2nd Engrossment - 82nd Legislature (2001 - 2002) Posted on 12/15/2009 12:00am
Engrossments | ||
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Introduction | Posted on 02/12/2001 | |
1st Engrossment | Posted on 03/21/2001 | |
2nd Engrossment | Posted on 04/04/2001 |
1.1 A bill for an act 1.2 relating to mental health; establishing duties for 1.3 reducing and preventing suicides; establishing 1.4 requirements for discharge plans and transition 1.5 services for offenders with mental illness; providing 1.6 coverage requirements for health plans; providing for 1.7 a calculation to regional treatment centers based on 1.8 population size; adjusting payment rates for certain 1.9 mental health providers; establishing coverage 1.10 requirements for mental health services and treatment; 1.11 adding certain services covered under case management, 1.12 community support, and day treatment services; 1.13 requiring studies; defining certain mental health 1.14 provisions; establishing team case management services 1.15 and continuing care benefit program; covering certain 1.16 transportation costs; adding provisions to the prepaid 1.17 health plan; requiring development of a payment 1.18 system; appropriating money; amending Minnesota 1.19 Statutes 2000, sections 245.462, subdivisions 3, 6, 8, 1.20 18, 20, and by adding subdivisions; 245.466, 1.21 subdivision 2; 245.470, by adding a subdivision; 1.22 245.4711, by adding a subdivision; 245.4871, 1.23 subdivisions 10, 17, 27, 29, and by adding 1.24 subdivisions; 245.4875, subdivision 2; 245.4876, 1.25 subdivision 1, and by adding subdivisions; 245.488, by 1.26 adding a subdivision; 245.4885, subdivision 1; 246.54; 1.27 256.969, subdivision 3a, and by adding a subdivision; 1.28 256B.0625, subdivision 17, and by adding subdivisions; 1.29 256B.69, by adding subdivisions; 260C.201, subdivision 1.30 1; proposing coding for new law in Minnesota Statutes, 1.31 chapters 62Q; 145; 244; 245; 246; 256B; and 299A. 1.32 BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF MINNESOTA: 1.33 ARTICLE 1 1.34 SUICIDE PREVENTION 1.35 Section 1. [145.56] [SUICIDE PREVENTION.] 1.36 Subdivision 1. [PUBLIC HEALTH GOAL; SUICIDE PREVENTION 1.37 PLAN.] The commissioner of health shall make suicide prevention 1.38 an important public health goal of the state and shall conduct 2.1 suicide prevention activities to accomplish that goal using an 2.2 evidence-based, public health approach focused on prevention. 2.3 The commissioner shall refine, coordinate, and implement the 2.4 state's suicide prevention plan, in collaboration with assigned 2.5 staff from the department of human services; the department of 2.6 public safety; the department of children, families, and 2.7 learning; and appropriate agencies, organizations, and 2.8 institutions in the community. 2.9 Subd. 2. [EDUCATION AND OUTREACH TO PUBLIC, MEDIA, AND 2.10 POLICYMAKERS.] (a) The commissioner of health shall create or 2.11 contract for an ongoing public education campaign to raise 2.12 awareness of suicide as a public health issue and of the 2.13 preventability of many suicides. The campaign must: (1) be 2.14 coordinated with other existing suicide prevention outreach and 2.15 awareness campaigns; (2) promote broad-based public awareness in 2.16 the general population; (3) establish the connection between 2.17 depression and other psychiatric illnesses, and suicide; and (4) 2.18 include tactics targeted to populations at risk for suicide, and 2.19 to individuals who influence members of at-risk populations and 2.20 are in positions to identify the warning signs of suicide and 2.21 make appropriate referrals. Through the grant-making process, 2.22 the commissioner shall promote the use of a common language, 2.23 uniform terminology, and consistent messages regarding suicide, 2.24 symptoms of depression and other psychiatric illnesses, 2.25 substance abuse, warning signs of suicide, risk factors, and 2.26 help-seeking behaviors. 2.27 (b) The commissioner shall establish partnerships with 2.28 media vendors in the state to: 2.29 (1) implement an ongoing, coordinated, multistrategy, 2.30 multimedia, and multipartner public awareness and antistigma 2.31 campaign that is consistent with the policy goals of this 2.32 section; and 2.33 (2) educate media vendors, media associations, reporters, 2.34 advertising vendors, and members of the entertainment industry 2.35 about suicide, suicidal behavior, mental illness, substance 2.36 abuse, and help-seeking behaviors. 3.1 (c) The commissioner shall disseminate education materials 3.2 to educate appropriate state and local officials and 3.3 policymakers about suicide, suicidal behavior, depression and 3.4 other psychiatric illnesses, and substance abuse, and their 3.5 impact on state and local health care, social services, 3.6 education, law enforcement, employment, and corrections systems. 3.7 Subd. 3. [COMMUNITY-BASED PROGRAMS.] (a) The commissioner 3.8 shall establish a grant program consistent with the policy goals 3.9 of this section to fund: 3.10 (1) community-based programs to provide education, 3.11 outreach, and advocacy services to populations who may be at 3.12 risk for suicide; and 3.13 (2) community-based programs that educate natural community 3.14 helpers and gatekeepers, such as family members, spiritual 3.15 leaders, coaches, and business people, on how to prevent suicide 3.16 by encouraging help-seeking behaviors. 3.17 (b) Education to populations at risk for suicide and to 3.18 community helpers and gatekeepers must include information on 3.19 the symptoms of depression and other psychiatric illnesses, the 3.20 warning signs of suicide, skills for preventing suicides, and 3.21 making or seeking effective referrals to intervention and 3.22 community resources. 3.23 Subd. 4. [PROGRAMS IN SCHOOLS AND WORKPLACES.] (a) The 3.24 commissioner shall establish a grant program consistent with the 3.25 policy goals of this section to fund community-based programs to 3.26 provide suicide prevention education in schools using a 3.27 three-pronged approach of education to students, school staff, 3.28 and parents at the junior and senior high school levels. 3.29 (b) The commissioner shall promote the use of employee 3.30 assistance and workplace programs to support employees with 3.31 depression and other psychiatric illnesses and substance abuse 3.32 problems, and refer them to other services available in the 3.33 community. In promoting these programs, the commissioner shall 3.34 collaborate with employer and professional associations, unions, 3.35 and safety councils. Community-based programs that provide 3.36 these services may apply for funding under subdivision 3. 4.1 Subd. 5. [PROFESSIONAL EDUCATION.] The commissioner shall 4.2 establish a grant program consistent with the policy goals of 4.3 this section to fund academic and other institutions, 4.4 associations, licensing boards, and organizations to provide 4.5 professional education on suicide prevention as part of 4.6 preservice or continuing education. Curricula may include 4.7 information on suicide and suicidal behavior; screening, 4.8 prevention, and intervention; and screening, referral, and 4.9 treatment for depression and other psychiatric illnesses. 4.10 Professionals to whom this education may be targeted include 4.11 teachers, administrators, and other school staff; health care 4.12 providers; mental health providers, including but not limited to 4.13 psychologists and social workers; corrections personnel; law 4.14 enforcement personnel; social services providers; and members of 4.15 faith-based professions. 4.16 Subd. 6. [COLLECTING AND REPORTING SUICIDE DATA.] The 4.17 commissioner shall coordinate with federal, regional, local, and 4.18 other state agencies to collect, analyze, and annually issue a 4.19 public report on Minnesota-specific data on suicide and suicidal 4.20 behaviors. The data collected and reported must include 4.21 demographic-specific data, data on the insurance status of 4.22 persons who commit or attempt suicide, data on 4.23 posthospitalization outcomes for persons who attempt suicide, 4.24 and data on associated costs of suicide and suicidal behaviors 4.25 to various systems, including but not limited to the health 4.26 care, social services, and law enforcement systems. The data 4.27 must be summary data as defined in section 13.02 and must not 4.28 identify individuals. 4.29 Subd. 7. [RESEARCH AGENDA.] The commissioner shall make 4.30 grants and assist entities in seeking nonstate funding sources 4.31 to fund research that is consistent with the research agenda 4.32 established in the Minnesota department of health's January 15, 4.33 2000, suicide prevention plan, and that furthers understanding 4.34 of the risks and protective factors related to suicide and 4.35 suicidal behaviors, effective prevention programs, clinical 4.36 treatments, and culturally specific interventions in Minnesota. 5.1 Subd. 8. [POLICIES OF INSTITUTIONAL SETTINGS.] The 5.2 commissioner shall periodically survey and evaluate the suicide 5.3 prevention and intervention policies and practices of 5.4 institutional settings licensed by the state, including foster 5.5 care and jails, and recommend modifications to the policies and 5.6 practices as appropriate. 5.7 Subd. 9. [SUICIDE REPORTING PRACTICES.] The commissioner 5.8 shall study current practices of determining and reporting 5.9 suicides and shall make recommendations to professionals and 5.10 organizations that report suicides to ensure that suicides are 5.11 accurately reported. 5.12 Subd. 10. [PERIODIC EVALUATIONS; BIENNIAL REPORTS.] The 5.13 commissioner shall conduct periodic evaluations of the impact of 5.14 and outcomes from implementation of the state's suicide 5.15 prevention plan and each of the activities specified in this 5.16 section. By July 1, 2002, and July 1 of each even-numbered year 5.17 thereafter, the commissioner shall report the results of these 5.18 evaluations to the chairs of the policy and finance committees 5.19 in the house and senate with jurisdiction over health and human 5.20 services issues. 5.21 Sec. 2. [299A.76] [SUICIDE STATISTICS.] 5.22 (a) The commissioner of public safety shall not: 5.23 (1) include any statistics on committing suicide or 5.24 attempting suicide in any compilation of crime statistics 5.25 published by the commissioner; or 5.26 (2) label as a crime statistic, any data on committing 5.27 suicide or attempting suicide. 5.28 (b) This section does not apply to the crimes of aiding 5.29 suicide under section 609.215, subdivision 1, or aiding 5.30 attempted suicide under section 609.215, subdivision 2, or to 5.31 statistics directly related to the commission of a crime. 5.32 Sec. 3. [STUDY; CRISIS RESPONSE SYSTEM.] 5.33 The commissioner of health shall study the existing suicide 5.34 crisis response system in Minnesota to identify gaps in basic 5.35 suicide crisis intervention, safety net, and follow-up services; 5.36 identify barriers to obtaining these services; determine costs 6.1 for providing these services; and provide recommendations for 6.2 addressing identified gaps in and barriers to services. This 6.3 study shall be reported to the chairs of the policy and finance 6.4 committees in the house and senate with jurisdiction over health 6.5 and human services issues by May 1, 2002. 6.6 Sec. 4. [APPROPRIATIONS.] 6.7 (a) $12,450,000 is appropriated for the 2002-2003 biennium 6.8 from the general fund to the commissioner of health for suicide 6.9 prevention activities. Of this amount: 6.10 (1) $300,000 is for refining, coordinating, and 6.11 implementing the suicide prevention plan under Minnesota 6.12 Statutes, section 145.56, subdivision 1; 6.13 (2) $3,000,000 is for the education and outreach activities 6.14 under Minnesota Statutes, section 145.56, subdivision 2; 6.15 (3) $6,000,000 is to fund community-based programs under 6.16 Minnesota Statutes, section 145.56, subdivision 3; 6.17 (4) $1,000,000 is for the programs in schools and 6.18 workplaces under Minnesota Statutes, section 145.56, subdivision 6.19 4; 6.20 (5) $1,000,000 is for the professional education activities 6.21 under Minnesota Statutes, section 145.56, subdivision 5; 6.22 (6) $500,000 is to collect and report on suicide data under 6.23 Minnesota Statutes, section 145.56, subdivision 6; 6.24 (7) $500,000 is to promote and fund research under 6.25 Minnesota Statutes, section 145.56, subdivision 7; 6.26 (8) $100,000 is to survey and evaluate suicide prevention 6.27 and intervention policies in institutions under Minnesota 6.28 Statutes, section 145.56, subdivision 8; and 6.29 (9) $50,000 is to conduct the study of suicide reporting 6.30 practices under Minnesota Statutes, section 145.56, subdivision 6.31 9. 6.32 (b) $70,000 is appropriated for the fiscal year ending June 6.33 30, 2002, from the general fund to the commissioner of health to 6.34 conduct the study in section 3 on the existing crisis response 6.35 system. This appropriation is one-time funding and shall not 6.36 become part of the base level funding for the 2004-2005 biennium. 7.1 ARTICLE 2 7.2 CORRECTIONS 7.3 Section 1. [244.054] [DISCHARGE PLANS; OFFENDERS WITH 7.4 SERIOUS AND PERSISTENT MENTAL ILLNESS.] 7.5 Subdivision 1. [OFFER TO DEVELOP PLAN.] The commissioner 7.6 shall offer to develop a discharge plan for community-based 7.7 services for every offender with serious and persistent mental 7.8 illness, as defined in section 245.462, subdivision 20, 7.9 paragraph (c), who is being released from a correctional 7.10 facility. If an offender is being released pursuant to section 7.11 244.05, the offender may choose to have the discharge plan made 7.12 one of the conditions of the offender's supervised release and 7.13 shall follow the conditions to the extent that services are 7.14 available and offered to the offender. 7.15 Subd. 2. [CONTENT OF PLAN.] If an offender chooses to have 7.16 a discharge plan developed, the commissioner shall develop and 7.17 implement a discharge plan, which must include at least the 7.18 following: 7.19 (1) at least 90 days before the offender is due to be 7.20 discharged, the commissioner shall designate a department of 7.21 corrections agent with mental health training to serve as the 7.22 primary person responsible for carrying out discharge planning 7.23 activities; 7.24 (2) at least 75 days before the offender is due to be 7.25 discharged, the offender's designated agent shall: 7.26 (i) obtain informed consent and releases of information 7.27 from the offender that are needed for transition services; 7.28 (ii) contact the county human services department in the 7.29 community where the offender expects to reside following 7.30 discharge, and inform the department of the offender's impending 7.31 discharge and the planned date of the offender's return to the 7.32 community; determine whether the county or a designated 7.33 contracted provider will provide case management services to the 7.34 offender; refer the offender to the case management services 7.35 provider; and confirm that the case management services provider 7.36 will have opened the offender's case prior to the offender's 8.1 discharge; and 8.2 (iii) refer the offender to appropriate staff in the county 8.3 human services department in the community where the offender 8.4 expects to reside following discharge, for enrollment of the 8.5 offender, if eligible, in medical assistance or general 8.6 assistance medical care, using special procedures established by 8.7 process and department of human services bulletin; 8.8 (3) at least 2-1/2 months before discharge, the offender's 8.9 designated agent shall secure timely appointments for the 8.10 offender with a psychiatrist no later than 30 days following 8.11 discharge, and with other program staff at a community mental 8.12 health provider that is able to serve former offenders with 8.13 serious and persistent mental illness; 8.14 (4) at least 30 days before discharge, the offender's 8.15 designated agent shall convene a predischarge assessment and 8.16 planning meeting of key staff from the programs in which the 8.17 offender has participated while in the correctional facility, 8.18 the offender, and the supervising agent assigned to the 8.19 offender. At the meeting, attendees shall provide background 8.20 information and continuing care recommendations for the 8.21 offender, including information on the offender's risk for 8.22 relapse; current medications, including dosage and frequency; 8.23 therapy and behavioral goals; diagnostic and assessment 8.24 information, including results of a chemical dependency 8.25 evaluation; confirmation of appointments with a psychiatrist and 8.26 other program staff in the community; a relapse prevention plan; 8.27 continuing care needs; needs for housing, employment, and 8.28 finance support and assistance; and recommendations for 8.29 successful community integration, including chemical dependency 8.30 treatment or support if chemical dependency is a risk factor. 8.31 Immediately following this meeting, the offender's designated 8.32 agent shall summarize this background information and continuing 8.33 care recommendations in a written report; 8.34 (5) immediately following the predischarge assessment and 8.35 planning meeting, the provider of mental health case management 8.36 services who will serve the offender following discharge shall 9.1 offer to make arrangements and referrals for housing, financial 9.2 support, benefits assistance, employment counseling, and other 9.3 services required in sections 245.461 to 245.486; 9.4 (6) at least ten days before the offender's first scheduled 9.5 postdischarge appointment with a mental health provider, the 9.6 offender's designated agent shall transfer the following records 9.7 to the offender's case management services provider and 9.8 psychiatrist: the predischarge assessment and planning report, 9.9 medical records, and pharmacy records. These records may be 9.10 transferred only if the offender provides informed consent for 9.11 their release; 9.12 (7) upon discharge, the offender's designated agent shall 9.13 ensure that the offender leaves the correctional facility with 9.14 at least a ten-day supply of all necessary medications; and 9.15 (8) upon discharge, the prescribing authority at the 9.16 offender's correctional facility shall telephone in 9.17 prescriptions for all necessary medications to a pharmacy in the 9.18 community where the offender plans to reside. The prescriptions 9.19 must provide at least a 30-day supply of all necessary 9.20 medications, and must be able to be refilled once for one 9.21 additional 30-day supply. 9.22 Sec. 2. [TRANSITIONAL SERVICES FOR MENTALLY ILL OFFENDERS 9.23 RELEASED FROM PRISON; PILOT PROGRAM.] 9.24 Subdivision 1. [PROGRAM ESTABLISHED.] The commissioner of 9.25 corrections, in collaboration with the commissioner of human 9.26 services, shall establish a pilot project grant program with 9.27 goals and evaluation criteria and make grants to provide startup 9.28 funding for two counties or two groups of counties to provide 9.29 transitional housing and other community support services for 9.30 former state inmates who have been diagnosed with a serious 9.31 mental illness and who have been discharged from prison. Grant 9.32 applicants must submit a proposed comprehensive plan for 9.33 providing the housing and support services and evaluating the 9.34 provision of services, and must provide a 25 percent funding 9.35 match. The commissioner shall make grants available to 9.36 successful applicants by February 1, 2002. Grant recipients are 10.1 eligible for funding under this section for the first three 10.2 years of operation of their programs for housing and support 10.3 services. 10.4 Subd. 2. [REPORT.] By January 15, 2003, the commissioner 10.5 shall report to the chairs and ranking minority members of the 10.6 house and senate committees and divisions having jurisdiction 10.7 over criminal justice policy and funding on the effectiveness of 10.8 the grants made and pilot projects funded under this section. 10.9 Sec. 3. [APPROPRIATIONS.] 10.10 (a) $....... each year is appropriated from the general 10.11 fund to the department of corrections, mental health division 10.12 for the fiscal biennium ending June 30, 2003. Of this amount, 10.13 $....... each year is for hiring or contracting for additional 10.14 mental health services and treatment in the state correctional 10.15 facilities. The services and treatment must meet current 10.16 community standards of care; and $....... each year is for 10.17 purchasing appropriate medications for offenders who have been 10.18 diagnosed with a serious and persistent mental illness. This 10.19 appropriation is part of the department's base budget. 10.20 (b) $....... is appropriated from the general fund to the 10.21 department of corrections, mental health division for the fiscal 10.22 biennium ending June 30, 2003, to fund the development of 10.23 discharge plans under Minnesota Statutes, section 244.054, for 10.24 offenders with serious and persistent mental illness. 10.25 (c) $....... is appropriated from the general fund to the 10.26 department of corrections, mental health division for the fiscal 10.27 year ending June 30, 2002, for the grants described in section 10.28 2, subdivision 1 and the report described in section 2, 10.29 subdivision 2. 10.30 (d) $....... is appropriated from the general fund to the 10.31 commissioner of human services for the fiscal biennium ending 10.32 June 30, 2003, to increase funding to county boards under 10.33 Minnesota Rules, parts 9535.1700 to 9535.1760. Funds are 10.34 available under this paragraph only to county boards that submit 10.35 plans to the commissioner specifying how the funds will be 10.36 used. County boards shall use the additional funds for 11.1 participation by county staff, contract providers, and mental 11.2 health professionals in the development of discharge plans under 11.3 Minnesota Statutes, section 244.054, for offenders with serious 11.4 and persistent mental illness. 11.5 ARTICLE 3 11.6 REIMBURSEMENT RATES 11.7 Section 1. [245.4862] [RATE ADJUSTMENTS.] 11.8 On July 1, 2001, and July 1, 2002, the commissioner of 11.9 human services shall increase reimbursement rates for adult 11.10 residential program grants under Minnesota Rules, parts 11.11 9535.2000 to 9535.3000 and adult and family community support 11.12 grants under Minnesota Rules, parts 9535.1700 to 9535.1760, by 11.13 three percent each fiscal year. 11.14 Sec. 2. Minnesota Statutes 2000, section 246.54, is 11.15 amended to read: 11.16 246.54 [LIABILITY OF COUNTY; REIMBURSEMENT.] 11.17 (a) Except for chemical dependency services provided under 11.18 sections 254B.01 to 254B.09, the client's county shall pay to 11.19 the state of Minnesota a portion of the cost of care provided in 11.20 a regional treatment center to a client legally settled in that 11.21 county. A county's payment shall be made from the county's own 11.22 sources of revenueand, funds distributed to the county under 11.23 section 246.541, subdivision 2, or both. Payments shall be paid 11.24 as follows: 11.25 (1) payments to the state from the county shall equal ten 11.26 percent of the cost of care, as determined by the commissioner, 11.27 for each day, or the portion thereof, that the client spends at 11.28 a regional treatment center. If payments received by the state 11.29 under sections 246.50 to 246.53 exceed 90 percent of the cost of 11.30 care, the county shall be responsible for paying the state only 11.31 the remaining amount; and 11.32 (2) if funds are distributed to the county under section 11.33 246.541, subdivision 2, the county shall pay to the state up to 11.34 50 percent of the cost of care, as determined by the 11.35 commissioner, for each day or portion thereof that the client 11.36 spends at a regional treatment center. The percentage of the 12.1 county's responsibility under this clause shall be limited by 12.2 the amount of funds distributed to the county under section 12.3 246.541, subdivision 2, for this purpose. 12.4 (b) The county shall not be entitled to reimbursement from 12.5 the client, the client's estate, or from the client's relatives, 12.6 except as provided in section 246.53. No such payments shall be 12.7 made for any client who was last committed prior to July 1, 1947. 12.8 Sec. 3. [246.541] [APPROPRIATION TO COUNTIES FOR REGIONAL 12.9 TREATMENT CENTER CARE OR DIVERSION PROGRAMS.] 12.10 Subdivision 1. [CALCULATING APPROPRIATION BASED ON 12.11 POPULATION SIZE.] (a) Beginning January 1, 2002, and each 12.12 January 1 thereafter, the commissioner shall: 12.13 (1) compare the state appropriated funds to regional 12.14 treatment centers through direct appropriations for the two most 12.15 recently completed fiscal years; 12.16 (2) determine what portion of the difference in the amounts 12.17 appropriated is attributable to a decrease in the populations 12.18 being served at regional treatment centers; and 12.19 (3) certify the amount that is attributable to a decrease 12.20 in the populations being served at regional treatment centers to 12.21 the commissioner of finance. 12.22 (b) Beginning July 1, 2002, when there is a decrease in 12.23 state funds appropriated to regional treatment centers due to a 12.24 decrease in population being served, the difference in the 12.25 amounts appropriated each year must be appropriated to the 12.26 commissioner for distribution to counties according to 12.27 subdivision 2. 12.28 Subd. 2. [DISTRIBUTION TO COUNTIES.] The commissioner 12.29 shall develop a methodology for distributing funds appropriated 12.30 under subdivision 1 and other direct appropriations made by the 12.31 legislature for this purpose to each county based on a five-year 12.32 average of the county's spending, for the most recent five 12.33 fiscal years, for client cost of care under section 246.54, as a 12.34 proportion of the average of total spending by all counties for 12.35 client cost of care under section 246.54. Based on that 12.36 methodology, the commissioner shall distribute the funds to 13.1 counties. 13.2 Subd. 3. [COUNTY USES OF FUNDS.] Counties may use the 13.3 funds distributed under subdivision 2: 13.4 (1) for the county portion of the cost of care for clients 13.5 at regional treatment centers under section 246.54, paragraph 13.6 (a), clause (2); or 13.7 (2) to develop programs to divert clients with mental 13.8 illness from receiving regional treatment center inpatient 13.9 services to receiving services provided in less restrictive 13.10 community settings, when such diversion is appropriate to meet 13.11 client needs. 13.12 Sec. 4. [256B.761] [REIMBURSEMENT FOR MENTAL HEALTH 13.13 SERVICES.] 13.14 Effective for services rendered on or after July 1, 2001, 13.15 payment for medication management provided to psychiatric 13.16 patients, outpatient mental health services, day treatment 13.17 services, home-based mental health services, and family 13.18 community support services shall be paid at the lower of (1) 13.19 submitted charges, or (2) the 50th percentile of 1999 charges. 13.20 Sec. 5. [256B.762] [MENTAL HEALTH CLINIC REIMBURSEMENT.] 13.21 Subdivision 1. [RATE INCREASE.] Effective for services 13.22 rendered on or after January 1, 2002, payment rates for: (1) 13.23 community mental health center services under section 256B.0625, 13.24 subdivision 5; (2) services provided by mental health clinics 13.25 and centers certified under Minnesota Rules, parts 9520.0750 to 13.26 9520.0870, or hospital outpatient psychiatric departments, 13.27 designated as essential community providers under section 13.28 62Q.19; and (3) services provided by mental health clinics and 13.29 centers certified under Minnesota Rules, parts 9520.0750 to 13.30 9520.0870, or hospital outpatient psychiatric departments, that 13.31 receive at least 30 percent of their revenue from contracts with 13.32 a county or counties to provide services under the adult and 13.33 children's mental health acts, shall be increased by ten percent 13.34 over the rates in effect on July 1, 2001. This reimbursement 13.35 increase shall be in addition to any other reimbursement 13.36 increases enacted by the 2001 legislature. 14.1 Subd. 2. [SETTLE-UP.] Beginning July 1, 2001, the 14.2 commissioner shall implement a settle-up procedure to pay 14.3 community mental health centers and mental health clinics and 14.4 centers for services provided to prepaid medical assistance, 14.5 prepaid general assistance medical care, and MinnesotaCare 14.6 enrollees. The settle-up procedure must pay community mental 14.7 health centers and mental health clinics and centers the 14.8 difference between the state health care program reimbursement 14.9 rate and the reimbursement received from the prepaid health 14.10 plan. The settle-up procedure must be based on that used by the 14.11 commissioner to reimburse federally qualified health centers and 14.12 rural health clinics. 14.13 Sec. 6. [STAGED RATE ADJUSTMENT.] 14.14 On July 1, 2001, and July 1, 2002, the commissioner of 14.15 human services shall increase reimbursement rates for adult 14.16 residential program grants under Minnesota Rules, parts 14.17 9535.2000 to 9535.3000 and adult and family community support 14.18 grants under Minnesota Rules, parts 9535.1700 to 9535.1760, by 14.19 three percent each fiscal year. 14.20 Sec. 7. [APPROPRIATIONS.] 14.21 Subdivision 1. [RATE ADJUSTMENT; CERTAIN MENTAL HEALTH 14.22 PROVIDERS.] $....... is appropriated from the general fund to 14.23 the commissioner of human services for the biennium ending June 14.24 30, 2003, to increase adult residential program grants and adult 14.25 and family community support grants as provided under Minnesota 14.26 Statutes, section 245.4862. 14.27 Subd. 2. [REGIONAL TREATMENT CENTER COST OF CARE OR 14.28 DIVERSION PROGRAMS.] $5,000,000 is appropriated for the 14.29 2002-2003 biennium from the general fund to the commissioner of 14.30 human services for distribution to counties under Minnesota 14.31 Statutes, section 246.541, subdivision 2, to be used according 14.32 to Minnesota Statutes, section 246.541, subdivision 3. 14.33 Subd. 3. [STAGED RATE ADJUSTMENT; CERTAIN MENTAL HEALTH 14.34 PROVIDERS.] $....... is appropriated from the general fund to 14.35 the commissioner of human services for the biennium ending June 14.36 30, 2003, to increase adult residential program grants and adult 15.1 and family community support grants as provided under section 6. 15.2 ARTICLE 4 15.3 COVERED SERVICES 15.4 Section 1. Minnesota Statutes 2000, section 245.462, 15.5 subdivision 3, is amended to read: 15.6 Subd. 3. [CASE MANAGEMENT SERVICES.] "Case management 15.7 services" means activities that are coordinated with the 15.8 community support services program as defined in subdivision 6 15.9 and are designed to help adults with serious and persistent 15.10 mental illness in gaining access to needed medical, social, 15.11 educational, vocational, and other necessary services as they 15.12 relate to the client's mental health needs. Case management 15.13 services include developing a functional assessment, an 15.14 individual community support plan, referring and assisting the 15.15 person to obtain needed mental health and other services, 15.16 ensuring coordination of services, and monitoring the delivery 15.17 of services. For adults between the ages of 18 and 22 who are 15.18 eligible for case management services under subdivision 20, 15.19 paragraph (c), clause (6), case management services also include 15.20 advocacy for and coordination of all transition services for 15.21 which the adult is eligible or which the adult is receiving, 15.22 including vocational, educational, housing, and life skills 15.23 transition services. 15.24 Sec. 2. Minnesota Statutes 2000, section 245.462, 15.25 subdivision 6, is amended to read: 15.26 Subd. 6. [COMMUNITY SUPPORT SERVICES PROGRAM.] "Community 15.27 support services program" means services, other than inpatient 15.28 or residential treatment services, provided or coordinated by an 15.29 identified program and staff under the clinical supervision of a 15.30 mental health professional designed to help adults with serious 15.31 and persistent mental illness to function and remain in the 15.32 community. A community support services program includes: 15.33 (1) client outreach, 15.34 (2) medication monitoring, 15.35 (3) assistance in independent living skills, 15.36 (4) development of employability and work-related 16.1 opportunities, 16.2 (5) crisis assistance, 16.3 (6) psychosocial rehabilitation, 16.4 (7) help in applying for government benefits,and16.5 (8) housing support services, 16.6 (9) education and consultation provided to families and 16.7 other individuals as an extension of the treatment process, and 16.8 (10) assistance to consumers in pursuing complaints and 16.9 appeals, and obtaining access to dispute resolution processes. 16.10 A community support services program may also administer a 16.11 program under section 245.4713 to reimburse the transportation 16.12 costs of individuals who provide transportation to adults with 16.13 serious and persistent mental illness. The community support 16.14 services program must be coordinated with the case management 16.15 services specified in section 245.4711. 16.16 Sec. 3. Minnesota Statutes 2000, section 245.462, is 16.17 amended by adding a subdivision to read: 16.18 Subd. 7a. [CRISIS INTERVENTION SERVICES.] Crisis 16.19 intervention services are short-term, intensive, nonresidential 16.20 mental health services that include assessment, mental health 16.21 rehabilitative services, and a crisis disposition plan. Crisis 16.22 intervention services are intended to help the recipient return 16.23 to a baseline level of functioning or prevent further harmful 16.24 consequences due to the psychiatric symptoms. 16.25 Sec. 4. Minnesota Statutes 2000, section 245.462, is 16.26 amended by adding a subdivision to read: 16.27 Subd. 7b. [CRISIS STABILIZATION SERVICES.] Crisis 16.28 stabilization services are assessment and intensive 16.29 individualized rehabilitative services provided in a recipient's 16.30 home or a short-term residential setting. Crisis stabilization 16.31 services are intended to prevent further deterioration or 16.32 exacerbation of psychiatric symptoms or to help the recipient to 16.33 reside in the recipient's usual living arrangement during or 16.34 following a mental health crisis or emergency. 16.35 Sec. 5. Minnesota Statutes 2000, section 245.462, 16.36 subdivision 8, is amended to read: 17.1 Subd. 8. [DAY TREATMENT SERVICES.] "Day treatment," "day 17.2 treatment services," or "day treatment program" means a 17.3 structured program of treatment and care provided to an adult in 17.4 or by: (1) a hospital accredited by the joint commission on 17.5 accreditation of health organizations and licensed under 17.6 sections 144.50 to 144.55; (2) a community mental health center 17.7 under section 245.62; or (3) an entity that is under contract 17.8 with the county board to operate a program that meets the 17.9 requirements of section 245.4712, subdivision 2, and Minnesota 17.10 Rules, parts 9505.0170 to 9505.0475. Day treatment consists of 17.11 group psychotherapy and other intensive therapeutic services 17.12 that are provided at least one day a week by a multidisciplinary 17.13 staff under the clinical supervision of a mental health 17.14 professional. Day treatment may include education and 17.15 consultation provided to families and other individuals as part 17.16 of the treatment process. The services are aimed at stabilizing 17.17 the adult's mental health status, providing mental health 17.18 services, and developing and improving the adult's independent 17.19 living and socialization skills. The goal of day treatment is 17.20 to reduce or relieve mental illness and to enable the adult to 17.21 live in the community. Day treatment services are not a part of 17.22 inpatient or residential treatment services. Day treatment 17.23 services are distinguished from day care by their structured 17.24 therapeutic program of psychotherapy services. The commissioner 17.25 may limit medical assistance reimbursement for day treatment to 17.26 15 hours per week per person instead of the three hours per day 17.27 per person specified in Minnesota Rules, part 9505.0323, subpart 17.28 15. 17.29 Sec. 6. Minnesota Statutes 2000, section 245.462, is 17.30 amended by adding a subdivision to read: 17.31 Subd. 14a. [MENTAL HEALTH CRISIS.] "Mental health crisis" 17.32 means an urgent behavioral, emotional, or psychiatric condition 17.33 that would, in the determination of a mental health 17.34 professional, result in significantly reduced levels of 17.35 functioning in primary activities of daily living if mental 17.36 health crisis services are not provided as soon as possible, 18.1 usually within 24 hours. 18.2 Sec. 7. Minnesota Statutes 2000, section 245.462, is 18.3 amended by adding a subdivision to read: 18.4 Subd. 14b. [MENTAL HEALTH EMERGENCY.] "Mental health 18.5 emergency" means an urgent behavioral, emotional, or psychiatric 18.6 situation that would, in the determination of a mental health 18.7 professional, pose an immediate threat to the physical health or 18.8 safety of the adult or others if mental health crisis services 18.9 are not provided. 18.10 Sec. 8. Minnesota Statutes 2000, section 245.462, is 18.11 amended by adding a subdivision to read: 18.12 Subd. 14c. [MENTAL HEALTH CRISIS SERVICES.] "Mental health 18.13 crisis services" means crisis assessment, crisis intervention, 18.14 and crisis stabilization services that are not billed as part of 18.15 hospital emergency room care or an inpatient hospital admission. 18.16 Sec. 9. Minnesota Statutes 2000, section 245.462, 18.17 subdivision 18, is amended to read: 18.18 Subd. 18. [MENTAL HEALTH PROFESSIONAL.] "Mental health 18.19 professional" means a person providing clinical services in the 18.20 treatment of mental illness who is qualified in at least one of 18.21 the following ways: 18.22 (1) in psychiatric nursing: a registered nurse who is 18.23 licensed under sections 148.171 to 148.285, and who is certified 18.24 as a clinical specialist in adult psychiatric and mental health 18.25 nursing by a national nurse certification organization or who 18.26 has a master's degree in nursing or one of the behavioral 18.27 sciences or related fields from an accredited college or 18.28 university or its equivalent, with at least 4,000 hours of 18.29 post-master's supervised experience in the delivery of clinical 18.30 services in the treatment of mental illness; 18.31 (2) in clinical social work: a person licensed as an 18.32 independent clinical social worker under section 148B.21, 18.33 subdivision 6, or a person with a master's degree in social work 18.34 from an accredited college or university, with at least 4,000 18.35 hours of post-master's supervised experience in the delivery of 18.36 clinical services in the treatment of mental illness; 19.1 (3) in psychology:a psychologistan individual licensed 19.2 by the board of psychology under sections 148.88 to 148.98 who 19.3 has stated to the board of psychology competencies in the 19.4 diagnosis and treatment of mental illness; 19.5 (4) in psychiatry: a physician licensed under chapter 147 19.6 and certified by the American board of psychiatry and neurology 19.7 or eligible for board certification in psychiatry; 19.8 (5) in marriage and family therapy: the mental health 19.9 professional must be a marriage and family therapist licensed 19.10 under sections 148B.29 to 148B.39 with at least two years of 19.11 post-master's supervised experience in the delivery of clinical 19.12 services in the treatment of mental illness; or 19.13 (6) in allied fields: a person with a master's degree from 19.14 an accredited college or university in one of the behavioral 19.15 sciences or related fields, with at least 4,000 hours of 19.16 post-master's supervised experience in the delivery of clinical 19.17 services in the treatment of mental illness. 19.18 Sec. 10. Minnesota Statutes 2000, section 245.462, 19.19 subdivision 20, is amended to read: 19.20 Subd. 20. [MENTAL ILLNESS.] (a) "Mental illness" means an 19.21 organic disorder of the brain or a clinically significant 19.22 disorder of thought, mood, perception, orientation, memory, or 19.23 behavior that is listed in the clinical manual of the 19.24 International Classification of Diseases (ICD-9-CM), current 19.25 edition, code range 290.0 to 302.99 or 306.0 to 316.0 or the 19.26 corresponding code in the American Psychiatric Association's 19.27 Diagnostic and Statistical Manual of Mental Disorders (DSM-MD), 19.28 current edition, Axes I, II, or III, and that seriously limits a 19.29 person's capacity to function in primary aspects of daily living 19.30 such as personal relations, living arrangements, work, and 19.31 recreation. 19.32 (b) An "adult with acute mental illness" means an adult who 19.33 has a mental illness that is serious enough to require prompt 19.34 intervention. 19.35 (c) For purposes of case management and community support 19.36 services, a "person with serious and persistent mental illness" 20.1 means an adult who has a mental illness and meets at least one 20.2 of the following criteria: 20.3 (1) the adult has undergone two or more episodes of 20.4 inpatient care for a mental illness within the preceding 24 20.5 months; 20.6 (2) the adult has experienced a continuous psychiatric 20.7 hospitalization or residential treatment exceeding six months' 20.8 duration within the preceding 12 months; 20.9 (3) the adult: 20.10 (i) has a diagnosis of schizophrenia, bipolar disorder, 20.11 major depression,orborderline personality disorder, or severe 20.12 anxiety disorder such as panic disorder, obsessive-compulsive 20.13 disorder, posttraumatic stress disorder, and social anxiety 20.14 disorder; 20.15 (ii) indicates a significant impairment in functioning; and 20.16 (iii) has a written opinion from a mental health 20.17 professional, in the last three years, stating that either: (A) 20.18 the adult is reasonably likely to have future episodes requiring 20.19 inpatient or residential treatment, of a frequency described in 20.20 clause (1) or (2), unless ongoing case management or community 20.21 support services are provided; or (B) ongoing case management 20.22 and community support services are appropriate to prevent 20.23 relapse and maintain community functioning or to avoid 20.24 hospitalization or residential treatment; 20.25 (4) the adult has, in the last three years, been committed 20.26 by a court as a mentally ill person under chapter 253B, or the 20.27 adult's commitment has been stayed or continued;or20.28 (5) the adult (i) was eligible under clauses (1) to (4), 20.29 but the specified time period has expired or the adult was 20.30 eligible as a child under section 245.4871, subdivision 6; and 20.31 (ii) has a written opinion from a mental health professional, in 20.32 the last three years, stating that the adult is reasonably 20.33 likely to have future episodes requiring inpatient or 20.34 residential treatment, of a frequency described in clause (1) or 20.35 (2), unless ongoing case management or community support 20.36 services are provided; or 21.1 (6) the adult is between the ages of 18 and 22 and as a 21.2 child (i) was eligible for services under sections 245.487 to 21.3 245.4888 as a child with severe emotional disturbance, as 21.4 defined in section 245.4871, subdivision 6; or (ii) was eligible 21.5 for special education services under the Individuals with 21.6 Disabilities Education Act or chapter 125A as a child with an 21.7 emotional or behavioral disorder, as defined in Minnesota Rules, 21.8 part 3525.1329, subpart 1. 21.9 Sec. 11. Minnesota Statutes 2000, section 245.462, is 21.10 amended by adding a subdivision to read: 21.11 Subd. 25a. [SIGNIFICANT IMPAIRMENT IN 21.12 FUNCTIONING.] "Significant impairment in functioning" means a 21.13 condition, including significant suicidal ideation or thoughts 21.14 of harming self or others, which harmfully affects, recurrently 21.15 or consistently, a person's activities of daily living in 21.16 employment, housing, family, and social relationships, or 21.17 education. 21.18 Sec. 12. Minnesota Statutes 2000, section 245.466, 21.19 subdivision 2, is amended to read: 21.20 Subd. 2. [ADULT MENTAL HEALTH SERVICES.] The adult mental 21.21 health service system developed by each county board must 21.22 include the following services: 21.23 (1) education and prevention services in accordance with 21.24 section 245.468; 21.25 (2) emergency services in accordance with section 245.469; 21.26 (3) outpatient services in accordance with section 245.470; 21.27 (4) community support program services in accordance with 21.28 section 245.4711; 21.29 (5) residential treatment services in accordance with 21.30 section 245.472; 21.31 (6) acute care hospital inpatient treatment services in 21.32 accordance with section 245.473; 21.33 (7) regional treatment center inpatient services in 21.34 accordance with section 245.474; 21.35 (8) screening in accordance with section 245.476;and21.36 (9) case management in accordance with sections 245.462, 22.1 subdivision 3; and 245.4711; and 22.2 (10) mental health crisis services in accordance with 22.3 section 245.470, subdivision 3. 22.4 Sec. 13. Minnesota Statutes 2000, section 245.470, is 22.5 amended by adding a subdivision to read: 22.6 Subd. 3. [MENTAL HEALTH CRISIS SERVICES.] County boards 22.7 must provide or contract for enough mental health crisis 22.8 services within the county to meet the needs of adults with 22.9 mental illness residing in the county who are determined, 22.10 through an assessment by a mental health professional, to be 22.11 experiencing a mental health crisis or mental health emergency. 22.12 The mental health crisis services provided must be medically 22.13 necessary, as defined in section 62Q.53, subdivision 2, and 22.14 appropriate or socially necessary for the safety of the adult or 22.15 others. 22.16 Sec. 14. Minnesota Statutes 2000, section 245.4711, is 22.17 amended by adding a subdivision to read: 22.18 Subd. 6a. [TEAM CASE MANAGEMENT SERVICES.] One year before 22.19 a child's eligibility for mental health services under sections 22.20 245.487 to 245.4888 ends, a child with severe emotional 22.21 disturbance who is reasonably expected to require mental health 22.22 services under sections 245.461 to 245.486 is eligible for team 22.23 case management services from both a case management service 22.24 provider for adults and a case management service provider for 22.25 children. Team case management services may be available until 22.26 age 22. To the extent possible, the case management service 22.27 provider for children who served the child shall continue to 22.28 serve that person as part of the team under this subdivision. 22.29 Case management service providers providing team case management 22.30 services may each receive separate payment for services 22.31 provided, according to section 256B.0625, subdivision 20, 22.32 paragraph (f). 22.33 Sec. 15. [245.4713] [REIMBURSEMENT FOR TRANSPORTATION 22.34 COSTS.] 22.35 A community support services program that a county board 22.36 contracts with for community support services may administer a 23.1 program to reimburse individuals and organizations for 23.2 transporting adults with serious and persistent mental illness 23.3 to health care and social support services deemed necessary by 23.4 case managers or mental health professionals serving the 23.5 adults. The program may reimburse individuals and organizations 23.6 for transportation costs that may not be billed to the medical 23.7 assistance program under section 256B.0625. Individuals and 23.8 organizations that may be reimbursed include, but are not 23.9 limited to, providers of outpatient mental health services and 23.10 members of consumer cooperatives. If a community support 23.11 services program chooses to administer a reimbursement program, 23.12 the program may apply to the commissioner for the funds through 23.13 an application process established by the commissioner. The 23.14 commissioner shall establish reimbursement rates to be used by 23.15 community support services programs. 23.16 Sec. 16. Minnesota Statutes 2000, section 245.4871, is 23.17 amended by adding a subdivision to read: 23.18 Subd. 9b. [CRISIS INTERVENTION SERVICES.] Crisis 23.19 intervention services are short-term, intensive, nonresidential 23.20 mental health services that include assessment, mental health 23.21 rehabilitative services, and a crisis disposition plan. Crisis 23.22 intervention services are intended to help the recipient return 23.23 to a baseline level of functioning or prevent further harmful 23.24 consequences due to the psychiatric symptoms. 23.25 Sec. 17. Minnesota Statutes 2000, section 245.4871, is 23.26 amended by adding a subdivision to read: 23.27 Subd. 9c. [CRISIS STABILIZATION SERVICES.] Crisis 23.28 stabilization services covers assessment and intensive 23.29 individualized rehabilitative services provided in a recipient's 23.30 home or a short-term residential setting. Crisis stabilization 23.31 services are intended to prevent further deterioration or 23.32 exacerbation of psychiatric symptoms or help the recipient to 23.33 reside in the recipient's usual living arrangement during or 23.34 following a mental health crisis or emergency. 23.35 Sec. 18. Minnesota Statutes 2000, section 245.4871, 23.36 subdivision 10, is amended to read: 24.1 Subd. 10. [DAY TREATMENT SERVICES.] "Day treatment," "day 24.2 treatment services," or "day treatment program" means a 24.3 structured program of treatment and care provided to a child in: 24.4 (1) an outpatient hospital accredited by the joint 24.5 commission on accreditation of health organizations and licensed 24.6 under sections 144.50 to 144.55; 24.7 (2) a community mental health center under section 245.62; 24.8 (3) an entity that is under contract with the county board 24.9 to operate a program that meets the requirements of section 24.10 245.4884, subdivision 2, and Minnesota Rules, parts 9505.0170 to 24.11 9505.0475; or 24.12 (4) an entity that operates a program that meets the 24.13 requirements of section 245.4884, subdivision 2, and Minnesota 24.14 Rules, parts 9505.0170 to 9505.0475, that is under contract with 24.15 an entity that is under contract with a county board. 24.16 Day treatment consists of group psychotherapy and other 24.17 intensive therapeutic services that are provided for a minimum 24.18 three-hour time block by a multidisciplinary staff under the 24.19 clinical supervision of a mental health professional. Day 24.20 treatment may include education and consultation provided to 24.21 families and other individuals as an extension of the treatment 24.22 process. The services are aimed at stabilizing the child's 24.23 mental health status, and developing and improving the child's 24.24 daily independent living and socialization skills. Day 24.25 treatment services are distinguished from day care by their 24.26 structured therapeutic program of psychotherapy services. Day 24.27 treatment services are not a part of inpatient hospital or 24.28 residential treatment services. Day treatment services for a 24.29 child are an integrated set of education, therapy, and family 24.30 interventions. 24.31 A day treatment service must be available to a child at 24.32 least five days a week throughout the year and must be 24.33 coordinated with, integrated with, or part of an education 24.34 program offered by the child's school. 24.35 Sec. 19. Minnesota Statutes 2000, section 245.4871, 24.36 subdivision 17, is amended to read: 25.1 Subd. 17. [FAMILY COMMUNITY SUPPORT SERVICES.] "Family 25.2 community support services" means services provided under the 25.3 clinical supervision of a mental health professional and 25.4 designed to help each child with severe emotional disturbance to 25.5 function and remain with the child's family in the community. 25.6 Family community support services do not include acute care 25.7 hospital inpatient treatment, residential treatment services, or 25.8 regional treatment center services. Family community support 25.9 services include: 25.10 (1) client outreach to each child with severe emotional 25.11 disturbance and the child's family; 25.12 (2) medication monitoring where necessary; 25.13 (3) assistance in developing independent living skills; 25.14 (4) assistance in developing parenting skills necessary to 25.15 address the needs of the child with severe emotional 25.16 disturbance; 25.17 (5) assistance with leisure and recreational activities; 25.18 (6) crisis assistance, including crisis placement and 25.19 respite care; 25.20 (7) professional home-based family treatment; 25.21 (8) foster care with therapeutic supports; 25.22 (9) day treatment; 25.23 (10) assistance in locating respite care and special needs 25.24 day care;and25.25 (11) assistance in obtaining potential financial resources, 25.26 including those benefits listed in section 245.4884, subdivision 25.27 5; 25.28 (12) education and consultation provided to families and 25.29 other individuals as an extension of the treatment process; and 25.30 (13) assistance to consumers in pursuing complaints and 25.31 appeals, and obtaining access to dispute resolution processes. 25.32 Sec. 20. Minnesota Statutes 2000, section 245.4871, is 25.33 amended by adding a subdivision to read: 25.34 Subd. 24a. [MENTAL HEALTH CRISIS.] "Mental health crisis" 25.35 means an urgent behavioral, emotional, or psychiatric condition 25.36 that would, in the determination of a mental health 26.1 professional, result in significantly reduced levels of 26.2 functioning in primary activities of daily living if mental 26.3 health crisis services are not provided as soon as possible, 26.4 usually within 24 hours. 26.5 Sec. 21. Minnesota Statutes 2000, section 245.4871, is 26.6 amended by adding a subdivision to read: 26.7 Subd. 24b. [MENTAL HEALTH EMERGENCY.] "Mental health 26.8 emergency" means an urgent behavioral, emotional, or psychiatric 26.9 situation that would, in the determination of a mental health 26.10 professional, pose an immediate threat to the physical health or 26.11 safety of the child or others if mental health crisis services 26.12 are not provided. 26.13 Sec. 22. Minnesota Statutes 2000, section 245.4871, is 26.14 amended by adding a subdivision to read: 26.15 Subd. 24c. [MENTAL HEALTH CRISIS SERVICES.] "Mental health 26.16 crisis services" means crisis assessment, crisis intervention, 26.17 and crisis stabilization services that are not billed as part of 26.18 hospital emergency room care or an inpatient hospital admission. 26.19 Sec. 23. Minnesota Statutes 2000, section 245.4871, 26.20 subdivision 27, is amended to read: 26.21 Subd. 27. [MENTAL HEALTH PROFESSIONAL.] "Mental health 26.22 professional" means a person providing clinical services in the 26.23 diagnosis and treatment of children's emotional disorders. A 26.24 mental health professional must have training and experience in 26.25 working with children consistent with the age group to which the 26.26 mental health professional is assigned. A mental health 26.27 professional must be qualified in at least one of the following 26.28 ways: 26.29 (1) in psychiatric nursing, the mental health professional 26.30 must be a registered nurse who is licensed under sections 26.31 148.171 to 148.285 and who is certified as a clinical specialist 26.32 in child and adolescent psychiatric or mental health nursing by 26.33 a national nurse certification organization or who has a 26.34 master's degree in nursing or one of the behavioral sciences or 26.35 related fields from an accredited college or university or its 26.36 equivalent, with at least 4,000 hours of post-master's 27.1 supervised experience in the delivery of clinical services in 27.2 the treatment of mental illness; 27.3 (2) in clinical social work, the mental health professional 27.4 must be a person licensed as an independent clinical social 27.5 worker under section 148B.21, subdivision 6, or a person with a 27.6 master's degree in social work from an accredited college or 27.7 university, with at least 4,000 hours of post-master's 27.8 supervised experience in the delivery of clinical services in 27.9 the treatment of mental disorders; 27.10 (3) in psychology, the mental health professional must bea27.11psychologistan individual licensed by the board of psychology 27.12 under sections 148.88 to 148.98 who has stated to the board of 27.13 psychology competencies in the diagnosis and treatment of mental 27.14 disorders; 27.15 (4) in psychiatry, the mental health professional must be a 27.16 physician licensed under chapter 147 and certified by the 27.17 American board of psychiatry and neurology or eligible for board 27.18 certification in psychiatry; 27.19 (5) in marriage and family therapy, the mental health 27.20 professional must be a marriage and family therapist licensed 27.21 under sections 148B.29 to 148B.39 with at least two years of 27.22 post-master's supervised experience in the delivery of clinical 27.23 services in the treatment of mental disorders or emotional 27.24 disturbances; or 27.25 (6) in allied fields, the mental health professional must 27.26 be a person with a master's degree from an accredited college or 27.27 university in one of the behavioral sciences or related fields, 27.28 with at least 4,000 hours of post-master's supervised experience 27.29 in the delivery of clinical services in the treatment of 27.30 emotional disturbances. 27.31 Sec. 24. Minnesota Statutes 2000, section 245.4871, 27.32 subdivision 29, is amended to read: 27.33 Subd. 29. [OUTPATIENT SERVICES.] "Outpatient services" 27.34 means mental health services, excluding day treatment and 27.35 community support services programs, provided by or under the 27.36 clinical supervision of a mental health professional to children 28.1 with emotional disturbances who live outside a hospital. 28.2 Outpatient services include clinical activities such as 28.3 individual, group, and family therapy; individual treatment 28.4 planning; diagnostic assessments; medication management; and 28.5 psychological testing. Outpatient services include education 28.6 and consultation provided to families and other individuals as 28.7 an extension of the treatment process. 28.8 Sec. 25. Minnesota Statutes 2000, section 245.4875, 28.9 subdivision 2, is amended to read: 28.10 Subd. 2. [CHILDREN'S MENTAL HEALTH SERVICES.] The 28.11 children's mental health service system developed by each county 28.12 board must include the following services: 28.13 (1) education and prevention services according to section 28.14 245.4877; 28.15 (2) mental health identification and intervention services 28.16 according to section 245.4878; 28.17 (3) emergency services according to section 245.4879; 28.18 (4) outpatient services according to section 245.488; 28.19 (5) family community support services according to section 28.20 245.4881; 28.21 (6) day treatment services according to section 245.4884, 28.22 subdivision 2; 28.23 (7) residential treatment services according to section 28.24 245.4882; 28.25 (8) acute care hospital inpatient treatment services 28.26 according to section 245.4883; 28.27 (9) screening according to section 245.4885; 28.28 (10) case management according to section 245.4881; 28.29 (11) therapeutic support of foster care according to 28.30 section 245.4884, subdivision 4;and28.31 (12) professional home-based family treatment according to 28.32 section 245.4884, subdivision 4; and 28.33 (13) mental health crisis services according to section 28.34 245.488, subdivision 3. 28.35 Sec. 26. Minnesota Statutes 2000, section 245.4876, 28.36 subdivision 1, is amended to read: 29.1 Subdivision 1. [CRITERIA.] Children's mental health 29.2 services required by sections 245.487 to 245.4888 must be: 29.3 (1) based, when feasible, on research findings; 29.4 (2) based on individual clinical, cultural, and ethnic 29.5 needs, and other special needs of the children being served; 29.6 (3) delivered in a manner that improves family functioning 29.7 when clinically appropriate; 29.8 (4) provided in the most appropriate, least restrictive 29.9 setting that meets the requirements in subdivision 1a, and that 29.10 is available to the county board to meet the child's treatment 29.11 needs; 29.12 (5) accessible to all age groups of children; 29.13 (6) appropriate to the developmental age of the child being 29.14 served; 29.15 (7) delivered in a manner that provides accountability to 29.16 the child for the quality of service delivered and continuity of 29.17 services to the child during the years the child needs services 29.18 from the local system of care; 29.19 (8) provided by qualified individuals as required in 29.20 sections 245.487 to 245.4888; 29.21 (9) coordinated with children's mental health services 29.22 offered by other providers; 29.23 (10) provided under conditions that protect the rights and 29.24 dignity of the individuals being served; and 29.25 (11) provided in a manner and setting most likely to 29.26 facilitate progress toward treatment goals. 29.27 Sec. 27. Minnesota Statutes 2000, section 245.4876, is 29.28 amended by adding a subdivision to read: 29.29 Subd. 1a. [APPROPRIATE SETTING TO RECEIVE SERVICES.] A 29.30 child must be provided with mental health services in the least 29.31 restrictive setting that is appropriate to the needs and current 29.32 condition of the individual child. For a child to receive 29.33 mental health services in a residential treatment or acute care 29.34 hospital inpatient setting, the family may not be required to 29.35 demonstrate that services were first provided in a less 29.36 restrictive setting and that the child failed to make progress 30.1 toward or meet treatment goals in the less restrictive setting. 30.2 Sec. 28. Minnesota Statutes 2000, section 245.4876, is 30.3 amended by adding a subdivision to read: 30.4 Subd. 1b. [APPROPRIATE; DEFINITION.] For purposes of this 30.5 section, "appropriate" means that activity which, based on a 30.6 preponderance of the evidence, is consistent with the 30.7 professional recommendations of the current mental health 30.8 professionals treating the child. 30.9 Sec. 29. Minnesota Statutes 2000, section 245.488, is 30.10 amended by adding a subdivision to read: 30.11 Subd. 3. [MENTAL HEALTH CRISIS SERVICES.] County boards 30.12 must provide or contract for enough mental health crisis 30.13 services within the county to meet the needs of children with 30.14 emotional disturbance residing in the county who are determined, 30.15 through an assessment by a mental health professional, to be 30.16 experiencing a mental health crisis or mental health emergency. 30.17 The mental health crisis services provided must be medically 30.18 necessary, as defined in section 62Q.53, subdivision 2, and 30.19 appropriate or socially necessary for the safety of the child or 30.20 others. 30.21 Sec. 30. Minnesota Statutes 2000, section 245.4885, 30.22 subdivision 1, is amended to read: 30.23 Subdivision 1. [SCREENING REQUIRED.] The county board 30.24 shall, prior to admission, except in the case of emergency 30.25 admission, screen all children referred for treatment of severe 30.26 emotional disturbance to a residential treatment facility or 30.27 informally admitted to a regional treatment center if public 30.28 funds are used to pay for the services. The county board shall 30.29 also screen all children admitted to an acute care hospital for 30.30 treatment of severe emotional disturbance if public funds other 30.31 than reimbursement under chapters 256B and 256D are used to pay 30.32 for the services. If a child is admitted to a residential 30.33 treatment facility or acute care hospital for emergency 30.34 treatment or held for emergency care by a regional treatment 30.35 center under section 253B.05, subdivision 1, screening must 30.36 occur within three working days of admission. Screening shall 31.1 determine whether the proposed treatment: 31.2 (1) is necessary; 31.3 (2) is appropriate to the child's individual treatment 31.4 needs. For purposes of this clause, "appropriate" has the 31.5 meaning given in section 245.4876, subdivision 1b; 31.6 (3) cannot be effectively provided in the child's home; and 31.7 (4) provides a length of stay as short as possible 31.8 consistent with the individual child's need. 31.9 When a screening is conducted, the county board may not 31.10 determine that referral or admission to a residential treatment 31.11 facility or acute care hospital is not appropriate solely 31.12 because services were not first provided to the child in a less 31.13 restrictive setting and the child failed to make progress toward 31.14 or meet treatment goals in the less restrictive setting. 31.15 Screening shall include both a diagnostic assessment and a 31.16 functional assessment which evaluates family, school, and 31.17 community living situations. If a diagnostic assessment or 31.18 functional assessment has been completed by a mental health 31.19 professional within 180 days, a new diagnostic or functional 31.20 assessment need not be completed unless in the opinion of the 31.21 current treating mental health professional the child's mental 31.22 health status has changed markedly since the assessment was 31.23 completed. The child's parent shall be notified if an 31.24 assessment will not be completed and of the reasons. A copy of 31.25 the notice shall be placed in the child's file. Recommendations 31.26 developed as part of the screening process shall include 31.27 specific community services needed by the child and, if 31.28 appropriate, the child's family, and shall indicate whether or 31.29 not these services are available and accessible to the child and 31.30 family. 31.31 During the screening process, the child, child's family, or 31.32 child's legal representative, as appropriate, must be informed 31.33 of the child's eligibility for case management services and 31.34 family community support services and that an individual family 31.35 community support plan is being developed by the case manager, 31.36 if assigned. 32.1 Screening shall be in compliance with section 256F.07 or 32.2 260C.212, whichever applies. Wherever possible, the parent 32.3 shall be consulted in the screening process, unless clinically 32.4 inappropriate. 32.5 The screening process, and placement decision, and 32.6 recommendations for mental health services must be documented in 32.7 the child's record. 32.8 An alternate review process may be approved by the 32.9 commissioner if the county board demonstrates that an alternate 32.10 review process has been established by the county board and the 32.11 times of review, persons responsible for the review, and review 32.12 criteria are comparable to the standards in clauses (1) to (4). 32.13 Sec. 31. Minnesota Statutes 2000, section 256.969, 32.14 subdivision 3a, is amended to read: 32.15 Subd. 3a. [PAYMENTS.] Acute care hospital billings under 32.16 the medical assistance program must not be submitted until the 32.17 recipient is discharged. However, the commissioner shall 32.18 establish monthly interim payments for inpatient hospitals that 32.19 have individual patient lengths of stay over 30 days regardless 32.20 of diagnostic category. Except as provided in subdivision 3b, 32.21 medical assistance reimbursement for treatment of mental illness 32.22 shall be reimbursed based on diagnostic classifications. The 32.23 commissioner may selectively contract with hospitals for 32.24 services within the diagnostic categories relating to mental 32.25 illness and chemical dependency under competitive bidding when 32.26 reasonable geographic access by recipients can be assured but 32.27 shall not require, in the admissions criteria for persons with 32.28 mental illness, any commitment or petition under chapter 253B as 32.29 a condition of obtaining these services. No physician shall be 32.30 denied the privilege of treating a recipient required to use a 32.31 hospital under contract with the commissioner, as long as the 32.32 physician meets credentialing standards of the individual 32.33 hospital. Individual hospital payments established under this 32.34 section and sections 256.9685, 256.9686, and 256.9695, in 32.35 addition to third party and recipient liability, for discharges 32.36 occurring during the rate year shall not exceed, in aggregate, 33.1 the charges for the medical assistance covered inpatient 33.2 services paid for the same period of time to the hospital. This 33.3 payment limitation shall be calculated separately for medical 33.4 assistance and general assistance medical care services. The 33.5 limitation on general assistance medical care shall be effective 33.6 for admissions occurring on or after July 1, 1991. Services 33.7 that have rates established under subdivision 11 or 12, must be 33.8 limited separately from other services. After consulting with 33.9 the affected hospitals, the commissioner may consider related 33.10 hospitals one entity and may merge the payment rates while 33.11 maintaining separate provider numbers. The operating and 33.12 property base rates per admission or per day shall be derived 33.13 from the best Medicare and claims data available when rates are 33.14 established. The commissioner shall determine the best Medicare 33.15 and claims data, taking into consideration variables of recency 33.16 of the data, audit disposition, settlement status, and the 33.17 ability to set rates in a timely manner. The commissioner shall 33.18 notify hospitals of payment rates by December 1 of the year 33.19 preceding the rate year. The rate setting data must reflect the 33.20 admissions data used to establish relative values. Base year 33.21 changes from 1981 to the base year established for the rate year 33.22 beginning January 1, 1991, and for subsequent rate years, shall 33.23 not be limited to the limits ending June 30, 1987, on the 33.24 maximum rate of increase under subdivision 1. The commissioner 33.25 may adjust base year cost, relative value, and case mix index 33.26 data to exclude the costs of services that have been 33.27 discontinued by the October 1 of the year preceding the rate 33.28 year or that are paid separately from inpatient services. 33.29 Inpatient stays that encompass portions of two or more rate 33.30 years shall have payments established based on payment rates in 33.31 effect at the time of admission unless the date of admission 33.32 preceded the rate year in effect by six months or more. In this 33.33 case, operating payment rates for services rendered during the 33.34 rate year in effect and established based on the date of 33.35 admission shall be adjusted to the rate year in effect by the 33.36 hospital cost index. 34.1 Sec. 32. Minnesota Statutes 2000, section 256.969, is 34.2 amended by adding a subdivision to read: 34.3 Subd. 3b. [CONTINUING CARE PROGRAM FOR PERSONS WITH MENTAL 34.4 ILLNESS.] The commissioner shall establish a continuing care 34.5 benefit program for persons with mental illness, in which 34.6 persons with mental illness may obtain acute care hospital 34.7 inpatient treatment for mental illness for a length of stay 34.8 beyond that allowed by the diagnostic classifications for mental 34.9 illness according to subdivision 3a. Persons with mental 34.10 illness may obtain inpatient treatment under this program in 34.11 hospital beds for which the commissioner contracts under 34.12 subdivision 3a. The commissioner shall contract externally with 34.13 a utilization review organization to authorize persons with 34.14 mental illness to access the continuing care benefit program. 34.15 The commissioner shall establish admission criteria to allow 34.16 persons with mental illness to access the continuing care 34.17 benefit program. If a court orders acute care hospital 34.18 inpatient treatment for mental illness for a person, the person 34.19 may obtain the treatment under the continuing care benefit 34.20 program. The commissioner shall not require, as part of the 34.21 admission criteria, any commitment or petition under chapter 34.22 253B as a condition of accessing the program. 34.23 Sec. 33. Minnesota Statutes 2000, section 256B.0625, 34.24 subdivision 17, is amended to read: 34.25 Subd. 17. [TRANSPORTATION COSTS.] (a) Medical assistance 34.26 covers transportation costs incurred solely for obtaining 34.27 emergency medical care or transportation costs incurred by 34.28 nonambulatory persons in obtaining emergency or nonemergency 34.29 medical care when paid directly to an ambulance company, common 34.30 carrier, or other recognized providers of transportation 34.31 services. For the purpose of this subdivision, a person who is 34.32 incapable of transport by taxicab or bus shall be considered to 34.33 be nonambulatory. 34.34 (b) Medical assistance covers special transportation, as 34.35 defined in Minnesota Rules, part 9505.0315, subpart 1, item F, 34.36 if the provider receives and maintains a current physician's 35.1 order by the recipient's attending physician certifying that the 35.2 recipient has a physical or mental impairment that would 35.3 prohibit the recipient from safely accessing and using a bus, 35.4 taxi, other commercial transportation, or private automobile. 35.5 Notwithstanding Minnesota Rules, part 9505.0315, subpart 1, item 35.6 D, medical assistance covers special transportation services 35.7 necessary to obtain a service not covered by medical assistance, 35.8 if this service is part of the person's individual treatment 35.9 plan. Special transportation includes driver-assisted service 35.10 to eligible individuals. Driver-assisted service includes 35.11 passenger pickup at and return to the individual's residence or 35.12 place of business, assistance with admittance of the individual 35.13 to the medical facility, and assistance in passenger securement 35.14 or in securing of wheelchairs or stretchers in the vehicle. The 35.15 commissioner shall establish maximum medical assistance 35.16 reimbursement rates for special transportation services for 35.17 persons who need a wheelchair lift van or stretcher-equipped 35.18 vehicle and for those who do not need a wheelchair lift van or 35.19 stretcher-equipped vehicle. The average of these two rates per 35.20 trip must not exceed $15 for the base rate and $1.20 per mile. 35.21 Special transportation provided to nonambulatory persons who do 35.22 not need a wheelchair lift van or stretcher-equipped vehicle, 35.23 may be reimbursed at a lower rate than special transportation 35.24 provided to persons who need a wheelchair lift van or 35.25 stretcher-equipped vehicle. 35.26 Sec. 34. Minnesota Statutes 2000, section 256B.0625, is 35.27 amended by adding a subdivision to read: 35.28 Subd. 43. [CONTINUING CARE FOR PERSONS WITH MENTAL 35.29 ILLNESS.] Medical assistance covers a continuing care benefit 35.30 for persons with mental illness established under section 35.31 256.969, subdivision 3b, in which persons with mental illness 35.32 may obtain acute care hospital inpatient treatment for a length 35.33 of stay beyond that allowed by the diagnostic classifications 35.34 for mental illness. 35.35 Sec. 35. Minnesota Statutes 2000, section 256B.0625, is 35.36 amended by adding a subdivision to read: 36.1 Subd. 44. [COMMUNITY SUPPORT SERVICES PROGRAM.] Medical 36.2 assistance covers services included under a community support 36.3 services program, as defined in section 245.462, subdivision 6. 36.4 Sec. 36. Minnesota Statutes 2000, section 256B.0625, is 36.5 amended by adding a subdivision to read: 36.6 Subd. 45. [MENTAL HEALTH EVALUATION AND MANAGEMENT; 36.7 CLINICAL SUPERVISION.] (a) Medical assistance covers the 36.8 following evaluation and management services related to mental 36.9 health symptoms, treatment, and supportive services: 36.10 (1) outpatient services performed by mental health 36.11 professionals in community mental health centers under 36.12 subdivision 5 or section 245.62, community health clinics under 36.13 Minnesota Rules, part 9505.0255, public health clinics under 36.14 Minnesota Rules, part 9505.0380, or mental health centers and 36.15 mental health clinics certified under Minnesota Rules, parts 36.16 9520.0750 to 9520.0870; 36.17 (2) inpatient evaluation and management services performed 36.18 by psychiatrists for day treatment, partial hospitalization, 36.19 crisis intervention, and nonresidential crisis stabilization 36.20 services; and 36.21 (3) consultation, evaluation, and management services 36.22 provided via telemedicine. 36.23 (b) Medical assistance covers clinical supervision services 36.24 that are required as a condition of payment for services 36.25 provided under subdivisions 3 and 5, and Minnesota Rules, parts 36.26 9505.0323, 9505.0324, and 9505.0326. 36.27 Sec. 37. Minnesota Statutes 2000, section 256B.0625, is 36.28 amended by adding a subdivision to read: 36.29 Subd. 46. [MENTAL HEALTH CRISIS SERVICES.] Medical 36.30 assistance covers adult and child mental health crisis services 36.31 as defined in sections 245.462, subdivision 14c, and 245.4871, 36.32 subdivision 24c. 36.33 Sec. 38. Minnesota Statutes 2000, section 260C.201, 36.34 subdivision 1, is amended to read: 36.35 Subdivision 1. [DISPOSITIONS.] (a) If the court finds that 36.36 the child is in need of protection or services or neglected and 37.1 in foster care, it shall enter an order making any of the 37.2 following dispositions of the case: 37.3 (1) place the child under the protective supervision of the 37.4 local social services agency or child-placing agency in the home 37.5 of a parent of the child under conditions prescribed by the 37.6 court directed to the correction of the child's need for 37.7 protection or services, or: 37.8 (i) the court may order the child into the home of a parent 37.9 who does not otherwise have legal custody of the child, however, 37.10 an order under this section does not confer legal custody on 37.11 that parent; 37.12 (ii) if the court orders the child into the home of a 37.13 father who is not adjudicated, he must cooperate with paternity 37.14 establishment proceedings regarding the child in the appropriate 37.15 jurisdiction as one of the conditions prescribed by the court 37.16 for the child to continue in his home; 37.17 (iii) the court may order the child into the home of a 37.18 noncustodial parent with conditions and may also order both the 37.19 noncustodial and the custodial parent to comply with the 37.20 requirements of a case plan under subdivision 2; 37.21 (2) transfer legal custody to one of the following: 37.22 (i) a child-placing agency; or 37.23 (ii) the local social services agency. 37.24 In placing a child whose custody has been transferred under 37.25 this paragraph, the agencies shall follow the requirements of 37.26 section 260C.193, subdivision 3; 37.27 (3) if the child has been adjudicated as a child in need of 37.28 protection or services because the child is in need of special 37.29treatment andservices or carefor reasons of physical or mental37.30healthto treat or ameliorate a physical or mental disability, 37.31 the court may order the child's parent, guardian, or custodian 37.32 to provide it. The court may order the child's health plan 37.33 company to provide mental health services to the child. Section 37.34 62Q.535 applies to an order for mental health services directed 37.35 to the child's health plan company. If the health plan, parent, 37.36 guardian, or custodian fails or is unable to provide this 38.1 treatment or care, the court may order it provided. Absent 38.2 specific written findings by the court that the child's 38.3 disability is the result of abuse or neglect by the child's 38.4 parent or guardian, the court shall not transfer legal custody 38.5 of the child for the purpose of obtaining special treatment or 38.6 care solely because the parent is unable to provide the 38.7 treatment or care. If the court's order for mental health 38.8 treatment is based on a diagnosis made by a treatment 38.9 professional, the court may order that the diagnosing 38.10 professional not provide the treatment to the child if it finds 38.11 that such an order is in the child's best interests; or 38.12 (4) if the court believes that the child has sufficient 38.13 maturity and judgment and that it is in the best interests of 38.14 the child, the court may order a child 16 years old or older to 38.15 be allowed to live independently, either alone or with others as 38.16 approved by the court under supervision the court considers 38.17 appropriate, if the county board, after consultation with the 38.18 court, has specifically authorized this dispositional 38.19 alternative for a child. 38.20 (b) If the child was adjudicated in need of protection or 38.21 services because the child is a runaway or habitual truant, the 38.22 court may order any of the following dispositions in addition to 38.23 or as alternatives to the dispositions authorized under 38.24 paragraph (a): 38.25 (1) counsel the child or the child's parents, guardian, or 38.26 custodian; 38.27 (2) place the child under the supervision of a probation 38.28 officer or other suitable person in the child's own home under 38.29 conditions prescribed by the court, including reasonable rules 38.30 for the child's conduct and the conduct of the parents, 38.31 guardian, or custodian, designed for the physical, mental, and 38.32 moral well-being and behavior of the child; or with the consent 38.33 of the commissioner of corrections, place the child in a group 38.34 foster care facility which is under the commissioner's 38.35 management and supervision; 38.36 (3) subject to the court's supervision, transfer legal 39.1 custody of the child to one of the following: 39.2 (i) a reputable person of good moral character. No person 39.3 may receive custody of two or more unrelated children unless 39.4 licensed to operate a residential program under sections 245A.01 39.5 to 245A.16; or 39.6 (ii) a county probation officer for placement in a group 39.7 foster home established under the direction of the juvenile 39.8 court and licensed pursuant to section 241.021; 39.9 (4) require the child to pay a fine of up to $100. The 39.10 court shall order payment of the fine in a manner that will not 39.11 impose undue financial hardship upon the child; 39.12 (5) require the child to participate in a community service 39.13 project; 39.14 (6) order the child to undergo a chemical dependency 39.15 evaluation and, if warranted by the evaluation, order 39.16 participation by the child in a drug awareness program or an 39.17 inpatient or outpatient chemical dependency treatment program; 39.18 (7) if the court believes that it is in the best interests 39.19 of the child and of public safety that the child's driver's 39.20 license or instruction permit be canceled, the court may order 39.21 the commissioner of public safety to cancel the child's license 39.22 or permit for any period up to the child's 18th birthday. If 39.23 the child does not have a driver's license or permit, the court 39.24 may order a denial of driving privileges for any period up to 39.25 the child's 18th birthday. The court shall forward an order 39.26 issued under this clause to the commissioner, who shall cancel 39.27 the license or permit or deny driving privileges without a 39.28 hearing for the period specified by the court. At any time 39.29 before the expiration of the period of cancellation or denial, 39.30 the court may, for good cause, order the commissioner of public 39.31 safety to allow the child to apply for a license or permit, and 39.32 the commissioner shall so authorize; 39.33 (8) order that the child's parent or legal guardian deliver 39.34 the child to school at the beginning of each school day for a 39.35 period of time specified by the court; or 39.36 (9) require the child to perform any other activities or 40.1 participate in any other treatment programs deemed appropriate 40.2 by the court. 40.3 To the extent practicable, the court shall enter a 40.4 disposition order the same day it makes a finding that a child 40.5 is in need of protection or services or neglected and in foster 40.6 care, but in no event more than 15 days after the finding unless 40.7 the court finds that the best interests of the child will be 40.8 served by granting a delay. If the child was under eight years 40.9 of age at the time the petition was filed, the disposition order 40.10 must be entered within ten days of the finding and the court may 40.11 not grant a delay unless good cause is shown and the court finds 40.12 the best interests of the child will be served by the delay. 40.13 (c) If a child who is 14 years of age or older is 40.14 adjudicated in need of protection or services because the child 40.15 is a habitual truant and truancy procedures involving the child 40.16 were previously dealt with by a school attendance review board 40.17 or county attorney mediation program under section 260A.06 or 40.18 260A.07, the court shall order a cancellation or denial of 40.19 driving privileges under paragraph (b), clause (7), for any 40.20 period up to the child's 18th birthday. 40.21 (d) In the case of a child adjudicated in need of 40.22 protection or services because the child has committed domestic 40.23 abuse and been ordered excluded from the child's parent's home, 40.24 the court shall dismiss jurisdiction if the court, at any time, 40.25 finds the parent is able or willing to provide an alternative 40.26 safe living arrangement for the child, as defined in Laws 1997, 40.27 chapter 239, article 10, section 2. 40.28 Sec. 39. [NOTICE REGARDING ESTABLISHMENT OF CONTINUING 40.29 CARE BENEFIT PROGRAM.] 40.30 When the continuing care benefit program for persons with 40.31 mental illness under Minnesota Statutes, section 256.969, 40.32 subdivision 3b, is established, the commissioner of human 40.33 services shall notify counties, health plan companies with 40.34 prepaid medical assistance contracts, health care providers, and 40.35 enrollees of the benefit program through bulletins, workshops, 40.36 and other meetings. 41.1 Sec. 40. [STUDY; LENGTH OF STAY FOR MEDICARE-ELIGIBLE 41.2 PERSONS.] 41.3 The commissioner of human services shall study and make 41.4 recommendations on how Medicare-eligible persons with mental 41.5 illness may obtain acute care hospital inpatient treatment for 41.6 mental illness for a length of stay beyond that allowed by the 41.7 diagnostic classifications for mental illness according to 41.8 Minnesota Statutes, section 256.969, subdivision 3a. The study 41.9 and recommendations shall be reported to the legislature by 41.10 January 15, 2002. 41.11 Sec. 41. [APPROPRIATIONS.] 41.12 Subdivision 1. [TRANSPORTATION COSTS.] $....... is 41.13 appropriated from the general fund for the 2002-2003 biennium to 41.14 the commissioner of human services for grants to community 41.15 support services programs with which county boards contract for 41.16 the provision of community support services. Community support 41.17 services programs shall use the funds to reimburse the 41.18 transportation costs of individuals and organizations that 41.19 transport adults with serious and persistent mental illness 41.20 according to Minnesota Statutes, section 245.4713. 41.21 Subd. 2. [ADDITIONAL CONTRACT BEDS.] $....... is 41.22 appropriated for the 2002-2003 biennium from the general fund to 41.23 the commissioner of human services to increase funding for state 41.24 mental health grants. The commissioner shall use this 41.25 appropriation to contract with hospitals for additional beds to 41.26 provide acute care hospital inpatient services to persons with 41.27 mental illness, including persons covered by Medicare, who are 41.28 not eligible under the medical assistance contract under 41.29 Minnesota Statutes, section 256.969, subdivision 3b, and who 41.30 require a length of stay beyond that allowed by the diagnostic 41.31 classifications for mental illness. 41.32 Subd. 3. [CRISIS SERVICES.] $....... is appropriated from 41.33 the general fund to the commissioner of human services, for the 41.34 biennium ending June 30, 2003, to increase funding provided to 41.35 county boards under Minnesota Rules, parts 9535.1700 to 41.36 9535.1760. County boards shall use the additional funding to 42.1 reimburse or contract with mental health providers to pay for 42.2 adult and child mental health crisis services as defined in 42.3 Minnesota Statutes, sections 245.462, subdivision 14c, and 42.4 245.4871, subdivision 24c. 42.5 Subd. 4. [COMMUNITY SOCIAL SERVICES ACT.] $....... is 42.6 appropriated from the general fund to the commissioner of human 42.7 services, for the biennium ending June 30, 2003, to increase 42.8 funding provided to county boards under the Title XX block 42.9 grant. County boards shall use the additional funding to 42.10 increase reimbursement rates for mental health providers to pay 42.11 for education, consultation, and support services provided to 42.12 families and other individuals. 42.13 Subd. 5. [RULE 78 FUNDING.] $....... is appropriated from 42.14 the general fund to the commissioner of human services, for the 42.15 biennium ending June 30, 2003, to increase funding provided to 42.16 county boards under Minnesota Rules, parts 9535.1700 to 42.17 9535.1760. County boards shall use the additional funding to 42.18 increase reimbursement rates for mental health providers to pay 42.19 for education, consultation, and support services provided to 42.20 families and other individuals. 42.21 ARTICLE 5 42.22 HEALTH PLAN COVERAGE 42.23 Section 1. [62Q.471] [EXCLUSION FOR SUICIDE ATTEMPTS 42.24 PROHIBITED.] 42.25 (a) No health plan may exclude or reduce coverage for 42.26 health care for an enrollee that is otherwise covered under the 42.27 health plan, on the basis that the need for the health care 42.28 arose out of a suicide or suicide attempt by the enrollee. 42.29 (b) For purposes of this section, "health plan" has the 42.30 meaning given in section 62Q.01, subdivision 3, but includes the 42.31 coverages described in section 62A.011, clauses (7) and (10). 42.32 Sec. 2. [62Q.527] [COVERAGE OF NONFORMULARY DRUGS FOR 42.33 MENTAL ILLNESS AND EMOTIONAL DISTURBANCE.] 42.34 Subdivision 1. [DEFINITIONS.] (a) For purposes of this 42.35 section, the following terms have the meanings given to them. 42.36 (b) "Emotional disturbance" has the meaning given in 43.1 section 245.4871, subdivision 15. 43.2 (c) "Mental illness" has the meaning given in section 43.3 245.462, subdivision 20, paragraph (a). 43.4 Subd. 2. [REQUIRED COVERAGE.] A health plan must provide 43.5 coverage for an antipsychotic, antimania, or antidementia drug 43.6 prescribed to treat emotional disturbance or mental illness 43.7 regardless of whether the drug is in the health plan's drug 43.8 formulary, if the health care provider prescribing the drug (i) 43.9 indicates to the dispensing pharmacist, orally or in writing 43.10 according to section 151.21, that the prescription must be 43.11 dispensed as communicated; and (ii) certifies in writing to the 43.12 health plan company that the drug prescribed will best treat the 43.13 patient's condition. For drugs covered under this section, no 43.14 health plan company, which has received the certification from 43.15 the health care provider, may: 43.16 (A) impose a special deductible, copayment, coinsurance, or 43.17 other special payment requirement that the health plan does not 43.18 apply to drugs that are in the health plan's drug formulary; or 43.19 (B) require written certification from the prescribing 43.20 provider each time a prescription is refilled or renewed that 43.21 the drug prescribed will best treat the patient's condition. 43.22 Subd. 3. [CONTINUING CARE.] Individuals receiving a 43.23 prescribed drug to treat a diagnosed mental illness or emotional 43.24 disturbance, may continue to receive the prescribed drug, 43.25 without the imposition of a special deductible, co-payment, 43.26 coinsurance, or other special payment requirements, when a 43.27 health plan's drug formulary changes or an enrollee changes 43.28 health plans and the medication has been shown to effectively 43.29 treat the patient's condition. In order to be eligible for this 43.30 continuing care benefit, the patient must have been treated with 43.31 the drug for 60 days prior to a change in a health plan's drug 43.32 formulary or a change in the enrollee's health plan. 43.33 Sec. 3. [62Q.535] [COVERAGE FOR COURT-ORDERED MENTAL 43.34 HEALTH SERVICES.] 43.35 Subdivision 1. [MENTAL HEALTH SERVICES.] For purposes of 43.36 this section, mental health services means all covered services 44.1 that are intended to treat or ameliorate an emotional, 44.2 behavioral, or psychiatric condition and that are covered by the 44.3 policy, contract, or certificate of coverage of the enrollee's 44.4 health plan company or by law. 44.5 Subd. 2. [COVERAGE REQUIRED.] All health plan companies 44.6 that provide coverage for mental health services must cover or 44.7 provide mental health services ordered by a court of competent 44.8 jurisdiction under a court order that is issued on the basis of 44.9 a behavioral care evaluation, performed by a licensed 44.10 psychiatrist or a doctoral level licensed psychologist, which 44.11 includes a diagnosis and an individual treatment plan for care 44.12 in the most appropriate, least restrictive environment. The 44.13 health plan company must be given a copy of the court order and 44.14 behavioral evaluation. The health plan company shall be 44.15 financially liable for the evaluation if performed by a 44.16 participating provider of the health plan company and shall be 44.17 financially liable for the care included in the court-ordered 44.18 treatment plan if the care is covered by the health plan company 44.19 and ordered to be provided by a participating provider or 44.20 another provider as required by rule or statute. This 44.21 court-ordered coverage must not be subject to a separate medical 44.22 necessity determination by a health plan company under its 44.23 utilization procedures. 44.24 Sec. 4. [EFFECTIVE DATE.] 44.25 This article is effective January 1, 2002, and applies to 44.26 contracts issued or renewed on or after that date. 44.27 ARTICLE 6 44.28 OTHER MENTAL HEALTH ISSUES 44.29 Section 1. Minnesota Statutes 2000, section 256B.69, is 44.30 amended by adding a subdivision to read: 44.31 Subd. 28. [DISENROLLMENT DUE TO DISABILITY STATUS OR 44.32 EXCLUDED PLACEMENT.] If a recipient is disenrolled from the 44.33 prepaid medical assistance program as a result of a change in 44.34 eligibility status due to disability or placement in an 44.35 institution for mental disease or other excluded placement, the 44.36 prepaid health plan shall remain financially liable for all 45.1 medical assistance services provided to the individual for a 45.2 period of 90 days from the date of disenrollment, if the prepaid 45.3 health plan would have been obligated to provide those services 45.4 had the individual remained enrolled in the prepaid medical 45.5 assistance program. 45.6 Sec. 2. Minnesota Statutes 2000, section 256B.69, is 45.7 amended by adding a subdivision to read: 45.8 Subd. 29. [INFORMATION ON BEHAVIORAL HEALTH CARE.] (a) The 45.9 commissioner shall develop a standard definition of behavioral 45.10 health care services based on claims, procedures, and encounter 45.11 data, and beginning January 1, 2002, for prepaid medical 45.12 assistance, prepaid general assistance medical care, and 45.13 MinnesotaCare program contracts renewed, entered into, or in 45.14 effect on or after that date, shall collect behavioral health 45.15 claims data from prepaid health plans. For each prepaid health 45.16 plan, the commissioner shall calculate on a quarterly basis the 45.17 ratio of expenditures for behavioral health services to the 45.18 total capitation payment received, and shall make this 45.19 information available to the public upon request. 45.20 (b) Beginning January 1, 2002, for prepaid medical 45.21 assistance program contracts renewed, entered into, or in effect 45.22 on or after that date, the commissioner shall collect 45.23 information from prepaid health plans on: (1) the number of 45.24 enrollees disenrolled as a result of a change in eligibility 45.25 status due to disability or placement in an institution for 45.26 mental diseases or other excluded placement; and (2) changes in 45.27 the health condition of the enrollee that led to the change. 45.28 The commissioner shall make information on each prepaid health 45.29 plan available to the public upon request, in a form that does 45.30 not identify individual enrollees. 45.31 Sec. 3. [DEVELOPMENT OF PAYMENT SYSTEM FOR ADULT 45.32 RESIDENTIAL SERVICES GRANTS.] 45.33 The commissioner of human services shall review funding 45.34 methods for adult residential services grants under Minnesota 45.35 Rules, parts 9535.2000 to 9535.3000, and shall develop a payment 45.36 system that takes into account client difficulty of care as 46.1 manifested by client physical, mental, or behavioral 46.2 conditions. The payment system must provide reimbursement for 46.3 education, consultation, and support services provided to 46.4 families and other individuals as an extension of the treatment 46.5 process. The commissioner shall present recommendations and 46.6 draft legislation for an adult residential services payment 46.7 system to the legislature by January 15, 2002. The 46.8 recommendations must address whether additional funding for 46.9 adult residential services grants is necessary for the provision 46.10 of high quality services under a payment reimbursement system. 46.11 Sec. 4. [DELIVERY OF SERVICES TO INDIVIDUALS WITH DUAL 46.12 DIAGNOSES.] 46.13 The commissioner of human services shall develop plans to 46.14 improve the delivery of services to individuals with dual 46.15 diagnoses of: 46.16 (1) serious and persistent mental illness and chemical 46.17 dependency; 46.18 (2) serious emotional disturbance and chemical dependency; 46.19 (3) mental illness and developmental disability; 46.20 (4) mental illness and traumatic brain injury; and 46.21 (5) serious emotional disturbance and developmental 46.22 disability. 46.23 The plans must address the coordination and integration of 46.24 programs and funding sources and include recommendations for 46.25 modifying state grants and provider reimbursement rates based on 46.26 complexity of condition and the level of care needed by an 46.27 individual or group of individuals. The commissioner shall 46.28 present the plans and any statutory changes needed to implement 46.29 the plans to the legislature by February 1, 2002.