Bill Text: IA HF2402 | 2023-2024 | 90th General Assembly | Enrolled
Bill Title: A bill for an act relating to behavioral health services for children including psychiatric medical institutions for children. (Formerly HSB 502.) Effective date: 07/01/2024.
Spectrum: Committee Bill
Status: (Passed) 2024-05-01 - Signed by Governor. H.J. 937. [HF2402 Detail]
Download: Iowa-2023-HF2402-Enrolled.html
House
File
2402
-
Enrolled
House
File
2402
AN
ACT
RELATING
TO
BEHAVIORAL
HEALTH
SERVICES
FOR
CHILDREN
INCLUDING
PSYCHIATRIC
MEDICAL
INSTITUTIONS
FOR
CHILDREN.
BE
IT
ENACTED
BY
THE
GENERAL
ASSEMBLY
OF
THE
STATE
OF
IOWA:
Section
1.
Section
135H.6,
subsection
1,
paragraph
d,
Code
2024,
is
amended
by
striking
the
paragraph.
Sec.
2.
Section
135H.6,
subsections
2,
3,
4,
and
5,
Code
2024,
are
amended
to
read
as
follows:
2.
The
department
of
health
and
human
services
shall
not
give
approval
to
an
application
which
would
cause
the
total
number
of
beds
licensed
under
this
chapter
for
services
reimbursed
by
the
medical
assistance
program
under
chapter
249A
to
exceed
four
hundred
thirty
beds
,
unless
the
director
of
health
and
human
services
determines
approval
of
such
an
application
is
necessary
for
good
cause.
Good
cause
is
established
if
the
health
and
safety
of
Iowans
would
be
adversely
impacted
if
the
application
for
additional
beds
is
not
approved
.
3.
In
addition
to
the
beds
authorized
under
subsection
2
,
the
department
of
health
and
human
services
may
establish
not
more
than
thirty
beds
licensed
under
this
chapter
at
the
state
mental
health
institute
at
Independence.
The
beds
shall
be
exempt
from
the
certificate
of
need
requirement
under
subsection
1
,
paragraph
“d”
.
4.
The
department
of
health
and
human
services
may
give
approval
to
conversion
of
beds
approved
under
subsection
2
,
to
House
File
2402,
p.
2
beds
which
are
specialized
to
provide
substance
use
disorder
treatment.
However,
the
total
number
of
beds
approved
under
subsection
2
and
this
subsection
shall
not
exceed
four
hundred
thirty
,
unless
approved
for
good
cause
by
the
director
pursuant
to
subsection
2
.
Conversion
of
beds
under
this
subsection
shall
not
require
a
revision
of
the
certificate
of
need
issued
for
the
psychiatric
institution
making
the
conversion.
Beds
for
children
who
do
not
reside
in
this
state
and
whose
service
costs
are
not
paid
by
public
funds
in
this
state
are
not
subject
to
the
limitations
on
the
number
of
beds
and
certificate
of
need
requirements
otherwise
applicable
under
this
section
.
5.
A
psychiatric
institution
licensed
prior
to
July
1,
1999,
may
exceed
the
number
of
beds
authorized
under
subsection
2
if
the
excess
beds
are
used
to
provide
services
funded
from
a
source
other
than
the
medical
assistance
program
under
chapter
249A
.
Notwithstanding
subsection
1
,
paragraphs
“d”
and
paragraph
“e”
,
and
subsection
2
,
the
provision
of
services
using
those
excess
beds
does
not
require
a
certificate
of
need
or
a
review
by
the
department
of
health
and
human
services.
Sec.
3.
PSYCHIATRIC
MEDICAL
INSTITUTIONS
FOR
CHILDREN
——
ENHANCED
MEDICAID
REIMBURSEMENT.
No
later
than
January
1,
2025,
the
department
of
health
and
human
services
shall
select
one
or
more
psychiatric
medical
institutions
for
children
(PMICs)
to
provide
access
to
PMIC
services
for
children
with
specialized
needs
including
problematic
sexualized
behaviors,
a
history
of
aggression,
or
a
diagnosis
of
intellectual
or
developmental
disability.
Prior
to
rendering
services,
a
selected
PMIC
shall
be
licensed
pursuant
to
section
135H.4
and
offer
a
payment
structure
that
provides
enhanced
reimbursement,
which
may
be
used
to
provide
increased
staffing
ratios,
ongoing
training
of
staff
in
specialized
programs
that
provide
evidence-based
treatment,
and
appropriate
services
and
modalities,
including
but
not
limited
to
telemedicine,
for
children
and
their
families.
Sec.
4.
REDUCTION
OF
REGULATORY
BARRIERS
AND
RESTRICTIONS
——
PSYCHIATRIC
MEDICAL
INSTITUTIONS
FOR
CHILDREN.
The
department
of
health
and
human
services
shall
review
the
department’s
administrative
rules
regarding
psychiatric
medical
House
File
2402,
p.
3
institutions
for
children
(PMICs)
and
shall
update
the
rules,
informed
by
the
findings
of
the
association
of
children’s
residential
centers’
most
recent
nationwide
survey
and
scan
of
psychiatric
residential
treatment
facilities,
and
the
recommendations
of
the
coalition
for
family
and
children’s
services
in
Iowa,
to
do
all
of
the
following:
1.
Allow
a
physician
assistant
or
advanced
registered
nurse
practitioner
to
serve
as
a
member
of
the
plan
of
care
team
as
a
member
who
is
experienced
in
child
psychiatry
or
child
psychology
pursuant
to
481
IAC
41.13(2).
2.
Allow
a
physician
assistant
or
advanced
registered
nurse
practitioner
to
be
a
member
of
the
team
to
complete
the
certification
of
need
for
services
for
a
PMIC
placement
pursuant
to
481
IAC
41.9.
3.
Allow
licensed
professionals,
based
on
competencies
rather
than
license
type,
to
order
the
use
of
restraints
or
seclusions
and
to
conduct
post-restraint
or
seclusion
assessments,
including
via
telehealth,
to
increase
response
times
and
expand
access
to
care.
The
department
of
inspections,
appeals,
and
licensing
shall
adopt
rules
pursuant
to
chapter
17A
to
administer
this
subsection.
4.
a.
Allow
family
therapy
and
family
behavioral
health
intervention
services
to
be
included
in
billable
services
during
the
placement
of
a
child
in
a
PMIC
without
requiring
the
child’s
presence
for
the
family
to
work
on
targeted
skills
essential
for
the
child’s
success
and
to
prepare
the
family
for
the
child’s
return
home.
b.
Provide
reimbursement
codes
to
cover
services
beyond
those
provided
outside
the
PMIC
care
team
as
necessary
to
adequately
treat
substance
use
disorder,
sexualized
behaviors,
autism,
and
other
services
needed
to
support
the
child.
5.
Standardize
all
of
the
following
across
all
managed
care
organizations
as
follows:
a.
Require
that
authorization
for
a
PMIC
placement
shall
be
retroactive
to
the
date
the
request
for
authorization
is
submitted
to
the
managed
care
organization
not
the
date
the
managed
care
organization
responds;
or
require
a
managed
care
organization
to
respond
within
five
business
days
from
receipt
of
a
request
for
authorization
for
a
PMIC
placement,
if
the
House
File
2402,
p.
4
certification
of
need
and
independent
assessment
have
been
received
in
a
timely
manner.
b.
Prohibit
a
managed
care
organization
from
denying
authorization
for
a
PMIC
placement
based
on
lack
of
parental
involvement,
lack
of
participation
in
behavioral
health
intervention
services
on
an
outpatient
basis,
or
based
on
other
perceived
behavioral
issues.
c.
Allow
a
managed
care
organization
to
authorize
an
initial
PMIC
placement
of
sixty
days
upon
admission
with
concurrent
stay
reviews
every
thirty
days
thereafter.
A
PMIC
shall
submit
a
care
plan
to
the
managed
care
organization
within
thirty
days
of
the
admission.
d.
Require
concurrent
stay
reviews
to
be
standardized
and
limited
to
a
brief
description
of
progress,
or
lack
of
progress,
toward
the
child’s
goals
and
objectives.
e.
Require
a
managed
care
organization
to
offer
support
to
families,
including
assistance
with
transportation
to
and
from
a
PMIC
to
visit
a
child.
6.
Notwithstanding
any
provision
of
law
to
the
contrary,
allow
a
previously
licensed
PMIC
that
has
the
capacity
to
provide
up
to
an
additional
four
intermediate
care
facility
for
persons
with
an
intellectual
disability
beds,
and
which
additional
beds
meet
all
other
licensing
and
state
fire
marshal
requirements,
to
increase
their
licensed
capacity
to
include
the
additional
beds
without
further
review
including
by
the
health
facilities
council.
7.
Allow
for
step-down
PMIC
placements
or
supervised
apartment
living
for
a
child
to
utilize
programming
provided
in
a
PMIC
while
living
independently
in
a
smaller
residential
setting
without
twenty-four-hour
supervision.
Sec.
5.
HAWKI
PROGRAM
——
BENEFITS
INCLUDED
IN
QUALIFIED
CHILD
HEALTH
PLAN
——
REVIEW.
The
department
of
health
and
human
services
shall
review
the
benefits
included
in
a
qualified
child
health
plan
under
the
Hawki
program
and
shall
specifically
address
the
inclusion
of
applied
behavior
analysis
services
as
a
covered
benefit.
The
department
shall
report
the
findings
of
the
review
to
the
general
assembly
by
December
1,
2024.
Sec.
6.
DEPARTMENTAL
REVIEW
AND
REPORT.
The
department
of
House
File
2402,
p.
5
health
and
human
services
shall
review
the
effectiveness
of
the
reduction
of
regulatory
barriers
and
restrictions
provisions
specified
in
this
Act
and
shall
report
the
resulting
costs
and
savings
to
the
governor
and
the
general
assembly
by
March
1,
2025.
______________________________
PAT
GRASSLEY
Speaker
of
the
House
______________________________
AMY
SINCLAIR
President
of
the
Senate
I
hereby
certify
that
this
bill
originated
in
the
House
and
is
known
as
House
File
2402,
Ninetieth
General
Assembly.
______________________________
MEGHAN
NELSON
Chief
Clerk
of
the
House
Approved
_______________,
2024
______________________________
KIM
REYNOLDS
Governor
