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Iowa Legislature Moves to Expand Access to Behavioral Health

In its most recent session, the Iowa Legislature took steps to address the statewide shortage of behavioral health services. It passed two laws intended to broaden access to services, and also authorized two work groups to review how the state's existing behavioral health resources could be employed more efficiently. Those groups are required to report back to the Legislature by year end.

Iowa's Director of Human Services will be required, under HF2456, to maintain a minimum of six access centers to offer services on a "no reject, no eject basis." Those centers must be able to serve individuals with a serious mental health or substance use disorder, including those who are court-ordered to participate in mental health or substance use disorder treatment. In addition, the Director is tasked with setting up 22 community treatment teams as well as intensive residential service homes to provide services to up to 120 persons.

The access centers are intended to manage all aspects of both behavioral health and physical health services for their clients. All of the newly required services are to be within specified "core service domains," that include traditional mental health treatment and medication management to assess and improve the client's condition. In addition, the Director is required to provide for crisis management and develop support for community living, for employment, and for activities leading to employment.

HF2456 also requires a review of the commitment process under Chapters 125 and 229 by the Department of Human Services ("DHS"), in cooperation with the Department of Public Health, the judicial branch, and several other stakeholders. This work group is instructed to "report recommendations for improvements . . . to increase efficiencies and more appropriately utilize the array of mental health and disability services available based upon an individual's needs," by December 31, 2018. A similar work group, to be led by DHS and the Iowa Department of Inspections and Appeals, is tasked to report on "the role of tertiary care psychiatric hospitals in the array of mental health services" by November 30, 2018.

In keeping with the focus on broadening access, the Legislature also adopted a bill supporting telehealth, HF2305 that prohibits insurance companies from discriminating "between coverage benefits for health care services that are provided in person and the same health care services that are delivered through telehealth." While the text does not expressly require insurance companies to pay the same rates for telehealth as for in-person health care services, it is a significant move in the direction of full parity. HF2305 is expected to reduce the current difficulty of accessing behavioral health services by making it easier for psychiatrists and psychologists to reach rural patients.


Thomas S. Dean

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