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House Study Bill 176 - IntroducedA Bill ForAn Act 1relating to mental health and disability services
2provided by the state and judicial procedures relating to
3child in need of assistance proceedings, adoptions, and the
4confinement of persons found incompetent to stand trial.
5BE IT ENACTED BY THE GENERAL ASSEMBLY OF THE STATE OF IOWA:
1DIVISION I
2STATE MENTAL HEALTH Institutes — SPECIALIZATION
3 Section 1. Section 226.1, subsection 2, paragraph a,
4subparagraph (1), Code 2023, is amended to read as follows:
5(1) Treatment, training, care, habilitation, and support
6of persons with mental illness or a substance abuse problem
7 including:
8(a) Specialized treatment of behaviorally complex youth at
9a mental health institute located in Independence.
10(b) Specialized treatment and security for adults ordered
11by the court into the custody of the state for the purposes of
12competency restoration, adults who have been acquitted of a
13crime by reason of insanity, and similarly situated adults at a
14mental health institute in Cherokee.
15DIVISION II
16CHILD IN NEED OF ASSISTANCE — SAFETY PLANS — TEMPORARY
17REMOVAL
18 Sec. 2. Section 232.79B, subsections 1, 2, and 3, Code 2023,
19are amended to read as follows:
201. For the purposes of this section, “safety plan” means
21a short-term, time-limited agreement entered into between the
22department and a child’s parent or guardian designed to address
23signs of imminent or impending danger to a child identified by
24the department.
252. Upon the department’s determination that potential harm
26to a child may be mitigated by the development of a safety
27plan, the department may enter into a safety plan with the
28child’s parent or guardian.
293. A safety plan shall not be construed as a removal from
30parental or guardian custody absent a court order placing
31the child with a person or facility other than the parent or
32guardian who entered into the safety plan.
33 Sec. 3. Section 232.95, subsection 4, Code 2023, is amended
34to read as follows:
354. If the court orders the child removed from the home
-1-1pursuant to subsection 2, paragraph “a” “b” or “c”, the court
2shall hold a hearing to review the removal order within six
3months unless a dispositional hearing pursuant to section
4232.99 has been held.
5 Sec. 4. Section 232.102, subsection 10, Code 2023, is
6amended by striking the subsection.
7DIVISION III
8MENTAL HEALTH AND DISABILITY SERVICES REGIONS — GOVERNANCE —
9CASH RESERVES — CORE SERVICES — REPORT
10 Sec. 5. Section 225C.7A, subsection 7, Code 2023, is amended
11by striking the subsection and inserting in lieu thereof the
12following:
137. For the fiscal year beginning July 1, 2023, and each
14succeeding fiscal year, each mental health and disability
15services region for which the amount certified during the
16fiscal year under section 331.391, subsection 4, paragraph “b”,
17exceeds ten percent of the actual expenditures of the region
18for the fiscal year preceding the fiscal year in progress, the
19remaining quarterly payments of the region’s regional service
20payment shall be reduced by an amount equal to the amount by
21which the region’s amount certified under section 331.391,
22subsection 4, paragraph “b”, exceeds ten percent of the actual
23expenditures of the region for the fiscal year preceding the
24fiscal year in progress, but the amount of the reduction
25shall not exceed the total amount of the region’s regional
26service payment for the fiscal year. If the region’s remaining
27quarterly payments are insufficient to effectuate the required
28reductions under this paragraph, the region is required to
29pay to the department any amount for which the reduction in
30quarterly payments could not be made. The amount of reductions
31to quarterly payments and amounts paid to the department under
32this paragraph shall be transferred and credited to the region
33incentive fund under subsection 8.
34 Sec. 6. Section 225C.7A, subsection 8, paragraph c,
35subparagraph (2), subparagraph division (b), Code 2023, is
-2-1amended by striking the subparagraph division and inserting in
2lieu thereof the following:
3(b) For applications for fiscal years beginning on or after
4July 1, 2023, ten percent of the actual expenditures of the
5mental health and disability services region for the fiscal
6year that commenced two years prior to the fiscal year of
7application for assistance.
8 Sec. 7. Section 331.390, subsection 2, Code 2023, is amended
9by striking the subsection and inserting in lieu thereof the
10following:
112. The governing board shall comply with all of the
12following requirements:
13a. Each member of the governing board shall have one vote.
14b. The membership of the governing board shall not include
15employees of the department of health and human services or a
16nonelected employee of a county.
17c. The membership of the governing board shall consist of
18the following:
19(1) Members representing the boards of supervisors of
20counties comprising the region. Members representing the
21boards of supervisors for a region’s counties shall not exceed
22forty-nine percent of the total membership of the governing
23board.
24(2) One member who is an adult person who utilizes mental
25health and disability services or is an actively involved
26relative of such an adult person. This member shall be
27designated by the regional advisory committee formed by the
28governing board pursuant to paragraph “d”.
29(3) One member representing adult service providers in
30the region. This member shall be designated by the regional
31advisory committee formed by the governing board pursuant to
32paragraph “d”.
33(4) One member representing children’s behavioral health
34services providers in the region. This member shall be
35designated by the regional children’s advisory committee formed
-3-1by the governing board pursuant to paragraph “e”.
2(5) One member representing the education system in the
3region. This member shall be designated by the regional
4children’s advisory committee formed by the governing board
5pursuant to paragraph “e”.
6(6) One member who is a parent of a child who utilizes
7children’s behavioral health services or who is an actively
8involved relative of such a child. This member shall be
9designated by the regional children’s advisory committee formed
10by the governing board pursuant to paragraph “e”.
11(7) One member representing law enforcement in the region.
12(8) One member representing the judicial system in the
13region.
14d. The governing board shall have a regional advisory
15committee consisting of adults who utilize services or actively
16involved relatives of such adults, service providers, and
17regional governing board members.
18e. The governing board shall have a regional children’s
19advisory committee consisting of parents of children who
20utilize services or actively involved relatives of such
21children, a member of the education system, an early childhood
22advocate, a child welfare advocate, a children’s behavioral
23health service provider, a member of the juvenile court, a
24pediatrician, a child care provider, a local law enforcement
25representative, and regional governing board members.
26 Sec. 8. Section 331.391, subsection 4, paragraph c, Code
272023, is amended to read as follows:
28c. For fiscal years beginning on or after July 1, 2023, the
29region’s cash flow amount shall not exceed five ten percent
30of the actual expenditures from the combined account for the
31fiscal year preceding the fiscal year in progress.
32 Sec. 9. Section 331.397, subsection 4, Code 2023, is amended
33by adding the following new paragraph:
34 NEW PARAGRAPH. g. Outpatient competency restoration.
35 Sec. 10. Section 331.397A, subsection 4, Code 2023, is
-4-1amended by adding the following new paragraph:
2 NEW PARAGRAPH. c. Outpatient competency restoration.
3 Sec. 11. Section 331.400, Code 2023, is amended to read as
4follows:
5331.400 Quarterly Annual reports.
6Beginning with the fiscal year beginning July 1, 2022 2023,
7the department shall deliver on a quarterly an annual basis
8a report to the general assembly that provides a summary of
9the status of implementing core services in each region,
10the accessibility of core services in each region, how each
11region is using the funding provided under section 225C.7A,
12and recommendations for improvements to the mental health and
13disability services system in order to attain the outcome
14improvement goals set by the department consistent with the
15goals specified in the performance-based contracts under
16section 225C.7A, subsection 2, paragraph “c”, subparagraph (5).
17DIVISION IV
18ADOPTION NOTICES — HEARINGS
19 Sec. 12. Section 600.11, subsection 2, paragraph a,
20subparagraph (7), Code 2023, is amended by striking the
21subparagraph.
22 Sec. 13. Section 600.11, subsection 2, Code 2023, is amended
23by adding the following new paragraph:
24 NEW PARAGRAPH. 0b. (1) At least twenty days prior to the
25adoption hearing, a copy of the order setting the adoption
26hearing shall be provided to siblings of the person to be
27adopted when either of the following applies:
28(a) The sibling and the person to be adopted have an
29existing relationship.
30(b) There is a court finding that ongoing contact with
31the person to be adopted is in the best interest of each
32sibling and the person to be adopted was a minor child when the
33parents of the person to be adopted had their parental rights
34terminated subsequent to the person to be adopted having been
35adjudicated a child in need of assistance.
-5- 1(2) Notwithstanding subsection 3, a copy of the order
2setting the adoption hearing may be provided to a sibling via
3ordinary mail if the sibling’s address is known. A copy of an
4order setting an adoption hearing sent to a sibling under ten
5years of age shall be addressed to the sibling’s custodian or
6guardian.
7(3) This paragraph does not require a copy of the order
8setting the adoption hearing to be provided to any of the
9following:
10(a) A person whose parental rights have been terminated with
11regard to the person to be adopted.
12(b) Siblings who are placed with the sibling to be adopted
13at the time the court issued the order setting the adoption
14hearing.
15(c) A previously adopted sibling, unless the siblings were
16the subjects of child in need of assistance or termination of
17parental rights proceedings that occurred at the same time.
18DIVISION V
19CONFINEMENT OF PERSONS FOUND INCOMPETENT TO STAND TRIAL
20 Sec. 14. Section 812.6, subsection 1, Code 2023, is amended
21to read as follows:
221. If the court finds the defendant does not pose a danger
23to the public peace and safety, is otherwise qualified for
24pretrial release, and is willing to cooperate with treatment,
25the court shall order, as a condition of pretrial release,
26that the defendant obtain mental health treatment designed to
27restore the defendant to competency. The costs of treatment
28pursuant to this subsection shall be paid by the mental
29health and disability services region for the county of the
30defendant’s residency pursuant to chapter 225C regardless of
31whether the defendant meets financial eligibility requirements
32under section 225C.62 or 225C.66.
33 Sec. 15. Section 812.7, Code 2023, is amended to read as
34follows:
35812.7 Mental status reports.
-6- 1The psychiatrist or licensed doctorate-level psychologist
2providing evaluating the progress of the outpatient competency
3restoration treatment to of the defendant, or the director of
4the facility where the defendant is being held and treated
5pursuant to a court order, shall provide a written status
6report to the court regarding the defendant’s mental disorder
7within, methods used to restore competency to the defendant,
8the defendant’s current abilities related to competency,
9and whether it appears the defendant’s competency can be
10restored within a reasonable amount of time. The psychiatrist,
11psychologist, or director shall submit an initial report to
12the court no later than thirty days of after the defendant’s
13placement pursuant to section 812.6. The report shall also
14state whether it appears that the defendant can be restored to
15competency in a reasonable amount of time. Progress reports
16shall be provided to the court, and subsequent reports every
17sixty days or less thereafter after the submission of the
18initial report until the defendant’s competency is restored or
19the placement of the defendant is terminated.
20 Sec. 16. Section 812.8, subsections 1 and 3, Code 2023, are
21amended to read as follows:
221. At any time, upon a finding by a psychiatrist or licensed
23doctorate-level psychologist that there is a substantial
24probability that the defendant has acquired the ability
25to appreciate the charge, understand the proceedings, and
26effectively assist in the defendant’s defense, the psychiatrist
27or licensed doctorate-level psychologist providing evaluating
28the progress of the defendant’s outpatient treatment to the
29defendant or the director of the inpatient facility shall
30immediately notify the court. After receiving notice the court
31shall proceed as provided in subsection 4.
323. At any time upon a finding by a treating an evaluating
33 psychiatrist or licensed doctorate-level psychologist that
34there is no substantial probability that the defendant will
35be restored to competency in a reasonable amount of time,
-7-1the psychiatrist or licensed doctorate-level psychologist
2providing evaluating the defendant’s outpatient treatment to
3the defendant or the director of the inpatient facility shall
4immediately notify the court. Upon receiving notification, the
5court shall proceed as provided under subsection 4.
6DIVISION VI
7CONFORMING code CHANGES
8 Sec. 17. Section 256.25, subsections 2 and 3, Code 2023, are
9amended to read as follows:
102. A school district, which may collaborate and partner
11with one or more school districts, area education agencies,
12accredited nonpublic schools, nonprofit agencies, and
13institutions that provide children’s mental health services,
14located in mental health and disability services regions
15providing children’s behavioral health services in accordance
16with chapter 331 225C, subchapter III VII, part 6, may apply
17for a grant under this program to establish a therapeutic
18classroom in the school district in accordance with this
19section.
203. The department shall develop a grant application
21and selection and evaluation criteria. Selection criteria
22shall include a method for prioritizing grant applications
23submitted by school districts. First priority shall be given
24to applications submitted by school districts that submitted an
25application pursuant to this section for the previous fiscal
26year. Second priority shall be given to applications submitted
27by school districts that, pursuant to subsection 2, are
28collaborating and partnering with one or more school districts,
29area education agencies, accredited nonpublic schools,
30nonprofit agencies, or institutions that provide mental health
31services for children. Third priority shall be given to
32applications submitted by school districts located in mental
33health and disability services regions providing behavioral
34health services for children in accordance with chapter 331
35 225C, subchapter III, part 6 VII. Grant awards shall be
-8-1distributed as equitably as possible among small, medium, and
2large school districts. For purposes of this subsection, a
3small school district is a district with an actual enrollment
4of fewer than six hundred pupils; a medium school district is a
5district with an actual enrollment that is at least six hundred
6pupils, but less than two thousand five hundred pupils; and a
7large school district is a district with an actual enrollment
8of two thousand five hundred or more pupils.
9DIVISION VII
10CODE EDITOR DIRECTIVE — MENTAL HEALTH and DISABILITY SERVICES
11CODE TRANSFERS
12 Sec. 18. CODE EDITOR DIRECTIVE.
131. The Code editor is directed to make the following
14transfers:
15a. Section 331.388 to section 225C.55.
16b. Section 331.389 to section 225C.56.
17c. Section 331.390, as amended in this Act, to section
18225C.57.
19d. Section 331.391, as amended in this Act, to section
20225C.58.
21e. Section 331.392 to section 225C.59.
22f. Section 331.393 to section 225C.60.
23g. Section 331.394 to section 225C.61.
24h. Section 331.395 to section 225C.62.
25i. Section 331.396 to section 225C.63.
26j. Section 331.396A to section 225C.64.
27k. Section 331.397, as amended in this Act, to section
28225C.65.
29l. Section 331.397A, as amended in this Act, to section
30225C.66.
31m. Section 331.398 to section 225C.67.
32n. Section 331.399 to section 225C.68.
33o. Section 331.400, as amended in this Act, to section
34225C.69.
352. The Code editor shall correct internal references in the
-9-1Code and in any enacted legislation as necessary due to the
2enactment of this section.
33. The Code editor may add a new subchapter to chapter
4225C preceding section 225C.55 entitled “MENTAL HEALTH AND
5DISABILITY SERVICES — REGIONAL SERVICE SYSTEM — CHILDREN’S
6BEHAVIORAL HEALTH SYSTEM”.
7EXPLANATION
8The inclusion of this explanation does not constitute agreement with
9the explanation’s substance by the members of the general assembly.
10This bill relates to mental health and disability services
11provided by the state and judicial procedures relating to
12child in need of assistance proceedings, adoptions, and the
13confinement of persons found incompetent to stand trial. The
14bill is organized into divisions.
15DIVISION I — STATE MENTAL HEALTH INSTITUTES —
16SPECIALIZATION. The bill removes persons who solely have a
17substance abuse problem as a population eligible to receive
18treatment, training, care, habilitation, and support at a state
19mental health institute.
20The bill designates the state mental health institute
21located in Independence, Iowa, for specialized treatment of
22behaviorally complex youth, and designates the state mental
23health institute located in Cherokee, Iowa, for specialized
24treatment and security of adults ordered by the court into
25the custody of the state for the purposes of competency
26restoration, adults who have been acquitted of a crime by
27reason of insanity, and similarly situated adults.
28DIVISION II — CHILD IN NEED OF ASSISTANCE — SAFETY PLANS
29— TEMPORARY REMOVAL. The bill allows, in a child in need
30of assistance proceeding, a child’s guardian to enter into a
31safety plan, and prohibits a safety plan from being construed
32as a child’s removal from a guardian absent a court order
33placing the child with a person or facility other than the
34guardian who entered into the safety plan.
35The bill makes a corrective change to Code section
-10-1232.95(2)(a) relating to hearings concerning the temporary
2removal of a child in child in need of assistance cases.
3The bill strikes Code section 232.102(10) relating to
4transfer of legal custody of a child in a child in need of
5assistance case for placement and visitation of the child by
6the child’s grandparents, great-grandparents, and certain other
7adult relatives.
8DIVISION III — MENTAL HEALTH AND DISABILITY SERVICES
9REGIONS — GOVERNANCE — CASH RESERVES — CORE SERVICES —
10REPORT. The bill increases the amount of moneys a mental
11health and disability services (MHDS) regional combined account
12may have before payments to the MHDS region are reduced and
13an MHDS region is disqualified from receiving funding from
14an MHDS incentive fund. The bill provides that, for fiscal
15years beginning on or after July 1, 2023, an MHDS region’s cash
16reserves cannot exceed 10 percent of the actual expenditures
17from the combined account for the fiscal year preceding the
18fiscal year in progress. Under current law, for fiscal years
19beginning on or after July 1, 2023, an MHDS region’s cash
20reserves cannot exceed 5 percent of the actual expenditures
21from the combined account for the fiscal year preceding the
22fiscal year in progress.
23The bill makes changes to the regional governance of
24MHDS governing boards. The bill allows each member of an
25MHDS governing board to have a vote, limits the number of
26representatives county boards of supervisors may have on an
27MHDS regional governing board to 49 percent of the total
28governing board membership, and adds a member representing law
29enforcement and a member representing the judicial system in an
30MHDS region as representatives on an MHDS governing board.
31The bill limits an MHDS region’s cash flow amount to 10
32percent of the actual expenditures from the combined account
33for the fiscal year preceding the fiscal year in progress.
34Under current law, the cash flow amount is limited to 5 percent
35of the actual expenditures from the combined account for the
-11-1fiscal year preceding the fiscal year in progress.
2The bill adds outpatient competency restoration as a core
3service for both adult and children’s MHDS regions.
4The bill requires the department of health and human
5services (HHS) to deliver a report on an annual basis to the
6general assembly that provides a summary of the status of
7implementing core services in each region, the accessibility
8of core services in each region, how each region is using the
9funding provided to MHDS regions, and recommendations for
10improvements to the MHDS system in order to attain the outcome
11improvement goals set by HHS. Under current law, HHS is
12required to give such a report on a quarterly basis.
13DIVISION IV — ADOPTION NOTICES — HEARINGS. The bill
14requires an adoption petitioner to provide a copy of the order
15setting the adoption hearing to siblings of a person to be
16adopted at least 20 days prior to the adoption hearing when
17there is either an existing relationship or a court finding
18that ongoing contact with the person to be adopted is in the
19best interests of each sibling and the person to be adopted was
20a minor child when the parents of the person to be adopted had
21their parental rights terminated subsequent to the person to be
22adopted having been adjudicated a child in need of assistance.
23The bill allows a copy of the order setting the adoption
24hearing to be provided to a sibling via ordinary mail if the
25sibling’s address is known. A copy of an order setting an
26adoption hearing sent to a sibling under 10 years of age shall
27be addressed to the sibling’s custodian or guardian.
28The bill does not require a copy of the order setting the
29adoption hearing to be provided to a person whose parental
30rights have been terminated with regard to the person to be
31adopted; siblings who are placed with the sibling to be adopted
32at the time the court issued the order setting the adoption
33hearing; or a previously adopted sibling, unless the siblings
34were the subjects of child in need of assistance or termination
35of parental rights proceedings that occurred at the same time.
-12- 1DIVISION V — CONFINEMENT OF PERSONS FOUND INCOMPETENT TO
2STAND TRIAL. The bill requires the MHDS region for the county
3of a defendant’s residency to pay for the costs of mental
4health treatment the defendant receives as a condition of
5pretrial release.
6The bill allows a psychiatrist or licensed doctorate-level
7psychologist evaluating the progress of a defendant’s
8outpatient competency restoration treatment, or the director
9of the facility where the defendant is being held and treated
10pursuant to a court order, to provide a written status report
11to the court regarding the defendant’s mental disorder. Under
12current law, only the psychiatrist or licensed doctorate
13level psychologist providing the defendant’s treatment or the
14director of the facility where the defendant is being held and
15treated can provide the written status report.
16The bill requires a written status report prepared for an
17incompetent defendant to include the methods used to restore
18competency to the defendant, the defendant’s current abilities
19related to competency, and whether it appears the defendant’s
20competency can be restored within a reasonable amount of time.
21The bill requires a psychiatrist, psychologist, or director to
22submit an initial report to the court no later than 30 days
23after the defendant’s placement by the court for treatment, and
24subsequent reports every 60 days or less after submission of
25the initial report until the defendant’s competency is restored
26or the placement of the defendant is terminated.
27The bill requires a psychiatrist or licensed doctorate-level
28psychologist evaluating the progress of a defendant’s
29outpatient competency restoration treatment, or the director
30of the facility where the defendant is being held and treated
31pursuant to a court order, to notify a court if there is a
32substantial probability or is no substantial probability that
33a defendant formerly deemed incompetent either has acquired
34the ability to appreciate the charge against the defendant,
35understand the proceedings, and effectively assist in the
-13-1defendant’s defense or will be restored to competency in
2a reasonable amount of time. Under current law, only the
3psychiatrist or licensed doctorate-level psychologist providing
4the defendant’s treatment or the director of the facility where
5the defendant is being held and treated could provide such
6notice to a court.
7DIVISION VI — CONFORMING CODE CHANGE. The bill makes a
8conforming change to Code section 256.25 (therapeutic classroom
9incentive grant program — fund).
10DIVISION VII — CODE TRANSFERS. The bill transfers Code
11sections 331.388 through 331.400 (mental health and disability
12services — regional service system — children’s behavioral
13health system) to Code sections 225C.55 through 225C.69 and
14directs the Code editor to make conforming changes.
-14-dg/rh
2provided by the state and judicial procedures relating to
3child in need of assistance proceedings, adoptions, and the
4confinement of persons found incompetent to stand trial.
5BE IT ENACTED BY THE GENERAL ASSEMBLY OF THE STATE OF IOWA:
1DIVISION I
2STATE MENTAL HEALTH Institutes — SPECIALIZATION
3 Section 1. Section 226.1, subsection 2, paragraph a,
4subparagraph (1), Code 2023, is amended to read as follows:
5(1) Treatment, training, care, habilitation, and support
6of persons with mental illness or a substance abuse problem
7 including:
8(a) Specialized treatment of behaviorally complex youth at
9a mental health institute located in Independence.
10(b) Specialized treatment and security for adults ordered
11by the court into the custody of the state for the purposes of
12competency restoration, adults who have been acquitted of a
13crime by reason of insanity, and similarly situated adults at a
14mental health institute in Cherokee.
15DIVISION II
16CHILD IN NEED OF ASSISTANCE — SAFETY PLANS — TEMPORARY
17REMOVAL
18 Sec. 2. Section 232.79B, subsections 1, 2, and 3, Code 2023,
19are amended to read as follows:
201. For the purposes of this section, “safety plan” means
21a short-term, time-limited agreement entered into between the
22department and a child’s parent or guardian designed to address
23signs of imminent or impending danger to a child identified by
24the department.
252. Upon the department’s determination that potential harm
26to a child may be mitigated by the development of a safety
27plan, the department may enter into a safety plan with the
28child’s parent or guardian.
293. A safety plan shall not be construed as a removal from
30parental or guardian custody absent a court order placing
31the child with a person or facility other than the parent or
32guardian who entered into the safety plan.
33 Sec. 3. Section 232.95, subsection 4, Code 2023, is amended
34to read as follows:
354. If the court orders the child removed from the home
-1-1pursuant to subsection 2, paragraph “a” “b” or “c”, the court
2shall hold a hearing to review the removal order within six
3months unless a dispositional hearing pursuant to section
4232.99 has been held.
5 Sec. 4. Section 232.102, subsection 10, Code 2023, is
6amended by striking the subsection.
7DIVISION III
8MENTAL HEALTH AND DISABILITY SERVICES REGIONS — GOVERNANCE —
9CASH RESERVES — CORE SERVICES — REPORT
10 Sec. 5. Section 225C.7A, subsection 7, Code 2023, is amended
11by striking the subsection and inserting in lieu thereof the
12following:
137. For the fiscal year beginning July 1, 2023, and each
14succeeding fiscal year, each mental health and disability
15services region for which the amount certified during the
16fiscal year under section 331.391, subsection 4, paragraph “b”,
17exceeds ten percent of the actual expenditures of the region
18for the fiscal year preceding the fiscal year in progress, the
19remaining quarterly payments of the region’s regional service
20payment shall be reduced by an amount equal to the amount by
21which the region’s amount certified under section 331.391,
22subsection 4, paragraph “b”, exceeds ten percent of the actual
23expenditures of the region for the fiscal year preceding the
24fiscal year in progress, but the amount of the reduction
25shall not exceed the total amount of the region’s regional
26service payment for the fiscal year. If the region’s remaining
27quarterly payments are insufficient to effectuate the required
28reductions under this paragraph, the region is required to
29pay to the department any amount for which the reduction in
30quarterly payments could not be made. The amount of reductions
31to quarterly payments and amounts paid to the department under
32this paragraph shall be transferred and credited to the region
33incentive fund under subsection 8.
34 Sec. 6. Section 225C.7A, subsection 8, paragraph c,
35subparagraph (2), subparagraph division (b), Code 2023, is
-2-1amended by striking the subparagraph division and inserting in
2lieu thereof the following:
3(b) For applications for fiscal years beginning on or after
4July 1, 2023, ten percent of the actual expenditures of the
5mental health and disability services region for the fiscal
6year that commenced two years prior to the fiscal year of
7application for assistance.
8 Sec. 7. Section 331.390, subsection 2, Code 2023, is amended
9by striking the subsection and inserting in lieu thereof the
10following:
112. The governing board shall comply with all of the
12following requirements:
13a. Each member of the governing board shall have one vote.
14b. The membership of the governing board shall not include
15employees of the department of health and human services or a
16nonelected employee of a county.
17c. The membership of the governing board shall consist of
18the following:
19(1) Members representing the boards of supervisors of
20counties comprising the region. Members representing the
21boards of supervisors for a region’s counties shall not exceed
22forty-nine percent of the total membership of the governing
23board.
24(2) One member who is an adult person who utilizes mental
25health and disability services or is an actively involved
26relative of such an adult person. This member shall be
27designated by the regional advisory committee formed by the
28governing board pursuant to paragraph “d”.
29(3) One member representing adult service providers in
30the region. This member shall be designated by the regional
31advisory committee formed by the governing board pursuant to
32paragraph “d”.
33(4) One member representing children’s behavioral health
34services providers in the region. This member shall be
35designated by the regional children’s advisory committee formed
-3-1by the governing board pursuant to paragraph “e”.
2(5) One member representing the education system in the
3region. This member shall be designated by the regional
4children’s advisory committee formed by the governing board
5pursuant to paragraph “e”.
6(6) One member who is a parent of a child who utilizes
7children’s behavioral health services or who is an actively
8involved relative of such a child. This member shall be
9designated by the regional children’s advisory committee formed
10by the governing board pursuant to paragraph “e”.
11(7) One member representing law enforcement in the region.
12(8) One member representing the judicial system in the
13region.
14d. The governing board shall have a regional advisory
15committee consisting of adults who utilize services or actively
16involved relatives of such adults, service providers, and
17regional governing board members.
18e. The governing board shall have a regional children’s
19advisory committee consisting of parents of children who
20utilize services or actively involved relatives of such
21children, a member of the education system, an early childhood
22advocate, a child welfare advocate, a children’s behavioral
23health service provider, a member of the juvenile court, a
24pediatrician, a child care provider, a local law enforcement
25representative, and regional governing board members.
26 Sec. 8. Section 331.391, subsection 4, paragraph c, Code
272023, is amended to read as follows:
28c. For fiscal years beginning on or after July 1, 2023, the
29region’s cash flow amount shall not exceed five ten percent
30of the actual expenditures from the combined account for the
31fiscal year preceding the fiscal year in progress.
32 Sec. 9. Section 331.397, subsection 4, Code 2023, is amended
33by adding the following new paragraph:
34 NEW PARAGRAPH. g. Outpatient competency restoration.
35 Sec. 10. Section 331.397A, subsection 4, Code 2023, is
-4-1amended by adding the following new paragraph:
2 NEW PARAGRAPH. c. Outpatient competency restoration.
3 Sec. 11. Section 331.400, Code 2023, is amended to read as
4follows:
5331.400 Quarterly Annual reports.
6Beginning with the fiscal year beginning July 1, 2022 2023,
7the department shall deliver on a quarterly an annual basis
8a report to the general assembly that provides a summary of
9the status of implementing core services in each region,
10the accessibility of core services in each region, how each
11region is using the funding provided under section 225C.7A,
12and recommendations for improvements to the mental health and
13disability services system in order to attain the outcome
14improvement goals set by the department consistent with the
15goals specified in the performance-based contracts under
16section 225C.7A, subsection 2, paragraph “c”, subparagraph (5).
17DIVISION IV
18ADOPTION NOTICES — HEARINGS
19 Sec. 12. Section 600.11, subsection 2, paragraph a,
20subparagraph (7), Code 2023, is amended by striking the
21subparagraph.
22 Sec. 13. Section 600.11, subsection 2, Code 2023, is amended
23by adding the following new paragraph:
24 NEW PARAGRAPH. 0b. (1) At least twenty days prior to the
25adoption hearing, a copy of the order setting the adoption
26hearing shall be provided to siblings of the person to be
27adopted when either of the following applies:
28(a) The sibling and the person to be adopted have an
29existing relationship.
30(b) There is a court finding that ongoing contact with
31the person to be adopted is in the best interest of each
32sibling and the person to be adopted was a minor child when the
33parents of the person to be adopted had their parental rights
34terminated subsequent to the person to be adopted having been
35adjudicated a child in need of assistance.
-5- 1(2) Notwithstanding subsection 3, a copy of the order
2setting the adoption hearing may be provided to a sibling via
3ordinary mail if the sibling’s address is known. A copy of an
4order setting an adoption hearing sent to a sibling under ten
5years of age shall be addressed to the sibling’s custodian or
6guardian.
7(3) This paragraph does not require a copy of the order
8setting the adoption hearing to be provided to any of the
9following:
10(a) A person whose parental rights have been terminated with
11regard to the person to be adopted.
12(b) Siblings who are placed with the sibling to be adopted
13at the time the court issued the order setting the adoption
14hearing.
15(c) A previously adopted sibling, unless the siblings were
16the subjects of child in need of assistance or termination of
17parental rights proceedings that occurred at the same time.
18DIVISION V
19CONFINEMENT OF PERSONS FOUND INCOMPETENT TO STAND TRIAL
20 Sec. 14. Section 812.6, subsection 1, Code 2023, is amended
21to read as follows:
221. If the court finds the defendant does not pose a danger
23to the public peace and safety, is otherwise qualified for
24pretrial release, and is willing to cooperate with treatment,
25the court shall order, as a condition of pretrial release,
26that the defendant obtain mental health treatment designed to
27restore the defendant to competency. The costs of treatment
28pursuant to this subsection shall be paid by the mental
29health and disability services region for the county of the
30defendant’s residency pursuant to chapter 225C regardless of
31whether the defendant meets financial eligibility requirements
32under section 225C.62 or 225C.66.
33 Sec. 15. Section 812.7, Code 2023, is amended to read as
34follows:
35812.7 Mental status reports.
-6- 1The psychiatrist or licensed doctorate-level psychologist
2providing evaluating the progress of the outpatient competency
3restoration treatment to of the defendant, or the director of
4the facility where the defendant is being held and treated
5pursuant to a court order, shall provide a written status
6report to the court regarding the defendant’s mental disorder
7within, methods used to restore competency to the defendant,
8the defendant’s current abilities related to competency,
9and whether it appears the defendant’s competency can be
10restored within a reasonable amount of time. The psychiatrist,
11psychologist, or director shall submit an initial report to
12the court no later than thirty days of after the defendant’s
13placement pursuant to section 812.6. The report shall also
14state whether it appears that the defendant can be restored to
15competency in a reasonable amount of time. Progress reports
16shall be provided to the court, and subsequent reports every
17sixty days or less thereafter after the submission of the
18initial report until the defendant’s competency is restored or
19the placement of the defendant is terminated.
20 Sec. 16. Section 812.8, subsections 1 and 3, Code 2023, are
21amended to read as follows:
221. At any time, upon a finding by a psychiatrist or licensed
23doctorate-level psychologist that there is a substantial
24probability that the defendant has acquired the ability
25to appreciate the charge, understand the proceedings, and
26effectively assist in the defendant’s defense, the psychiatrist
27or licensed doctorate-level psychologist providing evaluating
28the progress of the defendant’s outpatient treatment to the
29defendant or the director of the inpatient facility shall
30immediately notify the court. After receiving notice the court
31shall proceed as provided in subsection 4.
323. At any time upon a finding by a treating an evaluating
33 psychiatrist or licensed doctorate-level psychologist that
34there is no substantial probability that the defendant will
35be restored to competency in a reasonable amount of time,
-7-1the psychiatrist or licensed doctorate-level psychologist
2providing evaluating the defendant’s outpatient treatment to
3the defendant or the director of the inpatient facility shall
4immediately notify the court. Upon receiving notification, the
5court shall proceed as provided under subsection 4.
6DIVISION VI
7CONFORMING code CHANGES
8 Sec. 17. Section 256.25, subsections 2 and 3, Code 2023, are
9amended to read as follows:
102. A school district, which may collaborate and partner
11with one or more school districts, area education agencies,
12accredited nonpublic schools, nonprofit agencies, and
13institutions that provide children’s mental health services,
14located in mental health and disability services regions
15providing children’s behavioral health services in accordance
16with chapter 331 225C, subchapter III VII, part 6, may apply
17for a grant under this program to establish a therapeutic
18classroom in the school district in accordance with this
19section.
203. The department shall develop a grant application
21and selection and evaluation criteria. Selection criteria
22shall include a method for prioritizing grant applications
23submitted by school districts. First priority shall be given
24to applications submitted by school districts that submitted an
25application pursuant to this section for the previous fiscal
26year. Second priority shall be given to applications submitted
27by school districts that, pursuant to subsection 2, are
28collaborating and partnering with one or more school districts,
29area education agencies, accredited nonpublic schools,
30nonprofit agencies, or institutions that provide mental health
31services for children. Third priority shall be given to
32applications submitted by school districts located in mental
33health and disability services regions providing behavioral
34health services for children in accordance with chapter 331
35 225C, subchapter III, part 6 VII. Grant awards shall be
-8-1distributed as equitably as possible among small, medium, and
2large school districts. For purposes of this subsection, a
3small school district is a district with an actual enrollment
4of fewer than six hundred pupils; a medium school district is a
5district with an actual enrollment that is at least six hundred
6pupils, but less than two thousand five hundred pupils; and a
7large school district is a district with an actual enrollment
8of two thousand five hundred or more pupils.
9DIVISION VII
10CODE EDITOR DIRECTIVE — MENTAL HEALTH and DISABILITY SERVICES
11CODE TRANSFERS
12 Sec. 18. CODE EDITOR DIRECTIVE.
131. The Code editor is directed to make the following
14transfers:
15a. Section 331.388 to section 225C.55.
16b. Section 331.389 to section 225C.56.
17c. Section 331.390, as amended in this Act, to section
18225C.57.
19d. Section 331.391, as amended in this Act, to section
20225C.58.
21e. Section 331.392 to section 225C.59.
22f. Section 331.393 to section 225C.60.
23g. Section 331.394 to section 225C.61.
24h. Section 331.395 to section 225C.62.
25i. Section 331.396 to section 225C.63.
26j. Section 331.396A to section 225C.64.
27k. Section 331.397, as amended in this Act, to section
28225C.65.
29l. Section 331.397A, as amended in this Act, to section
30225C.66.
31m. Section 331.398 to section 225C.67.
32n. Section 331.399 to section 225C.68.
33o. Section 331.400, as amended in this Act, to section
34225C.69.
352. The Code editor shall correct internal references in the
-9-1Code and in any enacted legislation as necessary due to the
2enactment of this section.
33. The Code editor may add a new subchapter to chapter
4225C preceding section 225C.55 entitled “MENTAL HEALTH AND
5DISABILITY SERVICES — REGIONAL SERVICE SYSTEM — CHILDREN’S
6BEHAVIORAL HEALTH SYSTEM”.
7EXPLANATION
8The inclusion of this explanation does not constitute agreement with
9the explanation’s substance by the members of the general assembly.
10This bill relates to mental health and disability services
11provided by the state and judicial procedures relating to
12child in need of assistance proceedings, adoptions, and the
13confinement of persons found incompetent to stand trial. The
14bill is organized into divisions.
15DIVISION I — STATE MENTAL HEALTH INSTITUTES —
16SPECIALIZATION. The bill removes persons who solely have a
17substance abuse problem as a population eligible to receive
18treatment, training, care, habilitation, and support at a state
19mental health institute.
20The bill designates the state mental health institute
21located in Independence, Iowa, for specialized treatment of
22behaviorally complex youth, and designates the state mental
23health institute located in Cherokee, Iowa, for specialized
24treatment and security of adults ordered by the court into
25the custody of the state for the purposes of competency
26restoration, adults who have been acquitted of a crime by
27reason of insanity, and similarly situated adults.
28DIVISION II — CHILD IN NEED OF ASSISTANCE — SAFETY PLANS
29— TEMPORARY REMOVAL. The bill allows, in a child in need
30of assistance proceeding, a child’s guardian to enter into a
31safety plan, and prohibits a safety plan from being construed
32as a child’s removal from a guardian absent a court order
33placing the child with a person or facility other than the
34guardian who entered into the safety plan.
35The bill makes a corrective change to Code section
-10-1232.95(2)(a) relating to hearings concerning the temporary
2removal of a child in child in need of assistance cases.
3The bill strikes Code section 232.102(10) relating to
4transfer of legal custody of a child in a child in need of
5assistance case for placement and visitation of the child by
6the child’s grandparents, great-grandparents, and certain other
7adult relatives.
8DIVISION III — MENTAL HEALTH AND DISABILITY SERVICES
9REGIONS — GOVERNANCE — CASH RESERVES — CORE SERVICES —
10REPORT. The bill increases the amount of moneys a mental
11health and disability services (MHDS) regional combined account
12may have before payments to the MHDS region are reduced and
13an MHDS region is disqualified from receiving funding from
14an MHDS incentive fund. The bill provides that, for fiscal
15years beginning on or after July 1, 2023, an MHDS region’s cash
16reserves cannot exceed 10 percent of the actual expenditures
17from the combined account for the fiscal year preceding the
18fiscal year in progress. Under current law, for fiscal years
19beginning on or after July 1, 2023, an MHDS region’s cash
20reserves cannot exceed 5 percent of the actual expenditures
21from the combined account for the fiscal year preceding the
22fiscal year in progress.
23The bill makes changes to the regional governance of
24MHDS governing boards. The bill allows each member of an
25MHDS governing board to have a vote, limits the number of
26representatives county boards of supervisors may have on an
27MHDS regional governing board to 49 percent of the total
28governing board membership, and adds a member representing law
29enforcement and a member representing the judicial system in an
30MHDS region as representatives on an MHDS governing board.
31The bill limits an MHDS region’s cash flow amount to 10
32percent of the actual expenditures from the combined account
33for the fiscal year preceding the fiscal year in progress.
34Under current law, the cash flow amount is limited to 5 percent
35of the actual expenditures from the combined account for the
-11-1fiscal year preceding the fiscal year in progress.
2The bill adds outpatient competency restoration as a core
3service for both adult and children’s MHDS regions.
4The bill requires the department of health and human
5services (HHS) to deliver a report on an annual basis to the
6general assembly that provides a summary of the status of
7implementing core services in each region, the accessibility
8of core services in each region, how each region is using the
9funding provided to MHDS regions, and recommendations for
10improvements to the MHDS system in order to attain the outcome
11improvement goals set by HHS. Under current law, HHS is
12required to give such a report on a quarterly basis.
13DIVISION IV — ADOPTION NOTICES — HEARINGS. The bill
14requires an adoption petitioner to provide a copy of the order
15setting the adoption hearing to siblings of a person to be
16adopted at least 20 days prior to the adoption hearing when
17there is either an existing relationship or a court finding
18that ongoing contact with the person to be adopted is in the
19best interests of each sibling and the person to be adopted was
20a minor child when the parents of the person to be adopted had
21their parental rights terminated subsequent to the person to be
22adopted having been adjudicated a child in need of assistance.
23The bill allows a copy of the order setting the adoption
24hearing to be provided to a sibling via ordinary mail if the
25sibling’s address is known. A copy of an order setting an
26adoption hearing sent to a sibling under 10 years of age shall
27be addressed to the sibling’s custodian or guardian.
28The bill does not require a copy of the order setting the
29adoption hearing to be provided to a person whose parental
30rights have been terminated with regard to the person to be
31adopted; siblings who are placed with the sibling to be adopted
32at the time the court issued the order setting the adoption
33hearing; or a previously adopted sibling, unless the siblings
34were the subjects of child in need of assistance or termination
35of parental rights proceedings that occurred at the same time.
-12- 1DIVISION V — CONFINEMENT OF PERSONS FOUND INCOMPETENT TO
2STAND TRIAL. The bill requires the MHDS region for the county
3of a defendant’s residency to pay for the costs of mental
4health treatment the defendant receives as a condition of
5pretrial release.
6The bill allows a psychiatrist or licensed doctorate-level
7psychologist evaluating the progress of a defendant’s
8outpatient competency restoration treatment, or the director
9of the facility where the defendant is being held and treated
10pursuant to a court order, to provide a written status report
11to the court regarding the defendant’s mental disorder. Under
12current law, only the psychiatrist or licensed doctorate
13level psychologist providing the defendant’s treatment or the
14director of the facility where the defendant is being held and
15treated can provide the written status report.
16The bill requires a written status report prepared for an
17incompetent defendant to include the methods used to restore
18competency to the defendant, the defendant’s current abilities
19related to competency, and whether it appears the defendant’s
20competency can be restored within a reasonable amount of time.
21The bill requires a psychiatrist, psychologist, or director to
22submit an initial report to the court no later than 30 days
23after the defendant’s placement by the court for treatment, and
24subsequent reports every 60 days or less after submission of
25the initial report until the defendant’s competency is restored
26or the placement of the defendant is terminated.
27The bill requires a psychiatrist or licensed doctorate-level
28psychologist evaluating the progress of a defendant’s
29outpatient competency restoration treatment, or the director
30of the facility where the defendant is being held and treated
31pursuant to a court order, to notify a court if there is a
32substantial probability or is no substantial probability that
33a defendant formerly deemed incompetent either has acquired
34the ability to appreciate the charge against the defendant,
35understand the proceedings, and effectively assist in the
-13-1defendant’s defense or will be restored to competency in
2a reasonable amount of time. Under current law, only the
3psychiatrist or licensed doctorate-level psychologist providing
4the defendant’s treatment or the director of the facility where
5the defendant is being held and treated could provide such
6notice to a court.
7DIVISION VI — CONFORMING CODE CHANGE. The bill makes a
8conforming change to Code section 256.25 (therapeutic classroom
9incentive grant program — fund).
10DIVISION VII — CODE TRANSFERS. The bill transfers Code
11sections 331.388 through 331.400 (mental health and disability
12services — regional service system — children’s behavioral
13health system) to Code sections 225C.55 through 225C.69 and
14directs the Code editor to make conforming changes.
-14-dg/rh