Legal authority

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

Definitions

Clinical supervision: The overall responsibility for the control and direction of EIDBI service delivery, including:

Qualified supervising professionals (QSPs) are the primary clinical supervisors. Other qualified EIDBI providers may supplement clinical supervision services as clinically appropriate. During clinical supervision, the QSP takes full professional responsibility for the service provided by each supervisee and the clinical effectiveness of all interventions.

Supervisee: An individual EIDBI provider who receives documented clinical supervision while they deliver EIDBI services. They may be working toward licensure or certification.

Clinical supervision requirements

QSPs must ensure the supervisee:

EIDBI providers must make sure they provide and receive supervision that aligns with their enrollment requirements.

Minimum supervision ratio requirement

As of Jan. 1, 2026, QSPs must provide at least one hour of clinical supervision for every 16 hours of direct treatment, unless otherwise specified in the person’s EIDBI ITP and Progress Monitoring Form, DHS-7109. For more information, refer to EIDBI – How to complete ITP and Progress Monitoring, DHS-7109.

Clinical standards for proportionate supervision

As of Jan. 1, 2026, providers must:

Additional standards

In addition to the EIDBI clinical supervision requirements above, when applicable, providers must follow the supervision requirements for:

Recommended guidelines for clinical supervision

Clinical supervision frequency and intensity

To ensure consistent oversight of direct intervention services, EIDBI providers should determine clinical supervision frequency and intensity based on the factors below:

Note: These factors may require clinical supervision frequency different from the 1:16 ratio.

Responsibilities

The qualified EIDBI provider(s) who deliver clinical supervision are responsible to:

Caseload guidelines

DHS recommends clinical supervisors have a consistent and manageable EIDBI caseload that allows them to:

How to determine clinical supervisor caseloads

Clinical supervisors with expertise in a variety of conditions, complex symptoms or behavior needs and a well-trained and integrated support team may be able to support a slightly higher caseload than clinical supervisors with limited experience or who support supervisees with limited training.

QSP assignment and caseload structure

QSPs must have a consistent caseload of people receiving services and staff to ensure effective coordination and continuity of care. Each person receiving services must have one clearly designated primary QSP who is responsible for meeting clinical supervision requirements. Agencies can assign additional (i.e., backup) QSPs if necessary.

A maximum of two QSPs may sign a child’s treatment plan and share responsibility for clinical supervision and overall program integrity. DHS discourages providers from assigning more than two QSPs because each QSP must sign the plan and consistently coordinate and document supervision. Limiting the number of QSPs:

Telehealth requirements

An EIDBI provider may provide clinical supervision via telehealth as clinically appropriate for the person who receives services and within the EIDBI requirements. For guidelines about electronic communication, refer to EIDBI – Telehealth services.

Documentation

Clinical supervisors should document clinical supervision in:

Recommended documentation

Documentation in the supervisee’s record should include:

Required documentation

Documentation in the person’s ITP and case notes should include any clinical supervision related to the person’s treatment. For instructions and more information, refer to: