Legislative changes for licensed and certified programs

Licensing moratorium changes: Changes were made to licensing moratorium exception 245A.03, subd. 7 (a) (5) to now include people receiving customized living services under an elderly waiver. The individual is no longer required to have been residing in the customized living facility before July 1, 2022. The date the exception is available has been extended to December 31, 2023. Changes were also made to licensing moratorium exception 245A.03, subd. 7 (a) (1) to clarify that this exception is to ensure people age 55 and older living in settings who want and need to access corporate foster care services are able to do so. Effective May 25, 2023. Chapter 61, Article 1, Section 2 and Chapter 50, Article 1, Section 14

Prone restraint and contraindicated restraint prohibitions: A prone restraint is a physical or mechanical restraint that places a person in a face-down position. New requirements for all licensed and certified programs prohibit the use of prone restraints except in the specific brief instances listed in statute. Additionally, programs must not use any type of restraint that is contraindicated for a person's known medical or psychological conditions. The program must assess and document these contraindications prior to using restraints on a person. Effective July 1, 2023. Chapter 70, Article 17, Section 19

Documenting first date of direct contact: License holders must document the first date that each background study subject has direct contact with a person served at the program. The program must provide this date to DHS upon request. Effective January 1, 2024. Chapter 70, Article 17, Section 13

Certified Child Care Center Implementation Plan for 2023 Legislative Changes

Licensed Child Care Centers Implementation Plan for 2023 Legislative Changes

Non-profit controlling individuals: The 2023 Legislature made changes to the definitions for owner and controlling individual in Minnesota Statutes, section 245A.02 to include a nonprofit corporation as a type of owner of a licensed program and therefore also a controlling individual. Programs with a nonprofit corporation included as a controlling individual will be able to change their board of directors without having to apply for a new license. This will eliminate a burdensome and redundant licensing process for nonprofit corporations that other types of organizations are not required to complete. The new language also clarifies that the definition of a controlling individual includes the president and treasurer of the board of directors of a nonprofit corporation. Effective July 1, 2023. Chapter 70, Article 17, Sections 9 and 10

Department of Children, Youth, and Families: The state of Minnesota is working on a transition to create a new Department of Children, Youth, and Families (DCYF). Several programs serving children and youth that are currently the responsibility of the Minnesota Departments of Human Services, Public Safety, and Education will be included in the transfer to the new Department. A commissioner for this new cabinet-level agency will be appointed by July 1, 2024, with the complete transfer of programs completed by July 1, 2025. There are no immediate changes. A new Implementation Office within Minnesota Management and Budget will guide the transition, in consultation with the relevant departments. Licensing will share more information as it becomes available.

Maltreatment of Minors Act (MOMA) training: In addition to the orientation training, programs must also train each mandatory reporter annually on the maltreatment of minors reporting requirements and definitions in Minnesota Statutes, Chapter 260E. Effective January 1, 2024. Chapter 70, Article 8, Section 36

Documenting first date of direct contact: License holders must document the first date that each background study subject has direct contact with a person served at the program. The program must provide this date to DHS upon request. Effective January 1, 2024. Chapter 70, Article 17, Section 13

Prone restraint and contraindicated restraint prohibitions: A prone restraint is a physical or mechanical restraint that places a person in a face-down position. New requirements for all licensed and certified programs prohibit the use of prone restraints except in the specific brief instances listed in statute. Additionally, programs must not use any type of restraint that is contraindicated for a person's known medical or psychological conditions. The program must assess and document these contraindications prior to using restraints on a person. Effective July 1, 2023. Chapter 70, Article 17, Section 19

Department of Children, Youth, and Families: The state of Minnesota is working on a transition to create a new Department of Children, Youth, and Families (DCYF). Several programs serving children and youth that are currently the responsibility of the Minnesota Departments of Human Services, Public Safety, and Education will be included in the transfer to the new Department. A commissioner for this new cabinet-level agency will be appointed by July 1, 2024, with the complete transfer of programs completed by July 1, 2025. There are no immediate changes. A new Implementation Office within Minnesota Management and Budget will guide the transition, in consultation with the relevant departments. Licensing will share more information as it becomes available.

Infant safe sleep: New language has been added to Minnesota Statutes, section 245A.1435 to align with the American Association of Pediatrics’ (AAP) recommendations for infant safe sleep and to provide greater clarity for license holders. When an infant is placed down to sleep, the infant’s pacifier cannot have anything attached to it and the infant’s clothing or sleepwear cannot have weighted materials, a hood, or a bib. An infant may wear a helmet while sleeping if the license holder has specific documentation. A plain language definition of swaddling has been incorporated, as well as clarity on the type of sleepwear that is appropriate for swaddling. License holders have the option to request a variance to permit the use of a cradleboard, if requested by a parent or guardian for a cultural accommodation. Effective January 1, 2024. Chapter 70, Article 8, Sections 4, 19, 20, and 21

Child foster care license holder qualifications: Language has been added in 245A.11, subd. 12, similar to the “personal characteristics of applicants” found in Minnesota Rules 2960.3060, Subp. 3. The new language makes clear that these are ongoing expectations, and not just at the time of application. Effective January 1, 2024. Chapter 70, Article 8, Section 17

Maltreatment of Minors Act (MOMA) training: In addition to the orientation training, programs must also train each mandatory reporter each year on the maltreatment of minors reporting requirements and definitions in Minnesota Statutes, chapter 260E. Effective January 1, 2024. Chapter 70, Article 8, Section 36

Documenting first date of direct contact: License holders must document the first date that each background study subject has direct contact with a person served at the program. This does not apply to family child foster care. The program must provide this date to DHS upon request. Effective January 1, 2024. Chapter 70, Article 17, Section 13

Children's Residential Facilities: 2023 Legislative changes and program implementation

Prone and contraindicated restraint prohibitions: A prone restraint is a physical or mechanical restraint that places a person in a face-down position. New requirements for all licensed and certified programs prohibit the use of prone restraints except in the specific brief instances listed in statute. Additionally, programs must not use any type of restraint that is contraindicated for a person's known medical or psychological conditions. The program must assess and document these contraindications prior to using restraints on a person. Effective July 1, 2023. Chapter 70, Article 17, Section 19

Family Child Care fire code updates: Codifies the most current, applicable 2020 fire code standards for family child care and special family child care in MN Statutes 245A, the Human Services Licensing Act. Effective July 1, 2023. Chapter 70, Article 8, Sections 18 and 32-35

ELICI use required for county licensors: Requires all county family child care licensors to use the Electronic Licensing Inspection Checklist Information (ELICI) to log information collected during a licensing review or investigation. Effective July 1, 2023. Chapter 70, Article 8, Section 24

Infant safe sleep: New language has been added to Minnesota Statutes, section 245A.1435 to align with the American Association of Pediatrics’ (AAP) recommendations for infant safe sleep and to provide greater clarity for license holders. When an infant is placed down to sleep, the infant’s pacifier cannot have anything attached to it and the infant’s clothing or sleepwear cannot have weighted materials, a hood, or a bib. An infant may wear a helmet while sleeping if the license holder has specific documentation. A plain language definition of swaddling has been incorporated, as well as clarity on the type of sleepwear that is appropriate for swaddling. License holders have the option to request a variance to permit the use of a cradleboard, if requested by a parent or guardian for a cultural accommodation. Effective January 1, 2024. Chapter 70, Article 8, Sections 4, 19, 20, and 21

Nonprofit controlling individuals: The 2023 Legislature made changes to the definitions for owner and controlling individual in Minnesota Statutes, section 245A.02 to include a nonprofit corporation as a type of owner of a licensed program and therefore also a controlling individual. Programs with a nonprofit corporation included as a controlling individual will be able to change their board of directors without having to apply for a new license. This will eliminate a burdensome and redundant licensing process for nonprofit corporations that other types of organizations are not required to complete. The new language also clarifies that the definition of a controlling individual includes the president and treasurer of the board of directors of a nonprofit corporation. Effective July 1, 2023. Chapter 70, Article 17, Sections 9 and 10

Prone and contraindicated restraint prohibitions: A prone restraint is a physical or mechanical restraint that places a person in a face-down position. Licensed and certified programs are prohibited from using prone restraints except in the specific brief instances listed in statute. Additionally, programs must not use any type of restraint that is contraindicated for a person's known medical or psychological conditions. The program must assess and document these contraindications prior to using restraints on a person. Effective July 1, 2023. Chapter 70, Article 17, Section 19

IRTS/RCS (245I.23) Programs: 2023 Legislative changes and program implementation

Certified Mental Health Clinics (245I.20): 2023 Legislative changes and program implementation

Psychiatric Residential Treatment Facilities: 2023 Legislative changes and program implementation

Residential Facilities for Adults with Mental Illness: 2023 Legislative changes and program implementation

Substance Use Disorder Treatment Programs: 2023 Legislative changes and program implementation

Withdrawal Management and Detoxification Programs: 2023 Legislative changes and program implementation

Adult foster care (AFC) and community residential setting (CRS) license capacity: This section is dependent on federal approval. New language temporarily modifies the existing fifth bed variance for AFCs and CRSs to allow for up to six beds for emergency crisis and respite services. This allowance for up to six beds expires 365 days after federal approval. This section also clarifies that AFC and CRS with a capacity up to six are not required to also be licensed as an adult residential mental health program. Chapter 98, Article 4, Section 12

Vulnerable Adults Act definitions: The vulnerable adult maltreatment law definitions for abuse, caregiver, and neglect changed to provide more clarity. Effective July 1, 2022. Chapter 98, Article 8, Sections 47-49

Physician Assistant: Physician assistant was added as an alternative in several areas of statute that previously required a physician or advanced practice registered nurse. This includes the family adult day services (FADS) requirements in Minnesota Statutes, 245A.143, subdivisions 2, 7, and 8. These changes are effective August 1, 2022. Chapter 58, Sections 96-98

Injury reporting: Minnesota Statutes, chapter 245H.11 outlines when a certified child care center must report an injury to a child in the program to the Department of Human Services. New language has been added to require this report to occur when a child’s injury required treatment by a physician, an advanced practice registered nurse (APRN), or a physician assistant. Previously, the statute only mentioned treatment by a physician or APRN. This change is effective August 1, 2022. Chapter 58, Section 112

Alternative sleeping position for an infant: Language was added to the safe sleep statute, Minnesota Statutes, 245A.1435, to also allow a physician assistant to direct an alternative sleeping position for an infant. Previously the statute only allowed a physician or advanced practice registered nurse to provide this direction. This change is effective August 1, 2022. Chapter 58, Section 99

Foster Youth Ombudsperson: A new Office of the Foster Youth Ombudsperson is created. A Board of the Foster Youth Ombudsperson will oversee and make recommendations to the ombudsperson. Chapter 63

Alternative sleeping position for an infant: Language was added to the safe sleep statute, Minnesota Statutes, 245A.1435, to also allow a physician assistant to direct an alternative sleeping position for an infant. Previously the statute only allowed a physician or advanced practice registered nurse to provide this direction. This change is effective August 1, 2022. Chapter 58, Section 99

Children’s Residential Facilities: 2022 Legislative changes and program implementation

Primary provider of care for Special Family Child Care. This language authorizes the primary provider of care for a special family child care program to communicate on matters related to licensing. It also adds primary provider of care to the definition of controlling individual. Chapter 98, Article 12, Sections 1 and 2

Child care regulation modernization pilot project authorization. This section gives DHS the authority to conduct and administer pilot projects to test methods and procedures for the family child care and child care center regulation modernization projects. Chapter 98, Article 12, Section 19

Physician assistant direction for alternative sleeping position. This section adds physician assistants as professionals who can direct an alternative sleeping position for an infant in a licensed program. Chapter 58, Section 99

Adult foster care (AFC) and community residential setting (CRS) license capacity – This section is dependent on federal approval. The new language temporarily modifies the existing fifth bed variance for AFCs and CRSs to allow for up to six beds for emergency crisis and respite services. This allowance for up to six beds expires 365 days after federal approval. This section also clarifies that AFCs and CRSs with a capacity up to six are not required to also be licensed as an adult residential mental health program. Chapter 98, Article 4, Section 12. 

HCBS service termination – This section provides additional clarity on service terminations for 245D services. One change to note is that staff are now specifically identified as persons whose health and safety may be considered when determining if services need to be terminated. Chapter 98, Article 5, Section 1. 

Remote adult day – This section establishes remote adult day as a permanent option for adult day services. This language takes effect on Jan. 1, 2023. Chapter 98, Article 7, Sections 1-7. 

Vulnerable adult maltreatment definitions – Vulnerable adult maltreatment law definitions for abuse, caregiver, and neglect changed to provide more clarity. Chapter 98, Article 8, Sections 47-49. 

Changes to terminology – Effective July 1, 2022, the term “coordinated service and support plan” will change to “support plan.” The term “community support plan” will change to “assessment summary.” Chapter 98, Article 17, Section 26. 

Physician assistants – Physician assistant was added as an alternative to a physician in several requirements that previously included a physician. These changes are effective Aug. 1, 2022. Chapter 58, Sections 102-104.

Uniform Service Standards (USS) corrections: Several changes were made to update, clarify, or improve the USS requirements in Minnesota Statutes, chapter 245I. 

These include a clarification or change that: 

• Allows providers to use another tool DHS authorizes instead of the Level of Care Utilization System for Psychiatric and Addiction Services (LOCUS) (Chapter 98, Article 4, Section 18)
• Clarifies that the definition of a staff person includes staff that do not provide services but only if the staff has physical access to clients (Chapter 98, Article 4, Section 19)
• Specifies that only providers that use volunteers must have a policy about volunteers (Chapter 98, Article 4, Section 21)
• Updates mental health practitioner qualifications to align with previous statutory changes (Chapter 98, Article 4, Section 22)
• Clarifies the types of mental health rehabilitation workers and mental health practitioners that must complete additional training hours before providing services (Chapter 98, Article 4, Section 23)
• Removes requirement for the staff person’s printed name on each progress note. The note still must include the staff person’s signature. (Chapter 98, Article 4, Section 24)
• Clarifies the parts of the record retention requirements that apply only to programs that close (Chapter 98, Article 4, Section 25)
• Corrects the items in a diagnostic assessment a program can delay to avoid retraumatizing or harming the client's willingness to engage in treatment (Chapter 98, Article 4, Section 27), and
• Corrects statutory cross references (Chapter 98, Article 4, Sections 20, 26, and 29).

Effective October 17, 2022.

Locked Programs: For programs that lock the exit doors to prohibit clients from leaving, adds licensing requirements to Minnesota Statutes, section 245I.23, to formalize existing practices and standards. Locked programs must meet applicable building and fire codes and have an appropriate health department license. Policies and procedures must include information about the court orders that authorize the program to prohibit clients from leaving. Each client must be informed of either the right to the leave the facility or that they cannot leave the facility due to a court order. Client treatment plans must reflect the restriction to the facility. Effective October 17, 2022. Chapter 99, Article 1, Section 13.

Vulnerable adult maltreatment definitions: Vulnerable adult maltreatment law definitions for abuse, caregiver, and neglect changed to provide more clarity. Programs should update any policies or training materials that contain these definitions with the new versions. Effective July 1, 2022. Chapter 98, Article 8, Sections 47 to 49.

Physician assistants: Background study laws now include physician assistants in addition to physicians and advanced practice registered nurses in relation to the serious maltreatment definition and continuous affiliation requirements. Effective August 1, 2022. Chapter 58, sections 100 and 101.

Uniform Service Standards (USS) corrections: Several changes were made to update, clarify, or improve the USS requirements in Minnesota Statutes, chapter 245I.

These include a clarification or change that:

• Clarifies that the definition of a staff person includes staff that do not provide services but only if the staff has physical access to clients (Chapter 98, Article 4, Section 19)
• Specifies that only providers that use volunteers must have a policy about volunteers (Chapter 98, Article 4, Section 21)
• Updates mental health practitioner qualifications to align with previous statutory changes (Chapter 98, Article 4, Section 22)
• Clarifies the types of mental health practitioners that must complete additional training hours before providing services (Chapter 98, Article 4, Section 23)
• Removes requirement for the staff person’s printed name on each progress note. The note still must include the staff person’s signature. (Chapter 98, Article 4, Section 24)
• Clarifies the parts of the record retention requirements that apply only to programs that close (Chapter 98, Article 4, Section 25)
• Corrects the items in a diagnostic assessment a program can delay to avoid retraumatizing or harming the client's willingness to engage in treatment (Chapter 98, Article 4, Section 27)
• Specifies the requirement to document case reviews (Chapter 98, Article 4, Section 28), and
• Corrects statutory cross references (Chapter 98, Article 4, Section 20).

Effective October 17, 2022.

Staff to resident ratio: Lowers staff to resident ratio requirements during normal sleeping hours to allow programs to have one staff person for every six residents present within a living unit. This change also requires a provider to adjust sleeping-hour staffing levels if the clinical needs of the residents in the facility require more staff for the clients. Facilities will need to update policies and procedures to reflect this new ratio. Effective July 1, 2022. Chapter 98, Article 6, Section 8. 

Vulnerable adult maltreatment law definitions: Vulnerable adult maltreatment law definitions for abuse, caregiver, and neglect changed to provide more clarity. Programs should update any policies or training materials that contain these definitions with the new versions. Effective July 1, 2022. Chapter 98, Article 8, Sections 47 to 49. 

Physician assistants: Background study laws now include physician assistants in addition to physicians and advanced practice registered nurses in relation to the serious maltreatment definition and continuous affiliation requirements. Effective August 1, 2022. Chapter 58, sections 100 and 101.

Vulnerable adult maltreatment law definitions: Vulnerable adult maltreatment law definitions for abuse, caregiver, and neglect changed to provide more clarity. Programs should update any policies or training materials that contain these definitions with the new versions. Effective July 1, 2022. Chapter 98, Article 8, Sections 47 to 49. 

Physician assistants: Background study laws now include physician assistants in addition to physicians and advanced practice registered nurses in relation to the serious maltreatment definition and continuous affiliation requirements. Effective August 1, 2022. Chapter 58, sections 100 and 101.

Substance Use Disorder Treatment: 2022 Legislative changes and program implementation

Withdrawal Management and Detoxification Programs: 2022 Legislative changes and program implementation

Modernizing child care center regulations: DHS will contract with an independent organization or individual consultant to: 1) develop a proposal for updated child care center licensing standards, 2) develop a proposal for a risk-based model for monitoring compliance with child care center licensing standards, and 3) determine which child care centers should be eligible for abbreviated inspections. The organization or consultant will implement a stakeholder engagement process to solicit input and use national regulatory best practices and statistical methodologies to inform their work.

The Minnesota Legislature made changes in 2021 for family child care. Information about these changes is available in this Implementation Plan (PDF)

• Child foster care background study reform: The legislature passed a major reform to the background study process for family child foster care. The new law better aligns the background study requirements for family child foster care licensure with the federal Adam Walsh background study requirements. The list of disqualifying crimes was reviewed and some crimes were removed, while others were assigned a five-year or permanent disqualification. There will no longer be seven and ten-year disqualifications, or seven and ten-year bars to setting aside a disqualification. The bill also establishes a process for counties and private agencies to review nondisqualifying background study information before making a recommendation to grant, deny, or revoke a license. These changes were given a delayed effective date of July 1, 2022, to allow time for staffing, technology updates, and training required for implementation. Note: these changes only relate to family child foster care and do not impact foster residence settings.
• Child foster care licensing guidelines: By July 1, 2023, the Commissioner is directed to consult with stakeholders and develop family foster setting licensing guidelines for county and private agencies. DHS Licensing and Child Safety and Permanency will work jointly on this initiative and be hiring positions to support this work. 
• Family First Prevention Services Act (FFPSA): Federal standards in the FFPSA require residential programs for children to meet specific requirements if a county uses Title IV-E funds to pay for the child in the program. Four types of specialized setting certifications have been established in Minnesota to help ensure that programs meet the federal requirements for these types of settings. A program’s decision to add these certifications to a license will depend on whether or not a county uses Title IV-E funds for children in the facility or setting. DHS Licensing will complete license certifications for all children's residential facilities and foster residence settings. More information about these certifications is on the FFPSA Specialized Settings License Certifications website. Please note that there is no change to the county/private agency licensing process for foster residence settings.
• Documentation of first date working in a program: Effective August 1, 2021, child foster residence setting license holders must document the first date a background study subject begins working in a program to demonstrate compliance with background study laws. This includes both background study subjects who have direct contact and those who do not have direct contact with persons served by the program.

• Family Adult Foster Care Home definition: A definition of “family adult foster care home” has been added to Minnesota Statutes, Chapter 245A, effective August 1, 2021. It makes clear that the license holder must live in the residence and be the primary caregiver. This is the same definition that was previously in section 144D.01, Subd. 7.
• Licensing moratorium language: With the implementation of assisted living licensure by the Minnesota Department of Health, Minnesota Statutes, Chapter 144D will be repealed on August 1, 2021. Changes were made to the licensing moratorium language in 245A.03, Subd. 7 (1) to remove the obsolete 144D citation and maintain the moratorium exception for programs serving this population.

The 2021 Legislature changed several laws that impact the Department of Human Services (DHS) licensed substance use disorder treatment programs.

Substance Use Disorder Treatment: 2021 Legislative Changes (PDF)

Effective July 1, 2021

Annual license fee: Withdrawal management programs must pay an annual license fee based on the licensed capacity as described below. A detoxification program that also operates a withdrawal management program at the same location will not have to pay an additional fee. Dually licensed programs will only pay one fee based on the licensed capacity of the program with the higher overall capacity. The capacity of the program determines the amount of the fee as follows:

Licensed Capacity	License Fee
1 to 24 persons	$760
25 to 49 persons	$960
50 or more persons	$1,160

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The fee amounts are the same as the existing fees for detoxification programs. Please see, Minnesota Session Laws - 2021, 1st Special Session, Chapter 7, Article 2, Section 6 for this change.

Effective July 1, 2021

Family First Prevention Services Act (FFPSA) license certifications: Federal standards in the Family First Prevention Services Act (FFPSA) require residential programs for children to meet specific requirements if a county uses Title IV-E funds to pay for the child in the program. Four types of specialized setting certifications have been established in Minnesota to help ensure that programs meet the federal requirements for these types of settings. A program’s decision to add these certifications to a license will depend on whether or not a county uses Title IV-E funds for children in the facility or setting. More information about these certifications is on the license certification webpage. 

Effective August 1, 2021 

Documentation of first date working in a program: License holders must document the first date a background study subject begins working in a program to demonstrate compliance with background study laws. This includes both background study subjects who have direct contact and those who do not have direct contact with persons served by the program.

Effective July 1, 2022, or upon federal approval, whichever is later

Mental Health Uniform Service Standards: The licensing requirements in the Intensive Residential Treatment Services/Residential Crisis Stabilization (IRTS/RCS) variance will end and be replaced with the new updated requirements in Minnesota Statutes, chapter 245I. Although some of the new requirements will be similar to existing standards, several areas will change. DHS will send an implementation plan to providers later this year that will contain information on how the new requirements are different from the existing ones and the steps to take to meet the new requirements. Please see Minnesota Session Laws - 2021, Regular Session, Chapter 30, Article 15, Sections 1 to 14 and 16 for the requirements.

Effective July 1, 2022, or upon federal approval, whichever is later

Mental Health Uniform Service Standards: The mental health clinic certification requirements in Minnesota Rules, parts 9520.0750 to 9520.0870 (Rule 29) will be repealed and replaced with the new updated requirements in Minnesota Statutes, chapter 245I. Although some of the new requirements will be similar to existing standards, several areas will change. DHS will send an implementation plan to providers later this year that will contain information on how the new requirements are different from the existing ones and the steps to take to meet the new requirements. Please see Minnesota Session Laws - 2021, Regular Session, Chapter 30, Article 15, Sections 1 to 13 and 15 for the requirements.

• 2020 Substance Use Disorder Treatment Programs Legislative Changes
• 2020 Withdrawal Management Programs Legislative Changes
• 2020 Children's Residential Facilities Legislative Changes

• 2020 Legislative Changes for Child Care Centers

• 2020 Legislative Changes for Certified Child Care Centers

The Implementation Plan DHS-4380 (PDF) for changes made by the 2020 Legislature that impact licensing requirements for family child care programs.

• 2020 Child Foster Residence Settings Implementation Plan

• 2020 HCBS Implementation Plan

New definition of residential program for chapter 245D: The new law clarifies the definition of residential program for the purposes of HCBS provided under chapter 245D to spell out when a provider needs a residential setting license. (Effective: Jan. 1, 2020)

Changes for certified license-exempt child care center providers - effective Sept. 30, 2019

• Due process rights: Certified centers that are denied certification may request reconsideration. Those that lose certification, including due to a finding of maltreatment or revocation of child care assistance payment authorization, may request reconsideration.
• Risk reduction plan: Certified centers must create a basic plan to minimize risks focusing on traffic, water, and electrical hazards. 
• Supervision of children: Certified centers must follow basic supervision requirements. Staff may allow for variation based upon the ages and needs of the children and must intervene when necessary to ensure a child’s safety.
• Emergency plan: Certified centers must include accommodations for infants and toddlers in their emergency plan if their program serves those ages.
• Behavior guidance: Certified centers must ensure staff and volunteers use positive behavior guidance and prohibit staff from engaging in behavior that may harm children. 
• Written policies: Certified centers must maintain written health and safety policies and reporting abuse and neglect policies.
• Fire marshal inspection options: Certified centers that need a fire inspection will be required to pay $50 to the state fire marshal for the inspection.
• Training requirements: The certified center director, all staff, substitutes and unsupervised volunteers must receive Pediatric First Aid and CPR, Child Development, Orientation and In-Service training initially and ongoing. If applicable, these individuals must also complete Sudden Unexpected Infant Death and Abusive Head Trauma Prevention training. There is no minimum number of hours required for substitutes or unsupervised volunteers. These changes bring Minnesota into compliance with the federal Child Care Development Block Grant Reauthorization Act of 2014.
• Renewal deadlines: All training and reviews of policies are moved from annual to calendar year.

Changes for child care center providers - effective Sept. 30, 2019

• In-service training hours: The overall number of in-service training hours each calendar year is reduced to 24 hours for staff who work 20+ hours/week and 12 hours for those who work less than 20 hours/week. In addition, it clarifies who needs to complete in-service training and what types of training need to be completed at specific frequencies. 
• Supervision policy: Within the licensed space, a school-age child may use the restroom and retrieve items from a cubby/locker without direct sight and sound supervision. A program staff person must have knowledge of the child’s whereabouts and check on the child at least every five minutes.
• Reusable water bottle and cup policy: Centers that develop a written policy that includes all requirements and follow Minnesota food code sanitation and health requirements may offer children drinking water in a reusable water bottle or cup rather than a disposable cup. A variance will no longer be required.
• Training requirements: The center director, all staff, substitutes and unsupervised volunteers must receive Orientation, Child Development, First Aid, and CPR training initially and ongoing. If applicable, these individuals must also complete Sudden Unexpected Infant Death, Abusive Head Trauma Prevention, and Child Passenger Restraint System training. Training documentation must now include the person’s first date of direct contact and first date of unsupervised contact with children. These changes bring Minnesota into compliance with the federal Child Care Development Block Grant Reauthorization Act of 2014. 
• Emergency plan: Centers must include accommodations for infants and toddlers in their emergency plan. 
• Telephone requirement: A cell phone may be used to meet the requirement to have a telephone located within the center as long as certain requirements are met.
• Transporting children in care: Training on the proper use and installation of child restraint systems is required before transporting a child under 8 years old (previous requirement was under 9 years old). Anyone with a current, valid driver’s license may transport children. The driver is not required to have a Minnesota driver’s license.
• Renewal deadlines: Most training and review of policies are moved from annual to calendar year.

CARS training: Effective September 30, 2019, a variance to the child passenger restraint systems training requirement may be granted for an emergency relative placement, so long as the individual has completed an approved child seat safety check up and repeats the checkup each time the child needs a different size car seat.
Additionally, the age for which training on the proper use and installation of child restraint systems in motor vehicles is required is reduced for transporting children under 9-years-old to children under 8-years-old.

Variances for capacity: Effective October 1, 2019, the conditions under which a county can grant a variance for exceeding capacity will change to bring Minnesota into compliance with new federal requirements. Any variances for capacity that are issued prior to October 1, 2019, will remain in effect until January 1, 2020.

Changes for family child care providers - effective Sept. 30, 2019 (unless otherwise noted)

• Use of substitutes: Providers can now use substitute caregivers for up to 500 hours annually rather than 30 days in a calendar year. Providers must document the substitute caregivers’ names and the dates and number of hours for which they provided care. 
• Variance for extended use of substitutes: DHS may grant time-limited variances to providers who need to use substitute caregivers for more than 500 hours annually. Providers who are granted variances must notify parents and guardians. 
• Supervision of provider’s own child: This law clarifies that under certain conditions an individual who is related to the provider may be in the home and may supervise the provider’s own child without completing training requirements. 
• Emergency replacement: In an emergency, when a provider needs to close down their business for the day, an adult who has not completed training or a background study may stay with the children if certain conditions are met. 
• Fire code: The law updates family child care fire code standards to align with the State Fire Code, almost of all of which are a reduction in requirements. 
• Clarification when requirements are disputed: Providers may seek clarification from DHS if they dispute their county licensor’s interpretation of a licensing requirement during a licensing inspection or exit interview. County licensors cannot issue a correction order for the disputed licensing requirement until DHS has provided clarification to the licensor and provider about the requirement. 
• Emergency preparedness plan: Emergency plans will need to include how providers would accommodate infants and toddlers in the case of an emergency. DHS will be updating the template emergency plan and, for those who want to simply add to their current plan, providing an additional page that can be filled out and attached. Although the plan will need to be available upon request of a parent/guardian, providers no longer need to post or share emergency plans with parents or guardians.     
• Changes to telephone requirements: Providers are no longer required to post emergency numbers by their phones. The law also clarifies that a cell phone can be used to meet the telephone requirement. 
• Reporting suspected child maltreatment policies and procedures: Providers will need to use DHS’ policies and procedures for reporting suspected child maltreatment. 
• Training requirements following relocation: A licensed child care provider who relocates within the state does not need to complete orientation training. 
• Child care background study subject: The law clarifies when volunteers, contractors and others need a background study. (This change does not impact household members or employees. As noted above, we will provide more details in an upcoming implementation plan on background studies, which will be emailed before July 1.) (Effective: July 1, 2019) 

Changes for licensors - effective Sept. 30, 2019 (unless otherwise noted)

• Reporting fires in providers’ homes by county agencies: Licensors will need to report to DHS and the State Fire Marshal when there is a fire in a family child care setting that required the service of a fire department. 
• Exit interviews: Licensors cannot issue a correction order or negative licensing action for violations of rule or law that are not discussed during an exit interview, unless the provider does not participate in or complete the exit interview. 
• Licensing data: Correction orders and licensing fines that are more than seven years old will be classified as private data, which means they cannot be made available to the general public upon request. (Effective: Aug. 1, 2019) 
• Mandatory fraud reporting: Licensors must immediately report any suspected fraud to county human services investigators or the DHS Office of Inspector General. (Effective: July 1, 2019)

Changes for DHS—effective Sept. 30, 2019 (unless otherwise noted)

• Family Child Care Task Force: A family child care task force will convene to discuss family child care topics. (The first meeting must be held by Aug. 15, 2019.) 
• License format: The language printed on licenses is changing. The licenses will now state that parents who have questions about their child’s care may call the licensing agency. DHS will reduce the size of the font used to print the licensing agency’s telephone number because it is no longer required to print the telephone number in bold and large font. In making the required changes to the license, DHS took the opportunity to update the design and logo at the same time. DHS reformatted and updated the logo on all DHS licenses so the new licenses will look different from the current licenses. Starting this week, all new licenses will be printed with the new format. Regardless of their license renewal date, all current providers will receive a new license printed with the new format within the next month. (Effective day following final enactment) 
• Plain-language handbook: By Jan. 1, 2020, DHS will develop a plain-language handbook that describes the process and requirements to become a licensed family child care provider.  
• Record keeping and documentation requirements: DHS will review child care licensing and background studies record keeping and documentation requirements to identify if they could be streamlined. DHS will establish a process for providers to submit information to DHS electronically. 
• Correction order analysis: DHS will review licensing inspection results to identify trends and inconsistencies and provide training if necessary.  
• Special family child care: The law clarifies that when there are two or more licensed providers operating their programs in the same building, each program must function as a distinct program and follow applicable rules and laws. It expands the availability of this type of care by allowing the commissioner to grant variances for: primary care providers, nonprofit organizations, church or religious organizations, employers, or community collaboratives to be licensed as special family child care providers. 
• Additional background study databases: Background studies will include a search of three additional name-based databases to meet federal requirements. DHS will initiate these additional searches; this will not impact what is required to be entered in NETStudy 2.0 and will not increase background study fees. (Effective for studies initiated after July 1, 2019) 
• Background study clearance notice: The commissioner may issue a clearance notice for a background study subject who has resided in another state within the past five years if 1) another state has not responded to a request for criminal, sex offender, or maltreatment information after 10 days, and 2) the lack of a response from another state is the only reason that the study could not be cleared. (Effective: July 1, 2019) 

Changes for Home and Community Based Services - effective July 1, 2019

• Service plan review and evaluation: When license holders annually meet with a person and their legal representative and case manager, the discussion must include how technology might be used to meet the person’s desired outcomes. The coordinated service and support plan addendum must include a summary of this discussion. However, this does not require technology to be used for the provision of services.
• Annual training: The law eliminates the minimum number of hours that annual training required for direct service staff providing intensive or basic services. Direct service staff providing intensive or basic services still need to complete annual training on the same topics that are currently required.
• Alternative sources of training: DHS will no longer be responsible for preapproving trainings or approving alternative online trainings or competency based assessments.
• Positive support qualifications: The law modifies the titles and qualifications for staff replacing behavior support services with positive support services.
• New waiver services to chapter 245D applicability: The law updates the applicability section of chapter 245D to include new waiver services. (Effective Jan. 1, 2021, or upon federal approval, whichever is later)
• New definition of residential program for chapter 245D: The new law clarifies the definition of residential program for the purposes of HCBS provided under chapter 245D to spell out when a provider needs a residential setting license. (Effective: Jan. 1, 2020)
• Integrated community supports setting’s capacity report: License holders that provide integrated community supports must submit a setting’s capacity report to DHS. Only one license holder may deliver integrated community supports in a multifamily housing building. (Effective: Upon date of federal approval)

Changes for providers effective – July 1, 2019

• Definitions: The following terms are now defined: day of service initiation, group counseling, person-centered, staff member, treatment week and volunteer. The definitions for client and student intern are updated.
• Initial services plan: The timeline for completion is extended. The plan must be person-centered and client-specific. The standards for addressing the needs of the client are clarified.
• Comprehensive assessment: The timeline for completion is extended for nonresidential programs. Requirements for using a comprehensive assessment completed prior to service initiation are changed. Details were added to several assessment items.
• Assessment summary: The timeline for completion is clarified for nonresidential programs.
• Treatment plan: The timeline for completion is extended. The plans must be person-centered and updated based on the client's level of participation. Family involvement requirement is revised. Specific goals are added to the list of items required in the treatment plan. Nonresidential programs must document the specific services the client has an assessed need for and the plan to provide the services.
• Service discharge summary: Timeline for completion is simplified. Requires the program to provide the client a copy of the service discharge summary upon request. The list of items required in the summary is revised and is now the same regardless of discharge type.
• Treatment services: Peer recovery support services is changed from a required to an additional treatment service. Care coordination is renamed treatment coordination. Qualification requirements for people providing treatment services are changed. DHS will maintain a current list of the professionals qualified to provide treatment services. Programs may provide the following services off-site if certain conditions are met: therapeutic recreation, stress management and physical well-being, living skills development, employment services and educational services.
• Description of treatment services: The description must identify which services meet the definition of group counseling and must define the program's treatment week.
• Group size: The number of clients who are allowed to receive a group treatment service together is changed. The number of clients who are allowed in a group will now depend on the type of treatment service and the method of payment for the treatment service. Requirements for group sizes are in Minnesota Statutes, sections 245G.10, subdivision 4 and 254B.05, subdivision 5, paragraph (g) and programs must meet the requirements in both.
• Treatment coordinator: Qualifications for this position are revised. Mental health professionals, with substance use treatment and assessments within their scope of practice, may provide supervision to a treatment coordinator. Decreases the frequency of supervision from weekly to monthly.
• Recovery peer qualifications: Updates credentials required for the position.
• Indirect services: Eliminates the requirement for adolescent programs to allocate 25% of staff time to indirect services.
• Naloxone: Training requirements for administering naloxone are revised. 
• Opioid Treatment Programs: Requires programs to comply with existing requirements of other state and federal agencies. Prescribers, that are not physicians, may complete most duties currently required to be completed by a physician, if the prescriber meets the qualifications for a practitioner. The eight-point criteria now must be completed for take home doses for Sundays and state and federal holidays, in addition to all other days. Revises progress note and treatment plan review requirements. Prescription monitoring program requirements are revised. The medical director must be informed of possible diversion issues.
• Clients with children programs - fire code: Updates fire code standards to align with current State Fire Code. Most of the updates are a reduction in requirements.

Changes for providers effective – September 30, 2019

• Transporting children: Training on the proper use and installation of child passenger restraint systems is required before transporting a child under 8 years old (previous requirement was under 9 years old).

The 2018 law requires individuals affiliated with a DHS-licensed program to have a fingerprint-based FBI check if the individual :

• Currently lives outside of Minnesota or 
• Has lived outside of Minnesota in the last five years.  

This change is effective starting in August 2018.  More information will be posted on the DHS website and in NETStudy 2.0. The law also clarifies several sections of statute related to privacy notices and data retention. (Minnesota Laws 2018, Chapter 166)