Legislative changes for licensed and certified programs

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 crisis stabilization services: For children’s residential facilities with a mental health treatment or shelter certification, creates a new service type of crisis stabilization services that programs may choose to provide. Programs that provide crisis stabilization services must have the capacity to directly provide the treatment services the new standards include and program staff must have access to a mental health professional or clinical trainee by telephone or in-person within 30 minutes. Mental health treatment programs providing crisis stabilization are not required to complete a diagnostic assessment or treatment plan if a client is at the program for 35 days or less. Crisis stabilization programs must complete an immediate needs assessment within 12 hours and a crisis treatment plan within 24 hours of admission. Effective July 1, 2022. Chapter 99, Article 1, Section 12. 

Substance use disorder term: The more up-to-date term “substance use disorder” replaces the term “chemical dependency” in all Minnesota Statutes and Rules. Effective July 1, 2022. Chapter 98, Article 4, Section 51. 

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. 

Diagnostic assessments – mental health treatment: For children’s residential facilities with a mental health treatment certification, extends the timeframe to complete a diagnostic assessment from 5 days to within 10 days of a client’s admission. Mental health treatment programs must also meet the new diagnostic assessment requirements in Minnesota Statutes, section 245I.10, subdivision 6. Programs may still use a diagnostic assessment completed within 180 days prior to admission if certain conditions are met. Effective upon federal approval*. Chapter 98, Article 4, Section 7. Similar changes are also made by Chapter 99, Article 1, Section 8. 

Treatment plans – mental health treatment: Retains existing treatment plan requirements for children’s residential mental health treatment programs and exempts these programs from the new treatment plan requirements in the Uniform Service Standards (USS). These changes do not impact providers and retain existing standards. Effective upon federal approval*. Chapter 98, Article 4, Sections 6 and 8. 

*Changes will become effective along with the Uniform Service Standards (USS) upon federal approval of State Plan Amendments by the Centers for Medicare & Medicaid Services. We now anticipate this approval will occur by Sept. 15, 2022. 

Resident screening timeframes – mental health treatment: For children’s residential facilities with a mental health treatment certification, extends timeframes to complete resident screenings. This allows providers up to 10 days to complete the mental health, education, substance use disorder, and vulnerability screenings and assessment. The health screening and screening for sexually abusive behavior must still occur within the timeframes in Minnesota Rules, part 2960.0070, subpart 5, item C. Effective January 1, 2023, or upon federal approval, whichever is later. Chapter 99, Article 1, Section 8. 

Staff person substance use problems – substance use disorder treatment: For children’s residential facilities with a substance use disorder treatment certification, several changes simplify program personnel policy requirements for staff with substance use problems and align these standards for several different types of licensed programs. This eliminates requirements to be free from substance use problems prior to employment, employee attestation statements about problematic substance use, and archaic definitions of substance use problems. The new requirement to replace these standards is to have a personnel policy that describes the process for disciplinary action, suspension, or dismissal of a staff person if they violate the drug and alcohol policy required by the existing requirements in Minnesota Statutes, section 245A.04, subdivision 1, paragraph (c). The repeal of rule requirements are effective January 1, 2023 and DHS intends to make the other rule changes effective on this same date. Chapter 98, Article 12, Sections 20 and 21. 

Physician assistants: Adds physician assistants as professionals who can direct an alternative sleeping position for an infant in a licensed program. Includes physician assistants in relation to serious maltreatment definition and continuous affiliation requirements in background study laws. Effective August 1, 2022. Chapter 58, sections 99 to 101.

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 not yet effective 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 upon federal approval*.

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 upon federal approval*. Chapter 99, Article 1, Section 13.

*Changes made to the not yet effective Uniform Service Standards (USS) in Minnesota Statutes, chapter 245I will become effective with the rest of the USS requirements upon federal approval of State Plan Amendments by the Centers for Medicare & Medicaid Services. We now anticipate this approval will occur by Sept. 15, 2022.

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 not yet effective 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 upon federal approval. These changes made to the not yet effective Uniform Service Standards (USS) in Minnesota Statutes, chapter 245I will become effective with the rest of the USS requirements upon federal approval of State Plan Amendments by the Centers for Medicare & Medicaid Services. We now anticipate this approval will occur by Sept. 15, 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. Additionally, a provider must adjust sleeping-hour staffing levels based on the clinical needs of the residents in the facility. Facilities will need to update policies and procedures to reflect this new ratio. Effective upon federal approval*. Chapter 98, Article 6, Section 8. *Although this change in session law is effective July 1, 2022, federal approval of a State Plan Amendment by the Centers for Medicare & Medicaid Services is still necessary. 

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.

Medication administration: Unlicensed staff with appropriate training may now administer intramuscular injections of naloxone or epinephrine and may administer intranasally any type of medication. Effective June 3, 2022 (day following final enactment). Chapter 98, Article 12, Section 11. 

Licensed professionals in private practice definition: New language clarifies the activities of licensed professionals in private practice which require a substance use disorder treatment program license and the activities that do not require a program license. Effective June 3, 2022 (day following final enactment). Chapter 98, Article 12, Section 7. 

Alcohol and drug counselor definition: The definition for the term “alcohol and drug counselor” changes to include all types of licensed professionals that meet the qualifications in Minnesota Statutes, section 245G.11, subdivision 5. Effective June 3, 2022 (day following final enactment). Chapter 98, Article 12, Section 6. 

Methadone take-home dose clarification: For opioid treatment programs, the requirements for the number of unsupervised use methadone doses (take-home doses) a client may have now align with federal standards. Effective June 3, 2022 (day following final enactment). Chapter 98, Article 12, Section 17. 

Guest Speakers: Guest speakers may present information to clients as part of a treatment service while under the continuous direct observation of the alcohol and drug counselor that provides the service. The alcohol and drug counselor must visually observe and listen to the presentation of information by a guest speaker the entire time during the service. The new guidelines clarify that training requirements and background study laws apply to guest speakers but allows those that present one day a month or less to receive less orientation trainings. Effective July 1, 2022. Chapter 98, Article 4, Sections 15 to 17. 

Substance use disorder term: The more up-to-date term “substance use disorder” replaces the term “chemical dependency” in all Minnesota Statutes and Rules. Effective July 1, 2022. Chapter 98, Article 4, Section 51. 

Vulnerable adult maltreatment definitions: 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 to 49. 

Weekly treatment documentation reduction: Several requirements change to reduce weekly documentation. This simplifies weekly treatment plan reviews and replaces parts of the weekly review with easier to understand documentation requirements. The staff person that provides a treatment service must document the service and the client’s response within seven days. Residential programs must document appointments and attendance or medication concerns on the day each occurs. The timeframe for documenting a significant event changes from immediately to on the day the event occurs. These changes remove the requirement for outpatient programs to document client medical appointments, medication concerns, and treatment service attendance concerns. The new requirements clarify that the alcohol and drug counselor responsible for the client's treatment plan must complete the treatment plan review. Effective August 1, 2022. Chapter 98, Article 12, Sections 8 to 10 and 12. 

Physician assistants: Physician assistants may perform certain tasks or duties that previously required a physician or advanced practice registered nurse. Effective August 1, 2022. Chapter 58, sections 99 to 101 and 107 to 111. 

Staff person substance use problems: Several changes simplify program personnel policy requirements for staff with substance use problems and align these standards for several different types of licensed programs. This eliminates requirements to be free from substance use problems prior to employment, employee attestation statements about problematic substance use, and archaic definitions of substance use problems. The new requirement to replace these standards is to have a personnel policy that describes the process for disciplinary action, suspension, or dismissal of a staff person if they violate the drug and alcohol policy required by the existing requirements in Minnesota Statutes, section 245A.04, subdivision 1, paragraph (c). Effective January 1, 2023. Chapter 98, Article 12, Sections 13, 15, and 21. 

Child safety in parents with children programs: Only for programs that serve children that live with their parents at residential substance use disorder treatment programs, adjustments are made to clarify and simplify existing safe sleep and other child safety requirements. This incorporates feedback from programs about how to improve the requirements and make them easier to follow. Effective January 1, 2023. Chapter 98, Article 12, Section 3. 

Removing outdated progress note term: The term “treatment plan review” replaces the outdated term “progress note” in two areas that still referenced the document that no longer exists in the requirements. Effective January 1, 2023. Chapter 98, Article 12, Sections 14 and 16.

Substance use disorder term:  The more up-to-date term “substance use disorder” replaces the term “chemical dependency” in all Minnesota Statutes and Rules. Effective July 1, 2022. Chapter 98, Article 4, Section 51.

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:  For withdrawal management programs only, physician assistants may perform certain tasks or duties that previously required a physician or advanced practice registered nurse. Effective August 1, 2022. Chapter 58, sections 100, 101, 105, and 106

Staff person substance use problems:  Several changes simplify program personnel policy requirements for staff with substance use problems and align these standards for several different types of licensed programs. This eliminates requirements to be free from substance use problems prior to employment, employee attestation statements about problematic substance use, and archaic definitions of substance use problems. The new requirement to replace these standards is to have a personnel policy that describes the process for disciplinary action, suspension, or dismissal of a staff person if they violate the drug and alcohol policy required by the existing requirements in Minnesota Statutes, section 245A.04, subdivision 1, paragraph (c). Effective January 1, 2023*. Chapter 98, Article 12, Sections 4, 5, and 21. *The repeal of detoxification program rule requirements in section 21 are effective January 1, 2023 and DHS intends to make the other rule changes that section 20 describes effective on this same date.

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).

Changes for child care center providers and for the Minnesota Department of Human Services are outlined below.

Changes for child care center providers

Correction orders no longer need to be posted:  As of Aug. 1, providers are no longer required to post correction orders at their program location. (Minnesota Laws 2018, Chapter 153)

Exemption from the Positive Supports Rule:  As of Aug. 1, child care providers are not required to follow the Positive Supports Rule, including the training requirements. Providers who care for a child with a developmental disability or related condition must follow the child's individual child care program plan as required under Minnesota Rules, part 9503.0065, subpart 3, and are prohibited from using certain procedures (such as mechanical restraints and seclusion). (Minnesota Laws 2018, Chapter 163)

Additional flexibility for staff qualifications: In an effort to make it easier for licensed child care centers to address workforce shortages, DHS will consider variances for staff qualification requirements. When reviewing a variance request, the DHS must consider the staff person’s level of professional development, including the steps completed on the Minnesota Career Lattice. (Minnesota Laws 2018, Chapter 200, section 1) 

Changes for the Department of Human Services

Communications from DHS in plain language: DHS must use plain language when issuing a licensing action (such as notices for license denials, conditional licenses, revocations, suspensions and fines). The notice must also explain the reasons for taking the action in plain language. Additionally, DHS must use plain language when communicating with providers about changes to law or policy. (Minnesota Laws 2018, Chapter 200, sections 2, 3, 4, and 6) 

New information to be included in Report to Legislature: DHS must add the following information to the 2018 Status of Child Care Report, which is required to be submitted to the legislature by Feb. 1, 2019:     

• Administrative reforms DHS has taken or is in the process of taking 
• An evaluation of other state’s models to reduce the barriers and burdens for child care providers
• A summary of ideas from providers of administrative reforms that could be undertaken without legislative action 
• A summary of outreach efforts
• A description of federal and state laws, and the DHS guidelines for the information that is posted on the Licensing Information Lookup website. (Minnesota Laws 2018, Chapter 200, section 10)

The 2017 Status of Child Care Report DHS-7660 (PDF) 

Information about licensing reviews and investigations on Licensing Information Lookup: DHS must comply with federal law by posting information about licensing reviews and investigations conducted at child care programs, including the date of the visit, any violations found and (if applicable) how the violations were addressed. (Minnesota Laws 2018, Chapter 200, section 10)

Guidelines for the Posting of Child Care Licensing Information: DHS is required to provide each licensed child care provider with a printed copy of the guidelines document, Posting of Child Care Licensing Information DHS-7698 (PDF), which includes information about what licensing data will or will not be posted on Licensing Information Lookup. (Minnesota Laws 2018, Chapter 200, section 10)

Regional meetings for providers: DHS must hold regional meetings with child care providers to discuss the changes to the information that is being posted online and to gather input about potential future enhancements to the Licensing Information Lookup website. (Minnesota Laws 2018, Chapter 200, section 10)

Background study changes: Beginning June 18, all newly initiated background studies for minors (17 years of age and younger) affiliated with family adult foster care programs will have a name and date of birth state study instead of one that uses fingerprints. (Minnesota Laws 2018, Chapter 166)

Fetal alcohol syndrome training: Clarifies that child foster care providers must take at least one hour of training on fetal alcohol syndrome annually. Completion of the annual fetal alcohol syndrome training is counted as part of the 12 hours of required annual training requirement. Effective Aug. 1, 2018.  (Minnesota Laws 2018, Chapter 188, section 1)  

Background study changes: Beginning June 18, all newly initiated background studies for minors (17 years of age and younger) affiliated with family child foster care programs will have a name and date of birth state study instead of one that uses fingerprints. (Minnesota Laws 2018, Chapter 166)

Changes for family child care providers, county licensors, and the Minnesota Department of Human Services are outlined below.

Changes for family child care providers

Correction orders no longer need to be posted: As of Aug. 1, providers are no longer required to post correction orders at their program location. (Minnesota Laws 2018, Chapter 153)

Reduction in insurance paperwork: As of Aug. 1, providers with continuous insurance coverage only need to notify parents/guardians if their insurance coverage changes, instead of sending a new notice each year. (Minnesota Laws 2018, Chapter 200, section 7) 

Additional flexibility for Class D providers: As of Aug. 1, providers with a Class D Specialized Infant and Toddler license will be allowed to flex down to one caregiver on days that six or fewer children are in care. When flexing down, the provider must follow the ratio and group size requirements for a Class B license. (Minnesota Laws 2018, Chapter 200, section 5)  

Exemption from the Positive Supports Rule:  As of Aug. 1, child care providers are not required to follow the Positive Supports Rule, including taking the training that it required. Providers who care for a child with a developmental disability or related condition must follow the child's individual education plan (IEP) and are prohibited from using certain procedures (such as mechanical restraints and seclusion).  (Minnesota Laws 2018, Chapter 163)

Background studies for children: Historically, children (ages 13 – 17) living in the household with a family child care program were required to have a state background study based on their name and date of birth. In 2017, a law change would have required these children to have a state background study based upon their fingerprints. The 2017 law never went into effect because DHS had not finished updating its computer system and did not require providers to meet the enhanced requirements.

After much conversation among providers, legislators, and DHS staff, the 2017 law was changed in 2018. Under the new law, most children (ages of 13 to 17) living in the household with a family child care program will continue to be required to have a state background study based on their name and date of birth. There are a number of circumstances in which a child living in the household would be required to have a fingerprint-based FBI background study.

A fingerprint-based FBI check will be required for children living in the household if they meet any of these requirements: 

• They supervise children, or 
• They are employed by the child care provider, or
• They live outside of Minnesota, or
• They  have lived outside of Minnesota at any time in the last five years, or
• They have a Minnesota criminal record, or
• There is reasonable cause to believe that they may have a criminal record in another state. • 

The new law also capped the cost of background studies for children at $20, unless a fingerprint-based FBI background study is required (in which case an additional fingerprinting fee is also required).

The background studies conducted by DHS are not available right now while DHS finishes updating its computer system.  Providers will be given more information before they need to take any action and will continue to complete county studies until they receive further notice from DHS.  (Minnesota Laws 2018, Chapter 166)

Changes for county licensors 

Clarifies county recommendation process for licensing actions: When county licensors believe that a family child care provider should receive a licensing action more serious than a correction order (such as a fine, suspension, revocation or conditional license), the county makes a recommendation to DHS and DHS makes the final decision. The county cannot tell the provider or anyone else which action they are recommending. This information is considered confidential.  Once a county makes a recommendation to DHS, the county sends the provider a notice that says: 

• The county is recommending that DHS take a licensing action
• DHS will review the recommendation and decide what to do
• If a licensing action is issued, DHS will explain the reasons and provide instructions for how to appeal the decision.
  (Minnesota Laws 2018, Chapter 200, section 9) 

Fraud training: By Dec. 31, 2019, DHS must provide training to county licensors about how to identify and prevent fraud in the child care assistance program. (Minnesota Laws 2018, Chapter 200, section 8)

Changes for DHS

Communications from DHS in plain language: DHS must use plain language when issuing a licensing action (such as notices for license denials, conditional licenses, revocations, suspensions and fines). The notice must also explain the reasons for taking the action in plain language. Additionally, DHS must use plain language when communicating with providers about changes to law or policy.  (Minnesota Laws 2018, Chapter 200, sections 2, 3, 4, and 6)  

New information to be included in the report to Legislature: DHS must add the following information to the 2018 Status of Child Care Report, which is required to be submitted to the legislature by Feb. 1, 2019: 

• Administrative reforms DHS has taken or is in the process of taking 
• An evaluation of other state’s models to reduce the barriers and burdens for child care providers
• A summary of ideas from providers of administrative reforms that could be undertaken without legislative action 
• A summary of outreach efforts
• A description of federal and state laws, and the DHS guidelines for the information that is posted on the Licensing Information Lookup website. (Minnesota Laws 2018, Chapter 200, section 10)   

Information about licensing reviews and investigations on Licensing Information Lookup: DHS must comply with federal law by posting information about licensing reviews and investigations conducted at child care programs, including the date of the visit, any violations found and (if applicable) how the violations were addressed. (Minnesota Laws 2018, Chapter 200, section 10) Note: Beginning May 11, 2018, DHS began posting this information for family child care programs. 

Guidelines for the Posting of Child Care Licensing Information: DHS is required to provide each licensed child care provider with a printed copy of the Guidelines on the Posting of Child Care Licensing Information DHS-7698, which includes information about what licensing data will or will not be posted on the Licensing Information Lookup website. (Minnesota Laws 2018, Chapter 200, section 10) In May 2018, a copy of the guidelines was mailed to every licensed family child care provider in the state. 

Regional meetings for providers and county licensors: DHS must hold regional meetings with child care providers and county licensors to discuss the changes to the information that is being posted online and to gather input about potential future enhancements to the Licensing Information Lookup website. (Minnesota Laws 2018, Chapter 200, section 10) 

Revised definitions of mental health practitioner and mental health rehabilitation worker:  Revises definitions of mental health practitioner and mental health rehabilitation worker by adding ways to meet the qualification and training requirements. No one currently in these positions will be affected by the changed definitions. Effective May 12, 2018.  (Minnesota Laws 2018, Chapter 128)

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)