Empowering Mental Health in Minnesota: The Impact of Legislative Policy on IRTS and ACT Services

Mar 12, 2024

Today’s mental health care movement began in the 1970s when states began closing institutions housing, often notoriously, people living with mental illness. What has followed, largely thanks to the voices and advocacy of individuals and organizations, is the iterative creation of a mental health care ecosystem of community-based service providers, traditional health care institutions, policies, funding, and countless levers to pull in service to people with mental illness. 

The Minnesota Legislature, like all state legislatures, has the responsibility and authority to enact laws, shape policies and rulemaking, and unlock funding to influence mental health care. With Minnesota currently ranking 28th in the nation when it comes to the prevalence of mental illness and rates of access to care, according to Mental Health America, it’s important to understand why the Legislature’s work matters to our work and what we can do to improve mental health care services and access.

Let’s look at five marquee mental health programs and how they’re connected to the work of the Minnesota Legislature:

Behavioral Health Home (BHH)

The term “behavioral health home” services refers to a model of care focused on integration of primary care, mental health services, and social services and supports for adults diagnosed with mental illness or children diagnosed with emotional disturbance. The behavioral health home (BHH) services model of care utilizes a multidisciplinary team to deliver person-centered services designed to support a person in coordinating care and services while reaching his or her health and wellness goals. Per legislative rule, to provide BHH services, an agency like Guild must be enrolled as a Minnesota Health Care Programs (MHCP) provider and must successfully complete the MHCP certification process, and we are required to and provide care management, care coordination, health and wellness, comprehensive transitional care, individual and family supports, and referrals to community supports. You can learn more about BHH from a Guild Registered Nurse and BHH Team Supervisor.

Intensive Residential Treatment Services (IRTS)

Intensive residential treatment services (IRTS) is a community-based, medically monitored level of care for an adult client to promote their recovery and to develop and achieve psychiatric stability, personal and emotional adjustment, self-sufficiency, and other skills that help them transition to a more independent setting. IRTS are provided by qualified mental health staff on-site 24 hours a day. IRTS are time-limited and directed to a targeted date of discharge with specific member outcomes. Like with BHH, IRTS providers must be enrolled with Minnesota Health Care Programs, and any IRTS site, of which Guild operates two – one in Savage and one in South St. Paul – must have a statement of need from the local mental health authority or an approved need determination by the Minnesota Department of Human Services commissioner. As a provider we are licensed through the Department of Human Services per Minnesota statute.

What’s happening RIGHT NOW: At the time of writing, the Minnesota Legislature is reviewing changes to the cost-based rate-setting calculation (House File #1683) for the IRTS program. These changes would enable Guild to cover anticipated staffing and capital costs, alleviate cash flow pressures, and mitigate ER pressures on hospitals due to psychiatric bed shortages just to name a few! You can help advocate for these changes by making your voice heard through our advocacy toolkit.

Assertive Community Treatment (ACT)

Assertive community treatment (ACT) means intensive nonresidential treatment and rehabilitative mental health services provided according to the assertive community treatment model. ACT provides a single, fixed point of responsibility for treatment, rehabilitation and support needs for clients. Services are offered 24 hours per day, seven days per week, in a community-based setting, and are provided as a team-based model. ACT programs are certified by the Minnesota Department of Human Services (DHS) and contract with a host county. For Guild those counties are Dakota and Ramsey, which determines eligibility for ACT services.

Youth Assertive Community Treatment (Youth ACT)

Youth Assertive Community Treatment (Youth ACT)/Intensive Rehabilitative Mental Health Services (IRMHS) is an intensive, comprehensive and nonresidential rehabilitative mental health service for youth between the ages of 8 and 21. Services are delivered using a multidisciplinary team approach and are available 24 hours a day, seven days per week. Youth ACT/IRMHS teams work intensively with youth with severe mental health or co-occurring mental health and substance use issues to assist them with remaining in their community while reducing the need for residential or inpatient placements. Teams also work with youth leaving these placements to ensure a smooth transition back to their home, family and community. Services are delivered in an age-appropriate and culturally sensitive manner designed to meet the specific needs of each client. Guild’s Youth ACT team consists of Licensed Mental Health Professionals, a Psychiatrist, Peer Recovery Specialist, Nurse, Licensed Alcohol and Drug Counselor, and an Education Specialist. 

What’s happening RIGHT NOW: At the time of writing, the Minnesota Legislature is reviewing changes under Senate File #3552 and House File #3865 that would align requirements with current staffing realities while maintaining care quality for all ACT programs and reduce barriers to services to cover more counties in the state while enhancing transparency DHS certification standards.You can help advocate for these changes by making your voice heard through our advocacy toolkit.

Targeted Care Management (TCM)

Adult mental health targeted case management (AMH-TCM) are services provided to individuals on medical assistance (MA) with a serious and persistent mental illness (SPMI). Mental health targeted case managers work with clients to assess and address the profound effects of housing instability, food insecurity, and other social determinants of health. Using a person-centered approach, licensed providers, like Guild Team Leads and Case Managers, assess, plan, refer, coordinate and assist the person in gaining access to physical and mental health care, affordable housing, employment or education, health insurance and other assistance programs, and more.


These programs are not just acronyms. They are lifelines for individuals battling mental illness and for organizations fostering crisis recovery and facilitating in-home community health.

The requirements laid out by the Minnesota Legislature in law, statute and rule are more than guidelines: they’re a beacon of hope for those in the throes of mental illness. From crisis recovery to community access, Minnesota’s mental health ecosystem is creating a supportive environment for recovery and wellbeing.