Minnesota Health Care Programs (MHCP) members must have a diagnosis of mental illness as determined by a diagnostic assessment. The diagnosis must be included in the diagnostic code list published by DHS.
Full Answer
What are the rules for residential substance use disorder treatment in Minnesota?
Residential substance use disorder treatment programs that serve people 16 or 17 years of age may be licensed under Minnesota Statutes, chapter 245G or Minnesota Rules, chapter 2960 Residential substance use disorder treatment programs serving people younger than 16 years of age must be licensed under Minnesota Rules, chapter 2960.
What does the Minnesota Department of Human Services do for mental health?
Direct care and treatment / Minnesota Department of Human Services Direct care and treatment DHS operates an array of residential and treatment programs serving people with mental illness, developmental disabilities and chemical dependency. This information is intended to help patients and their families learn more about the programs.
What are the maltreatment reporting requirements in Minnesota?
Under Minnesota law all enrolled providers are required to report all suspected maltreatment including abuse, neglect or financial exploitation of a vulnerable adult to the common entry point following the requirements in Minnesota Statutes 626.557, subd. 4.
How do I Bill treatment services to the plan and MHCP?
Bill treatment services to the plan and bill room and board to MHCP as follows: Bill freestanding or residential program room-and-board charges (revenue codes 1003 or 1002) that are authorized by the MCO directly to MHCP. Report the following information in the “Value Code” field:
What is a treatment plan review?
The Treatment Plan Review is utilized to capture the client's progress toward goals for problems that they are currently being treated for.
What should a treatment plan include?
A treatment plan will include the patient or client's personal information, the diagnosis (or diagnoses, as is often the case with mental illness), a general outline of the treatment prescribed, and space to measure outcomes as the client progresses through treatment.
How does a treatment plan work?
In mental health, a treatment plan refers to a written document that outlines the proposed goals, plan, and methods of therapy. It will be used by you and your therapist to direct the steps to take in treating whatever you're working on.
How often should you review a treatment plan?
Treatment plans are usually updated on a regular basis, often every six months or so, to allow for changes in your priorities and to reflect on the progress you have made.
How do you write a treatment plan example?
Treatment plans usually follow a simple format and typically include the following information:The patient's personal information, psychological history and demographics.A diagnosis of the current mental health problem.High-priority treatment goals.Measurable objectives.A timeline for treatment progress.More items...•
What are some examples of treatment goals?
Treatment Plan Goals and Objectives Examples of goals include: The patient will learn to cope with negative feelings without using substances. The patient will learn how to build positive communication skills. The patient will learn how to express anger towards their spouse in a healthy way.
What are the four components of the treatment plan?
There are four necessary steps to creating an appropriate substance abuse treatment plan: identifying the problem statements, creating goals, defining objectives to reach those goals, and establishing interventions.
What does a counseling treatment plan look like?
A counseling treatment plan is a document that you create in collaboration with a client. It includes important details like the client's history, presenting problems, a list of treatment goals and objectives, and what interventions you'll use to help the client progress.
What is an individual treatment plan?
A written individualized treatment plan, referred to as Treatment Plan, is a comprehensive, progressive, personalized plan that includes all prescribed Behavioral Health (BH) services. It is person-centered, recovery oriented, culturally competent and addresses personalized goals and objectives.
When should a treatment plan be revised?
In evaluating and revising a treatment plan treatment providers should get cooperation from the client. Many programs already comply with licensing regulations to review and revise the treatment plan periodically (e.g., weekly or every 30 days).
How do you review a treatment plan simple practice?
To do this:Navigate to the client's Overview page.Click New > Diagnosis & Treatment Plan.Click Load previous. This option will only populate if you have a previous treatment plan stored for this client.
What does it mean to stay with your treatment plan?
Treatment plan means a documented plan that describes the patient's condition and procedures that will be needed, detailing the treatment to be provided and expected outcome and expected duration of the treatment prescribed by the healthcare professional.
How old do you have to be to be a substance abuse counselor in Minnesota?
Residential substance use disorder treatment programs that serve people 16 or 17 years of age may be licensed under Minnesota Statutes, chapter 245G or Minnesota Rules, chapter 2960. Residential substance use disorder treatment programs serving people younger than 16 years of age must be licensed under Minnesota Rules, chapter 2960.
Is substance use disorder a residential or outpatient program?
Substance use disorder treatment programs may be licensed as outpatient or residential and may also be certified to provide the additional services of adolescent treatment, people with children in treatment, co-occurring disorder treatment or opioid treatment.
What is an integrated treatment plan?
The CCBHC Integrated Treatment Plan (ITP) is the result of a person and family-centered planning process in which the member, any family or member-defined natural supports, CCBHC service providers, external service providers as appropriate, and care coordination staff are engaged in creation of the integrated treatment plan. ITP development should include the member and all interested parties; however, at minimum, the ITP must be completed in a face-to-face interaction with the member. It must be reviewed and signed by a qualified mental health professional or by a mental health practitioner working as a clinical trainee.
How often do you need to update a CCBHC?
Once a person becomes a CCBHC client, the person must receive a CCBHC Comprehensive Evaluation followed by an Integrated Treatment Plan within 60 days from the Preliminary Screening and Risk Assessment. Note that in Minnesota we found that, although the federal criteria calls for Integrated Treatment Plan updates to occur every 90 days, this did not align with state standards for quality care. Therefore, we have amended the standards in MN to allow for updates to occur up to every 6 months. Based on the needs of the person or family, the evaluation process and timeline could look like either option below:
How often do ITP updates need to be updated?
Providers must update the ITP at least every 6 months and anytime there is significant change in the member’s situation, functioning, service methods or at the request of the member or the member’s legal guardian. ITP updates require the member be present and include engagement of any member-defined natural supports, CCBHC service providers, external service providers, as appropriate, and care coordination staff.
What are Minnesota rules?
Minnesota Rules 9505.2160 to 9505.2245 (enacted June 10, 1991; amended March 18, 1995) establish a program of surveillance, integrity, review and control. They authorize a post-payment review process to ensure compliance with MHCP requirements by monitoring the use of health services by recipients and the delivery of health services by vendors. Within DHS, the SIRS section is responsible for identifying and investigating suspected fraud, theft, and abuse. SIRS is authorized to seek monetary recovery, to impose administrative sanctions, and to seek civil or criminal action through the office of Attorney General (AG). Referrals are made both to the Medicaid Fraud Control Unit (MFCU), and to the civil section of the AG's office. Information about the monitoring of recipient use of health services is found in Health Care Programs and Services.
How long does MHCP reprocess payments?
MHCP will reprocess and reverse payments retroactive to six years following federal Required Provider Agreement regulations and Minnesota’s Covered Services rule that prohibits payment of a service to non-enrolled providers. Providers will see reversed claims as adjustments on their remittance advices.
What is MHCP violation?
Violating Provider Agreement. A provider who fails to comply with the terms of participation in the provider agreement or with requirements of the rules governing MHCP is subject to monetary recovery, Minnesota Rules, part 9505 program sanctions, or civil or criminal action.
How long does it take to notify MHCP of a sale?
An MHCP provider who sells or transfers ownership or control of a provider entity enrolled in MHCP must notify MHCP Provider Enrollment no later than 30 days before the effective date of the sale or transfer by submitting a Provider Entity Sale or Transfer Addendum (DHS-5550) (PDF).
What is MHCP reporting?
As a professional or professional’s delegate engaged in social services and the care of vulnerable adults, MHCP enrolled providers are mandated reporters under Minnesota Statute 626.557. Under Minnesota law all enrolled providers are required to report all suspected maltreatment including abuse, neglect or financial exploitation of a vulnerable adult to the common entry point following the requirements in Minnesota Statutes 626.557, subd. 4.
Why is advance notification required for MHCP?
Advance notification to MHCP Provider Enrollment is critical for providers of home care and waivered services due to the impact of a provider number change on service agreements through which they bill. See additional requirements in Home Care Services and HCBS Waiver Programs and AC Program.
Who does MHCP mail payments to?
MHCP must make all payments to the provider . However, MHCP may mail payment to a billing agent (such as an accounting firm or billing service) that furnishes statements and receives payments in the name of the provider if the agent's compensation for these services is any of the following:
What is the direction of a mental health aide?
Direction must also include determining that the mental health behavioral aide has the skills to interact with the member and the member's family in ways that convey personal and cultural respect and that the aide actively solicits information relevant to treatment from the family.
How long does a child have to be in a hospital for CTSS?
Up to 15 hours of CTSS may also be provided when the service components of CTSS are identified in the discharge plan and are provided within a six-month time period if the child participates in a partial hospitalization program or resides in one of the following:
What is CTSS in mental health?
CTSS is a flexible package of mental health services for children who require varying therapeutic and rehabilitative levels of intervention. CTSS addresses the conditions of emotional disturbance that impair and interfere with an individual’s ability to function independently. For children with emotional disturbances, rehabilitation means a series or multidisciplinary combination of psychiatric and psychosocial interventions to:
How long does it take to get a CTSS?
The diagnostic assessment used to establish eligibility for CTSS must be done by a mental health professional or clinical trainee within 365 days before CTSS services begin. In addition to the general MHCP requirements for a Diagnostic Assessment (DA), CTSS requires that the DA:
Does a child need psychotherapy?
A provider must deliver, or arrange for, medically necessary psychotherapy, unless the child's parent or caregiver chooses not to receive it.
What is the SUD system in Minnesota?
Minnesota is implementing a Substance Use Disorder (SUD) System Reform Federal Demonstration Project that incorporates the American Society of Addiction Medicine (ASAM) criteria to establish specific residential and outpatient levels of care for SUD treatment services under the authority of section 1115 (a) of the Social Security Act.
What is a drug counseling code?
The code is defined as “alcohol and/or drug counseling per hour.”. The code is defined by a unit of time. Unit of time is attained when the mid-point is passed, and more than half of the time must be spent performing the service for reporting a specific code, excluding any breaks. Residential programs.
How long does a hospital claim have to be for interim billing?
Bill residential and inpatient hospital claims that span multiple months using interim billing method. Include the date of discharge on the final treatment claim along with appropriate patient status code.
When will SUD services be available?
Effective Oct. 1, 2020, until July 1, 2022, SUD treatment services may be accessed directly by going to a provider (Direct Access) or obtaining a service agreement from a county ...
Can you receive reimbursement for a SUD?
You will not receive reimbursment as a SUD treatment provider unless you have complied with the DAANES requirements for each Behavioral Health Fund (BHF) recipient. All SUD clients regardless of funding need to be entered into DAANES for each admission episode.
Do providers have to be enrolled in MHCP?
Providers must be enrolled with MHCP as an eligible provider of specific services, specialties or complexity add-ons to receive reimbursement from MHCP. Providers are responsible for knowing and understanding the rules and regulations pertaining to any services they submit for reimbursement.
What is MHCP in Minnesota?
Minnesota Health Care Programs (MHCP) members must have a diagnosis of mental illness as determined by a diagnostic assessment. The diagnosis must be included in the diagnostic code list published by DHS.
How many sessions of psychotherapy are required for a family psychotherapist?
Exception: The initial diagnostic assessment allows for a member to be eligible to receive up to three sessions of a combination of individual or family psychotherapy or family psychoeducation before the provider completes the diagnostic assessment.
How many families can you have in a family psychotherapy group?
• Multiple family group psychotherapy is designed for at least two, but no more than five, related or unrelated families, regardless of family members’ MHCP eligibility status or the number of family members who participate in the family psychotherapy session. The families must be related to at least one person in the group.
What is psychotherapy therapy?
Psychotherapy is: • A planned and structured, face-to-face treatment of a member’s mental illness. • Directed to accomplish measurable goals and objectives specified in the member’s individual treatment plan (ITP)
What is the treatment of a person with mental illness?
Overview. "Psychotherapy" means treatment of a person with mental illness that applies the most appropriate psychological, psychiatric, psychosocial, or interpersonal method that conforms to prevailing community standards of professional practice to meet the mental health needs of the member. Psychotherapy is:
Do you need to keep progress notes for a psychotherapy session?
While providers need to keep progress notes in order to document treatment, it is at the discretion of the provider whether to keep additional psychotherapy notes. A psychotherapy note is the documentation or analysis of the contents of conversation during an individual, group or family psychotherapy session.
Definition
Level of care (LOC): A particular amount of care and services required to meet a person's needs.
Determining level of care
The lead agency determines level of care during an assessment process for people who request home and community-based services under Medical Assistance (MA).
HCBS waiver that requires this level of care
The Developmental Disabilities (DD) Waiver requires a person to need an ICF/DD level of care.
Hospital
For hospital level of care, the person must meet all of the following criteria:
HCBS waiver that requires this level of care
The Community Alternative Care (CAC) Waiver requires a person to need a hospital level of care.
Nursing facility
For nursing facility (NF) level of care, a person must meet one of the following five categories of need:
Neurobehavioral hospital
For neurobehavioral hospital (NB) level of care, the person must meet NF level of care criteria and require all of the following:
How many sessions of mental health services can you have in Minnesota?
for a client who is not currently receiving mental health services covered by medical assistance, a crisis assessment as specified in Minnesota Statutes, section 256B.0624 or 256B.0944, conducted in the past 60 days may be used to allow up to ten sessions of mental health services within a 12-month period.
How often should a mental health plan be reviewed?
reviewed at least once every 90 days, and revised as necessary. Revisions to the initial individual treatment plan do not require a new diagnostic assessment unless the client's mental health status has changed markedly as provided in subpart 2.
How many sessions of mental health services are allowed in a 12-month period?
may be used to allow up to ten sessions of mental health services as specified in part 9505.0372 within a 12-month period before a standard or extended diagnostic assessment is required when the client is:
How many hours of supervision for mental health?
has at least 6,000 hours of supervised experience in the delivery of mental health services to clients with mental illness. Hours worked as a mental health behavioral aide I or II under Minnesota Statutes, section 256B.0943, subdivision 7, may be included in the 6,000 hours of experience for child clients;
What is a tribally approved mental health professional?
a tribally approved mental health care professional, who meets the standards in Minnesota Statutes, section 256B.02, subdivision 7, paragraphs (b) and (c), and who is serving a federally recognized Indian tribe; or
What is a marriage and family therapist in Minnesota?
in marriage and family therapy, a person licensed as a marriage and family therapist by the Minnesota Board of Marriage and Family Therapy under Minnesota Statutes, sections 148B.29 to 148B.39, and defined in parts 5300.0100 to 5300.0350;
What is a psychology license in Minnesota?
in psychology, a person licensed by the Minnesota Board of Psychology under Minnesota Statutes, sections 148.88 to 148.98, who has stated to the board competencies in the diagnosis and treatment of mental illness;