H.F. _____ DIVISION I 1 ACCESS TO CERTAIN MENTAL HEALTH, SUBSTANCE ABUSE, AND 2 DISABILITY SERVICES 3 Section 1. Section 331.391, subsection 4, Code 2017, is 4 amended to read as follows: 5 4. If a region is meeting the financial obligations for 6 implementation of its regional service system management 7 plan for a fiscal year and residual funding is anticipated, 8 the regional administrator shall reserve an adequate amount 9 for cash flow of expenditure obligations in the next fiscal 10 year. The cash flow amount shall not exceed twenty-five 11 percent of the gross expenditures budgeted for the combined 12 account or for all regional accounts for the fiscal year in 13 progress. Residual funding remaining after the cash flow 14 amount is reserved shall be used to expand the region’s core 15 services under section 331.397, subsection 4 , and then to make 16 additional core service domains available in the region as 17 enumerated in section 331.397, subsection 6 . 18 Sec. 2. Section 331.397, subsection 4, Code 2017, is amended 19 by adding the following new paragraphs: 20 NEW PARAGRAPH . g. Comprehensive facility and 21 community-based crisis services, including but not limited to 22 all of the following: 23 (1) Twenty-four-hour crisis hotline. 24 (2) Mobile response. 25 (3) Twenty-three-hour crisis observation and holding, and 26 crisis stabilization facility and community-based services. 27 (4) Crisis residential services. 28 NEW PARAGRAPH . h. Subacute services provided in facility 29 and community-based settings. 30 NEW PARAGRAPH . i. Justice system-involved services, 31 including but not limited to all of the following: 32 (1) Jail diversion. 33 (2) Crisis intervention training. 34 (3) Civil commitment prescreening. 35 -1- LSB 2630YC (4) 87 hb/rh/sc 1/ 5

H.F. _____ NEW PARAGRAPH . j. Advances in the use of evidence-based 1 treatment, including but not limited to all of the following: 2 (1) Positive behavior support. 3 (2) Assertive community treatment. 4 (3) Peer self-help drop-in centers. 5 DIVISION II 6 TRANSFER OF EXCESS FUNDS 7 Sec. 3. Section 331.424A, subsection 4, Code 2017, is 8 amended to read as follows: 9 4. a. An amount shall be reserved in the county services 10 fund to address cash flow obligations in the next fiscal year. 11 The cash flow amount shall not exceed twenty-five percent 12 of the gross expenditures budgeted from the county services 13 fund for the fiscal year in progress. The cash flow amount 14 for a county’s services fund shall be specified in based on 15 the financial provisions of the regional governance agreement 16 entered into by the county under section 331.392 . 17 b. Beginning with the fiscal year beginning July 1, 2022, 18 if on July 1 of a fiscal year the amount of funds reserved 19 to address cash flow obligations exceeds twenty-five percent 20 of the gross expenditures budgeted for the fiscal year, the 21 county shall transfer such excess amount to the treasurer of 22 state to be credited to the property tax relief fund created in 23 section 426B.1. The county treasurer shall pay the funds to 24 the treasurer of state on or before September 1. 25 Sec. 4. Section 331.432, subsection 3, Code 2017, is amended 26 to read as follows: 27 3. Except as authorized in section 331.477 , transfers 28 of moneys between the county mental health and disabilities 29 services fund created pursuant to section 331.424A and any 30 other fund are prohibited. This subsection does not apply to 31 transfers made pursuant to section 331.424A, subsection 4, 32 paragraph “b” . 33 DIVISION III 34 MENTAL HEALTH, DISABILITY, AND SUBSTANCE USE DISORDER SERVICES 35 -2- LSB 2630YC (4) 87 hb/rh/sc 2/ 5

H.F. _____ WORKGROUP 1 Sec. 5. WORKGROUP —— MENTAL HEALTH, DISABILITY, AND 2 SUBSTANCE USE DISORDER SERVICES. The department of human 3 services shall convene a stakeholder workgroup to make 4 recommendations relating to the delivery of, access to, and 5 coordination and continuity of mental health, disability, 6 and substance use disorder services for individuals with 7 complex mental health, disability, and substance use disorder 8 needs. The recommendations of the workgroup shall be based 9 on recommendations proposed by the department. The workgroup 10 shall be comprised of representatives from community mental 11 health centers, crisis response service providers, law 12 enforcement agencies, the national alliance on mental illness, 13 the judicial system, managed care organizations, and other 14 entities as appropriate. The workgroup shall submit a report 15 with recommendations to the governor and general assembly by 16 December 1, 2017. 17 DIVISION IV 18 BED TRACKING SYSTEM 19 Sec. 6. DIRECTIVE TO DEPARTMENT OF HUMAN SERVICES —— 20 PSYCHIATRIC BED TRACKING SYSTEM. The department of human 21 services shall amend its administrative rules pursuant to 22 chapter 17A to require the state mental health institutes 23 and hospitals licensed to provide inpatient psychiatric 24 treatment and services to participate in the psychiatric bed 25 tracking system and to report the number of beds available 26 for persons with a co-occurring mental illness and substance 27 abuse disorder. The department shall issue a quarterly report 28 on state mental health institutes and hospitals licensed to 29 provide inpatient psychiatric treatment and services that are 30 noncompliant with daily updates. 31 EXPLANATION 32 The inclusion of this explanation does not constitute agreement with 33 the explanation’s substance by the members of the general assembly. 34 This bill relates to access to and funding of certain mental 35 -3- LSB 2630YC (4) 87 hb/rh/sc 3/ 5

H.F. _____ health, substance abuse, and disability services. 1 Division I relates to certain mental health, substance 2 abuse, and disability services. 3 Under current law, a mental health and disability services 4 region must make certain initial core services available to 5 eligible residents of a region including residents with a 6 diagnosis of a mental illness, subject to available funding 7 and regardless of the funding source for the service. If 8 money is available after funding the initial core services, a 9 region must make certain additional core services available to 10 eligible residents who are not eligible for Medicaid or who 11 are not receiving other third-party payments for the services, 12 when public funds are made available for such services. The 13 additional core services include comprehensive facility and 14 community-based crisis services, subacute services provided in 15 facility and community-based settings, justice system-involved 16 services, and evidence-based treatment. The bill amends 17 current law to redesignate these additional core services as 18 initial core services that must be made available by a region. 19 Division II relates to the transfer of excess funds from the 20 county mental health and disabilities services fund. 21 Under current law, counties are required to reserve an 22 amount to address cash flow obligations in the next fiscal 23 year that does not exceed 25 percent of the gross expenditures 24 budgeted from the county services fund for the fiscal year in 25 progress. The bill provides that beginning with the fiscal 26 year beginning July 1, 2022, the amount of funds in the county 27 services fund on July 1 of a fiscal year that exceed 25 percent 28 of the budgeted gross expenditures for the fiscal year shall 29 be transferred to the treasurer of state to be credited to 30 the property tax relief fund created in current Code section 31 426B.1. 32 Division III requires the department of human services 33 to convene a stakeholder workgroup to make recommendations 34 relating to the delivery of, access to, and coordination 35 -4- LSB 2630YC (4) 87 hb/rh/sc 4/ 5

H.F. _____ and continuity of mental health and disability services 1 for individuals with complex mental health, disability, 2 and substance use disorder needs based upon recommendations 3 proposed by the department. The workgroup shall be comprised 4 of representatives from community mental health centers, 5 crisis response service providers, law enforcement agencies, 6 the national alliance on mental illness, the judicial 7 system, managed care organizations, and other entities as 8 appropriate. The bill directs the workgroup to submit a report 9 with recommendations to the governor and general assembly by 10 December 1, 2017. 11 Division IV relates to the psychiatric bed tracking system. 12 The bill directs the department of human services to 13 amend its administrative rules to require the state mental 14 health institutes and hospitals licensed to provide inpatient 15 psychiatric treatment and services to participate in the 16 psychiatric bed tracking system and to report the number of 17 beds available for persons with a co-occurring mental illness 18 and substance abuse disorder. The bill directs the department 19 to file quarterly reports listing the mental health institutes 20 and hospitals licensed to provide inpatient psychiatric 21 treatment and services that are not compliant with daily 22 updates. 23 -5- LSB 2630YC (4) 87 hb/rh/sc 5/ 5