1.1Senator Hoffman moved to amend
H.F. No. 1403 as follows:
1.2Page 18, delete section 17 and insert:
1.3 "Sec. 17. Minnesota Statutes 2022, section 245G.22, subdivision 15, is amended to read:
1.4 Subd. 15.
Nonmedication treatment services; documentation. (a) The program must
1.5offer at least 50 consecutive minutes of individual or group therapy treatment services
as
1.6defined in section
245G.07, subdivision 1, paragraph (a), clause (1), per week, for the first
1.7ten weeks following the day of service initiation, and at least 50 consecutive minutes
per
1.8month thereafter. As clinically appropriate, the program may offer these services
cumulatively
1.9and not consecutively in increments of no less than 15 minutes over the required time
period,
1.10and for a total of 60 minutes of treatment services over the time period, and must
document
1.11the reason for providing services cumulatively in the client's record. The program
may offer
1.12additional levels of service when deemed clinically necessary.
1.13(b) Notwithstanding the requirements of comprehensive assessments in section
245G.05,
1.14the assessment must be completed within 21 days from the day of service initiation.
1.15(c) Notwithstanding the requirements of individual treatment plans set forth in section
1.16245G.06:
1.17(1) treatment plan contents for a maintenance client are not required to include goals
1.18the client must reach to complete treatment and have services terminated;
1.19(2) treatment plans for a client in a taper or detox status must include goals the
client
1.20must reach to complete treatment and have services terminated; and
1.21(3) for the ten weeks following the day of service initiation for all new admissions,
1.22readmissions, and transfers, a weekly treatment plan review must be documented once
the
1.23treatment plan is completed. Subsequently, the counselor must document treatment plan
1.24reviews in the six dimensions at least once monthly or, when clinical need warrants,
more
1.25frequently."
1.26Page 19, line 31, delete everything after the period and insert "
The license holder may
1.27continue to serve a client who was receiving services at the program on June 30, 2024,
at
1.28a counselor to client ratio of up to one to 60 and is not required to discharge any
clients in
1.29order to return to the counselor to client ratio of one to 50. The license holder
may not,
1.30however, serve a new client after June 30, 2024, unless the counselor who would supervise
1.31the new client is supervising fewer than 50 existing clients."
1.32Page 19, delete line 32
2.1Page 50, after line 9, insert:
2.2 "Sec. 8. Minnesota Statutes 2022, section 245G.01, is amended by adding a subdivision
2.3to read:
2.4 Subd. 4a. American Society of Addiction Medicine criteria or ASAM
2.5criteria. "American Society of Addiction Medicine criteria" or "ASAM criteria" has the
2.6meaning provided in section 254B.01, subdivision 2a.
2.7EFFECTIVE DATE.This section is effective January 1, 2024."
2.8Page 55, line 14, before "
level" insert "
ASAM" and delete "
and the" and insert "
under
2.9which the client is receiving services;"
2.10Page 55, delete lines 15 and 16
2.11Page 57, delete lines 1 to 8 and insert:
2.12"
(f) For a client receiving nonresidential opioid treatment program services according
2.13to section 245G.22:
2.14(1) a treatment plan review must be completed weekly for the ten weeks following
2.15completion of the treatment plan; and
2.16(2) monthly thereafter.
2.17Treatment plan reviews must be completed more frequently when clinical needs warrant.
2.18(g) Notwithstanding paragraphs (e) and (f), clause (2), for a client in a nonresidential
2.19program with a treatment plan that clearly indicates less than five hours of skilled
treatment
2.20services will be provided to the client each month, a treatment plan review must be
completed
2.21once every 90 days. Treatment plan reviews must be completed more frequently when
2.22clinical needs warrant."
2.23Page 76, after line 6, insert:
2.24 "Sec. 52. Minnesota Statutes 2022, section 254B.05, subdivision 5, is amended to read:
2.25 Subd. 5.
Rate requirements. (a) The commissioner shall establish rates for substance
2.26use disorder services and service enhancements funded under this chapter.
2.27(b) Eligible substance use disorder treatment services include:
2.28(1)
outpatient treatment services that are licensed according to sections
245G.01 to
2.29245G.17, or applicable tribal license; those licensed, as applicable, according to chapter
3.1245G or applicable Tribal license and provided according to the following ASAM levels
3.2of care:
3.3(i) ASAM level 0.5 early intervention services provided according to section 254B.19,
3.4subdivision 1, clause (1);
3.5(ii) ASAM level 1.0 outpatient services provided according to section 254B.19,
3.6subdivision 1, clause (2);
3.7(iii) ASAM level 2.1 intensive outpatient services provided according to section 254B.19,
3.8subdivision 1, clause (3);
3.9(iv) ASAM level 2.5 partial hospitalization services provided according to section
3.10254B.19, subdivision 1, clause (4);
3.11(v) ASAM level 3.1 clinically managed low-intensity residential services provided
3.12according to section 254B.19, subdivision 1, clause (5);
3.13(vi) ASAM level 3.3 clinically managed population-specific high-intensity residential
3.14services provided according to section 254B.19, subdivision 1, clause (6); and
3.15(vii) ASAM level 3.5 clinically managed high-intensity residential services provided
3.16according to section 254B.19, subdivision 1, clause (7);
3.17(2) comprehensive assessments provided according to sections
245.4863, paragraph (a),
3.18and
245G.05;
3.19(3)
care treatment coordination services provided according to section
245G.07,
3.20subdivision 1, paragraph (a), clause (5);
3.21(4) peer recovery support services provided according to section
245G.07, subdivision
3.222, clause (8);
3.23(5)
on July 1, 2019, or upon federal approval, whichever is later, withdrawal management
3.24services provided according to chapter
245F;
3.25(6) substance use disorder treatment services with medications for opioid use disorder
3.26that are provided in an opioid treatment program licensed according to sections
245G.01
3.27to
245G.17 and
245G.22, or applicable tribal license;
3.28(7) substance use disorder treatment with medications for opioid use disorder plus
3.29enhanced treatment services that meet the requirements of clause (6) and provide nine
hours
3.30of clinical services each week;
4.1(8) high, medium, and low intensity residential treatment services that are licensed
4.2according to sections
245G.01 to
245G.17 and
245G.21 or applicable tribal license which
4.3provide, respectively, 30, 15, and five hours of clinical services each week;
4.4(9) (8) hospital-based treatment services that are licensed according to sections
245G.01
4.5to
245G.17 or applicable tribal license and licensed as a hospital under sections
144.50 to
4.6144.56;
4.7(10) (9) adolescent treatment programs that are licensed as outpatient treatment programs
4.8according to sections
245G.01 to
245G.18 or as residential treatment programs according
4.9to Minnesota Rules, parts 2960.0010 to 2960.0220, and 2960.0430 to 2960.0490, or
4.10applicable tribal license;
4.11(11) high-intensity residential treatment (10) ASAM 3.5 clinically managed high-intensity
4.12residential services that are licensed according to sections
245G.01 to
245G.17 and
245G.21
4.13or applicable tribal license, which provide
30 hours of clinical services each week ASAM
4.14level of care 3.5 according to section 254B.19, subdivision 1, clause (7), and is provided
4.15by a state-operated vendor or to clients who have been civilly committed to the commissioner,
4.16present the most complex and difficult care needs, and are a potential threat to the
community;
4.17and
4.18(12) (11) room and board facilities that meet the requirements of subdivision 1a.
4.19(c) The commissioner shall establish higher rates for programs that meet the requirements
4.20of paragraph (b) and one of the following additional requirements:
4.21(1) programs that serve parents with their children if the program:
4.22(i) provides on-site child care during the hours of treatment activity that:
4.23(A) is licensed under chapter 245A as a child care center under Minnesota Rules, chapter
4.249503; or
4.25(B) meets the licensure exclusion criteria of section
245A.03, subdivision 2, paragraph
4.26(a), clause (6), and meets the requirements under section
245G.19, subdivision 4; or
4.27(ii) arranges for off-site child care during hours of treatment activity at a facility
that is
4.28licensed under chapter
245A as:
4.29(A) a child care center under Minnesota Rules, chapter 9503; or
4.30(B) a family child care home under Minnesota Rules, chapter 9502;
4.31(2) culturally specific or culturally responsive programs as defined in section
254B.01,
4.32subdivision 4a;
5.1(3) disability responsive programs as defined in section
254B.01, subdivision 4b;
5.2(4) programs that offer medical services delivered by appropriately credentialed health
5.3care staff in an amount equal to two hours per client per week if the medical needs
of the
5.4client and the nature and provision of any medical services provided are documented
in the
5.5client file; or
5.6(5) programs that offer services to individuals with co-occurring mental health and
5.7substance use disorder problems if:
5.8(i) the program meets the co-occurring requirements in section
245G.20;
5.9(ii) 25 percent of the counseling staff are licensed mental health professionals under
5.10section
245I.04, subdivision 2, or are students or licensing candidates under the supervision
5.11of a licensed alcohol and drug counselor supervisor and mental health professional
under
5.12section
245I.04, subdivision 2, except that no more than 50 percent of the mental health
5.13staff may be students or licensing candidates with time documented to be directly
related
5.14to provisions of co-occurring services;
5.15(iii) clients scoring positive on a standardized mental health screen receive a mental
5.16health diagnostic assessment within ten days of admission;
5.17(iv) the program has standards for multidisciplinary case review that include a monthly
5.18review for each client that, at a minimum, includes a licensed mental health professional
5.19and licensed alcohol and drug counselor, and their involvement in the review is documented;
5.20(v) family education is offered that addresses mental health and substance use disorder
5.21and the interaction between the two; and
5.22(vi) co-occurring counseling staff shall receive eight hours of co-occurring disorder
5.23training annually.
5.24(d) In order to be eligible for a higher rate under paragraph (c), clause (1), a program
5.25that provides arrangements for off-site child care must maintain current documentation
at
5.26the substance use disorder facility of the child care provider's current licensure
to provide
5.27child care services. Programs that provide child care according to paragraph (c),
clause (1),
5.28must be deemed in compliance with the licensing requirements in section
245G.19.
5.29(e) Adolescent residential programs that meet the requirements of Minnesota Rules,
5.30parts 2960.0430 to 2960.0490 and 2960.0580 to 2960.0690, are exempt from the requirements
5.31in paragraph (c), clause (4), items (i) to (iv).
6.1(f) Subject to federal approval, substance use disorder services that are otherwise
covered
6.2as direct face-to-face services may be provided via telehealth as defined in section
256B.0625,
6.3subdivision 3b. The use of telehealth to deliver services must be medically appropriate
to
6.4the condition and needs of the person being served. Reimbursement shall be at the
same
6.5rates and under the same conditions that would otherwise apply to direct face-to-face
services.
6.6(g) For the purpose of reimbursement under this section, substance use disorder treatment
6.7services provided in a group setting without a group participant maximum or maximum
6.8client to staff ratio under chapter 245G shall not exceed a client to staff ratio
of 48 to one.
6.9At least one of the attending staff must meet the qualifications as established under
this
6.10chapter for the type of treatment service provided. A recovery peer may not be included
as
6.11part of the staff ratio.
6.12(h) Payment for outpatient substance use disorder services that are licensed according
6.13to sections
245G.01 to
245G.17 is limited to six hours per day or 30 hours per week unless
6.14prior authorization of a greater number of hours is obtained from the commissioner.
6.15(i) Payment for substance use disorder services under this section must start from
the
6.16day of service initiation, when the comprehensive assessment is completed within the
6.17required timelines.
6.18EFFECTIVE DATE.The amendments to paragraph (b), clause (1), items (i) to (iv),
6.19are effective January 1, 2025, or upon federal approval, whichever is later. The amendments
6.20to paragraph (b), clause (1), items (v) to (vii), are effective January 1, 2024, or
upon federal
6.21approval, whichever is later. The amendments to paragraph (b), clauses (2) to (11),
are
6.22effective January 1, 2024. Paragraph (i) is effective July 1, 2023."
6.23Page 91, delete lines 20 to 25 and insert:
6.24"
(e) Recovery community organizations approved by the commissioner before June 30,
6.252023, shall retain their designation as recovery community organizations."
6.26Renumber the sections in sequence and correct the internal references
6.27Amend the title accordingly
6.28The motion prevailed. #did not prevail. So the amendment was #not adopted.