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

133.11    Section 1. Minnesota Statutes 2012, section 245.462, subdivision 20, is amended to read:
133.12    Subd. 20. Mental illness. (a) "Mental illness" means an organic disorder of the brain
133.13or a clinically significant disorder of thought, mood, perception, orientation, memory, or
133.14behavior that is detailed in a diagnostic codes list published by the commissioner, and that
133.15seriously limits a person's capacity to function in primary aspects of daily living such as
133.16personal relations, living arrangements, work, and recreation.
133.17    (b) An "adult with acute mental illness" means an adult who has a mental illness that
133.18is serious enough to require prompt intervention.
133.19    (c) For purposes of case management and community support services, a "person
133.20with serious and persistent mental illness" means an adult who has a mental illness and
133.21meets at least one of the following criteria:
133.22    (1) the adult has undergone two or more episodes of inpatient care for a mental
133.23illness within the preceding 24 months;
133.24    (2) the adult has experienced a continuous psychiatric hospitalization or residential
133.25treatment exceeding six months' duration within the preceding 12 months;
133.26    (3) the adult has been treated by a crisis team two or more times within the preceding
133.2724 months;
133.28    (4) the adult:
133.29    (i) has a diagnosis of schizophrenia, bipolar disorder, major depression,
133.30schizoaffective disorder, or borderline personality disorder;
133.31    (ii) indicates a significant impairment in functioning; and
133.32    (iii) has a written opinion from a mental health professional, in the last three years,
133.33stating that the adult is reasonably likely to have future episodes requiring inpatient or
134.1residential treatment, of a frequency described in clause (1) or (2), unless ongoing case
134.2management or community support services are provided;
134.3    (5) the adult has, in the last three years, been committed by a court as a person who is
134.4mentally ill under chapter 253B, or the adult's commitment has been stayed or continued; or
134.5    (6) the adult (i) was eligible under clauses (1) to (5), but the specified time period
134.6has expired or the adult was eligible as a child under section 245.4871, subdivision 6; and
134.7(ii) has a written opinion from a mental health professional, in the last three years, stating
134.8that the adult is reasonably likely to have future episodes requiring inpatient or residential
134.9treatment, of a frequency described in clause (1) or (2), unless ongoing case management
134.10or community support services are provided; or
134.11    (7) the adult was eligible as a child under section 245.4871, subdivision 6, and is
134.12age 21 or younger.

134.13    Sec. 2. Minnesota Statutes 2012, section 245.4661, subdivision 5, is amended to read:
134.14    Subd. 5. Planning for pilot projects. (a) Each local plan for a pilot project, with
134.15the exception of the placement of a Minnesota specialty treatment facility as defined in
134.16paragraph (c), must be developed under the direction of the county board, or multiple
134.17county boards acting jointly, as the local mental health authority. The planning process
134.18for each pilot shall include, but not be limited to, mental health consumers, families,
134.19advocates, local mental health advisory councils, local and state providers, representatives
134.20of state and local public employee bargaining units, and the department of human services.
134.21As part of the planning process, the county board or boards shall designate a managing
134.22entity responsible for receipt of funds and management of the pilot project.
134.23(b) For Minnesota specialty treatment facilities, the commissioner shall issue a
134.24request for proposal for regions in which a need has been identified for services.
134.25(c) For purposes of this section, Minnesota specialty treatment facility is defined as
134.26an intensive rehabilitative mental health service under section 256B.0622, subdivision 2,
134.27paragraph (b).

134.28    Sec. 3. Minnesota Statutes 2012, section 245.4661, subdivision 6, is amended to read:
134.29    Subd. 6. Duties of commissioner. (a) For purposes of the pilot projects, the
134.30commissioner shall facilitate integration of funds or other resources as needed and
134.31requested by each project. These resources may include:
134.32(1) residential services funds administered under Minnesota Rules, parts 9535.2000
134.33to 9535.3000, in an amount to be determined by mutual agreement between the project's
134.34managing entity and the commissioner of human services after an examination of the
135.1county's historical utilization of facilities located both within and outside of the county
135.2and licensed under Minnesota Rules, parts 9520.0500 to 9520.0690;
135.3(2) community support services funds administered under Minnesota Rules, parts
135.49535.1700 to 9535.1760;
135.5(3) other mental health special project funds;
135.6(4) medical assistance, general assistance medical care, MinnesotaCare and group
135.7residential housing if requested by the project's managing entity, and if the commissioner
135.8determines this would be consistent with the state's overall health care reform efforts; and
135.9(5) regional treatment center resources consistent with section 246.0136, subdivision
135.101 .; and
135.11(6) funds transferred from section 246.18, subdivision 8, for grants to providers to
135.12participate in mental health specialty treatment services, awarded to providers through
135.13a request for proposal process.
135.14(b) The commissioner shall consider the following criteria in awarding start-up and
135.15implementation grants for the pilot projects:
135.16(1) the ability of the proposed projects to accomplish the objectives described in
135.17subdivision 2;
135.18(2) the size of the target population to be served; and
135.19(3) geographical distribution.
135.20(c) The commissioner shall review overall status of the projects initiatives at least
135.21every two years and recommend any legislative changes needed by January 15 of each
135.22odd-numbered year.
135.23(d) The commissioner may waive administrative rule requirements which are
135.24incompatible with the implementation of the pilot project.
135.25(e) The commissioner may exempt the participating counties from fiscal sanctions
135.26for noncompliance with requirements in laws and rules which are incompatible with the
135.27implementation of the pilot project.
135.28(f) The commissioner may award grants to an entity designated by a county board or
135.29group of county boards to pay for start-up and implementation costs of the pilot project.

135.30    Sec. 4. Minnesota Statutes 2012, section 245.4682, subdivision 2, is amended to read:
135.31    Subd. 2. General provisions. (a) In the design and implementation of reforms to
135.32the mental health system, the commissioner shall:
135.33    (1) consult with consumers, families, counties, tribes, advocates, providers, and
135.34other stakeholders;
136.1    (2) bring to the legislature, and the State Advisory Council on Mental Health, by
136.2January 15, 2008, recommendations for legislation to update the role of counties and to
136.3clarify the case management roles, functions, and decision-making authority of health
136.4plans and counties, and to clarify county retention of the responsibility for the delivery of
136.5social services as required under subdivision 3, paragraph (a);
136.6    (3) withhold implementation of any recommended changes in case management
136.7roles, functions, and decision-making authority until after the release of the report due
136.8January 15, 2008;
136.9    (4) ensure continuity of care for persons affected by these reforms including
136.10ensuring client choice of provider by requiring broad provider networks and developing
136.11mechanisms to facilitate a smooth transition of service responsibilities;
136.12    (5) provide accountability for the efficient and effective use of public and private
136.13resources in achieving positive outcomes for consumers;
136.14    (6) ensure client access to applicable protections and appeals; and
136.15    (7) make budget transfers necessary to implement the reallocation of services and
136.16client responsibilities between counties and health care programs that do not increase the
136.17state and county costs and efficiently allocate state funds.
136.18    (b) When making transfers under paragraph (a) necessary to implement movement
136.19of responsibility for clients and services between counties and health care programs,
136.20the commissioner, in consultation with counties, shall ensure that any transfer of state
136.21grants to health care programs, including the value of case management transfer grants
136.22under section 256B.0625, subdivision 20, does not exceed the value of the services being
136.23transferred for the latest 12-month period for which data is available. The commissioner
136.24may make quarterly adjustments based on the availability of additional data during the
136.25first four quarters after the transfers first occur. If case management transfer grants under
136.26section 256B.0625, subdivision 20, are repealed and the value, based on the last year prior
136.27to repeal, exceeds the value of the services being transferred, the difference becomes an
136.28ongoing part of each county's adult and children's mental health grants under sections
136.29245.4661 , 245.4889, and 256E.12.
136.30    (c) This appropriation is not authorized to be expended after December 31, 2010,
136.31unless approved by the legislature.

136.32    Sec. 5. Minnesota Statutes 2012, section 245.4875, subdivision 8, is amended to read:
136.33    Subd. 8. Transition services. The county board may continue to provide mental
136.34health services as defined in sections 245.487 to 245.4889 to persons over 18 years of
137.1age, but under 21 years of age, if the person was receiving case management or family
137.2community support services prior to age 18, and if one of the following conditions is met:
137.3(1) the person is receiving special education services through the local school
137.4district; or
137.5(2) it is in the best interest of the person to continue services defined in sections
137.6245.487 to 245.4889; or
137.7(3) the person is requesting services and the services are medically necessary.

137.8    Sec. 6. Minnesota Statutes 2012, section 245.4881, subdivision 1, is amended to read:
137.9    Subdivision 1. Availability of case management services. (a) The county board
137.10shall provide case management services for each child with severe emotional disturbance
137.11who is a resident of the county and the child's family who request or consent to the services.
137.12Case management services may be continued must be offered to be provided for a child with
137.13a serious emotional disturbance who is over the age of 18 consistent with section 245.4875,
137.14subdivision 8 , or the child's legal representative, provided the child's service needs can be
137.15met within the children's service system. Before discontinuing case management services
137.16under this subdivision for children between the ages of 17 and 21, a transition plan
137.17must be developed. The transition plan must be developed with the child and, with the
137.18consent of a child age 18 or over, the child's parent, guardian, or legal representative. The
137.19transition plan should include plans for health insurance, housing, education, employment,
137.20and treatment. Staffing ratios must be sufficient to serve the needs of the clients. The case
137.21manager must meet the requirements in section 245.4871, subdivision 4.
137.22(b) Except as permitted by law and the commissioner under demonstration projects,
137.23case management services provided to children with severe emotional disturbance eligible
137.24for medical assistance must be billed to the medical assistance program under sections
137.25256B.02, subdivision 8 , and 256B.0625.
137.26(c) Case management services are eligible for reimbursement under the medical
137.27assistance program. Costs of mentoring, supervision, and continuing education may be
137.28included in the reimbursement rate methodology used for case management services under
137.29the medical assistance program.

137.30    Sec. 7. Minnesota Statutes 2012, section 246.18, subdivision 8, is amended to read:
137.31    Subd. 8. State-operated services account. (a) The state-operated services account is
137.32established in the special revenue fund. Revenue generated by new state-operated services
137.33listed under this section established after July 1, 2010, that are not enterprise activities must
137.34be deposited into the state-operated services account, unless otherwise specified in law:
138.1(1) intensive residential treatment services;
138.2(2) foster care services; and
138.3(3) psychiatric extensive recovery treatment services.
138.4(b) Funds deposited in the state-operated services account are available to the
138.5commissioner of human services for the purposes of:
138.6(1) providing services needed to transition individuals from institutional settings
138.7within state-operated services to the community when those services have no other
138.8adequate funding source;
138.9(2) grants to providers participating in mental health specialty treatment services
138.10under section 245.4661; and
138.11(3) to fund the operation of the Intensive Residential Treatment Service program in
138.12Willmar.

138.13    Sec. 8. Minnesota Statutes 2012, section 246.18, is amended by adding a subdivision
138.14to read:
138.15    Subd. 9. Transfers. The commissioner may transfer state mental health grant funds
138.16to the account in subdivision 8 for noncovered allowable costs of a provider certified and
138.17licensed under section 256B.0622, and operating under section 246.014.

138.18    Sec. 9. Minnesota Statutes 2012, section 253B.10, subdivision 1, is amended to read:
138.19    Subdivision 1. Administrative requirements. (a) When a person is committed,
138.20the court shall issue a warrant or an order committing the patient to the custody of the
138.21head of the treatment facility. The warrant or order shall state that the patient meets the
138.22statutory criteria for civil commitment.
138.23(b) The commissioner shall prioritize patients being admitted from jail or a
138.24correctional institution who are:
138.25(1) ordered confined in a state hospital for an examination under Minnesota Rules of
138.26Criminal Procedure, rules 20.01, subdivision 4, paragraph (a), and 20.02, subdivision 2;
138.27(2) under civil commitment for competency treatment and continuing supervision
138.28under Minnesota Rules of Criminal Procedure, rule 20.01, subdivision 7;
138.29(3) found not guilty by reason of mental illness under Minnesota Rules of Criminal
138.30Procedure, rule 20.02, subdivision 8, and under civil commitment or are ordered to be
138.31detained in a state hospital or other facility pending completion of the civil commitment
138.32proceedings; or
138.33(4) committed under this chapter to the commissioner after dismissal of the patient's
138.34criminal charges.
139.1Patients described in this paragraph must be admitted to a service operated by the
139.2commissioner within 48 hours. The commitment must be ordered by the court as provided
139.3in section 253B.09, subdivision 1, paragraph (c).
139.4(c) Upon the arrival of a patient at the designated treatment facility, the head of the
139.5facility shall retain the duplicate of the warrant and endorse receipt upon the original
139.6warrant or acknowledge receipt of the order. The endorsed receipt or acknowledgment
139.7must be filed in the court of commitment. After arrival, the patient shall be under the
139.8control and custody of the head of the treatment facility.
139.9(d) Copies of the petition for commitment, the court's findings of fact and
139.10conclusions of law, the court order committing the patient, the report of the examiners,
139.11and the prepetition report shall be provided promptly to the treatment facility.

139.12    Sec. 10. Minnesota Statutes 2012, section 254B.13, is amended to read:
139.13254B.13 PILOT PROJECTS; CHEMICAL HEALTH CARE.
139.14    Subdivision 1. Authorization for navigator pilot projects. The commissioner may
139.15approve and implement navigator pilot projects developed under the planning process
139.16required under Laws 2009, chapter 79, article 7, section 26, to provide alternatives to and
139.17enhance coordination of the delivery of chemical health services required under section
139.18254B.03 .
139.19    Subd. 2. Program design and implementation. (a) The commissioner and
139.20counties participating in the navigator pilot projects shall continue to work in partnership
139.21to refine and implement the navigator pilot projects initiated under Laws 2009, chapter
139.2279, article 7, section 26.
139.23(b) The commissioner and counties participating in the navigator pilot projects shall
139.24complete the planning phase by June 30, 2010, and, if approved by the commissioner for
139.25implementation, enter into agreements governing the operation of the navigator pilot
139.26projects with implementation scheduled no earlier than July 1, 2010.
139.27    Subd. 2a. Eligibility for navigator pilot program. (a) To be considered for
139.28participation in a navigator pilot program, an individual must:
139.29(1) be a resident of a county with an approved navigator program;
139.30(2) be eligible for consolidated chemical dependency treatment fund services;
139.31(3) be a voluntary participant in the navigator program;
139.32(4) satisfy one of the following items:
139.33(i) have at least one severity rating of three or above in dimension four, five, or six in
139.34a comprehensive assessment under Minnesota Rules, part 9530.6422; or
140.1(ii) have at least one severity rating of two or above in dimension four, five, or six in
140.2a comprehensive assessment under Minnesota Rules, part 9530.6422, and be currently
140.3participating in a Rule 31 treatment program under Minnesota Rules, parts 9530.6405 to
140.49530.6505, or be within 60 days following discharge after participation in a Rule 31
140.5treatment program; and
140.6(5) have had at least two treatment episodes in the past two years, not limited
140.7to episodes reimbursed by the consolidated chemical dependency treatment funds. An
140.8admission to an emergency room, a detoxification program, or a hospital may be substituted
140.9for one treatment episode if it resulted from the individual's substance use disorder.
140.10(b) New eligibility criteria may be added as mutually agreed upon by the
140.11commissioner and participating navigator programs.
140.12    Subd. 3. Program evaluation. The commissioner shall evaluate navigator pilot
140.13projects under this section and report the results of the evaluation to the chairs and
140.14ranking minority members of the legislative committees with jurisdiction over chemical
140.15health issues by January 15, 2014. Evaluation of the navigator pilot projects must be
140.16based on outcome evaluation criteria negotiated with the navigator pilot projects prior
140.17to implementation.
140.18    Subd. 4. Notice of navigator project discontinuation. Each county's participation
140.19in the navigator pilot project may be discontinued for any reason by the county or the
140.20commissioner of human services after 30 days' written notice to the other party. Any
140.21unspent funds held for the exiting county's pro rata share in the special revenue fund under
140.22the authority in subdivision 5, paragraph (d), shall be transferred to the consolidated
140.23chemical dependency treatment fund following discontinuation of the pilot project.
140.24    Subd. 5. Duties of commissioner. (a) Notwithstanding any other provisions in
140.25this chapter, the commissioner may authorize navigator pilot projects to use chemical
140.26dependency treatment funds to pay for nontreatment navigator pilot services:
140.27(1) in addition to those authorized under section 254B.03, subdivision 2, paragraph
140.28(a); and
140.29(2) by vendors in addition to those authorized under section 254B.05 when not
140.30providing chemical dependency treatment services.
140.31(b) For purposes of this section, "nontreatment navigator pilot services" include
140.32navigator services, peer support, family engagement and support, housing support, rent
140.33subsidies, supported employment, and independent living skills.
140.34(c) State expenditures for chemical dependency services and nontreatment navigator
140.35pilot services provided by or through the navigator pilot projects must not be greater than
140.36the chemical dependency treatment fund expected share of forecasted expenditures in the
141.1absence of the navigator pilot projects. The commissioner may restructure the schedule of
141.2payments between the state and participating counties under the local agency share and
141.3division of cost provisions under section 254B.03, subdivisions 3 and 4, as necessary to
141.4facilitate the operation of the navigator pilot projects.
141.5(d) To the extent that state fiscal year expenditures within a pilot project are less
141.6than the expected share of forecasted expenditures in the absence of the pilot projects,
141.7the commissioner shall deposit the unexpended funds in a separate account within the
141.8consolidated chemical dependency treatment fund, and make these funds available for
141.9expenditure by the pilot projects the following year. To the extent that treatment and
141.10nontreatment pilot services expenditures within the pilot project exceed the amount
141.11expected in the absence of the pilot projects, the pilot project county or counties are
141.12responsible for the portion of nontreatment pilot services expenditures in excess of the
141.13otherwise expected share of forecasted expenditures.
141.14(e) (d) The commissioner may waive administrative rule requirements that are
141.15incompatible with the implementation of the navigator pilot project, except that any
141.16chemical dependency treatment funded under this section must continue to be provided
141.17by a licensed treatment provider.
141.18(f) (e) The commissioner shall not approve or enter into any agreement related to
141.19navigator pilot projects authorized under this section that puts current or future federal
141.20funding at risk.
141.21(f) The commissioner shall provide participating navigator pilot projects with
141.22transactional data, reports, provider data, and other data generated by county activity to
141.23assess and measure outcomes. This information must be transmitted or made available in
141.24an acceptable form to participating navigator pilot projects at least once every six months
141.25or within a reasonable time following the commissioner's receipt of information from the
141.26counties needed to comply with this paragraph.
141.27    Subd. 6. Duties of county board. The county board, or other county entity that
141.28is approved to administer a navigator pilot project, shall:
141.29(1) administer the navigator pilot project in a manner consistent with the objectives
141.30described in subdivision 2 and the planning process in subdivision 5;
141.31(2) ensure that no one is denied chemical dependency treatment services for which
141.32they would otherwise be eligible under section 254A.03, subdivision 3; and
141.33(3) provide the commissioner with timely and pertinent information as negotiated in
141.34agreements governing operation of the navigator pilot projects.
142.1    Subd. 7. Managed care. An individual who is eligible for the navigator pilot
142.2program under subdivision 2a is excluded from mandatory enrollment in managed care
142.3until these services are included in the health plan's benefit set.
142.4    Subd. 8. Authorization for continuation of navigator pilots. The navigator pilot
142.5projects implemented pursuant to subdivision 1 are authorized to continue operation after
142.6July 1, 2013, under existing agreements governing operation of the pilot projects.
142.7EFFECTIVE DATE.The amendments to subdivisions 1 to 6 and 8 are effective
142.8August 1, 2013. Subdivision 7 is effective July 1, 2013.

142.9    Sec. 11. [254B.14] CONTINUUM OF CARE PILOT PROJECTS; CHEMICAL
142.10HEALTH CARE.
142.11    Subdivision 1. Authorization for continuum of care pilot projects. The
142.12commissioner shall establish chemical dependency continuum of care pilot projects to
142.13begin implementing the measures developed with stakeholder input and identified in the
142.14report completed pursuant to Laws 2012, chapter 247, article 5, section 8. The pilot
142.15projects are intended to improve the effectiveness and efficiency of the service continuum
142.16for chemically dependent individuals in Minnesota while reducing duplication of efforts
142.17and promoting scientifically supported practices.
142.18    Subd. 2. Program implementation. (a) The commissioner, in coordination with
142.19representatives of the Minnesota Association of County Social Service Administrators
142.20and the Minnesota Inter-County Association, shall develop a process for identifying and
142.21selecting interested counties and providers for participation in the continuum of care pilot
142.22projects. There will be three pilot projects; one representing the northern region, one for
142.23the metro region, and one for the southern region. The selection process of counties and
142.24providers must include consideration of population size, geographic distribution, cultural
142.25and racial demographics, and provider accessibility. The commissioner shall identify
142.26counties and providers that are selected for participation in the continuum of care pilot
142.27projects no later than September 30, 2013.
142.28(b) The commissioner and entities participating in the continuum of care pilot
142.29projects shall enter into agreements governing the operation of the continuum of care pilot
142.30projects. The agreements shall identify pilot project outcomes and include timelines for
142.31implementation and beginning operation of the pilot projects.
142.32(c) Entities that are currently participating in the navigator pilot project are
142.33eligible to participate in the continuum of care pilot project subsequent to or instead of
142.34participating in the navigator pilot project.
143.1(d) The commissioner may waive administrative rule requirements that are
143.2incompatible with implementation of the continuum of care pilot projects.
143.3(e) Notwithstanding section 254A.19, the commissioner may designate noncounty
143.4entities to complete chemical use assessments and placement authorizations required
143.5under section 254A.19 and Minnesota Rules, parts 9530.6600 to 9530.6655. Section
143.6254A.19, subdivision 3, is applicable to the continuum of care pilot projects at the
143.7discretion of the commissioner.
143.8    Subd. 3. Program design. (a) The operation of the pilot projects shall include:
143.9(1) new services that are responsive to the chronic nature of substance use disorder;
143.10(2) telehealth services, when appropriate to address barriers to services;
143.11(3) services that assure integration with the mental health delivery system when
143.12appropriate;
143.13(4) services that address the needs of diverse populations; and
143.14(5) an assessment and access process that permits clients to present directly to a
143.15service provider for a substance use disorder assessment and authorization of services.
143.16(b) Prior to implementation of the continuum of care pilot projects, a utilization
143.17review process must be developed and agreed to by the commissioner, participating
143.18counties, and providers. The utilization review process shall be described in the
143.19agreements governing operation of the continuum of care pilot projects.
143.20    Subd. 4. Notice of project discontinuation. Each entity's participation in the
143.21continuum of care pilot project may be discontinued for any reason by the county or the
143.22commissioner after 30 days' written notice to the entity.
143.23    Subd. 5. Duties of commissioner. (a) Notwithstanding any other provisions in this
143.24chapter, the commissioner may authorize chemical dependency treatment funds to pay for
143.25nontreatment services arranged by continuum of care pilot projects. Individuals who are
143.26currently accessing Rule 31 treatment services are eligible for concurrent participation in
143.27the continuum of care pilot projects.
143.28(b) County expenditures for continuum of care pilot project services shall not
143.29be greater than their expected share of forecasted expenditures in the absence of the
143.30continuum of care pilot projects.
143.31EFFECTIVE DATE.This section is effective August 1, 2013.

143.32    Sec. 12. Minnesota Statutes 2012, section 256B.02, subdivision 12, is amended to read:
143.33    Subd. 12. Third-party payer. "Third-party payer" means a person, entity, or agency
143.34or government program that has a probable obligation to pay all or part of the costs of a
143.35medical assistance recipient's health services. Third-party payer includes an entity under
144.1contract with the recipient to cover all or part of the recipient's medical costs. Third-party
144.2payer does not include a school district for costs for clinical mental health care.

144.3    Sec. 13. [256B.0616] MENTAL HEALTH CERTIFIED FAMILY PEER
144.4SPECIALIST.
144.5    Subdivision 1. Scope. Medical assistance covers mental health certified family peer
144.6specialists services, as established in subdivision 2, subject to federal approval, if provided
144.7to recipients who have an emotional disturbance or severe emotional disturbance under
144.8chapter 245, and are provided by a certified family peer specialist who has completed the
144.9training under subdivision 5. A family peer specialist cannot provide services to the
144.10peer specialist's family.
144.11    Subd. 2. Establishment. The commissioner of human services shall establish a
144.12certified family peer specialists program model which:
144.13(1) provides nonclinical family peer support counseling, building on the strengths
144.14of families and helping them achieve desired outcomes;
144.15(2) collaborates with others providing care or support to the family;
144.16(3) provides nonadversarial advocacy;
144.17(4) promotes the individual family culture in the treatment milieu;
144.18(5) links parents to other parents in the community;
144.19(6) offers support and encouragement;
144.20(7) assists parents in developing coping mechanisms and problem-solving skills;
144.21(8) promotes resiliency, self-advocacy, development of natural supports, and
144.22maintenance of skills learned in other support services;
144.23(9) establishes and provides peer led parent support groups; and
144.24(10) increases the child's ability to function better within the child's home, school,
144.25and community by educating parents on community resources, assisting with problem
144.26solving, and educating parents on mental illnesses.
144.27    Subd. 3. Eligibility. Family peer support services may be located in inpatient
144.28hospitalization, partial hospitalization, residential treatment, treatment foster care, day
144.29treatment, children's therapeutic services and supports, or crisis services.
144.30    Subd. 4. Peer support specialist program providers. The commissioner shall
144.31develop a process to certify family peer support specialist programs, in accordance with
144.32the federal guidelines, in order for the program to bill for reimbursable services. Family
144.33peer support programs must operate within an existing mental health community provider
144.34or center.
145.1    Subd. 5. Certified family peer specialist training and certification. The
145.2commissioner shall develop a training and certification process for certified family peer
145.3specialists who must be at least 21 years of age and have a high school diploma or its
145.4equivalent. The candidates must have raised or are currently raising a child with a mental
145.5illness, have had experience navigating the children's mental health system, and must
145.6demonstrate leadership and advocacy skills and a strong dedication to family-driven and
145.7family-focused services. The training curriculum must teach participating family peer
145.8specialists specific skills relevant to providing peer support to other parents. In addition
145.9to initial training and certification, the commissioner shall develop ongoing continuing
145.10educational workshops on pertinent issues related to family peer support counseling.

145.11    Sec. 14. Minnesota Statutes 2012, section 256B.0623, subdivision 2, is amended to read:
145.12    Subd. 2. Definitions. For purposes of this section, the following terms have the
145.13meanings given them.
145.14(a) "Adult rehabilitative mental health services" means mental health services
145.15which are rehabilitative and enable the recipient to develop and enhance psychiatric
145.16stability, social competencies, personal and emotional adjustment, and independent living,
145.17parenting skills, and community skills, when these abilities are impaired by the symptoms
145.18of mental illness. Adult rehabilitative mental health services are also appropriate when
145.19provided to enable a recipient to retain stability and functioning, if the recipient would
145.20be at risk of significant functional decompensation or more restrictive service settings
145.21without these services.
145.22(1) Adult rehabilitative mental health services instruct, assist, and support the
145.23recipient in areas such as: interpersonal communication skills, community resource
145.24utilization and integration skills, crisis assistance, relapse prevention skills, health care
145.25directives, budgeting and shopping skills, healthy lifestyle skills and practices, cooking
145.26and nutrition skills, transportation skills, medication education and monitoring, mental
145.27illness symptom management skills, household management skills, employment-related
145.28skills, parenting skills, and transition to community living services.
145.29(2) These services shall be provided to the recipient on a one-to-one basis in the
145.30recipient's home or another community setting or in groups.
145.31(b) "Medication education services" means services provided individually or in
145.32groups which focus on educating the recipient about mental illness and symptoms; the role
145.33and effects of medications in treating symptoms of mental illness; and the side effects of
145.34medications. Medication education is coordinated with medication management services
146.1and does not duplicate it. Medication education services are provided by physicians,
146.2pharmacists, physician's assistants, or registered nurses.
146.3(c) "Transition to community living services" means services which maintain
146.4continuity of contact between the rehabilitation services provider and the recipient and
146.5which facilitate discharge from a hospital, residential treatment program under Minnesota
146.6Rules, chapter 9505, board and lodging facility, or nursing home. Transition to community
146.7living services are not intended to provide other areas of adult rehabilitative mental health
146.8services.

146.9    Sec. 15. Minnesota Statutes 2012, section 256B.0625, subdivision 48, is amended to
146.10read:
146.11    Subd. 48. Psychiatric consultation to primary care practitioners. Effective
146.12January 1, 2006, Medical assistance covers consultation provided by a psychiatrist,
146.13psychologist, or an advanced practice registered nurse certified in psychiatric mental
146.14health via telephone, e-mail, facsimile, or other means of communication to primary care
146.15practitioners, including pediatricians. The need for consultation and the receipt of the
146.16consultation must be documented in the patient record maintained by the primary care
146.17practitioner. If the patient consents, and subject to federal limitations and data privacy
146.18provisions, the consultation may be provided without the patient present.

146.19    Sec. 16. Minnesota Statutes 2012, section 256B.0625, subdivision 56, is amended to
146.20read:
146.21    Subd. 56. Medical service coordination. (a)(1) Medical assistance covers in-reach
146.22community-based service coordination that is performed through a hospital emergency
146.23department as an eligible procedure under a state healthcare program for a frequent user.
146.24A frequent user is defined as an individual who has frequented the hospital emergency
146.25department for services three or more times in the previous four consecutive months.
146.26In-reach community-based service coordination includes navigating services to address a
146.27client's mental health, chemical health, social, economic, and housing needs, or any other
146.28activity targeted at reducing the incidence of emergency room and other nonmedically
146.29necessary health care utilization.
146.30(2) Medical assistance covers in-reach community-based service coordination that
146.31is performed through a hospital emergency department or inpatient psychiatric unit,
146.32residential treatment center, community mental health center, children's therapeutic
146.33services and supports provider, or juvenile justice facility as an eligible service for a child
146.34or young adult up to age 26 with a serious emotional disturbance.
147.1    (b) Reimbursement must be made in 15-minute increments and allowed for up to 60
147.2days posthospital discharge based upon the specific identified emergency department visit
147.3or inpatient admitting event. In-reach community-based service coordination shall seek to
147.4connect frequent users with existing covered services available to them, including, but not
147.5limited to, targeted case management, waiver case management, or care coordination in a
147.6health care home. For children and young adults with a serious emotional disturbance,
147.7in-reach community-based service coordination shall seek to connect them with existing
147.8covered services, including targeted case management, waiver case management, care
147.9coordination in a health care home, children's therapeutic services and supports, crisis
147.10services, and respite care. Eligible in-reach service coordinators must hold a minimum
147.11of a bachelor's degree in social work, public health, corrections, or a related field. The
147.12commissioner shall submit any necessary application for waivers to the Centers for
147.13Medicare and Medicaid Services to implement this subdivision.
147.14    (c) For the purposes of this subdivision, "in-reach community-based service
147.15coordination" means the practice of a community-based worker with training, knowledge,
147.16skills, and ability to access a continuum of services, including housing, transportation,
147.17chemical and mental health treatment, employment, education, and peer support services,
147.18by working with an organization's staff to transition an individual back into the individual's
147.19living environment. In-reach community-based service coordination includes working
147.20with the individual during their discharge and for up to a defined amount of time in the
147.21individual's living environment, reducing the individual's need for readmittance.

147.22    Sec. 17. Minnesota Statutes 2012, section 256B.0625, is amended by adding a
147.23subdivision to read:
147.24    Subd. 61. Family psychoeducation services. Effective July 1, 2013, or upon
147.25federal approval, whichever is later, medical assistance covers family psychoeducation
147.26services provided to a child up to age 21 with a diagnosed mental health condition when
147.27identified in the child's individual treatment plan and provided by a licensed mental health
147.28professional, as defined in Minnesota Rules, part 9505.0371, subpart 5, item A, or a
147.29clinical trainee, as defined in Minnesota Rules, part 9505.0371, subpart 5, item C, who
147.30has determined it medically necessary to involve family members in the child's care. For
147.31the purposes of this subdivision, "family psychoeducation services" means information
147.32or demonstration provided to an individual or family as part of an individual, family,
147.33multifamily group, or peer group session to explain, educate, and support the child and
147.34family in understanding a child's symptoms of mental illness, the impact on the child's
147.35development, and needed components of treatment and skill development so that the
148.1individual, family, or group can help the child to prevent relapse, prevent the acquisition
148.2of comorbid disorders, and to achieve optimal mental health and long-term resilience.

148.3    Sec. 18. Minnesota Statutes 2012, section 256B.0625, is amended by adding a
148.4subdivision to read:
148.5    Subd. 62. Mental health clinical care consultation. Effective July 1, 2013, or upon
148.6federal approval, whichever is later, medical assistance covers clinical care consultation
148.7for a person up to age 21 who is diagnosed with a complex mental health condition or a
148.8mental health condition that co-occurs with other complex and chronic conditions, when
148.9described in the person's individual treatment plan and provided by a licensed mental
148.10health professional, as defined in Minnesota Rules, part 9505.0371, subpart 5, item A,
148.11or a clinical trainee. For the purposes of this subdivision, "clinical care consultation"
148.12means communication from a treating mental health professional to other providers or
148.13educators not under the clinical supervision of the treating mental health professional
148.14who are working with the same client to inform, inquire, and instruct regarding the
148.15client's symptoms; strategies for effective engagement, care, and intervention needs; and
148.16treatment expectations across service settings; and to direct and coordinate clinical service
148.17components provided to the client and family.

148.18    Sec. 19. Minnesota Statutes 2012, section 256B.0943, subdivision 1, is amended to read:
148.19    Subdivision 1. Definitions. For purposes of this section, the following terms have
148.20the meanings given them.
148.21(a) "Assessment" includes the provision of commissioner-approved assessment
148.22tools and completion of a functional assessment under Minnesota Rules, part 9520.0902,
148.23subpart 21.
148.24(b) "Care coordination" means contact with other professionals, educators, and
148.25caregivers of the client in person or by telephone to facilitate continuity and consistency in
148.26support of the client and the treatment plan, screening to determine client suitability for
148.27treatment, and development and updating of the treatment plan.
148.28(a) (c) "Children's therapeutic services and supports" means the flexible package
148.29of mental health services for children who require varying therapeutic and rehabilitative
148.30levels of intervention. The services are time-limited interventions that are delivered using
148.31various treatment modalities and combinations of services designed to reach treatment
148.32outcomes identified in the individual treatment plan.
148.33(b) (d) "Clinical supervision" means the overall responsibility of the mental health
148.34professional for the control and direction of individualized treatment planning, service
149.1delivery, and treatment review for each client. A mental health professional who is an
149.2enrolled Minnesota health care program provider accepts full professional responsibility
149.3for a supervisee's actions and decisions, instructs the supervisee in the supervisee's work,
149.4and oversees or directs the supervisee's work.
149.5(c) (e) "County board" means the county board of commissioners or board
149.6established under sections 402.01 to 402.10 or 471.59.
149.7(d) (f) "Crisis assistance" has the meaning given in section 245.4871, subdivision 9a.
149.8(e) (g) "Culturally competent provider" means a provider who understands and
149.9can utilize to a client's benefit the client's culture when providing services to the client.
149.10A provider may be culturally competent because the provider is of the same cultural or
149.11ethnic group as the client or the provider has developed the knowledge and skills through
149.12training and experience to provide services to culturally diverse clients.
149.13(f) (h) "Day treatment program" for children means a site-based structured program
149.14consisting of group psychotherapy for more than three individuals and other intensive
149.15therapeutic services provided by a multidisciplinary team, under the clinical supervision
149.16of a mental health professional.
149.17(g) (i) "Diagnostic assessment" has the meaning given in section 245.4871,
149.18subdivision 11 .
149.19(h) (j) "Direct service time" means the time that a mental health professional, mental
149.20health practitioner, or mental health behavioral aide spends face-to-face with a client
149.21and the client's family. Direct service time includes time in which the provider obtains
149.22a client's history or provides service components of children's therapeutic services and
149.23supports. Direct service time does not include time doing work before and after providing
149.24direct services, including scheduling, maintaining clinical records, consulting with others
149.25about the client's mental health status, preparing reports, receiving clinical supervision,
149.26and revising the client's individual treatment plan.
149.27(i) (k) "Direction of mental health behavioral aide" means the activities of a mental
149.28health professional or mental health practitioner in guiding the mental health behavioral
149.29aide in providing services to a client. The direction of a mental health behavioral aide
149.30must be based on the client's individualized treatment plan and meet the requirements in
149.31subdivision 6, paragraph (b), clause (5).
149.32(j) (l) "Emotional disturbance" has the meaning given in section 245.4871,
149.33subdivision 15 . For persons at least age 18 but under age 21, mental illness has the
149.34meaning given in section 245.462, subdivision 20, paragraph (a).
149.35(k) (m) "Individual behavioral plan" means a plan of intervention, treatment, and
149.36services for a child written by a mental health professional or mental health practitioner,
150.1under the clinical supervision of a mental health professional, to guide the work of the
150.2mental health behavioral aide.
150.3(l) (n) "Individual treatment plan" has the meaning given in section 245.4871,
150.4subdivision 21 .
150.5(m) (o) "Mental health behavioral aide services" means medically necessary
150.6one-on-one activities performed by a trained paraprofessional to assist a child retain
150.7or generalize psychosocial skills as taught by a mental health professional or mental
150.8health practitioner and as described in the child's individual treatment plan and individual
150.9behavior plan. Activities involve working directly with the child or child's family as
150.10provided in subdivision 9, paragraph (b), clause (4).
150.11(n) (p) "Mental health professional" means an individual as defined in section
150.12245.4871, subdivision 27 , clauses (1) to (6), or tribal vendor as defined in section 256B.02,
150.13subdivision 7 , paragraph (b).
150.14(o) (q) "Preschool program" means a day program licensed under Minnesota Rules,
150.15parts 9503.0005 to 9503.0175, and enrolled as a children's therapeutic services and
150.16supports provider to provide a structured treatment program to a child who is at least 33
150.17months old but who has not yet attended the first day of kindergarten.
150.18(p) (r) "Skills training" means individual, family, or group training, delivered
150.19by or under the direction of a mental health professional, designed to facilitate the
150.20acquisition of psychosocial skills that are medically necessary to rehabilitate the child
150.21to an age-appropriate developmental trajectory heretofore disrupted by a psychiatric
150.22illness or to self-monitor, compensate for, cope with, counteract, or replace skills deficits
150.23or maladaptive skills acquired over the course of a psychiatric illness. Skills training
150.24is subject to the following requirements:
150.25(1) a mental health professional or a mental health practitioner must provide skills
150.26training;
150.27(2) the child must always be present during skills training; however, a brief absence
150.28of the child for no more than ten percent of the session unit may be allowed to redirect or
150.29instruct family members;
150.30(3) skills training delivered to children or their families must be targeted to the
150.31specific deficits or maladaptations of the child's mental health disorder and must be
150.32prescribed in the child's individual treatment plan;
150.33(4) skills training delivered to the child's family must teach skills needed by parents
150.34to enhance the child's skill development and to help the child use in daily life the skills
150.35previously taught by a mental health professional or mental health practitioner and to
150.36develop or maintain a home environment that supports the child's progressive use skills;
151.1(5) group skills training may be provided to multiple recipients who, because of the
151.2nature of their emotional, behavioral, or social dysfunction, can derive mutual benefit from
151.3interaction in a group setting, which must be staffed as follows:
151.4(i) one mental health professional or one mental health practitioner under supervision
151.5of a licensed mental health professional must work with a group of four to eight clients; or
151.6(ii) two mental health professionals or two mental health practitioners under
151.7supervision of a licensed mental health professional, or one professional plus one
151.8practitioner must work with a group of nine to 12 clients.

151.9    Sec. 20. Minnesota Statutes 2012, section 256B.0943, subdivision 2, is amended to read:
151.10    Subd. 2. Covered service components of children's therapeutic services and
151.11supports. (a) Subject to federal approval, medical assistance covers medically necessary
151.12children's therapeutic services and supports as defined in this section that an eligible
151.13provider entity certified under subdivision 4 provides to a client eligible under subdivision
151.143.
151.15(b) The service components of children's therapeutic services and supports are:
151.16(1) individual, family, and group psychotherapy;
151.17(2) individual, family, or group skills training provided by a mental health
151.18professional or mental health practitioner;
151.19(3) crisis assistance;
151.20(4) mental health behavioral aide services; and
151.21(5) direction of a mental health behavioral aide.;
151.22(6) care coordination provided by a mental health professional or mental health
151.23practitioner;
151.24(7) assessment provided by a mental health professional or mental health practitioner;
151.25(8) clinical care consultation provided by a mental health professional under section
151.26256B.0625, subdivision 62;
151.27(9) family psychoeducation under section 256B.0625, subdivision 61; and
151.28(10) services provided by a family peer specialist under section 256B.0616.
151.29(c) Service components in paragraph (b) may be combined to constitute therapeutic
151.30programs, including day treatment programs and therapeutic preschool programs.

151.31    Sec. 21. Minnesota Statutes 2012, section 256B.0943, subdivision 7, is amended to read:
151.32    Subd. 7. Qualifications of individual and team providers. (a) An individual
151.33or team provider working within the scope of the provider's practice or qualifications
152.1may provide service components of children's therapeutic services and supports that are
152.2identified as medically necessary in a client's individual treatment plan.
152.3(b) An individual provider must be qualified as:
152.4(1) a mental health professional as defined in subdivision 1, paragraph (n); or
152.5(2) a mental health practitioner as defined in section 245.4871, subdivision 26. The
152.6mental health practitioner must work under the clinical supervision of a mental health
152.7professional; or
152.8(3) a mental health behavioral aide working under the clinical supervision of a
152.9mental health professional to implement the rehabilitative mental health services identified
152.10in the client's individual treatment plan and individual behavior plan.
152.11(A) A level I mental health behavioral aide must:
152.12(i) be at least 18 years old;
152.13(ii) have a high school diploma or general equivalency diploma (GED) or two years
152.14of experience as a primary caregiver to a child with severe emotional disturbance within
152.15the previous ten years; and
152.16(iii) meet preservice and continuing education requirements under subdivision 8.
152.17(B) A level II mental health behavioral aide must:
152.18(i) be at least 18 years old;
152.19(ii) have an associate or bachelor's degree or 4,000 hours of experience in delivering
152.20clinical services in the treatment of mental illness concerning children or adolescents or
152.21complete a certificate program established under subdivision 8a; and
152.22(iii) meet preservice and continuing education requirements in subdivision 8.
152.23(c) A preschool program multidisciplinary team must include at least one mental
152.24health professional and one or more of the following individuals under the clinical
152.25supervision of a mental health professional:
152.26(i) a mental health practitioner; or
152.27(ii) a program person, including a teacher, assistant teacher, or aide, who meets the
152.28qualifications and training standards of a level I mental health behavioral aide.
152.29(d) A day treatment multidisciplinary team must include at least one mental health
152.30professional and one mental health practitioner.

152.31    Sec. 22. Minnesota Statutes 2012, section 256B.0943, is amended by adding a
152.32subdivision to read:
152.33    Subd. 8a. Level II mental health behavioral aide. The commissioner of human
152.34services, in collaboration with the Board of Trustees of the Minnesota State Colleges and
152.35Universities, shall develop a certificate program of not fewer than 11 credits for level II
153.1mental health behavioral aides. The program shall include classroom and field-based
153.2learning. The program components must include, but not be limited to, mental illnesses
153.3in children, parent and family perspectives, skill training, documentation and reporting,
153.4communication skills, and cultural competence.

153.5    Sec. 23. Minnesota Statutes 2012, section 256B.0946, is amended to read:
153.6256B.0946 INTENSIVE TREATMENT IN FOSTER CARE.
153.7    Subdivision 1. Required covered service components. (a) Effective July 1, 2006,
153.8 upon enactment and subject to federal approval, medical assistance covers medically
153.9necessary intensive treatment services described under paragraph (b) that are provided
153.10by a provider entity eligible under subdivision 3 to a client eligible under subdivision 2
153.11who is placed in a treatment foster home licensed under Minnesota Rules, parts 2960.3000
153.12to 2960.3340.
153.13(b) Intensive treatment services to children with severe emotional disturbance mental
153.14illness residing in treatment foster care family settings must meet the relevant standards
153.15for mental health services under sections 245.487 to 245.4889. In addition, that comprise
153.16 specific required service components provided in clauses (1) to (5), are reimbursed by
153.17medical assistance must when they meet the following standards:
153.18(1) case management service component must meet the standards in Minnesota
153.19Rules, parts 9520.0900 to 9520.0926 and 9505.0322, excluding subparts 6 and 10;
153.20(1) psychotherapy provided by a mental health professional as defined in Minnesota
153.21Rules, part 9505.0371, subpart 5, item A, or a clinical trainee, as defined in Minnesota
153.22Rules, part 9505.0371, subpart 5, item C;
153.23(2) psychotherapy, crisis assistance, and skills training components must meet the
153.24 provided according to standards for children's therapeutic services and supports in section
153.25256B.0943 ; and
153.26(3) individual family, and group psychoeducation services under supervision of,
153.27defined in subdivision 1a, paragraph (q), provided by a mental health professional. or a
153.28clinical trainee;
153.29(4) clinical care consultation, as defined in subdivision 1a, and provided by a mental
153.30health professional or a clinical trainee; and
153.31(5) service delivery payment requirements as provided under subdivision 4.
153.32    Subd. 1a. Definitions. For the purposes of this section, the following terms have
153.33the meanings given them.
153.34(a) "Clinical care consultation" means communication from a treating clinician to
153.35other providers working with the same client to inform, inquire, and instruct regarding
154.1the client's symptoms, strategies for effective engagement, care and intervention needs,
154.2and treatment expectations across service settings, including but not limited to the client's
154.3school, social services, day care, probation, home, primary care, medication prescribers,
154.4disabilities services, and other mental health providers and to direct and coordinate clinical
154.5service components provided to the client and family.
154.6(b) "Clinical supervision" means the documented time a clinical supervisor and
154.7supervisee spend together to discuss the supervisee's work, to review individual client
154.8cases, and for the supervisee's professional development. It includes the documented
154.9oversight and supervision responsibility for planning, implementation, and evaluation of
154.10services for a client's mental health treatment.
154.11(c) "Clinical supervisor" means the mental health professional who is responsible
154.12for clinical supervision.
154.13(d) "Clinical trainee" has the meaning given in Minnesota Rules, part 9505.0371,
154.14subpart 5, item C;
154.15(e) "Crisis assistance" has the meaning given in section 245.4871, subdivision 9a,
154.16including the development of a plan that addresses prevention and intervention strategies
154.17to be used in a potential crisis, but does not include actual crisis intervention.
154.18(f) "Culturally appropriate" means providing mental health services in a manner that
154.19incorporates the child's cultural influences, as defined in Minnesota Rules, part 9505.0370,
154.20subpart 9, into interventions as a way to maximize resiliency factors and utilize cultural
154.21strengths and resources to promote overall wellness.
154.22(g) "Culture" means the distinct ways of living and understanding the world that
154.23are used by a group of people and are transmitted from one generation to another or
154.24adopted by an individual.
154.25(h) "Diagnostic assessment" has the meaning given in Minnesota Rules, part
154.269505.0370, subpart 11.
154.27(i) "Family" means a person who is identified by the client or the client's parent or
154.28guardian as being important to the client's mental health treatment. Family may include,
154.29but is not limited to, parents, foster parents, children, spouse, committed partners, former
154.30spouses, persons related by blood or adoption, persons who are a part of the client's
154.31permanency plan, or persons who are presently residing together as a family unit.
154.32(j) "Foster care" has the meaning given in section 260C.007, subdivision 18.
154.33(k) "Foster family setting" means the foster home in which the license holder resides.
154.34(l) "Individual treatment plan" has the meaning given in Minnesota Rules, part
154.359505.0370, subpart 15.
155.1(m) "Mental health practitioner" has the meaning given in Minnesota Rules, part
155.29505.0370, subpart 17.
155.3(n) "Mental health professional" has the meaning given in Minnesota Rules, part
155.49505.0370, subpart 18.
155.5(o) "Mental illness" has the meaning given in Minnesota Rules, part 9505.0370,
155.6subpart 20.
155.7(p) "Parent" has the meaning given in section 260C.007, subdivision 25.
155.8(q) "Psychoeducation services" means information or demonstration provided to
155.9an individual, family, or group to explain, educate, and support the individual, family, or
155.10group in understanding a child's symptoms of mental illness, the impact on the child's
155.11development, and needed components of treatment and skill development so that the
155.12individual, family, or group can help the child to prevent relapse, prevent the acquisition
155.13of comorbid disorders, and to achieve optimal mental health and long-term resilience.
155.14(r) "Psychotherapy" has the meaning given in Minnesota Rules, part 9505.0370,
155.15subpart 27.
155.16(s) "Team consultation and treatment planning" means the coordination of treatment
155.17plans and consultation among providers in a group concerning the treatment needs of the
155.18child, including disseminating the child's treatment service schedule to all members of the
155.19service team. Team members must include all mental health professionals working with
155.20the child, a parent, the child unless the team lead or parent deem it clinically inappropriate,
155.21and at least two of the following: an individualized education program case manager;
155.22probation agent; children's mental health case manager; child welfare worker, including
155.23adoption or guardianship worker; primary care provider; foster parent; and any other
155.24member of the child's service team.
155.25    Subd. 2. Determination of client eligibility. A client's eligibility to receive
155.26treatment foster care under this section shall be determined by An eligible recipient is an
155.27individual, from birth through age 20, who is currently placed in a foster home licensed
155.28under Minnesota Rules, parts 2960.3000 to 2960.3340, and has received a diagnostic
155.29assessment, and an evaluation of level of care needed, and development of an individual
155.30treatment plan, as defined in paragraphs (a) to (c) and (b).
155.31(a) The diagnostic assessment must:
155.32(1) meet criteria described in Minnesota Rules, part 9505.0372, subpart 1, and be
155.33conducted by a psychiatrist, licensed psychologist, or licensed independent clinical social
155.34worker that is mental health professional or a clinical trainee;
155.35(2) determine whether or not a child meets the criteria for mental illness, as defined
155.36in Minnesota Rules, part 9505.0370, subpart 20;
156.1(3) document that intensive treatment services are medically necessary within a
156.2foster family setting to ameliorate identified symptoms and functional impairments;
156.3(4) be performed within 180 days prior to before the start of service; and
156.4(2) include current diagnoses on all five axes of the client's current mental health
156.5status;
156.6(3) determine whether or not a child meets the criteria for severe emotional
156.7disturbance in section 245.4871, subdivision 6, or for serious and persistent mental illness
156.8in section 245.462, subdivision 20; and
156.9(4) be completed annually until age 18. For individuals between age 18 and 21,
156.10unless a client's mental health condition has changed markedly since the client's most
156.11recent diagnostic assessment, annual updating is necessary. For the purpose of this section,
156.12"updating" means a written summary, including current diagnoses on all five axes, by a
156.13mental health professional of the client's current mental status and service needs.
156.14(5) be completed as either a standard or extended diagnostic assessment annually to
156.15determine continued eligibility for the service.
156.16(b) The evaluation of level of care must be conducted by the placing county with
156.17an instrument, tribe, or case manager in conjunction with the diagnostic assessment as
156.18described by Minnesota Rules, part 9505.0372, subpart 1, item B, using a validated tool
156.19 approved by the commissioner of human services and not subject to the rulemaking
156.20process, consistent with section 245.4885, subdivision 1, paragraph (d), the result of which
156.21evaluation demonstrates that the child requires intensive intervention without 24-hour
156.22medical monitoring. The commissioner shall update the list of approved level of care
156.23instruments tools annually and publish on the department's Web site.
156.24(c) The individual treatment plan must be:
156.25(1) based on the information in the client's diagnostic assessment;
156.26(2) developed through a child-centered, family driven planning process that identifies
156.27service needs and individualized, planned, and culturally appropriate interventions that
156.28contain specific measurable treatment goals and objectives for the client and treatment
156.29strategies for the client's family and foster family;
156.30(3) reviewed at least once every 90 days and revised; and
156.31(4) signed by the client or, if appropriate, by the client's parent or other person
156.32authorized by statute to consent to mental health services for the client.
156.33    Subd. 3. Eligible mental health services providers. (a) Eligible providers for
156.34intensive children's mental health services in a foster family setting must be certified
156.35by the state and have a service provision contract with a county board or a reservation
157.1tribal council and must be able to demonstrate the ability to provide all of the services
157.2required in this section.
157.3(b) For purposes of this section, a provider agency must have an individual
157.4placement agreement for each recipient and must be a licensed child placing agency, under
157.5Minnesota Rules, parts 9543.0010 to 9543.0150, and either be:
157.6(1) a county county-operated entity certified by the state;
157.7(2) an Indian Health Services facility operated by a tribe or tribal organization under
157.8funding authorized by United States Code, title 25, sections 450f to 450n, or title 3 of the
157.9Indian Self-Determination Act, Public Law 93-638, section 638 (facilities or providers); or
157.10(3) a noncounty entity under contract with a county board.
157.11(c) Certified providers that do not meet the service delivery standards required in
157.12this section shall be subject to a decertification process.
157.13(d) For the purposes of this section, all services delivered to a client must be
157.14provided by a mental health professional or a clinical trainee.
157.15    Subd. 4. Eligible provider responsibilities Service delivery payment
157.16requirements. (a) To be an eligible provider for payment under this section, a provider
157.17must develop and practice written policies and procedures for treatment foster care services
157.18 intensive treatment in foster care, consistent with subdivision 1, paragraph (b), clauses (1),
157.19(2), and (3) and comply with the following requirements in paragraphs (b) to (n).
157.20(b) In delivering services under this section, a treatment foster care provider must
157.21ensure that staff caseload size reasonably enables the provider to play an active role in
157.22service planning, monitoring, delivering, and reviewing for discharge planning to meet
157.23the needs of the client, the client's foster family, and the birth family, as specified in each
157.24client's individual treatment plan.
157.25(b) A qualified clinical supervisor, as defined in and performing in compliance with
157.26Minnesota Rules, part 9505.0371, subpart 5, item D, must supervise the treatment and
157.27provision of services described in this section.
157.28(c) Each client receiving treatment services must receive an extended diagnostic
157.29assessment, as described in Minnesota Rules, part 9505.0372, subpart 1, item C, within
157.3030 days of enrollment in this service unless the client has a previous extended diagnostic
157.31assessment that the client, parent, and mental health professional agree still accurately
157.32describes the client's current mental health functioning.
157.33(d) Each previous and current mental health, school, and physical health treatment
157.34provider must be contacted to request documentation of treatment and assessments that the
157.35eligible client has received and this information must be reviewed and incorporated into
157.36the diagnostic assessment and team consultation and treatment planning review process.
158.1(e) Each client receiving treatment must be assessed for a trauma history and
158.2the client's treatment plan must document how the results of the assessment will be
158.3incorporated into treatment.
158.4(f) Each client receiving treatment services must have an individual treatment plan
158.5that is reviewed, evaluated, and signed every 90 days using the team consultation and
158.6treatment planning process, as defined in subdivision 1a, paragraph (s).
158.7(g) Care consultation, as defined in subdivision 1a, paragraph (a), must be provided
158.8in accordance with the client's individual treatment plan.
158.9(h) Each client must have a crisis assistance plan within ten days of initiating
158.10services and must have access to clinical phone support 24 hours per day, seven days per
158.11week, during the course of treatment, and the crisis plan must demonstrate coordination
158.12with the local or regional mobile crisis intervention team.
158.13(i) Services must be delivered and documented at least three days per week, equaling
158.14at least six hours of treatment per week, unless reduced units of service are specified on
158.15the treatment plan as part of transition or on a discharge plan to another service or level of
158.16care. Documentation must comply with Minnesota Rules, parts 9505.2175 and 9505.2197.
158.17(j) Location of service delivery must be in the client's home, day care setting,
158.18school, or other community-based setting that is specified on the client's individualized
158.19treatment plan.
158.20(k) Treatment must be developmentally and culturally appropriate for the client.
158.21(l) Services must be delivered in continual collaboration and consultation with the
158.22client's medical providers and, in particular, with prescribers of psychotropic medications,
158.23including those prescribed on an off-label basis, and members of the service team must be
158.24aware of the medication regimen and potential side effects.
158.25(m) Parents, siblings, foster parents, and members of the child's permanency plan
158.26must be involved in treatment and service delivery unless otherwise noted in the treatment
158.27plan.
158.28(n) Transition planning for the child must be conducted starting with the first
158.29treatment plan and must be addressed throughout treatment to support the child's
158.30permanency plan and postdischarge mental health service needs.
158.31    Subd. 5. Service authorization. The commissioner will administer authorizations
158.32for services under this section in compliance with section 256B.0625, subdivision 25.
158.33    Subd. 6. Excluded services. (a) Services in clauses (1) to (4) (7) are not covered
158.34under this section and are not eligible for medical assistance payment as components of
158.35intensive treatment in foster care services, but may be billed separately:
159.1(1) treatment foster care services provided in violation of medical assistance policy
159.2in Minnesota Rules, part 9505.0220;
159.3(2) service components of children's therapeutic services and supports
159.4simultaneously provided by more than one treatment foster care provider;
159.5(3) home and community-based waiver services; and
159.6(4) treatment foster care services provided to a child without a level of care
159.7determination according to section 245.4885, subdivision 1.
159.8(1) inpatient psychiatric hospital treatment;
159.9(2) mental health targeted case management;
159.10(3) partial hospitalization;
159.11(4) medication management;
159.12(5) children's mental health day treatment services;
159.13(6) crisis response services under section 256B.0944; and
159.14(7) transportation.
159.15(b) Children receiving intensive treatment in foster care services are not eligible for
159.16medical assistance reimbursement for the following services while receiving intensive
159.17treatment in foster care:
159.18(1) mental health case management services under section 256B.0625, subdivision
159.1920 ; and
159.20(2) (1) psychotherapy and skill skills training components of children's therapeutic
159.21services and supports under section 256B.0625, subdivision 35b.;
159.22(2) mental health behavioral aide services as defined in section 256B.0943,
159.23subdivision 1, paragraph (m);
159.24(3) home and community-based waiver services;
159.25(4) mental health residential treatment; and
159.26(5) room and board costs as defined in section 256I.03, subdivision 6.
159.27    Subd. 7. Medical assistance payment and rate setting. The commissioner shall
159.28establish a single daily per-client encounter rate for intensive treatment in foster care
159.29services. The rate must be constructed to cover only eligible services delivered to an
159.30eligible recipient by an eligible provider, as prescribed in subdivision 1, paragraph (b).

159.31    Sec. 24. Minnesota Statutes 2012, section 256B.761, is amended to read:
159.32256B.761 REIMBURSEMENT FOR MENTAL HEALTH SERVICES.
159.33(a) Effective for services rendered on or after July 1, 2001, payment for medication
159.34management provided to psychiatric patients, outpatient mental health services, day
159.35treatment services, home-based mental health services, and family community support
160.1services shall be paid at the lower of (1) submitted charges, or (2) 75.6 percent of the
160.250th percentile of 1999 charges.
160.3(b) Effective July 1, 2001, the medical assistance rates for outpatient mental health
160.4services provided by an entity that operates: (1) a Medicare-certified comprehensive
160.5outpatient rehabilitation facility; and (2) a facility that was certified prior to January 1,
160.61993, with at least 33 percent of the clients receiving rehabilitation services in the most
160.7recent calendar year who are medical assistance recipients, will be increased by 38 percent,
160.8when those services are provided within the comprehensive outpatient rehabilitation
160.9facility and provided to residents of nursing facilities owned by the entity.
160.10(c) The commissioner shall establish three levels of payment for mental health
160.11diagnostic assessment, based on three levels of complexity. The aggregate payment under
160.12the tiered rates must not exceed the projected aggregate payments for mental health
160.13diagnostic assessment under the previous single rate. The new rate structure is effective
160.14January 1, 2011, or upon federal approval, whichever is later.
160.15(d) In addition to rate increases otherwise provided, the commissioner may
160.16restructure coverage policy and rates to improve access to adult rehabilitative mental
160.17health services under section 256B.0623 and related mental health support services under
160.18section 256B.021, subdivision 4, paragraph (f), clause (2). For state fiscal years 2015 and
160.192016, the projected state share of increased costs due to this paragraph is transferred
160.20from adult mental health grants under sections 245.4661 and 256E.12. The transfer for
160.21fiscal year 2016 is a permanent base adjustment for subsequent fiscal years. Payments
160.22made to managed care plans and county-based purchasing plans under sections 256B.69,
160.23256B.692, and 256L.12 shall reflect the rate changes described in this paragraph.

160.24    Sec. 25. Minnesota Statutes 2012, section 256I.05, subdivision 1e, is amended to read:
160.25    Subd. 1e. Supplementary rate for certain facilities. (a) Notwithstanding the
160.26provisions of subdivisions 1a and 1c, beginning July 1, 2005, a county agency shall
160.27negotiate a supplementary rate in addition to the rate specified in subdivision 1, not to
160.28exceed $700 per month, including any legislatively authorized inflationary adjustments,
160.29for a group residential housing provider that:
160.30(1) is located in Hennepin County and has had a group residential housing contract
160.31with the county since June 1996;
160.32(2) operates in three separate locations a 75-bed facility, a 50-bed facility, and a
160.3326-bed facility; and
161.1(3) serves a chemically dependent clientele, providing 24 hours per day supervision
161.2and limiting a resident's maximum length of stay to 13 months out of a consecutive
161.324-month period.
161.4(b) Notwithstanding subdivisions 1a and 1c, a county agency shall negotiate a
161.5supplementary rate in addition to the rate specified in subdivision 1, not to exceed $700
161.6per month, including any legislatively authorized inflationary adjustments, of a group
161.7residential provider that:
161.8(1) is located in St. Louis County and has had a group residential housing contract
161.9with the county since 2006;
161.10(2) operates a 62-bed facility; and
161.11(3) serves a chemically dependent adult male clientele, providing 24 hours per
161.12day supervision and limiting a resident's maximum length of stay to 13 months out of
161.13a consecutive 24-month period.
161.14(c) Notwithstanding subdivisions 1a and 1c, beginning July 1, 2013, a county agency
161.15shall negotiate a supplementary rate in addition to the rate specified in subdivision 1, not
161.16to exceed $700 per month, including any legislatively authorized inflationary adjustments,
161.17for the group residential provider described under paragraphs (a) and (b), not to exceed
161.18an additional 115 beds.

161.19    Sec. 26. CHILD AND ADOLESCENT BEHAVIORAL HEALTH SERVICES.
161.20The commissioner of human services shall, in consultation with children's mental
161.21health community providers, hospitals providing care to children, children's mental health
161.22advocates, and other interested parties, develop recommendations and legislation, if
161.23necessary, for the state-operated child and adolescent behavioral health services facility
161.24to ensure that:
161.25(1) the facility and the services provided meet the needs of children with serious
161.26emotional disturbances, autism spectrum disorders, reactive attachment disorder, PTSD,
161.27serious emotional disturbance co-occurring with a developmental disability, borderline
161.28personality disorder, schizophrenia, fetal alcohol spectrum disorders, brain injuries,
161.29violent tendencies, and complex medical issues;
161.30(2) qualified personnel and staff can be recruited who have specific expertise and
161.31training to treat the children in the facility; and
161.32(3) the treatment provided at the facility is high-quality, effective treatment.

161.33    Sec. 27. PILOT PROVIDER INPUT SURVEY OF PEDIATRIC SERVICES AND
161.34CHILDREN'S MENTAL HEALTH SERVICES.
162.1(a) To assess the efficiency and other operational issues in the management of the
162.2health care delivery system, the commissioner of human services shall initiate a provider
162.3survey. The pilot survey shall consist of an electronic survey of providers of pediatric
162.4services and children's mental health services to identify and measure issues that arise in
162.5dealing with the management of medical assistance. To the maximum degree possible,
162.6existing technology shall be used and interns sought to analyze the results.
162.7(b) The survey questions must focus on seven key business functions provided
162.8by medical assistance contractors: provider inquiries; provider outreach and education;
162.9claims processing; appeals; provider enrollment; medical review; and provider audit and
162.10reimbursement. The commissioner must consider the results of the survey in evaluating
162.11and renewing managed care and fee-for-service management contracts.
162.12(c) The commissioner shall report by January 15, 2014, the results of the survey to
162.13the chairs of the health and human services policy and finance committees and shall
162.14make recommendations on the value of implementing an annual survey with a rotating
162.15list of provider groups as a component of the continuous quality improvement system for
162.16medical assistance.