Text: HF02113 Text: HF02115 Text: HF02100 - HF02199 Text: HF Index Bills and Amendments: General Index Bill History: General Index
PAG LIN 1 1 DIVISION I 1 2 WAIVER SERVICES 1 3 Section 1. Section 135C.6, subsection 8, Code 2001, is 1 4 amended to read as follows: 1 5 8. The following residential programs to which the 1 6 department of human services applies accreditation, 1 7 certification, or standards of review shall not be required to 1 8 be licensed as a health care facility under this chapter: 1 9 a. A residential programwhichthat provides care to not 1 10 more thanfoursix individuals and receives moneys 1 11 appropriated to the department of human services under 1 12 provisions of a federally approved home and community-based 1 13 services waiver for persons with mental retardation or other 1 14 medical assistance program under chapter 249A. In approving a 1 15 residential program under this paragraph, the department of 1 16 human services shall consider the geographic location of the 1 17 program so as to avoid an overconcentration of such programs 1 18 in an area. In order to be approved under this paragraph, a 1 19 residential program shall not be required to involve the 1 20 conversion of a licensed residential care facility for persons 1 21 with mental retardation. 1 22 b. A total of forty residential care facilities for 1 23 persons with mental retardationwhichthat are licensed to 1 24 serve no more than five individuals may be authorized by the 1 25 department of human services to convert to operation as a 1 26 residential program under the provisions of a medical 1 27 assistance home and community-based services waiver for 1 28 persons with mental retardation. A converted residential 1 29 program is subject to the conditions stated in paragraph "a" 1 30except that the program shall not serve more than five1 31individuals.The department of human services shall allocate1 32conversion authorizations to provide for eight conversions in1 33each of the department's five service regions.1 34 Sec. 2. Section 249A.29, subsection 1, unnumbered 1 35 paragraph 1, Code 2001, is amended to read as follows: 2 1 For purposes of this section and section 249A.30 unless the 2 2 context otherwise requires: 2 3 Sec. 3. NEW SECTION. 249A.30 HOME AND COMMUNITY-BASED 2 4 WAIVER SERVICES REIMBURSEMENT. 2 5 1. The base reimbursement rate for a provider shall be 2 6 recalculated at least every three years to adjust for the 2 7 changes in costs during the immediately preceding three-year 2 8 period. 2 9 2. The annual inflation factor used to adjust a provider's 2 10 reimbursement rate for a fiscal year shall not exceed the 2 11 percentage increase in the employment cost index for private 2 12 industry compensation issued by the federal department of 2 13 labor, bureau of labor statistics, for the most recently 2 14 completed calendar year. 2 15 Sec. 4. RULES. 2 16 1. The department of human services and the mental health 2 17 and developmental disabilities commission shall adopt new 2 18 rules or amend or repeal existing rules so that services 2 19 provided to a person with a developmental disability under 2 20 provisions of a federally approved medical assistance home and 2 21 community-based services waiver for persons with mental 2 22 retardation, supported community living services, and any 2 23 other funding or program providing support to persons with a 2 24 developmental disability allows for residential programs to 2 25 serve not more than six individuals. The rules to be amended 2 26 or repealed shall include but are not limited to all of the 2 27 following: 2 28 a. Supported community living services under 441 IAC 2 29 78.41(1)(c). In addition, the restrictions in 441 IAC 2 30 78.41(1)(d), providing that no more than eight consumers shall 2 31 reside in settings with a maximum of four living units and 2 32 requiring that in larger settings the majority of living units 2 33 must be occupied by individuals who do not have a disability, 2 34 shall be eliminated. 2 35 b. Supported community living services providers under 441 3 1 IAC 77.37(14)(e), relating to restrictions on the number of 3 2 supported community living recipients that may be provided for 3 3 in a living unit. 3 4 c. Residential-based supported community living service 3 5 providers under 441 IAC 77.37(23)(e), relating to a general 3 6 limit of four beds allowed in a living unit. 3 7 2. The department of human services and the mental health 3 8 and developmental disabilities commission shall adopt new 3 9 rules or amend or repeal existing rules so that services 3 10 provided under provisions of a federally approved medical 3 11 assistance home and community-based services waiver for 3 12 persons with mental retardation allow children who are sixteen 3 13 years of age or older to utilize supported community living 3 14 services for community vocational training and support. 3 15 Sec. 5. IMPLEMENTATION OF ACT. Section 25B.2, subsection 3 16 3, shall not apply to sections 249A.29 and 249A.30 as amended 3 17 or enacted by this division of this Act. 3 18 DIVISION II 3 19 INTERMEDIATE CARE FACILITIES 3 20 FOR PERSONS WITH MENTAL RETARDATION 3 21 Sec. 6. Section 135.63, subsection 4, Code 2001, is 3 22 amended to read as follows: 3 23 4.For the period beginning July 1, 1995, and ending June3 2430, 1998, theThe department shall not process applications 3 25 for and the council shall not consider a new or changed 3 26 institutional health service for an intermediate care facility 3 27 for persons with mental retardation except as provided in this 3 28 subsection. 3 29 a.For the period beginning July 1, 1995, and ending June3 3030, 1998, theThe department and council shall process 3 31 applications and consider applications if either of the 3 32 following conditions are met: 3 33 (1) An institutional health facility is reducing the size 3 34 of the facility's intermediate care facility for the persons 3 35 with mental retardation program and wishes to convert an 4 1 existing number of the facility's approved beds in that 4 2 program to smaller living environments in accordance with 4 3 state policies in effect regarding the size and location of 4 4 such facilities. 4 5 (2) An institutional health facility proposes to locate a 4 6 new intermediate care facility for persons with mental 4 7 retardation in an area of the state identified by the 4 8 department of human services as underserved by intermediate 4 9 care facility beds for persons with mental retardation. 4 10 b. Both of the following requirements shall apply to an 4 11 application considered under this section: 4 12 (1) The new or changed beds shall not result in an 4 13 increase in the total number of medical assistance certified 4 14 intermediate care facility beds for persons with mental 4 15 retardation in the state as of July 1, 1994. 4 16 (2) A letter of support for the application is provided by 4 17the director of human services andthe county board of 4 18 supervisors, or the board's designee, in the county in which 4 19 the beds would be located. 4 20 Sec. 7. Section 135.64, subsection 4, Code 2001, is 4 21 amended by striking the subsection. 4 22 DIVISION III 4 23 COMMUNITY MENTAL HEALTH CENTERS 4 24 Sec. 8. MEDICAL ASSISTANCE PROVIDER REQUIREMENTS. 4 25 Effective July 1, 2002, the department of human services shall 4 26 revise the medical assistance provider requirements applicable 4 27 to community mental health centers in the department's policy 4 28 manuals to implement all of the following: 4 29 1. Revision of the condition of payment provision relating 4 30 to services provided by a qualified mental health 4 31 professional, as defined in section 229.1, and requiring an 4 32 initial evaluation to include at least one personal interview 4 33 with a psychiatrist. Under the revision, a qualified staff 4 34 person must conduct a patient's initial evaluation interview 4 35 and if the evaluation results indicate a need for a referral 5 1 for an interview with a psychiatrist, then such a referral 5 2 shall be required. 5 3 2. Elimination of the requirement for a patient staffing 5 4 meeting to be held within four weeks following the date of the 5 5 patient's initial evaluation interview. Instead, the purpose 5 6 of this requirement shall be achieved through the peer review 5 7 process in effect for community mental health centers. 5 8 3. Make conforming amendments to policy manuals as 5 9 necessary to implement subsections 1 and 2. 5 10 DIVISION IV 5 11 SINGLE ENTRY POINT PROCESS 5 12 Sec. 9. Section 331.440, subsection 1, Code 2001, is 5 13 amended by adding the following new paragraph: 5 14 NEW PARAGRAPH. d. The single entry point process staff in 5 15 a county shall assist the court with the involuntary 5 16 hospitalization of persons with mental illness under chapter 5 17 229. 5 18 DIVISION V 5 19 EMERGENCY RULES 5 20 Sec. 10. EMERGENCY RULES. Rules adopted, amended, or 5 21 repealed pursuant to this Act shall be processed as emergency 5 22 rules under section 17A.4, subsection 2, and section 17A.5, 5 23 subsection 2, paragraph "b", and the rules shall be effective 5 24 immediately upon filing, unless the effective date is delayed 5 25 by the administrative rules review committee, notwithstanding 5 26 section 17A.4, subsection 5, and section 17A.8, subsection 9, 5 27 or a later date is specified in the rules. Any rules adopted, 5 28 amended, or repealed pursuant to this Act shall not take 5 29 effect before the rules are reviewed by the administrative 5 30 rules review committee. Any rules adopted, amended, or 5 31 repealed pursuant to this Act shall also be published as a 5 32 notice of intended action as provided in section 17A.4. 5 33 EXPLANATION 5 34 This bill relates to mental health and developmental 5 35 disability services and involuntary hospitalization 6 1 requirements including medical assistance waiver services, 6 2 intermediate care facilities for persons with mental 6 3 retardation, community mental health centers, and the county 6 4 single entry point process. 6 5 Division I of the bill relates to the requirements 6 6 involving the home and community-based services under the 6 7 medical assistance program. Code section 135C.6, relating to 6 8 an exemption from required licensing of a certain type of 6 9 residential program as a health care facility, is amended. 6 10 Under current law, a residential program providing care to not 6 11 more than four individuals and receiving moneys under such a 6 12 waiver for persons with mental retardation or other medical 6 13 assistance program is not required to have a health care 6 14 facility license. The bill increases the number of 6 15 individuals from four to six. 6 16 In addition, the bill expands a related provision in 6 17 current law that allows up to 40 residential care facilities 6 18 for persons with mental retardation serving not more than five 6 19 persons to convert to a waiver program facility. The bill 6 20 would allow those converted facilities to serve up to six 6 21 individuals and eliminates obsolete language referring to the 6 22 five regions of the department of human services. 6 23 Division I of the bill includes new Code section 249A.30, 6 24 establishing new reimbursement requirements for home and 6 25 community-based services providers under the medical 6 26 assistance program. The bill amends Code section 249A.29 to 6 27 utilize existing definitions for waiver providers in the new 6 28 section. Under the bill, a waiver provider's base 6 29 reimbursement rate is required to be recalculated at least 6 30 every three years. The annual inflation factor used to adjust 6 31 a waiver provider's reimbursement rate for a fiscal year is 6 32 limited to the percentage increase in the employment cost 6 33 index for private industry compensation issued for the most 6 34 recently completed calendar year by the federal department of 6 35 labor, bureau of labor statistics. These provisions may 7 1 include a state mandate as defined in Code section 25B.3. The 7 2 bill makes inapplicable Code section 25B.2, subsection 3, 7 3 which would relieve a political subdivision from complying 7 4 with a state mandate if funding for the cost of the state 7 5 mandate is not provided or specified. Therefore, political 7 6 subdivisions are required to comply with any state mandate 7 7 included in these provisions of the bill. 7 8 Division I of the bill requires the department of human 7 9 services and the mental health and developmental disabilities 7 10 commission to adopt new rules or amend existing rules so that 7 11 residential services for a person with a developmental 7 12 disability under the waiver program and other funding or 7 13 programs for such persons allow residential programs to serve 7 14 up to six individuals. In addition the bill lists existing 7 15 rules that must be revised involving supported community 7 16 living services in order to eliminate restrictions limiting 7 17 the number of consumers to fewer than allowed by the bill and 7 18 a requirement that the majority of living units must be 7 19 occupied by individuals who do not have a disability. In 7 20 addition, the bill requires a change in waiver rules for 7 21 persons with mental retardation so that children who are age 7 22 16 or older may utilize supported community living services 7 23 for community vocational training and support. 7 24 Division II of the bill relates to certificate of need 7 25 requirements for intermediate care facilities for persons with 7 26 mental retardation (ICFMR). The bill amends Code section 7 27 135.63, subsection 4, which under current law was only 7 28 applicable to the period beginning July 1, 1995, and ending 7 29 June 30, 1998, to make the requirements permanent. In 7 30 addition the bill eliminates requirements that an ICFMR 7 31 applicant must have a letter of support from the director of 7 32 human services and must meet standards for family scale and 7 33 size, location, and community inclusion in rules adopted by 7 34 the department of human services. 7 35 Division III of the bill relates to medical assistance 8 1 provider requirements involving community mental health 8 2 centers in the department's policy manual. Effective July 1, 8 3 2002, the bill directs the department of human services to 8 4 revise the provision that requires a patient to have an 8 5 interview with a psychiatrist in order for a qualified mental 8 6 health professional's services to be reimbursable. The bill 8 7 instead requires the initial evaluation interview to be 8 8 performed by a qualified staff person and if that evaluation 8 9 indicates a need for referral for an interview with a 8 10 psychiatrist, that referral is required. The bill also 8 11 provides for elimination of a requirement for a patient 8 12 staffing meeting to be held within four weeks of the initial 8 13 interview, providing that this purpose is to be achieved 8 14 through the peer review process in effect for community mental 8 15 health centers. 8 16 Division IV of the bill amends the requirements applicable 8 17 to the single entry point process established under Code 8 18 section 331.440 by counties for the delivery of mental health, 8 19 mental retardation, and developmental disabilities services 8 20 which are paid for in whole or in part by county funds. The 8 21 bill requires the single entry point process staff in a county 8 22 to assist the court with involuntary hospitalization of 8 23 persons with mental illness under Code chapter 229. 8 24 Division V of the bill provides that rules adopted, 8 25 amended, or repealed pursuant to the bill are to be processed 8 26 through the emergency provisions of Code chapter 17A so that 8 27 notice and comment periods are not required. However, the 8 28 rules cannot take effect before the rules are reviewed by the 8 29 administrative rules review committee. Unless the committee 8 30 delays the effective date or the rules include a later 8 31 effective date, the rules take effect immediately upon 8 32 adoption. 8 33 LSB 5581YH 79 8 34 jp/hk/91
Text: HF02113 Text: HF02115 Text: HF02100 - HF02199 Text: HF Index Bills and Amendments: General Index Bill History: General Index
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