HF 2143

as introduced - 94th Legislature (2025 - 2026) Posted on 03/10/2025 02:46pm

A bill for an act
relating to mental health; modifying the definition of mental illness; making changes
to medical assistance transportation reimbursement rates; establishing a grant
program for children at risk of bipolar disorder; requiring a report; appropriating
money for the children's first episode of psychosis program; amending Minnesota
Statutes 2024, sections 62A.673, subdivision 2; 245.462, subdivision 20;
256B.0625, subdivision 17.

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

Section 1.

Minnesota Statutes 2024, section 62A.673, subdivision 2, is amended to read:

Subd. 2.

Definitions.

(a) For purposes of this section, the terms defined in this subdivision
have the meanings given.

(b) "Distant site" means a site at which a health care provider is located while providing
health care services or consultations by means of telehealth.

(c) "Health care provider" means a health care professional who is licensed or registered
by the state to perform health care services within the provider's scope of practice and in
accordance with state law. A health care provider includes a mental health professional
under section 245I.04, subdivision 2; a mental health practitioner under section 245I.04,
subdivision 4; a clinical trainee under section 245I.04, subdivision 6; a treatment coordinator
under section 245G.11, subdivision 7; an alcohol and drug counselor under section 245G.11,
subdivision 5; and a recovery peer under section 245G.11, subdivision 8.

(d) "Health carrier" has the meaning given in section 62A.011, subdivision 2.

(e) "Health plan" has the meaning given in section 62A.011, subdivision 3. Health plan
includes dental plans as defined in section 62Q.76, subdivision 3, but does not include dental
plans that provide indemnity-based benefits, regardless of expenses incurred, and are designed
to pay benefits directly to the policy holder.

(f) "Originating site" means a site at which a patient is located at the time health care
services are provided to the patient by means of telehealth. For purposes of store-and-forward
technology, the originating site also means the location at which a health care provider
transfers or transmits information to the distant site.

(g) "Store-and-forward technology" means the asynchronous electronic transfer or
transmission of a patient's medical information or data from an originating site to a distant
site for the purposes of diagnostic and therapeutic assistance in the care of a patient.

(h) "Telehealth" means the delivery of health care services or consultations through the
use of real time two-way interactive audio and visual communications to provide or support
health care delivery and facilitate the assessment, diagnosis, consultation, treatment,
education, and care management of a patient's health care. Telehealth includes the application
of secure video conferencing, store-and-forward technology, and synchronous interactions
between a patient located at an originating site and a health care provider located at a distant
site. deleted text begin Until July 1, 2025, deleted text end Telehealth also includes audio-only communication between a
health care provider and a patient in accordance with subdivision 6, paragraph (b). Telehealth
does not include communication between health care providers that consists solely of a
telephone conversation, email, or facsimile transmission. Telehealth does not include
communication between a health care provider and a patient that consists solely of an email
or facsimile transmission. Telehealth does not include telemonitoring services as defined
in paragraph (i).

(i) "Telemonitoring services" means the remote monitoring of clinical data related to
the enrollee's vital signs or biometric data by a monitoring device or equipment that transmits
the data electronically to a health care provider for analysis. Telemonitoring is intended to
collect an enrollee's health-related data for the purpose of assisting a health care provider
in assessing and monitoring the enrollee's medical condition or status.

Sec. 2.

Minnesota Statutes 2024, section 245.462, subdivision 20, is amended to read:

Subd. 20.

Mental illness.

(a) "Mental illness" means an organic disorder of the brain or
a clinically significant disorder of thought, mood, perception, orientation, memory, or
behavior that is detailed in a diagnostic codes list published by the commissioner, and that
seriously limits a person's capacity to function in primary aspects of daily living such as
personal relations, living arrangements, work, and recreation.

(b) An "adult with acute mental illness" means an adult who has a mental illness that is
serious enough to require prompt intervention.

(c) For purposes of new text begin enrolling in new text end case management and community support services, a
"person with serious and persistent mental illness" means an adult who has a mental illness
and meets at least one of the following criteria:

(1) the adult has undergone deleted text begin two deleted text end new text begin one new text end or more episodes of inpatient new text begin , residential, or crisis
residential new text end care for a mental illness within the preceding deleted text begin 24 deleted text end new text begin 12 new text end months;

(2) the adult has experienced a continuous psychiatric hospitalization or residential
treatment exceeding six months' duration within the preceding 12 months;

(3) the adult has been treated by a crisis team two or more times within the preceding
24 months;

(4) the adult:

(i) has a diagnosis of schizophrenia, bipolar disorder, major depression, schizoaffective
disorder, new text begin posttraumatic stress disorder, generalized anxiety disorder, panic disorder, eating
disorder, new text end or borderline personality disorder;

(ii) indicates a significant impairment in functioning; and

(iii) has a written opinion from a mental health professional, in the last three years,
stating that the adult is reasonably likely to have future episodes requiring inpatient or
residential treatment, of a frequency described in clause (1) or (2), new text begin or the need for in-home
services to remain in one's home, new text end unless ongoing case management or community support
services are provided;

(5) the adult has, in the last deleted text begin three deleted text end new text begin five new text end years, been committed by a court as a person deleted text begin who
is mentally ill deleted text end new text begin with a mental illness new text end under chapter 253B, or the adult's commitment has been
stayed or continued; new text begin or
new text end

deleted text begin (6) the adult (i) was eligible under clauses (1) to (5), but the specified time period has
expired or the adult was eligible as a child under section 245.4871, subdivision 6; and (ii)
has a written opinion from a mental health professional, in the last three years, stating that
the adult is reasonably likely to have future episodes requiring inpatient or residential
treatment, of a frequency described in clause (1) or (2), unless ongoing case management
or community support services are provided; or
deleted text end

deleted text begin (7) deleted text end new text begin (6) new text end the adult was eligible as a child under section 245.4871, subdivision 6, and is
age 21 or younger.

new text begin (d) Adults may continue to receive case management or community support services if,
in the written opinion of a mental health professional, the person needs case management
or community support services to maintain the person's recovery.
new text end

Sec. 3.

Minnesota Statutes 2024, section 256B.0625, subdivision 17, is amended to read:

Subd. 17.

Transportation costs.

(a) "Nonemergency medical transportation service"
means motor vehicle transportation provided by a public or private person that serves
Minnesota health care program beneficiaries who do not require emergency ambulance
service, as defined in section 144E.001, subdivision 3, to obtain covered medical services.

(b) For purposes of this subdivision, "rural urban commuting area" or "RUCA" means
a census-tract based classification system under which a geographical area is determined
to be urban, rural, or super rural.

(c) Medical assistance covers medical transportation costs incurred solely for obtaining
emergency medical care or transportation costs incurred by eligible persons in obtaining
emergency or nonemergency medical care when paid directly to an ambulance company,
nonemergency medical transportation company, or other recognized providers of
transportation services. Medical transportation must be provided by:

(1) nonemergency medical transportation providers who meet the requirements of this
subdivision;

(2) ambulances, as defined in section 144E.001, subdivision 2;

(3) taxicabs that meet the requirements of this subdivision;

(4) public transportation, within the meaning of "public transportation" as defined in
section 174.22, subdivision 7; or

(5) not-for-hire vehicles, including volunteer drivers, as defined in section 65B.472,
subdivision 1, paragraph (p).

(d) Medical assistance covers nonemergency medical transportation provided by
nonemergency medical transportation providers enrolled in the Minnesota health care
programs. All nonemergency medical transportation providers must comply with the
operating standards for special transportation service as defined in sections 174.29 to 174.30
and Minnesota Rules, chapter 8840, and all drivers must be individually enrolled with the
commissioner and reported on the claim as the individual who provided the service. All
nonemergency medical transportation providers shall bill for nonemergency medical
transportation services in accordance with Minnesota health care programs criteria. Publicly
operated transit systems, volunteers, and not-for-hire vehicles are exempt from the
requirements outlined in this paragraph.

(e) An organization may be terminated, denied, or suspended from enrollment if:

(1) the provider has not initiated background studies on the individuals specified in
section 174.30, subdivision 10, paragraph (a), clauses (1) to (3); or

(2) the provider has initiated background studies on the individuals specified in section
174.30, subdivision 10, paragraph (a), clauses (1) to (3), and:

(i) the commissioner has sent the provider a notice that the individual has been
disqualified under section 245C.14; and

(ii) the individual has not received a disqualification set-aside specific to the special
transportation services provider under sections 245C.22 and 245C.23.

(f) The administrative agency of nonemergency medical transportation must:

(1) adhere to the policies defined by the commissioner;

(2) pay nonemergency medical transportation providers for services provided to
Minnesota health care programs beneficiaries to obtain covered medical services;

(3) provide data monthly to the commissioner on appeals, complaints, no-shows, canceled
trips, and number of trips by mode; and

(4) by July 1, 2016, in accordance with subdivision 18e, utilize a web-based single
administrative structure assessment tool that meets the technical requirements established
by the commissioner, reconciles trip information with claims being submitted by providers,
and ensures prompt payment for nonemergency medical transportation services.

(g) Until the commissioner implements the single administrative structure and delivery
system under subdivision 18e, clients shall obtain their level-of-service certificate from the
commissioner or an entity approved by the commissioner that does not dispatch rides for
clients using modes of transportation under paragraph (l), clauses (4), (5), (6), and (7).

(h) The commissioner may use an order by the recipient's attending physician, advanced
practice registered nurse, physician assistant, or a medical or mental health professional to
certify that the recipient requires nonemergency medical transportation services.
Nonemergency medical transportation providers shall perform driver-assisted services for
eligible individuals, when appropriate. Driver-assisted service includes passenger pickup
at and return to the individual's residence or place of business, assistance with admittance
of the individual to the medical facility, and assistance in passenger securement or in securing
of wheelchairs, child seats, or stretchers in the vehicle.

(i) Nonemergency medical transportation providers must take clients to the health care
provider using the most direct route, and must not exceed 30 miles for a trip to a primary
care provider or 60 miles for a trip to a specialty care provider, unless the client receives
authorization from the local agency.

(j) Nonemergency medical transportation providers may not bill for separate base rates
for the continuation of a trip beyond the original destination. Nonemergency medical
transportation providers must maintain trip logs, which include pickup and drop-off times,
signed by the medical provider or client, whichever is deemed most appropriate, attesting
to mileage traveled to obtain covered medical services. Clients requesting client mileage
reimbursement must sign the trip log attesting mileage traveled to obtain covered medical
services.

(k) The administrative agency shall use the level of service process established by the
commissioner to determine the client's most appropriate mode of transportation. If public
transit or a certified transportation provider is not available to provide the appropriate service
mode for the client, the client may receive a onetime service upgrade.

(l) The covered modes of transportation are:

(1) client reimbursement, which includes client mileage reimbursement provided to
clients who have their own transportation, or to family or an acquaintance who provides
transportation to the client;

(2) volunteer transport, which includes transportation by volunteers using their own
vehicle;

(3) unassisted transport, which includes transportation provided to a client by a taxicab
or public transit. If a taxicab or public transit is not available, the client can receive
transportation from another nonemergency medical transportation provider;

(4) assisted transport, which includes transport provided to clients who require assistance
by a nonemergency medical transportation provider;

(5) lift-equipped/ramp transport, which includes transport provided to a client who is
dependent on a device and requires a nonemergency medical transportation provider with
a vehicle containing a lift or ramp;

(6) protected transport, which includes transport provided to a client who has received
a prescreening that has deemed other forms of transportation inappropriate and who requires
a provider: (i) with a protected vehicle that is not an ambulance or police car and has safety
locks, a video recorder, and a transparent thermoplastic partition between the passenger and
the vehicle driver; and (ii) who is certified as a protected transport provider; and

(7) stretcher transport, which includes transport for a client in a prone or supine position
and requires a nonemergency medical transportation provider with a vehicle that can transport
a client in a prone or supine position.

(m) The local agency shall be the single administrative agency and shall administer and
reimburse for modes defined in paragraph (l) according to paragraphs (p) and (q) when the
commissioner has developed, made available, and funded the web-based single administrative
structure, assessment tool, and level of need assessment under subdivision 18e. The local
agency's financial obligation is limited to funds provided by the state or federal government.

(n) The commissioner shall:

(1) verify that the mode and use of nonemergency medical transportation is appropriate;

(2) verify that the client is going to an approved medical appointment; and

(3) investigate all complaints and appeals.

(o) The administrative agency shall pay for the services provided in this subdivision and
seek reimbursement from the commissioner, if appropriate. As vendors of medical care,
local agencies are subject to the provisions in section 256B.041, the sanctions and monetary
recovery actions in section 256B.064, and Minnesota Rules, parts 9505.2160 to 9505.2245.

(p) Payments for nonemergency medical transportation must be paid based on the client's
assessed mode under paragraph (k), not the type of vehicle used to provide the service. The
medical assistance reimbursement rates for nonemergency medical transportation services
that are payable by or on behalf of the commissioner for nonemergency medical
transportation services are:

(1) $0.22 per mile for client reimbursement;

(2) up to 100 percent of the Internal Revenue Service business deduction rate for volunteer
transport;

(3) equivalent to the standard fare for unassisted transport when provided by public
transit, and $12.10 for the base rate and $1.43 per mile when provided by a nonemergency
medical transportation provider;

(4) $14.30 for the base rate and $1.43 per mile for assisted transport;

(5) $19.80 for the base rate and $1.70 per mile for lift-equipped/ramp transport;

(6) $75 for the base rate new text begin for the first 100 miles and an additional $75 for trips over 100
miles new text end and $2.40 per mile for protected transport; and

(7) $60 for the base rate and $2.40 per mile for stretcher transport, and $9 per trip for
an additional attendant if deemed medically necessary.

(q) The base rate for nonemergency medical transportation services in areas defined
under RUCA to be super rural is equal to 111.3 percent of the respective base rate in
paragraph (p), clauses (1) to (7). The mileage rate for nonemergency medical transportation
services in areas defined under RUCA to be rural or super rural areas is:

(1) for a trip equal to 17 miles or less, equal to 125 percent of the respective mileage
rate in paragraph (p), clauses (1) to (7); and

(2) for a trip between 18 and 50 miles, equal to 112.5 percent of the respective mileage
rate in paragraph (p), clauses (1) to (7).

(r) For purposes of reimbursement rates for nonemergency medical transportation services
under paragraphs (p) and (q), the zip code of the recipient's place of residence shall determine
whether the urban, rural, or super rural reimbursement rate applies.

(s) The commissioner, when determining reimbursement rates for nonemergency medical
transportation under paragraphs (p) and (q), shall exempt all modes of transportation listed
under paragraph (l) from Minnesota Rules, part 9505.0445, item R, subitem (2).

(t) Effective for the first day of each calendar quarter in which the price of gasoline as
posted publicly by the United States Energy Information Administration exceeds $3.00 per
gallon, the commissioner shall adjust the rate paid per mile in paragraph (p) by one percent
up or down for every increase or decrease of ten cents for the price of gasoline. The increase
or decrease must be calculated using a base gasoline price of $3.00. The percentage increase
or decrease must be calculated using the average of the most recently available price of all
grades of gasoline for Minnesota as posted publicly by the United States Energy Information
Administration.

Sec. 4. new text begin EARLY EPISODE OF BIPOLAR DISORDER GRANT PROGRAM.
new text end

new text begin Subdivision 1. new text end

new text begin Creation. new text end

new text begin The early episode of bipolar disorder grant program is
established in the Department of Human Services to fund evidence-based interventions for
youth and young adults at risk of developing or experiencing an early episode of bipolar
disorder. Early episode of bipolar disorder services are eligible for children's mental health
grants as specified in Minnesota Statutes, section 245.4889, subdivision 1, paragraph (b),
clause (15). The Department of Human Services shall seek to establish programs around
Minnesota.
new text end

new text begin Subd. 2. new text end

new text begin Activities. new text end

new text begin (a) All grant programs must:
new text end

new text begin (1) provide intensive treatment and support for adolescents and young adults experiencing
or at risk of experiencing early episodes of bipolar disorder. Intensive treatment and support
includes medication management, psychoeducation for an individual and an individual's
family, case management, employment support, education support, cognitive behavioral
approaches, social skills training, peer and family peer support, crisis planning, and stress
management;
new text end

new text begin (2) conduct outreach and provide training and guidance to mental health and health care
professionals, including postsecondary health clinicians, on bipolar disorder symptoms,
screening tools, the grant program, and best practices; and
new text end

new text begin (3) use all available funding streams.
new text end

new text begin (b) Grant money may also be used to pay for housing or travel expenses for individuals
receiving services or to address other barriers preventing individuals and their families from
participating in early episode of bipolar disorder services.
new text end

new text begin Subd. 3. new text end

new text begin Eligibility. new text end

new text begin Program activities must be provided to people 15 to 40 years old
with early signs of or experiencing bipolar disorder.
new text end

new text begin Subd. 4. new text end

new text begin Outcomes. new text end

new text begin Evaluation of program activities must utilize evidence-based
practices and must include the following outcome evaluation criteria:
new text end

new text begin (1) whether individuals experience a reduction in symptoms;
new text end

new text begin (2) whether individuals experience a decrease in inpatient mental health hospitalizations
or interactions with the criminal justice system; and
new text end

new text begin (3) whether individuals experience an increase in educational attainment or employment.
new text end

new text begin Subd. 5. new text end

new text begin Federal aid or grants. new text end

new text begin The commissioner of human services must comply with
all conditions and requirements necessary to receive federal aid or grants. The Department
of Human Services must provide a yearly report to the chairs of the senate Finance Committee
and house of representatives Ways and Means Committee detailing the use of state and
federal funds, number of programs funded, number of people served, and evaluation data.
new text end

Sec. 5. new text begin CHILDREN'S FIRST EPISODE OF PSYCHOSIS.
new text end

new text begin $....... in fiscal year 2026 and $....... in fiscal year 2027 are appropriated from the general
fund to the commissioner of human services to implement a first episode of psychosis grant
under Minnesota Statutes, section 245.4905. This amount is added to the base. New money
may be used to fully fund current programs, increase a current program's capacity, and
expand programs to outside the metropolitan counties. The commissioner of human services
must continue to fund current programs to ensure stability and continuity of care, providing
that the program has met requirements for past usage of funds.
new text end