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S.F. No. 2690 - Modifying Provisions Related to Mental Health
Author: Senator Rich Draheim
Prepared By: Liam Monahan, Senate Analyst (651/296-1791)
Joan White, Senate Counsel (651/296-3814)
Date: March 23, 2018


Section 1 (144.551, subdivision 1)  amends the hospital bed moratorium by adding an exception for projects that add new beds to an existing hospital that provides emergency medical services, add new psychiatric hospital beds for children and adults who have a mental illness or new beds for adults with substance use disorder, demonstrate collaboration or development of alternatives to hospitalization that are supported by the community providers, and demonstrate a need for beds through data collected from emergency services and mobile crisis teams. The commissioner shall expedite the review of these proposed projects and may approve up to 100 new beds per year.

Section 2 (245A.04, subdivision 7) amends the Department of Human Services Licensing Act. The new language in this section allows a license to be transferable if the license or certification is one for mental health centers or clinics, residential programs, or substance use disorder treatment programs, or if the transfer is being made to a provider that already holds at least one other license or certification of the same type as the one being transferred.

Section 3 (245G.03, subdivision 1a) amends the chapter of law related to chemical dependency licensed treatment facilities, by exempting programs licensed under this chapter from the assessment of need process. New language also states that the commissioner may deny a license if the commissioner determines that the services currently available in the local area are sufficient and new services would be detrimental to individuals seeking those services.

Section 4 (256.478) establishes the transition to community initiative.  Subdivision 1 provides the eligibility criteria, which is an individual who would otherwise remain at Anoka Metro RTC or the Minnesota Security Hospital, and the individual's discharge would be significantly delayed without additional resources available through this program, and the individual met treatment objectives and no longer needs hospital-level care or a secure treatment setting.  The commissioner shall make available transition to community initiative grants to serve individuals who do not meet eligibility criteria for medical assistance but otherwise meet criteria under the waiver allocation for transition populations, or otherwise meet the criteria under subdivision 1, and pay for services and supports that are not eligible for reimbursement under medical assistance.

Sections 5 and 6 (256B.0622, subdivisions 3a and 4) eliminate the requirement that assertive community treatment providers and intensive residential treatment services providers, respectively, must have a contact with the host county.

Section 7 (256B.0623, subdivision 4) amends adult rehabilitative mental health services by striking language that requires a noncounty provider to obtain additional certification from each county in which it will provide services.

Section 8 (256B.0624, subdivision 4) modifies adult crisis response services, by requiring that a provider that is providing crisis stabilization services in a residential setting is exempt from the requirements under paragraph (a), but must meet the standards under paragraph (c).

Section 9 (256B.0915, subdivision 3b) modifies the elderly waiver to permit a special monthly budget limit for individuals who are eligible for elderly waiver services and also meet the eligibility requirements for the transition to community initiative listed in section 4 of the bill.

Paragraph (a) deletes obsolete language and makes conforming changes.

Paragraph (b) creates the special monthly budget limit and applies the same automatic adjustments to the limit as currently apply to the conversion monthly budget limit for residents exiting nursing facilities; and applies the same modified limit under the consumer-directed community supports option as currently applies to the conversion monthly budget limit.

Paragraph (c) permits the commissioner to make payments to managed care plans in addition to the standard capitated rate to cover documented costs associated with a portion of the additional costs of the special monthly budget limit.

Paragraph (d) allows the service rate for adult foster care or customized living to exceed the standard service rate for these services if the recipient has both a conversion monthly budget limit or a special monthly budget limit and the total cost of all services does not exceed the applicable monthly budget limits.

Section 10 (256B.092, subdivision 13) substitutes the transition to community initiative eligibility criteria for the existing eligibility criteria for additional waiver allocations under the developmental disability waiver.  The eligibility criteria are substantively equivalent.

Section 11 (256B.49, subdivision 24) substitutes the transition to community initiative eligibility criteria for the existing eligibility criteria for additional waiver allocations under the disability waivers.  The eligibility criteria are substantively equivalent.

Section 12 requires the Commissioner of Human Services to provide grants to adult mental health initiatives, counties, Indian tribes, or community mental health providers for planning and development of community-based competency assessment and restoration services to support individuals who have been referred for examination or found by a court to be incapable of understanding the criminal proceedings or participating in their defense. Grants must be issued through a competitive request for proposals process, and applicants must demonstrate the ability to sustain the project after onetime state grant funding ceases.

Section 13 establishes a pilot project for hybrid intensive residential treatment services. Under subdivision 1, the commissioner is required to administer grants to establish alternative community services for individuals who no longer need the level of care provided at Anoka Metro Regional Treatment Center, and have involvement with the criminal justice system or have been committed to the commissioner and diversion from jail is appropriate.

Subdivision 2 establishes the pilot project, which is modeled after the intensive residential treatment services, except that lengths of stay may be 180 days or more, the number of beds may be six to 16, and residents automatically qualify for housing support under Minnesota Statutes, chapter 256I. 

Subdivision 3 requires that the projects evaluate the effectiveness of the programs, including rates of rehospitalization, employment, criminal justice involvement, and engagement in treatment, and provide the evaluation to the legislative committees with jurisdiction over mental health issues by February 15, 2020.

Section 14 appropriates funds for the transition grants and the hybrid intensive residential treatment services.

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