HF 2184 (LSB 5353HH (5) 83)

HOUSE FILE 2184

BY  HEDDENS and HEATON

A BILL FOR

An Act amending the duties of the mental health, mental retardation, developmental disabilities, and brain injury commission and related provisions.
BE IT ENACTED BY THE GENERAL ASSEMBLY OF THE STATE OF IOWA:

DIVISION I
GENERAL AMENDMENTS
    Section 1.  Section 229.24, subsection 3, unnumbered paragraph 1, Code 2009, is amended to read as follows:
   If all or part of the costs associated with hospitalization of an individual under this chapter are chargeable to a county of legal settlement, the clerk of the district court shall provide to the county of legal settlement and to the county in which the hospitalization order is entered, in a form prescribed by the mental health, mental retardation, developmental disabilities, and brain injury commission, the following information pertaining to the individual which would be confidential under subsection 1:
    Sec. 2.  Section 230A.2, Code 2009, is amended to read as follows:
   230A.2  Services offered.

   A community mental health center established or operating as authorized by section 230A.1 may offer to residents of the county or counties it serves any or all of the mental health services defined by the mental health, mental retardation, developmental disabilities, and brain injury commission in the comprehensive state mental health and disability services plan under section 225C.6B.
    Sec. 3.  Section 230A.15, Code 2009, is amended to read as follows:
   230A.15  Comprehensive community mental health program.

   A community mental health center established or operating as authorized by section 230A.1, or which a county or group of counties has agreed to establish or support pursuant to that section, may with approval of the board or boards of supervisors of the county or counties supporting or establishing the center, undertake to provide a comprehensive community mental health program for the county or counties. A center providing a comprehensive community mental health program shall, at a minimum, make available to residents of the county or counties it serves all of the comprehensive mental health services described in the comprehensive state mental health and disability services plan under section 225C.6B.
    Sec. 4.  Section 331.424A, subsection 1, Code Supplement 2009, is amended to read as follows:
   1.  For the purposes of this chapter, unless the context otherwise requires, “services fund” means the county mental health, mental retardation, and developmental disabilities services fund created in subsection 2. The county finance committee created in section 333A.2 shall consult with the state commission in adopting shall adopt rules and prescribing forms for administering the services fund.  The county finance committee created in section 333A.2 shall prescribe forms in accordance with the rules adopted by the state commission. The forms shall allow for reporting of services for persons with brain injury and other optional services funded through a services fund.
    Sec. 5.  Section 331.438, subsection 1, paragraph b, Code 2009, is amended to read as follows:
   b.  “Qualified mental health, mental retardation, and developmental disabilities services” means the services specified on forms issued in the rules adopted by the county finance committee following consultation with the state commission for administering the services fund, pursuant to section 331.424A.
    Sec. 6.  Section 331.438, subsection 4, paragraph b, Code 2009, is amended to read as follows:
   b.  The state commission shall do all of the following:
   (1)  Identify Receive and review reports from the department of human services identifying characteristics of the service county services system, including amounts expended, equity of funding among counties, funding sources, provider types, service availability, and equity of service availability among counties and among persons served.
   (2)  Assess the accuracy and uniformity of recordkeeping and reporting in the service system.
   (3)  Identify for each county the factors associated with inflationary growth of the service system.
   (4)  Identify opportunities for containing service system growth.
   (5)  (2)  Consider proposals for revising service county services system administrative rules.
   (6)  Consider provisions and adopt rules for counties to implement a central point of coordination to plan, budget, and monitor county expenditures for the service system. The provisions shall provide options for counties to implement the central point of coordination in collaboration with other counties.
   (7)  Develop criteria for annual county mental health, mental retardation, and developmental disabilities plans.
   (8)  (3)  Adopt administrative rules identifying qualified mental health, mental retardation, and developmental disabilities service expenditures for purposes of state payment pursuant to subsection 1 relating to county management plans.
   (9)  Adopt rules for the county central point of coordination and clinical assessment processes required under section 331.440 and other rules necessary for the implementation of county management plans and expenditure reports required for state payment pursuant to section 331.439.
   (10)  Consider recommendations to improve the programs and cost-effectiveness of state and county contracting processes and procedures, including strategies for negotiations relating to managed care. The recommendations implemented by the commission for the state and county regarding managed care shall include but are not limited to standards for limiting excess costs and profits, and for restricting cost shifting under a managed care system.
   (11)  (4)  Provide input, when appropriate, to the director of human services in any decision involving administrative rules which were adopted by the department of human services pertaining to the mental illness, mental retardation, and developmental disabilities services system administered by counties.
   (12)  Identify the fiscal impact of existing or proposed legislation and administrative rules on state and county expenditures.
   (13)  Adopt administrative rules providing statewide standards and a monitoring methodology to determine whether cost-effective individualized services are available as required pursuant to section 331.439, subsection 1, paragraph “b”.
   (14)  (5)  Consider recommendations for and adopt administrative rules establishing statewide minimum standards for services and other support required to be available to persons covered by a county management plan under section 331.439.
   (15)  (6)  Consider recommendations for measuring and improving the quality of state and county mental health, mental retardation, and developmental disabilities services and other support.
   (16)  Develop a procedure for each county to disclose to the department of human services information approved by the commission concerning the mental health, mental retardation, developmental disabilities, and brain injury services provided to the individuals served through the county central point of coordination process. The procedure shall incorporate protections to ensure that if individually identified information is disclosed, it is disclosed and maintained in compliance with applicable Iowa and federal confidentiality laws, including but not limited to federal Health Insurance Portability and Accountability Act, Pub. L. No. 104-191, requirements.
    Sec. 7.  Section 331.439, subsection 1, unnumbered paragraph 1, Code 2009, is amended to read as follows:
   The state payment to eligible counties under this section shall be made as provided in sections 331.438 and 426B.2. A county is eligible for the state payment, as defined in section 331.438, for a fiscal year if the director of human services, in consultation with the state commission, determines for a specific fiscal year that all of the following conditions are met:
    Sec. 8.  Section 331.439, subsection 1, paragraph a, Code 2009, is amended to read as follows:
   a.  The county accurately reported by December 1 the county’s expenditures for mental health, mental retardation, and developmental disabilities services and the information required under section 225C.6A, subsection 2 3, paragraph “c”, for the previous fiscal year on forms prescribed by in accordance with rules adopted by the state commission. If the department determines good cause exists, the department may extend a deadline otherwise imposed under this chapter, chapter 225C, or chapter 426B for a county’s reporting concerning mental health, mental retardation, or developmental disabilities services or related revenues and expenditures.
    Sec. 9.  Section 331.439, subsection 1, paragraph b, unnumbered paragraph 1, Code 2009, is amended to read as follows:
   The county developed and implemented a county management plan for the county’s mental health, mental retardation, and developmental disabilities services system in accordance with the provisions of this paragraph “b”. The plan shall comply with the administrative rules adopted for this purpose by the state commission and is subject to the approval of the director of human services in consultation with the state commission. The plan shall include a description of the county’s service management provision for mental health, mental retardation, and developmental disabilities services. For mental retardation and developmental disabilities service management, the plan shall describe the county’s development and implementation of a managed system of cost-effective individualized services and shall comply with the provisions of paragraph “f”. The goal of this part of the plan shall be to assist the individuals served to be as independent, productive, and integrated into the community as possible. The service management provisions for mental health shall comply with the provisions of paragraph “e”. A county is subject to all of the following provisions in regard to the county’s services system management plan and planning process:
    Sec. 10.  Section 331.439, subsection 1, paragraph b, subparagraphs (2) and (3), Code 2009, are amended to read as follows:
   (2)  For informational purposes, the county shall submit a management plan review to the department of human services by December 1 of each year. The annual review shall incorporate an analysis of the data associated with the services system managed during the preceding fiscal year by the county or by a managed care private entity on behalf of the county. The annual review shall also identify measurable outcomes and results showing the county’s progress in fulfilling the purposes listed in paragraph “c”, and in achieving the disability services outcomes and indicators identified by the commission pursuant to section 225C.6.
   (3)  For informational purposes, every three years the county shall submit to the department of human services a three-year strategic plan. The strategic plan shall describe how the county will proceed to attain the plan’s goals and objectives, and the measurable outcomes and results necessary for moving the county’s service services system toward an individualized, community-based focus in accordance with paragraph “c”. The three-year strategic plan shall be submitted by April 1, 2000, and by April 1 of every third year thereafter.
    Sec. 11.  Section 331.439, subsection 1, paragraphs c, e, and f, Code 2009, are amended to read as follows:
   c.  The county implements its county management plan under paragraph “b” and other service management functions in a manner that seeks to achieve all of the following purposes identified in section 225C.1 for persons who are covered by the plan or are otherwise subject to the county’s service services system management functions:
   (1)  The service services system seeks to empower persons to exercise their own choices about the amounts and types of services and other support received.
   (2)  The service services system seeks to empower the persons to accept responsibility, exercise choices, and take risks.
   (3)  The service services system seeks to provide services and other support that are individualized, provided to produce results, flexible, and cost-effective.
   (4)  The service services system seeks to provide services and other supports support in a manner which supports the ability of the persons to live, learn, work, and recreate in communities of their choice.
   e.  (1)  For mental health service management, the county may either directly implement a system of service management and contract with service providers, or contract with a private entity to manage the county services system, provided all requirements of this lettered paragraph are met by the private entity. The mental health service management services system shall incorporate a central point of coordination and clinical assessment process developed in accordance with the provisions of section 331.440.
   (2)  A managed care The county services system for mental health proposed by a county shall include but is not limited to all of the following elements which shall be specified in administrative rules adopted by the state commission:
   (a)  The enrollment and eligibility process.
   (b)  The scope of services included.
   (c)  The method of plan administration.
   (d)  The process for managing utilization and access to services and other assistance.
   (e)  The quality assurance process.
   (f)  The risk management provisions and fiscal viability of the provisions, if the county contracts with a private managed care entity.
   f.  For mental retardation and developmental disabilities services management, the county must either develop and implement a managed system of care which addresses a full array of appropriate services and cost-effective delivery of services by contracting directly with service providers or contract by contracting with a state-approved managed care contractor or contractors private entity to manage the county services system. Any system or contract implemented under this paragraph The county services system shall incorporate a central point of coordination and clinical assessment process developed in accordance with the provisions of section 331.440. The elements of the county managed system of care a county services system shall be specified in rules developed by the department of human services in consultation with and adopted by the state commission.
    Sec. 12.  Section 331.439, subsection 3, paragraph b, Code 2009, is amended to read as follows:
   b.  Based upon information contained in county management plans and budgets and proposals made by representatives of counties, the state commission shall recommend an allowed growth factor adjustment to the governor by November 15 for the fiscal year which commences two years from the beginning date of the fiscal year in progress at the time the recommendation is made. The allowed growth factor adjustment shall may address various costs including but not limited to the costs associated with new consumers of service, service cost inflation, and investments for economy and efficiency. In developing the service cost inflation recommendation, the state commission shall consider the cost trends indicated by the gross expenditure amount reported in the expenditure reports submitted by counties pursuant to subsection 1, paragraph “a”. The governor shall consider the state commission’s recommendation in developing the governor’s recommendation for an allowed growth factor adjustment for such fiscal year. The governor’s recommendation shall be submitted at the time the governor’s proposed budget for the succeeding fiscal year is submitted in accordance with chapter 8.
    Sec. 13.  Section 331.439, subsection 7, Code 2009, is amended to read as follows:
   7.  A county shall annually report data concerning the county’s services system managed by in accordance with the county management plan. At a minimum, the data reported shall indicate the number of different individuals who utilized services in a fiscal year and the various types of services. Data reported under this subsection shall be submitted with the county’s expenditure report required under subsection 1, paragraph “a”.

DIVISION II
CODE CHAPTER 225C AMENDMENTS
    Sec. 14.  Section 225C.4, subsection 1, paragraph a, Code 2009, is amended to read as follows:
   a.  Prepare and administer the comprehensive mental health and disability services plan as provided in section 225C.6B, including state mental health and mental retardation plans for the provision of disability services within the state and prepare and administer the state developmental disabilities plan. The administrator shall consult with the Iowa department of public health, the state board of regents or a body designated by the board for that purpose, the department of management or a body designated by the director of the department for that purpose, the department of education, the department of workforce development and any other appropriate governmental body, in order to facilitate coordination of disability services provided in this state. The state mental health and mental retardation plans shall be consistent with the state health plan, and shall incorporate county disability services plans.
    Sec. 15.  Section 225C.6, subsections 1 and 3, Code 2009, are amended to read as follows:
   1.  To the extent funding is available, the commission shall perform the following duties:
   a.  Advise the administrator on the administration of the overall state disability services system.
   b.  Adopt necessary rules pursuant to chapter 17A which relate to disability programs and services, including but not limited to definitions of each disability included within the term “disability services” as necessary for purposes of state, county, and regional planning, programs, and services.
   c.  Adopt standards for community mental health centers, services, and programs as recommended under section 230A.16. The commission administrator shall determine whether to grant, deny, or revoke the accreditation of the centers, services, and programs.
   d.  Adopt standards for the care of and services to persons with mental illness and mental retardation residing in county care facilities recommended under section 227.4 the provision under medical assistance of individual case management services.
   e.  Unless another governmental body sets standards for a service available to persons with disabilities, adopt state standards for that service. The commission shall provide that a service provider’s compliance with standards for a service set by a nationally recognized body shall be deemed to be in compliance with the state standards adopted by the commission for that service. The commission shall adopt state standards for those residential and community-based providers of services to persons with mental illness or developmental disabilities that are not otherwise subject to licensure by the department of human services or department of inspections and appeals, including but not limited to remedial services payable under the medical assistance program and other services payable from funds credited to a county mental health, mental retardation, and developmental disabilities services fund created in section 331.424A. In addition, the The commission shall review the licensing standards used by the department of human services or department of inspections and appeals for those facilities providing disability services to persons with mental illness or developmental disabilities.
   f.  Assure that proper reconsideration and appeal procedures are available to persons aggrieved by decisions, actions, or circumstances relating to accreditation.
   g.  Adopt necessary rules for awarding grants from the state and federal government as well as other moneys that become available to the division for grant purposes.
   h.  Annually submit to the governor and the general assembly:
   (1)  A report concerning the activities of the commission.
   (2)  Recommendations formulated by the commission for changes in law.
   i.  By January 1 of each odd-numbered year, submit to the governor and the general assembly an evaluation of:
   (1)  The extent to which services to persons with disabilities are actually available to persons in each county in the state and the quality of those services.
   (2)  The effectiveness of the services being provided by disability service providers in this state and by each of the state mental health institutes established under chapter 226 and by each of the state resource centers established under chapter 222.
   j.  Advise the administrator, the council on human services, the governor, and the general assembly on budgets and appropriations concerning disability services.
   k.  Coordinate activities with the governor’s developmental disabilities council and the mental health planning council, created pursuant to federal law.  Work with other state agencies on coordinating, collaborating, and communicating concerning activities involving persons with disabilities.
   l.  Establish standards for the provision under medical assistance of individual case management services. The commission shall determine whether to grant, deny, or revoke the accreditation of the services.
   m.  l.  Identify basic financial eligibility standards for disability services. The standards shall include but are not limited to the following:
   (1)  A financial eligibility standard providing that a person with an income equal to or less than one hundred fifty percent of the federal poverty level, as defined by the most recently revised poverty income guidelines published by the United States department of health and human services, is eligible for disability services paid with public funding. However, a county may apply a copayment requirement for a particular disability service to a person with an income equal to or less than one hundred fifty percent of the federal poverty level, provided the disability service and the copayment amount both comply with rules adopted by the commission applying uniform standards with respect to copayment requirements. A person with an income above one hundred fifty percent of the federal poverty level may be eligible subject to a copayment or other cost-sharing arrangement subject to limitations adopted in rule by the commission.
   (2)  A requirement that a person who is eligible for federally funded services and other support must apply for the services and support.
   (3)  Resource limitations that are derived from the federal supplemental security income program limitations. A person with resources above the federal supplemental security income program limitations may be eligible subject to limitations adopted in rule by the commission. If a person does not qualify for federally funded services and other support but meets income, resource, and functional eligibility requirements, the following types of resources shall be disregarded:
   (a)  A retirement account that is in the accumulation stage.
   (b)  A burial, medical savings, or assistive technology account.
   n.  m.  Identify disability services outcomes and indicators to support the ability of eligible persons with a disability to live, learn, work, and recreate in communities of the persons’ choice. The identification duty includes but is not limited to responsibility for identifying, collecting, and analyzing data as necessary to issue reports on outcomes and indicators at the county and state levels.
   o.  Prepare five-year plans based upon the county management plans developed pursuant to section 331.439.
   p.  Work with other state agencies on coordinating, collaborating, and communicating concerning activities involving persons with disabilities.
   q.  Perform analyses and other functions associated with a redesign of the mental health and developmental disability services systems for adults and for children.
   3.  If the executive branch creates a committee, task force, council, or other advisory body to consider mental health and developmental disabilities disability services policy, services, or program options involving children or adult consumers, the commission is designated to receive and consider any report, findings, recommendations, or other work product issued by such body. The commission may address the report, findings, recommendations, or other work product in fulfilling the commission’s functions and to advise the department, council on human services, governor, and general assembly concerning disability services.
    Sec. 16.  Section 225C.6A, Code 2009, is amended to read as follows:
   225C.6A  Mental health, developmental disability, and brain injury service system redesign implementation.
   1.  Purpose.  It is the intent of the general assembly to implement a redesign of the mental health, developmental disability, and brain injury service system over a period of years in order to transition to a coordinated system for Iowans with mental illness, mental retardation or other developmental disabilities, or brain injury. Because of the significance of the redesign to the persons who may be affected by it and the degree of uncertainty regarding the extent of funding changes necessary for implementation, the department and the commission shall not implement a redesign provision through rulemaking or other means unless specific statutory authority provides for the provision’s implementation.
   2.  Initial activities.  For the fiscal years beginning July 1, 2004, and July 1, 2005, the The commission shall do the following relating to redesign of the disability services system in the state:
   a.  1.  Identify sources of revenue to support statewide delivery of core disability services to eligible disability populations.
   b.  Further develop adult disability services system redesign proposals and propose a redesign of the children’s disability service system. The redesign of the children’s system shall address issues associated with an individual’s transition between the two systems.
   2.  Ensure there is a continuous improvement process for development and maintenance of the disability services system for adults and children. The process shall include but is not limited to data collection and reporting provisions.
   c.  (1)  3.  a.  Plan, collect, and analyze data as necessary to issue cost estimates for serving additional populations and providing core disability services statewide. The department shall maintain compliance with applicable federal and state privacy laws to ensure the confidentiality and integrity of individually identifiable disability services data. The department shall regularly assess the status of the compliance in order to assure that data security is protected.
   (2)  b.  In implementing a system under this paragraph “c” subsection for collecting and analyzing state, county, and private contractor data, the department shall establish a client identifier for the individuals receiving services. The client identifier shall be used in lieu of the individual’s name or social security number. The client identifier shall consist of the last four digits of an individual’s social security number, the first three letters of the individual’s last name, the individual’s date of birth, and the individual’s gender in an order determined by the department.
   (3)  c.  Each county shall report to the department annually on or before December 1, for the preceding fiscal year the following information for each individual served:  demographic information, expenditure data, and data concerning the services and other support provided to each individual, as specified in administrative rule adopted by the commission.
   d.  With consumer input, identify and propose standardized functional assessment tools and processes for use in the eligibility determination process when eligibility for a particular disability population group is implemented. The tools and processes shall be integrated with those utilized for the medical assistance program under chapter 249A. For the initial diagnostic criteria, the commission shall consider identifying a qualifying functional assessment score and any of the following diagnoses:  mental illness, chronic mental illness, mental retardation, developmental disability, or brain injury.
   e.  The commission shall adopt a multiyear plan for developing and providing the data, cost projections, revenue requirements, and other information needed to support decision making concerning redesign provisions. The information shall be provided as part of the commission’s regular reports to the governor and general assembly or more often as determined to be appropriate by the commission.
   f.  Propose case rates for disability services.
   g.  4.  Work with county representatives and other qualified persons to develop an implementation plan for replacing the county of legal settlement approach to determining service system funding responsibilities with an approach based upon residency. The plan shall address a statewide standard for proof of residency, outline a plan for establishing a data system for identifying residency of eligible individuals, address residency issues for individuals who began residing in a county due to a court order or criminal sentence or to obtain services in that county, recommend an approach for contesting a residency determination, and address other implementation issues.
    Sec. 17.  Section 225C.6B, subsection 1, Code 2009, is amended to read as follows:
   1.  Intent.
   a.  The general assembly intends for the state to implement a comprehensive, continuous, and integrated state mental health and disability services plan in accordance with the requirements of sections 225C.4 and 225C.6 and other provisions of this chapter, by increasing the department’s responsibilities in the development, funding, oversight, and ongoing leadership of mental health and disability services in this state.
   b.  In order to further the purposes listed in sections section 225C.1 and 225C.27 and in other provisions of this chapter, the general assembly intends that efforts focus on the goal of making available a comprehensive array of high-quality, evidence-based consumer and family-centered mental health and disability services and other support in the least restrictive, community-based setting appropriate for a consumer.
   c.  In addition, it is the intent of the general assembly to promote policies and practices that achieve for consumers the earliest possible detection of mental health problems and the need for disability services and for early intervention; to stress that all health care programs address mental health disorders with the same urgency as physical health disorders; to promote the policies of all public programs that serve adults and children with mental disorders or with a need for disability services, including but not limited to child welfare, Medicaid, education, housing, criminal and juvenile justice, substance abuse treatment, and employment services; to consider the special mental health and disability services needs of adults and children; and to promote recovery and resiliency as expected outcomes for all consumers.
    Sec. 18.  Section 225C.6B, subsection 2, Code 2009, is amended by striking the subsection and inserting in lieu thereof the following:
   2.  Comprehensive plan.  The division shall develop a comprehensive written five-year state mental health and disability services plan with annual updates and readopt the plan every five years. The plan shall describe the key components of the state’s mental health and disability services system, including the services that are community-based, state institution-based, or regional or state-based. The five-year plan and each update shall be submitted annually to the commission on or before October 30 for review and approval.
    Sec. 19.  Section 225C.21, subsection 2, Code 2009, is amended to read as follows:
   2.  The commission shall adopt rules pursuant to chapter 17A establishing minimum standards for supported community living services. The commission administrator shall determine whether to grant, deny, or revoke approval for any supported community living service.
    Sec. 20.  Section 225C.52, subsection 1, Code 2009, is amended to read as follows:
   1.  Establishing a comprehensive community-based mental health services system for children and youth is part of fulfilling the requirements of the division and the commission to facilitate a comprehensive, continuous, and integrated state mental health and disability services plan in accordance with sections 225C.4, 225C.6, and 225C.6A, and other provisions of this chapter. The purpose of establishing the children’s system is to improve access for children and youth with serious emotional disturbances and youth with other qualifying mental health disorders to mental health treatment, services, and other support in the least restrictive setting possible so the children and youth can live with their families and remain in their communities. The children’s system is also intended to meet the needs of children and youth who have mental health disorders that co-occur with substance abuse, mental retardation, developmental disabilities, or other disabilities. The children’s system shall emphasize community-level collaborative efforts between children and youth and the families and the state’s systems of education, child welfare, juvenile justice, health care, substance abuse, and mental health.
    Sec. 21.  REPEAL.  Section 225C.27, Code 2009, is repealed.

DIVISION III
COMMISSION AND WAIVER NAME CHANGE
    Sec. 22.  Section 225C.2, subsection 3, Code 2009, is amended to read as follows:
   3.  “Commission” means the mental health, mental retardation, developmental disabilities, and brain injury and disability services commission.
    Sec. 23.  Section 225C.5, subsection 1, unnumbered paragraph 1, Code Supplement 2009, is amended to read as follows:
   A mental health, mental retardation, developmental disabilities, and brain injury and disability services commission is created as the state policy-making body for the provision of services to persons with mental illness, mental retardation or other developmental disabilities, or brain injury. The commission’s voting members shall be appointed to three-year staggered terms by the governor and are subject to confirmation by the senate. Commission members shall be appointed on the basis of interest and experience in the fields of mental health, mental retardation or other developmental disabilities, and brain injury, in a manner so as to ensure adequate representation from persons with disabilities and individuals knowledgeable concerning disability services. The department shall provide staff support to the commission, and the commission may utilize staff support and other assistance provided to the commission by other persons. The commission shall meet at least four times per year. The membership of the commission shall consist of the following persons who, at the time of appointment to the commission, are active members of the indicated groups:
    Sec. 24.  Section 249A.12, subsection 4, paragraph b, Code 2009, is amended to read as follows:
   b.  Effective July 1, 1995, the The state shall be responsible for all of the nonfederal share of medical assistance home and community-based services waivers for persons with mental retardation intellectual disabilities services provided to minors and a county is not required to reimburse the department and shall not be billed for the nonfederal share of the costs of the services.
    Sec. 25.  Section 249A.12, subsection 5, paragraph a, unnumbered paragraph 1, Code 2009, is amended to read as follows:
   The mental health, mental retardation, developmental disabilities, and brain injury and disability services commission shall recommend to the department the actions necessary to assist in the transition of individuals being served in an intermediate care facility for persons with mental retardation, who are appropriate for the transition, to services funded under a medical assistance home and community-based services waiver for persons with mental retardation intellectual disabilities in a manner which maximizes the use of existing public and private facilities. The actions may include but are not limited to submitting any of the following or a combination of any of the following as a request for a revision of the medical assistance home and community-based services waiver for persons with mental retardation in effect as of June 30, 1996 intellectual disabilities:
    Sec. 26.  Section 249A.12, subsection 5, paragraph a, subparagraph (1), Code 2009, is amended to read as follows:
   (1)  Allow for the transition of intermediate care facilities for persons with mental retardation licensed under chapter 135C as of June 30, 1996, to services funded under the medical assistance home and community-based services waiver for persons with mental retardation intellectual disabilities. The request shall be for inclusion of additional persons under the waiver associated with the transition.
    Sec. 27.  Section 249A.12, subsection 6, paragraphs a and b, Code 2009, are amended to read as follows:
   a.  Effective July 1, 2003, the The provisions of the home and community-based services waiver for persons with mental retardation intellectual disabilities shall include adult day care, prevocational, and transportation services. Transportation shall be included as a separately payable service.
   b.  The department of human services shall seek federal approval to amend the home and community-based services waiver for persons with mental retardation intellectual disabilities to include day habilitation services. Inclusion of day habilitation services in the waiver shall take effect upon receipt of federal approval and no later than July 1, 2004.
    Sec. 28.  Section 423.3, subsection 18, paragraph f, subparagraph (6), Code Supplement 2009, is amended to read as follows:
   (6)  MR Intellectual disabilities waiver service providers, described in 441 IAC 77.37.
    Sec. 29.  MENTAL HEALTH, MENTAL RETARDATION, DEVELOPMENTAL DISABILITIES, AND BRAIN INJURY COMMISSION TERMINOLOGY CHANGES —— CODE EDITOR’S DIRECTIVE.
   1.  Sections 230A.16, 230A.17, 230A.18, 249A.12, 331.438, and 426B.4, Code 2009, and sections 135C.23, 249A.4, 249A.31, and 426B.5, Code Supplement 2009, are amended by striking the term “mental health, mental retardation, developmental disabilities, and brain injury commission” and inserting in lieu thereof the term “mental health and disability services commission”.
   2.  This division of this Act changes the name of the mental health, mental retardation, developmental disabilities, and brain injury commission to the mental health and disability services commission. The Code editor shall correct any references to the term “mental health, mental retardation, developmental disabilities, and brain injury commission” anywhere else in the Iowa Code or Iowa Code Supplement, in any bills awaiting codification, in this Act, and in any bills enacted by the Eighty-third General Assembly, 2010 Regular Session, or any extraordinary session.
    Sec. 30.  HOME AND COMMUNITY-BASED SERVICES WAIVER FOR PERSONS WITH MENTAL RETARDATION TERMINOLOGY CHANGES —— CODE EDITOR’S DIRECTIVE.
   1.  Sections 135C.6, 219.1, 249A.26, and 249A.30, Code 2009, are amended by striking the term “waiver for persons with mental retardation” and inserting in lieu thereof the term “waiver for persons with intellectual disabilities”.
   2.  This division of this Act changes the name of the home and community-based services waiver for persons with mental retardation under the medical assistance program to the waiver for persons with intellectual disabilities. The Code editor shall correct any references to the term “waiver for persons with mental retardation” or other forms of the term anywhere else in the Iowa Code or Iowa Code Supplement, in any bills awaiting codification, in this Act, and in any bills enacted by the Eighty-third General Assembly, 2010 Regular Session, or any extraordinary session.
EXPLANATION
   This bill revises the duties of the mental health, mental retardation, developmental disabilities, and brain injury commission and related provisions. The bill is organized into divisions.
   GENERAL AMENDMENTS. This division provides general amendments associated with the commission in Code chapters other than Code chapter 225C.
   Code section 229.24, relating to the confidentiality requirements for involuntary hospitalization proceedings, is amended to eliminate the use of a form prescribed by the commission when the clerk of court provides information to counties concerning the commitment of an individual when the costs of the individual’s care are chargeable to a county.
   Code section 230A.2, relating to the services offered by a community mental health center, is amended to eliminate a reference to the commission in defining services included in the comprehensive mental health and developmental disability services plan addressed by the bill in Code section 225C.6B.
   Code section 230A.15, relating to requirements for a comprehensive community mental health program, is amended to include a reference to the comprehensive plan addressed by the bill.
   Code section 331.424A, establishing the county mental health, mental retardation, and developmental disabilities (MH/MR/DD) services funds, is amended to provide for adoption of rules by the commission and issuance of forms by the county finance committee in accordance with those rules. The forms are to allow for reporting of services for persons with brain injury and other optional services funded through a services fund.
   Code section 331.438, relating to county MH/MR/DD services expenditures and the county and state planning associated with the expenditures, is amended to strike a reference to the expenditure reporting forms. In addition, the bill reduces the number of duties for the commission enumerated in that section from 16 to six.
   Code section 331.439, relating to county eligibility for state property tax relief and allowed growth funding in connection with MH/MR/DD services, is amended to address several issues. A requirement that the director of human services consult with the commission when the director determines various qualifications are met by counties is eliminated. A reference to forms in a reporting requirement is eliminated. Terminology references to county services are revised to incorporate the term “services system”. A limitation in current law authorizing county services to be contracted out to a managed care contractor is replaced with authority to contract with any state-approved private entity. Certain costs are made optional instead of being required to be addressed by the allowed growth adjustment factor annually recommended by the commission to the governor.
   CODE CHAPTER 225C AMENDMENTS. This division amends Code chapter 225C, relating to the services and other support available to a person with mental illness, mental retardation, developmental disabilities, or brain injury (MI/MR/DD/BI), defined by the Code chapter as “disability services”.
   Code section 225C.4, relating the duties of the administrator of the division of mental health and disability services, is amended to include a reference to the comprehensive plan addressed by the bill.
   Code section 225C.6, relating to the duties of the commission, is amended to reorganize the list of duties. In addition, the bill shifts responsibility from the commission to the department of human services’ mental health and disability services administrator for determining whether to grant, deny, or revoke service provider accreditations. The commission retains responsibility for adopting the standards used. An existing requirement for the commission to coordinate with other bodies is expanded to include the mental health planning council and other state agencies generally.
   Code section 225C.6A, relating to a service system redesign the commission worked on in fiscal years 2004-2005 and 2005-2006, is amended to eliminate obsolete language and to make various planning responsibilities permanent. Pursuant to Code section 225C.6B, as amended in the bill, the commission is required to develop a comprehensive five-year plan for mental health and all disability services. The plan is to be revised every five years and updated annually.
   Code section 225C.21, relating to supported community services, is amended to shift the provider accreditation determination responsibility from the commission to the department’s division administrator.
   Code section 225C.52, relating to the mental health services system for children, is amended to include a reference to the comprehensive plan responsibility included in the bill.
   The bill repeals Code section 225C.27, the purpose section of the bill of rights and service quality standards of persons with mental retardation, developmental disabilities, brain injury, or chronic mental illness. The Code section requires the commission to adopt rules to promote and encourage fulfillment of the individual due process and participation in planning rights provisions of the bill of rights in Code section 225C.28B.
   COMMISSION AND WAIVER NAME CHANGE. This division changes the name of the mental health, mental retardation, developmental disabilities, and brain injury commission to the mental health and disability services commission and the name of the home and community-based services waiver for persons with mental retardation under the medical assistance program to the waiver for persons with intellectual disabilities. Various specific Code provisions are addressed and the Code editor is authorized to make these changes in other provisions.