SF 1953

1st Engrossment - 94th Legislature (2025 - 2026)

Posted on 06/06/2025 12:14 p.m.

A bill for an act
relating to mental health; modifying the definition of mental illness; making changes
to medical assistance transportation reimbursement rates; establishing a grant
program for children at risk of bipolar disorder; requiring a report; appropriating
money for the children's first episode of psychosis program; amending Minnesota
Statutes 2024, sections 245.462, subdivision 20; 245.467, subdivision 4; 245.4711,
subdivisions 1, 4; 245.4712, subdivisions 1, 3; 245.4889, subdivision 1; 245I.05,
subdivisions 3, 5; 245I.11, subdivision 5; 256B.0625, subdivisions 3b, 17, 20;
proposing coding for new law in Minnesota Statutes, chapter 245.

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

Section 1.

Minnesota Statutes 2024, section 245.462, subdivision 20, is amended to read:

Subd. 20.

Mental illness.

(a) "Mental illness" means an organic disorder of the brain or
a clinically significant disorder of thought, mood, perception, orientation, memory, or
behavior that is detailed in a diagnostic codes list published by the commissioner, and that
seriously limits a person's capacity to function in primary aspects of daily living such as
personal relations, living arrangements, work, and recreation.

(b) An "adult with acute mental illness" means an adult who has a mental illness that is
serious enough to require prompt intervention.

(c) For purposes of new text begin enrolling in new text end case management and community support services, a
"person with serious and persistent mental illness" means an adult who has a mental illness
and meets at least one of the following criteria:

(1) the adult has undergone deleted text begin two deleted text end new text begin one new text end or more episodes of inpatient new text begin , residential, or crisis
residential new text end care for a mental illness within the preceding deleted text begin 24 deleted text end new text begin 12 new text end months;

(2) the adult has experienced a continuous psychiatric hospitalization or residential
treatment exceeding six months' duration within the preceding 12 months;

(3) the adult has been treated by a crisis team two or more times within the preceding
24 months;

(4) the adult:

(i) has a diagnosis of schizophrenia, bipolar disorder, major depression, schizoaffective
disorder, new text begin posttraumatic stress disorder, generalized anxiety disorder, panic disorder, eating
disorder, new text end or borderline personality disorder;

(ii) indicates a significant impairment in functioning; and

(iii) has a written opinion from a mental health professional, in the last three years,
stating that the adult is reasonably likely to have future episodes requiring inpatient or
residential treatment, of a frequency described in clause (1) or (2), new text begin or the need for in-home
services to remain in one's home, new text end unless ongoing case management or community support
services are provided;

(5) the adult has, in the last deleted text begin three deleted text end new text begin five new text end years, been committed by a court as a person deleted text begin who
is mentally ill deleted text end new text begin with a mental illness new text end under chapter 253B, or the adult's commitment has been
stayed or continued; new text begin or
new text end

deleted text begin (6) the adult (i) was eligible under clauses (1) to (5), but the specified time period has
expired or the adult was eligible as a child under section 245.4871, subdivision 6; and (ii)
has a written opinion from a mental health professional, in the last three years, stating that
the adult is reasonably likely to have future episodes requiring inpatient or residential
treatment, of a frequency described in clause (1) or (2), unless ongoing case management
or community support services are provided; or
deleted text end

deleted text begin (7) deleted text end new text begin (6) new text end the adult was eligible as a child under section 245.4871, subdivision 6, and is
age 21 or younger.

new text begin (d) For purposes of enrolling in case management and community support services, a
"person with a complex post-traumatic stress disorder" or "C-PTSD" means an adult who
has a mental illness and meets the following criteria:
new text end

new text begin (1) the adult has post-traumatic stress disorder (PTSD) symptoms that significantly
interfere with daily functioning related to intergenerational trauma, racial trauma, or
unresolved historical grief; and
new text end

new text begin (2) the adult has a written opinion from a mental health professional that includes
documentation of:
new text end

new text begin (i) culturally sensitive assessments or screenings and identification of intergenerational
trauma, racial trauma, or unresolved historical grief;
new text end

new text begin (ii) significant impairment in functioning due to the PTSD symptoms that meet C-PTSD
condition eligibility; and
new text end

new text begin (iii) increasing concerns within the last three years that indicates the adult is at a
reasonable likelihood of experiencing significant episodes of PTSD with increased frequency,
impacting daily functioning unless mitigated by targeted case management or community
support services.
new text end

new text begin (e) Adults may continue to receive case management or community support services if,
in the written opinion of a mental health professional, the person needs case management
or community support services to maintain the person's recovery.
new text end

new text begin EFFECTIVE DATE. new text end

new text begin Paragraph (d) is effective upon federal approval. The commissioner
of human services shall notify the revisor of statutes when federal approval is obtained.
new text end

Sec. 2.

Minnesota Statutes 2024, section 245.467, subdivision 4, is amended to read:

Subd. 4.

Referral for case management.

Each provider of emergency services, day
treatment services, outpatient treatment, community support services, residential treatment,
acute care hospital inpatient treatment, or regional treatment center inpatient treatment must
inform each of its clients with serious and persistent mental illness new text begin or a complex
post-traumatic stress disorder new text end of the availability and potential benefits to the client of case
management. If the client consents, the provider must refer the client by notifying the county
employee designated by the county board to coordinate case management activities of the
client's name and address and by informing the client of whom to contact to request case
management. The provider must document compliance with this subdivision in the client's
record.

new text begin EFFECTIVE DATE. new text end

new text begin This section is effective upon federal approval. The commissioner
of human services shall notify the revisor of statutes when federal approval is obtained.
new text end

Sec. 3.

Minnesota Statutes 2024, section 245.4711, subdivision 1, is amended to read:

Subdivision 1.

Availability of case management services.

(a) deleted text begin By January 1, 1989, deleted text end The
county board shall provide case management services for all adults with serious and persistent
mental illness new text begin or a complex post-traumatic stress disorder new text end who are residents of the county
and who request or consent to the services and to each adult for whom the court appoints a
case manager. Staffing ratios must be sufficient to serve the needs of the clients. The case
manager must meet the requirements in section 245.462, subdivision 4.

(b) Case management services provided to adults with serious and persistent mental
illness new text begin or a complex post-traumatic stress disorder new text end eligible for medical assistance must be
billed to the medical assistance program under sections 256B.02, subdivision 8, and
256B.0625.

(c) Case management services are eligible for reimbursement under the medical assistance
program. Costs associated with mentoring, supervision, and continuing education may be
included in the reimbursement rate methodology used for case management services under
the medical assistance program.

new text begin EFFECTIVE DATE. new text end

new text begin This section is effective upon federal approval. The commissioner
of human services shall notify the revisor of statutes when federal approval is obtained.
new text end

Sec. 4.

Minnesota Statutes 2024, section 245.4711, subdivision 4, is amended to read:

Subd. 4.

Individual community support plan.

(a) The case manager must develop an
individual community support plan for each adult that incorporates the client's individual
treatment plan. The individual treatment plan may not be a substitute for the development
of an individual community support plan. The individual community support plan must be
developed within 30 days of client intake and reviewed at least every 180 days after it is
developed, unless the case manager receives a written request from the client or the client's
family for a review of the plan every 90 days after it is developed. The case manager is
responsible for developing the individual community support plan based on a diagnostic
assessment and a functional assessment and for implementing and monitoring the delivery
of services according to the individual community support plan. To the extent possible, the
adult with serious and persistent mental illness new text begin or a complex post-traumatic stress disorder new text end ,
the person's family, advocates, service providers, and significant others must be involved
in all phases of development and implementation of the individual community support plan.

(b) The client's individual community support plan must state:

(1) the goals of each service;

(2) the activities for accomplishing each goal;

(3) a schedule for each activity; and

(4) the frequency of face-to-face contacts by the case manager, as appropriate to client
need and the implementation of the individual community support plan.

new text begin EFFECTIVE DATE. new text end

new text begin This section is effective upon federal approval. The commissioner
of human services shall notify the revisor of statutes when federal approval is obtained.
new text end

Sec. 5.

Minnesota Statutes 2024, section 245.4712, subdivision 1, is amended to read:

Subdivision 1.

Availability of community support services.

(a) County boards must
provide or contract for sufficient community support services within the county to meet the
needs of adults with serious and persistent mental illness new text begin or a complex post-traumatic stress
disorder new text end who are residents of the county. Adults may be required to pay a fee according to
section 245.481. The community support services program must be designed to improve
the ability of adults with serious and persistent mental illness new text begin or a complex post-traumatic
stress disorder new text end to:

(1) find and maintain competitive employment;

(2) handle basic activities of daily living;

(3) participate in leisure time activities;

(4) set goals and plans; and

(5) obtain and maintain appropriate living arrangements.

The community support services program must also be designed to reduce the need for
and use of more intensive, costly, or restrictive placements both in number of admissions
and length of stay.

(b) Community support services are those services that are supportive in nature and not
necessarily treatment oriented, and include:

(1) conducting outreach activities such as home visits, health and wellness checks, and
problem solving;

(2) connecting people to resources to meet their basic needs;

(3) finding, securing, and supporting people in their housing;

(4) attaining and maintaining health insurance benefits;

(5) assisting with job applications, finding and maintaining employment, and securing
a stable financial situation;

(6) fostering social support, including support groups, mentoring, peer support, and other
efforts to prevent isolation and promote recovery; and

(7) educating about mental illness, treatment, and recovery.

(c) Community support services shall use all available funding streams. The county shall
maintain the level of expenditures for this program, as required under section 245.4835.
County boards must continue to provide funds for those services not covered by other
funding streams and to maintain an infrastructure to carry out these services. The county is
encouraged to fund evidence-based practices such as Individual Placement and Supported
Employment and Illness Management and Recovery.

(d) The commissioner shall collect data on community support services programs,
including, but not limited to, demographic information such as age, sex, race, the number
of people served, and information related to housing, employment, hospitalization, symptoms,
and satisfaction with services.

new text begin EFFECTIVE DATE. new text end

new text begin This section is effective upon federal approval. The commissioner
of human services shall notify the revisor of statutes when federal approval is obtained.
new text end

Sec. 6.

Minnesota Statutes 2024, section 245.4712, subdivision 3, is amended to read:

Subd. 3.

Benefits assistance.

The county board must offer to help adults with serious
and persistent mental illness new text begin or a complex post-traumatic stress disorder new text end in applying for
state and federal benefits, including Supplemental Security Income, medical assistance,
Medicare, general assistance, and Minnesota supplemental aid. The help must be offered
as part of the community support program available to adults with serious and persistent
mental illness new text begin or a complex post-traumatic stress disorder new text end for whom the county is financially
responsible and who may qualify for these benefits.

Sec. 7.

Minnesota Statutes 2024, section 245.4889, subdivision 1, is amended to read:

Subdivision 1.

Establishment and authority.

(a) The commissioner is authorized to
make grants from available appropriations to assist:

(1) counties;

(2) Indian tribes;

(3) children's collaboratives under section 142D.15 or 245.493; or

(4) mental health service providers.

(b) The following services are eligible for grants under this section:

(1) services to children with emotional disturbances as defined in section 245.4871,
subdivision 15, and their families;

(2) transition services under section 245.4875, subdivision 8, for young adults under
age 21 and their families;

(3) respite care services for children with emotional disturbances or severe emotional
disturbances who are at risk of residential treatment or hospitalization, who are already in
out-of-home placement in family foster settings as defined in chapter 142B and at risk of
change in out-of-home placement or placement in a residential facility or other higher level
of care, who have utilized crisis services or emergency room services, or who have
experienced a loss of in-home staffing support. Allowable activities and expenses for respite
care services are defined under subdivision 4. A child is not required to have case
management services to receive respite care services. Counties must work to provide access
to regularly scheduled respite care;

(4) children's mental health crisis services;

(5) child-, youth-, and family-specific mobile response and stabilization services models;

(6) mental health services for people from cultural and ethnic minorities, including
supervision of clinical trainees who are Black, indigenous, or people of color;

(7) children's mental health screening and follow-up diagnostic assessment and treatment;

(8) services to promote and develop the capacity of providers to use evidence-based
practices in providing children's mental health services;

(9) school-linked mental health services under section 245.4901;

(10) building evidence-based mental health intervention capacity for children birth to
age five;

(11) suicide prevention and counseling services that use text messaging statewide;

(12) mental health first aid training;

(13) training for parents, collaborative partners, and mental health providers on the
impact of adverse childhood experiences and trauma and development of an interactive
website to share information and strategies to promote resilience and prevent trauma;

(14) transition age services to develop or expand mental health treatment and supports
for adolescents and young adults 26 years of age or younger;

(15) early childhood mental health consultation;

(16) evidence-based interventions for youth at risk of developing or experiencing a first
episode of psychosis, and a public awareness campaign on the signs and symptoms of
psychosis;

(17) psychiatric consultation for primary care practitioners; deleted text begin and
deleted text end

(18) providers to begin operations and meet program requirements when establishing a
new children's mental health program. These may be start-up grants new text begin ; and
new text end

new text begin (19) evidence-based interventions for youth and young adults at risk of developing or
experiencing an early episode of bipolar disorder new text end .

(c) Services under paragraph (b) must be designed to help each child to function and
remain with the child's family in the community and delivered consistent with the child's
treatment plan. Transition services to eligible young adults under this paragraph must be
designed to foster independent living in the community.

(d) As a condition of receiving grant funds, a grantee shall obtain all available third-party
reimbursement sources, if applicable.

(e) The commissioner may establish and design a pilot program to expand the mobile
response and stabilization services model for children, youth, and families. The commissioner
may use grant funding to consult with a qualified expert entity to assist in the formulation
of measurable outcomes and explore and position the state to submit a Medicaid state plan
amendment to scale the model statewide.

Sec. 8.

new text begin [245.4904] EARLY EPISODE OF BIPOLAR DISORDER GRANT
PROGRAM.
new text end

new text begin Subdivision 1. new text end

new text begin Establishment. new text end

new text begin The commissioner of human services must establish an
early episode of bipolar disorder grant program within the department to fund evidence-based
interventions for youth and young adults at risk of developing or experiencing an early
episode of bipolar disorder.
new text end

new text begin Subd. 2. new text end

new text begin Definitions. new text end

new text begin For the purposes of this section, "youth and young adults" means
individuals who are 15 years of age or older and under 41 years of age.
new text end

new text begin Subd. 3. new text end

new text begin Activities. new text end

new text begin (a) All grantees must:
new text end

new text begin (1) provide intensive treatment and support for youth and young adults experiencing or
at risk of experiencing early episodes of bipolar disorder. Intensive treatment and support
may include medication management, psychoeducation for an individual and the individual's
family, case management, employment support, education support, cognitive behavioral
approaches, social skills training, peer and family peer support, crisis planning, and stress
management;
new text end

new text begin (2) conduct outreach and provide training and guidance to mental health and health care
professionals, including postsecondary health clinicians, on bipolar disorder symptoms,
screening tools, the early episode of bipolar disorder grant program, and best practices; and
new text end

new text begin (3) use all available funding streams.
new text end

new text begin (b) Grant money may be used to pay for housing or travel expenses for individuals
receiving services or to address other barriers that prevent individuals and their families
from participating in early episode of bipolar disorder services.
new text end

new text begin (c) Program activities must only be provided to youth and young adults experiencing
bipolar disorder or early episodes of bipolar disorder.
new text end

new text begin Subd. 4. new text end

new text begin Outcomes and report. new text end

new text begin (a) The commissioner must annually evaluate the early
episode of bipolar grant program.
new text end

new text begin (b) The evaluation must utilize evidence-based practices and must include the following
outcome evaluation criteria:
new text end

new text begin (1) whether individuals experience a reduction in symptoms;
new text end

new text begin (2) whether individuals experience a decrease in inpatient mental health hospitalizations
or interactions with the criminal justice system; and
new text end

new text begin (3) whether individuals experience an increase in educational attainment or employment.
new text end

new text begin (c) By July 1, 2026, and every July 1 thereafter, the commissioner must provide a report
to the chairs and ranking minority members of the legislative committees with jurisdiction
over mental health, along with the chairs and ranking minority members of the senate finance
committee and house of representatives ways and means committee. The report must include
the number of grantees receiving funds under this section, the number of individuals served
under this section, data from the evaluation conducted under this subdivision, and information
on the use of state and federal funds for the services provided under this section.
new text end

new text begin Subd. 5. new text end

new text begin Funding. new text end

new text begin Early episode of bipolar disorder services are eligible for children's
mental health grants as specified in section 245.4889, subdivision 1, paragraph (b), clause
(19).
new text end

new text begin Subd. 6. new text end

new text begin Federal aid or grants. new text end

new text begin The commissioner of human services must comply with
all conditions and requirements necessary to receive federal aid or grants.
new text end

Sec. 9.

Minnesota Statutes 2024, section 245I.05, subdivision 3, is amended to read:

Subd. 3.

Initial training.

(a) A staff person must receive training about:

(1) vulnerable adult maltreatment under section 245A.65, subdivision 3; and

(2) the maltreatment of minor reporting requirements and definitions in chapter 260E
within 72 hours of first providing direct contact services to a client.

(b) Before providing direct contact services to a client, a staff person must receive training
about:

(1) client rights and protections under section 245I.12;

(2) the Minnesota Health Records Act, including client confidentiality, family engagement
under section 144.294, and client privacy;

(3) emergency procedures that the staff person must follow when responding to a fire,
inclement weather, a report of a missing person, and a behavioral or medical emergency;

(4) specific activities and job functions for which the staff person is responsible, including
the license holder's program policies and procedures applicable to the staff person's position;

(5) professional boundaries that the staff person must maintain; and

(6) specific needs of each client to whom the staff person will be providing direct contact
services, including each client's developmental status, cognitive functioning, and physical
and mental abilities.

(c) Before providing direct contact services to a client, a mental health rehabilitation
worker, mental health behavioral aide, or mental health practitioner required to receive the
training according to section 245I.04, subdivision 4, must receive 30 hours of training about:

(1) mental illnesses;

(2) client recovery and resiliency;

(3) mental health de-escalation techniques;

(4) co-occurring mental illness and substance use disorders; and

(5) psychotropic medications and medication side effects new text begin , including tardive dyskinesia new text end .

(d) Within 90 days of first providing direct contact services to an adult client, mental
health practitioner, mental health certified peer specialist, or mental health rehabilitation
worker must receive training about:

(1) trauma-informed care and secondary trauma;

(2) person-centered individual treatment plans, including seeking partnerships with
family and other natural supports;

(3) co-occurring substance use disorders; and

(4) culturally responsive treatment practices.

(e) Within 90 days of first providing direct contact services to a child client, mental
health practitioner, mental health certified family peer specialist, mental health certified
peer specialist, or mental health behavioral aide must receive training about the topics in
clauses (1) to (5). This training must address the developmental characteristics of each child
served by the license holder and address the needs of each child in the context of the child's
family, support system, and culture. Training topics must include:

(1) trauma-informed care and secondary trauma, including adverse childhood experiences
(ACEs);

(2) family-centered treatment plan development, including seeking partnership with a
child client's family and other natural supports;

(3) mental illness and co-occurring substance use disorders in family systems;

(4) culturally responsive treatment practices; and

(5) child development, including cognitive functioning, and physical and mental abilities.

(f) For a mental health behavioral aide, the training under paragraph (e) must include
parent team training using a curriculum approved by the commissioner.

Sec. 10.

Minnesota Statutes 2024, section 245I.05, subdivision 5, is amended to read:

Subd. 5.

Additional training for medication administration.

(a) Prior to administering
medications to a client under delegated authority or observing a client self-administer
medications, a staff person who is not a licensed prescriber, registered nurse, or licensed
practical nurse qualified under section 148.171, subdivision 8, must receive training about
psychotropic medications, side effects new text begin including tardive dyskinesia new text end , and medication
management.

(b) Prior to administering medications to a client under delegated authority, a staff person
must successfully complete a:

(1) medication administration training program for unlicensed personnel through an
accredited Minnesota postsecondary educational institution with completion of the course
documented in writing and placed in the staff person's personnel file; or

(2) formalized training program taught by a registered nurse or licensed prescriber that
is offered by the license holder. A staff person's successful completion of the formalized
training program must include direct observation of the staff person to determine the staff
person's areas of competency.

Sec. 11.

Minnesota Statutes 2024, section 245I.11, subdivision 5, is amended to read:

Subd. 5.

Medication administration in residential programs.

If a license holder is
licensed as a residential program, the license holder must:

(1) assess and document each client's ability to self-administer medication. In the
assessment, the license holder must evaluate the client's ability to: (i) comply with prescribed
medication regimens; and (ii) store the client's medications safely and in a manner that
protects other individuals in the facility. Through the assessment process, the license holder
must assist the client in developing the skills necessary to safely self-administer medication;

(2) monitor the effectiveness of medications, side effects of medications, and adverse
reactions to medications new text begin , including symptoms and signs of tardive dyskinesia, new text end for each
client. The license holder must address and document any concerns about a client's
medications;

(3) ensure that no staff person or client gives a legend drug supply for one client to
another client;

(4) have policies and procedures for: (i) keeping a record of each client's medication
orders; (ii) keeping a record of any incident of deferring a client's medications; (iii)
documenting any incident when a client's medication is omitted; and (iv) documenting when
a client refuses to take medications as prescribed; and

(5) document and track medication errors, document whether the license holder notified
anyone about the medication error, determine if the license holder must take any follow-up
actions, and identify the staff persons who are responsible for taking follow-up actions.

Sec. 12.

Minnesota Statutes 2024, section 256B.0625, subdivision 3b, is amended to read:

Subd. 3b.

Telehealth services.

(a) Medical assistance covers medically necessary services
and consultations delivered by a health care provider through telehealth in the same manner
as if the service or consultation was delivered through in-person contact. Services or
consultations delivered through telehealth shall be paid at the full allowable rate.

(b) The commissioner may establish criteria that a health care provider must attest to in
order to demonstrate the safety or efficacy of delivering a particular service through
telehealth. The attestation may include that the health care provider:

(1) has identified the categories or types of services the health care provider will provide
through telehealth;

(2) has written policies and procedures specific to services delivered through telehealth
that are regularly reviewed and updated;

(3) has policies and procedures that adequately address patient safety before, during,
and after the service is delivered through telehealth;

(4) has established protocols addressing how and when to discontinue telehealth services;
and

(5) has an established quality assurance process related to delivering services through
telehealth.

(c) As a condition of payment, a licensed health care provider must document each
occurrence of a health service delivered through telehealth to a medical assistance enrollee.
Health care service records for services delivered through telehealth must meet the
requirements set forth in Minnesota Rules, part 9505.2175, subparts 1 and 2, and must
document:

(1) the type of service delivered through telehealth;

(2) the time the service began and the time the service ended, including an a.m. and p.m.
designation;

(3) the health care provider's basis for determining that telehealth is an appropriate and
effective means for delivering the service to the enrollee;

(4) the mode of transmission used to deliver the service through telehealth and records
evidencing that a particular mode of transmission was utilized;

(5) the location of the originating site and the distant site;

(6) if the claim for payment is based on a physician's consultation with another physician
through telehealth, the written opinion from the consulting physician providing the telehealth
consultation; and

(7) compliance with the criteria attested to by the health care provider in accordance
with paragraph (b).

(d) Telehealth visits provided through audio and visual communication or accessible
video-based platforms may be used to satisfy the face-to-face requirement for reimbursement
under the payment methods that apply to a federally qualified health center, rural health
clinic, Indian health service, 638 tribal clinic, and certified community behavioral health
clinic, if the service would have otherwise qualified for payment if performed in person.

(e) For purposes of this subdivision, unless otherwise covered under this chapter:

(1) "telehealth" means the delivery of health care services or consultations using real-time
two-way interactive audio and visual communication or accessible telehealth video-based
platforms to provide or support health care delivery and facilitate the assessment, diagnosis,
consultation, treatment, education, and care management of a patient's health care. Telehealth
includes: the application of secure video conferencing consisting of a real-time, full-motion
synchronized video; store-and-forward technology; and synchronous interactions, between
a patient located at an originating site and a health care provider located at a distant site.
Telehealth does not include communication between health care providers, or between a
health care provider and a patient that consists solely of an audio-only communication,
email, or facsimile transmission or as specified by law new text begin , except that between January 1, 2026,
and January 1, 2029, telehealth includes communication between a health care provider and
a patient that solely consists of audio-only communication new text end ;

(2) "health care provider" means a health care provider as defined under section 62A.673;
a community paramedic as defined under section 144E.001, subdivision 5f; a community
health worker who meets the criteria under subdivision 49, paragraph (a); a mental health
certified peer specialist under section 245I.04, subdivision 10; a mental health certified
family peer specialist under section 245I.04, subdivision 12; a mental health rehabilitation
worker under section 245I.04, subdivision 14; a mental health behavioral aide under section
245I.04, subdivision 16; a treatment coordinator under section 245G.11, subdivision 7; an
alcohol and drug counselor under section 245G.11, subdivision 5; or a recovery peer under
section 245G.11, subdivision 8; and

(3) "originating site," "distant site," and "store-and-forward technology" have the
meanings given in section 62A.673, subdivision 2.

new text begin EFFECTIVE DATE. new text end

new text begin This section is effective January 1, 2026, or upon federal approval,
whichever is later. The commissioner of human services shall notify the revisor of statutes
when federal approval is obtained.
new text end

Sec. 13.

Minnesota Statutes 2024, section 256B.0625, subdivision 17, is amended to read:

Subd. 17.

Transportation costs.

(a) "Nonemergency medical transportation service"
means motor vehicle transportation provided by a public or private person that serves
Minnesota health care program beneficiaries who do not require emergency ambulance
service, as defined in section 144E.001, subdivision 3, to obtain covered medical services.

(b) For purposes of this subdivision, "rural urban commuting area" or "RUCA" means
a census-tract based classification system under which a geographical area is determined
to be urban, rural, or super rural.

(c) Medical assistance covers medical transportation costs incurred solely for obtaining
emergency medical care or transportation costs incurred by eligible persons in obtaining
emergency or nonemergency medical care when paid directly to an ambulance company,
nonemergency medical transportation company, or other recognized providers of
transportation services. Medical transportation must be provided by:

(1) nonemergency medical transportation providers who meet the requirements of this
subdivision;

(2) ambulances, as defined in section 144E.001, subdivision 2;

(3) taxicabs that meet the requirements of this subdivision;

(4) public transportation, within the meaning of "public transportation" as defined in
section 174.22, subdivision 7; or

(5) not-for-hire vehicles, including volunteer drivers, as defined in section 65B.472,
subdivision 1, paragraph (p).

(d) Medical assistance covers nonemergency medical transportation provided by
nonemergency medical transportation providers enrolled in the Minnesota health care
programs. All nonemergency medical transportation providers must comply with the
operating standards for special transportation service as defined in sections 174.29 to 174.30
and Minnesota Rules, chapter 8840, and all drivers must be individually enrolled with the
commissioner and reported on the claim as the individual who provided the service. All
nonemergency medical transportation providers shall bill for nonemergency medical
transportation services in accordance with Minnesota health care programs criteria. Publicly
operated transit systems, volunteers, and not-for-hire vehicles are exempt from the
requirements outlined in this paragraph.

(e) An organization may be terminated, denied, or suspended from enrollment if:

(1) the provider has not initiated background studies on the individuals specified in
section 174.30, subdivision 10, paragraph (a), clauses (1) to (3); or

(2) the provider has initiated background studies on the individuals specified in section
174.30, subdivision 10, paragraph (a), clauses (1) to (3), and:

(i) the commissioner has sent the provider a notice that the individual has been
disqualified under section 245C.14; and

(ii) the individual has not received a disqualification set-aside specific to the special
transportation services provider under sections 245C.22 and 245C.23.

(f) The administrative agency of nonemergency medical transportation must:

(1) adhere to the policies defined by the commissioner;

(2) pay nonemergency medical transportation providers for services provided to
Minnesota health care programs beneficiaries to obtain covered medical services;

(3) provide data monthly to the commissioner on appeals, complaints, no-shows, canceled
trips, and number of trips by mode; and

(4) by July 1, 2016, in accordance with subdivision 18e, utilize a web-based single
administrative structure assessment tool that meets the technical requirements established
by the commissioner, reconciles trip information with claims being submitted by providers,
and ensures prompt payment for nonemergency medical transportation services.

(g) Until the commissioner implements the single administrative structure and delivery
system under subdivision 18e, clients shall obtain their level-of-service certificate from the
commissioner or an entity approved by the commissioner that does not dispatch rides for
clients using modes of transportation under paragraph (l), clauses (4), (5), (6), and (7).

(h) The commissioner may use an order by the recipient's attending physician, advanced
practice registered nurse, physician assistant, or a medical or mental health professional to
certify that the recipient requires nonemergency medical transportation services.
Nonemergency medical transportation providers shall perform driver-assisted services for
eligible individuals, when appropriate. Driver-assisted service includes passenger pickup
at and return to the individual's residence or place of business, assistance with admittance
of the individual to the medical facility, and assistance in passenger securement or in securing
of wheelchairs, child seats, or stretchers in the vehicle.

(i) Nonemergency medical transportation providers must take clients to the health care
provider using the most direct route, and must not exceed 30 miles for a trip to a primary
care provider or 60 miles for a trip to a specialty care provider, unless the client receives
authorization from the local agency.

(j) Nonemergency medical transportation providers may not bill for separate base rates
for the continuation of a trip beyond the original destination. Nonemergency medical
transportation providers must maintain trip logs, which include pickup and drop-off times,
signed by the medical provider or client, whichever is deemed most appropriate, attesting
to mileage traveled to obtain covered medical services. Clients requesting client mileage
reimbursement must sign the trip log attesting mileage traveled to obtain covered medical
services.

(k) The administrative agency shall use the level of service process established by the
commissioner to determine the client's most appropriate mode of transportation. If public
transit or a certified transportation provider is not available to provide the appropriate service
mode for the client, the client may receive a onetime service upgrade.

(l) The covered modes of transportation are:

(1) client reimbursement, which includes client mileage reimbursement provided to
clients who have their own transportation, or to family or an acquaintance who provides
transportation to the client;

(2) volunteer transport, which includes transportation by volunteers using their own
vehicle;

(3) unassisted transport, which includes transportation provided to a client by a taxicab
or public transit. If a taxicab or public transit is not available, the client can receive
transportation from another nonemergency medical transportation provider;

(4) assisted transport, which includes transport provided to clients who require assistance
by a nonemergency medical transportation provider;

(5) lift-equipped/ramp transport, which includes transport provided to a client who is
dependent on a device and requires a nonemergency medical transportation provider with
a vehicle containing a lift or ramp;

(6) protected transport, which includes transport provided to a client who has received
a prescreening that has deemed other forms of transportation inappropriate and who requires
a provider: (i) with a protected vehicle that is not an ambulance or police car and has safety
locks, a video recorder, and a transparent thermoplastic partition between the passenger and
the vehicle driver; and (ii) who is certified as a protected transport provider; and

(7) stretcher transport, which includes transport for a client in a prone or supine position
and requires a nonemergency medical transportation provider with a vehicle that can transport
a client in a prone or supine position.

(m) The local agency shall be the single administrative agency and shall administer and
reimburse for modes defined in paragraph (l) according to paragraphs (p) and (q) when the
commissioner has developed, made available, and funded the web-based single administrative
structure, assessment tool, and level of need assessment under subdivision 18e. The local
agency's financial obligation is limited to funds provided by the state or federal government.

(n) The commissioner shall:

(1) verify that the mode and use of nonemergency medical transportation is appropriate;

(2) verify that the client is going to an approved medical appointment; and

(3) investigate all complaints and appeals.

(o) The administrative agency shall pay for the services provided in this subdivision and
seek reimbursement from the commissioner, if appropriate. As vendors of medical care,
local agencies are subject to the provisions in section 256B.041, the sanctions and monetary
recovery actions in section 256B.064, and Minnesota Rules, parts 9505.2160 to 9505.2245.

(p) Payments for nonemergency medical transportation must be paid based on the client's
assessed mode under paragraph (k), not the type of vehicle used to provide the service. The
medical assistance reimbursement rates for nonemergency medical transportation services
that are payable by or on behalf of the commissioner for nonemergency medical
transportation services are:

(1) $0.22 per mile for client reimbursement;

(2) up to 100 percent of the Internal Revenue Service business deduction rate for volunteer
transport;

(3) equivalent to the standard fare for unassisted transport when provided by public
transit, and $12.10 for the base rate and $1.43 per mile when provided by a nonemergency
medical transportation provider;

(4) $14.30 for the base rate and $1.43 per mile for assisted transport;

(5) $19.80 for the base rate and $1.70 per mile for lift-equipped/ramp transport;

(6) $75 for the base rate new text begin for the first 100 miles and an additional $75 for trips over 100
miles new text end and $2.40 per mile for protected transport; and

(7) $60 for the base rate and $2.40 per mile for stretcher transport, and $9 per trip for
an additional attendant if deemed medically necessary.

(q) The base rate for nonemergency medical transportation services in areas defined
under RUCA to be super rural is equal to 111.3 percent of the respective base rate in
paragraph (p), clauses (1) to (7). The mileage rate for nonemergency medical transportation
services in areas defined under RUCA to be rural or super rural areas is:

(1) for a trip equal to 17 miles or less, equal to 125 percent of the respective mileage
rate in paragraph (p), clauses (1) to (7); and

(2) for a trip between 18 and 50 miles, equal to 112.5 percent of the respective mileage
rate in paragraph (p), clauses (1) to (7).

(r) For purposes of reimbursement rates for nonemergency medical transportation services
under paragraphs (p) and (q), the zip code of the recipient's place of residence shall determine
whether the urban, rural, or super rural reimbursement rate applies.

(s) The commissioner, when determining reimbursement rates for nonemergency medical
transportation under paragraphs (p) and (q), shall exempt all modes of transportation listed
under paragraph (l) from Minnesota Rules, part 9505.0445, item R, subitem (2).

(t) Effective for the first day of each calendar quarter in which the price of gasoline as
posted publicly by the United States Energy Information Administration exceeds $3.00 per
gallon, the commissioner shall adjust the rate paid per mile in paragraph (p) by one percent
up or down for every increase or decrease of ten cents for the price of gasoline. The increase
or decrease must be calculated using a base gasoline price of $3.00. The percentage increase
or decrease must be calculated using the average of the most recently available price of all
grades of gasoline for Minnesota as posted publicly by the United States Energy Information
Administration.

Sec. 14.

Minnesota Statutes 2024, section 256B.0625, subdivision 20, is amended to read:

Subd. 20.

Mental health case management.

(a) To the extent authorized by rule of the
state agency, medical assistance covers case management services to persons with serious
and persistent mental illness new text begin , persons with a complex post-traumatic stress disorder, new text end and
children with severe emotional disturbance. Services provided under this section must meet
the relevant standards in sections 245.461 to 245.4887, the Comprehensive Adult and
Children's Mental Health Acts, Minnesota Rules, parts 9520.0900 to 9520.0926, and
9505.0322, excluding subpart 10.

(b) Entities meeting program standards set out in rules governing family community
support services as defined in section 245.4871, subdivision 17, are eligible for medical
assistance reimbursement for case management services for children with severe emotional
disturbance when these services meet the program standards in Minnesota Rules, parts
9520.0900 to 9520.0926 and 9505.0322, excluding subparts 6 and 10.

(c) Medical assistance and MinnesotaCare payment for mental health case management
shall be made on a monthly basis. In order to receive payment for an eligible child, the
provider must document at least a face-to-face contact either in person or by interactive
video that meets the requirements of subdivision 20b with the child, the child's parents, or
the child's legal representative. To receive payment for an eligible adult, the provider must
document:

(1) at least a face-to-face contact with the adult or the adult's legal representative either
in person or by interactive video that meets the requirements of subdivision 20b; or

(2) at least a telephone contact with the adult or the adult's legal representative and
document a face-to-face contact either in person or by interactive video that meets the
requirements of subdivision 20b with the adult or the adult's legal representative within the
preceding two months.

(d) Payment for mental health case management provided by county or state staff shall
be based on the monthly rate methodology under section 256B.094, subdivision 6, paragraph
(b), with separate rates calculated for child welfare and mental health, and within mental
health, separate rates for children and adults.

(e) Payment for mental health case management provided by Indian health services or
by agencies operated by Indian tribes may be made according to this section or other relevant
federally approved rate setting methodology.

(f) Payment for mental health case management provided by vendors who contract with
a county must be calculated in accordance with section 256B.076, subdivision 2. Payment
for mental health case management provided by vendors who contract with a Tribe must
be based on a monthly rate negotiated by the Tribe. The rate must not exceed the rate charged
by the vendor for the same service to other payers. If the service is provided by a team of
contracted vendors, the team shall determine how to distribute the rate among its members.
No reimbursement received by contracted vendors shall be returned to the county or tribe,
except to reimburse the county or tribe for advance funding provided by the county or tribe
to the vendor.

(g) If the service is provided by a team which includes contracted vendors, tribal staff,
and county or state staff, the costs for county or state staff participation in the team shall be
included in the rate for county-provided services. In this case, the contracted vendor, the
tribal agency, and the county may each receive separate payment for services provided by
each entity in the same month. In order to prevent duplication of services, each entity must
document, in the recipient's file, the need for team case management and a description of
the roles of the team members.

(h) Notwithstanding section 256B.19, subdivision 1, the nonfederal share of costs for
mental health case management shall be provided by the recipient's county of responsibility,
as defined in sections 256G.01 to 256G.12, from sources other than federal funds or funds
used to match other federal funds. If the service is provided by a tribal agency, the nonfederal
share, if any, shall be provided by the recipient's tribe. When this service is paid by the state
without a federal share through fee-for-service, 50 percent of the cost shall be provided by
the recipient's county of responsibility.

(i) Notwithstanding any administrative rule to the contrary, prepaid medical assistance
and MinnesotaCare include mental health case management. When the service is provided
through prepaid capitation, the nonfederal share is paid by the state and the county pays no
share.

(j) The commissioner may suspend, reduce, or terminate the reimbursement to a provider
that does not meet the reporting or other requirements of this section. The county of
responsibility, as defined in sections 256G.01 to 256G.12, or, if applicable, the tribal agency,
is responsible for any federal disallowances. The county or tribe may share this responsibility
with its contracted vendors.

(k) The commissioner shall set aside a portion of the federal funds earned for county
expenditures under this section to repay the special revenue maximization account under
section 256.01, subdivision 2, paragraph (n). The repayment is limited to:

(1) the costs of developing and implementing this section; and

(2) programming the information systems.

(l) Payments to counties and tribal agencies for case management expenditures under
this section shall only be made from federal earnings from services provided under this
section. When this service is paid by the state without a federal share through fee-for-service,
50 percent of the cost shall be provided by the state. Payments to county-contracted vendors
shall include the federal earnings, the state share, and the county share.

(m) Case management services under this subdivision do not include therapy, treatment,
legal, or outreach services.

(n) If the recipient is a resident of a nursing facility, intermediate care facility, or hospital,
and the recipient's institutional care is paid by medical assistance, payment for case
management services under this subdivision is limited to the lesser of:

(1) the last 180 days of the recipient's residency in that facility and may not exceed more
than six months in a calendar year; or

(2) the limits and conditions which apply to federal Medicaid funding for this service.

(o) Payment for case management services under this subdivision shall not duplicate
payments made under other program authorities for the same purpose.

(p) If the recipient is receiving care in a hospital, nursing facility, or residential setting
licensed under chapter 245A or 245D that is staffed 24 hours a day, seven days a week,
mental health targeted case management services must actively support identification of
community alternatives for the recipient and discharge planning.

new text begin EFFECTIVE DATE. new text end

new text begin This section is effective upon federal approval. The commissioner
of human services shall notify the revisor of statutes when federal approval is obtained.
new text end

Sec. 15. new text begin APPROPRIATION; EARLY EPISODE OF BIPOLAR DISORDER GRANT
PROGRAM.
new text end

new text begin $....... in fiscal year 2026 and $....... in fiscal year 2027 are appropriated from the general
fund to the commissioner of human services for the early episode of bipolar disorder grant
program under Minnesota Statutes, section 245.4904.
new text end

Sec. 16. new text begin APPROPRIATION; FIRST EPISODE OF PSYCHOSIS GRANT
PROGRAM.
new text end

new text begin (a) $....... in fiscal year 2026 and $....... in fiscal year 2027 are appropriated from the
general fund to the commissioner of human services for the first episode of psychosis grant
program under Minnesota Statutes, section 245.4905. This amount is added to the base.
new text end

new text begin (b) The commissioner of human services must fund current programs to ensure stability
and continuity of care, as long as the program has met the requirements for past usage of
funds. Funds may be used to fully fund current programs, increase a current program's
capacity, and expand programs to outside the seven-county metropolitan area.
new text end