House File 2707 - Reprinted HOUSE FILE 2707 BY COMMITTEE ON HEALTH AND HUMAN SERVICES (SUCCESSOR TO HSB 622) (COMPANION TO SF 2338 BY COMMITTEE ON HEALTH AND HUMAN SERVICES) (As Amended and Passed by the House April 15, 2026 ) A BILL FOR An Act relating to alignment of delivery of health and human 1 services programs and services, aging and disability 2 services, and volunteer services, and including 3 applicability and effective date provisions. 4 BE IT ENACTED BY THE GENERAL ASSEMBLY OF THE STATE OF IOWA: 5 HF 2707 (3) 91 dg/ko/md

H.F. 2707 DIVISION I 1 HEALTH AND HUMAN SERVICES DISTRICTS 2 Section 1. Section 12.51, subsection 1, Code 2026, is 3 amended to read as follows: 4 1. As used in this section unless the context otherwise 5 requires: 6 a. “Administrative services organization” means the same as 7 defined in section 225A.1 . 8 b. “Behavioral health district” means the same as defined 9 in section 225A.1 . 10 c. “Behavioral health district advisory council” means the 11 same as defined in section 225A.1. 12 c. d. “Department” means the department of health and human 13 services. 14 d. “District behavioral health advisory council” means the 15 same as defined in section 225A.1 . 16 Sec. 2. Section 12.51, subsection 2, paragraph b, 17 subparagraph (3), subparagraph division (d), subparagraph 18 subdivision (ii), Code 2026, is amended to read as follows: 19 (ii) Input from each district behavioral health district 20 advisory council regarding disbursements from the fund, 21 intended outcomes, and recommendations for future disbursements 22 from the fund. 23 Sec. 3. Section 217.1, Code 2026, is amended by adding the 24 following new subsection: 25 NEW SUBSECTION . 4. “Health and human services district” or 26 “HHS district” means a geographic, multicounty area designated 27 by the department under section 217.1B for statewide program 28 and service delivery. 29 Sec. 4. NEW SECTION . 217.1B Health and human services 30 districts. 31 1. The department shall divide the entirety of the state 32 into designated health and human services districts. The 33 initial HHS districts shall be the same as the behavioral 34 health districts designated pursuant to section 225A.4, Code 35 -1- HF 2707 (3) 91 dg/ko/md 1/ 13

H.F. 2707 2026, and that exist on the effective date of this division 1 of this Act. Beginning the calendar year that begins January 2 1, 2032, and every ten consecutive calendar years thereafter, 3 the department shall review the efficacy of the designated HHS 4 districts in performing the HHS districts’ functions during the 5 immediately preceding ten consecutive calendar years. 6 2. a. The department may modify a designated HHS district. 7 When modifying a designated HHS district, the department shall 8 consider all of the following: 9 (1) City and county boundaries. 10 (2) The population size that can be effectively served in a 11 specific area. 12 (3) Areas of high need for services. 13 (4) Patterns various populations exhibit when accessing or 14 receiving services. 15 b. Notwithstanding chapter 17A, the manner in which 16 the modification of an HHS district is made, including the 17 determination of boundaries for a modified HHS district, shall 18 not be subject to judicial review. 19 3. The department shall adopt rules pursuant to chapter 17A 20 to administer this section. 21 Sec. 5. Section 225A.1, Code 2026, is amended to read as 22 follows: 23 225A.1 Definitions. 24 As used in this chapter unless the context otherwise 25 requires: 26 1. “Administrative services organization” means an entity 27 designated by the department pursuant to section 225A.4 , to 28 develop and perform planning and administrative services in 29 accordance with a district behavioral health service system 30 district plan. 31 2. “Behavioral health condition” means a substantial 32 limitation in major life activities due to a mental, 33 behavioral, or addictive disorder or condition diagnosed in 34 accordance with the criteria provided in the most current 35 -2- HF 2707 (3) 91 dg/ko/md 2/ 13

H.F. 2707 edition of the diagnostic and statistical manual of mental 1 disorders, published by the American psychiatric association. 2 3. “Behavioral health district” or “district” means a 3 geographic, multicounty, sub-state area as designated by the 4 department under section 225A.4 health and human services 5 district utilized for the purpose of administering the 6 behavioral health service system . 7 4. “Behavioral health district advisory council” means an 8 advisory council established pursuant to section 225A.5. 9 4. 5. “Behavioral health provider” or “provider” means an 10 individual, firm, corporation, association, or institution 11 that, pursuant to this chapter , is providing or has been 12 approved by the department to provide services to an individual 13 with a behavioral health condition. 14 5. 6. “Behavioral health service system” means the 15 behavioral health service system established in section 225A.3 . 16 7. “Behavioral health service system district plan” or 17 “behavioral health district plan” means a plan developed by 18 an administrative services organization and approved by the 19 department that outlines the services intended to be provided 20 within the administrative services organization’s behavioral 21 health district. 22 8. “Behavioral health service system state plan” means 23 the plan developed by the department that describes the key 24 components of the behavioral health service system. 25 6. 9. “Caregiver” means an adult family member, or other 26 individual, who is providing care to a person outside of a 27 formal program. 28 7. 10. “Community mental health center” means an entity 29 designated by the department to address the mental health needs 30 of one or more counties. 31 8. 11. “Department” means the department of health and 32 human services. 33 9. 12. “Director” means the director of the department of 34 health and human services. 35 -3- HF 2707 (3) 91 dg/ko/md 3/ 13

H.F. 2707 10. “District behavioral health advisory council” 1 or “advisory council” means a council established by an 2 administrative services organization under section 225A.5 , to 3 identify opportunities, address challenges, and advise the 4 administrative services organization in accordance with section 5 225A.5 . 6 11. “District behavioral health service system plan” or 7 “district behavioral health plan” means a plan developed by 8 an administrative services organization and approved by the 9 department to outline the services intended to be provided 10 within the administrative services organization’s behavioral 11 health district. 12 13. “Health and human services district” or “HHS district” 13 means the same as defined in section 217.1. 14 12. 14. “Indicated prevention” means prevention activities 15 designed to prevent the onset of substance use disorders in 16 individuals who do not meet the medical criteria for addiction, 17 but who show early signs of developing a substance use disorder 18 in the future. 19 13. 15. “Selective prevention” means prevention activities 20 designed to target subsets of the total population who are 21 considered at-risk for a substance use disorder by virtue of 22 their membership in a particular segment of the population. 23 Selective prevention targets the entire subgroup, regardless of 24 the degree of risk of any individual within the group. 25 14. “State behavioral health service system plan” or 26 “state behavioral health plan” means the plan developed by the 27 department that describes the key components of the state’s 28 behavioral health service system. 29 15. 16. “Universal prevention” means prevention activities 30 designed to address an entire population class for the purpose 31 of preventing or delaying the use of alcohol, tobacco, and 32 other drugs. Population classes include but are not limited 33 to the national population, local populations, community 34 populations, school populations, and neighborhood populations. 35 -4- HF 2707 (3) 91 dg/ko/md 4/ 13

H.F. 2707 Sec. 6. Section 225A.2, subsection 3, paragraph c, Code 1 2026, is amended to read as follows: 2 c. Review and approve district behavioral health service 3 system district plans developed in accordance with the state 4 behavioral health service system state plan. 5 Sec. 7. Section 225A.3, subsection 2, paragraph a, 6 subparagraph (1), unnumbered paragraph 1, Code 2026, is amended 7 to read as follows: 8 Develop a state behavioral health service system state plan 9 that accomplishes all of the following: 10 Sec. 8. Section 225A.3, subsection 2, paragraph a, 11 subparagraph (1), subparagraph division (d), Code 2026, is 12 amended to read as follows: 13 (d) Is consistent with the department’s agency strategic 14 plan adopted pursuant to section 8E.206 8E.204 . 15 Sec. 9. Section 225A.3, subsection 2, paragraph a, 16 subparagraph (2), unnumbered paragraph 1, Code 2026, is amended 17 to read as follows: 18 The department shall do all of the following when developing 19 the state behavioral health service system state plan: 20 Sec. 10. Section 225A.3, subsection 2, paragraph a, 21 subparagraph (2), subparagraph division (b), Code 2026, is 22 amended to read as follows: 23 (b) Publish the proposed state behavioral health service 24 system state plan on the department’s internet site and 25 allow the public to review and comment on the proposed state 26 behavioral health service system state plan prior to the 27 adoption of the proposed state behavioral health service system 28 state plan. 29 Sec. 11. Section 225A.3, subsection 2, paragraph c, Code 30 2026, is amended to read as follows: 31 c. Oversee, provide technical assistance to, and 32 monitor administrative services organizations to ensure the 33 administrative services organizations’ compliance with district 34 behavioral health district plans. 35 -5- HF 2707 (3) 91 dg/ko/md 5/ 13

H.F. 2707 Sec. 12. Section 225A.3, subsection 2, paragraph k, 1 subparagraph (9), Code 2026, is amended to read as follows: 2 (9) Any other requirements the department deems necessary 3 to ensure that an administrative services organization 4 fulfills the administrative services organization’s duties 5 as established in this chapter , and as established in the 6 administrative services organization’s district behavioral 7 health district plan. 8 Sec. 13. Section 225A.4, subsection 1, Code 2026, is amended 9 to read as follows: 10 1. a. The department shall divide the entirety of the state 11 into designated behavioral health districts. Behavioral make 12 available behavioral health prevention, education, early 13 intervention, treatment, recovery support, and crisis services 14 related to mental health and addictive disorders, including 15 but not limited to alcohol use, substance use, tobacco use, 16 and problem gambling , shall be made available through in a 17 consistent manner in each behavioral health district in a 18 manner consistent with directives each district receives from 19 the department . 20 b. For the purpose of providing equitable access to all 21 services provided through the behavioral health service 22 system, the department shall consider all of the following when 23 designating behavioral health districts: 24 (1) City and county lines. 25 (2) The maximum population size that behavioral health 26 services available in an area are able to effectively serve. 27 (3) Areas of high need for behavioral health services. 28 (4) Patterns various populations exhibit when accessing or 29 receiving behavioral health services. 30 c. Notwithstanding chapter 17A , the manner in which the 31 department designates behavioral health districts including but 32 not limited to the determination of the boundaries for each 33 district shall not be subject to judicial review. 34 Sec. 14. Section 225A.4, subsection 2, paragraph a, Code 35 -6- HF 2707 (3) 91 dg/ko/md 6/ 13

H.F. 2707 2026, is amended to read as follows: 1 a. The department shall designate an administrative services 2 organization for each behavioral health district to oversee and 3 organize each behavioral health district and the behavioral 4 health services associated with the behavioral health district. 5 The department shall may issue requests for proposals for 6 administrative services organization candidates. 7 Sec. 15. Section 225A.4, subsection 2, paragraph b, 8 subparagraph (2), Code 2026, is amended to read as follows: 9 (2) A public or private nonprofit agency located in a 10 the behavioral health district for which the agency is being 11 designated an administrative services organization , or any 12 separate organizational unit within the that public or private 13 nonprofit agency, that has the capabilities to engage in the 14 planning or provision of a broad range of behavioral health 15 prevention, education, early intervention, treatment, recovery 16 support, and crisis services related to mental health and 17 addictive disorders, including but not limited to alcohol use, 18 substance use, tobacco use, and problem gambling, only as 19 directed by the department. 20 Sec. 16. Section 225A.4, subsection 2, paragraph c, 21 subparagraph (2), Code 2026, is amended to read as follows: 22 (2) Whether the entity has demonstrated the ability to 23 ensure the delivery of behavioral health services within the 24 behavioral health district as required by the department by 25 rule. 26 Sec. 17. Section 225A.4, subsection 5, Code 2026, is amended 27 to read as follows: 28 5. Each administrative services organization shall perform 29 all of the following duties: 30 a. Develop and administer a district behavioral health 31 district plan in accordance with the standards adopted by the 32 department by rule. 33 b. Coordinate the administration of the district behavioral 34 health district plan with federal, state, and local resources 35 -7- HF 2707 (3) 91 dg/ko/md 7/ 13

H.F. 2707 in order to develop a comprehensive and coordinated local 1 behavioral health service system. 2 c. Enter into contracts necessary to provide services under 3 the district behavioral health district plan. 4 d. Oversee, provide technical assistance to, and monitor 5 the compliance of providers contracted by the administrative 6 services organization to provide behavioral health services in 7 accordance with the district behavioral health district plan. 8 e. Establish a district behavioral health district advisory 9 council pursuant to section 225A.5 . 10 Sec. 18. Section 225A.5, Code 2026, is amended to read as 11 follows: 12 225A.5 District behavioral Behavioral health district 13 advisory councils. 14 1. Each administrative services organization shall 15 establish a district behavioral health district advisory 16 council that shall do all of the following: 17 a. Identify opportunities and address challenges based on 18 updates received from the administrative services organization 19 regarding the implementation of the district behavioral health 20 district plan. 21 b. Advise the administrative services organization while the 22 administrative services organization is developing behavioral 23 health policies. 24 c. Advise the administrative services organization on how to 25 best provide access to behavioral health prevention, education, 26 early intervention, treatment, recovery support, and crisis 27 services related to mental health and addictive disorders, 28 including but not limited to alcohol use, substance use, 29 tobacco use, and problem gambling, throughout the behavioral 30 health district as directed by the department. 31 2. An A behavioral health district advisory council shall 32 consist of ten members. Members shall be appointed by the 33 administrative services organization subject to the following 34 requirements: 35 -8- HF 2707 (3) 91 dg/ko/md 8/ 13

H.F. 2707 a. Three members shall be local elected public officials 1 currently holding office within the behavioral health district, 2 or the public official’s designated representative. 3 b. Three members shall be chosen in accordance with 4 procedures established by the administrative services 5 organization to ensure representation of the populations 6 served within the behavioral health district. At least one 7 member chosen under this paragraph shall represent child and 8 adolescent persons. 9 c. Three members shall be chosen who have experience 10 or education related to core behavioral health functions, 11 essential behavioral health services, behavioral health 12 prevention, behavioral health treatment, population-based 13 behavioral health services, or community-based behavioral 14 health initiatives. 15 d. One member shall be a law enforcement representative from 16 within the behavioral health district. 17 3. An A behavioral health district advisory council shall 18 perform the duties required under this section regardless of 19 whether any seat on the behavioral health district advisory 20 council is vacant. 21 Sec. 19. Section 225A.6, subsection 4, Code 2026, is amended 22 to read as follows: 23 4. Administrative services organizations shall report 24 to the department, in a manner specified by the department, 25 information including but not limited to demographic 26 information, expenditure data, and data concerning the 27 behavioral health services and other support provided to 28 individuals in the administrative service organization’s 29 behavioral health district. 30 Sec. 20. Section 225A.7, subsection 2, paragraph a, Code 31 2026, is amended to read as follows: 32 a. Distributions to administrative services organizations 33 to provide services as outlined in the organizations’ district 34 behavioral health district plan. 35 -9- HF 2707 (3) 91 dg/ko/md 9/ 13

H.F. 2707 Sec. 21. Section 225A.8, subsection 2, unnumbered paragraph 1 1, Code 2026, is amended to read as follows: 2 To promote comprehensive tobacco use prevention and control 3 initiatives outlined in the state behavioral health service 4 system state plan, an entity shall not perform any of the 5 following acts: 6 Sec. 22. EFFECTIVE DATE. This division of this Act, being 7 deemed of immediate importance, takes effect upon enactment. 8 DIVISION II 9 AGING AND DISABILITY SERVICES 10 Sec. 23. DEPARTMENT OF HEALTH AND HUMAN SERVICES AND AREA 11 AGENCIES ON AGING —— REDESIGNATION OF PLANNING AND SERVICE 12 AREAS —— REVIEW AND REPORT. 13 1. For purposes of this section, unless the context 14 otherwise requires: 15 a. “Area agency on aging” means the same as defined in 42 16 U.S.C. §3002. 17 b. “Department” means the department of health and human 18 services. 19 c. “Health and human services district” means the same as 20 defined in section 217.1, as amended in division I of this Act. 21 d. “Planning and service area” means the same as defined in 22 42 U.S.C. §3002. 23 e. “Redesignation” means the process described in 45 C.F.R. 24 §1321.13(e) to change the designation of a planning and service 25 area. 26 2. The department shall not submit an application for 27 redesignation for federal approval prior to January 1, 2027. 28 3. a. The department and each area agency on aging shall 29 collaborate in good faith to do all of the following: 30 (1) Determine the full fiscal impact of a proposed 31 redesignation including but not limited to the costs related 32 to all of the following: 33 (a) Transition. 34 (b) Administration. 35 -10- HF 2707 (3) 91 dg/ko/md 10/ 13

H.F. 2707 (c) Information technology. 1 (d) Property. 2 (e) Contract modifications. 3 (f) Personnel. 4 (g) The long-term finances of the state and each affected 5 area agency on aging. 6 (2) Determine the effects of a proposed redesignation on all 7 of the following: 8 (a) Service continuity. 9 (b) Client access. 10 (c) Provider networks. 11 (d) Rural service delivery. 12 (e) Wait lists. 13 (f) Consumer choice. 14 (g) Outcomes for older Iowans. 15 (3) Identify and recommend reasonable alternatives to 16 redesignation and reasonable means to align aging services 17 coordination with the geographic boundaries of health and 18 human services districts in a manner that adequately achieves 19 the state’s policy objectives for the delivery of aging and 20 disability services. 21 (4) Recommend the date by which a proposed planning 22 and service area will be implemented as the result of a 23 redesignation. 24 b. In completing the requirements under paragraph “a”, the 25 department and each area agency on aging shall do all of the 26 following as applicable: 27 (1) Provide information and data to the department as 28 determined necessary by the department. 29 (2) Engage with and receive input from relevant 30 stakeholders including but not limited to service providers, 31 consumer representatives, advocates for older Iowans, and 32 representatives of rural and underserved communities. 33 c. No later than December 15, 2026, the department shall 34 submit a report to the general assembly that details the 35 -11- HF 2707 (3) 91 dg/ko/md 11/ 13

H.F. 2707 results of the collaboration between the department and the 1 area agencies on aging under paragraph “a”. Stakeholders shall 2 be provided a meaningful opportunity to review and provide 3 comments on the report prior to the department submitting the 4 report. A summary of the input from the stakeholder review and 5 stakeholder comments shall be included in the report. 6 DIVISION III 7 VOLUNTEER SERVICES 8 Sec. 24. Section 15H.2, subsection 1, Code 2026, is amended 9 to read as follows: 10 1. The Iowa commission on volunteer service is created 11 within the department. The governor shall appoint the 12 commission’s members. The director may employ personnel as 13 necessary to carry out the duties and responsibilities of the 14 commission. 15 Sec. 25. Section 15H.4, Code 2026, is amended to read as 16 follows: 17 15H.4 Administration —— funding. 18 1. a. The department shall serve as the lead agency for 19 administration of the commission. 20 b. The department may consult with the department of 21 education, the state board of regents, and the department of 22 workforce development for any additional administrative support 23 as necessary to fulfill the duties of the commission. 24 c. All other state agencies, at the request of the 25 department, shall provide assistance to the commission to 26 ensure a fully coordinated state effort for promoting national 27 and community service. 28 d. The commission may delegate the administration of 29 nonpolicymaking duties, in compliance with 42 U.S.C. §12638, 30 to the executive director and the personnel of the department 31 subunit for volunteerism created in section 217.13. 32 2. The commission may accept funds and in-kind services from 33 other state, federal, and private entities. 34 Sec. 26. Section 217.13, Code 2026, is amended by striking 35 -12- HF 2707 (3) 91 dg/ko/md 12/ 13

H.F. 2707 the section and inserting in lieu thereof the following: 1 217.13 Department subunit for volunteerism —— volunteer 2 liability. 3 1. A subunit for volunteerism is created within the 4 department under the department’s administrative authority to 5 establish volunteer programs designed to enhance the services 6 provided by the department and to provide administrative 7 support for the nonpolicymaking duties of the Iowa commission 8 on volunteer service as delegated pursuant to section 15H.4. 9 2. a. The director shall appoint an executive director 10 to oversee the administration of the department subunit for 11 volunteerism and to carry out the nonpolicymaking duties of the 12 Iowa commission on volunteer service as delegated pursuant to 13 section 15H.4. 14 b. The department may employ personnel for the subunit 15 for volunteerism as necessary to carry out the duties of the 16 subunit for volunteerism and the nonpolicymaking duties of the 17 Iowa commission on volunteer service as delegated pursuant to 18 section 15H.4. 19 3. All volunteers registered with programs administered 20 under this section and in compliance with rules adopted by 21 the department pursuant to chapter 17A shall be considered 22 employees of the state for purposes of chapter 669. However, 23 this section does not exempt a volunteer guardian from an 24 action brought under section 658.1A, or a volunteer guardian 25 or volunteer conservator from an action brought under section 26 658.3. This section shall not be construed to relieve a 27 volunteer guardian or conservator from duties under chapter 28 633. 29 4. The department shall adopt rules pursuant to chapter 17A 30 to administer this section. 31 Sec. 27. EFFECTIVE DATE. This division of this Act, being 32 deemed of immediate importance, takes effect upon enactment. 33 -13- HF 2707 (3) 91 dg/ko/md 13/ 13