HF 2416

Introduction - 94th Legislature (2025 - 2026)

Posted on 03/17/2025 02:59 p.m.

A bill for an act
relating to direct care and treatment; modifying county cost of care provisions;
modifying required admission timelines; requiring a report; appropriating money;
amending Minnesota Statutes 2024, sections 246.54, subdivisions 1a, 1b; 246C.07,
by adding a subdivision; 253B.10, subdivision 1; proposing coding for new law
in Minnesota Statutes, chapter 253B.

BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF MINNESOTA:

Section 1.

Minnesota Statutes 2024, section 246.54, subdivision 1a, is amended to read:

Subd. 1a.

Anoka-Metro Regional Treatment Center.

(a) A county's payment of the
cost of care provided at Anoka-Metro Regional Treatment Center shall be according to the
following schedule:

(1) zero percent for the first 30 days;

(2) 20 percent for days 31 and over if the stay is determined to be clinically appropriate
for the client; and

(3) 100 percent for each day during the stay, including the day of admission, when the
facility determines that it is clinically appropriate for the client to be discharged new text begin , except as
provided in paragraph (c) new text end .

(b) If payments received by the state under sections 246.50 to 246.53 exceed 80 percent
of the cost of care for days over 31 for clients who meet the criteria in paragraph (a), clause
(2), the county shall be responsible for paying the state only the remaining amount. The
county shall not be entitled to reimbursement from the client, the client's estate, or from the
client's relatives, except as provided in section 246.53.

deleted text begin (c) Between July 1, 2023, and March 31, 2025, the county is not responsible for the cost
of care under paragraph (a), clause (3), for a person who is committed as a person who has
a mental illness and is dangerous to the public under section 253B.18 and who is awaiting
transfer to another state-operated facility or program. This paragraph expires March 31,
2025.
deleted text end

deleted text begin (d) Between April 1, 2025, and June 30, 2025, deleted text end new text begin (c) new text end The county is not responsible for the
cost of care under paragraph (a), clause (3), for a person who is civilly committed, if the
client is awaiting transfer:

(1) to a facility operated by the Department of Corrections; or

(2) to another state-operated facility or program, and the Direct Care and Treatment
executive medical director's office or a designee has determined that:

(i) the client meets criteria for admission to that state-operated facility or program; and

(ii) the state-operated facility or program is the only facility or program that can
reasonably serve the client. deleted text begin This paragraph expires June 30, 2025.
deleted text end

deleted text begin (e) deleted text end new text begin (d) new text end Notwithstanding any law to the contrary, the client is not responsible for payment
of the cost of care under this subdivision.

new text begin EFFECTIVE DATE. new text end

new text begin This section is effective the day following final enactment.
new text end

Sec. 2.

Minnesota Statutes 2024, section 246.54, subdivision 1b, is amended to read:

Subd. 1b.

Community behavioral health hospitals.

(a) A county's payment of the cost
of care provided at state-operated community-based behavioral health hospitals for adults
and children shall be deleted text begin according to the following schedule: (1) deleted text end 100 percent for each day
during the stay, including the day of admission, when the facility determines that it is
clinically appropriate for the client to be discharged deleted text begin ; and deleted text end new text begin , except as provided in paragraph
(c).
new text end

deleted text begin (2) deleted text end new text begin (b) new text end The county shall not be entitled to reimbursement from the client, the client's
estate, or from the client's relatives, except as provided in section 246.53.

deleted text begin (b) Between July 1, 2023, and March 31, 2025, the county is not responsible for the cost
of care under paragraph (a), clause (1), for a person committed as a person who has a mental
illness and is dangerous to the public under section 253B.18 and who is awaiting transfer
to another state-operated facility or program. This paragraph expires March 31, 2025.
deleted text end

(c) deleted text begin Between April 1, 2025, and June 30, 2025, deleted text end The county is not responsible for the cost
of care under paragraph (a) deleted text begin , clause (1), deleted text end for a person who is civilly committed, if the client
is awaiting transfer:

(1) to a facility operated by the Department of Corrections; or

(2) to another state-operated facility or program, and the Direct Care and Treatment
executive medical director's office or a designee has determined that:

(i) the client meets criteria for admission to that state-operated facility or program; and

(ii) the state-operated facility or program is the only facility or program that can
reasonably serve the client. deleted text begin This paragraph expires June 30, 2025.
deleted text end

(d) Notwithstanding any law to the contrary, the client is not responsible for payment
of the cost of care under this subdivision.

new text begin EFFECTIVE DATE. new text end

new text begin This section is effective the day following final enactment.
new text end

Sec. 3.

Minnesota Statutes 2024, section 246C.07, is amended by adding a subdivision to
read:

new text begin Subd. 9. new text end

new text begin Public notice of admission metrics. new text end

new text begin The executive board must establish and
update monthly a publicly accessible dashboard that displays data on referrals for services
provided by Direct Care and Treatment, including referrals resulting from a court order for
competency attainment, a competency examination, or treatment following civil commitment.
The dashboard must include at least measures of the number of individuals awaiting
admission or acceptance into a program operated by Direct Care and Treatment; the number
of individuals awaiting admission or acceptance into a program operated by Direct Care
and Treatment, by program; the longest, shortest, and average time individuals are on a
waitlist; and the longest, shortest, and average time individuals are on a waitlist, by program.
The executive board must also publish monthly publicly relevant information regarding
admissions policies, procedures, and factors impacting relative priority status.
new text end

Sec. 4.

Minnesota Statutes 2024, section 253B.10, subdivision 1, is amended to read:

Subdivision 1.

Administrative requirements.

(a) When a person is committed, the
court shall issue a warrant or an order committing the patient to the custody of the head of
the treatment facility, state-operated treatment program, or community-based treatment
program. The warrant or order shall state that the patient meets the statutory criteria for
civil commitment.

(b) The executive board shall prioritize civilly committed patients being admitted from
jail or a correctional institution or who are referred to a state-operated treatment facility for
competency attainment or a competency examination under sections 611.40 to 611.59 for
admission to a medically appropriate state-operated direct care and treatment bed based on
the decisions of physicians in the executive medical director's office, using a priority
admissions framework. The framework must account for a range of factors for priority
admission, including but not limited to:

(1) the length of time the person has been on a waiting list for admission to a
state-operated direct care and treatment program since the date of the order under paragraph
(a), or the date of an order issued under sections 611.40 to 611.59;

(2) the intensity of the treatment the person needs, based on medical acuity;

(3) the person's revoked provisional discharge status;

(4) the person's safety and safety of others in the person's current environment;

(5) whether the person has access to necessary or court-ordered treatment;

(6) distinct and articulable negative impacts of an admission delay on the facility referring
the individual for treatment; and

(7) any relevant federal prioritization requirements.

Patients described in this paragraph must be admitted to a state-operated treatment program
within deleted text begin 48 hours deleted text end new text begin the timelines specified in section 253B.1005 new text end . The commitment must be
ordered by the court as provided in section 253B.09, subdivision 1, paragraph (d). Patients
committed to a secure treatment facility or less restrictive setting as ordered by the court
under section 253B.18, subdivisions 1 and 2, must be prioritized for admission to a
state-operated treatment program using the priority admissions framework in this paragraph.

(c) Upon the arrival of a patient at the designated treatment facility, state-operated
treatment program, or community-based treatment program, the head of the facility or
program shall retain the duplicate of the warrant and endorse receipt upon the original
warrant or acknowledge receipt of the order. The endorsed receipt or acknowledgment must
be filed in the court of commitment. After arrival, the patient shall be under the control and
custody of the head of the facility or program.

(d) Copies of the petition for commitment, the court's findings of fact and conclusions
of law, the court order committing the patient, the report of the court examiners, and the
prepetition report, and any medical and behavioral information available shall be provided
at the time of admission of a patient to the designated treatment facility or program to which
the patient is committed. Upon a patient's referral to the executive board for admission
pursuant to subdivision 1, paragraph (b), any inpatient hospital, treatment facility, jail, or
correctional facility that has provided care or supervision to the patient in the previous two
years shall, when requested by the treatment facility or executive board, provide copies of
the patient's medical and behavioral records to the executive board for purposes of
preadmission planning. This information shall be provided by the head of the treatment
facility to treatment facility staff in a consistent and timely manner and pursuant to all
applicable laws.

deleted text begin (e) Patients described in paragraph (b) must be admitted to a state-operated treatment
program within 48 hours of the Office of Executive Medical Director, under section 246C.09,
or a designee determining that a medically appropriate bed is available. This paragraph
expires on June 30, 2025.
deleted text end

deleted text begin (f) deleted text end new text begin (e) new text end Within four business days of determining which state-operated direct care and
treatment program or programs are appropriate for an individual, the executive medical
deleted text begin director's office deleted text end new text begin director new text end or a designee must notify the source of the referral and the
responsible county human services agency, the individual being ordered to direct care and
treatment, and the district court that issued the order of the determination. The notice shall
include deleted text begin which program or programs are appropriate for deleted text end new text begin the person's relative priority status
by quartile and the factors impacting new text end the person's priority status new text begin , projected admission date,
and contact information for the Direct Care and Treatment Central Preadmissions Office.
For any individuals not admitted to a state-operated direct care and treatment program within
ten business days after previous notice, the executive medical director or a designee must
provide additional notice to the responsible county human services agency, the individual
being ordered to direct care and treatment, and the district court that issued the order of the
determination. The additional notice must include updates to the same information provided
in the previous notice new text end . Any interested person new text begin or the individual being ordered to direct care
and treatment new text end may provide additional information new text begin to new text end or request updated priority status about
the individual deleted text begin to deleted text end new text begin from new text end the executive medical director's office or a designee while the
individual is awaiting admission. deleted text begin Updated deleted text end Priority status deleted text begin of deleted text end new text begin information regarding new text end an
individual will only be disclosed to interested persons who are legally authorized to receive
private information about the individual new text begin , including the designated agency and the facility
to which the individual is awaiting admission new text end . new text begin Specific updated priority status information
may be withheld from the individual being ordered to direct care and treatment if in the
judgment of the physicians in the executive medical director's office the information will
jeopardize the health or wellbeing of the individual. new text end When an available bed has been
identified, the executive medical director's office or a designee must notify the designated
agency and the facility where the individual is awaiting admission that the individual has
been accepted for admission to a particular state-operated direct care and treatment program
and the earliest possible date the admission can occur. The designated agency or facility
where the individual is awaiting admission must transport the individual to the admitting
state-operated direct care and treatment program no more than 48 hours after the offered
admission date.

Sec. 5.

new text begin [253B.1005] ADMISSION TIMELINES.
new text end

new text begin Subdivision 1. new text end

new text begin Admission required within 48 hours. new text end

new text begin Patients described in section
253B.10, subdivision 1, paragraph (b), must be admitted to a state-operated treatment
program within 48 hours. This subdivision expires upon the effective date of subdivision
2.
new text end

new text begin Subd. 2. new text end

new text begin Admission required within ten days. new text end

new text begin Effective upon capacity at secure forensic
mental health treatment facilities operated by Direct Care and Treatment reaching 431 fully
staffed and operational beds, capacity at Anoka-Metro Regional Treatment Center reaching
132 fully staffed and operational beds, and the total capacity at adult community behavioral
health hospitals operated by Direct Care and Treatment reaching 115 fully staffed and
operational beds, patients described in section 253B.10, subdivision 1, paragraph (b), must
be admitted to a state-operated treatment program within ten calendar days.
new text end

new text begin EFFECTIVE DATE. new text end

new text begin This section is effective July 1, 2025.
new text end

Sec. 6.

new text begin [253B.101] COST OF DELAYED ADMISSION.
new text end

new text begin The Direct Care and Treatment executive board must reimburse any state agency, county,
municipality, or other political subdivision of the state for demonstrated costs incurred
beyond the first 30 calendar days to confine a civilly committed patient in a jail or a
correctional institution who is awaiting admission to a state-operated treatment program.
new text end

new text begin EFFECTIVE DATE. new text end

new text begin This section is effective July 1, 2025, and applies to civil
commitments occurring on or after that date.
new text end

Sec. 7. new text begin PRIORITY ADMISSIONS REVIEW PANEL.
new text end

new text begin (a) A panel appointed by the Direct Care and Treatment executive board, consisting of
all members who served on the Priority Admissions Review Panel under Laws 2024, chapter
127, article 49, section 7, must:
new text end

new text begin (1) evaluate existing mobile crisis programs and funding and make recommendations
to improve the quality and availability of mobile crisis services in the state;
new text end

new text begin (2) evaluate the county correctional facility long-acting injectable antipsychotic
medication pilot program established under Laws 2024, chapter 127, article 49, section 12,
and make recommendations related to the continuation of the pilot program;
new text end

new text begin (3) evaluate existing intensive residential treatment services and make recommendations
to improve the quality and availability of intensive residential treatment services in the state;
and
new text end

new text begin (4) study local fiscal impacts and provide evaluation support consistent with Minnesota
Statutes, section 16A.055, subdivision 1a, of the limited capacity in and access to
state-operated treatment programs, nonstate-operated treatment programs, competency
evaluations, and competency attainment services.
new text end

new text begin (b) The commissioner of management and budget must provide the panel with technical
assistance and with outcome and fiscal analysis for the purposes of the study of local fiscal
impacts under paragraph (a), clause (4).
new text end

new text begin (c) By February 1, 2026, the panel must submit a written report to the chairs and ranking
minority members of the legislative committees with jurisdiction over public safety and
human services that includes the results of the panel's evaluations and study under paragraph
(a) and any legislative proposals the panel recommends as a result of its evaluations and
study.
new text end

Sec. 8. new text begin APPROPRIATION; EXPANDED CAPACITY AT SECURE TREATMENT
FACILITIES.
new text end

new text begin $....... in fiscal year 2026 and $....... in fiscal year 2027 are appropriated from the general
fund to the Direct Care and Treatment executive board to expand forensic mental health
program capacity at secure treatment facilities by 20 percent over the available capacity as
of June 30, 2025. The expanded capacity is estimated to be an additional 72 fully staffed
beds.
new text end

Sec. 9. new text begin APPROPRIATION; EXPANDED CAPACITY AT ANOKA-METRO
REGIONAL TREATMENT CENTER.
new text end

new text begin $....... in fiscal year 2026 and $....... in fiscal year 2027 are appropriated from the general
fund to the Direct Care and Treatment executive board to expand adult mental health
treatment service capacity at Anoka-Metro Regional Treatment Center by 20 percent over
the available capacity as of June 30, 2025. The expanded capacity is estimated to be an
additional 22 fully staffed beds.
new text end

Sec. 10. new text begin APPROPRIATION; EXPANDED CAPACITY AT ADULT COMMUNITY
BEHAVIOR HEALTH HOSPITALS.
new text end

new text begin $....... in fiscal year 2026 and $....... in fiscal year 2027 are appropriated from the general
fund to the Direct Care and Treatment executive board to expand adult mental health service
capacity at community behavioral health hospitals by 20 percent over the available capacity
as of June 30, 2025. The expanded capacity is estimated to be an additional 19 fully staffed
beds.
new text end