House Study Bill 109



                                    SENATE/HOUSE FILE       
                                    BY  (PROPOSED DEPARTMENT
                                        OF HUMAN SERVICES
                                        BILL)

                                         A BILL FOR

     1 An Act relating to mental health and disability services
     2    requirements involving the department of human services
     3    and including effective date and retroactive applicability
     4    provisions.
     5 BE IT ENACTED BY THE GENERAL ASSEMBLY OF THE STATE OF IOWA:
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PAG LIN



  1  1                           DIVISION I
  1  2     MENTAL HEALTH AND DISABILITY SERVICES CLIENT IDENTIFIER
  1  3    Section 1.  Section 225C.6A, subsection 3, paragraph b, Code
  1  4 2013, is amended to read as follows:
  1  5    b.  In implementing a system under this subsection for
  1  6 collecting and analyzing state, county, and private contractor
  1  7 data, the department shall establish a client identifier for
  1  8 the individuals receiving services. The client identifier
  1  9 shall be used in lieu of the individual's name or social
  1 10 security number. The client identifier shall consist of the
  1 11 last four digits of an individual's social security number,
  1 12 the first three letters of the individual's last name, the
  1 13 individual's date of birth, and the individual's gender in an
  1 14 order determined by the department.
  1 15                           DIVISION II
  1 16     INTERAGENCY INFORMATION SERVICE ON PERSONS WITH MENTAL
  1 17                          DISABILITIES
  1 18    Sec. 2.  REPEAL.  Section 218.11, Code 2013, is repealed.
  1 19    Sec. 3.  REPEAL.  Chapter 220A, Code 2013, is repealed.
  1 20                          DIVISION III
  1 21             SUBACUTE MENTAL HEALTH CARE FACILITIES
  1 22    Sec. 4.  Section 135G.3, subsection 2, Code 2013, is amended
  1 23 to read as follows:
  1 24    2.  The licensed psychiatrist providing supervision of the
  1 25 subacute care facility facility's treatment care plans shall
  1 26 evaluate the condition of each resident as medically necessary
  1 27 and shall be available to residents of the facility on an
  1 28 on=call basis at all other times. Additional evaluation and
  1 29 treatment may be provided by a mental health professional. The
  1 30 subacute care facility may employ a seclusion room meeting the
  1 31 conditions described in 42 C.F.R. { 483.364(b) with approval of
  1 32 the licensed psychiatrist of the facility or by order of the
  1 33 resident's physician, a physician assistant, or an advanced
  1 34 registered nurse practitioner.
  1 35    Sec. 5.  Section 135G.4, subsection 2, Code 2013, is amended
  2  1 to read as follows:
  2  2    2.  An intermediate care facility for persons with mental
  2  3 illness licensed under chapter 135C may convert to a subacute
  2  4 care facility by providing submitting an application for a
  2  5 license in accordance with section 135G.5 accompanied by
  2  6  written notice to the department that the facility has employed
  2  7 a full=time psychiatrist and desires to make the conversion.
  2  8 An intermediate care facility for persons with mental illness
  2  9 applying for a license under this subsection remains subject to
  2 10 subsection 1 until a license is issued.
  2 11    Sec. 6.  EFFECTIVE UPON ENACTMENT.  This division of this
  2 12 Act, being deemed of immediate importance, takes effect upon
  2 13 enactment.
  2 14    Sec. 7.  RETROACTIVE APPLICABILITY.  This division of this
  2 15 Act applies retroactively to July 1, 2012.
  2 16                           DIVISION IV
  2 17     COMMUNITY MENTAL HEALTH SERVICES BLOCK GRANT ALLOCATION
  2 18    Sec. 8.  2011 Iowa Acts, chapter 126, section 20, subsection
  2 19 1, paragraph d, is amended to read as follows:
  2 20    d.  Of the amount allocated to eligible services providers
  2 21 under paragraph "c", 70 percent shall be distributed to the
  2 22 state's accredited community mental health centers established
  2 23 or designated by counties the department in collaboration with
  2 24 mental health and disability services regions in accordance
  2 25 with law chapter 230A or applicable administrative rule.
  2 26 If a county has not established or designated a community
  2 27 mental health center and has received a waiver from the
  2 28 mental health and disability services commission, the mental
  2 29 health services provider designated by that county is was
  2 30 designated as authorized in section 230A.107, subsection 2,
  2 31 the provider remains eligible to receive funding distributed
  2 32 pursuant to this paragraph in lieu of as a community mental
  2 33 health center. The funding distributed shall be used by
  2 34 recipients of the funding for the purpose of developing and
  2 35 providing evidence=based practices and emergency services
  3  1 to adults with a serious mental illness and children with
  3  2 a serious emotional disturbance. The distribution amounts
  3  3 shall be announced at the beginning of the federal fiscal
  3  4 year and distributed on a quarterly basis according to the
  3  5 formulas used in previous fiscal years.  It is the intent of
  3  6 the general assembly that the distribution amounts for future
  3  7 federal fiscal years shall be determined by the department in
  3  8 consultation with the mental health and disability services
  3  9 regional administrators and announced by the beginning of the
  3 10 federal fiscal year. Recipients shall submit quarterly reports
  3 11 containing data consistent with the performance measures
  3 12 approved by the federal substance abuse and mental health
  3 13 services administration.
  3 14    Sec. 9.  EFFECTIVE UPON ENACTMENT.  This division of this
  3 15 Act, being deemed of immediate importance, takes effect upon
  3 16 enactment.
  3 17                           EXPLANATION
  3 18    This bill relates to mental health and disability services
  3 19 requirements involving the department of human services (DHS)
  3 20 and is organized into divisions.
  3 21    MENTAL HEALTH AND DISABILITY SERVICES CLIENT IDENTIFIER.
  3 22 This division amends Code section 225C.6A, relating to
  3 23 disability services system redesign data, by eliminating
  3 24 specific requirements for the client identifier that is used in
  3 25 lieu of an individual's name or social security number.
  3 26    INTERAGENCY INFORMATION SERVICE ON PERSONS WITH MENTAL
  3 27 DISABILITIES.  This division repeals Code chapter 220A,
  3 28 requiring  DHS to provide for a central data control and
  3 29 exchange agency for persons believed to have mental
  3 30 disabilities known as the "interagency case information
  3 31 service".
  3 32    The Code chapter includes sections stating purpose,
  3 33 providing definitions, designating DHS as the administrative
  3 34 agency for the information service, listing other state
  3 35 agencies required to provide and receive information, listing
  4  1 DHS duties, authorizing other public and private agencies to
  4  2 provide or receive information, exempting the information
  4  3 exchange from any state law or administrative rule that would
  4  4 restrict information from being exchanged by the service,
  4  5 authorizing the service to disseminate statistical information,
  4  6 and providing immunity from liability for agencies and persons
  4  7 participating under the Code chapter.
  4  8    The division also repeals Code section 218.11 in the Code
  4  9 chapter relating to institutions governed by DHS.  The Code
  4 10 section requires DHS to be the administrative agency for the
  4 11 information service and perform the duties required by Code
  4 12 chapter 220A.
  4 13    SUBACUTE MENTAL HEALTH CARE FACILITIES.  This division
  4 14 amends certain provisions for licensure of subacute mental
  4 15 health care facilities enacted in 2012 Iowa Acts, ch. 1120
  4 16 (SF 2315). Licensure is administered by the department of
  4 17 inspections and appeals in conjunction with DHS.
  4 18    Code section 135G.3 is amended to require a licensed
  4 19 psychiatrist to provide supervision of the subacute care
  4 20 facility's treatment care plans rather than the subacute care
  4 21 facility itself.
  4 22    Code section 135G.4, requiring licensure of subacute
  4 23 care facilities and authorizing a licensed intermediate care
  4 24 facility for persons with mental illness (ICF/MI) to convert
  4 25 to a licensed subacute facility after notifying the department
  4 26 of inspections and appeals that certain requirements are
  4 27 being met, is amended to require the ICF/MI to also submit
  4 28 an application for licensure as a subacute care facility.
  4 29 An ICF/MI is prohibited from establishing, operating, or
  4 30 maintaining a subacute care facility until issued a license to
  4 31 do so.
  4 32    This division takes effect upon enactment and is
  4 33 retroactively applicable to July 1, 2012.
  4 34    COMMUNITY MENTAL HEALTH SERVICES BLOCK GRANT ALLOCATION.
  4 35 This division amends the allocation requirements in the federal
  5  1 community mental health services block grant appropriation for
  5  2 federal fiscal year 2012=2013 made in 2011 Iowa Acts, chapter
  5  3 126.
  5  4    The amendments reflect changes made in Code chapter 230A
  5  5 for designation of community mental health centers.  The
  5  6 amended Code chapter allows a for=profit corporation, nonprofit
  5  7 corporation, or county hospital providing mental health
  5  8 services to county residents pursuant to a waiver approved
  5  9 under Code section 225C.7, subsection 3, Code 2011, as of
  5 10 October 1, 2010, to be designated as a community mental
  5 11 health center.  Otherwise, only a nonprofit corporation can be
  5 12 designated as a community mental health center.  In addition,
  5 13 the amendments state legislative intent that in future federal
  5 14 fiscal years the distribution amounts for centers will be
  5 15 determined by DHS in consultation with the mental health and
  5 16 disability services regional administrators and announced by
  5 17 the beginning of the federal fiscal year.
  5 18    The division takes effect upon enactment.
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