H.F. 419 DIVISION I 1 MENTAL HEALTH AND DISABILITY SERVICES CLIENT IDENTIFIER 2 Section 1. Section 225C.6A, subsection 3, paragraph b, Code 3 2013, is amended to read as follows: 4 b. In implementing a system under this subsection for 5 collecting and analyzing state, county, and private contractor 6 data, the department shall establish a client identifier for 7 the individuals receiving services. The client identifier 8 shall be used in lieu of the individual’s name or social 9 security number. The client identifier shall consist of the 10 last four digits of an individual’s social security number, 11 the first three letters of the individual’s last name, the 12 individual’s date of birth, and the individual’s gender in an 13 order determined by the department. 14 DIVISION II 15 INTERAGENCY INFORMATION SERVICE ON PERSONS WITH MENTAL 16 DISABILITIES 17 Sec. 2. REPEAL. Section 218.11, Code 2013, is repealed. 18 Sec. 3. REPEAL. Chapter 220A, Code 2013, is repealed. 19 DIVISION III 20 SUBACUTE MENTAL HEALTH CARE FACILITIES 21 Sec. 4. Section 135G.3, subsections 1 and 2, Code 2013, are 22 amended to read as follows: 23 1. A subacute care facility shall utilize a team of 24 professionals to direct an organized program of diagnostic 25 services, subacute mental health services, and rehabilitative 26 services to meet the needs of residents in accordance with 27 a treatment care plan developed for each resident under 28 the supervision of a licensed psychiatrist mental health 29 professional . The goal of a treatment care plan is to 30 transition residents to a less restrictive environment, 31 including a home-based community setting. Social and 32 rehabilitative services shall also be provided under the 33 direction of a mental health professional. 34 2. The licensed psychiatrist mental health professional 35 -1- LSB 1153HV (2) 85 jp/nh 1/ 6

H.F. 419 providing supervision of the subacute care facility facility’s 1 treatment care plans shall evaluate the condition of each 2 resident as medically necessary and shall be available to 3 residents of the facility on an on-call basis at all other 4 times. Additional evaluation and treatment may be provided 5 by a mental health professional. The subacute care facility 6 may employ a seclusion room meeting the conditions described 7 in 42 C.F.R. § 483.364(b) with approval of the a licensed 8 psychiatrist of the facility or by order of the resident’s 9 physician, a physician assistant, or an advanced registered 10 nurse practitioner. 11 Sec. 5. Section 135G.4, subsection 2, Code 2013, is amended 12 to read as follows: 13 2. An intermediate care facility for persons with mental 14 illness licensed under chapter 135C may convert to a subacute 15 care facility by providing submitting an application for a 16 license in accordance with section 135G.5 accompanied by 17 written notice to the department that the facility has employed 18 a full-time psychiatrist mental health professional and desires 19 to make the conversion. An intermediate care facility for 20 persons with mental illness applying for a license under this 21 subsection remains subject to subsection 1 until a license is 22 issued. 23 Sec. 6. EFFECTIVE UPON ENACTMENT. This division of this 24 Act, being deemed of immediate importance, takes effect upon 25 enactment. 26 Sec. 7. RETROACTIVE APPLICABILITY. This division of this 27 Act applies retroactively to July 1, 2012. 28 DIVISION IV 29 COMMUNITY MENTAL HEALTH SERVICES BLOCK GRANT ALLOCATION 30 Sec. 8. 2011 Iowa Acts, chapter 126, section 20, subsection 31 1, paragraph d, is amended to read as follows: 32 d. Of the amount allocated to eligible services providers 33 under paragraph “c”, 70 percent shall be distributed to the 34 state’s accredited community mental health centers established 35 -2- LSB 1153HV (2) 85 jp/nh 2/ 6

H.F. 419 or designated by counties in accordance with law chapter 1 230A or applicable administrative rule. If a county has not 2 established or designated a community mental health center and 3 has received a waiver from the mental health and disability 4 services commission, the mental health services provider 5 designated by that county is was designated as authorized in 6 section 230A.107, subsection 2, the provider remains eligible 7 to receive funding distributed pursuant to this paragraph in 8 lieu of as a community mental health center. The funding 9 distributed shall be used by recipients of the funding for the 10 purpose of developing and providing evidence-based practices 11 and emergency staff training or services to adults with a 12 serious mental illness and children with a serious emotional 13 disturbance. The distribution amounts shall be announced at 14 the beginning of the federal fiscal year and distributed on 15 a quarterly basis according to the formulas used in previous 16 fiscal years . Recipients shall submit quarterly reports 17 containing data consistent with the performance measures 18 approved by the federal substance abuse and mental health 19 services administration. 20 Sec. 9. EFFECTIVE UPON ENACTMENT. This division of this 21 Act, being deemed of immediate importance, takes effect upon 22 enactment. 23 EXPLANATION 24 This bill relates to mental health and disability services 25 requirements involving the department of human services (DHS) 26 and is organized into divisions. 27 MENTAL HEALTH AND DISABILITY SERVICES CLIENT IDENTIFIER. 28 This division amends Code section 225C.6A, relating to 29 disability services system redesign data, by eliminating 30 specific requirements for the client identifier that is used in 31 lieu of an individual’s name or social security number. 32 INTERAGENCY INFORMATION SERVICE ON PERSONS WITH MENTAL 33 DISABILITIES. This division repeals Code chapter 220A, 34 requiring DHS to provide for a central data control and 35 -3- LSB 1153HV (2) 85 jp/nh 3/ 6

H.F. 419 exchange agency for persons believed to have mental 1 disabilities known as the “interagency case information 2 service”. 3 The Code chapter includes sections stating purpose, 4 providing definitions, designating DHS as the administrative 5 agency for the information service, listing other state 6 agencies required to provide and receive information, listing 7 DHS duties, authorizing other public and private agencies to 8 provide or receive information, exempting the information 9 exchange from any state law or administrative rule that would 10 restrict information from being exchanged by the service, 11 authorizing the service to disseminate statistical information, 12 and providing immunity from liability for agencies and persons 13 participating under the Code chapter. 14 The division also repeals Code section 218.11 in the Code 15 chapter relating to institutions governed by DHS. The Code 16 section requires DHS to be the administrative agency for the 17 information service and perform the duties required by Code 18 chapter 220A. 19 SUBACUTE MENTAL HEALTH CARE FACILITIES. This division 20 amends certain provisions for licensure of subacute mental 21 health care facilities enacted in 2012 Iowa Acts, ch. 1120 22 (SF 2315). Licensure is administered by the department of 23 inspections and appeals in conjunction with DHS. 24 A number of duties assigned to a psychiatrist are changed to 25 be instead assigned to a mental health professional. “Mental 26 health professional” is a term defined in Code section 228.1 27 to mean an individual who holds at least a master’s degree in a 28 mental health field, including but not limited to psychology, 29 counseling and guidance, nursing, and social work, or is an 30 advanced registered nurse practitioner, a physician assistant, 31 or a physician and surgeon or an osteopathic physician and 32 surgeon, holds a current Iowa license if practicing in a field 33 covered by an Iowa licensure law, and has at least two years of 34 clinical experience or an individual who holds a current Iowa 35 -4- LSB 1153HV (2) 85 jp/nh 4/ 6

H.F. 419 license if practicing in a field covered by an Iowa licensure 1 law and is a psychiatrist, an advanced registered nurse 2 practitioner who holds a national certification in psychiatric 3 mental health care registered by the board of nursing, a 4 physician assistant practicing under the supervision of a 5 psychiatrist, or an individual who holds a doctorate degree in 6 psychology and is licensed by the board of psychology. 7 Code section 135G.3 is amended to require that a mental 8 health professional, instead of a licensed psychiatrist, shall 9 be used to develop and to provide supervision of the subacute 10 care facility’s treatment care plans instead of supervision of 11 the subacute care facility itself. 12 Code section 135G.4, requiring licensure of subacute 13 care facilities and authorizing a licensed intermediate care 14 facility for persons with mental illness (ICF/MI) to convert 15 to a licensed subacute facility after notifying the department 16 of inspections and appeals that certain requirements are 17 being met, is amended to require the ICF/MI to also submit 18 an application for licensure as a subacute care facility. 19 An ICF/MI is prohibited from establishing, operating, or 20 maintaining a subacute care facility until issued a license to 21 do so. In addition, the requirement for the ICF/MI to provide 22 notice it has employed a full-time psychiatrist is changed 23 to a mental health professional and the full-time employment 24 requirement is removed. 25 This division takes effect upon enactment and is 26 retroactively applicable to July 1, 2012. 27 COMMUNITY MENTAL HEALTH SERVICES BLOCK GRANT ALLOCATION. 28 This division amends certain requirements in the federal 29 community mental health services block grant appropriation for 30 federal fiscal year 2012-2013 made in 2011 Iowa Acts, chapter 31 126. 32 The amendments reflect changes made in Code chapter 230A 33 for designation of community mental health centers. The 34 amended Code chapter allows a for-profit corporation, nonprofit 35 -5- LSB 1153HV (2) 85 jp/nh 5/ 6

H.F. 419 corporation, or county hospital providing mental health 1 services to county residents pursuant to a waiver approved 2 under Code section 225C.7, subsection 3, Code 2011, as of 3 October 1, 2010, to be designated as a community mental 4 health center. Otherwise, only a nonprofit corporation can be 5 designated as a community mental health center. 6 In addition, a requirement that recipients of the funding 7 use the funding for developing and providing evidence-based 8 practices and emergency services is revised so that the funding 9 may be used for staff training and any services for adults with 10 a serious mental illness and children with a serious emotional 11 disturbance. A restriction that requires distribution of the 12 funding according to the formulas used in previous fiscal years 13 is removed. 14 The division takes effect upon enactment. 15 -6- LSB 1153HV (2) 85 jp/nh 6/ 6