1998 Minnesota Statutes

     245.462 Definitions. 

    Subdivision 1.    Definitions.  The definitions in this 
 section apply to sections 245.461 to 245.486. 

    Subd. 2.    Acute care hospital inpatient treatment.  
 "Acute care hospital inpatient treatment" means short-term 
 medical, nursing, and psychosocial services provided in an acute 
 care hospital licensed under chapter 144.  

    Subd. 3.    Case management services.  "Case management 
 services" means activities that are coordinated with the 
 community support services program as defined in subdivision 6 
 and are designed to help adults with serious and persistent 
 mental illness in gaining access to needed medical, social, 
 educational, vocational, and other necessary services as they 
 relate to the client's mental health needs.  Case management 
 services include developing a functional assessment, an 
 individual community support plan, referring and assisting the 
 person to obtain needed mental health and other services, 
 ensuring coordination of services, and monitoring the delivery 
 of services. 

    Subd. 4.    Case manager.  (a) "Case manager" means an 
 individual employed by the county or other entity authorized by 
 the county board to provide case management services specified 
 in section 245.4711.  A case manager must have a bachelor's 
 degree in one of the behavioral sciences or related fields from 
 an accredited college or university and have at least 2,000 
 hours of supervised experience in the delivery of services to 
 adults with mental illness, must be skilled in the process of 
 identifying and assessing a wide range of client needs, and must 
 be knowledgeable about local community resources and how to use 
 those resources for the benefit of the client.  The case manager 
 shall meet in person with a mental health professional at least 
 once each month to obtain clinical supervision of the case 
 manager's activities.  Case managers with a bachelor's degree 
 but without 2,000 hours of supervised experience in the delivery 
 of services to adults with mental illness must complete 40 hours 
 of training approved by the commissioner of human services in 
 case management skills and in the characteristics and needs of 
 adults with serious and persistent mental illness and must 
 receive clinical supervision regarding individual service 
 delivery from a mental health professional at least once each 
 week until the requirement of 2,000 hours of supervised 
 experience is met.  Clinical supervision must be documented in 
 the client record. 

    Until June 30, 1999, an immigrant who does not have the 
 qualifications specified in this subdivision may provide case 
 management services to adult immigrants with serious and 
 persistent mental illness who are members of the same ethnic 
 group as the case manager if the person:  (1) is actively 
 pursuing credits toward the completion of a bachelor's degree in 
 one of the behavioral sciences or a related field from an 
 accredited college or university; (2) completes 40 hours of 
 training as specified in this subdivision; and (3) receives 
 clinical supervision at least once a week until the requirements 
 of this subdivision are met. 

    (b) The commissioner may approve waivers submitted by 
 counties to allow case managers without a bachelor's degree but 
 with 6,000 hours of supervised experience in the delivery of 
 services to adults with mental illness if the person: 

    (1) meets the qualifications for a mental health 
 practitioner in subdivision 26; 

    (2) has completed 40 hours of training approved by the 
 commissioner in case management skills and in the 
 characteristics and needs of adults with serious and persistent 
 mental illness; and 

    (3) demonstrates that the 6,000 hours of supervised 
 experience are in identifying functional needs of persons with 
 mental illness, coordinating assessment information and making 
 referrals to appropriate service providers, coordinating a 
 variety of services to support and treat persons with mental 
 illness, and monitoring to ensure appropriate provision of 
 services.  The county board is responsible to verify that all 
 qualifications, including content of supervised experience, have 
 been met.  

    Subd. 4a.    Clinical supervision.  "Clinical 
 supervision" means the oversight responsibility for individual 
 treatment plans and individual mental health service delivery, 
 including that provided by the case manager.  Clinical 
 supervision must be accomplished by full or part-time employment 
 of or contracts with mental health professionals.  Clinical 
 supervision must be documented by the mental health professional 
 cosigning individual treatment plans and by entries in the 
 client's record regarding supervisory activities. 

    Subd. 5.    Commissioner.  "Commissioner" means the 
 commissioner of human services.  

    Subd. 6.    Community support services program.  
 "Community support services program" means services, other than 
 inpatient or residential treatment services, provided or 
 coordinated by an identified program and staff under the 
 clinical supervision of a mental health professional designed to 
 help adults with serious and persistent mental illness to 
 function and remain in the community.  A community support 
 services program includes: 

    (1) client outreach, 

    (2) medication monitoring, 

    (3) assistance in independent living skills, 

    (4) development of employability and work-related 
 opportunities, 

    (5) crisis assistance, 

    (6) psychosocial rehabilitation, 

    (7) help in applying for government benefits, and 

    (8) housing support services.  

    The community support services program must be coordinated 
 with the case management services specified in section 245.4711. 

    Subd. 7.    County board.  "County board" means the 
 county board of commissioners or board established pursuant to 
 the joint powers act, section 471.59, or the human services 
 board act, sections 402.01 to 402.10.  

    Subd. 8.    Day treatment services.  "Day treatment," 
 "day treatment services," or "day treatment program" means a 
 structured program of treatment and care provided to an adult in 
 or by:  (1) a hospital accredited by the joint commission on 
 accreditation of health organizations and licensed under 
 sections 144.50 to 144.55; (2) a community mental health center 
 under section 245.62; or (3) an entity that is under contract 
 with the county board to operate a program that meets the 
 requirements of section 245.4712, subdivision 2, and Minnesota 
 Rules, parts 9505.0170 to 9505.0475.  Day treatment consists of 
 group psychotherapy and other intensive therapeutic services 
 that are provided at least one day a week by a multidisciplinary 
 staff under the clinical supervision of a mental health 
 professional.  The services are aimed at stabilizing the adult's 
 mental health status, providing mental health services, and 
 developing and improving the adult's independent living and 
 socialization skills.  The goal of day treatment is to reduce or 
 relieve mental illness and to enable the adult to live in the 
 community.  Day treatment services are not a part of inpatient 
 or residential treatment services.  Day treatment services are 
 distinguished from day care by their structured therapeutic 
 program of psychotherapy services.  The commissioner may limit 
 medical assistance reimbursement for day treatment to 15 hours 
 per week per person instead of the three hours per day per 
 person specified in Minnesota Rules, part 9505.0323, subpart 15. 

    Subd. 9.    Diagnostic assessment.  "Diagnostic 
 assessment" means a written summary of the history, diagnosis, 
 strengths, vulnerabilities, and general service needs of an 
 adult with a mental illness using diagnostic, interview, and 
 other relevant mental health techniques provided by a mental 
 health professional used in developing an individual treatment 
 plan or individual community support plan.  

    Subd. 10.    Education and prevention services.  
 "Education and prevention services" means services designed to 
 educate the general public or special high-risk target 
 populations about mental illness, to increase the understanding 
 and acceptance of problems associated with mental illness, to 
 increase people's awareness of the availability of resources and 
 services, and to improve people's skills in dealing with 
 high-risk situations known to affect people's mental health and 
 functioning.  The services include the distribution of 
 information to individuals and agencies identified by the county 
 board and the local mental health advisory council, on 
 predictors and symptoms of mental disorders, where mental health 
 services are available in the county, and how to access the 
 services. 

    Subd. 11.    Emergency services.  "Emergency services" 
 means an immediate response service available on a 24-hour, 
 seven-day-a-week basis for persons having a psychiatric crisis, 
 a mental health crisis, or emergency.  

    Subd. 11a.    Functional assessment.  "Functional 
 assessment" means an assessment by the case manager of the 
 adult's:  

    (1) mental health symptoms as presented in the adult's 
 diagnostic assessment; 

    (2) mental health needs as presented in the adult's 
 diagnostic assessment; 

    (3) use of drugs and alcohol; 

    (4) vocational and educational functioning; 

    (5) social functioning, including the use of leisure time; 

    (6) interpersonal functioning, including relationships with 
 the adult's family; 

    (7) self-care and independent living capacity; 

    (8) medical and dental health; 

    (9) financial assistance needs; 

    (10) housing and transportation needs; and 

    (11) other needs and problems. 

    Subd. 12.    Individual community support plan.  
 "Individual community support plan" means a written plan 
 developed by a case manager on the basis of a diagnostic 
 assessment and functional assessment.  The plan identifies 
 specific services needed by an adult with serious and persistent 
 mental illness to develop independence or improved functioning 
 in daily living, health and medication management, social 
 functioning, interpersonal relationships, financial management, 
 housing, transportation, and employment.  

    Subd. 13.    Individual placement agreement.  
 "Individual placement agreement" means a written agreement or 
 supplement to a service contract entered into between the county 
 board and a service provider on behalf of an individual adult to 
 provide residential treatment services.  

    Subd. 14.    Individual treatment plan.  "Individual 
 treatment plan" means a written plan of intervention, treatment, 
 and services for an adult with mental illness that is developed 
 by a service provider under the clinical supervision of a mental 
 health professional on the basis of a diagnostic assessment.  
 The plan identifies goals and objectives of treatment, treatment 
 strategy, a schedule for accomplishing treatment goals and 
 objectives, and the individual responsible for providing 
 treatment to the adult with mental illness. 

    Subd. 15. Repealed, 1991 c 94 s 25 

    Subd. 16.    Mental health funds.  "Mental health funds" 
 are funds expended under sections 245.73 and 256E.12, federal 
 mental health block grant funds, and funds expended under 
 section 256D.06 to facilities licensed under Minnesota Rules, 
 parts 9520.0500 to 9520.0690. 

    Subd. 17.    Mental health practitioner.  "Mental health 
 practitioner" means a person providing services to persons with 
 mental illness who is qualified in at least one of the following 
 ways:  

    (1) holds a bachelor's degree in one of the behavioral 
 sciences or related fields from an accredited college or 
 university and has at least 2,000 hours of supervised experience 
 in the delivery of services to persons with mental illness; 

    (2) has at least 6,000 hours of supervised experience in 
 the delivery of services to persons with mental illness; 

    (3) is a graduate student in one of the behavioral sciences 
 or related fields and is formally assigned by an accredited 
 college or university to an agency or facility for clinical 
 training; or 

    (4) holds a master's or other graduate degree in one of the 
 behavioral sciences or related fields from an accredited college 
 or university and has less than 4,000 hours post-master's 
 experience in the treatment of mental illness. 

    Subd. 18.    Mental health professional.  "Mental health 
 professional" means a person providing clinical services in the 
 treatment of mental illness who is qualified in at least one of 
 the following ways:  

    (1) in psychiatric nursing:  a registered nurse who is 
 licensed under sections 148.171 to 148.285, and who is certified 
 as a clinical specialist in adult psychiatric and mental health 
 nursing by the American nurses association or who has a master's 
 degree in nursing or one of the behavioral sciences or related 
 fields from an accredited college or university or its 
 equivalent, with at least 4,000 hours of post-master's 
 supervised experience in the delivery of clinical services in 
 the treatment of mental illness; 

    (2) in clinical social work:  a person licensed as an 
 independent clinical social worker under section 148B.21, 
 subdivision 6, or a person with a master's degree in social work 
 from an accredited college or university, with at least 4,000 
 hours of post-master's supervised experience in the delivery of 
 clinical services in the treatment of mental illness; 

    (3) in psychology:  a psychologist licensed under sections 
 148.88 to 148.98 who has stated to the board of psychology 
 competencies in the diagnosis and treatment of mental illness; 

    (4) in psychiatry:  a physician licensed under chapter 147 
 and certified by the American board of psychiatry and neurology 
 or eligible for board certification in psychiatry; 

    (5) in marriage and family therapy:  the mental health 
 professional must be a marriage and family therapist licensed 
 under sections 148B.29 to 148B.39 with at least two years of 
 post-master's supervised experience in the delivery of clinical 
 services in the treatment of mental illness; or 

    (6) in allied fields:  a person with a master's degree from 
 an accredited college or university in one of the behavioral 
 sciences or related fields, with at least 4,000 hours of 
 post-master's supervised experience in the delivery of clinical 
 services in the treatment of mental illness.  

    Subd. 19.    Mental health services.  "Mental health 
 services" means at least all of the treatment services and case 
 management activities that are provided to adults with mental 
 illness and are described in sections 245.461 to 245.486. 

    Subd. 20.    Mental illness.  (a) "Mental illness" means 
 an organic disorder of the brain or a clinically significant 
 disorder of thought, mood, perception, orientation, memory, or 
 behavior that is listed in the clinical manual of the 
 International Classification of Diseases (ICD-9-CM), current 
 edition, code range 290.0 to 302.99 or 306.0 to 316.0 or the 
 corresponding code in the American Psychiatric Association's 
 Diagnostic and Statistical Manual of Mental Disorders (DSM-MD), 
 current edition, Axes I, II, or III, and that seriously limits a 
 person's capacity to function in primary aspects of daily living 
 such as personal relations, living arrangements, work, and 
 recreation.  

    (b) An "adult with acute mental illness" means an adult who 
 has a mental illness that is serious enough to require prompt 
 intervention.  

    (c) For purposes of case management and community support 
 services, a "person with serious and persistent mental illness" 
 means an adult who has a mental illness and meets at least one 
 of the following criteria: 

    (1) the adult has undergone two or more episodes of 
 inpatient care for a mental illness within the preceding 24 
 months; 

    (2) the adult has experienced a continuous psychiatric 
 hospitalization or residential treatment exceeding six months' 
 duration within the preceding 12 months; 

    (3) the adult: 

    (i) has a diagnosis of schizophrenia, bipolar disorder, 
 major depression, or borderline personality disorder; 

    (ii) indicates a significant impairment in functioning; and 

    (iii) has a written opinion from a mental health 
 professional, in the last three years, stating that the adult is 
 reasonably likely to have future episodes requiring inpatient or 
 residential treatment, of a frequency described in clause (1) or 
 (2), unless ongoing case management or community support 
 services are provided; 

    (4) the adult has, in the last three years, been committed 
 by a court as a mentally ill person under chapter 253B, or the 
 adult's commitment has been stayed or continued; or 

    (5) the adult (i) was eligible under clauses (1) to (4), 
 but the specified time period has expired or the adult was 
 eligible as a child under section 245.4871, subdivision 6; and 
 (ii) has a written opinion from a mental health professional, in 
 the last three years, stating that the adult is reasonably 
 likely to have future episodes requiring inpatient or 
 residential treatment, of a frequency described in clause (1) or 
 (2), unless ongoing case management or community support 
 services are provided. 

    Subd. 21.    Outpatient services.  "Outpatient services" 
 means mental health services, excluding day treatment and 
 community support services programs, provided by or under the 
 clinical supervision of a mental health professional to adults 
 with mental illness who live outside a hospital.  Outpatient 
 services include clinical activities such as individual, group, 
 and family therapy; individual treatment planning; diagnostic 
 assessments; medication management; and psychological testing.  

    Subd. 22.    Regional treatment center inpatient services. 
  "Regional treatment center inpatient services" means the 
 24-hour-a-day comprehensive medical, nursing, or psychosocial 
 services provided in a regional treatment center operated by the 
 state.  

    Subd. 23.    Residential treatment.  "Residential 
 treatment" means a 24-hour-a-day program under the clinical 
 supervision of a mental health professional, in a community 
 residential setting other than an acute care hospital or 
 regional treatment center inpatient unit, that must be licensed 
 as a residential treatment program for adults with mental 
 illness under Minnesota Rules, parts 9520.0500 to 9520.0690 or 
 other rules adopted by the commissioner. 

    Subd. 24.    Service provider.  "Service provider" means 
 either a county board or an individual or agency including a 
 regional treatment center under contract with the county board 
 that provides adult mental health services funded by sections 
 245.461 to 245.486. 

    Subd. 25. Repealed, 1989 c 282 art 4 s 64 

    HIST: 1987 c 403 art 2 s 17; 1988 c 689 art 2 s 64-73; 1989 c 
 282 art 4 s 2; 1990 c 426 art 2 s 6; 1990 c 568 art 5 s 34; 1991 
 c 292 art 6 s 3,4; 1992 c 526 s 1; 1Sp1993 c 1 art 7 s 2,3; 1996 
 c 451 art 5 s 4; 1997 c 7 art 1 s 94; 1998 c 407 art 4 s 2,3