ARMHS frequently asked questions

Yes, possibly. A co-occurring mental health diagnosis, in keeping with federal guidelines for serious mental illness (SMI) is necessary, as well as being eligible to receive services.

If you are an organization, you must follow the steps listed on the ARMHS web page. If you are an individual, you must determine what qualifications you have to provide services, and then find an ARMHS organization that is hiring staff or decide if you can open your own business.

For adult mental health services, behavioral science includes social work and psychology. Related fields include nursing, occupational therapy, rehabilitation and vocational rehabilitation. Other acceptable related fields must include 30 semester college credits in the following core class areas: human services, psychology, social work and rehabilitation. A valid transcript is required to demonstrate the practitioner has the required qualifications.

See the MHCP Provider Manual for a description of the qualifications for mental health practitioners and MHRWs. Some of the differences are:

• MHRWs implement ARMHS services as described in the individual treatment plan under the direction of the mental health professional or the assigned lead mental health practitioner. A mental health professional conducts clinical supervision.
• The MHRW cannot conduct the functional assessment or write the individual treatment plan (ITP). The MHRW can implement the ITP.
• For MA reimbursement, MHRWs and MHPs have different billing rates for different service activities.
• Progress notes written by a MHRW would be co-signed by the ARMHS clinical supervisor or treatment director.

The MHCP Provider Manual  summarizes the supervision needed by the MHRW.

At least once a month the MHRW will receive individual or group clinical supervision from the mental health professional clinical supervisor. In addition, the lead mental health practitioner or mental health professional must directly observe a newly hired MHRW delivering services to recipients for at least six hours per 40 hours worked during the first 160 hours that the MHRW works. Then, direct service observation by a mental health professional or lead mental health practitioner will occur for at least six hours for every six months of employment until the MHRW qualifies as a mental health practitioner. 

Field supervision by the mental health professional clinical supervisor or lead mental health practitioner must be documented and located in the MHRW personnel record. The log identifies the date of field supervision, amount of time observed, observation comments, and signature and title of the field supervisor. The lead mental health practitioner must review and co-sign the progress note associated with the observed session. 

Until the MHRW qualifies as a mental health practitioner, the lead mental health practitioner or mental health practitioner clinical supervisor must review and approve all progress notes and indicate they have done so by co-signing the progress notes along with the MHRW. (Minnesota Statute section 245.462, Subdivision 17)

At minimum, mental health practitioners are required to participate in either individual or group clinical supervision conducted by the mental health practitioner once a month.

Yes. Review Psychiatric Consultations to Primary Care Providers in the Mental Health Services section of the MHCP Provider Manual for billing and service delivery policy about consultation services.

Follow the authorization process described in the ARMHS section of the MHCP Provider Manual

See the mental health codes and maximum adjusted FFS rates chart and additional information on the Mental Health Codes, Maximum FFS Rates, and Eligible Providers

Documentation that is being conducted  concurrently with the client is a billable service.

If your claim is fee-for-service, contact the MHCP Provider Call Center at 800-366-5411 or 651-431-2700. If your claim is through one of the managed care organizations (MCOs), you need to contact the MCO directly.

Yes. We will only accept and process ARMHS certification applications from organizations that successfully attended the  DHS ARMHS information sessions. Clinical staff must take the online prerequisite training before taking the ARMHS information sessions.

No, you do not need to purchase worker’s compensation insurance before submitting the ARMHS certification application, but you must submit a quote from a licensed insurance agency. The ability to start services would be contingent upon the approved agency’s activation of the insurance plan.

List your corporate headquarters. As you grow, you will need to inform MHCP as well as the Adult Mental Health Division at DHS of your additional satellite office locations. You are not required to have an office location in every county where you are approved to deliver services.

Certification applications are only accepted electronically. Submit applications to dhs.mhrehab-adult@state.mn.us.

No. Psychiatric evaluations do not meet the standards of a diagnostic assessment. The requirements for a diagnostic assessment are in Minnesota Rules 9505.0371. Providers must assess and document all components listed in Rules for the assessment to meet our requirements and be reimbursed as a diagnostic assessment. A psychiatrist who is billing for a DA must follow the DA rules.

No, DHS does not endorse a specific form. Guidance is available in the Diagnostic Assessment section of the MHCP Provider Manual.

No. You can update a diagnostic assessment when the standard or extended diagnostic assessment is less than three years old. The person will need a new diagnostic assessment by year four. For example, a client receives a standard diagnostic assessment in 2011. In 2012 and 2013 the clinician may choose to do an adult update if their clinical judgment determines that is the best diagnostic option for the client. In 2014, the client needs to have a new standard or extended diagnostic assessment to determine eligibility for ongoing mental health services.

Yes. In 2007, the Minnesota Legislature mandated in Minnesota Statutes 62J.495, that, “By January 1, 2015, all hospitals and health care providers must have in place an interoperable electronic health records system within their hospital system or clinical practice setting.” MHCP also has an Industry Initiative on Electronic Health Records.

That depends. People age 18 up to age 21 are eligible for both ARMHS and CTSS, and must meet the eligibility criteria for either or both programs. Which program is appropriate depends on the needs of the person. Typically, CTSS is provided to a person who is still in a dependent situation; that is, the person is living with family, trying to complete school and needs to develop skills and abilities other people their age are typically able to do. A person who is still struggling to deal adequately with emotional regulation, being able to function in a school setting, being able to cope within the structure of their family situation where they are still a dependent, etc., are situations that are appropriately addressed through CTSS.

ARMHS focuses on the following adult expectations:

• The ability to live independently
• The ability to set life goals and work toward them as an adult
• The ability to acquire and hold a job
• The ability to take care of others who are dependent upon them

Examples of where the young adult may benefit from ARMHS include the following: 

• An 18 year old who is working to develop skills or manage mental health symptoms necessary to finding, acquiring and holding a job is appropriate for ARMHS, but these are not typically goals one would expect to find under CTSS. Why? Because the person is focusing on achieving adult needs related to successful and effective adult expectations.
• An 18 year old who is entering college and dealing with lack of skills for managing emotional outbursts and being able to manage relationships with their family members and friends may be more appropriate for CTSS. Why? Because the person is still in a predominantly adolescent role, acquiring education and is still managing relationships where they are dependent on others sometimes making decisions for them.

We could imagine both scenarios where these assumptions are false. When they are, they should be dealt with by focusing on that person’s needs and asking whether the primary issues are related to restoring the person to normally expected developmental functioning (CTSS) or whether the person is struggling to achieve independence and self-reliance in the broader world despite their mental health disorder (ARMHS).

Adult foster care (AFC) is considered someone’s residence or home. If your organization has no relationship to the AFCs in which you want to provide ARMHS services, then you may do so. However, if your organization owns the foster care facilities that you are going into, you need to have a separate administration set up to provide ARMHS services. You can find additional guidance in Minnesota Statutes 256B.0623 Subd. 13 Clause 11.

No. TCM is coordinating, linking, or monitoring—that is, “brokering” style activities according to federal definition. ARMHS is providing direct treatment service. One person could do both, but must maintain separate billing practices.

Send a request to dhs.mhrehab-adult@state.mn.us and you will receive a secure email to utilize.

Yes. The size limit is 20MB.

Notify the ARMHS Consultant, at dhs.mhrehab-adult@state.mn.us, that you will be mailing your documentation instead. Mail a jump drive, with your electronic documents to:

Mental Health Division
Attn: ARMHS Consultant
PO Box 64981
St Paul, MN 55164-0981

Note: Paper copies are not accepted.