Human services policy law modifies health services, SUD direct access and peer recovery requirements

Numerous human services policy and technical changes are the focus of a new law.

Sponsored by Rep. Peter Fischer (DFL-Maplewood) and Sen. John Hoffman (DFL-Champlin), it takes effect Aug. 1, 2023, unless otherwise noted.

Aging, disability, and behavioral health services

For the community-based services workforce development grant, the law will exclude the grant from counting as income or an asset when determining eligibility for several public economic or health care programs. The maximum income eligibility for the grant will be expanded from 200% to 300% of the federal poverty guidelines.

Minor modifications include:

• an exception to the corporate foster care moratorium, effective May 25, 2023;

• the list of basic support services and intensive support services under statutes that govern home and community-based services standards;

• switching the opioid treatment program nonmedication treatment services plan review to once every three months rather than monthly;

• the maximum number of clients for an opioid treatment counselor will increase from 50 to 60, between July 1, 2023, and June 30, 2024;

• behavioral health fund room and board vendor requirements will require awake staff on site whenever a client is present as opposed to 24 hours per day; and

• the elderly waiver customized living monthly service rate limit will change by removing the subtraction of maintenance needs allowance.

A statute that limits the Department of Human Services delegation of certain licensing authority to county agencies will include community residential settings, effective May 25, 2023.

The June 30, 2023, expiration date for the American Indian Advisory Council and the state traumatic brain injury program will be removed.

Effective May 25, 2023, the Department of Human Services will be allowed to establish a systemic critical incident review team to examine incidents related to vulnerable adults in facilities or services where the department is the lead investigative agency.

For consumer surveys of home and community-based services the department will be able to request de-identified demographic information of clients. Demographic information may also appear in the home and community-based services report card.

Moreover, licensed assisted living facilities must participate in resident experience and family surveys when requested.

Both effective May 25, 2023, the department, counties of financial responsibility and the participating license holder will no longer need a contract for approved adult foster care planned closures, and guardians will have the opportunity to appoint or name a person to exercise signature authority over an ABLE account.

The new law repeals the chemical health care pilot project and the treatment for pregnant and postpartum women with substance use disorder project, as well as the expiration dates of the Cultural and Ethnic Communities Leadership Council and the American Indian Child Welfare Advisory Council. All of which took effect May 25, 2023. (Art. 1, Secs. 14-18, 20-21, 23, 26-29, 31-36, 38)

Substance use disorder direct access

Cross-referencing and terminology updates will be made to reflect the change from “Rule 25” assessments and placements for substance use disorder services to the current direct access model for comprehensive assessments and services.

Modifying comprehensive substance use disorder assessments, the law will increase the time from within three days to five days after service initiation and will require an alcohol and drug counselor to sign and date the comprehensive review and update, effective Jan. 1, 2024.

In addition to requiring a program to provide listed education material to clients assessed for opioid use disorder within 24 hours, these assessments will be modified to include:

• a diagnosis of a substance use disorder or finding that a client does not meet the criteria for a diagnosis;

• a determination involving co-occurring mental health disorders;

• a risk rating and summary; and

• a recommendation for the American Society for Addiction Medicine level of care, all of which are effective Jan. 1, 2024.

Further changes effective Jan. 1, 2024, will:

• modify the timeframe a substance use disorder treatment provider has to develop an individual treatment plan for a client;

• outline individual treatment plan requirements;

• alter treatment plan review requirements, such as adding toxicology results if available;

• establish a treatment plan review frequency of once every 14 days for clients in residential treatment programs, reviews for clients in a nonresidential program will vary by need;

• remove an assessment summary from client record contents; and

• require eligible vendors to implement the standards set by the American Society for Addiction Medicine for each client assigned an ASAM level of care.

The law will compel local agencies to determine a client’s financial eligibility for the behavioral health fund and pay for eligible clients. Clients whose income is within current household size and income guidelines will not pay a fee.

Behavioral health fund vendors must participate in DAANES.

Furthermore, the law will repeal language regarding alcohol safety programs, chemical use assessments, opioid treatment programs, placing authorities, chemical use assessments, emergency room patients, probation officer as contact, assessment via telehealth, substance use disorder rules, and vendor collections.

The repeals of language involving individual treatment plan contents and substance use disorder assessment summary take effect Jan. 1, 2024. (Art. 2, Secs. 12-18, 49-51, 53, 61)

Peer recovery and recovery community organization requirements

This law will modify the qualifications and scope of practice for recovery peers, as well as establish eligibility requirements for recovery community organizations to be vendors of peer support services.

Upon federal approval, new requirements for recovery peers will include having at least one year in recovery from a substance use disorder and holding a current credential from either the Minnesota Certification Board, the Upper Midwest Indian Council on Addictive Disorders, or the National Association for Alcoholism and Drug Abuse Counselors.

A recovery peer must also provide individualized peer support, promote a client’s goals and development, and support a client’s maintenance of skills.

The law specifies that a recovery community organization must be a nonprofit and lists eligibility qualifications to be vendors.

Additionally, organizations must meet membership or accreditation requirements of the Association of Recovery Community Organizations, Council on Accreditation of Peer Recovery Support Services, or a statewide recovery community organization. To maintain eligibility, these requirements must be met by June 30, 2024.

A state agency hearing will be available for aggrieved recovery community organizations seeking behavioral health fund vendor eligibility. (Art. 3, Secs. 2-7)

Other changes

Lastly, the new law will add the following entities to the definition of “settling defendant” for opioid settlements: Teva Pharmaceuticals; Allergan plc; CVS Health Corporation; Walgreens Boots Alliance, Inc.; and Walmart, Inc. (Art. 4, Sec. 1)

HF1403*/SF2818/CH50

HF1403* / SF2818 / CH50