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Bills and Amendments: General Index     Bill History: General Index

House File 2537

Partial Bill History

Bill Text

PAG LIN
  1  1                                             HOUSE FILE 2537
  1  2  
  1  3                             AN ACT
  1  4 ADDRESSING REDESIGN OF THE SYSTEM FOR SERVICES AND OTHER
  1  5    SUPPORT PROVIDED FOR PERSONS WITH MENTAL ILLNESS, MENTAL
  1  6    RETARDATION OR OTHER DEVELOPMENTAL DISABILITIES, OR BRAIN
  1  7    INJURY.
  1  8 
  1  9 BE IT ENACTED BY THE GENERAL ASSEMBLY OF THE STATE OF IOWA:
  1 10 
  1 11                           DIVISION I
  1 12      COMMISSION – SINGLE ENTRY POINT PROCESS NAME CHANGES
  1 13    Section 1.  Section 135C.23, subsection 2, unnumbered
  1 14 paragraph 2, Code 2003, is amended to read as follows:
  1 15    This section does not prohibit the admission of a patient
  1 16 with a history of dangerous or disturbing behavior to an
  1 17 intermediate care facility for persons with mental illness,
  1 18 intermediate care facility for persons with mental
  1 19 retardation, nursing facility, or county care facility when
  1 20 the intermediate care facility for persons with mental
  1 21 illness, intermediate care facility for persons with mental
  1 22 retardation, nursing facility, or county care facility has a
  1 23 program which has received prior approval from the department
  1 24 to properly care for and manage the patient.  An intermediate
  1 25 care facility for persons with mental illness, intermediate
  1 26 care facility for persons with mental retardation, nursing
  1 27 facility, or county care facility is required to transfer or
  1 28 discharge a resident with dangerous or disturbing behavior
  1 29 when the intermediate care facility for persons with mental
  1 30 illness, intermediate care facility for persons with mental
  1 31 retardation, nursing facility, or county care facility cannot
  1 32 control the resident's dangerous or disturbing behavior.  The
  1 33 department, in coordination with the state mental health and,
  1 34 mental retardation, developmental disabilities, and brain
  1 35 injury commission created in section 225C.5, shall adopt rules
  2  1 pursuant to chapter 17A for programs to be required in
  2  2 intermediate care facilities for persons with mental illness,
  2  3 intermediate care facilities for persons with mental
  2  4 retardation, nursing facilities, and county care facilities
  2  5 that admit patients or have residents with histories of
  2  6 dangerous or disturbing behavior.
  2  7    Sec. 2.  Section 154D.2, subsection 1, paragraph b, Code
  2  8 2003, is amended to read as follows:
  2  9    b.  Has at least two years of supervised clinical
  2 10 experience or its equivalent as approved by the board in
  2 11 consultation with the mental health and, mental retardation,
  2 12 developmental disabilities, and brain injury commission
  2 13 created in section 225C.5.
  2 14    Sec. 3.  Section 154D.2, subsection 2, paragraph b, Code
  2 15 2003, is amended to read as follows:
  2 16    b.  Has at least two years of clinical experience,
  2 17 supervised by a licensee, in assessing mental health needs and
  2 18 problems and in providing appropriate mental health services
  2 19 as approved by the board of behavioral science examiners in
  2 20 consultation with the mental health and, mental retardation,
  2 21 developmental disabilities, and brain injury commission
  2 22 created in section 225C.5.
  2 23    Sec. 4.  Section 225C.2, subsection 2, Code 2003, is
  2 24 amended to read as follows:
  2 25    2.  "Commission" means the mental health and, mental
  2 26 retardation, developmental disabilities, and brain injury
  2 27 commission.
  2 28    Sec. 5.  Section 225C.5, subsection 1, unnumbered paragraph
  2 29 1, Code Supplement 2003, is amended to read as follows:
  2 30    A mental health and, mental retardation, developmental
  2 31 disabilities, and brain injury commission is created as the
  2 32 state policy-making body for the provision of services to
  2 33 persons with mental illness, mental retardation or other
  2 34 developmental disabilities, or brain injury.  The commission
  2 35 shall consist of sixteen voting members appointed to three-
  3  1 year staggered terms by the governor and subject to
  3  2 confirmation by the senate.  Commission members shall be
  3  3 appointed on the basis of interest and experience in the
  3  4 fields of mental health, mental retardation or other
  3  5 developmental disabilities, and brain injury, in a manner so
  3  6 as to ensure adequate representation from persons with
  3  7 disabilities and individuals knowledgeable concerning
  3  8 disability services.  The department shall provide staff
  3  9 support to the commission, and the commission may utilize
  3 10 staff support and other assistance provided to the commission
  3 11 by other persons.  The commission shall meet at least four
  3 12 times per year.  Members of the commission shall include the
  3 13 following persons who, at the time of appointment to the
  3 14 commission, are active members of the indicated groups:
  3 15    Sec. 6.  Section 225C.7, subsection 3, Code 2003, is
  3 16 amended to read as follows:
  3 17    3.  If a county has not established or is not affiliated
  3 18 with a community mental health center under chapter 230A, the
  3 19 county shall expend a portion of the money received under this
  3 20 appropriation to contract with a community mental health
  3 21 center to provide mental health services to the county's
  3 22 residents.  If such a contractual relationship is unworkable
  3 23 or undesirable, the mental health and developmental
  3 24 disabilities commission may waive the expenditure requirement.
  3 25 However, if the commission waives the requirement, the
  3 26 commission shall address the specific concerns of the county
  3 27 and shall attempt to facilitate the provision of mental health
  3 28 services to the county's residents through an affiliation
  3 29 agreement or other means.
  3 30    Sec. 7.  Section 227.4, Code 2003, is amended to read as
  3 31 follows:
  3 32    227.4  STANDARDS FOR CARE OF PERSONS WITH MENTAL ILLNESS OR
  3 33 MENTAL RETARDATION DEVELOPMENTAL DISABILITIES IN COUNTY CARE
  3 34 FACILITIES.
  3 35    The administrator, in cooperation with the department of
  4  1 inspections and appeals, shall recommend, and the mental
  4  2 health and, mental retardation, developmental disabilities,
  4  3 and brain injury commission created in section 225C.5 shall
  4  4 adopt standards for the care of and services to persons with
  4  5 mental illness or mental retardation developmental
  4  6 disabilities residing in county care facilities.  The
  4  7 standards shall be enforced by the department of inspections
  4  8 and appeals as a part of the licensure inspection conducted
  4  9 pursuant to chapter 135C.  The objective of the standards is
  4 10 to ensure that persons with mental illness or mental
  4 11 retardation developmental disabilities who are residents of
  4 12 county care facilities are not only adequately fed, clothed,
  4 13 and housed, but are also offered reasonable opportunities for
  4 14 productive work and recreational activities suited to their
  4 15 physical and mental abilities and offering both a constructive
  4 16 outlet for their energies and, if possible, therapeutic
  4 17 benefit.  When recommending standards under this section, the
  4 18 administrator shall designate an advisory committee
  4 19 representing administrators of county care facilities, county
  4 20 mental health and developmental disabilities regional planning
  4 21 councils, and county care facility resident advocate
  4 22 committees to assist in the establishment of standards.
  4 23    Sec. 8.  Section 229.24, subsection 3, unnumbered paragraph
  4 24 1, Code 2003, is amended to read as follows:
  4 25    If all or part of the costs associated with hospitalization
  4 26 of an individual under this chapter are chargeable to a county
  4 27 of legal settlement, the clerk of the district court shall
  4 28 provide to the county of legal settlement and to the county in
  4 29 which the hospitalization order is entered, in a form
  4 30 prescribed by the mental health and, mental retardation,
  4 31 developmental disabilities, and brain injury commission, the
  4 32 following information pertaining to the individual which would
  4 33 be confidential under subsection 1:
  4 34    Sec. 9.  Section 230A.2, Code 2003, is amended to read as
  4 35 follows:
  5  1    230A.2  SERVICES OFFERED.
  5  2    A community mental health center established or operating
  5  3 as authorized by section 230A.1 may offer to residents of the
  5  4 county or counties it serves any or all of the mental health
  5  5 services defined by the mental health and, mental retardation,
  5  6 developmental disabilities, and brain injury commission in the
  5  7 state mental health plan.
  5  8    Sec. 10.  Section 230A.16, unnumbered paragraph 1, Code
  5  9 2003, is amended to read as follows:
  5 10    The administrator of the division of mental health and
  5 11 developmental disabilities of the department of human services
  5 12 shall recommend and the mental health and, mental retardation,
  5 13 developmental disabilities, and brain injury commission shall
  5 14 adopt standards for community mental health centers and
  5 15 comprehensive community mental health programs, with the
  5 16 overall objective of ensuring that each center and each
  5 17 affiliate providing services under contract with a center
  5 18 furnishes high quality mental health services within a
  5 19 framework of accountability to the community it serves.  The
  5 20 standards shall be in substantial conformity with those of the
  5 21 psychiatric committee of the joint commission on accreditation
  5 22 of health care organizations and other recognized national
  5 23 standards for evaluation of psychiatric facilities unless in
  5 24 the judgment of the administrator of the division of mental
  5 25 health and developmental disabilities, with approval of the
  5 26 mental health and, mental retardation, developmental
  5 27 disabilities, and brain injury commission, there are sound
  5 28 reasons for departing from the standards.  When recommending
  5 29 standards under this section, the administrator of the
  5 30 division shall designate an advisory committee representing
  5 31 boards of directors and professional staff of community mental
  5 32 health centers to assist in the formulation or revision of
  5 33 standards.  At least a simple majority of the members of the
  5 34 advisory committee shall be lay representatives of community
  5 35 mental health center boards of directors.  At least one member
  6  1 of the advisory committee shall be a member of a county board
  6  2 of supervisors.  The standards recommended under this section
  6  3 shall include requirements that each community mental health
  6  4 center established or operating as authorized by section
  6  5 230A.1 shall:
  6  6    Sec. 11.  Section 230A.17, Code 2003, is amended to read as
  6  7 follows:
  6  8    230A.17  REVIEW AND EVALUATION.
  6  9    The administrator of the division of mental health and
  6 10 developmental disabilities of the department of human services
  6 11 may review and evaluate any community mental health center
  6 12 upon the recommendation of the mental health and, mental
  6 13 retardation, developmental disabilities, and brain injury
  6 14 commission, and shall do so upon the written request of the
  6 15 center's board of directors, its chief medical or
  6 16 administrative officer, or the board of supervisors of any
  6 17 county from which the center receives public funds.  The cost
  6 18 of the review shall be paid by the division.
  6 19    Sec. 12.  Section 230A.18, Code 2003, is amended to read as
  6 20 follows:
  6 21    230A.18  REPORT OF REVIEW AND EVALUATION.
  6 22    Upon completion of a review made pursuant to section
  6 23 230A.17, the review shall be submitted to the board of
  6 24 directors and chief medical or administrative officer of the
  6 25 center.  If the review concludes that the center fails to meet
  6 26 any of the standards established pursuant to section 230A.16,
  6 27 subsection 1, and that the response of the center to this
  6 28 finding is unsatisfactory, these conclusions shall be reported
  6 29 to the mental health and, mental retardation, developmental
  6 30 disabilities, and brain injury commission which may forward
  6 31 the conclusions to the board of directors of the center and
  6 32 request an appropriate response within thirty days.  If no
  6 33 response is received within thirty days, or if the response is
  6 34 unsatisfactory, the commission may call this fact to the
  6 35 attention of the board of supervisors of the county or
  7  1 counties served by the center, and in doing so shall indicate
  7  2 what corrective steps have been recommended to the center's
  7  3 board of directors.
  7  4    Sec. 13.  Section 231.44, subsection 2, Code Supplement
  7  5 2003, is amended to read as follows:
  7  6    2.  The responsibilities of the resident advocate committee
  7  7 are in accordance with the rules adopted by the commission
  7  8 pursuant to chapter 17A.  When adopting the rules, the
  7  9 commission shall consider the needs of residents of elder
  7 10 group homes as defined in section 231B.1 and each category of
  7 11 licensed health care facility as defined in section 135C.1,
  7 12 subsection 6, and the services each facility may render.  The
  7 13 commission shall coordinate the development of rules with the
  7 14 mental health and, mental retardation, developmental
  7 15 disabilities, and brain injury commission created in section
  7 16 225C.5 to the extent the rules would apply to a facility
  7 17 primarily serving persons with mental illness, mental
  7 18 retardation, or a other developmental disability, or brain
  7 19 injury.  The commission shall coordinate the development of
  7 20 appropriate rules with other state agencies.
  7 21    Sec. 14.  Section 249A.4, subsection 15, Code Supplement
  7 22 2003, is amended to read as follows:
  7 23    15.  Establish appropriate reimbursement rates for
  7 24 community mental health centers that are accredited by the
  7 25 mental health and, mental retardation, developmental
  7 26 disabilities, and brain injury commission.  The reimbursement
  7 27 rates shall be phased in over the three-year period beginning
  7 28 July 1, 1998, and ending June 30, 2001.
  7 29    Sec. 15.  Section 249A.12, subsection 5, paragraph a,
  7 30 unnumbered paragraph 1, Code Supplement 2003, is amended to
  7 31 read as follows:
  7 32    The mental health and, mental retardation, developmental
  7 33 disabilities, and brain injury commission shall recommend to
  7 34 the department the actions necessary to assist in the
  7 35 transition of individuals being served in an intermediate care
  8  1 facility for persons with mental retardation, who are
  8  2 appropriate for the transition, to services funded under a
  8  3 medical assistance waiver for home and community-based
  8  4 services for persons with mental retardation in a manner which
  8  5 maximizes the use of existing public and private facilities.
  8  6 The actions may include but are not limited to submitting any
  8  7 of the following or a combination of any of the following as a
  8  8 request for a revision of the medical assistance waiver for
  8  9 home and community-based services for persons with mental
  8 10 retardation in effect as of June 30, 1996:
  8 11    Sec. 16.  Section 249A.12, subsection 5, paragraph b, Code
  8 12 Supplement 2003, is amended to read as follows:
  8 13    b.  In implementing the provisions of this subsection, the
  8 14 mental health and, mental retardation, developmental
  8 15 disabilities, and brain injury commission shall consult with
  8 16 other states.  The waiver revision request or other action
  8 17 necessary to assist in the transition of service provision
  8 18 from intermediate care facilities for persons with mental
  8 19 retardation to alternative programs shall be implemented by
  8 20 the department in a manner that can appropriately meet the
  8 21 needs of individuals at an overall lower cost to counties, the
  8 22 federal government, and the state.  In addition, the
  8 23 department shall take into consideration significant federal
  8 24 changes to the medical assistance program in formulating the
  8 25 department's actions under this subsection.  The department
  8 26 shall consult with the mental health and, mental retardation,
  8 27 developmental disabilities, and brain injury commission in
  8 28 adopting rules for oversight of facilities converted pursuant
  8 29 to this subsection.  A transition approach described in
  8 30 paragraph "a" may be modified as necessary to obtain federal
  8 31 waiver approval.
  8 32    Sec. 17.  Section 249A.31, subsection 1, Code 2003, is
  8 33 amended to read as follows:
  8 34    1.  Providers of individual case management services for
  8 35 persons with mental retardation, a developmental disability,
  9  1 or chronic mental illness in accordance with standards adopted
  9  2 by the mental health and, mental retardation, developmental
  9  3 disabilities, and brain injury commission pursuant to section
  9  4 225C.6.
  9  5    Sec. 18.  Section 331.424A, subsection 1, Code Supplement
  9  6 2003, is amended to read as follows:
  9  7    1.  For the purposes of this chapter, unless the context
  9  8 otherwise requires, "services fund" means the county mental
  9  9 health, mental retardation, and developmental disabilities
  9 10 services fund created in subsection 2.  The county finance
  9 11 committee created in section 333A.2 shall consult with the
  9 12 mental health and developmental disabilities state commission
  9 13 in adopting rules and prescribing forms for administering the
  9 14 services fund.
  9 15    Sec. 19.  Section 331.438, subsection 1, paragraph c, Code
  9 16 2003, is amended to read as follows:
  9 17    c.  "Qualified mental health, mental retardation, and
  9 18 developmental disabilities services" means the services
  9 19 specified on forms issued by the county finance committee
  9 20 following consultation with the mental health and
  9 21 developmental disabilities state commission.
  9 22    Sec. 20.  Section 331.438, subsection 1, Code 2003, is
  9 23 amended by adding the following new paragraph:
  9 24    NEW PARAGRAPH.  cc.  "State commission" means the mental
  9 25 health, mental retardation, developmental disabilities, and
  9 26 brain injury commission created in section 225C.5.
  9 27    Sec. 21.  Section 331.438, subsection 4, paragraph a, Code
  9 28 2003, is amended to read as follows:
  9 29    a.  The mental health and developmental disabilities state
  9 30 commission shall make recommendations and take actions for
  9 31 joint state and county planning, implementing, and funding of
  9 32 mental health, mental retardation, and or other developmental
  9 33 disabilities, and brain injury services, including but not
  9 34 limited to developing and implementing fiscal and
  9 35 accountability controls, establishing management plans, and
 10  1 ensuring that eligible persons have access to appropriate and
 10  2 cost-effective services.
 10  3    Sec. 22.  Section 331.438, subsection 4, paragraph b,
 10  4 unnumbered paragraph 1, Code 2003, is amended to read as
 10  5 follows:
 10  6    The mental health and developmental disabilities state
 10  7 commission shall do all of the following:
 10  8    Sec. 23.  Section 331.438, subsection 4, paragraph b,
 10  9 subparagraphs (6) and (9), Code 2003, are amended to read as
 10 10 follows:
 10 11    (6)  Consider provisions and adopt rules for counties to
 10 12 implement a single central point of accountability
 10 13 coordination to plan, budget, and monitor county expenditures
 10 14 for the service system.  The provisions shall provide options
 10 15 for counties to implement the single central point of
 10 16 coordination in collaboration with other counties.
 10 17    (9)  Adopt rules for the county single entry central point
 10 18 of coordination and clinical assessment processes required
 10 19 under section 331.440 and other rules necessary for the
 10 20 implementation of county management plans and expenditure
 10 21 reports required for state payment pursuant to section
 10 22 331.439.
 10 23    Sec. 24.  Section 331.439, subsection 1, unnumbered
 10 24 paragraph 1, Code 2003, is amended to read as follows:
 10 25    The state payment to eligible counties under this section
 10 26 shall be made as provided in sections 331.438 and 426B.2.  A
 10 27 county is eligible for the state payment, as defined in
 10 28 section 331.438, for the a fiscal year beginning July 1, 1996,
 10 29 and for subsequent fiscal years if the director of human
 10 30 services, in consultation with the mental health and
 10 31 developmental disabilities state commission, determines for a
 10 32 specific fiscal year that all of the following conditions are
 10 33 met:
 10 34    Sec. 25.  Section 331.439, subsection 1, paragraph b,
 10 35 unnumbered paragraph 1, Code 2003, is amended to read as
 11  1 follows:
 11  2    The county developed and implemented a county management
 11  3 plan for the county's mental health, mental retardation, and
 11  4 developmental disabilities services in accordance with the
 11  5 provisions of this paragraph "b".  The plan shall comply with
 11  6 the administrative rules adopted for this purpose by the
 11  7 mental health and developmental disabilities state commission
 11  8 and is subject to the approval of the director of human
 11  9 services in consultation with the commission.  The plan shall
 11 10 include a description of the county's service management
 11 11 provision for mental health, mental retardation, and
 11 12 developmental disabilities services.  For mental retardation
 11 13 and developmental disabilities service management, the plan
 11 14 shall describe the county's development and implementation of
 11 15 a managed system of cost-effective individualized services and
 11 16 shall comply with the provisions of paragraph "d".  The goal
 11 17 of this part of the plan shall be to assist the individuals
 11 18 served to be as independent, productive, and integrated into
 11 19 the community as possible.  The service management provisions
 11 20 for mental health shall comply with the provisions of
 11 21 paragraph "c".  A county is subject to all of the following
 11 22 provisions in regard to the county's management plan and
 11 23 planning process:
 11 24    Sec. 26.  Section 331.439, subsection 1, paragraph b,
 11 25 subparagraph (1), Code 2003, is amended to read as follows:
 11 26    (1)  The county shall have in effect an approved policies
 11 27 and procedures manual for the county's services fund.  The
 11 28 county management plan shall be defined in the manual.  The
 11 29 manual submitted by the county as part of the county's
 11 30 management plan for the fiscal year beginning July 1, 2000, as
 11 31 approved by the director of human services, shall remain in
 11 32 effect, subject to amendment.  An amendment to the manual
 11 33 shall be submitted to the department of human services at
 11 34 least forty-five days prior to the date of implementation.
 11 35 Prior to implementation of any amendment to the manual, the
 12  1 amendment must be approved by the director of human services
 12  2 in consultation with the mental health and developmental
 12  3 disabilities state commission.
 12  4    Sec. 27.  Section 331.439, subsection 1, paragraph c,
 12  5 subparagraph (2), unnumbered paragraph 1, Code 2003, is
 12  6 amended to read as follows:
 12  7    A managed care system for mental health proposed by a
 12  8 county shall include but is not limited to all of the
 12  9 following elements which shall be specified in administrative
 12 10 rules adopted by the mental health and developmental
 12 11 disabilities state commission:
 12 12    Sec. 28.  Section 331.439, subsection 1, paragraph d, Code
 12 13 2003, is amended to read as follows:
 12 14    d.  For mental retardation and developmental disabilities
 12 15 services management, the county must either develop and
 12 16 implement a managed system of care which addresses a full
 12 17 array of appropriate services and cost-effective delivery of
 12 18 services or contract with a state-approved managed care
 12 19 contractor or contractors.  Any system or contract implemented
 12 20 under this paragraph shall incorporate a single entry central
 12 21 point of coordination and clinical assessment process
 12 22 developed in accordance with the provisions of section
 12 23 331.440.  The elements of the county managed system of care
 12 24 shall be specified in rules developed by the department of
 12 25 human services in consultation with and adopted by the mental
 12 26 health and developmental disabilities state commission.
 12 27    Sec. 29.  Section 331.439, subsection 3, paragraph b, Code
 12 28 2003, is amended to read as follows:
 12 29    b.  Based upon information contained in county management
 12 30 plans and budgets and proposals made by representatives of
 12 31 counties, the mental health and developmental disabilities
 12 32 state commission shall recommend an allowed growth factor
 12 33 adjustment to the governor by November 15 for the fiscal year
 12 34 which commences two years from the beginning date of the
 12 35 fiscal year in progress at the time the recommendation is
 13  1 made.  The allowed growth factor adjustment shall address
 13  2 costs associated with new consumers of service, service cost
 13  3 inflation, and investments for economy and efficiency.  In
 13  4 developing the service cost inflation recommendation, the
 13  5 state commission shall consider the cost trends indicated by
 13  6 the gross expenditure amount reported in the expenditure
 13  7 reports submitted by counties pursuant to subsection 1,
 13  8 paragraph "a".  The governor shall consider the state
 13  9 commission's recommendation in developing the governor's
 13 10 recommendation for an allowed growth factor adjustment for
 13 11 such fiscal year.  The governor's recommendation shall be
 13 12 submitted at the time the governor's proposed budget for the
 13 13 succeeding fiscal year is submitted in accordance with chapter
 13 14 8.
 13 15    Sec. 30.  Section 331.440, Code 2003, is amended to read as
 13 16 follows:
 13 17    331.440  MENTAL HEALTH, MENTAL RETARDATION, AND
 13 18 DEVELOPMENTAL DISABILITIES SERVICES – SINGLE ENTRY CENTRAL
 13 19 POINT OF COORDINATION PROCESS.
 13 20    1.  a.  For the purposes of this section, unless the
 13 21 context otherwise requires, "single entry "central point of
 13 22 coordination process" means a single entry central point of
 13 23 coordination process established by a county or consortium of
 13 24 counties for the delivery of mental health, mental
 13 25 retardation, and developmental disabilities services which are
 13 26 paid for in whole or in part by county funds.  The single
 13 27 entry central point of coordination process may include but is
 13 28 not limited to reviewing a person's eligibility for services,
 13 29 determining the appropriateness of the type, level, and
 13 30 duration of services, and performing periodic review of the
 13 31 person's continuing eligibility and need for services.  Any
 13 32 recommendations developed concerning a person's plan of
 13 33 services shall be consistent with the person's unique
 13 34 strengths, circumstances, priorities, concerns, abilities, and
 13 35 capabilities.  For those services funded under the medical
 14  1 assistance program, the single entry central point of
 14  2 coordination process shall be used to assure that the person
 14  3 is aware of the appropriate service options available to the
 14  4 person.
 14  5    b.  The single entry central point of coordination process
 14  6 may include a clinical assessment process to identify a
 14  7 person's service needs and to make recommendations regarding
 14  8 the person's plan for services.  The clinical assessment
 14  9 process shall utilize qualified mental health professionals
 14 10 and qualified mental retardation professionals.
 14 11    c.  The single entry central point of coordination and
 14 12 clinical assessment process shall include provision for the
 14 13 county's participation in a management information system
 14 14 developed in accordance with rules adopted pursuant to
 14 15 subsection 3.
 14 16    2.  The department of human services shall seek federal
 14 17 approval as necessary for the single entry central point of
 14 18 coordination and clinical assessment processes to be eligible
 14 19 for federal financial participation under the medical
 14 20 assistance program.  A county may implement the single entry
 14 21 central point of coordination process as part of a consortium
 14 22 of counties and may implement the process beginning with the
 14 23 fiscal year ending June 30, 1995.
 14 24    3.  An application for services may be made through the
 14 25 single entry central point of coordination process of a
 14 26 person's county of residence.  However, if a person who is
 14 27 subject to a single entry central point of coordination
 14 28 process has legal settlement in another county or the costs of
 14 29 services or other support provided to the person are the
 14 30 financial responsibility of the state, an authorization
 14 31 through the single entry central point of coordination process
 14 32 shall be coordinated with the person's county of legal
 14 33 settlement or with the state, as applicable.  The county of
 14 34 residence and county of legal settlement of a person subject
 14 35 to a single entry central point of coordination process may
 15  1 mutually agree that the single entry central point of
 15  2 coordination process functions shall be performed by the
 15  3 single entry central point of coordination process of the
 15  4 person's county of legal settlement.
 15  5    4.  The mental health and developmental disabilities state
 15  6 commission shall consider the recommendations of county
 15  7 representatives in adopting rules outlining standards and
 15  8 requirements for implementation of the single entry central
 15  9 point of coordination and clinical assessment processes on the
 15 10 date required by subsection 2.  The rules shall permit
 15 11 counties options in implementing the process based upon a
 15 12 county's consumer population and available service delivery
 15 13 system.
 15 14    Sec. 31.  Section 426B.4, Code 2003, is amended to read as
 15 15 follows:
 15 16    426B.4  RULES.
 15 17    The mental health and, mental retardation, developmental
 15 18 disabilities, and brain injury commission shall consult with
 15 19 county representatives and the director of human services in
 15 20 prescribing forms and adopting rules pursuant to chapter 17A
 15 21 to administer this chapter.
 15 22    Sec. 32.  Section 426B.5, subsection 2, paragraph c, Code
 15 23 Supplement 2003, is amended to read as follows:
 15 24    c.  A risk pool board is created.  The board shall consist
 15 25 of two county supervisors, two county auditors, a member of
 15 26 the mental health and, mental retardation, developmental
 15 27 disabilities, and brain injury commission who is not a member
 15 28 of a county board of supervisors, a member of the county
 15 29 finance committee created in chapter 333A who is not an
 15 30 elected official, a representative of a provider of mental
 15 31 health or developmental disabilities services selected from
 15 32 nominees submitted by the Iowa association of community
 15 33 providers, and two single entry central point of coordination
 15 34 process administrators, all appointed by the governor, and one
 15 35 member appointed by the director of human services.  All
 16  1 members appointed by the governor shall be subject to
 16  2 confirmation by the senate.  Members shall serve for three-
 16  3 year terms.  A vacancy shall be filled in the same manner as
 16  4 the original appointment.  Expenses and other costs of the
 16  5 risk pool board members representing counties shall be paid by
 16  6 the county of origin.  Expenses and other costs of risk pool
 16  7 board members who do not represent counties shall be paid from
 16  8 a source determined by the governor.  Staff assistance to the
 16  9 board shall be provided by the department of human services
 16 10 and counties.  Actuarial expenses and other direct
 16 11 administrative costs shall be charged to the pool.
 16 12    Sec. 33.  SINGLE ENTRY POINT PROCESS AND COMMISSION
 16 13 TERMINOLOGY CHANGES – CODE EDITOR'S DIRECTIVE.
 16 14    1.  Sections 218.99, 222.2, 222.13, 222.13A, 222.28,
 16 15 222.59, 222.60, 222.61, 222.62, 222.64, 222.73, 225.11,
 16 16 225.15, 225.17, 225C.2, 225C.14, 225C.16, 227.10, 229.1,
 16 17 229.1B, 229.11, 229.13, 229.14, 229.14A, 229.42, 230.1,
 16 18 230A.13, 249A.26, 331.439, and 331.440A, Code 2003, and
 16 19 sections 225C.5, 232.2, and 235.7, Code Supplement 2003, are
 16 20 amended by striking the term "single entry point process" and
 16 21 inserting in lieu thereof the term "central point of
 16 22 coordination process".
 16 23    2.  In addition to the name change for the single entry
 16 24 point process, this division of this Act changes the name of
 16 25 the mental health and developmental disabilities commission to
 16 26 the mental health, mental retardation, developmental
 16 27 disabilities, and brain injury commission.  The Code editor
 16 28 shall correct any references to the term "single entry point
 16 29 process" or the term "mental health and developmental
 16 30 disabilities commission" anywhere else in the Iowa Code, in
 16 31 any bills awaiting codification, in this Act, and in any bills
 16 32 enacted by the Eightieth General Assembly, 2004 Regular
 16 33 Session or any extraordinary session.  
 16 34                           DIVISION II
 16 35               LEGAL SETTLEMENT DISPUTE RESOLUTION
 17  1    Sec. 34.  NEW SECTION.  225C.6A  MENTAL HEALTH,
 17  2 DEVELOPMENTAL DISABILITY, AND BRAIN INJURY SERVICE SYSTEM
 17  3 REDESIGN IMPLEMENTATION.
 17  4    1.  PURPOSE.  It is the intent of the general assembly to
 17  5 implement a redesign of the mental health, developmental
 17  6 disability, and brain injury service system over a period of
 17  7 years in order to transition to a coordinated system for
 17  8 Iowans with mental illness, mental retardation or other
 17  9 developmental disabilities, or brain injury.  Because of the
 17 10 significance of the redesign to the persons who may be
 17 11 affected by it and the degree of uncertainty regarding the
 17 12 extent of funding changes necessary for implementation, the
 17 13 department and the commission shall not implement a redesign
 17 14 provision through rulemaking or other means unless specific
 17 15 statutory authority provides for the provision's
 17 16 implementation.
 17 17    2.  INITIAL ACTIVITIES.  For the fiscal years beginning
 17 18 July 1, 2004, and July 1, 2005, the commission shall do the
 17 19 following:
 17 20    a.  Identify sources of revenue to support statewide
 17 21 delivery of core disability services to eligible disability
 17 22 populations.
 17 23    b.  Further develop adult disability services system
 17 24 redesign proposals and propose a redesign of the children's
 17 25 disability service system.  The redesign of the children's
 17 26 system shall address issues associated with an individual's
 17 27 transition between the two systems.
 17 28    c.  Plan, collect, and analyze data as necessary to issue
 17 29 cost estimates for serving additional populations and
 17 30 providing core disability services statewide.
 17 31    d.  With consumer input, identify and propose standardized
 17 32 functional assessment tools and processes for use in the
 17 33 eligibility determination process when eligibility for a
 17 34 particular disability population group is implemented.  The
 17 35 tools and processes shall be integrated with those utilized
 18  1 for the medical assistance program under chapter 249A.  For
 18  2 the initial diagnostic criteria, the commission shall consider
 18  3 identifying a qualifying functional assessment score and any
 18  4 of the following diagnoses:  mental illness, chronic mental
 18  5 illness, mental retardation, developmental disability, or
 18  6 brain injury.
 18  7    e.  The commission shall adopt a multiyear plan for
 18  8 developing and providing the data, cost projections, revenue
 18  9 requirements, and other information needed to support decision
 18 10 making concerning redesign provisions.  The information shall
 18 11 be provided as part of the commission's regular reports to the
 18 12 governor and general assembly or more often as determined to
 18 13 be appropriate by the commission.
 18 14    f.  Propose case rates for disability services.
 18 15    g.  Work with county representatives and other qualified
 18 16 persons to develop an implementation plan for replacing the
 18 17 county of legal settlement approach to determining service
 18 18 system funding responsibilities with an approach based upon
 18 19 residency.  The plan shall address a statewide standard for
 18 20 proof of residency, outline a plan for establishing a data
 18 21 system for identifying residency of eligible individuals,
 18 22 address residency issues for individuals who began residing in
 18 23 a county due to a court order or criminal sentence or to
 18 24 obtain services in that county, recommend an approach for
 18 25 contesting a residency determination, and address other
 18 26 implementation issues.
 18 27    Sec. 35.  OTHER REDESIGN ACTIVITIES.
 18 28    1.  The department of human services and the mental health,
 18 29 developmental disabilities, and brain injury commission shall
 18 30 report on the actions taken and proposals made to implement
 18 31 the provisions of section 225C.6A, as enacted by this Act, in
 18 32 the commission's annual report to the governor and general
 18 33 assembly submitted pursuant to section 225C.6 for
 18 34 consideration by the general assemblies meeting in 2005, 2006,
 18 35 and 2007.  In addition, the department and commission shall
 19  1 submit a progress report to the governor and general assembly
 19  2 in July 2004, July 2005, and July 2006, on the implementation
 19  3 of the provisions.  Any proposal shall include data needed to
 19  4 address the proposal, including the potential impact on
 19  5 counties bordering other states.
 19  6    2.  Subject to funding availability, the department and
 19  7 commission shall address all of the following state-level
 19  8 adult disability service system redesign activities during the
 19  9 fiscal year beginning July 1, 2004, and ending June 30, 2005:
 19 10    a.  Propose a new disability services information
 19 11 technology system.
 19 12    b.  Improve state administration of disability services by
 19 13 consolidating disability services into a new departmental
 19 14 division or other appropriate strategy.
 19 15    c.  Improve the interfaces between departmental
 19 16 administrative units and other state agencies directly or
 19 17 indirectly involved with persons with mental illness,
 19 18 developmental disabilities, or brain injury.
 19 19    d.  Solicit and incorporate input regarding the service
 19 20 system and service system funding from persons receiving
 19 21 services, service providers, and county central point of
 19 22 coordination process administrators.
 19 23    e.  Provide information to the public regarding the service
 19 24 system.  
 19 25                          DIVISION III
 19 26               LEGAL SETTLEMENT DISPUTE RESOLUTION
 19 27    Sec. 36.  NEW SECTION.  225C.8  LEGAL SETTLEMENT DISPUTE
 19 28 RESOLUTION.
 19 29    1.  a.  The dispute resolution process implemented in
 19 30 accordance with this section applies to legal settlement
 19 31 disputes and is not applicable to disputes involving persons
 19 32 committed to a state facility pursuant to chapter 812 or rule
 19 33 of criminal procedure 2.22, Iowa court rules, or to disputes
 19 34 of service authorization decisions made through the county
 19 35 single entry point process.
 20  1    b.  If a county receives a billing for services provided to
 20  2 a person under chapter 222, 230, or 249A, or objects to a
 20  3 legal settlement determination certified by the department or
 20  4 another county and asserts either that the person has legal
 20  5 settlement in another county or that the person has no legal
 20  6 settlement or the legal settlement is unknown so that the
 20  7 person is deemed to be a state case, the person's legal
 20  8 settlement status shall be determined as provided in this
 20  9 section.  The county shall notify the department of the
 20 10 county's assertion within one hundred twenty days of receiving
 20 11 the billing.  If the county asserts that the person has legal
 20 12 settlement in another county, that county shall be notified at
 20 13 the same time as the department.  If the department disputes a
 20 14 legal settlement determination certification made by a county,
 20 15 the department shall notify the affected counties of the
 20 16 department's assertion.
 20 17    2.  The department or the county that received the
 20 18 notification, as applicable, shall respond to the party that
 20 19 provided the notification within forty-five days of receiving
 20 20 the notification.  If the parties cannot agree to a settlement
 20 21 as to the person's legal settlement status within ninety days
 20 22 of the date of notification, on motion of any of the parties,
 20 23 the matter shall be referred to the department of inspections
 20 24 and appeals for a contested case hearing under chapter 17A
 20 25 before an administrative law judge assigned in accordance with
 20 26 section 10A.801 to determine the person's legal settlement
 20 27 status.
 20 28    3.  a.  The administrative law judge's determination of the
 20 29 person's legal settlement status is a final agency action,
 20 30 notwithstanding contrary provisions of section 17A.15.  The
 20 31 party that does not prevail in the determination or subsequent
 20 32 judicial review is liable for costs associated with the
 20 33 proceeding, including reimbursement of the department of
 20 34 inspections and appeals' actual costs associated with the
 20 35 administrative proceeding.  Judicial review of the
 21  1 determination may be sought in accordance with section 17A.19.
 21  2    b.  If following the determination of a person's legal
 21  3 settlement status in accordance with this section, additional
 21  4 evidence becomes available that merits a change in that
 21  5 determination, the parties affected may change the
 21  6 determination by mutual agreement.  Otherwise, a party may
 21  7 move that the matter be reconsidered.
 21  8    4.  Unless a petition is filed for judicial review, the
 21  9 administrative law judge's determination of the person's legal
 21 10 settlement status shall result in one of the following:
 21 11    a.  If a county is determined to be the person's county of
 21 12 legal settlement, the county shall pay the amounts due and
 21 13 shall reimburse any other amounts paid for services provided
 21 14 under chapter 222, 230, or 249A by the county or the
 21 15 department on the person's behalf prior to issuance of the
 21 16 decision.  The payment or reimbursement shall be remitted
 21 17 within forty-five days of the date the decision was issued.
 21 18 After the forty-five-day period, a penalty may be applied as
 21 19 authorized under section 222.68, 222.75, or 230.22.
 21 20    b.  If it is determined that the person has no legal
 21 21 settlement or the legal settlement is unknown so that the
 21 22 person is deemed to be a state case, the department shall
 21 23 credit the county for any payment made on behalf of the person
 21 24 by the county prior to issuance of the decision.  The credit
 21 25 shall be applied by the department on a county billing no
 21 26 later than the end of the quarter immediately following the
 21 27 date of the decision's issuance.
 21 28    Sec. 37.  Section 222.61, unnumbered paragraph 1, Code
 21 29 2003, is amended to read as follows:
 21 30    When a county receives an application on behalf of any
 21 31 person for admission to a resource center or a special unit or
 21 32 when any a court issues an order committing any person to a
 21 33 resource center or a special unit, the board of supervisors
 21 34 shall utilize the single entry point process to determine or
 21 35 the court shall determine and enter as a matter of record
 22  1 whether certify that the legal settlement of the person is in
 22  2 one of the following:
 22  3    Sec. 38.  Section 222.62, Code 2003, is amended to read as
 22  4 follows:
 22  5    222.62  SETTLEMENT IN ANOTHER COUNTY.
 22  6    Whenever When the board of supervisors utilizes a
 22  7 determines through the single entry point process to determine
 22  8 or the court determines that the legal settlement of the
 22  9 person is other than in the county in which the application is
 22 10 received or the court is located, the board or court shall, as
 22 11 soon as determination is made, certify such finding the
 22 12 determination shall be certified to the superintendent of the
 22 13 resource center or the special unit where the person is a
 22 14 patient.  The certification shall be accompanied by a copy of
 22 15 the evidence supporting the determination.  The superintendent
 22 16 shall charge the expenses already incurred and unadjusted, and
 22 17 all future expenses of the patient, to the county so certified
 22 18 until the patient's to be the county of legal settlement shall
 22 19 be otherwise determined as provided by this chapter.
 22 20    Sec. 39.  Section 222.63, Code 2003, is amended to read as
 22 21 follows:
 22 22    222.63  FINDING OF SETTLEMENT – OBJECTION.
 22 23    Said finding of A board of supervisors' certification
 22 24 utilizing the single entry point process that a person's legal
 22 25 settlement is in another county shall also be certified sent
 22 26 by the board of supervisors or the court to the county auditor
 22 27 of the county of legal settlement.  The certification shall be
 22 28 accompanied by a copy of the evidence supporting the
 22 29 determination.  Such The auditor of the county of legal
 22 30 settlement shall lay such notification before submit the
 22 31 certification to the board of supervisors of the auditor's
 22 32 county whereupon and it shall be conclusively presumed that
 22 33 the patient has a legal settlement in said that county unless
 22 34 the that county shall, within six months, in writing filed
 22 35 with the board of supervisors or the court giving such notice,
 23  1 dispute said legal settlement disputes the determination of
 23  2 legal settlement as provided in section 225C.8.
 23  3    Sec. 40.  Section 222.64, Code 2003, is amended to read as
 23  4 follows:
 23  5    222.64  FOREIGN STATE OR COUNTRY OR UNKNOWN LEGAL
 23  6 SETTLEMENT.
 23  7    If the legal settlement of the person is found determined
 23  8 by the board of supervisors through a the single entry point
 23  9 process or the court to be in a foreign state or country or is
 23 10 found determined to be unknown, the board of supervisors or
 23 11 the court shall immediately notify certify the determination
 23 12 to the administrator of the finding and shall furnish the
 23 13 administrator with a copy of the evidence taken on the
 23 14 question of legal settlement.  The certification shall be
 23 15 accompanied by a copy of the evidence supporting the
 23 16 determination.  The care of the person shall be as arranged by
 23 17 the board of supervisors or by an order as the court may
 23 18 enter.  Application for admission or order of commitment may
 23 19 be made pending investigation by the administrator.
 23 20    Sec. 41.  Section 222.65, Code 2003, is amended to read as
 23 21 follows:
 23 22    222.65  INVESTIGATION.
 23 23    The If an application is made for placement of a person in
 23 24 a state resource center or special unit, the administrator
 23 25 shall immediately investigate the legal settlement of the
 23 26 person and proceed as follows:
 23 27    1.  If the administrator finds that the decision of the
 23 28 board of supervisors or the court concurs with a certified
 23 29 determination as to legal settlement of the person is correct
 23 30 so that the person is deemed a state case, the administrator
 23 31 shall cause the person either to be transferred to a resource
 23 32 center or a special unit and there maintained at the expense
 23 33 of the state or to be transferred to the place of foreign
 23 34 settlement.
 23 35    2.  If the administrator finds that the decision of the
 24  1 board of supervisors or the court is not correct disputes a
 24  2 certified determination of legal settlement, the administrator
 24  3 shall order the person transferred to a state resource center
 24  4 or a special unit and there maintained at the expense of the
 24  5 county of legal settlement in this state until the dispute is
 24  6 resolved.
 24  7    3.  If the administrator disputes a certified determination
 24  8 of legal settlement, the administrator shall utilize the
 24  9 procedure provided in section 225C.8 to resolve the dispute.
 24 10 A determination of the person's legal settlement status made
 24 11 pursuant to section 225C.8 is conclusive.
 24 12    Sec. 42.  Section 222.67, Code 2003, is amended to read as
 24 13 follows:
 24 14    222.67  CHARGE ON FINDING OF SETTLEMENT.
 24 15    Where If a person has been received into a resource center
 24 16 or a special unit as a patient whose legal settlement is
 24 17 supposedly outside the state or is unknown and the
 24 18 administrator finds determines that the legal settlement of
 24 19 the patient was at the time of admission or commitment in a
 24 20 county of this state, the administrator shall certify the
 24 21 determination and charge all legal costs and expenses
 24 22 pertaining to the admission or commitment and support of the
 24 23 patient to the county of such legal settlement.  The
 24 24 certification shall be sent to the county of legal settlement.
 24 25 The certification shall be accompanied by a copy of the
 24 26 evidence supporting the determination.  If the person's legal
 24 27 settlement status has been determined in accordance with
 24 28 section 225C.8, the legal costs and expenses shall be charged
 24 29 to the county or as a state case in accordance with that
 24 30 determination.  The costs and expenses shall be collected as
 24 31 provided by law in other cases.
 24 32    Sec. 43.  Section 222.70, Code 2003, is amended by striking
 24 33 the section and inserting in lieu thereof the following:
 24 34    222.70  LEGAL SETTLEMENT DISPUTES.
 24 35    If a dispute arises between counties or between the
 25  1 department and a county as to the legal settlement of a person
 25  2 admitted or committed to a resource center, a special unit, or
 25  3 a community-based service, the dispute shall be resolved as
 25  4 provided in section 225C.8.
 25  5    Sec. 44.  Section 230.2, unnumbered paragraph 1, Code 2003,
 25  6 is amended to read as follows:
 25  7    The If a person's legal settlement status is disputed,
 25  8 legal settlement shall be determined in accordance with
 25  9 section 225C.8.  Otherwise, the district court shall may, when
 25 10 a the person is ordered placed in a hospital for psychiatric
 25 11 examination and appropriate treatment, or as soon thereafter
 25 12 as it the court obtains the proper information, determine and
 25 13 enter of record whether the legal settlement of said the
 25 14 person is one of the following:
 25 15    Sec. 45.  Section 230.3, Code 2003, is amended to read as
 25 16 follows:
 25 17    230.3  CERTIFICATION OF SETTLEMENT.
 25 18    If such a person's legal settlement is found determined
 25 19 through the county's single entry point process to be in
 25 20 another county of this state, the court shall, as soon as said
 25 21 determination is made, the county making the determination
 25 22 shall certify such finding the determination to the
 25 23 superintendent of the hospital to which said patient the
 25 24 person is admitted or committed, and thereupon said.  The
 25 25 certification shall be accompanied by a copy of the evidence
 25 26 supporting the determination.  Upon receiving the
 25 27 certification, the superintendent shall charge the expenses
 25 28 already incurred and unadjusted, and all future expenses of
 25 29 such patient, the person to the county so certified until said
 25 30 determined to be the county of legal settlement shall be
 25 31 otherwise determined as hereinafter provided.
 25 32    Sec. 46.  Section 230.4, Code 2003, is amended to read as
 25 33 follows:
 25 34    230.4  CERTIFICATION TO DEBTOR COUNTY.
 25 35    Said finding A determination of a person's legal settlement
 26  1 made in accordance with section 230.2 or 230.3 shall also be
 26  2 certified sent by the court or the county to the county
 26  3 auditor of the county of such legal settlement.  The
 26  4 certification shall be accompanied by a copy of the evidence
 26  5 supporting the determination.  Such The auditor shall lay such
 26  6 notification before provide the certification to the board of
 26  7 supervisors of the auditor's county, and it shall be
 26  8 conclusively presumed that such the person has a legal
 26  9 settlement in said the notified county unless said that county
 26 10 shall within sixty days give notice in writing to the court
 26 11 that the county disputes the finding of legal settlement as
 26 12 provided in section 225C.8.
 26 13    Sec. 47.  Section 230.5, Code 2003, is amended to read as
 26 14 follows:
 26 15    230.5  NONRESIDENTS.
 26 16    If such a person's legal settlement is found by the court
 26 17 determined in accordance with section 230.2 or 230.3 to be in
 26 18 some a foreign state or country, or is unknown, the court or
 26 19 the county shall immediately notify the certify the
 26 20 determination to the administrator of the finding and furnish
 26 21 the administrator with a copy of the evidence taken on the
 26 22 question of legal settlement, and shall in its.  The
 26 23 certification shall be accompanied by a copy of the evidence
 26 24 supporting the determination.  A court order issued pursuant
 26 25 to section 229.13 shall direct that the patient be
 26 26 hospitalized at the appropriate state hospital for persons
 26 27 with mental illness.
 26 28    Sec. 48.  Section 230.6, Code 2003, is amended to read as
 26 29 follows:
 26 30    230.6  DETERMINATION INVESTIGATION BY ADMINISTRATOR.
 26 31    The administrator shall immediately investigate the legal
 26 32 settlement of said a patient and proceed as follows:
 26 33    1.  If the administrator finds that the decision of the
 26 34 court as to concurs with a certified determination of legal
 26 35 settlement is correct concerning the patient, the
 27  1 administrator shall cause said the patient either to be
 27  2 transferred to a state hospital for persons with mental
 27  3 illness at the expense of the state, or to be transferred,
 27  4 with approval of the court as required by chapter 229 to the
 27  5 place of foreign settlement.
 27  6    2.  If the administrator finds that the decision of the
 27  7 court is not correct disputes a certified legal settlement
 27  8 determination, the administrator shall order said the patient
 27  9 to be maintained at a state hospital for persons with mental
 27 10 illness at the expense of the state, and shall at once inform
 27 11 the court of such finding and request that the court's order
 27 12 be modified accordingly until the dispute is resolved.
 27 13    3.  If the administrator disputes a legal settlement
 27 14 determination, the administrator shall utilize the procedure
 27 15 provided in section 225C.8 to resolve the dispute.  A
 27 16 determination of the person's legal settlement status made
 27 17 pursuant to section 225C.8 is conclusive.
 27 18    Sec. 49.  Section 230.9, Code 2003, is amended to read as
 27 19 follows:
 27 20    230.9  SUBSEQUENT DISCOVERY OF RESIDENCE.
 27 21    If, after a patient person has been received into by a
 27 22 state hospital for persons with mental illness as a state case
 27 23 patient whose legal settlement is supposed to be outside this
 27 24 state or unknown, the administrator finds determines that the
 27 25 legal settlement of said patient the person was, at the time
 27 26 of admission or commitment, in a county of this state, said
 27 27 the administrator shall certify the determination and charge
 27 28 all legal costs and expenses pertaining to the admission or
 27 29 commitment and support of said patient the person to the
 27 30 county of such legal settlement, and the same.  The
 27 31 certification shall be sent to the county of legal settlement.
 27 32 The certification shall be accompanied by a copy of the
 27 33 evidence supporting the determination.  The costs and expenses
 27 34 shall be collected as provided by law in other cases.  If the
 27 35 person's legal settlement status has been determined in
 28  1 accordance with section 225C.8, the legal costs and expenses
 28  2 shall be charged to the county or as a state case in
 28  3 accordance with that determination.
 28  4    Sec. 50.  Section 230.12, Code 2003, is amended by striking
 28  5 the section and inserting in lieu thereof the following:
 28  6    230.12  LEGAL SETTLEMENT DISPUTES.
 28  7    If a dispute arises between different counties or between
 28  8 the administrator and a county as to the legal settlement of a
 28  9 person admitted or committed to a state hospital for persons
 28 10 with mental illness, the dispute shall be resolved as provided
 28 11 in section 225C.8.
 28 12    Sec. 51.  Section 232.141, subsection 8, Code 2003, is
 28 13 amended to read as follows:
 28 14    8.  This subsection applies only to placements in a
 28 15 juvenile shelter care home which is publicly owned, operated
 28 16 as a county or multicounty shelter care home, organized under
 28 17 a chapter 28E agreement, or operated by a private juvenile
 28 18 shelter care home.  If the actual and allowable costs of a
 28 19 child's shelter care placement exceed the amount the
 28 20 department is authorized to pay in accordance with law and
 28 21 administrative rule, the unpaid costs may be recovered from
 28 22 the child's county of legal settlement.  However, the maximum
 28 23 amount of the unpaid costs which may be recovered under this
 28 24 subsection is limited to the difference between the amount the
 28 25 department is authorized to pay and the statewide average of
 28 26 the actual and allowable rates in effect in May of the
 28 27 preceding fiscal year for reimbursement of juvenile shelter
 28 28 care homes.  In no case shall the home be reimbursed for more
 28 29 than the home's actual and allowable costs.  The unpaid costs
 28 30 are payable pursuant to filing of verified claims against the
 28 31 county of legal settlement.  A detailed statement of the facts
 28 32 upon which a claim is based shall accompany the claim.  Any
 28 33 dispute between counties arising from filings of claims
 28 34 pursuant to this subsection shall be settled in the manner
 28 35 provided to determine legal settlement in section 230.12
 29  1 225C.8.
 29  2    Sec. 52.  Section 249A.26, Code 2003, is amended by adding
 29  3 the following new subsection:
 29  4    NEW SUBSECTION.  5.  If a dispute arises between different
 29  5 counties or between the department and a county as to the
 29  6 legal settlement of a person who receives medical assistance
 29  7 for which the nonfederal share is payable in whole or in part
 29  8 by a county of legal settlement, and cannot be resolved by the
 29  9 parties, the dispute shall be resolved as provided in section
 29 10 225C.8.
 29 11    Sec. 53.  Section 252.23, Code 2003, is amended to read as
 29 12 follows:
 29 13    252.23  TRIAL.
 29 14    If the alleged settlement is disputed, then, within thirty
 29 15 days after notice as provided in section 252.22, a copy of the
 29 16 notices sent and received shall be filed in the office of the
 29 17 clerk of the district court of the county against which claim
 29 18 is made, and a cause docketed without other pleadings, and
 29 19 tried as an ordinary action, in which the county granting the
 29 20 assistance shall be plaintiff, and the other defendant, and
 29 21 the burden of proof shall be upon the county granting the
 29 22 assistance.  However, a legal settlement dispute initiated
 29 23 under chapter 222, 230, or 249A shall be resolved as provided
 29 24 in section 225C.8.
 29 25    Sec. 54.  APPLICABILITY.
 29 26    1.  The timeframes specified in section 225C.8, as enacted
 29 27 by this division of this Act, are applicable to legal
 29 28 settlement disputes involving billings for services provided
 29 29 on or after July 1, 2004.
 29 30    2.  For legal settlement disputes involving billings for
 29 31 services provided prior to July 1, 2004, unless the county
 29 32 disputed the billing prior to July 1, 2004, the person's legal
 29 33 settlement shall be deemed to be in the county that was billed
 29 34 for services provided to the person.  However, if a county
 29 35 disputed the billing for a service provided prior to July 1,
 30  1 2004, and the matter cannot be resolved with the department of
 30  2 human services or with the other county, in lieu of the forty-
 30  3 five-day period specified in section 225C.8, subsection 2, a
 30  4 party may move for the matter to be resolved in the manner
 30  5 provided in section 225C.8, at any time prior to January 1,
 30  6 2005.  If a party has not made such a motion, effective
 30  7 January 1, 2005, the matter shall be closed and the person's
 30  8 legal settlement shall be in the county that was billed for
 30  9 services provided to the person.
 30 10    Sec. 55.  Sections 222.71, 222.72, 230.13, and 230.14, Code
 30 11 2003, are repealed.  
 30 12 
 30 13 
 30 14                                                             
 30 15                               CHRISTOPHER C. RANTS
 30 16                               Speaker of the House
 30 17 
 30 18 
 30 19                                                             
 30 20                               JEFFREY M. LAMBERTI
 30 21                               President of the Senate
 30 22 
 30 23    I hereby certify that this bill originated in the House and
 30 24 is known as House File 2537, Eightieth General Assembly.
 30 25 
 30 26 
 30 27                                                             
 30 28                               MARGARET THOMSON
 30 29                               Chief Clerk of the House
 30 30 Approved                , 2004
 30 31 
 30 32 
 30 33                            
 30 34 THOMAS J. VILSACK
 30 35 Governor
     
Text: HF02536                           Text: HF02538
Text: HF02500 - HF02599                 Text: HF Index
Bills and Amendments: General Index     Bill History: General Index

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