Legislative News February 6, 2012

Legislative news – 02/06/2012

IMHCA/IAMFT Day on the Hill – Monday, February 6 (TODAY!!)

Please join other mental health counselors at the Iowa State Capitol today, Monday, February 6, 2012 as part of our annual lobby day. IMHCA will partner with IAMFT to talk with legislators about issues important to our professions, most notably the effort to redesign the mental health delivery system. We will begin with a quick briefing and lobbying tutorial at the Lucas Building Cafeteria (6th Floor) at 3:00 p.m. As a group, we will walk through the tunnel to the Capitol to meet with legislators. Our lobbyist, Emily Piper, will provide you with a list of targeted legislators in the House and Senate and be available to help you answer any questions.

This is your opportunity to talk about the role that you play in providing mental health services in Iowa, the types of cases that you see and the demand for your services. No one can speak better for your profession than you and we hope you will make time out of your busy schedule to join us. This is our opportunity to have direct input into the mental health redesign and to offer our thoughts on how to best accomplish that goal. There is no cost to attend. We look forward to seeing you at the Iowa State Capitol!

Mental Health Reform Update

The interim committee on mental health reform met Thursday and voted to formally dissolve and send two of the three bill drafts to the House and Senate Human Resources Committee for further consideration. The larger draft is considered more controversial as it establishes the new regional delivery system and the financing mechanisms. The two drafts which will be introduced as study bills include (1) a bill incorporating the recommendations of the DHS-Judicial Workgroup and (2) a bill that incorporates terminology changes for mental retardation and adult day care.

Draft #1 (regional delivery system): This bill draft addresses the overall regional delivery system. Specific concerns that have been identified at this point include the following:

1. A person must be diagnosed with a mental health, behavioral or emotional disorder to be eligible for treatment under this system. The diagnosis is tied to the reimbursement to the provider. It would appear that if a provider in this regional system sees a patient who is not subsequently diagnosed, there is no reimbursement mechanism.
2. Any provider of services who participates in this delivery system must be capable of working with individuals who have co-occurring disabilities or specialized needs. It is unclear if this means a provider must be able to diagnose and treat any intellectual disability, mental health condition or substance abuse problem.
3. The bill establishes a workforce development workgroup to formulate recommendations on workforce development issues. This workgroup is heavily weighted against providers and those institutions that provide education and training to mental health providers.
4. The Regional Service System Outcomes and Performance Measures committee is a required component but like the workgroup above, is heavily weighted against providers. This committee is responsible for developing and monitoring outcomes and performance measures for service delivery.
5. The regional governance structure is a required component and does not include any providers. This governance structure is responsible for determining budgets, qualified providers, services etc.
6. The dispute resolution mechanism available to providers is too long. This bill draft sets that process at a minimum of 120 days.

Draft #2 (Judicial work group): This bill addresses the committal process and basically encompasses six major changes:

1. Creates a 12-hour training requirement for law enforcement officers to be taken every three years
2. Allows for involuntary commitment without filing with court if access to the court to file is not possible at the time
3. Resident care facilities don’t have to admit a person who has a court referral unless the care facility director gives prior approval – new level of approval
4. Strikes the definition of qualified mental health professional in 229.1, subsection 14 and instead refers back to the definition of a qualified mental health professional contained in 228.1, subsection 6. This does not expand the list who professions considered to qualified mental health providers.
5. Deletes all duties and rights of qualified mental health professionals who are not physicians from 229, placing sole reliance on physicians for hospitalization. This includes removing language the specifically authorizes a physician to consult with or utilize the services of a qualified mental health professional as defined in 228.1, subsection 6. Author’s note: I’m not sure the intent was to do this and will likely be addressed as the bill moves through the process.
6. Establishes a pre-application screening process for involuntary hospitalization in 229.6 to prevent people being hospitalized and going through the court process if they are not really in need of the hospitalization. The state court administrator is given the power to develop the pre-application screening program.

Submitted by: 

Emily Piper | [email protected]

Piper Consulting Services

P.O. Box 12011 | Des Moines, Iowa 50312-2011

Phone: 515-202-7772 | Fax: 866-869-2842