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    3rd Path/ Children’s Mental Health Residential Services Path

    In compliance with legislation that passed in 2021, the state of Minnesota has developed another way to access Children’s Residential Facilities (CRF) (formerly known as Residential Treatment Centers or RTC) services to assist children living with severe emotional disturbance (SED) and their families. This pathway is called the Children’s Mental Health (CMH) Residential Services Path, also referred to as “3rd Path,” which was developed with the goal of providing children and their families an alternative way to gain access to services to meet a child’s individual and specific needs in a CRF.

    Room and board costs

    The 3rd Path does not fund licensed CRFs in the same manner as the two existing service entry methods or “paths.” When accessing children’s residential services using the existing paths, the county or initiative tribe has placement authority. The three initiative tribes are Red Lake Nation, Leech Lake Band of Ojibwe, and White Earth Nation. Historically, when a child is admitted to a CRF, they may enter via a voluntary placement agreement (VPA) or through a placement for juvenile safety reasons. In both circumstances, the court is involved. Because of this court involvement, the county or initiative tribe receives federal IV-E reimbursement. IV-E reimbursement is used to pay for the cost of room and board. Medical Assistance (MA), pre-paid health plans/managed care (MCO), and private insurance, if applicable, are responsible for the cost of mental health services provided in the CRF.

    In situations where a child and family choose 3rd Path, a voluntary placement agreement (VPA) is not utilized. A child accesses this as a service rather than a placement, and the county or initiative tribe does not receive IV-E funds. Through 3rd path, room and board is covered by the behavioral health fund at the adolescent room and board rate.

    Treatment costs

    If the child is enrolled in Fee for Service Medical Assistance (MA) the county must share in treatment costs not paid by the Federal Participation per the division of costs statute. The county’s responsibility for treatment costs does not depend on how the child was admitted to treatment, it depends on whether the child is enrolled in MA. For children enrolled in one of the initiative tribes, providers will continue to bill the tribes for treatment costs and tribes will continue to submit those costs to the state for reimbursement. If a child is enrolled in an MCO, the MCO will be responsible for the treatment portion of costs, and room and board costs will be billed through the state.

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