HF98 (Legislative Session 94 (2025-2026))
Case management associate, mental health behavioral aide, and mental health rehabilitation worker supervision requirements modified; mental health residential program critical incident reporting requirements modified, and other mental health policies modified.
Related bill: SF477
AI Generated Summary
Purpose
- This bill makes changes to how certain mental health services are supervised and delivered in Minnesota. It updates case management requirements, modifies supervision for frontline mental health workers, adjusts certain client rights for intensive residential treatment and residential crisis stabilization, strengthens critical incident reporting and treatment planning in residential settings, updates staffing and roles for Assertive Community Treatment (ACT) teams, and adds a provision allowing payment for case management contacts conducted by secure electronic messaging. It amends several sections of Minnesota statutes to implement these changes.
Main Provisions
Case management supervision and qualifications (Section 1)
- Defines who can be a case management service provider and what they must know and do.
- Requires case managers to be a mental health practitioner or have a bachelor’s degree in behavioral sciences or related fields; if not, they must meet alternative qualifications.
- Sets supervision and continuing education requirements for case managers and case management associates (CMAs); CMAs must work under supervision and meet specific training and mentoring rules.
- Creates pathways for case managers with varying backgrounds, including an immigrant CMA option with training and supervision.
- Allows payment for adult mental health case management contacts conducted via secure electronic messaging.
Supervision for certain frontline workers (Section 2)
- Requires direct observation and regular supervision of mental health behavioral aides (MHBA) and mental health rehabilitation workers (MHRW).
- Specifies the minimum frequency of direct observation and supervision, especially during the first six months of employment and thereafter.
Client rights and grievance process (Sections 3–4)
- Keeps the health care bill of rights for clients, but notes that certain sections of that bill do not apply to intensive residential treatment services (IRTS) or residential crisis stabilization services (RCS).
- Requires license holders to protect rights including non-discrimination and privacy around recording, with options to refuse photos or recordings not used for identification or supervision.
- Strengthens grievance procedures: clearly explain them at admission, post the procedures, allow complaints to be filed by clients or their representatives, acknowledge receipt within 3 business days, provide a final written response within a set period, and allow appeals for managed care reductions or denials. Prohibits retaliation for grievances.
Critical incidents reporting (Section 5)
- If a license holder runs a residential program, they must report all critical incidents to the state commissioner within 10 days using an approved form.
- Keeps a central file of critical incidents accessible to the commissioner.
- Provides exceptions if the incident has already been reported to an Ombudsman or the Minnesota Adult Abuse Reporting Center.
Intensive Residential Treatment Services (IRTS) assessment and treatment planning (Section 6)
- Sets timelines for initial evaluation and treatment planning after a client’s admission (e.g., within 12 hours for immediate needs; within 24 hours for an initial treatment plan).
- Requires level of care assessments within 5–10 days and again within 60 days; ensures medical necessity is documented if needed.
- Requires ongoing updates to diagnostic assessments and treatment plans, with a focus on preparing the client for a successful transition from IRTS to another setting.
- Calls for explicit documentation of referrals, resources, and who is responsible for following up.
- Requires assessments of substance use history and its impact, including relationships, housing, finances, and safety.
- Requires weekly reviews of treatment plans and abuse prevention plans by qualified professionals, with documentation in the client’s file.
- Includes specific requirements for substance use assessments and ongoing monitoring for clients with substance use disorders.
ACT team staffing and roles (Section 7)
- Reframes ACT team structure and qualifications:
- Team leader must be a mental health professional and a full-time, dedicated staff member who can provide after-hours support.
- Psychiatric care providers, nursing staff, cooccurring disorder specialists, vocational specialists, mental health certified peer specialists, and a program administrative assistant are defined roles with specific responsibilities and staffing rules.
- Sets limits on how many staff can occupy certain roles (e.g., no more than two cooccurring disorder specialists; no more than two psychiatric care providers sharing the same role) and requires certain full-time equivalents based on client load.
- Psychiatric care providers must have experience with serious and persistent mental illness, work closely with the ACT team, and handle medication education, monitoring, and communication with inpatient teams as needed.
- Nursing staff manage medications, monitor health, and coordinate with the rest of the ACT team.
- Cooccurring disorder specialists must have specific training in cooccurring disorders and can be licensed professionals (e.g., licensed alcohol and drug counselors) meeting certain criteria.
- Vocational specialists provide employment and education services and must not refer clients outside the ACT framework for vocational services.
- Mental health certified peer specialists provide recovery-focused coaching and support and must be integrated as full team members without compromising their role.
- Each ACT team must document schedules, designate a primary team member for each client (responsible for the individual treatment plan and family support), and ensure all team members have appropriate training and collaborate as a multidisciplinary team.
- Emphasizes training requirements for all ACT team members and the need for a collaborative, client-centered approach.
Significant Changes to Existing Law
- Exemption from certain health care rights for IRTS/RCS: Some sections of the health care bill of rights do not apply to intensive residential treatment services or residential crisis stabilization services.
- Expanded supervision and education requirements: More explicit and frequent supervision and direct observation for case managers, CMAs, MHBA, and MHRW.
- Stricter and clearer ACT team structure: Redefined roles, staffing ratios, after-hours coverage, and multi-disciplinary collaboration requirements for ACT teams.
- New and revised reporting requirements: Enhanced critical incident reporting, ongoing treatment plan reviews, and substance use assessments with documented follow-up.
- Broader pathways and qualification options: New or expanded routes for CMAs and other frontline staff to meet requirements (including immigrant pathways and various combinations of education and experience).
- Electronic communications: Authorization and payment for case management contacts conducted via secure electronic messaging.
Impact Focus (Who is Affected)
- Providers delivering case management, MHBA, MHRW, and other ACT-related services will face new or changed supervision, training, and staffing rules.
- Residential programs offering IRTS or RCS will see changes to client rights, incident reporting, and treatment planning timelines.
- Clients receiving mental health services, particularly in residential or community-based settings, may experience changes in supervision quality, treatment planning, grievance processes, and access to services through secure electronic messaging.
Relevant Terms - case management, case manager, case management associate (CMA), CMA supervision, case management supervisor - mental health behavioral aide (MHBA), mental health rehabilitation worker (MHRW), direct observation - intensive residential treatment services (IRTS), residential crisis stabilization services (RCS) - assertive community treatment (ACT) team, ACT team leader, psychiatric care provider, nursing staff - cooccurring disorder specialist, vocational specialist, mental health certified peer specialist - emergency reporting, critical incidents, licensing, commissioner - level of care assessment, initial treatment plan, individual treatment plan, treatment supervisor - substance use disorder (SUD), substance use assessment - health care bill of rights, discrimination protections, grievance procedure - secure electronic messaging, remote case management - immigrant CMA pathway, mentoring, supervision hours
Actions
| Date | Chamber | Where | Type | Name | Committee Name |
|---|---|---|---|---|---|
| February 10, 2025 | House | Action | Introduction and first reading, referred to | Human Services Finance and Policy | |
| February 13, 2025 | House | Action | Author added | ||
| February 17, 2025 | House | Action | Authors added | ||
| February 26, 2025 | House | Action | Author added |
Citations
[
{
"analysis": {
"added": [
"Definition of ‘case management service provider’.",
"Expanded qualifications for case managers, including being a mental health practitioner or possessing a bachelor’s degree in behavioral sciences or related fields.",
"Outlines supervision, continuing education, and mentoring requirements for case managers and case management associates."
],
"removed": [],
"summary": "This bill amends Minnesota Statutes 2024 section 245.462, subdivision 4 to define 'case management service provider' and specify requirements for case managers and supervision.",
"modified": [
"Substantial revisions to the structure and content of subdivision 4 describing case management service providers and related qualifications."
]
},
"citation": "245.462",
"subdivision": "4"
},
{
"analysis": {
"added": [
"Direct observation by a mental health professional or qualified supervisor at specified frequencies (twice per month for the first six months, then monthly thereafter).",
"Observation activities must be documented, and the staff performing direct observation must approve the progress notes."
],
"removed": [],
"summary": "This bill amends Minnesota Statutes 2024 section 245I.06, subdivision 3 to establish treatment supervision and direct observation requirements for mental health behavioral aides and mental health rehabilitation workers.",
"modified": [
"Introduces explicit supervision and observation cadence for MH behavioral aides and MH rehabilitation workers."
]
},
"citation": "245I.06",
"subdivision": "3"
},
{
"analysis": {
"added": [
"Rights aligned with the Health Care Bill of Rights (section 144.651).",
"Right to be free from discrimination as specified, with protections regarding state and federal laws including the Minnesota Human Rights Act (chapter 363A).",
"Right to be informed prior to any photograph or audio/video recording."
],
"removed": [],
"summary": "This bill amends Minnesota Statutes 2024 section 245I.12, subdivision 1 to address client rights, including references to the Health Care Bill of Rights and related exemptions and laws.",
"modified": [
"Establishes exemptions for intensive residential treatment services and residential crisis stabilization services from certain sections of 144.651 and clarifies the legal framework for client rights."
]
},
"citation": "245I.12",
"subdivision": "1"
},
{
"analysis": {
"added": [
"A formal grievance procedure must be described to clients and include current public contact information for DHS Licensing Division, the Office of Ombudsman for Mental Health and Developmental Disabilities, the Department of Health Office of Health Facilities Complaints, and relevant licensing boards.",
"Processing steps include admission explanation, posting of the procedure, and timelines for acknowledgment and responses."
],
"removed": [],
"summary": "This bill amends Minnesota Statutes 2024 section 245I.12, subdivision 5 to address client grievances.",
"modified": [
"Imposes structured timelines and escalation provisions for grievances, and requires notices related to managed care organization decisions when applicable."
]
},
"citation": "245I.12",
"subdivision": "5"
},
{
"analysis": {
"added": [
"License holders must report all critical incidents to the commissioner within ten days using a form approved by the commissioner.",
"Reporting to the commissioner may be unnecessary if the incidents are already reported to the Office of Ombudsman for Mental Health and Developmental Disabilities or the Minnesota Adult Abuse Reporting Center.",
"Requires maintaining a central record of critical incidents accessible to the commissioner upon request for at least two licensing periods."
],
"removed": [],
"summary": "This bill amends Minnesota Statutes 2024 section 245I.13 (CRITICAL INCIDENTS).",
"modified": [
"Clarifies reporting timelines, forms, and cross-reporting expectations for critical incidents."
]
},
"citation": "245I.13",
"subdivision": ""
},
{
"analysis": {
"added": [
"Timeline-driven requirements for initial evaluation (within 12 hours), initial treatment plan (within 24 hours), and ongoing planning elements.",
"Requirements for treatment planning participation by the client and involvement of a treatment supervisor when required.",
"Obligation to include admission-related factors (health/safety, supports, housing, legal issues) and measurable treatment goals and interventions.",
"Necessity to document level of care assessments and medical necessity for continued intensive services."
],
"removed": [],
"summary": "This bill amends Minnesota Statutes 2024 section 245I.23, subdivision 7 regarding Intensive Residential Treatment Services assessment and treatment planning.",
"modified": [
"Substantial enhancements to the assessment, planning, and documentation process for intensive residential treatment services, including specific timelines and content."
]
},
"citation": "245I.23",
"subdivision": "7"
},
{
"analysis": {
"added": [
"Detailed staffing framework for ACT teams including team leader, psychiatric care provider, nursing staff, cooccurring disorder specialist, vocational specialist, mental health certified peer specialist, program administrative assistant, and additional staff as needed.",
"Defined qualifications for the team leader and other roles, including on-call availability and direct service expectations.",
"Clarified supervisory and administrative responsibilities of the team leader and the provision of after-hours support."
],
"removed": [],
"summary": "This bill amends Minnesota Statutes 2024 section 256B.0622, subdivision 7a to address Assertive Community Treatment (ACT) team staff requirements and roles.",
"modified": [
"Creates a comprehensive, role-based staffing model for ACT teams with explicit qualifications and responsibilities."
]
},
"citation": "256B.0622",
"subdivision": "7a"
},
{
"analysis": {
"added": [],
"removed": [],
"summary": "This bill references the Health Care Bill of Rights located in Minnesota Statutes section 144.651 as the basis for client rights.",
"modified": [
"Uses 144.651 to define client rights applicable to license holders under intensive residential treatment and related services."
]
},
"citation": "144.651",
"subdivision": ""
},
{
"analysis": {
"added": [],
"removed": [],
"summary": "This bill references the Minnesota Human Rights Act, codified in chapter 363A, as part of compliance with client rights.",
"modified": [
"Affirms that license holders must follow all applicable state and federal laws, including the Minnesota Human Rights Act (chapter 363A)."
]
},
"citation": "363A",
"subdivision": ""
},
{
"analysis": {
"added": [
"Allows or contemplates use of licensed alcohol and drug counselors (or equivalent) in cooccurring disorder treatment within ACT teams."
],
"removed": [],
"summary": "This bill references Minnesota Statutes 2024 section 148F.01 subdivision 5 in relation to cooccurring disorder treatment staff.",
"modified": [
"Integrates cross-reference to cooccurring disorder training and credentialing within ACT team roles."
]
},
"citation": "148F.01",
"subdivision": "5"
},
{
"analysis": {
"added": [
"Identifies cooccurring disorder specialists as part of ACT team staffing and training requirements."
],
"removed": [],
"summary": "This bill references Minnesota Statutes 2024 section 245G.11 subdivision 5 in the context of cooccurring disorders within ACT teams.",
"modified": [
"Aligns ACT team staffing with requirements for cooccurring disorder treatment roles."
]
},
"citation": "245G.11",
"subdivision": "5"
},
{
"analysis": {
"added": [
"Requires completion of an individual abuse prevention plan as part of a client’s initial treatment plan."
],
"removed": [],
"summary": "This bill cites Minnesota Statutes 2024 section 245A.65 subdivision 2, paragraph b regarding abuse prevention planning.",
"modified": [
"Incorporates abuse prevention planning into initial treatment planning requirements."
]
},
"citation": "245A.65",
"subdivision": "2, paragraph b"
},
{
"analysis": {
"added": [],
"removed": [],
"summary": "This bill references Minnesota Statutes 2024 section 245I.08 subdivision 3 in relation to supervision for certain mental health staff.",
"modified": [
"Incorporates cross-reference to subd. 3 provisions governing supervision/overseeing of certain mental health workers within treatment programs."
]
},
"citation": "245I.08",
"subdivision": "3"
},
{
"analysis": {
"added": [],
"removed": [],
"summary": "This bill references Minnesota Statutes 2024 section 245I.10 subdivision 8 in relation to treatment planning.",
"modified": [
"Cites subd. 8 provisions as part of requirements for individual treatment plan development and updates."
]
},
"citation": "245I.10",
"subdivision": "8"
},
{
"analysis": {
"added": [
"Case managers must be a mental health practitioner (as defined) or have a relevant bachelor’s degree; CMA must meet specified experience or credential criteria."
],
"removed": [],
"summary": "This bill amends Minnesota Statutes 2024 section 245I.04 subdivision 4 to specify qualifications for case managers and CMA (case management associates).",
"modified": [
"Establishes or clarifies education/experience prerequisites and related supervision requirements for case management staff."
]
},
"citation": "245I.04",
"subdivision": "4"
}
]Progress through the legislative process
In Committee