HF 2258

as introduced - 87th Legislature (2011 - 2012) Posted on 03/05/2012 10:19am

A bill for an act
relating to human services; creating a chemical health navigation program;
limiting residential chemical dependency treatment; requiring a report; amending
Minnesota Statutes 2010, sections 254B.03, subdivision 1; 254B.04, subdivision
1; 256B.69, subdivision 6; proposing coding for new law in Minnesota Statutes,
chapter 254B.

BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF MINNESOTA:

Section 1.

Minnesota Statutes 2010, section 254B.03, subdivision 1, is amended to read:

Subdivision 1.

Local agency duties.

(a) Every local agency shall provide chemical
dependency services to persons residing within its jurisdiction who meet criteria
established by the commissioner for placement in a chemical dependency residential
or nonresidential treatment service new text begin subject to the limitations on residential chemical
dependency treatment in section 254B.04, subdivision 1 new text end . Chemical dependency money
must be administered by the local agencies according to law and rules adopted by the
commissioner under sections 14.001 to 14.69.

(b) In order to contain costs, the commissioner of human services shall select eligible
vendors of chemical dependency services who can provide economical and appropriate
treatment. Unless the local agency is a social services department directly administered by
a county or human services board, the local agency shall not be an eligible vendor under
section 254B.05. The commissioner may approve proposals from county boards to provide
services in an economical manner or to control utilization, with safeguards to ensure that
necessary services are provided. If a county implements a demonstration or experimental
medical services funding plan, the commissioner shall transfer the money as appropriate.

(c) A culturally specific vendor that provides assessments under a variance under
Minnesota Rules, part 9530.6610, shall be allowed to provide assessment services to
persons not covered by the variance.

Sec. 2.

Minnesota Statutes 2010, section 254B.04, subdivision 1, is amended to read:

Subdivision 1.

Eligibility.

(a) Persons eligible for benefits under Code of Federal
Regulations, title 25, part 20, persons eligible for medical assistance benefits under
sections 256B.055, 256B.056, and 256B.057, subdivisions 1, 2, 5, and 6, or who meet
the income standards of section 256B.056, subdivision 4, and persons eligible for general
assistance medical care under section 256D.03, subdivision 3, are entitled to chemical
dependency fund services new text begin subject to the following limitations: new text end new text begin (1) no more than three
residential chemical dependency treatment episodes for the same person in a four-year
period of time unless the person meets the criteria established by the commissioner of
human services; and new text end new text begin (2) no more than four residential chemical dependency treatment
episodes in a lifetime unless the person meets the criteria established by the commissioner
of human services. For purposes of this section, "episode" means a span of treatment
without interruption of 30 days or more new text end . State money appropriated for this paragraph must
be placed in a separate account established for this purpose.

Persons with dependent children who are determined to be in need of chemical
dependency treatment pursuant to an assessment under section 626.556, subdivision 10, or
a case plan under section 260C.201, subdivision 6, or 260C.212, shall be assisted by the
local agency to access needed treatment services. Treatment services must be appropriate
for the individual or family, which may include long-term care treatment or treatment in a
facility that allows the dependent children to stay in the treatment facility. The county
shall pay for out-of-home placement costs, if applicable.

(b) A person not entitled to services under paragraph (a), but with family income
that is less than 215 percent of the federal poverty guidelines for the applicable family
size, shall be eligible to receive chemical dependency fund services within the limit
of funds appropriated for this group for the fiscal year. If notified by the state agency
of limited funds, a county must give preferential treatment to persons with dependent
children who are in need of chemical dependency treatment pursuant to an assessment
under section 626.556, subdivision 10, or a case plan under section 260C.201, subdivision
6, or 260C.212. A county may spend money from its own sources to serve persons under
this paragraph. State money appropriated for this paragraph must be placed in a separate
account established for this purpose.

(c) Persons whose income is between 215 percent and 412 percent of the federal
poverty guidelines for the applicable family size shall be eligible for chemical dependency
services on a sliding fee basis, within the limit of funds appropriated for this group for the
fiscal year. Persons eligible under this paragraph must contribute to the cost of services
according to the sliding fee scale established under subdivision 3. A county may spend
money from its own sources to provide services to persons under this paragraph. State
money appropriated for this paragraph must be placed in a separate account established
for this purpose.

new text begin EFFECTIVE DATE. new text end

new text begin This section is effective for all chemical dependency
residential treatment beginning on or after July 1, 2012.
new text end

Sec. 3.

new text begin [254B.14] CHEMICAL HEALTH NAVIGATION PROGRAM.
new text end

new text begin Subdivision 1. new text end

new text begin Establishment; purpose. new text end

new text begin (a) There is established a state-county
chemical health navigation program. The Department of Human Services and interested
counties shall work in partnership to augment the current chemical health service delivery
system to promote better outcomes for eligible individuals and greater accountability and
productivity in the delivery of state and county funded chemical dependency services.
new text end

new text begin (b) The navigation program shall allow flexibility for eligible individuals to
timely access needed services as well as to align systems and services to offer the most
appropriate level of chemical health services to eligible individuals.
new text end

new text begin (c) Chemical health navigation programs must maintain eligibility requirements for
the consolidated chemical dependency treatment fund, continue to meet the requirements
of Minnesota Rules, parts 9530.6405 to 9530.6505 and 9530.6600 to 9530.6655, and must
not put current and future federal funding of chemical health services at risk.
new text end

new text begin Subd. 2. new text end

new text begin Program implementation. new text end

new text begin (a) Each county's participation in the chemical
health navigation program is voluntary.
new text end

new text begin (b) The commissioner and each county participating in the chemical health
navigation program shall enter into an agreement governing the operation of the county's
navigation program. Each county shall implement its program within 60 days of the final
agreement with the commissioner.
new text end

new text begin Subd. 3. new text end

new text begin Notice of program discontinuation. new text end

new text begin Each county's participation in the
chemical health navigation program may be discontinued for any reason by the county or
the commissioner after 30 days' written notice to the other party. Any unspent funds held
for the exiting county's pro rata share in the special revenue fund under the authority in
subdivision 5, paragraph (d), shall be transferred to the consolidated chemical dependency
treatment fund following discontinuation of the program.
new text end

new text begin Subd. 4. new text end

new text begin Eligibility for navigator program. new text end

new text begin To be considered for participation in
a navigator program, an individual must:
new text end

new text begin (1) be a resident of a county with an approved navigator program;
new text end

new text begin (2) be eligible for chemical dependency fund services;
new text end

new text begin (3) have a score of at least three in two or more dimensions of the placement criteria
in a Rule 25 assessment under Minnesota Rules, parts 9530.6600 to 9530.6655;
new text end

new text begin (4) have had at least two treatment episodes in the past two years, not limited to
episodes reimbursed by the consolidated chemical dependency treatment funds; and
new text end

new text begin (5) be a voluntary participant in the navigator program.
new text end

new text begin Subd. 5. new text end

new text begin Duties of commissioner. new text end

new text begin (a) Notwithstanding any other provisions in this
chapter, the commissioner may authorize chemical health navigator programs to use
chemical dependency treatment funds to pay for nontreatment services:
new text end

new text begin (1) in addition to those authorized under section 254B.03, subdivision 2, paragraph
(a); and
new text end

new text begin (2) by vendors in addition to those authorized under section 254B.05 when not
providing chemical dependency treatment services.
new text end

new text begin (b) Participating counties may contract with providers to provide nontreatment
services pursuant to section 256B.69, subdivision 6, paragraph (c).
new text end

new text begin (c) For the purposes of this section, "nontreatment services" include
community-based navigator services, peer support, family engagement and support,
housing support and rent subsidy for up to 90 days, supported employment, and
independent living skills.
new text end

new text begin (d) State expenditures for chemical dependency services and nontreatment
services provided through the navigator programs must not be greater than the chemical
dependency treatment fund expected share of forecasted expenditures in the absence of
the navigator programs. The commissioner may restructure the schedule of payments
between the state and participating counties under the local agency share and division of
cost provisions under section 254B.03, subdivisions 3 and 4, as necessary to facilitate
the operation of the navigation programs.
new text end

new text begin (e) To the extent that state fiscal year expenditures within a county's navigator
program are less than the expected share of forecasted expenditures in the absence of the
navigator program, the commissioner shall deposit the unexpended funds in a separate
account within the consolidated chemical dependency treatment fund, and make these
funds available for expenditure by the county for the following year. To the extent that
treatment and nontreatment services expenditures within a county's navigator program
exceed the amount expected in the absence of the navigator program, the county shall be
responsible for the portion of costs for nontreatment services expended in excess of the
otherwise expected share of forecasted expenditures.
new text end

new text begin (f) The commissioner may waive administrative rule requirements that are
incompatible with the implementation of navigator programs, except that any chemical
dependency treatment funded under this section must continue to be provided by a
licensed treatment provider.
new text end

new text begin (g) The commissioner shall not approve or enter into any agreement related to
navigator programs authorized under this section that puts current or future federal
funding at risk.
new text end

new text begin (h) The commissioner shall provide participating counties with transactional data,
reports, provider data, and other data generated by county activity to assess and measure
outcomes. This information must be transmitted to participating counties at least once
every six months.
new text end

new text begin Subd. 6. new text end

new text begin Duties of county board. new text end

new text begin The county board, or other county entity that is
approved to administer a navigator program, shall:
new text end

new text begin (1) administer the program in a manner consistent with this section;
new text end

new text begin (2) ensure that no one is denied chemical dependency treatment services for which
they would otherwise be eligible under section 254A.03, subdivision 3; and
new text end

new text begin (3) provide the commissioner with timely and pertinent information as negotiated in
the agreement governing operation of the county's navigator program.
new text end

new text begin Subd. 7. new text end

new text begin Report. new text end

new text begin The commissioner, in partnership with participating counties,
shall provide an annual report on the achievement of navigator program outcomes to the
legislative committees with jurisdiction over chemical health. The report shall address
qualitative and quantitative outcomes.
new text end

new text begin EFFECTIVE DATE. new text end

new text begin This section is effective the day following final enactment.
new text end

Sec. 4.

Minnesota Statutes 2010, section 256B.69, subdivision 6, is amended to read:

Subd. 6.

Service delivery.

(a) Each demonstration provider shall be responsible for
the health care coordination for eligible individuals. Demonstration providers:

(1) shall authorize and arrange for the provision of all needed health services
including but not limited to the full range of services listed in sections 256B.02,
subdivision 8, and 256B.0625 in order to ensure appropriate health care is delivered to
enrollees. Notwithstanding section 256B.0621, demonstration providers that provide
nursing home and community-based services under this section shall provide relocation
service coordination to enrolled persons age 65 and over;

(2) shall accept the prospective, per capita payment from the commissioner in return
for the provision of comprehensive and coordinated health care services for eligible
individuals enrolled in the program;

(3) may contract with other health care and social service practitioners to provide
services to enrollees; and

(4) shall institute recipient grievance procedures according to the method established
by the project, utilizing applicable requirements of chapter 62D. Disputes not resolved
through this process shall be appealable to the commissioner as provided in subdivision 11.

(b) Demonstration providers must comply with the standards for claims settlement
under section 72A.201, subdivisions 4, 5, 7, and 8, when contracting with other health
care and social service practitioners to provide services to enrollees. A demonstration
provider must pay a clean claim, as defined in Code of Federal Regulations, title 42,
section 447.45(b), within 30 business days of the date of acceptance of the claim.

new text begin (c) Demonstration providers may contract with counties participating in the chemical
health navigation program established under section 254B.14, to provide chemical
dependency nontreatment services as defined in section 254B.14, subdivision 5, paragraph
(b), using capitation payments received under this section and section 256B.692.
new text end

Sec. 5. new text begin COMMISSIONER'S CRITERIA FOR RESIDENTIAL TREATMENT.
new text end

new text begin (a) The commissioner of human services shall develop specific criteria to approve
treatment for individuals who require residential chemical dependency treatment in excess
of the maximum allowed in Minnesota Statutes, section 254B.04, subdivision 1, due to
co-occurring disorders, including disorders related to cognition, traumatic brain injury, or
documented disability. Criteria shall be developed for use no later than October 1, 2012.
new text end

new text begin (b) The commissioner may grant approval for treatment in excess of the maximum
allowed in Minnesota Statutes, section 254B.04, subdivision 1, upon the request of any
eligible individual.
new text end