Minnesota Legislature
SF 2549
1st Engrossment - 89th Legislature (2015 - 2016) Posted on 03/18/2016 09:14am
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A bill for an act
relating to human services; modifying certain certified community behavioral
health clinic requirements; amending Minnesota Statutes 2015 Supplement,
section 245.735, subdivisions 3, 4.
BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF MINNESOTA:
Section 1.
Minnesota Statutes 2015 Supplement, section 245.735, subdivision 3,
is amended to read:
Subd. 3.
deleted text begin Reform projectsdeleted text end new text begin Certified community behavioral health clinicsnew text end .
(a) The
commissioner shall establish deleted text begin standards fordeleted text end new text begin anew text end state certification deleted text begin of clinics asdeleted text end new text begin process for
new text end certified community behavioral health clinicsdeleted text begin , in accordancedeleted text end new text begin (CCBHCs) to be eligible for
the prospective payment system in paragraph (f). Entities that choose to be CCBHCs must:
new text end
new text begin (1) complynew text end with the new text begin CCBHC new text end criteria published deleted text begin on or before September 1, 2015,deleted text end by
the United States Department of Health and Human Servicesdeleted text begin . Certification standards
established by the commissioner shall require that:deleted text end new text begin ;
new text end
deleted text begin (1)deleted text end new text begin (2) employ or contract fornew text end clinic staff new text begin who new text end have backgrounds in diverse
disciplines, deleted text begin includedeleted text end new text begin includingnew text end licensed mental health professionals, and new text begin staff who new text end are
culturally and linguistically trained to serve the needs of the clinic's patient population;
deleted text begin (2)deleted text end new text begin (3) ensure thatnew text end clinic services are available and accessible new text begin to patients of all ages
and genders new text end and that crisis management services are available 24 hours per day;
deleted text begin (3)deleted text end new text begin (4) establishnew text end fees for clinic services deleted text begin are establisheddeleted text end new text begin for non-medical assistance
patientsnew text end using a sliding fee scale deleted text begin anddeleted text end new text begin that ensures thatnew text end services to patients are not denied
or limited due to a patient's inability to pay for services;
deleted text begin
(4) clinics provide coordination of care across settings and providers to ensure
seamless transitions for patients across the full spectrum of health services, including
acute, chronic, and behavioral needs. Care coordination may be accomplished through
partnerships or formal contracts with federally qualified health centers, inpatient
psychiatric facilities, substance use and detoxification facilities, community-based mental
health providers, and other community services, supports, and providers including
schools, child welfare agencies, juvenile and criminal justice agencies, Indian Health
Services clinics, tribally licensed health care and mental health facilities, urban Indian
health clinics, Department of Veterans Affairs medical centers, outpatient clinics, drop-in
centers, acute care hospitals, and hospital outpatient clinics;
deleted text end
new text begin
(5) comply with quality
assurance reporting requirements and other reporting requirements, including any required
reporting of encounter data, clinical outcomes data, and quality data;
new text end
deleted text begin (5) services provided by clinics includedeleted text end new text begin (6) providenew text end crisis mental health services,
new text begin withdrawal management services, new text end emergency crisis intervention services, and stabilization
services; screening, assessment, and diagnosis services, including risk assessments and
level of care determinations; patient-centered treatment planning; outpatient mental
health and substance use services; targeted case management; psychiatric rehabilitation
services; peer support and counselor services and family support services; and intensive
community-based mental health services, including mental health services for members of
the armed forces and veterans; deleted text begin and
deleted text end
deleted text begin
(6) clinics comply with quality assurance reporting requirements and other reporting
requirements, including any required reporting of encounter data, clinical outcomes data,
and quality data.
deleted text end
new text begin
(7) provide coordination of care across settings and providers to ensure
seamless transitions for patients across the full spectrum of health services, including
acute, chronic, and behavioral needs. Care coordination may be accomplished through
partnerships or formal contracts with:
new text end
new text begin
(i) counties, health plans, pharmacists, pharmacies, rural health clinics, federally
qualified health centers, inpatient psychiatric facilities, substance use and detoxification
facilities, community-based mental health providers; and
new text end
new text begin
(ii) other community services, supports, and providers, including schools, child
welfare agencies, juvenile and criminal justice agencies, Indian health services clinics,
tribally licensed health care and mental health facilities, urban Indian health clinics,
Department of Veterans Affairs medical centers, outpatient clinics, drop-in centers, acute
care hospitals, and hospital outpatient clinics;
new text end
new text begin
(8) be certified as mental health clinics under section 245.69, subdivision 2;
new text end
new text begin
(9) comply with standards relating to integrated treatment for co-occurring mental
illness and substance use disorders in adults or children under Minnesota Rules, chapter
9533;
new text end
new text begin
(10) comply with standards relating to mental health services in Minnesota Rules,
parts 9505.0370 to 9505.0372;
new text end
new text begin
(11) be licensed to provide chemical dependency treatment under Minnesota Rules,
parts 9530.6405 to 9530.6505;
new text end
new text begin
(12) be certified to provide children's therapeutic services and supports under
section 256B.0943;
new text end
new text begin
(13) be certified to provide adult rehabilitative mental health services under section
256B.0623;
new text end
new text begin
(14) be enrolled to provide mental health crisis response services under section
256B.0624;
new text end
new text begin
(15) be enrolled to provide mental health targeted case management under section
256B.0625, subdivision 20;
new text end
new text begin
(16) comply with standards relating to mental health case management in Minnesota
Rules, parts 9520.0900 to 9520.0926; and
new text end
new text begin
(17) provide services that comply with the evidence-based practices described in
paragraph (e).
new text end
new text begin
(b) If an entity is unable to provide one or more of the services listed in paragraph
(a), clauses (6) to (17), the commissioner may certify the entity as a CCBHC if it has a
current contract with another entity that has the required authority to provide that service
and that meets federal CCBHC criteria as a designated collaborating organization; or, to
the extent allowed by the federal CCBHC criteria, the commissioner may approve a
referral arrangement. The CCBHC must meet federal requirements regarding the type and
scope of services to be provided directly by the CCBHC.
new text end
new text begin
(c) Notwithstanding other law that requires a county contract or other form of county
approval for certain services listed in paragraph (a), clause (6), a clinic that otherwise
meets CCBHC requirements may receive the prospective payment under paragraph (f)
for those services without a county contract or county approval. There is no county
share when medical assistance pays the CCBHC prospective payment. As part of the
certification process in paragraph (a), the commissioner shall require a letter of support
from the CCBHC's host county confirming that the CCBHC and the county or counties it
serves have an ongoing relationship to facilitate access and continuity of care, especially
for individuals who are uninsured or who may go on and off medical assistance.
new text end
new text begin
(d) When the standards listed in paragraph (a) or other applicable standards
conflict or address similar issues in duplicative or incompatible ways, the commissioner
may grant variances to state requirements if the variances do not conflict with federal
requirements. If standards overlap, the commissioner may substitute all or a part of a
licensure or certification that is substantially the same as another licensure or certification.
The commissioner shall consult with stakeholders, as described in subdivision 4, before
granting variances under this provision.
new text end
new text begin
(e) The commissioner shall issue a list of required evidence-based practices to be
delivered by certified community behavioral health clinics, and may also provide a list
of recommended evidence-based practices. The commissioner may update the list to
reflect advances in outcomes research and medical services for persons living with mental
illnesses or substance use disorders. The commissioner shall take into consideration the
adequacy of evidence to support the efficacy of the practice, the quality of workforce
available, and the current availability of the practice in the state. At least 30 days before
issuing the initial list and any revisions, the commissioner shall provide stakeholders
with an opportunity to comment.
new text end
deleted text begin (b)deleted text end new text begin (f)new text end The commissioner shall establish standards and methodologies for a
prospective payment system for medical assistance payments for mental health services
delivered by certified community behavioral health clinics, in accordance with guidance
issued deleted text begin on or before September 1, 2015,deleted text end by the Centers for Medicare and Medicaid
Services. During the operation of the demonstration project, payments shall comply with
federal requirements for deleted text begin a 90 percentdeleted text end new text begin annew text end enhanced federal medical assistance percentage.
new text begin The commissioner may include quality bonus payments in the prospective payment
system based on federal criteria and on a clinic's provision of the evidence-based practices
in paragraph (e). The prospective payments system does not apply to MinnesotaCare.
Implementation of the prospective payment system is effective July 1, 2017, or upon
federal approval, whichever is later.
new text end
new text begin
(g) The commissioner shall seek federal approval to continue federal financial
participation in payment for CCBHC services after the federal demonstration period
ends for clinics that were certified as CCBHCs during the demonstration period and
that continue to meet the CCBHC certification standards in paragraph (a). Payment
for CCBHC services shall cease effective July 1, 2019, if continued federal financial
participation for the payment of CCBHC services cannot be obtained.
new text end
new text begin
(h) To the extent allowed by federal law, the commissioner may limit the number of
certified clinics so that the projected claims for certified clinics will not exceed the funds
budgeted for this purpose. The commissioner shall give preference to clinics that:
new text end
new text begin
(1) are located in both rural and urban areas, with at least one in each, as defined
by federal criteria;
new text end
new text begin
(2) provide a comprehensive range of services and evidence-based practices for all
age groups, with services being fully coordinated and integrated; and
new text end
new text begin
(3) enhance the state's ability to meet the federal priorities to be selected as a
CCBHC demonstration state.
new text end
new text begin
(i) The commissioner shall recertify CCBHCs at least every three years. The
commissioner shall establish a process for decertification and shall require corrective
action, medical assistance repayment, or decertification of a CCBHC that no longer
meets the requirements in this section or that fails to meet the standards provided by the
commissioner in the application and certification process.
new text end
new text begin EFFECTIVE DATE. new text end
new text begin
This section is effective the day following final enactment.
new text end
Sec. 2.
Minnesota Statutes 2015 Supplement, section 245.735, subdivision 4, is
amended to read:
Subd. 4.
Public participation.
In developing deleted text begin the projectsdeleted text end new text begin and implementing
certified community behavioral health clinicsnew text end under subdivision 3, the commissioner shall
consultnew text begin , collaborate, and partnernew text end with new text begin stakeholders, including but not limited to new text end mental
health providers, new text begin substance use disorder treatment providers, new text end advocacy organizations,
licensed mental health professionals, new text begin counties, tribes, hospitals, other health care
providers, new text end and Minnesota public health care program enrollees who receive mental health
services and their families.
new text begin EFFECTIVE DATE. new text end
new text begin
This section is effective the day following final enactment.
new text end