1.2relating to human services; requiring an electronic survey of providers of
1.3pediatric services and children's mental health services; establishing new mental
1.4health services covered under medical assistance;amending Minnesota Statutes
1.52012, sections 256B.02, subdivision 12; 256B.0625, subdivision 56, by adding
1.6subdivisions; 256B.0943, subdivisions 1, 2; proposing coding for new law in
1.7Minnesota Statutes, chapter 256B.
1.8BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF MINNESOTA:

1.9    Section 1. Minnesota Statutes 2012, section 256B.02, subdivision 12, is amended to
1.10read:
1.11    Subd. 12. Third-party payer. "Third-party payer" means a person, entity, or agency
1.12or government program that has a probable obligation to pay all or part of the costs of a
1.13medical assistance recipient's health services. Third-party payer includes an entity under
1.14contract with the recipient to cover all or part of the recipient's medical costs. Third-party
1.15payer does not include a school district for costs for clinical mental health care.

1.16    Sec. 2. [256B.0616] MENTAL HEALTH CERTIFIED FAMILY PEER
1.17SPECIALIST.
1.18    Subdivision 1. Scope. Medical assistance covers mental health certified family peer
1.19specialists services, as established in subdivision 2, subject to federal approval, if provided
1.20to recipients who have an emotional disturbance or severe emotional disturbance under
1.21chapter 245, and are provided by a certified family peer specialist who has completed the
1.22training under subdivision 5. A family peer specialist cannot provide services to the
1.23peer specialist's family.
2.1    Subd. 2. Establishment. The commissioner of human services shall establish a
2.2certified family peer specialists program model which:
2.3(1) provides nonclinical family peer support counseling, building on the strengths
2.4of families and helping them achieve desired outcomes;
2.5(2) collaborates with others providing care or support to the family;
2.6(3) provides nonadversarial advocacy;
2.7(4) promotes the individual family culture in the treatment milieu;
2.8(5) links parents to other parents in the community;
2.9(6) offers support and encouragement;
2.10(7) assists parents in developing coping mechanisms and problem-solving skills;
2.11(8) promotes resiliency, self-advocacy, development of natural supports, and
2.12maintenance of skills learned in other support services;
2.13(9) establishes and provides peer led parent support groups; and
2.14(10) increases the child's ability to function better within the child's home, school,
2.15and community by educating parents on community resources, assisting with problem
2.16solving, and educating parents on mental illnesses.
2.17    Subd. 3. Eligibility. Family peer specialist services may be located in inpatient
2.18hospitalization, partial hospitalization, residential treatment, treatment foster care, day
2.19treatment, children's therapeutic services and supports, or crisis services.
2.20    Subd. 4. Peer specialist program providers. The commissioner shall develop
2.21a process to certify family peer specialist programs, in accordance with the federal
2.22guidelines, in order for the program to bill for reimbursable services. Family peer specialist
2.23programs must operate within an existing mental health community provider or center.
2.24    Subd. 5. Certified family peer specialist training and certification. The
2.25commissioner shall develop a training and certification process for certified family peer
2.26specialists who must be at least 21 years of age and have a high school diploma or its
2.27equivalent. The candidates must have raised or are currently raising a child with a mental
2.28illness, have had experience navigating the children's mental health system, and must
2.29demonstrate leadership and advocacy skills and a strong dedication to family-driven and
2.30family-focused services. The training curriculum must teach participating family peer
2.31specialists specific skills relevant to providing peer support to other parents. In addition
2.32to initial training and certification, the commissioner shall develop ongoing continuing
2.33educational workshops on pertinent issues related to family peer specialist services.

2.34    Sec. 3. Minnesota Statutes 2012, section 256B.0625, is amended by adding a
2.35subdivision to read:
3.1    Subd. 35c. School-based mental health services. Medical assistance covers
3.2mental health services provided in a school by an individual licensed as a professional
3.3counselor under sections 148B.50 to 148B.593 when the licensed professional counselor
3.4is supervised by a licensed mental health professional.

3.5    Sec. 4. Minnesota Statutes 2012, section 256B.0625, subdivision 56, is amended to read:
3.6    Subd. 56. Medical service coordination. (a)(1) Medical assistance covers in-reach
3.7community-based service coordination that is performed through a hospital emergency
3.8department as an eligible procedure under a state healthcare program for a frequent user.
3.9A frequent user is defined as an individual who has frequented the hospital emergency
3.10department for services three or more times in the previous four consecutive months.
3.11In-reach community-based service coordination includes navigating services to address a
3.12client's mental health, chemical health, social, economic, and housing needs, or any other
3.13activity targeted at reducing the incidence of emergency room and other nonmedically
3.14necessary health care utilization.
3.15(2) Medical assistance also covers in-reach community-based service coordination
3.16that is performed through a hospital emergency department or inpatient psychiatric unit,
3.17residential treatment center, community mental health center, children's therapeutic
3.18services and supports provider, or juvenile justice facility as an eligible provider under a
3.19state health care program for a child with a serious emotional disturbance and for young
3.20adults up to age 26.
3.21    (b) Reimbursement must be made in 15-minute increments and allowed for up to
3.2260 days posthospital discharge based upon the specific identified emergency department
3.23visit or inpatient admitting event. In-reach community-based service coordination
3.24shall seek to connect frequent users with existing covered services available to them,
3.25including, but not limited to, targeted case management, waiver case management, or care
3.26coordination in a health care home. For children with a serious emotional disturbance,
3.27in-reach community-based service coordination shall seek to connect them with existing
3.28covered services, including targeted case management, waiver case management, care
3.29coordination in a health care home, children's therapeutic services and supports, crisis
3.30services, and respite care. Eligible in-reach service coordinators must hold a minimum
3.31of a bachelor's degree in social work, public health, corrections, or a related field. The
3.32commissioner shall submit any necessary application for waivers to the Centers for
3.33Medicare and Medicaid Services to implement this subdivision.
3.34    (c) For the purposes of this subdivision, "in-reach community-based service
3.35coordination" means the practice of a community-based worker with training, knowledge,
4.1skills, and ability to access a continuum of services, including housing, transportation,
4.2chemical and mental health treatment, employment, education, and peer support services,
4.3by working with an organization's staff to transition an individual back into the individual's
4.4living environment. In-reach community-based service coordination includes working
4.5with the individual during their discharge and for up to a defined amount of time in the
4.6individual's living environment, reducing the individual's need for readmittance.

4.7    Sec. 5. Minnesota Statutes 2012, section 256B.0625, is amended by adding a
4.8subdivision to read:
4.9    Subd. 61. Family psychoeducation services. Effective July 1, 2013, and subject to
4.10federal approval, medical assistance covers family psychoeducation services provided
4.11to or on behalf of a child up to age 21 with a diagnosed mental health condition when
4.12identified in the child's individual treatment plan and provided by a licensed mental health
4.13professional, as defined in Minnesota Rules, part 9505.0371, subpart 5, item A, or a
4.14clinical trainee, as defined in Minnesota Rules, part 9505.0371, subpart 5, item C, who
4.15has determined it medically necessary to involve family members in the child's care. For
4.16the purposes of this subdivision, "family psychoeducation services" means information
4.17or demonstration provided to an individual or family as part of an individual, family,
4.18multifamily group, or peer group session to explain, educate, and support the child and
4.19family in understanding a child's symptoms of mental illness, the impact on the child's
4.20development, and needed components of treatment and skill development so that the
4.21individual, family, or group can help the child to prevent relapse, prevent the acquisition
4.22of comorbid disorders, and to achieve optimal mental health and long-term resilience.

4.23    Sec. 6. Minnesota Statutes 2012, section 256B.0625, is amended by adding a
4.24subdivision to read:
4.25    Subd. 62. Mental health clinical care consultation. Effective July 1, 2013,
4.26and subject to federal approval, medical assistance covers clinical care consultation for
4.27a person up to age 21 who is diagnosed with a complex mental health condition or a
4.28mental health condition that co-occurs with other complex and chronic conditions, when
4.29described in the person's individual treatment plan and provided by a licensed mental
4.30health professional, as defined in Minnesota Rules, part 9505.0371, subpart 5, item A. For
4.31the purposes of this subdivision, "clinical care consultation" means communication from a
4.32treating mental health professional to other providers not under the clinical supervision of
4.33the treating mental health professional who are working with the same client to inform,
4.34inquire, and instruct regarding the client's symptoms, strategies for effective engagement,
5.1care and intervention needs, and treatment expectations across service settings; and to
5.2direct and coordinate clinical services components provided to the client and family.

5.3    Sec. 7. Minnesota Statutes 2012, section 256B.0943, subdivision 1, is amended to read:
5.4    Subdivision 1. Definitions. For purposes of this section, the following terms have
5.5the meanings given them.
5.6(a) "Children's therapeutic services and supports" means the flexible package of
5.7mental health services for children who require varying therapeutic and rehabilitative
5.8levels of intervention. The services are time-limited interventions that are delivered using
5.9various treatment modalities and combinations of services designed to reach treatment
5.10outcomes identified in the individual treatment plan.
5.11(b) "Clinical supervision" means the overall responsibility of the mental health
5.12professional for the control and direction of individualized treatment planning, service
5.13delivery, and treatment review for each client. A mental health professional who is an
5.14enrolled Minnesota health care program provider accepts full professional responsibility
5.15for a supervisee's actions and decisions, instructs the supervisee in the supervisee's work,
5.16and oversees or directs the supervisee's work.
5.17(c) "County board" means the county board of commissioners or board established
5.18under sections 402.01 to 402.10 or 471.59.
5.19(d) "Crisis assistance" has the meaning given in section 245.4871, subdivision 9a.
5.20(e) "Culturally competent provider" means a provider who understands and can
5.21utilize to a client's benefit the client's culture when providing services to the client. A
5.22provider may be culturally competent because the provider is of the same cultural or
5.23ethnic group as the client or the provider has developed the knowledge and skills through
5.24training and experience to provide services to culturally diverse clients.
5.25(f) "Day treatment program" for children means a site-based structured program
5.26consisting of group psychotherapy for more than three individuals and other intensive
5.27therapeutic services provided by a multidisciplinary team, under the clinical supervision
5.28of a mental health professional.
5.29(g) "Diagnostic assessment" has the meaning given in section 245.4871, subdivision
5.3011 .
5.31(h) "Direct service time" means the time that a mental health professional, mental
5.32health practitioner, or mental health behavioral aide spends face-to-face with a client
5.33and the client's family. Direct service time includes time in which the provider obtains
5.34a client's history or provides service components of children's therapeutic services and
5.35supports. Direct service time does not include time doing work before and after providing
6.1direct services, including scheduling, maintaining clinical records, consulting with others
6.2about the client's mental health status, preparing reports, receiving clinical supervision,
6.3and revising the client's individual treatment plan.
6.4(i) "Direction of mental health behavioral aide" means the activities of a mental
6.5health professional or mental health practitioner in guiding the mental health behavioral
6.6aide in providing services to a client. The direction of a mental health behavioral aide
6.7must be based on the client's individualized treatment plan and meet the requirements in
6.8subdivision 6, paragraph (b), clause (5).
6.9(j) "Emotional disturbance" has the meaning given in section 245.4871, subdivision
6.1015 . For persons at least age 18 but under age 21, mental illness has the meaning given in
6.11section 245.462, subdivision 20, paragraph (a).
6.12(k) "Individual behavioral plan" means a plan of intervention, treatment, and
6.13services for a child written by a mental health professional or mental health practitioner,
6.14under the clinical supervision of a mental health professional, to guide the work of the
6.15mental health behavioral aide.
6.16(l) "Individual treatment plan" has the meaning given in section 245.4871,
6.17subdivision 21 .
6.18(m) "Mental health behavioral aide services" means medically necessary one-on-one
6.19activities performed by a trained paraprofessional to assist a child retain or generalize
6.20psychosocial skills as taught by a mental health professional or mental health practitioner
6.21and as described in the child's individual treatment plan and individual behavior plan.
6.22Activities involve working directly with the child or child's family as provided in
6.23subdivision 9, paragraph (b), clause (4).
6.24(n) "Mental health professional" means an individual as defined in section 245.4871,
6.25subdivision 27 , clauses (1) to (6), or tribal vendor as defined in section 256B.02,
6.26subdivision 7 , paragraph (b).
6.27(o) "Preschool program" means a day program licensed under Minnesota Rules,
6.28parts 9503.0005 to 9503.0175, and enrolled as a children's therapeutic services and
6.29supports provider to provide a structured treatment program to a child who is at least 33
6.30months old but who has not yet attended the first day of kindergarten.
6.31(p) "Skills training" means individual, family, or group training, delivered by or
6.32under the direction of a mental health professional, designed to facilitate the acquisition
6.33of psychosocial skills that are medically necessary to rehabilitate the child to an
6.34age-appropriate developmental trajectory heretofore disrupted by a psychiatric illness
6.35or to self-monitor, compensate for, cope with, counteract, or replace skills deficits or
7.1maladaptive skills acquired over the course of a psychiatric illness. Skills training is
7.2subject to the following requirements:
7.3(1) a mental health professional or a mental health practitioner must provide skills
7.4training;
7.5(2) the child must always be present during skills training; however, a brief absence
7.6of the child for no more than ten percent of the session unit may be allowed to redirect or
7.7instruct family members;
7.8(3) skills training delivered to children or their families must be targeted to the
7.9specific deficits or maladaptations of the child's mental health disorder and must be
7.10prescribed in the child's individual treatment plan;
7.11(4) skills training delivered to the child's family must teach skills needed by parents
7.12to enhance the child's skill development and to help the child use in daily life the skills
7.13previously taught by a mental health professional or mental health practitioner and to
7.14develop or maintain a home environment that supports the child's progressive use skills;
7.15(5) group skills training may be provided to multiple recipients who, because of the
7.16nature of their emotional, behavioral, or social dysfunction, can derive mutual benefit from
7.17interaction in a group setting, which must be staffed as follows:
7.18(i) one mental health professional or one mental health practitioner under supervision
7.19of a licensed mental health professional must work with a group of four to eight clients; or
7.20(ii) two mental health professionals or two mental health practitioners under
7.21supervision of a licensed mental health professional, or one professional plus one
7.22practitioner must work with a group of nine to 12 clients.
7.23(q) "Care coordination" means contact with other professionals, educators, and
7.24caregivers of the client in person or by telephone to facilitate continuity and consistency in
7.25support of the client and the treatment plan, screening to determine client suitability for
7.26treatment, and development and updating of the treatment plan.
7.27(r) Assessment includes the provision of commissioner-approved assessment tools
7.28and completion of a functional assessment.

7.29    Sec. 8. Minnesota Statutes 2012, section 256B.0943, subdivision 2, is amended to read:
7.30    Subd. 2. Covered service components of children's therapeutic services and
7.31supports. (a) Subject to federal approval, medical assistance covers medically necessary
7.32children's therapeutic services and supports as defined in this section that an eligible
7.33provider entity certified under subdivision 4 provides to a client eligible under subdivision
7.343.
7.35(b) The service components of children's therapeutic services and supports are:
8.1(1) individual, family, and group psychotherapy;
8.2(2) individual, family, or group skills training provided by a mental health
8.3professional or mental health practitioner;
8.4(3) crisis assistance;
8.5(4) mental health behavioral aide services; and
8.6(5) direction of a mental health behavioral aide.;
8.7(6) care coordination provided by a mental health professional or mental health
8.8practitioner;
8.9(7) assessment provided by a mental health professional or mental health practitioner;
8.10(8) clinical care consultation provided by a mental health professional under section
8.11256B.0625, subdivision 62;
8.12(9) family psychoeducation under section 256B.0625, subdivision 61; and
8.13(10) services provided by a certified family peer specialist under section 256B.0616.
8.14(c) Service components in paragraph (b) may be combined to constitute therapeutic
8.15programs, including day treatment programs and therapeutic preschool programs.

8.16    Sec. 9. PILOT PROVIDER INPUT SURVEY.
8.17(a) To assess the efficiency and other operational issues in the management of the
8.18health care delivery system, the commissioner of human services shall initiate a provider
8.19survey. The pilot survey shall consist of an electronic survey of providers of pediatric
8.20services and children's mental health services to identify and measure issues that arise in
8.21dealing with the management of medical assistance. To the maximum degree possible
8.22existing technology shall be used and interns sought to analyze the results.
8.23(b) The survey questions must focus on seven key business functions provided
8.24by medical assistance contractors: provider inquiries; provider outreach and education;
8.25claims processing; appeals; provider enrollment; medical review; and provider audit and
8.26reimbursement. The commissioner must consider the results of the survey in evaluating
8.27and renewing managed care and fee-for-service management contracts.
8.28(c) The commissioner shall report the results of the survey to the chairs of the health
8.29and human services policy and finance committees and shall make recommendations on
8.30the value of implementing an annual survey with a rotating list of provider groups as a
8.31component of the continuous quality improvement system for medical assistance.