Minnesota Legislature
SF 595
as introduced - 90th Legislature (2017 - 2018) Posted on 02/23/2017 08:31am
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A bill for an act
relating to human services; allowing interactive video for targeted case
management; amending Minnesota Statutes 2016, sections 256B.0621, subdivision
10; 256B.0625, subdivision 20, by adding a subdivision; 256B.0924, by adding a
subdivision.
BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF MINNESOTA:
Section 1.
Minnesota Statutes 2016, section 256B.0621, subdivision 10, is amended to
read:
Subd. 10.
Payment rates.
The commissioner shall set payment rates for targeted case
management under this subdivision. Case managers may bill according to the following
criteria:
(1) for relocation targeted case management, case managers may bill for direct case
management activities, including face-to-face deleted text begin anddeleted text end new text begin contact,new text end telephone deleted text begin contactsdeleted text end new text begin contactnew text end , new text begin and
interactive video contact according to section 256B.0924, subdivision 4a, new text end in the lesser of:
(i) 180 days preceding an eligible recipient's discharge from an institution; or
(ii) the limits and conditions which apply to federal Medicaid funding for this service;
(2) for home care targeted case management, case managers may bill for direct case
management activities, including face-to-face and telephone contacts; and
(3) billings for targeted case management services under this subdivision shall not
duplicate payments made under other program authorities for the same purpose.
Sec. 2.
Minnesota Statutes 2016, section 256B.0625, subdivision 20, is amended to read:
Subd. 20.
Mental health case management.
(a) To the extent authorized by rule of the
state agency, medical assistance covers case management services to persons with serious
and persistent mental illness and children with severe emotional disturbance. Services
provided under this section must meet the relevant standards in sections 245.461 to 245.4887,
the Comprehensive Adult and Children's Mental Health Acts, Minnesota Rules, parts
9520.0900 to 9520.0926, and 9505.0322, excluding subpart 10.
(b) Entities meeting program standards set out in rules governing family community
support services as defined in section 245.4871, subdivision 17, are eligible for medical
assistance reimbursement for case management services for children with severe emotional
disturbance when these services meet the program standards in Minnesota Rules, parts
9520.0900 to 9520.0926 and 9505.0322, excluding subparts 6 and 10.
(c) Medical assistance and MinnesotaCare payment for mental health case management
shall be made on a monthly basis. In order to receive payment for an eligible child, the
provider must document at least a face-to-face contact with the child, the child's parents, or
the child's legal representative. To receive payment for an eligible adult, the provider must
document:
(1) at least a face-to-face contact with the adult or the adult's legal representativenew text begin or a
contact by interactive video that meets the requirements of subdivision 20bnew text end ; or
(2) at least a telephone contact with the adult or the adult's legal representative and
document a face-to-face contact new text begin or a contact by interactive video that meets the requirements
of subdivision 20b new text end with the adult or the adult's legal representative within the preceding
two months.
(d) Payment for mental health case management provided by county or state staff shall
be based on the monthly rate methodology under section 256B.094, subdivision 6, paragraph
(b), with separate rates calculated for child welfare and mental health, and within mental
health, separate rates for children and adults.
(e) Payment for mental health case management provided by Indian health services or
by agencies operated by Indian tribes may be made according to this section or other relevant
federally approved rate setting methodology.
(f) Payment for mental health case management provided by vendors who contract with
a county or Indian tribe shall be based on a monthly rate negotiated by the host county or
tribe. The negotiated rate must not exceed the rate charged by the vendor for the same
service to other payers. If the service is provided by a team of contracted vendors, the county
or tribe may negotiate a team rate with a vendor who is a member of the team. The team
shall determine how to distribute the rate among its members. No reimbursement received
by contracted vendors shall be returned to the county or tribe, except to reimburse the county
or tribe for advance funding provided by the county or tribe to the vendor.
(g) If the service is provided by a team which includes contracted vendors, tribal staff,
and county or state staff, the costs for county or state staff participation in the team shall be
included in the rate for county-provided services. In this case, the contracted vendor, the
tribal agency, and the county may each receive separate payment for services provided by
each entity in the same month. In order to prevent duplication of services, each entity must
document, in the recipient's file, the need for team case management and a description of
the roles of the team members.
(h) Notwithstanding section 256B.19, subdivision 1, the nonfederal share of costs for
mental health case management shall be provided by the recipient's county of responsibility,
as defined in sections 256G.01 to 256G.12, from sources other than federal funds or funds
used to match other federal funds. If the service is provided by a tribal agency, the nonfederal
share, if any, shall be provided by the recipient's tribe. When this service is paid by the state
without a federal share through fee-for-service, 50 percent of the cost shall be provided by
the recipient's county of responsibility.
(i) Notwithstanding any administrative rule to the contrary, prepaid medical assistance
and MinnesotaCare include mental health case management. When the service is provided
through prepaid capitation, the nonfederal share is paid by the state and the county pays no
share.
(j) The commissioner may suspend, reduce, or terminate the reimbursement to a provider
that does not meet the reporting or other requirements of this section. The county of
responsibility, as defined in sections 256G.01 to 256G.12, or, if applicable, the tribal agency,
is responsible for any federal disallowances. The county or tribe may share this responsibility
with its contracted vendors.
(k) The commissioner shall set aside a portion of the federal funds earned for county
expenditures under this section to repay the special revenue maximization account under
section 256.01, subdivision 2, paragraph (o). The repayment is limited to:
(1) the costs of developing and implementing this section; and
(2) programming the information systems.
(l) Payments to counties and tribal agencies for case management expenditures under
this section shall only be made from federal earnings from services provided under this
section. When this service is paid by the state without a federal share through fee-for-service,
50 percent of the cost shall be provided by the state. Payments to county-contracted vendors
shall include the federal earnings, the state share, and the county share.
(m) Case management services under this subdivision do not include therapy, treatment,
legal, or outreach services.
(n) If the recipient is a resident of a nursing facility, intermediate care facility, or hospital,
and the recipient's institutional care is paid by medical assistance, payment for case
management services under this subdivision is limited to the lesser of:
(1) the last 180 days of the recipient's residency in that facility and may not exceed more
than six months in a calendar year; or
(2) the limits and conditions which apply to federal Medicaid funding for this service.
(o) Payment for case management services under this subdivision shall not duplicate
payments made under other program authorities for the same purpose.
new text begin
(p) If the recipient is receiving care in a hospital, nursing facility, or residential setting
licensed under chapter 245A or 245D that is staffed 24 hours a day, seven days a week,
mental health targeted case management services must actively support identification of
community alternatives for the recipient and discharge planning.
new text end
Sec. 3.
Minnesota Statutes 2016, section 256B.0625, is amended by adding a subdivision
to read:
new text begin Subd. 20b. new text end
new text begin Mental health targeted case management through interactive video. new text end
new text begin
(a)
Subject to federal approval, contact made for targeted case management by interactive video
shall be eligible for payment if:
new text end
new text begin
(1) the person receiving targeted case management services is residing in:
new text end
new text begin
(i) a hospital;
new text end
new text begin
(ii) a nursing facility; or
new text end
new text begin
(iii) a residential setting licensed under chapter 245A or 245D or a boarding and lodging
establishment or lodging establishment that provides supportive services or health supervision
services according to section 157.17 that is staffed 24 hours a day, seven days a week;
new text end
new text begin
(2) interactive video is in the best interests of the person and is deemed appropriate by
the person receiving targeted case management or the person's legal guardian, the case
management provider, and the provider operating the setting where the person is residing;
new text end
new text begin
(3) the use of interactive video is approved as part of the person's written personal service
or case plan, taking into consideration the person's vulnerability and active personal
relationships; and
new text end
new text begin
(4) interactive video is used for up to, but not more than, 50 percent of the minimum
required face-to-face contact.
new text end
new text begin
(b) The person receiving targeted case management or the person's legal guardian has
the right to choose and consent to the use of interactive video under this subdivision and
has the right to refuse the use of interactive video at any time.
new text end
new text begin
(c) The commissioner shall establish criteria that a targeted case management provider
must attest to in order to demonstrate the safety or efficacy of delivering the service via
interactive video. The attestation may include that the case management provider has:
new text end
new text begin
(1) written policies and procedures specific to interactive video services that are regularly
reviewed and updated;
new text end
new text begin
(2) policies and procedures that adequately address client safety before, during, and after
the interactive video services are rendered;
new text end
new text begin
(3) established protocols addressing how and when to discontinue interactive video
services; and
new text end
new text begin
(4) established a quality assurance process related to interactive video services.
new text end
new text begin
(d) As a condition of payment, the targeted case management provider must document
the following for each occurrence of targeted case management provided by interactive
video:
new text end
new text begin
(1) the time the service began and the time the service ended, including an a.m. and p.m.
designation;
new text end
new text begin
(2) the basis for determining that interactive video is an appropriate and effective means
for delivering the service to the person receiving case management services;
new text end
new text begin
(3) the mode of transmission of the interactive video services and records evidencing
that a particular mode of transmission was utilized;
new text end
new text begin
(4) the location of the originating site and the distant site; and
new text end
new text begin
(5) compliance with the criteria attested to by the targeted case management provider
as provided in paragraph (c).
new text end
Sec. 4.
Minnesota Statutes 2016, section 256B.0924, is amended by adding a subdivision
to read:
new text begin Subd. 4a. new text end
new text begin Targeted case management through interactive video. new text end
new text begin
(a) Subject to federal
approval, contact made for targeted case management by interactive video shall be eligible
for payment under subdivision 6 if:
new text end
new text begin
(1) the person receiving targeted case management services is residing in:
new text end
new text begin
(i) a hospital;
new text end
new text begin
(ii) a nursing facility; or
new text end
new text begin
(iii) a residential setting licensed under chapter 245A or 245D or a boarding and lodging
establishment or lodging establishment that provides supportive services or health supervision
services according to section 157.17 that is staffed 24 hours a day, seven days a week;
new text end
new text begin
(2) interactive video is in the best interests of the person and is deemed appropriate by
the person receiving targeted case management or the person's legal guardian, the case
management provider, and the provider operating the setting where the person is residing;
new text end
new text begin
(3) the use of interactive video is approved as part of the person's written personal service
or case plan; and
new text end
new text begin
(4) interactive video is used for up to, but not more than, 50 percent of the minimum
required face-to-face contact.
new text end
new text begin
(b) The person receiving targeted case management or the person's legal guardian has
the right to choose and consent to the use of interactive video under this subdivision and
has the right to refuse the use of interactive video at any time.
new text end
new text begin
(c) The commissioner shall establish criteria that a targeted case management provider
must attest to in order to demonstrate the safety or efficacy of delivering the service via
interactive video. The attestation may include that the case management provider has:
new text end
new text begin
(1) written policies and procedures specific to interactive video services that are regularly
reviewed and updated;
new text end
new text begin
(2) policies and procedures that adequately address client safety before, during, and after
the interactive video services are rendered;
new text end
new text begin
(3) established protocols addressing how and when to discontinue interactive video
services; and
new text end
new text begin
(4) established a quality assurance process related to interactive video services.
new text end
new text begin
(d) As a condition of payment, the targeted case management provider must document
the following for each occurrence of targeted case management provided by interactive
video:
new text end
new text begin
(1) the time the service began and the time the service ended, including an a.m. and p.m.
designation;
new text end
new text begin
(2) the basis for determining that interactive video is an appropriate and effective means
for delivering the service to the person receiving case management services;
new text end
new text begin
(3) the mode of transmission of the interactive video services and records evidencing
that a particular mode of transmission was utilized;
new text end
new text begin
(4) the location of the originating site and the distant site; and
new text end
new text begin
(5) compliance with the criteria attested to by the targeted case management provider
as provided in paragraph (c).
new text end
Sec. 5. new text begin COMMISSIONER DUTY TO SEEK FEDERAL APPROVAL.
new text end
new text begin
The commissioner of human services shall seek federal approval that is necessary to
implement Minnesota Statutes, sections 256B.0621, subdivision 10; and 256B.0625,
subdivision 20, for interactive video contact.
new text end