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

Clinical supervision: A required component of EIDBI services that covers the overall responsibility for the control and direction of EIDBI service delivery, including:

Clinical supervision supports the quality and effectiveness of EIDBI services. This page explains clinical supervision requirements, including:

Qualified supervising professionals (QSPs) are the primary clinical supervisors for EIDBI services. During clinical supervision, the QSP must:

Note: Additional QSPs or other qualified EIDBI providers may only supplement clinical supervision as clinically appropriate.

Primary and secondary QSPs

Each provider agency must:

The primary QSP is responsible for overall clinical oversight and signs the person’s ITP.
Note: If the agency assigns a secondary QSP, both QSPs must sign the person’s ITP.

For more information, refer to EIDBI – QSP qualifications, roles and responsibilities.

The QSP must provide at least one hour of clinical supervision for every 16 hours of direct intervention (i.e., 1:16 ratio). This standard applies unless the QSP follows the exception process below.

Exceptions

The QSP must determine whether the standard 1:16 clinical supervision ratio is appropriate based on the person’s individual clinical needs. They should consider the following factors:

If the QSP determines the standard 1:16 ratio does not meet the person’s clinical needs and an exception is medically necessary, the QSP must:

For more information, refer to EIDBI – How to complete ITP and Progress Monitoring, DHS-7109.

Observation and direction is a component of clinical supervision used to:

The QSP must provide observation and direction for EIDBI intervention at least once per month for each person receiving services. For more information, refer to EIDBI – Observation and direction.

An EIDBI provider may only provide clinical supervision via telehealth when it is clinically appropriate for the person receiving services and allowed under EIDBI service requirements. The provider must document the clinical rationale for telehealth services in the person’s ITP.

The QSP may provide observation and direction via telehealth for no more than two consecutive months. Observation and direction must occur in person in the third month.

For additional guidelines about telehealth, refer to EIDBI – Telehealth services.

The QSP must document clinical supervision in the person’s health service record, including the person’s ITP and progress notes, when applicable.

For more information, refer to:

Before providing clinical supervision, provider agencies must determine whether the applicable EIDBI service requires authorization. For service authorization requirements, refer to MHCP Provider Manual – EIDBI – Service authorization.

To bill for a clinical supervision activity, providers must meet the coverage, documentation and billing requirements for the applicable EIDBI service.
Note: Not all clinical supervision activities are billable.

For more information, refer to MHCP Provider Manual – EIDBI – Billing.