H.F. _____ DIVISION I 1 SYSTEM REDESIGN —— IMPLEMENTATION 2 REGIONAL FORMATION REQUIREMENTS 3 Section 1. Section 331.389, subsection 3, paragraph a, Code 4 2013, is amended to read as follows: 5 a. The counties comprising the region are contiguous except 6 that a region may include a county that is not contiguous with 7 any of the other counties in the region, if the county that is 8 not contiguous has had a formal relationship for two years or 9 longer with one or more of the other counties in the region for 10 the provision of mental health and disability services . 11 ELIGIBILITY MAINTENANCE 12 Sec. 2. Section 331.396, subsection 1, Code 2013, is amended 13 by adding the following new paragraph: 14 NEW PARAGRAPH . 0d. Notwithstanding paragraphs “a” through 15 “c” , the person is an adult or child who received mental health 16 services from a county in accordance with the county’s service 17 management plan approved under section 331.439, Code 2013. 18 Sec. 3. Section 331.396, subsection 2, Code 2013, is amended 19 by adding the following new paragraph: 20 NEW PARAGRAPH . 0d. Notwithstanding paragraphs “a” through 21 “c” , the person is an adult or child who received intellectual 22 disability services from a county in accordance with the 23 county’s service management plan approved in accordance with 24 section 331.439, Code 2013. 25 Sec. 4. Section 331.397, subsection 2, paragraph b, Code 26 2013, is amended to read as follows: 27 b. Until funding is designated for other service 28 populations, eligibility for the service domains listed in this 29 section shall be limited to such persons who are in need of 30 mental health or intellectual disability services. However, if 31 a county in a region was providing services to an individual 32 child or to an individual adult person with a developmental 33 disability other than intellectual disability or a brain injury 34 prior to formation of the region, the individual child or adult 35 -1- LSB 1663HC (3) 85 jp/rj 1/ 16

H.F. _____ person shall remain eligible for the services provided when the 1 region is formed, provided that funds are available to continue 2 such services. 3 STATE PAYMENTS TO REGION 4 Sec. 5. Section 426B.3, subsection 4, as enacted by 2012 5 Iowa Acts, chapter 1120, section 137, is amended to read as 6 follows: 7 4. a. For the fiscal years beginning July 1, 2013, and 8 July 1, 2014, a county with a county population expenditure 9 target amount that exceeds the amount of the county’s base year 10 expenditures for mental health and disabilities services shall 11 receive an equalization payment for the difference. 12 b. The equalization payments determined in accordance 13 with this subsection shall be made by the department of human 14 services for each fiscal year as provided in appropriations 15 made from the property tax relief fund for this purpose. If 16 the county is part of a region that has been approved by the 17 department in accordance with section 331.389, to commence 18 partial or full operations, the county’s equalization payment 19 shall be remitted to the region for expenditure as approved by 20 the region’s governing board. 21 STRATEGIC PLAN REQUIREMENT FOR FY 2013-2014 22 Sec. 6. 2012 Iowa Acts, chapter 1128, section 8, is amended 23 to read as follows: 24 SEC. 8. COUNTY MENTAL HEALTH, MENTAL RETARDATION 25 INTELLECTUAL DISABILITY , AND DEVELOPMENTAL DISABILITIES 26 SERVICES MANAGEMENT PLAN —— STRATEGIC PLAN. Notwithstanding 27 section 331.439, subsection 1 , paragraph “b”, subparagraph (3), 28 counties are not required to submit a three-year strategic 29 plan by April 1, 2012, to the department of human services. A 30 county’s strategic plan in effect as of the effective date of 31 this section shall remain in effect until the regional service 32 system management plan for the region to which the county 33 belongs is approved in accordance with section 331.393 , subject 34 to modification before that date as necessary to conform with 35 -2- LSB 1663HC (3) 85 jp/rj 2/ 16

H.F. _____ statutory changes affecting the plan and any amendments to the 1 plan that are adopted in accordance with law . 2 TRANSITION FUND —— SERVICES MAINTENANCE 3 Sec. 7. TRANSITION FUND —— SERVICES MAINTENANCE. A county 4 receiving an allocation of funding from the mental health 5 and disability services redesign transition fund created in 6 2012 Iowa Acts, chapter 1120, section 23, shall utilize the 7 allocation so that the services available to an individual 8 child or other individual person in accordance with the 9 county’s approved service management plan in effect as of 10 June 30, 2012, remain in place provided the child or other 11 person continues to comply with the eligibility requirements 12 applicable under the plan as of that date. 13 REDESIGN EQUALIZATION PAYMENT APPROPRIATION 14 Sec. 8. MENTAL HEALTH AND DISABILITY SERVICES —— 15 EQUALIZATION PAYMENTS TRANSFER AND APPROPRIATION. 16 1. There is transferred from the general fund of the 17 state to the department of human services for the fiscal year 18 beginning July 1, 2013, and ending June 30, 2014, the following 19 amount, or so much thereof as is necessary, to be used for the 20 purposes designated: 21 For deposit in the property tax relief fund created in 22 section 426B.1, for distribution as provided in this section: 23 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ 29,820,478 24 2. The moneys credited to the property tax relief fund in 25 accordance with this section are appropriated to the department 26 of human services for distribution of equalization payments for 27 counties in the amounts specified in section 426B.3, subsection 28 4, as enacted by 2012 Iowa Acts, chapter 1120, section 137, 29 for the fiscal year beginning July 1, 2013. If the county is 30 part of a region that has been approved by the department in 31 accordance with section 331.389, to commence partial or full 32 operations, the county’s equalization payment shall be remitted 33 to the region for expenditure as approved by the region’s 34 governing board. The payments shall be remitted on or before 35 -3- LSB 1663HC (3) 85 jp/rj 3/ 16

H.F. _____ July 15, 2013. 1 MEDICAID OBLIGATION COST SETTLEMENT 2 Sec. 9. COUNTY MEDICAL ASSISTANCE NONFEDERAL SHARE —— 3 COST SETTLEMENT. Any county obligation for payment to the 4 department of human services of the nonfederal share of 5 the cost of services provided under the medical assistance 6 program prior to July 1, 2012, pursuant to sections 249A.12 7 and 249A.26, shall remain at the amount billed through the 8 period ending June 30, 2013. It is further intended that the 9 department of human services will determine the financial 10 need of counties as necessary to minimize the effects of the 11 change in determining the financial responsibility for such 12 services based on legal settlement to residency. It is further 13 intended that the final monthly billings for the obligations 14 shall be remitted to counties on or before August 1, 2013. 15 Any adjustments to the final amounts billed for such services 16 that occur on or after July 1, 2013, shall be applied to the 17 appropriation made to the department of human services from the 18 general fund of the state for the medical assistance program. 19 TRANSITION FROM LEGAL SETTLEMENT TO RESIDENCY 20 Sec. 10. MENTAL HEALTH AND DISABILITY REGIONAL SERVICES 21 FUND —— FY 2013-2014. It is the intent of the general assembly 22 that moneys credited to the mental health and disability 23 regional services fund created in 2012 Iowa Acts, chapter 1120, 24 section 9, for the fiscal year beginning July 1, 2013, will 25 be used to pay the costs of county or regionally administered 26 non-Medicaid mental health and disability services. It is 27 further intended that the department of human services will 28 determine the financial need of counties as necessary to 29 minimize the effects of the change in determining the financial 30 responsibility for such services based on legal settlement 31 to residency. It is further intended that if the county of 32 residence is part of a region that has been approved by the 33 department in accordance with section 331.389, to commence 34 partial or full operations, the moneys addressed by this 35 -4- LSB 1663HC (3) 85 jp/rj 4/ 16

H.F. _____ section will be remitted to the region for expenditure as 1 approved by the region’s governing board. 2 Sec. 11. EFFECTIVE UPON ENACTMENT. This division of this 3 Act, being deemed of immediate importance, takes effect upon 4 enactment. 5 DIVISION II 6 DATA AND STATISTICAL INFORMATION AND OUTCOME AND PERFORMANCE 7 MEASURES 8 Sec. 12. Section 225C.4, subsection 1, paragraph j, Code 9 2013, is amended to read as follows: 10 j. Establish and maintain a data collection and management 11 information system oriented to the needs of patients, 12 providers, the department, and other programs or facilities in 13 accordance with section 225C.6A . The system shall be used to 14 identify, collect, and analyze service outcome and performance 15 measures data in order to assess the effects of the services on 16 the persons utilizing the services. The administrator shall 17 annually submit to the commission information collected by the 18 department indicating the changes and trends in the disability 19 services system. The administrator shall make the outcome data 20 available to the public. 21 Sec. 13. Section 225C.6A, Code 2013, is amended to read as 22 follows: 23 225C.6A Disability services system redesign central data 24 repository . 25 1. The commission department shall do the following 26 relating to redesign of data concerning the disability services 27 system in the state: 28 1. Identify sources of revenue to support statewide 29 delivery of core disability services to eligible disability 30 populations. 31 2. Ensure there is a continuous improvement process for 32 development and maintenance of the disability services system 33 for adults and children. The process shall include but is not 34 limited to data collection and reporting provisions. 35 -5- LSB 1663HC (3) 85 jp/rj 5/ 16

H.F. _____ 3. a. Plan, collect, and analyze data as necessary to 1 issue cost estimates for serving additional populations and 2 providing core disability services statewide. The department 3 shall maintain compliance with applicable federal and state 4 privacy laws to ensure the confidentiality and integrity of 5 individually identifiable disability services data. The 6 department shall regularly may periodically assess the status 7 of the compliance in order to assure that data security is 8 protected. 9 b. In implementing Implement a system central data 10 repository under this subsection section for collecting and 11 analyzing state, county and region , and private contractor 12 data , the . The department shall establish a client identifier 13 for the individuals receiving services. The client identifier 14 shall be used in lieu of the individual’s name or social 15 security number. The client identifier shall consist of the 16 last four digits of an individual’s social security number, 17 the first three letters of the individual’s last name, the 18 individual’s date of birth, and the individual’s gender in an 19 order determined by the department. 20 c. Consult on an ongoing basis with regional administrators, 21 service providers, and other stakeholders in implementing the 22 central data repository and operations of the repository. The 23 consultation shall focus on minimizing the state and local 24 costs associated with operating the repository. 25 d. Engage with other state and local government and 26 nongovernmental entities operating the Iowa health information 27 network under chapter 135 and other data systems that maintain 28 information relating to individuals with information in the 29 central data repository in order to integrate data concerning 30 individuals. 31 c. 2. A county or region shall not be required to utilize a 32 uniform data operational or transactional system. However, the 33 system utilized shall have the capacity to exchange information 34 with the department, counties and regions, contractors, and 35 -6- LSB 1663HC (3) 85 jp/rj 6/ 16

H.F. _____ others involved with services to persons with a disability 1 who have authorized access to the central data repository. 2 The information exchanged shall be labeled consistently 3 and share the same definitions. Each county regional 4 administrator shall regularly report to the department annually 5 on or before December 1, for the preceding fiscal year the 6 following information for each individual served: demographic 7 information, expenditure data, and data concerning the services 8 and other support provided to each individual, as specified 9 in administrative rule adopted by the commission by the 10 department . 11 4. Work with county representatives and other qualified 12 persons to develop an implementation plan for replacing the 13 county of legal settlement approach to determining service 14 system funding responsibilities with an approach based upon 15 residency. The plan shall address a statewide standard for 16 proof of residency, outline a plan for establishing a data 17 system for identifying residency of eligible individuals, 18 address residency issues for individuals who began residing in 19 a county due to a court order or criminal sentence or to obtain 20 services in that county, recommend an approach for contesting 21 a residency determination, and address other implementation 22 issues. 23 3. The outcome and performance measures applied to the 24 regional disability services system shall utilize measurement 25 domains. The department may identify other measurement domains 26 in consultation with system stakeholders to be utilized in 27 addition to the following initial set of measurement domains: 28 a. Access to services. 29 b. Life in the community. 30 c. Person-centeredness. 31 d. Health and wellness. 32 e. Quality of life and safety. 33 f. Family and natural supports. 34 4. a. The processes used for collecting outcome and 35 -7- LSB 1663HC (3) 85 jp/rj 7/ 16

H.F. _____ performance measures data shall include but are not limited 1 to direct surveys of the individuals and families receiving 2 services and the providers of the services. The department 3 shall involve a workgroup of persons who are knowledgeable 4 about both the regional service system and survey techniques 5 to implement and maintain the processes. The workgroup shall 6 conduct an ongoing evaluation for the purpose of eliminating 7 the collection of information that is not utilized. The 8 surveys shall be conducted with a conflict-free approach in 9 which someone other than a provider of services surveys an 10 individual receiving the services. 11 b. The outcome and performance measures data shall encompass 12 and provide a means to evaluate both the regional services and 13 the services funded by the medical assistance program provided 14 to the same service populations. 15 c. The department shall develop and implement an 16 internet-based approach with graphical display of information 17 to provide outcome and performance measures data to the public 18 and those engaged with the regional service system. 19 d. The department shall include any significant costs for 20 collecting and interpreting outcome and performance measures 21 and other data in the department’s operating budget. 22 Sec. 14. REPEAL. The amendment to section 225C.4, 23 subsection 1, paragraph j, in 2012 Iowa Acts, chapter 1120, 24 section 2, is repealed. 25 Sec. 15. REPEAL. The amendments to section 225C.6A, in 2012 26 Iowa Acts, chapter 1120, sections 6, 7, and 95, are repealed. 27 DIVISION III 28 CHILDREN’S CABINET 29 Sec. 16. NEW SECTION . 242.1 Findings. 30 The general assembly finds there is a need for a state-level 31 children’s cabinet to provide guidance, oversight, problem 32 solving, long-term strategy development, and collaboration 33 among the state and local efforts to build a comprehensive, 34 coordinated system to promote the well-being of the children 35 -8- LSB 1663HC (3) 85 jp/rj 8/ 16

H.F. _____ in this state and to address the needs of children for mental 1 health treatment and other specialized services. 2 Sec. 17. NEW SECTION . 242.2 Children’s cabinet established. 3 There is established within the department of human services 4 a children’s cabinet. 5 1. The voting members of the children’s cabinet shall 6 consist of the following: 7 a. The director of the department of education or the 8 director’s designee. 9 b. The director of the department of human services or the 10 director’s designee. This member shall be chairperson of the 11 cabinet. 12 c. The director of the department of public health or the 13 director’s designee. 14 d. A parent of a child with a severe emotional disturbance 15 or a disability who is the primary caregiver for that child, 16 appointed by the governor. 17 e. A juvenile court judge or juvenile court officer 18 appointed by the chief justice of the supreme court. 19 f. A community-based provider of child welfare, health, 20 or juvenile justice services to children, appointed by the 21 director of human services. 22 g. A member of the early childhood Iowa state board, 23 appointed by the state board. 24 h. A community stakeholder who is not affiliated with a 25 provider of services, appointed by the governor. 26 i. Not more than three other members designated by 27 the cabinet chairperson to ensure adequate representation 28 of the persons and interests who may be affected by the 29 recommendations made by the cabinet. 30 2. In addition to the voting members, there shall be four ex 31 officio, nonvoting members of the children’s cabinet. These 32 members shall be two state representatives, one appointed by 33 the speaker of the house of representatives and one by the 34 minority leader of the house of representatives, and two state 35 -9- LSB 1663HC (3) 85 jp/rj 9/ 16

H.F. _____ senators, one appointed by the majority leader of the senate 1 and one by the minority leader of the senate. 2 3. a. The voting members, other than department directors 3 and their designees, shall be appointed for four-year terms. 4 The terms of such members begin on May 1 in the year of 5 appointment and expire on April 30 in the year of expiration. 6 b. Vacancies shall be filled in the same manner as original 7 appointments. A vacancy shall be filled for the unexpired 8 term. 9 c. The voting members shall receive actual and necessary 10 expenses incurred in the performance of their duties and 11 legislative members shall be compensated as provided in section 12 2.32A. 13 4. Staffing services for the children’s cabinet shall be 14 provided by the department of human services. 15 Sec. 18. NEW SECTION . 242.3 Duties. 16 The children’s cabinet shall perform the following duties to 17 address the needs of children and families in this state: 18 1. Recommend operating provisions for health homes for 19 children implemented by the department of human services. The 20 provisions shall include but are not limited to all of the 21 following: 22 a. Identification of quality expectations. 23 b. Identification of performance criteria. 24 c. Provisions for monitoring the implementation of 25 specialized health homes. 26 2. Gather information and improve the understanding of 27 policymakers and the public of how the various service systems 28 intended to meet the needs of children and families operate at 29 the local level. 30 3. Address areas of overlap, gaps, and conflict between 31 service systems. 32 4. Support the evolution of service systems in implementing 33 new services and enhancing existing services to address the 34 needs of children and families through process improvement 35 -10- LSB 1663HC (3) 85 jp/rj 10/ 16

H.F. _____ methodologies. 1 5. Assist policymakers and service system users in 2 understanding and effectively managing system costs. 3 6. Ensure services offered are evidence-based. 4 7. Issue guidelines to enable the services and other support 5 which is provided by or under the control of state entities and 6 delivered at the local level to have sufficient flexibility to 7 engage local resources and meet unique needs of children and 8 families. 9 8. Integrate efforts of policymakers and service providers 10 to improve the well-being of community members in addition to 11 children and families. 12 9. Implement strategies so that the children and families 13 engaged with the service systems avoid the need for higher 14 level services and other support. 15 10. Submit a report annually by December 15 to the governor, 16 general assembly, and supreme court providing findings and 17 recommendations and issue other reports as deemed necessary by 18 the cabinet. 19 Sec. 19. INITIAL TERMS. Notwithstanding section 242.2, 20 subsection 3, paragraph “a”, as enacted by this division of 21 this Act, the appointing authorities for the members of the 22 children’s cabinet created by this division of this Act who are 23 subject to terms of service shall be coordinated so that the 24 initial terms of approximately half of such members are two 25 years and the remainder are for four years and remain staggered 26 thereafter. 27 EXPLANATION 28 This bill relates to mental health and disability services 29 (MH/DS) administered by counties and the regions being formed 30 by counties to provide adult MH/DS that are not covered by the 31 medical assistance (Medicaid) program, children’s services, 32 and makes appropriations. The bill addresses a portion of 33 the recommendations made to the mental health and disability 34 services redesign fiscal viability study committee by various 35 -11- LSB 1663HC (3) 85 jp/rj 11/ 16

H.F. _____ committees and workgroups created or continued by the MH/DS 1 redesign legislation enacted in 2012 Iowa Acts, chapter 1120 2 (SF 2315) and chapter 1133 (SF 2336) and includes related 3 provisions. The bill is organized into divisions according to 4 the committee or workgroup that made the recommendations. 5 SYSTEM REDESIGN IMPLEMENTATION. The transition committee 6 was created by the department of human services (DHS) pursuant 7 to SF 2315, section 22, consisting of “appropriate stakeholders 8 with whom to consult on the transition from the current 9 mental health and disability services system to the regional 10 service system”. This division addresses some system redesign 11 recommendations made by the transition committee and includes 12 related provisions. 13 Code section 331.389, relating to the criteria for county 14 agreements to form MH/DS regions, is amended to provide an 15 exception from the requirement that the counties comprising a 16 region must be contiguous. The exception allows a region to 17 include a county that is not contiguous with the other counties 18 in the region. The county that is not contiguous must have had 19 a formal relationship for two years or longer with one or more 20 of the other counties in the region for the provision of MH/DS. 21 Code section 331.396, relating to diagnosis and functional 22 assessment requirements for eligibility for the regional 23 service system, is amended to provide that a child or adult 24 person who received mental health or intellectual disability 25 services under an approved county management plan, remains 26 eligible under the regional system regardless of the financial 27 eligibility requirements, adult age requirement, and diagnosis 28 requirements for the regional system. The person’s eligibility 29 for individualized services is subject to determination in 30 accordance with a functional assessment. 31 Code section 331.397, relating to the requirements 32 for regional core services, is amended to provide that 33 an individual child or individual adult person with a 34 developmental disability or a brain injury who was receiving 35 -12- LSB 1663HC (3) 85 jp/rj 12/ 16

H.F. _____ services prior to formation of a region remains eligible for 1 the services after formation of the region, subject to the 2 availability of funding. 3 Code section 426B.3, as amended by SF 2315, relates to 4 eligibility for equalization payments from the state in fiscal 5 years 2013-2014 and 2014-2015 for those counties with a base 6 year levy which is less than a target amount computed by 7 multiplying the county’s general population times a statewide 8 per capita expenditure target amount of $47.28. The bill 9 provides that if the county is part of a region approved by 10 DHS to commence partial or full operations, the county’s 11 equalization payment is remitted to the region for expenditure 12 as approved by the region’s governing board. 13 Under Code section 331.439, counties are required to submit 14 a three-year strategic plan for MH/DS and the latest plan was 15 due by April 1, 2012. In accordance with 2012 Iowa Acts, 16 chapter 1128, the strategic plan submission was not required 17 and the existing strategic plan remained in effect. The bill 18 provides that a county’s strategic plan remains in effect, 19 unless modified pursuant to statute or amended by the county, 20 until it is replaced by approval of the regional service system 21 management plan for the region to which the county belongs. 22 If a county receives an allocation of funding from the mental 23 health and disability services redesign transition fund created 24 in SF 2315, the county is required to utilize the allocation 25 so that the services provided to an individual child or other 26 individual person receiving services in accordance with the 27 county’s approved service management plan in effect as of 28 June 30, 2012, remain in place provided the child or other 29 person continues to comply with the eligibility requirements 30 applicable under the plan as of that date. 31 A transfer of approximately $30 million is made from 32 the general fund of the state to DHS to be credited to the 33 property tax relief fund and is appropriated for DHS to make 34 equalization payments to eligible counties for FY 2013-2014. 35 -13- LSB 1663HC (3) 85 jp/rj 13/ 16

H.F. _____ Any county obligation for payment to DHS of the nonfederal 1 share of the cost of services provided under the Medicaid 2 program prior to July 1, 2012, is required to remain at the 3 amount billed through the period ending June 30, 2013. Any 4 adjustments that occur on or after July 1, 2013, are to be 5 applied to the appropriation made for the Medicaid program. 6 A legislative intent section addresses funding appropriated 7 to DHS for FY 2013-2014, to support the costs of non-Medicaid 8 mental health and disability services provided by counties. 9 DHS would be required to determine the financial need of 10 counties necessary to address the effects of the change from 11 determining financial responsibility for such services on the 12 basis of county of legal settlement to county of residence. 13 If the county of residence is part of a region that has been 14 approved by DHS to commence partial or full operations, the 15 DHS moneys would be remitted to the region for expenditure as 16 approved by the region’s governing board. 17 This division takes effect upon enactment. 18 DATA AND STATISTICAL INFORMATION AND OUTCOME AND PERFORMANCE 19 MEASURES. This division relates to recommendations submitted 20 by the data and statistical information integration workgroup 21 and the outcomes and performance measures committee. 22 Current law is amended in Code section 225C.4, relating 23 to the duties of the DHS MH/DS division administrator, and 24 in Code section 225C.6A, relating to disability services 25 system redesign, to delineate requirements pertaining to 26 MH/DS state collection and management information systems 27 and outcome and performance data. These Code provisions 28 were previously amended by SF 2315. The bill incorporates 29 the SF 2315 amendments and adds new language and repeals 30 the SF 2315 amendments that would otherwise take effect on 31 July 1, 2013. For Code section 225C.4, the bill references 32 in the administrator’s duties the specific new requirements 33 established by the bill in Code section 225C.6A. The new 34 requirements pertain to DHS implementation of a central data 35 -14- LSB 1663HC (3) 85 jp/rj 14/ 16

H.F. _____ repository, information exchange capacity, regular reporting 1 of individual information, data security, consultation with 2 regional staff, providers, and other stakeholders, engaging 3 with other data systems, outcome and performance measure 4 domains, use of surveys, evaluation of both regional and 5 Medicaid services, provision of data to the public via an 6 internet-based approach with graphical information, and 7 inclusion of significant costs associated with the data and 8 measures in the DHS budget. 9 CHILDREN’S CABINET. This division relates to the 10 recommendations submitted by the children’s disability 11 workgroup to create a children’s cabinet. 12 New Code section 242.1 lists legislative findings as to the 13 need for the children’s cabinet. The needs identified are 14 to provide guidance, oversight, problem solving, long-term 15 strategy development, and collaboration among the state and 16 local efforts to build a comprehensive, coordinated system to 17 promote the well-being of the children in this state and to 18 address the needs of children for mental health treatment and 19 other specialized services. 20 New Code section 242.2 provides for appointment of members 21 to the children’s cabinet. The director of the department of 22 human services (DHS) or the director’s designee is to be the 23 chairperson of the cabinet and appoint up to three additional 24 members to the cabinet, and DHS is required to staff the 25 cabinet. Various state agencies are identified for membership 26 along with community stakeholders. Four members of the 27 general assembly are required to be appointed to serve in an 28 ex officio, nonvoting capacity. 29 New Code section 242.3 delineates the duties of the 30 children’s cabinet, including the recommendation of operating 31 provisions for health homes for children and the practices 32 utilized by other aspects of the service systems for children. 33 The children’s cabinet is required to report annually by 34 December 15 to the governor, general assembly, and supreme 35 -15- LSB 1663HC (3) 85 jp/rj 15/ 16