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Behavioral Health Update - February 2019

Key Highlights in this topic/WORKGROUP for the PREVIOUS month:

Competency Restoration Program/Rule 20:

Leah Kaiser from Hennepin County reported in on a meeting she attended along with Angela Youngerberg in which the County Attorney’s Association is bringing forward a legislative proposal that would expand the pool of individuals needing to be restored to competency, regardless of the offense and would subsequently be prosecuted upon restoration. This would include all Targeted misdemeanors.  Considering the current position being taken by DHS on Competency Restoration responsibility this expansion creates numerous concerns for counties.  It had been hoped that the County Attorney Association efforts around CRP would help navigate through the current concerns MACSSA has around CRP.  This appears to make the situation worse. (Attached MCAA PowerPoint)

SUD Reform: 

Representatives from SUD Reform State/County workgroup met with Maisha Giles and Matt Burdick yesterday to discuss the future of this workgroup.  DHS is interested in having new players at the table from DHS.  County workgroup members will meet soon to plan future efforts.  The question was discussed about what counties are doing while direct billing is not available to providers for the new services.  Are counties opening spans of eligibility in CCDTF for straight MA individuals for the new SUD services (billing mechanism is not working currently)?  No:  Stearns and Anoka.  Yes:  Hennepin and Blue Earth.  

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.   The latest is that our author in the house (Zerwas, with Liebling support) indicates that we should not be so concerned about the fiscal note that will appear on a position that includes an Administrative Law Judge being the deciding voice, and really opposes any position of ours that includes the Commissioner being the decision-maker.  DHS will not be thrilled with this position.  Essentially, Zerwas wants to continue with the plan we all agreed upon last year.  The criteria as drafted is very similar to what was presented at MACSSA with only a slight adjustment in the final bullet. The recommendation now is to go with the appeal to an Administrative Law Judge (not directly to the Commissioner or a 5-person panel). 

  • the county is not given notice of not meeting medical criteria; orhe hospital paperwork is not complete, delaying the discharge; or
  • the determination of not meeting medical criteria is made on a holiday or weekend; or
  • the discharge does not occur because the hospital does not agree with the discharge plan; or
  • the discharge is delayed due to lack of bed availability for individuals who meet “safety net criteria,” resulting in state-operated services as the only option.

Local Mental Health Authority Discussion:

There is so much going on in the mental health area and legislative items.  It feels like the LMHA structure is changing and/or being impacted with no County specific position.  How do we have an intentional conversation about LMHA?  How do we have the right people involved in the right areas at the right time to have impact?  Could we identify point people for target areas and they stay up to date on the issues and respond/coordinate what is happening?  A follow up conversation with the topic leads and others will follow to try and identify target items and an approach with this.

 

Requested Actions needed from MACSSA in the next month:

 

APPARENT TRENDS IN THIS TOPIC AREA:

.Issues/Concerns regarding this topic this month:

LMHA Direction and MACSSA Position

 

Legislative Impacts:

MACSSA has numerous support and promote positions around Behavioral Health.  SUD Reform and CRP are top items.

 

Bulletins, Publications, or supporting materials to be included with this update:

MCAA Power point

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