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Minnesota Legislature

Office of the Revisor of Statutes

Chapter 256B

Section 256B.0943

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256B.0943 CHILDREN'S THERAPEUTIC SERVICES AND SUPPORTS.
    Subdivision 1. Definitions. For purposes of this section, the following terms have the
meanings given them.
(a) "Children's therapeutic services and supports" means the flexible package of mental
health services for children who require varying therapeutic and rehabilitative levels of
intervention. The services are time-limited interventions that are delivered using various treatment
modalities and combinations of services designed to reach treatment outcomes identified in the
individual treatment plan.
(b) "Clinical supervision" means the overall responsibility of the mental health professional
for the control and direction of individualized treatment planning, service delivery, and treatment
review for each client. A mental health professional who is an enrolled Minnesota health care
program provider accepts full professional responsibility for a supervisee's actions and decisions,
instructs the supervisee in the supervisee's work, and oversees or directs the supervisee's work.
(c) "County board" means the county board of commissioners or board established under
sections 402.01 to 402.10 or 471.59.
(d) "Crisis assistance" has the meaning given in section 245.4871, subdivision 9a.
(e) "Culturally competent provider" means a provider who understands and can utilize to a
client's benefit the client's culture when providing services to the client. A provider may be
culturally competent because the provider is of the same cultural or ethnic group as the client or
the provider has developed the knowledge and skills through training and experience to provide
services to culturally diverse clients.
(f) "Day treatment program" for children means a site-based structured program consisting
of group psychotherapy for more than three individuals and other intensive therapeutic
services provided by a multidisciplinary team, under the clinical supervision of a mental health
professional.
(g) "Diagnostic assessment" has the meaning given in section 245.4871, subdivision 11.
(h) "Direct service time" means the time that a mental health professional, mental health
practitioner, or mental health behavioral aide spends face-to-face with a client and the client's
family. Direct service time includes time in which the provider obtains a client's history or
provides service components of children's therapeutic services and supports. Direct service time
does not include time doing work before and after providing direct services, including scheduling,
maintaining clinical records, consulting with others about the client's mental health status,
preparing reports, receiving clinical supervision directly related to the client's psychotherapy
session, and revising the client's individual treatment plan.
(i) "Direction of mental health behavioral aide" means the activities of a mental health
professional or mental health practitioner in guiding the mental health behavioral aide in
providing services to a client. The direction of a mental health behavioral aide must be based on
the client's individualized treatment plan and meet the requirements in subdivision 6, paragraph
(b), clause (5).
(j) "Emotional disturbance" has the meaning given in section 245.4871, subdivision 15. For
persons at least age 18 but under age 21, mental illness has the meaning given in section 245.462,
subdivision 20
, paragraph (a).
(k) "Individual behavioral plan" means a plan of intervention, treatment, and services for
a child written by a mental health professional or mental health practitioner, under the clinical
supervision of a mental health professional, to guide the work of the mental health behavioral aide.
(l) "Individual treatment plan" has the meaning given in section 245.4871, subdivision 21.
(m) "Mental health professional" means an individual as defined in section 245.4871,
subdivision 27
, clauses (1) to (5), or tribal vendor as defined in section 256B.02, subdivision 7,
paragraph (b).
(n) "Preschool program" means a day program licensed under Minnesota Rules, parts
9503.0005 to 9503.0175, and enrolled as a children's therapeutic services and supports provider
to provide a structured treatment program to a child who is at least 33 months old but who has
not yet attended the first day of kindergarten.
(o) "Skills training" means individual, family, or group training designed to improve the
basic functioning of the child with emotional disturbance and the child's family in the activities
of daily living and community living, and to improve the social functioning of the child and the
child's family in areas important to the child's maintaining or reestablishing residency in the
community. Individual, family, and group skills training must:
(1) consist of activities designed to promote skill development of the child and the child's
family in the use of age-appropriate daily living skills, interpersonal and family relationships,
and leisure and recreational services;
(2) consist of activities that will assist the family's understanding of normal child
development and to use parenting skills that will help the child with emotional disturbance
achieve the goals outlined in the child's individual treatment plan; and
(3) promote family preservation and unification, promote the family's integration with the
community, and reduce the use of unnecessary out-of-home placement or institutionalization of
children with emotional disturbance.
    Subd. 2. Covered service components of children's therapeutic services and supports. (a)
Subject to federal approval, medical assistance covers medically necessary children's therapeutic
services and supports as defined in this section that an eligible provider entity under subdivisions
4 and 5 provides to a client eligible under subdivision 3.
(b) The service components of children's therapeutic services and supports are:
(1) individual, family, and group psychotherapy;
(2) individual, family, or group skills training provided by a mental health professional or
mental health practitioner;
(3) crisis assistance;
(4) mental health behavioral aide services; and
(5) direction of a mental health behavioral aide.
(c) Service components may be combined to constitute therapeutic programs, including day
treatment programs and preschool programs. Although day treatment and preschool programs
have specific client and provider eligibility requirements, medical assistance only pays for the
service components listed in paragraph (b).
    Subd. 3. Determination of client eligibility. A client's eligibility to receive children's
therapeutic services and supports under this section shall be determined based on a diagnostic
assessment by a mental health professional that is performed within 180 days of the initial start
of service. The diagnostic assessment must:
(1) include current diagnoses on all five axes of the client's current mental health status;
(2) determine whether a child under age 18 has a diagnosis of emotional disturbance or, if the
person is between the ages of 18 and 21, whether the person has a mental illness;
(3) document children's therapeutic services and supports as medically necessary to address
an identified disability, functional impairment, and the individual client's needs and goals;
(4) be used in the development of the individualized treatment plan; and
(5) be completed annually until age 18. A client with autism spectrum disorder or pervasive
developmental disorder may receive a diagnostic assessment once every three years, at the request
of the parent or guardian, if a mental health professional agrees there has been little change in
the condition and that an annual assessment is not needed. For individuals between age 18 and
21, unless a client's mental health condition has changed markedly since the client's most recent
diagnostic assessment, annual updating is necessary. For the purpose of this section, "updating"
means a written summary, including current diagnoses on all five axes, by a mental health
professional of the client's current mental health status and service needs.
    Subd. 4. Provider entity certification. (a) Effective July 1, 2003, the commissioner shall
establish an initial provider entity application and certification process and recertification process
to determine whether a provider entity has an administrative and clinical infrastructure that meets
the requirements in subdivisions 5 and 6. The commissioner shall recertify a provider entity
at least every three years. The commissioner shall establish a process for decertification of a
provider entity that no longer meets the requirements in this section. The county, tribe, and the
commissioner shall be mutually responsible and accountable for the county's, tribe's, and state's
part of the certification, recertification, and decertification processes.
(b) For purposes of this section, a provider entity must be:
(1) an Indian health services facility or a facility owned and operated by a tribe or tribal
organization operating as a 638 facility under Public Law 93-638 certified by the state;
(2) a county-operated entity certified by the state; or
(3) a noncounty entity recommended for certification by the provider's host county and
certified by the state.
    Subd. 5. Provider entity administrative infrastructure requirements. (a) To be an eligible
provider entity under this section, a provider entity must have an administrative infrastructure that
establishes authority and accountability for decision making and oversight of functions, including
finance, personnel, system management, clinical practice, and performance measurement. The
provider must have written policies and procedures that it reviews and updates every three years
and distributes to staff initially and upon each subsequent update.
(b) The administrative infrastructure written policies and procedures must include:
(1) personnel procedures, including a process for: (i) recruiting, hiring, training, and retention
of culturally and linguistically competent providers; (ii) conducting a criminal background
check on all direct service providers and volunteers; (iii) investigating, reporting, and acting on
violations of ethical conduct standards; (iv) investigating, reporting, and acting on violations of
data privacy policies that are compliant with federal and state laws; (v) utilizing volunteers,
including screening applicants, training and supervising volunteers, and providing liability
coverage for volunteers; and (vi) documenting that each mental health professional, mental health
practitioner, or mental health behavioral aide meets the applicable provider qualification criteria,
training criteria under subdivision 8, and clinical supervision or direction of a mental health
behavioral aide requirements under subdivision 6;
(2) fiscal procedures, including internal fiscal control practices and a process for collecting
revenue that is compliant with federal and state laws;
(3) if a client is receiving services from a case manager or other provider entity, a service
coordination process that ensures services are provided in the most appropriate manner to achieve
maximum benefit to the client. The provider entity must ensure coordination and nonduplication
of services consistent with county board coordination procedures established under section
245.4881, subdivision 5;
(4) a performance measurement system, including monitoring to determine cultural
appropriateness of services identified in the individual treatment plan, as determined by the
client's culture, beliefs, values, and language, and family-driven services; and
(5) a process to establish and maintain individual client records. The client's records must
include:
(i) the client's personal information;
(ii) forms applicable to data privacy;
(iii) the client's diagnostic assessment, updates, results of tests, individual treatment plan,
and individual behavior plan, if necessary;
(iv) documentation of service delivery as specified under subdivision 6;
(v) telephone contacts;
(vi) discharge plan; and
(vii) if applicable, insurance information.
    Subd. 6. Provider entity clinical infrastructure requirements. (a) To be an eligible
provider entity under this section, a provider entity must have a clinical infrastructure that
utilizes diagnostic assessment, an individualized treatment plan, service delivery, and individual
treatment plan review that are culturally competent, child-centered, and family-driven to achieve
maximum benefit for the client. The provider entity must review and update the clinical policies
and procedures every three years and must distribute the policies and procedures to staff initially
and upon each subsequent update.
    (b) The clinical infrastructure written policies and procedures must include policies and
procedures for:
    (1) providing or obtaining a client's diagnostic assessment that identifies acute and chronic
clinical disorders, co-occurring medical conditions, sources of psychological and environmental
problems, and a functional assessment. The functional assessment must clearly summarize the
client's individual strengths and needs;
    (2) developing an individual treatment plan that is:
    (i) based on the information in the client's diagnostic assessment;
    (ii) developed no later than the end of the first psychotherapy session after the completion
of the client's diagnostic assessment by the mental health professional who provides the client's
psychotherapy;
    (iii) developed through a child-centered, family-driven planning process that identifies
service needs and individualized, planned, and culturally appropriate interventions that contain
specific treatment goals and objectives for the client and the client's family or foster family;
    (iv) reviewed at least once every 90 days and revised, if necessary; and
    (v) signed by the client or, if appropriate, by the client's parent or other person authorized
by statute to consent to mental health services for the client;
    (3) developing an individual behavior plan that documents services to be provided by the
mental health behavioral aide. The individual behavior plan must include:
    (i) detailed instructions on the service to be provided;
    (ii) time allocated to each service;
    (iii) methods of documenting the child's behavior;
    (iv) methods of monitoring the child's progress in reaching objectives; and
    (v) goals to increase or decrease targeted behavior as identified in the individual treatment
plan;
    (4) clinical supervision of the mental health practitioner and mental health behavioral aide.
A mental health professional must document the clinical supervision the professional provides
by cosigning individual treatment plans and making entries in the client's record on supervisory
activities. Clinical supervision does not include the authority to make or terminate court-ordered
placements of the child. A clinical supervisor must be available for urgent consultation as required
by the individual client's needs or the situation. Clinical supervision may occur individually or
in a small group to discuss treatment and review progress toward goals. The focus of clinical
supervision must be the client's treatment needs and progress and the mental health practitioner's
or behavioral aide's ability to provide services;
    (4a) CTSS certified provider entities providing day treatment programs must meet the
conditions in items (i) to (iii):
    (i) the supervisor must be present and available on the premises more than 50 percent of
the time in a five-working-day period during which the supervisee is providing a mental health
service;
    (ii) the diagnosis and the client's individual treatment plan or a change in the diagnosis or
individual treatment plan must be made by or reviewed, approved, and signed by the supervisor;
and
    (iii) every 30 days, the supervisor must review and sign the record of the client's care for
all activities in the preceding 30-day period;
    (4b) for all other services provided under CTSS, clinical supervision standards provided in
items (i) to (iii) must be used:
    (i) medical assistance shall reimburse a mental health practitioner who maintains a consulting
relationship with a mental health professional who accepts full professional responsibility and
is present on site for at least one observation during the first 12 hours in which the mental
health practitioner provides the individual, family, or group skills training to the child or the
child's family;
    (ii) thereafter, the mental health professional is required to be present on site for observation
as clinically appropriate when the mental health practitioner is providing individual, family, or
group skills training to the child or the child's family; and
    (iii) the observation must be a minimum of one clinical unit. The on-site presence of the
mental health professional must be documented in the child's record and signed by the mental
health professional who accepts full professional responsibility;
    (5) providing direction to a mental health behavioral aide. For entities that employ mental
health behavioral aides, the clinical supervisor must be employed by the provider entity or
other certified children's therapeutic supports and services provider entity to ensure necessary
and appropriate oversight for the client's treatment and continuity of care. The mental health
professional or mental health practitioner giving direction must begin with the goals on the
individualized treatment plan, and instruct the mental health behavioral aide on how to construct
therapeutic activities and interventions that will lead to goal attainment. The professional or
practitioner giving direction must also instruct the mental health behavioral aide about the client's
diagnosis, functional status, and other characteristics that are likely to affect service delivery.
Direction must also include determining that the mental health behavioral aide has the skills to
interact with the client and the client's family in ways that convey personal and cultural respect
and that the aide actively solicits information relevant to treatment from the family. The aide
must be able to clearly explain the activities the aide is doing with the client and the activities'
relationship to treatment goals. Direction is more didactic than is supervision and requires the
professional or practitioner providing it to continuously evaluate the mental health behavioral
aide's ability to carry out the activities of the individualized treatment plan and the individualized
behavior plan. When providing direction, the professional or practitioner must:
    (i) review progress notes prepared by the mental health behavioral aide for accuracy and
consistency with diagnostic assessment, treatment plan, and behavior goals and the professional
or practitioner must approve and sign the progress notes;
    (ii) identify changes in treatment strategies, revise the individual behavior plan, and
communicate treatment instructions and methodologies as appropriate to ensure that treatment
is implemented correctly;
    (iii) demonstrate family-friendly behaviors that support healthy collaboration among the
child, the child's family, and providers as treatment is planned and implemented;
    (iv) ensure that the mental health behavioral aide is able to effectively communicate with the
child, the child's family, and the provider; and
    (v) record the results of any evaluation and corrective actions taken to modify the work of
the mental health behavioral aide;
    (6) providing service delivery that implements the individual treatment plan and meets the
requirements under subdivision 9; and
    (7) individual treatment plan review. The review must determine the extent to which the
services have met the goals and objectives in the previous treatment plan. The review must
assess the client's progress and ensure that services and treatment goals continue to be necessary
and appropriate to the client and the client's family or foster family. Revision of the individual
treatment plan does not require a new diagnostic assessment unless the client's mental health
status has changed markedly. The updated treatment plan must be signed by the client, if
appropriate, and by the client's parent or other person authorized by statute to give consent to the
mental health services for the child.
    Subd. 7. Qualifications of individual and team providers. (a) An individual or team
provider working within the scope of the provider's practice or qualifications may provide service
components of children's therapeutic services and supports that are identified as medically
necessary in a client's individual treatment plan.
(b) An individual provider must be qualified as:
(1) a mental health professional as defined in subdivision 1, paragraph (m); or
(2) a mental health practitioner as defined in section 245.4871, subdivision 26. The mental
health practitioner must work under the clinical supervision of a mental health professional; or
(3) a mental health behavioral aide working under the direction of a mental health
professional to implement the rehabilitative mental health services identified in the client's
individual treatment plan.
(A) A level I mental health behavioral aide must:
(i) be at least 18 years old;
(ii) have a high school diploma or general equivalency diploma (GED) or two years of
experience as a primary caregiver to a child with severe emotional disturbance within the previous
ten years; and
(iii) meet preservice and continuing education requirements under subdivision 8.
(B) A level II mental health behavioral aide must:
(i) be at least 18 years old;
(ii) have an associate or bachelor's degree or 4,000 hours of experience in delivering clinical
services in the treatment of mental illness concerning children or adolescents; and
(iii) meet preservice and continuing education requirements in subdivision 8.
(c) A preschool program multidisciplinary team must include at least one mental health
professional and one or more of the following individuals under the clinical supervision of a
mental health professional:
(i) a mental health practitioner; or
(ii) a program person, including a teacher, assistant teacher, or aide, who meets the
qualifications and training standards of a level I mental health behavioral aide.
(d) A day treatment multidisciplinary team must include at least one mental health
professional and one mental health practitioner.
    Subd. 8. Required preservice and continuing education. (a) A provider entity shall
establish a plan to provide preservice and continuing education for staff. The plan must clearly
describe the type of training necessary to maintain current skills and obtain new skills and that
relates to the provider entity's goals and objectives for services offered.
    (b) A provider that employs a mental health behavioral aide under this section must require
the mental health behavioral aide to complete 30 hours of preservice training. The preservice
training must include topics specified in Minnesota Rules, part 9535.4068, subparts 1 and 2, and
parent team training. The preservice training must include 15 hours of in-person training of a
mental health behavioral aide in mental health services delivery and eight hours of parent team
training. Curricula for parent team training must be approved in advance by the commissioner.
Components of parent team training include:
    (1) partnering with parents;
    (2) fundamentals of family support;
    (3) fundamentals of policy and decision making;
    (4) defining equal partnership;
    (5) complexities of the parent and service provider partnership in multiple service delivery
systems due to system strengths and weaknesses;
    (6) sibling impacts;
    (7) support networks; and
    (8) community resources.
    (c) A provider entity that employs a mental health practitioner and a mental health behavioral
aide to provide children's therapeutic services and supports under this section must require the
mental health practitioner and mental health behavioral aide to complete 20 hours of continuing
education every two calendar years. The continuing education must be related to serving the needs
of a child with emotional disturbance in the child's home environment and the child's family. The
topics covered in orientation and training must conform to Minnesota Rules, part 9535.4068.
    (d) The provider entity must document the mental health practitioner's or mental health
behavioral aide's annual completion of the required continuing education. The documentation
must include the date, subject, and number of hours of the continuing education, and attendance
records, as verified by the staff member's signature, job title, and the instructor's name. The
provider entity must keep documentation for each employee, including records of attendance at
professional workshops and conferences, at a central location and in the employee's personnel file.
    Subd. 9. Service delivery criteria. (a) In delivering services under this section, a certified
provider entity must ensure that:
    (1) each individual provider's caseload size permits the provider to deliver services to both
clients with severe, complex needs and clients with less intensive needs. The provider's caseload
size should reasonably enable the provider to play an active role in service planning, monitoring,
and delivering services to meet the client's and client's family's needs, as specified in each client's
individual treatment plan;
    (2) site-based programs, including day treatment and preschool programs, provide staffing
and facilities to ensure the client's health, safety, and protection of rights, and that the programs
are able to implement each client's individual treatment plan;
    (3) a day treatment program is provided to a group of clients by a multidisciplinary team
under the clinical supervision of a mental health professional. The day treatment program must be
provided in and by: (i) an outpatient hospital accredited by the Joint Commission on Accreditation
of Health Organizations and licensed under sections 144.50 to 144.55; (ii) a community mental
health center under section 245.62; and (iii) an entity that is under contract with the county
board to operate a program that meets the requirements of sections 245.4712, subdivision 2, and
245.4884, subdivision 2, and Minnesota Rules, parts 9505.0170 to 9505.0475. The day treatment
program must stabilize the client's mental health status while developing and improving the
client's independent living and socialization skills. The goal of the day treatment program must be
to reduce or relieve the effects of mental illness and provide training to enable the client to live
in the community. The program must be available at least one day a week for a three-hour time
block. The three-hour time block must include at least one hour, but no more than two hours,
of individual or group psychotherapy. The remainder of the three-hour time block may include
recreation therapy, socialization therapy, or independent living skills therapy, but only if the
therapies are included in the client's individual treatment plan. Day treatment programs are not
part of inpatient or residential treatment services; and
    (4) a preschool program is a structured treatment program offered to a child who is at
least 33 months old, but who has not yet reached the first day of kindergarten, by a preschool
multidisciplinary team in a day program licensed under Minnesota Rules, parts 9503.0005 to
9503.0175. The program must be available at least one day a week for a minimum two-hour time
block. The structured treatment program may include individual or group psychotherapy and
recreation therapy, socialization therapy, or independent living skills therapy, if included in the
client's individual treatment plan.
    (b) A provider entity must deliver the service components of children's therapeutic services
and supports in compliance with the following requirements:
    (1) individual, family, and group psychotherapy must be delivered as specified in Minnesota
Rules, part 9505.0323;
    (2) individual, family, or group skills training must be provided by a mental health
professional or a mental health practitioner who has a consulting relationship with a mental health
professional who accepts full professional responsibility for the training;
    (3) crisis assistance must be time-limited and designed to resolve or stabilize crisis through
arrangements for direct intervention and support services to the child and the child's family.
Crisis assistance must utilize resources designed to address abrupt or substantial changes in the
functioning of the child or the child's family as evidenced by a sudden change in behavior with
negative consequences for well being, a loss of usual coping mechanisms, or the presentation
of danger to self or others;
    (4) medically necessary services that are provided by a mental health behavioral aide must
be designed to improve the functioning of the child and support the family in activities of daily
and community living. A mental health behavioral aide must document the delivery of services in
written progress notes. The mental health behavioral aide must implement goals in the treatment
plan for the child's emotional disturbance that allow the child to acquire developmentally and
therapeutically appropriate daily living skills, social skills, and leisure and recreational skills
through targeted activities. These activities may include:
    (i) assisting a child as needed with skills development in dressing, eating, and toileting;
    (ii) assisting, monitoring, and guiding the child to complete tasks, including facilitating the
child's participation in medical appointments;
    (iii) observing the child and intervening to redirect the child's inappropriate behavior;
    (iv) assisting the child in using age-appropriate self-management skills as related to the
child's emotional disorder or mental illness, including problem solving, decision making,
communication, conflict resolution, anger management, social skills, and recreational skills;
    (v) implementing deescalation techniques as recommended by the mental health professional;
    (vi) implementing any other mental health service that the mental health professional has
approved as being within the scope of the behavioral aide's duties; or
    (vii) assisting the parents to develop and use parenting skills that help the child achieve the
goals outlined in the child's individual treatment plan or individual behavioral plan. Parenting
skills must be directed exclusively to the child's treatment; and
    (5) direction of a mental health behavioral aide must include the following:
    (i) a total of one hour of on-site observation by a mental health professional during the
first 12 hours of service provided to a child;
    (ii) ongoing on-site observation by a mental health professional or mental health practitioner
for at least a total of one hour during every 40 hours of service provided to a child; and
    (iii) immediate accessibility of the mental health professional or mental health practitioner
to the mental health behavioral aide during service provision.
    Subd. 10. Service authorization. The commissioner shall publish in the State Register a list
of health services that require prior authorization, as well as the criteria and standards used to
select health services on the list. The list and the criteria and standards used to formulate the list
are not subject to the requirements of sections 14.001 to 14.69. The commissioner's decision on
whether prior authorization is required for a health service is not subject to administrative appeal.
    Subd. 11. Documentation and billing. (a) A provider entity must document the services
it provides under this section. The provider entity must ensure that the entity's documentation
standards meet the requirements of federal and state laws. Services billed under this section that
are not documented according to this subdivision shall be subject to monetary recovery by the
commissioner. The provider entity may not bill for anything other than direct service time.
    (b) An individual mental health provider must promptly document the following in a client's
record after providing services to the client:
    (1) each occurrence of the client's mental health service, including the date, type, length, and
scope of the service;
    (2) the name of the person who gave the service;
    (3) contact made with other persons interested in the client, including representatives of
the courts, corrections systems, or schools. The provider must document the name and date
of each contact;
    (4) any contact made with the client's other mental health providers, case manager, family
members, primary caregiver, legal representative, or the reason the provider did not contact the
client's family members, primary caregiver, or legal representative, if applicable; and
    (5) required clinical supervision, as appropriate.
    Subd. 12. Excluded services. The following services are not eligible for medical assistance
payment as children's therapeutic services and supports:
    (1) service components of children's therapeutic services and supports simultaneously
provided by more than one provider entity unless prior authorization is obtained;
    (2) children's therapeutic services and supports provided in violation of medical assistance
policy in Minnesota Rules, part 9505.0220;
    (3) mental health behavioral aide services provided by a personal care assistant who is not
qualified as a mental health behavioral aide and employed by a certified children's therapeutic
services and supports provider entity;
    (4) service components of CTSS that are the responsibility of a residential or program license
holder, including foster care providers under the terms of a service agreement or administrative
rules governing licensure;
    (5) adjunctive activities that may be offered by a provider entity but are not otherwise
covered by medical assistance, including:
    (i) a service that is primarily recreation oriented or that is provided in a setting that is not
medically supervised. This includes sports activities, exercise groups, activities such as craft
hours, leisure time, social hours, meal or snack time, trips to community activities, and tours;
    (ii) a social or educational service that does not have or cannot reasonably be expected to
have a therapeutic outcome related to the client's emotional disturbance;
    (iii) consultation with other providers or service agency staff about the care or progress
of a client;
    (iv) prevention or education programs provided to the community; and
    (v) treatment for clients with primary diagnoses of alcohol or other drug abuse; and
    (6) activities that are not direct service time.
    Subd. 13. Exception to excluded services. Notwithstanding subdivision 12, up to 15 hours
of children's therapeutic services and supports provided within a six-month period to a child with
severe emotional disturbance who is residing in a hospital; a group home as defined in Minnesota
Rules, parts 2960.0130 to 2960.0220; a residential treatment facility licensed under Minnesota
Rules, parts 2960.0580 to 2960.0690; a regional treatment center; or other institutional group
setting or who is participating in a program of partial hospitalization are eligible for medical
assistance payment if part of the discharge plan.
History: 1Sp2003 c 14 art 4 s 8; 2004 c 228 art 1 s 38-42; 2005 c 98 art 2 s 9-11; 1Sp2005 c
4 art 2 s 11; 2007 c 147 art 8 s 22; art 11 s 18-21