General Assembly: 81 (2006 Regular GA) - Chapter 1114 - Brain injury services program


Published: 2006-05-23

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259 LAWS OF THE EIGHTY-FIRST G.A., 2006 SESSION CH. 1114

CH. 1114CH. 1114

CHAPTER 1114

BRAIN INJURY SERVICES PROGRAM

H.F. 2772

AN ACT creating a brain injury services program and providing for allocation of a previously enacted appropriation.

Be It Enacted by the General Assembly of the State of Iowa:

Section 1. NEW SECTION. 135.22B BRAIN INJURY SERVICES PROGRAM. 1. DEFINITIONS. For the purposes of this section: a. “Brain injury services waiver” means the state’s medical assistance home and commu-

nity-based services waiver for persons with brain injury implemented under chapter 249A. b. “Program administrator” means the division of the department designated to administer

the brain injury services program in accordance with subsection 2. 2. PROGRAM CREATED. a. A brain injury services program is created and shall be administered by a division of the

Iowa department of public health in cooperation with counties and the department of human services. b. The division of the department assigned to administer the advisory council on brain inju-

ries under section 135.22A shall be the program administrator. The division duties shall in- clude but are not limited to serving as the fiscal agent and contract administrator for the pro- gram and providing program oversight. c. The division shall consult with the advisory council on brain injuries, established pursu-

ant to section 135.22A, regarding the program and shall report to the council concerning the program at least quarterly. The council shall make recommendations to the department con- cerning the program’s operation. 3. PURPOSE. The purpose of the brain injury services program is to provide services, ser-

vice funding, or other support for personswith a brain injury under one of the programcompo- nents established pursuant to this section. 4. GENERAL REQUIREMENTS — WAIVER ELIGIBLE COMPONENT. a. The component of thebrain injury servicesprogram forpersons eligible for thebrain inju-

ry services waiver is subject to the requirements provided in this subsection. b. If a person is eligible for the brain injury services waiver and is on the waiting list for the

waiver but the appropriation for themedical assistance programdoes not have sufficient fund- ing designated to pay the nonfederal share of the costs to remove the person from the waiting list, the brain injury services programmay provide the funding for the nonfederal share of the costs in order for the person to be removed from the waiting list and receive services under the waiver. c. A person who receives support under the waiver eligible component is not eligible to re-

ceive support under the cost-share component of the program. d. Provision of funding under the waiver eligible component is not an entitlement. Subject

to the department of human services requirements for the brain injury serviceswaiverwaiting list, the program administrator shall make the final determinationwhether fundingwill be au- thorized under this component. 5. GENERAL REQUIREMENTS — COST-SHARE COMPONENT. The cost-share compo-

nent of the brain injury services program shall be directed to persons who have been deter- mined to be ineligible for the brain injury services waiver or persons who are eligible for the waiver but fundingwas not authorized or available to providewaiver eligibility for the persons under thewaiver eligible component. The cost-share component is subject to general require- ments which shall include but are not limited to all of the following: a. Services offered are consistentwith the services offered through the brain injury services

waiver.

260LAWS OF THE EIGHTY-FIRST G.A., 2006 SESSIONCH. 1114

b. Each service consumer has a service plan developed prior to service implementation and the service plan is reviewed and updated at least quarterly. c. All other funding sources for which the service consumer is eligible are utilized to the

greatest extent possible. The funding sources potentially available include but are not limited to community resources and public and private benefit programs. d. The maximum monthly cost of the services provided shall be based on the maximum

monthly amount authorized for the brain injury services waiver. e. Assistance under the cost-share component shall bemade available to a designated num-

ber of service consumers who are eligible, as determined from the funding available for the cost-share component, on a first-come, first-served basis. f. Nothing in this section shall be construed or is intended as, or shall imply, a grant of en-

titlement to services to persons who are eligible for participation in the cost-share component based upon the eligibility provisions adopted consistent with the requirements of this section. Any obligation to provide services pursuant to this section is limited to the extent of the funds appropriated or provided for the cost-share component. 6. COST-SHARECOMPONENTELIGIBILITY. An individualmustmeet all of the following

requirements in order to be eligible for the cost-share component of the brain injury services program: a. The individual is age one month through sixty-four years. b. The individual has a diagnosed brain injury as defined in section 135.22. c. The individual is a resident of this state and either a United States citizen or a qualified

alien as defined in 8 U.S.C. § 1641. d. The cost-share component’s financial eligibility requirements shall be established in ad-

ministrative rule. In establishing the requirements, the department shall consider the eligibil- ity and cost-share requirements used for the hawk-i programunder chapter 514I. The individ- ual must meet the cost-share component’s financial eligibility requirements and be willing to pay a cost-share for the cost-share component. e. The individual does not receive services or funding under any type of medical assistance

home and community-based services waiver. 7. COST-SHARE REQUIREMENTS. a. An individual’s cost-share responsibility for services under the cost-share component

shall be determined on a sliding scale based upon the individual’s family income. An individu- al’s cost-share shall be assessed as a copayment, which shall not exceed thirty percent of the cost payable for the service. b. The service provider shall bill the department for the portion of the cost payable for the

service that is not covered by the individual’s copayment responsibility. 8. APPLICATION PROCESS. a. The applicationmaterials for services under both thewaiver eligible and cost-share com-

ponents of the brain injury services programshall use the application formandothermaterials of the brain injury services waiver. In order to apply for the brain injury services program, the applicant must authorize the department of human services to provide the applicant’s waiver applicationmaterials to the brain injury services program. The applicationmaterials provided shall include but are not limited to the waiver application, and any denial letter, financial as- sessment, and functional assessment regarding the person. b. If a functional assessment for the waiver has not been completed due to a person’s finan-

cial ineligibility for the waiver, the brain injury services programmay provide for a functional assessment todetermine theperson’s needsby reimbursing the department of human services for the assessment. c. The program administrator shall file copies of the individual’s application and needs as-

sessment with the program resource facilitator assigned to the individual’s geographic area. d. The department’s program administrator shall make a final determination as to whether

program funding will be authorized under the cost-share component. 9. SERVICE PROVIDERS ANDREIMBURSEMENT. All of the following requirements ap-

ply to service providers and reimbursement rates payable for services under the cost-share component:

261 LAWS OF THE EIGHTY-FIRST G.A., 2006 SESSION CH. 1114

a. A service provider must either be certified to provide services under the brain injury ser- vices waiver or have a contract with a county to provide services and will become certified to provide services under such waiver within a reasonable period of time specified in rule. b. The reimbursement rate payable for the cost of a service provided under the cost-share

component is the rate payable under themedical assistance program. However, if the service provided does not have a medical assistance program reimbursement rate, the rate shall be the amount payable under the county contract. 10. RESOURCE FACILITATION. The program shall utilize resource facilitators to facili-

tate program services. The resource facilitator shall be available to provide ongoing support for individuals with brain injury in coping with the issues of living with a brain injury and in assisting such individuals in transitioning back to employment and living in the community. The resource facilitator is intended to provide a linkage to existing services and increase the capacity of the state’s providers of services to persons with brain injury by doing all of the fol- lowing: a. Providing brain injury-specific information, support, and resources. b. Enhancing the usage of support commonly available to an individual with brain injury

from the community, family, and personal contacts and linking such individuals to appropri- ate services and community resources. c. Training service providers to provide appropriate brain injury services. d. Accessing, securing, andmaximizing the private and public funding available to support

an individual with a brain injury.

Sec. 2. 2005 Iowa Acts, chapter 179, section 1, subsection 2, paragraph d, is amended to read as follows: d. For distribution to counties as cost-share for county coverage of services to adult persons

with the Iowa department of public health for the brain injury in accordance with the law en- acted as a result of the provisions of 2005 Iowa Acts, House File 876, or other law providing for such coverage to commence service program in the fiscal year beginning July 1, 2006, as provided in accordancewith section 135.22B, if enacted by the Eighty-first General Assembly, 2006 Session:

$ 2,426,893. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Theamount allocated in this paragraph “d” shall be allocatedby the Iowadepartment ofpub-

lic health as follows: (1) For state cost-share of services provided under section 135.22B:

$ 2,092,665. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . (2) For contract resource facilitator services:

$ 173,125. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . (3) For a sole source contract with a statewide association representing community provid-

ers of mental health, mental retardation, and brain injury services to provide, in collaboration with a statewide organization representing individuals with a brain injury and their families, brain injury training services and recruiting of service providers to increase the capacity with- in this state to address the needs of individuals with brain injuries and such individuals’ fami- lies:

$ 40,000. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . (4) For reimbursement for needs assessments performed under section 135.22B:

$ 26,750. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . (5) For match of federal funding, administrative and personnel costs including salaries,

support, maintenance, and miscellaneous purposes: $ 94,353. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

Notwithstanding section 8.33, the appropriatedmoneys allocated in this paragraph “d” that remain unencumbered or unobligated at the close of the fiscal year shall not revert but shall remain available for expenditure for the purposes designated until the close of the succeeding fiscal year.

Sec. 3. EMERGENCY RULES. The Iowa department of public health may adopt adminis-

262LAWS OF THE EIGHTY-FIRST G.A., 2006 SESSIONCH. 1114

trative rules under section 17A.4, subsection 2, and section 17A.5, subsection 2, paragraph “b”, to implement the provisions of this Act, and the rules shall become effective immediately upon filing or on a later effective date specified in the rules, unless the effective date is delayed by the administrative rules review committee. Any rules adopted in accordancewith this section shall not take effect before the rules are reviewed by the administrative rules review commit- tee. The delay authority provided to the administrative rules review committee under section 17A.4, subsection 5, and section 17A.8, subsection 9, shall be applicable to a delay imposed under this section, notwithstanding a provision in those sectionsmaking them inapplicable to section 17A.5, subsection 2, paragraph “b”. Any rules adopted in accordance with the provi- sions of this section shall also be published as notice of intended action as provided in section 17A.4.

Approved May 23, 2006

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CH. 1115CH. 1115

CHAPTER 1115

MENTAL HEALTH AND DISABILITY SERVICES

H.F. 2780

AN ACT relating to persons with mental illness, mental retardation, developmental disabili- ties, or brain injury by addressing purposes and quality standards for services and other support available for such persons, establishing basic financial eligibility standards, ad- dressing state and county financial responsibility for the cost of the services andother sup- port, changing the name of a departmental division, providing for an increase in the reim- bursement of certain service providers, and providing effective and applicability dates.

Be It Enacted by the General Assembly of the State of Iowa:

DIVISION I PURPOSES AND QUALITY STANDARDS

Section 1. Section 125.82, subsection 3, Code 2005, as amended by 2006 Iowa Acts, Senate File 2362,1 section 1, if enacted, and 2006 Iowa Acts, Senate File 2217,2 section 30, if enacted, is amended to read as follows: 3. The person who filed the application and a licensed physician, or qualified mental health

professional as defined in section 229.1 228.1, or certified alcohol and drug counselor certified by the nongovernmental Iowa board of substance abuse certification who has examined the respondent in connectionwith the commitment hearing shall be present at the hearing, unless the court for good cause finds that their presence or testimony is not necessary. The applicant, respondent, and the respondent’s attorney may waive the presence or telephonic appearance of the licensed physician, or qualifiedmental health professional, or certified alcohol and drug counselor who examined the respondent and agree to submit as evidence the written report of the licensed physician, or qualifiedmental health professional, or certified alcohol and drug counselor. The respondent’s attorney shall inform the court if the respondent’s attorney rea- sonably believes that the respondent, due to diminished capacity, cannot make an adequately consideredwaiver decision. “Good cause” for finding that the testimony of the licensed physi- cian, or qualified mental health professional, or certified alcohol and drug counselor who ex-

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1 Chapter 1116 herein 2 Chapter 1159 herein