SF 1864

1st Engrossment - 88th Legislature (2013 - 2014) Posted on 03/27/2014 08:34am

A bill for an act
relating to human services; modifying mental health crisis intervention and
stabilization services; amending Minnesota Statutes 2012, sections 253B.066,
subdivision 1; 256B.0615, subdivision 3; 256B.0624, subdivisions 2, 5, 6, 10.

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

Section 1.

Minnesota Statutes 2012, section 253B.066, subdivision 1, is amended to
read:

Subdivision 1.

Treatment alternatives.

If the court orders early intervention
under section 253B.065, subdivision 5, the court may include in its order a variety of
treatment alternatives including, but not limited to, day treatment, medication compliance
monitoring, new text begin assertive community treatment, crisis assessment and stabilization, partial
hospitalization, new text end and short-term hospitalization not to exceed 21 days.

If the court orders short-term hospitalization and the proposed patient will not go
voluntarily, the court may direct a health officer, peace officer, or other person to take the
person into custody and transport the person to the hospital.

Sec. 2.

Minnesota Statutes 2012, section 256B.0615, subdivision 3, is amended to read:

Subd. 3.

Eligibility.

Peer support services may be made available to consumers of
(1) deleted text begin the deleted text end intensive rehabilitative mental health services under section 256B.0622; (2) adult
rehabilitative mental health services under section 256B.0623; and (3) crisis stabilization
new text begin and mental health mobile crisis intervention new text end services under section 256B.0624.

Sec. 3.

Minnesota Statutes 2012, section 256B.0624, subdivision 2, is amended to read:

Subd. 2.

Definitions.

For purposes of this section, the following terms have the
meanings given them.

(a) "Mental health crisis" is an adult behavioral, emotional, or psychiatric situation
which, but for the provision of crisis response services, would likely result in significantly
reduced levels of functioning in primary activities of daily living, or in an emergency
situation, or in the placement of the recipient in a more restrictive setting, including, but
not limited to, inpatient hospitalization.

(b) "Mental health emergency" is an adult behavioral, emotional, or psychiatric
situation which causes an immediate need for mental health services and is consistent
with section 62Q.55.

A mental health crisis or emergency is determined for medical assistance service
reimbursement by a physician, a mental health professional, or crisis mental health
practitioner with input from the recipient whenever possible.

(c) "Mental health crisis assessment" means an immediate face-to-face assessment
by a physician, a mental health professional, or mental health practitioner under the
clinical supervision of a mental health professional, following a screening that suggests
that the adult may be experiencing a mental health crisis or mental health emergency
situation. new text begin It includes, when feasible, assessing whether the person might be willing to
voluntarily accept treatment, determining whether the person has an advance directive,
and obtaining information and history from involved family members or caretakers.
new text end

(d) "Mental health mobile crisis intervention services" means face-to-face,
short-term intensive mental health services initiated during a mental health crisis or mental
health emergency to help the recipient cope with immediate stressors, identify and utilize
available resources and strengths, new text begin engage in voluntary treatment, new text end and begin to return to the
recipient's baseline level of functioning.

(1) This service is provided on site by a mobile crisis intervention team outside of
an inpatient hospital setting. Mental health mobile crisis intervention services must be
available 24 hours a day, seven days a week.

(2) The initial screening must consider other available services to determine which
service intervention would best address the recipient's needs and circumstances.

(3) The mobile crisis intervention team must be available to meet promptly
face-to-face with a person in mental health crisis or emergency in a community setting or
hospital emergency room.

(4) The intervention must consist of a mental health crisis assessment and a crisis
treatment plan.

new text begin (5) The team must be available to individuals who are experiencing a co-occurring
substance use disorder, who do not need the level of care provided in a detoxification
facility.
new text end

deleted text begin (5) deleted text end new text begin (6) new text end The treatment plan must include recommendations for any needed crisis
stabilization services for the recipient new text begin , including engagement in treatment planning and
family psychoeducation new text end .

(e) "Mental health crisis stabilization services" means individualized mental
health services provided to a recipient following crisis intervention services which are
designed to restore the recipient to the recipient's prior functional level. Mental health
crisis stabilization services may be provided in the recipient's home, the home of a family
member or friend of the recipient, another community setting, or a short-term supervised,
licensed residential program. Mental health crisis stabilization does not include partial
hospitalization or day treatment. new text begin Mental health crisis stabilization services includes
family psychoeducation.
new text end

Sec. 4.

Minnesota Statutes 2012, section 256B.0624, subdivision 5, is amended to read:

Subd. 5.

Mobile crisis intervention staff qualifications.

For provision of adult
mental health mobile crisis intervention services, a mobile crisis intervention team is
comprised of at least two mental health professionals as defined in section 245.462,
subdivision 18, clauses (1) to (6), or a combination of at least one mental health
professional and one mental health practitioner as defined in section 245.462, subdivision
17, with the required mental health crisis training and under the clinical supervision of
a mental health professional on the team. The team must have at least two people with
at least one member providing on-site crisis intervention services when needed. Team
members must be experienced in mental health assessment, crisis intervention techniques,
new text begin treatment engagement strategies, working with families, new text end and clinical decision-making
under emergency conditions and have knowledge of local services and resources.
The team must recommend and coordinate the team's services with appropriate local
resources such as the county social services agency, mental health services, and local
law enforcement when necessary.

Sec. 5.

Minnesota Statutes 2012, section 256B.0624, subdivision 6, is amended to read:

Subd. 6.

Crisis assessment and mobile intervention treatment planning.

(a)
Prior to initiating mobile crisis intervention services, a screening of the potential crisis
situation must be conducted. The screening may use the resources of crisis assistance
and emergency services as defined in sections 245.462, subdivision 6, and 245.469,
subdivisions 1 and 2. The screening must gather information, determine whether a crisis
situation exists, identify parties involved, and determine an appropriate response.

(b) If a crisis exists, a crisis assessment must be completed. A crisis assessment
evaluates any immediate needs for which emergency services are needed and, as time
permits, the recipient's current life situation, sources of stress, mental health problems
and symptoms, strengths, cultural considerations, support network, vulnerabilities, current
functioning, and the recipient's preferences as communicated directly by the recipient,
or as communicated in a health care directive as described in chapters 145C and 253B,
the treatment plan described under paragraph (d), a crisis prevention plan, or a wellness
recovery action plan.

(c) If the crisis assessment determines mobile crisis intervention services are needed,
the intervention services must be provided promptly. As opportunity presents during the
intervention, at least two members of the mobile crisis intervention team must confer
directly or by telephone about the assessment, treatment plan, and actions taken and
needed. At least one of the team members must be on site providing crisis intervention
services. If providing on-site crisis intervention services, a mental health practitioner must
seek clinical supervision as required in subdivision 9.

(d) The mobile crisis intervention team must develop an initial, brief crisis treatment
plan as soon as appropriate but no later than 24 hours after the initial face-to-face
intervention. The plan must address the needs and problems noted in the crisis assessment
and include measurable short-term goals, cultural considerations, and frequency and type
of services to be provided to achieve the goals and reduce or eliminate the crisis. The
treatment plan must be updated as needed to reflect current goals and services.

(e) The team must document which short-term goals have been met and when no
further crisis intervention services are required.

(f) If the recipient's crisis is stabilized, but the recipient needs a referral to other
services, the team must provide referrals to these services. If the recipient has a case
manager, planning for other services must be coordinated with the case manager. new text begin If the
recipient is unable to follow up on the referral, the team must link the recipient to the
service and follow up to ensure the recipient is receiving the service.
new text end

new text begin (g) If the recipient's crisis is stabilized and the recipient does not have an advance
directive, the case manager or crisis team shall offer to work with the recipient to develop
one.
new text end

Sec. 6.

Minnesota Statutes 2012, section 256B.0624, subdivision 10, is amended to read:

Subd. 10.

Recipient file.

Providers of mobile crisis intervention or crisis stabilization
services must maintain a file for each recipient containing the following information:

(1) individual crisis treatment plans signed by the recipient, mental health
professional, and mental health practitioner who developed the crisis treatment plan, or
if the recipient refused to sign the plan, the date and reason stated by the recipient as to
why the recipient would not sign the plan;

(2) signed release forms;

(3) recipient health information and current medications;

(4) emergency contacts for the recipient;

(5) case records which document the date of service, place of service delivery,
signature of the person providing the service, and the nature, extent, and units of service.
Direct or telephone contact with the recipient's family or others should be documented;

(6) required clinical supervision by mental health professionals;

(7) summary of the recipient's case reviews by staff; deleted text begin and
deleted text end

(8) any written information by the recipient that the recipient wants in the file new text begin ; and
new text end

new text begin (9) an advance directive, if there is one available new text end .

Documentation in the file must comply with all requirements of the commissioner.