House
File
2402
-
Introduced
HOUSE
FILE
2402
BY
COMMITTEE
ON
HEALTH
AND
HUMAN
SERVICES
(SUCCESSOR
TO
HSB
502)
A
BILL
FOR
An
Act
relating
to
psychiatric
medical
institutions
for
1
children.
2
BE
IT
ENACTED
BY
THE
GENERAL
ASSEMBLY
OF
THE
STATE
OF
IOWA:
3
TLSB
5260HV
(2)
90
pf/ko
H.F.
2402
Section
1.
PSYCHIATRIC
MEDICAL
INSTITUTIONS
FOR
CHILDREN
1
——
ENHANCED
MEDICAID
REIMBURSEMENT
——
COMPETITIVE
BIDDING
2
PROCESS.
No
later
than
January
1,
2025,
the
department
of
3
health
and
human
services
shall
utilize
a
competitive
bidding
4
process
and
issue
an
invitation
to
bid
to
select
one
or
5
more
currently
licensed
psychiatric
medical
institutions
for
6
children
(PMICs),
as
defined
in
section
135H.1,
located
in
the
7
state,
to
provide
access
to
PMIC
services
for
children
with
8
specialized
needs
including
problematic
sexualized
behaviors,
9
a
history
of
aggression,
or
a
diagnosis
of
intellectual
or
10
developmental
disability.
The
invitation
to
bid
shall
offer
a
11
payment
structure
that
provides
enhanced
reimbursement
for
a
12
PMIC
that
meets
the
selection
criteria
and
which
may
be
used
to
13
provide
increased
staffing
ratios,
ongoing
training
of
staff
in
14
specialized
programs
that
provide
evidence-based
treatment,
and
15
appropriate
services
and
modalities,
including
but
not
limited
16
to
telemedicine,
for
children
and
their
families.
17
Sec.
2.
REDUCTION
OF
REGULATORY
BARRIERS
AND
RESTRICTIONS
18
——
PSYCHIATRIC
MEDICAL
INSTITUTIONS
FOR
CHILDREN.
The
19
department
of
health
and
human
services
shall
review
the
20
department’s
administrative
rules
regarding
psychiatric
medical
21
institutions
for
children
(PMICs)
and
shall
update
the
rules,
22
informed
by
the
findings
of
the
association
of
children’s
23
residential
centers’
most
recent
nationwide
survey
and
scan
24
of
psychiatric
residential
treatment
facilities,
and
the
25
recommendations
of
the
coalition
for
family
and
children’s
26
services
in
Iowa,
to
do
all
of
the
following:
27
1.
Allow
a
physician
assistant
or
advanced
registered
nurse
28
practitioner
to
serve
as
a
member
of
the
plan
of
care
team
29
as
a
member
who
is
experienced
in
child
psychiatry
or
child
30
psychology
pursuant
to
481
IAC
41.13(2).
31
2.
Allow
a
physician
assistant
or
advanced
registered
32
nurse
practitioner
to
be
a
member
of
the
team
to
complete
33
the
certification
of
need
for
services
for
a
PMIC
placement
34
pursuant
to
481
IAC
41.9.
35
-1-
LSB
5260HV
(2)
90
pf/ko
1/
4
H.F.
2402
3.
Remove
the
reserve
bed
day
limitations
for
1
hospitalizations
and
expand
the
number
of
other
therapeutic
2
absences
beyond
thirty
days
to
allow
for
skill
acquisition,
3
stabilization,
and
continuity
of
care
as
deemed
necessary
by
4
the
child’s
medical
providers
and
in
accordance
with
a
child’s
5
discharge
plan.
6
4.
Allow
licensed
professionals,
based
on
competencies
7
rather
than
license
type,
to
order
the
use
of
restraints
8
or
seclusions
and
to
conduct
post-restraint
or
seclusion
9
assessments,
including
via
telehealth,
to
increase
response
10
times
and
expand
access
to
care.
11
5.
a.
Require
therapy
and
behavioral
health
intervention
12
services
to
be
included
as
required
services
provided
during
13
a
placement
at
a
PMIC
to
provide
continuity
of
care,
maintain
14
established
clinical
relationships,
and
avoid
disruption
in
15
services
or
delays
in
reestablishing
care
post
discharge.
16
b.
Require
family
therapy
and
family
behavioral
health
17
intervention
services
to
be
included
in
required
services
18
during
the
placement
of
a
child
in
a
PMIC
without
requiring
19
the
child’s
presence
for
the
family
to
work
on
targeted
skills
20
essential
for
the
child’s
success
and
to
prepare
the
family
for
21
the
child’s
return
home.
22
c.
Provide
reimbursement
codes
to
cover
services
beyond
23
those
provided
outside
the
PMIC
care
team
as
necessary
to
24
adequately
treat
substance
use
disorder,
sexualized
behaviors,
25
autism,
and
other
services
needed
to
support
the
child.
26
6.
Standardize
all
of
the
following
across
all
managed
care
27
organizations
as
follows:
28
a.
Require
that
authorization
for
a
PMIC
placement
shall
29
be
retroactive
to
the
date
the
request
for
authorization
is
30
submitted
to
the
managed
care
organization
not
the
date
the
31
managed
care
organization
responds;
or
require
a
managed
care
32
organization
to
respond
within
two
business
days
from
receipt
33
of
a
request
for
authorization
for
a
PMIC
placement.
34
b.
Prohibit
a
managed
care
organization
from
denying
35
-2-
LSB
5260HV
(2)
90
pf/ko
2/
4
H.F.
2402
authorization
for
a
PMIC
placement
based
on
lack
of
parental
1
involvement,
lack
of
participation
in
behavioral
health
2
intervention
services
on
an
outpatient
basis,
or
based
on
other
3
perceived
behavioral
issues.
4
c.
Require
a
managed
care
organization
to
authorize
an
5
initial
PMIC
placement
of
ninety
days
upon
admission
with
6
concurrent
stay
reviews
every
thirty
days
thereafter.
7
d.
Require
concurrent
stay
reviews
to
be
standardized
8
and
limited
to
a
brief
description
of
progress,
or
lack
of
9
progress,
toward
the
child’s
goals
and
objectives.
10
e.
Require
a
managed
care
organization
to
offer
support
to
11
families,
including
assistance
with
transportation
to
and
from
12
a
PMIC
to
visit
a
child.
13
7.
Notwithstanding
any
provision
of
law
to
the
contrary,
14
including
certificate
of
need
requirements,
allow
a
previously
15
licensed
PMIC
that
has
the
capacity
to
provide
up
to
an
16
additional
four
intermediate
care
facility
for
persons
with
an
17
intellectual
disability
beds,
and
which
additional
beds
meet
18
all
other
licensing
and
state
fire
marshal
requirements,
to
19
increase
their
licensed
capacity
to
include
the
additional
20
beds
without
further
review
including
by
the
health
facilities
21
council.
22
8.
Allow
for
step-down
PMIC
placements
or
supervised
23
apartment
living
for
a
child
to
utilize
programming
provided
24
in
a
PMIC
while
living
independently
in
a
smaller
residential
25
setting
without
twenty-four-hour
supervision.
26
EXPLANATION
27
The
inclusion
of
this
explanation
does
not
constitute
agreement
with
28
the
explanation’s
substance
by
the
members
of
the
general
assembly.
29
This
bill
relates
to
psychiatric
medical
institutions
for
30
children
(PMICs).
The
bill
requires
the
department
of
health
31
and
human
services
(HHS),
no
later
than
January
1,
2025,
to
32
utilize
a
competitive
bidding
process
and
issue
an
invitation
33
to
bid
to
select
one
or
more
currently
licensed
PMICs
in
the
34
state
to
provide
access
to
PMIC
services
for
children
with
35
-3-
LSB
5260HV
(2)
90
pf/ko
3/
4
H.F.
2402
specialized
needs
including
problematic
sexualized
behaviors,
1
a
history
of
aggression,
or
a
diagnosis
of
intellectual
or
2
developmental
disability.
The
invitation
to
bid
shall
offer
a
3
payment
structure
that
provides
enhanced
reimbursement
for
a
4
PMIC
that
meets
the
selection
criteria
and
which
may
be
used
to
5
provide
increased
staffing
ratios,
ongoing
training
of
staff
in
6
specialized
programs
that
provide
evidence-based
treatment,
and
7
appropriate
services
and
modalities,
including
but
not
limited
8
to
telemedicine,
for
children
and
their
families.
9
The
bill
also
requires
HHS
to
review
and
update
10
administrative
rules
regarding
PMICs
to
allow
physician
11
assistants
and
advanced
registered
nurse
practitioners
to
12
serve
as
a
member
of
the
plan
of
care
team
and
to
complete
the
13
certification
of
need
for
services
for
a
PMIC
placement;
to
14
remove
the
reserve
bed
day
limitations
for
hospitalizations
15
and
expand
the
number
of
other
therapeutic
absences
allowed;
16
to
allow
licensed
professionals,
based
on
competencies
rather
17
than
license
type,
to
order
the
use
of
restraints
or
seclusions
18
and
to
conduct
post-restraint
or
seclusion
assessments,
19
including
via
telehealth,
to
increase
response
times
and
expand
20
access
to
care;
to
require
therapy
and
behavioral
health
21
intervention
services
as
required
services
during
a
PMIC
22
placement,
to
require
family
therapy
and
family
behavioral
23
health
intervention
services
as
required
services
during
the
24
placement
of
a
child
in
a
PMIC
to
prepare
the
family
for
25
the
child’s
return
home,
and
to
provide
reimbursement
codes
26
to
cover
certain
services
beyond
those
provided
outside
the
27
PMIC
care
team
to
support
the
child;
to
standardize
certain
28
activities
across
all
managed
care
organizations;
to
allow
29
for
certain
exceptions
for
PMICs
to
increase
capacity
without
30
further
certificate
of
need
review;
and
to
allow
for
step-down
31
PMIC
placements
or
supervised
apartment
living
for
a
child.
32
-4-
LSB
5260HV
(2)
90
pf/ko
4/
4