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Bills and Amendments: General Index     Bill History: General Index

Senate File 2248

Partial Bill History

Bill Text

PAG LIN
  1  1                           DIVISION I
  1  2      COMMISSION – SINGLE ENTRY POINT PROCESS NAME CHANGES
  1  3    Section 1.  Section 135C.23, subsection 2, unnumbered
  1  4 paragraph 2, Code 2003, is amended to read as follows:
  1  5    This section does not prohibit the admission of a patient
  1  6 with a history of dangerous or disturbing behavior to an
  1  7 intermediate care facility for persons with mental illness,
  1  8 intermediate care facility for persons with mental
  1  9 retardation, nursing facility, or county care facility when
  1 10 the intermediate care facility for persons with mental
  1 11 illness, intermediate care facility for persons with mental
  1 12 retardation, nursing facility, or county care facility has a
  1 13 program which has received prior approval from the department
  1 14 to properly care for and manage the patient.  An intermediate
  1 15 care facility for persons with mental illness, intermediate
  1 16 care facility for persons with mental retardation, nursing
  1 17 facility, or county care facility is required to transfer or
  1 18 discharge a resident with dangerous or disturbing behavior
  1 19 when the intermediate care facility for persons with mental
  1 20 illness, intermediate care facility for persons with mental
  1 21 retardation, nursing facility, or county care facility cannot
  1 22 control the resident's dangerous or disturbing behavior.  The
  1 23 department, in coordination with the state mental health, and
  1 24 developmental disabilities, and brain injury commission
  1 25 created in section 225C.5, shall adopt rules pursuant to
  1 26 chapter 17A for programs to be required in intermediate care
  1 27 facilities for persons with mental illness, intermediate care
  1 28 facilities for persons with mental retardation, nursing
  1 29 facilities, and county care facilities that admit patients or
  1 30 have residents with histories of dangerous or disturbing
  1 31 behavior.
  1 32    Sec. 2.  Section 154D.2, subsection 1, paragraph b, Code
  1 33 2003, is amended to read as follows:
  1 34    b.  Has at least two years of supervised clinical
  1 35 experience or its equivalent as approved by the board in
  2  1 consultation with the mental health, and developmental
  2  2 disabilities, and brain injury commission created in section
  2  3 225C.5.
  2  4    Sec. 3.  Section 154D.2, subsection 2, paragraph b, Code
  2  5 2003, is amended to read as follows:
  2  6    b.  Has at least two years of clinical experience,
  2  7 supervised by a licensee, in assessing mental health needs and
  2  8 problems and in providing appropriate mental health services
  2  9 as approved by the board of behavioral science examiners in
  2 10 consultation with the mental health, and developmental
  2 11 disabilities, and brain injury commission created in section
  2 12 225C.5.
  2 13    Sec. 4.  Section 225C.2, subsection 2, Code 2003, is
  2 14 amended to read as follows:
  2 15    2.  "Commission" means the mental health, and developmental
  2 16 disabilities, and brain injury commission.
  2 17    Sec. 5.  Section 225C.5, subsection 1, unnumbered paragraph
  2 18 1, Code Supplement 2003, is amended to read as follows:
  2 19    A mental health, and developmental disabilities, and brain
  2 20 injury commission is created as the state policy-making body
  2 21 for the provision of services to persons with mental illness,
  2 22 mental retardation or other developmental disabilities, or
  2 23 brain injury.  The commission shall consist of sixteen voting
  2 24 members appointed to three-year staggered terms by the
  2 25 governor and subject to confirmation by the senate.
  2 26 Commission members shall be appointed on the basis of interest
  2 27 and experience in the fields of mental health, mental
  2 28 retardation or other developmental disabilities, and brain
  2 29 injury, in a manner so as to ensure adequate representation
  2 30 from persons with disabilities and individuals knowledgeable
  2 31 concerning disability services.  The department shall provide
  2 32 staff support to the commission, and the commission may
  2 33 utilize staff support and other assistance provided to the
  2 34 commission by other persons.  The commission shall meet at
  2 35 least four times per year.  Members of the commission shall
  3  1 include the following persons who, at the time of appointment
  3  2 to the commission, are active members of the indicated groups:
  3  3    Sec. 6.  Section 225C.7, subsection 3, Code 2003, is
  3  4 amended to read as follows:
  3  5    3.  If a county has not established or is not affiliated
  3  6 with a community mental health center under chapter 230A, the
  3  7 county shall expend a portion of the money received under this
  3  8 appropriation to contract with a community mental health
  3  9 center to provide mental health services to the county's
  3 10 residents.  If such a contractual relationship is unworkable
  3 11 or undesirable, the mental health and developmental
  3 12 disabilities commission may waive the expenditure requirement.
  3 13 However, if the commission waives the requirement, the
  3 14 commission shall address the specific concerns of the county
  3 15 and shall attempt to facilitate the provision of mental health
  3 16 services to the county's residents through an affiliation
  3 17 agreement or other means.
  3 18    Sec. 7.  Section 227.4, Code 2003, is amended to read as
  3 19 follows:
  3 20    227.4  STANDARDS FOR CARE OF PERSONS WITH MENTAL ILLNESS OR
  3 21 MENTAL RETARDATION DEVELOPMENTAL DISABILITIES IN COUNTY CARE
  3 22 FACILITIES.
  3 23    The administrator, in cooperation with the department of
  3 24 inspections and appeals, shall recommend, and the mental
  3 25 health, and developmental disabilities, and brain injury
  3 26 commission created in section 225C.5 shall adopt standards for
  3 27 the care of and services to persons with mental illness or
  3 28 mental retardation developmental disabilities residing in
  3 29 county care facilities.  The standards shall be enforced by
  3 30 the department of inspections and appeals as a part of the
  3 31 licensure inspection conducted pursuant to chapter 135C.  The
  3 32 objective of the standards is to ensure that persons with
  3 33 mental illness or mental retardation developmental
  3 34 disabilities who are residents of county care facilities are
  3 35 not only adequately fed, clothed, and housed, but are also
  4  1 offered reasonable opportunities for productive work and
  4  2 recreational activities suited to their physical and mental
  4  3 abilities and offering both a constructive outlet for their
  4  4 energies and, if possible, therapeutic benefit.  When
  4  5 recommending standards under this section, the administrator
  4  6 shall designate an advisory committee representing
  4  7 administrators of county care facilities, county mental health
  4  8 and developmental disabilities regional planning councils, and
  4  9 county care facility resident advocate committees to assist in
  4 10 the establishment of standards.
  4 11    Sec. 8.  Section 229.24, subsection 3, unnumbered paragraph
  4 12 1, Code 2003, is amended to read as follows:
  4 13    If all or part of the costs associated with hospitalization
  4 14 of an individual under this chapter are chargeable to a county
  4 15 of legal settlement, the clerk of the district court shall
  4 16 provide to the county of legal settlement and to the county in
  4 17 which the hospitalization order is entered, in a form
  4 18 prescribed by the mental health, and developmental
  4 19 disabilities, and brain injury commission, the following
  4 20 information pertaining to the individual which would be
  4 21 confidential under subsection 1:
  4 22    Sec. 9.  Section 230A.2, Code 2003, is amended to read as
  4 23 follows:
  4 24    230A.2  SERVICES OFFERED.
  4 25    A community mental health center established or operating
  4 26 as authorized by section 230A.1 may offer to residents of the
  4 27 county or counties it serves any or all of the mental health
  4 28 services defined by the mental health, and developmental
  4 29 disabilities, and brain injury commission in the state mental
  4 30 health plan.
  4 31    Sec. 10.  Section 230A.16, unnumbered paragraph 1, Code
  4 32 2003, is amended to read as follows:
  4 33    The administrator of the division of mental health and
  4 34 developmental disabilities of the department of human services
  4 35 shall recommend and the mental health, and developmental
  5  1 disabilities, and brain injury commission shall adopt
  5  2 standards for community mental health centers and
  5  3 comprehensive community mental health programs, with the
  5  4 overall objective of ensuring that each center and each
  5  5 affiliate providing services under contract with a center
  5  6 furnishes high quality mental health services within a
  5  7 framework of accountability to the community it serves.  The
  5  8 standards shall be in substantial conformity with those of the
  5  9 psychiatric committee of the joint commission on accreditation
  5 10 of health care organizations and other recognized national
  5 11 standards for evaluation of psychiatric facilities unless in
  5 12 the judgment of the administrator of the division of mental
  5 13 health and developmental disabilities, with approval of the
  5 14 mental health, and developmental disabilities, and brain
  5 15 injury commission, there are sound reasons for departing from
  5 16 the standards.  When recommending standards under this
  5 17 section, the administrator of the division shall designate an
  5 18 advisory committee representing boards of directors and
  5 19 professional staff of community mental health centers to
  5 20 assist in the formulation or revision of standards.  At least
  5 21 a simple majority of the members of the advisory committee
  5 22 shall be lay representatives of community mental health center
  5 23 boards of directors.  At least one member of the advisory
  5 24 committee shall be a member of a county board of supervisors.
  5 25 The standards recommended under this section shall include
  5 26 requirements that each community mental health center
  5 27 established or operating as authorized by section 230A.1
  5 28 shall:
  5 29    Sec. 11.  Section 230A.17, Code 2003, is amended to read as
  5 30 follows:
  5 31    230A.17  REVIEW AND EVALUATION.
  5 32    The administrator of the division of mental health and
  5 33 developmental disabilities of the department of human services
  5 34 may review and evaluate any community mental health center
  5 35 upon the recommendation of the mental health, and
  6  1 developmental disabilities, and brain injury commission, and
  6  2 shall do so upon the written request of the center's board of
  6  3 directors, its chief medical or administrative officer, or the
  6  4 board of supervisors of any county from which the center
  6  5 receives public funds.  The cost of the review shall be paid
  6  6 by the division.
  6  7    Sec. 12.  Section 230A.18, Code 2003, is amended to read as
  6  8 follows:
  6  9    230A.18  REPORT OF REVIEW AND EVALUATION.
  6 10    Upon completion of a review made pursuant to section
  6 11 230A.17, the review shall be submitted to the board of
  6 12 directors and chief medical or administrative officer of the
  6 13 center.  If the review concludes that the center fails to meet
  6 14 any of the standards established pursuant to section 230A.16,
  6 15 subsection 1, and that the response of the center to this
  6 16 finding is unsatisfactory, these conclusions shall be reported
  6 17 to the mental health, and developmental disabilities, and
  6 18 brain injury commission which may forward the conclusions to
  6 19 the board of directors of the center and request an
  6 20 appropriate response within thirty days.  If no response is
  6 21 received within thirty days, or if the response is
  6 22 unsatisfactory, the commission may call this fact to the
  6 23 attention of the board of supervisors of the county or
  6 24 counties served by the center, and in doing so shall indicate
  6 25 what corrective steps have been recommended to the center's
  6 26 board of directors.
  6 27    Sec. 13.  Section 231.44, subsection 2, Code Supplement
  6 28 2003, is amended to read as follows:
  6 29    2.  The responsibilities of the resident advocate committee
  6 30 are in accordance with the rules adopted by the commission
  6 31 pursuant to chapter 17A.  When adopting the rules, the
  6 32 commission shall consider the needs of residents of elder
  6 33 group homes as defined in section 231B.1 and each category of
  6 34 licensed health care facility as defined in section 135C.1,
  6 35 subsection 6, and the services each facility may render.  The
  7  1 commission shall coordinate the development of rules with the
  7  2 mental health, and developmental disabilities, and brain
  7  3 injury commission created in section 225C.5 to the extent the
  7  4 rules would apply to a facility primarily serving persons with
  7  5 mental illness, mental retardation, or a other developmental
  7  6 disability, or brain injury.  The commission shall coordinate
  7  7 the development of appropriate rules with other state
  7  8 agencies.
  7  9    Sec. 14.  Section 249A.4, subsection 15, Code Supplement
  7 10 2003, is amended to read as follows:
  7 11    15.  Establish appropriate reimbursement rates for
  7 12 community mental health centers that are accredited by the
  7 13 mental health, and developmental disabilities, and brain
  7 14 injury commission.  The reimbursement rates shall be phased in
  7 15 over the three-year period beginning July 1, 1998, and ending
  7 16 June 30, 2001.
  7 17    Sec. 15.  Section 249A.12, subsection 5, paragraph a,
  7 18 unnumbered paragraph 1, Code Supplement 2003, is amended to
  7 19 read as follows:
  7 20    The mental health, and developmental disabilities, and
  7 21 brain injury commission shall recommend to the department the
  7 22 actions necessary to assist in the transition of individuals
  7 23 being served in an intermediate care facility for persons with
  7 24 mental retardation, who are appropriate for the transition, to
  7 25 services funded under a medical assistance waiver for home and
  7 26 community-based services for persons with mental retardation
  7 27 in a manner which maximizes the use of existing public and
  7 28 private facilities.  The actions may include but are not
  7 29 limited to submitting any of the following or a combination of
  7 30 any of the following as a request for a revision of the
  7 31 medical assistance waiver for home and community-based
  7 32 services for persons with mental retardation in effect as of
  7 33 June 30, 1996:
  7 34    Sec. 16.  Section 249A.12, subsection 5, paragraph b, Code
  7 35 Supplement 2003, is amended to read as follows:
  8  1    b.  In implementing the provisions of this subsection, the
  8  2 mental health, and developmental disabilities, and brain
  8  3 injury commission shall consult with other states.  The waiver
  8  4 revision request or other action necessary to assist in the
  8  5 transition of service provision from intermediate care
  8  6 facilities for persons with mental retardation to alternative
  8  7 programs shall be implemented by the department in a manner
  8  8 that can appropriately meet the needs of individuals at an
  8  9 overall lower cost to counties, the federal government, and
  8 10 the state.  In addition, the department shall take into
  8 11 consideration significant federal changes to the medical
  8 12 assistance program in formulating the department's actions
  8 13 under this subsection.  The department shall consult with the
  8 14 mental health, and developmental disabilities, and brain
  8 15 injury commission in adopting rules for oversight of
  8 16 facilities converted pursuant to this subsection.  A
  8 17 transition approach described in paragraph "a" may be modified
  8 18 as necessary to obtain federal waiver approval.
  8 19    Sec. 17.  Section 249A.31, subsection 1, Code 2003, is
  8 20 amended to read as follows:
  8 21    1.  Providers of individual case management services for
  8 22 persons with mental retardation, a developmental disability,
  8 23 or chronic mental illness in accordance with standards adopted
  8 24 by the mental health, and developmental disabilities, and
  8 25 brain injury commission pursuant to section 225C.6.
  8 26    Sec. 18.  Section 331.424A, subsection 1, Code Supplement
  8 27 2003, is amended to read as follows:
  8 28    1.  For the purposes of this chapter, unless the context
  8 29 otherwise requires, "services fund" means the county mental
  8 30 health, mental retardation, and developmental disabilities
  8 31 services fund created in subsection 2.  The county finance
  8 32 committee created in section 333A.2 shall consult with the
  8 33 mental health and developmental disabilities state commission
  8 34 in adopting rules and prescribing forms for administering the
  8 35 services fund.
  9  1    Sec. 19.  Section 331.438, subsection 1, paragraph c, Code
  9  2 2003, is amended to read as follows:
  9  3    c.  "Qualified mental health, mental retardation, and
  9  4 developmental disabilities services" means the services
  9  5 specified on forms issued by the county finance committee
  9  6 following consultation with the mental health and
  9  7 developmental disabilities state commission.
  9  8    Sec. 20.  Section 331.438, subsection 1, Code 2003, is
  9  9 amended by adding the following new paragraph:
  9 10    NEW PARAGRAPH.  cc.  "State commission" means the mental
  9 11 health, developmental disabilities, and brain injury
  9 12 commission created in section 225C.5.
  9 13    Sec. 21.  Section 331.438, subsection 4, paragraph a, Code
  9 14 2003, is amended to read as follows:
  9 15    a.  The mental health and developmental disabilities state
  9 16 commission shall make recommendations and take actions for
  9 17 joint state and county planning, implementing, and funding of
  9 18 mental health, mental retardation, and developmental
  9 19 disabilities, and brain injury services, including but not
  9 20 limited to developing and implementing fiscal and
  9 21 accountability controls, establishing management plans, and
  9 22 ensuring that eligible persons have access to appropriate and
  9 23 cost-effective services.
  9 24    Sec. 22.  Section 331.438, subsection 4, paragraph b,
  9 25 unnumbered paragraph 1, Code 2003, is amended to read as
  9 26 follows:
  9 27    The mental health and developmental disabilities state
  9 28 commission shall do all of the following:
  9 29    Sec. 23.  Section 331.438, subsection 4, paragraph b,
  9 30 subparagraphs (6) and (9), Code 2003, are amended to read as
  9 31 follows:
  9 32    (6)  Consider provisions and adopt rules for counties to
  9 33 implement a single central point of accountability
  9 34 coordination to plan, budget, and monitor county expenditures
  9 35 for the service system.  The provisions shall provide options
 10  1 for counties to implement the single central point of
 10  2 coordination in collaboration with other counties.
 10  3    (9)  Adopt rules for the county single entry central point
 10  4 of coordination and clinical assessment processes required
 10  5 under section 331.440 and other rules necessary for the
 10  6 implementation of county management plans and expenditure
 10  7 reports required for state payment pursuant to section
 10  8 331.439.
 10  9    Sec. 24.  Section 331.439, subsection 1, unnumbered
 10 10 paragraph 1, Code 2003, is amended to read as follows:
 10 11    The state payment to eligible counties under this section
 10 12 shall be made as provided in sections 331.438 and 426B.2.  A
 10 13 county is eligible for the state payment, as defined in
 10 14 section 331.438, for the a fiscal year beginning July 1, 1996,
 10 15 and for subsequent fiscal years if the director of human
 10 16 services, in consultation with the mental health and
 10 17 developmental disabilities state commission, determines for a
 10 18 specific fiscal year that all of the following conditions are
 10 19 met:
 10 20    Sec. 25.  Section 331.439, subsection 1, paragraph b,
 10 21 unnumbered paragraph 1, Code 2003, is amended to read as
 10 22 follows:
 10 23    The county developed and implemented a county management
 10 24 plan for the county's mental health, mental retardation, and
 10 25 developmental disabilities services in accordance with the
 10 26 provisions of this paragraph "b".  The plan shall comply with
 10 27 the administrative rules adopted for this purpose by the
 10 28 mental health and developmental disabilities state commission
 10 29 and is subject to the approval of the director of human
 10 30 services in consultation with the commission.  The plan shall
 10 31 include a description of the county's service management
 10 32 provision for mental health, mental retardation, and
 10 33 developmental disabilities services.  For mental retardation
 10 34 and developmental disabilities service management, the plan
 10 35 shall describe the county's development and implementation of
 11  1 a managed system of cost-effective individualized services and
 11  2 shall comply with the provisions of paragraph "d".  The goal
 11  3 of this part of the plan shall be to assist the individuals
 11  4 served to be as independent, productive, and integrated into
 11  5 the community as possible.  The service management provisions
 11  6 for mental health shall comply with the provisions of
 11  7 paragraph "c".  A county is subject to all of the following
 11  8 provisions in regard to the county's management plan and
 11  9 planning process:
 11 10    Sec. 26.  Section 331.439, subsection 1, paragraph b,
 11 11 subparagraph (1), Code 2003, is amended to read as follows:
 11 12    (1)  The county shall have in effect an approved policies
 11 13 and procedures manual for the county's services fund.  The
 11 14 county management plan shall be defined in the manual.  The
 11 15 manual submitted by the county as part of the county's
 11 16 management plan for the fiscal year beginning July 1, 2000, as
 11 17 approved by the director of human services, shall remain in
 11 18 effect, subject to amendment.  An amendment to the manual
 11 19 shall be submitted to the department of human services at
 11 20 least forty-five days prior to the date of implementation.
 11 21 Prior to implementation of any amendment to the manual, the
 11 22 amendment must be approved by the director of human services
 11 23 in consultation with the mental health and developmental
 11 24 disabilities state commission.
 11 25    Sec. 27.  Section 331.439, subsection 1, paragraph c,
 11 26 subparagraph (2), unnumbered paragraph 1, Code 2003, is
 11 27 amended to read as follows:
 11 28    A managed care system for mental health proposed by a
 11 29 county shall include but is not limited to all of the
 11 30 following elements which shall be specified in administrative
 11 31 rules adopted by the mental health and developmental
 11 32 disabilities state commission:
 11 33    Sec. 28.  Section 331.439, subsection 1, paragraph d, Code
 11 34 2003, is amended to read as follows:
 11 35    d.  For mental retardation and developmental disabilities
 12  1 services management, the county must either develop and
 12  2 implement a managed system of care which addresses a full
 12  3 array of appropriate services and cost-effective delivery of
 12  4 services or contract with a state-approved managed care
 12  5 contractor or contractors.  Any system or contract implemented
 12  6 under this paragraph shall incorporate a single entry central
 12  7 point of coordination and clinical assessment process
 12  8 developed in accordance with the provisions of section
 12  9 331.440.  The elements of the county managed system of care
 12 10 shall be specified in rules developed by the department of
 12 11 human services in consultation with and adopted by the mental
 12 12 health and developmental disabilities state commission.
 12 13    Sec. 29.  Section 331.439, subsection 3, paragraph b, Code
 12 14 2003, is amended to read as follows:
 12 15    b.  Based upon information contained in county management
 12 16 plans and budgets and proposals made by representatives of
 12 17 counties, the mental health and developmental disabilities
 12 18 state commission shall recommend an allowed growth factor
 12 19 adjustment to the governor by November 15 for the fiscal year
 12 20 which commences two years from the beginning date of the
 12 21 fiscal year in progress at the time the recommendation is
 12 22 made.  The allowed growth factor adjustment shall address
 12 23 costs associated with new consumers of service, service cost
 12 24 inflation, and investments for economy and efficiency.  In
 12 25 developing the service cost inflation recommendation, the
 12 26 state commission shall consider the cost trends indicated by
 12 27 the gross expenditure amount reported in the expenditure
 12 28 reports submitted by counties pursuant to subsection 1,
 12 29 paragraph "a".  The governor shall consider the state
 12 30 commission's recommendation in developing the governor's
 12 31 recommendation for an allowed growth factor adjustment for
 12 32 such fiscal year.  The governor's recommendation shall be
 12 33 submitted at the time the governor's proposed budget for the
 12 34 succeeding fiscal year is submitted in accordance with chapter
 12 35 8.
 13  1    Sec. 30.  Section 331.440, Code 2003, is amended to read as
 13  2 follows:
 13  3    331.440  MENTAL HEALTH, MENTAL RETARDATION, AND
 13  4 DEVELOPMENTAL DISABILITIES SERVICES – SINGLE ENTRY CENTRAL
 13  5 POINT OF COORDINATION PROCESS.
 13  6    1.  a.  For the purposes of this section, unless the
 13  7 context otherwise requires, "single entry "central point of
 13  8 coordination process" means a single entry central point of
 13  9 coordination process established by a county or consortium of
 13 10 counties for the delivery of mental health, mental
 13 11 retardation, and developmental disabilities services which are
 13 12 paid for in whole or in part by county funds.  The single
 13 13 entry central point of coordination process may include but is
 13 14 not limited to reviewing a person's eligibility for services,
 13 15 determining the appropriateness of the type, level, and
 13 16 duration of services, and performing periodic review of the
 13 17 person's continuing eligibility and need for services.  Any
 13 18 recommendations developed concerning a person's plan of
 13 19 services shall be consistent with the person's unique
 13 20 strengths, circumstances, priorities, concerns, abilities, and
 13 21 capabilities.  For those services funded under the medical
 13 22 assistance program, the single entry central point of
 13 23 coordination process shall be used to assure that the person
 13 24 is aware of the appropriate service options available to the
 13 25 person.
 13 26    b.  The single entry central point of coordination process
 13 27 may include a clinical assessment process to identify a
 13 28 person's service needs and to make recommendations regarding
 13 29 the person's plan for services.  The clinical assessment
 13 30 process shall utilize qualified mental health professionals
 13 31 and qualified mental retardation professionals.
 13 32    c.  The single entry central point of coordination and
 13 33 clinical assessment process shall include provision for the
 13 34 county's participation in a management information system
 13 35 developed in accordance with rules adopted pursuant to
 14  1 subsection 3.
 14  2    2.  The department of human services shall seek federal
 14  3 approval as necessary for the single entry central point of
 14  4 coordination and clinical assessment processes to be eligible
 14  5 for federal financial participation under the medical
 14  6 assistance program.  A county may implement the single entry
 14  7 central point of coordination process as part of a consortium
 14  8 of counties and may implement the process beginning with the
 14  9 fiscal year ending June 30, 1995.
 14 10    3.  An application for services may be made through the
 14 11 single entry central point of coordination process of a
 14 12 person's county of residence.  However, if a person who is
 14 13 subject to a single entry central point of coordination
 14 14 process has legal settlement in another county or the costs of
 14 15 services or other support provided to the person are the
 14 16 financial responsibility of the state, an authorization
 14 17 through the single entry central point of coordination process
 14 18 shall be coordinated with the person's county of legal
 14 19 settlement or with the state, as applicable.  The county of
 14 20 residence and county of legal settlement of a person subject
 14 21 to a single entry central point of coordination process may
 14 22 mutually agree that the single entry central point of
 14 23 coordination process functions shall be performed by the
 14 24 single entry central point of coordination process of the
 14 25 person's county of legal settlement.
 14 26    4.  The mental health and developmental disabilities state
 14 27 commission shall consider the recommendations of county
 14 28 representatives in adopting rules outlining standards and
 14 29 requirements for implementation of the single entry central
 14 30 point of coordination and clinical assessment processes on the
 14 31 date required by subsection 2.  The rules shall permit
 14 32 counties options in implementing the process based upon a
 14 33 county's consumer population and available service delivery
 14 34 system.
 14 35    Sec. 31.  Section 426B.4, Code 2003, is amended to read as
 15  1 follows:
 15  2    426B.4  RULES.
 15  3    The mental health, and developmental disabilities, and
 15  4 brain injury commission shall consult with county
 15  5 representatives and the director of human services in
 15  6 prescribing forms and adopting rules pursuant to chapter 17A
 15  7 to administer this chapter.
 15  8    Sec. 32.  Section 426B.5, subsection 2, paragraph c, Code
 15  9 Supplement 2003, is amended to read as follows:
 15 10    c.  A risk pool board is created.  The board shall consist
 15 11 of two county supervisors, two county auditors, a member of
 15 12 the mental health, and developmental disabilities, and brain
 15 13 injury commission who is not a member of a county board of
 15 14 supervisors, a member of the county finance committee created
 15 15 in chapter 333A who is not an elected official, a
 15 16 representative of a provider of mental health or developmental
 15 17 disabilities services selected from nominees submitted by the
 15 18 Iowa association of community providers, and two single entry
 15 19 central point of coordination process administrators, all
 15 20 appointed by the governor, and one member appointed by the
 15 21 director of human services.  All members appointed by the
 15 22 governor shall be subject to confirmation by the senate.
 15 23 Members shall serve for three-year terms.  A vacancy shall be
 15 24 filled in the same manner as the original appointment.
 15 25 Expenses and other costs of the risk pool board members
 15 26 representing counties shall be paid by the county of origin.
 15 27 Expenses and other costs of risk pool board members who do not
 15 28 represent counties shall be paid from a source determined by
 15 29 the governor.  Staff assistance to the board shall be provided
 15 30 by the department of human services and counties.  Actuarial
 15 31 expenses and other direct administrative costs shall be
 15 32 charged to the pool.
 15 33    Sec. 33.  SINGLE ENTRY POINT PROCESS AND COMMISSION
 15 34 TERMINOLOGY CHANGES – CODE EDITOR'S DIRECTIVE.
 15 35    1.  Sections 218.99, 222.2, 222.13, 222.13A, 222.28,
 16  1 222.59, 222.60, 222.61, 222.62, 222.64, 222.73, 225.11,
 16  2 225.15, 225.17, 225C.2, 225C.14, 225C.16, 227.10, 229.1,
 16  3 229.1B, 229.11, 229.13, 229.14, 229.14A, 229.42, 230.1,
 16  4 230A.13, 249A.26, 331.439, and 331.440A, Code 2003, and
 16  5 sections 225C.5, 232.2, and 235.7, Code Supplement 2003, are
 16  6 amended by striking the term "single entry point process" and
 16  7 inserting in lieu thereof the term "central point of
 16  8 coordination process".
 16  9    2.  In addition to the name change for the single entry
 16 10 point process, this division of this Act changes the name of
 16 11 the mental health and developmental disabilities commission to
 16 12 the mental health, developmental disabilities, and brain
 16 13 injury commission.  The Code editor shall correct any
 16 14 references to the term "single entry point process" or the
 16 15 term "mental health and developmental disabilities commission"
 16 16 anywhere else in the Iowa Code, in any bills awaiting
 16 17 codification, and in any bills enacted by the Eightieth
 16 18 General Assembly, 2004 Regular Session or any extraordinary
 16 19 session.  
 16 20                           DIVISION II
 16 21                     REDESIGN IMPLEMENTATION
 16 22    Sec. 34.  NEW SECTION.  225C.6A  MENTAL HEALTH,
 16 23 DEVELOPMENTAL DISABILITY, AND BRAIN INJURY SERVICE SYSTEM
 16 24 REDESIGN IMPLEMENTATION.
 16 25    1.  PURPOSE.  It is the intent of the general assembly to
 16 26 implement a redesign of the mental health, developmental
 16 27 disability, and brain injury service system over a period of
 16 28 years in order to transition to a coordinated system for
 16 29 Iowans with mental illness, mental retardation or other
 16 30 developmental disabilities, or brain injury.
 16 31    2.  INITIAL ACTIVITIES.  For the fiscal years beginning
 16 32 July 1, 2004, and July 1, 2005, the commission shall do the
 16 33 following:
 16 34    a.  Identify sources of revenue to support statewide
 16 35 delivery of core disability services to eligible disability
 17  1 populations.
 17  2    b.  Further develop adult disability services system
 17  3 redesign proposals and propose a redesign of the children's
 17  4 disability service system.  The redesign of the children's
 17  5 system shall address issues associated with an individual's
 17  6 transition between the two systems.
 17  7    c.  Plan, collect, and analyze data as necessary to issue
 17  8 cost estimates for serving additional populations and
 17  9 providing core disability services statewide.
 17 10    d.  With consumer input, identify and propose standardized
 17 11 functional assessment tools and processes for use in the
 17 12 eligibility determination process when eligibility for a
 17 13 particular disability population group is implemented.  The
 17 14 tools and processes shall be integrated with those utilized
 17 15 for the medical assistance program under chapter 249A.  For
 17 16 the initial diagnostic criteria, the commission shall consider
 17 17 identifying a qualifying functional assessment score and any
 17 18 of the following diagnoses:  mental illness, chronic mental
 17 19 illness, mental retardation, developmental disability, or
 17 20 brain injury.
 17 21    e.  Propose case rates for disability services.
 17 22    f.  Work with county representatives and other qualified
 17 23 persons to develop an implementation plan for replacing the
 17 24 county of legal settlement approach to determining service
 17 25 system funding responsibilities with an approach based upon
 17 26 residency.  The plan shall address a statewide standard for
 17 27 proof of residency, identify a plan for establishing a data
 17 28 system for identifying residency of eligible individuals,
 17 29 address transition issues for individuals who began residing
 17 30 in a county due to a court order or criminal sentence or to
 17 31 obtain services in that county, recommend an approach for
 17 32 contesting a residency determination, and address other
 17 33 implementation issues.  In addition, the commission shall
 17 34 propose an alternative means for the resolution of disputes
 17 35 under the legal settlement approach that would expedite and
 18  1 improve the legal settlement determination process.
 18  2    Sec. 35.  OTHER REDESIGN ACTIVITIES.
 18  3    1.  The department of human services and the mental health,
 18  4 developmental disabilities, and brain injury commission shall
 18  5 report on the actions taken and proposals made to implement
 18  6 the provisions of section 225C.6A, as enacted by this Act, in
 18  7 the commission's annual report to the governor and general
 18  8 assembly submitted pursuant to section 225C.6 for
 18  9 consideration by the general assemblies meeting in 2005, 2006,
 18 10 and 2007.  In addition, the department and commission shall
 18 11 submit a progress report to the governor and general assembly
 18 12 in July 2004, July 2005, and July 2006, on the implementation
 18 13 of the provisions.  Any proposal shall include data needed to
 18 14 address the proposal, including the potential impact on
 18 15 counties bordering other states.
 18 16    2.  Subject to funding availability, the department and
 18 17 commission shall address all of the following state-level
 18 18 adult disability service system redesign activities during the
 18 19 fiscal year beginning July 1, 2004, and ending June 30, 2005:
 18 20    a.  Propose a new disability services information
 18 21 technology system.
 18 22    b.  Improve state administration of disability services by
 18 23 consolidating disability services into a new departmental
 18 24 division or other appropriate strategy.
 18 25    c.  Improve the interfaces between departmental
 18 26 administrative units and other state agencies directly or
 18 27 indirectly involved with persons with mental illness,
 18 28 developmental disabilities, or brain injury.
 18 29    d.  Solicit and incorporate input regarding the service
 18 30 system and service system funding from persons receiving
 18 31 services, service coordination providers, and county central
 18 32 point of coordination process administrators.
 18 33    e.  Provide information to the public regarding the service
 18 34 system.  
 18 35                           EXPLANATION
 19  1    This bill addresses redesign of the system for services and
 19  2 other support provided for persons with mental illness, mental
 19  3 retardation or other developmental disabilities, or brain
 19  4 injury (MI/MR/DD/BI).  The bill is organized into divisions.
 19  5    Division I changes the name of the mental health and
 19  6 developmental disabilities commission to the mental health,
 19  7 developmental disabilities, and brain injury commission
 19  8 throughout the Code.  The commission is part of the department
 19  9 of human services (DHS).  The division also changes the term
 19 10 "single entry point process" to "central point of coordination
 19 11 process".  This process is used by counties to manage county
 19 12 services to persons with MI/DD/BI.  The division includes a
 19 13 directive to the Code editor to make the terminology changes
 19 14 in other enactments.
 19 15    Division II provides legislative intent for implementation
 19 16 of system redesign over a period of years.  New Code section
 19 17 225C.6A states the purpose of the system redesign and directs
 19 18 the commission to perform various redesign activities in
 19 19 fiscal years 2004-2005 and 2005-2006.  An uncodified section
 19 20 includes other implementation activities for the commission
 19 21 and the department of human services and includes semiannual
 19 22 reporting requirements.  
 19 23 LSB 5250SV 80
 19 24 jp/pj/5
     
Text: SF02247                           Text: SF02249
Text: SF02200 - SF02299                 Text: SF Index
Bills and Amendments: General Index     Bill History: General Index

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