Sponsor: Social Services
Title
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Proposed Changes and Additions to Social Services Fees
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Recommendation
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Approve proposed changes to rates for Mental Health services and additions of a fee schedule for Guardianship services.
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Background and Rationale
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Ramsey County Social Services provides services related to Mental Health and Guardianship. The proposed fee changes and additions reflect the cost of services and allow the county to obtain reimbursement for services provided and control unexpected costs from court-ordered fees.
Mental Health has an established client fee schedule. The Minnesota Department of Human Services (DHS) has implemented legislative changes affecting reimbursement for Substance Use Disorder (SUD) treatment services. These changes, effective August 1, 2026, establish new billing requirements, procedure codes, and reimbursement rates for counties and providers delivering outpatient SUD services.
To ensure compliance with these new state requirements, the Social Services Department is updating the Mental Health client fee schedule to incorporate the required SUD treatment procedure codes and rates established by the Minnesota Department of Human Services. The updated fee schedule adds outpatient Substance Use Disorder treatment services, including individual counseling, group counseling, and individual psychoeducation, using the appropriate Healthcare Common Procedure Coding System (HCPCS) procedure codes and reimbursement rates required under state guidance.
Updating the fee schedule will ensure Ramsey County remains compliant with state and federal billing requirements, accurately reflects currently authorized services, and supports consistent billing practices for Substance Use Disorder treatment services provided to county residents. The proposed rates align with the reimbursement methodology established by the Minnesota Department of Human Services and will replace the previous billing structure for these services effective August 1, 2026.
Most guardianship cases eligible for county funding are handled through the county’s committee and contracted guardianship agencies. These cases have a contracted rate of payment for services and are funded through the Ramsey County Social Services budget. The Social Services Department is establishing a fee schedule for professional guardians, conservator and legal services to control court-ordered costs. Minnesota Statutes, section 524.5-502 allows courts to order guardianship, conservatorship and related legal fees be paid by the County of Financial Responsibility if the individual subject to guardianship/conservatorship is “indigent” (i.e., does not have sufficient assets to pay for the legal and guardian or conservatorship services and is eligible for a court fee waiver). While determining the appropriate fees to order, the court must consider a fee schedule set by the county. The guardianship fees are set at an appropriate level to ensure that Ramsey County is competitive with nearby counties.
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County Goals (Check those advanced by Action)
☒ Well-being ☐ Prosperity ☐ Opportunity ☐ Accountability
Racial Equity Impact
Approximately 60% of clients served by the Mental Health Division and approximately 32% of the clients served through Ramsey County Guardianship services are from racially and ethnically diverse communities. In addition, approximately 40% of clients receiving clinical services are uninsured and self-pay, with fees determined using Ramsey County's sliding fee scale based on an individual's ability to pay.
The proposed fee schedule updates do not change eligibility for services, access to care, or the county's sliding fee discount program. These administrative updates ensure services are billed accurately and consistently under current state requirements while continuing to support equitable access to behavioral health services for all residents, regardless of insurance status or ability to pay. Establishing a fee schedule for guardianship services may reduce uncontrolled cost variability and help preserve county resources to maintain services for residents with the greatest needs.
Community Participation Level and Impact
The proposed fee changes reflect the Social Service Department’s commitment to provide services that meet client needs, to treat clients fairly and accurately charge for the services provided to the community. Social Services is informing the community through this request of the rate updates.
☒ Inform ☐ Consult ☐ Involve ☐ Collaborate ☐ Empower
Fiscal Impact
The proposed fee schedule updates for Mental Health incorporate new procedure codes and reimbursement rates established by the Minnesota Department of Human Services for outpatient Substance Use Disorder treatment services effective August 1, 2026. Approval of the updated fee schedule will allow Ramsey County to bill for these services in accordance with current state requirements and maintain compliance with applicable billing regulations.
The fiscal impact is expected to be minimal, as the updates primarily reflect changes in state-established billing codes and reimbursement methodology rather than an expansion of services. Implementing the revised fee schedule will support accurate reimbursement for eligible services and help ensure continued revenue recovery for outpatient Substance Use Disorder treatment services provided by the Mental Health Center.
A market analysis was conducted on rates for professional guardianship services. The rates are aligned with other counties in the metro area. Establishing the fee schedule to control court-ordered fees for guardianship services will allow the county to serve an anticipated increase in guardianship clients annually while remaining within the Social Services budget.
Last Previous Action
On August 8, 2023, the Ramsey County Board of Commissioners approved the updated fee schedule (Resolution B2023-128).
Attachments
1. SSD Fee Schedule