225C.6B - MENTAL HEALTH SERVICES SYSTEM IMPROVEMENT -- LEGISLATIVE INTENT -- PLANNING AND IMPLEMENTATION.
225C.6B MENTAL HEALTH SERVICES SYSTEM IMPROVEMENT --
LEGISLATIVE INTENT -- PLANNING AND IMPLEMENTATION.
1. Intent.
a. The general assembly intends for the state to implement a
comprehensive, continuous, and integrated state mental health
services plan in accordance with the requirements of sections 225C.4
and 225C.6 and other provisions of this chapter, by increasing the
department's responsibilities in the development, funding, oversight,
and ongoing leadership of mental health services in this state.
b. In order to further the purposes listed in sections 225C.1
and 225C.27 and in other provisions of this chapter, the general
assembly intends that efforts focus on the goal of making available a
comprehensive array of high-quality, evidence-based consumer and
family-centered mental health services and other support in the least
restrictive, community-based setting appropriate for a consumer.
c. In addition, it is the intent of the general assembly to
promote policies and practices that achieve for consumers the
earliest possible detection of mental health problems and early
intervention; to stress that all health care programs address mental
health disorders with the same urgency as physical health disorders;
to promote the policies of all public programs that serve adults and
children with mental disorders, including but not limited to child
welfare, Medicaid, education, housing, criminal and juvenile justice,
substance abuse treatment, and employment services; to consider the
special mental health needs of adults and children; and to promote
recovery and resiliency as expected outcomes for all consumers.
2. Planning and implementation. In order to build upon the
partnership between the state and counties in providing mental health
and disability services in the state, the workgroups established for
purposes of this subsection shall engage equal proportions
representing the department, counties, and service providers. The
county and provider representatives shall be appointed by the
statewide associations representing counties and community providers.
In addition, each workgroup shall include a representative of the
commission, the mental health planning and advisory council,
consumers, and a statewide advocacy organization. A workgroup shall
be established for each of the following tasks provided for in this
subsection: alternative distribution formulas, community mental
health center plan, core mental health services, and the two
comprehensive plan items. The division shall perform all of the
following tasks in taking steps to improve the mental health services
system for adults and children in this state:
a. Alternative distribution formulas. Identify alternative
formulas for distributing mental health, mental retardation, and
developmental disabilities allowed growth factor adjustment funding
to counties. The alternative formulas shall provide methodologies
that, as compared to the current methodologies, are more readily
understood, better reflect the needs for services, respond to
utilization patterns, acknowledge historical county spending, and
address disparities in funding and service availability. The
formulas shall serve to strengthen the partnership between the
department and counties in the state's services system. The division
may engage assistance from expert consultants with experience with
funding allocation systems as necessary to evaluate options. The
department shall report with findings and recommendations to the
commission on or before November 1, 2007, and shall review and make
recommendations to the department on or before December 1, 2007. The
department shall submit the final report to the chairpersons and
ranking members of the general assembly's committees on human
resources and the joint appropriations subcommittee on health and
human services, and to associated legislative staff, on or before
January 31, 2008.
b. Community mental health center plan. Prepare a phased
plan for increasing state responsibility for and oversight of mental
health services provided by community mental health centers and the
providers approved to fill the role of a center. The plan shall
provide for an initial implementation date of July 1, 2008. The plan
shall be submitted to the commission on or before October 1, 2007.
The commission shall review the plan and provide comments to the
department on or before November 1, 2007. The plan shall be
submitted to the governor and general assembly on or before January
31, 2008. The department shall ensure that key stakeholders are
engaged in the planning process, including but not limited to the
commission, mental health services providers, individuals with
expertise in the delivery of mental health services, youth and adult
consumers, family members of consumers, advocacy organizations, and
counties.
c. Core mental health services. Identify core mental health
services to be offered in each area of the state by community mental
health centers and core services agency providers. The workgroup for
this task shall be established no later than August 1, 2007. The
core services shall be designed to address the needs of target
populations identified by the workgroup and the services may include
but are not limited to emergency services, school-based mental health
services, short-term counseling, prescreening for those subject to
involuntary treatment orders, and evidence-based practices. The
division shall submit to the commission on or before October 1, 2007,
proposed administrative rules and legislation to amend chapter 230A
as necessary to implement the core services beginning July 1, 2008.
The commission shall review and revise the proposed administrative
rules and shall adopt the administrative rules after the general
assembly has reviewed and approved the proposal. The proposals shall
be submitted to the general assembly for review on or before January
31, 2008.
d. Mental health and core service agency standards and
accreditation. Identify standards for accreditation of core
services agencies that are not a community mental health center but
may serve as a provider approved to fill the role of a center. Such
core services agencies could be approved to provide core mental
health services for children and adults on a regional basis. The
standards shall be submitted to the commission for review and
recommendation on or before December 1, 2007, and to the governor and
general assembly on or before January 31, 2008.
e. Co-occurring disorders. The division and the department
of public health shall give priority to the efforts underway to
develop an implementation plan for addressing co-occurring mental
health and substance abuse disorders in order to establish a
comprehensive, continuous, and integrated system of care for such
disorders. The division and the department of public health shall
participate in a policy academy on co-occurring mental health and
substance abuse disorders as part of developing an implementation
plan for commission review by April 1, 2008. The commission shall
review and make recommendations on the plan on or before May 1, 2008.
The plan shall then be submitted to the governor and general assembly
on or before June 1, 2008. The division may engage experts in the
field of co-occurring mental health and substance abuse disorders to
facilitate this planning process.
f. Evidence-based practices. Begin phased implementation of
evidence-based practices for mental health services over a period of
several years.
(1) Not later than October 1, 2007, in order to provide a
reasonable timeline for the implementation of evidence-based
practices with mental health and disability services providers, the
division shall provide for implementation of two adult and two
children evidence-based practices per year over a three-year period.
(2) The division shall develop a comprehensive training program
concerning such practices for community mental health centers, state
resource centers and mental health institutes, and other providers,
in collaboration with the Iowa consortium for mental health and
mental health service providers. The division shall consult with
experts on behavioral health workforce development regarding
implementation of the mental health and disability services training
and the curriculum and training opportunities offered.
(3) The department shall apply measures to ensure appropriate
reimbursement is available to all providers for the implementation of
mandated evidence-based practices and request appropriate funding for
evidence-based practices from the governor and general assembly as
part of the implementation plan. The implementation plan shall be
submitted to the governor and general assembly on or before January
31, 2008.
(4) The department shall provide the commission with a plan for
review to implement the provisions of this paragraph "f".
g. Comprehensive plan.
(1) Complete a written plan describing the key components of the
state's mental health services system, including the services
addressed in this subsection and those that are community-based,
state institution-based, or regional or state-based. The plan shall
incorporate the community mental health center plan provisions
implemented pursuant to this subsection. The plan shall be submitted
to the commission on or before November 15, 2008, and to the governor
and general assembly on or before December 15, 2008.
(2) In addition, complete a written plan for the department to
assume leadership and to assign and reassign significant financial
responsibility for the components of the mental health services
system in this state, including but not limited to the actions needed
to implement the provisions of this subsection involving community
mental health centers, core mental health services, core services
agencies, co-occurring disorders, and evidence-based practices. The
plan shall include recommendations for funding levels, payment
methodologies for new and existing services, and allocation changes
necessary for the department to assume significant financial
responsibility for mental health services. The plan shall be
submitted to the commission on or before November 15, 2008, and the
commission shall provide review and recommendations on the plan to
the department on or before December 15, 2008. The plan shall be
submitted to the governor and general assembly on or before January
15, 2009.
(3) The planning provisions of this paragraph shall be directed
toward the goal of strengthening the partnership between the
department and counties in the state's services system. Section History: Recent Form
2007 Acts, ch 218, §93