Text: HSB00212 Text: HSB00214 Text: HSB00200 - HSB00299 Text: HSB Index Bills and Amendments: General Index Bill History: General Index
PAG LIN 1 1 DIVISION I 1 2 MENTAL HEALTH AND DEVELOPMENTAL DISABILITIES COMMISSION 1 3 Section 1. Section 225C.4, subsection 1, paragraph p, Code 1 4 1999, is amended to read as follows: 1 5 p. Recommendand enforceto the commission minimum 1 6 accreditation standards for the maintenance and operation of 1 7 community mental health centers, services, and programs under 1 8 section 230A.16. The administrator's review and evaluation of 1 9 the centers, services, and programs for compliance with the 1 10 adopted standards shall be as provided in section 230A.17. 1 11 Sec. 2. Section 225C.4, subsection 1, Code 1999, is 1 12 amended by adding the following new paragraph: 1 13 NEW PARAGRAPH. pp. Recommend to the commission minimum 1 14 standards for supported community living services. The 1 15 administrator shall review and evaluate the services for 1 16 compliance with the adopted standards. 1 17 Sec. 3. Section 225C.6, subsection 1, paragraph c, Code 1 18 1999, is amended to read as follows: 1 19 c. Adopt standards for community mental health centers, 1 20 services, and programs as recommended under section 230A.16. 1 21 The commission shall determine whether to grant, deny, or 1 22 revoke the accreditation of the centers, services, and 1 23 programs. 1 24 Sec. 4. Section 225C.6, subsection 1, paragraph l, Code 1 25 1999, is amended to read as follows: 1 26 l. Establish standards for the provision under medical 1 27 assistance of individual case management services. The 1 28 commission shall determine whether to grant, deny, or revoke 1 29 the accreditation of the services. 1 30 Sec. 5. Section 225C.21, subsection 2, Code 1999, is 1 31 amended to read as follows: 1 32 2. Thedepartmentcommission shall adopt rules pursuant to 1 33 chapter 17A establishing minimum standards forthe programming1 34ofsupported community living services. The department shall 1 35approve alldetermine whether to grant, deny, or revoke 2 1 approval for any supported community livingservices which2 2meet the minimum standardsservice. 2 3 DIVISION II 2 4 STATE-COUNTY MANAGEMENT COMMITTEE 2 5 Sec. 6. Section 331.438, subsection 4, paragraph b, 2 6 unnumbered paragraph 1, Code 1999, is amended to read as 2 7 follows: 2 8 The management committee shall consist ofnot more than2 9twelvefourteen voting members as follows: 2 10 Sec. 7. Section 331.438, subsection 4, paragraph b, 2 11 subparagraph (1), Code 1999, is amended to read as follows: 2 12 (1)An equal number of not more than nineThree members 2 13 shall be appointed by the director of human servicesand. The 2 14 director or another employee of the department of human 2 15 services designated by the director also shall serve as a 2 16 member. Four members shall be appointed by the Iowa state 2 17 association of countiesand one. One additional member shall 2 18 be jointly appointed by both entities.MembersThe four 2 19 members appointed by the Iowa state association of counties 2 20 shall be selected from a pool nominated by the county 2 21 supervisor affiliate of the associationwith four members from2 22the affiliate. The affiliate shall select the nominees from 2 23 the affiliate through a secret ballot process. 2 24 Sec. 8. Section 331.438, subsection 4, paragraph b, Code 2 25 1999, is amended by adding the following new subparagraph 2 26 after subparagraph (1) and renumbering the subsequent 2 27 subparagraphs: 2 28 NEW SUBPARAGRAPH. (2) The committee shall include two 2 29 members appointed by the community services affiliate of the 2 30 Iowa state association of counties. 2 31 Sec. 9. Section 331.438, subsection 4, paragraph b, 2 32 subparagraph (4), Code 1999, is amended to read as follows: 2 33 (4) A member who is not a legislator shall have expenses 2 34 and other costs paid by the state or the county entity that 2 35 the member represents. The committee shallestablish terms3 1for its members,elect officers, adopt operating procedures, 3 2 and meet as deemed necessary by the committee. Terms of 3 3 office for the appointed voting members of the committee are 3 4 three years and shall be staggered. A vacancy on the 3 5 committee shall be filled in the same manner as the original 3 6 appointment. 3 7 Sec. 10. CORE SET OF SERVICES AND OTHER SUPPORT. The 3 8 state-county management committee shall explore the 3 9 feasibility of establishing a core set of mental health and 3 10 mental retardation and other developmental disabilities 3 11 services and other support that would be available statewide. 3 12 The committee shall include findings and a recommendation in 3 13 its annual report to the governor and general assembly on 3 14 January 1, 2000. 3 15 Sec. 11. STAGGERED TERMS. Effective July 1, 1999, the 3 16 appointing authorities for the state-county management 3 17 committee shall provide by mutual agreement for the staggering 3 18 of the terms of voting members of the committee so that the 3 19 terms of at least four members expire each year. Based on 3 20 this mutual agreement, the terms of individuals who are voting 3 21 members of the committee as of June 30, 1999, shall either 3 22 expire June 30, 1999, or be for one, two, or three years 3 23 beginning on July 1, 1999. The terms of the two 3 24 representatives of county single entry point process 3 25 administrators shall commence July 1, 1999. This section 3 26 takes effect June 30, 1999. 3 27 DIVISION III 3 28 ALLOWED GROWTH FACTOR ADJUSTMENT 3 29 Sec. 12. Section 331.439, subsection 3, paragraph b, Code 3 30 1999, is amended to read as follows: 3 31 b. Based upon information contained in county management 3 32 plans and budgets, thestate-county management committee3 33 department of human services shall recommend in the 3 34 department's estimate of expenditure requirements submitted in 3 35 accordance with section 8.23, an allowed growth factor 4 1 adjustment to the governorby November 15for the fiscal year 4 2 which commences two years from the beginning date of the 4 3 fiscal year in progress at the time the recommendation is 4 4 made. The allowed growth factor adjustment shall address 4 5 costs associated with new consumers of service, service cost 4 6 inflation, and investments for economy and efficiency. In 4 7 developing the service cost inflation recommendation, the 4 8committeedepartment shall consider the cost trends indicated 4 9 by the gross expenditure amount reported in the expenditure 4 10 reports submitted by counties pursuant to subsection 1, 4 11 paragraph "a". The governor shall consider thecommittee's4 12 department's recommendation in developing the governor's 4 13 recommendation for an allowed growth factor adjustment for 4 14 such fiscal year. The governor's recommendation shall be 4 15 submitted at the time the governor's proposed budget for the 4 16 succeeding fiscal year is submitted in accordance with chapter 4 17 8. 4 18 DIVISION IV 4 19 COUNTY MANAGEMENT PLAN PROVISIONS 4 20 Sec. 13. Section 331.439, subsection 1, paragraph b, Code 4 21 1999, is amended to read as follows: 4 22 b. The county developed and implemented a county 4 23 management plan for the county's mental health, mental 4 24 retardation, and developmental disabilities services in 4 25 accordance with the provisions of this paragraph "b". The 4 26 plan shall comply with the administrative rules adopted for 4 27 this purpose by the council on human services and is subject 4 28 to the approval of the director of human services in 4 29 consultation with the state-county management committee 4 30 created in section 331.438. The plan shall include a 4 31 description of the county's service management provision for 4 32 mental health, mental retardation, and developmental 4 33 disabilities services. For mental retardation and 4 34 developmental disabilities service management, the plan shall 4 35 describe the county's development and implementation of a 5 1 managed system of cost-effective individualized services and 5 2 shall comply with the provisions of paragraph "d". The goal 5 3 of this part of the plan shall be to assist the individuals 5 4 served to be as independent, productive, and integrated into 5 5 the community as possible. The service management provisions 5 6 for mental health shall comply with the provisions of 5 7 paragraph "c". A county is subject to all of the following 5 8 provisions relating to county's management plan: 5 9 (1) The county shall have in effect an approved policies 5 10 and procedures manual for the county's services fund. The 5 11 manual submitted by the county as part of the county's 5 12 management plan for the fiscal year beginning July 1, 1999, as 5 13 approved by the director of human services, shall remain in 5 14 effect, subject to amendment. Prior to implementation of any 5 15 amendment to the manual, the amendment must be approved by the 5 16 director of human services in consultation with the state- 5 17 county management committee. 5 18 (2) The county shall submit a management plan review to 5 19 the department of human services by April 1 of each year. The 5 20 annual review shall incorporate an analysis of the data 5 21 associated with the services managed during the preceding 5 22 fiscal year by the county or by a managed care entity on 5 23 behalf of the county. The review shall provide the basis for 5 24 the county's strategic planning process. 5 25 (3) The county shall submit a strategic plan to the 5 26 department of human services by April 1 of each year. The 5 27 strategic plan shall describe how the county will proceed to 5 28 attain the goals and objectives contained in the strategic 5 29 plan for the succeeding fiscal year. 5 30 Sec. 14. Section 331.439, subsection 1, paragraph c, 5 31 subparagraph (1), Code 1999, is amended to read as follows: 5 32 (1) For mental health service management, the county may 5 33 either directly implement a system of service management and 5 34 contract with service providers, or contract with a private 5 35 entity to manage the system, provided all requirements of this 6 1 lettered paragraph are met by the private entity. The mental 6 2 health service management shall incorporate a single entry 6 3 point and clinical assessment process developed in accordance 6 4 with the provisions of section 331.440.The county shall6 5submit this part of the plan to the department of human6 6services for approval by April 1 for the succeeding year.6 7Initially, this part of the plan shall be submitted to the6 8department by April 1, 1996, and the county shall implement6 9the approved plan by July 1, 1996.6 10 Sec. 15. Section 331.439, subsection 1, paragraphs d and 6 11 e, Code 1999, are amended to read as follows: 6 12 d. For mental retardation and developmental disabilities 6 13 services management, the county must either develop and 6 14 implement a managed system of care which addresses a full 6 15 array of appropriate services and cost-effective delivery of 6 16 services or contract with a state-approved managed care 6 17 contractor or contractors. Any system or contract implemented 6 18 under this paragraph shall incorporate a single entry point 6 19 and clinical assessment process developed in accordance with 6 20 the provisions of section 331.440. The elements of the 6 21 managed system of care and the state-approved managed care 6 22 contract or contracts shall be specified in rules developed by 6 23 the department of human services in consultation with the 6 24 state-county management committee and adopted by the council 6 25 on human services.Initially, this part of the plan shall be6 26submitted to the department for approval on or before October6 271, 1996, and shall be implemented on or before January 1,6 281997. In fiscal years succeeding the fiscal year of initial6 29implementation, this part of the plan shall be submitted to6 30the department of human services for approval by April 1 for6 31the succeeding fiscal year.6 32e. Changes to the approved plan are submitted at least6 33sixty days prior to the proposed change and are not to be6 34implemented prior to the director of human services' approval.6 35 DIVISION V 7 1 RESIDENTIAL CARE FACILITIES FOR PERSONS WITH MENTAL 7 2 RETARDATION 7 3 Sec. 16. Section 135C.6, subsection 8, paragraph b, Code 7 4 1999, is amended read as follows: 7 5 b. A total oftwentyforty residential care facilities for 7 6 persons with mental retardation which are licensed to serve no 7 7 more than five individuals may be authorized by the department 7 8 of human services to convert to operation as a residential 7 9 program under the provisions of a medical assistance home and 7 10 community-based services waiver for persons with mental 7 11 retardation. A converted residential program is subject to 7 12 the conditions stated in paragraph "a" except that the program 7 13 shall not serve more than five individuals.The department of7 14human services shall allocate conversion authorizations to7 15provide for four conversions in each of the department's five7 16service regions. If a conversion authorization allocated to a7 17region is not used for conversion by January 1, 1998, the7 18department of human services may reallocate the unused7 19conversion authorization to another region. The department of7 20human services shall study the cost effectiveness of the7 21conversions and provide an initial report to the general7 22assembly no later than January 2, 1998, and a final report no7 23later than December 15, 1998.7 24 EXPLANATION 7 25 This bill relates to mental health, mental retardation, and 7 26 developmental disabilities (MH/MR/DD) services and other 7 27 support. 7 28 Division I of the bill amends Code chapter 225C to provide 7 29 that the administrator of the division of mental health and 7 30 developmental disabilities recommends minimum standards for 7 31 community mental health centers and related services and 7 32 programs and evaluates compliance with the minimum standards. 7 33 However, the bill clarifies that the responsibility for 7 34 approving, denying, or revoking an accreditation is a duty of 7 35 the mental health and developmental disabilities commission. 8 1 The bill includes similar provisions for supported community 8 2 living services. 8 3 Division II relates to the state-county management 8 4 committee. Code section 331.438, relating to the MH/MR/DD 8 5 service delivery system and the state-county management 8 6 committee, is amended to change the committee's membership 8 7 provisions. Current law sets a limit on the number of members 8 8 appointed by the department of human services and the 8 9 counties. The bill changes these limits to reflect the number 8 10 of members to be appointed. The bill specifies that the 8 11 director of human services or a designee is to serve on the 8 12 committee. The membership of the committee is expanded by two 8 13 members to be appointed by the community services affiliate of 8 14 the Iowa state association of counties. 8 15 The state-county management committee is directed to 8 16 explore the feasibility of establishing a core set of mental 8 17 health, and mental retardation and other developmental 8 18 disabilities services and other support that would be 8 19 available statewide. The committee is to include findings and 8 20 a recommendation in its annual report to the governor and 8 21 general assembly on January 1, 2000. 8 22 The bill also provides for three-year terms of office for 8 23 the voting members of the committee. Under current law, the 8 24 committee itself determines the length of the terms of office. 8 25 The bill includes transition authority for the members' 8 26 appointing authorities to stagger the terms so that at least 8 27 four members' terms expire each year. The terms of the two 8 28 members appointed by the single entry point process 8 29 administrators are to commence July 1, 1999. This section of 8 30 the bill is effective on June 30, 1999. 8 31 Division III relates to the growth recommendation for 8 32 MH/MR/DD services. Code section 331.439, relating to county 8 33 management plans for MH/MR/DD services, is amended with 8 34 respect to allowed growth recommendations for the services 8 35 expenditures and state funding. The bill provides that the 9 1 department of human services is to make the initial 9 2 recommendation to the governor as to the amount of allowed 9 3 growth in the service system in place of the state-county 9 4 management committee. The recommendation is to be submitted 9 5 as part of the regular state budget process. 9 6 Division IV amends Code section 331.439, relating to the 9 7 county management plans for MH/MR/DD services. The bill 9 8 provides that the policy and procedures manual submitted by a 9 9 county with the county management plan for the fiscal year 9 10 beginning July 1, 1999, and approved by the director of human 9 11 services shall remain in effect subject to amendment. 9 12 Amendments to the policies and procedures manual are subject 9 13 to the director's approval in consultation with the state- 9 14 county management committee. 9 15 A county is also to submit an annual management plan review 9 16 of data concerning the services provided under the management 9 17 plan in the previous fiscal year. In addition, a county is to 9 18 submit a strategic plan which is based upon the annual review. 9 19 These two items are to be submitted annually by April 1. 9 20 This division also strikes provisions requiring management 9 21 plan submissions for mental health and for mental retardation 9 22 and developmental disabilities services to the department of 9 23 human services annually by April 1, and for changes to be 9 24 submitted to the director of human services for approval 60 9 25 days prior to implementation. 9 26 Division V of the bill amends Code section 135C.6, relating 9 27 to exemptions from required licensing of health care 9 28 facilities. Current law exempts up to 20 residential care 9 29 facilities for persons with mental retardation (RCFMRs) each 9 30 serving five persons or fewer that are authorized by the 9 31 department of human services to convert to operation in 9 32 accordance with a federal home and community-based waiver for 9 33 persons with mental retardation under medical assistance 9 34 (Medicaid). The bill expands the conversion authorization to 9 35 40 facilities and strikes language requiring distribution 10 1 among the department's regions and for reports due by certain 10 2 dates. 10 3 LSB 2343HC 78 10 4 jp/sc/14.2
Text: HSB00212 Text: HSB00214 Text: HSB00200 - HSB00299 Text: HSB Index Bills and Amendments: General Index Bill History: General Index
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