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House Research Department Revised: June 20I0 <br />Regulation of Health and Human Services Facilities Page 1 <br />Introduction <br />This guidebook gives an overview of state regulation of residential facilities that provide support <br />services for their residents. For each facility type, information in summary form is provided on <br />services delivered, clients, number of facilities and beds in Minnesota, facility and program <br />regulation, and sources of reimbursement. <br />For purposes of this guidebook, a `residential facility" is one in which the resident lives in a <br />group setting at a location that is not a single-family home or a medical institution such as an <br />inpatient hospital. "Support services" are defined broadly to include both health -related services <br />such as nursing and home health services and nonhealth-related services such as personal care <br />and home management services, <br />The main goals of this guidebook are to make it easier to distinguish different types of facilities <br />from each other and to distinguish between different aspects of state regulation. In general, <br />residential facilities providing support services must be licensed by the Minnesota Department of <br />Health (MDH) to operate in the state. MDH is responsible for setting health and safety standards <br />for facilities and for setting quality standards for certain support services. In addition, certain <br />treatment and support programs provided at facilities must be licensed by the Minnesota <br />Department of Human Services (DHS), and most must meet DHS standards to receive state and <br />federal funding. Finally, nursing homes and intermediate care facilities for persons with mental <br />retardation (ICFs/MR) must be certified by MDH in order to qualify for reimbursement under the <br />Medical Assistance (MA) program. <br />This division of responsibilities between two state agencies, and distinctions made between <br />facility and program standards, can lead to different forms of regulation for facilities with the <br />same MDH facility license. For example, facilities licensed by MDH as supervised living <br />facilities can have one or more of the following DHS program licenses: chapter 245B (residential <br />services for persons with mental retardation), Rule 32 (services for persons with chemical <br />dependency), Rule 36 (services for mentally ill persons), or Rule 80 (services for the physically <br />handicapped). Alternatively, facilities with different MDH facility licenses may be subject to <br />identical regulation. For example, "nursing homes" and "certified boarding care homes" are <br />separate MDH license categories, but both facility types can be certified by MDH as "nursing <br />facilities" for purposes of MA reimbursement. <br />It should also be noted that the same DHS program can be offered at more than one facility type. <br />For example, home and community -based waivered services can be provided in housing with <br />services establishments, board and lodging facilities with special services, and adult foster care <br />homes. Similarly, Rule 36 programs providing services for mentally ill persons can be offered at <br />noncertified boarding care homes, group homes licensed as supervised living facilities, and board <br />and lodging facilities. <br />48 <br />