​ARMHS and IRTS law Changes July 1 2022 – Minn. Stat. §245I

ARMHS and IRTS providers were once covered under Minn. Stat. §256B, but are now covered under Under Minn. Stat. §245I. Below you will find information related to what has changed and what providers need to do to comply with the new requirement. All of these changes will go into effect on July 1, 2022. 

ARMHS

 

Variances

What Has Changed

ARMHS providers can now seek variances from DHS. The commissioner may grant a variance, as long as it does not affect the staff qualifications or the health or safety of any person in a licensed or certified program and the applicant, license holder, or certification holder. However, to be granted the variance, the license holder must meet the requirements listed in Minn. Stat. §245I.011 subd. 2 (a). 

 

What Providers Must Do

If you believe that your program may require a variance, you should review the requirements and discuss it with the staff. 

 

Required Policies and Procedures 

For all of the following below, the main thing that providers must do is review their policies and procedures, update them as necessary, and train the staff on it if needed. 

 

Generally 

What Has Changed

Every two years, there must be documentation that a review of the program’s policies and procedures has happened (used to be every three years). This documentation must include the date of all policy and procedure revisions. Additionally, any changes must be communicated to each staff person and the necessary training must then be provided to each staff person to implement any policy and procedural change. Minn. Stat. §245I.03 subd. 1.

 

What Providers Must Do

Providers should update their policies to meet these requirements and train their staff accordingly.

 

Health and Safety

What Has Changed

There must be policies and procedures in place now to ensure the health and safety of clients and staff. Minn. Stat. §245I.03 subd. 2. 

 

Client Rights

What Has Changed

A license holder must have policies that describes how the program will ensure staff comply with applicable client rights and protections. This includes the rights listed in the health care bill of rights; the right to be free from discrimination; the right to be informed prior to a photograph, audio, or video recording; notice of rights; and client grievances. More information regarding all of these can be found here: Minn. Stat. §245I.12.

 

Behavioral Emergencies

What Has Changed

A license holder must now have behavioral emergency procedures. These procedures must include the following: (1) a plan designed to prevent the client from inflicting self-harm and harming others; (2) contact information for emergency resources that a staff person must use when the license holder’s behavioral emergency procedures are unsuccessful in controlling a client’s behavior; (3) the types of behavioral emergency procedures that a staff person may use; (4) the specific circumstances under which the program may use behavioral emergency procedures; and (5) the staff persons whom the license holder authorizes to implement behavioral emergency procedures. Minn. Stat. §245I.03 subd. 4.

 

Personnel 

What Has Changed

License holders must now add personnel related policies and procedures. For more information regarding this, please refer to Minn. Stat. §245I.03 subd. 8. 

 

Data Privacy

What Has Changed

There must be client data privacy policies and procedures that comply with state and federal laws. Minn. Stat. §245I.03 subd. 10. 

 

Provider Qualifications and Scope of Practice

For all of the following below, the main thing that must be done is reviewing/updating policies/forms/credentials and training staff as applicable.

 

Mental Health Practitioner Qualifications

What Has Changed

The phrase “supervised” experience is no longer included. Additionally, clinical trainee qualifications are separated out into another section. 

 

Mental Health Rehabilitation Worker Qualifications

What Has Changed

The term “staff person” includes a minimum age of 18. This represents a change from current state for MHRW’s, which had a minimum age of 21.

 

Training Requirements for Staff

Documentation of Training

What Has Changed

The license holder must document the method to evaluate the trainee’s competency upon completion of each training. This includes the following: (1) the topics of the training; (2) the name of the trainee; (3) the name and credentials of the trainer; (4) the license holder’s method of evaluating the trainee’s competency upon completion of training; (5) the date of the training; and

(6) the length of training in hours and minutes. Minn. Stat. §245I.05 subd. 2. 

 

What Providers Must Do

Providers must ensure trainings are documented/include all required information. 

 

Initial Training

What Has Changed

There is now a timeline for when the vulnerable adult and children training needs to be completed by (within 72 hours of providing services to clients). There are additional new training topics and required training for MHRW and practitioners within 90 days of contact for adult population. More information regarding this can be found under Minn. Stat. §245I.05 subd. 3. 

 

What Providers Must Do

Providers must update policies and training topics and train staff on the new topics and document the training for the staff training record.

 

Ongoing Training

What Has Changed

Staff who are not mental health professionals need 30 hours of training every two years. Minn. Stat. §245I.05 subd. 4.

 

What Providers Must Do

Update policies and training topics. Train staff on the new topics and document the training for the staff training record

 

Treatment Supervision

 

Generally 

What Has Changed

The term ‘treatment supervision’ is used now instead of ‘clinical supervision.’ There are specific required topics responsibilities for treatment supervisors. 245I has removed the requirement to

document/record instances for supervision. It expands allowable treatment supervision methods to include telephone calls without a video component. More information regarding this can be found under Minn. Stat. §245I.06 subd. 1.

 

What Providers Must Do

Update/review policies and train staff

 

Treatment Supervision Planning

What Has Changed

245I Changes requirements for supervision plans, which are required within 30 days of employment. For example, the supervision plan no longer requires defining if supervision is individual or group.

 

What Providers Must Do

Update policy/procedures and train staff as necessary. Update supervision plans for each staff person who provides services who is not a mental health professional or certified rehabilitation specialist

 

Treatment Supervision and Direct Observation of Mental Health Rehabilitation Workers and Mental Health Behavioral Aides

What Has Changed

245I changes the frequency of direct observation of a MHRW from “at least a total of one hour during every 40 hours of service provided” to “at least twice a month for the first six months and monthly thereafter.” The staff person who provided direct observation must approve the relevant progress note

 

What Providers Must Do

Update policies and procedures, train staff. Ensure observation and supervision occurs per requirements for MHRW’s.

 

Personnel Files 

Personnel File Requirements 

What Has Changed

245I adds a requirement to maintain a personnel file for every staff person. The list of the requirements are under Minn. Stat. §245I.07.

 

What Providers Must Do

Ensure all applicable items are contained in each staff person’s personnel file. Update policies/forms as required.

 

Documentation Standards

Documenting Approval

What Has Changed

245I allows a treatment supervisor up to five business days to approve diagnostic assessments, functional assessments, level of care assessments, and treatment plans. Minn. Stat. §245I.08 subd. 3. 

 

What Providers Must Do

Update policies and train staff.

 

Progress Notes

What Has Changed

There are now standard documentation requirements for progress notes. To see what must be included in progress notes, refer to Minn. Stat. §245I.08 subd. 4. 

 

What Providers Must Do

Review/update documentation requirements to match new criteria.

 

Client Files

Record Retention

What Has Changed

There is now a record retention standard for the certification requirement. License holders must retain client records of a discharged client for a minimum of five years from the date of the client’s discharge. Minn. Stat. §245I.09 subd. 2. 

 

Contents

What Has Changed

The new statute clarifies and compiles a list of everything that must be in a client’s file. The complete list can be found under Minn. Stat. §245I.09 subd. 3. It should be noted though that only the items listed that are applicable to or exist for the client must be in the file. For example, individual abuse prevention plans do not apply to ARMHS programs.

 

Generally

The brief diagnostic assessment should not be used to authorize ARMHS services.

 

Client Rights and Protections

Client Rights

What Has Changed

245I adds client rights to be free from discrimination and about photographs or audio or video

recordings of clients. Minn. Stat. §245I.12 subd. 1.

 

What Providers Must Do

Update/revise policies/forms and train staff. 

 

Restrictions to Client Rights 

What Has Changed

There is now a requirement to document any restriction of a client’s rights. Minn. Stat. §245I.12 subd. 2.

 

What Providers Must Do

Update/revise policies/forms and train staff.

 

Notice of Rights

What Has Changed

License holders must now give each client a copy of the client’s rights upon admission and document it was given and post a copy of the client’s rights in the facility. Minn. Stat. §245I.12 subd. 3.

 

What Providers Must Do

Update/revise policies/forms and train staff. Post client rights’ in a visible/accessible area to all clients. Give all clients a copy of client rights upon admission. 

 

Client Property

What Has Changed

There now requirements in place regarding client property. The requirements are laid out in Minn. Stat. §245A.04 subd. 13 and must be followed. 

 

What Providers Must Do

Update/revise policies and procedures.

 

Client Grievances

What Has Changed

There are now requirements for the grievance procedure. This can be found under Minn. Stat. §245I.12 subd. 5. 

 

What Providers Must Do

Providers must post the grievance procedure in a visible/accessible area for all clients and explain the grievance process to clients upon admission.

 

IRTS

Admission Criteria (Minn. 245I.23 subd. 15)

What Has Changed

Potential clients no longer need to be eligible for medical assistance to receive IRTS services. Additionally, 245I now specifies that the license holder must not limit or restrict intensive residential treatment services to a client based solely on the client’s substance use; the county in which the client resides; or whether the client elects to receive other services for which the client may be eligible, including case management services.

 

Overall Changes (Minn. Stat. 245I.23)

There is now more time for some initial documentation and assessment. The frequency of assessments is reduced, to allow more time for meaningful progress in the program. There is now flexibility for programs to choose between supervision models, as long as key information can be effectively communicated about clients at shift changes and after treatment plan reviews. There are now discharge standards to promote the retention of clients in treatment whenever possible, and to ensure clear communication at discharge. If an IRTS/RCS program chooses to initiate a client’s discharge, they would need to contact the case manager and family/natural supports before finalizing that step.