249A.26 - STATE AND COUNTY PARTICIPATION IN FUNDING FOR SERVICES TO PERSONS WITH DISABILITIES -- CASE MANAGEMENT.
249A.26 STATE AND COUNTY PARTICIPATION IN FUNDING FOR
SERVICES TO PERSONS WITH DISABILITIES -- CASE MANAGEMENT.
1. The state shall pay for one hundred percent of the nonfederal
share of the services paid for under any prepaid mental health
services plan for medical assistance implemented by the department as
authorized by law.
2. a. Except as provided for disallowed costs in section
249A.27, the county of legal settlement shall pay for fifty percent
of the nonfederal share of the cost and the state shall have
responsibility for the remaining fifty percent of the nonfederal
share of the cost of case management provided to adults, day
treatment, and partial hospitalization provided under the medical
assistance program for persons with mental retardation, a
developmental disability, or chronic mental illness. For purposes of
this section, persons with mental disorders resulting from
Alzheimer's disease or substance abuse shall not be considered
chronically mentally ill. To the maximum extent allowed under
federal law and regulations, the department shall consult with and
inform a county of legal settlement's central point of coordination
process, as defined in section 331.440, regarding the necessity for
and the provision of any service for which the county is required to
provide reimbursement under this subsection.
b. The state shall pay for one hundred percent of the
nonfederal share of the costs of case management provided for adults,
day treatment, partial hospitalization, and the home and
community-based services waiver services for persons who have no
legal settlement or the legal settlement is unknown so that the
persons are deemed to be state cases.
c. The case management services specified in this subsection
shall be paid for by a county only if the services are provided
outside of a managed care contract.
3. To the maximum extent allowed under federal law and
regulations, a person with mental illness or mental retardation shall
not be eligible for any service which is funded in whole or in part
by a county share of the nonfederal portion of medical assistance
funds unless the person is referred through the central point of
coordination process, as defined in section 331.440. However, to the
extent federal law allows referral of a medical assistance recipient
to a service without approval of the central point of coordination
process, the county of legal settlement shall be billed for the
nonfederal share of costs for any adult person for whom the county
would otherwise be responsible.
4. The county of legal settlement shall pay for one hundred
percent of the nonfederal share of the cost of services provided to
adult persons with chronic mental illness who qualify for
habilitation services in accordance with the rules adopted for the
services. The state shall pay for one hundred percent of the
nonfederal share of the cost of such services provided to such
persons who have no legal settlement or the legal settlement is
unknown so that the persons are deemed to be state cases.
5. The state shall pay for the entire nonfederal share of the
costs for case management services provided to persons seventeen
years of age or younger who are served in a home and community-based
services waiver program under the medical assistance program for
persons with mental retardation.
6. Funding under the medical assistance program shall be provided
for case management services for eligible persons seventeen years of
age or younger residing in counties with child welfare
decategorization projects implemented in accordance with section
232.188, provided these projects have included these persons in the
service plan and the decategorization project county is willing to
provide the nonfederal share of the costs.
7. Unless a county has paid or is paying for the nonfederal share
of the costs of a person's home and community-based waiver services
or placement in an intermediate care facility for persons with mental
retardation under the county's mental health, mental retardation, and
developmental disabilities services fund, or unless a county of legal
settlement would become liable for the costs of services for a person
at the level of care provided in an intermediate care facility for
persons with mental retardation due to the person reaching the age of
majority, the state shall pay for the nonfederal share of the costs
of an eligible person's services under the home and community-based
services waiver for persons with brain injury.
8. If a dispute arises between different counties or between the
department and a county as to the legal settlement of a person who
receives medical assistance for which the nonfederal share is payable
in whole or in part by a county of legal settlement, and cannot be
resolved by the parties, the dispute shall be resolved as provided in
section 225C.8.
9. Notwithstanding section 8.39, the department may transfer
funds appropriated for the medical assistance program to a separate
account established in the department's case management unit in an
amount necessary to pay for expenditures required to provide case
management for mental health, mental retardation, and developmental
disabilities services under the medical assistance program which are
jointly funded by the state and county, pending final settlement of
the expenditures. Funds received by the case management unit in
settlement of the expenditures shall be used to replace the
transferred funds and are available for the purposes for which the
funds were originally appropriated. Section History: Recent Form
91 Acts, ch 158, § 7; 92 Acts, ch 1241, § 74; 93 Acts, ch 172,
§43; 94 Acts, ch 1150, §3; 96 Acts, ch 1183, § 32; 2002 Acts, ch
1120, §3, 9; 2004 Acts, ch 1090, § 33, 52; 2005 Acts, ch 175, §113;
2007 Acts, ch 218, §119 Footnotes
Prohibition against requiring county funding for medical
assistance program waiver for services to persons with brain injury;
94 Acts, ch 1170, § 57