(4) If the commissioner has reasonable cause to believe that a potentially hazardous condition may be present or the licensed capacity is increased, the commissioner shall request a subsequent inspection and written report by a fire marshal to verify the absence of hazard. Nothing on this site should be taken as legal advice for any individual case or situation. "Self-determination" means the person makes decisions independently, plans for the person's own future, determines how money is spent for the person's supports, and takes responsibility for making these decisions. (9) be implemented in a manner that is contraindicated for any of the person's known medical or psychological limitations. Members. (3) except for a license holder who is the sole direct support staff, periodic performance evaluations completed by the license holder of the direct support staff person's ability to perform the job functions based on direct observation. 5)Have all of the documents ready, and then call 651-431-6624 M-TH. The purpose of the service plan review is to determine whether changes are needed to the service plan based on the assessment information, the license holder's evaluation of progress toward accomplishing outcomes, or other information provided by the support team or expanded support team. 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. Aunt or uncle. (a) The license holder must ensure that service sites owned or leased by the license holder are free from hazards that would threaten the health or safety of a person receiving services by ensuring the requirements in paragraphs (b) to (h) are met. The license holder must notify the local agency within 24 hours of the onset of changes in a residence resulting from construction, remodeling, or damages requiring repairs that require a building permit or may affect a licensing requirement in this chapter. The HCBS standards under Minnesota Statutes, chapter 245D, are part of a larger HCBS Waiver Provider Standards initiative to improve the dignity, health, and independence of the people we serve. (3) there is an agreement signed by the license holder, the prescriber, and the person or the person's legal representative specifying what injections may be given, when, how, and that the prescriber must retain responsibility for the license holder's giving the injections. or CADI). A facility must have a non-coin-operated telephone that is readily accessible. Typically, an aversive stimulus is unpleasant and penalizes or confines. The CPR training must include instruction, hands-on practice, and an observed skills assessment under the direct supervision of a CPR instructor; and. (2) nonmedical service providers to adapt their services to accommodate the health and safety needs of the person. The certification shall be printed on the license and identified on the commissioner's public website. Assessments must be conducted annually at a minimum or within 30 days of a written request from the person or the person's legal representative or case manager. (2) the person engages in conduct that poses an imminent risk of physical harm to self or others at a documented level of frequency, intensity, or duration requiring frequent daily ongoing intervention and monitoring as established in the person's support plan or support plan addendum. Minnesota Statutes, Chapter 245D, regulates the provision of home and community-based services to persons with disabilities and persons age 65 and older. At a minimum, the first aid kit must be equipped with accessible first aid supplies including bandages, sterile compresses, scissors, an ice bag or cold pack, an oral or surface thermometer, mild liquid soap, adhesive tape, and first aid manual. PSYCHOTROPIC MEDICATION USE AND MONITORING. (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. Below is a summary of the programs available for license and the checklist to get a license. (i) If, within ten working days of submitting changes to the support plan and support plan addendum, the person or the person's legal representative or case manager has not signed and returned to the license holder the support plan or support plan addendum or has not proposed written modifications to the license holder's submission, the submission is deemed approved and the support plan addendum becomes effective and remains in effect until the legal representative or case manager submits a written request to revise the support plan addendum. The notice must explain the revision that was made and include a copy of the revised policy and procedure. "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. Category: Uncategorized Tag: 245D ICS. INTEGRATED COMMUNITY SUPPORTS; SETTING CAPACITY REPORT. (b) The license holder must maintain the following information for each person: (1) an admission form signed by the person or the person's legal representative that includes: (i) identifying information, including the person's name, date of birth, address, and telephone number; and. (7) evaluating the information identified in clauses (1) to (6) to develop, document, and implement ongoing program improvements. The major classes of psychotropic medication are antipsychotic (neuroleptic), antidepressant, antianxiety, mood stabilizers, anticonvulsants, and stimulants and nonstimulants for the treatment of attention deficit/hyperactivity disorder. Mr. Noske comes highly recommended due to the legal representation he gave to my family. A volunteer may be counted as a direct support staff in calculating the staff-to-participant ratio if the volunteer meets the same standards and requirements as paid staff. (d) The staff person must review and receive instruction on medication setup, assistance, or administration procedures established for the person when assigned to the license holder according to section 245D.05, subdivision 1, paragraph (b). (2) The fire marshal inspection of a community residential setting must verify the residence is a dwelling unit within a residential occupancy as defined in section 9.117 of the State Fire Code. County Licensing Functions Under 245D 245D.21 Facility Licensure Requirements and ApplicationProcess. A license holder granted an alternate overnight supervision technology adult foster care license according to section 245A.11, subdivision 7a, that converts to a community residential setting satellite license according to this chapter, must retain that designation. The commissioner must accept a three-year accreditation from the Commission on Accreditation of Rehabilitation Facilities (CARF) as a qualifying accreditation. Injectable medications may be administered according to a prescriber's order and written instructions when one of the following conditions has been met: (1) a registered nurse or licensed practical nurse will administer the injection; (2) a supervising registered nurse with a physician's order has delegated the administration of injectable medication to an unlicensed staff member and has provided the necessary training; or. 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. (e) Notice of the proposed termination of service, including those situations that began with a temporary service suspension, must be given at least 90 days prior to termination of services under paragraph (b), clause (7), 60 days prior to termination when a license holder is providing intensive supports and services identified in section 245D.03, subdivision 1, paragraph (c), and 30 days prior to termination for all other services licensed under this chapter. Pets and service animals housed within the residence must be immunized and maintained in good health as required by local ordinances and state law. The facility must be clean and free from accumulations of dirt, grease, garbage, peeling paint, mold, vermin, and insects. Commission on Pensions & Retirement (LCPR), Lessard-Sams Outdoor Heritage Not everyone who has a 245A license is required to obtain a 245D-HCBS licenseas in the following situations. Interventions Support Services. 2012 c 216 art 18 s 24; 2013 c 108 art 8 s 32; 2014 c 291 art 4 s 58; art 8 s 3-5; 2014 c 312 art 27 s 41,42; 2015 c 71 art 7 s 18,19; 2017 c 90 s 13,14; 1Sp2019 c 9 art 5 s 14,15; 1Sp2020 c 2 art 2 s 6-8; art 8 s 66; 2022 c 98 art 17 s 26. This must be incorporated into the license holder's medication administration policy and procedures required under section 245D.11, subdivision 2, clause (3). Separate satellite license required for separate sites. "Commissioner" means the commissioner of the Department of Human Services or the commissioner's designated representative. Services, Legislators In addition to the training on this policy and procedure and the orientation and annual training required in section 245D.09, subdivision 4, the training for emergency use of manual restraint must incorporate the following subjects: (i) alternatives to manual restraint procedures, including techniques to identify events and environmental factors that may escalate conduct that poses an imminent risk of physical harm to self or others; (ii) de-escalation methods, positive support strategies, and how to avoid power struggles; (iii) simulated experiences of administering and receiving manual restraint procedures allowed by the license holder on an emergency basis; (iv) how to properly identify thresholds for implementing and ceasing restrictive procedures; (v) how to recognize, monitor, and respond to the person's physical signs of distress, including positional asphyxia; (vi) the physiological and psychological impact on the person and the staff when restrictive procedures are used; (vii) the communicative intent of behaviors; and. Reference Library, Office of the Providing structure and emotional support; . Exterior stairs and walkways must be kept free of ice and snow. (b) The designated manager must be competent to perform the duties as required and must minimally meet the education and training requirements identified in subdivision 2, paragraph (b), and have a minimum of three years of supervisory level experience in a program providing direct support services to persons with disabilities or persons age 65 and older. "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. "Incident" means an occurrence which involves a person and requires the program to make a response that is not a part of the program's ordinary provision of services to that person, and includes: (1) serious injury of a person as determined by section 245.91, subdivision 6; (3) any medical emergency, unexpected serious illness, or significant unexpected change in an illness or medical condition of a person that requires the program to call 911; physician, advanced practice registered nurse, or physician assistant treatment; or hospitalization; (4) any mental health crisis that requires the program to call 911, a mental health crisis intervention team, or a similar mental health response team or service when available and appropriate; (5) an act or situation involving a person that requires the program to call 911, law enforcement, or the fire department; (6) a person's unauthorized or unexplained absence from a program; (7) conduct by a person receiving services against another person receiving services that: (i) is so severe, pervasive, or objectively offensive that it substantially interferes with a person's opportunities to participate in or receive service or support; (ii) places the person in actual and reasonable fear of harm; (iii) places the person in actual and reasonable fear of damage to property of the person; or. Comparisons, Bill "Community residential setting" means a residential program as identified in section 245A.11, subdivision 8, where residential supports and services identified in section 245D.03, subdivision 1, paragraph (c), clause (3), items (i) and (ii), are provided and the license holder is the owner, lessor, or tenant of the facility licensed according to this chapter, and the license holder does not reside in the facility. Eligibility for an alternative licensing inspection. Click on Done following twice-examining everything. (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. "License" has the meaning given in section 245A.02, subdivision 8. OVERVIEW OF 245D HCBS LICENSE STRUCTURE . For purposes of this section, "facility" means both a community residential setting and day service facility and the physical plant. 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. A staff ratio requirement of one to eight equals 0.125. Community residential settings and day service facilities. The Home and Community Based Services ("HCBS") "Waiver" 245D License is issued by DHS under the Medicaid program ("Medical Assistance" in Minnesota). "Certification" means the commissioner's written authorization for a license holder to provide specialized services based on certification standards in section 245D.33. Positive support specialist qualifications. Nothing in this paragraph requires that the support plan include the use of technology for the provision of services. Programs approved for alternative licensing inspection; deemed compliance licensing requirements. 245d license training 245d license structure applicant and license holder notarized signature form mn dhs self-monitoring checklist 245d license lookup 245d license contact number 245d license phone number 245d billing. (c) The license holder must ensure the following information is documented in the person's medication administration record: (1) the information on the current prescription label or the prescriber's current written or electronically recorded order or prescription that includes the person's name, description of the medication or treatment to be provided, and the frequency and other information needed to safely and correctly administer the medication or treatment to ensure effectiveness; (2) information on any risks or other side effects that are reasonable to expect, and any contraindications to its use. The CPR training must include instruction, hands-on practice, and an observed skills assessment under the direct supervision of a CPR instructor. Me? The residence must meet the definition of a dwelling unit in a residential occupancy. The restriction must be implemented in the least restrictive alternative manner necessary to protect the person and provide support to reduce or eliminate the need for the restriction in the most integrated setting and inclusive manner. This applies even if you receive a difficulty of care rate in addition to GRH payments. Customize the template with smart fillable fields. Potable water from privately owned wells must be tested annually by a Department of Health-certified laboratory for coliform bacteria and nitrate nitrogens to verify safety. (b) The license holder must limit temporary service suspension to situations in which: (1) the person's conduct poses an imminent risk of physical harm to self or others and either positive support strategies have been implemented to resolve the issues leading to the temporary service suspension but have not been effective and additional positive support strategies would not achieve and maintain safety, or less restrictive measures would not resolve the issues leading to the suspension; (2) the person has emergent medical issues that exceed the license holder's ability to meet the person's needs; or. (v) individualized home support with family training services as defined under the brain injury, community alternative care, community access for disability inclusion, and developmental disabilities waiver plans; (3) residential supports and services, including: (i) supported living services as defined under the developmental disabilities waiver plan provided in a family or corporate child foster care residence, a family adult foster care residence, a community residential setting, or a supervised living facility; (ii) foster care services as defined in the brain injury, community alternative care, and community access for disability inclusion waiver plans provided in a family or corporate child foster care residence, a family adult foster care residence, or a community residential setting; (iii) community residential services as defined under the brain injury, community alternative care, community access for disability inclusion, and developmental disabilities waiver plans provided in a corporate child foster care residence, a community residential setting, or a supervised living facility; (iv) family residential services as defined in the brain injury, community alternative care, community access for disability inclusion, and developmental disabilities waiver plans provided in a family child foster care residence or a family adult foster care residence; and. (a) Each person receiving services must have a choice of roommate and must mutually consent, in writing, to sharing a bedroom with one another. The license holder must maintain documentation of the power-of-attorney in the service recipient record. The license holder must verify and document competence according to the requirements in section 245D.09, subdivision 3. (5) documentation of the expanded support team's approval and the recommendation from the interim panel required under paragraph (b). The license holder must protect service recipient records against loss, tampering, or unauthorized disclosure according to the requirements in sections 13.01 to 13.10 and 13.46. (b) Services must be provided in a manner that supports the person's preferences, daily needs, and activities and accomplishment of the person's personal goals and service outcomes, consistent with the principles of: (1) person-centered service planning and delivery that: (i) identifies and supports what is important to the person as well as what is important for the person, including preferences for when, how, and by whom direct support service is provided; (ii) uses that information to identify outcomes the person desires; and. Authorization must be obtained within five working days of service initiation and renewed annually thereafter. (d) The support plan addendum must include a summary of the discussion required in paragraph (c). Apply for An Associate Project Manager jobs that are part time, remote, internships, junior and senior level. (9) how services must be coordinated across other providers licensed under this chapter serving the person and members of the support team or expanded support team to ensure continuity of care and coordination of services for the person. Lists below contain links to specific sections in the manual about each service. (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. (b) If assigned responsibility for medication assistance or medication administration, the license holder must report the following to the person's legal representative and case manager as they occur or as otherwise directed in the support plan or the support plan addendum: (1) any reports required under subdivision 2, paragraph (c), clause (4); (2) a person's refusal or failure to take or receive medication or treatment as prescribed; or. A decision to terminate services must be reached in compliance with section 245D.10, subdivision 3. (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. (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). Documentation must include an assessment of the person with respect to the characteristics in subdivisions 4, 5, and 6. (iii) instructions on closing off the fire area, using fire extinguishers, and activating and responding to alarm systems; (ii) the location of audible or visual alarm systems, including but not limited to manual fire alarm boxes, smoke detectors, fire alarm enunciators and controls, and sprinkler systems; (iii) the location of exits, primary and secondary evacuation routes, and accessible egress routes, if any; and. 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). St. Paul Office This certification is voluntary for license holders. For purposes of this chapter, a community residential setting is a satellite of the home and community-based services license. 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