HOUSE FILE _____

BY  (PROPOSED COMMITTEE ON HUMAN RESOURCES BILL BY CHAIRPERSON MILLER)

A BILL FOR

An Act relating to county and state responsibilities for mental health, mental retardation, and developmental disabilities services for adults and children and including effective date provisions.
BE IT ENACTED BY THE GENERAL ASSEMBLY OF THE STATE OF IOWA:

   Section 1.  MENTAL HEALTH AND DISABILITY SERVICE SYSTEM REFORM.
   1.  The general assembly finds there is need to reform the mental health and disability services systems administered by counties and the state to address the needs of adults and children with mental illness, mental retardation, or developmental disabilities. Issues with the current systems include the following:
   a.  Lack of a set of core services uniformly available throughout the state.
   b.  Lack of uniformity in service expenditures throughout the state.
   c.  Disparity in county levy rates for the adult services system.
   d.  The need to improve the array of community-based services and services to avoid the use or continued use of crisis services.
   e.  The need to expand the availability of dual diagnosis mental health and substance abuse services.
   f.  The need to improve the consistency of services available to both youth and adult populations.
   g.  The need to coordinate the services systems for addressing the needs of children and youth with severe emotional disturbances, mental illness, mental retardation, developmental disabilities, and substance abuse problems among state and local education, health, and human services agencies.
   h.  The need to address the medical assistance (Medicaid) program changes in the federal Patient Protection and Affordable Care Act, Pub. L. No. 111-148, that will greatly expand the program’s eligibility for persons in the services systems beginning in calendar year 2014.
   i.  Dissatisfaction with using county of legal settlement determinations to determine county and state financial responsibility for adult services.
   2.  It is the intent of the general assembly to consider and enact legislation to do all of the following:
   a.  Phase in the full assumption by the state of the nonfederal share of the costs for Medicaid program services for adults now borne by counties by the implementation date of the Medicaid eligibility changes under the federal Patient Protection and Affordable Care Act.
   b.  Provide property tax relief and equity by having the state incrementally assume a greater role in funding the adult mental health and disability services system from counties when the repeals contained in this Act take effect.
   c.  Shift the balance of responsibilities for the adult services system between the state and counties so that the state ensures greater uniformity and there is sufficient size to develop effective services while maintaining local involvement that brings resources together in unique ways that best meet the needs of clients.
   d.  Provide options for maintaining and enhancing local entry points for admission into the services system for adults.
   e.  Engage the state and local government agencies involved with addressing the needs of children and youth with severe emotional disturbances, mental illness, mental retardation, developmental disabilities, and substance abuse problems in developing a coordinated system to meet those needs.
   f.  Consolidate provider reimbursement rate setting and provider selection authority.
   g.  Review the Code chapters relevant to the services systems and propose amendments for implementation of the reforms recommended by the committee.
   h.  Incorporate opportunities for implementing efficiencies, providing access to services at more levels, enhancing public-private partnerships, allowing options for local investments, and emphasizing the use of research-based methods and identified best practices.
   i.  Establish a state fund to collect cost savings realized from efficiencies and dedicate such moneys for use in expanding community capacity to provide services.
   j.  Create a state-county transition committee to address implementation of the legislation. The membership of the committee may include designees of the department of human services, the Iowa state association of counties, and service providers, consumers, and advocates. In addition, the membership may include members of the general assembly, serving as ex officio, nonvoting members.
   k.  Implement other provisions to reform and improve the services systems for adults and children.
   Sec. 2.  Section 331.424A, Code 2011, is amended by adding the following new subsection:
   NEW SUBSECTION.  6.  This section is repealed July 1, 2012.
   Sec. 3.  Section 331.438, Code 2011, is amended by adding the following new subsection:
   NEW SUBSECTION.  5.  This section is repealed July 1, 2012.
   Sec. 4.  Section 331.439, Code 2011, is amended by adding the following new subsection:
   NEW SUBSECTION.  10.  This section is repealed July 1, 2012.
   Sec. 5.  Section 331.440, Code 2011, is amended by adding the following new subsection:
   NEW SUBSECTION.  7.  This section is repealed July 1, 2012.
   Sec. 6.  NEW SECTION.  426B.6  Future repeal.
   This chapter is repealed July 1, 2012.
   Sec. 7.  CONFORMING PROVISIONS.  The legislative services agency shall prepare a study bill for consideration by the committees on human resources of the senate and house of representatives for the 2012 legislative session, providing conforming Code changes for implementation of the repeal provisions contained in this Act.
   Sec. 8.  EFFECTIVE UPON ENACTMENT.  This Act, being deemed of immediate importance, takes effect upon enactment.
EXPLANATION
   This bill relates to county and state responsibilities for mental health, mental retardation, and developmental disabilities (MH/MR/DD) services for adults and children.
   Legislative findings are stated in a temporary law section addressing reform of the systems for such services. Legislative intent is stated to consider and enact legislation to implement various system reform provisions outlined in the bill.
   The following Code provisions are repealed on July 1, 2012: Code section 331.424A, establishing county MH/MR/DD services funds and authorizing levies for the funds; Code section 331.438, outlining requirements for county MH/MR/DD services expenditures and joint state-county planning, implementing, and funding; Code section 331.439, requiring county management plans and other provisions regarding county eligibility for state property tax relief and allowed growth funding; Code section 331.440, providing for creation of the county central point of coordination process and county management of state case services; and Code chapter 426B, relating to property tax relief funding for the county-administered services, risk pool funding, and related provisions.
   The legislative services agency is directed to prepare legislation to conform other Code provisions to the repeals contained in the bill.
   The bill takes effect upon enactment.