House File 626 - Introduced HOUSE FILE 626 BY COMMITTEE ON HUMAN RESOURCES (SUCCESSOR TO HSB 83) A BILL FOR An Act relating to county and state responsibilities for mental 1 health, mental retardation, and developmental disabilities 2 services for adults and children, making appropriations, and 3 including effective date provisions. 4 BE IT ENACTED BY THE GENERAL ASSEMBLY OF THE STATE OF IOWA: 5 TLSB 2002HV (2) 84 jp/rj

H.F. 626 Section 1. MENTAL HEALTH AND DISABILITY SERVICE SYSTEM 1 REFORM. 2 1. The general assembly finds there is need to reform the 3 mental health and disability services systems administered 4 by counties and the state to address the needs of adults 5 and children with mental illness, mental retardation, or 6 developmental disabilities. Issues with the current systems 7 include the following: 8 a. Lack of a set of core services uniformly available 9 throughout the state. 10 b. Lack of uniformity in service expenditures throughout 11 the state. 12 c. Disparity in county levy rates for the adult services 13 system. 14 d. The need to improve the array of community-based services 15 and services to avoid the use or continued use of crisis 16 services. 17 e. The need to expand the availability of dual diagnosis 18 mental health and substance abuse services. 19 f. The need to improve the consistency of services available 20 to both youth and adult populations. 21 g. The need to coordinate the services systems for 22 addressing the needs of children and youth with severe 23 emotional disturbances, mental illness, mental retardation, 24 developmental disabilities, and substance abuse problems among 25 state and local education, health, and human services agencies. 26 h. The need to address the medical assistance (Medicaid) 27 program changes in the federal Patient Protection and 28 Affordable Care Act, Pub. L. No. 111-148, that will greatly 29 expand the program’s eligibility for persons in the services 30 systems beginning in calendar year 2014. 31 i. Dissatisfaction with using county of legal settlement 32 determinations to determine county and state financial 33 responsibility for adult services. 34 2. It is the intent of the general assembly to consider and 35 -1- LSB 2002HV (2) 84 jp/rj 1/ 4

H.F. 626 enact legislation to do all of the following: 1 a. Phase in the full assumption by the state of the 2 nonfederal share of the costs for Medicaid program services 3 for adults now borne by counties by the implementation date 4 of the Medicaid eligibility changes under the federal Patient 5 Protection and Affordable Care Act. 6 b. Provide property tax relief and equity by having the 7 state incrementally assume a greater role in funding the adult 8 mental health and disability services system from counties when 9 the repeals contained in this Act take effect. 10 c. Shift the balance of responsibilities for the adult 11 services system between the state and counties so that the 12 state ensures greater uniformity and there is sufficient 13 size to develop effective services while maintaining local 14 involvement that brings resources together in unique ways that 15 best meet the needs of clients. 16 d. Provide options for maintaining and enhancing local 17 entry points for admission into the services system for adults. 18 e. Engage the state and local government agencies involved 19 with addressing the needs of children and youth with severe 20 emotional disturbances, mental illness, mental retardation, 21 developmental disabilities, and substance abuse problems in 22 developing a coordinated system to meet those needs. 23 f. Consolidate provider reimbursement rate setting and 24 provider selection authority. 25 g. Review the Code chapters relevant to the services systems 26 and propose amendments for implementation of the reforms 27 recommended by the committee. 28 h. Incorporate opportunities for implementing efficiencies, 29 providing access to services at more levels, enhancing 30 public-private partnerships, allowing options for local 31 investments, and emphasizing the use of research-based methods 32 and identified best practices. 33 i. Establish a state fund to collect cost savings realized 34 from efficiencies and dedicate such moneys for use in expanding 35 -2- LSB 2002HV (2) 84 jp/rj 2/ 4

H.F. 626 community capacity to provide services. 1 j. Create a state-county transition committee to address 2 implementation of the legislation. The membership of the 3 committee may include designees of the department of human 4 services, the Iowa state association of counties, and service 5 providers, consumers, and advocates. In addition, the 6 membership may include members of the general assembly, serving 7 as ex officio, nonvoting members. 8 k. Implement other provisions to reform and improve the 9 services systems for adults and children. 10 Sec. 2. Section 331.424A, Code 2011, is amended by adding 11 the following new subsection: 12 NEW SUBSECTION . 6. This section is repealed July 1, 2012. 13 Sec. 3. Section 331.438, Code 2011, is amended by adding the 14 following new subsection: 15 NEW SUBSECTION . 5. This section is repealed July 1, 2012. 16 Sec. 4. Section 331.439, Code 2011, is amended by adding the 17 following new subsection: 18 NEW SUBSECTION . 10. This section is repealed July 1, 2012. 19 Sec. 5. Section 331.440, Code 2011, is amended by adding the 20 following new subsection: 21 NEW SUBSECTION . 7. This section is repealed July 1, 2012. 22 Sec. 6. NEW SECTION . 426B.6 Future repeal. 23 This chapter is repealed July 1, 2012. 24 Sec. 7. CONFORMING PROVISIONS. The legislative services 25 agency shall prepare a study bill for consideration by the 26 committees on human resources of the senate and house of 27 representatives for the 2012 legislative session, providing 28 conforming Code changes for implementation of the repeal 29 provisions contained in this Act. 30 Sec. 8. IMPLEMENTATION. There is appropriated from the 31 general fund of the state to the department of human services 32 for the fiscal year beginning July 1, 2011, and ending June 30, 33 2012, the following amount, or so much thereof as is necessary, 34 to be used for the purposes designated: 35 -3- LSB 2002HV (2) 84 jp/rj 3/ 4

H.F. 626 For costs associated with implementation of this Act: 1 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ 1,000,000 2 Sec. 9. EFFECTIVE UPON ENACTMENT. This Act, being deemed of 3 immediate importance, takes effect upon enactment. 4 EXPLANATION 5 This bill relates to county and state responsibilities 6 for mental health, mental retardation, and developmental 7 disabilities (MH/MR/DD) services for adults and children. 8 Legislative findings are stated in a temporary law 9 section addressing reform of the systems for such services. 10 Legislative intent is stated to consider and enact legislation 11 to implement various system reform provisions outlined in the 12 bill. 13 The following Code provisions are repealed on July 1, 2012: 14 Code section 331.424A, establishing county MH/MR/DD services 15 funds and authorizing levies for the funds; Code section 16 331.438, outlining requirements for county MH/MR/DD services 17 expenditures and joint state-county planning, implementing, 18 and funding; Code section 331.439, requiring county management 19 plans and other provisions regarding county eligibility for 20 state property tax relief and allowed growth funding; Code 21 section 331.440, providing for creation of the county central 22 point of coordination process and county management of state 23 case services; and Code chapter 426B, relating to property tax 24 relief funding for the county-administered services, risk pool 25 funding, and related provisions. 26 The legislative services agency is directed to prepare 27 legislation to conform other Code provisions to the repeals 28 contained in the bill. 29 An appropriation is provided to the department of human 30 services for implementation costs. 31 The bill takes effect upon enactment. 32 -4- LSB 2002HV (2) 84 jp/rj 4/ 4