The Minnesota Department of Human Services (DHS) Behavioral Health Division has received approval for a State Plan Amendment (SPA) (Minnesota Medicaid SPA 23-0008) from the Centers for Medicare and Medicaid Services (CMS) that will update the requirements for Children’s Therapeutic Services and Supports (CTSS).

This amendment authorizes the following changes to the CTSS services model which originally passed in the 2022 state legislative session:

1.      Removes the requirement for a Mental Health Behavioral Aide (MHBA) to use an Individual Behavior Plan (IBP). MHBA services will now solely be guided using an Individual Treatment Plan (ITP).

MHBA services are defined as medically necessary one-on-one activities performed by a trained paraprofessional to practice psychosocial skills and assist a child in retaining or generalizing psychosocial skills according to the child's treatment plan that a mental health professional, clinical trainee or mental health practitioner has previously taught to the child according to the child’s treatment plan.

2.      Removes the requirement for minimum program availability for day treatment hours and/or days. Day treatment psychotherapy and skills training continue to be determined by the child’s individual medical needs.

3.      Removes the requirement for a day treatment supervisor to be present on-site at day treatment program while a supervisee is providing mental health services to children.

4.      Removes the requirement for the treatment supervisor to review and sign the record of a child’s day treatment care every 30 days. Under the new requirements, the treatment supervisor determines the frequency of scheduled treatment supervision.

• Under new guidelines, a day treatment multidisciplinary team must include at least one mental health professional.

Finally, there are two additional updates approved for CTSS by the passing of the SPA:

• Removes the requirement for the administration and reporting of a standardized functional assessment instrument.
• Removes the requirement for prior authorization for psychotherapy services. Prior authorization continues to be required, however, in the following instances:

• When delivering day treatment skills training over 150 hours in a calendar year.
• When there is a need to provide day treatment services concurrent with other services.
• When skills training is simultaneously provided by more than one provider.

If you have any questions or concerns about these updates or CTSS, please send an email to dhs.ctss@state.mn.us.