1.1.................... moves to amend H.F. No. 1403, the first engrossment, as follows:
1.2Page 12, delete section 15
1.3Page 18, line 16, after "day" insert "support" and strike "under sections 252.41 to 252.46,
1.4and"
1.5Page 18, line 18, delete "and"
1.6Page 18, line 19, after the stricken "(iii)" insert "(ii)" and reinstate the stricken "day
1.7training and habilitation services under sections 252.41 to 252.46"
1.8Page 18, line 20, reinstate the stricken "; and"
1.9Page 18, line 21, delete "(ii)" and insert "(iii)"
1.10Page 18, line 23, strike "and"
1.11Page 24, line 33, delete "coordinated service and" and insert "community"
1.12Page 25, line 13, before the semicolon, insert "and the Office of Ombudsman for
1.13Long-Term Care"
1.14Page 25, line 30, delete "and"
1.15Page 26, line 2, delete the period and insert "; and"
1.16Page 26, after line 2, insert:
1.17"(6) other incidents determined by the commissioner."
1.18Page 30, after line 30, insert:

2.1    "Sec. 26. Minnesota Statutes 2022, section 256B.439, is amended by adding a subdivision
2.2to read:
2.3    Subd. 3e. Demographic information for home and community-based services report
2.4card. (a) For purposes of including relevant information in the home and community-based
2.5services report card for consumers on the populations served by providers and for other
2.6data analysis, the commissioner may request from providers the following summary data
2.7about clients served by the provider:
2.8(1) age;
2.9(2) race;
2.10(3) ethnicity; and
2.11(4) gender identity.
2.12(b) For the purposes of this subdivision, "summary data" has the meaning given in section
2.1313.02, subdivision 19. Providers must furnish the summary data only if the data on individuals
2.14is available to the provider. A provider is not required to collect any demographic data from
2.15clients for the sole purpose of providing the information requested by the commissioner
2.16under this subdivision. If a provider furnishes the requested summary data to the
2.17commissioner, the provider must provide notice to clients and associated key representatives
2.18that the client's demographic information was included in the summary data provided to the
2.19commissioner."
2.20Page 45, line 11, strike "in accordance with the criteria contained" and insert "identified"
2.21Page 45, line 13, delete "245G.05" and insert "254B.19, subdivision 1"
2.22Page 47, delete section 7 and insert:

2.23    "Sec. 7. Minnesota Statutes 2022, section 245F.06, subdivision 2, is amended to read:
2.24    Subd. 2. Comprehensive assessment and assessment summary. (a) Prior to a medically
2.25stable discharge, but not later than 72 hours following admission, a license holder must
2.26provide a comprehensive assessment and assessment summary according to sections
2.27245.4863, paragraph (a), and 245G.05, for each patient who has a positive screening for a
2.28substance use disorder. If a patient's medical condition prevents a comprehensive assessment
2.29from being completed within 72 hours, the license holder must document why the assessment
2.30was not completed. The comprehensive assessment must include documentation of the
2.31appropriateness of an involuntary referral through the civil commitment process.
3.1(b) If available to the program, a patient's previous comprehensive assessment may be
3.2used in the patient record. If a previously completed comprehensive assessment is used, its
3.3contents must be reviewed to ensure the assessment is accurate and current and complies
3.4with the requirements of this chapter. The review must be completed by a staff person
3.5qualified according to section 245G.11, subdivision 5. The license holder must document
3.6that the review was completed and that the previously completed assessment is accurate
3.7and current, or the license holder must complete an updated or new assessment.

3.8    Sec. 8. Minnesota Statutes 2022, section 245G.01, is amended by adding a subdivision to
3.9read:
3.10    Subd. 20c. Protective factors. "Protective factors" means the actions or efforts a person
3.11can take to reduce the negative impact of certain issues, such as substance use disorders,
3.12mental health disorders, and risk of suicide. Protective factors include connecting to positive
3.13supports in the community, a nutritious diet, exercise, attending counseling or 12-step
3.14groups, and taking appropriate medications.

3.15    Sec. 9. Minnesota Statutes 2022, section 245G.01, is amended by adding a subdivision to
3.16read:
3.17    Subd. 20d. Skilled treatment services. "Skilled treatment services" has the meaning
3.18provided in section 254B.01, subdivision 10.

3.19    Sec. 10. Minnesota Statutes 2022, section 245G.02, subdivision 2, is amended to read:
3.20    Subd. 2. Exemption from license requirement. This chapter does not apply to a county
3.21or recovery community organization that is providing a service for which the county or
3.22recovery community organization is an eligible vendor under section 254B.05. This chapter
3.23does not apply to an organization whose primary functions are information, referral,
3.24diagnosis, case management, and assessment for the purposes of client placement, education,
3.25support group services, or self-help programs. This chapter does not apply to the activities
3.26of a licensed professional in private practice. A license holder providing the initial set of
3.27substance use disorder services allowable under section 254A.03, subdivision 3, paragraph
3.28(c), to an individual referred to a licensed nonresidential substance use disorder treatment
3.29program after a positive screen for alcohol or substance misuse is exempt from sections
3.30245G.05; 245G.06, subdivisions 1, 1a, 2, and 4; 245G.07, subdivisions 1, paragraph (a),
3.31clauses (2) to (4), and 2, clauses (1) to (7); and 245G.17.
3.32EFFECTIVE DATE.This section is effective January 1, 2024.

4.1    Sec. 11. Minnesota Statutes 2022, section 245G.05, subdivision 1, is amended to read:
4.2    Subdivision 1. Comprehensive assessment. (a) A comprehensive assessment of the
4.3client's substance use disorder must be administered face-to-face by an alcohol and drug
4.4counselor within three five calendar days from the day of service initiation for a residential
4.5program or within three calendar days on which a treatment session has been provided of
4.6the day of service initiation for a client by the end of the fifth day on which a treatment
4.7service is provided in a nonresidential program. The number of days to complete the
4.8comprehensive assessment excludes the day of service initiation. If the comprehensive
4.9assessment is not completed within the required time frame, the person-centered reason for
4.10the delay and the planned completion date must be documented in the client's file. The
4.11comprehensive assessment is complete upon a qualified staff member's dated signature. If
4.12the client received a comprehensive assessment that authorized the treatment service, an
4.13alcohol and drug counselor may use the comprehensive assessment for requirements of this
4.14subdivision but must document a review of the comprehensive assessment and update the
4.15comprehensive assessment as clinically necessary to ensure compliance with this subdivision
4.16within applicable timelines. The comprehensive assessment must include sufficient
4.17information to complete the assessment summary according to subdivision 2 and the
4.18individual treatment plan according to section 245G.06. The comprehensive assessment
4.19must include information about the client's needs that relate to substance use and personal
4.20strengths that support recovery, including:
4.21(1) age, sex, cultural background, sexual orientation, living situation, economic status,
4.22and level of education;
4.23(2) a description of the circumstances on the day of service initiation;
4.24(3) a list of previous attempts at treatment for substance misuse or substance use disorder,
4.25compulsive gambling, or mental illness;
4.26(4) a list of substance use history including amounts and types of substances used,
4.27frequency and duration of use, periods of abstinence, and circumstances of relapse, if any.
4.28For each substance used within the previous 30 days, the information must include the date
4.29of the most recent use and address the absence or presence of previous withdrawal symptoms;
4.30(5) specific problem behaviors exhibited by the client when under the influence of
4.31substances;
4.32(6) the client's desire for family involvement in the treatment program, family history
4.33of substance use and misuse, history or presence of physical or sexual abuse, and level of
4.34family support;
5.1(7) physical and medical concerns or diagnoses, current medical treatment needed or
5.2being received related to the diagnoses, and whether the concerns need to be referred to an
5.3appropriate health care professional;
5.4(8) mental health history, including symptoms and the effect on the client's ability to
5.5function; current mental health treatment; and psychotropic medication needed to maintain
5.6stability. The assessment must utilize screening tools approved by the commissioner pursuant
5.7to section 245.4863 to identify whether the client screens positive for co-occurring disorders;
5.8(9) arrests and legal interventions related to substance use;
5.9(10) a description of how the client's use affected the client's ability to function
5.10appropriately in work and educational settings;
5.11(11) ability to understand written treatment materials, including rules and the client's
5.12rights;
5.13(12) a description of any risk-taking behavior, including behavior that puts the client at
5.14risk of exposure to blood-borne or sexually transmitted diseases;
5.15(13) social network in relation to expected support for recovery;
5.16(14) leisure time activities that are associated with substance use;
5.17(15) whether the client is pregnant and, if so, the health of the unborn child and the
5.18client's current involvement in prenatal care;
5.19(16) whether the client recognizes needs related to substance use and is willing to follow
5.20treatment recommendations; and
5.21(17) information from a collateral contact may be included, but is not required.
5.22(b) If the client is identified as having opioid use disorder or seeking treatment for opioid
5.23use disorder, the program must provide educational information to the client concerning:
5.24(1) risks for opioid use disorder and dependence;
5.25(2) treatment options, including the use of a medication for opioid use disorder;
5.26(3) the risk of and recognizing opioid overdose; and
5.27(4) the use, availability, and administration of naloxone to respond to opioid overdose.
5.28(c) The commissioner shall develop educational materials that are supported by research
5.29and updated periodically. The license holder must use the educational materials that are
5.30approved by the commissioner to comply with this requirement.
6.1(d) If the comprehensive assessment is completed to authorize treatment service for the
6.2client, at the earliest opportunity during the assessment interview the assessor shall determine
6.3if:
6.4(1) the client is in severe withdrawal and likely to be a danger to self or others;
6.5(2) the client has severe medical problems that require immediate attention; or
6.6(3) the client has severe emotional or behavioral symptoms that place the client or others
6.7at risk of harm.
6.8If one or more of the conditions in clauses (1) to (3) are present, the assessor must end the
6.9assessment interview and follow the procedures in the program's medical services plan
6.10under section 245G.08, subdivision 2, to help the client obtain the appropriate services. The
6.11assessment interview may resume when the condition is resolved. An alcohol and drug
6.12counselor must sign and date the comprehensive assessment review and update.
6.13EFFECTIVE DATE.This section is effective January 1, 2024.

6.14    Sec. 12. Minnesota Statutes 2022, section 245G.05, is amended by adding a subdivision
6.15to read:
6.16    Subd. 3. Comprehensive assessment requirements. (a) A comprehensive assessment
6.17must meet the requirements under section 245I.10, subdivision 6, paragraphs (b) and (c).
6.18It must also include:
6.19(1) a diagnosis of a substance use disorder or a finding that the client does not meet the
6.20criteria for a substance use disorder;
6.21(2) a determination of whether the individual screens positive for co-occurring mental
6.22health disorders using a screening tool approved by the commissioner pursuant to section
6.23245.4863;
6.24(3) a risk rating and summary to support the risk ratings within each of the dimensions
6.25listed in section 254B.04, subdivision 4; and
6.26(4) a recommendation for the ASAM level of care identified in section 254B.19,
6.27subdivision 1.
6.28(b) If the individual is assessed for opioid use disorder, the program must provide
6.29educational material to the client within 24 hours of service initiation on:
6.30(1) risks for opioid use disorder and dependence;
6.31(2) treatment options, including the use of a medication for opioid use disorder;
7.1(3) the risk and recognition of opioid overdose; and
7.2(4) the use, availability, and administration of an opiate antagonist to respond to opioid
7.3overdose.
7.4If the client is identified as having opioid use disorder at a later point, the required educational
7.5material must be provided at that point. The license holder must use the educational materials
7.6that are approved by the commissioner to comply with this requirement.
7.7EFFECTIVE DATE.This section is effective January 1, 2024.

7.8    Sec. 13. Minnesota Statutes 2022, section 245G.06, subdivision 1, is amended to read:
7.9    Subdivision 1. General. Each client must have a person-centered individual treatment
7.10plan developed by an alcohol and drug counselor within ten days from the day of service
7.11initiation for a residential program and within five calendar days, by the end of the tenth
7.12day on which a treatment session has been provided from the day of service initiation for
7.13a client in a nonresidential program, not to exceed 30 days. Opioid treatment programs must
7.14complete the individual treatment plan within 21 days from the day of service initiation.
7.15The number of days to complete the individual treatment plan excludes the day of service
7.16initiation. The individual treatment plan must be signed by the client and the alcohol and
7.17drug counselor and document the client's involvement in the development of the plan. The
7.18individual treatment plan is developed upon the qualified staff member's dated signature.
7.19Treatment planning must include ongoing assessment of client needs. An individual treatment
7.20plan must be updated based on new information gathered about the client's condition, the
7.21client's level of participation, and on whether methods identified have the intended effect.
7.22A change to the plan must be signed by the client and the alcohol and drug counselor. If the
7.23client chooses to have family or others involved in treatment services, the client's individual
7.24treatment plan must include how the family or others will be involved in the client's treatment.
7.25If a client is receiving treatment services or an assessment via telehealth and the alcohol
7.26and drug counselor documents the reason the client's signature cannot be obtained, the
7.27alcohol and drug counselor may document the client's verbal approval or electronic written
7.28approval of the treatment plan or change to the treatment plan in lieu of the client's signature.
7.29EFFECTIVE DATE.This section is effective January 1, 2024.

8.1    Sec. 14. Minnesota Statutes 2022, section 245G.06, is amended by adding a subdivision
8.2to read:
8.3    Subd. 1a. Individual treatment plan contents and process. (a) After completing a
8.4client's comprehensive assessment, the license holder must complete an individual treatment
8.5plan. The license holder must:
8.6(1) base the client's individual treatment plan on the client's comprehensive assessment;
8.7(2) use a person-centered, culturally appropriate planning process that allows the client's
8.8family and other natural supports to observe and participate in the client's individual treatment
8.9services, assessments, and treatment planning;
8.10(3) identify the client's treatment goals in relation to any or all of the applicable ASAM
8.11six dimensions identified in section 254B.04, subdivision 4, to ensure measurable treatment
8.12objectives, a treatment strategy, and a schedule for accomplishing the client's treatment
8.13goals and objectives;
8.14(4) document the level of care identified in section 254B.19, subdivision 1, and the
8.15program plans to provide to the client each week or, if less frequently than weekly, the
8.16number of hours of treatment services the program plans to provide to the client each month;
8.17(5) identify the participants involved in the client's treatment planning. The client must
8.18participate in the client's treatment planning. If applicable, the license holder must document
8.19the reasons that the license holder did not involve the client's family or other natural supports
8.20in the client's treatment planning;
8.21(6) identify resources to refer the client to when the client's needs will be addressed
8.22concurrently by another provider; and
8.23(7) identify maintenance strategy goals and methods designed to address relapse
8.24prevention and to strengthen the client's protective factors.
8.25EFFECTIVE DATE.This section is effective January 1, 2024.

8.26    Sec. 15. Minnesota Statutes 2022, section 245G.06, subdivision 3, is amended to read:
8.27    Subd. 3. Treatment plan review. A treatment plan review must be entered in a client's
8.28file weekly or after each treatment service, whichever is less frequent, completed by the
8.29alcohol and drug counselor responsible for the client's treatment plan. The review must
8.30indicate the span of time covered by the review and each of the six dimensions listed in
8.31section 245G.05, subdivision 2, paragraph (c). The review and must:
9.1(1) address each goal in the document client goals addressed since the last treatment
9.2plan review and whether the identified methods to address the goals are continue to be
9.3effective;
9.4(2) include document monitoring of any physical and mental health problems and include
9.5toxicology results for alcohol and substance use, when available;
9.6(3) document the participation of others involved in the individual's treatment planning,
9.7including when services are offered to the client's family or significant others;
9.8(4) if changes to the treatment plan are determined to be necessary, document staff
9.9recommendations for changes in the methods identified in the treatment plan and whether
9.10the client agrees with the change; and
9.11(5) include a review and evaluation of the individual abuse prevention plan according
9.12to section 245A.65.; and
9.13(6) document any referrals made since the previous treatment plan review.
9.14EFFECTIVE DATE.This section is effective January 1, 2024.

9.15    Sec. 16. Minnesota Statutes 2022, section 245G.06, is amended by adding a subdivision
9.16to read:
9.17    Subd. 3a. Frequency of treatment plan reviews. (a) A license holder must ensure that
9.18the alcohol and drug counselor responsible for a client's treatment plan completes and
9.19documents a treatment plan review that meets the requirements of subdivision 3 in each
9.20client's file, according to the frequencies required in this subdivision. All ASAM levels
9.21referred to in this chapter are those described in section 254B.19, subdivision 1.
9.22(b) For a client receiving residential ASAM level 3.3 or 3.5 high-intensity services or
9.23residential hospital-based services, a treatment plan review must be completed once every
9.2414 days.
9.25(c) For a client receiving residential ASAM level 3.1 low-intensity services or any other
9.26residential level not listed in paragraph (b), a treatment plan review must be completed once
9.27every 30 days.
9.28(d) For a client receiving nonresidential ASAM level 2.5 partial hospitalization services,
9.29a treatment plan review must be completed once every 14 days.
9.30(e) For a client receiving nonresidential ASAM level 1.0 outpatient or 2.1 intensive
9.31outpatient services or any other nonresidential level not included in paragraph (d), a treatment
9.32plan review must be completed once every 30 days.
10.1(f) For a client receiving nonresidential opioid treatment program services according to
10.2section 245G.22, a treatment plan review must be completed weekly for the ten weeks
10.3following completion of the treatment plan and monthly thereafter. Treatment plan reviews
10.4must be completed more frequently when clinical needs warrant.
10.5(g) Notwithstanding paragraphs (e) and (f), for a client in a nonresidential program with
10.6a treatment plan that clearly indicates less than five hours of skilled treatment services will
10.7be provided to the client each month, a treatment plan review must be completed once every
10.890 days.
10.9EFFECTIVE DATE.This section is effective January 1, 2024.

10.10    Sec. 17. Minnesota Statutes 2022, section 245G.06, subdivision 4, is amended to read:
10.11    Subd. 4. Service discharge summary. (a) An alcohol and drug counselor must write a
10.12service discharge summary for each client. The service discharge summary must be
10.13completed within five days of the client's service termination. A copy of the client's service
10.14discharge summary must be provided to the client upon the client's request.
10.15(b) The service discharge summary must be recorded in the six dimensions listed in
10.16section 245G.05, subdivision 2, paragraph (c) 254B.04, subdivision 4, and include the
10.17following information:
10.18(1) the client's issues, strengths, and needs while participating in treatment, including
10.19services provided;
10.20(2) the client's progress toward achieving each goal identified in the individual treatment
10.21plan;
10.22(3) a risk description according to section 245G.05 rating and description for each of
10.23the ASAM six dimensions;
10.24(4) the reasons for and circumstances of service termination. If a program discharges a
10.25client at staff request, the reason for discharge and the procedure followed for the decision
10.26to discharge must be documented and comply with the requirements in section 245G.14,
10.27subdivision 3, clause (3);
10.28(5) the client's living arrangements at service termination;
10.29(6) continuing care recommendations, including transitions between more or less intense
10.30services, or more frequent to less frequent services, and referrals made with specific attention
10.31to continuity of care for mental health, as needed; and
10.32(7) service termination diagnosis.
11.1EFFECTIVE DATE.This section is effective January 1, 2024.

11.2    Sec. 18. Minnesota Statutes 2022, section 245G.09, subdivision 3, is amended to read:
11.3    Subd. 3. Contents. Client records must contain the following:
11.4(1) documentation that the client was given information on client rights and
11.5responsibilities, grievance procedures, tuberculosis, and HIV, and that the client was provided
11.6an orientation to the program abuse prevention plan required under section 245A.65,
11.7subdivision 2, paragraph (a), clause (4). If the client has an opioid use disorder, the record
11.8must contain documentation that the client was provided educational information according
11.9to section 245G.05, subdivision 1 3, paragraph (b);
11.10(2) an initial services plan completed according to section 245G.04;
11.11(3) a comprehensive assessment completed according to section 245G.05;
11.12(4) an assessment summary completed according to section 245G.05, subdivision 2;
11.13(5) (4) an individual abuse prevention plan according to sections 245A.65, subdivision
11.142, and 626.557, subdivision 14, when applicable;
11.15(6) (5) an individual treatment plan according to section 245G.06, subdivisions 1 and
11.162;
11.17(7) (6) documentation of treatment services, significant events, appointments, concerns,
11.18and treatment plan reviews according to section 245G.06, subdivisions 2a, 2b, and 3, and
11.193a; and
11.20(8) (7) a summary at the time of service termination according to section 245G.06,
11.21subdivision 4.
11.22EFFECTIVE DATE.This section is effective January 1, 2024."
11.23Page 49, after line 30, insert:

11.24    "Sec. 17. Minnesota Statutes 2022, section 245I.10, subdivision 6, is amended to read:
11.25    Subd. 6. Standard diagnostic assessment; required elements. (a) Only a mental health
11.26professional or a clinical trainee may complete a standard diagnostic assessment of a client.
11.27A standard diagnostic assessment of a client must include a face-to-face interview with a
11.28client and a written evaluation of the client. The assessor must complete a client's standard
11.29diagnostic assessment within the client's cultural context. An alcohol and drug counselor
12.1may gather and document the information in paragraphs (b) and (c) when completing a
12.2comprehensive assessment according to section 245G.05.
12.3(b) When completing a standard diagnostic assessment of a client, the assessor must
12.4gather and document information about the client's current life situation, including the
12.5following information:
12.6(1) the client's age;
12.7(2) the client's current living situation, including the client's housing status and household
12.8members;
12.9(3) the status of the client's basic needs;
12.10(4) the client's education level and employment status;
12.11(5) the client's current medications;
12.12(6) any immediate risks to the client's health and safety, including withdrawal symptoms,
12.13medical conditions, and behavioral and emotional symptoms;
12.14(7) the client's perceptions of the client's condition;
12.15(8) the client's description of the client's symptoms, including the reason for the client's
12.16referral;
12.17(9) the client's history of mental health and substance use disorder treatment; and
12.18(10) cultural influences on the client.; and
12.19(11) substance use history, if applicable, including:
12.20(i) amounts and types of substances, frequency and duration, route of administration,
12.21periods of abstinence, and circumstances of relapse; and
12.22(ii) the impact to functioning when under the influence of substances, including legal
12.23interventions.
12.24(c) If the assessor cannot obtain the information that this paragraph requires without
12.25retraumatizing the client or harming the client's willingness to engage in treatment, the
12.26assessor must identify which topics will require further assessment during the course of the
12.27client's treatment. The assessor must gather and document information related to the following
12.28topics:
12.29(1) the client's relationship with the client's family and other significant personal
12.30relationships, including the client's evaluation of the quality of each relationship;
13.1(2) the client's strengths and resources, including the extent and quality of the client's
13.2social networks;
13.3(3) important developmental incidents in the client's life;
13.4(4) maltreatment, trauma, potential brain injuries, and abuse that the client has suffered;
13.5(5) the client's history of or exposure to alcohol and drug usage and treatment; and
13.6(6) the client's health history and the client's family health history, including the client's
13.7physical, chemical, and mental health history.
13.8(d) When completing a standard diagnostic assessment of a client, an assessor must use
13.9a recognized diagnostic framework.
13.10(1) When completing a standard diagnostic assessment of a client who is five years of
13.11age or younger, the assessor must use the current edition of the DC: 0-5 Diagnostic
13.12Classification of Mental Health and Development Disorders of Infancy and Early Childhood
13.13published by Zero to Three.
13.14(2) When completing a standard diagnostic assessment of a client who is six years of
13.15age or older, the assessor must use the current edition of the Diagnostic and Statistical
13.16Manual of Mental Disorders published by the American Psychiatric Association.
13.17(3) When completing a standard diagnostic assessment of a client who is five years of
13.18age or younger, an assessor must administer the Early Childhood Service Intensity Instrument
13.19(ECSII) to the client and include the results in the client's assessment.
13.20(4) When completing a standard diagnostic assessment of a client who is six to 17 years
13.21of age, an assessor must administer the Child and Adolescent Service Intensity Instrument
13.22(CASII) to the client and include the results in the client's assessment.
13.23(5) When completing a standard diagnostic assessment of a client who is 18 years of
13.24age or older, an assessor must use either (i) the CAGE-AID Questionnaire or (ii) the criteria
13.25in the most recent edition of the Diagnostic and Statistical Manual of Mental Disorders
13.26published by the American Psychiatric Association to screen and assess the client for a
13.27substance use disorder.
13.28(e) When completing a standard diagnostic assessment of a client, the assessor must
13.29include and document the following components of the assessment:
13.30(1) the client's mental status examination;
13.31(2) the client's baseline measurements; symptoms; behavior; skills; abilities; resources;
13.32vulnerabilities; safety needs, including client information that supports the assessor's findings
14.1after applying a recognized diagnostic framework from paragraph (d); and any differential
14.2diagnosis of the client; and
14.3(3) an explanation of: (i) how the assessor diagnosed the client using the information
14.4from the client's interview, assessment, psychological testing, and collateral information
14.5about the client; (ii) the client's needs; (iii) the client's risk factors; (iv) the client's strengths;
14.6and (v) the client's responsivity factors.
14.7(f) When completing a standard diagnostic assessment of a client, the assessor must
14.8consult the client and the client's family about which services that the client and the family
14.9prefer to treat the client. The assessor must make referrals for the client as to services required
14.10by law."
14.11Page 52, line 30, delete "and assessment summary"
14.12Page 53, line 6, delete "and assessment summary"
14.13Page 53, after line 8, insert:

14.14    "Sec. 24. Minnesota Statutes 2022, section 254B.01, is amended by adding a subdivision
14.15to read:
14.16    Subd. 2a. American Society of Addiction Medicine criteria or ASAM
14.17criteria. "American Society of Addiction Medicine criteria" or "ASAM criteria" means the
14.18clinical guidelines for purposes of assessment, treatment, placement, and transfer or discharge
14.19of individuals with substance use disorders. The ASAM criteria are contained in the most
14.20current edition of the ASAM Criteria: Treatment Criteria for Addictive, Substance-Related,
14.21and Co-Occurring Conditions."
14.22Page 53, line 11, delete "2a" and insert "2b"
14.23Page 53, line 15, delete "2b" and insert "2c"
14.24Page 53, line 19, delete "2c" and insert "2d"
14.25Page 54, after line 25, insert:

14.26    "Sec. 34. Minnesota Statutes 2022, section 254B.01, is amended by adding a subdivision
14.27to read:
14.28    Subd. 10. Skilled treatment services. "Skilled treatment services" includes the treatment
14.29services described in section 245G.07, subdivisions 1, paragraph (a), clauses (1) to (4), and
14.302, clauses (1) to (6). Skilled treatment services must be provided by qualified professionals
14.31as identified in section 245G.07, subdivision 3."
15.1Page 54, line 28, delete "10" and insert "11"
15.2Page 55, line 5, delete "11" and insert "12"
15.3Page 60, delete section 32 and insert:

15.4    "Sec. 43. Minnesota Statutes 2022, section 254B.04, is amended by adding a subdivision
15.5to read:
15.6    Subd. 4. Assessment criteria and risk descriptions. (a) The level of care determination
15.7must follow criteria approved by the commissioner.
15.8(b) Dimension 1: Acute intoxication and withdrawal potential. A vendor must use the
15.9following criteria in Dimension 1 to determine a client's acute intoxication and withdrawal
15.10potential, the client's ability to cope with withdrawal symptoms, and the client's current
15.11state of intoxication.
15.12(c) Dimension 2: Biomedical conditions and complications. The vendor must use the
15.13following criteria in Dimension 2 to determine a client's biomedical conditions and
15.14complications, the degree to which any physical disorder of the client would interfere with
15.15treatment for substance use, and the client's ability to tolerate any related discomfort. If the
15.16client is pregnant, the provider must determine the impact of continued substance use on
15.17the unborn child.
15.18(d) Dimension 3: Emotional, behavioral, and cognitive conditions and complications.
15.19The vendor must use the following criteria in Dimension 3 to determine a client's emotional,
15.20behavioral, and cognitive conditions and complications; the degree to which any condition
15.21or complication is likely to interfere with treatment for substance use or with functioning
15.22in significant life areas; and the likelihood of harm to self or others.
15.23(e) Dimension 4: Readiness for change. The vendor must use the following criteria in
15.24Dimension 4 to determine a client's readiness for change and the support necessary to keep
15.25the client involved in treatment services.
15.26(f) Dimension 5: Relapse, continued use, and continued problem potential. The vendor
15.27must use the following criteria in Dimension 5 to determine a client's relapse, continued
15.28use, and continued problem potential and the degree to which the client recognizes relapse
15.29issues and has the skills to prevent relapse of either substance use or mental health problems.
15.30(g) Dimension 6: Recovery environment. The vendor must use the following criteria in
15.31Dimension 6 to determine a client's recovery environment, whether the areas of the client's
15.32life are supportive of or antagonistic to treatment participation and recovery."
16.1Page 66, after line 11, insert:

16.2    "Section 49. [254B.19] AMERICAN SOCIETY OF ADDICTION MEDICINE
16.3STANDARDS OF CARE.
16.4    Subdivision 1. Level of care requirements. For each client assigned an ASAM level
16.5of care, eligible vendors must implement the standards set by the ASAM for the respective
16.6level of care. Additionally, vendors must meet the following requirements:
16.7(1) For ASAM level 0.5 early intervention targeting individuals who are at risk of
16.8developing a substance-related problem but may not have a diagnosed substance use disorder,
16.9early intervention services may include individual or group counseling, treatment
16.10coordination, peer recovery support, screening brief intervention, and referral to treatment
16.11provided according to section 254A.03, subdivision 3, paragraph (c).
16.12(2) For ASAM level 1.0 outpatient clients, adults must receive up to eight hours per
16.13week of skilled treatment services and adolescents must receive up to five hours per week.
16.14Services must be licensed according to section 245G.20 and meet requirements under section
16.15256B.0759. Peer recovery and treatment coordination may be provided beyond the hourly
16.16skilled treatment service hours allowable per week.
16.17(3) For ASAM level 2.1 intensive outpatient clients, adults must receive nine to 19 hours
16.18per week of skilled treatment services and adolescents must receive six or more hours per
16.19week. Vendors must be licensed according to section 245G.20 and must meet requirements
16.20under section 256B.0759. Peer recovery services and treatment coordination may be provided
16.21beyond the hourly skilled treatment service hours allowable per week. If clinically indicated
16.22on the client's treatment plan, this service may be provided in conjunction with room and
16.23board according to section 254B.05, subdivision 1a.
16.24(4) For ASAM level 2.5 partial hospitalization clients, adults must receive 20 hours or
16.25more of skilled treatment services. Services must be licensed according to section 245G.20
16.26and must meet requirements under section 256B.0759. Level 2.5 is for clients who need
16.27daily monitoring in a structured setting, as directed by the individual treatment plan and in
16.28accordance with the limitations in section 254B.05, subdivision 5, paragraph (h). If clinically
16.29indicated on the client's treatment plan, this service may be provided in conjunction with
16.30room and board according to section 254B.05, subdivision 1a.
16.31(5) For ASAM level 3.1 clinically managed low-intensity residential clients, programs
16.32must provide at least 5 hours of skilled treatment services per week according to each client's
17.1specific treatment schedule, as directed by the individual treatment plan. Programs must be
17.2licensed according to section 245G.20 and must meet requirements under section 256B.0759.
17.3(6) For ASAM level 3.3 clinically managed population-specific high-intensity residential
17.4clients, programs must be licensed according to section 245G.20 and must meet requirements
17.5under section 256B.0759. Programs must have 24-hour staffing coverage. Programs must
17.6be enrolled as a disability responsive program as described in section 254B.01, subdivision
17.74b, and must specialize in serving persons with a traumatic brain injury or a cognitive
17.8impairment so significant, and the resulting level of impairment so great, that outpatient or
17.9other levels of residential care would not be feasible or effective. Programs must provide,
17.10at a minimum, daily skilled treatment services seven days a week according to each client's
17.11specific treatment schedule, as directed by the individual treatment plan.
17.12(7) For ASAM level 3.5 clinically managed high-intensity residential clients, services
17.13must be licensed according to section 245G.20 and must meet requirements under section
17.14256B.0759. Programs must have 24-hour staffing coverage and provide, at a minimum,
17.15daily skilled treatment services seven days a week according to each client's specific treatment
17.16schedule, as directed by the individual treatment plan.
17.17(8) For ASAM level withdrawal management 3.2 clinically managed clients, withdrawal
17.18management must be provided according to chapter 245F.
17.19(9) For ASAM level withdrawal management 3.7 medically monitored clients, withdrawal
17.20management must be provided according to chapter 245F.
17.21    Subd. 2. Patient referral arrangement agreement. The license holder must maintain
17.22documentation of a formal patient referral arrangement agreement for each of the following
17.23ASAM levels of care not provided by the license holder:
17.24(1) level 1.0 outpatient;
17.25(2) level 2.1 intensive outpatient;
17.26(3) level 2.5 partial hospitalization;
17.27(4) level 3.1 clinically managed low-intensity residential;
17.28(5) level 3.3 clinically managed population-specific high-intensity residential;
17.29(6) level 3.5 clinically managed high-intensity residential;
17.30(7) level withdrawal management 3.2 clinically managed residential withdrawal
17.31management; and
18.1(8) level withdrawal management 3.7 medically monitored inpatient withdrawal
18.2management.
18.3    Subd. 3. Evidence-based practices. All services delivered within the ASAM levels of
18.4care referenced in subdivision 1, clauses (1) to (7), must have documentation of the
18.5evidence-based practices being utilized as referenced in the most current edition of the
18.6ASAM Criteria: Treatment Criteria for Addictive, Substance-Related, and Co-Occurring
18.7Conditions.
18.8    Subd. 4. Program outreach plan. Eligible vendors providing services under ASAM
18.9levels of care referenced in subdivision 1, clauses (2) to (7), must have a program outreach
18.10plan. The treatment director must document a review and update the plan annually. The
18.11program outreach plan must include treatment coordination strategies and processes to
18.12ensure seamless transitions across the continuum of care. The plan must include how the
18.13provider will:
18.14(1) increase the awareness of early intervention treatment services, including but not
18.15limited to the services defined in section 254A.03, subdivision 3, paragraph (c);
18.16(2) coordinate, as necessary, with certified community behavioral health clinics when
18.17a license holder is located in a geographic region served by a certified community behavioral
18.18health clinic;
18.19(3) establish a referral arrangement agreement with a withdrawal management program
18.20licensed under chapter 245F when a license holder is located in a geographic region in which
18.21a withdrawal management program is licensed under chapter 245F. If a withdrawal
18.22management program licensed under chapter 245F is not geographically accessible, the
18.23plan must include how the provider will address the client's need for this level of care;
18.24(4) coordinate with inpatient acute care hospitals, including emergency departments,
18.25hospital outpatient clinics, urgent care centers, residential crisis settings, medical
18.26detoxification inpatient facilities, and ambulatory detoxification providers in the area served
18.27by the provider to help transition individuals from emergency department or hospital settings
18.28and minimize the time between assessment and treatment;
18.29(5) develop and maintain collaboration with local county and Tribal human services
18.30agencies; and
18.31(6) collaborate with primary care and mental health settings.
18.32EFFECTIVE DATE.This section is effective January 1, 2024."
18.33Page 74, line 16, before "Minnesota" insert "(a)"
19.1Page 74, after line 18, insert:
19.2"(b) Minnesota Statutes 2022, sections 245G.05, subdivision 2; and 245G.06, subdivision
19.32, are repealed.
19.4(c) Minnesota Rules, parts 9530.7000, subparts 1, 2, 5, 6, 7, 8, 9, 10, 11, 13, 14, 15, 17a,
19.519, 20, and 21; 9530.7005; 9530.7010; 9530.7012; 9530.7015, subparts 1, 2a, 4, 5, and 6;
19.69530.7020, subparts 1, 1a, and 2; 9530.7021; 9530.7022, subpart 1; 9530.7025; and
19.79530.7030, subpart 1, are repealed.
19.8EFFECTIVE DATE.Paragraphs (a) and (c) are effective August 1, 2023. Paragraph
19.9(b) is effective January 1, 2024."
19.10Page 76, line 19, reinstate the stricken language and delete the new language and strike
19.11"7" and insert "4d"
19.12Renumber the sections in sequence
19.13Correct the title numbers accordingly