1.1.................... moves to amend H.F. No. 1750 as follows:
1.2Page 6, after line 5, insert:

1.3    "Section 1. Minnesota Statutes 2008, section 157.16, is amended by adding a
1.4subdivision to read:
1.5    Subd. 5. Exemption for certain establishments. This section does not apply to
1.6group residential facilities of ten or fewer beds licensed by the commissioner of human
1.7services under Minnesota Rules, chapter 2960, or Minnesota Rules, parts 9520.0500
1.8to 9520.0670, provided the facility employs or contracts with a certified food manager
1.9under Minnesota Rules, part 4626.2015.

1.10    Sec. 2. Minnesota Statutes 2008, section 245.4871, subdivision 10, is amended to read:
1.11    Subd. 10. Day treatment services. "Day treatment," "day treatment services," or
1.12"day treatment program" means a structured program of treatment and care provided to a
1.13child in:
1.14    (1) an outpatient hospital accredited by the Joint Commission on Accreditation of
1.15Health Organizations and licensed under sections 144.50 to 144.55;
1.16    (2) a community mental health center under section 245.62;
1.17    (3) an entity that is under contract with the county board to operate a program that
1.18meets the requirements of section 245.4884, subdivision 2, and Minnesota Rules, parts
1.199505.0170 to 9505.0475; or
1.20    (4) an entity that operates a program that meets the requirements of section
1.21245.4884, subdivision 2 , and Minnesota Rules, parts 9505.0170 to 9505.0475, that is
1.22under contract with an entity that is under contract with a county board.
1.23    Day treatment consists of group psychotherapy and other intensive therapeutic
1.24services that are provided for a minimum three-hour two-hour time block by a
1.25multidisciplinary staff under the clinical supervision of a mental health professional.
1.26Day treatment may include education and consultation provided to families and
2.1other individuals as an extension of the treatment process. The services are aimed at
2.2stabilizing the child's mental health status, and developing and improving the child's daily
2.3independent living and socialization skills. Day treatment services are distinguished from
2.4day care by their structured therapeutic program of psychotherapy services. Day treatment
2.5services are not a part of inpatient hospital or residential treatment services. Day treatment
2.6services for a child are an integrated set of education, therapy, and family interventions.
2.7    A day treatment service must be available to a child at least five days up to 15 hours
2.8 a week throughout the year and must be coordinated with, integrated with, or part of an
2.9education program offered by the child's school."
2.10Page 8, line 19, after "records" insert ", including records" and delete "the"
2.11Page 10, delete section 4
2.12Page 10, line 24, before "The" insert "(a)" and after "applicant" insert " or controlling
2.13individual: (1)"
2.14Page 10, line 25, strike the comma and after "or" insert "; (2)"
2.15Page 10, line 27 delete everything after "investigation" and insert a semicolon
2.16Page 10, lines 28 to 30, delete the new language and insert:
2.17    "(3) has a disqualification which has not been set aside under section 245C.22 and
2.18no variance has been granted; or
2.19    (4) has an individual required to have a background study under section 245C.03,
2.20subdivision 1, paragraph (a), clauses (2) or (6), that has a disqualification which has not
2.21been set aside under section 245C.22 and no variance has been granted."
2.22Page 10, line 30, before "An" insert "(b)"
2.23Page 14, after line 2, insert:

2.24    "Sec. .... Minnesota Statutes 2008, section 245A.11, is amended by adding a
2.25subdivision to read:
2.26    Subd. 7a. Alternate overnight supervision; adult foster care license. (a) The
2.27commissioner may grant an applicant or license holder an adult foster care license for a
2.28residence that does not have a caregiver in residence during normal sleeping hours as
2.29required under Minnesota Rules, part 9555.5105, subpart 37, item B, but uses monitoring
2.30technology to alert the license holder when an incident occurs that may jeopardize the
2.31health, safety, or rights of a foster care recipient. The applicant or license holder must
2.32comply with all other requirements under Minnesota Rules, parts 9555.5105 to 9555.6265,
2.33and the requirements under this subdivision. The license printed by the commissioner
2.34must state in bold and large font:
2.35    (1) that staff are not present on-site overnight; and
3.1    (2) the telephone number of the county's common entry point for making reports of
3.2suspected maltreatment of vulnerable adults under section 626.557, subdivision 9.
3.3    (b) Before a license is issued by the commissioner, and for the duration of the
3.4license, the applicant or license holder must establish, maintain, and document the
3.5implementation of written policies and procedures addressing the requirements in
3.6paragraphs (c) through (f).
3.7    (c) The applicant or license holder must have policies and procedures that:
3.8    (1) establish characteristics of target populations that will be admitted into the home,
3.9and characteristics of populations that will not be accepted into the home;
3.10    (2) explain the discharge process when a foster care recipient requires overnight
3.11supervision or other services that cannot be provided by the license holder due to the
3.12limited hours of onsite staff;
3.13    (3) describe the types of events to which the program will respond with a physical
3.14presence when those events occur in the home during time when staff are not onsite, and
3.15how the license holder's response plan meets the requirements in paragraph (d), clauses
3.16(1) or (2);
3.17    (4) establish a process for documenting a review of the implementation and
3.18effectiveness of the response protocol for the response required under paragraph (d),
3.19clauses (1) or (2). The documentation must include:
3.20    (i) a description of the triggering incident;
3.21    (ii) the date and time of the triggering incident;
3.22    (iii) the time of the response or responses under paragraph (d), clauses (1) or (2);
3.23    (iv) whether the response met the resident's needs;
3.24    (v) whether the existing policies and response protocols were followed; and
3.25    (vi) whether the existing policies and protocols are adequate or need modification.
3.26    When no physical presence response is completed for a three month period, the
3.27license holder's written policies and procedures must require a physical presence response
3.28drill be to conducted for which the effectiveness of the response protocol under paragraph
3.29(d), clauses (1) or (2) will be reviewed and documented as required under this clause; and
3.30    (5) establish that emergency and non-emergency phone numbers are posted in a
3.31prominent location in a common area of the home where they can be easily observed by a
3.32person responding to an incident who is not otherwise affiliated with the home.
3.33    (d) The license holder must document and include in the license application which
3.34method under clauses (1) or (2) is in place for responding to situations that present a serious
3.35risk to the health, safety, or rights of people receiving foster care services in the home:
4.1    (1) no more than ten minutes will pass before the license holder or the license
4.2holder's staff person will be physically present on site to respond to the situation; or
4.3    (2) more than ten minutes will bass before the license holder or the license holder's
4.4staff person is present on site to respond to the situation, and all of the following
4.5conditions are met:
4.6    (i) each foster care recipient's individualized plan of care, individual service plan
4.7under section 256B.092, subdivision 1b, if required, or individual resident placement
4.8agreement under Minnesota Rules, part 9555.5105, subpart 19, if required, identifies the
4.9maximum response time, greater than ten minutes, for a caretaker to be on site for that
4.10foster care recipient;
4.11    (ii) the license holder has a written description of the interactive technological
4.12applications that will assist a remote caretaker in communicating with and assessing the
4.13needs related to care, health, and life safety of the foster care recipients;
4.14    (iii) the license holder documents how the remote care attendants are qualified
4.15and capable of meeting the needs of the foster care recipients and assessing foster care
4.16recipients' needs under item (ii) during the absence of the license holder or license holder's
4.17staff person on site;
4.18    (iv) the license holder maintains written procedures to dispatch emergency response
4.19personnel to the site in the event of an observed emergency.
4.20    (e) All placement agreements, individual service agreements, and plans applicable
4.21to the foster care recipient must clearly state that the adult foster are license category is
4.22a program without the presence of a caregiver in the residence during normal sleeping
4.23hours; the protocols in place for responding to situations that present a serious risk
4.24to health, safety, or rights of foster care recipients under paragraph (d), clauses (1)
4.25or (2); and a signed informed consent from each foster care recipient or the person's
4.26legal representative documenting the person's or legal representative's agreement with
4.27placement in the program. If electronic monitoring technology is used in the home, the
4.28informed consent form must also explain the following:
4.29    (1) how any electronic monitoring is incorporated into the alternative supervision
4.30system;
4.31    (2) the backup system for any electronic monitoring in times of electrical outages or
4.32other equipment malfunctions;
4.33    (3) how staff are trained on the use of the technology;
4.34    (4) the event types and staff response times established under paragraph (d);
4.35    (5) how the license holder protects the foster care recipient's privacy related to
4.36electronic monitoring and related to any electronically recorded data generated by the
5.1monitoring system. The consent form must explain where and how the electronically
5.2recorded data is stored, with whom it will be shared, and how long it is retained; and
5.3    (6) the risks and benefits of the alternative overnight supervision system.
5.4    The written explanations under clauses (1) to (6) may be accomplished through
5.5cross-references to other policies and procedures as long as they are explained to the
5.6person giving consent, and the person giving consent is offered a copy.
5.7    (f) The license holder's lead county contract under section 256.0112 must clearly
5.8specify that this foster care service does not have on site overnight human supervision
5.9present."
5.10Page 14, line 6, before "When" insert "(a)"
5.11Page 14, line 8, strike ", and" and before "must" insert "The parent directive must be
5.12on a form approved by the commissioner and must include a statement that the parent or
5.13legal guardian has read the information provided by the Minnesota Sudden Infant Death
5.14Center, related to the risk of SIDS and the importance of placing an infant or child on the
5.15back to sleep to reduce the risk of SIDS. (b) The license holder"
5.16Page 14, line 9, strike "with" and insert "directly on" and after "mattress" insert
5.17"with a fitted crib sheet that fits tightly on the mattress and overlaps the mattress so it
5.18cannot be dislodged by pulling on the corner of the sheet"
5.19Page 14, after line 13, insert:

5.20    "Sec. .... Minnesota Statutes 2008, section 245A.144, is amended to read:
5.21245A.144 SUDDEN INFANT DEATH AND SHAKEN BABY SYNDROME
5.22FOR CHILD FOSTER CARE PROVIDERS.
5.23    (a) Licensed child foster care providers that care for infants or children through five
5.24years of age must document that before staff persons and caregivers assist in the care of
5.25infants or children through five years of age, they are instructed on the standards in section
5.26245A.1435 and receive training on reducing the risk of sudden infant death syndrome and
5.27shaken baby syndrome for infants and young children. This section does not apply to
5.28emergency relative foster care under section 245A.035. The training on reducing the risk
5.29of sudden infant death syndrome and shaken baby syndrome may be provided as:
5.30    (1) orientation training to child foster care providers, who care for infants or children
5.31through five years of age, under Minnesota Rules, part 2960.3070, subpart 1; or
5.32    (2) in-service training to child foster care providers, who care for infants or children
5.33through five years of age, under Minnesota Rules, part 2960.3070, subpart 2.
5.34    (b) Training required under this section must be at least one hour in length and must
5.35be completed at least once every five years. At a minimum, the training must address the
5.36risk factors related to sudden infant death syndrome and shaken baby syndrome, means
6.1of reducing the risk of sudden infant death syndrome and shaken baby syndrome, and
6.2license holder communication with parents regarding reducing the risk of sudden infant
6.3death syndrome and shaken baby syndrome.
6.4    (c) Training for child foster care providers must be approved by the county licensing
6.5agency and fulfills, in part, training required under Minnesota Rules, part 2960.3070.

6.6    Sec. .... Minnesota Statutes 2008, section 245A.1444, is amended to read:
6.7245A.1444 TRAINING ON RISK OF SUDDEN INFANT DEATH SYNDROME
6.8AND SHAKEN BABY SYNDROME BY OTHER PROGRAMS.
6.9    A licensed chemical dependency treatment program that serves clients with infants
6.10or children through five years of age who sleep at the program and a licensed children's
6.11residential facility that serves infants or children through five years of age must document
6.12that before program staff persons or volunteers assist in the care of infants or children
6.13through five years of age, they are instructed on the standards in section 245A.1435 and
6.14receive training on reducing the risk of sudden infant death syndrome and shaken baby
6.15syndrome. The training conducted under this section may be used to fulfill training
6.16requirements under Minnesota Rules, parts 2960.0100, subpart 3; and 9530.6490, subpart
6.174, item B.
6.18    This section does not apply to child care centers or family child care programs
6.19governed by sections 245A.40 and 245A.50."
6.20Page 15, after line 14, insert:

6.21    "Sec. .... Minnesota Statutes 2008, section 245A.40, subdivision 5, is amended to read:
6.22    Subd. 5. Sudden infant death syndrome and shaken baby syndrome training.
6.23    (a) License holders must document that before staff persons care for infants, they are
6.24instructed on the standards in section 245A.1435 and receive training on reducing the risk
6.25of sudden infant death syndrome. In addition, license holders must document that before
6.26staff persons care for infants or children under school age, they receive training on the
6.27risk of and shaken baby syndrome. The training in this subdivision may be provided as
6.28orientation training under subdivision 1 and in-service training under subdivision 7.
6.29    (b) Sudden infant death syndrome reduction Training required under this subdivision
6.30must be at least one one-half hour in length and must be completed at least once every
6.31five years. At a minimum, the training must address the risk factors related to sudden
6.32infant death syndrome and shaken baby syndrome, means of reducing the risk of sudden
6.33infant death syndrome and shaken baby syndrome in child care, and license holder
6.34communication with parents regarding reducing the risk of sudden infant death syndrome
6.35and shaken baby syndrome.
7.1    (c) Shaken baby syndrome training under this subdivision must be at least one-half
7.2hour in length, and must be completed at least once every five years. At a minimum, the
7.3training must address the risk factors related to shaken baby syndrome for infants and
7.4young children, means to reduce the risk of shaken baby syndrome in child care, and
7.5license holder communication with parents regarding reducing the risk of shaken baby
7.6syndrome.
7.7    (c) (d) The commissioner shall make available for viewing a video presentation on
7.8the dangers associated with shaking infants and young children. The video presentation
7.9must be part of the orientation and annual in-service training of licensed child care centers
7.10center staff persons caring for children under school age. The commissioner shall provide
7.11to child care providers and interested individuals, at cost, copies of a video approved by
7.12the commissioner of health under section 144.574 on the dangers associated with shaking
7.13infants and young children."
7.14Page 15, line 19, strike "and" and insert ". In addition, license holders must
7.15document that before staff persons, caregivers, and helpers assist in the care of infants and
7.16children under school age, they receive training on reducing the risk of"
7.17Page 15, line 22, after "(b)" insert "Sudden infant death syndrome reduction" and
7.18strike "one" and insert "one-half"
7.19Page 15, lines 24, 25, and 27, strike "and shaken baby syndrome"
7.20Page 15, line 28, after "(c)" insert "Shaken baby syndrome training required under
7.21this subdivision must be at least one-half hour in length and must be completed at least
7.22once every five years. At a minimum, the training must address the risk factors related
7.23to shaken baby syndrome, means of reducing the risk of shaken baby syndrome in child
7.24care, and license holder communication with parents regarding reducing the risk of shaken
7.25baby syndrome. (d)"
7.26Page 15, line 30, strike "(d)"and insert "(e)"
7.27Page 15, line 33, after "providers" insert "caring for children under school age"
7.28Page 16, line 16, reinstate "and"
7.29Page 16, line 17, delete the semicolon and insert a period
7.30Page 16, delete lines 18 to 26
7.31Page 16, after line 29, insert:

7.32    "Sec. .... Minnesota Statutes 2008, section 245C.04, subdivision 1, is amended to read:
7.33    Subdivision 1. Licensed programs. (a) The commissioner shall conduct a
7.34background study of an individual required to be studied under section 245C.03,
7.35subdivision 1 , at least upon application for initial license for all license types.
8.1    (b) The commissioner shall conduct a background study of an individual required to
8.2be studied under section 245C.03, subdivision 1, at reapplication for a license for adult
8.3foster care, family adult day services, and family child care.
8.4    (c) The commissioner is not required to conduct a study of an individual at the time
8.5of reapplication for a license if the individual's background study was completed by the
8.6commissioner of human services for an adult foster care license holder that is also:
8.7    (1) registered under chapter 144D; or
8.8    (2) licensed to provide home and community-based services to people with
8.9disabilities at the foster care location and the license holder does not reside in the foster
8.10care residence; and
8.11    (3) the following conditions are met:
8.12    (i) a study of the individual was conducted either at the time of initial licensure or
8.13when the individual became affiliated with the license holder;
8.14    (ii) the individual has been continuously affiliated with the license holder since
8.15the last study was conducted; and
8.16    (iii) the last study of the individual was conducted on or after October 1, 1995.
8.17    (d) From July 1, 2007, to June 30, 2009, the commissioner of human services shall
8.18conduct a study of an individual required to be studied under section 245C.03, at the
8.19time of reapplication for a child foster care license. The county or private agency shall
8.20collect and forward to the commissioner the information required under section 245C.05,
8.21subdivisions 1, paragraphs (a) and (b), and 5, paragraphs (a) and (b). The background
8.22study conducted by the commissioner of human services under this paragraph must
8.23include a review of the information required under section 245C.08, subdivisions 1,
8.24paragraph (a), clauses (1) to (5), 3, and 4.
8.25    (e) The commissioner of human services shall conduct a background study of an
8.26individual specified under section 245C.03, subdivision 1, paragraph (a), clauses (2)
8.27to (6), who is newly affiliated with a child foster care license holder. The county or
8.28private agency shall collect and forward to the commissioner the information required
8.29under section 245C.05, subdivisions 1 and 5. The background study conducted by the
8.30commissioner of human services under this paragraph must include a review of the
8.31information required under section 245C.08, subdivisions 1, 3, and 4.
8.32    (f) Applicants for licensure, license holders, and other entities as provided in this
8.33chapter must submit completed background study forms to the commissioner before
8.34individuals specified in section 245C.03, subdivision 1, begin positions allowing direct
8.35contact in any licensed program.
9.1    (g) For purposes of this section, a physician licensed under chapter 147 is considered
9.2to be continuously affiliated upon the license holder's receipt from the commissioner of
9.3health or human services of the physician's background study results.
9.4    (h) A license holder must provide the commissioner notice through the
9.5commissioner's online background study system or through a letter mailed to the
9.6commissioner when:
9.7    (1) an individual returns to a position requiring a background study following an
9.8absence of 45 or more consecutive days; or
9.9    (2) a program, which discontinued providing licensed direct contact services for 45
9.10or more consecutive days, again begins to provide direct contact licensed services.
9.11    The license holder shall maintain a copy of the notification provided to the
9.12commissioner under this paragraph in the program's files.

9.13    Sec. .... Minnesota Statutes 2008, section 245C.07, is amended to read:
9.14245C.07 STUDY SUBJECT AFFILIATED WITH MULTIPLE FACILITIES.
9.15    (a) When a license holder, applicant, or other entity owns multiple programs or
9.16services that are licensed by the Department of Human Services, Department of Health, or
9.17Department of Corrections, only one background study is required for an individual who
9.18provides direct contact services in one or more of the licensed programs or services if:
9.19    (1) the license holder designates one individual with one address and telephone
9.20number as the person to receive sensitive background study information for the multiple
9.21licensed programs or services that depend on the same background study; and
9.22    (2) the individual designated to receive the sensitive background study information
9.23is capable of determining, upon request of the department, whether a background study
9.24subject is providing direct contact services in one or more of the license holder's programs
9.25or services and, if so, at which location or locations.
9.26    (b) When a license holder maintains background study compliance for multiple
9.27licensed programs according to paragraph (a), and one or more of the licensed programs
9.28closes, the license holder shall immediately notify the commissioner which staff will be
9.29transferred to an active license so that the background studies can be electronically paired
9.30with the license holder's active program.
9.31    (b) (c) When a background study is being initiated by a licensed program or service
9.32or a foster care provider that is also registered under chapter 144D, a study subject
9.33affiliated with multiple licensed programs or services may attach to the background study
9.34form a cover letter indicating the additional names of the programs or services, addresses,
9.35and background study identification numbers.
10.1    When the commissioner receives a notice, the commissioner shall notify each
10.2program or service identified by the background study subject of the study results.
10.3    The background study notice the commissioner sends to the subsequent agencies
10.4shall satisfy those programs' or services' responsibilities for initiating a background study
10.5on that individual.

10.6    Sec. .... Minnesota Statutes 2008, section 245C.08, is amended to read:
10.7245C.08 BACKGROUND STUDY; COMMISSIONER REVIEWS.
10.8    Subdivision 1. Background studies conducted by commissioner Department of
10.9Human Services. (a) For a background study conducted by the commissioner Department
10.10of Human Services, the commissioner shall review:
10.11    (1) information related to names of substantiated perpetrators of maltreatment of
10.12vulnerable adults that has been received by the commissioner as required under section
10.13626.557, subdivision 9c , paragraph (i);
10.14    (2) the commissioner's records relating to the maltreatment of minors in licensed
10.15programs, and from findings of maltreatment of minors as indicated through the social
10.16service information system;
10.17    (3) information from juvenile courts as required in subdivision 4 for individuals listed
10.18in section 245C.03, subdivision 1, clauses (2), (5), and (6) when there is reasonable cause;
10.19    (4) information from the Bureau of Criminal Apprehension;
10.20    (5) except as provided in clause (6), information from the national crime information
10.21system when the commissioner has reasonable cause as defined under section 245C.05,
10.22subdivision 5; and
10.23    (6) for a background study related to a child foster care application for licensure or
10.24adoptions, the commissioner shall also review:
10.25    (i) information from the child abuse and neglect registry for any state in which the
10.26background study subject has resided for the past five years; and
10.27    (ii) information from national crime information databases, when the background
10.28study object subject is 18 years of age or older.
10.29    (b) Notwithstanding expungement by a court, the commissioner may consider
10.30information obtained under paragraph (a), clauses (3) and (4), unless the commissioner
10.31received notice of the petition for expungement and the court order for expungement is
10.32directed specifically to the commissioner.
10.33    Subd. 2. Background studies conducted by a county agency. (a) For a background
10.34study conducted by a county agency for adult foster care, family adult day services, and
10.35family child care services, the commissioner shall review:
11.1    (1) information from the county agency's record of substantiated maltreatment
11.2of adults and the maltreatment of minors;
11.3    (2) information from juvenile courts as required in subdivision 4 for individuals
11.4listed in section 245C.03, subdivision 1, clauses (2), (5), and (6):
11.5    (i) individuals listed in section 245C.03, subdivision 1, who are ages 13 through 23
11.6living in the household where the licensed services will be provided; and
11.7    (ii) any other individual listed under section 245C.03, subdivision 1, when there
11.8is reasonable cause; and
11.9    (3) information from the Bureau of Criminal Apprehension.
11.10    (b) If the individual has resided in the county for less than five years, the study shall
11.11include the records specified under paragraph (a) for the previous county or counties of
11.12residence for the past five years.
11.13    (c) Notwithstanding expungement by a court, the county agency may consider
11.14information obtained under paragraph (a), clause (3), unless the commissioner received
11.15notice of the petition for expungement and the court order for expungement is directed
11.16specifically to the commissioner.
11.17    Subd. 3. Arrest and investigative information. (a) For any background study
11.18completed under this section, if the commissioner has reasonable cause to believe the
11.19information is pertinent to the disqualification of an individual, the commissioner also
11.20may review arrest and investigative information from:
11.21    (1) the Bureau of Criminal Apprehension;
11.22    (2) the commissioner of health;
11.23    (3) a county attorney;
11.24    (4) a county sheriff;
11.25    (5) a county agency;
11.26    (6) a local chief of police;
11.27    (7) other states;
11.28    (8) the courts;
11.29    (9) the Federal Bureau of Investigation;
11.30    (10) the National Criminal Records Repository; and
11.31    (11) criminal records from other states.
11.32    (b) The commissioner is not required to conduct more than one review of a subject's
11.33records from the Federal Bureau of Investigation if a review of the subject's criminal
11.34history with the Federal Bureau of Investigation has already been completed by the
11.35commissioner and there has been no break in the subject's affiliation with the license
11.36holder who initiated the background study.
12.1    Subd. 4. Juvenile court records. (a) For a background study conducted by the
12.2Department of Human Services, The commissioner shall review records from the juvenile
12.3courts for an individual studied under section 245C.03, subdivision 1, clauses (2) and (5)
12.4when the commissioner has reasonable cause.
12.5    (b) For individuals studied under section 245C.03, subdivision 1, clauses (1), (3),
12.6(4), and (6), and subdivision 2, who are ages 13 to 17, the commissioner shall review
12.7records from the juvenile courts a background study conducted by a county agency, the
12.8commissioner shall review records from the juvenile courts for individuals listed in section
12.9245C.03, subdivision 1, who are ages 13 through 23 living in the household where the
12.10licensed services will be provided. The commissioner shall also review records from
12.11juvenile courts for any other individual listed under section 245C.03, subdivision 1, when
12.12the commissioner has reasonable cause.
12.13    (c) The juvenile courts shall help with the study by giving the commissioner existing
12.14juvenile court records relating to delinquency proceedings held on individuals described
12.15in section 245C.03, subdivision 1, clauses (2), (5), and (6), relating to delinquency
12.16proceedings held within either the five years immediately preceding the background study
12.17or the five years immediately preceding the individual's 18th birthday, whichever time
12.18period is longer when requested pursuant to this subdivision.
12.19    (d) For purposes of this chapter, a finding that a delinquency petition is proven in
12.20juvenile court shall be considered a conviction in state district court.
12.21    (e) Juvenile courts shall provide orders of involuntary and voluntary termination of
12.22parental rights under section 260C.301 to the commissioner upon request for purposes of
12.23conducting a background study under this chapter.

12.24    Sec. .... Minnesota Statutes 2008, section 245C.13, subdivision 2, is amended to read:
12.25    Subd. 2. Direct contact pending completion of background study. The subject
12.26of a background study may not perform any activity requiring a background study under
12.27paragraph (b) until the commissioner has issued one of the notices under paragraph (a).
12.28    (a) Notices from the commissioner required prior to activity under paragraph (b)
12.29include:
12.30    (1) a notice of the study results under section 245C.17 stating that:
12.31    (i) the individual is not disqualified; or
12.32    (ii) more time is needed to complete the study but the individual is not required to be
12.33removed from direct contact or access to people receiving services prior to completion
12.34of the study as provided under section 245C.17, subdivision 1, paragraph (b) or (c). The
12.35notice that more time is needed to complete the study must also indicate whether the
13.1individual is required to be under continuous direct supervision prior to completion of the
13.2background study;
13.3    (2) a notice that a disqualification has been set aside under section 245C.23; or
13.4    (3) a notice that a variance has been granted related to the individual under section
13.5245C.30 .
13.6    (b) Activities prohibited prior to receipt of notice under paragraph (a) include:
13.7    (1) being issued a license;
13.8    (2) living in the household where the licensed program will be provided;
13.9    (3) providing direct contact services to persons served by a program unless the
13.10subject is under continuous direct supervision; or
13.11    (4) having access to persons receiving services if the background study was
13.12completed under section 144.057, subdivision 1, or 245C.03, subdivision 1, paragraph (a),
13.13clause (2), (5), or (6), unless the subject is under continuous direct supervision."
13.14Page 24, line 5, delete "a year" and insert "six months"
13.15Page 30, after line 18, insert:

13.16    "Sec. .... [256.364] LICENSE; PERMIT.
13.17    Notwithstanding any law to the contrary, a municipality shall not require a massage
13.18therapist to obtain a license or permit when the therapist is working for or an employee of
13.19a medical professional licensed under chapters 147 or 148.

13.20    Sec. .... Minnesota Statutes 2008, section 245.4871, subdivision 10, is amended to read:
13.21    Subd. 10. Day treatment services. "Day treatment," "day treatment services," or
13.22"day treatment program" means a structured program of treatment and care provided to a
13.23child in:
13.24    (1) an outpatient hospital accredited by the Joint Commission on Accreditation of
13.25Health Organizations and licensed under sections 144.50 to 144.55;
13.26    (2) a community mental health center under section 245.62;
13.27    (3) an entity that is under contract with the county board to operate a program that
13.28meets the requirements of section 245.4884, subdivision 2, and Minnesota Rules, parts
13.299505.0170 to 9505.0475; or
13.30    (4) an entity that operates a program that meets the requirements of section
13.31245.4884, subdivision 2 , and Minnesota Rules, parts 9505.0170 to 9505.0475, that is
13.32under contract with an entity that is under contract with a county board.
13.33    Day treatment consists of group psychotherapy and other intensive therapeutic
13.34services that are provided for a minimum three-hour two-hour time block by a
13.35multidisciplinary staff under the clinical supervision of a mental health professional.
14.1Day treatment may include education and consultation provided to families and
14.2other individuals as an extension of the treatment process. The services are aimed at
14.3stabilizing the child's mental health status, and developing and improving the child's daily
14.4independent living and socialization skills. Day treatment services are distinguished from
14.5day care by their structured therapeutic program of psychotherapy services. Day treatment
14.6services are not a part of inpatient hospital or residential treatment services. Day treatment
14.7services for a child are an integrated set of education, therapy, and family interventions.
14.8    A day treatment service must be available to a child at least five days up to 15 hours
14.9 a week throughout the year and must be coordinated with, integrated with, or part of an
14.10education program offered by the child's school.

14.11    Sec .... Minnesota Statutes 2008, section 256B.0943, subdivision 4, is amended to read:
14.12    Subd. 4. Provider entity certification. (a) Effective July 1, 2003, the commissioner
14.13shall establish an initial provider entity application and certification process and
14.14recertification process to determine whether a provider entity has an administrative
14.15and clinical infrastructure that meets the requirements in subdivisions 5 and 6. The
14.16commissioner shall recertify a provider entity at least every three years. The commissioner
14.17shall establish a process for decertification of a provider entity that no longer meets the
14.18requirements in this section. The county, tribe, and the commissioner shall be mutually
14.19responsible and accountable for the county's, tribe's, and state's part of the certification,
14.20recertification, and decertification processes.
14.21    (b) For purposes of this section, a provider entity must be:
14.22    (1) an Indian health services facility or a facility owned and operated by a tribe or
14.23tribal organization operating as a 638 facility under Public Law 93-638 certified by the
14.24state;
14.25    (2) a county-operated entity certified by the state; or
14.26    (3) a noncounty entity recommended for certification by the provider's host county
14.27and certified by the state.

14.28    Sec. ... Minnesota Statutes 2008, section 256B.0943, subdivision 6, is amended to read:
14.29    Subd. 6. Provider entity clinical infrastructure requirements. (a) To be
14.30an eligible provider entity under this section, a provider entity must have a clinical
14.31infrastructure that utilizes diagnostic assessment, an individualized treatment plan,
14.32service delivery, and individual treatment plan review that are culturally competent,
14.33child-centered, and family-driven to achieve maximum benefit for the client. The provider
14.34entity must review, and update as necessary, the clinical policies and procedures every
15.1three years and must distribute the policies and procedures to staff initially and upon
15.2each subsequent update.
15.3    (b) The clinical infrastructure written policies and procedures must include policies
15.4and procedures for:
15.5    (1) providing or obtaining a client's diagnostic assessment that identifies acute and
15.6chronic clinical disorders, co-occurring medical conditions, sources of psychological
15.7and environmental problems, and including a functional assessment. The functional
15.8assessment component must clearly summarize the client's individual strengths and needs;
15.9    (2) developing an individual treatment plan that is:
15.10    (i) based on the information in the client's diagnostic assessment;
15.11    (ii) developed no later than the end of the first psychotherapy session after the
15.12completion of the client's diagnostic assessment by the mental health professional who
15.13provides the client's psychotherapy;
15.14    (iii) developed through a child-centered, family-driven planning process that
15.15identifies service needs and individualized, planned, and culturally appropriate
15.16interventions that contain specific treatment goals and objectives for the client and the
15.17client's family or foster family;
15.18    (iv) reviewed at least once every 90 days and revised, if necessary; and
15.19    (v) signed by the client or, if appropriate, by the client's parent or other person
15.20authorized by statute to consent to mental health services for the client;
15.21    (3) developing an individual behavior plan that documents services to be provided
15.22by the mental health behavioral aide. The individual behavior plan must include:
15.23    (i) detailed instructions on the service to be provided;
15.24    (ii) time allocated to each service;
15.25    (iii) methods of documenting the child's behavior;
15.26    (iv) methods of monitoring the child's progress in reaching objectives; and
15.27    (v) goals to increase or decrease targeted behavior as identified in the individual
15.28treatment plan;
15.29    (4) clinical supervision of the mental health practitioner and mental health behavioral
15.30aide. A mental health professional must document the clinical supervision the professional
15.31provides by cosigning individual treatment plans and making entries in the client's record
15.32on supervisory activities. Clinical supervision does not include the authority to make or
15.33terminate court-ordered placements of the child. A clinical supervisor must be available
15.34for urgent consultation as required by the individual client's needs or the situation. Clinical
15.35supervision may occur individually or in a small group to discuss treatment and review
15.36progress toward goals. The focus of clinical supervision must be the client's treatment
16.1needs and progress and the mental health practitioner's or behavioral aide's ability to
16.2provide services;
16.3    (4a) CTSS certified provider entities providing day treatment programs must meet
16.4the conditions in items (i) to (iii):
16.5    (i) the supervisor must be present and available on the premises more than 50
16.6percent of the time in a five-working-day period during which the supervisee is providing
16.7a mental health service;
16.8    (ii) the diagnosis and the client's individual treatment plan or a change in the
16.9diagnosis or individual treatment plan must be made by or reviewed, approved, and signed
16.10by the supervisor; and
16.11    (iii) every 30 days, the supervisor must review and sign the record of indicating the
16.12supervisor has reviewed the client's care for all activities in the preceding 30-day period;
16.13    (4b) for all other services provided under CTSS, clinical supervision standards
16.14provided in items (i) to (iii) must be used:
16.15    (i) medical assistance shall reimburse a mental health practitioner who maintains a
16.16consulting relationship with a mental health professional who accepts full professional
16.17responsibility and is present on site for at least one observation during the first 12 hours
16.18in which the mental health practitioner provides the individual, family, or group skills
16.19training to the child or the child's family;
16.20    (ii) thereafter, the mental health professional is required to be present on site for
16.21observation as clinically appropriate when the mental health practitioner is providing
16.22individual, family, or group skills training to the child or the child's family; and
16.23    (iii) when conducted, the observation must be a minimum of one clinical unit. The
16.24on-site presence of the mental health professional must be documented in the child's record
16.25and signed by the mental health professional who accepts full professional responsibility;
16.26    (5) providing direction to a mental health behavioral aide. For entities that employ
16.27mental health behavioral aides, the clinical supervisor must be employed by the provider
16.28entity or other certified children's therapeutic supports and services provider entity to
16.29ensure necessary and appropriate oversight for the client's treatment and continuity
16.30of care. The mental health professional or mental health practitioner giving direction
16.31must begin with the goals on the individualized treatment plan, and instruct the mental
16.32health behavioral aide on how to construct therapeutic activities and interventions that
16.33will lead to goal attainment. The professional or practitioner giving direction must also
16.34instruct the mental health behavioral aide about the client's diagnosis, functional status,
16.35and other characteristics that are likely to affect service delivery. Direction must also
16.36include determining that the mental health behavioral aide has the skills to interact with
17.1the client and the client's family in ways that convey personal and cultural respect and
17.2that the aide actively solicits information relevant to treatment from the family. The aide
17.3must be able to clearly explain the activities the aide is doing with the client and the
17.4activities' relationship to treatment goals. Direction is more didactic than is supervision
17.5and requires the professional or practitioner providing it to continuously evaluate the
17.6mental health behavioral aide's ability to carry out the activities of the individualized
17.7treatment plan and the individualized behavior plan. When providing direction, the
17.8professional or practitioner must:
17.9    (i) review progress notes prepared by the mental health behavioral aide for accuracy
17.10and consistency with diagnostic assessment, treatment plan, and behavior goals and the
17.11professional or practitioner must approve and sign the progress notes;
17.12    (ii) identify changes in treatment strategies, revise the individual behavior plan,
17.13and communicate treatment instructions and methodologies as appropriate to ensure
17.14that treatment is implemented correctly;
17.15    (iii) demonstrate family-friendly behaviors that support healthy collaboration among
17.16the child, the child's family, and providers as treatment is planned and implemented;
17.17    (iv) ensure that the mental health behavioral aide is able to effectively communicate
17.18with the child, the child's family, and the provider; and
17.19    (v) record the results of any evaluation and corrective actions taken to modify the
17.20work of the mental health behavioral aide;
17.21    (6) providing service delivery that implements the individual treatment plan and
17.22meets the requirements under subdivision 9; and
17.23    (7) individual treatment plan review. The review must determine the extent to which
17.24the services have met the goals and objectives in the previous treatment plan. The review
17.25must assess the client's progress and ensure that services and treatment goals continue to
17.26be necessary and appropriate to the client and the client's family or foster family. Revision
17.27of the individual treatment plan does not require a new diagnostic assessment unless the
17.28client's mental health status has changed markedly. The updated treatment plan must be
17.29signed by the client, if appropriate, and by the client's parent or other person authorized by
17.30statute to give consent to the mental health services for the child.

17.31    Sec. ... Minnesota Statutes 2008, section 256B.0943, subdivision 9, is amended to read:
17.32    Subd. 9. Service delivery criteria. (a) In delivering services under this section, a
17.33certified provider entity must ensure that:
17.34    (1) each individual provider's caseload size permits the provider to deliver services
17.35to both clients with severe, complex needs and clients with less intensive needs. The
18.1provider's caseload size should reasonably enable the provider to play an active role in
18.2service planning, monitoring, and delivering services to meet the client's and client's
18.3family's needs, as specified in each client's individual treatment plan;
18.4    (2) site-based programs, including day treatment and preschool programs, provide
18.5staffing and facilities to ensure the client's health, safety, and protection of rights, and that
18.6the programs are able to implement each client's individual treatment plan;
18.7    (3) a day treatment program is provided to a group of clients by a multidisciplinary
18.8team under the clinical supervision of a mental health professional. The day treatment
18.9program must be provided in and by: (i) an outpatient hospital accredited by the Joint
18.10Commission on Accreditation of Health Organizations and licensed under sections
18.11144.50 to 144.55; (ii) a community mental health center under section 245.62; and (iii)
18.12an entity that is under contract with the county board to operate a program that meets
18.13the requirements of sections 245.4712, subdivision 2, and 245.4884, subdivision 2,
18.14and Minnesota Rules, parts 9505.0170 to 9505.0475. The day treatment program must
18.15stabilize the client's mental health status while developing and improving the client's
18.16independent living and socialization skills. The goal of the day treatment program must
18.17be to reduce or relieve the effects of mental illness and provide training to enable the
18.18client to live in the community. The program must be available at least one day a week
18.19for a three-hour two-hour time block. The three-hour two-hour time block must include
18.20at least one hour, but no more than two hours, of individual or group psychotherapy.
18.21The remainder of the three-hour time block may include recreation therapy, socialization
18.22therapy, or independent living skills therapy, but only if the therapies are included in the
18.23client's individual treatment plan The structured treatment program may include individual
18.24or group psychotherapy and recreation therapy, socialization therapy, or independent
18.25living skills therapy, if included in the client's individual treatment plan. Day treatment
18.26programs are not part of inpatient or residential treatment services; and
18.27    (4) a preschool program is a structured treatment program offered to a child who
18.28is at least 33 months old, but who has not yet reached the first day of kindergarten, by a
18.29preschool multidisciplinary team in a day program licensed under Minnesota Rules, parts
18.309503.0005 to 9503.0175. The program must be available at least one day a week for a
18.31minimum two-hour time block. The structured treatment program may include individual
18.32or group psychotherapy and recreation therapy, socialization therapy, or independent
18.33living skills therapy, if included in the client's individual treatment plan.
18.34    (b) A provider entity must deliver the service components of children's therapeutic
18.35services and supports in compliance with the following requirements:
19.1    (1) individual, family, and group psychotherapy must be delivered as specified in
19.2Minnesota Rules, part 9505.0323;
19.3    (2) individual, family, or group skills training must be provided by a mental health
19.4professional or a mental health practitioner who has a consulting relationship with a
19.5mental health professional who accepts full professional responsibility for the training;
19.6    (3) crisis assistance must be time-limited and designed to resolve or stabilize crisis
19.7through arrangements for direct intervention and support services to the child and the
19.8child's family. Crisis assistance must utilize resources designed to address abrupt or
19.9substantial changes in the functioning of the child or the child's family as evidenced by
19.10a sudden change in behavior with negative consequences for well being, a loss of usual
19.11coping mechanisms, or the presentation of danger to self or others;
19.12    (4) medically necessary services that are provided by a mental health behavioral
19.13aide must be designed to improve the functioning of the child and support the family in
19.14activities of daily and community living. A mental health behavioral aide must document
19.15the delivery of services in written progress notes. The mental health behavioral aide
19.16must implement goals in the treatment plan for the child's emotional disturbance that
19.17allow the child to acquire developmentally and therapeutically appropriate daily living
19.18skills, social skills, and leisure and recreational skills through targeted activities. These
19.19activities may include:
19.20    (i) assisting a child as needed with skills development in dressing, eating, and
19.21toileting;
19.22    (ii) assisting, monitoring, and guiding the child to complete tasks, including
19.23facilitating the child's participation in medical appointments;
19.24    (iii) observing the child and intervening to redirect the child's inappropriate behavior;
19.25    (iv) assisting the child in using age-appropriate self-management skills as related
19.26to the child's emotional disorder or mental illness, including problem solving, decision
19.27making, communication, conflict resolution, anger management, social skills, and
19.28recreational skills;
19.29    (v) implementing deescalation techniques as recommended by the mental health
19.30professional;
19.31    (vi) implementing any other mental health service that the mental health professional
19.32has approved as being within the scope of the behavioral aide's duties; or
19.33    (vii) assisting the parents to develop and use parenting skills that help the child
19.34achieve the goals outlined in the child's individual treatment plan or individual behavioral
19.35plan. Parenting skills must be directed exclusively to the child's treatment; and
19.36    (5) direction of a mental health behavioral aide must include the following:
20.1    (i) a total of one hour of on-site observation by a mental health professional during
20.2the first 12 hours of service provided to a child;
20.3    (ii) ongoing on-site observation by a mental health professional or mental health
20.4practitioner for at least a total of one hour during every 40 hours of service provided
20.5to a child; and
20.6    (iii) immediate accessibility of the mental health professional or mental health
20.7practitioner to the mental health behavioral aide during service provision."
20.8Page 43, after line 18, insert:

20.9    "Sec. .... REPEALER.
20.10Minnesota Statutes 2008, section 245C.10, subdivision 1, is repealed."

20.11    "Sec. .... REVISOR'S INSTRUCTION.
20.12    The revisor of statutes shall correct the internal cross-reference to "section 245C.03,
20.13subdivision 1, clauses (3) and (4)" in section 245C.03, subdivision 4, by inserting
20.14"paragraph (a)," after "subdivision 1,". The revisor of statutes shall correct the internal
20.15cross-reference to section 245C.03, subdivision 1, clauses (2), (5), and (6) in section
20.16245C.14, subdivision 2, by inserting "paragraph (a)," after "subdivision 1,.""