Bill Text: IA HF690 | 2019-2020 | 88th General Assembly | Introduced
NOTE: There are more recent revisions of this legislation. Read Latest Draft
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. (Formerly HSB 206.) Effective 7-1-19.
Spectrum: Committee Bill
Status: (Passed) 2019-05-01 - Signed by Governor. H.J. 1083. [HF690 Detail]
Download: Iowa-2019-HF690-Introduced.html
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. (Formerly HSB 206.) Effective 7-1-19.
Spectrum: Committee Bill
Status: (Passed) 2019-05-01 - Signed by Governor. H.J. 1083. [HF690 Detail]
Download: Iowa-2019-HF690-Introduced.html
House
File
690
-
Introduced
HOUSE
FILE
690
BY
COMMITTEE
ON
HUMAN
RESOURCES
(SUCCESSOR
TO
HSB
206)
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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690
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
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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
currently
utilizing
or
who
has
utilized
behavioral
health
32
services.
33
n.
One
member
shall
be
a
sheriff.
34
o.
One
member
shall
be
a
pediatrician.
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One
member
shall
be
a
representative
from
the
health
care
1
system.
2
q.
One
member
shall
be
a
chief
executive
officer
of
a
mental
3
health
and
disability
services
region.
4
r.
In
addition
to
the
voting
members,
the
membership
shall
5
include
four
members
of
the
general
assembly
with
one
member
6
designated
by
each
of
the
following:
the
majority
leader
of
7
the
senate,
the
minority
leader
of
the
senate,
the
speaker
of
8
the
house
of
representatives,
and
the
minority
leader
of
the
9
house
of
representatives.
A
legislative
member
serves
for
a
10
term
as
provided
in
section
69.16B
in
a
nonvoting,
ex
officio
11
capacity
and
is
not
eligible
for
per
diem
and
expenses
as
12
provided
in
section
2.10.
13
2.
The
four-year
terms
shall
begin
and
end
as
provided
in
14
section
69.19.
Vacancies
on
the
state
board
shall
be
filled
as
15
provided
in
section
2.32.
A
member
shall
not
be
appointed
for
16
more
than
two
consecutive
four-year
terms.
17
3.
The
director
and
the
director
of
the
department
of
18
education,
or
their
designees,
shall
serve
as
co-chairpersons
19
of
the
state
board.
Board
members
shall
not
be
entitled
to
a
20
per
diem
as
specified
in
section
7E.6
and
shall
not
be
entitled
21
to
actual
and
necessary
expenses
incurred
while
engaged
in
22
their
official
duties.
23
Sec.
9.
NEW
SECTION
.
225C.52
Children’s
behavioral
health
24
system
state
board
——
duties.
25
1.
To
the
extent
funding
is
available,
the
state
board
shall
26
perform
the
following
duties:
27
a.
Advise
the
administrator
on
the
administration
of
the
28
children’s
behavioral
health
system.
29
b.
Provide
consultation
services
to
agencies
regarding
30
the
development
of
administrative
rules
for
the
children’s
31
behavioral
health
system.
32
c.
Identify
behavioral
health
outcomes
and
indicators
for
33
eligible
children
with
a
serious
emotional
disturbance
to
34
promote
children
living
with
their
own
families
and
in
the
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community.
1
d.
Submit
a
written
report
on
or
before
December
1
of
each
2
year
to
the
governor
and
the
general
assembly.
At
a
minimum,
3
the
report
shall
include
a
summary
of
all
activities
undertaken
4
by
the
state
board,
a
summary
of
state
board
activities,
5
and
results
from
identified
behavioral
health
outcomes
and
6
indicators
for
the
children’s
behavioral
health
system.
7
Sec.
10.
Section
331.388,
Code
2019,
is
amended
by
adding
8
the
following
new
subsections:
9
NEW
SUBSECTION
.
01.
“Children’s
behavioral
health
services”
10
means
the
same
as
defined
in
section
225C.2.
11
NEW
SUBSECTION
.
4A.
“Serious
emotional
disturbance”
means
12
the
same
as
defined
in
section
225C.2.
13
NEW
SUBSECTION
.
4B.
“State
board”
means
the
children’s
14
system
state
board
created
in
section
225C.51.
15
Sec.
11.
Section
331.390,
subsection
2,
Code
2019,
is
16
amended
by
striking
the
subsection
and
inserting
in
lieu
17
thereof
the
following:
18
2.
The
governing
board
shall
comply
with
all
of
the
19
following
requirements:
20
a.
The
voting
membership
of
the
governing
board
shall
21
consist
of
at
least
one
board
of
supervisors
member
from
each
22
county
comprising
the
region
or
their
designees.
23
b.
The
membership
of
the
governing
board
shall
also
include
24
one
adult
person
who
utilizes
mental
health
and
disability
25
services
or
is
an
actively
involved
relative
of
such
an
adult
26
person.
This
member
shall
be
designated
by
the
regional
27
advisory
committee
formed
by
the
governing
board
pursuant
to
28
paragraph
“h”
.
29
c.
The
membership
of
the
governing
board
shall
not
include
30
employees
of
the
department
of
human
services
or
an
unelected
31
employee
of
a
county.
32
d.
The
membership
of
the
governing
board
shall
also
consist
33
of
one
member
representing
adult
service
providers
in
the
34
region.
This
member
shall
be
designated
by
the
regional
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advisory
committee
formed
by
the
governing
board
pursuant
to
1
paragraph
“h”
.
The
member
designated
in
accordance
with
this
2
paragraph
shall
serve
in
a
nonvoting,
ex
officio
capacity.
3
e.
The
membership
of
the
governing
board
shall
also
4
consist
of
one
member
representing
children’s
behavioral
5
health
services
providers
in
the
region.
This
member
shall
be
6
designated
by
the
regional
children’s
advisory
committee
formed
7
by
the
governing
board
pursuant
to
paragraph
“i”
.
The
member
8
designated
in
accordance
with
this
paragraph
shall
serve
in
a
9
nonvoting,
ex
officio
capacity.
10
f.
The
membership
of
the
governing
board
shall
also
consist
11
of
one
member
representing
area
education
agency
administrators
12
in
the
region.
This
member
shall
be
designated
by
the
regional
13
children’s
advisory
committee
formed
by
the
governing
board
14
pursuant
to
paragraph
“i”
.
15
g.
The
membership
of
the
governing
board
shall
also
16
consist
of
one
member
who
is
a
parent
of
a
child
who
utilizes
17
children’s
behavioral
health
services
or
actively
involved
18
relatives
of
such
children.
This
member
shall
be
designated
19
by
the
regional
children’s
advisory
committee
formed
by
the
20
governing
board
pursuant
to
paragraph
“i”
.
21
h.
The
governing
board
shall
have
a
regional
advisory
22
committee
consisting
of
adults
who
utilize
services
or
actively
23
involved
relatives
of
such
adults,
service
providers,
and
24
regional
governing
board
members.
25
i.
The
governing
board
shall
have
a
regional
children’s
26
advisory
committee
consisting
of
parents
of
children
who
27
utilize
services
or
actively
involved
relatives
of
such
28
children,
an
area
education
agency
administrator,
an
early
29
childhood
advocate,
a
child
welfare
advocate,
a
children’s
30
behavioral
health
service
provider,
a
member
of
the
juvenile
31
court,
a
pediatrician,
a
child
care
provider,
a
local
law
32
enforcement
representative,
and
regional
governing
board
33
members.
34
Sec.
12.
Section
331.390,
subsection
3,
paragraph
b,
Code
35
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is
amended
to
read
as
follows:
1
b.
The
regional
administrator
staff
shall
include
one
or
2
more
coordinators
of
mental
health
and
disability
services
3
and
one
or
more
coordinators
of
children’s
behavioral
4
health
services
.
A
coordinator
shall
possess
a
bachelor’s
5
or
higher
level
degree
in
a
human
services-related
or
6
administration-related
field,
including
but
not
limited
7
to
social
work,
psychology,
nursing,
or
public
or
business
8
administration,
from
an
accredited
college
or
university.
9
However,
in
lieu
of
a
degree
in
public
or
business
10
administration,
a
coordinator
may
provide
documentation
of
11
relevant
management
experience.
An
action
of
a
coordinator
12
involving
a
clinical
decision
shall
be
made
in
conjunction
with
13
a
professional
who
is
trained
in
the
delivery
of
the
mental
14
health
or
disability
service
or
children’s
behavioral
health
15
service
addressed
by
the
clinical
decision.
The
regional
16
administrator
shall
determine
whether
referral
to
a
coordinator
17
of
mental
health
and
disability
services
or
children’s
18
behavioral
health
services
is
required
for
a
person
or
child
19
seeking
to
access
a
service
through
a
local
access
point
of
the
20
regional
service
system
or
the
children’s
behavioral
health
21
system
.
22
Sec.
13.
Section
331.393,
subsection
2,
Code
2019,
is
23
amended
by
adding
the
following
new
paragraphs:
24
NEW
PARAGRAPH
.
i.
The
scope
of
children’s
behavioral
health
25
core
services.
Each
service
included
shall
be
described
and
a
26
projection
of
need
shall
be
included.
27
NEW
PARAGRAPH
.
j.
The
eligibility
requirements
for
28
children’s
behavioral
health
core
services
under
the
children’s
29
behavioral
health
system.
30
Sec.
14.
Section
331.393,
subsection
4,
paragraph
g,
31
subparagraph
(1),
Code
2019,
is
amended
to
read
as
follows:
32
(1)
Performance
and
outcome
measures
relating
to
the
33
health,
safety,
education,
work
performance,
and
community
34
residency
of
the
persons
receiving
the
services.
35
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Sec.
15.
Section
331.396,
subsection
1,
paragraph
b,
Code
1
2019,
is
amended
to
read
as
follows:
2
b.
The
person
is
at
least
eighteen
years
of
age
and
is
a
3
resident
of
this
state.
However,
a
person
who
is
seventeen
4
years
of
age,
is
a
resident
of
this
state,
and
is
receiving
5
publicly
funded
children’s
services
may
be
considered
eligible
6
for
services
through
the
regional
service
system
during
the
7
three-month
period
preceding
the
person’s
eighteenth
birthday
8
in
order
to
provide
a
smooth
transition
from
children’s
to
9
adult
services.
10
Sec.
16.
Section
331.396,
subsection
1,
paragraph
d,
Code
11
2019,
is
amended
by
striking
the
paragraph.
12
Sec.
17.
NEW
SECTION
.
331.396A
Eligibility
requirements
——
13
children’s
behavioral
health
services.
14
A
child
shall
be
eligible
for
behavioral
health
services
15
under
the
children’s
behavioral
health
system
if
all
of
the
16
following
conditions
are
met:
17
1.
The
child
is
under
eighteen
years
of
age
and
is
a
18
resident
of
this
state.
19
2.
The
child
has
been
diagnosed
with
a
serious
emotional
20
disturbance.
21
3.
a.
The
child’s
family
has
a
family
income
equal
to
or
22
less
than
five
hundred
percent
of
the
federal
poverty
level
as
23
defined
by
the
most
recently
revised
poverty
income
guidelines
24
published
by
the
United
States
department
of
health
and
human
25
services.
26
b.
Notwithstanding
subparagraph
(1),
a
child’s
family
whose
27
household
income
is
between
one
hundred
fifty
percent
but
not
28
more
than
five
hundred
percent
of
the
federal
poverty
level
29
shall
be
eligible
for
behavioral
health
services
subject
to
30
a
copayment,
a
single
statewide
sliding
fee
scale,
or
other
31
cost-sharing
requirements
approved
by
the
department.
32
Sec.
18.
NEW
SECTION
.
331.397A
Children’s
behavioral
health
33
core
services.
34
1.
For
the
purposes
of
this
section,
unless
the
context
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otherwise
requires,
“domain”
means
a
set
of
similar
behavioral
1
health
services
that
can
be
provided
depending
on
a
child’s
2
service
needs.
3
2.
a.
(1)
A
region
shall
work
with
children’s
behavioral
4
health
service
providers
to
ensure
that
services
in
the
5
required
behavioral
health
core
service
domains
in
subsection
6
4
are
available
to
children
who
are
residents
of
the
region,
7
regardless
of
any
potential
payment
source
for
the
services.
8
(2)
Subject
to
the
available
appropriations,
the
director
9
of
human
services
shall
ensure
the
behavioral
health
core
10
service
domains
listed
in
subsection
4
are
covered
services
11
for
the
medical
assistance
program
under
chapter
249A
to
the
12
greatest
extent
allowable
under
federal
regulations.
The
13
medical
assistance
program
shall
reimburse
Medicaid
enrolled
14
providers
for
Medicaid
covered
services
under
subsection
4
when
15
the
services
are
medically
necessary,
the
Medicaid
enrolled
16
provider
submits
an
appropriate
claim
for
such
services,
and
17
no
other
third-party
payor
is
responsible
for
reimbursement
18
of
such
services.
Within
the
funds
available,
the
region
19
shall
pay
for
such
services
for
eligible
children
when
payment
20
through
the
medical
assistance
program
or
another
third-party
21
payment
is
not
available,
unless
the
child
is
on
a
waiting
list
22
for
such
payment
or
it
has
been
determined
that
the
child
does
23
not
meet
the
eligibility
criteria
for
any
such
service.
24
b.
Until
funding
is
designed
for
other
service
populations,
25
eligibility
for
the
service
domains
listed
in
this
section
26
shall
be
limited
to
such
children
who
are
in
need
of
behavioral
27
health
services.
28
3.
Pursuant
to
recommendations
made
by
the
state
board,
the
29
department
of
human
services
shall
adopt
rules
to
define
the
30
services
included
in
the
core
domains
listed
in
this
section.
31
The
rules
shall
provide
service
definitions,
service
provider
32
standards,
service
access
standards,
and
service
implementation
33
dates,
and
shall
provide
consistency,
to
the
extent
possible,
34
with
similar
service
definitions
under
the
medical
assistance
35
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program.
1
4.
The
children’s
behavioral
health
core
service
domains
2
shall
include
all
of
the
following:
3
a.
Treatment
designed
to
ameliorate
a
child’s
serious
4
emotional
disturbance,
including
but
not
limited
to
all
of
the
5
following:
6
(1)
Prevention,
early
identification,
early
intervention,
7
and
education.
8
(2)
Assessment
and
evaluation
relating
to
eligibility
for
9
services.
10
(3)
Medication
prescribing
and
management.
11
(4)
Behavioral
health
outpatient
therapy.
12
b.
Comprehensive
facility
and
community-based
crisis
13
services
regardless
of
a
diagnosis
of
a
serious
emotional
14
disturbance,
including
all
of
the
following:
15
(1)
Mobile
response.
16
(2)
Crisis
stabilization
community-based
services.
17
(3)
Crisis
stabilization
residential
services.
18
(4)
Behavioral
health
inpatient
treatment.
19
(5)
A
statewide
twenty-four-hour
crisis
hotline.
20
5.
A
region
shall
ensure
that
services
within
the
following
21
additional
core
service
domains
are
available
to
children
not
22
eligible
for
the
medical
assistance
program
under
chapter
249A
23
or
receiving
other
third-party
payment
for
the
services,
when
24
public
funds
are
made
available
for
such
services:
25
a.
Treatment
designed
to
ameliorate
a
child’s
serious
26
emotional
disturbance
including
but
not
limited
to
behavioral
27
health
school-based
therapy.
28
b.
Support
for
community
living
including
but
not
limited
29
to
all
of
the
following:
30
(1)
Family
support.
31
(2)
Peer
support.
32
(3)
Therapeutic
foster
care.
33
(4)
Respite
care.
34
c.
Transition
services
for
children
to
the
adult
mental
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health
system
providing
an
appropriate
match
with
a
child’s
1
abilities
based
upon
informed,
person-centered
choices
made
2
from
an
array
of
options
including
but
not
limited
to
all
of
3
the
following:
4
(1)
Day
habilitation.
5
(2)
Job
development.
6
(3)
Supported
employment.
7
(4)
Prevocational
services.
8
(5)
Educational
services.
9
d.
Service
coordination
including
physical
health
and
10
primary
care
that
follow
the
principles
of
the
system
of
care
11
including
but
not
limited
to
all
of
the
following:
12
(1)
Care
coordination.
13
(2)
Health
homes.
14
Sec.
19.
MENTAL
HEALTH
AND
DISABILITY
SERVICES
REGION
15
——
CHILDREN’S
BEHAVIORAL
HEALTH
SERVICES
IMPLEMENTATION
16
PLAN.
Each
mental
health
and
disability
services
region
shall
17
submit
to
the
department
of
human
services
an
implementation
18
plan
to
implement
children’s
behavioral
health
services
19
described
under
section
331.397A,
as
enacted
in
this
Act,
no
20
later
than
April
1,
2020.
21
Sec.
20.
DEPARTMENT
OF
HUMAN
SERVICES
——
RULES.
The
22
department
of
human
services
shall
submit
a
notice
of
intended
23
action
to
the
administrative
rules
coordinator
and
the
24
Iowa
administrative
code
editor
pursuant
to
section
17A.4,
25
subsection
1,
paragraph
“a”,
not
later
than
January
1,
2020,
26
for
the
adoption
of
rules
to
implement
this
Act.
27
Sec.
21.
REPEAL.
Sections
225C.51,
225C.52,
225C.53,
and
28
225C.54,
Code
2019,
are
repealed.
29
Sec.
22.
CODE
EDITOR’S
DIRECTIVES.
The
Code
editor
may
30
change
the
current
subchapter
title
of
chapter
225C,
subchapter
31
VI,
to
“CHILDREN’S
BEHAVIORAL
HEALTH
SYSTEM”.
32
The
Code
editor
may
change
the
current
subchapter
title
of
33
chapter
331,
part
6,
to
“MENTAL
HEALTH
AND
DISABILITY
SERVICES
34
——
REGIONAL
SERVICE
SYSTEM
——
CHILDREN’S
BEHAVIORAL
HEALTH
35
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SYSTEM”.
1
EXPLANATION
2
The
inclusion
of
this
explanation
does
not
constitute
agreement
with
3
the
explanation’s
substance
by
the
members
of
the
general
assembly.
4
This
bill
relates
to
mental
health
and
disability
services
5
including
the
establishment
of
a
children’s
behavioral
health
6
system
and
a
children’s
behavioral
health
system
state
board,
7
and
requiring
certain
children’s
behavioral
health
core
8
services.
9
DEFINITIONS.
The
bill
provides
definitions
for
the
10
children’s
behavioral
health
system.
“Child”
or
“children”
11
is
defined
as
a
person
or
persons
under
18
years
of
age.
12
“Children’s
behavioral
health
services”
is
defined
as
services
13
for
children
with
a
“serious
emotional
disturbance”
defined
14
as
a
diagnosable
mental,
behavioral,
or
emotional
disorder
15
of
sufficient
duration
to
meet
diagnostic
criteria
specified
16
within
the
most
current
diagnostic
and
statistical
manual
17
of
mental
disorders
published
by
the
American
psychiatric
18
association
that
results
in
a
functional
impairment,
but
19
does
not
include
substance
use
and
developmental
disorders
20
unless
such
disorders
co-occur
with
such
a
diagnosable
mental,
21
behavioral,
or
emotional
disorder.
“Children’s
system”
22
or
“children’s
behavioral
health
system”
is
defined
as
the
23
behavioral
health
services
system
for
children
created
in
the
24
bill.
25
CHILDREN’S
BEHAVIORAL
HEALTH
SYSTEM
STATE
BOARD.
The
bill
26
establishes
a
children’s
behavioral
health
system
state
board
27
(state
board)
as
the
state
body
to
provide
guidance
on
the
28
implementation
and
management
of
the
children’s
behavioral
29
health
system
and
for
the
provision
of
services
to
children
30
with
a
serious
emotional
disturbance.
31
The
bill
specifies
the
membership
of
the
board
and
provides
32
that
the
state
board’s
public
voting
members
shall
be
appointed
33
to
four-year
staggered
terms
by
the
governor
and
are
subject
34
to
confirmation
by
the
senate.
All
other
state
board
voting
35
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members
shall
be
appointed
to
four-year
terms
and
are
not
1
subject
to
senate
confirmation.
A
member
shall
not
be
2
appointed
for
more
than
two
consecutive
four-year
terms.
State
3
board
members
shall
be
appointed
on
the
basis
of
interest
4
and
experience
in
the
fields
of
children’s
behavioral
health
5
to
ensure
representation
from
persons
with
life
experiences
6
and
persons
knowledgeable
about
children’s
behavioral
health
7
services.
The
state
board
shall
be
co-chaired
by
the
director
8
of
the
department
of
human
services
(DHS)
and
the
director
of
9
the
department
of
education,
or
their
designees.
In
addition
10
to
the
voting
members,
the
membership
shall
include
four
11
members
of
the
general
assembly
to
serve
in
a
nonvoting,
ex
12
officio
capacity
on
the
board.
13
The
bill
requires
the
DHS
to
provide
support
to
the
state
14
board
and
the
state
board
may
utilize
staff
support
and
other
15
assistance
provided
to
the
state
board
by
other
persons.
The
16
state
board
is
required
to
meet
a
minimum
of
four
times
per
17
year.
18
The
state
board
is
required
to
advise
the
administrator
19
of
the
division
of
mental
health
and
disability
services
of
20
DHS
on
the
administration
of
the
children’s
behavioral
health
21
system,
provide
consultation
services
to
agencies
regarding
22
the
development
of
administrative
rules
for
the
children’s
23
behavioral
health
system,
identify
behavioral
health
outcomes
24
and
indicators
for
eligible
children
with
a
serious
emotional
25
disturbance
to
promote
children
living
with
their
own
families
26
and
in
the
community;
and
submit
a
written
report
on
or
27
before
December
1
of
each
year
to
the
governor
and
the
general
28
assembly.
29
ELIGIBILITY
REQUIREMENTS
——
CHILDREN’S
BEHAVIORAL
HEALTH
30
SERVICES.
Under
current
law,
a
person
who
is
17
years
of
31
age,
is
a
resident
of
Iowa,
and
is
receiving
publicly
funded
32
children’s
mental
health
services
may
be
considered
eligible
33
for
mental
health
services
through
the
adult
mental
health
34
and
disability
services
regional
service
system
during
the
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three-month
period
preceding
the
person’s
18th
birthday
in
1
order
to
provide
a
smooth
transition
from
children’s
services
2
to
adult
services.
The
bill
strikes
this
provision
and
3
provides
that
a
child
shall
be
eligible
for
behavioral
health
4
services
under
the
children’s
behavioral
health
system
if
the
5
child
is
under
18
years
of
age,
a
resident
of
Iowa,
has
been
6
diagnosed
with
a
serious
emotional
disturbance,
and
the
child’s
7
family
has
a
household
income
equal
to
or
less
than
500
percent
8
of
the
federal
poverty
level,
except
that
a
child’s
family
9
whose
household
income
is
between
150
percent
but
not
more
than
10
500
percent
of
the
federal
poverty
level
shall
be
eligible
for
11
behavioral
health
services
subject
to
a
copayment,
a
single
12
statewide
sliding
fee
scale,
or
other
cost-sharing
requirements
13
approved
by
DHS.
The
bill
does
not
apply
to
intellectual
14
disability
services
or
brain
injury
services
for
children
under
15
the
children’s
behavioral
health
system.
16
CHILDREN’S
BEHAVIORAL
HEALTH
SYSTEM
——
CORE
SERVICES.
The
17
bill
provides
that,
subject
to
available
appropriations,
the
18
director
of
DHS
shall
ensure
that
the
children’s
behavioral
19
health
core
service
domains,
as
specified
in
the
bill,
are
20
covered
services
for
the
medical
assistance
program
under
Code
21
chapter
249A
to
the
greatest
extent
allowable
under
federal
22
regulations.
The
bill
provides
the
medical
assistance
program
23
shall
reimburse
Medicaid
enrolled
providers
for
Medicaid
24
covered
services
when
the
services
are
medically
necessary,
the
25
Medicaid
enrolled
provider
submits
an
appropriate
claim
for
26
such
services,
and
no
other
third-party
payor
is
responsible
27
for
reimbursement
of
such
services.
Within
the
funds
28
available,
each
mental
health
and
disability
services
region
29
is
required
to
pay
for
such
services
for
eligible
children
30
when
payment
through
the
medical
assistance
program
or
another
31
third-party
payment
is
not
available,
unless
a
child
is
on
a
32
waiting
list
for
such
payment
or
it
has
been
determined
that
33
the
child
does
not
meet
the
eligibility
criteria
for
any
such
34
service.
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The
bill
provides
that
until
funding
is
designed
for
other
1
service
populations,
eligibility
for
the
core
services
shall
be
2
limited
to
such
children
who
are
in
need
of
behavioral
health
3
services.
4
The
bill
requires
DHS
to
adopt
rules
pursuant
to
5
recommendations
made
by
the
state
board
to
define
the
services
6
included
in
the
core
domains.
The
rules
shall
provide
service
7
definitions,
service
provider
standards,
service
access
8
standards,
and
service
implementation
dates,
and
shall
also
9
provide
consistency,
to
the
extent
possible,
with
similar
10
service
definitions
under
the
medical
assistance
program.
11
The
bill
requires
each
mental
health
and
disability
12
services
region
to
submit
to
DHS
plans
to
implement
children’s
13
behavioral
health
services
no
later
than
April
1,
2020.
14
MENTAL
HEALTH
AND
DISABILITY
SERVICES
——
ADMINISTRATOR’S
15
DUTIES.
The
bill
requires
the
administrator
of
the
division
16
of
mental
health
and
disability
services
of
DHS
to
assist
17
the
state
board
in
planning
for
community-based
children’s
18
behavioral
health
services
and
to
encourage
and
facilitate
19
coordination
of
children’s
behavioral
health
services
with
20
the
objective
of
developing
and
maintaining
in
the
state
a
21
children’s
behavioral
health
system
to
provide
behavioral
22
health
services
to
all
children
in
this
state
who
need
the
23
services,
regardless
of
the
place
of
residence
or
economic
24
circumstances
of
those
children.
The
administrator
shall
work
25
with
the
state
board
and
other
state
agencies,
including
but
26
not
limited
to
the
departments
of
education
and
public
health,
27
to
develop
and
implement
a
strategic
plan
to
expand
access
to
28
qualified
mental
health
workers
across
the
state.
29
The
bill
requires
the
administrator
to
establish
and
30
maintain
a
data
collection
and
management
information
system
31
oriented
to
the
needs
of
children
utilizing
the
children’s
32
behavioral
health
system,
providers,
DHS,
and
other
programs
or
33
facilities
in
accordance
with
the
disability
services
system
34
data
repository
established
in
Code
section
225C.6A.
The
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system
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
DHS
indicating
the
changes
and
trends
5
in
the
children’s
behavioral
health
system.
The
administrator
6
shall
make
the
outcome
data
available
to
the
public.
7
Current
law
requires
the
administrator
to
enter
into
8
performance-based
contracts
with
mental
health
and
disability
9
services
regional
administrators
which
may
include
requirements
10
for
the
regional
service
system
to
attain
outcomes
within
11
a
specified
range
of
acceptable
performance
in
certain
12
categories.
The
bill
expands
the
categories
to
include
a
13
school
attendance
category.
14
STATE
AND
REGIONAL
DISABILITY
SERVICE
SYSTEMS.
Current
law
15
provides
that
the
publicly
financed
disability
services
for
16
persons
with
mental
illness,
intellectual
disability
or
other
17
developmental
disability,
or
brain
injury
in
Iowa
shall
be
18
provided
by
DHS
and
the
counties
operating
together
as
regions
19
and
provides
for
financial
and
administrative
responsibility
20
for
such
services.
The
bill
provides
that
children’s
21
behavioral
health
services
provided
to
eligible
children
that
22
are
not
covered
under
the
medical
assistance
program
or
other
23
third-party
payor
are
the
responsibility
of
the
mental
health
24
and
disabilities
regional
service
system.
25
MENTAL
HEALTH
AND
DISABILITY
SERVICES
REGIONS.
The
bill
26
makes
changes
to
the
mental
health
and
disability
services
27
regional
governing
board
(governing
board).
The
governing
28
board
membership
shall
consist
of
at
least
one
board
of
29
supervisors
member
from
each
county
comprising
the
region
30
who
shall
be
a
voting
member;
one
adult
person
who
utilizes
31
mental
health
and
disability
services
or
is
an
actively
32
involved
relative
of
such
an
adult
person
designated
by
the
33
regional
advisory
committee
formed
by
the
governing
board;
34
one
member
representing
adult
service
providers
in
the
region
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designated
by
the
regional
advisory
committee
formed
by
the
1
governing
board,
who
shall
serve
in
a
nonvoting,
ex
officio
2
capacity;
one
member
representing
children’s
behavioral
health
3
service
providers
in
the
region
designated
by
the
regional
4
children’s
advisory
committee
formed
by
the
governing
board,
5
who
shall
serve
in
a
nonvoting,
ex
officio
capacity;
one
member
6
representing
area
education
agency
administrators
in
the
region
7
designated
by
the
regional
children’s
advisory
committee
formed
8
by
the
governing
board;
and
one
member
who
is
a
parent
of
a
9
child
who
utilizes
children’s
behavioral
health
services
or
10
actively
involved
relatives
of
such
children
designated
by
the
11
regional
children’s
advisory
committee.
The
membership
of
12
the
governing
board
shall
not
include
employees
of
DHS
or
an
13
unelected
employee
of
a
county.
14
The
bill
adds
to
the
regional
administrator
staff
one
or
more
15
coordinators
of
children’s
behavioral
health
services.
16
The
bill
requires
a
mental
health
and
disability
region
to
17
include
provisions
relating
to
eligibility
requirements
for
18
children’s
behavioral
health
core
services
under
the
children’s
19
behavioral
health
system
and
performance
and
outcome
measures
20
relating
to
education
in
a
region’s
annual
service
and
budget
21
plan.
22
RULES.
The
bill
requires
DHS
to
submit
a
notice
of
intended
23
action
to
the
administrative
rules
coordinator
and
the
Iowa
24
administrative
code
editor
not
later
than
January
1,
2020,
for
25
the
adoption
of
rules
to
implement
the
bill.
26
MISCELLANEOUS
CODE
CHANGES.
The
bill
makes
technical
27
changes
to
Code
section
225C.2(9)
by
striking
the
term
“person
28
with
a
disability”
as
that
term
is
not
used
in
Code
chapter
29
225C
(mental
health
and
disability
services)
and
to
Code
30
section
225C.4
to
include
mental
health
services
in
references
31
to
disability
services
in
that
Code
section.
32
REPEALS.
The
bill
repeals
2019
Code
sections
225C.51,
33
225C.52,
225C.53,
and
225C.54.
The
bill
replaces
2019
Code
34
sections
225C.51
and
225C.52
with
new
content
in
the
bill.
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