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House File 690 - ReprintedA Bill ForAn Act 1relating to mental health and disability services,
2including the establishment of a children’s behavioral
3health system and a children’s behavioral health system
4state board, and requiring certain children’s behavioral
5health core services.
6BE IT ENACTED BY THE GENERAL ASSEMBLY OF THE STATE OF IOWA:
1 Section 1. Section 225C.2, Code 2019, is amended by adding
2the following new subsections:
3 new subsection. 1A. “Child” or “children” means a person or
4persons under eighteen years of age.
5 new subsection. 1B. “Children’s behavioral health
6services” means services for children with a serious emotional
7disturbance.
8 new subsection. 1C. “Children’s behavioral health system” or
9“children’s system” means the behavioral health service system
10for children implemented pursuant to this subchapter.
11 new subsection. 11. “Serious emotional disturbance” means
12a diagnosable mental, behavioral, or emotional disorder of
13sufficient duration to meet diagnostic criteria specified
14within the most current diagnostic and statistical manual
15of mental disorders published by the American psychiatric
16association that results in a functional impairment. “Serious
17emotional disturbance” does not include substance use and
18developmental disorders unless such disorders co-occur with
19such a diagnosable mental, behavioral, or emotional disorder.
20 new subsection. 12. “State board” means the children’s
21behavioral health system state board created in section
22225C.51.
23 Sec. 2. Section 225C.2, subsection 9, Code 2019, is amended
24by striking the subsection.
25 Sec. 3. Section 225C.4, subsection 1, Code 2019, is amended
26by adding the following new paragraph:
27 NEW PARAGRAPH. 0c. Assist the state board in planning for
28community-based children’s behavioral health services.
29 Sec. 4. Section 225C.4, subsection 1, paragraphs d and j,
30Code 2019, are amended to read as follows:
31d. Encourage and facilitate coordination of mental health
32and disability services with the objective of developing and
33maintaining in the state a mental health and disability service
34delivery system to provide disability services to all persons
35in this state who need the services, regardless of the place
-1-1of residence or economic circumstances of those persons. The
2administrator shall work with the commission and other state
3agencies, including but not limited to the departments of
4corrections, education, and public health and the state board
5of regents, to develop and implement a strategic plan to expand
6access to qualified mental health workers across the state.
7j. Establish and maintain a data collection and management
8information system oriented to the needs of patients,
9providers, the department, and other programs or facilities in
10accordance with section 225C.6A. The system shall be used to
11identify, collect, and analyze service outcome and performance
12measures data in order to assess the effects of the services on
13the persons utilizing the services. The administrator shall
14annually submit to the commission information collected by the
15department indicating the changes and trends in the mental
16health and disability services system. The administrator shall
17make the outcome data available to the public.
18 Sec. 5. Section 225C.4, subsection 1, Code 2019, is amended
19by adding the following new paragraphs:
20 NEW PARAGRAPH. 0k. Encourage and facilitate coordination
21of children’s behavioral health services with the objective of
22developing and maintaining in the state a children’s behavioral
23health system to provide behavioral health services to all
24children in this state who need the services, regardless of the
25place of residence or economic circumstances of those children.
26The administrator shall work with the state board and other
27state agencies including but not limited to the department of
28education and the department of public health to develop and
29implement a strategic plan to expand access to qualified mental
30health workers across the state.
31 NEW PARAGRAPH. 00k. Establish and maintain a data
32collection and management information system oriented to the
33needs of children utilizing the children’s behavioral health
34system, providers, the department, and other programs or
35facilities in accordance with section 225C.6A. The system
-2-1shall be used to identify, collect, and analyze service
2outcome and performance measures data in order to assess the
3effects of the services on the children utilizing the services.
4The administrator shall annually submit to the state board
5information collected by the department indicating the changes
6and trends in the children’s behavioral health system. The
7administrator shall make the outcome data available to the
8public.
9 Sec. 6. Section 225C.4, subsection 1, paragraph u, Code
102019, is amended by adding the following new subparagraph:
11 NEW SUBPARAGRAPH. (9) School attendance.
12 Sec. 7. Section 225C.6B, subsection 3, Code 2019, is amended
13by adding the following new paragraph:
14 NEW PARAGRAPH. c. Children’s behavioral health services
15provided to eligible children that are not covered under the
16medical assistance program or other third-party payor are the
17responsibility of the county-based regional service system.
18 Sec. 8. NEW SECTION. 225C.51 Children’s behavioral health
19system state board.
201. A children’s behavioral health system state board
21is created as the state body to provide guidance on the
22implementation and management of a children’s behavioral health
23system for the provision of services to children with a serious
24emotional disturbance. The state board’s public voting members
25shall be appointed to four-year staggered terms by the governor
26and are subject to confirmation by the senate. All other
27state board voting members shall be appointed to four-year
28staggered terms and are not subject to confirmation by the
29senate. State board members shall be appointed on the basis of
30interest and experience in the fields of children’s behavioral
31health to ensure adequate representation from persons with life
32experiences and from persons knowledgeable about children’s
33behavioral health services. The department shall provide
34support to the state board, and the board may utilize staff
35support and other assistance provided to the state board by
-3-1other persons. The state board shall meet at least four times
2per year. The membership of the state board shall consist of
3the following persons who, at the time of appointment to the
4state board, are active members of the indicated groups:
5a. The director of the department or the director’s
6designee.
7b. The director of the department of education or the
8director’s designee.
9c. The director of the department of public health or the
10director’s designee.
11d. The director of workforce development or the director’s
12designee.
13e. One member shall be selected from nominees submitted by
14the state court administrator.
15f. One member shall be selected from nominees submitted
16by the early childhood Iowa office in the department of
17management.
18g. One member shall be a member of the mental health and
19disability services commission.
20h. One member shall be a board member or an employee of a
21provider of mental health services to children.
22i. One member shall be a board member or an employee of a
23provider of child welfare services.
24j. One member shall be an administrator of an area education
25agency.
26k. One member shall be an educator, counselor, or
27administrator of a school district.
28l. One member shall be a representative of an established
29advocacy organization whose mission or purpose it is, in part,
30to further goals related to children’s mental health.
31m. One member shall be a parent or guardian of a child
32currently utilizing or who has utilized behavioral health
33services.
34n. One member shall be a sheriff.
35o. One member shall be a pediatrician.
-4- 1p. One member shall be a representative from a health care
2system.
3q. One member shall be a chief executive officer of a mental
4health and disability services region.
5r. In addition to the voting members, the membership shall
6include four members of the general assembly with one member
7designated by each of the following: the majority leader of
8the senate, the minority leader of the senate, the speaker of
9the house of representatives, and the minority leader of the
10house of representatives. A legislative member serves for a
11term as provided in section 69.16B in a nonvoting, ex officio
12capacity and is not eligible for per diem and expenses as
13provided in section 2.10.
142. The four-year terms shall begin and end as provided in
15section 69.19. Vacancies on the state board shall be filled as
16provided in section 2.32. A member shall not be appointed for
17more than two consecutive four-year terms.
183. The director and the director of the department of
19education, or their designees, shall serve as co-chairpersons
20of the state board. Board members shall not be entitled to a
21per diem as specified in section 7E.6 and shall not be entitled
22to actual and necessary expenses incurred while engaged in
23their official duties.
24 Sec. 9. NEW SECTION. 225C.52 Children’s behavioral health
25system state board — duties.
26To the extent funding is available, the state board shall
27perform the following duties:
281. Advise the administrator on the administration of the
29children’s behavioral health system.
302. Provide consultation services to agencies regarding
31the development of administrative rules for the children’s
32behavioral health system.
333. Identify behavioral health outcomes and indicators for
34eligible children with a serious emotional disturbance to
35promote children living with their own families and in the
-5-1community.
24. Submit a written report on or before December 1 of each
3year to the governor and the general assembly. At a minimum,
4the report shall include a summary of all activities undertaken
5by the state board, a summary of state board activities,
6and results from identified behavioral health outcomes and
7indicators for the children’s behavioral health system.
8 Sec. 10. Section 331.388, Code 2019, is amended by adding
9the following new subsections:
10 NEW SUBSECTION. 01. “Children’s behavioral health services”
11means the same as defined in section 225C.2.
12 NEW SUBSECTION. 4A. “Serious emotional disturbance” means
13the same as defined in section 225C.2.
14 NEW SUBSECTION. 4B. “State board” means the children’s
15system state board created in section 225C.51.
16 Sec. 11. Section 331.390, subsection 2, Code 2019, is
17amended by striking the subsection and inserting in lieu
18thereof the following:
192. The governing board shall comply with all of the
20following requirements:
21a. The voting membership of the governing board shall
22consist of at least one board of supervisors member from each
23county comprising the region or their designees.
24b. The membership of the governing board shall also include
25one adult person who utilizes mental health and disability
26services or is an actively involved relative of such an adult
27person. This member shall be designated by the regional
28advisory committee formed by the governing board pursuant to
29paragraph “h”.
30c. The membership of the governing board shall not include
31employees of the department of human services or an unelected
32employee of a county.
33d. The membership of the governing board shall also consist
34of one member representing adult service providers in the
35region. This member shall be designated by the regional
-6-1advisory committee formed by the governing board pursuant to
2paragraph “h”. The member designated in accordance with this
3paragraph shall serve in a nonvoting, ex officio capacity.
4e. The membership of the governing board shall also
5consist of one member representing children’s behavioral
6health services providers in the region. This member shall be
7designated by the regional children’s advisory committee formed
8by the governing board pursuant to paragraph “i”. The member
9designated in accordance with this paragraph shall serve in a
10nonvoting, ex officio capacity.
11f. The membership of the governing board shall also consist
12of one member representing the education system in the region.
13This member shall be designated by the regional children’s
14advisory committee formed by the governing board pursuant to
15paragraph “i”.
16g. The membership of the governing board shall also
17consist of one member who is a parent of a child who utilizes
18children’s behavioral health services or actively involved
19relatives of such children. This member shall be designated
20by the regional children’s advisory committee formed by the
21governing board pursuant to paragraph “i”.
22h. The governing board shall have a regional advisory
23committee consisting of adults who utilize services or actively
24involved relatives of such adults, service providers, and
25regional governing board members.
26i. The governing board shall have a regional children’s
27advisory committee consisting of parents of children who
28utilize services or actively involved relatives of such
29children, a member of the education system, an early childhood
30advocate, a child welfare advocate, a children’s behavioral
31health service provider, a member of the juvenile court, a
32pediatrician, a child care provider, a local law enforcement
33representative, and regional governing board members.
34 Sec. 12. Section 331.390, subsection 3, paragraph b, Code
352019, is amended to read as follows:
-7- 1b. The regional administrator staff shall include one or
2more coordinators of mental health and disability services
3and one or more coordinators of children’s behavioral
4health services. A coordinator shall possess a bachelor’s
5or higher level degree in a human services-related or
6administration-related field, including but not limited
7to social work, psychology, nursing, or public or business
8administration, from an accredited college or university.
9However, in lieu of a degree in public or business
10administration, a coordinator may provide documentation of
11relevant management experience. An action of a coordinator
12involving a clinical decision shall be made in conjunction with
13a professional who is trained in the delivery of the mental
14health or disability service or children’s behavioral health
15service addressed by the clinical decision. The regional
16administrator shall determine whether referral to a coordinator
17of mental health and disability services or children’s
18behavioral health services is required for a person or child
19 seeking to access a service through a local access point of the
20regional service system or the children’s behavioral health
21system.
22 Sec. 13. Section 331.393, subsection 2, Code 2019, is
23amended by adding the following new paragraphs:
24 NEW PARAGRAPH. i. The scope of children’s behavioral health
25core services. Each service included shall be described and a
26projection of need shall be included.
27 NEW PARAGRAPH. j. The eligibility requirements for
28children’s behavioral health core services under the children’s
29behavioral health system.
30 Sec. 14. Section 331.393, subsection 4, paragraph g,
31subparagraph (1), Code 2019, is amended to read as follows:
32(1) Performance and outcome measures relating to the
33health, safety, education, work performance, and community
34residency of the persons receiving the services.
35 Sec. 15. Section 331.396, subsection 1, paragraph b, Code
-8-12019, is amended to read as follows:
2b. The person is at least eighteen years of age and is a
3resident of this state. However, a person who is seventeen
4years of age, is a resident of this state, and is receiving
5publicly funded children’s services may be considered eligible
6for services through the regional service system during the
7three-month period preceding the person’s eighteenth birthday
8in order to provide a smooth transition from children’s to
9adult services.
10 Sec. 16. Section 331.396, subsection 1, paragraph d, Code
112019, is amended by striking the paragraph.
12 Sec. 17. NEW SECTION. 331.396A Eligibility requirements —
13children’s behavioral health services.
14A child shall be eligible for behavioral health services
15under the regional service system if all of the following
16conditions are met:
171. The child is under eighteen years of age and is a
18resident of this state.
192. The child has been diagnosed with a serious emotional
20disturbance.
213. a. The child’s family has a family income equal to or
22less than five hundred percent of the federal poverty level as
23defined by the most recently revised poverty income guidelines
24published by the United States department of health and human
25services.
26b. Notwithstanding paragraph “a”, a child’s family whose
27household income is between one hundred fifty percent but not
28more than five hundred percent of the federal poverty level
29shall be eligible for behavioral health services subject to
30a copayment, a single statewide sliding fee scale, or other
31cost-sharing requirements approved by the department.
32 Sec. 18. NEW SECTION. 331.397A Children’s behavioral health
33core services.
341. For the purposes of this section, unless the context
35otherwise requires, “domain” means a set of similar behavioral
-9-1health services that can be provided depending on a child’s
2service needs.
32. a. (1) A region shall work with children’s behavioral
4health service providers to ensure that services in the
5required behavioral health core service domains in subsection
64 are available to children who are residents of the region,
7regardless of any potential payment source for the services.
8(2) Subject to the available appropriations, the director
9of human services shall ensure the behavioral health core
10service domains listed in subsection 4 are covered services
11for the medical assistance program under chapter 249A to the
12greatest extent allowable under federal regulations. The
13medical assistance program shall reimburse Medicaid enrolled
14providers for Medicaid covered services under subsection 4 when
15the services are medically necessary, the Medicaid enrolled
16provider submits an appropriate claim for such services, and
17no other third-party payor is responsible for reimbursement
18of such services. Within the funds available, the region
19shall pay for such services for eligible children when payment
20through the medical assistance program or another third-party
21payment is not available, unless the child is on a waiting list
22for such payment or it has been determined that the child does
23not meet the eligibility criteria for any such service.
24b. Until funding is designed for other service populations,
25eligibility for the service domains listed in this section
26shall be limited to such children who are in need of behavioral
27health services.
283. Pursuant to recommendations made by the state board, the
29department of human services shall adopt rules to define the
30services included in the core domains listed in this section.
31The rules shall provide service definitions, service provider
32standards, service access standards, and service implementation
33dates, and shall provide consistency, to the extent possible,
34with similar service definitions under the medical assistance
35program.
-10- 14. The children’s behavioral health core service domains
2shall include all of the following:
3a. Treatment designed to ameliorate a child’s serious
4emotional disturbance, including but not limited to all of the
5following:
6(1) Prevention, early identification, early intervention,
7and education.
8(2) Assessment and evaluation relating to eligibility for
9services.
10(3) Medication prescribing and management.
11(4) Behavioral health outpatient therapy.
12b. Comprehensive facility and community-based crisis
13services regardless of a diagnosis of a serious emotional
14disturbance, including all of the following:
15(1) Mobile response.
16(2) Crisis stabilization community-based services.
17(3) Crisis stabilization residential services.
18(4) Behavioral health inpatient treatment.
195. A region shall ensure that services within the following
20additional core service domains are available to children not
21eligible for the medical assistance program under chapter 249A
22or receiving other third-party payment for the services, when
23public funds are made available for such services:
24a. Treatment designed to ameliorate a child’s serious
25emotional disturbance including but not limited to behavioral
26health school-based therapy.
27b. Support for community living including but not limited
28to all of the following:
29(1) Family support.
30(2) Peer support.
31(3) Therapeutic foster care.
32(4) Respite care.
33c. Transition services for children to the adult mental
34health system providing an appropriate match with a child’s
35abilities based upon informed, person-centered choices made
-11-1from an array of options including but not limited to all of
2the following:
3(1) Day habilitation.
4(2) Job development.
5(3) Supported employment.
6(4) Prevocational services.
7(5) Educational services.
8d. Service coordination including physical health and
9primary care that follow the principles of the system of care
10including but not limited to all of the following:
11(1) Care coordination.
12(2) Health homes.
13 Sec. 19. DEPARTMENT OF HUMAN SERVICES AND DEPARTMENT OF
14PUBLIC HEALTH — CRISIS HOTLINE. The department of human
15services and the department of public health shall provide
16a single, statewide twenty-four-hour crisis hotline that
17incorporates information for families of children with a
18serious emotional disturbance which may be provided through
19expansion of the YourLifeIowa platform.
20 Sec. 20. MENTAL HEALTH AND DISABILITY SERVICES REGION
21— CHILDREN’S BEHAVIORAL HEALTH SERVICES IMPLEMENTATION
22PLAN. Each mental health and disability services region shall
23submit to the department of human services an implementation
24plan to implement children’s behavioral health services
25described under section 331.397A, as enacted in this Act, no
26later than April 1, 2020.
27 Sec. 21. DEPARTMENT OF HUMAN SERVICES — RULES. The
28department of human services shall submit a notice of intended
29action to the administrative rules coordinator and the
30Iowa administrative code editor pursuant to section 17A.4,
31subsection 1, paragraph “a”, not later than January 1, 2020,
32for the adoption of rules to implement this Act.
33 Sec. 22. REPEAL. Sections 225C.51, 225C.52, 225C.53, and
34225C.54, Code 2019, are repealed.
35 Sec. 23. CODE EDITOR’S DIRECTIVES. The Code editor may
-12-1change the current subchapter title of chapter 225C, subchapter
2VI, to “CHILDREN’S BEHAVIORAL HEALTH SYSTEM”.
3The Code editor may change the current subchapter title of
4chapter 331, part 6, to “MENTAL HEALTH AND DISABILITY SERVICES
5— REGIONAL SERVICE SYSTEM — CHILDREN’S BEHAVIORAL HEALTH
6SYSTEM”.
hb/rh/md
2including the establishment of a children’s behavioral
3health system and a children’s behavioral health system
4state board, and requiring certain children’s behavioral
5health core services.
6BE IT ENACTED BY THE GENERAL ASSEMBLY OF THE STATE OF IOWA:
1 Section 1. Section 225C.2, Code 2019, is amended by adding
2the following new subsections:
3 new subsection. 1A. “Child” or “children” means a person or
4persons under eighteen years of age.
5 new subsection. 1B. “Children’s behavioral health
6services” means services for children with a serious emotional
7disturbance.
8 new subsection. 1C. “Children’s behavioral health system” or
9“children’s system” means the behavioral health service system
10for children implemented pursuant to this subchapter.
11 new subsection. 11. “Serious emotional disturbance” means
12a diagnosable mental, behavioral, or emotional disorder of
13sufficient duration to meet diagnostic criteria specified
14within the most current diagnostic and statistical manual
15of mental disorders published by the American psychiatric
16association that results in a functional impairment. “Serious
17emotional disturbance” does not include substance use and
18developmental disorders unless such disorders co-occur with
19such a diagnosable mental, behavioral, or emotional disorder.
20 new subsection. 12. “State board” means the children’s
21behavioral health system state board created in section
22225C.51.
23 Sec. 2. Section 225C.2, subsection 9, Code 2019, is amended
24by striking the subsection.
25 Sec. 3. Section 225C.4, subsection 1, Code 2019, is amended
26by adding the following new paragraph:
27 NEW PARAGRAPH. 0c. Assist the state board in planning for
28community-based children’s behavioral health services.
29 Sec. 4. Section 225C.4, subsection 1, paragraphs d and j,
30Code 2019, are amended to read as follows:
31d. Encourage and facilitate coordination of mental health
32and disability services with the objective of developing and
33maintaining in the state a mental health and disability service
34delivery system to provide disability services to all persons
35in this state who need the services, regardless of the place
-1-1of residence or economic circumstances of those persons. The
2administrator shall work with the commission and other state
3agencies, including but not limited to the departments of
4corrections, education, and public health and the state board
5of regents, to develop and implement a strategic plan to expand
6access to qualified mental health workers across the state.
7j. Establish and maintain a data collection and management
8information system oriented to the needs of patients,
9providers, the department, and other programs or facilities in
10accordance with section 225C.6A. The system shall be used to
11identify, collect, and analyze service outcome and performance
12measures data in order to assess the effects of the services on
13the persons utilizing the services. The administrator shall
14annually submit to the commission information collected by the
15department indicating the changes and trends in the mental
16health and disability services system. The administrator shall
17make the outcome data available to the public.
18 Sec. 5. Section 225C.4, subsection 1, Code 2019, is amended
19by adding the following new paragraphs:
20 NEW PARAGRAPH. 0k. Encourage and facilitate coordination
21of children’s behavioral health services with the objective of
22developing and maintaining in the state a children’s behavioral
23health system to provide behavioral health services to all
24children in this state who need the services, regardless of the
25place of residence or economic circumstances of those children.
26The administrator shall work with the state board and other
27state agencies including but not limited to the department of
28education and the department of public health to develop and
29implement a strategic plan to expand access to qualified mental
30health workers across the state.
31 NEW PARAGRAPH. 00k. Establish and maintain a data
32collection and management information system oriented to the
33needs of children utilizing the children’s behavioral health
34system, providers, the department, and other programs or
35facilities in accordance with section 225C.6A. The system
-2-1shall be used to identify, collect, and analyze service
2outcome and performance measures data in order to assess the
3effects of the services on the children utilizing the services.
4The administrator shall annually submit to the state board
5information collected by the department indicating the changes
6and trends in the children’s behavioral health system. The
7administrator shall make the outcome data available to the
8public.
9 Sec. 6. Section 225C.4, subsection 1, paragraph u, Code
102019, is amended by adding the following new subparagraph:
11 NEW SUBPARAGRAPH. (9) School attendance.
12 Sec. 7. Section 225C.6B, subsection 3, Code 2019, is amended
13by adding the following new paragraph:
14 NEW PARAGRAPH. c. Children’s behavioral health services
15provided to eligible children that are not covered under the
16medical assistance program or other third-party payor are the
17responsibility of the county-based regional service system.
18 Sec. 8. NEW SECTION. 225C.51 Children’s behavioral health
19system state board.
201. A children’s behavioral health system state board
21is created as the state body to provide guidance on the
22implementation and management of a children’s behavioral health
23system for the provision of services to children with a serious
24emotional disturbance. The state board’s public voting members
25shall be appointed to four-year staggered terms by the governor
26and are subject to confirmation by the senate. All other
27state board voting members shall be appointed to four-year
28staggered terms and are not subject to confirmation by the
29senate. State board members shall be appointed on the basis of
30interest and experience in the fields of children’s behavioral
31health to ensure adequate representation from persons with life
32experiences and from persons knowledgeable about children’s
33behavioral health services. The department shall provide
34support to the state board, and the board may utilize staff
35support and other assistance provided to the state board by
-3-1other persons. The state board shall meet at least four times
2per year. The membership of the state board shall consist of
3the following persons who, at the time of appointment to the
4state board, are active members of the indicated groups:
5a. The director of the department or the director’s
6designee.
7b. The director of the department of education or the
8director’s designee.
9c. The director of the department of public health or the
10director’s designee.
11d. The director of workforce development or the director’s
12designee.
13e. One member shall be selected from nominees submitted by
14the state court administrator.
15f. One member shall be selected from nominees submitted
16by the early childhood Iowa office in the department of
17management.
18g. One member shall be a member of the mental health and
19disability services commission.
20h. One member shall be a board member or an employee of a
21provider of mental health services to children.
22i. One member shall be a board member or an employee of a
23provider of child welfare services.
24j. One member shall be an administrator of an area education
25agency.
26k. One member shall be an educator, counselor, or
27administrator of a school district.
28l. One member shall be a representative of an established
29advocacy organization whose mission or purpose it is, in part,
30to further goals related to children’s mental health.
31m. One member shall be a parent or guardian of a child
32currently utilizing or who has utilized behavioral health
33services.
34n. One member shall be a sheriff.
35o. One member shall be a pediatrician.
-4- 1p. One member shall be a representative from a health care
2system.
3q. One member shall be a chief executive officer of a mental
4health and disability services region.
5r. In addition to the voting members, the membership shall
6include four members of the general assembly with one member
7designated by each of the following: the majority leader of
8the senate, the minority leader of the senate, the speaker of
9the house of representatives, and the minority leader of the
10house of representatives. A legislative member serves for a
11term as provided in section 69.16B in a nonvoting, ex officio
12capacity and is not eligible for per diem and expenses as
13provided in section 2.10.
142. The four-year terms shall begin and end as provided in
15section 69.19. Vacancies on the state board shall be filled as
16provided in section 2.32. A member shall not be appointed for
17more than two consecutive four-year terms.
183. The director and the director of the department of
19education, or their designees, shall serve as co-chairpersons
20of the state board. Board members shall not be entitled to a
21per diem as specified in section 7E.6 and shall not be entitled
22to actual and necessary expenses incurred while engaged in
23their official duties.
24 Sec. 9. NEW SECTION. 225C.52 Children’s behavioral health
25system state board — duties.
26To the extent funding is available, the state board shall
27perform the following duties:
281. Advise the administrator on the administration of the
29children’s behavioral health system.
302. Provide consultation services to agencies regarding
31the development of administrative rules for the children’s
32behavioral health system.
333. Identify behavioral health outcomes and indicators for
34eligible children with a serious emotional disturbance to
35promote children living with their own families and in the
-5-1community.
24. Submit a written report on or before December 1 of each
3year to the governor and the general assembly. At a minimum,
4the report shall include a summary of all activities undertaken
5by the state board, a summary of state board activities,
6and results from identified behavioral health outcomes and
7indicators for the children’s behavioral health system.
8 Sec. 10. Section 331.388, Code 2019, is amended by adding
9the following new subsections:
10 NEW SUBSECTION. 01. “Children’s behavioral health services”
11means the same as defined in section 225C.2.
12 NEW SUBSECTION. 4A. “Serious emotional disturbance” means
13the same as defined in section 225C.2.
14 NEW SUBSECTION. 4B. “State board” means the children’s
15system state board created in section 225C.51.
16 Sec. 11. Section 331.390, subsection 2, Code 2019, is
17amended by striking the subsection and inserting in lieu
18thereof the following:
192. The governing board shall comply with all of the
20following requirements:
21a. The voting membership of the governing board shall
22consist of at least one board of supervisors member from each
23county comprising the region or their designees.
24b. The membership of the governing board shall also include
25one adult person who utilizes mental health and disability
26services or is an actively involved relative of such an adult
27person. This member shall be designated by the regional
28advisory committee formed by the governing board pursuant to
29paragraph “h”.
30c. The membership of the governing board shall not include
31employees of the department of human services or an unelected
32employee of a county.
33d. The membership of the governing board shall also consist
34of one member representing adult service providers in the
35region. This member shall be designated by the regional
-6-1advisory committee formed by the governing board pursuant to
2paragraph “h”. The member designated in accordance with this
3paragraph shall serve in a nonvoting, ex officio capacity.
4e. The membership of the governing board shall also
5consist of one member representing children’s behavioral
6health services providers in the region. This member shall be
7designated by the regional children’s advisory committee formed
8by the governing board pursuant to paragraph “i”. The member
9designated in accordance with this paragraph shall serve in a
10nonvoting, ex officio capacity.
11f. The membership of the governing board shall also consist
12of one member representing the education system in the region.
13This member shall be designated by the regional children’s
14advisory committee formed by the governing board pursuant to
15paragraph “i”.
16g. The membership of the governing board shall also
17consist of one member who is a parent of a child who utilizes
18children’s behavioral health services or actively involved
19relatives of such children. This member shall be designated
20by the regional children’s advisory committee formed by the
21governing board pursuant to paragraph “i”.
22h. The governing board shall have a regional advisory
23committee consisting of adults who utilize services or actively
24involved relatives of such adults, service providers, and
25regional governing board members.
26i. The governing board shall have a regional children’s
27advisory committee consisting of parents of children who
28utilize services or actively involved relatives of such
29children, a member of the education system, an early childhood
30advocate, a child welfare advocate, a children’s behavioral
31health service provider, a member of the juvenile court, a
32pediatrician, a child care provider, a local law enforcement
33representative, and regional governing board members.
34 Sec. 12. Section 331.390, subsection 3, paragraph b, Code
352019, is amended to read as follows:
-7- 1b. The regional administrator staff shall include one or
2more coordinators of mental health and disability services
3and one or more coordinators of children’s behavioral
4health services. A coordinator shall possess a bachelor’s
5or higher level degree in a human services-related or
6administration-related field, including but not limited
7to social work, psychology, nursing, or public or business
8administration, from an accredited college or university.
9However, in lieu of a degree in public or business
10administration, a coordinator may provide documentation of
11relevant management experience. An action of a coordinator
12involving a clinical decision shall be made in conjunction with
13a professional who is trained in the delivery of the mental
14health or disability service or children’s behavioral health
15service addressed by the clinical decision. The regional
16administrator shall determine whether referral to a coordinator
17of mental health and disability services or children’s
18behavioral health services is required for a person or child
19 seeking to access a service through a local access point of the
20regional service system or the children’s behavioral health
21system.
22 Sec. 13. Section 331.393, subsection 2, Code 2019, is
23amended by adding the following new paragraphs:
24 NEW PARAGRAPH. i. The scope of children’s behavioral health
25core services. Each service included shall be described and a
26projection of need shall be included.
27 NEW PARAGRAPH. j. The eligibility requirements for
28children’s behavioral health core services under the children’s
29behavioral health system.
30 Sec. 14. Section 331.393, subsection 4, paragraph g,
31subparagraph (1), Code 2019, is amended to read as follows:
32(1) Performance and outcome measures relating to the
33health, safety, education, work performance, and community
34residency of the persons receiving the services.
35 Sec. 15. Section 331.396, subsection 1, paragraph b, Code
-8-12019, is amended to read as follows:
2b. The person is at least eighteen years of age and is a
3resident of this state. However, a person who is seventeen
4years of age, is a resident of this state, and is receiving
5publicly funded children’s services may be considered eligible
6for services through the regional service system during the
7three-month period preceding the person’s eighteenth birthday
8in order to provide a smooth transition from children’s to
9adult services.
10 Sec. 16. Section 331.396, subsection 1, paragraph d, Code
112019, is amended by striking the paragraph.
12 Sec. 17. NEW SECTION. 331.396A Eligibility requirements —
13children’s behavioral health services.
14A child shall be eligible for behavioral health services
15under the regional service system if all of the following
16conditions are met:
171. The child is under eighteen years of age and is a
18resident of this state.
192. The child has been diagnosed with a serious emotional
20disturbance.
213. a. The child’s family has a family income equal to or
22less than five hundred percent of the federal poverty level as
23defined by the most recently revised poverty income guidelines
24published by the United States department of health and human
25services.
26b. Notwithstanding paragraph “a”, a child’s family whose
27household income is between one hundred fifty percent but not
28more than five hundred percent of the federal poverty level
29shall be eligible for behavioral health services subject to
30a copayment, a single statewide sliding fee scale, or other
31cost-sharing requirements approved by the department.
32 Sec. 18. NEW SECTION. 331.397A Children’s behavioral health
33core services.
341. For the purposes of this section, unless the context
35otherwise requires, “domain” means a set of similar behavioral
-9-1health services that can be provided depending on a child’s
2service needs.
32. a. (1) A region shall work with children’s behavioral
4health service providers to ensure that services in the
5required behavioral health core service domains in subsection
64 are available to children who are residents of the region,
7regardless of any potential payment source for the services.
8(2) Subject to the available appropriations, the director
9of human services shall ensure the behavioral health core
10service domains listed in subsection 4 are covered services
11for the medical assistance program under chapter 249A to the
12greatest extent allowable under federal regulations. The
13medical assistance program shall reimburse Medicaid enrolled
14providers for Medicaid covered services under subsection 4 when
15the services are medically necessary, the Medicaid enrolled
16provider submits an appropriate claim for such services, and
17no other third-party payor is responsible for reimbursement
18of such services. Within the funds available, the region
19shall pay for such services for eligible children when payment
20through the medical assistance program or another third-party
21payment is not available, unless the child is on a waiting list
22for such payment or it has been determined that the child does
23not meet the eligibility criteria for any such service.
24b. Until funding is designed for other service populations,
25eligibility for the service domains listed in this section
26shall be limited to such children who are in need of behavioral
27health services.
283. Pursuant to recommendations made by the state board, the
29department of human services shall adopt rules to define the
30services included in the core domains listed in this section.
31The rules shall provide service definitions, service provider
32standards, service access standards, and service implementation
33dates, and shall provide consistency, to the extent possible,
34with similar service definitions under the medical assistance
35program.
-10- 14. The children’s behavioral health core service domains
2shall include all of the following:
3a. Treatment designed to ameliorate a child’s serious
4emotional disturbance, including but not limited to all of the
5following:
6(1) Prevention, early identification, early intervention,
7and education.
8(2) Assessment and evaluation relating to eligibility for
9services.
10(3) Medication prescribing and management.
11(4) Behavioral health outpatient therapy.
12b. Comprehensive facility and community-based crisis
13services regardless of a diagnosis of a serious emotional
14disturbance, including all of the following:
15(1) Mobile response.
16(2) Crisis stabilization community-based services.
17(3) Crisis stabilization residential services.
18(4) Behavioral health inpatient treatment.
195. A region shall ensure that services within the following
20additional core service domains are available to children not
21eligible for the medical assistance program under chapter 249A
22or receiving other third-party payment for the services, when
23public funds are made available for such services:
24a. Treatment designed to ameliorate a child’s serious
25emotional disturbance including but not limited to behavioral
26health school-based therapy.
27b. Support for community living including but not limited
28to all of the following:
29(1) Family support.
30(2) Peer support.
31(3) Therapeutic foster care.
32(4) Respite care.
33c. Transition services for children to the adult mental
34health system providing an appropriate match with a child’s
35abilities based upon informed, person-centered choices made
-11-1from an array of options including but not limited to all of
2the following:
3(1) Day habilitation.
4(2) Job development.
5(3) Supported employment.
6(4) Prevocational services.
7(5) Educational services.
8d. Service coordination including physical health and
9primary care that follow the principles of the system of care
10including but not limited to all of the following:
11(1) Care coordination.
12(2) Health homes.
13 Sec. 19. DEPARTMENT OF HUMAN SERVICES AND DEPARTMENT OF
14PUBLIC HEALTH — CRISIS HOTLINE. The department of human
15services and the department of public health shall provide
16a single, statewide twenty-four-hour crisis hotline that
17incorporates information for families of children with a
18serious emotional disturbance which may be provided through
19expansion of the YourLifeIowa platform.
20 Sec. 20. MENTAL HEALTH AND DISABILITY SERVICES REGION
21— CHILDREN’S BEHAVIORAL HEALTH SERVICES IMPLEMENTATION
22PLAN. Each mental health and disability services region shall
23submit to the department of human services an implementation
24plan to implement children’s behavioral health services
25described under section 331.397A, as enacted in this Act, no
26later than April 1, 2020.
27 Sec. 21. DEPARTMENT OF HUMAN SERVICES — RULES. The
28department of human services shall submit a notice of intended
29action to the administrative rules coordinator and the
30Iowa administrative code editor pursuant to section 17A.4,
31subsection 1, paragraph “a”, not later than January 1, 2020,
32for the adoption of rules to implement this Act.
33 Sec. 22. REPEAL. Sections 225C.51, 225C.52, 225C.53, and
34225C.54, Code 2019, are repealed.
35 Sec. 23. CODE EDITOR’S DIRECTIVES. The Code editor may
-12-1change the current subchapter title of chapter 225C, subchapter
2VI, to “CHILDREN’S BEHAVIORAL HEALTH SYSTEM”.
3The Code editor may change the current subchapter title of
4chapter 331, part 6, to “MENTAL HEALTH AND DISABILITY SERVICES
5— REGIONAL SERVICE SYSTEM — CHILDREN’S BEHAVIORAL HEALTH
6SYSTEM”.
hb/rh/md