Minnesota Legislature
SF 4460
as introduced - 93rd Legislature (2023 - 2024) Posted on 04/12/2024 09:54am
Current Version - as introduced
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A bill for an act
relating to behavioral health; modifying civil commitment priority admission
requirements; specifying that a prisoner in a correctional facility is not responsible
for co-payments for mental health medications; allowing for reimbursement of
county co-payment expenses; appropriating money; amending Minnesota Statutes
2023 Supplement, sections 253B.10, subdivision 1; 641.15, subdivision 2.
BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF MINNESOTA:
Section 1.
Minnesota Statutes 2023 Supplement, section 253B.10, subdivision 1, is amended
to read:
Subdivision 1.
Administrative requirements.
(a) When a person is committed, the
court shall issue a warrant or an order committing the patient to the custody of the head of
the treatment facility, state-operated treatment program, or community-based treatment
program. The warrant or order shall state that the patient meets the statutory criteria for
civil commitment.
(b) deleted text begin The commissioner shall prioritize patients being admitted from jail or a correctional
institution who aredeleted text end new text begin A person committed to the commissioner must be prioritized for admission
to a medically appropriate state-operated treatment program based on the decisions of
physicians in the executive medical director's office, using a priority admissions framework.
The framework must account for a range of factors for priority admission, including but
not limited tonew text end :
(1) deleted text begin ordered confined in a state-operated treatment program for an examination under
Minnesota Rules of Criminal Procedure,deleted text end deleted text begin rules 20.01, subdivision 4deleted text end deleted text begin , paragraph (a), and
deleted text end deleted text begin 20.02, subdivision 2deleted text end new text begin the length of time the person has been on a waiting list for admission
to a state-operated treatment programnew text end ;
(2) deleted text begin under civil commitment for competency treatment and continuing supervision under
Minnesota Rules of Criminal Procedure, deleted text end deleted text begin rule 20.01, subdivision 7deleted text end new text begin the intensity of the
treatment the person needs, based on medical acuitynew text end ;
(3) deleted text begin found not guilty by reason of mental illness under Minnesota Rules of Criminal
Procedure, deleted text end deleted text begin rule 20.02, subdivision 8deleted text end deleted text begin , and under civil commitment or are ordered to be
detained in a state-operated treatment program pending completion of the civil commitment
proceedings; ordeleted text end new text begin the person's provisional discharge status;
new text end
(4) deleted text begin committed under this chapter to the commissioner after dismissal of the patient's
criminal charges.deleted text end new text begin the person's safety and safety of others in the person's current environment;
new text end
new text begin
(5) constitutional or due process violations that may result without priority admission;
new text end
new text begin
(6) whether the person has access to necessary treatment in a program that is not a
state-operated treatment program;
new text end
new text begin
(7) negative impacts of an admission delay on the facility referring the individual for
treatment; and
new text end
new text begin
(8) any relevant federal prioritization requirements.
new text end
deleted text begin
Patients described in this paragraph must be admitted to a state-operated treatment program
within 48 hours. The commitment must be ordered by the court as provided in section
253B.09, subdivision 1, paragraph (d).
deleted text end
(c) Upon the arrival of a patient at the designated treatment facility, state-operated
treatment program, or community-based treatment program, the head of the facility or
program shall retain the duplicate of the warrant and endorse receipt upon the original
warrant or acknowledge receipt of the order. The endorsed receipt or acknowledgment must
be filed in the court of commitment. After arrival, the patient shall be under the control and
custody of the head of the facility or program.
(d) Copies of the petition for commitment, the court's findings of fact and conclusions
of law, the court order committing the patient, the report of the court examiners, and the
prepetition report, and any medical and behavioral information available shall be provided
at the time of admission of a patient to the designated treatment facility or program to which
the patient is committed. Upon a patient's referral to the commissioner of human services
for admission pursuant to subdivision 1, paragraph (b), any inpatient hospital, treatment
facility, jail, or correctional facility that has provided care or supervision to the patient in
the previous two years shall, when requested by the treatment facility or commissioner,
provide copies of the patient's medical and behavioral records to the Department of Human
Services for purposes of preadmission planning. This information shall be provided by the
head of the treatment facility to treatment facility staff in a consistent and timely manner
and pursuant to all applicable laws.
(e) Patients described in paragraph (b) must be admitted to a state-operated treatment
program within 48 hours of the Office of Medical Director, under section 246.018, or a
designee determining that a medically appropriate bed is available. This paragraph expires
on June 30, 2025.
new text begin
(f) A panel, appointed by the commissioner, consisting of members who served on the
Task Force on Priority Admissions to State-Operated Treatment Programs, must review
de-identified data quarterly for one year following the implementation of the priority
admissions framework to ensure that the framework is implemented and applied equitably.
The panel must advise the commissioner and the direct care and treatment executive board
on the effectiveness of the framework and priority admissions generally. Following the
panel's initial assessment and advice, a quality committee, established by the direct care
and treatment executive board, must continue to review de-identified data quarterly and
provide a quarterly report to the executive board on the effectiveness of the framework and
priority admissions.
new text end
Sec. 2.
Minnesota Statutes 2023 Supplement, section 641.15, subdivision 2, is amended
to read:
Subd. 2.
Medical aid.
Except as provided in section 466.101, the county board shall
pay the costs of medical services provided to prisoners pursuant to this section. The amount
paid by the county board for a medical service shall not exceed the maximum allowed
medical assistance payment rate for the service, as determined by the commissioner of
human services. In the absence of a health or medical insurance or health plan that has a
contractual obligation with the provider or the prisoner, medical providers shall charge no
higher than the rate negotiated between the county and the provider. In the absence of an
agreement between the county and the provider, the provider may not charge an amount
that exceeds the maximum allowed medical assistance payment rate for the service, as
determined by the commissioner of human services. The county is entitled to reimbursement
from the prisoner for payment of medical bills to the extent that the prisoner to whom the
medical aid was provided has the ability to pay the bills. The prisoner shall, at a minimum,
incur co-payment obligations for health care services provided by a county correctional
facility. The county board shall determine the co-payment amount. new text begin A prisoner shall not
have a co-payment obligation for receiving a mental health medication in the correctional
facility. The county board may seek reimbursement for co-payment costs from the
commissioner of human services. new text end Notwithstanding any law to the contrary, the co-payment
shall be deducted from any of the prisoner's funds held by the county, to the extent possible.
If there is a disagreement between the county and a prisoner concerning the prisoner's ability
to pay, the court with jurisdiction over the defendant shall determine the extent, if any, of
the prisoner's ability to pay for the medical services. If a prisoner is covered by health or
medical insurance or other health plan when medical services are provided, the medical
provider shall bill that health or medical insurance or other plan. If the county providing
the medical services for a prisoner that has coverage under health or medical insurance or
other plan, that county has a right of subrogation to be reimbursed by the insurance carrier
for all sums spent by it for medical services to the prisoner that are covered by the policy
of insurance or health plan, in accordance with the benefits, limitations, exclusions, provider
restrictions, and other provisions of the policy or health plan. The county may maintain an
action to enforce this subrogation right. The county does not have a right of subrogation
against the medical assistance program. The county shall not charge prisoners for telephone
calls to MNsure navigators, the Minnesota Warmline, a mental health provider, or calls for
the purpose of providing case management or mental health services as defined in section
245.462 to prisoners.
Sec. 3. new text begin APPROPRIATION; CORRECTIONAL FACILITY MENTAL HEALTH
COSTS AND SERVICES.
new text end
new text begin
$....... in fiscal year 2025 is appropriated from the general fund to the direct care and
treatment executive board for services and costs for prisoners receiving mental health
medications in correctional facilities. The executive board must use these funds to:
new text end
new text begin
(1) pay for injectable medications or neuroleptic medications used for mental health
treatment of prisoners in correctional facilities, and related billable provider costs;
new text end
new text begin
(2) create a position within the Department of Direct Care and Treatment to provide
education, support, and technical assistance to counties and correctional facilities on the
provision of medications for mental health treatment, and assist with finding providers to
deliver the mental health medications; and
new text end
new text begin
(3) reimburse county boards for co-payment costs incurred for mental health medications
provided in correctional facilities, pursuant to Minnesota Statutes, section 641.15, subdivision
2.
new text end