245I Legislative Changes

Recovery Peers
245I will be adding a new provider category that has previously only been for substance use treatment programs. The qualifications to be a recovery peer are:

• A minimum of one year in recovery from substance use disorder; and
• Hold a current credential from the Minnesota Certification Board, the Upper Midwest Counsel on Addictive Disorders, or the National Association for Alcoholism and Drug Abuse Counselors that shows that the person possess skills in the areas of ethics, boundaries, advocacy, mentoring, education, and recovery and wellness support.

The scope of practice for recovery peers will include providing individualized peer support, promoting a client’s recovery goals, self-sufficiency, self-advocacy, and development of natural supports, and supporting a client’s maintenance of skills that the client has learned from other services, all while under the supervision of an alcohol and drug counselor. (Minn. Stat. 245I.04, Subd. 18, 19)

Clinical Trainee’s Training
Soon clinical trainees will no longer be required to receive training on specified topics in Minnesota Statute 245I.05 Subd. 3(d-e) within 90 days of providing direct contact services to an adult or child client. 

Documentation Requirements
New documentation standards will require that for client files that the client’s name is on each page of their file and for staff personnel files, that the staff person’s name is on each page of their personnel file. (Minn. Stat. 245I.08, Subd. 2)

Documentation Approval
Current law requires that treatment supervisors must approve and sign off on documentation completed by a clinical trainee or mental health practitioner within five business days of initial completion. New law will be changing so that the treatment supervisor will have ten business days to approve and sign off on the documentation. (Minn. Stat. 245I.08, Subd. 3)

Diagnostic Assessment
The requirements for diagnostic assessments will be changing. New law will allow a Program to complete either a new diagnostic assessment or an updated assessment when there are changes in the client’s mental health or mental health needs, whereas currently, an update was not sufficient. Also, the diagnostic assessment and its updates will be based more upon the client’s needs and status and not on periods of time, so a full diagnostic assessment is not required annually and soon the client will also be able to request for a new assessment to be done. (Minn. Stat. 245I.10, Subd. 2)

For Diagnostic Assessments, clinicians will no longer be required to administer the Early Childhood Service Intensity Instrument (ECSII) to clients aged five or younger. Clinicians will also no longer need to administer the Child and Adolescent Service Intensity Instrument (CASII) to clients aged six to 17 years old. (Minn. Stat. 245I.10, Subd. 6)

Additionally, when completing the diagnostic assessment, information from prior assessments and other providers will be able to be used if the source of the information is documented in the new assessment. 

New elements will be required on the standard diagnostic assessment, that include information about:

• Any immediate risks to the client’s health and safety, including withdrawal symptoms, medical conditions, and behavioral and emotional symptoms;
• The client’s history of mental health and substance use disorder treatment;
• Substance use history, if applicable, including amounts and types of substances, frequency and duration, route of administration, periods of abstinence, and circumstances of relapse and the impact to functioning when under the influence of substances, including legal interventions. 

(Minn. Stat. 245I.10, Subd. 6)

Medication Orders
For Programs who store, prescribe, or administer medications or observe a client self-administer medications, the Program will no longer need to obtain prescription renewals from a licensed prescriber every 90 days for psychotropic medications and annually for all other medications. 

(Minn. Stat. 245I.11, Subd. 4)

Client Rights
Client rights under 245I have been expanded to include gender identity. In addition to the health care bill of rights, 245I programs must also ensure clients have the right to be free from discrimination based on several factors that will also now include their sex or gender identity. 

Mental Health Clinics
Case reviews, completed every two months, as a part of treatment supervision for mental health practitioners and clinical trainees will soon no longer be required. (Minn. Stat. 245I.20, Subd. 5)

For psychiatry services that are billed as evaluation and management services, they must be documented in accordance with the most recent procedural terminology as published by the American Medical Association, even if a diagnostic assessment, functional assessment, or treatment plan is completed by the psychiatrist. (Minn. Stat,, 245I.20, Subd. 6)