In the State of Minnesota, chemical dependency treatment is funded for state residences who don’t have insurance coverage and have significant income limitations (see eligibility descriptions below). This fund is called the Consolidated Chemical Dependency Treatment Fund (CCDTF). In Douglas County, eligibility for the fund, coordination of access to treatment, and funding for treatment are handled by Douglas County Social Services, a resident’s tribal social services agency, or the managed care plan (for persons who have that coverage – all Minnesota Care plans are managed care plans and residents may have selected a managed care organization to handle their Medical Assistance/MA).
Access to CCDTF and CD Treatment Services:
The county or tribal agency determines the recipient’s need for treatment by conducting a Rule 25 chemical use assessment and will also determine whether the recipient is eligible to have their treatment paid for using public funds.
- Recipients who are on MA or MinnesotaCare and receiving services through a Managed Care Organization (MCO) should contact their MCO for a Rule 25 assessment. The MCO will instruct them how to access this assessment and the appropriate treatment services.
- Recipients who are on MA or MinnesotaCare and who are not receiving their services through an MCO should contact the Rule 25 assessment number at their county or tribe of residence. The county or tribal worker completes an assessment (called a Rule 25 assessment), determines eligibility for services, coordinates access to services, and coordinates funding (via the CCDTF) for these services.
Eligibility for the CCDTF is based on two criteria: clinical and financial eligibility. If a recipient is determined to have both a clinical need for treatment and is financially eligible for the CCDTF, then the CCDTF can pay for their CD treatment services. The Consolidated Chemical Dependence Treatment Fund (CCDTF) is the only fee-for-service payment mechanism for CD treatment services in Minnesota. Medical Assistance (MA) and MinnesotaCare (MNCare) recipients not receiving their services through a Managed Care Organization (MCO) must receive funding for their services through the CCDTF. Individuals not on public health care can also receive services through the CCDTF if they meet CCDTF income and household size guidelines.
Clinical eligibility is based on the results of a Rule 25 chemical use assessment.
This is a face-to-face interview conducted by a qualified assessor. The assessor gathers information using the Rule 25 Assessment Tool and Minnesota Matrix to determine clinical eligibility. Recipients who score a severity rating of 2, 3, or 4 in Dimensions IV, V, or VI meet clinical eligibility for treatment.
A Rule 25 assessment using the Rule 25 Assessment Tool and Minnesota Matrix is required for any individual seeking public payment for CD treatment services.
Financial eligibility has two parts:
- If an individual has private, commercial insurance that covers 100% of the type and length of treatment they need, then they are not eligible for the CCDTF. If the recipient has less than 100% coverage, i.e. a copay, a deductible, or an 80/20 policy, then the recipient may be eligible.
- The second part of financial eligibility is whether the individual meets the CCDTF financial eligibility guidelines. The CCDTF financial eligibility guidelines are 100% of the Federal Poverty Guidelines (FPG) based on the CCDTF definitions of household size and income. The DHS Bulletin #09-51-01 DHS Updates CCDTF Operations, Eligibility for State Fiscal Year 2010 includes the current financial eligibility guidelines, along with CCDTF definitions of household size and income.
Chemical Dependency Definitions:
Assessor: A person qualified to perform a chemical use assessment, who has a relationship with a placing authority for conducting chemical use assessments.
Chemical Use Assessment/Rule 25 Assessment: An assessment interview and written listing of the recipient’s specific problems related to chemical use and risk description that will enable the assessor to determine an appropriate treatment planning decision according to the Minnesota Matrix.
MCO or “Managed Care Organization” also referred to by the MCO plan’s description PPHP or “Prepaid Health Plan”: An organization that contracts with MHCP to provide medical services, including CD treatment services, to recipients in exchange for a prepaid capitation rate and uses authorized funds.
Placing Authority: An authorized county, prepaid health plan, or tribal governing board.
Rule 24: The Consolidated Chemical Dependency Treatment Fund rules. This rule regulates county and provider responsibilities as well as client eligibility.
Rule 25: Establishes criteria for the appropriate level of chemical dependency care for MHCP recipients.