HF 196

2nd Committee Engrossment - 85th Legislature (2007 - 2008) Posted on 12/22/2009 12:37pm

1.1A bill for an act

1.2relating to human services; changing mental health provisions; requiring mental
1.3health screening for certain inmates; establishing children's mental health
1.4grants and training; requiring students of higher education to carry health
1.5insurance; creating a loan forgiveness program; creating crisis intervention
1.6team grants; making changes to mental health funding provisions; modifying
1.7medical assistance covered services; increasing provider reimbursement
1.8rates; establishing pilot projects and work groups; authorizing grant funding;
1.9requiring reports; appropriating money;amending Minnesota Statutes 2006,
1.10sections 245.462, subdivision 20; 245.50, subdivision 5; 256B.038; 256B.0622,
1.11subdivision 2; 256B.0623, subdivisions 2, 5, 8, 12; 256B.0625, subdivisions
1.1238, 43, 46, by adding subdivisions; 256B.0943, subdivisions 1, 2, by adding
1.13subdivisions; 256B.69, subdivisions 5g, 5h; 256B.763; 256D.03, subdivisions
1.143, 4; 256D.44, subdivision 5; 256L.03, subdivisions 1, 5; 256L.035; 256L.07,
1.15subdivision 3; 256L.12, subdivision 9a; 641.15, by adding a subdivision;
1.16proposing coding for new law in Minnesota Statutes, chapters 135A; 144; 245;
1.17245A; 256; 256B; 626; 641.
1.18BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF MINNESOTA:

1.19ARTICLE 1

1.20CRIMINAL JUSTICE

1.21    Section 1. Minnesota Statutes 2006, section 256D.03, subdivision 3, is amended to
1.22read:
1.23    Subd. 3. General assistance medical care; eligibility. (a) General assistance
1.24medical care may be paid for any person who is not eligible for medical assistance under
1.25chapter 256B, including eligibility for medical assistance based on a spenddown of excess
1.26income according to section 256B.056, subdivision 5, or MinnesotaCare as defined in
1.27paragraph (b), except as provided in paragraph (c), and:
2.1    (1) who is receiving assistance under section 256D.05, except for families with
2.2children who are eligible under Minnesota family investment program (MFIP), or who is
2.3having a payment made on the person's behalf under sections 256I.01 to 256I.06; or
2.4    (2) who is a resident of Minnesota; and
2.5    (i) who has gross countable income not in excess of 75 percent of the federal poverty
2.6guidelines for the family size, using a six-month budget period and whose equity in assets
2.7is not in excess of $1,000 per assistance unit. General assistance medical care is not
2.8available for applicants or enrollees who are otherwise eligible for medical assistance but
2.9fail to verify their assets. Enrollees who become eligible for medical assistance shall be
2.10terminated and transferred to medical assistance. Exempt assets, the reduction of excess
2.11assets, and the waiver of excess assets must conform to the medical assistance program in
2.12section 256B.056, subdivision 3, with the following exception: the maximum amount of
2.13undistributed funds in a trust that could be distributed to or on behalf of the beneficiary by
2.14the trustee, assuming the full exercise of the trustee's discretion under the terms of the
2.15trust, must be applied toward the asset maximum;
2.16    (ii) who has gross countable income above 75 percent of the federal poverty
2.17guidelines but not in excess of 175 percent of the federal poverty guidelines for the
2.18family size, using a six-month budget period, whose equity in assets is not in excess
2.19of the limits in section 256B.056, subdivision 3c, and who applies during an inpatient
2.20hospitalization; or
2.21    (iii) the commissioner shall adjust the income standards under this section each July
2.221 by the annual update of the federal poverty guidelines following publication by the
2.23United States Department of Health and Human Services.
2.24    (b) Effective for applications and renewals processed on or after September 1, 2006,
2.25general assistance medical care may not be paid for applicants or recipients who are adults
2.26with dependent children under 21 whose gross family income is equal to or less than 275
2.27percent of the federal poverty guidelines who are not described in paragraph (e).
2.28    (c) Effective for applications and renewals processed on or after September 1, 2006,
2.29general assistance medical care may be paid for applicants and recipients who meet all
2.30eligibility requirements of paragraph (a), clause (2), item (i), for a temporary period
2.31beginning the date of application. Immediately following approval of general assistance
2.32medical care, enrollees shall be enrolled in MinnesotaCare under section 256L.04,
2.33subdivision 7 , with covered services as provided in section 256L.03 for the rest of the
2.34six-month eligibility period, until their six-month renewal.
3.1    (d) To be eligible for general assistance medical care following enrollment in
3.2MinnesotaCare as required by paragraph (c), an individual must complete a new
3.3application.
3.4    (e) Applicants and recipients eligible under paragraph (a), clause (1); who have
3.5applied for and are awaiting a determination of blindness or disability by the state medical
3.6review team or a determination of eligibility for Supplemental Security Income or Social
3.7Security Disability Insurance by the Social Security Administration; who fail to meet the
3.8requirements of section 256L.09, subdivision 2; who are classified as end-stage renal
3.9disease beneficiaries in the Medicare program; who are enrolled in private health care
3.10coverage as defined in section 256B.02, subdivision 9; who are eligible under paragraph
3.11(j); or who receive treatment funded pursuant to section 254B.02 are exempt from the
3.12MinnesotaCare enrollment requirements of this subdivision.
3.13    (f) For applications received on or after October 1, 2003, eligibility may begin no
3.14earlier than the date of application. For individuals eligible under paragraph (a), clause
3.15(2), item (i), a redetermination of eligibility must occur every 12 months. Individuals are
3.16eligible under paragraph (a), clause (2), item (ii), only during inpatient hospitalization but
3.17may reapply if there is a subsequent period of inpatient hospitalization.
3.18    (g) Beginning September 1, 2006, Minnesota health care program applications and
3.19renewals completed by recipients and applicants who are persons described in paragraph
3.20(c) and submitted to the county agency shall be determined for MinnesotaCare eligibility
3.21by the county agency. If all other eligibility requirements of this subdivision are met,
3.22eligibility for general assistance medical care shall be available in any month during which
3.23MinnesotaCare enrollment is pending. Upon notification of eligibility for MinnesotaCare,
3.24notice of termination for eligibility for general assistance medical care shall be sent to
3.25an applicant or recipient. If all other eligibility requirements of this subdivision are
3.26met, eligibility for general assistance medical care shall be available until enrollment in
3.27MinnesotaCare subject to the provisions of paragraphs (c), (e), and (f).
3.28    (h) The date of an initial Minnesota health care program application necessary to
3.29begin a determination of eligibility shall be the date the applicant has provided a name,
3.30address, and Social Security number, signed and dated, to the county agency or the
3.31Department of Human Services. If the applicant is unable to provide a name, address,
3.32Social Security number, and signature when health care is delivered due to a medical
3.33condition or disability, a health care provider may act on an applicant's behalf to establish
3.34the date of an initial Minnesota health care program application by providing the county
3.35agency or Department of Human Services with provider identification and a temporary
3.36unique identifier for the applicant. The applicant must complete the remainder of the
4.1application and provide necessary verification before eligibility can be determined. The
4.2county agency must assist the applicant in obtaining verification if necessary.
4.3    (i) County agencies are authorized to use all automated databases containing
4.4information regarding recipients' or applicants' income in order to determine eligibility for
4.5general assistance medical care or MinnesotaCare. Such use shall be considered sufficient
4.6in order to determine eligibility and premium payments by the county agency.
4.7    (j) General assistance medical care is not available for a person in a correctional
4.8facility unless the person is detained by law for less than one year in a county correctional
4.9or detention facility as a person accused or convicted of a crime, or admitted as an
4.10inpatient to a hospital on a criminal hold order, and the person is a recipient of general
4.11assistance medical care at the time the person is detained by law or admitted on a criminal
4.12hold order and as long as the person continues to meet other eligibility requirements
4.13of this subdivision.
4.14    (k) General assistance medical care is not available for applicants or recipients who
4.15do not cooperate with the county agency to meet the requirements of medical assistance.
4.16    (l) In determining the amount of assets of an individual eligible under paragraph
4.17(a), clause (2), item (i), there shall be included any asset or interest in an asset, including
4.18an asset excluded under paragraph (a), that was given away, sold, or disposed of for
4.19less than fair market value within the 60 months preceding application for general
4.20assistance medical care or during the period of eligibility. Any transfer described in this
4.21paragraph shall be presumed to have been for the purpose of establishing eligibility for
4.22general assistance medical care, unless the individual furnishes convincing evidence to
4.23establish that the transaction was exclusively for another purpose. For purposes of this
4.24paragraph, the value of the asset or interest shall be the fair market value at the time it
4.25was given away, sold, or disposed of, less the amount of compensation received. For any
4.26uncompensated transfer, the number of months of ineligibility, including partial months,
4.27shall be calculated by dividing the uncompensated transfer amount by the average monthly
4.28per person payment made by the medical assistance program to skilled nursing facilities
4.29for the previous calendar year. The individual shall remain ineligible until this fixed period
4.30has expired. The period of ineligibility may exceed 30 months, and a reapplication for
4.31benefits after 30 months from the date of the transfer shall not result in eligibility unless
4.32and until the period of ineligibility has expired. The period of ineligibility begins in the
4.33month the transfer was reported to the county agency, or if the transfer was not reported,
4.34the month in which the county agency discovered the transfer, whichever comes first. For
4.35applicants, the period of ineligibility begins on the date of the first approved application.
5.1    (m) When determining eligibility for any state benefits under this subdivision,
5.2the income and resources of all noncitizens shall be deemed to include their sponsor's
5.3income and resources as defined in the Personal Responsibility and Work Opportunity
5.4Reconciliation Act of 1996, title IV, Public Law 104-193, sections 421 and 422, and
5.5subsequently set out in federal rules.
5.6    (n) Undocumented noncitizens and nonimmigrants are ineligible for general
5.7assistance medical care. For purposes of this subdivision, a nonimmigrant is an individual
5.8in one or more of the classes listed in United States Code, title 8, section 1101(a)(15), and
5.9an undocumented noncitizen is an individual who resides in the United States without the
5.10approval or acquiescence of the Immigration and Naturalization Service.
5.11    (o) Notwithstanding any other provision of law, a noncitizen who is ineligible for
5.12medical assistance due to the deeming of a sponsor's income and resources, is ineligible
5.13for general assistance medical care.
5.14    (p) Effective July 1, 2003, general assistance medical care emergency services end.
5.15    (q) Effective July 1, 2007, individuals in a correctional facility who have been
5.16diagnosed with a mental illness as defined in section 245.462, subdivision 20, are
5.17eligible for general assistance medical care for three months from the date of release
5.18from confinement.

5.19    Sec. 2. Minnesota Statutes 2006, section 641.15, is amended by adding a subdivision
5.20to read:
5.21    Subd. 3a. Intake procedure; approved mental health screening. As part of its
5.22intake procedure for new prisoners, the sheriff shall use a mental health screening tool
5.23approved by the commissioner of corrections in consultation with the commissioner of
5.24human services to identify persons who may have mental illness.

5.25    Sec. 3. [641.156] COUNTY JAIL REENTRY PROJECTS; GRANTS.
5.26    Subdivision 1. Purpose. The purpose of the reentry project is to promote public
5.27safety, prevent recidivism, and promote a successful reintegration into the community
5.28by providing services to individuals confined in jails and county regional jails who are
5.29identified as having mental illness, traumatic brain injury, chemical dependency, or being
5.30homeless.
5.31    Subd. 2. Grants. (a) The commissioner of corrections, in consultation with the
5.32commissioner of human services, shall award grants to county boards for two-year reentry
5.33pilot projects. At a minimum, one project must be located outside the seven-county
6.1metropolitan area. Projects will target prisoners in jails and county regional jails who
6.2are identified as having:
6.3    (1) a mental illness, as defined in section 245.462, subdivision 20;
6.4    (2) a traumatic brain injury, as defined in section 256B.093, subdivision 4;
6.5    (3) chemical dependency, as defined in section 253B.02, subdivision 2; or
6.6    (4) a history of homelessness, as defined in section 116L.361, subdivision 5.
6.7    (b) The projects shall provide a range of services including, but not limited to,
6.8screening and assessment, client-specific programming, discharge planning and reentry
6.9assistance, and follow-up for at least six months after the prisoner has reentered the
6.10community.
6.11    Subd. 3. Applications. A grant applicant shall prepare and submit to the
6.12commissioner of corrections a written proposal detailing the plan and strategies on how
6.13the applicant will implement the program components in subdivision 4. The application
6.14shall include a proposed evaluation component of outcome measures including, but not
6.15limited to, numbers of prisoners served, recidivism, restoration of public benefits, and
6.16status regarding housing, employment, and treatment needs after six months.
6.17    Subd. 4. Program components. Each participating county shall:
6.18    (a) develop a written collaborative plan between the county jail or county regional
6.19jail and the county social services agency;
6.20    (b) assess each prisoner upon entry into the jail or county regional jail using a
6.21screening tool approved by the commissioner of corrections in consultation with the
6.22commissioner of human services to identify prisoners with the characteristics listed in
6.23subdivision 2, paragraph (a);
6.24    (c) ensure prisoners who are identified with a positive screening and who will be
6.25incarcerated for less than 30 days are offered follow-up care and referred to appropriate
6.26professionals;
6.27    (d) ensure prisoners who are identified as having a characteristic listed in subdivision
6.282, paragraph (a), and who will be incarcerated 30 days or longer, are provided with
6.29appropriate treatment and programming including, but not limited to, mental health
6.30treatment, counseling, living and employment skills development, substance abuse
6.31treatment, GED and literacy training, and referrals to aftercare treatment and skills training;
6.32    (e) offer to develop a discharge plan for prisoners identified as having a characteristic
6.33listed in subdivision 2, paragraph (a), who will be incarcerated for 90 days or longer.
6.34Discharge planning components must include:
6.35    (1) at least 60 days prior to the prisoner's release, the person responsible for discharge
6.36planning authorized by this section shall begin assisting the prisoner to establish, or
7.1reestablish, benefits such as medical assistance, veterans' benefits, MinnesotaCare, general
7.2assistance medical care, Social Security insurance, housing assistance, and submitting in
7.3a timely manner a prisoner's application for any benefits for which the prisoner may
7.4be eligible upon release;
7.5    (2) obtaining informed consent and releases of information from the prisoner that
7.6are needed for transition services, identifying treatment needs, referring the prisoner
7.7to appropriate services in the community, and arranging for basic needs such as food,
7.8housing, transportation, employment, and GED services;
7.9    (3) securing appointments for a prisoner to be treated by a psychiatrist within 30
7.10days of release, if appropriate;
7.11    (4) securing appointments for a prisoner with a community mental health provider
7.12and a chemical dependency provider within 30 days of release, if appropriate;
7.13    (5) ensuring that the prisoner, when released from custody, has at least a 14-day
7.14supply of all necessary medications, and a prescription for at least a 30-day supply of all
7.15necessary medication that can be refilled once for an additional 30-day supply;
7.16    (6) arranging for the prisoner to have a state photo identification card when released.
7.17The identification card must not disclose the prisoner's incarceration or criminal record
7.18and must list an address other than the address of the jail or county regional jail. The
7.19identification card expires on the date of birth of the holder four years after the date of
7.20issue; and
7.21    (7) identifying prisoners who had a case manager prior to incarceration, and
7.22maintaining contact with that case manager to provide service coordination for the
7.23prisoner upon release. For prisoners without a case manager, making appropriate referrals
7.24for case management services or offering to provide follow-up services to assist the
7.25prisoner in obtaining stable housing, public benefits, and community services for up to
7.26six months after release;
7.27    (f) recording the number of prisoners identified under subdivision 2, paragraph (a),
7.28and the number of prisoners who received federal benefits upon entry into the jail or
7.29county regional jail; and
7.30    (g) maintaining accurate records to complete the program evaluation.

7.31    Sec. 4. DISCIPLINARY CONFINEMENT; PROTOCOL.
7.32    The commissioner of corrections shall develop a protocol that is fair, firm, and
7.33consistent so that inmates have an opportunity to be released from disciplinary confinement
7.34in a timely manner. For those inmates in disciplinary confinement who are nearing their
7.35release date, the commissioner of corrections shall, when possible, develop a reentry plan.

8.1    Sec. 5. APPROPRIATIONS.
8.2    Subdivision 1. Grant program. $....... is appropriated from the general fund to
8.3the commissioner of corrections for fiscal year 2008 and $....... for fiscal year 2009 to
8.4administer the grant program established in section 3.
8.5    Subd. 2. Discharge planning. $....... is appropriated from the general fund to
8.6the commissioner of human services for fiscal year 2008 to fund discharge planning for
8.7offenders with serious and persistent mental illness as defined in Minnesota Statutes,
8.8section 245.462, subdivision 20, paragraph (c), who are pending release from correctional
8.9facilities.
8.10    Subd. 3. Mental health courts. $....... for fiscal year 2008 and $....... for fiscal
8.11year 2009 are appropriated from the general fund to the Supreme Court to develop and
8.12implement standards for mental health courts.

8.13ARTICLE 2

8.14CHILDREN'S MENTAL HEALTH

8.15    Section 1. [245.4889] CHILDREN'S MENTAL HEALTH GRANTS.
8.16    Subdivision 1. Establishment and authority. (a) The commissioner is authorized
8.17to make grants from available appropriations to assist:
8.18    (1) counties;
8.19    (2) Indian tribes;
8.20    (3) children's collaboratives under section 124D.23 or 245.493; or
8.21    (4) mental health service providers
8.22in providing services to children with emotional disturbances as defined in section
8.23245.4871, subdivision 15, and their families. The commissioner may also authorize grants
8.24to assist young adults meeting the criteria for transition services in section 245.4875,
8.25subdivision 8, and their families.
8.26    (b) Services under paragraph (a) must be designed to help each child to function and
8.27remain with the child's family in the community and must be delivered consistent with the
8.28child's treatment plan. Transition services under paragraph (a) to eligible young adults
8.29must be designed to foster independent living in the community.
8.30    Subd. 2. Grant application and reporting requirements. To apply for a grant an
8.31applicant organization shall submit an application and budget for the use of the money
8.32in the form specified by the commissioner. The commissioner shall make grants only to
8.33entities whose applications and budgets are approved by the commissioner. In awarding
9.1grants, the commissioner shall give priority to those counties whose applications indicate
9.2plans to collaborate in the development, funding, and delivery of services with other
9.3agencies in the local system of care. The commissioner shall specify requirements for
9.4reports, including quarterly fiscal reports under section 256.01, subdivision 2, paragraph
9.5(q). The commissioner shall require collection of data and periodic reports that the
9.6commissioner deems necessary to demonstrate the effectiveness of each service.

9.7    Sec. 2. [245A.175] MENTAL HEALTH TRAINING REQUIREMENT.
9.8    Child foster care providers licensed by the commissioner of human services must
9.9complete two hours of training before admitting a foster care child that addresses
9.10the causes, symptoms, and key warning signs of mental health disorders; cultural
9.11considerations; and effective approaches for dealing with a child's behaviors. At least one
9.12hour of the annual 12-hour training requirement for foster parents must be completed
9.13each year on children's mental health issues and treatment. Training curriculum shall be
9.14approved by the commissioner of human services.

9.15    Sec. 3. [256.9961] COLLABORATIVE SERVICES FOR HIGH-RISK
9.16CHILDREN.
9.17    To provide early intervention collaborative services to children who are at high risk
9.18for child maltreatment, substance use, mental illness, and serious and violent offending,
9.19but not subject to the delinquency provisions of chapter 260B, the commissioner of human
9.20services shall fund one or more projects that identify and serve these children. The
9.21projects shall include the following program components:
9.22    (1) multidimensional screening instruments;
9.23    (2) multidisciplinary and multijurisdictional collaborative services;
9.24    (3) integrated information systems;
9.25    (4) intensive in-home and community casework;
9.26    (5) continuous tracking of outcomes; and
9.27    (6) multidimensional evaluations and cost benefit analysis.
9.28Projects must use all available funding streams.

9.29    Sec. 4. Minnesota Statutes 2006, section 256B.0943, is amended by adding a
9.30subdivision to read:
9.31    Subd. 14. Rate increase for children's therapeutic services and supports. For
9.32services defined in clauses (1) and (2) rendered on or after July 1, 2007, payment rates
9.33shall be increased by 33.7 percent over the rates in effect on January 1, 2006, for:
10.1    (1) services when provided as a component of children's therapeutic services and
10.2support including, but not limited to, individual and group skills training, individual and
10.3group psychotherapy, and provider travel; and
10.4    (2) diagnostic assessments of children and adolescents.
10.5    The commissioner shall adjust rates paid to prepaid health plans under contract with
10.6the commissioner to reflect the rate increases provided in clauses (1) and (2). The prepaid
10.7health plans must pass this rate increase to the providers of the services identified in
10.8clauses (1) and (2).

10.9    Sec. 5. COLUMBIA TEENSCREEN GRANTS.
10.10    The commissioner of education shall develop a request for proposals for grants to
10.11implement the Columbia TeenScreen program. The request for proposals shall require
10.12the grant applicant to specify how the applicant will follow, implement, and conduct the
10.13essential components of the Columbia TeenScreen program. Applicants for grants shall
10.14be limited to public schools, family service collaboratives, and children's mental health
10.15collaboratives.

10.16    Sec. 6. CHILDREN'S MENTAL HEALTH WORK GROUP; REPORT.
10.17    The commissioner of human services shall convene a work group to study the unmet
10.18need for funding of wraparound services to address the needs of children diagnosed
10.19with an emotional disturbance or a severe emotional disturbance. The work group shall
10.20consist of representatives from the Department of Health, the Department of Education,
10.21organizations that provide or advocate for children's mental health services, and Minnesota
10.22counties. The commissioner shall report the results of the work group's findings and
10.23recommendations to the chairs of the house and senate committees with jurisdiction over
10.24children's mental health no later than January 1, 2008.

10.25    Sec. 7. TRAUMA-FOCUSED EVIDENCE-BASED PRACTICES TO
10.26CHILDREN.
10.27    Organizations that are certified to provide children's therapeutic services and
10.28supports under Minnesota Statutes, section 256B.0943, are eligible to apply for a grant.
10.29Grants are to be used to provide trauma-focused evidence-based practices to children
10.30who are living in a battered women's shelter, homeless shelter, transitional housing, or
10.31supported housing. Children served must have been exposed to or witnessed domestic
10.32violence, have been exposed to or witnessed community violence, or be a refugee. Priority
10.33shall be given to organizations that demonstrate collaboration with battered women's
11.1shelters, homeless shelters, or providers of transitional housing or supported housing. The
11.2commissioner shall specify which constitutes evidence-based practice. Organizations shall
11.3use all available funding streams.

11.4    Sec. 8. RESPITE CARE.
11.5    (a) The commissioner of human services shall allocate amounts for respite care
11.6funding to counties based on population. Counties shall be reimbursed for the costs of
11.7respite care for families with a child who has a severe emotional disturbance. Total
11.8reimbursement shall not exceed the county's allocation. Any funds not used by a county
11.9may be reallocated to other counties.
11.10    (b) Funds allocated under paragraph (a) may be used for day, night, overnight, and
11.11summer or vacation respite care. Funds may be used for in-home or out-of-home respite
11.12care.
11.13    (c) Up to 25 percent of the funds allocated under paragraph (a) in the first year may
11.14be used to recruit, train, and support respite care providers.
11.15    (d) The commissioner shall convene a work group composed of stakeholders to
11.16determine:
11.17    (1) how funds in subsequent years may be used;
11.18    (2) how funds shall be disbursed to counties;
11.19    (3) who is eligible to provide respite care;
11.20    (4) how families access respite care;
11.21    (5) how respite care rates will be established; and
11.22    (6) what outcome data will be collected.
11.23The work group shall also examine how to use existing tools to determine difficulty of
11.24care rates.

11.25    Sec. 9. APPROPRIATIONS.
11.26    Subdivision 1. Evidence-based practice. $....... in fiscal year 2008 and $....... in
11.27fiscal year 2009 are appropriated from the general fund to the commissioner of human
11.28services to develop and implement evidence-based practice in children's mental health
11.29care and treatment.
11.30    Subd. 2. Columbia TeenScreen grants. $....... in fiscal year 2008 and $....... in
11.31fiscal year 2009 are appropriated from the general fund to the commissioner of education
11.32to administer five Columbia TeenScreen grant programs in section 5.
12.1    Subd. 3. Early intervention collaborative programs. $....... in fiscal year 2008
12.2and $....... in fiscal year 2009 are appropriated from the general fund to the commissioner
12.3of human services to fund the early intervention collaborative programs in section 3.
12.4    Subd. 4. Childhood trauma; grants. $....... in fiscal year 2008 and $....... in fiscal
12.5year 2009 are appropriated from the general fund to the commissioner of human services
12.6to make grants for the purpose of maintaining and expanding evidence-based practices
12.7under section 7 that support children and youth who have been exposed to violence or
12.8who are refugees.
12.9    Subd. 5. Respite care. $ ....... in fiscal year 2008 is appropriated from general fund
12.10to the commissioner of human services to fund respite care for children under section 8
12.11who have a diagnosis of emotional disturbance or severe emotional disturbance.

12.12ARTICLE 3

12.13MISCELLANEOUS

12.14    Section 1. [135A.141] QUALIFYING STUDENT HEALTH INSURANCE
12.15PROGRAM.
12.16    Subdivision 1. Health insurance required. (a) Every full-time and part-time
12.17student enrolled in a public or private institution of higher education located in the state
12.18shall participate in a qualifying student health insurance program. For the purposes of
12.19this section, "part-time student" means a student participating in at least 50 percent of the
12.20full-time curriculum. An institution may elect to allow students to waive participation
12.21in its student health insurance program or any part of it if the institution permitting such
12.22waivers requires students waiving participation to certify in writing, prior to any academic
12.23year in which they do not participate in the institution's plan, that they are participating
12.24in a health insurance plan having comparable coverage.
12.25    (b) An individual shall be exempt from this section if the individual files a sworn
12.26affidavit with the individual's public or private institution of higher education that the
12.27individual does not have creditable coverage and that the individual's sincerely held
12.28religious beliefs are the basis of the individual's refusal to obtain and maintain creditable
12.29coverage.
12.30    Subd. 2. Report. Each public and private institution of higher education shall submit
12.31an annual report to the commissioner of health detailing its procedures for complying
12.32with the provisions of this section. Prior to the implementation of this section, the
12.33commissioner of health shall submit a report to the house and senate committees on health
12.34policy and finance that includes, but is not limited to, an analysis of the number of students
13.1lacking health insurance, the costs of the requirements of this section to the students and
13.2the institutions of higher education, and a proposed method for meeting the costs.
13.3    Subd. 3. Rules. The commissioner of health shall issue regulations to define
13.4qualifying student health insurance programs, to establish procedures to monitor
13.5compliance, and to implement the provisions of this section.

13.6    Sec. 2. [144.206] LOAN FORGIVENESS PROGRAM.
13.7    (a) For the purposes of this section, "qualified educational loan" means a
13.8government, commercial, or foundation loan for actual costs paid for tuition, reasonable
13.9education expenses, and reasonable living expenses related to the graduate education
13.10of a mental health professional.
13.11    (b) (1) A loan forgiveness program account is established. The commissioner of
13.12health shall use money from the account to establish a loan forgiveness program for
13.13individuals who are employed by a nonprofit agency that provides mental health services
13.14for cultural or ethnic minority clients.
13.15    (2) Appropriations made to the account do not cancel and are available until
13.16expended, except that at the end of the biennium, any remaining balance in the account
13.17that is not committed by contract and is not needed to fulfill existing commitments shall
13.18cancel to the fund.
13.19    (c) To be eligible to participate in the loan forgiveness program, an individual must
13.20be employed by a nonprofit agency that provides mental health services for cultural or
13.21ethnic minority clients and must be of the same culture or ethnicity as the clients. An
13.22applicant selected to participate must sign a contract agreeing to remain employed with
13.23the nonprofit agency for a three-year full-time term, which shall begin no later than 30
13.24days following completion of the required training.
13.25    (d) The commissioner may select applicants each year for participation in the loan
13.26forgiveness program, within the limits of available funding. Applicants are responsible for
13.27securing their own qualified educational loans. The commissioner shall select participants
13.28based on their suitability for practice serving the required cultural or ethnic minority
13.29population. The commissioner shall give preference to applicants closest to completing
13.30their education.
13.31    (e) For each year that a participant meets the service obligation required under
13.32paragraph (c), the commissioner shall make annual disbursements directly to the
13.33participant equivalent to 25 percent of the participant's loan indebtedness, not to exceed
13.34the balance of the participant's qualifying educational loans. Before receiving loan
13.35repayment disbursements, and as requested, the participant and the employer must
14.1complete and return to the commissioner an affidavit of practice form provided by the
14.2commissioner verifying that the participant is practicing as required under paragraph (c).
14.3The participant must provide the commissioner with verification that the full amount of
14.4the loan repayment disbursement received by the participant has been applied toward
14.5the designated loans. After each disbursement, verification must be received by the
14.6commissioner and approved before the next loan repayment disbursement is made.
14.7    (f) If a participant does not fulfill the minimum commitment of service under
14.8paragraph (c), the commissioner shall collect from the participant the full amount paid
14.9to the participant under the loan forgiveness program plus interest at the rate established
14.10under section 270C.40. The commissioner shall deposit the money collected in the
14.11general fund. The commissioner shall allow waivers of all or part of the money owed
14.12the commissioner as a result of nonfulfillment if emergency circumstances prevented
14.13fulfillment of the minimum service commitment.

14.14    Sec. 3. Minnesota Statutes 2006, section 245.462, subdivision 20, is amended to read:
14.15    Subd. 20. Mental illness. (a) "Mental illness" means an organic disorder of the
14.16brain or a clinically significant disorder of thought, mood, perception, orientation,
14.17memory, or behavior that is listed in the clinical manual of the International Classification
14.18of Diseases (ICD-9-CM), current edition, code range 290.0 to 302.99 or 306.0 to 316.0
14.19or the corresponding code in the American Psychiatric Association's Diagnostic and
14.20Statistical Manual of Mental Disorders (DSM-MD), current edition, Axes I, II, or III, and
14.21that seriously limits a person's capacity to function in primary aspects of daily living such
14.22as personal relations, living arrangements, work, and recreation.
14.23    (b) An "adult with acute mental illness" means an adult who has a mental illness that
14.24is serious enough to require prompt intervention.
14.25    (c) For purposes of case management and community support services, a "person
14.26with serious and persistent mental illness" means an adult who has a mental illness and
14.27meets at least one of the following criteria:
14.28    (1) the adult has undergone two or more episodes of inpatient care for a mental
14.29illness within the preceding 24 months;
14.30    (2) the adult has experienced a continuous psychiatric hospitalization or residential
14.31treatment exceeding six months' duration within the preceding 12 months;
14.32    (3) the adult has been an inmate at a jail or county regional jail or a prisoner at a
14.33correctional facility two or more times within the preceding 24 months;
14.34    (4) the adult has experienced continuous confinement in a jail, county regional jail,
14.35or correctional facility for more than six months' duration within the preceding 12 months;
15.1    (5) the adult has been treated by a crisis team two or more times within the preceding
15.224 months;
15.3    (6) the adult:
15.4    (i) has a diagnosis of schizophrenia, bipolar disorder, major depression, or borderline
15.5personality disorder;
15.6    (ii) indicates a significant impairment in functioning; and
15.7    (iii) has a written opinion from a mental health professional, in the last three years,
15.8stating that the adult is reasonably likely to have future episodes requiring inpatient or
15.9residential treatment, of a frequency described in clause (1) or (2), unless ongoing case
15.10management or community support services are provided;
15.11    (4) (7) the adult has, in the last three years, been committed by a court as a person
15.12who is mentally ill under chapter 253B, or the adult's commitment has been stayed or
15.13continued; or
15.14    (5) (8) the adult (i) was eligible under clauses (1) to (4) (7), but the specified time
15.15period has expired or the adult was eligible as a child under section 245.4871, subdivision
15.166 ; and (ii) has a written opinion from a mental health professional, in the last three years,
15.17stating that the adult is reasonably likely to have future episodes requiring inpatient or
15.18residential treatment, of a frequency described in clause (1) or (2), unless ongoing case
15.19management or community support services are provided.

15.20    Sec. 4. Minnesota Statutes 2006, section 245.50, subdivision 5, is amended to read:
15.21    Subd. 5. Special contracts; bordering states. (a) An individual who is detained,
15.22committed, or placed on an involuntary basis under chapter 253B may be confined or
15.23treated in a bordering state pursuant to a contract under this section. An individual who is
15.24detained, committed, or placed on an involuntary basis under the civil law of a bordering
15.25state may be confined or treated in Minnesota pursuant to a contract under this section. A
15.26peace or health officer who is acting under the authority of the sending state may transport
15.27an individual to a receiving agency that provides services pursuant to a contract under
15.28this section and may transport the individual back to the sending state under the laws
15.29of the sending state. Court orders valid under the law of the sending state are granted
15.30recognition and reciprocity in the receiving state for individuals covered by a contract
15.31under this section to the extent that the court orders relate to confinement for treatment
15.32or care of mental illness or chemical dependency. Such treatment or care may address
15.33other conditions that may be co-occurring with the mental illness or chemical dependency.
15.34These court orders are not subject to legal challenge in the courts of the receiving state.
15.35Individuals who are detained, committed, or placed under the law of a sending state and
16.1who are transferred to a receiving state under this section continue to be in the legal
16.2custody of the authority responsible for them under the law of the sending state. Except
16.3in emergencies, those individuals may not be transferred, removed, or furloughed from
16.4a receiving agency without the specific approval of the authority responsible for them
16.5under the law of the sending state.
16.6    (b) While in the receiving state pursuant to a contract under this section, an
16.7individual shall be subject to the sending state's laws and rules relating to length of
16.8confinement, reexaminations, and extensions of confinement. No individual may be sent
16.9to another state pursuant to a contract under this section until the receiving state has
16.10enacted a law recognizing the validity and applicability of this section.
16.11    (c) If an individual receiving services pursuant to a contract under this section leaves
16.12the receiving agency without permission and the individual is subject to involuntary
16.13confinement under the law of the sending state, the receiving agency shall use all
16.14reasonable means to return the individual to the receiving agency. The receiving agency
16.15shall immediately report the absence to the sending agency. The receiving state has the
16.16primary responsibility for, and the authority to direct, the return of these individuals
16.17within its borders and is liable for the cost of the action to the extent that it would be
16.18liable for costs of its own resident.
16.19    (d) Responsibility for payment for the cost of care remains with the sending agency.
16.20    (e) This subdivision also applies to county contracts under subdivision 2 which
16.21include emergency care and treatment provided to a county resident in a bordering state.
16.22    (f) If a Minnesota resident is admitted to a facility in a bordering state under this
16.23chapter, a physician, licensed psychologist who has a doctoral degree in psychology, or
16.24an advance practice registered nurse certified in mental health, who is licensed in the
16.25bordering state, may act as an examiner under sections 253B.07, 253B.08, 253B.092,
16.26253B.12, and 253B.17 subject to the same requirements and limitations in section
16.27253B.02, subdivision 7.

16.28    Sec. 5. [245.6961] CULTURALLY COMPETENT MENTAL HEALTH
16.29SERVICES.
16.30    Subdivision 1. Services; grants. The commissioner is authorized to make grants
16.31to nonprofit organizations to ensure that culturally competent mental health services are
16.32provided to individuals throughout the state. The grants are intended to provide direct
16.33services and to serve as a bridge to existing mental health providers and organizations that
16.34reflect the community they serve. The grants may be used to:
16.35    (1) provide services and supports to low-income families from different cultures;
17.1    (2) provide technical assistance to mental health and health care providers who have
17.2clients in need of culturally appropriate services;
17.3    (3) translate information for patients and their families;
17.4    (4) colocate services at clinics, schools, and other locations;
17.5    (5) provide services and supports using telemedicine to reach families in need of
17.6information and support in communities where there are no culturally specific providers;
17.7and
17.8    (6) provide culturally specific support services.
17.9    Subd. 2. Task force. The commissioner shall appoint a task force to develop
17.10criteria for eligibility, services, and outcome measurement. Meeting children's therapeutic
17.11services and support standards cannot be one of the criteria for receiving funding through
17.12this program.

17.13    Sec. 6. [626.96] CRISIS INTERVENTION TEAM GRANTS.
17.14    Subdivision 1. Request for proposals. The commissioner of public safety shall
17.15create a competitive grant process using request for proposals for crisis intervention team
17.16training for local police and sheriff departments. Before making grants under this section,
17.17the commissioner shall consult with the following organizations or individuals regarding
17.18the development of the request for proposals:
17.19    (1) the Barbara Schneider Foundation;
17.20    (2) the National Alliance on Mental Illness;
17.21    (3) the Minnesota Mental Health Association; and
17.22    (4) national experts on crisis intervention team training.
17.23    Subd. 2. Training requirements. The training provided with grants made under
17.24this section must include, but is not limited to, the following components:
17.25    (1) an overview of mental illnesses and the mental health system;
17.26    (2) site visits to psychiatric receiving facilities;
17.27    (3) an overview of mental health courts;
17.28    (4) an overview of specific psychiatric conditions, their manifestations, and
17.29treatment; and
17.30    (5) crisis intervention team reporting and data collection.
17.31    At least 20 percent of each training session must involve scenario-based role play
17.32training with the use of a professional acting company with crisis intervention team
17.33training experience. The training provided under this subdivision must be at least 40
17.34hours. The training must encourage and support the statewide development of crisis
17.35intervention teams for law enforcement. The training must promote the development of
18.1local collaboration among public safety professionals, community mental health and
18.2emergency medicine providers, and members of the public.

18.3    Sec. 7. MINNESOTA FAMILY INVESTMENT PROGRAM AND CHILDREN'S
18.4MENTAL HEALTH PILOT PROJECT.
18.5    Subdivision 1. Pilot project authorized. The commissioner of human services
18.6shall fund a two-year pilot project to measure the impact of children's identified mental
18.7health needs, including social and emotional needs, on Minnesota family investment
18.8program (MFIP) participants' ability to obtain and retain employment. The project shall
18.9also measure the impact on work activity of MFIP participants' needs to address their
18.10children's identified mental health needs.
18.11    Subd. 2. Provider and agency proposals. (a) Interested MFIP providers and
18.12agencies shall:
18.13    (1) submit proposals defining how they will identify participants whose children
18.14have mental health needs that hinder the employment process;
18.15    (2) connect families with appropriate developmental, social, and emotional
18.16screenings and services; and
18.17    (3) incorporate those services into the participant's employment plan.
18.18Each proposal under this paragraph must include an evaluation component.
18.19    (b) Interested MFIP providers and agencies shall develop a protocol to inform MFIP
18.20participants of the following:
18.21    (1) the availability of developmental, social, and emotional screening tools for
18.22children and youth;
18.23    (2) the purpose of the screenings;
18.24    (3) how the information will be used to assist the participants in identifying and
18.25addressing potential barriers to employment; and
18.26    (4) that their employment plan may be modified based on the screening results.
18.27    Subd. 3. Program components. (a) MFIP providers shall obtain the participant's
18.28written consent for participation in the pilot project, including consent for developmental,
18.29social, and emotional screening.
18.30    (b) MFIP providers shall coordinate with county social service agencies and health
18.31plans to assist recipients in arranging referrals indicated by the screening results.
18.32    (c) Tools used for developmental, social, and emotional screenings shall be approved
18.33by the commissioner of human services.
18.34    Subd. 4. Program evaluation. The commissioner of human services shall conduct
18.35an evaluation of the pilot project to determine:
19.1    (1) the number of participants who took part in the screening;
19.2    (2) the number of children who were screened and what screening tools were used;
19.3    (3) the number of children who were identified in the screening who needed referral
19.4or follow-up services;
19.5    (4) the number of children who received services, what agency provided the services,
19.6and what type of services were provided;
19.7    (5) the number of employment plans that were adjusted to include the activities
19.8recommended in the screenings;
19.9    (6) the changes in work participation rates;
19.10    (7) the changes in earned income;
19.11    (8) the changes in sanction rates; and
19.12    (9) the participants' report of program effectiveness.
19.13    Subd. 5. Work activity. Participant involvement in screenings and subsequent
19.14referral and follow-up services shall count as work activity under Minnesota Statutes,
19.15section 256J.49, subdivision 13.

19.16    Sec. 8. EVIDENCE-BASED PRACTICE.
19.17    The commissioner of human services shall make a onetime consultation with
19.18stakeholder groups and make budget-neutral changes to medical assistance coverage and
19.19benefits to implement evidence-based practices as defined by the Agency for Healthcare
19.20Research and Quality Practice Guidelines or Substance Abuse and Mental Health Services
19.21Administration.

19.22    Sec. 9. EMPLOYMENT SUPPORT.
19.23    (a) The commissioner of the Department of Employment and Economic
19.24Development shall fund special projects providing employment support to:
19.25    (1) young people with mental illness who are transitioning from school to work;
19.26    (2) people with a serious mental illness who are receiving services through a mental
19.27health court; and
19.28    (3) people with serious mental illness who are receiving services through a civil
19.29commitment court.
19.30    (b) Special projects shall include incentive payments to providers that place
19.31individuals in jobs that allow them to leave SSI and SSDI dependency and become
19.32economically self-sufficient.
19.33    (c) Projects under paragraph (a) must demonstrate interagency collaboration.

20.1    Sec. 10. TELEHEALTH.
20.2    (a) The Office of Enterprise Technology in consultation with the commissioner
20.3of human services shall provide interconnectivity, bridging, or gateway for televideo
20.4conferencing at no cost to the providers between:
20.5    (1) state and county agency sites; and
20.6    (2) community provider sites or association of community providers sites.
20.7    (b) Community providers eligible for the televideo conferencing interconnectivity
20.8are those enrolled as medical assistance providers under Minnesota Statutes, section
20.9256B.0625, subdivision 5, or under contract with counties to provide services under
20.10Minnesota Statutes, sections 245.461 to 245.486, the Minnesota Comprehensive Adult
20.11Mental Health Act; Minnesota Statutes, sections 245.4712 to 245.4861, community
20.12support and day treatment services; or Minnesota Statutes, sections 245.487 to 245.4887,
20.13the Minnesota Comprehensive Children's Mental Health Act.

20.14    Sec. 11. DUAL DIAGNOSIS; DEMONSTRATION PROJECT.
20.15    (a) The commissioner of human services shall fund demonstration projects for high
20.16risk adults with serious mental illness and co-occurring substance abuse problems. The
20.17projects must include, but not be limited to, the following:
20.18    (1) housing services, including rent or housing subsidies, housing with clinical
20.19staff, or housing support;
20.20    (2) assertive outreach services; and
20.21    (3) intensive direct therapeutic, rehabilitative, and care management services
20.22oriented to harm reduction.
20.23    (b) The commissioner shall work with providers to ensure proper licensure or
20.24certification to meet medical assistance or third-party payor reimbursement requirements.

20.25    Sec. 12. INPATIENT PSYCHIATRIC BEDS; STUDY.
20.26    (a) The commissioner of health shall study the status of inpatient psychiatric beds
20.27in Minnesota and provide recommendations to the legislature on improving access to
20.28inpatient care, especially for children and adolescents. In conducting the study, the
20.29commissioner shall consult with the commissioner of human services and representatives
20.30from psychiatry, hospitals, emergency medicine, and mental health advocacy.
20.31    (b) The study shall consider the following:
20.32    (1) the number and frequency of patients, both adults and children, diverted to other
20.33hospitals because of the unavailability of an appropriate psychiatric bed in the hospital for
20.34which they sought care;
21.1    (2) the effect on emergency rooms due to the inability to place a patient in a
21.2psychiatric hospital bed;
21.3    (3) the difference in health plan reimbursement for psychiatric beds compared
21.4to beds devoted to general medical care and the effect this reimbursement has on the
21.5availability of inpatient psychiatric beds;
21.6    (4) the number of psychiatric beds per capita in Minnesota compared to the number
21.7of psychiatric beds per capita in the United States, and the appropriate number of
21.8psychiatric beds per capita in Minnesota; and
21.9    (5) the number of practicing child and adolescent psychiatrists and the number
21.10necessary per capita to meet the needs of Minnesota children.
21.11    (c) The commissioner shall report recommendations to the legislature by January
21.1215, 2008.

21.13    Sec. 13. INCENTIVE PAYMENTS; RULES.
21.14    (a) The commissioner of employment and economic development under rulemaking
21.15authority granted in Minnesota Statutes, section 116J.035, shall develop rules to
21.16implement incentive payments to providers that place individuals in jobs that allow them
21.17to leave SSI and SSDI dependency and become economically self-sufficient.
21.18    (b) The commissioner of employment and economic development under rulemaking
21.19authority granted in Minnesota Statutes, section 116J.035, shall develop rules to implement
21.20incentive payments for providers that place individuals in jobs that provide benefits.

21.21    Sec. 14. APPROPRIATIONS.
21.22    Subdivision 1. Employment support. (a) $....... is appropriated in fiscal year 2008
21.23from the general fund to the commissioner of employment and economic development to
21.24fund special projects focused on providing employment support under section 9.
21.25    (b) $....... in fiscal year 2008 and $....... in fiscal year 2009 are appropriated
21.26to the commissioner of employment and economic development for the extended
21.27employment-serious mental illness program under section 9.
21.28    (c) $1,000,000 in fiscal year 2008 and $1,000,000 in fiscal year 2009 are appropriated
21.29to the commissioner of employment and economic development to supplement funds
21.30paid for wage incentive for the community support fund established in Minnesota Rules,
21.31part 3300.2045.
21.32    Subd. 2. Community mental health programs. $....... is appropriated in fiscal year
21.332008 from the general fund to the commissioner of human services to contract for training
22.1and consultation for clinical supervisors and staff of community mental health centers who
22.2provide services to children and adults. The purpose of the training and consultation is to
22.3improve clinical supervision of staff, strengthen compliance with federal and state rules
22.4and regulations, and to recommend strategies for standardization and simplification of
22.5administrative functions among community mental health centers.
22.6    Subd. 3. Culturally competent mental health services grants. $....... in fiscal
22.7year 2008 and $....... in fiscal year 2009 are appropriated from the general fund to the
22.8commissioner of human services for development and implementation of grants for
22.9culturally competent mental health services under section 5.
22.10    Subd. 4. Bridges rental housing assistance program. $3,400,000 in fiscal year
22.112008 and $3,400,000 in fiscal year 2009 are appropriated from the general fund to the
22.12Housing Finance Agency for the Bridges rental housing assistance program under
22.13Minnesota Statutes, section 462A.2097. These appropriations are in addition to any base
22.14appropriations for this purpose and shall become part of the agency's base.
22.15    Subd. 5. MFIP and children's mental health pilot project. $....... in fiscal
22.16year 2008 and $....... in fiscal year 2009 are appropriated from the general fund to the
22.17commissioner of human services to fund the pilot project under section 7.
22.18    Subd. 6. Crisis intervention training. $144,000 is appropriated in fiscal year 2008
22.19from the general fund to the commissioner of public safety to fund grants to local police
22.20departments to conduct crisis intervention training under section 6. The commissioner
22.21may use up to 2.5 percent of the amount appropriated under this subdivision for costs of
22.22administering the grant program.
22.23    Subd. 7. Televideo conferencing. (b) $....... in fiscal year 2008 and $....... in fiscal
22.24year 2009 are appropriated from the general fund to the Office of Enterprise Technology
22.25to provide televideo conferencing under section 10.
22.26    Subd. 8. Dual diagnosis; demonstration project. $....... in fiscal year 2008 and
22.27$....... in fiscal year 2009 are appropriated from the general fund to the commissioner of
22.28human services to fund the demonstration projects under section 11.

22.29ARTICLE 4

22.30MENTAL HEALTH FUNDING

22.31    Section 1. Minnesota Statutes 2006, section 256B.038, is amended to read:
22.32256B.038 PROVIDER RATE INCREASES AFTER JUNE 30, 1999.
23.1    (a) For fiscal years beginning on or after July 1, 1999, the commissioner of finance
23.2shall include an annual inflationary adjustment in payment rates for the services listed
23.3in paragraph (b) as a budget change request in each biennial detailed expenditure budget
23.4submitted to the legislature under section 16A.11. The adjustment shall be accomplished
23.5by indexing the rates in effect for inflation based on the change in the Consumer Price
23.6Index-All Items (United States city average)(CPI-U) as forecasted by Data Resources,
23.7Inc., in the fourth quarter of the prior year for the calendar year during which the rate
23.8increase occurs.
23.9    (b) Within the limits of appropriations specifically for this purpose, the commissioner
23.10shall apply the rate increases in paragraph (a) to home and community-based waiver
23.11services for persons with developmental disabilities under section 256B.501; home and
23.12community-based waiver services for the elderly under section 256B.0915; waivered
23.13services under community alternatives for disabled individuals under section 256B.49;
23.14community alternative care waivered services under section 256B.49; traumatic brain
23.15injury waivered services under section 256B.49; nursing services and home health services
23.16under section 256B.0625, subdivision 6a; personal care services and nursing supervision
23.17of personal care services under section 256B.0625, subdivision 19a; private duty nursing
23.18services under section 256B.0625, subdivision 7; day training and habilitation services
23.19for adults with developmental disabilities under sections 252.40 to 252.46; physical
23.20therapy services under sections 256B.0625, subdivision 8, and 256D.03, subdivision 4;
23.21occupational therapy services under sections 256B.0625, subdivision 8a, and 256D.03,
23.22subdivision 4 ; speech-language therapy services under section 256D.03, subdivision
23.234 , and Minnesota Rules, part 9505.0390; respiratory therapy services under section
23.24256D.03, subdivision 4 , and Minnesota Rules, part 9505.0295; physician services under
23.25section 256B.0625, subdivision 3; dental services under sections 256B.0625, subdivision
23.269 , and 256D.03, subdivision 4; alternative care services under section 256B.0913; adult
23.27residential program grants under Minnesota Rules, parts 9535.2000 to 9535.3000;
23.28adult and family community support grants under Minnesota Rules, parts 9535.1700
23.29to 9535.1760; and semi-independent living services under section 252.275, including
23.30SILS funding under county social services grants formerly funded under chapter 256I;
23.31children's therapeutic services and support services under section 256B.0943; and adult
23.32rehabilitative mental health services under section 256B.0623.
23.33    (c) The commissioner shall increase prepaid medical assistance program capitation
23.34rates as appropriate to reflect the rate increases in this section.
23.35    (d) In implementing this section, the commissioner shall consider proposing a
23.36schedule to equalize rates paid by different programs for the same service.

24.1    Sec. 2. [256B.0615] MENTAL HEALTH CERTIFIED PEER SPECIALIST.
24.2    Subdivision 1. Scope. Medical assistance covers mental health certified peers
24.3specialists services, as established in subdivision 2, subject to federal approval, if provided
24.4to recipients who are eligible for services under sections 256B.0622 and 256B.0623,
24.5and are provided by a certified peer specialist who has completed the training under
24.6subdivision 5.
24.7    Subd. 2. Establishment. The commissioner of human services shall establish a
24.8certified peer specialists program model, which:
24.9    (1) provides nonclinical peer support counseling by certified peer specialists;
24.10    (2) provides a part of a wraparound continuum of services in conjunction with
24.11other community mental health services;
24.12    (3) is individualized to the consumer; and
24.13    (4) promotes socialization, recovery, self-sufficiency, self-advocacy, development of
24.14natural supports, and maintenance of skills learned in other support services.
24.15    Subd. 3. Eligibility. Peer support services may be made available to consumers
24.16of the intensive rehabilitative mental health services under section 256B.0622 and adult
24.17rehabilitative mental health services under section 256B.0623.
24.18    Subd. 4. Peer support specialist program providers. The commissioner shall
24.19develop a process to certify peer support specialist programs, in accordance with the
24.20federal guidelines, in order for the program to bill for reimbursable services. Peer support
24.21programs may be freestanding or within existing mental health community provider
24.22centers.
24.23    Subd. 5. Certified peer specialist training and certification. The commissioner
24.24of human services shall develop a training and certification process for certified peer
24.25specialists who must be at least 21 years of age and have a high school diploma or its
24.26equivalent. The candidates must have had a primary diagnosis of mental illness and be a
24.27current or former consumer of mental health services, must demonstrate leadership and
24.28advocacy skills, and must have a strong dedication to recovery. The training curriculum
24.29must teach participating consumers specific skills relevant to providing peer support
24.30to other consumers. In addition to initial training and certification, the commissioner
24.31shall develop ongoing continuing educational workshops on pertinent issues related to
24.32peer support counseling.

24.33    Sec. 3. Minnesota Statutes 2006, section 256B.0622, subdivision 2, is amended to read:
24.34    Subd. 2. Definitions. For purposes of this section, the following terms have the
24.35meanings given them.
25.1    (a) "Intensive nonresidential rehabilitative mental health services" means adult
25.2rehabilitative mental health services as defined in section 256B.0623, subdivision 2,
25.3paragraph (a), except that these services are provided by a multidisciplinary staff using
25.4a total team approach consistent with assertive community treatment, the Fairweather
25.5Lodge treatment model, as defined by the standards established by the National Coalition
25.6for Community Living, and other evidence-based practices, and directed to recipients with
25.7a serious mental illness who require intensive services.
25.8    (b) "Intensive residential rehabilitative mental health services" means short-term,
25.9time-limited services provided in a residential setting to recipients who are in need of
25.10more restrictive settings and are at risk of significant functional deterioration if they do
25.11not receive these services. Services are designed to develop and enhance psychiatric
25.12stability, personal and emotional adjustment, self-sufficiency, and skills to live in a more
25.13independent setting. Services must be directed toward a targeted discharge date with
25.14specified client outcomes and must be consistent with the Fairweather Lodge treatment
25.15model as defined in paragraph (a), and other evidence-based practices.
25.16    (c) "Evidence-based practices" are nationally recognized mental health services that
25.17are proven by substantial research to be effective in helping individuals with serious
25.18mental illness obtain specific treatment goals.
25.19    (d) "Overnight staff" means a member of the intensive residential rehabilitative
25.20mental health treatment team who is responsible during hours when recipients are
25.21typically asleep.
25.22    (e) "Treatment team" means all staff who provide services under this section
25.23to recipients. At a minimum, this includes the clinical supervisor, mental health
25.24professionals, as defined in section 245.462, subdivision 18, clauses (1) to (5); mental
25.25health practitioners, and as defined in section 245.462, subdivision 17; mental health
25.26rehabilitation workers under section 256B.0623, subdivision 5, clause (3); and certified
25.27peer specialists under section 256B.0615.

25.28    Sec. 4. Minnesota Statutes 2006, section 256B.0623, subdivision 2, is amended to read:
25.29    Subd. 2. Definitions. For purposes of this section, the following terms have the
25.30meanings given them.
25.31    (a) "Adult rehabilitative mental health services" means mental health services which
25.32are rehabilitative and enable the recipient to develop and enhance psychiatric stability,
25.33social competencies, personal and emotional adjustment, and independent living and
25.34community skills, when these abilities are impaired by the symptoms of mental illness.
25.35Adult rehabilitative mental health services are also appropriate when provided to enable a
26.1recipient to retain stability and functioning, if the recipient would be at risk of significant
26.2functional decompensation or more restrictive service settings without these services.
26.3    (1) Adult rehabilitative mental health services instruct, assist, and support the
26.4recipient in areas such as: interpersonal communication skills, community resource
26.5utilization and integration skills, crisis assistance, relapse prevention skills, health care
26.6directives, budgeting and shopping skills, healthy lifestyle skills and practices, cooking
26.7and nutrition skills, transportation skills, medication education and monitoring, mental
26.8illness symptom management skills, household management skills, employment-related
26.9skills, and transition to community living services.
26.10    (2) These services shall be provided to the recipient on a one-to-one basis in the
26.11recipient's home or another community setting or in groups.
26.12    (b) "Medication education services" means services provided individually or in
26.13groups which focus on educating the recipient about mental illness and symptoms; the role
26.14and effects of medications in treating symptoms of mental illness; and the side effects of
26.15medications. Medication education is coordinated with medication management services
26.16and does not duplicate it. Medication education services are provided by physicians,
26.17pharmacists, physician's assistants, or registered nurses.
26.18    (c) "Transition to community living services" means services which maintain
26.19continuity of contact between the rehabilitation services provider and the recipient and
26.20which facilitate discharge from a hospital, residential treatment program under Minnesota
26.21Rules, chapter 9505, board and lodging facility, or nursing home. Transition to community
26.22living services are not intended to provide other areas of adult rehabilitative mental health
26.23services.
26.24    (d) "Family psychoeducation" is a multimodal outpatient therapy and rehabilitative
26.25service that involves parents, families, and others as resources in the treatment, recovery,
26.26and improved functioning of a person with mental illness or emotional disturbance,
26.27in which families learn about the illness, family reactions, and types of treatment and
26.28supports. Families learn to develop skills to handle problems posed by mental illness
26.29including coping, managing stress, ensuring safety, creating social support, identifying
26.30resources, and supporting treatment and recovery goals. Services include family
26.31counseling, family treatment planning, and family support using cognitive, behavioral,
26.32problem-solving, and communication strategies, and may involve individual, family, and
26.33group intervention activities for consumers and families together, families only, or brief
26.34intermittent consultations at critical times in an episode of care. Eligible providers must
26.35be certified to provide both outpatient mental health services and rehabilitative services
26.36under this section.

27.1    Sec. 5. Minnesota Statutes 2006, section 256B.0623, subdivision 5, is amended to read:
27.2    Subd. 5. Qualifications of provider staff. Adult rehabilitative mental health
27.3services must be provided by qualified individual provider staff of a certified provider
27.4entity. Individual provider staff must be qualified under one of the following criteria:
27.5    (1) a mental health professional as defined in section 245.462, subdivision 18,
27.6clauses (1) to (5). If the recipient has a current diagnostic assessment by a licensed
27.7mental health professional as defined in section 245.462, subdivision 18, clauses (1) to
27.8(5), recommending receipt of adult mental health rehabilitative services, the definition of
27.9mental health professional for purposes of this section includes a person who is qualified
27.10under section 245.462, subdivision 18, clause (6), and who holds a current and valid
27.11national certification as a certified rehabilitation counselor or certified psychosocial
27.12rehabilitation practitioner;
27.13    (2) a mental health practitioner as defined in section 245.462, subdivision 17. The
27.14mental health practitioner must work under the clinical supervision of a mental health
27.15professional; or
27.16    (3) a certified peer specialist under section 256B.0615. The certified peer specialist
27.17must work under the clinical supervision of a mental health professional; or
27.18    (3) (4) a mental health rehabilitation worker. A mental health rehabilitation worker
27.19means a staff person working under the direction of a mental health practitioner or mental
27.20health professional and under the clinical supervision of a mental health professional in
27.21the implementation of rehabilitative mental health services as identified in the recipient's
27.22individual treatment plan who:
27.23    (i) is at least 21 years of age;
27.24    (ii) has a high school diploma or equivalent;
27.25    (iii) has successfully completed 30 hours of training during the past two years in all
27.26of the following areas: recipient rights, recipient-centered individual treatment planning,
27.27behavioral terminology, mental illness, co-occurring mental illness and substance abuse,
27.28psychotropic medications and side effects, functional assessment, local community
27.29resources, adult vulnerability, recipient confidentiality; and
27.30    (iv) meets the qualifications in subitem (A) or (B):
27.31    (A) has an associate of arts degree in one of the behavioral sciences or human
27.32services, or is a registered nurse without a bachelor's degree, or who within the previous
27.33ten years has:
27.34    (1) three years of personal life experience with serious and persistent mental illness;
27.35    (2) three years of life experience as a primary caregiver to an adult with a serious
27.36mental illness or traumatic brain injury; or
28.1    (3) 4,000 hours of supervised paid work experience in the delivery of mental health
28.2services to adults with a serious mental illness or traumatic brain injury; or
28.3    (B)(1) is fluent in the non-English language or competent in the culture of the
28.4ethnic group to which at least 20 percent of the mental health rehabilitation worker's
28.5clients belong;
28.6    (2) receives during the first 2,000 hours of work, monthly documented individual
28.7clinical supervision by a mental health professional;
28.8    (3) has 18 hours of documented field supervision by a mental health professional
28.9or practitioner during the first 160 hours of contact work with recipients, and at least six
28.10hours of field supervision quarterly during the following year;
28.11    (4) has review and cosignature of charting of recipient contacts during field
28.12supervision by a mental health professional or practitioner; and
28.13    (5) has 40 hours of additional continuing education on mental health topics during
28.14the first year of employment.

28.15    Sec. 6. Minnesota Statutes 2006, section 256B.0623, subdivision 8, is amended to read:
28.16    Subd. 8. Diagnostic assessment. Providers of adult rehabilitative mental
28.17health services must complete a diagnostic assessment as defined in section 245.462,
28.18subdivision 9 , within five days after the recipient's second visit or within 30 days after
28.19intake, whichever occurs first. A diagnostic assessment must be reimbursed at the
28.20same rate as an assessment under section 256B.0655, subdivision 8. In cases where a
28.21diagnostic assessment is available that reflects the recipient's current status, and has been
28.22completed within 180 days preceding admission, an update must be completed. An
28.23update shall include a written summary by a mental health professional of the recipient's
28.24current mental health status and service needs. If the recipient's mental health status
28.25has changed significantly since the adult's most recent diagnostic assessment, a new
28.26diagnostic assessment is required. For initial implementation of adult rehabilitative mental
28.27health services, until June 30, 2005, a diagnostic assessment that reflects the recipient's
28.28current status and has been completed within the past three years preceding admission
28.29is acceptable.

28.30    Sec. 7. Minnesota Statutes 2006, section 256B.0623, subdivision 12, is amended to
28.31read:
28.32    Subd. 12. Additional requirements. (a) Providers of adult rehabilitative
28.33mental health services must comply with the requirements relating to referrals for case
28.34management in section 245.467, subdivision 4.
29.1    (b) Adult rehabilitative mental health services are provided for most recipients
29.2in the recipient's home and community. Services may also be provided at the home of
29.3a relative or significant other, job site, psychosocial clubhouse, drop-in center, social
29.4setting, classroom, or other places in the community. Except for "transition to community
29.5services," the place of service does not include a regional treatment center, nursing
29.6home, residential treatment facility licensed under Minnesota Rules, parts 9520.0500 to
29.79520.0670 (Rule 36), or an acute care hospital.
29.8    (c) Adult rehabilitative mental health services may be provided in group settings if
29.9appropriate to each participating recipient's needs and treatment plan. A group is defined
29.10as two to ten clients, at least one of whom is a recipient, who is concurrently receiving a
29.11service which is identified in this section. The service and group must be specified in the
29.12recipient's treatment plan. No more than two qualified staff may bill Medicaid for services
29.13provided to the same group of recipients. If two adult rehabilitative mental health workers
29.14bill for recipients in the same group session, they must each bill for different recipients.
29.15    (d) Subject to federal approval, adult rehabilitative mental health services include
29.16family psychoeducation, coordination and care management, and collateral contacts.

29.17    Sec. 8. Minnesota Statutes 2006, section 256B.0625, subdivision 38, is amended to
29.18read:
29.19    Subd. 38. Payments for mental health services. (a) Payments for mental
29.20health services covered under the medical assistance program that are provided by
29.21masters-prepared mental health professionals shall be 80 percent of the rate paid to
29.22doctoral-prepared professionals. Payments for mental health services covered under
29.23the medical assistance program that are provided by masters-prepared mental health
29.24professionals employed by community mental health centers shall be 100 percent of the
29.25rate paid to doctoral-prepared professionals. For purposes of reimbursement of mental
29.26health professionals under the medical assistance program, all
29.27    (b) Payments for mental health services covered under the medical assistance
29.28program that are provided by social workers who:
29.29    (1) have received a master's degree in social work from a program accredited by the
29.30Council on Social Work Education;
29.31    (2) are licensed at the level of graduate social worker or independent social worker;
29.32and
29.33    (3) are practicing clinical social work under appropriate supervision, as defined by
29.34chapter 148D; and
30.1    (4) meet all requirements under Minnesota Rules, part 9505.0323, subpart 24, and.
30.2Payments under this paragraph shall be paid accordingly according to Minnesota Rules,
30.3part 9505.0323, subpart 24, unless paragraph (c) is applicable.
30.4    (c) Payments for mental health services covered under the medical assistance
30.5program that are provided by an individual who:
30.6    (1) is employed by a community mental health center and who has completed all
30.7requirements for licensure or board certification as a mental health professional except for
30.8the requirements for supervised experience in the delivery of mental health services; and
30.9    (2) who is a student in a bona fide field placement or internship under a program
30.10leading to completion of the requirements for licensure as a mental health professional
30.11shall be reimbursed at 100 percent of the rate paid to the supervising professional.
30.12The individual providing the service under this paragraph must be under the clinical
30.13supervision of a fully qualified mental health professional.
30.14    (d) Subject to federal approval, medical assistance covers clinical supervision of
30.15mental health practitioners by a mental health professional when clinical supervision is
30.16required as part of other medical assistance services.

30.17    Sec. 9. Minnesota Statutes 2006, section 256B.0625, subdivision 43, is amended to
30.18read:
30.19    Subd. 43. Mental health provider travel time. Medical assistance covers provider
30.20travel time. The per-minute rate is to be calculated at two times the IRS mileage rate if
30.21a recipient's individual treatment plan requires the provision of mental health services
30.22outside of the provider's normal place of business. This Reimbursement under this
30.23subdivision does not include any travel time which is included in other billable services,
30.24and is only covered when the mental health service being provided to a recipient is
30.25covered under medical assistance.

30.26    Sec. 10. Minnesota Statutes 2006, section 256B.0625, subdivision 46, is amended to
30.27read:
30.28    Subd. 46. Mental health telemedicine. Effective January 1, 2006, and subject to
30.29federal approval, mental health services that are otherwise covered by medical assistance
30.30as direct face-to-face services may be provided via two-way interactive video. Use of
30.31two-way interactive video must be medically appropriate to the condition and needs
30.32of the person being served. Reimbursement is at the same rates and under the same
30.33conditions that would otherwise apply to the service and shall include payment for the
30.34originating facility fee and the cost of broadband connections. The interactive video
31.1equipment and connection must comply with Medicare standards in effect at the time
31.2the service is provided.

31.3    Sec. 11. Minnesota Statutes 2006, section 256B.0625, is amended by adding a
31.4subdivision to read:
31.5    Subd. 50. Intensive mental health outpatient treatment. (a) Effective January
31.61, 2008, and subject to federal approval, medical assistance covers intensive mental
31.7health outpatient treatment. Intensive mental health outpatient treatment is a multimodal,
31.8therapeutic, and rehabilitative service that is provided for at least two hours per day and at
31.9least nine to 20 hours per week. The service provides an opportunity to combine existing
31.10covered services to deliver the necessary intensity and frequency of services identified
31.11in the individual treatment plan. Components of intensive mental health outpatient
31.12treatment include, but are not limited to:
31.13    (1) individual, family, or multifamily group psychotherapy or psychoeducational
31.14services;
31.15    (2) adjunctive services such as medical monitoring, family psychoeducation,
31.16behavioral parent training, rehabilitative services, medication education, relapse
31.17prevention, illness management and recovery services, and care coordination; and
31.18    (3) service coordination and referral for medical care or social services.
31.19    (b) During transition into or from services, intensive outpatient treatment under
31.20paragraph (a) may include time-limited services in multiple settings as clinically
31.21necessary. The service must be paid as a per diem based on 90 percent of the rate paid
31.22for partial hospitalization. Eligible providers must be licensed or certified to provide
31.23all aspects of the service.

31.24    Sec. 12. Minnesota Statutes 2006, section 256B.0625, is amended by adding a
31.25subdivision to read:
31.26    Subd. 51. Care management. Effective January 1, 2008, and subject to
31.27federal approval, medical assistance covers up to six hours of service per client per
31.28year, without authorization, of coordination and care management as a component of
31.29children's therapeutic services and supports, adult rehabilitative mental health services,
31.30or community mental health services. These services must be directed by an individual
31.31treatment plan and are solely for the purpose of improving continuity and access to
31.32appropriate and necessary services.

32.1    Sec. 13. Minnesota Statutes 2006, section 256B.0625, is amended by adding a
32.2subdivision to read:
32.3    Subd. 52. Collateral contacts. Effective January 1, 2008, and subject to federal
32.4approval, medical assistance covers up to six hours of service per client per year of
32.5collateral contacts as a component of children's therapeutic services and supports, adult
32.6rehabilitative mental health services, and community mental health services. These
32.7services must be directed by an individual treatment plan, and are solely for the purpose of
32.8assisting parents and others toward understanding, accommodating, and better caregiving
32.9of the person with mental illness or emotional disturbance.

32.10    Sec. 14. Minnesota Statutes 2006, section 256B.0625, is amended by adding a
32.11subdivision to read:
32.12    Subd. 53. Mental health services; dual eligible clients. Effective for services
32.13rendered on or after January 1, 2008, and subject to federal approval, medical assistance
32.14payments for community mental health and psychiatry services provided to dual eligible
32.15clients shall be paid at the Medicare reimbursement rate or at the medical assistance
32.16payment rate in effect on January 1, 2008, whichever is greater.

32.17    Sec. 15. Minnesota Statutes 2006, section 256B.0943, subdivision 1, is amended to
32.18read:
32.19    Subdivision 1. Definitions. For purposes of this section, the following terms have
32.20the meanings given them.
32.21    (a) "Children's therapeutic services and supports" means the flexible package of
32.22mental health services for children who require varying therapeutic and rehabilitative
32.23levels of intervention. The services are time-limited interventions that are delivered using
32.24various treatment modalities and combinations of services designed to reach treatment
32.25outcomes identified in the individual treatment plan.
32.26    (b) "Clinical supervision" means the overall responsibility of the mental health
32.27professional for the control and direction of individualized treatment planning, service
32.28delivery, and treatment review for each client. A mental health professional who is an
32.29enrolled Minnesota health care program provider accepts full professional responsibility
32.30for a supervisee's actions and decisions, instructs the supervisee in the supervisee's work,
32.31and oversees or directs the supervisee's work.
32.32    (c) "County board" means the county board of commissioners or board established
32.33under sections 402.01 to 402.10 or 471.59.
32.34    (d) "Crisis assistance" has the meaning given in section 245.4871, subdivision 9a.
33.1    (e) "Culturally competent provider" means a provider who understands and can
33.2utilize to a client's benefit the client's culture when providing services to the client. A
33.3provider may be culturally competent because the provider is of the same cultural or
33.4ethnic group as the client or the provider has developed the knowledge and skills through
33.5training and experience to provide services to culturally diverse clients.
33.6    (f) "Day treatment program" for children means a site-based structured program
33.7consisting of group psychotherapy for more than three individuals and other intensive
33.8therapeutic services provided by a multidisciplinary team, under the clinical supervision
33.9of a mental health professional.
33.10    (g) "Diagnostic assessment" has the meaning given in section 245.4871, subdivision
33.1111 .
33.12    (h) "Direct service time" means the time that a mental health professional, mental
33.13health practitioner, or mental health behavioral aide spends face-to-face with a client
33.14and the client's family. Direct service time includes time in which the provider obtains
33.15a client's history or provides service components of children's therapeutic services and
33.16supports. Direct service time does not include time doing work before and after providing
33.17direct services, including scheduling, maintaining clinical records, consulting with others
33.18about the client's mental health status, preparing reports, receiving clinical supervision
33.19directly related to the client's psychotherapy session, and revising the client's individual
33.20treatment plan.
33.21    (i) "Direction of mental health behavioral aide" means the activities of a mental
33.22health professional or mental health practitioner in guiding the mental health behavioral
33.23aide in providing services to a client. The direction of a mental health behavioral aide
33.24must be based on the client's individualized treatment plan and meet the requirements in
33.25subdivision 6, paragraph (b), clause (5).
33.26    (j) "Emotional disturbance" has the meaning given in section 245.4871, subdivision
33.2715 . For persons at least age 18 but under age 21, mental illness has the meaning given in
33.28section 245.462, subdivision 20, paragraph (a).
33.29    (k) "Family psychoeducation" is a multimodal outpatient therapy and rehabilitative
33.30service that involves parents, families, and others as resources in the treatment, recovery,
33.31and improved functioning of a person with mental illness or emotional disturbance,
33.32in which families learn about the illness, family reactions, and types of treatment and
33.33supports. Families learn to develop skills to handle problems posed by mental illness
33.34including coping, managing stress, ensuring safety, creating social support, identifying
33.35resources, and supporting treatment and recovery goals. Services include family
33.36counseling, family treatment planning, and family support using cognitive, behavioral,
34.1problem-solving, and communication strategies, and may involve individual, family, and
34.2group intervention activities for consumers and families together, families only, or brief
34.3intermittent consultations at critical times in an episode of care. Eligible providers must
34.4be certified to provide both outpatient mental health services and rehabilitative services
34.5under section 256B.0943.
34.6    (l) "Individual behavioral plan" means a plan of intervention, treatment, and services
34.7for a child written by a mental health professional or mental health practitioner, under
34.8the clinical supervision of a mental health professional, to guide the work of the mental
34.9health behavioral aide.
34.10    (l) (m) "Individual treatment plan" has the meaning given in section 245.4871,
34.11subdivision 21 .
34.12    (m) (n) "Mental health professional" means an individual as defined in section
34.13245.4871, subdivision 27 , clauses (1) to (5), or tribal vendor as defined in section 256B.02,
34.14subdivision 7 , paragraph (b).
34.15    (n) (o) "Preschool program" means a day program licensed under Minnesota Rules,
34.16parts 9503.0005 to 9503.0175, and enrolled as a children's therapeutic services and
34.17supports provider to provide a structured treatment program to a child who is at least 33
34.18months old but who has not yet attended the first day of kindergarten.
34.19    (o) (p) "Skills training" means individual, family, or group training designed to
34.20improve the basic functioning of the child with emotional disturbance and the child's
34.21family in the activities of daily living and community living, and to improve the social
34.22functioning of the child and the child's family in areas important to the child's maintaining
34.23or reestablishing residency in the community. Individual, family, and group skills training
34.24must:
34.25    (1) consist of activities designed to promote skill development of the child and the
34.26child's family in the use of age-appropriate daily living skills, interpersonal and family
34.27relationships, and leisure and recreational services;
34.28    (2) consist of activities that will assist the family's understanding of normal child
34.29development and to use parenting skills that will help the child with emotional disturbance
34.30achieve the goals outlined in the child's individual treatment plan; and
34.31    (3) promote family preservation and unification, promote the family's integration
34.32with the community, and reduce the use of unnecessary out-of-home placement or
34.33institutionalization of children with emotional disturbance.

34.34    Sec. 16. Minnesota Statutes 2006, section 256B.0943, subdivision 2, is amended to
34.35read:
35.1    Subd. 2. Covered service components of children's therapeutic services and
35.2supports. (a) Subject to federal approval, medical assistance covers medically necessary
35.3children's therapeutic services and supports as defined in this section that an eligible
35.4provider entity under subdivisions 4 and 5 provides to a client eligible under subdivision 3.
35.5    (b) The service components of children's therapeutic services and supports are:
35.6    (1) individual, family, and group psychotherapy, and family psychoeducation;
35.7    (2) individual, family, or group skills training provided by a mental health
35.8professional or mental health practitioner;
35.9    (3) crisis assistance;
35.10    (4) mental health behavioral aide services; and
35.11    (5) direction of a mental health behavioral aide;
35.12    (6) coordination and care management; and
35.13    (7) collateral contacts.
35.14    (c) Service components may be combined to constitute therapeutic programs,
35.15including day treatment programs and preschool programs. Although day treatment and
35.16preschool programs have specific client and provider eligibility requirements, medical
35.17assistance only pays for the service components listed in paragraph (b).

35.18    Sec. 17. Minnesota Statutes 2006, section 256B.0943, is amended by adding a
35.19subdivision to read:
35.20    Subd. 11a. Reimbursement of diagnostic assessments. A diagnostic assessment
35.21under this section must be reimbursed at the same rate as an assessment under section
35.22256B.0655, subdivision 8.

35.23    Sec. 18. Minnesota Statutes 2006, section 256B.69, subdivision 5g, is amended to read:
35.24    Subd. 5g. Payment for covered services. For services rendered on or after January
35.251, 2003, the total payment made to managed care plans for providing covered services
35.26under the medical assistance and general assistance medical care programs is reduced by
35.27.5 percent from their current statutory rates. This provision excludes payments for nursing
35.28home services, home and community-based waivers, and payments to demonstration
35.29projects for persons with disabilities, and mental health services added as covered benefits
35.30after December 31, 2007.

35.31    Sec. 19. Minnesota Statutes 2006, section 256B.69, subdivision 5h, is amended to read:
35.32    Subd. 5h. Payment reduction. In addition to the reduction in subdivision 5g,
35.33the total payment made to managed care plans under the medical assistance program is
36.1reduced 1.0 percent for services provided on or after October 1, 2003, and an additional
36.21.0 percent for services provided on or after January 1, 2004. This provision excludes
36.3payments for nursing home services, home and community-based waivers, and payments
36.4to demonstration projects for persons with disabilities, and mental health services added as
36.5covered benefits after December 1, 2007.

36.6    Sec. 20. Minnesota Statutes 2006, section 256B.763, is amended to read:
36.7256B.763 CRITICAL ACCESS MENTAL HEALTH RATE INCREASE.
36.8    (a) For services defined in paragraph (b) and rendered on or after July 1, 2007,
36.9payment rates shall be increased by 23.7 percent over the rates in effect on January 1,
36.102006, for:
36.11    (1) psychiatrists and advanced practice registered nurses with a psychiatric specialty;
36.12    (2) community mental health centers under section 256B.0625, subdivision 5; and
36.13    (3) mental health clinics and centers certified under Minnesota Rules, parts
36.149520.0750 to 9520.0870, or hospital outpatient psychiatric departments that are designated
36.15as essential community providers under section 62Q.19.
36.16    (b) This increase applies to group skills training when provided as a component of
36.17children's therapeutic services and support, psychotherapy, medication management,
36.18evaluation and management, diagnostic assessment, explanation of findings, psychological
36.19testing, neuropsychological services, direction of behavioral aides, and inpatient
36.20consultation.
36.21    (c) This increase does not apply to rates that are governed by section 256B.0625,
36.22subdivision 30, or 256B.761, paragraph (b), other cost-based rates, rates that are
36.23negotiated with the county, rates that are established by the federal government, or rates
36.24that increased between January 1, 2004, and January 1, 2005.
36.25    (d) Effective January 1, 2008, this increase applies to providers of individual and
36.26group skills training, individual and group psychotherapy, diagnostic assessments, travel,
36.27and other services when provided as a component of children's therapeutic services and
36.28support.
36.29    (e) Effective January 1, 2008, payment rates for all services not included in
36.30paragraph (b) shall increase by 23.7 percent over rates in effect on January 1, 2006, for all
36.31services provided by community mental health centers under 256B.0625, subdivision 5.
36.32    (f) The commissioner shall adjust rates paid to prepaid health plans under contract
36.33with the commissioner to reflect the rate increases provided in paragraph paragraphs (a),
36.34(d), and (e). The prepaid health plan must pass this rate increase to the providers identified
36.35in paragraph paragraphs (a), (d), and (e).

37.1    Sec. 21. Minnesota Statutes 2006, section 256D.03, subdivision 4, is amended to read:
37.2    Subd. 4. General assistance medical care; services. (a)(i) For a person who is
37.3eligible under subdivision 3, paragraph (a), clause (2), item (i), general assistance medical
37.4care covers, except as provided in paragraph (c):
37.5    (1) inpatient hospital services;
37.6    (2) outpatient hospital services;
37.7    (3) services provided by Medicare certified rehabilitation agencies;
37.8    (4) prescription drugs and other products recommended through the process
37.9established in section 256B.0625, subdivision 13;
37.10    (5) equipment necessary to administer insulin and diagnostic supplies and equipment
37.11for diabetics to monitor blood sugar level;
37.12    (6) eyeglasses and eye examinations provided by a physician or optometrist;
37.13    (7) hearing aids;
37.14    (8) prosthetic devices;
37.15    (9) laboratory and X-ray services;
37.16    (10) physician's services;
37.17    (11) medical transportation except special transportation;
37.18    (12) chiropractic services as covered under the medical assistance program;
37.19    (13) podiatric services;
37.20    (14) dental services as covered under the medical assistance program;
37.21    (15) outpatient services provided by a mental health center or clinic that is under
37.22contract with the county board and is established under section 245.62 mental health
37.23services covered under chapter 256B;
37.24    (16) day treatment services for mental illness provided under contract with the
37.25county board;
37.26    (17) prescribed medications for persons who have been diagnosed as mentally ill as
37.27necessary to prevent more restrictive institutionalization;
37.28    (18) psychological services, (17) medical supplies and equipment, and Medicare
37.29premiums, coinsurance and deductible payments;
37.30    (19) (18) medical equipment not specifically listed in this paragraph when the use
37.31of the equipment will prevent the need for costlier services that are reimbursable under
37.32this subdivision;
37.33    (20) (19) services performed by a certified pediatric nurse practitioner, a
37.34certified family nurse practitioner, a certified adult nurse practitioner, a certified
37.35obstetric/gynecological nurse practitioner, a certified neonatal nurse practitioner, or a
37.36certified geriatric nurse practitioner in independent practice, if (1) the service is otherwise
38.1covered under this chapter as a physician service, (2) the service provided on an inpatient
38.2basis is not included as part of the cost for inpatient services included in the operating
38.3payment rate, and (3) the service is within the scope of practice of the nurse practitioner's
38.4license as a registered nurse, as defined in section 148.171;
38.5    (21) (20) services of a certified public health nurse or a registered nurse practicing
38.6in a public health nursing clinic that is a department of, or that operates under the direct
38.7authority of, a unit of government, if the service is within the scope of practice of the
38.8public health nurse's license as a registered nurse, as defined in section 148.171;
38.9    (22) (21) telemedicine consultations, to the extent they are covered under section
38.10256B.0625, subdivision 3b ; and
38.11    (23) mental health telemedicine and psychiatric consultation as covered under
38.12section 256B.0625, subdivisions 46 and 48
38.13    (22) up to six hours of service per client per year, without authorization, of
38.14consultation and care coordination as directed by an individual treatment plan, and as a
38.15component of children's therapeutic services and supports, adult rehabilitative mental
38.16health services, or community mental health services; and
38.17    (23) up to six hours of service per client per year for collateral contacts as a
38.18component of children's therapeutic services and supports, adult rehabilitative mental
38.19health services, or community mental health services. These services must be directed
38.20by an individual treatment plan and are solely for the purpose of assisting parents and
38.21others toward understanding, accommodating, and better caregiving of the person with
38.22mental illness or emotional disturbance.
38.23    (ii) Effective October 1, 2003, for a person who is eligible under subdivision 3,
38.24paragraph (a), clause (2), item (ii), general assistance medical care coverage is limited
38.25to inpatient hospital services, including physician services provided during the inpatient
38.26hospital stay. A $1,000 deductible is required for each inpatient hospitalization.
38.27    (b) Effective August 1, 2005, sex reassignment surgery is not covered under this
38.28subdivision.
38.29    (c) In order to contain costs, the commissioner of human services shall select
38.30vendors of medical care who can provide the most economical care consistent with high
38.31medical standards and shall where possible contract with organizations on a prepaid
38.32capitation basis to provide these services. The commissioner shall consider proposals by
38.33counties and vendors for prepaid health plans, competitive bidding programs, block grants,
38.34or other vendor payment mechanisms designed to provide services in an economical
38.35manner or to control utilization, with safeguards to ensure that necessary services are
38.36provided. Before implementing prepaid programs in counties with a county operated or
39.1affiliated public teaching hospital or a hospital or clinic operated by the University of
39.2Minnesota, the commissioner shall consider the risks the prepaid program creates for the
39.3hospital and allow the county or hospital the opportunity to participate in the program in a
39.4manner that reflects the risk of adverse selection and the nature of the patients served by
39.5the hospital, provided the terms of participation in the program are competitive with the
39.6terms of other participants considering the nature of the population served. Payment for
39.7services provided pursuant to this subdivision shall be as provided to medical assistance
39.8vendors of these services under sections 256B.02, subdivision 8, and 256B.0625. For
39.9payments made during fiscal year 1990 and later years, the commissioner shall consult
39.10with an independent actuary in establishing prepayment rates, but shall retain final control
39.11over the rate methodology.
39.12    (d) Recipients eligible under subdivision 3, paragraph (a), shall pay the following
39.13co-payments for services provided on or after October 1, 2003:
39.14    (1) $25 for eyeglasses;
39.15    (2) $25 for nonemergency visits to a hospital-based emergency room;
39.16    (3) $3 per brand-name drug prescription and $1 per generic drug prescription,
39.17subject to a $12 per month maximum for prescription drug co-payments. No co-payments
39.18shall apply to antipsychotic drugs when used for the treatment of mental illness; and
39.19    (4) 50 percent coinsurance on restorative dental services.
39.20    (e) Co-payments shall be limited to one per day per provider for nonpreventive visits,
39.21eyeglasses, and nonemergency visits to a hospital-based emergency room. Recipients of
39.22general assistance medical care are responsible for all co-payments in this subdivision.
39.23The general assistance medical care reimbursement to the provider shall be reduced by
39.24the amount of the co-payment, except that reimbursement for prescription drugs shall not
39.25be reduced once a recipient has reached the $12 per month maximum for prescription
39.26drug co-payments. The provider collects the co-payment from the recipient. Providers
39.27may not deny services to recipients who are unable to pay the co-payment, except as
39.28provided in paragraph (f).
39.29    (f) If it is the routine business practice of a provider to refuse service to an individual
39.30with uncollected debt, the provider may include uncollected co-payments under this
39.31section. A provider must give advance notice to a recipient with uncollected debt before
39.32services can be denied.
39.33    (g) Any county may, from its own resources, provide medical payments for which
39.34state payments are not made.
39.35    (h) Chemical dependency services that are reimbursed under chapter 254B must not
39.36be reimbursed under general assistance medical care.
40.1    (i) The maximum payment for new vendors enrolled in the general assistance
40.2medical care program after the base year shall be determined from the average usual and
40.3customary charge of the same vendor type enrolled in the base year.
40.4    (j) The conditions of payment for services under this subdivision are the same as the
40.5conditions specified in rules adopted under chapter 256B governing the medical assistance
40.6program, unless otherwise provided by statute or rule.
40.7    (k) Inpatient and outpatient payments shall be reduced by five percent, effective July
40.81, 2003. This reduction is in addition to the five percent reduction effective July 1, 2003,
40.9and incorporated by reference in paragraph (i).
40.10    (l) Payments for all other health services except inpatient, outpatient, and pharmacy
40.11services shall be reduced by five percent, effective July 1, 2003.
40.12    (m) Payments to managed care plans shall be reduced by five percent for services
40.13provided on or after October 1, 2003.
40.14    (n) A hospital receiving a reduced payment as a result of this section may apply the
40.15unpaid balance toward satisfaction of the hospital's bad debts.
40.16    (o) Fee-for-service payments for nonpreventive visits shall be reduced by $3
40.17for services provided on or after January 1, 2006. For purposes of this subdivision, a
40.18visit means an episode of service which is required because of a recipient's symptoms,
40.19diagnosis, or established illness, and which is delivered in an ambulatory setting by
40.20a physician or physician ancillary, chiropractor, podiatrist, advance practice nurse,
40.21audiologist, optician, or optometrist.
40.22    (p) Payments to managed care plans shall not be increased as a result of the removal
40.23of the $3 nonpreventive visit co-payment effective January 1, 2006.
40.24    (q) Payments for mental health services added as covered benefits after December 1,
40.252007, are not subject to the reductions in paragraphs (i), (k), (l), and (m).

40.26    Sec. 22. Minnesota Statutes 2006, section 256D.44, subdivision 5, is amended to read:
40.27    Subd. 5. Special needs. In addition to the state standards of assistance established in
40.28subdivisions 1 to 4, payments are allowed for the following special needs of recipients of
40.29Minnesota supplemental aid who are not residents of a nursing home, a regional treatment
40.30center, or a group residential housing facility.
40.31    (a) The county agency shall pay a monthly allowance for medically prescribed
40.32diets if the cost of those additional dietary needs cannot be met through some other
40.33maintenance benefit. The need for special diets or dietary items must be prescribed by
40.34a licensed physician. Costs for special diets shall be determined as percentages of the
40.35allotment for a one-person household under the thrifty food plan as defined by the United
41.1States Department of Agriculture. The types of diets and the percentages of the thrifty
41.2food plan that are covered are as follows:
41.3    (1) high protein diet, at least 80 grams daily, 25 percent of thrifty food plan;
41.4    (2) controlled protein diet, 40 to 60 grams and requires special products, 100 percent
41.5of thrifty food plan;
41.6    (3) controlled protein diet, less than 40 grams and requires special products, 125
41.7percent of thrifty food plan;
41.8    (4) low cholesterol diet, 25 percent of thrifty food plan;
41.9    (5) high residue diet, 20 percent of thrifty food plan;
41.10    (6) pregnancy and lactation diet, 35 percent of thrifty food plan;
41.11    (7) gluten-free diet, 25 percent of thrifty food plan;
41.12    (8) lactose-free diet, 25 percent of thrifty food plan;
41.13    (9) antidumping diet, 15 percent of thrifty food plan;
41.14    (10) hypoglycemic diet, 15 percent of thrifty food plan; or
41.15    (11) ketogenic diet, 25 percent of thrifty food plan.
41.16    (b) Payment for nonrecurring special needs must be allowed for necessary home
41.17repairs or necessary repairs or replacement of household furniture and appliances using
41.18the payment standard of the AFDC program in effect on July 16, 1996, for these expenses,
41.19as long as other funding sources are not available.
41.20    (c) A fee for guardian or conservator service is allowed at a reasonable rate
41.21negotiated by the county or approved by the court. This rate shall not exceed five percent
41.22of the assistance unit's gross monthly income up to a maximum of $100 per month. If the
41.23guardian or conservator is a member of the county agency staff, no fee is allowed.
41.24    (d) The county agency shall continue to pay a monthly allowance of $68 for
41.25restaurant meals for a person who was receiving a restaurant meal allowance on June 1,
41.261990, and who eats two or more meals in a restaurant daily. The allowance must continue
41.27until the person has not received Minnesota supplemental aid for one full calendar month
41.28or until the person's living arrangement changes and the person no longer meets the criteria
41.29for the restaurant meal allowance, whichever occurs first.
41.30    (e) A fee of ten percent of the recipient's gross income or $25, whichever is less,
41.31is allowed for representative payee services provided by an agency that meets the
41.32requirements under SSI regulations to charge a fee for representative payee services. This
41.33special need is available to all recipients of Minnesota supplemental aid regardless of
41.34their living arrangement.
41.35    (f) Notwithstanding the language in this subdivision, an amount equal to the
41.36maximum allotment authorized by the federal Food Stamp Program for a single individual
42.1which is in effect on the first day of January July of the previous current state fiscal
42.2year will be added to the standards of assistance established in subdivisions 1 to 4 for
42.3individuals under the age of 65 who are relocating from an institution, or an adult mental
42.4health residential treatment program under section 256B.0622, or an adult eligible for the
42.5community alternatives for disabled individuals waiver, and who are shelter needy. An
42.6eligible individual who receives this benefit prior to age 65 may continue to receive the
42.7benefit after the age of 65.
42.8    "Shelter needy" means that the assistance unit incurs monthly shelter costs that
42.9exceed 40 percent of the assistance unit's gross income before the application of this
42.10special needs standard. "Gross income" for the purposes of this section is the applicant's or
42.11recipient's income as defined in section 256D.35, subdivision 10, or the standard specified
42.12in subdivision 3, whichever is greater. A recipient of a federal or state housing subsidy,
42.13that limits shelter costs to a percentage of gross income, shall not be considered shelter
42.14needy for purposes of this paragraph.

42.15    Sec. 23. Minnesota Statutes 2006, section 256L.03, subdivision 1, is amended to read:
42.16    Subdivision 1. Covered health services. For individuals under section 256L.04,
42.17subdivision 7 , with income no greater than 75 percent of the federal poverty guidelines
42.18or for families with children under section 256L.04, subdivision 1, all subdivisions of
42.19this section apply. "Covered health services" means the health services reimbursed
42.20under chapter 256B, with the exception of inpatient hospital services, special education
42.21services, private duty nursing services, adult dental care services other than services
42.22covered under section 256B.0625, subdivision 9, orthodontic services, nonemergency
42.23medical transportation services, personal care assistant and case management services,
42.24nursing home or intermediate care facilities services, inpatient mental health services,
42.25and chemical dependency services. Outpatient mental health services covered under the
42.26MinnesotaCare program are limited to diagnostic assessments, psychological testing,
42.27explanation of findings, mental health telemedicine, psychiatric consultation, medication
42.28management by a physician, day treatment, partial hospitalization, and individual, family,
42.29and group psychotherapy.
42.30    No public funds shall be used for coverage of abortion under MinnesotaCare
42.31except where the life of the female would be endangered or substantial and irreversible
42.32impairment of a major bodily function would result if the fetus were carried to term; or
42.33where the pregnancy is the result of rape or incest.
42.34    Covered health services shall be expanded as provided in this section.

43.1    Sec. 24. Minnesota Statutes 2006, section 256L.03, subdivision 5, is amended to read:
43.2    Subd. 5. Co-payments and coinsurance. (a) Except as provided in paragraphs (b)
43.3and (c), the MinnesotaCare benefit plan shall include the following co-payments and
43.4coinsurance requirements for all enrollees:
43.5    (1) ten percent of the paid charges for inpatient hospital services for adult enrollees,
43.6subject to an annual inpatient out-of-pocket maximum of $1,000 per individual and
43.7$3,000 per family;
43.8    (2) $3 per prescription for adult enrollees;
43.9    (3) $25 for eyeglasses for adult enrollees;
43.10    (4) $3 per nonpreventive visit. For purposes of this subdivision, a "visit" means an
43.11episode of service which is required because of a recipient's symptoms, diagnosis, or
43.12established illness, and which is delivered in an ambulatory setting by a physician or
43.13physician ancillary, chiropractor, podiatrist, nurse midwife, advanced practice nurse,
43.14audiologist, optician, or optometrist; and
43.15    (5) $6 for nonemergency visits to a hospital-based emergency room.
43.16    (b) Paragraph (a), clause (1), does not apply to parents and relative caretakers of
43.17children under the age of 21 in households with family income equal to or less than 175
43.18percent of the federal poverty guidelines. Paragraph (a), clause (1), does not apply to
43.19parents and relative caretakers of children under the age of 21 in households with family
43.20income greater than 175 percent of the federal poverty guidelines for inpatient hospital
43.21admissions occurring on or after January 1, 2001.
43.22    (c) Paragraph (a), clauses (1) to (4), do not apply to pregnant women and children
43.23under the age of 21.
43.24    (d) Paragraph (a), clause (4), does not apply to mental health services.
43.25    (e) Adult enrollees with family gross income that exceeds 175 percent of the
43.26federal poverty guidelines and who are not pregnant shall be financially responsible for
43.27the coinsurance amount, if applicable, and amounts which exceed the $10,000 inpatient
43.28hospital benefit limit.
43.29    (e) (f) When a MinnesotaCare enrollee becomes a member of a prepaid health plan,
43.30or changes from one prepaid health plan to another during a calendar year, any charges
43.31submitted towards the $10,000 annual inpatient benefit limit, and any out-of-pocket
43.32expenses incurred by the enrollee for inpatient services, that were submitted or incurred
43.33prior to enrollment, or prior to the change in health plans, shall be disregarded.

44.1    Sec. 25. Minnesota Statutes 2006, section 256L.035, is amended to read:
44.2256L.035 LIMITED BENEFITS COVERAGE FOR CERTAIN SINGLE
44.3ADULTS AND HOUSEHOLDS WITHOUT CHILDREN.
44.4    (a) "Covered health services" for individuals under section 256L.04, subdivision
44.57 , with income above 75 percent, but not exceeding 175 percent, of the federal poverty
44.6guideline means:
44.7    (1) inpatient hospitalization benefits with a ten percent co-payment up to $1,000 and
44.8subject to an annual limitation of $10,000;
44.9    (2) physician services provided during an inpatient stay; and
44.10    (3) physician services not provided during an inpatient stay; outpatient hospital
44.11services; freestanding ambulatory surgical center services; chiropractic services; lab and
44.12diagnostic services; diabetic supplies and equipment; mental health services as covered
44.13under chapter 256B; and prescription drugs; subject to the following co-payments:
44.14    (i) $50 co-pay per emergency room visit;
44.15    (ii) $3 co-pay per prescription drug; and
44.16    (iii) $5 co-pay per nonpreventive visit; except this co-pay does not apply to mental
44.17health services or community mental health services.
44.18The services covered under this section may be provided by a physician, physician
44.19ancillary, chiropractor, psychologist, or licensed independent clinical social worker, or
44.20other mental health providers covered under chapter 256B if the services are within the
44.21scope of practice of that health care professional.
44.22    For purposes of this section, "a visit" means an episode of service which is required
44.23because of a recipient's symptoms, diagnosis, or established illness, and which is delivered
44.24in an ambulatory setting by any health care provider identified in this paragraph.
44.25    Enrollees are responsible for all co-payments in this section.
44.26    (b) Reimbursement to the providers shall be reduced by the amount of the
44.27co-payment, except that reimbursement for prescription drugs shall not be reduced once a
44.28recipient has reached the $20 per month maximum for prescription drug co-payments.
44.29The provider collects the co-payment from the recipient. Providers may not deny services
44.30to recipients who are unable to pay the co-payment, except as provided in paragraph (c).
44.31    (c) If it is the routine business practice of a provider to refuse service to an individual
44.32with uncollected debt, the provider may include uncollected co-payments under this
44.33section. A provider must give advance notice to a recipient with uncollected debt before
44.34services can be denied.

44.35    Sec. 26. Minnesota Statutes 2006, section 256L.07, subdivision 3, is amended to read:
45.1    Subd. 3. Other health coverage. (a) Families and individuals enrolled in the
45.2MinnesotaCare program must have no health coverage while enrolled or for at least four
45.3months prior to application and renewal. Children enrolled in the original children's health
45.4plan and children in families with income equal to or less than 150 percent of the federal
45.5poverty guidelines, who have other health insurance, are eligible if the coverage:
45.6    (1) lacks two or more of the following:
45.7    (i) basic hospital insurance;
45.8    (ii) medical-surgical insurance;
45.9    (iii) prescription drug coverage;
45.10    (iv) dental coverage; or
45.11    (v) vision coverage; or
45.12    (vi) mental health coverage;
45.13    (2) requires a deductible of $100 or more per person per year; or
45.14    (3) lacks coverage because the child has exceeded the maximum coverage for a
45.15particular diagnosis or the policy excludes a particular diagnosis.
45.16    The commissioner may change this eligibility criterion for sliding scale premiums
45.17in order to remain within the limits of available appropriations. The requirement of no
45.18health coverage does not apply to newborns.
45.19    (b) Medical assistance, general assistance medical care, and the Civilian Health and
45.20Medical Program of the Uniformed Service, CHAMPUS, or other coverage provided under
45.21United States Code, title 10, subtitle A, part II, chapter 55, are not considered insurance or
45.22health coverage for purposes of the four-month requirement described in this subdivision.
45.23    (c) For purposes of this subdivision, an applicant or enrollee who is entitled to
45.24Medicare Part A or enrolled in Medicare Part B coverage under title XVIII of the Social
45.25Security Act, United States Code, title 42, sections 1395c to 1395w-152, is considered to
45.26have health coverage. An applicant or enrollee who is entitled to premium-free Medicare
45.27Part A may not refuse to apply for or enroll in Medicare coverage to establish eligibility
45.28for MinnesotaCare.
45.29    (d) Applicants who were recipients of medical assistance or general assistance
45.30medical care within one month of application must meet the provisions of this subdivision
45.31and subdivision 2.
45.32    (e) Cost-effective health insurance that was paid for by medical assistance is not
45.33considered health coverage for purposes of the four-month requirement under this
45.34section, except if the insurance continued after medical assistance no longer considered it
45.35cost-effective or after medical assistance closed.

46.1    Sec. 27. Minnesota Statutes 2006, section 256L.12, subdivision 9a, is amended to read:
46.2    Subd. 9a. Rate setting; ratable reduction. For services rendered on or after
46.3October 1, 2003, the total payment made to managed care plans under the MinnesotaCare
46.4program is reduced 1.0 percent. This provision excludes payments for mental health
46.5services added as covered benefits after December 31, 2007.

46.6    Sec. 28. MENTAL HEALTH SERVICES PROVIDER RATE INCREASES.
46.7    (a) The commissioner of human services shall increase reimbursement rates or rate
46.8limits, as applicable, by ... percent for the rate period beginning October 1, 2007, and the
46.9rate period beginning October 1, 2008, effective for services rendered on or after those
46.10dates.
46.11    (b) The ... percent annual rate increase described in this section must be provided to:
46.12    (1) children's therapeutic services and supports under Minnesota Statutes, section
46.13256B.0943; and
46.14    (2) adult rehabilitative mental health services under Minnesota Statutes, section
46.15256B.0623.
46.16    (c) Providers that receive a rate increase under this section shall use 75 percent of
46.17the additional revenue to increase wages and benefits and pay associated costs for all
46.18employees, except for management fees, the administrator, and central office staffs.
46.19    (d) For public employees, the increase for wages and benefits for certain staff is
46.20available and pay rates shall be increased only to the extent that they comply with laws
46.21governing public employees collective bargaining. Money received by a provider for pay
46.22increases under this section may be used only for increases implemented on or after the
46.23first day of the rate period in which the increase is available and must not be used for
46.24increases implemented prior to that date.
46.25    (e) A copy of the provider's plan for complying with paragraph (c) must be made
46.26available to all employees by giving each employee a copy or by posting a copy in an area
46.27of the provider's operation to which all employees have access. If an employee does not
46.28receive the adjustment, if any, described in the plan and is unable to resolve the problem
46.29with the provider, the employee may contact the employee's union representative. If the
46.30employee is not covered by a collective bargaining agreement, the employee may contact
46.31the commissioner at a telephone number provided by the commissioner and included in
46.32the provider's plan.

46.33    Sec. 29. APPROPRIATIONS.
47.1    Subdivision 1. Mobile mental health crisis services. (a) $5,000,000 in fiscal year
47.22008 and $7,250,000 in fiscal year 2009 are appropriated from the general fund to the
47.3commissioner of human services for statewide funding of mobile mental health crisis
47.4services.
47.5    (b) Providers must utilize all available funding streams.
47.6    Subd. 2. Mental health tracking system. $448,000 in fiscal year 2008 and
47.7$324,000 in fiscal year 2009 are appropriated from the general fund to the commissioner
47.8of human services to fund implementation of the mental health services outcomes and
47.9tracking system.
47.10    Subd. 3. Suicide prevention programs. $....... in fiscal year 2008 and $....... in
47.11fiscal year 2009 are appropriated from the general fund to the commissioner of health to
47.12fund the suicide prevention program and to administer grants for institutions of higher
47.13education in the state of Minnesota to coordinate implementation of youth suicide early
47.14intervention and prevention strategies.