Text: S03216                            Text: S03218
Text: S03200 - S03299                   Text: S Index
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Senate Amendment 3217

Amendment Text

PAG LIN
  1  1    Amend House File 664, as amended, passed, and
  1  2 reprinted by the House, as follows:
  1  3    #1.  Page 1, by inserting before line 1 the
  1  4 following:  
  1  5                       "DIVISION I
  1  6     ADULT MH/MR/DD SERVICES FUNDING PILOT PROJECT".
  1  7    #2.  Page 5, by striking line 24 and inserting the
  1  8 following:   "areas, designated by the governor."
  1  9    #3.  Page 8, by inserting after line 21 the
  1 10 following:  
  1 11                      "DIVISION    
  1 12      MENTAL HEALTH AND DEVELOPMENTAL DISABILITIES
  1 13                       COMMISSION
  1 14    Sec.    .  Section 225C.4, subsection 1, paragraph
  1 15 p, Code 1999, is amended to read as follows:
  1 16    p.  Recommend and enforce to the commission minimum
  1 17 accreditation standards for the maintenance and
  1 18 operation of community mental health centers,
  1 19 services, and programs under section 230A.16.  The
  1 20 administrator's review and evaluation of the centers,
  1 21 services, and programs for compliance with the adopted
  1 22 standards shall be as provided in section 230A.17.
  1 23    Sec.    .  Section 225C.4, subsection 1, Code 1999,
  1 24 is amended by adding the following new paragraph:
  1 25    NEW PARAGRAPH.  pp.  Recommend to the commission
  1 26 minimum standards for supported community living
  1 27 services.  The administrator shall review and evaluate
  1 28 the services for compliance with the adopted
  1 29 standards.
  1 30    Sec.    .  Section 225C.6, subsection 1, paragraph
  1 31 c, Code 1999, is amended to read as follows:
  1 32    c.  Adopt standards for community mental health
  1 33 centers, services, and programs as recommended under
  1 34 section 230A.16.  The commission shall determine
  1 35 whether to grant, deny, or revoke the accreditation of
  1 36 the centers, services, and programs.
  1 37    Sec.    .  Section 225C.6, subsection 1, paragraph
  1 38 l, Code 1999, is amended to read as follows:
  1 39    l.  Establish standards for the provision under
  1 40 medical assistance of individual case management
  1 41 services.  The commission shall determine whether to
  1 42 grant, deny, or revoke the accreditation of the
  1 43 services.
  1 44    Sec.    .  Section 225C.21, subsection 2, Code
  1 45 1999, is amended to read as follows:
  1 46    2.  The department commission shall adopt rules
  1 47 pursuant to chapter 17A establishing minimum standards
  1 48 for the programming of supported community living
  1 49 services.  The department commission shall approve all
  1 50 determine whether to grant, deny, or revoke approval
  2  1 for any supported community living services which meet
  2  2 the minimum standards service.  
  2  3                      DIVISION    
  2  4            STATE-COUNTY MANAGEMENT COMMITTEE
  2  5    Sec.    .  Section 331.438, subsection 4, paragraph
  2  6 b, unnumbered paragraph 1, Code 1999, is amended to
  2  7 read as follows:
  2  8    The management committee shall consist of not more
  2  9 than twelve thirteen voting members as follows:
  2 10    Sec.    .  Section 331.438, subsection 4, paragraph
  2 11 b, subparagraph (1), Code 1999, is amended to read as
  2 12 follows:
  2 13    (1)  An equal number of not more than nine Four
  2 14 members shall be appointed by the director of human
  2 15 services and.  Four members shall be appointed by the
  2 16 Iowa state association of counties and one additional
  2 17 member shall be jointly appointed by both entities.
  2 18 Members appointed by the Iowa state association of
  2 19 counties shall be selected from a pool nominated by
  2 20 the county supervisor affiliate of the association
  2 21 with four members from the affiliate.  The affiliate
  2 22 shall select the nominees through a secret ballot
  2 23 process.  In addition, two members shall be appointed
  2 24 by the community services affiliate of the Iowa state
  2 25 association of counties.
  2 26    Sec.    .  Section 331.438, subsection 4, paragraph
  2 27 b, subparagraph (4), Code 1999, is amended to read as
  2 28 follows:
  2 29    (4)  A member who is not a legislator shall have
  2 30 expenses and other costs paid by the state or the
  2 31 county entity that the member represents.  The
  2 32 committee shall establish terms for its members, elect
  2 33 officers, adopt operating procedures, and meet as
  2 34 deemed necessary by the committee.  Terms of office
  2 35 for the appointed voting members of the committee are
  2 36 three years and shall be staggered.  A vacancy on the
  2 37 committee shall be filled in the same manner as the
  2 38 original appointment.
  2 39    Sec.    .  SERVICE SYSTEM ISSUES.  The state-county
  2 40 management committee shall create a task force to
  2 41 consider issues and options regarding statewide
  2 42 eligibility standards, identification of core or basic
  2 43 services to be made reasonably available statewide,
  2 44 statewide equity and other considerations associated
  2 45 with distributing state funding, implementation of
  2 46 funding decategorization, changes in the membership
  2 47 composition of the committee, legal settlement issues,
  2 48 improved utilization of available funding streams, and
  2 49 the allowed growth recommendation process.  In
  2 50 considering the allowed growth recommendation process,
  3  1 the task force shall review the divergence between
  3  2 unmet needs in the service delivery system and county
  3  3 expenditure trends and shall make specific
  3  4 recommendations as to how allowed growth funding can
  3  5 best be distributed to address services that are not
  3  6 adequately funded and population groups that are not
  3  7 served or are underserved.  The committee shall
  3  8 consider the task force report and incorporate the
  3  9 committee's findings and recommendations on these
  3 10 topics in the committee's annual report to the
  3 11 governor and general assembly on January 1, 2000.
  3 12    Sec.    .  STAGGERED TERMS.  Effective July 1,
  3 13 1999, the appointing authorities for the state-county
  3 14 management committee shall provide by mutual agreement
  3 15 for the staggering of the terms of voting members of
  3 16 the committee so that the terms of at least four
  3 17 members expire each year.  Based on this mutual
  3 18 agreement, the terms of individuals who are voting
  3 19 members of the committee as of June 30, 1999, shall
  3 20 either expire June 30, 1999, or be for one, two, or
  3 21 three years beginning on July 1, 1999.  The terms of
  3 22 the two members appointed by the community services
  3 23 affiliate of the Iowa state association of counties
  3 24 shall commence July 1, 1999.  This section takes
  3 25 effect June 30, 1999.  
  3 26                      DIVISION    
  3 27            COUNTY MANAGEMENT PLAN PROVISIONS
  3 28    Sec.    .  Section 331.439, subsection 1, paragraph
  3 29 b, Code 1999, is amended to read as follows:
  3 30    b.  The county developed and implemented a county
  3 31 management plan for the county's mental health, mental
  3 32 retardation, and developmental disabilities services
  3 33 in accordance with the provisions of this paragraph
  3 34 "b".  The plan shall comply with the administrative
  3 35 rules adopted for this purpose by the council on human
  3 36 services and is subject to the approval of the
  3 37 director of human services in consultation with the
  3 38 state-county management committee created in section
  3 39 331.438.  The plan shall include a description of the
  3 40 county's service management provision for mental
  3 41 health, mental retardation, and developmental
  3 42 disabilities services.  For mental retardation and
  3 43 developmental disabilities service management, the
  3 44 plan shall describe the county's development and
  3 45 implementation of a managed system of cost-effective
  3 46 individualized services and shall comply with the
  3 47 provisions of paragraph "d".  The goal of this part of
  3 48 the plan shall be to assist the individuals served to
  3 49 be as independent, productive, and integrated into the
  3 50 community as possible.  The service management
  4  1 provisions for mental health shall comply with the
  4  2 provisions of paragraph "c".  A county is subject to
  4  3 all of the following provisions in regard to the
  4  4 county's management plan and planning process:
  4  5    (1)  The county shall have in effect an approved
  4  6 policies and procedures manual for the county's
  4  7 services fund.  The county management plan shall be
  4  8 defined in the manual.  The manual submitted by the
  4  9 county as part of the county's management plan for the
  4 10 fiscal year beginning July 1, 2000, as approved by the
  4 11 director of human services, shall remain in effect,
  4 12 subject to amendment.  An amendment to the manual
  4 13 shall be submitted to the department of human services
  4 14 at least forty-five days prior to the date of
  4 15 implementation.  Prior to implementation of any
  4 16 amendment to the manual, the amendment must be
  4 17 approved by the director of human services in
  4 18 consultation with the state-county management
  4 19 committee.
  4 20    (2) For informational purposes, the county shall
  4 21 submit a management plan review to the department of
  4 22 human services by April 1 of each year.  The annual
  4 23 review shall incorporate an analysis of the data
  4 24 associated with the services managed during the
  4 25 preceding fiscal year by the county or by a managed
  4 26 care entity on behalf of the county.
  4 27    (3)  For informational purposes, every three years
  4 28 the county shall submit to the department of human
  4 29 services a three-year strategic plan.  The strategic
  4 30 plan shall describe how the county will proceed to
  4 31 attain the goals and objectives contained in the
  4 32 strategic plan for the duration of the plan.  The
  4 33 three-year strategic plan shall be submitted by April
  4 34 1, 2000, and by April 1 of every third year
  4 35 thereafter.
  4 36    Sec.    .  Section 331.439, subsection 1, paragraph
  4 37 c, subparagraph (1), Code 1999, is amended to read as
  4 38 follows:
  4 39    (1)  For mental health service management, the
  4 40 county may either directly implement a system of
  4 41 service management and contract with service
  4 42 providers, or contract with a private entity to manage
  4 43 the system, provided all requirements of this lettered
  4 44 paragraph are met by the private entity.  The mental
  4 45 health service management shall incorporate a single
  4 46 entry point and clinical assessment process developed
  4 47 in accordance with the provisions of section 331.440.
  4 48 The county shall submit this part of the plan to the
  4 49 department of human services for approval by April 1
  4 50 for the succeeding year.  Initially, this part of the
  5  1 plan shall be submitted to the department by April 1,
  5  2 1996, and the county shall implement the approved plan
  5  3 by July 1, 1996.
  5  4    Sec.    .  Section 331.439, subsection 1,
  5  5 paragraphs d and e, Code 1999, are amended to read as
  5  6 follows:
  5  7    d.  For mental retardation and developmental
  5  8 disabilities services management, the county must
  5  9 either develop and implement a managed system of care
  5 10 which addresses a full array of appropriate services
  5 11 and cost-effective delivery of services or contract
  5 12 with a state-approved managed care contractor or
  5 13 contractors.  Any system or contract implemented under
  5 14 this paragraph shall incorporate a single entry point
  5 15 and clinical assessment process developed in
  5 16 accordance with the provisions of section 331.440.
  5 17 The elements of the managed system of care and the
  5 18 state-approved managed care contract or contracts
  5 19 shall be specified in rules developed by the
  5 20 department of human services in consultation with the
  5 21 state-county management committee and adopted by the
  5 22 council on human services.  Initially, this part of
  5 23 the plan shall be submitted to the department for
  5 24 approval on or before October 1, 1996, and shall be
  5 25 implemented on or before January 1, 1997.  In fiscal
  5 26 years succeeding the fiscal year of initial
  5 27 implementation, this part of the plan shall be
  5 28 submitted to the department of human services for
  5 29 approval by April 1 for the succeeding fiscal year.
  5 30    e.  Changes to the approved plan are submitted at
  5 31 least sixty days prior to the proposed change and are
  5 32 not to be implemented prior to the director of human
  5 33 services' approval.
  5 34    Sec.    .  EFFECTIVE DATE – APPLICABILITY.  This
  5 35 division of this Act takes effect July 1, 2000, except
  5 36 that the management plan and planning process
  5 37 provisions under section 331.439, as amended by this
  5 38 division of this Act, take effect upon enactment and
  5 39 are applicable for purposes of preparation and
  5 40 submission of the management plan by April 1, 2000,
  5 41 for the fiscal year beginning July 1, 2000.  
  5 42                      DIVISION    
  5 43   RESIDENTIAL CARE FACILITIES FOR PERSONS WITH MENTAL
  5 44                       RETARDATION
  5 45    Sec. ___.  Section 135C.6, subsection 8, paragraphs
  5 46 a and b, Code 1999, are amended to read as follows:
  5 47    a.  A residential program which provides care to
  5 48 not more than four individuals and receives moneys
  5 49 appropriated to the department of human services under
  5 50 provisions of a federally approved home and community-
  6  1 based services waiver for persons with mental
  6  2 retardation or other medical assistance program under
  6  3 chapter 249A.  In approving a residential program
  6  4 under this paragraph, the department of human services
  6  5 shall consider the geographic location of the program
  6  6 so as to avoid an overconcentration of such programs
  6  7 in an area.  In order to be approved under this
  6  8 paragraph, a residential program shall not be required
  6  9 to involve the conversion of a licensed residential
  6 10 care facility for persons with mental retardation.
  6 11    b.  A total of twenty forty residential care
  6 12 facilities for persons with mental retardation which
  6 13 are licensed to serve no more than five individuals
  6 14 may be authorized by the department of human services
  6 15 to convert to operation as a residential program under
  6 16 the provisions of a medical assistance home and
  6 17 community-based services waiver for persons with
  6 18 mental retardation.  A converted residential program
  6 19 is subject to the conditions stated in paragraph "a"
  6 20 except that the program shall not serve more than five
  6 21 individuals.  The department of human services shall
  6 22 allocate conversion authorizations to provide for four
  6 23 conversions in each of the department's five service
  6 24 regions.  If a conversion authorization allocated to a
  6 25 region is not used for conversion by January 1, 1998,
  6 26 the department of human services may reallocate the
  6 27 unused conversion authorization to another region.
  6 28 The department of human services shall study the cost
  6 29 effectiveness of the conversions and provide an
  6 30 initial report to the general assembly no later than
  6 31 January 2, 1998, and a final report no later than
  6 32 December 15, 1998."
  6 33    #4.  Title page, by striking lines 1 through 3 and
  6 34 inserting the following:  "An Act relating to mental
  6 35 health, mental retardation, and other developmental
  6 36 disabilities and including effective date and
  6 37 applicability provisions." 
  6 38 
  6 39 
  6 40                               
  6 41 COMMITTEE ON HUMAN RESOURCES
  6 42 NANCY BOETTGER, Chairperson
  6 43 HF 664.302 78
  6 44 jp/cf
     

Text: S03216                            Text: S03218
Text: S03200 - S03299                   Text: S Index
Bills and Amendments: General Index     Bill History: General Index

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