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STATE OF IOWA
KIM REYNOLDS
GOVERNOR
April 30, 2026
The Honorable Paul Pate
Secretary of State of Iowa
State Capitol
Des Moines, Iowa 50319
Dear Mr. Secretary,
I hereby transmit:
House File 2707, an Act relating to alignment of delivery of health and human services
programs and services, aging and disability services, and volunteer services, and
including applicability and effective date provisions.
The above House File is hereby approved on this date.
Sincerjly,
Leyiolds
Governor of lowa^
cc: Secretary of the Senate
Clerk of the House
STATE CAPITOL DES MOINES, IOWA 50319 515.281.5211 WWW.GOVERNOR.IOWA.GOV
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House File 2707
AN ACT
RELATING TO ALIGNMENT OF DELIVERY OF HEALTH AND HUMAN SERVICES
PROGRAMS AND SERVICES, AGING AND DISABILITY SERVICES,
AND VOLUNTEER SERVICES, AND INCLUDING APPLICABILITY AND
EFFECTIVE DATE PROVISIONS,
BE IT ENACTED BY THE GENERAL ASSEMBLY OF THE STATE OF IOWA:
DIVISION I
HEALTH AND HUMAN SERVICES DISTRICTS
Section 1. Section 12.51, subsection 1, Code 2026, is
amended to read as follows:
1. As used in this section unless the context otherwise
requires:
a. "^Administrative services organization" means the same as
defined in section 225A.1.
b. "^Behavioral health district" the same as defined
in section 225A.1.
c. "^Behavioral health district advisory council" means the
same as defined in section 225A.1.
€-r dj_ "^Department" means the department of health and human
services.
d-i "^District behavioral health advisory council" moano the
same aa defined in aoction 225A.1.
Sec. 2. Section 12.51, subsection 2, paragraph b,
subparagraph (3), subparagraph division (d), subparagraph
subdivision (ii). Code 2026, is amended to read as follows:
House Pile 2707r p. 2
(ii) Input from each diatrict behavioral health district
advisory council regarding disbursements from the fund,
intended outcomes, and recommendations for future disbursements
from the fund.
Sec. 3. Section 217.1, Code 2026, is amended by adding the
following new subsection:
NEW SUBSECTION. 4, "^Health and human services district'' or
'^HHS district" a geographic, multicounty area designated
by the department under section 217.IB for statewide program
and service delivery.
Sec. 4. NEW SECTION. 217.IB Health and human services
districts.
1. The department shall divide the entirety of the state
into designated health and human services districts. The
initial HHS districts shall be the same as the behavioral
health districts designated pursuant to section 225A.4, Code
2026, and that exist on the effective date of this division
of this Act. Beginning the calendar year that begins January
1, 2032, and every ten consecutive calendar years thereafter,
the department shall review the efficacy of the designated HHS
districts in performing the HHS districts' functions during the
immediately preceding ten consecutive calendar years.
2. a. The department may modify a designated HHS district.
When modifying a designated HHS district, the department shall
consider all of the following:
(1) City and county boundaries.
(2) The population size that can be effectively served in a
specific area.
(3) Areas of high need for services.
(4) Patterns various populations exhibit when accessing or
receiving services.
b. Notwithstanding chapter 17A, the manner in which
the modification of an HHS district is made, including the
determination of boundaries for a modified HHS district, shall
not be subject to judicial review.
3. The department shall adopt rules pursuant to chapter 17A
to administer this section.
Sec. 5. Section 225A.1, Code 2026, is amended to read as
follows:
House File 2707f p. 3
225A.1 Definitions.
As used in this chapter unless the context otherwise
requires:
1. "^Administrative services organization" means an entity
designated by the department pursuant to section 225A.4, to
develop and perform planning and administrative services in
accordance with a district behavioral health service system
district plan.
2. "'Behavioral health condition" means a substantial
limitation in major life activities due to a mental,
behavioral, or addictive disorder or condition diagnosed in
accordance with the criteria provided in the most current
edition of the diagnostic and statistical manual of mental
disorders, published by the American psychiatric association.
3. "'Behavioral health district" ©t—"'district" means a
geographic, multicounty,—sub state area as designated by the
department under section 225A.4 health and human services
district utilized for the purpose of administering the
behavioral health service system.
4. "'Behavioral health district advisory council" means an
advisory council established pursuant to section 225A.5.
■4-r ^ "'Behavioral health provider" or "'provider" means an
individual, firm, corporation, association, or institution
that, pursuant to this chapter, is providing or has been
approved by the department to provide services to an individual
with a behavioral health condition.
5-r "^Behavioral health service system" means the
behavioral health service system established in section 225A,3.
7. "'Behavioral health service system district plan" or
"'behavioral health district plan" means a plan developed by
an administrative services organization and approved by the
department that outlines the services intended to be provided
within the administrative services organization's behavioral
health district.
8. "'Behavioral health service system state plan" means
the plan developed by the department that describes the key
components of the behavioral health service system.
€-r ""Caregiver" means an adult family member, or other
individual, who is providing care to a person outside of a
House File 2707, p. 4
formal program.
9-r 10. ^^Community mental health center" means an entity
designated by the department to address the mental health needs
of one or more counties.
•8-r 11. '^Department" means the department of health and
human services.
9-r 12. '^Director" means the director of the department of
health and human services.
ItOt—'^District behavioral health advisory council"
or '^advisory council" a council established by an
adminiotrativG scrvicoa organisation under section 225A.5,—be
identify opportunities, addroaa challenges, and advise the
administrative services organization in accordance with oection
225A.5.
■Ht! '^District behavioral health ecrvicc system plan" or
'^district behavioral health plan" means a plan developed by
an administrative services organization and approved by the
department to outline the services intended to be provided
within the administrative services organisation's behavioral
health district.
13. "^Health and human services district" or "^HHS district"
means the same as defined in section 217.1.
•3r2-r 14. "^Indicated prevention" means prevention activities
designed to prevent the onset of substance use disorders in
individuals who do not meet the medical criteria for addiction,
but who show early signs of developing a substance use disorder
in the future.
15. "^Selective prevention" means prevention activities
designed to target subsets of the total population who are
considered at-risk for a substance use disorder by virtue of
their membership in a particular segment of the population.
Selective prevention targets the entire subgroup, regardless of
the degree of risk of any individual within the group.
i-4-! '^Gtate behavioral health acrvicc system plan" or
'^Dtatc behavioral health plan" means the plan developed by the
department that deacribes the key components of the staters
behavioral health service system.
i5-r 16. '^Universal prevention" means prevention activities
designed to address an entire population class for the purpose
House File 2707, p. 5
of preventing or delaying the use of alcohol, tobacco, and
other drugs. Population classes include but are not limited
to the national population, local populations, community
populations, school populations, and neighborhood populations.
Sec. 6. Section 225A.2, subsection 3, paragraph c. Code
2026, is amended to read as follows:
c» Review and approve district behavioral health service
system district plans developed in accordance with the state
behavioral health service system state plan.
Sec. 7. Section 225A.3, subsection 2, paragraph a,
subparagraph (1), unnumbered paragraph 1, Code 2026, is amended
to read as follows:
Develop a state behavioral health service system state plan
that accomplishes all of the following:
Sec. 8. Section 225A.3, subsection 2, paragraph a,
subparagraph (1), subparagraph division (d). Code 2026, is
amended to read as follows:
(d) Is consistent with the department's agency strategic
plan adopted pursuant to section BE.206 BE.204.
Sec. 9. Section 225A.3r subsection 2, paragraph a,
subparagraph (2), unnumbered paragraph 1, Code 2026, is amended
to read as follows:
The department shall do all of the following when developing
the state behavioral health service system state plan:
Sec. 10. Section 225A.3r subsection 2, paragraph a,
subparagraph (2), subparagraph division (b). Code 2026, is
amended to read as follows:
(b) Publish the proposed state behavioral health service
system state plan on the department's internet site and
allow the public to review and comment on the proposed state
behavioral health service system state plan prior to the
adoption of the proposed state behavioral health service system
state plan.
Sec. 11. Section 225A.3, subsection 2, paragraph c. Code
2026, is amended to read as follows:
c. Oversee, provide technical assistance to, and
monitor administrative services organizations to ensure the
administrative services organizations' compliance with district
behavioral health district plans.
House File 2707, p. 6
Sec. 12. Section 225A.3, subsection 2, paragraph k,
subparagraph (9), Code 2026, is amended to read as follows:
(9) Any other requirements the department deems necessary
to ensure that an administrative services organization
fulfills the administrative services organization's duties
as established in this chapter, and as established in the
administrative services organization's district behavioral
health district plan.
Sec. 13. Section 225A.4, subsection 1, Code 2026, is amended
to read as follows:
1. a. The department shall divide the entirety of the
state into designated behavioral health districts.—Behavioral
make available behavioral health prevention, education, early
intervention, treatment, recovery support, and crisis services
related to mental health and addictive disorders, including
but not limited to alcohol use, substance use, tobacco use,
and problem gambling^ shall be made available through in a
consistent manner in each behavioral health district in a
manner consistent with dircctivos each district rccGivcs from
the department.
b-.—For the purpose of providing equitable access to all
services provided through the behavioral health service
system, the department shall consider all of the following when
designating behavioral health districts:
fi-)—City and county lines.
-^2-)—The maximum population size that behavioral health
services available in an area are able to effectively serve.
■(-3d—Areas of high need for behavioral health services.
■(-4d—Patterns various populations exhibit v^hen accessing or
receiving behavioral health services.
€-»—Notwithstanding chapter 17A,—the manner in which the
department designates behavioral health districts including but
not limited to the determination of the boundaries for each
district shall not be subject to judicial review.
Sec. 14. Section 225A.4, subsection 2, paragraph a. Code
2026, is amended to read as follows:
a. The department shall designate an administrative services
organization for each behavioral health district to oversee and
organize each behavioral health district and the behavioral
House File 2707r p. 7
health services associated with the behavioral health district.
The department shall may issue requests for proposals for
administrative services organization candidates.
Sec. 15. Section 225A.4, subsection 2, paragraph b,
subparagraph (2), Code 2026r is amended to read as follows:
(2) A public or private nonprofit agency located in a
the behavioral health district for which the agency is being
designated an administrative services organization, or any
separate organizational unit within that public or private
nonprofit agency, that has the capabilities to engage in the
planning or provision of a broad range of behavioral health
prevention, education, early intervention, treatment, recovery
support, and crisis services related to mental health and
addictive disorders, including but not limited to alcohol use,
substance use, tobacco use, and problem gambling, only as
directed by the department.
Sec. 16. Section 225A.4, subsection 2, paragraph c,
subparagraph (2), Code 2026, is amended to read as follows:
(2) Whether the entity has demonstrated the ability to
ensure the delivery of behavioral health services within the
behavioral health district as required by the department by
rule.
Sec. 17. Section 225A.4, subsection 5, Code 2026, is amended
to read as follows:
5. Each administrative services organization shall perform
all of the following duties:
a. Develop and administer a district behavioral health
district plan in accordance with the standards adopted by the
department by rule.
b. Coordinate the administration of the district behavioral
health district plan with federal, state, and local resources
in order to develop a comprehensive and coordinated local
behavioral health service system.
c. Enter into contracts necessary to provide services under
the district behavioral health district plan.
d. Oversee, provide technical assistance to, and monitor
the compliance of providers contracted by the administrative
services organization to provide behavioral health services in
accordance with the district behavioral health district plan.
House Pile 2707, p. 8
e. Establish a district behavioral health district advisory
council pursuant to section 225A.5.
Sec. 18. Section 225A.5r Code 2026, is amended to read as
follows:
225A.5 Diotrict behavioral Behavioral health district
advisory councils.
1. Each administrative services organization shall
establish a district behavioral health district advisory
council that shall do all of the following;
a. Identify opportunities and address challenges based on
updates received from the administrative services organization
regarding the implementation of the diotrict behavioral health
district plan.
b» Advise the administrative services organization while the
administrative services organization is developing behavioral
health policies.
c. Advise the administrative services organization on how to
best provide access to behavioral health prevention, education,
early intervention, treatment, recovery support, and crisis
services related to mental health and addictive disorders,
including but not limited to alcohol use, substance use,
tobacco use, and problem gambling, throughout the behavioral
health district as directed by the department.
2. Aft A behavioral health district advisory council shall
consist of ten members. Members shall be appointed by the
administrative services organization subject to the following
requirements:
a. Three members shall be local elected public officials
currently holding office within the behavioral health district,
or the public official's designated representative.
b. Three members shall be chosen in accordance with
procedures established by the administrative services
organization to ensure representation of the populations
served within the behavioral health district. At least one
member chosen under this paragraph shall represent child and
adolescent persons.
c. Three members shall be chosen who have experience
or education related to core behavioral health functions,
essential behavioral health services, behavioral health
House File 2707, p. 9
prevention, behavioral health treatment, population-based
behavioral health services, or community-based behavioral
health initiatives.
d. One member shall be a law enforcement representative from
within the behavioral health district.
3. ftft A behavioral health district advisory council shall
perform the duties required under this section regardless of
whether any seat on the behavioral health district advisory
council is vacant.
Sec. 19. Section 225A.6, subsection 4, Code 2026, is amended
to read as follows:
4. Administrative services organizations shall report
to the department, in a manner specified by the department,
information including but not limited to demographic
information, expenditure data, and data concerning the
behavioral health services and other support provided to
individuals in the administrative service organization's
behavioral health district.
Sec. 20. Section 225A.7, subsection 2, paragraph a. Code
2026, is amended to read as follows:
a. Distributions to administrative services organizations
to provide services as outlined in the organizations' district
behavioral health district plan.
Sec. 21. Section 225A.8, subsection 2, unnumbered paragraph
1, Code 2026, is amended to read as follows:
To promote comprehensive tobacco use prevention and control
initiatives outlined in the state behavioral health service
system state plan, an entity shall not perform any of the
following acts:
Sec. 22. EFFECTIVE DATE, This division of this Act, being
deemed of immediate importance, takes effect upon enactment.
DIVISION II
AGING AND DISABILITY SERVICES
Sec. 23. DEPARTMENT OF HEALTH AND HUMAN SERVICES AND AREA
AGENCIES ON AGING — REDESIGNATION OF PLANNING AND SERVICE
AREAS — REVIEW AND REPORT.
1. For purposes of this section, unless the context
otherwise requires:
a. ^Area agency on aging" means the same as defined in 42
House File 2707, p. 10
U.S.C. §3002.
b. ^Department" means the department of health and human
services.
c. ^^Health and human services district" means the same as
defined in section 217.1, as amended in division I of this Act.
d. ^^Planning and service area" means the same as defined in
42 U.S.C. §3002.
e. ^^Redesignation" means the process described in 45 C.F.R.
§1321,13(e) to change the designation of a planning and service
area.
2. The department shall not submit an application for
redesignation for federal approval prior to January 1, 2027.
3. a. The department and each area agency on aging shall
collaborate in good faith to do all of the following:
(1) Determine the full fiscal impact of a proposed
redesignation including but not limited to the costs related
to all of the following:
(a) Transition.
(b) Administration.
(c) Information technology.
(d) Property.
(e) Contract modifications.
(f) Personnel,
(g) The long-term finances of the state and each affected
area agency on aging.
(2) Determine the effects of a proposed redesignation on all
of the following:
(a) Service continuity.
(b) Client access.
(c) Provider networks.
(d) Rural service delivery.
(e) Wait lists.
(f) Consumer choice.
(g) Outcomes for older lowans.
(3) Identify and recommend reasonable alternatives to
redesignation and reasonable means to align aging services
coordination with the geographic boundaries of health and
human services districts in a manner that adequately achieves
the state's policy objectives for the delivery of aging and
House File 2707, p. 11
disability services.
(4) Recommend the date by which a proposed planning
and service area will be implemented as the result of a
redesignation.
b. In completing the requirements under paragraph ^a", the
department and each area agency on aging shall do all of the
following as applicable:
(1) Provide information and data to the department as
determined necessary by the department.
(2) Engage with and receive input from relevant
stakeholders including but not limited to service providers,
consumer representatives, advocates for older lowans, and
representatives of rural and underserved communities.
c. No later than December 15, 2026, the department shall
submit a report to the general assembly that details the
results of the collaboration between the department and the
area agencies on aging under paragraph ^^a". Stakeholders shall
be provided a meaningful opportunity to review and provide
comments on the report prior to the department submitting the
report. A summary of the input from the stakeholder review and
stakeholder comments shall be included in the report.
DIVISION III
VOLUNTEER SERVICES
Sec. 24. Section 15H.2, subsection 1, Code 2026, is amended
to read as follows:
1. The Iowa commission on volunteer service is created
within the department. The governor shall appoint the
commission's members. ¥he director may employ personnel as
noccssary to carry out the duties and roDponoibilitioa of the
commiaaion.
Sec. 25. Section 15H.4, Code 2026, is amended to read as
follows:
15H.4 Administration — funding.
1. ^ The department shall serve as the lead agency for
administration of the commission.
b. The department may consult with the department of
education, the state board of regents, and the department of
workforce development for aisy additional administrative support
as necessary to fulfill the duties of the commission.
House Pile 2707, p. 12
c. All Other state agencies, at the request of the
department, shall provide assistance to the commission to
ensure a fully coordinated state effort for promoting national
and community service.
d. The commission may delegate the administration of
nonpolicymaking duties, in compliance with 42 U.S.C. §12638,
to the executive director and the personnel of the department
subunit for volunteerism created in section 217.13.
2. The commission may accept funds and in-kind services from
other state, federal, and private entities.
Sec. 26. Section 217.13, Code 2026, is amended by striking
the section and inserting in lieu thereof the following:
217.13 Department subunit for volunteerism — volunteer
liability.
1. A subunit for volunteerism is created within the
department under the department's administrative authority to
establish volunteer programs designed to enhance the services
provided by the department and to provide administrative
support for the nonpolicymaking duties of the Iowa commission
on volunteer service as delegated pursuant to section 15H.4.
2. a. The director shall appoint an executive director
to oversee the administration of the department subunit for
volunteerism and to carry out the nonpolicymaking duties of the
Iowa commission on volunteer service as delegated pursuant to
section 15H.4.
b. The department may employ personnel for the subunit
for volunteerism as necessary to carry out the duties of the
subunit for volunteerism and the nonpolicymaking duties of the
Iowa commission on volunteer service as delegated pursuant to
section 15H.4.
3. All volunteers registered with programs administered
under this section and in compliance with rules adopted by
the department pursuant to chapter 17A shall be considered
employees of the state for purposes of chapter 669. However,
this section does not exempt a volunteer guardian from an
action brought under section 658.lA, or a volunteer guardian
or volunteer conservator from an action brought under section
658.3. This section shall not be construed to relieve a
House File 2707, p. 13
volunteer guardian or conservator from duties under chapter
633.
4. The department shall adopt rules pursuant to chapter 17A
to administer this section.
Sec, 27. EFFECTIVE DATE, This division of this Act, being
deemed of immediate importance, takes effect upon enactment.
PAT GRASS]
Speaker dt the House
AMY SINC^IR
President of the Senate
I hereby certify that this bill originated in the House and
is known as House File 2707, Ninety-first General Assembly,
Approved
tHAN .NELSON
Chief Ithe House
, 2026
Gover