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HF 2415

as introduced - 91st Legislature (2019 - 2020) Posted on 03/27/2019 01:30pm

KEY: stricken = removed, old language.
underscored = added, new language.

Current Version - as introduced

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A bill for an act
relating to human services; modifying medical assistance coverage for community
health workers; modifying medical assistance reimbursement rates for doula
services; establishing permanent grant program for integrated care for high-risk
pregnancies; requiring reports; appropriating money; amending Minnesota Statutes
2018, sections 256B.0625, subdivision 49; 256B.79, subdivisions 2, 3, 4, 5, 6;
proposing coding for new law in Minnesota Statutes, chapter 256B; repealing
Minnesota Statutes 2018, section 256B.79, subdivision 7.

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

Section 1.

Minnesota Statutes 2018, section 256B.0625, subdivision 49, is amended to
read:


Subd. 49.

Community health worker.

(a) Medical assistance covers the care
coordination and patient education services provided by a community health worker if the
community health worker has:

(1) received a certificate from the Minnesota State Colleges and Universities System
approved community health worker curriculum; deleted text begin or
deleted text end

(2) at least five years of supervised experience with an enrolled physician, registered
nurse, advanced practice registered nurse, mental health professional as defined in section
245.462, subdivision 18, clauses (1) to (6), and section 245.4871, subdivision 27, clauses
(1) to (5), or dentist, or at least five years of supervised experience by a certified public
health nurse operating under the direct authority of an enrolled unit of governmentdeleted text begin .deleted text end new text begin ; or
new text end

new text begin (3) for a community health worker affiliated with an integrated perinatal care
collaborative, a high school diploma and at least one year of supervised experience with an
enrolled physician, registered nurse, advanced practice registered nurse, public health nurse,
or mental health professional as defined in sections 245.462, subdivision 18, clauses (1) to
(6), and 245.4871, subdivision 27, clauses (1) to (5).
new text end

deleted text begin Community health workers eligible for payment under clause (2) must complete the
certification program by January 1, 2010, to continue to be eligible for payment.
deleted text end

(b) Community health workers must work under the supervision of a medical assistance
enrolled physician, registered nurse, advanced practice registered nurse, mental health
professional as defined in section 245.462, subdivision 18, clauses (1) to (6), and section
245.4871, subdivision 27, clauses (1) to (5), or dentist, or work under the supervision of a
certified public health nurse operating under the direct authority of an enrolled unit of
government.

(c) Care coordination and patient education services covered under this subdivision
include, but are not limited to, services relating to oral health and dental care.

Sec. 2.

new text begin [256B.758] REIMBURSEMENT FOR DOULA SERVICES.
new text end

new text begin Effective for services provided on or after July 1, 2019, payments for doula services
provided by a certified doula shall be $47 per prenatal or postpartum visit, up to a total of
six visits, and $488 for attending and providing doula services at a birth.
new text end

Sec. 3.

Minnesota Statutes 2018, section 256B.79, subdivision 2, is amended to read:


Subd. 2.

deleted text begin Pilotdeleted text end new text begin Grantnew text end program established.

The commissioner shall implement a deleted text begin pilotdeleted text end new text begin
grant
new text end program to improve birth outcomes and strengthen early parental resilience for pregnant
women who are medical assistance enrollees, are at significantly elevated risk for adverse
outcomes of pregnancy, and are in targeted populations. The program must promote the
provision of integrated care and enhanced services to these pregnant women, including
postpartum coordination to ensure ongoing continuity of care, by qualified integrated
perinatal care collaboratives.

Sec. 4.

Minnesota Statutes 2018, section 256B.79, subdivision 3, is amended to read:


Subd. 3.

Grant awards.

The commissioner shall award grants to qualifying applicants
to support interdisciplinary, integrated perinatal care. deleted text begin Grants must be awarded beginning
July 1, 2016.
deleted text end Grant funds must be distributed through a request for proposals process to a
designated lead agency within an entity that has been determined to be a qualified integrated
perinatal care collaborative or within an entity in the process of meeting the qualifications
to become a qualified integrated perinatal care collaborativenew text begin , and priority shall be given to
qualified integrated perinatal care collaboratives that received grants under this section prior
to January 1, 2019
new text end . Grant awards must be used to support interdisciplinary, team-based
needs assessments, planning, and implementation of integrated care and enhanced services
for targeted populations. In determining grant award amounts, the commissioner shall
consider the identified health and social risks linked to adverse outcomes and attributed to
enrollees within the identified targeted population.

Sec. 5.

Minnesota Statutes 2018, section 256B.79, subdivision 4, is amended to read:


Subd. 4.

Eligibility for grants.

To be eligible for a grant under this section, an entity
must deleted text begin show that the entity meets or is in the process of meetingdeleted text end new text begin meet new text end qualifications established
by the commissioner to be a qualified integrated perinatal care collaborative. These
qualifications must include evidence that the entity has deleted text begin or is in the process of developingdeleted text end
policies, services, and partnerships to support interdisciplinary, integrated care. The policies,
services, and partnerships must meet specific criteria and be approved by the commissioner.
The commissioner shall deleted text begin establish a process todeleted text end review the collaborative's capacity for
interdisciplinary, integrated care, to be reviewed at the commissioner's discretion. In
determining whether the entity meets the qualifications for a qualified integrated perinatal
care collaborative, the commissioner shall verify and review whether the entity's policies,
services, and partnerships:

(1) optimize early identification of drug and alcohol dependency and abuse during
pregnancy, effectively coordinate referrals and follow-up of identified patients to
evidence-based or evidence-informed treatment, and integrate perinatal care services with
behavioral health and substance abuse services;

(2) enhance access to, and effective use of, needed health care or tribal health care
services, public health or tribal public health services, social services, mental health services,
chemical dependency services, or services provided by community-based providers by
bridging cultural gaps within systems of care and by integrating community-based
paraprofessionals such as doulas and community health workers as routinely available
service components;

(3) encourage patient education about prenatal care, birthing, and postpartum care, and
document how patient education is provided. Patient education may include information
on nutrition, reproductive life planning, breastfeeding, and parenting;

(4) integrate child welfare case planning with substance abuse treatment planning and
monitoring, as appropriate;

(5) effectively systematize screening, collaborative care planning, referrals, and follow
up for behavioral and social risks known to be associated with adverse outcomes and known
to be prevalent within the targeted populations;

(6) facilitate ongoing continuity of care to include postpartum coordination and referrals
for interconception care, continued treatment for substance abuse, identification and referrals
for maternal depression and other chronic mental health conditions, continued medication
management for chronic diseases, and appropriate referrals to tribal or county-based social
services agencies and tribal or county-based public health nursing services; and

(7) implement ongoing quality improvement activities as determined by the commissioner,
including collection and use of data from qualified providers on metrics of quality such as
health outcomes and processes of care, and the use of other data that has been collected by
the commissioner.

Sec. 6.

Minnesota Statutes 2018, section 256B.79, subdivision 5, is amended to read:


Subd. 5.

Gaps in communication, support, and care.

A collaborative receiving a grant
under this section must deleted text begin develop means of identifying and reportingdeleted text end new text begin identify and report new text end gaps
in the collaborative's communication, administrative support, and direct carenew text begin , if any,new text end that
must be remedied for the collaborative to new text begin continue to new text end effectively provide integrated care
and enhanced services to targeted populations.

Sec. 7.

Minnesota Statutes 2018, section 256B.79, subdivision 6, is amended to read:


Subd. 6.

Report.

By January 31, deleted text begin 2019deleted text end new text begin 2021, and every two years thereafternew text end , the
commissioner shall report to the chairs and ranking minority members of the legislative
committees with jurisdiction over health and human services policy and finance on the
status and deleted text begin progressdeleted text end new text begin outcomesnew text end of the deleted text begin pilotdeleted text end new text begin grantnew text end program. The report must:

(1) describe the capacity of collaboratives receiving grants under this section;

(2) contain aggregate information about enrollees served within targeted populations;

(3) describe the utilization of enhanced prenatal services;

(4) for enrollees identified with maternal substance use disorders, describe the utilization
of substance use treatment and dispositions of any child protection cases;new text begin and
new text end

(5) contain data on outcomes within targeted populations and compare these outcomes
to outcomes statewide, using standard categories of race and ethnicitydeleted text begin ; anddeleted text end new text begin .
new text end

deleted text begin (6) include recommendations for continuing the program or sustaining improvements
through other means beyond June 30, 2019.
deleted text end

Sec. 8. new text begin APPROPRIATION; INTEGRATED CARE FOR HIGH-RISK PREGNANT
WOMEN.
new text end

new text begin $....... in fiscal year 2020 and $....... in fiscal year 2021 are appropriated from the general
fund to the commissioner of human services for the integrated care for high-risk pregnant
women grant program under Minnesota Statutes, section 256B.79.
new text end

Sec. 9. new text begin REPEALER.
new text end

new text begin Minnesota Statutes 2018, section 256B.79, subdivision 7, 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 the day following final enactment.
new text end

APPENDIX

Repealed Minnesota Statutes: 19-4606

256B.79 INTEGRATED CARE FOR HIGH-RISK PREGNANT WOMEN.

Subd. 7.

Expiration.

This section expires June 30, 2019.