HF 3495

1st Engrossment - 93rd Legislature (2023 - 2024) Posted on 04/12/2024 12:04am

A bill for an act
relating to behavioral health; modifying provisions related to mental and behavioral
health care, including service standards, adult and child mental health services
grants, substance use disorder services, supportive housing, and provider
certification and reimbursement; appropriating money; requiring reports; amending
Minnesota Statutes 2022, sections 144.226, by adding a subdivision; 148F.025,
subdivision 2; 245.462, subdivision 6; 245.4663, subdivision 2; 245G.01, by adding
subdivisions; 245G.07, subdivisions 3, 3a; 245G.11, subdivision 7; 245I.02,
subdivisions 17, 19; 245I.04, subdivision 6; 245I.10, subdivision 9; 245I.11,
subdivision 1, by adding a subdivision; 245I.20, subdivision 4; 245I.23, subdivision
14; 256B.0622, subdivisions 2a, 3a, 7a, 7d; 256B.0623, subdivision 5; 256B.0624,
subdivision 7; 256B.0625, subdivision 20; 256B.0757, subdivisions 4a, 4d, 5, by
adding a subdivision; 256B.0943, subdivisions 3, 12; 256B.0947, subdivision 5;
256B.76, subdivision 6; 256I.04, subdivision 2f; Minnesota Statutes 2023
Supplement, sections 245.4889, subdivision 1; 245G.05, subdivision 1; 245G.06,
subdivisions 1, 3, 3a, 4; 254B.04, subdivision 1a; 256.969, subdivision 2b;
256B.0622, subdivisions 7b, 8; 256B.0625, subdivision 5m; 256B.0941, subdivision
3; 256B.0947, subdivision 7; 256B.76, subdivision 1; 256B.761; 256D.01,
subdivision 1a; 256I.05, subdivisions 1a, 11; Laws 2021, First Special Session
chapter 7, article 17, section 12, as amended; Laws 2023, chapter 70, article 20,
section 2, subdivision 29; proposing coding for new law in Minnesota Statutes,
chapters 144; 253B; 256B; repealing Minnesota Statutes 2022, sections 256D.19,
subdivisions 1, 2; 256D.20, subdivisions 1, 2, 3, 4; 256D.23, subdivisions 1, 2, 3;
Minnesota Rules, part 2960.0620, subpart 3.

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

ARTICLE 1

MENTAL HEALTH UNIFORM SERVICE STANDARDS

Section 1.

Minnesota Statutes 2022, section 245I.02, subdivision 17, is amended to read:

Subd. 17.

Functional assessment.

"Functional assessment" means the assessment of a
client's current level of functioning relative to functioning that is appropriate for someone
the client's age. deleted text begin For a client five years of age or younger, a functional assessment is the
Early Childhood Service Intensity Instrument (ESCII). For a client six to 17 years of age,
a functional assessment is the Child and Adolescent Service Intensity Instrument (CASII).
For a client 18 years of age or older, a functional assessment is the functional assessment
described in section 245I.10, subdivision 9.
deleted text end

Sec. 2.

Minnesota Statutes 2022, section 245I.02, subdivision 19, is amended to read:

Subd. 19.

Level of care assessment.

"Level of care assessment" means the level of care
decision support tool appropriate to the client's age. deleted text begin For a client five years of age or younger,
a level of care assessment is the Early Childhood Service Intensity Instrument (ESCII). For
a client six to 17 years of age, a level of care assessment is the Child and Adolescent Service
Intensity Instrument (CASII). For a client 18 years of age or older, a level of care assessment
is the Level of Care Utilization System for Psychiatric and Addiction Services (LOCUS)
or another tool authorized by the commissioner.
deleted text end

Sec. 3.

Minnesota Statutes 2022, section 245I.04, subdivision 6, is amended to read:

Subd. 6.

Clinical trainee qualifications.

(a) A clinical trainee is a staff person who: (1)
is enrolled in an accredited graduate program of study to prepare the staff person for
independent licensure as a mental health professional and who is participating in a practicum
or internship with the license holder through the individual's graduate program; deleted text begin or deleted text end (2) has
completed an accredited graduate program of study to prepare the staff person for independent
licensure as a mental health professional and who is in compliance with the requirements
of the applicable health-related licensing board, including requirements for supervised
practice deleted text begin . deleted text end new text begin ; or (3) has completed an accredited graduate program of study to prepare the staff
person for independent licensure as a mental health professional, has completed a practicum
or internship and has not yet taken or received the results from the required test or is waiting
for the final licensure decision.
new text end

(b) A clinical trainee is responsible for notifying and applying to a health-related licensing
board to ensure that the trainee meets the requirements of the health-related licensing board.
As permitted by a health-related licensing board, treatment supervision under this chapter
may be integrated into a plan to meet the supervisory requirements of the health-related
licensing board but does not supersede those requirements.

Sec. 4.

Minnesota Statutes 2022, section 245I.10, subdivision 9, is amended to read:

Subd. 9.

Functional assessment; required elements.

new text begin (a) new text end When a license holder is
completing a functional assessment for an adult client, the license holder must:

(1) complete a functional assessment of the client after completing the client's diagnostic
assessment;

(2) use a collaborative process that allows the client and the client's family and other
natural supports, the client's referral sources, and the client's providers to provide information
about how the client's symptoms of mental illness impact the client's functioning;

(3) if applicable, document the reasons that the license holder did not contact the client's
family and other natural supports;

(4) assess and document how the client's symptoms of mental illness impact the client's
functioning in the following areas:

(i) the client's mental health symptoms;

(ii) the client's mental health service needs;

(iii) the client's substance use;

(iv) the client's vocational and educational functioning;

(v) the client's social functioning, including the use of leisure time;

(vi) the client's interpersonal functioning, including relationships with the client's family
and other natural supports;

(vii) the client's ability to provide self-care and live independently;

(viii) the client's medical and dental health;

(ix) the client's financial assistance needs; and

(x) the client's housing and transportation needs;

deleted text begin (5) include a narrative summarizing the client's strengths, resources, and all areas of
functional impairment;
deleted text end

deleted text begin (6) deleted text end new text begin (5) new text end complete the client's functional assessment before the client's initial individual
treatment plan unless a service specifies otherwise; and

deleted text begin (7) deleted text end new text begin (6) new text end update the client's functional assessment with the client's current functioning
whenever there is a significant change in the client's functioning or at least every deleted text begin 180 deleted text end new text begin 365 new text end
days, unless a service specifies otherwise.

new text begin (b) A license holder may use any available, validated measurement tool, including but
not limited to the Daily Living Activities-20, when completing the required elements of a
functional assessment under this subdivision.
new text end

Sec. 5.

Minnesota Statutes 2022, section 245I.11, subdivision 1, is amended to read:

Subdivision 1.

Generally.

new text begin (a) new text end If a license holder is licensed as a residential program,
stores or administers client medications, or observes clients self-administer medications,
the license holder must ensure that a staff person who is a registered nurse or licensed
prescriber is responsible for overseeing storage and administration of client medications
and observing as a client self-administers medications, including training according to
section 245I.05, subdivision 6, and documenting the occurrence according to section 245I.08,
subdivision 5.

new text begin (b) For purposes of this section, "observed self-administration" means the preparation
and administration of a medication by a client to themselves under the direct supervision
of a registered nurse or a staff member to whom a registered nurse delegates supervision
duty. Observed self-administration does not include a client's use of a medication that they
keep in their own possession while participating in a program.
new text end

Sec. 6.

Minnesota Statutes 2022, section 245I.11, is amended by adding a subdivision to
read:

new text begin Subd. 6. new text end

new text begin Medication administration in children's day treatment settings. new text end

new text begin (a) For a
program providing children's day treatment services under section 256B.0943, the license
holder must maintain policies and procedures that state whether the program will store
medication and administer or allow observed self-administration.
new text end

new text begin (b) For a program providing children's day treatment services under section 256B.0943
that does not store medications but allows clients to use a medication that they keep in their
own possession while participating in a program, the license holder must maintain
documentation from a licensed prescriber regarding the safety of medications held by clients,
including:
new text end

new text begin (1) an evaluation that the client is capable of holding and administering the medication
safely;
new text end

new text begin (2) an evaluation of whether the medication is prone to diversion, misuse, or self-injury;
and
new text end

new text begin (3) any conditions under which the license holder should no longer allow the client to
maintain the medication in their own possession.
new text end

Sec. 7.

Minnesota Statutes 2022, section 245I.20, subdivision 4, is amended to read:

Subd. 4.

Minimum staffing standards.

(a) A certification holder's treatment team must
consist of at least four mental health professionals. At least two of the mental health
professionals must be employed by or under contract with the mental health clinic for a
minimum of 35 hours per week each. deleted text begin Each of the two mental health professionals must
specialize in a different mental health discipline.
deleted text end

(b) The treatment team must include:

(1) a physician qualified as a mental health professional according to section 245I.04,
subdivision 2, clause (4), or a nurse qualified as a mental health professional according to
section 245I.04, subdivision 2, clause (1); and

(2) a psychologist qualified as a mental health professional according to section 245I.04,
subdivision 2, clause (3).

(c) The staff persons fulfilling the requirement in paragraph (b) must provide clinical
services at least:

(1) eight hours every two weeks if the mental health clinic has over 25.0 full-time
equivalent treatment team members;

(2) eight hours each month if the mental health clinic has 15.1 to 25.0 full-time equivalent
treatment team members;

(3) four hours each month if the mental health clinic has 5.1 to 15.0 full-time equivalent
treatment team members; or

(4) two hours each month if the mental health clinic has 2.0 to 5.0 full-time equivalent
treatment team members or only provides in-home services to clients.

(d) The certification holder must maintain a record that demonstrates compliance with
this subdivision.

Sec. 8.

Minnesota Statutes 2022, section 245I.23, subdivision 14, is amended to read:

Subd. 14.

Weekly team meetings.

(a) The license holder must hold weekly team meetings
and ancillary meetings according to this subdivision.

(b) A mental health professional or certified rehabilitation specialist must hold at least
one team meeting each calendar week deleted text begin and deleted text end new text begin . The mental health professional or certified
rehabilitation specialist must new text end be physically present at the team meeting new text begin , except as permitted
under paragraph (d) new text end . All treatment team members, including treatment team members who
work on a part-time or intermittent basis, must participate in a minimum of one team meeting
during each calendar week when the treatment team member is working for the license
holder. The license holder must document all weekly team meetings, including the names
of meeting attendees new text begin , and indicate whether the meeting was conducted remotely under
paragraph (d) new text end .

(c) If a treatment team member cannot participate in a weekly team meeting, the treatment
team member must participate in an ancillary meeting. A mental health professional, certified
rehabilitation specialist, clinical trainee, or mental health practitioner who participated in
the most recent weekly team meeting may lead the ancillary meeting. During the ancillary
meeting, the treatment team member leading the ancillary meeting must review the
information that was shared at the most recent weekly team meeting, including revisions
to client treatment plans and other information that the treatment supervisors exchanged
with treatment team members. The license holder must document all ancillary meetings,
including the names of meeting attendees.

new text begin (d) A license holder may permit one weekly meeting to occur remotely and without
physical presence due to illness or weather conditions. If the conditions that prevent physical
presence persist for longer than one week, the license holder must request a variance to
conduct additional meetings remotely.
new text end

ARTICLE 2

ADULT MENTAL HEALTH SERVICES

Section 1.

Minnesota Statutes 2022, section 245.462, subdivision 6, is amended to read:

Subd. 6.

Community support services program.

"Community support services program"
means services, other than inpatient or residential treatment services, provided or coordinated
by an identified program and staff under the treatment supervision of a mental health
professional designed to help adults with serious and persistent mental illness to function
and remain in the community. A community support services program includes:

(1) client outreach,

(2) medication monitoring,

(3) assistance in independent living skills,

(4) development of employability and work-related opportunities,

(5) crisis assistance,

(6) psychosocial rehabilitation,

(7) help in applying for government benefits, and

(8) housing support services.

The community support services program must be coordinated with the case management
services specified in section 245.4711. new text begin A program that meets the accreditation standards
for Clubhouse International model programs meets the requirements of this subdivision.
new text end

Sec. 2.

new text begin [253B.042] ENGAGEMENT SERVICES PILOT GRANTS.
new text end

new text begin Subdivision 1. new text end

new text begin Creation. new text end

new text begin The engagement services pilot grant program is established
in the Department of Human Services, to provide grants to counties or certified community
behavioral health centers to provide engagement services under section 253B.041.
Engagement services provide culturally responsive, person-centered early interventions to
prevent an individual from meeting the criteria for civil commitment and promote positive
outcomes.
new text end

new text begin Subd. 2. new text end

new text begin Allowable grant activities. new text end

new text begin (a) Grantees must use grant money to:
new text end

new text begin (1) develop a system to respond to requests for engagement services;
new text end

new text begin (2) provide the following engagement services, taking into account an individual's
preferences for treatment services and supports:
new text end

new text begin (i) assertive attempts to engage an individual in voluntary treatment for mental illness
for at least 90 days;
new text end

new text begin (ii) efforts to engage an individual's existing support systems and interested persons,
including but not limited to providing education on restricting means of harm and suicide
prevention, when the provider determines that such engagement would be helpful; and
new text end

new text begin (iii) collaboration with the individual to meet the individual's immediate needs, including
but not limited to housing access, food and income assistance, disability verification,
medication management, and medical treatment;
new text end

new text begin (3) conduct outreach to families and providers; and
new text end

new text begin (4) evaluate the impact of engagement services on decreasing civil commitments,
increasing engagement in treatment, decreasing police involvement with individuals
exhibiting symptoms of serious mental illness, and other measures.
new text end

new text begin (b) Engagement services staff must have completed training on person-centered care.
Staff may include but are not limited to mobile crisis providers under section 256B.0624,
certified peer specialists under section 256B.0615, community-based treatment programs
staff, and homeless outreach workers.
new text end

new text begin Subd. 3. new text end

new text begin Outcome evaluation. new text end

new text begin The commissioner of management and budget must
formally evaluate outcomes of grants awarded under this section, using an experimental or
quasi-experimental design. The commissioner shall consult with the commissioner of
management and budget to ensure that grants are administered to facilitate this evaluation.
Grantees must collect and provide the information needed to the commissioner of human
services to complete the evaluation. The commissioner must provide the information collected
to the commissioner of management and budget to conduct the evaluation. The commissioner
of management and budget may obtain additional relevant data to support the evaluation
study pursuant to section 15.08.
new text end

Sec. 3.

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

Subd. 2a.

Eligibility for assertive community treatment.

new text begin (a) new text end An eligible client for
assertive community treatment is an individual who meets the following criteria as assessed
by an ACT team:

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

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

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

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

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

(iii) significant difficulty maintaining a safe living situation;

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

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

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

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

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

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

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

(vii) significant difficulty meeting basic survival needs;

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

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

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

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

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

(xiii) difficulty effectively using traditional office-based outpatient services;

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

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

new text begin (b) An individual meets the criteria for assertive community treatment under this section
immediately following participation in a first episode of psychosis program if the individual:
new text end

new text begin (1) meets the eligibility requirements outlined in paragraph (a), clauses (1), (2), (5), and
(6);
new text end

new text begin (2) is currently participating in a first episode of psychosis program under section
245.4905; and
new text end

new text begin (3) needs the level of intensity provided by an ACT team, in the opinion of the individual's
first episode of psychosis program, in order to prevent crisis services, hospitalization,
homelessness, and involvement with the criminal justice system.
new text end

Sec. 4.

Minnesota Statutes 2022, section 256B.0622, subdivision 3a, is amended to read:

Subd. 3a.

Provider certification and contract requirements for assertive community
treatment.

(a) The assertive community treatment provider must deleted text begin :
deleted text end

deleted text begin (1) have a contract with the host county to provide assertive community treatment
services; and
deleted text end

deleted text begin (2) deleted text end have each ACT team be certified by the state following the certification process and
procedures developed by the commissioner. The certification process determines whether
the ACT team meets the standards for assertive community treatment under this section,
the standards in chapter 245I as required in section 245I.011, subdivision 5, and minimum
program fidelity standards as measured by a nationally recognized fidelity tool approved
by the commissioner. Recertification must occur at least every three years.

(b) An ACT team certified under this subdivision must meet the following standards:

(1) have capacity to recruit, hire, manage, and train required ACT team members;

(2) have adequate administrative ability to ensure availability of services;

(3) ensure flexibility in service delivery to respond to the changing and intermittent care
needs of a client as identified by the client and the individual treatment plan;

(4) keep all necessary records required by law;

(5) be an enrolled Medicaid provider; and

(6) establish and maintain a quality assurance plan to determine specific service outcomes
and the client's satisfaction with services.

(c) The commissioner may intervene at any time and decertify an ACT team with cause.
The commissioner shall establish a process for decertification of an ACT team and shall
require corrective action, medical assistance repayment, or decertification of an ACT team
that no longer meets the requirements in this section or that fails to meet the clinical quality
standards or administrative standards provided by the commissioner in the application and
certification process. The decertification is subject to appeal to the state.

Sec. 5.

Minnesota Statutes 2022, section 256B.0622, subdivision 7a, is amended to read:

Subd. 7a.

Assertive community treatment team staff requirements and roles.

(a)
The required treatment staff qualifications and roles for an ACT team are:

(1) the team leader:

(i) shall be a mental health professional. Individuals who are not licensed but who are
eligible for licensure and are otherwise qualified may also fulfill this role deleted text begin but must obtain
full licensure within 24 months of assuming the role of team leader deleted text end ;

(ii) must be an active member of the ACT team and provide some direct services to
clients;

(iii) must be a single full-time staff member, dedicated to the ACT team, who is
responsible for overseeing the administrative operations of the team deleted text begin , providing treatment
supervision of services in conjunction with the psychiatrist or psychiatric care provider, deleted text end and
supervising team members to ensure delivery of best and ethical practices; and

(iv) must be available to deleted text begin provide deleted text end new text begin ensure that new text end overall treatment supervision to the ACT
team new text begin is available new text end after regular business hours and on weekends and holidays deleted text begin . The team
leader may delegate this duty to another deleted text end new text begin and is provided by a new text end qualified member of the ACT
team;

(2) the psychiatric care provider:

(i) must be a mental health professional permitted to prescribe psychiatric medications
as part of the mental health professional's scope of practice. The psychiatric care provider
must have demonstrated clinical experience working with individuals with serious and
persistent mental illness;

(ii) shall collaborate with the team leader in sharing overall clinical responsibility for
screening and admitting clients; monitoring clients' treatment and team member service
delivery; educating staff on psychiatric and nonpsychiatric medications, their side effects,
and health-related conditions; actively collaborating with nurses; and helping provide
treatment supervision to the team;

(iii) shall fulfill the following functions for assertive community treatment clients:
provide assessment and treatment of clients' symptoms and response to medications, including
side effects; provide brief therapy to clients; provide diagnostic and medication education
to clients, with medication decisions based on shared decision making; monitor clients'
nonpsychiatric medical conditions and nonpsychiatric medications; and conduct home and
community visits;

(iv) shall serve as the point of contact for psychiatric treatment if a client is hospitalized
for mental health treatment and shall communicate directly with the client's inpatient
psychiatric care providers to ensure continuity of care;

(v) shall have a minimum full-time equivalency that is prorated at a rate of 16 hours per
50 clients. Part-time psychiatric care providers shall have designated hours to work on the
team, with sufficient blocks of time on consistent days to carry out the provider's clinical,
supervisory, and administrative responsibilities. No more than two psychiatric care providers
may share this role; and

(vi) shall provide psychiatric backup to the program after regular business hours and on
weekends and holidays. The psychiatric care provider may delegate this duty to another
qualified psychiatric provider;

(3) the nursing staff:

(i) shall consist of one to three registered nurses or advanced practice registered nurses,
of whom at least one has a minimum of one-year experience working with adults with
serious mental illness and a working knowledge of psychiatric medications. No more than
two individuals can share a full-time equivalent position;

(ii) are responsible for managing medication, administering and documenting medication
treatment, and managing a secure medication room; and

(iii) shall develop strategies, in collaboration with clients, to maximize taking medications
as prescribed; screen and monitor clients' mental and physical health conditions and
medication side effects; engage in health promotion, prevention, and education activities;
communicate and coordinate services with other medical providers; facilitate the development
of the individual treatment plan for clients assigned; and educate the ACT team in monitoring
psychiatric and physical health symptoms and medication side effects;

(4) the co-occurring disorder specialist:

(i) shall be a full-time equivalent co-occurring disorder specialist who has received
specific training on co-occurring disorders that is consistent with national evidence-based
practices. The training must include practical knowledge of common substances and how
they affect mental illnesses, the ability to assess substance use disorders and the client's
stage of treatment, motivational interviewing, and skills necessary to provide counseling to
clients at all different stages of change and treatment. The co-occurring disorder specialist
may also be an individual who is a licensed alcohol and drug counselor as described in
section 148F.01, subdivision 5, or a counselor who otherwise meets the training, experience,
and other requirements in section 245G.11, subdivision 5. No more than two co-occurring
disorder specialists may occupy this role; and

(ii) shall provide or facilitate the provision of co-occurring disorder treatment to clients.
The co-occurring disorder specialist shall serve as a consultant and educator to fellow ACT
team members on co-occurring disorders;

(5) the vocational specialist:

(i) shall be a full-time vocational specialist who has at least one-year experience providing
employment services or advanced education that involved field training in vocational services
to individuals with mental illness. An individual who does not meet these qualifications
may also serve as the vocational specialist upon completing a training plan approved by the
commissioner;

(ii) shall provide or facilitate the provision of vocational services to clients. The vocational
specialist serves as a consultant and educator to fellow ACT team members on these services;
and

(iii) must not refer individuals to receive any type of vocational services or linkage by
providers outside of the ACT team;

(6) the mental health certified peer specialist:

(i) shall be a full-time equivalent. No more than two individuals can share this position.
The mental health certified peer specialist is a fully integrated team member who provides
highly individualized services in the community and promotes the self-determination and
shared decision-making abilities of clients. This requirement may be waived due to workforce
shortages upon approval of the commissioner;

(ii) must provide coaching, mentoring, and consultation to the clients to promote recovery,
self-advocacy, and self-direction, promote wellness management strategies, and assist clients
in developing advance directives; and

(iii) must model recovery values, attitudes, beliefs, and personal action to encourage
wellness and resilience, provide consultation to team members, promote a culture where
the clients' points of view and preferences are recognized, understood, respected, and
integrated into treatment, and serve in a manner equivalent to other team members;

(7) the program administrative assistant shall be a full-time office-based program
administrative assistant position assigned to solely work with the ACT team, providing a
range of supports to the team, clients, and families; and

(8) additional staff:

(i) shall be based on team size. Additional treatment team staff may include mental
health professionals; clinical trainees; certified rehabilitation specialists; mental health
practitioners; or mental health rehabilitation workers. These individuals shall have the
knowledge, skills, and abilities required by the population served to carry out rehabilitation
and support functions; and

(ii) shall be selected based on specific program needs or the population served.

(b) Each ACT team must clearly document schedules for all ACT team members.

(c) Each ACT team member must serve as a primary team member for clients assigned
by the team leader and are responsible for facilitating the individual treatment plan process
for those clients. The primary team member for a client is the responsible team member
knowledgeable about the client's life and circumstances and writes the individual treatment
plan. The primary team member provides individual supportive therapy or counseling, and
provides primary support and education to the client's family and support system.

(d) Members of the ACT team must have strong clinical skills, professional qualifications,
experience, and competency to provide a full breadth of rehabilitation services. Each staff
member shall be proficient in their respective discipline and be able to work collaboratively
as a member of a multidisciplinary team to deliver the majority of the treatment,
rehabilitation, and support services clients require to fully benefit from receiving assertive
community treatment.

(e) Each ACT team member must fulfill training requirements established by the
commissioner.

Sec. 6.

Minnesota Statutes 2023 Supplement, section 256B.0622, subdivision 7b, is
amended to read:

Subd. 7b.

Assertive community treatment program deleted text begin size and opportunities deleted text end new text begin scores new text end .

deleted text begin (a) deleted text end
Each ACT team deleted text begin shall maintain an annual average caseload that does not exceed 100 clients.
Staff-to-client ratios shall be based on team size as follows: deleted text end new text begin must demonstrate that the team
attained a passing score according to the most recently issued Tool for Measurement of
Assertive Community Treatment (TMACT).
new text end

deleted text begin (1) a small ACT team must:
deleted text end

deleted text begin (i) employ at least six but no more than seven full-time treatment team staff, excluding
the program assistant and the psychiatric care provider;
deleted text end

deleted text begin (ii) serve an annual average maximum of no more than 50 clients;
deleted text end

deleted text begin (iii) ensure at least one full-time equivalent position for every eight clients served;
deleted text end

deleted text begin (iv) schedule ACT team staff on weekdays and on-call duty to provide crisis services
and deliver services after hours when staff are not working;
deleted text end

deleted text begin (v) provide crisis services during business hours if the small ACT team does not have
sufficient staff numbers to operate an after-hours on-call system. During all other hours,
the ACT team may arrange for coverage for crisis assessment and intervention services
through a reliable crisis-intervention provider as long as there is a mechanism by which the
ACT team communicates routinely with the crisis-intervention provider and the on-call
ACT team staff are available to see clients face-to-face when necessary or if requested by
the crisis-intervention services provider;
deleted text end

deleted text begin (vi) adjust schedules and provide staff to carry out the needed service activities in the
evenings or on weekend days or holidays, when necessary;
deleted text end

deleted text begin (vii) arrange for and provide psychiatric backup during all hours the psychiatric care
provider is not regularly scheduled to work. If availability of the ACT team's psychiatric
care provider during all hours is not feasible, alternative psychiatric prescriber backup must
be arranged and a mechanism of timely communication and coordination established in
writing; and
deleted text end

deleted text begin (viii) be composed of, at minimum, one full-time team leader, at least 16 hours each
week per 50 clients of psychiatric provider time, or equivalent if fewer clients, one full-time
equivalent nursing, one full-time co-occurring disorder specialist, one full-time equivalent
mental health certified peer specialist, one full-time vocational specialist, one full-time
program assistant, and at least one additional full-time ACT team member who has mental
health professional, certified rehabilitation specialist, clinical trainee, or mental health
practitioner status; and
deleted text end

deleted text begin (2) a midsize ACT team shall:
deleted text end

deleted text begin (i) be composed of, at minimum, one full-time team leader, at least 16 hours of psychiatry
time for 51 clients, with an additional two hours for every six clients added to the team, 1.5
to two full-time equivalent nursing staff, one full-time co-occurring disorder specialist, one
full-time equivalent mental health certified peer specialist, one full-time vocational specialist,
one full-time program assistant, and at least 1.5 to two additional full-time equivalent ACT
members, with at least one dedicated full-time staff member with mental health professional
status. Remaining team members may have mental health professional, certified rehabilitation
specialist, clinical trainee, or mental health practitioner status;
deleted text end

deleted text begin (ii) employ seven or more treatment team full-time equivalents, excluding the program
assistant and the psychiatric care provider;
deleted text end

deleted text begin (iii) serve an annual average maximum caseload of 51 to 74 clients;
deleted text end

deleted text begin (iv) ensure at least one full-time equivalent position for every nine clients served;
deleted text end

deleted text begin (v) schedule ACT team staff for a minimum of ten-hour shift coverage on weekdays
and six- to eight-hour shift coverage on weekends and holidays. In addition to these minimum
specifications, staff are regularly scheduled to provide the necessary services on a
client-by-client basis in the evenings and on weekends and holidays;
deleted text end

deleted text begin (vi) schedule ACT team staff on-call duty to provide crisis services and deliver services
when staff are not working;
deleted text end

deleted text begin (vii) have the authority to arrange for coverage for crisis assessment and intervention
services through a reliable crisis-intervention provider as long as there is a mechanism by
which the ACT team communicates routinely with the crisis-intervention provider and the
on-call ACT team staff are available to see clients face-to-face when necessary or if requested
by the crisis-intervention services provider; and
deleted text end

deleted text begin (viii) arrange for and provide psychiatric backup during all hours the psychiatric care
provider is not regularly scheduled to work. If availability of the psychiatric care provider
during all hours is not feasible, alternative psychiatric prescriber backup must be arranged
and a mechanism of timely communication and coordination established in writing;
deleted text end

deleted text begin (3) a large ACT team must:
deleted text end

deleted text begin (i) be composed of, at minimum, one full-time team leader, at least 32 hours each week
per 100 clients, or equivalent of psychiatry time, three full-time equivalent nursing staff,
one full-time co-occurring disorder specialist, one full-time equivalent mental health certified
peer specialist, one full-time vocational specialist, one full-time program assistant, and at
least two additional full-time equivalent ACT team members, with at least one dedicated
full-time staff member with mental health professional status. Remaining team members
may have mental health professional or mental health practitioner status;
deleted text end

deleted text begin (ii) employ nine or more treatment team full-time equivalents, excluding the program
assistant and psychiatric care provider;
deleted text end

deleted text begin (iii) serve an annual average maximum caseload of 75 to 100 clients;
deleted text end

deleted text begin (iv) ensure at least one full-time equivalent position for every nine individuals served;
deleted text end

deleted text begin (v) schedule staff to work two eight-hour shifts, with a minimum of two staff on the
second shift providing services at least 12 hours per day weekdays. For weekends and
holidays, the team must operate and schedule ACT team staff to work one eight-hour shift,
with a minimum of two staff each weekend day and every holiday;
deleted text end

deleted text begin (vi) schedule ACT team staff on-call duty to provide crisis services and deliver services
when staff are not working; and
deleted text end

deleted text begin (vii) arrange for and provide psychiatric backup during all hours the psychiatric care
provider is not regularly scheduled to work. If availability of the ACT team psychiatric care
provider during all hours is not feasible, alternative psychiatric backup must be arranged
and a mechanism of timely communication and coordination established in writing.
deleted text end

deleted text begin (b) An ACT team of any size may have a staff-to-client ratio that is lower than the
requirements described in paragraph (a) upon approval by the commissioner, but may not
exceed a one-to-ten staff-to-client ratio.
deleted text end

Sec. 7.

Minnesota Statutes 2022, section 256B.0622, subdivision 7d, is amended to read:

Subd. 7d.

Assertive community treatment assessment and individual treatment
plan.

(a) An initial assessment shall be completed the day of the client's admission to
assertive community treatment by the ACT team leader or the psychiatric care provider,
with participation by designated ACT team members and the client. The initial assessment
must include obtaining or completing a standard diagnostic assessment according to section
245I.10, subdivision 6, and completing a 30-day individual treatment plan. The team leader,
psychiatric care provider, or other mental health professional designated by the team leader
or psychiatric care provider, must update the client's diagnostic assessment deleted text begin at least annually deleted text end new text begin
as required under section 245I.10, subdivision 2, paragraphs (f) and (g) new text end .

(b) A functional assessment must be completed according to section 245I.10, subdivision
9. Each part of the functional assessment areas shall be completed by each respective team
specialist or an ACT team member with skill and knowledge in the area being assessed.

(c) Between 30 and 45 days after the client's admission to assertive community treatment,
the entire ACT team must hold a comprehensive case conference, where all team members,
including the psychiatric provider, present information discovered from the completed
assessments and provide treatment recommendations. The conference must serve as the
basis for the first individual treatment plan, which must be written by the primary team
member.

(d) The client's psychiatric care provider, primary team member, and individual treatment
team members shall assume responsibility for preparing the written narrative of the results
from the psychiatric and social functioning history timeline and the comprehensive
assessment.

(e) The primary team member and individual treatment team members shall be assigned
by the team leader in collaboration with the psychiatric care provider by the time of the first
treatment planning meeting or 30 days after admission, whichever occurs first.

(f) Individual treatment plans must be developed through the following treatment planning
process:

(1) The individual treatment plan shall be developed in collaboration with the client and
the client's preferred natural supports, and guardian, if applicable and appropriate. The ACT
team shall evaluate, together with each client, the client's needs, strengths, and preferences
and develop the individual treatment plan collaboratively. The ACT team shall make every
effort to ensure that the client and the client's family and natural supports, with the client's
consent, are in attendance at the treatment planning meeting, are involved in ongoing
meetings related to treatment, and have the necessary supports to fully participate. The
client's participation in the development of the individual treatment plan shall be documented.

(2) The client and the ACT team shall work together to formulate and prioritize the
issues, set goals, research approaches and interventions, and establish the plan. The plan is
individually tailored so that the treatment, rehabilitation, and support approaches and
interventions achieve optimum symptom reduction, help fulfill the personal needs and
aspirations of the client, take into account the cultural beliefs and realities of the individual,
and improve all the aspects of psychosocial functioning that are important to the client. The
process supports strengths, rehabilitation, and recovery.

(3) Each client's individual treatment plan shall identify service needs, strengths and
capacities, and barriers, and set specific and measurable short- and long-term goals for each
service need. The individual treatment plan must clearly specify the approaches and
interventions necessary for the client to achieve the individual goals, when the interventions
shall happen, and identify which ACT team member shall carry out the approaches and
interventions.

(4) The primary team member and the individual treatment team, together with the client
and the client's family and natural supports with the client's consent, are responsible for
reviewing and rewriting the treatment goals and individual treatment plan whenever there
is a major decision point in the client's course of treatment or at least every six months.

(5) The primary team member shall prepare a summary that thoroughly describes in
writing the client's and the individual treatment team's evaluation of the client's progress
and goal attainment, the effectiveness of the interventions, and the satisfaction with services
since the last individual treatment plan. The client's most recent diagnostic assessment must
be included with the treatment plan summary.

(6) The individual treatment plan and review must be approved or acknowledged by the
client, the primary team member, the team leader, the psychiatric care provider, and all
individual treatment team members. A copy of the approved individual treatment plan must
be made available to the client.

Sec. 8.

Minnesota Statutes 2023 Supplement, section 256B.0622, subdivision 8, is amended
to read:

Subd. 8.

Medical assistance payment for assertive community treatment and
intensive residential treatment services.

(a) Payment for intensive residential treatment
services and assertive community treatment in this section shall be based on one daily rate
per provider inclusive of the following services received by an eligible client in a given
calendar day: all rehabilitative services under this section, staff travel time to provide
rehabilitative services under this section, and nonresidential crisis stabilization services
under section 256B.0624.

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

(c) The commissioner shall determine one rate for each provider that will bill medical
assistance for residential services under this section and one rate for each assertive community
treatment provider. If a single entity provides both services, one rate is established for the
entity's residential services and another rate for the entity's nonresidential services under
this section. A provider is not eligible for payment under this section without authorization
from the commissioner. The commissioner shall develop rates using the following criteria:

(1) the provider's cost for services shall include direct services costs, other program
costs, and other costs determined as follows:

(i) the direct services costs must be determined using actual costs of salaries, benefits,
payroll taxes, and training of direct service staff and service-related transportation;

(ii) other program costs not included in item (i) must be determined as a specified
percentage of the direct services costs as determined by item (i). The percentage used shall
be determined by the commissioner based upon the average of percentages that represent
the relationship of other program costs to direct services costs among the entities that provide
similar services;

(iii) physical plant costs calculated based on the percentage of space within the program
that is entirely devoted to treatment and programming. This does not include administrative
or residential space;

(iv) assertive community treatment physical plant costs must be reimbursed as part of
the costs described in item (ii); deleted text begin and
deleted text end

(v) subject to federal approval, up to an additional five percent of the total rate may be
added to the program rate as a quality incentive based upon the entity meeting performance
criteria specified by the commissioner;

new text begin (vi) for assertive community treatment, intensive residential treatment services, and
adult residential crisis stabilization services, estimated additional direct care staffing
compensation costs, subject to review by the commissioner; and
new text end

new text begin (vii) for intensive residential treatment services and adult residential crisis stabilization
services, estimated new capital costs, subject to review by the commissioner;
new text end

(2) actual cost is defined as costs which are allowable, allocable, and reasonable, and
consistent with federal reimbursement requirements under Code of Federal Regulations,
title 48, chapter 1, part 31, relating to for-profit entities, and Office of Management and
Budget Circular Number A-122, relating to nonprofit entities;

(3) the number of service units;

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

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

(d) The rate for intensive residential treatment services and assertive community treatment
must exclude the medical assistance room and board rate, as defined in section 256B.056,
subdivision 5d, and services not covered under this section, such as partial hospitalization,
home care, and inpatient services.

(e) Physician services that are not separately billed may be included in the rate to the
extent that a psychiatrist, or other health care professional providing physician services
within their scope of practice, is a member of the intensive residential treatment services
treatment team. Physician services, whether billed separately or included in the rate, may
be delivered by telehealth. For purposes of this paragraph, "telehealth" has the meaning
given to "mental health telehealth" in section 256B.0625, subdivision 46, when telehealth
is used to provide intensive residential treatment services.

(f) When services under this section are provided by an assertive community treatment
provider, case management functions must be an integral part of the team.

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

(h) The rates for existing programs must be established prospectively based upon the
expenditures and utilization over a prior 12-month period using the criteria established in
paragraph (c). The rates for new programs must be established based upon estimated
expenditures and estimated utilization using the criteria established in paragraph (c). new text begin For a
rate that was set incorporating the provider's estimated direct care staffing compensation
and new capital costs, the commissioner must reconcile the provider's rate with the provider's
actual costs from the prior 12 months.
new text end

(i) Effective for the rate years beginning on and after January 1, 2024, rates for assertive
community treatment, adult residential crisis stabilization services, and intensive residential
treatment services must be annually adjusted for inflation using the Centers for Medicare
and Medicaid Services Medicare Economic Index, as forecasted in the fourth quarter of the
calendar year before the rate year. The inflation adjustment must be based on the 12-month
period from the midpoint of the previous rate year to the midpoint of the rate year for which
the rate is being determined.

(j) Entities who discontinue providing services must be subject to a settle-up process
whereby actual costs and reimbursement for the previous 12 months are compared. In the
event that the entity was paid more than the entity's actual costs plus any applicable
performance-related funding due the provider, the excess payment must be reimbursed to
the department. If a provider's revenue is less than actual allowed costs due to lower
utilization than projected, the commissioner may reimburse the provider to recover its actual
allowable costs. The resulting adjustments by the commissioner must be proportional to the
percent of total units of service reimbursed by the commissioner and must reflect a difference
of greater than five percent.

(k) A provider may request of the commissioner a review of any rate-setting decision
made under this subdivision.

new text begin EFFECTIVE DATE. new text end

new text begin This section is effective January 1, 2025, or upon federal approval,
whichever is later. The commissioner of human services shall notify the revisor of statutes
when federal approval is obtained.
new text end

Sec. 9.

Minnesota Statutes 2022, section 256B.0623, subdivision 5, is amended to read:

Subd. 5.

Qualifications of provider staff.

Adult rehabilitative mental health services
must be provided by qualified individual provider staff of a certified provider entity.
Individual provider staff must be qualified as:

(1) a mental health professional who is qualified according to section 245I.04, subdivision
2;

(2) a certified rehabilitation specialist who is qualified according to section 245I.04,
subdivision 8;

(3) a clinical trainee who is qualified according to section 245I.04, subdivision 6;

(4) a mental health practitioner qualified according to section 245I.04, subdivision 4;

(5) a mental health certified peer specialist who is qualified according to section 245I.04,
subdivision 10; deleted text begin or
deleted text end

(6) a mental health rehabilitation worker who is qualified according to section 245I.04,
subdivision 14 deleted text begin . deleted text end new text begin ; or
new text end

new text begin (7) a licensed occupational therapist, as defined in section 148.6402, subdivision 14.
new text end

Sec. 10.

Minnesota Statutes 2022, section 256B.0624, subdivision 7, is amended to read:

Subd. 7.

Crisis stabilization services.

(a) Crisis stabilization services must be provided
by qualified staff of a crisis stabilization services provider entity and must meet the following
standards:

(1) a crisis treatment plan must be developed that meets the criteria in subdivision 11;

(2) staff must be qualified as defined in subdivision 8;

(3) crisis stabilization services must be delivered according to the crisis treatment plan
and include face-to-face contact with the recipient by qualified staff for further assessment,
help with referrals, updating of the crisis treatment plan, skills training, and collaboration
with other service providers in the community; and

(4) if a provider delivers crisis stabilization services while the recipient is absent, the
provider must document the reason for delivering services while the recipient is absent.

(b) If crisis stabilization services are provided in a supervised, licensed residential setting
that serves no more than four adult residents, and one or more individuals are present at the
setting to receive residential crisis stabilization, the residential staff must include, for at
least eight hours per day, at least one mental health professional, clinical trainee, certified
rehabilitation specialist, or mental health practitioner. The commissioner shall establish a
statewide per diem rate for crisis stabilization services provided under this paragraph to
medical assistance enrollees. The rate for a provider shall not exceed the rate charged by
that provider for the same service to other payers. Payment shall not be made to more than
one entity for each individual for services provided under this paragraph on a given day.
The commissioner shall set rates prospectively for the annual rate period. The commissioner
shall require providers to submit annual cost reports on a uniform cost reporting form and
shall use submitted cost reports to inform the rate-setting process. The commissioner shall
recalculate the statewide per diem every year.

new text begin (c) For crisis stabilization services provided in a supervised, licensed residential setting
that serves more than four adult residents, the commissioner must set prospective rates for
the annual rate period using the same methodology described under section 256B.0622,
subdivision 8, for intensive residential treatment services.
new text end

new text begin EFFECTIVE DATE. new text end

new text begin This section is effective January 1, 2025, or upon federal approval,
whichever is later. The commissioner of human services shall notify the revisor of statutes
when federal approval is obtained.
new text end

Sec. 11.

Minnesota Statutes 2022, section 256B.0625, subdivision 20, is amended to read:

Subd. 20.

Mental health case management.

(a) To the extent authorized by rule of the
state agency, medical assistance covers case management services to persons with serious
and persistent mental illness and children with severe emotional disturbance. Services
provided under this section must meet the relevant standards in sections 245.461 to 245.4887,
the Comprehensive Adult and Children's Mental Health Acts, Minnesota Rules, parts
9520.0900 to 9520.0926, and 9505.0322, excluding subpart 10.

(b) Entities meeting program standards set out in rules governing family community
support services as defined in section 245.4871, subdivision 17, are eligible for medical
assistance reimbursement for case management services for children with severe emotional
disturbance when these services meet the program standards in Minnesota Rules, parts
9520.0900 to 9520.0926 and 9505.0322, excluding subparts 6 and 10.

(c) Medical assistance and MinnesotaCare payment for mental health case management
shall be made on a monthly basis. In order to receive payment for an eligible child, the
provider must document at least a face-to-face contact either in person or by interactive
video that meets the requirements of subdivision 20b with the child, the child's parents, or
the child's legal representative. To receive payment for an eligible adult, the provider must
document:

(1) at least a face-to-face contact with the adult or the adult's legal representative either
in person or by interactive video that meets the requirements of subdivision 20b; or

(2) at least a telephone contact new text begin or contact via secure electronic message, if preferred by
the adult client, new text end with the adult or the adult's legal representative and document a face-to-face
contact either in person or by interactive video that meets the requirements of subdivision
20b with the adult or the adult's legal representative within the preceding two months.

(d) Payment for mental health case management provided by county or state staff shall
be based on the monthly rate methodology under section 256B.094, subdivision 6, paragraph
(b), with separate rates calculated for child welfare and mental health, and within mental
health, separate rates for children and adults.

(e) Payment for mental health case management provided by Indian health services or
by agencies operated by Indian tribes may be made according to this section or other relevant
federally approved rate setting methodology.

(f) Payment for mental health case management provided by vendors who contract with
a county must be calculated in accordance with section 256B.076, subdivision 2. Payment
for mental health case management provided by vendors who contract with a Tribe must
be based on a monthly rate negotiated by the Tribe. The rate must not exceed the rate charged
by the vendor for the same service to other payers. If the service is provided by a team of
contracted vendors, the team shall determine how to distribute the rate among its members.
No reimbursement received by contracted vendors shall be returned to the county or tribe,
except to reimburse the county or tribe for advance funding provided by the county or tribe
to the vendor.

(g) If the service is provided by a team which includes contracted vendors, tribal staff,
and county or state staff, the costs for county or state staff participation in the team shall be
included in the rate for county-provided services. In this case, the contracted vendor, the
tribal agency, and the county may each receive separate payment for services provided by
each entity in the same month. In order to prevent duplication of services, each entity must
document, in the recipient's file, the need for team case management and a description of
the roles of the team members.

(h) Notwithstanding section 256B.19, subdivision 1, the nonfederal share of costs for
mental health case management shall be provided by the recipient's county of responsibility,
as defined in sections 256G.01 to 256G.12, from sources other than federal funds or funds
used to match other federal funds. If the service is provided by a tribal agency, the nonfederal
share, if any, shall be provided by the recipient's tribe. When this service is paid by the state
without a federal share through fee-for-service, 50 percent of the cost shall be provided by
the recipient's county of responsibility.

(i) Notwithstanding any administrative rule to the contrary, prepaid medical assistance
and MinnesotaCare include mental health case management. When the service is provided
through prepaid capitation, the nonfederal share is paid by the state and the county pays no
share.

(j) The commissioner may suspend, reduce, or terminate the reimbursement to a provider
that does not meet the reporting or other requirements of this section. The county of
responsibility, as defined in sections 256G.01 to 256G.12, or, if applicable, the tribal agency,
is responsible for any federal disallowances. The county or tribe may share this responsibility
with its contracted vendors.

(k) The commissioner shall set aside a portion of the federal funds earned for county
expenditures under this section to repay the special revenue maximization account under
section 256.01, subdivision 2, paragraph (o). The repayment is limited to:

(1) the costs of developing and implementing this section; and

(2) programming the information systems.

(l) Payments to counties and tribal agencies for case management expenditures under
this section shall only be made from federal earnings from services provided under this
section. When this service is paid by the state without a federal share through fee-for-service,
50 percent of the cost shall be provided by the state. Payments to county-contracted vendors
shall include the federal earnings, the state share, and the county share.

(m) Case management services under this subdivision do not include therapy, treatment,
legal, or outreach services.

(n) If the recipient is a resident of a nursing facility, intermediate care facility, or hospital,
and the recipient's institutional care is paid by medical assistance, payment for case
management services under this subdivision is limited to the lesser of:

(1) the last 180 days of the recipient's residency in that facility and may not exceed more
than six months in a calendar year; or

(2) the limits and conditions which apply to federal Medicaid funding for this service.

(o) Payment for case management services under this subdivision shall not duplicate
payments made under other program authorities for the same purpose.

(p) If the recipient is receiving care in a hospital, nursing facility, or residential setting
licensed under chapter 245A or 245D that is staffed 24 hours a day, seven days a week,
mental health targeted case management services must actively support identification of
community alternatives for the recipient and discharge planning.

Sec. 12. new text begin REVISOR INSTRUCTION.
new text end

new text begin The revisor of statutes, in consultation with the Office of Senate Counsel, Research and
Fiscal Analysis; the House Research Department; and the commissioner of human services,
shall prepare legislation for the 2025 legislative session to recodify Minnesota Statutes,
section 256B.0622, to move provisions related to assertive community treatment and intensive
residential treatment services into separate sections of statute. The revisor shall correct any
cross-references made necessary by this recodification.
new text end

ARTICLE 3

CHILDREN'S MENTAL HEALTH SERVICES

Section 1.

Minnesota Statutes 2023 Supplement, section 245.4889, subdivision 1, is
amended to read:

Subdivision 1.

Establishment and authority.

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

(1) counties;

(2) Indian tribes;

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

(4) mental health service providers.

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

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

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

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

(4) children's mental health crisis services;

(5) child-, youth-, and family-specific mobile response and stabilization services models;

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

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

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

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

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

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

(12) mental health first aid training;

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

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

(15) early childhood mental health consultation;

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

(17) psychiatric consultation for primary care practitioners; and

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

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

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

(e) The commissioner may establish and design a pilot program to expand the mobile
response and stabilization services model for children, youth, and families. The commissioner
may use grant funding to consult with a qualified expert entity to assist in the formulation
of measurable outcomes and explore and position the state to submit a Medicaid state plan
amendment to scale the model statewide.

Sec. 2.

Minnesota Statutes 2023 Supplement, section 256B.0941, subdivision 3, is amended
to read:

Subd. 3.

Per diem rate.

(a) The commissioner must establish one per diem rate per
provider for psychiatric residential treatment facility services for individuals 21 years of
age or younger. The rate for a provider must not exceed the rate charged by that provider
for the same service to other payers. Payment must not be made to more than one entity for
each individual for services provided under this section on a given day. The commissioner
must set rates prospectively for the annual rate period. The commissioner must require
providers to submit annual cost reports on a uniform cost reporting form and must use
submitted cost reports to inform the rate-setting process. The cost reporting must be done
according to federal requirements for Medicare cost reports.

(b) The following are included in the rate:

(1) costs necessary for licensure and accreditation, meeting all staffing standards for
participation, meeting all service standards for participation, meeting all requirements for
active treatment, maintaining medical records, conducting utilization review, meeting
inspection of care, and discharge planning. The direct services costs must be determined
using the actual cost of salaries, benefits, payroll taxes, and training of direct services staff
and service-related transportation; deleted text begin and
deleted text end

(2) payment for room and board provided by facilities meeting all accreditation and
licensing requirements for participation deleted text begin . deleted text end new text begin ;
new text end

new text begin (3) estimated additional direct care staffing compensation costs, subject to review by
the commissioner; and
new text end

new text begin (4) estimated new capital costs, subject to review by the commissioner.
new text end

(c) A facility may submit a claim for payment outside of the per diem for professional
services arranged by and provided at the facility by an appropriately licensed professional
who is enrolled as a provider with Minnesota health care programs. Arranged services may
be billed by either the facility or the licensed professional. These services must be included
in the individual plan of care and are subject to prior authorization.

(d) Medicaid must reimburse for concurrent services as approved by the commissioner
to support continuity of care and successful discharge from the facility. "Concurrent services"
means services provided by another entity or provider while the individual is admitted to a
psychiatric residential treatment facility. Payment for concurrent services may be limited
and these services are subject to prior authorization by the state's medical review agent.
Concurrent services may include targeted case management, assertive community treatment,
clinical care consultation, team consultation, and treatment planning.

(e) Payment rates under this subdivision must not include the costs of providing the
following services:

(1) educational services;

(2) acute medical care or specialty services for other medical conditions;

(3) dental services; and

(4) pharmacy drug costs.

(f) For purposes of this section, "actual cost" means costs that are allowable, allocable,
reasonable, and consistent with federal reimbursement requirements in Code of Federal
Regulations, title 48, chapter 1, part 31, relating to for-profit entities, and the Office of
Management and Budget Circular Number A-122, relating to nonprofit entities.

(g) The commissioner shall annually adjust psychiatric residential treatment facility
services per diem rates to reflect the change in the Centers for Medicare and Medicaid
Services Inpatient Psychiatric Facility Market Basket. The commissioner shall use the
indices as forecasted for the midpoint of the prior rate year to the midpoint of the current
rate year.

new text begin (h) For a rate that was set incorporating the provider's estimated direct care staffing
compensation and new capital costs under paragraph (b), the commissioner must reconcile
the provider's rate with the provider's actual costs from the prior 12 months.
new text end

new text begin EFFECTIVE DATE. new text end

new text begin This section is effective January 1, 2025, or upon federal approval,
whichever is later. The commissioner of human services shall notify the revisor of statutes
when federal approval is obtained.
new text end

Sec. 3.

Minnesota Statutes 2022, section 256B.0943, subdivision 3, is amended to read:

Subd. 3.

Determination of client eligibility.

new text begin (a) Based on a client's needs identified in
a crisis assessment, a hospital's medical history and presentation examination, or a brief
diagnostic assessment under section 245I.10, subdivision 5, a license holder may provide
a client with any combination of psychotherapy sessions, group psychotherapy sessions,
family psychotherapy sessions, and family psychoeducation sessions.
new text end

deleted text begin (a) deleted text end new text begin (b) new text end A client's new text begin ongoing new text end eligibility to receive children's therapeutic services and supports
under this section shall be determined based on a standard diagnostic assessment by a mental
health professional or a clinical trainee that is performed within one year before the initial
start of service new text begin and updated as required under section 245I.10, subdivision 2 new text end . The standard
diagnostic assessment must:

(1) determine whether a child under age 18 has a diagnosis of emotional disturbance or,
if the person is between the ages of 18 and 21, whether the person has a mental illness;

(2) document children's therapeutic services and supports as medically necessary to
address an identified disability, functional impairment, and the individual client's needs and
goals; and

(3) be used in the development of the individual treatment plan.

deleted text begin (b) deleted text end new text begin (c) new text end Notwithstanding paragraph deleted text begin (a) deleted text end new text begin (b) new text end , a client may be determined to be eligible for
up to five days of day treatment under this section based on a hospital's medical history and
presentation examination of the client.

deleted text begin (c) deleted text end new text begin (d) new text end Children's therapeutic services and supports include development and rehabilitative
services that support a child's developmental treatment needs.

Sec. 4.

Minnesota Statutes 2022, section 256B.0943, subdivision 12, is amended to read:

Subd. 12.

Excluded services.

The following services are not eligible for medical
assistance payment as children's therapeutic services and supports:

(1) service components of children's therapeutic services and supports simultaneously
provided by more than one provider entity unless prior authorization is obtained;

deleted text begin (2) treatment by multiple providers within the same agency at the same clock time;
deleted text end

deleted text begin (3) deleted text end new text begin (2) new text end children's therapeutic services and supports provided in violation of medical
assistance policy in Minnesota Rules, part 9505.0220;

deleted text begin (4) deleted text end new text begin (3) new text end mental health behavioral aide services provided by a personal care assistant who
is not qualified as a mental health behavioral aide and employed by a certified children's
therapeutic services and supports provider entity;

deleted text begin (5) deleted text end new text begin (4) new text end service components of CTSS that are the responsibility of a residential or program
license holder, including foster care providers under the terms of a service agreement or
administrative rules governing licensure; and

deleted text begin (6) deleted text end new text begin (5) new text end adjunctive activities that may be offered by a provider entity but are not otherwise
covered by medical assistance, including:

(i) a service that is primarily recreation oriented or that is provided in a setting that is
not medically supervised. This includes sports activities, exercise groups, activities such as
craft hours, leisure time, social hours, meal or snack time, trips to community activities,
and tours;

(ii) a social or educational service that does not have or cannot reasonably be expected
to have a therapeutic outcome related to the client's emotional disturbance;

(iii) prevention or education programs provided to the community; and

(iv) treatment for clients with primary diagnoses of alcohol or other drug abuse.

Sec. 5.

Minnesota Statutes 2022, section 256B.0947, subdivision 5, is amended to read:

Subd. 5.

Standards for intensive nonresidential rehabilitative providers.

(a) Services
must meet the standards in this section and chapter 245I as required in section 245I.011,
subdivision 5.

(b) The treatment team must have specialized training in providing services to the specific
age group of youth that the team serves. An individual treatment team must serve youth
who are: (1) at least eight years of age or older and under 16 years of age, or (2) at least 14
years of age or older and under 21 years of age.

(c) The treatment team for intensive nonresidential rehabilitative mental health services
comprises both permanently employed core team members and client-specific team members
as follows:

(1) Based on professional qualifications and client needs, clinically qualified core team
members are assigned on a rotating basis as the client's lead worker to coordinate a client's
care. The core team must comprise at least four full-time equivalent direct care staff and
must minimally include:

(i) a mental health professional who serves as team leader to provide administrative
direction and treatment supervision to the team;

(ii) an advanced-practice registered nurse with certification in psychiatric or mental
health care or a board-certified child and adolescent psychiatrist, either of which must be
credentialed to prescribe medications;

deleted text begin (iii) a licensed alcohol and drug counselor who is also trained in mental health
interventions; and
deleted text end

deleted text begin (iv) deleted text end new text begin (iii) new text end a mental health certified peer specialist who is qualified according to section
245I.04, subdivision 10, and is also a former children's mental health consumer deleted text begin . deleted text end new text begin ; and
new text end

new text begin (iv) a co-occurring disorder specialist who meets the requirements under section
256B.0622, subdivision 7a, paragraph (a), clause (4), who will provide or facilitate the
provision of co-occurring disorder treatment to clients.
new text end

(2) The core team may also include any of the following:

(i) additional mental health professionals;

(ii) a vocational specialist;

(iii) an educational specialist with knowledge and experience working with youth
regarding special education requirements and goals, special education plans, and coordination
of educational activities with health care activities;

(iv) a child and adolescent psychiatrist who may be retained on a consultant basis;

(v) a clinical trainee qualified according to section 245I.04, subdivision 6;

(vi) a mental health practitioner qualified according to section 245I.04, subdivision 4;

(vii) a case management service provider, as defined in section 245.4871, subdivision
4;

(viii) a housing access specialist; and

(ix) a family peer specialist as defined in subdivision 2, paragraph (j).

(3) A treatment team may include, in addition to those in clause (1) or (2), ad hoc
members not employed by the team who consult on a specific client and who must accept
overall clinical direction from the treatment team for the duration of the client's placement
with the treatment team and must be paid by the provider agency at the rate for a typical
session by that provider with that client or at a rate negotiated with the client-specific
member. Client-specific treatment team members may include:

(i) the mental health professional treating the client prior to placement with the treatment
team;

(ii) the client's current substance use counselor, if applicable;

(iii) a lead member of the client's individualized education program team or school-based
mental health provider, if applicable;

(iv) a representative from the client's health care home or primary care clinic, as needed
to ensure integration of medical and behavioral health care;

(v) the client's probation officer or other juvenile justice representative, if applicable;
and

(vi) the client's current vocational or employment counselor, if applicable.

(d) The treatment supervisor shall be an active member of the treatment team and shall
function as a practicing clinician at least on a part-time basis. The treatment team shall meet
with the treatment supervisor at least weekly to discuss recipients' progress and make rapid
adjustments to meet recipients' needs. The team meeting must include client-specific case
reviews and general treatment discussions among team members. Client-specific case
reviews and planning must be documented in the individual client's treatment record.

(e) The staffing ratio must not exceed ten clients to one full-time equivalent treatment
team position.

(f) The treatment team shall serve no more than 80 clients at any one time. Should local
demand exceed the team's capacity, an additional team must be established rather than
exceed this limit.

(g) Nonclinical staff shall have prompt access in person or by telephone to a mental
health practitioner, clinical trainee, or mental health professional. The provider shall have
the capacity to promptly and appropriately respond to emergent needs and make any
necessary staffing adjustments to ensure the health and safety of clients.

(h) The intensive nonresidential rehabilitative mental health services provider shall
participate in evaluation of the assertive community treatment for youth (Youth ACT) model
as conducted by the commissioner, including the collection and reporting of data and the
reporting of performance measures as specified by contract with the commissioner.

(i) A regional treatment team may serve multiple counties.

Sec. 6.

Minnesota Statutes 2023 Supplement, section 256B.0947, subdivision 7, is amended
to read:

Subd. 7.

Medical assistance payment and rate setting.

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

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

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

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

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

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

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

(5) the costs of other services that will be separately reimbursed deleted text begin . deleted text end new text begin ; and
new text end

new text begin (6) the estimated additional direct care staffing compensation costs for the next rate year
as reported by entities providing the service, subject to review by the commissioner.
new text end

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

(e) Effective for the rate years beginning on and after January 1, 2024, rates must be
annually adjusted for inflation using the Centers for Medicare and Medicaid Services
Medicare Economic Index, as forecasted in the fourth quarter of the calendar year before
the rate year. The inflation adjustment must be based on the 12-month period from the
midpoint of the previous rate year to the midpoint of the rate year for which the rate is being
determined.

new text begin (f) For a rate that was set incorporating the provider's estimated direct care staffing
compensation and new capital costs under paragraph (c), the commissioner must reconcile
the provider's rate with the provider's actual costs from the prior 12 months.
new text end

new text begin EFFECTIVE DATE. new text end

new text begin This section is effective January 1, 2025, or upon federal approval,
whichever is later. The commissioner of human services shall notify the revisor of statutes
when federal approval is obtained.
new text end

Sec. 7. new text begin DIRECTION TO COMMISSIONER OF HUMAN SERVICES; RESPITE
CARE ACCESS.
new text end

new text begin The commissioner of human services, in coordination with stakeholders, must develop
proposals by December 31, 2025, to increase access to licensed respite foster care homes
that take into consideration the new rule directing title IV-E agencies to adopt one set of
licensing or approval standards for all relative or kinship foster family homes that is different
from the licensing or approval standards used for nonrelative or nonkinship foster family
homes, as provided by the Federal Register, volume 88, page 66700.
new text end

Sec. 8. new text begin DIRECTION TO COMMISSIONER; MEDICAL ASSISTANCE
CHILDREN'S RESIDENTIAL MENTAL HEALTH CRISIS STABILIZATION.
new text end

new text begin (a) The commissioner of human services must consult with providers, advocates, Tribal
Nations, counties, people with lived experience as or with a child in a mental health crisis,
and other interested community members to develop a covered benefit under medical
assistance to provide residential mental health crisis stabilization for children. The benefit
must:
new text end

new text begin (1) consist of evidence-based promising practices or culturally responsive treatment
services for children under the age of 21 experiencing a mental health crisis;
new text end

new text begin (2) embody an integrative care model that supports individuals experiencing a mental
health crisis who may also be experiencing co-occurring conditions;
new text end

new text begin (3) qualify for federal financial participation; and
new text end

new text begin (4) include services that support children and families, including but not limited to:
new text end

new text begin (i) an assessment of the child's immediate needs and factors that led to the mental health
crisis;
new text end

new text begin (ii) individualized care to address immediate needs and restore the child to a precrisis
level of functioning;
new text end

new text begin (iii) 24-hour on-site staff and assistance;
new text end

new text begin (iv) supportive counseling and clinical services;
new text end

new text begin (v) skills training and positive support services, as identified in the child's individual
crisis stabilization plan;
new text end

new text begin (vi) referrals to other service providers in the community as needed and to support the
child's transition from residential crisis stabilization services;
new text end

new text begin (vii) development of an individualized and culturally responsive crisis response action
plan; and
new text end

new text begin (viii) assistance to access and store medication.
new text end

new text begin (b) When developing the new benefit, the commissioner must make recommendations
for providers to be reimbursed for room and board.
new text end

new text begin (c) The commissioner must consult with or contract with rate-setting experts to develop
a prospective data-based rate methodology for the children's residential mental health crisis
stabilization benefit.
new text end

new text begin (d) No later than October 1, 2025, the commissioner must submit to the chairs and
ranking minority members of the legislative committees with jurisdiction over human
services policy and finance a report detailing for the children's residential mental health
crisis stabilization benefit the proposed:
new text end

new text begin (1) eligibility, clinical and service requirements, provider standards, licensing
requirements, and reimbursement rates;
new text end

new text begin (2) process for community engagement, community input, and crisis models studied in
other states;
new text end

new text begin (3) deadline for the commissioner to submit a state plan amendment to the Centers for
Medicare and Medicaid Services; and
new text end

new text begin (4) draft legislation with the statutory changes necessary to implement the benefit.
new text end

new text begin EFFECTIVE DATE. new text end

new text begin This section is effective July 1, 2024.
new text end

Sec. 9. new text begin DIRECTION TO COMMISSIONER; CHILDREN'S RESIDENTIAL
FACILITY RULEMAKING.
new text end

new text begin (a) The commissioner of human services must use the expedited rulemaking process
and comply with all requirements under Minnesota Statutes, section 14.389, to adopt the
amendments required under this section.
new text end

new text begin (b) The commissioner of human services must amend Minnesota Rules, chapter 2960,
to replace all instances of the term "clinical supervision" with the term "treatment
supervision."
new text end

new text begin (c) The commissioner of human services must amend Minnesota Rules, part 2960.0020,
to replace all instances of the term "clinical supervisor" with the term "treatment supervisor."
new text end

new text begin (d) The commissioner of human services must amend Minnesota Rules, part 2960.0020,
to add the definition of "licensed prescriber" to mean an individual who is authorized to
prescribe legend drugs under Minnesota Statutes, section 151.37.
new text end

new text begin (e) The commissioner of human services must amend Minnesota Rules, parts 2960.0020
to 2960.0710, to replace all instances of "physician" with "licensed prescriber."
new text end

new text begin (f) The commissioner of human services must amend Minnesota Rules, part 2960.0620,
subpart 1, item B, to allow a license holder to meet requirements by obtaining a copy of the
resident's medication management or evaluation treatment plan from the licensed prescriber.
new text end

new text begin (g) The commissioner of human services must amend Minnesota Rules, part 2960.0620,
subpart 5, to:
new text end

new text begin (1) remove the requirement for the license holder to conduct a psychotropic medication
review;
new text end

new text begin (2) require the license holder to document treatment coordination with the licensed
prescriber; and
new text end

new text begin (3) strike items A to D, and remove the requirements for the license holder to consider
and document items A to D at a quarterly review and provide the information in items A
and D to the licensed prescriber for review.
new text end

new text begin (h) The commissioner of human services must amend Minnesota Rules, part 2960.0620,
subpart 2, to strike all of the current language and insert the following language: "If a resident
is prescribed a psychotropic medication, the license holder must monitor for side effects of
the medication. Within 24 hours of admission, a registered nurse or licensed prescriber must
assess the resident for and document any current side effects and document instructions for
how frequently the license holder must monitor for side effects of the psychotropic
medications the resident is taking. When a resident begins taking a new psychotropic
medication or stops taking a psychotropic medication, the license holder must monitor for
side effects according to the instructions of the registered nurse or licensed prescriber. The
license holder must monitor for side effects using standardized checklists, rating scales, or
other tools according to the instructions of the registered nurse or licensed prescriber. The
license holder must provide the results of the checklist, rating scale, or other tool to the
licensed prescriber for review."
new text end

new text begin (i) The commissioner of human services must amend Minnesota Rules, part 2960.0630,
subpart 2, to allow license holders to use the ancillary meeting process under Minnesota
Statutes, section 245I.23, subdivision 14, paragraph (c), if a staff member cannot participate
in a weekly clinical supervision session.
new text end

new text begin (j) The commissioner of human services must amend Minnesota Rules, part 2960.0630,
subpart 3, to strike item D.
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. 10. new text begin REPEALER.
new text end

new text begin Minnesota Rules, part 2960.0620, subpart 3, new text end new text begin is repealed.
new text end

ARTICLE 4

SUBSTANCE USE DISORDER SERVICES

Section 1.

new text begin [144.2256] CERTIFIED BIRTH RECORD FOR PERSONS ELIGIBLE
FOR MEDICAL ASSISTANCE.
new text end

new text begin Subdivision 1. new text end

new text begin Application; birth record. new text end

new text begin A subject of a birth record who is eligible
for medical assistance according to chapter 256B and who has been treated for a substance
use disorder within the last 12 months may apply to the state registrar or a local issuance
office for a certified birth record according to this section. The state registrar or local issuance
office shall issue a certified birth record, or statement of no vital record found, to a subject
of a birth record who submits:
new text end

new text begin (1) a completed application signed by the subject of the birth record;
new text end

new text begin (2) a statement of eligibility from an employee of a human services agency or treatment
provider licensed under chapter 245G that receives public funding to provide services to
people with substance use disorders. The statement must verify the subject of the birth
record is eligible for medical assistance according to chapter 256B and has been treated for
a substance use disorder in the last 12 months. The statement must comply with the
requirements in subdivision 2; and
new text end

new text begin (3) identification in the form of:
new text end

new text begin (i) a document of identity listed in Minnesota Rules, part 4601.2600, subpart 8, or, at
the discretion of the state registrar or local issuance office, Minnesota Rules, part 4601.2600,
subpart 9;
new text end

new text begin (ii) a statement that complies with Minnesota Rules, part 4601.2600, subparts 6 and 7;
or
new text end

new text begin (iii) a statement of identity provided by the employee of a human services agency or
treatment provider that receives public funding to provide services to people with substance
use disorders who verified eligibility. The statement must comply with Minnesota Rules,
part 4601.2600, subpart 7.
new text end

new text begin Subd. 2. new text end

new text begin Statement of eligibility. new text end

new text begin A statement of eligibility must be from an employee
of a human services agency or treatment provider that receives public funding to provide
services to people with substance use disorders and must verify the subject of the birth
record is eligible for medical assistance according to chapter 256B and has been treated for
a substance use disorder within the last 12 months. The statement of eligibility must include:
new text end

new text begin (1) the employee's first name, middle name, if any, and last name; home or business
address; telephone number, if any; and email address, if any;
new text end

new text begin (2) the name of the human services agency or treatment provider that receives public
funding to provide services to people with substance use disorders that employs the person
making the eligibility statement;
new text end

new text begin (3) the first name, middle name, if any, and last name of the subject of the birth record;
new text end

new text begin (4) a copy of the individual's employment identification or verification of employment
linking the employee to the human services agency or treatment provider that provided
treatment; and
new text end

new text begin (5) a statement specifying the relationship of the individual providing the eligibility
statement to the subject of the birth record.
new text end

new text begin Subd. 3. new text end

new text begin Data practices. new text end

new text begin Data listed under subdivision 1, clauses (2) and (3), are private
data on individuals.
new text end

Sec. 2.

Minnesota Statutes 2022, section 144.226, is amended by adding a subdivision to
read:

new text begin Subd. 9. new text end

new text begin Birth record fees waived for persons treated for substance use disorders. new text end

new text begin A
subject of a birth record who is eligible for medical assistance according to chapter 256B
and who has been treated for a substance use disorder within the last 12 months must not
be charged any of the fees specified in this section for a certified birth record or statement
of no vital record found under section 144.2256.
new text end

new text begin EFFECTIVE DATE. new text end

new text begin This section is effective January 1, 2024.
new text end

Sec. 3.

Minnesota Statutes 2022, section 148F.025, subdivision 2, is amended to read:

Subd. 2.

Education requirements for licensure.

An applicant for licensure must submit
evidence satisfactory to the board that the applicant has:

(1) received a bachelor's new text begin or master's new text end degree from an accredited school or educational
program; and

(2) received 18 semester credits or 270 clock hours of academic course work and 880
clock hours of supervised alcohol and drug counseling practicum from an accredited school
or education program. The course work and practicum do not have to be part of the bachelor's
degree earned under clause (1). The academic course work must be in the following areas:

(i) an overview of the transdisciplinary foundations of alcohol and drug counseling,
including theories of chemical dependency, the continuum of care, and the process of change;

(ii) pharmacology of substance abuse disorders and the dynamics of addiction, including
substance use disorder treatment with medications for opioid use disorder;

(iii) professional and ethical responsibilities;

(iv) multicultural aspects of chemical dependency;

(v) co-occurring disorders; and

(vi) the core functions defined in section 148F.01, subdivision 10.

Sec. 4.

Minnesota Statutes 2022, section 245G.01, is amended by adding a subdivision to
read:

new text begin Subd. 8a. new text end

new text begin Clinical trainee. new text end

new text begin "Clinical trainee" means a staff person who is qualified
according to section 245I.04, subdivision 6, working under the supervision of a mental
health professional.
new text end

Sec. 5.

Minnesota Statutes 2022, section 245G.01, is amended by adding a subdivision to
read:

new text begin Subd. 17a. new text end

new text begin Mental health professional. new text end

new text begin "Mental health professional" means a staff
person who is qualified under section 245I.04, subdivision 2.
new text end

Sec. 6.

Minnesota Statutes 2022, section 245G.01, is amended by adding a subdivision to
read:

new text begin Subd. 17b. new text end

new text begin Qualified professional. new text end

new text begin "Qualified professional" means a licensed alcohol
and drug counselor; mental health professional; registered nurse who has completed at least
12 hours of training in diagnosing and treating addiction, co-occurring disorders, or substance
use disorder; or clinical trainee working under the supervision of a mental health professional.
new text end

Sec. 7.

Minnesota Statutes 2023 Supplement, section 245G.05, subdivision 1, is amended
to read:

Subdivision 1.

Comprehensive assessment.

A comprehensive assessment of the client's
substance use disorder must be administered face-to-face by deleted text begin an alcohol and drug counselor deleted text end new text begin
a qualified professional new text end within five calendar days from the day of service initiation for a
residential program or by the end of the fifth day on which a treatment service is provided
in a nonresidential program. The number of days to complete the comprehensive assessment
excludes the day of service initiation. If the comprehensive assessment is not completed
within the required time frame, the person-centered reason for the delay and the planned
completion date must be documented in the client's file. The comprehensive assessment is
complete upon a qualified deleted text begin staff member's deleted text end new text begin professional's new text end dated signature. If the client received
a comprehensive assessment that authorized the treatment service, deleted text begin an alcohol and drug
counselor deleted text end new text begin a qualified professional new text end may use the comprehensive assessment for requirements
of this subdivision but must document a review of the comprehensive assessment and update
the comprehensive assessment as clinically necessary to ensure compliance with this
subdivision within applicable timelines. An alcohol and drug counselor must sign and date
the comprehensive assessment review and update.

Sec. 8.

Minnesota Statutes 2023 Supplement, section 245G.06, subdivision 1, is amended
to read:

Subdivision 1.

General.

Each client must have a person-centered individual treatment
plan developed by deleted text begin an alcohol and drug counselor deleted text end new text begin a qualified professional new text end within ten days
from the day of service initiation for a residential program, by the end of the tenth day on
which a treatment session has been provided from the day of service initiation for a client
in a nonresidential program, not to exceed 30 days. Opioid treatment programs must complete
the individual treatment plan within 21 days from the day of service initiation. The number
of days to complete the individual treatment plan excludes the day of service initiation. The
individual treatment plan must be signed by the client and the deleted text begin alcohol and drug counselor deleted text end new text begin
qualified professional new text end and document the client's involvement in the development of the
plan. The individual treatment plan is developed upon the qualified deleted text begin staff member's deleted text end new text begin
professional's new text end dated signature. Treatment planning must include ongoing assessment of
client needs. An individual treatment plan must be updated based on new information
gathered about the client's condition, the client's level of participation, and on whether
methods identified have the intended effect. A change to the plan must be signed by the
client and the deleted text begin alcohol and drug counselor deleted text end new text begin qualified professional new text end . If the client chooses to
have family or others involved in treatment services, the client's individual treatment plan
must include how the family or others will be involved in the client's treatment. If a client
is receiving treatment services or an assessment via telehealth and the deleted text begin alcohol and drug
counselor deleted text end new text begin qualified professional new text end documents the reason the client's signature cannot be
obtained, the deleted text begin alcohol and drug counselor deleted text end new text begin qualified professional new text end may document the client's
verbal approval or electronic written approval of the treatment plan or change to the treatment
plan in lieu of the client's signature.

Sec. 9.

Minnesota Statutes 2023 Supplement, section 245G.06, subdivision 3, is amended
to read:

Subd. 3.

Treatment plan review.

A treatment plan review must be completed by the
deleted text begin alcohol and drug counselor deleted text end new text begin qualified professional new text end responsible for the client's treatment plan.
The review must indicate the span of time covered by the review and must:

(1) document client goals addressed since the last treatment plan review and whether
the identified methods continue to be effective;

(2) document monitoring of any physical and mental health problems and include
toxicology results for alcohol and substance use, when available;

(3) document the participation of others involved in the individual's treatment planning,
including when services are offered to the client's family or significant others;

(4) if changes to the treatment plan are determined to be necessary, document staff
recommendations for changes in the methods identified in the treatment plan and whether
the client agrees with the change;

(5) include a review and evaluation of the individual abuse prevention plan according
to section 245A.65; and

(6) document any referrals made since the previous treatment plan review.

Sec. 10.

Minnesota Statutes 2023 Supplement, section 245G.06, subdivision 3a, is amended
to read:

Subd. 3a.

Frequency of treatment plan reviews.

(a) A license holder must ensure that
the deleted text begin alcohol and drug counselor deleted text end new text begin qualified professional new text end responsible for a client's treatment
plan completes and documents a treatment plan review that meets the requirements of
subdivision 3 in each client's file, according to the frequencies required in this subdivision.
All ASAM levels referred to in this chapter are those described in section 254B.19,
subdivision 1.

(b) For a client receiving residential ASAM level 3.3 or 3.5 high-intensity services or
residential hospital-based services, a treatment plan review must be completed once every
14 days.

(c) For a client receiving residential ASAM level 3.1 low-intensity services or any other
residential level not listed in paragraph (b), a treatment plan review must be completed once
every 30 days.

(d) For a client receiving nonresidential ASAM level 2.5 partial hospitalization services,
a treatment plan review must be completed once every 14 days.

(e) For a client receiving nonresidential ASAM level 1.0 outpatient or 2.1 intensive
outpatient services or any other nonresidential level not included in paragraph (d), a treatment
plan review must be completed once every 30 days.

(f) For a client receiving nonresidential opioid treatment program services according to
section 245G.22:

(1) a treatment plan review must be completed weekly for the ten weeks following
completion of the treatment plan; and

(2) monthly thereafter.

Treatment plan reviews must be completed more frequently when clinical needs warrant.

(g) Notwithstanding paragraphs (e) and (f), clause (2), for a client in a nonresidential
program with a treatment plan that clearly indicates less than five hours of skilled treatment
services will be provided to the client each month, a treatment plan review must be completed
once every 90 days. Treatment plan reviews must be completed more frequently when
clinical needs warrant.

Sec. 11.

Minnesota Statutes 2023 Supplement, section 245G.06, subdivision 4, is amended
to read:

Subd. 4.

Service discharge summary.

(a) deleted text begin An alcohol and drug counselor deleted text end new text begin A qualified
professional new text end must write a service discharge summary for each client. The service discharge
summary must be completed within five days of the client's service termination. A copy of
the client's service discharge summary must be provided to the client upon the client's
request.

(b) The service discharge summary must be recorded in the six dimensions listed in
section 254B.04, subdivision 4, and include the following information:

(1) the client's issues, strengths, and needs while participating in treatment, including
services provided;

(2) the client's progress toward achieving each goal identified in the individual treatment
plan;

(3) a risk rating and description for each of the ASAM six dimensions;

(4) the reasons for and circumstances of service termination. If a program discharges a
client at staff request, the reason for discharge and the procedure followed for the decision
to discharge must be documented and comply with the requirements in section 245G.14,
subdivision 3, clause (3);

(5) the client's living arrangements at service termination;

(6) continuing care recommendations, including transitions between more or less intense
services, or more frequent to less frequent services, and referrals made with specific attention
to continuity of care for mental health, as needed; and

(7) service termination diagnosis.

Sec. 12.

Minnesota Statutes 2022, section 245G.07, subdivision 3, is amended to read:

Subd. 3.

deleted text begin Counselors deleted text end new text begin Qualified professionals new text end .

All treatment services, except peer
recovery support services and treatment coordination, must be provided by an alcohol and
drug counselor qualified according to section 245G.11, subdivision 5, new text begin or any other qualified
professional, as defined in section 245G.01, subdivision 17b, new text end unless the individual providing
the service is specifically qualified according to the accepted credential required to provide
the service. The commissioner shall maintain a current list of professionals qualified to
provide treatment services.

Sec. 13.

Minnesota Statutes 2022, section 245G.07, subdivision 3a, is amended to read:

Subd. 3a.

Use of guest speakers.

(a) The license holder may allow a guest speaker to
present information to clients as part of a treatment service provided by deleted text begin an alcohol and drug
counselor deleted text end new text begin a qualified professional new text end , according to the requirements of this subdivision.

(b) deleted text begin An alcohol and drug counselor deleted text end new text begin A qualified professional new text end must visually observe and
listen to the presentation of information by a guest speaker the entire time the guest speaker
presents information to the clients. The deleted text begin alcohol and drug counselor deleted text end new text begin qualified professional new text end
is responsible for all information the guest speaker presents to the clients.

(c) The presentation of information by a guest speaker constitutes a direct contact service,
as defined in section 245C.02, subdivision 11.

(d) The license holder must provide the guest speaker with all training required for staff
members. If the guest speaker provides direct contact services one day a month or less, the
license holder must only provide the guest speaker with orientation training on the following
subjects before the guest speaker provides direct contact services:

(1) mandatory reporting of maltreatment, as specified in sections 245A.65, 626.557, and
626.5572 and chapter 260E;

(2) applicable client confidentiality rules and regulations;

(3) ethical standards for client interactions; and

(4) emergency procedures.

Sec. 14.

Minnesota Statutes 2022, section 245G.11, subdivision 7, is amended to read:

Subd. 7.

Treatment coordination provider qualifications.

(a) Treatment coordination
must be provided by qualified staff. An individual is qualified to provide treatment
coordination if the individual meets the qualifications of an alcohol and drug counselor
under subdivision 5 or if the individual:

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

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

(3) has successfully completed deleted text begin 30 hours of classroom instruction on treatment
coordination for an individual with substance use disorder deleted text end new text begin specific training on substance
use and co-occurring disorders that is consistent with national evidence-based practices new text end ; new text begin
and
new text end

(4) deleted text begin has either deleted text end new text begin meets one of the following criteria new text end :

(i) new text begin has new text end a bachelor's degree in one of the behavioral sciences or related fields new text begin and at least
1,000 hours of supervised experience working with individuals with substance use disorder new text end ;
deleted text begin or
deleted text end

new text begin (ii) is qualified as a mental health practitioner under section 245I.04, subdivision 4; or
new text end

deleted text begin (ii) deleted text end new text begin (iii) has a new text end current certification as an alcohol and drug counselor, level I, by the Upper
Midwest Indian Council on Addictive Disorders deleted text begin ; and deleted text end new text begin .
new text end

deleted text begin (5) has at least 2,000 hours of supervised experience working with individuals with
substance use disorder.
deleted text end

(b) A treatment coordinator must receive at least one hour of supervision regarding
individual service delivery from an alcohol and drug counselor, or a mental health
professional who has substance use treatment and assessments within the scope of their
practice, on a monthly basis.

Sec. 15.

Minnesota Statutes 2023 Supplement, section 254B.04, subdivision 1a, is amended
to read:

Subd. 1a.

Client eligibility.

(a) Persons eligible for benefits under Code of Federal
Regulations, title 25, part 20, who meet the income standards of section 256B.056,
subdivision 4, and are not enrolled in medical assistance, are entitled to behavioral health
fund services. State money appropriated for this paragraph must be placed in a separate
account established for this purpose.

(b) Persons with dependent children who are determined to be in need of substance use
disorder treatment pursuant to an assessment under section 260E.20, subdivision 1, or in
need of chemical dependency treatment pursuant to a case plan under section 260C.201,
subdivision 6, or 260C.212, shall be assisted by the local agency to access needed treatment
services. Treatment services must be appropriate for the individual or family, which may
include long-term care treatment or treatment in a facility that allows the dependent children
to stay in the treatment facility. The county shall pay for out-of-home placement costs, if
applicable.

(c) Notwithstanding paragraph (a), persons enrolled in medical assistance are eligible
for room and board services under section 254B.05, subdivision 5, paragraph (b), clause
(12).

(d) A client is eligible to have substance use disorder treatment paid for with funds from
the behavioral health fund when the client:

(1) is eligible for MFIP as determined under chapter 256J;

(2) is eligible for medical assistance as determined under Minnesota Rules, parts
9505.0010 to 9505.0150;

(3) is eligible for general assistance, general assistance medical care, or work readiness
as determined under Minnesota Rules, parts 9500.1200 to 9500.1318; or

(4) has income that is within current household size and income guidelines for entitled
persons, as defined in this subdivision and subdivision 7.

(e) Clients who meet the financial eligibility requirement in paragraph (a) and who have
a third-party payment source are eligible for the behavioral health fund if the third-party
payment source pays less than 100 percent of the cost of treatment services for eligible
clients.

(f) A client is ineligible to have substance use disorder treatment services paid for with
behavioral health fund money if the client:

(1) has an income that exceeds current household size and income guidelines for entitled
persons as defined in this subdivision and subdivision 7; or

(2) has an available third-party payment source that will pay the total cost of the client's
treatment.

(g) A client who is disenrolled from a state prepaid health plan during a treatment episode
is eligible for continued treatment service that is paid for by the behavioral health fund until
the treatment episode is completed or the client is re-enrolled in a state prepaid health plan
if the client:

(1) continues to be enrolled in MinnesotaCare, medical assistance, or general assistance
medical care; or

(2) is eligible according to paragraphs (a) and (b) and is determined eligible by a local
agency under section 254B.04.

(h) When a county commits a client under chapter 253B to a regional treatment center
for substance use disorder services and the client is ineligible for the behavioral health fund,
the county is responsible for the payment to the regional treatment center according to
section 254B.05, subdivision 4.

new text begin (i) Notwithstanding paragraph (a), persons enrolled in MinnesotaCare are eligible for
room and board services under section 254B.05, subdivision 1a, paragraph (e).
new text end

new text begin EFFECTIVE DATE. new text end

new text begin This section is effective January 1, 2025, or upon federal approval,
whichever is later. The commissioner of human services shall notify the revisor of statutes
when federal approval is obtained.
new text end

ARTICLE 5

HOUSING SUPPORTS

Section 1.

Minnesota Statutes 2023 Supplement, section 256D.01, subdivision 1a, is
amended to read:

Subd. 1a.

Standards.

(a) A principal objective in providing general assistance is to
provide for single adults, childless couples, or children as defined in section 256D.02,
subdivision 2b, ineligible for federal programs who are unable to provide for themselves.
The minimum standard of assistance determines the total amount of the general assistance
grant without separate standards for shelter, utilities, or other needs.

(b) The standard of assistance for an assistance unit consisting of a recipient who is
childless and unmarried or living apart from children and spouse and who does not live with
a parent or parents or a legal custodian, or consisting of a childless couple, is $350 per month
effective October 1, 2024, and must be adjusted by a percentage equal to the change in the
consumer price index as of January 1 every year, beginning October 1, 2025.

(c) For an assistance unit consisting of a single adult who lives with a parent or parents,
the general assistance standard of assistance is $350 per month effective October 1, deleted text begin 2023 deleted text end new text begin
2024 new text end , and must be adjusted by a percentage equal to the change in the consumer price index
as of January 1 every year, beginning October 1, 2025. Benefits received by a responsible
relative of the assistance unit under the Supplemental Security Income program, a workers'
compensation program, the Minnesota supplemental aid program, or any other program
based on the responsible relative's disability, and any benefits received by a responsible
relative of the assistance unit under the Social Security retirement program, may not be
counted in the determination of eligibility or benefit level for the assistance unit. Except as
provided below, the assistance unit is ineligible for general assistance if the available
resources or the countable income of the assistance unit and the parent or parents with whom
the assistance unit lives are such that a family consisting of the assistance unit's parent or
parents, the parent or parents' other family members and the assistance unit as the only or
additional minor child would be financially ineligible for general assistance. For the purposes
of calculating the countable income of the assistance unit's parent or parents, the calculation
methods must follow the provisions under section 256P.06.

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 2022, section 256I.04, subdivision 2f, is amended to read:

Subd. 2f.

Required services.

(a) In deleted text begin licensed and registered deleted text end new text begin authorized new text end settings under
subdivision 2a, providers shall ensure that participants have at a minimum:

(1) food preparation and service for three nutritional meals a day on site;

(2) a bed, clothing storage, linen, bedding, laundering, and laundry supplies or service;

(3) housekeeping, including cleaning and lavatory supplies or service; and

(4) maintenance and operation of the building and grounds, including heat, water, garbage
removal, electricity, telephone for the site, cooling, supplies, and parts and tools to repair
and maintain equipment and facilities.

(b) In addition, when providers serve participants described in subdivision 1, paragraph
(c), the providers are required to assist the participants in applying for continuing housing
support payments before the end of the eligibility period.

Sec. 3.

Minnesota Statutes 2023 Supplement, section 256I.05, subdivision 1a, is amended
to read:

Subd. 1a.

Supplementary service rates.

(a) Subject to the provisions of section 256I.04,
subdivision 3, the agency may negotiate a payment not to exceed $494.91 for other services
necessary to provide room and board if the residence is licensed by or registered by the
Department of Health, or licensed by the Department of Human Services to provide services
in addition to room and board, and if the provider of services is not also concurrently
receiving funding for services for a recipient in the residence under the following programs
or funding sources: (1) home and community-based waiver services under chapter 256S or
section 256B.0913, 256B.092, or 256B.49; (2) personal care assistance under section
256B.0659; (3) community first services and supports under section 256B.85; or (4) services
for adults with mental illness grants under section 245.73. If funding is available for other
necessary services through a home and community-based waiver under chapter 256S, or
section 256B.0913, 256B.092, or 256B.49; personal care assistance services under section
256B.0659; community first services and supports under section 256B.85; or services for
adults with mental illness grants under section 245.73, then the housing support rate is
limited to the rate set in subdivision 1. Unless otherwise provided in law, in no case may
the supplementary service rate exceed $494.91. The registration and licensure requirement
does not apply to establishments which are exempt from state licensure because they are
located on Indian reservations and for which the tribe has prescribed health and safety
requirements. Service payments under this section may be prohibited under rules to prevent
the supplanting of federal funds with state funds.

deleted text begin (b) The commissioner is authorized to make cost-neutral transfers from the housing
support fund for beds under this section to other funding programs administered by the
department after consultation with the agency in which the affected beds are located. The
commissioner may also make cost-neutral transfers from the housing support fund to agencies
for beds permanently removed from the housing support census under a plan submitted by
the agency and approved by the commissioner. The commissioner shall report the amount
of any transfers under this provision annually to the legislature.
deleted text end

deleted text begin (c) deleted text end new text begin (b) new text end Agencies must not negotiate supplementary service rates with providers of housing
support that are licensed as board and lodging with special services and that do not encourage
a policy of sobriety on their premises and make referrals to available community services
for volunteer and employment opportunities for residents.

Sec. 4.

Minnesota Statutes 2023 Supplement, section 256I.05, subdivision 11, is amended
to read:

Subd. 11.

deleted text begin Transfer of emergency shelter funds deleted text end new text begin Cost-neutral transfers from the
housing support fund new text end .

new text begin (a) The commissioner is authorized to make cost-neutral transfers
from the housing support fund for beds under this section to other funding programs
administered by the department after consultation with the agency in which the affected
beds are located.
new text end

new text begin (b) The commissioner may also make cost-neutral transfers from the housing support
fund to agencies for beds removed from the housing support census under a plan submitted
by the agency and approved by the commissioner.
new text end

deleted text begin (a) deleted text end new text begin (c) new text end The commissioner shall make a cost-neutral transfer of funding from the housing
support fund to the agency for emergency shelter beds removed from the housing support
census under a deleted text begin biennial deleted text end plan submitted by the agency and approved by the commissioner. new text begin
Plans submitted under this paragraph must include anticipated and actual outcomes for
persons experiencing homelessness in emergency shelters.
new text end

deleted text begin The plan deleted text end new text begin (d) Plans submitted under paragraph (b) or (c) new text end must describe: (1) deleted text begin anticipated
and actual outcomes for persons experiencing homelessness in emergency shelters; (2) deleted text end
improved efficiencies in administration; deleted text begin (3) deleted text end new text begin (2) new text end requirements for individual eligibility; and
deleted text begin (4) deleted text end new text begin (3) new text end plans for quality assurance monitoring and quality assurance outcomes. The
commissioner shall review deleted text begin the deleted text end agency deleted text begin plan deleted text end new text begin plans new text end to monitor implementation and outcomes
at least biennially, and more frequently if the commissioner deems necessary.

deleted text begin (b) The deleted text end new text begin (e) new text end Funding under paragraph deleted text begin (a) deleted text end new text begin (b), (c), or (d) new text end may be used for the provision
of room and board or supplemental services according to section 256I.03, subdivisions 14a
and 14b. Providers must meet the requirements of section 256I.04, subdivisions 2a to 2f.
Funding must be allocated annually, and the room and board portion of the allocation shall
be adjusted according to the percentage change in the housing support room and board rate.
deleted text begin The room and board portion of the allocation shall be determined at the time of transfer. deleted text end
The commissioner or agency may return beds to the housing support fund with 180 days'
notice, including financial reconciliation.

Sec. 5. new text begin REVISOR INSTRUCTION.
new text end

new text begin The revisor of statutes shall renumber Minnesota Statutes, section 256D.21, as Minnesota
Statutes, section 261.004.
new text end

Sec. 6. new text begin REPEALER.
new text end

new text begin Minnesota Statutes 2022, sections 256D.19, subdivisions 1 and 2; 256D.20, subdivisions
1, 2, 3, and 4; and 256D.23, subdivisions 1, 2, and 3, new text end new text begin are repealed.
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

ARTICLE 6

MISCELLANEOUS

Section 1.

new text begin [144.88] MENTAL HEALTH AND SUBSTANCE USE DISORDER
EDUCATION CENTER.
new text end

new text begin Subdivision 1. new text end

new text begin Establishment. new text end

new text begin The Mental Health and Substance Use Disorder Education
Center is established in the Department of Health. The purposes of the center are to increase
the number of professionals, practitioners, and peers working in mental health and substance
use disorder treatment; increase the diversity of professionals, practitioners, and peers
working in mental health and substance use disorder treatment; and facilitate a culturally
informed and responsive mental health and substance use disorder treatment workforce.
new text end

new text begin Subd. 2. new text end

new text begin Activities. new text end

new text begin The Mental Health and Substance Use Disorder Education Center
must:
new text end

new text begin (1) analyze the geographic and demographic availability of licensed mental health and
substance use disorder treatment professionals, identify gaps, and prioritize the need for
additional licensed professionals by type, location, and demographics;
new text end

new text begin (2) create a program that exposes high school and college students to careers in the
mental health and substance use disorder fields;
new text end

new text begin (3) create a website for individuals considering becoming a mental health provider that
clearly labels the steps necessary to achieve licensure and certification in the various mental
health fields and lists resources and links for more information;
new text end

new text begin (4) create a job board for organizations seeking employees to provide mental health and
substance use disorder treatment, services, and supports;
new text end

new text begin (5) track the number of students at the undergraduate and graduate levels who are
graduating from programs in Minnesota that could facilitate a career as a mental health or
substance use disorder treatment practitioner or professional and work with Minnesota
colleges and universities to support the students in obtaining licensure;
new text end

new text begin (6) identify barriers to mental health professional licensure and make recommendations
to address the barriers;
new text end

new text begin (7) establish learning collaborative partnerships with mental health and substance use
disorder treatment providers, schools, criminal justice agencies, and others;
new text end

new text begin (8) promote and expand loan forgiveness programs, funding for professionals to become
supervisors, funding to pay for supervision, and funding for pathways to licensure;
new text end

new text begin (9) identify barriers to using loan forgiveness programs and develop recommendations
to address the barriers;
new text end

new text begin (10) work to expand Medicaid graduate medical education to other mental health
professionals;
new text end

new text begin (11) identify current sites for internships and practicums and assess the need for additional
sites;
new text end

new text begin (12) develop training to increase the knowledge about mental health and substance use
disorders for other health care professionals, including but not limited to community health
workers, pediatricians, primary care physicians, physician assistants, and nurses; and
new text end

new text begin (13) support training for integrated mental health and primary care in rural areas.
new text end

new text begin Subd. 3. new text end

new text begin Reports. new text end

new text begin Beginning January 1, 2025, the commissioner of health shall submit
an annual report to the chairs and ranking minority members of the legislative committees
with jurisdiction over health finance and policy summarizing the center's activities and
progress in addressing the mental health and substance use disorder treatment workforce
shortage.
new text end

Sec. 2.

Minnesota Statutes 2022, section 245.4663, subdivision 2, is amended to read:

Subd. 2.

Eligible providers.

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

(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;
deleted text begin or
deleted text end

(2) primarily serve underrepresented communities as defined in section 148E.010,
subdivision 20 deleted text begin . deleted text end new text begin ; or
new text end

new text begin (3) provide services to people in a city or township that is not within the seven-county
metropolitan area as defined in section 473.121, subdivision 2, and is not the city of Duluth,
Mankato, Moorhead, Rochester, or St. Cloud.
new text end

Sec. 3.

Minnesota Statutes 2023 Supplement, section 256.969, subdivision 2b, is amended
to read:

Subd. 2b.

Hospital payment rates.

(a) For discharges occurring on or after November
1, 2014, hospital inpatient services for hospitals located in Minnesota shall be paid according
to the following:

(1) critical access hospitals as defined by Medicare shall be paid using a cost-based
methodology;

(2) long-term hospitals as defined by Medicare shall be paid on a per diem methodology
under subdivision 25;

(3) rehabilitation hospitals or units of hospitals that are recognized as rehabilitation
distinct parts as defined by Medicare shall be paid according to the methodology under
subdivision 12; and

(4) all other hospitals shall be paid on a diagnosis-related group (DRG) methodology.

(b) For the period beginning January 1, 2011, through October 31, 2014, rates shall not
be rebased, except that a Minnesota long-term hospital shall be rebased effective January
1, 2011, based on its most recent Medicare cost report ending on or before September 1,
2008, with the provisions under subdivisions 9 and 23, based on the rates in effect on
December 31, 2010. For rate setting periods after November 1, 2014, in which the base
years are updated, a Minnesota long-term hospital's base year shall remain within the same
period as other hospitals.

(c) Effective for discharges occurring on and after November 1, 2014, payment rates
for hospital inpatient services provided by hospitals located in Minnesota or the local trade
area, except for the hospitals paid under the methodologies described in paragraph (a),
clauses (2) and (3), shall be rebased, incorporating cost and payment methodologies in a
manner similar to Medicare. The base year or years for the rates effective November 1,
2014, shall be calendar year 2012. The rebasing under this paragraph shall be budget neutral,
ensuring that the total aggregate payments under the rebased system are equal to the total
aggregate payments that were made for the same number and types of services in the base
year. Separate budget neutrality calculations shall be determined for payments made to
critical access hospitals and payments made to hospitals paid under the DRG system. Only
the rate increases or decreases under subdivision 3a or 3c that applied to the hospitals being
rebased during the entire base period shall be incorporated into the budget neutrality
calculation.

(d) For discharges occurring on or after November 1, 2014, through the next rebasing
that occurs, the rebased rates under paragraph (c) that apply to hospitals under paragraph
(a), clause (4), shall include adjustments to the projected rates that result in no greater than
a five percent increase or decrease from the base year payments for any hospital. Any
adjustments to the rates made by the commissioner under this paragraph and paragraph (e)
shall maintain budget neutrality as described in paragraph (c).

(e) For discharges occurring on or after November 1, 2014, the commissioner may make
additional adjustments to the rebased rates, and when evaluating whether additional
adjustments should be made, the commissioner shall consider the impact of the rates on the
following:

(1) pediatric services;

(2) behavioral health services;

(3) trauma services as defined by the National Uniform Billing Committee;

(4) transplant services;

(5) obstetric services, newborn services, and behavioral health services provided by
hospitals outside the seven-county metropolitan area;

(6) outlier admissions;

(7) low-volume providers; and

(8) services provided by small rural hospitals that are not critical access hospitals.

(f) Hospital payment rates established under paragraph (c) must incorporate the following:

(1) for hospitals paid under the DRG methodology, the base year payment rate per
admission is standardized by the applicable Medicare wage index and adjusted by the
hospital's disproportionate population adjustment;

(2) for critical access hospitals, payment rates for discharges between November 1, 2014,
and June 30, 2015, shall be set to the same rate of payment that applied for discharges on
October 31, 2014;

(3) the cost and charge data used to establish hospital payment rates must only reflect
inpatient services covered by medical assistance; and

(4) in determining hospital payment rates for discharges occurring on or after the rate
year beginning January 1, 2011, through December 31, 2012, the hospital payment rate per
discharge shall be based on the cost-finding methods and allowable costs of the Medicare
program in effect during the base year or years. In determining hospital payment rates for
discharges in subsequent base years, the per discharge rates shall be based on the cost-finding
methods and allowable costs of the Medicare program in effect during the base year or
years.

(g) The commissioner shall validate the rates effective November 1, 2014, by applying
the rates established under paragraph (c), and any adjustments made to the rates under
paragraph (d) or (e), to hospital claims paid in calendar year 2013 to determine whether the
total aggregate payments for the same number and types of services under the rebased rates
are equal to the total aggregate payments made during calendar year 2013.

(h) Effective for discharges occurring on or after July 1, 2017, and every two years
thereafter, payment rates under this section shall be rebased to reflect only those changes
in hospital costs between the existing base year or years and the next base year or years. In
any year that inpatient claims volume falls below the threshold required to ensure a
statistically valid sample of claims, the commissioner may combine claims data from two
consecutive years to serve as the base year. Years in which inpatient claims volume is
reduced or altered due to a pandemic or other public health emergency shall not be used as
a base year or part of a base year if the base year includes more than one year. Changes in
costs between base years shall be measured using the lower of the hospital cost index defined
in subdivision 1, paragraph (a), or the percentage change in the case mix adjusted cost per
claim. The commissioner shall establish the base year for each rebasing period considering
the most recent year or years for which filed Medicare cost reports are available, except
that the base years for the rebasing effective July 1, 2023, are calendar years 2018 and 2019.
The estimated change in the average payment per hospital discharge resulting from a
scheduled rebasing must be calculated and made available to the legislature by January 15
of each year in which rebasing is scheduled to occur, and must include by hospital the
differential in payment rates compared to the individual hospital's costs.

(i) Effective for discharges occurring on or after July 1, 2015, inpatient payment rates
for critical access hospitals located in Minnesota or the local trade area shall be determined
using a new cost-based methodology. The commissioner shall establish within the
methodology tiers of payment designed to promote efficiency and cost-effectiveness.
Payment rates for hospitals under this paragraph shall be set at a level that does not exceed
the total cost for critical access hospitals as reflected in base year cost reports. Until the
next rebasing that occurs, the new methodology shall result in no greater than a five percent
decrease from the base year payments for any hospital, except a hospital that had payments
that were greater than 100 percent of the hospital's costs in the base year shall have their
rate set equal to 100 percent of costs in the base year. The rates paid for discharges on and
after July 1, 2016, covered under this paragraph shall be increased by the inflation factor
in subdivision 1, paragraph (a). The new cost-based rate shall be the final rate and shall not
be settled to actual incurred costs. Hospitals shall be assigned a payment tier based on the
following criteria:

(1) hospitals that had payments at or below 80 percent of their costs in the base year
shall have a rate set that equals 85 percent of their base year costs;

(2) hospitals that had payments that were above 80 percent, up to and including 90
percent of their costs in the base year shall have a rate set that equals 95 percent of their
base year costs; and

(3) hospitals that had payments that were above 90 percent of their costs in the base year
shall have a rate set that equals 100 percent of their base year costs.

(j) The commissioner may refine the payment tiers and criteria for critical access hospitals
to coincide with the next rebasing under paragraph (h). The factors used to develop the new
methodology may include, but are not limited to:

(1) the ratio between the hospital's costs for treating medical assistance patients and the
hospital's charges to the medical assistance program;

(2) the ratio between the hospital's costs for treating medical assistance patients and the
hospital's payments received from the medical assistance program for the care of medical
assistance patients;

(3) the ratio between the hospital's charges to the medical assistance program and the
hospital's payments received from the medical assistance program for the care of medical
assistance patients;

(4) the statewide average increases in the ratios identified in clauses (1), (2), and (3);

(5) the proportion of that hospital's costs that are administrative and trends in
administrative costs; and

(6) geographic location.

(k) Effective for discharges occurring on or after January 1, 2024, the rates paid to
hospitals described in paragraph (a), clauses (2) to (4), must include a rate factor specific
to each hospital that qualifies for a medical education and research cost distribution under
section 62J.692, subdivision 4, paragraph (a).

new text begin (l) Effective for discharges occurring on or after January 1, 2025, the commissioner shall
increase payments for inpatient mental health services provided by hospitals paid under the
DRG methodology by increasing the adjustment for mental health services under paragraph
(e).
new text end

new text begin (m) Effective for discharges occurring on or after January 1, 2025, the commissioner
shall increase capitation payments made to managed care plans and county-based purchasing
plans to reflect the rate increase provided under paragraph (l). Managed care and
county-based purchasing plans must use the capitation rate increase provided under this
paragraph to increase payment rates for inpatient mental health services provided by hospitals
paid under the DRG methodology. The commissioner must monitor the effect of this rate
increase on enrollee access to inpatient mental health services. If for any contract year
federal approval is not received for this paragraph, the commissioner must adjust the
capitation rates paid to managed care plans and county-based purchasing plans for that
contract year to reflect the removal of this paragraph. Contracts between managed care
plans and county-based purchasing plans and providers to whom this paragraph applies
must allow recovery of payments from those providers if capitation rates are adjusted in
accordance with this paragraph. Payment recoveries must not exceed the amount equal to
any increase in rates that results from this paragraph.
new text end

Sec. 4.

new text begin [256B.0617] MENTAL HEALTH SERVICES PROVIDER CERTIFICATION.
new text end

new text begin (a) The commissioner of human services shall establish an initial provider entity
application and certification and recertification processes to determine whether a provider
entity has administrative and clinical infrastructures that meet the certification requirements.
This process shall apply to providers of the following services:
new text end

new text begin (1) assertive community treatment under section 256B.0622, subdivision 3a;
new text end

new text begin (2) children's intensive behavioral health services under section 256B.0946; and
new text end

new text begin (3) intensive nonresidential rehabilitative mental health services under section 256B.0947.
new text end

new text begin (b) The commissioner shall recertify a provider entity every three years using the
individual provider's certification anniversary or the calendar year end. The commissioner
may approve a recertification extension in the interest of sustaining services when a certain
date for recertification is identified.
new text end

new text begin (c) The commissioner shall establish a process for decertification of a provider entity
and shall require corrective action, medical assistance repayment, or decertification of a
provider entity that no longer meets the requirements in this section or that fails to meet the
clinical quality standards or administrative standards provided by the commissioner in the
application and certification process.
new text end

new text begin (d) The commissioner must provide the following to provider entities for the certification,
recertification, and decertification processes:
new text end

new text begin (1) a structured listing of required provider certification criteria;
new text end

new text begin (2) a formal written letter with a determination of certification, recertification, or
decertification signed by the commissioner or the appropriate division director; and
new text end

new text begin (3) a formal written communication outlining the process for necessary corrective action
and follow-up by the commissioner signed by the commissioner or the appropriate division
director, if applicable.
new text end

new text begin EFFECTIVE DATE. new text end

new text begin This section is effective July 1, 2024, and the commissioner of
human services must implement all requirements of this section by September 1, 2024.
new text end

Sec. 5.

Minnesota Statutes 2023 Supplement, section 256B.0625, subdivision 5m, is
amended to read:

Subd. 5m.

Certified community behavioral health clinic services.

(a) Medical
assistance covers services provided by a not-for-profit certified community behavioral health
clinic (CCBHC) that meets the requirements of section 245.735, subdivision 3.

(b) The commissioner shall reimburse CCBHCs on a per-day basis for each day that an
eligible service is delivered using the CCBHC daily bundled rate system for medical
assistance payments as described in paragraph (c). The commissioner shall include a quality
incentive payment in the CCBHC daily bundled rate system as described in paragraph (e).
There is no county share for medical assistance services when reimbursed through the
CCBHC daily bundled rate system.

(c) The commissioner shall ensure that the CCBHC daily bundled rate system for CCBHC
payments under medical assistance meets the following requirements:

(1) the CCBHC daily bundled rate shall be a provider-specific rate calculated for each
CCBHC, based on the daily cost of providing CCBHC services and the total annual allowable
CCBHC costs divided by the total annual number of CCBHC visits. For calculating the
payment rate, total annual visits include visits covered by medical assistance and visits not
covered by medical assistance. Allowable costs include but are not limited to the salaries
and benefits of medical assistance providers; the cost of CCBHC services provided under
section 245.735, subdivision 3, paragraph (a), clauses (6) and (7); and other costs such as
insurance or supplies needed to provide CCBHC services;

(2) payment shall be limited to one payment per day per medical assistance enrollee
when an eligible CCBHC service is provided. A CCBHC visit is eligible for reimbursement
if at least one of the CCBHC services listed under section 245.735, subdivision 3, paragraph
(a), clause (6), is furnished to a medical assistance enrollee by a health care practitioner or
licensed agency employed by or under contract with a CCBHC;

(3) initial CCBHC daily bundled rates for newly certified CCBHCs under section 245.735,
subdivision 3, shall be established by the commissioner using a provider-specific rate based
on the newly certified CCBHC's audited historical cost report data adjusted for the expected
cost of delivering CCBHC services. Estimates are subject to review by the commissioner
and must include the expected cost of providing the full scope of CCBHC services and the
expected number of visits for the rate period;

(4) the commissioner shall rebase CCBHC rates once every two years following the last
rebasing and no less than 12 months following an initial rate or a rate change due to a change
in the scope of services new text begin . For CCBHCs certified after September 31, 2020, and before January
1, 2021, the commissioner shall rebase rates according to this clause beginning for dates of
service provided on January 1, 2024 new text end ;

(5) the commissioner shall provide for a 60-day appeals process after notice of the results
of the rebasing;

(6) an entity that receives a CCBHC daily bundled rate that overlaps with another federal
Medicaid rate is not eligible for the CCBHC rate methodology;

(7) payments for CCBHC services to individuals enrolled in managed care shall be
coordinated with the state's phase-out of CCBHC wrap payments. The commissioner shall
complete the phase-out of CCBHC wrap payments within 60 days of the implementation
of the CCBHC daily bundled rate system in the Medicaid Management Information System
(MMIS), for CCBHCs reimbursed under this chapter, with a final settlement of payments
due made payable to CCBHCs no later than 18 months thereafter;

(8) the CCBHC daily bundled rate for each CCBHC shall be updated by trending each
provider-specific rate by the Medicare Economic Index for primary care services. This
update shall occur each year in between rebasing periods determined by the commissioner
in accordance with clause (4). CCBHCs must provide data on costs and visits to the state
annually using the CCBHC cost report established by the commissioner; and

(9) a CCBHC may request a rate adjustment for changes in the CCBHC's scope of
services when such changes are expected to result in an adjustment to the CCBHC payment
rate by 2.5 percent or more. The CCBHC must provide the commissioner with information
regarding the changes in the scope of services, including the estimated cost of providing
the new or modified services and any projected increase or decrease in the number of visits
resulting from the change. Estimated costs are subject to review by the commissioner. Rate
adjustments for changes in scope shall occur no more than once per year in between rebasing
periods per CCBHC and are effective on the date of the annual CCBHC rate update.

(d) Managed care plans and county-based purchasing plans shall reimburse CCBHC
providers at the CCBHC daily bundled rate. The commissioner shall monitor the effect of
this requirement on the rate of access to the services delivered by CCBHC providers. If, for
any contract year, federal approval is not received for this paragraph, the commissioner
must adjust the capitation rates paid to managed care plans and county-based purchasing
plans for that contract year to reflect the removal of this provision. Contracts between
managed care plans and county-based purchasing plans and providers to whom this paragraph
applies must allow recovery of payments from those providers if capitation rates are adjusted
in accordance with this paragraph. Payment recoveries must not exceed the amount equal
to any increase in rates that results from this provision. This paragraph expires if federal
approval is not received for this paragraph at any time.

(e) The commissioner shall implement a quality incentive payment program for CCBHCs
that meets the following requirements:

(1) a CCBHC shall receive a quality incentive payment upon meeting specific numeric
thresholds for performance metrics established by the commissioner, in addition to payments
for which the CCBHC is eligible under the CCBHC daily bundled rate system described in
paragraph (c);

(2) a CCBHC must be certified and enrolled as a CCBHC for the entire measurement
year to be eligible for incentive payments;

(3) each CCBHC shall receive written notice of the criteria that must be met in order to
receive quality incentive payments at least 90 days prior to the measurement year; and

(4) a CCBHC must provide the commissioner with data needed to determine incentive
payment eligibility within six months following the measurement year. The commissioner
shall notify CCBHC providers of their performance on the required measures and the
incentive payment amount within 12 months following the measurement year.

(f) All claims to managed care plans for CCBHC services as provided under this section
shall be submitted directly to, and paid by, the commissioner on the dates specified no later
than January 1 of the following calendar year, if:

(1) one or more managed care plans does not comply with the federal requirement for
payment of clean claims to CCBHCs, as defined in Code of Federal Regulations, title 42,
section 447.45(b), and the managed care plan does not resolve the payment issue within 30
days of noncompliance; and

(2) the total amount of clean claims not paid in accordance with federal requirements
by one or more managed care plans is 50 percent of, or greater than, the total CCBHC claims
eligible for payment by managed care plans.

If the conditions in this paragraph are met between January 1 and June 30 of a calendar
year, claims shall be submitted to and paid by the commissioner beginning on January 1 of
the following year. If the conditions in this paragraph are met between July 1 and December
31 of a calendar year, claims shall be submitted to and paid by the commissioner beginning
on July 1 of the following year.

(g) Peer services provided by a CCBHC certified under section 245.735 are a covered
service under medical assistance when a licensed mental health professional or alcohol and
drug counselor determines that peer services are medically necessary. Eligibility under this
subdivision for peer services provided by a CCBHC supersede eligibility standards under
sections 256B.0615, 256B.0616, and 245G.07, subdivision 2, clause (8).

Sec. 6.

Minnesota Statutes 2022, section 256B.0757, subdivision 4a, is amended to read:

Subd. 4a.

Behavioral health home services provider requirements.

A behavioral
health home services provider must:

(1) be an enrolled Minnesota Health Care Programs provider;

(2) provide a medical assistance covered primary care or behavioral health service;

(3) utilize an electronic health record;

(4) utilize an electronic patient registry that contains data elements required by the
commissioner;

(5) demonstrate the organization's capacity to administer screenings approved by the
commissioner for substance use disorder or alcohol and tobacco use;

(6) demonstrate the organization's capacity to refer an individual to resources appropriate
to the individual's screening results;

(7) have policies and procedures to track referrals to ensure that the referral met the
individual's needs;

(8) conduct a brief needs assessment when an individual begins receiving behavioral
health home services. The brief needs assessment must be completed with input from the
individual and the individual's identified supports. The brief needs assessment must address
the individual's immediate safety and transportation needs and potential barriers to
participating in behavioral health home services;

(9) conduct a health wellness assessment within 60 days after intake that contains all
required elements identified by the commissioner;

(10) conduct a health action plan that contains all required elements identified by the
commissioner. The plan must be completed within 90 days after intake and must be updated
at least once every six months, or more frequently if significant changes to an individual's
needs or goals occur;

(11) agree to cooperate with and participate in the state's monitoring and evaluation of
behavioral health home services; and

(12) obtain the individual's deleted text begin written deleted text end consent to begin receiving behavioral health home
services using a form approved by the commissioner.

new text begin EFFECTIVE DATE. new text end

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

Sec. 7.

Minnesota Statutes 2022, section 256B.0757, subdivision 4d, is amended to read:

Subd. 4d.

Behavioral health home services delivery standards.

(a) A behavioral health
home services provider must meet the following service delivery standards:

(1) establish and maintain processes to support the coordination of an individual's primary
care, behavioral health, and dental care;

(2) maintain a team-based model of care, including regular coordination and
communication between behavioral health home services team members;

(3) use evidence-based practices that recognize and are tailored to the medical, social,
economic, behavioral health, functional impairment, cultural, and environmental factors
affecting the individual's health and health care choices;

(4) use person-centered planning practices to ensure the individual's health action plan
accurately reflects the individual's preferences, goals, resources, and optimal outcomes for
the individual and the individual's identified supports;

(5) use the patient registry to identify individuals and population subgroups requiring
specific levels or types of care and provide or refer the individual to needed treatment,
intervention, or services;

(6) deleted text begin utilize the Department of Human Services Partner Portal to deleted text end identify past and current
treatment or services and identify potential gaps in care new text begin using a tool approved by the
commissioner new text end ;

(7) deliver services consistent with the standards for frequency and face-to-face contact
required by the commissioner;

(8) ensure that a diagnostic assessment is completed for each individual receiving
behavioral health home services within six months of the start of behavioral health home
services;

(9) deliver services in locations and settings that meet the needs of the individual;

(10) provide a central point of contact to ensure that individuals and the individual's
identified supports can successfully navigate the array of services that impact the individual's
health and well-being;

(11) have capacity to assess an individual's readiness for change and the individual's
capacity to integrate new health care or community supports into the individual's life;

(12) offer or facilitate the provision of wellness and prevention education on
evidenced-based curriculums specific to the prevention and management of common chronic
conditions;

(13) help an individual set up and prepare for medical, behavioral health, social service,
or community support appointments, including accompanying the individual to appointments
as appropriate, and providing follow-up with the individual after these appointments;

(14) offer or facilitate the provision of health coaching related to chronic disease
management and how to navigate complex systems of care to the individual, the individual's
family, and identified supports;

(15) connect an individual, the individual's family, and identified supports to appropriate
support services that help the individual overcome access or service barriers, increase
self-sufficiency skills, and improve overall health;

(16) provide effective referrals and timely access to services; and

(17) establish a continuous quality improvement process for providing behavioral health
home services.

(b) The behavioral health home services provider must also create a plan, in partnership
with the individual and the individual's identified supports, to support the individual after
discharge from a hospital, residential treatment program, or other setting. The plan must
include protocols for:

(1) maintaining contact between the behavioral health home services team member, the
individual, and the individual's identified supports during and after discharge;

(2) linking the individual to new resources as needed;

(3) reestablishing the individual's existing services and community and social supports;
and

(4) following up with appropriate entities to transfer or obtain the individual's service
records as necessary for continued care.

(c) If the individual is enrolled in a managed care plan, a behavioral health home services
provider must:

(1) notify the behavioral health home services contact designated by the managed care
plan within 30 days of when the individual begins behavioral health home services; and

(2) adhere to the managed care plan communication and coordination requirements
described in the behavioral health home services manual.

(d) Before terminating behavioral health home services, the behavioral health home
services provider must:

(1) provide a 60-day notice of termination of behavioral health home services to all
individuals receiving behavioral health home services, the commissioner, and managed care
plans, if applicable; and

(2) refer individuals receiving behavioral health home services to a new behavioral
health home services provider.

new text begin EFFECTIVE DATE. new text end

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

Sec. 8.

Minnesota Statutes 2022, section 256B.0757, subdivision 5, is amended to read:

Subd. 5.

Payments new text begin for health home services new text end .

The commissioner shall make payments
to each designated provider for the provision of health home services described in subdivision
3 new text begin , other than behavioral health home services, new text end to each eligible individual under subdivision
2 that selects the health home as a provider.

new text begin EFFECTIVE DATE. new text end

new text begin This section is effective January 1, 2025, or upon federal approval,
whichever is later. The commissioner of human services shall notify the revisor of statutes
when federal approval is obtained.
new text end

Sec. 9.

Minnesota Statutes 2022, section 256B.0757, is amended by adding a subdivision
to read:

new text begin Subd. 5a. new text end

new text begin Payments for behavioral health home services. new text end

new text begin (a) Notwithstanding
subdivision 5, the commissioner shall determine and implement a single statewide
reimbursement rate for behavioral health home services under this section. The rate must
be no less than $408 per member per month. The commissioner must adjust the statewide
reimbursement rate annually according to the change from the midpoint of the previous rate
year to the midpoint of the rate year for which the rate is being determined using the Centers
for Medicare and Medicaid Services Medicare Economic Index as forecasted in the fourth
quarter of the calendar year before the rate year.
new text end

new text begin (b) The commissioner must review and update the behavioral health home service rate
under paragraph (a) at least every four years. The updated rate must account for the average
hours required for behavioral health home team members spent providing services and the
Department of Labor prevailing wage for required behavioral health home team members.
The updated rate must ensure that behavioral health home services rates are sufficient to
allow providers to meet required certifications, training, and practice transformation
standards, staff qualification requirements, and service delivery standards.
new text end

new text begin EFFECTIVE DATE. new text end

new text begin This section is effective January 1, 2025, or upon federal approval,
whichever is later. The commissioner of human services shall notify the revisor of statutes
when federal approval is obtained.
new text end

Sec. 10.

Minnesota Statutes 2023 Supplement, section 256B.76, subdivision 1, is amended
to read:

Subdivision 1.

Physician and professional services reimbursement.

deleted text begin (a) Effective for
services rendered on or after October 1, 1992, the commissioner shall make payments for
physician services as follows:
deleted text end

deleted text begin (1) payment for level one Centers for Medicare and Medicaid Services' common
procedural coding system codes titled "office and other outpatient services," "preventive
medicine new and established patient," "delivery, antepartum, and postpartum care," "critical
care," cesarean delivery and pharmacologic management provided to psychiatric patients,
and level three codes for enhanced services for prenatal high risk, shall be paid at the lower
of (i) submitted charges, or (ii) 25 percent above the rate in effect on June 30, 1992;
deleted text end

deleted text begin (2) payments for all other services shall be paid at the lower of (i) submitted charges,
or (ii) 15.4 percent above the rate in effect on June 30, 1992; and
deleted text end

deleted text begin (3) all physician rates shall be converted from the 50th percentile of 1982 to the 50th
percentile of 1989, less the percent in aggregate necessary to equal the above increases
except that payment rates for home health agency services shall be the rates in effect on
September 30, 1992.
deleted text end

deleted text begin (b) deleted text end new text begin (a) new text end Effective for services rendered on or after January 1, 2000, new text begin through December
31, 2024, new text end payment rates for physician and professional services shall be increased by three
percent over the rates in effect on December 31, 1999, except for home health agency and
family planning agency services. The increases in this paragraph shall be implemented
January 1, 2000, for managed care.

deleted text begin (c) deleted text end new text begin (b) new text end Effective for services rendered on or after July 1, 2009, new text begin through December 31,
2024, new text end payment rates for physician and professional services shall be reduced by five percent,
except that for the period July 1, 2009, through June 30, 2010, payment rates shall be reduced
by 6.5 percent for the medical assistance and general assistance medical care programs,
over the rates in effect on June 30, 2009. This reduction and the reductions in paragraph (d)
do not apply to office or other outpatient visits, preventive medicine visits and family
planning visits billed by physicians, advanced practice registered nurses, or physician
assistants in a family planning agency or in one of the following primary care practices:
general practice, general internal medicine, general pediatrics, general geriatrics, and family
medicine. This reduction and the reductions in paragraph (d) do not apply to federally
qualified health centers, rural health centers, and Indian health services. Effective October
1, 2009, payments made to managed care plans and county-based purchasing plans under
sections 256B.69, 256B.692, and 256L.12 shall reflect the payment reduction described in
this paragraph.

deleted text begin (d) deleted text end new text begin (c) new text end Effective for services rendered on or after July 1, 2010, new text begin through December 31,
2024, new text end payment rates for physician and professional services shall be reduced an additional
seven percent over the five percent reduction in rates described in paragraph (c). This
additional reduction does not apply to physical therapy services, occupational therapy
services, and speech pathology and related services provided on or after July 1, 2010. This
additional reduction does not apply to physician services billed by a psychiatrist or an
advanced practice registered nurse with a specialty in mental health. Effective October 1,
2010, payments made to managed care plans and county-based purchasing plans under
sections 256B.69, 256B.692, and 256L.12 shall reflect the payment reduction described in
this paragraph.

deleted text begin (e) Effective for services rendered on or after September 1, 2011, through June 30, 2013,
payment rates for physician and professional services shall be reduced three percent from
the rates in effect on August 31, 2011. This reduction does not apply to physical therapy
services, occupational therapy services, and speech pathology and related services.
deleted text end

deleted text begin (f) deleted text end new text begin (d) new text end Effective for services rendered on or after September 1, 2014, new text begin through December
31, 2024, new text end payment rates for physician and professional services, including physical therapy,
occupational therapy, speech pathology, and mental health services shall be increased by
five percent from the rates in effect on August 31, 2014. In calculating this rate increase,
the commissioner shall not include in the base rate for August 31, 2014, the rate increase
provided under section 256B.76, subdivision 7. This increase does not apply to federally
qualified health centers, rural health centers, and Indian health services. Payments made to
managed care plans and county-based purchasing plans shall not be adjusted to reflect
payments under this paragraph.

deleted text begin (g) deleted text end new text begin (e) new text end Effective for services rendered on or after July 1, 2015, payment rates for physical
therapy, occupational therapy, and speech pathology and related services provided by a
hospital meeting the criteria specified in section 62Q.19, subdivision 1, paragraph (a), clause
(4), shall be increased by 90 percent from the rates in effect on June 30, 2015. Payments
made to managed care plans and county-based purchasing plans shall not be adjusted to
reflect payments under this paragraph.

deleted text begin (h) deleted text end new text begin (f) new text end Any ratables effective before July 1, 2015, do not apply to early intensive
developmental and behavioral intervention (EIDBI) benefits described in section 256B.0949.

deleted text begin (i) deleted text end new text begin (g) new text end The commissioner may reimburse physicians and other licensed professionals for
costs incurred to pay the fee for testing newborns who are medical assistance enrollees for
heritable and congenital disorders under section 144.125, subdivision 1, paragraph (c), when
the sample is collected outside of an inpatient hospital or freestanding birth center and the
cost is not recognized by another payment source.

Sec. 11.

Minnesota Statutes 2022, section 256B.76, subdivision 6, is amended to read:

Subd. 6.

Medicare relative value units.

deleted text begin Effective for services rendered on or after
January 1, 2007, the commissioner shall make payments for physician and professional
services based on the Medicare relative value units (RVU's). This change shall be budget
neutral and the cost of implementing RVU's will be incorporated in the established conversion
factor deleted text end new text begin (a) Effective for physician and professional services included in the Medicare Physician
Fee Schedule for mental health services, the commissioner shall make payments at rates
equal to 100 percent of the corresponding rates in the Medicare Physician Fee Schedule.
Payment rates set under this paragraph must use Medicare relative value units (RVUs) and
conversion factors equal to those in the Medicare Physician Fee Schedule to implement the
resource-based relative value scale new text end .

new text begin (b) The commissioner shall revise fee-for-service payment methodologies under this
section upon the issuance of a Medicare Physician Fee Schedule final rule by the Centers
for Medicare and Medicaid Services to ensure the payment rates under this subdivision are
equal to the corresponding rates in the final rule.
new text end

new text begin (c) All mental health services performed in a primary care or mental health care health
professional shortage area, medically underserved area, or medically underserved population,
as maintained and updated by the United States Department of Health and Human Services,
are eligible for a ten percent bonus payment. Such services are eligible for a bonus based
upon the performance of the service in a health professional shortage area if the provider
maintains an office in a health professional shortage area.
new text end

new text begin (d) Effective for services rendered on or after January 1, 2025, the commissioner shall
increase capitation payments made to managed care plans and county-based purchasing
plans to reflect the rate increases provided under this subdivision. Managed care and
county-based purchasing plans must use the capitation rate increase provided under this
paragraph to increase payment rates to the providers corresponding to the rate increases.
The commissioner must monitor the effect of this rate increase on enrollee access to services
under this subdivision. If for any contract year federal approval is not received for this
paragraph, the commissioner must adjust the capitation rates paid to managed care plans
and county-based purchasing plans for that contract year to reflect the removal of this
paragraph. Contracts between managed care plans and county-based purchasing plans and
providers to whom this paragraph applies must allow recovery of payments from those
providers if capitation rates are adjusted in accordance with this paragraph. Payment
recoveries must not exceed the amount equal to any increase in rates that results from this
paragraph.
new text end

Sec. 12.

Minnesota Statutes 2023 Supplement, section 256B.761, is amended to read:

256B.761 REIMBURSEMENT FOR MENTAL HEALTH SERVICES.

(a) Effective for services rendered on or after July 1, 2001, payment for medication
management provided to psychiatric patients, outpatient mental health services, day treatment
services, home-based mental health services, and family community support services shall
be paid at the lower of (1) submitted charges, or (2) 75.6 percent of the 50th percentile of
1999 charges.

(b) Effective July 1, 2001, the medical assistance rates for outpatient mental health
services provided by an entity that operates: (1) a Medicare-certified comprehensive
outpatient rehabilitation facility; and (2) a facility that was certified prior to January 1, 1993,
with at least 33 percent of the clients receiving rehabilitation services in the most recent
calendar year who are medical assistance recipients, will be increased by 38 percent, when
those services are provided within the comprehensive outpatient rehabilitation facility and
provided to residents of nursing facilities owned by the entity.

(c) In addition to rate increases otherwise provided, the commissioner may restructure
coverage policy and rates to improve access to adult rehabilitative mental health services
under section 256B.0623 and related mental health support services under section 256B.021,
subdivision 4, paragraph (f), clause (2). For state fiscal years 2015 and 2016, the projected
state share of increased costs due to this paragraph is transferred from adult mental health
grants under sections 245.4661 and 256E.12. The transfer for fiscal year 2016 is a permanent
base adjustment for subsequent fiscal years. Payments made to managed care plans and
county-based purchasing plans under sections 256B.69, 256B.692, and 256L.12 shall reflect
the rate changes described in this paragraph.

(d) Any ratables effective before July 1, 2015, do not apply to early intensive
developmental and behavioral intervention (EIDBI) benefits described in section 256B.0949.

(e) Effective for services rendered on or after January 1, 2024, payment rates for
behavioral health services included in the rate analysis required by Laws 2021, First Special
Session chapter 7, article 17, section 18, except for adult day treatment services under section
256B.0671, subdivision 3; early intensive developmental and behavioral intervention services
under section 256B.0949; and substance use disorder services under chapter 254B, must be
increased by three percent from the rates in effect on December 31, 2023. Effective for
services rendered on or after January 1, 2025, payment rates for behavioral health services
included in the rate analysis required by Laws 2021, First Special Session chapter 7, article
17, section 18, except for adult day treatment services under section 256B.0671, subdivision
3; early intensive developmental behavioral intervention services under section 256B.0949;
and substance use disorder services under chapter 254B, must be annually adjusted according
to the change from the midpoint of the previous rate year to the midpoint of the rate year
for which the rate is being determined using the Centers for Medicare and Medicaid Services
Medicare Economic Index as forecasted in the fourth quarter of the calendar year before
the rate year. For payments made in accordance with this paragraph, if and to the extent
that the commissioner identifies that the state has received federal financial participation
for behavioral health services in excess of the amount allowed under United States Code,
title 42, section 447.321, the state shall repay the excess amount to the Centers for Medicare
and Medicaid Services with state money and maintain the full payment rate under this
paragraph. This paragraph does not apply to federally qualified health centers, rural health
centers, Indian health services, certified community behavioral health clinics, cost-based
rates, and rates that are negotiated with the county. This paragraph expires upon legislative
implementation of the new rate methodology resulting from the rate analysis required by
Laws 2021, First Special Session chapter 7, article 17, section 18.

(f) Effective January 1, 2024, the commissioner shall increase capitation payments made
to managed care plans and county-based purchasing plans to reflect the behavioral health
service rate increase provided in paragraph (e). Managed care and county-based purchasing
plans must use the capitation rate increase provided under this paragraph to increase payment
rates to behavioral health services providers. The commissioner must monitor the effect of
this rate increase on enrollee access to behavioral health services. If for any contract year
federal approval is not received for this paragraph, the commissioner must adjust the
capitation rates paid to managed care plans and county-based purchasing plans for that
contract year to reflect the removal of this provision. Contracts between managed care plans
and county-based purchasing plans and providers to whom this paragraph applies must
allow recovery of payments from those providers if capitation rates are adjusted in accordance
with this paragraph. Payment recoveries must not exceed the amount equal to any increase
in rates that results from this provision.

new text begin (g) Effective for mental health services under this section billed and coded under
Healthcare Common Procedure Coding System H, S, and T codes, the payment rates shall
be increased as necessary to align with the Medicare Physician Fee Schedule.
new text end

Sec. 13. new text begin MENTAL HEALTH SERVICES FORMULA-BASED ALLOCATION.
new text end

new text begin The commissioner of human services shall consult with the commissioner of management
and budget, counties, Tribes, mental health providers, and advocacy organizations to develop
recommendations for moving from the children's and adult mental health grant funding
structure to a formula-based allocation structure for mental health services. The
recommendations must consider formula-based allocations for grants for respite care,
school-linked behavioral health, mobile crisis teams, and first episode of psychosis programs.
new text end

ARTICLE 7

APPROPRIATIONS

Section 1.

Laws 2021, First Special Session chapter 7, article 17, section 12, as amended
by Laws 2022, chapter 98, article 15, section 13, Laws 2022, chapter 99, article 1, section
43, and Laws 2023, chapter 70, article 20, section 18, is amended to read:

Sec. 12. ADULT AND CHILDREN'S MOBILE TRANSITION UNITS.

(a) This act includes $1,572,000 in fiscal year 2022 and $0 in fiscal year 2023 for the
commissioner of human services to create adult and children's mental health transition and
support teams to facilitate transition back to the community or to the least restrictive level
of care from inpatient psychiatric settings, emergency departments new text begin , inpatient hospitalization,
juvenile detention facilities new text end , residential treatment facilities, and child and adolescent
behavioral health hospitals. Any unexpended amount in fiscal year 2022 is available through
June 30, 2023. The general fund base included in this act for this purpose is $1,875,000 in
fiscal year 2024 and deleted text begin $0 deleted text end new text begin $2,500,000 new text end in fiscal year 2025.

(b) Beginning April 1, 2024, counties may fund and continue conducting activities
funded under this section.

deleted text begin (c) This section expires March 31, 2024.
deleted text end

new text begin EFFECTIVE DATE. new text end

new text begin This section is effective retroactively from January 1, 2024.
new text end

Sec. 2.

Laws 2023, chapter 70, article 20, section 2, subdivision 29, is amended to read:

Subd. 29. Grant Programs; Adult Mental Health Grants

132,327,000

121,270,000

(a) Mobile crisis grants to Tribal Nations.
$1,000,000 in fiscal year 2024 and $1,000,000
in fiscal year 2025 are for mobile crisis grants
under Minnesota Statutes section 245.4661,
subdivision 9, paragraph (b), clause (15), to
Tribal Nations.

(b) Mental health provider supervision
grant program. $1,500,000 in fiscal year
2024 and $1,500,000 in fiscal year 2025 are
for the mental health provider supervision
grant program under Minnesota Statutes,
section 245.4663.

(c) Minnesota State University, Mankato
community behavioral health center.
$750,000 in fiscal year 2024 and $750,000 in
fiscal year 2025 are for a grant to the Center
for Rural Behavioral Health at Minnesota State
University, Mankato to establish a community
behavioral health center and training clinic.
The community behavioral health center must
provide comprehensive, culturally specific,
trauma-informed, practice- and
evidence-based, person- and family-centered
mental health and substance use disorder
treatment services in Blue Earth County and
the surrounding region to individuals of all
ages, regardless of an individual's ability to
pay or place of residence. The community
behavioral health center and training clinic
must also provide training and workforce
development opportunities to students enrolled
in the university's training programs in the
fields of social work, counseling and student
personnel, alcohol and drug studies,
psychology, and nursing. Upon request, the
commissioner must make information
regarding the use of this grant funding
available to the chairs and ranking minority
members of the legislative committees with
jurisdiction over behavioral health. This is a
onetime appropriation and is available until
June 30, 2027.

(d) White Earth Nation; adult mental health
initiative. $300,000 in fiscal year 2024 and
$300,000 in fiscal year 2025 are for adult
mental health initiative grants to the White
Earth Nation. This is a onetime appropriation.

(e) Mobile crisis grants. $8,472,000 in fiscal
year 2024 and deleted text begin $8,380,000 deleted text end new text begin $8,472,000 new text end in fiscal
year 2025 are for the mobile crisis grants
under Minnesota Statutes, section 245.4661,
subdivision 9, paragraph (b), clause (15). This
deleted text begin is a onetime deleted text end appropriation deleted text begin and deleted text end is available
until June 30, 2027. new text begin This funding is added to
the base.
new text end

(f) Base level adjustment. The general fund
base is $121,980,000 in fiscal year 2026 and
$121,980,000 in fiscal year 2027.

Sec. 3. new text begin APPROPRIATION; SOMALI MENTAL HEALTH PILOT PROJECT.
new text end

new text begin (a) $900,000 in fiscal year 2024 and $900,000 in fiscal year 2025 are appropriated from
the general fund to the commissioner of human services for a grant to the Intercultural
Mutual Assistance Association for a pilot project in the city of Rochester to provide mental
health education and support services to Somali students and mothers. The Intercultural
Mutual Assistance Association shall partner with the Rochester Math and Science Academy
and the Somali American Social Service Association to implement the pilot project.
new text end

new text begin (b) As part of the pilot project, the Intercultural Mutual Assistance Association and its
partners shall:
new text end

new text begin (1) expand a dialectical behavioral therapy skills in schools pilot program for 20 or more
additional students attending the Rochester Math and Science Academy and offer the program
annually;
new text end

new text begin (2) develop and provide an educational program at the Rochester Math and Science
Academy to build resiliency skills and improve students' social and emotional development;
and
new text end

new text begin (3) establish a discussion group for mothers of students attending the Rochester Math
and Science Academy to promote physical and emotional wellness.
new text end

new text begin (c) Grant funds may be used for pilot program development and implementation, staffing,
training, and administrative costs.
new text end

new text begin (d) By January 15, 2025, the Intercultural Mutual Assistance Association must submit
a report to the chairs and ranking minority members of the legislative committees with
jurisdiction over mental health detailing the results of the pilot project. This is a onetime
appropriation.
new text end

Sec. 4. new text begin APPROPRIATION; ENGAGEMENT SERVICES PILOT GRANTS.
new text end

new text begin $2,000,000 in fiscal year 2025 is appropriated from the general fund to the commissioner
of human services for engagement services pilot grants under Minnesota Statutes, section
253B.042. This funding is added to the base.
new text end

Sec. 5. new text begin APPROPRIATION; PROTECTED TRANSPORT START-UP GRANTS.
new text end

new text begin $500,000 in fiscal year 2025 is appropriated from the general fund to the commissioner
of human services to provide start-up grants to nonemergency medical transportation
providers to configure vehicles to meet protected transport requirements. This funding is
added to the base.
new text end

Sec. 6. new text begin APPROPRIATION; RESPITE CARE SERVICES.
new text end

new text begin (a) $5,000,000 in fiscal year 2025 is appropriated from the general fund to the
commissioner of human services for respite care services under Minnesota Statutes, section
245.4889, subdivision 1, paragraph (b), clause (3).
new text end

new text begin (b) Of this appropriation, $1,000,000 in fiscal year 2025 is for grants to private
child-placing agencies, as defined in Minnesota Rules, chapter 9545, to conduct recruitment
and support licensing activities that are specific to increasing the availability of licensed
foster homes to provide respite care services.
new text end

Sec. 7. new text begin APPROPRIATION; IN-HOME CHILDREN'S MENTAL HEALTH
INFRASTRUCTURE GRANTS.
new text end

new text begin (a) $5,000,000 in fiscal year 2025 is appropriated from the general fund to the
commissioner of human services for infrastructure grants to develop family-centered in-home
mental health services that include children's intensive behavioral health services under
Minnesota Statutes, section 256B.0946; intensive rehabilitative mental health services under
Minnesota Statutes, section 256B.0947; services under Minnesota Statutes, section
256B.0943, that are provided in the home; and high-fidelity wrap around and collaborative
intensive bridging services eligible for grants under Minnesota Statutes, section 245.4889,
subdivision 1, paragraph (b), clause (17).
new text end

new text begin (b) Grant funding may be used for start-up costs, including but not limited to initial
hiring for specialized roles, staff training, technical assistance, and ancillary service costs
required to establish and support the launch of these intensive mental health team models.
new text end

Sec. 8. new text begin APPROPRIATION; CHILDREN'S RESIDENTIAL TREATMENT
PROGRAMS.
new text end

new text begin $2,500,000 in fiscal year 2025 is appropriated from the general fund to the commissioner
of human services for a grant to an organization that provides children's residential treatment
for mental health and substance use disorder to modify and sustain its children's residential
treatment programs in Minnesota. Grant funds must be used to implement a planned
consolidation of existing children's residential treatment programs and to create a specialized
children's residential treatment program campus for children and youth with complex,
high-acuity behavioral health treatment needs. This is a onetime appropriation.
new text end

APPENDIX

Repealed Minnesota Statutes: H3495-1

256D.19 ABOLITION OF TOWNSHIP SYSTEM OF POOR RELIEF.

Subdivision 1.

Town system abolished.

The town system for caring for the poor in each of the counties in which it is in effect is hereby abolished. The local social services agency of each county shall administer general assistance under the provisions of Laws 1973, chapter 650, article 21.

Subd. 2.

Local social services agencies duty.

All local social services agencies affected by Laws 1973, chapter 650, article 21 are hereby authorized to take over for the county as of January 1, 1974, the ownership of all case records relating to the administration of poor relief.

256D.20 TRANSFER OF TOWN EMPLOYEES.

Subdivision 1.

Rules for merit system.

The term "merit system" as used herein shall mean the rules for a merit system of personnel administration for employees of local social services agencies adopted by the commissioner of human services in accordance with the provisions of section 393.07, including the merit system established for Hennepin County pursuant to Laws 1965, chapter 855, as amended, the federal Social Security article as amended, and merit system standards and regulations issued by the federal Social Security Board and the United States Children's Bureau.

Subd. 2.

Designation of employees.

All employees of any municipality or town who are engaged full time in poor relief work therein on January 1, 1974 shall be retained as employees of the county and placed under the jurisdiction of its local social services agency.

All transferred employees shall be blanketed into the merit system with comparable status, classification, longevity, and seniority, and subject to the administrative requirements of the local social services agency. Employees with permanent status under any civil service provision on January 1, 1974, shall be granted permanent status under the merit system at comparable classifications and in accordance with work assignments made under the authority of the local social services agency as provided by the merit system rules.

The determination of proper job allocation shall be the responsibility of the personnel officer or director as provided under merit system rules applicable to the county involved with the right of appeal of allocation to the Merit System Council or personnel board by any employee affected by this transfer.

All transferred employees shall receive salaries for the classification to which they are allocated in accordance with the schedule in effect for local social services agency employees and at a salary step which they normally would have received had they been employed by the local social services agency for the same period of service they had previously served under the civil service provisions of any municipality or town; provided, however, that no salary shall be reduced as a result of the transfer.

All accumulated sick leave of transferred employees in the amount of 60 days or less shall be transferred to the records of the local social services agency and such accumulated sick leave shall be the legal liability of the local social services agency. All accumulated sick leave in excess of 60 days shall be paid in cash to transferred employees by the municipality or town by which they were employed prior to their transfer, at the time of transfer. In lieu of the cash payment, the municipality or town shall, at the option of the employee concerned, allow a leave of absence with pay, prior to transfer, for all or part of the accumulated sick leave.

Subd. 3.

Merit system transfer.

Employees of municipalities and towns engaged in the work of administering poor relief who are not covered by civil service provisions shall be blanketed into the merit system subject to a qualifying examination. Employees with one year or more service shall be subject to a qualifying examination and those with less than one year's service shall be subject to an open competitive examination.

Subd. 4.

Disbursement of vacation time.

All vacation leave of employees referred to in subdivision 2, accumulated prior to their transfer to county employment shall be paid in cash to them by the municipality or town by which they were employed prior to their transfer, and at the time of their transfer. In lieu of the cash payment, the municipality or town shall, at the option of the employee concerned, allow a leave of absence with pay, prior to such transfer, for all or part of the accumulated vacation time.

256D.23 TEMPORARY COUNTY ASSISTANCE PROGRAM.

Subdivision 1.

Program established.

Minnesota residents who meet the income and resource standards of section 256D.01, subdivision 1a, but do not qualify for cash benefits under sections 256D.01 to 256D.21, may qualify for a county payment under this section.

Subd. 2.

Payment amount, duration, and method.

(a) A county may make a payment of up to $203 for a single individual and up to $260 for a married couple under the terms of this subdivision.

(b) Payments to an individual or married couple may only be made once in a calendar year. If the applicant qualifies for a payment as a result of an emergency, as defined by the county, the payment shall be made within ten working days of the date of application. If the applicant does not qualify under the county definition of emergency, the payment shall be made at the beginning of the second month following the month of application, and the applicant must receive the payment in person at the local agency office.

(c) Payments may be made in the form of cash or as vendor payments for rent and utilities. If vendor payments are made, they shall be equal to $203 for a single individual or $260 for a married couple, or the actual amount of rent and utilities, whichever is less.

(d) Each county must develop policies and procedures as necessary to implement this section.

(e) Payments under this section are not an entitlement. No county is required to make a payment in excess of the amount available to the county under subdivision 3.

Subd. 3.

State allocation to counties.

The commissioner shall allocate to each county on an annual basis the amount specifically appropriated for payments under this section. The allocation shall be based on each county's proportionate share of state fiscal year 1994 work readiness expenditures.

Repealed Minnesota Rule: H3495-1

2960.0620 USE OF PSYCHOTROPIC MEDICATIONS.

Subp. 3.

Monitoring for tardive dyskinesia.

The license holder, under the direction of a medically licensed person, must monitor for tardive dyskinesia at least every three months if a resident is prescribed antipsychotic medication or amoxapine and must document the monitoring. A resident prescribed antipsychotic medication or amoxapine for more than 90 days must be checked for tardive dyskinesia at least 30 and 60 days after discontinuation of the antipsychotic medication or amoxapine. Monitoring must include use of a standardized rating scale and examination procedure. The license holder must provide the assessments to the physician for review if the results meet criteria that require physician review.