Text: HSB00212                          Text: HSB00214
Text: HSB00200 - HSB00299               Text: HSB Index
Bills and Amendments: General Index     Bill History: General Index



House Study Bill 213

Bill Text

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.  Recommend and enforce to 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.  The department commission shall adopt rules pursuant to
  1 33 chapter 17A establishing minimum standards for the programming
  1 34 of supported community living services.  The department shall
  1 35 approve all determine whether to grant, deny, or revoke
  2  1 approval for any supported community living services which
  2  2 meet the minimum standards service.  
  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 of not more than
  2  9 twelve fourteen 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 nine Three members
  2 13 shall be appointed by the director of human services and.  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 counties and one.  One additional member shall
  2 18 be jointly appointed by both entities.  Members The 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 association with four members from
  2 22 the 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 shall establish terms
  3  1 for 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, the state-county management committee
  3 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 governor by November 15 for 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  8 committee department 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 the committee's
  4 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 shall
  6  5 submit this part of the plan to the department of human
  6  6 services for approval by April 1 for the succeeding year.
  6  7 Initially, this part of the plan shall be submitted to the
  6  8 department by April 1, 1996, and the county shall implement
  6  9 the 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 be
  6 26 submitted to the department for approval on or before October
  6 27 1, 1996, and shall be implemented on or before January 1,
  6 28 1997.  In fiscal years succeeding the fiscal year of initial
  6 29 implementation, this part of the plan shall be submitted to
  6 30 the department of human services for approval by April 1 for
  6 31 the succeeding fiscal year.
  6 32    e.  Changes to the approved plan are submitted at least
  6 33 sixty days prior to the proposed change and are not to be
  6 34 implemented 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 of twenty forty 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 of
  7 14 human services shall allocate conversion authorizations to
  7 15 provide for four conversions in each of the department's five
  7 16 service regions.  If a conversion authorization allocated to a
  7 17 region is not used for conversion by January 1, 1998, the
  7 18 department of human services may reallocate the unused
  7 19 conversion authorization to another region.  The department of
  7 20 human services shall study the cost effectiveness of the
  7 21 conversions and provide an initial report to the general
  7 22 assembly no later than January 2, 1998, and a final report no
  7 23 later 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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