House
File
2402
-
Reprinted
HOUSE
FILE
2402
BY
COMMITTEE
ON
HEALTH
AND
HUMAN
SERVICES
(SUCCESSOR
TO
HSB
502)
(As
Amended
and
Passed
by
the
House
February
21,
2024
)
A
BILL
FOR
An
Act
relating
to
behavioral
health
services
for
children
1
including
psychiatric
medical
institutions
for
children.
2
BE
IT
ENACTED
BY
THE
GENERAL
ASSEMBLY
OF
THE
STATE
OF
IOWA:
3
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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.
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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.
Allow
therapy
and
behavioral
health
intervention
12
services
to
be
included
as
billable
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.
Allow
family
therapy
and
family
behavioral
health
17
intervention
services
to
be
included
in
billable
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
five
business
days
from
receipt
33
of
a
request
for
authorization
for
a
PMIC
placement,
if
the
34
certification
of
need
and
independent
assessment
have
been
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received
in
a
timely
manner.
1
b.
Prohibit
a
managed
care
organization
from
denying
2
authorization
for
a
PMIC
placement
based
on
lack
of
parental
3
involvement,
lack
of
participation
in
behavioral
health
4
intervention
services
on
an
outpatient
basis,
or
based
on
other
5
perceived
behavioral
issues.
6
c.
Allow
a
managed
care
organization
to
authorize
an
initial
7
PMIC
placement
of
sixty
days
upon
admission
with
concurrent
8
stay
reviews
every
thirty
days
thereafter.
A
PMIC
shall
submit
9
a
care
plan
to
the
managed
care
organization
within
thirty
days
10
of
the
admission.
11
d.
Require
concurrent
stay
reviews
to
be
standardized
12
and
limited
to
a
brief
description
of
progress,
or
lack
of
13
progress,
toward
the
child’s
goals
and
objectives.
14
e.
Require
a
managed
care
organization
to
offer
support
to
15
families,
including
assistance
with
transportation
to
and
from
16
a
PMIC
to
visit
a
child.
17
7.
Notwithstanding
any
provision
of
law
to
the
contrary,
18
including
certificate
of
need
requirements,
allow
a
previously
19
licensed
PMIC
that
has
the
capacity
to
provide
up
to
an
20
additional
four
intermediate
care
facility
for
persons
with
an
21
intellectual
disability
beds,
and
which
additional
beds
meet
22
all
other
licensing
and
state
fire
marshal
requirements,
to
23
increase
their
licensed
capacity
to
include
the
additional
24
beds
without
further
review
including
by
the
health
facilities
25
council.
26
8.
Allow
for
step-down
PMIC
placements
or
supervised
27
apartment
living
for
a
child
to
utilize
programming
provided
28
in
a
PMIC
while
living
independently
in
a
smaller
residential
29
setting
without
twenty-four-hour
supervision.
30
Sec.
3.
HAWKI
PROGRAM
——
BENEFITS
INCLUDED
IN
QUALIFIED
31
CHILD
HEALTH
PLAN
——
REVIEW.
The
department
of
health
32
and
human
services
shall
review
the
benefits
included
in
a
33
qualified
child
health
plan
under
the
Hawki
program
and
shall
34
specifically
address
the
inclusion
of
applied
behavior
analysis
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services
as
a
covered
benefit.
The
department
shall
report
the
1
findings
of
the
review
to
the
general
assembly
by
December
1,
2
2024.
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