Reviewing and reporting medication and treatment issues. The license holder is prohibited from using chemical restraints, mechanical restraints, manual restraints, time out, seclusion, or any other aversive or deprivation procedure, as a substitute for adequate staffing, for a behavioral or therapeutic program to reduce or eliminate behavior, as punishment, or for staff convenience. The policy and procedures must comply with the requirements of this section and must specify the following: (1) a description of the positive support strategies and techniques staff must use to attempt to de-escalate a person's behavior before it poses an imminent risk of physical harm to self or others; (2) a description of the types of manual restraints the license holder allows staff to use on an emergency basis, if any. Prone restraint does not include brief physical holding of a person who, during an emergency use of manual restraint, rolls into a prone position, if the person is restored to a standing, sitting, or side-lying position as quickly as possible; (8) apply back or chest pressure while a person is in a prone position as identified in clause (7), supine position, or side-lying position; or. Action taken by the license holder must include, at a minimum: (1) consultation with the person's support team or expanded support team to identify and resolve issues leading to issuance of the notice; and. Food served must meet any special dietary needs of a person as prescribed by the person's physician, advanced practice registered nurse, physician assistant, or dietitian. The refusal to authorize medication administration must be reported to the prescriber as expediently as possible. Individuals who become ill during the day. (c) A license holder or staff person is restricted from accepting an appointment as a guardian as follows: (1) under section 524.5-309 of the Uniform Probate Code, any individual or agency that provides residence, custodial care, medical care, employment training, or other care or services for which the individual or agency receives a fee may not be appointed as guardian unless related to the respondent by blood, marriage, or adoption; and. disability waivers. Connect with a social worker Discuss and select which HCBS Waiver best meets your needs Discuss and select services from your specific HCBS Waiver service menu 3. Providing structure and emotional support; . Programs approved for alternative licensing inspection; deemed compliance licensing requirements. DAY SERVICES FACILITIES; HEALTH AND SAFETY REQUIREMENTS. (vi) the determination of whether corrective action is necessary based on the results of the review. (e) The license holder must annually notify all persons, or their legal representatives, and case managers of any procedural revisions to policies required under this chapter, other than those in paragraph (c). DAY SERVICES FACILITIES; SATELLITE LICENSURE REQUIREMENTS AND APPLICATION PROCESS. As a result of this research, the Rate Management System applied the legislated transportation values to full-day day training and . color: #ffffff; } Description Description. The 245D "HCBS Waiver" license is issued by DHS under the Medicaid program ("Medical Assistance" in Minnesota). The license holder must provide written reports regarding the person's progress or status as requested by the person, the person's legal representative, the case manager, or the team. 2013 c 108 art 8 s 33; 2014 c 312 art 27 s 43-45; 2015 c 78 art 6 s 31; 1Sp2019 c 9 art 5 s 16-18; 2022 c 98 art 17 s 26. For a one-page overview, see this 245D license structure (PDF). Research, Public (b) A license holder or staff person may not accept powers-of-attorney from a person receiving services from the license holder for any purpose. The license holder must ensure that volunteers who provide direct support services to persons served by the program receive the training, orientation, and supervision necessary to fulfill their responsibilities. (2) nonmedical service providers to adapt their services to accommodate the health and safety needs of the person. (iv) substantially disrupts the orderly operation of the program; (8) any sexual activity between persons receiving services involving force or coercion as defined under section 609.341, subdivisions 3 and 14; (9) any emergency use of manual restraint as identified in section 245D.061 or successor provisions; or. (a) License holders providing basic support services must meet the requirements of this subdivision. Calendar, General Orders of the The 245D HCBS Waiver license is issued by DHS under the Medicaid program (Medical Assistance in Minnesota). Committees, Joint Committees Calendar for the Day, Fiscal For purposes of this chapter, a day services facility license is a satellite license of the day services program. (a) License holders must develop a positive support transition plan on the forms and in the manner prescribed by the commissioner for a person who requires intervention in order to maintain safety when it is known that the person's behavior poses an immediate risk of physical harm to self or others. Programs, Pronunciation Refusal to authorize psychotropic medication. Companion Linc is a 245D Waivered Services Provider that supports approximately 150 individuals throughout the Metro Area with a variety of intellectual and/or physical needs, including Autism, Down Syndrome, and Cerebral Palsy. (b) The license holder must document the supports and methods to be implemented to support the person and accomplish outcomes related to acquiring, retaining, or improving skills and physical, mental, and emotional health and well-being. Individuals will have the opportunity for the development and exercise of decision making, choice . Blvd., St. Paul, MN 55155. Reporting emergency use of manual restraint incident. (2) the Health Insurance Portability and Accountability Act of 1996 (HIPAA), to the extent that the license holder performs a function or activity involving the use of protected health information as defined under Code of Federal Regulations, title 45, section 164.501, including, but not limited to, providing health care services; health care claims processing or administration; data analysis, processing, or administration; utilization review; quality assurance; billing; benefit management; practice management; repricing; or as otherwise provided by Code of Federal Regulations, title 45, section 160.103. Rule Status, State County Licensing Functions Under 245D 245D.21 Facility Licensure Requirements and ApplicationProcess. (2) on a daily basis the person requires verbal prompts or spot checks and minimal or no physical assistance to successfully complete at least three of the following activities: toileting, communicating basic needs, eating, or ambulating. The health authority may require retesting and corrective measures if results exceed state water standards in Minnesota Rules, chapter 4720, or in the event of flooding or an incident which may put the well at risk of contamination. If the service termination is from residential supports and services as defined in section 245D.03, subdivision 1, paragraph (c), clause (3), the license holder must also notify the commissioner in writing; and. (a) The facility capacity of each day service facility must be determined by the amount of primary space available, the scheduling of activities at other service sites, and the space requirements of all persons receiving services at the facility, not just the licensed services. "Direct contact" has the meaning given in section 245C.02, subdivision 11, and is used interchangeably with the term "direct support service.". (v) eight hours of instruction on principles of person-centered thinking; (3) be determined by a positive support professional to have the training and prerequisite skills required to provide positive practice strategies as well as behavior reduction approved and permitted intervention to the person who receives positive support; and. When used on a continuous basis, it must be addressed in a person's support plan addendum as identified in sections 245D.07 and 245D.071. Meetings, Standing Each incident and emergency report file must contain a written summary of the incident. (b) Based on the results of the internal review, the license holder must develop, document, and implement a corrective action plan for the program designed to correct current lapses and prevent future lapses in performance by individuals or the license holder, if any. [Repealed by amendment, 2013 c 108 art 8 s 23]. To learn more about Minnesota Statute 245D, you can go to https://www.revisor.mn.gov/statutes/?id=245D. This includes homemaking, respite, adult companion, personal support, and night supervision. Any use of manual restraint as allowed in this paragraph must comply with the restrictions identified in subdivision 6, paragraph (b). At the time initial authorization is obtained, the license holder must survey, document, and implement the preferences of the person or the person's legal representative and the case manager for frequency of receiving a statement that itemizes receipts and disbursements of funds or other property. Person requiring staff ratio of one to six. (i) psychologist licensed under sections 148.88 to 148.98, who has stated to the Board of Psychology competencies in the above identified areas; (ii) clinical social worker licensed as an independent clinical social worker under chapter 148D, or a person with a master's degree in social work from an accredited college or university, with at least 4,000 hours of post-master's supervised experience in the delivery of clinical services in the areas identified in clauses (1) to (11); (iii) physician licensed under chapter 147 and certified by the American Board of Psychiatry and Neurology or eligible for board certification in psychiatry with competencies in the areas identified in clauses (1) to (11); (iv) licensed professional clinical counselor licensed under sections 148B.29 to 148B.39 with at least 4,000 hours of post-master's supervised experience in the delivery of clinical services who has demonstrated competencies in the areas identified in clauses (1) to (11); (v) person with a master's degree from an accredited college or university in one of the behavioral sciences or related fields, with at least 4,000 hours of post-master's supervised experience in the delivery of clinical services with demonstrated competencies in the areas identified in clauses (1) to (11); (vi) person with a master's degree or PhD in one of the behavioral sciences or related fields with demonstrated expertise in positive support services, as determined by the person's needs as outlined in the person's assessment summary; or. "Treatment" means the provision of care, other than medications, ordered or prescribed by a licensed health or mental health professional, provided to a person to cure, rehabilitate, or ease symptoms. "Commissioner" means the commissioner of the Department of Human Services or the commissioner's designated representative. (c) A day services facility must have a minimum of 40 square feet of primary space available for each person receiving services who is present at the site at any one time. If a person chooses to use a mattress other than an innerspring mattress or chooses not to have a mattress frame or support, the license holder must document this choice and allow the alternative desired by the person. (b) The license holder must develop, implement, and maintain the following documentation in the person's support plan addendum according to the requirements in sections 245D.07 and 245D.071: (1) a description of the target symptoms that the psychotropic medication is to alleviate; and. "Deprivation procedure" means the removal of a positive reinforcer following a response resulting in, or intended to result in, a decrease in the frequency, duration, or intensity of that response. The license holder must provide the monitoring data to the expanded support team for review every three months, or as otherwise requested by the person or the person's legal representative. FosterCare (AFCRule203 & Child Foster Care Rule2960) CRS (MN Statutes,sections 245D.21 - 245D.26) licensed by County. (4) the license holder maintained substantial compliance with the other requirements of chapters 245A and 245C and other applicable laws and rules. (b) The license holder must ensure that the designated coordinator is competent to perform the required duties identified in paragraph (a) through education, training, and work experience relevant to the primary disability of persons served by the license holder and the individual persons for whom the designated coordinator is responsible. The support plan or support plan addendum must include a summary of this discussion. [Repealed by amendment, 2013 c 108 art 8 s 25]. [Repealed by amendment, 2013 c 108 art 8 s 27]. COMMUNITY RESIDENTIAL SETTINGS; PHYSICAL PLANT AND ENVIRONMENT. This requirement does not apply to temporary suspensions issued under paragraph (b), clause (3). The designated manager is responsible for the following: (1) maintaining a current understanding of the licensing requirements sufficient to ensure compliance throughout the program as identified in section 245A.04, subdivision 1, paragraph (e), and when applicable, as identified in section 256B.04, subdivision 21, paragraph (g); (2) ensuring the duties of the designated coordinator are fulfilled according to the requirements in subdivision 2; (3) ensuring the program implements corrective action identified as necessary by the program following review of incident and emergency reports according to the requirements in section 245D.11, subdivision 2, clause (7). Companion Linc is a 245D Waivered Services Provider that supports approximately 130 individuals throughout the Metro Area with a variety of intellectual and/or physical needs, including Autism, Down Syndrome, and Cerebral Palsy. The license holder must ensure that the requirements in clauses (2) and (3) have been met before administering medication or treatment. (3) maintain information about the service suspension, including the written notice of temporary service suspension, in the service recipient record. A restriction may be implemented only when the required approval has been obtained. 2. Person requiring staff ratio of one to four. (e) A license holder providing residential services to persons in an ICF/DD is exempt from compliance with sections 245D.04; 245D.05, subdivision 1b; 245D.06, subdivision 2, clauses (4) and (5); 245D.071, subdivisions 4 and 5; 245D.081, subdivision 2; 245D.09, subdivision 7; 245D.095, subdivision 2; and 245D.11, subdivision 3. This requirement does not apply to notices of service termination issued under paragraph (b), clauses (4) and (7); and. License holder responsibility for individual rights of persons served by the program. If approval is withdrawn, the right must be immediately and fully restored. Minnesota residents with disabilities or chronic illnesses who need certain levels of care may qualify for the Minnesota HCBS waiver programs. The review must include an evaluation of whether related policies and procedures were followed, whether the policies and procedures were adequate, whether there is a need for additional staff training, whether the reported event is similar to past events with the persons or the services involved, and whether there is a need for corrective action by the license holder to protect the health and safety of persons receiving services. Home and community-based services licensed under this chapter for which the commissioner is the license holder with a qualifying accreditation are excluded from being approved for an alternative licensing inspection. This section applies to both community residential settings and day services facilities. Supervision must be provided until the caretaker arrives to bring the person home. The license holder must increase the number of direct support staff members present at any one time beyond the number arrived at in subdivision 4 if necessary when any one or combination of the following circumstances can be documented by the commissioner as existing: (1) the health and welfare needs of the persons receiving services cannot be met by the number of staff members available under the staffing pattern in effect even though the number has been accurately calculated under subdivision 7; or. (2) the interim review panel established in section 245.8251, subdivision 4, recommends commissioner approval of the emergency use of the procedures. Orientation or training received by the staff person from sources other than the license holder in the same subjects as identified in subdivision 4 may count toward the orientation and annual training requirements if received in the 12-month period before the staff person's date of hire. DAY SERVICES FACILITIES; SATELLITE LICENSURE REQUIREMENTS AND APPLICATION PROCESS. "Family foster care" means a child foster family setting licensed according to Minnesota Rules, parts 2960.3000 to 2960.3340, or an adult foster care home licensed according to Minnesota Rules, parts 9555.5105 to 9555.6265, where the license holder lives in the home. "Day services facility" means a facility licensed according to this chapter at which persons receive day services licensed under this chapter from the license holder's direct support staff for a cumulative total of more than 30 days within any 12-month period and the license holder is the owner, lessor, or tenant of the facility. (c) The license holder must maintain a copy of the internal review and the corrective action plan, if any, in the person's service recipient record. (3) providing the most integrated setting and inclusive service delivery that supports, promotes, and allows: (i) inclusion and participation in the person's community as desired by the person in a manner that enables the person to interact with nondisabled persons to the fullest extent possible and supports the person in developing and maintaining a role as a valued community member; (ii) opportunities for self-sufficiency as well as developing and maintaining social relationships and natural supports; and. 2013 c 108 art 8 s 30; 2014 c 291 art 8 s 1,2; 2014 c 312 art 27 s 37-39,77; 2015 c 71 art 7 s 17; 2017 c 90 s 12; 1Sp2019 c 9 art 5 s 12,13; 1Sp2020 c 2 art 2 s 4; art 4 s 1; 2022 c 98 art 17 s 26. 245D ICS Program Structure (Individual) quantity. (1) maintain a log of quarterly fire drills on file in the facility; (2) provide an emergency response plan that is readily available to staff and persons receiving services; (3) inform each person of a designated area within the facility where the person should go for emergency shelter during severe weather and the designated assembly points outside the facility; and. (c) Written requests for the emergency use of the procedures must be developed and submitted to the commissioner by the designated coordinator with input from the person's expanded support team in accordance with the requirements set by the interim review panel, in addition to the following: (1) a copy of the person's current positive support transition plan and copies of each positive support transition plan review containing data on the progress of the plan from the previous year; (2) documentation of a good faith effort to eliminate the use of the procedures that had been part of an approved positive support transition plan; (3) justification for the continued use of the procedures that identifies the imminent risk of serious injury due to the person's self-injurious behavior if the procedures were eliminated; (4) documentation of the clinicians consulted in creating and maintaining the positive support transition plan; and. Reports & Information, House (a) The license holder must give the person or the person's legal representative, case manager, and other people as identified by the person or the person's legal representative, an opportunity to participate in the ongoing review and development of the service plan and the methods used to support the person and accomplish outcomes identified in subdivisions 3 and 4. Intermediate care facility for persons with developmental disabilities or ICF/DD. A person must be assigned a staff ratio requirement of one to eight if: (1) the person does not meet the requirements in subdivision 4; and. "Mental health crisis intervention team" means a mental health crisis response provider as identified in section 256B.0624. The license holder must ensure that a background study has been completed according to the requirements in sections 245C.03, subdivision 1, and 245C.04. Competency in these areas is determined by the license holder through knowledge testing or observed skill assessment conducted by the trainer or instructor or by an individual who has been previously deemed competent by the trainer or instructor in the area being assessed; and. "Chemical restraint" means the administration of a drug or medication to control the person's behavior or restrict the person's freedom of movement and is not a standard treatment or dosage for the person's medical or psychological condition. For purposes of this chapter, "case manager" includes case management services as defined in Minnesota Rules, part 9520.0902, subpart 3. Sign it in a few clicks Draw your signature, type it, upload its image, or use your mobile device as a signature pad. 245D Basic Licensed Services. (8) integrated community support as defined under the brain injury and community access for disability inclusion waiver plans beginning January 1, 2021, and community alternative care and developmental disabilities waiver plans beginning January 1, 2023. The license holder must ensure that a background study has been completed according to the requirements in sections 245C.03, subdivision 1, and 245C.04. (2) the qualifications of the specialist identified in the person's support plan. Termination or denial of subsequent approval. (5) Any condition cited by a fire marshal, building official, or health authority as hazardous or creating an immediate danger of fire or threat to health and safety must be corrected before a license is issued by the department, and for community residential settings, before a license is reissued. Email: info@hrc.com. When an area has a 911 number or a mental health crisis intervention team number, both numbers must be posted and the emergency number listed must be 911. This level of supervision and protection allows risk taking to the extent that there is no reasonable likelihood that serious harm will happen to the person or others. (d) For the purposes of this section, the license holder's license includes services licensed under this chapter that were previously licensed under chapter 245B until December 31, 2013. A person may choose not to have a cabinet, dresser, shelves, or a mirror in the bedroom, as otherwise required under paragraph (d), clause (3) or (4). For purposes of this section, "prone restraint" means use of manual restraint that places a person in a face-down position. Business, Senate Medication administration must be taught by a registered nurse, clinical nurse specialist, certified nurse practitioner, physician assistant, or physician if, at the time of service initiation or any time thereafter, the person has or develops a health care condition that affects the service options available to the person because the condition requires: (1) specialized or intensive medical or nursing supervision; and. MN-ITS initial user ID, password and registration instructions included in Welcome Letter. DFL/GOP, House & Video Archives, Session (d) If there are elevators in the facility, the license holder must have elevators inspected each year. 2013 c 108 art 8 s 26; 2014 c 275 art 1 s 50,140; 2014 c 312 art 27 s 30; 2022 c 98 art 17 s 26. The license holder must ensure that the person and the person's representative are notified before admission of the presence of pets in the residence. If the license holder uses a subcontractor or temporary staff to perform services licensed under this chapter on the license holder's behalf, the license holder must ensure that the subcontractor or temporary staff meets and maintains compliance with all requirements under this chapter that apply to the services to be provided, including training, orientation, and supervision necessary to fulfill their responsibilities. (8) individualized home supports services as defined under the brain injury, community alternative care, and community access for disability inclusion, and developmental disabilities waiver plans. The license holder shall complete a monitoring form, approved by the commissioner, for each incident involving the emergency use of a manual restraint. If the person or the person's legal representative refuses to authorize the administration of a psychotropic medication as ordered by the prescriber, the license holder must not administer the medication. Archive, Session Laws (h) The documentation required under sections 245D.07 and 245D.071 must meet the individual program plan requirements identified in section 256B.092 or successor provisions. Staff monitoring the procedure must not be the staff implementing the procedure when possible. This information is not intended to create, and receipt or viewing does not constitute, an attorney-client relationship. The license holder must maintain documentation that the applicable requirements have been met. "License" has the meaning given in section 245A.02, subdivision 8. SLF (MN.Statutes,Chapter 144) licensed by MN Dept. background-color: #2ea3f2; This service includes how to provide Integrated Community Supports services in your business, leasing property management, rental structure, and how to maximize your waiver services (how it will cover the gap of rent . OVERVIEW OF 245D HCBS LICENSE STRUCTURE PROGRAM CATEGORY OF SERVICE SERVICE FACILITY LICENSE LICENSE . Spreadsheet, Minnesota For purposes of this section, "substantial and consistent compliance" means: (1) the license holder's license was not made conditional, suspended, or revoked; (2) there have been no substantiated allegations of maltreatment against the license holder; (3) there were no program deficiencies identified that would jeopardize the health, safety, or rights of persons being served; and. The commissioner's decision that the conditions for approval for an alternative licensing inspection have not been met is final and not subject to appeal under the provisions of chapter 14. and Legislative Business, House (h) For state-operated community-based services, the license holder shall prioritize the capacity created within the existing service site by the termination of services under paragraph (b), clause (7), to serve persons described in section 252.50, subdivision 5, paragraph (a), clause (1). No person receiving services must be counted as or be substituted for a staff member in calculating the staff-to-participant ratio. (a) Within five working days after the completion of the internal review required in subdivision 6, the license holder must consult with the expanded support team following the emergency use of manual restraint to: (1) discuss the incident reported in subdivision 5, to define the antecedent or event that gave rise to the behavior resulting in the manual restraint and identify the perceived function the behavior served; and. (b) At least once per year, the license holder, in coordination with the person's support team or expanded support team, must meet with the person, the person's legal representative, the case manager, and other people as identified by the person or the person's legal representative to discuss how technology might be used to meet the person's desired outcomes. Interventions Support Services. Nothing in this paragraph requires the support plan addendum to include the use of technology for the provision of services. "Psychotropic medication" means any medication prescribed to treat the symptoms of mental illness that affect thought processes, mood, sleep, or behavior. If the support team or expanded support team makes a determination that is contrary to the recommendation of a licensed professional treating the person, the license holder must document the specific reasons why a contrary decision was made. Roster, Upcoming Below is a summary of the programs available for license and the checklist to get a license. Topic (Index), Rules The license holder must establish policies and procedures that promote health and welfare by ensuring: (1) use of universal precautions and sanitary practices in compliance with section 245D.06, subdivision 2, clause (5); (2) if the license holder operates a residential program, health service coordination and care according to the requirements in section 245D.05, subdivision 1; (3) safe medication assistance and administration according to the requirements in sections 245D.05, subdivisions 1a, 2, and 5, and 245D.051, that are established in consultation with a registered nurse, advanced practice registered nurse, physician assistant, or medical doctor and require completion of medication administration training according to the requirements in section 245D.09, subdivision 4a, paragraph (d). Restrictions identified in section 245A.02, subdivision 8 the service suspension, including the written notice of service. 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