HF 722

1st Division Engrossment - 92nd Legislature (2021 - 2022) Posted on 02/24/2021 11:23am

A bill for an act
relating to human services; increasing payment rates for certain substance use
disorder treatment providers; appropriating money; amending Minnesota Statutes
2020, sections 254B.01, subdivision 4a, by adding a subdivision; 254B.05,
subdivision 5; 254B.12, by adding a subdivision.

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

Section 1.

Minnesota Statutes 2020, section 254B.01, subdivision 4a, is amended to read:

Subd. 4a.

Culturally specific new text begin or culturally responsive new text end program.

(a) "Culturally specific
new text begin or culturally responsive new text end program" means a substance use disorder treatment service program
or subprogram that is deleted text begin recovery-focused and deleted text end new text begin culturally responsive or new text end culturally specific when
the program new text begin attests that it new text end :

(1) improves service quality to and outcomes of a specific deleted text begin population deleted text end new text begin community that
shares a common language, racial, ethnic, or social background new text end by advancing health equity
to help eliminate health disparities; deleted text begin and
deleted text end

(2) ensures effective, equitable, comprehensive, and respectful quality care services that
are responsive to an individual within a specific deleted text begin population's deleted text end new text begin community's new text end values, beliefs
and practices, health literacy, preferred language, and other communication needs deleted text begin . deleted text end new text begin ; and
new text end

new text begin (3) is compliant with the national standards for culturally and linguistically appropriate
services or other equivalent standards, as determined by the commissioner.
new text end

(b) A tribally licensed substance use disorder program that is designated as serving a
culturally specific population by the applicable tribal government is deemed to satisfy this
subdivision.

new text begin (c) A program satisfies the requirements of this subdivision if it attests that the program:
new text end

new text begin (1) is designed to address the unique needs of individuals who share a common language,
racial, ethnic, or social background;
new text end

new text begin (2) is governed with significant input from individuals of that specific background; and
new text end

new text begin (3) employs individuals to provide treatment services, at least 50 percent of whom are
members of the specific community being served.
new text end

Sec. 2.

Minnesota Statutes 2020, section 254B.01, is amended by adding a subdivision to
read:

new text begin Subd. 4b. new text end

new text begin Disability responsive program. new text end

new text begin "Disability responsive program" means a
program that:
new text end

new text begin (1) is designed to serve individuals with disabilities, including individuals with traumatic
brain injuries, developmental disabilities, cognitive disabilities, and physical disabilities;
and
new text end

new text begin (2) employs individuals to provide treatment services who have the necessary professional
training, as approved by the commissioner, to serve individuals with the specific disabilities
that the program is designed to serve.
new text end

Sec. 3.

Minnesota Statutes 2020, section 254B.05, subdivision 5, is amended to read:

Subd. 5.

Rate requirements.

(a) The commissioner shall establish rates for substance
use disorder services and service enhancements funded under this chapter.

(b) Eligible substance use disorder treatment services include:

(1) outpatient treatment services that are licensed according to sections 245G.01 to
245G.17, or applicable tribal license;

(2) comprehensive assessments provided according to sections 245.4863, paragraph (a),
and 245G.05;

(3) care coordination services provided according to section 245G.07, subdivision 1,
paragraph (a), clause (5);

(4) peer recovery support services provided according to section 245G.07, subdivision
2, clause (8);

(5) on July 1, 2019, or upon federal approval, whichever is later, withdrawal management
services provided according to chapter 245F;

(6) medication-assisted therapy services that are licensed according to sections 245G.01
to 245G.17 and 245G.22, or applicable tribal license;

(7) medication-assisted therapy plus enhanced treatment services that meet the
requirements of clause (6) and provide nine hours of clinical services each week;

(8) high, medium, and low intensity residential treatment services that are licensed
according to sections 245G.01 to 245G.17 and 245G.21 or applicable tribal license which
provide, respectively, 30, 15, and five hours of clinical services each week;

(9) hospital-based treatment services that are licensed according to sections 245G.01 to
245G.17 or applicable tribal license and licensed as a hospital under sections 144.50 to
144.56;

(10) adolescent treatment programs that are licensed as outpatient treatment programs
according to sections 245G.01 to 245G.18 or as residential treatment programs according
to Minnesota Rules, parts 2960.0010 to 2960.0220, and 2960.0430 to 2960.0490, or
applicable tribal license;

(11) high-intensity residential treatment services that are licensed according to sections
245G.01 to 245G.17 and 245G.21 or applicable tribal license, which provide 30 hours of
clinical services each week provided by a state-operated vendor or to clients who have been
civilly committed to the commissioner, present the most complex and difficult care needs,
and are a potential threat to the community; and

(12) room and board facilities that meet the requirements of subdivision 1a.

(c) The commissioner shall establish higher rates for programs that meet the requirements
of paragraph (b) and one of the following additional requirements:

(1) programs that serve parents with their children if the program:

(i) provides on-site child care during the hours of treatment activity that:

(A) is licensed under chapter 245A as a child care center under Minnesota Rules, chapter
9503; or

(B) meets the licensure exclusion criteria of section 245A.03, subdivision 2, paragraph
(a), clause (6), and meets the requirements under section 245G.19, subdivision 4; or

(ii) arranges for off-site child care during hours of treatment activity at a facility that is
licensed under chapter 245A as:

(A) a child care center under Minnesota Rules, chapter 9503; or

(B) a family child care home under Minnesota Rules, chapter 9502;

(2) culturally specific new text begin or culturally responsive new text end programs as defined in section 254B.01,
subdivision 4a deleted text begin , or programs or subprograms serving special populations, if the program or
subprogram meets the following requirements: deleted text end new text begin ;
new text end

deleted text begin (i) is designed to address the unique needs of individuals who share a common language,
racial, ethnic, or social background;
deleted text end

deleted text begin (ii) is governed with significant input from individuals of that specific background; and
deleted text end

deleted text begin (iii) employs individuals to provide individual or group therapy, at least 50 percent of
whom are of that specific background, except when the common social background of the
individuals served is a traumatic brain injury or cognitive disability and the program employs
treatment staff who have the necessary professional training, as approved by the
commissioner, to serve clients with the specific disabilities that the program is designed to
serve;
deleted text end

(3) programs that offer medical services delivered by appropriately credentialed health
care staff in an amount equal to two hours per client per week if the medical needs of the
client and the nature and provision of any medical services provided are documented in the
client file; deleted text begin and
deleted text end

(4) programs that offer services to individuals with co-occurring mental health and
chemical dependency problems if:

(i) the program meets the co-occurring requirements in section 245G.20;

(ii) 25 percent of the counseling staff are licensed mental health professionals, as defined
in section 245.462, subdivision 18, clauses (1) to (6), or are students or licensing candidates
under the supervision of a licensed alcohol and drug counselor supervisor and licensed
mental health professional, except that no more than 50 percent of the mental health staff
may be students or licensing candidates with time documented to be directly related to
provisions of co-occurring services;

(iii) clients scoring positive on a standardized mental health screen receive a mental
health diagnostic assessment within ten days of admission;

(iv) the program has standards for multidisciplinary case review that include a monthly
review for each client that, at a minimum, includes a licensed mental health professional
and licensed alcohol and drug counselor, and their involvement in the review is documented;

(v) family education is offered that addresses mental health and substance abuse disorders
and the interaction between the two; and

(vi) co-occurring counseling staff shall receive eight hours of co-occurring disorder
training annually deleted text begin . deleted text end new text begin ; and
new text end

new text begin (5) disability responsive programs as defined in section 254B.01, subdivision 4b.
new text end

(d) In order to be eligible for a higher rate under paragraph (c), clause (1), a program
that provides arrangements for off-site child care must maintain current documentation at
the chemical dependency facility of the child care provider's current licensure to provide
child care services. Programs that provide child care according to paragraph (c), clause (1),
must be deemed in compliance with the licensing requirements in section 245G.19.

(e) Adolescent residential programs that meet the requirements of Minnesota Rules,
parts 2960.0430 to 2960.0490 and 2960.0580 to 2960.0690, are exempt from the requirements
in paragraph (c), clause (4), items (i) to (iv).

(f) Subject to federal approval, chemical dependency services that are otherwise covered
as direct face-to-face services may be provided via two-way interactive video. The use of
two-way interactive video must be medically appropriate to the condition and needs of the
person being served. Reimbursement shall be at the same rates and under the same conditions
that would otherwise apply to direct face-to-face services. The interactive video equipment
and connection must comply with Medicare standards in effect at the time the service is
provided.

(g) For the purpose of reimbursement under this section, substance use disorder treatment
services provided in a group setting without a group participant maximum or maximum
client to staff ratio under chapter 245G shall not exceed a client to staff ratio of 48 to one.
At least one of the attending staff must meet the qualifications as established under this
chapter for the type of treatment service provided. A recovery peer may not be included as
part of the staff ratio.

Sec. 4.

Minnesota Statutes 2020, section 254B.12, is amended by adding a subdivision to
read:

new text begin Subd. 4. new text end

new text begin Culturally specific or culturally responsive program and disability
responsive program provider rate increase. new text end

new text begin For the chemical dependency services listed
in section 254B.05, subdivision 5, provided by programs that meet the requirements of
section 254B.05, subdivision 5, paragraph (c), clauses (2) and (5), on or after July 1, 2021,
payment rates shall be increased by five percent over the rates in effect on January 1, 2021.
The commissioner shall increase prepaid medical assistance capitation rates as appropriate
to reflect this increase.
new text end

Sec. 5. new text begin DIRECTION TO COMMISSIONER; CULTURALLY AND
LINGUISTICALLY APPROPRIATE SERVICES.
new text end

new text begin The commissioner of human services, in consultation with substance use disorder
treatment providers, lead agencies, and individuals who receive substance use disorder
treatment services, shall develop a statewide implementation and transition plan for culturally
and linguistically appropriate services (CLAS) national standards, including technical
assistance for providers to transition to the CLAS standards and to improve disparate
treatment outcomes. The commissioner must consult with individuals who are Black,
indigenous, people of color, and linguistically diverse in the development of the
implementation and transition plans under this section.
new text end

Sec. 6. new text begin APPROPRIATION; CULTURALLY AND LINGUISTICALLY
APPROPRIATE SERVICES IMPLEMENTATION GRANTS.
new text end

new text begin $....... in fiscal year 2022 and $....... in fiscal year 2023 are appropriated from the general
fund to the commissioner of human services for grants to substance use disorder treatment
providers to implement culturally and linguistically appropriate services standards, according
to the implementation and transition plan developed by the commissioner.
new text end