<a id="pl.1.3"></a><var>1.3</var>medical assistance reimbursement and eligibility; changing provider qualification <br/>
<a id="pl.1.4"></a><var>1.4</var>and training requirements; amending mental health behavioral aide services; <br/>
<a id="pl.1.5"></a><var>1.5</var>providing coverage of mental health behavioral aide services; changing special <br/>
<a id="pl.1.6"></a><var>1.6</var>contracts with bordering states; requiring a new rate setting methodology;<br/>
<a id="pl.1.7"></a><var>1.7</var>amending Minnesota Statutes 2008, sections 148C.11, subdivision 1; 245.4871, <br/>
<a id="pl.1.8"></a><var>1.8</var>subdivision 26; 245.4885, subdivision 1; 245.50, subdivision 5; 256B.0615, <br/>
<a id="pl.1.9"></a><var>1.9</var>subdivisions 1, 3; 256B.0622, subdivision 8; 256B.0623, subdivision 5; <br/>
<a id="pl.1.10"></a><var>1.10</var>256B.0624, subdivision 8; 256B.0625, subdivision 49; 256B.0943, subdivisions <br/>
<a id="pl.1.11"></a><var>1.11</var>1, 2, 4, 5, 6, 7, 9; 256B.0944, subdivision 5.<br/>
<a id="pl.1.12"></a><var>1.12</var>BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF MINNESOTA:<br/>
<br/>
<a id="bill.0.1.0"></a><a id="pl.1.13"></a><var>1.13</var>    Section 1. Minnesota Statutes 2008, section 148C.11, subdivision 1, is amended to read:<br/>
<a id="pl.1.14"></a><var>1.14</var>    Subdivision 1. <b>Other professionals.</b> (a) Nothing in this chapter prevents members <br/>
<a id="pl.1.15"></a><var>1.15</var>of other professions or occupations from performing functions for which they are qualified <br/>
<a id="pl.1.16"></a><var>1.16</var>or licensed. This exception includes, but is not limited to: licensed physicians; registered <br/>
<a id="pl.1.17"></a><var>1.17</var>nurses; licensed practical nurses; licensed psychological practitioners; members of <br/>
<a id="pl.1.18"></a><var>1.18</var>the clergy; American Indian medicine men and women; licensed attorneys; probation <br/>
<a id="pl.1.19"></a><var>1.19</var>officers; licensed marriage and family therapists; licensed social workers; social workers <br/>
<a id="pl.1.20"></a><var>1.20</var>employed by city, county, or state agencies; licensed professional counselors; licensed <br/>
<a id="pl.1.21"></a><var>1.21</var>school counselors; registered occupational therapists or occupational therapy assistants; <br/>
<a id="pl.1.22"></a><var>1.22</var>city, county, or state employees when providing assessments or case management under <br/>
<a id="pl.1.23"></a><var>1.23</var>Minnesota Rules, chapter 9530; and until July 1, 2009, individuals providing integrated <br/>
<a id="pl.1.24"></a><var>1.24</var>dual-diagnosis treatment in adult mental health rehabilitative programs certified by the <br/>
<a id="pl.1.25"></a><var>1.25</var>Department of Human Services under section 
         <statute_ref>256B.0622</statute_ref> or 
         <statute_ref>256B.0623</statute_ref>.<br/>
<a id="pl.2.1"></a><var>2.1</var>    (b) Nothing in this chapter prohibits technicians and resident managers in programs <br/>
<a id="pl.2.2"></a><var>2.2</var>licensed by the Department of Human Services from discharging their duties as provided <br/>
<a id="pl.2.3"></a><var>2.3</var>in Minnesota Rules, chapter 9530.<br/>
<a id="pl.2.4"></a><var>2.4</var>    (c) Any person who is exempt under this subdivision but who elects to obtain a <br/>
<a id="pl.2.5"></a><var>2.5</var>license under this chapter is subject to this chapter to the same extent as other licensees. <br/>
<a id="pl.2.6"></a><var>2.6</var>The board shall issue a license without examination to an applicant who is licensed or <br/>
<a id="pl.2.7"></a><var>2.7</var>registered in a profession identified in paragraph (a) if the applicant:<br/>
<a id="pl.2.8"></a><var>2.8</var>    (1) shows evidence of current licensure or registration; and<br/>
<a id="pl.2.9"></a><var>2.9</var>    (2) has submitted to the board a plan for supervision during the first 2,000 hours of <br/>
<a id="pl.2.10"></a><var>2.10</var>professional practice or has submitted proof of supervised professional practice that is <br/>
<a id="pl.2.11"></a><var>2.11</var>acceptable to the board.<br/>
<a id="pl.2.12"></a><var>2.12</var>    (d) Any person who is exempt from licensure under this section must not use a <br/>
<a id="pl.2.13"></a><var>2.13</var>title incorporating the words "alcohol and drug counselor" or "licensed alcohol and drug <br/>
<a id="pl.2.14"></a><var>2.14</var>counselor" or otherwise hold themselves out to the public by any title or description <br/>
<a id="pl.2.15"></a><var>2.15</var>stating or implying that they are engaged in the practice of alcohol and drug counseling, <br/>
<a id="pl.2.16"></a><var>2.16</var>or that they are licensed to engage in the practice of alcohol and drug counseling unless <br/>
<a id="pl.2.17"></a><var>2.17</var>that person is also licensed as an alcohol and drug counselor. Persons engaged in the <br/>
<a id="pl.2.18"></a><var>2.18</var>practice of alcohol and drug counseling are not exempt from the board's jurisdiction <br/>
<a id="pl.2.19"></a><var>2.19</var>solely by the use of one of the above titles.<br/>
<br/>
<a id="bill.0.2.0"></a><a id="pl.2.20"></a><var>2.20</var>    Sec. 2. Minnesota Statutes 2008, section 245.4871, subdivision 26, is amended to read:<br/>
<a id="pl.2.21"></a><var>2.21</var>    Subd. 26. <b>Mental health practitioner.</b> "Mental health practitioner" means a person <br/>
<a id="pl.2.22"></a><var>2.22</var>providing services to children with emotional disturbances. A mental health practitioner <br/>
<a id="pl.2.23"></a><var>2.23</var>must have training and experience in working with children. A mental health practitioner <br/>
<a id="pl.2.24"></a><var>2.24</var>must be qualified in at least one of the following ways:<br/>
<a id="pl.2.25"></a><var>2.25</var>(1) holds a bachelor's degree in one of the behavioral sciences or related fields from <br/>
<a id="pl.2.26"></a><var>2.26</var>an accredited college or university and:<br/>
<a id="pl.2.27"></a><var>2.27</var>(i) has at least 2,000 hours of supervised experience in the delivery of mental health <br/>
<a id="pl.2.28"></a><var>2.28</var>services to children with emotional disturbances; or<br/>
<a id="pl.2.29"></a><var>2.29</var>(ii) is fluent in the non-English language of the ethnic group to which at least 50 <br/>
<a id="pl.2.30"></a><var>2.30</var>percent of the practitioner's clients belong, completes 40 hours of training in the delivery <br/>
<a id="pl.2.31"></a><var>2.31</var>of services to children with emotional disturbances, and receives clinical supervision from <br/>
<a id="pl.2.32"></a><var>2.32</var>a mental health professional at least once a week until the requirement of 2,000 hours <br/>
<a id="pl.2.33"></a><var>2.33</var>of supervised experience is met;<br/>
<a id="pl.2.34"></a><var>2.34</var>(2) has at least 6,000 hours of supervised experience in the delivery of mental <br/>
<a id="pl.2.35"></a><var>2.35</var>health services to children with emotional disturbances; hours worked as a mental health <br/>
<a id="pl.3.1"></a><var>3.1</var>behavioral aide I or II under section 256B.0943, subdivision 7, may be included in the <br/>
<a id="pl.3.2"></a><var>3.2</var>6,000 hours of experience; <br/>
<a id="pl.3.3"></a><var>3.3</var>(3) is a graduate student in one of the behavioral sciences or related fields and is <br/>
<a id="pl.3.4"></a><var>3.4</var>formally assigned by an accredited college or university to an agency or facility for <br/>
<a id="pl.3.5"></a><var>3.5</var>clinical training; or<br/>
<a id="pl.3.6"></a><var>3.6</var>(4) holds a master's or other graduate degree in one of the behavioral sciences or <br/>
<a id="pl.3.7"></a><var>3.7</var>related fields from an accredited college or university and has less than 4,000 hours <br/>
<a id="pl.3.8"></a><var>3.8</var>post-master's experience in the treatment of emotional disturbance.<br/>
<br/>
<a id="bill.0.3.0"></a><a id="pl.3.9"></a><var>3.9</var>    Sec. 3. Minnesota Statutes 2008, section 245.4885, subdivision 1, is amended to read:<br/>
<a id="pl.3.10"></a><var>3.10</var>    Subdivision 1. <b>Admission criteria.</b> The county board shall, prior to admission, <br/>
<a id="pl.3.11"></a><var>3.11</var>except in the case of emergency admission, determine the needed level of care for all <br/>
<a id="pl.3.12"></a><var>3.12</var>children referred for treatment of severe emotional disturbance in a treatment foster care <br/>
<a id="pl.3.13"></a><var>3.13</var>setting, residential treatment facility, or informally admitted to a regional treatment center <br/>
<a id="pl.3.14"></a><var>3.14</var>if public funds are used to pay for the services. The county board shall also determine the <br/>
<a id="pl.3.15"></a><var>3.15</var>needed level of care for all children admitted to an acute care hospital for treatment of <br/>
<a id="pl.3.16"></a><var>3.16</var>severe emotional disturbance if public funds other than reimbursement under chapters <br/>
<a id="pl.3.17"></a><var>3.17</var>256B and 256D are used to pay for the services. The level of care determination shall <br/>
<a id="pl.3.18"></a><var>3.18</var>determine whether the proposed treatment:<br/>
<a id="pl.3.19"></a><var>3.19</var>(1) is necessary;<br/>
<a id="pl.3.20"></a><var>3.20</var>(2) is appropriate to the child's individual treatment needs;<br/>
<a id="pl.3.21"></a><var>3.21</var>(3) cannot be effectively provided in the child's home; and<br/>
<a id="pl.3.22"></a><var>3.22</var>(4) provides a length of stay as short as possible consistent with the individual <br/>
<a id="pl.3.23"></a><var>3.23</var>child's need.<br/>
<a id="pl.3.24"></a><var>3.24</var>When a level of care determination is conducted, the county board may not <br/>
<a id="pl.3.25"></a><var>3.25</var>determine that referral or admission to a treatment foster care setting, or residential <br/>
<a id="pl.3.26"></a><var>3.26</var>treatment facility, or acute care hospital is not appropriate solely because services were <br/>
<a id="pl.3.27"></a><var>3.27</var>not first provided to the child in a less restrictive setting and the child failed to make <br/>
<a id="pl.3.28"></a><var>3.28</var>progress toward or meet treatment goals in the less restrictive setting. The level of care <br/>
<a id="pl.3.29"></a><var>3.29</var>determination must be based on a diagnostic assessment that includes a functional <br/>
<a id="pl.3.30"></a><var>3.30</var>assessment which evaluates family, school, and community living situations; and an <br/>
<a id="pl.3.31"></a><var>3.31</var>assessment of the child's need for care out of the home using a validated tool which <br/>
<a id="pl.3.32"></a><var>3.32</var>assesses a child's functional status and assigns an appropriate level of care. The validated <br/>
<a id="pl.3.33"></a><var>3.33</var>tool must be approved by the commissioner of human services. If a diagnostic assessment <br/>
<a id="pl.3.34"></a><var>3.34</var>including a functional assessment has been completed by a mental health professional <br/>
<a id="pl.3.35"></a><var>3.35</var>within the past 180 days, a new diagnostic assessment need not be completed unless in the <br/>
<a id="pl.4.1"></a><var>4.1</var>opinion of the current treating mental health professional the child's mental health status <br/>
<a id="pl.4.2"></a><var>4.2</var>has changed markedly since the assessment was completed. The child's parent shall be <br/>
<a id="pl.4.3"></a><var>4.3</var>notified if an assessment will not be completed and of the reasons. A copy of the notice <br/>
<a id="pl.4.4"></a><var>4.4</var>shall be placed in the child's file. Recommendations developed as part of the level of care <br/>
<a id="pl.4.5"></a><var>4.5</var>determination process shall include specific community services needed by the child and, <br/>
<a id="pl.4.6"></a><var>4.6</var>if appropriate, the child's family, and shall indicate whether or not these services are <br/>
<a id="pl.4.7"></a><var>4.7</var>available and accessible to the child and family.<br/>
<a id="pl.4.8"></a><var>4.8</var>During the level of care determination process, the child, child's family, or child's <br/>
<a id="pl.4.9"></a><var>4.9</var>legal representative, as appropriate, must be informed of the child's eligibility for case <br/>
<a id="pl.4.10"></a><var>4.10</var>management services and family community support services and that an individual <br/>
<a id="pl.4.11"></a><var>4.11</var>family community support plan is being developed by the case manager, if assigned.<br/>
<a id="pl.4.12"></a><var>4.12</var>The level of care determination shall comply with section 
         <statute_ref>260C.212</statute_ref>. Wherever <br/>
<a id="pl.4.13"></a><var>4.13</var>possible, the parent shall be consulted in the process, unless clinically inappropriate.<br/>
<a id="pl.4.14"></a><var>4.14</var>The level of care determination, and placement decision, and recommendations for <br/>
<a id="pl.4.15"></a><var>4.15</var>mental health services must be documented in the child's record.<br/>
<a id="pl.4.16"></a><var>4.16</var>An alternate review process may be approved by the commissioner if the county <br/>
<a id="pl.4.17"></a><var>4.17</var>board demonstrates that an alternate review process has been established by the county <br/>
<a id="pl.4.18"></a><var>4.18</var>board and the times of review, persons responsible for the review, and review criteria are <br/>
<a id="pl.4.19"></a><var>4.19</var>comparable to the standards in clauses (1) to (4).<br/>
<br/>
<a id="bill.0.4.0"></a><a id="pl.4.20"></a><var>4.20</var>    Sec. 4. Minnesota Statutes 2008, section 245.50, subdivision 5, is amended to read:<br/>
<a id="pl.4.21"></a><var>4.21</var>    Subd. 5. <b>Special contracts; bordering states.</b> (a) An individual who is detained, <br/>
<a id="pl.4.22"></a><var>4.22</var>committed, or placed on an involuntary basis under chapter 253B may be confined or <br/>
<a id="pl.4.23"></a><var>4.23</var>treated in a bordering state pursuant to a contract under this section. An individual who is <br/>
<a id="pl.4.24"></a><var>4.24</var>detained, committed, or placed on an involuntary basis under the civil law of a bordering <br/>
<a id="pl.4.25"></a><var>4.25</var>state may be confined or treated in Minnesota pursuant to a contract under this section. A <br/>
<a id="pl.4.26"></a><var>4.26</var>peace or health officer who is acting under the authority of the sending state may transport <br/>
<a id="pl.4.27"></a><var>4.27</var>an individual to a receiving agency that provides services pursuant to a contract under <br/>
<a id="pl.4.28"></a><var>4.28</var>this section and may transport the individual back to the sending state under the laws <br/>
<a id="pl.4.29"></a><var>4.29</var>of the sending state. Court orders valid under the law of the sending state are granted <br/>
<a id="pl.4.30"></a><var>4.30</var>recognition and reciprocity in the receiving state for individuals covered by a contract <br/>
<a id="pl.4.31"></a><var>4.31</var>under this section to the extent that the court orders relate to confinement for treatment <br/>
<a id="pl.4.32"></a><var>4.32</var>or care of mental illness or chemical dependency. Such treatment or care may address <br/>
<a id="pl.4.33"></a><var>4.33</var>other conditions that may be co-occurring with the mental illness or chemical dependency. <br/>
<a id="pl.4.34"></a><var>4.34</var>These court orders are not subject to legal challenge in the courts of the receiving state. <br/>
<a id="pl.4.35"></a><var>4.35</var>Individuals who are detained, committed, or placed under the law of a sending state and <br/>
<a id="pl.5.1"></a><var>5.1</var>who are transferred to a receiving state under this section continue to be in the legal <br/>
<a id="pl.5.2"></a><var>5.2</var>custody of the authority responsible for them under the law of the sending state. Except <br/>
<a id="pl.5.3"></a><var>5.3</var>in emergencies, those individuals may not be transferred, removed, or furloughed from <br/>
<a id="pl.5.4"></a><var>5.4</var>a receiving agency without the specific approval of the authority responsible for them <br/>
<a id="pl.5.5"></a><var>5.5</var>under the law of the sending state.<br/>
<a id="pl.5.6"></a><var>5.6</var>    (b) While in the receiving state pursuant to a contract under this section, an <br/>
<a id="pl.5.7"></a><var>5.7</var>individual shall be subject to the sending state's laws and rules relating to length of <br/>
<a id="pl.5.8"></a><var>5.8</var>confinement, reexaminations, and extensions of confinement. No individual may be sent <br/>
<a id="pl.5.9"></a><var>5.9</var>to another state pursuant to a contract under this section until the receiving state has <br/>
<a id="pl.5.10"></a><var>5.10</var>enacted a law recognizing the validity and applicability of this section.<br/>
<a id="pl.5.11"></a><var>5.11</var>    (c) If an individual receiving services pursuant to a contract under this section leaves <br/>
<a id="pl.5.12"></a><var>5.12</var>the receiving agency without permission and the individual is subject to involuntary <br/>
<a id="pl.5.13"></a><var>5.13</var>confinement under the law of the sending state, the receiving agency shall use all <br/>
<a id="pl.5.14"></a><var>5.14</var>reasonable means to return the individual to the receiving agency. The receiving agency <br/>
<a id="pl.5.15"></a><var>5.15</var>shall immediately report the absence to the sending agency. The receiving state has the <br/>
<a id="pl.5.16"></a><var>5.16</var>primary responsibility for, and the authority to direct, the return of these individuals <br/>
<a id="pl.5.17"></a><var>5.17</var>within its borders and is liable for the cost of the action to the extent that it would be <br/>
<a id="pl.5.18"></a><var>5.18</var>liable for costs of its own resident.<br/>
<a id="pl.5.19"></a><var>5.19</var>    (d) Responsibility for payment for the cost of care remains with the sending agency.<br/>
<a id="pl.5.20"></a><var>5.20</var>    (e) This subdivision also applies to county contracts under subdivision 2 which <br/>
<a id="pl.5.21"></a><var>5.21</var>include emergency care and treatment provided to a county resident in a bordering state.<br/>
<a id="pl.5.22"></a><var>5.22</var>    (f) If a Minnesota resident is admitted to a facility in a bordering state under this <br/>
<a id="pl.5.23"></a><var>5.23</var>chapter, a physician, licensed psychologist who has a doctoral degree in psychology, or <br/>
<a id="pl.5.24"></a><var>5.24</var>an advance practice registered nurse certified in mental health, who is licensed in the <br/>
<a id="pl.5.25"></a><var>5.25</var>bordering state, may act as an examiner under sections 
         <statute_ref>253B.07</statute_ref>, 
         <statute_ref>253B.08</statute_ref>, 
         <statute_ref>253B.092</statute_ref>, <br/>
<statute_ref><a id="pl.5.26"></a><var>5.26</var>253B.12
         </statute_ref>, and 
         <statute_ref>253B.17</statute_ref> subject to the same requirements and limitations in section <br/>
<statute_ref><a id="pl.5.27"></a><var>5.27</var>253B.02, subdivision 7
         </statute_ref>. The examiner may initiate an emergency hold under section <br/>
<a id="pl.5.28"></a><var>5.28</var>253B.05 on a Minnesota resident who is in a hospital under contract with a Minnesota <br/>
<a id="pl.5.29"></a><var>5.29</var>governmental entity under this section providing the patient, in the professional opinion of <br/>
<a id="pl.5.30"></a><var>5.30</var>the examiner, meets the criteria in section 253B.05.<br/>
<br/>
<a id="bill.0.5.0"></a><a id="pl.5.31"></a><var>5.31</var>    Sec. 5. Minnesota Statutes 2008, section 256B.0615, subdivision 1, is amended to read:<br/>
<a id="pl.5.32"></a><var>5.32</var>    Subdivision 1. <b>Scope.</b> Medical assistance covers mental health certified peers <br/>
<a id="pl.5.33"></a><var>5.33</var>specialists services, as established in subdivision 2, subject to federal approval, if provided <br/>
<a id="pl.5.34"></a><var>5.34</var>to recipients who are eligible for services under sections 
         <statute_ref>256B.0622</statute_ref> and,
<statute_ref>256B.0623</statute_ref>, and <br/>
<a id="pl.6.1"></a><var>6.1</var>256B.0624 and are provided by a certified peer specialist who has completed the training <br/>
<a id="pl.6.2"></a><var>6.2</var>under subdivision 5.<br/>
<br/>
<a id="bill.0.6.0"></a><a id="pl.6.3"></a><var>6.3</var>    Sec. 6. Minnesota Statutes 2008, section 256B.0615, subdivision 3, is amended to read:<br/>
<a id="pl.6.4"></a><var>6.4</var>    Subd. 3. <b>Eligibility.</b> Peer support services may be made available to consumers <br/>
<a id="pl.6.5"></a><var>6.5</var>of (1) the intensive rehabilitative mental health services under section 
         <statute_ref>256B.0622;</statute_ref> and <br/>
<a id="pl.6.6"></a><var>6.6</var>(2) adult rehabilitative mental health services under section 
         <statute_ref>256B.0623</statute_ref>; and (3) crisis <br/>
<a id="pl.6.7"></a><var>6.7</var>stabilization services under section 256B.0624.<br/>
<br/>
<a id="bill.0.7.0"></a><a id="pl.6.8"></a><var>6.8</var>    Sec. 7. Minnesota Statutes 2008, section 256B.0622, subdivision 8, is amended to read:<br/>
<a id="pl.6.9"></a><var>6.9</var>    Subd. 8. <b>Medical assistance payment for intensive rehabilitative mental health </b><br/>
<a id="pl.6.10"></a><var>6.10</var><b>services.</b> (a) Payment for residential and nonresidential services in this section shall be <br/>
<a id="pl.6.11"></a><var>6.11</var>based on one daily rate per provider inclusive of the following services received by an <br/>
<a id="pl.6.12"></a><var>6.12</var>eligible recipient in a given calendar day: all rehabilitative services under this section, <br/>
<a id="pl.6.13"></a><var>6.13</var>staff travel time to provide rehabilitative services under this section, and nonresidential <br/>
<a id="pl.6.14"></a><var>6.14</var>crisis stabilization services under section 
         <statute_ref>256B.0624</statute_ref>. <br/>
<a id="pl.6.15"></a><var>6.15</var>(b) Except as indicated in paragraph (c), payment will not be made to more than one <br/>
<a id="pl.6.16"></a><var>6.16</var>entity for each recipient for services provided under this section on a given day. If services <br/>
<a id="pl.6.17"></a><var>6.17</var>under this section are provided by a team that includes staff from more than one entity, the <br/>
<a id="pl.6.18"></a><var>6.18</var>team must determine how to distribute the payment among the members.<br/>
<a id="pl.6.19"></a><var>6.19</var>(c) The host county shall recommend to the commissioner one rate for each entity <br/>
<a id="pl.6.20"></a><var>6.20</var>that will bill medical assistance for residential services under this section and two rates <br/>
<a id="pl.6.21"></a><var>6.21</var>one rate for each nonresidential provider. The first nonresidential rate is for recipients who <br/>
<a id="pl.6.22"></a><var>6.22</var>are not receiving residential services. The second nonresidential rate is for recipients <br/>
<a id="pl.6.23"></a><var>6.23</var>who are temporarily receiving residential services and need continued contact with the <br/>
<a id="pl.6.24"></a><var>6.24</var>nonresidential team to assure timely discharge from residential services. In developing <br/>
<a id="pl.6.25"></a><var>6.25</var>these rates, the host county shall consider and document:<br/>
<a id="pl.6.26"></a><var>6.26</var>(1) the cost for similar services in the local trade area;<br/>
<a id="pl.6.27"></a><var>6.27</var>(2) actual costs incurred by entities providing the services;<br/>
<a id="pl.6.28"></a><var>6.28</var>(3) the intensity and frequency of services to be provided to each recipient, including <br/>
<a id="pl.6.29"></a><var>6.29</var>the proposed overall number of units of service to be delivered;<br/>
<a id="pl.6.30"></a><var>6.30</var>(4) the degree to which recipients will receive services other than services under <br/>
<a id="pl.6.31"></a><var>6.31</var>this section;<br/>
<a id="pl.6.32"></a><var>6.32</var>(5) the costs of other services that will be separately reimbursed; and<br/>
<a id="pl.6.33"></a><var>6.33</var>(6) input from the local planning process authorized by the adult mental health <br/>
<a id="pl.6.34"></a><var>6.34</var>initiative under section 
         <statute_ref>245.4661</statute_ref>, regarding recipients' service needs. <br/>
<a id="pl.7.1"></a><var>7.1</var>(d) The rate for intensive rehabilitative mental health services must exclude room <br/>
<a id="pl.7.2"></a><var>7.2</var>and board, as defined in section 
         <statute_ref>256I.03, subdivision 6</statute_ref>, and services not covered under <br/>
<a id="pl.7.3"></a><var>7.3</var>this section, such as partial hospitalization, home care, and inpatient services. Physician <br/>
<a id="pl.7.4"></a><var>7.4</var>services that are not separately billed may be included in the rate to the extent that a <br/>
<a id="pl.7.5"></a><var>7.5</var>psychiatrist is a member of the treatment team. The county's recommendation shall <br/>
<a id="pl.7.6"></a><var>7.6</var>specify the period for which the rate will be applicable, not to exceed two years. <br/>
<a id="pl.7.7"></a><var>7.7</var>(e) When services under this section are provided by an assertive community team, <br/>
<a id="pl.7.8"></a><var>7.8</var>case management functions must be an integral part of the team.<br/>
<a id="pl.7.9"></a><var>7.9</var>(f) The rate for a provider must not exceed the rate charged by that provider for <br/>
<a id="pl.7.10"></a><var>7.10</var>the same service to other payors.<br/>
<a id="pl.7.11"></a><var>7.11</var>(g) The commissioner shall approve or reject the county's rate recommendation, <br/>
<a id="pl.7.12"></a><var>7.12</var>based on the commissioner's own analysis of the criteria in paragraph (c).<br/>
<br/>
<a id="bill.0.8.0"></a><a id="pl.7.13"></a><var>7.13</var>    Sec. 8. Minnesota Statutes 2008, section 256B.0623, subdivision 5, is amended to read:<br/>
<a id="pl.7.14"></a><var>7.14</var>    Subd. 5. <b>Qualifications of provider staff.</b> Adult rehabilitative mental health <br/>
<a id="pl.7.15"></a><var>7.15</var>services must be provided by qualified individual provider staff of a certified provider <br/>
<a id="pl.7.16"></a><var>7.16</var>entity. Individual provider staff must be qualified under one of the following criteria:<br/>
<a id="pl.7.17"></a><var>7.17</var>    (1) a mental health professional as defined in section 
         <statute_ref>245.462, subdivision 18</statute_ref>, <br/>
<a id="pl.7.18"></a><var>7.18</var>clauses (1) to (5). If the recipient has a current diagnostic assessment by a licensed <br/>
<a id="pl.7.19"></a><var>7.19</var>mental health professional as defined in section 
         <statute_ref>245.462, subdivision 18</statute_ref>, clauses (1) to <br/>
<a id="pl.7.20"></a><var>7.20</var>(5), recommending receipt of adult mental health rehabilitative services, the definition of <br/>
<a id="pl.7.21"></a><var>7.21</var>mental health professional for purposes of this section includes a person who is qualified <br/>
<a id="pl.7.22"></a><var>7.22</var>under section 
         <statute_ref>245.462, subdivision 18</statute_ref>, clause (6), and who holds a current and valid <br/>
<a id="pl.7.23"></a><var>7.23</var>national certification as a certified rehabilitation counselor or certified psychosocial <br/>
<a id="pl.7.24"></a><var>7.24</var>rehabilitation practitioner; <br/>
<a id="pl.7.25"></a><var>7.25</var>    (2) a mental health practitioner as defined in section 
         <statute_ref>245.462, subdivision 17</statute_ref>. The <br/>
<a id="pl.7.26"></a><var>7.26</var>mental health practitioner must work under the clinical supervision of a mental health <br/>
<a id="pl.7.27"></a><var>7.27</var>professional; <br/>
<a id="pl.7.28"></a><var>7.28</var>    (3) a certified peer specialist under section 
         <statute_ref>256B.0615</statute_ref>. The certified peer specialist <br/>
<a id="pl.7.29"></a><var>7.29</var>must work under the clinical supervision of a mental health professional; or<br/>
<a id="pl.7.30"></a><var>7.30</var>    (4) a mental health rehabilitation worker. A mental health rehabilitation worker <br/>
<a id="pl.7.31"></a><var>7.31</var>means a staff person working under the direction of a mental health practitioner or mental <br/>
<a id="pl.7.32"></a><var>7.32</var>health professional and under the clinical supervision of a mental health professional in <br/>
<a id="pl.7.33"></a><var>7.33</var>the implementation of rehabilitative mental health services as identified in the recipient's <br/>
<a id="pl.7.34"></a><var>7.34</var>individual treatment plan who:<br/>
<a id="pl.7.35"></a><var>7.35</var>    (i) is at least 21 years of age;<br/>
<a id="pl.8.1"></a><var>8.1</var>    (ii) has a high school diploma or equivalent;<br/>
<a id="pl.8.2"></a><var>8.2</var>    (iii) has successfully completed 30 hours of training during the past two years <br/>
<a id="pl.8.3"></a><var>8.3</var>immediately prior to the date of hire, or before provision of direct services, in all of <br/>
<a id="pl.8.4"></a><var>8.4</var>the following areas: recipient rights, recipient-centered individual treatment planning, <br/>
<a id="pl.8.5"></a><var>8.5</var>behavioral terminology, mental illness, co-occurring mental illness and substance abuse, <br/>
<a id="pl.8.6"></a><var>8.6</var>psychotropic medications and side effects, functional assessment, local community <br/>
<a id="pl.8.7"></a><var>8.7</var>resources, adult vulnerability, recipient confidentiality; and<br/>
<a id="pl.8.8"></a><var>8.8</var>    (iv) meets the qualifications in subitem (A) or (B):<br/>
<a id="pl.8.9"></a><var>8.9</var>    (A) has an associate of arts degree or two years full-time postsecondary education <br/>
<a id="pl.8.10"></a><var>8.10</var>in one of the behavioral sciences or human services, or; is a registered nurse without a <br/>
<a id="pl.8.11"></a><var>8.11</var>bachelor's degree,; or who within the previous ten years has:<br/>
<a id="pl.8.12"></a><var>8.12</var>    (1) three years of personal life experience with serious and persistent mental illness;<br/>
<a id="pl.8.13"></a><var>8.13</var>    (2) three years of life experience as a primary caregiver to an adult with a serious <br/>
<a id="pl.8.14"></a><var>8.14</var>mental illness or traumatic brain injury; or<br/>
<a id="pl.8.15"></a><var>8.15</var>    (3) 4,000 hours of supervised paid work experience in the delivery of mental health <br/>
<a id="pl.8.16"></a><var>8.16</var>services to adults with a serious mental illness or traumatic brain injury; or<br/>
<a id="pl.8.17"></a><var>8.17</var>    (B)(1) is fluent in the non-English language or competent in the culture of the <br/>
<a id="pl.8.18"></a><var>8.18</var>ethnic group to which at least 20 percent of the mental health rehabilitation worker's <br/>
<a id="pl.8.19"></a><var>8.19</var>clients belong;<br/>
<a id="pl.8.20"></a><var>8.20</var>    (2) receives during the first 2,000 hours of work, monthly documented individual <br/>
<a id="pl.8.21"></a><var>8.21</var>clinical supervision by a mental health professional;<br/>
<a id="pl.8.22"></a><var>8.22</var>    (3) has 18 hours of documented field supervision by a mental health professional <br/>
<a id="pl.8.23"></a><var>8.23</var>or practitioner during the first 160 hours of contact work with recipients, and at least six <br/>
<a id="pl.8.24"></a><var>8.24</var>hours of field supervision quarterly during the following year;<br/>
<a id="pl.8.25"></a><var>8.25</var>    (4) has review and cosignature of charting of recipient contacts during field <br/>
<a id="pl.8.26"></a><var>8.26</var>supervision by a mental health professional or practitioner; and<br/>
<a id="pl.8.27"></a><var>8.27</var>    (5) has 40 15 hours of additional continuing education on mental health topics during <br/>
<a id="pl.8.28"></a><var>8.28</var>the first year of employment and 15 hours during every additional year of employment.<br/>
<br/>
<a id="bill.0.9.0"></a><a id="pl.8.29"></a><var>8.29</var>    Sec. 9. Minnesota Statutes 2008, section 256B.0624, subdivision 8, is amended to read:<br/>
<a id="pl.8.30"></a><var>8.30</var>    Subd. 8. <b>Adult crisis stabilization staff qualifications.</b> (a) Adult mental health <br/>
<a id="pl.8.31"></a><var>8.31</var>crisis stabilization services must be provided by qualified individual staff of a qualified <br/>
<a id="pl.8.32"></a><var>8.32</var>provider entity. Individual provider staff must have the following qualifications:<br/>
<a id="pl.8.33"></a><var>8.33</var>(1) be a mental health professional as defined in section 
         <statute_ref>245.462, subdivision 18</statute_ref>, <br/>
<a id="pl.8.34"></a><var>8.34</var>clauses (1) to (5); <br/>
<a id="pl.9.1"></a><var>9.1</var>(2) be a mental health practitioner as defined in section 
         <statute_ref>245.462, subdivision 17</statute_ref>. <br/>
<a id="pl.9.2"></a><var>9.2</var>The mental health practitioner must work under the clinical supervision of a mental health <br/>
<a id="pl.9.3"></a><var>9.3</var>professional; or <br/>
<a id="pl.9.4"></a><var>9.4</var>(3) be a certified peer specialist under section 256B.0615. The certified peer <br/>
<a id="pl.9.5"></a><var>9.5</var>specialist must work under the clinical supervision of a mental health professional; or<br/>
<a id="pl.9.6"></a><var>9.6</var>(4) be a mental health rehabilitation worker who meets the criteria in section <br/>
<statute_ref><a id="pl.9.7"></a><var>9.7</var>256B.0623, subdivision 5
         </statute_ref>, clause (3) (4); works under the direction of a mental health <br/>
<a id="pl.9.8"></a><var>9.8</var>practitioner as defined in section 
         <statute_ref>245.462, subdivision 17</statute_ref>, or under direction of a <br/>
<a id="pl.9.9"></a><var>9.9</var>mental health professional; and works under the clinical supervision of a mental health <br/>
<a id="pl.9.10"></a><var>9.10</var>professional. <br/>
<a id="pl.9.11"></a><var>9.11</var>(b) Mental health practitioners and mental health rehabilitation workers must have <br/>
<a id="pl.9.12"></a><var>9.12</var>completed at least 30 hours of training in crisis intervention and stabilization during <br/>
<a id="pl.9.13"></a><var>9.13</var>the past two years.<br/>
<br/>
<a id="bill.0.10.0"></a><a id="pl.9.14"></a><var>9.14</var>    Sec. 10. Minnesota Statutes 2008, section 256B.0625, subdivision 49, is amended to <br/>
<a id="pl.9.15"></a><var>9.15</var>read:<br/>
<a id="pl.9.16"></a><var>9.16</var>    Subd. 49.  <b>Community health worker.</b> (a) Medical assistance covers the care <br/>
<a id="pl.9.17"></a><var>9.17</var>coordination and patient education services provided by a community health worker if <br/>
<a id="pl.9.18"></a><var>9.18</var>the community health worker has: <br/>
<a id="pl.9.19"></a><var>9.19</var>    (1) received a certificate from the Minnesota State Colleges and Universities System <br/>
<a id="pl.9.20"></a><var>9.20</var>approved community health worker curriculum; or <br/>
<a id="pl.9.21"></a><var>9.21</var>    (2) at least five years of supervised experience with an enrolled physician, registered <br/>
<a id="pl.9.22"></a><var>9.22</var>nurse, advanced practice registered nurse, mental health professional as defined in section <br/>
<a id="pl.9.23"></a><var>9.23</var>245.462, subdivision 18, clauses (1) to (5), and section 245.4871, subdivision 27, clauses <br/>
<a id="pl.9.24"></a><var>9.24</var>(1) to (5), or dentist, or at least five years of supervised experience by a certified public <br/>
<a id="pl.9.25"></a><var>9.25</var>health nurse operating under the direct authority of an enrolled unit of government. <br/>
<a id="pl.9.26"></a><var>9.26</var>Community health workers eligible for payment under clause (2) must complete the <br/>
<a id="pl.9.27"></a><var>9.27</var>certification program by January 1, 2010, to continue to be eligible for payment. <br/>
<a id="pl.9.28"></a><var>9.28</var>    (b) Community health workers must work under the supervision of a medical <br/>
<a id="pl.9.29"></a><var>9.29</var>assistance enrolled physician, registered nurse, advanced practice registered nurse, <br/>
<a id="pl.9.30"></a><var>9.30</var>mental health professional as defined in section 245.462, subdivision 18, clauses (1) to <br/>
<a id="pl.9.31"></a><var>9.31</var>(5), and section 245.4871, subdivision 27, clauses (1) to (5), or dentist, or work under <br/>
<a id="pl.9.32"></a><var>9.32</var>the supervision of a certified public health nurse operating under the direct authority of <br/>
<a id="pl.9.33"></a><var>9.33</var>an enrolled unit of government. <br/>
<a id="pl.9.34"></a><var>9.34</var>    (c) Care coordination and patient education services covered under this subdivision <br/>
<a id="pl.9.35"></a><var>9.35</var>include, but are not limited to, services relating to oral health and dental care. <br/>
<br/>
<a id="bill.0.11.0"></a><a id="pl.10.1"></a><var>10.1</var>    Sec. 11. Minnesota Statutes 2008, section 256B.0943, subdivision 1, is amended to <br/>
<a id="pl.10.2"></a><var>10.2</var>read:<br/>
<a id="pl.10.3"></a><var>10.3</var>    Subdivision 1. <b>Definitions.</b> For purposes of this section, the following terms have <br/>
<a id="pl.10.4"></a><var>10.4</var>the meanings given them.<br/>
<a id="pl.10.5"></a><var>10.5</var>(a) "Children's therapeutic services and supports" means the flexible package of <br/>
<a id="pl.10.6"></a><var>10.6</var>mental health services for children who require varying therapeutic and rehabilitative <br/>
<a id="pl.10.7"></a><var>10.7</var>levels of intervention. The services are time-limited interventions that are delivered using <br/>
<a id="pl.10.8"></a><var>10.8</var>various treatment modalities and combinations of services designed to reach treatment <br/>
<a id="pl.10.9"></a><var>10.9</var>outcomes identified in the individual treatment plan.<br/>
<a id="pl.10.10"></a><var>10.10</var>(b) "Clinical supervision" means the overall responsibility of the mental health <br/>
<a id="pl.10.11"></a><var>10.11</var>professional for the control and direction of individualized treatment planning, service <br/>
<a id="pl.10.12"></a><var>10.12</var>delivery, and treatment review for each client. A mental health professional who is an <br/>
<a id="pl.10.13"></a><var>10.13</var>enrolled Minnesota health care program provider accepts full professional responsibility <br/>
<a id="pl.10.14"></a><var>10.14</var>for a supervisee's actions and decisions, instructs the supervisee in the supervisee's work, <br/>
<a id="pl.10.15"></a><var>10.15</var>and oversees or directs the supervisee's work.<br/>
<a id="pl.10.16"></a><var>10.16</var>(c) "County board" means the county board of commissioners or board established <br/>
<a id="pl.10.17"></a><var>10.17</var>under sections 
         <statute_ref>402.01</statute_ref> to 
         <statute_ref>402.10</statute_ref> or 
         <statute_ref>471.59</statute_ref>.  <br/>
<a id="pl.10.18"></a><var>10.18</var>(d) "Crisis assistance" has the meaning given in section 
         <statute_ref>245.4871, subdivision 9a</statute_ref>.  <br/>
<a id="pl.10.19"></a><var>10.19</var>(e) "Culturally competent provider" means a provider who understands and can <br/>
<a id="pl.10.20"></a><var>10.20</var>utilize to a client's benefit the client's culture when providing services to the client. A <br/>
<a id="pl.10.21"></a><var>10.21</var>provider may be culturally competent because the provider is of the same cultural or <br/>
<a id="pl.10.22"></a><var>10.22</var>ethnic group as the client or the provider has developed the knowledge and skills through <br/>
<a id="pl.10.23"></a><var>10.23</var>training and experience to provide services to culturally diverse clients.<br/>
<a id="pl.10.24"></a><var>10.24</var>(f) "Day treatment program" for children means a site-based structured program <br/>
<a id="pl.10.25"></a><var>10.25</var>consisting of group psychotherapy for more than three individuals and other intensive <br/>
<a id="pl.10.26"></a><var>10.26</var>therapeutic services provided by a multidisciplinary team, under the clinical supervision <br/>
<a id="pl.10.27"></a><var>10.27</var>of a mental health professional.<br/>
<a id="pl.10.28"></a><var>10.28</var>(g) "Diagnostic assessment" has the meaning given in section 
         <statute_ref>245.4871, subdivision <br/>
<a id="pl.10.29"></a><var>10.29</var>11
         </statute_ref>.  <br/>
<a id="pl.10.30"></a><var>10.30</var>(h) "Direct service time" means the time that a mental health professional, mental <br/>
<a id="pl.10.31"></a><var>10.31</var>health practitioner, or mental health behavioral aide spends face-to-face with a client <br/>
<a id="pl.10.32"></a><var>10.32</var>and the client's family. Direct service time includes time in which the provider obtains <br/>
<a id="pl.10.33"></a><var>10.33</var>a client's history or provides service components of children's therapeutic services and <br/>
<a id="pl.10.34"></a><var>10.34</var>supports. Direct service time does not include time doing work before and after providing <br/>
<a id="pl.10.35"></a><var>10.35</var>direct services, including scheduling, maintaining clinical records, consulting with others <br/>
<a id="pl.10.36"></a><var>10.36</var>about the client's mental health status, preparing reports, receiving clinical supervision <br/>
<a id="pl.11.1"></a><var>11.1</var>directly related to the client's psychotherapy session, and revising the client's individual <br/>
<a id="pl.11.2"></a><var>11.2</var>treatment plan.<br/>
<a id="pl.11.3"></a><var>11.3</var>(i) "Direction of mental health behavioral aide" means the activities of a mental <br/>
<a id="pl.11.4"></a><var>11.4</var>health professional or mental health practitioner in guiding the mental health behavioral <br/>
<a id="pl.11.5"></a><var>11.5</var>aide in providing services to a client. The direction of a mental health behavioral aide <br/>
<a id="pl.11.6"></a><var>11.6</var>must be based on the client's individualized treatment plan and meet the requirements in <br/>
<a id="pl.11.7"></a><var>11.7</var>subdivision 6, paragraph (b), clause (5).<br/>
<a id="pl.11.8"></a><var>11.8</var>(j) "Emotional disturbance" has the meaning given in section 
         <statute_ref>245.4871, subdivision <br/>
<a id="pl.11.9"></a><var>11.9</var>15
         </statute_ref>. For persons at least age 18 but under age 21, mental illness has the meaning given in <br/>
<a id="pl.11.10"></a><var>11.10</var>section 
         <statute_ref>245.462, subdivision 20</statute_ref>, paragraph (a).  <br/>
<a id="pl.11.11"></a><var>11.11</var>(k) "Individual behavioral plan" means a plan of intervention, treatment, and <br/>
<a id="pl.11.12"></a><var>11.12</var>services for a child written by a mental health professional or mental health practitioner, <br/>
<a id="pl.11.13"></a><var>11.13</var>under the clinical supervision of a mental health professional, to guide the work of the <br/>
<a id="pl.11.14"></a><var>11.14</var>mental health behavioral aide.<br/>
<a id="pl.11.15"></a><var>11.15</var>(l) "Individual treatment plan" has the meaning given in section 
         <statute_ref>245.4871, <br/>
<a id="pl.11.16"></a><var>11.16</var>subdivision 21
         </statute_ref>.  <br/>
<a id="pl.11.17"></a><var>11.17</var>(m) "Mental health behavioral aide services" means medically necessary one-on-one <br/>
<a id="pl.11.18"></a><var>11.18</var>activities performed by a trained paraprofessional to assist a child retain or generalize <br/>
<a id="pl.11.19"></a><var>11.19</var>psychosocial skills as taught by a mental health professional or mental health practitioner <br/>
<a id="pl.11.20"></a><var>11.20</var>and as described in the child's individual treatment plan and individual behavior plan. <br/>
<a id="pl.11.21"></a><var>11.21</var>Activities involve working directly with the child or child's family as provided in <br/>
<a id="pl.11.22"></a><var>11.22</var>subdivision 9, paragraph (b), clause (4).<br/>
<a id="pl.11.23"></a><var>11.23</var>(m) (n) "Mental health professional" means an individual as defined in section <br/>
<statute_ref><a id="pl.11.24"></a><var>11.24</var>245.4871, subdivision 27
         </statute_ref>, clauses (1) to (5), or tribal vendor as defined in section 
         <statute_ref>256B.02, <br/>
<a id="pl.11.25"></a><var>11.25</var>subdivision 7
         </statute_ref>, paragraph (b).  <br/>
<a id="pl.11.26"></a><var>11.26</var>(n) (o) "Preschool program" means a day program licensed under Minnesota Rules, <br/>
<a id="pl.11.27"></a><var>11.27</var>parts 9503.0005 to 9503.0175, and enrolled as a children's therapeutic services and <br/>
<a id="pl.11.28"></a><var>11.28</var>supports provider to provide a structured treatment program to a child who is at least 33 <br/>
<a id="pl.11.29"></a><var>11.29</var>months old but who has not yet attended the first day of kindergarten.<br/>
<a id="pl.11.30"></a><var>11.30</var>(o) (p) "Skills training" means individual, family, or group training, delivered by <br/>
<a id="pl.11.31"></a><var>11.31</var>or under the direction of a mental health professional, designed to improve the basic <br/>
<a id="pl.11.32"></a><var>11.32</var>functioning of the child with emotional disturbance and the child's family in the activities <br/>
<a id="pl.11.33"></a><var>11.33</var>of daily living and community living, and to improve the social functioning of the child <br/>
<a id="pl.11.34"></a><var>11.34</var>and the child's family in areas important to the child's maintaining or reestablishing <br/>
<a id="pl.11.35"></a><var>11.35</var>residency in the community. Individual, family, and group skills training must:<br/>
<a id="pl.12.1"></a><var>12.1</var>(1) consist of activities designed to promote skill development of the child and the <br/>
<a id="pl.12.2"></a><var>12.2</var>child's family in the use of age-appropriate daily living skills, interpersonal and family <br/>
<a id="pl.12.3"></a><var>12.3</var>relationships, and leisure and recreational services;<br/>
<a id="pl.12.4"></a><var>12.4</var>(2) consist of activities that will assist the family's understanding of normal child <br/>
<a id="pl.12.5"></a><var>12.5</var>development and to use parenting skills that will help the child with emotional disturbance <br/>
<a id="pl.12.6"></a><var>12.6</var>achieve the goals outlined in the child's individual treatment plan; and<br/>
<a id="pl.12.7"></a><var>12.7</var>(3) promote family preservation and unification, promote the family's integration <br/>
<a id="pl.12.8"></a><var>12.8</var>with the community, and reduce the use of unnecessary out-of-home placement or <br/>
<a id="pl.12.9"></a><var>12.9</var>institutionalization of children with emotional disturbance. facilitate the acquisition <br/>
<a id="pl.12.10"></a><var>12.10</var>of psychosocial skills that are medically necessary to rehabilitate the child to an <br/>
<a id="pl.12.11"></a><var>12.11</var>age-appropriate developmental trajectory heretofore disrupted by a psychiatric illness <br/>
<a id="pl.12.12"></a><var>12.12</var>or to self-monitor, compensate for, cope with, counteract, or replace skills deficits or <br/>
<a id="pl.12.13"></a><var>12.13</var>maladaptive skills acquired over the course of a psychiatric illness. Skills training is <br/>
<a id="pl.12.14"></a><var>12.14</var>subject to the following requirements:<br/>
<a id="pl.12.15"></a><var>12.15</var>(1) a mental health professional or a mental health practitioner must provide skills <br/>
<a id="pl.12.16"></a><var>12.16</var>training;<br/>
<a id="pl.12.17"></a><var>12.17</var>(2) the child must always be present during skills training; however, a brief absence <br/>
<a id="pl.12.18"></a><var>12.18</var>of the child for no more than ten percent of the session unit may be allowed to redirect or <br/>
<a id="pl.12.19"></a><var>12.19</var>instruct family members;<br/>
<a id="pl.12.20"></a><var>12.20</var>(3) skills training delivered to children or their families must be targeted to the <br/>
<a id="pl.12.21"></a><var>12.21</var>specific deficits or maladaptations of the child's mental health disorder and must be <br/>
<a id="pl.12.22"></a><var>12.22</var>prescribed in the child's individual treatment plan; <br/>
<a id="pl.12.23"></a><var>12.23</var>(4) skills training delivered to the child's family must teach skills needed by parents <br/>
<a id="pl.12.24"></a><var>12.24</var>to enhance the child's skill development and to help the child use in daily life the skills <br/>
<a id="pl.12.25"></a><var>12.25</var>previously taught by a mental health professional or mental health practitioner and to <br/>
<a id="pl.12.26"></a><var>12.26</var>develop or maintain a home environment that supports the child's progressive use skills;<br/>
<a id="pl.12.27"></a><var>12.27</var>(5) group skills training may be provided to multiple recipients who, because of the <br/>
<a id="pl.12.28"></a><var>12.28</var>nature of their emotional, behavioral, or social dysfunction, can derive mutual benefit from <br/>
<a id="pl.12.29"></a><var>12.29</var>interaction in a group setting, which must be staffed as follows:<br/>
<a id="pl.12.30"></a><var>12.30</var>(i) one mental health professional or one mental health practitioner under supervision <br/>
<a id="pl.12.31"></a><var>12.31</var>of a licensed mental health professional must work with a group of four to eight clients; or<br/>
<a id="pl.12.32"></a><var>12.32</var>(ii) two mental health professionals or two mental health practitioners under <br/>
<a id="pl.12.33"></a><var>12.33</var>supervision of a licensed mental health professional, or one professional plus one <br/>
<a id="pl.12.34"></a><var>12.34</var>practitioner must work with a group of nine to 12 clients.<br/>
<br/>
<a id="bill.0.12.0"></a><a id="pl.13.1"></a><var>13.1</var>    Sec. 12. Minnesota Statutes 2008, section 256B.0943, subdivision 2, is amended to <br/>
<a id="pl.13.2"></a><var>13.2</var>read:<br/>
<a id="pl.13.3"></a><var>13.3</var>    Subd. 2. <b>Covered service components of children's therapeutic services and </b><br/>
<a id="pl.13.4"></a><var>13.4</var><b>supports.</b> (a) Subject to federal approval, medical assistance covers medically necessary <br/>
<a id="pl.13.5"></a><var>13.5</var>children's therapeutic services and supports as defined in this section that an eligible <br/>
<a id="pl.13.6"></a><var>13.6</var>provider entity certified under subdivisions subdivision 4 and 5 provides to a client <br/>
<a id="pl.13.7"></a><var>13.7</var>eligible under subdivision 3.<br/>
<a id="pl.13.8"></a><var>13.8</var>(b) The service components of children's therapeutic services and supports are:<br/>
<a id="pl.13.9"></a><var>13.9</var>(1) individual, family, and group psychotherapy;<br/>
<a id="pl.13.10"></a><var>13.10</var>(2) individual, family, or group skills training provided by a mental health <br/>
<a id="pl.13.11"></a><var>13.11</var>professional or mental health practitioner;<br/>
<a id="pl.13.12"></a><var>13.12</var>(3) crisis assistance;<br/>
<a id="pl.13.13"></a><var>13.13</var>(4) mental health behavioral aide services; and<br/>
<a id="pl.13.14"></a><var>13.14</var>(5) direction of a mental health behavioral aide.<br/>
<a id="pl.13.15"></a><var>13.15</var>(c) Service components in paragraph (b) may be combined to constitute therapeutic <br/>
<a id="pl.13.16"></a><var>13.16</var>programs, including day treatment programs and therapeutic preschool programs. <br/>
<a id="pl.13.17"></a><var>13.17</var>Although day treatment and preschool programs have specific client and provider <br/>
<a id="pl.13.18"></a><var>13.18</var>eligibility requirements, medical assistance only pays for the service components listed in <br/>
<a id="pl.13.19"></a><var>13.19</var>paragraph (b).<br/>
<br/>
<a id="bill.0.13.0"></a><a id="pl.13.20"></a><var>13.20</var>    Sec. 13. Minnesota Statutes 2008, section 256B.0943, subdivision 4, is amended to <br/>
<a id="pl.13.21"></a><var>13.21</var>read:<br/>
<a id="pl.13.22"></a><var>13.22</var>    Subd. 4. <b>Provider entity certification.</b> (a) Effective July 1, 2003, the commissioner <br/>
<a id="pl.13.23"></a><var>13.23</var>shall establish an initial provider entity application and certification process and <br/>
<a id="pl.13.24"></a><var>13.24</var>recertification process to determine whether a provider entity has an administrative <br/>
<a id="pl.13.25"></a><var>13.25</var>and clinical infrastructure that meets the requirements in subdivisions 5 and 6. The <br/>
<a id="pl.13.26"></a><var>13.26</var>commissioner shall recertify a provider entity at least every three years. The commissioner <br/>
<a id="pl.13.27"></a><var>13.27</var>shall establish a process for decertification of a provider entity that no longer meets the <br/>
<a id="pl.13.28"></a><var>13.28</var>requirements in this section. The county, tribe, and the commissioner shall be mutually <br/>
<a id="pl.13.29"></a><var>13.29</var>responsible and accountable for the county's, tribe's, and state's part of the certification, <br/>
<a id="pl.13.30"></a><var>13.30</var>recertification, and decertification processes.<br/>
<a id="pl.13.31"></a><var>13.31</var>(b) For purposes of this section, a provider entity must be:<br/>
<a id="pl.13.32"></a><var>13.32</var>(1) an Indian health services facility or a facility owned and operated by a tribe or <br/>
<a id="pl.13.33"></a><var>13.33</var>tribal organization operating as a 638 facility under Public Law 93-638 certified by the <br/>
<a id="pl.13.34"></a><var>13.34</var>state;<br/>
<a id="pl.13.35"></a><var>13.35</var>(2) a county-operated entity certified by the state; or<br/>
<a id="pl.14.1"></a><var>14.1</var>(3) a noncounty entity recommended for certification by the provider's host county <br/>
<a id="pl.14.2"></a><var>14.2</var>and certified by the state.<br/>
<br/>
<a id="bill.0.14.0"></a><a id="pl.14.3"></a><var>14.3</var>    Sec. 14. Minnesota Statutes 2008, section 256B.0943, subdivision 5, is amended to <br/>
<a id="pl.14.4"></a><var>14.4</var>read:<br/>
<a id="pl.14.5"></a><var>14.5</var>    Subd. 5.  <b>Provider entity administrative infrastructure requirements.</b> (a) To be <br/>
<a id="pl.14.6"></a><var>14.6</var>an eligible provider entity under this section, a provider entity must have an administrative <br/>
<a id="pl.14.7"></a><var>14.7</var>infrastructure that establishes authority and accountability for decision making and <br/>
<a id="pl.14.8"></a><var>14.8</var>oversight of functions, including finance, personnel, system management, clinical practice, <br/>
<a id="pl.14.9"></a><var>14.9</var>and performance measurement. The provider must have written policies and procedures <br/>
<a id="pl.14.10"></a><var>14.10</var>that it reviews and updates every three years and distributes to staff initially and upon <br/>
<a id="pl.14.11"></a><var>14.11</var>each subsequent update. <br/>
<a id="pl.14.12"></a><var>14.12</var>(b) The administrative infrastructure written policies and procedures must include: <br/>
<a id="pl.14.13"></a><var>14.13</var>(1) personnel procedures, including a process for: (i) recruiting, hiring, training, and <br/>
<a id="pl.14.14"></a><var>14.14</var>retention of culturally and linguistically competent providers; (ii) conducting a criminal <br/>
<a id="pl.14.15"></a><var>14.15</var>background check on all direct service providers and volunteers; (iii) investigating, <br/>
<a id="pl.14.16"></a><var>14.16</var>reporting, and acting on violations of ethical conduct standards; (iv) investigating, <br/>
<a id="pl.14.17"></a><var>14.17</var>reporting, and acting on violations of data privacy policies that are compliant with <br/>
<a id="pl.14.18"></a><var>14.18</var>federal and state laws; (v) utilizing volunteers, including screening applicants, training <br/>
<a id="pl.14.19"></a><var>14.19</var>and supervising volunteers, and providing liability coverage for volunteers; and (vi) <br/>
<a id="pl.14.20"></a><var>14.20</var>documenting that each mental health professional, mental health practitioner, or mental <br/>
<a id="pl.14.21"></a><var>14.21</var>health behavioral aide meets the applicable provider qualification criteria, training criteria <br/>
<a id="pl.14.22"></a><var>14.22</var>under subdivision 8, and clinical supervision or direction of a mental health behavioral <br/>
<a id="pl.14.23"></a><var>14.23</var>aide requirements under subdivision 6; <br/>
<a id="pl.14.24"></a><var>14.24</var>(2) fiscal procedures, including internal fiscal control practices and a process for <br/>
<a id="pl.14.25"></a><var>14.25</var>collecting revenue that is compliant with federal and state laws; <br/>
<a id="pl.14.26"></a><var>14.26</var>(3) if a client is receiving services from a case manager or other provider entity, a <br/>
<a id="pl.14.27"></a><var>14.27</var>service coordination process that ensures services are provided in the most appropriate <br/>
<a id="pl.14.28"></a><var>14.28</var>manner to achieve maximum benefit to the client. The provider entity must ensure <br/>
<a id="pl.14.29"></a><var>14.29</var>coordination and nonduplication of services consistent with county board coordination <br/>
<a id="pl.14.30"></a><var>14.30</var>procedures established under section 
<statute_ref>245.4881, subdivision 5</statute_ref>; <br/>
<a id="pl.14.31"></a><var>14.31</var>(4) (3) a performance measurement system, including monitoring to determine <br/>
<a id="pl.14.32"></a><var>14.32</var>cultural appropriateness of services identified in the individual treatment plan, as <br/>
<a id="pl.14.33"></a><var>14.33</var>determined by the client's culture, beliefs, values, and language, and family-driven <br/>
<a id="pl.14.34"></a><var>14.34</var>services; and <br/>
<a id="pl.15.1"></a><var>15.1</var>(5) (4) a process to establish and maintain individual client records. The client's <br/>
<a id="pl.15.2"></a><var>15.2</var>records must include: <br/>
<a id="pl.15.3"></a><var>15.3</var>(i) the client's personal information; <br/>
<a id="pl.15.4"></a><var>15.4</var>(ii) forms applicable to data privacy; <br/>
<a id="pl.15.5"></a><var>15.5</var>(iii) the client's diagnostic assessment, updates, results of tests, individual treatment <br/>
<a id="pl.15.6"></a><var>15.6</var>plan, and individual behavior plan, if necessary; <br/>
<a id="pl.15.7"></a><var>15.7</var>(iv) documentation of service delivery as specified under subdivision 6; <br/>
<a id="pl.15.8"></a><var>15.8</var>(v) telephone contacts; <br/>
<a id="pl.15.9"></a><var>15.9</var>(vi) discharge plan; and <br/>
<a id="pl.15.10"></a><var>15.10</var>(vii) if applicable, insurance information. <br/>
<a id="pl.15.11"></a><var>15.11</var>(c) A provider entity that uses a restrictive procedure with a client must meet the <br/>
<a id="pl.15.12"></a><var>15.12</var>requirements of section 
         <statute_ref>245.8261</statute_ref>. <br/>
<br/>
<a id="bill.0.15.0"></a><a id="pl.15.13"></a><var>15.13</var>    Sec. 15. Minnesota Statutes 2008, section 256B.0943, subdivision 6, is amended to <br/>
<a id="pl.15.14"></a><var>15.14</var>read:<br/>
<a id="pl.15.15"></a><var>15.15</var>    Subd. 6. <b>Provider entity clinical infrastructure requirements.</b> (a) To be <br/>
<a id="pl.15.16"></a><var>15.16</var>an eligible provider entity under this section, a provider entity must have a clinical <br/>
<a id="pl.15.17"></a><var>15.17</var>infrastructure that utilizes diagnostic assessment, an individualized treatment plan plans, <br/>
<a id="pl.15.18"></a><var>15.18</var>service delivery, and individual treatment plan review that are culturally competent, <br/>
<a id="pl.15.19"></a><var>15.19</var>child-centered, and family-driven to achieve maximum benefit for the client. The provider <br/>
<a id="pl.15.20"></a><var>15.20</var>entity must review, and update as necessary, the clinical policies and procedures every <br/>
<a id="pl.15.21"></a><var>15.21</var>three years and must distribute the policies and procedures to staff initially and upon <br/>
<a id="pl.15.22"></a><var>15.22</var>each subsequent update.<br/>
<a id="pl.15.23"></a><var>15.23</var>    (b) The clinical infrastructure written policies and procedures must include policies <br/>
<a id="pl.15.24"></a><var>15.24</var>and procedures for:<br/>
<a id="pl.15.25"></a><var>15.25</var>    (1) providing or obtaining a client's diagnostic assessment that identifies acute and <br/>
<a id="pl.15.26"></a><var>15.26</var>chronic clinical disorders, co-occurring medical conditions, sources of psychological <br/>
<a id="pl.15.27"></a><var>15.27</var>and environmental problems, and including a functional assessment. The functional <br/>
<a id="pl.15.28"></a><var>15.28</var>assessment must clearly summarize the client's individual strengths and needs;<br/>
<a id="pl.15.29"></a><var>15.29</var>    (2) developing an individual treatment plan that is:<br/>
<a id="pl.15.30"></a><var>15.30</var>    (i) is based on the information in the client's diagnostic assessment;<br/>
<a id="pl.15.31"></a><var>15.31</var>(ii) identified goals and objectives of treatment, treatment strategy, schedule for <br/>
<a id="pl.15.32"></a><var>15.32</var>accomplishing treatment goals and objectives, and the individuals responsible for <br/>
<a id="pl.15.33"></a><var>15.33</var>providing treatment services and supports;<br/>
<a id="pl.15.34"></a><var>15.34</var>    (ii) (iii) is developed no later than the end of the first psychotherapy session after the <br/>
<a id="pl.15.35"></a><var>15.35</var>after completion of the client's diagnostic assessment by the a mental health professional <br/>
<a id="pl.16.1"></a><var>16.1</var>who provides the client's psychotherapy and before the provision of children's therapeutic <br/>
<a id="pl.16.2"></a><var>16.2</var>services and supports;<br/>
<a id="pl.16.3"></a><var>16.3</var>    (iii) (iv) is developed through a child-centered, family-driven, culturally appropriate <br/>
<a id="pl.16.4"></a><var>16.4</var> planning process that identifies service needs and individualized, planned, and culturally <br/>
<a id="pl.16.5"></a><var>16.5</var>appropriate interventions that contain specific treatment goals and objectives for the client <br/>
<a id="pl.16.6"></a><var>16.6</var>and the client's family or foster family;<br/>
<a id="pl.16.7"></a><var>16.7</var>    (iv) (v) is reviewed at least once every 90 days and revised, if necessary; and<br/>
<a id="pl.16.8"></a><var>16.8</var>    (v) (vi) is signed by the clinical supervisor and by the client or, if appropriate, by the <br/>
<a id="pl.16.9"></a><var>16.9</var>client's parent or other person authorized by statute to consent to mental health services <br/>
<a id="pl.16.10"></a><var>16.10</var>for the client;<br/>
<a id="pl.16.11"></a><var>16.11</var>    (3) developing an individual behavior plan that documents services treatment <br/>
<a id="pl.16.12"></a><var>16.12</var>strategies to be provided by the mental health behavioral aide. The individual behavior <br/>
<a id="pl.16.13"></a><var>16.13</var>plan must include:<br/>
<a id="pl.16.14"></a><var>16.14</var>    (i) detailed instructions on the service treatment strategies to be provided;<br/>
<a id="pl.16.15"></a><var>16.15</var>    (ii) time allocated to each service treatment strategy;<br/>
<a id="pl.16.16"></a><var>16.16</var>    (iii) methods of documenting the child's behavior;<br/>
<a id="pl.16.17"></a><var>16.17</var>    (iv) methods of monitoring the child's progress in reaching objectives; and<br/>
<a id="pl.16.18"></a><var>16.18</var>    (v) goals to increase or decrease targeted behavior as identified in the individual <br/>
<a id="pl.16.19"></a><var>16.19</var>treatment plan;<br/>
<a id="pl.16.20"></a><var>16.20</var>    (4) providing clinical supervision of the mental health practitioner and mental health <br/>
<a id="pl.16.21"></a><var>16.21</var>behavioral aide. A mental health professional must document the clinical supervision <br/>
<a id="pl.16.22"></a><var>16.22</var>the professional provides by cosigning individual treatment plans and making entries in <br/>
<a id="pl.16.23"></a><var>16.23</var>the client's record on supervisory activities. Clinical supervision does not include the <br/>
<a id="pl.16.24"></a><var>16.24</var>authority to make or terminate court-ordered placements of the child. A clinical supervisor <br/>
<a id="pl.16.25"></a><var>16.25</var>must be available for urgent consultation as required by the individual client's needs or <br/>
<a id="pl.16.26"></a><var>16.26</var>the situation. Clinical supervision may occur individually or in a small group to discuss <br/>
<a id="pl.16.27"></a><var>16.27</var>treatment and review progress toward goals. The focus of clinical supervision must be the <br/>
<a id="pl.16.28"></a><var>16.28</var>client's treatment needs and progress and the mental health practitioner's or behavioral <br/>
<a id="pl.16.29"></a><var>16.29</var>aide's ability to provide services;<br/>
<a id="pl.16.30"></a><var>16.30</var>    (4a) CTSS certified provider entities providing meeting day treatment and <br/>
<a id="pl.16.31"></a><var>16.31</var>therapeutic preschool programs must meet the conditions in items (i) to (iii):<br/>
<a id="pl.16.32"></a><var>16.32</var>    (i) the supervisor must be present and available on the premises more than 50 <br/>
<a id="pl.16.33"></a><var>16.33</var>percent of the time in a five-working-day period during which the supervisee is providing <br/>
<a id="pl.16.34"></a><var>16.34</var>a mental health service;<br/>
<a id="pl.17.1"></a><var>17.1</var>    (ii) the diagnosis and the client's individual treatment plan or a change in the <br/>
<a id="pl.17.2"></a><var>17.2</var>diagnosis or individual treatment plan must be made by or reviewed, approved, and signed <br/>
<a id="pl.17.3"></a><var>17.3</var>by the supervisor; and<br/>
<a id="pl.17.4"></a><var>17.4</var>    (iii) every 30 days, the supervisor must review and sign the record of indicating the <br/>
<a id="pl.17.5"></a><var>17.5</var>supervisor has reviewed the client's care for all activities in the preceding 30-day period;<br/>
<a id="pl.17.6"></a><var>17.6</var>    (4b) meeting the clinical supervision standards in items (i) to (iii) for all other <br/>
<a id="pl.17.7"></a><var>17.7</var>services provided under CTSS, clinical supervision standards provided in items (i) to <br/>
<a id="pl.17.8"></a><var>17.8</var>(iii) must be used:<br/>
<a id="pl.17.9"></a><var>17.9</var>    (i) medical assistance shall reimburse for services provided by a mental health <br/>
<a id="pl.17.10"></a><var>17.10</var>practitioner who maintains a consulting relationship with a mental health professional who <br/>
<a id="pl.17.11"></a><var>17.11</var>accepts full professional responsibility and is present on site for at least one observation <br/>
<a id="pl.17.12"></a><var>17.12</var>during the first 12 hours in which the mental health practitioner provides the individual, <br/>
<a id="pl.17.13"></a><var>17.13</var>family, or group skills training to the child or the child's family;<br/>
<a id="pl.17.14"></a><var>17.14</var>(ii) medical assistance shall reimburse for services provided by a mental health <br/>
<a id="pl.17.15"></a><var>17.15</var>behavioral aide who maintains a consulting relationship with a mental health professional <br/>
<a id="pl.17.16"></a><var>17.16</var>who accepts full professional responsibility and has an approved plan for clinical <br/>
<a id="pl.17.17"></a><var>17.17</var>supervision of the behavioral aide. Plans will be approved in accordance with supervision <br/>
<a id="pl.17.18"></a><var>17.18</var>standards promulgated by the commissioner of human services;<br/>
<a id="pl.17.19"></a><var>17.19</var>    (ii) thereafter, (iii) the mental health professional is required to be present on site <br/>
<a id="pl.17.20"></a><var>17.20</var>for observation as clinically appropriate when the mental health practitioner or mental <br/>
<a id="pl.17.21"></a><var>17.21</var>health behavioral aide is providing individual, family, or group skills training to the child <br/>
<a id="pl.17.22"></a><var>17.22</var>or the child's family CTSS services; and<br/>
<a id="pl.17.23"></a><var>17.23</var>    (iii) (iv) when conducted, the observation must be a minimum of one clinical <br/>
<a id="pl.17.24"></a><var>17.24</var>unit. The on-site presence of the mental health professional must be documented in the <br/>
<a id="pl.17.25"></a><var>17.25</var>child's record and signed by the mental health professional who accepts full professional <br/>
<a id="pl.17.26"></a><var>17.26</var>responsibility;<br/>
<a id="pl.17.27"></a><var>17.27</var>    (5) providing direction to a mental health behavioral aide. For entities that employ <br/>
<a id="pl.17.28"></a><var>17.28</var>mental health behavioral aides, the clinical supervisor must be employed by the provider <br/>
<a id="pl.17.29"></a><var>17.29</var>entity or other certified children's therapeutic supports and services provider entity to <br/>
<a id="pl.17.30"></a><var>17.30</var>ensure necessary and appropriate oversight for the client's treatment and continuity <br/>
<a id="pl.17.31"></a><var>17.31</var>of care. The mental health professional or mental health practitioner giving direction <br/>
<a id="pl.17.32"></a><var>17.32</var>must begin with the goals on the individualized treatment plan, and instruct the mental <br/>
<a id="pl.17.33"></a><var>17.33</var>health behavioral aide on how to construct therapeutic activities and interventions that <br/>
<a id="pl.17.34"></a><var>17.34</var>will lead to goal attainment. The professional or practitioner giving direction must also <br/>
<a id="pl.17.35"></a><var>17.35</var>instruct the mental health behavioral aide about the client's diagnosis, functional status, <br/>
<a id="pl.17.36"></a><var>17.36</var>and other characteristics that are likely to affect service delivery. Direction must also <br/>
<a id="pl.18.1"></a><var>18.1</var>include determining that the mental health behavioral aide has the skills to interact with <br/>
<a id="pl.18.2"></a><var>18.2</var>the client and the client's family in ways that convey personal and cultural respect and <br/>
<a id="pl.18.3"></a><var>18.3</var>that the aide actively solicits information relevant to treatment from the family. The aide <br/>
<a id="pl.18.4"></a><var>18.4</var>must be able to clearly explain the activities the aide is doing with the client and the <br/>
<a id="pl.18.5"></a><var>18.5</var>activities' relationship to treatment goals. Direction is more didactic than is supervision <br/>
<a id="pl.18.6"></a><var>18.6</var>and requires the professional or practitioner providing it to continuously evaluate the <br/>
<a id="pl.18.7"></a><var>18.7</var>mental health behavioral aide's ability to carry out the activities of the individualized <br/>
<a id="pl.18.8"></a><var>18.8</var>treatment plan and the individualized behavior plan. When providing direction, the <br/>
<a id="pl.18.9"></a><var>18.9</var>professional or practitioner must:<br/>
<a id="pl.18.10"></a><var>18.10</var>    (i) review progress notes prepared by the mental health behavioral aide for accuracy <br/>
<a id="pl.18.11"></a><var>18.11</var>and consistency with diagnostic assessment, treatment plan, and behavior goals and the <br/>
<a id="pl.18.12"></a><var>18.12</var>professional or practitioner must approve and sign the progress notes;<br/>
<a id="pl.18.13"></a><var>18.13</var>    (ii) identify changes in treatment strategies, revise the individual behavior plan, <br/>
<a id="pl.18.14"></a><var>18.14</var>and communicate treatment instructions and methodologies as appropriate to ensure <br/>
<a id="pl.18.15"></a><var>18.15</var>that treatment is implemented correctly;<br/>
<a id="pl.18.16"></a><var>18.16</var>    (iii) demonstrate family-friendly behaviors that support healthy collaboration among <br/>
<a id="pl.18.17"></a><var>18.17</var>the child, the child's family, and providers as treatment is planned and implemented;<br/>
<a id="pl.18.18"></a><var>18.18</var>    (iv) ensure that the mental health behavioral aide is able to effectively communicate <br/>
<a id="pl.18.19"></a><var>18.19</var>with the child, the child's family, and the provider; and<br/>
<a id="pl.18.20"></a><var>18.20</var>    (v) record the results of any evaluation and corrective actions taken to modify the <br/>
<a id="pl.18.21"></a><var>18.21</var>work of the mental health behavioral aide;<br/>
<a id="pl.18.22"></a><var>18.22</var>    (6) providing service delivery that implements the individual treatment plan and <br/>
<a id="pl.18.23"></a><var>18.23</var>meets the requirements under subdivision 9; and<br/>
<a id="pl.18.24"></a><var>18.24</var>    (7) individual treatment plan review. The review must determine the extent to which <br/>
<a id="pl.18.25"></a><var>18.25</var>the services have met the goals and objectives in the previous treatment plan. The review <br/>
<a id="pl.18.26"></a><var>18.26</var>must assess the client's progress and ensure that services and treatment goals continue to <br/>
<a id="pl.18.27"></a><var>18.27</var>be necessary and appropriate to the client and the client's family or foster family. Revision <br/>
<a id="pl.18.28"></a><var>18.28</var>of the individual treatment plan does not require a new diagnostic assessment unless the <br/>
<a id="pl.18.29"></a><var>18.29</var>client's mental health status has changed markedly. The updated treatment plan must be <br/>
<a id="pl.18.30"></a><var>18.30</var>signed by the clinical supervisor and by the client, if appropriate, and by the client's <br/>
<a id="pl.18.31"></a><var>18.31</var>parent or other person authorized by statute to give consent to the mental health services <br/>
<a id="pl.18.32"></a><var>18.32</var>for the child.<br/>
<br/>
<a id="bill.0.16.0"></a><a id="pl.18.33"></a><var>18.33</var>    Sec. 16. Minnesota Statutes 2008, section 256B.0943, subdivision 7, is amended to <br/>
<a id="pl.18.34"></a><var>18.34</var>read:<br/>
<a id="pl.19.1"></a><var>19.1</var>    Subd. 7. <b>Qualifications of individual and team providers.</b> (a) An individual <br/>
<a id="pl.19.2"></a><var>19.2</var>or team provider working within the scope of the provider's practice or qualifications <br/>
<a id="pl.19.3"></a><var>19.3</var>may provide service components of children's therapeutic services and supports that are <br/>
<a id="pl.19.4"></a><var>19.4</var>identified as medically necessary in a client's individual treatment plan.<br/>
<a id="pl.19.5"></a><var>19.5</var>(b) An individual provider must be qualified as:<br/>
<a id="pl.19.6"></a><var>19.6</var>(1) a mental health professional as defined in subdivision 1, paragraph (m); or<br/>
<a id="pl.19.7"></a><var>19.7</var>(2) a mental health practitioner as defined in section 
         <statute_ref>245.4871, subdivision 26</statute_ref>. The <br/>
<a id="pl.19.8"></a><var>19.8</var>mental health practitioner must work under the clinical supervision of a mental health <br/>
<a id="pl.19.9"></a><var>19.9</var>professional; or  <br/>
<a id="pl.19.10"></a><var>19.10</var>(3) a mental health behavioral aide working under the direction clinical supervision <br/>
<a id="pl.19.11"></a><var>19.11</var>of a mental health professional to implement the rehabilitative mental health services <br/>
<a id="pl.19.12"></a><var>19.12</var>identified in the client's individual treatment plan and individual behavior plan.<br/>
<a id="pl.19.13"></a><var>19.13</var>(A) A level I mental health behavioral aide must:<br/>
<a id="pl.19.14"></a><var>19.14</var>(i) be at least 18 years old;<br/>
<a id="pl.19.15"></a><var>19.15</var>(ii) have a high school diploma or general equivalency diploma (GED) or two years <br/>
<a id="pl.19.16"></a><var>19.16</var>of experience as a primary caregiver to a child with severe emotional disturbance within <br/>
<a id="pl.19.17"></a><var>19.17</var>the previous ten years; and<br/>
<a id="pl.19.18"></a><var>19.18</var>(iii) meet preservice and continuing education requirements under subdivision 8.<br/>
<a id="pl.19.19"></a><var>19.19</var>(B) A level II mental health behavioral aide must:<br/>
<a id="pl.19.20"></a><var>19.20</var>(i) be at least 18 years old;<br/>
<a id="pl.19.21"></a><var>19.21</var>(ii) have an associate or bachelor's degree or 4,000 hours of experience in delivering <br/>
<a id="pl.19.22"></a><var>19.22</var>clinical services in the treatment of mental illness concerning children or adolescents. <br/>
<a id="pl.19.23"></a><var>19.23</var>Hours worked as a mental health behavioral aide I may be included in the 4,000 hours <br/>
<a id="pl.19.24"></a><var>19.24</var>of experience; and<br/>
<a id="pl.19.25"></a><var>19.25</var>(iii) meet preservice and continuing education requirements in subdivision 8.<br/>
<a id="pl.19.26"></a><var>19.26</var>(c) A preschool program multidisciplinary team must include at least one mental <br/>
<a id="pl.19.27"></a><var>19.27</var>health professional and one or more of the following individuals under the clinical <br/>
<a id="pl.19.28"></a><var>19.28</var>supervision of a mental health professional:<br/>
<a id="pl.19.29"></a><var>19.29</var>(i) a mental health practitioner; or<br/>
<a id="pl.19.30"></a><var>19.30</var>(ii) a program person, including a teacher, assistant teacher, or aide, who meets the <br/>
<a id="pl.19.31"></a><var>19.31</var>qualifications and training standards of a level I mental health behavioral aide.<br/>
<a id="pl.19.32"></a><var>19.32</var>(d) A day treatment multidisciplinary team must include at least one mental health <br/>
<a id="pl.19.33"></a><var>19.33</var>professional and one mental health practitioner.<br/>
<br/>
<a id="bill.0.17.0"></a><a id="pl.19.34"></a><var>19.34</var>    Sec. 17. Minnesota Statutes 2008, section 256B.0943, subdivision 9, is amended to <br/>
<a id="pl.19.35"></a><var>19.35</var>read:<br/>
<a id="pl.20.1"></a><var>20.1</var>    Subd. 9. <b>Service delivery criteria.</b> (a) In delivering services under this section, a <br/>
<a id="pl.20.2"></a><var>20.2</var>certified provider entity must ensure that:<br/>
<a id="pl.20.3"></a><var>20.3</var>    (1) each individual provider's caseload size permits the provider to deliver services <br/>
<a id="pl.20.4"></a><var>20.4</var>to both clients with severe, complex needs and clients with less intensive needs. The <br/>
<a id="pl.20.5"></a><var>20.5</var>provider's caseload size should reasonably enable the provider to play an active role in <br/>
<a id="pl.20.6"></a><var>20.6</var>service planning, monitoring, and delivering services to meet the client's and client's <br/>
<a id="pl.20.7"></a><var>20.7</var>family's needs, as specified in each client's individual treatment plan;<br/>
<a id="pl.20.8"></a><var>20.8</var>    (2) site-based programs, including day treatment and preschool programs, provide <br/>
<a id="pl.20.9"></a><var>20.9</var>staffing and facilities to ensure the client's health, safety, and protection of rights, and that <br/>
<a id="pl.20.10"></a><var>20.10</var>the programs are able to implement each client's individual treatment plan;<br/>
<a id="pl.20.11"></a><var>20.11</var>    (3) a day treatment program is provided to a group of clients by a multidisciplinary <br/>
<a id="pl.20.12"></a><var>20.12</var>team under the clinical supervision of a mental health professional. The day treatment <br/>
<a id="pl.20.13"></a><var>20.13</var>program must be provided in and by: (i) an outpatient hospital accredited by the Joint <br/>
<a id="pl.20.14"></a><var>20.14</var>Commission on Accreditation of Health Organizations and licensed under sections 
         <statute_ref>144.50</statute_ref> <br/>
<a id="pl.20.15"></a><var>20.15</var>to 
         <statute_ref>144.55</statute_ref>; (ii) a community mental health center under section 
         <statute_ref>245.62</statute_ref>; and or (iii) an <br/>
<a id="pl.20.16"></a><var>20.16</var>entity that is under contract with the county board to operate a program that meets the <br/>
<a id="pl.20.17"></a><var>20.17</var>requirements of sections 
         <statute_ref>245.4712, subdivision 2</statute_ref>, and or 
<statute_ref>245.4884, subdivision 2</statute_ref>, and <br/>
<a id="pl.20.18"></a><var>20.18</var>Minnesota Rules, parts 9505.0170 to 9505.0475. The day treatment program must <br/>
<a id="pl.20.19"></a><var>20.19</var>stabilize the client's mental health status while developing and improving the client's <br/>
<a id="pl.20.20"></a><var>20.20</var>independent living and socialization skills. The goal of the day treatment program must <br/>
<a id="pl.20.21"></a><var>20.21</var>be to reduce or relieve the effects of mental illness and provide training to enable the <br/>
<a id="pl.20.22"></a><var>20.22</var>client to live in the community. The program must be available at least one day a week <br/>
<a id="pl.20.23"></a><var>20.23</var>for a three-hour two-hour time block. The three-hour two-hour time block must include <br/>
<a id="pl.20.24"></a><var>20.24</var>at least one hour, but no more than two hours, of individual or group psychotherapy. <br/>
<a id="pl.20.25"></a><var>20.25</var>The remainder of the three-hour time block may include recreation therapy, socialization <br/>
<a id="pl.20.26"></a><var>20.26</var>therapy, or independent living skills therapy, but only if the therapies are included in the <br/>
<a id="pl.20.27"></a><var>20.27</var>client's individual treatment plan. The remainder of the structured treatment program <br/>
<a id="pl.20.28"></a><var>20.28</var>may include individual or group psychotherapy and individual or group skills training, if <br/>
<a id="pl.20.29"></a><var>20.29</var>included in the client's individual treatment plan. Day treatment programs are not part of <br/>
<a id="pl.20.30"></a><var>20.30</var>inpatient or residential treatment services. A day treatment program may provide fewer <br/>
<a id="pl.20.31"></a><var>20.31</var>than the minimally required hours for a particular child during a billing period in which <br/>
<a id="pl.20.32"></a><var>20.32</var>the child is transitioning into, or out of, the program; and<br/>
<a id="pl.20.33"></a><var>20.33</var>    (4) a therapeutic preschool program is a structured treatment program offered <br/>
<a id="pl.20.34"></a><var>20.34</var>to a child who is at least 33 months old, but who has not yet reached the first day of <br/>
<a id="pl.20.35"></a><var>20.35</var>kindergarten, by a preschool multidisciplinary team in a day program licensed under <br/>
<a id="pl.20.36"></a><var>20.36</var>Minnesota Rules, parts 9503.0005 to 9503.0175. The program must be available at <br/>
<a id="pl.21.1"></a><var>21.1</var>least one day a week for a minimum two-hour time block two hours per day, five days <br/>
<a id="pl.21.2"></a><var>21.2</var>per week, and 12 months of each calendar year. The structured treatment program may <br/>
<a id="pl.21.3"></a><var>21.3</var>include individual or group psychotherapy and recreation therapy, socialization therapy, <br/>
<a id="pl.21.4"></a><var>21.4</var>or independent living skills therapy individual or group skills training, if included in the <br/>
<a id="pl.21.5"></a><var>21.5</var>client's individual treatment plan. A therapeutic preschool program may provide fewer <br/>
<a id="pl.21.6"></a><var>21.6</var>than the minimally required hours for a particular child during a billing period in which <br/>
<a id="pl.21.7"></a><var>21.7</var>the child is transitioning into, or out of, the program.<br/>
<a id="pl.21.8"></a><var>21.8</var>    (b) A provider entity must deliver the service components of children's therapeutic <br/>
<a id="pl.21.9"></a><var>21.9</var>services and supports in compliance with the following requirements:<br/>
<a id="pl.21.10"></a><var>21.10</var>    (1) individual, family, and group psychotherapy must be delivered as specified in <br/>
<a id="pl.21.11"></a><var>21.11</var>Minnesota Rules, part 9505.0323;<br/>
<a id="pl.21.12"></a><var>21.12</var>    (2) individual, family, or group skills training must be provided by a mental health <br/>
<a id="pl.21.13"></a><var>21.13</var>professional or a mental health practitioner who has a consulting relationship with a <br/>
<a id="pl.21.14"></a><var>21.14</var>mental health professional who accepts full professional responsibility for the training;<br/>
<a id="pl.21.15"></a><var>21.15</var>    (3) crisis assistance must be time-limited and designed to resolve or stabilize crisis <br/>
<a id="pl.21.16"></a><var>21.16</var>through arrangements for direct intervention and support services to the child and the <br/>
<a id="pl.21.17"></a><var>21.17</var>child's family. Crisis assistance must utilize resources designed to address abrupt or <br/>
<a id="pl.21.18"></a><var>21.18</var>substantial changes in the functioning of the child or the child's family as evidenced by <br/>
<a id="pl.21.19"></a><var>21.19</var>a sudden change in behavior with negative consequences for well being, a loss of usual <br/>
<a id="pl.21.20"></a><var>21.20</var>coping mechanisms, or the presentation of danger to self or others;<br/>
<a id="pl.21.21"></a><var>21.21</var>    (4) mental health behavioral aide services must be medically necessary services that <br/>
<a id="pl.21.22"></a><var>21.22</var>are provided by a mental health behavioral aide must be treatment services, identified in <br/>
<a id="pl.21.23"></a><var>21.23</var>the child's individual treatment plan and individual behavior plan, which are performed <br/>
<a id="pl.21.24"></a><var>21.24</var>minimally by a paraprofessional qualified according to subdivision 7, paragraph (b), <br/>
<a id="pl.21.25"></a><var>21.25</var>clause (3), and which are designed to improve the functioning of the child and support <br/>
<a id="pl.21.26"></a><var>21.26</var>the family in activities of daily and community living. in the progressive use of <br/>
<a id="pl.21.27"></a><var>21.27</var>developmentally appropriate psychosocial skills. Activities involve working directly with <br/>
<a id="pl.21.28"></a><var>21.28</var>the child, child-peer groupings, or child-family groupings to practice, repeat, reintroduce, <br/>
<a id="pl.21.29"></a><var>21.29</var>and master the skills defined in subdivision 1, paragraph (p), as previously taught by a <br/>
<a id="pl.21.30"></a><var>21.30</var>mental health professional or mental health practitioner including:<br/>
<a id="pl.21.31"></a><var>21.31</var>(i) providing cues or prompts in skill-building peer-to-peer or parent-child <br/>
<a id="pl.21.32"></a><var>21.32</var>interactions so that the child progressively recognizes and responds to the cues <br/>
<a id="pl.21.33"></a><var>21.33</var>independently;<br/>
<a id="pl.21.34"></a><var>21.34</var>(ii) performing as a practice partner or role-play partner;<br/>
<a id="pl.21.35"></a><var>21.35</var>(iii) reinforcing the child's accomplishments;<br/>
<a id="pl.21.36"></a><var>21.36</var>(iv) generalizing skill-building activities in the child's multiple natural settings;<br/>
<a id="pl.22.1"></a><var>22.1</var>(v) assigning further practice activities; and<br/>
<a id="pl.22.2"></a><var>22.2</var>(vi) intervening as necessary to redirect the child's target behavior and to de-escalate <br/>
<a id="pl.22.3"></a><var>22.3</var>behavior that puts the child or other person at risk of injury.<br/>
<a id="pl.22.4"></a><var>22.4</var>A mental health behavioral aide must document the delivery of services in written progress <br/>
<a id="pl.22.5"></a><var>22.5</var>notes. The mental health behavioral aide must implement goals in the treatment plan for <br/>
<a id="pl.22.6"></a><var>22.6</var>the child's emotional disturbance that allow the child to acquire developmentally and <br/>
<a id="pl.22.7"></a><var>22.7</var>therapeutically appropriate daily living skills, social skills, and leisure and recreational <br/>
<a id="pl.22.8"></a><var>22.8</var>skills through targeted activities. These activities may include:<br/>
<a id="pl.22.9"></a><var>22.9</var>    (i) assisting a child as needed with skills development in dressing, eating, and <br/>
<a id="pl.22.10"></a><var>22.10</var>toileting;<br/>
<a id="pl.22.11"></a><var>22.11</var>    (ii) assisting, monitoring, and guiding the child to complete tasks, including <br/>
<a id="pl.22.12"></a><var>22.12</var>facilitating the child's participation in medical appointments;<br/>
<a id="pl.22.13"></a><var>22.13</var>    (iii) observing the child and intervening to redirect the child's inappropriate behavior;<br/>
<a id="pl.22.14"></a><var>22.14</var>    (iv) assisting the child in using age-appropriate self-management skills as related <br/>
<a id="pl.22.15"></a><var>22.15</var>to the child's emotional disorder or mental illness, including problem solving, decision <br/>
<a id="pl.22.16"></a><var>22.16</var>making, communication, conflict resolution, anger management, social skills, and <br/>
<a id="pl.22.17"></a><var>22.17</var>recreational skills;<br/>
<a id="pl.22.18"></a><var>22.18</var>    (v) implementing deescalation techniques as recommended by the mental health <br/>
<a id="pl.22.19"></a><var>22.19</var>professional;<br/>
<a id="pl.22.20"></a><var>22.20</var>    (vi) implementing any other mental health service that the mental health professional <br/>
<a id="pl.22.21"></a><var>22.21</var>has approved as being within the scope of the behavioral aide's duties; or<br/>
<a id="pl.22.22"></a><var>22.22</var>    (vii) assisting the parents to develop and use parenting skills that help the child <br/>
<a id="pl.22.23"></a><var>22.23</var>achieve the goals outlined in the child's individual treatment plan or individual behavioral <br/>
<a id="pl.22.24"></a><var>22.24</var>plan. Parenting skills must be directed exclusively to the child's treatment treatment <br/>
<a id="pl.22.25"></a><var>22.25</var>strategies in the individual treatment plan and the individual behavior plan. The mental <br/>
<a id="pl.22.26"></a><var>22.26</var>health behavioral aide must document the delivery of services in written progress notes. <br/>
<a id="pl.22.27"></a><var>22.27</var>Progress notes must reflect implementation of the treatment strategies, as performed by <br/>
<a id="pl.22.28"></a><var>22.28</var>the mental health behavioral aide and the child's responses to the treatment strategies; and<br/>
<a id="pl.22.29"></a><var>22.29</var>    (5) direction of a mental health behavioral aide must include the following:<br/>
<a id="pl.22.30"></a><var>22.30</var>    (i) a total of one hour of on-site observation by a mental health professional during <br/>
<a id="pl.22.31"></a><var>22.31</var>the first 12 hours of service provided to a child;<br/>
<a id="pl.22.32"></a><var>22.32</var>    (ii) ongoing on-site observation by a mental health professional or mental health <br/>
<a id="pl.22.33"></a><var>22.33</var>practitioner for at least a total of one hour during every 40 hours of service provided <br/>
<a id="pl.22.34"></a><var>22.34</var>to a child; and<br/>
<a id="pl.22.35"></a><var>22.35</var>    (iii) immediate accessibility of the mental health professional or mental health <br/>
<a id="pl.22.36"></a><var>22.36</var>practitioner to the mental health behavioral aide during service provision.<br/>
<br/>
<a id="bill.0.18.0"></a><a id="pl.23.1"></a><var>23.1</var>    Sec. 18. Minnesota Statutes 2008, section 256B.0944, subdivision 5, is amended to <br/>
<a id="pl.23.2"></a><var>23.2</var>read:<br/>
<a id="pl.23.3"></a><var>23.3</var>    Subd. 5. <b>Mobile crisis intervention staff qualifications.</b> (a) To provide children's <br/>
<a id="pl.23.4"></a><var>23.4</var>mental health mobile crisis intervention services, a mobile crisis intervention team must <br/>
<a id="pl.23.5"></a><var>23.5</var>include:<br/>
<a id="pl.23.6"></a><var>23.6</var>(1) at least two mental health professionals as defined in section 
         <statute_ref>256B.0943, <br/>
<a id="pl.23.7"></a><var>23.7</var>subdivision 1
         </statute_ref>, paragraph (m) (n); or <br/>
<a id="pl.23.8"></a><var>23.8</var>(2) a combination of at least one mental health professional and one mental health <br/>
<a id="pl.23.9"></a><var>23.9</var>practitioner as defined in section 
         <statute_ref>245.4871, subdivision 26</statute_ref>, with the required mental <br/>
<a id="pl.23.10"></a><var>23.10</var>health crisis training and under the clinical supervision of a mental health professional on <br/>
<a id="pl.23.11"></a><var>23.11</var>the team. <br/>
<a id="pl.23.12"></a><var>23.12</var>(b) The team must have at least two people with at least one member providing <br/>
<a id="pl.23.13"></a><var>23.13</var>on-site crisis intervention services when needed. Team members must be experienced in <br/>
<a id="pl.23.14"></a><var>23.14</var>mental health assessment, crisis intervention techniques, and clinical decision making <br/>
<a id="pl.23.15"></a><var>23.15</var>under emergency conditions and have knowledge of local services and resources. The <br/>
<a id="pl.23.16"></a><var>23.16</var>team must recommend and coordinate the team's services with appropriate local resources, <br/>
<a id="pl.23.17"></a><var>23.17</var>including the county social services agency, mental health service providers, and local law <br/>
<a id="pl.23.18"></a><var>23.18</var>enforcement, if necessary.<br/>
<br/>
<a id="bill.0.19.0"></a><a id="pl.23.19"></a><var>23.19</var>    Sec. 19. <b>RATE SETTING.</b><br/>
<a id="pl.23.20"></a><var>23.20</var>The commissioner shall implement a new statewide rate setting methodology for <br/>
<a id="pl.23.21"></a><var>23.21</var>intensive residential and nonresidential mental health services starting January 1, 2010. <br/>
<a id="pl.23.22"></a><var>23.22</var>The new rate setting methodology shall be fiscally neutral and consistent with federal and <br/>
<a id="pl.23.23"></a><var>23.23</var>state Medicaid rules, regulations, procedures, and practices.<br/>
<a id="pl.23.24"></a><var>23.24</var><b>EFFECTIVE DATE.</b>This section is effective for services provided on or after <br/>
<a id="pl.23.25"></a><var>23.25</var>January 1, 2010, and does not change contracts or agreements relating to services provided <br/>
<a id="pl.23.26"></a><var>23.26</var>before January 1, 2010.<br/>