Legislative Update – Final Week

Under the Golden Dome

At 12:15 am on May 25, the 89th General Assembly adjourned sine die (to adjourn without picking a date in the future to meet).   The final two days of the legislature were a flurry of activity as the two chambers moved budget bills, outstanding policy bills and the standing appropriations bill which is generally a vehicle for last minute policy issues.   


While education issues dominated the legislative session, legislators did adopt some important mental health changes.  The biggest success for IMHCA is the creation of a new loan repayment program for non-prescribing mental health programs.  Mental health counselors, along with marriage and family therapists, licensed independent social workers and psychologists now have a program to incent licensed practitioners to serve in federally designated mental health shortage areas.  This is a huge win for IMHCA and its members.  In addition, the legislature provided sufficient funding to enter 13 practitioners into the loan repayment program.  Watch for more information on this important new program as the college student aid commission develops rules to implement it.   


Final Bills of Impact to IMHCA Members

HF 2167:  This bill clarifies that autism is a mental health condition by aligning state and federal definitions.  IMHCA is registered in support of the bill. Governor Reynolds signed the bill into law on April 12, 2021.  


HF 2200This bill expands the current statutory authority to establish a direct healthcare agreement between any licensed healthcare provider and a patient.  Current law only allows that to occur between a primary care provider and a patient.   A direct healthcare agreement means that the provider agrees to provide specific services to the patient for a specified time and for a service charge.  IMHCA is registered as undecided.  Governor Reynolds signed the bill into law on May 12, 2021.  


HF 2416:  This bill prohibits schools, community colleges, private colleges and regents institutions from allowing transgender girls from participating in girls sports.  IMHCA is registered opposed.  Governor Reynolds signed the bill into law on Mar 3, 2022.


HF 2549:  This bill creates a mental health provider loan repayment program for individuals who agree to serve in a mental health shortage area for five years.  To qualify, you must have graduated from a recognized program in Iowa and be licensed to practice in Iowa.  The definition of a mental health provider is tied to those without prescriptive authority in 228.1 (defines mental health provider).  Successful applicants would receive up to $8,000 for each of the five years.  HF 2575 provides $520,000 to fund 13 positions.  IMHCA is registered in support.  The bill passed both chambers and is headed to the governor for her consideration.


HF 2575: The education budget includes the following items of interest:

  • $520,000 to the college student aid commission to fund a mental health loan repayment program (see HF 2549/SF 2195 for details).   This amount would fund 13 positions.
  • $3,383,936 to the area education agencies for children’s mental health training and services (increase of $200,000).


HF 2578: The health and human services budget includes the following items of interest:

Department of Public Health:

  • $306,000 for 24-hour crisis hotline for children’s mental health
  • $384,000 for autism assistance and support provided through the University of Iowa
  • $250,000 to Des Moines University to provide primary care physicians with training to identify mental illnesses
  • $800,000 for rural psychiatry residencies
  • $150,000 for psychiatric training for physicians assistants and nurse practitioners

Department of Human Services

  • Directs DHS to submit a state plan amendment to allow for medicaid coverage of functional family therapy and multisystemic therapy
  • $188,000 for autism assistance and support provided through the University of Iowa
    • $25,000 is directed to a psychiatric medical institution for children (PMIC) which provides school-based services in Linn County (Tanager Place)
  • $300,000 to support the children’s behavioral health system state board
  • Increases reimbursement for acute psychiatric hospitals to the level of federal increases OR as supported by Medicaid audited costs
  • Directs DHS to create a tiered rate reimbursement for psychiatric intensive inpatient care
  • Allows community mental health centers to be reimbursed at 100% of reasonable costs OR the alternative reimbursement rate methodology approved by DHS 
  • DHS-DPH merger:
    • Any legislation needed shall be drafted by October 1, 2022
    • Transition period is July 1, 2022 – June 30, 2023
  • Creates a statewide maternal postpartum support program
  • Directs DHS to examine Medicaid postpartum coverage and provide recommendations by December 15, 2021
  • Requires insurance companies (effective upon enactment) to cover telehealth mental health services provided by out-of-state practitioners if:
    • Licensed in Iowa by the appropriate licensure board
    • Meet the same criteria for coverage as if located in the state
  • Creates up to 12 new psychiatric residency slots at the University of Iowa in cooperation with the mental health institutes at Cherokee and Independence and facilities at Woodward and Eldora:
    • Must fulfill at least part of residency at one of those institutions
    • Preference is given to Iowa residents and to those who have undergraduate degrees and medical degrees from an Iowa college or university
    • Provides $100,000 for each approved position


Bills that Died

HSB 564:  This bill allows the state office of the ombudsman to procure AND release confidential records as part of its investigation into a state agency or board.  


HSB 727:  This bill consolidates the nine area education agencies into four and requires the boards to allow employees to provide services remotely rather than in person.   


HF 2134:  This bill prohibits non-compete agreements that would place limits on an employees ability to work for a different employer within a specified amount of time; working for a different employer in a specified geographical area or working for a different employer who is similar to the employee’s work with the current employer.  


HF 2179: This bill adopts the compact language for professional counseling.


HF 2225:  This bill merges the boards of behavioral science and the social work.


HF 2386/SSB 3054:  Allows the release of psychological test materials to the opposing counsel if the litigation included a question of the individual’s cognitive ability.   This provides an open door to making it easier to get all mental health records during litigation.  


HF 2399:  This bill prohibits revoking a prior authorization when reimbursement is submitted and requires that a prior authorization is valid for at least ninety days.   


SF 487: This bill puts in place requirements for new occupational licenses, requires review of existing licenses every five years and puts oversight on scope of practice expansion within current licenses.


SF 2307:  Eliminates independent verification of college transcripts for licensure in Iowa.  


SF 2354:  Extends Medicaid coverage for postpartum support for up to one year after birth.  (note study included in HF 2578)