Minnesota 2025-2026 Regular Session

Minnesota Senate Bill SF1811 Compare Versions

Only one version of the bill is available at this time.

Old	New	Differences
1	1	1.1 A bill for an act
2	2	1.2 relating to behavioral health; adding occupational therapy services, occupational
3	3	1.3 therapists, and occupational therapy assistants to mental health uniform service
4	4	1.4 standards, mental health services, and children's mental health grants; amending
5	5	1.5 Minnesota Statutes 2024, sections 245.4889, subdivision 1; 245I.02, by adding
6	6	1.6 subdivisions; 245I.04, by adding subdivisions; 245I.23, subdivisions 2, 4, 5;
7	7	1.7 256B.0622, subdivisions 2, 7a; 256B.0671, subdivision 3; 256B.0941, subdivision
8	8	1.8 2; 256B.0943, subdivisions 1, 2, 7, 9; 256B.0947, subdivisions 2, 3a, 5.
9	9	1.9BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF MINNESOTA:
10	10	1.10 Section 1. Minnesota Statutes 2024, section 245.4889, subdivision 1, is amended to read:
11	11	1.11 Subdivision 1.Establishment and authority.(a) The commissioner is authorized to
12	12	1.12make grants from available appropriations to assist:
13	13	1.13 (1) counties;
14	14	1.14 (2) Indian tribes;
15	15	1.15 (3) children's collaboratives under section 142D.15 or 245.493; or
16	16	1.16 (4) mental health service providers.
17	17	1.17 (b) The following services are eligible for grants under this section:
18	18	1.18 (1) services to children with emotional disturbances as defined in section 245.4871,
19	19	1.19subdivision 15, and their families;
20	20	1.20 (2) transition services under section 245.4875, subdivision 8, for young adults under
21	21	1.21age 21 and their families;
22	22	1.22 (3) respite care services for children with emotional disturbances or severe emotional
23	23	1.23disturbances who are at risk of residential treatment or hospitalization, who are already in
24	24	1Section 1.
25	25	25-02621 as introduced01/23/25 REVISOR DTT/LJ
26	26	SENATE
27	27	STATE OF MINNESOTA
28	28	S.F. No. 1811NINETY-FOURTH SESSION
29	29	(SENATE AUTHORS: KUPEC, Abeler and Hoffman)
30	30	OFFICIAL STATUSD-PGDATE
31	31	Introduction and first reading02/24/2025
32	32	Referred to Health and Human Services 2.1out-of-home placement in family foster settings as defined in chapter 142B and at risk of
33	33	2.2change in out-of-home placement or placement in a residential facility or other higher level
34	34	2.3of care, who have utilized crisis services or emergency room services, or who have
35	35	2.4experienced a loss of in-home staffing support. Allowable activities and expenses for respite
36	36	2.5care services are defined under subdivision 4. A child is not required to have case
37	37	2.6management services to receive respite care services. Counties must work to provide access
38	38	2.7to regularly scheduled respite care;
39	39	2.8 (4) children's mental health crisis services;
40	40	2.9 (5) child-, youth-, and family-specific mobile response and stabilization services models;
41	41	2.10 (6) mental health services for people from cultural and ethnic minorities, including
42	42	2.11supervision of clinical trainees who are Black, indigenous, or people of color;
43	43	2.12 (7) children's mental health screening and follow-up diagnostic assessment and treatment;
44	44	2.13 (8) services to promote and develop the capacity of providers to use evidence-based
45	45	2.14practices in providing children's mental health services;
46	46	2.15 (9) school-linked mental health services under section 245.4901;
47	47	2.16 (10) building evidence-based mental health intervention capacity for children birth to
48	48	2.17age five;
49	49	2.18 (11) suicide prevention and counseling services that use text messaging statewide;
50	50	2.19 (12) mental health first aid training;
51	51	2.20 (13) training for parents, collaborative partners, and mental health providers on the
52	52	2.21impact of adverse childhood experiences and trauma and development of an interactive
53	53	2.22website to share information and strategies to promote resilience and prevent trauma;
54	54	2.23 (14) transition age services to develop or expand mental health treatment and supports
55	55	2.24for adolescents and young adults 26 years of age or younger;
56	56	2.25 (15) early childhood mental health consultation;
57	57	2.26 (16) evidence-based interventions for youth at risk of developing or experiencing a first
58	58	2.27episode of psychosis, and a public awareness campaign on the signs and symptoms of
59	59	2.28psychosis;
60	60	2.29 (17) psychiatric consultation for primary care practitioners; and
61	61	2.30 (18) providers to begin operations and meet program requirements when establishing a
62	62	2.31new children's mental health program. These may be start-up grants.; and
63	63	2Section 1.
64	64	25-02621 as introduced01/23/25 REVISOR DTT/LJ 3.1 (19) occupational therapy services as defined in section 245I.02, subdivision 29b, for
65	65	3.2children with emotional disturbances.
66	66	3.3 (c) Services under paragraph (b) must be designed to help each child to function and
67	67	3.4remain with the child's family in the community and delivered consistent with the child's
68	68	3.5treatment plan. Transition services to eligible young adults under this paragraph must be
69	69	3.6designed to foster independent living in the community.
70	70	3.7 (d) As a condition of receiving grant funds, a grantee shall obtain all available third-party
71	71	3.8reimbursement sources, if applicable.
72	72	3.9 (e) The commissioner may establish and design a pilot program to expand the mobile
73	73	3.10response and stabilization services model for children, youth, and families. The commissioner
74	74	3.11may use grant funding to consult with a qualified expert entity to assist in the formulation
75	75	3.12of measurable outcomes and explore and position the state to submit a Medicaid state plan
76	76	3.13amendment to scale the model statewide.
77	77	3.14 Sec. 2. Minnesota Statutes 2024, section 245I.02, is amended by adding a subdivision to
78	78	3.15read:
79	79	3.16 Subd. 29a.Occupational therapist or occupational therapy assistant."Occupational
80	80	3.17therapist or occupational therapy assistant" means a staff person who is qualified under
81	81	3.18section 245I.04, subdivision 20.
82	82	3.19 Sec. 3. Minnesota Statutes 2024, section 245I.02, is amended by adding a subdivision to
83	83	3.20read:
84	84	3.21 Subd. 29b.Occupational therapy services."Occupational therapy services" means
85	85	3.22services related to behavioral health provided to a client within the scope of practice for
86	86	3.23occupational therapists and occupational therapy assistants under section 148.6404. A license
87	87	3.24or certification holder may offer and provide for occupational therapy services as part of a
88	88	3.25client's behavioral health assessment, treatment planning, and treatment services.
89	89	3.26Occupational therapy services include but are not limited to screening, evaluation,
90	90	3.27intervention, and consultation to develop, recover, and maintain a client's:
91	91	3.28 (1) sensory integrative, neuromuscular, motor, emotional, motivational, cognitive, or
92	92	3.29psychosocial components of performance;
93	93	3.30 (2) daily living skills;
94	94	3.31 (3) feeding and swallowing skills;
95	95	3Sec. 3.
96	96	25-02621 as introduced01/23/25 REVISOR DTT/LJ 4.1 (4) play and leisure skills;
97	97	4.2 (5) educational participation skills;
98	98	4.3 (6) functional performance and work participation skills;
99	99	4.4 (7) community mobility; and
100	100	4.5 (8) health and wellness.
101	101	4.6 Sec. 4. Minnesota Statutes 2024, section 245I.04, is amended by adding a subdivision to
102	102	4.7read:
103	103	4.8 Subd. 20.Occupational therapist and occupational therapy assistant qualifications.In
104	104	4.9order to provide occupational therapy services in a behavioral health setting, an occupational
105	105	4.10therapist or occupational therapy assistant must:
106	106	4.11 (1) be licensed under sections 148.6401 to 148.6450;
107	107	4.12 (2) for an occupational therapist, complete at least 480 hours of supervised work
108	108	4.13experience in a behavioral health treatment setting; and
109	109	4.14 (3) for an occupational therapy assistant, complete at least 320 hours of supervised work
110	110	4.15experience in a behavioral health treatment setting.
111	111	4.16 Sec. 5. Minnesota Statutes 2024, section 245I.04, is amended by adding a subdivision to
112	112	4.17read:
113	113	4.18 Subd. 21.Occupational therapist and occupational therapy assistant scope of
114	114	4.19practice.(a) An occupational therapist must maintain a valid license and must only provide
115	115	4.20occupational therapy services to a client within the occupational therapist's scope of practice
116	116	4.21under section 148.6404.
117	117	4.22 (b) An occupational therapy assistant must maintain a valid license and must only provide
118	118	4.23occupational therapy services to a client within the scope of practice under section 148.6404,
119	119	4.24under the supervision of an occupational therapist pursuant to section 148.6432.
120	120	4.25 Sec. 6. Minnesota Statutes 2024, section 245I.23, subdivision 2, is amended to read:
121	121	4.26 Subd. 2.Definitions.(a) "Program location" means a set of rooms that are each physically
122	122	4.27self-contained and have defining walls extending from floor to ceiling. Program location
123	123	4.28includes bedrooms, living rooms or lounge areas, bathrooms, and connecting areas.
124	124	4.29 (b) "Treatment team" means a group of staff persons who provide intensive residential
125	125	4.30treatment services or residential crisis stabilization to clients. The treatment team includes
126	126	4Sec. 6.
127	127	25-02621 as introduced01/23/25 REVISOR DTT/LJ 5.1mental health professionals, mental health practitioners, clinical trainees, certified
128	128	5.2rehabilitation specialists, mental health rehabilitation workers, and mental health certified
129	129	5.3peer specialists and may include occupational therapists or occupational therapy assistants.
130	130	5.4 Sec. 7. Minnesota Statutes 2024, section 245I.23, subdivision 4, is amended to read:
131	131	5.5 Subd. 4.Required intensive residential treatment services.(a) On a daily basis, the
132	132	5.6license holder must follow a client's treatment plan to provide intensive residential treatment
133	133	5.7services to the client to improve the client's functioning.
134	134	5.8 (b) The license holder must offer and have the capacity to directly provide the following
135	135	5.9treatment services to each client:
136	136	5.10 (1) rehabilitative mental health services;
137	137	5.11 (2) crisis prevention planning to assist a client with:
138	138	5.12 (i) identifying and addressing patterns in the client's history and experience of the client's
139	139	5.13mental illness; and
140	140	5.14 (ii) developing crisis prevention strategies that include de-escalation strategies that have
141	141	5.15been effective for the client in the past;
142	142	5.16 (3) health services and administering medication;
143	143	5.17 (4) co-occurring substance use disorder treatment;
144	144	5.18 (5) engaging the client's family and other natural supports in the client's treatment and
145	145	5.19educating the client's family and other natural supports to strengthen the client's social and
146	146	5.20family relationships; and
147	147	5.21 (6) making referrals for the client to other service providers in the community and
148	148	5.22supporting the client's transition from intensive residential treatment services to another
149	149	5.23setting.
150	150	5.24 (c) The license holder must include Illness Management and Recovery (IMR), Enhanced
151	151	5.25Illness Management and Recovery (E-IMR), or other similar interventions in the license
152	152	5.26holder's programming as approved by the commissioner.
153	153	5.27 (d) The license holder may also offer and have the capacity to directly provide medically
154	154	5.28necessary occupational therapy services to each client.
155	155	5Sec. 7.
156	156	25-02621 as introduced01/23/25 REVISOR DTT/LJ 6.1 Sec. 8. Minnesota Statutes 2024, section 245I.23, subdivision 5, is amended to read:
157	157	6.2 Subd. 5.Required residential crisis stabilization services.(a) On a daily basis, the
158	158	6.3license holder must follow a client's individual crisis treatment plan to provide services to
159	159	6.4the client in residential crisis stabilization to improve the client's functioning.
160	160	6.5 (b) The license holder must offer and have the capacity to directly provide the following
161	161	6.6treatment services to the client:
162	162	6.7 (1) crisis stabilization services as described in section 256B.0624, subdivision 7;
163	163	6.8 (2) rehabilitative mental health services;
164	164	6.9 (3) health services and administering the client's medications; and
165	165	6.10 (4) making referrals for the client to other service providers in the community and
166	166	6.11supporting the client's transition from residential crisis stabilization to another setting.
167	167	6.12 (c) The license holder may also offer and have the capacity to directly provide medically
168	168	6.13necessary occupational therapy services to each client.
169	169	6.14 Sec. 9. Minnesota Statutes 2024, section 256B.0622, subdivision 2, is amended to read:
170	170	6.15 Subd. 2.Definitions.(a) For purposes of this section, the following terms have the
171	171	6.16meanings given them.
172	172	6.17 (b) "ACT team" means the group of interdisciplinary mental health staff who work as
173	173	6.18a team to provide assertive community treatment.
174	174	6.19 (c) "Assertive community treatment" means intensive nonresidential treatment and
175	175	6.20rehabilitative mental health services provided according to the assertive community treatment
176	176	6.21model. Assertive community treatment provides a single, fixed point of responsibility for
177	177	6.22treatment, rehabilitation, and support needs for clients. Services are offered 24 hours per
178	178	6.23day, seven days per week, in a community-based setting.
179	179	6.24 (d) "Individual treatment plan" means a plan described by section 245I.10, subdivisions
180	180	6.257 and 8.
181	181	6.26 (e) "Crisis assessment and intervention" means mobile crisis response services under
182	182	6.27section 256B.0624.
183	183	6.28 (f) "Individual treatment team" means a minimum of three members of the ACT team
184	184	6.29who are responsible for consistently carrying out most of a client's assertive community
185	185	6.30treatment services.
186	186	6Sec. 9.
187	187	25-02621 as introduced01/23/25 REVISOR DTT/LJ 7.1 (g) "Primary team member" means the person who leads and coordinates the activities
188	188	7.2of the individual treatment team and is the individual treatment team member who has
189	189	7.3primary responsibility for establishing and maintaining a therapeutic relationship with the
190	190	7.4client on a continuing basis.
191	191	7.5 (h) "Certified rehabilitation specialist" means a staff person who is qualified according
192	192	7.6to section 245I.04, subdivision 8.
193	193	7.7 (i) "Clinical trainee" means a staff person who is qualified according to section 245I.04,
194	194	7.8subdivision 6.
195	195	7.9 (j) "Mental health certified peer specialist" means a staff person who is qualified
196	196	7.10according to section 245I.04, subdivision 10.
197	197	7.11 (k) "Mental health practitioner" means a staff person who is qualified according to section
198	198	7.12245I.04, subdivision 4.
199	199	7.13 (l) "Mental health professional" means a staff person who is qualified according to
200	200	7.14section 245I.04, subdivision 2.
201	201	7.15 (m) "Mental health rehabilitation worker" means a staff person who is qualified according
202	202	7.16to section 245I.04, subdivision 14.
203	203	7.17 (n) "Occupational therapist or occupational therapy assistant" means a staff person who
204	204	7.18is qualified according to section 245I.04, subdivision 20.
205	205	7.19 Sec. 10. Minnesota Statutes 2024, section 256B.0622, subdivision 7a, is amended to read:
206	206	7.20 Subd. 7a.Assertive community treatment team staff requirements and roles.(a)
207	207	7.21The required treatment staff qualifications and roles for an ACT team are:
208	208	7.22 (1) the team leader:
209	209	7.23 (i) shall be a mental health professional. Individuals who are not licensed but who are
210	210	7.24eligible for licensure and are otherwise qualified may also fulfill this role;
211	211	7.25 (ii) must be an active member of the ACT team and provide some direct services to
212	212	7.26clients;
213	213	7.27 (iii) must be a single full-time staff member, dedicated to the ACT team, who is
214	214	7.28responsible for overseeing the administrative operations of the team and supervising team
215	215	7.29members to ensure delivery of best and ethical practices; and
216	216	7Sec. 10.
217	217	25-02621 as introduced01/23/25 REVISOR DTT/LJ 8.1 (iv) must be available to ensure that overall treatment supervision to the ACT team is
218	218	8.2available after regular business hours and on weekends and holidays and is provided by a
219	219	8.3qualified member of the ACT team;
220	220	8.4 (2) the psychiatric care provider:
221	221	8.5 (i) must be a mental health professional permitted to prescribe psychiatric medications
222	222	8.6as part of the mental health professional's scope of practice. The psychiatric care provider
223	223	8.7must have demonstrated clinical experience working with individuals with serious and
224	224	8.8persistent mental illness;
225	225	8.9 (ii) shall collaborate with the team leader in sharing overall clinical responsibility for
226	226	8.10screening and admitting clients; monitoring clients' treatment and team member service
227	227	8.11delivery; educating staff on psychiatric and nonpsychiatric medications, their side effects,
228	228	8.12and health-related conditions; actively collaborating with nurses; and helping provide
229	229	8.13treatment supervision to the team;
230	230	8.14 (iii) shall fulfill the following functions for assertive community treatment clients:
231	231	8.15provide assessment and treatment of clients' symptoms and response to medications, including
232	232	8.16side effects; provide brief therapy to clients; provide diagnostic and medication education
233	233	8.17to clients, with medication decisions based on shared decision making; monitor clients'
234	234	8.18nonpsychiatric medical conditions and nonpsychiatric medications; and conduct home and
235	235	8.19community visits;
236	236	8.20 (iv) shall serve as the point of contact for psychiatric treatment if a client is hospitalized
237	237	8.21for mental health treatment and shall communicate directly with the client's inpatient
238	238	8.22psychiatric care providers to ensure continuity of care;
239	239	8.23 (v) shall have a minimum full-time equivalency that is prorated at a rate of 16 hours per
240	240	8.2450 clients. Part-time psychiatric care providers shall have designated hours to work on the
241	241	8.25team, with sufficient blocks of time on consistent days to carry out the provider's clinical,
242	242	8.26supervisory, and administrative responsibilities. No more than two psychiatric care providers
243	243	8.27may share this role; and
244	244	8.28 (vi) shall provide psychiatric backup to the program after regular business hours and on
245	245	8.29weekends and holidays. The psychiatric care provider may delegate this duty to another
246	246	8.30qualified psychiatric provider;
247	247	8.31 (3) the nursing staff:
248	248	8.32 (i) shall consist of one to three registered nurses or advanced practice registered nurses,
249	249	8.33of whom at least one has a minimum of one-year experience working with adults with
250	250	8Sec. 10.
251	251	25-02621 as introduced01/23/25 REVISOR DTT/LJ 9.1serious mental illness and a working knowledge of psychiatric medications. No more than
252	252	9.2two individuals can share a full-time equivalent position;
253	253	9.3 (ii) are responsible for managing medication, administering and documenting medication
254	254	9.4treatment, and managing a secure medication room; and
255	255	9.5 (iii) shall develop strategies, in collaboration with clients, to maximize taking medications
256	256	9.6as prescribed; screen and monitor clients' mental and physical health conditions and
257	257	9.7medication side effects; engage in health promotion, prevention, and education activities;
258	258	9.8communicate and coordinate services with other medical providers; facilitate the development
259	259	9.9of the individual treatment plan for clients assigned; and educate the ACT team in monitoring
260	260	9.10psychiatric and physical health symptoms and medication side effects;
261	261	9.11 (4) the co-occurring disorder specialist:
262	262	9.12 (i) shall be a full-time equivalent co-occurring disorder specialist who has received
263	263	9.13specific training on co-occurring disorders that is consistent with national evidence-based
264	264	9.14practices. The training must include practical knowledge of common substances and how
265	265	9.15they affect mental illnesses, the ability to assess substance use disorders and the client's
266	266	9.16stage of treatment, motivational interviewing, and skills necessary to provide counseling to
267	267	9.17clients at all different stages of change and treatment. The co-occurring disorder specialist
268	268	9.18may also be an individual who is a licensed alcohol and drug counselor as described in
269	269	9.19section 148F.01, subdivision 5, or a counselor who otherwise meets the training, experience,
270	270	9.20and other requirements in section 245G.11, subdivision 5. No more than two co-occurring
271	271	9.21disorder specialists may occupy this role; and
272	272	9.22 (ii) shall provide or facilitate the provision of co-occurring disorder treatment to clients.
273	273	9.23The co-occurring disorder specialist shall serve as a consultant and educator to fellow ACT
274	274	9.24team members on co-occurring disorders;
275	275	9.25 (5) the vocational specialist:
276	276	9.26 (i) shall be a full-time vocational specialist who has at least one-year experience providing
277	277	9.27employment services or advanced education that involved field training in vocational services
278	278	9.28to individuals with mental illness. An individual who does not meet these qualifications
279	279	9.29may also serve as the vocational specialist upon completing a training plan approved by the
280	280	9.30commissioner;
281	281	9.31 (ii) shall provide or facilitate the provision of vocational services to clients. The vocational
282	282	9.32specialist serves as a consultant and educator to fellow ACT team members on these services;
283	283	9.33and
284	284	9Sec. 10.
285	285	25-02621 as introduced01/23/25 REVISOR DTT/LJ 10.1 (iii) must not refer individuals to receive any type of vocational services or linkage by
286	286	10.2providers outside of the ACT team;
287	287	10.3 (6) the mental health certified peer specialist:
288	288	10.4 (i) shall be a full-time equivalent. No more than two individuals can share this position.
289	289	10.5The mental health certified peer specialist is a fully integrated team member who provides
290	290	10.6highly individualized services in the community and promotes the self-determination and
291	291	10.7shared decision-making abilities of clients. This requirement may be waived due to workforce
292	292	10.8shortages upon approval of the commissioner;
293	293	10.9 (ii) must provide coaching, mentoring, and consultation to the clients to promote recovery,
294	294	10.10self-advocacy, and self-direction, promote wellness management strategies, and assist clients
295	295	10.11in developing advance directives; and
296	296	10.12 (iii) must model recovery values, attitudes, beliefs, and personal action to encourage
297	297	10.13wellness and resilience, provide consultation to team members, promote a culture where
298	298	10.14the clients' points of view and preferences are recognized, understood, respected, and
299	299	10.15integrated into treatment, and serve in a manner equivalent to other team members;
300	300	10.16 (7) the program administrative assistant shall be a full-time office-based program
301	301	10.17administrative assistant position assigned to solely work with the ACT team, providing a
302	302	10.18range of supports to the team, clients, and families; and
303	303	10.19 (8) additional staff:
304	304	10.20 (i) shall be based on team size. Additional treatment team staff may include mental
305	305	10.21health professionals; clinical trainees; certified rehabilitation specialists; mental health
306	306	10.22practitioners; or mental health rehabilitation workers; or occupational therapists or
307	307	10.23occupational therapy assistants. These individuals shall have the knowledge, skills, and
308	308	10.24abilities required by the population served to carry out rehabilitation and support functions;
309	309	10.25and
310	310	10.26 (ii) shall be selected based on specific program needs or the population served.
311	311	10.27 (b) Each ACT team must clearly document schedules for all ACT team members.
312	312	10.28 (c) Each ACT team member must serve as a primary team member for clients assigned
313	313	10.29by the team leader and are responsible for facilitating the individual treatment plan process
314	314	10.30for those clients. The primary team member for a client is the responsible team member
315	315	10.31knowledgeable about the client's life and circumstances and writes the individual treatment
316	316	10.32plan. The primary team member provides individual supportive therapy or counseling, and
317	317	10.33provides primary support and education to the client's family and support system.
318	318	10Sec. 10.
319	319	25-02621 as introduced01/23/25 REVISOR DTT/LJ 11.1 (d) Members of the ACT team must have strong clinical skills, professional qualifications,
320	320	11.2experience, and competency to provide a full breadth of rehabilitation services. Each staff
321	321	11.3member shall be proficient in their respective discipline and be able to work collaboratively
322	322	11.4as a member of a multidisciplinary team to deliver the majority of the treatment,
323	323	11.5rehabilitation, and support services clients require to fully benefit from receiving assertive
324	324	11.6community treatment.
325	325	11.7 (e) Each ACT team member must fulfill training requirements established by the
326	326	11.8commissioner.
327	327	11.9 Sec. 11. Minnesota Statutes 2024, section 256B.0671, subdivision 3, is amended to read:
328	328	11.10 Subd. 3.Adult day treatment services.(a) Medical assistance covers adult day treatment
329	329	11.11(ADT) services that are provided under contract with the county board. Adult day treatment
330	330	11.12payment is subject to the conditions in paragraphs (b) to (e). The provider must make
331	331	11.13reasonable and good faith efforts to report individual client outcomes to the commissioner
332	332	11.14using instruments, protocols, and forms approved by the commissioner.
333	333	11.15 (b) Adult day treatment is an intensive psychotherapeutic treatment to reduce or relieve
334	334	11.16the effects of mental illness on a client to enable the client to benefit from a lower level of
335	335	11.17care and to live and function more independently in the community. Adult day treatment
336	336	11.18services must be provided to a client to stabilize the client's mental health and to improve
337	337	11.19the client's independent living and socialization skills. Adult day treatment must consist of
338	338	11.20at least one hour of group psychotherapy and must include group time focused on
339	339	11.21rehabilitative interventions or other therapeutic services that a multidisciplinary team provides
340	340	11.22to each client. Adult day treatment services are not a part of inpatient or residential treatment
341	341	11.23services. The following providers may apply to become adult day treatment providers:
342	342	11.24 (1) a hospital with Centers for Medicare and Medicaid Services approved hospital
343	343	11.25accreditation and licensed under sections 144.50 to 144.55;
344	344	11.26 (2) a community mental health center under section 256B.0625, subdivision 5; or
345	345	11.27 (3) an entity that is under contract with the county board to operate a program that meets
346	346	11.28the requirements of section 245.4712, subdivision 2, and Minnesota Rules, parts 9505.0170
347	347	11.29to 9505.0475.
348	348	11.30 (c) An adult day treatment services provider must:
349	349	11.31 (1) ensure that the commissioner has approved of the organization as an adult day
350	350	11.32treatment provider organization;
351	351	11Sec. 11.
352	352	25-02621 as introduced01/23/25 REVISOR DTT/LJ 12.1 (2) ensure that a multidisciplinary team provides ADT services to a group of clients. A
353	353	12.2mental health professional must supervise each multidisciplinary staff person who provides
354	354	12.3ADT services;
355	355	12.4 (3) make ADT services available to the client at least two days a week for at least three
356	356	12.5consecutive hours per day. ADT services may be longer than three hours per day, but medical
357	357	12.6assistance may not reimburse a provider for more than 15 hours per week;
358	358	12.7 (4) provide ADT services to each client that includes group psychotherapy by a mental
359	359	12.8health professional or clinical trainee and daily rehabilitative interventions by a mental
360	360	12.9health professional, clinical trainee, or mental health practitioner; and
361	361	12.10 (5) include ADT services in the client's individual treatment plan, when appropriate.
362	362	12.11The adult day treatment provider must:
363	363	12.12 (i) complete a functional assessment of each client under section 245I.10, subdivision
364	364	12.139;
365	365	12.14 (ii) notwithstanding section 245I.10, subdivision 8, review the client's progress and
366	366	12.15update the individual treatment plan at least every 90 days until the client is discharged
367	367	12.16from the program; and
368	368	12.17 (iii) include a discharge plan for the client in the client's individual treatment plan.
369	369	12.18 (d) An adult day treatment services provider may make skilled occupational therapy
370	370	12.19services, provided by an occupational therapist or occupational therapy assistant who is
371	371	12.20qualified according to section 245I.04, subdivision 20, available to each client.
372	372	12.21 (d) (e) To be eligible for adult day treatment, a client must:
373	373	12.22 (1) be 18 years of age or older;
374	374	12.23 (2) not reside in a nursing facility, hospital, institute of mental disease, or state-operated
375	375	12.24treatment center unless the client has an active discharge plan that indicates a move to an
376	376	12.25independent living setting within 180 days;
377	377	12.26 (3) have the capacity to engage in rehabilitative programming, skills activities, and
378	378	12.27psychotherapy in the structured, therapeutic setting of an adult day treatment program and
379	379	12.28demonstrate measurable improvements in functioning resulting from participation in the
380	380	12.29adult day treatment program;
381	381	12.30 (4) have a level of care assessment under section 245I.02, subdivision 19, recommending
382	382	12.31that the client participate in services with the level of intensity and duration of an adult day
383	383	12.32treatment program; and
384	384	12Sec. 11.
385	385	25-02621 as introduced01/23/25 REVISOR DTT/LJ 13.1 (5) have the recommendation of a mental health professional for adult day treatment
386	386	13.2services. The mental health professional must find that adult day treatment services are
387	387	13.3medically necessary for the client.
388	388	13.4 (e) (f) Medical assistance does not cover the following services as adult day treatment
389	389	13.5services:
390	390	13.6 (1) services that are primarily recreational or that are provided in a setting that is not
391	391	13.7under medical supervision, including sports activities, exercise groups, craft hours, leisure
392	392	13.8time, social hours, meal or snack time, trips to community activities, and tours;
393	393	13.9 (2) social or educational services that do not have or cannot reasonably be expected to
394	394	13.10have a therapeutic outcome related to the client's mental illness;
395	395	13.11 (3) consultations with other providers or service agency staff persons about the care or
396	396	13.12progress of a client;
397	397	13.13 (4) prevention or education programs that are provided to the community;
398	398	13.14 (5) day treatment for clients with a primary diagnosis of a substance use disorder;
399	399	13.15 (6) day treatment provided in the client's home;
400	400	13.16 (7) psychotherapy for more than two hours per day; and
401	401	13.17 (8) participation in meal preparation and eating that is not part of a clinical treatment
402	402	13.18plan to address the client's eating disorder.
403	403	13.19Sec. 12. Minnesota Statutes 2024, section 256B.0941, subdivision 2, is amended to read:
404	404	13.20 Subd. 2.Services.(a) Psychiatric residential treatment facility service providers must
405	405	13.21offer and have the capacity to provide the following services:
406	406	13.22 (1) development of the individual plan of care, review of the individual plan of care
407	407	13.23every 30 days, and discharge planning by required members of the treatment team according
408	408	13.24to Code of Federal Regulations, title 42, sections 441.155 to 441.156;
409	409	13.25 (2) any services provided by a psychiatrist or physician for development of an individual
410	410	13.26plan of care, conducting a review of the individual plan of care every 30 days, and discharge
411	411	13.27planning by required members of the treatment team according to Code of Federal
412	412	13.28Regulations, title 42, sections 441.155 to 441.156;
413	413	13.29 (3) active treatment seven days per week that may include individual, family, or group
414	414	13.30therapy as determined by the individual care plan;
415	415	13.31 (4) individual therapy, provided a minimum of twice per week;
416	416	13Sec. 12.
417	417	25-02621 as introduced01/23/25 REVISOR DTT/LJ 14.1 (5) family engagement activities, provided a minimum of once per week;
418	418	14.2 (6) consultation with other professionals, including case managers, primary care
419	419	14.3professionals, community-based mental health providers, school staff, occupational therapists
420	420	14.4or occupational therapy assistants who are qualified according to section 245I.04, subdivision
421	421	14.520, if the provider offers occupational therapy services under paragraph (b), or other support
422	422	14.6planners;
423	423	14.7 (7) coordination of educational services between local and resident school districts and
424	424	14.8the facility;
425	425	14.9 (8) 24-hour nursing; and
426	426	14.10 (9) direct care and supervision, supportive services for daily living and safety, and
427	427	14.11positive behavior management.
428	428	14.12 (b) Psychiatric residential treatment facility service providers may offer and have the
429	429	14.13capacity to provide occupational therapy services under section 245I.02, subdivision 29b.
430	430	14.14Sec. 13. Minnesota Statutes 2024, section 256B.0943, subdivision 1, is amended to read:
431	431	14.15 Subdivision 1.Definitions.(a) For purposes of this section, the following terms have
432	432	14.16the meanings given them.
433	433	14.17 (b) "Children's therapeutic services and supports" means the flexible package of mental
434	434	14.18health services for children who require varying therapeutic and rehabilitative levels of
435	435	14.19intervention to treat a diagnosed emotional disturbance, as defined in section 245.4871,
436	436	14.20subdivision 15, or a diagnosed mental illness, as defined in section 245.462, subdivision
437	437	14.2120. The services are time-limited interventions that are delivered using various treatment
438	438	14.22modalities and combinations of services designed to reach treatment outcomes identified
439	439	14.23in the individual treatment plan.
440	440	14.24 (c) "Clinical trainee" means a staff person who is qualified according to section 245I.04,
441	441	14.25subdivision 6.
442	442	14.26 (d) "Crisis planning" has the meaning given in section 245.4871, subdivision 9a.
443	443	14.27 (e) "Culturally competent provider" means a provider who understands and can utilize
444	444	14.28to a client's benefit the client's culture when providing services to the client. A provider
445	445	14.29may be culturally competent because the provider is of the same cultural or ethnic group
446	446	14.30as the client or the provider has developed the knowledge and skills through training and
447	447	14.31experience to provide services to culturally diverse clients.
448	448	14Sec. 13.
449	449	25-02621 as introduced01/23/25 REVISOR DTT/LJ 15.1 (f) "Day treatment program" for children means a site-based structured mental health
450	450	15.2program consisting of psychotherapy for three or more individuals and individual or group
451	451	15.3skills training provided by a team, under the treatment supervision of a mental health
452	452	15.4professional.
453	453	15.5 (g) "Direct service time" means the time that a mental health professional, clinical trainee,
454	454	15.6mental health practitioner, or mental health behavioral aide spends face-to-face with a client
455	455	15.7and the client's family or providing covered services through telehealth as defined under
456	456	15.8section 256B.0625, subdivision 3b. Direct service time includes time in which the provider
457	457	15.9obtains a client's history, develops a client's treatment plan, records individual treatment
458	458	15.10outcomes, or provides service components of children's therapeutic services and supports.
459	459	15.11Direct service time does not include time doing work before and after providing direct
460	460	15.12services, including scheduling or maintaining clinical records.
461	461	15.13 (h) "Direction of mental health behavioral aide" means the activities of a mental health
462	462	15.14professional, clinical trainee, or mental health practitioner in guiding the mental health
463	463	15.15behavioral aide in providing services to a client. The direction of a mental health behavioral
464	464	15.16aide must be based on the client's individual treatment plan and meet the requirements in
465	465	15.17subdivision 6, paragraph (b), clause (7).
466	466	15.18 (i) "Emotional disturbance" has the meaning given in section 245.4871, subdivision 15.
467	467	15.19 (j) "Individual treatment plan" means the plan described in section 245I.10, subdivisions
468	468	15.207 and 8.
469	469	15.21 (k) "Mental health behavioral aide services" means medically necessary one-on-one
470	470	15.22activities performed by a mental health behavioral aide qualified according to section
471	471	15.23245I.04, subdivision 16, to assist a child retain or generalize psychosocial skills as previously
472	472	15.24trained by a mental health professional, clinical trainee, or mental health practitioner and
473	473	15.25as described in the child's individual treatment plan and individual behavior plan. Activities
474	474	15.26involve working directly with the child or child's family as provided in subdivision 9,
475	475	15.27paragraph (b), clause (4).
476	476	15.28 (l) "Mental health certified family peer specialist" means a staff person who is qualified
477	477	15.29according to section 245I.04, subdivision 12.
478	478	15.30 (m) "Mental health practitioner" means a staff person who is qualified according to
479	479	15.31section 245I.04, subdivision 4.
480	480	15.32 (n) "Mental health professional" means a staff person who is qualified according to
481	481	15.33section 245I.04, subdivision 2.
482	482	15Sec. 13.
483	483	25-02621 as introduced01/23/25 REVISOR DTT/LJ 16.1 (o) "Mental health service plan development" includes:
484	484	16.2 (1) development and revision of a child's individual treatment plan; and
485	485	16.3 (2) administering and reporting standardized outcome measurements approved by the
486	486	16.4commissioner, as periodically needed to evaluate the effectiveness of treatment.
487	487	16.5 (p) "Mental illness," for persons at least age 18 but under age 21, has the meaning given
488	488	16.6in section 245.462, subdivision 20, paragraph (a).
489	489	16.7 (q) "Occupational therapist or occupational therapy assistant" means a staff person who
490	490	16.8is qualified according to section 245I.04, subdivision 20.
491	491	16.9 (r) "Occupational therapy services" has the meaning given in section 245I.02, subdivision
492	492	16.1029b.
493	493	16.11 (q) (s) "Psychotherapy" means the treatment described in section 256B.0671, subdivision
494	494	16.1211.
495	495	16.13 (r) (t) "Rehabilitative services" or "psychiatric rehabilitation services" means interventions
496	496	16.14to: (1) restore a child or adolescent to an age-appropriate developmental trajectory that had
497	497	16.15been disrupted by a psychiatric illness; or (2) enable the child to self-monitor, compensate
498	498	16.16for, cope with, counteract, or replace psychosocial skills deficits or maladaptive skills
499	499	16.17acquired over the course of a psychiatric illness. Psychiatric rehabilitation services for
500	500	16.18children combine coordinated psychotherapy to address internal psychological, emotional,
501	501	16.19and intellectual processing deficits, and skills training to restore personal and social
502	502	16.20functioning. Psychiatric rehabilitation services establish a progressive series of goals with
503	503	16.21each achievement building upon a prior achievement.
504	504	16.22 (s) (u) "Skills training" means individual, family, or group training, delivered by or under
505	505	16.23the supervision of a mental health professional, designed to facilitate the acquisition of
506	506	16.24psychosocial skills that are medically necessary to rehabilitate the child to an age-appropriate
507	507	16.25developmental trajectory heretofore disrupted by a psychiatric illness or to enable the child
508	508	16.26to self-monitor, compensate for, cope with, counteract, or replace skills deficits or
509	509	16.27maladaptive skills acquired over the course of a psychiatric illness. Skills training is subject
510	510	16.28to the service delivery requirements under subdivision 9, paragraph (b), clause (2).
511	511	16.29 (t) (v) "Standard diagnostic assessment" means the assessment described in section
512	512	16.30245I.10, subdivision 6.
513	513	16.31 (u) (w) "Treatment supervision" means the supervision described in section 245I.06.
514	514	16Sec. 13.
515	515	25-02621 as introduced01/23/25 REVISOR DTT/LJ 17.1 Sec. 14. Minnesota Statutes 2024, section 256B.0943, subdivision 2, is amended to read:
516	516	17.2 Subd. 2.Covered service components of children's therapeutic services and
517	517	17.3supports.(a) Subject to federal approval, medical assistance covers medically necessary
518	518	17.4children's therapeutic services and supports when the services are provided by an eligible
519	519	17.5provider entity certified under and meeting the standards in this section. The provider entity
520	520	17.6must make reasonable and good faith efforts to report individual client outcomes to the
521	521	17.7commissioner, using instruments and protocols approved by the commissioner.
522	522	17.8 (b) The service components of children's therapeutic services and supports are:
523	523	17.9 (1) patient and/or family psychotherapy, family psychotherapy, psychotherapy for crisis,
524	524	17.10and group psychotherapy;
525	525	17.11 (2) individual, family, or group skills training provided by a mental health professional,
526	526	17.12clinical trainee, or mental health practitioner;
527	527	17.13 (3) crisis planning;
528	528	17.14 (4) mental health behavioral aide services;
529	529	17.15 (5) direction of a mental health behavioral aide;
530	530	17.16 (6) mental health service plan development; and
531	531	17.17 (7) children's day treatment.; and
532	532	17.18 (8) medically necessary occupational therapy services, provided by an occupational
533	533	17.19therapist or occupational therapy assistant.
534	534	17.20Sec. 15. Minnesota Statutes 2024, section 256B.0943, subdivision 7, is amended to read:
535	535	17.21 Subd. 7.Qualifications of individual and team providers.(a) An individual or team
536	536	17.22provider working within the scope of the provider's practice or qualifications may provide
537	537	17.23service components of children's therapeutic services and supports that are identified as
538	538	17.24medically necessary in a client's individual treatment plan.
539	539	17.25 (b) An individual provider must be qualified as a:
540	540	17.26 (1) a mental health professional;
541	541	17.27 (2) a clinical trainee;
542	542	17.28 (3) a mental health practitioner;
543	543	17.29 (4) a mental health certified family peer specialist; or
544	544	17.30 (5) a mental health behavioral aide.; or
545	545	17Sec. 15.
546	546	25-02621 as introduced01/23/25 REVISOR DTT/LJ 18.1 (6) an occupational therapist or occupational therapy assistant, for medically necessary
547	547	18.2occupational therapy services.
548	548	18.3 (c) A day treatment team must include one mental health professional or clinical trainee.
549	549	18.4 Sec. 16. Minnesota Statutes 2024, section 256B.0943, subdivision 9, is amended to read:
550	550	18.5 Subd. 9.Service delivery criteria.(a) In delivering services under this section, a certified
551	551	18.6provider entity must ensure that:
552	552	18.7 (1) the provider's caseload size should reasonably enable the provider to play an active
553	553	18.8role in service planning, monitoring, and delivering services to meet the client's and client's
554	554	18.9family's needs, as specified in each client's individual treatment plan;
555	555	18.10 (2) site-based programs, including day treatment programs, provide staffing and facilities
556	556	18.11to ensure the client's health, safety, and protection of rights, and that the programs are able
557	557	18.12to implement each client's individual treatment plan; and
558	558	18.13 (3) a day treatment program is provided to a group of clients by a team under the treatment
559	559	18.14supervision of a mental health professional. The day treatment program must be provided
560	560	18.15in and by: (i) an outpatient hospital accredited by the Joint Commission on Accreditation
561	561	18.16of Health Organizations and licensed under sections 144.50 to 144.55; (ii) a community
562	562	18.17mental health center under section 245.62; or (iii) an entity that is certified under subdivision
563	563	18.184 to operate a program that meets the requirements of section 245.4884, subdivision 2, and
564	564	18.19Minnesota Rules, parts 9505.0170 to 9505.0475. The day treatment program must stabilize
565	565	18.20the client's mental health status while developing and improving the client's independent
566	566	18.21living and socialization skills. The goal of the day treatment program must be to reduce or
567	567	18.22relieve the effects of mental illness and provide training to enable the client to live in the
568	568	18.23community. The remainder of the structured treatment program may include patient and/or
569	569	18.24family or group psychotherapy, and individual or group skills training, if included in the
570	570	18.25client's individual treatment plan. Day treatment programs are not part of inpatient or
571	571	18.26residential treatment services. When a day treatment group that meets the minimum group
572	572	18.27size requirement temporarily falls below the minimum group size because of a member's
573	573	18.28temporary absence, medical assistance covers a group session conducted for the group
574	574	18.29members in attendance. A day treatment program may provide fewer than the minimally
575	575	18.30required hours for a particular child during a billing period in which the child is transitioning
576	576	18.31into, or out of, the program.
577	577	18Sec. 16.
578	578	25-02621 as introduced01/23/25 REVISOR DTT/LJ 19.1 (b) To be eligible for medical assistance payment, a provider entity must deliver the
579	579	19.2service components of children's therapeutic services and supports in compliance with the
580	580	19.3following requirements:
581	581	19.4 (1) psychotherapy to address the child's underlying mental health disorder must be
582	582	19.5documented as part of the child's ongoing treatment. A provider must deliver or arrange for
583	583	19.6medically necessary psychotherapy unless the child's parent or caregiver chooses not to
584	584	19.7receive it or the provider determines that psychotherapy is no longer medically necessary.
585	585	19.8When a provider determines that psychotherapy is no longer medically necessary, the
586	586	19.9provider must update required documentation, including but not limited to the individual
587	587	19.10treatment plan, the child's medical record, or other authorizations, to include the
588	588	19.11determination. When a provider determines that a child needs psychotherapy but
589	589	19.12psychotherapy cannot be delivered due to a shortage of licensed mental health professionals
590	590	19.13in the child's community, the provider must document the lack of access in the child's
591	591	19.14medical record;
592	592	19.15 (2) individual, family, or group skills training is subject to the following requirements:
593	593	19.16 (i) a mental health professional, clinical trainee, occupational therapist or occupational
594	594	19.17therapy assistant, or mental health practitioner shall provide skills training;
595	595	19.18 (ii) skills training delivered to a child or the child's family must be targeted to the specific
596	596	19.19deficits or maladaptations of the child's mental health disorder and must be prescribed in
597	597	19.20the child's individual treatment plan;
598	598	19.21 (iii) group skills training may be provided to multiple recipients who, because of the
599	599	19.22nature of their emotional, behavioral, or social dysfunction, can derive mutual benefit from
600	600	19.23interaction in a group setting, which must be staffed as follows:
601	601	19.24 (A) one mental health professional, clinical trainee, occupational therapist or occupational
602	602	19.25therapy assistant, or mental health practitioner must work with a group of three to eight
603	603	19.26clients; or
604	604	19.27 (B) any combination of two mental health professionals, clinical trainees, or mental
605	605	19.28health practitioners must work with a group of nine to 12 clients;
606	606	19.29 (iv) a mental health professional, clinical trainee, occupational therapist or occupational
607	607	19.30therapy assistant, or mental health practitioner must have taught the psychosocial skill before
608	608	19.31a mental health behavioral aide may practice that skill with the client; and
609	609	19.32 (v) for group skills training, when a skills group that meets the minimum group size
610	610	19.33requirement temporarily falls below the minimum group size because of a group member's
611	611	19Sec. 16.
612	612	25-02621 as introduced01/23/25 REVISOR DTT/LJ 20.1temporary absence, the provider may conduct the session for the group members in
613	613	20.2attendance;
614	614	20.3 (3) crisis planning to a child and family must include development of a written plan that
615	615	20.4anticipates the particular factors specific to the child that may precipitate a psychiatric crisis
616	616	20.5for the child in the near future. The written plan must document actions that the family
617	617	20.6should be prepared to take to resolve or stabilize a crisis, such as advance arrangements for
618	618	20.7direct intervention and support services to the child and the child's family. Crisis planning
619	619	20.8must include preparing resources designed to address abrupt or substantial changes in the
620	620	20.9functioning of the child or the child's family when sudden change in behavior or a loss of
621	621	20.10usual coping mechanisms is observed, or the child begins to present a danger to self or
622	622	20.11others;
623	623	20.12 (4) mental health behavioral aide services must be medically necessary treatment services,
624	624	20.13identified in the child's individual treatment plan.
625	625	20.14To be eligible for medical assistance payment, mental health behavioral aide services must
626	626	20.15be delivered to a child who has been diagnosed with an emotional disturbance or a mental
627	627	20.16illness, as provided in subdivision 1, paragraph (a). The mental health behavioral aide must
628	628	20.17document the delivery of services in written progress notes. Progress notes must reflect
629	629	20.18implementation of the treatment strategies, as performed by the mental health behavioral
630	630	20.19aide and the child's responses to the treatment strategies; and
631	631	20.20 (5) mental health service plan development must be performed in consultation with the
632	632	20.21child's family and, when appropriate, with other key participants in the child's life by the
633	633	20.22child's treating mental health professional or clinical trainee or by a mental health practitioner
634	634	20.23and approved by the treating mental health professional. Treatment plan drafting consists
635	635	20.24of development, review, and revision by face-to-face or electronic communication. The
636	636	20.25provider must document events, including the time spent with the family and other key
637	637	20.26participants in the child's life to approve the individual treatment plan. Medical assistance
638	638	20.27covers service plan development before completion of the child's individual treatment plan.
639	639	20.28Service plan development is covered only if a treatment plan is completed for the child. If
640	640	20.29upon review it is determined that a treatment plan was not completed for the child, the
641	641	20.30commissioner shall recover the payment for the service plan development.; and
642	642	20.31 (6) occupational therapy services must be medically necessary treatment services,
643	643	20.32identified in the child's individual treatment plan.
644	644	20Sec. 16.
645	645	25-02621 as introduced01/23/25 REVISOR DTT/LJ 21.1 Sec. 17. Minnesota Statutes 2024, section 256B.0947, subdivision 2, is amended to read:
646	646	21.2 Subd. 2.Definitions.For purposes of this section, the following terms have the meanings
647	647	21.3given them.
648	648	21.4 (a) "Intensive nonresidential rehabilitative mental health services" means child
649	649	21.5rehabilitative mental health services as defined in section 256B.0943, except that these
650	650	21.6services are provided by a multidisciplinary staff using a total team approach consistent
651	651	21.7with assertive community treatment, as adapted for youth, and are directed to recipients
652	652	21.8who are eight years of age or older and under 21 years of age who require intensive services
653	653	21.9to prevent admission to an inpatient psychiatric hospital or placement in a residential
654	654	21.10treatment facility or who require intensive services to step down from inpatient or residential
655	655	21.11care to community-based care.
656	656	21.12 (b) "Co-occurring mental illness and substance use disorder" means a dual diagnosis of
657	657	21.13at least one form of mental illness and at least one substance use disorder. Substance use
658	658	21.14disorders include alcohol or drug abuse or dependence, excluding nicotine use.
659	659	21.15 (c) "Standard diagnostic assessment" means the assessment described in section 245I.10,
660	660	21.16subdivision 6.
661	661	21.17 (d) "Medication education services" means services provided individually or in groups,
662	662	21.18which focus on:
663	663	21.19 (1) educating the client and client's family or significant nonfamilial supporters about
664	664	21.20mental illness and symptoms;
665	665	21.21 (2) the role and effects of medications in treating symptoms of mental illness; and
666	666	21.22 (3) the side effects of medications.
667	667	21.23Medication education is coordinated with medication management services and does not
668	668	21.24duplicate it. Medication education services are provided by physicians, pharmacists, or
669	669	21.25registered nurses with certification in psychiatric and mental health care.
670	670	21.26 (e) "Mental health professional" means a staff person who is qualified according to
671	671	21.27section 245I.04, subdivision 2.
672	672	21.28 (f) "Provider agency" means a for-profit or nonprofit organization established to
673	673	21.29administer an assertive community treatment for youth team.
674	674	21.30 (g) "Substance use disorders" means one or more of the disorders defined in the diagnostic
675	675	21.31and statistical manual of mental disorders, current edition.
676	676	21.32 (h) "Transition services" means:
677	677	21Sec. 17.
678	678	25-02621 as introduced01/23/25 REVISOR DTT/LJ 22.1 (1) activities, materials, consultation, and coordination that ensures continuity of the
679	679	22.2client's care in advance of and in preparation for the client's move from one stage of care
680	680	22.3or life to another by maintaining contact with the client and assisting the client to establish
681	681	22.4provider relationships;
682	682	22.5 (2) providing the client with knowledge and skills needed posttransition;
683	683	22.6 (3) establishing communication between sending and receiving entities;
684	684	22.7 (4) supporting a client's request for service authorization and enrollment; and
685	685	22.8 (5) establishing and enforcing procedures and schedules.
686	686	22.9 (i) "Treatment team" means all staff who provide services to recipients under this section.
687	687	22.10 (j) "Family peer specialist" means a staff person who is qualified under section
688	688	22.11256B.0616.
689	689	22.12 (k) "Occupational therapist or occupational therapy assistant" means a staff person who
690	690	22.13is qualified according to section 245I.04, subdivision 20.
691	691	22.14 (l) "Occupational therapy services" has the meaning given in section 245I.02, subdivision
692	692	22.1529b.
693	693	22.16Sec. 18. Minnesota Statutes 2024, section 256B.0947, subdivision 3a, is amended to read:
694	694	22.17 Subd. 3a.Required service components.(a) Intensive nonresidential rehabilitative
695	695	22.18mental health services, supports, and ancillary activities that are covered by a single daily
696	696	22.19rate per client must include the following, as needed by the individual client:
697	697	22.20 (1) individual, family, and group psychotherapy;
698	698	22.21 (2) individual, family, and group skills training, as defined in section 256B.0943,
699	699	22.22subdivision 1, paragraph (u);
700	700	22.23 (3) crisis planning as defined in section 245.4871, subdivision 9a;
701	701	22.24 (4) medication management provided by a physician, an advanced practice registered
702	702	22.25nurse with certification in psychiatric and mental health care, or a physician assistant;
703	703	22.26 (5) mental health case management as provided in section 256B.0625, subdivision 20;
704	704	22.27 (6) medication education services as defined in this section;
705	705	22.28 (7) care coordination by a client-specific lead worker assigned by and responsible to the
706	706	22.29treatment team;
707	707	22Sec. 18.
708	708	25-02621 as introduced01/23/25 REVISOR DTT/LJ 23.1 (8) psychoeducation of and consultation and coordination with the client's biological,
709	709	23.2adoptive, or foster family and, in the case of a youth living independently, the client's
710	710	23.3immediate nonfamilial support network;
711	711	23.4 (9) clinical consultation to a client's employer or school or to other service agencies or
712	712	23.5to the courts to assist in managing the mental illness or co-occurring disorder and to develop
713	713	23.6client support systems;
714	714	23.7 (10) coordination with, or performance of, crisis intervention and stabilization services
715	715	23.8as defined in section 256B.0624;
716	716	23.9 (11) transition services;
717	717	23.10 (12) co-occurring substance use disorder treatment as defined in section 245I.02,
718	718	23.11subdivision 11; and
719	719	23.12 (13) housing access support that assists clients to find, obtain, retain, and move to safe
720	720	23.13and adequate housing. Housing access support does not provide monetary assistance for
721	721	23.14rent, damage deposits, or application fees.
722	722	23.15 (b) Intensive nonresidential rehabilitative mental health services, supports, and ancillary
723	723	23.16activities covered by the single daily rate per client may also include medically necessary
724	724	23.17occupational therapy services.
725	725	23.18 (b) (c) The provider shall ensure and document the following by means of performing
726	726	23.19the required function or by contracting with a qualified person or entity: client access to
727	727	23.20crisis intervention services, as defined in section 256B.0624, and available 24 hours per
728	728	23.21day and seven days per week.
729	729	23.22Sec. 19. Minnesota Statutes 2024, section 256B.0947, subdivision 5, is amended to read:
730	730	23.23 Subd. 5.Standards for intensive nonresidential rehabilitative providers.(a) Services
731	731	23.24must meet the standards in this section and chapter 245I as required in section 245I.011,
732	732	23.25subdivision 5.
733	733	23.26 (b) The treatment team must have specialized training in providing services to the specific
734	734	23.27age group of youth that the team serves. An individual treatment team must serve youth
735	735	23.28who are: (1) at least eight years of age or older and under 16 years of age, or (2) at least 14
736	736	23.29years of age or older and under 21 years of age.
737	737	23.30 (c) The treatment team for intensive nonresidential rehabilitative mental health services
738	738	23.31comprises both permanently employed core team members and client-specific team members
739	739	23.32as follows:
740	740	23Sec. 19.
741	741	25-02621 as introduced01/23/25 REVISOR DTT/LJ 24.1 (1) Based on professional qualifications and client needs, clinically qualified core team
742	742	24.2members are assigned on a rotating basis as the client's lead worker to coordinate a client's
743	743	24.3care. The core team must comprise at least four full-time equivalent direct care staff and
744	744	24.4must minimally include:
745	745	24.5 (i) a mental health professional who serves as team leader to provide administrative
746	746	24.6direction and treatment supervision to the team;
747	747	24.7 (ii) an advanced-practice registered nurse with certification in psychiatric or mental
748	748	24.8health care or a board-certified child and adolescent psychiatrist, either of which must be
749	749	24.9credentialed to prescribe medications;
750	750	24.10 (iii) a mental health certified peer specialist who is qualified according to section 245I.04,
751	751	24.11subdivision 10, and is also a former children's mental health consumer; and
752	752	24.12 (iv) a co-occurring disorder specialist who meets the requirements under section
753	753	24.13256B.0622, subdivision 7a, paragraph (a), clause (4), who will provide or facilitate the
754	754	24.14provision of co-occurring disorder treatment to clients.
755	755	24.15 (2) The core team may also include any of the following:
756	756	24.16 (i) additional mental health professionals;
757	757	24.17 (ii) a vocational specialist;
758	758	24.18 (iii) an educational specialist with knowledge and experience working with youth
759	759	24.19regarding special education requirements and goals, special education plans, and coordination
760	760	24.20of educational activities with health care activities;
761	761	24.21 (iv) a child and adolescent psychiatrist who may be retained on a consultant basis;
762	762	24.22 (v) a clinical trainee qualified according to section 245I.04, subdivision 6;
763	763	24.23 (vi) a mental health practitioner qualified according to section 245I.04, subdivision 4;
764	764	24.24 (vii) a case management service provider, as defined in section 245.4871, subdivision
765	765	24.254;
766	766	24.26 (viii) a housing access specialist; and
767	767	24.27 (ix) a family peer specialist as defined in subdivision 2, paragraph (j).; and
768	768	24.28 (x) an occupational therapist or occupational therapy assistant.
769	769	24.29 (3) A treatment team may include, in addition to those in clause (1) or (2), ad hoc
770	770	24.30members not employed by the team who consult on a specific client and who must accept
771	771	24.31overall clinical direction from the treatment team for the duration of the client's placement
772	772	24Sec. 19.
773	773	25-02621 as introduced01/23/25 REVISOR DTT/LJ 25.1with the treatment team and must be paid by the provider agency at the rate for a typical
774	774	25.2session by that provider with that client or at a rate negotiated with the client-specific
775	775	25.3member. Client-specific treatment team members may include:
776	776	25.4 (i) the mental health professional treating the client prior to placement with the treatment
777	777	25.5team;
778	778	25.6 (ii) the client's current substance use counselor, if applicable;
779	779	25.7 (iii) a lead member of the client's individualized education program team or school-based
780	780	25.8mental health provider, if applicable;
781	781	25.9 (iv) a representative from the client's health care home or primary care clinic, as needed
782	782	25.10to ensure integration of medical and behavioral health care;
783	783	25.11 (v) the client's probation officer or other juvenile justice representative, if applicable;
784	784	25.12and
785	785	25.13 (vi) the client's current vocational or employment counselor, if applicable.
786	786	25.14 (d) The treatment supervisor shall be an active member of the treatment team and shall
787	787	25.15function as a practicing clinician at least on a part-time basis. The treatment team shall meet
788	788	25.16with the treatment supervisor at least weekly to discuss recipients' progress and make rapid
789	789	25.17adjustments to meet recipients' needs. The team meeting must include client-specific case
790	790	25.18reviews and general treatment discussions among team members. Client-specific case
791	791	25.19reviews and planning must be documented in the individual client's treatment record.
792	792	25.20 (e) The staffing ratio must not exceed ten clients to one full-time equivalent treatment
793	793	25.21team position.
794	794	25.22 (f) The treatment team shall serve no more than 80 clients at any one time. Should local
795	795	25.23demand exceed the team's capacity, an additional team must be established rather than
796	796	25.24exceed this limit.
797	797	25.25 (g) Nonclinical staff shall have prompt access in person or by telephone to a mental
798	798	25.26health practitioner, clinical trainee, or mental health professional. The provider shall have
799	799	25.27the capacity to promptly and appropriately respond to emergent needs and make any
800	800	25.28necessary staffing adjustments to ensure the health and safety of clients.
801	801	25.29 (h) The intensive nonresidential rehabilitative mental health services provider shall
802	802	25.30participate in evaluation of the assertive community treatment for youth (Youth ACT) model
803	803	25.31as conducted by the commissioner, including the collection and reporting of data and the
804	804	25.32reporting of performance measures as specified by contract with the commissioner.
805	805	25Sec. 19.
806	806	25-02621 as introduced01/23/25 REVISOR DTT/LJ 26.1 (i) A regional treatment team may serve multiple counties.
807	807	26Sec. 19.
808	808	25-02621 as introduced01/23/25 REVISOR DTT/LJ