245.4682 MENTAL HEALTH SERVICE DELIVERY AND FINANCE REFORM.
Subdivision 1. Policy.
The commissioner of human services shall undertake a series of
reforms to address the underlying structural, financial, and organizational problems in Minnesota's
mental health system with the goal of improving the availability, quality, and accountability of
mental health care within the state.
Subd. 2. General provisions.
(a) In the design and implementation of reforms to the mental
health system, the commissioner shall:
(1) consult with consumers, families, counties, tribes, advocates, providers, and other
(2) bring to the legislature, and the State Advisory Council on Mental Health, by January
15, 2008, recommendations for legislation to update the role of counties and to clarify the case
management roles, functions, and decision-making authority of health plans and counties, and
to clarify county retention of the responsibility for the delivery of social services as required
under subdivision 3, paragraph (a);
(3) withhold implementation of any recommended changes in case management roles,
functions, and decision-making authority until after the release of the report due January 15, 2008;
(4) ensure continuity of care for persons affected by these reforms including ensuring client
choice of provider by requiring broad provider networks and developing mechanisms to facilitate
a smooth transition of service responsibilities;
(5) provide accountability for the efficient and effective use of public and private resources
in achieving positive outcomes for consumers;
(6) ensure client access to applicable protections and appeals; and
(7) make budget transfers necessary to implement the reallocation of services and client
responsibilities between counties and health care programs that do not increase the state and
county costs and efficiently allocate state funds.
(b) When making transfers under paragraph (a) necessary to implement movement
of responsibility for clients and services between counties and health care programs, the
commissioner, in consultation with counties, shall ensure that any transfer of state grants to health
care programs, including the value of case management transfer grants under section
, does not exceed the value of the services being transferred for the latest 12-month
period for which data is available. The commissioner may make quarterly adjustments based on
the availability of additional data during the first four quarters after the transfers first occur. If
case management transfer grants under section
256B.0625, subdivision 20
, are repealed and the
value, based on the last year prior to repeal, exceeds the value of the services being transferred,
the difference becomes an ongoing part of each county's adult and children's mental health grants
(c) This appropriation is not authorized to be expended after December 31, 2010, unless
approved by the legislature.
Subd. 3. Projects for coordination of care.
(a) Consistent with section
256D and 256L, the commissioner is authorized to solicit, approve, and implement up to three
projects to demonstrate the integration of physical and mental health services within prepaid
health plans and their coordination with social services. The commissioner shall require that each
project be based on locally defined partnerships that include at least one health maintenance
organization, community integrated service network, or accountable provider network authorized
and operating under chapter 62D, 62N, or 62T, or county-based purchasing entity under section
that is eligible to contract with the commissioner as a prepaid health plan, and the
county or counties within the service area. Counties shall retain responsibility and authority for
social services in these locally defined partnerships.
(b) The commissioner, in consultation with consumers, families, and their representatives,
(1) determine criteria for approving the projects and use those criteria to solicit proposals for
preferred integrated networks. The commissioner must develop criteria to evaluate the partnership
proposed by the county and prepaid health plan to coordinate access and delivery of services. The
proposal must at a minimum address how the partnership will coordinate the provision of:
(i) client outreach and identification of health and social service needs paired with expedited
access to appropriate resources;
(ii) activities to maintain continuity of health care coverage;
(iii) children's residential mental health treatment and treatment foster care;
(iv) court-ordered assessments and treatments;
(v) prepetition screening and commitments under chapter 253B;
(vi) assessment and treatment of children identified through mental health screening of
child welfare and juvenile corrections cases;
(vii) home and community-based waiver services;
(viii) assistance with finding and maintaining employment;
(ix) housing; and
(2) determine specifications for contracts with prepaid health plans to improve the plan's
ability to serve persons with mental health conditions, including specifications addressing:
(i) early identification and intervention of physical and behavioral health problems;
(ii) communication between the enrollee and the health plan;
(iii) facilitation of enrollment for persons who are also eligible for a Medicare special needs
plan offered by the health plan;
(iv) risk screening procedures;
(v) health care coordination;
(vi) member services and access to applicable protections and appeal processes;
(vii) specialty provider networks;
(viii) transportation services;
(ix) treatment planning; and
(x) administrative simplification for providers;
(3) begin implementation of the projects no earlier than January 1, 2009, with not more
than 40 percent of the statewide population included during calendar year 2009 and additional
counties included in subsequent years;
(4) waive any administrative rule not consistent with the implementation of the projects;
(5) allow potential bidders at least 90 days to respond to the request for proposals; and
(6) conduct an independent evaluation to determine if mental health outcomes have
improved in that county or counties according to measurable standards designed in consultation
with the advisory body established under this subdivision and reviewed by the State Advisory
Council on Mental Health.
(c) Notwithstanding any statute or administrative rule to the contrary, the commissioner
may enroll all persons eligible for medical assistance with serious mental illness or emotional
disturbance in the prepaid plan of their choice within the project service area unless:
(1) the individual is eligible for home and community-based services for persons with
developmental disabilities and related conditions under section
(2) the individual has a basis for exclusion from the prepaid plan under section
, other than disability, mental illness, or emotional disturbance.
(d) The commissioner shall involve organizations representing persons with mental illness
and their families in the development and distribution of information used to educate potential
enrollees regarding their options for health care and mental health service delivery under this
(e) If the person described in paragraph (c) does not elect to remain in fee-for-service
medical assistance, or declines to choose a plan, the commissioner may preferentially assign that
person to the prepaid plan participating in the preferred integrated network. The commissioner
shall implement the enrollment changes within a project's service area on the timeline specified in
that project's approved application.
(f) A person enrolled in a prepaid health plan under paragraphs (c) and (d) may disenroll
from the plan at any time.
(g) The commissioner, in consultation with consumers, families, and their representatives,
shall evaluate the projects begun in 2009, and shall refine the design of the service integration
projects before expanding the projects. The commissioner shall report to the chairs of the
legislative committees with jurisdiction over mental health services by March 1, 2008, on plans
for evaluation of preferred integrated networks established under this subdivision.
(h) The commissioner shall apply for any federal waivers necessary to implement these
(i) Payment for Medicaid service providers under this subdivision for the months of May and
June will be made no earlier than July 1 of the same calendar year.
History: 2007 c 147 art 8 s 5