SF 4664

as introduced - 93rd Legislature (2023 - 2024) Posted on 03/07/2024 04:48pm

A bill for an act
relating to mental health; modifying respite care grants; creating a youth care
professional training program; modifying adult and children's mobile transition
units; appropriating money; amending Minnesota Statutes 2023 Supplement,
section 245.4889, subdivision 1; Laws 2021, First Special Session chapter 7, article
17, section 12, as amended; proposing coding for new law in Minnesota Statutes,
chapter 245.

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

Section 1.

Minnesota Statutes 2023 Supplement, section 245.4889, subdivision 1, is
amended to read:

Subdivision 1.

Establishment and authority.

(a) The commissioner is authorized to
make grants from available appropriations to assist:

(1) counties;

(2) Indian tribes;

(3) children's collaboratives under section 124D.23 or 245.493; or

(4) mental health service providers.

(b) The following services are eligible for grants under this section:

(1) services to children with emotional disturbances as defined in section 245.4871,
subdivision 15, and their families;

(2) transition services under section 245.4875, subdivision 8, for young adults under
age 21 and their families;

(3) respite care services for children with emotional disturbances or severe emotional
disturbances who are at risk of deleted text begin out-of-home placement or deleted text end new text begin residential treatment or
hospitalization, who are new text end already in out-of-home placement in family foster settings as defined
in chapter 245A and at risk of change in out-of-home placement or placement in a residential
facility or other higher level of care new text begin , who have utilized crisis services or emergency room
services, or who have experienced a loss of in-home staffing support new text end . Allowable activities
and expenses for respite care services are defined under subdivision 4. A child is not required
to have case management services to receive respite care services new text begin . Counties must work to
provide regular access to regularly scheduled respite care new text end ;

(4) children's mental health crisis services;

(5) child-, youth-, and family-specific mobile response and stabilization services models;

(6) mental health services for people from cultural and ethnic minorities, including
supervision of clinical trainees who are Black, indigenous, or people of color;

(7) children's mental health screening and follow-up diagnostic assessment and treatment;

(8) services to promote and develop the capacity of providers to use evidence-based
practices in providing children's mental health services;

(9) school-linked mental health services under section 245.4901;

(10) building evidence-based mental health intervention capacity for children birth to
age five;

(11) suicide prevention and counseling services that use text messaging statewide;

(12) mental health first aid training;

(13) training for parents, collaborative partners, and mental health providers on the
impact of adverse childhood experiences and trauma and development of an interactive
website to share information and strategies to promote resilience and prevent trauma;

(14) transition age services to develop or expand mental health treatment and supports
for adolescents and young adults 26 years of age or younger;

(15) early childhood mental health consultation;

(16) evidence-based interventions for youth at risk of developing or experiencing a first
episode of psychosis, and a public awareness campaign on the signs and symptoms of
psychosis;

(17) psychiatric consultation for primary care practitioners; and

(18) providers to begin operations and meet program requirements when establishing a
new children's mental health program. These may be start-up grants.

(c) Services under paragraph (b) must be designed to help each child to function and
remain with the child's family in the community and delivered consistent with the child's
treatment plan. Transition services to eligible young adults under this paragraph must be
designed to foster independent living in the community.

(d) As a condition of receiving grant funds, a grantee shall obtain all available third-party
reimbursement sources, if applicable.

(e) The commissioner may establish and design a pilot program to expand the mobile
response and stabilization services model for children, youth, and families. The commissioner
may use grant funding to consult with a qualified expert entity to assist in the formulation
of measurable outcomes and explore and position the state to submit a Medicaid state plan
amendment to scale the model statewide.

Sec. 2.

new text begin [245.4908] YOUTH CARE PROFESSIONAL TRAINING PROGRAM.
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
youth care professional training program to provide relevant onboarding and initial and
annual training requirements for direct care staff in children's residential treatment settings
described in Minnesota Rules, chapter 2960, excluding foster care and foster residences,
and that provide day treatment services described in section 256B.0943.
new text end

new text begin Subd. 2. new text end

new text begin Program development. new text end

new text begin The commissioner must contract with a third-party
training provider who has expertise in child welfare, trauma-informed care, and youth
development. The training provider must establish a curriculum for and administer the
training program. The training provider must include children's residential and children's
mental health day treatment providers in the development of the curriculum.
new text end

new text begin Subd. 3. new text end

new text begin Program activities. new text end

new text begin (a) The training provider must teach participants how to
provide services to a person according to a trauma-informed model of care.
new text end

new text begin (b) Courses taught to program participants must cover Minnesota Rules, chapter 2960,
including:
new text end

new text begin (1) data practices regulations and issues;
new text end

new text begin (2) culturally competent care;
new text end

new text begin (3) racial bias and racism;
new text end

new text begin (4) physical, mental, sensory, and health-related disabilities, bias, and discrimination;
new text end

new text begin (5) gender-based needs and sexual orientation;
new text end

new text begin (6) critical incident report writing;
new text end

new text begin (7) staff and resident grievance procedure;
new text end

new text begin (8) medication assistance; and
new text end

new text begin (9) CPR and first aid.
new text end

new text begin (c) The training provider must create and maintain a youth care professional registry
where participants who complete the training program can be listed. When a participant
completes the training program, their name and the completion date must be listed in the
youth care professional registry. The training provider must maintain a learning management
system to keep a record of each participant's completed training programs. A participant's
record may be shared with any child-serving organization the participant is employed with,
with the participant's written approval.
new text end

Sec. 3.

Laws 2021, First Special Session chapter 7, article 17, section 12, as amended by
Laws 2022, chapter 98, article 15, section 13, Laws 2022, chapter 99, article 1, section 43,
and Laws 2023, chapter 70, article 20, section 18, is amended to read:

Sec. 12. ADULT AND CHILDREN'S MOBILE TRANSITION UNITS.

(a) This act includes $1,572,000 in fiscal year 2022 and $0 in fiscal year 2023 for the
commissioner of human services to create adult and children's mental health transition and
support teams to facilitate transition back to the community or to the least restrictive level
of care from inpatient psychiatric settings, emergency departments new text begin , inpatient hospitalization,
juvenile detention facilities new text end , residential treatment facilities, and child and adolescent
behavioral health hospitals. Any unexpended amount in fiscal year 2022 is available through
June 30, 2023. The general fund base included in this act for this purpose is $1,875,000 in
fiscal year 2024 and deleted text begin $0 deleted text end new text begin $2,500,000 new text end in fiscal year 2025.

(b) Beginning April 1, 2024, counties may fund and continue conducting activities
funded under this section.

deleted text begin (c) This section expires March 31, 2024.
deleted text end

new text begin EFFECTIVE DATE. new text end

new text begin This section is effective retroactively from January 1, 2024.
new text end

Sec. 4. new text begin DIRECTION TO COMMISSIONER OF HUMAN SERVICES; RESPITE
CARE ACCESS.
new text end

new text begin The commissioner of human services, in coordination with stakeholders, must develop
proposals by December 31, 2025, to increase access to licensed respite foster care homes
that take into consideration the new rule directing title IV-E agencies to adopt one set of
licensing or approval standards for all relative or kinship foster family homes that is different
from the licensing or approval standards used for nonrelative/nonkinship foster family
homes, as provided by the Federal Register, volume 88, page 66700.
new text end

Sec. 5. new text begin DIRECTION TO COMMISSIONER; MEDICAL ASSISTANCE
CHILDREN'S RESIDENTIAL MENTAL HEALTH CRISIS STABILIZATION.
new text end

new text begin (a) The commissioner of human services must consult with providers, advocates, Tribal
Nations, counties, people with lived experience as or with a child in a mental health crisis,
and other interested community members to develop a covered benefit under medical
assistance to provide residential mental health crisis stabilization for children. The benefit
must:
new text end

new text begin (1) consist of evidence-based promising practices, or culturally responsive treatment
services for children under the age of 21 experiencing a mental health crisis;
new text end

new text begin (2) embody an integrative care model that supports individuals experiencing a mental
health crisis who may also be experiencing co-occurring conditions;
new text end

new text begin (3) qualify for federal financial participation; and
new text end

new text begin (4) include services that support children and families, including but not limited to:
new text end

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

new text begin (ii) individualized care 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 and clinical services;
new text end

new text begin (v) skills training and positive support services, 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 an individualized and culturally responsive crisis response action
plan; and
new text end

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

new text begin (b) When developing the new benefit, the commissioner must make recommendations
for providers to be reimbursed for room and board.
new text end

new text begin (c) The commissioner must consult with or contract with rate-setting experts to develop
a prospective data-based rate methodology for the children's residential mental health crisis
stabilization benefit.
new text end

new text begin (d) No later than October 1, 2025, the commissioner must submit to the chairs and
ranking minority members of the legislative committees with jurisdiction over human
services policy and finance a report detailing for the children's residential mental health
crisis stabilization benefit the proposed:
new text end

new text begin (1) eligibility, clinical and service requirements, provider standards, licensing
requirements, and reimbursement rates;
new text end

new text begin (2) process for community engagement, community input, and crisis models studied in
other states;
new text end

new text begin (3) deadline for the commissioner to submit a state plan amendment to the Centers for
Medicare and Medicaid Services; and
new text end

new text begin (4) draft legislation with the statutory changes necessary to implement the benefit.
new text end

new text begin EFFECTIVE DATE. new text end

new text begin This section is effective July 1, 2024.
new text end

Sec. 6. new text begin SCHOOL-LINKED BEHAVIORAL HEALTH GRANT BASE.
new text end

new text begin The base for school-linked behavioral health grants under Minnesota Statutes, section
245.4901, is increased by $2,500,000 in fiscal year 2026 and $2,500,000 in fiscal year 2027.
new text end

Sec. 7. new text begin APPROPRIATION; YOUTH CARE PROFESSIONAL TRAINING
PROGRAM.
new text end

new text begin $1,500,000 in fiscal year 2025 is appropriated from the general fund to the commissioner
of human services to contract with a third-party training provider who will develop the
youth care professional training program under Minnesota Statutes, section 245.4908, who
will administer the training program, and who will maintain a youth care professional registry
with information on participants who complete the training program. The general fund base
for this appropriation is $950,000 in fiscal year 2026 and $0 in fiscal year 2027.
new text end

Sec. 8. new text begin APPROPRIATION; RESPITE CARE SERVICES.
new text end

new text begin (a) $5,000,000 in fiscal year 2025 is appropriated from the general fund to the
commissioner of human services for respite care services under Minnesota Statutes, section
245.4889, subdivision 1, paragraph (b), clause (3).
new text end

new text begin (b) Of this appropriation, $1,000,000 in fiscal year 2025 is for grants to private
child-placing agencies, as defined in Minnesota Rules, chapter 9545, to conduct recruitment
and support licensing activities that are specific to increasing the availability of licensed
foster homes to provide respite care services.
new text end

Sec. 9. new text begin APPROPRIATION; COMMUNITY-BASED GROUP HOME CARE.
new text end

new text begin $2,000,000 in fiscal year 2025 is appropriated from the general fund to the commissioner
of human services for grants to organizations that serve children under Minnesota Rules,
chapter 2960. Grant funds must be used to develop community-based group home care to
serve children who require 24/7 supervised support to successfully live at their highest level
of community integration in the least restrictive setting.
new text end

Sec. 10. new text begin APPROPRIATION; IN-HOME CHILDREN'S MENTAL HEALTH
INFRASTRUCTURE GRANTS.
new text end

new text begin (a) $10,000,000 in fiscal year 2025 is appropriated from the general fund to the
commissioner of human services for infrastructure grants to develop family-centered in-home
mental health services that include children's intensive behavioral health services under
Minnesota Statutes, section 256B.0946; intensive rehabilitative mental health services under
Minnesota Statutes, section 256B.0947; services under Minnesota Statutes, section
256B.0943, that are provided in-home; and Hi-Fidelity Wrap Around and Collaborative
Intensive Bridging Services under Minnesota Statutes, section 245.4889, subdivision 1,
paragraph (b), clause (17).
new text end

new text begin (b) Grant funding may be used for start-up costs including but not limited to initial hiring
for specialized roles, staff training, technical assistance, and ancillary service costs required
to establish and support the launch of these intensive mental health team models.
new text end