Bill Text: IA SSB1197 | 2019-2020 | 88th General Assembly | Introduced
Bill Title: A bill for an act relating to mental health and disability services, including the establishment of a children's behavioral health system and a children's behavioral health system state board, and requiring certain children's behavioral health core services.
Spectrum: Committee Bill
Status: (N/A - Dead) 2019-02-25 - Subcommittee Meeting: 02/27/2019 11:00AM RM 22. [SSB1197 Detail]
Download: Iowa-2019-SSB1197-Introduced.html
Senate
Study
Bill
1197
-
Introduced
SENATE/HOUSE
FILE
_____
BY
(PROPOSED
GOVERNOR
BILL)
A
BILL
FOR
An
Act
relating
to
mental
health
and
disability
services,
1
including
the
establishment
of
a
children’s
behavioral
2
health
system
and
a
children’s
behavioral
health
system
3
state
board,
and
requiring
certain
children’s
behavioral
4
health
core
services.
5
BE
IT
ENACTED
BY
THE
GENERAL
ASSEMBLY
OF
THE
STATE
OF
IOWA:
6
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Section
1.
Section
225C.2,
Code
2019,
is
amended
by
adding
1
the
following
new
subsections:
2
NEW
SUBSECTION
.
1A.
“Child”
or
“children”
means
a
person
or
3
persons
under
eighteen
years
of
age.
4
NEW
SUBSECTION
.
1B.
“Children’s
behavioral
health
5
services”
means
services
for
children
with
a
serious
emotional
6
disturbance.
7
NEW
SUBSECTION
.
1C.
“Children’s
behavioral
health
system”
or
8
“children’s
system”
means
the
behavioral
health
service
system
9
for
children
implemented
pursuant
to
this
subchapter.
10
NEW
SUBSECTION
.
11.
“Serious
emotional
disturbance”
means
11
a
diagnosable
mental,
behavioral,
or
emotional
disorder
of
12
sufficient
duration
to
meet
diagnostic
criteria
specified
13
within
the
most
current
diagnostic
and
statistical
manual
14
of
mental
disorders
published
by
the
American
psychiatric
15
association
that
results
in
a
functional
impairment.
“Serious
16
emotional
disturbance”
does
not
include
substance
use
and
17
developmental
disorders
unless
such
disorders
co-occur
with
18
such
a
diagnosable
mental,
behavioral,
or
emotional
disorder.
19
NEW
SUBSECTION
.
12.
“State
board”
means
the
children’s
20
behavioral
health
system
state
board
created
in
section
21
225C.51.
22
Sec.
2.
Section
225C.2,
subsection
9,
Code
2019,
is
amended
23
by
striking
the
subsection.
24
Sec.
3.
Section
225C.4,
subsection
1,
Code
2019,
is
amended
25
by
adding
the
following
new
paragraph:
26
NEW
PARAGRAPH
.
0c.
Assist
the
state
board
in
planning
for
27
community-based
children’s
behavioral
health
services.
28
Sec.
4.
Section
225C.4,
subsection
1,
paragraphs
d
and
j,
29
Code
2019,
are
amended
to
read
as
follows:
30
d.
Encourage
and
facilitate
coordination
of
mental
health
31
and
disability
services
with
the
objective
of
developing
and
32
maintaining
in
the
state
a
mental
health
and
disability
service
33
delivery
system
to
provide
disability
services
to
all
persons
34
in
this
state
who
need
the
services,
regardless
of
the
place
35
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of
residence
or
economic
circumstances
of
those
persons.
The
1
administrator
shall
work
with
the
commission
and
other
state
2
agencies,
including
but
not
limited
to
the
departments
of
3
corrections,
education,
and
public
health
and
the
state
board
4
of
regents,
to
develop
and
implement
a
strategic
plan
to
expand
5
access
to
qualified
mental
health
workers
across
the
state.
6
j.
Establish
and
maintain
a
data
collection
and
management
7
information
system
oriented
to
the
needs
of
patients,
8
providers,
the
department,
and
other
programs
or
facilities
in
9
accordance
with
section
225C.6A
.
The
system
shall
be
used
to
10
identify,
collect,
and
analyze
service
outcome
and
performance
11
measures
data
in
order
to
assess
the
effects
of
the
services
on
12
the
persons
utilizing
the
services.
The
administrator
shall
13
annually
submit
to
the
commission
information
collected
by
the
14
department
indicating
the
changes
and
trends
in
the
mental
15
health
and
disability
services
system.
The
administrator
shall
16
make
the
outcome
data
available
to
the
public.
17
Sec.
5.
Section
225C.4,
subsection
1,
Code
2019,
is
amended
18
by
adding
the
following
new
paragraphs:
19
NEW
PARAGRAPH
.
0k.
Encourage
and
facilitate
coordination
20
of
children’s
behavioral
health
services
with
the
objective
of
21
developing
and
maintaining
in
the
state
a
children’s
behavioral
22
health
system
to
provide
behavioral
health
services
to
all
23
children
in
this
state
who
need
the
services,
regardless
of
the
24
place
of
residence
or
economic
circumstances
of
those
children.
25
The
administrator
shall
work
with
the
state
board
and
other
26
state
agencies
including
but
not
limited
to
the
department
of
27
education
and
the
department
of
public
health
to
develop
and
28
implement
a
strategic
plan
to
expand
access
to
qualified
mental
29
health
workers
across
the
state.
30
NEW
PARAGRAPH
.
00k.
Establish
and
maintain
a
data
31
collection
and
management
information
system
oriented
to
the
32
needs
of
children
utilizing
the
children’s
behavioral
health
33
system,
providers,
the
department,
and
other
programs
or
34
facilities
in
accordance
with
section
225C.6A.
The
system
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shall
be
used
to
identify,
collect,
and
analyze
service
1
outcome
and
performance
measures
data
in
order
to
assess
the
2
effects
of
the
services
on
the
children
utilizing
the
services.
3
The
administrator
shall
annually
submit
to
the
state
board
4
information
collected
by
the
department
indicating
the
changes
5
and
trends
in
the
children’s
behavioral
health
system.
The
6
administrator
shall
make
the
outcome
data
available
to
the
7
public.
8
Sec.
6.
Section
225C.4,
subsection
1,
paragraph
u,
Code
9
2019,
is
amended
by
adding
the
following
new
subparagraph:
10
NEW
SUBPARAGRAPH
.
(9)
School
attendance.
11
Sec.
7.
Section
225C.6B,
subsection
3,
Code
2019,
is
amended
12
by
adding
the
following
new
paragraph:
13
NEW
PARAGRAPH
.
c.
Children’s
behavioral
health
services
14
provided
to
eligible
children
that
are
not
covered
under
the
15
medical
assistance
program
or
other
third-party
payor
are
the
16
responsibility
of
the
county-based
regional
service
system.
17
Sec.
8.
NEW
SECTION
.
225C.51
Children’s
behavioral
health
18
system
state
board.
19
1.
A
children’s
behavioral
health
system
state
board
20
is
created
as
the
state
body
to
provide
guidance
on
the
21
implementation
and
management
of
a
children’s
behavioral
health
22
system
for
the
provision
of
services
to
children
with
a
serious
23
emotional
disturbance.
The
state
board’s
public
voting
members
24
shall
be
appointed
to
four-year
staggered
terms
by
the
governor
25
and
are
subject
to
confirmation
by
the
senate.
All
other
26
state
board
voting
members
shall
be
appointed
to
four-year
27
staggered
terms
and
are
not
subject
to
confirmation
by
the
28
senate.
State
board
members
shall
be
appointed
on
the
basis
of
29
interest
and
experience
in
the
fields
of
children’s
behavioral
30
health
to
ensure
adequate
representation
from
persons
with
life
31
experiences
and
from
persons
knowledgeable
about
children’s
32
behavioral
health
services.
The
department
shall
provide
33
support
to
the
state
board,
and
the
board
may
utilize
staff
34
support
and
other
assistance
provided
to
the
state
board
by
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other
persons.
The
state
board
shall
meet
at
least
four
times
1
per
year.
The
membership
of
the
state
board
shall
consist
of
2
the
following
persons
who,
at
the
time
of
appointment
to
the
3
state
board,
are
active
members
of
the
indicated
groups:
4
a.
The
director
of
the
department
or
the
director’s
5
designee.
6
b.
The
director
of
the
department
of
education
or
the
7
director’s
designee.
8
c.
The
director
of
the
department
of
public
health
or
the
9
director’s
designee.
10
d.
The
director
of
workforce
development
or
the
director’s
11
designee.
12
e.
One
member
shall
be
selected
from
nominees
submitted
by
13
the
state
court
administrator.
14
f.
One
member
shall
be
selected
from
nominees
submitted
15
by
the
early
childhood
Iowa
office
in
the
department
of
16
management.
17
g.
One
member
shall
be
a
member
of
the
mental
health
and
18
disability
services
commission.
19
h.
One
member
shall
be
a
board
member
or
an
employee
of
a
20
provider
of
mental
health
services
to
children.
21
i.
One
member
shall
be
a
board
member
or
an
employee
of
a
22
provider
of
child
welfare
services.
23
j.
One
member
shall
be
an
administrator
of
an
area
education
24
agency.
25
k.
One
member
shall
be
an
educator,
counselor,
or
26
administrator
of
a
school
district.
27
l.
One
member
shall
be
a
representative
of
an
established
28
advocacy
organization
whose
mission
or
purpose
it
is,
in
part,
29
to
further
goals
related
to
children’s
mental
health.
30
m.
One
member
shall
be
a
parent
or
guardian
of
a
child
31
utilizing
behavioral
health
services.
32
n.
One
member
shall
be
a
chief
executive
officer
of
a
mental
33
health
and
disability
services
region.
34
o.
In
addition
to
the
voting
members,
the
membership
shall
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include
four
members
of
the
general
assembly
with
one
member
1
designated
by
each
of
the
following:
the
majority
leader
of
2
the
senate,
the
minority
leader
of
the
senate,
the
speaker
of
3
the
house
of
representatives,
and
the
minority
leader
of
the
4
house
of
representatives.
A
legislative
member
serves
for
a
5
term
as
provided
in
section
69.16B
in
a
nonvoting,
ex
officio
6
capacity
and
is
not
eligible
for
per
diem
and
expenses
as
7
provided
in
section
2.10.
8
2.
The
four-year
terms
shall
begin
and
end
as
provided
in
9
section
69.19.
Vacancies
on
the
state
board
shall
be
filled
as
10
provided
in
section
2.32.
A
member
shall
not
be
appointed
for
11
more
than
two
consecutive
four-year
terms.
12
3.
The
director
and
the
director
of
the
department
of
13
education,
or
their
designees,
shall
serve
as
co-chairpersons
14
of
the
state
board.
Board
members
shall
not
be
entitled
to
a
15
per
diem
as
specified
in
section
7E.6
and
shall
not
be
entitled
16
to
actual
and
necessary
expenses
incurred
while
engaged
in
17
their
official
duties.
18
Sec.
9.
NEW
SECTION
.
225C.52
Children’s
behavioral
health
19
system
state
board
——
duties.
20
1.
To
the
extent
funding
is
available,
the
state
board
shall
21
perform
the
following
duties:
22
a.
Advise
the
administrator
on
the
administration
of
the
23
children’s
behavioral
health
system.
24
b.
Provide
consultation
services
to
agencies
regarding
25
the
development
of
administrative
rules
for
the
children’s
26
behavioral
health
system.
27
c.
Identify
behavioral
health
outcomes
and
indicators
for
28
eligible
children
with
a
serious
emotional
disturbance
to
29
promote
children
living
with
their
own
families
and
in
the
30
community.
31
d.
Submit
a
written
report
on
or
before
December
1
of
each
32
year
to
the
governor
and
the
general
assembly.
At
a
minimum,
33
the
report
shall
include
a
summary
of
all
activities
undertaken
34
by
the
state
board,
a
summary
of
state
board
activities,
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and
results
from
identified
behavioral
health
outcomes
and
1
indicators
for
the
children’s
behavioral
health
system.
2
Sec.
10.
Section
331.388,
Code
2019,
is
amended
by
adding
3
the
following
new
subsections:
4
NEW
SUBSECTION
.
01.
“Children’s
behavioral
health
services”
5
means
the
same
as
defined
in
section
225C.2.
6
NEW
SUBSECTION
.
4A.
“Serious
emotional
disturbance”
means
7
the
same
as
defined
in
section
225C.2.
8
NEW
SUBSECTION
.
4B.
“State
board”
means
the
children’s
9
system
state
board
created
in
section
225C.51.
10
Sec.
11.
Section
331.390,
subsection
2,
Code
2019,
is
11
amended
by
striking
the
subsection
and
inserting
in
lieu
12
thereof
the
following:
13
2.
The
governing
board
shall
comply
with
all
of
the
14
following
requirements:
15
a.
The
voting
membership
of
the
governing
board
shall
16
consist
of
at
least
one
board
of
supervisors
member
from
each
17
county
comprising
the
region
or
their
designees.
18
b.
The
membership
of
the
governing
board
shall
also
include
19
one
adult
person
who
utilizes
mental
health
and
disability
20
services
or
is
an
actively
involved
relative
of
such
an
adult
21
person.
This
member
shall
be
designated
by
the
regional
22
advisory
committee
formed
by
the
governing
board
pursuant
to
23
paragraph
“h”
.
24
c.
The
membership
of
the
governing
board
shall
not
include
25
employees
of
the
department
of
human
services
or
an
unelected
26
employee
of
a
county.
27
d.
The
membership
of
the
governing
board
shall
also
consist
28
of
one
member
representing
adult
service
providers
in
the
29
region.
This
member
shall
be
designated
by
the
regional
30
advisory
committee
formed
by
the
governing
board
pursuant
to
31
paragraph
“h”
.
The
member
designated
in
accordance
with
this
32
paragraph
shall
serve
in
a
nonvoting,
ex
officio
capacity.
33
e.
The
membership
of
the
governing
board
shall
also
34
consist
of
one
member
representing
children’s
behavioral
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health
services
providers
in
the
region.
This
member
shall
be
1
designated
by
the
regional
children’s
advisory
committee
formed
2
by
the
governing
board
pursuant
to
paragraph
“i”
.
The
member
3
designated
in
accordance
with
this
paragraph
shall
serve
in
a
4
nonvoting,
ex
officio
capacity.
5
f.
The
membership
of
the
governing
board
shall
also
consist
6
of
one
member
representing
area
education
agency
administrators
7
in
the
region.
This
member
shall
be
designated
by
the
regional
8
children’s
advisory
committee
formed
by
the
governing
board
9
pursuant
to
paragraph
“i”
.
10
g.
The
membership
of
the
governing
board
shall
also
11
consist
of
one
member
who
is
a
parent
of
a
child
who
utilizes
12
children’s
behavioral
health
services
or
actively
involved
13
relatives
of
such
children.
This
member
shall
be
designated
14
by
the
regional
children’s
advisory
committee
formed
by
the
15
governing
board
pursuant
to
paragraph
“i”
.
16
h.
The
governing
board
shall
have
a
regional
advisory
17
committee
consisting
of
adults
who
utilize
services
or
actively
18
involved
relatives
of
such
adults,
service
providers,
and
19
regional
governing
board
members.
20
i.
The
governing
board
shall
have
a
regional
children’s
21
advisory
committee
consisting
of
parents
of
children
who
22
utilize
services
or
actively
involved
relatives
of
such
23
children,
an
area
education
agency
administrator,
an
early
24
childhood
advocate,
a
child
welfare
advocate,
a
children’s
25
behavioral
health
service
provider,
a
member
of
the
juvenile
26
court,
a
pediatrician,
a
child
care
provider,
a
local
law
27
enforcement
representative,
and
regional
governing
board
28
members.
29
Sec.
12.
Section
331.390,
subsection
3,
paragraph
b,
Code
30
2019,
is
amended
to
read
as
follows:
31
b.
The
regional
administrator
staff
shall
include
one
or
32
more
coordinators
of
mental
health
and
disability
services
33
and
one
or
more
coordinators
of
children’s
behavioral
34
health
services
.
A
coordinator
shall
possess
a
bachelor’s
35
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_____
H.F.
_____
or
higher
level
degree
in
a
human
services-related
or
1
administration-related
field,
including
but
not
limited
2
to
social
work,
psychology,
nursing,
or
public
or
business
3
administration,
from
an
accredited
college
or
university.
4
However,
in
lieu
of
a
degree
in
public
or
business
5
administration,
a
coordinator
may
provide
documentation
of
6
relevant
management
experience.
An
action
of
a
coordinator
7
involving
a
clinical
decision
shall
be
made
in
conjunction
with
8
a
professional
who
is
trained
in
the
delivery
of
the
mental
9
health
or
disability
service
or
children’s
behavioral
health
10
service
addressed
by
the
clinical
decision.
The
regional
11
administrator
shall
determine
whether
referral
to
a
coordinator
12
of
mental
health
and
disability
services
or
children’s
13
behavioral
health
services
is
required
for
a
person
or
child
14
seeking
to
access
a
service
through
a
local
access
point
of
the
15
regional
service
system
or
the
children’s
behavioral
health
16
system
.
17
Sec.
13.
Section
331.393,
subsection
2,
Code
2019,
is
18
amended
by
adding
the
following
new
paragraphs:
19
NEW
PARAGRAPH
.
i.
The
scope
of
children’s
behavioral
health
20
core
services.
Each
service
included
shall
be
described
and
a
21
projection
of
need
shall
be
included.
22
NEW
PARAGRAPH
.
j.
The
eligibility
requirements
for
23
children’s
behavioral
health
core
services
under
the
children’s
24
behavioral
health
system.
25
Sec.
14.
Section
331.393,
subsection
4,
paragraph
g,
26
subparagraph
(1),
Code
2019,
is
amended
to
read
as
follows:
27
(1)
Performance
and
outcome
measures
relating
to
the
28
health,
safety,
education,
work
performance,
and
community
29
residency
of
the
persons
receiving
the
services.
30
Sec.
15.
Section
331.396,
subsection
1,
paragraph
b,
Code
31
2019,
is
amended
to
read
as
follows:
32
b.
The
person
is
at
least
eighteen
years
of
age
and
is
a
33
resident
of
this
state.
However,
a
person
who
is
seventeen
34
years
of
age,
is
a
resident
of
this
state,
and
is
receiving
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H.F.
_____
publicly
funded
children’s
services
may
be
considered
eligible
1
for
services
through
the
regional
service
system
during
the
2
three-month
period
preceding
the
person’s
eighteenth
birthday
3
in
order
to
provide
a
smooth
transition
from
children’s
to
4
adult
services.
5
Sec.
16.
Section
331.396,
subsection
1,
paragraph
d,
Code
6
2019,
is
amended
by
striking
the
paragraph.
7
Sec.
17.
NEW
SECTION
.
331.396A
Eligibility
requirements
——
8
children’s
behavioral
health
services.
9
1.
A
child
shall
be
eligible
for
behavioral
health
services
10
under
the
children’s
behavioral
health
system
if
all
of
the
11
following
conditions
are
met:
12
a.
The
child
is
under
eighteen
years
of
age
and
is
a
13
resident
of
this
state.
14
b.
The
child
has
been
diagnosed
with
a
serious
emotional
15
disturbance.
16
c.
(1)
The
child’s
family
has
a
family
income
equal
to
or
17
less
than
five
hundred
percent
of
the
federal
poverty
level
as
18
defined
by
the
most
recently
revised
poverty
income
guidelines
19
published
by
the
United
States
department
of
health
and
human
20
services.
21
(2)
Notwithstanding
subparagraph
(1),
a
child’s
family
22
whose
household
income
is
between
one
hundred
fifty
percent
23
but
not
more
than
five
hundred
percent
of
the
federal
poverty
24
level
shall
be
eligible
for
behavioral
health
services
subject
25
to
a
copayment,
a
single
statewide
sliding
fee
scale,
or
other
26
cost-sharing
requirements
approved
by
the
department.
27
Sec.
18.
NEW
SECTION
.
331.397A
Children’s
behavioral
health
28
core
services.
29
1.
For
the
purposes
of
this
section,
unless
the
context
30
otherwise
requires,
“domain”
means
a
set
of
similar
behavioral
31
health
services
that
can
be
provided
depending
on
a
child’s
32
service
needs.
33
2.
a.
(1)
A
region
shall
work
with
children’s
behavioral
34
health
service
providers
to
ensure
that
services
in
the
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required
behavioral
health
core
service
domains
in
subsection
1
4
are
available
to
children
who
are
residents
of
the
region,
2
regardless
of
any
potential
payment
source
for
the
services.
3
(2)
Subject
to
the
available
appropriations,
the
director
4
of
human
services
shall
ensure
the
behavioral
health
core
5
service
domains
listed
in
subsection
4
are
covered
services
6
for
the
medical
assistance
program
under
chapter
249A
to
the
7
greatest
extent
allowable
under
federal
regulations.
The
8
medical
assistance
program
shall
reimburse
Medicaid
enrolled
9
providers
for
Medicaid
covered
services
under
subsection
4
when
10
the
services
are
medically
necessary,
the
Medicaid
enrolled
11
provider
submits
an
appropriate
claim
for
such
services,
and
12
no
other
third-party
payor
is
responsible
for
reimbursement
13
of
such
services.
Within
the
funds
available,
the
region
14
shall
pay
for
such
services
for
eligible
children
when
payment
15
through
the
medical
assistance
program
or
another
third-party
16
payment
is
not
available,
unless
the
child
is
on
a
waiting
list
17
for
such
payment
or
it
has
been
determined
that
the
child
does
18
not
meet
the
eligibility
criteria
for
any
such
service.
19
b.
Until
funding
is
designed
for
other
service
populations,
20
eligibility
for
the
service
domains
listed
in
this
section
21
shall
be
limited
to
such
children
who
are
in
need
of
behavioral
22
health
services.
23
3.
Pursuant
to
recommendations
made
by
the
state
board,
the
24
department
of
human
services
shall
adopt
rules
to
define
the
25
services
included
in
the
core
domains
listed
in
this
section.
26
The
rules
shall
provide
service
definitions,
service
provider
27
standards,
service
access
standards,
and
service
implementation
28
dates,
and
shall
provide
consistency,
to
the
extent
possible,
29
with
similar
service
definitions
under
the
medical
assistance
30
program.
31
4.
The
children’s
behavioral
health
core
service
domains
32
shall
include
all
of
the
following:
33
a.
Treatment
designed
to
ameliorate
a
child’s
serious
34
emotional
disturbance,
including
but
not
limited
to
all
of
the
35
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following:
1
(1)
Prevention,
early
identification,
early
intervention,
2
and
education.
3
(2)
Assessment
and
evaluation
relating
to
eligibility
for
4
services.
5
(3)
Medication
prescribing
and
management.
6
(4)
Behavioral
health
outpatient
therapy.
7
b.
Comprehensive
facility
and
community-based
crisis
8
services,
including
all
of
the
following:
9
(1)
Mobile
response.
10
(2)
Crisis
stabilization
community-based
services.
11
(3)
Crisis
stabilization
residential
services.
12
(4)
Behavioral
health
inpatient
treatment.
13
5.
A
region
shall
ensure
that
services
within
the
following
14
additional
core
service
domains
are
available
to
children
not
15
eligible
for
the
medical
assistance
program
under
chapter
249A
16
or
receiving
other
third-party
payment
for
the
services,
when
17
public
funds
are
made
available
for
such
services:
18
a.
Treatment
designed
to
ameliorate
a
child’s
serious
19
emotional
disturbance
including
but
not
limited
to
behavioral
20
health
school-based
therapy.
21
b.
Support
for
community
living
including
but
not
limited
22
to
all
of
the
following:
23
(1)
Family
support.
24
(2)
Peer
support.
25
(3)
Therapeutic
foster
care.
26
(4)
Respite
care.
27
c.
Transition
services
for
children
to
the
adult
mental
28
health
system
providing
an
appropriate
match
with
a
child’s
29
abilities
based
upon
informed,
person-centered
choices
made
30
from
an
array
of
options
including
but
not
limited
to
all
of
31
the
following:
32
(1)
Day
habilitation.
33
(2)
Job
development.
34
(3)
Supported
employment.
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(4)
Prevocational
services.
1
(5)
Educational
services.
2
d.
Service
coordination
including
physical
health
and
3
primary
care
that
follow
the
principles
of
the
system
of
care
4
including
but
not
limited
to
all
of
the
following:
5
(1)
Care
coordination.
6
(2)
Health
homes.
7
Sec.
19.
MENTAL
HEALTH
AND
DISABILITY
SERVICES
REGION
8
——
CHILDREN’S
BEHAVIORAL
HEALTH
SERVICES
IMPLEMENTATION
9
PLAN.
Each
mental
health
and
disability
services
region
shall
10
submit
to
the
department
of
human
services
an
implementation
11
plan
to
implement
children’s
behavioral
health
services
12
described
under
section
331.397A,
as
enacted
in
this
Act,
no
13
later
than
April
1,
2020.
14
Sec.
20.
DEPARTMENT
OF
HUMAN
SERVICES
——
RULES.
The
15
department
of
human
services
shall
adopt
rules
pursuant
to
16
chapter
17A
to
administer
this
Act.
17
Sec.
21.
REPEAL.
Sections
225C.51,
225C.52,
225C.53,
and
18
225C.54,
Code
2019,
are
repealed.
19
Sec.
22.
CODE
EDITOR’S
DIRECTIVES.
The
Code
editor
may
20
change
the
current
subchapter
title
of
chapter
225C,
subchapter
21
VI,
to
“CHILDREN’S
BEHAVIORAL
HEALTH
SYSTEM”.
22
The
Code
editor
may
change
the
current
subchapter
title
of
23
chapter
331,
part
6,
to
“MENTAL
HEALTH
AND
DISABILITY
SERVICES
24
——
REGIONAL
SERVICE
SYSTEM
——
CHILDREN’S
BEHAVIORAL
HEALTH
25
SYSTEM”.
26
EXPLANATION
27
The
inclusion
of
this
explanation
does
not
constitute
agreement
with
28
the
explanation’s
substance
by
the
members
of
the
general
assembly.
29
This
bill
relates
to
mental
health
and
disability
services
30
including
the
establishment
of
a
children’s
behavioral
health
31
system
and
a
children’s
behavioral
health
system
state
board,
32
and
requiring
certain
children’s
behavioral
health
core
33
services.
34
DEFINITIONS.
The
bill
provides
definitions
for
the
35
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children’s
behavioral
health
system.
“Child”
or
“children”
1
is
defined
as
a
person
or
persons
under
18
years
of
age.
2
“Children’s
behavioral
health
services”
is
defined
as
services
3
for
children
with
a
“serious
emotional
disturbance”
defined
4
as
a
diagnosable
mental,
behavioral,
or
emotional
disorder
5
of
sufficient
duration
to
meet
diagnostic
criteria
specified
6
within
the
most
current
diagnostic
and
statistical
manual
7
of
mental
disorders
published
by
the
American
psychiatric
8
association
that
results
in
a
functional
impairment,
but
9
does
not
include
substance
use
and
developmental
disorders
10
unless
such
disorders
co-occur
with
such
a
diagnosable
mental,
11
behavioral,
or
emotional
disorder.
“Children’s
system”
12
or
“children’s
behavioral
health
system”
is
defined
as
the
13
behavioral
health
services
system
for
children
created
in
the
14
bill.
15
CHILDREN’S
BEHAVIORAL
HEALTH
SYSTEM
STATE
BOARD.
The
bill
16
establishes
a
children’s
behavioral
health
system
state
board
17
(state
board)
as
the
state
body
to
provide
guidance
on
the
18
implementation
and
management
of
the
children’s
behavioral
19
health
system
and
for
the
provision
of
services
to
children
20
with
a
serious
emotional
disturbance.
21
The
bill
specifies
the
membership
of
the
board
and
provides
22
that
the
state
board’s
public
voting
members
shall
be
appointed
23
to
four-year
staggered
terms
by
the
governor
and
are
subject
24
to
confirmation
by
the
senate.
All
other
state
board
voting
25
members
shall
be
appointed
to
four-year
terms
and
are
not
26
subject
to
senate
confirmation.
A
member
shall
not
be
27
appointed
for
more
than
two
consecutive
four-year
terms.
State
28
board
members
shall
be
appointed
on
the
basis
of
interest
29
and
experience
in
the
fields
of
children’s
behavioral
health
30
to
ensure
representation
from
persons
with
life
experiences
31
and
persons
knowledgeable
about
children’s
behavioral
health
32
services.
The
state
board
shall
be
co-chaired
by
the
director
33
of
the
department
of
human
services
(DHS)
and
the
director
of
34
the
department
of
education,
or
their
designees.
In
addition
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to
the
voting
members,
the
membership
shall
include
four
1
members
of
the
general
assembly
to
serve
in
a
nonvoting,
ex
2
officio
capacity
on
the
board.
3
The
bill
requires
the
DHS
to
provide
support
to
the
state
4
board
and
the
state
board
may
utilize
staff
support
and
other
5
assistance
provided
to
the
state
board
by
other
persons.
The
6
state
board
is
required
to
meet
a
minimum
of
four
times
per
7
year.
8
The
state
board
is
required
to
advise
the
administrator
9
of
the
division
of
mental
health
and
disability
services
of
10
DHS
on
the
administration
of
the
children’s
behavioral
health
11
system,
provide
consultation
services
to
agencies
regarding
12
the
development
of
administrative
rules
for
the
children’s
13
behavioral
health
system,
identify
behavioral
health
outcomes
14
and
indicators
for
eligible
children
with
a
serious
emotional
15
disturbance
to
promote
children
living
with
their
own
families
16
and
in
the
community;
and
submit
a
written
report
on
or
17
before
December
1
of
each
year
to
the
governor
and
the
general
18
assembly.
19
ELIGIBILITY
REQUIREMENTS
——
CHILDREN’S
BEHAVIORAL
HEALTH
20
SERVICES.
Under
current
law,
a
person
who
is
17
years
of
21
age,
is
a
resident
of
Iowa,
and
is
receiving
publicly
funded
22
children’s
mental
health
services
may
be
considered
eligible
23
for
mental
health
services
through
the
adult
mental
health
24
and
disability
services
regional
service
system
during
the
25
three-month
period
preceding
the
person’s
18th
birthday
in
26
order
to
provide
a
smooth
transition
from
children’s
services
27
to
adult
services.
The
bill
strikes
this
provision
and
28
provides
that
a
child
shall
be
eligible
for
behavioral
health
29
services
under
the
children’s
behavioral
health
system
if
the
30
child
is
under
18
years
of
age,
a
resident
of
Iowa,
has
been
31
diagnosed
with
a
serious
emotional
disturbance,
and
the
child’s
32
family
has
a
household
income
equal
to
or
less
than
500
percent
33
of
the
federal
poverty
level,
except
that
a
child’s
family
34
whose
household
income
is
between
150
percent
but
not
more
than
35
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_____
H.F.
_____
500
percent
of
the
federal
poverty
level
shall
be
eligible
for
1
behavioral
health
services
subject
to
a
copayment,
a
single
2
statewide
sliding
fee
scale,
or
other
cost-sharing
requirements
3
approved
by
DHS.
The
bill
does
not
apply
to
intellectual
4
disability
services
or
brain
injury
services
for
children
under
5
the
children’s
behavioral
health
system.
6
CHILDREN’S
BEHAVIORAL
HEALTH
SYSTEM
——
CORE
SERVICES.
The
7
bill
provides
that,
subject
to
available
appropriations,
the
8
director
of
DHS
shall
ensure
that
the
children’s
behavioral
9
health
core
service
domains,
as
specified
in
the
bill,
are
10
covered
services
for
the
medical
assistance
program
under
Code
11
chapter
249A
to
the
greatest
extent
allowable
under
federal
12
regulations.
The
bill
provides
the
medical
assistance
program
13
shall
reimburse
Medicaid
enrolled
providers
for
Medicaid
14
covered
services
when
the
services
are
medically
necessary,
the
15
Medicaid
enrolled
provider
submits
an
appropriate
claim
for
16
such
services,
and
no
other
third-party
payor
is
responsible
17
for
reimbursement
of
such
services.
Within
the
funds
18
available,
each
mental
health
and
disability
services
region
19
is
required
to
pay
for
such
services
for
eligible
children
20
when
payment
through
the
medical
assistance
program
or
another
21
third-party
payment
is
not
available,
unless
a
child
is
on
a
22
waiting
list
for
such
payment
or
it
has
been
determined
that
23
the
child
does
not
meet
the
eligibility
criteria
for
any
such
24
service.
25
The
bill
provides
that
until
funding
is
designed
for
other
26
service
populations,
eligibility
for
the
core
services
shall
be
27
limited
to
such
children
who
are
in
need
of
behavioral
health
28
services.
29
The
bill
requires
DHS
to
adopt
rules
pursuant
to
30
recommendations
made
by
the
state
board
to
define
the
services
31
included
in
the
core
domains.
The
rules
shall
provide
service
32
definitions,
service
provider
standards,
service
access
33
standards,
and
service
implementation
dates,
and
shall
also
34
provide
consistency,
to
the
extent
possible,
with
similar
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service
definitions
under
the
medical
assistance
program.
1
The
bill
requires
each
mental
health
and
disability
2
services
region
to
submit
to
DHS
plans
to
implement
children’s
3
behavioral
health
services
no
later
than
April
1,
2020.
4
MENTAL
HEALTH
AND
DISABILITY
SERVICES
——
ADMINISTRATOR’S
5
DUTIES.
The
bill
requires
the
administrator
of
the
division
6
of
mental
health
and
disability
services
of
DHS
to
assist
7
the
state
board
in
planning
for
community-based
children’s
8
behavioral
health
services
and
to
encourage
and
facilitate
9
coordination
of
children’s
behavioral
health
services
with
10
the
objective
of
developing
and
maintaining
in
the
state
a
11
children’s
behavioral
health
system
to
provide
behavioral
12
health
services
to
all
children
in
this
state
who
need
the
13
services,
regardless
of
the
place
of
residence
or
economic
14
circumstances
of
those
children.
The
administrator
shall
work
15
with
the
state
board
and
other
state
agencies,
including
but
16
not
limited
to
the
departments
of
education
and
public
health,
17
to
develop
and
implement
a
strategic
plan
to
expand
access
to
18
qualified
mental
health
workers
across
the
state.
19
The
bill
requires
the
administrator
to
establish
and
20
maintain
a
data
collection
and
management
information
system
21
oriented
to
the
needs
of
children
utilizing
the
children’s
22
behavioral
health
system,
providers,
DHS,
and
other
programs
or
23
facilities
in
accordance
with
the
disability
services
system
24
data
repository
established
in
Code
section
225C.6A.
The
25
system
shall
be
used
to
identify,
collect,
and
analyze
service
26
outcome
and
performance
measures
data
in
order
to
assess
the
27
effects
of
the
services
on
the
children
utilizing
the
services.
28
The
administrator
shall
annually
submit
to
the
state
board
29
information
collected
by
DHS
indicating
the
changes
and
trends
30
in
the
children’s
behavioral
health
system.
The
administrator
31
shall
make
the
outcome
data
available
to
the
public.
32
Current
law
requires
the
administrator
to
enter
into
33
performance-based
contracts
with
mental
health
and
disability
34
services
regional
administrators
which
may
include
requirements
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for
the
regional
service
system
to
attain
outcomes
within
1
a
specified
range
of
acceptable
performance
in
certain
2
categories.
The
bill
expands
the
categories
to
include
a
3
school
attendance
category.
4
STATE
AND
REGIONAL
DISABILITY
SERVICE
SYSTEMS.
Current
law
5
provides
that
the
publicly
financed
disability
services
for
6
persons
with
mental
illness,
intellectual
disability
or
other
7
developmental
disability,
or
brain
injury
in
Iowa
shall
be
8
provided
by
DHS
and
the
counties
operating
together
as
regions
9
and
provides
for
financial
and
administrative
responsibility
10
for
such
services.
The
bill
provides
that
children’s
11
behavioral
health
services
provided
to
eligible
children
that
12
are
not
covered
under
the
medical
assistance
program
or
other
13
third-party
payor
are
the
responsibility
of
the
mental
health
14
and
disabilities
regional
service
system.
15
MENTAL
HEALTH
AND
DISABILITY
SERVICES
REGIONS.
The
bill
16
makes
changes
to
the
mental
health
and
disability
services
17
regional
governing
board
(governing
board).
The
governing
18
board
membership
shall
consist
of
at
least
one
board
of
19
supervisors
member
from
each
county
comprising
the
region
20
who
shall
be
a
voting
member;
one
adult
person
who
utilizes
21
mental
health
and
disability
services
or
is
an
actively
22
involved
relative
of
such
an
adult
person
designated
by
the
23
regional
advisory
committee
formed
by
the
governing
board;
24
one
member
representing
adult
service
providers
in
the
region
25
designated
by
the
regional
advisory
committee
formed
by
the
26
governing
board,
who
shall
serve
in
a
nonvoting,
ex
officio
27
capacity;
one
member
representing
children’s
behavioral
health
28
service
providers
in
the
region
designated
by
the
regional
29
children’s
advisory
committee
formed
by
the
governing
board,
30
who
shall
serve
in
a
nonvoting,
ex
officio
capacity;
one
member
31
representing
area
education
agency
administrators
in
the
region
32
designated
by
the
regional
children’s
advisory
committee
formed
33
by
the
governing
board;
and
one
member
who
is
a
parent
of
a
34
child
who
utilizes
children’s
behavioral
health
services
or
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actively
involved
relatives
of
such
children
designated
by
the
1
regional
children’s
advisory
committee.
The
membership
of
2
the
governing
board
shall
not
include
employees
of
DHS
or
an
3
unelected
employee
of
a
county.
4
The
bill
adds
to
the
regional
administrator
staff
one
or
more
5
coordinators
of
children’s
behavioral
health
services.
6
The
bill
requires
a
mental
health
and
disability
region
to
7
include
provisions
relating
to
eligibility
requirements
for
8
children’s
behavioral
health
core
services
under
the
children’s
9
behavioral
health
system
and
performance
and
outcome
measures
10
relating
to
education
in
a
region’s
annual
service
and
budget
11
plan.
12
The
bill
makes
technical
changes
to
Code
section
225C.2(9)
13
by
striking
the
term
“person
with
a
disability”
as
that
term
14
is
not
used
in
Code
chapter
225C
(mental
health
and
disability
15
services)
and
to
Code
section
225C.4
to
include
mental
health
16
services
in
references
to
disability
services
in
that
Code
17
section.
18
The
bill
repeals
2019
Code
sections
225C.51,
225C.52,
19
225C.53,
and
225C.54.
The
bill
replaces
2019
Code
sections
20
225C.51
and
225C.52
with
new
content
in
the
bill.
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