House File 2331 - Introduced HOUSE FILE 2331 BY ROGERS A BILL FOR An Act relating to mental health services, including the 1 provision of intensive residential service homes for persons 2 with serious and persistent mental illness under Medicaid 3 managed care and out-of-state placements for persons with 4 mental illness. 5 BE IT ENACTED BY THE GENERAL ASSEMBLY OF THE STATE OF IOWA: 6 TLSB 6076YH (4) 87 hb/rh

H.F. 2331 Section 1. DEPARTMENT OF HUMAN SERVICES —— INTENSIVE 1 RESIDENTIAL SERVICE HOMES FOR PERSONS WITH SERIOUS AND 2 PERSISTENT MENTAL ILLNESS. 3 1. The department of human services shall establish 4 intensive residential service homes (IRSH) to serve children or 5 adults diagnosed with a serious and persistent mental illness 6 and that may also have an accompanying co-occurring diagnosis 7 of developmental or intellectual disability or substance use 8 disorder. Each IRSH shall contain sixteen or fewer beds. The 9 department shall adopt rules pursuant to chapter 17A that 10 require each IRSH to meet all of the following requirements: 11 a. Be located in an area zoned for single or multiple-family 12 housing. 13 b. Provide staffing twenty-four hours a day, seven days a 14 week, and have a staff-to-resident ratio of two residents per 15 staff member. 16 c. Ensure treatment plans are developed by a comprehensive 17 interdisciplinary team selected by the person that the 18 comprehensive interdisciplinary team develops and implements 19 the person’s person-centered plan. 20 d. Ensure access to active medication management and 21 outpatient therapy, including evidence-based therapy. 22 e. Provide access to assertive community treatment services 23 if there is a demonstrated need. 24 f. Develop, as appropriate, a thorough wellness recovery 25 action plan. 26 g. Be licensed as a substance use disorder treatment program 27 or have a cooperative agreement with a licensed substance use 28 disorder treatment services facility. 29 h. Accept persons who are court-ordered for treatment. 30 i. Accept persons referred to the IRSH regardless of 31 the severity of a person’s mental illness or co-occurring 32 condition. 33 j. Serve persons with similar conditions and diagnoses. 34 2. The department shall establish criteria for admission to 35 -1- LSB 6076YH (4) 87 hb/rh 1/ 3

H.F. 2331 IRSHs based on the December 2017 report of the complex service 1 needs workgroup created by the department of human services 2 pursuant to 2017 Iowa Acts, chapter 109, section 17. 3 3. The department shall work with stakeholders, Medicaid 4 managed care organizations, and mental health and disability 5 services regions to establish reimbursement rates as an 6 expansion of the tiered rate system of reimbursement for 7 habilitation services. 8 Sec. 2. DEPARTMENT OF HUMAN SERVICES —— OUT-OF-STATE 9 PLACEMENT OF PERSONS WITH MENTAL ILLNESS. The department 10 of human services shall study the number of out-of-state 11 placements for care and treatment of persons with mental 12 illness, the reasons for and costs associated with such 13 placements, and any other factors the department deems 14 necessary to review and analyze the effectiveness of such 15 out-of-state placements. The department shall provide a report 16 containing findings and recommendations to the governor and 17 general assembly by December 15, 2018. 18 EXPLANATION 19 The inclusion of this explanation does not constitute agreement with 20 the explanation’s substance by the members of the general assembly. 21 This bill directs the department of human services to 22 establish intensive residential service homes (IRSH) to serve 23 children or adults diagnosed with a serious and persistent 24 mental illness and any accompanying co-occurring diagnosis 25 of developmental or intellectual disability or substance use 26 disorder. The IRSHs shall contain 16 or fewer beds. The bill 27 provides that the department shall adopt rules that require 28 an IRSH home to be located in an area zoned for single or 29 multiple-family housing; be staffed 24 hours a day, seven days 30 per week, and have a staff-to-resident ratio of two residents 31 per staff member; ensure treatment plans are developed by a 32 comprehensive interdisciplinary team selected by the person 33 that the comprehensive interdisciplinary team develops and 34 implements the person’s person-centered plan; ensure access to 35 -2- LSB 6076YH (4) 87 hb/rh 2/ 3

H.F. 2331 active medication management and outpatient therapy, including 1 evidence-based therapy; provide access to assertive community 2 treatment services if there is a demonstrated need; develop, 3 as appropriate, a thorough wellness recovery action plan; be 4 licensed as a substance use disorder treatment program or 5 have a cooperative agreement with a licensed substance use 6 disorder treatment services facility; accept persons who are 7 court-ordered for treatment; accept persons regardless of 8 the severity of a person’s mental illness or co-occurring 9 condition; and serve persons with similar conditions and 10 diagnoses. The bill directs the department to establish 11 criteria for admission to an IRSH based on the December 2017 12 report from the complex service needs workgroup created by the 13 department pursuant to 2017 Iowa Acts, chapter 109, section 17. 14 The department is required to work with stakeholders, Medicaid 15 managed care organizations, and mental health and disability 16 services regions to establish reimbursement rates based on the 17 tiered rate system for habilitation services. 18 The bill requires the department to study the number of 19 out-of-state placements for care and treatment of persons 20 with mental illness and submit a report with findings and 21 recommendations to the governor and general assembly by 22 December 15, 2018. 23 -3- LSB 6076YH (4) 87 hb/rh 3/ 3