1.1 	A bill for an act
1.2 	relating to human services; amending mental health provisions; changing 
1.3 	medical assistance reimbursement and eligibility; changing provider qualification 
1.4 	and training requirements; amending mental health behavioral aide services; 
1.5 	adding an excluded service;amending Minnesota Statutes 2008, sections 
1.6 	148C.11, subdivision 1; 245.4885, subdivision 1; 256B.0615, subdivisions 1, 3; 
1.7 	256B.0622, subdivision 8, by adding a subdivision; 256B.0623, subdivision 5; 
1.8 	256B.0624, subdivision 8; 256B.0625, subdivision 49; 256B.0943, subdivisions 
1.9 	1, 2, 4, 5, 6, 7, 9; 256B.0944, subdivision 5.
1.10 	BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF MINNESOTA:

1.11 	Section 1. Minnesota Statutes 2008, section 148C.11, subdivision 1, is amended to read:
1.12 		Subdivision 1.Other professionals. (a) Nothing in this chapter prevents members 
1.13 	of other professions or occupations from performing functions for which they are qualified 
1.14 	or licensed. This exception includes, but is not limited to: licensed physicians; registered 
1.15 	nurses; licensed practical nurses; licensed psychological practitioners; members of 
1.16 	the clergy; American Indian medicine men and women; licensed attorneys; probation 
1.17 	officers; licensed marriage and family therapists; licensed social workers; social workers 
1.18 	employed by city, county, or state agencies; licensed professional counselors; licensed 
1.19 	school counselors; registered occupational therapists or occupational therapy assistants; 
1.20 	city, county, or state employees when providing assessments or case management under 
1.21 	Minnesota Rules, chapter 9530; and ~~until July 1, 2009,~~ individuals providing integrated 
1.22 	dual-diagnosis treatment in adult mental health rehabilitative programs certified by the 
1.23 	Department of Human Services under section 256B.0622 or 256B.0623.
1.24 	(b) Nothing in this chapter prohibits technicians and resident managers in programs 
1.25 	licensed by the Department of Human Services from discharging their duties as provided 
1.26 	in Minnesota Rules, chapter 9530.
2.1 	(c) Any person who is exempt under this subdivision but who elects to obtain a 
2.2 	license under this chapter is subject to this chapter to the same extent as other licensees. 
2.3 	The board shall issue a license without examination to an applicant who is licensed or 
2.4 	registered in a profession identified in paragraph (a) if the applicant:
2.5 	(1) shows evidence of current licensure or registration; and
2.6 	(2) has submitted to the board a plan for supervision during the first 2,000 hours of 
2.7 	professional practice or has submitted proof of supervised professional practice that is 
2.8 	acceptable to the board.
2.9 	(d) Any person who is exempt from licensure under this section must not use a 
2.10 	title incorporating the words "alcohol and drug counselor" or "licensed alcohol and drug 
2.11 	counselor" or otherwise hold themselves out to the public by any title or description 
2.12 	stating or implying that they are engaged in the practice of alcohol and drug counseling, 
2.13 	or that they are licensed to engage in the practice of alcohol and drug counseling unless 
2.14 	that person is also licensed as an alcohol and drug counselor. Persons engaged in the 
2.15 	practice of alcohol and drug counseling are not exempt from the board's jurisdiction 
2.16 	solely by the use of one of the above titles.

2.17 	Sec. 2. Minnesota Statutes 2008, section 245.4885, subdivision 1, is amended to read:
2.18 		Subdivision 1.Admission criteria. The county board shall, prior to admission, 
2.19 	except in the case of emergency admission, determine the needed level of care for all 
2.20 	children referred for treatment of severe emotional disturbance in a treatment foster care 
2.21 	setting, residential treatment facility, or informally admitted to a regional treatment center 
2.22 	if public funds are used to pay for the services. ~~The county board shall also determine the~~ 
2.23 	~~needed level of care for all children admitted to an acute care hospital for treatment of~~ 
2.24 	~~severe emotional disturbance if public funds other than reimbursement under chapters~~ 
2.25 	~~256B and 256D are used to pay for the services.~~ The level of care determination shall 
2.26 	determine whether the proposed treatment:
2.27 	(1) is necessary;
2.28 	(2) is appropriate to the child's individual treatment needs;
2.29 	(3) cannot be effectively provided in the child's home; and
2.30 	(4) provides a length of stay as short as possible consistent with the individual 
2.31 	child's need.
2.32 	When a level of care determination is conducted, the county board may not 
2.33 	determine that referral or admission to a treatment foster care setting~~,~~ or residential 
2.34 	treatment facility~~, or acute care hospital~~ is not appropriate solely because services were 
2.35 	not first provided to the child in a less restrictive setting and the child failed to make 
3.1 	progress toward or meet treatment goals in the less restrictive setting. The level of care 
3.2 	determination must be based on a diagnostic assessment that includes a functional 
3.3 	assessment which evaluates family, school, and community living situations; and an 
3.4 	assessment of the child's need for care out of the home using a validated tool which 
3.5 	assesses a child's functional status and assigns an appropriate level of care. The validated 
3.6 	tool must be approved by the commissioner of human services. If a diagnostic assessment 
3.7 	including a functional assessment has been completed by a mental health professional 
3.8 	within the past 180 days, a new diagnostic assessment need not be completed unless in the 
3.9 	opinion of the current treating mental health professional the child's mental health status 
3.10 	has changed markedly since the assessment was completed. The child's parent shall be 
3.11 	notified if an assessment will not be completed and of the reasons. A copy of the notice 
3.12 	shall be placed in the child's file. Recommendations developed as part of the level of care 
3.13 	determination process shall include specific community services needed by the child and, 
3.14 	if appropriate, the child's family, and shall indicate whether or not these services are 
3.15 	available and accessible to the child and family.
3.16 	During the level of care determination process, the child, child's family, or child's 
3.17 	legal representative, as appropriate, must be informed of the child's eligibility for case 
3.18 	management services and family community support services and that an individual 
3.19 	family community support plan is being developed by the case manager, if assigned.
3.20 	The level of care determination shall comply with section 260C.212. Wherever 
3.21 	possible, the parent shall be consulted in the process, unless clinically inappropriate.
3.22 	The level of care determination, and placement decision, and recommendations for 
3.23 	mental health services must be documented in the child's record.
3.24 	An alternate review process may be approved by the commissioner if the county 
3.25 	board demonstrates that an alternate review process has been established by the county 
3.26 	board and the times of review, persons responsible for the review, and review criteria are 
3.27 	comparable to the standards in clauses (1) to (4).

3.28 	Sec. 3. Minnesota Statutes 2008, section 256B.0615, subdivision 1, is amended to read:
3.29 		Subdivision 1.Scope. Medical assistance covers mental health certified peers 
3.30 	specialists services, as established in subdivision 2, subject to federal approval, if provided 
3.31 	to recipients who are eligible for services under sections 256B.0622~~and~~,256B.0623, and 
3.32 	256B.0624 and are provided by a certified peer specialist who has completed the training 
3.33 	under subdivision 5.

3.34 	Sec. 4. Minnesota Statutes 2008, section 256B.0615, subdivision 3, is amended to read:
4.1 		Subd. 3.Eligibility. Peer support services may be made available to consumers 
4.2 	of (1) the intensive rehabilitative mental health services under section 256B.0622;~~and~~
4.3 	(2) adult rehabilitative mental health services under section 256B.0623; and (3) crisis 
4.4 	stabilization services under section 256B.0624.

4.5 	Sec. 5. Minnesota Statutes 2008, section 256B.0622, subdivision 8, is amended to read:
4.6 		Subd. 8.Medical assistance payment for intensive rehabilitative mental health 
4.7 	services. (a) Payment for residential and nonresidential services in this section shall be 
4.8 	based on one daily rate per provider inclusive of the following services received by an 
4.9 	eligible recipient in a given calendar day: all rehabilitative services under this section, 
4.10 	staff travel time to provide rehabilitative services under this section, and nonresidential 
4.11 	crisis stabilization services under section 256B.0624. 
4.12 	(b) Except as indicated in paragraph (c), payment will not be made to more than one 
4.13 	entity for each recipient for services provided under this section on a given day. If services 
4.14 	under this section are provided by a team that includes staff from more than one entity, the 
4.15 	team must determine how to distribute the payment among the members.
4.16 	(c) The host county shall recommend to the commissioner one rate for each entity 
4.17 	that will bill medical assistance for residential services under this section and ~~two rates~~
4.18 	one rate for each nonresidential provider. ~~The first nonresidential rate is for recipients who~~ 
4.19 	~~are not receiving residential services. The second nonresidential rate is for recipients~~ 
4.20 	~~who are temporarily receiving residential services and need continued contact with the~~ 
4.21 	~~nonresidential team to assure timely discharge from residential services.~~ In developing 
4.22 	these rates, the host county shall consider and document:
4.23 	(1) the cost for similar services in the local trade area;
4.24 	(2) ~~actual~~ that the proposed costs incurred by entities providing the services are 
4.25 	allowable, allocable and reasonable, and are consistent with federal reimbursement 
4.26 	requirements including Code of Federal Regulations, title 48, chapter 1, part 31 and Office 
4.27 	of Management and Budget Circular Number A-122;
4.28 	(3) the intensity and frequency of services to be provided to each recipient, including 
4.29 	the proposed overall number of units of service to be delivered;
4.30 	(4) the degree to which recipients will receive services other than services under 
4.31 	this section;
4.32 	(5) the costs of other services that will be separately reimbursed; and
4.33 	(6) input from the local planning process authorized by the adult mental health 
4.34 	initiative under section 245.4661, regarding recipients' service needs. 
5.1 	(d) The rate for intensive rehabilitative mental health services must exclude room 
5.2 	and board, as defined in section 256I.03, subdivision 6, and services not covered under 
5.3 	this section, such as partial hospitalization, home care, and inpatient services. Physician 
5.4 	services that are not separately billed may be included in the rate to the extent that a 
5.5 	psychiatrist is a member of the treatment team. The county's recommendation shall 
5.6 	specify the period for which the rate will be applicable, not to exceed two years. 
5.7 	(e) When services under this section are provided by an assertive community team, 
5.8 	case management functions must be an integral part of the team.
5.9 	(f) The rate for a provider must not exceed the rate charged by that provider for 
5.10 	the same service to other payors.
5.11 	(g) The commissioner shall approve or reject the county's rate recommendation, 
5.12 	based on the commissioner's own analysis of the criteria in paragraph (c).

5.13 	Sec. 6. Minnesota Statutes 2008, section 256B.0622, is amended by adding a 
5.14 	subdivision to read:
5.15 		Subd. 8a.Adjustments based on actual costs and units. (a) After each calendar 
5.16 	year, the commissioner shall compare actual costs and units of service for each provider to 
5.17 	the costs and units of service that were used as the basis for the approved rate.
5.18 	(b) For purposes of this subdivision, "revenue" means actual units of service 
5.19 	multiplied by the approved rate and "allowed cost" means costs that are consistent with 
5.20 	the budget that was used as the basis for the approved rate, or other costs subsequently 
5.21 	approved by the county and the commissioner based on the criteria in subdivision 8, 
5.22 	paragraph (c), clause (2).
5.23 	(c) If a provider's revenue is more than 105 percent of actual allowed costs, the 
5.24 	commissioner shall require repayment from the provider so that revenue does not exceed 
5.25 	105 percent of actual allowed costs. The repayment to the commissioner must be 
5.26 	proportional to the percent of total units of service reimbursed by the commissioner.
5.27 	(d) If a provider's revenue is less than 95 percent of actual allowed costs, the 
5.28 	commissioner shall adjust the rate so that the provider can recover 95 percent of actual 
5.29 	allowable costs. The resulting additional payment by the commissioner must be 
5.30 	proportional to the percent of total units of service reimbursed by the commissioner.
5.31 	(e) The commissioner is not obligated to adjust rates in successive years to offset 
5.32 	provider losses if actual units of service continue to be less than projected.

5.33 	Sec. 7. Minnesota Statutes 2008, section 256B.0623, subdivision 5, is amended to read:
6.1 		Subd. 5.Qualifications of provider staff. Adult rehabilitative mental health 
6.2 	services must be provided by qualified individual provider staff of a certified provider 
6.3 	entity. Individual provider staff must be qualified under one of the following criteria:
6.4 	(1) a mental health professional as defined in section 245.462, subdivision 18, 
6.5 	clauses (1) to (5). If the recipient has a current diagnostic assessment by a licensed 
6.6 	mental health professional as defined in section 245.462, subdivision 18, clauses (1) to 
6.7 	(5), recommending receipt of adult mental health rehabilitative services, the definition of 
6.8 	mental health professional for purposes of this section includes a person who is qualified 
6.9 	under section 245.462, subdivision 18, clause (6), and who holds a current and valid 
6.10 	national certification as a certified rehabilitation counselor or certified psychosocial 
6.11 	rehabilitation practitioner; 
6.12 	(2) a mental health practitioner as defined in section 245.462, subdivision 17. The 
6.13 	mental health practitioner must work under the clinical supervision of a mental health 
6.14 	professional; 
6.15 	(3) a certified peer specialist under section 256B.0615. The certified peer specialist 
6.16 	must work under the clinical supervision of a mental health professional; or
6.17 	(4) a mental health rehabilitation worker. A mental health rehabilitation worker 
6.18 	means a staff person working under the direction of a mental health practitioner or mental 
6.19 	health professional and under the clinical supervision of a mental health professional in 
6.20 	the implementation of rehabilitative mental health services as identified in the recipient's 
6.21 	individual treatment plan who:
6.22 	(i) is at least 21 years of age;
6.23 	(ii) has a high school diploma or equivalent;
6.24 	(iii) has successfully completed 30 hours of training during the ~~past~~ two years 
6.25 	immediately prior to the date of hire, or before provision of direct services, in all of 
6.26 	the following areas: recipient rights, recipient-centered individual treatment planning, 
6.27 	behavioral terminology, mental illness, co-occurring mental illness and substance abuse, 
6.28 	psychotropic medications and side effects, functional assessment, local community 
6.29 	resources, adult vulnerability, recipient confidentiality; and
6.30 	(iv) meets the qualifications in subitem (A) or (B):
6.31 	(A) has an associate of arts degree or two years full-time postsecondary education 
6.32 	in one of the behavioral sciences or human services~~, or~~; is a registered nurse without a 
6.33 	bachelor's degree~~,~~; or who within the previous ten years has:
6.34 	(1) three years of personal life experience with serious and persistent mental illness;
6.35 	(2) three years of life experience as a primary caregiver to an adult with a serious 
6.36 	mental illness or traumatic brain injury; or
7.1 	(3) 4,000 hours of supervised paid work experience in the delivery of mental health 
7.2 	services to adults with a serious mental illness or traumatic brain injury; or
7.3 	(B)(1) is fluent in the non-English language or competent in the culture of the 
7.4 	ethnic group to which at least 20 percent of the mental health rehabilitation worker's 
7.5 	clients belong;
7.6 	(2) receives during the first 2,000 hours of work, monthly documented individual 
7.7 	clinical supervision by a mental health professional;
7.8 	(3) has 18 hours of documented field supervision by a mental health professional 
7.9 	or practitioner during the first 160 hours of contact work with recipients, and at least six 
7.10 	hours of field supervision quarterly during the following year;
7.11 	(4) has review and cosignature of charting of recipient contacts during field 
7.12 	supervision by a mental health professional or practitioner; and
7.13 	(5) has ~~40~~ 15 hours of additional continuing education on mental health topics during 
7.14 	the first year of employment and 15 hours during every additional year of employment.

7.15 	Sec. 8. Minnesota Statutes 2008, section 256B.0624, subdivision 8, is amended to read:
7.16 		Subd. 8.Adult crisis stabilization staff qualifications. (a) Adult mental health 
7.17 	crisis stabilization services must be provided by qualified individual staff of a qualified 
7.18 	provider entity. Individual provider staff must have the following qualifications:
7.19 	(1) be a mental health professional as defined in section 245.462, subdivision 18, 
7.20 	clauses (1) to (5); 
7.21 	(2) be a mental health practitioner as defined in section 245.462, subdivision 17. 
7.22 	The mental health practitioner must work under the clinical supervision of a mental health 
7.23 	professional; or 
7.24 	(3) be a certified peer specialist under section 256B.0615. The certified peer 
7.25 	specialist must work under the clinical supervision of a mental health professional; or
7.26 	(4) be a mental health rehabilitation worker who meets the criteria in section 
7.27 	256B.0623, subdivision 5, clause (3); works under the direction of a mental health 
7.28 	practitioner as defined in section 245.462, subdivision 17, or under direction of a 
7.29 	mental health professional; and works under the clinical supervision of a mental health 
7.30 	professional. 
7.31 	(b) Mental health practitioners and mental health rehabilitation workers must have 
7.32 	completed at least 30 hours of training in crisis intervention and stabilization during 
7.33 	the past two years.

8.1 	Sec. 9. Minnesota Statutes 2008, section 256B.0625, subdivision 49, is amended to 
8.2 	read:
8.3 		Subd. 49. Community health worker. (a) Medical assistance covers the care 
8.4 	coordination and patient education services provided by a community health worker if 
8.5 	the community health worker has: 
8.6 	(1) received a certificate from the Minnesota State Colleges and Universities System 
8.7 	approved community health worker curriculum; or 
8.8 	(2) at least five years of supervised experience with an enrolled physician, registered 
8.9 	nurse, advanced practice registered nurse, mental health professional as defined in section 
8.10 	245.462, subdivision 18, clauses (1) to (5), and section 245.4871, subdivision 27, clauses 
8.11 	(1) to (5), or dentist, or at least five years of supervised experience by a certified public 
8.12 	health nurse operating under the direct authority of an enrolled unit of government. 
8.13 	Community health workers eligible for payment under clause (2) must complete the 
8.14 	certification program by January 1, 2010, to continue to be eligible for payment. 
8.15 	(b) Community health workers must work under the supervision of a medical 
8.16 	assistance enrolled physician, registered nurse, advanced practice registered nurse, 
8.17 	mental health professional as defined in section 245.462, subdivision 18, clauses (1) to 
8.18 	(5), and section 245.4871, subdivision 27, clauses (1) to (5), or dentist, or work under 
8.19 	the supervision of a certified public health nurse operating under the direct authority of 
8.20 	an enrolled unit of government. 
8.21 	(c) Care coordination and patient education services covered under this subdivision 
8.22 	include, but are not limited to, services relating to oral health and dental care. 

8.23 	Sec. 10. Minnesota Statutes 2008, section 256B.0943, subdivision 1, is amended to 
8.24 	read:
8.25 		Subdivision 1.Definitions. For purposes of this section, the following terms have 
8.26 	the meanings given them.
8.27 	(a) "Children's therapeutic services and supports" means the flexible package of 
8.28 	mental health services for children who require varying therapeutic and rehabilitative 
8.29 	levels of intervention. The services are time-limited interventions that are delivered using 
8.30 	various treatment modalities and combinations of services designed to reach treatment 
8.31 	outcomes identified in the individual treatment plan.
8.32 	(b) "Clinical supervision" means the overall responsibility of the mental health 
8.33 	professional for the control and direction of individualized treatment planning, service 
8.34 	delivery, and treatment review for each client. A mental health professional who is an 
8.35 	enrolled Minnesota health care program provider accepts full professional responsibility 
9.1 	for a supervisee's actions and decisions, instructs the supervisee in the supervisee's work, 
9.2 	and oversees or directs the supervisee's work.
9.3 	(c) "County board" means the county board of commissioners or board established 
9.4 	under sections 402.01 to 402.10 or 471.59.  
9.5 	(d) "Crisis assistance" has the meaning given in section 245.4871, subdivision 9a.  
9.6 	(e) "Culturally competent provider" means a provider who understands and can 
9.7 	utilize to a client's benefit the client's culture when providing services to the client. A 
9.8 	provider may be culturally competent because the provider is of the same cultural or 
9.9 	ethnic group as the client or the provider has developed the knowledge and skills through 
9.10 	training and experience to provide services to culturally diverse clients.
9.11 	(f) "Day treatment program" for children means a site-based structured program 
9.12 	consisting of group psychotherapy for more than three individuals and other intensive 
9.13 	therapeutic services provided by a multidisciplinary team, under the clinical supervision 
9.14 	of a mental health professional.
9.15 	(g) "Diagnostic assessment" has the meaning given in section 245.4871, subdivision 
9.16 	11.  
9.17 	(h) "Direct service time" means the time that a mental health professional, mental 
9.18 	health practitioner, or mental health behavioral aide spends face-to-face with a client 
9.19 	and the client's family. Direct service time includes time in which the provider obtains 
9.20 	a client's history or provides service components of children's therapeutic services and 
9.21 	supports. Notwithstanding Minnesota Rules, part 9505.0323, subpart 1, item M, direct 
9.22 	service time does not include time doing work before and after providing direct services, 
9.23 	including scheduling, maintaining clinical records, consulting with others about the client's 
9.24 	mental health status, preparing reports, receiving clinical supervision ~~directly related to~~ 
9.25 	~~the client's psychotherapy session~~, and revising the client's individual treatment plan.
9.26 	(i) "Direction of mental health behavioral aide" means the activities of a mental 
9.27 	health professional or mental health practitioner in guiding the mental health behavioral 
9.28 	aide in providing services to a client. The direction of a mental health behavioral aide 
9.29 	must be based on the client's individualized treatment plan and meet the requirements in 
9.30 	subdivision 6, paragraph (b), clause (5).
9.31 	(j) "Emotional disturbance" has the meaning given in section 245.4871, subdivision 
9.32 	15. For persons at least age 18 but under age 21, mental illness has the meaning given in 
9.33 	section 245.462, subdivision 20, paragraph (a).  
9.34 	(k) "Individual behavioral plan" means a plan of intervention, treatment, and 
9.35 	services for a child written by a mental health professional or mental health practitioner, 
10.1 	under the clinical supervision of a mental health professional, to guide the work of the 
10.2 	mental health behavioral aide.
10.3 	(l) "Individual treatment plan" has the meaning given in section 245.4871, 
10.4 	subdivision 21.  
10.5 	(m) "Mental health behavioral aide services" means medically necessary one-on-one 
10.6 	activities performed by a trained paraprofessional to assist a child retain or generalize 
10.7 	psychosocial skills as taught by a mental health professional or mental health practitioner 
10.8 	and as described in the child's individual treatment plan and individual behavior plan. 
10.9 	Activities involve working directly with the child or child's family as provided in 
10.10 	subdivision 9, paragraph (b), clause (4).
10.11 	~~(m)~~(n) "Mental health professional" means an individual as defined in section 
10.12 	245.4871, subdivision 27, clauses (1) to (5), or tribal vendor as defined in section 256B.02, 
10.13 	subdivision 7, paragraph (b).  
10.14 	~~(n)~~(o) "Preschool program" means a day program licensed under Minnesota Rules, 
10.15 	parts 9503.0005 to 9503.0175, and enrolled as a children's therapeutic services and 
10.16 	supports provider to provide a structured treatment program to a child who is at least 33 
10.17 	months old but who has not yet attended the first day of kindergarten.
10.18 	~~(o)~~(p) "Skills training" means individual, family, or group training, delivered by 
10.19 	or under the direction of a mental health professional, designed to ~~improve the basic~~ 
10.20 	~~functioning of the child with emotional disturbance and the child's family in the activities~~ 
10.21 	~~of daily living and community living, and to improve the social functioning of the child~~ 
10.22 	~~and the child's family in areas important to the child's maintaining or reestablishing~~ 
10.23 	~~residency in the community. Individual, family, and group skills training must:~~
10.24 	~~(1) consist of activities designed to promote skill development of the child and the~~ 
10.25 	~~child's family in the use of age-appropriate daily living skills, interpersonal and family~~ 
10.26 	~~relationships, and leisure and recreational services;~~
10.27 	~~(2) consist of activities that will assist the family's understanding of normal child~~ 
10.28 	~~development and to use parenting skills that will help the child with emotional disturbance~~ 
10.29 	~~achieve the goals outlined in the child's individual treatment plan; and~~
10.30 	~~(3) promote family preservation and unification, promote the family's integration~~ 
10.31 	~~with the community, and reduce the use of unnecessary out-of-home placement or~~ 
10.32 	~~institutionalization of children with emotional disturbance.~~ facilitate the acquisition 
10.33 	of psychosocial skills that are medically necessary to rehabilitate the child to an 
10.34 	age-appropriate developmental trajectory heretofore disrupted by a psychiatric illness 
10.35 	or to self-monitor, compensate for, cope with, counteract, or replace skills deficits or 
11.1 	maladaptive skills acquired over the course of a psychiatric illness. Skills training is 
11.2 	subject to the following requirements:
11.3 	(1) a mental health professional or a mental health practitioner must provide skills 
11.4 	training;
11.5 	(2) the child must always be present during skills training; however, a brief absence 
11.6 	of the child for no more than ten percent of the session unit may be allowed to redirect or 
11.7 	instruct family members;
11.8 	(3) skills training delivered to children or their families must be targeted to the 
11.9 	specific deficits or maladaptations of the child's mental health disorder and must be 
11.10 	prescribed in the child's individual treatment plan; and
11.11 	(4) group skills training may be provided to multiple recipients who, because of the 
11.12 	nature of their emotional, behavioral, or social dysfunction, can derive mutual benefit from 
11.13 	interaction in a group setting, which must be staffed as follows:
11.14 	(i) one mental health professional or one mental health practitioner under supervision 
11.15 	of a licensed mental health professional must work with a group of four to eight clients; or
11.16 	(ii) two mental health professionals or two mental health practitioners under 
11.17 	supervision of a licensed mental health professional, or one professional plus one 
11.18 	practitioner must work with a group of nine to 12 clients.

11.19 	Sec. 11. Minnesota Statutes 2008, section 256B.0943, subdivision 2, is amended to 
11.20 	read:
11.21 		Subd. 2.Covered service components of children's therapeutic services and 
11.22 	supports. (a) Subject to federal approval, medical assistance covers medically necessary 
11.23 	children's therapeutic services and supports as defined in this section that an eligible 
11.24 	provider entity certified under ~~subdivisions~~subdivision 4 ~~and 5~~ provides to a client 
11.25 	eligible under subdivision 3.
11.26 	(b) The service components of children's therapeutic services and supports are:
11.27 	(1) individual, family, and group psychotherapy;
11.28 	(2) individual, family, or group skills training provided by a mental health 
11.29 	professional or mental health practitioner;
11.30 	(3) crisis assistance;
11.31 	(4) mental health behavioral aide services; and
11.32 	(5) direction of a mental health behavioral aide.
11.33 	(c) Service components in paragraph (b) may be combined to constitute therapeutic 
11.34 	programs, including day treatment programs and therapeutic preschool programs. 
11.35 	~~Although day treatment and preschool programs have specific client and provider~~ 
12.1 	~~eligibility requirements, medical assistance only pays for the service components listed in~~ 
12.2 	~~paragraph (b).~~

12.3 	Sec. 12. Minnesota Statutes 2008, section 256B.0943, subdivision 4, is amended to 
12.4 	read:
12.5 		Subd. 4.Provider entity certification. (a) Effective July 1, 2003, the commissioner 
12.6 	shall establish an initial provider entity application and certification process and 
12.7 	recertification process to determine whether a provider entity has an administrative 
12.8 	and clinical infrastructure that meets the requirements in subdivisions 5 and 6. The 
12.9 	commissioner shall recertify a provider entity at least every three years. The commissioner 
12.10 	shall establish a process for decertification of a provider entity that no longer meets the 
12.11 	requirements in this section. ~~The county, tribe, and the commissioner shall be mutually~~ 
12.12 	~~responsible and accountable for the county's, tribe's, and state's part of the certification,~~ 
12.13 	~~recertification, and decertification processes.~~
12.14 	(b) For purposes of this section, a provider entity must be:
12.15 	(1) an Indian health services facility or a facility owned and operated by a tribe or 
12.16 	tribal organization operating as a 638 facility under Public Law 93-638 certified by the 
12.17 	state;
12.18 	(2) a county-operated entity certified by the state; or
12.19 	(3) a noncounty entity ~~recommended for certification by the provider's host county~~ 
12.20 	~~and~~ certified by the state.

12.21 	Sec. 13. Minnesota Statutes 2008, section 256B.0943, subdivision 5, is amended to 
12.22 	read:
12.23 		Subd. 5. Provider entity administrative infrastructure requirements. (a) To be 
12.24 	an eligible provider entity under this section, a provider entity must have an administrative 
12.25 	infrastructure that establishes authority and accountability for decision making and 
12.26 	oversight of functions, including finance, personnel, system management, clinical practice, 
12.27 	and performance measurement. The provider must have written policies and procedures 
12.28 	that it reviews and updates every three years and distributes to staff initially and upon 
12.29 	each subsequent update. 
12.30 	(b) The administrative infrastructure written policies and procedures must include: 
12.31 	(1) personnel procedures, including a process for: (i) recruiting, hiring, training, and 
12.32 	retention of culturally and linguistically competent providers; (ii) conducting a criminal 
12.33 	background check on all direct service providers and volunteers; (iii) investigating, 
12.34 	reporting, and acting on violations of ethical conduct standards; (iv) investigating, 
13.1 	reporting, and acting on violations of data privacy policies that are compliant with 
13.2 	federal and state laws; (v) utilizing volunteers, including screening applicants, training 
13.3 	and supervising volunteers, and providing liability coverage for volunteers; and (vi) 
13.4 	documenting that each mental health professional, mental health practitioner, or mental 
13.5 	health behavioral aide meets the applicable provider qualification criteria, training criteria 
13.6 	under subdivision 8, and clinical supervision or direction of a mental health behavioral 
13.7 	aide requirements under subdivision 6; 
13.8 	(2) fiscal procedures, including internal fiscal control practices and a process for 
13.9 	collecting revenue that is compliant with federal and state laws; 
13.10 	~~(3) if a client is receiving services from a case manager or other provider entity, a~~ 
13.11 	~~service coordination process that ensures services are provided in the most appropriate~~ 
13.12 	~~manner to achieve maximum benefit to the client. The provider entity must ensure~~ 
13.13 	~~coordination and nonduplication of services consistent with county board coordination~~ 
13.14 	~~procedures established under section 245.4881, subdivision 5;~~ 
13.15 	~~(4)~~ (3) a performance measurement system, including monitoring to determine 
13.16 	cultural appropriateness of services identified in the individual treatment plan, as 
13.17 	determined by the client's culture, beliefs, values, and language, and family-driven 
13.18 	services; and 
13.19 	~~(5)~~ (4) a process to establish and maintain individual client records. The client's 
13.20 	records must include: 
13.21 	(i) the client's personal information; 
13.22 	(ii) forms applicable to data privacy; 
13.23 	(iii) the client's diagnostic assessment, updates, results of tests, individual treatment 
13.24 	plan, and individual behavior plan, if necessary; 
13.25 	(iv) documentation of service delivery as specified under subdivision 6; 
13.26 	(v) telephone contacts; 
13.27 	(vi) discharge plan; and 
13.28 	(vii) if applicable, insurance information. 
13.29 	(c) A provider entity that uses a restrictive procedure with a client must meet the 
13.30 	requirements of section 245.8261. 

13.31 	Sec. 14. Minnesota Statutes 2008, section 256B.0943, subdivision 6, is amended to 
13.32 	read:
13.33 		Subd. 6.Provider entity clinical infrastructure requirements. (a) To be 
13.34 	an eligible provider entity under this section, a provider entity must have a clinical 
13.35 	infrastructure that utilizes diagnostic assessment, ~~an~~ individualized treatment ~~plan~~ plans, 
14.1 	service delivery, and individual treatment plan review that are culturally competent, 
14.2 	child-centered, and family-driven to achieve maximum benefit for the client. The provider 
14.3 	entity must review and update the clinical policies and procedures every three years and 
14.4 	must distribute the policies and procedures to staff initially and upon each subsequent 
14.5 	update.
14.6 	(b) The clinical infrastructure written policies and procedures must include policies 
14.7 	and procedures for:
14.8 	(1) providing or obtaining a client's diagnostic assessment that identifies acute and 
14.9 	chronic clinical disorders, co-occurring medical conditions, sources of psychological and 
14.10 	environmental problems, and a functional assessment. The functional assessment must 
14.11 	clearly summarize the client's individual strengths and needs;
14.12 	(2) developing an individual treatment plan that ~~is~~:
14.13 	(i) is based on the information in the client's diagnostic assessment;
14.14 	(ii) identifies goals and objectives of treatment, treatment strategy, schedule for 
14.15 	accomplishing treatment goals and objectives, and the individuals responsible for 
14.16 	providing treatment services and supports;
14.17 	~~(ii)~~(iii) is developed ~~no later than the end of the first psychotherapy session after the~~
14.18 	after completion of the client's diagnostic assessment by ~~the~~a mental health professional 
14.19 	~~who provides the client's psychotherapy~~ and before the provision of children's therapeutic 
14.20 	services and supports;
14.21 	~~(iii)~~(iv) is developed through a child-centered, family-driven, culturally appropriate
14.22 	planning process ~~that identifies service needs and individualized, planned, and culturally~~ 
14.23 	~~appropriate interventions that contain specific treatment goals and objectives for the client~~ 
14.24 	~~and the client's family or foster family~~;
14.25 	~~(iv)~~(v) is reviewed at least once every 90 days and revised, if necessary; and
14.26 	~~(v)~~(vi) is signed by the clinical supervisor and by the client or~~, if appropriate, by the~~
14.27 	client's parent or other person authorized by statute to consent to mental health services 
14.28 	for the client;
14.29 	(3) developing an individual behavior plan that documents ~~services~~treatment 
14.30 	strategies to be provided by the mental health behavioral aide. The individual behavior 
14.31 	plan must include:
14.32 	(i) detailed instructions on the ~~service~~treatment strategies to be provided;
14.33 	(ii) time allocated to each ~~service~~ treatment strategy;
14.34 	(iii) methods of documenting the child's behavior;
14.35 	(iv) methods of monitoring the child's progress in reaching objectives; and
15.1 	(v) goals to increase or decrease targeted behavior as identified in the individual 
15.2 	treatment plan;
15.3 	(4) providing clinical supervision of the mental health practitioner and mental health 
15.4 	behavioral aide. A mental health professional must document the clinical supervision 
15.5 	the professional provides by cosigning individual treatment plans and making entries in 
15.6 	the client's record on supervisory activities. Clinical supervision does not include the 
15.7 	authority to make or terminate court-ordered placements of the child. A clinical supervisor 
15.8 	must be available for urgent consultation as required by the individual client's needs or 
15.9 	the situation. Clinical supervision may occur individually or in a small group to discuss 
15.10 	treatment and review progress toward goals. The focus of clinical supervision must be the 
15.11 	client's treatment needs and progress and the mental health practitioner's or behavioral 
15.12 	aide's ability to provide services;
15.13 	(4a) ~~CTSS certified provider entities providing~~meeting day treatment and 
15.14 	therapeutic preschool programs ~~must meet the~~ conditions in items (i) to (iii):
15.15 	(i) the supervisor must be present and available on the premises more than 50 
15.16 	percent of the time in a five-working-day period during which the supervisee is providing 
15.17 	a mental health service;
15.18 	(ii) the diagnosis and the client's individual treatment plan or a change in the 
15.19 	diagnosis or individual treatment plan must be made by or reviewed, approved, and signed 
15.20 	by the supervisor; and
15.21 	(iii) every 30 days, the supervisor must review and sign the record of the client's care 
15.22 	for all activities in the preceding 30-day period;
15.23 	(4b) meeting the clinical supervision standards in items (i) to (iii) for all other 
15.24 	services provided under CTSS~~, clinical supervision standards provided in items (i) to~~ 
15.25 	~~(iii) must be used~~:
15.26 	(i) medical assistance shall reimburse a mental health practitioner and a mental 
15.27 	health behavioral aide who maintains a consulting relationship with a mental health 
15.28 	professional who accepts full professional responsibility and is present on site for at 
15.29 	least one clock hour for observation during the first 12 hours in which the mental health 
15.30 	practitioner or mental health behavioral aide provides ~~the individual, family, or group~~ 
15.31 	~~skills training to the child or the child's family~~ children's therapeutic services and supports;
15.32 	(ii) thereafter, the mental health professional is required to be present on site for 
15.33 	observation as clinically appropriate when the mental health practitioner or mental health 
15.34 	behavioral aide is providing ~~individual, family, or group skills training to the child or the~~ 
15.35 	~~child's family~~ CTSS services; and
16.1 	(iii) the ~~observation must be a minimum of one clinical unit. The~~ on-site presence of 
16.2 	the mental health professional must be documented in the child's record and signed by the 
16.3 	mental health professional who accepts full professional responsibility;
16.4 	(5) providing direction to a mental health behavioral aide. For entities that employ 
16.5 	mental health behavioral aides, the clinical supervisor must be employed by the provider 
16.6 	entity or other certified children's therapeutic supports and services provider entity to 
16.7 	ensure necessary and appropriate oversight for the client's treatment and continuity 
16.8 	of care. The mental health professional or mental health practitioner giving direction 
16.9 	must begin with the goals on the individualized treatment plan, and instruct the mental 
16.10 	health behavioral aide on how to construct therapeutic activities and interventions that 
16.11 	will lead to goal attainment. The professional or practitioner giving direction must also 
16.12 	instruct the mental health behavioral aide about the client's diagnosis, functional status, 
16.13 	and other characteristics that are likely to affect service delivery. Direction must also 
16.14 	include determining that the mental health behavioral aide has the skills to interact with 
16.15 	the client and the client's family in ways that convey personal and cultural respect and 
16.16 	that the aide actively solicits information relevant to treatment from the family. The aide 
16.17 	must be able to clearly explain the activities the aide is doing with the client and the 
16.18 	activities' relationship to treatment goals. Direction is more didactic than is supervision 
16.19 	and requires the professional or practitioner providing it to continuously evaluate the 
16.20 	mental health behavioral aide's ability to carry out the activities of the individualized 
16.21 	treatment plan and the individualized behavior plan. When providing direction, the 
16.22 	professional or practitioner must:
16.23 	(i) review progress notes prepared by the mental health behavioral aide for accuracy 
16.24 	and consistency with diagnostic assessment, treatment plan, and behavior goals and the 
16.25 	professional or practitioner must approve and sign the progress notes;
16.26 	(ii) identify changes in treatment strategies, revise the individual behavior plan, 
16.27 	and communicate treatment instructions and methodologies as appropriate to ensure 
16.28 	that treatment is implemented correctly;
16.29 	(iii) demonstrate family-friendly behaviors that support healthy collaboration among 
16.30 	the child, the child's family, and providers as treatment is planned and implemented;
16.31 	(iv) ensure that the mental health behavioral aide is able to effectively communicate 
16.32 	with the child, the child's family, and the provider; and
16.33 	(v) record the results of any evaluation and corrective actions taken to modify the 
16.34 	work of the mental health behavioral aide;
16.35 	(6) providing service delivery that implements the individual treatment plan and 
16.36 	meets the requirements under subdivision 9; and
17.1 	(7) individual treatment plan review. The review must determine the extent to which 
17.2 	the services have met the goals and objectives in the previous treatment plan. The review 
17.3 	must assess the client's progress and ensure that services and treatment goals continue to 
17.4 	be necessary and appropriate to the client and the client's family or foster family. Revision 
17.5 	of the individual treatment plan does not require a new diagnostic assessment unless the 
17.6 	client's mental health status has changed markedly. The updated treatment plan must be 
17.7 	signed by the clinical supervisor and by the client, if appropriate, and by the client's 
17.8 	parent or other person authorized by statute to give consent to the mental health services 
17.9 	for the child.

17.10 	Sec. 15. Minnesota Statutes 2008, section 256B.0943, subdivision 7, is amended to 
17.11 	read:
17.12 		Subd. 7.Qualifications of individual and team providers. (a) An individual 
17.13 	or team provider working within the scope of the provider's practice or qualifications 
17.14 	may provide service components of children's therapeutic services and supports that are 
17.15 	identified as medically necessary in a client's individual treatment plan.
17.16 	(b) An individual provider must be qualified as:
17.17 	(1) a mental health professional as defined in subdivision 1, paragraph (m); or
17.18 	(2) a mental health practitioner as defined in section 245.4871, subdivision 26. The 
17.19 	mental health practitioner must work under the clinical supervision of a mental health 
17.20 	professional; or  
17.21 	(3) a mental health behavioral aide working under the ~~direction~~clinical supervision 
17.22 	of a mental health professional to implement the rehabilitative mental health services 
17.23 	identified in the client's individual treatment plan and individual behavior plan.
17.24 	(A) A level I mental health behavioral aide must:
17.25 	(i) be at least 18 years old;
17.26 	(ii) have a high school diploma or general equivalency diploma (GED) or two years 
17.27 	of experience as a primary caregiver to a child with severe emotional disturbance within 
17.28 	the previous ten years; and
17.29 	(iii) meet preservice and continuing education requirements under subdivision 8.
17.30 	(B) A level II mental health behavioral aide must:
17.31 	(i) be at least 18 years old;
17.32 	(ii) have an associate or bachelor's degree or 4,000 hours of experience in delivering 
17.33 	clinical services in the treatment of mental illness concerning children or adolescents; and
17.34 	(iii) meet preservice and continuing education requirements in subdivision 8.
18.1 	(c) A preschool program multidisciplinary team must include at least one mental 
18.2 	health professional and one or more of the following individuals under the clinical 
18.3 	supervision of a mental health professional:
18.4 	(i) a mental health practitioner; or
18.5 	(ii) a program person, including a teacher, assistant teacher, or aide, who meets the 
18.6 	qualifications and training standards of a level I mental health behavioral aide.
18.7 	(d) A day treatment multidisciplinary team must include at least one mental health 
18.8 	professional and one mental health practitioner.

18.9 	Sec. 16. Minnesota Statutes 2008, section 256B.0943, subdivision 9, is amended to 
18.10 	read:
18.11 		Subd. 9.Service delivery criteria. (a) In delivering services under this section, a 
18.12 	certified provider entity must ensure that:
18.13 	(1) each individual provider's caseload size permits the provider to deliver services 
18.14 	to both clients with severe, complex needs and clients with less intensive needs. The 
18.15 	provider's caseload size should reasonably enable the provider to play an active role in 
18.16 	service planning, monitoring, and delivering services to meet the client's and client's 
18.17 	family's needs, as specified in each client's individual treatment plan;
18.18 	(2) site-based programs, including day treatment and preschool programs, provide 
18.19 	staffing and facilities to ensure the client's health, safety, and protection of rights, and that 
18.20 	the programs are able to implement each client's individual treatment plan;
18.21 	(3) a day treatment program is provided to a group of clients by a multidisciplinary 
18.22 	team under the clinical supervision of a mental health professional. The day treatment 
18.23 	program must be provided in and by: (i) an outpatient hospital accredited by the Joint 
18.24 	Commission on Accreditation of Health Organizations and licensed under sections 144.50
18.25 	to 144.55; (ii) a community mental health center under section 245.62; ~~and~~or (iii) an 
18.26 	entity that is under contract with the county board to operate a program that meets the 
18.27 	requirements of sections 245.4712, subdivision 2, ~~and~~or 245.4884, subdivision 2, and 
18.28 	Minnesota Rules, parts 9505.0170 to 9505.0475. The day treatment program must 
18.29 	stabilize the client's mental health status while developing and improving the client's 
18.30 	independent living and socialization skills. The goal of the day treatment program must be 
18.31 	to reduce or relieve the effects of mental illness and provide training to enable the client 
18.32 	to live in the community. The program must be available ~~at least one day a week for a~~ 
18.33 	~~three-hour time block~~ three hours per day, five days per week, and 12 months of each 
18.34 	calendar year. The three-hour daily time block must include at least one hour, but no more 
18.35 	than two hours, of individual or group psychotherapy. The remainder of the three-hour 
19.1 	time block may include ~~recreation therapy, socialization therapy, or independent living~~ 
19.2 	~~skills therapy,~~individual or group skills training but only if the therapies are included in 
19.3 	the client's individual treatment plan. Day treatment programs are not part of inpatient 
19.4 	or residential treatment services. A day treatment program may provide fewer than the 
19.5 	minimally required hours for a particular child during a billing period in which the child is 
19.6 	transitioning into, or out of, the program; and 
19.7 	(4) a therapeutic preschool program is a structured treatment program offered 
19.8 	to a child who is at least 33 months old, but who has not yet reached the first day of 
19.9 	kindergarten, by a preschool multidisciplinary team in a day program licensed under 
19.10 	Minnesota Rules, parts 9503.0005 to 9503.0175. The program must be available ~~at~~ 
19.11 	~~least one day a week for a minimum two-hour time block~~ two hours per day, five days 
19.12 	per week, and 12 months of each calendar year. The structured treatment program may 
19.13 	include individual or group psychotherapy and ~~recreation therapy, socialization therapy,~~ 
19.14 	~~or independent living skills therapy~~ individual or group skills training, if included in the 
19.15 	client's individual treatment plan. A therapeutic preschool program may provide fewer 
19.16 	than the minimally required hours for a particular child during a billing period in which 
19.17 	the child is transitioning into, or out of, the program.
19.18 	(b) A provider entity must deliver the service components of children's therapeutic 
19.19 	services and supports in compliance with the following requirements:
19.20 	(1) individual, family, and group psychotherapy must be delivered as specified in 
19.21 	Minnesota Rules, part 9505.0323;
19.22 	(2) individual, family, or group skills training must be provided by a mental health 
19.23 	professional or a mental health practitioner who has a consulting relationship with a 
19.24 	mental health professional who accepts full professional responsibility for the training;
19.25 	(3) crisis assistance must be time-limited and designed to resolve or stabilize crisis 
19.26 	through arrangements for direct intervention and support services to the child and the 
19.27 	child's family. Crisis assistance must utilize resources designed to address abrupt or 
19.28 	substantial changes in the functioning of the child or the child's family as evidenced by 
19.29 	a sudden change in behavior with negative consequences for well being, a loss of usual 
19.30 	coping mechanisms, or the presentation of danger to self or others;
19.31 	(4) mental health behavioral aide services must be medically necessary ~~services that~~ 
19.32 	~~are provided by a mental health behavioral aide must be~~treatment services, identified in 
19.33 	the child's individual treatment plan and individual behavior plan, which are performed 
19.34 	minimally by a paraprofessional qualified according to subdivision 7, paragraph (b), 
19.35 	clause (3), and which are designed to improve the functioning of the child ~~and support~~ 
19.36 	~~the family in activities of daily and community living.~~ in the progressive use of 
20.1 	developmentally appropriate psychosocial skills. Activities involve working directly with 
20.2 	the child, child-peer groupings, or child-family groupings to practice, repeat, reintroduce, 
20.3 	and master the skills defined in subdivision 1, paragraph (p), as previously taught by a 
20.4 	mental health professional or mental health practitioner including:
20.5 	(i) providing cues or prompts in skill-building peer-to-peer or parent-child 
20.6 	interactions so that the child progressively recognizes and responds to the cues 
20.7 	independently;
20.8 	(ii) performing as a practice partner or role-play partner;
20.9 	(iii) reinforcing the child's accomplishments;
20.10 	(iv) generalizing skill-building activities in the child's multiple natural settings;
20.11 	(v) assigning further practice activities; and
20.12 	(vi) intervening as necessary to redirect the child's target behavior and to de-escalate 
20.13 	behavior that puts the child or other person at risk of injury.
20.14 	A mental health behavioral aide must document the delivery of services in written progress 
20.15 	notes. The mental health behavioral aide must implement ~~goals in the treatment plan for~~ 
20.16 	~~the child's emotional disturbance that allow the child to acquire developmentally and~~ 
20.17 	~~therapeutically appropriate daily living skills, social skills, and leisure and recreational~~ 
20.18 	~~skills through targeted activities. These activities may include:~~
20.19 	~~(i) assisting a child as needed with skills development in dressing, eating, and~~ 
20.20 	~~toileting;~~
20.21 	~~(ii) assisting, monitoring, and guiding the child to complete tasks, including~~ 
20.22 	~~facilitating the child's participation in medical appointments;~~
20.23 	~~(iii) observing the child and intervening to redirect the child's inappropriate behavior;~~
20.24 	~~(iv) assisting the child in using age-appropriate self-management skills as related~~ 
20.25 	~~to the child's emotional disorder or mental illness, including problem solving, decision~~ 
20.26 	~~making, communication, conflict resolution, anger management, social skills, and~~ 
20.27 	~~recreational skills;~~
20.28 	~~(v) implementing deescalation techniques as recommended by the mental health~~ 
20.29 	~~professional;~~
20.30 	~~(vi) implementing any other mental health service that the mental health professional~~ 
20.31 	~~has approved as being within the scope of the behavioral aide's duties; or~~
20.32 	~~(vii) assisting the parents to develop and use parenting skills that help the child~~ 
20.33 	~~achieve the goals outlined in the child's individual treatment plan or individual behavioral~~ 
20.34 	~~plan. Parenting skills must be directed exclusively to the child's treatment~~ treatment 
20.35 	strategies in the individual treatment plan and the individual behavior plan. The mental 
20.36 	health behavioral aide must document the delivery of services in written progress notes. 
21.1 	Progress notes must reflect implementation of the treatment strategies, as performed by 
21.2 	the mental health behavioral aide and the child's responses to the treatment strategies; and
21.3 	(5) direction of a mental health behavioral aide must include the following:
21.4 	(i) a total of one hour of on-site observation by a mental health professional during 
21.5 	the first 12 hours of service provided to a child;
21.6 	(ii) ongoing on-site observation by a mental health professional or mental health 
21.7 	practitioner for at least a total of one hour during every 40 hours of service provided 
21.8 	to a child; and
21.9 	(iii) immediate accessibility of the mental health professional or mental health 
21.10 	practitioner to the mental health behavioral aide during service provision.

21.11 	Sec. 17. Minnesota Statutes 2008, section 256B.0944, subdivision 5, is amended to 
21.12 	read:
21.13 		Subd. 5.Mobile crisis intervention staff qualifications. (a) To provide children's 
21.14 	mental health mobile crisis intervention services, a mobile crisis intervention team must 
21.15 	include:
21.16 	(1) at least two mental health professionals as defined in section 256B.0943, 
21.17 	subdivision 1, paragraph ~~(m)~~ (n); or 
21.18 	(2) a combination of at least one mental health professional and one mental health 
21.19 	practitioner as defined in section 245.4871, subdivision 26, with the required mental 
21.20 	health crisis training and under the clinical supervision of a mental health professional on 
21.21 	the team. 
21.22 	(b) The team must have at least two people with at least one member providing 
21.23 	on-site crisis intervention services when needed. Team members must be experienced in 
21.24 	mental health assessment, crisis intervention techniques, and clinical decision making 
21.25 	under emergency conditions and have knowledge of local services and resources. The 
21.26 	team must recommend and coordinate the team's services with appropriate local resources, 
21.27 	including the county social services agency, mental health service providers, and local law 
21.28 	enforcement, if necessary.