House File 630 - Introduced HOUSE FILE 630 BY M. SMITH , ABDUL-SAMAD , ANDERSON , BEARINGER , BENNETT , BRECKENRIDGE , BROWN-POWERS , COHOON , DERRY , DONAHUE , EHLERT , FORBES , GAINES , GASKILL , HALL , HEDDENS , HUNTER , ISENHART , JACOBY , JAMES , JUDGE , KACENA , KONFRST , KRESSIG , KURTH , KURTZ , LENSING , MASCHER , MATSON , McCONKEY , B. MEYER , NIELSEN , OLDSON , OURTH , PRICHARD , RUNNING-MARQUARDT , R. SMITH , STAED , STECKMAN , SUNDE , THEDE , WESSEL-KROESCHELL , WILLIAMS , WINCKLER , and WOLFE A BILL FOR An Act relating to mental health supports and services for 1 children and adults, including the establishment of a mental 2 health professional fellowship program. 3 BE IT ENACTED BY THE GENERAL ASSEMBLY OF THE STATE OF IOWA: 4 TLSB 1630YH (6) 88 hb/rh

H.F. 630 Section 1. Section 135.175, subsection 1, paragraph a, Code 1 2019, is amended to read as follows: 2 a. A health care workforce support initiative is established 3 to provide for the coordination and support of various efforts 4 to address the health care workforce shortage in this state. 5 This initiative shall include the medical residency training 6 state matching grants program created in section 135.176 , 7 the mental health professional fellowship program created in 8 section 135.177, the nurse residency state matching grants 9 program created in section 135.178 , and the fulfilling Iowa’s 10 need for dentists matching grant program created in section 11 135.179 . 12 Sec. 2. Section 135.175, subsection 5, Code 2019, is amended 13 by adding the following new paragraph: 14 NEW PARAGRAPH . e. The mental health professional fellowship 15 program account. The mental health professional fellowship 16 program account shall be under the control of the department 17 and the moneys in the account shall be used for the purposes of 18 the mental health professional fellowship program as specified 19 in section 135.177. Moneys in the account shall consist of 20 moneys appropriated or allocated for deposit in or received 21 by the fund or the account and specifically dedicated to the 22 mental health professional fellowship program or the account 23 for the purposes of the account. 24 Sec. 3. NEW SECTION . 135.177 Mental health professional 25 fellowship program. 26 1. For the purposes of this section, “mental health 27 professional shortage area” means a geographic area in this 28 state that has been designated by the United States department 29 of health and human services, health resources and services 30 administration, bureau of health professionals, as having a 31 shortage of mental health professionals. 32 2. The department, in cooperation with the college 33 student aid commission, shall establish a mental health 34 professional fellowship program in accordance with this 35 -1- LSB 1630YH (6) 88 hb/rh 1/ 8

H.F. 630 section. Funding for the program may be provided through 1 the health care workforce shortage fund or the mental health 2 professional fellowship program account created in section 3 135.175. The purpose of the program is to determine the 4 effect of specialized training and support for mental health 5 professionals in providing mental health services to address 6 Iowa’s shortage of mental health professionals. 7 3. The program shall provide for all of the following: 8 a. Collaboration between Iowa institutions of higher 9 education and mental health professional programs to educate 10 mental health professionals. 11 b. Elderly, youth, and general population clinical 12 experiences, with a primary emphasis on youth clinical 13 experiences and a secondary emphasis on elderly and general 14 population clinical experiences. 15 c. Supervision of students participating in the program 16 provided by Iowa institutions of higher education and other 17 clinical partners participating in the program. 18 4. A contract for the program shall stipulate the time 19 period the mental health professional shall practice in 20 a mental health professional shortage area in this state. 21 In addition, the contract shall stipulate that the mental 22 health professional repay any funds paid on the mental health 23 professional’s behalf by the program if the mental health 24 professional is unable to fulfill the time period in the 25 contract. 26 5. State and private entity clinical partners shall 27 regularly evaluate and document their experiences with the 28 approaches utilized and outcomes achieved by the program 29 to identify an optimal model for operating the program. 30 The evaluation process shall include but is not limited to 31 identifying ways the program’s clinical and training components 32 could be modified to facilitate other students and practicing 33 mental health professionals specializing as mental health 34 professionals. 35 -2- LSB 1630YH (6) 88 hb/rh 2/ 8

H.F. 630 Sec. 4. Section 135H.3, subsection 1, Code 2019, is amended 1 to read as follows: 2 1. A psychiatric medical institution for children shall 3 utilize a team of professionals to direct an organized program 4 of diagnostic services, psychiatric services, nursing care, 5 and rehabilitative services to meet the needs of residents 6 in accordance with a medical care plan developed for each 7 resident. The membership of the team of professionals may 8 shall include but is not limited to an advanced registered 9 nurse practitioner or a physician assistant mental health 10 professionals . Social Psychiatric, social, and rehabilitative 11 services shall be provided under the direction of by a 12 qualified mental health professional. 13 Sec. 5. Section 225C.52, subsection 1, Code 2019, is amended 14 to read as follows: 15 1. Establishing a comprehensive community-based mental 16 health services system for children and youth is part of 17 fulfilling the requirements of the division and the commission 18 to facilitate a comprehensive, continuous, and integrated state 19 mental health and disability services plan in accordance with 20 sections 225C.4 , 225C.6 , and 225C.6A , and other provisions 21 of this chapter . The purpose of establishing the children’s 22 system is to improve access for children and youth with 23 serious emotional disturbances and youth with other qualifying 24 mental health disorders to mental health treatment, services, 25 and other support in the least restrictive setting possible 26 so the children and youth can live with their families and 27 remain in their communities. The children’s system is also 28 intended to meet the needs of children and youth who have 29 mental health disorders that co-occur with substance abuse, 30 intellectual disability, developmental disabilities, or 31 other disabilities. The children’s system shall emphasize 32 community-level collaborative efforts between children and 33 youth and the families and the state’s systems of education, 34 child welfare, juvenile justice, health care, substance abuse, 35 -3- LSB 1630YH (6) 88 hb/rh 3/ 8

H.F. 630 and mental health. The children’s system shall ensure the 1 children and youth served are provided treatment by a mental 2 health professional as defined in section 228.1 or a person who 3 has obtained an advanced degree that will qualify the person as 4 a mental health professional following a period of professional 5 supervision. 6 Sec. 6. NEW SECTION . 279.70A Suicide prevention committee. 7 1. The board of directors of a school district shall 8 require all schools in the school district to develop suicide 9 prevention committees. Each suicide prevention committee shall 10 include a mental health professional, a parent or guardian, 11 a current student of the public school, and a member of the 12 clergy of a religious denomination within the school district. 13 2. A suicide prevention committee shall perform all of the 14 following duties: 15 a. Collect, review, and analyze the circumstances related to 16 the suicide of a child in the school district. 17 b. Recommend to the school district suicide and postvention 18 services to be offered to students and school personnel. For 19 purposes of this paragraph, “postvention” means the same as 20 defined in section 256.7, subsection 33. 21 c. Assist all school districts following the suicide of a 22 child. 23 d. Develop strategies to increase awareness for increased 24 child suicide attempts after a child’s suicide in the school 25 district. 26 Sec. 7. NEW SECTION . 279.70B Children’s mental health 27 services. 28 The board of directors of a school district may develop and 29 implement mental health services at each attendance center in 30 the district. The school district may coordinate with mental 31 health professionals within the school district to provide 32 services at the attendance center for students who are in need 33 of mental health services. 34 Sec. 8. ADVERSE CHILDHOOD EXPERIENCES. The departments 35 -4- LSB 1630YH (6) 88 hb/rh 4/ 8

H.F. 630 of human services and public health shall develop information 1 related to the identification of adverse childhood experiences. 2 The information shall be distributed to the board of directors 3 of a school district for distribution during required training 4 pursuant to section 279.70. The departments shall provide 5 support services to a school district following media reports 6 relating to adverse childhood experiences impacting ten or more 7 children within the school district or a report of a suicide of 8 a child from the school district. 9 Sec. 9. CHILDREN’S MENTAL HEALTH INFORMATION —— 10 DISTRIBUTION. The department of public health shall develop 11 information relating to the identification of the early signs 12 and symptoms of mental health concerns in children and shall 13 coordinate with existing statewide mental health hotlines to 14 distribute the information to members of the public utilizing 15 telephone and text messaging systems. 16 EXPLANATION 17 The inclusion of this explanation does not constitute agreement with 18 the explanation’s substance by the members of the general assembly. 19 This bill relates to mental health supports and services for 20 children and adults, including the establishment of a mental 21 health professional fellowship program. 22 MENTAL HEALTH PROFESSIONAL FELLOWSHIP PROGRAM AND 23 ACCOUNT. The bill requires the department of public health, 24 in cooperation with the college student aid commission, 25 to establish a mental health professional fellowship 26 program. The purpose of the program is to determine the 27 effect of specialized training and support for mental health 28 professionals in providing mental health services to address 29 Iowa’s shortage of mental health professionals. The bill 30 requires the program to provide for collaboration between 31 Iowa institutions of higher education and mental health 32 professional programs to educate mental health professionals; 33 elderly, youth, and general population clinical experiences, 34 with a primary emphasis on youth clinical experiences and a 35 -5- LSB 1630YH (6) 88 hb/rh 5/ 8

H.F. 630 secondary emphasis on elderly and general population clinical 1 experiences; and supervision of students in the program by 2 Iowa institutions of higher education and other clinical 3 partners. The bill provides that a contract for the program 4 shall stipulate the time period the mental health professional 5 shall practice in a mental health professional shortage area 6 in this state. In addition, the contract shall stipulate 7 that the mental health professional repay any funds paid on 8 the mental health professional’s behalf by the program if the 9 mental health professional is unable to fulfill the time period 10 in the contract. The bill provides that state and private 11 entity clinical partners are required to regularly evaluate and 12 document their experiences with the approaches utilized and 13 outcomes achieved by the program to identify an optimal model 14 for operating the program. The evaluation process is required 15 to include but is not limited to identifying the ways the 16 program’s clinical and training components could be modified 17 to facilitate other students and practicing mental health 18 professionals specializing as mental health professionals. 19 Current Code section 135.175 establishes a health care 20 workforce support initiative to provide for the coordination 21 and support of various efforts to address the health care 22 workforce shortage in Iowa. The initiative includes the 23 medical residency training state matching grants program; 24 the nurse residence state matching grants program; and the 25 fulfilling Iowa’s need for dentists matching grant program. 26 The bill provides the health care workforce support initiative 27 shall also provide coordination and support to the mental 28 health professional fellowship program. 29 CHILDREN’S MENTAL HEALTH SERVICES. Under current Code, 30 a psychiatric medical institution for children (PMIC) shall 31 utilize a team of professionals to direct an organized program 32 of diagnostic services, psychiatric services, nursing care, 33 and rehabilitative services to meet the needs of residents 34 in accordance with a medical care plan developed for each 35 -6- LSB 1630YH (6) 88 hb/rh 6/ 8

H.F. 630 resident. The membership of the team may include an advanced 1 registered nurse practitioner or a physician assistant. 2 Social and rehabilitative services shall be provided under the 3 direction of a qualified mental health professional. The bill 4 amends current law to provide the membership of a PMIC team 5 of professionals shall include but is not limited to mental 6 health professionals. The bill also provides that psychiatric, 7 social, and rehabilitative services shall be provided by a 8 mental health professional. 9 Current Code section 225C.52 establishes the purpose for 10 the community-based mental health services system for children 11 and youth. The bill amends the purpose to provide that the 12 children’s system shall ensure that the children and youth 13 served are provided treatment by a mental health professional 14 or by a person who holds an advanced degree that will qualify 15 the person as a mental health professional following a required 16 period of supervision. 17 The bill provides the board of directors of a school 18 district may develop and implement mental health services for 19 students at each attendance center in the district. The bill 20 provides the school district may coordinate with mental health 21 professionals within the school district to provide services at 22 the attendance center for students who are in need of mental 23 health services. 24 SUICIDE PREVENTION COMMITTEES. The bill directs the board 25 of directors of a school district to require all schools in the 26 school district to develop suicide prevention committees. Each 27 committee shall include a mental health professional, a parent 28 or guardian, a current student of the public school, and a 29 member of the clergy of a religious denomination in the school 30 district. 31 A suicide prevention committee is required to collect, 32 review, and analyze the circumstances related to the suicide 33 of a child in the school district, recommend to the school 34 district suicide prevention and postvention services to 35 -7- LSB 1630YH (6) 88 hb/rh 7/ 8

H.F. 630 be offered to students and school personnel, assist school 1 districts following the suicide of a child, and develop 2 strategies to increase awareness for increased child suicide 3 attempts after a child’s suicide in the school district. 4 ADVERSE CHILDHOOD EXPERIENCES. The bill requires the 5 departments of human services and public health to develop 6 information related to the identification of adverse childhood 7 experiences. The departments are required to distribute such 8 information to the board of directors of a school district 9 for distribution during required training pursuant to Code 10 section 279.70 (relating to training on suicide prevention, 11 adverse childhood experiences identification, and toxic stress 12 response mitigation strategies for school personnel). The 13 bill requires the departments to provide support services to 14 a school district following media reports relating to adverse 15 childhood experiences impacting 10 or more children within the 16 school district or a report of a suicide of a child from the 17 school district. 18 CHILDREN’S MENTAL HEALTH INFORMATION —— DISTRIBUTION. The 19 bill requires the department of public health to develop 20 information relating to the identification of the early signs 21 and symptoms of mental health concerns in children and to 22 coordinate with existing statewide mental health hotlines to 23 distribute the information to members of the public utilizing 24 telephone and text messaging systems. 25 -8- LSB 1630YH (6) 88 hb/rh 8/ 8