1.1 	A bill for an act
1.2 	relating to human services; expanding children's
1.3 	therapeutic services and support; amending Minnesota
1.4 	Statutes 2004, section 256B.0943, subdivisions 1, 2.
1.5 	BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF MINNESOTA:

1.6 	Section 1. Minnesota Statutes 2004, section 256B.0943,
1.7 	subdivision 1, is amended to read:
1.8 		Subdivision 1.Definitions.  For purposes of this
1.9 	section, the following terms have the meanings given them.
1.10 	(a) "Care coordination" means activities that ensure:
1.11 	(1) services are provided in the most appropriate manner to
1.12 	achieve maximum benefit to the client;
1.13 	(2) nonduplication of services with county case managers;
1.14 	(3) coordination of care with county social services,
1.15 	community corrections, and schools; and 
1.16 	(4) services are culturally competent, child-centered, and
1.17 	family-driven.
1.18 	Care coordination may include activities that coordinate,
1.19 	for a particular client, any of the following:
1.20 	(1) children's therapeutic services and supports covered
1.21 	service components, as provided in subdivision 2, paragraph (b),
1.22 	including psychotherapy, skills training, crisis assistance,
1.23 	mental health behavioral aide services, direction to a mental
1.24 	health behavioral aide, and family psychoeducation;
1.25 	(2) other medical assistance reimbursable services that are
2.1 	not covered components of children's therapeutic services and
2.2 	supports, including, but not limited to, outpatient treatment
2.3 	and home and community-based waivered services;
2.4 	(3) other components of a therapeutic program not covered
2.5 	by medical assistance as part of children's therapeutic services
2.6 	and supports, including, but not limited to, a day treatment
2.7 	program, a preschool program, and other therapeutic activities
2.8 	included in the child's individual treatment plan;
2.9 	(4) obtaining the client's history;
2.10 	(5) diagnostic assessment, including functional assessment;
2.11 	(6) development, review, and updating of the client's
2.12 	individual treatment plan;
2.13 	(7) development, review, and updating of the client's
2.14 	individual behavioral plan;
2.15 	(8) entry of a client's data into the performance
2.16 	measurement system;
2.17 	(9) maintenance of clinical records;
2.18 	(10) scheduling for the client;
2.19 	(11) documentation required for billing;
2.20 	(12) consultation with other providers;
2.21 	(13) services that are the responsibility of a residential
2.22 	treatment provider, foster care provider, hospital, group home,
2.23 	regional treatment center, or other institutional group setting
2.24 	and the discharge planning from such settings; and 
2.25 	(14) adjunctive activities offered by a provider who does
2.26 	not provide children's therapeutic services and supports that
2.27 	are not covered by medical assistance, including, but not
2.28 	limited to, recreational services; social or educational
2.29 	services not expected to have a therapeutic outcome related to
2.30 	the client's emotional disturbance; consultation with other
2.31 	providers; and chemical dependency treatment.
2.32 	(b) "Children's therapeutic services and supports" means
2.33 	the flexible package of mental health services for children who
2.34 	require varying therapeutic and rehabilitative levels of
2.35 	intervention.  The services are time-limited interventions that
2.36 	are delivered using various treatment modalities and
3.1 	combinations of services designed to reach treatment outcomes
3.2 	identified in the individual treatment plan.
3.3 	(b) (c) "Clinical supervision" means the overall
3.4 	responsibility of the mental health professional for the control
3.5 	and direction of individualized treatment planning, service
3.6 	delivery, and treatment review for each client.  A mental health
3.7 	professional who is an enrolled Minnesota health care program
3.8 	provider accepts full professional responsibility for a
3.9 	supervisee's actions and decisions, instructs the supervisee in
3.10 	the supervisee's work, and oversees or directs the supervisee's
3.11 	work.
3.12 	(c) (d) "County board" means the county board of
3.13 	commissioners or board established under sections 402.01 to
3.14 	402.10 or 471.59.
3.15 	(d) (e) "Crisis assistance" has the meaning given in
3.16 	section 245.4871, subdivision 9a.
3.17 	(e) (f) "Culturally competent provider" means a provider
3.18 	who understands and can utilize to a client's benefit the
3.19 	client's culture when providing services to the client.  A
3.20 	provider may be culturally competent because the provider is of
3.21 	the same cultural or ethnic group as the client or the provider
3.22 	has developed the knowledge and skills through training and
3.23 	experience to provide services to culturally diverse clients.
3.24 	(f) (g) "Day treatment program" for children means a
3.25 	site-based structured program consisting of group psychotherapy
3.26 	for more than three individuals and other intensive therapeutic
3.27 	services provided by a multidisciplinary team, under the
3.28 	clinical supervision of a mental health professional.
3.29 	(g) (h) "Diagnostic assessment" has the meaning given in
3.30 	section 245.4871, subdivision 11.
3.31 	(h) (i) "Direct service time" means the time that a mental
3.32 	health professional, mental health practitioner, or mental
3.33 	health behavioral aide spends face-to-face with a client and the
3.34 	client's family.  Direct service time includes time in which the
3.35 	provider obtains a client's history or provides service
3.36 	components of children's therapeutic services and supports.
4.1 	Direct service time does not include time doing work before and
4.2 	after providing direct services, including scheduling,
4.3 	maintaining clinical records, consulting with others about the
4.4 	client's mental health status, preparing reports, receiving
4.5 	clinical supervision directly related to the client's
4.6 	psychotherapy session, and revising the client's individual
4.7 	treatment plan.
4.8 	(i) (j) "Direction of mental health behavioral aide" means
4.9 	the activities of a mental health professional or mental health
4.10 	practitioner in guiding the mental health behavioral aide in
4.11 	providing services to a client.  The direction of a mental
4.12 	health behavioral aide must be based on the client's
4.13 	individualized treatment plan and meet the requirements in
4.14 	subdivision 6, paragraph (b), clause (5).
4.15 	(j) (k) "Emotional disturbance" has the meaning given in
4.16 	section 245.4871, subdivision 15.  For persons at least age 18
4.17 	but under age 21, mental illness has the meaning given in
4.18 	section 245.462, subdivision 20, paragraph (a).
4.19 	(k) (l) "Family psychoeducation services" means education
4.20 	provided under the supervision of a mental health professional
4.21 	to a parent, family member, foster parent, or guardian about the
4.22 	child's mental health condition.
4.23 	(m) "Individual behavioral plan" means a plan of
4.24 	intervention, treatment, and services for a child written by a
4.25 	mental health professional or mental health practitioner, under
4.26 	the clinical supervision of a mental health professional, to
4.27 	guide the work of the mental health behavioral aide.
4.28 	(l) (n) "Individual treatment plan" has the meaning given
4.29 	in section 245.4871, subdivision 21.
4.30 	(m) (o) "Mental health professional" means an individual as
4.31 	defined in section 245.4871, subdivision 27, clauses (1) to (5),
4.32 	or tribal vendor as defined in section 256B.02, subdivision 7,
4.33 	paragraph (b).
4.34 	(n) (p) "Preschool program" means a day program licensed
4.35 	under Minnesota Rules, parts 9503.0005 to 9503.0175, and
4.36 	enrolled as a children's therapeutic services and supports
5.1 	provider to provide a structured treatment program to a child
5.2 	who is at least 33 months old but who has not yet attended the
5.3 	first day of kindergarten.
5.4 	(o) (q) "Skills training" means individual, family, or
5.5 	group training designed to improve the basic functioning of the
5.6 	child with emotional disturbance and the child's family in the
5.7 	activities of daily living and community living, and to improve
5.8 	the social functioning of the child and the child's family in
5.9 	areas important to the child's maintaining or reestablishing
5.10 	residency in the community.  Individual, family, and group
5.11 	skills training must:
5.12 	(1) consist of activities designed to promote skill
5.13 	development of the child and the child's family in the use of
5.14 	age-appropriate daily living skills, interpersonal and family
5.15 	relationships, and leisure and recreational services;
5.16 	(2) consist of activities that will assist the family's
5.17 	understanding of normal child development and to use parenting
5.18 	skills that will help the child with emotional disturbance
5.19 	achieve the goals outlined in the child's individual treatment
5.20 	plan; and
5.21 	(3) promote family preservation and unification, promote
5.22 	the family's integration with the community, and reduce the use
5.23 	of unnecessary out-of-home placement or institutionalization of
5.24 	children with emotional disturbance.

5.25 	Sec. 2. Minnesota Statutes 2004, section 256B.0943,
5.26 	subdivision 2, is amended to read:
5.27 		Subd. 2.Covered service components of children's
5.28 	therapeutic services and supports.  (a) Subject to federal
5.29 	approval, medical assistance covers medically necessary
5.30 	children's therapeutic services and supports as defined in this
5.31 	section that an eligible provider entity under subdivisions 4
5.32 	and 5 provides to a client eligible under subdivision 3.
5.33 	(b) The service components of children's therapeutic
5.34 	services and supports are:
5.35 	(1) individual, family, and group psychotherapy;
5.36 	(2) individual, family, or group skills training provided
6.1 	by a mental health professional or mental health practitioner;
6.2 	(3) crisis assistance;
6.3 	(4) mental health behavioral aide services; and 
6.4 	(5) direction of a mental health behavioral aide;
6.5 	(6) care coordination services; and 
6.6 	(7) family psychoeducation services.
6.7 	(c) Service components may be combined to constitute
6.8 	therapeutic programs, including day treatment programs and
6.9 	preschool programs.  Although day treatment and preschool
6.10 	programs have specific client and provider eligibility
6.11 	requirements, medical assistance only pays for the service
6.12 	components listed in paragraph (b).

6.13 	Sec. 3. FEDERAL APPROVAL; EFFECTIVE DATE.
 6.14 	If federal approval is required, the commissioner shall
6.15 	apply for federal approval, and sections 1 and 2 are effective
6.16 	upon federal approval.  If federal approval is not necessary,
6.17 	sections 1 and 2 are effective July 1, 2006.