HF 669

as introduced - 94th Legislature (2025 - 2026) Posted on 03/24/2025 04:08pm

A bill for an act
relating to human services; modifying children's mental health programs;
appropriating money; amending Minnesota Statutes 2024, sections 245.4901,
subdivision 3; 256B.0625, subdivisions 17, 18h; 256B.0943, subdivisions 1, 2.

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

Section 1.

Minnesota Statutes 2024, section 245.4901, subdivision 3, is amended to read:

Subd. 3.

Allowable grant activities and related expenses.

(a) Allowable grant activities
and related expenses may include but are not limited to:

(1) identifying and diagnosing mental health conditions and substance use disorders of
students;

(2) delivering mental health and substance use disorder treatment and services to students
and their families, including via telehealth consistent with section 256B.0625, subdivision
3b;

(3) supporting families in meeting their child's needs, including new text begin accessing needed mental
health services to support the parent in caregiving and new text end navigating health care, social service,
and juvenile justice systems;

(4) providing transportation for students receiving school-linked behavioral health
services when school is not in session;

(5) building the capacity of schools to meet the needs of students with mental health and
substance use disorder concerns, including school staff development activities for licensed
and nonlicensed staff; and

(6) purchasing equipment, connection charges, on-site coordination, set-up fees, and
site fees in order to deliver school-linked behavioral health services via telehealth.

(b) Grantees shall obtain all available third-party reimbursement sources as a condition
of receiving a grant. For purposes of this grant program, a third-party reimbursement source
excludes a public school as defined in section 120A.20, subdivision 1. Grantees shall serve
students regardless of health coverage status or ability to pay.

Sec. 2.

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. new text begin The
administrative agency must provide assisted transport to any client 20 years of age or younger
found eligible for unassisted transport, unless either the client is 16 years of age or older
and declines the upgrade, or the client is 15 years of age or younger and the client's parent
or guardian declines the upgrade on the client's behalf. new text end 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 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.

new text begin (u) The medical assistance reimbursement rates for unassisted transport and assisted
transport provided to clients under the age of 21 by a nonemergency medical transportation
service provider certified as a type III school bus provider are equal to 125 percent of the
respective base and mileage rates in paragraph (p), clauses (3) and (4).
new text end

new text begin EFFECTIVE DATE. new text end

new text begin This section is effective January 1, 2026.
new text end

Sec. 3.

Minnesota Statutes 2024, section 256B.0625, subdivision 18h, is amended to read:

Subd. 18h.

Nonemergency medical transportation provisions related to managed
care.

(a) The following nonemergency medical transportation (NEMT) subdivisions apply
to managed care plans and county-based purchasing plans:

(1) subdivision 17, deleted text begin paragraphs deleted text end new text begin paragraph new text end (a) deleted text begin , (b), (i), and (n) deleted text end ;

new text begin (2) subdivision 17, paragraph (c);
new text end

new text begin (3) subdivision 17, paragraph (l);
new text end

new text begin (4) subdivision 17, paragraph (q);
new text end

new text begin (5) subdivision 17, paragraph (u);
new text end

deleted text begin (2) deleted text end new text begin (6) new text end subdivision 18; and

deleted text begin (3) deleted text end new text begin (7) new text end subdivision 18a.

(b) A nonemergency medical transportation provider must comply with the operating
standards for special transportation service specified in sections 174.29 to 174.30 and
Minnesota Rules, chapter 8840. Publicly operated transit systems, volunteers, and not-for-hire
vehicles are exempt from the requirements in this paragraph.

(c) Managed care plans and county-based purchasing plans must provide a fuel adjustment
for NEMT rates when fuel exceeds $3 per gallon. new text begin This paragraph expires if federal approval
is not received for this paragraph at any time.
new text end

new text begin (d) new text end If, for any contract year, federal approval is not received for deleted text begin this deleted text end new text begin the provisions listed
in new text end paragraph new text begin (e) new text end , 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 deleted text begin this
provision deleted text end new text begin those provisions new text end . 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 deleted text begin this deleted text end new text begin the provisions listed in new text end paragraph new text begin (e) new text end . deleted text begin This paragraph expires if federal
approval is not received for this paragraph at any time.
deleted text end

new text begin (e) Paragraph (d) applies to the following provisions:
new text end

new text begin (1) paragraph (a), clause (5); and
new text end

new text begin (2) paragraph (c).
new text end

new text begin EFFECTIVE DATE. new text end

new text begin This section is effective January 1, 2026.
new text end

Sec. 4.

Minnesota Statutes 2024, section 256B.0943, subdivision 1, is amended to read:

Subdivision 1.

Definitions.

(a) For purposes of this section, the following terms have
the meanings given them.

(b) "Children's therapeutic services and supports" means the flexible package of mental
health services for children who require varying therapeutic and rehabilitative levels of
intervention to treat a diagnosed emotional disturbance, as defined in section 245.4871,
subdivision 15, or a diagnosed mental illness, as defined in section 245.462, subdivision
20. The services are time-limited interventions that are delivered using various treatment
modalities and combinations of services designed to reach treatment outcomes identified
in the individual treatment plan.

(c) "Clinical trainee" means a staff person who is qualified according to section 245I.04,
subdivision 6.

(d) "Crisis planning" has the meaning given in section 245.4871, subdivision 9a.

(e) "Culturally competent provider" means a provider who understands and can utilize
to a client's benefit the client's culture when providing services to the client. A provider
may be culturally competent because the provider is of the same cultural or ethnic group
as the client or the provider has developed the knowledge and skills through training and
experience to provide services to culturally diverse clients.

(f) "Day treatment program" for children means a site-based structured mental health
program consisting of psychotherapy for three or more individuals and individual or group
skills training provided by a team, under the treatment supervision of a mental health
professional.

(g) "Direct service time" means the time that a mental health professional, clinical trainee,
mental health practitioner, or mental health behavioral aide spends face-to-face with a client
and the client's family or providing covered services through telehealth as defined under
section 256B.0625, subdivision 3b. Direct service time includes time in which the provider
obtains a client's history, develops a client's treatment plan, records individual treatment
outcomes, or provides service components of children's therapeutic services and supports.
Direct service time does not include time doing work before and after providing direct
services, including scheduling or maintaining clinical records.

(h) "Direction of mental health behavioral aide" means the activities of a mental health
professional, clinical trainee, or mental health practitioner in guiding the mental health
behavioral aide in providing services to a client. The direction of a mental health behavioral
aide must be based on the client's individual treatment plan and meet the requirements in
subdivision 6, paragraph (b), clause (7).

(i) "Emotional disturbance" has the meaning given in section 245.4871, subdivision 15.

(j) "Individual treatment plan" means the plan described in section 245I.10, subdivisions
7 and 8.

(k) "Mental health behavioral aide services" means medically necessary one-on-one
activities performed by a mental health behavioral aide qualified according to section
245I.04, subdivision 16, to assist a child retain or generalize psychosocial skills as previously
trained by a mental health professional, clinical trainee, or mental health practitioner and
as described in the child's individual treatment plan and individual behavior plan. Activities
involve working directly with the child or child's family as provided in subdivision 9,
paragraph (b), clause (4).

(l) "Mental health certified family peer specialist" means a staff person who is qualified
according to section 245I.04, subdivision 12.

(m) "Mental health practitioner" means a staff person who is qualified according to
section 245I.04, subdivision 4.

(n) "Mental health professional" means a staff person who is qualified according to
section 245I.04, subdivision 2.

(o) "Mental health service plan development" includes:

(1) development and revision of a child's individual treatment plan; and

(2) administering and reporting standardized outcome measurements approved by the
commissioner, as periodically needed to evaluate the effectiveness of treatment.

(p) "Mental illness," for persons at least age 18 but under age 21, has the meaning given
in section 245.462, subdivision 20, paragraph (a).

(q) "Psychotherapy" means the treatment described in section 256B.0671, subdivision
11.

(r) "Rehabilitative services" or "psychiatric rehabilitation services" means interventions
to: (1) restore a child or adolescent to an age-appropriate developmental trajectory that had
been disrupted by a psychiatric illness; or (2) enable the child to self-monitor, compensate
for, cope with, counteract, or replace psychosocial skills deficits or maladaptive skills
acquired over the course of a psychiatric illness. Psychiatric rehabilitation services for
children combine coordinated psychotherapy to address internal psychological, emotional,
and intellectual processing deficits, and skills training to restore personal and social
functioning. Psychiatric rehabilitation services establish a progressive series of goals with
each achievement building upon a prior achievement.

(s) "Skills training" means individual, family, or group training, delivered by or under
the supervision of a mental health professional, designed to facilitate the acquisition of
psychosocial skills that are medically necessary to rehabilitate the child to an age-appropriate
developmental trajectory heretofore disrupted by a psychiatric illness or to enable the child
to self-monitor, compensate for, cope with, counteract, or replace skills deficits or
maladaptive skills acquired over the course of a psychiatric illness. Skills training is subject
to the service delivery requirements under subdivision 9, paragraph (b), clause (2).

(t) "Standard diagnostic assessment" means the assessment described in section 245I.10,
subdivision 6.

(u) "Treatment supervision" means the supervision described in section 245I.06.

new text begin (v) "Transition to community living services" means services that:
new text end

new text begin (1) maintain continuity of contact between the children's therapeutic services and supports
provider and the client and the client's family;
new text end

new text begin (2) facilitate discharge from a hospital, juvenile detention, or residential treatment setting;
and
new text end

new text begin (3) support the client's integration into the child's family and community.
new text end

new text begin Transition to community living services are not intended to provide other types of services
within children's therapeutic services and supports.
new text end

Sec. 5.

Minnesota Statutes 2024, section 256B.0943, subdivision 2, is amended to read:

Subd. 2.

Covered service components of children's therapeutic services and
supports.

(a) Subject to federal approval, medical assistance covers medically necessary
children's therapeutic services and supports when the services are provided by an eligible
provider entity certified under and meeting the standards in this section. The provider entity
must make reasonable and good faith efforts to report individual client outcomes to the
commissioner, using instruments and protocols approved by the commissioner.

(b) The service components of children's therapeutic services and supports are:

(1) patient and/or family psychotherapy, family psychotherapy, psychotherapy for crisis,
and group psychotherapy;

(2) individual, family, or group skills training provided by a mental health professional,
clinical trainee, or mental health practitioner;

(3) crisis planning;

(4) mental health behavioral aide services;

(5) direction of a mental health behavioral aide;

(6) mental health service plan development; deleted text begin and
deleted text end

(7) children's day treatment new text begin ; and
new text end

new text begin (8) transition to community living services new text end .

Sec. 6. new text begin APPROPRIATION; SCHOOL-LINKED BEHAVIORAL HEALTH GRANTS.
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 for school-linked behavioral health grants
under Minnesota Statutes, section 245.4901.
new text end