1.1 	A bill for an act
1.2 	relating to mental health; modifying the definition of mental illness; making changes 
1.3 	to medical assistance transportation reimbursement rates; establishing a grant 
1.4 	program for children at risk of bipolar disorder; requiring a report; appropriating 
1.5 	money for the children's first episode of psychosis program;amending Minnesota 
1.6 	Statutes 2024, sections 62A.673, subdivision 2; 245.462, subdivision 20; 
1.7 	256B.0625, subdivision 17.
1.8 	BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF MINNESOTA:

1.9 	Section 1. Minnesota Statutes 2024, section 62A.673, subdivision 2, is amended to read:
1.10 		Subd. 2.Definitions. (a) For purposes of this section, the terms defined in this subdivision 
1.11 	have the meanings given.
1.12 	(b) "Distant site" means a site at which a health care provider is located while providing 
1.13 	health care services or consultations by means of telehealth.
1.14 	(c) "Health care provider" means a health care professional who is licensed or registered 
1.15 	by the state to perform health care services within the provider's scope of practice and in 
1.16 	accordance with state law. A health care provider includes a mental health professional 
1.17 	under section 245I.04, subdivision 2; a mental health practitioner under section 245I.04, 
1.18 	subdivision 4; a clinical trainee under section 245I.04, subdivision 6; a treatment coordinator 
1.19 	under section 245G.11, subdivision 7; an alcohol and drug counselor under section 245G.11, 
1.20 	subdivision 5; and a recovery peer under section 245G.11, subdivision 8.
1.21 	(d) "Health carrier" has the meaning given in section 62A.011, subdivision 2.
1.22 	(e) "Health plan" has the meaning given in section 62A.011, subdivision 3. Health plan 
1.23 	includes dental plans as defined in section 62Q.76, subdivision 3, but does not include dental 
2.1 	plans that provide indemnity-based benefits, regardless of expenses incurred, and are designed 
2.2 	to pay benefits directly to the policy holder.
2.3 	(f) "Originating site" means a site at which a patient is located at the time health care 
2.4 	services are provided to the patient by means of telehealth. For purposes of store-and-forward 
2.5 	technology, the originating site also means the location at which a health care provider 
2.6 	transfers or transmits information to the distant site.
2.7 	(g) "Store-and-forward technology" means the asynchronous electronic transfer or 
2.8 	transmission of a patient's medical information or data from an originating site to a distant 
2.9 	site for the purposes of diagnostic and therapeutic assistance in the care of a patient.
2.10 	(h) "Telehealth" means the delivery of health care services or consultations through the 
2.11 	use of real time two-way interactive audio and visual communications to provide or support 
2.12 	health care delivery and facilitate the assessment, diagnosis, consultation, treatment, 
2.13 	education, and care management of a patient's health care. Telehealth includes the application 
2.14 	of secure video conferencing, store-and-forward technology, and synchronous interactions 
2.15 	between a patient located at an originating site and a health care provider located at a distant 
2.16 	site. Until July 1, 2025, Telehealth also includes audio-only communication between a 
2.17 	health care provider and a patient in accordance with subdivision 6, paragraph (b). Telehealth 
2.18 	does not include communication between health care providers that consists solely of a 
2.19 	telephone conversation, email, or facsimile transmission. Telehealth does not include 
2.20 	communication between a health care provider and a patient that consists solely of an email 
2.21 	or facsimile transmission. Telehealth does not include telemonitoring services as defined 
2.22 	in paragraph (i).
2.23 	(i) "Telemonitoring services" means the remote monitoring of clinical data related to 
2.24 	the enrollee's vital signs or biometric data by a monitoring device or equipment that transmits 
2.25 	the data electronically to a health care provider for analysis. Telemonitoring is intended to 
2.26 	collect an enrollee's health-related data for the purpose of assisting a health care provider 
2.27 	in assessing and monitoring the enrollee's medical condition or status.

2.28 	Sec. 2. Minnesota Statutes 2024, section 245.462, subdivision 20, is amended to read:
2.29 		Subd. 20.Mental illness. (a) "Mental illness" means an organic disorder of the brain or 
2.30 	a clinically significant disorder of thought, mood, perception, orientation, memory, or 
2.31 	behavior that is detailed in a diagnostic codes list published by the commissioner, and that 
2.32 	seriously limits a person's capacity to function in primary aspects of daily living such as 
2.33 	personal relations, living arrangements, work, and recreation.
3.1 	(b) An "adult with acute mental illness" means an adult who has a mental illness that is 
3.2 	serious enough to require prompt intervention.
3.3 	(c) For purposes of enrolling in case management and community support services, a 
3.4 	"person with serious and persistent mental illness" means an adult who has a mental illness 
3.5 	and meets at least one of the following criteria:
3.6 	(1) the adult has undergone two one or more episodes of inpatient, residential, or crisis 
3.7 	residential care for a mental illness within the preceding 24 12 months;
3.8 	(2) the adult has experienced a continuous psychiatric hospitalization or residential 
3.9 	treatment exceeding six months' duration within the preceding 12 months;
3.10 	(3) the adult has been treated by a crisis team two or more times within the preceding 
3.11 	24 months;
3.12 	(4) the adult:
3.13 	(i) has a diagnosis of schizophrenia, bipolar disorder, major depression, schizoaffective 
3.14 	disorder, posttraumatic stress disorder, generalized anxiety disorder, panic disorder, eating 
3.15 	disorder, or borderline personality disorder;
3.16 	(ii) indicates a significant impairment in functioning; and
3.17 	(iii) has a written opinion from a mental health professional, in the last three years, 
3.18 	stating that the adult is reasonably likely to have future episodes requiring inpatient or 
3.19 	residential treatment, of a frequency described in clause (1) or (2), or the need for in-home 
3.20 	services to remain in one's home, unless ongoing case management or community support 
3.21 	services are provided;
3.22 	(5) the adult has, in the last threefive years, been committed by a court as a person who 
3.23 	is mentally ill with a mental illness under chapter 253B, or the adult's commitment has been 
3.24 	stayed or continued; or
3.25 	(6) the adult (i) was eligible under clauses (1) to (5), but the specified time period has 
3.26 	expired or the adult was eligible as a child under section 245.4871, subdivision 6; and (ii) 
3.27 	has a written opinion from a mental health professional, in the last three years, stating that 
3.28 	the adult is reasonably likely to have future episodes requiring inpatient or residential 
3.29 	treatment, of a frequency described in clause (1) or (2), unless ongoing case management 
3.30 	or community support services are provided; or
3.31 	(7) (6) the adult was eligible as a child under section 245.4871, subdivision 6, and is 
3.32 	age 21 or younger.
4.1 	(d) Adults may continue to receive case management or community support services if, 
4.2 	in the written opinion of a mental health professional, the person needs case management 
4.3 	or community support services to maintain the person's recovery.

4.4 	Sec. 3. Minnesota Statutes 2024, section 256B.0625, subdivision 17, is amended to read:
4.5 		Subd. 17.Transportation costs. (a) "Nonemergency medical transportation service" 
4.6 	means motor vehicle transportation provided by a public or private person that serves 
4.7 	Minnesota health care program beneficiaries who do not require emergency ambulance 
4.8 	service, as defined in section 144E.001, subdivision 3, to obtain covered medical services.
4.9 	(b) For purposes of this subdivision, "rural urban commuting area" or "RUCA" means 
4.10 	a census-tract based classification system under which a geographical area is determined 
4.11 	to be urban, rural, or super rural.
4.12 	(c) Medical assistance covers medical transportation costs incurred solely for obtaining 
4.13 	emergency medical care or transportation costs incurred by eligible persons in obtaining 
4.14 	emergency or nonemergency medical care when paid directly to an ambulance company, 
4.15 	nonemergency medical transportation company, or other recognized providers of 
4.16 	transportation services. Medical transportation must be provided by:
4.17 	(1) nonemergency medical transportation providers who meet the requirements of this 
4.18 	subdivision;
4.19 	(2) ambulances, as defined in section 144E.001, subdivision 2;
4.20 	(3) taxicabs that meet the requirements of this subdivision;
4.21 	(4) public transportation, within the meaning of "public transportation" as defined in 
4.22 	section 174.22, subdivision 7; or
4.23 	(5) not-for-hire vehicles, including volunteer drivers, as defined in section 65B.472, 
4.24 	subdivision 1, paragraph (p).
4.25 	(d) Medical assistance covers nonemergency medical transportation provided by 
4.26 	nonemergency medical transportation providers enrolled in the Minnesota health care 
4.27 	programs. All nonemergency medical transportation providers must comply with the 
4.28 	operating standards for special transportation service as defined in sections 174.29 to 174.30 
4.29 	and Minnesota Rules, chapter 8840, and all drivers must be individually enrolled with the 
4.30 	commissioner and reported on the claim as the individual who provided the service. All 
4.31 	nonemergency medical transportation providers shall bill for nonemergency medical 
4.32 	transportation services in accordance with Minnesota health care programs criteria. Publicly 
5.1 	operated transit systems, volunteers, and not-for-hire vehicles are exempt from the 
5.2 	requirements outlined in this paragraph.
5.3 	(e) An organization may be terminated, denied, or suspended from enrollment if:
5.4 	(1) the provider has not initiated background studies on the individuals specified in 
5.5 	section 174.30, subdivision 10, paragraph (a), clauses (1) to (3); or
5.6 	(2) the provider has initiated background studies on the individuals specified in section 
5.7 	174.30, subdivision 10, paragraph (a), clauses (1) to (3), and:
5.8 	(i) the commissioner has sent the provider a notice that the individual has been 
5.9 	disqualified under section 245C.14; and
5.10 	(ii) the individual has not received a disqualification set-aside specific to the special 
5.11 	transportation services provider under sections 245C.22 and 245C.23.
5.12 	(f) The administrative agency of nonemergency medical transportation must:
5.13 	(1) adhere to the policies defined by the commissioner;
5.14 	(2) pay nonemergency medical transportation providers for services provided to 
5.15 	Minnesota health care programs beneficiaries to obtain covered medical services;
5.16 	(3) provide data monthly to the commissioner on appeals, complaints, no-shows, canceled 
5.17 	trips, and number of trips by mode; and
5.18 	(4) by July 1, 2016, in accordance with subdivision 18e, utilize a web-based single 
5.19 	administrative structure assessment tool that meets the technical requirements established 
5.20 	by the commissioner, reconciles trip information with claims being submitted by providers, 
5.21 	and ensures prompt payment for nonemergency medical transportation services.
5.22 	(g) Until the commissioner implements the single administrative structure and delivery 
5.23 	system under subdivision 18e, clients shall obtain their level-of-service certificate from the 
5.24 	commissioner or an entity approved by the commissioner that does not dispatch rides for 
5.25 	clients using modes of transportation under paragraph (l), clauses (4), (5), (6), and (7).
5.26 	(h) The commissioner may use an order by the recipient's attending physician, advanced 
5.27 	practice registered nurse, physician assistant, or a medical or mental health professional to 
5.28 	certify that the recipient requires nonemergency medical transportation services. 
5.29 	Nonemergency medical transportation providers shall perform driver-assisted services for 
5.30 	eligible individuals, when appropriate. Driver-assisted service includes passenger pickup 
5.31 	at and return to the individual's residence or place of business, assistance with admittance 
6.1 	of the individual to the medical facility, and assistance in passenger securement or in securing 
6.2 	of wheelchairs, child seats, or stretchers in the vehicle.
6.3 	(i) Nonemergency medical transportation providers must take clients to the health care 
6.4 	provider using the most direct route, and must not exceed 30 miles for a trip to a primary 
6.5 	care provider or 60 miles for a trip to a specialty care provider, unless the client receives 
6.6 	authorization from the local agency.
6.7 	(j) Nonemergency medical transportation providers may not bill for separate base rates 
6.8 	for the continuation of a trip beyond the original destination. Nonemergency medical 
6.9 	transportation providers must maintain trip logs, which include pickup and drop-off times, 
6.10 	signed by the medical provider or client, whichever is deemed most appropriate, attesting 
6.11 	to mileage traveled to obtain covered medical services. Clients requesting client mileage 
6.12 	reimbursement must sign the trip log attesting mileage traveled to obtain covered medical 
6.13 	services.
6.14 	(k) The administrative agency shall use the level of service process established by the 
6.15 	commissioner to determine the client's most appropriate mode of transportation. If public 
6.16 	transit or a certified transportation provider is not available to provide the appropriate service 
6.17 	mode for the client, the client may receive a onetime service upgrade.
6.18 	(l) The covered modes of transportation are:
6.19 	(1) client reimbursement, which includes client mileage reimbursement provided to 
6.20 	clients who have their own transportation, or to family or an acquaintance who provides 
6.21 	transportation to the client;
6.22 	(2) volunteer transport, which includes transportation by volunteers using their own 
6.23 	vehicle;
6.24 	(3) unassisted transport, which includes transportation provided to a client by a taxicab 
6.25 	or public transit. If a taxicab or public transit is not available, the client can receive 
6.26 	transportation from another nonemergency medical transportation provider;
6.27 	(4) assisted transport, which includes transport provided to clients who require assistance 
6.28 	by a nonemergency medical transportation provider;
6.29 	(5) lift-equipped/ramp transport, which includes transport provided to a client who is 
6.30 	dependent on a device and requires a nonemergency medical transportation provider with 
6.31 	a vehicle containing a lift or ramp;
6.32 	(6) protected transport, which includes transport provided to a client who has received 
6.33 	a prescreening that has deemed other forms of transportation inappropriate and who requires 
7.1 	a provider: (i) with a protected vehicle that is not an ambulance or police car and has safety 
7.2 	locks, a video recorder, and a transparent thermoplastic partition between the passenger and 
7.3 	the vehicle driver; and (ii) who is certified as a protected transport provider; and
7.4 	(7) stretcher transport, which includes transport for a client in a prone or supine position 
7.5 	and requires a nonemergency medical transportation provider with a vehicle that can transport 
7.6 	a client in a prone or supine position.
7.7 	(m) The local agency shall be the single administrative agency and shall administer and 
7.8 	reimburse for modes defined in paragraph (l) according to paragraphs (p) and (q) when the 
7.9 	commissioner has developed, made available, and funded the web-based single administrative 
7.10 	structure, assessment tool, and level of need assessment under subdivision 18e. The local 
7.11 	agency's financial obligation is limited to funds provided by the state or federal government.
7.12 	(n) The commissioner shall:
7.13 	(1) verify that the mode and use of nonemergency medical transportation is appropriate;
7.14 	(2) verify that the client is going to an approved medical appointment; and
7.15 	(3) investigate all complaints and appeals.
7.16 	(o) The administrative agency shall pay for the services provided in this subdivision and 
7.17 	seek reimbursement from the commissioner, if appropriate. As vendors of medical care, 
7.18 	local agencies are subject to the provisions in section 256B.041, the sanctions and monetary 
7.19 	recovery actions in section 256B.064, and Minnesota Rules, parts 9505.2160 to 9505.2245.
7.20 	(p) Payments for nonemergency medical transportation must be paid based on the client's 
7.21 	assessed mode under paragraph (k), not the type of vehicle used to provide the service. The 
7.22 	medical assistance reimbursement rates for nonemergency medical transportation services 
7.23 	that are payable by or on behalf of the commissioner for nonemergency medical 
7.24 	transportation services are:
7.25 	(1) $0.22 per mile for client reimbursement;
7.26 	(2) up to 100 percent of the Internal Revenue Service business deduction rate for volunteer 
7.27 	transport;
7.28 	(3) equivalent to the standard fare for unassisted transport when provided by public 
7.29 	transit, and $12.10 for the base rate and $1.43 per mile when provided by a nonemergency 
7.30 	medical transportation provider;
7.31 	(4) $14.30 for the base rate and $1.43 per mile for assisted transport;
7.32 	(5) $19.80 for the base rate and $1.70 per mile for lift-equipped/ramp transport;
8.1 	(6) $75 for the base rate for the first 100 miles and an additional $75 for trips over 100 
8.2 	miles and $2.40 per mile for protected transport; and
8.3 	(7) $60 for the base rate and $2.40 per mile for stretcher transport, and $9 per trip for 
8.4 	an additional attendant if deemed medically necessary.
8.5 	(q) The base rate for nonemergency medical transportation services in areas defined 
8.6 	under RUCA to be super rural is equal to 111.3 percent of the respective base rate in 
8.7 	paragraph (p), clauses (1) to (7). The mileage rate for nonemergency medical transportation 
8.8 	services in areas defined under RUCA to be rural or super rural areas is:
8.9 	(1) for a trip equal to 17 miles or less, equal to 125 percent of the respective mileage 
8.10 	rate in paragraph (p), clauses (1) to (7); and
8.11 	(2) for a trip between 18 and 50 miles, equal to 112.5 percent of the respective mileage 
8.12 	rate in paragraph (p), clauses (1) to (7).
8.13 	(r) For purposes of reimbursement rates for nonemergency medical transportation services 
8.14 	under paragraphs (p) and (q), the zip code of the recipient's place of residence shall determine 
8.15 	whether the urban, rural, or super rural reimbursement rate applies.
8.16 	(s) The commissioner, when determining reimbursement rates for nonemergency medical 
8.17 	transportation under paragraphs (p) and (q), shall exempt all modes of transportation listed 
8.18 	under paragraph (l) from Minnesota Rules, part 9505.0445, item R, subitem (2).
8.19 	(t) Effective for the first day of each calendar quarter in which the price of gasoline as 
8.20 	posted publicly by the United States Energy Information Administration exceeds $3.00 per 
8.21 	gallon, the commissioner shall adjust the rate paid per mile in paragraph (p) by one percent 
8.22 	up or down for every increase or decrease of ten cents for the price of gasoline. The increase 
8.23 	or decrease must be calculated using a base gasoline price of $3.00. The percentage increase 
8.24 	or decrease must be calculated using the average of the most recently available price of all 
8.25 	grades of gasoline for Minnesota as posted publicly by the United States Energy Information 
8.26 	Administration.

8.27 	Sec. 4. EARLY EPISODE OF BIPOLAR DISORDER GRANT PROGRAM.
 8.28 		Subdivision 1.Creation. The early episode of bipolar disorder grant program is 
8.29 	established in the Department of Human Services to fund evidence-based interventions for 
8.30 	youth and young adults at risk of developing or experiencing an early episode of bipolar 
8.31 	disorder. Early episode of bipolar disorder services are eligible for children's mental health 
8.32 	grants as specified in Minnesota Statutes, section 245.4889, subdivision 1, paragraph (b), 
9.1 	clause (15). The Department of Human Services shall seek to establish programs around 
9.2 	Minnesota.
9.3 		Subd. 2.Activities. (a) All grant programs must:
9.4 	(1) provide intensive treatment and support for adolescents and young adults experiencing 
9.5 	or at risk of experiencing early episodes of bipolar disorder. Intensive treatment and support 
9.6 	includes medication management, psychoeducation for an individual and an individual's 
9.7 	family, case management, employment support, education support, cognitive behavioral 
9.8 	approaches, social skills training, peer and family peer support, crisis planning, and stress 
9.9 	management;
9.10 	(2) conduct outreach and provide training and guidance to mental health and health care 
9.11 	professionals, including postsecondary health clinicians, on bipolar disorder symptoms, 
9.12 	screening tools, the grant program, and best practices; and
9.13 	(3) use all available funding streams.
9.14 	(b) Grant money may also be used to pay for housing or travel expenses for individuals 
9.15 	receiving services or to address other barriers preventing individuals and their families from 
9.16 	participating in early episode of bipolar disorder services.
9.17 		Subd. 3.Eligibility. Program activities must be provided to people 15 to 40 years old 
9.18 	with early signs of or experiencing bipolar disorder.
9.19 		Subd. 4.Outcomes. Evaluation of program activities must utilize evidence-based 
9.20 	practices and must include the following outcome evaluation criteria:
9.21 	(1) whether individuals experience a reduction in symptoms;
9.22 	(2) whether individuals experience a decrease in inpatient mental health hospitalizations 
9.23 	or interactions with the criminal justice system; and
9.24 	(3) whether individuals experience an increase in educational attainment or employment.
9.25 		Subd. 5.Federal aid or grants. The commissioner of human services must comply with 
9.26 	all conditions and requirements necessary to receive federal aid or grants. The Department 
9.27 	of Human Services must provide a yearly report to the chairs of the senate Finance Committee 
9.28 	and house of representatives Ways and Means Committee detailing the use of state and 
9.29 	federal funds, number of programs funded, number of people served, and evaluation data.

10.1 	Sec. 5. CHILDREN'S FIRST EPISODE OF PSYCHOSIS.
 10.2 	$....... in fiscal year 2026 and $....... in fiscal year 2027 are appropriated from the general 
10.3 	fund to the commissioner of human services to implement a first episode of psychosis grant 
10.4 	under Minnesota Statutes, section 245.4905. This amount is added to the base. New money 
10.5 	may be used to fully fund current programs, increase a current program's capacity, and 
10.6 	expand programs to outside the metropolitan counties. The commissioner of human services 
10.7 	must continue to fund current programs to ensure stability and continuity of care, providing 
10.8 	that the program has met requirements for past usage of funds.