HF 2758

Introduction - 94th Legislature (2025 - 2026)

Posted on 03/24/2025 03:04 p.m.

A bill for an act
relating to human services; recodifying assertive community treatment and intensive
residential treatment services statutory language; making conforming changes;
amending Minnesota Statutes 2024, sections 148F.11, subdivision 1; 245.4662,
subdivision 1; 245.4906, subdivision 2; 254B.04, subdivision 1a; 254B.05,
subdivision 1a; 256.478, subdivision 2; 256B.0615, subdivisions 1, 3; 256B.0622,
subdivisions 1, 8, 11, 12; 256B.82; 256D.44, subdivision 5; proposing coding for
new law in Minnesota Statutes, chapter 256B; repealing Minnesota Statutes 2024,
section 256B.0622, subdivision 4.

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

ARTICLE 1

RECODIFICATION

Section 1.

Minnesota Statutes 2024, section 256B.0622, subdivision 1, is amended to read:

Subdivision 1.

Scope.

(a) Subject to federal approval, medical assistance covers medically
necessary, assertive community treatment when the services are provided by an entity
certified under and meeting the standards in this section.

deleted text begin (b) Subject to federal approval, medical assistance covers medically necessary, intensive
residential treatment services when the services are provided by an entity licensed under
and meeting the standards in section 245I.23.
deleted text end

deleted text begin (c) deleted text end new text begin (b) new text end The provider entity must make reasonable and good faith efforts to report
individual client outcomes to the commissioner, using instruments and protocols approved
by the commissioner.

Sec. 2.

Minnesota Statutes 2024, section 256B.0622, subdivision 8, is amended to read:

Subd. 8.

Medical assistance payment for assertive community treatment deleted text begin and
intensive residential treatment deleted text end services.

(a) Payment for deleted text begin intensive residential treatment
services and deleted text end assertive community treatment in this section shall be based on one daily rate
per provider inclusive of the following services received by an eligible client in a given
calendar day: all rehabilitative services under this section, staff travel time to provide
rehabilitative services under this section, and nonresidential crisis stabilization services
under section 256B.0624.

(b) Except as indicated in paragraph deleted text begin (d) deleted text end new text begin (c) new text end , payment will not be made to more than one
entity for each client for services provided under this section on a given day. If services
under this section are provided by a team that includes staff from more than one entity, the
team must determine how to distribute the payment among the members.

deleted text begin (c) Payment must not be made based solely on a court order to participate in intensive
residential treatment services. If a client has a court order to participate in the program or
to obtain assessment for treatment and follow treatment recommendations, payment under
this section must only be provided if the client is eligible for the service and the service is
determined to be medically necessary.
deleted text end

deleted text begin (d) deleted text end new text begin (c) new text end The commissioner shall determine deleted text begin one rate for each provider that will bill medical
assistance for residential services under this section and deleted text end one rate for each assertive community
treatment provider new text begin under this section new text end . If a single entity provides both deleted text begin services deleted text end new text begin intensive
residential treatment services under section 256B.0632 and assertive community treatment
under this section new text end , one rate is established for the entity's new text begin intensive new text end residential new text begin treatment new text end
services new text begin under section 256B.0632 new text end and another rate for the entity's deleted text begin nonresidential deleted text end new text begin assertive
community treatment new text end services under this section. A provider is not eligible for payment
under this section without authorization from the commissioner. The commissioner shall
develop rates using the following criteria:

(1) the provider's cost for services shall include direct services costs, other program
costs, and other costs determined as follows:

(i) the direct services costs must be determined using actual costs of salaries, benefits,
payroll taxes, and training of direct service staff and service-related transportation;

(ii) other program costs not included in item (i) must be determined as a specified
percentage of the direct services costs as determined by item (i). The percentage used shall
be determined by the commissioner based upon the average of percentages that represent
the relationship of other program costs to direct services costs among the entities that provide
similar services;

(iii) physical plant costs calculated based on the percentage of space within the program
that is entirely devoted to treatment and programming. This does not include administrative
or residential space;

(iv) assertive community treatment physical plant costs must be reimbursed as part of
the costs described in item (ii); and

(v) subject to federal approval, up to an additional five percent of the total rate may be
added to the program rate as a quality incentive based upon the entity meeting performance
criteria specified by the commissioner;

(2) actual deleted text begin cost is deleted text end new text begin costs are new text end defined as costs which are allowable, allocable, and reasonable,
and consistent with federal reimbursement requirements under Code of Federal Regulations,
title 48, chapter 1, part 31, relating to for-profit entities, and Office of Management and
Budget Circular Number A-122, relating to nonprofit entities;

(3) the number of service units;

(4) the degree to which clients will receive services other than services under this section new text begin
or section 256B.0632 new text end ; and

(5) the costs of other services that will be separately reimbursed.

deleted text begin (e) deleted text end new text begin (d) new text end The rate for deleted text begin intensive residential treatment services and deleted text end assertive community
treatment must exclude the medical assistance room and board rate, as defined in section
256B.056, subdivision 5d, and services not covered under this section, such as partial
hospitalization, home care, and inpatient services.

deleted text begin (f) Physician services that are not separately billed may be included in the rate to the
extent that a psychiatrist, or other health care professional providing physician services
within their scope of practice, is a member of the intensive residential treatment services
treatment team. Physician services, whether billed separately or included in the rate, may
be delivered by telehealth. For purposes of this paragraph, "telehealth" has the meaning
given to "mental health telehealth" in section 256B.0625, subdivision 46, when telehealth
is used to provide intensive residential treatment services.
deleted text end

deleted text begin (g) deleted text end new text begin (e) new text end When services under this section are provided by an assertive community treatment
provider, case management functions must be an integral part of the team.

deleted text begin (h) deleted text end new text begin (f) new text end The rate for a provider must not exceed the rate charged by that provider for the
same service to other payors.

deleted text begin (i) deleted text end new text begin (g) new text end The rates for existing programs must be established prospectively based upon the
expenditures and utilization over a prior 12-month period using the criteria established in
paragraph deleted text begin (d) deleted text end new text begin (c) new text end . The rates for new programs must be established based upon estimated
expenditures and estimated utilization using the criteria established in paragraph deleted text begin (d) deleted text end new text begin (c) new text end .

deleted text begin (j) deleted text end new text begin (h) new text end Effective for the rate years beginning on and after January 1, 2024, rates for
assertive community treatment, adult residential crisis stabilization services, and intensive
residential treatment services must be annually adjusted for inflation using the Centers for
Medicare and Medicaid Services Medicare Economic Index, as forecasted in the third quarter
of the calendar year before the rate year. The inflation adjustment must be based on the
12-month period from the midpoint of the previous rate year to the midpoint of the rate year
for which the rate is being determined. new text begin This paragraph expires upon federal approval.
new text end

new text begin (i) Effective upon the expiration of paragraph (h), and effective for the rate years
beginning on and after January 1, 2024, rates for assertive community treatment services
must be annually adjusted for inflation using the Centers for Medicare and Medicaid Services
Medicare Economic Index, as forecasted in the third quarter of the calendar year before the
rate year. The inflation adjustment must be based on the 12-month period from the midpoint
of the previous rate year to the midpoint of the rate year for which the rate is being
determined.
new text end

deleted text begin (k) deleted text end new text begin (j) new text end Entities who discontinue providing services must be subject to a settle-up process
whereby actual costs and reimbursement for the previous 12 months are compared. In the
event that the entity was paid more than the entity's actual costs plus any applicable
performance-related funding due the provider, the excess payment must be reimbursed to
the department. If a provider's revenue is less than actual allowed costs due to lower
utilization than projected, the commissioner may reimburse the provider to recover its actual
allowable costs. The resulting adjustments by the commissioner must be proportional to the
percent of total units of service reimbursed by the commissioner and must reflect a difference
of greater than five percent.

deleted text begin (l) deleted text end new text begin (k) new text end A provider may request of the commissioner a review of any rate-setting decision
made under this subdivision.

Sec. 3.

Minnesota Statutes 2024, section 256B.0622, subdivision 11, is amended to read:

Subd. 11.

Sustainability grants.

The commissioner may disburse grant funds directly
to deleted text begin intensive residential treatment services providers and deleted text end assertive community treatment
providers to maintain access to these services.

Sec. 4.

Minnesota Statutes 2024, section 256B.0622, subdivision 12, is amended to read:

Subd. 12.

Start-up grants.

The commissioner may, within available appropriations,
disburse grant funding to counties, Indian tribes, or mental health service providers to
establish additional assertive community treatment teams deleted text begin , intensive residential treatment
services, or crisis residential services deleted text end .

Sec. 5.

new text begin [256B.0632] INTENSIVE RESIDENTIAL TREATMENT SERVICES.
new text end

new text begin Subdivision 1. new text end

new text begin Scope. new text end

new text begin (a) Subject to federal approval, medical assistance covers medically
necessary, intensive residential treatment services when the services are provided by an
entity licensed under and meeting the standards in section 245I.23.
new text end

new text begin (b) The provider entity must make reasonable and good faith efforts to report individual
client outcomes to the commissioner, using instruments and protocols approved by the
commissioner.
new text end

new text begin Subd. 2. new text end

new text begin Provider entity licensure and contract requirements for intensive residential
treatment services. new text end

new text begin (a) The commissioner shall develop procedures for counties and
providers to submit other documentation as needed to allow the commissioner to determine
whether the standards in this section are met.
new text end

new text begin (b) A provider entity must specify in the provider entity's application what geographic
area and populations will be served by the proposed program. A provider entity must
document that the capacity or program specialties of existing programs are not sufficient
to meet the service needs of the target population. A provider entity must submit evidence
of ongoing relationships with other providers and levels of care to facilitate referrals to and
from the proposed program.
new text end

new text begin (c) A provider entity must submit documentation that the provider entity requested a
statement of need from each county board and Tribal authority that serves as a local mental
health authority in the proposed service area. The statement of need must specify if the local
mental health authority supports or does not support the need for the proposed program and
the basis for this determination. If a local mental health authority does not respond within
60 days of the receipt of the request, the commissioner shall determine the need for the
program based on the documentation submitted by the provider entity.
new text end

new text begin Subd. 3. new text end

new text begin Medical assistance payment for intensive residential treatment services. new text end

new text begin (a)
Payment for intensive residential treatment services in this section shall be based on one
daily rate per provider inclusive of the following services received by an eligible client in
a given calendar day: all rehabilitative services under this section, staff travel time to provide
rehabilitative services under this section, and nonresidential crisis stabilization services
under section 256B.0624.
new text end

new text begin (b) Except as indicated in paragraph (d), payment will not be made to more than one
entity for each client for services provided under this section on a given day. If services
under this section are provided by a team that includes staff from more than one entity, the
team must determine how to distribute the payment among the members.
new text end

new text begin (c) Payment must not be made based solely on a court order to participate in intensive
residential treatment services. If a client has a court order to participate in the program or
to obtain assessment for treatment and follow treatment recommendations, payment under
this section must only be provided if the client is eligible for the service and the service is
determined to be medically necessary.
new text end

new text begin (d) The commissioner shall determine one rate for each provider that will bill medical
assistance for intensive residential treatment services under this section. If a single entity
provides both intensive residential treatment services under this section and assertive
community treatment under section 256B.0622, one rate is established for the entity's
intensive residential treatment services under this section and another rate for the entity's
assertive community treatment services under section 256B.0622. A provider is not eligible
for payment under this section without authorization from the commissioner. The
commissioner shall develop rates using the following criteria:
new text end

new text begin (1) the provider's cost for services shall include direct services costs, other program
costs, and other costs determined as follows:
new text end

new text begin (i) the direct services costs must be determined using actual costs of salaries, benefits,
payroll taxes, and training of direct service staff and service-related transportation;
new text end

new text begin (ii) other program costs not included in item (i) must be determined as a specified
percentage of the direct services costs as determined by item (i). The percentage used shall
be determined by the commissioner based upon the average of percentages that represent
the relationship of other program costs to direct services costs among the entities that provide
similar services;
new text end

new text begin (iii) physical plant costs calculated based on the percentage of space within the program
that is entirely devoted to treatment and programming. This does not include administrative
or residential space; and
new text end

new text begin (iv) subject to federal approval, up to an additional five percent of the total rate may be
added to the program rate as a quality incentive based upon the entity meeting performance
criteria specified by the commissioner;
new text end

new text begin (2) actual costs are defined as costs which are allowable, allocable, and reasonable, and
consistent with federal reimbursement requirements under Code of Federal Regulations,
title 48, chapter 1, part 31, relating to for-profit entities, and Office of Management and
Budget Circular Number A-122, relating to nonprofit entities;
new text end

new text begin (3) the number of services units;
new text end

new text begin (4) the degree to which clients will receive services other than services under this section
or section 256B.0622; and
new text end

new text begin (5) the costs of other services that will be separately reimbursed.
new text end

new text begin (e) The rate for intensive residential treatment services must exclude the medical
assistance room and board rate, as defined in section 256B.056, subdivision 5d, and services
not covered under this section, such as partial hospitalization, home care, and inpatient
services.
new text end

new text begin (f) Physician services that are not separately billed may be included in the rate to the
extent that a psychiatrist, or other health care professional providing physician services
within their scope of practice, is a member of the intensive residential treatment services
treatment team. Physician services, whether billed separately or included in the rate, may
be delivered by telehealth. For purposes of this paragraph, "telehealth" has the meaning
given to "mental health telehealth" in section 256B.0625, subdivision 46, when telehealth
is used to provide intensive residential treatment services.
new text end

new text begin (g) The rate for a provider must not exceed the rate charged by that provider for the
same service to other payors.
new text end

new text begin (h) The rates for existing programs must be established prospectively based upon the
expenditures and utilization over a prior 12-month period using the criteria established in
paragraph (d). The rates for new programs must be established based upon estimated
expenditures and estimated utilization using the criteria established in paragraph (d).
new text end

new text begin (i) Effective upon the expiration of section 256B.0622, subdivision 8, paragraph (h),
and effective for rate years beginning on and after January 1, 2024, rates for intensive
residential treatment services and adult residential crisis stabilization services must be
annually adjusted for inflation using the Centers for Medicare and Medicaid Services
Medicare Economic Index, as forecasted in the third quarter of the calendar year before the
rate year. The inflation adjustment must be based on the 12-month period from the midpoint
of the previous rate year to the midpoint of the rate year for which the rate is being
determined.
new text end

new text begin (j) Entities who discontinue providing services must be subject to a settle-up process
whereby actual costs and reimbursement for the previous 12 months are compared. In the
event that the entity was paid more than the entity's actual costs plus any applicable
performance-related funding due the provider, the excess payment must be reimbursed to
the department. If a provider's revenue is less than actual allowed costs due to lower
utilization than projected, the commissioner may reimburse the provider to recover its actual
allowable costs. The resulting adjustments by the commissioner must be proportional to the
percent of total units of service reimbursed by the commissioner and must reflect a difference
of greater than five percent.
new text end

new text begin (k) A provider may request of the commissioner a review of any rate-setting decision
made under this subdivision.
new text end

new text begin Subd. 4. new text end

new text begin Provider enrollment; rate setting for county-operated entities. new text end

new text begin Counties
that employ their own staff to provide services under this section shall apply directly to the
commissioner for enrollment and rate setting. In this case, a county contract is not required.
new text end

new text begin Subd. 5. new text end

new text begin Provider enrollment; rate setting for specialized program. new text end

new text begin A county contract
is not required for a provider proposing to serve a subpopulation of eligible clients under
the following circumstances:
new text end

new text begin (1) the provider demonstrates that the subpopulation to be served requires a specialized
program which is not available from county-approved entities; and
new text end

new text begin (2) the subpopulation to be served is of such a low incidence that it is not feasible to
develop a program serving a single county or regional group of counties.
new text end

new text begin Subd. 6. new text end

new text begin Sustainability grants. new text end

new text begin The commissioner may disburse grant funds directly to
intensive residential treatment services providers to maintain access to these services.
new text end

new text begin Subd. 7. new text end

new text begin Start-up grants. new text end

new text begin The commissioner may, within available appropriations,
disburse grant funding to counties, Indian Tribes, or mental health service providers to
establish additional intensive residential treatment services and residential crisis services.
new text end

Sec. 6. new text begin REPEALER.
new text end

new text begin Minnesota Statutes 2024, section 256B.0622, subdivision 4, new text end new text begin is repealed.
new text end

ARTICLE 2

CONFORMING CHANGES

Section 1.

Minnesota Statutes 2024, section 148F.11, subdivision 1, is amended to read:

Subdivision 1.

Other professionals.

(a) Nothing in this chapter prevents members of
other professions or occupations from performing functions for which they are qualified or
licensed. This exception includes, but is not limited to: licensed physicians; registered nurses;
licensed practical nurses; licensed psychologists and licensed psychological practitioners;
members of the clergy provided such services are provided within the scope of regular
ministries; American Indian medicine men and women; licensed attorneys; probation officers;
licensed marriage and family therapists; licensed social workers; social workers employed
by city, county, or state agencies; licensed professional counselors; licensed professional
clinical counselors; licensed school counselors; registered occupational therapists or
occupational therapy assistants; Upper Midwest Indian Council on Addictive Disorders
(UMICAD) certified counselors when providing services to Native American people; city,
county, or state employees when providing assessments or case management under Minnesota
Rules, chapter 9530; and staff persons providing co-occurring substance use disorder
treatment in adult mental health rehabilitative programs certified or licensed by the
Department of Human Services under section 245I.23, 256B.0622, deleted text begin or deleted text end 256B.0623 new text begin , or
256B.0632 new text end .

(b) Nothing in this chapter prohibits technicians and resident managers in programs
licensed by the Department of Human Services from discharging their duties as provided
in Minnesota Rules, chapter 9530.

(c) Any person who is exempt from licensure under this section must not use a title
incorporating the words "alcohol and drug counselor" or "licensed alcohol and drug
counselor" or otherwise hold himself or herself out to the public by any title or description
stating or implying that he or she is engaged in the practice of alcohol and drug counseling,
or that he or she is licensed to engage in the practice of alcohol and drug counseling, unless
that person is also licensed as an alcohol and drug counselor. Persons engaged in the practice
of alcohol and drug counseling are not exempt from the board's jurisdiction solely by the
use of one of the titles in paragraph (a).

Sec. 2.

Minnesota Statutes 2024, section 245.4662, subdivision 1, is amended to read:

Subdivision 1.

Definitions.

(a) For purposes of this section, the following terms have
the meanings given them.

(b) "Community partnership" means a project involving the collaboration of two or more
eligible applicants.

(c) "Eligible applicant" means an eligible county, Indian tribe, mental health service
provider, hospital, or community partnership. Eligible applicant does not include a
state-operated direct care and treatment facility or program under chapters 246 and 246C.

(d) "Intensive residential treatment services" has the meaning given in section deleted text begin 256B.0622 deleted text end new text begin
256B.0632 new text end .

(e) "Metropolitan area" means the seven-county metropolitan area, as defined in section
473.121, subdivision 2.

Sec. 3.

Minnesota Statutes 2024, section 245.4906, subdivision 2, is amended to read:

Subd. 2.

Eligible applicants.

An eligible applicant is a licensed entity or provider that
employs a mental health certified peer specialist qualified under section 245I.04, subdivision
10, and that provides services to individuals receiving assertive community treatment deleted text begin or
intensive residential treatment services deleted text end under section 256B.0622, new text begin intensive residential
treatment services under section 256B.0632, new text end adult rehabilitative mental health services
under section 256B.0623, or crisis response services under section 256B.0624.

Sec. 4.

Minnesota Statutes 2024, section 254B.04, subdivision 1a, is amended to read:

Subd. 1a.

Client eligibility.

(a) Persons eligible for benefits under Code of Federal
Regulations, title 25, part 20, who meet the income standards of section 256B.056,
subdivision 4, and are not enrolled in medical assistance, are entitled to behavioral health
fund services. State money appropriated for this paragraph must be placed in a separate
account established for this purpose.

(b) Persons with dependent children who are determined to be in need of substance use
disorder treatment pursuant to an assessment under section 260E.20, subdivision 1, or in
need of chemical dependency treatment pursuant to a case plan under section 260C.201,
subdivision 6, or 260C.212, shall be assisted by the local agency to access needed treatment
services. Treatment services must be appropriate for the individual or family, which may
include long-term care treatment or treatment in a facility that allows the dependent children
to stay in the treatment facility. The county shall pay for out-of-home placement costs, if
applicable.

(c) Notwithstanding paragraph (a), any person enrolled in medical assistance or
MinnesotaCare is eligible for room and board services under section 254B.05, subdivision
5, paragraph (b), clause (9).

(d) A client is eligible to have substance use disorder treatment paid for with funds from
the behavioral health fund when the client:

(1) is eligible for MFIP as determined under chapter 142G;

(2) is eligible for medical assistance as determined under Minnesota Rules, parts
9505.0010 to 9505.0150;

(3) is eligible for general assistance, general assistance medical care, or work readiness
as determined under Minnesota Rules, parts 9500.1200 to 9500.1318; or

(4) has income that is within current household size and income guidelines for entitled
persons, as defined in this subdivision and subdivision 7.

(e) Clients who meet the financial eligibility requirement in paragraph (a) and who have
a third-party payment source are eligible for the behavioral health fund if the third-party
payment source pays less than 100 percent of the cost of treatment services for eligible
clients.

(f) A client is ineligible to have substance use disorder treatment services paid for with
behavioral health fund money if the client:

(1) has an income that exceeds current household size and income guidelines for entitled
persons as defined in this subdivision and subdivision 7; or

(2) has an available third-party payment source that will pay the total cost of the client's
treatment.

(g) A client who is disenrolled from a state prepaid health plan during a treatment episode
is eligible for continued treatment service that is paid for by the behavioral health fund until
the treatment episode is completed or the client is re-enrolled in a state prepaid health plan
if the client:

(1) continues to be enrolled in MinnesotaCare, medical assistance, or general assistance
medical care; or

(2) is eligible according to paragraphs (a) and (b) and is determined eligible by a local
agency under section 254B.04.

(h) When a county commits a client under chapter 253B to a regional treatment center
for substance use disorder services and the client is ineligible for the behavioral health fund,
the county is responsible for the payment to the regional treatment center according to
section 254B.05, subdivision 4.

(i) Persons enrolled in MinnesotaCare are eligible for room and board services when
provided through intensive residential treatment services and residential crisis services under
section deleted text begin 256B.0622 deleted text end new text begin 256B.0632 new text end .

Sec. 5.

Minnesota Statutes 2024, section 254B.05, subdivision 1a, is amended to read:

Subd. 1a.

Room and board provider requirements.

(a) Vendors of room and board
are eligible for behavioral health fund payment if the vendor:

(1) has rules prohibiting residents bringing chemicals into the facility or using chemicals
while residing in the facility and provide consequences for infractions of those rules;

(2) is determined to meet applicable health and safety requirements;

(3) is not a jail or prison;

(4) is not concurrently receiving funds under chapter 256I for the recipient;

(5) admits individuals who are 18 years of age or older;

(6) is registered as a board and lodging or lodging establishment according to section
157.17;

(7) has awake staff on site whenever a client is present;

(8) has staff who are at least 18 years of age and meet the requirements of section
245G.11, subdivision 1, paragraph (b);

(9) has emergency behavioral procedures that meet the requirements of section 245G.16;

(10) meets the requirements of section 245G.08, subdivision 5, if administering
medications to clients;

(11) meets the abuse prevention requirements of section 245A.65, including a policy on
fraternization and the mandatory reporting requirements of section 626.557;

(12) documents coordination with the treatment provider to ensure compliance with
section 254B.03, subdivision 2;

(13) protects client funds and ensures freedom from exploitation by meeting the
provisions of section 245A.04, subdivision 13;

(14) has a grievance procedure that meets the requirements of section 245G.15,
subdivision 2; and

(15) has sleeping and bathroom facilities for men and women separated by a door that
is locked, has an alarm, or is supervised by awake staff.

(b) Programs licensed according to Minnesota Rules, chapter 2960, are exempt from
paragraph (a), clauses (5) to (15).

(c) Programs providing children's mental health crisis admissions and stabilization under
section 245.4882, subdivision 6, are eligible vendors of room and board.

(d) Programs providing children's residential services under section 245.4882, except
services for individuals who have a placement under chapter 260C or 260D, are eligible
vendors of room and board.

(e) Licensed programs providing intensive residential treatment services or residential
crisis stabilization services pursuant to section deleted text begin 256B.0622 or deleted text end 256B.0624 new text begin or 256B.0632 new text end are
eligible vendors of room and board and are exempt from paragraph (a), clauses (6) to (15).

(f) A vendor that is not licensed as a residential treatment program must have a policy
to address staffing coverage when a client may unexpectedly need to be present at the room
and board site.

Sec. 6.

Minnesota Statutes 2024, section 256.478, subdivision 2, is amended to read:

Subd. 2.

Eligibility.

An individual is eligible for the transition to community initiative
if the individual can demonstrate that current services are not capable of meeting individual
treatment and service needs that can be met in the community with support, and the individual
meets at least one of the following criteria:

(1) the person meets the criteria under section 256B.092, subdivision 13, or 256B.49,
subdivision 24;

(2) the person has met treatment objectives and no longer requires a hospital-level care,
residential-level care, or a secure treatment setting, but the person's discharge from the
Anoka Metro Regional Treatment Center, the Minnesota Forensic Mental Health Program,
the Child and Adolescent Behavioral Health Hospital program, a psychiatric residential
treatment facility under section 256B.0941, intensive residential treatment services under
section deleted text begin 256B.0622 deleted text end new text begin 256B.0632 new text end , children's residential services under section 245.4882,
juvenile detention facility, county supervised building, or a hospital would be substantially
delayed without additional resources available through the transitions to community initiative;

(3) the person (i) is receiving customized living services reimbursed under section
256B.4914, 24-hour customized living services reimbursed under section 256B.4914, or
community residential services reimbursed under section 256B.4914; (ii) expresses a desire
to move; and (iii) has received approval from the commissioner; or

(4) the person can demonstrate that the person's needs are beyond the scope of current
service designs and grant funding can support the inclusion of additional supports for the
person to access appropriate treatment and services in the least restrictive environment.

Sec. 7.

Minnesota Statutes 2024, section 256B.0615, subdivision 1, is amended to read:

Subdivision 1.

Scope.

Medical assistance covers mental health certified peer specialist
services, as established in subdivision 2, if provided to recipients who are eligible for services
under sections 256B.0622, 256B.0623, deleted text begin and deleted text end 256B.0624 new text begin , and 256B.0632 new text end and are provided
by a mental health certified peer specialist who has completed the training under subdivision
5 and is qualified according to section 245I.04, subdivision 10.

Sec. 8.

Minnesota Statutes 2024, section 256B.0615, subdivision 3, is amended to read:

Subd. 3.

Eligibility.

Peer support services may be made available to consumers of (1)
intensive residential treatment services under section deleted text begin 256B.0622 deleted text end new text begin 256B.0632 new text end ; (2) adult
rehabilitative mental health services under section 256B.0623; and (3) crisis stabilization
and mental health mobile crisis intervention services under section 256B.0624.

Sec. 9.

Minnesota Statutes 2024, section 256B.82, is amended to read:

256B.82 PREPAID PLANS AND MENTAL HEALTH REHABILITATIVE
SERVICES.

Medical assistance and MinnesotaCare prepaid health plans may include coverage for
adult mental health rehabilitative services under section 256B.0623, intensive rehabilitative
services under section deleted text begin 256B.0622 deleted text end new text begin 256B.0632 new text end , and adult mental health crisis response services
under section 256B.0624, beginning January 1, 2005.

By January 15, 2004, the commissioner shall report to the legislature how these services
should be included in prepaid plans. The commissioner shall consult with mental health
advocates, health plans, and counties in developing this report. The report recommendations
must include a plan to ensure coordination of these services between health plans and
counties, assure recipient access to essential community providers, and monitor the health
plans' delivery of services through utilization review and quality standards.

Sec. 10.

Minnesota Statutes 2024, section 256D.44, subdivision 5, is amended to read:

Subd. 5.

Special needs.

(a) In addition to the state standards of assistance established
in subdivisions 1 to 4, payments are allowed for the following special needs of recipients
of Minnesota supplemental aid who are not residents of a nursing home, a regional treatment
center, or a setting authorized to receive housing support payments under chapter 256I.

(b) The county agency shall pay a monthly allowance for medically prescribed diets if
the cost of those additional dietary needs cannot be met through some other maintenance
benefit. The need for special diets or dietary items must be prescribed by a licensed physician,
advanced practice registered nurse, or physician assistant. Costs for special diets shall be
determined as percentages of the allotment for a one-person household under the thrifty
food plan as defined by the United States Department of Agriculture. The types of diets and
the percentages of the thrifty food plan that are covered are as follows:

(1) high protein diet, at least 80 grams daily, 25 percent of thrifty food plan;

(2) controlled protein diet, 40 to 60 grams and requires special products, 100 percent of
thrifty food plan;

(3) controlled protein diet, less than 40 grams and requires special products, 125 percent
of thrifty food plan;

(4) low cholesterol diet, 25 percent of thrifty food plan;

(5) high residue diet, 20 percent of thrifty food plan;

(6) pregnancy and lactation diet, 35 percent of thrifty food plan;

(7) gluten-free diet, 25 percent of thrifty food plan;

(8) lactose-free diet, 25 percent of thrifty food plan;

(9) antidumping diet, 15 percent of thrifty food plan;

(10) hypoglycemic diet, 15 percent of thrifty food plan; or

(11) ketogenic diet, 25 percent of thrifty food plan.

(c) Payment for nonrecurring special needs must be allowed for necessary home repairs
or necessary repairs or replacement of household furniture and appliances using the payment
standard of the AFDC program in effect on July 16, 1996, for these expenses, as long as
other funding sources are not available.

(d) A fee for guardian or conservator service is allowed at a reasonable rate negotiated
by the county or approved by the court. This rate shall not exceed five percent of the
assistance unit's gross monthly income up to a maximum of $100 per month. If the guardian
or conservator is a member of the county agency staff, no fee is allowed.

(e) The county agency shall continue to pay a monthly allowance of $68 for restaurant
meals for a person who was receiving a restaurant meal allowance on June 1, 1990, and
who eats two or more meals in a restaurant daily. The allowance must continue until the
person has not received Minnesota supplemental aid for one full calendar month or until
the person's living arrangement changes and the person no longer meets the criteria for the
restaurant meal allowance, whichever occurs first.

(f) A fee equal to the maximum monthly amount allowed by the Social Security
Administration is allowed for representative payee services provided by an agency that
meets the requirements under SSI regulations to charge a fee for representative payee
services. This special need is available to all recipients of Minnesota supplemental aid
regardless of their living arrangement.

(g)(1) Notwithstanding the language in this subdivision, an amount equal to one-half of
the maximum federal Supplemental Security Income payment amount for a single individual
which is in effect on the first day of July of each year will be added to the standards of
assistance established in subdivisions 1 to 4 for adults under the age of 65 who qualify as
in need of housing assistance and are:

(i) relocating from an institution, a setting authorized to receive housing support under
chapter 256I, or an adult mental health residential treatment program under section deleted text begin 256B.0622 deleted text end new text begin
256B.0632 new text end ;

(ii) eligible for personal care assistance under section 256B.0659; or

(iii) home and community-based waiver recipients living in their own home or rented
or leased apartment.

(2) Notwithstanding subdivision 3, paragraph (c), an individual eligible for the shelter
needy benefit under this paragraph is considered a household of one. An eligible individual
who receives this benefit prior to age 65 may continue to receive the benefit after the age
of 65.

(3) "Housing assistance" means that the assistance unit incurs monthly shelter costs that
exceed 40 percent of the assistance unit's gross income before the application of this special
needs standard. "Gross income" for the purposes of this section is the applicant's or recipient's
income as defined in section 256D.35, subdivision 10, or the standard specified in subdivision
3, paragraph (a) or (b), whichever is greater. A recipient of a federal or state housing subsidy,
that limits shelter costs to a percentage of gross income, shall not be considered in need of
housing assistance for purposes of this paragraph.

APPENDIX

Repealed Minnesota Statutes: 25-05140

256B.0622 ASSERTIVE COMMUNITY TREATMENT AND INTENSIVE RESIDENTIAL TREATMENT SERVICES.

Subd. 4.

Provider entity licensure and contract requirements for intensive residential treatment services.

(a) The commissioner shall develop procedures for counties and providers to submit other documentation as needed to allow the commissioner to determine whether the standards in this section are met.

(b) A provider entity must specify in the provider entity's application what geographic area and populations will be served by the proposed program. A provider entity must document that the capacity or program specialties of existing programs are not sufficient to meet the service needs of the target population. A provider entity must submit evidence of ongoing relationships with other providers and levels of care to facilitate referrals to and from the proposed program.

(c) A provider entity must submit documentation that the provider entity requested a statement of need from each county board and tribal authority that serves as a local mental health authority in the proposed service area. The statement of need must specify if the local mental health authority supports or does not support the need for the proposed program and the basis for this determination. If a local mental health authority does not respond within 60 days of the receipt of the request, the commissioner shall determine the need for the program based on the documentation submitted by the provider entity.