Bill Text: IA SF525 | 2011-2012 | 84th General Assembly | Amended
NOTE: There are more recent revisions of this legislation. Read Latest Draft
Bill Title: A bill for an act relating to reforming state and county responsibilities for adult disability services, making appropriations, and including effective date provisions. (Formerly SSB 1077 and SF 481.) Various effective dates; see sections 5, 23, and 62 of bill (see also SF 533, section 151).
Spectrum: Committee Bill
Status: (Passed) 2011-12-31 - END OF 2011 ACTIONS [SF525 Detail]
Download: Iowa-2011-SF525-Amended.html
Bill Title: A bill for an act relating to reforming state and county responsibilities for adult disability services, making appropriations, and including effective date provisions. (Formerly SSB 1077 and SF 481.) Various effective dates; see sections 5, 23, and 62 of bill (see also SF 533, section 151).
Spectrum: Committee Bill
Status: (Passed) 2011-12-31 - END OF 2011 ACTIONS [SF525 Detail]
Download: Iowa-2011-SF525-Amended.html
Senate
File
525
-
Reprinted
SENATE
FILE
525
BY
COMMITTEE
ON
APPROPRIATIONS
(SUCCESSOR
TO
SF
481)
(SUCCESSOR
TO
SSB
1077)
(As
Amended
and
Passed
by
the
Senate
April
20,
2011
)
A
BILL
FOR
An
Act
relating
to
reforming
state
and
county
responsibilities
1
for
adult
disability
services,
making
appropriations,
and
2
including
effective
date
provisions.
3
BE
IT
ENACTED
BY
THE
GENERAL
ASSEMBLY
OF
THE
STATE
OF
IOWA:
4
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525
(4)
84
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525
Section
1.
ADULT
DISABILITY
SERVICES
SYSTEM
REDESIGN.
1
1.
For
the
purposes
of
this
section,
“disability
services”
2
means
services
and
other
support
available
to
a
person
3
with
mental
illness
or
an
intellectual
disability
or
other
4
developmental
disability.
5
2.
It
is
the
intent
of
the
general
assembly
to
redesign
the
6
system
for
adult
disability
services
to
implement
all
of
the
7
following:
8
a.
Shifting
the
funding
responsibility
for
the
nonfederal
9
share
of
adult
disability
services
paid
for
by
the
Medicaid
10
program,
including
but
not
limited
to
all
costs
for
the
state
11
resource
centers,
from
the
counties
to
the
state.
12
b.
Reorganizing
adult
disability
services
not
paid
for
by
13
the
Medicaid
program
to
be
administered
by
the
counties
on
14
a
regional
basis,
providing
for
the
regions
to
serve
as
the
15
single
point
of
entry
for
the
adult
disability
services
not
16
funded
by
the
Medicaid
program.
17
c.
Devising
new
approaches
for
addressing
the
needs
for
18
publicly
funded
services
for
persons
with
brain
injuries.
19
d.
Implementing
contracting
between
the
state
and
the
20
county
regions,
designating
a
region
to
serve
as
a
Medicaid
21
local
point
of
access,
and
provider
of
case
management
22
or
service
coordination,
service
navigation
support,
and
23
assistance
with
service
intake.
The
region
will
determine
the
24
Medicaid
targeted
case
management
provider
for
the
region.
25
In
addition,
the
region
will
coordinate
and
liaison
with
the
26
department
of
human
services
concerning
the
adult
disability
27
services
covered
by
the
Medicaid
program
so
that
services
28
covered
by
that
program
and
the
region
are
integrated
and
29
coordinated.
30
e.
Implementing
measures
for
Medicaid
and
non-Medicaid
31
services
to
be
provided
in
the
most
community-based,
least
32
restrictive,
and
integrated
setting
appropriate
to
a
consumer’s
33
needs.
34
f.
Providing
funding
in
order
for
the
state
to
assume
the
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525
nonfederal
share
of
the
Medicaid
program
costs
by
means
of
1
the
state
retaining
the
following
funding
sources
currently
2
distributed
to
the
counties
for
adult
disability
services:
3
(1)
Appropriations
made
for
purposes
of
the
mental
health
4
and
developmental
disabilities
community
services
fund
in
5
accordance
with
section
225C.7.
6
(2)
Appropriations
made
for
purposes
of
the
allowed
growth
7
factor
adjustment
as
described
in
sections
331.439
and
426B.5.
8
(3)
Appropriations
made
for
the
property
tax
relief
fund
9
pursuant
to
section
426B.1
and
replacement
generation
tax
10
revenues
deposited
in
the
fund
pursuant
to
section
437A.15.
11
g.
Maintaining
the
following
funding
sources
for
the
county
12
regional
system:
13
(1)
Appropriations
made
for
state
cases
services
under
14
section
331.440,
Code
2011.
15
(2)
Distribution
of
the
federal
social
services
block
grant
16
allocation
for
local
purchase.
17
h.
Addressing
county
property
tax
funding
for
adult
18
disability
services
on
a
regional
basis
and
revising
property
19
taxation
for
adult
disability
services
to
a
levy
rate
that
is
20
uniform,
adequate,
and
fair.
21
i.
Creating
new
state
funding
sources
for
the
following
22
purposes:
23
(1)
To
serve
as
an
incentive
and
to
defray
new
24
administrative
costs
for
reorganizing
adult
disability
services
25
to
be
administered
by
counties
on
a
regional
basis.
26
(2)
For
regions
to
bid
to
implement
demonstration
projects
27
to
test
new
evidence-based
adult
disability
services
for
28
periods
of
three
to
five
years.
29
(3)
For
counties
to
test
innovative
approaches
for
the
30
delivery
of
adult
disability
services.
31
j.
Providing
for
the
department
of
human
services
to
work
32
with
counties
and
other
stakeholders
to
identify
the
core
adult
33
disability
services
to
be
available
in
each
region
and
to
34
establish
standards
for
the
regional
system.
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525
k.
Addressing
the
needs
of
consumers
with
co-occurring
1
disorders
in
a
manner
that
is
seamless
to
the
consumers.
2
l.
Replacing
legal
settlement
as
the
basis
for
determining
3
financial
responsibility
for
publicly
funded
disability
4
services
by
determining
responsibility
based
upon
residency.
5
3.
Beginning
on
the
effective
date
of
this
Act
and
6
continuing
through
the
fiscal
year
beginning
July
1,
2011,
the
7
department
of
human
services
shall
consult
with
a
stakeholder
8
group
formed
by
the
department
in
developing
a
plan
and
9
implementation
provisions
for
a
system
for
adults
in
need
10
of
publicly
funded
disability
services
and
related
support,
11
proposing
but
not
limited
to
all
of
the
following:
12
a.
Identifying
clear
definitions
and
requirements
for
the
13
following:
14
(1)
Eligibility
criteria
for
the
individual
to
be
served.
15
(2)
The
array
of
core
services
and
other
support
to
be
16
included
in
regional
adult
disability
services
plans
and
to
be
17
delivered
based
on
individual
needs
and
medical
necessity.
18
(3)
Outcome
measures,
including
but
not
limited
to
measures
19
addressing
individual
choice,
empowerment,
and
community.
20
(4)
Quality
assurance
measures.
21
(5)
Provider
accreditation,
certification,
or
licensure
22
requirements
to
ensure
high
quality
services
while
avoiding
23
unreasonable
expectations
and
duplicative
surveys.
24
(6)
A
process
to
evaluate
and
resolve
workforce
shortage
25
issues.
26
(7)
Input
in
regional
service
plans
and
delivery
provisions
27
by
consumer
and
provider
representatives.
28
(8)
A
process
for
representatives
of
the
regional
system
29
to
regularly
engage
the
department
in
resolving
Medicaid
and
30
non-Medicaid
issues
involving
documentation
requirements,
31
electronic
records,
reimbursement
methodologies,
and
other
32
measures
to
improve
the
services
and
other
support
available
33
to
consumers.
34
b.
Incorporating
strategies
to
allow
individuals
to
receive
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services
in
accordance
with
the
principles
established
in
1
Olmstead
v.
L.C.,
527
U.S.
581
(1999),
in
order
for
services
to
2
be
provided
in
the
most
community-based,
least
restrictive,
and
3
integrated
setting
appropriate
to
an
individual’s
needs.
4
c.
Continuing
the
department’s
leadership
role
in
the
5
Medicaid
program
in
defining
services
covered,
establishing
6
reimbursement
methodologies,
providing
other
administrative
7
functions,
and
expanding
the
program
to
incorporate
the
8
opportunities
provided
by
the
federal
Patient
Protection
and
9
Affordable
Care
Act,
Pub.
L.
No.
111-148.
10
d.
Implementing
mental
health
crisis
response
services
11
statewide
in
a
manner
determined
to
be
most
appropriate
by
each
12
region.
13
e.
Implementing
a
subacute
level
of
care
to
provide
14
short-term
mental
health
services
in
a
structured
residential
15
setting
that
supplies
a
less
intensive
level
of
care
than
is
16
supplied
by
acute
psychiatric
services.
17
f.
Identifying
new
approaches
for
addressing
the
needs
for
18
publicly
funded
services
for
persons
with
brain
injury.
19
g.
With
the
department
of
public
health,
providing
20
approaches
for
addressing
the
needs
of
consumers
with
21
co-occurring
substance
abuse
and
mental
health
disorders
in
a
22
manner
that
is
seamless
to
the
consumers.
23
h.
Designating
measures
for
the
redesigned
system
to
24
address
the
needs
of
children
with
mental,
behavioral,
or
25
emotional
disorders.
26
4.
a.
The
target
date
for
full
implementation
of
the
27
plan
and
implementation
provisions
described
in
subsections
28
2
and
3
shall
be
July
1,
2013,
provided,
however,
that
any
29
expansion
of
services
is
subject
to
available
funding.
The
30
plan
and
implementation
provisions
shall
be
submitted
to
31
the
governor
and
general
assembly
on
or
before
December
15,
32
2011.
A
progress
update
providing
preliminary
recommendations
33
delineating
the
major
responsibilities
of
the
department
34
and
regions,
the
relationship
of
Medicaid
funded
services
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to
non-Medicaid
services,
and
the
funding
needs
of
regions
1
shall
be
submitted
to
the
members
of
the
joint
appropriations
2
subcommittee
on
health
and
human
services
and
the
legislative
3
services
agency
in
October
2011.
4
b.
The
initial
plan
and
implementation
provisions
shall
5
recommend
detailed
core
services
and
criteria
provisions
for
6
counties
to
affiliate
with
a
regional
entity
to
be
organized
7
by
the
affiliating
counties
under
chapter
28E.
Following
8
enactment
of
the
core
services
and
regional
criteria,
if
a
9
county
has
not
formally
agreed
to
affiliate
with
a
regional
10
entity
by
July
1,
2012,
the
county’s
regional
affiliation
11
shall
be
determined
by
the
department.
The
regional
criteria
12
considered
for
recommendation
shall
include
but
are
not
limited
13
to
all
of
the
following:
14
(1)
Requiring
the
region
to
consist
of
contiguous
counties
15
adjoining
one
of
the
following
urban
areas:
Ames,
Cedar
16
Rapids,
Council
Bluffs,
Davenport,
Des
Moines,
Iowa
City,
Sioux
17
City,
or
Waterloo.
18
(2)
Evaluating
a
proposed
region’s
capacity
for
providing
19
core
services
and
performing
required
functions.
20
(3)
Requiring
the
region
to
encompass
at
least
one
community
21
mental
health
center
or
federally
qualified
health
center
with
22
providers
qualified
to
provide
psychiatric
services,
either
23
directly
or
with
assistance
from
psychiatric
consultants,
that
24
has
the
capacity
to
provide
outpatient
services
for
the
region
25
and
has
provided
evidence
of
a
commitment
to
provide
outpatient
26
services
for
the
region.
27
(4)
Requiring
the
region
to
encompass
or
have
reasonably
28
close
proximity
to
a
hospital
with
an
inpatient
psychiatric
29
unit
or
state
mental
health
institute,
that
has
the
capacity
30
to
provide
inpatient
services
for
the
region
and
has
provided
31
evidence
of
a
commitment
to
provide
inpatient
services
for
the
32
region.
33
(5)
Requiring
the
administrative
structure
utilized
by
34
a
region
to
have
clear
lines
of
accountability
and
to
serve
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as
a
lead
agency
with
shared
county
staff
or
other
means
of
1
limiting
administrative
costs
to
not
more
than
five
percent
of
2
expenditures.
3
5.
The
legislative
council
is
requested
to
authorize
a
4
legislative
interim
study
committee
to
meet
during
the
2011
5
legislative
interim
and
assist
with
the
adult
disability
6
services
system
redesign
addressed
by
this
Act,
to
make
7
recommendations
for
implementing
county
disability
services
8
levy
changes
to
support
adult
disability
services
regions
with
9
levies
that
are
uniform,
adequate,
and
fair,
and
to
consider
10
statutory
amendments
necessary
for
implementation
of
the
system
11
redesign.
12
Sec.
2.
DEPARTMENT
OF
HUMAN
SERVICES.
There
is
appropriated
13
from
the
general
fund
of
the
state
to
the
department
of
human
14
services
for
the
fiscal
year
beginning
July
1,
2010,
and
ending
15
June
30,
2011,
the
following
amount,
or
so
much
thereof
as
is
16
necessary,
to
be
used
for
the
purposes
designated:
17
For
planning
costs
associated
with
implementation
of
this
18
Act:
19
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
$
250,000
20
Notwithstanding
section
8.33,
moneys
appropriated
in
this
21
section
that
remain
unencumbered
or
unobligated
at
the
close
of
22
the
fiscal
year
shall
not
revert
but
shall
remain
available
for
23
expenditure
for
the
purposes
designated
until
the
close
of
the
24
succeeding
fiscal
year.
25
Sec.
3.
EFFECTIVE
UPON
ENACTMENT.
This
Act,
being
deemed
of
26
immediate
importance,
takes
effect
upon
enactment.
27
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