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HF 3418

1st Engrossment - 92nd Legislature (2021 - 2022) Posted on 04/19/2022 11:29am

KEY: stricken = removed, old language.
underscored = added, new language.
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A bill for an act
relating to mental health; making additional mental health professionals eligible
for loan forgiveness under the health professional education loan forgiveness
program; establishing a mental health provider supervision grant program and a
mental health professional scholarship grant program; modifying qualifications
for case managers; appropriating money; amending Minnesota Statutes 2020,
sections 144.1501, subdivision 4; 245.462, subdivision 4; Minnesota Statutes 2021
Supplement, section 144.1501, subdivision 2; 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 2021 Supplement, section 144.1501, subdivision 2, is
amended to read:


Subd. 2.

Creation of account.

(a) A health professional education loan forgiveness
program account is established. The commissioner of health shall use money from the
account to establish a loan forgiveness program:

(1) for medical residents, mental health professionals, and alcohol and drug counselors
agreeing to practice in designated rural areas or underserved urban communities or
specializing in the area of pediatric psychiatry;

(2) for midlevel practitioners agreeing to practice in designated rural areas or to teach
at least 12 credit hours, or 720 hours per year in the nursing field in a postsecondary program
at the undergraduate level or the equivalent at the graduate level;

(3) for nurses who agree to practice in a Minnesota nursing home; an intermediate care
facility for persons with developmental disability; a hospital if the hospital owns and operates
a Minnesota nursing home and a minimum of 50 percent of the hours worked by the nurse
is in the nursing home; a housing with services establishment as defined in section 144D.01,
subdivision 4; or for a home care provider as defined in section 144A.43, subdivision 4; or
agree to teach at least 12 credit hours, or 720 hours per year in the nursing field in a
postsecondary program at the undergraduate level or the equivalent at the graduate level;

(4) for other health care technicians agreeing to teach at least 12 credit hours, or 720
hours per year in their designated field in a postsecondary program at the undergraduate
level or the equivalent at the graduate level. The commissioner, in consultation with the
Healthcare Education-Industry Partnership, shall determine the health care fields where the
need is the greatest, including, but not limited to, respiratory therapy, clinical laboratory
technology, radiologic technology, and surgical technology;

(5) for pharmacists, advanced dental therapists, dental therapists, and public health nurses
who agree to practice in designated rural areas; deleted text beginand
deleted text end

(6) for dentists agreeing to deliver at least 25 percent of the dentist's yearly patient
encounters to state public program enrollees or patients receiving sliding fee schedule
discounts through a formal sliding fee schedule meeting the standards established by the
United States Department of Health and Human Services under Code of Federal Regulations,
title 42, section deleted text begin51, chapter 303.deleted text endnew text begin 51c.303; and
new text end

new text begin (7) for mental health professionals agreeing to provide up to 768 hours per year of clinical
supervision in their designated field.
new text end

(b) Appropriations made to the account do not cancel and are available until expended,
except that at the end of each biennium, any remaining balance in the account that is not
committed by contract and not needed to fulfill existing commitments shall cancel to the
fund.

Sec. 2.

Minnesota Statutes 2020, section 144.1501, subdivision 4, is amended to read:


Subd. 4.

Loan forgiveness.

The commissioner of health may select applicants each year
for participation in the loan forgiveness program, within the limits of available funding. In
considering applicationsnew text begin from applicants who are mental health professionals, the
commissioner shall give preference to applicants who demonstrate competence in providing
culturally responsive services or are providing services to underserved communities,
including communities in rural areas. In considering applications from all other applicants
new text end,
the commissioner shall give preference to applicants who document diverse cultural
competencies. The commissioner shall distribute available funds for loan forgiveness
proportionally among the eligible professions according to the vacancy rate for each
profession in the required geographic area, facility type, teaching area, patient group, or
specialty type specified in subdivision 2. The commissioner shall allocate funds for physician
loan forgiveness so that 75 percent of the funds available are used for rural physician loan
forgiveness and 25 percent of the funds available are used for underserved urban communities
and pediatric psychiatry loan forgiveness. If the commissioner does not receive enough
qualified applicants each year to use the entire allocation of funds for any eligible profession,
the remaining funds may be allocated proportionally among the other eligible professions
according to the vacancy rate for each profession in the required geographic area, patient
group, or facility type specified in subdivision 2. Applicants are responsible for securing
their own qualified educational loans. The commissioner shall select participants based on
their suitability for practice serving the required geographic area or facility type specified
in subdivision 2, as indicated by experience or training. The commissioner shall give
preference to applicants closest to completing their training. For each year that a participant
meets the service obligation required under subdivision 3, up to a maximum of four years,
the commissioner shall make annual disbursements directly to the participant equivalent to
15 percent of the average educational debt for indebted graduates in their profession in the
year closest to the applicant's selection for which information is available, not to exceed the
balance of the participant's qualifying educational loans. Before receiving loan repayment
disbursements and as requested, the participant must complete and return to the commissioner
a confirmation of practice form provided by the commissioner verifying that the participant
is practicing as required under subdivisions 2 and 3. The participant must provide the
commissioner with verification that the full amount of loan repayment disbursement received
by the participant has been applied toward the designated loans. After each disbursement,
verification must be received by the commissioner and approved before the next loan
repayment disbursement is made. Participants who move their practice remain eligible for
loan repayment as long as they practice as required under subdivision 2.

Sec. 3.

new text begin [144.1508] MENTAL HEALTH PROVIDER SUPERVISION GRANT
PROGRAM.
new text end

new text begin Subdivision 1. new text end

new text begin Definitions. new text end

new text begin (a) For purposes of this section, the following terms have
the meanings given.
new text end

new text begin (b) "Mental health professional" means an individual with a qualification specified in
section 245I.04, subdivision 2.
new text end

new text begin (c) "Underrepresented community" has the meaning given in section 148E.010,
subdivision 20.
new text end

new text begin Subd. 2. new text end

new text begin Grant program established. new text end

new text begin The commissioner of health shall award grants
to licensed or certified mental health providers who meet the criteria in subdivision 3 to
fund supervision of interns and clinical trainees who are working toward becoming a licensed
mental health professional and to subsidize the costs of mental health professional licensing
applications and examination fees for clinical trainees.
new text end

new text begin Subd. 3. new text end

new text begin Eligible providers. new text end

new text begin In order to be eligible for a grant under this section, a mental
health provider must:
new text end

new text begin (1) provide at least 25 percent of the provider's yearly patient encounters to state public
program enrollees or patients receiving sliding fee schedule discounts through a formal
sliding fee schedule meeting the standards established by the United States Department of
Health and Human Services under Code of Federal Regulations, title 42, section 51c.303;
or
new text end

new text begin (2) primarily serve persons from communities of color or underrepresented communities.
new text end

new text begin Subd. 4. new text end

new text begin Application; grant award. new text end

new text begin A mental health provider seeking a grant under
this section must apply to the commissioner at a time and in a manner specified by the
commissioner. The commissioner shall review each application to determine if the application
is complete, the mental health provider is eligible for a grant, and the proposed project is
an allowable use of grant funds. The commissioner must determine the grant amount awarded
to applicants that the commissioner determines will receive a grant.
new text end

new text begin Subd. 5. new text end

new text begin Allowable uses of grant funds. new text end

new text begin A mental health provider must use grant funds
received under this section for one or more of the following:
new text end

new text begin (1) to pay for direct supervision hours for interns and clinical trainees, in an amount up
to $7,500 per intern or clinical trainee;
new text end

new text begin (2) to establish a program to provide supervision to multiple interns or clinical trainees;
or
new text end

new text begin (3) to pay mental health professional licensing application and examination fees for
clinical trainees.
new text end

new text begin Subd. 6. new text end

new text begin Program oversight. new text end

new text begin During the grant period, the commissioner may require
grant recipients to provide the commissioner with information necessary to evaluate the
program.
new text end

Sec. 4.

new text begin [144.1509] MENTAL HEALTH PROFESSIONAL SCHOLARSHIP GRANT
PROGRAM.
new text end

new text begin Subdivision 1. new text end

new text begin Definitions. new text end

new text begin (a) For purposes of this section, the following terms have
the meanings given.
new text end

new text begin (b) "Mental health professional" means an individual with a qualification specified in
section 245I.04, subdivision 2.
new text end

new text begin (c) "Underrepresented community" has the meaning given in section 148E.010,
subdivision 20.
new text end

new text begin Subd. 2. new text end

new text begin Grant program established. new text end

new text begin A mental health professional scholarship program
is established to assist mental health providers in funding employee scholarships for master's
level education programs in order to create a pathway to becoming a mental health
professional.
new text end

new text begin Subd. 3. new text end

new text begin Provision of grants. new text end

new text begin The commissioner of health shall award grants to licensed
or certified mental health providers who meet the criteria in subdivision 4 to provide tuition
reimbursement for master's level programs and certain related costs for individuals who
have worked for the mental health provider for at least the past two years in one or more of
the following roles:
new text end

new text begin (1) a mental health behavioral aide who meets a qualification in section 245I.04,
subdivision 16;
new text end

new text begin (2) a mental health certified family peer specialist who meets the qualifications in section
245I.04, subdivision 12;
new text end

new text begin (3) a mental health certified peer specialist who meets the qualifications in section
245I.04, subdivision 10;
new text end

new text begin (4) a mental health practitioner who meets a qualification in section 245I.04, subdivision
4;
new text end

new text begin (5) a mental health rehabilitation worker who meets the qualifications in section 245I.04,
subdivision 14;
new text end

new text begin (6) an individual employed in a role in which the individual provides face-to-face client
services at a mental health center or certified community behavioral health center; or
new text end

new text begin (7) a staff person who provides care or services to residents of a residential treatment
facility.
new text end

new text begin Subd. 4. new text end

new text begin Eligibility. new text end

new text begin In order to be eligible for a grant under this section, a mental health
provider must:
new text end

new text begin (1) primarily provide at least 25 percent of the provider's yearly patient encounters to
state public program enrollees or patients receiving sliding fee schedule discounts through
a formal sliding fee schedule meeting the standards established by the United States
Department of Health and Human Services under Code of Federal Regulations, title 42,
section 51c.303; or
new text end

new text begin (2) primarily serve people from communities of color or underrepresented communities.
new text end

new text begin Subd. 5. new text end

new text begin Request for proposals. new text end

new text begin The commissioner must publish a request for proposals
in the State Register specifying provider eligibility requirements, criteria for a qualifying
employee scholarship program, provider selection criteria, documentation required for
program participation, the maximum award amount, and methods of evaluation. The
commissioner must publish additional requests for proposals each year in which funding is
available for this purpose.
new text end

new text begin Subd. 6. new text end

new text begin Application requirements. new text end

new text begin An eligible provider seeking a grant under this
section must submit an application to the commissioner. An application must contain a
complete description of the employee scholarship program being proposed by the applicant,
including the need for the mental health provider to enhance the education of its workforce,
the process the mental health provider will use to determine which employees will be eligible
for scholarships, any other funding sources for scholarships, the amount of funding sought
for the scholarship program, a proposed budget detailing how funds will be spent, and plans
to retain eligible employees after completion of the education program.
new text end

new text begin Subd. 7. new text end

new text begin Selection process. new text end

new text begin The commissioner shall determine a maximum award amount
for grants and shall select grant recipients based on the information provided in the grant
application, including the demonstrated need for the applicant provider to enhance the
education of its workforce, the proposed process to select employees for scholarships, the
applicant's proposed budget, and other criteria as determined by the commissioner.
new text end

new text begin Subd. 8. new text end

new text begin Grant agreements. new text end

new text begin Notwithstanding any law or rule to the contrary, funds
awarded to a grant recipient in a grant agreement do not lapse until the grant agreement
expires.
new text end

new text begin Subd. 9. new text end

new text begin Allowable uses of grant funds. new text end

new text begin A mental health provider receiving a grant
under this section must use the grant funds for one or more of the following:
new text end

new text begin (1) to provide employees with tuition reimbursement for a master's level program in a
discipline that will allow the employee to qualify as a mental health professional; or
new text end

new text begin (2) for resources and supports, such as child care and transportation, that allow an
employee to attend a master's level program specified in clause (1).
new text end

new text begin Subd. 10. new text end

new text begin Reporting requirements. new text end

new text begin A mental health provider receiving a grant under
this section shall submit to the commissioner an invoice for reimbursement and a report,
on a schedule determined by the commissioner and using a form supplied by the
commissioner. The report must include the amount spent on scholarships; the number of
employees who received scholarships; and, for each scholarship recipient, the recipient's
name, current position, amount awarded, educational institution attended, name of the
educational program, and expected or actual program completion date.
new text end

Sec. 5.

Minnesota Statutes 2020, section 245.462, subdivision 4, is amended to read:


Subd. 4.

Case management service provider.

(a) "Case management service provider"
means a case manager or case manager associate employed by the county or other entity
authorized by the county board to provide case management services specified in section
245.4711.

(b) A case manager must:

(1) be skilled in the process of identifying and assessing a wide range of client needs;

(2) be knowledgeable about local community resources and how to use those resources
for the benefit of the client;

(3) new text beginbe a mental health practitioner as defined in section 245I.04, subdivision 4, ornew text end have
a bachelor's degree in one of the behavioral sciences or related fields including, but not
limited to, social work, psychology, or nursing from an accredited college or university deleted text beginordeleted text endnew text begin.
A case manager who is not a mental health practitioner and who does not have a bachelor's
degree in one of the behavioral sciences or related fields must
new text end meet the requirements of
paragraph (c); and

(4) meet the supervision and continuing education requirements described in paragraphs
(d), (e), and (f), as applicable.

(c) Case managers without a bachelor's degree must meet one of the requirements in
clauses (1) to (3):

(1) have three or four years of experience as a case manager associate as defined in this
section;

(2) be a registered nurse without a bachelor's degree and have a combination of
specialized training in psychiatry and work experience consisting of community interaction
and involvement or community discharge planning in a mental health setting totaling three
years; or

(3) be a person who qualified as a case manager under the 1998 Department of Human
Service waiver provision and meet the continuing education and mentoring requirements
in this section.

(d) A case manager with at least 2,000 hours of supervised experience in the delivery
of services to adults with mental illness must receive regular ongoing supervision and clinical
supervision totaling 38 hours per year of which at least one hour per month must be clinical
supervision regarding individual service delivery with a case management supervisor. The
remaining 26 hours of supervision may be provided by a case manager with two years of
experience. Group supervision may not constitute more than one-half of the required
supervision hours. Clinical supervision must be documented in the client record.

(e) A case manager without 2,000 hours of supervised experience in the delivery of
services to adults with mental illness must:

(1) receive clinical supervision regarding individual service delivery from a mental
health professional at least one hour per week until the requirement of 2,000 hours of
experience is met; and

(2) complete 40 hours of training approved by the commissioner in case management
skills and the characteristics and needs of adults with serious and persistent mental illness.

(f) A case manager who is not licensed, registered, or certified by a health-related
licensing board must receive 30 hours of continuing education and training in mental illness
and mental health services every two years.

(g) A case manager associate (CMA) must:

(1) work under the direction of a case manager or case management supervisor;

(2) be at least 21 years of age;

(3) have at least a high school diploma or its equivalent; and

(4) meet one of the following criteria:

(i) have an associate of arts degree in one of the behavioral sciences or human services;

(ii) be a certified peer specialist under section 256B.0615;

(iii) be a registered nurse without a bachelor's degree;

(iv) within the previous ten years, have three years of life experience with serious and
persistent mental illness as defined in subdivision 20; or as a child had severe emotional
disturbance as defined in section 245.4871, subdivision 6; or have three years life experience
as a primary caregiver to an adult with serious and persistent mental illness within the
previous ten years;

(v) have 6,000 hours work experience as a nondegreed state hospital technician; or

(vi) have at least 6,000 hours of supervised experience in the delivery of services to
persons with mental illness.

Individuals meeting one of the criteria in items (i) to (v) may qualify as a case manager
after four years of supervised work experience as a case manager associate. Individuals
meeting the criteria in item (vi) may qualify as a case manager after three years of supervised
experience as a case manager associate.

(h) A case management associate must meet the following supervision, mentoring, and
continuing education requirements:

(1) have 40 hours of preservice training described under paragraph (e), clause (2);

(2) receive at least 40 hours of continuing education in mental illness and mental health
services annually; and

(3) receive at least five hours of mentoring per week from a case management mentor.

A "case management mentor" means a qualified, practicing case manager or case management
supervisor who teaches or advises and provides intensive training and clinical supervision
to one or more case manager associates. Mentoring may occur while providing direct services
to consumers in the office or in the field and may be provided to individuals or groups of
case manager associates. At least two mentoring hours per week must be individual and
face-to-face.

(i) A case management supervisor must meet the criteria for mental health professionals,
as specified in subdivision 18.

(j) An immigrant who does not have the qualifications specified in this subdivision may
provide case management services to adult immigrants with serious and persistent mental
illness who are members of the same ethnic group as the case manager if the person:

(1) is currently enrolled in and is actively pursuing credits toward the completion of a
bachelor's degree in one of the behavioral sciences or a related field including, but not
limited to, social work, psychology, or nursing from an accredited college or university;

(2) completes 40 hours of training as specified in this subdivision; and

(3) receives clinical supervision at least once a week until the requirements of this
subdivision are met.

Sec. 6. new text beginAPPROPRIATIONS.
new text end

new text begin (a) $1,000,000 in fiscal year 2023 is appropriated from the general fund to the
commissioner of health for loan forgiveness for additional mental health professionals
through the health professional education loan forgiveness program under Minnesota Statutes,
section 144.1501.
new text end

new text begin (b) $1,200,000 in fiscal year 2023 is appropriated from the general fund to the
commissioner of health for the mental health provider supervision grant program under
Minnesota Statutes, section 144.1508.
new text end

new text begin (c) $250,000 in fiscal year 2023 is appropriated from the general fund to the commissioner
of health for the mental health professional scholarship grant program under Minnesota
Statutes, section 144.1509.
new text end

new text begin (d) $150,000 in fiscal year 2023 is appropriated from the general fund to the commissioner
of human services to increase the number of training sessions offered to certify individuals
as mental health certified peer specialists or mental health certified family peer specialists.
new text end

new text begin (e) $1,200,000 in fiscal year 2023 is appropriated from the general fund to the
commissioner of human services for the cultural and ethnic minority infrastructure grant
program to fund:
new text end

new text begin (1) workforce development activities focused on recruiting, supporting, training, and
supervision activities for mental health and substance use disorder practitioners and
professionals;
new text end

new text begin (2) provision of support to members of culturally diverse and ethnic minority communities
to qualify as behavioral health professionals, practitioners, clinical supervisors, recovery
peer specialists, mental health certified peer specialists, and mental health certified family
peer specialists;
new text end

new text begin (3) culturally specific outreach, early intervention, trauma-informed services, and recovery
support in mental health and substance use disorder services;
new text end

new text begin (4) provision of trauma-informed, culturally responsive mental health and substance use
disorder supports and services for children and families, youth, or adults who are from
cultural and ethnic minority backgrounds and are uninsured or underinsured;
new text end

new text begin (5) expansion and infrastructure improvement activities, especially in greater Minnesota;
and
new text end

new text begin (6) activities to increase the availability of culturally responsive mental health and
substance use disorder services for children and families, youth, or adults or to increase the
availability of substance use disorder services for individuals from cultural and ethnic
minorities in the state.
new text end

new text begin (f) $25,000 in fiscal year 2023 is appropriated from the general fund to the commissioner
of health to establish and maintain a website that will serve as an information clearinghouse
for mental health professionals and individuals seeking to qualify as a mental health
professional. The website must contain information on the various master's level programs
to become a mental health professional, requirements for supervision, where to find
supervision, how to access tools to study for the applicable licensing examination, links to
loan forgiveness programs and tuition reimbursement programs, and other topics of use to
individuals seeking to become a mental health professional. This is a onetime appropriation.
new text end