NAMI Minnesota Conference
St. Paul, MN
November 16, 2013
Glenace Edwall, Cynthia Godin and Sue Abderholden
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2013 Children’s Mental Health Legislation:
Glenace Edwall
2013 Adult Mental Health Legislation:
Cynthia Godin
2014 Plans and Prospects: Sue Abderholden
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Grant expansions and additions
Medicaid benefit changes
Policy and infrastructure studies, changes
School-Linked Mental Health
Grants increased by 50% for first year of
biennium, 100% for second for total increase of
$7.434 million
RFP yielded >40 applications, with requests
totaling nearly twice the appropriation
Contract negotiations in process; target
initiation of services 1/1/14
Crisis Teams Expansion
Work with AMHD to establish four joint childadult 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
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 referrals
Contract negotiation with vendor nearing
completion; worked to develop connections
with local mobile crisis response teams
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 illnesses
RFP in preparation
Intensive Treatment in Foster Care
Revision of Section 256B.0946, first enacted in
2005 and delayed several times for fiscal
considerations
Targeted 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
providers
State Plan Amendment (SPA) submitted
Family Peer Specialists
Family Peer Specialists may serve families in
wide variety of CMH service settings
See NAMI-MN Legislative Summary for range of
functions which FPS may provide
Stakeholders interested in multiple pathways to
certification, to allow possibilities for building
professional ladders as well as immediate
service possibilities
SPA to be submitted by January, 2014
Family Psychoeducation
New 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
Clinical Care Consultation
Benefit 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
Mental Health Service Plan Development
Children’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
In-Reach Services
In-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
Psychiatric Consultation
MHCP 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 psychiatrists
SPA submitted
Autism Coverage
DHS 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
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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
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 treatment
Stakeholder meetings scheduled November
through January, 2014
Case Management for Transition-Age Youth
Continued 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
developed
Bulletin in preparation; incorporated into TCM
training
Case Management Redesign
DHS 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 report
Stakeholder meetings scheduled through
January
Pilot Provider Survey
DHS 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
Mental Health Behavioral Aide (MHBA) II
Certificate Development
Legislation 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 development
Meetings with MnSCU began last summer
Work Force Development Summit
MnSCU 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
Social Work Licensure
Social 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.
Juvenile Justice System Report
Legislature 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 conditions
CMHD is participating
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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.
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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.
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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.
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Transition to Community Initiative
$8.2 million to assist individuals ready to
discharge from AMRTC or Minnesota Security
Hospital
Strengthens community mental health
options
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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.
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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
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Expansion of Individual Placement Support
model
Combines employment service provider
services with mental health services
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Crisis Teams, earlier intervention
First Episode
County control
Day treatment
Corporate Foster Care
Juvenile Justice
Housing/Bonding
Criminal Justice
Seclusion and Restraint
Case Management
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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