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