Minnesota 2025-2026 Regular Session

Minnesota Senate Bill SF2986 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 human services; recodifying assertive community treatment and intensive
3	3	1.3 residential treatment services statutory language; making conforming changes;
4	4	1.4 amending Minnesota Statutes 2024, sections 148F.11, subdivision 1; 245.4662,
5	5	1.5 subdivision 1; 245.4906, subdivision 2; 254B.04, subdivision 1a; 254B.05,
6	6	1.6 subdivision 1a; 256.478, subdivision 2; 256B.0615, subdivisions 1, 3; 256B.0622,
7	7	1.7 subdivisions 1, 8, 11, 12; 256B.82; 256D.44, subdivision 5; proposing coding for
8	8	1.8 new law in Minnesota Statutes, chapter 256B; repealing Minnesota Statutes 2024,
9	9	1.9 section 256B.0622, subdivision 4.
10	10	1.10BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF MINNESOTA:
11	11	1.11 ARTICLE 1
12	12	1.12 RECODIFICATION
13	13	1.13 Section 1. Minnesota Statutes 2024, section 256B.0622, subdivision 1, is amended to read:
14	14	1.14 Subdivision 1.Scope.(a) Subject to federal approval, medical assistance covers medically
15	15	1.15necessary, assertive community treatment when the services are provided by an entity
16	16	1.16certified under and meeting the standards in this section.
17	17	1.17 (b) Subject to federal approval, medical assistance covers medically necessary, intensive
18	18	1.18residential treatment services when the services are provided by an entity licensed under
19	19	1.19and meeting the standards in section 245I.23.
20	20	1.20 (c) (b) The provider entity must make reasonable and good faith efforts to report
21	21	1.21individual client outcomes to the commissioner, using instruments and protocols approved
22	22	1.22by the commissioner.
23	23	1Article 1 Section 1.
24	24	25-05140 as introduced03/20/25 REVISOR AGW/LN
25	25	SENATE
26	26	STATE OF MINNESOTA
27	27	S.F. No. 2986NINETY-FOURTH SESSION
28	28	(SENATE AUTHORS: WIKLUND)
29	29	OFFICIAL STATUSD-PGDATE
30	30	Introduction and first reading03/27/2025
31	31	Referred to Health and Human Services 2.1 Sec. 2. Minnesota Statutes 2024, section 256B.0622, subdivision 8, is amended to read:
32	32	2.2 Subd. 8.Medical assistance payment for assertive community treatment and
33	33	2.3intensive residential treatment services.(a) Payment for intensive residential treatment
34	34	2.4services and assertive community treatment in this section shall be based on one daily rate
35	35	2.5per provider inclusive of the following services received by an eligible client in a given
36	36	2.6calendar day: all rehabilitative services under this section, staff travel time to provide
37	37	2.7rehabilitative services under this section, and nonresidential crisis stabilization services
38	38	2.8under section 256B.0624.
39	39	2.9 (b) Except as indicated in paragraph (d) (c), payment will not be made to more than one
40	40	2.10entity for each client for services provided under this section on a given day. If services
41	41	2.11under this section are provided by a team that includes staff from more than one entity, the
42	42	2.12team must determine how to distribute the payment among the members.
43	43	2.13 (c) Payment must not be made based solely on a court order to participate in intensive
44	44	2.14residential treatment services. If a client has a court order to participate in the program or
45	45	2.15to obtain assessment for treatment and follow treatment recommendations, payment under
46	46	2.16this section must only be provided if the client is eligible for the service and the service is
47	47	2.17determined to be medically necessary.
48	48	2.18 (d) (c) The commissioner shall determine one rate for each provider that will bill medical
49	49	2.19assistance for residential services under this section and one rate for each assertive community
50	50	2.20treatment provider under this section. If a single entity provides both services intensive
51	51	2.21residential treatment services under section 256B.0632 and assertive community treatment
52	52	2.22under this section, one rate is established for the entity's intensive residential treatment
53	53	2.23services under section 256B.0632 and another rate for the entity's nonresidential assertive
54	54	2.24community treatment services under this section. A provider is not eligible for payment
55	55	2.25under this section without authorization from the commissioner. The commissioner shall
56	56	2.26develop rates using the following criteria:
57	57	2.27 (1) the provider's cost for services shall include direct services costs, other program
58	58	2.28costs, and other costs determined as follows:
59	59	2.29 (i) the direct services costs must be determined using actual costs of salaries, benefits,
60	60	2.30payroll taxes, and training of direct service staff and service-related transportation;
61	61	2.31 (ii) other program costs not included in item (i) must be determined as a specified
62	62	2.32percentage of the direct services costs as determined by item (i). The percentage used shall
63	63	2.33be determined by the commissioner based upon the average of percentages that represent
64	64	2Article 1 Sec. 2.
65	65	25-05140 as introduced03/20/25 REVISOR AGW/LN 3.1the relationship of other program costs to direct services costs among the entities that provide
66	66	3.2similar services;
67	67	3.3 (iii) physical plant costs calculated based on the percentage of space within the program
68	68	3.4that is entirely devoted to treatment and programming. This does not include administrative
69	69	3.5or residential space;
70	70	3.6 (iv) assertive community treatment physical plant costs must be reimbursed as part of
71	71	3.7the costs described in item (ii); and
72	72	3.8 (v) subject to federal approval, up to an additional five percent of the total rate may be
73	73	3.9added to the program rate as a quality incentive based upon the entity meeting performance
74	74	3.10criteria specified by the commissioner;
75	75	3.11 (2) actual cost is costs are defined as costs which are allowable, allocable, and reasonable,
76	76	3.12and consistent with federal reimbursement requirements under Code of Federal Regulations,
77	77	3.13title 48, chapter 1, part 31, relating to for-profit entities, and Office of Management and
78	78	3.14Budget Circular Number A-122, relating to nonprofit entities;
79	79	3.15 (3) the number of service units;
80	80	3.16 (4) the degree to which clients will receive services other than services under this section
81	81	3.17or section 256B.0632; and
82	82	3.18 (5) the costs of other services that will be separately reimbursed.
83	83	3.19 (e) (d) The rate for intensive residential treatment services and assertive community
84	84	3.20treatment must exclude the medical assistance room and board rate, as defined in section
85	85	3.21256B.056, subdivision 5d, and services not covered under this section, such as partial
86	86	3.22hospitalization, home care, and inpatient services.
87	87	3.23 (f) Physician services that are not separately billed may be included in the rate to the
88	88	3.24extent that a psychiatrist, or other health care professional providing physician services
89	89	3.25within their scope of practice, is a member of the intensive residential treatment services
90	90	3.26treatment team. Physician services, whether billed separately or included in the rate, may
91	91	3.27be delivered by telehealth. For purposes of this paragraph, "telehealth" has the meaning
92	92	3.28given to "mental health telehealth" in section 256B.0625, subdivision 46, when telehealth
93	93	3.29is used to provide intensive residential treatment services.
94	94	3.30 (g) (e) When services under this section are provided by an assertive community treatment
95	95	3.31provider, case management functions must be an integral part of the team.
96	96	3Article 1 Sec. 2.
97	97	25-05140 as introduced03/20/25 REVISOR AGW/LN 4.1 (h) (f) The rate for a provider must not exceed the rate charged by that provider for the
98	98	4.2same service to other payors.
99	99	4.3 (i) (g) The rates for existing programs must be established prospectively based upon the
100	100	4.4expenditures and utilization over a prior 12-month period using the criteria established in
101	101	4.5paragraph (d) (c). The rates for new programs must be established based upon estimated
102	102	4.6expenditures and estimated utilization using the criteria established in paragraph (d) (c).
103	103	4.7 (j) (h) Effective for the rate years beginning on and after January 1, 2024, rates for
104	104	4.8assertive community treatment, adult residential crisis stabilization services, and intensive
105	105	4.9residential treatment services must be annually adjusted for inflation using the Centers for
106	106	4.10Medicare and Medicaid Services Medicare Economic Index, as forecasted in the third quarter
107	107	4.11of the calendar year before the rate year. The inflation adjustment must be based on the
108	108	4.1212-month period from the midpoint of the previous rate year to the midpoint of the rate year
109	109	4.13for which the rate is being determined. This paragraph expires upon federal approval.
110	110	4.14 (i) Effective upon the expiration of paragraph (h), and effective for the rate years
111	111	4.15beginning on and after January 1, 2024, rates for assertive community treatment services
112	112	4.16must be annually adjusted for inflation using the Centers for Medicare and Medicaid Services
113	113	4.17Medicare Economic Index, as forecasted in the third quarter of the calendar year before the
114	114	4.18rate year. The inflation adjustment must be based on the 12-month period from the midpoint
115	115	4.19of the previous rate year to the midpoint of the rate year for which the rate is being
116	116	4.20determined.
117	117	4.21 (k) (j) Entities who discontinue providing services must be subject to a settle-up process
118	118	4.22whereby actual costs and reimbursement for the previous 12 months are compared. In the
119	119	4.23event that the entity was paid more than the entity's actual costs plus any applicable
120	120	4.24performance-related funding due the provider, the excess payment must be reimbursed to
121	121	4.25the department. If a provider's revenue is less than actual allowed costs due to lower
122	122	4.26utilization than projected, the commissioner may reimburse the provider to recover its actual
123	123	4.27allowable costs. The resulting adjustments by the commissioner must be proportional to the
124	124	4.28percent of total units of service reimbursed by the commissioner and must reflect a difference
125	125	4.29of greater than five percent.
126	126	4.30 (l) (k) A provider may request of the commissioner a review of any rate-setting decision
127	127	4.31made under this subdivision.
128	128	4Article 1 Sec. 2.
129	129	25-05140 as introduced03/20/25 REVISOR AGW/LN 5.1 Sec. 3. Minnesota Statutes 2024, section 256B.0622, subdivision 11, is amended to read:
130	130	5.2 Subd. 11.Sustainability grants.The commissioner may disburse grant funds directly
131	131	5.3to intensive residential treatment services providers and assertive community treatment
132	132	5.4providers to maintain access to these services.
133	133	5.5 Sec. 4. Minnesota Statutes 2024, section 256B.0622, subdivision 12, is amended to read:
134	134	5.6 Subd. 12.Start-up grants.The commissioner may, within available appropriations,
135	135	5.7disburse grant funding to counties, Indian tribes, or mental health service providers to
136	136	5.8establish additional assertive community treatment teams, intensive residential treatment
137	137	5.9services, or crisis residential services.
138	138	5.10 Sec. 5. [256B.0632] INTENSIVE RESIDENTIAL TREATMENT SERVICES.
139	139	5.11 Subdivision 1.Scope.(a) Subject to federal approval, medical assistance covers medically
140	140	5.12necessary, intensive residential treatment services when the services are provided by an
141	141	5.13entity licensed under and meeting the standards in section 245I.23.
142	142	5.14 (b) The provider entity must make reasonable and good faith efforts to report individual
143	143	5.15client outcomes to the commissioner, using instruments and protocols approved by the
144	144	5.16commissioner.
145	145	5.17 Subd. 2.Provider entity licensure and contract requirements for intensive residential
146	146	5.18treatment services.(a) The commissioner shall develop procedures for counties and
147	147	5.19providers to submit other documentation as needed to allow the commissioner to determine
148	148	5.20whether the standards in this section are met.
149	149	5.21 (b) A provider entity must specify in the provider entity's application what geographic
150	150	5.22area and populations will be served by the proposed program. A provider entity must
151	151	5.23document that the capacity or program specialties of existing programs are not sufficient
152	152	5.24to meet the service needs of the target population. A provider entity must submit evidence
153	153	5.25of ongoing relationships with other providers and levels of care to facilitate referrals to and
154	154	5.26from the proposed program.
155	155	5.27 (c) A provider entity must submit documentation that the provider entity requested a
156	156	5.28statement of need from each county board and Tribal authority that serves as a local mental
157	157	5.29health authority in the proposed service area. The statement of need must specify if the local
158	158	5.30mental health authority supports or does not support the need for the proposed program and
159	159	5.31the basis for this determination. If a local mental health authority does not respond within
160	160	5Article 1 Sec. 5.
161	161	25-05140 as introduced03/20/25 REVISOR AGW/LN 6.160 days of the receipt of the request, the commissioner shall determine the need for the
162	162	6.2program based on the documentation submitted by the provider entity.
163	163	6.3 Subd. 3.Medical assistance payment for intensive residential treatment services.(a)
164	164	6.4Payment for intensive residential treatment services in this section shall be based on one
165	165	6.5daily rate per provider inclusive of the following services received by an eligible client in
166	166	6.6a given calendar day: all rehabilitative services under this section, staff travel time to provide
167	167	6.7rehabilitative services under this section, and nonresidential crisis stabilization services
168	168	6.8under section 256B.0624.
169	169	6.9 (b) Except as indicated in paragraph (d), payment will not be made to more than one
170	170	6.10entity for each client for services provided under this section on a given day. If services
171	171	6.11under this section are provided by a team that includes staff from more than one entity, the
172	172	6.12team must determine how to distribute the payment among the members.
173	173	6.13 (c) Payment must not be made based solely on a court order to participate in intensive
174	174	6.14residential treatment services. If a client has a court order to participate in the program or
175	175	6.15to obtain assessment for treatment and follow treatment recommendations, payment under
176	176	6.16this section must only be provided if the client is eligible for the service and the service is
177	177	6.17determined to be medically necessary.
178	178	6.18 (d) The commissioner shall determine one rate for each provider that will bill medical
179	179	6.19assistance for intensive residential treatment services under this section. If a single entity
180	180	6.20provides both intensive residential treatment services under this section and assertive
181	181	6.21community treatment under section 256B.0622, one rate is established for the entity's
182	182	6.22intensive residential treatment services under this section and another rate for the entity's
183	183	6.23assertive community treatment services under section 256B.0622. A provider is not eligible
184	184	6.24for payment under this section without authorization from the commissioner. The
185	185	6.25commissioner shall develop rates using the following criteria:
186	186	6.26 (1) the provider's cost for services shall include direct services costs, other program
187	187	6.27costs, and other costs determined as follows:
188	188	6.28 (i) the direct services costs must be determined using actual costs of salaries, benefits,
189	189	6.29payroll taxes, and training of direct service staff and service-related transportation;
190	190	6.30 (ii) other program costs not included in item (i) must be determined as a specified
191	191	6.31percentage of the direct services costs as determined by item (i). The percentage used shall
192	192	6.32be determined by the commissioner based upon the average of percentages that represent
193	193	6.33the relationship of other program costs to direct services costs among the entities that provide
194	194	6.34similar services;
195	195	6Article 1 Sec. 5.
196	196	25-05140 as introduced03/20/25 REVISOR AGW/LN 7.1 (iii) physical plant costs calculated based on the percentage of space within the program
197	197	7.2that is entirely devoted to treatment and programming. This does not include administrative
198	198	7.3or residential space; and
199	199	7.4 (iv) subject to federal approval, up to an additional five percent of the total rate may be
200	200	7.5added to the program rate as a quality incentive based upon the entity meeting performance
201	201	7.6criteria specified by the commissioner;
202	202	7.7 (2) actual costs are defined as costs which are allowable, allocable, and reasonable, and
203	203	7.8consistent with federal reimbursement requirements under Code of Federal Regulations,
204	204	7.9title 48, chapter 1, part 31, relating to for-profit entities, and Office of Management and
205	205	7.10Budget Circular Number A-122, relating to nonprofit entities;
206	206	7.11 (3) the number of services units;
207	207	7.12 (4) the degree to which clients will receive services other than services under this section
208	208	7.13or section 256B.0622; and
209	209	7.14 (5) the costs of other services that will be separately reimbursed.
210	210	7.15 (e) The rate for intensive residential treatment services must exclude the medical
211	211	7.16assistance room and board rate, as defined in section 256B.056, subdivision 5d, and services
212	212	7.17not covered under this section, such as partial hospitalization, home care, and inpatient
213	213	7.18services.
214	214	7.19 (f) Physician services that are not separately billed may be included in the rate to the
215	215	7.20extent that a psychiatrist, or other health care professional providing physician services
216	216	7.21within their scope of practice, is a member of the intensive residential treatment services
217	217	7.22treatment team. Physician services, whether billed separately or included in the rate, may
218	218	7.23be delivered by telehealth. For purposes of this paragraph, "telehealth" has the meaning
219	219	7.24given to "mental health telehealth" in section 256B.0625, subdivision 46, when telehealth
220	220	7.25is used to provide intensive residential treatment services.
221	221	7.26 (g) The rate for a provider must not exceed the rate charged by that provider for the
222	222	7.27same service to other payors.
223	223	7.28 (h) The rates for existing programs must be established prospectively based upon the
224	224	7.29expenditures and utilization over a prior 12-month period using the criteria established in
225	225	7.30paragraph (d). The rates for new programs must be established based upon estimated
226	226	7.31expenditures and estimated utilization using the criteria established in paragraph (d).
227	227	7.32 (i) Effective upon the expiration of section 256B.0622, subdivision 8, paragraph (h),
228	228	7.33and effective for rate years beginning on and after January 1, 2024, rates for intensive
229	229	7Article 1 Sec. 5.
230	230	25-05140 as introduced03/20/25 REVISOR AGW/LN 8.1residential treatment services and adult residential crisis stabilization services must be
231	231	8.2annually adjusted for inflation using the Centers for Medicare and Medicaid Services
232	232	8.3Medicare Economic Index, as forecasted in the third quarter of the calendar year before the
233	233	8.4rate year. The inflation adjustment must be based on the 12-month period from the midpoint
234	234	8.5of the previous rate year to the midpoint of the rate year for which the rate is being
235	235	8.6determined.
236	236	8.7 (j) Entities who discontinue providing services must be subject to a settle-up process
237	237	8.8whereby actual costs and reimbursement for the previous 12 months are compared. In the
238	238	8.9event that the entity was paid more than the entity's actual costs plus any applicable
239	239	8.10performance-related funding due the provider, the excess payment must be reimbursed to
240	240	8.11the department. If a provider's revenue is less than actual allowed costs due to lower
241	241	8.12utilization than projected, the commissioner may reimburse the provider to recover its actual
242	242	8.13allowable costs. The resulting adjustments by the commissioner must be proportional to the
243	243	8.14percent of total units of service reimbursed by the commissioner and must reflect a difference
244	244	8.15of greater than five percent.
245	245	8.16 (k) A provider may request of the commissioner a review of any rate-setting decision
246	246	8.17made under this subdivision.
247	247	8.18 Subd. 4.Provider enrollment; rate setting for county-operated entities.Counties
248	248	8.19that employ their own staff to provide services under this section shall apply directly to the
249	249	8.20commissioner for enrollment and rate setting. In this case, a county contract is not required.
250	250	8.21 Subd. 5.Provider enrollment; rate setting for specialized program.A county contract
251	251	8.22is not required for a provider proposing to serve a subpopulation of eligible clients under
252	252	8.23the following circumstances:
253	253	8.24 (1) the provider demonstrates that the subpopulation to be served requires a specialized
254	254	8.25program which is not available from county-approved entities; and
255	255	8.26 (2) the subpopulation to be served is of such a low incidence that it is not feasible to
256	256	8.27develop a program serving a single county or regional group of counties.
257	257	8.28 Subd. 6.Sustainability grants.The commissioner may disburse grant funds directly to
258	258	8.29intensive residential treatment services providers to maintain access to these services.
259	259	8.30 Subd. 7.Start-up grants.The commissioner may, within available appropriations,
260	260	8.31disburse grant funding to counties, Indian Tribes, or mental health service providers to
261	261	8.32establish additional intensive residential treatment services and residential crisis services.
262	262	8Article 1 Sec. 5.
263	263	25-05140 as introduced03/20/25 REVISOR AGW/LN 9.1 Sec. 6. REPEALER.
264	264	9.2 Minnesota Statutes 2024, section 256B.0622, subdivision 4, is repealed.
265	265	9.3 ARTICLE 2
266	266	9.4 CONFORMING CHANGES
267	267	9.5 Section 1. Minnesota Statutes 2024, section 148F.11, subdivision 1, is amended to read:
268	268	9.6 Subdivision 1.Other professionals.(a) Nothing in this chapter prevents members of
269	269	9.7other professions or occupations from performing functions for which they are qualified or
270	270	9.8licensed. This exception includes, but is not limited to: licensed physicians; registered nurses;
271	271	9.9licensed practical nurses; licensed psychologists and licensed psychological practitioners;
272	272	9.10members of the clergy provided such services are provided within the scope of regular
273	273	9.11ministries; American Indian medicine men and women; licensed attorneys; probation officers;
274	274	9.12licensed marriage and family therapists; licensed social workers; social workers employed
275	275	9.13by city, county, or state agencies; licensed professional counselors; licensed professional
276	276	9.14clinical counselors; licensed school counselors; registered occupational therapists or
277	277	9.15occupational therapy assistants; Upper Midwest Indian Council on Addictive Disorders
278	278	9.16(UMICAD) certified counselors when providing services to Native American people; city,
279	279	9.17county, or state employees when providing assessments or case management under Minnesota
280	280	9.18Rules, chapter 9530; and staff persons providing co-occurring substance use disorder
281	281	9.19treatment in adult mental health rehabilitative programs certified or licensed by the
282	282	9.20Department of Human Services under section 245I.23, 256B.0622, or 256B.0623, or
283	283	9.21256B.0632.
284	284	9.22 (b) Nothing in this chapter prohibits technicians and resident managers in programs
285	285	9.23licensed by the Department of Human Services from discharging their duties as provided
286	286	9.24in Minnesota Rules, chapter 9530.
287	287	9.25 (c) Any person who is exempt from licensure under this section must not use a title
288	288	9.26incorporating the words "alcohol and drug counselor" or "licensed alcohol and drug
289	289	9.27counselor" or otherwise hold himself or herself out to the public by any title or description
290	290	9.28stating or implying that he or she is engaged in the practice of alcohol and drug counseling,
291	291	9.29or that he or she is licensed to engage in the practice of alcohol and drug counseling, unless
292	292	9.30that person is also licensed as an alcohol and drug counselor. Persons engaged in the practice
293	293	9.31of alcohol and drug counseling are not exempt from the board's jurisdiction solely by the
294	294	9.32use of one of the titles in paragraph (a).
295	295	9Article 2 Section 1.
296	296	25-05140 as introduced03/20/25 REVISOR AGW/LN 10.1 Sec. 2. Minnesota Statutes 2024, section 245.4662, subdivision 1, is amended to read:
297	297	10.2 Subdivision 1.Definitions.(a) For purposes of this section, the following terms have
298	298	10.3the meanings given them.
299	299	10.4 (b) "Community partnership" means a project involving the collaboration of two or more
300	300	10.5eligible applicants.
301	301	10.6 (c) "Eligible applicant" means an eligible county, Indian tribe, mental health service
302	302	10.7provider, hospital, or community partnership. Eligible applicant does not include a
303	303	10.8state-operated direct care and treatment facility or program under chapters 246 and 246C.
304	304	10.9 (d) "Intensive residential treatment services" has the meaning given in section 256B.0622
305	305	10.10256B.0632.
306	306	10.11 (e) "Metropolitan area" means the seven-county metropolitan area, as defined in section
307	307	10.12473.121, subdivision 2.
308	308	10.13Sec. 3. Minnesota Statutes 2024, section 245.4906, subdivision 2, is amended to read:
309	309	10.14 Subd. 2.Eligible applicants.An eligible applicant is a licensed entity or provider that
310	310	10.15employs a mental health certified peer specialist qualified under section 245I.04, subdivision
311	311	10.1610, and that provides services to individuals receiving assertive community treatment or
312	312	10.17intensive residential treatment services under section 256B.0622, intensive residential
313	313	10.18treatment services under section 256B.0632, adult rehabilitative mental health services
314	314	10.19under section 256B.0623, or crisis response services under section 256B.0624.
315	315	10.20Sec. 4. Minnesota Statutes 2024, section 254B.04, subdivision 1a, is amended to read:
316	316	10.21 Subd. 1a.Client eligibility.(a) Persons eligible for benefits under Code of Federal
317	317	10.22Regulations, title 25, part 20, who meet the income standards of section 256B.056,
318	318	10.23subdivision 4, and are not enrolled in medical assistance, are entitled to behavioral health
319	319	10.24fund services. State money appropriated for this paragraph must be placed in a separate
320	320	10.25account established for this purpose.
321	321	10.26 (b) Persons with dependent children who are determined to be in need of substance use
322	322	10.27disorder treatment pursuant to an assessment under section 260E.20, subdivision 1, or in
323	323	10.28need of chemical dependency treatment pursuant to a case plan under section 260C.201,
324	324	10.29subdivision 6, or 260C.212, shall be assisted by the local agency to access needed treatment
325	325	10.30services. Treatment services must be appropriate for the individual or family, which may
326	326	10.31include long-term care treatment or treatment in a facility that allows the dependent children
327	327	10Article 2 Sec. 4.
328	328	25-05140 as introduced03/20/25 REVISOR AGW/LN 11.1to stay in the treatment facility. The county shall pay for out-of-home placement costs, if
329	329	11.2applicable.
330	330	11.3 (c) Notwithstanding paragraph (a), any person enrolled in medical assistance or
331	331	11.4MinnesotaCare is eligible for room and board services under section 254B.05, subdivision
332	332	11.55, paragraph (b), clause (9).
333	333	11.6 (d) A client is eligible to have substance use disorder treatment paid for with funds from
334	334	11.7the behavioral health fund when the client:
335	335	11.8 (1) is eligible for MFIP as determined under chapter 142G;
336	336	11.9 (2) is eligible for medical assistance as determined under Minnesota Rules, parts
337	337	11.109505.0010 to 9505.0150;
338	338	11.11 (3) is eligible for general assistance, general assistance medical care, or work readiness
339	339	11.12as determined under Minnesota Rules, parts 9500.1200 to 9500.1318; or
340	340	11.13 (4) has income that is within current household size and income guidelines for entitled
341	341	11.14persons, as defined in this subdivision and subdivision 7.
342	342	11.15 (e) Clients who meet the financial eligibility requirement in paragraph (a) and who have
343	343	11.16a third-party payment source are eligible for the behavioral health fund if the third-party
344	344	11.17payment source pays less than 100 percent of the cost of treatment services for eligible
345	345	11.18clients.
346	346	11.19 (f) A client is ineligible to have substance use disorder treatment services paid for with
347	347	11.20behavioral health fund money if the client:
348	348	11.21 (1) has an income that exceeds current household size and income guidelines for entitled
349	349	11.22persons as defined in this subdivision and subdivision 7; or
350	350	11.23 (2) has an available third-party payment source that will pay the total cost of the client's
351	351	11.24treatment.
352	352	11.25 (g) A client who is disenrolled from a state prepaid health plan during a treatment episode
353	353	11.26is eligible for continued treatment service that is paid for by the behavioral health fund until
354	354	11.27the treatment episode is completed or the client is re-enrolled in a state prepaid health plan
355	355	11.28if the client:
356	356	11.29 (1) continues to be enrolled in MinnesotaCare, medical assistance, or general assistance
357	357	11.30medical care; or
358	358	11.31 (2) is eligible according to paragraphs (a) and (b) and is determined eligible by a local
359	359	11.32agency under section 254B.04.
360	360	11Article 2 Sec. 4.
361	361	25-05140 as introduced03/20/25 REVISOR AGW/LN 12.1 (h) When a county commits a client under chapter 253B to a regional treatment center
362	362	12.2for substance use disorder services and the client is ineligible for the behavioral health fund,
363	363	12.3the county is responsible for the payment to the regional treatment center according to
364	364	12.4section 254B.05, subdivision 4.
365	365	12.5 (i) Persons enrolled in MinnesotaCare are eligible for room and board services when
366	366	12.6provided through intensive residential treatment services and residential crisis services under
367	367	12.7section 256B.0622 256B.0632.
368	368	12.8 Sec. 5. Minnesota Statutes 2024, section 254B.05, subdivision 1a, is amended to read:
369	369	12.9 Subd. 1a.Room and board provider requirements.(a) Vendors of room and board
370	370	12.10are eligible for behavioral health fund payment if the vendor:
371	371	12.11 (1) has rules prohibiting residents bringing chemicals into the facility or using chemicals
372	372	12.12while residing in the facility and provide consequences for infractions of those rules;
373	373	12.13 (2) is determined to meet applicable health and safety requirements;
374	374	12.14 (3) is not a jail or prison;
375	375	12.15 (4) is not concurrently receiving funds under chapter 256I for the recipient;
376	376	12.16 (5) admits individuals who are 18 years of age or older;
377	377	12.17 (6) is registered as a board and lodging or lodging establishment according to section
378	378	12.18157.17;
379	379	12.19 (7) has awake staff on site whenever a client is present;
380	380	12.20 (8) has staff who are at least 18 years of age and meet the requirements of section
381	381	12.21245G.11, subdivision 1, paragraph (b);
382	382	12.22 (9) has emergency behavioral procedures that meet the requirements of section 245G.16;
383	383	12.23 (10) meets the requirements of section 245G.08, subdivision 5, if administering
384	384	12.24medications to clients;
385	385	12.25 (11) meets the abuse prevention requirements of section 245A.65, including a policy on
386	386	12.26fraternization and the mandatory reporting requirements of section 626.557;
387	387	12.27 (12) documents coordination with the treatment provider to ensure compliance with
388	388	12.28section 254B.03, subdivision 2;
389	389	12.29 (13) protects client funds and ensures freedom from exploitation by meeting the
390	390	12.30provisions of section 245A.04, subdivision 13;
391	391	12Article 2 Sec. 5.
392	392	25-05140 as introduced03/20/25 REVISOR AGW/LN 13.1 (14) has a grievance procedure that meets the requirements of section 245G.15,
393	393	13.2subdivision 2; and
394	394	13.3 (15) has sleeping and bathroom facilities for men and women separated by a door that
395	395	13.4is locked, has an alarm, or is supervised by awake staff.
396	396	13.5 (b) Programs licensed according to Minnesota Rules, chapter 2960, are exempt from
397	397	13.6paragraph (a), clauses (5) to (15).
398	398	13.7 (c) Programs providing children's mental health crisis admissions and stabilization under
399	399	13.8section 245.4882, subdivision 6, are eligible vendors of room and board.
400	400	13.9 (d) Programs providing children's residential services under section 245.4882, except
401	401	13.10services for individuals who have a placement under chapter 260C or 260D, are eligible
402	402	13.11vendors of room and board.
403	403	13.12 (e) Licensed programs providing intensive residential treatment services or residential
404	404	13.13crisis stabilization services pursuant to section 256B.0622 or 256B.0624 or 256B.0632 are
405	405	13.14eligible vendors of room and board and are exempt from paragraph (a), clauses (6) to (15).
406	406	13.15 (f) A vendor that is not licensed as a residential treatment program must have a policy
407	407	13.16to address staffing coverage when a client may unexpectedly need to be present at the room
408	408	13.17and board site.
409	409	13.18Sec. 6. Minnesota Statutes 2024, section 256.478, subdivision 2, is amended to read:
410	410	13.19 Subd. 2.Eligibility.An individual is eligible for the transition to community initiative
411	411	13.20if the individual can demonstrate that current services are not capable of meeting individual
412	412	13.21treatment and service needs that can be met in the community with support, and the individual
413	413	13.22meets at least one of the following criteria:
414	414	13.23 (1) the person meets the criteria under section 256B.092, subdivision 13, or 256B.49,
415	415	13.24subdivision 24;
416	416	13.25 (2) the person has met treatment objectives and no longer requires a hospital-level care,
417	417	13.26residential-level care, or a secure treatment setting, but the person's discharge from the
418	418	13.27Anoka Metro Regional Treatment Center, the Minnesota Forensic Mental Health Program,
419	419	13.28the Child and Adolescent Behavioral Health Hospital program, a psychiatric residential
420	420	13.29treatment facility under section 256B.0941, intensive residential treatment services under
421	421	13.30section 256B.0622 256B.0632, children's residential services under section 245.4882,
422	422	13.31juvenile detention facility, county supervised building, or a hospital would be substantially
423	423	13.32delayed without additional resources available through the transitions to community initiative;
424	424	13Article 2 Sec. 6.
425	425	25-05140 as introduced03/20/25 REVISOR AGW/LN 14.1 (3) the person (i) is receiving customized living services reimbursed under section
426	426	14.2256B.4914, 24-hour customized living services reimbursed under section 256B.4914, or
427	427	14.3community residential services reimbursed under section 256B.4914; (ii) expresses a desire
428	428	14.4to move; and (iii) has received approval from the commissioner; or
429	429	14.5 (4) the person can demonstrate that the person's needs are beyond the scope of current
430	430	14.6service designs and grant funding can support the inclusion of additional supports for the
431	431	14.7person to access appropriate treatment and services in the least restrictive environment.
432	432	14.8 Sec. 7. Minnesota Statutes 2024, section 256B.0615, subdivision 1, is amended to read:
433	433	14.9 Subdivision 1.Scope.Medical assistance covers mental health certified peer specialist
434	434	14.10services, as established in subdivision 2, if provided to recipients who are eligible for services
435	435	14.11under sections 256B.0622, 256B.0623, and 256B.0624, and 256B.0632 and are provided
436	436	14.12by a mental health certified peer specialist who has completed the training under subdivision
437	437	14.135 and is qualified according to section 245I.04, subdivision 10.
438	438	14.14Sec. 8. Minnesota Statutes 2024, section 256B.0615, subdivision 3, is amended to read:
439	439	14.15 Subd. 3.Eligibility.Peer support services may be made available to consumers of (1)
440	440	14.16intensive residential treatment services under section 256B.0622 256B.0632; (2) adult
441	441	14.17rehabilitative mental health services under section 256B.0623; and (3) crisis stabilization
442	442	14.18and mental health mobile crisis intervention services under section 256B.0624.
443	443	14.19Sec. 9. Minnesota Statutes 2024, section 256B.82, is amended to read:
444	444	14.20 256B.82 PREPAID PLANS AND MENTAL HEALTH REHABILITATIVE
445	445	14.21SERVICES.
446	446	14.22 Medical assistance and MinnesotaCare prepaid health plans may include coverage for
447	447	14.23adult mental health rehabilitative services under section 256B.0623, intensive rehabilitative
448	448	14.24services under section 256B.0622 256B.0632, and adult mental health crisis response services
449	449	14.25under section 256B.0624, beginning January 1, 2005.
450	450	14.26 By January 15, 2004, the commissioner shall report to the legislature how these services
451	451	14.27should be included in prepaid plans. The commissioner shall consult with mental health
452	452	14.28advocates, health plans, and counties in developing this report. The report recommendations
453	453	14.29must include a plan to ensure coordination of these services between health plans and
454	454	14.30counties, assure recipient access to essential community providers, and monitor the health
455	455	14.31plans' delivery of services through utilization review and quality standards.
456	456	14Article 2 Sec. 9.
457	457	25-05140 as introduced03/20/25 REVISOR AGW/LN 15.1 Sec. 10. Minnesota Statutes 2024, section 256D.44, subdivision 5, is amended to read:
458	458	15.2 Subd. 5.Special needs.(a) In addition to the state standards of assistance established
459	459	15.3in subdivisions 1 to 4, payments are allowed for the following special needs of recipients
460	460	15.4of Minnesota supplemental aid who are not residents of a nursing home, a regional treatment
461	461	15.5center, or a setting authorized to receive housing support payments under chapter 256I.
462	462	15.6 (b) The county agency shall pay a monthly allowance for medically prescribed diets if
463	463	15.7the cost of those additional dietary needs cannot be met through some other maintenance
464	464	15.8benefit. The need for special diets or dietary items must be prescribed by a licensed physician,
465	465	15.9advanced practice registered nurse, or physician assistant. Costs for special diets shall be
466	466	15.10determined as percentages of the allotment for a one-person household under the thrifty
467	467	15.11food plan as defined by the United States Department of Agriculture. The types of diets and
468	468	15.12the percentages of the thrifty food plan that are covered are as follows:
469	469	15.13 (1) high protein diet, at least 80 grams daily, 25 percent of thrifty food plan;
470	470	15.14 (2) controlled protein diet, 40 to 60 grams and requires special products, 100 percent of
471	471	15.15thrifty food plan;
472	472	15.16 (3) controlled protein diet, less than 40 grams and requires special products, 125 percent
473	473	15.17of thrifty food plan;
474	474	15.18 (4) low cholesterol diet, 25 percent of thrifty food plan;
475	475	15.19 (5) high residue diet, 20 percent of thrifty food plan;
476	476	15.20 (6) pregnancy and lactation diet, 35 percent of thrifty food plan;
477	477	15.21 (7) gluten-free diet, 25 percent of thrifty food plan;
478	478	15.22 (8) lactose-free diet, 25 percent of thrifty food plan;
479	479	15.23 (9) antidumping diet, 15 percent of thrifty food plan;
480	480	15.24 (10) hypoglycemic diet, 15 percent of thrifty food plan; or
481	481	15.25 (11) ketogenic diet, 25 percent of thrifty food plan.
482	482	15.26 (c) Payment for nonrecurring special needs must be allowed for necessary home repairs
483	483	15.27or necessary repairs or replacement of household furniture and appliances using the payment
484	484	15.28standard of the AFDC program in effect on July 16, 1996, for these expenses, as long as
485	485	15.29other funding sources are not available.
486	486	15.30 (d) A fee for guardian or conservator service is allowed at a reasonable rate negotiated
487	487	15.31by the county or approved by the court. This rate shall not exceed five percent of the
488	488	15Article 2 Sec. 10.
489	489	25-05140 as introduced03/20/25 REVISOR AGW/LN 16.1assistance unit's gross monthly income up to a maximum of $100 per month. If the guardian
490	490	16.2or conservator is a member of the county agency staff, no fee is allowed.
491	491	16.3 (e) The county agency shall continue to pay a monthly allowance of $68 for restaurant
492	492	16.4meals for a person who was receiving a restaurant meal allowance on June 1, 1990, and
493	493	16.5who eats two or more meals in a restaurant daily. The allowance must continue until the
494	494	16.6person has not received Minnesota supplemental aid for one full calendar month or until
495	495	16.7the person's living arrangement changes and the person no longer meets the criteria for the
496	496	16.8restaurant meal allowance, whichever occurs first.
497	497	16.9 (f) A fee equal to the maximum monthly amount allowed by the Social Security
498	498	16.10Administration is allowed for representative payee services provided by an agency that
499	499	16.11meets the requirements under SSI regulations to charge a fee for representative payee
500	500	16.12services. This special need is available to all recipients of Minnesota supplemental aid
501	501	16.13regardless of their living arrangement.
502	502	16.14 (g)(1) Notwithstanding the language in this subdivision, an amount equal to one-half of
503	503	16.15the maximum federal Supplemental Security Income payment amount for a single individual
504	504	16.16which is in effect on the first day of July of each year will be added to the standards of
505	505	16.17assistance established in subdivisions 1 to 4 for adults under the age of 65 who qualify as
506	506	16.18in need of housing assistance and are:
507	507	16.19 (i) relocating from an institution, a setting authorized to receive housing support under
508	508	16.20chapter 256I, or an adult mental health residential treatment program under section 256B.0622
509	509	16.21256B.0632;
510	510	16.22 (ii) eligible for personal care assistance under section 256B.0659; or
511	511	16.23 (iii) home and community-based waiver recipients living in their own home or rented
512	512	16.24or leased apartment.
513	513	16.25 (2) Notwithstanding subdivision 3, paragraph (c), an individual eligible for the shelter
514	514	16.26needy benefit under this paragraph is considered a household of one. An eligible individual
515	515	16.27who receives this benefit prior to age 65 may continue to receive the benefit after the age
516	516	16.28of 65.
517	517	16.29 (3) "Housing assistance" means that the assistance unit incurs monthly shelter costs that
518	518	16.30exceed 40 percent of the assistance unit's gross income before the application of this special
519	519	16.31needs standard. "Gross income" for the purposes of this section is the applicant's or recipient's
520	520	16.32income as defined in section 256D.35, subdivision 10, or the standard specified in subdivision
521	521	16.333, paragraph (a) or (b), whichever is greater. A recipient of a federal or state housing subsidy,
522	522	16Article 2 Sec. 10.
523	523	25-05140 as introduced03/20/25 REVISOR AGW/LN 17.1that limits shelter costs to a percentage of gross income, shall not be considered in need of
524	524	17.2housing assistance for purposes of this paragraph.
525	525	17Article 2 Sec. 10.
526	526	25-05140 as introduced03/20/25 REVISOR AGW/LN Page.Ln 1.11RECODIFICATION...............................................................................ARTICLE 1
527	527	Page.Ln 9.3CONFORMING CHANGES.................................................................ARTICLE 2
528	528	1
529	529	APPENDIX
530	530	Article locations for 25-05140 256B.0622 ASSERTIVE COMMUNITY TREATMENT AND INTENSIVE RESIDENTIAL
531	531	TREATMENT SERVICES.
532	532	Subd. 4.Provider entity licensure and contract requirements for intensive residential
533	533	treatment services.(a) The commissioner shall develop procedures for counties and providers to
534	534	submit other documentation as needed to allow the commissioner to determine whether the standards
535	535	in this section are met.
536	536	(b) A provider entity must specify in the provider entity's application what geographic area and
537	537	populations will be served by the proposed program. A provider entity must document that the
538	538	capacity or program specialties of existing programs are not sufficient to meet the service needs of
539	539	the target population. A provider entity must submit evidence of ongoing relationships with other
540	540	providers and levels of care to facilitate referrals to and from the proposed program.
541	541	(c) A provider entity must submit documentation that the provider entity requested a statement
542	542	of need from each county board and tribal authority that serves as a local mental health authority
543	543	in the proposed service area. The statement of need must specify if the local mental health authority
544	544	supports or does not support the need for the proposed program and the basis for this determination.
545	545	If a local mental health authority does not respond within 60 days of the receipt of the request, the
546	546	commissioner shall determine the need for the program based on the documentation submitted by
547	547	the provider entity.
548	548	1R
549	549	APPENDIX
550	550	Repealed Minnesota Statutes: 25-05140