1.1 	A bill for an act
1.2 	relating to human services; modifying certain certified community behavioral 
1.3 	health clinic requirements;amending Minnesota Statutes 2015 Supplement, 
1.4 	section 245.735, subdivisions 3, 4.
1.5 	BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF MINNESOTA:

1.6 	Section 1. Minnesota Statutes 2015 Supplement, section 245.735, subdivision 3, 
1.7 	is amended to read:
1.8 		Subd. 3.Reform projects Certified community behavioral health clinics. (a) The 
1.9 	commissioner shall establish standards for a state certification of clinics as process for 
1.10 	certified community behavioral health clinics, in accordance (CCBHCs) to be eligible for 
1.11 	the prospective payment system in paragraph (f). Entities that choose to be CCBHCs must:
1.12 	(1) comply with the CCBHC criteria published on or before September 1, 2015, by 
1.13 	the United States Department of Health and Human Services. Certification standards 
1.14 	established by the commissioner shall require that:;
1.15 	(1) (2) employ or contract for clinic staff who have backgrounds in diverse 
1.16 	disciplines, include including licensed mental health professionals, and staff who are 
1.17 	culturally and linguistically trained to serve the needs of the clinic's patient population;
1.18 	(2) (3) ensure that clinic services are available and accessible to patients of all ages 
1.19 	and genders and that crisis management services are available 24 hours per day;
1.20 	(3) (4) establish fees for clinic services are established for non-medical assistance 
1.21 	patients using a sliding fee scale and that ensures that services to patients are not denied 
1.22 	or limited due to a patient's inability to pay for services;
1.23 	(4) clinics provide coordination of care across settings and providers to ensure 
1.24 	seamless transitions for patients across the full spectrum of health services, including 
2.1 	acute, chronic, and behavioral needs. Care coordination may be accomplished through 
2.2 	partnerships or formal contracts with federally qualified health centers, inpatient 
2.3 	psychiatric facilities, substance use and detoxification facilities, community-based mental 
2.4 	health providers, and other community services, supports, and providers including 
2.5 	schools, child welfare agencies, juvenile and criminal justice agencies, Indian Health 
2.6 	Services clinics, tribally licensed health care and mental health facilities, urban Indian 
2.7 	health clinics, Department of Veterans Affairs medical centers, outpatient clinics, drop-in 
2.8 	centers, acute care hospitals, and hospital outpatient clinics; (5) comply with quality 
2.9 	assurance reporting requirements and other reporting requirements, including any required 
2.10 	reporting of encounter data, clinical outcomes data, and quality data;
2.11 	(5) services provided by clinics include (6) provide crisis mental health services, 
2.12 	withdrawal management services, emergency crisis intervention services, and stabilization 
2.13 	services; screening, assessment, and diagnosis services, including risk assessments and 
2.14 	level of care determinations; patient-centered treatment planning; outpatient mental 
2.15 	health and substance use services; targeted case management; psychiatric rehabilitation 
2.16 	services; peer support and counselor services and family support services; and intensive 
2.17 	community-based mental health services, including mental health services for members of 
2.18 	the armed forces and veterans; and
2.19 	(6) clinics comply with quality assurance reporting requirements and other reporting 
2.20 	requirements, including any required reporting of encounter data, clinical outcomes data, 
2.21 	and quality data. (7) provide coordination of care across settings and providers to ensure 
2.22 	seamless transitions for patients across the full spectrum of health services, including 
2.23 	acute, chronic, and behavioral needs. Care coordination may be accomplished through 
2.24 	partnerships or formal contracts with:
2.25 	(i) counties, health plans, pharmacists, pharmacies, rural health clinics, federally 
2.26 	qualified health centers, inpatient psychiatric facilities, substance use and detoxification 
2.27 	facilities, community-based mental health providers; and
2.28 	(ii) other community services, supports, and providers, including schools, child 
2.29 	welfare agencies, juvenile and criminal justice agencies, Indian health services clinics, 
2.30 	tribally licensed health care and mental health facilities, urban Indian health clinics, 
2.31 	Department of Veterans Affairs medical centers, outpatient clinics, drop-in centers, acute 
2.32 	care hospitals, and hospital outpatient clinics;
2.33 	(8) be certified as mental health clinics under section 245.69, subdivision 2;
2.34 	(9) comply with standards relating to integrated treatment for co-occurring mental 
2.35 	illness and substance use disorders in adults or children under Minnesota Rules, chapter 
2.36 	9533;
3.1 	(10) comply with standards relating to mental health services in Minnesota Rules, 
3.2 	parts 9505.0370 to 9505.0372;
3.3 	(11) be licensed to provide chemical dependency treatment under Minnesota Rules, 
3.4 	parts 9530.6405 to 9530.6505;
3.5 	(12) be certified to provide children's therapeutic services and supports under 
3.6 	section 256B.0943;
3.7 	(13) be certified to provide adult rehabilitative mental health services under section 
3.8 	256B.0623;
3.9 	(14) be enrolled to provide mental health crisis response services under section 
3.10 	256B.0624;
3.11 	(15) be enrolled to provide mental health targeted case management under section 
3.12 	256B.0625, subdivision 20;
3.13 	(16) comply with standards relating to mental health case management in Minnesota 
3.14 	Rules, parts 9520.0900 to 9520.0926; and
3.15 	(17) provide services that comply with the evidence-based practices described in 
3.16 	paragraph (e).
3.17 	(b) If an entity is unable to provide one or more of the services listed in paragraph 
3.18 	(a), clauses (6) to (17), the commissioner may certify the entity as a CCBHC if it has a 
3.19 	current contract with another entity that has the required authority to provide that service 
3.20 	and that meets federal CCBHC criteria as a designated collaborating organization; or, to 
3.21 	the extent allowed by the federal CCBHC criteria, the commissioner may approve a 
3.22 	referral arrangement. The CCBHC must meet federal requirements regarding the type and 
3.23 	scope of services to be provided directly by the CCBHC.
3.24 	(c) Notwithstanding other law that requires a county contract or other form of county 
3.25 	approval for certain services listed in paragraph (a), clause (6), a clinic that otherwise 
3.26 	meets CCBHC requirements may receive the prospective payment under paragraph (f) 
3.27 	for those services without a county contract or county approval. There is no county 
3.28 	share when medical assistance pays the CCBHC prospective payment. As part of the 
3.29 	certification process in paragraph (a), the commissioner shall require a letter of support 
3.30 	from the CCBHC's host county confirming that the CCBHC and the county or counties it 
3.31 	serves have an ongoing relationship to facilitate access and continuity of care, especially 
3.32 	for individuals who are uninsured or who may go on and off medical assistance.
3.33 	(d) When the standards listed in paragraph (a) or other applicable standards 
3.34 	conflict or address similar issues in duplicative or incompatible ways, the commissioner 
3.35 	may grant variances to state requirements if the variances do not conflict with federal 
3.36 	requirements. If standards overlap, the commissioner may substitute all or a part of a 
4.1 	licensure or certification that is substantially the same as another licensure or certification. 
4.2 	The commissioner shall consult with stakeholders, as described in subdivision 4, before 
4.3 	granting variances under this provision.
4.4 	(e) The commissioner shall issue a list of required evidence-based practices to be 
4.5 	delivered by certified community behavioral health clinics, and may also provide a list 
4.6 	of recommended evidence-based practices. The commissioner may update the list to 
4.7 	reflect advances in outcomes research and medical services for persons living with mental 
4.8 	illnesses or substance use disorders. The commissioner shall take into consideration the 
4.9 	adequacy of evidence to support the efficacy of the practice, the quality of workforce 
4.10 	available, and the current availability of the practice in the state. At least 30 days before 
4.11 	issuing the initial list and any revisions, the commissioner shall provide stakeholders 
4.12 	with an opportunity to comment.
4.13 	(b) (f) The commissioner shall establish standards and methodologies for a 
4.14 	prospective payment system for medical assistance payments for mental health services 
4.15 	delivered by certified community behavioral health clinics, in accordance with guidance 
4.16 	issued on or before September 1, 2015, by the Centers for Medicare and Medicaid 
4.17 	Services. During the operation of the demonstration project, payments shall comply with 
4.18 	federal requirements for a 90 percent an enhanced federal medical assistance percentage. 
4.19 	The commissioner may include quality bonus payments in the prospective payment 
4.20 	system based on federal criteria and on a clinic's provision of the evidence-based practices 
4.21 	in paragraph (e). The prospective payments system does not apply to MinnesotaCare. 
4.22 	Implementation of the prospective payment system is effective July 1, 2017, or upon 
4.23 	federal approval, whichever is later.
4.24 	(g) The commissioner shall seek federal approval to continue federal financial 
4.25 	participation in payment for CCBHC services after the federal demonstration period 
4.26 	ends for clinics that were certified as CCBHCs during the demonstration period and 
4.27 	that continue to meet the CCBHC certification standards in paragraph (a). Payment 
4.28 	for CCBHC services shall cease effective July 1, 2019, if continued federal financial 
4.29 	participation for the payment of CCBHC services cannot be obtained.
4.30 	(h) To the extent allowed by federal law, the commissioner may limit the number of 
4.31 	certified clinics so that the projected claims for certified clinics will not exceed the funds 
4.32 	budgeted for this purpose. The commissioner shall give preference to clinics that:
4.33 	(1) are located in both rural and urban areas, with at least one in each, as defined 
4.34 	by federal criteria;
4.35 	(2) provide a comprehensive range of services and evidence-based practices for all 
4.36 	age groups, with services being fully coordinated and integrated; and
5.1 	(3) enhance the state's ability to meet the federal priorities to be selected as a 
5.2 	CCBHC demonstration state.
5.3 	(i) The commissioner shall recertify CCBHCs at least every three years. The 
5.4 	commissioner shall establish a process for decertification and shall require corrective 
5.5 	action, medical assistance repayment, or decertification of a CCBHC that no longer 
5.6 	meets the requirements in this section or that fails to meet the standards provided by the 
5.7 	commissioner in the application and certification process.

5.8 	EFFECTIVE DATE. This section is effective the day following final enactment.

5.9 	Sec. 2. Minnesota Statutes 2015 Supplement, section 245.735, subdivision 4, is 
5.10 	amended to read:
5.11 		Subd. 4.Public participation. In developing the projects and implementing 
5.12 	certified community behavioral health clinics under subdivision 3, the commissioner shall 
5.13 	consult, collaborate, and partner with stakeholders, including but not limited to mental 
5.14 	health providers, substance use disorder treatment providers, advocacy organizations, 
5.15 	licensed mental health professionals, counties, tribes, hospitals, other health care 
5.16 	providers, and Minnesota public health care program enrollees who receive mental health 
5.17 	services and their families.

5.18 	EFFECTIVE DATE. This section is effective the day following final enactment.