Text: SF439            Text: SF441
Complete Bill History


Senate File 440

SENATE FILE BY COMMITTEE ON APPROPRIATIONS (SUCCESSOR TO SF 415) (SUCCESSOR TO SSB 1199) (As Amended and Passed by the Senate April 16, 2013) A BILL FOR 1 An Act relating to human services involving mental health 2 and disability services and children's services, making 3 appropriations, and including effective dates. 4 BE IT ENACTED BY THE GENERAL ASSEMBLY OF THE STATE OF IOWA: SF 440 (5) 85 jp/rj/jh PAG LIN 1 1 DIVISION I 1 2 SYSTEM REDESIGN ==== IMPLEMENTATION 1 3 RESEARCH=BASED PRACTICE 1 4 Section 1. Section 331.388, Code 2013, is amended by adding 1 5 the following new subsection: 1 6 NEW SUBSECTION. 4A. "Research=based practice" means a 1 7 service or other support in which the efficacy of the service 1 8 or other support is recognized as an evidence=based practice, 1 9 or is deemed to be an emerging and promising practice, or which 1 10 is part of a demonstration and will supply evidence as to the 1 11 effectiveness of the service or other support. 1 12 Sec. 2. Section 331.393, subsection 4, paragraph g, 1 13 unnumbered paragraph 1, Code 2013, is amended to read as 1 14 follows: 1 15 The requirements for designation of targeted case management 1 16 providers and for implementation of evidence=based models 1 17 of case management that apply research=based practice. The 1 18 requirements shall be designed to provide the person receiving 1 19 the case management with a choice of providers, allow a 1 20 service provider to be the case manager but prohibit the 1 21 provider from referring a person receiving the case management 1 22 only to services administered by the provider, and include 1 23 other provisions to ensure compliance with but not exceed 1 24 federal requirements for conflict=free case management. The 1 25 qualifications of targeted case managers and other persons 1 26 providing service coordination under the management plan shall 1 27 be specified in the rules. The rules shall also include but 1 28 are not limited to all of the following relating to targeted 1 29 case management and service coordination services: 1 30 Sec. 3. Section 331.397, subsection 5, paragraph b, Code 1 31 2013, is amended to read as follows: 1 32 b. Providing evidence=based services that apply 1 33 research=based practice. 1 34 Sec. 4. Section 331.397, subsection 6, paragraph d, Code 1 35 2013, is amended to read as follows: 2 1 d. Advances in the use of evidence=based treatment applying 2 2 research=based practice, including but not limited to all of 2 3 the following: 2 4 (1) Positive behavior support. 2 5 (2) Assertive community treatment. 2 6 (3) Peer self=help drop=in centers. 2 7 Sec. 5. Section 331.397, subsection 7, paragraphs b and c, 2 8 Code 2013, are amended to read as follows: 2 9 b. The efficacy of the services or other support is are 2 10 recognized as an evidence=based a research=based practice, is 2 11 deemed to be an emerging and promising practice, or providing 2 12 the services is part of a demonstration and will supply 2 13 evidence as to the services' effectiveness. 2 14 c. A determination that the services or other support 2 15 provides an effective alternative to existing services 2 16 that have been shown by the evidence research base to be 2 17 ineffective, to not yield the desired outcome, or to not 2 18 support the principles outlined in Olmstead v. L.C., 527 U.S. 2 19 581 (1999). 2 20 COMMUNITY CORRECTIONS SYSTEM ACCESS TO REGIONAL SERVICES 2 21 Sec. 6. Section 331.395, Code 2013, is amended by adding the 2 22 following new subsection: 2 23 NEW SUBSECTION. 5. If adequate funding is provided through 2 24 a state appropriation made for purposes of paying for services 2 25 authorized pursuant to this subsection, a person with an income 2 26 within the level specified in subsection 1 who is housed by or 2 27 supervised by a judicial district department of correctional 2 28 services established under chapter 905 shall be deemed to 2 29 have met the income and resource eligibility requirements for 2 30 services under the regional service system. 2 31 ELIGIBILITY MAINTENANCE 2 32 Sec. 7. Section 331.396, subsection 1, paragraph b, Code 2 33 2013, is amended to read as follows: 2 34 b. The person is at least eighteen years of age and is a 2 35 resident of this state. However, a person who is seventeen 3 1 years of age, is a resident of this state, and is receiving 3 2 publicly funded children's services may be considered eligible 3 3 for services through the regional service system during the 3 4 three=month period preceding the person's eighteenth birthday 3 5 in order to provide a smooth transition from children's 3 6 to adult services. In addition, a person who is less than 3 7 eighteen years of age and a resident of this state may be 3 8 eligible, as determined by the region, for those mental health 3 9 services made available to all or a portion of the residents 3 10 of the region of the same age and eligibility class under the 3 11 county management plan of one or more counties of the region 3 12 applicable prior to formation of the region. 3 13 Sec. 8. Section 331.396, subsection 2, paragraph b, Code 3 14 2013, is amended to read as follows: 3 15 b. The person is at least eighteen years of age and is a 3 16 resident of this state. However, a person who is seventeen 3 17 years of age, is a resident of this state, and is receiving 3 18 publicly funded children's services may be considered eligible 3 19 for services through the regional service system during the 3 20 three=month period preceding the person's eighteenth birthday 3 21 in order to provide a smooth transition from children's 3 22 to adult services. In addition, a person who is less than 3 23 eighteen years of age and a resident of this state may be 3 24 eligible, as determined by the region, for those intellectual 3 25 disability services made available to all or a portion of the 3 26 residents of the region of the same age and eligibility class 3 27 under the county management plan of one or more counties of the 3 28 region applicable prior to formation of the region. 3 29 Sec. 9. Section 331.397, subsection 2, paragraph b, Code 3 30 2013, is amended to read as follows: 3 31 b. Until funding is designated for other service 3 32 populations, eligibility for the service domains listed in this 3 33 section shall be limited to such persons who are in need of 3 34 mental health or intellectual disability services. However, if 3 35 a county in a region was providing services to an individual 4 1 person eligibility class of persons with a developmental 4 2 disability other than intellectual disability or a brain injury 4 3 prior to formation of the region, the individual person class 4 4 of persons shall remain eligible for the services provided when 4 5 the region is formed, provided that funds are available to 4 6 continue such services. 4 7 CORE SERVICES 4 8 Sec. 10. Section 331.397, subsection 4, paragraphs c and d, 4 9 Code 2013, are amended to read as follows: 4 10 c. Support for community living and other living 4 11 arrangements, including but not limited to all of the 4 12 following: 4 13 (1) Home health aide. 4 14 (2) Home and vehicle modifications. 4 15 (3) Respite. 4 16 (4) Supportive community living. 4 17 (5) Residential care facility living arrangements. 4 18 d. Support for employment and work activity, including but 4 19 not limited to all of the following: 4 20 (1) Day habilitation. 4 21 (2) Job development. 4 22 (3) Supported employment. 4 23 (4) Prevocational services. 4 24 (5) Other work activity services. 4 25 STATE PAYMENTS TO REGION 4 26 Sec. 11. Section 426B.3, subsection 4, as enacted by 2012 4 27 Iowa Acts, chapter 1120, section 137, is amended to read as 4 28 follows: 4 29 4. a. For the fiscal years beginning July 1, 2013, and 4 30 July 1, 2014, a county with a county population expenditure 4 31 target amount that exceeds the amount of the county's base year 4 32 expenditures for mental health and disabilities services shall 4 33 receive an equalization payment for the difference. 4 34 b. The equalization payments determined in accordance 4 35 with this subsection shall be made by the department of human 5 1 services for each fiscal year as provided in appropriations 5 2 made from the property tax relief fund for this purpose. If 5 3 the county is part of a region that has been approved by the 5 4 department in accordance with section 331.389, to commence 5 5 partial or full operations, the county's equalization payment 5 6 shall be remitted to the region for expenditure as approved by 5 7 the region's governing board. 5 8 STRATEGIC PLAN REQUIREMENT FOR FY 2013=2014 5 9 Sec. 12. 2012 Iowa Acts, chapter 1128, section 8, is amended 5 10 to read as follows: 5 11 SEC. 8. COUNTY MENTAL HEALTH, MENTAL RETARDATION 5 12 INTELLECTUAL DISABILITY, AND DEVELOPMENTAL DISABILITIES 5 13 SERVICES MANAGEMENT PLAN ==== STRATEGIC PLAN. Notwithstanding 5 14 section 331.439, subsection 1, paragraph "b", subparagraph (3), 5 15 counties are not required to submit a three=year strategic 5 16 plan by April 1, 2012, to the department of human services. A 5 17 county's strategic plan in effect as of the effective date of 5 18 this section shall remain in effect until the regional service 5 19 system management plan for the region to which the county 5 20 belongs is approved in accordance with section 331.393, subject 5 21 to modification before that date as necessary to conform with 5 22 statutory changes affecting the plan and any amendments to the 5 23 plan that are adopted in accordance with law. 5 24 RISK POOL DISTRIBUTIONS 5 25 Sec. 13. 2012 Iowa Acts, chapter 1128, section 6, 5 26 subsections 5 and 6, as amended by 2012 Iowa Acts, chapter 5 27 1133, section 67, are amended to read as follows: 5 28 5. If moneys from a distribution made under this section are 5 29 not expended by a county by June 30, 2013 2015, for services 5 30 provided by that date under the applicable service management 5 31 plan, the county shall reimburse the unexpended moneys to the 5 32 department by August 30, 2013 2015, and the moneys reimbursed 5 33 shall be credited to the risk pool in the property tax relief 5 34 fund. 5 35 6. The risk pool board shall submit annual reports to the 6 1 governor and general assembly on or before December 31, 2012 6 2 and 2013, regarding the expenditure of funds distributed under 6 3 this section. The final annual report shall be submitted on or 6 4 before December 31, 2015. 6 5 TRANSITION FUND ==== SERVICES MAINTENANCE 6 6 Sec. 14. TRANSITION FUND ==== SERVICES MAINTENANCE. A county 6 7 receiving an allocation of funding from the mental health and 6 8 disability services redesign transition fund created in 2012 6 9 Iowa Acts, chapter 1120, section 23, shall utilize the funding 6 10 received by the county as necessary for the services covered 6 11 in accordance with the county's approved management plan in 6 12 effect as of June 30, 2012, for the fiscal year beginning July 6 13 1, 2012, and ending June 30, 2013. 6 14 REDESIGN EQUALIZATION PAYMENTS AND RISK POOL 6 15 Sec. 15. EQUALIZATION PAYMENTS AND RISK POOL. 6 16 1. There is transferred from the general fund of the state 6 17 to the property tax relief fund created in section 426B.1 6 18 for the fiscal year beginning July 1, 2012, and ending June 6 19 30, 2013, the following amount to be used for the purposes 6 20 designated: 6 21 .................................................. $ 42,826,316 6 22 2. a. The moneys credited to the property tax relief 6 23 fund in accordance with this section are appropriated to the 6 24 department of human services for the fiscal year beginning July 6 25 1, 2013, and ending June 30, 2014, for distribution to counties 6 26 and regions in accordance with this section. If a county is 6 27 part of a region that has been approved by the department to 6 28 commence partial or full operations in accordance with section 6 29 331.389 for the fiscal year, the county's payment made pursuant 6 30 to this section shall be remitted to the region for expenditure 6 31 as approved by the region's governing board. The payments made 6 32 under this section are in lieu of equalization payments for the 6 33 fiscal year beginning July 1, 2013, otherwise required under 6 34 section 426B.3, as amended by 2012 Iowa Acts, section 137. 6 35 b. For the purposes of this section, unless the context 7 1 otherwise requires: 7 2 (1) "Net expenditures from the county's services fund" 7 3 means a county's payments for non=Medicaid services, as 7 4 reported to the department of management pursuant to section 7 5 331.403, plus any reimbursement of moneys distributed to the 7 6 county pursuant to 2012 Iowa Acts, chapter 1128, section 6, as 7 7 amended by 2012 Iowa Acts, chapter 1133, section 67, and less 7 8 any moneys expended by the county as a provider of services 7 9 that were reimbursed to the county. 7 10 (2) "Population" means the same as defined in section 7 11 331.388. 7 12 (3) "Services fund" means a county's mental health and 7 13 disabilities services fund created in accordance with section 7 14 331.424A. 7 15 3. Of the amount appropriated in this section, $31,388,667 7 16 shall be distributed to counties as per capita growth payments 7 17 in accordance with this section. 7 18 4. A per capita growth amount shall be distributed to each 7 19 county in two payments. The provisional per capita growth 7 20 amount for the fiscal year is $10.25, with the final amount 7 21 determined in accordance with subsection 5. A county's first 7 22 per capita growth payment shall be the product of $8.25 of the 7 23 provisional per capita growth amount times the county's general 7 24 population for the fiscal year. 7 25 5. The moneys transferred to the property tax relief fund 7 26 for the fiscal year beginning July 1, 2013, from the federal 7 27 social services block grant pursuant to 2013 Iowa Acts, House 7 28 File 614, or any other 2013 Iowa Acts, if enacted and from 7 29 the federal temporary assistance for needy families block 7 30 grant, totaling at least $11,774,275, are appropriated to the 7 31 department of human services for the fiscal year beginning July 7 32 1, 2013, to be used for distribution of state payment program 7 33 remittances to counties for the fiscal year in accordance 7 34 with this subsection. The state payment program remittance 7 35 shall be an amount equal to the amount paid to a county of 8 1 residence under the program for state case services known as 8 2 the state payment program, implemented pursuant to section 8 3 331.440, subsection 5, during the most recently available 8 4 twelve=month period. The department shall draw upon the 8 5 appropriation made from the general fund of the state for the 8 6 medical assistance program for the fiscal year as necessary for 8 7 cash flow purposes in order to comply with the date specified 8 8 for remitting payments to counties in subsection 6, and to 8 9 distribute at least the amount specified in this subsection. 8 10 If the procedure for reduced federal funds specified in 2013 8 11 Iowa Acts, House File 614, or any other 2013 Iowa Acts, if 8 12 enacted, reduces the amount of block grant funding available 8 13 for the purposes of this subsection, the amount drawn from the 8 14 medical assistance appropriation shall be increased to replace 8 15 the amount of the reduction. 8 16 6. The first per capita growth payment due a county under 8 17 subsection 4 and any state payment program remittance due a 8 18 county under subsection 5, shall be combined and remitted to 8 19 the counties on or before July 15, 2013. 8 20 7. a. Of the amount appropriated in this section, 8 21 $11,437,649 shall be distributed to counties as stabilization 8 22 payments in accordance with this subsection. A stabilization 8 23 payment shall be distributed to each county for which the 8 24 amount of net expenditures from the county's services fund 8 25 under section 331.424A for the fiscal year beginning July 1, 8 26 2012, exceeds the sum of the county's state payment program 8 27 remittance under subsection 5 plus the dollar amount of the 8 28 county's services fund levies for the fiscal year beginning 8 29 July 1, 2013. A county's stabilization payment amount shall 8 30 be equal to the excess net expenditures amount. To receive 8 31 a stabilization payment, on or before December 1, 2013, the 8 32 county shall submit a statement of net expenditures from 8 33 the county's services fund for the fiscal year beginning 8 34 July 1, 2012. The statement shall be accompanied by the 8 35 annual financial report for that fiscal year submitted to the 9 1 department of management pursuant to section 331.403. The 9 2 department shall determine the county's stabilization payment 9 3 amount by subtracting the sum of the county's state payment 9 4 program remittance and the dollar amount of the county's 9 5 certified levy amount for the services fund for the fiscal year 9 6 from the county's statement of total net expenditures. 9 7 b. If the sum of the total of all eligible counties' 9 8 stabilization payments plus the product of $2.00 of the 9 9 provisional per capita growth payment amount under subsection 9 10 4 times the state's general population for the fiscal year is 9 11 greater or less than the amount of moneys remaining after the 9 12 first per capita growth payments made pursuant to subsection 9 13 4 and the amount allocated in this subsection, the department 9 14 shall identify a final per capita growth amount by adjusting 9 15 the provisional per capita growth amount as necessary to 9 16 distribute all of the moneys remaining. If the total of the 9 17 stabilization payments exceeds the amount allocated in this 9 18 subsection, the provisional per capita growth amount shall be 9 19 reduced to provide sufficient funding to address the excess. 9 20 If the total of the stabilization payments is less than the 9 21 amount allocated in this subsection, the provisional per 9 22 capita growth amount shall be increased to address the reduced 9 23 amount. A county's second per capita growth payment shall be 9 24 the product of the remainder of the final per capita growth 9 25 amount as adjusted by the department times the county's general 9 26 population for the fiscal year. 9 27 c. Each county's second per capita growth payment shall be 9 28 combined with any stabilization payment due the county. The 9 29 payments shall be remitted to the counties on or before January 9 30 2, 2014. 9 31 SUBSTANCE=RELATED DISORDER DETOXIFICATION 9 32 Sec. 16. COORDINATION OF DETOXIFICATION SERVICES. The 9 33 department of human services shall review options for the 9 34 mental health and disability services regions to coordinate 9 35 detoxification funding provided by counties and other such 10 1 disorder funding provided by counties in place of county 10 2 coordination. The department shall report to the governor and 10 3 general assembly its findings, options, and recommendations on 10 4 or before October 15, 2013. 10 5 MEDICAID OBLIGATION COST SETTLEMENT 10 6 Sec. 17. COUNTY MEDICAL ASSISTANCE NONFEDERAL SHARE ==== 10 7 COST SETTLEMENT. Any county obligation for payment to the 10 8 department of human services of the nonfederal share of the 10 9 cost of services provided under the medical assistance program 10 10 prior to July 1, 2012, pursuant to sections 249A.12 and 10 11 249A.26, shall remain at the amount agreed upon as of June 30, 10 12 2013. Beginning July 1, 2013, other than a county payment on 10 13 the obligation or for a charge when the county is the provider 10 14 of the service, the department shall be responsible for any 10 15 adjustment that would otherwise be applied to the amount of the 10 16 county obligation after that date due to cost settlement of 10 17 charges or other reasons. 10 18 COUNTY MENTAL HEALTH AND DISABILITY 10 19 SERVICES FUND ==== FY 2013=2014 10 20 Sec. 18. SERVICES FUND ==== MANAGEMENT PLAN. For the fiscal 10 21 year beginning July 1, 2013, and ending June 30, 2014, the 10 22 appropriations made by the county board of supervisors for 10 23 payment for mental health and disability services pursuant 10 24 to section 331.424A, subsection 3, as enacted by 2012 Iowa 10 25 Acts, chapter 1120, section 132, shall be made in accordance 10 26 with the county's service management plan approved under 10 27 section 331.439, Code 2013, until the county management plan is 10 28 replaced by a regional service system management plan approved 10 29 under section 331.393. 10 30 Sec. 19. CONTINUATION OF MENTAL HEALTH AND DISABILITY 10 31 SERVICES REDESIGN FISCAL VIABILITY STUDY COMMITTEE. The 10 32 legislative council is requested to continue for the 2013 10 33 legislative interim the mental health and disability services 10 34 redesign fiscal viability study committee initially created by 10 35 the legislative council in 2012. The legislative council is 11 1 requested to add at least four citizen members to the study 11 2 committee to provide representation for service consumers, 11 3 service providers, county supervisors, and the community 11 4 services affiliate of the Iowa state association of counties. 11 5 In addition to monitoring implementation of the mental health 11 6 and disability services redesign and receiving reports from 11 7 stakeholder groups engaged in implementation of the redesign, 11 8 the study committee shall be directed to propose a permanent 11 9 approach for state, county, and regional financing of the 11 10 redesign. 11 11 Sec. 20. EFFECTIVE UPON ENACTMENT. This division of this 11 12 Act, being deemed of immediate importance, takes effect upon 11 13 enactment. 11 14 DIVISION II 11 15 DATA AND STATISTICAL INFORMATION AND OUTCOME AND PERFORMANCE 11 16 MEASURES 11 17 Sec. 21. Section 225C.4, subsection 1, paragraph j, Code 11 18 2013, is amended to read as follows: 11 19 j. Establish and maintain a data collection and management 11 20 information system oriented to the needs of patients, 11 21 providers, the department, and other programs or facilities in 11 22 accordance with section 225C.6A. The system shall be used to 11 23 identify, collect, and analyze service outcome and performance 11 24 measures data in order to assess the effects of the services on 11 25 the persons utilizing the services. The administrator shall 11 26 annually submit to the commission information collected by the 11 27 department indicating the changes and trends in the disability 11 28 services system. The administrator shall make the outcome data 11 29 available to the public. 11 30 Sec. 22. Section 225C.6A, Code 2013, is amended to read as 11 31 follows: 11 32 225C.6A Disability services system redesign central data 11 33 repository. 11 34 1. The commission department shall do the following 11 35 relating to redesign of data concerning the disability services 12 1 system in the state: 12 2 1. Identify sources of revenue to support statewide 12 3 delivery of core disability services to eligible disability 12 4 populations. 12 5 2. Ensure there is a continuous improvement process for 12 6 development and maintenance of the disability services system 12 7 for adults and children. The process shall include but is not 12 8 limited to data collection and reporting provisions. 12 9 3. a. Plan, collect, and analyze data as necessary to 12 10 issue cost estimates for serving additional populations and 12 11 providing core disability services statewide. The department 12 12 shall maintain compliance with applicable federal and state 12 13 privacy laws to ensure the confidentiality and integrity of 12 14 individually identifiable disability services data. The 12 15 department shall regularly may periodically assess the status 12 16 of the compliance in order to assure that data security is 12 17 protected. 12 18 b. In implementing Implement a system central data 12 19 repository under this subsection section for collecting and 12 20 analyzing state, county and region, and private contractor 12 21 data, the. The department shall establish a client identifier 12 22 for the individuals receiving services. The client identifier 12 23 shall be used in lieu of the individual's name or social 12 24 security number. The client identifier shall consist of the 12 25 last four digits of an individual's social security number, 12 26 the first three letters of the individual's last name, the 12 27 individual's date of birth, and the individual's gender in an 12 28 order determined by the department. 12 29 c. Consult on an ongoing basis with regional administrators, 12 30 service providers, and other stakeholders in implementing the 12 31 central data repository and operations of the repository. The 12 32 consultation shall focus on minimizing the state and local 12 33 costs associated with operating the repository. 12 34 d. Engage with other state and local government and 12 35 nongovernmental entities operating the Iowa health information 13 1 network under chapter 135 and other data systems that maintain 13 2 information relating to individuals with information in the 13 3 central data repository in order to integrate data concerning 13 4 individuals. 13 5 c. 2. A county or region shall not be required to utilize a 13 6 uniform data operational or transactional system. However, the 13 7 system utilized shall have the capacity to exchange information 13 8 with the department, counties and regions, contractors, and 13 9 others involved with services to persons with a disability 13 10 who have authorized access to the central data repository. 13 11 The information exchanged shall be labeled consistently 13 12 and share the same definitions. Each county regional 13 13 administrator shall regularly report to the department annually 13 14 on or before December 1, for the preceding fiscal year the 13 15 following information for each individual served: demographic 13 16 information, expenditure data, and data concerning the services 13 17 and other support provided to each individual, as specified 13 18 in administrative rule adopted by the commission by the 13 19 department. 13 20 4. Work with county representatives and other qualified 13 21 persons to develop an implementation plan for replacing the 13 22 county of legal settlement approach to determining service 13 23 system funding responsibilities with an approach based upon 13 24 residency. The plan shall address a statewide standard for 13 25 proof of residency, outline a plan for establishing a data 13 26 system for identifying residency of eligible individuals, 13 27 address residency issues for individuals who began residing in 13 28 a county due to a court order or criminal sentence or to obtain 13 29 services in that county, recommend an approach for contesting 13 30 a residency determination, and address other implementation 13 31 issues. 13 32 3. The outcome and performance measures applied to the 13 33 regional disability services system shall utilize measurement 13 34 domains. The department may identify other measurement domains 13 35 in consultation with system stakeholders to be utilized in 14 1 addition to the following initial set of measurement domains: 14 2 a. Access to services. 14 3 b. Life in the community. 14 4 c. Person=centeredness. 14 5 d. Health and wellness. 14 6 e. Quality of life and safety. 14 7 f. Family and natural supports. 14 8 4. a. The processes used for collecting outcome and 14 9 performance measures data shall include but are not limited 14 10 to direct surveys of the individuals and families receiving 14 11 services and the providers of the services. The department 14 12 shall involve a workgroup of persons who are knowledgeable 14 13 about both the regional service system and survey techniques 14 14 to implement and maintain the processes. The workgroup shall 14 15 conduct an ongoing evaluation for the purpose of eliminating 14 16 the collection of information that is not utilized. The 14 17 surveys shall be conducted with a conflict=free approach in 14 18 which someone other than a provider of services surveys an 14 19 individual receiving the services. 14 20 b. The outcome and performance measures data shall encompass 14 21 and provide a means to evaluate both the regional services and 14 22 the services funded by the medical assistance program provided 14 23 to the same service populations. 14 24 c. The department shall develop and implement an 14 25 internet=based approach with graphical display of information 14 26 to provide outcome and performance measures data to the public 14 27 and those engaged with the regional service system. 14 28 d. The department shall include any significant costs for 14 29 collecting and interpreting outcome and performance measures 14 30 and other data in the department's operating budget. 14 31 Sec. 23. REPEAL. The amendment to section 225C.4, 14 32 subsection 1, paragraph j, in 2012 Iowa Acts, chapter 1120, 14 33 section 2, is repealed. 14 34 Sec. 24. REPEAL. The amendments to section 225C.6A, in 2012 14 35 Iowa Acts, chapter 1120, sections 6, 7, and 95, are repealed. 15 1 DIVISION III 15 2 CHILDREN'S CABINET 15 3 Sec. 25. NEW SECTION. 242.1 Findings. 15 4 The general assembly finds there is a need for a 15 5 state=level children's cabinet to provide guidance, oversight, 15 6 problem=solving, and long=term strategy development, and to 15 7 foster collaboration among state and local efforts to build a 15 8 comprehensive, coordinated system of care in order to promote 15 9 the well=being of the children in this state. The system of 15 10 care should address all domains of child physical, mental, 15 11 intellectual, developmental, and social health and meet the 15 12 particular needs of children for family=centered mental health 15 13 and disability services and for other appropriate specialized 15 14 services. 15 15 Sec. 26. NEW SECTION. 242.2 Children's cabinet established. 15 16 There is established within the department of human services 15 17 a children's cabinet. 15 18 1. The voting members of the children's cabinet shall 15 19 consist of the following: 15 20 a. The director of the department of education or the 15 21 director's designee. 15 22 b. The director of the department of human services or the 15 23 director's designee. This member shall be chairperson of the 15 24 cabinet. 15 25 c. The director of the department of inspections and appeals 15 26 or the director's designee. 15 27 d. The director of the department of public health or the 15 28 director's designee. 15 29 e. A parent of a child with a severe emotional disturbance 15 30 or a disability who is the primary caregiver for that child, 15 31 appointed by the governor. 15 32 f. A juvenile court judge or juvenile court officer 15 33 appointed by the chief justice of the supreme court. 15 34 g. A community=based provider of child welfare, health, 15 35 or juvenile justice services to children, appointed by the 16 1 director of human services. 16 2 h. A member of the early childhood Iowa state board or the 16 3 early childhood stakeholders alliance, appointed by the state 16 4 board. 16 5 i. A community stakeholder who is not affiliated with a 16 6 provider of services, appointed by the governor. 16 7 j. A member of a child advocacy organization approved by the 16 8 members of the children's cabinet. 16 9 k. A member of the Iowa chapter of the American academy 16 10 of pediatrics who has expertise in pediatric health care and 16 11 addressing the needs of children with special needs, designated 16 12 by the Iowa chapter. 16 13 l. An area education agency staff member who works with 16 14 early childhood services, appointed by the state's area 16 15 education agency directors. 16 16 m. An area education agency staff member who works with 16 17 children's mental health services, appointed by the state's 16 18 area education agency directors. 16 19 n. Not more than three other members designated by 16 20 the cabinet chairperson to ensure adequate representation 16 21 of the persons and interests who may be affected by the 16 22 recommendations made by the cabinet. 16 23 2. In addition to the voting members, there shall be four ex 16 24 officio, nonvoting members of the children's cabinet. These 16 25 members shall be two state representatives, one appointed by 16 26 the speaker of the house of representatives and one by the 16 27 minority leader of the house of representatives, and two state 16 28 senators, one appointed by the majority leader of the senate 16 29 and one by the minority leader of the senate. 16 30 3. a. The voting members, other than department directors 16 31 and their designees, shall be appointed for four=year terms. 16 32 The terms of such members begin on May 1 in the year of 16 33 appointment and expire on April 30 in the year of expiration. 16 34 b. Vacancies shall be filled in the same manner as original 16 35 appointments. A vacancy shall be filled for the unexpired 17 1 term. 17 2 c. The voting members shall receive actual and necessary 17 3 expenses incurred in the performance of their duties and 17 4 legislative members shall be compensated as provided in section 17 5 2.32A. 17 6 4. Staffing services for the children's cabinet shall be 17 7 provided by the department of human services. 17 8 Sec. 27. NEW SECTION. 242.3 Duties. 17 9 The children's cabinet shall perform the following duties 17 10 in making recommendations to the agencies and organizations 17 11 represented on the cabinet, the governor, the general assembly, 17 12 and the judicial branch to address the needs of children and 17 13 families in this state: 17 14 1. Recommend operating provisions for health homes for 17 15 children implemented by the department of human services. The 17 16 provisions shall include but are not limited to all of the 17 17 following: 17 18 a. Identification of quality metrics. 17 19 b. Identification of performance criteria. 17 20 c. Provisions for monitoring the implementation of 17 21 specialized health homes. 17 22 d. Identification of system of care principles and values 17 23 based on the recommendations of the workgroup for redesign of 17 24 publicly funded children's disability services implemented by 17 25 the department of human services in accordance with 2011 Iowa 17 26 Acts, chapter 121, section 1, subsection 4, paragraph "i". 17 27 2. Gather information and improve the understanding of 17 28 policymakers and the public of how the various service systems 17 29 intended to meet the needs of children and families operate at 17 30 the local level. 17 31 3. Address areas of overlap, gaps, and conflict between 17 32 service systems. 17 33 4. Support the evolution of service systems in implementing 17 34 new services and enhancing existing services to address the 17 35 needs of children and families through process improvement 18 1 methodologies. 18 2 5. Assist policymakers and service system users in 18 3 understanding and effectively managing system costs. 18 4 6. Ensure services offered are evidence=based. 18 5 7. Issue guidelines to enable the services and other support 18 6 which is provided by or under the control of state entities and 18 7 delivered at the local level to have sufficient flexibility to 18 8 engage local resources and meet unique needs of children and 18 9 families. 18 10 8. Integrate efforts of policymakers and service providers 18 11 to improve the well=being of community members in addition to 18 12 children and families. 18 13 9. Implement strategies so that the children and families 18 14 engaged with the service systems avoid the need for higher 18 15 level services and other support. 18 16 10. Oversee the practices utilized by accountable care 18 17 organizations and other care management entities operating on 18 18 behalf of the state in the provision of government supported 18 19 children's services and systems of care. 18 20 11. Identify and promote evidence=based practices that may 18 21 be creatively applied in appropriate settings for prevention 18 22 and early identification of social, emotional, behavioral, and 18 23 developmental risk factors for children from birth through age 18 24 eight. 18 25 12. Making periodic recommendations to the agencies 18 26 and organizations represented on the cabinet. An agency or 18 27 organization receiving such a recommendation shall respond 18 28 in writing to the children's cabinet detailing how the 18 29 recommendation was addressed. The response shall be submitted 18 30 not later than sixty business days following the date of the 18 31 receipt of the recommendation. 18 32 13. Submit a report annually by December 15 to the governor, 18 33 general assembly, and supreme court providing findings and 18 34 recommendations and issue other reports as deemed necessary by 18 35 the cabinet. 19 1 Sec. 28. INITIAL TERMS. Notwithstanding section 242.2, 19 2 subsection 3, paragraph "a", as enacted by this division of 19 3 this Act, the appointing authorities for the members of the 19 4 children's cabinet created by this division of this Act who are 19 5 subject to terms of service shall be coordinated so that the 19 6 initial terms of approximately half of such members are two 19 7 years and the remainder are for four years and remain staggered 19 8 thereafter. 19 9 DIVISION IV 19 10 CENTER FOR CHILD HEALTH INNOVATION AND EXCELLENCE 19 11 Sec. 29. Section 135.11, Code 2013, is amended by adding the 19 12 following new subsection: 19 13 NEW SUBSECTION. 32. Create and operate, subject to 19 14 appropriation of funding by the general assembly, a center for 19 15 child health excellence and innovation. The purpose of the 19 16 center is to provide a policy forum for efforts to improve 19 17 child health, including but not limited to improving health 19 18 quality, demonstrating better health outcomes, and reducing 19 19 long=term health care costs. 19 20 a. The center shall engage major providers of child health 19 21 services and associated groups, including but not limited to 19 22 representatives of the department, the medical assistance 19 23 program administrator, child health specialty clinics, the 19 24 association representing community health centers, the state 19 25 council created by the department for the department's project 19 26 LAUNCH initiative, staff of institutions of higher education 19 27 with expertise in pediatric health and child health care, the 19 28 prevention of disabilities policy council in conjunction with 19 29 the center for disabilities and development of the university 19 30 of Iowa's children's hospital, and others. 19 31 b. The center shall lead the review and analysis of public 19 32 policy efforts that are directed toward the purpose of the 19 33 center. 19 34 c. The center shall develop community=based initiatives 19 35 to promote healthy child development, leveraging medical 20 1 assistance program funding where possible. The initiatives 20 2 of Iowa shall include but are not limited to the promotion of 20 3 demonstration programs within the behavioral health managed 20 4 care contract and the development of a grant application for 20 5 federal and foundation funding opportunities that focus upon 20 6 improving child health through innovation and the diffusion of 20 7 innovation. 20 8 d. The center shall develop an early childhood mental health 20 9 certification for professionals and others engaged in working 20 10 with young children. 20 11 e. The center shall draw upon national and state 20 12 expertise in the field of child health, including experts 20 13 from Iowa's institutions of higher education, health provider 20 14 organizations, and health policy and advocacy organizations. 20 15 The center shall seek support from the Iowa research 20 16 community in data report development and analysis of available 20 17 information from Iowa child health data sources. 20 18 f. The center shall work with the departments of human 20 19 services and public health and with the governor and members 20 20 of the general assembly in child health public policy efforts 20 21 such as providing medical assistance funding as necessary to 20 22 expand the department's initiative to provide for adequate 20 23 developmental surveillance and screening during a child's first 20 24 five years to be available statewide and enabling child care 20 25 resource and referral service agencies to facilitate provision 20 26 of child mental health consultation for child care providers. 20 27 g. The center shall submit a report of its activities and 20 28 policy recommendations to the general assembly by December 15 20 29 annually. SF 440 (5) 85 jp/rj/jh
Text: SF439            Text: SF441 Complete Bill History