245B.07 Management standards.
Subdivision 1. Consumer data file. The license holder must maintain the following information for each consumer:
(1) identifying information that includes date of birth, medications, legal representative, history, medical, and other individual-specific information, and names and telephone numbers of contacts;
(2) consumer health information, including individual medication administration and monitoring information;
(3) the consumer's individual service plan. When a consumer's case manager does not provide a current individual service plan, the license holder shall make a written request to the case manager to provide a copy of the individual service plan and inform the consumer or the consumer's legal representative of the right to an individual service plan and the right to appeal under section 256.045;
(4) copies of assessments, analyses, summaries, and recommendations;
(5) progress review reports;
(6) incidents involving the consumer;
(7) reports required under section 245B.05, subdivision 7;
(8) discharge summary, when applicable;
(9) record of other license holders serving the consumer that includes a contact person and telephone numbers, services being provided, services that require coordination between two license holders, and name of staff responsible for coordination;
(10) information about verbal aggression directed at the consumer by another consumer; and
(11) information about self-abuse.
Subd. 2. Access to records. The license holder must ensure that the following people have access to the information in subdivision 1:
(1) the consumer, the consumer's legal representative, and anyone properly authorized by the consumer or legal representative;
(2) the consumer's case manager;
(3) staff providing direct services to the consumer unless the information is not relevant to carrying out the individual service plan; and
(4) the county adult foster care licensor, when services are also licensed as an adult foster home. Adult foster home means a licensed residence operated by an operator who, for financial gain or otherwise, provides 24-hour foster care to no more than four functionally impaired residents.
Subd. 3. Retention of consumer's records. The license holder must retain the records required for consumers for at least three years following termination of services.
Subd. 4. Staff qualifications. (a) The license holder must ensure that staff is competent through training, experience, and education to meet the consumer's needs and additional requirements as written in the individual service plan. Staff qualifications must be documented. Staff under 18 years of age may not perform overnight duties or administer medication.
(b) Delivery and evaluation of services provided by the license holder to a consumer must be coordinated by a designated person. The designated person or coordinator must minimally have a four-year degree in a field related to service provision, and one year work experience with consumers with mental retardation or related conditions, a two-year degree in a field related to service provision, and two years of work experience with consumers with mental retardation or related conditions, or a diploma in community-based developmental disability services from an accredited postsecondary institution and two years of work experience with consumers with mental retardation or related conditions. The coordinator must provide supervision, support, and evaluation of activities that include:
(1) oversight of the license holder's responsibilities designated in the individual service plan;
(2) instruction and assistance to staff implementing the individual service plan areas;
(3) evaluation of the effectiveness of service delivery, methodologies, and progress on consumer outcomes based on the condition set for objective change; and
(4) review of incident and emergency reports, identification of incident patterns, and implementation of corrective action as necessary to reduce occurrences.
(c) The coordinator is responsible for taking the action necessary to facilitate the accomplishment of the outcomes for each consumer as specified in the consumer's individual service plan.
(d) The license holder must provide for adequate supervision of direct care staff to ensure implementation of the individual service plan.
Subd. 5. Staff orientation. (a) Within 60 days of hiring staff who provide direct service, the license holder must provide 30 hours of staff orientation. Direct care staff must complete 15 of the 30 hours orientation before providing any unsupervised direct service to a consumer. If the staff person has received orientation training from a license holder licensed under this chapter, or provides semi-independent living services only, the 15-hour requirement may be reduced to eight hours. The total orientation of 30 hours may be reduced to 15 hours if the staff person has previously received orientation training from a license holder licensed under this chapter.
(b) The 30 hours of orientation must combine supervised on-the-job training with coverage of the following material:
(1) review of the consumer's service plans and risk management plan to achieve an understanding of the consumer as a unique individual;
(2) review and instruction on the license holder's policies and procedures, including their location and access;
(3) emergency procedures;
(4) explanation of specific job functions, including implementing objectives from the consumer's individual service plan;
(5) explanation of responsibilities related to section 245A.65; sections 626.556 and 626.557, governing maltreatment reporting and service planning for children and vulnerable adults; and section 245.825, governing use of aversive and deprivation procedures;
(6) medication administration as it applies to the individual consumer, from a training curriculum developed by a health services professional described in section 245B.05, subdivision 5, and when the consumer meets the criteria of having overriding health care needs, then medication administration taught by a health services professional. Staff may administer medications only after they demonstrate the ability, as defined in the license holder's medication administration policy and procedures. Once a consumer with overriding health care needs is admitted, staff will be provided with remedial training as deemed necessary by the license holder and the health professional to meet the needs of that consumer.
For purposes of this section, overriding health care needs means a health care condition that affects the service options available to the consumer because the condition requires:
(i) specialized or intensive medical or nursing supervision; and
(ii) nonmedical service providers to adapt their services to accommodate the health and safety needs of the consumer;
(7) consumer rights; and
(8) other topics necessary as determined by the consumer's individual service plan or other areas identified by the license holder.
(c) The license holder must document each employee's orientation received.
Subd. 6. Staff training. (a) A license holder providing semi-independent living services shall ensure that direct service staff annually complete hours of training equal to one percent of the number of hours the staff person worked. All other license holders shall ensure that direct service staff annually complete hours of training as follows:
(1) if the direct services staff have been employed for one to 24 months and:
(i) the average number of work hours scheduled per week is 30 to 40 hours, the staff must annually complete 40 training hours;
(ii) the average number of work hours scheduled per week is 20 to 29 hours, the staff must annually complete 30 training hours; and
(iii) the average number of work hours scheduled per week is one to 19 hours, the staff must annually complete 20 training hours; or
(2) if the direct services staff have been employed for more than 24 months and:
(i) the average number of work hours scheduled per week is 30 to 40 hours, the staff must annually complete 20 training hours;
(ii) the average number of work hours scheduled per week is 20 to 29 hours, the staff must annually complete 15 training hours; and
(iii) the average number of work hours scheduled per week is one to 19 hours, the staff must annually complete 12 training hours.
If direct service staff has received training from a license holder licensed under a program rule identified in this chapter or completed course work regarding disability-related issues from a postsecondary educational institute, that training may also count toward training requirements for other services and for other license holders.
(b) The license holder must document the training completed by each employee.
(c) Training shall address staff competencies necessary to address the consumer needs as identified in the consumer's individual service plan and ensure consumer health, safety, and protection of rights. Training may also include other areas identified by the license holder.
(d) For consumers requiring a 24-hour plan of care, the license holder shall provide training in cardiopulmonary resuscitation, from a qualified source determined by the commissioner, if the consumer's health needs as determined by the consumer's physician indicate trained staff would be necessary to the consumer.
Subd. 7. Volunteers. The license holder must ensure that volunteers who provide direct services to consumers receive the training and orientation necessary to fulfill their responsibilities.
Subd. 8. Policies and procedures. The license holder must develop and implement the policies and procedures in paragraphs (1) to (3).
(1) Policies and procedures that promote consumer health and safety by ensuring:
(i) consumer safety in emergency situations;
(ii) consumer health through sanitary practices;
(iii) safe transportation, when the license holder is responsible for transportation of consumers, with provisions for handling emergency situations;
(iv) a system of record keeping for both individuals and the organization, for review of incidents and emergencies, and corrective action if needed;
(vi) safe medication administration as identified in section 245B.05, subdivision 5, incorporating an observed skill assessment to ensure that staff demonstrate the ability to administer medications consistent with the license holder's policy and procedures;
(vii) psychotropic medication monitoring when the consumer is prescribed a psychotropic medication, including the use of the psychotropic medication use checklist. If the responsibility for implementing the psychotropic medication use checklist has not been assigned in the individual service plan and the consumer lives in a licensed site, the residential license holder shall be designated; and
(viii) criteria for admission or service initiation developed by the license holder.
(2) Policies and procedures that protect consumer rights and privacy by ensuring:
(i) consumer data privacy, in compliance with the Minnesota Data Practices Act, chapter 13; and
(ii) that complaint procedures provide consumers with a simple process to bring grievances and consumers receive a response to the grievance within a reasonable time period. The license holder must provide a copy of the program's grievance procedure and time lines for addressing grievances. The program's grievance procedure must permit consumers served by the program and the authorized representatives to bring a grievance to the highest level of authority in the program.
(3) Policies and procedures that promote continuity and quality of consumer supports by ensuring:
(i) continuity of care and service coordination, including provisions for service termination, temporary service suspension, and efforts made by the license holder to coordinate services with other vendors who also provide support to the consumer. The policy must include the following requirements:
(A) the license holder must notify the consumer or consumer's legal representative and the consumer's case manager in writing of the intended termination or temporary service suspension and the consumer's right to seek a temporary order staying the termination or suspension of service according to the procedures in section 256.045, subdivision 4a or subdivision 6, paragraph (c);
(B) notice of the proposed termination of services, including those situations that began with a temporary service suspension, must be given at least 60 days before the proposed termination is to become effective;
(C) the license holder must provide information requested by the consumer or consumer's legal representative or case manager when services are temporarily suspended or upon notice of termination;
(D) use of temporary service suspension procedures are restricted to situations in which the consumer's behavior causes immediate and serious danger to the health and safety of the individual or others;
(E) prior to giving notice of service termination or temporary service suspension, the license holder must document actions taken to minimize or eliminate the need for service termination or temporary service suspension; and
(F) during the period of temporary service suspension, the license holder will work with the appropriate county agency to develop reasonable alternatives to protect the individual and others; and
(ii) quality services measured through a program evaluation process including regular evaluations of consumer satisfaction and sharing the results of the evaluations with the consumers and legal representatives.
Subd. 9. Availability of current written policies and procedures. The license holder shall:
(1) review and update, as needed, the written policies and procedures in this chapter;
(2) inform consumers or the consumer's legal representatives of the written policies and procedures in this chapter upon service initiation. Copies must be available to consumers or the consumer's legal representatives, case managers, the county where services are located, and the commissioner upon request;
(3) provide all consumers or the consumers' legal representatives and case managers a copy and explanation of revisions to policies and procedures that affect consumers' service-related or protection-related rights under section 245B.04. Unless there is reasonable cause, the license holder must provide this notice at least 30 days before implementing the revised policy and procedure. The license holder must document the reason for not providing the notice at least 30 days before implementing the revisions;
(4) annually notify all consumers or the consumers' legal representatives and case managers of any revised policies and procedures under this chapter, other than those in clause (3). Upon request, the license holder must provide the consumer or consumer's legal representative and case manager copies of the revised policies and procedures;
(5) before implementing revisions to policies and procedures under this chapter, inform all employees of the revised policies and procedures; and
(6) document and maintain relevant information related to the policies and procedures in this chapter.
Subd. 10. Consumer funds. (a) The license holder must ensure that consumers retain the use and availability of personal funds or property unless restrictions are justified in the consumer's individual service plan.
(b) The license holder must ensure separation of consumer funds from funds of the license holder, the program, or program staff.
(c) Whenever the license holder assists a consumer with the safekeeping of funds or other property, the license holder must have written authorization to do so by the consumer or the consumer's legal representative, and the case manager. In addition, the license holder must:
(1) document receipt and disbursement of the consumer's funds or the property;
(2) annually survey, document, and implement the preferences of the consumer, consumer's legal representative, and the case manager for frequency of receiving a statement that itemizes receipts and disbursements of consumer funds or other property; and
(3) return to the consumer upon the consumer's request, funds and property in the license holder's possession subject to restrictions in the consumer's individual service plan, as soon as possible, but no later than three working days after the date of the request.
(d) License holders and program staff must not:
(1) borrow money from a consumer;
(2) purchase personal items from a consumer;
(3) sell merchandise or personal services to a consumer;
(4) require a consumer to purchase items for which the license holder is eligible for reimbursement; or
(5) use consumer funds in a manner that would violate section 256B.04, or any rules promulgated under that section.
Subd. 11. Travel time to and from a day training and habilitation site. Except in unusual circumstances, the license holder must not transport a consumer receiving services for longer than 90 minutes per one-way trip. Nothing in this subdivision relieves the provider of the obligation to provide the number of program hours as identified in the individualized service plan.
Subd. 12. Separate license required for separate sites. The license holder shall apply for separate licenses for each day training and habilitation service site owned or leased by the license holder at which persons receiving services and the provider's employees who provide training and habilitation services are present for a cumulative total of more than 30 days within any 12-month period, and for each residential service site. Notwithstanding this subdivision, a separate license is not required for a day training and habilitation service site used only for the limited purpose of providing transportation to consumers receiving community-based day training and habilitation services from a license holder.
Subd. 13. Variance. The commissioner may grant a variance to any of the requirements in sections 245B.02 to 245B.07 except section 245B.07, subdivision 8(1)(vii), or provisions governing data practices and information rights of consumers if the conditions in section 245A.04, subdivision 9 are met. Upon the request of the license holder, the commissioner shall continue variances from the standards in this chapter previously granted under Minnesota Rules that are repealed as a result of this chapter. The commissioner may approve variances for a license holder on a program, geographic, or organizational basis.