HF 1198

2nd Engrossment - 93rd Legislature (2023 - 2024) Posted on 03/15/2023 10:37am

A bill for an act
relating to human services; expanding child care assistance to certain families;
expanding and modifying grants and rules regarding children's mental health;
modifying the transition to community initiative; modifying training requirements
for mental health staff; modifying covered transportation services; modifying
coverage of mental health clinical care coordination; modifying rules regarding
children's long-term stays in the emergency room; establishing the rural family
response and stabilization services pilot program; requiring reports; appropriating
money; amending Minnesota Statutes 2022, sections 119B.05, subdivision 1;
245.4662; 245.4889, subdivision 1; 245I.04, subdivisions 5, 7; 254B.05, subdivision
1a; 256.478; 256B.0616, subdivisions 4, 5, by adding a subdivision; 256B.0622,
subdivision 2a; 256B.0624, subdivisions 5, 8; 256B.0625, subdivisions 17, 45a;
256B.0659, subdivisions 1, 17a; 256B.0671, subdivision 7; 256B.0943, by adding
a subdivision; 256B.0946, subdivision 7; 256B.0947, subdivision 7, by adding a
subdivision; 260C.007, subdivision 6; 260C.708; proposing coding for new law
in Minnesota Statutes, chapter 144.

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

Section 1.

Minnesota Statutes 2022, section 119B.05, subdivision 1, is amended to read:

Subdivision 1.

Eligible participants.

Families eligible for child care assistance under
the MFIP child care program are:

(1) MFIP participants who are employed or in job search and meet the requirements of
section 119B.10;

(2) persons who are members of transition year families under section 119B.011,
subdivision 20, and meet the requirements of section 119B.10;

(3) families who are participating in employment orientation or job search, or other
employment or training activities that are included in an approved employability development
plan under section 256J.95;

(4) MFIP families who are participating in work job search, job support, employment,
or training activities as required in their employment plan, or in appeals, hearings,
assessments, or orientations according to chapter 256J;

(5) MFIP families who are participating in social services activities under chapter 256J
as required in their employment plan approved according to chapter 256J;

(6) families who are participating in services or activities that are included in an approved
family stabilization plan under section 256J.575;

new text begin (7) MFIP child-only families under section 256J.88, for up to 20 hours of child care per
week for children ages six and under, as recommended by the treating mental health
professional, when the child's primary caregiver has a diagnosis of a mental illness;
new text end

deleted text begin (7) deleted text end new text begin (8) new text end families who are participating in programs as required in tribal contracts under
section 119B.02, subdivision 2, or 256.01, subdivision 2;

deleted text begin (8) deleted text end new text begin (9) new text end families who are participating in the transition year extension under section
119B.011, subdivision 20a;

deleted text begin (9) deleted text end new text begin (10) new text end student parents as defined under section 119B.011, subdivision 19b; and

deleted text begin (10) deleted text end new text begin (11) new text end student parents who turn 21 years of age and who continue to meet the other
requirements under section 119B.011, subdivision 19b. A student parent continues to be
eligible until the student parent is approved for basic sliding fee child care assistance or
until the student parent's redetermination, whichever comes first. At the student parent's
redetermination, if the student parent was not approved for basic sliding fee child care
assistance, a student parent's eligibility ends following a 15-day adverse action notice.

Sec. 2.

new text begin [144.3435] NONRESIDENTIAL MENTAL HEALTH SERVICES.
new text end

new text begin A minor who 16 years of age or older may give effective consent for nonresidential
mental health services, and the consent of no other person is required. For purposes of this
section, "nonresidential mental health services" means outpatient services as defined in
section 245.4871, subdivision 29, provided to a minor who is not residing in a hospital,
inpatient unit, or licensed residential treatment facility or program.
new text end

Sec. 3.

Minnesota Statutes 2022, section 245.4662, is amended to read:

245.4662 MENTAL HEALTH INNOVATION GRANT PROGRAM.

Subdivision 1.

Definitions.

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

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

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

(d) "Intensive residential treatment services" has the meaning given in section 256B.0622.

new text begin (e) "Psychiatric residential treatment facility" has the meaning given in section
256B.0941.
new text end

deleted text begin (e) deleted text end new text begin (f) new text end "Metropolitan area" means the seven-county metropolitan area, as defined in
section 473.121, subdivision 2.

Subd. 2.

Grants authorized.

new text begin (a) new text end The commissioner of human services shall, in
consultation with stakeholders, award grants to eligible applicants to new text begin :
new text end

new text begin (1) new text end plan, establish, or operate programs to improve accessibility and quality of
community-based, outpatient mental health services and reduce the number of clients
admitted to regional treatment centers and community behavioral health hospitals deleted text begin . deleted text end new text begin ; or
new text end

new text begin (2) plan, establish, or operate programs to address the specific needs of children who
need specialized services and who have a mental illness, including:
new text end

new text begin (i) autism spectrum disorders with self-injury or aggression;
new text end

new text begin (ii) reactive attachment disorder or post-traumatic stress disorder with aggression;
new text end

new text begin (iii) a co-occurring intellectual disability or developmental disability;
new text end

new text begin (iv) a traumatic brain injury;
new text end

new text begin (v) a co-occurring complex medical issue; and
new text end

new text begin (vi) severe emotional dysregulation and schizophrenia.
new text end

new text begin (b) new text end The commissioner shall award half of all grant funds to eligible applicants in the
metropolitan area and half of all grant funds to eligible applicants outside the metropolitan
area. An applicant may apply for and the commissioner may award grants for two-year
periods. The commissioner may reallocate underspending among grantees within the same
grant period. The mental health innovation account is established under section 246.18 for
ongoing funding.

Subd. 3.

Allocation of grants.

(a) An application must be on a form and contain
information as specified by the commissioner but at a minimum must contain:

(1) a description of the purpose or project for which grant funds will be used;

(2) a description of the specific problem the grant funds will address;

(3) a letter of support from the local mental health authority;

(4) a description of achievable objectives, a work plan, and a timeline for implementation
and completion of processes or projects enabled by the grant; and

(5) a process for documenting and evaluating results of the grant.

(b) The commissioner shall review each application to determine whether the application
is complete and whether the applicant and the project are eligible for a grant. In evaluating
applications according to paragraph (c), the commissioner shall establish criteria including,
but not limited to: the eligibility of the project; the applicant's thoroughness and clarity in
describing the problem grant funds are intended to address; a description of the applicant's
proposed project; a description of the population demographics and service area of the
proposed project; the manner in which the applicant will demonstrate the effectiveness of
any projects undertaken; the proposed project's longevity and demonstrated financial
sustainability after the initial grant period; and evidence of efficiencies and effectiveness
gained through collaborative efforts. The commissioner may also consider other relevant
factors. In evaluating applications, the commissioner may request additional information
regarding a proposed project, including information on project cost. An applicant's failure
to provide the information requested disqualifies an applicant. The commissioner shall
determine the number of grants awarded.

(c) Eligible applicants may receive grants under this section for purposes including, but
not limited to, the following:

(1) intensive residential treatment services new text begin or psychiatric residential treatment services
new text end providing time-limited mental health services in a residential setting;

(2) the creation of stand-alone urgent care centers for mental health and psychiatric
consultation services, crisis residential services, or collaboration between crisis teams and
critical access hospitals;

(3) establishing new community mental health services or expanding the capacity of
existing services, including supportive housing; and

(4) other innovative projects that improve options for mental health services in community
settings and reduce the number of new text begin :
new text end

new text begin (i) new text end clients who remain in regional treatment centers and community behavioral health
hospitals beyond when discharge is determined to be clinically appropriate deleted text begin . deleted text end new text begin ; or
new text end

new text begin (ii) children who have boarded in an emergency room or whose discharge from an
emergency room or residential setting is delayed because no other options for their care are
available.
new text end

Sec. 4.

Minnesota Statutes 2022, section 245.4889, subdivision 1, is amended to read:

Subdivision 1.

Establishment and authority.

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

(1) counties;

(2) Indian tribes;

(3) children's collaboratives under section 124D.23 or 245.493; or

(4) mental health service providers.

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

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

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

(3) respite care services for children with emotional disturbances or severe emotional
disturbances who are at risk of deleted text begin out-of-home placement or deleted text end new text begin residential treatment or
hospitalization, who are new text end already in out-of-home placement in family foster settings as defined
in chapter 245A and at risk of change in out-of-home placement or placement in a residential
facility or other higher level of care new text begin , who have utilized crisis services or emergency room
services, or who have experienced a loss of in-home staffing support new text end . Allowable activities
and expenses for respite care services are defined under subdivision 4. A child is not required
to have case management services to receive respite care services new text begin . Counties must work to
provide access to regularly scheduled respite care new text end ;

(4) children's mental health crisis services;

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

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

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

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

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

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

(11) mental health first aid training;

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

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

(14) early childhood mental health consultation;

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

(16) psychiatric consultation for primary care practitioners; and

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

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

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

Sec. 5.

Minnesota Statutes 2022, section 245I.04, subdivision 5, is amended to read:

Subd. 5.

Mental health practitioner scope of practice.

(a) A mental health practitioner
under the treatment supervision of a mental health professional or certified rehabilitation
specialist may provide an adult client with client education, rehabilitative mental health
services, functional assessments, level of care assessments, and treatment plans. A mental
health practitioner under the treatment supervision of a mental health professional may
provide skill-building services to a child client deleted text begin and deleted text end new text begin , new text end complete treatment plans for a child
client new text begin , and provide clinical care consultation as defined in section 256B.0671, subdivision
7 new text end .

(b) A mental health practitioner must not provide treatment supervision to other staff
persons. A mental health practitioner may provide direction to mental health rehabilitation
workers and mental health behavioral aides.

(c) A mental health practitioner who provides services to clients according to section
256B.0624 or 256B.0944 may perform crisis assessments and interventions for a client.

Sec. 6.

Minnesota Statutes 2022, section 245I.04, subdivision 7, is amended to read:

Subd. 7.

Clinical trainee scope of practice.

(a) A clinical trainee under the treatment
supervision of a mental health professional may provide a client with psychotherapy, client
education, rehabilitative mental health services, diagnostic assessments, functional
assessments, level of care assessments, and treatment plans. new text begin A mental health practitioner
clinical trainee under the treatment supervision of a mental health professional may provide
clinical care consultation as defined in section 256B.0671, subdivision 7.
new text end

(b) A clinical trainee must not provide treatment supervision to other staff persons. A
clinical trainee may provide direction to mental health behavioral aides and mental health
rehabilitation workers.

(c) A psychological clinical trainee under the treatment supervision of a psychologist
may perform psychological testing of clients.

(d) A clinical trainee must not provide services to clients that violate any practice act of
a health-related licensing board, including failure to obtain licensure if licensure is required.

Sec. 7.

Minnesota Statutes 2022, section 254B.05, subdivision 1a, is amended to read:

Subd. 1a.

Room and board provider requirements.

(a) Effective January 1, 2000,
vendors of room and board are eligible for behavioral health fund payment if the vendor:

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

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

(3) is not a jail or prison;

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

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

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

(7) has awake staff on site 24 hours per day;

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

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

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

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

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

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

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

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

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

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

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

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

Sec. 8.

Minnesota Statutes 2022, section 256.478, is amended to read:

256.478 new text begin CHILD AND ADULT new text end TRANSITION TO COMMUNITY INITIATIVE.

Subdivision 1.

Purpose.

(a) The commissioner shall establish the transition to community
initiative to award grants to serve individuals for whom supports and services not covered
by medical assistance would allow them to:

(1) live in the least restrictive setting and as independently as possible;

new text begin (2) access services that support short- and long-term needs for developmental growth
or individualized treatment needs;
new text end

deleted text begin (2) deleted text end new text begin (3) new text end build or maintain relationships with family and friends; and

deleted text begin (3) deleted text end new text begin (4) new text end participate in community life.

(b) Grantees must ensure that deleted text begin individuals deleted text end new text begin the individual or the child and family new text end are
engaged in a process that involves person-centered planning and informed choice
decision-making. The informed choice decision-making process must provide accessible
written information and be experiential whenever possible.

Subd. 2.

Eligibility.

deleted text begin An individual deleted text end new text begin A child or adult new text end is eligible for the transition to
community initiative if the deleted text begin individual deleted text end new text begin child or adult new text end does not meet eligibility criteria for the
medical assistance program under section 256B.056 or 256B.057 deleted text begin , but deleted text end new text begin or can demonstrate
that current services are not capable of meeting individual treatment and service needs that
can be met in the community with support, and new text end who meets at least one of the following
criteria:

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

(2) the person has met treatment objectives and no longer requires a hospital-level care
or a secure treatment setting, but the person's discharge from the Anoka Metro Regional
Treatment Center, the Minnesota Security Hospital, or a community behavioral health
hospital would be substantially delayed without additional resources available through the
transitions to community initiative;

(3) the person is in a community hospital, new text begin juvenile detention facility, or county supervised
building, new text end but alternative community living options would be appropriate for the person, and
the person has received approval from the commissioner; deleted text begin or
deleted text end

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

new text begin (5) the person can demonstrate that individual needs are beyond the scope of current
service designs and grant funding can support the inclusion of additional supports for the
child or adult to access appropriate treatment and services in the least restrictive environment.
new text end

Sec. 9.

Minnesota Statutes 2022, section 256B.0616, subdivision 4, is amended to read:

Subd. 4.

Peer support specialist program providers.

The commissioner shall develop
a process to certify family new text begin and youth new text end peer support specialist programs new text begin and associated training
support new text end , in accordance with the federal guidelines deleted text begin , deleted text end in order for the program to bill for
reimbursable services. Family new text begin and youth new text end peer support programs must operate within an
existing mental health community provider or center.

Sec. 10.

Minnesota Statutes 2022, section 256B.0616, subdivision 5, is amended to read:

Subd. 5.

Certified family new text begin and youth new text end peer specialist training and certification.

The
commissioner shall develop deleted text begin a deleted text end new text begin or approve the use of an existing new text end training and certification
process for certified family new text begin and youth new text end peer specialists. deleted text begin The deleted text end new text begin Family peer new text end candidates must
have raised or be currently raising a child with a mental illness, have had experience
navigating the children's mental health system, and deleted text begin must deleted text end demonstrate leadership and advocacy
skills and a strong dedication to family-driven and family-focused services. new text begin Youth peer
candidates must have demonstrated lived experience in children's mental health or related
adverse experiences in adolescence, a high school degree, and leadership and advocacy
skills with a focus on supporting client voices. new text end The training curriculum must teach
participating family new text begin and youth new text end peer specialists specific skills relevant to providing peer
support to other parents new text begin or youth in mental health treatment new text end . In addition to initial training
and certification, the commissioner shall develop ongoing continuing educational workshops
on pertinent issues related to family new text begin and youth new text end peer support counseling. new text begin Training for family
and youth peer support specialists can be delivered by the commissioner or by organizations
approved by the commissioner.
new text end

Sec. 11.

Minnesota Statutes 2022, section 256B.0616, is amended by adding a subdivision
to read:

new text begin Subd. 6. new text end

new text begin Payment rate increase. new text end

new text begin Payment rates for services provided under this section
rendered on or after January 1, 2024, shall be increased by 50 percent over the rates in effect
on December 31, 2023.
new text end

Sec. 12.

Minnesota Statutes 2022, section 256B.0622, subdivision 2a, is amended to read:

Subd. 2a.

Eligibility for assertive community treatment.

An eligible client for assertive
community treatment is an individual who meets the following criteria as assessed by an
ACT team:

(1) is age 18 or older. Individuals ages 16 and 17 may be eligible upon approval by the
commissioner;

(2) has a primary diagnosis of schizophrenia, schizoaffective disorder, major depressive
disorder with psychotic features, other psychotic disorders, or bipolar disorder. Individuals
with other psychiatric illnesses may qualify for assertive community treatment if they have
a serious mental illness and meet the criteria outlined in clauses (3) and (4), but no more
than ten percent of an ACT team's clients may be eligible based on this criteria. Individuals
with a primary diagnosis of a substance use disorder, intellectual developmental disabilities,
borderline personality disorder, antisocial personality disorder, traumatic brain injury, or
an autism spectrum disorder are not eligible for assertive community treatment;

(3) has significant functional impairment as demonstrated by at least one of the following
conditions:

(i) significant difficulty consistently performing the range of routine tasks required for
basic adult functioning in the community or persistent difficulty performing daily living
tasks without significant support or assistance;

(ii) significant difficulty maintaining employment at a self-sustaining level or significant
difficulty consistently carrying out the head-of-household responsibilities; or

(iii) significant difficulty maintaining a safe living situation;

(4) has a need for continuous high-intensity services as evidenced by at least two of the
following:

(i) two or more psychiatric hospitalizations or residential crisis stabilization services in
the previous 12 months;

(ii) frequent utilization of mental health crisis services in the previous six months;

(iii) 30 or more consecutive days of psychiatric hospitalization in the previous 24 months;

(iv) intractable, persistent, or prolonged severe psychiatric symptoms;

(v) coexisting mental health and substance use disorders lasting at least six months;

(vi) recent history of involvement with the criminal justice system or demonstrated risk
of future involvement;

(vii) significant difficulty meeting basic survival needs;

(viii) residing in substandard housing, experiencing homelessness, or facing imminent
risk of homelessness;

(ix) significant impairment with social and interpersonal functioning such that basic
needs are in jeopardy;

(x) coexisting mental health and physical health disorders lasting at least six months;

(xi) residing in an inpatient or supervised community residence but clinically assessed
to be able to live in a more independent living situation if intensive services are provided;

(xii) requiring a residential placement if more intensive services are not available; deleted text begin or
deleted text end

(xiii) difficulty effectively using traditional office-based outpatient services; new text begin or
new text end

new text begin (xiv) receiving services under section 256B.0947 and continuing to meet the criteria but
for turning age 21;
new text end

(5) there are no indications that other available community-based services would be
equally or more effective as evidenced by consistent and extensive efforts to treat the
individual; and

(6) in the written opinion of a licensed mental health professional, has the need for mental
health services that cannot be met with other available community-based services, or is
likely to experience a mental health crisis or require a more restrictive setting if assertive
community treatment is not provided.

Sec. 13.

Minnesota Statutes 2022, section 256B.0624, subdivision 5, is amended to read:

Subd. 5.

Crisis assessment and intervention staff qualifications.

(a) Qualified
individual staff of a qualified provider entity must provide crisis assessment and intervention
services to a recipient. A staff member providing crisis assessment and intervention services
to a recipient must be qualified as a:

(1) mental health professional;

(2) clinical trainee;

(3) mental health practitioner;

(4) mental health certified family peer specialist; or

(5) mental health certified peer specialist.

(b) When crisis assessment and intervention services are provided to a recipient in the
community, a mental health professional, clinical trainee, or mental health practitioner must
lead the response.

(c) The 30 hours of ongoing training required by section 245I.05, subdivision 4, paragraph
(b), must be specific to providing crisis services to children and adults and include training
about evidence-based practices identified by the commissioner of health to reduce the
recipient's risk of suicide and self-injurious behavior.

new text begin (d) At least 6 hours of the ongoing training under paragraph (c) must be specific to
working with families and providing crisis stabilization services to children and include the
following topics:
new text end

new text begin (1) developmental tasks of childhood and adolescence;
new text end

new text begin (2) family relationships;
new text end

new text begin (3) child and youth engagement and motivation, including motivational interviewing;
new text end

new text begin (4) culturally responsive care, including care for lesbian, gay, bisexual, transgender, and
queer youth;
new text end

new text begin (5) positive behavior support;
new text end

new text begin (6) crisis intervention for youth with developmental disabilities;
new text end

new text begin (7) child traumatic stress, trauma-informed care, and trauma-focused cognitive behavioral
therapy; and
new text end

new text begin (8) youth substance use.
new text end

deleted text begin (d) deleted text end new text begin (e) new text end Team members must be experienced in crisis assessment, crisis intervention
techniques, treatment engagement strategies, working with families, and clinical
decision-making under emergency conditions and have knowledge of local services and
resources.

Sec. 14.

Minnesota Statutes 2022, section 256B.0624, subdivision 8, is amended to read:

Subd. 8.

Crisis stabilization staff qualifications.

(a) Mental health crisis stabilization
services must be provided by qualified individual staff of a qualified provider entity. A staff
member providing crisis stabilization services to a recipient must be qualified as a:

(1) mental health professional;

(2) certified rehabilitation specialist;

(3) clinical trainee;

(4) mental health practitioner;

(5) mental health certified family peer specialist;

(6) mental health certified peer specialist; or

(7) mental health rehabilitation worker.

(b) The 30 hours of ongoing training required in section 245I.05, subdivision 4, paragraph
(b), must be specific to providing crisis services to children and adults and include training
about evidence-based practices identified by the commissioner of health to reduce a recipient's
risk of suicide and self-injurious behavior.

new text begin (c) At least 6 hours of the ongoing training under this subdivision must be specific to
working with families and providing crisis stabilization services to children and include the
following topics:
new text end

new text begin (1) developmental tasks of childhood and adolescence;
new text end

new text begin (2) family relationships;
new text end

new text begin (3) child and youth engagement and motivation, including motivational interviewing;
new text end

new text begin (4) culturally responsive care, including care for lesbian, gay, bisexual, transgender, and
queer youth;
new text end

new text begin (5) positive behavior support;
new text end

new text begin (6) crisis intervention for youth with developmental disabilities;
new text end

new text begin (7) child traumatic stress, trauma-informed care, and trauma-focused cognitive behavioral
therapy; and
new text end

new text begin (8) youth substance use.
new text end

Sec. 15.

Minnesota Statutes 2022, section 256B.0625, subdivision 17, is amended to read:

Subd. 17.

Transportation costs.

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

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

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

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

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

(4) public transit, as defined in section 174.22, subdivision 7; deleted text begin or
deleted text end

(5) not-for-hire vehicles, including volunteer drivers, as defined in section 65B.472,
subdivision 1, paragraph (h) deleted text begin . deleted text end new text begin ; or
new text end

new text begin (6) type III vehicles, as defined in section 169.011, subdivision 71, paragraph (h), that
meet the requirements of this subdivision.
new text end

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

(h) The administrative agency shall use the level of service process established by the
commissioner to determine the client's most appropriate mode of transportation. new text begin Clients 20
years of age or younger are eligible for assisted transport, unless they meet the requirements
for lift-equipped transport, ramp transport, or stretcher transport. new text end If public transit or a certified
transportation provider is not available to provide the appropriate service mode for the client,
the client may receive a onetime service upgrade.

(i) The covered modes of transportation are:

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

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

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

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

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

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

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

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

(k) The commissioner shall:

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

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

(3) investigate all complaints and appeals.

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

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

(1) $0.22 per mile for client reimbursement;

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

(3) equivalent to the standard fare for unassisted transport when provided by public
transit, and $11 for the base rate and $1.30 per mile when provided by a nonemergency
medical transportation provider;

(4) $13 for the base rate and $1.30 per mile for assisted transport;

(5) $18 for the base rate and $1.55 per mile for lift-equipped/ramp transport;

(6) $75 for the base rate and $2.40 per mile for protected transport; and

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

new text begin (n) The base rate and mileage rate for nonemergency medical transportation services is
equal to 125 percent of the respective base and mileage rate in paragraph (m), clauses (4)
and (5), when the client is 20 years old or younger and provided by a type III vehicle, as
defined in section 169.011, subdivision 71, paragraph (h).
new text end

deleted text begin (n) deleted text end new text begin (o) new text end The base rate for nonemergency medical transportation services in areas defined
under RUCA to be super rural is equal to 111.3 percent of the respective base rate in
paragraph (m), clauses (1) to (7). The mileage rate for nonemergency medical transportation
services in areas defined under RUCA to be rural or super rural areas is:

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

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

deleted text begin (o) deleted text end new text begin (p) new text end For purposes of reimbursement rates for nonemergency medical transportation
services under paragraphs (m) deleted text begin and (n) deleted text end new text begin to (o) new text end , the zip code of the recipient's place of residence
shall determine whether the urban, rural, or super rural reimbursement rate applies.

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

deleted text begin (q) deleted text end new text begin (r) new text end The commissioner, when determining reimbursement rates for nonemergency
medical transportation under paragraphs (m) deleted text begin and (n) deleted text end new text begin to (o) new text end , shall exempt all modes of
transportation listed under paragraph (i) from Minnesota Rules, part 9505.0445, item R,
subitem (2).

Sec. 16.

Minnesota Statutes 2022, section 256B.0625, subdivision 45a, is amended to
read:

Subd. 45a.

Psychiatric residential treatment facility services for persons younger
than 21 years of age.

(a) Medical assistance covers psychiatric residential treatment facility
services, according to section 256B.0941, for persons younger than 21 years of age.
Individuals who reach age 21 at the time they are receiving services are eligible to continue
receiving services until they no longer require services or until they reach age 22, whichever
occurs first.

(b) For purposes of this subdivision, "psychiatric residential treatment facility" means
a facility other than a hospital that provides psychiatric services, as described in Code of
Federal Regulations, title 42, sections 441.151 to 441.182, to individuals under age 21 in
an inpatient setting.

(c) The commissioner shall enroll up to deleted text begin 150 deleted text end new text begin 250 new text end certified psychiatric residential treatment
facility services beds new text begin at up to ten sites new text end . The commissioner may enroll an additional 80
certified psychiatric residential treatment facility services beds beginning July 1, 2020, and
an additional 70 certified psychiatric residential treatment facility services beds beginning
July 1, 2023. The commissioner shall select psychiatric residential treatment facility services
providers through a request for proposals process. Providers of state-operated services may
respond to the request for proposals. new text begin Providers may specialize in the treatment of children
with specific diagnoses, disabilities, or other health care conditions. new text end The commissioner shall
prioritize programs that demonstrate the capacity to serve children and youth with aggressive
and risky behaviors toward themselves or others, multiple diagnoses, neurodevelopmental
disorders, or complex trauma related issues.

Sec. 17.

Minnesota Statutes 2022, section 256B.0659, subdivision 1, is amended to read:

Subdivision 1.

Definitions.

(a) For the purposes of this section, the terms defined in
paragraphs (b) to (r) have the meanings given unless otherwise provided in text.

(b) "Activities of daily living" means grooming, dressing, bathing, transferring, mobility,
positioning, eating, and toileting.

(c) "Behavior," effective January 1, 2010, means a category to determine the home care
rating and is based on the criteria found in this section. "Level I behavior" means physical
aggression deleted text begin towards deleted text end new text begin toward new text end self, others, or destruction of property that requires the immediate
response of another person.

(d) "Complex health-related needs," effective January 1, 2010, means a category to
determine the home care rating and is based on the criteria found in this section.

(e) "Critical activities of daily living," effective January 1, 2010, means transferring,
mobility, eating, and toileting.

(f) "Dependency in activities of daily living" means a person requires assistance to begin
and complete one or more of the activities of daily living.

(g) "Extended personal care assistance service" means personal care assistance services
included in a service plan under one of the home and community-based services waivers
authorized under chapter 256S and sections 256B.092, subdivision 5, and 256B.49, which
exceed the amount, duration, and frequency of the state plan personal care assistance services
for participants who:

(1) need assistance provided periodically during a week, but less than daily will not be
able to remain in their homes without the assistance, and other replacement services are
more expensive or are not available when personal care assistance services are to be reduced;
deleted text begin or
deleted text end

(2) need additional personal care assistance services beyond the amount authorized by
the state plan personal care assistance assessment in order to ensure that their safety, health,
and welfare are provided for in their homes deleted text begin . deleted text end new text begin ; or
new text end

new text begin (3) due to their mental illness or co-occurring diagnosis, have experienced long stays in
the emergency room with a delayed discharge from the hospital and the family cannot hire
staff to provide in-home care.
new text end

(h) "Health-related procedures and tasks" means procedures and tasks that can be
delegated or assigned by a licensed health care professional under state law to be performed
by a personal care assistant.

(i) "Instrumental activities of daily living" means activities to include meal planning and
preparation; basic assistance with paying bills; shopping for food, clothing, and other
essential items; performing household tasks integral to the personal care assistance services;
communication by telephone and other media; and traveling, including to medical
appointments and to participate in the community.

(j) "Managing employee" has the same definition as Code of Federal Regulations, title
42, section 455.

(k) "Qualified professional" means a professional providing supervision of personal care
assistance services and staff as defined in section 256B.0625, subdivision 19c.

(l) "Personal care assistance provider agency" means a medical assistance enrolled
provider that provides or assists with providing personal care assistance services and includes
a personal care assistance provider organization, personal care assistance choice agency,
class A licensed nursing agency, and Medicare-certified home health agency.

(m) "Personal care assistant" or "PCA" means an individual employed by a personal
care assistance agency who provides personal care assistance services.

(n) "Personal care assistance care plan" means a written description of personal care
assistance services developed by the personal care assistance provider according to the
service plan.

(o) "Responsible party" means an individual who is capable of providing the support
necessary to assist the recipient to live in the community.

(p) "Self-administered medication" means medication taken orally, by injection, nebulizer,
or insertion, or applied topically without the need for assistance.

(q) "Service plan" means a written summary of the assessment and description of the
services needed by the recipient.

(r) "Wages and benefits" means wages and salaries, the employer's share of FICA taxes,
Medicare taxes, state and federal unemployment taxes, workers' compensation, mileage
reimbursement, health and dental insurance, life insurance, disability insurance, long-term
care insurance, uniform allowance, and contributions to employee retirement accounts.

Sec. 18.

Minnesota Statutes 2022, section 256B.0659, subdivision 17a, is amended to
read:

Subd. 17a.

Enhanced rate.

new text begin (a) new text end An enhanced rate of 107.5 percent of the rate paid for
personal care assistance services shall be paid for services provided to persons who qualify
for ten or more hours of personal care assistance services per day when provided by a
personal care assistant who meets the requirements of subdivision 11, paragraph (d).

new text begin (b) An enhanced rate of 20 percent in addition to any enhancement in paragraph (a) must
be paid for services provided to children with a mental illness or developmental disability
who exhibit high aggression.
new text end

new text begin (c) new text end Any change in the eligibility criteria for the enhanced rate for personal care assistance
services as described in this subdivision and referenced in subdivision 11, paragraph (d),
does not constitute a change in a term or condition for individual providers as defined in
section 256B.0711, and is not subject to the state's obligation to meet and negotiate under
chapter 179A.

Sec. 19.

Minnesota Statutes 2022, section 256B.0671, subdivision 7, is amended to read:

Subd. 7.

Mental health clinical care consultation.

(a) Subject to federal approval,
medical assistance covers clinical care consultation for a person up to age 21 who is
diagnosed with a complex mental health condition or a mental health condition that co-occurs
with other complex and chronic conditions, when described in the person's individual
treatment plan and provided by a mental health professional new text begin as defined in section 245I.04,
subdivision 2, a mental health practitioner as defined in section 245I.04, subdivision 4, new text end or
a clinical trainee new text begin , as defined in section 254I.04, subdivision 6 new text end . new text begin This medical assistance
benefit covers all mental health clinical care consultation services delivered by treating
providers, as needed based on the person's individual treatment plan.
new text end

(b) "Clinical care consultation" means communication from a treating mental health
professional to other providers or educators not under the treatment supervision of the
treating mental health professional who are working with the same client to inform, inquire,
and instruct regarding the client's symptoms; strategies for effective engagement, care, and
intervention needs; and treatment expectations across service settings and to direct and
coordinate clinical service components provided to the client and family.

Sec. 20.

Minnesota Statutes 2022, section 256B.0943, is amended by adding a subdivision
to read:

new text begin Subd. 14. new text end

new text begin At-home services rate enhancement. new text end

new text begin The commissioner shall implement a
30 percent rate increase to providers of children's therapeutic services and supports for all
services provided directly to the child or family in their home.
new text end

Sec. 21.

Minnesota Statutes 2022, section 256B.0946, subdivision 7, is amended to read:

Subd. 7.

Medical assistance payment and rate setting.

The commissioner shall establish
a single daily per-client encounter rate for children's intensive behavioral health services.
The rate must be constructed to cover only eligible services delivered to an eligible recipient
by an eligible provider, as prescribed in subdivision 1, paragraph (b). new text begin The rate must be
increased by 30 percent for all services provided directly to the child or family in their home.
new text end

Sec. 22.

Minnesota Statutes 2022, section 256B.0947, subdivision 7, is amended to read:

Subd. 7.

Medical assistance payment and rate setting.

(a) Payment for services in this
section must be based on one daily encounter rate per provider inclusive of the following
services received by an eligible client in a given calendar day: all rehabilitative services,
supports, and ancillary activities under this section, staff travel time to provide rehabilitative
services under this section, and crisis response services under section 256B.0624.

(b) Payment must not be made to more than one entity for each client for services
provided under this section on a given day. If services under this section are provided by a
team that includes staff from more than one entity, the team shall determine how to distribute
the payment among the members.

(c) The commissioner shall establish regional cost-based rates for entities that will bill
medical assistance for nonresidential intensive rehabilitative mental health services. In
developing these rates, the commissioner shall consider:

(1) the cost for similar services in the health care trade area;

(2) actual costs incurred by entities providing the services;

(3) the intensity and frequency of services to be provided to each client;

(4) the degree to which clients will receive services other than services under this section;
and

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

(d) The rate for a provider must not exceed the rate charged by that provider for the
same service to other payers.

new text begin (e) The commissioner must apply an enhanced rate of 130 percent for all services provided
directly to the client or family in their home.
new text end

Sec. 23.

Minnesota Statutes 2022, section 256B.0947, is amended by adding a subdivision
to read:

new text begin Subd. 10. new text end

new text begin Young adult continuity of care. new text end

new text begin A client who received services under this
section or section 256B.0946 and aged out of eligibility may continue to receive services
from the same providers under this section until the client is 27 years old.
new text end

Sec. 24.

Minnesota Statutes 2022, section 260C.007, subdivision 6, is amended to read:

Subd. 6.

Child in need of protection or services.

"Child in need of protection or
services" means a child who is in need of protection or services because the child:

(1) is abandoned or without parent, guardian, or custodian new text begin . A child must not be considered
abandoned if a child's parent cannot take their child home from an emergency room because
appropriate services are not in place or available to keep the child, other family members,
or other people in the home safe new text end ;

(2)(i) has been a victim of physical or sexual abuse as defined in section 260E.03,
subdivision 18 or 20, (ii) resides with or has resided with a victim of child abuse as defined
in subdivision 5 or domestic child abuse as defined in subdivision 13, (iii) resides with or
would reside with a perpetrator of domestic child abuse as defined in subdivision 13 or child
abuse as defined in subdivision 5 or 13, or (iv) is a victim of emotional maltreatment as
defined in subdivision 15;

(3) is without necessary food, clothing, shelter, education, or other required care for the
child's physical or mental health or morals because the child's parent, guardian, or custodian
is unable or unwilling to provide that care new text begin . This does not include when required and
appropriate care for the child is not available in the mental health system new text end ;

(4) is without the special care made necessary by a physical, mental, or emotional
condition because the child's parent, guardian, or custodian is unable or unwilling to provide
that care new text begin . This does not include when required and appropriate care for the child is not
available in the mental health system new text end ;

(5) is medically neglected, which includes, but is not limited to, the withholding of
medically indicated treatment from an infant with a disability with a life-threatening
condition. The term "withholding of medically indicated treatment" means the failure to
respond to the infant's life-threatening conditions by providing treatment, including
appropriate nutrition, hydration, and medication which, in the treating physician's, advanced
practice registered nurse's, or physician assistant's reasonable medical judgment, will be
most likely to be effective in ameliorating or correcting all conditions, except that the term
does not include the failure to provide treatment other than appropriate nutrition, hydration,
or medication to an infant when, in the treating physician's, advanced practice registered
nurse's, or physician assistant's reasonable medical judgment:

(i) the infant is chronically and irreversibly comatose;

(ii) the provision of the treatment would merely prolong dying, not be effective in
ameliorating or correcting all of the infant's life-threatening conditions, or otherwise be
futile in terms of the survival of the infant; or

(iii) the provision of the treatment would be virtually futile in terms of the survival of
the infant and the treatment itself under the circumstances would be inhumane;

(6) is one whose parent, guardian, or other custodian for good cause desires to be relieved
of the child's care and custody, including a child who entered foster care under a voluntary
placement agreement between the parent and the responsible social services agency under
section 260C.227;

(7) has been placed for adoption or care in violation of law;

(8) is without proper parental care because of the emotional, mental, or physical disability,
or state of immaturity of the child's parent, guardian, or other custodian;

(9) is one whose behavior, condition, or environment is such as to be injurious or
dangerous to the child or others. An injurious or dangerous environment may include, but
is not limited to, the exposure of a child to criminal activity in the child's home;

(10) is experiencing growth delays, which may be referred to as failure to thrive, that
have been diagnosed by a physician and are due to parental neglect;

(11) is a sexually exploited youth;

(12) has committed a delinquent act or a juvenile petty offense before becoming ten
years old;

(13) is a runaway;

(14) is a habitual truant;

(15) has been found incompetent to proceed or has been found not guilty by reason of
mental illness or mental deficiency in connection with a delinquency proceeding, a
certification under section 260B.125, an extended jurisdiction juvenile prosecution, or a
proceeding involving a juvenile petty offense; or

(16) has a parent whose parental rights to one or more other children were involuntarily
terminated or whose custodial rights to another child have been involuntarily transferred to
a relative and there is a case plan prepared by the responsible social services agency
documenting a compelling reason why filing the termination of parental rights petition under
section 260C.503, subdivision 2, is not in the best interests of the child.

Sec. 25.

Minnesota Statutes 2022, section 260C.708, is amended to read:

260C.708 OUT-OF-HOME PLACEMENT PLAN FOR QUALIFIED
RESIDENTIAL TREATMENT PROGRAM PLACEMENTS.

(a) When the responsible social services agency places a child in a qualified residential
treatment program as defined in section 260C.007, subdivision 26d, the out-of-home
placement plan must include:

(1) the case plan requirements in section 260C.212;

(2) the reasonable and good faith efforts of the responsible social services agency to
identify and include all of the individuals required to be on the child's family and permanency
team under section 260C.007;

(3) all contact information for members of the child's family and permanency team and
for other relatives who are not part of the family and permanency team;

(4) evidence that the agency scheduled meetings of the family and permanency team,
including meetings relating to the assessment required under section 260C.704, at a time
and place convenient for the family;

(5) evidence that the family and permanency team is involved in the assessment required
under section 260C.704 to determine the appropriateness of the child's placement in a
qualified residential treatment program;

(6) the family and permanency team's placement preferences for the child in the
assessment required under section 260C.704. When making a decision about the child's
placement preferences, the family and permanency team must recognize:

(i) that the agency should place a child with the child's siblings unless a court finds that
placing a child with the child's siblings is not possible due to a child's specialized placement
needs or is otherwise contrary to the child's best interests; and

(ii) that the agency should place an Indian child according to the requirements of the
Indian Child Welfare Act, the Minnesota Family Preservation Act under sections 260.751
to 260.835, and section 260C.193, subdivision 3, paragraph (g);

(7) when reunification of the child with the child's parent or legal guardian is the agency's
goal, evidence demonstrating that the parent or legal guardian provided input about the
members of the family and permanency team under section 260C.706;

(8) when the agency's permanency goal is to reunify the child with the child's parent or
legal guardian, the out-of-home placement plan must identify services and supports that
maintain the parent-child relationship and the parent's legal authority, decision-making, and
responsibility for ongoing planning for the child. In addition, the agency must assist the
parent with visiting and contacting the child;

(9) when the agency's permanency goal is to transfer permanent legal and physical
custody of the child to a proposed guardian or to finalize the child's adoption, the case plan
must document the agency's steps to transfer permanent legal and physical custody of the
child or finalize adoption, as required in section 260C.212, subdivision 1, paragraph (c),
clauses (6) and (7); and

(10) the qualified individual's recommendation regarding the child's placement in a
qualified residential treatment program and the court approval or disapproval of the placement
as required in section 260C.71.

(b) If the placement preferences of the family and permanency team, child, and tribe, if
applicable, are not consistent with the placement setting that the qualified individual
recommends, the case plan must include the reasons why the qualified individual did not
recommend following the preferences of the family and permanency team, child, and the
tribe.

(c) The agency must file the out-of-home placement plan with the court as part of the
60-day court order under section 260C.71.

new text begin (d) The agency must provide aftercare services as defined by the federal Family First
Prevention Services Act to the child for the six months following discharge from the qualified
residential treatment program. The services may include clinical care consultation, as defined
in section 256B.0671, subdivision 7, and family and youth peer specialists under section
256B.0616.
new text end

Sec. 26. new text begin RURAL FAMILY RESPONSE AND STABILIZATION SERVICES PILOT
PROGRAM; APPROPRIATION.
new text end

new text begin (a) The commissioner of human services must establish a pilot program to provide family
response and stabilization services in rural areas. Services must be provided at no cost to
families with children ages five to 18 who have a mental illness and must include:
new text end

new text begin (1) an immediate in-person response within one hour;
new text end

new text begin (2) support and engagement for up to 72 hours following the initial contact;
new text end

new text begin (3) connection to supports and resources in the community; and
new text end

new text begin (4) an optional stabilization service for up to eight weeks to help children and families
navigate systems, put natural and formal supports in place, and improve ability to manage
symptoms and unsafe behaviors.
new text end

new text begin (b) The commissioner must require reporting and establish program objectives including:
new text end

new text begin (1) increasing mental health support to families in rural areas;
new text end

new text begin (2) reducing emergency department utilization;
new text end

new text begin (3) reducing total days rural children with mental illness spend out of home; and
new text end

new text begin (4) reducing law enforcement and juvenile justice involvement.
new text end

new text begin (c) $....... in fiscal year 2024 is appropriated from the general fund to the commissioner
of human services for the rural family response and stabilization services pilot program.
The department must develop a request for proposals for counties and adult mental health
initiatives in rural Minnesota to meet the requirements of the pilot program. A county or
adult mental health initiative may serve multiple counties provided the grantee can respond
in person within one hour in the established service area.
new text end

Sec. 27. new text begin DIRECTION TO THE COMMISSIONER; BEHAVIORAL HEALTH FUND
ROOM AND BOARD RATES.
new text end

new text begin The commissioner of human services must update the behavioral health fund room and
board rate schedule to include services provided under Minnesota Statutes, section 245.4882,
for individuals who do not have a placement under Minnesota Statutes, chapter 260C or
260D. The commissioner must establish room and board rates commensurate with current
room and board rates for adolescent programs licensed under Minnesota Statutes, section
245G.18.
new text end

Sec. 28. new text begin DIRECTION TO THE COMMISSIONER; COLLABORATIVE INTENSIVE
BRIDGING SERVICES.
new text end

new text begin No later than June 30, 2026, the commissioner of human services shall request approval
of a benefit and corresponding rate from the Centers for Medicare and Medicaid Services
to support collaborative intensive bridging services. The commissioner shall use all available
supporting data and consult with counties, service providers, and evaluators in making the
request.
new text end

Sec. 29. new text begin APPROPRIATION; CHILD AND ADULT TRANSITION TO COMMUNITY
INITIATIVE.
new text end

new text begin $480,000 in fiscal year 2024 and $1,087,000 in fiscal year 2025 are appropriated from
the general fund to the commissioner of human services for additional funding for grants
awarded under the child and adult transition to community initiative in Minnesota Statutes,
section 256.478.
new text end

Sec. 30. new text begin APPROPRIATION; RESPITE CARE SERVICES.
new text end

new text begin $350,000 in fiscal year 2024 and $350,000 in fiscal year 2025 are appropriated from the
general fund to the commissioner of human services for children's mental health grants
under Minnesota Statutes, section 245.4889, subdivision 1, paragraph (b), clause (3), to
provide respite care services to families of children with serious mental illness.
new text end

Sec. 31. new text begin APPROPRIATION; CHILDREN'S SCHOOL-LINKED BEHAVIORAL
HEALTH GRANTS.
new text end

new text begin $2,000,000 in fiscal year 2024 and $4,000,000 in fiscal year 2025 are appropriated from
the general fund to the commissioner of human services for children's school-linked
behavioral health services. At least 25 percent of the new funding must be targeted to
providers that can serve schools that have the highest percentage of special education students
categorized as having an emotional or behavioral disorder or being high poverty. The
commissioner shall ensure that grants are distributed to rural and urban counties. The
commissioner shall require grantees to use all available third-party reimbursement sources
as a condition of receipt of grant funds. The commissioner shall consult with school districts
that have not received school-linked behavioral health grants but want to collaborate with
a community mental health provider. The commissioner shall also work with culturally
specific providers so that the providers can serve students from their community in multiple
schools. When administering grants under this program, the commissioner shall take into
account the need to have consistency of providers over time among schools and students.
new text end

Sec. 32. new text begin APPROPRIATION; INTERMEDIATE SCHOOL-LINKED BEHAVIORAL
HEALTH GRANTS.
new text end

new text begin $4,400,000 in fiscal year 2024 and $4,400,000 in fiscal year 2025 are appropriated from
the general fund to the commissioner of human services for intermediate school-linked
behavioral health grants.
new text end

Sec. 33. new text begin APPROPRIATION; SHELTER-LINKED MENTAL HEALTH GRANTS.
new text end

new text begin $1,500,000 in fiscal year 2024 and $1,500,000 in fiscal year 2025 are appropriated from
the general fund to the commissioner of human services for shelter-linked youth mental
health grants under Minnesota Statutes, section 256K.46.
new text end

Sec. 34. new text begin APPROPRIATION; STATE MEDICAL REVIEW TEAM STAFFING.
new text end

new text begin $....... in fiscal year 2024 is appropriated from the general fund to the commissioner of
human services to increase the staffing of the state medical review team to ensure timely
processing of disability determinations, including case specialists, disability analysts, appeals
staff, and supervisors.
new text end

Sec. 35. new text begin APPROPRIATION; EARLY CHILDHOOD MENTAL HEALTH SERVICES
AND CONSULTATION.
new text end

new text begin $1,000,000 in fiscal year 2024 and $1,000,000 in fiscal year 2025 are appropriated from
the general fund to the commissioner of human services to expand early childhood mental
health services under Minnesota Statutes, section 245.4889, subdivision 1, paragraph (b),
clause (9), and early childhood mental health consultation grants under Minnesota Statutes,
section 245.4889, subdivision 1, paragraph (b), clause (14). The commissioner, in
consultation with early childhood mental health providers and advocates, shall develop an
abbreviated assessment to support access to early childhood mental health services. Mental
health consultation grants must be to early learning programs in schools, family home
visiting programs, public health programs, and health care settings. Mental health consultation
includes a mental health professional with early childhood competency providing training,
regular on-site consultation to staff serving high-risk and low-income families, and referrals
to clinical services for parents and children struggling with mental health conditions. The
commissioner may award money to new grantees and proportionately among current grantees
based on the number of regions a grantee serves.
new text end

Sec. 36. new text begin APPROPRIATION; MFIP CHILD CARE ASSISTANCE EXPANSION.
new text end

new text begin $....... in fiscal year 2024 and $....... in fiscal year 2025 are appropriated from the general
fund to the commissioner of human services to cover administrative costs of expanding
MFIP child care assistance to child-only cases under Minnesota Statutes, section 119B.05,
subdivision 1, clause (7).
new text end

Sec. 37. new text begin APPROPRIATION; MOBILE CRISIS TEAM ONGOING TRAINING.
new text end

new text begin $....... in fiscal year 2024 is appropriated from the general fund to the commissioner of
human services to provide ongoing training to mobile crisis teams on providing crisis
assessment, intervention, and stabilization services to children and working with families
in crisis situations.
new text end

Sec. 38. new text begin APPROPRIATION; PSYCHIATRIC RESIDENTIAL TREATMENT
FACILITIES.
new text end

new text begin $2,000,000 in fiscal year 2024 and $1,500,000 in fiscal year 2025 are appropriated from
the general fund to the commissioner of human services for start-up and capacity development
grants to psychiatric residential treatment facilities as described in Minnesota Statutes,
section 256B.0941. Grantees may use grant money to increase capacity in existing facilities,
support additional training and equipment to serve specialized child needs, and address the
emergency workforce shortage.
new text end

Sec. 39. new text begin APPROPRIATION; TRAINING GRANTS FOR INTENSIVE IN-HOME
SERVICES.
new text end

new text begin $1,250,000 in fiscal year 2024 is appropriated from the general fund to the commissioner
of human services for grants for training of staff providing intensive in-home children's
mental health care under Minnesota Statutes, sections 256B.0943, 256B.0946, and
256B.0947. Grant money shall be to reimburse certified providers for training on
evidence-based practices, trauma-informed approaches, and de-escalation and train-the-trainer
models to equip staff and families accessing intensive mental health care models to effectively
care for children while they access treatment and maintain safety.
new text end

Sec. 40. new text begin APPROPRIATION; COLLABORATIVE INTENSIVE BRIDGING
SERVICES.
new text end

new text begin $2,010,000 in fiscal year 2024 and $2,010,000 in fiscal year 2025 are appropriated from
the general fund to the commissioner of human services for grants to sustain existing mental
health infrastructure. The grant must include money for:
new text end

new text begin (1) maintaining current levels of collaborative intensive bridging services and evaluation;
new text end

new text begin (2) limited expansions of collaborative intensive bridging services and evaluation; and
new text end

new text begin (3) training and technical assistance by an expert contractor with experience in
collaborative intensive bridging services to counties and service providers on maintaining
fidelity to the collaborative intensive bridging services model.
new text end

Sec. 41. new text begin APPROPRIATION; CHILDREN'S MENTAL HEALTH DISCHARGE
OPTIONS.
new text end

new text begin $....... in fiscal year 2024 and $....... in fiscal year 2025 are appropriated from the general
fund to the commissioner of human services for developing placement options for children
with mental illness whose discharge from the emergency room is delayed because no other
options for their care are available.
new text end