HF 944

1st Division Engrossment - 92nd Legislature (2021 - 2022) Posted on 03/01/2021 12:43pm

A bill for an act
relating to human services; modifying residential treatment and children's mental
health provisions; amending Minnesota Statutes 2020, sections 245.4871,
subdivision 32; 245.4874, subdivision 1; 245.4882, subdivision 1; 256B.0945,
subdivision 1, by adding subdivisions.

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

Section 1.

Minnesota Statutes 2020, section 245.4871, subdivision 32, is amended to read:

Subd. 32.

Residential treatment.

"Residential treatment" means a 24-hour-a-day program
under the clinical supervision of a mental health professional, in a community residential
setting other than an acute care hospital or regional treatment center inpatient unit, that must
be licensed as a residential treatment program for children with emotional disturbances
under Minnesota Rules, parts 2960.0580 to 2960.0700, or other rules adopted by the
commissioner new text begin or as a psychiatric residential treatment program under section 256B.0941 new text end .

Sec. 2.

Minnesota Statutes 2020, section 245.4874, subdivision 1, is amended to read:

Subdivision 1.

Duties of county board.

(a) The county board must:

(1) develop a system of affordable and locally available children's mental health services
according to sections 245.487 to 245.4889;

(2) consider the assessment of unmet needs in the county as reported by the local
children's mental health advisory council under section 245.4875, subdivision 5, paragraph
(b), clause (3). The county shall provide, upon request of the local children's mental health
advisory council, readily available data to assist in the determination of unmet needs;

(3) assure that parents and providers in the county receive information about how to
gain access to services provided according to sections 245.487 to 245.4889;

(4) coordinate the delivery of children's mental health services with services provided
by social services, education, corrections, health, and vocational agencies to improve the
availability of mental health services to children and the cost-effectiveness of their delivery;

(5) assure that mental health services delivered according to sections 245.487 to 245.4889
are delivered expeditiously and are appropriate to the child's diagnostic assessment and
individual treatment plan;

(6) provide for case management services to each child with severe emotional disturbance
according to sections 245.486; 245.4871, subdivisions 3 and 4; and 245.4881, subdivisions
1, 3, and 5;

(7) provide for screening of each child under section 245.4885 upon admission to a
residential treatment facility, deleted text begin acute care hospital inpatient treatment, or informal admission
deleted text end deleted text begin to a regional treatment center; deleted text end new text begin except for a child who is directly referred to residential
services under section 256B.0945, subdivision 1a;
new text end

(8) prudently administer grants and purchase-of-service contracts that the county board
determines are necessary to fulfill its responsibilities under sections 245.487 to 245.4889;

(9) assure that mental health professionals, mental health practitioners, and case managers
employed by or under contract to the county to provide mental health services are qualified
under section 245.4871;

(10) assure that children's mental health services are coordinated with adult mental health
services specified in sections 245.461 to 245.486 so that a continuum of mental health
services is available to serve persons with mental illness, regardless of the person's age;

(11) assure that culturally competent mental health consultants are used as necessary to
assist the county board in assessing and providing appropriate treatment for children of
cultural or racial minority heritage; and

(12) consistent with section 245.486, arrange for or provide a children's mental health
screening for:

(i) a child receiving child protective services;

(ii) a child in out-of-home placement;

(iii) a child for whom parental rights have been terminated;

(iv) a child found to be delinquent; or

(v) a child found to have committed a juvenile petty offense for the third or subsequent
time.

A children's mental health screening is not required when a screening or diagnostic
assessment has been performed within the previous 180 days, or the child is currently under
the care of a mental health professional.

(b) When a child is receiving protective services or is in out-of-home placement, the
court or county agency must notify a parent or guardian whose parental rights have not been
terminated of the potential mental health screening and the option to prevent the screening
by notifying the court or county agency in writing.

(c) When a child is found to be delinquent or a child is found to have committed a
juvenile petty offense for the third or subsequent time, the court or county agency must
obtain written informed consent from the parent or legal guardian before a screening is
conducted unless the court, notwithstanding the parent's failure to consent, determines that
the screening is in the child's best interest.

(d) The screening shall be conducted with a screening instrument approved by the
commissioner of human services according to criteria that are updated and issued annually
to ensure that approved screening instruments are valid and useful for child welfare and
juvenile justice populations. Screenings shall be conducted by a mental health practitioner
as defined in section 245.4871, subdivision 26, or a probation officer or local social services
agency staff person who is trained in the use of the screening instrument. Training in the
use of the instrument shall include:

(1) training in the administration of the instrument;

(2) the interpretation of its validity given the child's current circumstances;

(3) the state and federal data practices laws and confidentiality standards;

(4) the parental consent requirement; and

(5) providing respect for families and cultural values.

If the screen indicates a need for assessment, the child's family, or if the family lacks
mental health insurance, the local social services agency, in consultation with the child's
family, shall have conducted a diagnostic assessment, including a functional assessment.
The administration of the screening shall safeguard the privacy of children receiving the
screening and their families and shall comply with the Minnesota Government Data Practices
Act, chapter 13, and the federal Health Insurance Portability and Accountability Act of
1996, Public Law 104-191. Screening results shall be considered private data and the
commissioner shall not collect individual screening results.

(e) When the county board refers clients to providers of children's therapeutic services
and supports under section 256B.0943, the county board must clearly identify the desired
services components not covered under section 256B.0943 and identify the reimbursement
source for those requested services, the method of payment, and the payment rate to the
provider.

Sec. 3.

Minnesota Statutes 2020, section 245.4882, subdivision 1, is amended to read:

Subdivision 1.

Availability of residential treatment services.

County boards must
provide or contract for enough residential treatment services to meet the needs of each child
with severe emotional disturbance residing in the county and needing this level of care.
Length of stay is based on the child's residential treatment need and shall be subject to the
six-month review process established in section 260C.203, and for children in voluntary
placement for treatment, the court review process in section 260D.06 new text begin , except for a child
who is directly referred to residential services under section 256B.0945, subdivision 1a new text end .
Services must be appropriate to the child's age and treatment needs and must be made
available as close to the county as possible. Residential treatment must be designed to:

(1) help the child improve family living and social interaction skills;

(2) help the child gain the necessary skills to return to the community;

(3) stabilize crisis admissions; and

(4) work with families throughout the placement to improve the ability of the families
to care for children with severe emotional disturbance in the home.

Sec. 4.

Minnesota Statutes 2020, section 256B.0945, subdivision 1, is amended to read:

Subdivision 1.

Residential services; provider qualifications.

(a) Counties must arrange
to provide residential services for children with severe emotional disturbance according to
sections 245.4882, 245.4885, and this section.

(b) Services must be provided by a facility that is licensed according to section 245.4882
and administrative rules promulgated thereunder, and under contract with the county.

(c) Eligible service costs may be claimed for a facility that is located in a state that
borders Minnesota if:

(1) the facility is the closest facility to the child's home, providing the appropriate level
of care; and

(2) the commissioner of human services has completed an inspection of the out-of-state
program according to the interagency agreement with the commissioner of corrections under
section 260B.198, subdivision 11, paragraph (b), and the program has been certified by the
commissioner of corrections under section 260B.198, subdivision 11, paragraph (a), to
substantially meet the standards applicable to children's residential mental health treatment
programs under Minnesota Rules, chapter 2960. Nothing in this section requires the
commissioner of human services to enforce the background study requirements under chapter
245C or the requirements related to prevention and investigation of alleged maltreatment
under section 626.557 or chapter 260E. Complaints received by the commissioner of human
services must be referred to the out-of-state licensing authority for possible follow-up.

(d) Notwithstanding paragraph (b), eligible service costs may be claimed for an
out-of-state inpatient treatment facility if:

(1) the facility specializes in providing mental health services to children who are deaf,
deafblind, or hard-of-hearing and who use American Sign Language as their first language;

(2) the facility is licensed by the state in which it is located; and

(3) the state in which the facility is located is a member state of the Interstate Compact
on Mental Health.

new text begin (e) While a child is in residential treatment, the child's custodial parent or legal custodian
retains legal custody of the child and retains decision-making authority for the child except
that the commissioner of human services or a managed care organization retains authority
to make determinations related to the medical necessity and clinical appropriateness of a
placement.
new text end

Sec. 5.

Minnesota Statutes 2020, section 256B.0945, is amended by adding a subdivision
to read:

new text begin Subd. 1a. new text end

new text begin Residential services; direct referral. new text end

new text begin (a) Notwithstanding subdivision 1,
paragraph (a), a child is eligible for residential services under this chapter without a referral
from the county if the child meets the following criteria:
new text end

new text begin (1) the child has a mental health diagnosis as defined in the most recent edition of the
Diagnostic and Statistical Manual for Mental Disorders;
new text end

new text begin (2) before admission, services are determined to be medically necessary for the child
based on a review of the child's diagnostic and functional assessment; and
new text end

new text begin (3) the child was referred to residential treatment by a qualified mental health professional
as defined in section 245.4871, subdivision 27, clauses (1) to (6).
new text end

new text begin (b) The commissioner of human services shall provide oversight by reviewing the use
of referrals for clients admitted to residential treatment under paragraph (a) to ensure that
eligibility criteria, clinical services, and treatment planning reflect clinical, state, and federal
standards for residential treatment level of care.
new text end

new text begin (c) A residential treatment facility must notify the county where the child and family
reside within ten days after the date that a child was first admitted to the facility in order to
facilitate the child's transition to less restrictive community-based services.
new text end

new text begin EFFECTIVE DATE. new text end

new text begin This section is effective January 1, 2022.
new text end

Sec. 6.

Minnesota Statutes 2020, section 256B.0945, is amended by adding a subdivision
to read:

new text begin Subd. 4a. new text end

new text begin Payment rates; direct referral. new text end

new text begin Notwithstanding subdivision 4 and section
256B.19, when children enrolled in medical assistance are provided services under
subdivision 1a:
new text end

new text begin (1) the commissioner shall directly pay the provider for services paid for on a
fee-for-service basis; and
new text end

new text begin (2) there is no county share.
new text end

new text begin EFFECTIVE DATE. new text end

new text begin This section is effective January 1, 2022.
new text end