SF 1161

as introduced - 88th Legislature (2013 - 2014) Posted on 03/15/2013 09:12am

A bill for an act
relating to human services; modifying chemical and mental health provisions;
modifying provisions related to funding mental health services; providing for coverage of family psychoeducation services and clinical care consultations in the medical assistance program; amending Minnesota Statutes 2012, sections 245.4682, subdivision 2; 246.18,
subdivision 8, by adding a subdivision; 256B.0625, by adding subdivisions;
256B.761.

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

Section 1.

Minnesota Statutes 2012, section 245.4682, subdivision 2, is amended to read:

Subd. 2.

General provisions.

(a) In the design and implementation of reforms to
the mental health system, the commissioner shall:

(1) consult with consumers, families, counties, tribes, advocates, providers, and
other stakeholders;

(2) bring to the legislature, and the State Advisory Council on Mental Health, by
January 15, 2008, recommendations for legislation to update the role of counties and to
clarify the case management roles, functions, and decision-making authority of health
plans and counties, and to clarify county retention of the responsibility for the delivery of
social services as required under subdivision 3, paragraph (a);

(3) withhold implementation of any recommended changes in case management
roles, functions, and decision-making authority until after the release of the report due
January 15, 2008;

(4) ensure continuity of care for persons affected by these reforms including
ensuring client choice of provider by requiring broad provider networks and developing
mechanisms to facilitate a smooth transition of service responsibilities;

(5) provide accountability for the efficient and effective use of public and private
resources in achieving positive outcomes for consumers;

(6) ensure client access to applicable protections and appeals; and

(7) make budget transfers necessary to implement the reallocation of services and
client responsibilities between counties and health care programs that do not increase the
state and county costs and efficiently allocate state funds.

(b) When making transfers under paragraph (a) necessary to implement movement
of responsibility for clients and services between counties and health care programs,
the commissioner, in consultation with counties, shall ensure that any transfer of state
grants to health care programs, including the value of case management transfer grants
under section 256B.0625, subdivision 20, does not exceed the value of the services being
transferred for the latest 12-month period for which data is available. The commissioner
may make quarterly adjustments based on the availability of additional data during the
first four quarters after the transfers first occur. If case management transfer grants under
section 256B.0625, subdivision 20, are repealed and the value, based on the last year prior
to repeal, exceeds the value of the services being transferred, the difference becomes an
ongoing part of each county's adult deleted text begin and children's deleted text end mental health grants under sections
245.4661 deleted text begin , 245.4889, deleted text end and 256E.12.

(c) This appropriation is not authorized to be expended after December 31, 2010,
unless approved by the legislature.

Sec. 2.

Minnesota Statutes 2012, section 246.18, subdivision 8, is amended to read:

Subd. 8.

State-operated services account.

new text begin (a) new text end The state-operated services account is
established in the special revenue fund. Revenue generated by new state-operated services
listed under this section established after July 1, 2010, that are not enterprise activities must
be deposited into the state-operated services account, unless otherwise specified in law:

(1) intensive residential treatment services;

(2) foster care services; and

(3) psychiatric extensive recovery treatment services.

new text begin (b) Funds deposited in the state-operated services account are available to the
commissioner of human services for the purposes of:
new text end

new text begin (1) providing services needed to transition individuals from institutional settings
within state-operated services to the community when those services have no other
adequate funding source; and
new text end

new text begin (2) grants to providers participating in mental health specialty treatment services
under section 245.4661.
new text end

Sec. 3.

Minnesota Statutes 2012, section 246.18, is amended by adding a subdivision
to read:

new text begin Subd. 9. new text end

new text begin Transfers. new text end

new text begin The commissioner may transfer state mental health grant funds
to the account in subdivision 8 for noncovered allowable costs of a provider certified and
licensed under section 256B.0622, and operating under section 246.014.
new text end

Sec. 4.

Minnesota Statutes 2012, section 256B.0625, is amended by adding a
subdivision to read:

new text begin Subd. 61. new text end

new text begin Family psychoeducation services. new text end

new text begin Effective July 1, 2013, or upon
federal approval, whichever is later, medical assistance covers family psychoeducation
services provided to a child up to age 21 with a diagnosed mental health condition when
identified in the child's individual treatment plan and provided by a licensed mental health
professional, as defined in Minnesota Rules, part 9505.0371, subpart 5, item A, or a
clinical trainee, as defined in Minnesota Rules, part 9505.0371, subpart 5, item C, who
has determined it medically necessary to involve family members in the child's care. For
the purposes of this subdivision, "family psychoeducation services" means information
or demonstration provided to an individual or family as part of an individual, family,
multifamily group, or peer group session to explain, educate, and support the child and
family in understanding a child's symptoms of mental illness, the impact on the child's
development, and needed components of treatment and skill development so that the
individual, family, or group can help the child to prevent relapse, prevent the acquisition
of comorbid disorders, and to achieve optimal mental health and long-term resilience.
new text end

Sec. 5.

Minnesota Statutes 2012, section 256B.0625, is amended by adding a
subdivision to read:

new text begin Subd. 62. new text end

new text begin Mental health clinical care consultation. new text end

new text begin Effective July 1, 2013, or upon
federal approval, whichever is later, medical assistance covers clinical care consultation
for a person up to age 21 who is diagnosed with a complex mental health condition or a
mental health condition that co-occurs with other complex and chronic conditions, when
described in the person's individual treatment plan and provided by a licensed mental
health professional, as defined in Minnesota Rules, part 9505.0371, subpart 5, item A. For
the purposes of this subdivision, "clinical care consultation" means communication from a
treating mental health professional to other providers not under the clinical supervision of
the treating mental health professional who are working with the same client to inform,
inquire, and instruct regarding the client's symptoms; strategies for effective engagement,
care, and intervention needs; and treatment expectations across service settings; and to
direct and coordinate clinical service components provided to the client and family.
new text end

Sec. 6.

Minnesota Statutes 2012, section 256B.761, is amended to read:

256B.761 REIMBURSEMENT FOR MENTAL HEALTH SERVICES.

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

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

(c) The commissioner shall establish three levels of payment for mental health
diagnostic assessment, based on three levels of complexity. The aggregate payment under
the tiered rates must not exceed the projected aggregate payments for mental health
diagnostic assessment under the previous single rate. The new rate structure is effective
January 1, 2011, or upon federal approval, whichever is later.

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