HF 3738

1st Division Engrossment - 92nd Legislature (2021 - 2022) Posted on 03/16/2022 12:12pm

A bill for an act
relating to human services; modifying children's therapeutic services and supports;
directing the commissioner of human services to develop a new Medicaid-eligible
mental health benefit for children and families; requiring a report; amending
Minnesota Statutes 2021 Supplement, section 256B.0943, subdivisions 1, 2, 4, 6,
7, 9; repealing Minnesota Statutes 2020, section 256B.0943, subdivision 8a.

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

Section 1.

Minnesota Statutes 2021 Supplement, section 256B.0943, subdivision 1, is
amended to read:

Subdivision 1.

Definitions.

For purposes of this section, the following terms have the
meanings given them.

new text begin (a) "Care consultation" means consultative activities and communications between
mental health care providers and primary care clinical care providers, families, school
support staff, and clients. Care consultation may include psychiatric consultation with
primary care practitioners and mental health clinical care consultation.
new text end

new text begin (b) "Care coordination" means the activities required to coordinate care across settings
and providers for the people served to ensure seamless transitions across the full spectrum
of health services. Care coordination includes documenting a plan of care for medical care,
behavioral health, and social services and supports in the integrated treatment plan, assisting
with obtaining appointments, confirming that clients attend appointments, developing a
crisis plan, tracking medication, and implementing care coordination agreements with
external providers. Care coordination may include psychiatric consultation with primary
care practitioners and mental health clinical care consultation.
new text end

deleted text begin (a) deleted text end new text begin (c) new text end "Children's therapeutic services and supports" means the flexible package of
mental health services for children who require varying therapeutic and rehabilitative levels
of intervention to treat a diagnosed emotional disturbance, as defined in section 245.4871,
subdivision 15, or a diagnosed mental illness, as defined in section 245.462, subdivision
20. The services are time-limited interventions that are delivered using various treatment
modalities and combinations of services designed to reach treatment outcomes identified
in the individual treatment plan.

deleted text begin (b) deleted text end new text begin (d) new text end "Clinical trainee" means a staff person who is qualified according to section
245I.04, subdivision 6.

deleted text begin (c) deleted text end new text begin (e) new text end "Crisis planning" has the meaning given in section 245.4871, subdivision 9a.

deleted text begin (d) deleted text end new text begin (f) new text end "Culturally competent provider" means a provider who understands and can utilize
to a client's benefit the client's culture when providing services to the client. A provider
may be culturally competent because the provider is of the same cultural or ethnic group
as the client or the provider has developed the knowledge and skills through training and
experience to provide services to culturally diverse clients.

deleted text begin (e) deleted text end new text begin (g) new text end "Day treatment program" for children means a site-based structured mental health
program consisting of psychotherapy for three or more individuals and individual or group
skills training provided by a team, under the treatment supervision of a mental health
professional.

deleted text begin (f) deleted text end new text begin (h) new text end "Standard diagnostic assessment" means the assessment described in 245I.10,
subdivision 6.

deleted text begin (g) deleted text end new text begin (i) new text end "Direct service time" means the time that a mental health professional, clinical
trainee, mental health practitioner, or mental health behavioral aide spends face-to-face with
a client and the client's family or providing covered services through telehealth as defined
under section 256B.0625, subdivision 3b. Direct service time includes time in which the
provider obtains a client's history, develops a client's treatment plan, records individual
treatment outcomes, or provides service components of children's therapeutic services and
supports. Direct service time does not include time doing work before and after providing
direct services, including scheduling or maintaining clinical records.

deleted text begin (h) deleted text end new text begin (j) new text end "Direction of mental health behavioral aide" means the activities of a mental
health professional, clinical trainee, or mental health practitioner in guiding the mental
health behavioral aide in providing services to a client. The direction of a mental health
behavioral aide must be based on the client's individual treatment plan and meet the
requirements in subdivision 6, paragraph (b), clause (7).

deleted text begin (i) deleted text end new text begin (k) new text end "Emotional disturbance" has the meaning given in section 245.4871, subdivision
15.

deleted text begin (j) "Individual behavioral plan" means a plan of intervention, treatment, and services
for a child written by a mental health professional or a clinical trainee or mental health
practitioner under the treatment supervision of a mental health professional, to guide the
work of the mental health behavioral aide. The individual behavioral plan may be
incorporated into the child's individual treatment plan so long as the behavioral plan is
separately communicable to the mental health behavioral aide.
deleted text end

deleted text begin (k) deleted text end new text begin (l) new text end "Individual treatment plan" means the plan described in section 245I.10,
subdivisions 7 and 8.

deleted text begin (l) deleted text end new text begin (m) new text end "Mental health behavioral aide services" means medically necessary one-on-one
activities performed by a mental health behavioral aide qualified according to section
245I.04, subdivision 16, to assist a child retain or generalize psychosocial skills as previously
trained by a mental health professional, clinical trainee, or mental health practitioner and
as described in the child's individual treatment plan and individual behavior plan. Activities
involve working directly with the child or child's family as provided in subdivision 9,
paragraph (b), clause (4).

deleted text begin (m) deleted text end new text begin (n) new text end "Mental health certified family peer specialist" means a staff person who is
qualified according to section 245I.04, subdivision 12.

deleted text begin (n) deleted text end new text begin (o) new text end "Mental health practitioner" means a staff person who is qualified according to
section 245I.04, subdivision 4.

deleted text begin (o) deleted text end new text begin (p) new text end "Mental health professional" means a staff person who is qualified according to
section 245I.04, subdivision 2.

deleted text begin (p) deleted text end new text begin (q) new text end "Mental health service plan development" includes:

deleted text begin (1) the development, review, and revision of a child's individual treatment plan, including
involvement of the client or client's parents, primary caregiver, or other person authorized
to consent to mental health services for the client, and including arrangement of treatment
and support activities specified in the individual treatment plan; and
deleted text end

new text begin (1) development and revision of a child's individual treatment plan, including care
consultation and care coordination services; and
new text end

(2) administering and reporting the standardized outcome measurements in section
245I.10, subdivision 6, paragraph (d), clauses (3) and (4), and other standardized outcome
measurements approved by the commissioner, as periodically needed to evaluate the
effectiveness of treatment.

deleted text begin (q) deleted text end new text begin (r) new text end "Mental illness," for persons at least age 18 but under age 21, has the meaning
given in section 245.462, subdivision 20, paragraph (a).

deleted text begin (r) deleted text end new text begin (s) new text end "Psychotherapy" means the treatment described in section 256B.0671, subdivision
11.

deleted text begin (s) deleted text end new text begin (t) new text end "Rehabilitative services" or "psychiatric rehabilitation services" means interventions
to: (1) restore a child or adolescent to an age-appropriate developmental trajectory that had
been disrupted by a psychiatric illness; or (2) enable the child to self-monitor, compensate
for, cope with, counteract, or replace psychosocial skills deficits or maladaptive skills
acquired over the course of a psychiatric illness. Psychiatric rehabilitation services for
children combine coordinated psychotherapy to address internal psychological, emotional,
and intellectual processing deficits, and skills training to restore personal and social
functioning. Psychiatric rehabilitation services establish a progressive series of goals with
each achievement building upon a prior achievement.

deleted text begin (t) deleted text end new text begin (u) new text end "Skills training" means individual, family, or group training, delivered by or under
the supervision of a mental health professional, designed to facilitate the acquisition of
psychosocial skills that are medically necessary to rehabilitate the child to an age-appropriate
developmental trajectory heretofore disrupted by a psychiatric illness or to enable the child
to self-monitor, compensate for, cope with, counteract, or replace skills deficits or
maladaptive skills acquired over the course of a psychiatric illness. Skills training is subject
to the service delivery requirements under subdivision 9, paragraph (b), clause (2).

deleted text begin (u) deleted text end new text begin (v) new text end "Treatment supervision" means the supervision described in section 245I.06.

new text begin EFFECTIVE DATE. new text end

new text begin This section is effective July 1, 2022, or upon federal approval,
whichever is later. The commissioner of human services shall notify the revisor of statutes
when federal approval is obtained.
new text end

Sec. 2.

Minnesota Statutes 2021 Supplement, section 256B.0943, subdivision 2, is amended
to read:

Subd. 2.

Covered service components of children's therapeutic services and
supports.

(a) Subject to federal approval, medical assistance covers medically necessary
children's therapeutic services and supports when the services are provided by an eligible
provider entity certified under and meeting the standards in this section. The provider entity
must make reasonable and good faith efforts to report individual client outcomes to the
commissioner, using instruments and protocols approved by the commissioner.

(b) The service components of children's therapeutic services and supports are:

(1) patient and/or family psychotherapy, family psychotherapy, psychotherapy for crisis,
and group psychotherapy;

(2) individual, family, or group skills training provided by a mental health professional,
clinical trainee, or mental health practitioner;

(3) crisis planning;

(4) mental health behavioral aide services;

(5) direction of a mental health behavioral aide;

(6) mental health service plan development; deleted text begin and
deleted text end

(7) children's day treatment deleted text begin . deleted text end new text begin ;
new text end

new text begin (8) care coordination;
new text end

new text begin (9) care consultation;
new text end

new text begin (10) travel to and from a client's location; and
new text end

new text begin (11) individual treatment plan development.
new text end

new text begin EFFECTIVE DATE. new text end

new text begin This section is effective July 1, 2022, or upon federal approval,
whichever is later. The commissioner of human services shall notify the revisor of statutes
when federal approval is obtained.
new text end

Sec. 3.

Minnesota Statutes 2021 Supplement, section 256B.0943, subdivision 4, is amended
to read:

Subd. 4.

Provider entity certification.

(a) The commissioner shall establish an initial
provider entity application and certification process and recertification process to determine
whether a provider entity has an administrative and clinical infrastructure that meets the
requirements in subdivisions 5 and 6. A provider entity must be certified for the three core
rehabilitation services of psychotherapy, skills training, and crisis planning. The
commissioner shall recertify a provider entity deleted text begin at least deleted text end every three years new text begin using the individual
provider's certification anniversary or the calendar year end, whichever is later. The
commissioner may approve a recertification extension, in the interest of sustaining services,
when a certain date for recertification is identified new text end . The commissioner shall establish a
process for decertification of a provider entity and shall require corrective action, medical
assistance repayment, or decertification of a provider entity that no longer meets the
requirements in this section or that fails to meet the clinical quality standards or administrative
standards provided by the commissioner in the application and certification process.

new text begin (b) The commissioner must provide the following to providers for the certification,
recertification, and decertification processes:
new text end

new text begin (1) a structured listing of required provider certification criteria;
new text end

new text begin (2) a formal written letter with a determination of certification, recertification, or
decertification, signed by the commissioner or the appropriate division director; and
new text end

new text begin (3) a formal written communication outlining the process for necessary corrective action
and follow-up by the commissioner, if applicable.
new text end

deleted text begin (b) deleted text end new text begin (c) new text end For purposes of this section, a provider entity must meet the standards in this
section and chapter 245I, as required under section 245I.011, subdivision 5, and be:

(1) an Indian health services facility or a facility owned and operated by a tribe or tribal
organization operating as a 638 facility under Public Law 93-638 certified by the state;

(2) a county-operated entity certified by the state; or

(3) a noncounty entity certified by the state.

new text begin EFFECTIVE DATE. new text end

new text begin This section is effective July 1, 2022, or upon federal approval,
whichever is later. The commissioner of human services shall notify the revisor of statutes
when federal approval is obtained.
new text end

Sec. 4.

Minnesota Statutes 2021 Supplement, section 256B.0943, subdivision 6, is amended
to read:

Subd. 6.

Provider entity clinical infrastructure requirements.

(a) To be an eligible
provider entity under this section, a provider entity must have a clinical infrastructure that
utilizes diagnostic assessment, individual treatment plans, service delivery, and individual
treatment plan review that are culturally competent, child-centered, and family-driven to
achieve maximum benefit for the client. The provider entity must review, and update as
necessary, the clinical policies and procedures every three years, must distribute the policies
and procedures to staff initially and upon each subsequent update, and must train staff
accordingly.

(b) The clinical infrastructure written policies and procedures must include policies and
procedures for meeting the requirements in this subdivision:

(1) providing or obtaining a client's standard diagnostic assessment, including a standard
diagnostic assessment. When required components of the standard diagnostic assessment
are not provided in an outside or independent assessment or cannot be attained immediately,
the provider entity must determine the missing information within 30 days and amend the
child's standard diagnostic assessment or incorporate the information into the child's
individual treatment plan;

(2) developing an individual treatment plan;

deleted text begin (3) developing an individual behavior plan that documents and describes interventions
to be provided by the mental health behavioral aide. The individual behavior plan must
include:
deleted text end

deleted text begin (i) detailed instructions on the psychosocial skills to be practiced;
deleted text end

deleted text begin (ii) time allocated to each intervention;
deleted text end

deleted text begin (iii) methods of documenting the child's behavior;
deleted text end

deleted text begin (iv) methods of monitoring the child's progress in reaching objectives; and
deleted text end

deleted text begin (v) goals to increase or decrease targeted behavior as identified in the individual treatment
plan;
deleted text end

deleted text begin (4) deleted text end new text begin (3) new text end providing treatment supervision plans for staff according to section 245I.06.
Treatment supervision does not include the authority to make or terminate court-ordered
placements of the child. A treatment supervisor must be available for urgent consultation
as required by the individual client's needs or the situation;

deleted text begin (5) meeting day treatment program conditions in items (i) and (ii):
deleted text end

deleted text begin (i) the treatment supervisor must be present and available on the premises more than 50
percent of the time in a provider's standard working week during which the supervisee is
providing a mental health service; and
deleted text end

deleted text begin (ii) every 30 days, the treatment supervisor must review and sign the record indicating
the supervisor has reviewed the client's care for all activities in the preceding 30-day period;
deleted text end

deleted text begin (6) meeting the treatment supervision standards in items (i) and (ii) for all other services
provided under CTSS:
deleted text end

deleted text begin (i) the mental health professional is required to be present at the site of service delivery
for observation as clinically appropriate when the clinical trainee, mental health practitioner,
or mental health behavioral aide is providing CTSS services; and
deleted text end

deleted text begin (ii) when conducted, the on-site presence of the mental health professional must be
documented in the child's record and signed by the mental health professional who accepts
full professional responsibility;
deleted text end

deleted text begin (7) providing direction to a mental health behavioral aide. For entities that employ mental
health behavioral aides, the treatment supervisor must be employed by the provider entity
or other provider certified to provide mental health behavioral aide services to ensure
necessary and appropriate oversight for the client's treatment and continuity of care. The
staff giving direction must begin with the goals on the individual treatment plan, and instruct
the mental health behavioral aide on how to implement therapeutic activities and interventions
that will lead to goal attainment. The staff giving direction must also instruct the mental
health behavioral aide about the client's diagnosis, functional status, and other characteristics
that are likely to affect service delivery. Direction must also include determining that the
mental health behavioral aide has the skills to interact with the client and the client's family
in ways that convey personal and cultural respect and that the aide actively solicits
information relevant to treatment from the family. The aide must be able to clearly explain
or demonstrate the activities the aide is doing with the client and the activities' relationship
to treatment goals. Direction is more didactic than is supervision and requires the staff
providing it to continuously evaluate the mental health behavioral aide's ability to carry out
the activities of the individual treatment plan and the individual behavior plan. When
providing direction, the staff must:
deleted text end

deleted text begin (i) review progress notes prepared by the mental health behavioral aide for accuracy and
consistency with diagnostic assessment, treatment plan, and behavior goals and the staff
must approve and sign the progress notes;
deleted text end

deleted text begin (ii) identify changes in treatment strategies, revise the individual behavior plan, and
communicate treatment instructions and methodologies as appropriate to ensure that treatment
is implemented correctly;
deleted text end

deleted text begin (iii) demonstrate family-friendly behaviors that support healthy collaboration among
the child, the child's family, and providers as treatment is planned and implemented;
deleted text end

deleted text begin (iv) ensure that the mental health behavioral aide is able to effectively communicate
with the child, the child's family, and the provider;
deleted text end

deleted text begin (v) record the results of any evaluation and corrective actions taken to modify the work
of the mental health behavioral aide; and
deleted text end

deleted text begin (vi) ensure deleted text end new text begin (4) ensuring new text end the immediate accessibility of a mental health professional,
clinical trainee, or mental health practitioner to the behavioral aide during service delivery;

deleted text begin (8) deleted text end new text begin (5) new text end providing service delivery that implements the individual treatment plan and
meets the requirements under subdivision 9; and

deleted text begin (9) deleted text end new text begin (6) new text end individual treatment plan review. The review must determine the extent to which
the services have met each of the goals and objectives in the treatment plan. The review
must assess the client's progress and ensure that services and treatment goals continue to
be necessary and appropriate to the client and the client's family or foster family.

new text begin EFFECTIVE DATE. new text end

new text begin This section is effective July 1, 2022, or upon federal approval,
whichever is later. The commissioner of human services shall notify the revisor of statutes
when federal approval is obtained.
new text end

Sec. 5.

Minnesota Statutes 2021 Supplement, section 256B.0943, subdivision 7, is amended
to read:

Subd. 7.

Qualifications of individual and team providers.

(a) An individual or team
provider working within the scope of the provider's practice or qualifications may provide
service components of children's therapeutic services and supports that are identified as
medically necessary in a client's individual treatment plan.

(b) An individual provider must be qualified as a:

(1) mental health professional;

(2) clinical trainee;

(3) mental health practitioner;

(4) mental health certified family peer specialist; or

(5) mental health behavioral aide.

(c) A day treatment team must include deleted text begin at least deleted text end one mental health professional or clinical
trainee deleted text begin and one mental health practitioner deleted text end .

new text begin EFFECTIVE DATE. new text end

new text begin This section is effective July 1, 2022, or upon federal approval,
whichever is later. The commissioner of human services shall notify the revisor of statutes
when federal approval is obtained.
new text end

Sec. 6.

Minnesota Statutes 2021 Supplement, section 256B.0943, subdivision 9, is amended
to read:

Subd. 9.

Service delivery criteria.

(a) In delivering services under this section, a certified
provider entity must ensure that:

(1) the provider's caseload size should reasonably enable the provider to play an active
role in service planning, monitoring, and delivering services to meet the client's and client's
family's needs, as specified in each client's individual treatment plan;

(2) site-based programs, including day treatment programs, provide staffing and facilities
to ensure the client's health, safety, and protection of rights, and that the programs are able
to implement each client's individual treatment plan; and

(3) a day treatment program is provided to a group of clients by a team under the treatment
supervision of a mental health professional. The day treatment program must be provided
in and by: (i) an outpatient hospital accredited by the Joint Commission on Accreditation
of Health Organizations and licensed under sections 144.50 to 144.55; (ii) a community
mental health center under section 245.62; or (iii) an entity that is certified under subdivision
4 to operate a program that meets the requirements of section 245.4884, subdivision 2, and
Minnesota Rules, parts 9505.0170 to 9505.0475. The day treatment program must stabilize
the client's mental health status while developing and improving the client's independent
living and socialization skills. The goal of the day treatment program must be to reduce or
relieve the effects of mental illness and provide training to enable the client to live in the
community. deleted text begin The program must be available year-round at least three to five days per week,
two or three hours per day, unless the normal five-day school week is shortened by a holiday,
weather-related cancellation, or other districtwide reduction in a school week. A child
transitioning into or out of day treatment must receive a minimum treatment of one day a
week for a two-hour time block. The two-hour time block must include at least one hour of
patient and/or family or group psychotherapy. deleted text end The remainder of the structured treatment
program may include patient and/or family or group psychotherapy, and individual or group
skills training, if included in the client's individual treatment plan. Day treatment programs
are not part of inpatient or residential treatment services. When a day treatment group that
meets the minimum group size requirement temporarily falls below the minimum group
size because of a member's temporary absence, medical assistance covers a group session
conducted for the group members in attendance. A day treatment program may provide
fewer than the minimally required hours for a particular child during a billing period in
which the child is transitioning into, or out of, the program.

(b) To be eligible for medical assistance payment, a provider entity must deliver the
service components of children's therapeutic services and supports in compliance with the
following requirements:

(1) psychotherapy to address the child's underlying mental health disorder must be
documented as part of the child's ongoing treatment. A provider must deliver deleted text begin , deleted text end or arrange
for deleted text begin , deleted text end medically necessary psychotherapy deleted text begin , deleted text end unless the child's parent or caregiver chooses not
to receive it new text begin or the provider determines that psychotherapy is no longer medically necessary.
When a provider determines that psychotherapy is no longer medically necessary, the
provider must update required documentation, including but not limited to the individual
treatment plan, the child's medical record, or other authorizations, to include the
determination new text end . deleted text begin When a provider delivering other services to a child under this section deems
it not medically necessary to provide psychotherapy to the child for a period of 90 days or
longer, the provider entity must document the medical reasons why psychotherapy is not
necessary. deleted text end When a provider determines that a child needs psychotherapy but psychotherapy
cannot be delivered due to a shortage of licensed mental health professionals in the child's
community, the provider must document the lack of access in the child's medical record;

(2) individual, family, or group skills training is subject to the following requirements:

(i) a mental health professional, clinical trainee, or mental health practitioner shall provide
skills training;

(ii) skills training delivered to a child or the child's family must be targeted to the specific
deficits or maladaptations of the child's mental health disorder and must be prescribed in
the child's individual treatment plan;

deleted text begin (iii) the mental health professional delivering or supervising the delivery of skills training
must document any underlying psychiatric condition and must document how skills training
is being used in conjunction with psychotherapy to address the underlying condition;
deleted text end

deleted text begin (iv) skills training delivered to the child's family must teach skills needed by parents to
enhance the child's skill development, to help the child utilize daily life skills taught by a
mental health professional, clinical trainee, or mental health practitioner, and to develop or
maintain a home environment that supports the child's progressive use of skills;
deleted text end

deleted text begin (v) deleted text end new text begin (iii) new text end group skills training may be provided to multiple recipients who, because of the
nature of their emotional, behavioral, or social dysfunction, can derive mutual benefit from
interaction in a group setting, which must be staffed as follows:

(A) one mental health professional, clinical trainee, or mental health practitioner must
work with a group of three to eight clients; or

(B) any combination of two mental health professionals, clinical trainees, or mental
health practitioners must work with a group of nine to 12 clients;

deleted text begin (vi) deleted text end new text begin (iv) new text end a mental health professional, clinical trainee, or mental health practitioner must
have taught the psychosocial skill before a mental health behavioral aide may practice that
skill with the client; and

deleted text begin (vii) deleted text end new text begin (v) new text end for group skills training, when a skills group that meets the minimum group
size requirement temporarily falls below the minimum group size because of a group
member's temporary absence, the provider may conduct the session for the group members
in attendance;

(3) crisis planning to a child and family must include development of a written plan that
anticipates the particular factors specific to the child that may precipitate a psychiatric crisis
for the child in the near future. The written plan must document actions that the family
should be prepared to take to resolve or stabilize a crisis, such as advance arrangements for
direct intervention and support services to the child and the child's family. Crisis planning
must include preparing resources designed to address abrupt or substantial changes in the
functioning of the child or the child's family when sudden change in behavior or a loss of
usual coping mechanisms is observed, or the child begins to present a danger to self or
others;

(4) mental health behavioral aide services must be medically necessary treatment services,
identified in the child's individual treatment plan deleted text begin and individual behavior plan deleted text end deleted text begin , and which
are designed to improve the functioning of the child in the progressive use of developmentally
appropriate psychosocial skills. Activities involve working directly with the child, child-peer
groupings, or child-family groupings to practice, repeat, reintroduce, and master the skills
defined in subdivision 1, paragraph (t), as previously taught by a mental health professional,
clinical trainee, or mental health practitioner including: deleted text end new text begin .
new text end

deleted text begin (i) providing cues or prompts in skill-building peer-to-peer or parent-child interactions
so that the child progressively recognizes and responds to the cues independently;
deleted text end

deleted text begin (ii) performing as a practice partner or role-play partner;
deleted text end

deleted text begin (iii) reinforcing the child's accomplishments;
deleted text end

deleted text begin (iv) generalizing skill-building activities in the child's multiple natural settings;
deleted text end

deleted text begin (v) assigning further practice activities; and
deleted text end

deleted text begin (vi) intervening as necessary to redirect the child's target behavior and to de-escalate
behavior that puts the child or other person at risk of injury.
deleted text end

To be eligible for medical assistance payment, mental health behavioral aide services must
be delivered to a child who has been diagnosed with an emotional disturbance or a mental
illness, as provided in subdivision 1, paragraph deleted text begin (a) deleted text end new text begin (c) new text end . deleted text begin The mental health behavioral aide
must implement treatment strategies in the individual treatment plan and the individual
behavior plan as developed by the mental health professional, clinical trainee, or mental
health practitioner providing direction for the mental health behavioral aide. deleted text end The mental
health behavioral aide must document the delivery of services in written progress notes.
Progress notes must reflect implementation of the treatment strategies, as performed by the
mental health behavioral aide and the child's responses to the treatment strategies; and

(5) mental health service plan development must be performed in consultation with the
child's family and, when appropriate, with other key participants in the child's life by the
child's treating mental health professional or clinical trainee or by a mental health practitioner
and approved by the treating mental health professional. Treatment plan drafting consists
of development, review, and revision by face-to-face or electronic communication. The
provider must document events, including the time spent with the family and other key
participants in the child's life to approve the individual treatment plan. Medical assistance
covers service plan development before completion of the child's individual treatment plan.
Service plan development is covered only if a treatment plan is completed for the child. If
upon review it is determined that a treatment plan was not completed for the child, the
commissioner shall recover the payment for the service plan development.

new text begin EFFECTIVE DATE. new text end

new text begin This section is effective July 1, 2022, or upon federal approval,
whichever is later. The commissioner of human services shall notify the revisor of statutes
when federal approval is obtained.
new text end

Sec. 7. new text begin DIRECTION TO COMMISSIONER; DEVELOPMENT OF NEW
MEDICAID-ELIGIBLE MENTAL HEALTH BENEFIT FOR CHILDREN AND
FAMILIES.
new text end

new text begin (a) The commissioner of human services, in consultation with providers, families,
educators, and advocates, shall develop a new benefit reimbursable under medical assistance
to provide mental health care for children. The benefit must:
new text end

new text begin (1) consist of services that contribute to effective treatment within an individual client's
service plan;
new text end

new text begin (2) provide for simplicity of service design and administration;
new text end

new text begin (3) support participation by all payors; and
new text end

new text begin (4) include services that support children and families with:
new text end

new text begin (i) psychotherapy;
new text end

new text begin (ii) skill building;
new text end

new text begin (iii) related services individualized to meet child and family needs; and
new text end

new text begin (iv) care coordination between community providers and schools.
new text end

new text begin (b) The benefit must use a single assessment to access care from all eligible mental
health, school-based, and related service providers. The benefit must be family-driven in
treatment planning and service provision.
new text end

new text begin (c) Eligible services must not be denied based on service location or service entity.
new text end

new text begin (d) No later than February 1, 2023, the commissioner, in consultation with stakeholders,
schools, and providers, shall report to the legislative committees and divisions with
jurisdiction over human services policy and finance with a timeline for developing the fiscal
and service analysis in order to submit a state plan amendment to the Centers for Medicare
and Medicaid Services to receive a federal Medicaid match for the new mental health benefit
under this section.
new text end

Sec. 8. new text begin REPEALER.
new text end

new text begin Minnesota Statutes 2020, section 256B.0943, subdivision 8a, new text end new text begin is repealed.
new text end

new text begin EFFECTIVE DATE. new text end

new text begin This section is effective July 1, 2022, or upon federal approval,
whichever is later. The commissioner of human services shall notify the revisor of statutes
when federal approval is obtained.
new text end

APPENDIX

Repealed Minnesota Statutes: DIVH3738-1

256B.0943 CHILDREN'S THERAPEUTIC SERVICES AND SUPPORTS.

Subd. 8a.

Level II mental health behavioral aide.

The commissioner of human services, in collaboration with children's mental health providers and the Board of Trustees of the Minnesota State Colleges and Universities, shall develop a certificate program for level II mental health behavioral aides.