Minnesota’s recently enacted omnibus health and human services bill includes changes to mental health services in Minnesota that could have an impact on children, youth, and families involved in the child welfare system.
Children’s Mental Health Services to Adult Mental Health Services
“Mental illness” (“MI”) definition modified. Case management and community support services for adults with mental illness have been expanded to include adults who were eligible to receive children’s mental health (CMH) services as children with severe emotional disturbance (SED) and who are currently under age 21. For youth who remain in foster care until age 21, this could provide greater access (and potentially an easier transition) to Adult Mental Health (AMH) services once they turn age 18. This is especially true for those children and youth who have SED diagnoses that would not qualify them for AMH services without a written statement from a mental health professional stating their likelihood of relapsing without services.
Continuation of CMH case management services at client request. Foster youth over age 18 but under age 21 will now be able to request continuation of mental health services through the county, provided that the services are medically necessary. Previously, transition services were only available if the person was receiving special education services or if the continuation of services was in the best interest of the person.
CMH case management services must be offered post age 18 to children with SED. However, the service needs of the child must be able to be met within the children’s service system. Should case management services be discontinued, transition plans for children ages 17 to 21 are now required. These plans should include plans for health insurance, housing, education, employment, and treatment.
Taking into consideration these three changes, it would appear that a youth in foster care who turns 18 and who received case management services as a child with a SED diagnosis would be eligible for a continuation of case management services through the children’s mental health system, provided that the CMH system could meet that youth’s service needs. If the CMH system could not meet the youth’s needs, then a transition plan to AMH services would be developed and, according to the new MI definition, that youth would automatically be eligible for AMH services.
Mental Health Certified Family Peer Specialist Services
Medical assistance will now begin covering mental health certified family specialist services (pending federal approval) for individuals with emotional disturbance or severe emotional disturbance. Services will include:

  • provision of nonclinical, strengths-based family peer support counseling;
  • collaboration with others providing care to the family;
  • advocacy:
  • promotion of individual family culture;
  • linkage of parents to other parents in the community;
  • support and encouragement;
  • assistance with helping parents develop coping mechanisms and problem-solving skills;
  • promotion of resiliency and skills learned in other support services;
  • establishment and provision of peer-led parent support groups; and
  • parental education on community resources and MI in order to increase the child’s ability to function better within the home, school, and community.

One of the locations in which family peer support services may be located is treatment foster care, which has great implications for youth and families involved in the child welfare system.
Family peer specialists must go through a training and certification process (to be developed by the Department of Human Services). They must also be at least 21 years old and have a high school diploma or equivalent. Additionally, because they are “peer” specialists, they must have raised or are currently raising a child with MI, have had experience navigating the CMH system, and must “demonstrate leadership and advocacy skills and a strong dedication to family-driven and family-focused services.”
Other notable changes
Adult rehabilitative mental health services (ARMHS) now include parenting skills within the umbrella of services. This is important, considering that parents with MI are at greater risk of involvement in the child welfare system and termination of their parental rights than their peers without MI. (Our Fall 2013 CW360° will include an article on this topic.)
In-reach community-based service coordination through a hospital emergency room or inpatient psychiatric unit for children up to age 21 with SED is now covered by medical assistance. Coordination efforts include navigating and arranging for community-based services prior to discharge in order to reduce incidents of emergency room use or inpatient readmission.
Family psychoeducation services provided to a child up to age 21 with a diagnosed mental health condition are now covered by medical assistance.
Clinical care consultation for a child up to age 21 who is diagnosed with a complex mental health condition is now covered by medical assistance.
Tell us how you see these changes impacting your practice—leave a comment below!
Thanks to Kelly Pieper, MSW, LGSW for her insight!