Senate File 2364 H-8301 Amend Senate File 2364, as amended, passed, and reprinted by 1 the Senate, as follows: 2 1. Page 1, before line 1 by inserting: 3 < Section 1. NEW SECTION . 225C.54A Mental health services 4 system for children and youth —— regional core services. 5 1. For the purposes of this section, unless the context 6 otherwise requires, “domain” means a set of similar services 7 that can be provided depending upon a child’s or youth’s 8 service needs. 9 2. a. (1) A region shall work with service providers to 10 ensure that mental health and disability services are available 11 to children and youth who are residents of the region, 12 regardless of the potential payment source for the services. 13 (2) Subject to the available appropriations, the director 14 of human services shall ensure the mental health and disability 15 service domains listed in subsection 4 are covered services 16 for the medical assistance program under chapter 249A to the 17 greatest extent allowable under federal regulations. Within 18 funds available, the region shall pay for such services for 19 eligible children and youth when payment through the medical 20 assistance program or another third-party payment is not 21 available, unless the child or youth is on a waiting list for 22 such payment or it has been determined that the child or youth 23 does not meet the eligibility criteria for any such service. 24 b. Until funding is designated for other mental health 25 and disability service populations, eligibility for the 26 service domains listed in this section shall be limited to 27 such children and youth who are in need of mental health or 28 intellectual disability services. However, if a county in 29 a region was providing services to an eligibility class of 30 children and youth with a developmental disability other than 31 intellectual disability or a brain injury prior to formation 32 of the region, the class of children and youth shall remain 33 eligible for the services provided when the region was formed, 34 provided that funds are available to continue such services 35 -1- SF2364.4796 (4) 87 hb/rh 1/ 5 #1.

without limiting or reducing core services. 1 3. Pursuant to recommendations made by the director of human 2 services, the state commission shall adopt rules as required by 3 section 225C.6 to define the services included in the initial 4 and additional core service domains listed in this section . 5 The rules shall provide consistency, to the extent possible, 6 with similar service definitions under the medical assistance 7 program. The rules relating to the credentialing of a person 8 directly providing services shall require all of the following: 9 a. The person shall provide services and represent the 10 person as competent only within the boundaries of the person’s 11 education, training, license, certification, consultation 12 received, supervised experience, or other relevant professional 13 experience. 14 b. The person shall provide services in substantive areas 15 or use intervention techniques or approaches that are new only 16 after engaging in appropriate study, training, consultation, 17 and supervision from a person who is competent in those areas, 18 techniques, or approaches. 19 c. If generally recognized standards do not exist with 20 respect to an emerging area of practice, the person shall 21 exercise careful judgment and take responsible steps, 22 including obtaining appropriate education, research, training, 23 consultation, and supervision, in order to ensure competence 24 and to protect from harm the persons receiving the services in 25 the emerging area of practice. 26 4. The initial core service domains shall include the 27 following: 28 a. Treatment designed to ameliorate a child’s or youth’s 29 condition, including but not limited to all of the following: 30 (1) Assessment and evaluation. 31 (2) Mental health outpatient therapy. 32 (3) Medication prescribing and management. 33 (4) Mental health inpatient treatment. 34 b. Basic crisis response provisions, including but not 35 -2- SF2364.4796 (4) 87 hb/rh 2/ 5

limited to all of the following: 1 (1) Twenty-four-hour access to crisis response. 2 (2) Evaluation. 3 (3) Personal emergency response system. 4 c. Support for community living, including but not limited 5 to all of the following: 6 (1) Home health aide. 7 (2) Home and vehicle modifications. 8 (3) Respite. 9 (4) Supportive community living. 10 d. Support for employment or for activities leading to 11 employment providing an appropriate match with the child’s or 12 youth’s abilities based upon informed, person-centered choices 13 made from an array of options, including but not limited to all 14 of the following: 15 (1) Day habilitation. 16 (2) Job development. 17 (3) Supported employment. 18 (4) Prevocational services. 19 e. Recovery services, including but not limited to all of 20 the following: 21 (1) Family support. 22 (2) Peer support. 23 f. Service coordination including coordinating physical 24 health and primary care, including but not limited to all of 25 the following: 26 (1) Case management. 27 (2) Health homes. 28 5. A region shall ensure that access is available to 29 providers of core services that demonstrate competencies 30 necessary for all of the following: 31 a. Serving children and youth with co-occurring conditions. 32 b. Providing evidence-based services. 33 c. Providing trauma-informed care that recognizes the 34 presence of trauma symptoms in children and youth receiving 35 -3- SF2364.4796 (4) 87 hb/rh 3/ 5

services. > 1 2. Page 1, after line 35 by inserting: 2 < Sec. ___. Section 331.396, subsection 1, paragraph d, Code 3 2018, is amended by striking the paragraph. 4 Sec. ___. Section 331.396, subsection 2, paragraph d, Code 5 2018, is amended by striking the paragraph. 6 Sec. ___. DEPARTMENT OF HUMAN SERVICES —— TRANSFER OF MENTAL 7 HEALTH AND DISABILITY SERVICES REGIONS TO THE DEPARTMENT OF 8 PUBLIC HEALTH. 9 1. Beginning July 1, 2018, the director of human services 10 shall work with the director of public health to transfer the 11 duties of the department of human services regarding the mental 12 health and disability services regions to the department of 13 public health effective July 1, 2019. 14 2. Any contract entered into by the department of human 15 services in matters related to the mental health and disability 16 services regions in effect at the conclusion of the fiscal year 17 beginning July 1, 2018, shall continue in full force and effect 18 pending transfer of such contracts to the department of public 19 health. 20 3. Any rule, regulation, form, order, or directive 21 promulgated by the department of human services regarding the 22 mental health and disability services regions in existence at 23 the conclusion of the fiscal year beginning July 1, 2018, shall 24 continue in full force and effect until amended, repealed, or 25 supplemented by affirmative action of the department of public 26 health. 27 4. With regard to updating references and format in the Iowa 28 administrative code in order to correspond to the transferring 29 of the duties related to the mental health and disability 30 services region from the department of human services to 31 the department of public health, the administrative rules 32 coordinator and the administrative rules review committee, in 33 consultation with the administrative code editor, shall jointly 34 develop a schedule for the necessary updating of the Iowa 35 -4- SF2364.4796 (4) 87 hb/rh 4/ 5 #2.

administrative code. 1 5. The director of human services, in cooperation with the 2 director of public health, pursuant to section 2.16, shall 3 prepare draft legislation for submission to the legislative 4 services agency, as necessary, for consideration by the general 5 assembly during the 2019 legislative session, necessary to 6 complete the transfer of its duties related to the mental 7 health and disability services regions to the department of 8 public health effective July 1, 2019. > 9 3. Title page, line 1, after < Act > by inserting < relating to 10 child and adult services and safety by > 11 4. Title page, line 3, after < buildings > by inserting < , and 12 by providing for other related services including mental health 13 and disability services > 14 5. By renumbering as necessary. 15 ______________________________ MASCHER of Johnson -5- SF2364.4796 (4) 87 hb/rh 5/ 5 #3. #4. #5.