Iowa Senate passes mental-health improvements

Support is unanimous for bill now headed for governor's signature

Sen. Mark Chelgren

R-Ottumwa
Sen. Mark Chelgren R-Ottumwa
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DES MOINES — The Iowa Senate on Wednesday unanimously backed legislation now headed to Gov. Kim Reynolds’ desk that will expand and improve mental health and substance abuse disorder services for Iowans statewide.

The governor is expected to sign House File 2456, which has a broad scope — dealing with commitments, licensing of subacute mental health facilities, disclosure of mental health issues to law enforcement, video conferencing of hospitalization hearings, transportation service contracts, mental health and disability services quarterly reports, regional core services, reduction of fund balances from mental health regions, commitment process report and a tertiary care psychiatric hospitals report.

“This is a transformative piece of legislation,” said Sen. Mark Chelgren, R-Ottumwa, floor manager of legislation that builds on Iowa’s community-based regional mental health system and seeks to decrease fragmentation of services.

“Mental-health care has been a challenge for this state and for actually all of the states for quite a while,” Chelgren said. “I know the governor’s office is excited to be able to sign this piece of legislation. It’s important to her also.”

Sen. Jeff Edler, R-State Center, praised legislators for coming up with a bipartisan approach to “dealing with some of the most delicate needs that Iowans have.”

Among the features of the legislation are the establishment of six new access centers offering short-term assistance to Iowans in crisis situations as a lower-cost option to psychiatric hospital units often already at capacity.

The bill also removes the state’s cap on sub-acute beds, expands treatment teams that monitor and assist Iowans with chronic mental illness, improves communication and processes between mental-health professionals and law enforcement.

It also allows providers rather than judges to make mental health care determinations in the least restrictive environment and includes other elements designed to enhance crisis-intervention and evidence-based services to de-escalate problems in a proper treatment setting.

“This is important legislation,” said Sen. Amanda Ragan, D-Mason City. “This is about serving people in the place they need to be served.”

The biggest concern raised during Wednesday’s debate was funding and the state’s long-term commitment to assuring providers get paid on time in a mental-health system that mainly is financed by county property taxes and state and federal Medicaid money.

Independent Sen. David Johnson of Ocheyedan pointed to a fiscal note prepared by the nonpartisan Legislative Services Agency indicating the state’s share of the program costs and wondering whether legislators would “belly up to the bar, so to speak.”

Sen. Matt McCoy, D-Des Moines, said he heard funding concerns from his county supervisors, given that the Legislature appears to be “walking away” from a 2013 commitment to “backfill” property tax revenue after commercial rates were reduced by 10 percent.

“There’s a great deal in this bill that there is to like,” McCoy said despite those funding concerns. “This is something we need. This is something that is bipartisan. This is something that makes enormous sense. The devil is in the detail of how we’re going to honor our commitment as a state.”

SUICIDE TRAINING

Also Wednesday, senators voted 49-0 to direct the state Board of Educational Examiners to adopt administrative rules to require anyone seeking to hold or renew a teaching license to complete at least one hour of training on suicide awareness and prevention.

The requirement would begin in July 2019.

ALCOHOL TESTING

The Senate also voted 44-5 to approve House File 2383 to lower the standard for alcohol impairment in a private workplace from 0.04 to 0.02 blood alcohol content, which is the accepted federal level for truck drivers.

Employers may require alcohol testing if they have a written policy.

Iowa law includes specific rules for workplace alcohol testing as well as safeguards for the employee, including up to two tests to confirm the original results.

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