1.1 	A bill for an act
1.2 	relating to human services; modifying mental health crisis intervention and 
1.3 	stabilization services; amending Minnesota Statutes 2012, sections 253B.066, 
1.4 	subdivision 1; 256B.0615, subdivision 3; 256B.0624, subdivisions 2, 5, 6, 10.
1.5 	BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF MINNESOTA:

1.6 	Section 1. Minnesota Statutes 2012, section 253B.066, subdivision 1, is amended to 
1.7 	read:
1.8 		Subdivision 1.Treatment alternatives. If the court orders early intervention 
1.9 	under section 253B.065, subdivision 5, the court may include in its order a variety of 
1.10 	treatment alternatives including, but not limited to, day treatment, medication compliance 
1.11 	monitoring, assertive community treatment, crisis stabilization, partial hospitalization, and 
1.12 	short-term hospitalization not to exceed 21 days.
1.13 	If the court orders short-term hospitalization and the proposed patient will not go 
1.14 	voluntarily, the court may direct a health officer, peace officer, or other person to take the 
1.15 	person into custody and transport the person to the hospital.

1.16 	Sec. 2. Minnesota Statutes 2012, section 256B.0615, subdivision 3, is amended to read:
1.17 		Subd. 3.Eligibility. Peer support services may be made available to consumers of 
1.18 	(1) the intensive rehabilitative mental health services under section 256B.0622; (2) adult 
1.19 	rehabilitative mental health services under section 256B.0623; and (3) crisis stabilization 
1.20 	and mental health mobile crisis intervention services under section 256B.0624.

1.21 	Sec. 3. Minnesota Statutes 2012, section 256B.0624, subdivision 2, is amended to read:
2.1 		Subd. 2.Definitions. For purposes of this section, the following terms have the 
2.2 	meanings given them.
2.3 	(a) "Mental health crisis" is an adult behavioral, emotional, or psychiatric situation 
2.4 	which, but for the provision of crisis response services, would likely result in significantly 
2.5 	reduced levels of functioning in primary activities of daily living, or in an emergency 
2.6 	situation, or in the placement of the recipient in a more restrictive setting, including, but 
2.7 	not limited to, inpatient hospitalization.
2.8 	(b) "Mental health emergency" is an adult behavioral, emotional, or psychiatric 
2.9 	situation which causes an immediate need for mental health services and is consistent 
2.10 	with section 62Q.55.
2.11 	A mental health crisis or emergency is determined for medical assistance service 
2.12 	reimbursement by a physician, a mental health professional, or crisis mental health 
2.13 	practitioner with input from the recipient whenever possible.
2.14 	(c) "Mental health crisis assessment" means an immediate face-to-face assessment 
2.15 	by a physician, a mental health professional, or mental health practitioner under the 
2.16 	clinical supervision of a mental health professional, following a screening that suggests 
2.17 	that the adult may be experiencing a mental health crisis or mental health emergency 
2.18 	situation. It includes assessing whether the person might be willing to voluntarily accept 
2.19 	treatment, determining whether the person has an advance directive, and obtaining 
2.20 	information and history from involved family members or caretakers.
2.21 	(d) "Mental health mobile crisis intervention services" means face-to-face, 
2.22 	short-term intensive mental health services initiated during a mental health crisis or mental 
2.23 	health emergency to help the recipient cope with immediate stressors, identify and utilize 
2.24 	available resources and strengths, engage in voluntary treatment, and begin to return to the 
2.25 	recipient's baseline level of functioning.
2.26 	(1) This service is provided on site by a mobile crisis intervention team outside of 
2.27 	an inpatient hospital setting. Mental health mobile crisis intervention services must be 
2.28 	available 24 hours a day, seven days a week.
2.29 	(2) The initial screening must consider other available services to determine which 
2.30 	service intervention would best address the recipient's needs and circumstances.
2.31 	(3) The mobile crisis intervention team must be available to meet promptly 
2.32 	face-to-face with a person in mental health crisis or emergency in a community setting or 
2.33 	hospital emergency room.
2.34 	(4) The intervention must consist of a mental health crisis assessment and a crisis 
2.35 	treatment plan.
3.1 	(5) The treatment plan must include recommendations for any needed crisis 
3.2 	stabilization services for the recipient, including engagement in treatment planning and 
3.3 	family psychoeducation.
3.4 	(e) "Mental health crisis stabilization services" means individualized mental 
3.5 	health services provided to a recipient following crisis intervention services which are 
3.6 	designed to restore the recipient to the recipient's prior functional level. Mental health 
3.7 	crisis stabilization services may be provided in the recipient's home, the home of a family 
3.8 	member or friend of the recipient, another community setting, or a short-term supervised, 
3.9 	licensed residential program. Mental health crisis stabilization does not include partial 
3.10 	hospitalization or day treatment. Mental health crisis stabilization services includes 
3.11 	family psychoeducation.

3.12 	Sec. 4. Minnesota Statutes 2012, section 256B.0624, subdivision 5, is amended to read:
3.13 		Subd. 5.Mobile crisis intervention staff qualifications. For provision of adult 
3.14 	mental health mobile crisis intervention services, a mobile crisis intervention team is 
3.15 	comprised of at least two mental health professionals as defined in section 245.462, 
3.16 	subdivision 18, clauses (1) to (6), or a combination of at least one mental health 
3.17 	professional and one mental health practitioner as defined in section 245.462, subdivision 
3.18 	17, with the required mental health crisis training and under the clinical supervision of 
3.19 	a mental health professional on the team. The team must have at least two people with 
3.20 	at least one member providing on-site crisis intervention services when needed. Team 
3.21 	members must be experienced in mental health assessment, crisis intervention techniques, 
3.22 	treatment engagement strategies, working with families, and clinical decision-making 
3.23 	under emergency conditions and have knowledge of local services and resources. 
3.24 	The team must recommend and coordinate the team's services with appropriate local 
3.25 	resources such as the county social services agency, mental health services, and local 
3.26 	law enforcement when necessary.

3.27 	Sec. 5. Minnesota Statutes 2012, section 256B.0624, subdivision 6, is amended to read:
3.28 		Subd. 6.Crisis assessment and mobile intervention treatment planning. (a) 
3.29 	Prior to initiating mobile crisis intervention services, a screening of the potential crisis 
3.30 	situation must be conducted. The screening may use the resources of crisis assistance 
3.31 	and emergency services as defined in sections 245.462, subdivision 6, and 245.469, 
3.32 	subdivisions 1 and 2. The screening must gather information, determine whether a crisis 
3.33 	situation exists, identify parties involved, and determine an appropriate response.
4.1 	(b) If a crisis exists, a crisis assessment must be completed. A crisis assessment 
4.2 	evaluates any immediate needs for which emergency services are needed and, as time 
4.3 	permits, the recipient's current life situation, sources of stress, mental health problems 
4.4 	and symptoms, strengths, cultural considerations, support network, vulnerabilities, current 
4.5 	functioning, and the recipient's preferences as communicated directly by the recipient, 
4.6 	or as communicated in a health care directive as described in chapters 145C and 253B, 
4.7 	the treatment plan described under paragraph (d), a crisis prevention plan, or a wellness 
4.8 	recovery action plan.
4.9 	(c) If the crisis assessment determines mobile crisis intervention services are needed, 
4.10 	the intervention services must be provided promptly. As opportunity presents during the 
4.11 	intervention, at least two members of the mobile crisis intervention team must confer 
4.12 	directly or by telephone about the assessment, treatment plan, and actions taken and 
4.13 	needed. At least one of the team members must be on site providing crisis intervention 
4.14 	services. If providing on-site crisis intervention services, a mental health practitioner must 
4.15 	seek clinical supervision as required in subdivision 9.
4.16 	(d) The mobile crisis intervention team must develop an initial, brief crisis treatment 
4.17 	plan as soon as appropriate but no later than 24 hours after the initial face-to-face 
4.18 	intervention. The plan must address the needs and problems noted in the crisis assessment 
4.19 	and include measurable short-term goals, cultural considerations, and frequency and type 
4.20 	of services to be provided to achieve the goals and reduce or eliminate the crisis. The 
4.21 	treatment plan must be updated as needed to reflect current goals and services.
4.22 	(e) The team must document which short-term goals have been met and when no 
4.23 	further crisis intervention services are required.
4.24 	(f) If the recipient's crisis is stabilized, but the recipient needs a referral to other 
4.25 	services, the team must provide referrals to these services. If the recipient has a case 
4.26 	manager, planning for other services must be coordinated with the case manager. If the 
4.27 	recipient is unable to follow up on the referral, the team must link the recipient to the 
4.28 	service and follow up to ensure the recipient is receiving the service.
4.29 	(g) If the recipient's crisis is stabilized and the recipient does not have an advance 
4.30 	directive, the case manager or crisis team shall work with the recipient to develop one.

4.31 	Sec. 6. Minnesota Statutes 2012, section 256B.0624, subdivision 10, is amended to read:
4.32 		Subd. 10.Recipient file. Providers of mobile crisis intervention or crisis stabilization 
4.33 	services must maintain a file for each recipient containing the following information:
4.34 	(1) individual crisis treatment plans signed by the recipient, mental health 
4.35 	professional, and mental health practitioner who developed the crisis treatment plan, or 
5.1 	if the recipient refused to sign the plan, the date and reason stated by the recipient as to 
5.2 	why the recipient would not sign the plan;
5.3 	(2) signed release forms;
5.4 	(3) recipient health information and current medications;
5.5 	(4) emergency contacts for the recipient;
5.6 	(5) case records which document the date of service, place of service delivery, 
5.7 	signature of the person providing the service, and the nature, extent, and units of service. 
5.8 	Direct or telephone contact with the recipient's family or others should be documented;
5.9 	(6) required clinical supervision by mental health professionals;
5.10 	(7) summary of the recipient's case reviews by staff; and
5.11 	(8) any written information by the recipient that the recipient wants in the file; and
5.12 	(9) an advance directive, if there is one available.
5.13 	Documentation in the file must comply with all requirements of the commissioner.