1.1                          A bill for an act 
  1.2             relating to mental health; establishing duties for 
  1.3             reducing and preventing suicides; establishing 
  1.4             requirements for discharge plans and transition 
  1.5             services for offenders with mental illness; providing 
  1.6             coverage requirements for health plans; providing for 
  1.7             a calculation to regional treatment centers based on 
  1.8             population size; adjusting payment rates for certain 
  1.9             mental health providers; establishing coverage 
  1.10            requirements for mental health services and treatment; 
  1.11            adding certain services covered under case management, 
  1.12            community support, and day treatment services; 
  1.13            requiring studies; defining certain mental health 
  1.14            provisions; establishing team case management services 
  1.15            and continuing care benefit program; covering certain 
  1.16            transportation costs; adding provisions to the prepaid 
  1.17            health plan; requiring development of a payment 
  1.18            system; appropriating money; amending Minnesota 
  1.19            Statutes 2000, sections 245.462, subdivisions 3, 6, 8, 
  1.20            18, 20, and by adding subdivisions; 245.466, 
  1.21            subdivision 2; 245.470, by adding a subdivision; 
  1.22            245.4711, by adding a subdivision; 245.4871, 
  1.23            subdivisions 10, 17, 27, 29, and by adding 
  1.24            subdivisions; 245.4875, subdivision 2; 245.4876, 
  1.25            subdivision 1, and by adding subdivisions; 245.488, by 
  1.26            adding a subdivision; 245.4885, subdivision 1; 246.54; 
  1.27            256.969, subdivision 3a, and by adding a subdivision; 
  1.28            256B.0625, subdivision 17, and by adding subdivisions; 
  1.29            256B.69, by adding subdivisions; 260C.201, subdivision 
  1.30            1; proposing coding for new law in Minnesota Statutes, 
  1.31            chapters 62Q; 145; 244; 245; 246; 256B; and 299A. 
  1.32  BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF MINNESOTA: 
  1.33                             ARTICLE 1 
  1.34                         SUICIDE PREVENTION 
  1.35     Section 1.  [145.56] [SUICIDE PREVENTION.] 
  1.36     Subdivision 1.  [PUBLIC HEALTH GOAL; SUICIDE PREVENTION 
  1.37  PLAN.] The commissioner of health shall make suicide prevention 
  1.38  an important public health goal of the state and shall conduct 
  2.1   suicide prevention activities to accomplish that goal using an 
  2.2   evidence-based, public health approach focused on prevention.  
  2.3   The commissioner shall refine, coordinate, and implement the 
  2.4   state's suicide prevention plan, in collaboration with assigned 
  2.5   staff from the department of human services; the department of 
  2.6   public safety; the department of children, families, and 
  2.7   learning; and appropriate agencies, organizations, and 
  2.8   institutions in the community. 
  2.9      Subd. 2.  [EDUCATION AND OUTREACH TO PUBLIC, MEDIA, AND 
  2.10  POLICYMAKERS.] (a) The commissioner of health shall create or 
  2.11  contract for an ongoing public education campaign to raise 
  2.12  awareness of suicide as a public health issue and of the 
  2.13  preventability of many suicides.  The campaign must:  (1) be 
  2.14  coordinated with other existing suicide prevention outreach and 
  2.15  awareness campaigns; (2) promote broad-based public awareness in 
  2.16  the general population; (3) establish the connection between 
  2.17  depression and other psychiatric illnesses, and suicide; and (4) 
  2.18  include tactics targeted to populations at risk for suicide, and 
  2.19  to individuals who influence members of at-risk populations and 
  2.20  are in positions to identify the warning signs of suicide and 
  2.21  make appropriate referrals.  Through the grant-making process, 
  2.22  the commissioner shall promote the use of a common language, 
  2.23  uniform terminology, and consistent messages regarding suicide, 
  2.24  symptoms of depression and other psychiatric illnesses, 
  2.25  substance abuse, warning signs of suicide, risk factors, and 
  2.26  help-seeking behaviors. 
  2.27     (b) The commissioner shall establish partnerships with 
  2.28  media vendors in the state to: 
  2.29     (1) implement an ongoing, coordinated, multistrategy, 
  2.30  multimedia, and multipartner public awareness and antistigma 
  2.31  campaign that is consistent with the policy goals of this 
  2.32  section; and 
  2.33     (2) educate media vendors, media associations, reporters, 
  2.34  advertising vendors, and members of the entertainment industry 
  2.35  about suicide, suicidal behavior, mental illness, substance 
  2.36  abuse, and help-seeking behaviors. 
  3.1      (c) The commissioner shall disseminate education materials 
  3.2   to educate appropriate state and local officials and 
  3.3   policymakers about suicide, suicidal behavior, depression and 
  3.4   other psychiatric illnesses, and substance abuse, and their 
  3.5   impact on state and local health care, social services, 
  3.6   education, law enforcement, employment, and corrections systems. 
  3.7      Subd. 3.  [COMMUNITY-BASED PROGRAMS.] (a) The commissioner 
  3.8   shall establish a grant program consistent with the policy goals 
  3.9   of this section to fund: 
  3.10     (1) community-based programs to provide education, 
  3.11  outreach, and advocacy services to populations who may be at 
  3.12  risk for suicide; and 
  3.13     (2) community-based programs that educate natural community 
  3.14  helpers and gatekeepers, such as family members, spiritual 
  3.15  leaders, coaches, and business people, on how to prevent suicide 
  3.16  by encouraging help-seeking behaviors. 
  3.17     (b) Education to populations at risk for suicide and to 
  3.18  community helpers and gatekeepers must include information on 
  3.19  the symptoms of depression and other psychiatric illnesses, the 
  3.20  warning signs of suicide, skills for preventing suicides, and 
  3.21  making or seeking effective referrals to intervention and 
  3.22  community resources. 
  3.23     Subd. 4.  [PROGRAMS IN SCHOOLS AND WORKPLACES.] (a) The 
  3.24  commissioner shall establish a grant program consistent with the 
  3.25  policy goals of this section to fund community-based programs to 
  3.26  provide suicide prevention education in schools using a 
  3.27  three-pronged approach of education to students, school staff, 
  3.28  and parents at the junior and senior high school levels. 
  3.29     (b) The commissioner shall promote the use of employee 
  3.30  assistance and workplace programs to support employees with 
  3.31  depression and other psychiatric illnesses and substance abuse 
  3.32  problems, and refer them to other services available in the 
  3.33  community.  In promoting these programs, the commissioner shall 
  3.34  collaborate with employer and professional associations, unions, 
  3.35  and safety councils.  Community-based programs that provide 
  3.36  these services may apply for funding under subdivision 3. 
  4.1      Subd. 5.  [PROFESSIONAL EDUCATION.] The commissioner shall 
  4.2   establish a grant program consistent with the policy goals of 
  4.3   this section to fund academic and other institutions, 
  4.4   associations, licensing boards, and organizations to provide 
  4.5   professional education on suicide prevention as part of 
  4.6   preservice or continuing education.  Curricula may include 
  4.7   information on suicide and suicidal behavior; screening, 
  4.8   prevention, and intervention; and screening, referral, and 
  4.9   treatment for depression and other psychiatric illnesses. 
  4.10  Professionals to whom this education may be targeted include 
  4.11  teachers, administrators, and other school staff; health care 
  4.12  providers; mental health providers, including but not limited to 
  4.13  psychologists and social workers; corrections personnel; law 
  4.14  enforcement personnel; social services providers; and members of 
  4.15  faith-based professions. 
  4.16     Subd. 6.  [COLLECTING AND REPORTING SUICIDE DATA.] The 
  4.17  commissioner shall coordinate with federal, regional, local, and 
  4.18  other state agencies to collect, analyze, and annually issue a 
  4.19  public report on Minnesota-specific data on suicide and suicidal 
  4.20  behaviors.  The data collected and reported must include 
  4.21  demographic-specific data, data on the insurance status of 
  4.22  persons who commit or attempt suicide, data on 
  4.23  posthospitalization outcomes for persons who attempt suicide, 
  4.24  and data on associated costs of suicide and suicidal behaviors 
  4.25  to various systems, including but not limited to the health 
  4.26  care, social services, and law enforcement systems.  The data 
  4.27  must be summary data as defined in section 13.02 and must not 
  4.28  identify individuals. 
  4.29     Subd. 7.  [RESEARCH AGENDA.] The commissioner shall make 
  4.30  grants and assist entities in seeking nonstate funding sources 
  4.31  to fund research that is consistent with the research agenda 
  4.32  established in the Minnesota department of health's January 15, 
  4.33  2000, suicide prevention plan, and that furthers understanding 
  4.34  of the risks and protective factors related to suicide and 
  4.35  suicidal behaviors, effective prevention programs, clinical 
  4.36  treatments, and culturally specific interventions in Minnesota. 
  5.1      Subd. 8.  [POLICIES OF INSTITUTIONAL SETTINGS.] The 
  5.2   commissioner shall periodically survey and evaluate the suicide 
  5.3   prevention and intervention policies and practices of 
  5.4   institutional settings licensed by the state, including foster 
  5.5   care and jails, and recommend modifications to the policies and 
  5.6   practices as appropriate. 
  5.7      Subd. 9.  [SUICIDE REPORTING PRACTICES.] The commissioner 
  5.8   shall study current practices of determining and reporting 
  5.9   suicides and shall make recommendations to professionals and 
  5.10  organizations that report suicides to ensure that suicides are 
  5.11  accurately reported. 
  5.12     Subd. 10.  [PERIODIC EVALUATIONS; BIENNIAL REPORTS.] The 
  5.13  commissioner shall conduct periodic evaluations of the impact of 
  5.14  and outcomes from implementation of the state's suicide 
  5.15  prevention plan and each of the activities specified in this 
  5.16  section.  By July 1, 2002, and July 1 of each even-numbered year 
  5.17  thereafter, the commissioner shall report the results of these 
  5.18  evaluations to the chairs of the policy and finance committees 
  5.19  in the house and senate with jurisdiction over health and human 
  5.20  services issues. 
  5.21     Sec. 2.  [299A.76] [SUICIDE STATISTICS.] 
  5.22     (a) The commissioner of public safety shall not: 
  5.23     (1) include any statistics on committing suicide or 
  5.24  attempting suicide in any compilation of crime statistics 
  5.25  published by the commissioner; or 
  5.26     (2) label as a crime statistic, any data on committing 
  5.27  suicide or attempting suicide. 
  5.28     (b) This section does not apply to the crimes of aiding 
  5.29  suicide under section 609.215, subdivision 1, or aiding 
  5.30  attempted suicide under section 609.215, subdivision 2, or to 
  5.31  statistics directly related to the commission of a crime. 
  5.32     Sec. 3.  [STUDY; CRISIS RESPONSE SYSTEM.] 
  5.33     The commissioner of health shall study the existing suicide 
  5.34  crisis response system in Minnesota to identify gaps in basic 
  5.35  suicide crisis intervention, safety net, and follow-up services; 
  5.36  identify barriers to obtaining these services; determine costs 
  6.1   for providing these services; and provide recommendations for 
  6.2   addressing identified gaps in and barriers to services.  This 
  6.3   study shall be reported to the chairs of the policy and finance 
  6.4   committees in the house and senate with jurisdiction over health 
  6.5   and human services issues by May 1, 2002. 
  6.6      Sec. 4.  [APPROPRIATIONS.] 
  6.7      (a) $12,450,000 is appropriated for the 2002-2003 biennium 
  6.8   from the general fund to the commissioner of health for suicide 
  6.9   prevention activities.  Of this amount: 
  6.10     (1) $300,000 is for refining, coordinating, and 
  6.11  implementing the suicide prevention plan under Minnesota 
  6.12  Statutes, section 145.56, subdivision 1; 
  6.13     (2) $3,000,000 is for the education and outreach activities 
  6.14  under Minnesota Statutes, section 145.56, subdivision 2; 
  6.15     (3) $6,000,000 is to fund community-based programs under 
  6.16  Minnesota Statutes, section 145.56, subdivision 3; 
  6.17     (4) $1,000,000 is for the programs in schools and 
  6.18  workplaces under Minnesota Statutes, section 145.56, subdivision 
  6.19  4; 
  6.20     (5) $1,000,000 is for the professional education activities 
  6.21  under Minnesota Statutes, section 145.56, subdivision 5; 
  6.22     (6) $500,000 is to collect and report on suicide data under 
  6.23  Minnesota Statutes, section 145.56, subdivision 6; 
  6.24     (7) $500,000 is to promote and fund research under 
  6.25  Minnesota Statutes, section 145.56, subdivision 7; 
  6.26     (8) $100,000 is to survey and evaluate suicide prevention 
  6.27  and intervention policies in institutions under Minnesota 
  6.28  Statutes, section 145.56, subdivision 8; and 
  6.29     (9) $50,000 is to conduct the study of suicide reporting 
  6.30  practices under Minnesota Statutes, section 145.56, subdivision 
  6.31  9. 
  6.32     (b) $70,000 is appropriated for the fiscal year ending June 
  6.33  30, 2002, from the general fund to the commissioner of health to 
  6.34  conduct the study in section 3 on the existing crisis response 
  6.35  system.  This appropriation is one-time funding and shall not 
  6.36  become part of the base level funding for the 2004-2005 biennium.
  7.1                              ARTICLE 2 
  7.2                             CORRECTIONS 
  7.3      Section 1.  [244.054] [DISCHARGE PLANS; OFFENDERS WITH 
  7.4   SERIOUS AND PERSISTENT MENTAL ILLNESS.] 
  7.5      Subdivision 1.  [OFFER TO DEVELOP PLAN.] The commissioner 
  7.6   shall offer to develop a discharge plan for community-based 
  7.7   services for every offender with serious and persistent mental 
  7.8   illness, as defined in section 245.462, subdivision 20, 
  7.9   paragraph (c), who is being released from a correctional 
  7.10  facility.  If an offender is being released pursuant to section 
  7.11  244.05, the offender may choose to have the discharge plan made 
  7.12  one of the conditions of the offender's supervised release and 
  7.13  shall follow the conditions to the extent that services are 
  7.14  available and offered to the offender. 
  7.15     Subd. 2.  [CONTENT OF PLAN.] If an offender chooses to have 
  7.16  a discharge plan developed, the commissioner shall develop and 
  7.17  implement a discharge plan, which must include at least the 
  7.18  following: 
  7.19     (1) at least 90 days before the offender is due to be 
  7.20  discharged, the commissioner shall designate a department of 
  7.21  corrections agent with mental health training to serve as the 
  7.22  primary person responsible for carrying out discharge planning 
  7.23  activities; 
  7.24     (2) at least 75 days before the offender is due to be 
  7.25  discharged, the offender's designated agent shall: 
  7.26     (i) obtain informed consent and releases of information 
  7.27  from the offender that are needed for transition services; 
  7.28     (ii) contact the county human services department in the 
  7.29  community where the offender expects to reside following 
  7.30  discharge, and inform the department of the offender's impending 
  7.31  discharge and the planned date of the offender's return to the 
  7.32  community; determine whether the county or a designated 
  7.33  contracted provider will provide case management services to the 
  7.34  offender; refer the offender to the case management services 
  7.35  provider; and confirm that the case management services provider 
  7.36  will have opened the offender's case prior to the offender's 
  8.1   discharge; and 
  8.2      (iii) refer the offender to appropriate staff in the county 
  8.3   human services department in the community where the offender 
  8.4   expects to reside following discharge, for enrollment of the 
  8.5   offender, if eligible, in medical assistance or general 
  8.6   assistance medical care, using special procedures established by 
  8.7   process and department of human services bulletin; 
  8.8      (3) at least 2-1/2 months before discharge, the offender's 
  8.9   designated agent shall secure timely appointments for the 
  8.10  offender with a psychiatrist no later than 30 days following 
  8.11  discharge, and with other program staff at a community mental 
  8.12  health provider that is able to serve former offenders with 
  8.13  serious and persistent mental illness; 
  8.14     (4) at least 30 days before discharge, the offender's 
  8.15  designated agent shall convene a predischarge assessment and 
  8.16  planning meeting of key staff from the programs in which the 
  8.17  offender has participated while in the correctional facility, 
  8.18  the offender, and the supervising agent assigned to the 
  8.19  offender.  At the meeting, attendees shall provide background 
  8.20  information and continuing care recommendations for the 
  8.21  offender, including information on the offender's risk for 
  8.22  relapse; current medications, including dosage and frequency; 
  8.23  therapy and behavioral goals; diagnostic and assessment 
  8.24  information, including results of a chemical dependency 
  8.25  evaluation; confirmation of appointments with a psychiatrist and 
  8.26  other program staff in the community; a relapse prevention plan; 
  8.27  continuing care needs; needs for housing, employment, and 
  8.28  finance support and assistance; and recommendations for 
  8.29  successful community integration, including chemical dependency 
  8.30  treatment or support if chemical dependency is a risk factor.  
  8.31  Immediately following this meeting, the offender's designated 
  8.32  agent shall summarize this background information and continuing 
  8.33  care recommendations in a written report; 
  8.34     (5) immediately following the predischarge assessment and 
  8.35  planning meeting, the provider of mental health case management 
  8.36  services who will serve the offender following discharge shall 
  9.1   offer to make arrangements and referrals for housing, financial 
  9.2   support, benefits assistance, employment counseling, and other 
  9.3   services required in sections 245.461 to 245.486; 
  9.4      (6) at least ten days before the offender's first scheduled 
  9.5   postdischarge appointment with a mental health provider, the 
  9.6   offender's designated agent shall transfer the following records 
  9.7   to the offender's case management services provider and 
  9.8   psychiatrist:  the predischarge assessment and planning report, 
  9.9   medical records, and pharmacy records.  These records may be 
  9.10  transferred only if the offender provides informed consent for 
  9.11  their release; 
  9.12     (7) upon discharge, the offender's designated agent shall 
  9.13  ensure that the offender leaves the correctional facility with 
  9.14  at least a ten-day supply of all necessary medications; and 
  9.15     (8) upon discharge, the prescribing authority at the 
  9.16  offender's correctional facility shall telephone in 
  9.17  prescriptions for all necessary medications to a pharmacy in the 
  9.18  community where the offender plans to reside.  The prescriptions 
  9.19  must provide at least a 30-day supply of all necessary 
  9.20  medications, and must be able to be refilled once for one 
  9.21  additional 30-day supply. 
  9.22     Sec. 2.  [TRANSITIONAL SERVICES FOR MENTALLY ILL OFFENDERS 
  9.23  RELEASED FROM PRISON; PILOT PROGRAM.] 
  9.24     Subdivision 1.  [PROGRAM ESTABLISHED.] The commissioner of 
  9.25  corrections, in collaboration with the commissioner of human 
  9.26  services, shall establish a pilot project grant program with 
  9.27  goals and evaluation criteria and make grants to provide startup 
  9.28  funding for two counties or two groups of counties to provide 
  9.29  transitional housing and other community support services for 
  9.30  former state inmates who have been diagnosed with a serious 
  9.31  mental illness and who have been discharged from prison.  Grant 
  9.32  applicants must submit a proposed comprehensive plan for 
  9.33  providing the housing and support services and evaluating the 
  9.34  provision of services, and must provide a 25 percent funding 
  9.35  match.  The commissioner shall make grants available to 
  9.36  successful applicants by February 1, 2002.  Grant recipients are 
 10.1   eligible for funding under this section for the first three 
 10.2   years of operation of their programs for housing and support 
 10.3   services.  
 10.4      Subd. 2.  [REPORT.] By January 15, 2003, the commissioner 
 10.5   shall report to the chairs and ranking minority members of the 
 10.6   house and senate committees and divisions having jurisdiction 
 10.7   over criminal justice policy and funding on the effectiveness of 
 10.8   the grants made and pilot projects funded under this section. 
 10.9      Sec. 3.  [APPROPRIATIONS.] 
 10.10     (a) $....... each year is appropriated from the general 
 10.11  fund to the department of corrections, mental health division 
 10.12  for the fiscal biennium ending June 30, 2003.  Of this amount, 
 10.13  $....... each year is for hiring or contracting for additional 
 10.14  mental health services and treatment in the state correctional 
 10.15  facilities.  The services and treatment must meet current 
 10.16  community standards of care; and $....... each year is for 
 10.17  purchasing appropriate medications for offenders who have been 
 10.18  diagnosed with a serious and persistent mental illness.  This 
 10.19  appropriation is part of the department's base budget. 
 10.20     (b) $....... is appropriated from the general fund to the 
 10.21  department of corrections, mental health division for the fiscal 
 10.22  biennium ending June 30, 2003, to fund the development of 
 10.23  discharge plans under Minnesota Statutes, section 244.054, for 
 10.24  offenders with serious and persistent mental illness. 
 10.25     (c) $....... is appropriated from the general fund to the 
 10.26  department of corrections, mental health division for the fiscal 
 10.27  year ending June 30, 2002, for the grants described in section 
 10.28  2, subdivision 1 and the report described in section 2, 
 10.29  subdivision 2. 
 10.30     (d) $....... is appropriated from the general fund to the 
 10.31  commissioner of human services for the fiscal biennium ending 
 10.32  June 30, 2003, to increase funding to county boards under 
 10.33  Minnesota Rules, parts 9535.1700 to 9535.1760.  Funds are 
 10.34  available under this paragraph only to county boards that submit 
 10.35  plans to the commissioner specifying how the funds will be 
 10.36  used.  County boards shall use the additional funds for 
 11.1   participation by county staff, contract providers, and mental 
 11.2   health professionals in the development of discharge plans under 
 11.3   Minnesota Statutes, section 244.054, for offenders with serious 
 11.4   and persistent mental illness. 
 11.5                              ARTICLE 3 
 11.6                         REIMBURSEMENT RATES 
 11.7      Section 1.  [245.4862] [RATE ADJUSTMENTS.] 
 11.8      On July 1, 2001, and July 1, 2002, the commissioner of 
 11.9   human services shall increase reimbursement rates for adult 
 11.10  residential program grants under Minnesota Rules, parts 
 11.11  9535.2000 to 9535.3000 and adult and family community support 
 11.12  grants under Minnesota Rules, parts 9535.1700 to 9535.1760, by 
 11.13  three percent each fiscal year. 
 11.14     Sec. 2.  Minnesota Statutes 2000, section 246.54, is 
 11.15  amended to read: 
 11.16     246.54 [LIABILITY OF COUNTY; REIMBURSEMENT.] 
 11.17     (a) Except for chemical dependency services provided under 
 11.18  sections 254B.01 to 254B.09, the client's county shall pay to 
 11.19  the state of Minnesota a portion of the cost of care provided in 
 11.20  a regional treatment center to a client legally settled in that 
 11.21  county.  A county's payment shall be made from the county's own 
 11.22  sources of revenue ~~and~~, funds distributed to the county under 
 11.23  section 246.541, subdivision 2, or both.  Payments shall be paid 
 11.24  as follows:  
 11.25     (1) payments to the state from the county shall equal ten 
 11.26  percent of the cost of care, as determined by the commissioner, 
 11.27  for each day, or the portion thereof, that the client spends at 
 11.28  a regional treatment center.  If payments received by the state 
 11.29  under sections 246.50 to 246.53 exceed 90 percent of the cost of 
 11.30  care, the county shall be responsible for paying the state only 
 11.31  the remaining amount; and 
 11.32     (2) if funds are distributed to the county under section 
 11.33  246.541, subdivision 2, the county shall pay to the state up to 
 11.34  50 percent of the cost of care, as determined by the 
 11.35  commissioner, for each day or portion thereof that the client 
 11.36  spends at a regional treatment center.  The percentage of the 
 12.1   county's responsibility under this clause shall be limited by 
 12.2   the amount of funds distributed to the county under section 
 12.3   246.541, subdivision 2, for this purpose. 
 12.4      (b) The county shall not be entitled to reimbursement from 
 12.5   the client, the client's estate, or from the client's relatives, 
 12.6   except as provided in section 246.53.  No such payments shall be 
 12.7   made for any client who was last committed prior to July 1, 1947.
 12.8      Sec. 3.  [246.541] [APPROPRIATION TO COUNTIES FOR REGIONAL 
 12.9   TREATMENT CENTER CARE OR DIVERSION PROGRAMS.] 
 12.10     Subdivision 1.  [CALCULATING APPROPRIATION BASED ON 
 12.11  POPULATION SIZE.] (a) Beginning January 1, 2002, and each 
 12.12  January 1 thereafter, the commissioner shall: 
 12.13     (1) compare the state appropriated funds to regional 
 12.14  treatment centers through direct appropriations for the two most 
 12.15  recently completed fiscal years; 
 12.16     (2) determine what portion of the difference in the amounts 
 12.17  appropriated is attributable to a decrease in the populations 
 12.18  being served at regional treatment centers; and 
 12.19     (3) certify the amount that is attributable to a decrease 
 12.20  in the populations being served at regional treatment centers to 
 12.21  the commissioner of finance. 
 12.22     (b) Beginning July 1, 2002, when there is a decrease in 
 12.23  state funds appropriated to regional treatment centers due to a 
 12.24  decrease in population being served, the difference in the 
 12.25  amounts appropriated each year must be appropriated to the 
 12.26  commissioner for distribution to counties according to 
 12.27  subdivision 2. 
 12.28     Subd. 2.  [DISTRIBUTION TO COUNTIES.] The commissioner 
 12.29  shall develop a methodology for distributing funds appropriated 
 12.30  under subdivision 1 and other direct appropriations made by the 
 12.31  legislature for this purpose to each county based on a five-year 
 12.32  average of the county's spending, for the most recent five 
 12.33  fiscal years, for client cost of care under section 246.54, as a 
 12.34  proportion of the average of total spending by all counties for 
 12.35  client cost of care under section 246.54.  Based on that 
 12.36  methodology, the commissioner shall distribute the funds to 
 13.1   counties. 
 13.2      Subd. 3.  [COUNTY USES OF FUNDS.] Counties may use the 
 13.3   funds distributed under subdivision 2: 
 13.4      (1) for the county portion of the cost of care for clients 
 13.5   at regional treatment centers under section 246.54, paragraph 
 13.6   (a), clause (2); or 
 13.7      (2) to develop programs to divert clients with mental 
 13.8   illness from receiving regional treatment center inpatient 
 13.9   services to receiving services provided in less restrictive 
 13.10  community settings, when such diversion is appropriate to meet 
 13.11  client needs. 
 13.12     Sec. 4.  [256B.761] [REIMBURSEMENT FOR MENTAL HEALTH 
 13.13  SERVICES.] 
 13.14     Effective for services rendered on or after July 1, 2001, 
 13.15  payment for medication management provided to psychiatric 
 13.16  patients, outpatient mental health services, day treatment 
 13.17  services, home-based mental health services, and family 
 13.18  community support services shall be paid at the lower of (1) 
 13.19  submitted charges, or (2) the 50th percentile of 1999 charges. 
 13.20     Sec. 5.  [256B.762] [MENTAL HEALTH CLINIC REIMBURSEMENT.] 
 13.21     Subdivision 1.  [RATE INCREASE.] Effective for services 
 13.22  rendered on or after January 1, 2002, payment rates for:  (1) 
 13.23  community mental health center services under section 256B.0625, 
 13.24  subdivision 5; (2) services provided by mental health clinics 
 13.25  and centers certified under Minnesota Rules, parts 9520.0750 to 
 13.26  9520.0870, or hospital outpatient psychiatric departments, 
 13.27  designated as essential community providers under section 
 13.28  62Q.19; and (3) services provided by mental health clinics and 
 13.29  centers certified under Minnesota Rules, parts 9520.0750 to 
 13.30  9520.0870, or hospital outpatient psychiatric departments, that 
 13.31  receive at least 30 percent of their revenue from contracts with 
 13.32  a county or counties to provide services under the adult and 
 13.33  children's mental health acts, shall be increased by ten percent 
 13.34  over the rates in effect on July 1, 2001.  This reimbursement 
 13.35  increase shall be in addition to any other reimbursement 
 13.36  increases enacted by the 2001 legislature. 
 14.1      Subd. 2.  [SETTLE-UP.] Beginning July 1, 2001, the 
 14.2   commissioner shall implement a settle-up procedure to pay 
 14.3   community mental health centers and mental health clinics and 
 14.4   centers for services provided to prepaid medical assistance, 
 14.5   prepaid general assistance medical care, and MinnesotaCare 
 14.6   enrollees.  The settle-up procedure must pay community mental 
 14.7   health centers and mental health clinics and centers the 
 14.8   difference between the state health care program reimbursement 
 14.9   rate and the reimbursement received from the prepaid health 
 14.10  plan.  The settle-up procedure must be based on that used by the 
 14.11  commissioner to reimburse federally qualified health centers and 
 14.12  rural health clinics. 
 14.13     Sec. 6.  [STAGED RATE ADJUSTMENT.] 
 14.14     On July 1, 2001, and July 1, 2002, the commissioner of 
 14.15  human services shall increase reimbursement rates for adult 
 14.16  residential program grants under Minnesota Rules, parts 
 14.17  9535.2000 to 9535.3000 and adult and family community support 
 14.18  grants under Minnesota Rules, parts 9535.1700 to 9535.1760, by 
 14.19  three percent each fiscal year.  
 14.20     Sec. 7.  [APPROPRIATIONS.] 
 14.21     Subdivision 1.  [RATE ADJUSTMENT; CERTAIN MENTAL HEALTH 
 14.22  PROVIDERS.] $....... is appropriated from the general fund to 
 14.23  the commissioner of human services for the biennium ending June 
 14.24  30, 2003, to increase adult residential program grants and adult 
 14.25  and family community support grants as provided under Minnesota 
 14.26  Statutes, section 245.4862. 
 14.27     Subd. 2.  [REGIONAL TREATMENT CENTER COST OF CARE OR 
 14.28  DIVERSION PROGRAMS.] $5,000,000 is appropriated for the 
 14.29  2002-2003 biennium from the general fund to the commissioner of 
 14.30  human services for distribution to counties under Minnesota 
 14.31  Statutes, section 246.541, subdivision 2, to be used according 
 14.32  to Minnesota Statutes, section 246.541, subdivision 3. 
 14.33     Subd. 3.  [STAGED RATE ADJUSTMENT; CERTAIN MENTAL HEALTH 
 14.34  PROVIDERS.] $....... is appropriated from the general fund to 
 14.35  the commissioner of human services for the biennium ending June 
 14.36  30, 2003, to increase adult residential program grants and adult 
 15.1   and family community support grants as provided under section 6. 
 15.2                              ARTICLE 4 
 15.3                           COVERED SERVICES 
 15.4      Section 1.  Minnesota Statutes 2000, section 245.462, 
 15.5   subdivision 3, is amended to read: 
 15.6      Subd. 3.  [CASE MANAGEMENT SERVICES.] "Case management 
 15.7   services" means activities that are coordinated with the 
 15.8   community support services program as defined in subdivision 6 
 15.9   and are designed to help adults with serious and persistent 
 15.10  mental illness in gaining access to needed medical, social, 
 15.11  educational, vocational, and other necessary services as they 
 15.12  relate to the client's mental health needs.  Case management 
 15.13  services include developing a functional assessment, an 
 15.14  individual community support plan, referring and assisting the 
 15.15  person to obtain needed mental health and other services, 
 15.16  ensuring coordination of services, and monitoring the delivery 
 15.17  of services.  For adults between the ages of 18 and 22 who are 
 15.18  eligible for case management services under subdivision 20, 
 15.19  paragraph (c), clause (6), case management services also include 
 15.20  advocacy for and coordination of all transition services for 
 15.21  which the adult is eligible or which the adult is receiving, 
 15.22  including vocational, educational, housing, and life skills 
 15.23  transition services.  
 15.24     Sec. 2.  Minnesota Statutes 2000, section 245.462, 
 15.25  subdivision 6, is amended to read: 
 15.26     Subd. 6.  [COMMUNITY SUPPORT SERVICES PROGRAM.] "Community 
 15.27  support services program" means services, other than inpatient 
 15.28  or residential treatment services, provided or coordinated by an 
 15.29  identified program and staff under the clinical supervision of a 
 15.30  mental health professional designed to help adults with serious 
 15.31  and persistent mental illness to function and remain in the 
 15.32  community.  A community support services program includes: 
 15.33     (1) client outreach, 
 15.34     (2) medication monitoring, 
 15.35     (3) assistance in independent living skills, 
 15.36     (4) development of employability and work-related 
 16.1   opportunities, 
 16.2      (5) crisis assistance, 
 16.3      (6) psychosocial rehabilitation, 
 16.4      (7) help in applying for government benefits, ~~and~~ 
 16.5      (8) housing support services, 
 16.6      (9) education and consultation provided to families and 
 16.7   other individuals as an extension of the treatment process, and 
 16.8      (10) assistance to consumers in pursuing complaints and 
 16.9   appeals, and obtaining access to dispute resolution processes.  
 16.10     A community support services program may also administer a 
 16.11  program under section 245.4713 to reimburse the transportation 
 16.12  costs of individuals who provide transportation to adults with 
 16.13  serious and persistent mental illness.  The community support 
 16.14  services program must be coordinated with the case management 
 16.15  services specified in section 245.4711. 
 16.16     Sec. 3.  Minnesota Statutes 2000, section 245.462, is 
 16.17  amended by adding a subdivision to read: 
 16.18     Subd. 7a.  [CRISIS INTERVENTION SERVICES.] Crisis 
 16.19  intervention services are short-term, intensive, nonresidential 
 16.20  mental health services that include assessment, mental health 
 16.21  rehabilitative services, and a crisis disposition plan.  Crisis 
 16.22  intervention services are intended to help the recipient return 
 16.23  to a baseline level of functioning or prevent further harmful 
 16.24  consequences due to the psychiatric symptoms. 
 16.25     Sec. 4.  Minnesota Statutes 2000, section 245.462, is 
 16.26  amended by adding a subdivision to read: 
 16.27     Subd. 7b.  [CRISIS STABILIZATION SERVICES.] Crisis 
 16.28  stabilization services are assessment and intensive 
 16.29  individualized rehabilitative services provided in a recipient's 
 16.30  home or a short-term residential setting.  Crisis stabilization 
 16.31  services are intended to prevent further deterioration or 
 16.32  exacerbation of psychiatric symptoms or to help the recipient to 
 16.33  reside in the recipient's usual living arrangement during or 
 16.34  following a mental health crisis or emergency. 
 16.35     Sec. 5.  Minnesota Statutes 2000, section 245.462, 
 16.36  subdivision 8, is amended to read: 
 17.1      Subd. 8.  [DAY TREATMENT SERVICES.] "Day treatment," "day 
 17.2   treatment services," or "day treatment program" means a 
 17.3   structured program of treatment and care provided to an adult in 
 17.4   or by:  (1) a hospital accredited by the joint commission on 
 17.5   accreditation of health organizations and licensed under 
 17.6   sections 144.50 to 144.55; (2) a community mental health center 
 17.7   under section 245.62; or (3) an entity that is under contract 
 17.8   with the county board to operate a program that meets the 
 17.9   requirements of section 245.4712, subdivision 2, and Minnesota 
 17.10  Rules, parts 9505.0170 to 9505.0475.  Day treatment consists of 
 17.11  group psychotherapy and other intensive therapeutic services 
 17.12  that are provided at least one day a week by a multidisciplinary 
 17.13  staff under the clinical supervision of a mental health 
 17.14  professional.  Day treatment may include education and 
 17.15  consultation provided to families and other individuals as part 
 17.16  of the treatment process.  The services are aimed at stabilizing 
 17.17  the adult's mental health status, providing mental health 
 17.18  services, and developing and improving the adult's independent 
 17.19  living and socialization skills.  The goal of day treatment is 
 17.20  to reduce or relieve mental illness and to enable the adult to 
 17.21  live in the community.  Day treatment services are not a part of 
 17.22  inpatient or residential treatment services.  Day treatment 
 17.23  services are distinguished from day care by their structured 
 17.24  therapeutic program of psychotherapy services.  The commissioner 
 17.25  may limit medical assistance reimbursement for day treatment to 
 17.26  15 hours per week per person instead of the three hours per day 
 17.27  per person specified in Minnesota Rules, part 9505.0323, subpart 
 17.28  15. 
 17.29     Sec. 6.  Minnesota Statutes 2000, section 245.462, is 
 17.30  amended by adding a subdivision to read: 
 17.31     Subd. 14a.  [MENTAL HEALTH CRISIS.] "Mental health crisis" 
 17.32  means an urgent behavioral, emotional, or psychiatric condition 
 17.33  that would, in the determination of a mental health 
 17.34  professional, result in significantly reduced levels of 
 17.35  functioning in primary activities of daily living if mental 
 17.36  health crisis services are not provided as soon as possible, 
 18.1   usually within 24 hours. 
 18.2      Sec. 7.  Minnesota Statutes 2000, section 245.462, is 
 18.3   amended by adding a subdivision to read: 
 18.4      Subd. 14b.  [MENTAL HEALTH EMERGENCY.] "Mental health 
 18.5   emergency" means an urgent behavioral, emotional, or psychiatric 
 18.6   situation that would, in the determination of a mental health 
 18.7   professional, pose an immediate threat to the physical health or 
 18.8   safety of the adult or others if mental health crisis services 
 18.9   are not provided. 
 18.10     Sec. 8.  Minnesota Statutes 2000, section 245.462, is 
 18.11  amended by adding a subdivision to read: 
 18.12     Subd. 14c.  [MENTAL HEALTH CRISIS SERVICES.] "Mental health 
 18.13  crisis services" means crisis assessment, crisis intervention, 
 18.14  and crisis stabilization services that are not billed as part of 
 18.15  hospital emergency room care or an inpatient hospital admission. 
 18.16     Sec. 9.  Minnesota Statutes 2000, section 245.462, 
 18.17  subdivision 18, is amended to read: 
 18.18     Subd. 18.  [MENTAL HEALTH PROFESSIONAL.] "Mental health 
 18.19  professional" means a person providing clinical services in the 
 18.20  treatment of mental illness who is qualified in at least one of 
 18.21  the following ways:  
 18.22     (1) in psychiatric nursing:  a registered nurse who is 
 18.23  licensed under sections 148.171 to 148.285, and who is certified 
 18.24  as a clinical specialist in adult psychiatric and mental health 
 18.25  nursing by a national nurse certification organization or who 
 18.26  has a master's degree in nursing or one of the behavioral 
 18.27  sciences or related fields from an accredited college or 
 18.28  university or its equivalent, with at least 4,000 hours of 
 18.29  post-master's supervised experience in the delivery of clinical 
 18.30  services in the treatment of mental illness; 
 18.31     (2) in clinical social work:  a person licensed as an 
 18.32  independent clinical social worker under section 148B.21, 
 18.33  subdivision 6, or a person with a master's degree in social work 
 18.34  from an accredited college or university, with at least 4,000 
 18.35  hours of post-master's supervised experience in the delivery of 
 18.36  clinical services in the treatment of mental illness; 
 19.1      (3) in psychology:  ~~a psychologist~~ an individual licensed 
 19.2   by the board of psychology under sections 148.88 to 148.98 who 
 19.3   has stated to the board of psychology competencies in the 
 19.4   diagnosis and treatment of mental illness; 
 19.5      (4) in psychiatry:  a physician licensed under chapter 147 
 19.6   and certified by the American board of psychiatry and neurology 
 19.7   or eligible for board certification in psychiatry; 
 19.8      (5) in marriage and family therapy:  the mental health 
 19.9   professional must be a marriage and family therapist licensed 
 19.10  under sections 148B.29 to 148B.39 with at least two years of 
 19.11  post-master's supervised experience in the delivery of clinical 
 19.12  services in the treatment of mental illness; or 
 19.13     (6) in allied fields:  a person with a master's degree from 
 19.14  an accredited college or university in one of the behavioral 
 19.15  sciences or related fields, with at least 4,000 hours of 
 19.16  post-master's supervised experience in the delivery of clinical 
 19.17  services in the treatment of mental illness.  
 19.18     Sec. 10.  Minnesota Statutes 2000, section 245.462, 
 19.19  subdivision 20, is amended to read: 
 19.20     Subd. 20.  [MENTAL ILLNESS.] (a) "Mental illness" means an 
 19.21  organic disorder of the brain or a clinically significant 
 19.22  disorder of thought, mood, perception, orientation, memory, or 
 19.23  behavior that is listed in the clinical manual of the 
 19.24  International Classification of Diseases (ICD-9-CM), current 
 19.25  edition, code range 290.0 to 302.99 or 306.0 to 316.0 or the 
 19.26  corresponding code in the American Psychiatric Association's 
 19.27  Diagnostic and Statistical Manual of Mental Disorders (DSM-MD), 
 19.28  current edition, Axes I, II, or III, and that seriously limits a 
 19.29  person's capacity to function in primary aspects of daily living 
 19.30  such as personal relations, living arrangements, work, and 
 19.31  recreation.  
 19.32     (b) An "adult with acute mental illness" means an adult who 
 19.33  has a mental illness that is serious enough to require prompt 
 19.34  intervention.  
 19.35     (c) For purposes of case management and community support 
 19.36  services, a "person with serious and persistent mental illness" 
 20.1   means an adult who has a mental illness and meets at least one 
 20.2   of the following criteria: 
 20.3      (1) the adult has undergone two or more episodes of 
 20.4   inpatient care for a mental illness within the preceding 24 
 20.5   months; 
 20.6      (2) the adult has experienced a continuous psychiatric 
 20.7   hospitalization or residential treatment exceeding six months' 
 20.8   duration within the preceding 12 months; 
 20.9      (3) the adult: 
 20.10     (i) has a diagnosis of schizophrenia, bipolar disorder, 
 20.11  major depression, ~~or~~ borderline personality disorder, or severe 
 20.12  anxiety disorder such as panic disorder, obsessive-compulsive 
 20.13  disorder, posttraumatic stress disorder, and social anxiety 
 20.14  disorder; 
 20.15     (ii) indicates a significant impairment in functioning; and 
 20.16     (iii) has a written opinion from a mental health 
 20.17  professional, in the last three years, stating that either:  (A) 
 20.18  the adult is reasonably likely to have future episodes requiring 
 20.19  inpatient or residential treatment, of a frequency described in 
 20.20  clause (1) or (2), unless ongoing case management or community 
 20.21  support services are provided; or (B) ongoing case management 
 20.22  and community support services are appropriate to prevent 
 20.23  relapse and maintain community functioning or to avoid 
 20.24  hospitalization or residential treatment; 
 20.25     (4) the adult has, in the last three years, been committed 
 20.26  by a court as a mentally ill person under chapter 253B, or the 
 20.27  adult's commitment has been stayed or continued; ~~or~~ 
 20.28     (5) the adult (i) was eligible under clauses (1) to (4), 
 20.29  but the specified time period has expired or the adult was 
 20.30  eligible as a child under section 245.4871, subdivision 6; and 
 20.31  (ii) has a written opinion from a mental health professional, in 
 20.32  the last three years, stating that the adult is reasonably 
 20.33  likely to have future episodes requiring inpatient or 
 20.34  residential treatment, of a frequency described in clause (1) or 
 20.35  (2), unless ongoing case management or community support 
 20.36  services are provided; or 
 21.1      (6) the adult is between the ages of 18 and 22 and as a 
 21.2   child (i) was eligible for services under sections 245.487 to 
 21.3   245.4888 as a child with severe emotional disturbance, as 
 21.4   defined in section 245.4871, subdivision 6; or (ii) was eligible 
 21.5   for special education services under the Individuals with 
 21.6   Disabilities Education Act or chapter 125A as a child with an 
 21.7   emotional or behavioral disorder, as defined in Minnesota Rules, 
 21.8   part 3525.1329, subpart 1. 
 21.9      Sec. 11.  Minnesota Statutes 2000, section 245.462, is 
 21.10  amended by adding a subdivision to read: 
 21.11     Subd. 25a.  [SIGNIFICANT IMPAIRMENT IN 
 21.12  FUNCTIONING.] "Significant impairment in functioning" means a 
 21.13  condition, including significant suicidal ideation or thoughts 
 21.14  of harming self or others, which harmfully affects, recurrently 
 21.15  or consistently, a person's activities of daily living in 
 21.16  employment, housing, family, and social relationships, or 
 21.17  education. 
 21.18     Sec. 12.  Minnesota Statutes 2000, section 245.466, 
 21.19  subdivision 2, is amended to read: 
 21.20     Subd. 2.  [ADULT MENTAL HEALTH SERVICES.] The adult mental 
 21.21  health service system developed by each county board must 
 21.22  include the following services:  
 21.23     (1) education and prevention services in accordance with 
 21.24  section 245.468; 
 21.25     (2) emergency services in accordance with section 245.469; 
 21.26     (3) outpatient services in accordance with section 245.470; 
 21.27     (4) community support program services in accordance with 
 21.28  section 245.4711; 
 21.29     (5) residential treatment services in accordance with 
 21.30  section 245.472; 
 21.31     (6) acute care hospital inpatient treatment services in 
 21.32  accordance with section 245.473; 
 21.33     (7) regional treatment center inpatient services in 
 21.34  accordance with section 245.474; 
 21.35     (8) screening in accordance with section 245.476; ~~and~~ 
 21.36     (9) case management in accordance with sections 245.462, 
 22.1   subdivision 3; and 245.4711; and 
 22.2      (10) mental health crisis services in accordance with 
 22.3   section 245.470, subdivision 3. 
 22.4      Sec. 13.  Minnesota Statutes 2000, section 245.470, is 
 22.5   amended by adding a subdivision to read: 
 22.6      Subd. 3.  [MENTAL HEALTH CRISIS SERVICES.] County boards 
 22.7   must provide or contract for enough mental health crisis 
 22.8   services within the county to meet the needs of adults with 
 22.9   mental illness residing in the county who are determined, 
 22.10  through an assessment by a mental health professional, to be 
 22.11  experiencing a mental health crisis or mental health emergency.  
 22.12  The mental health crisis services provided must be medically 
 22.13  necessary, as defined in section 62Q.53, subdivision 2, and 
 22.14  appropriate or socially necessary for the safety of the adult or 
 22.15  others. 
 22.16     Sec. 14.  Minnesota Statutes 2000, section 245.4711, is 
 22.17  amended by adding a subdivision to read: 
 22.18     Subd. 6a.  [TEAM CASE MANAGEMENT SERVICES.] One year before 
 22.19  a child's eligibility for mental health services under sections 
 22.20  245.487 to 245.4888 ends, a child with severe emotional 
 22.21  disturbance who is reasonably expected to require mental health 
 22.22  services under sections 245.461 to 245.486 is eligible for team 
 22.23  case management services from both a case management service 
 22.24  provider for adults and a case management service provider for 
 22.25  children.  Team case management services may be available until 
 22.26  age 22.  To the extent possible, the case management service 
 22.27  provider for children who served the child shall continue to 
 22.28  serve that person as part of the team under this subdivision.  
 22.29  Case management service providers providing team case management 
 22.30  services may each receive separate payment for services 
 22.31  provided, according to section 256B.0625, subdivision 20, 
 22.32  paragraph (f). 
 22.33     Sec. 15.  [245.4713] [REIMBURSEMENT FOR TRANSPORTATION 
 22.34  COSTS.] 
 22.35     A community support services program that a county board 
 22.36  contracts with for community support services may administer a 
 23.1   program to reimburse individuals and organizations for 
 23.2   transporting adults with serious and persistent mental illness 
 23.3   to health care and social support services deemed necessary by 
 23.4   case managers or mental health professionals serving the 
 23.5   adults.  The program may reimburse individuals and organizations 
 23.6   for transportation costs that may not be billed to the medical 
 23.7   assistance program under section 256B.0625.  Individuals and 
 23.8   organizations that may be reimbursed include, but are not 
 23.9   limited to, providers of outpatient mental health services and 
 23.10  members of consumer cooperatives.  If a community support 
 23.11  services program chooses to administer a reimbursement program, 
 23.12  the program may apply to the commissioner for the funds through 
 23.13  an application process established by the commissioner.  The 
 23.14  commissioner shall establish reimbursement rates to be used by 
 23.15  community support services programs. 
 23.16     Sec. 16.  Minnesota Statutes 2000, section 245.4871, is 
 23.17  amended by adding a subdivision to read: 
 23.18     Subd. 9b.  [CRISIS INTERVENTION SERVICES.] Crisis 
 23.19  intervention services are short-term, intensive, nonresidential 
 23.20  mental health services that include assessment, mental health 
 23.21  rehabilitative services, and a crisis disposition plan.  Crisis 
 23.22  intervention services are intended to help the recipient return 
 23.23  to a baseline level of functioning or prevent further harmful 
 23.24  consequences due to the psychiatric symptoms. 
 23.25     Sec. 17.  Minnesota Statutes 2000, section 245.4871, is 
 23.26  amended by adding a subdivision to read: 
 23.27     Subd. 9c.  [CRISIS STABILIZATION SERVICES.] Crisis 
 23.28  stabilization services covers assessment and intensive 
 23.29  individualized rehabilitative services provided in a recipient's 
 23.30  home or a short-term residential setting.  Crisis stabilization 
 23.31  services are intended to prevent further deterioration or 
 23.32  exacerbation of psychiatric symptoms or help the recipient to 
 23.33  reside in the recipient's usual living arrangement during or 
 23.34  following a mental health crisis or emergency. 
 23.35     Sec. 18.  Minnesota Statutes 2000, section 245.4871, 
 23.36  subdivision 10, is amended to read: 
 24.1      Subd. 10.  [DAY TREATMENT SERVICES.] "Day treatment," "day 
 24.2   treatment services," or "day treatment program" means a 
 24.3   structured program of treatment and care provided to a child in: 
 24.4      (1) an outpatient hospital accredited by the joint 
 24.5   commission on accreditation of health organizations and licensed 
 24.6   under sections 144.50 to 144.55; 
 24.7      (2) a community mental health center under section 245.62; 
 24.8      (3) an entity that is under contract with the county board 
 24.9   to operate a program that meets the requirements of section 
 24.10  245.4884, subdivision 2, and Minnesota Rules, parts 9505.0170 to 
 24.11  9505.0475; or 
 24.12     (4) an entity that operates a program that meets the 
 24.13  requirements of section 245.4884, subdivision 2, and Minnesota 
 24.14  Rules, parts 9505.0170 to 9505.0475, that is under contract with 
 24.15  an entity that is under contract with a county board. 
 24.16     Day treatment consists of group psychotherapy and other 
 24.17  intensive therapeutic services that are provided for a minimum 
 24.18  three-hour time block by a multidisciplinary staff under the 
 24.19  clinical supervision of a mental health professional.  Day 
 24.20  treatment may include education and consultation provided to 
 24.21  families and other individuals as an extension of the treatment 
 24.22  process.  The services are aimed at stabilizing the child's 
 24.23  mental health status, and developing and improving the child's 
 24.24  daily independent living and socialization skills.  Day 
 24.25  treatment services are distinguished from day care by their 
 24.26  structured therapeutic program of psychotherapy services.  Day 
 24.27  treatment services are not a part of inpatient hospital or 
 24.28  residential treatment services.  Day treatment services for a 
 24.29  child are an integrated set of education, therapy, and family 
 24.30  interventions. 
 24.31     A day treatment service must be available to a child at 
 24.32  least five days a week throughout the year and must be 
 24.33  coordinated with, integrated with, or part of an education 
 24.34  program offered by the child's school. 
 24.35     Sec. 19.  Minnesota Statutes 2000, section 245.4871, 
 24.36  subdivision 17, is amended to read: 
 25.1      Subd. 17.  [FAMILY COMMUNITY SUPPORT SERVICES.] "Family 
 25.2   community support services" means services provided under the 
 25.3   clinical supervision of a mental health professional and 
 25.4   designed to help each child with severe emotional disturbance to 
 25.5   function and remain with the child's family in the community.  
 25.6   Family community support services do not include acute care 
 25.7   hospital inpatient treatment, residential treatment services, or 
 25.8   regional treatment center services.  Family community support 
 25.9   services include:  
 25.10     (1) client outreach to each child with severe emotional 
 25.11  disturbance and the child's family; 
 25.12     (2) medication monitoring where necessary; 
 25.13     (3) assistance in developing independent living skills; 
 25.14     (4) assistance in developing parenting skills necessary to 
 25.15  address the needs of the child with severe emotional 
 25.16  disturbance; 
 25.17     (5) assistance with leisure and recreational activities; 
 25.18     (6) crisis assistance, including crisis placement and 
 25.19  respite care; 
 25.20     (7) professional home-based family treatment; 
 25.21     (8) foster care with therapeutic supports; 
 25.22     (9) day treatment; 
 25.23     (10) assistance in locating respite care and special needs 
 25.24  day care; ~~and~~ 
 25.25     (11) assistance in obtaining potential financial resources, 
 25.26  including those benefits listed in section 245.4884, subdivision 
 25.27  5; 
 25.28     (12) education and consultation provided to families and 
 25.29  other individuals as an extension of the treatment process; and 
 25.30     (13) assistance to consumers in pursuing complaints and 
 25.31  appeals, and obtaining access to dispute resolution processes. 
 25.32     Sec. 20.  Minnesota Statutes 2000, section 245.4871, is 
 25.33  amended by adding a subdivision to read: 
 25.34     Subd. 24a.  [MENTAL HEALTH CRISIS.] "Mental health crisis" 
 25.35  means an urgent behavioral, emotional, or psychiatric condition 
 25.36  that would, in the determination of a mental health 
 26.1   professional, result in significantly reduced levels of 
 26.2   functioning in primary activities of daily living if mental 
 26.3   health crisis services are not provided as soon as possible, 
 26.4   usually within 24 hours. 
 26.5      Sec. 21.  Minnesota Statutes 2000, section 245.4871, is 
 26.6   amended by adding a subdivision to read: 
 26.7      Subd. 24b.  [MENTAL HEALTH EMERGENCY.] "Mental health 
 26.8   emergency" means an urgent behavioral, emotional, or psychiatric 
 26.9   situation that would, in the determination of a mental health 
 26.10  professional, pose an immediate threat to the physical health or 
 26.11  safety of the child or others if mental health crisis services 
 26.12  are not provided. 
 26.13     Sec. 22.  Minnesota Statutes 2000, section 245.4871, is 
 26.14  amended by adding a subdivision to read: 
 26.15     Subd. 24c.  [MENTAL HEALTH CRISIS SERVICES.] "Mental health 
 26.16  crisis services" means crisis assessment, crisis intervention, 
 26.17  and crisis stabilization services that are not billed as part of 
 26.18  hospital emergency room care or an inpatient hospital admission. 
 26.19     Sec. 23.  Minnesota Statutes 2000, section 245.4871, 
 26.20  subdivision 27, is amended to read: 
 26.21     Subd. 27.  [MENTAL HEALTH PROFESSIONAL.] "Mental health 
 26.22  professional" means a person providing clinical services in the 
 26.23  diagnosis and treatment of children's emotional disorders.  A 
 26.24  mental health professional must have training and experience in 
 26.25  working with children consistent with the age group to which the 
 26.26  mental health professional is assigned.  A mental health 
 26.27  professional must be qualified in at least one of the following 
 26.28  ways:  
 26.29     (1) in psychiatric nursing, the mental health professional 
 26.30  must be a registered nurse who is licensed under sections 
 26.31  148.171 to 148.285 and who is certified as a clinical specialist 
 26.32  in child and adolescent psychiatric or mental health nursing by 
 26.33  a national nurse certification organization or who has a 
 26.34  master's degree in nursing or one of the behavioral sciences or 
 26.35  related fields from an accredited college or university or its 
 26.36  equivalent, with at least 4,000 hours of post-master's 
 27.1   supervised experience in the delivery of clinical services in 
 27.2   the treatment of mental illness; 
 27.3      (2) in clinical social work, the mental health professional 
 27.4   must be a person licensed as an independent clinical social 
 27.5   worker under section 148B.21, subdivision 6, or a person with a 
 27.6   master's degree in social work from an accredited college or 
 27.7   university, with at least 4,000 hours of post-master's 
 27.8   supervised experience in the delivery of clinical services in 
 27.9   the treatment of mental disorders; 
 27.10     (3) in psychology, the mental health professional must be ~~a~~ 
 27.11  ~~psychologist~~ an individual licensed by the board of psychology 
 27.12  under sections 148.88 to 148.98 who has stated to the board of 
 27.13  psychology competencies in the diagnosis and treatment of mental 
 27.14  disorders; 
 27.15     (4) in psychiatry, the mental health professional must be a 
 27.16  physician licensed under chapter 147 and certified by the 
 27.17  American board of psychiatry and neurology or eligible for board 
 27.18  certification in psychiatry; 
 27.19     (5) in marriage and family therapy, the mental health 
 27.20  professional must be a marriage and family therapist licensed 
 27.21  under sections 148B.29 to 148B.39 with at least two years of 
 27.22  post-master's supervised experience in the delivery of clinical 
 27.23  services in the treatment of mental disorders or emotional 
 27.24  disturbances; or 
 27.25     (6) in allied fields, the mental health professional must 
 27.26  be a person with a master's degree from an accredited college or 
 27.27  university in one of the behavioral sciences or related fields, 
 27.28  with at least 4,000 hours of post-master's supervised experience 
 27.29  in the delivery of clinical services in the treatment of 
 27.30  emotional disturbances. 
 27.31     Sec. 24.  Minnesota Statutes 2000, section 245.4871, 
 27.32  subdivision 29, is amended to read: 
 27.33     Subd. 29.  [OUTPATIENT SERVICES.] "Outpatient services" 
 27.34  means mental health services, excluding day treatment and 
 27.35  community support services programs, provided by or under the 
 27.36  clinical supervision of a mental health professional to children 
 28.1   with emotional disturbances who live outside a hospital.  
 28.2   Outpatient services include clinical activities such as 
 28.3   individual, group, and family therapy; individual treatment 
 28.4   planning; diagnostic assessments; medication management; and 
 28.5   psychological testing.  Outpatient services include education 
 28.6   and consultation provided to families and other individuals as 
 28.7   an extension of the treatment process. 
 28.8      Sec. 25.  Minnesota Statutes 2000, section 245.4875, 
 28.9   subdivision 2, is amended to read: 
 28.10     Subd. 2.  [CHILDREN'S MENTAL HEALTH SERVICES.] The 
 28.11  children's mental health service system developed by each county 
 28.12  board must include the following services:  
 28.13     (1) education and prevention services according to section 
 28.14  245.4877; 
 28.15     (2) mental health identification and intervention services 
 28.16  according to section 245.4878; 
 28.17     (3) emergency services according to section 245.4879; 
 28.18     (4) outpatient services according to section 245.488; 
 28.19     (5) family community support services according to section 
 28.20  245.4881; 
 28.21     (6) day treatment services according to section 245.4884, 
 28.22  subdivision 2; 
 28.23     (7) residential treatment services according to section 
 28.24  245.4882; 
 28.25     (8) acute care hospital inpatient treatment services 
 28.26  according to section 245.4883; 
 28.27     (9) screening according to section 245.4885; 
 28.28     (10) case management according to section 245.4881; 
 28.29     (11) therapeutic support of foster care according to 
 28.30  section 245.4884, subdivision 4; ~~and~~ 
 28.31     (12) professional home-based family treatment according to 
 28.32  section 245.4884, subdivision 4; and 
 28.33     (13) mental health crisis services according to section 
 28.34  245.488, subdivision 3. 
 28.35     Sec. 26.  Minnesota Statutes 2000, section 245.4876, 
 28.36  subdivision 1, is amended to read: 
 29.1      Subdivision 1.  [CRITERIA.] Children's mental health 
 29.2   services required by sections 245.487 to 245.4888 must be:  
 29.3      (1) based, when feasible, on research findings; 
 29.4      (2) based on individual clinical, cultural, and ethnic 
 29.5   needs, and other special needs of the children being served; 
 29.6      (3) delivered in a manner that improves family functioning 
 29.7   when clinically appropriate; 
 29.8      (4) provided in the most appropriate, least restrictive 
 29.9   setting that meets the requirements in subdivision 1a, and that 
 29.10  is available to the county board to meet the child's treatment 
 29.11  needs; 
 29.12     (5) accessible to all age groups of children; 
 29.13     (6) appropriate to the developmental age of the child being 
 29.14  served; 
 29.15     (7) delivered in a manner that provides accountability to 
 29.16  the child for the quality of service delivered and continuity of 
 29.17  services to the child during the years the child needs services 
 29.18  from the local system of care; 
 29.19     (8) provided by qualified individuals as required in 
 29.20  sections 245.487 to 245.4888; 
 29.21     (9) coordinated with children's mental health services 
 29.22  offered by other providers; 
 29.23     (10) provided under conditions that protect the rights and 
 29.24  dignity of the individuals being served; and 
 29.25     (11) provided in a manner and setting most likely to 
 29.26  facilitate progress toward treatment goals. 
 29.27     Sec. 27.  Minnesota Statutes 2000, section 245.4876, is 
 29.28  amended by adding a subdivision to read: 
 29.29     Subd. 1a.  [APPROPRIATE SETTING TO RECEIVE SERVICES.] A 
 29.30  child must be provided with mental health services in the least 
 29.31  restrictive setting that is appropriate to the needs and current 
 29.32  condition of the individual child.  For a child to receive 
 29.33  mental health services in a residential treatment or acute care 
 29.34  hospital inpatient setting, the family may not be required to 
 29.35  demonstrate that services were first provided in a less 
 29.36  restrictive setting and that the child failed to make progress 
 30.1   toward or meet treatment goals in the less restrictive setting. 
 30.2      Sec. 28.  Minnesota Statutes 2000, section 245.4876, is 
 30.3   amended by adding a subdivision to read: 
 30.4      Subd. 1b.  [APPROPRIATE; DEFINITION.] For purposes of this 
 30.5   section, "appropriate" means that activity which, based on a 
 30.6   preponderance of the evidence, is consistent with the 
 30.7   professional recommendations of the current mental health 
 30.8   professionals treating the child. 
 30.9      Sec. 29.  Minnesota Statutes 2000, section 245.488, is 
 30.10  amended by adding a subdivision to read: 
 30.11     Subd. 3.  [MENTAL HEALTH CRISIS SERVICES.] County boards 
 30.12  must provide or contract for enough mental health crisis 
 30.13  services within the county to meet the needs of children with 
 30.14  emotional disturbance residing in the county who are determined, 
 30.15  through an assessment by a mental health professional, to be 
 30.16  experiencing a mental health crisis or mental health emergency. 
 30.17  The mental health crisis services provided must be medically 
 30.18  necessary, as defined in section 62Q.53, subdivision 2, and 
 30.19  appropriate or socially necessary for the safety of the child or 
 30.20  others. 
 30.21     Sec. 30.  Minnesota Statutes 2000, section 245.4885, 
 30.22  subdivision 1, is amended to read: 
 30.23     Subdivision 1.  [SCREENING REQUIRED.] The county board 
 30.24  shall, prior to admission, except in the case of emergency 
 30.25  admission, screen all children referred for treatment of severe 
 30.26  emotional disturbance to a residential treatment facility or 
 30.27  informally admitted to a regional treatment center if public 
 30.28  funds are used to pay for the services.  The county board shall 
 30.29  also screen all children admitted to an acute care hospital for 
 30.30  treatment of severe emotional disturbance if public funds other 
 30.31  than reimbursement under chapters 256B and 256D are used to pay 
 30.32  for the services.  If a child is admitted to a residential 
 30.33  treatment facility or acute care hospital for emergency 
 30.34  treatment or held for emergency care by a regional treatment 
 30.35  center under section 253B.05, subdivision 1, screening must 
 30.36  occur within three working days of admission.  Screening shall 
 31.1   determine whether the proposed treatment:  
 31.2      (1) is necessary; 
 31.3      (2) is appropriate to the child's individual treatment 
 31.4   needs.  For purposes of this clause, "appropriate" has the 
 31.5   meaning given in section 245.4876, subdivision 1b; 
 31.6      (3) cannot be effectively provided in the child's home; and 
 31.7      (4) provides a length of stay as short as possible 
 31.8   consistent with the individual child's need. 
 31.9      When a screening is conducted, the county board may not 
 31.10  determine that referral or admission to a residential treatment 
 31.11  facility or acute care hospital is not appropriate solely 
 31.12  because services were not first provided to the child in a less 
 31.13  restrictive setting and the child failed to make progress toward 
 31.14  or meet treatment goals in the less restrictive setting.  
 31.15  Screening shall include both a diagnostic assessment and a 
 31.16  functional assessment which evaluates family, school, and 
 31.17  community living situations.  If a diagnostic assessment or 
 31.18  functional assessment has been completed by a mental health 
 31.19  professional within 180 days, a new diagnostic or functional 
 31.20  assessment need not be completed unless in the opinion of the 
 31.21  current treating mental health professional the child's mental 
 31.22  health status has changed markedly since the assessment was 
 31.23  completed.  The child's parent shall be notified if an 
 31.24  assessment will not be completed and of the reasons.  A copy of 
 31.25  the notice shall be placed in the child's file.  Recommendations 
 31.26  developed as part of the screening process shall include 
 31.27  specific community services needed by the child and, if 
 31.28  appropriate, the child's family, and shall indicate whether or 
 31.29  not these services are available and accessible to the child and 
 31.30  family.  
 31.31     During the screening process, the child, child's family, or 
 31.32  child's legal representative, as appropriate, must be informed 
 31.33  of the child's eligibility for case management services and 
 31.34  family community support services and that an individual family 
 31.35  community support plan is being developed by the case manager, 
 31.36  if assigned.  
 32.1      Screening shall be in compliance with section 256F.07 or 
 32.2   260C.212, whichever applies.  Wherever possible, the parent 
 32.3   shall be consulted in the screening process, unless clinically 
 32.4   inappropriate.  
 32.5      The screening process, and placement decision, and 
 32.6   recommendations for mental health services must be documented in 
 32.7   the child's record.  
 32.8      An alternate review process may be approved by the 
 32.9   commissioner if the county board demonstrates that an alternate 
 32.10  review process has been established by the county board and the 
 32.11  times of review, persons responsible for the review, and review 
 32.12  criteria are comparable to the standards in clauses (1) to (4). 
 32.13     Sec. 31.  Minnesota Statutes 2000, section 256.969, 
 32.14  subdivision 3a, is amended to read: 
 32.15     Subd. 3a.  [PAYMENTS.] Acute care hospital billings under 
 32.16  the medical assistance program must not be submitted until the 
 32.17  recipient is discharged.  However, the commissioner shall 
 32.18  establish monthly interim payments for inpatient hospitals that 
 32.19  have individual patient lengths of stay over 30 days regardless 
 32.20  of diagnostic category.  Except as provided in subdivision 3b, 
 32.21  medical assistance reimbursement for treatment of mental illness 
 32.22  shall be reimbursed based on diagnostic classifications.  The 
 32.23  commissioner may selectively contract with hospitals for 
 32.24  services within the diagnostic categories relating to mental 
 32.25  illness and chemical dependency under competitive bidding when 
 32.26  reasonable geographic access by recipients can be assured but 
 32.27  shall not require, in the admissions criteria for persons with 
 32.28  mental illness, any commitment or petition under chapter 253B as 
 32.29  a condition of obtaining these services.  No physician shall be 
 32.30  denied the privilege of treating a recipient required to use a 
 32.31  hospital under contract with the commissioner, as long as the 
 32.32  physician meets credentialing standards of the individual 
 32.33  hospital.  Individual hospital payments established under this 
 32.34  section and sections 256.9685, 256.9686, and 256.9695, in 
 32.35  addition to third party and recipient liability, for discharges 
 32.36  occurring during the rate year shall not exceed, in aggregate, 
 33.1   the charges for the medical assistance covered inpatient 
 33.2   services paid for the same period of time to the hospital.  This 
 33.3   payment limitation shall be calculated separately for medical 
 33.4   assistance and general assistance medical care services.  The 
 33.5   limitation on general assistance medical care shall be effective 
 33.6   for admissions occurring on or after July 1, 1991.  Services 
 33.7   that have rates established under subdivision 11 or 12, must be 
 33.8   limited separately from other services.  After consulting with 
 33.9   the affected hospitals, the commissioner may consider related 
 33.10  hospitals one entity and may merge the payment rates while 
 33.11  maintaining separate provider numbers.  The operating and 
 33.12  property base rates per admission or per day shall be derived 
 33.13  from the best Medicare and claims data available when rates are 
 33.14  established.  The commissioner shall determine the best Medicare 
 33.15  and claims data, taking into consideration variables of recency 
 33.16  of the data, audit disposition, settlement status, and the 
 33.17  ability to set rates in a timely manner.  The commissioner shall 
 33.18  notify hospitals of payment rates by December 1 of the year 
 33.19  preceding the rate year.  The rate setting data must reflect the 
 33.20  admissions data used to establish relative values.  Base year 
 33.21  changes from 1981 to the base year established for the rate year 
 33.22  beginning January 1, 1991, and for subsequent rate years, shall 
 33.23  not be limited to the limits ending June 30, 1987, on the 
 33.24  maximum rate of increase under subdivision 1.  The commissioner 
 33.25  may adjust base year cost, relative value, and case mix index 
 33.26  data to exclude the costs of services that have been 
 33.27  discontinued by the October 1 of the year preceding the rate 
 33.28  year or that are paid separately from inpatient services.  
 33.29  Inpatient stays that encompass portions of two or more rate 
 33.30  years shall have payments established based on payment rates in 
 33.31  effect at the time of admission unless the date of admission 
 33.32  preceded the rate year in effect by six months or more.  In this 
 33.33  case, operating payment rates for services rendered during the 
 33.34  rate year in effect and established based on the date of 
 33.35  admission shall be adjusted to the rate year in effect by the 
 33.36  hospital cost index. 
 34.1      Sec. 32.  Minnesota Statutes 2000, section 256.969, is 
 34.2   amended by adding a subdivision to read: 
 34.3      Subd. 3b.  [CONTINUING CARE PROGRAM FOR PERSONS WITH MENTAL 
 34.4   ILLNESS.] The commissioner shall establish a continuing care 
 34.5   benefit program for persons with mental illness, in which 
 34.6   persons with mental illness may obtain acute care hospital 
 34.7   inpatient treatment for mental illness for a length of stay 
 34.8   beyond that allowed by the diagnostic classifications for mental 
 34.9   illness according to subdivision 3a.  Persons with mental 
 34.10  illness may obtain inpatient treatment under this program in 
 34.11  hospital beds for which the commissioner contracts under 
 34.12  subdivision 3a.  The commissioner shall contract externally with 
 34.13  a utilization review organization to authorize persons with 
 34.14  mental illness to access the continuing care benefit program.  
 34.15  The commissioner shall establish admission criteria to allow 
 34.16  persons with mental illness to access the continuing care 
 34.17  benefit program.  If a court orders acute care hospital 
 34.18  inpatient treatment for mental illness for a person, the person 
 34.19  may obtain the treatment under the continuing care benefit 
 34.20  program.  The commissioner shall not require, as part of the 
 34.21  admission criteria, any commitment or petition under chapter 
 34.22  253B as a condition of accessing the program. 
 34.23     Sec. 33.  Minnesota Statutes 2000, section 256B.0625, 
 34.24  subdivision 17, is amended to read: 
 34.25     Subd. 17.  [TRANSPORTATION COSTS.] (a) Medical assistance 
 34.26  covers transportation costs incurred solely for obtaining 
 34.27  emergency medical care or transportation costs incurred by 
 34.28  nonambulatory persons in obtaining emergency or nonemergency 
 34.29  medical care when paid directly to an ambulance company, common 
 34.30  carrier, or other recognized providers of transportation 
 34.31  services.  For the purpose of this subdivision, a person who is 
 34.32  incapable of transport by taxicab or bus shall be considered to 
 34.33  be nonambulatory. 
 34.34     (b) Medical assistance covers special transportation, as 
 34.35  defined in Minnesota Rules, part 9505.0315, subpart 1, item F, 
 34.36  if the provider receives and maintains a current physician's 
 35.1   order by the recipient's attending physician certifying that the 
 35.2   recipient has a physical or mental impairment that would 
 35.3   prohibit the recipient from safely accessing and using a bus, 
 35.4   taxi, other commercial transportation, or private automobile.  
 35.5   Notwithstanding Minnesota Rules, part 9505.0315, subpart 1, item 
 35.6   D, medical assistance covers special transportation services 
 35.7   necessary to obtain a service not covered by medical assistance, 
 35.8   if this service is part of the person's individual treatment 
 35.9   plan.  Special transportation includes driver-assisted service 
 35.10  to eligible individuals.  Driver-assisted service includes 
 35.11  passenger pickup at and return to the individual's residence or 
 35.12  place of business, assistance with admittance of the individual 
 35.13  to the medical facility, and assistance in passenger securement 
 35.14  or in securing of wheelchairs or stretchers in the vehicle.  The 
 35.15  commissioner shall establish maximum medical assistance 
 35.16  reimbursement rates for special transportation services for 
 35.17  persons who need a wheelchair lift van or stretcher-equipped 
 35.18  vehicle and for those who do not need a wheelchair lift van or 
 35.19  stretcher-equipped vehicle.  The average of these two rates per 
 35.20  trip must not exceed $15 for the base rate and $1.20 per mile.  
 35.21  Special transportation provided to nonambulatory persons who do 
 35.22  not need a wheelchair lift van or stretcher-equipped vehicle, 
 35.23  may be reimbursed at a lower rate than special transportation 
 35.24  provided to persons who need a wheelchair lift van or 
 35.25  stretcher-equipped vehicle. 
 35.26     Sec. 34.  Minnesota Statutes 2000, section 256B.0625, is 
 35.27  amended by adding a subdivision to read: 
 35.28     Subd. 43.  [CONTINUING CARE FOR PERSONS WITH MENTAL 
 35.29  ILLNESS.] Medical assistance covers a continuing care benefit 
 35.30  for persons with mental illness established under section 
 35.31  256.969, subdivision 3b, in which persons with mental illness 
 35.32  may obtain acute care hospital inpatient treatment for a length 
 35.33  of stay beyond that allowed by the diagnostic classifications 
 35.34  for mental illness. 
 35.35     Sec. 35.  Minnesota Statutes 2000, section 256B.0625, is 
 35.36  amended by adding a subdivision to read: 
 36.1      Subd. 44.  [COMMUNITY SUPPORT SERVICES PROGRAM.] Medical 
 36.2   assistance covers services included under a community support 
 36.3   services program, as defined in section 245.462, subdivision 6. 
 36.4      Sec. 36.  Minnesota Statutes 2000, section 256B.0625, is 
 36.5   amended by adding a subdivision to read: 
 36.6      Subd. 45.  [MENTAL HEALTH EVALUATION AND MANAGEMENT; 
 36.7   CLINICAL SUPERVISION.] (a) Medical assistance covers the 
 36.8   following evaluation and management services related to mental 
 36.9   health symptoms, treatment, and supportive services: 
 36.10     (1) outpatient services performed by mental health 
 36.11  professionals in community mental health centers under 
 36.12  subdivision 5 or section 245.62, community health clinics under 
 36.13  Minnesota Rules, part 9505.0255, public health clinics under 
 36.14  Minnesota Rules, part 9505.0380, or mental health centers and 
 36.15  mental health clinics certified under Minnesota Rules, parts 
 36.16  9520.0750 to 9520.0870; 
 36.17     (2) inpatient evaluation and management services performed 
 36.18  by psychiatrists for day treatment, partial hospitalization, 
 36.19  crisis intervention, and nonresidential crisis stabilization 
 36.20  services; and 
 36.21     (3) consultation, evaluation, and management services 
 36.22  provided via telemedicine. 
 36.23     (b) Medical assistance covers clinical supervision services 
 36.24  that are required as a condition of payment for services 
 36.25  provided under subdivisions 3 and 5, and Minnesota Rules, parts 
 36.26  9505.0323, 9505.0324, and 9505.0326. 
 36.27     Sec. 37.  Minnesota Statutes 2000, section 256B.0625, is 
 36.28  amended by adding a subdivision to read: 
 36.29     Subd. 46.  [MENTAL HEALTH CRISIS SERVICES.] Medical 
 36.30  assistance covers adult and child mental health crisis services 
 36.31  as defined in sections 245.462, subdivision 14c, and 245.4871, 
 36.32  subdivision 24c. 
 36.33     Sec. 38.  Minnesota Statutes 2000, section 260C.201, 
 36.34  subdivision 1, is amended to read: 
 36.35     Subdivision 1.  [DISPOSITIONS.] (a) If the court finds that 
 36.36  the child is in need of protection or services or neglected and 
 37.1   in foster care, it shall enter an order making any of the 
 37.2   following dispositions of the case: 
 37.3      (1) place the child under the protective supervision of the 
 37.4   local social services agency or child-placing agency in the home 
 37.5   of a parent of the child under conditions prescribed by the 
 37.6   court directed to the correction of the child's need for 
 37.7   protection or services, or: 
 37.8      (i) the court may order the child into the home of a parent 
 37.9   who does not otherwise have legal custody of the child, however, 
 37.10  an order under this section does not confer legal custody on 
 37.11  that parent; 
 37.12     (ii) if the court orders the child into the home of a 
 37.13  father who is not adjudicated, he must cooperate with paternity 
 37.14  establishment proceedings regarding the child in the appropriate 
 37.15  jurisdiction as one of the conditions prescribed by the court 
 37.16  for the child to continue in his home; 
 37.17     (iii) the court may order the child into the home of a 
 37.18  noncustodial parent with conditions and may also order both the 
 37.19  noncustodial and the custodial parent to comply with the 
 37.20  requirements of a case plan under subdivision 2; 
 37.21     (2) transfer legal custody to one of the following: 
 37.22     (i) a child-placing agency; or 
 37.23     (ii) the local social services agency. 
 37.24     In placing a child whose custody has been transferred under 
 37.25  this paragraph, the agencies shall follow the requirements of 
 37.26  section 260C.193, subdivision 3; 
 37.27     (3) if the child has been adjudicated as a child in need of 
 37.28  protection or services because the child is in need of special 
 37.29  ~~treatment and~~ services or care ~~for reasons of physical or mental~~ 
 37.30  ~~health~~ to treat or ameliorate a physical or mental disability, 
 37.31  the court may order the child's parent, guardian, or custodian 
 37.32  to provide it.  The court may order the child's health plan 
 37.33  company to provide mental health services to the child.  Section 
 37.34  62Q.535 applies to an order for mental health services directed 
 37.35  to the child's health plan company.  If the health plan, parent, 
 37.36  guardian, or custodian fails or is unable to provide this 
 38.1   treatment or care, the court may order it provided.  Absent 
 38.2   specific written findings by the court that the child's 
 38.3   disability is the result of abuse or neglect by the child's 
 38.4   parent or guardian, the court shall not transfer legal custody 
 38.5   of the child for the purpose of obtaining special treatment or 
 38.6   care solely because the parent is unable to provide the 
 38.7   treatment or care.  If the court's order for mental health 
 38.8   treatment is based on a diagnosis made by a treatment 
 38.9   professional, the court may order that the diagnosing 
 38.10  professional not provide the treatment to the child if it finds 
 38.11  that such an order is in the child's best interests; or 
 38.12     (4) if the court believes that the child has sufficient 
 38.13  maturity and judgment and that it is in the best interests of 
 38.14  the child, the court may order a child 16 years old or older to 
 38.15  be allowed to live independently, either alone or with others as 
 38.16  approved by the court under supervision the court considers 
 38.17  appropriate, if the county board, after consultation with the 
 38.18  court, has specifically authorized this dispositional 
 38.19  alternative for a child. 
 38.20     (b) If the child was adjudicated in need of protection or 
 38.21  services because the child is a runaway or habitual truant, the 
 38.22  court may order any of the following dispositions in addition to 
 38.23  or as alternatives to the dispositions authorized under 
 38.24  paragraph (a): 
 38.25     (1) counsel the child or the child's parents, guardian, or 
 38.26  custodian; 
 38.27     (2) place the child under the supervision of a probation 
 38.28  officer or other suitable person in the child's own home under 
 38.29  conditions prescribed by the court, including reasonable rules 
 38.30  for the child's conduct and the conduct of the parents, 
 38.31  guardian, or custodian, designed for the physical, mental, and 
 38.32  moral well-being and behavior of the child; or with the consent 
 38.33  of the commissioner of corrections, place the child in a group 
 38.34  foster care facility which is under the commissioner's 
 38.35  management and supervision; 
 38.36     (3) subject to the court's supervision, transfer legal 
 39.1   custody of the child to one of the following: 
 39.2      (i) a reputable person of good moral character.  No person 
 39.3   may receive custody of two or more unrelated children unless 
 39.4   licensed to operate a residential program under sections 245A.01 
 39.5   to 245A.16; or 
 39.6      (ii) a county probation officer for placement in a group 
 39.7   foster home established under the direction of the juvenile 
 39.8   court and licensed pursuant to section 241.021; 
 39.9      (4) require the child to pay a fine of up to $100.  The 
 39.10  court shall order payment of the fine in a manner that will not 
 39.11  impose undue financial hardship upon the child; 
 39.12     (5) require the child to participate in a community service 
 39.13  project; 
 39.14     (6) order the child to undergo a chemical dependency 
 39.15  evaluation and, if warranted by the evaluation, order 
 39.16  participation by the child in a drug awareness program or an 
 39.17  inpatient or outpatient chemical dependency treatment program; 
 39.18     (7) if the court believes that it is in the best interests 
 39.19  of the child and of public safety that the child's driver's 
 39.20  license or instruction permit be canceled, the court may order 
 39.21  the commissioner of public safety to cancel the child's license 
 39.22  or permit for any period up to the child's 18th birthday.  If 
 39.23  the child does not have a driver's license or permit, the court 
 39.24  may order a denial of driving privileges for any period up to 
 39.25  the child's 18th birthday.  The court shall forward an order 
 39.26  issued under this clause to the commissioner, who shall cancel 
 39.27  the license or permit or deny driving privileges without a 
 39.28  hearing for the period specified by the court.  At any time 
 39.29  before the expiration of the period of cancellation or denial, 
 39.30  the court may, for good cause, order the commissioner of public 
 39.31  safety to allow the child to apply for a license or permit, and 
 39.32  the commissioner shall so authorize; 
 39.33     (8) order that the child's parent or legal guardian deliver 
 39.34  the child to school at the beginning of each school day for a 
 39.35  period of time specified by the court; or 
 39.36     (9) require the child to perform any other activities or 
 40.1   participate in any other treatment programs deemed appropriate 
 40.2   by the court.  
 40.3      To the extent practicable, the court shall enter a 
 40.4   disposition order the same day it makes a finding that a child 
 40.5   is in need of protection or services or neglected and in foster 
 40.6   care, but in no event more than 15 days after the finding unless 
 40.7   the court finds that the best interests of the child will be 
 40.8   served by granting a delay.  If the child was under eight years 
 40.9   of age at the time the petition was filed, the disposition order 
 40.10  must be entered within ten days of the finding and the court may 
 40.11  not grant a delay unless good cause is shown and the court finds 
 40.12  the best interests of the child will be served by the delay. 
 40.13     (c) If a child who is 14 years of age or older is 
 40.14  adjudicated in need of protection or services because the child 
 40.15  is a habitual truant and truancy procedures involving the child 
 40.16  were previously dealt with by a school attendance review board 
 40.17  or county attorney mediation program under section 260A.06 or 
 40.18  260A.07, the court shall order a cancellation or denial of 
 40.19  driving privileges under paragraph (b), clause (7), for any 
 40.20  period up to the child's 18th birthday. 
 40.21     (d) In the case of a child adjudicated in need of 
 40.22  protection or services because the child has committed domestic 
 40.23  abuse and been ordered excluded from the child's parent's home, 
 40.24  the court shall dismiss jurisdiction if the court, at any time, 
 40.25  finds the parent is able or willing to provide an alternative 
 40.26  safe living arrangement for the child, as defined in Laws 1997, 
 40.27  chapter 239, article 10, section 2.  
 40.28     Sec. 39.  [NOTICE REGARDING ESTABLISHMENT OF CONTINUING 
 40.29  CARE BENEFIT PROGRAM.] 
 40.30     When the continuing care benefit program for persons with 
 40.31  mental illness under Minnesota Statutes, section 256.969, 
 40.32  subdivision 3b, is established, the commissioner of human 
 40.33  services shall notify counties, health plan companies with 
 40.34  prepaid medical assistance contracts, health care providers, and 
 40.35  enrollees of the benefit program through bulletins, workshops, 
 40.36  and other meetings. 
 41.1      Sec. 40.  [STUDY; LENGTH OF STAY FOR MEDICARE-ELIGIBLE 
 41.2   PERSONS.] 
 41.3      The commissioner of human services shall study and make 
 41.4   recommendations on how Medicare-eligible persons with mental 
 41.5   illness may obtain acute care hospital inpatient treatment for 
 41.6   mental illness for a length of stay beyond that allowed by the 
 41.7   diagnostic classifications for mental illness according to 
 41.8   Minnesota Statutes, section 256.969, subdivision 3a.  The study 
 41.9   and recommendations shall be reported to the legislature by 
 41.10  January 15, 2002. 
 41.11     Sec. 41.  [APPROPRIATIONS.] 
 41.12     Subdivision 1.  [TRANSPORTATION COSTS.] $....... is 
 41.13  appropriated from the general fund for the 2002-2003 biennium to 
 41.14  the commissioner of human services for grants to community 
 41.15  support services programs with which county boards contract for 
 41.16  the provision of community support services.  Community support 
 41.17  services programs shall use the funds to reimburse the 
 41.18  transportation costs of individuals and organizations that 
 41.19  transport adults with serious and persistent mental illness 
 41.20  according to Minnesota Statutes, section 245.4713. 
 41.21     Subd. 2.  [ADDITIONAL CONTRACT BEDS.] $....... is 
 41.22  appropriated for the 2002-2003 biennium from the general fund to 
 41.23  the commissioner of human services to increase funding for state 
 41.24  mental health grants.  The commissioner shall use this 
 41.25  appropriation to contract with hospitals for additional beds to 
 41.26  provide acute care hospital inpatient services to persons with 
 41.27  mental illness, including persons covered by Medicare, who are 
 41.28  not eligible under the medical assistance contract under 
 41.29  Minnesota Statutes, section 256.969, subdivision 3b, and who 
 41.30  require a length of stay beyond that allowed by the diagnostic 
 41.31  classifications for mental illness. 
 41.32     Subd. 3.  [CRISIS SERVICES.] $....... is appropriated from 
 41.33  the general fund to the commissioner of human services, for the 
 41.34  biennium ending June 30, 2003, to increase funding provided to 
 41.35  county boards under Minnesota Rules, parts 9535.1700 to 
 41.36  9535.1760.  County boards shall use the additional funding to 
 42.1   reimburse or contract with mental health providers to pay for 
 42.2   adult and child mental health crisis services as defined in 
 42.3   Minnesota Statutes, sections 245.462, subdivision 14c, and 
 42.4   245.4871, subdivision 24c. 
 42.5      Subd. 4.  [COMMUNITY SOCIAL SERVICES ACT.] $....... is 
 42.6   appropriated from the general fund to the commissioner of human 
 42.7   services, for the biennium ending June 30, 2003, to increase 
 42.8   funding provided to county boards under the Title XX block 
 42.9   grant.  County boards shall use the additional funding to 
 42.10  increase reimbursement rates for mental health providers to pay 
 42.11  for education, consultation, and support services provided to 
 42.12  families and other individuals. 
 42.13     Subd. 5.  [RULE 78 FUNDING.] $....... is appropriated from 
 42.14  the general fund to the commissioner of human services, for the 
 42.15  biennium ending June 30, 2003, to increase funding provided to 
 42.16  county boards under Minnesota Rules, parts 9535.1700 to 
 42.17  9535.1760.  County boards shall use the additional funding to 
 42.18  increase reimbursement rates for mental health providers to pay 
 42.19  for education, consultation, and support services provided to 
 42.20  families and other individuals. 
 42.21                             ARTICLE 5
 42.22                        HEALTH PLAN COVERAGE 
 42.23     Section 1.  [62Q.471] [EXCLUSION FOR SUICIDE ATTEMPTS 
 42.24  PROHIBITED.] 
 42.25     (a) No health plan may exclude or reduce coverage for 
 42.26  health care for an enrollee that is otherwise covered under the 
 42.27  health plan, on the basis that the need for the health care 
 42.28  arose out of a suicide or suicide attempt by the enrollee. 
 42.29     (b) For purposes of this section, "health plan" has the 
 42.30  meaning given in section 62Q.01, subdivision 3, but includes the 
 42.31  coverages described in section 62A.011, clauses (7) and (10). 
 42.32     Sec. 2.  [62Q.527] [COVERAGE OF NONFORMULARY DRUGS FOR 
 42.33  MENTAL ILLNESS AND EMOTIONAL DISTURBANCE.] 
 42.34     Subdivision 1.  [DEFINITIONS.] (a) For purposes of this 
 42.35  section, the following terms have the meanings given to them. 
 42.36     (b) "Emotional disturbance" has the meaning given in 
 43.1   section 245.4871, subdivision 15. 
 43.2      (c) "Mental illness" has the meaning given in section 
 43.3   245.462, subdivision 20, paragraph (a). 
 43.4      Subd. 2.  [REQUIRED COVERAGE.] A health plan must provide 
 43.5   coverage for an antipsychotic, antimania, or antidementia drug 
 43.6   prescribed to treat emotional disturbance or mental illness 
 43.7   regardless of whether the drug is in the health plan's drug 
 43.8   formulary, if the health care provider prescribing the drug (i) 
 43.9   indicates to the dispensing pharmacist, orally or in writing 
 43.10  according to section 151.21, that the prescription must be 
 43.11  dispensed as communicated; and (ii) certifies in writing to the 
 43.12  health plan company that the drug prescribed will best treat the 
 43.13  patient's condition.  For drugs covered under this section, no 
 43.14  health plan company, which has received the certification from 
 43.15  the health care provider, may: 
 43.16     (A) impose a special deductible, copayment, coinsurance, or 
 43.17  other special payment requirement that the health plan does not 
 43.18  apply to drugs that are in the health plan's drug formulary; or 
 43.19     (B) require written certification from the prescribing 
 43.20  provider each time a prescription is refilled or renewed that 
 43.21  the drug prescribed will best treat the patient's condition. 
 43.22     Subd. 3.  [CONTINUING CARE.] Individuals receiving a 
 43.23  prescribed drug to treat a diagnosed mental illness or emotional 
 43.24  disturbance, may continue to receive the prescribed drug, 
 43.25  without the imposition of a special deductible, co-payment, 
 43.26  coinsurance, or other special payment requirements, when a 
 43.27  health plan's drug formulary changes or an enrollee changes 
 43.28  health plans and the medication has been shown to effectively 
 43.29  treat the patient's condition.  In order to be eligible for this 
 43.30  continuing care benefit, the patient must have been treated with 
 43.31  the drug for 60 days prior to a change in a health plan's drug 
 43.32  formulary or a change in the enrollee's health plan. 
 43.33     Sec. 3.  [62Q.535] [COVERAGE FOR COURT-ORDERED MENTAL 
 43.34  HEALTH SERVICES.] 
 43.35     Subdivision 1.  [MENTAL HEALTH SERVICES.] For purposes of 
 43.36  this section, mental health services means all covered services 
 44.1   that are intended to treat or ameliorate an emotional, 
 44.2   behavioral, or psychiatric condition and that are covered by the 
 44.3   policy, contract, or certificate of coverage of the enrollee's 
 44.4   health plan company or by law. 
 44.5      Subd. 2.  [COVERAGE REQUIRED.] All health plan companies 
 44.6   that provide coverage for mental health services must cover or 
 44.7   provide mental health services ordered by a court of competent 
 44.8   jurisdiction under a court order that is issued on the basis of 
 44.9   a behavioral care evaluation, performed by a licensed 
 44.10  psychiatrist or a doctoral level licensed psychologist, which 
 44.11  includes a diagnosis and an individual treatment plan for care 
 44.12  in the most appropriate, least restrictive environment.  The 
 44.13  health plan company must be given a copy of the court order and 
 44.14  behavioral evaluation.  The health plan company shall be 
 44.15  financially liable for the evaluation if performed by a 
 44.16  participating provider of the health plan company and shall be 
 44.17  financially liable for the care included in the court-ordered 
 44.18  treatment plan if the care is covered by the health plan company 
 44.19  and ordered to be provided by a participating provider or 
 44.20  another provider as required by rule or statute.  This 
 44.21  court-ordered coverage must not be subject to a separate medical 
 44.22  necessity determination by a health plan company under its 
 44.23  utilization procedures.  
 44.24     Sec. 4.  [EFFECTIVE DATE.] 
 44.25     This article is effective January 1, 2002, and applies to 
 44.26  contracts issued or renewed on or after that date. 
 44.27                             ARTICLE 6
 44.28                     OTHER MENTAL HEALTH ISSUES 
 44.29     Section 1.  Minnesota Statutes 2000, section 256B.69, is 
 44.30  amended by adding a subdivision to read: 
 44.31     Subd. 28.  [DISENROLLMENT DUE TO DISABILITY STATUS OR 
 44.32  EXCLUDED PLACEMENT.] If a recipient is disenrolled from the 
 44.33  prepaid medical assistance program as a result of a change in 
 44.34  eligibility status due to disability or placement in an 
 44.35  institution for mental disease or other excluded placement, the 
 44.36  prepaid health plan shall remain financially liable for all 
 45.1   medical assistance services provided to the individual for a 
 45.2   period of 90 days from the date of disenrollment, if the prepaid 
 45.3   health plan would have been obligated to provide those services 
 45.4   had the individual remained enrolled in the prepaid medical 
 45.5   assistance program. 
 45.6      Sec. 2.  Minnesota Statutes 2000, section 256B.69, is 
 45.7   amended by adding a subdivision to read: 
 45.8      Subd. 29.  [INFORMATION ON BEHAVIORAL HEALTH CARE.] (a) The 
 45.9   commissioner shall develop a standard definition of behavioral 
 45.10  health care services based on claims, procedures, and encounter 
 45.11  data, and beginning January 1, 2002, for prepaid medical 
 45.12  assistance, prepaid general assistance medical care, and 
 45.13  MinnesotaCare program contracts renewed, entered into, or in 
 45.14  effect on or after that date, shall collect behavioral health 
 45.15  claims data from prepaid health plans.  For each prepaid health 
 45.16  plan, the commissioner shall calculate on a quarterly basis the 
 45.17  ratio of expenditures for behavioral health services to the 
 45.18  total capitation payment received, and shall make this 
 45.19  information available to the public upon request. 
 45.20     (b) Beginning January 1, 2002, for prepaid medical 
 45.21  assistance program contracts renewed, entered into, or in effect 
 45.22  on or after that date, the commissioner shall collect 
 45.23  information from prepaid health plans on:  (1) the number of 
 45.24  enrollees disenrolled as a result of a change in eligibility 
 45.25  status due to disability or placement in an institution for 
 45.26  mental diseases or other excluded placement; and (2) changes in 
 45.27  the health condition of the enrollee that led to the change.  
 45.28  The commissioner shall make information on each prepaid health 
 45.29  plan available to the public upon request, in a form that does 
 45.30  not identify individual enrollees. 
 45.31     Sec. 3.  [DEVELOPMENT OF PAYMENT SYSTEM FOR ADULT 
 45.32  RESIDENTIAL SERVICES GRANTS.] 
 45.33     The commissioner of human services shall review funding 
 45.34  methods for adult residential services grants under Minnesota 
 45.35  Rules, parts 9535.2000 to 9535.3000, and shall develop a payment 
 45.36  system that takes into account client difficulty of care as 
 46.1   manifested by client physical, mental, or behavioral 
 46.2   conditions.  The payment system must provide reimbursement for 
 46.3   education, consultation, and support services provided to 
 46.4   families and other individuals as an extension of the treatment 
 46.5   process.  The commissioner shall present recommendations and 
 46.6   draft legislation for an adult residential services payment 
 46.7   system to the legislature by January 15, 2002.  The 
 46.8   recommendations must address whether additional funding for 
 46.9   adult residential services grants is necessary for the provision 
 46.10  of high quality services under a payment reimbursement system. 
 46.11     Sec. 4.  [DELIVERY OF SERVICES TO INDIVIDUALS WITH DUAL 
 46.12  DIAGNOSES.] 
 46.13     The commissioner of human services shall develop plans to 
 46.14  improve the delivery of services to individuals with dual 
 46.15  diagnoses of: 
 46.16     (1) serious and persistent mental illness and chemical 
 46.17  dependency; 
 46.18     (2) serious emotional disturbance and chemical dependency; 
 46.19     (3) mental illness and developmental disability; 
 46.20     (4) mental illness and traumatic brain injury; and 
 46.21     (5) serious emotional disturbance and developmental 
 46.22  disability.  
 46.23  The plans must address the coordination and integration of 
 46.24  programs and funding sources and include recommendations for 
 46.25  modifying state grants and provider reimbursement rates based on 
 46.26  complexity of condition and the level of care needed by an 
 46.27  individual or group of individuals.  The commissioner shall 
 46.28  present the plans and any statutory changes needed to implement 
 46.29  the plans to the legislature by February 1, 2002.