SF 3249

1st Engrossment - 92nd Legislature (2021 - 2022) Posted on 04/06/2022 02:46pm

A bill for an act
relating to mental health; creating a mental health provider supervision grant
program; modifying adult mental health initiatives; modifying intensive residential
treatment services; modifying mental health fee-for-service payment rate; removing
county share; creating mental health urgency room grant program; directing the
commissioner to develop medical assistance mental health benefit for children;
establishing forensic navigator services; appropriating money; amending Minnesota
Statutes 2020, sections 245.4661, as amended; 256B.0622, subdivision 5a;
Minnesota Statutes 2021 Supplement, sections 245I.23, subdivision 19; 256B.0625,
subdivisions 5, 56a; proposing coding for new law in Minnesota Statutes, chapters
144; 245; 611; repealing Minnesota Statutes 2020, section 245.4661, subdivision
8.

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

Section 1.

new text begin [144.1508] MENTAL HEALTH PROVIDER SUPERVISION GRANT
PROGRAM.
new text end

new text begin Subdivision 1. new text end

new text begin Definitions. new text end

new text begin (a) For purposes of this section, the following terms have
the meanings given.
new text end

new text begin (b) "Mental health professional" means an individual who meets one of the qualifications
specified in section 245I.04, subdivision 2.
new text end

new text begin (c) "Underrepresented community" has the meaning given in section 148E.010,
subdivision 20.
new text end

new text begin Subd. 2. new text end

new text begin Grant program established. new text end

new text begin The commissioner of health shall award grants
to licensed or certified mental health providers who meet the criteria in subdivision 3 to
fund supervision of interns and clinical trainees who are working toward becoming a mental
health professional and to subsidize the costs of licensing applications and examination fees
for clinical trainees.
new text end

new text begin Subd. 3. new text end

new text begin Eligible providers. new text end

new text begin In order to be eligible for a grant under this section, a mental
health provider must:
new text end

new text begin (1) provide at least 25 percent of the provider's yearly patient encounters to state public
program enrollees or patients receiving sliding fee schedule discounts through a formal
sliding fee schedule meeting the standards established by the United States Department of
Health and Human Services under Code of Federal Regulations, title 42, section 51c.303;
or
new text end

new text begin (2) primarily serve underrepresented communities.
new text end

new text begin Subd. 4. new text end

new text begin Application; grant award. new text end

new text begin A mental health provider seeking a grant under
this section must apply to the commissioner at a time and in a manner specified by the
commissioner. The commissioner shall review each application to determine if the application
is complete, the mental health provider is eligible for a grant, and the proposed project is
an allowable use of grant funds. The commissioner must determine the grant amount awarded
to applicants that the commissioner determines will receive a grant.
new text end

new text begin Subd. 5. new text end

new text begin Allowable uses of grant funds. new text end

new text begin A mental health provider must use grant funds
received under this section for one or more of the following:
new text end

new text begin (1) to pay for direct supervision hours for interns and clinical trainees, in an amount up
to $7,500 per intern or clinical trainee;
new text end

new text begin (2) to establish a program to provide supervision to multiple interns or clinical trainees;
or
new text end

new text begin (3) to pay licensing application and examination fees for clinical trainees.
new text end

new text begin Subd. 6. new text end

new text begin Program oversight. new text end

new text begin During the grant period, the commissioner may require
grant recipients to provide the commissioner with information necessary to evaluate the
program.
new text end

Sec. 2.

new text begin [245.096] CHANGES TO GRANT PROGRAMS.
new text end

new text begin Prior to making any changes to a grant program administered by the Department of
Human Services, the commissioner of human services must provide a report on the nature
of the changes, the effect the changes will have, whether any funding will change, and other
relevant information, to the chairs and ranking minority members of the legislative
committees with jurisdiction over human services. The report must be provided prior to the
start of a regular session and the proposed changes cannot be implemented until after the
adjournment of that regular session.
new text end

Sec. 3.

Minnesota Statutes 2020, section 245.4661, as amended by Laws 2021, chapter
30, article 17, section 21, is amended to read:

245.4661 deleted text begin PILOT PROJECTS; deleted text end ADULT MENTAL HEALTH new text begin INITIATIVE new text end
SERVICES.

Subdivision 1.

deleted text begin Authorization for pilot projects deleted text end new text begin Adult mental health initiative
services new text end .

deleted text begin The commissioner of human services may approve pilot projects to provide
alternatives to or enhance coordination of deleted text end new text begin Each county board must provide or contract for
sufficient infrastructure for new text end the delivery of mental health services deleted text begin required under the
Minnesota Comprehensive Adult Mental Health Act, sections 245.461 to 245.486 deleted text end new text begin for adults
in the county with serious and persistent mental illness through adult mental health initiatives new text end . new text begin
A client may be required to pay a fee for services pursuant to section 245.481. Adult mental
health initiatives must be designed to improve the ability of adults with serious and persistent
mental illness to receive services.
new text end

Subd. 2.

Program design and implementation.

deleted text begin The pilot projects deleted text end new text begin Adult mental health
initiatives new text end shall be deleted text begin established to design, plan, and improve the deleted text end new text begin responsible for designing,
planning, improving, and maintaining a new text end mental health service delivery system for adults
with serious and persistent mental illness that would:

(1) provide an expanded array of services from which clients can choose services
appropriate to their needs;

(2) be based on purchasing strategies that improve access and coordinate services without
cost shifting;

(3) incorporate existing state facilities and resources into the community mental health
infrastructure through creative partnerships with local vendors; and

(4) utilize existing categorical funding streams and reimbursement sources in combined
and creative ways, except appropriations to regional treatment centers and all funds that are
attributable to the operation of state-operated services are excluded unless appropriated
specifically by the legislature for a purpose consistent with this section or section 246.0136,
subdivision 1.

Subd. 3.

deleted text begin Program deleted text end new text begin Adult mental health initiative new text end evaluation.

Evaluation of each deleted text begin project deleted text end new text begin
adult mental health initiative new text end will be based on outcome evaluation criteria negotiated with
each deleted text begin project deleted text end new text begin county or region new text end prior to implementation.

Subd. 4.

Notice of deleted text begin project deleted text end new text begin adult mental health initiative new text end discontinuation.

Each deleted text begin project deleted text end new text begin
adult mental health initiative new text end may be discontinued for any reason by the deleted text begin project's deleted text end managing
entity or the commissioner of human services, after 90 days' written notice to the other
party.

Subd. 5.

Planning for deleted text begin pilot projects deleted text end new text begin adult mental health initiatives new text end .

(a) Each local
plan for deleted text begin a pilot project deleted text end new text begin adult mental health initiative services new text end , with the exception of the
placement deleted text begin of a Minnesota specialty treatment facility as defined in paragraph (c) deleted text end new text begin of intensive
residential treatment services facilities licensed under chapter 245I new text end , must be developed
under the direction of the county board, or multiple county boards acting jointly, as the local
mental health authority. The planning process for each deleted text begin pilot deleted text end new text begin adult mental health initiative new text end
shall include, but not be limited to, mental health consumers, families, advocates, local
mental health advisory councils, local and state providers, representatives of state and local
public employee bargaining units, and the department of human services. As part of the
planning process, the county board or boards shall designate a managing entity responsible
for receipt of funds and management of deleted text begin the pilot project deleted text end new text begin adult mental health initiatives new text end .

(b) For deleted text begin Minnesota specialty deleted text end new text begin intensive residential new text end treatment new text begin services new text end facilities, the
commissioner shall issue a request for proposal for regions in which a need has been
identified for services.

deleted text begin (c) For purposes of this section, "Minnesota specialty treatment facility" is defined as
an intensive residential treatment service licensed under chapter 245I.
deleted text end

Subd. 6.

Duties of commissioner.

(a) For purposes of deleted text begin the pilot projects deleted text end new text begin adult mental
health initiatives new text end , the commissioner shall facilitate integration of funds or other resources
as needed and requested by each deleted text begin project deleted text end new text begin adult mental health initiative new text end . These resources may
include:

(1) community support services funds administered under Minnesota Rules, parts
9535.1700 to 9535.1760;

(2) other mental health special project funds;

(3) medical assistance, MinnesotaCare, and housing support under chapter 256I if
requested by the deleted text begin project's deleted text end new text begin adult mental health initiative's new text end managing entity, and if the
commissioner determines this would be consistent with the state's overall health care reform
efforts; and

(4) regional treatment center resources consistent with section 246.0136, subdivision 1.

(b) The commissioner shall consider the following criteria in awarding deleted text begin start-up and
implementation deleted text end grants for deleted text begin the pilot projects deleted text end new text begin adult mental health initiatives new text end :

(1) the ability of the deleted text begin proposed projects deleted text end new text begin initiatives new text end to accomplish the objectives described
in subdivision 2;

(2) the size of the target population to be served; and

(3) geographical distribution.

(c) The commissioner shall review overall status of the deleted text begin projects deleted text end initiatives at least every
two years and recommend any legislative changes needed by January 15 of each
odd-numbered year.

(d) The commissioner may waive administrative rule requirements deleted text begin which deleted text end new text begin that new text end are
incompatible with the implementation of the deleted text begin pilot project deleted text end new text begin adult mental health initiative new text end .

(e) The commissioner may exempt the participating counties from fiscal sanctions for
noncompliance with requirements in laws and rules deleted text begin which deleted text end new text begin that new text end are incompatible with the
implementation of the deleted text begin pilot project deleted text end new text begin adult mental health initiative new text end .

(f) The commissioner may award grants to an entity designated by a county board or
group of county boards to pay for start-up and implementation costs of the deleted text begin pilot project deleted text end new text begin
adult mental health initiative new text end .

Subd. 7.

Duties of county board.

The county board, or other entity which is approved
to administer deleted text begin a pilot project deleted text end new text begin an adult mental health initiative new text end , shall:

(1) administer the deleted text begin project deleted text end new text begin initiative new text end in a manner deleted text begin which deleted text end new text begin that new text end is consistent with the objectives
described in subdivision 2 and the planning process described in subdivision 5;

(2) assure that no one is denied services for deleted text begin which deleted text end new text begin that new text end they would otherwise be eligible;
and

(3) provide the commissioner of human services with timely and pertinent information
through the following methods:

(i) submission of mental health plans and plan amendments which are based on a format
and timetable determined by the commissioner;

(ii) submission of social services expenditure and grant reconciliation reports, based on
a coding format to be determined by mutual agreement between the deleted text begin project's deleted text end new text begin initiative's new text end
managing entity and the commissioner; and

(iii) submission of data and participation in an evaluation of the deleted text begin pilot projects deleted text end new text begin adult
mental health initiatives new text end , to be designed cooperatively by the commissioner and the deleted text begin projects deleted text end new text begin
initiatives new text end .

Subd. 8.

Budget flexibility.

The commissioner may make budget transfers that do not
increase the state share of costs to effectively implement the restructuring of adult mental
health services.

Subd. 9.

Services and programs.

(a) The following three distinct grant programs are
funded under this section:

(1) mental health crisis services;

(2) housing with supports for adults with serious mental illness; and

(3) projects for assistance in transitioning from homelessness (PATH program).

(b) In addition, the following are eligible for grant funds:

(1) community education and prevention;

(2) client outreach;

(3) early identification and intervention;

(4) adult outpatient diagnostic assessment and psychological testing;

(5) peer support services;

(6) community support program services (CSP);

(7) adult residential crisis stabilization;

(8) supported employment;

(9) assertive community treatment (ACT);

(10) housing subsidies;

(11) basic living, social skills, and community intervention;

(12) emergency response services;

(13) adult outpatient psychotherapy;

(14) adult outpatient medication management;

(15) adult mobile crisis services;

(16) adult day treatment;

(17) partial hospitalization;

(18) adult residential treatment;

(19) adult mental health targeted case management;

(20) intensive community rehabilitative services (ICRS); and

(21) transportation.

Subd. 10.

Commissioner duty to report on use of grant funds biennially.

By November
1, 2016, and biennially thereafter, the commissioner of human services shall provide
sufficient information to the members of the legislative committees having jurisdiction over
mental health funding and policy issues to evaluate the use of funds appropriated under this
section deleted text begin of law deleted text end . The commissioner shall provide, at a minimum, the following information:

(1) the amount of funding to new text begin adult new text end mental health initiatives, what programs and services
were funded in the previous two years, gaps in services that each initiative brought to the
attention of the commissioner, and outcome data for the programs and services that were
funded; and

(2) the amount of funding for other targeted services and the location of services.

new text begin Subd. 11. new text end

new text begin Adult mental health initiative funding. new text end

new text begin When implementing the reformed
funding formula to distribute adult mental health initiative funds, the commissioner shall
ensure that no adult mental health initiative region receives less than the amount the region
received in fiscal year 2022 in combined adult mental health initiative funding and Moose
Lake Alternative funding.
new text end

Sec. 4.

Minnesota Statutes 2021 Supplement, section 245I.23, subdivision 19, is amended
to read:

Subd. 19.

Program facility.

(a) The license holder must be licensed or certified as a
board and lodging facility, supervised living facility, or a boarding care home by the
Department of Health.

(b) The license holder must have a capacity of five to 16 beds and the program must not
be declared as an institution for mental disease.

(c) The license holder must furnish each program location to meet the psychological,
emotional, and developmental needs of clients.

(d) The license holder must provide one living room or lounge area per program location.
There must be space available to provide services according to each client's treatment plan,
such as an area for learning recreation time skills and areas for learning independent living
skills, such as laundering clothes and preparing meals.

(e) The license holder must ensure that each program location allows each client to have
privacy. Each client must have privacy during assessment interviews and counseling sessions.
Each client must have a space designated for the client to see outside visitors at the program
facility.

new text begin (f) Notwithstanding any other provision of law, the license holder may operate a locked
facility to provide treatment for patients who have been transferred from a jail or have been
deemed incompetent to stand trial and a judge determines that the patient needs to be in a
secure facility. The locked facility must meet building and fire code requirements. The
commissioner may, within available appropriations, disburse grant funding to counties,
Tribes, or mental health service providers to establish new locked facilities.
new text end

new text begin EFFECTIVE DATE. new text end

new text begin This section is effective July 1, 2022, or upon federal approval,
whichever is later. The commissioner of human services shall notify the revisor of statutes
when federal approval is obtained.
new text end

Sec. 5.

Minnesota Statutes 2020, section 256B.0622, subdivision 5a, is amended to read:

Subd. 5a.

Standards for intensive residential rehabilitative mental health services.

(a)
The standards in this subdivision apply to intensive residential mental health services.

(b) The provider of intensive residential treatment services must have sufficient staff to
provide 24-hour-per-day coverage to deliver the rehabilitative services described in the
treatment plan and to safely supervise and direct the activities of clients, given the client's
level of behavioral and psychiatric stability, cultural needs, and vulnerability. The provider
must have the capacity within the facility to provide integrated services for chemical
dependency, illness management services, and family education, when appropriate. new text begin
Notwithstanding any other provision of law, the license holder may operate a locked facility
to provide treatment for patients who have been transferred from a jail or have been deemed
incompetent to stand trial and a judge determines that the patient needs to be in a secure
facility. The locked facility must meet building and fire code requirements.
new text end

(c) At a minimum:

(1) staff must provide direction and supervision whenever clients are present in the
facility;

(2) staff must remain awake during all work hours;

(3) there must be a staffing ratio of at least one to nine clients for each day and evening
shift. If more than nine clients are present at the residential site, there must be a minimum
of two staff during day and evening shifts, one of whom must be a mental health practitioner
or mental health professional;

(4) if services are provided to clients who need the services of a medical professional,
the provider shall ensure that these services are provided either by the provider's own medical
staff or through referral to a medical professional; and

(5) the provider must ensure the timely availability of a licensed registered nurse, either
directly employed or under contract, who is responsible for ensuring the effectiveness and
safety of medication administration in the facility and assessing clients for medication side
effects and drug interactions.

(d) Services must be provided by qualified staff as defined in section 256B.0623,
subdivision 5, who are trained and supervised according to section 256B.0623, subdivision
6, except that mental health rehabilitation workers acting as overnight staff are not required
to comply with section 256B.0623, subdivision 5, paragraph (a), clause (4), item (iv).

(e) The clinical supervisor must be an active member of the intensive residential services
treatment team. The team must meet with the clinical supervisor at least weekly to discuss
clients' progress and make rapid adjustments to meet clients' needs. The team meeting shall
include client-specific case reviews and general treatment discussions among team members.
Client-specific case reviews and planning must be documented in the client's treatment
record.

(f) Treatment staff must have prompt access in person or by telephone to a mental health
practitioner or mental health professional. The provider must have the capacity to promptly
and appropriately respond to emergent needs and make any necessary staffing adjustments
to ensure the health and safety of clients.

(g) The initial functional assessment must be completed within ten days of intake and
updated at least every 30 days, or prior to discharge from the service, whichever comes
first.

(h) The initial individual treatment plan must be completed within 24 hours of admission.
Within ten days of admission, the initial treatment plan must be refined and further developed,
except for providers certified according to Minnesota Rules, parts 9533.0010 to 9533.0180.
The individual treatment plan must be reviewed with the client and updated at least monthly.

new text begin EFFECTIVE DATE. new text end

new text begin This section is effective July 1, 2022, or upon federal approval,
whichever is later. The commissioner of human services shall notify the revisor of statutes
when federal approval is obtained.
new text end

Sec. 6.

Minnesota Statutes 2021 Supplement, section 256B.0625, subdivision 5, is amended
to read:

Subd. 5.

Community mental health center services.

Medical assistance covers
community mental health center services provided by a community mental health center
that meets the requirements in paragraphs (a) to (j).

(a) The provider must be certified as a mental health clinic under section 245I.20.

(b) In addition to the policies and procedures required by section 245I.03, the provider
must establish, enforce, and maintain the policies and procedures for oversight of clinical
services by a doctoral-level psychologist or a board-certified or board-eligible psychiatrist.
These policies and procedures must be developed with the involvement of a doctoral-level
psychologist and a board-certified or board-eligible psychiatrist, and must include:

(1) requirements for when to seek clinical consultation with a doctoral-level psychologist
or a board-certified or board-eligible psychiatrist;

(2) requirements for the involvement of a doctoral-level psychologist or a board-certified
or board-eligible psychiatrist in the direction of clinical services; and

(3) involvement of a doctoral-level psychologist or a board-certified or board-eligible
psychiatrist in quality improvement initiatives and review as part of a multidisciplinary care
team.

(c) The provider must be a private nonprofit corporation or a governmental agency and
have a community board of directors as specified by section 245.66.

(d) The provider must have a sliding fee scale that meets the requirements in section
245.481, and agree to serve within the limits of its capacity all individuals residing in its
service delivery area.

(e) At a minimum, the provider must provide the following outpatient mental health
services: diagnostic assessment; explanation of findings; family, group, and individual
psychotherapy, including crisis intervention psychotherapy services, psychological testing,
and medication management. In addition, the provider must provide or be capable of
providing upon request of the local mental health authority day treatment services, multiple
family group psychotherapy, and professional home-based mental health services. The
provider must have the capacity to provide such services to specialized populations such
as the elderly, families with children, persons who are seriously and persistently mentally
ill, and children who are seriously emotionally disturbed.

(f) The provider must be capable of providing the services specified in paragraph (e) to
individuals who are dually diagnosed with mental illness or emotional disturbance, and
substance use disorder, and to individuals who are dually diagnosed with a mental illness
or emotional disturbance and developmental disability.

(g) The provider must provide 24-hour emergency care services or demonstrate the
capacity to assist recipients in need of such services to access such services on a 24-hour
basis.

(h) The provider must have a contract with the local mental health authority to provide
one or more of the services specified in paragraph (e).

(i) The provider must agree, upon request of the local mental health authority, to enter
into a contract with the county to provide mental health services not reimbursable under
the medical assistance program.

(j) The provider may not be enrolled with the medical assistance program as both a
hospital and a community mental health center. The community mental health center's
administrative, organizational, and financial structure must be separate and distinct from
that of the hospital.

(k) The commissioner may require the provider to annually attest that the provider meets
the requirements in this subdivision using a form that the commissioner provides.

new text begin (l) Managed care plans and county-based purchasing plans shall reimburse a provider
at a rate that is at least equal to the fee-for-service payment rate. The commissioner shall
monitor the effect of this requirement on the rate of access to the services delivered by
mental health providers. If, for any contract year, federal approval is not received for this
paragraph, the commissioner must adjust the capitation rates paid to managed care plans
and county-based purchasing plans for that contract year to reflect the removal of this
provision. Contracts between managed care plans and county-based purchasing plans and
providers to whom this paragraph applies must allow recovery of payments from those
providers if capitation rates are adjusted in accordance with this paragraph. Payment
recoveries must not exceed the amount equal to any increase in rates that results from this
provision. This paragraph expires if federal approval is not received for this paragraph at
any time.
new text end

Sec. 7.

Minnesota Statutes 2021 Supplement, section 256B.0625, subdivision 56a, is
amended to read:

Subd. 56a.

Officer-involved community-based care coordination.

(a) Medical
assistance covers officer-involved community-based care coordination for an individual
who:

(1) has screened positive for benefiting from treatment for a mental illness or substance
use disorder using a tool approved by the commissioner;

(2) does not require the security of a public detention facility and is not considered an
inmate of a public institution as defined in Code of Federal Regulations, title 42, section
435.1010;

(3) meets the eligibility requirements in section 256B.056; and

(4) has agreed to participate in officer-involved community-based care coordination.

(b) Officer-involved community-based care coordination means navigating services to
address a client's mental health, chemical health, social, economic, and housing needs, or
any other activity targeted at reducing the incidence of jail utilization and connecting
individuals with existing covered services available to them, including, but not limited to,
targeted case management, waiver case management, or care coordination.

(c) Officer-involved community-based care coordination must be provided by an
individual who is an employee of or is under contract with a county, or is an employee of
or under contract with an Indian health service facility or facility owned and operated by a
tribe or a tribal organization operating under Public Law 93-638 as a 638 facility to provide
officer-involved community-based care coordination and is qualified under one of the
following criteria:

(1) a mental health professional;

(2) a clinical trainee qualified according to section 245I.04, subdivision 6, working under
the treatment supervision of a mental health professional according to section 245I.06;

(3) a mental health practitioner qualified according to section 245I.04, subdivision 4,
working under the treatment supervision of a mental health professional according to section
245I.06;

(4) a mental health certified peer specialist qualified according to section 245I.04,
subdivision 10, working under the treatment supervision of a mental health professional
according to section 245I.06;

(5) an individual qualified as an alcohol and drug counselor under section 245G.11,
subdivision 5; or

(6) a recovery peer qualified under section 245G.11, subdivision 8, working under the
supervision of an individual qualified as an alcohol and drug counselor under section
245G.11, subdivision 5.

(d) Reimbursement is allowed for up to 60 days following the initial determination of
eligibility.

(e) Providers of officer-involved community-based care coordination shall annually
report to the commissioner on the number of individuals served, and number of the
community-based services that were accessed by recipients. The commissioner shall ensure
that services and payments provided under officer-involved community-based care
coordination do not duplicate services or payments provided under section 256B.0625,
subdivision 20, 256B.0753, 256B.0755, or 256B.0757.

deleted text begin (f) Notwithstanding section 256B.19, subdivision 1, the nonfederal share of cost for
officer-involved community-based care coordination services shall be provided by the
county providing the services, from sources other than federal funds or funds used to match
other federal funds.
deleted text end

Sec. 8.

new text begin [611.41] DEFINITIONS.
new text end

new text begin (a) For the purposes of sections 611.41 to 611.43, the following terms have the meanings
given.
new text end

new text begin (b) "Cognitive impairment" means any deficiency in the ability to think, perceive, reason,
or remember caused by injury, genetic condition, or brain abnormality.
new text end

new text begin (c) "Competency restoration program" means a structured program of clinical and
educational services that is designed to identify and address barriers to a defendant's ability
to understand the criminal proceedings, consult with counsel, and participate in the defense.
new text end

new text begin (d) "Forensic navigator" means a person who provides the services under section 611.42,
subdivision 2.
new text end

new text begin (e) "Mental illness" means an organic disorder of the brain or a substantial psychiatric
disorder of thought, mood, perception, orientation, or memory.
new text end

Sec. 9.

new text begin [611.42] FORENSIC NAVIGATOR SERVICES.
new text end

new text begin Subdivision 1. new text end

new text begin Availability of forensic navigator services. new text end

new text begin Counties must provide or
contract for enough forensic navigator services to meet the needs of adult defendants in
each judicial district upon a motion regarding competency pursuant to Minnesota Rule of
Criminal Procedure 20.01.
new text end

new text begin Subd. 2. new text end

new text begin Duties. new text end

new text begin (a) Forensic navigators shall provide services to assist defendants with
mental illnesses and cognitive impairments. Services may include, but are not limited to:
new text end

new text begin (1) developing bridge plans under subdivision 3 of this section;
new text end

new text begin (2) coordinating timely placement in court-ordered competency restoration programs;
new text end

new text begin (3) providing competency restoration education;
new text end

new text begin (4) reporting to the county on the progress of defendants in a competence restoration
program;
new text end

new text begin (5) providing coordinating services to help defendants access needed mental health,
medical, housing, financial, social, transportation, precharge and pretrial diversion, and
other necessary services provided by other programs and community service providers; and
new text end

new text begin (6) communicating with and offering supportive resources to defendants and family
members of defendants.
new text end

new text begin (b) As the accountable party over the defendant, forensic navigators must meet at least
quarterly with the defendant.
new text end

new text begin (c) If a defendant's charges are dismissed, the appointed forensic navigator may continue
assertive outreach with the individual for up to 90 days to assist in attaining stability in the
community.
new text end

new text begin Subd. 3. new text end

new text begin Bridge plans. new text end

new text begin (a) The forensic navigator must prepare bridge plans with the
defendant. The bridge plan must include:
new text end

new text begin (1) a confirmed housing address the defendant will use, including but not limited to
emergency shelters;
new text end

new text begin (2) if possible, the dates, times, locations, and contact information for any appointments
made to further coordinate support and assistance for the defendant in the community,
including but not limited to mental health and substance use disorder treatment, or a list of
referrals to services; and
new text end

new text begin (3) any other referrals, resources, or recommendations the forensic navigator deems
necessary.
new text end

new text begin (b) Bridge plans and any supporting records or other data submitted with those plans
are not accessible to the public.
new text end

new text begin Subd. 4. new text end

new text begin Funds. new text end

new text begin Each fiscal year, the commissioner of human services must distribute
the total amount appropriated for forensic navigator services under this section to counties
based upon their proportional share of persons deemed incompetent to stand trial and using
the forensic navigator services during the prior fiscal year.
new text end

Sec. 10.

new text begin [611.43] COMPETENCY RESTORATION CURRICULUM.
new text end

new text begin (a) By January 1, 2023, counties must choose a competency restoration curriculum to
educate and assist defendants receiving forensic navigator services to attain the ability to:
new text end

new text begin (1) rationally consult with counsel;
new text end

new text begin (2) understand the proceedings; and
new text end

new text begin (3) participate in the defense.
new text end

new text begin (b) The curriculum must be flexible enough to be delivered by individuals with various
levels of education and qualifications, including but not limited to professionals in criminal
justice, health care, mental health care, and social services.
new text end

Sec. 11. new text begin DIRECTION TO COMMISSIONER OF HUMAN SERVICES;
DEVELOPMENT OF MEDICAL ASSISTANCE ELIGIBLE MENTAL HEALTH
BENEFIT FOR CHILDREN IN CRISIS.
new text end

new text begin (a) The commissioner of human services, in consultation with providers, counties, and
other stakeholders, must develop a covered service under medical assistance to provide
residential crisis stabilization for children. The benefit must:
new text end

new text begin (1) consist of services that contribute to effective treatment to children experiencing a
mental health crisis;
new text end

new text begin (2) provide for simplicity of service, design, and administration;
new text end

new text begin (3) support participation by all payors; and
new text end

new text begin (4) include services that support children and families that comprise of:
new text end

new text begin (i) an assessment of the child's immediate needs and factors that lead to the mental health
crisis;
new text end

new text begin (ii) individualized treatment to address immediate needs and restore the child to a precrisis
level of functioning;
new text end

new text begin (iii) 24-hour on-site staff and assistance;
new text end

new text begin (iv) supportive counseling;
new text end

new text begin (v) skills training as identified in the child's individual crisis stabilization plan;
new text end

new text begin (vi) referrals to other service providers in the community as needed and to support the
child's transition from residential crisis stabilization services;
new text end

new text begin (vii) development of a crisis response action plan; and
new text end

new text begin (viii) assistance to access and store medication.
new text end

new text begin (c) Eligible services must not be denied based on service location or service entity.
new text end

new text begin (d) When developing the new benefit, the commission must also make recommendations
or propose a method for medical assistance enrollees to also receive a housing support
benefit to cover room and board.
new text end

new text begin (e) No later than February 1, 2023, the commissioner, in consultation with counties,
stakeholders, and providers, must submit to the chairs and ranking minority members of
the legislative committees with jurisdiction over human services policy and finance a timeline
for developing the fiscal and service analysis for the mental health benefit under this section,
and a deadline for the commissioner to submit a state plan amendment to the Centers for
Medicare and Medicaid Services.
new text end

Sec. 12. new text begin MENTAL HEALTH URGENCY ROOM GRANTS.
new text end

new text begin Subdivision 1. new text end

new text begin Establishment. new text end

new text begin The commissioner of human services must establish a
competitive grant program for medical providers and nonprofits seeking to become a
first-contact resource for youths having a mental health crisis through the use of urgency
rooms.
new text end

new text begin Subd. 2. new text end

new text begin Goal. new text end

new text begin The goal of this grant program is to address emergency mental health
needs by creating urgency rooms that can be used by youths age 25 and under having a
mental health crisis as a first-contact resource.
new text end

new text begin Subd. 3. new text end

new text begin Eligible applicants. new text end

new text begin (a) To be eligible for a grant under this section, applicants
must be:
new text end

new text begin (1) an existing medical provider, including hospitals or emergency rooms;
new text end

new text begin (2) a nonprofit that is in the business of providing mental health services; or
new text end

new text begin (3) a nonprofit serving an underserved or rural community that will partner with an
existing medical provider or nonprofit that is in the business of providing mental health
services.
new text end

new text begin (b) Applicants must have staff who are licensed mental health professionals as defined
under Minnesota Statutes, section 245I.02, subdivision 27.
new text end

new text begin (c) Applicants may have the capability to:
new text end

new text begin (1) perform a medical evaluation and mental health evaluation upon a youth's admittance
to an urgency room;
new text end

new text begin (2) accommodate a youth's stay for up to 72 hours;
new text end

new text begin (3) conduct a substance use disorder screening;
new text end

new text begin (4) conduct a mental health crisis assessment;
new text end

new text begin (5) provide peer support services;
new text end

new text begin (6) provide crisis stabilization services;
new text end

new text begin (7) provide access to crisis psychiatry; and
new text end

new text begin (8) provide access to care planning and case management.
new text end

new text begin (d) Applicants must have a connection to inpatient and outpatient mental health services,
including a physical health screening.
new text end

new text begin (e) Applicants that are not medical providers must agree to partner with a nearby
emergency room or hospital to provide services in the event of an emergency.
new text end

new text begin (f) Applicants must agree to accept patients regardless of their insurance status or their
ability to pay.
new text end

new text begin Subd. 4. new text end

new text begin Applications. new text end

new text begin (a) Entities seeking grants under this section shall apply to the
commissioner. The grant applicant must include a description of the project that the applicant
is proposing, the amount of money that the applicant is seeking, a proposed budget describing
how the applicant will spend the grant money, and how the applicant intends to meet the
goals of the program. Nonprofits that serve an underserved or rural community that are
partnering with an existing medical provider or nonprofit that is in the business of providing
mental health services must submit a joint application with the partnering entity.
new text end

new text begin (b) Priority must be given to applications that:
new text end

new text begin (1) demonstrate a need for the program in the region;
new text end

new text begin (2) provide a detailed service plan, including the services that will be provided and to
whom, and staffing requirements;
new text end

new text begin (3) provide an estimated cost of operating the program;
new text end

new text begin (4) verify financial sustainability by detailing sufficient funding sources and the capacity
to obtain third-party payments for services provided, including private insurance and federal
Medicaid and Medicare financial participation;
new text end

new text begin (5) demonstrate an ability and willingness to build on existing resources in the
community; and
new text end

new text begin (6) agree to an evaluation of services and financial viability by the commissioner.
new text end

new text begin Subd. 5. new text end

new text begin Grant activities. new text end

new text begin Grantees must use grant money to create urgency rooms to
provide emergency mental health services and become a first-contact resource for youths
having a mental health crisis. Grant money uses may include funding for:
new text end

new text begin (1) expanding current space to create an urgency room;
new text end

new text begin (2) performing medical or mental health evaluations;
new text end

new text begin (3) developing a care plan for the youth; or
new text end

new text begin (4) providing recommendations for further care, either at an inpatient or outpatient
facility.
new text end

new text begin Subd. 6. new text end

new text begin Reporting. new text end

new text begin (a) Grantees must provide a report to the commissioner in a manner
specified by the commissioner on the following:
new text end

new text begin (1) how grant funds were spent;
new text end

new text begin (2) how many youths the grantee served; and
new text end

new text begin (3) how the grantee met the goal of the grant program.
new text end

new text begin (b) The commissioner must provide a report to the chairs and ranking minority members
of the legislative committees with jurisdiction over human services regarding grant activities
one year from the date all grant contracts have been executed. The commissioner must
provide an updated report two years from the date all grant contracts have been executed
on the progress of the grant program and how grant funds were spent. This report must be
made available to the public.
new text end

Sec. 13. new text begin APPROPRIATION; SCHOOL-LINKED MENTAL HEALTH GRANTS.
new text end

new text begin $....... in fiscal year 2023 is appropriated from the general fund to the commissioner of
human services for school-linked mental health grants under Minnesota Statutes, section
245.4901. This is a onetime appropriation.
new text end

Sec. 14. new text begin APPROPRIATION; SHELTER-LINKED MENTAL HEALTH GRANTS.
new text end

new text begin $....... in fiscal year 2023 is appropriated from the general fund to the commissioner of
human services for shelter-linked youth mental health grants under Minnesota Statutes,
section 256K.46.
new text end

Sec. 15. new text begin APPROPRIATION; EXPAND MOBILE CRISIS.
new text end

new text begin $....... in fiscal year 2023 is appropriated from the general fund to the commissioner of
human services for additional funding for grants for adult mobile crisis services under
Minnesota Statutes, section 245.4661, subdivision 9, paragraph (b), clause (15).
new text end

Sec. 16. new text begin APPROPRIATION; MENTAL HEALTH URGENCY ROOMS GRANT
PROGRAM.
new text end

new text begin $....... in fiscal year 2023 is appropriated from the general fund to the commissioner of
human services for mental health urgency room grants in section 12. This is a onetime
appropriation.
new text end

Sec. 17. new text begin APPROPRIATION; MENTAL HEALTH PROFESSIONAL LOAN
FORGIVENESS.
new text end

new text begin Notwithstanding the priorities and distribution requirements under Minnesota Statutes,
section 144.1501, $....... is appropriated in fiscal year 2023 from the general fund to the
commissioner of health for the health professional loan forgiveness program to be used for
loan forgiveness only for individuals who are eligible mental health professionals under
Minnesota Statutes, section 144.1501. Notwithstanding Minnesota Statutes, section 144.1501,
subdivision 2, paragraph (b), if the commissioner of health does not receive enough qualified
mental health professional applicants within fiscal year 2023 to use this entire appropriation,
the remaining funds shall be carried over to the next biennium and allocated proportionally
among the other eligible professions in accordance with Minnesota Statutes, section 144.1501,
subdivision 2.
new text end

Sec. 18. new text begin APPROPRIATION; MENTAL HEALTH PROVIDER SUPERVISION
GRANT PROGRAM.
new text end

new text begin $....... is appropriated in fiscal year 2023 from the general fund to the commissioner of
health for the mental health provider supervision grant program under Minnesota Statutes,
section 144.1508.
new text end

Sec. 19. new text begin APPROPRIATION; INTENSIVE RESIDENTIAL TREATMENT
SERVICES.
new text end

new text begin $....... in fiscal year 2023 is appropriated from the general fund to the commissioner of
human services to provide start-up funds to intensive residential treatment service providers
to provide treatment in locked facilities for patients who have been transferred from a jail
or who have been deemed incompetent to stand trial and a judge has determined that the
patient needs to be in a secure facility. This is a onetime appropriation.
new text end

Sec. 20. new text begin APPROPRIATION; ADULT MENTAL HEALTH INITIATIVES FUNDING.
new text end

new text begin $....... in fiscal year 2023 is appropriated from the general fund to the commissioner of
human services to ensure that no adult mental health initiative region receives less funding
due to formula changes pursuant to Minnesota Statutes, section 245.4661, subdivision 11.
new text end

Sec. 21. new text begin APPROPRIATION; FORENSIC NAVIGATORS.
new text end

new text begin $2,000,000 in fiscal year 2023 is appropriated from the general fund to the commissioner
of human services for the costs associated with providing forensic navigator services under
Minnesota Statutes, section 611.42. The general fund base for this appropriation is $2,000,000
in fiscal year 2024 and $2,000,000 in fiscal year 2025.
new text end

Sec. 22. new text begin REPEALER.
new text end

new text begin Minnesota Statutes 2020, section 245.4661, subdivision 8, new text end new text begin is repealed.
new text end

APPENDIX

Repealed Minnesota Statutes: S3249-1

245.4661 PILOT PROJECTS; ADULT MENTAL HEALTH SERVICES.

Subd. 8.

Budget flexibility.

The commissioner may make budget transfers that do not increase the state share of costs to effectively implement the restructuring of adult mental health services.