H.F. 161 Section 1. Section 225C.6B, subsection 3, as enacted by 1 2012 Iowa Acts, chapter 1120, section 8, is amended to read as 2 follows: 3 3. State and regional disability service systems. The 4 publicly financed disability services for persons with mental 5 illness, intellectual disability or other developmental 6 disability, or brain injury in this state shall be provided by 7 the department and the counties operating together as regions. 8 The financial and administrative responsibility for such 9 services is as follows: 10 a. Disability services for children and adults that are 11 covered under the medical assistance program pursuant to 12 chapter 249A are the responsibility of the state. 13 b. Adult mental Mental health and intellectual disability 14 services for children and adults that are not covered under 15 the medical assistance program are the responsibility of 16 the county-based regional service system. However, the 17 county-based regional services system is not responsible for 18 such mental health and intellectual disability services for 19 a child subject to a court order under chapter 232, services 20 recommended or authorized by the department or juvenile court 21 services to avoid or eliminate the need for such a court order, 22 services provided through the mental health service system 23 for children and youth administered by the department under 24 subchapter VI of this chapter, and other public welfare, child 25 welfare, and juvenile justice services funded in whole or in 26 part by the state or federal government. 27 Sec. 2. Section 331.389, subsection 1, paragraph a, Code 28 2013, is amended to read as follows: 29 a. Local access to mental health and disability services 30 for children and adults that are not covered under the medical 31 assistance program shall be provided either by counties 32 organized into a regional service system or by individual 33 counties that are exempted as provided by this subsection . 34 The department of human services shall encourage counties to 35 -1- LSB 1628HH (3) 85 jp/rj 1/ 4

H.F. 161 enter into a regional system when the regional approach is 1 likely to increase the availability of services to residents 2 of the state who need the services. It is the intent of the 3 general assembly that the child and adult residents of this 4 state should have access to needed mental health and disability 5 services regardless of the location of their residence. 6 Sec. 3. Section 331.396, subsection 1, paragraph b, Code 7 2013, is amended to read as follows: 8 b. The person is at least eighteen years of age and is a 9 resident of this state. However, a A person who is seventeen 10 years of age, is a resident of this state, and is receiving 11 publicly funded state-funded children’s services may but 12 will be eligible for services under the regional services 13 system upon becoming eighteen years of age shall be considered 14 eligible for provided services through the regional service 15 system during the three-month period preceding the person’s 16 eighteenth birthday in order to provide a smooth transition 17 from state-funded children’s services to county-funded adult 18 services. 19 Sec. 4. Section 331.396, subsection 2, paragraph b, Code 20 2013, is amended to read as follows: 21 b. The person is at least eighteen years of age and is a 22 resident of this state. However, a A person who is seventeen 23 years of age, is a resident of this state, and is receiving 24 publicly funded state-funded children’s services may but will 25 be eligible for services funded under the regional services 26 system upon becoming eighteen years of age shall be considered 27 eligible for provided services through the regional service 28 system during the three-month period preceding the person’s 29 eighteenth birthday in order to provide a smooth transition 30 from state-funded children’s services to county-funded adult 31 services. 32 Sec. 5. IMPLEMENTATION OF ACT. Section 25B.2, subsection 33 3, shall not apply to this Act. 34 EXPLANATION 35 -2- LSB 1628HH (3) 85 jp/rj 2/ 4

H.F. 161 This bill requires regional mental health and disability 1 services to be provided to both children and adults. 2 Under current law enacted in 2012 Iowa Acts, chapter 1120 3 (SF 2315) to redesign mental health and disability services, 4 counties are in the process of forming into regions to provide 5 a system for the delivery of such services to adults that are 6 not covered by the medical assistance (Medicaid) program. 7 Initially, the service system is required to cover adults with 8 mental health needs and adults with an intellectual disability. 9 Under current law, the state has financial and 10 administrative responsibility for publicly financed disability 11 services for adults and children with mental illness, 12 intellectual disability or other developmental disability, or 13 brain injury covered under the Medicaid program. Counties 14 operating together as regions in this state have financial and 15 administrative responsibility for non-Medicaid mental health 16 and intellectual disability services provided to adults. 17 The bill expands this regional system responsibility 18 to include children. However, the bill specifies that the 19 regional service system is not responsible for such mental 20 health and intellectual disability services for a child subject 21 to a court order under Code chapter 232 (primarily juvenile 22 delinquency, child in need of assistance, and termination of 23 parental rights), services recommended or authorized by the 24 department or juvenile court services to avoid or eliminate 25 the need for such a court order, services provided through 26 the mental health service system for children and youth 27 administered by the department of human services under Code 28 chapter 225G, and other public welfare, child welfare, and 29 juvenile justice services funded in whole or in part by the 30 state or federal government. 31 Current law in Code section 331.396 includes eligibility for 32 services under the regional service system for the three-month 33 period preceding age 18 for children receiving publicly funded 34 children’s services in order to provide a smooth transition 35 -3- LSB 1628HH (3) 85 jp/rj 3/ 4

H.F. 161 to the adult system. The bill continues this eligibility for 1 children transitioning from state-funded children’s services to 2 the county-funded regional system. 3 The bill may include a state mandate as defined in Code 4 section 25B.3. The bill makes inapplicable Code section 25B.2, 5 subsection 3, which would relieve a political subdivision from 6 complying with a state mandate if funding for the cost of 7 the state mandate is not provided or specified. Therefore, 8 political subdivisions are required to comply with any state 9 mandate included in the bill. 10 -4- LSB 1628HH (3) 85 jp/rj 4/ 4