H.F. 665 Section 1. NEW SECTION . 261K.1 Definitions. 1 As used in this chapter, unless the context otherwise 2 requires: 3 1. “Advisor” means a staff member who provides academic, 4 professional, and personal support to students. 5 2. “Linkage agreement” means a formal agreement between a 6 public institution of higher education and an off-campus mental 7 health provider or agency. 8 3. “Mental health condition” means a symptom consistent with 9 a mental illness as defined in section 135C.1. 10 4. “Public institution of higher education” means an 11 institution of higher education governed by the state board of 12 regents or a community college. 13 5. “Recovery model” means the model developed by the federal 14 substance abuse and mental health services administration that 15 defines the process of recovery and includes the four major 16 dimensions that support a life in recovery, which are health, 17 home, purpose, and community. 18 6. “Resident assistant” means a student who is responsible 19 for supervising and assisting other students who live in the 20 same student housing facility. 21 7. “Telehealth” means the evaluation, diagnosis, or 22 interpretation of electronically transmitted patient-specific 23 data between a remote location and a licensed health 24 care professional that generates interaction or treatment 25 recommendations. “Telehealth” includes telemedicine and the 26 delivery of health care services provided by an interactive 27 telecommunications system 28 Sec. 2. NEW SECTION . 261K.2 Mental health awareness —— 29 required functions. 30 To raise mental health awareness on the campuses of public 31 institutions of higher education, each institution shall do all 32 of the following: 33 1. Develop and implement an annual student orientation 34 session aimed at raising awareness about mental health 35 -1- LSB 1997YH (5) 91 je/jh 1/ 10

H.F. 665 conditions. 1 2. Assess courses and seminars available to students 2 through their regular academic coursework and implement mental 3 health awareness curricula where opportunities for integration 4 with such coursework exist. 5 3. Publish on the institution’s internet site or mobile 6 application information dedicated solely to the mental health 7 resources available to students at the institution and in the 8 surrounding community. 9 4. Distribute messages related to mental health resources 10 that encourage help-seeking behavior through the online 11 learning platform of the institution during high stress 12 periods of the academic year, including but not limited to 13 midterm or final examinations. Such resources shall include 14 stigma-reducing strategies based on documented best practices. 15 5. Three years after the effective date of this Act, 16 implement an online screening tool to raise awareness and 17 establish a mechanism to link or refer students of the 18 institution to mental health services. The screening and 19 services shall be available for students year-round and shall 20 at minimum do all of the following: 21 a. Include validated screening tools for depression, an 22 anxiety disorder, an eating disorder, substance use disorder, 23 alcohol use disorder, post-traumatic stress disorder, and 24 bipolar disorder. 25 b. Provide resources for immediate connection to services, 26 if indicated, including emergency resources. 27 c. Provide general information about all mental 28 health-related resources available to students of the 29 institution. 30 d. Function anonymously. 31 6. At least once per academic term and at times of high 32 academic stress, including midterm or final examinations, 33 provide students information regarding online mental health 34 screenings. 35 -2- LSB 1997YH (5) 91 je/jh 2/ 10

H.F. 665 7. Provide contact information for the national suicide 1 prevention lifeline, the crisis text line, a local suicide 2 prevention hotline, and the mental health counseling center 3 or program of the institution on the back of each student 4 identification card issued by the institution after July 1, 5 2026, if the institution issues student identification cards. 6 If the institution does not issue student identification cards, 7 the institution shall include such contact information on its 8 internet site. The contact information shall identify text 9 messaging capability if applicable. The contact information 10 shall also be included in the institution’s student handbook 11 and any student planner custom printed by the institution for 12 distribution to students. 13 Sec. 3. NEW SECTION . 261K.3 Policies and procedures —— 14 training. 15 1. The state board of regents and the board of directors 16 of each community college shall designate an expert panel to 17 develop and implement policies and procedures as provided in 18 this subsection. Section 4A.5 does not apply to such a panel. 19 The policies and procedures shall do all of the following: 20 a. Advise students, faculty, and staff on the proper 21 procedures for identifying and addressing the needs of students 22 exhibiting symptoms of mental health conditions. 23 b. Promote understanding of the requirements of section 24 504 of the federal Rehabilitation Act of 1973 and the federal 25 Americans with Disabilities Act of 1990 to increase knowledge 26 and understanding of student protections under the law. 27 c. Provide training on mental health conditions as 28 appropriate. 29 2. The mental health technical assistance center 30 established under section 261K.6 shall set initial standards 31 for policies and procedures described in subsection 1 to ensure 32 statewide consistency. 33 3. All resident assistants in a student housing facility, 34 advisors, and campus security officers of a public institution 35 -3- LSB 1997YH (5) 91 je/jh 3/ 10

H.F. 665 of higher education shall participate in a national mental 1 health first aid training course or a similar program prior to 2 the commencement of their duties. Such training shall include 3 the policies and procedures developed by the institution of 4 higher education described in subsection 1. 5 Sec. 4. NEW SECTION . 261K.4 Peer support programs. 6 1. Each public institution of higher education shall 7 develop and implement a peer support program utilizing student 8 peers to support students living with mental health conditions 9 on campus. Peer support programs may be housed within resident 10 assistant programs, counseling centers, or wellness centers on 11 campus. 12 2. Peer support programs shall utilize best practices for 13 peer support, which shall include but are not limited to all 14 of the following: 15 a. Use of the tenets of the recovery model for mental 16 health. 17 b. Adequate planning and preparation, including 18 standardizing guidance and practices, identifying needs of the 19 target population, and aligning program goals to meet those 20 needs. 21 c. Clearly articulated policies, especially regarding role 22 boundaries and confidentiality. 23 d. Systematic screening with defined selection criteria 24 for peer supporters, such as communication skills, leadership 25 ability, character, previous experience or training, and 26 ability to serve as a positive role model. 27 e. Identification of benefits from peer status, such as 28 experiential learning, social support, leadership, and improved 29 self-confidence. 30 f. Continuing education for peer supporters to support each 31 other and improve peer support skills. 32 g. Flexibility in availability by offering services 33 through drop-in immediate support and the ability to schedule 34 appointments. 35 -4- LSB 1997YH (5) 91 je/jh 4/ 10

H.F. 665 Sec. 5. NEW SECTION . 261K.5 Strategic partnerships. 1 1. Each public institution of higher education shall 2 establish strategic partnerships with local mental health 3 service providers to improve overall campus mental wellness 4 and augment on-campus capacity. The strategic partnerships 5 shall include linkage agreements with off-campus mental health 6 service providers that establish a process for referrals for 7 students when needs cannot be met on campus due to the limits 8 of on-campus capacity or preference of the student. The 9 strategic partnerships shall also include all of the following: 10 a. Avenues for on-campus and off-campus mental health 11 service providers to increase visibility to students through 12 marketing and outreach. 13 b. Opportunities to engage the student body through 14 student outreach initiatives such as mindfulness workshops or 15 campus-wide wellness fairs. 16 c. Opportunities to support awareness and training 17 requirements under this chapter. 18 2. a. Through a combination of on-campus capacity, 19 off-campus linkage agreements with mental health service 20 providers, and contracted telehealth therapy services, each 21 public institution of higher education shall attempt to meet 22 a benchmark ratio of one clinical, nonstudent staff member to 23 one thousand two hundred fifty students. If linkage agreements 24 are used, the agreements shall include the capacity of students 25 that providers are expected to serve within the agency. 26 b. By July 1, 2027, and at least once every five years 27 thereafter, the mental health technical assistance center 28 established under section 261K.6 shall submit a report to 29 the general assembly and the governor proposing an updated 30 ratio based on actual ratios in this state and any new 31 information available related to appropriate benchmarks for 32 clinician-to-student ratios. The updated ratio shall represent 33 a ratio of no less than one clinical, nonstudent staff member 34 to one thousand two hundred fifty students. 35 -5- LSB 1997YH (5) 91 je/jh 5/ 10

H.F. 665 3. Each public institution of higher education shall work 1 with local entities, such as on-campus mental health counseling 2 centers or wellness centers, local mental health service 3 providers, or nonproviders, such as affiliates of the national 4 alliance on mental illness, and any other entities to implement 5 the requirements of sections 261K.2 and 261K.3. 6 Sec. 6. NEW SECTION . 261K.6 Mental health technical 7 assistance center. 8 The department of health and human services, in consultation 9 with the state board of regents and the Iowa association for 10 community colleges, shall establish a mental health technical 11 assistance center. Section 4A.5 does not apply to the center. 12 The center is responsible for all of the following: 13 1. Developing standardized policies for medical leave 14 related to mental health conditions for students of a public 15 institution of higher education, which may be adopted by a 16 public institution of higher education. 17 2. Providing tailored support to public institutions of 18 higher education in reviewing policies related to students 19 living with mental health conditions and their academic 20 standing. 21 3. Establishing initial standards for policies and 22 procedures under section 261K.3, subsection 1. 23 4. Disseminating best practices around peer support 24 programs as provided in section 261K.4, including widely 25 accepted selection criteria for individuals serving in a peer 26 support role. 27 5. Developing statewide standards and best practices for 28 partnerships between local mental health agencies and public 29 institutions of higher education across the state. 30 6. Collecting, analyzing, and disseminating data related to 31 mental health needs and academic engagement across the state. 32 7. Compiling data collected by each public institution of 33 higher education related to program evaluation under section 34 261K.7 and analyzing and disseminating best practices to each 35 -6- LSB 1997YH (5) 91 je/jh 6/ 10

H.F. 665 institution and the public based on such data. 1 8. Monitoring and evaluating linkage agreements under 2 section 261K.5 to ensure capacity is met by each public 3 institution of higher education. 4 9. Facilitating a learning community across all public 5 institutions of higher education to support capacity building 6 and learning across those institutions. 7 Sec. 7. NEW SECTION . 261K.7 Program evaluation. 8 Each public institution of higher education shall evaluate 9 the following programs or functions provided in this chapter 10 for effectiveness and quality in the following manner: 11 1. A public institution of higher education shall evaluate 12 mental health awareness functions under section 261K.2 with 13 monitoring measures including but not limited to: 14 a. Increased understanding of mental health conditions. 15 b. Reduced stigma toward mental health conditions. 16 c. Increased understanding of mental health resources 17 available to students. 18 d. Increased understanding of resources for mental health 19 emergencies available to students. 20 e. Viewing each internet site or mobile application of the 21 public institution of higher education that provides mental 22 health resources. 23 2. A public institution of higher education shall evaluate 24 peer support programs under section 261K.4 with monitoring 25 measures including but not limited to: 26 a. Improved symptomatology. 27 b. Connection to additional services as needed. 28 c. Student satisfaction. 29 d. Wait time for drop-in appointments. 30 e. Wait time for scheduled appointments. 31 f. Satisfaction with the training curriculum for peer 32 supporters. 33 3. A public institution of higher education shall evaluate 34 strategic partnerships under section 261K.5 with monitoring 35 -7- LSB 1997YH (5) 91 je/jh 7/ 10

H.F. 665 measures including but not limited to: 1 a. Wait time for drop-in appointments for on-campus or 2 off-campus telehealth therapy providers. 3 b. Wait time for scheduled appointments for on-campus or 4 off-campus telehealth therapy providers. 5 c. The ratio of clinical, nonstudent staff to the student 6 population and the number of linkage agreements and contracts 7 in place based on the student population. 8 d. Student satisfaction with on-campus or off-campus 9 telehealth therapy providers. 10 e. Range of treatment models offered to students. 11 f. Average length of stay in treatment. 12 g. Number and range of student outreach initiatives, such as 13 telehealth mindfulness workshops or campus-wide wellness fairs. 14 h. Number of students served annually. 15 Sec. 8. IMPLEMENTATION OF ACT. Section 25B.2, subsection 16 3, shall not apply to this Act. 17 EXPLANATION 18 The inclusion of this explanation does not constitute agreement with 19 the explanation’s substance by the members of the general assembly. 20 This bill relates to mental health services at public 21 institutions of higher education. The bill defines a “public 22 institution of higher education” as an institution of higher 23 education governed by the state board of regents or a community 24 college. 25 The bill requires public institutions of higher education 26 (institutions) to carry out various specified functions to 27 raise mental health awareness on their campuses. Specified 28 functions include developing and implementing an annual 29 student orientation session aimed at raising awareness about 30 mental health conditions, assessing courses and seminars 31 available to students through their regular academic coursework 32 and implementing mental health awareness curricula where 33 opportunities for integration with such coursework exist, and 34 distributing certain information about mental health resources 35 -8- LSB 1997YH (5) 91 je/jh 8/ 10

H.F. 665 to students. 1 The bill requires the state board of regents and the 2 board of directors of each community college to designate an 3 expert panel to develop and implement specified policies and 4 procedures relating to mental health. Specified policies and 5 procedures include advising students, faculty, and staff on 6 the proper procedures for identifying and addressing the needs 7 of students exhibiting symptoms of mental health conditions 8 and promoting understanding of the requirements of section 9 504 of the federal Rehabilitation Act of 1973 and the federal 10 Americans with Disabilities Act of 1990. The bill also 11 requires all resident assistants in a student housing facility, 12 advisors, and campus security officers of an institution to 13 participate in a national mental health first aid training 14 course. 15 The bill requires each institution to develop and implement 16 a peer support program utilizing student peers to support 17 students living with mental health conditions on campus. The 18 bill requires peer support programs to utilize best practices 19 for peer support. Such best practices include use of the 20 tenets of the recovery model, as defined in the bill, for 21 mental health, adequate planning and preparation, and clearly 22 articulated policies. 23 The bill requires each institution to establish strategic 24 partnerships with local mental health service providers to 25 improve overall campus mental wellness and augment on-campus 26 capacity. The strategic partnerships shall include linkage 27 agreements, as defined in the bill, with off-campus mental 28 health service providers that establish a process for referrals 29 for students when needs cannot be met on campus due to the 30 limits of on-campus capacity or preference of the student. 31 The bill provides additional functions of such strategic 32 partnerships, including meeting a benchmark ratio of clinical, 33 nonstudent staff members to students and reporting on the ratio 34 to the general assembly and the governor. 35 -9- LSB 1997YH (5) 91 je/jh 9/ 10

H.F. 665 The bill requires the department of health and human 1 services, in consultation with the state board of regents and 2 the Iowa association for community colleges, to establish 3 a mental health technical assistance center. The bill 4 specifies responsibilities of the center, including developing 5 standardized policies for medical leave related to mental 6 health conditions for students, providing tailored support 7 to institutions in reviewing policies related to students 8 living with mental health conditions and their academic 9 standing, and developing statewide standards and best practices 10 for partnerships between local mental health agencies and 11 institutions. The center also assists institutions with 12 implementation of various provisions of the bill. 13 The bill requires each institution to evaluate the specified 14 programs or functions provided in the bill for effectiveness 15 and quality. The bill specifies monitoring measures to be used 16 for evaluation of each program or function. 17 The bill may include a state mandate as defined in Code 18 section 25B.3. The bill makes inapplicable Code section 25B.2, 19 subsection 3, which would relieve a political subdivision from 20 complying with a state mandate if funding for the cost of 21 the state mandate is not provided or specified. Therefore, 22 political subdivisions are required to comply with any state 23 mandate included in the bill. 24 -10- LSB 1997YH (5) 91 je/jh 10/ 10