Behavioral Health e-Memo

Children’s Mental Health Residential Service Path Timeframe

The Children’s Mental Health Residential Service Path is an optional way for children with a severe emotional disturbance to gain access to residential treatment services. This path requires a mental health professional to conduct a level of care screening. A voluntary placement agreement and a court-ordered placement do not occur.  Through this option, a child may or may not access Rule 79 children’s mental health case management services while accessing children’s residential treatment based on the choice of the parent or the child’s legal representative. The county will maintain payment responsibility. Services must comply with Minnesota Statutes, section 245.4885.

The Children’s Mental Health Residential Service Path will be implemented in the first quarter of year 2022. The Minnesota Department of Human Services (DHS) does not have additional policy guidance or information to provide at this time.  DHS will provide additional updates, details, and guidance as they become available.

The Children’s Mental Health Residential Service Path language relates to amendments in Minnesota Statutes 245.4882 and Minnesota Statutes 245.4885. 

Minnesota Statutes 2020, section 245.4882, subdivision 1 and subdivision 3 have been amended. 

Minnesota Statute 245.4882, subdivision 1 amendment removes:

• the agency’s responsibility to hold 6-month reviews in compliance
• the 90-day court review process.

Minnesota Statutes 245.4882, subdivision 3, is amended to add a requirement for the discharge planning to begin within 30 calendar days after the youth enters residential treatment.  The planning must include identification of and referral to the appropriate home and community supports that meet the needs of the child and family.

Minnesota Statutes 2020, section 245.4885, subdivision 1, has been amended to:

• All children with a severe emotional disturbance who are referred for treatment in foster care, residential treatment or informally admitted to a treatment center shall undergo an assessment if county funds are used. This assessment is the level of care screening.
• The county board shall determine the appropriate level of care when county funds are used to pay for the child’s treatment, including residential treatment in a qualified residential treatment program.
• If the county board does not have responsibility for the child’s placement and the child is enrolled in a prepaid health program, the health plan must determine the child’s appropriate level of care.
• The county board or other entity may not use the child’s history of prior services, time spent in less restrictive settings, and the child’s level of success in meeting their treatment goals as factors when making a screening decision.
• The level of care determination must be based on a diagnostic assessment of a child that evaluates the child's family, school, and community living situations; and an assessment of the child's need for care out of the home using a validated tool which assesses a child's functional status and assigns an appropriate level of care to the child. The diagnostic assessment does not include a functional assessment. The validated tool is the Child and Adolescent Service Intensity Instrument (CASII) as completed by the Mental Health Professional. The child and the child's family must be invited to any meeting where the level of care determination is discussed and where decisions regarding residential treatment are made. The child and the child's family may invite other relatives, friends, tribal representatives or advocates to attend these meetings.
• The level of care determination, placement decision, and recommendations for mental health services must be documented in the child's record. The family must be provided this information upon request.

 Significant changes in policy include:

• The agency does not conduct a Juvenile Screening Team for the youth to receive the Residential Treatment service.
• The Children’s Mental Health Residential Path is considered a service, not a placement. Guidance will follow at a later date to indicate how this can be documented.
• A family has the option to have or not have a case manager.
• The county maintains financial responsibility for the placement. The county does not retain placement responsibility.

Laws of Minnesota, 1^st Special Session, Chapter 7, Article 16, sec. 2, subd. 32

• (a) Children's Residential Facilities. $1,964,000 in fiscal year 2022 and $1,979,000 in fiscal year 2023 are to reimburse counties and Tribal governments for a portion of the costs of treatment in children's residential facilities. The commissioner shall distribute the appropriation on an annual basis to counties and Tribal governments proportionally based on a methodology developed by the commissioner.

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For more information about this e-Memo please feel free to contact us at youropinionmatters.dhs@state.mn.us