1.1 A bill for an act 1.2 relating to human services; establishing medical assistance coverage of psychiatric 1.3 collaborative care model services; appropriating money; proposing coding for new 1.4 law in Minnesota Statutes, chapter 256B. 1.5BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF MINNESOTA: 1.6 Section 1. [256B.077] PSYCHIATRIC COLLABORATIVE CARE MODEL. 1.7 Subdivision 1.Definitions.(a) For the purposes of this section, the following terms have 1.8the meanings given. 1.9 (b) "Behavioral health care manager" means an individual who: 1.10 (1) is clinical staff; 1.11 (2) has formal education or specialized training in behavioral health; 1.12 (3) works under the oversight and direction of a treating medical provider; 1.13 (4) meets the qualifications for a mental health professional, mental health practitioner, 1.14or clinical trainee set forth in section 245I.04; and 1.15 (5) is directly employed by or working under contract for the treating medical provider. 1.16Behavioral health care manager includes a licensed addiction counselor or registered nurse 1.17with training and experience in behavioral health when treating a substance use disorder. 1.18 (c) "Eligible individual" means an individual diagnosed with a mental illness, substance 1.19use disorder, or other behavioral health condition by a treating medical provider. 1Section 1. REVISOR AGW H0958-1HF958 FIRST ENGROSSMENT State of Minnesota This Document can be made available in alternative formats upon request HOUSE OF REPRESENTATIVES H. F. No. 958 NINETY-FOURTH SESSION Authored by Nadeau, Bierman, Backer, Perryman, Elkins and others02/17/2025 The bill was read for the first time and referred to the Committee on Health Finance and Policy Adoption of Report: Amended and re-referred to the Committee on Human Services Finance and Policy03/03/2025 2.1 (d) "Initial psychiatric collaborative care management" means psychiatric collaborative 2.2care management directed by the treating medical provider, including the following with 2.3appropriate documentation: 2.4 (1) outreach and engagement; 2.5 (2) initial assessment; 2.6 (3) development of an individualized treatment plan; 2.7 (4) review of a treatment plan by a psychiatric consultant; 2.8 (5) entry into the patient registry; and 2.9 (6) brief interventions using evidence-based techniques. 2.10 (e) "Psychiatric collaborative care model services" means medical services provided 2.11under an evidence-based model of behavioral health integration that utilizes behavioral 2.12health care management and psychiatric consultation provided through a formal collaborative 2.13arrangement among a primary care team consisting of a primary care provider, a care 2.14manager, and a psychiatric consultant. Psychiatric collaborative care model services include 2.15but are not limited to initial and subsequent psychiatric collaborative care management. 2.16 (f) "Psychiatric consultant" means an individual who: 2.17 (1) is qualified as a licensed physician, psychiatrist, medical professional specializing 2.18in addiction medicine, advanced practice registered nurse, or a physician assistant; 2.19 (2) is directly employed by or working under contract for the treating medical provider; 2.20and 2.21 (3) supports the treating medical provider and behavioral health care manager in the 2.22patient's treatment. 2.23 (g) "Subsequent psychiatric collaborative care management" means psychiatric 2.24collaborative care management directed by the treating medical provider, including the 2.25following with appropriate documentation: 2.26 (1) tracking individual follow-up and progress using the registry; 2.27 (2) weekly caseload consultation with the psychiatric consultant; 2.28 (3) collaboration and coordination of the individual's behavioral health care with the 2.29treating medical provider and any other treating behavioral health providers; 2.30 (4) review of progress and recommended treatment modifications, including medication 2.31management; 2Section 1. REVISOR AGW H0958-1HF958 FIRST ENGROSSMENT 3.1 (5) brief interventions using evidence-based techniques; and 3.2 (6) monitoring of individual outcomes with (i) routine use of clinically appropriate and 3.3culturally responsive validated rating scales, and (ii) relapse prevention planning with 3.4individuals as they achieve remission of symptoms or other treatment goals and are prepared 3.5for discharge from active treatment. 3.6 (h) "Treating medical provider" means a primary care physician, advanced practice 3.7registered nurse, or physician assistant that bills for psychiatric collaborative care services 3.8and oversees all aspects of the individual's health care working in collaboration with the 3.9individual's behavioral health care manager and psychiatric consultant. 3.10 Subd. 2.Psychiatric collaborative care model covered.Medical assistance covers 3.11psychiatric collaborative care model services for eligible individuals. 3.12 Subd. 3.Psychiatric collaborative care provider requirements.A provider must meet 3.13the following conditions to be eligible for reimbursement under this section: 3.14 (1) be an enrolled provider in the Minnesota Health Care Programs; 3.15 (2) attest that care will be delivered consistent with the core principles and fidelity to 3.16the psychiatric collaborative care model in the manner determined by the commissioner; 3.17 (3) provide a primary care or behavioral health service covered by medical assistance; 3.18 (4) utilize an electronic health record; 3.19 (5) utilize an electronic patient registry that contains relevant data elements; 3.20 (6) have policies and procedures to track referrals to ensure that the referral meets the 3.21individual's needs; 3.22 (7) conduct subsequent psychiatric collaborative care management; 3.23 (8) agree to cooperate with and participate in the state's monitoring and evaluation of 3.24psychiatric collaborative care model services in the manner determined by the commissioner; 3.25and 3.26 (9) obtain the individual's verbal or written consent to begin receiving psychiatric 3.27collaborative care model services and to consult with relevant specialists in the manner 3.28determined by the commissioner. 3.29 Subd. 4.Expressly allowable sites.Sites eligible to bill for services provided under this 3.30section include but are not limited to federally qualified health centers and rural health 3.31centers. 3Section 1. REVISOR AGW H0958-1HF958 FIRST ENGROSSMENT 4.1 Subd. 5.Payments.The commissioner must make payments to the treating medical 4.2provider at the current Medicare reimbursement rate. 4.3 Subd. 6.Evaluation.(a) The commissioner must identify and collect data and outcome 4.4measures from providers of psychiatric collaborative care model services. 4.5 (b) The commissioner must review the rates required under subdivision 5 on a regular 4.6basis to ensure adequate sustainability. 4.7 (c) The commissioner's findings under this subdivision may be used to establish provider 4.8standards, modify services and eligibility, or recommend funding for provider learning 4.9communities. 4.10 EFFECTIVE DATE.This section is effective January 1, 2026, or upon federal approval, 4.11whichever is later. The commissioner of human services shall notify the revisor of statutes 4.12when federal approval is obtained. 4.13 Sec. 2. APPROPRIATIONS. 4.14 (a) $500,000 in fiscal year 2026 and $500,000 in fiscal year 2027 are appropriated from 4.15the ....... fund to the commissioner of human services for grants that cover start-up and 4.16capacity building costs of implementing a psychiatric collaborative care model including 4.17but not limited to training for providers, establishing a required patient registry, and enrolling 4.18initial patients. 4.19 (b) This section expires June 30, 2035. 4Sec. 2. REVISOR AGW H0958-1HF958 FIRST ENGROSSMENT