff member making the entry. Client records must be protected against loss, tampering, or unauthorized disclosure in compliance with Minnesota Statutes, section 254A.09, Code of Federal Regulations, title 42, chapter 1, part 2, subpart B, sections 2.1 to 2.67, and Code of Federal Regulations, title 45, parts 160 to 164, and, if applicable, Minnesota Statutes, chapter 13.

Subp. 2.

Records retention.

Records of discharged clients must be retained by a license holder for seven years. License holders that cease to provide treatment services must retain client records for seven years from the date of facility closure and must notify the commissioner of the location of the records and the name of a person responsible for maintaining the records.

Subp. 3.

Client records, contents.

Client records must contain the following:

A.

documentation that the client was given information on client rights, responsibilities, grievance procedures, tuberculosis, and HIV, and that the client was provided an orientation to the program abuse prevention plan as required under Minnesota Statutes, section 245A.65, subdivision 2, paragraph (a), clause (4);

B.

an initial services plan completed according to part 9530.6420;

C.

a comprehensive assessment completed according to part 9530.6422;

D.

an assessment summary completed according to part 9530.6422, subpart 2;

E.

an individual abuse prevention plan that complies with Minnesota Statutes, sections 245A.65, subdivision 2, and 626.557, subdivision 14, when applicable;

F.

an individual treatment plan, as required under part 9530.6425, subparts 1 and 2;

G.

progress notes, as required in part 9530.6425, subpart 3; and

H.

a summary of termination of services, written according to part 9530.6425, subpart 4.

Subp. 4.

Electronic records.

A license holder who intends to use electronic record keeping or electronic signatures to comply with parts 9530.6405 to 9530.6505 must first obtain written permission from the commissioner. The commissioner must grant permission after the license holder provides documentation demonstrating the license holder's use of a system for ensuring security of electronic records. Use of electronic record keeping or electronic signatures does not alter the license holder's obligations under state or federal law, regulation, or rule.

9530.6445 STAFFING REQUIREMENTS.

Subpart 1.

Treatment director required.

A license holder must have a treatment director.

Subp. 2.

Alcohol and drug counselor supervisor requirements.

A license holder must employ an alcohol and drug counselor supervisor who meets the requirements under part 9530.6450, subpart 4. An individual may be simultaneously employed as a treatment director, alcohol and drug counselor supervisor, and an alcohol and drug counselor if the individual meets the qualifications for each position. If an alcohol and drug counselor is simultaneously an alcohol and drug counselor supervisor or treatment director, that individual must be considered a 0.5 full-time equivalent alcohol and drug counselor for purposes of meeting the staffing requirements under subpart 4.

Subp. 3.

Responsible staff person.

A treatment director must designate a staff member who, when present in the facility, is responsible for the delivery of treatment services. A license holder must have a designated staff person during all hours of operation. A license holder providing room and board and treatment at the same site must have a responsible staff person on duty 24 hours a day. The designated staff person must know and understand the implications of parts 9530.6405 to 9530.6505 and Minnesota Statutes, sections 245A.65, 626.556, 626.557, and 626.5572.

Subp. 4.

Staffing requirements.

At least 25 percent of a counselor's scheduled work hours must be allocated to indirect services, including documentation of client services, coordination of services with others, treatment team meetings, and other duties. A counseling group shall not exceed an average of 16 clients during any 30 consecutive calendar days. It is the responsibility of the license holder to determine an acceptable group size based on the client's needs. A counselor in a program treating intravenous drug abusers must not supervise more than 50 clients. The license holder must maintain a record that documents compliance with this subpart.

Subp. 5.

Medical emergencies.

When clients are present, a license holder must have at least one staff person on the premises who has a current American Red Cross standard first aid certificate or an equivalent certificate and at least one staff person on the premises who has a current American Red Cross community, American Heart Association, or equivalent CPR certificate. A single staff person with both certifications satisfies this requirement.

9530.6450 STAFF QUALIFICATIONS.

Subpart 1.

Qualifications of all staff members with direct client contact.

All staff members who have direct client contact must be at least 18 years of age. At the time of hiring, all staff members must meet the qualifications in item A or B. A chemical use problem for purposes of this subpart is a problem listed by the license holder in the personnel policies and procedures according to part 9530.6460, subpart 1, item E.

A.

Treatment directors, supervisors, nurses, counselors, and other professionals must be free of chemical use problems for at least the two years immediately preceding their hiring and must sign a statement attesting to that fact.

B.

Paraprofessionals and all other staff members with direct client contact must be free of chemical use problems for at least one year immediately preceding their hiring and must sign a statement attesting to that fact.

Subp. 2.

Employment; prohibition on chemical use problems.

Staff members with direct client contact must be free from chemical use problems as a condition of employment, but are not required to sign additional statements. Staff members with direct client contact who are not free from chemical use problems must be removed from any responsibilities that include direct client contact for the time period specified in subpart 1. The time period begins to run on the date the employee begins receiving treatment services or the date of the last incident as described in the list developed according to part 9530.6460, subpart 1, item E.

Subp. 3.

Treatment director qualifications.

In addition to meeting the requirements of subpart 1, a treatment director must know and understand the implications of parts 9530.6405 to 9530.6505 and Minnesota Statutes, chapter 245A, and sections 626.556, 626.557, and 626.5572. A treatment director must:

A.

have at least one year of work experience in direct service to individuals with chemical use problems or one year of work experience in the management or administration of direct service to individuals with chemical use problems; and

B.

have a baccalaureate degree or three years of work experience in administration or personnel supervision in human services.

Subp. 4.

Alcohol and drug counselor supervisor qualifications.

In addition to meeting the requirements of subpart 1, an alcohol and drug counselor supervisor must meet the following qualifications:

A.

the individual is competent in the areas specified in subpart 5;

B.

the individual has three or more years of experience providing individual and group counseling to chemically dependent clients except that, prior to January 1, 2005, an individual employed in a program formerly licensed under parts 9530.5000 to 9530.6400is required to have one or more years experience; and

C.

the individual knows and understands the implications of parts 9530.6405 to 9530.6505 and Minnesota Statutes, sections 245A.65, 626.556, 626.557, and 626.5572.

Subp. 5.

Alcohol and drug counselor qualifications.

In addition to meeting the requirements of subpart 1, an alcohol and drug counselor must be either licensed or exempt from licensure under Minnesota Statutes, chapter 148C. An alcohol and drug counselor must document competence in screening for and working with clients with mental health problems, through education, training, and experience.

A.

Alcohol and drug counselors licensed under Minnesota Statutes, chapter 148C, must comply with rules adopted under Minnesota Statutes, chapter 148C.

B.

Counselors exempt under Minnesota Statutes, chapter 148C, must be competent, as evidenced by one of the following:

(1)

completion of at least a baccalaureate degree with a major or concentration in social work, nursing, sociology, human services, or psychology, or licensure as a registered nurse; successful completion of a minimum of 120 hours of classroom instruction in which each of the core functions listed in Minnesota Statutes, chapter 148C, is covered; and successful completion of 440 hours of supervised experience as an alcohol and drug counselor, either as a student or as a staff member;

(2)

completion of 270 hours of alcohol and drug counselor training in which each of the core functions listed in Minnesota Statutes, chapter 148C, is covered, and successful completion of 880 hours of supervised experience as an alcohol and drug counselor, either as a student, or as a staff member;

(3)

current certification as an alcohol and drug counselor or alcohol and drug counselor reciprocal, through the evaluation process established by the International Certification and Reciprocity Consortium Alcohol and Other Drug Abuse, Inc., and published in the Case Presentation Method Trainer's Manual, copyright 1993. The manual is incorporated by reference. It is available at the State Law Library, Judicial Center, 25 Reverend Dr. Martin Luther King Jr. Blvd., St. Paul, Minnesota 55155;

(4)

completion of a bachelor's degree including 480 hours of alcohol and drug counseling education from an accredited school or educational program and 880 hours of alcohol and drug counseling practicum; or

(5)

employment in a program formerly licensed under parts 9530.5000 to 9530.6400 and successful completion of 6,000 hours of supervised work experience in a licensed program as an alcohol and drug counselor prior to January 1, 2005.

Subp. 6.

Paraprofessional qualifications and duties.

A paraprofessional must comply with subpart 1 and have knowledge of client rights, outlined in Minnesota Statutes, section 148F.165, and of staff responsibilities. A paraprofessional may not admit, transfer, or discharge clients but may be the person responsible for the delivery of treatment services as required in part 9530.6445, subpart 3.

Subp. 7.

Volunteers.

Volunteers may provide treatment services when they are supervised and can be seen or heard by a staff member meeting the criteria in subpart 4 or 5, but may not practice alcohol and drug counseling unless qualified under subpart 5.

Subp. 8.

Student interns.

A qualified staff person must supervise and be responsible for all treatment services performed by student interns and must review and sign all assessments, progress notes, and treatment plans prepared by the intern. Student interns must meet the requirements in subpart 1, item A, and receive the orientation and training required in part 9530.6460, subpart 1, item G, and subpart 2.

Subp. 9.

Individuals with temporary permit.

Individuals with a temporary permit from the Board of Behavioral Health and Therapy may provide chemical dependency treatment services under the conditions in either item A or B.

A.

The individual is supervised by a licensed alcohol and drug counselor assigned by the license holder. The licensed alcohol and drug counselor must document the amount and type of supervision at least weekly. The supervision must relate to clinical practices. One licensed alcohol and drug counselor may not supervise more than three individuals with temporary permits, according to Minnesota Statutes, section 148C.01, subdivision 12a.

B.

The individual is supervised by a clinical supervisor approved by the Board of Behavioral Health and Therapy. The supervision must be documented and meet the requirements of Minnesota Statutes, section 148C.044, subdivision 4.

9530.6455 PROVIDER POLICIES AND PROCEDURES.

License holders must develop a written policy and procedures manual indexed according to Minnesota Statutes, section 245A.04, subdivision 14, paragraph (c), so that staff may have immediate access to all policies and procedures and so that consumers of the services and other authorized parties may have access to all policies and procedures. The manual must contain the following materials:

A.

assessment and treatment planning policies, which include screening for mental health concerns, and the inclusion of treatment objectives related to identified mental health concerns in the client's treatment plan;

B.

policies and procedures regarding HIV that comply with Minnesota Statutes, section 245A.19;

C.

the methods and resources used by the license holder to provide information on tuberculosis and tuberculosis screening to all clients and to report known cases of tuberculosis infection according to Minnesota Statutes, section 144.4804;

D.

personnel policies that comply with part 9530.6460;

E.

policies and procedures that protect client rights as required under part 9530.6470;

F.

a medical services plan that complies with part 9530.6435;

G.

emergency procedures that comply with part 9530.6475;

H.

policies and procedures for maintaining client records under part 9530.6440;

I.

procedures for reporting the maltreatment of minors under Minnesota Statutes, section 626.556, and vulnerable adults under Minnesota Statutes, sections 245A.65, 626.557, and 626.5572;

J.

a description of treatment services including the amount and type of client services provided;

K.

the methods used to achieve desired client outcomes; and

L.

the hours of operation and target population served.

9530.6460 PERSONNEL POLICIES AND PROCEDURES.

Subpart 1.

Policy requirements.

License holders must have written personnel policies and must make them available to each staff member. The policies must:

A.

assure that staff member retention, promotion, job assignment, or pay are not affected by a good faith communication between a staff member and the Department of Health, the Department of Human Services, the ombudsman for mental health and developmental disabilities, law enforcement, or local agencies for the investigation of complaints regarding a client's rights, health, or safety;

B.

contain job descriptions for each position specifying responsibilities, degree of authority to execute job responsibilities, and qualifications;

C.

provide for job performance evaluations based on standards of job performance to be conducted on a regular and continuing basis, including a written annual review;

D.

describe behavior that constitutes grounds for disciplinary action, suspension or dismissal, including policies that address chemical use problems and meet the requirements of part 9530.6450, subpart 1, policies prohibiting personal involvement with clients in violation of Minnesota Statutes, chapter 604, and policies prohibiting client abuse as specified under Minnesota Statutes, sections 245A.65, 626.556, 626.557, and 626.5572;

E.

list behaviors or incidents that are considered chemical use problems. The list must include:

(1)

receiving treatment for chemical use within the period specified for the position in the staff qualification requirements;

(2)

chemical use that has a negative impact on the staff member's job performance;

(3)

chemical use that affects the credibility of treatment services with clients, referral sources, or other members of the community; and

(4)

symptoms of intoxication or withdrawal on the job;

F.

include a chart or description of the organizational structure indicating lines of authority and responsibilities;

G.

include orientation within 24 working hours of starting for all new staff based on a written plan that, at a minimum, must provide for training related to the specific job functions for which the staff member was hired, policies and procedures, client confidentiality, the human immunodeficiency virus minimum standards, and client needs; and

H.

policies outlining the license holder's response to staff members with behavior problems that interfere with the provision of treatment services.

Subp. 2.

Staff development.

A license holder must ensure that each staff person has the training required in items A to E.

A.

All staff must be trained every two years in client confidentiality rules and regulations and client ethical boundaries.

B.

All staff must be trained every two years in emergency procedures and client rights as specified in Minnesota Statutes, sections 144.651, 148F.165, and 253B.03.

C.

All staff with direct client contact must be trained every year on mandatory reporting as specified under Minnesota Statutes, sections 245A.65, 626.556, 626.5561, 626.5563, 626.557, and 626.5572, including specific training covering the facility's policies concerning obtaining client releases of information.

D.

All staff with direct client contact must receive training upon hiring and annually thereafter on the human immunodeficiency virus minimum standards according to Minnesota Statutes, section 245A.19.

E.

Treatment directors, supervisors, nurses, and counselors must obtain 12 hours of training in co-occurring mental health problems and substance use disorder that includes competencies related to philosophy, screening, assessment, diagnosis and treatment planning, documentation, programming, medication, collaboration, mental health consultation, and discharge planning. Staff employed by a license holder on the date this rule is adopted must obtain the training within 12 months of the date of adoption. New staff who have not obtained such training must obtain it within 12 months of the date this rule is adopted or within six months of hire, whichever is later. Staff may request, and the license holder may grant credit for, relevant training obtained prior to January 1, 2005.

Subp. 3.

Personnel files.

The license holder must maintain a separate personnel file for each staff member. At a minimum, the personnel file must be maintained to meet the requirements under parts 9530.6405 to 9530.6505 and contain the following:

A.

a completed application for employment signed by the staff member and containing the staff member's qualifications for employment;

B.

documentation related to the applicant's background study data, as defined in Minnesota Statutes, chapter 245C;

C.

for staff members who will be providing psychotherapy services, employer names and addresses for the past five years for which the staff member provided psychotherapy services, and documentation of an inquiry made to these former employers regarding substantiated sexual contact with a client as required by Minnesota Statutes, chapter 604;

D.

documentation of completed orientation and training;

E.

documentation demonstrating compliance with parts 9530.6450 and 9530.6485, subpart 2; and

F.

documentation demonstrating compliance with part 9530.6435, subpart 3, for staff members who administer medications.

9530.6465 SERVICE INITIATION AND TERMINATION POLICIES.

Subpart 1.

Service initiation policy.

A license holder must have a written service initiation policy containing service initiation preferences which comply with this rule and Code of Federal Regulations, title 45, part 96.131, and specific service initiation criteria. The license holder must not initiate services for individuals who do not meet the service initiation criteria. The service initiation criteria must be either posted in the area of the facility where services for clients are initiated, or given to all interested persons upon request. Titles of all staff members authorized to initiate services for clients must be listed in the services initiation and termination policies. A license holder that serves intravenous drug abusers must have a written policy that provides service initiation preference as required by Code of Federal Regulations, title 45, part 96.131.

Subp. 2.

License holder responsibilities; terminating or denying services.

A license holder has specific responsibilities when terminating services or denying treatment service initiation to clients for reasons of health, behavior, or criminal activity.

A.

The license holder must have and comply with a written protocol for assisting clients in need of care not provided by the license holder, and for clients who pose a substantial likelihood of harm to themselves or others, if the behavior is beyond the behavior management capabilities of the staff. All service terminations and denials of service initiation which pose an immediate threat to the health of any individual or require immediate medical intervention must be referred to a medical facility capable of admitting the individual.

B.

All service termination policies and denials of service initiation that involve the commission of a crime against a license holder's staff member or on a license holder's property, as provided under Code of Federal Regulations, title 42, section 2.12(c)(5), and Code of Federal Regulations, title 45, parts 160 to 164, must be reported to a law enforcement agency with proper jurisdiction.

Subp. 3.

Service termination and transfer policies.

A license holder must have a written policy specifying the conditions under which clients must be discharged. The policy must include:

A.

procedures for individuals whose services have been terminated under subpart 2;

B.

a description of client behavior that constitutes reason for a staff-requested service termination and a process for providing this information to clients;

C.

procedures consistent with Minnesota Statutes, section 253B.16, subdivision 2, that staff must follow when a client admitted under Minnesota Statutes, chapter 253B, is to have services terminated;

D.

procedures staff must follow when a client leaves against staff or medical advice and when the client may be dangerous to self or others;

E.

procedures for communicating staff-approved service termination criteria to clients, including the expectations in the client's individual treatment plan according to part 9530.6425; and

F.

titles of staff members authorized to terminate client services must be listed in the service initiation and termination policies.

9530.6470 POLICIES AND PROCEDURES THAT PROTECT CLIENT RIGHTS.

Subpart 1.

Client rights; explanation.

Clients have the rights identified in Minnesota Statutes, sections 144.651, 148F.165, and 253B.03, as applicable. The license holder must give each client upon service initiation a written statement of client's rights and responsibilities. Staff must review the statement with clients at that time.

Subp. 2.

Grievance procedure.

Upon service initiation, the license holder must explain the grievance procedure to the client or their representative. The grievance procedure must be posted in a place visible to clients, and made available upon a client's request. The grievance procedure must also be made available to former clients upon request. The grievance procedure must require that:

A.

staff help the client develop and process a grievance;

B.

telephone numbers and addresses of the Department of Human Services, licensing division; the Office of Ombudsman for Mental Health and Developmental Disabilities; the Minnesota Department of Health, Office of Alcohol and Drug Counselor Licensing Program, and Office of Health Facilities Complaints; when applicable, be made available to clients; and

C.

a license holder be obligated to respond to the client's grievance within three days of a staff member's receipt of the grievance, and the client be permitted to bring the grievance to the highest level of authority in the program if not resolved by other staff members.

Subp. 3.

Photographs of client.

All photographs, video tapes, and motion pictures of clients taken in the provision of treatment services are considered client records. Photographs for identification and recordings by video and audio tape for the purpose of enhancing either therapy or staff supervision may be required of clients, but may only be available for use as communications within a program. Clients must be informed when their actions are being recorded by camera or tape, and have the right to deny any taping or photography, except as authorized by this subpart.

9530.6475 BEHAVIORAL EMERGENCY PROCEDURES.

A.

A license holder or applicant must have written procedures that staff must follow when responding to a client who exhibits behavior that is threatening to the safety of the client or others. The procedures must include:

(1)

a plan designed to prevent the client from hurting themselves or others;

(2)

contact information for emergency resources that staff must consult when a client's behavior cannot be controlled by the procedures established in the plan;

(3)

types of procedures that may be used;

(4)

circumstances under which emergency procedures may be used; and

(5)

staff members authorized to implement emergency procedures.

B.

Behavioral emergency procedures must not be used to enforce facility rules or for the convenience of staff. Behavioral emergency procedures must not be part of any client's treatment plan, or used at any time for any reason except in response to specific current behaviors that threaten the safety of the client or others. Behavioral emergency procedures may not include the use of seclusion or restraint.

9530.6480 EVALUATION.

Subpart 1.

Participation in drug and alcohol abuse normative evaluation system.

License holders must participate in the drug and alcohol abuse normative evaluation system by submitting information about each client to the commissioner in a format specified by the commissioner.

Subp. 2.

Commissioner requests.

A license holder must submit additional information requested by the commissioner that is necessary to meet statutory or federal funding requirements.

9530.6485 LICENSE HOLDERS SERVING ADOLESCENTS.

Subpart 1.

License holders serving adolescents.

A residential treatment program that serves persons under 18 years of age must be licensed as a residential program for children in out-of-home placement by the department unless the license holder is exempt under Minnesota Statutes, section 245A.03, subdivision 2.

Subp. 2.

Alcohol and drug counselor qualifications.

In addition to the requirements specified in part 9530.6450, subparts 1 and 5, an alcohol and drug counselor providing treatment services to adolescents must have:

A.

an additional 30 hours of classroom instruction or one three-credit semester college course in adolescent development. This training need only be completed one time; and

B.

at least 150 hours of supervised experience as an adolescent counselor, either as a student or as a staff member.

Subp. 3.

Staffing ratios.

At least 25 percent of a counselor's scheduled work hours must be allocated to indirect services, including documentation of client services, coordination of services with others, treatment team meetings, and other duties. A counseling group consisting entirely of adolescents must not exceed 16 clients. It is the responsibility of the license holder to determine an acceptable group size based on the needs of the clients.

Subp. 4.

Academic program requirements.

Clients who are required to attend school must be enrolled and attending an educational program that has been approved by the Minnesota Department of Education.

Subp. 5.

Program requirements.

In addition to the requirements specified in the client's treatment plan under part 9530.6425, programs serving adolescents must include the following:

A.

coordination with the school system to address the client's academic needs;

B.

when appropriate, a plan that addresses the client's leisure activities without chemical use; and

C.

a plan that addresses family involvement in the adolescent's treatment.

9530.6490 LICENSE HOLDERS SERVING CLIENTS WITH CHILDREN.

Subpart 1.

Health license requirements.

In addition to the requirements of parts 9530.6405 to 9530.6480, all license holders that offer supervision of children of clients are subject to the requirements of this part. License holders providing room and board for clients and their children must have an appropriate facility license from the Minnesota Department of Health.

Subp. 2.

Supervision of children defined.

"Supervision of children" means a caregiver is within sight or hearing of an infant, toddler, or preschooler at all times so that the caregiver can intervene to protect the health and safety of the child. For the school age child it means a caregiver is available to help and care for the child so that the child's health and safety is protected.

Subp. 3.

Policy and schedule required.

License holders must meet the following requirements:

A.

license holders must have a policy and schedule delineating the times and circumstances under which the license holder is responsible for supervision of children in the program and when the child's parents are responsible for child supervision. The policy must explain how the program will communicate its policy about child supervision responsibility to the parents; and

B.

license holders must have written procedures addressing the actions to be taken by staff if children are neglected or abused including while the children are under the supervision of their parents.

Subp. 4.

Additional licensing requirements.

During the times the license holder is responsible for the supervision of children, the license holder must meet the following standards:

A.

child and adult ratios in part 9502.0367;

B.

day care training in Minnesota Statutes, section 245A.50;

C.

behavior guidance in part 9502.0395;

D.

activities and equipment in part 9502.0415;

E.

physical environment in part 9502.0425; and

F.

water, food, and nutrition in part 9502.0445, unless the license holder has a license from the Minnesota Department of Health.

9530.6495 LICENSE HOLDERS SERVING PERSONS WITH SUBSTANCE USE AND MENTAL HEALTH DISORDERS.

In addition to meeting the requirements of parts 9530.6405 to 9530.6490, license holders specializing in the treatment of persons with substance use disorder and mental health problems must:

A.

demonstrate that staffing levels are appropriate for treating clients with substance use disorder and mental health problems, and that there is adequate staff with mental health training;

B.

have continuing access to a medical provider with appropriate expertise in prescribing psychotropic medications;

C.

have a mental health professional available for staff supervision and consultation;

D.

determine group size, structure, and content with consideration for the special needs of those with substance use disorder and mental health disorders;

E.

have documentation of active interventions to stabilize mental health symptoms present in treatment plans and progress notes;

F.

have continuing documentation of collaboration with continuing care mental health providers, and involvement of those providers in treatment planning meetings;

G.

have available program materials adapted to individuals with mental health problems;

H.

have policies that provide flexibility for clients who may lapse in treatment or may have difficulty adhering to established treatment rules as a result of a mental illness, with the goal of helping clients successfully complete treatment; and

I.

have individual psychotherapy and case management available during the treatment process.

9530.6500 PROGRAMS SERVING INTRAVENOUS DRUG ABUSERS.

Subpart 1.

Additional requirements.

In addition to the requirements of parts 9530.6405 to 9530.6505, programs serving intravenous drug abusers must comply with the requirements of this part.

Subp. 2.

Capacity management and waiting list system compliance.

A program serving intravenous drug abusers must notify the department within seven days of when the program reaches both 90 and 100 percent of the program's capacity to care for clients. Each week, the program must report its capacity, current enrolled dosing clients, and any waiting list. A program reporting 90 percent of capacity must also notify the department when its census has increased or decreased from the 90 percent level.

Subp. 3.

Waiting list.

A program serving intravenous drug abusers must have a waiting list system. Each person seeking admission must be placed on the waiting list if the person cannot be admitted within 14 days of the date of application, unless the applicant is assessed by the program and found not to be eligible for admission according to parts 9530.6405 to 9530.6505, and Code of Federal Regulations, title 42, part 1, subchapter A, section 8.12(e), and Code of Federal Regulations, title 45, parts 160 to 164. The waiting list must assign a unique patient identifier for each intravenous drug abuser seeking treatment while awaiting admission. An applicant on a waiting list who receives no services under part 9530.6430, subpart 1, must not be considered a "client" as defined in part 9530.6405, subpart 8.

Subp. 4.

Client referral.

Programs serving intravenous drug abusers must consult the capacity management system so that persons on waiting lists are admitted at the earliest time to a program providing appropriate treatment within a reasonable geographic area. If the patient has been referred through a public payment system and if the program is not able to serve the client within 14 days of the date of application for admission, the program must contact and inform the referring agency of any available treatment capacity listed in the state capacity management system.

Subp. 5.

Outreach.

Programs serving intravenous drug abusers must carry out activities to encourage individuals in need of treatment to undergo treatment. The program's outreach model must:

A.

select, train, and supervise outreach workers;

B.

contact, communicate, and follow up with high risk substance abusers, their associates, and neighborhood residents within the constraints of federal and state confidentiality requirements, including Code of Federal Regulations, title 42, sections 2.1 to 2.67, and Code of Federal Regulations, title 45, parts 160 to 164;

C.

promote awareness among injecting drug abusers about the relationship between injecting drug abuse and communicable diseases such as HIV; and

D.

recommend steps that can be taken to ensure that HIV transmission does not occur.

Subp. 6.

Central registry.

Programs serving intravenous drug abusers must comply with requirements to submit information and necessary consents to the state central registry for each client admitted, as specified by the commissioner. The client's failure to provide the information will prohibit involvement in an opiate treatment program. The information submitted must include the client's:

A.

full name and all aliases;

B.

date of admission;

C.

date of birth;

D.

Social Security number or INS number, if any;

E.

enrollment status in other current or last known opiate treatment programs;

F.

government-issued photo-identification card number; and

G.

driver's license number, if any.

The information in items A to G must be submitted in a format prescribed by the commissioner, with the original kept in the client's chart, whenever a client is accepted for treatment, the client's type or dosage of a drug is changed, or the client's treatment is interrupted, resumed, or terminated.

9530.6505 REQUIREMENTS FOR LICENSED RESIDENTIAL TREATMENT.

Subpart 1.

Applicability.

A license holder who provides supervised room and board at the licensed program site as a treatment component is defined as a residential program according to Minnesota Statutes, section 245A.02, subdivision 14, and is subject to this part.

Subp. 2.

Visitors.

Clients must be allowed to receive visitors at times prescribed by the license holder. The license holder must set and post a notice of visiting rules and hours, including both day and evening times. A client's right to receive visitors other than a personal physician, religious advisor, county case manager, parole or probation officer, or attorney may be subject to visiting hours established by the license holder for all clients. The treatment director or designee may impose limitations as necessary for the welfare of a client provided that limitations and the reasons for them are documented in the client's file. Clients must be allowed to receive visits at all reasonable times from their personal physicians, religious advisors, county case managers, parole or probation officers, and attorneys.

Subp. 3.

Client property management.

A license holder who provides room and board and treatment services to clients in the same facility, and any license holder that accepts client property must meet the requirements in Minnesota Statutes, section 245A.04, subdivision 13, for handling resident funds and property. In the course of client property management, license holders:

A.

may establish policies regarding the use of personal property to assure that treatment activities and the rights of other patients are not infringed;

B.

may take temporary custody of property for violation of facility policies;

C.

must retain the client's property for a minimum of seven days after discharge if the client does not reclaim property upon service termination, or for a minimum of 30 days if the client does not reclaim property upon service termination and has received room and board services from the license holder; and

D.

must return all property held in trust to the client upon service termination regardless of the client's service termination status, except:

(1)

drugs, drug paraphernalia, and drug containers that are forfeited under Minnesota Statutes, section 609.5316, must be destroyed by staff or given over to the custody of a local law enforcement agency, according to Code of Federal Regulations, title 42, chapter 1, part 2, subpart B, sections 2.1 to 2.67, and Code of Federal Regulations, title 45, parts 160 to 164;

(2)

weapons, explosives, and other property which can cause serious harm to self or others must be given over to the custody of a local law enforcement agency, and the client must be notified of the transfer and of the right to reclaim any lawful property transferred; and

(3)

medications that have been determined by a physician to be harmful after examining the client, except when the client's personal physician approves the medication for continued use.

Subp. 4.

Health facility license.

A license holder who provides room and board and treatment services in the same facility must have the appropriate license from the Department of Health.

Subp. 5.

Facility abuse prevention plan.

A license holder must establish and enforce an ongoing facility abuse prevention plan consistent with Minnesota Statutes, sections 245A.65 and 626.557, subdivision 14.

Subp. 6.

Individual abuse prevention plan.

A license holder must prepare an individual abuse prevention plan for each client as specified under Minnesota Statutes, sections 245A.65, subdivision 2, and 626.557, subdivision 14.

Subp. 7.

Health services.

License holders must have written procedures for assessing and monitoring client health, including a standardized data collection tool for collecting health-related information about each client. The policies and procedures must be approved and signed by a registered nurse.

Subp. 8.

Administration of medications.

License holders must meet the administration of medications requirements of part 9530.6435, subpart 3.