4th Engrossment - 82nd Legislature (2001 - 2002) Posted on 12/15/2009 12:00am
1.1 A bill for an act 1.2 relating to mental health; establishing duties for 1.3 reducing and preventing suicides; establishing 1.4 requirements for discharge plans and transition 1.5 services for offenders with mental illness; providing 1.6 coverage requirements for health plans; adjusting 1.7 payment rates for certain mental health providers; 1.8 establishing coverage requirements for mental health 1.9 services and treatment; requiring studies; 1.10 appropriating money; amending Minnesota Statutes 2000, 1.11 sections 245.462, subdivisions 3, 6, 8, 18, 20, by 1.12 adding subdivisions; 245.466, subdivision 2; 245.470, 1.13 by adding a subdivision; 245.4711, by adding a 1.14 subdivision; 245.474, subdivision 2, by adding a 1.15 subdivision; 245.4871, subdivisions 10, 17, 27, 29, by 1.16 adding subdivisions; 245.4875, subdivision 2; 1.17 245.4876, subdivision 1, by adding subdivisions; 1.18 245.488, by adding a subdivision; 245.4885, 1.19 subdivision 1; 246.54; 256.969, subdivision 3a, by 1.20 adding a subdivision; 256B.0625, subdivision 17, by 1.21 adding subdivisions; 256B.69, by adding a subdivision; 1.22 256E.12, subdivision 1, by adding a subdivision; 1.23 260C.201, subdivision 1; proposing coding for new law 1.24 in Minnesota Statutes, chapters 62Q; 145; 244; 245; 1.25 246; 256B; 299A. 1.26 BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF MINNESOTA: 1.27 ARTICLE 1 1.28 SUICIDE PREVENTION 1.29 Section 1. [145.56] [SUICIDE PREVENTION.] 1.30 Subdivision 1. [PUBLIC HEALTH GOAL; SUICIDE PREVENTION 1.31 PLAN.] The commissioner of health shall make suicide prevention 1.32 an important public health goal of the state and shall conduct 1.33 suicide prevention activities to accomplish that goal using an 1.34 evidenced-based, public health approach focused on prevention. 1.35 The commissioner shall refine, coordinate, and implement the 2.1 state's suicide prevention plan, in collaboration with assigned 2.2 staff from the department of human services; the department of 2.3 public safety; the department of children, families, and 2.4 learning; and appropriate agencies, organizations, and 2.5 institutions in the community. 2.6 Subd. 2. [EDUCATION AND OUTREACH TO PUBLIC, MEDIA, AND 2.7 POLICYMAKERS.] (a) The commissioner of health shall create or 2.8 contract for an ongoing public education campaign to raise 2.9 awareness of suicide as a public health issue and of the 2.10 preventability of many suicides. The campaign must: (1) be 2.11 coordinated with other existing suicide prevention outreach and 2.12 awareness campaigns; (2) promote broad-based public awareness in 2.13 the general population; (3) establish the connection between 2.14 depression and other psychiatric illnesses, and suicide; and (4) 2.15 include tactics targeted to populations at risk for suicide, and 2.16 to individuals who influence members of at-risk populations and 2.17 are in positions to identify the warning signs of suicide and 2.18 make appropriate referrals. Through the grant-making process, 2.19 the commissioner shall promote the use of a common language, 2.20 uniform terminology, and consistent messages regarding suicide, 2.21 symptoms of depression and other psychiatric illnesses, 2.22 substance abuse, warning signs of suicide, risk factors, and 2.23 help-seeking behaviors. 2.24 (b) The commissioner shall establish partnerships with 2.25 media vendors in the state to: 2.26 (1) implement an ongoing, coordinated, multistrategy, 2.27 multimedia, and multipartner public awareness and antistigma 2.28 campaign that is consistent with the policy goals of this 2.29 section; and 2.30 (2) educate media vendors, media associations, reporters, 2.31 advertising vendors, and members of the entertainment industry 2.32 about suicide, suicidal behavior, mental illness, substance 2.33 abuse, and help-seeking behaviors. 2.34 (c) The commissioner shall disseminate education materials 2.35 to educate appropriate state and local officials and 2.36 policymakers about suicide, suicidal behavior, depression and 3.1 other psychiatric illnesses, and substance abuse, and their 3.2 impact on state and local health care, social services, 3.3 education, law enforcement, employment, and corrections systems. 3.4 Subd. 3. [COMMUNITY-BASED PROGRAMS.] (a) The commissioner 3.5 shall establish a grant program consistent with the policy goals 3.6 of this section to fund: 3.7 (1) community-based programs to provide education, 3.8 outreach, and advocacy services to populations who may be at 3.9 risk for suicide; and 3.10 (2) community-based programs that educate natural community 3.11 helpers and gatekeepers, such as family members, spiritual 3.12 leaders, coaches, and business people, on how to prevent suicide 3.13 by encouraging help-seeking behaviors. 3.14 (b) Education to populations at risk for suicide and to 3.15 community helpers and gatekeepers must include information on 3.16 the symptoms of depression and other psychiatric illnesses, the 3.17 warning signs of suicide, skills for preventing suicides, and 3.18 making or seeking effective referrals to intervention and 3.19 community resources. 3.20 Subd. 4. [PROGRAMS IN SCHOOLS AND WORKPLACES.] (a) The 3.21 commissioner shall establish a grant program consistent with the 3.22 policy goals of this section to fund community-based programs to 3.23 provide suicide prevention education in schools using a 3.24 three-pronged approach of education to students, school staff, 3.25 and parents at the junior and senior high school levels. 3.26 (b) The commissioner shall promote the use of employee 3.27 assistance and workplace programs to support employees with 3.28 depression and other psychiatric illnesses and substance abuse 3.29 problems, and refer them to other services available in the 3.30 community. In promoting these programs, the commissioner shall 3.31 collaborate with employer and professional associations, unions, 3.32 and safety councils. Community-based programs that provide 3.33 these services may apply for funding under subdivision 3. 3.34 Subd. 5. [PROFESSIONAL EDUCATION.] The commissioner shall 3.35 establish a grant program consistent with the policy goals of 3.36 this section to fund academic and other institutions, 4.1 associations, licensing boards, and organizations to provide 4.2 professional education on suicide prevention as part of 4.3 preservice or continuing education. Curricula may include 4.4 information on suicide and suicidal behavior; screening, 4.5 prevention, and intervention; and screening, referral, and 4.6 treatment for depression and other psychiatric illnesses. 4.7 Professionals to whom this education may be targeted include 4.8 teachers, administrators, and other school staff; health care 4.9 providers; mental health providers, including but not limited to 4.10 psychologists and social workers; corrections personnel; law 4.11 enforcement personnel; social services providers; and members of 4.12 faith-based professions. 4.13 Subd. 6. [COLLECTING AND REPORTING SUICIDE DATA.] The 4.14 commissioner shall coordinate with federal, regional, local, and 4.15 other state agencies to collect, analyze, and annually issue a 4.16 public report on Minnesota-specific data on suicide and suicidal 4.17 behaviors. The data collected and reported must include 4.18 demographic-specific data, data on the insurance status of 4.19 persons who commit or attempt suicide, data on 4.20 posthospitalization outcomes for persons who attempt suicide, 4.21 and data on associated costs of suicide and suicidal behaviors 4.22 to various systems, including but not limited to the health 4.23 care, social services, and law enforcement systems. The data 4.24 must be summary data as defined in section 13.02 and must not 4.25 identify individuals. 4.26 Subd. 7. [RESEARCH AGENDA.] The commissioner shall make 4.27 grants and assist entities in seeking nonstate funding sources 4.28 to fund research that is consistent with the research agenda 4.29 established in the Minnesota department of health's January 15, 4.30 2000, suicide prevention plan, and that furthers understanding 4.31 of the risks and protective factors related to suicide and 4.32 suicidal behaviors, effective prevention programs, clinical 4.33 treatments, and culturally specific interventions in Minnesota. 4.34 Subd. 8. [POLICIES OF INSTITUTIONAL SETTINGS.] The 4.35 commissioner shall periodically survey and evaluate the suicide 4.36 prevention and intervention policies and practices of 5.1 institutional settings licensed by the state, including foster 5.2 care and jails, and recommend modifications to the policies and 5.3 practices as appropriate. 5.4 Subd. 9. [SUICIDE REPORTING PRACTICES.] The commissioner 5.5 shall study current practices of determining and reporting 5.6 suicides and shall make recommendations to professionals and 5.7 organizations that report suicides to ensure that suicides are 5.8 accurately reported. 5.9 Subd. 10. [PERIODIC EVALUATIONS; BIENNIAL REPORTS.] The 5.10 commissioner shall conduct periodic evaluations of the impact of 5.11 and outcomes from implementation of the state's suicide 5.12 prevention plan and each of the activities specified in this 5.13 section. By July 1, 2002, and July 1 of each even-numbered year 5.14 thereafter, the commissioner shall report the results of these 5.15 evaluations to the chairs of the policy and finance committees 5.16 in the house and senate with jurisdiction over health and human 5.17 services issues. 5.18 Sec. 2. [299A.76] [SUICIDE STATISTICS.] 5.19 (a) The commissioner of public safety shall not: 5.20 (1) include any statistics on committing suicide or 5.21 attempting suicide in any compilation of crime statistics 5.22 published by the commissioner; or 5.23 (2) label as a crime statistic, any data on committing 5.24 suicide or attempting suicide. 5.25 (b) This section does not apply to the crimes of aiding 5.26 suicide under section 609.215, subdivision 1, or aiding 5.27 attempted suicide under section 609.215, subdivision 2, or to 5.28 statistics on a suicide directly related to the commission of a 5.29 crime. 5.30 Sec. 3. [STUDY; CRISIS RESPONSE SYSTEM.] 5.31 The commissioner of health shall study the existing suicide 5.32 crisis response system in Minnesota to identify gaps in basic 5.33 suicide crisis intervention, safety net, and follow-up services; 5.34 identify barriers to obtaining these services; determine costs 5.35 for providing these services; and provide recommendations for 5.36 addressing identified gaps in and barriers to services. This 6.1 study shall be reported to the chairs of the policy and finance 6.2 committees in the house and senate with jurisdiction over health 6.3 and human services issues by January 15, 2002. 6.4 Sec. 4. [APPROPRIATIONS.] 6.5 (a) $12,450,000 is appropriated for the 2002-2003 biennium 6.6 from the general fund to the commissioner of health for suicide 6.7 prevention activities. Of this amount: 6.8 (1) $300,000 is for refining, coordinating, and 6.9 implementing the suicide prevention plan under Minnesota 6.10 Statutes, section 145.56, subdivision 1; 6.11 (2) $3,000,000 is for the education and outreach activities 6.12 under Minnesota Statutes, section 145.56, subdivision 2; 6.13 (3) $6,000,000 is to fund community-based programs under 6.14 Minnesota Statutes, section 145.56, subdivision 3; 6.15 (4) $1,000,000 is for the programs in schools and 6.16 workplaces under Minnesota Statutes, section 145.56, subdivision 6.17 4; 6.18 (5) $1,000,000 is for the professional education activities 6.19 under Minnesota Statutes, section 145.56, subdivision 5; 6.20 (6) $500,000 is to collect and report on suicide data under 6.21 Minnesota Statutes, section 145.56, subdivision 6; 6.22 (7) $500,000 is to promote and fund research under 6.23 Minnesota Statutes, section 145.56, subdivision 7; 6.24 (8) $100,000 is to survey and evaluate suicide prevention 6.25 and intervention policies in institutions under Minnesota 6.26 Statutes, section 145.56, subdivision 8; and 6.27 (9) $50,000 is to conduct the study of suicide reporting 6.28 practices under Minnesota Statutes, section 145.56, subdivision 6.29 9. 6.30 (b) $70,000 is appropriated for the fiscal year ending June 6.31 30, 2002, from the general fund to the commissioner of health to 6.32 conduct the study in section 3 on the existing crisis response 6.33 system. This appropriation is one-time funding and shall not 6.34 become part of the base level funding for the 2004-2005 biennium. 6.35 ARTICLE 2 6.36 CORRECTIONS 7.1 Section 1. [244.054] [DISCHARGE PLANS; OFFENDERS WITH 7.2 SERIOUS AND PERSISTENT MENTAL ILLNESS.] 7.3 Subdivision 1. [OFFER TO DEVELOP PLAN.] The commissioner 7.4 shall offer to develop a discharge plan for community-based 7.5 services for every offender with serious and persistent mental 7.6 illness, as defined in section 245.462, subdivision 20, 7.7 paragraph (c), who is being released from a correctional 7.8 facility. If an offender is being released pursuant to section 7.9 244.05, the offender may choose to have the discharge plan made 7.10 one of the conditions of the offender's supervised release and 7.11 shall follow the conditions to the extent that services are 7.12 available and offered to the offender. 7.13 Subd. 2. [CONTENT OF PLAN.] If an offender chooses to have 7.14 a discharge plan developed, the commissioner shall develop and 7.15 implement a discharge plan, which must include at least the 7.16 following: 7.17 (1) at least 90 days before the offender is due to be 7.18 discharged, the commissioner shall designate a department of 7.19 corrections agent with mental health training to serve as the 7.20 primary person responsible for carrying out discharge planning 7.21 activities; 7.22 (2) at least 75 days before the offender is due to be 7.23 discharged, the offender's designated agent shall: 7.24 (i) obtain informed consent and releases of information 7.25 from the offender that are needed for transition services; 7.26 (ii) contact the county human services department in the 7.27 community where the offender expects to reside following 7.28 discharge, and inform the department of the offender's impending 7.29 discharge and the planned date of the offender's return to the 7.30 community; determine whether the county or a designated 7.31 contracted provider will provide case management services to the 7.32 offender; refer the offender to the case management services 7.33 provider; and confirm that the case management services provider 7.34 will have opened the offender's case prior to the offender's 7.35 discharge; and 7.36 (iii) refer the offender to appropriate staff in the county 8.1 human services department in the community where the offender 8.2 expects to reside following discharge, for enrollment of the 8.3 offender if eligible in medical assistance or general assistance 8.4 medical care, using special procedures established by process 8.5 and department of human services bulletin; 8.6 (3) at least 2-1/2 months before discharge, the offender's 8.7 designated agent shall secure timely appointments for the 8.8 offender with a psychiatrist no later than 30 days following 8.9 discharge, and with other program staff at a community mental 8.10 health provider that is able to serve former offenders with 8.11 serious and persistent mental illness; 8.12 (4) at least 30 days before discharge, the offender's 8.13 designated agent shall convene a predischarge assessment and 8.14 planning meeting of key staff from the programs in which the 8.15 offender has participated while in the correctional facility, 8.16 the offender, and the supervising agent assigned to the 8.17 offender. At the meeting, attendees shall provide background 8.18 information and continuing care recommendations for the 8.19 offender, including information on the offender's risk for 8.20 relapse; current medications, including dosage and frequency; 8.21 therapy and behavioral goals; diagnostic and assessment 8.22 information, including results of a chemical dependency 8.23 evaluation; confirmation of appointments with a psychiatrist and 8.24 other program staff in the community; a relapse prevention plan; 8.25 continuing care needs; needs for housing, employment, and 8.26 finance support and assistance; and recommendations for 8.27 successful community integration, including chemical dependency 8.28 treatment or support if chemical dependency is a risk factor. 8.29 Immediately following this meeting, the offender's designated 8.30 agent shall summarize this background information and continuing 8.31 care recommendations in a written report; 8.32 (5) immediately following the predischarge assessment and 8.33 planning meeting, the provider of mental health case management 8.34 services who will serve the offender following discharge shall 8.35 offer to make arrangements and referrals for housing, financial 8.36 support, benefits assistance, employment counseling, and other 9.1 services required in sections 245.461 to 245.486; 9.2 (6) at least ten days before the offender's first scheduled 9.3 postdischarge appointment with a mental health provider, the 9.4 offender's designated agent shall transfer the following records 9.5 to the offender's case management services provider and 9.6 psychiatrist: the predischarge assessment and planning report, 9.7 medical records, and pharmacy records. These records may be 9.8 transferred only if the offender provides informed consent for 9.9 their release; 9.10 (7) upon discharge, the offender's designated agent shall 9.11 ensure that the offender leaves the correctional facility with 9.12 at least a ten-day supply of all necessary medications; and 9.13 (8) upon discharge, the prescribing authority at the 9.14 offender's correctional facility shall telephone in 9.15 prescriptions for all necessary medications to a pharmacy in the 9.16 community where the offender plans to reside. The prescriptions 9.17 must provide at least a 30-day supply of all necessary 9.18 medications, and must be able to be refilled once for one 9.19 additional 30-day supply. 9.20 Sec. 2. [245.4662] [REIMBURSEMENT FOR COUNTY HUMAN SERVICE 9.21 INVOLVEMENT IN PRISON DISCHARGES.] 9.22 County human services departments or a provider authorized 9.23 by the county may invoice the commissioner of human services at 9.24 a rate of $500 for every offender with serious and persistent 9.25 mental illness who is discharged from prison and for whom the 9.26 county or contracted staff provided the services which are 9.27 required from county human services in section 244.054. The 9.28 commissioner shall pay these invoices in the order they are 9.29 received up to the limit of funds appropriated for this purpose. 9.30 Sec. 3. [TRANSITIONAL SERVICES FOR MENTALLY ILL OFFENDERS 9.31 RELEASED FROM PRISON; PILOT PROGRAM.] 9.32 Subdivision 1. [PROGRAM ESTABLISHED.] The commissioner of 9.33 corrections, in collaboration with the commissioner of human 9.34 services, shall establish a pilot project grant program with 9.35 goals and evaluation criteria and make grants to provide startup 9.36 funding for two counties or two groups of counties to provide 10.1 transitional housing and other community support services for 10.2 former state inmates who have been diagnosed with a serious 10.3 mental illness and who have been discharged from prison. Grant 10.4 applicants must submit a proposed comprehensive plan for 10.5 providing the housing and support services and evaluating the 10.6 provision of services, and must provide a 25 percent funding 10.7 match. The commissioner shall make grants available to 10.8 successful applicants by February 1, 2002. Grant recipients are 10.9 eligible for funding under this section for the first three 10.10 years of operation of their programs for housing and support 10.11 services. 10.12 Subd. 2. [REPORT.] By January 15, 2003, the commissioner 10.13 shall report to the chairs and ranking minority members of the 10.14 house and senate committees and divisions having jurisdiction 10.15 over criminal justice policy and funding on the effectiveness of 10.16 the grants made and pilot projects funded under this section. 10.17 Sec. 4. [STUDY.] 10.18 The commissioner of corrections, in collaboration with the 10.19 commissioner of human services, shall plan, develop, and 10.20 implement a study to assess and identify barriers to successful 10.21 reintegration into the community of offenders who await 10.22 discharge from a correctional facility and have conditions which 10.23 include traumatic brain injury and fetal alcohol syndrome. 10.24 The study must: 10.25 (1) identify the number and the status of offenders in 10.26 correctional facilities operated by the department of 10.27 corrections who are determined to be affected by a mental 10.28 condition such as traumatic brain injury or fetal alcohol 10.29 syndrome; 10.30 (2) review and evaluate the scope and extent of any 10.31 treatments and supports currently available to offenders with 10.32 the mental conditions to be studied; 10.33 (3) evaluate the successes and deficiencies of released 10.34 offenders with traumatic brain injury and fetal alcohol syndrome 10.35 for recidivism and community integration; and 10.36 (4) make recommendations, based on findings identified in 11.1 the study that would address unfavorable outcomes. 11.2 The commissioner of corrections shall incorporate the 11.3 study's recommendations to improve discharged offenders' 11.4 reintegration into the community and to reduce recidivism by 11.5 utilizing a discharge planning process that refers the 11.6 discharged offender to appropriate community services for which 11.7 the released offender is eligible. 11.8 By February 1, 2002, the commissioner shall report to the 11.9 chairs and ranking minority members of the house and senate 11.10 committees and divisions having jurisdiction over criminal 11.11 justice policy and funding on the findings and any 11.12 recommendations resulting from the study. 11.13 Sec. 5. [APPROPRIATIONS.] 11.14 (a) $....... each year is appropriated from the general 11.15 fund to the department of corrections, mental health division 11.16 for the fiscal biennium ending June 30, 2003. Of this amount, 11.17 $....... each year is for hiring or contracting for additional 11.18 mental health services and treatment in the state correctional 11.19 facilities. The services and treatment must meet current 11.20 community standards of care; and $....... each year is for 11.21 purchasing appropriate medications for offenders who have been 11.22 diagnosed with a serious and persistent mental illness. This 11.23 appropriation is part of the department's base budget. 11.24 (b) $....... is appropriated from the general fund to the 11.25 department of corrections, mental health division for the fiscal 11.26 biennium ending June 30, 2003, to fund the development of 11.27 discharge plans under Minnesota Statutes, section 244.054, for 11.28 offenders with serious and persistent mental illness. 11.29 (c) $....... is appropriated from the general fund to the 11.30 department of corrections, mental health division for the fiscal 11.31 year ending June 30, 2002, for the grants described in section 11.32 3, subdivision 1 and the reports described in section 3, 11.33 subdivision 2, and section 4. 11.34 (d) $....... is appropriated from the general fund to the 11.35 commissioner of human services for the fiscal biennium ending 11.36 June 30, 2003, to reimburse invoices submitted under Minnesota 12.1 Statutes, section 245.4662. 12.2 ARTICLE 3 12.3 REIMBURSEMENT RATES 12.4 Section 1. [245.4862] [ANNUAL RATE ADJUSTMENTS.] 12.5 Subdivision 1. [PROVISION OF RATE INCREASES.] Beginning 12.6 July 1, 2001, and each July 1 thereafter, the commissioner of 12.7 human services shall increase reimbursement rates for adult 12.8 residential program grants under Minnesota Rules, parts 12.9 9535.2000 to 9535.3000 and adult and family community support 12.10 grants under Minnesota Rules, parts 9535.1700 to 9535.1760, by 12.11 the percentage change in the Consumer Price Index for urban 12.12 consumers (CPI) for the previous calendar year. 12.13 Subd. 2. [USE OF INCREASE.] Providers that receive a rate 12.14 increase under this section shall use at least 80 percent of the 12.15 additional revenue to increase the compensation paid to 12.16 employees other than the administrator and central office staff. 12.17 Subd. 3. [PROVIDER PLAN.] A copy of the provider's plan 12.18 for complying with subdivision 2 must be made available to all 12.19 employees. This must be done by giving each employee a copy or 12.20 by posting it in an area of the provider's operation to which 12.21 all employees have access. If an employee does not receive the 12.22 compensation adjustment described in the plan and is unable to 12.23 resolve the problem with the provider, the employee may contact 12.24 the employee's union representative. If the employee is not 12.25 covered by a collective bargaining agreement, the employee may 12.26 contact the commissioner at a telephone number provided by the 12.27 commissioner and included in the provider's plan. 12.28 Sec. 2. Minnesota Statutes 2000, section 246.54, is 12.29 amended to read: 12.30 246.54 [LIABILITY OF COUNTY; REIMBURSEMENT.] 12.31 (a) Except for chemical dependency services provided under 12.32 sections 254B.01 to 254B.09, the client's county shall pay to 12.33 the state of Minnesota a portion of the cost of care provided in 12.34 a regional treatment center to a client legally settled in that 12.35 county. A county's payment shall be made from the county's own 12.36 sources of revenueand, funds distributed to the county under 13.1 section 246.541, subdivision 2, or both. Payments shall be paid 13.2 as follows: 13.3 (1) payments to the state from the county shall equal ten 13.4 percent of the cost of care, as determined by the commissioner, 13.5 for each day, or the portion thereof, that the client spends at 13.6 a regional treatment center. If payments received by the state 13.7 under sections 246.50 to 246.53 exceed 90 percent of the cost of 13.8 care, the county shall be responsible for paying the state only 13.9 the remaining amount; and 13.10 (2) if funds are distributed to the county under section 13.11 246.541, subdivision 2, the county shall pay to the state up to 13.12 50 percent of the cost of care, as determined by the 13.13 commissioner, for each day or portion thereof that the client 13.14 spends at a regional treatment center. The percentage of the 13.15 county's responsibility under this clause shall be limited by 13.16 the amount of funds distributed to the county under section 13.17 246.541, subdivision 2, for this purpose. 13.18 (b) The county shall not be entitled to reimbursement from 13.19 the client, the client's estate, or from the client's relatives, 13.20 except as provided in section 246.53. No such payments shall be 13.21 made for any client who was last committed prior to July 1, 1947. 13.22 Sec. 3. [246.541] [APPROPRIATION TO COUNTIES FOR REGIONAL 13.23 TREATMENT CENTER CARE OR DIVERSION PROGRAMS.] 13.24 Subdivision 1. [CALCULATING APPROPRIATION BASED ON 13.25 POPULATION SIZE.] (a) Beginning January 1, 2002, and each 13.26 January 1 thereafter, the commissioner shall: 13.27 (1) compare the state appropriated funds to regional 13.28 treatment centers through direct appropriations for the two most 13.29 recently completed fiscal years; 13.30 (2) determine what portion of the difference in the amounts 13.31 appropriated is attributable to a decrease in the populations 13.32 being served at regional treatment centers; and 13.33 (3) certify the amount that is attributable to a decrease 13.34 in the populations being served at regional treatment centers to 13.35 the commissioner of finance. 13.36 (b) Beginning July 1, 2002, when there is a decrease in 14.1 state funds appropriated to regional treatment centers due to a 14.2 decrease in population being served, the difference in the 14.3 amounts appropriated each year must be appropriated to the 14.4 commissioner for distribution to counties according to 14.5 subdivision 2. 14.6 Subd. 2. [DISTRIBUTION TO COUNTIES.] The commissioner 14.7 shall develop a methodology for distributing funds appropriated 14.8 under subdivision 1 and other direct appropriations made by the 14.9 legislature for this purpose to each county based on a five-year 14.10 average of the county's spending, for the most recent five 14.11 fiscal years, for client cost of care under section 246.54, as a 14.12 proportion of the average of total spending by all counties for 14.13 client cost of care under section 246.54. Based on that 14.14 methodology, the commissioner shall distribute the funds to 14.15 counties. 14.16 Subd. 3. [COUNTY USES OF FUNDS.] Counties may use the 14.17 funds distributed under subdivision 2: 14.18 (1) for the county portion of the cost of care for clients 14.19 at regional treatment centers under section 246.54, paragraph 14.20 (a), clause (2); or 14.21 (2) to develop programs to divert clients with mental 14.22 illness from receiving regional treatment center inpatient 14.23 services to receiving services provided in less restrictive 14.24 community settings, when such diversion is appropriate to meet 14.25 client needs. 14.26 Sec. 4. [256B.761] [REIMBURSEMENT FOR MENTAL HEALTH 14.27 SERVICES.] 14.28 Effective for services rendered on or after July 1, 2001, 14.29 payment for medication management provided to psychiatric 14.30 patients, outpatient mental health services, day treatment 14.31 services, home-based mental health services, and family 14.32 community support services shall be paid at the lower of (1) 14.33 submitted charges, or (2) the 50th percentile of 1999 charges. 14.34 Sec. 5. [256B.762] [MENTAL HEALTH CLINIC REIMBURSEMENT.] 14.35 Subdivision 1. [RATE INCREASE.] Effective for services 14.36 rendered on or after January 1, 2002, payment rates for: (1) 15.1 community mental health center services under section 256B.0625, 15.2 subdivision 5; (2) services provided by mental health clinics 15.3 and centers certified under Minnesota Rules, parts 9520.0750 to 15.4 9520.0870, or hospital outpatient psychiatric departments, 15.5 designated as essential community providers under section 15.6 62Q.19; and (3) services provided by mental health clinics and 15.7 centers certified under Minnesota Rules, parts 9520.0750 to 15.8 9520.0870, or hospital outpatient psychiatric departments, that 15.9 receive at least 30 percent of their revenue from contracts with 15.10 a county or counties to provide services under the adult and 15.11 children's mental health acts, shall be increased by 20 percent 15.12 over the rates in effect on July 1, 2001. This reimbursement 15.13 increase shall be in addition to any other reimbursement 15.14 increases enacted by the 2001 legislature. 15.15 Subd. 2. [SETTLE-UP.] Beginning July 1, 2001, the 15.16 commissioner shall implement a settle-up procedure to pay 15.17 community mental health centers and mental health clinics and 15.18 centers for services provided to prepaid medical assistance, 15.19 prepaid general assistance medical care, and MinnesotaCare 15.20 enrollees. The settle-up procedure must pay community mental 15.21 health centers and mental health clinics and centers the 15.22 difference between the state health care program reimbursement 15.23 rate and the reimbursement received from the prepaid health 15.24 plan. The settle-up procedure must be based on that used by the 15.25 commissioner to reimburse federally qualified health centers and 15.26 rural health clinics. 15.27 Sec. 6. [STAGED RATE ADJUSTMENT.] 15.28 (a) Beginning July 1, 2001, and each July 1 through July 1, 15.29 2004, the commissioner of human services shall increase 15.30 reimbursement rates for adult residential program grants under 15.31 Minnesota Rules, parts 9535.2000 to 9535.3000 and adult and 15.32 family community support grants under Minnesota Rules, parts 15.33 9535.1700 to 9535.1760, by one-fourth of the percentage change 15.34 in the Consumer Price Index for urban consumers (CPI) between 15.35 January 1, 1990, and December 31, 2000. 15.36 (b) Providers that receive a rate increase under this 16.1 section must use at least 80 percent of the additional revenue 16.2 to increase the compensation paid to employees other than the 16.3 administrator and central office staff. 16.4 (c) A copy of the provider's plan for complying with 16.5 paragraph (b) must be made available to all employees. This 16.6 must be done by giving each employee a copy or by posting it in 16.7 an area of the provider's operation to which all employees have 16.8 access. If an employee does not receive the compensation 16.9 adjustment described in the plan and is unable to resolve the 16.10 problem with the provider, the employee may contact the 16.11 employee's union representative. If the employee is not covered 16.12 by a collective bargaining agreement, the employee may contact 16.13 the commissioner of human services at a telephone number 16.14 provided by the commissioner and included in the provider's plan. 16.15 Sec. 7. [APPROPRIATIONS.] 16.16 Subdivision 1. [ANNUAL RATE ADJUSTMENT; CERTAIN MENTAL 16.17 HEALTH PROVIDERS.] $....... is appropriated from the general 16.18 fund to the commissioner of human services for the biennium 16.19 ending June 30, 2003, to increase adult residential program 16.20 grants and adult and family community support grants as provided 16.21 under Minnesota Statutes, section 245.4862. 16.22 Subd. 2. [REGIONAL TREATMENT CENTER COST OF CARE OR 16.23 DIVERSION PROGRAMS.] $5,000,000 is appropriated for the 16.24 2002-2003 biennium from the general fund to the commissioner of 16.25 human services for distribution to counties under Minnesota 16.26 Statutes, section 246.541, subdivision 2, to be used according 16.27 to Minnesota Statutes, section 246.541, subdivision 3. 16.28 Subd. 3. [STAGED RATE ADJUSTMENT; CERTAIN MENTAL HEALTH 16.29 PROVIDERS.] $....... is appropriated from the general fund to 16.30 the commissioner of human services for the biennium ending June 16.31 30, 2003, to increase adult residential program grants and adult 16.32 and family community support grants as provided under section 6. 16.33 ARTICLE 4 16.34 COVERED SERVICES 16.35 Section 1. Minnesota Statutes 2000, section 245.462, 16.36 subdivision 3, is amended to read: 17.1 Subd. 3. [CASE MANAGEMENT SERVICES.] "Case management 17.2 services" means activities that are coordinated with the 17.3 community support services program as defined in subdivision 6 17.4 and are designed to help adults with serious and persistent 17.5 mental illness in gaining access to needed medical, social, 17.6 educational, vocational, and other necessary services as they 17.7 relate to the client's mental health needs. Case management 17.8 services include developing a functional assessment, an 17.9 individual community support plan, referring and assisting the 17.10 person to obtain needed mental health and other services, 17.11 ensuring coordination of services, and monitoring the delivery 17.12 of services. For adults between the ages of 18 and 25 who are 17.13 eligible for case management services under subdivision 20, 17.14 paragraph (c), clause (6), case management services also include 17.15 advocacy for and coordination of all transition services for 17.16 which the adult is eligible or which the adult is receiving, 17.17 including vocational, educational, housing, and life skills 17.18 transition services. 17.19 Sec. 2. Minnesota Statutes 2000, section 245.462, 17.20 subdivision 6, is amended to read: 17.21 Subd. 6. [COMMUNITY SUPPORT SERVICES PROGRAM.] "Community 17.22 support services program" means services, other than inpatient 17.23 or residential treatment services, provided or coordinated by an 17.24 identified program and staff under the clinical supervision of a 17.25 mental health professional designed to help adults with serious 17.26 and persistent mental illness to function and remain in the 17.27 community. A community support services program includes: 17.28 (1) client outreach, 17.29 (2) medication monitoring, 17.30 (3) assistance in independent living skills, 17.31 (4) development of employability and work-related 17.32 opportunities, 17.33 (5) crisis assistance, 17.34 (6) psychosocial rehabilitation, 17.35 (7) help in applying for government benefits,and17.36 (8) housing support services, 18.1 (9) education and consultation provided to families and 18.2 other individuals as an extension of the treatment process, and 18.3 (10) assistance to consumers in pursuing complaints and 18.4 appeals, and obtaining access to dispute resolution processes. 18.5 A community support services program may also administer a 18.6 program under section 245.4713 to reimburse the transportation 18.7 costs of individuals who provide transportation to adults with 18.8 serious and persistent mental illness. The community support 18.9 services program must be coordinated with the case management 18.10 services specified in section 245.4711. 18.11 Sec. 3. Minnesota Statutes 2000, section 245.462, is 18.12 amended by adding a subdivision to read: 18.13 Subd. 7a. [CRISIS INTERVENTION SERVICES.] Crisis 18.14 intervention services are short-term, intensive, nonresidential 18.15 mental health services that include assessment, mental health 18.16 rehabilitative services, and a crisis disposition plan. Crisis 18.17 intervention services are intended to help the recipient return 18.18 to a baseline level of functioning or prevent further harmful 18.19 consequences due to the psychiatric symptoms. 18.20 Sec. 4. Minnesota Statutes 2000, section 245.462, is 18.21 amended by adding a subdivision to read: 18.22 Subd. 7b. [CRISIS STABILIZATION SERVICES.] Crisis 18.23 stabilization services are assessment and intensive 18.24 individualized rehabilitative services provided in a recipient's 18.25 home or a short-term residential setting. Crisis stabilization 18.26 services are intended to prevent further deterioration or 18.27 exacerbation of psychiatric symptoms or to help the recipient to 18.28 reside in the recipient's usual living arrangement during or 18.29 following a mental health crisis or emergency. 18.30 Sec. 5. Minnesota Statutes 2000, section 245.462, 18.31 subdivision 8, is amended to read: 18.32 Subd. 8. [DAY TREATMENT SERVICES.] "Day treatment," "day 18.33 treatment services," or "day treatment program" means a 18.34 structured program of treatment and care provided to an adult in 18.35 or by: (1) a hospital accredited by the joint commission on 18.36 accreditation of health organizations and licensed under 19.1 sections 144.50 to 144.55; (2) a community mental health center 19.2 under section 245.62; or (3) an entity that is under contract 19.3 with the county board to operate a program that meets the 19.4 requirements of section 245.4712, subdivision 2, and Minnesota 19.5 Rules, parts 9505.0170 to 9505.0475. Day treatment consists of 19.6 group psychotherapy and other intensive therapeutic services 19.7 that are provided at least one day a week by a multidisciplinary 19.8 staff under the clinical supervision of a mental health 19.9 professional. Day treatment may include education and 19.10 consultation provided to families and other individuals as part 19.11 of the treatment process. The services are aimed at stabilizing 19.12 the adult's mental health status, providing mental health 19.13 services, and developing and improving the adult's independent 19.14 living and socialization skills. The goal of day treatment is 19.15 to reduce or relieve mental illness and to enable the adult to 19.16 live in the community. Day treatment services are not a part of 19.17 inpatient or residential treatment services. Day treatment 19.18 services are distinguished from day care by their structured 19.19 therapeutic program of psychotherapy services. The commissioner 19.20 may limit medical assistance reimbursement for day treatment to 19.21 15 hours per week per person instead of the three hours per day 19.22 per person specified in Minnesota Rules, part 9505.0323, subpart 19.23 15. 19.24 Sec. 6. Minnesota Statutes 2000, section 245.462, is 19.25 amended by adding a subdivision to read: 19.26 Subd. 14a. [MENTAL HEALTH CRISIS.] "Mental health crisis" 19.27 means an urgent behavioral, emotional, or psychiatric condition 19.28 that would, in the determination of a mental health 19.29 professional, result in significantly reduced levels of 19.30 functioning in primary activities of daily living if mental 19.31 health crisis services are not provided as soon as possible, 19.32 usually within 24 hours. 19.33 Sec. 7. Minnesota Statutes 2000, section 245.462, is 19.34 amended by adding a subdivision to read: 19.35 Subd. 14b. [MENTAL HEALTH EMERGENCY.] "Mental health 19.36 emergency" means an urgent behavioral, emotional, or psychiatric 20.1 situation that would, in the determination of a mental health 20.2 professional, pose an immediate threat to the physical health or 20.3 safety of the adult or others if mental health crisis services 20.4 are not provided. 20.5 Sec. 8. Minnesota Statutes 2000, section 245.462, is 20.6 amended by adding a subdivision to read: 20.7 Subd. 14c. [MENTAL HEALTH CRISIS SERVICES.] "Mental health 20.8 crisis services" means crisis assessment, crisis intervention, 20.9 and crisis stabilization services that are not billed as part of 20.10 hospital emergency room care or an inpatient hospital admission. 20.11 Sec. 9. Minnesota Statutes 2000, section 245.462, 20.12 subdivision 18, is amended to read: 20.13 Subd. 18. [MENTAL HEALTH PROFESSIONAL.] "Mental health 20.14 professional" means a person providing clinical services in the 20.15 treatment of mental illness who is qualified in at least one of 20.16 the following ways: 20.17 (1) in psychiatric nursing: a registered nurse who is 20.18 licensed under sections 148.171 to 148.285, and who is certified 20.19 as a clinical specialist in adult psychiatric and mental health 20.20 nursing by a national nurse certification organization or who 20.21 has a master's degree in nursing or one of the behavioral 20.22 sciences or related fields from an accredited college or 20.23 university or its equivalent, with at least 4,000 hours of 20.24 post-master's supervised experience in the delivery of clinical 20.25 services in the treatment of mental illness; 20.26 (2) in clinical social work: a person licensed as an 20.27 independent clinical social worker under section 148B.21, 20.28 subdivision 6, or a person with a master's degree in social work 20.29 from an accredited college or university, with at least 4,000 20.30 hours of post-master's supervised experience in the delivery of 20.31 clinical services in the treatment of mental illness; 20.32 (3) in psychology:a psychologistan individual licensed 20.33 by the board of psychology under sections 148.88 to 148.98 who 20.34 has stated to the board of psychology competencies in the 20.35 diagnosis and treatment of mental illness; 20.36 (4) in psychiatry: a physician licensed under chapter 147 21.1 and certified by the American board of psychiatry and neurology 21.2 or eligible for board certification in psychiatry; 21.3 (5) in marriage and family therapy: the mental health 21.4 professional must be a marriage and family therapist licensed 21.5 under sections 148B.29 to 148B.39 with at least two years of 21.6 post-master's supervised experience in the delivery of clinical 21.7 services in the treatment of mental illness; or 21.8 (6) in allied fields: a person with a master's degree from 21.9 an accredited college or university in one of the behavioral 21.10 sciences or related fields, with at least 4,000 hours of 21.11 post-master's supervised experience in the delivery of clinical 21.12 services in the treatment of mental illness. 21.13 Sec. 10. Minnesota Statutes 2000, section 245.462, 21.14 subdivision 20, is amended to read: 21.15 Subd. 20. [MENTAL ILLNESS.] (a) "Mental illness" means an 21.16 organic disorder of the brain or a clinically significant 21.17 disorder of thought, mood, perception, orientation, memory, or 21.18 behavior that is listed in the clinical manual of the 21.19 International Classification of Diseases (ICD-9-CM), current 21.20 edition, code range 290.0 to 302.99 or 306.0 to 316.0 or the 21.21 corresponding code in the American Psychiatric Association's 21.22 Diagnostic and Statistical Manual of Mental Disorders (DSM-MD), 21.23 current edition, Axes I, II, or III, and that seriously limits a 21.24 person's capacity to function in primary aspects of daily living 21.25 such as personal relations, living arrangements, work, and 21.26 recreation. 21.27 (b) An "adult with acute mental illness" means an adult who 21.28 has a mental illness that is serious enough to require prompt 21.29 intervention. 21.30 (c) For purposes of case management and community support 21.31 services, a "person with serious and persistent mental illness" 21.32 means an adult who has a mental illness and meets at least one 21.33 of the following criteria: 21.34 (1) the adult has undergone two or more episodes of 21.35 inpatient care for a mental illness within the preceding 24 21.36 months; 22.1 (2) the adult has experienced a continuous psychiatric 22.2 hospitalization or residential treatment exceeding six months' 22.3 duration within the preceding 12 months; 22.4 (3) the adult: 22.5 (i) has a diagnosis of schizophrenia, bipolar disorder, 22.6 major depression,orborderline personality disorder, or severe 22.7 anxiety disorder such as panic disorder, obsessive-compulsive 22.8 disorder, posttraumatic stress disorder, and social anxiety 22.9 disorder; 22.10 (ii) indicates a significant impairment in functioning; and 22.11 (iii) has a written opinion from a mental health 22.12 professional, in the last three years, stating that either: (A) 22.13 the adult is reasonably likely to have future episodes requiring 22.14 inpatient or residential treatment, of a frequency described in 22.15 clause (1) or (2), unless ongoing case management or community 22.16 support services are provided; or (B) ongoing case management 22.17 and community support services are appropriate to prevent 22.18 relapse and maintain community functioning or to avoid 22.19 hospitalization or residential treatment; 22.20 (4) the adult has, in the last three years, been committed 22.21 by a court as a mentally ill person under chapter 253B, or the 22.22 adult's commitment has been stayed or continued;or22.23 (5) the adult (i) was eligible under clauses (1) to (4), 22.24 but the specified time period has expired or the adult was 22.25 eligible as a child under section 245.4871, subdivision 6; and 22.26 (ii) has a written opinion from a mental health professional, in 22.27 the last three years, stating that the adult is reasonably 22.28 likely to have future episodes requiring inpatient or 22.29 residential treatment, of a frequency described in clause (1) or 22.30 (2), unless ongoing case management or community support 22.31 services are provided; or 22.32 (6) the adult is between the ages of 18 and 25 and as a 22.33 child (i) was eligible for services under sections 245.487 to 22.34 245.4888 as a child with severe emotional disturbance, as 22.35 defined in section 245.4871, subdivision 6; or (ii) was eligible 22.36 for special education services under the Individuals with 23.1 Disabilities Education Act or chapter 125A as a child with an 23.2 emotional or behavioral disorder, as defined in Minnesota Rules, 23.3 part 3525.1329, subpart 1. 23.4 Sec. 11. Minnesota Statutes 2000, section 245.462, is 23.5 amended by adding a subdivision to read: 23.6 Subd. 25a. [SIGNIFICANT IMPAIRMENT IN 23.7 FUNCTIONING.] "Significant impairment in functioning" means a 23.8 condition, including significant suicidal ideation or thoughts 23.9 of harming self or others, which harmfully affects, recurrently 23.10 or consistently, a person's activities of daily living in 23.11 employment, housing, family, and social relationships, or 23.12 education. 23.13 Sec. 12. Minnesota Statutes 2000, section 245.466, 23.14 subdivision 2, is amended to read: 23.15 Subd. 2. [ADULT MENTAL HEALTH SERVICES.] The adult mental 23.16 health service system developed by each county board must 23.17 include the following services: 23.18 (1) education and prevention services in accordance with 23.19 section 245.468; 23.20 (2) emergency services in accordance with section 245.469; 23.21 (3) outpatient services in accordance with section 245.470; 23.22 (4) community support program services in accordance with 23.23 section 245.4711; 23.24 (5) residential treatment services in accordance with 23.25 section 245.472; 23.26 (6) acute care hospital inpatient treatment services in 23.27 accordance with section 245.473; 23.28 (7) regional treatment center inpatient services in 23.29 accordance with section 245.474; 23.30 (8) screening in accordance with section 245.476;and23.31 (9) case management in accordance with sections 245.462, 23.32 subdivision 3; and 245.4711; and 23.33 (10) mental health crisis services in accordance with 23.34 section 245.470, subdivision 3. 23.35 Sec. 13. Minnesota Statutes 2000, section 245.470, is 23.36 amended by adding a subdivision to read: 24.1 Subd. 3. [MENTAL HEALTH CRISIS SERVICES.] County boards 24.2 must provide or contract for enough mental health crisis 24.3 services within the county to meet the needs of adults with 24.4 mental illness residing in the county who are determined, 24.5 through an assessment by a mental health professional, to be 24.6 experiencing a mental health crisis or mental health emergency. 24.7 The mental health crisis services provided must be medically 24.8 necessary, as defined in section 62Q.53, subdivision 2, and 24.9 appropriate or socially necessary for the safety of the adult or 24.10 others. 24.11 Sec. 14. Minnesota Statutes 2000, section 245.4711, is 24.12 amended by adding a subdivision to read: 24.13 Subd. 6a. [TEAM CASE MANAGEMENT SERVICES.] One year before 24.14 a child's eligibility for mental health services under sections 24.15 245.487 to 245.4888 ends, a child with severe emotional 24.16 disturbance who is reasonably expected to require mental health 24.17 services under sections 245.461 to 245.486 is eligible for team 24.18 case management services from both a case management service 24.19 provider for adults and a case management service provider for 24.20 children. Team case management services may be available until 24.21 age 22. To the extent possible, the case management service 24.22 provider for children who served the child shall continue to 24.23 serve that person as part of the team under this subdivision. 24.24 Case management service providers providing team case management 24.25 services may each receive separate payment for services 24.26 provided, according to section 256B.0625, subdivision 20, 24.27 paragraph (f). 24.28 Sec. 15. [245.4713] [REIMBURSEMENT FOR TRANSPORTATION 24.29 COSTS.] 24.30 A community support services program that a county board 24.31 contracts with for community support services may administer a 24.32 program to reimburse individuals and organizations for 24.33 transporting adults with serious and persistent mental illness 24.34 to health care and social support services deemed necessary by 24.35 case managers or mental health professionals serving the 24.36 adults. The program may reimburse individuals and organizations 25.1 for transportation costs that may not be billed to the medical 25.2 assistance program under section 256B.0625. Individuals and 25.3 organizations that may be reimbursed include, but are not 25.4 limited to, providers of outpatient mental health services, 25.5 members of consumer cooperatives, family members and friends who 25.6 are providing transportation, and other individuals and 25.7 organizations providing transportation to adults. If a 25.8 community support services program chooses to administer a 25.9 reimbursement program, the program may apply to the commissioner 25.10 for the funds through an application process established by the 25.11 commissioner. The commissioner shall establish reimbursement 25.12 rates to be used by community support services programs. 25.13 Sec. 16. Minnesota Statutes 2000, section 245.4871, is 25.14 amended by adding a subdivision to read: 25.15 Subd. 9b. [CRISIS INTERVENTION SERVICES.] Crisis 25.16 intervention services are short-term, intensive, nonresidential 25.17 mental health services that include assessment, mental health 25.18 rehabilitative services, and a crisis disposition plan. Crisis 25.19 intervention services are intended to help the recipient return 25.20 to a baseline level of functioning or prevent further harmful 25.21 consequences due to the psychiatric symptoms. 25.22 Sec. 17. Minnesota Statutes 2000, section 245.4871, is 25.23 amended by adding a subdivision to read: 25.24 Subd. 9c. [CRISIS STABILIZATION SERVICES.] Crisis 25.25 stabilization services covers assessment and intensive 25.26 individualized rehabilitative services provided in a recipient's 25.27 home or a short-term residential setting. Crisis stabilization 25.28 services are intended to prevent further deterioration or 25.29 exacerbation of psychiatric symptoms or help the recipient to 25.30 reside in the recipient's usual living arrangement during or 25.31 following a mental health crisis or emergency. 25.32 Sec. 18. Minnesota Statutes 2000, section 245.4871, 25.33 subdivision 10, is amended to read: 25.34 Subd. 10. [DAY TREATMENT SERVICES.] "Day treatment," "day 25.35 treatment services," or "day treatment program" means a 25.36 structured program of treatment and care provided to a child in: 26.1 (1) an outpatient hospital accredited by the joint 26.2 commission on accreditation of health organizations and licensed 26.3 under sections 144.50 to 144.55; 26.4 (2) a community mental health center under section 245.62; 26.5 (3) an entity that is under contract with the county board 26.6 to operate a program that meets the requirements of section 26.7 245.4884, subdivision 2, and Minnesota Rules, parts 9505.0170 to 26.8 9505.0475; or 26.9 (4) an entity that operates a program that meets the 26.10 requirements of section 245.4884, subdivision 2, and Minnesota 26.11 Rules, parts 9505.0170 to 9505.0475, that is under contract with 26.12 an entity that is under contract with a county board. 26.13 Day treatment consists of group psychotherapy and other 26.14 intensive therapeutic services that are provided for a minimum 26.15 three-hour time block by a multidisciplinary staff under the 26.16 clinical supervision of a mental health professional. Day 26.17 treatment may include education and consultation provided to 26.18 families and other individuals as an extension of the treatment 26.19 process. The services are aimed at stabilizing the child's 26.20 mental health status, and developing and improving the child's 26.21 daily independent living and socialization skills. Day 26.22 treatment services are distinguished from day care by their 26.23 structured therapeutic program of psychotherapy services. Day 26.24 treatment services are not a part of inpatient hospital or 26.25 residential treatment services. Day treatment services for a 26.26 child are an integrated set of education, therapy, and family 26.27 interventions. 26.28 A day treatment service must be available to a child at 26.29 least five days a week throughout the year and must be 26.30 coordinated with, integrated with, or part of an education 26.31 program offered by the child's school. 26.32 Sec. 19. Minnesota Statutes 2000, section 245.4871, 26.33 subdivision 17, is amended to read: 26.34 Subd. 17. [FAMILY COMMUNITY SUPPORT SERVICES.] "Family 26.35 community support services" means services provided under the 26.36 clinical supervision of a mental health professional and 27.1 designed to help each child with severe emotional disturbance to 27.2 function and remain with the child's family in the community. 27.3 Family community support services do not include acute care 27.4 hospital inpatient treatment, residential treatment services, or 27.5 regional treatment center services. Family community support 27.6 services include: 27.7 (1) client outreach to each child with severe emotional 27.8 disturbance and the child's family; 27.9 (2) medication monitoring where necessary; 27.10 (3) assistance in developing independent living skills; 27.11 (4) assistance in developing parenting skills necessary to 27.12 address the needs of the child with severe emotional 27.13 disturbance; 27.14 (5) assistance with leisure and recreational activities; 27.15 (6) crisis assistance, including crisis placement and 27.16 respite care; 27.17 (7) professional home-based family treatment; 27.18 (8) foster care with therapeutic supports; 27.19 (9) day treatment; 27.20 (10) assistance in locating respite care and special needs 27.21 day care;and27.22 (11) assistance in obtaining potential financial resources, 27.23 including those benefits listed in section 245.4884, subdivision 27.24 5; 27.25 (12) education and consultation provided to families and 27.26 other individuals as an extension of the treatment process; and 27.27 (13) assistance to consumers in pursuing complaints and 27.28 appeals, and obtaining access to dispute resolution processes. 27.29 Sec. 20. Minnesota Statutes 2000, section 245.4871, is 27.30 amended by adding a subdivision to read: 27.31 Subd. 24a. [MENTAL HEALTH CRISIS.] "Mental health crisis" 27.32 means an urgent behavioral, emotional, or psychiatric condition 27.33 that would, in the determination of a mental health 27.34 professional, result in significantly reduced levels of 27.35 functioning in primary activities of daily living if mental 27.36 health crisis services are not provided as soon as possible, 28.1 usually within 24 hours. 28.2 Sec. 21. Minnesota Statutes 2000, section 245.4871, is 28.3 amended by adding a subdivision to read: 28.4 Subd. 24b. [MENTAL HEALTH EMERGENCY.] "Mental health 28.5 emergency" means an urgent behavioral, emotional, or psychiatric 28.6 situation that would, in the determination of a mental health 28.7 professional, pose an immediate threat to the physical health or 28.8 safety of the child or others if mental health crisis services 28.9 are not provided. 28.10 Sec. 22. Minnesota Statutes 2000, section 245.4871, is 28.11 amended by adding a subdivision to read: 28.12 Subd. 24c. [MENTAL HEALTH CRISIS SERVICES.] "Mental health 28.13 crisis services" means crisis assessment, crisis intervention, 28.14 and crisis stabilization services that are not billed as part of 28.15 hospital emergency room care or an inpatient hospital admission. 28.16 Sec. 23. Minnesota Statutes 2000, section 245.4871, 28.17 subdivision 27, is amended to read: 28.18 Subd. 27. [MENTAL HEALTH PROFESSIONAL.] "Mental health 28.19 professional" means a person providing clinical services in the 28.20 diagnosis and treatment of children's emotional disorders. A 28.21 mental health professional must have training and experience in 28.22 working with children consistent with the age group to which the 28.23 mental health professional is assigned. A mental health 28.24 professional must be qualified in at least one of the following 28.25 ways: 28.26 (1) in psychiatric nursing, the mental health professional 28.27 must be a registered nurse who is licensed under sections 28.28 148.171 to 148.285 and who is certified as a clinical specialist 28.29 in child and adolescent psychiatric or mental health nursing by 28.30 a national nurse certification organization or who has a 28.31 master's degree in nursing or one of the behavioral sciences or 28.32 related fields from an accredited college or university or its 28.33 equivalent, with at least 4,000 hours of post-master's 28.34 supervised experience in the delivery of clinical services in 28.35 the treatment of mental illness; 28.36 (2) in clinical social work, the mental health professional 29.1 must be a person licensed as an independent clinical social 29.2 worker under section 148B.21, subdivision 6, or a person with a 29.3 master's degree in social work from an accredited college or 29.4 university, with at least 4,000 hours of post-master's 29.5 supervised experience in the delivery of clinical services in 29.6 the treatment of mental disorders; 29.7 (3) in psychology, the mental health professional must bea29.8psychologistan individual licensed by the board of psychology 29.9 under sections 148.88 to 148.98 who has stated to the board of 29.10 psychology competencies in the diagnosis and treatment of mental 29.11 disorders; 29.12 (4) in psychiatry, the mental health professional must be a 29.13 physician licensed under chapter 147 and certified by the 29.14 American board of psychiatry and neurology or eligible for board 29.15 certification in psychiatry; 29.16 (5) in marriage and family therapy, the mental health 29.17 professional must be a marriage and family therapist licensed 29.18 under sections 148B.29 to 148B.39 with at least two years of 29.19 post-master's supervised experience in the delivery of clinical 29.20 services in the treatment of mental disorders or emotional 29.21 disturbances; or 29.22 (6) in allied fields, the mental health professional must 29.23 be a person with a master's degree from an accredited college or 29.24 university in one of the behavioral sciences or related fields, 29.25 with at least 4,000 hours of post-master's supervised experience 29.26 in the delivery of clinical services in the treatment of 29.27 emotional disturbances. 29.28 Sec. 24. Minnesota Statutes 2000, section 245.4871, 29.29 subdivision 29, is amended to read: 29.30 Subd. 29. [OUTPATIENT SERVICES.] "Outpatient services" 29.31 means mental health services, excluding day treatment and 29.32 community support services programs, provided by or under the 29.33 clinical supervision of a mental health professional to children 29.34 with emotional disturbances who live outside a hospital. 29.35 Outpatient services include clinical activities such as 29.36 individual, group, and family therapy; individual treatment 30.1 planning; diagnostic assessments; medication management; and 30.2 psychological testing. Outpatient services include education 30.3 and consultation provided to families and other individuals as 30.4 an extension of the treatment process. 30.5 Sec. 25. Minnesota Statutes 2000, section 245.4875, 30.6 subdivision 2, is amended to read: 30.7 Subd. 2. [CHILDREN'S MENTAL HEALTH SERVICES.] The 30.8 children's mental health service system developed by each county 30.9 board must include the following services: 30.10 (1) education and prevention services according to section 30.11 245.4877; 30.12 (2) mental health identification and intervention services 30.13 according to section 245.4878; 30.14 (3) emergency services according to section 245.4879; 30.15 (4) outpatient services according to section 245.488; 30.16 (5) family community support services according to section 30.17 245.4881; 30.18 (6) day treatment services according to section 245.4884, 30.19 subdivision 2; 30.20 (7) residential treatment services according to section 30.21 245.4882; 30.22 (8) acute care hospital inpatient treatment services 30.23 according to section 245.4883; 30.24 (9) screening according to section 245.4885; 30.25 (10) case management according to section 245.4881; 30.26 (11) therapeutic support of foster care according to 30.27 section 245.4884, subdivision 4;and30.28 (12) professional home-based family treatment according to 30.29 section 245.4884, subdivision 4; and 30.30 (13) mental health crisis services according to section 30.31 245.488, subdivision 3. 30.32 Sec. 26. Minnesota Statutes 2000, section 245.4876, 30.33 subdivision 1, is amended to read: 30.34 Subdivision 1. [CRITERIA.] Children's mental health 30.35 services required by sections 245.487 to 245.4888 must be: 30.36 (1) based, when feasible, on research findings; 31.1 (2) based on individual clinical, cultural, and ethnic 31.2 needs, and other special needs of the children being served; 31.3 (3) delivered in a manner that improves family functioning 31.4 when clinically appropriate; 31.5 (4) provided in the most appropriate, least restrictive 31.6 setting that meets the requirements in subdivision 1a, and that 31.7 is available to the county board to meet the child's treatment 31.8 needs; 31.9 (5) accessible to all age groups of children; 31.10 (6) appropriate to the developmental age of the child being 31.11 served; 31.12 (7) delivered in a manner that provides accountability to 31.13 the child for the quality of service delivered and continuity of 31.14 services to the child during the years the child needs services 31.15 from the local system of care; 31.16 (8) provided by qualified individuals as required in 31.17 sections 245.487 to 245.4888; 31.18 (9) coordinated with children's mental health services 31.19 offered by other providers; 31.20 (10) provided under conditions that protect the rights and 31.21 dignity of the individuals being served; and 31.22 (11) provided in a manner and setting most likely to 31.23 facilitate progress toward treatment goals. 31.24 Sec. 27. Minnesota Statutes 2000, section 245.4876, is 31.25 amended by adding a subdivision to read: 31.26 Subd. 1a. [APPROPRIATE SETTING TO RECEIVE SERVICES.] A 31.27 child must be provided with mental health services in the least 31.28 restrictive setting that is appropriate to the needs and current 31.29 condition of the individual child. For a child to receive 31.30 mental health services in a residential treatment or acute care 31.31 hospital inpatient setting, the family may not be required to 31.32 demonstrate that services were first provided in a less 31.33 restrictive setting and that the child failed to make progress 31.34 toward or meet treatment goals in the less restrictive setting. 31.35 Sec. 28. Minnesota Statutes 2000, section 245.4876, is 31.36 amended by adding a subdivision to read: 32.1 Subd. 1b. [APPROPRIATE; DEFINITION.] For purposes of this 32.2 section, "appropriate" means that activity which, based on a 32.3 preponderance of the evidence, is consistent with the 32.4 professional recommendations of the current mental health 32.5 professionals treating the child. 32.6 Sec. 29. Minnesota Statutes 2000, section 245.488, is 32.7 amended by adding a subdivision to read: 32.8 Subd. 3. [MENTAL HEALTH CRISIS SERVICES.] County boards 32.9 must provide or contract for enough mental health crisis 32.10 services within the county to meet the needs of children with 32.11 emotional disturbance residing in the county who are determined, 32.12 through an assessment by a mental health professional, to be 32.13 experiencing a mental health crisis or mental health emergency. 32.14 The mental health crisis services provided must be medically 32.15 necessary, as defined in section 62Q.53, subdivision 2, and 32.16 appropriate or socially necessary for the safety of the child or 32.17 others. 32.18 Sec. 30. Minnesota Statutes 2000, section 245.4885, 32.19 subdivision 1, is amended to read: 32.20 Subdivision 1. [SCREENING REQUIRED.] The county board 32.21 shall, prior to admission, except in the case of emergency 32.22 admission, screen all children referred for treatment of severe 32.23 emotional disturbance to a residential treatment facility or 32.24 informally admitted to a regional treatment center if public 32.25 funds are used to pay for the services. The county board shall 32.26 also screen all children admitted to an acute care hospital for 32.27 treatment of severe emotional disturbance if public funds other 32.28 than reimbursement under chapters 256B and 256D are used to pay 32.29 for the services. If a child is admitted to a residential 32.30 treatment facility or acute care hospital for emergency 32.31 treatment or held for emergency care by a regional treatment 32.32 center under section 253B.05, subdivision 1, screening must 32.33 occur within three working days of admission. Screening shall 32.34 determine whether the proposed treatment: 32.35 (1) is necessary; 32.36 (2) is appropriate to the child's individual treatment 33.1 needs. For purposes of this clause, "appropriate" has the 33.2 meaning given in section 245.4876, subdivision 1b; 33.3 (3) cannot be effectively provided in the child's home; and 33.4 (4) provides a length of stay as short as possible 33.5 consistent with the individual child's need. 33.6 When a screening is conducted, the county board may not 33.7 determine that referral or admission to a residential treatment 33.8 facility or acute care hospital is not appropriate solely 33.9 because services were not first provided to the child in a less 33.10 restrictive setting and the child failed to make progress toward 33.11 or meet treatment goals in the less restrictive setting. 33.12 Screening shall include both a diagnostic assessment and a 33.13 functional assessment which evaluates family, school, and 33.14 community living situations. If a diagnostic assessment or 33.15 functional assessment has been completed by a mental health 33.16 professional within 180 days, a new diagnostic or functional 33.17 assessment need not be completed unless in the opinion of the 33.18 current treating mental health professional the child's mental 33.19 health status has changed markedly since the assessment was 33.20 completed. The child's parent shall be notified if an 33.21 assessment will not be completed and of the reasons. A copy of 33.22 the notice shall be placed in the child's file. Recommendations 33.23 developed as part of the screening process shall include 33.24 specific community services needed by the child and, if 33.25 appropriate, the child's family, and shall indicate whether or 33.26 not these services are available and accessible to the child and 33.27 family. 33.28 During the screening process, the child, child's family, or 33.29 child's legal representative, as appropriate, must be informed 33.30 of the child's eligibility for case management services and 33.31 family community support services and that an individual family 33.32 community support plan is being developed by the case manager, 33.33 if assigned. 33.34 Screening shall be in compliance with section 256F.07 or 33.35 260C.212, whichever applies. Wherever possible, the parent 33.36 shall be consulted in the screening process, unless clinically 34.1 inappropriate. 34.2 The screening process, and placement decision, and 34.3 recommendations for mental health services must be documented in 34.4 the child's record. 34.5 An alternate review process may be approved by the 34.6 commissioner if the county board demonstrates that an alternate 34.7 review process has been established by the county board and the 34.8 times of review, persons responsible for the review, and review 34.9 criteria are comparable to the standards in clauses (1) to (4). 34.10 Sec. 31. Minnesota Statutes 2000, section 256.969, 34.11 subdivision 3a, is amended to read: 34.12 Subd. 3a. [PAYMENTS.] Acute care hospital billings under 34.13 the medical assistance program must not be submitted until the 34.14 recipient is discharged. However, the commissioner shall 34.15 establish monthly interim payments for inpatient hospitals that 34.16 have individual patient lengths of stay over 30 days regardless 34.17 of diagnostic category. Except as provided in subdivision 3b, 34.18 medical assistance reimbursement for treatment of mental illness 34.19 shall be reimbursed based on diagnostic classifications. The 34.20 commissioner may selectively contract with hospitals for 34.21 services within the diagnostic categories relating to mental 34.22 illness and chemical dependency under competitive bidding when 34.23 reasonable geographic access by recipients can be assured but 34.24 shall not require, in the admissions criteria for persons with 34.25 mental illness, any commitment or petition under chapter 253B as 34.26 a condition of obtaining these services. No physician shall be 34.27 denied the privilege of treating a recipient required to use a 34.28 hospital under contract with the commissioner, as long as the 34.29 physician meets credentialing standards of the individual 34.30 hospital. Individual hospital payments established under this 34.31 section and sections 256.9685, 256.9686, and 256.9695, in 34.32 addition to third party and recipient liability, for discharges 34.33 occurring during the rate year shall not exceed, in aggregate, 34.34 the charges for the medical assistance covered inpatient 34.35 services paid for the same period of time to the hospital. This 34.36 payment limitation shall be calculated separately for medical 35.1 assistance and general assistance medical care services. The 35.2 limitation on general assistance medical care shall be effective 35.3 for admissions occurring on or after July 1, 1991. Services 35.4 that have rates established under subdivision 11 or 12, must be 35.5 limited separately from other services. After consulting with 35.6 the affected hospitals, the commissioner may consider related 35.7 hospitals one entity and may merge the payment rates while 35.8 maintaining separate provider numbers. The operating and 35.9 property base rates per admission or per day shall be derived 35.10 from the best Medicare and claims data available when rates are 35.11 established. The commissioner shall determine the best Medicare 35.12 and claims data, taking into consideration variables of recency 35.13 of the data, audit disposition, settlement status, and the 35.14 ability to set rates in a timely manner. The commissioner shall 35.15 notify hospitals of payment rates by December 1 of the year 35.16 preceding the rate year. The rate setting data must reflect the 35.17 admissions data used to establish relative values. Base year 35.18 changes from 1981 to the base year established for the rate year 35.19 beginning January 1, 1991, and for subsequent rate years, shall 35.20 not be limited to the limits ending June 30, 1987, on the 35.21 maximum rate of increase under subdivision 1. The commissioner 35.22 may adjust base year cost, relative value, and case mix index 35.23 data to exclude the costs of services that have been 35.24 discontinued by the October 1 of the year preceding the rate 35.25 year or that are paid separately from inpatient services. 35.26 Inpatient stays that encompass portions of two or more rate 35.27 years shall have payments established based on payment rates in 35.28 effect at the time of admission unless the date of admission 35.29 preceded the rate year in effect by six months or more. In this 35.30 case, operating payment rates for services rendered during the 35.31 rate year in effect and established based on the date of 35.32 admission shall be adjusted to the rate year in effect by the 35.33 hospital cost index. 35.34 Sec. 32. Minnesota Statutes 2000, section 256.969, is 35.35 amended by adding a subdivision to read: 35.36 Subd. 3b. [CONTINUING CARE PROGRAM FOR PERSONS WITH MENTAL 36.1 ILLNESS.] The commissioner shall establish a continuing care 36.2 benefit program for persons with mental illness, in which 36.3 persons with mental illness may obtain acute care hospital 36.4 inpatient treatment for mental illness for a length of stay 36.5 beyond that allowed by the diagnostic classifications for mental 36.6 illness according to subdivision 3a. Persons with mental 36.7 illness may obtain inpatient treatment under this program in 36.8 hospital beds for which the commissioner contracts under 36.9 subdivision 3a. The commissioner shall contract externally with 36.10 a utilization review organization to authorize persons with 36.11 mental illness to access the continuing care benefit program. 36.12 The commissioner shall establish admission criteria to allow 36.13 persons with mental illness to access the continuing care 36.14 benefit program. If a court orders acute care hospital 36.15 inpatient treatment for mental illness for a person, the person 36.16 may obtain the treatment under the continuing care benefit 36.17 program. The commissioner shall not require, as part of the 36.18 admission criteria, any commitment or petition under chapter 36.19 253B as a condition of accessing the program. 36.20 Sec. 33. Minnesota Statutes 2000, section 256B.0625, 36.21 subdivision 17, is amended to read: 36.22 Subd. 17. [TRANSPORTATION COSTS.] (a) Medical assistance 36.23 covers transportation costs incurred solely for obtaining 36.24 emergency medical care or transportation costs incurred by 36.25 nonambulatory persons in obtaining emergency or nonemergency 36.26 medical care when paid directly to an ambulance company, common 36.27 carrier, or other recognized providers of transportation 36.28 services. For the purpose of this subdivision, a person who is 36.29 incapable of transport by taxicab or bus shall be considered to 36.30 be nonambulatory. 36.31 (b) Medical assistance covers special transportation, as 36.32 defined in Minnesota Rules, part 9505.0315, subpart 1, item F, 36.33 if the provider receives and maintains a current physician's 36.34 order by the recipient's attending physician certifying that the 36.35 recipient has a physical or mental impairment that would 36.36 prohibit the recipient from safely accessing and using a bus, 37.1 taxi, other commercial transportation, or private automobile. 37.2 Notwithstanding Minnesota Rules, part 9505.0315, subpart 1, item 37.3 D, medical assistance covers special transportation services 37.4 necessary to obtain a service not covered by medical assistance, 37.5 if this service is part of the person's individual treatment 37.6 plan. Special transportation includes driver-assisted service 37.7 to eligible individuals. Driver-assisted service includes 37.8 passenger pickup at and return to the individual's residence or 37.9 place of business, assistance with admittance of the individual 37.10 to the medical facility, and assistance in passenger securement 37.11 or in securing of wheelchairs or stretchers in the vehicle. The 37.12 commissioner shall establish maximum medical assistance 37.13 reimbursement rates for special transportation services for 37.14 persons who need a wheelchair lift van or stretcher-equipped 37.15 vehicle and for those who do not need a wheelchair lift van or 37.16 stretcher-equipped vehicle. The average of these two rates per 37.17 trip must not exceed $15 for the base rate and $1.20 per mile. 37.18 Special transportation provided to nonambulatory persons who do 37.19 not need a wheelchair lift van or stretcher-equipped vehicle, 37.20 may be reimbursed at a lower rate than special transportation 37.21 provided to persons who need a wheelchair lift van or 37.22 stretcher-equipped vehicle. 37.23 Sec. 34. Minnesota Statutes 2000, section 256B.0625, is 37.24 amended by adding a subdivision to read: 37.25 Subd. 43. [CONTINUING CARE FOR PERSONS WITH MENTAL 37.26 ILLNESS.] Medical assistance covers a continuing care benefit 37.27 for persons with mental illness established under section 37.28 256.969, subdivision 3b, in which persons with mental illness 37.29 may obtain acute care hospital inpatient treatment for a length 37.30 of stay beyond that allowed by the diagnostic classifications 37.31 for mental illness. 37.32 Sec. 35. Minnesota Statutes 2000, section 256B.0625, is 37.33 amended by adding a subdivision to read: 37.34 Subd. 44. [COMMUNITY SUPPORT SERVICES PROGRAM.] Medical 37.35 assistance covers services included under a community support 37.36 services program, as defined in section 245.462, subdivision 6. 38.1 Sec. 36. Minnesota Statutes 2000, section 256B.0625, is 38.2 amended by adding a subdivision to read: 38.3 Subd. 45. [MENTAL HEALTH EVALUATION AND MANAGEMENT; 38.4 CLINICAL SUPERVISION.] (a) Medical assistance covers the 38.5 following evaluation and management services related to mental 38.6 health symptoms, treatment, and supportive services: 38.7 (1) outpatient services performed by mental health 38.8 professionals in community mental health centers under 38.9 subdivision 5 or section 245.62, community health clinics under 38.10 Minnesota Rules, part 9505.0255, public health clinics under 38.11 Minnesota Rules, part 9505.0380, or mental health centers and 38.12 mental health clinics certified under Minnesota Rules, parts 38.13 9520.0750 to 9520.0870; 38.14 (2) inpatient evaluation and management services performed 38.15 by psychiatrists for day treatment, partial hospitalization, 38.16 crisis intervention, and nonresidential crisis stabilization 38.17 services; and 38.18 (3) consultation, evaluation, and management services 38.19 provided via telemedicine. 38.20 (b) Medical assistance covers clinical supervision services 38.21 that are required as a condition of payment for services 38.22 provided under subdivisions 3 and 5, and Minnesota Rules, parts 38.23 9505.0323, 9505.0324, and 9505.0326. 38.24 Sec. 37. Minnesota Statutes 2000, section 256B.0625, is 38.25 amended by adding a subdivision to read: 38.26 Subd. 46. [MENTAL HEALTH CRISIS SERVICES.] Medical 38.27 assistance covers adult and child mental health crisis services 38.28 as defined in sections 245.462, subdivision 14c, and 245.4871, 38.29 subdivision 24c. 38.30 Sec. 38. [256B.063] [PRESUMPTIVE ELIGIBILITY FOR PERSONS 38.31 EXPERIENCING A MENTAL HEALTH CRISIS OR EMERGENCY.] 38.32 Medical assistance coverage is available during a 38.33 presumptive eligibility period for adults and children 38.34 experiencing a mental health crisis as defined in sections 38.35 245.462, subdivision 14a, or 245.4871, subdivision 24a, or a 38.36 mental health emergency as defined in sections 245.462, 39.1 subdivision 14b, or 245.4871, subdivision 24b. For purposes of 39.2 this section, the presumptive eligibility period begins on the 39.3 date on which a county human services agency, or an entity 39.4 designated by the county, determines, on the basis of 39.5 preliminary information, that the household income of the child 39.6 or adult does not exceed the applicable medical assistance 39.7 income limit. The presumptive eligibility period ends on the 39.8 day on which a determination is made with respect to the 39.9 eligibility of the child or adult, except in the event an 39.10 application is not filed by the last day of the month following 39.11 the month during which the determination based on preliminary 39.12 information is made, the presumptive eligibility period ends on 39.13 that last day of the month. 39.14 Sec. 39. Minnesota Statutes 2000, section 256E.12, 39.15 subdivision 1, is amended to read: 39.16 Subdivision 1. The commissioner shall establish a 39.17 statewide program to assist counties in providing services to 39.18 persons with serious and persistent mental illness as defined in 39.19 section 245.462, subdivision 20. The commissioner shall make 39.20 grants to counties to establish, operate, or contract with 39.21 private providers to provide services designed to help persons 39.22 with serious and persistent mental illness remain and function 39.23 in their own communities. Grants received pursuant to this 39.24 section may be used to fund community support services programs 39.25 as specified in section 245.462, subdivision 6,; the purchase, 39.26 financing, or lease of passenger vehicles by nonprofit community 39.27 mental health providers to transport adults with serious and 39.28 persistent mental illness as specified in subdivision 5; and 39.29 case management activities that cannot be billed to the medical 39.30 assistance program under sections 256B.02, subdivision 8, and 39.31 256B.0625. 39.32 Sec. 40. Minnesota Statutes 2000, section 256E.12, is 39.33 amended by adding a subdivision to read: 39.34 Subd. 5. [ACQUISITION OF PASSENGER VEHICLES.] A nonprofit 39.35 community mental health provider may purchase, finance the 39.36 purchase of, or lease one or more passenger vehicles, to be used 40.1 to transport adults with serious and persistent mental illness 40.2 to receive health care and social services deemed necessary by 40.3 the case managers or mental health professionals serving the 40.4 adults. A provider who chooses to purchase, finance the 40.5 purchase of, or lease one or more passenger vehicles may apply 40.6 to the county board for funds through an application process 40.7 established by the county board. 40.8 Sec. 41. Minnesota Statutes 2000, section 260C.201, 40.9 subdivision 1, is amended to read: 40.10 Subdivision 1. [DISPOSITIONS.] (a) If the court finds that 40.11 the child is in need of protection or services or neglected and 40.12 in foster care, it shall enter an order making any of the 40.13 following dispositions of the case: 40.14 (1) place the child under the protective supervision of the 40.15 local social services agency or child-placing agency in the home 40.16 of a parent of the child under conditions prescribed by the 40.17 court directed to the correction of the child's need for 40.18 protection or services, or: 40.19 (i) the court may order the child into the home of a parent 40.20 who does not otherwise have legal custody of the child, however, 40.21 an order under this section does not confer legal custody on 40.22 that parent; 40.23 (ii) if the court orders the child into the home of a 40.24 father who is not adjudicated, he must cooperate with paternity 40.25 establishment proceedings regarding the child in the appropriate 40.26 jurisdiction as one of the conditions prescribed by the court 40.27 for the child to continue in his home; 40.28 (iii) the court may order the child into the home of a 40.29 noncustodial parent with conditions and may also order both the 40.30 noncustodial and the custodial parent to comply with the 40.31 requirements of a case plan under subdivision 2; 40.32 (2) transfer legal custody to one of the following: 40.33 (i) a child-placing agency; or 40.34 (ii) the local social services agency. 40.35 In placing a child whose custody has been transferred under 40.36 this paragraph, the agencies shall follow the requirements of 41.1 section 260C.193, subdivision 3; 41.2 (3) if the child has been adjudicated as a child in need of 41.3 protection or services because the child is in need of special 41.4treatment andservices or carefor reasons of physical or mental41.5healthto treat or ameliorate a physical or mental disability, 41.6 the court may order the child's parent, guardian, or custodian 41.7 to provide it. The court may order the child's health plan 41.8 company to provide mental health services to the child. Section 41.9 62Q.535 applies to an order for mental health services directed 41.10 to the child's health plan company. If the health plan, parent, 41.11 guardian, or custodian fails or is unable to provide this 41.12 treatment or care, the court may order it provided. Absent 41.13 specific written findings by the court that the child's 41.14 disability is the result of abuse or neglect by the child's 41.15 parent or guardian, the court shall not transfer legal custody 41.16 of the child for the purpose of obtaining special treatment or 41.17 care solely because the parent is unable to provide the 41.18 treatment or care. If the court's order for mental health 41.19 treatment is based on a diagnosis made by a treatment 41.20 professional, the court may order that the diagnosing 41.21 professional not provide the treatment to the child if it finds 41.22 that such an order is in the child's best interests; or 41.23 (4) if the court believes that the child has sufficient 41.24 maturity and judgment and that it is in the best interests of 41.25 the child, the court may order a child 16 years old or older to 41.26 be allowed to live independently, either alone or with others as 41.27 approved by the court under supervision the court considers 41.28 appropriate, if the county board, after consultation with the 41.29 court, has specifically authorized this dispositional 41.30 alternative for a child. 41.31 (b) If the child was adjudicated in need of protection or 41.32 services because the child is a runaway or habitual truant, the 41.33 court may order any of the following dispositions in addition to 41.34 or as alternatives to the dispositions authorized under 41.35 paragraph (a): 41.36 (1) counsel the child or the child's parents, guardian, or 42.1 custodian; 42.2 (2) place the child under the supervision of a probation 42.3 officer or other suitable person in the child's own home under 42.4 conditions prescribed by the court, including reasonable rules 42.5 for the child's conduct and the conduct of the parents, 42.6 guardian, or custodian, designed for the physical, mental, and 42.7 moral well-being and behavior of the child; or with the consent 42.8 of the commissioner of corrections, place the child in a group 42.9 foster care facility which is under the commissioner's 42.10 management and supervision; 42.11 (3) subject to the court's supervision, transfer legal 42.12 custody of the child to one of the following: 42.13 (i) a reputable person of good moral character. No person 42.14 may receive custody of two or more unrelated children unless 42.15 licensed to operate a residential program under sections 245A.01 42.16 to 245A.16; or 42.17 (ii) a county probation officer for placement in a group 42.18 foster home established under the direction of the juvenile 42.19 court and licensed pursuant to section 241.021; 42.20 (4) require the child to pay a fine of up to $100. The 42.21 court shall order payment of the fine in a manner that will not 42.22 impose undue financial hardship upon the child; 42.23 (5) require the child to participate in a community service 42.24 project; 42.25 (6) order the child to undergo a chemical dependency 42.26 evaluation and, if warranted by the evaluation, order 42.27 participation by the child in a drug awareness program or an 42.28 inpatient or outpatient chemical dependency treatment program; 42.29 (7) if the court believes that it is in the best interests 42.30 of the child and of public safety that the child's driver's 42.31 license or instruction permit be canceled, the court may order 42.32 the commissioner of public safety to cancel the child's license 42.33 or permit for any period up to the child's 18th birthday. If 42.34 the child does not have a driver's license or permit, the court 42.35 may order a denial of driving privileges for any period up to 42.36 the child's 18th birthday. The court shall forward an order 43.1 issued under this clause to the commissioner, who shall cancel 43.2 the license or permit or deny driving privileges without a 43.3 hearing for the period specified by the court. At any time 43.4 before the expiration of the period of cancellation or denial, 43.5 the court may, for good cause, order the commissioner of public 43.6 safety to allow the child to apply for a license or permit, and 43.7 the commissioner shall so authorize; 43.8 (8) order that the child's parent or legal guardian deliver 43.9 the child to school at the beginning of each school day for a 43.10 period of time specified by the court; or 43.11 (9) require the child to perform any other activities or 43.12 participate in any other treatment programs deemed appropriate 43.13 by the court. 43.14 To the extent practicable, the court shall enter a 43.15 disposition order the same day it makes a finding that a child 43.16 is in need of protection or services or neglected and in foster 43.17 care, but in no event more than 15 days after the finding unless 43.18 the court finds that the best interests of the child will be 43.19 served by granting a delay. If the child was under eight years 43.20 of age at the time the petition was filed, the disposition order 43.21 must be entered within ten days of the finding and the court may 43.22 not grant a delay unless good cause is shown and the court finds 43.23 the best interests of the child will be served by the delay. 43.24 (c) If a child who is 14 years of age or older is 43.25 adjudicated in need of protection or services because the child 43.26 is a habitual truant and truancy procedures involving the child 43.27 were previously dealt with by a school attendance review board 43.28 or county attorney mediation program under section 260A.06 or 43.29 260A.07, the court shall order a cancellation or denial of 43.30 driving privileges under paragraph (b), clause (7), for any 43.31 period up to the child's 18th birthday. 43.32 (d) In the case of a child adjudicated in need of 43.33 protection or services because the child has committed domestic 43.34 abuse and been ordered excluded from the child's parent's home, 43.35 the court shall dismiss jurisdiction if the court, at any time, 43.36 finds the parent is able or willing to provide an alternative 44.1 safe living arrangement for the child, as defined in Laws 1997, 44.2 chapter 239, article 10, section 2. 44.3 Sec. 42. [PILOT PROGRAM; ADVOCACY SERVICES FOR CERTAIN 44.4 CHILDREN WITH SEVERE EMOTIONAL DISTURBANCE.] 44.5 The commissioner of human services shall establish a pilot 44.6 program to provide advocacy services to children with severe 44.7 emotional disturbance who are reasonably expected to require 44.8 mental health services under Minnesota Statutes, sections 44.9 245.461 to 245.486. Advocacy services shall be available 44.10 beginning one year before a child's eligibility for mental 44.11 health services under Minnesota Statutes, sections 245.487 to 44.12 245.4888, ends and shall be available until age 25. 44.13 Organizations that receive grants from the commissioner under 44.14 this pilot program shall advocate for these persons to ensure 44.15 that they receive all the transition services for which they are 44.16 eligible, including vocational, educational, housing, and life 44.17 skills transition services. 44.18 Sec. 43. [NOTICE REGARDING ESTABLISHMENT OF CONTINUING 44.19 CARE BENEFIT PROGRAM.] 44.20 When the continuing care benefit program for persons with 44.21 mental illness under Minnesota Statutes, section 256.969, 44.22 subdivision 3b, is established, the commissioner of human 44.23 services shall notify counties, health plan companies with 44.24 prepaid medical assistance contracts, health care providers, and 44.25 enrollees of the benefit program through bulletins, workshops, 44.26 and other meetings. 44.27 Sec. 44. [STUDY; LENGTH OF STAY FOR MEDICARE-ELIGIBLE 44.28 PERSONS.] 44.29 The commissioner of human services shall study and make 44.30 recommendations on how Medicare-eligible persons with mental 44.31 illness may obtain acute care hospital inpatient treatment for 44.32 mental illness for a length of stay beyond that allowed by the 44.33 diagnostic classifications for mental illness according to 44.34 Minnesota Statutes, section 256.969, subdivision 3a. The study 44.35 and recommendations shall be reported to the legislature by 44.36 January 15, 2002. 45.1 Sec. 45. [APPROPRIATIONS.] 45.2 Subdivision 1. [ACQUISITION OF PASSENGER 45.3 VEHICLES.] $....... is appropriated from the general fund for 45.4 the 2002-2003 biennium to the commissioner of human services to 45.5 increase funding to county boards under Minnesota Rules, parts 45.6 9535.1700 to 9535.1760. County boards shall use the additional 45.7 funds to provide grants to nonprofit community mental health 45.8 providers to purchase, finance the purchase of, or lease 45.9 passenger vehicles according to Minnesota Statutes, section 45.10 256E.12, subdivision 5. 45.11 Subd. 2. [TRANSPORTATION COSTS.] $....... is appropriated 45.12 from the general fund for the 2002-2003 biennium to the 45.13 commissioner of human services for grants to community support 45.14 services programs with which county boards contract for the 45.15 provision of community support services. Community support 45.16 services programs shall use the funds to reimburse the 45.17 transportation costs of individuals and organizations that 45.18 transport adults with serious and persistent mental illness 45.19 according to Minnesota Statutes, section 245.4713. 45.20 Subd. 3. [ADDITIONAL CONTRACT BEDS.] $....... is 45.21 appropriated for the 2002-2003 biennium from the general fund to 45.22 the commissioner of human services to increase funding for state 45.23 mental health grants. The commissioner shall use this 45.24 appropriation to contract with hospitals for additional beds to 45.25 provide acute care hospital inpatient services to persons with 45.26 mental illness, including persons covered by Medicare, who are 45.27 not eligible under the medical assistance contract under 45.28 Minnesota Statutes, section 256.969, subdivision 3b, and who 45.29 require a length of stay beyond that allowed by the diagnostic 45.30 classifications for mental illness. 45.31 Subd. 4. [PILOT PROGRAM; ADVOCACY SERVICES.] $....... is 45.32 appropriated for the 2002-2003 biennium from the general fund to 45.33 the commissioner of human services for a pilot program, 45.34 established according to section 42, to provide advocacy 45.35 services to certain children with severe emotional disturbance. 45.36 Subd. 5. [CRISIS SERVICES.] $....... is appropriated from 46.1 the general fund to the commissioner of human services, for the 46.2 biennium ending June 30, 2003, to increase funding provided to 46.3 county boards under Minnesota Rules, parts 9535.1700 to 46.4 9535.1760. County boards shall use the additional funding to 46.5 reimburse or contract with mental health providers to pay for 46.6 adult and child mental health crisis services as defined in 46.7 Minnesota Statutes, sections 245.462, subdivision 14c, and 46.8 245.4871, subdivision 24c. 46.9 Subd. 6. [PRESUMPTIVE ELIGIBILITY.] $....... is 46.10 appropriated from the general fund to the commissioner of human 46.11 services, for the biennium ending June 30, 2003, for costs 46.12 related to implementing presumptive eligibility under Minnesota 46.13 Statutes, section 256B.063. 46.14 Subd. 7. [COMMUNITY SOCIAL SERVICES ACT.] $....... is 46.15 appropriated from the general fund to the commissioner of human 46.16 services, for the biennium ending June 30, 2003, to increase 46.17 funding provided to county boards under the Title XX block 46.18 grant. County boards shall use the additional funding to 46.19 increase reimbursement rates for mental health providers to pay 46.20 for education, consultation, and support services provided to 46.21 families and other individuals. 46.22 Subd. 8. [RULE 78 FUNDING.] $....... is appropriated from 46.23 the general fund to the commissioner of human services, for the 46.24 biennium ending June 30, 2003, to increase funding provided to 46.25 county boards under Minnesota Rules, parts 9535.1700 to 46.26 9535.1760. County boards shall use the additional funding to 46.27 increase reimbursement rates for mental health providers to pay 46.28 for education, consultation, and support services provided to 46.29 families and other individuals. 46.30 ARTICLE 5 46.31 HEALTH PLAN COVERAGE 46.32 Section 1. [62Q.471] [EXCLUSION FOR SUICIDE ATTEMPTS 46.33 PROHIBITED.] 46.34 (a) No health plan may exclude or reduce coverage for 46.35 health care for an enrollee that is otherwise covered under the 46.36 health plan, on the basis that the need for the health care 47.1 arose out of a suicide or suicide attempt by the enrollee. 47.2 (b) For purposes of this section, "health plan" has the 47.3 meaning given in section 62Q.01, subdivision 3, but includes the 47.4 coverages described in section 62A.011, clauses (7) and (10). 47.5 Sec. 2. [62Q.527] [COVERAGE OF NONFORMULARY DRUGS FOR 47.6 MENTAL ILLNESS AND EMOTIONAL DISTURBANCE.] 47.7 Subdivision 1. [DEFINITIONS.] (a) For purposes of this 47.8 section, the following terms have the meanings given to them. 47.9 (b) "Emotional disturbance" has the meaning given in 47.10 section 245.4871, subdivision 15. 47.11 (c) "Mental illness" has the meaning given in section 47.12 245.462, subdivision 20, paragraph (a). 47.13 Subd. 2. [REQUIRED COVERAGE.] A health plan must provide 47.14 coverage for an antipsychotic, antimania, or antidementia drug 47.15 prescribed to treat emotional disturbance or mental illness 47.16 regardless of whether the drug is in the health plan's drug 47.17 formulary, if the health care provider prescribing the drug (i) 47.18 indicates to the dispensing pharmacist, orally or in writing 47.19 according to section 151.21, that the prescription must be 47.20 dispensed as communicated; and (ii) certifies in writing to the 47.21 health plan company that the drug prescribed will best treat the 47.22 patient's condition. For drugs covered under this section, no 47.23 health plan company, which has received the certification from 47.24 the health care provider, may: 47.25 (A) impose a special deductible, copayment, coinsurance, or 47.26 other special payment requirement that the health plan does not 47.27 apply to drugs that are in the health plan's drug formulary; or 47.28 (B) require written certification from the prescribing 47.29 provider each time a prescription is refilled or renewed that 47.30 the drug prescribed will best treat the patient's condition. 47.31 Subd. 3. [CONTINUING CARE.] Individuals receiving a 47.32 prescribed drug to treat a diagnosed mental illness or emotional 47.33 disturbance, may continue to receive the prescribed drug, 47.34 without the imposition of a special deductible, copayment, 47.35 coinsurance, or other special payment requirements, when a 47.36 health plan's drug formulary changes or an enrollee changes 48.1 health plans and the medication has been shown to effectively 48.2 treat the patient's condition. In order to be eligible for this 48.3 continuing care benefit, the patient must have been treated with 48.4 the drug for 60 days prior to a change in a health plan's drug 48.5 formulary or a change in the enrollee's health plan. 48.6 Sec. 3. [62Q.535] [COVERAGE FOR COURT-ORDERED MENTAL 48.7 HEALTH SERVICES.] 48.8 Subdivision 1. [MENTAL HEALTH SERVICES.] For purposes of 48.9 this section, mental health services means all covered services 48.10 that are intended to treat or ameliorate an emotional, 48.11 behavioral, or psychiatric condition and that are covered by the 48.12 policy, contract, or certificate of coverage of the enrollee's 48.13 health plan company or by law. 48.14 Subd. 2. [COVERAGE REQUIRED.] All health plan companies 48.15 that provide coverage for mental health services must cover or 48.16 provide mental health services ordered by a court of competent 48.17 jurisdiction under a court order that is issued on the basis of 48.18 a behavioral care evaluation performed by a licensed 48.19 psychiatrist or a doctoral level licensed psychologist, which 48.20 includes a diagnosis and an individual treatment plan for care 48.21 in the most appropriate, least restrictive environment. The 48.22 health plan company must be given a copy of the court order and 48.23 the behavioral care evaluation. The health plan company shall 48.24 be financially liable for the evaluation if performed by a 48.25 participating provider of the health plan company and shall be 48.26 financially liable for the care included in the court-ordered 48.27 individual treatment plan if the care is covered by the health 48.28 plan company and ordered to be provided by a participating 48.29 provider or another provider as required by rule or law. This 48.30 court-ordered coverage must not be subject to a separate medical 48.31 necessity determination by a health plan company under its 48.32 utilization procedures. 48.33 Sec. 4. [EFFECTIVE DATE.] 48.34 This article is effective January 1, 2002, and applies to 48.35 contracts issued or renewed on or after that date. 48.36 ARTICLE 6 49.1 OTHER MENTAL HEALTH ISSUES 49.2 Section 1. Minnesota Statutes 2000, section 245.474, 49.3 subdivision 2, is amended to read: 49.4 Subd. 2. [QUALITY OF SERVICE.] The commissioner shall 49.5 biennially determine the needs of all adults with mental illness 49.6 who are served by regional treatment centers or at any state 49.7 facility or program as defined in section 246.50, subdivision 3, 49.8 by administering a client-based evaluation system. The 49.9 client-based evaluation system must include at least the 49.10 following independent measurements: behavioral development 49.11 assessment; habilitation program assessment; medical needs 49.12 assessment; maladaptive behavioral assessment; and vocational 49.13 behavior assessment. The commissioner shallproposeby rule 49.14 establish staff ratiosto the legislaturefor the mental health 49.15 and support units in regional treatment centers as indicated by 49.16 the results of the client-based evaluation system and the types 49.17 of state-operated services needed. Theproposedstaffing ratios 49.18 shall include professional, nursing, direct care, medical, 49.19 clerical, and support staff based on the client-based evaluation 49.20 system. The commissioner shall recompute staffing ratios 49.21 andrecommendationsamend rules on staff ratios as necessary on 49.22 a biennial basis. 49.23 Sec. 2. Minnesota Statutes 2000, section 245.474, is 49.24 amended by adding a subdivision to read: 49.25 Subd. 4. [STAFF SAFETY TRAINING.] The commissioner shall 49.26 by rule require all staff in mental health and support units at 49.27 regional treatment centers who have contact with persons with 49.28 mental illness or severe emotional disturbance to be 49.29 appropriately trained in violence reduction and violence 49.30 prevention, and shall establish criteria for such training. 49.31 Training programs shall be developed with input from consumer 49.32 advocacy organizations, and shall employ violence prevention 49.33 techniques as preferable to physical interaction. 49.34 Sec. 3. Minnesota Statutes 2000, section 256B.69, is 49.35 amended by adding a subdivision to read: 49.36 Subd. 29. [INFORMATION ON BEHAVIORAL HEALTH CARE.] (a) The 50.1 commissioner shall develop a standard definition of behavioral 50.2 health care services based on claims, procedures, and encounter 50.3 data, and beginning January 1, 2002, for prepaid medical 50.4 assistance, prepaid general assistance medical care, and 50.5 MinnesotaCare program contracts renewed, entered into, or in 50.6 effect on or after that date, shall collect behavioral health 50.7 claims data from prepaid health plans. For each prepaid health 50.8 plan, the commissioner shall calculate on a quarterly basis the 50.9 ratio of expenditures for behavioral health services to the 50.10 total capitation payment received, and shall make this 50.11 information available to the public upon request. 50.12 (b) Beginning January 1, 2002, for prepaid medical 50.13 assistance program contracts renewed, entered into, or in effect 50.14 on or after that date, the commissioner shall collect 50.15 information from prepaid health plans on: (1) the number of 50.16 enrollees disenrolled as a result of a change in eligibility 50.17 status due to disability or placement in an institution for 50.18 mental diseases or other excluded placement; and (2) changes in 50.19 the health condition of the enrollee that led to the change. 50.20 The commissioner shall make information on each prepaid health 50.21 plan available to the public upon request, in a form that does 50.22 not identify individual enrollees. 50.23 Sec. 4. [DEVELOPMENT OF PAYMENT SYSTEM FOR ADULT 50.24 RESIDENTIAL SERVICES GRANTS.] 50.25 The commissioner of human services shall review funding 50.26 methods for adult residential services grants under Minnesota 50.27 Rules, parts 9535.2000 to 9535.3000, and shall develop a payment 50.28 system that takes into account client difficulty of care as 50.29 manifested by client physical, mental, or behavioral 50.30 conditions. The payment system must provide reimbursement for 50.31 education, consultation, and support services provided to 50.32 families and other individuals as an extension of the treatment 50.33 process. The commissioner shall present recommendations and 50.34 draft legislation for an adult residential services payment 50.35 system to the legislature by January 15, 2002. The 50.36 recommendations must address whether additional funding for 51.1 adult residential services grants is necessary for the provision 51.2 of high quality services under a payment reimbursement system. 51.3 Sec. 5. [DELIVERY OF SERVICES TO INDIVIDUALS WITH DUAL 51.4 DIAGNOSES.] 51.5 The commissioner of human services shall develop plans to 51.6 improve the delivery of services to individuals with dual 51.7 diagnoses of: 51.8 (1) serious and persistent mental illness and chemical 51.9 dependency; 51.10 (2) serious emotional disturbance and chemical dependency; 51.11 (3) mental illness and developmental disability; 51.12 (4) mental illness and traumatic brain injury; and 51.13 (5) serious emotional disturbance and developmental 51.14 disability. 51.15 The plans must address the coordination and integration of 51.16 programs and funding sources and include recommendations for 51.17 modifying state grants and provider reimbursement rates based on 51.18 complexity of condition and the level of care needed by an 51.19 individual or group of individuals. The commissioner shall 51.20 present the plans and any statutory changes needed to implement 51.21 the plans to the legislature by February 1, 2002.