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Senate File 2211

Partial Bill History

Bill Text

PAG LIN
  1  1    Section 1.  Section 225C.5, subsection 1, Code 2001, is
  1  2 amended to read as follows:
  1  3    1.  A mental health and developmental disabilities
  1  4 commission is created as the state policy-making body for the
  1  5 provision of services to persons with mental illness, mental
  1  6 retardation or other developmental disabilities, or brain
  1  7 injury.  The commission shall consist of fifteen voting
  1  8 members appointed to three-year staggered terms by the
  1  9 governor and subject to confirmation by the senate.
  1 10 Commission members shall be appointed on the basis of interest
  1 11 and experience in the fields of mental health, mental
  1 12 retardation or other developmental disabilities, and brain
  1 13 injury, in a manner so that, if possible, the composition of
  1 14 the commission will comply with the requirements of the
  1 15 Community Mental Health Centers Amendments of 1975, 42 U.S.C.
  1 16 } 2689t(a) (1976) relative to a state mental health advisory
  1 17 council, and so as to ensure adequate representation from
  1 18 persons with disabilities and individuals knowledgeable
  1 19 concerning disability services.  The department shall provide
  1 20 staff support to the commission, and the commission may
  1 21 utilize staff support and other assistance provided to the
  1 22 commission by other persons.  Members of the commission shall
  1 23 include the following persons who, at the time of appointment
  1 24 to the commission, are active members of the indicated groups:
  1 25    a.  Four members shall be members of a county board of
  1 26 supervisors selected from nominees submitted by the county
  1 27 supervisor affiliate of the Iowa state association of
  1 28 counties.
  1 29    b.  Two members shall be members of a mental health and
  1 30 developmental disabilities regional planning council.
  1 31    c.  One member shall be either an active board member of a
  1 32 community mental health center or of a statewide association
  1 33 of persons with mental illness or of family members of persons
  1 34 with mental illness.
  1 35    d.  One member shall be either an active board member of an
  2  1 agency serving persons with mental retardation or of a
  2  2 statewide association for persons with mental retardation.
  2  3    e.  One member shall be an active member of a statewide
  2  4 organization for persons with developmental disabilities other
  2  5 than mental retardation.
  2  6    f.  One member shall be an active member of a statewide
  2  7 organization for persons with brain injury.
  2  8    g.  Two members shall be administrators of the single entry
  2  9 point process established in accordance with section 331.440
  2 10 selected from nominees submitted by the community services
  2 11 affiliate of the Iowa state association of counties.
  2 12    h.  One member shall be selected from nominees submitted by
  2 13 the state's council of the association of federal, state,
  2 14 county, and municipal employees.
  2 15    i.  One member shall be a service consumer.
  2 16    j.  One member shall be selected from nominees submitted by
  2 17 service advocates.
  2 18    k.  In addition to the voting members, the membership shall
  2 19 include four members of the general assembly with one member
  2 20 designated by each of the following:  the majority leader of
  2 21 the senate, the minority leader of the senate, the speaker of
  2 22 the house of representatives, and the minority leader of the
  2 23 house of representatives.  A legislative member serves in an
  2 24 ex officio, nonvoting capacity and is eligible for per diem
  2 25 and expenses as provided in section 2.10.
  2 26    Sec. 2.  Section 229.24, subsection 3, unnumbered paragraph
  2 27 1, Code 2001, is amended to read as follows:
  2 28    If all or part of the costs associated with hospitalization
  2 29 of an individual under this chapter are chargeable to a county
  2 30 of legal settlement, the clerk of the district court shall
  2 31 provide to the county of legal settlement and to the county in
  2 32 which the hospitalization order is entered, in a form
  2 33 prescribed by the council on human services pursuant to a
  2 34 recommendation of the state-county management committee
  2 35 established in section 331.438 mental health and developmental
  3  1 disabilities commission, the following information pertaining
  3  2 to the individual which would be confidential under subsection
  3  3 1:
  3  4    Sec. 3.  Section 249A.12, subsection 5, paragraph a,
  3  5 unnumbered paragraph 1, Code Supplement 2001, is amended to
  3  6 read as follows:
  3  7    The state-county management committee mental health and
  3  8 developmental disabilities commission shall recommend to the
  3  9 department the actions necessary to assist in the transition
  3 10 of individuals being served in an intermediate care facility
  3 11 for persons with mental retardation, who are appropriate for
  3 12 the transition, to services funded under a medical assistance
  3 13 waiver for home and community-based services for persons with
  3 14 mental retardation in a manner which maximizes the use of
  3 15 existing public and private facilities.  The actions may
  3 16 include but are not limited to submitting any of the following
  3 17 or a combination of any of the following as a request for a
  3 18 revision of the medical assistance waiver for home and
  3 19 community-based services for persons with mental retardation
  3 20 in effect as of June 30, 1996:
  3 21    Sec. 4.  Section 249A.12, subsection 5, paragraph b,
  3 22 unnumbered paragraph 1, Code Supplement 2001, is amended to
  3 23 read as follows:
  3 24    In implementing the provisions of this subsection, the
  3 25 state-county management committee mental health and
  3 26 developmental disabilities commission shall consult with other
  3 27 states.  The waiver revision request or other action necessary
  3 28 to assist in the transition of service provision from
  3 29 intermediate care facilities for persons with mental
  3 30 retardation to alternative programs shall be implemented by
  3 31 the department in a manner that can appropriately meet the
  3 32 needs of individuals at an overall lower cost to counties, the
  3 33 federal government, and the state.  In addition, the
  3 34 department shall take into consideration significant federal
  3 35 changes to the medical assistance program in formulating the
  4  1 department's actions under this subsection.  The department
  4  2 shall consult with the state-county management committee in
  4  3 adopting rules mental health and developmental disabilities
  4  4 commission shall adopt rules for oversight of facilities
  4  5 converted pursuant to this subsection.  A transition approach
  4  6 described in paragraph "a" may be modified as necessary to
  4  7 obtain federal waiver approval.  The department shall report
  4  8 on or before January 2, 1997, to the general assembly
  4  9 regarding its actions under this subsection and any federal
  4 10 response, and shall submit an update upon receiving a federal
  4 11 response to the waiver request or other action taken which
  4 12 requires a federal response.  If implementation of any of the
  4 13 provisions of this subsection does not require a federal
  4 14 waiver, the department shall implement the provisions in the
  4 15 fiscal year beginning July 1, 1996.
  4 16    Sec. 5.  Section 331.424A, subsection 1, Code Supplement
  4 17 2001, is amended to read as follows:
  4 18    1.  For the purposes of this chapter, unless the context
  4 19 otherwise requires, "services fund" means the county mental
  4 20 health, mental retardation, and developmental disabilities
  4 21 services fund created in subsection 2.  The county finance
  4 22 committee created in section 333A.2 shall consult with the
  4 23 state-county management committee mental health and
  4 24 developmental disabilities commission in adopting rules and
  4 25 prescribing forms for administering the services fund.
  4 26    Sec. 6.  Section 331.438, subsection 1, paragraph c, Code
  4 27 Supplement 2001, is amended to read as follows:
  4 28    c.  "Qualified mental health, mental retardation, and
  4 29 developmental disabilities services" means the services
  4 30 specified on forms issued by the county finance committee
  4 31 following consultation with the state-county management
  4 32 committee mental health and developmental disabilities
  4 33 commission.
  4 34    Sec. 7.  Section 331.438, subsection 4, paragraph a, Code
  4 35 Supplement 2001, is amended to read as follows:
  5  1    a.  A The mental health and developmental disabilities
  5  2 commission shall state-county management committee is created
  5  3 in the department of human services to make recommendations
  5  4 and take actions for joint state and county planning,
  5  5 implementing, and funding of mental health, mental
  5  6 retardation, and developmental disabilities services,
  5  7 including but not limited to developing and implementing
  5  8 fiscal and accountability controls, establishing management
  5  9 plans, and ensuring that eligible persons have access to
  5 10 appropriate and cost-effective services.
  5 11    Sec. 8.  Section 331.438, subsection 4, paragraph b, Code
  5 12 Supplement 2001, is amended by striking the paragraph.
  5 13    Sec. 9.  Section 331.438, subsection 4, paragraph c, Code
  5 14 Supplement 2001, is amended to read as follows:
  5 15    c.  The management committee mental health and
  5 16 developmental disabilities commission shall do all of the
  5 17 following:
  5 18    (1)  Identify characteristics of the service system,
  5 19 including amounts expended, equity of funding among counties,
  5 20 funding sources, provider types, service availability, and
  5 21 equity of service availability among counties and among
  5 22 persons served.
  5 23    (2)  Assess the accuracy and uniformity of recordkeeping
  5 24 and reporting in the service system.
  5 25    (3)  Identify for each county the factors associated with
  5 26 inflationary growth of the service system.
  5 27    (4)  Identify opportunities for containing service system
  5 28 growth.
  5 29    (5)  Make recommendations Consider proposals for revising
  5 30 service system administrative rules.
  5 31    (6)  Consider provisions and adopt rules for counties to
  5 32 implement a single point of accountability to plan, budget,
  5 33 and monitor county expenditures for the service system.  The
  5 34 provisions shall provide options for counties to implement the
  5 35 single point in collaboration with other counties.
  6  1    (7)  Develop criteria for annual county mental health,
  6  2 mental retardation, and developmental disabilities plans.
  6  3    (8)  Make recommendations to the council on human services
  6  4 for Adopt administrative rules identifying qualified mental
  6  5 health, mental retardation, and developmental disabilities
  6  6 service expenditures for purposes of state payment pursuant to
  6  7 subsection 1.
  6  8    (9)  Make recommendations to the council on human services
  6  9 for administrative Adopt rules for the county single entry
  6 10 point and clinical assessment processes required under section
  6 11 331.440 and other rules necessary for the implementation of
  6 12 county management plans and expenditure reports required for
  6 13 state payment pursuant to section 331.439.
  6 14    (10)  Make Consider recommendations to improve the programs
  6 15 and cost effectiveness of state and county contracting
  6 16 processes and procedures, including strategies for
  6 17 negotiations relating to managed care.  The recommendations
  6 18 developed implemented by the commission for the state and
  6 19 county regarding managed care shall include but are not
  6 20 limited to standards for limiting excess costs and profits,
  6 21 and for restricting cost shifting under a managed care system.
  6 22    (11)  Provide input, when appropriate, to the director of
  6 23 human services in any decision involving administrative rules
  6 24 which were initially recommended adopted by the management
  6 25 committee department of human services pertaining to the
  6 26 mental illness, mental retardation, and developmental
  6 27 disabilities services administered by counties.
  6 28    (12)  Identify the fiscal impact of existing or proposed
  6 29 legislation and administrative rules on state and county
  6 30 expenditures.
  6 31    (13)  No later than January 1, annually, submit a report to
  6 32 the governor, the general assembly, and the department of
  6 33 human services concerning the management committee's
  6 34 activities and findings.
  6 35    (14)  On or before December 1, 1994, submit to the governor
  7  1 and general assembly a methodology for the state and counties
  7  2 to move toward the goal of an equal partnership in the funding
  7  3 of mental health, mental retardation, and developmental
  7  4 disabilities services.  The committee consideration of
  7  5 methodology options shall include an expenditure per consumer
  7  6 basis.
  7  7    (15)  Make recommendations to the mental health and
  7  8 developmental disabilities commission for
  7  9    (13)  Adopt administrative rules providing statewide
  7 10 standards and a monitoring methodology to determine whether
  7 11 cost-effective individualized services are available as
  7 12 required pursuant to section 331.439, subsection 1, paragraph
  7 13 "b".
  7 14    (16) (14)  Make Consider recommendations to the mental
  7 15 health and developmental disabilities commission for and adopt
  7 16 administrative rules establishing statewide minimum standards
  7 17 for services and other support required to be available to
  7 18 persons covered by a county management plan under section
  7 19 331.439.
  7 20    (17) (15)  Make Consider recommendations to the mental
  7 21 health and developmental disabilities commission and counties
  7 22 for measuring and improving the quality of state and county
  7 23 mental health, mental retardation, and developmental
  7 24 disabilities services and other support.
  7 25    Sec. 10.  Section 331.439, subsection 1, unnumbered
  7 26 paragraph 1, Code 2001, is amended to read as follows:
  7 27    The state payment to eligible counties under this section
  7 28 shall be made as provided in sections 331.438 and 426B.2.  A
  7 29 county is eligible for the state payment, as defined in
  7 30 section 331.438, for the fiscal year beginning July 1, 1996,
  7 31 and for subsequent fiscal years if the director of human
  7 32 services, in consultation with the state-county management
  7 33 committee mental health and developmental disabilities
  7 34 commission, determines for a specific fiscal year that all of
  7 35 the following conditions are met:
  8  1    Sec. 11.  Section 331.439, subsection 1, paragraph b,
  8  2 unnumbered paragraph 1, Code 2001, is amended to read as
  8  3 follows:
  8  4    The county developed and implemented a county management
  8  5 plan for the county's mental health, mental retardation, and
  8  6 developmental disabilities services in accordance with the
  8  7 provisions of this paragraph "b".  The plan shall comply with
  8  8 the administrative rules adopted for this purpose by the
  8  9 council on human services mental health and developmental
  8 10 disabilities commission and is subject to the approval of the
  8 11 director of human services in consultation with the state-
  8 12 county management committee created in section 331.438
  8 13 commission.  The plan shall include a description of the
  8 14 county's service management provision for mental health,
  8 15 mental retardation, and developmental disabilities services.
  8 16 For mental retardation and developmental disabilities service
  8 17 management, the plan shall describe the county's development
  8 18 and implementation of a managed system of cost-effective
  8 19 individualized services and shall comply with the provisions
  8 20 of paragraph "d".  The goal of this part of the plan shall be
  8 21 to assist the individuals served to be as independent,
  8 22 productive, and integrated into the community as possible.
  8 23 The service management provisions for mental health shall
  8 24 comply with the provisions of paragraph "c".  A county is
  8 25 subject to all of the following provisions in regard to the
  8 26 county's management plan and planning process:
  8 27    Sec. 12.  Section 331.439, subsection 1, paragraph b,
  8 28 subparagraph (1), Code 2001, is amended to read as follows:
  8 29    (1)  The county shall have in effect an approved policies
  8 30 and procedures manual for the county's services fund.  The
  8 31 county management plan shall be defined in the manual.  The
  8 32 manual submitted by the county as part of the county's
  8 33 management plan for the fiscal year beginning July 1, 2000, as
  8 34 approved by the director of human services, shall remain in
  8 35 effect, subject to amendment.  An amendment to the manual
  9  1 shall be submitted to the department of human services at
  9  2 least forty-five days prior to the date of implementation.
  9  3 Prior to implementation of any amendment to the manual, the
  9  4 amendment must be approved by the director of human services
  9  5 in consultation with the state-county management committee
  9  6 mental health and developmental disabilities commission.
  9  7    Sec. 13.  Section 331.439, subsection 1, paragraph c,
  9  8 subparagraph (2), unnumbered paragraph 1, Code 2001, is
  9  9 amended to read as follows:
  9 10    The basis for determining whether a managed care system for
  9 11 mental health proposed by a county is comparable to a mental
  9 12 health managed care contractor approved by the department of
  9 13 human services shall include but is not limited to all of the
  9 14 following elements which shall be specified in administrative
  9 15 rules adopted by the council on human services in consultation
  9 16 with the state-county management committee mental health and
  9 17 developmental disabilities commission:
  9 18    Sec. 14.  Section 331.439, subsection 1, paragraph d, Code
  9 19 2001, is amended to read as follows:
  9 20    d.  For mental retardation and developmental disabilities
  9 21 services management, the county must either develop and
  9 22 implement a managed system of care which addresses a full
  9 23 array of appropriate services and cost-effective delivery of
  9 24 services or contract with a state-approved managed care
  9 25 contractor or contractors.  Any system or contract implemented
  9 26 under this paragraph shall incorporate a single entry point
  9 27 and clinical assessment process developed in accordance with
  9 28 the provisions of section 331.440.  The elements of the
  9 29 managed system of care and the state-approved managed care
  9 30 contract or contracts shall be specified in rules developed by
  9 31 the department of human services in consultation with the
  9 32 state-county management committee and adopted by the council
  9 33 on human services mental health and developmental disabilities
  9 34 commission.
  9 35    Sec. 15.  Section 331.439, subsection 3, paragraph b, Code
 10  1 2001, is amended to read as follows:
 10  2    b.  Based upon information contained in county management
 10  3 plans and budgets and proposals made by representatives of
 10  4 counties, the state-county management committee mental health
 10  5 and developmental disabilities commission shall recommend an
 10  6 allowed growth factor adjustment to the governor by November
 10  7 15 for the fiscal year which commences two years from the
 10  8 beginning date of the fiscal year in progress at the time the
 10  9 recommendation is made.  The allowed growth factor adjustment
 10 10 shall address costs associated with new consumers of service,
 10 11 service cost inflation, and investments for economy and
 10 12 efficiency.  In developing the service cost inflation
 10 13 recommendation, the committee commission shall consider the
 10 14 cost trends indicated by the gross expenditure amount reported
 10 15 in the expenditure reports submitted by counties pursuant to
 10 16 subsection 1, paragraph "a".  The governor shall consider the
 10 17 committee's commission's recommendation in developing the
 10 18 governor's recommendation for an allowed growth factor
 10 19 adjustment for such fiscal year.  The governor's
 10 20 recommendation shall be submitted at the time the governor's
 10 21 proposed budget for the succeeding fiscal year is submitted in
 10 22 accordance with chapter 8.
 10 23    Sec. 16.  Section 331.440, subsection 4, Code 2001, is
 10 24 amended to read as follows:
 10 25    4.  The council on human services mental health and
 10 26 developmental disabilities commission shall consider the
 10 27 recommendations of the state-county management committee
 10 28 established in section 331.438 county representatives in
 10 29 adopting rules outlining standards and requirements for
 10 30 implementation of the single entry point and clinical
 10 31 assessment processes on the date required by subsection 2.
 10 32 The rules shall permit counties options in implementing the
 10 33 process based upon a county's consumer population and
 10 34 available service delivery system.
 10 35    Sec. 17.  Section 426B.4, Code 2001, is amended to read as
 11  1 follows:
 11  2    426B.4  RULES.
 11  3    The council on human services mental health and
 11  4 developmental disabilities commission shall consult with the
 11  5 state-county management committee created in section 331.438
 11  6 county representatives and the director of human services in
 11  7 prescribing forms and adopting rules pursuant to chapter 17A
 11  8 to administer this chapter.
 11  9    Sec. 18.  Section 426B.5, subsection 2, paragraph c, Code
 11 10 Supplement 2001, is amended to read as follows:
 11 11    c.  A risk pool board is created.  The board shall consist
 11 12 of two county supervisors, two county auditors, a member of
 11 13 the state-county management committee created in section
 11 14 331.438 mental health and developmental disabilities
 11 15 commission who was not appointed by the Iowa state association
 11 16 of counties is not a member of a county board of supervisors
 11 17 or employed by a service provider, a member of the county
 11 18 finance committee created in chapter 333A who is not an
 11 19 elected official, and two single entry point process
 11 20 administrators, all appointed by the governor, and one member
 11 21 appointed by the director of human services.  All members
 11 22 appointed by the governor shall be subject to confirmation by
 11 23 the senate.  Members shall serve for three-year terms.  A
 11 24 vacancy shall be filled in the same manner as the original
 11 25 appointment.  Expenses and other costs of the risk pool board
 11 26 members representing counties shall be paid by the county of
 11 27 origin.  Expenses and other costs of risk pool board members
 11 28 who do not represent counties shall be paid from a source
 11 29 determined by the governor.  Staff assistance to the board
 11 30 shall be provided by the department of human services and
 11 31 counties.  Actuarial expenses and other direct administrative
 11 32 costs shall be charged to the pool.
 11 33    Sec. 19.  CODE EDITOR DIRECTIVE.  The Code editor shall
 11 34 amend the headnote to section 331.438 to remove the reference
 11 35 to "management committee" and instead reference the mental
 12  1 health and developmental disabilities commission or utilize
 12  2 other language as determined to be most appropriate by the
 12  3 Code editor.
 12  4    Sec. 20.  ADOPTED RULES.  Notwithstanding the transfer in
 12  5 this Act of the authority to adopt rules from the council on
 12  6 human services to the mental health and developmental
 12  7 disabilities commission, a rule adopted by the council on
 12  8 human services prior to July 1, 2002, shall remain in effect
 12  9 unless amended or repealed by the commission or pursuant to
 12 10 other executive or legislative branch action.
 12 11    Sec. 21.  COMMISSION MEMBERS.  The revision in the
 12 12 membership of the mental health and developmental disabilities
 12 13 commission in accordance with section 225C.5, as amended by
 12 14 this Act, shall be implemented by applying the new membership
 12 15 requirements for voting members as membership terms expire and
 12 16 other vacancies in membership occur.  The revision shall be
 12 17 fully complete on or before June 30, 2005.  
 12 18                           EXPLANATION
 12 19    This bill provides for the mental health and developmental
 12 20 disabilities commission to assume the duties of the state-
 12 21 county management committee, incorporates membership positions
 12 22 from the committee into the commission, and transfers certain
 12 23 rules adoption authority from the council on human services to
 12 24 the commission.
 12 25    Code section 225C.5, relating to the membership of the
 12 26 commission, is amended to make the following revisions in the
 12 27 membership appointed by the governor and confirmed by the
 12 28 senate:  the existing positions for county supervisors must be
 12 29 appointed from nominees submitted by the supervisors affiliate
 12 30 of the Iowa state association of counties, two positions are
 12 31 designated for administrators of the county single entry point
 12 32 process for mental health and developmental disabilities
 12 33 services, one member is to be nominated by the state council
 12 34 for the American association of federal, state, county, and
 12 35 municipal employees, one member is to be nominated by service
 13  1 consumers, and one member is to be nominated by service
 13  2 advocates.  In addition, four members of the general assembly
 13  3 are to be designated by legislative leaders to serve in an ex
 13  4 officio, nonvoting capacity.
 13  5    The bill includes conforming changes throughout the Code to
 13  6 change references to the state-county management committee to
 13  7 the commission and to transfer rules adoption authority for
 13  8 various county-administered mental health and developmental
 13  9 disabilities services from the council on human services to
 13 10 the commission.
 13 11    Under current law, the primary responsibilities and
 13 12 membership appointment provisions for the state-county
 13 13 management committee are in Code section 331.438 as part of
 13 14 the county home rule Code chapter.  The bill transfers the
 13 15 committee's duties to the commission, eliminates references to
 13 16 the committee, and repeals the committee's membership
 13 17 requirements in Code section 331.438.
 13 18    The bill includes a directive to the Code editor to make a
 13 19 conforming change to the headnote for Code section 331.438,
 13 20 provides that the rules adopted by the council on human
 13 21 services prior to the effective date of the Act will remain in
 13 22 effect until amended or repealed by the commission or pursuant
 13 23 to legislative or executive action, and provides that the
 13 24 changes in the membership of the commission are to be
 13 25 implemented by June 30, 2005, at the time there is membership
 13 26 attrition.  
 13 27 LSB 6404SS 79
 13 28 jp/sh/8
     

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