Bill Text: MN SF1161 | 2013-2014 | 88th Legislature | Introduced
Bill Title: Mental health provisions modifications; medical assistance (MA) family psychoeducation services and clinical care consultations coverage authorization
Spectrum: Partisan Bill (Democrat 1-0)
Status: (Introduced - Dead) 2013-03-14 - Comm report: To pass and re-referred to Finance [SF1161 Detail]
Download: Minnesota-2013-SF1161-Introduced.html
1.2relating to human services; modifying chemical and mental health provisions;
modifying provisions related to funding mental health services; providing for coverage of family psychoeducation services and clinical care consultations in the medical assistance program;1.3amending Minnesota Statutes 2012, sections 245.4682, subdivision 2; 246.18,
1.4subdivision 8, by adding a subdivision; 256B.0625, by adding subdivisions;
1.5256B.761.
1.6BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF MINNESOTA:
1.7 Section 1. Minnesota Statutes 2012, section 245.4682, subdivision 2, is amended to read:
1.8 Subd. 2. General provisions. (a) In the design and implementation of reforms to
1.9the mental health system, the commissioner shall:
1.10 (1) consult with consumers, families, counties, tribes, advocates, providers, and
1.11other stakeholders;
1.12 (2) bring to the legislature, and the State Advisory Council on Mental Health, by
1.13January 15, 2008, recommendations for legislation to update the role of counties and to
1.14clarify the case management roles, functions, and decision-making authority of health
1.15plans and counties, and to clarify county retention of the responsibility for the delivery of
1.16social services as required under subdivision 3, paragraph (a);
1.17 (3) withhold implementation of any recommended changes in case management
1.18roles, functions, and decision-making authority until after the release of the report due
1.19January 15, 2008;
1.20 (4) ensure continuity of care for persons affected by these reforms including
1.21ensuring client choice of provider by requiring broad provider networks and developing
1.22mechanisms to facilitate a smooth transition of service responsibilities;
1.23 (5) provide accountability for the efficient and effective use of public and private
1.24resources in achieving positive outcomes for consumers;
1.25 (6) ensure client access to applicable protections and appeals; and
2.1 (7) make budget transfers necessary to implement the reallocation of services and
2.2client responsibilities between counties and health care programs that do not increase the
2.3state and county costs and efficiently allocate state funds.
2.4 (b) When making transfers under paragraph (a) necessary to implement movement
2.5of responsibility for clients and services between counties and health care programs,
2.6the commissioner, in consultation with counties, shall ensure that any transfer of state
2.7grants to health care programs, including the value of case management transfer grants
2.8under section256B.0625, subdivision 20 , does not exceed the value of the services being
2.9transferred for the latest 12-month period for which data is available. The commissioner
2.10may make quarterly adjustments based on the availability of additional data during the
2.11first four quarters after the transfers first occur. If case management transfer grants under
2.12section256B.0625, subdivision 20 , are repealed and the value, based on the last year prior
2.13to repeal, exceeds the value of the services being transferred, the difference becomes an
2.14ongoing part of each county's adultand children's mental health grants under sections
2.15245.4661
,
245.4889, and
256E.12 .
2.16 (c) This appropriation is not authorized to be expended after December 31, 2010,
2.17unless approved by the legislature.
2.18 Sec. 2. Minnesota Statutes 2012, section 246.18, subdivision 8, is amended to read:
2.19 Subd. 8. State-operated services account. (a) The state-operated services account is
2.20established in the special revenue fund. Revenue generated by new state-operated services
2.21listed under this section established after July 1, 2010, that are not enterprise activities must
2.22be deposited into the state-operated services account, unless otherwise specified in law:
2.23(1) intensive residential treatment services;
2.24(2) foster care services; and
2.25(3) psychiatric extensive recovery treatment services.
2.26(b) Funds deposited in the state-operated services account are available to the
2.27commissioner of human services for the purposes of:
2.28(1) providing services needed to transition individuals from institutional settings
2.29within state-operated services to the community when those services have no other
2.30adequate funding source; and
2.31(2) grants to providers participating in mental health specialty treatment services
2.32under section 245.4661.
2.33 Sec. 3. Minnesota Statutes 2012, section 246.18, is amended by adding a subdivision
2.34to read:
3.1 Subd. 9. Transfers. The commissioner may transfer state mental health grant funds
3.2to the account in subdivision 8 for noncovered allowable costs of a provider certified and
3.3licensed under section 256B.0622, and operating under section 246.014.
3.4 Sec. 4. Minnesota Statutes 2012, section 256B.0625, is amended by adding a
3.5subdivision to read:
3.6 Subd. 61. Family psychoeducation services. Effective July 1, 2013, or upon
3.7federal approval, whichever is later, medical assistance covers family psychoeducation
3.8services provided to a child up to age 21 with a diagnosed mental health condition when
3.9identified in the child's individual treatment plan and provided by a licensed mental health
3.10professional, as defined in Minnesota Rules, part 9505.0371, subpart 5, item A, or a
3.11clinical trainee, as defined in Minnesota Rules, part 9505.0371, subpart 5, item C, who
3.12has determined it medically necessary to involve family members in the child's care. For
3.13the purposes of this subdivision, "family psychoeducation services" means information
3.14or demonstration provided to an individual or family as part of an individual, family,
3.15multifamily group, or peer group session to explain, educate, and support the child and
3.16family in understanding a child's symptoms of mental illness, the impact on the child's
3.17development, and needed components of treatment and skill development so that the
3.18individual, family, or group can help the child to prevent relapse, prevent the acquisition
3.19of comorbid disorders, and to achieve optimal mental health and long-term resilience.
3.20 Sec. 5. Minnesota Statutes 2012, section 256B.0625, is amended by adding a
3.21subdivision to read:
3.22 Subd. 62. Mental health clinical care consultation. Effective July 1, 2013, or upon
3.23federal approval, whichever is later, medical assistance covers clinical care consultation
3.24for a person up to age 21 who is diagnosed with a complex mental health condition or a
3.25mental health condition that co-occurs with other complex and chronic conditions, when
3.26described in the person's individual treatment plan and provided by a licensed mental
3.27health professional, as defined in Minnesota Rules, part 9505.0371, subpart 5, item A. For
3.28the purposes of this subdivision, "clinical care consultation" means communication from a
3.29treating mental health professional to other providers not under the clinical supervision of
3.30the treating mental health professional who are working with the same client to inform,
3.31inquire, and instruct regarding the client's symptoms; strategies for effective engagement,
3.32care, and intervention needs; and treatment expectations across service settings; and to
3.33direct and coordinate clinical service components provided to the client and family.
4.1 Sec. 6. Minnesota Statutes 2012, section 256B.761, is amended to read:
4.2256B.761 REIMBURSEMENT FOR MENTAL HEALTH SERVICES.
4.3(a) Effective for services rendered on or after July 1, 2001, payment for medication
4.4management provided to psychiatric patients, outpatient mental health services, day
4.5treatment services, home-based mental health services, and family community support
4.6services shall be paid at the lower of (1) submitted charges, or (2) 75.6 percent of the
4.750th percentile of 1999 charges.
4.8(b) Effective July 1, 2001, the medical assistance rates for outpatient mental health
4.9services provided by an entity that operates: (1) a Medicare-certified comprehensive
4.10outpatient rehabilitation facility; and (2) a facility that was certified prior to January 1,
4.111993, with at least 33 percent of the clients receiving rehabilitation services in the most
4.12recent calendar year who are medical assistance recipients, will be increased by 38 percent,
4.13when those services are provided within the comprehensive outpatient rehabilitation
4.14facility and provided to residents of nursing facilities owned by the entity.
4.15(c) The commissioner shall establish three levels of payment for mental health
4.16diagnostic assessment, based on three levels of complexity. The aggregate payment under
4.17the tiered rates must not exceed the projected aggregate payments for mental health
4.18diagnostic assessment under the previous single rate. The new rate structure is effective
4.19January 1, 2011, or upon federal approval, whichever is later.
4.20(d) In addition to rate increases otherwise provided, the commissioner may
4.21restructure coverage policy and rates to improve access to adult rehabilitative mental
4.22health services under section 256B.0623 and related mental health support services under
4.23section 256B.021, subdivision 4, paragraph (f), clause (2). For state fiscal years 2015 and
4.242016, the projected state share of increased costs due to this paragraph is transferred
4.25from adult mental health grants under sections 245.4661 and 256E.12. The transfer for
4.26fiscal year 2016 is a permanent base adjustment for subsequent fiscal years. Payments
4.27made to managed care plans and county-based purchasing plans under sections 256B.69,
4.28256B.692, and 256L.12 shall reflect the rate changes described in this paragraph.
modifying provisions related to funding mental health services; providing for coverage of family psychoeducation services and clinical care consultations in the medical assistance program;1.3amending Minnesota Statutes 2012, sections 245.4682, subdivision 2; 246.18,
1.4subdivision 8, by adding a subdivision; 256B.0625, by adding subdivisions;
1.5256B.761.
1.6BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF MINNESOTA:
1.7 Section 1. Minnesota Statutes 2012, section 245.4682, subdivision 2, is amended to read:
1.8 Subd. 2. General provisions. (a) In the design and implementation of reforms to
1.9the mental health system, the commissioner shall:
1.10 (1) consult with consumers, families, counties, tribes, advocates, providers, and
1.11other stakeholders;
1.12 (2) bring to the legislature, and the State Advisory Council on Mental Health, by
1.13January 15, 2008, recommendations for legislation to update the role of counties and to
1.14clarify the case management roles, functions, and decision-making authority of health
1.15plans and counties, and to clarify county retention of the responsibility for the delivery of
1.16social services as required under subdivision 3, paragraph (a);
1.17 (3) withhold implementation of any recommended changes in case management
1.18roles, functions, and decision-making authority until after the release of the report due
1.19January 15, 2008;
1.20 (4) ensure continuity of care for persons affected by these reforms including
1.21ensuring client choice of provider by requiring broad provider networks and developing
1.22mechanisms to facilitate a smooth transition of service responsibilities;
1.23 (5) provide accountability for the efficient and effective use of public and private
1.24resources in achieving positive outcomes for consumers;
1.25 (6) ensure client access to applicable protections and appeals; and
2.1 (7) make budget transfers necessary to implement the reallocation of services and
2.2client responsibilities between counties and health care programs that do not increase the
2.3state and county costs and efficiently allocate state funds.
2.4 (b) When making transfers under paragraph (a) necessary to implement movement
2.5of responsibility for clients and services between counties and health care programs,
2.6the commissioner, in consultation with counties, shall ensure that any transfer of state
2.7grants to health care programs, including the value of case management transfer grants
2.8under section
2.9transferred for the latest 12-month period for which data is available. The commissioner
2.10may make quarterly adjustments based on the availability of additional data during the
2.11first four quarters after the transfers first occur. If case management transfer grants under
2.12section
2.13to repeal, exceeds the value of the services being transferred, the difference becomes an
2.14ongoing part of each county's adult
2.16 (c) This appropriation is not authorized to be expended after December 31, 2010,
2.17unless approved by the legislature.
2.18 Sec. 2. Minnesota Statutes 2012, section 246.18, subdivision 8, is amended to read:
2.19 Subd. 8. State-operated services account. (a) The state-operated services account is
2.20established in the special revenue fund. Revenue generated by new state-operated services
2.21listed under this section established after July 1, 2010, that are not enterprise activities must
2.22be deposited into the state-operated services account, unless otherwise specified in law:
2.23(1) intensive residential treatment services;
2.24(2) foster care services; and
2.25(3) psychiatric extensive recovery treatment services.
2.26(b) Funds deposited in the state-operated services account are available to the
2.27commissioner of human services for the purposes of:
2.28(1) providing services needed to transition individuals from institutional settings
2.29within state-operated services to the community when those services have no other
2.30adequate funding source; and
2.31(2) grants to providers participating in mental health specialty treatment services
2.32under section 245.4661.
2.33 Sec. 3. Minnesota Statutes 2012, section 246.18, is amended by adding a subdivision
2.34to read:
3.1 Subd. 9. Transfers. The commissioner may transfer state mental health grant funds
3.2to the account in subdivision 8 for noncovered allowable costs of a provider certified and
3.3licensed under section 256B.0622, and operating under section 246.014.
3.4 Sec. 4. Minnesota Statutes 2012, section 256B.0625, is amended by adding a
3.5subdivision to read:
3.6 Subd. 61. Family psychoeducation services. Effective July 1, 2013, or upon
3.7federal approval, whichever is later, medical assistance covers family psychoeducation
3.8services provided to a child up to age 21 with a diagnosed mental health condition when
3.9identified in the child's individual treatment plan and provided by a licensed mental health
3.10professional, as defined in Minnesota Rules, part 9505.0371, subpart 5, item A, or a
3.11clinical trainee, as defined in Minnesota Rules, part 9505.0371, subpart 5, item C, who
3.12has determined it medically necessary to involve family members in the child's care. For
3.13the purposes of this subdivision, "family psychoeducation services" means information
3.14or demonstration provided to an individual or family as part of an individual, family,
3.15multifamily group, or peer group session to explain, educate, and support the child and
3.16family in understanding a child's symptoms of mental illness, the impact on the child's
3.17development, and needed components of treatment and skill development so that the
3.18individual, family, or group can help the child to prevent relapse, prevent the acquisition
3.19of comorbid disorders, and to achieve optimal mental health and long-term resilience.
3.20 Sec. 5. Minnesota Statutes 2012, section 256B.0625, is amended by adding a
3.21subdivision to read:
3.22 Subd. 62. Mental health clinical care consultation. Effective July 1, 2013, or upon
3.23federal approval, whichever is later, medical assistance covers clinical care consultation
3.24for a person up to age 21 who is diagnosed with a complex mental health condition or a
3.25mental health condition that co-occurs with other complex and chronic conditions, when
3.26described in the person's individual treatment plan and provided by a licensed mental
3.27health professional, as defined in Minnesota Rules, part 9505.0371, subpart 5, item A. For
3.28the purposes of this subdivision, "clinical care consultation" means communication from a
3.29treating mental health professional to other providers not under the clinical supervision of
3.30the treating mental health professional who are working with the same client to inform,
3.31inquire, and instruct regarding the client's symptoms; strategies for effective engagement,
3.32care, and intervention needs; and treatment expectations across service settings; and to
3.33direct and coordinate clinical service components provided to the client and family.
4.1 Sec. 6. Minnesota Statutes 2012, section 256B.761, is amended to read:
4.2256B.761 REIMBURSEMENT FOR MENTAL HEALTH SERVICES.
4.3(a) Effective for services rendered on or after July 1, 2001, payment for medication
4.4management provided to psychiatric patients, outpatient mental health services, day
4.5treatment services, home-based mental health services, and family community support
4.6services shall be paid at the lower of (1) submitted charges, or (2) 75.6 percent of the
4.750th percentile of 1999 charges.
4.8(b) Effective July 1, 2001, the medical assistance rates for outpatient mental health
4.9services provided by an entity that operates: (1) a Medicare-certified comprehensive
4.10outpatient rehabilitation facility; and (2) a facility that was certified prior to January 1,
4.111993, with at least 33 percent of the clients receiving rehabilitation services in the most
4.12recent calendar year who are medical assistance recipients, will be increased by 38 percent,
4.13when those services are provided within the comprehensive outpatient rehabilitation
4.14facility and provided to residents of nursing facilities owned by the entity.
4.15(c) The commissioner shall establish three levels of payment for mental health
4.16diagnostic assessment, based on three levels of complexity. The aggregate payment under
4.17the tiered rates must not exceed the projected aggregate payments for mental health
4.18diagnostic assessment under the previous single rate. The new rate structure is effective
4.19January 1, 2011, or upon federal approval, whichever is later.
4.20(d) In addition to rate increases otherwise provided, the commissioner may
4.21restructure coverage policy and rates to improve access to adult rehabilitative mental
4.22health services under section 256B.0623 and related mental health support services under
4.23section 256B.021, subdivision 4, paragraph (f), clause (2). For state fiscal years 2015 and
4.242016, the projected state share of increased costs due to this paragraph is transferred
4.25from adult mental health grants under sections 245.4661 and 256E.12. The transfer for
4.26fiscal year 2016 is a permanent base adjustment for subsequent fiscal years. Payments
4.27made to managed care plans and county-based purchasing plans under sections 256B.69,
4.28256B.692, and 256L.12 shall reflect the rate changes described in this paragraph.
