2013 legislative summary
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2013 Legislative Summary
NAMI Minnesota ConferenceSt. Paul, MN
November 16, 2013Glenace Edwall, Cynthia Godin and Sue Abderholden
2013 Children’s Mental Health Legislation: Glenace Edwall
2013 Adult Mental Health Legislation: Cynthia Godin
2014 Plans and Prospects: Sue Abderholden
Overview
1. Grant expansions and additions2. Medicaid benefit changes3. Policy and infrastructure studies, changes
Children’s Mental Health (CMH) Legislation
School-Linked Mental Health Grants increased by 50% for first year of biennium, 100% for second for total increase of $7.434 millionRFP yielded >40 applications, with requests totaling nearly twice the appropriationContract negotiations in process; target initiation of services 1/1/14
CMH Grants
Crisis Teams ExpansionWork with AMHD to establish four joint child-adult mobile crisis response teams in previously unserved regions of the state.RFP funded by $1.5 million increase for biennium issued and closed; applications in review
CMH Grants
Text Messaging Crisis Line$1.25 million was appropriated to establish a text message suicide prevention program, allowing youth and adults to connect with crisis counselors and obtain emergency information and referralsContract negotiation with vendor nearing completion; worked to develop connections with local mobile crisis response teams
CMH Grants
Youth Mental Health First Aid Training$45,000 appropriate for biennium to fund training available to teachers, human service personnel, law enforcement and others who come into contact with children with mental health symptoms or illnessesRFP in preparation
CMH Grants
Intensive Treatment in Foster CareRevision of Section 256B.0946, first enacted in 2005 and delayed several times for fiscal considerationsTargeted for children in foster care to through age 20 with ED/SED, including trauma assessment, clinical services, 24/7 phone support; may be provided by outpatient or CTSS providersState Plan Amendment (SPA) submitted
CMH Benefits in Minnesota Health Care Programs
Family Peer SpecialistsFamily Peer Specialists may serve families in wide variety of CMH service settingsSee NAMI-MN Legislative Summary for range of functions which FPS may provideStakeholders interested in multiple pathways to certification, to allow possibilities for building professional ladders as well as immediate service possibilitiesSPA to be submitted by January, 2014
CMH Benefits
Family PsychoeducationNew state plan benefit to provide help to families in understanding symptoms, impact on child’s development, roles of treatment and skill development, and ways to promote resilience and prevent co-morbidities and relapse
SPA submitted
CMH Benefits
Clinical Care ConsultationBenefit sought by both DHS and providers, to allow reimbursement for communicating with other providers and educators; necessary for integrating care across systems and settings
Spa to be submitted to coordinate with Behavioral Health Home development
CMH Benefits
Mental Health Service Plan DevelopmentChildren’s Therapeutic Services and Supports (CTSS) providers will be reimbursed for development, review and revision of individual treatment plans, including time spent meeting with parents/caregivers and completing assessment and outcome measurements
SPA submitted
CMH Benefits
In-Reach ServicesIn-reach services previously available to MHCP recipients now explicitly extended to children and adolescents, with lower usage thresholds (ED > twice in past 3 months or hospitalization > twice in past 4 months or discharge to shelter). Provides for arranging for services and supports prior to discharge
SPA submitted
CMH Benefits
Psychiatric ConsultationMHCP currently covers psychiatric consultation by a psychiatrist to a primary care providers; service was expanded to include consultation by a licensed psychologist or advanced practice nurse certified in psychiatric mental health. Applies to both children and adults, but may have particular impact for children because of acute shortage of C&A psychiatristsSPA submitted
CMH Benefits
Autism CoverageDHS directed to develop new benefit termed Autism Early Intensive Intervention, to include applied behavior analysis, developmental treatment approaches, and naturalistic and parent training models.CMHD involved in planning; intersection with current CTSS services to be determined
CMH Benefits
Mental health practitioner who is a clinical trainee may conduct diagnostic assessment under supervision
Fees under TEFRA program eliminated for families with income <275% of federal poverty line
Unused Therapeutic Preschool option under CTSS repealed
Mental health providers and other health professionals will have reimbursement increased by 5% beginning 9/1/14
Other Changes in CMH Benefits
Child and Adolescent Behavioral Health Services (CABHS)DHS, consulting with stakeholders, will develop recommendations for the CABHS facility (Willmar) to ensure that it is meeting intensive service needs, can secure appropriate staffing, and provides effective treatmentStakeholder meetings scheduled November through January, 2014
CMH Infrastructure and Policy
Case Management for Transition-Age YouthContinued case management services must be offered by a county or health plan to an adolescent who is receiving CMH case management and is turning 18, and whose needs can be met within the CMH system. Before discontinuing case management for youth 17-21, a transition plan must be developedBulletin in preparation; incorporated into TCM training
CMH Infrastructure and Policy
Case Management RedesignDHS required to submit report to legislature by February, 2014 with recommendations for changes to case management. CMHD and AMHD have established own process with stakeholders to submit recommendations specific to mental health case management into DHS reportStakeholder meetings scheduled through January
CMH Infrastructure and Policy
Pilot Provider SurveyDHS directed to survey CMH providers and pediatric home health providers to identify and measure issues in the management of MHCP; report to be submitted to legislature by January 15, 2014
Performance Measurement and Quality Improvement (PMQI) section of HCA is lead
CMH Infrastructure and Policy
Mental Health Behavioral Aide (MHBA) II Certificate DevelopmentLegislation added completion of a certificate program as a credentialing option for a Level II MHBA, and directed DHS to work with Minnesota State Colleges and Universities (MnSCU) to develop a certificate program. Course may dovetail with Family Peer Specialist credential developmentMeetings with MnSCU began last summer
CMH Infrastructure and Policy
Work Force Development SummitMnSCU will convene a summit to develop a comprehensive plan to increase the numbers of qualified individuals working at all levels in the child and adult mental health systems; plan to be submitted to legislature by January 15, 2015
One stakeholder meeting held; steering committee formed; summit scheduled for May 28, 2014
CMH Infrastructure and Policy
Social Work LicensureSocial workers employed by tribal agencies will be eligible for licensure under grandparenting provisions previously available to city, state or nonprofit employees. County social workers are still not required to be licensed.
CMH Infrastructure and Policy
Juvenile Justice System ReportLegislature directed NAMI-MN to convene a workgroup to report policy recommendations by February 15, 2014 to improve outcomes for children and adolescents in the juvenile justice system; c. 70% of these children have diagnosable mental health conditionsCMHD is participating
CMH Infrastructure and Policy
Adjust Adult Rehabilitative Mental Health Services payment rate, services.
Increases payment rates for ARMHS services, which help adults with serious mental illness to gain emotional stability and learn new coping skills. Expands the range of these services and adds provider reimbursement for currently unfunded but necessary services such as mental health functional assessments.
Adult Mental Health Legislation
Mental Health Specialty Residential Treatment Service
Establishes a 24/7 medically monitored mental health special treatment service as a transition service from psychiatric hospitalization for individuals with mental illness and complex treatment needs who require a longer stabilization period.
Adult Mental Health Legislation
Willmar Intensive Residential Treatment Service (IRTS) remains open
Operations at the Willmar IRTS will continue due to the Legislature's agreement to use dedicated State Operated Services resources and facility revenue.
Adult Mental Health Legislation
Transition to Community Initiative
$8.2 million to assist individuals ready to discharge from AMRTC or Minnesota Security Hospital
Strengthens community mental health options
Adult Mental Health Legislation
Substance Abuse Screening, Brief Intervention and Referral to Treatment
Expands the number of primary care clinicians trained to use the Screening Brief Intervention and Referral to Treatment process to identify people at risk of drug or alcohol abuse so treatment can be offered.
Substance Abuse Legislation
Zumbro Valley Mental Health Center legislative appropriation
Provides funding for a two-year pilot to develop integrated treatment, adding primary care (nursing) services to the mental health center
Integrated Treatment Legislation
Expansion of Individual Placement Support model
Combines employment service provider services with mental health services
Employment related Legislation
Crisis Teams, earlier intervention First Episode County control Day treatment Corporate Foster Care Juvenile Justice Housing/Bonding Criminal Justice Seclusion and Restraint Case Management
2014 Legislative Session
Glenace Edwall Director, Children’s Mental Health Division, DHS glenace.edwall@state.mn.us
Cynthia Godin Director, Adult Mental Health Division, DHS cynthia.godin@state.mn.us
Sue Abderholden Executive Director, NAMI Minnesota sabderholden@namimn.org
Contact Information
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