Bill Text: IA SF481 | 2011-2012 | 84th General Assembly | Introduced
Bill Title: A bill for an act relating to reforming state and county responsibilities for mental health and disabilities services, making appropriations, and including effective date provisions. (Formerly SSB 1077; see SF 525.)
Spectrum: Committee Bill
Status: (Introduced - Dead) 2011-12-31 - END OF 2011 ACTIONS [SF481 Detail]
Download: Iowa-2011-SF481-Introduced.html
Senate
File
481
-
Introduced
SENATE
FILE
481
BY
COMMITTEE
ON
HUMAN
RESOURCES
(SUCCESSOR
TO
SSB
1077)
A
BILL
FOR
An
Act
relating
to
reforming
state
and
county
responsibilities
1
for
mental
health
and
disabilities
services,
making
2
appropriations,
and
including
effective
date
provisions.
3
BE
IT
ENACTED
BY
THE
GENERAL
ASSEMBLY
OF
THE
STATE
OF
IOWA:
4
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Section
1.
REFORM
OF
MENTAL
HEALTH
AND
DISABILITY
SERVICES
1
——
FINDINGS,
PURPOSE,
AND
PLANNING
PROVISIONS.
2
1.
The
general
assembly
finds
that
full
implementation
3
of
the
federal
Patient
Protection
and
Affordable
Care
Act,
4
Pub.
L.
No.
111-148,
in
2014
will
have
a
significant
impact
5
on
services
to
low-income
Iowans
because
eligibility
for
the
6
Medicaid
program
will
be
simplified
to
include
individuals
7
having
an
income
at
or
below
133
percent
of
the
federal
8
poverty
level.
Consequently,
the
additional
categorical
9
eligibility
requirements
now
applicable
for
Medicaid
program
10
eligibility,
such
as
being
a
recipient
of
federal
supplemental
11
security
income
(SSI)
or
for
meeting
Medicaid
program
waiver
12
requirements,
will
no
longer
apply.
Because
Medicaid
is
such
13
a
significant
funding
source
for
Iowa’s
mental
health
system
14
for
children
and
adults,
the
simplified
eligibility
change
15
presents
an
opportunity
to
reform
that
system.
The
simplified
16
Medicaid
eligibility
provisions
coming
into
force
in
2014
also
17
will
provide
Medicaid
eligibility
to
many
adults
whose
services
18
costs
are
wholly
or
primarily
a
county
responsibility.
19
2.
Under
current
law,
counties
pay
the
nonfederal
share
20
of
the
costs
of
Medicaid
program
services
provided
to
address
21
the
needs
of
eligible
adults
with
mental
illness.
Because
the
22
increases
in
overall
funding
for
such
services
have
experienced
23
very
limited
growth
in
recent
years,
the
annual
increases
24
needed
to
fund
the
county
Medicaid
responsibility
have
been
25
reducing
the
funding
counties
have
available
to
fund
other
26
non-Medicaid
services.
With
the
federal
expansion
in
those
27
eligible
for
the
Medicaid
program,
significant
new
funding
will
28
be
needed
to
provide
the
match
for
the
new
eligible
adults.
29
3.
It
is
the
intent
of
the
general
assembly
to
incrementally
30
shift
responsibility
for
the
funding
of
services
for
adults
31
with
mental
illness
from
the
counties
to
the
state
so
that
32
the
shift
is
completed
by
2014
when
the
new
federal
law
takes
33
effect.
34
4.
Among
adults
who
have
a
serious
mental
illness,
the
35
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incidence
of
those
with
a
co-occurring
disorder
involving
abuse
1
of
alcohol
or
another
substance
is
much
higher
than
among
the
2
population
without
such
an
illness.
However,
the
availability
3
of
treatment
that
simultaneously
addresses
both
disorders
is
4
very
limited.
5
5.
a.
Under
current
law,
if
an
adult
has
a
serious
mental
6
illness
and
does
not
have
a
means
of
paying
for
services,
the
7
primary
responsibility
to
fund
and
make
the
services
available
8
is
assigned
to
counties.
Although
many
common
elements
do
9
exist
among
the
service
arrays
offered
by
counties,
a
basic
set
10
of
services
is
not
available
in
all
counties,
waiting
lists
for
11
some
services
are
in
effect
in
some
counties,
the
availability
12
of
community-based
services
in
some
counties
is
very
limited,
13
and
other
disparities
exist.
14
b.
It
is
the
intent
of
the
general
assembly
to
address
such
15
disparity
by
shifting
the
payment
responsibility
for
adult
16
mental
illness
services
from
the
counties
to
the
state
and
17
developing
a
regional
approach
to
provide
system
access
and
18
navigation
and
care
coordination
functions.
19
6.
Counties
are
limited
to
levying
approximately
$125
20
million
in
property
taxes
statewide
for
the
services
due
to
law
21
enacted
in
the
mid-1990s.
The
state
distributes
to
counties
22
approximately
$89
million
to
replace
equivalent
reductions
23
in
the
amount
of
property
taxes
raised
for
this
purpose.
In
24
addition,
for
fiscal
year
2010-2011,
the
state
will
distribute
25
to
counties
approximately
$49
million
in
allowed
growth
funds,
26
approximately
$14
million
in
community
services
funds,
and
27
approximately
$11
million
to
reimburse
for
state
cases.
28
7.
Beginning
on
the
effective
date
of
this
section
and
29
continuing
through
the
fiscal
year
beginning
July
1,
2011,
the
30
department
of
human
services
shall
consult
with
stakeholders
in
31
developing
a
plan
and
implementation
provisions
for
a
system
32
for
adults
in
need
of
publicly
funded
mental
health
services
33
and
related
support,
proposing
but
not
limited
to
all
of
the
34
following:
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a.
Identifying
clear
definitions
and
requirements
for
the
1
following:
2
(1)
Characteristics
of
the
service
populations.
3
(2)
The
array
of
services
and
support
to
be
included.
4
(3)
Outcome
measures.
5
(4)
Quality
assurance
measures.
6
(5)
Provider
accreditation,
certification,
or
licensure
7
requirements.
8
b.
Incorporating
strategies
to
allow
individuals
to
receive
9
services
in
accordance
with
the
principles
established
in
10
Olmstead
v.
L.C.,
527
U.S.
581
(1999),
in
order
for
services
11
to
be
provided
in
the
most
community-based,
integrated
12
setting
appropriate
to
an
individual’s
needs
and
in
the
least
13
restrictive
setting.
14
c.
Continuing
the
department’s
leadership
role
in
the
15
Medicaid
program
in
defining
services
covered,
establishing
16
reimbursement
methodologies,
providing
other
administrative
17
functions,
and
expanding
the
program
to
incorporate
the
18
opportunities
provided
by
the
federal
Patient
Protection
and
19
Affordable
Care
Act,
Pub.
L.
No.
111-148.
20
d.
Identifying
criteria
for
regional
entities
to
operate
21
under
performance-based
contracts
with
the
department.
22
e.
Paying
all
vendors
for
services
and
other
support
under
23
the
system.
24
f.
Identifying
an
equitable
approach
for
pooling
and
25
redistributing
both
county
and
state
funding
to
support
the
26
system,
eliminate
legal
settlement
for
determining
funding
27
liability,
and
achieve
other
public
policy
objectives.
28
g.
Implementing
mental
health
crisis
response
services
29
statewide.
30
h.
Implementing
a
subacute
level
of
care.
31
i.
Utilizing
the
target
date
of
January
1,
2013,
for
full
32
implementation
of
the
adult
service
system.
The
department
33
shall
submit
the
initial
plan
and
implementation
provisions
to
34
the
governor
and
general
assembly
on
or
before
December
15,
35
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481
2011.
1
8.
a.
The
department
shall
begin
developing
a
similar
plan
2
and
implementation
provisions
for
a
system
for
children
in
need
3
of
publicly
funded
mental
health
services
and
related
support
4
for
submission
to
the
governor
and
general
assembly
by
December
5
15,
2012.
6
b.
The
department
shall
begin
developing
a
similar
plan
7
and
implementation
provisions
for
a
system
for
adults
in
need
8
of
publicly
funded
intellectual
disabilities
and
brain
injury
9
services
and
related
support
for
submission
to
the
governor
and
10
general
assembly
by
December
15,
2013.
11
c.
The
department
shall
begin
developing
a
similar
plan
12
and
implementation
provisions
for
a
system
for
children
and
13
adults
in
need
of
publicly
funded
dual
diagnosis
mental
illness
14
and
intellectual
disabilities
services
and
related
support
for
15
submission
to
the
governor
and
general
assembly
by
December
15,
16
2014.
17
d.
The
department
shall
begin
developing
a
similar
plan
and
18
implementation
provisions
for
a
system
for
children
and
adults
19
in
need
of
publicly
funded
co-occurring
substance
abuse
and
20
mental
illness
services
and
related
support
for
submission
to
21
the
governor
and
general
assembly
by
December
15,
2014.
22
Sec.
2.
DEPARTMENT
OF
HUMAN
SERVICES.
There
is
appropriated
23
from
the
general
fund
of
the
state
to
the
department
of
human
24
services
for
the
fiscal
year
beginning
July
1,
2011,
and
ending
25
June
30,
2012,
the
following
amount,
or
so
much
thereof
as
is
26
necessary,
to
be
used
for
the
purposes
designated:
27
For
planning
costs
associated
with
implementation
of
this
28
Act:
29
.
.
.
.
.
.
.
.
.
.
.
.
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.
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.
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.
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.
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.
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.
.
.
.
.
.
.
.
.
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.
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.
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.
.
$
50,000
30
Sec.
3.
EFFECTIVE
UPON
ENACTMENT.
This
Act,
being
deemed
of
31
immediate
importance,
takes
effect
upon
enactment.
32
EXPLANATION
33
This
bill
relates
to
the
reform
of
state
and
county
34
responsibilities
for
mental
health
and
disability
services.
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481
Legislative
findings
are
stated
concerning
the
current
system
1
and
for
shifting
the
payment
responsibility
for
adult
mental
2
illness
services
from
the
counties
to
the
state
and
developing
3
a
regional
approach
to
provide
system
access
and
navigation
and
4
care
coordination
functions.
5
The
department
of
human
services
is
charged
with
developing
6
a
plan
and
implementation
provisions
for
adult
mental
health
7
services
and
related
support
as
specified
in
the
bill
with
a
8
target
implementation
date
of
January
1,
2013.
The
plan
is
9
required
to
be
submitted
to
the
general
assembly
and
governor
10
by
December
15,
2011.
11
The
department
is
required
to
submit
similar
plans
and
12
implementation
provisions
for
the
following:
for
children’s
13
mental
health
services
by
December
15,
2012;
for
intellectual
14
disabilities
and
brain
injury
services
by
December
15,
15
2013;
and
for
dual
diagnosis
mental
illness
and
intellectual
16
disability
services
and
for
co-occurring
substance
abuse
and
17
mental
illness
services
by
December
15,
2014.
18
An
appropriation
is
made
to
the
department
for
19
implementation
costs.
20
The
bill
takes
effect
upon
enactment.
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