1999 Minnesota Statutes

     256B.0945 Residential services for children with severe 
  emotional disturbance. 

    Subdivision 1.    Provider qualifications.  Counties 
 must arrange to provide residential services for children with 
 severe emotional disturbance according to section 245.4882 and 
 this section.  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. 
 Facilities providing services under subdivision 2, paragraph 
 (a), must be accredited as a psychiatric facility by the Joint 
 Commission on Accreditation of Healthcare Organizations, the 
 Commission on Accreditation of Rehabilitation Facilities, or the 
 Council on Accreditation.  Accreditation is not required for 
 facilities providing services under subdivision 2, paragraph (b).

    Subd. 2.    Covered services.  All services must be 
 included in a child's individualized treatment or collaborative 
 family service plan as defined in chapter 245.  

    (a) For facilities that are institutions for mental 
 diseases according to statute and regulation or are not 
 institutions for mental diseases but choose to provide services 
 under this paragraph, medical assistance covers the full 
 contract rate, including room and board if the services meet the 
 requirements of Code of Federal Regulations, title 42, section 
 440.160.  

    (b) For facilities that are not institutions for mental 
 diseases according to federal statute and regulation and are not 
 providing services under paragraph (a), medical assistance 
 covers mental health related services that are required to be 
 provided by a residential facility under section 245.4882 and 
 administrative rules promulgated thereunder, except for room and 
 board. 

    Subd. 3.    Centralized disbursement of medical assistance 
 payments.  Notwithstanding section 256B.041, county payments 
 for the cost of residential services provided under this section 
 shall not be made to the state treasurer. 

    Subd. 4.    Payment rates.  (a) Notwithstanding sections 
 256.025, subdivision 2; 256B.19; and 256B.041, payments to 
 counties for residential services provided by a residential 
 facility shall only be made of federal earnings for services 
 provided under this section, and the nonfederal share of costs 
 for services provided under this section shall be paid by the 
 county from sources other than federal funds or funds used to 
 match other federal funds.  Total annual payments for federal 
 earnings shall not exceed the federal medical assistance 
 percentage matching rate multiplied by the total county 
 expenditures for services provided under section 245.4882 for 
 either (1) the calendar year 1999 or (2) the average annual 
 expenditures for the calendar years 1995 to 1999, whichever is 
 greater.  Payment to counties for services provided according to 
 subdivision 2, paragraph (a), shall be the federal share of the 
 contract rate.  Payment to counties for services provided 
 according to subdivision 2, paragraph (b), shall be a proportion 
 of the per day contract rate that relates to rehabilitative 
 mental health services and shall not include payment for costs 
 or services that are billed to the IV-E program as room and 
 board.  

    (b) Annual earnings that exceed a county's limit as 
 established under paragraph (a) shall be retained by the 
 commissioner and managed as grants for community-based 
 children's mental health services under section 245.4886.  The 
 commissioner may target these grant funds as necessary to reduce 
 reliance on residential treatment of children with severe 
 emotional disturbance. 

    (c) The commissioner shall set aside a portion of the 
 federal funds earned under this section to cover the state costs 
 of two staff positions and support costs necessary in 
 administering this section.  Any unexpended funds from the 
 set-aside shall be distributed to the counties in proportion to 
 their earnings under this section. 

    Subd. 5.    Quality measures.  Counties must collect and 
 report to the commissioner information on outcomes for services 
 provided under this section using standardized tools that 
 measure functioning, living stability, and parent and child 
 satisfaction consistent with the goals of sections 245.4876, 
 subdivision 1, and 256F.01.  The commissioner shall designate 
 standardized tools to be used and shall collect and analyze 
 individualized outcome data on a statewide basis and report to 
 the legislature by December 1, 2003.  The commissioner shall 
 provide standardized tools that measure child and adolescent 
 functional assessment for intake and discharge, child behavior, 
 residential living environment and placement stability, and 
 satisfaction for youth and family members. 

    Subd. 6.    Federal earnings.  Use of new federal 
 funding earned from services provided under this section is 
 limited to:  

    (1) increasing prevention and early intervention and 
 supportive services to meet the mental health and child welfare 
 needs of the children and families in the system of care; 

    (2) replacing reductions in federal IV-E reimbursement 
 resulting from new medical assistance coverage; and 

    (3) paying the nonfederal share of additional provider 
 costs due to accreditation and new program standards necessary 
 for Medicaid reimbursement.  

 For purposes of this section, early intervention and supportive 
 services include alternative responses to child maltreatment 
 reports under chapter 626 and services outlined in sections 
 245.4875, subdivision 2, children's mental health, and 256F.05, 
 subdivision 8, family preservation services.  

    Subd. 7.    Maintenance of effort.  (a) Counties that 
 receive payment under this section must maintain a level of 
 expenditures such that each year's county expenditures for early 
 intervention and supportive services is at least equal to that 
 county's average expenditures for those services for calendar 
 years 1998 and 1999.  For purposes of this section, "county 
 expenditures" are the total expenditures for those services 
 minus the state and federal revenues specifically designated for 
 these services. 

    (b) The commissioner may waive the requirements in 
 paragraph (a) if any of the conditions specified in section 
 256F.13, subdivision 1, paragraph (a), clause (4), items (i) to 
 (iv), are met.  

    Subd. 8.    Reports.  The commissioner shall review 
 county expenditures annually using reports required under 
 sections 245.482; 256.01, subdivision 2, clause (17); and 
 256E.08, subdivision 8, to ensure that counties meet their 
 obligation under subdivision 7, and that the base level of 
 expenditures for mental health and child welfare early 
 intervention and family support services and children's mental 
 health residential treatment is continued from sources other 
 than federal funds earned under this section. 

    Subd. 9.    Sanctions.  The commissioner may suspend, 
 reduce, or terminate the federal reimbursement to a county that 
 does not meet one or all of the requirements of this section. 

    Subd. 10.    Recommendations.  The commissioner shall 
 provide recommendations to the legislature by January 15, 2000, 
 regarding any amendments to this section that may be necessary 
 or advisable prior to implementation. 

    HIST: 1999 c 245 art 8 s 9 

*   NOTE: This section, as added by Laws 1999, chapter 245, 
*article 8, section 9, is effective July 1, 2000.  Laws 1999, 
*chapter 245, article 8, section 87.