Text: HF02557 Text: HF02559 Text: HF02500 - HF02599 Text: HF Index Bills and Amendments: General Index Bill History: General Index
PAG LIN 1 1 HOUSE FILE 2558 1 2 1 3 AN ACT 1 4 RELATING TO MENTAL HEALTH, DEVELOPMENTAL DISABILITY, AND SUB- 1 5 STANCE ABUSE SERVICE, COMMITMENT, AND PAYMENT PROVISIONS, 1 6 AND INCLUDING AN APPLICABILITY PROVISION AND AN EFFECTIVE 1 7 DATE. 1 8 1 9 BE IT ENACTED BY THE GENERAL ASSEMBLY OF THE STATE OF IOWA: 1 10 1 11 DIVISION I 1 12 COMMUNITY MENTAL HEALTH CENTERS 1 13 Section 1. Section 230A.1, Code 1997, is amended to read 1 14 as follows: 1 15 230A.1 ESTABLISHMENT AND SUPPORT OF COMMUNITY MENTAL 1 16 HEALTH CENTERS. 1 17 A county or affiliated counties, by action of the board or 1 18 boards of supervisors, with approval of the administrator of 1 19 the division of mental health and developmental disabilities 1 20 of the department of human services, may establish a community 1 21 mental health center under this chapter to serve the county or 1 22 counties.In establishing the community mental health center,1 23the board of supervisors of each county involved may make a1 24single nonrecurring expenditure, in an amount determined by1 25the board.This section does not limit the authority of the 1 26 board or boards of supervisors of any county or group of 1 27 counties to continue to expend money to support operation of 1 28 the center, and to form agreements with the board of 1 29 supervisors of any additional county for that county to join 1 30 in supporting and receiving services from or through the 1 31 center. 1 32 Sec. 2. Section 230A.3, Code 1997, is amended to read as 1 33 follows: 1 34 230A.3 FORMS OF ORGANIZATION. 1 35 Each community mental health center established or 2 1 continued in operation as authorized by section 230A.1 shall 2 2 be organized and administered in accordance with one of the 2 3two alternative forms prescribed by this chapter. The two2 4alternative forms arefollowing alternative forms: 2 5 1. Direct establishment of the center by the county or 2 6 counties supporting it and administration of the center by an 2 7 elected board of trustees, pursuant to sections 230A.4 to 2 8 230A.11. 2 9 2. Establishment of the center by a nonprofit corporation 2 10 providing services to the county or counties on the basis of 2 11 an agreement with the board or boards of supervisors, pursuant 2 12 to sections 230A.12 and 230A.13. 2 13 3. Continued operation of a center originally established 2 14 prior to July 1, 1998, under subsection 2 without an agreement 2 15 with the board or boards of supervisors which originally 2 16 established the center, provided the center is in compliance 2 17 with the applicable standards adopted by the mental health and 2 18 mental retardation commission. 2 19 Sec. 3. Section 230A.12, unnumbered paragraph 1, Code 2 20 1997, is amended to read as follows: 2 21 Each community mental health center established or 2 22 continued in operation pursuant to section 230A.3,subsection2 232,shall be organized under the Iowa nonprofit corporation Act 2 24 appearing as chapter 504A, except that a community mental 2 25 health center organized under chapter 504 prior to July 1, 2 26 1974, shall not be required by this chapter to adopt the Iowa 2 27 nonprofit corporation Act if it is not otherwise required to 2 28 do so by law. The board of directors of each such community 2 29 mental health center shall enter into an agreement with the 2 30 county or affiliated counties which are to be served by the 2 31 center, which agreement shall include but need not be limited 2 32 to the period of time for which the agreement is to be in 2 33 force, what services the center is to provide for residents of 2 34 the county or counties to be served, standards the center is 2 35 to follow in determining whether and to what extent persons 3 1 seeking services from the center shall be considered able to 3 2 pay the cost of the services received, and policies regarding 3 3 availability of the center's services to persons who are not 3 4 residents of the county or counties served by the center. The 3 5 board of directors, in addition to exercising the powers of 3 6 the board of directors of a nonprofit corporation may: 3 7 Sec. 4. Section 249A.4, Code Supplement 1997, is amended 3 8 by adding the following new subsection: 3 9 NEW SUBSECTION. 15. Establish appropriate reimbursement 3 10 rates for community mental health centers that are accredited 3 11 by the mental health and mental retardation commission. The 3 12 reimbursement rates shall be phased-in over the three-year 3 13 period beginning July 1, 1998, and ending June 30, 2001. 3 14 Sec. 5. Section 230A.3, subsection 3, as enacted by this 3 15 Act, is repealed on July 1, 2001. 3 16 DIVISION II 3 17 LEGAL SETTLEMENT 3 18 Sec. 6. Section 230.1, unnumbered paragraph 1, Code 1997, 3 19 is amended to read as follows: 3 20 The necessary and legal costs and expenses attending the 3 21 taking into custody, care, investigation, admission, 3 22 commitment, and support of a person with mental illness 3 23 admitted or committed to a state hospital shall be paid by a 3 24 county or by the state as follows: 3 25 Sec. 7. Section 230.1, subsections 1 and 2, Code 1997, are 3 26 amended to read as follows: 3 27 1. By the county in which such person has a legal 3 28 settlement,orif the person is eighteen years of age or 3 29 older. 3 30 2. By the state when such person has no legal settlement 3 31 in this state,orwhensuchthe person's legal settlement is 3 32 unknown, or if the person is under eighteen years of age. 3 33 Sec. 8. Section 252.16, subsection 8, Code Supplement 3 34 1997, is amended to read as follows: 3 35 8. A person receiving treatment or support services from 4 1 any provider, whether organized for pecuniary profit or not or 4 2 whether supported by charitable or public or private funds, 4 3 that provides treatment or services for mental retardation, 4 4 developmental disabilities, mental health, brain injury, or 4 5 substance abuse does not acquire legal settlement inthea 4 6 countyin which the site of the provider is locatedunless the 4 7 person continuously resides in that county for one year from 4 8 the date of the last treatment or support service received by 4 9 the person. 4 10 Sec. 9. LEGAL SETTLEMENT PLAN. The department of human 4 11 services shall work with the Iowa state association of 4 12 counties in developing proposals for legal settlement 4 13 determination and for expediting resolution of legal 4 14 settlement disputes. The department shall report on or before 4 15 December 1, 1998, to the general assembly and the governor 4 16 outlining proposals and providing other relevant 4 17 recommendations. 4 18 Sec. 10. EFFECTIVE DATE AND FISCAL ESTIMATE REQUIREMENT. 4 19 Sections 6 and 7 of this division of this Act, amending 4 20 section 230.1, take effect July 1, 1999. The department of 4 21 human services shall work with the Iowa state association of 4 22 counties, legislative fiscal bureau, the behavioral managed 4 23 care contractor under the medical assistance program, and 4 24 other knowledgeable persons in developing a fiscal estimate as 4 25 to the effect on state, county, and federal expenditures to 4 26 implement the provisions of section 230.1, as amended by this 4 27 Act. The state portion of the fiscal estimate shall be 4 28 incorporated into the department's budget for the fiscal year 4 29 beginning July 1, 1999. The department shall submit the 4 30 entire fiscal estimate to the governor and general assembly on 4 31 or before December 1, 1998. 4 32 DIVISION III 4 33 SUPPORTED COMMUNITY LIVING SERVICES 4 34 Sec. 11. Section 135C.6, subsection 1, Code Supplement 4 35 1997, is amended to read as follows: 5 1 1. A person or governmental unit acting severally or 5 2 jointly with any other person or governmental unit shall not 5 3 establish or operate a health care facility in this state 5 4 without a license for the facility. A supported community,5 5supervised apartmentlivingarrangementservice, as defined in 5 6 section 225C.21, is not required to be licensed under this 5 7 chapter, but is subject to approval under section 225C.21 in 5 8 order to receive public funding. 5 9 Sec. 12. Section 225C.21, Code 1997, is amended to read as 5 10 follows: 5 11 225C.21COMMUNITY, SUPERVISED APARTMENTSUPPORTED 5 12 COMMUNITY LIVINGARRANGEMENTSSERVICES. 5 13 1. As used in this section, "supported community,5 14supervised apartmentlivingarrangementservices" meansthe5 15provision of a residenceservices provided in a 5 16 noninstitutional setting to adult persons with mental illness, 5 17 mental retardation, or developmental disabilitieswho are5 18capable of living semi-independently but require minimal5 19supervisionto meet the persons' daily living needs. 5 20 2. The department shall adopt rules pursuant to chapter 5 21 17A establishing minimum standards for the programming of 5 22 supported community, supervised apartmentlivingarrangements5 23 services. The department shall approve all supported 5 24 community, supervised apartmentlivingarrangementsservices 5 25 which meet the minimum standards. 5 26 3. Approved supported community, supervised apartment5 27 livingarrangementsservices may receive funding from the 5 28 state, federal and state social services block grant funds, 5 29 and other appropriate funding sources, consistent with state 5 30 legislation and federal regulations. The funding may be 5 31 provided on a per diem, per hour, or grant basis, as 5 32 appropriate. 5 33 Sec. 13. Section 235B.3, subsection 2, paragraph e, 5 34 subparagraph (6), Code 1997, is amended to read as follows: 5 35 (6) A member of the staff or an employee of a supported 6 1 community, supervised apartmentlivingarrangementservice, 6 2 sheltered workshop, or work activity center. 6 3 DIVISION IV 6 4 HOME AND COMMUNITY-BASED WAIVER SERVICES 6 5 Sec. 14. Section 135C.6, subsection 8, Code Supplement 6 6 1997, is amended to read as follows: 6 7 8. The following residential programs to which the 6 8 department of human services applies accreditation, 6 9 certification, or standards of review shall not be required to 6 10 be licensed as a health care facility under this chapter: 6 11 a. A residential program which provides care to not more 6 12 thanthreefour individuals and receives moneys appropriated 6 13 to the department of human services under provisions of a 6 14 federally approved home and community-based services waiver 6 15 for persons with mental retardation or other medical 6 16 assistance program under chapter 249A. 6 17b. A residential program which serves not more than four6 18individuals and is operating under provisions of a federally6 19approved home and community-based waiver for persons with6 20mental retardation, if all individuals residing in the program6 21receive on-site staff supervision during the entire time6 22period the individuals are present in the program's living6 23unit. The need for the on-site supervision shall be reflected6 24in each individual's program plan developed pursuant to the6 25department of human services' rules relating to case6 26management for persons with mental retardation.In approving 6 27 a residential program under this paragraph, the department of 6 28 human services shall consider the geographic location of the 6 29 program so as to avoid an overconcentration of such programs 6 30 in an area. 6 31c.b. A total of twenty residential care facilities for 6 32 persons with mental retardation which are licensed to serve no 6 33 more than five individuals may be authorized by the department 6 34 of human services to convert to operation as a residential 6 35 program under the provisions of a medical assistance home and 7 1 community-based services waiver for persons with mental 7 2 retardation. A converted residential program is subject to 7 3 the conditions stated in paragraph"b""a" except that the 7 4 program shall not serve more than five individuals. The 7 5 department of human services shall allocate conversion 7 6 authorizations to provide for four conversions in each of the 7 7 department's five service regions. If a conversion 7 8 authorization allocated to a region is not used for conversion 7 9 by January 1, 1998, the department of human services may 7 10 reallocate the unused conversion authorization to another 7 11 region. The department of human services shall study the cost 7 12 effectiveness of the conversions and provide an initial report 7 13 to the general assembly no later than January 2, 1998, and a 7 14 final report no later than December 15, 1998. 7 15 DIVISION V 7 16 MENTAL HEALTH AND DEVELOPMENTAL DISABILITIES 7 17 Sec. 15. Section 225C.6, subsection 1, Code 1997, is 7 18 amended to read as follows: 7 19 1. To the extent funding is available, the commission 7 20 shall perform the following duties: 7 21 a. Advise the administrator on the administration of the 7 22 overall stateplans fordisability services system. 7 23 b. Adopt necessary rules pursuant to chapter 17A which 7 24 relate to disability programs and services, including but not 7 25 limited to definitions of each disability included within the 7 26 term "disability services" as necessary for purposes of state, 7 27 county, and regional planning, programs, and services. 7 28 c. Adopt standards foraccreditation of community mental7 29health centers and comprehensive communitymental health 7 30 centers, services, and programs as recommended under section 7 31 230A.16. 7 32 d. Adopt standards for the care of and services to persons 7 33 with mental illness and mental retardation residing in county 7 34 care facilities recommended under section 227.4. 7 35 e.Adopt standards for the delivery of disability services8 1by the division, and for the maintenance and operation of8 2public or private facilities offering services to persons with8 3disabilities, which are not subject to licensure by the8 4department or the department of inspections and appeals, and8 5review the standards employed by the department or the8 6department of inspections and appeals for licensing facilities8 7which provide services toIf no other person sets standards 8 8 for a service available to persons with disabilities, adopt 8 9 standards for that service. 8 10 f. Assure that proper appeal procedures are available to 8 11 persons aggrieved by decisions, actions, or circumstances 8 12 relating to accreditation. 8 13 g.AwardAdopt necessary rules for awarding grants from 8 14 the state and federal government as well as other moneys that 8 15 become available to the division for grant purposes. 8 16h. Review and rank applications for federal mental health8 17grants prior to submission to the appropriate federal agency.8 18i.h. Annually submit to the governor and the general 8 19 assembly: 8 20 (1) A report concerning the activities of the commission. 8 21 (2) Recommendations formulated by the commission for 8 22 changes in law. 8 23j.i. By January 1 of each odd-numbered year, submit to 8 24 the governor and the general assembly an evaluation of: 8 25 (1) The extent to which services to persons with 8 26 disabilitiesstipulated in the state plansare actually 8 27 available to persons in each county in the state and the 8 28 quality of those services. 8 29 (2) Thecosteffectiveness of the services being provided 8 30 by disability service providers in this state and by each of 8 31 the state mental health institutes established under chapter 8 32 226 and by each of the state hospital-schools established 8 33 under chapter 222. 8 34(3) The cost effectiveness of programs carried out by8 35randomly selected providers receiving money from the state for9 1disability services.9 2k.j. Advise the administrator, the council on human 9 3 services, the governor, and the general assembly on budgets 9 4 and appropriations concerning disability services. 9 5l.k.ConsultCoordinate activities with the Iowa 9 6 governor's planning council for developmental disabilitiesat9 7least twice a year. 9 8m.l. Establish standards for the provision under medical 9 9 assistance of individual case management services. 9 10n. Establish standards for the structure of a service9 11coordination system which ensures a linkage between the9 12service coordination system and individual case management9 13services.9 14o.m. Identify model eligibility guidelines for disability 9 15 services. 9 16p. Identify model guidelines for purchase of disability9 17services and for disability service reimbursement9 18methodologies.9 19q. Prepare, for mental health and developmental9 20disabilities regional planning councils, advance estimates of9 21state and, to the extent possible, federal funds available to9 22counties for purchase of disability services.9 23r.n. Identify basic disability services for planning 9 24 purposes. 9 25s.o. Prepare five-year plans based upon the county 9 26 management plans developedby mental health and developmental9 27disabilities regional planning councilspursuant to section 9 28 331.439. 9 29t. Identify disability services which are eligible for9 30state payment under the mental health and developmental9 31disabilities community services fund created in section9 32225C.7.9 33 p. Work with other state agencies on coordinating, 9 34 collaborating, and communicating concerning activities 9 35 involving persons with disabilities. 10 1 Sec. 16. ACCREDITATION OR CERTIFICATION OF SERVICE 10 2 PROVIDERS. Effective July 1, 1998, the department of human 10 3 services shall include persons with Prader-Willi syndrome, 10 4 who, due to their disability, experience limitations in three 10 5 or more of the major life activities as defined in the federal 10 6 Developmental Disability Assistance and Bill of Rights Act, 10 7 Pub. L. No. 101-496, in the definition of "persons with 10 8 developmental disabilities" used in the department's rules for 10 9 accreditation or certification of providers of services to 10 10 persons with mental illness, mental retardation, and 10 11 developmental disabilities, in 441 IAC 24. 10 12 DIVISION VI 10 13 COUNTY MANAGEMENT PLANS 10 14 Sec. 17. COUNTY MANAGEMENT PLAN PROCESS. The state-county 10 15 management committee shall review the requirements in law and 10 16 rule applicable to county management plans for mental health, 10 17 mental retardation, and development disability services. The 10 18 review shall include, but is not limited to, options for 10 19 allowing a plan to apply to a three-year period with annual 10 20 opportunities for public input and amendment and other 10 21 proposals for streamlining the county management plan process. 10 22 The committee shall include the results of the review in the 10 23 committee's annual report. 10 24 Sec. 18. Section 331.439, subsection 8, Code Supplement 10 25 1997, is amended by striking the subsection and inserting in 10 26 lieu thereof the following: 10 27 8. A county's management plans submitted under this 10 28 section shall provide for services to children from community 10 29 mental health centers and other mental health service 10 30 providers accredited under chapter 225C. 10 31 Sec. 19. 1997 Iowa Acts, chapter 169, section 25, is 10 32 repealed. 10 33 Sec. 20. EFFECTIVE DATE – APPLICABILITY. Sections 18 and 10 34 19 of this division of this Act, amending section 331.439, 10 35 subsection 8, and repealing a 1997 Iowa Acts provision, being 11 1 deemed of immediate importance, take effect upon enactment. A 11 2 county's compliance with any amendment to the county's 11 3 management plan submitted by the county pursuant to 1997 Iowa 11 4 Acts, chapter 169, sections 24 and 25, shall be at the 11 5 county's option or as required under other applicable law. 11 6 DIVISION VII 11 7 DUAL CIVIL COMMITMENTS 11 8 Sec. 21. NEW SECTION. 125.75B DUAL FILINGS. 11 9 An application for involuntary commitment or treatment of a 11 10 respondent under this chapter may be filed contemporaneously 11 11 with an application for involuntary hospitalization of the 11 12 respondent under chapter 229. 11 13 Sec. 22. NEW SECTION. 229.2A DUAL FILINGS. 11 14 An application for involuntary hospitalization of a 11 15 respondent under this chapter may be filed contemporaneously 11 16 with an application for involuntary commitment or treatment of 11 17 the respondent under chapter 125. 11 18 Sec. 23. Section 229.21, subsection 3, Code 1997, is 11 19 amended to read as follows: 11 20 3. a. Any respondent with respect to whom the judicial 11 21 hospitalization referee has found the contention that the 11 22 respondent is seriously mentally impaired or a chronic 11 23 substance abuser sustained by clear and convincing evidence 11 24 presented at a hearing held under section 229.12 or section 11 25 125.82, may appeal from the referee's finding to a judge of 11 26 the district court by giving the clerk notice in writing, 11 27 withinseventen days after the referee's finding is made, 11 28 that an appealtherefromis taken. The appeal may be signed 11 29 by the respondent or by the respondent's next friend, guardian 11 30 or attorney. 11 31 b. An order of a judicial hospitalization referee with a 11 32 finding that the respondent is seriously mentally impaired or 11 33 a chronic substance abuser shall include the following notice, 11 34 located conspicuously on the face of the order: 11 35 "NOTE: The respondent may appeal from this order to a 12 1 judge of the district court by giving written notice of the 12 2 appeal to the clerk of the district court within ten days 12 3 after the date of this order. The appeal may be signed by the 12 4 respondent or by the respondent's next friend, guardian, or 12 5 attorney. For a more complete description of the respondent's 12 6 appeal rights, consult section 229.21 of the Code of Iowa or 12 7 an attorney." 12 8 c. Whensoappealed, the matter shall stand for trial de 12 9 novo. Upon appeal, the court shall schedule a hospitalization 12 10 or commitment hearing before a district judge at the earliest 12 11 practicable time. 12 12 Sec. 24. Section 229.27, subsection 4, Code 1997, is 12 13 amended by striking the subsection. 12 14 Sec. 25. IMPLEMENTATION OF ACT. Section 25B.2, subsection 12 15 3, shall not apply to this division of this Act. 12 16 DIVISION VIII 12 17 SEXUALLY VIOLENT PREDATORS 12 18 Sec. 26. Section 229A.12, if enacted by 1998 Iowa Acts, 12 19 Senate File 2398, section 12, is amended to read as follows: 12 20 229A.12 DIRECTOR OF HUMAN SERVICES – RESPONSIBILITY FOR 12 21 COSTS – DUTIES – REIMBURSEMENT. 12 22 The director of human services shall be responsible for all 12 23 costs relating to the evaluation and treatment of persons 12 24 committed to the director's custody under any provision of 12 25 this chapter. Reimbursement may be obtained by the director 12 26 from the patient and any person legally liable or bound by 12 27 contract for the support of the patient for the cost of care 12 28 and treatment provided. As used in this section, "any person 12 29 legally liable" does not include a political subdivision. 12 30 12 31 12 32 12 33 RON J. CORBETT 12 34 Speaker of the House 12 35 13 1 13 2 13 3 MARY E. KRAMER 13 4 President of the Senate 13 5 13 6 I hereby certify that this bill originated in the House and 13 7 is known as House File 2558, Seventy-seventh General Assembly. 13 8 13 9 13 10 13 11 ELIZABETH ISAACSON 13 12 Chief Clerk of the House 13 13 Approved , 1998 13 14 13 15 13 16 13 17 TERRY E. BRANSTAD 13 18 Governor
Text: HF02557 Text: HF02559 Text: HF02500 - HF02599 Text: HF Index Bills and Amendments: General Index Bill History: General Index
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