What is 245G – Substance Use Disorder License?

 

Defining 245G and Substance Use Disorder

As an attorney at Holt Law in Minnesota, I often field questions from healthcare professionals, medical spas, and licensed healthcare facilities about 245G and substance use disorder treatment. This topic is both important and complex, so let’s dive in and provide a comprehensive overview.

First, let’s define what 245G is. 245G refers to a specific section of Minnesota and Federal law that governs the provision of substance use disorder treatment services. More specifically, 245G outlines the requirements and standards that treatment programs must meet in order to be licensed and operate in the state.

Substance use disorder, sometimes referred to as drug addiction or alcoholism, is a chronic medical condition characterized by the uncontrolled use of substances like alcohol, opioids, stimulants, or other drugs. This condition can have severe negative impacts on a person’s physical health, mental well-being, relationships, employment, and overall quality of life. While substance use disorder is treatable, managing it often requires comprehensive, evidence-based treatment and ongoing support.

The 245G standards are in place to ensure that Minnesotans struggling with substance use disorder have access to high-quality, effective treatment services. These standards cover everything from the clinical services that must be provided, to the physical requirements of treatment facilities, to the credentials and training of staff. The goal is to create a consistent baseline of care across the state.

 

Unpacking the 245G Requirements

So, what exactly does 245G require? Let’s break it down:

 

Scope of Services

At the core of 245G are the requirements around the specific services that licensed substance use disorder treatment programs must offer. These include:

  • Comprehensive Assessment: Programs must conduct a thorough biopsychosocial assessment to fully understand the individual’s substance use history, medical/mental health needs, and social/environmental factors. This assessment forms the foundation of the treatment plan.
  • Individualized Treatment Planning: Based on the assessment, the program must work with the client to develop an individualized treatment plan that outlines their specific goals, the services and interventions that will be provided, and the expected timeline.
  • Counseling and Therapy: 245G requires the provision of individual, group, and family counseling and therapy, utilizing a range of evidence-based modalities like cognitive-behavioral therapy, motivational interviewing, and more.
  • Care Coordination: Programs must coordinate the client’s care with other relevant providers, such as primary care doctors, mental health professionals, social services, housing assistance, and so on. Effective care coordination is crucial for addressing the multifaceted needs of those with substance use disorder.
  • Medication Services: For clients who could benefit from medication-assisted treatment (MAT), the program must either provide those services on-site or have a mechanism in place to refer the client to an appropriate provider.
  • Peer Support: The use of peer support specialists, who are individuals in recovery themselves, is an important component of 245G programming. Peer support can enhance motivation, model healthy coping strategies, and provide an important social connection.
  • Continuing Care: 245G mandates that programs provide continuing care and relapse prevention services to support clients’ long-term recovery after the primary episode of treatment.

 

Staffing and Training Requirements

In addition to the clinical service requirements, 245G also lays out specific standards for the staff who work in licensed substance use disorder treatment programs. These include:

  • Credentialing: All counselors and therapists must hold the appropriate professional licenses and credentials, such as a Licensed Alcohol and Drug Counselor (LADC) credential.
  • Training: Staff must complete ongoing training in areas like trauma-informed care, cultural competence, motivational interviewing, pharmacology, and more.
  • Supervision: There are requirements around the frequency and nature of supervision that must be provided, particularly for counselors who are still obtaining their full credentials.
  • Staffing Levels: Programs must maintain adequate staffing levels to ensure clients receive the required individual and group counseling time.

 

Facility Requirements

The 245G law also specifies certain physical and operational requirements for substance use disorder treatment facilities, such as:

  • Square Footage and Design Standards: There are specific minimum requirements for the size and layout of client bedrooms, group therapy rooms, intake/assessment areas, and more.
  • Safety and Security: Facilities must meet standards around fire safety, security, and client supervision to ensure a safe environment.
  • Sanitation and Cleanliness: Programs must maintain clean, well-maintained facilities and follow proper protocols for sanitizing equipment, handling medications, and preventing the spread of infectious diseases.
  • Food Service: If the program provides meals, they must meet nutritional guidelines and accommodate special dietary needs.

These facility standards help create a therapeutic, healing environment that supports the recovery process.

 

Admission and Discharge Processes

245G also regulates the processes by which clients are admitted to and discharged from substance use disorder treatment programs. This includes:

  • Admission Criteria: Programs must have clearly defined admission criteria that do not discriminate and ensure clients are appropriate for the level of care offered.
  • Assessment Timeline: Clients must receive a comprehensive assessment within the first three calendar days of admission.
  • Discharge Planning: Programs must begin discharge planning from the point of admission and coordinate aftercare services to support the client’s continued recovery.
  • Discharge Criteria: There must be objective criteria for determining when a client has successfully completed the program or requires a different level of care.

These admission and discharge requirements help promote consistency, equity, and continuity of care.

 

Quality Improvement and Reporting

Finally, 245G mandates that licensed substance use disorder treatment programs have robust quality improvement processes and data reporting mechanisms in place. This includes:

  • Continuous Quality Improvement: Programs must have a quality improvement plan and hold regular meetings to review program data, identify areas for improvement, and implement changes.
  • Outcome Measurement: 245G requires the collection and reporting of various client outcome measures, such as abstinence rates, housing stability, employment status, and criminal justice involvement.
  • Incident Reporting: Programs must report any critical incidents, such as client injuries, medication errors, or instances of physical restraint, to the state regulatory body.

This quality and accountability framework helps ensure that treatment programs are delivering effective, safe, and ethical care.

 

Implications for Healthcare Providers

So, how does all of this 245G information relate to healthcare professionals, medical spas, and licensed healthcare facilities? There are a few key ways:

 

Referrals and Care Coordination

As mentioned earlier, 245G requires substance use disorder treatment programs to coordinate care with other relevant providers. This means that doctors, nurses, therapists, and other healthcare professionals will likely be asked to share information, participate in treatment planning, and work collaboratively with the client’s substance use disorder treatment team.

It’s important for healthcare providers to understand the 245G requirements so that they can effectively partner with licensed substance use disorder treatment programs. This might involve things like providing medical records, adjusting medication regimens, or making appropriate referrals.

 

Regulatory Compliance

If your healthcare organization or facility provides any substance use disorder treatment services, it must be licensed under 245G. This means adhering to all the standards we discussed around service scope, staffing, facility requirements, admission/discharge processes, and quality improvement.

Maintaining 245G compliance can be complex, so it’s critical for these providers to stay up-to-date on any changes to the law and work closely with their legal counsel. Failure to comply with 245G can result in penalties, license revocation, and even criminal charges in some cases.

 

Employee Training and Support

Even healthcare organizations that don’t directly provide substance use disorder treatment may have employees who interact with and support clients/patients dealing with these issues. 245G emphasizes the importance of staff training around topics like trauma-informed care, harm reduction, and recovery-oriented approaches.

Providing this type of training can help healthcare employees better understand substance use disorder, feel more equipped to have productive conversations, and connect patients to appropriate treatment resources. It also helps foster a more compassionate, non-judgmental organizational culture.

 

Policy Development

Given the complex legal and clinical requirements around substance use disorder treatment, healthcare organizations may need to develop robust internal policies and protocols. This could include things like:

  • Intake and assessment procedures for identifying substance use issues
  • Care coordination and referral processes
  • Employee training curricula
  • Incident reporting and quality improvement mechanisms
  • Confidentiality and data-sharing procedures

Having clear, well-documented policies that align with 245G can help ensure consistency, reduce liability, and ultimately improve patient/client outcomes.

 

Conclusion

Substance use disorder is a pervasive public health issue that requires a comprehensive, evidence-based approach to treatment and support. 245G is the Minnesota statute that establishes the standards for licensed substance use disorder treatment programs, covering everything from clinical services to facility requirements to quality assurance.

If you have any specific questions about 245G or need assistance with ensuring your organization’s policies and practices are aligned, I encourage you to reach out to the team at Holt Law. We’re here to provide the legal guidance and support you need.

 

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