Children's mental health: policies and procedures

See service rates information for current Medical Assistance rates for mental health services.

Behavioral health home services provide a team approach that assists people with navigating and coordinating across primary care, mental health, substance use disorder treatment, long-term services and supports, and social services.

Case management services help children and youth with severe mental illness and their families get the help they need. Case managers assess a child's needs and help connect the child and family to appropriate community resources, such as mental, educational, health, vocational, recreational, social, and other necessary services.

Certified Community Behavioral Health Clinics (CCBHC) are community clinics that offer mental health and substance use disorder services as well as a range of other services. A CCBHC provides outreach, increases access, improves services, and serves as a “one-stop-shop” within a defined service area.

Children’s Therapeutic Services and Supports (CTSS) is a rehabilitative mental health package covered by Minnesota Health Care Programs (MHCP). CTSS establishes policies and practices for certification and coverage of mental health services for children who require varying therapeutic and rehabilitative levels of intervention.

In addition to community services, CTSS is also available as a flexible package of mental health services for students who require varying therapeutic and rehabilitative levels of intervention. These services are time-limited interventions to reach treatment outcomes identified in the Individualized Education Plan (IEP).

Minnesota’s collaborative psychiatric consultation service for certain psychotropic medications for children is available to primary care providers, pediatricians, family practice physicians, psychiatrists and other practitioners.

There are currently 90 Collaboratives serving communities across Minnesota. Children’s Mental Health and Family Services Collaboratives promote promising prevention and early intervention strategies through an expansive public health approach encompassing all developmental dimensions of well-being.

Access short-term crisis intervention help for children with Mobile Crisis Mental Health Services.

DC:0-5 is an age-appropriate diagnostic assessment for young children. This tool classifies mental health and developmental disorders in children from birth through five years old considered in relationship to their families, culture and communities.

A mental health professional conducts a diagnostic assessment to determine whether a child or youth has a mental health disorder. The mental health professional interviews the child and/or family to gather information about the child’s life situation.

An early childhood mental health system of care provides mental health services to young children, ages birth to five, with a focus on uninsured and underinsured families. DHS awards grants to many communities to create comprehensive mental health systems and services to meet the needs of young children and their families.

When a person experiences first episode psychosis, it is important someone receive the right care as soon as possible. Psychosis can be treated, and early treatment increases the chance of a successful recovery.

Intensive Rehabilitative Mental Health Services (IRMHS) are nonresidential services for youth ages 16 through 20 with a serious mental illness or both a mental illness and substance abuse disorder. A multidisciplinary team provides a variety of services, including coordinating education/employment, health and housing services.

Intensive Treatment in Foster Care (ITFC) is a set of clinical mental health services to meet the needs of children ages 0 to 21 living in a family foster care setting and suffering from mental illness and functional impairments, who need intensive treatment services and coordination surrounding their out-of-home placement.

The Division of Licensing enforces standards adopted to protect the health, safety, rights and well-being of children and vulnerable adults in mental health programs required to be licensed under Minnesota Statutes, Chapter 245A and Minnesota Statutes, Chapter 245B (for programs serving people with developmental disabilities).

The goal of the partial hospitalization program is to resolve or stabilize an acute episode of mental illness. Partial hospitalization is a time-limited, structured program of multiple and intensive psychotherapy and other therapeutic services provided by a multidisciplinary team.

Psychiatric Residential Treatment Facilities (PRTF) provide inpatient treatment, such as therapeutic services and discharge planning to children and youth under age 21 with complex mental health conditions in a residential facility rather than a hospital.

Respite care services support children with emotional or behavioral disturbance to stay with the child's family or long-term primary caretaker. This type of support can also be used on an emergency or crisis basis. Respite care services provide temporary care for children with serious mental health needs who live at home.

School-linked behavioral health services connect or co-locate effective behavioral health services with schools and students at the local level. This project has proven particularly effective in reaching children who have never accessed behavioral health services.

Minnesota schools can now use Medical Assistance (MA) funding for mental health services provided to students with disabilities who are enrolled in MA, specifically school social work services and supports. This will build the capacity of schools to provide more and better mental health services to students. Learn more on the mental health services in special education webpage.

Screening for social, emotional and developmental concerns is essential to early identification of mental health problems in children and youth. It is the first step to discovering when a child may need further diagnosis and treatment.

Trauma-informed care (TF-CBT) addresses the needs of children and youth with Post Traumatic Stress Disorder (PTSD) or other significant behavioral problems related to traumatic life experiences. This evidence-based approach helps children and youth to process trauma and manage their distressing feelings and behaviors.

The Minnesota Comprehensive Children’s Mental Health Act establishes basic standards for children’s mental health services in Minnesota. It is primarily directed at counties, which are designated as local mental health authorities.

• 245.487 Policy and mission citation
• 245.4871 Definitions
• 245.4873 Coordination of children’s mental health system
• 245.4874 Duties of county board
• 245.4875 Local service delivery system
• 245.4876 Quality of services
• 245.4877 Education and prevention services
• 245.4878 Mental health identification and intervention
• 245.4879 Emergency services
• 245.488 Outpatient services
• 245.4881 Case management and family community support services
• 245.4882 Residential treatment services
• 245.4883 Acute care hospital inpatient services
• 245.4884 Family community support services
• 245.4885 Screening for inpatient and residential treatment
• 245.4887 Appeals
• 245.4889 Children’s mental health grants

Children’s Therapeutic Services and Supports establishes policies and practices for certification and coverage of mental health services for children who require varying therapeutic and rehabilitative levels of intervention.

Children’s Mental Health Crisis Response Services establishes policies and practices for certification and coverage of crisis response services for children with mental health emergencies.

Services for Children with Severe Emotional Disturbance establishes conditions for counties’ responsibility for the provision and payment for residential services for children with severe emotional disturbance.

Other statutes related to children’s mental health services can be found under “mental health services” in the Minnesota Statutes Index.

Rule 9520 (commonly known as Rule 29) establishes standards for treatment, staffing, and quality assurance standards for community mental health centers and clinics in Minnesota. Compliance with this rule is required for certain categories of Medical Assistance payments and certain types of private insurance reimbursement.

Rule 9505 (commonly known as Rule 47) is the state rule that governs Minnesota health care programs reimbursement for client and provider eligibility criteria, the client application process, county determination procedures, third party liability, assignment of rights to medical support, reimbursement for outpatient services, and service standards.

Rule 9520 (commonly known as Rule 79) establishes standards and procedures for mental health case management services in Minnesota for children with severe emotional disturbance. These standards apply to case managers who are employed by the county or under contract with a county.

Rule 2960 (“Umbrella Rule” - Licensure and Certification of Certain Programs for Children) establishes certification standards for children’s mental health residential facilities in Minnesota. Compliance with this rule is required for facilities that provide residential mental health treatment for children with severe emotional disturbance.

Center for Mental Health Services (CMHS)
Leads federal efforts to promote the prevention and treatment of mental disorders on behalf of adults who have serious mental illness and children with emotional disorders

MentalHealth.gov
Provides one-stop access to U.S. government mental health and mental health problems information and aims to educate and guide the general public and others

National Institute of Mental Health (NIMH)
Transforms the understanding and treatment of mental illnesses through basic and clinical research, paving the way for prevention, recovery and cure

Substance Abuse and Mental Health Services Administration (SAMHSA)
Leads public health efforts to advance the behavioral health of the nation with a mission to reduce the impact of substance abuse and mental illness on America’s communities

Autism Spectrum Disorders (ASD)
Provides information about possible signs, evaluation, treatment, and resources for families of children with autism spectrum disorder and related conditions

Children and Youth with Special Health Needs (CYSHN)
Works to improve population health through building the capacity of all systems that serve families of children and youth with special health needs

Children’s Mental Health and Family Services Collaboratives
Information, including directory, map and reports, about community partnerships working together to coordinate efforts to address the needs of children with complex problems

County Web Sites
Links to county web sites with contact, resources and services information

Help Me Grow
Provides resources for families about the development of young children for parents and professionals which include information on developmental milestones, videos, caregiver strategies to support development, screening and evaluation, and how to talk about developmental concerns

Local Mental Health Advisory Councils
Information about county local mental health advisory councils designed to involve consumers, families, providers, and public policy makers in improving local mental health services

Minnesota Association of Community Mental Health Programs (MACMHP)
Information about resources, training and networking for community-based mental health providers

Minnesota Tribal and County Health Care Directory
Information for contacting counties or tribes with questions about Minnesota Health Care Programs

Office of Ombudsman for Mental Health and Developmental Disabilities (OMHDD)
Promotes the highest attainable standards of treatment, competence, efficiency, and justice for persons receiving services for mental illness, developmental disabilities, chemical dependency, or emotional disturbance in children by receiving and investigating complaints against government agencies and/or officials

Special Education Programs
Provides resources to guide parents and educators through specialized instruction process for students with disabilities

Subcommittee on Children’s Mental Health
Provides information to the State Advisory Council on policies, laws, regulations, and services relating to children’s mental health

Tribal Web Sites
Links to web sites with contact, resources and services information for tribal communities

AspireMN
Promotes leadership, advocacy and quality standards in the delivery of an array of services for troubled children and their families

Autism Society of Minnesota (AuSM)
Committed to education, advocacy and support designed to enhance the lives of those affected by autism from birth through retirement

Minnesota Association for Children’s Mental Health (MACMH)
Promotes positive mental health for all infants, children, adolescents and their families

Minnesota Disability Law Center (MDLC)
Provides free civil legal assistance to Minnesotans with disabilities on legal issues related to their disabilities

NAMI Minnesota (National Alliance on Mental Illness)
Dedicated to improving the lives of children and adults with mental illnesses and their families through education, support and advocacy

PACER (Parent Advocacy Coalition for Educational Rights) Center
Serves as parenting training and information center for families of children and youth with all disabilities from birth through 21 years old

SAVE (Suicide Awareness Voices of Education)
Prevents suicide through public awareness and education, reduces stigma and serves as resource to those touched by suicide

American Academy of Pediatrics (AAP)
Committed to the optimal physical, mental and social health and well-being for all infants, children, adolescents, and young adults, including a focus on role of primary care clinicians in managing mental health concerns

Bazelon Center for Mental Health Law
Protects and advances the rights of adults and children with mental disabilities

Child Mind Institute
Dedicated to finding more effective treatments for childhood psychiatric and learning disorders, building the science of healthy brain development and empowering children and their families

NAMI (National Alliance on Mental Illness)
Dedicated to building better lives for Americans affected by mental illness by advocating for access to services, treatment, supports and research, raising awareness and building a community of hope

National Federation of Families for Children’s Mental Health (NFFCMH)
Provides advocacy at the national level for the rights of children and youth with emotional, behavioral and mental health challenges and their families, provides leadership and technical assistance to nationwide network of family run organizations and collaborates with other organizations to transform mental health care

National Technical Assistance Center for Children’s Mental Health (TA Center)
Dedicated to improving, sustaining and expanding systems of care and the services and supports they provide to improve the lives of children and youth with or at risk for mental health challenges and their families

Youth MOVE National
Devoted to improving services and systems that support positive growth and development by uniting the voices and causes of youth, raising awareness around youth issues and advocating for youth rights and voice in mental health and other systems that serve them

• Health Occupations Program, Minnesota Department of Health
• Minnesota Board of Behavioral Health and Therapy
• Minnesota Board of Marriage and Family Therapy
• Minnesota Board of Nursing
• Minnesota Board of Psychology
• Minnesota Board of Social Work
• Minnesota Credentialing Collaborative
• Minnesota Medical Association
• Minnesota Psychiatric Society

To clarify requirements to CTSS Community and Schools certified providers, the Behavioral Health Division prepared the following guidance regarding mental health diagnostic assessments.

• Regardless of the Individualized Educational Plan or Individualized Family Service Plan status, CTSS providers can offer mental health services to students who meet medical necessity for CTSS services.
• As long as all the components required in a standard diagnostic assessment (diagnostic formulation, medical necessity, functional assessments, etc.) are completed and documented, a special education evaluation, an Individualized Educational Plan or an Individualized Family Service Plan signed by an independent mental health professional, can be used to start CTSS services for children.
• When completed by a team led by a credentialed mental health professional, a special education evaluation or Individualized Education Program or Individualized Family Service Plan, completed according to Minnesota Rules, parts 3525.2710 or 3525.2810 or 3525.1350 or 3525.1351 or Minnesota Statutes § 125A.32, can determine medical necessity as long as it also meets all the requirements for the diagnostic assessment under Minnesota Rules, part 9505.0372.
• Component Assessments, as found in the special education evaluation, Individualized Education Program or an Individualized Family Service Plan, can be used to meet applicable requirements in the Diagnostic Assessment (DA), if diagnostic formulation and other portions related to medical necessity are completed and signed by an independent mental health professional.

Additional questions can be directed to dhs.ctss@state.mn.us.

To clarify requirements to CTSS Day Treatment providers, the Behavioral Health Division has prepared the following guidance.

Program availability

CTSS Day Treatment programs must be available:

• No less than one day per week, and no less than two hours per day
• No more than three hours per day, and no more than 15 hours per week.
• No more than described in the recipient’s Individual Treatment Plan.

Per available day, psychotherapy must be provided:

• No less than one hour
• No more than two hours.

Any remaining time should be devoted to skills training.

Also, it is not allowable for a provider to count one hour per day as maintenance or transition for quarantine and still consider this day treatment unless the child is transitioning into or out of the program.

Service hours

A full hour of service is considered if the service hour starts no more than eight minutes late or ends no more than eight minutes early. If transportation delays fall within this timeframe, a full hour of service is met.

Group size

The minimum size allowable for a group is two people. The provider must document in all group members’ notes that the group size was two due to the absence of the third (or more members) due to illness or other allowable reason.

On-site supervisors

It is allowable for an “on-site” qualified mental health professional to be virtually accessible as long as it is in compliance with the licensed professional’s licensing board requirement, is deemed appropriate based on the skill level of the supervisee (at the discretion of the supervisor) and the situation at hand, and is reflected in the supervision plan.

Staff requirements

Psychotherapy hour can be provided via telehealth on a limited basis and not part of a permanent plan with the therapist joining via telehealth and the skills worker on site for children ages 6 and up, as long as the professional is leading the session.

Also, skills training can be provided on days without psychotherapy if there is not a mental health professional available to provide therapy. In these instances, however, this service cannot be provided as day treatment because day treatment requires at least one hour of psychotherapy.

Additional questions can be directed to dhs.ctss@state.mn.us.