Text: HF02519 Text: HF02521 Text: HF02500 - HF02599 Text: HF Index Bills and Amendments: General Index Bill History: General Index
PAG LIN 1 1 DIVISION I 1 2 COMMUNITY MENTAL HEALTH CENTERS 1 3 Section 1. Section 230A.1, Code 1997, is amended to read 1 4 as follows: 1 5 230A.1 ESTABLISHMENT AND SUPPORT OF COMMUNITY MENTAL 1 6 HEALTH CENTERS. 1 7 1. A county or affiliated counties, by action of the board 1 8 or boards of supervisors prior to July 1, 1996, with approval 1 9 of the administrator of the division of mental health and 1 10 developmental disabilities of the department of human 1 11 services, may establish a community mental health center under 1 12 this chapter to serve the county or counties.In establishing1 13the community mental health center, the board of supervisors1 14of each county involved may make a single nonrecurring1 15expenditure, in an amount determined by the board.This 1 16 section does not limit the authority of the board or boards of 1 17 supervisors of any county or group of counties to continue to 1 18 expend money to support operation of the center, and to form 1 19 agreements with the board of supervisors of any additional 1 20 county for that county to join in supporting and receiving 1 21 services from or through the center. 1 22 2. A person shall not use the term "community mental 1 23 health center" or "mental health center" to describe the 1 24 person or represent to the public that the person is a 1 25 community mental health center or mental health center, unless 1 26 the person is established as a community mental health center 1 27 under this section and is subject to the standards for 1 28 community mental health centers adopted by the mental health 1 29 and mental retardation commission. A person who falsely uses 1 30 a term or otherwise makes a representation to the public in 1 31 violation of this subsection commits a simple misdemeanor. 1 32 Each day of continued violation is a separate offense. In 1 33 addition, a person may be restrained by temporary or permanent 1 34 injunction from wrongful use of the term or from other 1 35 representations to the public in violation of this subsection. 2 1 Sec. 2. Section 230A.3, Code 1997, is amended to read as 2 2 follows: 2 3 230A.3 FORMS OF ORGANIZATION. 2 4 Each community mental health center established or 2 5 continued in operation as authorized by section 230A.1 shall 2 6 be organized and administered in accordance with one of the 2 7twothree alternative forms prescribed by this chapter. The 2 8twothree alternative forms are: 2 9 1. Direct establishment of the center by the county or 2 10 counties supporting it and administration of the center by an 2 11 elected board of trustees, pursuant to sections 230A.4 to 2 12 230A.11. 2 13 2. Establishment of the center by a nonprofit corporation 2 14 providing services to the county or counties on the basis of 2 15 an agreement with the board or boards of supervisors, pursuant 2 16 to sections 230A.12 and 230A.13. 2 17 3. Continued operation of a center originally established 2 18 under subsection 2 without an agreement with the board or 2 19 boards of supervisors which originally established the center, 2 20 provided the center is in compliance with the applicable 2 21 standards adopted by the mental health and mental retardation 2 22 commission. 2 23 Sec. 3. Section 230A.12, unnumbered paragraph 1, Code 2 24 1997, is amended to read as follows: 2 25 Each community mental health center established or 2 26 continued in operation pursuant to section 230A.3, subsection 2 27 2 or 3, shall be organized under the Iowa nonprofit 2 28 corporation Act appearing as chapter 504A, except that a 2 29 community mental health center organized under chapter 504 2 30 prior to July 1, 1974, shall not be required by this chapter 2 31 to adopt the Iowa nonprofit corporation Act if it is not 2 32 otherwise required to do so by law. The board of directors of 2 33 each such community mental health center shall enter into an 2 34 agreement with the county or affiliated counties which are to 2 35 be served by the center, which agreement shall include but 3 1 need not be limited to the period of time for which the 3 2 agreement is to be in force, what services the center is to 3 3 provide for residents of the county or counties to be served, 3 4 standards the center is to follow in determining whether and 3 5 to what extent persons seeking services from the center shall 3 6 be considered able to pay the cost of the services received, 3 7 and policies regarding availability of the center's services 3 8 to persons who are not residents of the county or counties 3 9 served by the center. The board of directors, in addition to 3 10 exercising the powers of the board of directors of a nonprofit 3 11 corporation may: 3 12 Sec. 4. Section 249A.4, Code Supplement 1997, is amended 3 13 by adding the following new subsection: 3 14 NEW SUBSECTION. 15. Establish appropriate cost-related 3 15 reimbursement amounts for community mental health centers and 3 16 other community mental health service providers that are 3 17 accredited by the mental health and developmental disabilities 3 18 commission. 3 19 DIVISION II 3 20 LEGAL SETTLEMENT 3 21 Sec. 5. Section 230.1, subsections 1 and 2, Code 1997, are 3 22 amended to read as follows: 3 23 1. By the county in which such person has a legal 3 24 settlement,or if the person is eighteen years of age or 3 25 older. 3 26 2. By the state when such person has no legal settlement 3 27 in this state,orwhensuchthe person's legal settlement is 3 28 unknown, or if the person is under eighteen years of age. 3 29 Sec. 6. Section 230.12, subsection 1, Code 1997, is 3 30 amended to read as follows: 3 31 1. If a dispute arises between different counties or 3 32 between the administrator and a county as to the legal 3 33 settlement of a person admitted or committed to a state 3 34 hospital for persons with mental illness or to a local 3 35 hospital or other community-based service, the attorney 4 1 general, at the request of the administrator, shall, without 4 2 the advancement of fees, cause an action to be brought in the 4 3 district court of any county where such dispute exists, to 4 4 determine the person's legal settlement. This action may be 4 5 brought at any time when it appears that the dispute cannot be 4 6 amicably settled. All counties which may be the place of the 4 7 legal settlement, so far as known, shall be made defendants 4 8 and the allegation of the settlement may be in the 4 9 alternative. The action shall be tried as in equity. 4 10 Sec. 7. Section 230.14, Code 1997, is amended to read as 4 11 follows: 4 12 230.14 LEGAL SETTLEMENT IN CASES INVOLVING NONRESIDENCE OR 4 13 UNKNOWN SETTLEMENT. 4 14 If an alternative dispute resolution of the dispute filed 4 15 under section 230.12, subsection 2, stipulates or the court 4 16 finds that the legal settlement of the person with mental 4 17 illness, at the time of admission or commitment, was in a 4 18 foreign state or country, or was unknown, an order shall be 4 19 entered that the person shall be maintained in the state 4 20 hospital for persons with mental illness or in a local 4 21 hospital or other community-based service at the expense of 4 22 the state. Insuchthis case the state shall refund to any 4 23 county, with interest, all legal costs and expenses arising 4 24 out of the legal settlement dispute and paid by a county. Any 4 25 stipulation filed or decision by the court shall be final. 4 26 Sec. 8. Section 252.16, subsection 8, Code Supplement 4 27 1997, is amended to read as follows: 4 28 8. A person receiving treatment or support services from 4 29 any provider, whether organized for pecuniary profit or not or 4 30 whether supported by charitable or public or private funds, 4 31 that provides treatment or services for mental retardation, 4 32 developmental disabilities, mental health, brain injury, or 4 33 substance abuse does not acquire legal settlement inthea 4 34 countyin which the site of the provider is locatedunless the 4 35 person continuously resides in that county for one year from 5 1 the date of the last treatment or support service received by 5 2 the person. 5 3 DIVISION III 5 4 SUPPORTED COMMUNITY LIVING SERVICES 5 5 Sec. 9. Section 135C.6, subsection 1, Code Supplement 5 6 1997, is amended to read as follows: 5 7 1. A person or governmental unit acting severally or 5 8 jointly with any other person or governmental unit shall not 5 9 establish or operate a health care facility in this state 5 10 without a license for the facility. A supported community,5 11supervised apartmentlivingarrangementservice, as defined in 5 12 section 225C.21, is not required to be licensed under this 5 13 chapter, but is subject to approval under section 225C.21 in 5 14 order to receive public funding. 5 15 Sec. 10. Section 225C.21, Code 1997, is amended to read as 5 16 follows: 5 17 225C.21COMMUNITY, SUPERVISED APARTMENTSUPPORTED 5 18 COMMUNITY LIVINGARRANGEMENTSSERVICES. 5 19 1. As used in this section, "supported community,5 20supervised apartmentlivingarrangementservices" meansthe5 21provision of a residenceservices provided in a 5 22 noninstitutional setting to adult persons with mental illness, 5 23 mental retardation, or developmental disabilitieswho are5 24capable of living semi-independently but require minimal5 25supervisionto meet the persons' daily living needs. 5 26 2. The department shall adopt rules pursuant to chapter 5 27 17A establishing minimum standards for the programming of 5 28 supported community, supervised apartmentlivingarrangements5 29 services. The department shall approve all supported 5 30 community, supervised apartmentlivingarrangementsservices 5 31 which meet the minimum standards. 5 32 3. Approved supported community, supervised apartment5 33 livingarrangementsservices may receive funding from the 5 34 state, federal and state social services block grant funds, 5 35 and other appropriate funding sources, consistent with state 6 1 legislation and federal regulations. The funding may be 6 2 provided on a per diem, per hour, or grant basis, as 6 3 appropriate. 6 4 Sec. 11. Section 235B.3, subsection 2, paragraph e, 6 5 subparagraph (6), Code 1997, is amended to read as follows: 6 6 (6) A member of the staff or an employee of a supported 6 7 community, supervised apartmentlivingarrangementservice, 6 8 sheltered workshop, or work activity center. 6 9 DIVISION IV 6 10 HOME AND COMMUNITY-BASED WAIVER SERVICES 6 11 Sec. 12. Section 135C.6, subsection 8, Code Supplement 6 12 1997, is amended to read as follows: 6 13 8. The following residential programs to which the 6 14 department of human services applies accreditation, 6 15 certification, or standards of review shall not be required to 6 16 be licensed as a health care facility under this chapter: 6 17 a. A residential program which provides care to not more 6 18 thanthreefour individuals and receives moneys appropriated 6 19 to the department of human services under provisions of a 6 20 federally approved home and community-based services waiver 6 21 for persons with mental retardation or other medical 6 22 assistance program under chapter 249A. 6 23b. A residential program which serves not more than four6 24individuals and is operating under provisions of a federally6 25approved home and community-based waiver for persons with6 26mental retardation, if all individuals residing in the program6 27receive on-site staff supervision during the entire time6 28period the individuals are present in the program's living6 29unit. The need for the on-site supervision shall be reflected6 30in each individual's program plan developed pursuant to the6 31department of human services' rules relating to case6 32management for persons with mental retardation.In approving 6 33 a residential program under this paragraph, the department of 6 34 human services shall consider the geographic location of the 6 35 program so as to avoid an overconcentration of such programs 7 1 in an area. 7 2c.b. A total of twenty residential care facilities for 7 3 persons with mental retardation which are licensed to serve no 7 4 more than five individuals may be authorized by the department 7 5 of human services to convert to operation as a residential 7 6 program under the provisions of a medical assistance home and 7 7 community-based services waiver for persons with mental 7 8 retardation. A converted residential program is subject to 7 9 the conditions stated in paragraph"b""a" except that the 7 10 program shall not serve more than five individuals. The 7 11 department of human services shall allocate conversion 7 12 authorizations to provide for four conversions in each of the 7 13 department's five service regions. If a conversion 7 14 authorization allocated to a region is not used for conversion 7 15 by January 1, 1998, the department of human services may 7 16 reallocate the unused conversion authorization to another 7 17 region. The department of human services shall study the cost 7 18 effectiveness of the conversions and provide an initial report 7 19 to the general assembly no later than January 2, 1998, and a 7 20 final report no later than December 15, 1998. 7 21 DIVISION V 7 22 MENTAL HEALTH AND DEVELOPMENTAL DISABILITIES 7 23 Sec. 13. Section 225C.6, subsection 1, Code 1997, is 7 24 amended to read as follows: 7 25 1. To the extent funding is available, the commission 7 26 shall perform the following duties: 7 27 a. Advise the administrator on the administration of the 7 28 overall stateplans fordisability services system. 7 29 b. Adopt necessary rules pursuant to chapter 17A which 7 30 relate to disability programs and services, including but not 7 31 limited to definitions of each disability included within the 7 32 term "disability services" as necessary for purposes of state, 7 33 county, and regional planning, programs, and services. 7 34 c. Adopt standards foraccreditation of community mental7 35health centers and comprehensive communitymental health 8 1 centers, services, and programs as recommended under section 8 2 230A.16. 8 3 d. Adopt standards for the care of and services to persons 8 4 with mental illness and mental retardation residing in county 8 5 care facilities recommended under section 227.4. 8 6 e.Adopt standards for the delivery of disability services8 7by the division, and for the maintenance and operation of8 8public or private facilities offering services to persons with8 9disabilities, which are not subject to licensure by the8 10department or the department of inspections and appeals, and8 11review the standards employed by the department or the8 12department of inspections and appeals for licensing facilities8 13which provide services toIf no other person sets standards 8 14 for a service available to persons with disabilities, adopt 8 15 standards for that service. 8 16 f. Assure that proper appeal procedures are available to 8 17 persons aggrieved by decisions, actions, or circumstances 8 18 relating to accreditation. 8 19 g.AwardAdopt necessary rules for awarding grants from 8 20 the state and federal government as well as other moneys that 8 21 become available to the division for grant purposes. 8 22h. Review and rank applications for federal mental health8 23grants prior to submission to the appropriate federal agency.8 24i.h. Annually submit to the governor and the general 8 25 assembly: 8 26 (1) A report concerning the activities of the commission. 8 27 (2) Recommendations formulated by the commission for 8 28 changes in law. 8 29j.i. By January 1 of each odd-numbered year, submit to 8 30 the governor and the general assembly an evaluation of: 8 31 (1) The extent to which services to persons with 8 32 disabilitiesstipulated in the state plansare actually 8 33 available to persons in each county in the state and the 8 34 quality of those services. 8 35 (2) Thecosteffectiveness of the services being provided 9 1 by disability service providers in this state and by each of 9 2 the state mental health institutes established under chapter 9 3 226 and by each of the state hospital-schools established 9 4 under chapter 222. 9 5(3) The cost effectiveness of programs carried out by9 6randomly selected providers receiving money from the state for9 7disability services.9 8k.j. Advise the administrator, the council on human 9 9 services, the governor, and the general assembly on budgets 9 10 and appropriations concerning disability services. 9 11l.k.ConsultCoordinate activities with the Iowa 9 12 governor's planning council for developmental disabilitiesat9 13least twice a year. 9 14m.l. Establish standards for the provision under medical 9 15 assistance of individual case management services. 9 16n. Establish standards for the structure of a service9 17coordination system which ensures a linkage between the9 18service coordination system and individual case management9 19services.9 20o.m. Identify model eligibility guidelines for disability 9 21 services. 9 22p. Identify model guidelines for purchase of disability9 23services and for disability service reimbursement9 24methodologies.9 25q. Prepare, for mental health and developmental9 26disabilities regional planning councils, advance estimates of9 27state and, to the extent possible, federal funds available to9 28counties for purchase of disability services.9 29r.n. Identify basic disability services for planning 9 30 purposes. 9 31s.o. Prepare five-year plans based upon the county 9 32 management plans developedby mental health and developmental9 33disabilities regional planning councilspursuant to section 9 34 331.439. 9 35t. Identify disability services which are eligible for10 1state payment under the mental health and developmental10 2disabilities community services fund created in section10 3225C.7.10 4 p. Work with other state agencies on coordinating, 10 5 collaborating, and communicating concerning activities 10 6 involving persons with disabilities. 10 7 Sec. 14. Section 331.439, subsection 8, Code Supplement 10 8 1997, is amended by striking the subsection. 10 9 Sec. 15. 1997 Iowa Acts, chapter 169, section 25, is 10 10 repealed. 10 11 Sec. 16. EFFECTIVE DATE – APPLICABILITY. Sections 14 and 10 12 15 of this Act, amending section 331.439 and repealing a 1997 10 13 Iowa Acts provision, being deemed of immediate importance, 10 14 take effect upon enactment. A county's compliance with any 10 15 amendment to the county's management plan submitted by the 10 16 county pursuant to 1997 Iowa Acts, chapter 169, sections 24 10 17 and 25, shall be at the county's option or as required under 10 18 other applicable law. 10 19 EXPLANATION 10 20 This bill relates to mental health, developmental 10 21 disability, and substance abuse service provisions involving 10 22 medical assistance reimbursement, legal settlement, and age- 10 23 related requirements of county management plans. 10 24 Division I relates to establishment and continuance of 10 25 community mental health centers and to reimbursement amounts 10 26 for the centers. 10 27 Code section 230A.1, relating to establishment and 10 28 continued support of community mental health centers, is 10 29 amended. The bill provides the action of a board or boards of 10 30 supervisors to establish a center must have been taken prior 10 31 to July 1, 1996. Language is stricken which allows the board 10 32 or boards to make a single nonrecurring expenditure in 10 33 establishing a center. 10 34 In addition, the bill prohibits any person from using the 10 35 term "community mental health center" or "mental health 11 1 center" to describe the person unless the person is 11 2 established as a community mental health center and is in 11 3 compliance with applicable standards. A violator commits a 11 4 simple misdemeanor and every day of continued violation is a 11 5 separate offense. In addition, a person may be restrained by 11 6 injunction. 11 7 Code section 230A.3, relating to forms of organization of 11 8 centers, is amended to add a third type of organization. The 11 9 third type would allow a center established as a not-for- 11 10 profit corporation under contract with a board or boards of 11 11 supervisors to continue without an agreement with the county 11 12 or counties which originally established the center provided 11 13 the center complies with applicable standards. 11 14 Code section 230A.12 is amended to make a conforming 11 15 reference to a provision of the bill. 11 16 Code section 249A.4, relating to the duties of the director 11 17 of human services concerning the medical assistance program, 11 18 is amended to require the director to establish appropriate 11 19 cost-related reimbursement amounts for community mental health 11 20 centers and other community mental health providers accredited 11 21 by the mental health and developmental disabilities 11 22 commission. 11 23 Division II relates to legal settlement and payment of 11 24 mental health and disabilities services costs by the state and 11 25 counties. 11 26 Code section 230.1 is amended to provide that liability for 11 27 the costs and expenses of a person with mental illness 11 28 admitted or committed to a state hospital are to be paid by 11 29 the county or state based upon the new criteria of the age of 11 30 the person. These expenses and costs are to be paid by the 11 31 county if the person has legal settlement in the county or if 11 32 the person is 18 years of age or older. These expenses and 11 33 costs are to be paid by the state if the person has no legal 11 34 settlement, legal settlement is unknown, or the person is 11 35 under 18 years of age. 12 1 Code section 252.16, relating to how legal settlement is 12 2 acquired, is amended to delete language referring to the site 12 3 of a service provider in a county. 12 4 Division III relates to mental health and developmental 12 5 disability services provisions involving supported community 12 6 living services. 12 7 The division changes the definition of "community 12 8 supervised apartment living arrangements" (CSALAs) to 12 9 "supported community living services". The change is 12 10 reflected in Code section 135C.6, relating to exemptions from 12 11 health care facility licensing, in Code section 225C.21, which 12 12 currently authorizes CSALAs, and in Code section 235B.3, 12 13 relating to dependent adult abuse reports. 12 14 Division IV amends provisions in the exemption from health 12 15 care facility licensing requirements for medical assistance 12 16 home and community-based waiver residential services for 12 17 persons with mental retardation. Separate exemption 12 18 categories for programs serving three individuals and for 12 19 programs serving four individuals are combined to authorize 12 20 services to up to four individuals. A conforming amendment is 12 21 applied to provisions involving residential care facilities 12 22 for persons with mental retardation serving five individuals 12 23 which convert to a residential program under the waiver. 12 24 Code sections 230.12 and 230.14 are amended to expand the 12 25 authority for the state to bring a court action for resolution 12 26 of a legal settlement dispute to include persons with mental 12 27 illness committed or admitted to a local hospital or other 12 28 community-based service. Current law limits this authority to 12 29 persons with mental illness committed or admitted to a state 12 30 hospital for persons with mental illness. 12 31 Division V amends and deletes various duties of the mental 12 32 health and developmental disabilities commission under Code 12 33 section 225C.6. 12 34 Division V also affects county management plans. 12 35 Code section 331.439, which relates to age-related 13 1 requirements for county management plans for mental health and 13 2 mental retardation services, is amended to strike subsection 13 3 8, which requires a county management plan to allow for the 13 4 service needs of all ages of persons for whom expenditures may 13 5 be made from the county's services fund. In addition, the 13 6 bill repeals the 1997 session law provision which directed 13 7 counties which did not comply with the "all ages" management 13 8 plan requirement to amend their management plan as necessary 13 9 for compliance. Finally, these provisions of the bill take 13 10 effect upon enactment and the bill provides that a county's 13 11 compliance with any management plan amendment submitted to 13 12 conform with the requirements of the 1997 law is voluntary for 13 13 the county unless required by another applicable law. 13 14 LSB 3622HV 77 13 15 jp/jw/5
Text: HF02519 Text: HF02521 Text: HF02500 - HF02599 Text: HF Index Bills and Amendments: General Index Bill History: General Index
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