HF 3274

1st Division Engrossment - 92nd Legislature (2021 - 2022) Posted on 03/28/2022 11:13am

A bill for an act
relating to human services; modifying children's residential treatment; appropriating
money; amending Minnesota Statutes 2020, sections 245.4882, by adding a
subdivision; 256B.0941, subdivision 3, by adding a subdivision.

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

Section 1.

Minnesota Statutes 2020, section 245.4882, is amended by adding a subdivision
to read:

new text begin Subd. 2a. new text end

new text begin Assessment requirements. new text end

new text begin (a) A residential treatment service provider must
complete a diagnostic assessment of a child within ten calendar days of the child's admission.
If a diagnostic assessment has been completed by a mental health professional within the
past 180 days, a new diagnostic assessment need not be completed unless in the opinion of
the current treating mental health professional the child's mental health status has changed
markedly since the assessment was completed.
new text end

new text begin (b) The service provider must complete the screenings required by Minnesota Rules,
part 2960.0070, subpart 5, within ten calendar days.
new text end

Sec. 2.

Minnesota Statutes 2020, section 256B.0941, is amended by adding a subdivision
to read:

new text begin Subd. 2a. new text end

new text begin Sleeping hours. new text end

new text begin During normal sleeping hours, a psychiatric residential
treatment facility provider must provide at least one staff person for every six residents
present within a living unit. A provider must adjust sleeping-hour staffing levels based on
the clinical needs of the residents in the facility.
new text end

Sec. 3.

Minnesota Statutes 2020, section 256B.0941, subdivision 3, is amended to read:

Subd. 3.

Per diem rate.

(a) The commissioner must establish one per diem rate per
provider for psychiatric residential treatment facility services for individuals 21 years of
age or younger. The rate for a provider must not exceed the rate charged by that provider
for the same service to other payers. Payment must not be made to more than one entity for
each individual for services provided under this section on a given day. The commissioner
must set rates prospectively for the annual rate period. The commissioner must require
providers to submit annual cost reports on a uniform cost reporting form and must use
submitted cost reports to inform the rate-setting process. The cost reporting must be done
according to federal requirements for Medicare cost reports.

(b) The following are included in the rate:

(1) costs necessary for licensure and accreditation, meeting all staffing standards for
participation, meeting all service standards for participation, meeting all requirements for
active treatment, maintaining medical records, conducting utilization review, meeting
inspection of care, and discharge planning. The direct services costs must be determined
using the actual cost of salaries, benefits, payroll taxes, and training of direct services staff
and service-related transportation; and

(2) payment for room and board provided by facilities meeting all accreditation and
licensing requirements for participation.

(c) A facility may submit a claim for payment outside of the per diem for professional
services arranged by and provided at the facility by an appropriately licensed professional
who is enrolled as a provider with Minnesota health care programs. Arranged services may
be billed by either the facility or the licensed professional. These services must be included
in the individual plan of care and are subject to prior authorization.

(d) Medicaid must reimburse for concurrent services as approved by the commissioner
to support continuity of care and successful discharge from the facility. "Concurrent services"
means services provided by another entity or provider while the individual is admitted to a
psychiatric residential treatment facility. Payment for concurrent services may be limited
and these services are subject to prior authorization by the state's medical review agent.
Concurrent services may include targeted case management, assertive community treatment,
clinical care consultation, team consultation, and treatment planning.

(e) Payment rates under this subdivision must not include the costs of providing the
following services:

(1) educational services;

(2) acute medical care or specialty services for other medical conditions;

(3) dental services; and

(4) pharmacy drug costs.

(f) For purposes of this section, "actual cost" means costs that are allowable, allocable,
reasonable, and consistent with federal reimbursement requirements in Code of Federal
Regulations, title 48, chapter 1, part 31, relating to for-profit entities, and the Office of
Management and Budget Circular Number A-122, relating to nonprofit entities.

new text begin (g) The commissioner shall consult with providers and stakeholders to develop an
assessment tool that identifies when a child with a medical necessity for psychiatric
residential treatment facility level of care will require specialized care planning, including
but not limited to a one-on-one staffing ratio in a living environment. The commissioner
must develop the tool based on clinical and safety review and recommend best uses of the
protocols to align with reimbursement structures.
new text end

Sec. 4. new text begin APPROPRIATION; CHILDREN'S RESIDENTIAL TREATMENT
SERVICES.
new text end

new text begin $2,500,000 in fiscal year 2023 is appropriated from the American Rescue Plan state
fiscal recovery federal fund to the commissioner of human services to provide licensed
children's residential treatment facilities with emergency funding for:
new text end

new text begin (1) staff overtime;
new text end

new text begin (2) one-to-one staffing, as needed;
new text end

new text begin (3) staff recruitment and retention; and
new text end

new text begin (4) training and related costs to maintain quality staff.
new text end

new text begin Up to $500,000 of this appropriation may be allocated to support group home
organizations supporting children transitioning to lower levels of care. This is a onetime
appropriation.
new text end

Sec. 5. new text begin APPROPRIATION; PSYCHIATRIC RESIDENTIAL TREATMENT
FACILITY START-UP GRANTS.
new text end

new text begin $2,200,000 in fiscal year 2023 is appropriated from the general fund to the commissioner
of human services for psychiatric residential treatment facility start-up grants. Grants may
be awarded to existing or prospective psychiatric residential treatment facility sites. Grant
money may be used for:
new text end

new text begin (1) administrative expenses;
new text end

new text begin (2) consulting services;
new text end

new text begin (3) Health Insurance Portability and Accountability Act of 1996 compliance;
new text end

new text begin (4) therapeutic resources, including evidence-based, culturally appropriate curricula and
training programs for staff and clients;
new text end

new text begin (5) allowable physical renovations to the property; and
new text end

new text begin (6) emergency workforce shortage uses as determined by the commissioner.
new text end