1.1 A bill for an act
1.2 relating to direct care and treatment; modifying county cost of care provisions;
1.3 modifying required admission timelines; requiring a report; appropriating money;
1.4 amending Minnesota Statutes 2024, sections 246.54, subdivisions 1a, 1b; 246C.07,
1.5 by adding a subdivision; 253B.10, subdivision 1; proposing coding for new law
1.6 in Minnesota Statutes, chapter 253B.
1.7BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF MINNESOTA:
1.8 Section 1. Minnesota Statutes 2024, section 246.54, subdivision 1a, is amended to read:
1.9 Subd. 1a.Anoka-Metro Regional Treatment Center.(a) A county's payment of the
1.10cost of care provided at Anoka-Metro Regional Treatment Center shall be according to the
1.11following schedule:
1.12 (1) zero percent for the first 30 days;
1.13 (2) 20 percent for days 31 and over if the stay is determined to be clinically appropriate
1.14for the client; and
1.15 (3) 100 percent for each day during the stay, including the day of admission, when the
1.16facility determines that it is clinically appropriate for the client to be discharged, except as
1.17provided in paragraph (c).
1.18 (b) If payments received by the state under sections 246.50 to 246.53 exceed 80 percent
1.19of the cost of care for days over 31 for clients who meet the criteria in paragraph (a), clause
1.20(2), the county shall be responsible for paying the state only the remaining amount. The
1.21county shall not be entitled to reimbursement from the client, the client's estate, or from the
1.22client's relatives, except as provided in section 246.53.
1Section 1.
25-04585 as introduced03/10/25 REVISOR AGW/VJ
SENATE
STATE OF MINNESOTA
S.F. No. 2628NINETY-FOURTH SESSION
(SENATE AUTHORS: RASMUSSON, Hoffman and Anderson)
OFFICIAL STATUSD-PGDATE
Introduction and first reading03/17/2025
Referred to Human Services 2.1 (c) Between July 1, 2023, and March 31, 2025, the county is not responsible for the cost
2.2of care under paragraph (a), clause (3), for a person who is committed as a person who has
2.3a mental illness and is dangerous to the public under section 253B.18 and who is awaiting
2.4transfer to another state-operated facility or program. This paragraph expires March 31,
2.52025.
2.6 (d) Between April 1, 2025, and June 30, 2025, (c) The county is not responsible for the
2.7cost of care under paragraph (a), clause (3), for a person who is civilly committed, if the
2.8client is awaiting transfer:
2.9 (1) to a facility operated by the Department of Corrections; or
2.10 (2) to another state-operated facility or program, and the Direct Care and Treatment
2.11executive medical director's office or a designee has determined that:
2.12 (i) the client meets criteria for admission to that state-operated facility or program; and
2.13 (ii) the state-operated facility or program is the only facility or program that can
2.14reasonably serve the client. This paragraph expires June 30, 2025.
2.15 (e) (d) Notwithstanding any law to the contrary, the client is not responsible for payment
2.16of the cost of care under this subdivision.
2.17 EFFECTIVE DATE.This section is effective the day following final enactment.
2.18 Sec. 2. Minnesota Statutes 2024, section 246.54, subdivision 1b, is amended to read:
2.19 Subd. 1b.Community behavioral health hospitals.(a) A county's payment of the cost
2.20of care provided at state-operated community-based behavioral health hospitals for adults
2.21and children shall be according to the following schedule: (1) 100 percent for each day
2.22during the stay, including the day of admission, when the facility determines that it is
2.23clinically appropriate for the client to be discharged; and, except as provided in paragraph
2.24(c).
2.25 (2) (b) The county shall not be entitled to reimbursement from the client, the client's
2.26estate, or from the client's relatives, except as provided in section 246.53.
2.27 (b) Between July 1, 2023, and March 31, 2025, the county is not responsible for the cost
2.28of care under paragraph (a), clause (1), for a person committed as a person who has a mental
2.29illness and is dangerous to the public under section 253B.18 and who is awaiting transfer
2.30to another state-operated facility or program. This paragraph expires March 31, 2025.
2Sec. 2.
25-04585 as introduced03/10/25 REVISOR AGW/VJ 3.1 (c) Between April 1, 2025, and June 30, 2025, The county is not responsible for the cost
3.2of care under paragraph (a), clause (1), for a person who is civilly committed, if the client
3.3is awaiting transfer:
3.4 (1) to a facility operated by the Department of Corrections; or
3.5 (2) to another state-operated facility or program, and the Direct Care and Treatment
3.6executive medical director's office or a designee has determined that:
3.7 (i) the client meets criteria for admission to that state-operated facility or program; and
3.8 (ii) the state-operated facility or program is the only facility or program that can
3.9reasonably serve the client. This paragraph expires June 30, 2025.
3.10 (d) Notwithstanding any law to the contrary, the client is not responsible for payment
3.11of the cost of care under this subdivision.
3.12 EFFECTIVE DATE.This section is effective the day following final enactment.
3.13 Sec. 3. Minnesota Statutes 2024, section 246C.07, is amended by adding a subdivision to
3.14read:
3.15 Subd. 9.Public notice of admission metrics.The executive board must establish and
3.16update monthly a publicly accessible dashboard that displays data on referrals for services
3.17provided by Direct Care and Treatment, including referrals resulting from a court order for
3.18competency attainment, a competency examination, or treatment following civil commitment.
3.19The dashboard must include at least measures of the number of individuals awaiting
3.20admission or acceptance into a program operated by Direct Care and Treatment; the number
3.21of individuals awaiting admission or acceptance into a program operated by Direct Care
3.22and Treatment, by program; the longest, shortest, and average time individuals are on a
3.23waitlist; and the longest, shortest, and average time individuals are on a waitlist, by program.
3.24The executive board must also publish monthly publicly relevant information regarding
3.25admissions policies, procedures, and factors impacting relative priority status.
3.26 Sec. 4. Minnesota Statutes 2024, section 253B.10, subdivision 1, is amended to read:
3.27 Subdivision 1.Administrative requirements.(a) When a person is committed, the
3.28court shall issue a warrant or an order committing the patient to the custody of the head of
3.29the treatment facility, state-operated treatment program, or community-based treatment
3.30program. The warrant or order shall state that the patient meets the statutory criteria for
3.31civil commitment.
3Sec. 4.
25-04585 as introduced03/10/25 REVISOR AGW/VJ 4.1 (b) The executive board shall prioritize civilly committed patients being admitted from
4.2jail or a correctional institution or who are referred to a state-operated treatment facility for
4.3competency attainment or a competency examination under sections 611.40 to 611.59 for
4.4admission to a medically appropriate state-operated direct care and treatment bed based on
4.5the decisions of physicians in the executive medical director's office, using a priority
4.6admissions framework. The framework must account for a range of factors for priority
4.7admission, including but not limited to:
4.8 (1) the length of time the person has been on a waiting list for admission to a
4.9state-operated direct care and treatment program since the date of the order under paragraph
4.10(a), or the date of an order issued under sections 611.40 to 611.59;
4.11 (2) the intensity of the treatment the person needs, based on medical acuity;
4.12 (3) the person's revoked provisional discharge status;
4.13 (4) the person's safety and safety of others in the person's current environment;
4.14 (5) whether the person has access to necessary or court-ordered treatment;
4.15 (6) distinct and articulable negative impacts of an admission delay on the facility referring
4.16the individual for treatment; and
4.17 (7) any relevant federal prioritization requirements.
4.18Patients described in this paragraph must be admitted to a state-operated treatment program
4.19within 48 hours the timelines specified in section 253B.1005. The commitment must be
4.20ordered by the court as provided in section 253B.09, subdivision 1, paragraph (d). Patients
4.21committed to a secure treatment facility or less restrictive setting as ordered by the court
4.22under section 253B.18, subdivisions 1 and 2, must be prioritized for admission to a
4.23state-operated treatment program using the priority admissions framework in this paragraph.
4.24 (c) Upon the arrival of a patient at the designated treatment facility, state-operated
4.25treatment program, or community-based treatment program, the head of the facility or
4.26program shall retain the duplicate of the warrant and endorse receipt upon the original
4.27warrant or acknowledge receipt of the order. The endorsed receipt or acknowledgment must
4.28be filed in the court of commitment. After arrival, the patient shall be under the control and
4.29custody of the head of the facility or program.
4.30 (d) Copies of the petition for commitment, the court's findings of fact and conclusions
4.31of law, the court order committing the patient, the report of the court examiners, and the
4.32prepetition report, and any medical and behavioral information available shall be provided
4.33at the time of admission of a patient to the designated treatment facility or program to which
4Sec. 4.
25-04585 as introduced03/10/25 REVISOR AGW/VJ 5.1the patient is committed. Upon a patient's referral to the executive board for admission
5.2pursuant to subdivision 1, paragraph (b), any inpatient hospital, treatment facility, jail, or
5.3correctional facility that has provided care or supervision to the patient in the previous two
5.4years shall, when requested by the treatment facility or executive board, provide copies of
5.5the patient's medical and behavioral records to the executive board for purposes of
5.6preadmission planning. This information shall be provided by the head of the treatment
5.7facility to treatment facility staff in a consistent and timely manner and pursuant to all
5.8applicable laws.
5.9 (e) Patients described in paragraph (b) must be admitted to a state-operated treatment
5.10program within 48 hours of the Office of Executive Medical Director, under section 246C.09,
5.11or a designee determining that a medically appropriate bed is available. This paragraph
5.12expires on June 30, 2025.
5.13 (f) (e) Within four business days of determining which state-operated direct care and
5.14treatment program or programs are appropriate for an individual, the executive medical
5.15director's office director or a designee must notify the source of the referral and the
5.16responsible county human services agency, the individual being ordered to direct care and
5.17treatment, and the district court that issued the order of the determination. The notice shall
5.18include which program or programs are appropriate for the person's relative priority status
5.19by quartile and the factors impacting the person's priority status, projected admission date,
5.20and contact information for the Direct Care and Treatment Central Preadmissions Office.
5.21For any individuals not admitted to a state-operated direct care and treatment program within
5.22ten business days after previous notice, the executive medical director or a designee must
5.23provide additional notice to the responsible county human services agency, the individual
5.24being ordered to direct care and treatment, and the district court that issued the order of the
5.25determination. The additional notice must include updates to the same information provided
5.26in the previous notice. Any interested person or the individual being ordered to direct care
5.27and treatment may provide additional information to or request updated priority status about
5.28the individual to from the executive medical director's office or a designee while the
5.29individual is awaiting admission. Updated Priority status of information regarding an
5.30individual will only be disclosed to interested persons who are legally authorized to receive
5.31private information about the individual, including the designated agency and the facility
5.32to which the individual is awaiting admission. Specific updated priority status information
5.33may be withheld from the individual being ordered to direct care and treatment if in the
5.34judgment of the physicians in the executive medical director's office the information will
5.35jeopardize the health or wellbeing of the individual. When an available bed has been
5Sec. 4.
25-04585 as introduced03/10/25 REVISOR AGW/VJ 6.1identified, the executive medical director's office or a designee must notify the designated
6.2agency and the facility where the individual is awaiting admission that the individual has
6.3been accepted for admission to a particular state-operated direct care and treatment program
6.4and the earliest possible date the admission can occur. The designated agency or facility
6.5where the individual is awaiting admission must transport the individual to the admitting
6.6state-operated direct care and treatment program no more than 48 hours after the offered
6.7admission date.
6.8 Sec. 5. [253B.1005] ADMISSION TIMELINES.
6.9 Subdivision 1.Admission required within 48 hours.Patients described in section
6.10253B.10, subdivision 1, paragraph (b), must be admitted to a state-operated treatment
6.11program within 48 hours. This subdivision expires upon the effective date of subdivision
6.122.
6.13 Subd. 2.Admission required within ten days.Effective upon capacity at secure forensic
6.14mental health treatment facilities operated by Direct Care and Treatment reaching 431 fully
6.15staffed and operational beds, capacity at Anoka-Metro Regional Treatment Center reaching
6.16132 fully staffed and operational beds, and the total capacity at adult community behavioral
6.17health hospitals operated by Direct Care and Treatment reaching 115 fully staffed and
6.18operational beds, patients described in section 253B.10, subdivision 1, paragraph (b), must
6.19be admitted to a state-operated treatment program within ten calendar days.
6.20 EFFECTIVE DATE.This section is effective July 1, 2025.
6.21 Sec. 6. [253B.101] COST OF DELAYED ADMISSION.
6.22 The Direct Care and Treatment executive board must reimburse any state agency, county,
6.23municipality, or other political subdivision of the state for demonstrated costs incurred
6.24beyond the first 30 calendar days to confine a civilly committed patient in a jail or a
6.25correctional institution who is awaiting admission to a state-operated treatment program.
6.26 EFFECTIVE DATE.This section is effective July 1, 2025, and applies to civil
6.27commitments occurring on or after that date.
6.28 Sec. 7. PRIORITY ADMISSIONS REVIEW PANEL.
6.29 (a) A panel appointed by the Direct Care and Treatment executive board, consisting of
6.30all members who served on the Priority Admissions Review Panel under Laws 2024, chapter
6.31127, article 49, section 7, must:
6Sec. 7.
25-04585 as introduced03/10/25 REVISOR AGW/VJ 7.1 (1) evaluate existing mobile crisis programs and funding and make recommendations
7.2to improve the quality and availability of mobile crisis services in the state;
7.3 (2) evaluate the county correctional facility long-acting injectable antipsychotic
7.4medication pilot program established under Laws 2024, chapter 127, article 49, section 12,
7.5and make recommendations related to the continuation of the pilot program;
7.6 (3) evaluate existing intensive residential treatment services and make recommendations
7.7to improve the quality and availability of intensive residential treatment services in the state;
7.8and
7.9 (4) study local fiscal impacts and provide evaluation support consistent with Minnesota
7.10Statutes, section 16A.055, subdivision 1a, of the limited capacity in and access to
7.11state-operated treatment programs, nonstate-operated treatment programs, competency
7.12evaluations, and competency attainment services.
7.13 (b) The commissioner of management and budget must provide the panel with technical
7.14assistance and with outcome and fiscal analysis for the purposes of the study of local fiscal
7.15impacts under paragraph (a), clause (4).
7.16 (c) By February 1, 2026, the panel must submit a written report to the chairs and ranking
7.17minority members of the legislative committees with jurisdiction over public safety and
7.18human services that includes the results of the panel's evaluations and study under paragraph
7.19(a) and any legislative proposals the panel recommends as a result of its evaluations and
7.20study.
7.21 Sec. 8. APPROPRIATION; EXPANDED CAPACITY AT SECURE TREATMENT
7.22FACILITIES.
7.23 $....... in fiscal year 2026 and $....... in fiscal year 2027 are appropriated from the general
7.24fund to the Direct Care and Treatment executive board to expand forensic mental health
7.25program capacity at secure treatment facilities by 20 percent over the available capacity as
7.26of June 30, 2025. The expanded capacity is estimated to be an additional 72 fully staffed
7.27beds.
7.28 Sec. 9. APPROPRIATION; EXPANDED CAPACITY AT ANOKA-METRO
7.29REGIONAL TREATMENT CENTER.
7.30 $....... in fiscal year 2026 and $....... in fiscal year 2027 are appropriated from the general
7.31fund to the Direct Care and Treatment executive board to expand adult mental health
7.32treatment service capacity at Anoka-Metro Regional Treatment Center by 20 percent over
7Sec. 9.
25-04585 as introduced03/10/25 REVISOR AGW/VJ 8.1the available capacity as of June 30, 2025. The expanded capacity is estimated to be an
8.2additional 22 fully staffed beds.
8.3 Sec. 10. APPROPRIATION; EXPANDED CAPACITY AT ADULT COMMUNITY
8.4BEHAVIOR HEALTH HOSPITALS.
8.5 $....... in fiscal year 2026 and $....... in fiscal year 2027 are appropriated from the general
8.6fund to the Direct Care and Treatment executive board to expand adult mental health service
8.7capacity at community behavioral health hospitals by 20 percent over the available capacity
8.8as of June 30, 2025. The expanded capacity is estimated to be an additional 19 fully staffed
8.9beds.
8Sec. 10.
25-04585 as introduced03/10/25 REVISOR AGW/VJ