CMS-approved state plan amendment – 2017 (PDF), CMS-approved state plan amendment – 2018 update (PDF), CMS-approved state plan amendment – 2019 update (PDF), CMS-approved state plan amendment – 2022 update (PDF), Minn. Stat. §256B.0949

Agency: A legal entity enrolled with Minnesota Health Care Programs (MHCP) as a Medical Assistance (MA) provider, according to Minnesota Rules, part 9505.0195, to provide EIDBI services. This includes an individual licensed professional who practices independently and acts as an agency. The agency is legally responsible to make sure its employees provide EIDBI services according to all applicable laws.

Employee: A person who is employed temporarily, part time or full time by the agency that submits claims or billing for the work, services, supervision or treatment performed by the person. This does not include:

Legal representative: The parent of a child younger than age 18, a court-appointed guardian or other representative with legal authority to make decisions about services for a person.

Other representative with legal authority to make decisions: A health care agent or an attorney-in-fact authorized through a health care directive or power of attorney.

All people who receive EIDBI services and their legal representatives have rights and responsibilities, as listed on EIDBI – Your Rights and Responsibilities, DHS-7645A (PDF). EIDBI provider agencies and their staff also have responsibilities to the people to who receive services, as listed on EIDBI – Provider Agency Responsibilities, DHS-7645B (PDF).

To ensure each person and legal representative receives the best services possible, it is important that the:

The provider agency must review the rights and responsibilities with the person and their legal representative before services begin and at least every year thereafter. The provider agency gathers the signature of the person/legal representative to acknowledge the person/legal representative understands and agrees.

Note: Only people who can consent to treatment and make legal decisions can sign the forms. This may not include all caregivers. Providers must ensure the person who signs the forms has the legal authority to do so.

The person and legal representative have the right to:

1. Be protected as defined under the health care bill of rights (Minn. Stat. §144.651).

2. Choose an advocate to be present in all aspects of the person’s services at the request of the legal representative.

3. Be informed of the:

4. Be free from seclusion and restraint, except for emergency use of manual restraint (refer to emergency use of manual restraint section).

5. Be supervised by a responsible adult at all times.

6. Be notified by the agency within 24 hours if an incident occurs or the person is injured while receiving services, including what occurred and how agency staff responded to the incident.

7. Request a voluntary coordinated care conference (refer to EIDBI – Coordinated care conference).

8. Request a comprehensive multi-disciplinary evaluation (CMDE) provider of the person’s or legal representative’s choice.

9. Be free from all prohibitions, punishment, restraint, etc., as defined in the positive supports rule (Minn. R. 9544.0060).

For a complete list of the rights and responsibilities of people who receive services, refer to EIDBI – Your Rights and Responsibilities, DHS-7645A (PDF).

An agency delivering EIDBI services must:

1. Enroll as an MHCP provider and meet all applicable standards and requirements. For more information, refer to MHCP Provider Manual – EIDBI provider enrollment.

2. Demonstrate compliance with federal and state laws for the delivery of and billing for EIDBI services that prohibit providers from:

3. Verify and maintain records of a service provided to the person or legal representative, as described in Minn. R. 9505.2175 and Minn. R. 9505.2197.

4. Demonstrate that, while enrolled or seeking enrollment as an MHCP provider, the agency did not have a lead agency contract or provider agreement discontinued because of a fraud conviction.

5. Have established business practices, including:

6. Have an office located in Minnesota or a border state of Iowa, North Dakota, South Dakota or Wisconsin and provide MHCP EIDBI services to eligible people.

7. Comply with all background study requirements, including those in Minn. Stat. §245C. For more information, refer to DHS – EIDBI background studies.

8. Comply with any data requests.

9. Provide training for all agency staff on the requirements and responsibilities listed in DHS – Mandated reporter resources and the Vulnerable Adult Protection Act, including:

10. Have a written policy to resolve issues collaboratively, when possible, and share the policy with the person and their legal representative.
Note: The policy must include a timeline for when the person and legal representative will be notified about issues that arise during service delivery.

11. Provide the person’s legal representative with prompt notification if the person is injured or if an incident report is completed for any reason while being served by the agency. Note:

12. Provide the person or legal representative with a description of the treatment modality the person will receive before they start the service. This includes the staffing certification levels and training of staff who will provide the treatment (refer to EIDBI – Treatment modalities).

13. Ensure a qualified supervising professional (QSP) provides clinical supervision for a minimum of one hour for every 16 hours of direct treatment per person, unless otherwise authorized in the person’s individual treatment plan (ITP).

14. Conduct no more than two consecutive monthly required EIDBI intervention observation and direction sessions via telehealth.

For a complete list of provider agency responsibilities, refer to EIDBI – Provider Agency Responsibilities, DHS-7645B (PDF).

Effective Jan. 1, 2026, EIDBI provider agencies must fulfill all the following requirements:

EIDBI Compliance and Program Integrity Guide, DHS-8632 (PDF) is a comprehensive resource for EIDBI providers. By following the practices and guidelines in the guide and integrating these strategies into their workflow, providers can:

To maintain compliance and deliver high-quality services, providers must:

DHS recommends provider agencies review the following resources about required health and safety standards.

Department of Labor and Industry standards

The Minnesota Department of Labor and Industry (DLI) ensures Minnesota’s work and living environments are equitable, healthy and safe. For information on construction codes and licensing, occupational safety and health, wage and hour standards and workers’ compensation, refer to DLI.

Minnesota Occupational Safety and Health Administration (MNOSHA) program

The MNOSHA state-plan program is approved by federal Occupational Safety and Health Administration (OSHA) and protects workers at private and public worksites. The program has two parts:

When the EIDBI provider agency delivers the person’s initial ITP and annually thereafter, the EIDBI provider agency must:

People who receive EIDBI services must be free from seclusion or the use of manual restraints, except for the use of emergency manual restraints. Emergency use of manual restraint must be used only when:

The following does not constitute an emergency:

If emergency restraints are necessary, the EIDBI provider agency must:

1. Only implement the procedure in the least restrictive manner.

2. Return the person to a non-restricted environment or activity while ensuring the safety of the person and others from risk of physical harm.

3. Notify the person’s legal representative on the same day the procedure was used.

4. Document use of the emergency restraint in the person’s case notes, including:

The person’s primary language spoken at home, culture, values, goals and preferences must be reflected throughout the covered services.

The CMDE provider and QSP must:

All EIDBI agencies and providers must meet background study requirements, including those in Minn. Stat. §245C, before they provide and bill for any service. For more information, refer to DHS – Background studies.

Note: Rendering providers who do not have background study documentation on file are subject to monetary recovery of claims billed.

There are five provider types eligible to deliver EIDBI services. For more information, refer to EIDBI – Overview of EIDBI providers.

Note: Any volunteer, intern or other person that provides services and/or has direct contact with a person receiving services must meet all applicable EIDBI laws and policies. For more information, refer to DHS – EIDBI background studies.

Employee requirement

All level I, level II and level III providers must be employees of the EIDBI agency or agencies with which they are affiliated. For additional provider standards and qualifications, refer to:

Effective Jan. 1, 2026, all QSPs must be employees of all EIDBI agencies with which they are affiliated. For additional provider standards and qualifications for QSPs, refer to EIDBI – QSP qualifications, roles and responsibilities.

The EIDBI benefit is a medical service, and therefore, the EIDBI provider agency must keep a health service record for every person it serves. For more information, refer to EIDBI – Health service records.

Clinical supervision is required in EIDBI treatment. For more information, refer to EIDBI – Clinical supervision.

The person and legal representative have the right to file an appeal.

Person and legal representative

For information about the appeals process, refer to DHS – Appeals and DHS – Appeals frequently asked questions.

Providers

DHS recommends providers give the person and legal representative information about filing an appeal. For provider-related information about the appeals process, refer to CBSM – Appeals.