piers109uk/MN-Statutes huggingface dataset:
245D.25 COMMUNITY RESIDENTIAL SETTINGS; FOOD AND WATER.
Potable water from privately owned wells must be tested annually by a Department of Health-certified laboratory for coliform bacteria and nitrate nitrogens to verify safety. The health authority may require retesting and corrective measures if results exceed state water standards in Minnesota Rules, chapter 4720, or in the event of flooding or an incident which may put the well at risk of contamination. To prevent scalding, the water temperature of faucets must not exceed 120 degrees Fahrenheit.
Food served must meet any special dietary needs of a person as prescribed by the person's physician, advanced practice registered nurse, physician assistant, or dietitian. Three nutritionally balanced meals a day must be served or made available to persons, and nutritious snacks must be available between meals.
Food must be obtained, handled, and properly stored to prevent contamination, spoilage, or a threat to the health of a person.
245D.26 COMMUNITY RESIDENTIAL SETTINGS; SANITATION AND HEALTH.
Individual clean bed linens appropriate for the season and the person's comfort, including towels and wash cloths, must be available for each person. Usual or customary goods for the operation of a residence which are communally used by all persons receiving services living in the residence must be provided by the license holder, including household items for meal preparation, cleaning supplies to maintain the cleanliness of the residence, window coverings on windows for privacy, toilet paper, and hand soap.
Personal health and hygiene items must be stored in a safe and sanitary manner.
Pets and service animals housed within the residence must be immunized and maintained in good health as required by local ordinances and state law. The license holder must ensure that the person and the person's representative are notified before admission of the presence of pets in the residence.
License holders must comply with the requirements of the Minnesota Clean Indoor Air Act, sections 144.411 to 144.417, when smoking is permitted in the residence.
Weapons and ammunition must be stored separately in locked areas that are inaccessible to a person receiving services. For purposes of this subdivision, "weapons" means firearms and other instruments or devices designed for and capable of producing bodily harm.
245D.27 DAY SERVICES FACILITIES; SATELLITE LICENSURE REQUIREMENTS AND APPLICATION PROCESS.
Except for day service facilities on the same or adjoining lot, the license holder providing day services must apply for a separate license for each facility-based service site when the license holder is the owner, lessor, or tenant of the service site at which persons receive day services and the license holder's employees who provide day services are present for a cumulative total of more than 30 days within any 12-month period. For purposes of this chapter, a day services facility license is a satellite license of the day services program. A day services program may operate multiple licensed day service facilities in one or more counties in the state. For the purposes of this section, "adjoining lot" means day services facilities that are next door to or across the street from one another.
245D.28 DAY SERVICES FACILITIES; PHYSICAL PLANT AND SPACE REQUIREMENTS.
(a) The facility capacity of each day service facility must be determined by the amount of primary space available, the scheduling of activities at other service sites, and the space requirements of all persons receiving services at the facility, not just the licensed services. The facility capacity must specify the maximum number of persons that may receive services on site at any one time.
(b) When a facility is located in a multifunctional organization, the facility may share common space with the multifunctional organization if the required available primary space for use by persons receiving day services is maintained while the facility is operating. The license holder must comply at all times with all applicable fire and safety codes under section 245A.04, subdivision 2a, and adequate supervision requirements under section 245D.31 for all persons receiving day services.
(c) A day services facility must have a minimum of 40 square feet of primary space available for each person receiving services who is present at the site at any one time. Primary space does not include:
(1) common areas, such as hallways, stairways, closets, utility areas, bathrooms, and kitchens;
(2) floor areas beneath stationary equipment; or
(3) any space occupied by persons associated with the multifunctional organization while persons receiving day services are using common space.
Each person must be provided space in a closet, cabinet, on a shelf, or a coat hook for storage of personal items for the person's own use while receiving services at the facility, unless doing so would interfere with safety precautions, another person's work space, or violate a building or fire code.
245F.01 PURPOSE.
It is hereby declared to be the public policy of this state that the public interest is best served by providing efficient and effective withdrawal management services to persons in need of appropriate detoxification, assessment, intervention, and referral services. The services shall vary to address the unique medical needs of each patient and shall be responsive to the language and cultural needs of each patient. Services shall not be denied on the basis of a patient's inability to pay.
245D.29 DAY SERVICES FACILITIES; HEALTH AND SAFETY REQUIREMENTS.
If the license holder provides refrigeration at service sites owned or leased by the license holder for storing perishable foods and perishable portions of bag lunches, whether the foods are supplied by the license holder or the persons receiving services, the refrigeration must have a temperature of 40 degrees Fahrenheit or less.
Drinking water must be available to all persons receiving services. If a person is unable to request or obtain drinking water, it must be provided according to that person's individual needs. Drinking water must be provided in single-service containers or from drinking fountains accessible to all persons.
There must be an area in which a person receiving services can rest if:
(1) the person becomes ill during the day;
(2) the person does not live in a licensed residential site;
(3) the person requires supervision; and
(4) there is not a caretaker immediately available. Supervision must be provided until the caretaker arrives to bring the person home.
The license holder must establish general written safety procedures that include criteria for selecting, training, and supervising persons who work with hazardous machinery, tools, or substances. Safety procedures specific to each person's activities must be explained and be available in writing to all staff members and persons receiving services.
245D.33 ADULT MENTAL HEALTH CERTIFICATION STANDARDS.
(a) The commissioner of human services shall issue a mental health certification for services licensed under this chapter when a license holder is determined to have met the requirements under section 245A.03, subdivision 6a, paragraph (b). This certification is voluntary for license holders. The certification shall be printed on the license and identified on the commissioner's public website.
(b) License holders seeking certification under this section must request this certification on forms and in the manner prescribed by the commissioner.
(c) If the commissioner finds that the license holder has failed to comply with the certification requirements under section 245A.03, subdivision 6a, paragraph (b), the commissioner may issue a correction order and an order of conditional license in accordance with section 245A.06 or may issue a sanction in accordance with section 245A.07, including and up to removal of the certification.
(d) A denial of the certification or the removal of the certification based on a determination that the requirements under section 245A.03, subdivision 6a, paragraph (b), have not been met is not subject to appeal. A license holder that has been denied a certification or that has had a certification removed may again request certification when the license holder is in compliance with the requirements of section 245A.03, subdivision 6a, paragraph (b).
245G.011 BEHAVIORAL HEALTH CRISIS FACILITIES GRANTS.
"Commissioner" means the commissioner of human services.
"Eligible applicant" or "applicant" means a statutory or home rule charter city, county, housing and redevelopment authority, publicly owned hospital, or other public entity otherwise eligible to receive state general obligation bond proceeds that is designated to apply for a behavioral health crisis program facilities grant by the local mental health authority, established under section 245.466 or on behalf of a regional consortium of organizations that serve individuals with mental illness or a substance use disorder.
"Eligible project" or "project" means the acquisition or betterment of public land, buildings, and other public improvements of a capital nature within the meaning of the Minnesota Constitution, article XI, section 5, clause (a). It includes acquisition of land or interest in land, predesign, design, renovation, construction, furnishing, and equipping facilities in which to provide behavioral health crisis programs and services.
For purposes of this section, "behavioral health crisis facilities" or "facility" means a facility whose purpose is to provide mental health or substance use disorder services. Proceeds may be up to 100 percent of project costs, up to $5,000,000 per project. Priority must be given to proposals that:
(1) demonstrate a need for the program in the region;
(2) provide a detailed service plan, including the services that will be provided and to whom, and staffing requirements;
(3) provide an estimated cost of operating the program;
(4) verify financial sustainability by detailing sufficient funding sources and the capacity to obtain third-party payments for services provided, including private insurance and federal Medicaid and Medicare financial participation;
(5) demonstrate an ability and willingness to build on existing resources in the community; and
(6) agree to a comprehensive evaluation of services and financial viability by the commissioner.
[Repealed, 2024 c 108 art 6 s 6]
245F.04 PROGRAM LICENSURE.
An applicant for licensure as a clinically managed withdrawal management program or medically monitored withdrawal management program must meet the following requirements, except where otherwise noted. All programs must comply with federal requirements and the general requirements in sections 626.557 and 626.5572 and chapters 245A, 245C, and 260E. A withdrawal management program must be located in a hospital licensed under sections 144.50 to 144.581, or must be a supervised living facility with a class A or B license from the Department of Health under Minnesota Rules, parts 4665.0100 to 4665.9900.
Prior to the issuance of a license, an applicant must submit, on forms provided by the commissioner, documentation demonstrating the following:
(1) compliance with this section;
(2) 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 this section; and
(3) insurance coverage, including bonding, sufficient to cover all patient funds, property, and interests.
(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 the medical services provided by the program that affects the program's capacity to provide services required by the program's license designation as a clinically managed program or medically monitored program;
(3) a change in program capacity; or
(4) a change in location.
(b) A license holder must notify the commissioner and apply for a new license when a change in program ownership occurs.
The commissioner may grant variances to the requirements of this chapter under section 245A.04, subdivision 9.
A license holder providing withdrawal management services may admit an individual when the individual meets the admission criteria in section 245F.05, subdivisions 1 and 2. Any assessor providing an additional assessment to an individual must follow the process established in section 245F.06. If an assessor identifies an individual's need for withdrawal management services while the individual is a resident of a substance use disorder treatment facility, the provisions of section 256G.02, subdivision 4, paragraphs (c) and (d), shall apply.
245F.11 PATIENT PROPERTY MANAGEMENT.
A license holder must meet the requirements for handling patient funds and property in section 245A.04, subdivision 13, except:
(1) a license holder must establish policies regarding the use of personal property to assure that program activities and the rights of other patients are not infringed, and may take temporary custody of personal property if these policies are violated;
(2) a license holder must retain the patient's property for a minimum of seven days after discharge if the patient does not reclaim the property after discharge; and
(3) the license holder must return to the patient all of the patient's property held in trust at discharge, regardless of discharge status, except that:
(i) drugs, drug paraphernalia, and drug containers that are subject to forfeiture under section 609.5316 must be given over to the custody of a local law enforcement agency or, if giving the property over to the custody of a local law enforcement agency would violate Code of Federal Regulations, title 42, sections 2.1 to 2.67, and title 45, parts 160 to 164, destroyed by a staff person designated by the program director; and
(ii) weapons, explosives, and other property that may cause serious harm to self or others must be transferred to a local law enforcement agency. The patient must be notified of the transfer and the right to reclaim the property if the patient has a legal right to possess the item.
245G.04 SERVICE INITIATION.
The license holder must complete an initial services plan within 24 hours of the day of service initiation. The plan must be person-centered and client-specific, address the client's immediate health and safety concerns, and identify the treatment needs of the client to be addressed during the time between the day of service initiation and development of the individual treatment plan.
(a) Within 24 hours of the day of service initiation, a nonresidential program must determine 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.
(b) 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.
The license holder must provide opioid educational material to the client on the day of service initiation. The license holder must use the opioid educational material approved by the commissioner that contains information on:
(1) risks for opioid use disorder and dependence;
(2) treatment options, including the use of a medication for opioid use disorder;
(3) the risk and recognition of opioid overdose; and
(4) the use, availability, and administration of an opiate antagonist to respond to opioid overdose.
245F.13 MEDICATIONS.
A license holder must employ or contract with a registered nurse to develop the policies and procedures for medication administration. A registered nurse must provide supervision as defined in section 148.171, subdivision 23, for the administration of medications. For clinically managed programs, the registered nurse supervision must include on-site supervision at least monthly or more often as warranted by the health needs of the patient. The medication administration policies and procedures must include:
(1) a provision that patients may carry emergency medication such as nitroglycerin as instructed by their prescriber;
(2) requirements for recording the patient's use of medication, including staff signatures with date and time;
(3) guidelines regarding when to inform a licensed practitioner or a registered nurse of problems with medication administration, including failure to administer, patient refusal of a medication, adverse reactions, or errors; and
(4) procedures for acceptance, documentation, and implementation of prescriptions, whether written, oral, telephonic, or electronic.
A license holder must have in place and implement written policies and procedures relating to control of drugs. The policies and procedures must be developed by a registered nurse and must contain the following provisions:
(1) a requirement that all drugs must be stored in a locked compartment. Schedule II drugs, as defined in section 152.02, subdivision 3, must be stored in a separately locked compartment that is permanently affixed to the physical plant or a medication cart;
(2) a system for accounting for all scheduled drugs each shift;
(3) a procedure for recording a patient's use of medication, including staff signatures with time and date;
(4) a procedure for destruction of discontinued, outdated, or deteriorated medications;
(5) a statement that only authorized personnel are permitted to have access to the keys to the locked drug compartments; and
(6) a statement that no legend drug supply for one patient may be given to another patient.
245F.06 SCREENING AND COMPREHENSIVE ASSESSMENT.
A nurse or an alcohol and drug counselor must screen each patient upon admission to determine whether a comprehensive assessment is indicated. The license holder must screen patients at each admission, except that if the patient has already been determined to suffer from a substance use disorder, subdivision 2 applies.
(a) Prior to a medically stable discharge, but not later than 72 hours following admission, a license holder must provide a comprehensive assessment according to sections 245.4863, paragraph (a), and 245G.05, for each patient who has a positive screening for a substance use disorder. If a patient's medical condition prevents a comprehensive assessment from being completed within 72 hours, the license holder must document why the assessment was not completed. The comprehensive assessment must include documentation of the appropriateness of an involuntary referral through the civil commitment process.
(b) If available to the program, a patient's previous comprehensive assessment may be used in the patient record. If a previously completed comprehensive assessment is used, its contents must be reviewed to ensure the assessment is accurate and current and complies with the requirements of this chapter. The review must be completed by a staff person qualified according to section 245G.11, subdivision 5. The license holder must document that the review was completed and that the previously completed assessment is accurate and current, or the license holder must complete an updated or new assessment.
245F.03 APPLICATION.
(a) This chapter establishes minimum standards for withdrawal management programs licensed by the commissioner that serve one or more unrelated persons.
(b) This chapter does not apply to a withdrawal management program licensed as a hospital under sections 144.50 to 144.581. A withdrawal management program located in a hospital licensed under sections 144.50 to 144.581 that chooses to be licensed under this chapter is deemed to be in compliance with section 245F.13.
(c) Minnesota Rules, parts 9530.6600 to 9530.6655, do not apply to withdrawal management programs licensed under this chapter.
245G.03 LICENSING REQUIREMENTS.
(a) An applicant for a license to provide substance use disorder treatment must comply with the general requirements in section 626.557; chapters 245A, 245C, and 260E; and Minnesota Rules, chapter 9544.
(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.
(c) If a program is licensed according to this chapter and is part of a certified community behavioral health clinic under section 245.735, the license holder must comply with the requirements in section 245.735, subdivisions 4b to 4e, as part of the licensing requirements under this chapter.
(a) Before the commissioner issues a license, an applicant must submit, on forms provided by the commissioner, any documents the commissioner requires.
(b) The applicant must submit documentation that the applicant has notified the county as required under section 254B.03, subdivision 2.
(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:
(1) the Department of Health's licensure of the program;
(2) whether the license holder provides services specified in sections 245G.18 to 245G.22;
(3) location; or
(4) capacity if the license holder meets the requirements of section 245G.21.
(b) A license holder must notify the commissioner and must apply for a new license if there is a change in program ownership.
245G.05 COMPREHENSIVE ASSESSMENT AND ASSESSMENT SUMMARY.
A comprehensive assessment of the client's substance use disorder must be administered face-to-face by an alcohol and drug counselor within five calendar days from the day of service initiation for a residential program or by the end of the fifth day on which a treatment service is provided in a nonresidential program. The number of days to complete the comprehensive assessment excludes the day of service initiation. If the comprehensive assessment is not completed within the required time frame, the person-centered reason for the delay and the planned completion date must be documented in the client's file. The comprehensive assessment is complete upon a qualified staff member's dated signature. If the client received a comprehensive assessment that authorized the treatment service, an alcohol and drug counselor may use the comprehensive assessment for requirements of this subdivision but must document a review of the comprehensive assessment and update the comprehensive assessment as clinically necessary to ensure compliance with this subdivision within applicable timelines. An alcohol and drug counselor must sign and date the comprehensive assessment review and update.
MS 2022 [Repealed, 2023 c 50 art 2 s 63; 2023 c 61 art 4 s 28]
A comprehensive assessment must meet the requirements under section 245I.10, subdivision 6, paragraphs (b) and (c). It must also include:
(1) a diagnosis of a substance use disorder or a finding that the client does not meet the criteria for a substance use disorder;
(2) a determination of whether the individual screens positive for co-occurring mental health disorders using a screening tool approved by the commissioner pursuant to section 245.4863;
(3) a risk rating and summary to support the risk ratings within each of the dimensions listed in section 254B.04, subdivision 4; and
(4) a recommendation for the ASAM level of care identified in section 254B.19, subdivision 1.
245F.12 MEDICAL SERVICES.
Withdrawal management programs must have:
(1) a standardized data collection tool for collecting health-related information about each patient. The data collection tool must be developed in collaboration with a registered nurse and approved and signed by the medical director; and
(2) written procedures for a nurse to assess and monitor patient health within the nurse's scope of practice. The procedures must:
(i) be approved by the medical director;
(ii) include a follow-up screening conducted between four and 12 hours after service initiation to collect information relating to acute intoxication, other health complaints, and behavioral risk factors that the patient may not have communicated at service initiation;
(iii) specify the physical signs and symptoms that, when present, require consultation with a registered nurse or a physician and that require transfer to an acute care facility or a higher level of care than that provided by the program;
(iv) specify those staff members responsible for monitoring patient health and provide for hourly observation and for more frequent observation if the initial health assessment or follow-up screening indicates a need for intensive physical or behavioral health monitoring; and
(v) specify the actions to be taken to address specific complicating conditions, including pregnancy or the presence of physical signs or symptoms of any other medical condition.
In addition to the services listed in subdivision 1, clinically managed programs must:
(1) have a licensed practical nurse on site 24 hours a day and a medical director;
(2) provide an initial health assessment conducted by a nurse upon admission;
(3) provide daily on-site medical evaluation by a nurse;
(4) have a registered nurse available by telephone or in person for consultation 24 hours a day;
(5) have a licensed practitioner available by telephone or in person for consultation 24 hours a day; and
(6) have appropriately licensed staff available to administer medications according to prescriber-approved orders.
In addition to the services listed in subdivision 1, medically monitored programs must have a registered nurse on site 24 hours a day and a medical director. Medically monitored programs must provide intensive inpatient withdrawal management services which must include:
(1) an initial health assessment conducted by a registered nurse upon admission;
(2) the availability of a medical evaluation and consultation with a registered nurse 24 hours a day;
(3) the availability of a licensed practitioner by telephone or in person for consultation 24 hours a day;
(4) the ability to be seen within 24 hours or sooner by a licensed practitioner if the initial health assessment indicates the need to be seen;
(5) the availability of on-site monitoring of patient care seven days a week by a licensed practitioner; and
(6) appropriately licensed staff available to administer medications according to prescriber-approved orders.
245F.07 STABILIZATION PLANNING.
Within 12 hours of admission, a license holder must develop an individualized stabilization plan for each patient accepted for stabilization services. The plan must be based on the patient's initial health assessment and continually updated based on new information gathered about the patient's condition from the comprehensive assessment, medical evaluation and consultation, and ongoing monitoring and observations of the patient. The patient must have an opportunity to have direct involvement in the development of the plan. The stabilization plan must:
(1) identify medical needs and goals to be achieved while the patient is receiving services;
(2) specify stabilization services to address the identified medical needs and goals, including amount and frequency of services;
(3) specify the participation of others in the stabilization planning process and specific services where appropriate; and
(4) document the patient's participation in developing the content of the stabilization plan and any updates.
Progress notes must be entered in the patient's file at least daily and immediately following any significant event, including any change that impacts the medical, behavioral, or legal status of the patient. Progress notes must:
(1) include documentation of the patient's involvement in the stabilization services, including the type and amount of each stabilization service;
(2) include the monitoring and observations of the patient's medical needs;
(3) include documentation of referrals made to other services or agencies;
(4) specify the participation of others; and
(5) be legible, signed, and dated by the staff person completing the documentation.
Before a patient leaves the facility, the license holder must conduct discharge planning for the patient, document discharge planning in the patient's record, and provide the patient with a copy of the discharge plan. The discharge plan must include:
(1) referrals made to other services or agencies at the time of transition;
(2) the patient's plan for follow-up, aftercare, or other poststabilization services;
(3) documentation of the patient's participation in the development of the transition plan;
(4) any service that will continue after discharge under the direction of the license holder; and
(5) a stabilization summary and final evaluation of the patient's progress toward treatment objectives.
245F.10 PATIENT RIGHTS AND GRIEVANCE PROCEDURES.
Patients have the rights in sections 144.651, 148F.165, and 253B.03, as applicable. The license holder must give each patient, upon admission, a written statement of patient rights. Program staff must review the statement with the patient.
Upon admission, the license holder must explain the grievance procedure to the patient or patient's representative and give the patient a written copy of the procedure. The grievance procedure must be posted in a place visible to the patient and must be made available to current and former patients upon request. A license holder's written grievance procedure must include:
(1) staff assistance in developing and processing the grievance;
(2) an initial response to the patient who filed the grievance within 24 hours of the program's receipt of the grievance, and timelines for additional steps to be taken to resolve the grievance, including access to the person with the highest level of authority in the program if the grievance cannot be resolved by other staff members; and
(3) the current addresses and telephone numbers of the Department of Human Services Licensing Division, Department of Health Office of Health Facilities Complaints, Board of Behavioral Health and Therapy, Board of Medical Practice, Board of Nursing, and Office of the Ombudsman for Mental Health and Developmental Disabilities.
245G.02 APPLICABILITY.
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.
This chapter does not apply to a county or recovery community organization that is providing a service for which the county or recovery community organization is an eligible vendor under section 254B.05. This chapter does not apply 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. A license holder providing the initial set of substance use disorder services allowable under section 254A.03, subdivision 3, paragraph (c), to an individual referred to a licensed nonresidential substance use disorder treatment program after a positive screen for alcohol or substance misuse is exempt from sections 245G.05; 245G.06, subdivisions 1, 1a, and 4; 245G.07, subdivisions 1, paragraph (a), clauses (2) to (4), and 2, clauses (1) to (7); and 245G.17.
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 behavioral health 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.
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.
245G.09 CLIENT RECORDS.
(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. 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.
(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.
(c) The program must identify in the client record designation of an individual who is receiving services under section 254A.03, subdivision 3, including the start date and end date of services eligible under section 254A.03, subdivision 3.
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.
Client records must contain the following:
(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). If the client has an opioid use disorder, the record must contain documentation that the client was provided educational information according to section 245G.04, subdivision 3;
(2) an initial services plan completed according to section 245G.04;
(3) a comprehensive assessment completed according to section 245G.05;
(4) an individual abuse prevention plan according to sections 245A.65, subdivision 2, and 626.557, subdivision 14, when applicable;
(5) an individual treatment plan according to section 245G.06, subdivisions 1 and 1a;
(6) documentation of treatment services, significant events, appointments, concerns, and treatment plan reviews according to section 245G.06, subdivisions 2a, 2b, 3, and 3a; and
(7) a summary at the time of service termination according to section 245G.06, subdivision 4.
245G.10 STAFF REQUIREMENTS.
A license holder must have a treatment director.
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.
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, sections 245A.65, 626.557, and 626.5572, and chapter 260E.
It is the responsibility of the license holder to determine an acceptable group size based on each client's needs. Group counseling shall not exceed 16 clients. The license holder must maintain a record that documents compliance with this subdivision.
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.
A license holder must notify the commissioner within five business days of a change or vacancy in a key staff position. The key positions are a treatment director as required by subdivision 1, an alcohol and drug counselor supervisor as required by subdivision 2, and a registered nurse as required by section 245G.08, subdivision 5, paragraph (c). The license holder must notify the commissioner of the staffing change on a form approved by the commissioner and include the name of the staff person now assigned to the key staff position and the staff person's qualifications for the position. The license holder must notify the program licensor of a vacancy to discuss how the duties of the key staff position will be fulfilled during the vacancy.
245F.17 PERSONNEL FILES.
A license holder must maintain a separate personnel file for each staff member. At a minimum, the file must contain:
(1) a completed application for employment signed by the staff member that contains the staff member's qualifications for employment and documentation related to the applicant's background study data, as defined in chapter 245C;
(2) documentation of the staff member's current professional license or registration, if relevant;
(3) documentation of orientation and subsequent training; and
(4) an annual job performance evaluation.
245F.18 POLICY AND PROCEDURES MANUAL.
A license holder must develop a written policy and procedures manual that is alphabetically indexed and has a table of contents, so that staff have immediate access to all policies and procedures, and that consumers of the services and other authorized parties have access to all policies and procedures. The manual must contain the following materials:
(1) a description of patient education services as required in section 245F.06;
(2) personnel policies that comply with section 245F.16;
(3) admission information and referral and discharge policies that comply with section 245F.05;
(4) a health monitoring plan that complies with section 245F.12;
(5) a protective procedures policy that complies with section 245F.09, if the program elects to use protective procedures;
(6) policies and procedures for assuring appropriate patient-to-staff ratios that comply with section 245F.14;
(7) policies and procedures for assessing and documenting the susceptibility for risk of abuse to the patient as the basis for the individual abuse prevention plan required by section 245A.65;
(8) procedures for mandatory reporting as required by sections 245A.65 and 626.557 and chapter 260E;
(9) a medication control plan that complies with section 245F.13; and
(10) policies and procedures regarding HIV that meet the minimum standards under section 245A.19.
245G.12 PROVIDER POLICIES AND PROCEDURES.
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:
(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;
(2) policies and procedures regarding HIV according to section 245A.19;
(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;
(4) personnel policies according to section 245G.13;
(5) policies and procedures that protect a client's rights according to section 245G.15;
(6) a medical services plan according to section 245G.08;
(7) emergency procedures according to section 245G.16;
(8) policies and procedures for maintaining client records according to section 245G.09;
(9) procedures for reporting the maltreatment of minors according to chapter 260E, and vulnerable adults according to sections 245A.65, 626.557, and 626.5572;
(10) a description of treatment services that: (i) includes the amount and type of services provided; (ii) identifies which services meet the definition of group counseling under section 245G.01, subdivision 13a; (iii) identifies which groups and topics on which a guest speaker could provide services under the direct observation of an alcohol and drug counselor; and (iv) defines the program's treatment week;
(11) the methods used to achieve desired client outcomes;
(12) the hours of operation; and
(13) the target population served.
245F.19 PATIENT RECORDS.
A license holder must maintain a file of current patient records on the program premises where the treatment is provided. Each entry in each patient record must be signed and dated by the staff member making the entry. Patient records must be protected against loss, tampering, or unauthorized disclosure in compliance with chapter 13 and section 254A.09; Code of Federal Regulations, title 42, sections 2.1 to 2.67; and title 45, parts 160 to 164.
A license holder must retain and store records as required by section 245A.041, subdivisions 3 and 4.
Patient records must include the following:
(1) documentation of the patient's presenting problem, any substance use screening, the most recent assessment, and any updates;
(2) a stabilization plan and progress notes as required by section 245F.07, subdivisions 1 and 2;
(3) a discharge summary as required by section 245F.07, subdivision 3;
(4) an individual abuse prevention plan that complies with section 245A.65 and related rules;
(5) documentation of referrals made; and
(6) documentation of the monitoring and observations of the patient's medical needs.
245F.20 DATA COLLECTION REQUIRED.
The license holder must participate in the drug and alcohol abuse normative evaluation system (DAANES) by submitting, in a format provided by the commissioner, information concerning each patient admitted to the program. Staff submitting data must be trained by the license holder with the DAANES web manual.
245F.21 PAYMENT METHODOLOGY.
The commissioner shall develop a payment methodology for services provided under this chapter or by an Indian Health Services facility or a facility owned and operated by a tribe or tribal organization operating under Public Law 93-638 as a 638 facility. The commissioner shall seek federal approval for the methodology. Upon federal approval, the commissioner must seek and obtain legislative approval of the funding methodology to support the service.
245G.15 CLIENT RIGHTS PROTECTION.
A client has the rights identified in sections 144.651, 148F.165, and 253B.03, as applicable. The license holder must give each client on the day of 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.
On the day of 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:
(1) a staff member helps the client develop and process a grievance;
(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
(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.
(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.
(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.
245G.17 EVALUATION.
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.
245G.16 BEHAVIORAL EMERGENCY PROCEDURES.
(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:
(1) a plan designed to prevent a 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 behavioral emergency procedures;
(3) types of procedures that may be used;
(4) circumstances under which behavioral emergency procedures may be used; and
(5) staff members authorized to implement behavioral 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 behavior that threatens the safety of the client or others. Behavioral emergency procedures may not include the use of seclusion or restraint.
245G.18 LICENSE HOLDERS SERVING ADOLESCENTS.
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.
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:
(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
(2) at least 150 hours of supervised experience as an adolescent counselor, either as a student or as a staff member.
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.
A client who is required to attend school must be enrolled and attending an educational program that was approved by the Department of Education.
In addition to the requirements specified in the client's treatment plan under section 245G.06, programs serving an adolescent must include:
(1) coordination with the school system to address the client's academic needs;
(2) when appropriate, a plan that addresses the client's leisure activities without substance use; and
(3) a plan that addresses family involvement in the adolescent's treatment.