HF 2586

as introduced - 94th Legislature (2025 - 2026) Posted on 03/26/2025 12:35pm

A bill for an act
relating to state-operated services; extending cost of care exemption for certain
committed persons and 48-hour rule for admissions; establishing the Priority
Admission Review Panel; requiring creation of a Direct Care and Treatment
admissions dashboard and a limited exemption for admissions from hospital
settings; requiring a report; amending Minnesota Statutes 2024, sections 246.54,
subdivisions 1a, 1b; 253B.10, subdivision 1.

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

Section 1.

Minnesota Statutes 2024, section 246.54, subdivision 1a, is amended to read:

Subd. 1a.

Anoka-Metro Regional Treatment Center.

(a) A county's payment of the
cost of care provided at Anoka-Metro Regional Treatment Center shall be according to the
following schedule:

(1) zero percent for the first 30 days;

(2) 20 percent for days 31 and over if the stay is determined to be clinically appropriate
for the client; and

(3) 100 percent for each day during the stay, including the day of admission, when the
facility determines that it is clinically appropriate for the client to be discharged.

(b) If payments received by the state under sections 246.50 to 246.53 exceed 80 percent
of the cost of care for days over 31 for clients who meet the criteria in paragraph (a), clause
(2), the county shall be responsible for paying the state only the remaining amount. The
county shall not be entitled to reimbursement from the client, the client's estate, or from the
client's relatives, except as provided in section 246.53.

(c) deleted text begin Between July 1, 2023, and March 31 deleted text end new text begin Beginning July 1 new text end , 2025, the county is not
responsible for the cost of care under paragraph (a), clause (3), for a person who is committed
as a person who has a mental illness and is dangerous to the public under section 253B.18
and who is awaiting transfer to another state-operated facility or program. deleted text begin This paragraph
expires March 31, 2025.
deleted text end

(d) deleted text begin Between April 1, 2025, and June 30 deleted text end new text begin Beginning July 1 new text end , 2025, the county is not
responsible for the cost of care under paragraph (a), clause (3), for a person who is civilly
committed, if the client is awaiting transfer:

(1) to a facility operated by the Department of Corrections; or

(2) to another state-operated facility or program, and the Direct Care and Treatment
executive medical director's office or a designee has determined that:

(i) the client meets criteria for admission to that state-operated facility or program; and

(ii) the state-operated facility or program is the only facility or program that can
reasonably serve the client. deleted text begin This paragraph expires June 30, 2025.
deleted text end

(e) Notwithstanding any law to the contrary, the client is not responsible for payment
of the cost of care under this subdivision.

new text begin EFFECTIVE DATE. new text end

new text begin This section is effective retroactively from March 30, 2025.
new text end

Sec. 2.

Minnesota Statutes 2024, section 246.54, subdivision 1b, is amended to read:

Subd. 1b.

Community behavioral health hospitals.

(a) A county's payment of the cost
of care provided at state-operated community-based behavioral health hospitals for adults
and children shall be according to the following schedule:

(1) 100 percent for each day during the stay, including the day of admission, when the
facility determines that it is clinically appropriate for the client to be discharged; and

(2) the county shall not be entitled to reimbursement from the client, the client's estate,
or from the client's relatives, except as provided in section 246.53.

(b) deleted text begin Between July 1, 2023, and March 31 deleted text end new text begin Beginning July 1 new text end , 2025, the county is not
responsible for the cost of care under paragraph (a), clause (1), for a person committed as
a person who has a mental illness and is dangerous to the public under section 253B.18 and
who is awaiting transfer to another state-operated facility or program. deleted text begin This paragraph expires
March 31, 2025.
deleted text end

(c) deleted text begin Between April 1, 2025, and June 30 deleted text end new text begin Beginning July 1 new text end , 2025, the county is not
responsible for the cost of care under paragraph (a), clause (1), for a person who is civilly
committed, if the client is awaiting transfer:

(1) to a facility operated by the Department of Corrections; or

(2) to another state-operated facility or program, and the Direct Care and Treatment
executive medical director's office or a designee has determined that:

(i) the client meets criteria for admission to that state-operated facility or program; and

(ii) the state-operated facility or program is the only facility or program that can
reasonably serve the client. deleted text begin This paragraph expires June 30, 2025.
deleted text end

(d) Notwithstanding any law to the contrary, the client is not responsible for payment
of the cost of care under this subdivision.

new text begin EFFECTIVE DATE. new text end

new text begin This section is effective retroactively from March 30, 2025.
new text end

Sec. 3.

Minnesota Statutes 2024, section 253B.10, subdivision 1, is amended to read:

Subdivision 1.

Administrative requirements.

(a) When a person is committed, the
court shall issue a warrant or an order committing the patient to the custody of the head of
the treatment facility, state-operated treatment program, or community-based treatment
program. The warrant or order shall state that the patient meets the statutory criteria for
civil commitment.

(b) The executive board shall prioritize civilly committed patients being admitted from
jail or a correctional institution or who are referred to a state-operated treatment facility for
competency attainment or a competency examination under sections 611.40 to 611.59 for
admission to a medically appropriate state-operated direct care and treatment bed based on
the decisions of physicians in the executive medical director's office, using a priority
admissions framework. The framework must account for a range of factors for priority
admission, including but not limited to:

(1) the length of time the person has been on a waiting list for admission to a
state-operated direct care and treatment program since the date of the order under paragraph
(a), or the date of an order issued under sections 611.40 to 611.59;

(2) the intensity of the treatment the person needs, based on medical acuity;

(3) the person's revoked provisional discharge status;

(4) the person's safety and safety of others in the person's current environment;

(5) whether the person has access to necessary or court-ordered treatment;

(6) distinct and articulable negative impacts of an admission delay on the facility referring
the individual for treatment; and

(7) any relevant federal prioritization requirements.

Patients described in this paragraph must be admitted to a state-operated treatment program
within 48 hours. The commitment must be ordered by the court as provided in section
253B.09, subdivision 1, paragraph (d). Patients committed to a secure treatment facility or
less restrictive setting as ordered by the court under section 253B.18, subdivisions 1 and 2,
must be prioritized for admission to a state-operated treatment program using the priority
admissions framework in this paragraph.

(c) Upon the arrival of a patient at the designated treatment facility, state-operated
treatment program, or community-based treatment program, the head of the facility or
program shall retain the duplicate of the warrant and endorse receipt upon the original
warrant or acknowledge receipt of the order. The endorsed receipt or acknowledgment must
be filed in the court of commitment. After arrival, the patient shall be under the control and
custody of the head of the facility or program.

(d) Copies of the petition for commitment, the court's findings of fact and conclusions
of law, the court order committing the patient, the report of the court examiners, and the
prepetition report, and any medical and behavioral information available shall be provided
at the time of admission of a patient to the designated treatment facility or program to which
the patient is committed. Upon a patient's referral to the executive board for admission
pursuant to subdivision 1, paragraph (b), any inpatient hospital, treatment facility, jail, or
correctional facility that has provided care or supervision to the patient in the previous two
years shall, when requested by the treatment facility or executive board, provide copies of
the patient's medical and behavioral records to the executive board for purposes of
preadmission planning. This information shall be provided by the head of the treatment
facility to treatment facility staff in a consistent and timely manner and pursuant to all
applicable laws.

(e) Patients described in paragraph (b) must be admitted to a state-operated treatment
program within 48 hours of the Office of Executive Medical Director, under section 246C.09,
or a designee determining that a medically appropriate bed is available. This paragraph
expires on June 30, deleted text begin 2025 deleted text end new text begin 2027 new text end .

(f) Within four business days of determining which state-operated direct care and
treatment program or programs are appropriate for an individual, the executive medical
director's office or a designee must notify the source of the referral and the responsible
county human services agency, the individual being ordered to direct care and treatment,
and the district court that issued the order of the determination. The notice shall include
which program or programs are appropriate for the person's priority status. Any interested
person may provide additional information or request updated priority status about the
individual to the executive medical director's office or a designee while the individual is
awaiting admission. Updated priority status of an individual will only be disclosed to
interested persons who are legally authorized to receive private information about the
individual. When an available bed has been identified, the executive medical director's
office or a designee must notify the designated agency and the facility where the individual
is awaiting admission that the individual has been accepted for admission to a particular
state-operated direct care and treatment program and the earliest possible date the admission
can occur. The designated agency or facility where the individual is awaiting admission
must transport the individual to the admitting state-operated direct care and treatment
program no more than 48 hours after the offered admission date.

Sec. 4. new text begin PRIORITY ADMISSIONS REVIEW PANEL.
new text end

new text begin (a) The Priority Admissions Review Panel is established.
new text end

new text begin (b) The Direct Care and Treatment executive board shall appoint the members of the
panel. The panel must consist of all members who served on the Task Force on Priority
Admissions to State-Operated Treatment Programs under Laws 2023, chapter 61, article 8,
section 13, subdivision 2, and one member who has an active role as a union representative
representing staff at Direct Care and Treatment appointed by joint representatives of the
American Federation of State, County and Municipal Employees (AFSCME); Minnesota
Association of Professional Employees (MAPE); Minnesota Nurses Association (MNA);
Middle Management Association (MMA); and State Residential Schools Education
Association (SRSEA).
new text end

new text begin (c) The panel must:
new text end

new text begin (1) evaluate the 48-hour timeline for priority admissions required under Minnesota
Statutes, section 253B.10, subdivision 1, paragraph (b), and measure progress toward
implementing the recommendations of the task force;
new text end

new text begin (2) develop policy and legislative proposals related to the priority admissions timeline
in order to minimize litigation costs, maximize capacity in and access to direct care and
treatment programs, and address issues related to individuals awaiting admission to direct
care and treatment programs in jails and correctional institutions;
new text end

new text begin (3) by February 1, 2026, submit a written report to the chairs and ranking minority
members of the legislative committees with jurisdiction over public safety and human
services that includes legislative proposals to carry out recommendations; and
new text end

new text begin (4) review quarterly data provided by the executive board to measure the impact of
changes, including:
new text end

new text begin (i) priority admission waitlist data, including the time each individual spends on the
waitlist;
new text end

new text begin (ii) data regarding engagement by the admissions team;
new text end

new text begin (iii) priority notice data; and
new text end

new text begin (iv) other similar data relating to admissions.
new text end

Sec. 5. new text begin DIRECT CARE AND TREATMENT ADMISSIONS DASHBOARD.
new text end

new text begin (a) By January 1, 2026, the Direct Care and Treatment executive board must publish a
publicly accessible dashboard on the agency's website regarding referrals under Minnesota
Statutes, section 253B.10, subdivision 1, paragraph (b).
new text end

new text begin (b) The dashboard required under paragraph (a) must include data on:
new text end

new text begin (1) how many individuals are on the waitlists;
new text end

new text begin (2) how long the shortest, average, and longest wait times are for admission to Direct
Care and Treatment facilities; and
new text end

new text begin (3) the number of referrals, admissions, and waitlists and the length of time of individuals
on waitlists; and
new text end

new text begin (4) framework categories and referral sources.
new text end

new text begin (c) Any published data must be deidentified.
new text end

new text begin (d) Data on the dashboard are public data under Minnesota Statutes, section 13.03.
new text end

new text begin (e) The executive board must update the dashboard quarterly.
new text end

new text begin (f) The executive board must also include relevant admissions policies and contact
information for the Direct Care and Treatment Central Preadmission Office on the dashboard
required under paragraph (a).
new text end

new text begin (g) The executive board must provide information about an individual's relative placement
on the waitlist upon request by the individual or the individual's legal representative.
Information about the individual's relative placement on the waitlist must be designated as
confidential under Minnesota Statutes, section 13.02, subdivision 3, if the information
jeopardizes the health or wellbeing of the individual.
new text end

Sec. 6. new text begin DIRECTION FOR LIMITED EXCEPTION FOR ADMISSIONS FROM
HOSPITAL SETTINGS.
new text end

new text begin (a) The commissioner of human services or a designee must immediately approve an
exception to add up to ten patients per fiscal year who have been civilly committed and are
in hospital settings to the admission waitlist for medically appropriate direct care and
treatment beds under Minnesota Statutes, section 253B.10, subdivision 1, paragraph (b).
new text end

new text begin (b) The Direct Care and Treatment executive board is subject to the requirement under
paragraph (a) on and after the transfer of duties on July 1, 2025, from the commissioner of
human services to the executive board under Minnesota Statutes, section 246C.04.
new text end

new text begin (c) This section expires June 30, 2027.
new text end

new text begin EFFECTIVE DATE. new text end

new text begin This section is effective the day following final enactment.
new text end