House File 2466 - Introduced HOUSE FILE 2466 BY PRICHARD , BROWN-POWERS , JACOBY , COHOON , EHLERT , GAINES , OLSON , BRECKENRIDGE , HALL , HUNTER , STAED , WILBURN , THEDE , WILLIAMS , R. SMITH , McCONKEY , ABDUL-SAMAD , WESSEL-KROESCHELL , SUNDE , BEARINGER , MATSON , KRESSIG , JUDGE , RUNNING-MARQUARDT , GASKILL , OLDSON , KACENA , M. SMITH , KONFRST , McKEAN , DONAHUE , ANDERSON , STECKMAN , JAMES , and NIELSEN A BILL FOR An Act establishing a mental health and disability services 1 risk pool and risk pool board, making appropriations, and 2 including effective date provisions. 3 BE IT ENACTED BY THE GENERAL ASSEMBLY OF THE STATE OF IOWA: 4 TLSB 5332YH (3) 88 md/rh

H.F. 2466 Section 1. NEW SECTION . 426B.5A Risk pool. 1 1. For the purposes of this section, unless the context 2 otherwise requires: 3 a. “County services fund” means the same as defined in 4 section 331.424A. 5 b. “Mental health and disability services region” means 6 a mental health and disability services region formed in 7 accordance with section 331.389. 8 c. “Regional administrator” means the regional administrator 9 of a mental health and disability services region, as defined 10 in section 331.388. 11 2. a. A risk pool is created in the property tax relief 12 fund under section 426B.1. The pool shall consist of the 13 moneys credited to the pool by law. 14 b. For each fiscal year beginning on or after July 1, 2020, 15 there is appropriated annually from the general fund of the 16 state to the department of human services to be credited to the 17 risk pool twenty-four million two hundred thousand dollars to 18 be used as provided in this section. 19 3. A risk pool board is created. The board shall consist 20 of two county supervisors, two county auditors, a member of 21 the mental health and disability services commission created 22 under section 225C.5 who is not a member of a county board 23 of supervisors, a member of the county finance committee 24 created in chapter 333A who is not an elected official, a 25 representative of a provider of mental health or developmental 26 disabilities services selected from nominees submitted by 27 the Iowa association of community providers, and two staff 28 members of regional administrators of county mental health and 29 disability services regions, all appointed by the governor, 30 and one member appointed by the director of human services. 31 All members appointed by the governor shall be subject to 32 confirmation by the senate. Members shall serve for three-year 33 terms. A vacancy shall be filled in the same manner as the 34 original appointment. Expenses and other costs of the risk 35 -1- LSB 5332YH (3) 88 md/rh 1/ 6

H.F. 2466 pool board members representing counties shall be paid by the 1 county of origin. Expenses and other costs of risk pool board 2 members who do not represent counties shall be paid from a 3 source determined by the governor. Staff assistance to the 4 board shall be provided by the department of human services and 5 counties. Actuarial expenses and other direct administrative 6 costs shall be charged to the risk pool. 7 4. A regional administrator must apply to the risk pool 8 board for assistance from the risk pool on or before October 31 9 preceding the fiscal year for which assistance is requested. 10 The purpose of the assistance shall be to provide financial 11 support for services provided by one or more of the counties 12 comprising the regional administrator’s mental health and 13 disability services region. The risk pool board shall make its 14 final decisions on or before December 15 regarding acceptance 15 or rejection of the applications for assistance and the total 16 amount accepted shall be considered obligated. 17 5. Basic eligibility for risk pool assistance requires that 18 a mental health and disability services region meet all of the 19 following conditions: 20 a. The mental health and disability services region is in 21 compliance with the regional service system management plan 22 requirements of section 331.393. 23 b. The counties comprising the mental health and disability 24 services region each levied the maximum amount allowed for the 25 county’s services fund under section 331.424A and in compliance 26 with the region’s service system management plan for the fiscal 27 year of application for risk pool assistance. 28 c. The mental health and disability services region’s cash 29 flow amount, either reserved in the region’s combined account 30 or reserved among all separate county accounts under the 31 control of the region’s governing board, does not exceed forty 32 percent of the gross expenditures from the combined account or 33 from all separate county accounts under control of the region’s 34 governing board for the fiscal year preceding the fiscal year 35 -2- LSB 5332YH (3) 88 md/rh 2/ 6

H.F. 2466 in progress. 1 6. The risk pool board shall review the fiscal year-end 2 financial records for all mental health and disability services 3 regions that are granted risk pool assistance. If the board 4 determines a mental health and disability services region’s 5 actual need for risk pool assistance was less than the amount 6 of risk pool assistance granted to the mental health and 7 disability services region, the mental health and disability 8 services region shall refund the difference between the amount 9 of assistance granted and the actual need. The mental health 10 and disability services region shall submit the refund within 11 thirty days of receiving notice from the board. Refunds shall 12 be credited to the risk pool. The mental health and disability 13 services commission shall adopt rules pursuant to chapter 17A 14 providing criteria for the purposes of this subsection and as 15 necessary to implement the other provisions of this section. 16 7. The risk pool board shall determine application 17 requirements to ensure prudent use of risk pool assistance. 18 The board may accept or reject an application for assistance in 19 whole or in part. The decision of the board is final. 20 8. The total amount of risk pool assistance shall be limited 21 to the amount available in the risk pool for a fiscal year. Any 22 unobligated balance in the risk pool at the close of a fiscal 23 year shall remain in the risk pool for distribution in the 24 succeeding fiscal year. 25 9. Risk pool assistance shall only be made available to 26 address one or more of the following: 27 a. Continuing support for mandated services or 28 implementation of mandated services. 29 b. Avoiding the need for reduction or elimination of 30 critical services when the reduction or elimination places 31 consumers’ health or safety at risk. 32 c. Avoiding the need for reduction or elimination of a 33 mobile crisis team or other critical emergency services when 34 the reduction or elimination places the public’s health or 35 -3- LSB 5332YH (3) 88 md/rh 3/ 6

H.F. 2466 safety at risk. 1 d. Avoiding the need for reduction or elimination of 2 the services or other support provided to entire disability 3 populations. 4 e. Avoiding the need for reduction or elimination of 5 services or other support that maintain consumers in a 6 community setting, creating a risk that the consumers would be 7 placed in more restrictive, higher cost settings. 8 f. Implementing the children’s behavioral health core 9 service domains under section 331.397A. 10 10. Subject to the amount available and obligated from 11 the risk pool for a fiscal year, the department of human 12 services shall annually calculate the amount of moneys due 13 to eligible mental health and disability services regions in 14 accordance with the risk pool board’s decisions and that amount 15 is appropriated from the risk pool to the department of human 16 services for payment of the moneys due. The department shall 17 authorize the issuance of warrants payable to the mental health 18 and disability services regions for the amounts due and the 19 warrants shall be issued on or before January 1. 20 11. On or before March 1 and September 1 of each fiscal 21 year, the department of human services shall provide the risk 22 pool board with a report of the financial condition of the risk 23 pool. 24 12. If the risk pool board has made its decisions but has 25 determined that there are otherwise qualifying requests for 26 risk pool assistance that are beyond the amount available in 27 the risk pool fund for a fiscal year, the board shall compile 28 a list of such requests and the supporting information for 29 the requests. The list and information shall be submitted 30 to the mental health and disability services commission, the 31 department of human services, and the general assembly. 32 Sec. 2. EMERGENCY RULES. The mental health and disability 33 services commission, in accordance with the consultation 34 requirements of section 426B.4, may adopt emergency rules under 35 -4- LSB 5332YH (3) 88 md/rh 4/ 6

H.F. 2466 section 17A.4, subsection 3, and section 17A.5, subsection 2, 1 paragraph “b”, to implement the provisions of this Act and 2 the rules shall be effective immediately upon filing unless 3 a later date is specified in the rules. Any rules adopted 4 in accordance with this section shall also be published as a 5 notice of intended action as provided in section 17A.4. 6 Sec. 3. 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 This bill establishes a risk pool within the property tax 12 relief fund under Code section 426B.1 to provide funds to 13 mental health and disability services regions with an actual 14 need for risk pool assistance funding to implement or continue 15 specified required mental health and disability services for 16 adults and children. In addition to other moneys credited 17 to the risk pool by law, for each fiscal year beginning on 18 or after July 1, 2020, there is appropriated $24.2 million 19 annually from the general fund of the state to the department 20 of human services to be credited to the risk pool. 21 The bill creates a risk pool board. The board shall consist 22 of two county supervisors, two county auditors, a member of 23 the mental health and disability services commission who is 24 not a member of a county board of supervisors, a member of the 25 county finance committee who is not an elected official, a 26 representative of a provider of mental health or developmental 27 disabilities services selected from nominees submitted by 28 the Iowa association of community providers, and two staff 29 members of regional administrators of county mental health and 30 disability services regions, all appointed by the governor, 31 and one member appointed by the director of human services. 32 All members appointed by the governor shall be subject to 33 confirmation by the senate. Members shall serve for three-year 34 terms. 35 -5- LSB 5332YH (3) 88 md/rh 5/ 6

H.F. 2466 To receive funding, a regional administrator must apply 1 to the risk pool board for assistance from the risk pool on 2 or before October 31 preceding the fiscal year for which 3 assistance is requested. The purpose of the assistance shall 4 be to provide financial support for services provided by one or 5 more of the counties comprising the regional administrator’s 6 mental health and disability services region. The risk pool 7 board shall make its final decisions on or before December 8 15 regarding acceptance or rejection of the applications for 9 assistance and the total amount accepted shall be considered 10 obligated. 11 The bill establishes basic eligibility for risk pool 12 assistance, requires the risk pool board to review the fiscal 13 year-end financial records for all mental health and disability 14 services regions that are granted risk pool assistance, directs 15 the risk pool board to determine application requirements to 16 ensure prudent use of risk pool assistance, and establishes the 17 circumstances under which risk pool assistance is to be made 18 available. 19 The bill authorizes the mental health and disability 20 services commission to adopt emergency rules to implement the 21 provisions of the bill. 22 The bill takes effect upon enactment. 23 -6- LSB 5332YH (3) 88 md/rh 6/ 6