SF 2118 (LSB 5259XS (5) 89)

SENATE FILE 2118

BY  KINNEY

A BILL FOR

An Act relating to mental health and disability services funds to establish county-controlled accounts for administrative expenses and increase the amount mental health and disability services funds may carryforward.
BE IT ENACTED BY THE GENERAL ASSEMBLY OF THE STATE OF IOWA:

    Section 1.  Section 225C.7A, subsection 5, Code 2022, is amended to read as follows:
   5.  Regional service payments received by a region shall be deposited in the region’s combined account under section 331.391 and used solely for providing mental health and disability services under the regional service system management plan, or deposited into county administrative funds, as defined in section 331.391, subsection 1, paragraph “b”, for the payment of employees performing duties related to the mental health and disability services system. A regional administrator shall have the authority to transfer moneys from the region’s combined account.
    Sec. 2.  Section 225C.7A, subsection 7, paragraph b, Code 2022, is amended to read as follows:
   b.  For the fiscal year years beginning on or after July 1, 2022, each mental health and disability services region for which the amount certified during the fiscal year under section 331.391, subsection 4, paragraph “b”, exceeds twenty twenty-five percent of the actual expenditures of the region for the fiscal year preceding the fiscal year in progress, the remaining quarterly payments of the region’s regional service payment shall be reduced by an amount equal to the amount by which the region’s amount certified under section 331.391, subsection 4, paragraph “b”, exceeds twenty twenty-five percent of the actual expenditures of the region for the fiscal year preceding the fiscal year in progress, but the amount of the reduction shall not exceed the total amount of the region’s regional service payment for the fiscal year. If the region’s remaining quarterly payments are insufficient to effectuate the required reductions under this paragraph, the region is required to pay to the department of human services any amount for which the reduction in quarterly payments could not be made. The amount of reductions to quarterly payments and amounts paid to the department under this paragraph shall be transferred and credited to the region incentive fund under subsection 8.
    Sec. 3.  Section 225C.7A, subsection 7, paragraph c, Code 2022, is amended by striking the paragraph.
    Sec. 4.  Section 225C.7A, subsection 8, paragraph c, subparagraph (2), subparagraph division (b), subparagraph subdivision (ii), Code 2022, is amended to read as follows:
   (ii)  For applications for the fiscal year years beginning on or after July 1, 2022, twenty twenty-five percent of the actual expenditures of the mental health and disability services region for the fiscal year that commenced two years prior to the fiscal year of application for assistance.
    Sec. 5.  Section 225C.7A, subsection 8, paragraph c, subparagraph (2), subparagraph division (b), subparagraph subdivision (iii), Code 2022, is amended by striking the subparagraph subdivision.
    Sec. 6.  Section 331.391, subsections 1 and 3, Code 2022, are amended to read as follows:
   1.  a.  The funding under the control of the governing board shall be maintained in a combined account. A county exempted under section 331.389, subsection 1, shall maintain a county mental health and disability services fund for the deposit of funding received under section 225C.7A and appropriations specifically authorized to be made from the county mental health and disability services fund shall not be made from any other fund of the county. A county mental health and disability services fund established by an exempt county, to the extent feasible, shall be considered to be the same as a region combined account and shall be subject to the same requirements as a region’s combined account including expenses payable from county administrative funds pursuant to paragraph “b”.
   b.  The funding received pursuant to section 225C.7A, subsection 5, and under the control of a board of supervisors shall be maintained in a county administrative fund. Moneys in a county administrative fund shall only be used for the payment of county employees performing duties related to the mental health and disability services system.
   3.  The funding provided pursuant to appropriations from the mental health and disability services regional service fund created in section 225C.7A and from performance-based contracts with the department shall be credited to the account under the control of the governing board or account under the control of a board of supervisors.
    Sec. 7.  Section 331.391, subsection 4, paragraphs b and c, Code 2022, are amended to read as follows:
   b.  Each region shall certify to the department of human services on or before December 1, 2021, and each December 1 thereafter, the aggregate amount of the region’s cash flow amount in the combined account and each county administrative account at the conclusion of the most recently completed fiscal year.
   c.  For fiscal years beginning on or after July 1, 2023, the region’s cash flow amount shall not exceed five twenty-five percent of the aggregate actual expenditures from the combined account and each county administrative account for the fiscal year preceding the fiscal year in progress.
    Sec. 8.  Section 331.432, subsection 3, paragraph b, Code 2022, is amended to read as follows:
   b.  Payments or transfers of moneys from any fund of the county to a mental health and disability services region’s combined account under section 331.391 are prohibited. This paragraph applies to fiscal years beginning on or after July 1, 2022, but does not apply to transfers from a county public hospital fund under section 347.7 for the fiscal year beginning July 1, 2022, or the fiscal year beginning July 1, 2023, or a county administrative fund under section 331.391, subsection 1, paragraph “b”.
    Sec. 9.  2021 Iowa Acts, chapter 177, section 107, is amended to read as follows:
   SEC. 107.  DEPARTMENT OF HUMAN SERVICES —— MENTAL HEALTH AND DISABILITY REGIONS STUDY.  The department of human services shall convene a study committee to evaluate the current mental health and disability region structure and operations in the context of the changes made and the funding provided by this division of this Act. The study shall, at a minimum, use data-driven and outcome-based decision making to identify and recommend modifications to required core services for regions, and review how effectively each mental health and disability services region has implemented the core services outlined in sections 331.397 and 331.397A, including the degree of uniformity of the core services between the regions. The study committee membership shall include, at a minimum, a representative from each mental health and disability services region as the chief executive officer of each region designates. The department shall be authorized to contract with and retain the services of an independent contractor in order to conduct the study. The department shall submit a report detailing the study’s findings and recommendations to the general assembly and the governor no later than December 15, 2022.
    Sec. 10.  EFFECTIVE DATE.  The following, being deemed of immediate importance, takes effect upon enactment:
   The section of this Act amending 2021 Iowa Acts, chapter 177, section 107.
EXPLANATION
The inclusion of this explanation does not constitute agreement with
the explanation’s substance by the members of the general assembly.
   This bill relates to mental health and disability services funds to establish county-controlled accounts for administrative expenses and increase the amount mental health and disability services funds may carryforward.
   The mental health and disability services (MHDS) system is a system of 14 separate regional service areas consisting of one or more counties that work together to provide services related to mental health and disabilities to people within those regions. Under current law, a county may use a county mental health and disabilities services fund (county services fund) in order to pay for MHDS-related expenses. At the conclusion of fiscal year 2021-2022, the counties will be required to transfer any remaining amounts in their county services funds to a combined regional account.
   The bill establishes county administrative funds that will be controlled by a county’s board of supervisors and used solely for the payment of county employees performing duties related to the mental health and disability services system.
   The bill allows the regional administrator to transfer funds received by a region into a county administrative fund or from an MHDS regional combined account into a county administrative fund after June 30, 2022.
   The bill provides that, for the fiscal years beginning on or after July 1, 2022, an MHDS region’s payments from the state will be reduced by the amount the region’s combined fund exceeds 25 percent of its actual expenditures from the aggregate of the region’s combined account and county services funds. Under current law, for the fiscal year beginning July 1, 2022, state payments to regional accounts will be reduced by the amount that a region’s combined fund exceeds 20 percent of the region’s actual expenditures, and for fiscal years beginning July 1, 2023, and after, state payments to regional accounts will be reduced by the amount that a region’s combined fund exceeds 5 percent of the region’s actual expenditures.
   The bill provides that a region will remain eligible to receive funding from the state’s region incentive fund within the state MHDS regional service fund, assuming all other criteria are met, if, beginning in fiscal year 2022-2023, the region’s expenditures do not exceed 25 percent of the aggregate amounts in the region’s combined account and county services funds. Under current law, for a region to be eligible for additional region incentive fund moneys, and assuming other criteria are met, for the fiscal year beginning July 1, 2022, a region may not have funds in the region’s combined account in excess of 20 percent of the region’s actual expenditures, and in all fiscal years beginning July 1, 2023, and after, a region may not have funds in the region’s combined account in excess of 5 percent of the region’s actual expenditures.
   The bill allows a county administrative fund to transfer funds into an MHDS regional combined account.
   The bill provides that the scope of a study committee created by 2021 Iowa Acts, chapter 177, section 107, shall also include the use of data-driven and outcome-based decision making to identify and recommend modifications to required core services for MHDS regions. The bill also provides that the study committee membership shall include, at a minimum, a representative from each mental health and disability services region as the chief executive officer of each region designates. The changes to the MHDS study committee are effective upon enactment.