The 2007 legislative session
resulted in promising changes in mental health. The new funding
may be Minnesota’s
largest-ever increase for mental health ($34 million for FY08-09, $46 million
for FY2010-11, excluding COLAs). In addition, several important changes proposed
by a broad coalition of mental health stakeholders are beginning to take
hold.
GAMC and Minnesota Care
adopt “model” benefit set. The
Minnesota Mental Health Action Group (MMHAG), a collaboration of consumers,
mental health advocacy organizations, providers, government, and private
and public mental health care entities, has developed a “model
benefit set” that would provide adequate treatment and crucial
supports throughout one’s illness. A number of these benefits
have been added to Medical Assistance (MA). This year, MMHAG’s
influence spread further, as the 2007 legislature extended all MA mental
health benefits to General Assistance Medical Care (GAMC) and Minnesota
Care. The expanded benefits include services such as crisis intervention,
case management, and adult and children’s in-home aides. (Changes
are effective January 1, 2008, or in some cases January 1, 2009.)
New projects will integrate
physical and mental health care. A crucial goal of the mental health
community has been to create a system of care that recognizes mental
illnesses as illnesses and treats the whole person. Those with
severe mental illnesses have a disproportionate rate of other health
problems that go untreated; their lives, on average, are 25 years
shorter. Not surprisingly, when mental and physical health care
are coordinated, people’s
health improves greatly. Impressed by these realities, the legislature
authorized up to three MA projects to better integrate physical and
mental health care. Consumer participation in the new integrated
care networks will be voluntary. The legislation also authorizes
DHS to undertake reforms in financing and delivering services. (The
integrated care projects will be implemented in January 2009.)
Mental health peer specialists. Minnesota will be one of the first
state governments to sponsor a peer specialist training and certification
program. This milestone legislation was spearheaded by the Consumer
Survivor Network. Peer services will include nonclinical peer counseling
to promote socialization, recovery, self-sufficiency and self-advocacy,
and development of natural supports. (The effective date is July 1,
2007, subject to federal approval.)
Medical Assistance eligibility while in jail suspended rather than
terminated. Previously, MA eligibility was terminated for an individual
in jail or a correctional facility. The new provision allows suspension
instead, which will facilitate reinstatement when released. (Effective
July 1, 2007)
Other Medical Assistance changes include:
• Intensive outpatient treatment using dialectical behavioral therapy
was added to the benefit set for all state health programs (to start
in January 2008 if federally approved).
• Coverage for children’s treatment foster care is still awaiting
federal approval. (Effective date moved to July 1, 2009)
• Early intervention behavioral therapy for autism, which has seen
repeated delays in approval and implementation, has unfortunately
been repealed as a benefit.
Cost of living adjustments.
Many providers have badly needed rate increases in order to keep
programs operating and retain staff. The 2007 legislature increased
rates for Adult Mental Health Rehabilitation Services (AMHRS) and
Children’s Transitional Services and Supports
(CTSS), and increased children’s and adult mental health grants
to counties/providers. Also, CTSS and AMHRS services were added to
the critical access provider increase that passed in 2006. (These
changes take effect, variously, between October 1, 2007 and July
1, 2008.)
Regional children’s
mental health initiative. A two-year pilot project in southeast
Minnesota will focus on developing children’s
mental health services, improving service coordination, streamlining
service delivery and operations, and establishing a regional network
for out-of-home placement services. $1 million is allocated for
the biennium. (Effective July 1, 2007)
Voluntary placement
in children’s residential
treatment. Counties must use a placement agreement when placing a
child in mental health residential treatment. Under new legislation,
the agreement gives the county physical care, custody and control
but must not require parents or guardians to transfer legal custody.
(Effective July 1, 2007)
Many other significant
pieces of mental health legislation were passed this session. You
can find a more detailed legislative summary at www.dhs. state.mn.us
or at the Minnesota Legal Advocacy Project “What’s
New” at www.lsapmn.org ![]()
Patricia M. Siebert is a staff attorney at the Minnesota Disability
Law Center.
