Text: S05696 Text: S05698 Text: S05600 - S05699 Text: S Index Bills and Amendments: General Index Bill History: General Index
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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: "the 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 costsin effect on July 1, 19882 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 adjustedannuallyin a fiscal year to 2 21 reflect increased costs to the extent of the 2 22adjustment in the consumer price index published2 23annually in the federal register by the federal2 24department of labor, bureau of labor statistics2 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: "patient2 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 respondentis seriously mentally impairedhas 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 respondentis seriously4 27mentally impaired has beenhas a serious mental 4 28 impairment is sustained by clear and convincing 4 29 evidence,itthe court shall orderthea respondent 4 30placed inwhose 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, thesaidclerk". 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 costsin effect on July 1,6 51988billed 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 theadjustment in the consumer6 9price index published annually in the federal register6 10by the federal department of labor, bureau of labor6 11statisticspercentage 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 17, line 21, by striking the words 6 20 "appropriate and" and inserting the following: 6 21 "appropriate." 6 22 #35. Page 17, by striking lines 22 through 33 and 6 23 inserting the following: "The department's goal for 6 24 the maximum time period for submission of a claim to a 6 25 county is not more than sixty days following the 6 26 submission of the claim by the provider of the service 6 27 to the department. The department's goal for 6 28 completion and crediting of a county for cost 6 29 settlement for the actual costs of a home and 6 30 community-based waiver service is within two hundred 6 31 seventy days of the close of a fiscal year for which 6 32 cost reports are due from providers. The department 6 33 shall". 6 34 #36. By striking page 18, line 5 through page 19, 6 35 line 21 and inserting the following: 6 36 "NEW SUBSECTION. 5. a. The state-county 6 37 management committee shall recommend to the department 6 38 the actions necessary to assist in the transition of 6 39 individuals being served in an intermediate care 6 40 facility for the mentally retarded, who are 6 41 appropriate for the transition, to services funded 6 42 under a medical assistance waiver for home and 6 43 community-based services for persons with mental 6 44 retardation in a manner which maximizes the use of 6 45 existing public and private facilities. The actions 6 46 may include but are not limited to submitting any of 6 47 the following or a combination of any of the following 6 48 as a request for a revision of the medical assistance 6 49 waiver for home and community-based services for 6 50 persons with mental retardation in effect as of June 7 1 30, 1996: 7 2 (1) Allow for the transition of intermediate care 7 3 facilities for the mentally retarded licensed under 7 4 chapter 135C as of June 30, 1996, to services funded 7 5 under the medical assistance waiver for home and 7 6 community-based services for persons with mental 7 7 retardation. The request shall be for inclusion of 7 8 additional persons under the waiver associated with 7 9 the transition. 7 10 (2) Allow for reimbursement under the waiver for 7 11 day program or other service costs. 7 12 (3) Allow for exception provisions in which an 7 13 intermediate care facility for the mentally retarded 7 14 which does not meet size and other facility-related 7 15 requirements under the waiver in effect on June 30, 7 16 1996, may convert to a waiver service for a set period 7 17 of time such as five years. Following the set period 7 18 of time, the facility would be subject to the waiver 7 19 requirements applicable to services which were not 7 20 operating under the exception provisions. 7 21 b. In implementing the provisions of this 7 22 subsection, the state-county management committee 7 23 shall consult with other states. The waiver revision 7 24 request or other action necessary to assist in the 7 25 transition of service provision from intermediate care 7 26 facilities for the mentally retarded to alternative 7 27 programs shall be implemented by the department in a 7 28 manner that can appropriately meet the needs of 7 29 individuals at an overall lower cost to counties, the 7 30 federal government, and the state. In addition, the 7 31 department shall take into consideration significant 7 32 federal changes to the medical assistance program in 7 33 formulating the department's actions under this 7 34 subsection. The department shall consult with the 7 35 state-county management committee in adopting rules 7 36 for oversight of facilities converted pursuant to this 7 37 subsection. A transition approach described in 7 38 paragraph "a" may be modified as necessary to obtain 7 39 federal waiver approval. The department shall report 7 40 on or before January 2, 1997, to the general assembly 7 41 regarding its actions under this subsection and any 7 42 federal response, and shall submit an update upon 7 43 receiving a federal response to the waiver request or 7 44 other action taken which requires a federal response. 7 45 If implementation of any of the provisions of this 7 46 subsection does not require a federal waiver, the 7 47 department shall implement the provisions in the 7 48 fiscal year beginning July 1, 1996." 7 49 #37. Page 20, by striking lines 3 through 7 and 7 50 inserting the following: "ill. To the maximum extent 8 1 allowed under federal law and regulations, the 8 2 department shall consult with and inform a county of 8 3 legal settlement's single entry point process, as 8 4 defined in section 331.440, regarding the necessity 8 5 for and the provision of any service for which the 8 6 county is required to provide reimbursement under this 8 7 subsection. 8 8 3. To the maximum extent allowed under federal law 8 9 and regulations, a person with mental illness or 8 10 mental retardation shall not be eligible for any 8 11 service which is funded in whole or in part by a 8 12 county share of the nonfederal portion of medical 8 13 assistance funds unless the person is referred through 8 14 the single entry point process, as defined in section 8 15 331.440. However, to the extent federal law allows 8 16 referral of a medical assistance recipient to a 8 17 service without approval of the single entry point 8 18 process, the county of legal settlement shall be 8 19 billed for the nonfederal share of costs for any adult 8 20 person for whom the county would otherwise be 8 21 responsible." 8 22 #38. Page 21, by inserting after line 33 the 8 23 following: 8 24 "Sec. . Section 331.440, Code Supplement 1995, 8 25 is amended by adding the following new subsection: 8 26 NEW SUBSECTION. 2A. An application for services 8 27 may be made through the single entry point process of 8 28 a person's county of residence. However, if a person 8 29 who is subject to a single entry point process has 8 30 legal settlement in another county or the costs of 8 31 services or other support provided to the person are 8 32 the financial responsibility of the state, an 8 33 authorization through the single entry point process 8 34 shall be coordinated with the person's county of legal 8 35 settlement or with the state, as applicable. The 8 36 county of residence and county of legal settlement of 8 37 a person subject to a single entry point process may 8 38 mutually agree that the single entry point process 8 39 functions shall be performed by the single entry point 8 40 process of the person's county of legal settlement." 8 41 #39. Page 21, by inserting after line 33 the 8 42 following: 8 43 "Sec. . MEDICAL ASSISTANCE CLAIMS AND COST 8 44 SETTLEMENT. The department of human services shall 8 45 formulate a work group which includes representatives 8 46 of counties designated by the Iowa state association 8 47 of counties in developing a course of action to meet 8 48 the goals for submission of claims and completion of 8 49 cost settlement under section 249A.12, subsection 2, 8 50 as amended by this Act. A report which includes data 9 1 describing the conditions which cause the goal time 9 2 frames to be exceeded, other conditions associated 9 3 with billings and payments, and options to address the 9 4 problems identified shall be submitted to the governor 9 5 and general assembly on or before December 16, 1996. 9 6 The options may include possible sanctions for failure 9 7 to meet the time frames." 9 8 #40. Page 22, by striking lines 2 through 11. 9 9 #41. By renumbering, relettering, or redesignating 9 10 and correcting internal references as necessary. 9 11 9 12 9 13 9 14 ALBERT SORENSEN 9 15 HF 2427.703 76 9 16 jp/sc
Text: S05696 Text: S05698 Text: S05600 - S05699 Text: S Index Bills and Amendments: General Index Bill History: General Index
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