Text: HCR00112 Text: HCR00114 Text: HCR00100 - HCR00199 Text: HCR Index Bills and Amendments: General Index Bill History: General Index
PAG LIN 1 1 HOUSE CONCURRENT RESOLUTION NO. ____ 1 2 BY COMMITTEE ON LOCAL GOVERNMENT 1 3 (SUCCESSOR TO HSB 718) 1 4 A House Concurrent Resolution requesting that the 1 5 Legislative Council create a legislative mental 1 6 health and developmental disability services 1 7 restructuring task force. 1 8 WHEREAS, there is strong interest among those 1 9 involved with the mental health and developmental 1 10 disabilities service system in addressing a new phase 1 11 in the reform of the system; and 1 12 WHEREAS, initial study by counties, the Lieutenant 1 13 Governor, department of human services, and many 1 14 advocacy groups suggests that the approaches outlined 1 15 in this resolution are worthy of further study; NOW 1 16 THEREFORE, 1 17 BE IT RESOLVED BY THE HOUSE OF REPRESENTATIVES, THE 1 18 SENATE CONCURRING, That the Legislative Council is 1 19 requested to create a legislative mental health and 1 20 developmental disability (MH/DD) services 1 21 restructuring task force and to appoint a study 1 22 committee of legislators to receive and review task 1 23 force reports and to make recommendations for 1 24 legislative action. 1 25 1. The legislative study committee members should 1 26 be authorized to attend meetings of the task force as 1 27 needed. 1 28 2. If created, it is intended that the task force 1 29 will be appointed and commence deliberations as soon 1 30 as is practicable, provide a progress report to the 2 1 governor and general assembly for the 2001 legislative 2 2 session, and a final report for the 2002 legislative 2 3 session. The task force should be authorized to 2 4 create committees to address topics within the task 2 5 force's charge. 2 6 3. Legislative staffing for the task force may be 2 7 augmented with consultant and contract assistance as 2 8 authorized by the legislative council. 2 9 BE IT FURTHER RESOLVED, That the restructuring task 2 10 force should be directed to make recommendations to 2 11 attain the following objectives for the adult MH/DD 2 12 services system: 2 13 1. IMPLEMENT CORE SERVICES. Implement statewide 2 14 standardization of clinical and financial eligibility 2 15 requirements for adult MH/DD services to be included 2 16 in required county plans. The following aspects are 2 17 to be addressed in particular: 2 18 a. Clinical eligibility standards. A task force 2 19 committee consisting of county central point of 2 20 coordination administrators, clinicians, and other 2 21 professionals should review applicable state and 2 22 federal definitions and recommend standards for Iowa, 2 23 including but not limited to general clinical 2 24 eligibility standards, service access criteria, level 2 25 of care requirements, and terminology changes. 2 26 b. Financial eligibility standardization. Aspects 2 27 addressed should include resources, copayments, and 2 28 treatment of income and assets. 2 29 c. Persons served and costs. Determinations 2 30 should include how many counties serve persons with 3 1 developmental disabilities other than mental 3 2 retardation, types of service coverage, and cost for 3 3 all counties to make core services available to 3 4 persons with developmental disabilities. 3 5 2. EMPHASIZE COMMUNITY SERVICES. Modify statutory 3 6 mandates for provision of services to shift the 3 7 emphasis from institutional services to community 3 8 services by providing service consumers a reasonable 3 9 level of choice to meet individual needs; and begin 3 10 requiring inclusion of the core community services in 3 11 county plans applicable to fiscal year 2002-2003. The 3 12 following are to be considered as an initial set of 3 13 core community services: 3 14 a. (1) Mental illness services to include 3 15 outpatient treatment, inpatient psychiatric evaluation 3 16 and treatment at county-designated facilities. 3 17 (2) Court-appointed mental health advocate, 3 18 attorney, other legal assistance, and transportation 3 19 relating to civil commitment to be included in the 3 20 judicial branch budget. 3 21 b. Chronic mental illness services to include 3 22 services under paragraph "a"; service coordination, 3 23 employment, and psychosocial services funded under 3 24 medical assistance; residential services; and other 3 25 community support services. 3 26 c. (1) Mental retardation and other developmental 3 27 disabilities services to include residential services 3 28 and other community support services, employment and 3 29 day rehabilitation and habilitation services, medical 3 30 assistance home and community-based waiver services, 4 1 and service coordination. 4 2 (2) Court-appointed mental health advocate, 4 3 attorney, other legal assistance, and transportation 4 4 relating to civil commitment to be included in the 4 5 judicial branch budget. 4 6 d. Generally available services to include 4 7 outreach, intake, consultation and education, disaster 4 8 planning, and crisis response and hospital diversion 4 9 services. 4 10 3. REPLACE LEGAL SETTLEMENT PROCESS. Provide for 4 11 a transition from the current legal settlement process 4 12 of determining financial liability for service costs 4 13 to a process that provides for equitable service 4 14 access based upon residency. Implementation of this 4 15 approach would be coordinated with provisions for a 4 16 new funding formula. Exceptions shall be allowed for 4 17 individuals whose county of residence is a result of 4 18 service referral approved by another county and for 4 19 temporary residents for educational or other purposes. 4 20 Referrals from other states, transients from other 4 21 states, and illegal aliens shall remain a state 4 22 responsibility. 4 23 4. INCREASE FEDERAL FUNDING FOR SERVICES. Develop 4 24 strategies to significantly increase federal medical 4 25 assistance funding for mental health and developmental 4 26 disabilities services. Consultant assistance should 4 27 be obtained to complete the following tasks: 4 28 a. Determine the best means for implementing the 4 29 rehabilitation option under the medical assistance 4 30 state plan for mental health services outside the 5 1 state's managed care waiver. 5 2 b. Develop a specific means for expanding and 5 3 improving the flexibility of the medical assistance 5 4 home and community-based services waiver for persons 5 5 with mental retardation and for including persons with 5 6 other developmental disabilities. 5 7 5. INCREASE FEDERAL FUNDING FOR HOUSING. With 5 8 consultant assistance, develop a specific approach for 5 9 counties and the state to access federal housing 5 10 funding so that there is a statewide increase of seven 5 11 hundred fifty consumers in new subsidized housing 5 12 within three years of implementing the approach. The 5 13 following steps should be completed: 5 14 a. Develop a comprehensive state plan for housing 5 15 of persons with disabilities. 5 16 b. Develop technical assistance at the state level 5 17 to assist local communities in securing federal 5 18 housing funding that can be accessed without detailed 5 19 planning requirements and complex financing 5 20 structures. 5 21 6. DEVELOP FORMULA IN WHICH FUNDING FOLLOWS 5 22 CONSUMERS. Develop a new funding formula that links 5 23 state and federal funding to individual consumers 5 24 based upon a consumer's disability. The formula 5 25 should incorporate the following principles: 5 26 a. Allocating formula funding on a quarterly basis 5 27 while defining allowable elements for use of a county 5 28 fund balance and limiting those elements to a 5 29 specified percentage of the fund balance. If an 5 30 element exceeds the specified percentage in a quarter, 6 1 the next quarterly allocation would be reduced in an 6 2 amount equal to the excess. 6 3 b. Increased state funding levels in proportion to 6 4 county funding. 6 5 c. Initially maintaining maximum county levies for 6 6 adult MH/DD services at the amounts existing in fiscal 6 7 year 1999-2000. 6 8 d. Allocating any increased state funding to 6 9 achieve equity in service access. 6 10 e. Eventually allocating the state funding for 6 11 state institutions through counties so that these 6 12 services operate equally with other services. 6 13 f. Allotting state funding and administrative 6 14 costs for state cases to the individual service 6 15 consumer's county of residence. 6 16 g. Allocating state funding by use of a case rate 6 17 approach based upon a consumer's particular disability 6 18 grouping (mental illness, chronic mental illness, 6 19 mental retardation, or another developmental 6 20 disability other than mental retardation). 6 21 h. Allocating the risk for service cost increases 6 22 to counties and for eligible consumer increases to the 6 23 state. 6 24 i. Providing for risk management and flexibility 6 25 provisions such as case rate adjustments, allowing 6 26 waiting lists to be used for unanticipated new 6 27 eligible consumers, distributing quarterly allotments 6 28 to counties based upon the previous quarter's 6 29 enrollment, removing categorical funding restrictions, 6 30 applying standards to ensure county cash flow 7 1 capacity, and allowing inflation adjustments. 7 2 7. ADDRESS FINANCIAL RISK. In addition to other 7 3 provisions for dealing with financial risk for 7 4 unanticipated costs, provide for expanding the state 7 5 risk pool, for allowing access to risk pool funding 7 6 for specific purposes, and for allowing counties to 7 7 maintain fund balances for certain cost factors. 7 8 8. REDEFINE STATE AND COUNTY ROLES ENHANCE 7 9 CONSUMER CHOICE. Develop an implementation plan for 7 10 redefining state and county roles and enhancing 7 11 consumer input into the service system. The plan 7 12 should include provision for the following elements: 7 13 a. Review the roles of the state-county management 7 14 committee and the mental health and developmental 7 15 disabilities commission. 7 16 b. Using technical assistance to develop statewide 7 17 contracting, rate setting, and quality assurance 7 18 processes for the state, counties, and providers. 7 19 c. Clarifying department of human services' 7 20 responsibilities for implementing policy, standards, 7 21 and system evaluation. 7 22 d. Redefining the county role and responsibility 7 23 for local system planning, development, operations, 7 24 performance, and quality management. 7 25 e. Expanding the "net budgeting" approach for 7 26 state institutions to increase the institutions equity 7 27 with community service providers. 7 28 f. Improving collaboration between service 7 29 purchasers and groups composed of consumers, families 7 30 of consumers, and advocacy organizations such as the 8 1 Governor's Planning Council for Persons With 8 2 Developmental Disabilities by forming a representative 8 3 stakeholder advisory committee to respond to task 8 4 force recommendations; and 8 5 BE IT FURTHER RESOLVED, That the Legislative 8 6 Council is requested to limit task force membership to 8 7 not more than nineteen persons and to appoint the task 8 8 force to include all of the following: 8 9 1. One member representing the State-County 8 10 Management Committee. 8 11 2. One member representing the Mental Health and 8 12 Developmental Disabilities Commission. 8 13 3. Two members representing the Iowa Association 8 14 of Community Providers. 8 15 4. Two members representing consumers of mental 8 16 health and developmental disability services. 8 17 5. One member representing families of service 8 18 consumers. 8 19 6. One member representing consumer advocates. 8 20 7. One member representing the Iowa Governor's 8 21 Planning Council for Developmental Disabilities. 8 22 8. Four members representing counties with three 8 23 representing county central point of coordination 8 24 administrators and one representing county 8 25 supervisors. 8 26 9. Four members representing the Department of 8 27 Human Services. 8 28 10. One member representing the Iowa Farm Bureau 8 29 Federation. 8 30 11. One member representing participants at the 9 1 lieutenant Governor's Mental Health and Developmental 9 2 Disabilities Service System Summit held in December 9 3 1999; and 9 4 BE IT FURTHER RESOLVED, That the Legislative 9 5 Council is requested to create the task force as 9 6 expeditiously as possible upon passage of this 9 7 resolution. 9 8 LSB 6266HV 78 9 9 jp/cls/14.1
Text: HCR00112 Text: HCR00114 Text: HCR00100 - HCR00199 Text: HCR Index Bills and Amendments: General Index Bill History: General Index
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