Senate Study Bill 3136 SENATE/HOUSE FILE BY (PROPOSED DEPARTMENT OF HUMAN SERVICES BILL) Passed Senate, Date Passed House, Date Vote: Ayes Nays Vote: Ayes Nays Approved A BILL FOR 1 An Act providing for implementation of an emergency mental health 2 crisis services system. 3 BE IT ENACTED BY THE GENERAL ASSEMBLY OF THE STATE OF IOWA: 4 TLSB 5362DP 82 5 jp/rj/24 PAG LIN 1 1 Section 1. NEW SECTION. 225C.19 EMERGENCY MENTAL HEALTH 1 2 CRISIS SERVICES SYSTEM. 1 3 1. For the purposes of this section: 1 4 a. "Emergency mental health crisis services provider" 1 5 means a provider accredited or approved by the department to 1 6 provide emergency mental health crisis services. 1 7 b. "Emergency mental health crisis services system" or 1 8 "services system" means a coordinated array of crisis services 1 9 for providing a response to assist an individual adult or 1 10 child who is experiencing a mental health crisis or who is in 1 11 a situation that is reasonably likely to cause the individual 1 12 to have a mental health crisis unless assistance is provided. 1 13 2. a. The division shall implement an emergency mental 1 14 health crisis services system in accordance with this section. 1 15 b. The purpose of the services system is to provide a 1 16 statewide array of time=limited intervention services to 1 17 reduce escalation of crisis situations, relieve the immediate 1 18 distress of individuals experiencing a crisis situation, 1 19 reduce the risk of individuals in a crisis situation doing 1 20 harm to themselves or others, and promote timely access to 1 21 appropriate services for those who require ongoing mental 1 22 health services. 1 23 c. The services system shall be available twenty=four 1 24 hours per day, seven days per week to any individual who is 1 25 determined by self or others to be in a crisis situation, 1 26 regardless of whether the individual has been diagnosed with a 1 27 mental illness or a co=occurring mental illness and substance 1 28 abuse disorder, and shall address all ages, income levels, and 1 29 health coverage statuses. 1 30 d. The goals of an intervention offered by a provider 1 31 under the services system shall include but are not limited to 1 32 symptom reduction, stabilization of the individual receiving 1 33 the intervention, and restoration of the individual to a 1 34 previous level of functioning. 1 35 e. The elements of the services system shall be specified 2 1 in administrative rules adopted by the commission. 2 2 3. The services system elements shall include but are not 2 3 limited to all of the following: 2 4 a. Standards for accrediting or approving emergency mental 2 5 health crisis services providers. Such providers may include 2 6 but are not limited to a community mental health center, a 2 7 provider approved in a waiver adopted by the commission to 2 8 provide services to a county in lieu of a community mental 2 9 health center, a unit of the department or other state agency, 2 10 a county, or any other public or private provider who meets 2 11 the accreditation or approval standards for an emergency 2 12 mental health crisis services provider. 2 13 b. Identification by the division of geographic regions, 2 14 service areas, or other means of distributing and organizing 2 15 the emergency mental health crisis services system to ensure 2 16 statewide availability of the services. 2 17 c. Coordination of emergency mental health crisis services 2 18 with other mental health, substance abuse, and co=occurring 2 19 mental illness and substance abuse services available through 2 20 the state and counties to serve both children and adults. 2 21 d. Identification of basic services to be provided through 2 22 each accredited or approved emergency mental health crisis 2 23 services provider which may include but are not limited to 2 24 face=to=face crisis intervention, stabilization, support, 2 25 counseling, preadmission screening for individuals who may 2 26 require psychiatric hospitalization, transportation, and 2 27 follow=up services. 2 28 e. Identification of operational requirements for 2 29 emergency mental health crisis services provider accreditation 2 30 or approval which may include providing a telephone hotline, 2 31 mobile crisis staff, collaboration protocols, follow=up with 2 32 community services, information systems, and competency=based 2 33 training. 2 34 4. The division shall initially implement the program 2 35 through a competitive block grant process. The implementation 3 1 shall be limited to the extent of the appropriations provided 3 2 for the program. 3 3 Sec. 2. EMERGENCY RULES. The mental health, mental 3 4 retardation, developmental disabilities, and brain injury 3 5 commission may adopt administrative rules under section 17A.4, 3 6 subsection 2, and section 17A.5, subsection 2, paragraph "b", 3 7 to implement the provisions of this Act and the rules shall 3 8 become effective immediately upon filing or on a later 3 9 effective date specified in the rules, unless the effective 3 10 date is delayed by the administrative rules review committee. 3 11 Any rules adopted in accordance with this section shall not 3 12 take effect before the rules are reviewed by the 3 13 administrative rules review committee. The delay authority 3 14 provided to the administrative rules review committee under 3 15 section 17A.4, subsection 6, and section 17A.8, subsection 9, 3 16 shall be applicable to a delay imposed under this section, 3 17 notwithstanding a provision in those sections making them 3 18 inapplicable to section 17A.5, subsection 2, paragraph "b". 3 19 Any rules adopted in accordance with the provisions of this 3 20 section shall also be published as a notice of intended action 3 21 as provided in section 17A.4. 3 22 EXPLANATION 3 23 This bill provides for establishment of an emergency mental 3 24 health crisis services system through the division of mental 3 25 health and disability services of the department of human 3 26 services. The purpose of the system is to provide a statewide 3 27 array of time=limited services to reduce escalation of mental 3 28 health crisis situations, relieve the immediate distress of 3 29 individuals experiencing a crisis situation, reduce the risk 3 30 of individuals in a crisis situation doing harm to themselves 3 31 or others, and promote timely access to appropriate services 3 32 for those who require ongoing mental health services. 3 33 The system's general requirements are outlined in new Code 3 34 section 225C.19, including definitions, purpose, statewide 3 35 availability, goals, required elements, and initial 4 1 implementation through competitive block grants. The mental 4 2 health, mental retardation, developmental disabilities, and 4 3 brain injury commission is authorized to adopt administrative 4 4 rules for the system using emergency provisions that forgo 4 5 public comment periods but maintain a final review by the 4 6 administrative rules review committee prior to adoption of the 4 7 rules. 4 8 LSB 5362DP 82 4 9 jp/rj/24.1