Legislative changes for licensed programs

• 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

• 2020 Child Foster Residence Settings Implementation Plan

• 2020 HCBS Implementation Plan

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)

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.

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 

• 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)

Adult foster care bedroom requirements

Modifies existing requirements to require that adult foster care service recipients must have a choice of roommate and that each roommate must consent in writing to sharing a bedroom. Requires that the license holder provide a lock for each resident’s bedroom door unless otherwise indicated for the resident’s health, safety, or wellbeing. A restriction on the use of the lock must be documented and justified in the resident’s individual abuse prevention plan. S.F. 2, Article 2, Section 5. Creates a new subdivision, 9, in §245A.11. Effective May 31, 2017.

Documents provided at admission

Requires that a resident and a resident’s legal representative must be given, at admission, an explanation of the resident’s rights; a summary of the Vulnerable Adults Protection Act prepared by the department; and the name, address, and telephone number of the local agency to which complaints may be made. S.F. 2, Article 2, Section 6. Creates a new subdivision, 10, in §245A.11. Effective May 31, 2017.

Adult foster care resident rights

Codifies and makes modifications to existing Minnesota Rules, 9555.6255 relating to adult foster care recipient rights. Resident rights include the right to:

• Daily, private access to and use of a non-coin-operated telephone
• Receive and send mail or electronic correspondence or communication
• Use of and free access to common areas and the freedom to come and go from the residence
• Privacy for visits, including privacy in the resident’s bedroom
• Keep, use, and access the resident’s personal possession as space permits
• Choose visitors and time of visits, and participate in activities
• To share a bedroom and bed if both spouses are residents of the adult foster home
• Privacy, including the use of the lock on a resident’s bedroom door or unit door
• Furnish and decorate the resident’s bedroom or living unit
• Engage in chosen activities and have an individual schedule supported by the license holder that meets the resident’s preferences
• Freedom and support to access food at any time
• Have personal, financial, service, health, and medical information kept private and be advised of disclosure by the license holder
• Access records and recorded information about the resident according to applicable regulations
• Be free from maltreatment
• Be treated with courtesy and respect
• Reasonable observance of cultural and ethnic practice and religion
• Be free from bias and harassment regarding race, gender, age, disability, spirituality, and sexual orientation
• Be informed of and use grievance policies
• Assert rights personally, or have the rights asserted by a family member or representative
• Give or withhold informed consent to participate in any research or experimental treatment

Restrictions may be made to some rights; however, restrictions are only permitted if necessary to ensure the health, safety and well-being of the resident and must be implemented in the least restrictive manner to protect the resident and provide support to reduce or eliminate the need for the restriction. Any restriction of a resident’s right must be documented and justified in the resident’s individual abuse prevention plan. S.F. 2, Article 2, Section 6. Creates a new subdivision, 10, in §245A.11. Effective May 31, 2017. 

Elderly waiver recipient termination requirements

Modifies protection-related rights for recipients of Elderly Waiver home and community based services, requiring adult foster care license holders that provide foster care services to a resident under section 256B.0915 to:

• Provide annually a copy of the resident termination policy
• Include the case manager as part of the interdisciplinary team under section 245A.65, subdivision 2, paragraph (b)
• Establish policies and procedures for service termination that promote continuity of care and service coordination with the resident and the case manager and with another licensed caregiver, if any
• Document, prior to giving notice of service termination, actions taken to minimize or eliminate the need for termination
• Provide written notification of an intended service termination to the resident’s legal representative and case manager at least 30 days prior to termination of services

S.F. 2, Article 2, Sections 5-7. Creates new subdivisions, 9-11, in §245A.11. Effective May 31, 2017. S.F. 2, Article 2, Section 4. Modifies §245A.04, subdivision 14. Effective August 1.

Fifth bed adult foster care and community residential setting exception extended

Extends the existing exception through June 30, 2019 for a fifth bed in adult foster care and community residential settings if the fifth bed does not increase the overall statewide capacity of adult foster care and community residential setting beds. S.F. 359, section 1. Modifies §245A.11, subdivision 2a. Effective May 31, 2017. 

Substance use disorder reform 

Transforms Minnesota’s substance use disorder (SUD) continuum of care. Streamlines the process for accessing treatment by allowing individuals to go directly to providers to receive an assessment, allows licensed providers to be directly reimbursed for services and provide services outside of site-based treatment programs. Adds three new services — care coordination, peer recovery support and withdrawal management — to the continuum of care. Updates terminology relating to substance misuse and substance use disorders in chapters 245A and 254A. S.F. 2, Article 8, sections 12-35, 38-65, 67, and 75-77. Creates a new chapter, 245G, and repeals Minnesota Rules, parts 9530.6405 to 9530.6505 (Rule 31). Effective January 1, 2018.

Rule 31 requirements updated and codified at Chapter 245G

As part of the effort to reform Minnesota’s substance use disorder continuum of care, legislation codifies and makes updates to the requirements of Rule 31 to increase clarity and better protect clients. Modifications include:

• Revised time frames for the completion of an initial services plan
• Requirement that the comprehensive assessment be conducted by an alcohol and drug counselor, either within three days of service initiation for a residential program or during the initial session for all other programs
• Emphasis on person-centered treatment planning in individual treatment plans
• Ability to provide services at the license holder’s licensed location or another suitable location upon notification and approval of the commissioner, and the requirement to document the reason for providing remote services
• Requirements for standing naloxone orders and naloxone supply
• Requirement to develop a policy and procedure to track the attendance and services provided
• Requirement to have a written policy regarding the use of any electronic device that can record, transmit, or make images of another client

S.F. 2, Article 8, sections 12-35, 38-65, 67, and 75-77. Creates a new chapter, 245G. Effective January 1, 2018.

Required use of public benefits for room or board costs prohibited

Prohibits vendors from using a client’s public benefits to offset the cost of services paid under section 254B.03. Prohibits vendors from requiring the client to use public benefits, including but not limited to cash assistance benefits under Chapters 119B, 256D, 256J, or SNAP benefits, for room and board costs. Clarifies that retention of SNAP benefits is a right of a client receiving services through the consolidated chemical dependency treatment fund or through state contracted managed care entities. 

S.F. 2, Article 8, section 55. Modifies §254B.03, subdivision 2. Effective January 1, 2018.

Licensing inspection exit interview required

Requires the licensing agency to offer an exit interview following a licensing inspection to discuss violations of law or rule observed during the inspection and offer technical assistance on how to comply with applicable laws and rules. S.F. 2, Article 9, section 3. Modifies §245A.04, subdivision 4. Effective October 1, 2017.

Correction order posting modified

Requires the Commissioner to issue amended correction orders following a reversal or rescission of a correction order violation and modifies posting requirements for correction orders that are reversed or rescinded. S.F. 2, Article 9, section 5. Modifies §245A.06, subdivision 8. Effective July 1, 2017.

Correction order quotas prohibited

Prohibits the commissioner and county licensing agency from ordering, mandating, requiring, or suggesting to any person responsible for licensing or inspecting a family child care or child care center a quota for the issuance of correction orders. S.F. 2, Article 9, section 6. Modifies §245A.06. Effective July 1, 2017.

Fix-it ticket authorized

Requires the commissioner to issue, in lieu of a correction order, a fix-it ticket if the commissioner finds that 1) the license holder failed to comply with an applicable requirement that is eligible for a fix-it ticket; 2) the violation does not imminently endanger the health, safety, or rights of the persons served by the program; 3) the license holder did not receive a fix-it ticket or correction order for the violation at the license holder’s last licensing inspection; 4) the violation can be corrected at the time of inspection or within 48 hours, excluding Saturdays, Sundays, and holidays; and 5) the license holder corrects the violation at the time of inspection or agrees to correct the violation within 48 hours, excluding Saturdays, Sundays, and holidays. Within one week of receiving a fix-it ticket, the license holder must submit evidence that the license holder corrected the violation; if the license holder does not submit evidence or the evidence of the correction is insufficient, the commissioner must issue a correction order. The list of violations eligible for a fix-it ticket will be developed by the commissioner following consultation with license holders and county agencies. S.F. 2, Article 9, section 7. Creates a new section, §245A.065. Effective October 1, 2017.

Communication regarding changes to law and policy required

Requires the commissioner to provide information to child care license holders on a timely basis of changes to state and federal statute, rule, regulation and policy relating to the provision of licensed child care, the child care assistance program, and Parent Aware, including information to promote license holder compliance. S.F. 2, Article 9, section 9. Creates a new section, §245A.1434. Effective July 1, 2017.

Child care and development block grant changes

Modifies health and safety requirements and brings Minnesota into compliance with the health and safety requirements of the 2014 reauthorization of the Child Care and Development Block Grant. Changes include:

• Modifications to orientation training requirements
• Modifications to the existing child growth and development and behavior guidance training
• Requirement to complete first aid and CPR training every two years
• Modifications to in-service training requirements
• Requirement to complete and document orientation training on health and safety training at least once each year
• Requirements related to allergy prevention in response, handling and disposal of bodily fluids, and emergency preparedness

In addition, license holders will be required to use the DHS Child Care Emergency Plan (PDF). (Word Document) S.F. 2, Article 16, Sections 4, 7-13. Creates a new subdivision, 15, in §245A.14; creates new subdivision, 9, in 245A.40; modifies §245A.40 subdivisions 1, 2, 3, 4, and 7; creates a new section, §245A.41. Effective August 1, 2017.

Annual inspections

To bring Minnesota into compliance with federal requirements, the Department will be required to inspect licensed child care centers at least annually. The Department will begin phasing in annual inspections in August of 2017. Modifies §245A.09, subdivision 7. S.F. 2, Article 16, Section 2. Effective August 1, 2017.

Background study requirement modifications

Modifies the content and process of background studies for license holders and child care staff. The new background study, which will be valid for five years, will include a fingerprint check against the national criminal database and a name and date-of-birth check against the National Sex Offender public website. The background study will cost $40 in addition to a separate finger printing fee. All individuals whose activities involve the care or supervision of a child or include unsupervised access to children will be required to obtain the new enhanced background study. S.F. 2, Article 16, Sections 18-42. Various effective dates. The Department will contact license holders to alert them to when they must obtain the new, enhanced background study.

Licensing data and correction order posting guidelines 

No later than November 1, 2017, the commissioner shall develop guidelines for posting public licensing data for licensed child care programs following consultation with stakeholders. S.F. 2, Article 7, Section 35.

Sudden unexpected infant death and abusive head trauma training requirements for relatives clarified

Clarifies that an individual who is related to the license holder and who is involved only in the care of the license holder’s own infant or child under school age and who is not designated to be a caregiver, helper, or substitute for the licensed program is exempt from the sudden unexpected infant death and abusive head trauma training. S.F. 2, Article 7, section 24. Modifies §245A.50, subdivision 5. Effective July 1, 2017.

Definition of “annual” modified for purposes of 245A.50

Defines “annual” or “annually” for the purposes of family child care training requirements in section 245A.50 to mean the 12-month period beginning on the license effective date or the annual anniversary of the effective date and ending on the day prior to the annual anniversary of the license effective date. S.F. 2, Article 9, sections 1-2. Modifies §245A.02, subdivision 2b; creates a new subdivision, 2c, in 245A.02. Effective July 1, 2017. 

Licensing inspection exit interview required

Requires the county licensing agency to offer an exit interview following a licensing inspection to discuss violations of law or rule observed during the inspection and offer technical assistance on how to comply with applicable laws and rules. S.F. 2, Article 9, section 3. Modifies §245A.04, subdivision 4. Effective October 1, 2017.

Request for expedited correction order review permitted

Permits licensed family child care providers to request expedited review of a correction order if 1) the corrective action pending reconsideration would require either a substantial expenditure of funds or change to the licensed program and 2) the license holder describes actions the license holder will take in lieu of the corrective action to ensure the health and safety of children in care pending reconsideration of the correction order. S.F. 2, Article 9, section 4. Modifies §245A.02, subdivision 2. Effective July 1, 2017.

Fix-it ticket authorized

Requires the commissioner to issue, in lieu of a correction order, a fix-it ticket if the commissioner finds that 1) the license holder failed to comply with an applicable requirement that is eligible for a fix-it ticket; 2) the violation does not imminently endanger the health, safety, or rights of the persons served by the program; 3) the license holder did not receive a fix-it ticket or correction order for the violation at the license holder’s last licensing inspection; 4) the violation can be corrected at the time of inspection or within 48 hours, excluding Saturdays, Sundays, and holidays; and 5) the license holder corrects the violation at the time of inspection or agrees to correct the violation within 48 hours, excluding Saturdays, Sundays, and holidays. Within one week of receiving a fix-it ticket, the license holder must submit evidence that the license holder corrected the violation; if the license holder does not submit evidence or the evidence of the correction is insufficient, the commissioner must issue a correction order. The list of violations eligible for a fix-it ticket will be developed by the commissioner following consultation with license holders and county agencies. S.F. 2, Article 9, section 7. Creates a new section, §245A.065. Effective October 1, 2017.

Correction order quotas prohibited

Prohibits the commissioner and county licensing agency from ordering, mandating, requiring, or suggesting to any person responsible for licensing or inspecting a family child care or child care center a quota for the issuance of correction orders. S.F. 2, Article 9, section 6. Modifies §245A.06. Effective July 1, 2017.

Correction order posting modified

Requires the Commissioner to issue amended correction orders following a reversal or rescission of a correction order violation and modifies posting requirements for correction orders that are reversed or rescinded. S.F. 2, Article 9, section 5. Modifies §245A.06, subdivision 8. Effective July 1, 2017.

Annual inspections

To bring Minnesota into compliance with federal requirements, counties will now be required to inspect family child care programs at least annually. S.F. 2, Article 16, Section 5. Modifies §245A.16, subdivision 1. Effective August 1, 2017.

Communication regarding changes to law and policy required

Requires the commissioner to provide information to child care license holders on a timely basis of changes to state and federal statute, rule, regulation and policy relating to the provision of licensed child care, the child care assistance program, and Parent Aware, and child care licensing functions delegated to counties, including information to promote license holder compliance. S.F. 2, Article 9, Section 9. Creates new section, §245A.1434. Effective July 1, 2017.

Child care and development block grant changes

Brings Minnesota into compliance with the health and safety requirements of the 2014 reauthorization of the Child Care and Development Block Grant. Changes include: 

• Changes to parental access
• Modifications to the existing child growth and development and behavior guidance training
• Modifications to the existing supervising for safety training requirement
• Requirements relating to allergies, handling and disposal of bodily fluids, and emergency preparedness.

In addition, license holders will be required to use the DHS Child Care Emergency Plan (PDF) (Word Document). S.F. 2, Article 16, Sections 4, 14-17. Creates a new subdivision 15 in 245A.14; modifies 245A.50, subdivisions 2, 7. Creates a new section, 245A.51. Effective August 1, 2017. Modifies §245A.50, subdivision 9. Effective July 1, 2017.

Background study requirement modifications

Requires a new fingerprint-based background study for all licensed family child care and licensed child care centers and their staff and household members. The new background study, which will be valid for five years and will be conducted by the Department of Human Services, will include a review of Minnesota criminal records, predatory offender registry, and child abuse and neglect registry. It will also include a review of FBI criminal records, the National Sex Offender Public Website, and child abuse and neglect registries in any state where the subject has resided in the previous five years. The background study will cost $40 in addition to a separate finger printing fee. All individuals whose activities involve the care or supervision of a child or include unsupervised access to children will be required to obtain the new enhanced background study. S.F. 2, Article 16, Sections 18-42. Various effective dates. The Department will contact license holders with more details about these changes and alert them to when they must obtain the new, enhanced background study.

Licensing data and correction order posting guidelines 

No later than November 1, 2017, the commissioner shall develop guidelines for posting public licensing data for licensed child care programs following consultation with stakeholders. S.F. 2, Article 7, Section 35.

HCBS settings rule requirements implemented

Modifies protection-related rights for recipients of home and community based services, including that individuals have the right to:

• Access to three nutritionally balanced meals per day and nutritious snacks between meals
• Use the lock on the person’s bedroom or unit door
• Access to the person’s personal possessions at any time, including financial resources
• Come and go from the residence at will
• Choose the person’s visitors and time of the visits
• Freedom and support to access food and potable water at any time
• Furnish and decorate the person’s bedroom or living unit
• A setting that is clean, free from hazards that threaten the person’s health or safety, and that meets the definition of a dwelling unit within a residential occupancy as defined in the State Fire Code

Additionally requires that each person receiving services have a choice of roommate. S.F. 2, Article 2, section 8. Modifies §245D.04, subdivision 3. Effective May 31, 2017. S.F. 359, section 11, 16. Modifies §245D.04, subdivision 3 and §245D.24, subdivision 3. Effective May 31, 2017.

Assessment and initial service planning regarding schedule and technology

Modifies assessment and initial service planning to include the person’s preferences for how services and supports are provided, including how the provider will support the person to have control of the person’s schedule and a discussion of how technology might be used to meet the person’s desired outcomes as part of the 45-day planning meeting. A summary of the discussion regarding the use of technology must be included in the coordinated service and support plan or support plan addendum. S.F. 359, Section 12. Modifies §245D.071, subdivision 3. Effective May 31, 2017.

Fifth bed adult foster care and community residential setting exception extended

Extends the existing exception through June 30, 2019 for a fifth bed in adult foster care and community residential settings if the fifth bed does not increase the overall statewide capacity of adult foster care and community residential setting beds. S.F. 359, Section 1. Modifies §245A.11, subdivision 2a. Effective May 31, 2017. 

Modification of nonsupervisory staff orientation requirements

Modifies the orientation training requirement for direct support staff to the requirement that the license holder provide and ensure completion of orientation sufficient to create staff competency for direct support staff that combines on-the-job training and review of and instruction of topics described in statute. S.F. 359, Section 13. Modifies §245D.09, subdivision 4. Effective May 31, 2017. 

Residency agreement required

At admission or service initiation, requires the person or the person’s legal representative and the license holder to sign and date a residency agreement that includes service termination requirements for license holders providing certain services. The residency agreement must be reviewed annually, dated, and signed by the person or the person’s legal representative and the license holder. S.F. 359, Section 15. Modifies §245D.11, subdivision 4. Effective August 1, 2017.

Limited moratorium exception created

Establishes two exceptions to the moratorium on corporate foster care: one for people transitioning from the residential care waiver to foster care services and another for people residing in an unlicensed site for which a license is required. 

New foster care licenses or community residential setting licenses may be issued by the commissioner if the commissioner determines the license is needed for the transition of people from the residential care waiver services to foster care services if 1) the person’s case manager provided the person with information about the choice of service, service provider, and the location of service to help the person make an informed choice and 2) the person’s foster care services are less than or equal to the cost of the person’s services delivered in the residential care waiver service setting as determined by the lead agency. 

Additionally, new foster care licenses or community residential settings licenses for people receiving services under chapter 245D and residing in an unlicensed setting before May 1, 2017 and for which a license is required may also be issued. The exception does not apply to people living in their own home and there is a presumption that a foster care or community residential setting license is required for services provided to three or more people in a dwelling unit when the setting is controlled by the provider. A license holder may rebut this presumption by seeking reconsideration of the commissioner’s determination. This exception is only available until June 30, 2018 and is only available if 1) the person’s case manager provided the person with information to help the person make an informed choice and 2) the person’s services provided in the licensed foster care or community residential setting are less than or equal to the person’s services delivered in the unlicensed setting as determined by the lead agency. S.F. 2, Article 2, sections 3, 11, and 15-18. Modifies §245A.03 subdivision 7. Effective July 1, 2017. 

New employment services added 

Creates three new day employment services – employment exploration services, employment development services, and employment support services – to the brain injury, community alternative care, community access for disability inclusion, and developmental disability waiver plans. S.F. 2, Article 1, section 2. Modifies §245D.03 subdivision 1. Effective upon federal approval.

Addition of individualized home supports services for elderly waiver recipients

Adds individualized home supports to in-home services to the licensed services that may be provided to elderly waiver recipients. S.F. 2, Article 1, section 2. Modifies §245D.03 subdivision 1. Effective May 31, 2017.

Entry level mental health provider standards

Allows mental health practitioners to work in day treatment programs before obtaining 2,000 hours of supervised experience as long as they meet certain training and supervision requirements. Outlines an inclusive list of degrees that qualify a person to become a mental health practitioner. Allows provider staff other than mental health professionals and mental health practitioners to use restrictive procedures, as long as they have completed required training and have the clinical supervision of a mental health professional. Eliminates the requirement that a Certified Peer Specialist and Certified Family Peer Specialists have a high school diploma or its equivalent. H.F. 1186, Sections 1-5, 8. Modifies §245.462, subdivision 17; §245.4871, subdivision 26; §245.8261, subdivision 4; §256B.0615, subdivision 5; and §256.0943, subdivisions 9 and 13. Effective May 24, 2017.

Prohibition on initial licenses for IMD children’s residential facilities 

Prohibits the commissioner from issuing an initial license for children’s residential facilities that the Centers for Medicare and Medicaid Services would consider an institution for mental diseases, unless the facility only serves private pay clients. Grants authority to the commissioner to manage existing statewide capacity in children’s residential facilities subject to the moratorium. S.F. 2, Article 2, Section 3. Modifies §245A.03, subdivision 7. Effective July 1, 2017. 

Increase of fine for serious maltreatment for certain license types

Requires the license holder to forfeit $5,000 if the commissioner determines that the license holder is responsible for maltreatment that meets the definition of serious maltreatment as defined in 245C.02, subdivision 18. For programs that operate in the license holder’s home and programs licensed under Minnesota Rules, parts 9502.0300 to 9502.0495, the fine assessed against the license holder shall not exceed $1,000 for each determination of maltreatment. S.F. 2, Article 9, section 8. Modifies §245A.07, subdivision 3. Effective August 1, 2017.

Modified definition of “controlling individual”

Clarifies the definition of “controlling individual” to include the owner of a program or service provider licensed under 245A and, if applicable each officer of the organization, the authorized agent, the compliance officer, and each managerial official whose responsibilities include the direction of the management or policies of a program. Clarifies that all controlling individuals must comply with background study requirements. S.F. 2, Article 13, section 2; Article 16, section 19. Modifies §245A.02, subdivision 5a. Effective July 1, 2017. Modifies §245C.03, subdivision 1, effective when the Department of Human Services implements NETStudy 2.0 or October 1, 2017, whichever is later.

Modified definition of “owner”

Clarifies the definition of “owner” to mean the individual or organization that has a direct or indirect ownership interest of five percent or more in a program licensed under 245A. S.F. 2, Article 13, section 3. Creates new subdivision, 10b, in §245A.02. Effective July 1, 2017.

Certification of license-exempt centers accepting child care assistance payments

Beginning September 30, 2017, the DHS will begin a process to certify license-exempt child care centers that participate in the Child Care Assistance Program. Certification applications will be received and processed on a schedule to be determined by the department. . S.F. 2, Article 16, sections 43-59, 68  establishes application procedures, standards, and requirements for certified license-exempt child care centers. Effective August 1, 2017. Get answers to  frequently asked questions about the certification process.