1.1.................... moves to amend H.F. No. 1362, the delete everything amendment
1.2(A09-0461), as follows:
1.3Page 148, after line 7, insert:

1.4    "Section 1. Minnesota Statutes 2008, section 245.462, subdivision 18, is amended to
1.5read:
1.6    Subd. 18. Mental health professional. "Mental health professional" means a
1.7person providing clinical services in the treatment of mental illness who is qualified in at
1.8least one of the following ways:
1.9    (1) in psychiatric nursing: a registered nurse who is licensed under sections 148.171
1.10to 148.285; and:
1.11    (i) who is certified as a clinical specialist or as a nurse practitioner in adult or family
1.12psychiatric and mental health nursing by a national nurse certification organization; or
1.13    (ii) who has a master's degree in nursing or one of the behavioral sciences or related
1.14fields from an accredited college or university or its equivalent, with at least 4,000 hours
1.15of post-master's supervised experience in the delivery of clinical services in the treatment
1.16of mental illness;
1.17    (2) in clinical social work: a person licensed as an independent clinical social worker
1.18under chapter 148D, or a person with a master's degree in social work from an accredited
1.19college or university, with at least 4,000 hours of post-master's supervised experience in
1.20the delivery of clinical services in the treatment of mental illness;
1.21    (3) in psychology: an individual licensed by the Board of Psychology under sections
1.22148.88 to 148.98 who has stated to the Board of Psychology competencies in the diagnosis
1.23and treatment of mental illness;
1.24    (4) in psychiatry: a physician licensed under chapter 147 and certified by the
1.25American Board of Psychiatry and Neurology or eligible for board certification in
1.26psychiatry;
2.1    (5) in marriage and family therapy: the mental health professional must be a
2.2marriage and family therapist licensed under sections 148B.29 to 148B.39 with at least
2.3two years of post-master's supervised experience in the delivery of clinical services in
2.4the treatment of mental illness; or
2.5    (6) in licensed professional clinical counseling, the mental health professional
2.6shall be a licensed professional clinical counselor under section 148B.5301 with at least
2.74,000 hours of postmaster's supervised experience in the delivery of clinical services in
2.8the treatment of mental illness; or
2.9    (7) in allied fields: a person with a master's degree from an accredited college or
2.10university in one of the behavioral sciences or related fields, with at least 4,000 hours of
2.11post-master's supervised experience in the delivery of clinical services in the treatment of
2.12mental illness.

2.13    Sec. 2. Minnesota Statutes 2008, section 245.470, subdivision 1, is amended to read:
2.14    Subdivision 1. Availability of outpatient services. (a) County boards must provide
2.15or contract for enough outpatient services within the county to meet the needs of adults
2.16with mental illness residing in the county. Services may be provided directly by the
2.17county through county-operated mental health centers or mental health clinics approved
2.18by the commissioner under section 245.69, subdivision 2; by contract with privately
2.19operated mental health centers or mental health clinics approved by the commissioner
2.20under section 245.69, subdivision 2; by contract with hospital mental health outpatient
2.21programs certified by the Joint Commission on Accreditation of Hospital Organizations;
2.22or by contract with a licensed mental health professional as defined in section 245.462,
2.23subdivision 18 , clauses (1) to (4) (6). Clients may be required to pay a fee according to
2.24section 245.481. Outpatient services include:
2.25    (1) conducting diagnostic assessments;
2.26    (2) conducting psychological testing;
2.27    (3) developing or modifying individual treatment plans;
2.28    (4) making referrals and recommending placements as appropriate;
2.29    (5) treating an adult's mental health needs through therapy;
2.30    (6) prescribing and managing medication and evaluating the effectiveness of
2.31prescribed medication; and
2.32    (7) preventing placement in settings that are more intensive, costly, or restrictive
2.33than necessary and appropriate to meet client needs.
3.1    (b) County boards may request a waiver allowing outpatient services to be provided
3.2in a nearby trade area if it is determined that the client can best be served outside the
3.3county.

3.4    Sec. 3. Minnesota Statutes 2008, section 245.4871, subdivision 27, is amended to read:
3.5    Subd. 27. Mental health professional. "Mental health professional" means a
3.6person providing clinical services in the diagnosis and treatment of children's emotional
3.7disorders. A mental health professional must have training and experience in working with
3.8children consistent with the age group to which the mental health professional is assigned.
3.9A mental health professional must be qualified in at least one of the following ways:
3.10    (1) in psychiatric nursing, the mental health professional must be a registered nurse
3.11who is licensed under sections 148.171 to 148.285 and who is certified as a clinical
3.12specialist in child and adolescent psychiatric or mental health nursing by a national nurse
3.13certification organization or who has a master's degree in nursing or one of the behavioral
3.14sciences or related fields from an accredited college or university or its equivalent, with
3.15at least 4,000 hours of post-master's supervised experience in the delivery of clinical
3.16services in the treatment of mental illness;
3.17    (2) in clinical social work, the mental health professional must be a person licensed
3.18as an independent clinical social worker under chapter 148D, or a person with a master's
3.19degree in social work from an accredited college or university, with at least 4,000 hours of
3.20post-master's supervised experience in the delivery of clinical services in the treatment
3.21of mental disorders;
3.22    (3) in psychology, the mental health professional must be an individual licensed by
3.23the board of psychology under sections 148.88 to 148.98 who has stated to the board of
3.24psychology competencies in the diagnosis and treatment of mental disorders;
3.25    (4) in psychiatry, the mental health professional must be a physician licensed under
3.26chapter 147 and certified by the American board of psychiatry and neurology or eligible
3.27for board certification in psychiatry;
3.28    (5) in marriage and family therapy, the mental health professional must be a
3.29marriage and family therapist licensed under sections 148B.29 to 148B.39 with at least
3.30two years of post-master's supervised experience in the delivery of clinical services in the
3.31treatment of mental disorders or emotional disturbances; or
3.32    (6) in licensed professional clinical counseling, the mental health professional shall
3.33be a licensed professional clinical counselor under section 148B.5301 with at least 4,000
3.34hours of postmaster's supervised experience in the delivery of clinical services in the
3.35treatment of mental disorders or emotional disturbances; or
4.1    (7) in allied fields, the mental health professional must be a person with a master's
4.2degree from an accredited college or university in one of the behavioral sciences or related
4.3fields, with at least 4,000 hours of post-master's supervised experience in the delivery of
4.4clinical services in the treatment of emotional disturbances.

4.5    Sec. 4. Minnesota Statutes 2008, section 245.488, subdivision 1, is amended to read:
4.6    Subdivision 1. Availability of outpatient services. (a) County boards must provide
4.7or contract for enough outpatient services within the county to meet the needs of each
4.8child with emotional disturbance residing in the county and the child's family. Services
4.9may be provided directly by the county through county-operated mental health centers or
4.10mental health clinics approved by the commissioner under section 245.69, subdivision 2;
4.11by contract with privately operated mental health centers or mental health clinics approved
4.12by the commissioner under section 245.69, subdivision 2; by contract with hospital
4.13mental health outpatient programs certified by the Joint Commission on Accreditation
4.14of Hospital Organizations; or by contract with a licensed mental health professional as
4.15defined in section 245.4871, subdivision 27, clauses (1) to (4) (6). A child or a child's
4.16parent may be required to pay a fee based in accordance with section 245.481. Outpatient
4.17services include:
4.18    (1) conducting diagnostic assessments;
4.19    (2) conducting psychological testing;
4.20    (3) developing or modifying individual treatment plans;
4.21    (4) making referrals and recommending placements as appropriate;
4.22    (5) treating the child's mental health needs through therapy; and
4.23    (6) prescribing and managing medication and evaluating the effectiveness of
4.24prescribed medication.
4.25    (b) County boards may request a waiver allowing outpatient services to be provided
4.26in a nearby trade area if it is determined that the child requires necessary and appropriate
4.27services that are only available outside the county.
4.28    (c) Outpatient services offered by the county board to prevent placement must be at
4.29the level of treatment appropriate to the child's diagnostic assessment."
4.30Page 153, after line 19, insert:

4.31    "Sec. 12. Minnesota Statutes 2008, section 256B.0622, subdivision 2, is amended to
4.32read:
4.33    Subd. 2. Definitions. For purposes of this section, the following terms have the
4.34meanings given them.
5.1    (a) "Intensive nonresidential rehabilitative mental health services" means adult
5.2rehabilitative mental health services as defined in section 256B.0623, subdivision 2,
5.3paragraph (a), except that these services are provided by a multidisciplinary staff using
5.4a total team approach consistent with assertive community treatment, the Fairweather
5.5Lodge treatment model, as defined by the standards established by the National Coalition
5.6for Community Living, and other evidence-based practices, and directed to recipients with
5.7a serious mental illness who require intensive services.
5.8    (b) "Intensive residential rehabilitative mental health services" means short-term,
5.9time-limited services provided in a residential setting to recipients who are in need of
5.10more restrictive settings and are at risk of significant functional deterioration if they do
5.11not receive these services. Services are designed to develop and enhance psychiatric
5.12stability, personal and emotional adjustment, self-sufficiency, and skills to live in a more
5.13independent setting. Services must be directed toward a targeted discharge date with
5.14specified client outcomes and must be consistent with the Fairweather Lodge treatment
5.15model as defined in paragraph (a), and other evidence-based practices.
5.16    (c) "Evidence-based practices" are nationally recognized mental health services that
5.17are proven by substantial research to be effective in helping individuals with serious
5.18mental illness obtain specific treatment goals.
5.19    (d) "Overnight staff" means a member of the intensive residential rehabilitative
5.20mental health treatment team who is responsible during hours when recipients are
5.21typically asleep.
5.22    (e) "Treatment team" means all staff who provide services under this section to
5.23recipients. At a minimum, this includes the clinical supervisor, mental health professionals
5.24as defined in section 245.462, subdivision 18, clauses (1) to (5) (6); mental health
5.25practitioners as defined in section 245.462, subdivision 17; mental health rehabilitation
5.26workers under section 256B.0623, subdivision 5, clause (3); and certified peer specialists
5.27under section 256B.0615.

5.28    Sec. 13. Minnesota Statutes 2008, section 256B.0623, subdivision 5, is amended to
5.29read:
5.30    Subd. 5. Qualifications of provider staff. Adult rehabilitative mental health
5.31services must be provided by qualified individual provider staff of a certified provider
5.32entity. Individual provider staff must be qualified under one of the following criteria:
5.33    (1) a mental health professional as defined in section 245.462, subdivision 18,
5.34clauses (1) to (5) (6). If the recipient has a current diagnostic assessment by a licensed
5.35mental health professional as defined in section 245.462, subdivision 18, clauses (1) to (5)
6.1(6), recommending receipt of adult mental health rehabilitative services, the definition of
6.2mental health professional for purposes of this section includes a person who is qualified
6.3under section 245.462, subdivision 18, clause (6) (7), and who holds a current and valid
6.4national certification as a certified rehabilitation counselor or certified psychosocial
6.5rehabilitation practitioner;
6.6    (2) a mental health practitioner as defined in section 245.462, subdivision 17. The
6.7mental health practitioner must work under the clinical supervision of a mental health
6.8professional;
6.9    (3) a certified peer specialist under section 256B.0615. The certified peer specialist
6.10must work under the clinical supervision of a mental health professional; or
6.11    (4) a mental health rehabilitation worker. A mental health rehabilitation worker
6.12means a staff person working under the direction of a mental health practitioner or mental
6.13health professional and under the clinical supervision of a mental health professional in
6.14the implementation of rehabilitative mental health services as identified in the recipient's
6.15individual treatment plan who:
6.16    (i) is at least 21 years of age;
6.17    (ii) has a high school diploma or equivalent;
6.18    (iii) has successfully completed 30 hours of training during the past two years in all
6.19of the following areas: recipient rights, recipient-centered individual treatment planning,
6.20behavioral terminology, mental illness, co-occurring mental illness and substance abuse,
6.21psychotropic medications and side effects, functional assessment, local community
6.22resources, adult vulnerability, recipient confidentiality; and
6.23    (iv) meets the qualifications in subitem (A) or (B):
6.24    (A) has an associate of arts degree in one of the behavioral sciences or human
6.25services, or is a registered nurse without a bachelor's degree, or who within the previous
6.26ten years has:
6.27    (1) three years of personal life experience with serious and persistent mental illness;
6.28    (2) three years of life experience as a primary caregiver to an adult with a serious
6.29mental illness or traumatic brain injury; or
6.30    (3) 4,000 hours of supervised paid work experience in the delivery of mental health
6.31services to adults with a serious mental illness or traumatic brain injury; or
6.32    (B)(1) is fluent in the non-English language or competent in the culture of the
6.33ethnic group to which at least 20 percent of the mental health rehabilitation worker's
6.34clients belong;
6.35    (2) receives during the first 2,000 hours of work, monthly documented individual
6.36clinical supervision by a mental health professional;
7.1    (3) has 18 hours of documented field supervision by a mental health professional
7.2or practitioner during the first 160 hours of contact work with recipients, and at least six
7.3hours of field supervision quarterly during the following year;
7.4    (4) has review and cosignature of charting of recipient contacts during field
7.5supervision by a mental health professional or practitioner; and
7.6    (5) has 40 hours of additional continuing education on mental health topics during
7.7the first year of employment.

7.8    Sec. 14. Minnesota Statutes 2008, section 256B.0624, subdivision 5, is amended to
7.9read:
7.10    Subd. 5. Mobile crisis intervention staff qualifications. For provision of adult
7.11mental health mobile crisis intervention services, a mobile crisis intervention team is
7.12comprised of at least two mental health professionals as defined in section 245.462,
7.13subdivision 18 , clauses (1) to (5) (6), or a combination of at least one mental health
7.14professional and one mental health practitioner as defined in section 245.462, subdivision
7.1517 , with the required mental health crisis training and under the clinical supervision of
7.16a mental health professional on the team. The team must have at least two people with
7.17at least one member providing on-site crisis intervention services when needed. Team
7.18members must be experienced in mental health assessment, crisis intervention techniques,
7.19and clinical decision-making under emergency conditions and have knowledge of local
7.20services and resources. The team must recommend and coordinate the team's services
7.21with appropriate local resources such as the county social services agency, mental health
7.22services, and local law enforcement when necessary.

7.23    Sec. 15. Minnesota Statutes 2008, section 256B.0624, subdivision 8, is amended to
7.24read:
7.25    Subd. 8. Adult crisis stabilization staff qualifications. (a) Adult mental health
7.26crisis stabilization services must be provided by qualified individual staff of a qualified
7.27provider entity. Individual provider staff must have the following qualifications:
7.28    (1) be a mental health professional as defined in section 245.462, subdivision 18,
7.29clauses (1) to (5) (6);
7.30    (2) be a mental health practitioner as defined in section 245.462, subdivision 17.
7.31The mental health practitioner must work under the clinical supervision of a mental health
7.32professional; or
7.33    (3) be a mental health rehabilitation worker who meets the criteria in section
7.34256B.0623, subdivision 5 , clause (3); works under the direction of a mental health
7.35practitioner as defined in section 245.462, subdivision 17, or under direction of a
8.1mental health professional; and works under the clinical supervision of a mental health
8.2professional.
8.3    (b) Mental health practitioners and mental health rehabilitation workers must have
8.4completed at least 30 hours of training in crisis intervention and stabilization during
8.5the past two years."
8.6Page 153, after line 26, insert:

8.7    "Sec. 17. Minnesota Statutes 2008, section 256B.0625, subdivision 42, is amended to
8.8read:
8.9    Subd. 42. Mental health professional. Notwithstanding Minnesota Rules, part
8.109505.0175, subpart 28, the definition of a mental health professional shall include a person
8.11who is qualified as specified in section 245.462, subdivision 18, clause clauses (5) and (6);
8.12or 245.4871, subdivision 27, clause clauses (5) and (6), for the purpose of this section and
8.13Minnesota Rules, parts 9505.0170 to 9505.0475.

8.14    Sec. 18. Minnesota Statutes 2008, section 256B.0943, subdivision 1, is amended to
8.15read:
8.16    Subdivision 1. Definitions. For purposes of this section, the following terms have
8.17the meanings given them.
8.18    (a) "Children's therapeutic services and supports" means the flexible package of
8.19mental health services for children who require varying therapeutic and rehabilitative
8.20levels of intervention. The services are time-limited interventions that are delivered using
8.21various treatment modalities and combinations of services designed to reach treatment
8.22outcomes identified in the individual treatment plan.
8.23    (b) "Clinical supervision" means the overall responsibility of the mental health
8.24professional for the control and direction of individualized treatment planning, service
8.25delivery, and treatment review for each client. A mental health professional who is an
8.26enrolled Minnesota health care program provider accepts full professional responsibility
8.27for a supervisee's actions and decisions, instructs the supervisee in the supervisee's work,
8.28and oversees or directs the supervisee's work.
8.29    (c) "County board" means the county board of commissioners or board established
8.30under sections 402.01 to 402.10 or 471.59.
8.31    (d) "Crisis assistance" has the meaning given in section 245.4871, subdivision 9a.
8.32    (e) "Culturally competent provider" means a provider who understands and can
8.33utilize to a client's benefit the client's culture when providing services to the client. A
8.34provider may be culturally competent because the provider is of the same cultural or
9.1ethnic group as the client or the provider has developed the knowledge and skills through
9.2training and experience to provide services to culturally diverse clients.
9.3    (f) "Day treatment program" for children means a site-based structured program
9.4consisting of group psychotherapy for more than three individuals and other intensive
9.5therapeutic services provided by a multidisciplinary team, under the clinical supervision
9.6of a mental health professional.
9.7    (g) "Diagnostic assessment" has the meaning given in section 245.4871, subdivision
9.811 .
9.9    (h) "Direct service time" means the time that a mental health professional, mental
9.10health practitioner, or mental health behavioral aide spends face-to-face with a client
9.11and the client's family. Direct service time includes time in which the provider obtains
9.12a client's history or provides service components of children's therapeutic services and
9.13supports. Direct service time does not include time doing work before and after providing
9.14direct services, including scheduling, maintaining clinical records, consulting with others
9.15about the client's mental health status, preparing reports, receiving clinical supervision
9.16directly related to the client's psychotherapy session, and revising the client's individual
9.17treatment plan.
9.18    (i) "Direction of mental health behavioral aide" means the activities of a mental
9.19health professional or mental health practitioner in guiding the mental health behavioral
9.20aide in providing services to a client. The direction of a mental health behavioral aide
9.21must be based on the client's individualized treatment plan and meet the requirements in
9.22subdivision 6, paragraph (b), clause (5).
9.23    (j) "Emotional disturbance" has the meaning given in section 245.4871, subdivision
9.2415 . For persons at least age 18 but under age 21, mental illness has the meaning given in
9.25section 245.462, subdivision 20, paragraph (a).
9.26    (k) "Individual behavioral plan" means a plan of intervention, treatment, and
9.27services for a child written by a mental health professional or mental health practitioner,
9.28under the clinical supervision of a mental health professional, to guide the work of the
9.29mental health behavioral aide.
9.30    (l) "Individual treatment plan" has the meaning given in section 245.4871,
9.31subdivision 21 .
9.32    (m) "Mental health professional" means an individual as defined in section 245.4871,
9.33subdivision 27 , clauses (1) to (5) (6), or tribal vendor as defined in section 256B.02,
9.34subdivision 7 , paragraph (b).
9.35    (n) "Preschool program" means a day program licensed under Minnesota Rules,
9.36parts 9503.0005 to 9503.0175, and enrolled as a children's therapeutic services and
10.1supports provider to provide a structured treatment program to a child who is at least 33
10.2months old but who has not yet attended the first day of kindergarten.
10.3    (o) "Skills training" means individual, family, or group training designed to improve
10.4the basic functioning of the child with emotional disturbance and the child's family in the
10.5activities of daily living and community living, and to improve the social functioning of the
10.6child and the child's family in areas important to the child's maintaining or reestablishing
10.7residency in the community. Individual, family, and group skills training must:
10.8    (1) consist of activities designed to promote skill development of the child and the
10.9child's family in the use of age-appropriate daily living skills, interpersonal and family
10.10relationships, and leisure and recreational services;
10.11    (2) consist of activities that will assist the family's understanding of normal child
10.12development and to use parenting skills that will help the child with emotional disturbance
10.13achieve the goals outlined in the child's individual treatment plan; and
10.14    (3) promote family preservation and unification, promote the family's integration
10.15with the community, and reduce the use of unnecessary out-of-home placement or
10.16institutionalization of children with emotional disturbance."
10.17Page 155, after line 24, insert:

10.18    "Sec. 18. Minnesota Statutes 2008, section 256J.08, subdivision 73a, is amended to
10.19read:
10.20    Subd. 73a. Qualified professional. (a) For physical illness, injury, or incapacity,
10.21a "qualified professional" means a licensed physician, a physician's assistant, a nurse
10.22practitioner, or a licensed chiropractor.
10.23    (b) For developmental disability and intelligence testing, a "qualified professional"
10.24means an individual qualified by training and experience to administer the tests necessary
10.25to make determinations, such as tests of intellectual functioning, assessments of adaptive
10.26behavior, adaptive skills, and developmental functioning. These professionals include
10.27licensed psychologists, certified school psychologists, or certified psychometrists working
10.28under the supervision of a licensed psychologist.
10.29    (c) For learning disabilities, a "qualified professional" means a licensed psychologist
10.30or school psychologist with experience determining learning disabilities.
10.31    (d) For mental health, a "qualified professional" means a licensed physician or a
10.32qualified mental health professional. A "qualified mental health professional" means:
10.33    (1) for children, in psychiatric nursing, a registered nurse who is licensed under
10.34sections 148.171 to 148.285, and who is certified as a clinical specialist in child
10.35and adolescent psychiatric or mental health nursing by a national nurse certification
10.36organization or who has a master's degree in nursing or one of the behavioral sciences
11.1or related fields from an accredited college or university or its equivalent, with at least
11.24,000 hours of post-master's supervised experience in the delivery of clinical services in
11.3the treatment of mental illness;
11.4    (2) for adults, in psychiatric nursing, a registered nurse who is licensed under
11.5sections 148.171 to 148.285, and who is certified as a clinical specialist in adult psychiatric
11.6and mental health nursing by a national nurse certification organization or who has a
11.7master's degree in nursing or one of the behavioral sciences or related fields from an
11.8accredited college or university or its equivalent, with at least 4,000 hours of post-master's
11.9supervised experience in the delivery of clinical services in the treatment of mental illness;
11.10    (3) in clinical social work, a person licensed as an independent clinical social worker
11.11under chapter 148D, or a person with a master's degree in social work from an accredited
11.12college or university, with at least 4,000 hours of post-master's supervised experience in
11.13the delivery of clinical services in the treatment of mental illness;
11.14    (4) in psychology, an individual licensed by the Board of Psychology under sections
11.15148.88 to 148.98, who has stated to the Board of Psychology competencies in the
11.16diagnosis and treatment of mental illness;
11.17    (5) in psychiatry, a physician licensed under chapter 147 and certified by the
11.18American Board of Psychiatry and Neurology or eligible for board certification in
11.19psychiatry; and
11.20    (6) in marriage and family therapy, the mental health professional must be a
11.21marriage and family therapist licensed under sections 148B.29 to 148B.39, with at least
11.22two years of post-master's supervised experience in the delivery of clinical services in the
11.23treatment of mental illness; and
11.24    (7) in licensed professional clinical counseling, the mental health professional
11.25shall be a licensed professional clinical counselor under section 148B.5301 with at least
11.264,000 hours of postmaster's supervised experience in the delivery of clinical services in
11.27the treatment of mental illness.

11.28    Sec. 19. COST.
11.29    (a) In determining the additional cost to the state of adding licensed professional
11.30clinical counselors to the list of approved mental health professionals, the commissioner of
11.31human services shall consider the savings in decreased hospitalizations in rural Minnesota
11.32that result from increased access to a mental health professional.
11.33    (b) Using existing resources, the commissioner shall conduct a post-hospitalization
11.34review of admissions for mental health treatment to determine if the admissions were
11.35medically necessary. The commissioner shall use information and data acquired from
12.1these reviews to promote best practices for mental health treatment that will help prevent
12.2unwarranted hospitalizations.
12.3    (c) The commissioner may adjust rates paid to mental health professionals to reflect
12.4the additional medical assistance costs paid as a result of adding licensed professional
12.5clinical counselors to the list of approved mental health professionals."