SF 562, Section 1 (256B.0949) adds new language concerning an existing benefit for the treatment of children with autism spectrum disorders and related conditions.
Subdivision 1 changes the name of the existing autism early intensive intervention benefit to the Early Intensive Developmental and Behavioral Intervention (EIDBI) benefit and includes language specifying that the benefit is also available for the treatment of conditions related to autism spectrum disorders (ASD).
Subdivision 2 includes several new definitions, including definitions of “agency,” “ASD and related conditions,” “clinical supervision,” “comprehensive multidisciplinary evaluation,” “Department,” “Incident,” “individual treatment plan,” “legal representative,” “person-centered,” and “Qualified EIDBI provider.”
In addition, subdivision 2 expands the eligibility criteria for EIDBI services by replacing “child” with “person” and defining “person” as a person under the age of 21.
Subdivision 3 modifies the eligibility criteria for the EIDBI benefit to allow persons (as newly defined) with diagnoses of a condition related to an autism spectrum disorder to be eligible.
Subdivision 3a requires providers to ensure that service recipients and their families receive EIBDI services in a culturally and linguistically appropriate manner.
Subdivision 4 specifies the conditions a diagnosis of ASD or a related condition must meet in order for a person to be eligible for the EIDBI benefit.
Subdivision 5 requires a comprehensive multidisciplinary evaluation (CMDE) of potential service recipients be completed to determine if EIDBI services are medically necessary; and specifies what must be included in the evaluation.
Subdivision 5a specifies the CMDE provider qualification requirements.
Subdivision 6 requires an EIDBI professional to develop and monitor a person’s individual treatment plan, specifies the required elements of an individual treatment plan, and specifies the conditions under which service may be terminated by a provider.
Subdivision 7 requires that a person’s progress toward achieving treatment goals be evaluated at least every six months and specifies who must supervise the evaluation and the required elements of the evaluation.
Subdivision 8 requires the commissioner to work with stakeholders to continue to refine the details of the EIBDI benefit and incorporates new language and terminology into the list of suggested issues the commissioner could consider.
Subdivision 9 specifies the requirements any treatment method must meet to be a recognized treatment option for the purposes of the EIDBI benefit.
Subdivision 10 specifies that EIDBI services may not replace services defined in a person’s individualized education plan or individualized family service plan, although the subdivision explicitly permits EIDBI services during school hours; permits other resources available to persons to be coordinated with the EIDBI benefit; and requires the commissioner to integrate medical authorization procedures for this benefit with authorization procedures for other services.
Subdivision 11 makes conforming changes.
Subdivision 12 makes conforming changes.
Subdivision 13 lists and describes the services covered by the EIDBI benefit.
Subdivision 14 lists the rights of persons and of their legal representatives who receive the EIDBI benefit.
Subdivision 15 specifies the provider qualification requirements for each of the following EIBDI providers: level I treatment providers; level II treatment providers; level III treatment providers; and qualified supervising professionals.
Subdivision 16 lists and describes the duties and responsibilities of an agency.
Subdivision 17 requires the commissioner to consult with stakeholders to determine if there exists a shortage of qualified providers of EIDBI services, and if so, to develop a process and criteria for granting exceptions to the provider qualification requirements, the medical assistance provider enrollment requirements, or other applicable requirements. The commissioner is required to provide annual updates to the legislature concerning the status of the shortage of qualified EIBDI providers and the use of the qualification exception process. The commissioner may not terminate the exemption authority without providing 30 days’ notice for public comment.