December 6, 2019

Minnesota Proposes PTSD Treatment Guidelines

The Minnesota Department of Labor and Industry’s Workers’ Compensation Division recently proposed rules to establish criteria for the treatment of post-traumatic stress disorder (PTSD) for first responders.

Legislation across the country continues to expand workers’ comp coverage for PTSD to first responders, but these proposed rules are perhaps the first to dictate how workers’ comp professionals must manage the care of PTSD for first responders, providing a great level of detail.

The rules state that a PTSD diagnosis must be made by a licensed psychologist or psychiatrist according to the most recently published edition of the Diagnostics and Statistical Manual (DSM) of Mental Disorders by the American Psychiatric Association.

Furthermore, a mental healthcare provider must complete an initial evaluation that includes a determination of:

  • The patient’s functional status
  • The patient’s relevant family history
  • The patient’s history of mental health conditions and treatment
  • If the patient will harm themselves or others, and/or requires hospitalization
  • Whether the patient has any comorbid physical or psychiatric disorders

Regarding treatment planning, the guideline establishes that prior to providing psychotherapy, providers must engage and collaborate with the patient to create a plan for treatment that:

  • Specifies treatment modalities
  • Determines if telemedicine will be utilized
  • Assesses a patient’s current level of symptoms and functional status
  • Develops goals based on symptoms status, which adhere to a timetable within the prescribed number of psychotherapy sessions
  • Addresses the patient’s plan to return to work, including any necessary restrictions

The guideline also details which trauma-focused psychotherapies are indicated for the treatment of PTSD, listing several acceptable therapies, while also accepting any other treatment modality recommended by the treating mental health provider which is an evidence-based, trauma-focused psychotherapy that meets key legislative requirements

Additionally, the guidelines dictate which medications are indicated for the treatment of PTSD, and they also establish a 16-week duration of psychotherapy treatment, at which point a patient is reevaluated. This reevaluation determines if additional therapy is required, though exceptions to the 16-week duration are also listed. And finally, the guideline also covers documentation requirements, requirements for providers notifying payers, and much more.

Public commentary on these proposed rules was gathered through December 12th, and updated rules may available in the near future.

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