House File 876 - Reprinted HOUSE FILE BY COMMITTEE ON WAYS AND MEANS (SUCCESSOR TO HF 785) (SUCCESSOR TO HSB 223) Passed House, Date Passed Senate, Date Vote: Ayes Nays Vote: Ayes Nays Approved A BILL FOR 1 An Act relating to mental health, mental retardation, 2 developmental disabilities, and brain injury service 3 requirements and including an effective and applicability 4 date. 5 BE IT ENACTED BY THE GENERAL ASSEMBLY OF THE STATE OF IOWA: 6 TLSB 1611HZ 81 7 jp/sh/8 PAG LIN 1 1 Section 1. NEW SECTION. 225C.8A STATE CASES == MINIMUM 1 2 STANDARDS. 1 3 If a person receiving services or other support provided 1 4 under chapter 222, 230, or 249A has no legal settlement or the 1 5 legal settlement is unknown so that the person is deemed to be 1 6 a state case, the state's responsibility is limited to the 1 7 cost of services or other support under the minimum standards 1 8 required to be available to persons covered by a county 1 9 management plan in accordance with the rules adopted by the 1 10 commission pursuant to section 331.439A. However, a person 1 11 receiving services or other support as a state case as of June 1 12 30, 2006, shall remain eligible for the services or other 1 13 support available to the person on that date and the state 1 14 shall continue to be responsible for the cost. 1 15 Sec. 2. Section 331.439, Code 2005, is amended by adding 1 16 the following new subsection: 1 17 NEW SUBSECTION. 9. The county management plan shall 1 18 designate at least one hospital licensed under chapter 135B 1 19 that the county has contracted with to provide services 1 20 covered under the plan. If the designated hospital does not 1 21 have a bed available to provide the services, the county is 1 22 responsible for the cost of covered services provided at an 1 23 alternate hospital licensed under chapter 135B. 1 24 Sec. 3. NEW SECTION. 331.439A COUNTY MANAGEMENT PLANS == 1 25 MINIMUM STANDARDS. 1 26 The county management plan approved in accordance with 1 27 section 331.439 shall comply with the minimum standards for 1 28 the services and other support required to be available to 1 29 persons covered by the plan in accordance with administrative 1 30 rules adopted by the state commission to implement this 1 31 section. The rules shall address processes for managing 1 32 utilization and access to services and other support, 1 33 including but not limited to the usage of fiscal management 1 34 practices if state or county funding is insufficient to pay 1 35 the costs of the services and other support required to be 2 1 available. The initial minimum standards shall require the 2 2 provision of the services provided to persons covered by the 2 3 plan under the medical assistance program for which the county 2 4 is responsible for the nonfederal share and the availability 2 5 of the following services and other support, based upon an 2 6 individual having the specified primary diagnosis: 2 7 1. For persons with mental illness: 2 8 a. Payment of costs associated with commitment proceedings 2 9 that are a county responsibility, including but not limited to 2 10 costs for diagnostic evaluations, transportation by the 2 11 sheriff, legal representation, and the patient advocate. 2 12 b. Inpatient psychiatric evaluation and treatment in a 2 13 county=designated hospital. 2 14 c. Inpatient treatment provided at a state mental health 2 15 institute. 2 16 d. Outpatient treatment. 2 17 2. For persons with chronic mental illness: 2 18 a. Case management or service coordination that is funded 2 19 under the medical assistance program. 2 20 b. Payment of costs associated with commitment proceedings 2 21 that are a county responsibility, including but not limited to 2 22 costs for diagnostic evaluations, transportation by the 2 23 sheriff, legal representation, and the patient advocate. 2 24 c. Inpatient psychiatric evaluation and treatment in a 2 25 county=designated hospital. 2 26 d. Inpatient treatment provided at a state mental health 2 27 institute. 2 28 e. Outpatient treatment. 2 29 3. For persons with mental retardation: 2 30 a. Case management or service coordination that is funded 2 31 through the medical assistance program. 2 32 b. Payment of costs associated with commitment proceedings 2 33 that are a county responsibility, including but not limited to 2 34 costs for diagnostic evaluations, transportation by the 2 35 sheriff, and legal representation. 3 1 c. Employment=related services, including but not limited 3 2 to adult day care, sheltered workshop, work activity, and 3 3 supported employment. 3 4 d. Inpatient behavioral health evaluation and treatment in 3 5 a county=designated hospital. 3 6 e. Inpatient treatment provided at a state resource 3 7 center. 3 8 f. Outpatient treatment, including but not limited to 3 9 partial hospitalization and day treatment. 3 10 g. Residential services covered under the medical 3 11 assistance program. 3 12 4. For persons with a developmental disability other than 3 13 mental retardation: 3 14 a. Case management funded through the medical assistance 3 15 program. 3 16 b. Payment of costs associated with commitment proceedings 3 17 that are a county responsibility, including but not limited to 3 18 costs for diagnostic evaluations, transportation by the 3 19 sheriff, and legal representation. 3 20 c. Inpatient treatment provided at a state resource 3 21 center. 3 22 5. For persons with brain injury, services under the 3 23 medical assistance program home and community=based services 3 24 brain injury waiver that are received while utilizing an 3 25 approved waiver opening and are a county responsibility under 3 26 section 249A.26. 3 27 Sec. 4. PSYCHOACTIVE MEDICATION PILOT PROJECT. The 3 28 department of human services shall issue a request for 3 29 proposals during the fiscal year beginning July 1, 2005, for a 3 30 pilot project based out of a community mental health center 3 31 for providing no or low cost psychoactive medications to low= 3 32 income persons who are in need of treatment with the 3 33 medications. 3 34 Sec. 5. STATE CASES == FISCAL YEAR 2005=2006. If the 3 35 costs of the services provided to a person with mental 4 1 retardation receiving services as a state case can be covered 4 2 under a medical assistance program home and community=based 4 3 waiver or other medical assistance program provision, the 4 4 department of human services may transfer moneys to cover the 4 5 nonfederal share of such costs from the appropriation made for 4 6 the fiscal year beginning July 1, 2005, for state cases to the 4 7 appropriation made for the medical assistance program. The 4 8 department shall act expeditiously to obtain federal approval 4 9 for additional waiver slots to cover the state cases beginning 4 10 at the earliest possible time in the fiscal year, if such 4 11 approval is necessary. 4 12 Sec. 6. SERVICES FOR PERSONS WITH BRAIN INJURY == 4 13 LEGISLATIVE INTENT. 4 14 1. The general assembly intends to enact legislation in 4 15 the 2006 regular legislative session authorizing coverage 4 16 under county management plans of additional services and other 4 17 support for persons with brain injury, based upon the 4 18 information provided pursuant to this section. The general 4 19 assembly intends to provide for the availability of cost share 4 20 with counties for the coverage as part of the allowed growth 4 21 funding provided by the state for county mental health, mental 4 22 retardation, and developmental disabilities services 4 23 commencing in the fiscal year beginning July 1, 2006. 4 24 2. For the purposes of developing options under subsection 4 25 3, "individual with brain injury" means an individual resident 4 26 of this state who has a diagnosis of brain injury and is 4 27 described by all of the following: 4 28 a. The individual is age twenty=two through sixty=four 4 29 years. 4 30 b. The individual would be eligible under the income, 4 31 resource, and other eligibility requirements for the medical 4 32 assistance program home and community=based waiver for persons 4 33 with brain injury except the individual does not have 4 34 sufficient deficits under the waiver's functional assessment 4 35 requirements to qualify but the individual could achieve a 5 1 higher level of functioning or maintain the current level of 5 2 functioning with support from the services available under the 5 3 waiver. 5 4 c. The individual meets statewide functional assessment 5 5 eligibility requirements to be determined pursuant to this 5 6 section. 5 7 3. It is the intent of the general assembly to enact a 5 8 directive during the 2006 regular legislative session for the 5 9 mental health, mental retardation, developmental disabilities, 5 10 and brain injury commission to adopt functional assessment 5 11 eligibility requirements in rule that may be used to complete 5 12 the definition in subsection 2 and to identify parameters for 5 13 the eligibility requirements in the statutory directive. The 5 14 department of human services shall provide for the 5 15 department's contractor for medical assistance eligibility 5 16 determination to identify options that may be used for the 5 17 functional assessment eligibility requirements. A work group 5 18 consisting of representatives of the department of management, 5 19 department of human services, and the legislative services 5 20 agency shall develop cost projections for the options in 5 21 consultation with representatives of the Iowa state 5 22 association of counties and service providers. The work group 5 23 may provide for the options to be reviewed and revised by the 5 24 contractor based upon the cost projections. In addition, 5 25 proposals may be provided by the work group for revising the 5 26 definition in subsection 2 if necessary to develop improved 5 27 options. In addition to the functional assessment eligibility 5 28 requirements, the work group shall also identify options for a 5 29 minimum set of services and other support that may be made 5 30 available to persons with brain injury. The options shall be 5 31 designed in a manner so that the state and county funding 5 32 designated for provision of services to persons with brain 5 33 injury is not exceeded. 5 34 4. The work group shall submit a report of the options 5 35 developed pursuant to subsection 3 along with any findings and 6 1 recommendations to the governor, general assembly, and the 6 2 commission on or before December 16, 2005. 6 3 Sec. 7. EFFECTIVE AND APPLICABILITY DATE. The sections of 6 4 this Act enacting sections 225C.8A and 331.439A take effect 6 5 July 1, 2006. The mental health, mental retardation, 6 6 developmental disabilities, and brain injury commission shall 6 7 act in advance of that effective date by adopting rules to 6 8 implement the provisions that take effect July 1, 2006. 6 9 HF 876 6 10 jp/es/25