Bill Text: MN SF264 | 2013-2014 | 88th Legislature | Engrossed
Bill Title: Mental health certified family peer specialists program establishment under medical assistance (MA); electronic survey of providers of pediatric services and children's mental health services requirement
Sponsorship: Partisan Bill (Democrat 4)
Status: (Introduced - Dead) 2013-02-14 - Comm report: To pass as amended and re-refer to Finance [SF264 Detail]
Download: Minnesota-2013-SF264-Engrossed.html
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 support 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 support specialist program providers. The commissioner shall
2.21develop a process to certify family peer support specialist programs, in accordance with
2.22the federal guidelines, in order for the program to bill for reimbursable services. Family
2.23peer support programs must operate within an existing mental health community provider
2.24or center.
2.25 Subd. 5. Certified family peer specialist training and certification. The
2.26commissioner shall develop a training and certification process for certified family peer
2.27specialists who must be at least 21 years of age and have a high school diploma or its
2.28equivalent. The candidates must have raised or are currently raising a child with a mental
2.29illness, have had experience navigating the children's mental health system, and must
2.30demonstrate leadership and advocacy skills and a strong dedication to family-driven and
2.31family-focused services. The training curriculum must teach participating family peer
2.32specialists specific skills relevant to providing peer support to other parents. In addition
2.33to initial training and certification, the commissioner shall develop ongoing continuing
2.34educational workshops on pertinent issues related to family peer support counseling.
2.35 Sec. 3. Minnesota Statutes 2012, section 256B.0625, subdivision 56, is amended to read:
3.1 Subd. 56. Medical service coordination. (a)(1) Medical assistance covers in-reach
3.2community-based service coordination that is performed through a hospital emergency
3.3department as an eligible procedure under a state healthcare program for a frequent user.
3.4A frequent user is defined as an individual who has frequented the hospital emergency
3.5department for services three or more times in the previous four consecutive months.
3.6In-reach community-based service coordination includes navigating services to address a
3.7client's mental health, chemical health, social, economic, and housing needs, or any other
3.8activity targeted at reducing the incidence of emergency room and other nonmedically
3.9necessary health care utilization.
3.10(2) Medical assistance covers in-reach community-based service coordination that
3.11is performed through a hospital emergency department or inpatient psychiatric unit,
3.12residential treatment center, community mental health center, children's therapeutic
3.13services and supports provider, or juvenile justice facility as an eligible service for a child
3.14or young adult up to age 26 with a serious emotional disturbance.
3.15 (b) Reimbursement must be made in 15-minute increments and allowed for up to 60
3.16days posthospital discharge based upon the specific identified emergency department visit
3.17or inpatient admitting event. In-reach community-based service coordination shall seek to
3.18connect frequent users with existing covered services available to them, including, but not
3.19limited to, targeted case management, waiver case management, or care coordination in a
3.20health care home. For children and young adults with a serious emotional disturbance,
3.21in-reach community-based service coordination shall seek to connect them with existing
3.22covered services, including targeted case management, waiver case management, care
3.23coordination in a health care home, children's therapeutic services and supports, crisis
3.24services, and respite care. Eligible in-reach service coordinators must hold a minimum
3.25of a bachelor's degree in social work, public health, corrections, or a related field. The
3.26commissioner shall submit any necessary application for waivers to the Centers for
3.27Medicare and Medicaid Services to implement this subdivision.
3.28 (c) For the purposes of this subdivision, "in-reach community-based service
3.29coordination" means the practice of a community-based worker with training, knowledge,
3.30skills, and ability to access a continuum of services, including housing, transportation,
3.31chemical and mental health treatment, employment, education, and peer support services,
3.32by working with an organization's staff to transition an individual back into the individual's
3.33living environment. In-reach community-based service coordination includes working
3.34with the individual during their discharge and for up to a defined amount of time in the
3.35individual's living environment, reducing the individual's need for readmittance.
4.1 Sec. 4. Minnesota Statutes 2012, section 256B.0625, is amended by adding a
4.2subdivision to read:
4.3 Subd. 61. Family psychoeducation services. Effective July 1, 2013, and subject to
4.4federal approval, medical assistance covers family psychoeducation services provided
4.5to or on behalf of a child up to age 21 with a diagnosed mental health condition when
4.6identified in the child's individual treatment plan and provided by a licensed mental health
4.7professional, as defined in Minnesota Rules, part 9505.0371, subpart 5, item A, or a
4.8clinical trainee, as defined in Minnesota Rules, part 9505.0371, subpart 5, item C, who
4.9has determined it medically necessary to involve family members in the child's care. For
4.10the purposes of this subdivision, "family psychoeducation services" means information
4.11or demonstration provided to an individual or family as part of an individual, family,
4.12multifamily group, or peer group session to explain, educate, and support the child and
4.13family in understanding a child's symptoms of mental illness, the impact on the child's
4.14development, and needed components of treatment and skill development so that the
4.15individual, family, or group can help the child to prevent relapse, prevent the acquisition
4.16of comorbid disorders, and to achieve optimal mental health and long-term resilience.
4.17 Sec. 5. Minnesota Statutes 2012, section 256B.0625, is amended by adding a
4.18subdivision to read:
4.19 Subd. 62. Mental health clinical care consultation. Effective July 1, 2013,
4.20and subject to federal approval, medical assistance covers clinical care consultation for
4.21a person up to age 21 who is diagnosed with a complex mental health condition or a
4.22mental health condition that co-occurs with other complex and chronic conditions, when
4.23described in the person's individual treatment plan and provided by a licensed mental
4.24health professional, as defined in Minnesota Rules, part 9505.0371, subpart 5, item A. For
4.25the purposes of this subdivision, "clinical care consultation" means communication from a
4.26treating mental health professional to other providers not under the clinical supervision of
4.27the treating mental health professional who are working with the same client to inform,
4.28inquire, and instruct regarding the client's symptoms, strategies for effective engagement,
4.29care and intervention needs, and treatment expectations across service settings; and to
4.30direct and coordinate clinical services components provided to the client and family.
4.31 Sec. 6. Minnesota Statutes 2012, section 256B.0943, subdivision 1, is amended to read:
4.32 Subdivision 1. Definitions. For purposes of this section, the following terms have
4.33the meanings given them.
5.1(a) "Assessment" includes the provision of commissioner-approved assessment
5.2tools and completion of a functional assessment under Minnesota Rules, part 9520.0902,
5.3subpart 21.
5.4(b) "Care coordination" means contact with other professionals, educators, and
5.5caregivers of the client in person or by telephone to facilitate continuity and consistency in
5.6support of the client and the treatment plan, screening to determine client suitability for
5.7treatment, and development and updating of the treatment plan.
5.8(a) (c) "Children's therapeutic services and supports" means the flexible package
5.9of mental health services for children who require varying therapeutic and rehabilitative
5.10levels of intervention. The services are time-limited interventions that are delivered using
5.11various treatment modalities and combinations of services designed to reach treatment
5.12outcomes identified in the individual treatment plan.
5.13(b) (d) "Clinical supervision" means the overall responsibility of the mental health
5.14professional for the control and direction of individualized treatment planning, service
5.15delivery, and treatment review for each client. A mental health professional who is an
5.16enrolled Minnesota health care program provider accepts full professional responsibility
5.17for a supervisee's actions and decisions, instructs the supervisee in the supervisee's work,
5.18and oversees or directs the supervisee's work.
5.19(c) (e) "County board" means the county board of commissioners or board
5.20established under sections402.01 to
402.10 or
471.59 .
5.21(d) (f) "Crisis assistance" has the meaning given in section
245.4871, subdivision 9a .
5.22(e) (g) "Culturally competent provider" means a provider who understands and
5.23can utilize to a client's benefit the client's culture when providing services to the client.
5.24A provider may be culturally competent because the provider is of the same cultural or
5.25ethnic group as the client or the provider has developed the knowledge and skills through
5.26training and experience to provide services to culturally diverse clients.
5.27(f) (h) "Day treatment program" for children means a site-based structured program
5.28consisting of group psychotherapy for more than three individuals and other intensive
5.29therapeutic services provided by a multidisciplinary team, under the clinical supervision
5.30of a mental health professional.
5.31(g) (i) "Diagnostic assessment" has the meaning given in section
245.4871,
5.32subdivision 11 .
5.33(h) (j) "Direct service time" means the time that a mental health professional, mental
5.34health practitioner, or mental health behavioral aide spends face-to-face with a client
5.35and the client's family. Direct service time includes time in which the provider obtains
5.36a client's history or provides service components of children's therapeutic services and
6.1supports. Direct service time does not include time doing work before and after providing
6.2direct services, including scheduling, maintaining clinical records, consulting with others
6.3about the client's mental health status, preparing reports, receiving clinical supervision,
6.4and revising the client's individual treatment plan.
6.5(i) (k) "Direction of mental health behavioral aide" means the activities of a mental
6.6health professional or mental health practitioner in guiding the mental health behavioral
6.7aide in providing services to a client. The direction of a mental health behavioral aide
6.8must be based on the client's individualized treatment plan and meet the requirements in
6.9subdivision 6, paragraph (b), clause (5).
6.10(j) (l) "Emotional disturbance" has the meaning given in section
245.4871,
6.11subdivision 15 . For persons at least age 18 but under age 21, mental illness has the
6.12meaning given in section245.462, subdivision 20 , paragraph (a).
6.13(k) (m) "Individual behavioral plan" means a plan of intervention, treatment, and
6.14services for a child written by a mental health professional or mental health practitioner,
6.15under the clinical supervision of a mental health professional, to guide the work of the
6.16mental health behavioral aide.
6.17(l) (n) "Individual treatment plan" has the meaning given in section
245.4871,
6.18subdivision 21 .
6.19(m) (o) "Mental health behavioral aide services" means medically necessary
6.20one-on-one activities performed by a trained paraprofessional to assist a child retain
6.21or generalize psychosocial skills as taught by a mental health professional or mental
6.22health practitioner and as described in the child's individual treatment plan and individual
6.23behavior plan. Activities involve working directly with the child or child's family as
6.24provided in subdivision 9, paragraph (b), clause (4).
6.25(n) (p) "Mental health professional" means an individual as defined in section
6.26245.4871, subdivision 27
, clauses (1) to (6), or tribal vendor as defined in section
256B.02,
6.27subdivision 7 , paragraph (b).
6.28(o) (q) "Preschool program" means a day program licensed under Minnesota Rules,
6.29parts 9503.0005 to 9503.0175, and enrolled as a children's therapeutic services and
6.30supports provider to provide a structured treatment program to a child who is at least 33
6.31months old but who has not yet attended the first day of kindergarten.
6.32(p) (r) "Skills training" means individual, family, or group training, delivered
6.33by or under the direction of a mental health professional, designed to facilitate the
6.34acquisition of psychosocial skills that are medically necessary to rehabilitate the child
6.35to an age-appropriate developmental trajectory heretofore disrupted by a psychiatric
6.36illness or to self-monitor, compensate for, cope with, counteract, or replace skills deficits
7.1or maladaptive skills acquired over the course of a psychiatric illness. Skills training
7.2is subject 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 Sec. 7. Minnesota Statutes 2012, section 256B.0943, subdivision 2, is amended to read:
7.24 Subd. 2. Covered service components of children's therapeutic services and
7.25supports. (a) Subject to federal approval, medical assistance covers medically necessary
7.26children's therapeutic services and supports as defined in this section that an eligible
7.27provider entity certified under subdivision 4 provides to a client eligible under subdivision
7.283.
7.29(b) The service components of children's therapeutic services and supports are:
7.30(1) individual, family, and group psychotherapy;
7.31(2) individual, family, or group skills training provided by a mental health
7.32professional or mental health practitioner;
7.33(3) crisis assistance;
7.34(4) mental health behavioral aide services;and
7.35(5) direction of a mental health behavioral aide.;
8.1(6) care coordination provided by a mental health professional or mental health
8.2practitioner;
8.3(7) assessment provided by a mental health professional or mental health practitioner;
8.4(8) clinical care consultation provided by a mental health professional under section
8.5256B.0625, subdivision 62; and
8.6(9) family psychoeducation under section 256B.0625, subdivision 61.
8.7(c) Service components in paragraph (b) may be combined to constitute therapeutic
8.8programs, including day treatment programs and therapeutic preschool programs.
8.9 Sec. 8. PILOT PROVIDER INPUT SURVEY.
8.10(a) To assess the efficiency and other operational issues in the management of the
8.11health care delivery system, the commissioner of human services shall initiate a provider
8.12survey. The pilot survey shall consist of an electronic survey of providers of pediatric
8.13services and children's mental health services to identify and measure issues that arise in
8.14dealing with the management of medical assistance. To the maximum degree possible,
8.15existing technology shall be used and interns sought to analyze the results.
8.16(b) The survey questions must focus on seven key business functions provided
8.17by medical assistance contractors: provider inquiries; provider outreach and education;
8.18claims processing; appeals; provider enrollment; medical review; and provider audit and
8.19reimbursement. The commissioner must consider the results of the survey in evaluating
8.20and renewing managed care and fee-for-service management contracts.
8.21(c) The commissioner shall report by January 15, 2014, the results of the survey to
8.22the chairs of the health and human services policy and finance committees and shall
8.23make recommendations on the value of implementing an annual survey with a rotating
8.24list of provider groups as a component of the continuous quality improvement system for
8.25medical assistance.
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 support 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 support specialist program providers. The commissioner shall
2.21develop a process to certify family peer support specialist programs, in accordance with
2.22the federal guidelines, in order for the program to bill for reimbursable services. Family
2.23peer support programs must operate within an existing mental health community provider
2.24or center.
2.25 Subd. 5. Certified family peer specialist training and certification. The
2.26commissioner shall develop a training and certification process for certified family peer
2.27specialists who must be at least 21 years of age and have a high school diploma or its
2.28equivalent. The candidates must have raised or are currently raising a child with a mental
2.29illness, have had experience navigating the children's mental health system, and must
2.30demonstrate leadership and advocacy skills and a strong dedication to family-driven and
2.31family-focused services. The training curriculum must teach participating family peer
2.32specialists specific skills relevant to providing peer support to other parents. In addition
2.33to initial training and certification, the commissioner shall develop ongoing continuing
2.34educational workshops on pertinent issues related to family peer support counseling.
2.35 Sec. 3. Minnesota Statutes 2012, section 256B.0625, subdivision 56, is amended to read:
3.1 Subd. 56. Medical service coordination. (a)(1) Medical assistance covers in-reach
3.2community-based service coordination that is performed through a hospital emergency
3.3department as an eligible procedure under a state healthcare program for a frequent user.
3.4A frequent user is defined as an individual who has frequented the hospital emergency
3.5department for services three or more times in the previous four consecutive months.
3.6In-reach community-based service coordination includes navigating services to address a
3.7client's mental health, chemical health, social, economic, and housing needs, or any other
3.8activity targeted at reducing the incidence of emergency room and other nonmedically
3.9necessary health care utilization.
3.10(2) Medical assistance covers in-reach community-based service coordination that
3.11is performed through a hospital emergency department or inpatient psychiatric unit,
3.12residential treatment center, community mental health center, children's therapeutic
3.13services and supports provider, or juvenile justice facility as an eligible service for a child
3.14or young adult up to age 26 with a serious emotional disturbance.
3.15 (b) Reimbursement must be made in 15-minute increments and allowed for up to 60
3.16days posthospital discharge based upon the specific identified emergency department visit
3.17or inpatient admitting event. In-reach community-based service coordination shall seek to
3.18connect frequent users with existing covered services available to them, including, but not
3.19limited to, targeted case management, waiver case management, or care coordination in a
3.20health care home. For children and young adults with a serious emotional disturbance,
3.21in-reach community-based service coordination shall seek to connect them with existing
3.22covered services, including targeted case management, waiver case management, care
3.23coordination in a health care home, children's therapeutic services and supports, crisis
3.24services, and respite care. Eligible in-reach service coordinators must hold a minimum
3.25of a bachelor's degree in social work, public health, corrections, or a related field. The
3.26commissioner shall submit any necessary application for waivers to the Centers for
3.27Medicare and Medicaid Services to implement this subdivision.
3.28 (c) For the purposes of this subdivision, "in-reach community-based service
3.29coordination" means the practice of a community-based worker with training, knowledge,
3.30skills, and ability to access a continuum of services, including housing, transportation,
3.31chemical and mental health treatment, employment, education, and peer support services,
3.32by working with an organization's staff to transition an individual back into the individual's
3.33living environment. In-reach community-based service coordination includes working
3.34with the individual during their discharge and for up to a defined amount of time in the
3.35individual's living environment, reducing the individual's need for readmittance.
4.1 Sec. 4. Minnesota Statutes 2012, section 256B.0625, is amended by adding a
4.2subdivision to read:
4.3 Subd. 61. Family psychoeducation services. Effective July 1, 2013, and subject to
4.4federal approval, medical assistance covers family psychoeducation services provided
4.5to or on behalf of a child up to age 21 with a diagnosed mental health condition when
4.6identified in the child's individual treatment plan and provided by a licensed mental health
4.7professional, as defined in Minnesota Rules, part 9505.0371, subpart 5, item A, or a
4.8clinical trainee, as defined in Minnesota Rules, part 9505.0371, subpart 5, item C, who
4.9has determined it medically necessary to involve family members in the child's care. For
4.10the purposes of this subdivision, "family psychoeducation services" means information
4.11or demonstration provided to an individual or family as part of an individual, family,
4.12multifamily group, or peer group session to explain, educate, and support the child and
4.13family in understanding a child's symptoms of mental illness, the impact on the child's
4.14development, and needed components of treatment and skill development so that the
4.15individual, family, or group can help the child to prevent relapse, prevent the acquisition
4.16of comorbid disorders, and to achieve optimal mental health and long-term resilience.
4.17 Sec. 5. Minnesota Statutes 2012, section 256B.0625, is amended by adding a
4.18subdivision to read:
4.19 Subd. 62. Mental health clinical care consultation. Effective July 1, 2013,
4.20and subject to federal approval, medical assistance covers clinical care consultation for
4.21a person up to age 21 who is diagnosed with a complex mental health condition or a
4.22mental health condition that co-occurs with other complex and chronic conditions, when
4.23described in the person's individual treatment plan and provided by a licensed mental
4.24health professional, as defined in Minnesota Rules, part 9505.0371, subpart 5, item A. For
4.25the purposes of this subdivision, "clinical care consultation" means communication from a
4.26treating mental health professional to other providers not under the clinical supervision of
4.27the treating mental health professional who are working with the same client to inform,
4.28inquire, and instruct regarding the client's symptoms, strategies for effective engagement,
4.29care and intervention needs, and treatment expectations across service settings; and to
4.30direct and coordinate clinical services components provided to the client and family.
4.31 Sec. 6. Minnesota Statutes 2012, section 256B.0943, subdivision 1, is amended to read:
4.32 Subdivision 1. Definitions. For purposes of this section, the following terms have
4.33the meanings given them.
5.1(a) "Assessment" includes the provision of commissioner-approved assessment
5.2tools and completion of a functional assessment under Minnesota Rules, part 9520.0902,
5.3subpart 21.
5.4(b) "Care coordination" means contact with other professionals, educators, and
5.5caregivers of the client in person or by telephone to facilitate continuity and consistency in
5.6support of the client and the treatment plan, screening to determine client suitability for
5.7treatment, and development and updating of the treatment plan.
5.8
5.9of mental health services for children who require varying therapeutic and rehabilitative
5.10levels of intervention. The services are time-limited interventions that are delivered using
5.11various treatment modalities and combinations of services designed to reach treatment
5.12outcomes identified in the individual treatment plan.
5.13
5.14professional for the control and direction of individualized treatment planning, service
5.15delivery, and treatment review for each client. A mental health professional who is an
5.16enrolled Minnesota health care program provider accepts full professional responsibility
5.17for a supervisee's actions and decisions, instructs the supervisee in the supervisee's work,
5.18and oversees or directs the supervisee's work.
5.19
5.20established under sections
5.21
5.22
5.23can utilize to a client's benefit the client's culture when providing services to the client.
5.24A provider may be culturally competent because the provider is of the same cultural or
5.25ethnic group as the client or the provider has developed the knowledge and skills through
5.26training and experience to provide services to culturally diverse clients.
5.27
5.28consisting of group psychotherapy for more than three individuals and other intensive
5.29therapeutic services provided by a multidisciplinary team, under the clinical supervision
5.30of a mental health professional.
5.31
5.32subdivision 11
5.33
5.34health practitioner, or mental health behavioral aide spends face-to-face with a client
5.35and the client's family. Direct service time includes time in which the provider obtains
5.36a client's history or provides service components of children's therapeutic services and
6.1supports. Direct service time does not include time doing work before and after providing
6.2direct services, including scheduling, maintaining clinical records, consulting with others
6.3about the client's mental health status, preparing reports, receiving clinical supervision,
6.4and revising the client's individual treatment plan.
6.5
6.6health professional or mental health practitioner in guiding the mental health behavioral
6.7aide in providing services to a client. The direction of a mental health behavioral aide
6.8must be based on the client's individualized treatment plan and meet the requirements in
6.9subdivision 6, paragraph (b), clause (5).
6.10
6.11subdivision 15
6.12meaning given in section
6.13
6.14services for a child written by a mental health professional or mental health practitioner,
6.15under the clinical supervision of a mental health professional, to guide the work of the
6.16mental health behavioral aide.
6.17
6.18subdivision 21
6.19
6.20one-on-one activities performed by a trained paraprofessional to assist a child retain
6.21or generalize psychosocial skills as taught by a mental health professional or mental
6.22health practitioner and as described in the child's individual treatment plan and individual
6.23behavior plan. Activities involve working directly with the child or child's family as
6.24provided in subdivision 9, paragraph (b), clause (4).
6.25
6.27subdivision 7
6.28
6.29parts 9503.0005 to 9503.0175, and enrolled as a children's therapeutic services and
6.30supports provider to provide a structured treatment program to a child who is at least 33
6.31months old but who has not yet attended the first day of kindergarten.
6.32
6.33by or under the direction of a mental health professional, designed to facilitate the
6.34acquisition of psychosocial skills that are medically necessary to rehabilitate the child
6.35to an age-appropriate developmental trajectory heretofore disrupted by a psychiatric
6.36illness or to self-monitor, compensate for, cope with, counteract, or replace skills deficits
7.1or maladaptive skills acquired over the course of a psychiatric illness. Skills training
7.2is subject 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 Sec. 7. Minnesota Statutes 2012, section 256B.0943, subdivision 2, is amended to read:
7.24 Subd. 2. Covered service components of children's therapeutic services and
7.25supports. (a) Subject to federal approval, medical assistance covers medically necessary
7.26children's therapeutic services and supports as defined in this section that an eligible
7.27provider entity certified under subdivision 4 provides to a client eligible under subdivision
7.283.
7.29(b) The service components of children's therapeutic services and supports are:
7.30(1) individual, family, and group psychotherapy;
7.31(2) individual, family, or group skills training provided by a mental health
7.32professional or mental health practitioner;
7.33(3) crisis assistance;
7.34(4) mental health behavioral aide services;
7.35(5) direction of a mental health behavioral aide
8.1(6) care coordination provided by a mental health professional or mental health
8.2practitioner;
8.3(7) assessment provided by a mental health professional or mental health practitioner;
8.4(8) clinical care consultation provided by a mental health professional under section
8.5256B.0625, subdivision 62; and
8.6(9) family psychoeducation under section 256B.0625, subdivision 61.
8.7(c) Service components in paragraph (b) may be combined to constitute therapeutic
8.8programs, including day treatment programs and therapeutic preschool programs.
8.9 Sec. 8. PILOT PROVIDER INPUT SURVEY.
8.10(a) To assess the efficiency and other operational issues in the management of the
8.11health care delivery system, the commissioner of human services shall initiate a provider
8.12survey. The pilot survey shall consist of an electronic survey of providers of pediatric
8.13services and children's mental health services to identify and measure issues that arise in
8.14dealing with the management of medical assistance. To the maximum degree possible,
8.15existing technology shall be used and interns sought to analyze the results.
8.16(b) The survey questions must focus on seven key business functions provided
8.17by medical assistance contractors: provider inquiries; provider outreach and education;
8.18claims processing; appeals; provider enrollment; medical review; and provider audit and
8.19reimbursement. The commissioner must consider the results of the survey in evaluating
8.20and renewing managed care and fee-for-service management contracts.
8.21(c) The commissioner shall report by January 15, 2014, the results of the survey to
8.22the chairs of the health and human services policy and finance committees and shall
8.23make recommendations on the value of implementing an annual survey with a rotating
8.24list of provider groups as a component of the continuous quality improvement system for
8.25medical assistance.
