Officer-Involved Community-Based Care Coordination

Revised: March 19, 2025

· Overview

· Eligible Providers

· Eligible Members

· Covered Services

· Noncovered Services

· Billing

· Legal References

Overview

Officer-involved community-based care coordination is provided only by county human services agencies to address an individual’s mental health, chemical health, social, economic and housing needs, or any identified needs by connecting the individual to ongoing treatment, care coordination services, available public benefits and other available social supports.

Review the Officer-Involved Community-Based Care Coordination (OICC) webpage for more information about this service and the requirements for screening, staffing, reporting and documenting, and a list of counties providing OICC.

Eligible Providers

County human service agencies are eligible to enroll to provide and bill the officer-involved community-based care coordination services to Minnesota Health Care Programs (MHCP).

Counties must complete the Officer-Involved Care Coordination Assurance Statement (DHS-7340) (PDF) and email the completed form to communitybased-coordination.dhs@state.mn.us to enroll to provide OICC.

Refer to the How to become qualified to provide OICC services on the OICC webpage for more information, including staffing requirements.

Eligible Members

A member is eligible for officer-involved community-based care coordination services if all the following criteria are met:

· Is eligible for one of the following MHCP medical assistance programs: MA, NM, RM

· Has come into contact with law enforcement

· Has screened positive for benefiting from treatment for a mental illness or substance use disorder using the Officer-Involved Community-Based Care Coordination Screening Tool (DHS-7305) (PDF) or another screening tool submitted to communitybased-coordination.dhs@state.mn.us and approved by the commissioner

· Agrees to participate in officer-involved community-based care coordination services

· Is not considered an inmate of a public institution (refer to the following chart for examples)

OICC inmate of a public institution examples and eligibility

Eligible Person is not an inmate of a public institution	Not eligible Person is an inmate of a public institution
· Person is released to the community awaiting trial; · Person is on probation or parole; · Person is released to a halfway house and is at liberty to leave the halfway house to shop or work in the community without facility supervision.	· Person is under arrest and is being held at local jail for processing; · Person is in jail or prison; · Person has been released from jail or prison to a halfway house and the person is not free to leave the halfway house without facility supervision.

Covered Services

MHCP covers officer-involved community-based care coordination performed by a county employee or county subcontractor. This includes working with other providers to connect eligible members with existing MHCP-covered services, community-based services and other resources available to them.

Examples of covered services include, but are not limited to:

· Planning

· Development of an individual support plan with the member receiving services.

· Revising or updating the individual support plan with the member receiving services.

· Assisting the member with referrals to mental health, chemical health, social, economic assistance and housing.

· Following up with the member receiving services regarding referrals.

· Coordination with service or community providers

· Facilitating the flow of information about the member’s needs and goals with all relevant service or community providers (example: sending plan or relevant records)

· Following up with provider regarding referral

· Transition planning and related activities that include working with the member and his or her identified supports to ensure that necessary supports and services are in place during a transition.

Limitations

· Members may only receive up to 80 hours of services in a 60-day period once per calendar year.

· The 60-day period begins the first day service is provided.

Review the Service requirements and limitations on the OICC webpage for more information.

Noncovered Services

The initial screening of the individual to identify a need for services based on a mental illness or substance use disorder is not covered under officer-involved community-based care coordination.

Duplicative Services

Payment for duplicative services is prohibited. The member must choose which service best meets the member’s needs.

The following services are considered duplicative of officer-involved community-based care coordination services:

· Adult mental health targeted case management (AMH-TCM)

· Children’s mental health targeted case management (CMH-TCM)

· Relocation service coordination targeted case management (RSC-TCM)

· Vulnerable adult/developmental disability targeted case management (VA/DD-TCM)

· Health Care Homes (HCH) care coordination

· Behavioral health home (BHH) services

· Integrated Health Partnership (IHP) demonstration project

· Residential treatment services

· Intensive residential treatment services (IRTS)

· Institution for Mental Disease (IMD)

Billing

Only eligible county human services agencies who meet the requirements under Eligible Providers may bill MHCP for Officer-involved community-based care coordination. Refer to the Billing Policy Overview section of the MHCP Provider Manual for more information about MHCP billing guidelines.

Submit claims online using MN–ITS 837P Professional claim:

· Report the County Human Services Agency UMPI as the billing and treating provider

· Use a diagnosis code determined by a qualified licensed professional, or under the supervision of a qualified licensed professional

· Use procedure code T1016 with modifier HX

· Services are billable in 15-minute unit increments

· Bill usual and customary charge

Managed Care Organization (MCO) Members

OICC services are “carved out” of MCO coverage and are covered through MHCP fee-for-service.

Legal References

Code of Federal Regulations, title 42, section 435.1010, Definitions relating to institutional status
Minnesota Statutes, 256B.056, Eligibility requirements for medical assistance
Minnesota Statutes, 256B, subdivision 56a, Officer-involved community-based care coordination
Minnesota Statutes, 245.462, subdivision 17, Mental Health Practitioner
Minnesota Statutes, 256B.0615, Certified Peer Specialist
Minnesota Statutes, 245.462, subdivision 18, clauses (1) to (6), Licensed Mental Health Professional