1.1                          A bill for an act 
  1.2             relating to human services; adding to definition of 
  1.3             base level funding; adding provisions for local 
  1.4             children's mental health collaborative; changing 
  1.5             provisions for integrated fund task force; requiring 
  1.6             approval for a collaborative's integrated service 
  1.7             system; amending Minnesota Statutes 1994, sections 
  1.8             245.492, subdivisions 2, 6, 9, and 23; 245.493, 
  1.9             subdivision 2; 245.4932, subdivisions 1, 2, 3, and 4; 
  1.10            245.494, subdivisions 1 and 3; 245.495; 245.496, 
  1.11            subdivision 3, and by adding a subdivision; and 
  1.12            256B.0625, subdivision 37; proposing coding for new 
  1.13            law in Minnesota Statutes, chapter 245. 
  1.14  BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF MINNESOTA: 
  1.15     Section 1.  Minnesota Statutes 1994, section 245.492, 
  1.16  subdivision 2, is amended to read: 
  1.17     Subd. 2.  [BASE LEVEL FUNDING.] "Base level funding" means 
  1.18  funding received from state, federal, or local sources and 
  1.19  expended across the local system of care in fiscal year 1993 
  1.20  1995 for children's mental health services or, for special 
  1.21  education services, and for other services for children with 
  1.22  emotional or behavioral disturbances and their families. 
  1.23  In subsequent years, base level funding may be adjusted to 
  1.24  reflect decreases in the numbers of children in the target 
  1.25  population. 
  1.26     Sec. 2.  Minnesota Statutes 1994, section 245.492, 
  1.27  subdivision 6, is amended to read: 
  1.28     Subd. 6.  [INITIAL OPERATIONAL TARGET POPULATION.] "Initial 
  1.29  Operational target population" means a population of children 
  2.1   that the local children's mental health collaborative agrees to 
  2.2   serve in the start-up phase and who meet fall within the 
  2.3   criteria for the target population.  The initial operational 
  2.4   target population may be less than the target population. 
  2.5      Sec. 3.  Minnesota Statutes 1994, section 245.492, 
  2.6   subdivision 9, is amended to read: 
  2.7      Subd. 9.  [INTEGRATED SERVICE SYSTEM.] "Integrated service 
  2.8   system" means a coordinated set of procedures established by the 
  2.9   local children's mental health collaborative for coordinating 
  2.10  services and actions across categorical systems and agencies 
  2.11  that results in: 
  2.12     (1) integrated funding; 
  2.13     (2) improved outreach, early identification, and 
  2.14  intervention across systems; 
  2.15     (3) strong collaboration between parents and professionals 
  2.16  in identifying children in the target population facilitating 
  2.17  access to the integrated system, and coordinating care and 
  2.18  services for these children; 
  2.19     (4) a coordinated assessment process across systems that 
  2.20  determines which children need multiagency care coordination and 
  2.21  wraparound services; 
  2.22     (5) multiagency plan of care; and 
  2.23     (6) wraparound individualized rehabilitation services. 
  2.24  Services provided by the integrated service system must meet the 
  2.25  requirements set out in sections 245.487 to 245.4887.  Children 
  2.26  served by the integrated service system must be economically and 
  2.27  culturally representative of children in the service delivery 
  2.28  area. 
  2.29     Sec. 4.  Minnesota Statutes 1994, section 245.492, 
  2.30  subdivision 23, is amended to read: 
  2.31     Subd. 23.  [WRAPAROUND INDIVIDUALIZED REHABILITATION 
  2.32  SERVICES.] "Wraparound Individualized rehabilitation services" 
  2.33  are alternative, flexible, coordinated, and highly 
  2.34  individualized services that are based on a multiagency plan of 
  2.35  care.  These services are designed to build on the strengths and 
  2.36  respond to the needs identified in the child's multiagency 
  3.1   assessment and to improve the child's ability to function in the 
  3.2   home, school, and community.  Wraparound Individualized 
  3.3   rehabilitation services may include, but are not limited to, 
  3.4   residential services, respite services, services that assist the 
  3.5   child or family in enrolling in or participating in recreational 
  3.6   activities, assistance in purchasing otherwise unavailable items 
  3.7   or services important to maintain a specific child in the 
  3.8   family, and services that assist the child to participate in 
  3.9   more traditional services and programs. 
  3.10     Sec. 5.  Minnesota Statutes 1994, section 245.493, 
  3.11  subdivision 2, is amended to read: 
  3.12     Subd. 2.  [GENERAL DUTIES OF THE LOCAL CHILDREN'S MENTAL 
  3.13  HEALTH COLLABORATIVES.] Each local children's mental health 
  3.14  collaborative must: 
  3.15     (1) notify the commissioner of human services within ten 
  3.16  days of formation by signing a collaborative agreement and 
  3.17  providing the commissioner with a copy of the signed agreement; 
  3.18     (2) identify a service delivery area and an initial 
  3.19  operational target population within that service delivery area. 
  3.20  The initial operational target population must be economically 
  3.21  and culturally representative of children in the service 
  3.22  delivery area to be served by the local children's mental health 
  3.23  collaborative.  The size of the initial operational target 
  3.24  population must also be economically viable for the service 
  3.25  delivery area; 
  3.26     (2) (3) seek to maximize federal revenues available to 
  3.27  serve children in the target population by designating local 
  3.28  expenditures for mental health services for these children and 
  3.29  their families that can be matched with federal dollars; 
  3.30     (3) (4) in consultation with the local children's advisory 
  3.31  council and the local coordinating council, if it is not the 
  3.32  local children's mental health collaborative, design, develop, 
  3.33  and ensure implementation of an integrated service system that 
  3.34  meets the requirements for state and federal reimbursement and 
  3.35  develop interagency agreements necessary to implement the 
  3.36  system; 
  4.1      (4) (5) expand membership to include representatives of 
  4.2   other services in the local system of care including prepaid 
  4.3   health plans under contract with the commissioner of human 
  4.4   services to serve the mental health needs of children in the 
  4.5   target population and their families; 
  4.6      (5) (6) create or designate a management structure for 
  4.7   fiscal and clinical responsibility and outcome evaluation; 
  4.8      (6) (7) spend funds generated by the local children's 
  4.9   mental health collaborative as required in sections 245.491 to 
  4.10  245.496; and 
  4.11     (7) (8) explore methods and recommend changes needed at the 
  4.12  state level to reduce duplication and promote coordination of 
  4.13  services including the use of uniform forms for reporting, 
  4.14  billing, and planning of services.; 
  4.15     (9) submit its integrated service system design to the 
  4.16  state coordinating council for approval within one year of 
  4.17  notifying the commissioner of human services of its formation; 
  4.18     (10) provide an annual report that includes the elements 
  4.19  listed in section 245.494, subdivision 2, and the 
  4.20  collaborative's planned timeline to expand its operational 
  4.21  target population to the state coordinating council; and 
  4.22     (11) expand its operational target population. 
  4.23     Each local children's mental health collaborative may 
  4.24  contract with the commissioner of human services to become a 
  4.25  medical assistance provider of mental health services according 
  4.26  to section 245.4933. 
  4.27     Sec. 6.  Minnesota Statutes 1994, section 245.4932, 
  4.28  subdivision 1, is amended to read: 
  4.29     Subdivision 1.  [PROVIDER COLLABORATIVE RESPONSIBILITIES.] 
  4.30  The children's mental health collaborative shall have the 
  4.31  following authority and responsibilities regarding federal 
  4.32  revenue enhancement: 
  4.33     (1) the collaborative must establish an integrated fund; 
  4.34     (2) the collaborative shall designate a lead county or 
  4.35  other qualified entity as the fiscal agency for reporting, 
  4.36  claiming, and receiving payments; 
  5.1      (2) (3) the collaborative or lead county may enter into 
  5.2   subcontracts with other counties, school districts, special 
  5.3   education cooperatives, municipalities, and other public and 
  5.4   nonprofit entities for purposes of identifying and claiming 
  5.5   eligible expenditures to enhance federal reimbursement; 
  5.6      (3) (4) the collaborative shall use any enhanced revenue 
  5.7   attributable to the activities of the collaborative, including 
  5.8   administrative and service revenue, solely to provide mental 
  5.9   health services or to expand the operational target population.  
  5.10  The lead county or other qualified entity may not use enhanced 
  5.11  federal revenue for any other purpose; 
  5.12     (5) the members of the collaborative must continue the base 
  5.13  level of expenditures, as defined in section 245.492, 
  5.14  subdivision 2, for services for children with emotional or 
  5.15  behavioral disturbances and their families from any state, 
  5.16  county, federal, or other public or private funding source 
  5.17  which, in the absence of the new federal reimbursement earned 
  5.18  under sections 245.491 to 245.496, would have been available for 
  5.19  those services.  The base year for purposes of this subdivision 
  5.20  shall be the accounting period closest to state fiscal year 
  5.21  1993; 
  5.22     (4) (6) the collaborative or lead county must develop and 
  5.23  maintain an accounting and financial management system adequate 
  5.24  to support all claims for federal reimbursement, including a 
  5.25  clear audit trail and any provisions specified in the 
  5.26  contract with the commissioner of human services; 
  5.27     (5) (7) the collaborative shall or its members may elect to 
  5.28  pay the nonfederal share of the medical assistance costs for 
  5.29  services designated by the collaborative; and 
  5.30     (6) (8) the lead county or other qualified entity may not 
  5.31  use federal funds or local funds designated as matching for 
  5.32  other federal funds to provide the nonfederal share of medical 
  5.33  assistance. 
  5.34     Sec. 7.  Minnesota Statutes 1994, section 245.4932, 
  5.35  subdivision 2, is amended to read: 
  5.36     Subd. 2.  [COMMISSIONER'S RESPONSIBILITIES.] (1) 
  6.1   Notwithstanding sections 256B.19, subdivision 1, and 256B.0625, 
  6.2   the commissioner shall be required to amend the state medical 
  6.3   assistance plan to include as covered services eligible for 
  6.4   medical assistance reimbursement, those services eligible for 
  6.5   reimbursement under federal law or waiver, which a collaborative 
  6.6   elects to provide and for which the collaborative elects to pay 
  6.7   the nonfederal share of the medical assistance costs. 
  6.8      (2) The commissioner may suspend, reduce, or terminate the 
  6.9   federal reimbursement to a provider collaborative that does not 
  6.10  meet the requirements of sections 245.493 to 245.496. 
  6.11     (3) The commissioner shall recover from the collaborative 
  6.12  any federal fiscal disallowances or sanctions for audit 
  6.13  exceptions directly attributable to the collaborative's actions 
  6.14  or the proportional share if federal fiscal disallowances or 
  6.15  sanctions are based on a statewide random sample. 
  6.16     Sec. 8.  Minnesota Statutes 1994, section 245.4932, 
  6.17  subdivision 3, is amended to read: 
  6.18     Subd. 3.  [PAYMENTS.] Notwithstanding section 256.025, 
  6.19  subdivision 2, payments under sections 245.493 to 245.496 to 
  6.20  providers for wraparound service expenditures and expenditures 
  6.21  for other services for which the collaborative elects to pay the 
  6.22  nonfederal share of medical assistance shall only be made of 
  6.23  federal earnings from services provided under sections 245.493 
  6.24  to 245.496. 
  6.25     Sec. 9.  Minnesota Statutes 1994, section 245.4932, 
  6.26  subdivision 4, is amended to read: 
  6.27     Subd. 4.  [CENTRALIZED DISBURSEMENT OF MEDICAL ASSISTANCE 
  6.28  PAYMENTS.] Notwithstanding section 256B.041, and except for 
  6.29  family community support services and therapeutic support of 
  6.30  foster care, county payments for the cost of wraparound services 
  6.31  and other services for which the collaborative elects to pay the 
  6.32  nonfederal share, for reimbursement under medical assistance, 
  6.33  shall not be made to the state treasurer.  For purposes of 
  6.34  wraparound individualized rehabilitation services under sections 
  6.35  245.493 to 245.496, the centralized disbursement of payments to 
  6.36  providers under section 256B.041 consists only of federal 
  7.1   earnings from services provided under sections 245.493 to 
  7.2   245.496. 
  7.3      Sec. 10.  [245.4933] [MEDICAL ASSISTANCE PROVIDER STATUS.] 
  7.4      Subdivision 1.  [REQUIREMENTS TO SERVE CHILDREN NOT 
  7.5   ENROLLED IN A PREPAID MEDICAL ASSISTANCE OR MINNESOTACARE HEALTH 
  7.6   PLAN.] (a) In order for a local children's mental health 
  7.7   collaborative to become a prepaid provider of medical assistance 
  7.8   services and be eligible to receive medical assistance 
  7.9   reimbursement, the collaborative must: 
  7.10     (1) enter into a contract with the commissioner of human 
  7.11  services to provide mental health services including inpatient, 
  7.12  outpatient, medication management, services under the 
  7.13  rehabilitation option, and related physician services; 
  7.14     (2) meet the applicable federal requirements; 
  7.15     (3) either carry stop-loss insurance or enter into a 
  7.16  risk-sharing agreement with the commissioner of human services; 
  7.17  and 
  7.18     (4) provide medically necessary medical assistance mental 
  7.19  health services to children in the target population who enroll 
  7.20  in the local children's mental health collaborative. 
  7.21     (b) Upon execution of the provider contract with the 
  7.22  commissioner of human services the local children's mental 
  7.23  health collaborative may: 
  7.24     (1) provide mental health services which are not medical 
  7.25  assistance state plan services in addition to the state plan 
  7.26  services described in the contract with the commissioner of 
  7.27  human services; and 
  7.28     (2) enter into subcontracts which meet the requirements of 
  7.29  Code of Federal Regulations, title 42, section 434.6, with other 
  7.30  providers of mental health services including prepaid health 
  7.31  plans established under section 256B.69. 
  7.32     Subd. 2.  [REQUIREMENTS TO SERVE CHILDREN ENROLLED IN A 
  7.33  PREPAID HEALTH PLAN.] A children's mental health collaborative 
  7.34  may serve children in the collaborative's target population who 
  7.35  are enrolled in a prepaid health plan under contract with the 
  7.36  commissioner of human services by contracting with one or more 
  8.1   such health plans to provide medical assistance or MinnesotaCare 
  8.2   mental health services to children enrolled in the health plan.  
  8.3   The collaborative and the health plan shall work cooperatively 
  8.4   to ensure the integration of physical and mental health services.
  8.5      Subd. 3.  [REQUIREMENTS TO SERVE CHILDREN WHO BECOME 
  8.6   ENROLLED IN A PREPAID HEALTH PLAN.] A children's mental health 
  8.7   collaborative may provide prepaid medical assistance or 
  8.8   MinnesotaCare mental health services to children who are not 
  8.9   enrolled in prepaid health plans until those children are 
  8.10  enrolled.  Publication of a request for proposals in the State 
  8.11  Register shall serve as notice to the collaborative of the 
  8.12  commissioner's intent to execute contracts for medical 
  8.13  assistance and MinnesotaCare services.  In order to become or 
  8.14  continue to be a provider of medical assistance or MinnesotaCare 
  8.15  services the collaborative may contract with one or more such 
  8.16  prepaid health plans after the collaborative's target population 
  8.17  is enrolled in a prepaid health plan.  The collaborative and the 
  8.18  health plan shall work cooperatively to ensure the integration 
  8.19  of physical and mental health services. 
  8.20     Subd. 4.  [COMMISSIONER'S DUTIES.] (a) The commissioner of 
  8.21  human services shall provide to each children's mental health 
  8.22  collaborative that is considering whether to become a prepaid 
  8.23  provider of mental health services, the commissioner's best 
  8.24  estimate of a capitated payment rate prior to an actuarial study 
  8.25  based upon the collaborative's operational target population.  
  8.26  The capitated payment rate shall be adjusted annually, if 
  8.27  necessary, for changes in the operational target population. 
  8.28     (b) The commissioner shall negotiate risk adjustment and 
  8.29  reinsurance mechanisms with children's mental health 
  8.30  collaboratives that become medical assistance providers 
  8.31  including those that subcontract with prepaid health plans. 
  8.32     Subd. 5.  [NONCONTRACTING COLLABORATIVES.] A local 
  8.33  children's mental health collaborative that does not become a 
  8.34  prepaid provider of medical assistance or MinnesotaCare services 
  8.35  may provide services through individual members of a 
  8.36  noncontracting collaborative who have a medical assistance 
  9.1   provider agreement to eligible recipients who are not enrolled 
  9.2   in the health plan. 
  9.3      Subd. 6.  [INDIVIDUALIZED REHABILITATION SERVICES.] A 
  9.4   children's mental health collaborative with an integrated 
  9.5   service system approved by the state coordinating council may 
  9.6   become a medical assistance provider for the purpose of 
  9.7   obtaining prior authorization for and providing individualized 
  9.8   rehabilitation services. 
  9.9      Sec. 11.  Minnesota Statutes 1994, section 245.494, 
  9.10  subdivision 1, is amended to read: 
  9.11     Subdivision 1.  [STATE COORDINATING COUNCIL.] The state 
  9.12  coordinating council, in consultation with the integrated fund 
  9.13  task force, shall: 
  9.14     (1) assist local children's mental health collaboratives in 
  9.15  meeting the requirements of sections 245.491 to 245.496, by 
  9.16  seeking consultation and technical assistance from national 
  9.17  experts and coordinating presentations and assistance from these 
  9.18  experts to local children's mental health collaboratives; 
  9.19     (2) assist local children's mental health collaboratives in 
  9.20  identifying an economically viable initial operational target 
  9.21  population; 
  9.22     (3) develop methods to reduce duplication and promote 
  9.23  coordinated services including uniform forms for reporting, 
  9.24  billing, and planning of services; 
  9.25     (4) by September 1, 1994, develop a model multiagency plan 
  9.26  of care that can be used by local children's mental health 
  9.27  collaboratives in place of an individual education plan, 
  9.28  individual family community support plan, individual family 
  9.29  support plan, and an individual treatment plan; 
  9.30     (5) assist in the implementation and operation of local 
  9.31  children's mental health collaboratives by facilitating the 
  9.32  integration of funds, coordination of services, and measurement 
  9.33  of results, and by providing other assistance as needed; 
  9.34     (6) by July 1, 1993, develop a procedure for awarding 
  9.35  start-up funds.  Development of this procedure shall be exempt 
  9.36  from chapter 14; 
 10.1      (7) develop procedures and provide technical assistance to 
 10.2   allow local children's mental health collaboratives to integrate 
 10.3   resources for children's mental health services with other 
 10.4   resources available to serve children in the target population 
 10.5   in order to maximize federal participation and improve 
 10.6   efficiency of funding; 
 10.7      (8) ensure that local children's mental health 
 10.8   collaboratives and the services received through these 
 10.9   collaboratives meet the requirements set out in sections 245.491 
 10.10  to 245.496; 
 10.11     (9) identify base level funding from state and federal 
 10.12  sources across systems; 
 10.13     (10) explore ways to access additional federal funds and 
 10.14  enhance revenues available to address the needs of the target 
 10.15  population; 
 10.16     (11) develop a mechanism for identifying the state share of 
 10.17  funding for services to children in the target population and 
 10.18  for making these funds available on a per capita basis for 
 10.19  services provided through the local children's mental health 
 10.20  collaborative to children in the target population.  Each year 
 10.21  beginning January 1, 1994, forecast the growth in the state 
 10.22  share and increase funding for local children's mental health 
 10.23  collaboratives accordingly; 
 10.24     (12) identify barriers to integrated service systems that 
 10.25  arise from data practices and make recommendations including 
 10.26  legislative changes needed in the data practices act to address 
 10.27  these barriers; and 
 10.28     (13) annually review the expenditures of local children's 
 10.29  mental health collaboratives to ensure that funding for services 
 10.30  provided to the target population continues from sources other 
 10.31  than the federal funds earned under sections 245.491 to 245.496 
 10.32  and that federal funds earned are spent consistent with sections 
 10.33  245.491 to 245.496. 
 10.34     Sec. 12.  Minnesota Statutes 1994, section 245.494, 
 10.35  subdivision 3, is amended to read: 
 10.36     Subd. 3.  [DUTIES OF THE COMMISSIONER OF HUMAN SERVICES.] 
 11.1   The commissioner of human services, in consultation with the 
 11.2   integrated fund task force, shall: 
 11.3      (1) beginning January 1, in the first quarter of 1994, in 
 11.4   areas where a local children's mental health collaborative has 
 11.5   been established, based on an independent actuarial 
 11.6   analysis, separate identify all medical assistance, general 
 11.7   assistance medical care, and MinnesotaCare resources devoted to 
 11.8   mental health services for children and their families in the 
 11.9   target population including inpatient, outpatient, medication 
 11.10  management, services under the rehabilitation option, and 
 11.11  related physician services from in the total health capitation 
 11.12  from of prepaid plans, including plans established under 
 11.13  contract with the commissioner to provide medical assistance 
 11.14  services under section 256B.69;, for the target population as 
 11.15  identified in section 245.492, subdivision 21, and develop 
 11.16  guidelines for managing these mental health benefits that will 
 11.17  require all contractors to: 
 11.18     (i) provide mental health services eligible for medical 
 11.19  assistance reimbursement; 
 11.20     (ii) meet performance standards established by the 
 11.21  commissioner of human services including providing services 
 11.22  consistent with the requirements and standards set out in 
 11.23  sections 245.487 to 245.4888 and 245.491 to 245.496; 
 11.24     (iii) provide the commissioner of human services with data 
 11.25  consistent with that collected under sections 245.487 to 
 11.26  245.4888; and 
 11.27     (iv) in service delivery areas where there is a local 
 11.28  children's mental health collaborative for the target population 
 11.29  defined by local children's mental health collaborative: 
 11.30     (A) participate in the local children's mental health 
 11.31  collaborative; 
 11.32     (B) commit resources to the integrated fund that are 
 11.33  actuarially equivalent to resources received for the target 
 11.34  population being served by local children's mental health 
 11.35  collaboratives; and 
 11.36     (C) meet the requirements and the performance standards 
 12.1   developed for local children's mental health collaboratives; 
 12.2      (2) ensure that any prepaid health plan that is operating 
 12.3   within the jurisdiction of a local children's mental health 
 12.4   collaborative and that is able to meet all the requirements 
 12.5   under section 245.494, subdivision 3, paragraph (1), items (i) 
 12.6   to (iv), shall have 60 days from the date of receipt of written 
 12.7   notice of the establishment of the collaborative to decide 
 12.8   whether it will participate in the local children's mental 
 12.9   health collaborative; the prepaid health plan shall notify the 
 12.10  collaborative and the commissioner of its decision to 
 12.11  participate; 
 12.12     (3) (2) assist each children's mental health collaborative 
 12.13  to determine an actuarially feasible operational target 
 12.14  population; 
 12.15     (3) ensure that a prepaid health plan that contracts with 
 12.16  the commissioner to provide medical assistance or MinnesotaCare 
 12.17  services shall pass through the identified resources to a 
 12.18  collaborative or collaboratives upon the collaboratives meeting 
 12.19  the requirements of section 245.4933 to serve the 
 12.20  collaborative's operational target population.  The commissioner 
 12.21  shall, through an independent actuarial analysis, specify 
 12.22  differential rates the prepaid health plan must pay the 
 12.23  collaborative based upon severity, functioning, and other risk 
 12.24  factors, taking into consideration the fee-for-service 
 12.25  experience of children excluded from prepaid medical assistance 
 12.26  participation; 
 12.27     (4) ensure that a children's mental health collaborative 
 12.28  that enters into an agreement with a prepaid health plan under 
 12.29  contract with the commissioner shall accept medical assistance 
 12.30  recipients in the operational target population on a first-come, 
 12.31  first-served basis up to the collaborative's operating capacity 
 12.32  or as determined in the agreement between the collaborative and 
 12.33  the commissioner; 
 12.34     (5) ensure that a children's mental health collaborative 
 12.35  that receives resources passed through a prepaid health plan 
 12.36  under contract with the commissioner shall be subject to the 
 13.1   quality assurance standards, reporting of utilization 
 13.2   information, standards set out in sections 245.487 to 245.4888, 
 13.3   and other requirements established in Minnesota Rules, part 
 13.4   9500.1460; 
 13.5      (6) ensure that any prepaid health plan that contracts with 
 13.6   the commissioner, including a plan that contracts under section 
 13.7   256B.69, must enter into an agreement with any collaborative 
 13.8   operating in the same service delivery area that: 
 13.9      (i) meets the requirements of section 245.4933; 
 13.10     (ii) is willing to accept the rate determined by the 
 13.11  commissioner to provide medical assistance services; and 
 13.12     (iii) requests to contract with the prepaid health plan; 
 13.13     (7) ensure that no agreement between a health plan and a 
 13.14  collaborative shall terminate the legal responsibility of the 
 13.15  health plan to assure that all activities under the contract are 
 13.16  carried out.  The agreement may require the collaborative to 
 13.17  indemnify the health plan for activities that are not carried 
 13.18  out; 
 13.19     (8) ensure that where a collaborative enters into an 
 13.20  agreement with the commissioner to provide medical assistance 
 13.21  and MinnesotaCare services a separate capitation rate will be 
 13.22  determined through an independent actuarial analysis which is 
 13.23  based upon the factors set forth in clause (3) to be paid to a 
 13.24  collaborative for children in the operational target population 
 13.25  who are eligible for medical assistance but not included in the 
 13.26  prepaid health plan contract with the commissioner; 
 13.27     (9) ensure that in counties where no prepaid health plan 
 13.28  contract to provide medical assistance or MinnesotaCare services 
 13.29  exists, a children's mental health collaborative that meets the 
 13.30  requirements of section 245.4933 shall: 
 13.31     (i) be paid a capitated rate, actuarially determined, that 
 13.32  is based upon the collaborative's operational target population; 
 13.33     (ii) accept medical assistance or MinnesotaCare recipients 
 13.34  in the operational target population on a first-come, 
 13.35  first-served basis up to the collaborative's operating capacity 
 13.36  or as determined in the contract between the collaborative and 
 14.1   the commissioner; and 
 14.2      (iii) comply with quality assurance standards, reporting of 
 14.3   utilization information, standards set out in sections 245.487 
 14.4   to 245.4888, and other requirements established in Minnesota 
 14.5   Rules, part 9500.1460; 
 14.6      (10) subject to federal approval, in the development of 
 14.7   rates for local children's mental health collaboratives, the 
 14.8   commissioner shall consider, and may adjust, trend and 
 14.9   utilization factors, to reflect changes in mental health service 
 14.10  utilization and access; 
 14.11     (11) consider changes in mental health service utilization, 
 14.12  access, and price, and determine the actuarial value of the 
 14.13  services in the maintenance of rates for local children's mental 
 14.14  health collaborative provided services, subject to federal 
 14.15  approval; 
 14.16     (12) provide written notice to any prepaid health plan 
 14.17  operating within the service delivery area of a children's 
 14.18  mental health collaborative of the collaborative's existence 
 14.19  within 30 days of the commissioner's receipt of notice of the 
 14.20  collaborative's formation; 
 14.21     (13) ensure that in a geographic area where both a prepaid 
 14.22  health plan including those established under either section 
 14.23  256.9363 or 256B.69 and a local children's mental health 
 14.24  collaborative exist, medical assistance and MinnesotaCare 
 14.25  recipients in the operational target population who are enrolled 
 14.26  in prepaid health plans will have the choice to receive mental 
 14.27  health services through either the prepaid health plan or the 
 14.28  collaborative that has a contract with the prepaid health plan, 
 14.29  according to the terms of the contract; 
 14.30     (14) develop a mechanism for integrating medical assistance 
 14.31  resources for mental health service with resources for general 
 14.32  assistance medical care, MinnesotaCare, and any other state and 
 14.33  local resources available for services for children in the 
 14.34  operational target population, and develop a procedure for 
 14.35  making these resources available for use by a local children's 
 14.36  mental health collaborative; 
 15.1      (4) (15) gather data needed to manage mental health care 
 15.2   including evaluation data and data necessary to establish a 
 15.3   separate capitation rate for children's mental health services 
 15.4   if that option is selected; 
 15.5      (5) (16) by January 1, 1994, develop a model contract for 
 15.6   providers of mental health managed care that meets the 
 15.7   requirements set out in sections 245.491 to 245.496 and 256B.69, 
 15.8   and utilize this contract for all subsequent awards, and before 
 15.9   January 1, 1995, the commissioner of human services shall not 
 15.10  enter into or extend any contract for any prepaid plan that 
 15.11  would impede the implementation of sections 245.491 to 245.496; 
 15.12     (6) (17) develop revenue enhancement or rebate mechanisms 
 15.13  and procedures to certify expenditures made through local 
 15.14  children's mental health collaboratives for services including 
 15.15  administration and outreach that may be eligible for federal 
 15.16  financial participation under medical assistance, including 
 15.17  expenses for administration, and other federal programs; 
 15.18     (7) (18) ensure that new contracts and extensions or 
 15.19  modifications to existing contracts under section 256B.69 do not 
 15.20  impede implementation of sections 245.491 to 245.496; 
 15.21     (8) (19) provide technical assistance to help local 
 15.22  children's mental health collaboratives certify local 
 15.23  expenditures for federal financial participation, using due 
 15.24  diligence in order to meet implementation timelines for sections 
 15.25  245.491 to 245.496 and recommend necessary legislation to 
 15.26  enhance federal revenue, provide clinical and management 
 15.27  flexibility, and otherwise meet the goals of local children's 
 15.28  mental health collaboratives and request necessary state plan 
 15.29  amendments to maximize the availability of medical assistance 
 15.30  for activities undertaken by the local children's mental health 
 15.31  collaborative; 
 15.32     (9) (20) take all steps necessary to secure medical 
 15.33  assistance reimbursement under the rehabilitation option for 
 15.34  family community support services and therapeutic support of 
 15.35  foster care, and for residential treatment and wraparound 
 15.36  services when these services are provided through a local 
 16.1   children's mental health collaborative individualized 
 16.2   rehabilitation services; 
 16.3      (10) (21) provide a mechanism to identify separately the 
 16.4   reimbursement to a county for child welfare targeted case 
 16.5   management provided to children served by the local 
 16.6   collaborative for purposes of subsequent transfer by the county 
 16.7   to the integrated fund; and 
 16.8      (11)  where interested and qualified contractors are 
 16.9   available, finalize contracts within 180 days of receipt of 
 16.10  written notification of the establishment of a local children's 
 16.11  mental health collaborative. 
 16.12     (22) ensure that family members who are enrolled in a 
 16.13  prepaid health plan and whose children are receiving mental 
 16.14  health services through a local children's mental health 
 16.15  collaborative file complaints about mental health services 
 16.16  needed by the family members, the commissioner shall comply with 
 16.17  section 256B.031, subdivision 6.  A collaborative may assist a 
 16.18  family to make a complaint; and 
 16.19     (23) facilitate a smooth transition for children receiving 
 16.20  prepaid medical assistance or MinnesotaCare services through a 
 16.21  children's mental health collaborative who become enrolled in a 
 16.22  prepaid health plan. 
 16.23     Sec. 13.  Minnesota Statutes 1994, section 245.495, is 
 16.24  amended to read: 
 16.25     245.495 [ADDITIONAL FEDERAL REVENUES.] 
 16.26     (a) Each local children's mental health collaborative shall 
 16.27  report expenditures eligible for federal reimbursement in a 
 16.28  manner prescribed by the commissioner of human services under 
 16.29  section 256.01, subdivision 2, clause (17).  The commissioner of 
 16.30  human services shall pay all funds earned by each local 
 16.31  children's mental health collaborative to the collaborative.  
 16.32  Each local children's mental health collaborative must use these 
 16.33  funds to expand the initial operational target population or to 
 16.34  develop or provide mental health services through the local 
 16.35  integrated service system to children in the target population.  
 16.36  Funds may not be used to supplant funding for services to 
 17.1   children in the target population. 
 17.2      For purposes of this section, "mental health services" are 
 17.3   community-based, nonresidential services, which may include 
 17.4   respite care, that are identified in the child's multiagency 
 17.5   plan of care. 
 17.6      (b) The commissioner may set aside a portion of the federal 
 17.7   funds earned under this section to repay the special revenue 
 17.8   maximization account under section 256.01, subdivision 2, clause 
 17.9   (15).  The set-aside must not exceed five percent of the federal 
 17.10  reimbursement earned by collaboratives and repayment is limited 
 17.11  to: 
 17.12     (1) the costs of developing and implementing sections 
 17.13  245.491 to 245.496, including the costs of technical assistance 
 17.14  from the departments of human services, education, health, and 
 17.15  corrections to implement the children's mental health integrated 
 17.16  fund; 
 17.17     (2) programming the information systems; and 
 17.18     (3) any lost federal revenue for the central office claim 
 17.19  directly caused by the implementation of these sections. 
 17.20     (c) Any unexpended funds from the set-aside described in 
 17.21  paragraph (b) shall be distributed to counties according to 
 17.22  section 245.496, subdivision 2. 
 17.23     Sec. 14.  Minnesota Statutes 1994, section 245.496, 
 17.24  subdivision 3, is amended to read: 
 17.25     Subd. 3.  [SUBMISSION AND APPROVAL OF LOCAL COLLABORATIVE 
 17.26  PROPOSALS FOR INTEGRATED SYSTEMS.] By December 31, 1994, a local 
 17.27  children's mental health collaborative that received start-up 
 17.28  funds must submit to the state coordinating council its proposal 
 17.29  for creating and funding an integrated service system for 
 17.30  children in the target population.  A local children's mental 
 17.31  health collaborative which forms without receiving start-up 
 17.32  funds must submit its proposal for creating and funding an 
 17.33  integrated service system within one year of notifying the 
 17.34  commissioner of human services of its existence.  Within 60 days 
 17.35  of receiving the local collaborative proposal the state 
 17.36  coordinating council must review the proposal and notify the 
 18.1   local children's mental health collaborative as to whether or 
 18.2   not the proposal has been approved.  If the proposal is not 
 18.3   approved, the state coordinating council must indicate changes 
 18.4   needed to receive approval. 
 18.5      Sec. 15.  Minnesota Statutes 1994, section 245.496, is 
 18.6   amended by adding a subdivision to read: 
 18.7      Subd. 4.  [APPROVAL OF A COLLABORATIVE'S INTEGRATED SERVICE 
 18.8   SYSTEM.] A collaborative may not become a medical assistance 
 18.9   provider unless the state coordinating council approves a 
 18.10  collaborative's proposed integrated service system design.  The 
 18.11  state coordinating council shall approve the integrated service 
 18.12  system proposal only when the following elements are present: 
 18.13     (1) interagency agreements signed by the head of each 
 18.14  member agency who has the authority to obligate the agency and 
 18.15  which set forth the specific financial commitments of each 
 18.16  member agency; 
 18.17     (2) an adequate management structure for fiscal and 
 18.18  clinical responsibility including appropriate allocation of risk 
 18.19  and liability; 
 18.20     (3) a process of utilization review; and 
 18.21     (4) compliance with sections 245.491 to 245.496. 
 18.22     Sec. 16.  Minnesota Statutes 1994, section 256B.0625, 
 18.23  subdivision 37, is amended to read: 
 18.24     Subd. 37.  [WRAPAROUND INDIVIDUALIZED REHABILITATION 
 18.25  SERVICES.] Medical assistance covers wraparound individualized 
 18.26  rehabilitation services as defined in section 245.492, 
 18.27  subdivision 20, that are provided through a local children's 
 18.28  mental health collaborative, as that entity is defined in 
 18.29  section 245.492, subdivision 11 23, that are provided by a 
 18.30  collaborative, county, or an entity under contract with a county 
 18.31  through an integrated service system, as described in section 
 18.32  245.4931, that is approved by the state coordinating council, 
 18.33  subject to federal approval.