HF 665 (LSB 1997YH (5) 91)

HOUSE FILE 665

BY  KRESSIG, GOSA, GJERDE, WICHTENDAHL, WILBURN, BAGNIEWSKI, SCHOLTEN, COOLING, MADISON, B. MEYER, OLSON, SRINIVAS, JUDGE, and LEVIN

A BILL FOR

An Act relating to mental health services at public institutions of higher education.
BE IT ENACTED BY THE GENERAL ASSEMBLY OF THE STATE OF IOWA:

    Section 1.  NEW SECTION.  261K.1  Definitions.
  As used in this chapter, unless the context otherwise requires:
   1.  “Advisor” means a staff member who provides academic, professional, and personal support to students.
   2.  “Linkage agreement” means a formal agreement between a public institution of higher education and an off-campus mental health provider or agency.
   3.  “Mental health condition” means a symptom consistent with a mental illness as defined in section 135C.1.
   4.  “Public institution of higher education” means an institution of higher education governed by the state board of regents or a community college.
   5.  “Recovery model” means the model developed by the federal substance abuse and mental health services administration that defines the process of recovery and includes the four major dimensions that support a life in recovery, which are health, home, purpose, and community.
   6.  “Resident assistant” means a student who is responsible for supervising and assisting other students who live in the same student housing facility.
   7.  “Telehealth” means the evaluation, diagnosis, or interpretation of electronically transmitted patient-specific data between a remote location and a licensed health care professional that generates interaction or treatment recommendations. “Telehealth” includes telemedicine and the delivery of health care services provided by an interactive telecommunications system
    Sec. 2.  NEW SECTION.  261K.2  Mental health awareness —— required functions.
   To raise mental health awareness on the campuses of public institutions of higher education, each institution shall do all of the following:
   1.  Develop and implement an annual student orientation session aimed at raising awareness about mental health conditions.
   2.  Assess courses and seminars available to students through their regular academic coursework and implement mental health awareness curricula where opportunities for integration with such coursework exist.
   3.  Publish on the institution’s internet site or mobile application information dedicated solely to the mental health resources available to students at the institution and in the surrounding community.
   4.  Distribute messages related to mental health resources that encourage help-seeking behavior through the online learning platform of the institution during high stress periods of the academic year, including but not limited to midterm or final examinations. Such resources shall include stigma-reducing strategies based on documented best practices.
   5.  Three years after the effective date of this Act, implement an online screening tool to raise awareness and establish a mechanism to link or refer students of the institution to mental health services. The screening and services shall be available for students year-round and shall at minimum do all of the following:
   a.  Include validated screening tools for depression, an anxiety disorder, an eating disorder, substance use disorder, alcohol use disorder, post-traumatic stress disorder, and bipolar disorder.
   b.  Provide resources for immediate connection to services, if indicated, including emergency resources.
   c.  Provide general information about all mental health-related resources available to students of the institution.
   d.  Function anonymously.
   6.  At least once per academic term and at times of high academic stress, including midterm or final examinations, provide students information regarding online mental health screenings.
   7.  Provide contact information for the national suicide prevention lifeline, the crisis text line, a local suicide prevention hotline, and the mental health counseling center or program of the institution on the back of each student identification card issued by the institution after July 1, 2026, if the institution issues student identification cards. If the institution does not issue student identification cards, the institution shall include such contact information on its internet site. The contact information shall identify text messaging capability if applicable. The contact information shall also be included in the institution’s student handbook and any student planner custom printed by the institution for distribution to students.
    Sec. 3.  NEW SECTION.  261K.3  Policies and procedures —— training.
   1.  The state board of regents and the board of directors of each community college shall designate an expert panel to develop and implement policies and procedures as provided in this subsection. Section 4A.5 does not apply to such a panel. The policies and procedures shall do all of the following:
   a.  Advise students, faculty, and staff on the proper procedures for identifying and addressing the needs of students exhibiting symptoms of mental health conditions.
   b.  Promote understanding of the requirements of section 504 of the federal Rehabilitation Act of 1973 and the federal Americans with Disabilities Act of 1990 to increase knowledge and understanding of student protections under the law.
   c.  Provide training on mental health conditions as appropriate.
   2.  The mental health technical assistance center established under section 261K.6 shall set initial standards for policies and procedures described in subsection 1 to ensure statewide consistency.
   3.  All resident assistants in a student housing facility, advisors, and campus security officers of a public institution of higher education shall participate in a national mental health first aid training course or a similar program prior to the commencement of their duties. Such training shall include the policies and procedures developed by the institution of higher education described in subsection 1.
    Sec. 4.  NEW SECTION.  261K.4  Peer support programs.
   1.  Each public institution of higher education shall develop and implement a peer support program utilizing student peers to support students living with mental health conditions on campus. Peer support programs may be housed within resident assistant programs, counseling centers, or wellness centers on campus.
   2.  Peer support programs shall utilize best practices for peer support, which shall include but are not limited to all of the following:
   a.  Use of the tenets of the recovery model for mental health.
   b.  Adequate planning and preparation, including standardizing guidance and practices, identifying needs of the target population, and aligning program goals to meet those needs.
   c.  Clearly articulated policies, especially regarding role boundaries and confidentiality.
   d.  Systematic screening with defined selection criteria for peer supporters, such as communication skills, leadership ability, character, previous experience or training, and ability to serve as a positive role model.
   e.  Identification of benefits from peer status, such as experiential learning, social support, leadership, and improved self-confidence.
   f.  Continuing education for peer supporters to support each other and improve peer support skills.
   g.  Flexibility in availability by offering services through drop-in immediate support and the ability to schedule appointments.
    Sec. 5.  NEW SECTION.  261K.5  Strategic partnerships.
   1.  Each public institution of higher education shall establish strategic partnerships with local mental health service providers to improve overall campus mental wellness and augment on-campus capacity. The strategic partnerships shall include linkage agreements with off-campus mental health service providers that establish a process for referrals for students when needs cannot be met on campus due to the limits of on-campus capacity or preference of the student. The strategic partnerships shall also include all of the following:
   a.  Avenues for on-campus and off-campus mental health service providers to increase visibility to students through marketing and outreach.
   b.  Opportunities to engage the student body through student outreach initiatives such as mindfulness workshops or campus-wide wellness fairs.
   c.  Opportunities to support awareness and training requirements under this chapter.
   2.  a.  Through a combination of on-campus capacity, off-campus linkage agreements with mental health service providers, and contracted telehealth therapy services, each public institution of higher education shall attempt to meet a benchmark ratio of one clinical, nonstudent staff member to one thousand two hundred fifty students. If linkage agreements are used, the agreements shall include the capacity of students that providers are expected to serve within the agency.
   b.  By July 1, 2027, and at least once every five years thereafter, the mental health technical assistance center established under section 261K.6 shall submit a report to the general assembly and the governor proposing an updated ratio based on actual ratios in this state and any new information available related to appropriate benchmarks for clinician-to-student ratios. The updated ratio shall represent a ratio of no less than one clinical, nonstudent staff member to one thousand two hundred fifty students.
   3.  Each public institution of higher education shall work with local entities, such as on-campus mental health counseling centers or wellness centers, local mental health service providers, or nonproviders, such as affiliates of the national alliance on mental illness, and any other entities to implement the requirements of sections 261K.2 and 261K.3.
    Sec. 6.  NEW SECTION.  261K.6  Mental health technical assistance center.
   The department of health and human services, in consultation with the state board of regents and the Iowa association for community colleges, shall establish a mental health technical assistance center. Section 4A.5 does not apply to the center. The center is responsible for all of the following:
   1.  Developing standardized policies for medical leave related to mental health conditions for students of a public institution of higher education, which may be adopted by a public institution of higher education.
   2.  Providing tailored support to public institutions of higher education in reviewing policies related to students living with mental health conditions and their academic standing.
   3.  Establishing initial standards for policies and procedures under section 261K.3, subsection 1.
   4.  Disseminating best practices around peer support programs as provided in section 261K.4, including widely accepted selection criteria for individuals serving in a peer support role.
   5.  Developing statewide standards and best practices for partnerships between local mental health agencies and public institutions of higher education across the state.
   6.  Collecting, analyzing, and disseminating data related to mental health needs and academic engagement across the state.
   7.  Compiling data collected by each public institution of higher education related to program evaluation under section 261K.7 and analyzing and disseminating best practices to each institution and the public based on such data.
   8.  Monitoring and evaluating linkage agreements under section 261K.5 to ensure capacity is met by each public institution of higher education.
   9.  Facilitating a learning community across all public institutions of higher education to support capacity building and learning across those institutions.
    Sec. 7.  NEW SECTION.  261K.7  Program evaluation.
   Each public institution of higher education shall evaluate the following programs or functions provided in this chapter for effectiveness and quality in the following manner:
   1.  A public institution of higher education shall evaluate mental health awareness functions under section 261K.2 with monitoring measures including but not limited to:
   a.  Increased understanding of mental health conditions.
   b.  Reduced stigma toward mental health conditions.
   c.  Increased understanding of mental health resources available to students.
   d.  Increased understanding of resources for mental health emergencies available to students.
   e.  Viewing each internet site or mobile application of the public institution of higher education that provides mental health resources.
   2.  A public institution of higher education shall evaluate peer support programs under section 261K.4 with monitoring measures including but not limited to:
   a.  Improved symptomatology.
   b.  Connection to additional services as needed.
   c.  Student satisfaction.
   d.  Wait time for drop-in appointments.
   e.  Wait time for scheduled appointments.
   f.  Satisfaction with the training curriculum for peer supporters.
   3.  A public institution of higher education shall evaluate strategic partnerships under section 261K.5 with monitoring measures including but not limited to:
   a.  Wait time for drop-in appointments for on-campus or off-campus telehealth therapy providers.
   b.  Wait time for scheduled appointments for on-campus or off-campus telehealth therapy providers.
   c.  The ratio of clinical, nonstudent staff to the student population and the number of linkage agreements and contracts in place based on the student population.
   d.  Student satisfaction with on-campus or off-campus telehealth therapy providers.
   e.  Range of treatment models offered to students.
   f.  Average length of stay in treatment.
   g.  Number and range of student outreach initiatives, such as telehealth mindfulness workshops or campus-wide wellness fairs.
   h.  Number of students served annually.
    Sec. 8.  IMPLEMENTATION OF ACT.  Section 25B.2, subsection 3, shall not apply to this Act.
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 services at public institutions of higher education. The bill defines a “public institution of higher education” as an institution of higher education governed by the state board of regents or a community college.
   The bill requires public institutions of higher education (institutions) to carry out various specified functions to raise mental health awareness on their campuses. Specified functions include developing and implementing an annual student orientation session aimed at raising awareness about mental health conditions, assessing courses and seminars available to students through their regular academic coursework and implementing mental health awareness curricula where opportunities for integration with such coursework exist, and distributing certain information about mental health resources to students.
   The bill requires the state board of regents and the board of directors of each community college to designate an expert panel to develop and implement specified policies and procedures relating to mental health. Specified policies and procedures include advising students, faculty, and staff on the proper procedures for identifying and addressing the needs of students exhibiting symptoms of mental health conditions and promoting understanding of the requirements of section 504 of the federal Rehabilitation Act of 1973 and the federal Americans with Disabilities Act of 1990. The bill also requires all resident assistants in a student housing facility, advisors, and campus security officers of an institution to participate in a national mental health first aid training course.
   The bill requires each institution to develop and implement a peer support program utilizing student peers to support students living with mental health conditions on campus. The bill requires peer support programs to utilize best practices for peer support. Such best practices include use of the tenets of the recovery model, as defined in the bill, for mental health, adequate planning and preparation, and clearly articulated policies.
   The bill requires each institution to establish strategic partnerships with local mental health service providers to improve overall campus mental wellness and augment on-campus capacity. The strategic partnerships shall include linkage agreements, as defined in the bill, with off-campus mental health service providers that establish a process for referrals for students when needs cannot be met on campus due to the limits of on-campus capacity or preference of the student. The bill provides additional functions of such strategic partnerships, including meeting a benchmark ratio of clinical, nonstudent staff members to students and reporting on the ratio to the general assembly and the governor.
   The bill requires the department of health and human services, in consultation with the state board of regents and the Iowa association for community colleges, to establish a mental health technical assistance center. The bill specifies responsibilities of the center, including developing standardized policies for medical leave related to mental health conditions for students, providing tailored support to institutions in reviewing policies related to students living with mental health conditions and their academic standing, and developing statewide standards and best practices for partnerships between local mental health agencies and institutions. The center also assists institutions with implementation of various provisions of the bill.
   The bill requires each institution to evaluate the specified programs or functions provided in the bill for effectiveness and quality. The bill specifies monitoring measures to be used for evaluation of each program or function.
   The bill may include a state mandate as defined in Code section 25B.3. The bill makes inapplicable Code section 25B.2, subsection 3, which would relieve a political subdivision from complying with a state mandate if funding for the cost of the state mandate is not provided or specified. Therefore, political subdivisions are required to comply with any state mandate included in the bill.