This chapter may be cited as the "Home and Community-Based Services Standards" or "HCBS Standards.". If the license holder does not submit a request to renew approval as required, the commissioner must conduct a licensing inspection. Only staff providing direct support must be counted as staff members in calculating the staff-to-participant ratio. (4) maintain emergency contact information for persons served at the facility that can be readily accessed in an emergency. Research, Public The license holder must ensure that emergency use of manual restraints complies with the requirements of this chapter and the license holder's policy and procedures as required under subdivision 9. & Task Forces, Bills In Conference The summary must include a statement regarding any decision that is made regarding the use of technology and a description of any further research that needs to be completed before a decision regarding the use of technology can be made. Constitutional Amendments, Multimedia Audio, 2012 c 216 art 18 s 17; 2013 c 108 art 8 s 22; 2014 c 275 art 1 s 45-47; 2014 c 312 art 27 s 9-18; 2015 c 71 art 7 s 10; 2015 c 78 art 6 s 31; 2019 c 54 art 2 s 11-13; 1Sp2019 c 9 art 5 s 93; 2020 c 115 art 4 s 81; 1Sp2020 c 2 art 2 s 3; art 8 s 63; 2021 c 30 art 17 s 49; 2022 c 58 s 102; 2022 c 98 art 17 s 26. Safety procedures specific to each person's activities must be explained and be available in writing to all staff members and persons receiving services. Customize the template with smart fillable fields. (2) documentation methods the license holder will use to monitor and measure changes in the target symptoms that are to be alleviated by the psychotropic medication if required by the prescriber. If approval is withdrawn, the right must be immediately and fully restored. DO NOT create a new account. This authorization must be in writing or by another method that clearly indicates the person's free choice. (a) For purposes of this subdivision, "medication administration" means: (1) checking the person's medication record; (2) preparing the medication as necessary; (3) administering the medication or treatment to the person; (4) documenting the administration of the medication or treatment or the reason for not administering the medication or treatment; and. Services provided by a license holder to a person under the license holder's guardianship are not licensed services. (2) the interim review panel established in section 245.8251, subdivision 4, recommends commissioner approval of the emergency use of the procedures. For purposes of this chapter, a day services facility license is a satellite license of the day services program. Individualized Home Support. Archive, Minnesota "Support team" means the service planning team identified in section 256B.49, subdivision 15; the interdisciplinary team identified in Minnesota Rules, part 9525.0004, subpart 14; or the case management team as defined in Minnesota Rules, part 9520.0902, subpart 6. For purposes of this section, "prone restraint" means use of manual restraint that places a person in a face-down position. (vii) registered nurse who is licensed under sections 148.171 to 148.285, and who is certified as a clinical specialist or as a nurse practitioner in adult or family psychiatric and mental health nursing by a national nurse certification organization, or who has a master's degree in nursing or one of the behavioral sciences or related fields from an accredited college or university or its equivalent, with at least 4,000 hours of post-master's supervised experience in the delivery of clinical services. The support plan addendum must include a summary of this discussion. "Intermediate care facility for persons with developmental disabilities" or "ICF/DD" means a residential program licensed to serve four or more persons with developmental disabilities under section 252.28 and chapter 245A and licensed as a supervised living facility under chapter 144, which together are certified by the Department of Health as an intermediate care facility for persons with developmental disabilities. "Licensed health professional" means a person licensed in Minnesota to practice those professions described in section 214.01, subdivision 2. "Seclusion" means: (1) removing a person involuntarily to a room from which exit is prohibited by a staff person or a mechanism such as a lock, a device, or an object positioned to hold the door closed or otherwise prevent the person from leaving the room; or (2) otherwise involuntarily removing or separating a person from an area, activity, situation, or social contact with others and blocking or preventing the person's return. (a) The license holder is responsible for meeting health service needs assigned in the support plan or the support plan addendum, consistent with the person's health needs. "Case manager" means the individual designated to provide waiver case management services, care coordination, or long-term care consultation, as specified in chapter 256S and sections 256B.0913, 256B.092, and 256B.49, or successor provisions. (f) A person must be allowed to bring personal possessions into the bedroom and other designated storage space, if such space is available, in the residence. Five percent (5%) rate increase for continuing providers July 1, 2014Rate Increase Details. (3) concerns about a person's self-administration of medication or treatment. Reports & Information, House (3) be a board-certified behavior analyst or board-certified assistant behavior analyst by the Behavior Analyst Certification Board, Incorporated. (a) "Mechanical restraint" means the use of devices, materials, or equipment attached or adjacent to the person's body, or the use of practices that are intended to restrict freedom of movement or normal access to one's body or body parts, or limits a person's voluntary movement or holds a person immobile as an intervention precipitated by a person's behavior. 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. Nothing on this site should be taken as legal advice for any individual case or situation. (4) be under the direct supervision of a positive support professional. (c) If the commissioner finds that the license holder has failed to comply with the certification requirements under section 245A.03, subdivision 6a, paragraph (b), the commissioner may issue a correction order and an order of conditional license in accordance with section 245A.06 or may issue a sanction in accordance with section 245A.07, including and up to removal of the certification. St. Paul Office (3) emergency use of manual restraint subject to the requirements in section 245D.061. Council, Schedules, Calendars, (e) At least once per year, the license holder, in coordination with the person's support team or expanded support team, must meet with a person receiving day services, the person's legal representative, the case manager, and other people as identified by the person or the person's legal representative to discuss options for transitioning to an employment service described in section 245D.03, subdivision 1, paragraph (c), clauses (5) to (7). (b) In order to be eligible for an alternative licensing inspection, the program must have had at least one inspection by the commissioner following issuance of the initial license. Contact Accra "Support plan addendum" means the documentation that this chapter requires of the license holder for each person receiving services. (b) License holders seeking certification under this section must request this certification on forms and in the manner prescribed by the commissioner. The term certification and its derivatives have the same meaning and may be substituted for the term licensure and its derivatives in this chapter and chapter 245A. A staff ratio requirement of one to eight equals 0.125. (4) ensure the exercise and protection of the person's rights in the services provided by the license holder and as authorized in the support plan. Oftentimes the positive reinforcer available is goods, services, or activities to which the person is normally entitled. on MN Resources (LCCMR), Legislative (iv) the location of emergency shelter within the facility; (i) designated assembly points outside the facility; (iii) the routes of fire department access; (4) the responsibilities each staff person must assume in case of emergency; (5) procedures for conducting quarterly drills each year and recording the date of each drill in the file of emergency plans; (6) procedures for relocation or service suspension when services are interrupted for more than 24 hours; (7) for a community residential setting with three or more dwelling units, a floor plan that identifies the location of enclosed exit stairs; and. (7) for state-operated community-based services, the person no longer demonstrates complex behavioral needs that cannot be met by private community-based providers identified in section 252.50, subdivision 5, paragraph (a), clause (1). The commissioner must accept a three-year accreditation from the Commission on Accreditation of Rehabilitation Facilities (CARF) as a qualifying accreditation. (3) any space occupied by persons associated with the multifunctional organization while persons receiving day services are using common space. Information, Caucuses - 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. Individuals will have the opportunity for the development and exercise of decision making, choice . No person receiving services must be counted as or be substituted for a staff member in calculating the staff-to-participant ratio. (5) four years of full-time work experience providing direct care services to persons with disabilities or persons age 65 and older under the supervision of a staff person who meets the qualifications identified in clauses (1) to (3). Archive, Session Laws 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. (a) The license holder must maintain a record of current services provided to each person on the premises where the services are provided or coordinated. (2) the qualifications of the specialist identified in the person's support plan. This requirement does not apply to notices of service termination issued under paragraph (b), clauses (4) and (7); and. 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. (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. OVERVIEW OF 245D HCBS LICENSE STRUCTURE . (b) This chapter does not apply to corporate or family child foster care homes that do not provide services licensed under this chapter. If the license holder provides refrigeration at service sites owned or leased by the license holder for storing perishable foods and perishable portions of bag lunches, whether the foods are supplied by the license holder or the persons receiving services, the refrigeration must have a temperature of 40 degrees Fahrenheit or less. Unlicensed staff may perform medication setup or medication administration only after successful completion of a medication setup or medication administration training, from a training curriculum developed by a registered nurse or appropriate licensed health professional. (2) under section 245A.03, subdivision 2, paragraph (a), clause (1), a related individual as defined under section 245A.02, subdivision 13, is excluded from licensure. This requirement does not apply to temporary suspensions issued under paragraph (b), clause (3). (1) oversight by direct support staff as specified in the person's support plan or support plan addendum and awareness of the person's needs and activities; (2) responding to situations that present a serious risk to the health, safety, or rights of the person while services are being provided; and. The license holder must establish policies and procedures that promote continuity of care by ensuring that admission or service initiation criteria: (1) is consistent with the service-related rights identified in section 245D.04, subdivisions 2, clauses (4) to (7), and 3, clause (8); (2) identifies the criteria to be applied in determining whether the license holder can develop services to meet the needs specified in the person's support plan; (3) requires a license holder providing services in a health care facility to comply with the requirements in section 243.166, subdivision 4b, to provide notification to residents when a registered predatory offender is admitted into the program or to a potential admission when the facility was already serving a registered predatory offender. Adverse reactions must be immediately reported to the prescriber or a nurse. The designated coordinator may delegate the direct observation and competency assessment of the service delivery activities of direct support staff to an individual whom the designated coordinator has previously deemed competent in those activities; and. "Service site" means the location where the service is provided to the person, including, but not limited to, a facility licensed according to chapter 245A; a location where the license holder is the owner, lessor, or tenant; a person's own home; or a community-based location. The license holder must provide services as assigned in the support plan. (3) the presence of direct support staff at a service site while services are being provided, unless a determination has been made and documented in the person's support plan or support plan addendum that the person does not require the presence of direct support staff while services are being provided. For purposes of this subdivision, "weapons" means firearms and other instruments or devices designed for and capable of producing bodily harm. 16) MHCP sends you a Welcome Letter to confirm your enrollment. [Repealed by amendment, 2013 c 108 art 8 s 27]. If doors are locked from the inside, the license holder must document an assessment of the physical plant, the environment and the population served, identifying the risk factors which require the use of locked doors, and a statement of specific measures to be taken to minimize the safety risk to persons receiving services at the service site; (iv) a staff person is available at the service site who is trained in basic first aid and, when required in a person's support plan or support plan addendum, cardiopulmonary resuscitation (CPR) whenever persons are present and staff are required to be at the site to provide direct support service. (2) to be able to implement the responsibilities assigned to the license holder in each person's support plan or identified in the support plan addendum, according to the requirements of this chapter. 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. (b) The commissioner has limited authority to grant approval for the emergency use of procedures identified in subdivision 6 that had been part of an approved positive support transition plan when a person is at imminent risk of serious injury as defined in section 245.91, subdivision 6, due to self-injurious behavior and the following conditions are met: (1) the person's expanded support team approves the emergency use of the procedures; and. Our 245D program is a licensed Home and Community Based Program, providing Basic Services in a manner that supports the individual's preferences, daily needs, and activities needed to accomplish their personal goals. "Supervised living facility" has the meaning given in Minnesota Rules, part 4665.0100, subpart 10. (g) Heating, ventilation, air conditioning units, and other hot surfaces and moving parts of machinery must be shielded or enclosed. 03. COMMUNITY RESIDENTIAL SETTINGS; FOOD AND WATER. (6) there is a need for corrective action by the license holder to protect the health and welfare of persons. (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. For example, if an uncle provides services to his nephew, the uncle may be excluded from 245D licensure. National regulatory agencies include: United States of America: Division of Licensing and Regulation, U.S. Atomic Energy Commission, Washington 25, D.C. Person requiring staff ratio of one to six. The documentation must include the following information: (1) the justification for the restriction based on an assessment of the person's vulnerability related to exercising the right without restriction; (2) the objective measures set as conditions for ending the restriction; (3) a schedule for reviewing the need for the restriction based on the conditions for ending the restriction to occur semiannually from the date of initial approval, at a minimum, or more frequently if requested by the person, the person's legal representative, if any, and case manager; and.