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House Study Bill 156 - IntroducedA Bill ForAn Act 1relating to access to and funding of certain mental
2health, substance abuse, and disability services.
3BE IT ENACTED BY THE GENERAL ASSEMBLY OF THE STATE OF IOWA:
1DIVISION I
2ACCESS TO CERTAIN MENTAL HEALTH, SUBSTANCE ABUSE, AND
3DISABILITY SERVICES
4 Section 1. Section 331.391, subsection 4, Code 2017, is
5amended to read as follows:
64. If a region is meeting the financial obligations for
7implementation of its regional service system management
8plan for a fiscal year and residual funding is anticipated,
9the regional administrator shall reserve an adequate amount
10for cash flow of expenditure obligations in the next fiscal
11year. The cash flow amount shall not exceed twenty-five
12percent of the gross expenditures budgeted for the combined
13account or for all regional accounts for the fiscal year in
14progress. Residual funding remaining after the cash flow
15amount is reserved shall be used to expand the region’s core
16services under section 331.397, subsection 4, and then to make
17additional core service domains available in the region as
18enumerated in section 331.397, subsection 6.
19 Sec. 2. Section 331.397, subsection 4, Code 2017, is amended
20by adding the following new paragraphs:
21 NEW PARAGRAPH. g. Comprehensive facility and
22community-based crisis services, including but not limited to
23all of the following:
24(1) Twenty-four-hour crisis hotline.
25(2) Mobile response.
26(3) Twenty-three-hour crisis observation and holding, and
27crisis stabilization facility and community-based services.
28(4) Crisis residential services.
29 NEW PARAGRAPH. h. Subacute services provided in facility
30and community-based settings.
31 NEW PARAGRAPH. i. Justice system-involved services,
32including but not limited to all of the following:
33(1) Jail diversion.
34(2) Crisis intervention training.
35(3) Civil commitment prescreening.
-1-1 NEW PARAGRAPH. j. Advances in the use of evidence-based
2treatment, including but not limited to all of the following:
3(1) Positive behavior support.
4(2) Assertive community treatment.
5(3) Peer self-help drop-in centers.
6DIVISION II
7TRANSFER OF EXCESS FUNDS
8 Sec. 3. Section 331.424A, subsection 4, Code 2017, is
9amended to read as follows:
104. a. An amount shall be reserved in the county services
11fund to address cash flow obligations in the next fiscal year.
12The cash flow amount shall not exceed twenty-five percent
13of the gross expenditures budgeted from the county services
14fund for the fiscal year in progress. The cash flow amount
15for a county’s services fund shall be specified in based on
16the financial provisions of the regional governance agreement
17entered into by the county under section 331.392.
18b. Beginning with the fiscal year beginning July 1, 2022,
19if on July 1 of a fiscal year the amount of funds reserved
20to address cash flow obligations exceeds twenty-five percent
21of the gross expenditures budgeted for the fiscal year, the
22county shall transfer such excess amount to the treasurer of
23state to be credited to the property tax relief fund created in
24section 426B.1. The county treasurer shall pay the funds to
25the treasurer of state on or before September 1.
26 Sec. 4. Section 331.432, subsection 3, Code 2017, is amended
27to read as follows:
283. Except as authorized in section 331.477, transfers
29of moneys between the county mental health and disabilities
30services fund created pursuant to section 331.424A and any
31other fund are prohibited. This subsection does not apply to
32transfers made pursuant to section 331.424A, subsection 4,
33paragraph “b”.
34DIVISION III
35MENTAL HEALTH, DISABILITY, AND SUBSTANCE USE DISORDER SERVICES
-2-1WORKGROUP
2 Sec. 5. WORKGROUP — MENTAL HEALTH, DISABILITY, AND
3SUBSTANCE USE DISORDER SERVICES. The department of human
4services shall convene a stakeholder workgroup to make
5recommendations relating to the delivery of, access to, and
6coordination and continuity of mental health, disability,
7and substance use disorder services for individuals with
8complex mental health, disability, and substance use disorder
9needs. The recommendations of the workgroup shall be based
10on recommendations proposed by the department. The workgroup
11shall be comprised of representatives from community mental
12health centers, crisis response service providers, law
13enforcement agencies, the national alliance on mental illness,
14the judicial system, managed care organizations, and other
15entities as appropriate. The workgroup shall submit a report
16with recommendations to the governor and general assembly by
17December 1, 2017.
18DIVISION IV
19BED TRACKING SYSTEM
20 Sec. 6. DIRECTIVE TO DEPARTMENT OF HUMAN SERVICES —
21PSYCHIATRIC BED TRACKING SYSTEM. The department of human
22services shall amend its administrative rules pursuant to
23chapter 17A to require the state mental health institutes
24and hospitals licensed to provide inpatient psychiatric
25treatment and services to participate in the psychiatric bed
26tracking system and to report the number of beds available
27for persons with a co-occurring mental illness and substance
28abuse disorder. The department shall issue a quarterly report
29on state mental health institutes and hospitals licensed to
30provide inpatient psychiatric treatment and services that are
31noncompliant with daily updates.
32EXPLANATION
33The inclusion of this explanation does not constitute agreement with
34the explanation’s substance by the members of the general assembly.
35This bill relates to access to and funding of certain mental
-3-1health, substance abuse, and disability services.
2Division I relates to certain mental health, substance
3abuse, and disability services.
4Under current law, a mental health and disability services
5region must make certain initial core services available to
6eligible residents of a region including residents with a
7diagnosis of a mental illness, subject to available funding
8and regardless of the funding source for the service. If
9money is available after funding the initial core services, a
10region must make certain additional core services available to
11eligible residents who are not eligible for Medicaid or who
12are not receiving other third-party payments for the services,
13when public funds are made available for such services. The
14additional core services include comprehensive facility and
15community-based crisis services, subacute services provided in
16facility and community-based settings, justice system-involved
17services, and evidence-based treatment. The bill amends
18current law to redesignate these additional core services as
19initial core services that must be made available by a region.
20Division II relates to the transfer of excess funds from the
21county mental health and disabilities services fund.
22Under current law, counties are required to reserve an
23amount to address cash flow obligations in the next fiscal
24year that does not exceed 25 percent of the gross expenditures
25budgeted from the county services fund for the fiscal year in
26progress. The bill provides that beginning with the fiscal
27year beginning July 1, 2022, the amount of funds in the county
28services fund on July 1 of a fiscal year that exceed 25 percent
29of the budgeted gross expenditures for the fiscal year shall
30be transferred to the treasurer of state to be credited to
31the property tax relief fund created in current Code section
32426B.1.
33Division III requires the department of human services
34to convene a stakeholder workgroup to make recommendations
35relating to the delivery of, access to, and coordination
-4-1and continuity of mental health and disability services
2for individuals with complex mental health, disability,
3and substance use disorder needs based upon recommendations
4proposed by the department. The workgroup shall be comprised
5of representatives from community mental health centers,
6crisis response service providers, law enforcement agencies,
7the national alliance on mental illness, the judicial
8system, managed care organizations, and other entities as
9appropriate. The bill directs the workgroup to submit a report
10with recommendations to the governor and general assembly by
11December 1, 2017.
12Division IV relates to the psychiatric bed tracking system.
13The bill directs the department of human services to
14amend its administrative rules to require the state mental
15health institutes and hospitals licensed to provide inpatient
16psychiatric treatment and services to participate in the
17psychiatric bed tracking system and to report the number of
18beds available for persons with a co-occurring mental illness
19and substance abuse disorder. The bill directs the department
20to file quarterly reports listing the mental health institutes
21and hospitals licensed to provide inpatient psychiatric
22treatment and services that are not compliant with daily
23updates.
-5-hb/rh/sc
2health, substance abuse, and disability services.
3BE IT ENACTED BY THE GENERAL ASSEMBLY OF THE STATE OF IOWA:
1DIVISION I
2ACCESS TO CERTAIN MENTAL HEALTH, SUBSTANCE ABUSE, AND
3DISABILITY SERVICES
4 Section 1. Section 331.391, subsection 4, Code 2017, is
5amended to read as follows:
64. If a region is meeting the financial obligations for
7implementation of its regional service system management
8plan for a fiscal year and residual funding is anticipated,
9the regional administrator shall reserve an adequate amount
10for cash flow of expenditure obligations in the next fiscal
11year. The cash flow amount shall not exceed twenty-five
12percent of the gross expenditures budgeted for the combined
13account or for all regional accounts for the fiscal year in
14progress. Residual funding remaining after the cash flow
15amount is reserved shall be used to expand the region’s core
16services under section 331.397, subsection 4, and then to make
17additional core service domains available in the region as
18enumerated in section 331.397, subsection 6.
19 Sec. 2. Section 331.397, subsection 4, Code 2017, is amended
20by adding the following new paragraphs:
21 NEW PARAGRAPH. g. Comprehensive facility and
22community-based crisis services, including but not limited to
23all of the following:
24(1) Twenty-four-hour crisis hotline.
25(2) Mobile response.
26(3) Twenty-three-hour crisis observation and holding, and
27crisis stabilization facility and community-based services.
28(4) Crisis residential services.
29 NEW PARAGRAPH. h. Subacute services provided in facility
30and community-based settings.
31 NEW PARAGRAPH. i. Justice system-involved services,
32including but not limited to all of the following:
33(1) Jail diversion.
34(2) Crisis intervention training.
35(3) Civil commitment prescreening.
-1-1 NEW PARAGRAPH. j. Advances in the use of evidence-based
2treatment, including but not limited to all of the following:
3(1) Positive behavior support.
4(2) Assertive community treatment.
5(3) Peer self-help drop-in centers.
6DIVISION II
7TRANSFER OF EXCESS FUNDS
8 Sec. 3. Section 331.424A, subsection 4, Code 2017, is
9amended to read as follows:
104. a. An amount shall be reserved in the county services
11fund to address cash flow obligations in the next fiscal year.
12The cash flow amount shall not exceed twenty-five percent
13of the gross expenditures budgeted from the county services
14fund for the fiscal year in progress. The cash flow amount
15for a county’s services fund shall be specified in based on
16the financial provisions of the regional governance agreement
17entered into by the county under section 331.392.
18b. Beginning with the fiscal year beginning July 1, 2022,
19if on July 1 of a fiscal year the amount of funds reserved
20to address cash flow obligations exceeds twenty-five percent
21of the gross expenditures budgeted for the fiscal year, the
22county shall transfer such excess amount to the treasurer of
23state to be credited to the property tax relief fund created in
24section 426B.1. The county treasurer shall pay the funds to
25the treasurer of state on or before September 1.
26 Sec. 4. Section 331.432, subsection 3, Code 2017, is amended
27to read as follows:
283. Except as authorized in section 331.477, transfers
29of moneys between the county mental health and disabilities
30services fund created pursuant to section 331.424A and any
31other fund are prohibited. This subsection does not apply to
32transfers made pursuant to section 331.424A, subsection 4,
33paragraph “b”.
34DIVISION III
35MENTAL HEALTH, DISABILITY, AND SUBSTANCE USE DISORDER SERVICES
-2-1WORKGROUP
2 Sec. 5. WORKGROUP — MENTAL HEALTH, DISABILITY, AND
3SUBSTANCE USE DISORDER SERVICES. The department of human
4services shall convene a stakeholder workgroup to make
5recommendations relating to the delivery of, access to, and
6coordination and continuity of mental health, disability,
7and substance use disorder services for individuals with
8complex mental health, disability, and substance use disorder
9needs. The recommendations of the workgroup shall be based
10on recommendations proposed by the department. The workgroup
11shall be comprised of representatives from community mental
12health centers, crisis response service providers, law
13enforcement agencies, the national alliance on mental illness,
14the judicial system, managed care organizations, and other
15entities as appropriate. The workgroup shall submit a report
16with recommendations to the governor and general assembly by
17December 1, 2017.
18DIVISION IV
19BED TRACKING SYSTEM
20 Sec. 6. DIRECTIVE TO DEPARTMENT OF HUMAN SERVICES —
21PSYCHIATRIC BED TRACKING SYSTEM. The department of human
22services shall amend its administrative rules pursuant to
23chapter 17A to require the state mental health institutes
24and hospitals licensed to provide inpatient psychiatric
25treatment and services to participate in the psychiatric bed
26tracking system and to report the number of beds available
27for persons with a co-occurring mental illness and substance
28abuse disorder. The department shall issue a quarterly report
29on state mental health institutes and hospitals licensed to
30provide inpatient psychiatric treatment and services that are
31noncompliant with daily updates.
32EXPLANATION
33The inclusion of this explanation does not constitute agreement with
34the explanation’s substance by the members of the general assembly.
35This bill relates to access to and funding of certain mental
-3-1health, substance abuse, and disability services.
2Division I relates to certain mental health, substance
3abuse, and disability services.
4Under current law, a mental health and disability services
5region must make certain initial core services available to
6eligible residents of a region including residents with a
7diagnosis of a mental illness, subject to available funding
8and regardless of the funding source for the service. If
9money is available after funding the initial core services, a
10region must make certain additional core services available to
11eligible residents who are not eligible for Medicaid or who
12are not receiving other third-party payments for the services,
13when public funds are made available for such services. The
14additional core services include comprehensive facility and
15community-based crisis services, subacute services provided in
16facility and community-based settings, justice system-involved
17services, and evidence-based treatment. The bill amends
18current law to redesignate these additional core services as
19initial core services that must be made available by a region.
20Division II relates to the transfer of excess funds from the
21county mental health and disabilities services fund.
22Under current law, counties are required to reserve an
23amount to address cash flow obligations in the next fiscal
24year that does not exceed 25 percent of the gross expenditures
25budgeted from the county services fund for the fiscal year in
26progress. The bill provides that beginning with the fiscal
27year beginning July 1, 2022, the amount of funds in the county
28services fund on July 1 of a fiscal year that exceed 25 percent
29of the budgeted gross expenditures for the fiscal year shall
30be transferred to the treasurer of state to be credited to
31the property tax relief fund created in current Code section
32426B.1.
33Division III requires the department of human services
34to convene a stakeholder workgroup to make recommendations
35relating to the delivery of, access to, and coordination
-4-1and continuity of mental health and disability services
2for individuals with complex mental health, disability,
3and substance use disorder needs based upon recommendations
4proposed by the department. The workgroup shall be comprised
5of representatives from community mental health centers,
6crisis response service providers, law enforcement agencies,
7the national alliance on mental illness, the judicial
8system, managed care organizations, and other entities as
9appropriate. The bill directs the workgroup to submit a report
10with recommendations to the governor and general assembly by
11December 1, 2017.
12Division IV relates to the psychiatric bed tracking system.
13The bill directs the department of human services to
14amend its administrative rules to require the state mental
15health institutes and hospitals licensed to provide inpatient
16psychiatric treatment and services to participate in the
17psychiatric bed tracking system and to report the number of
18beds available for persons with a co-occurring mental illness
19and substance abuse disorder. The bill directs the department
20to file quarterly reports listing the mental health institutes
21and hospitals licensed to provide inpatient psychiatric
22treatment and services that are not compliant with daily
23updates.
-5-hb/rh/sc