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HF 2609

as introduced - 89th Legislature (2015 - 2016) Posted on 04/06/2016 12:53pm

KEY: stricken = removed, old language.
underscored = added, new language.
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A bill for an act
relating to human services; modifying certain certified community behavioral
health clinic requirements; amending Minnesota Statutes 2015 Supplement,
section 245.735, subdivisions 3, 4.

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

Section 1.

Minnesota Statutes 2015 Supplement, section 245.735, subdivision 3,
is amended to read:


Subd. 3.

deleted text beginReform projectsdeleted text endnew text begin Certified community behavioral health clinicsnew text end.

(a) The
commissioner shall establish deleted text beginstandards fordeleted text endnew text begin anew text end state certification deleted text beginof clinics asdeleted text endnew text begin process for
new text endcertified community behavioral health clinicsdeleted text begin, in accordancedeleted text endnew text begin (CCBHCs) to be eligible for
the prospective payment system in paragraph (f). Entities that choose to be CCBHCs must:
new text end

new text begin (1) complynew text end with the new text beginCCBHC new text endcriteria published deleted text beginon or before September 1, 2015,deleted text end by
the United States Department of Health and Human Servicesdeleted text begin. Certification standards
established by the commissioner shall require that:
deleted text endnew text begin;
new text end

deleted text begin (1)deleted text endnew text begin (2) employ or contract fornew text end clinic staff new text beginwho new text endhave backgrounds in diverse
disciplines, deleted text beginincludedeleted text endnew text begin includingnew text end licensed mental health professionals, and new text beginstaff who new text endare
culturally and linguistically trained to serve the needs of the clinic's patient population;

deleted text begin (2)deleted text endnew text begin (3) ensure thatnew text end clinic services are available and accessible and that crisis
management services are available 24 hours per day;

deleted text begin (3)deleted text endnew text begin (4) establishnew text end fees for clinic services deleted text beginare establisheddeleted text endnew text begin for non-medical assistance
patients
new text end using a sliding fee scale deleted text beginanddeleted text endnew text begin that ensures thatnew text end services to patients are not denied
or limited due to a patient's inability to pay for services;

deleted text begin (4) clinicsdeleted text endnew text begin (5) new text end provide coordination of care across settings and providers to ensure
seamless transitions for patients across the full spectrum of health services, including
acute, chronic, and behavioral needs. Care coordination may be accomplished through
partnerships or formal contracts with new text begincounties, health plans, pharmacists, rural health
clinics,
new text endfederally qualified health centers, inpatient psychiatric facilities, substance use and
detoxification facilities, community-based mental health providers, and other community
services, supports, and providers including schools, child welfare agencies, juvenile and
criminal justice agencies, Indian Health Services clinics, tribally licensed health care
and mental health facilities, urban Indian health clinics, Department of Veterans Affairs
medical centers, outpatient clinics, drop-in centers, acute care hospitals, and hospital
outpatient clinics;

deleted text begin (5) services provided by clinics includedeleted text endnew text begin (6) providenew text end crisis mental health services,
emergency crisis intervention services, and stabilization services; screening, assessment,
and diagnosis services, including risk assessments and level of care determinations;
patient-centered treatment planning; outpatient mental health and substance use services;
targeted case management; psychiatric rehabilitation services; peer support and counselor
services and family support services; and intensive community-based mental health
services, including mental health services for members of the armed forces and veterans;
deleted text beginand
deleted text end

deleted text begin (6) clinicsdeleted text endnew text begin (7)new text end comply with quality assurance reporting requirements and other
reporting requirements, including any required reporting of encounter data, clinical
outcomes data, and quality datadeleted text begin.deleted text endnew text begin;
new text end

new text begin (8) be certified as mental health clinics under section 245.69, subdivision 2;
new text end

new text begin (9) comply with standards relating to integrated treatment for co-occurring mental
illness and substance use disorders in adults or children under Minnesota Rules, chapter
9533;
new text end

new text begin (10) comply with standards relating to mental health services in Minnesota Rules,
parts 9505.0370 to 9505.0372;
new text end

new text begin (11) be licensed to provide chemical dependency treatment under Minnesota Rules,
parts 9530.6405 to 9530.6505;
new text end

new text begin (12) be certified to provide children's therapeutic services and supports under
section 256B.0943;
new text end

new text begin (13) be certified to provide adult rehabilitative mental health services under section
256B.0623;
new text end

new text begin (14) be enrolled to provide mental health crisis response services under section
256B.0624;
new text end

new text begin (15) be enrolled to provide mental health targeted case management under section
256B.0625, subdivision 20;
new text end

new text begin (16) comply with standards relating to mental health case management in Minnesota
Rules, parts 9520.0900 to 9520.0926; and
new text end

new text begin (17) provide services that comply with the evidence-based practices described in
paragraph (e).
new text end

new text begin (b) If an entity is unable to provide one or more of the services listed in paragraph
(a), clauses (6) to (17), the commissioner may certify the entity as a CCBHC if it has a
current contract with another entity that has the required authority to provide that service
and that meets federal CCBHC criteria as a designated collaborating organization; or, to
the extent allowed by the federal CCBHC criteria, the commissioner may approve a
referral arrangement. The CCBHC must meet federal requirements regarding the type and
scope of services to be provided directly by the CCBHC.
new text end

new text begin (c) Notwithstanding other law that requires a county contract or other form of county
approval for certain services listed in paragraph (a), clause (6), a clinic that otherwise
meets CCBHC requirements may receive the prospective payment under paragraph (f)
for those services without a county contract or county approval. There is no county
share when medical assistance pays the CCBHC prospective payment. As part of the
certification process in paragraph (a), the commissioner shall require a letter of support
from the CCBHC's host county confirming that the CCBHC and the counties it serves
have an ongoing relationship to facilitate access and continuity of care, especially for
individuals who are uninsured or who may go on and off medical assistance.
new text end

new text begin (d) In situations where the standards listed in paragraph (a) or other applicable
standards conflict or address similar issues in duplicative or incompatible ways, the
commissioner may grant variances to state requirements as long as the variances do not
conflict with federal requirements. In situations where standards overlap, the commissioner
may decide to substitute all or a part of a licensure or certification that is substantially
the same as another licensure or certification. The commissioner shall consult with
stakeholders, as described in subdivision 4, before granting variances under this provision.
new text end

new text begin (e) The commissioner shall issue a list of required and recommended evidence-based
practices to be delivered by certified community behavioral health clinics. The
commissioner may update the list to reflect advances in outcomes research and medical
services for persons living with mental illnesses or substance use disorders. The
commissioner shall take into consideration the adequacy of evidence to support the
efficacy of the practice, the quality of workforce available, and the current availability of
the practice in the state. At least 30 days before issuing the initial list and any revisions,
the commissioner shall provide stakeholders with an opportunity to comment.
new text end

deleted text begin (b)deleted text endnew text begin (f)new text end The commissioner shall establish standards and methodologies for a
prospective payment system for medical assistance payments for mental health services
delivered by certified community behavioral health clinics, in accordance with guidance
issued deleted text beginon or before September 1, 2015,deleted text end by the Centers for Medicare and Medicaid
Services. During the operation of the demonstration project, payments shall comply
with federal requirements for deleted text begina 90 percentdeleted text endnew text begin annew text end enhanced federal medical assistance
percentage. new text beginThe commissioner may include quality bonus payments in the prospective
payment system based on federal criteria and on a clinic's provision of the evidence-based
practices in paragraph (e). The prospective payment system does not include services
that have cost-based rates under other law. The prospective payments system does not
apply to MinnesotaCare. Implementation of the prospective payment system is effective
upon federal approval.
new text end

new text begin (g) The commissioner shall seek federal approval to continue federal financial
participation in payment for CCBHC services after the federal demonstration period
ends for clinics that were certified as CCBHCs during the demonstration period and
that continue to meet the CCBHC certification standards in paragraph (a). Payment
for CCBHC services shall cease effective July 1, 2019, if continued federal financial
participation for the payment of CCBHC services cannot be obtained.
new text end

new text begin (h) To the extent allowed by federal law, the commissioner may limit the number of
certified clinics so that the projected claims for certified clinics will not exceed the funds
budgeted for this purpose. The commissioner shall give preference to clinics that:
new text end

new text begin (1) are located in both rural and urban areas, with at least one in each, as defined
by federal criteria;
new text end

new text begin (2) provide a comprehensive range of services and evidence-based practices for all
age groups, with services being fully coordinated and integrated; and
new text end

new text begin (3) enhance the state's ability to meet the federal priorities to be selected as a
CCBHC demonstration state.
new text end

new text begin (i) The commissioner shall recertify CCBHCs at least every three years. The
commissioner shall establish a process for decertification and shall require corrective
action, medical assistance repayment, or decertification of a CCBHC that no longer
meets the requirements in this section or that fails to meet the standards provided by the
commissioner in the application and certification process.
new text end

new text begin EFFECTIVE DATE. new text end

new text begin This section is effective the day following final enactment.
new text end

Sec. 2.

Minnesota Statutes 2015 Supplement, section 245.735, subdivision 4, is
amended to read:


Subd. 4.

Public participation.

In developing deleted text beginthe projectsdeleted text endnew text begin and implementing
certified community behavioral health clinics
new text end under subdivision 3, the commissioner shall
consultnew text begin, collaborate, and partnernew text end with new text beginstakeholders, including but not limited to new text endmental
health providers, new text beginsubstance use disorder treatment providers, new text endadvocacy organizations,
licensed mental health professionals, new text begincounties, tribes, hospitals, other health care
providers,
new text endand Minnesota public health care program enrollees who receive mental health
services and their families.

new text begin EFFECTIVE DATE. new text end

new text begin This section is effective the day following final enactment.
new text end