HF 4021

as introduced - 92nd Legislature (2021 - 2022) Posted on 03/17/2022 05:31pm

A bill for an act
relating to human services; establishing residential treatment admission
requirements for children experiencing a mental health crisis; amending Minnesota
Statutes 2020, section 245.4882, by adding a subdivision; Minnesota Statutes 2021
Supplement, section 245.4885, subdivision 1.

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

Section 1.

Minnesota Statutes 2020, section 245.4882, is amended by adding a subdivision
to read:

new text begin Subd. 6. new text end

new text begin Crisis admissions and stabilization. new text end

new text begin (a) A child may be referred for residential
treatment services under this section for the purpose of crisis stabilization by the following:
new text end

new text begin (1) a mental health professional as defined in section 245I.04, subdivision 2;
new text end

new text begin (2) a physician licensed under chapter 147 who is assessing a child in an emergency
department; or
new text end

new text begin (3) a member of a mobile crisis team who meets the qualifications under section
256B.0624, subdivision 5 new text end new text begin .
new text end

new text begin (b) A provider making a referral under paragraph (a) must conduct an assessment of the
child's mental health needs and make a determination that the child is experiencing a mental
health crisis and is in need of residential treatment services under this section.
new text end

new text begin (c) A child may receive services under this subdivision for up to 30 days and must be
subject to the screening and admissions criteria and processes under section 245.4885
thereafter new text end new text begin .
new text end

Sec. 2.

Minnesota Statutes 2021 Supplement, section 245.4885, subdivision 1, is amended
to read:

Subdivision 1.

Admission criteria.

(a) Prior to admission or placement, except in the
case of an emergency, all children referred for treatment of severe emotional disturbance
in a treatment foster care setting, residential treatment facility, or informally admitted to a
regional treatment center shall undergo an assessment to determine the appropriate level of
care if county funds are used to pay for the child's services. new text begin An emergency includes a child
who is in need of and has been referred for crisis stabilization services under section
245.4882, subdivision 6. A child who has been referred to residential treatment for crisis
stabilization services in a residential treatment center is not required to undergo an assessment
under this section.
new text end

(b) The county board shall determine the appropriate level of care for a child when
county-controlled funds are used to pay for the child's residential treatment under this
chapter, including residential treatment provided in a qualified residential treatment program
as defined in section 260C.007, subdivision 26d. When a county board does not have
responsibility for a child's placement and the child is enrolled in a prepaid health program
under section 256B.69, the enrolled child's contracted health plan must determine the
appropriate level of care for the child. When Indian Health Services funds or funds of a
tribally owned facility funded under the Indian Self-Determination and Education Assistance
Act, Public Law 93-638, are used for the child, the Indian Health Services or 638 tribal
health facility must determine the appropriate level of care for the child. When more than
one entity bears responsibility for a child's coverage, the entities shall coordinate level of
care determination activities for the child to the extent possible.

(c) The child's level of care determination shall determine whether the proposed treatment:

(1) is necessary;

(2) is appropriate to the child's individual treatment needs;

(3) cannot be effectively provided in the child's home; and

(4) provides a length of stay as short as possible consistent with the individual child's
needs.

(d) When a level of care determination is conducted, the county board or other entity
may not determine that a screening of a child, referral, or admission to a residential treatment
facility is not appropriate solely because services were not first provided to the child in a
less restrictive setting and the child failed to make progress toward or meet treatment goals
in the less restrictive setting. The level of care determination must be based on a diagnostic
assessment of a child that evaluates the child's family, school, and community living
situations; and an assessment of the child's need for care out of the home using a validated
tool which assesses a child's functional status and assigns an appropriate level of care to the
child. The validated tool must be approved by the commissioner of human services and
may be the validated tool approved for the child's assessment under section 260C.704 if the
juvenile treatment screening team recommended placement of the child in a qualified
residential treatment program. If a diagnostic assessment has been completed by a mental
health professional within the past 180 days, a new diagnostic assessment need not be
completed unless in the opinion of the current treating mental health professional the child's
mental health status has changed markedly since the assessment was completed. The child's
parent shall be notified if an assessment will not be completed and of the reasons. A copy
of the notice shall be placed in the child's file. Recommendations developed as part of the
level of care determination process shall include specific community services needed by
the child and, if appropriate, the child's family, and shall indicate whether these services
are available and accessible to the child and the child's family. The child and the child's
family must be invited to any meeting where the level of care determination is discussed
and decisions regarding residential treatment are made. The child and the child's family
may invite other relatives, friends, or advocates to attend these meetings.

(e) During the level of care determination process, the child, child's family, or child's
legal representative, as appropriate, must be informed of the child's eligibility for case
management services and family community support services and that an individual family
community support plan is being developed by the case manager, if assigned.

(f) The level of care determination, placement decision, and recommendations for mental
health services must be documented in the child's record and made available to the child's
family, as appropriate.