Minnesota's Legislature Update

Though Minnesota’s Legislature does not convene again for several months, a number of projects are underway. If you have any interest in participating in the projects, please contact the MPA office at [email protected] or 952-564-3048.

Participation in the State Innovation Model (SIM)

Minnesota is one of six states that received a grant from the Centers for Medicare and Medicaid to develop and assess new models of health care delivery and payment. One focus of Minnesota’s plan is to bring more types of community providers into Accountable Care Organizations. Specifically, it focuses on the need to include behavioral health, long term care, public health, and social services into the mix of services so that care for the whole person can be integrated. A key feature is to expand access to electronic health records for these services. In response to a Request for Information, MPA provided recommendations for the kinds of technical, financial, and organizational support required for psychologists to acquire electronic records and provide integrated care. Hopefully some incentives and other assistance will support psychologists in the assessment, acquisition, implementation, and optimization of electronic health records.

Electronic Health Records

MPA’s Electronic Health Records Task Force is actively exploring options to assist psychologists. Meetings with some vendors have taken place. Stratis Health has received a grant from the Minnesota Department of Health (MDH) to develop a toolkit to assist behavioral health providers in understanding their needs for electronic health records (EHR) and managing the process of adoption. This toolkit will be available in January 2014. The Task Force has also met with representatives from the MDH Office of Health Information Technology. They are aware that psychologists need assistance in the adoption of EHR, and that adoption by the mandated deadline of January 1, 2015, may not be feasible for some providers. They have advised that psychologists must demonstrate progress in the acquisition and implementation of EHR by the deadline, and understand that it may take additional time for psychologists to be fully operational in their use of EHR. MDH emphasizes the importance of psychologists finding the product that is best for their settings rather than rushing to put something in place by the mandated deadline.

MPA has also been active in MDH planning meetings regarding health information technology. MPA has been designated as an alternate member of its e-Health Advisory Committee and participates in workgroups on Privacy and Security, and standards for health information exchange. This e-Health Advisory Committee is working closely with the SIM workgroups to extend the reach of electronic records.

Mental Health Workforce Task Force

Legislation was passed in the Minnesota 2013 session calling for a mental health workforce summit to be coordinated by MNSCU. MPA has been invited to participate on the steering committee that will develop the summit.

Legislative and Regulatory Issues

Payer Issues

Concerns have been raised about the availability of medical necessity criteria to assist providers and the public in treatment decision-making. After several attempts to address the problem with a local payer, the decision was made to contact state regulatory officials for assistance. Availability of medical necessity criteria upon request to any current or potential participant, beneficiary or contracted provider is required by 512(a)(4) of the Mental Health Parity and Addiction Equity Act. Medical necessity criteria availability is especially important as the public begins to use the insurance exchanges. Individuals, families, and employers deserve clarity about what services are available and the basis upon which they can be secured when deciding about insurance coverage.

Psychologists’ Role In Health Reform

Health reform is moving rapidly in Minnesota. It is imperative that MPA protect psychologists’ current roles, and assure that they are included in new models of care. MPA’s Legislative Committee may pursue legislation in the coming session to allow psychologists to direct health homes for individuals with serious and persistent mental illness.

Other Legislative Efforts 

MPA participates in the Minnesota Mental Health Legislative Network (Network), a group of mental health provider groups and advocates that partner on common legislative concerns. The coming session will be very short, and it is anticipated that only a few bills will be introduced. The Network is focusing on two projects:

Commitment Act

It is anticipated that there will be efforts on a variety of fronts to make changes to the mental health commitment laws so that they are more responsive to emergent mental health concerns and to keeping individuals in community based settings when possible.

Service Access For Early Warning Symptoms

The Legislative Network will pursue legislation and funds for a pilot project to provide team services to individuals and their families when symptoms begin to emerge but are not severe enough to warrant commitment. Hopefully, such an approach will engage individuals in a relationship with treatment providers and increase the likelihood for voluntarily engaging in treatment.

Trisha A. Stark, Ph.D., L.P., MPA, is the chair of the Legislative Committee and Electronic Health Records Task Force for MPA. She is involved in public policy and has a small private practice in Minneapolis.

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