Incarceration and mental health services receive boost through human services supplemental budget law

People leaving jail and prison face a higher risk of overdosing and dying than the general population. The human services supplemental budget aims to help eligible individuals who are about to exit incarceration apply for Medicaid.

Sponsored by Rep. Mohamud Noor (DFL-Mpls) and Sen. John Hoffman (DFL-Champlin), the provision is part of a new law that takes effect July 1, 2024, unless otherwise noted.

HF5280/SF5335*/CH125

Reentry demonstration waiver

Per the law, the Department of Human Services must submit a waiver application to the Centers for Medicare & Medicaid Services “to implement a medical assistance demonstration project to provide health care and coordination services that bridge to community-based services for individuals confined in state, local, or Tribal correctional facilities, or facilities located outside of the seven-county metropolitan area that have an inmate census with a significant proportion of Tribal members or American Indians, prior to community reentry.”

The application will be limited to three state correctional facilities, of which one must be the Shakopee women’s prison, four other correctional facilities for adults, two facilities for delinquent children and youth, and one facility owned and managed by a tribal government or a facility outside of the metro area that has an outsize proportion of tribal members or American Indians.

Services will generally be provided 90 days prior to release date and include case management activities to address physical and behavioral health needs, drug coverage including a 30-day supply upon release, substance use disorder assessments, treatment coordination services, and peer recovery support services. Service providers must meet certain conditions. A reentry services working group is to be established.

The re-entry demonstration waiver takes effect the latter of Jan. 1, 2026, or federal approval, except the working group takes effect July 1, 2024. (Art. 3, Secs. 12 and 13, 17-18)

Other working groups, task forces

Effective Jan. 1, 2025, the law establishes requirements that must be met when providing peer recovery support services. Too that end the Department of Human Services is directed to convene a working group to develop recommendations on topics related to peer recovery support services and recovery community organizations, including billing rates and practices, acceptable activities to bill for peer recovery support services, improving recovery peer supervision, and certification or other regulation of recovery community organizations and recovery peers. A report is due the Legislature by Aug. 1, 2025.

Effective May 25, 2024, the law establishes the Mentally Ill and Dangerous Civil Commitment Reform Task Force to evaluate relevant statutes and develop recommendations to optimize the use of state mental health resources and increase equitable access and outcomes for patients. A report is due the Legislature by Aug. 1, 2025. (Art. 3, Secs. 9, 16; Art. 4, Sec. 9)

Priority admissions

Admissions to direct care and treatment facilities for civilly committed people in a correctional institution or hospital receive attention in the law following work by the Task Force on Priority Admissions of State-Operated Treatment Programs. The Department of Human Services must immediately add 10 civilly committed individuals in the hospital to the waiting list. This is effective May 25, 2024.

Subsequently, the state will use a priority admissions framework to prioritize placements to medically appropriate state-operated direct care and treatment beds. The framework will account for the person’s time on a waiting list, the intensity of treatment needed, safety considerations, and the negative impacts of delayed admissions to the referring facility. Additionally, a review panel will be formed to evaluate the 48-hour priority admissions timeline and develop ideas to minimize litigation costs, maximize capacity in and access to state treatment programs, and address related issues. (Art. 4, Secs. 7, 11)

Aging services

The law addresses services for the elderly through several provisions.

Effective March 15, 2025, an assisted living facility with a licensed capacity of five or fewer residents will be permitted to operate under its current license if the facility is relocated with the approval of the Health Department during the period the current license is valid. Additionally, a limited exemption from the custom living setting moratorium and age limitation is provided when a facility is relocated.

Minimum requirements for required food service and other required services are spelled out in statute, staff orientation rules are clarified for someone who transfers from one licensed assisted living facility to another facility operated by the same licensee or by a licensee affiliated with the same corporate organization, effective July 1, 2025, updates employee training requirements for dementia care, mental illness and de-escalation.

A loan program previously reserved for financially distressed nursing facilities will now be open to any long-term services and support providers and facilities. It adjusts the per-resident, per-day rate for 24-hour customized living services provided to an elderly waiver participant in a designated disproportionate share facility for rate year 2025, and sunsets the disproportionate share rate adjustment on January 1, 2026.

The Department of Human Services “must study Minnesota's existing home and community-based services system for older adults and evaluate options to meet the needs of older adults with high support needs that cannot be addressed by services or individual participant budgets available under the elderly waiver.” A report is due the Legislature by Dec. 31, 2025. (Art. 2, Secs. 1-7, 15, 16, 18-21)

Other policy

The Department of Human Services must start a pilot program with county jails to administer long-acting injectable antipsychotic medications to prisoners for mental health treatment.

The law also establishes a Direct Care and Treatment executive board and an advisory committee for the agency. (Art. 4, Sec. 12; Art. 5, Secs. 22, 40-41)

Appropriations:

The law’s fiscal year 2025 spending provisions include:

• $5 million to construct a new Cedar Riverside Recreation Center;

• $4.5 million for a caregiver support program and caregiver respite services grants;

• $2.61 million for Minnesota’s regional food bank for purposes of the Emergency Food Assistance Program;

• $2.39 million to create a pilot program to educate county correctional facilities on protocols and best practices for the provision of involuntary medications for mental health treatment;

• $1.8 million to design a replacement facility for the Miller Building on the Anoka Metro Regional Treatment Center campus;

• $1.37 million to provide free communication services until June 30, 2026, to patients and clients in psychiatric hospitals and inpatient mental health and substance use disorder treatment facilities, group homes, and sex offender treatment facilities; and

• $1.32 million for mental health innovation grant programs for outpatient mental health services;

• $1.04 million for a pediatric hospital-to-home transition pilot program;

• $1 million for start-up funds to intensive residential treatment services providers to administer treatment in locked facilities for eligible patients;

• $1 million for employee incentives for the transition of CARE St. Peter to a forensic mental health program;

• $1 million for a county correctional facility mental health medication pilot program;

• $500,000 for a Dakota County disabilities services workforce shortage pilot project;

• $500,000 for Hennepin County to conduct a two-year pilot project to provide peer recovery support services to East African youth between ages 13 and 18;

• $400,000 for accessibility capital improvements to the Anoka County Human Services building in Blaine;

• $400,000 for a working group to streamline access, eligibility, and administration of state-funded supportive housing resources for people experiencing homelessness;

• $354,000 for African Immigrant Community Services to provide culturally and linguistically appropriate services to new Americans with disabilities, mental health needs, and substance use disorders.

SF5335* / HF5280 / CH125