1st Engrossment - 81st Legislature (1999 - 2000) Posted on 12/15/2009 12:00am
Engrossments | ||
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Introduction | Posted on 03/08/1999 | |
1st Engrossment | Posted on 03/22/1999 |
1.1 A bill for an act 1.2 relating to human services; modifying state-operated 1.3 services; changing adult mental health day treatment 1.4 and consolidated chemical dependency treatment fund 1.5 requirements; defining case management service 1.6 provider and changing requirements for case managers 1.7 and case manager associates; changing the definition 1.8 of mental health practitioner; amending Minnesota 1.9 Statutes 1998, sections 16C.10, subdivision 5; 1.10 245.462, subdivisions 4 and 17; 245.4711, subdivision 1.11 1; 245.4712, subdivision 2; 245.4871, subdivisions 4 1.12 and 26; 245.4881, subdivision 1; 246.18, subdivision 1.13 6; 253B.045, by adding subdivisions; 253B.07, 1.14 subdivision 1; 253B.185, by adding a subdivision; 1.15 254B.01, by adding a subdivision; 254B.02, subdivision 1.16 3; 254B.03, subdivision 2; 254B.04, subdivision 1; 1.17 254B.05, subdivision 1; and 256.01, subdivision 6; 1.18 Laws 1995, chapter 207, article 8, section 41, as 1.19 amended; proposing coding for new law in Minnesota 1.20 Statutes, chapter 246. 1.21 BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF MINNESOTA: 1.22 Section 1. Minnesota Statutes 1998, section 16C.10, 1.23 subdivision 5, is amended to read: 1.24 Subd. 5. [SPECIFIC PURCHASES.] The solicitation process 1.25 described in this chapter is not required for acquisition of the 1.26 following: 1.27 (1) merchandise for resale purchased under policies 1.28 determined by the commissioner; 1.29 (2) farm and garden products which, as determined by the 1.30 commissioner, may be purchased at the prevailing market price on 1.31 the date of sale; 1.32 (3) goods and services from the Minnesota correctional 1.33 facilities; 2.1 (4) goods and services from rehabilitation facilities and 2.2 sheltered workshops that are certified by the commissioner of 2.3 economic security; 2.4 (5) goods and services for use by a community-based 2.5residentialfacility operated by the commissioner of human 2.6 services; 2.7 (6) goods purchased at auction or when submitting a sealed 2.8 bid at auction provided that before authorizing such an action, 2.9 the commissioner consult with the requesting agency to determine 2.10 a fair and reasonable value for the goods considering factors 2.11 including, but not limited to, costs associated with submitting 2.12 a bid, travel, transportation, and storage. This fair and 2.13 reasonable value must represent the limit of the state's bid; 2.14 and 2.15 (7) utility services where no competition exists or where 2.16 rates are fixed by law or ordinance. 2.17 Sec. 2. Minnesota Statutes 1998, section 245.462, 2.18 subdivision 4, is amended to read: 2.19 Subd. 4. [CASEMANAGERMANAGEMENT SERVICE PROVIDER.] (a) 2.20 "Casemanagermanagement service provider" meansan individuala 2.21 case manager or case manager associate employed by the county or 2.22 other entity authorized by the county board to provide case 2.23 management services specified in section 245.4711. 2.24 A case manager must have a bachelor's degree in one of the 2.25 behavioral sciences or related fields including, but not limited 2.26 to, social work, psychology, or nursing from an accredited 2.27 college or universityand. A case manager must have at least 2.28 2,000 hours of supervised experience in the delivery of services 2.29 to adults with mental illness, must be skilled in the process of 2.30 identifying and assessing a wide range of client needs, and must 2.31 be knowledgeable about local community resources and how to use 2.32 those resources for the benefit of the client.The case manager2.33shall meet in person with a mental health professional at least2.34once each month to obtain clinical supervision of the case2.35manager's activities. Case managers with a bachelor's degree2.36but without 2,000 hours of supervised experience in the delivery3.1of services to adults with mental illness must complete 40 hours3.2of training approved by the commissioner of human services in3.3case management skills and in the characteristics and needs of3.4adults with serious and persistent mental illness and must3.5receive clinical supervision regarding individual service3.6delivery from a mental health professional at least once each3.7week until the requirement of 2,000 hours of supervised3.8experience is met.3.9 (b) Supervision for a case manager during the first year of 3.10 service providing case management services shall be one hour per 3.11 week of clinical supervision from a case management supervisor. 3.12 After the first year, the case manager shall receive regular 3.13 ongoing supervision totaling 38 hours per year, of which at 3.14 least one hour per month must be clinical supervision regarding 3.15 individual service delivery with a case management supervisor. 3.16 The remainder may be provided by a case manager with two years 3.17 of experience. Group supervision may not constitute more than 3.18 one-half of the required supervision hours. Clinical 3.19 supervision must be documented in the client record. 3.20 (c) A case manager with a bachelor's degree who is not 3.21 licensed, registered, or certified by a health-related licensing 3.22 board must receive 30 hours of continuing education and training 3.23 in mental illness and mental health services annually. 3.24 (d) A case manager with a bachelor's degree but without 3.25 2,000 hours of supervised experience described in paragraph (a), 3.26 must complete 40 hours of training approved by the commissioner 3.27 covering case management skills and the characteristics and 3.28 needs of adults with serious and persistent mental illness. 3.29 (e) Case managers without a bachelor's degree must meet one 3.30 of the requirements in clauses (1) to (3): 3.31 (1) have three or four years of experience as a case 3.32 manager associate; 3.33 (2) be a registered nurse without a bachelor's degree and 3.34 have a combination of specialized training in psychiatry and 3.35 work experience consisting of community interaction and 3.36 involvement or community discharge planning in a mental health 4.1 setting totaling three years; or 4.2 (3) be a person who qualified as a case manager under the 4.3 1998 department of human service federal waiver provision and 4.4 meet the continuing education and mentoring requirements in this 4.5 section. 4.6 (f) A case manager associate must work under the direction 4.7 of a case manager or case management supervisor and must be 21 4.8 years of age. A case manager associate must also have a high 4.9 school diploma and meet one of the following criteria: 4.10 (1) have an associate of arts degree in one of the 4.11 behavioral sciences or human services; 4.12 (2) be a registered nurse without a bachelor's degree; 4.13 (3) have three years of life experience with serious and 4.14 persistent mental illness as defined in section 245.462, 4.15 subdivision 20, within the previous ten years, or 6,000 hours 4.16 life experience as a primary caregiver to an adult with serious 4.17 and persistent mental illness within the previous ten years; 4.18 (4) have 6,000 hours work experience as a nondegreed state 4.19 hospital technician; or 4.20 (5) be a mental health practitioner as defined in section 4.21 245.462, subdivision 17, clause (2). 4.22 Individuals meeting one of the criteria in clauses (1) to 4.23 (4) may qualify as a case manager after four years of supervised 4.24 work experience as a case manager associate. Individuals 4.25 meeting the criteria in clause (5) may qualify as a case manager 4.26 after three years of supervised experience as a case manager 4.27 associate. 4.28 Case management associates must have 40 hours preservice 4.29 training under paragraph (d) and receive at least 40 hours of 4.30 continuing education in mental illness and mental health 4.31 services annually. Case manager associates shall receive at 4.32 least five hours of mentoring per week from a case management 4.33 mentor. A "case management mentor" means a qualified, 4.34 practicing case manager or case management supervisor who 4.35 teaches or advises and provides intensive training and clinical 4.36 supervision to one or more case manager associates. Mentoring 5.1 may occur while providing direct services to consumers in the 5.2 office or in the field and may be provided to individuals or 5.3 groups of case manager associates. At least two mentoring hours 5.4 per week must be individual and face-to-face. 5.5 (g) A case management supervisor must meet the criteria for 5.6 mental health professionals, as specified in section 245.462, 5.7 subdivision 18. 5.8 (h) Until June 30, 1999, an immigrant who does not have the 5.9 qualifications specified in this subdivision may provide case 5.10 management services to adult immigrants with serious and 5.11 persistent mental illness who are members of the same ethnic 5.12 group as the case manager if the person: (1) is actively 5.13 pursuing credits toward the completion of a bachelor's degree in 5.14 one of the behavioral sciences or a related field including, but 5.15 not limited to, social work, psychology, or nursing from an 5.16 accredited college or university; (2) completes 40 hours of 5.17 training as specified in this subdivision; and (3) receives 5.18 clinical supervision at least once a week until the requirements 5.19 of this subdivision are met. 5.20(b) The commissioner may approve waivers submitted by5.21counties to allow case managers without a bachelor's degree but5.22with 6,000 hours of supervised experience in the delivery of5.23services to adults with mental illness if the person:5.24(1) meets the qualifications for a mental health5.25practitioner in subdivision 26;5.26(2) has completed 40 hours of training approved by the5.27commissioner in case management skills and in the5.28characteristics and needs of adults with serious and persistent5.29mental illness; and5.30(3) demonstrates that the 6,000 hours of supervised5.31experience are in identifying functional needs of persons with5.32mental illness, coordinating assessment information and making5.33referrals to appropriate service providers, coordinating a5.34variety of services to support and treat persons with mental5.35illness, and monitoring to ensure appropriate provision of5.36services. The county board is responsible to verify that all6.1qualifications, including content of supervised experience, have6.2been met.6.3 Sec. 3. Minnesota Statutes 1998, section 245.462, 6.4 subdivision 17, is amended to read: 6.5 Subd. 17. [MENTAL HEALTH PRACTITIONER.] "Mental health 6.6 practitioner" means a person providing services to persons with 6.7 mental illness who is qualified in at least one of the following 6.8 ways: 6.9 (1) holds a bachelor's degree in one of the behavioral 6.10 sciences or related fields from an accredited college or 6.11 university and either: 6.12 (i) has at least 2,000 hours of supervised experience in 6.13 the delivery of services to persons with mental illness; or 6.14 (ii) is fluent in the non-English language of the ethnic 6.15 group to which over 50 percent of the practitioner's clients 6.16 belong, completes 40 hours of training in the delivery of 6.17 services to persons with mental illness, and is supervised by a 6.18 mental health professional at least once a week until 2,000 6.19 hours of supervised experience in delivering services to persons 6.20 with mental illness is obtained; 6.21 (2) has at least 6,000 hours of supervised experience in 6.22 the delivery of services to persons with mental illness; 6.23 (3) is a graduate student in one of the behavioral sciences 6.24 or related fields and is formally assigned by an accredited 6.25 college or university to an agency or facility for clinical 6.26 training; or 6.27 (4) holds a master's or other graduate degree in one of the 6.28 behavioral sciences or related fields from an accredited college 6.29 or university and has less than 4,000 hours post-master's 6.30 experience in the treatment of mental illness. 6.31 Sec. 4. Minnesota Statutes 1998, section 245.4711, 6.32 subdivision 1, is amended to read: 6.33 Subdivision 1. [AVAILABILITY OF CASE MANAGEMENT SERVICES.] 6.34 (a) By January 1, 1989, the county board shall provide case 6.35 management services for all adults with serious and persistent 6.36 mental illness who are residents of the county and who request 7.1 or consent to the services and to each adult for whom the court 7.2 appoints a case manager. Staffing ratios must be sufficient to 7.3 serve the needs of the clients. The case manager must meet the 7.4 requirements in section 245.462, subdivision 4. 7.5 (b) Case management services provided to adults with 7.6 serious and persistent mental illness eligible for medical 7.7 assistance must be billed to the medical assistance program 7.8 under sections 256B.02, subdivision 8, and 256B.0625. 7.9 (c) Case management services provided by a case manager 7.10 associate as defined in section 245.462, subdivision 4, are 7.11 eligible for reimbursement under the medical assistance 7.12 program. Costs associated with mentoring, supervision, and 7.13 continuing education may be included in the reimbursement rate 7.14 methodology used for case management services under the medical 7.15 assistance program. 7.16 Sec. 5. Minnesota Statutes 1998, section 245.4712, 7.17 subdivision 2, is amended to read: 7.18 Subd. 2. [DAY TREATMENT SERVICES PROVIDED.] (a) Day 7.19 treatment services must be developed as a part of the community 7.20 support services available to adults with serious and persistent 7.21 mental illness residing in the county. Adults may be required 7.22 to pay a fee according to section 245.481. Day treatment 7.23 services must be designed to: 7.24 (1) provide a structured environment for treatment; 7.25 (2) provide support for residing in the community; 7.26 (3) prevent placement in settings that are more intensive, 7.27 costly, or restrictive than necessary and appropriate to meet 7.28 client need; 7.29 (4) coordinate with or be offered in conjunction with a 7.30 local education agency's special education program; and 7.31 (5) operate on a continuous basis throughout the year. 7.32 (b) For purposes of complying with medical assistance 7.33 requirements, an adult day treatment program may choose among 7.34 the methods of clinical supervision specified in: 7.35 (1) Minnesota Rules, part 9505.0323, subpart 1, item F; 7.36 (2) Minnesota Rules, part 9505.0324, subpart 6, item F; or 8.1 (3) Minnesota Rules, part 9520.0800, subparts 2 to 6. 8.2 A day treatment program may demonstrate compliance with 8.3 these clinical supervision requirements by obtaining 8.4 certification from the commissioner under Minnesota Rules, parts 8.5 9520.0750 to 9520.0870, or by documenting in its own records 8.6 that it complies with one of the above methods. 8.7 (c) County boards may request a waiver from including day 8.8 treatment services if they can document that: 8.9 (1) an alternative plan of care exists through the county's 8.10 community support services for clients who would otherwise need 8.11 day treatment services; 8.12 (2) day treatment, if included, would be duplicative of 8.13 other components of the community support services; and 8.14 (3) county demographics and geography make the provision of 8.15 day treatment services cost ineffective and infeasible. 8.16 Sec. 6. Minnesota Statutes 1998, section 245.4871, 8.17 subdivision 4, is amended to read: 8.18 Subd. 4. [CASEMANAGERMANAGEMENT SERVICE PROVIDER.] (a) 8.19 "Casemanagermanagement service provider" meansan individuala 8.20 case manager or case manager associate employed by the county or 8.21 other entity authorized by the county board to provide case 8.22 management services specified in subdivision 3 for the child 8.23 with severe emotional disturbance and the child's family. A 8.24 case manager must have experience and training in working with 8.25 children. 8.26 (b) A case manager must: 8.27 (1) have at least a bachelor's degree in one of the 8.28 behavioral sciences or a related field including, but not 8.29 limited to, social work, psychology, or nursing from an 8.30 accredited college or university; 8.31 (2) have at least 2,000 hours of supervised experience in 8.32 the delivery of mental health services to children; 8.33 (3) have experience and training in identifying and 8.34 assessing a wide range of children's needs; and 8.35 (4) be knowledgeable about local community resources and 8.36 how to use those resources for the benefit of children and their 9.1 families. 9.2 (c) The case manager may be a member of any professional 9.3 discipline that is part of the local system of care for children 9.4 established by the county board. 9.5 (d) The case managermust meet in person with a mental9.6health professional at least once each month to obtain clinical9.7supervisionshall receive regular ongoing supervision totaling 9.8 38 hours per year, of which at least one hour per month must be 9.9 clinical supervision regarding individual service delivery with 9.10 a case management supervisor. The remainder may be provided by 9.11 a case manager with two years of experience. Group supervision 9.12 may not constitute more than one-half of the required 9.13 supervision hours. 9.14 (e) Case managers with a bachelor's degree but without 9.15 2,000 hours of supervised experience in the delivery of mental 9.16 health services to children with emotional disturbance must: 9.17 (1) begin 40 hours of training approved by the commissioner 9.18 of human services in case management skills and in the 9.19 characteristics and needs of children with severe emotional 9.20 disturbance before beginning to provide case management 9.21 services; and 9.22 (2) receive clinical supervision regarding individual 9.23 service delivery from a mental health professional at leastonce9.24 one hour each week until the requirement of 2,000 hours of 9.25 experience is met. 9.26 (f) Clinical supervision must be documented in the child's 9.27 record. When the case manager is not a mental health 9.28 professional, the county board must provide or contract for 9.29 needed clinical supervision. 9.30 (g) The county board must ensure that the case manager has 9.31 the freedom to access and coordinate the services within the 9.32 local system of care that are needed by the child. 9.33 (h) Case managers who have a bachelor's degree but are not 9.34 licensed, registered, or certified by a health-related licensing 9.35 board must receive 30 hours of continuing education and training 9.36 in severe emotional disturbance and mental health services 10.1 annually. 10.2 (i) Case managers without a bachelor's degree must meet one 10.3 of the requirements in clauses (1) to (3): 10.4 (1) have three or four years of experience as a case 10.5 manager associate; 10.6 (2) be a registered nurse without a bachelor's degree who 10.7 has a combination of specialized training in psychiatry and work 10.8 experience consisting of community interaction and involvement 10.9 or community discharge planning in a mental health setting 10.10 totaling three years; or 10.11 (3) be a person who qualified as a case manager under the 10.12 1998 department of human service federal waiver provision and 10.13 meets the continuing education and mentoring requirements in 10.14 this section. 10.15 (j) A case manager associate (CMA) must work under the 10.16 direction of a case manager or case management supervisor and 10.17 must be 21 years of age. A case manager associate must also 10.18 have a high school diploma and meet one of the following 10.19 criteria: 10.20 (1) have an associate of arts degree in one of the 10.21 behavioral sciences or human services; 10.22 (2) be a registered nurse without a bachelor's degree; 10.23 (3) have three years of life experience as a primary 10.24 caregiver to a child with serious emotional disturbance as 10.25 defined in section 245.4871, subdivision 6, within the last ten 10.26 years; 10.27 (4) have 6,000 hours work experience as a nondegreed state 10.28 hospital technician; or 10.29 (5) be a mental health practitioner as defined in section 10.30 245.462, subdivision 17, clause (2). 10.31 Individuals meeting one of the criteria in clauses (1) to 10.32 (4) may qualify as a case manager after four years of supervised 10.33 work experience as a case manager associate. Individuals 10.34 meeting the criteria in clause (5) may qualify as a case manager 10.35 after three years of supervised experience as a case manager 10.36 associate. 11.1 Case manager associates must have 40 hours of preservice 11.2 training under paragraph (e), clause (1), and receive at least 11.3 40 hours of continuing education in severe emotional disturbance 11.4 and mental health service annually. Case manager associates 11.5 shall receive at least five hours of mentoring per week from a 11.6 case management mentor. A "case management mentor" means a 11.7 qualified, practicing case manager or case management supervisor 11.8 who teaches or advises and provides intensive training and 11.9 clinical supervision to one or more case manager associates. 11.10 Mentoring may occur while providing direct services to consumers 11.11 in the office or in the field and may be provided to individuals 11.12 or groups of case manager associates. At least two mentoring 11.13 hours per week must be individual and face-to-face. 11.14 (k) A case management supervisor must meet the criteria for 11.15 a mental health professional as specified in section 245.4871, 11.16 subdivision 27. 11.17 (l) Until June 30, 1999, an immigrant who does not have the 11.18 qualifications specified in this subdivision may provide case 11.19 management services to child immigrants with severe emotional 11.20 disturbance of the same ethnic group as the immigrant if the 11.21 person: 11.22 (1) is actively pursuing credits toward the completion of a 11.23 bachelor's degree in one of the behavioral sciences or related 11.24 fields at an accredited college or university; 11.25 (2) completes 40 hours of training as specified in this 11.26 subdivision; and 11.27 (3) receives clinical supervision at least once a week 11.28 until the requirements of obtaining a bachelor's degree and 11.29 2,000 hours of supervised experience are met. 11.30(i) The commissioner may approve waivers submitted by11.31counties to allow case managers without a bachelor's degree but11.32with 6,000 hours of supervised experience in the delivery of11.33services to children with severe emotional disturbance if the11.34person:11.35(1) meets the qualifications for a mental health11.36practitioner in subdivision 26;12.1(2) has completed 40 hours of training approved by the12.2commissioner in case management skills and in the12.3characteristics and needs of children with severe emotional12.4disturbance; and12.5(3) demonstrates that the 6,000 hours of supervised12.6experience are in identifying functional needs of children with12.7severe emotional disturbance, coordinating assessment12.8information and making referrals to appropriate service12.9providers, coordinating a variety of services to support and12.10treat children with severe emotional disturbance, and monitoring12.11to ensure appropriate provision of services. The county board12.12is responsible to verify that all qualifications, including12.13content of supervised experience, have been met.12.14 Sec. 7. Minnesota Statutes 1998, section 245.4871, 12.15 subdivision 26, is amended to read: 12.16 Subd. 26. [MENTAL HEALTH PRACTITIONER.] "Mental health 12.17 practitioner" means a person providing services to children with 12.18 emotional disturbances. A mental health practitioner must have 12.19 training and experience in working with children. A mental 12.20 health practitioner must be qualified in at least one of the 12.21 following ways: 12.22 (1) holds a bachelor's degree in one of the behavioral 12.23 sciences or related fields from an accredited college or 12.24 university and either: 12.25 (i) has at least 2,000 hours of supervised experience in 12.26 the delivery of mental health services to children with 12.27 emotional disturbances; or 12.28 (ii) is fluent in the non-English language of the ethnic 12.29 group to which over 50 percent of the practitioner's clients 12.30 belong, completes 40 hours of training in the delivery of 12.31 services to children with emotional disturbances, and is 12.32 supervised by a mental health professional at least once a week 12.33 until 2,000 hours of supervised experience in delivering mental 12.34 health services to children with emotional disturbances is 12.35 obtained; 12.36 (2) has at least 6,000 hours of supervised experience in 13.1 the delivery of mental health services to children with 13.2 emotional disturbances; 13.3 (3) is a graduate student in one of the behavioral sciences 13.4 or related fields and is formally assigned by an accredited 13.5 college or university to an agency or facility for clinical 13.6 training; or 13.7 (4) holds a master's or other graduate degree in one of the 13.8 behavioral sciences or related fields from an accredited college 13.9 or university and has less than 4,000 hours post-master's 13.10 experience in the treatment of emotional disturbance. 13.11 Sec. 8. Minnesota Statutes 1998, section 245.4881, 13.12 subdivision 1, is amended to read: 13.13 Subdivision 1. [AVAILABILITY OF CASE MANAGEMENT SERVICES.] 13.14 (a) By April 1, 1992, the county board shall provide case 13.15 management services for each child with severe emotional 13.16 disturbance who is a resident of the county and the child's 13.17 family who request or consent to the services. Staffing ratios 13.18 must be sufficient to serve the needs of the clients. The case 13.19 manager must meet the requirements in section 245.4871, 13.20 subdivision 4. 13.21 (b) Except as permitted by law and the commissioner under 13.22 demonstration projects, case management services provided to 13.23 children with severe emotional disturbance eligible for medical 13.24 assistance must be billed to the medical assistance program 13.25 under sections 256B.02, subdivision 8, and 256B.0625. 13.26 (c) Case management services provided by case manager 13.27 associates as defined in section 245.4871, subdivision 4, are 13.28 eligible for reimbursement under the medical assistance 13.29 program. Costs of mentoring, supervision, and continuing 13.30 education may be included in the reimbursement rate methodology 13.31 used for case management services under the the medical 13.32 assistance program. 13.33 Sec. 9. [246.0136] [TRANSITION OF REGIONAL TREATMENT 13.34 CENTERS AND OTHER STATE-OPERATED SERVICES.] 13.35 Beginning with the 2000-2001 biennium the commissioner of 13.36 human services is directed to establish enterprise activities 14.1 within state-operated services. Enterprise activities are 14.2 defined as the range of services needed by people with 14.3 disabilities, which are delivered by state employees, and are 14.4 fully funded by public or private third-party health insurance 14.5 or other revenue sources that are available to the client that 14.6 provide reimbursement for the care provided. State-operated 14.7 services shall specialize in caring for vulnerable people for 14.8 whom no other providers are available or for whom state-operated 14.9 services may be the selected provider. The commissioner shall 14.10 determine prior to the biennial budget request the programs or 14.11 services within state-operated services that may be transitioned 14.12 to enterprise activities. Prior to the implementation of the 14.13 enterprise activity, the commissioner shall demonstrate that 14.14 there is public or private third-party health insurance or other 14.15 revenue available to the individuals served, that the revenues 14.16 collected fully fund the services, and that there are sufficient 14.17 funds for cash flow purposes. In subsequent biennia the base 14.18 state appropriation for state-operated services will be reduced 14.19 proportionate to the size of the enterprise activity. 14.20 Implementation of enterprise activities shall not limit access 14.21 to services by vulnerable populations served by state-operated 14.22 services. 14.23 Implementation will include consultation with stakeholders 14.24 including county boards, county social service agencies, 14.25 consumers, families, advocates, local mental health advisory 14.26 councils, local private and public providers, representatives of 14.27 state public employee bargaining units, and other affected state 14.28 and local agencies. All enterprise activities must conform with 14.29 collective bargaining agreements negotiated on behalf of 14.30 employees by their exclusive representatives. Implementation 14.31 shall include consideration of: 14.32 (1) creating public or private partnerships to facilitate 14.33 client access to needed services; 14.34 (2) administrative simplification and efficiencies 14.35 throughout the state-operated services system; 14.36 (3) creating a public group practice for state-operated 15.1 medical staff to increase flexibility in meeting client needs 15.2 and maximize third-party reimbursement; 15.3 (4) converting or disposing of buildings not utilized and 15.4 surplus land; and 15.5 (5) exploring the efficiencies and benefits of establishing 15.6 state-operated services as an independent state agency. 15.7 The commissioner of human services shall submit a report to 15.8 the legislature each January throughout a six-year 15.9 implementation period. 15.10 Sec. 10. Minnesota Statutes 1998, section 246.18, 15.11 subdivision 6, is amended to read: 15.12 Subd. 6. [COLLECTIONS DEDICATED.]Except for15.13state-operated programs and services funded through a direct15.14appropriation from the legislature, money received within the15.15regional treatment center system for the following15.16state-operated services is dedicated to the commissioner for the15.17provision of those services:15.18(1) community-based residential and day training and15.19habilitation services for mentally retarded persons;15.20(2) community health clinic services;15.21(3) accredited hospital outpatient department services;15.22(4) certified rehabilitation agency and rehabilitation15.23hospital services; or15.24(5) community-based transitional support services for15.25adults with serious and persistent mental illness.Except for 15.26 state-operated programs funded through a direct appropriation 15.27 from the legislature, any state-operated program or service 15.28 established and operated as an enterprise activity, shall retain 15.29 the revenues earned in an interest-bearing account. 15.30 When the commissioner determines the intent to transition 15.31 from a direct appropriation to enterprise activity, all 15.32 collections for the targeted state-operated service shall be 15.33 retained and deposited into an interest-bearing account. At the 15.34 end of the fiscal year, prior to establishing the enterprise 15.35 activity, collections up to the amount of the appropriation for 15.36 the targeted service shall be deposited to the general fund. 16.1 All funds in excess of the amount of the appropriation will be 16.2 retained and used by the enterprise activity for cash flow 16.3 purposes. 16.4 These funds must be deposited in the state treasury in a 16.5 revolving account and funds in the revolving account are 16.6 appropriated to the commissioner to operate the services 16.7 authorized, and any unexpended balances do not cancel but are 16.8 available until spent. 16.9 Sec. 11. Minnesota Statutes 1998, section 253B.045, is 16.10 amended by adding a subdivision to read: 16.11 Subd. 5. [HEALTH PLAN COMPANY; DEFINITION.] For purposes 16.12 of this section, "health plan company" has the meaning given it 16.13 in section 62Q.01, subdivision 4, and also includes a 16.14 demonstration provider as defined in section 256B.69, 16.15 subdivision 2, paragraph (b), a county or group of counties 16.16 participating in county-based purchasing according to section 16.17 256B.692, and a children's mental health collaborative under 16.18 contract to provide medical assistance for individuals enrolled 16.19 in the prepaid medical assistance and MinnesotaCare programs 16.20 according to sections 245.493 to 245.496. 16.21 Sec. 12. Minnesota Statutes 1998, section 253B.045, is 16.22 amended by adding a subdivision to read: 16.23 Subd. 6. [COVERAGE.] A health plan company must provide 16.24 coverage, according to the terms of the policy, contract, or 16.25 certificate of coverage, for all medically necessary covered 16.26 services as determined by the health plan company provided to an 16.27 enrollee that are ordered by the court under this chapter. 16.28 Sec. 13. Minnesota Statutes 1998, section 253B.07, 16.29 subdivision 1, is amended to read: 16.30 Subdivision 1. [PREPETITION SCREENING.] (a) Prior to 16.31 filing a petition for commitment of or early intervention for a 16.32 proposed patient, an interested person shall apply to the 16.33 designated agency in the county of the proposed patient's 16.34 residence or presence for conduct of a preliminary 16.35 investigation, except when the proposed patient has been 16.36 acquitted of a crime under section 611.026 and the county 17.1 attorney is required to file a petition for commitment. The 17.2 designated agency shall appoint a screening team to conduct an 17.3 investigation which shall include: 17.4 (i) a personal interview with the proposed patient and 17.5 other individuals who appear to have knowledge of the condition 17.6 of the proposed patient. If the proposed patient is not 17.7 interviewed, reasons must be documented; 17.8 (ii) identification and investigation of specific alleged 17.9 conduct which is the basis for application; 17.10 (iii) identification, exploration, and listing of the 17.11 reasons for rejecting or recommending alternatives to 17.12 involuntary placement; and 17.13 (iv) in the case of a commitment based on mental illness, 17.14 the following information, if it is known or available: 17.15 information that may be relevant to the administration of 17.16 neuroleptic medications, if necessary, including the existence 17.17 of a declaration under section 253B.03, subdivision 6d, or a 17.18 health care directive under chapter 145C or a guardian, 17.19 conservator, proxy, or agent with authority to make health care 17.20 decisions for the proposed patient; information regarding the 17.21 capacity of the proposed patient to make decisions regarding 17.22 administration of neuroleptic medication; and whether the 17.23 proposed patient is likely to consent or refuse consent to 17.24 administration of the medication. 17.25 The local agency shall seek input from the health plan 17.26 company in providing the court information about services the 17.27 enrollee needs and the "least restrictive alternatives." 17.28 (b) In conducting the investigation required by this 17.29 subdivision, the screening team shall have access to all 17.30 relevant medical records of proposed patients currently in 17.31 treatment facilities. Data collected pursuant to this clause 17.32 shall be considered private data on individuals. The 17.33 prepetition screening report is not admissible in any court 17.34 proceedings unrelated to the commitment proceedings. 17.35 (c) When the prepetition screening team recommends 17.36 commitment, a written report shall be sent to the county 18.1 attorney for the county in which the petition is to be filed. 18.2 (d) The prepetition screening team shall refuse to support 18.3 a petition if the investigation does not disclose evidence 18.4 sufficient to support commitment. Notice of the prepetition 18.5 screening team's decision shall be provided to the prospective 18.6 petitioner. 18.7 (e) If the interested person wishes to proceed with a 18.8 petition contrary to the recommendation of the prepetition 18.9 screening team, application may be made directly to the county 18.10 attorney, who may determine whether or not to proceed with the 18.11 petition. Notice of the county attorney's determination shall 18.12 be provided to the interested party. 18.13 (f) If the proposed patient has been acquitted of a crime 18.14 under section 611.026, the county attorney shall apply to the 18.15 designated county agency in the county in which the acquittal 18.16 took place for a preliminary investigation unless substantially 18.17 the same information relevant to the proposed patient's current 18.18 mental condition, as could be obtained by a preliminary 18.19 investigation, is part of the court record in the criminal 18.20 proceeding or is contained in the report of a mental examination 18.21 conducted in connection with the criminal proceeding. If a 18.22 court petitions for commitment pursuant to the rules of criminal 18.23 or juvenile procedure or a county attorney petitions pursuant to 18.24 acquittal of a criminal charge under section 611.026, the 18.25 prepetition investigation, if required by this section, shall be 18.26 completed within seven days after the filing of the petition. 18.27 Sec. 14. Minnesota Statutes 1998, section 253B.185, is 18.28 amended by adding a subdivision to read: 18.29 Subd. 5. [AFTERCARE AND CASE MANAGEMENT.] The state, in 18.30 collaboration with the designated agency, is responsible for 18.31 arranging and funding the aftercare and case management services 18.32 for persons under commitment as sexual psychopathic 18.33 personalities and sexually dangerous persons discharged after 18.34 July 1, 1999. 18.35 Sec. 15. Minnesota Statutes 1998, section 254B.01, is 18.36 amended by adding a subdivision to read: 19.1 Subd. 7. [ROOM AND BOARD RATE.] "Room and board rate" 19.2 means a rate set for shelter, fuel, food, utilities, household 19.3 supplies, and other costs necessary to provide room and board 19.4 for a person in need of chemical dependency services. 19.5 Sec. 16. Minnesota Statutes 1998, section 254B.02, 19.6 subdivision 3, is amended to read: 19.7 Subd. 3. [RESERVE ACCOUNT.] The commissioner shall 19.8 allocate money from the reserve account to counties that, during 19.9 the current fiscal year, have met or exceeded the base level of 19.10 expenditures for eligible chemical dependency services from 19.11 local money. The commissioner shall establish the base level 19.12 for fiscal year 1988 as the amount of local money used for 19.13 eligible services in calendar year 1986. In later years, the 19.14 base level must be increased in the same proportion as state 19.15 appropriations to implement Laws 1986, chapter 394, sections 8 19.16 to 20, are increased. The base level must be decreased if the 19.17 fund balance from which allocations are made under section 19.18 254B.02, subdivision 1, is decreased in later years. The local 19.19 match rate for the reserve account is the same rate as applied 19.20 to the initial allocation. Reserve account payments must not be 19.21 included when calculating the county adjustments made according 19.22 to subdivision 2. For counties providing medical assistance or 19.23 general assistance medical care through managed care plans on 19.24 January 1, 1996, the base year is fiscal year 1995. For 19.25 counties beginning provision of managed care after January 1, 19.26 1996, the base year is the most recent fiscal year before 19.27 enrollment in managed care begins. For counties providing 19.28 managed care, the base level will be increased or decreased in 19.29 proportion to changes in the fund balance from which allocations 19.30 are made under subdivision 2, but will be additionally increased 19.31 or decreased in proportion to the change in county adjusted 19.32 population made in subdivision 1, paragraphs (b) and 19.33 (c). Effective July 1, 1999, any funds deposited in the reserve 19.34 account funds in excess of those needed to meet obligations 19.35 incurred under this section and sections 254B.06 and 254B.09 19.36 shall cancel to the general fund. 20.1 Sec. 17. Minnesota Statutes 1998, section 254B.03, 20.2 subdivision 2, is amended to read: 20.3 Subd. 2. [CHEMICAL DEPENDENCYSERVICESFUND PAYMENT.] (a) 20.4 Payment from the chemical dependency fund is limited to payments 20.5 for services other than detoxification that, if located outside 20.6 of federally recognized tribal lands, would be required to be 20.7 licensed by the commissioner as a chemical dependency treatment 20.8 or rehabilitation program under sections 245A.01 to 245A.16, and 20.9 services other than detoxification provided in another state 20.10 that would be required to be licensed as a chemical dependency 20.11 program if the program were in the state. Out of state vendors 20.12 must also provide the commissioner with assurances that the 20.13 program complies substantially with state licensing requirements 20.14 and possesses all licenses and certifications required by the 20.15 host state to provide chemical dependency treatment.Hospitals20.16may apply for and receive licenses to be eligible vendors,20.17notwithstanding the provisions of section 245A.03.Except for 20.18 chemical dependency transitional rehabilitation programs, 20.19 vendors receiving payments from the chemical dependency fund 20.20 must not require copayment from a recipient of benefits for 20.21 services provided under this subdivision. Payment from the 20.22 chemical dependency fund shall be made for necessary room and 20.23 board costs provided by vendors certified according to section 20.24 254B.05, or in a community hospital licensed by the commissioner 20.25 of the department of health according to sections 144.50 to 20.26 144.56 to a client who is: 20.27 (1) determined to meet the criteria for placement in a 20.28 residential chemical dependency treatment program according to 20.29 rules adopted under section 254A.03, subdivision 3; and 20.30 (2) concurrently receiving a chemical dependency treatment 20.31 service in a program licensed by the commissioner and reimbursed 20.32 by the chemical dependency fund. 20.33 (b) A county may, from its own resources, provide chemical 20.34 dependency services for which state payments are not made. A 20.35 county may elect to use the same invoice procedures and obtain 20.36 the same state payment services as are used for chemical 21.1 dependency services for which state payments are made under this 21.2 section if county payments are made to the state in advance of 21.3 state payments to vendors. When a county uses the state system 21.4 for payment, the commissioner shall make monthly billings to the 21.5 county using the most recent available information to determine 21.6 the anticipated services for which payments will be made in the 21.7 coming month. Adjustment of any overestimate or underestimate 21.8 based on actual expenditures shall be made by the state agency 21.9 by adjusting the estimate for any succeeding month. 21.10 (c) The commissioner shall coordinate chemical dependency 21.11 services and determine whether there is a need for any proposed 21.12 expansion of chemical dependency treatment services. The 21.13 commissioner shall deny vendor certification to any provider 21.14 that has not received prior approval from the commissioner for 21.15 the creation of new programs or the expansion of existing 21.16 program capacity. The commissioner shall consider the 21.17 provider's capacity to obtain clients from outside the state 21.18 based on plans, agreements, and previous utilization history, 21.19 when determining the need for new treatment services. 21.20 Sec. 18. Minnesota Statutes 1998, section 254B.04, 21.21 subdivision 1, is amended to read: 21.22 Subdivision 1. [ELIGIBILITY.] (a) Persons eligible for 21.23 benefits under Code of Federal Regulations, title 25, part 20, 21.24 persons eligible for medical assistance benefits under sections 21.25 256B.055, 256B.056, and 256B.057, subdivisions 1, 2, 5, and 6, 21.26 or who meet the income standards of section 256B.056, 21.27 subdivision 4, and persons eligible for general assistance 21.28 medical care under section 256D.03, subdivision 3, are entitled 21.29 to chemical dependency fund services. State money appropriated 21.30 for this paragraph must be placed in a separate account 21.31 established for this purpose. 21.32 (b) A person not entitled to services under paragraph (a), 21.33 but with family income that is less than 60 percent of the state 21.34 median income for a family of like size and composition, shall 21.35 be eligible to receive chemical dependency fund services within 21.36 the limit of funds available after persons entitled to services 22.1 under paragraph (a) have been served. A county may spend money 22.2 from its own sources to serve persons under this paragraph. 22.3 State money appropriated for this paragraph must be placed in a 22.4 separate account established for this purpose. 22.5 (c) Persons whose income is between 60 percent and 115 22.6 percent of the state median income shall be eligible for 22.7 chemical dependency services on a sliding fee basis, within the 22.8 limit of funds available, after persons entitled to services 22.9 under paragraph (a) and persons eligible for services under 22.10 paragraph (b) have been served. Persons eligible under this 22.11 paragraph must contribute to the cost of services according to 22.12 the sliding fee scale established under subdivision 3. A county 22.13 may spend money from its own sources to provide services to 22.14 persons under this paragraph. State money appropriated for this 22.15 paragraph must be placed in a separate account established for 22.16 this purpose. 22.17 Sec. 19. Minnesota Statutes 1998, section 254B.05, 22.18 subdivision 1, is amended to read: 22.19 Subdivision 1. [LICENSURE REQUIRED.] Programs licensed by 22.20 the commissioner are eligible vendors. Hospitals may apply for 22.21 and receive licenses to be eligible vendors, notwithstanding the 22.22 provisions of section 245A.03. American Indian programs located 22.23 on federally recognized tribal lands that provide chemical 22.24 dependency primary treatment, extended care, transitional 22.25 residence, or outpatient treatment services, and are licensed by 22.26 tribal government are eligible vendors. Detoxification programs 22.27 are not eligible vendors. Programs that are not licensed as a 22.28 chemical dependency residential or nonresidential treatment 22.29 program by the commissioner or by tribal government are not 22.30 eligible vendors. To be eligible for payment under the 22.31 Consolidated Chemical Dependency Treatment Fund, a vendor of a 22.32 chemical dependency service must participate in the Drug and 22.33 Alcohol Abuse Normative Evaluation System and the treatment 22.34 accountability plan. 22.35 Effective January 1, 2000, vendors of room and board are 22.36 eligible for chemical dependency fund payment if the vendor: 23.1 (1) is certified by the county or tribal governing body as 23.2 having rules prohibiting residents bringing chemicals into the 23.3 facility or using chemicals while residing in the facility and 23.4 provide consequences for infractions of those rules; 23.5 (2) has a current contract with a county or tribal 23.6 governing body; 23.7 (3) is determined to meet applicable health and safety 23.8 requirements; 23.9 (4) is not a jail or prison; and 23.10 (5) is not concurrently receiving funds under chapter 256I 23.11 for the recipient. 23.12 Sec. 20. Minnesota Statutes 1998, section 256.01, 23.13 subdivision 6, is amended to read: 23.14 Subd. 6. [ADVISORY TASK FORCES.] The commissioner may 23.15 appoint advisory task forces to provide consultation on any of 23.16 the programs under the commissioner's administration and 23.17 supervision. A task force shall expire and the compensation, 23.18 terms of office and removal of members shall be as provided in 23.19 section 15.059. Notwithstanding section 15.059, the 23.20 commissioner may pay a per diem of $35 to consumers and family 23.21 members whose participation is needed in legislatively 23.22 authorized state-level task forces, and whose participation on 23.23 the task force is not as a paid representative of any agency, 23.24 organization, or association. 23.25 Sec. 21. Laws 1995, chapter 207, article 8, section 41, as 23.26 amended by Laws 1997, chapter 203, article 7, section 25, is 23.27 amended to read: 23.28 Sec. 41. [245.4661] [PILOT PROJECTSINITIATIVES TO 23.29TESTPROVIDE ALTERNATIVES TO DELIVERY OF ADULT MENTAL HEALTH 23.30 SERVICES.] 23.31 Subdivision 1. [AUTHORIZATION FORPILOT PROJECTSADULT 23.32 MENTAL HEALTH INITIATIVES.] The commissioner of human services 23.33 may approvepilot projectsadult mental health initiatives to 23.34testprovide alternatives to orthe enhancedenhance 23.35 coordination of the delivery of mental health services required 23.36 under the Minnesota Comprehensive Adult Mental Health Act, 24.1 Minnesota Statutes, sections 245.461 to 245.486. 24.2 Subd. 2. [PROGRAM DESIGN AND IMPLEMENTATION.] (a) The 24.3pilot projectsadult mental health initiatives shall be 24.4 established to design, plan, and improve the mental health 24.5 service delivery system for adults with serious and persistent 24.6 mental illness that would: 24.7 (1) provide an expanded array of services from which 24.8 clients can choose services appropriate to their needs; 24.9 (2) be based on purchasing strategies that improve access 24.10 and coordinate services without cost shifting; 24.11 (3) incorporate existing state facilities and resources 24.12 into the community mental health infrastructure through creative 24.13 partnerships with local vendors; and 24.14 (4) utilize existing categorical funding streams and 24.15 reimbursement sources in combined and creative ways, except 24.16 appropriations to regional treatment centers and all funds that 24.17 are attributable to the operation of state-operated services are 24.18 excluded unless appropriated specifically by the legislature for 24.19 a purpose consistent with this section. 24.20 (b) Allprojectsinitiatives funded by January 1, 1997, 24.21 must complete the planning phase and be operational by June 30, 24.22 1997; all projects funded by January 1, 1998, must be 24.23 operational by June 30, 1998. 24.24 Subd. 3. [PROGRAM EVALUATION.] Evaluation of eachproject24.25 initiative will be based on outcome evaluation criteria 24.26 negotiated with each project prior to implementation. 24.27 Subd. 4. [NOTICE OF PROJECT DISCONTINUATION.] Eachproject24.28 initiative may be discontinued for any reason by theproject's24.29 initiative's managing entity or the commissioner of human 24.30 services, after 90 days' written notice to the other party. 24.31 Subd. 5. [PLANNING FORPILOT PROJECTSADULT MENTAL HEALTH 24.32 INITIATIVES.] Each local plan fora pilot projectan initiative 24.33 must be developed under the direction of the county board, or 24.34 multiple county boards acting jointly, as the local mental 24.35 health authority. The planning process for each 24.36pilotinitiative shall include, but not be limited to, mental 25.1 health consumers, families, advocates, local mental health 25.2 advisory councils, local and state providers, representatives of 25.3 state and local public employee bargaining units, and the 25.4 department of human services. As part of the planning process, 25.5 the county board or boards shall designate a managing entity 25.6 responsible for receipt of funds and management of thepilot25.7projectinitiative. 25.8 Subd. 6. [DUTIES OF COMMISSIONER.] (a) For purposes of the 25.9pilot projectsadult mental health initiatives, the commissioner 25.10 shall facilitate integration of funds or other resources as 25.11 needed and requested by eachprojectinitiative. These 25.12 resources may include: 25.13 (1) residential services funds administered under Minnesota 25.14 Rules, parts 9535.2000 to 9535.3000, in an amount to be 25.15 determined by mutual agreement between theproject's25.16 initiative's managing entity and the commissioner of human 25.17 services after an examination of the county's historical 25.18 utilization of facilities located both within and outside of the 25.19 county and licensed under Minnesota Rules, parts 9520.0500 to 25.20 9520.0690; 25.21 (2) community support services funds administered under 25.22 Minnesota Rules, parts 9535.1700 to 9535.1760; 25.23 (3) other mental health special project funds; 25.24 (4) medical assistance, general assistance medical care, 25.25 MinnesotaCare and group residential housing if requested by the 25.26project'sinitiative's managing entity, and if the commissioner 25.27 determines this would be consistent with the state's overall 25.28 health care reform efforts; and 25.29 (5) regional treatment center nonfiscal resources to the 25.30 extent agreed to by theproject'sinitiative's managing entity 25.31 and the regional treatment center. 25.32 (b) The commissioner shall consider the following criteria 25.33 in awarding start-up and implementation grants for thepilot25.34projectsadult mental health initiatives: 25.35 (1) the ability of the proposedprojectsinitiatives to 25.36 accomplish the objectives described in subdivision 2; 26.1 (2) the size of the target population to be served; and 26.2 (3) geographical distribution. 26.3 (c)The commissioner shall review overall status of the26.4projects initiatives at least every two years and recommend any26.5legislative changes needed by January 15 of each odd-numbered26.6year.26.7(d)The commissioner may waive administrative rule 26.8 requirements which are incompatible with the implementation of 26.9 thepilot projectadult mental health initiatives. 26.10(e)(d) The commissioner may exempt the participating 26.11 counties from fiscal sanctions for noncompliance with 26.12 requirements in laws and rules which are incompatible with the 26.13 implementation of thepilot projectadult mental health 26.14 initiative. 26.15(f)(e) The commissioner may award grants to an entity 26.16 designated by a county board or group of county boards to pay 26.17 for start-up and implementation costs of thepilot projectadult 26.18 mental health initiative. 26.19 Subd. 7. [DUTIES OF COUNTY BOARD.] The county board, or 26.20 other entity which is approved to administera pilot projectan 26.21 adult mental health initiative, shall: 26.22 (1) administer the project in a manner which is consistent 26.23 with the objectives described in subdivision 2 and the planning 26.24 process described in subdivision 5; 26.25 (2) assure that no one is denied services for which they 26.26 would otherwise be eligible; and 26.27 (3) provide the commissioner of human services with timely 26.28 and pertinent information through the following methods: 26.29 (i) submission of community social services act plans and 26.30 plan amendments; 26.31 (ii) submission of social services expenditure and grant 26.32 reconciliation reports, based on a coding format to be 26.33 determined by mutual agreement between theproject's26.34 initiatives's managing entity and the commissioner; and 26.35 (iii) submission of data and participation in an evaluation 26.36 of thepilot projectsadult mental health initiatives, to be 27.1 designed cooperatively by the commissioner and theprojects27.2 initiatives.