Behavioral Health Update - April 2019

Key Highlights This Month:  

SUD Reform: 

Invitation for a webinar on Withdrawal Management. (attached) This is the second one; the first gave a historical perspective. 

The State/County workgroup met last month and are working through many of the issues.  DHS has proposed that current Rule 25 Assessors could be grandfathered in provided they meet certain requirements including 30+ hours of training.  If counties were able to provide comprehensive assessments with such credentialing the rate that would be paid by MA most likely would be lower and we agreed to that.  We are hopeful to have a legislative change yet this session on the insurance requirement (decrease to 1.5 million vs 2 million).  The State/County Workgroup meets at the end of the month and we hope to discuss further the supervision of care coordination.  Direct access has been delayed due to technology issues with the billing and is not expected to be ready until sometime next year. 

Local Mental Health Authority Discussion:

There will be a presentation at MACSSA to begin the conversation on the role of the county as the local mental health authority.  This will include a brief review of current statutes/requirements as well as some table talk discussion about what the role should be; Counties perspectives; Are there pieces we could let go and how What absolutely needs to stay with the county; Can we (MACSSA) speak with one voice representing counties; Can we be more Proactive not just Reactive.   This seems to come up in different ways each legislative season.  Discussion in this group about need to stay responsive to local needs and that the state currently does not seem to respond to local needs well.

Competency Restoration Program/Rule 20:

Current proposed legislation establishes a task force to study this issue (outpatient CRP).  County Attorney bill attached to Rosen bill.  Several counties being impacted on a case by case basis and trying to come up with solutions without “owning” cost and process!  Judges ordering Case Managers and others to provide Competency Restoration evaluation. Several counties using IRTS facilities.  Hennepin reports many clients they work with being impacted by the state no longer facilitating process.  Questions about what response (if any) was received on the request to pull back the change until all the partners could talk and work something out.  No clear path forward beyond Task force legislation.

DCT Appeals

Angie Youngerberg updated the group on the most recent discussion regarding legislative language and the Appeals process for billing issues with State Operated Facilities.  Language is in both house and senate side.  An agreement has been reached and the appeals will be handled by the Commissioner, not an administrative law judge.  Payment responsibility will go to the state, not the client.

Requested Actions Needed From MACSSA:  

New Trends in This Area:  

Issues/Concerns Regarding This Topic:  

LMHA Direction and MACSSA Position

CRP and no path forward to resolve beyond potential Task force legislation

Delay of Direct access for SUD Reform

Legislative Impacts:  

MACSSA has numerous support and promote positions around Behavioral Health.  

Supporting Materials:  

Webinar on Withdrawal Management
State Advisory Council on Mental Health (SACMH) Report o the Governor & Legislature
SACMH Summary Recommendations
Mental Health Legislative Network recommendations


Julie Ellis, Jerry Pederson

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