HF 3834

as introduced - 93rd Legislature (2023 - 2024) Posted on 02/15/2024 09:36am

A bill for an act
relating to health; providing medical assistance coverage for violence prevention
services; requiring initial and final reports on violence prevention services;
amending Minnesota Statutes 2022, section 256B.0625, by adding a subdivision;
proposing coding for new law in Minnesota Statutes, chapter 256B.

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

Section 1.

Minnesota Statutes 2022, section 256B.0625, is amended by adding a subdivision
to read:

Subd. 72.

Violence prevention services.

Medical assistance covers violence prevention
services, as provided in section 256B.0761.

EFFECTIVE DATE.

This section is effective January 1, 2025.

Sec. 2.

[256B.0761] VIOLENCE PREVENTION SERVICES.

Subdivision 1.

Definitions.

(a) For purposes of this section, the following definitions
apply.

(b) "Provider" means a violence prevention services provider that meets the standards
established by the Health Alliance for Violence Intervention or an equivalent accrediting
organization.

(c) "Violence prevention services" means services provided to promote improved health
outcomes and positive behavioral and environmental change, prevent injury and recidivism,
and reduce the likelihood that individuals who are victims of community violence will
commit or promote violence themselves.

(d) "Violence prevention professional" means an individual certified by the Health
Alliance for Violence Intervention or an equivalent accrediting organization to provide
violence prevention services.

Subd. 2.

Provider requirements.

To be eligible to receive reimbursement for the
provision of violence prevention services, a provider must:

(1) meet qualifications to bill as a medical assistance provider or to provide services
under contract with a medical assistance provider;

(2) ensure that all supervisors of violence prevention professionals have been certified
by the Health Alliance for Violence Intervention or an equivalent accrediting organization
as violence prevention professionals and have been providing violence prevention services
for a minimum of two years; and

(3) show and maintain evidence that all violence prevention professionals employed by
or under contract with the provider are certified by the Health Alliance for Violence
Intervention or an equivalent accrediting organization.

Subd. 3.

Settings.

Violence prevention services may be provided in any setting.

Subd. 4.

Recipient eligibility; criteria for coverage of services.

(a) To be eligible for
violence prevention services, a recipient must:

(1) have received medical treatment for an injury sustained due to an act of community
violence or be experiencing physical or mental illness symptoms due to exposure to
community violence;

(2) be referred for violence prevention services, as part of a determination of medical
necessity and coverage, by a physician or other qualified licensed health care practitioner
based on a determination that the recipient is at elevated risk of a violent injury or retaliation
resulting from another act of community violence; and

(3) meet the criteria in the Minnesota health care programs provider manual for enrollee
eligibility for violence prevention services.

(b) The services recommended through referral under paragraph (a), clause (2), must:

(1) meet the criteria for preventive services as specified in Code of Federal Regulations,
title 42, section 440.130(c);

(2) be within the practitioner's scope of practice under state law; and

(3) be designed to prevent further impacts of community violence, prevent future
community violence, prolong life, and promote the physical and mental health of the
individual.

Subd. 5.

Payment rate.

(a) Effective January 1, 2025, the violence prevention services
rate for services provided by a certified violence prevention professional must be at least
$25 for each 15-minute unit of service. This rate must be adjusted annually for inflation as
provided in subdivision 6.

(b) Services eligible for coverage as violence prevention services include:

(1) screening;

(2) assessment of needs;

(3) development of an individualized service plan;

(4) peer support;

(5) counseling, including counseling to address and mitigate the impacts of trauma;

(6) mentorship;

(7) conflict mediation;

(8) crisis intervention;

(9) patient education;

(10) discharge planning;

(11) documentation;

(12) transportation necessary to access services;

(13) care coordination services meeting the criteria in paragraph (c); and

(14) any additional services listed as violence prevention services in the Minnesota
health care programs provider manual.

(c) Care coordination services must be part of community violence prevention services
and must facilitate the recipient's access to appropriate services, including medical, behavioral
health, social, and other necessary services. These services must be designed to prevent
further impacts of community violence, prevent future community violence, prolong life,
and promote the recipient's physical and mental health, in accordance with the individualized
service plan.

Subd. 6.

Rate adjustments.

Effective for rate years beginning on or after January 1,
2026, the commissioner shall adjust payment rates for violence prevention services annually
for inflation using the Centers for Medicare and Medicaid Services Medicare Economic
Index, as forecasted in the second quarter of the calendar year before the rate year. The
inflation adjustment must be based on the 12-month period from the midpoint of the previous
rate year to the midpoint of the rate year for which the rate is being determined.

EFFECTIVE DATE.

This section is effective January 1, 2025.

Sec. 3. REPORT ON VIOLENCE PREVENTION SERVICES.

(a) The commissioner of human services shall report on medical assistance coverage of
violence prevention services to the chairs and ranking minority members of the legislative
committees with jurisdiction over health and human services finance and policy. The
commissioner shall submit an initial report by February 1, 2027, and a final report by
February 1, 2028.

(b) The reports must include but are not limited to:

(1) a list of the violence prevention service providers in Minnesota and the number of
service recipients;

(2) the estimated return on investment, including health care savings due to reduced
hospitalizations;

(3) the percentage of client goals met;

(4) follow-up information, if available, on whether repeat violent injuries decreased
since violence prevention services were provided, compared to the period before the services
were provided; and

(5) any other information that can be used to determine the effectiveness of violence
prevention services and their funding, including recommendations for improvements to
medical assistance coverage of violence prevention services.