1.1 	A bill for an act
1.2 	relating to human services; modifying policy provisions governing housing and 
1.3 	chemical and mental health;amending Minnesota Statutes 2018, sections 245G.01, 
1.4 	subdivisions 8, 21, by adding subdivisions; 245G.04; 245G.05; 245G.06, 
1.5 	subdivisions 1, 2, 4; 245G.07; 245G.08, subdivision 3; 245G.10, subdivision 4; 
1.6 	245G.11, subdivisions 7, 8; 245G.12; 245G.13, subdivision 1; 245G.15, 
1.7 	subdivisions 1, 2; 245G.18, subdivisions 3, 5; 245G.22, subdivisions 1, 2, 3, 4, 6, 
1.8 	7, 15, 16, 17, 19; 254B.04, by adding a subdivision; 254B.05, subdivisions 1, 5; 
1.9 	256B.0941, subdivisions 1, 3; 256I.03, subdivisions 8, 15; 256I.04, subdivisions 
1.10 	1, 2a, 2b, by adding subdivisions; 256I.05, subdivision 1c; repealing Minnesota 
1.11 	Statutes 2018, section 256I.05, subdivision 3.
1.12 	BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF MINNESOTA:

1.13 	ARTICLE 1
1.14 	HOUSING

1.15 	Section 1. Minnesota Statutes 2018, section 256I.03, subdivision 8, is amended to read:
1.16 		Subd. 8.Supplementary services. "Supplementary services" means housing support 
1.17 	services provided to individuals in addition to room and board including, but not limited 
1.18 	to, oversight and up to 24-hour supervision, medication reminders, assistance with 
1.19 	transportation, arranging for meetings and appointments, and arranging for medical and 
1.20 	social services, and services identified in section 256I.03, subdivision 12.

1.21 	Sec. 2. Minnesota Statutes 2018, section 256I.03, subdivision 15, is amended to read:
1.22 		Subd. 15.Supportive housing. "Supportive housing" means housing with support 
1.23 	services according to the continuum of care coordinated assessment system established 
1.24 	under Code of Federal Regulations, title 24, section 578.3 that is not time-limited and 
1.25 	provides or coordinates services necessary for a resident to maintain housing stability.

2.1 	Sec. 3. Minnesota Statutes 2018, section 256I.04, subdivision 1, is amended to read:
2.2 		Subdivision 1.Individual eligibility requirements. An individual is eligible for and 
2.3 	entitled to a housing support payment to be made on the individual's behalf if the agency 
2.4 	has approved the setting where the individual will receive housing support and the individual 
2.5 	meets the requirements in paragraph (a), (b), or (c).
2.6 	(a) The individual is aged, blind, or is over 18 years of age with a disability as determined 
2.7 	under the criteria used by the title II program of the Social Security Act, and meets the 
2.8 	resource restrictions and standards of section 256P.02, and the individual's countable income 
2.9 	after deducting the (1) exclusions and disregards of the SSI program, (2) the medical 
2.10 	assistance personal needs allowance under section 256B.35, and (3) an amount equal to the 
2.11 	income actually made available to a community spouse by an elderly waiver participant 
2.12 	under the provisions of sections 256B.0575, paragraph (a), clause (4), and 256B.058, 
2.13 	subdivision 2, is less than the monthly rate specified in the agency's agreement with the 
2.14 	provider of housing support in which the individual resides.
2.15 	(b) The individual meets a category of eligibility under section 256D.05, subdivision 1, 
2.16 	paragraph (a), clauses (1), (3), (4) to (8), and (13), and paragraph (b), if applicable, and the 
2.17 	individual's resources are less than the standards specified by section 256P.02, and the 
2.18 	individual's countable income as determined under section 256P.06, less the medical 
2.19 	assistance personal needs allowance under section 256B.35 is less than the monthly rate 
2.20 	specified in the agency's agreement with the provider of housing support in which the 
2.21 	individual resides.
2.22 	(c) The individual receives licensed residential crisis stabilization services under section 
2.23 	256B.0624, subdivision 7, and is receiving medical assistance. The individual may receive 
2.24 	concurrent housing support payments if receiving licensed residential crisis stabilization 
2.25 	services under section 256B.0624, subdivision 7.
2.26 	(d) An individual who receives ongoing rental subsidies is not eligible for housing 
2.27 	support payments under paragraph (a) or (b).

2.28 	Sec. 4. Minnesota Statutes 2018, section 256I.04, subdivision 2a, is amended to read:
2.29 		Subd. 2a.License required; staffing qualifications. (a) Except as provided in paragraph 
2.30 	(b), an agency may not enter into an agreement with an establishment to provide housing 
2.31 	support unless:
2.32 	(1) the establishment is licensed by the Department of Health as a hotel and restaurant; 
2.33 	a board and lodging establishment; a boarding care home before March 1, 1985; or a 
3.1 	supervised living facility, and the service provider for residents of the facility is licensed 
3.2 	under chapter 245A. However, an establishment licensed by the Department of Health to 
3.3 	provide lodging need not also be licensed to provide board if meals are being supplied to 
3.4 	residents under a contract with a food vendor who is licensed by the Department of Health;
3.5 	(2) the residence is: (i) licensed by the commissioner of human services under Minnesota 
3.6 	Rules, parts 9555.5050 to 9555.6265; (ii) certified by a county human services agency prior 
3.7 	to July 1, 1992, using the standards under Minnesota Rules, parts 9555.5050 to 9555.6265; 
3.8 	(iii) licensed by the commissioner under Minnesota Rules, parts 2960.0010 to 2960.0120, 
3.9 	with a variance under section 245A.04, subdivision 9; or (iv) licensed under section 245D.02, 
3.10 	subdivision 4a, as a community residential setting by the commissioner of human services; 
3.11 	or
3.12 	(3) the establishment is registered under chapter 144D and provides three meals a day.
3.13 	(b) The requirements under paragraph (a) do not apply to establishments exempt from 
3.14 	state licensure because they are:
3.15 	(1) located on Indian reservations and subject to tribal health and safety requirements; 
3.16 	or
3.17 	(2) a supportive housing establishment that has an approved habitability inspection and 
3.18 	an individual lease agreement and that serves people who have experienced long-term 
3.19 	homelessness and were referred through a coordinated assessment in section 256I.03, 
3.20 	subdivision 15 supportive housing establishments where an individual has an approved 
3.21 	habitability inspection and an individual lease agreement.
3.22 	(c) Supportive housing establishments  that serve individuals who have experienced 
3.23 	long-term homelessness and emergency shelters must participate in the homeless management 
3.24 	information system and a coordinated assessment system as defined by the commissioner.
3.25 	(d) Effective July 1, 2016, an agency shall not have an agreement with a provider of 
3.26 	housing support unless all staff members who have direct contact with recipients:
3.27 	(1) have skills and knowledge acquired through one or more of the following:
3.28 	(i) a course of study in a health- or human services-related field leading to a bachelor 
3.29 	of arts, bachelor of science, or associate's degree;
3.30 	(ii) one year of experience with the target population served;
3.31 	(iii) experience as a mental health certified peer specialist according to section 256B.0615; 
3.32 	or
4.1 	(iv) meeting the requirements for unlicensed personnel under sections 144A.43 to 
4.2 	144A.483;
4.3 	(2) hold a current driver's license appropriate to the vehicle driven if transporting 
4.4 	recipients;
4.5 	(3) complete training on vulnerable adults mandated reporting and child maltreatment 
4.6 	mandated reporting, where applicable; and
4.7 	(4) complete housing support orientation training offered by the commissioner.

4.8 	Sec. 5. Minnesota Statutes 2018, section 256I.04, subdivision 2b, is amended to read:
4.9 		Subd. 2b.Housing support agreements. (a) Agreements between agencies and providers 
4.10 	of housing support must be in writing on a form developed and approved by the commissioner 
4.11 	and must specify the name and address under which the establishment subject to the 
4.12 	agreement does business and under which the establishment, or service provider, if different 
4.13 	from the group residential housing establishment, is licensed by the Department of Health 
4.14 	or the Department of Human Services; the specific license or registration from the 
4.15 	Department of Health or the Department of Human Services held by the provider and the 
4.16 	number of beds subject to that license; the address of the location or locations at which 
4.17 	group residential housing is provided under this agreement; the per diem and monthly rates 
4.18 	that are to be paid from housing support funds for each eligible resident at each location; 
4.19 	the number of beds at each location which are subject to the agreement; whether the license 
4.20 	holder is a not-for-profit corporation under section 501(c)(3) of the Internal Revenue Code; 
4.21 	and a statement that the agreement is subject to the provisions of sections 256I.01 to 256I.06
4.22 	and subject to any changes to those sections.
4.23 	(b) Providers are required to verify the following minimum requirements in the 
4.24 	agreement:
4.25 	(1) current license or registration, including authorization if managing or monitoring 
4.26 	medications;
4.27 	(2) all staff who have direct contact with recipients meet the staff qualifications;
4.28 	(3) the provision of housing support;
4.29 	(4) the provision of supplementary services, if applicable;
4.30 	(5) reports of adverse events, including recipient death or serious injury; and
4.31 	(6) submission of residency requirements that could result in recipient eviction.; and
5.1 	(7) that the provider complies with the prohibition on limiting or restricting the number 
5.2 	of hours an applicant or recipient is employed, as specified in subdivision 5.
5.3 	(c) Agreements may be terminated with or without cause by the commissioner, the 
5.4 	agency, or the provider with two calendar months prior notice. The commissioner may 
5.5 	immediately terminate an agreement under subdivision 2d.

5.6 	Sec. 6. Minnesota Statutes 2018, section 256I.04, is amended by adding a subdivision to 
5.7 	read:
5.8 		Subd. 2h.Required supplementary services. A provider of supplementary services 
5.9 	shall ensure that a recipient has, at a minimum, assistance with services as identified in the 
5.10 	recipient's professional statement of need under section 256I.03, subdivision 12. A provider 
5.11 	of supplementary services shall maintain case notes with the date and description of services 
5.12 	provided to each recipient.

5.13 	Sec. 7. Minnesota Statutes 2018, section 256I.04, is amended by adding a subdivision to 
5.14 	read:
5.15 		Subd. 5.Employment. A provider is prohibited from limiting or restricting the number 
5.16 	of hours an applicant or recipient is employed.

5.17 	Sec. 8. Minnesota Statutes 2018, section 256I.05, subdivision 1c, is amended to read:
5.18 		Subd. 1c.Rate increases. An agency may not increase the rates negotiated for housing 
5.19 	support above those in effect on June 30, 1993, except as provided in paragraphs (a) to (f).
5.20 	(a) An agency may increase the rates for room and board to the MSA equivalent rate 
5.21 	for those settings whose current rate is below the MSA equivalent rate.
5.22 	(b) An agency may increase the rates for residents in adult foster care whose difficulty 
5.23 	of care has increased. The total housing support rate for these residents must not exceed the 
5.24 	maximum rate specified in subdivisions 1 and 1a. Agencies must not include nor increase 
5.25 	difficulty of care rates for adults in foster care whose difficulty of care is eligible for funding 
5.26 	by home and community-based waiver programs under title XIX of the Social Security Act.
5.27 	(c) The room and board rates will be increased each year when the MSA equivalent rate 
5.28 	is adjusted for SSI cost-of-living increases by the amount of the annual SSI increase, less 
5.29 	the amount of the increase in the medical assistance personal needs allowance under section 
5.30 	256B.35.
6.1 	(d) When housing support pays for an individual's room and board, or other costs 
6.2 	necessary to provide room and board, the rate payable to the residence must continue for 
6.3 	up to 18 calendar days per incident that the person is temporarily absent from the residence, 
6.4 	not to exceed 60 days in a calendar year, if the absence or absences have received the prior 
6.5 	approval of are reported in advance to the county agency's social service staff. Prior approval
6.6 	Advance reporting is not required for emergency absences due to crisis, illness, or injury.
6.7 	(e) For facilities meeting substantial change criteria within the prior year. Substantial 
6.8 	change criteria exists if the establishment experiences a 25 percent increase or decrease in 
6.9 	the total number of its beds, if the net cost of capital additions or improvements is in excess 
6.10 	of 15 percent of the current market value of the residence, or if the residence physically 
6.11 	moves, or changes its licensure, and incurs a resulting increase in operation and property 
6.12 	costs.
6.13 	(f) Until June 30, 1994, an agency may increase by up to five percent the total rate paid 
6.14 	for recipients of assistance under sections 256D.01 to 256D.21 or 256D.33 to 256D.54 who 
6.15 	reside in residences that are licensed by the commissioner of health as a boarding care home, 
6.16 	but are not certified for the purposes of the medical assistance program. However, an increase 
6.17 	under this clause must not exceed an amount equivalent to 65 percent of the 1991 medical 
6.18 	assistance reimbursement rate for nursing home resident class A, in the geographic grouping 
6.19 	in which the facility is located, as established under Minnesota Rules, parts 9549.0051 to 
6.20 	9549.0058.

6.21 	Sec. 9. REPEALER.
 6.22 	Minnesota Statutes 2018, section 256I.05, subdivision 3, is repealed.

6.23 	ARTICLE 2
6.24 	CHEMICAL AND MENTAL HEALTH

6.25 	Section 1. Minnesota Statutes 2018, section 245G.01, subdivision 8, is amended to read:
6.26 		Subd. 8.Client. "Client" means an individual accepted by a license holder for assessment 
6.27 	or treatment of a substance use disorder. An individual remains a client until the license 
6.28 	holder no longer provides or intends to provide the individual with treatment service. Client 
6.29 	also includes the meaning of patient under section 144.651, subdivision 2.

7.1 	Sec. 2. Minnesota Statutes 2018, section 245G.01, is amended by adding a subdivision to 
7.2 	read:
7.3 		Subd. 10a.Day of service initiation. "Day of service initiation" means the day the 
7.4 	license holder begins the provision of a treatment service identified in section 245G.07.

7.5 	Sec. 3. Minnesota Statutes 2018, section 245G.01, is amended by adding a subdivision to 
7.6 	read:
7.7 		Subd. 20a.Person-centered. "Person-centered" means a client actively participates in 
7.8 	the client's treatment planning of services. This includes a client making meaningful and 
7.9 	informed choices about the client's own goals, objectives, and the services the client receives 
7.10 	in collaboration with the client's identified natural supports.

7.11 	Sec. 4. Minnesota Statutes 2018, section 245G.01, is amended by adding a subdivision to 
7.12 	read:
7.13 		Subd. 20b.Staff or staff member. "Staff" or "staff member" means an individual who 
7.14 	works under the direction of the license holder regardless of the individual's employment 
7.15 	status including but not limited to an intern, consultant, individual who works part time, or 
7.16 	individual who does not provide direct care services.

7.17 	Sec. 5. Minnesota Statutes 2018, section 245G.01, subdivision 21, is amended to read:
7.18 		Subd. 21.Student intern. "Student intern" means an individual who is enrolled in a 
7.19 	program specializing in alcohol and drug counseling or mental health counseling at an 
7.20 	accredited educational institution and is authorized by a licensing board to provide services 
7.21 	under supervision of a licensed professional.

7.22 	Sec. 6. Minnesota Statutes 2018, section 245G.01, is amended by adding a subdivision to 
7.23 	read:
7.24 		Subd. 28.Treatment week. "Treatment week" means the seven-day period that the 
7.25 	program identified in the program's policy and procedure manual as the day of the week 
7.26 	that the treatment program week starts and ends for the purpose of identifying the nature 
7.27 	and number of treatment services an individual receives weekly.

8.1 	Sec. 7. Minnesota Statutes 2018, section 245G.01, is amended by adding a subdivision to 
8.2 	read:
8.3 		Subd. 29.Volunteer. "Volunteer" means an individual who, under the direction of the 
8.4 	license holder, provides services or an activity to a client without compensation.

8.5 	Sec. 8. Minnesota Statutes 2018, section 245G.04, is amended to read:
8.6 	245G.04 INITIAL SERVICES PLAN SERVICE INITIATION.
8.7 		Subdivision 1.Initial services plan. (a) The license holder must complete an initial 
8.8 	services plan on within 24 hours of the day of service initiation. The plan must be 
8.9 	person-centered and client-specific, address the client's immediate health and safety concerns, 
8.10 	and identify the treatment needs of the client to be addressed in the first treatment session, 
8.11 	and make treatment suggestions for the client during the time between intake the day of 
8.12 	service initiation and completion development of the individual treatment plan.
8.13 		Subd. 2.Vulnerable adult status. (b) The initial services plan must include a 
8.14 	determination of(a) Within 24 hours of the day of service initiation, a nonresidential program 
8.15 	must determine whether a client is a vulnerable adult as defined in section 626.5572, 
8.16 	subdivision 21. An adult client of a residential program is a vulnerable adult.
8.17 	(b) An individual abuse prevention plan, according to sections 245A.65, subdivision 2, 
8.18 	paragraph (b), and 626.557, subdivision 14, paragraph (b), is required for a client who meets 
8.19 	the definition of vulnerable adult.

8.20 	Sec. 9. Minnesota Statutes 2018, section 245G.05, is amended to read:
8.21 	245G.05 COMPREHENSIVE ASSESSMENT AND ASSESSMENT SUMMARY.
8.22 		Subdivision 1.Comprehensive assessment. (a) A comprehensive assessment of the 
8.23 	client's substance use disorder must be administered face-to-face by an alcohol and drug 
8.24 	counselor within three calendar days after from the day of service initiation for a residential 
8.25 	program or during the initial session for all other programs within three sessions of the day 
8.26 	of service initiation for a client in a nonresidential program. If the comprehensive assessment 
8.27 	is not completed during the initial session,within the required time frame, the client-centered
8.28 	person-centered reason for the delay and the planned completion date must be documented 
8.29 	in the client's file and the planned completion date. The comprehensive assessment is 
8.30 	complete upon a qualified staff member's dated signature. If the client received a 
8.31 	comprehensive assessment that authorized the treatment service, an alcohol and drug 
8.32 	counselor may use the comprehensive assessment for requirements of this subdivision but 
9.1 	must document a review theof the comprehensive assessment and update the comprehensive 
9.2 	assessment as necessary to determine ensure compliance with this subdivision, including
9.3 	within applicable timelines. If available, the alcohol and drug counselor may use current 
9.4 	information provided by a referring agency or other source as a supplement. Information 
9.5 	gathered more than 45 days before the date of admission is not considered current. The 
9.6 	comprehensive assessment must include sufficient information to complete the assessment 
9.7 	summary according to subdivision 2 and the individual treatment plan according to section 
9.8 	245G.06. The comprehensive assessment must include information about the client's needs 
9.9 	that relate to substance use and personal strengths that support recovery, including:
9.10 	(1) age, sex, cultural background, sexual orientation, living situation, economic status, 
9.11 	and level of education;
9.12 	(2) a description of the circumstances on the day of service initiation;
9.13 	(3) a list of previous attempts at treatment for substance misuse or substance use disorder, 
9.14 	compulsive gambling, or mental illness;
9.15 	(4) a list of substance use history including amounts and types of substances used, 
9.16 	frequency and duration of use, periods of abstinence, and circumstances of relapse, if any. 
9.17 	For each substance used within the previous 30 days, the information must include the date 
9.18 	of the most recent use and address the absence or presence of previous withdrawal symptoms;
9.19 	(5) specific problem behaviors exhibited by the client when under the influence of 
9.20 	substances;
9.21 	(6) family status the client's desire for family involvement in the treatment program, 
9.22 	family history of substance use and misuse, including history or presence of physical or 
9.23 	sexual abuse, and level of family support, and substance misuse or substance use disorder 
9.24 	of a family member or significant other;
9.25 	(7) physical and medical concerns or diagnoses, the severity of the concerns, and current 
9.26 	medical treatment needed or being received related to the diagnoses, and whether the 
9.27 	concerns are being addressed by a need to be referred to an appropriate health care 
9.28 	professional;
9.29 	(8) mental health history and psychiatric status, including symptoms, disability, and the 
9.30 	effect on the client's ability to function; current mental health treatment supports,; and 
9.31 	psychotropic medication needed to maintain stability;. The assessment must utilize screening 
9.32 	tools approved by the commissioner pursuant to section 245.4863 to identify whether the 
9.33 	client screens positive for co-occurring disorders;
10.1 	(9) arrests and legal interventions related to substance use;
10.2 	(10) a description of how the client's use affected the client's ability to function 
10.3 	appropriately in work and educational settings;
10.4 	(11) ability to understand written treatment materials, including rules and the client's 
10.5 	rights;
10.6 	(12) a description of any risk-taking behavior, including behavior that puts the client at 
10.7 	risk of exposure to blood-borne or sexually transmitted diseases;
10.8 	(13) social network in relation to expected support for recovery and;
10.9 	(14) leisure time activities that are associated with substance use;
10.10 	(14) (15) whether the client is pregnant and, if so, the health of the unborn child and the 
10.11 	client's current involvement in prenatal care;
10.12 	(15) (16) whether the client recognizes problems needs related to substance use and is 
10.13 	willing to follow treatment recommendations; and
10.14 	(16) collateral (17) information from a collateral contact may be included, but is not 
10.15 	required. If the assessor gathered sufficient information from the referral source or the client 
10.16 	to apply the criteria in Minnesota Rules, parts 9530.6620 and 9530.6622, a collateral contact 
10.17 	is not required.
10.18 	(b) If the client is identified as having opioid use disorder or seeking treatment for opioid 
10.19 	use disorder, the program must provide educational information to the client concerning:
10.20 	(1) risks for opioid use disorder and dependence;
10.21 	(2) treatment options, including the use of a medication for opioid use disorder;
10.22 	(3) the risk of and recognizing opioid overdose; and
10.23 	(4) the use, availability, and administration of naloxone to respond to opioid overdose.
10.24 	(c) The commissioner shall develop educational materials that are supported by research 
10.25 	and updated periodically. The license holder must use the educational materials that are 
10.26 	approved by the commissioner to comply with this requirement.
10.27 	(d) If the comprehensive assessment is completed to authorize treatment service for the 
10.28 	client, at the earliest opportunity during the assessment interview the assessor shall determine 
10.29 	if:
10.30 	(1) the client is in severe withdrawal and likely to be a danger to self or others;
11.1 	(2) the client has severe medical problems that require immediate attention; or
11.2 	(3) the client has severe emotional or behavioral symptoms that place the client or others 
11.3 	at risk of harm.
11.4 	If one or more of the conditions in clauses (1) to (3) are present, the assessor must end the 
11.5 	assessment interview and follow the procedures in the program's medical services plan 
11.6 	under section 245G.08, subdivision 2, to help the client obtain the appropriate services. The 
11.7 	assessment interview may resume when the condition is resolved.
11.8 		Subd. 2.Assessment summary. (a) An alcohol and drug counselor must complete an 
11.9 	assessment summary within three calendar days after from the day of service initiation for 
11.10 	a residential program and within three sessions for all other programs from the day of service 
11.11 	initiation for a client in a nonresidential program. The comprehensive assessment summary 
11.12 	is complete upon a qualified staff member's dated signature. If the comprehensive assessment 
11.13 	is used to authorize the treatment service, the alcohol and drug counselor must prepare an 
11.14 	assessment summary on the same date the comprehensive assessment is completed. If the 
11.15 	comprehensive assessment and assessment summary are to authorize treatment services, 
11.16 	the assessor must determine appropriate services for the client using the dimensions in 
11.17 	Minnesota Rules, part 9530.6622, and document the recommendations.
11.18 	(b) An assessment summary must include:
11.19 	(1) a risk description according to section 245G.05 for each dimension listed in paragraph 
11.20 	(c);
11.21 	(2) a narrative summary supporting the risk descriptions; and
11.22 	(3) a determination of whether the client has a substance use disorder.
11.23 	(c) An assessment summary must contain information relevant to treatment service 
11.24 	planning and recorded in the dimensions in clauses (1) to (6). The license holder must 
11.25 	consider:
11.26 	(1) Dimension 1, acute intoxication/withdrawal potential; the client's ability to cope with 
11.27 	withdrawal symptoms and current state of intoxication;
11.28 	(2) Dimension 2, biomedical conditions and complications; the degree to which any 
11.29 	physical disorder of the client would interfere with treatment for substance use, and the 
11.30 	client's ability to tolerate any related discomfort. The license holder must determine the 
11.31 	impact of continued chemical substance use on the unborn child, if the client is pregnant;
12.1 	(3) Dimension 3, emotional, behavioral, and cognitive conditions and complications; 
12.2 	the degree to which any condition or complication is likely to interfere with treatment for 
12.3 	substance use or with functioning in significant life areas and the likelihood of harm to self 
12.4 	or others;
12.5 	(4) Dimension 4, readiness for change; the support necessary to keep the client involved 
12.6 	in treatment service;
12.7 	(5) Dimension 5, relapse, continued use, and continued problem potential; the degree 
12.8 	to which the client recognizes relapse issues and has the skills to prevent relapse of either 
12.9 	substance use or mental health problems; and
12.10 	(6) Dimension 6, recovery environment; whether the areas of the client's life are 
12.11 	supportive of or antagonistic to treatment participation and recovery.

12.12 	Sec. 10. Minnesota Statutes 2018, section 245G.06, subdivision 1, is amended to read:
12.13 		Subdivision 1.General. Each client must have an a person-centered individual treatment 
12.14 	plan developed by an alcohol and drug counselor within seven ten days from the day of 
12.15 	service initiation for a residential program and within three five sessions for all other 
12.16 	programs from the day of service initiation for a client in a nonresidential program. Opioid 
12.17 	treatment programs must complete the individual treatment plan within 21 days from the 
12.18 	day of service initiation. The client must have active, direct involvement in selecting the 
12.19 	anticipated outcomes of the treatment process and developing the treatment plan. The 
12.20 	individual treatment plan must be signed by the client and the alcohol and drug counselor 
12.21 	and document the client's involvement in the development of the plan. The plan may be a 
12.22 	continuation of the initial services plan required in section 245G.04. The individual treatment 
12.23 	plan is developed upon the qualified staff member's dated signature. Treatment planning 
12.24 	must include ongoing assessment of client needs. An individual treatment plan must be 
12.25 	updated based on new information gathered about the client's condition, the client's level 
12.26 	of participation, and on whether methods identified have the intended effect. A change to 
12.27 	the plan must be signed by the client and the alcohol and drug counselor. The plan must 
12.28 	provide for the involvement of the client's family and people selected by the client as 
12.29 	important to the success of treatment at the earliest opportunity, consistent with the client's 
12.30 	treatment needs and written consent. If the client chooses to have family or others involved 
12.31 	in treatment, the client's individual treatment plan must include goals and methods identifying 
12.32 	how the family or others will be involved in the client's treatment.

13.1 	Sec. 11. Minnesota Statutes 2018, section 245G.06, subdivision 2, is amended to read:
13.2 		Subd. 2.Plan contents. An individual treatment plan must be recorded in the six 
13.3 	dimensions listed in section 245G.05, subdivision 2, paragraph (c), must address each issue 
13.4 	identified in the assessment summary, prioritized according to the client's needs and focus, 
13.5 	and must include:
13.6 	(1) specific goals and methods to address each identified need in the comprehensive 
13.7 	assessment summary, including amount, frequency, and anticipated duration of treatment 
13.8 	service. The methods must be appropriate to the client's language, reading skills, cultural 
13.9 	background, and strengths;
13.10 	(2) resources to refer the client to when the client's needs are to be addressed concurrently 
13.11 	by another provider and identification of whether the client has an assessed need of peer 
13.12 	support services and, if available, how peer support services are made available to the client 
13.13 	with an assessed need; and
13.14 	(3) goals the client must reach to complete treatment and terminate services.

13.15 	Sec. 12. Minnesota Statutes 2018, section 245G.06, subdivision 4, is amended to read:
13.16 		Subd. 4.Service discharge summary. (a) An alcohol and drug counselor must write a 
13.17 	service discharge summary for each client. The service discharge summary must be 
13.18 	completed within five days of the client's service termination or within five days from the 
13.19 	client's or program's decision to terminate services, whichever is earlier. The client's file 
13.20 	must include verification that the client was provided a copy of the client's service discharge 
13.21 	summary. If the program is unable to provide a copy of the client's service discharge summary 
13.22 	directly to the client, the program must document the reason.
13.23 	(b) The service discharge summary must be recorded in the six dimensions listed in 
13.24 	section 245G.05, subdivision 2, paragraph (c), and include the following information:
13.25 	(1) the client's issues, strengths, and needs while participating in treatment, including 
13.26 	services provided;
13.27 	(2) the client's progress toward achieving each goal identified in the individual treatment 
13.28 	plan;
13.29 	(3) a risk description according to section 245G.05; and
13.30 	(4) the reasons for and circumstances of service termination. If a program discharges a 
13.31 	client at staff request, the reason for discharge and the procedure followed for the decision 
13.32 	to discharge must be documented and comply with the program's policies on staff-initiated 
14.1 	client discharge. If a client is discharged at staff request, the program must give the client 
14.2 	crisis and other referrals appropriate for the client's needs and offer assistance to the client 
14.3 	to access the services. requirements in section 245G.14, subdivision 3, clause (3);
14.4 	(c) For a client who successfully completes treatment, the summary must also include:
14.5 	(1)(5) the client's living arrangements at service termination;
14.6 	(2)(6) continuing care recommendations, including transitions between more or less 
14.7 	intense services, or more frequent to less frequent services, and referrals made with specific 
14.8 	attention to continuity of care for mental health, as needed; and
14.9 	(3)(7) service termination diagnosis; and.
14.10 	(4) the client's prognosis.

14.11 	Sec. 13. Minnesota Statutes 2018, section 245G.07, is amended to read:
14.12 	245G.07 TREATMENT SERVICE.
14.13 		Subdivision 1.Treatment service. (a) A license holderlicensed residential treatment 
14.14 	program must offerprovide the following treatment services in clauses (1) to (5) to each 
14.15 	client, unless clinically inappropriate and the justifying clinical rationale is documented:. 
14.16 	A nonresidential treatment program must offer all treatment services in clauses (1) to (5) 
14.17 	and document in the individual treatment plan the specific services for which a client has 
14.18 	an assessed need and the plan to provide the services:
14.19 	(1) individual and group counseling to help the client identify and address needs related 
14.20 	to substance use and develop strategies to avoid harmful substance use after discharge and 
14.21 	to help the client obtain the services necessary to establish a lifestyle free of the harmful 
14.22 	effects of substance use disorder;. Notwithstanding subdivision 3, individual and group 
14.23 	counseling services must be provided by an individual who meets the staff qualifications 
14.24 	of an alcohol and drug counselor in section 245G.11, subdivision 5;
14.25 	(2) client education strategies to avoid inappropriate substance use and health problems 
14.26 	related to substance use and the necessary lifestyle changes to regain and maintain health. 
14.27 	Client education must include information on tuberculosis education on a form approved 
14.28 	by the commissioner, the human immunodeficiency virus according to section 245A.19, 
14.29 	other sexually transmitted diseases, drug and alcohol use during pregnancy, and hepatitis. 
14.30 	A licensed alcohol and drug counselor must be present during an educational group;
14.31 	(3) a service to help the client integrate gains made during treatment into daily living 
14.32 	and to reduce the client's reliance on a staff member for support;
15.1 	(4) a service to address issues related to co-occurring disorders, including client education 
15.2 	on symptoms of mental illness, the possibility of comorbidity, and the need for continued 
15.3 	medication compliance while recovering from substance use disorder. A group must address 
15.4 	co-occurring disorders, as needed. When treatment for mental health problems is indicated, 
15.5 	the treatment must be integrated into the client's individual treatment plan; and
15.6 	(5) on July 1, 2018, or upon federal approval, whichever is later, peer recovery support 
15.7 	services provided one-to-one by an individual in recovery. Peer support services include 
15.8 	education, advocacy, mentoring through self-disclosure of personal recovery experiences, 
15.9 	attending recovery and other support groups with a client, accompanying the client to 
15.10 	appointments that support recovery, assistance accessing resources to obtain housing, 
15.11 	employment, education, and advocacy services, and nonclinical recovery support to assist 
15.12 	the transition from treatment into the recovery community; and
15.13 	(6) on July 1, 2018, or upon federal approval, whichever is later, care (5) treatment
15.14 	coordination provided one-to-one by an individual who meets the staff qualifications in 
15.15 	section 245G.11, subdivision 7, or an alcohol and drug counselor under section 245G.11, 
15.16 	subdivision 5. Care Treatment coordination services include:
15.17 	(i) assistance in coordination with significant others to help in the treatment planning 
15.18 	process whenever possible;
15.19 	(ii) assistance in coordination with and follow up for medical services as identified in 
15.20 	the treatment plan;
15.21 	(iii) facilitation of referrals to substance use disorder services as indicated by a client's 
15.22 	medical provider, comprehensive assessment, or treatment plan;
15.23 	(iv) facilitation of referrals to mental health services as identified by a client's 
15.24 	comprehensive assessment or treatment plan;
15.25 	(v) assistance with referrals to economic assistance, social services, housing resources, 
15.26 	and prenatal care according to the client's needs;
15.27 	(vi) life skills advocacy and support accessing treatment follow-up, disease management, 
15.28 	and education services, including referral and linkages to long-term services and supports 
15.29 	as needed; and
15.30 	(vii) documentation of the provision of care treatment coordination services in the client's 
15.31 	file.
15.32 	(b) A treatment service provided to a client must be provided according to the individual 
15.33 	treatment plan and must consider cultural differences and special needs of a client.
16.1 		Subd. 2.Additional treatment service. A license holder may provide or arrange the 
16.2 	following additional treatment service as a part of the client's individual treatment plan:
16.3 	(1) relationship counseling provided by a qualified professional to help the client identify 
16.4 	the impact of the client's substance use disorder on others and to help the client and persons 
16.5 	in the client's support structure identify and change behaviors that contribute to the client's 
16.6 	substance use disorder;
16.7 	(2) therapeutic recreation to allow the client to participate in recreational activities 
16.8 	without the use of mood-altering chemicals and to plan and select leisure activities that do 
16.9 	not involve the inappropriate use of chemicals;
16.10 	(3) stress management and physical well-being to help the client reach and maintain an 
16.11 	appropriate level of health, physical fitness, and well-being;
16.12 	(4) living skills development to help the client learn basic skills necessary for independent 
16.13 	living;
16.14 	(5) employment or educational services to help the client become financially independent;
16.15 	(6) socialization skills development to help the client live and interact with others in a 
16.16 	positive and productive manner; and
16.17 	(7) room, board, and supervision at the treatment site to provide the client with a safe 
16.18 	and appropriate environment to gain and practice new skills.; and
16.19 	(8) peer recovery support services provided one-to-one by an individual in recovery. 
16.20 	Peer support services include education; advocacy; mentoring through self-disclosure of 
16.21 	personal recovery experiences; attending recovery and other support groups with a client; 
16.22 	accompanying the client to appointments that support recovery; assistance accessing resources 
16.23 	to obtain housing, employment, education, and advocacy services; and nonclinical recovery 
16.24 	support to assist the transition from treatment into the recovery community.
16.25 		Subd. 3.Counselors. A treatment service, including therapeutic recreation, must be 
16.26 	provided by an alcohol and drug counselor according to section 245G.11, unless the 
16.27 	individual providing the service is specifically qualified according to the accepted credential 
16.28 	required to provide the service. Therapeutic recreation does not include planned leisure 
16.29 	activities. The commissioner shall maintain a current list of professionals qualified to provide 
16.30 	treatment services, notwithstanding the staff qualification requirements in section 245G.11, 
16.31 	subdivision 4.
16.32 		Subd. 4.Location of service provision. The license holder may provide services at any 
16.33 	of the license holder's licensed locations or at another suitable location including a school, 
17.1 	government building, medical or behavioral health facility, or social service organization, 
17.2 	upon notification and approval of the commissioner. If services are provided off site from 
17.3 	the licensed site, the reason for the provision of services remotely must be documented.
17.4 	The license holder may provide additional services under subdivision 2, clauses (2) to (5), 
17.5 	off-site if the license holder includes a policy and procedure detailing the off-site location 
17.6 	as a part of the treatment service description and the program abuse prevention plan.

17.7 	Sec. 14. Minnesota Statutes 2018, section 245G.08, subdivision 3, is amended to read:
17.8 		Subd. 3.Standing order protocol. A license holder that maintains a supply of naloxone 
17.9 	available for emergency treatment of opioid overdose must have a written standing order 
17.10 	protocol by a physician who is licensed under chapter 147, that permits the license holder 
17.11 	to maintain a supply of naloxone on site, and. A license holder must require staff to undergo 
17.12 	specific training in administration of naloxone the specific mode of administration used at 
17.13 	the program, which may include intranasal administration, intramuscular injection, or both.

17.14 	Sec. 15. Minnesota Statutes 2018, section 245G.10, subdivision 4, is amended to read:
17.15 		Subd. 4.Staff requirement. It is the responsibility of the license holder to determine 
17.16 	an acceptable group size based on each client's needs except that treatment services provided 
17.17 	in a group shall not exceed 16 clients. A counselor in an opioid treatment program must not 
17.18 	supervise more than 50 clients. The license holder must maintain a record that documents 
17.19 	compliance with this subdivision.

17.20 	Sec. 16. Minnesota Statutes 2018, section 245G.11, subdivision 7, is amended to read:
17.21 		Subd. 7.Care Treatment coordination provider qualifications. (a) Care Treatment
17.22 	coordination must be provided by qualified staff. An individual is qualified to provide care
17.23 	treatment coordination if the individual: meets the qualifications of an alcohol and drug 
17.24 	counselor under subdivision 5. An individual who does not meet the qualifications of an 
17.25 	alcohol and drug counselor under subdivision 5 is qualified to provide treatment coordination 
17.26 	if the individual:
17.27 	(1) is skilled in the process of identifying and assessing a wide range of client needs;
17.28 	(2) is knowledgeable about local community resources and how to use those resources 
17.29 	for the benefit of the client;
17.30 	(3) has successfully completed 30 hours of classroom instruction on care treatment
17.31 	coordination for an individual with substance use disorder;
18.1 	(4) has either:
18.2 	(i) a bachelor's degree in one of the behavioral sciences or related fields; or
18.3 	(ii) current certification as an alcohol and drug counselor, level I, by the Upper Midwest 
18.4 	Indian Council on Addictive Disorders; and
18.5 	(5) has at least 2,000 hours of supervised experience working with individuals with 
18.6 	substance use disorder.
18.7 	(b) A care treatment coordinator must receive at least one hour of supervision regarding 
18.8 	individual service delivery from an alcohol and drug counselor weekly.

18.9 	Sec. 17. Minnesota Statutes 2018, section 245G.11, subdivision 8, is amended to read:
18.10 		Subd. 8.Recovery peer qualifications. A recovery peer must:
18.11 	(1) have a high school diploma or its equivalent;
18.12 	(2) have a minimum of one year in recovery from substance use disorder;
18.13 	(3) hold a current credential from a certification body approved by the commissioner 
18.14 	that demonstrates the Minnesota Certification Board, the Upper Midwest Indian Council 
18.15 	on Addictive Disorders, or the National Association for Alcoholism and Drug Abuse 
18.16 	Counselors. An individual may also receive a credential from a tribal nation when providing 
18.17 	peer recovery support services in a tribally licensed program. The credential must demonstrate
18.18 	skills and training in the domains of ethics and boundaries, advocacy, mentoring and 
18.19 	education, and recovery and wellness support; and
18.20 	(4) receive ongoing supervision in areas specific to the domains of the recovery peer's 
18.21 	role by an alcohol and drug counselor or an individual with a certification approved by the 
18.22 	commissioner.

18.23 	Sec. 18. Minnesota Statutes 2018, section 245G.12, is amended to read:
18.24 	245G.12 PROVIDER POLICIES AND PROCEDURES.
18.25 	A license holder must develop a written policies and procedures manual, indexed 
18.26 	according to section 245A.04, subdivision 14, paragraph (c), that provides staff members 
18.27 	immediate access to all policies and procedures and provides a client and other authorized 
18.28 	parties access to all policies and procedures. The manual must contain the following 
18.29 	materials:
19.1 	(1) assessment and treatment planning policies, including screening for mental health 
19.2 	concerns and treatment objectives related to the client's identified mental health concerns 
19.3 	in the client's treatment plan;
19.4 	(2) policies and procedures regarding HIV according to section 245A.19;
19.5 	(3) the license holder's methods and resources to provide information on tuberculosis 
19.6 	and tuberculosis screening to each client and to report a known tuberculosis infection 
19.7 	according to section 144.4804;
19.8 	(4) personnel policies according to section 245G.13;
19.9 	(5) policies and procedures that protect a client's rights according to section 245G.15;
19.10 	(6) a medical services plan according to section 245G.08;
19.11 	(7) emergency procedures according to section 245G.16;
19.12 	(8) policies and procedures for maintaining client records according to section 245G.09;
19.13 	(9) procedures for reporting the maltreatment of minors according to section 626.556, 
19.14 	and vulnerable adults according to sections 245A.65, 626.557, and 626.5572;
19.15 	(10) a description of treatment services, including the amount and type of services 
19.16 	provided and the program's treatment week;
19.17 	(11) the methods used to achieve desired client outcomes;
19.18 	(12) the hours of operation; and
19.19 	(13) the target population served.

19.20 	Sec. 19. Minnesota Statutes 2018, section 245G.13, subdivision 1, is amended to read:
19.21 		Subdivision 1.Personnel policy requirements. A license holder must have written 
19.22 	personnel policies that are available to each staff member. The personnel policies must:
19.23 	(1) ensure that staff member retention, promotion, job assignment, or pay are not affected 
19.24 	by a good faith communication between a staff member and the department, the Department 
19.25 	of Health, the ombudsman for mental health and developmental disabilities, law enforcement, 
19.26 	or a local agency for the investigation of a complaint regarding a client's rights, health, or 
19.27 	safety;
19.28 	(2) contain a job description for each staff member position specifying responsibilities, 
19.29 	degree of authority to execute job responsibilities, and qualification requirements;
20.1 	(3) provide for a job performance evaluation based on standards of job performance 
20.2 	conducted on a regular and continuing basis, including a written annual review;
20.3 	(4) describe behavior that constitutes grounds for disciplinary action, suspension, or 
20.4 	dismissal, including policies that address staff member problematic substance use and the 
20.5 	requirements of section 245G.11, subdivision 1, policies prohibiting personal involvement 
20.6 	with a client in violation of chapter 604, and policies prohibiting client abuse described in 
20.7 	sections 245A.65, 626.556, 626.557, and 626.5572;
20.8 	(5) identify how the program will identify whether behaviors or incidents are problematic 
20.9 	substance use, including a description of how the facility must address:
20.10 	(i) receiving treatment for substance use within the period specified for the position in 
20.11 	the staff qualification requirements, including medication-assisted treatment;
20.12 	(ii) substance use that negatively impacts the staff member's job performance;
20.13 	(iii) chemical substance use that affects the credibility of treatment services with a client, 
20.14 	referral source, or other member of the community;
20.15 	(iv) symptoms of intoxication or withdrawal on the job; and
20.16 	(v) the circumstances under which an individual who participates in monitoring by the 
20.17 	health professional services program for a substance use or mental health disorder is able 
20.18 	to provide services to the program's clients;
20.19 	(6) include a chart or description of the organizational structure indicating lines of 
20.20 	authority and responsibilities;
20.21 	(7) include orientation within 24 working hours of starting for each new staff member 
20.22 	based on a written plan that, at a minimum, must provide training related to the staff member's 
20.23 	specific job responsibilities, policies and procedures, client confidentiality, HIV minimum 
20.24 	standards, and client needs; and
20.25 	(8) include policies outlining the license holder's response to a staff member with a 
20.26 	behavior problem that interferes with the provision of treatment service.

20.27 	Sec. 20. Minnesota Statutes 2018, section 245G.15, subdivision 1, is amended to read:
20.28 		Subdivision 1.Explanation. A client has the rights identified in sections 144.651, 
20.29 	148F.165, and 253B.03, as applicable. The license holder must give each client at on the 
20.30 	day of service initiation a written statement of the client's rights and responsibilities. A staff 
20.31 	member must review the statement with a client at that time.

21.1 	Sec. 21. Minnesota Statutes 2018, section 245G.15, subdivision 2, is amended to read:
21.2 		Subd. 2.Grievance procedure. At On the day of service initiation, the license holder 
21.3 	must explain the grievance procedure to the client or the client's representative. The grievance 
21.4 	procedure must be posted in a place visible to clients, and made available upon a client's or 
21.5 	former client's request. The grievance procedure must require that:
21.6 	(1) a staff member helps the client develop and process a grievance;
21.7 	(2) current telephone numbers and addresses of the Department of Human Services, 
21.8 	Licensing Division; the Office of Ombudsman for Mental Health and Developmental 
21.9 	Disabilities; the Department of Health Office of Health Facilities Complaints; and the Board 
21.10 	of Behavioral Health and Therapy, when applicable, be made available to a client; and
21.11 	(3) a license holder responds to the client's grievance within three days of a staff member's 
21.12 	receipt of the grievance, and the client may bring the grievance to the highest level of 
21.13 	authority in the program if not resolved by another staff member.

21.14 	Sec. 22. Minnesota Statutes 2018, section 245G.18, subdivision 3, is amended to read:
21.15 		Subd. 3.Staff ratios. At least 25 percent of a counselor's scheduled work hours must 
21.16 	be allocated to indirect services, including documentation of client services, coordination 
21.17 	of services with others, treatment team meetings, and other duties. A counseling group 
21.18 	consisting entirely of adolescents must not exceed 16 adolescents. It is the responsibility of 
21.19 	the license holder to determine an acceptable group size based on the needs of the clients.

21.20 	Sec. 23. Minnesota Statutes 2018, section 245G.18, subdivision 5, is amended to read:
21.21 		Subd. 5.Program requirements. In addition to the requirements specified in the client's 
21.22 	treatment plan under section 245G.06, programs serving an adolescent must include:
21.23 	(1) coordination with the school system to address the client's academic needs;
21.24 	(2) when appropriate, a plan that addresses the client's leisure activities without chemical
21.25 	substance use; and
21.26 	(3) a plan that addresses family involvement in the adolescent's treatment.

21.27 	Sec. 24. Minnesota Statutes 2018, section 245G.22, subdivision 1, is amended to read:
21.28 		Subdivision 1.Additional requirements. (a) An opioid treatment program licensed 
21.29 	under this chapter must also: (1) comply with the requirements of this section and Code of 
21.30 	Federal Regulations, title 42, part 8. When federal guidance or interpretations are issued on 
22.1 	federal standards or requirements also required under this section, the federal guidance or 
22.2 	interpretations shall apply.; (2) be registered as a narcotic treatment program with the Drug 
22.3 	Enforcement Administration; (3) be accredited through an accreditation body approved by 
22.4 	the Division of Pharmacologic Therapy of the Center for Substance Abuse Treatment; (4) 
22.5 	be certified through the Division of Pharmacologic Therapy of the Center for Substance 
22.6 	Abuse Treatment; and (5) hold a license from the Minnesota Board of Pharmacy or equivalent 
22.7 	agency.
22.8 	(b) Where a standard in this section differs from a standard in an otherwise applicable 
22.9 	administrative rule or statute, the standard of this section applies.

22.10 	Sec. 25. Minnesota Statutes 2018, section 245G.22, subdivision 2, is amended to read:
22.11 		Subd. 2.Definitions. (a) For purposes of this section, the terms defined in this subdivision 
22.12 	have the meanings given them.
22.13 	(b) "Diversion" means the use of a medication for the treatment of opioid addiction being 
22.14 	diverted from intended use of the medication.
22.15 	(c) "Guest dose" means administration of a medication used for the treatment of opioid 
22.16 	addiction to a person who is not a client of the program that is administering or dispensing 
22.17 	the medication.
22.18 	(d) "Medical director" means a physician practitioner licensed to practice medicine in 
22.19 	the jurisdiction that the opioid treatment program is located who assumes responsibility for 
22.20 	administering all medical services performed by the program, either by performing the 
22.21 	services directly or by delegating specific responsibility to (1) authorized program physicians; 
22.22 	(2) advanced practice registered nurses, when approved by variance by the State Opioid 
22.23 	Treatment Authority under section 254A.03 and the federal Substance Abuse and Mental 
22.24 	Health Services Administration; or (3) health care professionals functioning under the 
22.25 	medical director's direct supervision a practitioner of the opioid treatment program.
22.26 	(e) "Medication used for the treatment of opioid use disorder" means a medication 
22.27 	approved by the Food and Drug Administration for the treatment of opioid use disorder.
22.28 	(f) "Minnesota health care programs" has the meaning given in section 256B.0636.
22.29 	(g) "Opioid treatment program" has the meaning given in Code of Federal Regulations, 
22.30 	title 42, section 8.12, and includes programs licensed under this chapter.
22.31 	(h) "Placing authority" has the meaning given in Minnesota Rules, part 9530.6605, 
22.32 	subpart 21a.
23.1 	(i) "Practitioner" means a staff member holding a current, unrestricted license to practice 
23.2 	medicine issued by the Board of Medical Practice or nursing issued by the Board of Nursing 
23.3 	and is currently registered with the Drug Enforcement Administration to order or dispense 
23.4 	controlled substances in Schedules II to V under the Controlled Substances Act, United 
23.5 	States Code, title 21, part B, section 821. Practitioner includes an advanced practice registered 
23.6 	nurse and physician assistant if the staff member receives a variance by the state opioid 
23.7 	treatment authority under section 254A.03 and the federal Substance Abuse and Mental 
23.8 	Health Services Administration.
23.9 	(i) (j) "Unsupervised use" means the use of a medication for the treatment of opioid use 
23.10 	disorder dispensed for use by a client outside of the program setting.

23.11 	Sec. 26. Minnesota Statutes 2018, section 245G.22, subdivision 3, is amended to read:
23.12 		Subd. 3.Medication orders. Before the program may administer or dispense a medication 
23.13 	used for the treatment of opioid use disorder:
23.14 	(1) a client-specific order must be received from an appropriately credentialed physician
23.15 	practitioner who is enrolled as a Minnesota health care programs provider and meets all 
23.16 	applicable provider standards;
23.17 	(2) the signed order must be documented in the client's record; and
23.18 	(3) if the physician practitioner that issued the order is not able to sign the order when 
23.19 	issued, the unsigned order must be entered in the client record at the time it was received, 
23.20 	and the physician practitioner must review the documentation and sign the order in the 
23.21 	client's record within 72 hours of the medication being ordered. The license holder must 
23.22 	report to the commissioner any medication error that endangers a client's health, as 
23.23 	determined by the medical director.

23.24 	Sec. 27. Minnesota Statutes 2018, section 245G.22, subdivision 4, is amended to read:
23.25 		Subd. 4.High dose requirements. A client being administered or dispensed a dose 
23.26 	beyond that set forth in subdivision 6, paragraph (a), clause (1), that exceeds 150 milligrams 
23.27 	of methadone or 24 milligrams of buprenorphine daily, and for each subsequent increase, 
23.28 	must meet face-to-face with a prescribing physician practitioner. The meeting must occur 
23.29 	before the administration or dispensing of the increased medication dose.

24.1 	Sec. 28. Minnesota Statutes 2018, section 245G.22, subdivision 6, is amended to read:
24.2 		Subd. 6.Criteria for unsupervised use. (a) To limit the potential for diversion of 
24.3 	medication used for the treatment of opioid use disorder to the illicit market, medication 
24.4 	dispensed to a client for unsupervised use shall be subject to the following requirements:
24.5 	of this subdivision.
24.6 	(1) Any client in an opioid treatment program may receive a single unsupervised use 
24.7 	dose for a day that the clinic is closed for business, including Sundays and state and federal 
24.8 	holidays; and.
24.9 	(2) other treatment program decisions on dispensing medications used for the treatment 
24.10 	of opioid use disorder to a client for unsupervised use shall be determined by the medical 
24.11 	director.
24.12 	(b) In determining whether a client may be permitted unsupervised use of medications, 
24.13 	a physician A practitioner with authority to prescribe must consider review and document
24.14 	the criteria in this paragraph. The criteria in this paragraph must also be considered (c) when 
24.15 	determining whether dispensing medication for a client's unsupervised use is appropriate 
24.16 	to implement, increase, or to extend the amount of time between visits to the program. The 
24.17 	criteria are:
24.18 	(1) absence of recent abuse of drugs including but not limited to opioids, non-narcotics, 
24.19 	and alcohol;
24.20 	(2) regularity of program attendance;
24.21 	(3) absence of serious behavioral problems at the program;
24.22 	(4) absence of known recent criminal activity such as drug dealing;
24.23 	(5) stability of the client's home environment and social relationships;
24.24 	(6) length of time in comprehensive maintenance treatment;
24.25 	(7) reasonable assurance that unsupervised use medication will be safely stored within 
24.26 	the client's home; and
24.27 	(8) whether the rehabilitative benefit the client derived from decreasing the frequency 
24.28 	of program attendance outweighs the potential risks of diversion or unsupervised use.
24.29 	(c) The determination, including the basis of the determination must be documented in 
24.30 	the client's medical record.

25.1 	Sec. 29. Minnesota Statutes 2018, section 245G.22, subdivision 7, is amended to read:
25.2 		Subd. 7.Restrictions for unsupervised use of methadone hydrochloride. (a) If a 
25.3 	physician with authority to prescribe medical director or prescribing practitioner assesses 
25.4 	and determines that a client meets the criteria in subdivision 6 and may be dispensed a 
25.5 	medication used for the treatment of opioid addiction, the restrictions in this subdivision 
25.6 	must be followed when the medication to be dispensed is methadone hydrochloride. The 
25.7 	results of the assessment must be contained in the client file.
25.8 	(b) During the first 90 days of treatment, the unsupervised use medication supply must 
25.9 	be limited to a maximum of a single dose each week and the client shall ingest all other 
25.10 	doses under direct supervision.
25.11 	(c) In the second 90 days of treatment, the unsupervised use medication supply must be 
25.12 	limited to two doses per week.
25.13 	(d) In the third 90 days of treatment, the unsupervised use medication supply must not 
25.14 	exceed three doses per week.
25.15 	(e) In the remaining months of the first year, a client may be given a maximum six-day 
25.16 	unsupervised use medication supply.
25.17 	(f) After one year of continuous treatment, a client may be given a maximum two-week 
25.18 	unsupervised use medication supply.
25.19 	(g) After two years of continuous treatment, a client may be given a maximum one-month 
25.20 	unsupervised use medication supply, but must make monthly visits to the program.

25.21 	Sec. 30. Minnesota Statutes 2018, section 245G.22, subdivision 15, is amended to read:
25.22 		Subd. 15.Nonmedication treatment services; documentation. (a) The program must 
25.23 	offer at least 50 consecutive minutes of individual or group therapy treatment services as 
25.24 	defined in section 245G.07, subdivision 1, paragraph (a), clause (1), per week, for the first 
25.25 	ten weeks following admission, and at least 50 consecutive minutes per month thereafter. 
25.26 	As clinically appropriate, the program may offer these services cumulatively and not 
25.27 	consecutively in increments of no less than 15 minutes over the required time period, and 
25.28 	for a total of 60 minutes of treatment services over the time period, and must document the 
25.29 	reason for providing services cumulatively in the client's record. The program may offer 
25.30 	additional levels of service when deemed clinically necessary.
25.31 	(b) Notwithstanding the requirements of comprehensive assessments in section 245G.05, 
25.32 	the assessment must be completed within 21 days from the day of service initiation.
26.1 	(c) Notwithstanding the requirements of individual treatment plans set forth in section 
26.2 	245G.06:
26.3 	(1) treatment plan contents for a maintenance client are not required to include goals 
26.4 	the client must reach to complete treatment and have services terminated;
26.5 	(2) treatment plans for a client in a taper or detox status must include goals the client 
26.6 	must reach to complete treatment and have services terminated;
26.7 	(3) for the initial ten weeks after admission for all new admissions, readmissions, and 
26.8 	transfers, progress notes a weekly treatment plan review must be entered in a client's file at 
26.9 	least weekly and be recorded in each of the six dimensions upon the development of the 
26.10 	treatment plan and thereafter documented upon the completion of the treatment plan. Prior 
26.11 	to the completion of the treatment plan, all services must be documented according to section 
26.12 	245G.06, subdivision 3. Subsequently, the counselor must document progress treatment 
26.13 	plan reviews in the six dimensions at least once monthly after the initial ten weeks or, when 
26.14 	clinical need warrants, more frequently; and.
26.15 	(4) upon the development of the treatment plan and thereafter, treatment plan reviews 
26.16 	must occur weekly, or after each treatment service, whichever is less frequent, for the first 
26.17 	ten weeks after the treatment plan is developed. Following the first ten weeks of treatment 
26.18 	plan reviews, reviews may occur monthly, unless the client's needs warrant more frequent 
26.19 	revisions or documentation.

26.20 	Sec. 31. Minnesota Statutes 2018, section 245G.22, subdivision 16, is amended to read:
26.21 		Subd. 16.Prescription monitoring program. (a) The program must develop and 
26.22 	maintain a policy and procedure that requires the ongoing monitoring of the data from the 
26.23 	prescription monitoring program (PMP) for each client. The policy and procedure must 
26.24 	include how the program meets the requirements in paragraph (b).
26.25 	(b) If When a medication used for the treatment of substance use disorder is administered 
26.26 	or dispensed to a client, the license holder shall be is subject to the following requirements:
26.27 	(1) upon admission to a methadone clinic outpatient an opioid treatment program, a 
26.28 	client must be notified in writing that the commissioner of human services and the medical 
26.29 	director must monitor the PMP to review the prescribed controlled drugs a client received;
26.30 	(2) the medical director or the medical director's delegate must review the data from the 
26.31 	PMP described in section 152.126 before the client is ordered any controlled substance, as 
26.32 	defined under section 152.126, subdivision 1, paragraph (c), including medications used 
27.1 	for the treatment of opioid addiction, and the medical director's or the medical director's 
27.2 	delegate's subsequent reviews of the PMP data must occur at least every 90 days;
27.3 	(3) a copy of the PMP data reviewed must be maintained in the client's file along with 
27.4 	the licensed practitioner's decision for frequency of ongoing PMP checks;
27.5 	(4) when the PMP data contains a recent history of multiple prescribers or multiple 
27.6 	prescriptions for controlled substances, the physician's review of the data and subsequent 
27.7 	actions must be documented in the client's file within 72 hours and must contain the medical 
27.8 	director's determination of whether or not the prescriptions place the client at risk of harm 
27.9 	and the actions to be taken in response to the PMP findings. The provider must conduct 
27.10 	subsequent reviews of the PMP on a monthly basis; and
27.11 	(5) if at any time the medical director licensed practitioner believes the use of the 
27.12 	controlled substances places the client at risk of harm, the program must seek the client's 
27.13 	consent to discuss the client's opioid treatment with other prescribers and must seek the 
27.14 	client's consent for the other prescriber to disclose to the opioid treatment program's medical 
27.15 	director the client's condition that formed the basis of the other prescriptions. If the 
27.16 	information is not obtained within seven days, the medical director must document whether 
27.17 	or not changes to the client's medication dose or number of unsupervised use doses are 
27.18 	necessary until the information is obtained.
27.19 	(c) The commissioner shall collaborate with the Minnesota Board of Pharmacy to develop 
27.20 	and implement an electronic system for the commissioner to routinely access the PMP data 
27.21 	to determine whether any client enrolled in an opioid addiction treatment program licensed 
27.22 	according to this section was prescribed or dispensed a controlled substance in addition to 
27.23 	that administered or dispensed by the opioid addiction treatment program. When the 
27.24 	commissioner determines there have been multiple prescribers or multiple prescriptions of 
27.25 	controlled substances for a client, the commissioner shall:
27.26 	(1) inform the medical director of the opioid treatment program only that the 
27.27 	commissioner determined the existence of multiple prescribers or multiple prescriptions of 
27.28 	controlled substances; and
27.29 	(2) direct the medical director of the opioid treatment program to access the data directly, 
27.30 	review the effect of the multiple prescribers or multiple prescriptions, and document the 
27.31 	review.
27.32 	(d) If determined necessary, the commissioner shall seek a federal waiver of, or exception 
27.33 	to, any applicable provision of Code of Federal Regulations, title 42, section 2.34 (c), before 
27.34 	implementing this subdivision.

28.1 	Sec. 32. Minnesota Statutes 2018, section 245G.22, subdivision 17, is amended to read:
28.2 		Subd. 17.Policies and procedures. (a) A license holder must develop and maintain the 
28.3 	policies and procedures required in this subdivision.
28.4 	(b) For a program that is not open every day of the year, the license holder must maintain 
28.5 	a policy and procedure that permits a client to receive a single covers requirements under 
28.6 	section 245G.22, subdivisions 6 and 7. Unsupervised use of medication used for the treatment 
28.7 	of opioid use disorder for days that the program is closed for business, including, but not 
28.8 	limited to, Sundays and state and federal holidays as required under subdivision 6, paragraph 
28.9 	(a), clause (1), must meet the requirements under section 245G.22, subdivisions 6 and 7.
28.10 	(c) The license holder must maintain a policy and procedure that includes specific 
28.11 	measures to reduce the possibility of diversion. The policy and procedure must:
28.12 	(1) specifically identify and define the responsibilities of the medical and administrative 
28.13 	staff for performing diversion control measures; and
28.14 	(2) include a process for contacting no less than five percent of clients who have 
28.15 	unsupervised use of medication, excluding clients approved solely under subdivision 6, 
28.16 	paragraph (a), clause (1), to require clients to physically return to the program each month. 
28.17 	The system must require clients to return to the program within a stipulated time frame and 
28.18 	turn in all unused medication containers related to opioid use disorder treatment. The license 
28.19 	holder must document all related contacts on a central log and the outcome of the contact 
28.20 	for each client in the client's record. The medical director must be informed of each outcome 
28.21 	that results in a situation in which a possible diversion issue was identified.
28.22 	(d) Medication used for the treatment of opioid use disorder must be ordered, 
28.23 	administered, and dispensed according to applicable state and federal regulations and the 
28.24 	standards set by applicable accreditation entities. If a medication order requires assessment 
28.25 	by the person administering or dispensing the medication to determine the amount to be 
28.26 	administered or dispensed, the assessment must be completed by an individual whose 
28.27 	professional scope of practice permits an assessment. For the purposes of enforcement of 
28.28 	this paragraph, the commissioner has the authority to monitor the person administering or 
28.29 	dispensing the medication for compliance with state and federal regulations and the relevant 
28.30 	standards of the license holder's accreditation agency and may issue licensing actions 
28.31 	according to sections 245A.05, 245A.06, and 245A.07, based on the commissioner's 
28.32 	determination of noncompliance.
28.33 	(e) A counselor in an opioid treatment program must not supervise more than 50 clients.

29.1 	Sec. 33. Minnesota Statutes 2018, section 245G.22, subdivision 19, is amended to read:
29.2 		Subd. 19.Placing authorities. A program must provide certain notification and 
29.3 	client-specific updates to placing authorities for a client who is enrolled in Minnesota health 
29.4 	care programs. At the request of the placing authority, the program must provide 
29.5 	client-specific updates, including but not limited to informing the placing authority of 
29.6 	positive drug screenings testings and changes in medications used for the treatment of opioid 
29.7 	use disorder ordered for the client.

29.8 	Sec. 34. Minnesota Statutes 2018, section 254B.04, is amended by adding a subdivision 
29.9 	to read:
29.10 		Subd. 2c.Eligibility to receive peer recovery support and treatment service 
29.11 	coordination. Notwithstanding Minnesota Rules, part 9530.6620, subpart 6, a placing 
29.12 	authority may authorize peer recovery support and treatment service coordination for a 
29.13 	person who scores a severity of one or more in dimension 4, 5, or 6, under Minnesota Rules, 
29.14 	part 9530.6622. Authorization for peer recovery support and treatment service coordination 
29.15 	under this subdivision does not need to be provided in conjunction with treatment services 
29.16 	under Minnesota Rules, part 9530.6622, subpart 4, 5, or 6.

29.17 	Sec. 35. Minnesota Statutes 2018, section 254B.05, subdivision 1, is amended to read:
29.18 		Subdivision 1.Licensure required. (a) Programs licensed by the commissioner are 
29.19 	eligible vendors. Hospitals may apply for and receive licenses to be eligible vendors, 
29.20 	notwithstanding the provisions of section 245A.03. American Indian programs that provide 
29.21 	substance use disorder treatment, extended care, transitional residence, or outpatient treatment 
29.22 	services, and are licensed by tribal government are eligible vendors.
29.23 	(b) On July 1, 2018, or upon federal approval, whichever is later, a licensed professional 
29.24 	in private practice who meets the requirements of section 245G.11, subdivisions 1 and 4, 
29.25 	is an eligible vendor of a comprehensive assessment and assessment summary provided 
29.26 	according to section 245G.05, and treatment services provided according to sections 245G.06 
29.27 	and 245G.07, subdivision 1, paragraphs (a), clauses (1) to (5) (4), and (b); and subdivision 
29.28 	2.
29.29 	(c) On July 1, 2018, or upon federal approval, whichever is later, a county is an eligible 
29.30 	vendor for a comprehensive assessment and assessment summary when provided by an 
29.31 	individual who meets the staffing credentials of section 245G.11, subdivisions 1 and 4, and 
29.32 	completed according to the requirements of section 245G.05. A county is an eligible vendor 
29.33 	of care coordination services when provided by an individual who meets the staffing 
30.1 	credentials of section 245G.11, subdivisions 1 and 7, and provided according to the 
30.2 	requirements of section 245G.07, subdivision 1, paragraph (a), clause (7) (5).
30.3 	(d) On July 1, 2018, or upon federal approval, whichever is later, a recovery community 
30.4 	organization that meets certification requirements identified by the commissioner is an 
30.5 	eligible vendor of peer support services.
30.6 	(e) Detoxification programs licensed under Minnesota Rules, parts 9530.6510 to 
30.7 	9530.6590, are not eligible vendors. Programs that are not licensed as a residential or 
30.8 	nonresidential substance use disorder treatment or withdrawal management program by the 
30.9 	commissioner or by tribal government or do not meet the requirements of subdivisions 1a 
30.10 	and 1b are not eligible vendors.

30.11 	Sec. 36. Minnesota Statutes 2018, section 254B.05, subdivision 5, is amended to read:
30.12 		Subd. 5.Rate requirements. (a) The commissioner shall establish rates for substance 
30.13 	use disorder services and service enhancements funded under this chapter.
30.14 	(b) Eligible substance use disorder treatment services include:
30.15 	(1) outpatient treatment services that are licensed according to sections 245G.01 to 
30.16 	245G.17, or applicable tribal license;
30.17 	(2) on July 1, 2018, or upon federal approval, whichever is later, comprehensive 
30.18 	assessments provided according to sections 245.4863, paragraph (a), and 245G.05, and 
30.19 	Minnesota Rules, part 9530.6422;
30.20 	(3) on July 1, 2018, or upon federal approval, whichever is later, care coordination 
30.21 	services provided according to section 245G.07, subdivision 1, paragraph (a), clause (6)
30.22 	(5);
30.23 	(4) on July 1, 2018, or upon federal approval, whichever is later, peer recovery support 
30.24 	services provided according to section 245G.07, subdivision 1, paragraph (a) 2, clause (5)
30.25 	(8);
30.26 	(5) on July 1, 2019, or upon federal approval, whichever is later, withdrawal management 
30.27 	services provided according to chapter 245F;
30.28 	(6) medication-assisted therapy services that are licensed according to sections 245G.01
30.29 	to 245G.17 and 245G.22, or applicable tribal license;
30.30 	(7) medication-assisted therapy plus enhanced treatment services that meet the 
30.31 	requirements of clause (6) and provide nine hours of clinical services each week;
31.1 	(8) high, medium, and low intensity residential treatment services that are licensed 
31.2 	according to sections 245G.01 to 245G.17 and 245G.21 or applicable tribal license which 
31.3 	provide, respectively, 30, 15, and five hours of clinical services each week;
31.4 	(9) hospital-based treatment services that are licensed according to sections 245G.01 to 
31.5 	245G.17 or applicable tribal license and licensed as a hospital under sections 144.50 to 
31.6 	144.56;
31.7 	(10) adolescent treatment programs that are licensed as outpatient treatment programs 
31.8 	according to sections 245G.01 to 245G.18 or as residential treatment programs according 
31.9 	to Minnesota Rules, parts 2960.0010 to 2960.0220, and 2960.0430 to 2960.0490, or 
31.10 	applicable tribal license;
31.11 	(11) high-intensity residential treatment services that are licensed according to sections 
31.12 	245G.01 to 245G.17 and 245G.21 or applicable tribal license, which provide 30 hours of 
31.13 	clinical services each week provided by a state-operated vendor or to clients who have been 
31.14 	civilly committed to the commissioner, present the most complex and difficult care needs, 
31.15 	and are a potential threat to the community; and
31.16 	(12) room and board facilities that meet the requirements of subdivision 1a.
31.17 	(c) The commissioner shall establish higher rates for programs that meet the requirements 
31.18 	of paragraph (b) and one of the following additional requirements:
31.19 	(1) programs that serve parents with their children if the program:
31.20 	(i) provides on-site child care during the hours of treatment activity that:
31.21 	(A) is licensed under chapter 245A as a child care center under Minnesota Rules, chapter 
31.22 	9503; or
31.23 	(B) meets the licensure exclusion criteria of section 245A.03, subdivision 2, paragraph 
31.24 	(a), clause (6), and meets the requirements under section 245G.19, subdivision 4; or
31.25 	(ii) arranges for off-site child care during hours of treatment activity at a facility that is 
31.26 	licensed under chapter 245A as:
31.27 	(A) a child care center under Minnesota Rules, chapter 9503; or
31.28 	(B) a family child care home under Minnesota Rules, chapter 9502;
31.29 	(2) culturally specific programs as defined in section 254B.01, subdivision 4a, or 
31.30 	programs or subprograms serving special populations, if the program or subprogram meets 
31.31 	the following requirements:
32.1 	(i) is designed to address the unique needs of individuals who share a common language, 
32.2 	racial, ethnic, or social background;
32.3 	(ii) is governed with significant input from individuals of that specific background; and
32.4 	(iii) employs individuals to provide individual or group therapy, at least 50 percent of 
32.5 	whom are of that specific background, except when the common social background of the 
32.6 	individuals served is a traumatic brain injury or cognitive disability and the program employs 
32.7 	treatment staff who have the necessary professional training, as approved by the 
32.8 	commissioner, to serve clients with the specific disabilities that the program is designed to 
32.9 	serve;
32.10 	(3) programs that offer medical services delivered by appropriately credentialed health 
32.11 	care staff in an amount equal to two hours per client per week if the medical needs of the 
32.12 	client and the nature and provision of any medical services provided are documented in the 
32.13 	client file; and
32.14 	(4) programs that offer services to individuals with co-occurring mental health and 
32.15 	chemical dependency problems if:
32.16 	(i) the program meets the co-occurring requirements in section 245G.20;
32.17 	(ii) 25 percent of the counseling staff are licensed mental health professionals, as defined 
32.18 	in section 245.462, subdivision 18, clauses (1) to (6), or are students or licensing candidates 
32.19 	under the supervision of a licensed alcohol and drug counselor supervisor and licensed 
32.20 	mental health professional, except that no more than 50 percent of the mental health staff 
32.21 	may be students or licensing candidates with time documented to be directly related to 
32.22 	provisions of co-occurring services;
32.23 	(iii) clients scoring positive on a standardized mental health screen receive a mental 
32.24 	health diagnostic assessment within ten days of admission;
32.25 	(iv) the program has standards for multidisciplinary case review that include a monthly 
32.26 	review for each client that, at a minimum, includes a licensed mental health professional 
32.27 	and licensed alcohol and drug counselor, and their involvement in the review is documented;
32.28 	(v) family education is offered that addresses mental health and substance abuse disorders 
32.29 	and the interaction between the two; and
32.30 	(vi) co-occurring counseling staff shall receive eight hours of co-occurring disorder 
32.31 	training annually.
33.1 	(d) In order to be eligible for a higher rate under paragraph (c), clause (1), a program 
33.2 	that provides arrangements for off-site child care must maintain current documentation at 
33.3 	the chemical dependency facility of the child care provider's current licensure to provide 
33.4 	child care services. Programs that provide child care according to paragraph (c), clause (1), 
33.5 	must be deemed in compliance with the licensing requirements in section 245G.19.
33.6 	(e) Adolescent residential programs that meet the requirements of Minnesota Rules, 
33.7 	parts 2960.0430 to 2960.0490 and 2960.0580 to 2960.0690, are exempt from the requirements 
33.8 	in paragraph (c), clause (4), items (i) to (iv).
33.9 	(f) Subject to federal approval, chemical dependency services that are otherwise covered 
33.10 	as direct face-to-face services may be provided via two-way interactive video. The use of 
33.11 	two-way interactive video must be medically appropriate to the condition and needs of the 
33.12 	person being served. Reimbursement shall be at the same rates and under the same conditions 
33.13 	that would otherwise apply to direct face-to-face services. The interactive video equipment 
33.14 	and connection must comply with Medicare standards in effect at the time the service is 
33.15 	provided.

33.16 	Sec. 37. Minnesota Statutes 2018, section 256B.0941, subdivision 1, is amended to read:
33.17 		Subdivision 1.Eligibility. (a) An individual who is eligible for mental health treatment 
33.18 	services in a psychiatric residential treatment facility must meet all of the following criteria:
33.19 	(1) before admission, services are determined to be medically necessary by the state's 
33.20 	medical review agent according to Code of Federal Regulations, title 42, section 441.152;
33.21 	(2) is younger than 21 years of age at the time of admission. Services may continue until 
33.22 	the individual meets criteria for discharge or reaches 22 years of age, whichever occurs 
33.23 	first;
33.24 	(3) has a mental health diagnosis as defined in the most recent edition of the Diagnostic 
33.25 	and Statistical Manual for Mental Disorders, as well as clinical evidence of severe aggression, 
33.26 	or a finding that the individual is a risk to self or others;
33.27 	(4) has functional impairment and a history of difficulty in functioning safely and 
33.28 	successfully in the community, school, home, or job; an inability to adequately care for 
33.29 	one's physical needs; or caregivers, guardians, or family members are unable to safely fulfill 
33.30 	the individual's needs;
33.31 	(5) requires psychiatric residential treatment under the direction of a physician to improve 
33.32 	the individual's condition or prevent further regression so that services will no longer be 
33.33 	needed;
34.1 	(6) utilized and exhausted other community-based mental health services, or clinical 
34.2 	evidence indicates that such services cannot provide the level of care needed; and
34.3 	(7) was referred for treatment in a psychiatric residential treatment facility by a qualified 
34.4 	mental health professional licensed as defined in section 245.4871, subdivision 27, clauses 
34.5 	(1) to (6).
34.6 	(b) A mental health professional making a referral shall submit documentation to the 
34.7 	state's medical review agent containing all information necessary to determine medical 
34.8 	necessity, including a standard diagnostic assessment completed within 180 days of the 
34.9 	individual's admission. Documentation shall include evidence of family participation in the 
34.10 	individual's treatment planning and signed consent for services.

34.11 	Sec. 38. Minnesota Statutes 2018, section 256B.0941, subdivision 3, is amended to read:
34.12 		Subd. 3.Per diem rate. (a) The commissioner shall establish a statewide per diem rate 
34.13 	for psychiatric residential treatment facility services for individuals 21 years of age or 
34.14 	younger. The rate for a provider must not exceed the rate charged by that provider for the 
34.15 	same service to other payers. Payment must not be made to more than one entity for each 
34.16 	individual for services provided under this section on a given day. The commissioner shall 
34.17 	set rates prospectively for the annual rate period. The commissioner shall require providers 
34.18 	to submit annual cost reports on a uniform cost reporting form and shall use submitted cost 
34.19 	reports to inform the rate-setting process. The cost reporting shall be done according to 
34.20 	federal requirements for Medicare cost reports.
34.21 	(b) The following are included in the rate:
34.22 	(1) costs necessary for licensure and accreditation, meeting all staffing standards for 
34.23 	participation, meeting all service standards for participation, meeting all requirements for 
34.24 	active treatment, maintaining medical records, conducting utilization review, meeting 
34.25 	inspection of care, and discharge planning. The direct services costs must be determined 
34.26 	using the actual cost of salaries, benefits, payroll taxes, and training of direct services staff 
34.27 	and service-related transportation; and
34.28 	(2) payment for room and board provided by facilities meeting all accreditation and 
34.29 	licensing requirements for participation.
34.30 	(c) A facility may submit a claim for payment outside of the per diem for professional 
34.31 	services arranged by and provided at the facility by an appropriately licensed professional 
34.32 	who is enrolled as a provider with Minnesota health care programs. Arranged services must 
34.33 	be billed by the facility on a separate claim, and the facility shall be responsible for payment 
35.1 	to the provider may be billed by either the facility or the licensed professional. These services 
35.2 	must be included in the individual plan of care and are subject to prior authorization by the 
35.3 	state's medical review agent.
35.4 	(d) Medicaid shall reimburse for concurrent services as approved by the commissioner 
35.5 	to support continuity of care and successful discharge from the facility. "Concurrent services" 
35.6 	means services provided by another entity or provider while the individual is admitted to a 
35.7 	psychiatric residential treatment facility. Payment for concurrent services may be limited 
35.8 	and these services are subject to prior authorization by the state's medical review agent. 
35.9 	Concurrent services may include targeted case management, assertive community treatment, 
35.10 	clinical care consultation, team consultation, and treatment planning.
35.11 	(e) Payment rates under this subdivision shall not include the costs of providing the 
35.12 	following services:
35.13 	(1) educational services;
35.14 	(2) acute medical care or specialty services for other medical conditions;
35.15 	(3) dental services; and
35.16 	(4) pharmacy drug costs.
35.17 	(f) For purposes of this section, "actual cost" means costs that are allowable, allocable, 
35.18 	reasonable, and consistent with federal reimbursement requirements in Code of Federal 
35.19 	Regulations, title 48, chapter 1, part 31, relating to for-profit entities, and the Office of 
35.20 	Management and Budget Circular Number A-122, relating to nonprofit entities.

APPENDIX 

Repealed Minnesota Statutes: 19-4395 

256I.05 MONTHLY RATES.Subd. 3.Limits on rates. 
When a room and board rate is used to pay for an individual's room and board, the rate payable to the residence must not exceed the rate paid by an individual not receiving a room and board rate under this chapter.