SF 4503

as introduced - 92nd Legislature (2021 - 2022) Posted on 04/20/2022 08:11am

A bill for an act
relating to human services; adding cultural practitioners to providers of chemical
dependency services; requiring Minnesota's Tribal nations to be informed of
changes in law; amending Minnesota Statutes 2020, sections 245G.07, subdivision
2; 245G.11, subdivision 5, by adding a subdivision; 256.01, by adding subdivisions;
Minnesota Statutes 2021 Supplement, section 254B.05, subdivision 5.

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

Section 1.

Minnesota Statutes 2020, section 245G.07, subdivision 2, is amended to read:

Subd. 2.

Additional treatment service.

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

(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;

(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;

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

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

(5) employment or educational services to help the client become financially independent;

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

(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; deleted text begin and
deleted text end

(8) peer recovery support services provided one-to-one by an individual in recovery
qualified according to section 245G.11, subdivision 8. 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 new text begin ; and
new text end

new text begin (9) holistic health services provided by medicine men and women and cultural
practitioners for Native American clientele, or in Native American programs new text end .

Sec. 2.

Minnesota Statutes 2020, section 245G.11, subdivision 5, is amended to read:

Subd. 5.

Alcohol and drug counselor qualifications.

(a) An alcohol and drug counselor
must either be licensed deleted text begin or deleted text end new text begin , new text end exempt from licensure under chapter 148F new text begin , or a medicine man
or woman or cultural practitioner providing holistic services under section 245G.07,
subdivision 2 new text end .

(b) An individual who is exempt from licensure under chapter 148F, must meet one of
the following additional requirements:

(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 chapter 148F is covered; and successful completion of 440
hours of supervised experience as an alcohol and drug counselor, either as a student or a
staff member;

(2) completion of at least 270 hours of drug counselor training in which each of the core
functions listed in chapter 148F 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.;

(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 Minnesota Rules, 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.

(c) An alcohol and drug counselor may not provide a treatment service that requires
professional licensure unless the individual possesses the necessary license. For the purposes
of enforcing this section, the commissioner has the authority to monitor a service provider's
compliance with the relevant standards of the service provider's profession and may issue
licensing actions against the license holder according to sections 245A.05, 245A.06, and
245A.07, based on the commissioner's determination of noncompliance.

Sec. 3.

Minnesota Statutes 2020, section 245G.11, is amended by adding a subdivision to
read:

new text begin Subd. 12. new text end

new text begin Holistic health services. new text end

new text begin A medicine man or woman or cultural practitioner
may provide holistic health services under this chapter.
new text end

Sec. 4.

Minnesota Statutes 2021 Supplement, section 254B.05, subdivision 5, is amended
to read:

Subd. 5.

Rate requirements.

(a) The commissioner shall establish rates for substance
use disorder services and service enhancements funded under this chapter.

(b) Eligible substance use disorder treatment services include:

(1) outpatient treatment services that are licensed according to sections 245G.01 to
245G.17, or applicable tribal license;

(2) comprehensive assessments provided according to sections 245.4863, paragraph (a),
and 245G.05;

(3) care coordination services provided according to section 245G.07, subdivision 1,
paragraph (a), clause (5);

(4) peer recovery support services provided according to section 245G.07, subdivision
2, clause (8);

(5) on July 1, 2019, or upon federal approval, whichever is later, withdrawal management
services provided according to chapter 245F;

(6) medication-assisted therapy services that are licensed according to sections 245G.01
to 245G.17 and 245G.22, or applicable tribal license;

(7) medication-assisted therapy plus enhanced treatment services that meet the
requirements of clause (6) and provide nine hours of clinical services each week;

(8) high, medium, and low intensity residential treatment services that are licensed
according to sections 245G.01 to 245G.17 and 245G.21 or applicable tribal license which
provide, respectively, 30, 15, and five hours of clinical services each week;

(9) hospital-based treatment services that are licensed according to sections 245G.01 to
245G.17 or applicable tribal license and licensed as a hospital under sections 144.50 to
144.56;

(10) adolescent treatment programs that are licensed as outpatient treatment programs
according to sections 245G.01 to 245G.18 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;

(11) high-intensity residential treatment services that are licensed according to sections
245G.01 to 245G.17 and 245G.21 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; deleted text begin and
deleted text end

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

new text begin (13) holistic health services provided by medicine men and women and cultural
practitioners under chapter 245G new text end .

(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 section 245G.19, subdivision 4; 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 or culturally responsive programs as defined in section 254B.01,
subdivision 4a;

(3) disability responsive programs as defined in section 254B.01, subdivision 4b;

(4) 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; or

(5) 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 section 245G.20;

(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 section 245G.19.

(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, substance use disorder services that are otherwise covered
as direct face-to-face services may be provided via telehealth as defined in section 256B.0625,
subdivision 3b. The use of telehealth to deliver services 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.

(g) For the purpose of reimbursement under this section, substance use disorder treatment
services provided in a group setting without a group participant maximum or maximum
client to staff ratio under chapter 245G shall not exceed a client to staff ratio of 48 to one.
At least one of the attending staff must meet the qualifications as established under this
chapter for the type of treatment service provided. A recovery peer may not be included as
part of the staff ratio.

(h) Payment for outpatient substance use disorder services that are licensed according
to sections 245G.01 to 245G.17 is limited to six hours per day or 30 hours per week unless
prior authorization of a greater number of hours is obtained from the commissioner.

Sec. 5.

Minnesota Statutes 2020, section 256.01, is amended by adding a subdivision to
read:

new text begin Subd. 43. new text end

new text begin Cultural grants. new text end

new text begin The department must inform the American Indian Advisory
Council and the Minnesota Indian Affairs Council of any cultural grants that are awarded
to help American Indians reclaim their spirituality and cultural identity.
new text end

Sec. 6.

Minnesota Statutes 2020, section 256.01, is amended by adding a subdivision to
read:

new text begin Subd. 44. new text end

new text begin Changes in state law. new text end

new text begin (a) The department's Office of Indian Policy must
inform Minnesota's Tribal nations, American Indian residents of Minnesota, and other
concerned stakeholders about any changes to state law that may affect Minnesota's Tribal
nations or American Indian residents of Minnesota.
new text end

new text begin (b) In order to comply with paragraph (a), the department may annually post the
information on the Office of Indian Policy's website.
new text end

Sec. 7.

Minnesota Statutes 2020, section 256.01, is amended by adding a subdivision to
read:

new text begin Subd. 45. new text end

new text begin Data and information. new text end

new text begin The department must use the data and information it
collects to promote legislation and policies that honor Minnesota's Tribal nations and their
sovereignty.
new text end