House File 2211 - Introduced HOUSE FILE 2211 BY ISENHART A BILL FOR An Act relating to county funding of services for persons with 1 substance-related disorders and co-occurring mental health 2 and substance-related disorders and including effective date 3 provisions. 4 BE IT ENACTED BY THE GENERAL ASSEMBLY OF THE STATE OF IOWA: 5 TLSB 5435YH (5) 87 hb/rh

H.F. 2211 Section 1. Section 331.391, subsection 4, paragraph b, Code 1 2018, is amended to read as follows: 2 b. For fiscal years beginning July 1, 2017, July 1, 2018, 3 and July 1, 2019, that portion of each region’s cash flow 4 amount either reserved in the combined account or reserved 5 among all separate county accounts under the control of the 6 governing board that exceeds twenty-five percent of the gross 7 expenditures from the combined account or from all separate 8 county accounts under control of the governing board in the 9 fiscal year preceding the fiscal year in progress shall be used 10 in whole or in part to fund the payment of services provided 11 under the regional service system management plan under section 12 331.393 , which may include expenses associated with increasing 13 capacity to provide services to persons with substance-related 14 disorders and persons with co-occurring mental health and 15 substance-related disorders . 16 Sec. 2. Section 331.393, subsection 2, Code 2018, is amended 17 to read as follows: 18 2. Each region shall submit to the department an annual 19 service and budget plan approved by the region’s governing 20 board and subject to approval by the director of human 21 services. Provisions for the director of human services’ 22 approval of the annual service and budget plan, and any 23 amendments to the plan, and other requirements shall be 24 specified in rule adopted by the state commission. 25 a. The provisions addressed in the annual plan shall include 26 but are not limited to all of the following: 27 a. (1) The region’s budget and financing provisions for 28 the next fiscal year. The provisions shall address how county, 29 regional, state, and other funding sources will be used to meet 30 the service needs within the region. 31 b. (2) The scope of services included in addition to 32 the required core services. Each service included shall be 33 described and projection of need and the funding necessary to 34 meet the need shall be included. 35 -1- LSB 5435YH (5) 87 hb/rh 1/ 4

H.F. 2211 c. (3) The location of the local access points for 1 services. 2 d. (4) The plan for assuring effective crisis prevention, 3 response, and resolution. 4 e. (5) The provider reimbursement provisions. A region’s 5 use of provider reimbursement approaches in addition to 6 fee-for-service reimbursement and for compensating the 7 providers engaged in a systems of care approach and other 8 nontraditional providers shall be encouraged. A region also 9 shall be encouraged to use and the department shall approve 10 funding approaches that identify and incorporate all services 11 and sources of funding used by persons receiving services, 12 including medical assistance program funding. 13 f. (6) Financial forecasting measures. 14 g. (7) The targeted case managers designated for the 15 region. 16 h. (8) The financial eligibility requirements for service 17 under the regional service system. A plan that otherwise 18 incorporates the financial eligibility requirements of section 19 331.395 but allows eligibility for persons with resources above 20 the minimum resource limitations adopted pursuant to section 21 331.395, subsection 1 , paragraph “c” , who were eligible under 22 resource limitations in effect prior to July 1, 2014, or are 23 authorized by the region as an exception to policy, shall be 24 deemed by the department to be in compliance with financial 25 eligibility requirements of section 331.395 . 26 b. The provisions addressed in the annual plan may include 27 a plan for the use of anticipated residual funding in excess 28 of twenty-five percent of the gross expenditures as provided 29 in section 331.391, subsection 4, paragraph “b” , to increase 30 capacity to provide services to persons with substance-related 31 disorders and co-occurring mental health and substance-related 32 disorders. 33 Sec. 3. Section 331.397, Code 2018, is amended by adding the 34 following new subsection: 35 -2- LSB 5435YH (5) 87 hb/rh 2/ 4

H.F. 2211 NEW SUBSECTION . 6A. Notwithstanding any other provision 1 of this section to the contrary, a regional service system 2 may provide funding to increase capacity to provide services 3 to persons with substance-related disorders and persons with 4 co-occurring mental health and substance-related disorders 5 pursuant to section 331.391, subsection 4, paragraph “b” . 6 Sec. 4. EFFECTIVE DATE. This Act, being deemed of immediate 7 importance, takes effect upon enactment. 8 EXPLANATION 9 The inclusion of this explanation does not constitute agreement with 10 the explanation’s substance by the members of the general assembly. 11 Under current law, if a mental health and disability 12 services region is meeting the financial obligations for 13 implementation of its regional service system management plan 14 for a fiscal year and residual funding is anticipated, the 15 regional administrator shall reserve an adequate amount of 16 unobligated and unencumbered funds for cash flow of expenditure 17 obligations in the next fiscal year. For fiscal years 18 beginning July 1, 2017, July 1, 2018, and July 1, 2019, that 19 portion of each region’s cash flow amount either reserved in 20 the combined account or reserved among all separate county 21 accounts under the control of the governing board that exceeds 22 25 percent of the gross expenditures from the combined account 23 or from all separate county accounts under the control of the 24 governing board in the fiscal year preceding the fiscal year in 25 progress are required to be used in whole or in part to fund the 26 payment of services provided under the regional service system 27 management plan. The bill provides such funds may be used 28 for expenses associated with increasing capacity to provide 29 services to persons with substance-related disorders and 30 persons with co-occurring mental health and substance-related 31 disorders. 32 Current law requires each region to submit to the department 33 of human services an annual service and budget plan approved 34 by the region’s governing board and subject to the approval of 35 -3- LSB 5435YH (5) 87 hb/rh 3/ 4

H.F. 2211 the director of human services. The bill provides the annual 1 service and budget plan may include a plan for the use of 2 anticipated residual funding in excess of 25 percent of the 3 gross expenditures to increase capacity to provide services 4 to persons with substance-related disorders and co-occurring 5 mental health and substance-related disorders, and that a 6 regional service system may provide funding for such services. 7 The bill takes effect upon enactment. 8 -4- LSB 5435YH (5) 87 hb/rh 4/ 4