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House Amendment 5916

Amendment Text

PAG LIN
  1  1    Amend House File 2427, as amended, passed, and
  1  2 reprinted by the House, as follows:
  1  3    #1.  Page 1, line 4, by striking the word
  1  4 "subsections" and inserting the following:
  1  5 "subsection".
  1  6    #2.  Page 1, by striking lines 5 through 8.
  1  7    #3.  Page 1, by striking lines 20 and 21 and
  1  8 inserting the following:  "a recommendation supporting
  1  9 the placement developed through the single entry point
  1 10 process.  After determining the legal settlement".
  1 11    #4.  Page 1, line 32, by inserting after the word
  1 12 "evaluation" the following:  ", performed through the
  1 13 single entry point process,".
  1 14    #5.  Page 2, by striking line 8 and inserting the
  1 15 following:  "as determined through the single entry
  1 16 point process."
  1 17    #6.  Page 2, line 35, by striking the words and
  1 18 figures "subsections 2 and 3" and inserting the
  1 19 following:  "subsection 2".
  1 20    #7.  Page 3, line 1, by striking the word "are" and
  1 21 inserting the following:  "is".
  1 22    #8.  Page 3, by striking lines 2 through 9 and
  1 23 inserting the following:
  1 24    "2.  Upon receipt of an application for voluntary
  1 25 admission of a minor, the board of supervisors shall
  1 26 provide for a preadmission diagnostic evaluation of
  1 27 the minor to confirm or establish the need for the
  1 28 admission.  The preadmission diagnostic evaluation
  1 29 shall be performed by a person who meets the
  1 30 qualifications of a qualified mental retardation
  1 31 professional who is designated through the single
  1 32 entry point process."
  1 33    #9.  By striking page 3, line 10, through page 4,
  1 34 line 26, and inserting the following:
  1 35    "Sec.    .  Section 222.28, Code 1995, is amended
  1 36 to read as follows:
  1 37    222.28  COMMISSION TO EXAMINE.
  1 38    The court may, at or prior to the final hearing,
  1 39 appoint a commission of one qualified physician and
  1 40 one qualified psychologist, designated through the
  1 41 single entry point process, who shall make a personal
  1 42 examination of the person alleged to be mentally
  1 43 retarded for the purpose of determining the mental
  1 44 condition of the person."
  1 45    #10.  Page 4, line 31, by striking the words
  1 46 "county of legal settlement" and inserting the
  1 47 following:  "single entry point process".
  1 48    #11.  Page 4, lines 33 and 34, by striking the
  1 49 words ", which are authorized in accordance with the
  1 50 county's management plan,".
  2  1    #12.  Page 5, by striking lines 10 through 12 and
  2  2 inserting the following:
  2  3    "NEW PARAGRAPH.  f.  A county shall not be billed
  2  4 for the cost of a patient unless the patient's
  2  5 admission is authorized through the applicable single
  2  6 entry point process.  The state hospital-school and
  2  7 the county shall work together to locate appropriate
  2  8 alternative placements and services, and to educate
  2  9 patients and the family members of patients regarding
  2 10 such alternatives."
  2 11    #13.  Page 5, by striking lines 13 through 23 and
  2 12 inserting the following:
  2 13    "Sec.    .  Section 222.73, subsection 2,
  2 14 unnumbered paragraph 2, Code Supplement 1995, is
  2 15 amended to read as follows:
  2 16    The per diem costs billed to each county shall not
  2 17 exceed the per diem costs in effect on July 1, 1988
  2 18 billed to the county in the fiscal year beginning July
  2 19 1, 1996.  However, the per diem costs billed to a
  2 20 county may be adjusted annually in a fiscal year to
  2 21 reflect increased costs to the extent of the
  2 22 adjustment in the consumer price index published
  2 23 annually in the federal register by the federal
  2 24 department of labor, bureau of labor statistics
  2 25 percentage increase in the total of county fixed
  2 26 budgets pursuant to the allowed growth factor
  2 27 adjustment authorized by the general assembly for that
  2 28 fiscal year in accordance with section 331.439.
  2 29    Sec.    .  EFFECTIVE DATE.  Section 222.73,
  2 30 subsection 2, unnumbered paragraph 2, Code Supplement
  2 31 1995, as amended by this division of this Act, takes
  2 32 effect July 1, 1997." 
  2 33    #14.  Page 6, line 3, by striking the words "An
  2 34 order".
  2 35    #15.  Page 6, by striking lines 4 and 5 and
  2 36 inserting the following:  "If the costs of a
  2 37 respondent's evaluation or treatment are payable in
  2 38 whole or in part by a county, an order under this
  2 39 section shall be for referral of the respondent
  2 40 through the single entry point process for an".
  2 41    #16.  Page 6, line 17, by striking the word
  2 42 "patient" and inserting the following:  "patient
  2 43 respondent".
  2 44    #17.  Page 6, by striking lines 30 through 32 and
  2 45 inserting the following:  "treatment, and hospital
  2 46 care under this section which are payable in whole or
  2 47 in part by a county shall only be provided as
  2 48 determined through the single entry point process."
  2 49    #18.  Page 7, by striking lines 17 and 18 and
  2 50 inserting the following:  "county shall only be
  3  1 provided as determined through the single entry point
  3  2 process."
  3  3    #19.  Page 7, by striking lines 21 through 24 and
  3  4 inserting the following:
  3  5    "NEW SUBSECTION.  8.  "Single entry point process"
  3  6 means the same as defined in section 331.440."
  3  7    #20.  Page 9, by striking lines 11 and 12 and
  3  8 inserting the following:  "performed through the
  3  9 single entry point process has confirmed that the".
  3 10    #21.  Page 9, by striking lines 17 and 18 and
  3 11 inserting the following:  "provided for through the
  3 12 single entry point process, the evaluation may be
  3 13 performed by a".
  3 14    #22.  Page 10, lines 27 and 28 by striking the
  3 15 words "by the person's county of legal settlement" and
  3 16 inserting the following:  "through the single entry
  3 17 point process".
  3 18    #23.  Page 11, by striking line 8 and inserting the
  3 19 following:  "designated through the single entry point
  3 20 process under section".
  3 21    #24.  Page 11, by striking line 14 and inserting
  3 22 the following:  "designated through the single entry
  3 23 point process under".
  3 24    #25.  Page 12, by striking lines 4 through 7 and
  3 25 inserting the following:  "whole or in part by a
  3 26 county is subject to an authorization for the transfer
  3 27 through the single entry point process."
  3 28    #26.  By striking page 12, line 8, through page 14,
  3 29 line 1, and inserting the following:
  3 30    "Sec.    .  Section 229.1, Code Supplement 1995, is
  3 31 amended by adding the following new subsection:
  3 32    NEW SUBSECTION.  15.  "Single entry point process"
  3 33 means the same as defined in section 331.440.
  3 34    Sec.    .  NEW SECTION.  229.1B  SINGLE ENTRY POINT
  3 35 PROCESS.
  3 36    Notwithstanding any provision of this chapter to
  3 37 the contrary, any person whose hospitalization
  3 38 expenses are payable in whole or in part by a county
  3 39 shall be subject to all requirements of the single
  3 40 entry point process.
  3 41    Sec.    .  Section 229.11, unnumbered paragraph 1,
  3 42 Code 1995, is amended to read as follows:
  3 43    If the applicant requests that the respondent be
  3 44 taken into immediate custody and the judge, upon
  3 45 reviewing the application and accompanying
  3 46 documentation, finds probable cause to believe that
  3 47 the respondent is seriously mentally impaired has a
  3 48 serious mental impairment and is likely to injure the
  3 49 respondent or other persons if allowed to remain at
  3 50 liberty, the judge may enter a written order directing
  4  1 that the respondent be taken into immediate custody by
  4  2 the sheriff or the sheriff's deputy and be detained
  4  3 until the hospitalization hearing, which.  The
  4  4 hospitalization hearing shall be held no more than
  4  5 five days after the date of the order, except that if
  4  6 the fifth day after the date of the order is a
  4  7 Saturday, Sunday, or a holiday, the hearing may be
  4  8 held on the next succeeding business day.  If the
  4  9 expenses of a respondent are payable in whole or in
  4 10 part by a county, for a placement in accordance with
  4 11 subsection 1, the judge shall give notice of the
  4 12 placement to the single entry point process and for a
  4 13 placement in accordance with subsection 2 or 3, the
  4 14 judge shall order the placement in a hospital or
  4 15 facility designated through the single entry point
  4 16 process.  The judge may order the respondent detained
  4 17 for the period of time until the hearing is held, and
  4 18 no longer, in accordance with subsection 1 if
  4 19 possible, and if not then in accordance with
  4 20 subsection 2 or, only if neither of these alternatives
  4 21 are available, in accordance with subsection 3.
  4 22 Detention may be:
  4 23    Sec.    .  Section 229.13, unnumbered paragraph 1,
  4 24 Code 1995, is amended to read as follows:
  4 25    If upon completion of the hearing the court finds
  4 26 that the contention that the respondent is seriously
  4 27 mentally impaired has been has a serious mental
  4 28 impairment is sustained by clear and convincing
  4 29 evidence, it the court shall order the a respondent
  4 30 placed in whose expenses are payable in whole or in
  4 31 part by a county committed to the care of a hospital
  4 32 or facility designated through the single entry point
  4 33 process, and shall order any other respondent
  4 34 committed to the care of a hospital or a facility
  4 35 licensed to care for persons with mental illness or
  4 36 substance abuse or under the care of a facility that
  4 37 is licensed to care for persons with mental illness or
  4 38 substance abuse on an outpatient basis as
  4 39 expeditiously as possible for a complete psychiatric
  4 40 evaluation and appropriate treatment.  If the
  4 41 respondent is ordered at the hearing to undergo
  4 42 outpatient treatment, the outpatient treatment
  4 43 provider must be notified and agree to provide the
  4 44 treatment prior to placement of the respondent under
  4 45 the treatment provider's care.  The court shall
  4 46 furnish to the chief medical officer of the hospital
  4 47 or facility at the time the respondent arrives at the
  4 48 hospital or facility a written finding of fact setting
  4 49 forth the evidence on which the finding is based.  If
  4 50 the respondent is ordered to undergo outpatient
  5  1 treatment, the order shall also require the respondent
  5  2 to cooperate with the treatment provider and comply
  5  3 with the course of treatment.
  5  4    PARAGRAPH DIVIDED.  The chief medical officer of
  5  5 the hospital or facility shall report to the court no
  5  6 more than fifteen days after the individual is
  5  7 admitted to or placed under the care of the hospital
  5  8 or facility, making a recommendation for disposition
  5  9 of the matter.  An extension of time may be granted
  5 10 for not to exceed seven days upon a showing of cause.
  5 11 A copy of the report shall be sent to the respondent's
  5 12 attorney, who may contest the need for an extension of
  5 13 time if one is requested.  Extension of time shall be
  5 14 granted upon request unless the request is contested,
  5 15 in which case the court shall make such inquiry as it
  5 16 deems appropriate and may either order the
  5 17 respondent's release from the hospital or facility or
  5 18 grant extension of time for psychiatric evaluation.
  5 19 If the chief medical officer fails to report to the
  5 20 court within fifteen days after the individual is
  5 21 admitted to or placed under the care of the hospital
  5 22 or facility, and no extension of time has been
  5 23 requested, the chief medical officer is guilty of
  5 24 contempt and shall be punished under chapter 665.  The
  5 25 court shall order a rehearing on the application to
  5 26 determine whether the respondent should continue to be
  5 27 held at or placed under the care of the facility."
  5 28    #27.  Page 14, line 25, by striking the word "in".
  5 29    #28.  Page 14, by striking line 26 and inserting
  5 30 the following:  "through the single entry point
  5 31 process, the said clerk".
  5 32    #29.  Page 14, lines 32 and 33, by striking the
  5 33 words "single entry point process of the person's
  5 34 county of legal settlement" and inserting the
  5 35 following:  "single entry point process".
  5 36    #30.  Page 15, by striking lines 6 through 9 and
  5 37 inserting the following:  "revenue and finance.  A
  5 38 county shall not be billed for the cost of a patient
  5 39 unless the patient's admission is authorized through
  5 40 the single entry point process.  The mental health
  5 41 institute and the county shall work together to locate
  5 42 appropriate alternative placements and services, and
  5 43 to educate patients and family members of patients
  5 44 regarding such alternatives."
  5 45    #31.  Page 15, line 15, by striking the word "in".
  5 46    #32.  Page 15, by striking lines 16 through 20 and
  5 47 inserting the following:  "through the single entry
  5 48 point process.  For the purposes of this chapter,
  5 49 "single entry point process" means the same as defined
  5 50 in section 331.440."
  6  1    #33.  Page 16, by striking lines 4 through 12 and
  6  2 inserting the following:
  6  3    "b.  The per diem costs billed to each county shall
  6  4 not exceed the per diem costs in effect on July 1,
  6  5 1988 billed to the county in the fiscal year beginning
  6  6 July 1, 1996.  However, the per diem costs billed to a
  6  7 county may be adjusted annually to reflect increased
  6  8 costs to the extent of the adjustment in the consumer
  6  9 price index published annually in the federal register
  6 10 by the federal department of labor, bureau of labor
  6 11 statistics percentage increase in the total of county
  6 12 fixed budgets pursuant to the allowed growth factor
  6 13 adjustment authorized by the general assembly for the
  6 14 fiscal year in accordance with section 331.439.
  6 15    Sec.    .  EFFECTIVE DATE.  Section 230.20,
  6 16 subsection 2, paragraph "b", Code Supplement 1995, as
  6 17 amended by this division of this Act, takes effect
  6 18 July 1, 1997."
  6 19    #34.  Page 16, by striking lines 16 through 30 and
  6 20 inserting the following:
  6 21    "Sec.    .  Section 230A.13, unnumbered paragraph
  6 22 2, Code 1995, is amended to read as follows:
  6 23    Release of administrative and diagnostic
  6 24 information which would identify, as defined in
  6 25 section 228.1, subsections 1 and 3, and demographic
  6 26 information necessary for aggregated reporting to meet
  6 27 the data requirements established by the department of
  6 28 human services, division of mental health and
  6 29 developmental disabilities, relating to an individual
  6 30 who is receiving or has received treatment at receives
  6 31 services from a community mental health center shall
  6 32 not through the applicable single entry point process,
  6 33 may be made a condition of support of that center by
  6 34 any county under this section.  Section 331.504,
  6 35 subsection 8 notwithstanding, a community mental
  6 36 health center shall not be required to file a claim
  6 37 which would in any manner identify such an individual,
  6 38 if the center's budget has been approved by the county
  6 39 board under this section and the center is in
  6 40 compliance with section 230A.16, subsection 3."
  6 41    #35.  Page 17, line 21, by striking the words
  6 42 "appropriate and" and inserting the following:
  6 43 "appropriate".
  6 44    #36.  Page 17, by striking lines 22 through 33 and
  6 45 inserting the following:  "The department's goal for
  6 46 the maximum time period for submission of a claim to a
  6 47 county is not more than sixty days following the
  6 48 submission of the claim by the provider of the service
  6 49 to the department.  The department's goal for
  6 50 completion and crediting of a county for cost
  7  1 settlement for the actual costs of a home and
  7  2 community-based waiver service is within two hundred
  7  3 seventy days of the close of a fiscal year for which
  7  4 cost reports are due from providers.  The department
  7  5 shall".
  7  6    #37.  By striking page 18, line 5 through page 19,
  7  7 line 21 and inserting the following:
  7  8    "NEW SUBSECTION.  5.  a.  The state-county
  7  9 management committee shall recommend to the department
  7 10 the actions necessary to assist in the transition of
  7 11 individuals being served in an intermediate care
  7 12 facility for the mentally retarded, who are
  7 13 appropriate for the transition, to services funded
  7 14 under a medical assistance waiver for home and
  7 15 community-based services for persons with mental
  7 16 retardation in a manner which maximizes the use of
  7 17 existing public and private facilities.  The actions
  7 18 may include but are not limited to submitting any of
  7 19 the following or a combination of any of the following
  7 20 as a request for a revision of the medical assistance
  7 21 waiver for home and community-based services for
  7 22 persons with mental retardation in effect as of June
  7 23 30, 1996:
  7 24    (1)  Allow for the transition of intermediate care
  7 25 facilities for the mentally retarded licensed under
  7 26 chapter 135C as of June 30, 1996, to services funded
  7 27 under the medical assistance waiver for home and
  7 28 community-based services for persons with mental
  7 29 retardation.  The request shall be for inclusion of
  7 30 additional persons under the waiver associated with
  7 31 the transition.
  7 32    (2)  Allow for reimbursement under the waiver for
  7 33 day program or other service costs.
  7 34    (3)  Allow for exception provisions in which an
  7 35 intermediate care facility for the mentally retarded
  7 36 which does not meet size and other facility-related
  7 37 requirements under the waiver in effect on June 30,
  7 38 1996, may convert to a waiver service for a set period
  7 39 of time such as five years.  Following the set period
  7 40 of time, the facility would be subject to the waiver
  7 41 requirements applicable to services which were not
  7 42 operating under the exception provisions.
  7 43    b.  In implementing the provisions of this
  7 44 subsection, the state-county management committee
  7 45 shall consult with other states.  The waiver revision
  7 46 request or other action necessary to assist in the
  7 47 transition of service provision from intermediate care
  7 48 facilities for the mentally retarded to alternative
  7 49 programs shall be implemented by the department in a
  7 50 manner that can appropriately meet the needs of
  8  1 individuals at an overall lower cost to counties, the
  8  2 federal government, and the state.  In addition, the
  8  3 department shall take into consideration significant
  8  4 federal changes to the medical assistance program in
  8  5 formulating the department's actions under this
  8  6 subsection.  The department shall consult with the
  8  7 state-county management committee in adopting rules
  8  8 for oversight of facilities converted pursuant to this
  8  9 subsection.  A transition approach described in
  8 10 paragraph "a" may be modified as necessary to obtain
  8 11 federal waiver approval.  The department shall report
  8 12 on or before January 2, 1997, to the general assembly
  8 13 regarding its actions under this subsection and any
  8 14 federal response, and shall submit an update upon
  8 15 receiving a federal response to the waiver request or
  8 16 other action taken which requires a federal response.
  8 17 If implementation of any of the provisions of this
  8 18 subsection does not require a federal waiver, the
  8 19 department shall implement the provisions in the
  8 20 fiscal year beginning July 1, 1996."
  8 21    #38.  Page 20, by striking lines 3 through 7 and
  8 22 inserting the following:  "ill.  To the maximum extent
  8 23 allowed under federal law and regulations, the
  8 24 department shall consult with and inform a county of
  8 25 legal settlement's single entry point process, as
  8 26 defined in section 331.440, regarding the necessity
  8 27 for and the provision of any service for which the
  8 28 county is required to provide reimbursement under this
  8 29 subsection.
  8 30    3.  To the maximum extent allowed under federal law
  8 31 and regulations, a person with mental illness or
  8 32 mental retardation shall not be eligible for any
  8 33 service which is funded in whole or in part by a
  8 34 county share of the nonfederal portion of medical
  8 35 assistance funds unless the person is referred through
  8 36 the single entry point process, as defined in section
  8 37 331.440.  However, to the extent federal law allows
  8 38 referral of a medical assistance recipient to a
  8 39 service without approval of the single entry point
  8 40 process, the county of legal settlement shall be
  8 41 billed for the nonfederal share of costs for any adult
  8 42 person for whom the county would otherwise be
  8 43 responsible."
  8 44    #39.  Page 21, by inserting after line 33 the
  8 45 following:
  8 46    "Sec.    .  Section 331.440, Code Supplement 1995,
  8 47 is amended by adding the following new subsection:
  8 48    NEW SUBSECTION.  2A.  An application for services
  8 49 may be made through the single entry point process of
  8 50 a person's county of residence.  However, if a person
  9  1 who is subject to a single entry point process has
  9  2 legal settlement in another county or the costs of
  9  3 services or other support provided to the person are
  9  4 the financial responsibility of the state, an
  9  5 authorization through the single entry point process
  9  6 shall be coordinated with the person's county of legal
  9  7 settlement or with the state, as applicable.  The
  9  8 county of residence and county of legal settlement of
  9  9 a person subject to a single entry point process may
  9 10 mutually agree that the single entry point process
  9 11 functions shall be performed by the single entry point
  9 12 process of the person's county of legal settlement."
  9 13    #40.  Page 21, by inserting after line 33 the
  9 14 following:
  9 15    "Sec.    .  MEDICAL ASSISTANCE CLAIMS AND COST
  9 16 SETTLEMENT.  The department of human services shall
  9 17 formulate a work group which includes representatives
  9 18 of counties designated by the Iowa state association
  9 19 of counties in developing a course of action to meet
  9 20 the goals for submission of claims and completion of
  9 21 cost settlement under section 249A.12, subsection 2,
  9 22 as amended by this Act.  A report which includes data
  9 23 describing the conditions which cause the goal time
  9 24 frames to be exceeded, other conditions associated
  9 25 with billings and payments, and options to address the
  9 26 problems identified shall be submitted to the governor
  9 27 and general assembly on or before December 16, 1996.
  9 28 The options may include possible sanctions for failure
  9 29 to meet the time frames."
  9 30    #41.  Page 22, by striking lines 2 through 11.
  9 31    #42.  By renumbering, relettering, or redesignating
  9 32 and correcting internal references as necessary.  
  9 33 HF 2427S
  9 34 jp/cc/26
     

Text: H05915                            Text: H05917
Text: H05900 - H05999                   Text: H Index
Bills and Amendments: General Index     Bill History: General Index

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