House File 697 H-1734 Amend House File 697 as follows: 1 1. Page 457, after line 6 by inserting: 2 < Sec. ___. NEW SECTION . 7E.8 Implementation of 3 federal statute, regulation, or policy. 4 1. Except as otherwise explicitly authorized by 5 state law, a state administrative agency charged with 6 the implementation of a federal statute, regulation, or 7 policy shall not exceed the specific requirements of 8 that statute, regulation, or policy. 9 2. Any portion of a state administrative agency 10 rule or policy that is in violation of subsection 1 is 11 void. > 12 2. Page 457, after line 6 by inserting: 13 < Sec. ___. NEW SECTION . 9.8 Employee 14 classifications. 15 In addition to public employees listed in section 16 20.4, public employees of the secretary of state who 17 hold positions that are classified in the information 18 technology specialist series and administrative 19 assistant series are excluded from chapter 20. > 20 3. Page 457, after line 6 by inserting: 21 < Sec. ___. NEW SECTION . 274.3 Exercise of powers 22 —— construction. 23 1. The board of directors of a school district 24 shall operate, control, and supervise all public 25 schools located within its district boundaries and may 26 exercise any broad and implied power related to the 27 operation, control, and supervision of those public 28 schools except as expressly prohibited or prescribed by 29 the Constitution of the State of Iowa or by statute. 30 2. Notwithstanding subsection 1, the board of 31 directors of a school district shall not have power to 32 levy any tax unless expressly authorized by the general 33 assembly. 34 3. This section shall not apply to a research and 35 development school as defined in section 256G.2 or to 36 a laboratory school as defined in section 265.1. The 37 board of directors of a school district in which such a 38 research and development school or laboratory school 39 is located shall not exercise over such a school any 40 powers granted to the board by subsection 1. 41 4. This chapter, chapter 257 and chapters 275 42 through 301, and other statutes relating to the 43 boards of directors of school districts and to school 44 districts shall be liberally construed to effectuate 45 the purposes of subsection 1. > 46 4. Page 457, after line 12 by inserting: 47 < Sec. ___. Section 422.11P, subsection 2, paragraph 48 b, Code 2011, as enacted by 2011 Iowa Acts, Senate File 49 531, section 25, is amended to read as follows: 50 -1- HF697.3306 (4) 84 tm/jp 1/ 57 #1. #2. #3. #4.
b. The tax credit shall apply to biodiesel blended 1 fuel classified as provided in this section , if the 2 classification meets the standards provided in section 3 214A.2 . In ensuring that biodiesel blended fuel meets 4 the classification requirements of this section, the 5 department shall take into account reasonable variances 6 due to testing and other limitations. > 7 5. Page 457, after line 12 by inserting: 8 < Sec. ___. Section 455A.6, subsection 5, Code 2011, 9 is amended by striking the subsection and inserting in 10 lieu thereof the following: 11 5. Six members of the commission is a quorum, and a 12 majority of the commission membership may act in any 13 matter within the jurisdiction of the commission. 14 Sec. ___. Section 455A.6, subsection 6, paragraph 15 a, Code 2011, is amended to read as follows: 16 a. Establish policy for the department and adopt 17 rules, pursuant to chapter 17A, necessary to provide 18 for the effective administration of chapter 455B, 455C, 19 or 459. The commission shall have only that authority 20 or discretion which is explicitly delegated to or 21 conferred upon the commission by chapter 455B, 455C, or 22 459, and shall not expand or enlarge on that authority 23 or discretion. > 24 6. Page 475, before line 24 by inserting: 25 < DIVISION ___ 26 HALLUCINOGENIC SUBSTANCES 27 Sec. ___. Section 124.204, subsection 4, Code 2011, 28 is amended by adding the following new paragraph: 29 NEW PARAGRAPH . ai. (1) Mephedrone, also known as 30 4-methylmethcathinone,(RS)-2-methylamino-l-(4-methylphenyl) 31 propan-1-one. 32 (2) Methylene-dioxypyrovalerone(MDPV)[(1-(1,3- 33 Benzodioxol-5-yl)-2-(1-pyrrolidinyl)-1-pentanone]. 34 (3) Salvia divinorum. 35 (4) Salvinorin A. 36 (5) Any substance, compound, mixture or preparation 37 which contains any quantity of any synthetic 38 cannabinoid that is not approved as a pharmaceutical, 39 including but not limited to the following: 40 (a) CP 47, 497 and homologues 2-[(1R, 3S)-3- 41 hydroxycyclohexyl]-5-(2-methyloctan-2-yl)phenol). 42 (b) HU-210[(6aR,10aR)-9-(hydroxymethyl)-6,6-dimethyl-3- 43 (2-methyloctan-2-yl)-6a,7,10,10a-tetrahydrobenzo[c] 44 chromen-1-ol)]. 45 (c) HU-211(dexanabinol, (6aS,10aS)-9-(hydroxymethyl)-6,6- 46 dimethyl-3-(2-methyloctan-2-yl)-6a,7,10,10a-tetrahydrobenzo[c] 47 chromen-1-ol). 48 (d) JWH-018 1-Pentyl-3-(1-naphthoyl)indole. 49 (e) JWH-073 1-Butyl-3-(1-naphthoyl)indole. 50 -2- HF697.3306 (4) 84 tm/jp 2/ 57 #5. #6.
(f) JWH-200 [1-[2-(4-morpholinyl)ethyl]-1H-indol-3-yl]-1- 1 naphthalenyl-methanone. 2 Sec. ___. Section 124.401, subsection 1, paragraph 3 c, subparagraph (8), Code 2011, is amended to read as 4 follows: 5 (8) Any other controlled substance, counterfeit 6 substance, or simulated controlled substance classified 7 in schedule I, II, or III , except as provided in 8 paragraph “d” . 9 Sec. ___. Section 124.401, subsection 1, paragraph 10 d, Code 2011, is amended to read as follows: 11 d. (1) Violation of this subsection , with respect 12 to any other controlled substances, counterfeit 13 substances, or simulated controlled substances 14 classified in schedule IV or V is an aggravated 15 misdemeanor. However, 16 (2) A violation of this subsection involving fifty 17 any of the following is a class “D” felony: 18 (a) Fifty kilograms or less of marijuana or 19 involving flunitrazepam is a class “D” felony . 20 (b) Flunitrazepam. 21 (c) A controlled substance, counterfeit substance, 22 or simulated controlled substance classified in section 23 124.204, subsection 4, paragraph “ai” . 24 Sec. ___. EFFECTIVE UPON ENACTMENT. This division 25 of this Act, being deemed of immediate importance, 26 takes effect upon enactment. > 27 7. Page 475, before line 24 by inserting: 28 < DIVISION ___ 29 FIRE EXTINGUISHING AND ALARM SYSTEMS CONTRACTORS AND 30 INSTALLERS —— ELECTRICIANS AND ELECTRICAL CONTRACTORS 31 —— LICENSING 32 Sec. ___. Section 100C.1, subsection 13, Code 2011, 33 is amended by adding the following new paragraph: 34 NEW PARAGRAPH . c. For a telecommunications 35 company that has been issued a certificate of public 36 convenience and necessity pursuant to section 476.29, 37 a person with whom the telecommunications company 38 contracts, who is certified by the national institute 39 for certification in engineering technologies as 40 required in paragraph “a” or “b” or who meets any other 41 criteria established by rule. 42 Sec. ___. Section 100C.2, subsection 3, Code 2011, 43 is amended by adding the following new paragraph: 44 NEW PARAGRAPH . d. This subsection shall not 45 apply to a responsible managing employee with whom a 46 telecommunications company contracts as provided in 47 section 100C.1, subsection 13, paragraph “c” . 48 Sec. ___. NEW SECTION . 103.1A Term “commercial” “commercial” “commercial” 49 applied. 50 -3- HF697.3306 (4) 84 tm/jp 3/ 57 #7.
As used in this chapter: 1 1. “Commercial” refers to a use, installation, 2 structure, or premises associated with a place of 3 business where goods, wares, services, or merchandise 4 is stored or offered for sale on a wholesale or retail 5 basis. 6 2. “Commercial” refers to a residence only if 7 the residence is also used as a place of business as 8 provided in subsection 1. 9 3. “Commercial” does not refer to a use, 10 installation, structure, or premises associated with 11 any of the following: 12 a. A farm. 13 b. An industrial installation. 14 Sec. ___. Section 103.22, subsection 7, Code 2011, 15 is amended to read as follows: 16 7. Prohibit an owner of property from performing 17 work on the owner’s principal residence, if such 18 residence is an existing dwelling rather than new 19 construction and is not an apartment that is attached 20 to any other apartment or building, as those terms are 21 defined in section 499B.2 , and is not larger than a 22 single-family dwelling, or farm property, excluding 23 commercial or industrial installations or installations 24 in public use buildings or facilities, or require 25 such owner to be licensed under this chapter . In 26 order to qualify for inapplicability pursuant to this 27 subsection , a residence shall qualify for the homestead 28 tax exemption. 29 Sec. ___. Section 103.22, Code 2011, is amended by 30 adding the following new subsection: 31 NEW SUBSECTION . 15. Apply to a person performing 32 any installation on a farm, if the person is associated 33 with the farm as a holder of a legal or equitable 34 interest, a relative or employee of the holder, or 35 an operator or manager of the farm. The provisions 36 of this chapter do not require such person to be 37 licensed. In addition, a permit is not required for an 38 installation on a farm, and an installation on a farm 39 is not required to be inspected. In order for a farm 40 building to qualify under this subsection, the farm 41 building must not be regularly open to the public as a 42 place of business for the retail sale of goods, wares, 43 services, or merchandise. > 44 8. Page 475, before line 24 by inserting: 45 < DIVISION ___ 46 CLASS “A” FELONIES —— JUVENILES 47 Sec. ___. Section 232.8, subsection 3, paragraph a, 48 Code 2011, is amended to read as follows: 49 a. The juvenile court, after a hearing and in 50 -4- HF697.3306 (4) 84 tm/jp 4/ 57 #8.
accordance with the provisions of section 232.45 , may 1 waive jurisdiction of a child alleged to have committed 2 a public offense so that the child may be prosecuted 3 as an adult or youthful offender for such offense in 4 another court. If the child , except a child being 5 prosecuted as a youthful offender, pleads guilty or is 6 found guilty of a public offense other than a class “A” 7 felony in another court of this state, that court may 8 suspend the sentence or, with the consent of the child, 9 defer judgment and without regard to restrictions 10 placed upon deferred judgments for adults, place the 11 child on probation for a period of not less than one 12 year upon such conditions as it may require. Upon 13 fulfillment of the conditions of probation, a child 14 who receives a deferred judgment shall be discharged 15 without entry of judgment. A child prosecuted as 16 a youthful offender shall be sentenced pursuant to 17 section 907.3A. 18 Sec. ___. Section 232.50, subsection 1, Code 2011, 19 is amended to read as follows: 20 1. As soon as practicable following the entry 21 of an order of adjudication pursuant to section 22 232.47 or notification that the child has received a 23 youthful offender deferred sentence been placed on 24 youthful offender status pursuant to section 907.3A , 25 the court shall hold a dispositional hearing in order 26 to determine what disposition should be made of the 27 matter. 28 Sec. ___. Section 232.52, subsection 1, Code 2011, 29 is amended to read as follows: 30 1. Pursuant to a hearing as provided in section 31 232.50 , the court shall enter the least restrictive 32 dispositional order appropriate in view of the 33 seriousness of the delinquent act, the child’s 34 culpability as indicated by the circumstances of 35 the particular case, the age of the child, the 36 child’s prior record, or the fact that the child has 37 received a youthful offender deferred sentence been 38 placed on youthful offender status under section 39 907.3A . The order shall specify the duration and 40 the nature of the disposition, including the type of 41 residence or confinement ordered and the individual, 42 agency, department , or facility in whom custody is 43 vested. In the case of a child who has received a 44 youthful offender deferred sentence been placed on 45 youthful offender status , the initial duration of the 46 dispositional order shall be until the child reaches 47 the age of eighteen. 48 Sec. ___. Section 232.54, subsection 1, paragraph 49 g, Code 2011, is amended to read as follows: 50 -5- HF697.3306 (4) 84 tm/jp 5/ 57
g. With respect to a juvenile court dispositional 1 order entered regarding a child who has received a 2 youthful offender deferred sentence been placed on 3 youthful offender status under section 907.3A , the 4 dispositional order may be terminated prior to the 5 child reaching the age of eighteen upon motion of the 6 child, the person or agency to whom custody of the 7 child has been transferred, or the county attorney 8 following a hearing before the juvenile court if it is 9 shown by clear and convincing evidence that it is in 10 the best interests of the child and the community to 11 terminate the order. The hearing may be waived if all 12 parties to the proceeding agree. The dispositional 13 order regarding a child who has received a youthful 14 offender deferred sentence been placed on youthful 15 offender status may also be terminated prior to the 16 child reaching the age of eighteen upon motion of the 17 county attorney, if the waiver of the child to district 18 court was conditioned upon the terms of an agreement 19 between the county attorney and the child, and the 20 child violates the terms of the agreement after the 21 waiver order has been entered. The district court 22 shall discharge the child’s youthful offender status 23 upon receiving a termination order under this section . 24 Sec. ___. Section 232.54, subsection 1, paragraph 25 h, unnumbered paragraph 1, Code 2011, is amended to 26 read as follows: 27 With respect to a dispositional order entered 28 regarding a child who has received a youthful offender 29 deferred sentence been placed on youthful offender 30 status under section 907.3A , the juvenile court may, 31 in the case of a child who violates the terms of the 32 order, modify or terminate the order in accordance with 33 the following: 34 Sec. ___. Section 232.55, subsection 3, Code 2011, 35 is amended to read as follows: 36 3. This section does not apply to dispositional 37 orders entered regarding a child who has received a 38 youthful offender deferred sentence been placed on 39 youthful offender status under section 907.3A who 40 is not discharged from probation before or upon the 41 child’s eighteenth birthday. 42 Sec. ___. Section 232.56, Code 2011, is amended to 43 read as follows: 44 232.56 Youthful offenders —— transfer to district 45 court supervision. 46 The juvenile court shall deliver a report, which 47 includes an assessment of the child by a juvenile court 48 officer after consulting with the judicial district 49 department of correctional services, to the district 50 -6- HF697.3306 (4) 84 tm/jp 6/ 57
court prior to the eighteenth birthday of a child who 1 has received a youthful offender deferred sentence 2 been placed on youthful offender status under section 3 907.3A . A hearing shall be held in the district court 4 in accordance with section 907.3A to determine whether 5 the child should be discharged from youthful offender 6 status or whether the child shall continue under the 7 supervision of the district court after the child’s 8 eighteenth birthday. 9 Sec. ___. Section 654.4B, subsection 2, paragraph 10 b, Code 2011, is amended to read as follows: 11 b. This subsection is repealed July 1, 2011 2012 . 12 Sec. ___. Section 902.1, Code 2011, is amended to 13 read as follows: 14 902.1 Class “A” felony. 15 1. Upon a plea of guilty, a verdict of guilty, or 16 a special verdict upon which a judgment of conviction 17 of a class “A” felony may be rendered, the court shall 18 enter a judgment of conviction and shall commit the 19 defendant into the custody of the director of the 20 Iowa department of corrections for the rest of the 21 defendant’s life. Nothing in the Iowa corrections code 22 pertaining to deferred judgment, deferred sentence, 23 suspended sentence, or reconsideration of sentence 24 applies to a class “A” felony, and a person convicted 25 of a class “A” felony shall not be released on parole 26 unless the governor commutes the sentence to a term of 27 years. 28 2. a. Notwithstanding subsection 1, a person 29 convicted of a class “A” felony, and who was under the 30 age of eighteen at the time the offense was committed 31 shall be eligible for parole after serving a minimum 32 term of confinement of twenty-five years. 33 b. If a person is paroled pursuant to this 34 subsection the person shall be subject to the same set 35 of procedures set out in chapters 901B, 905, 906, and 36 chapter 908, and rules adopted under those chapters for 37 persons on parole. 38 c. A person convicted of murder in the first degree 39 in violation of section 707.2 shall not be eligible for 40 parole pursuant to this subsection. 41 d. A person convicted of murder in the second 42 degree in violation of section 707.3 and who was also 43 convicted of either kidnapping in the first degree 44 in violation of section 710.2 or sexual abuse in the 45 first degree in violation of section 709.2, which 46 conviction arose out of the same set of facts as the 47 murder-in-the-second-degree conviction, shall not be 48 eligible for parole pursuant to this subsection. 49 Sec. ___. Section 907.3A, Code 2011, is amended to 50 -7- HF697.3306 (4) 84 tm/jp 7/ 57
read as follows: 1 907.3A Youthful offender deferred sentence —— 2 youthful offender status. 3 1. Notwithstanding section 907.3 but subject to any 4 conditions of the waiver order, the trial court shall, 5 upon a plea of guilty or a verdict of guilty, defer 6 sentence of a youthful offender place the juvenile 7 over whom the juvenile court has waived jurisdiction 8 pursuant to section 232.45, subsection 7 , and place 9 the juvenile on youthful offender status. The court 10 shall transfer supervision of the youthful offender to 11 the juvenile court for disposition in accordance with 12 section 232.52 . An adjudication of delinquency entered 13 by the juvenile court for a public offense shall not 14 be deemed a conviction and shall not preclude the 15 subsequent entry of a deferred judgment, conviction, 16 or sentence by the district court. The court shall 17 require supervision of the youthful offender in 18 accordance with section 232.54, subsection 1 , paragraph 19 “h” , or subsection 2 of this section . Notwithstanding 20 section 901.2, a presentence investigation shall not be 21 ordered by the court subsequent to an entry of a plea 22 of guilty or verdict of guilty or prior to deferral of 23 sentence of a youthful offender under this section. 24 2. The court shall hold a hearing prior to a 25 youthful offender’s eighteenth birthday to determine 26 whether the youthful offender shall continue on 27 youthful offender status after the youthful offender’s 28 eighteenth birthday under the supervision of the 29 court or be discharged . Notwithstanding section 30 901.2, the court may order a presentence investigation 31 report including a report for an offense classified 32 as a class “A” felony. The court shall review the 33 report of the juvenile court regarding the youthful 34 offender and prepared pursuant to section 232.56, 35 and any presentence investigation report, if ordered 36 by the court. The court shall hear evidence by or 37 on behalf of the youthful offender, by the county 38 attorney, and by the person or agency to whom custody 39 of the youthful offender was transferred. The court 40 shall make its decision , pursuant to the sentencing 41 options available in subsection 3, after considering 42 the services available to the youthful offender, the 43 evidence presented, the juvenile court’s report, the 44 presentence investigation report if ordered by the 45 court, the interests of the youthful offender, and 46 interests of the community. 47 3. a. Notwithstanding any provision of the Code 48 which prescribes a mandatory minimum sentence for the 49 offense committed by the youthful offender, following 50 -8- HF697.3306 (4) 84 tm/jp 8/ 57
transfer of the youthful offender from the juvenile 1 court back to the court having jurisdiction over the 2 criminal proceedings involving the youthful offender, 3 the court may continue the youthful offender deferred 4 sentence or enter a sentence, which may be a suspended 5 sentence. shall order one of the following sentencing 6 options: 7 (1) Defer judgment and place the youthful offender 8 on probation, upon the consent of the youthful 9 offender. 10 (2) Defer the sentence and place the youthful 11 offender on probation upon such terms and conditions 12 as the court may require. 13 (3) Suspend the sentence and place the youthful 14 offender on probation upon such terms and conditions 15 as the court may require. 16 (4) A term of confinement. 17 (5) Discharge the youthful offender from youthful 18 offender status and terminate the sentence. 19 b. Notwithstanding anything in section 907.7 to 20 the contrary, if the district court either grants 21 the youthful offender a deferred judgment, continues 22 the youthful offender deferred sentence , or enters a 23 sentence , and suspends the sentence, and places the 24 youthful offender on probation, the term of formal 25 supervision shall commence upon entry of the order by 26 the district court and may continue for a period not 27 to exceed five years. If the district court enters a 28 sentence of confinement, and the youthful offender was 29 previously placed in secure confinement by the juvenile 30 court under the terms of the initial disposition order 31 or any modification to the initial disposition order, 32 the person shall receive credit for any time spent in 33 secure confinement. During any period of probation 34 imposed by the district court, a youthful offender who 35 violates the terms of probation is subject to section 36 908.11 . 37 Sec. ___. Section 907.9, subsection 4, Code 2011, 38 is amended to read as follows: 39 4. At the expiration of the period of probation 40 if the fees imposed under section 905.14 and court 41 debt collected pursuant to section 602.8107 have been 42 paid, the court shall order the discharge of the person 43 from probation. If portions of the court debt remain 44 unpaid, the person shall establish a payment plan with 45 the clerk of the district court or the county attorney 46 prior to the discharge. The court shall forward to the 47 governor a recommendation for or against restoration 48 of citizenship rights to that person upon discharge. 49 A person who has been discharged from probation shall 50 -9- HF697.3306 (4) 84 tm/jp 9/ 57
no longer be held to answer for the person’s offense. 1 Upon discharge from probation, if judgment has been 2 deferred under section 907.3 , the court’s criminal 3 record with reference to the deferred judgment and any 4 counts dismissed by the court, which were contained in 5 the indictment, information, or complaint that resulted 6 in the deferred judgement, shall be expunged. The 7 record maintained by the state court administrator 8 as required by section 907.4 shall not be expunged. 9 The court’s record shall not be expunged in any other 10 circumstances. 11 Sec. ___. EFFECTIVE UPON ENACTMENT. The section 12 of this division of this Act amending section 654.4B, 13 being deemed of immediate importance, takes effect upon 14 enactment. > 15 9. Page 475, before line 24 by inserting: 16 < DIVISION ___ 17 STATE EXPENDITURE REQUIREMENTS —— REVENUE ESTIMATING 18 CONFERENCE —— APPROPRIATION TRANSFERS 19 Sec. ___. Section 8.22A, subsection 2, Code 2011, 20 is amended to read as follows: 21 2. The conference shall meet as often as deemed 22 necessary, but shall meet at least quarterly three 23 times per year . The conference may use sources of 24 information deemed appropriate. At each meeting, 25 the conference shall agree to estimates for the 26 current and the following fiscal years for the general 27 fund of the state, lottery revenues to be available 28 for disbursement, and from gambling revenues and 29 from interest earned on the cash reserve fund and 30 the economic emergency fund to be deposited in the 31 rebuild Iowa infrastructure fund. An estimate for the 32 following fiscal year, other than an estimate agreed to 33 pursuant to subsection 3, 4, or 5, shall be considered 34 a preliminary estimate. 35 Sec. ___. Section 8.39, subsections 1 and 2, Code 36 2011, are amended to read as follows: 37 1. Except as otherwise provided by law, an 38 appropriation or any part of it shall not be used 39 for any other purpose than that for which it was 40 made. However, with the prior written consent and 41 approval of the governor and the director of the 42 department of management, the governing board or head 43 of any state department, institution, or agency may, 44 at any time during the fiscal year, make a whole or 45 partial intradepartmental transfer of its unexpended 46 appropriations for purposes within the scope of such 47 department, institution, or agency. Such transfer 48 shall be to an appropriation made from the same 49 funding source and within the same fiscal year. The 50 -10- HF697.3306 (4) 84 tm/jp 10/ 57 #9.
amount of a transfer made from an appropriation under 1 this subsection shall be limited to not more than 2 one-twentieth of one percent of the total of all 3 appropriations made from the funding source of the 4 transferred appropriation for the fiscal year in which 5 the transfer is made. 6 2. If the appropriation of a department, 7 institution, or agency is insufficient to properly meet 8 the legitimate expenses of the department, institution, 9 or agency, the director, with the approval of the 10 governor, may make an interdepartmental transfer from 11 any other department, institution, or agency of the 12 state having an appropriation in excess of its needs, 13 of sufficient funds to meet that deficiency. Such 14 transfer shall be to an appropriation made from the 15 same funding source and within the same fiscal year. 16 The amount of a transfer made from an appropriation 17 under this subsection shall be limited to not more 18 than one-twentieth of one percent of the total of all 19 appropriations made from the funding source of the 20 transferred appropriation for the fiscal year in which 21 the transfer is made. An interdepartmental transfer 22 to an appropriation which is not an entitlement 23 appropriation is not authorized when the general 24 assembly is in regular session and, in addition, 25 the sum of interdepartmental transfers in a fiscal 26 year to an appropriation which is not an entitlement 27 appropriation shall not exceed fifty percent of the 28 amount of the appropriation as enacted by the general 29 assembly. For the purposes of this subsection , an 30 entitlement appropriation is a line item appropriation 31 to the state public defender for indigent defense or to 32 the department of human services for foster care, state 33 supplementary assistance, or medical assistance, or for 34 the family investment program. 35 Sec. ___. Section 8.39, Code 2011, is amended by 36 adding the following new subsection: 37 NEW SUBSECTION . 2A. The aggregate amount of 38 intradepartmental and interdepartmental transfers 39 made from all appropriations for a fiscal year 40 pursuant to this section is limited to not more than 41 one-fourth of one percent of the total amount of the 42 appropriations made from the general fund of the state 43 for the fiscal year. The aggregate amount of the 44 intradepartmental and interdepartmental transfers made 45 from an appropriation for a fiscal year is limited to 46 fifty percent of the appropriation. 47 Sec. ___. EFFECTIVE UPON ENACTMENT. This division 48 of this Act, being deemed of immediate importance, 49 takes effect upon enactment. > 50 -11- HF697.3306 (4) 84 tm/jp 11/ 57
10. Page 475 before line 24 by inserting: 1 < DIVISION ___ 2 SCHOOL DRESS CODES 3 Sec. ___. Section 279.58, subsection 1, Code 2011, 4 is amended by striking the subsection. 5 Sec. ___. Section 279.58, subsection 2, Code 2011, 6 is amended to read as follows: 7 2. The board of directors of a school district may 8 adopt, for the district or for an individual school 9 within the district, a dress code policy that prohibits 10 students from wearing gang-related or other specific 11 apparel prescribes standard dress, or that otherwise 12 imposes limitations on student dress without limiting 13 a student’s constitutional rights and privileges, 14 if the board determines that the policy is necessary 15 for would improve the health, safety, or positive 16 educational environment of students and staff in the 17 school environment or for the appropriate discipline 18 and operation of the school. 19 3. Adoption and enforcement of a dress code policy 20 pursuant to this section is not a violation of section 21 280.22 . 22 Sec. ___. EFFECTIVE UPON ENACTMENT. This division 23 of this Act, being deemed of immediate importance, 24 takes effect upon enactment. > 25 11. Page 475, before line 24 by inserting: 26 < DIVISION ___ 27 DAYS OF INSTRUCTION 28 Sec. ___. Section 256.7, subsection 19, Code 2011, 29 is amended to read as follows: 30 19. Define the minimum school day as a day 31 consisting of five and one-half hours of instructional 32 time for grades one through twelve. The minimum 33 hours as time spent with a licensed teacher that shall 34 be exclusive of the lunch period and parent-teacher 35 conferences , but may include passing time between 36 classes. Time spent on parent-teacher conferences 37 shall be considered instructional time. A school or 38 school district may record a day of school with less 39 than the minimum instructional hours as a minimum 40 school day if any of the following apply: 41 a. If emergency health or safety factors require 42 the late arrival or early dismissal of students on a 43 specific day. 44 b. If the total hours of instructional school 45 time for grades one through twelve for any five 46 consecutive school days equal a minimum of twenty-seven 47 and one-half hours, even though any one day of 48 school is less than the minimum instructional hours 49 because of a staff development opportunity provided 50 -12- HF697.3306 (4) 84 tm/jp 12/ 57 #10. #11.
for the professional instructional staff or because 1 parent-teacher conferences have been scheduled 2 beyond the regular school day. Furthermore, if the 3 total hours of instructional time for the first four 4 consecutive days equal at least twenty-seven and 5 one-half hours because parent-teacher conferences 6 have been scheduled beyond the regular school day, a 7 school or school district may record zero hours of 8 instructional time on the fifth consecutive school day 9 as a minimum school day. 10 Sec. ___. Section 256F.4, subsection 5, Code 2011, 11 is amended to read as follows: 12 5. A charter school or innovation zone school shall 13 provide instruction for at least the number of days 14 hours required by section 279.10, subsection 1 , or 15 shall provide at least the equivalent number of total 16 hours . 17 Sec. ___. Section 279.10, subsection 1, Code 2011, 18 is amended to read as follows: 19 1. The school year for each school district and 20 accredited nonpublic school shall begin on the first 21 day of July 1 and each regularly established elementary 22 and secondary school shall begin no sooner than a day 23 during the calendar week in which the first day of 24 September falls but no later than the first Monday 25 in December. However, if the first day of September 26 falls on a Sunday, school may begin on a day during the 27 calendar week which immediately precedes the first day 28 of September. School shall continue for at least one 29 hundred eighty days, except as provided in subsection 30 3 , and may be maintained The school calendar shall 31 include not less than one thousand eighty hours of 32 instruction during the entire calendar year. However, 33 if The board of directors of a school district and the 34 authorities in charge of an accredited nonpublic school 35 shall set the number of days of required attendance 36 for the school year as provided in section 299.1, 37 subsection 2, but the board of directors of a school 38 district shall hold a public hearing on any proposed 39 school calendar prior to adopting the school calendar. 40 If the board of directors of a district or the 41 authorities in charge of an accredited nonpublic school 42 extends the school calendar because inclement weather 43 caused the school district or accredited nonpublic 44 school to temporarily close school during the regular 45 school calendar, the school district or accredited 46 nonpublic school may excuse a graduating senior who 47 has met district or school requirements for graduation 48 from attendance during the extended school calendar. A 49 school corporation may begin employment of personnel 50 -13- HF697.3306 (4) 84 tm/jp 13/ 57
for in-service training and development purposes before 1 the date to begin elementary and secondary school. 2 Sec. ___. Section 279.10, subsections 2 and 3, Code 3 2011, are amended by striking the subsections. 4 Sec. ___. Section 299.4, subsection 1, Code 2011, 5 is amended to read as follows: 6 1. The parent, guardian, or legal custodian of a 7 child who is of compulsory attendance age, who places 8 the child under competent private instruction under 9 either section 299A.2 or 299A.3 , not in an accredited 10 school or a home school assistance program operated 11 by a school district or accredited nonpublic school, 12 shall furnish a report in duplicate on forms provided 13 by the public school district, to the district by the 14 earliest starting date specified in section 279.10, 15 subsection 1 September 1 of the school year in which 16 the child will be under competent private instruction . 17 The secretary shall retain and file one copy and 18 forward the other copy to the district’s area education 19 agency. The report shall state the name and age of the 20 child, the period of time during which the child has 21 been or will be under competent private instruction 22 for the year, an outline of the course of study, texts 23 used, and the name and address of the instructor. The 24 parent, guardian, or legal custodian of a child, who is 25 placing the child under competent private instruction 26 for the first time, shall also provide the district 27 with evidence that the child has had the immunizations 28 required under section 139A.8 , and, if the child is 29 elementary school age, a blood lead test in accordance 30 with section 135.105D . The term “outline of course of 31 study” shall include subjects covered, lesson plans, 32 and time spent on the areas of study. 33 Sec. ___. REPEAL. Section 256.22, Code 2011, is 34 repealed. 35 Sec. ___. EFFECTIVE DATE. This division of this 36 Act takes effect July 1, 2012. > 37 12. Page 475, before line 24 by inserting: 38 < DIVISION ___ 39 PRISON INDUSTRIES 40 Sec. ___. Section 904.805, Code 2011, is amended by 41 adding the following new subsection: 42 NEW SUBSECTION . 7. a. Report semiannually to the 43 general assembly’s standing committees on government 44 oversight regarding the operations of Iowa state 45 industries. 46 b. Report quarterly and annually to the industries 47 board, the governor, the auditor of state, and the 48 general assembly a full and complete statement of 49 Iowa state industries revenues and expenses for the 50 -14- HF697.3306 (4) 84 tm/jp 14/ 57 #12.
preceding quarter, and with respect to the annual 1 report, for the preceding year. 2 Sec. ___. Section 904.813, Code 2011, is amended by 3 adding the following new subsection: 4 NEW SUBSECTION . 3A. A capital expenditure in 5 an amount exceeding two hundred fifty thousand 6 dollars shall not be made from the Iowa state 7 industries revolving fund without authorization by a 8 constitutional majority of each house of the general 9 assembly, or approval by the legislative council if the 10 general assembly is not in session. 11 Sec. ___. EFFECTIVE UPON ENACTMENT. This division 12 of this Act, being deemed of immediate importance, 13 takes effect upon enactment. > 14 13. Page 475, before line 24 by inserting: 15 < DIVISION ___ 16 MEDICATION THERAPY MANAGEMENT 17 Sec. ___. NEW SECTION . 8A.440 Medication therapy 18 management. 19 1. As used in this section, unless the context 20 otherwise requires: 21 a. “Eligible employee” means an employee of the 22 state, with the exception of an employee of the state 23 board of regents or institutions under the state board 24 of regents, for whom group health plans are established 25 pursuant to chapter 509A providing for third-party 26 payment or prepayment for health or medical expenses. 27 b. “Medication therapy management” means a 28 systematic process performed by a licensed pharmacist, 29 designed to optimize therapeutic outcomes through 30 improved medication use and reduced risk of adverse 31 drug events, including all of the following services: 32 (1) A medication therapy review and in-person 33 consultation relating to all medications, vitamins, and 34 herbal supplements currently being taken by an eligible 35 individual. 36 (2) A medication action plan, subject to the 37 limitations specified in this section, communicated 38 to the individual and the individual’s primary care 39 physician or other appropriate prescriber to address 40 safety issues, inconsistencies, duplicative therapy, 41 omissions, and medication costs. The medication action 42 plan may include recommendations to the prescriber for 43 changes in drug therapy. 44 (3) Documentation and follow-up to ensure 45 consistent levels of pharmacy services and positive 46 outcomes. 47 2. a. The department shall amend the contract 48 for the provision of medication therapy management 49 services as initially required pursuant to 2010 Iowa 50 -15- HF697.3306 (4) 84 tm/jp 15/ 57 #13.
Acts, chapter 1193, section 166, to provide for the 1 continuation of medication therapy management services 2 for eligible employees who meet any of the following 3 criteria: 4 (1) An individual who takes four or more 5 prescription drugs to treat or prevent two or more 6 chronic medical conditions. 7 (2) An individual with a prescription drug therapy 8 problem who is identified by the prescribing physician 9 or other appropriate prescriber, and referred to a 10 pharmacist for medication therapy management services. 11 (3) An individual who meets other criteria 12 established by the third-party payment provider 13 contract, policy, or plan. 14 b. The contract shall require the entity to provide 15 annual reports to the general assembly detailing the 16 costs, savings, estimated cost avoidance and return 17 on investment, and patient outcomes related to the 18 medication therapy management services provided. The 19 entity shall guarantee demonstrated annual savings, 20 including any savings associated with cost avoidance at 21 least equal to the program’s costs with any shortfall 22 amount refunded to the state. The contract shall 23 include terms, conditions, and applicable measurement 24 standards associated with the demonstration of savings. 25 The department shall verify the demonstrated savings 26 reported by the entity was achieved in accordance with 27 the agreed upon measurement standards. The entity 28 shall be prohibited from using the entity’s employees 29 to provide the medication therapy management services 30 and shall instead be required to contract with licensed 31 pharmacies, pharmacists, or physicians. 32 c. The fees for pharmacist-delivered medication 33 therapy management services shall be separate from 34 the reimbursement for prescription drug product or 35 dispensing services; shall be determined by each 36 third-party payment provider contract, policy, or plan; 37 and must be reasonable based on the resources and time 38 required to provide the service. 39 d. A fee shall be established for physician 40 reimbursement for services delivered for medication 41 therapy management as determined by each third-party 42 payment provider contract, policy, or plan, and must be 43 reasonable based on the resources and time required to 44 provide the service. 45 e. If any part of the medication therapy management 46 plan developed by a pharmacist incorporates services 47 which are outside the pharmacist’s independent scope 48 of practice including the initiation of therapy, 49 modification of dosages, therapeutic interchange, or 50 -16- HF697.3306 (4) 84 tm/jp 16/ 57
changes in drug therapy, the express authorization 1 of the individual’s physician or other appropriate 2 prescriber is required. 3 f. The department shall utilize the services of the 4 college of pharmacy at a state university to validate 5 reported drug cost savings. 6 g. The results of the pilot program established 7 pursuant to 2010 Iowa Acts, chapter 1193, section 166, 8 for the period beginning July 1, 2010, and ending 9 December 31, 2011, shall be submitted to the general 10 assembly no later than March 1, 2012. 11 Sec. ___. APPROPRIATION —— DEPARTMENT OF 12 ADMINISTRATIVE SERVICES. There is appropriated from 13 the fees collected by the board of pharmacy pursuant 14 to chapter 155A and retained by the board of pharmacy 15 pursuant to the authority granted in section 147.82 16 to the department of administrative services for the 17 fiscal year beginning July 1, 2011, and ending June 30, 18 2012, the following amount or so much thereof as is 19 necessary, to be used for the purpose specified: 20 For the medication therapy management program as 21 enacted in this Act: 22 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ 510,000 23 Sec. ___. REPEAL. 2010 Iowa Acts, chapter 1193, 24 section 166, is repealed. 25 Sec. ___. EFFECTIVE UPON ENACTMENT. This division 26 of this Act, being deemed of immediate importance, 27 takes effect upon enactment. > 28 14. Page 475, before line 24 by inserting: 29 < DIVISION ___ 30 NOTICE OF MORTGAGE MEDIATION ASSISTANCE —— SUNSET 31 Sec. ___. Section 654.4B, subsection 2, paragraph 32 b, Code 2011, is amended to read as follows: 33 b. This subsection is repealed July 1, 2011 2012 . 34 Sec. ___. EFFECTIVE UPON ENACTMENT AND RETROACTIVE 35 APPLICABILITY. This division of this Act, being deemed 36 of immediate importance, takes effect upon enactment 37 and, if approved by the governor on or after July 1, 38 2011, shall apply retroactively to June 30, 2011. > 39 15. Page 475, before line 24 by inserting: 40 < DIVISION ___ 41 HOUSING DEVELOPMENT —— TAX STATUS 42 Sec. ___. Section 405.1, Code 2011, is amended to 43 read as follows: 44 405.1 Housing development —— tax status —— 45 limitation. 46 1. The board of supervisors of a county with a 47 population of less than twenty thousand may adopt 48 an ordinance providing that property acquired and 49 subdivided for development of housing shall continue 50 -17- HF697.3306 (4) 84 tm/jp 17/ 57 #14. #15.
to be assessed for taxation in the manner that it was 1 prior to the acquisition for housing. Each lot shall 2 continue to be taxed in the manner it was prior to 3 its acquisition for housing until the lot is sold for 4 construction or occupancy of housing or five years from 5 the date of subdivision, whichever is shorter. Upon 6 the sale or the expiration of the five-year ten-year 7 period, the property shall be assessed for taxation 8 as residential or commercial multifamily property, 9 whichever is applicable. 10 2. The board of supervisors of a county with 11 a population of twenty thousand or more may adopt 12 an ordinance providing that property acquired and 13 subdivided for development of housing shall continue 14 to be assessed for taxation in the manner that it was 15 prior to the acquisition for housing. Each lot shall 16 continue to be taxed in the manner it was prior to 17 its acquisition for housing until the lot is sold for 18 construction or occupancy of housing or three years 19 from the date of subdivision, whichever is shorter. 20 Upon the sale or the expiration of the three-year 21 period, the property shall be assessed for taxation 22 as residential or commercial multifamily property, 23 whichever is applicable. 24 Sec. ___. Section 441.72, Code 2011, is amended to 25 read as follows: 26 441.72 Assessment of platted lots. 27 When a subdivision plat is recorded pursuant to 28 chapter 354 , the individual lots within the subdivision 29 plat shall not be assessed in excess of the total 30 assessment of the land as acreage or unimproved 31 property for three ten years after the recording of 32 the plat or until the lot is actually improved with 33 permanent construction, whichever occurs first. When 34 an individual lot has been improved with permanent 35 construction, the lot shall be assessed for taxation 36 purposes as provided in chapter 428 and this chapter . 37 This section does not apply to special assessment 38 levies. 39 Sec. ___. EFFECTIVE UPON ENACTMENT AND RETROACTIVE 40 APPLICABILITY. This division of this Act, being deemed 41 of immediate importance, takes effect upon enactment 42 and applies retroactively to assessment years beginning 43 on or after January 1, 2011. The division applies 44 to subdivision plats recorded on or after January 1, 45 2004. > 46 16. Page 475, before line 24 by inserting: 47 < DIVISION ___ 48 MENTAL HEALTH AND DISABILITY SERVICES REDESIGN 49 SERVICE SYSTEM REDESIGN 50 -18- HF697.3306 (4) 84 tm/jp 18/ 57 #16.
Sec. ___. ADULT DISABILITY SERVICES SYSTEM 1 REDESIGN. 2 1. For the purposes of this section, “disability 3 services” means services and other support available 4 to a person with mental illness or an intellectual 5 disability or other developmental disability. 6 2. It is the intent of the general assembly to 7 redesign the system for adult disability services to 8 implement all of the following: 9 a. Shifting the funding responsibility for the 10 nonfederal share of adult disability services paid for 11 by the Medicaid program, including but not limited to 12 all costs for the state resource centers, from the 13 counties to the state. 14 b. Reorganizing adult disability services not paid 15 for by the Medicaid program into a system administered 16 on a regional basis in a manner that provides multiple 17 local points of access to adult disability services 18 both paid for by the Medicaid program and not paid for 19 by the Medicaid program. 20 c. Replacing legal settlement as the basis for 21 determining financial responsibility for publicly 22 funded disability services by determining such 23 responsibility based upon residency. 24 3. a. The legislative council is requested to 25 authorize an interim committee on mental health and 26 disability services for the 2011 legislative interim to 27 commence as soon as practicable. The purpose of the 28 interim committee is to closely engage with, monitor, 29 and make recommendations concerning the efforts of 30 the department of human services and workgroups of 31 stakeholders and experts created by the department 32 to develop detailed proposals for the redesign of 33 disability services pursuant to this Act, particularly 34 with regard to the identification of core services. 35 b. (1) It is intended that the interim committee 36 members consist of equal numbers of legislators from 37 both chambers and from both political parties and 38 for staff from the office of the governor and the 39 departments of human services and public health to be 40 designated to serve as ex officio, nonvoting members. 41 It is also requested that legislators serving on the 42 interim committee and other interested legislators 43 be authorized to participate in the meetings of the 44 workgroups and subcommittees addressed in this Act. 45 (2) In addition to addressing workgroup 46 recommendations, it is intended that the interim 47 committee address property tax issues, devise a means 48 of ensuring the state maintains its funding commitments 49 for the redesigned services system, recommend revisions 50 -19- HF697.3306 (4) 84 tm/jp 19/ 57
in the requirements for mental health professionals 1 who are engaged in the involuntary commitment and 2 examination processes under chapter 229, develop 3 proposed legislation for amending Code references to 4 mental retardation to instead refer to intellectual 5 disabilities, and consider issues posed by the 6 July 1, 2013, repeals of county disability services 7 administration and funding provisions in 2011 Iowa 8 Acts, Senate File 209, as amended by this Act. In 9 addressing the repeal provisions, the interim committee 10 shall include options for further revisions to the 11 repeal date amendments enacted by this Act. 12 (3) It is intended that the interim committee 13 shall receive and make recommendations concerning the 14 detailed and final proposals submitted by workgroups 15 during the 2011 legislative interim for consideration 16 by the general assembly in the 2012 legislative 17 session. 18 c. (1) The department of human services shall 19 design the workgroup process to facilitate effective 20 decision making while allowing for a broad array of 21 input. The workgroup process shall begin as soon after 22 the effective date of this Act as is practicable. The 23 membership of workgroups and subcommittees involved 24 with the process shall include consumers, service 25 providers, and advocates and provide for adequate 26 representation by both rural and urban interests. 27 The department of public health shall be represented 28 on those workgroups and subcommittees with a focus 29 relevant to the department. 30 (2) The detailed and final proposals developed 31 by the workgroups during the 2011 interim shall 32 be submitted to the interim committee on or before 33 December 9, 2011. 34 d. At least one workgroup shall address redesign 35 of the adult mental health system and at least 36 one workgroup shall address redesign of the adult 37 intellectual and other developmental disability system. 38 The workgroup process shall engage separate workgroups 39 and subcommittees enumerated in this Act and may 40 involve additional bodies in the process as determined 41 by the department. 42 e. It is intended that interim committee members 43 be engaged, to the extent possible, in workgroup 44 deliberations and begin formal discussions of 45 preliminary proposals developed by the workgroups 46 beginning in October. 47 4. The workgroup process implemented by the 48 department of human services pursuant to subsection 49 3 shall result in the submission of proposals for 50 -20- HF697.3306 (4) 84 tm/jp 20/ 57
redesign of adult disability services that include but 1 are not limited to all of the following: 2 a. Identifying clear definitions and requirements 3 for the following: 4 (1) Eligibility criteria for the individuals to be 5 served. 6 (2) The array of core services and other support to 7 be included in regional adult disability services plans 8 and to be delivered by providers based on individual 9 needs and medical necessity and in a manner that 10 promotes cost-effectiveness, uniformity, accessibility, 11 and best practice approaches. The array shall 12 encompass and integrate services and other support paid 13 for by both the Medicaid program and other sources. 14 (3) Outcome measures that focus on consumer needs, 15 including but not limited to measures addressing 16 individual choice, empowerment, and community. 17 (4) Quality assurance measures. 18 (5) Provider accreditation, certification, 19 or licensure requirements to ensure high quality 20 services while avoiding unreasonable expectations and 21 duplicative surveys. 22 (6) Input in regional service plans and delivery 23 provisions by consumer and provider representatives. 24 The input process shall engage local consumers, 25 providers, and counties in developing the regional 26 provisions. 27 (7) Provisions for representatives of the regional 28 system and the department to regularly engage in 29 discussions to resolve Medicaid and non-Medicaid 30 issues involving documentation requirements, electronic 31 records, reimbursement methodologies, cost projections, 32 and other measures to improve the services and other 33 support available to consumers. 34 b. Incorporating strategies to allow individuals 35 to receive services in accordance with the principles 36 established in Olmstead v. L.C., 527 U.S. 581 (1999), 37 in order for services to be provided in the most 38 community-based, least restrictive, and integrated 39 setting appropriate to an individual’s needs. 40 c. Continuing the department’s leadership role 41 in the Medicaid program in defining services covered, 42 establishing reimbursement methodologies, providing 43 other administrative functions, and engaging in federal 44 options for program enhancements that are beneficial to 45 consumers and the state such as medical or behavioral 46 health homes. 47 d. Implementing mental health crisis response 48 services statewide in a manner determined to be most 49 appropriate by each region. 50 -21- HF697.3306 (4) 84 tm/jp 21/ 57
e. Implementing a subacute level of care to provide 1 short-term mental health services in a structured 2 residential setting that supplies a less intensive 3 level of care than is supplied by acute psychiatric 4 services. 5 f. Reviewing best practices and programs utilized 6 by other states in identifying new approaches for 7 addressing the needs for publicly funded services for 8 persons with brain injury. The proposals regarding 9 these approaches may be submitted after the workgroup 10 submission date set out in subsection 3. 11 g. Developing a proposal for addressing service 12 provider shortages. The development of the proposal 13 shall incorporate an examination of scope of practice 14 limitations and barriers to recruiting providers, 15 including but not limited to variation in health 16 insurance payment provisions for the services provided 17 by different types of providers. 18 h. Developing a proposal for service providers 19 addressing co-occurring mental health, intellectual 20 disability, brain injury, and substance abuse 21 disorders. Each workgroup or subcommittee shall 22 address co-occurring disorders as appropriate to the 23 focus of the workgroup or subcommittee. The overall 24 proposal may be developed by a body consisting of 25 members from other workgroups or subcommittees. The 26 proposal shall also provide options, developed in 27 coordination with the judicial branch and department 28 of human services workgroup, for implementation 29 of the provision of advocates to patients with 30 substance-related disorders. 31 i. Developing a proposal for redesign of publicly 32 funded children’s disability services, including but 33 not limited to the needs of children who are placed 34 out-of-state due to the lack of treatment services 35 in this state. The proposal shall be developed by a 36 separate workgroup or subcommittee and in addition to 37 the other interests and representation required by this 38 section, the membership shall include education system 39 and juvenile court representatives. The preliminary 40 findings and recommendations, and the initial proposal 41 shall be submitted by the October and December 2011 42 dates required for other workgroups and subcommittees. 43 The initial proposal developed during the 2011 44 legislative interim shall include an analysis of gaps 45 in the children’s system and other planning provisions 46 necessary to complete the final proposal for submission 47 on or before December 10, 2012. 48 j. Developing a proposal for adult disability 49 services not paid for by the Medicaid program to be 50 -22- HF697.3306 (4) 84 tm/jp 22/ 57
administered on a regional basis in a manner that 1 provides multiple local points of access for consumers 2 needing adult disability services, regardless of 3 the funding sources for the services. The proposal 4 shall be integrated with the other proposals under 5 this subsection and shall be developed by a separate 6 workgroup or subcommittee engaging both urban and rural 7 county supervisors and central-point-of-coordination 8 administrators and other experts. The considerations 9 for inclusion in the proposal for forming regional 10 entities shall include but are not limited to all of 11 the following: 12 (1) Modifying the relevant provisions of chapter 13 28E for use by counties in forming regional entities 14 and addressing other necessary contracting measures. 15 (2) Providing for performance-based contracting 16 between the department of human services and regional 17 entities to ensure the existence of multiple, local 18 points of access for adult disability services 19 eligibility, intake, and authorization, service 20 navigation support, and case coordination or case 21 management, regardless of the funding sources for the 22 services. 23 (3) Developing a three-year service plan and annual 24 update to meet the needs of consumers. 25 (4) Providing for the regional entities to 26 implement performance-based contracts, uniform cost 27 reports, and consistent reimbursement practices and 28 payment methodologies with local providers of services 29 not paid for by the Medicaid program. 30 (5) Providing for the regional entities to 31 determine the Medicaid program targeted case managers 32 to serve the regions. 33 (6) Providing for the regional entities and the 34 department of human services to regularly coordinate 35 and communicate with one another concerning the adult 36 disability services paid for by the Medicaid program so 37 that services paid for by the program and the regional 38 entities are integrated and coordinated. 39 (7) Identifying sufficient population size to 40 attain economy of scale, adequate financial resources, 41 and appropriate service delivery. 42 (8) Addressing full participation in regional 43 entities by counties. 44 (9) Including dispute resolution provisions for 45 county-to-county relationships, county-to-region 46 relationships, and region-to-state relationships. 47 (10) Providing for a consumer appeal process that 48 is clear, impartial, and consistent, with consideration 49 of an option that appeals beyond the regional level 50 -23- HF697.3306 (4) 84 tm/jp 23/ 57
should be to a state administrative law judge. 1 (11) Addressing financial management provisions, 2 including appropriate financial reserve levels. 3 (12) Proposing other criteria for forming regional 4 entities. The other criteria considered shall include 5 but are not limited to all of the following: 6 (a) Requiring a region to consist of contiguous 7 counties. 8 (b) Evaluating a proposed region’s capacity 9 for providing core services and performing required 10 functions. 11 (c) Requiring a region to encompass at least 12 one community mental health center or federally 13 qualified health center with providers qualified to 14 provide psychiatric services, either directly or with 15 assistance from psychiatric consultants, that has the 16 capacity to provide outpatient services for the region 17 and has provided evidence of a commitment to provide 18 outpatient services for the region. 19 (d) Requiring a region to encompass or have 20 reasonably close proximity to a hospital with an 21 inpatient psychiatric unit or to a state mental health 22 institute, that has the capacity to provide inpatient 23 services for the region and has provided evidence of 24 a commitment to provide inpatient services for the 25 region. 26 (e) Requiring an administrative structure utilized 27 by a region to have clear lines of accountability and 28 to serve as a lead agency with shared county staff or 29 other means of limiting administrative costs to not 30 more than five percent of expenditures. 31 5. The target date for full implementation of 32 the plan and implementation provisions described in 33 subsections 3 and 4 shall be July 1, 2013, provided, 34 however, that any expansion of services is subject to 35 available funding. 36 Sec. ___. CONTINUATION OF WORKGROUP BY JUDICIAL 37 BRANCH AND DEPARTMENT OF HUMAN SERVICES. The judicial 38 branch and department of human services shall continue 39 the workgroup implemented pursuant to 2010 Iowa Acts, 40 chapter 1192, section 24, subsection 2, to improve 41 the processes for involuntary commitment for chronic 42 substance abuse under chapter 125 and for serious 43 mental illness under chapter 229, and shall coordinate 44 its efforts with the legislative interim committee and 45 other workgroups initiated pursuant to this Act. The 46 recommendations issued by the workgroup shall address 47 options to the current provision of transportation 48 by the county sheriff; to the role, supervision, 49 and funding of mental health patient advocates and 50 -24- HF697.3306 (4) 84 tm/jp 24/ 57
substance-related disorder patient advocates, along 1 with options for implementation of the provision of 2 advocates to patients with such disorders; for revising 3 requirements for mental health professionals who are 4 engaged in the involuntary commitment and examination 5 processes under chapter 229; for authorizing the 6 court to order an involuntary hold of a patient under 7 section 229.10 for not more than twenty-three hours 8 who was not initially taken into custody but declined 9 to be examined pursuant to a previous court order; 10 and for civil commitment prescreening. Preliminary 11 recommendations shall be submitted to the legislative 12 interim committee in October 2011, as specified by the 13 interim committee. Additional stakeholders shall be 14 added as necessary to facilitate the workgroup efforts. 15 The workgroup shall complete deliberations and submit 16 a final report to the legislative interim committee 17 providing findings and recommendations on or before 18 December 9, 2011. 19 Sec. ___. SERVICE SYSTEM DATA AND STATISTICAL 20 INFORMATION INTEGRATION. In coordination with 21 the legislative interim committee and workgroups 22 initiated pursuant to this Act, representatives of the 23 department of human services, department of public 24 health, and the community services network hosted by 25 the Iowa state association of counties shall develop 26 implementation provisions for an integrated data and 27 statistical information system for mental health, 28 disability services, and substance abuse services. 29 The implementation provisions shall incorporate 30 federal data and statistical information requirements. 31 When completed, the departments and affiliate shall 32 report on the integrated system to the governor, 33 the joint appropriations subcommittee on health and 34 human services, and the legislative services agency, 35 providing their findings and recommendations. 36 Sec. ___. DEPARTMENT OF HUMAN SERVICES. There is 37 appropriated from the general fund of the state to 38 the department of human services for the fiscal year 39 beginning July 1, 2010, and ending June 30, 2011, the 40 following amount, or so much thereof as is necessary, 41 to be used for the purposes designated: 42 For the costs of planning and other processes 43 associated with implementation of this Act: 44 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ 250,000 45 Notwithstanding section 8.47 or any other provision 46 of law to the contrary, the department may utilize a 47 sole source approach to contract to support planning 48 and other processes associated with implementation 49 of this Act. Notwithstanding section 8.33, moneys 50 -25- HF697.3306 (4) 84 tm/jp 25/ 57
appropriated in this section that remain unencumbered 1 or unobligated at the close of the fiscal year shall 2 not revert but shall remain available for expenditure 3 for the purposes designated until the close of the 4 succeeding fiscal year. 5 Sec. ___. EFFECTIVE UPON ENACTMENT. This division 6 of this Act, being deemed of immediate importance, 7 takes effect upon enactment and, unless otherwise 8 provided by this division of this Act, if approved by 9 the governor on or after July 1, 2011, shall apply 10 retroactively to June 30, 2011. 11 DIVISION ___ 12 MENTAL HEALTH AND DISABILITY SERVICES REDESIGN 13 CONFORMING PROVISIONS 14 Sec. ___. CONFORMING PROVISIONS. The legislative 15 services agency shall prepare a study bill for 16 consideration by the committees on human resources of 17 the senate and house of representatives for the 2012 18 legislative session, providing any necessary conforming 19 Code changes for implementation of the mental health 20 and disabilities services redesign divisions contained 21 in this Act. 22 DIVISION ___ 23 MENTAL HEALTH AND DISABILITY SERVICES REDESIGN 24 PSYCHIATRIC MEDICAL INSTITUTIONS FOR CHILDREN 25 Sec. ___. Section 135H.3, subsection 1, Code 2011, 26 is amended to read as follows: 27 1. A psychiatric medical institution for children 28 shall utilize a team of professionals to direct an 29 organized program of diagnostic services, psychiatric 30 services, nursing care, and rehabilitative services 31 to meet the needs of residents in accordance with a 32 medical care plan developed for each resident. The 33 membership of the team of professionals may include 34 but is not limited to an advanced registered nurse 35 practitioner or a physician assistant. Social and 36 rehabilitative services shall be provided under the 37 direction of a qualified mental health professional. 38 Sec. ___. Section 135H.6, subsection 8, Code 2011, 39 is amended to read as follows: 40 8. The department of human services may give 41 approval to conversion of beds approved under 42 subsection 6 , to beds which are specialized to provide 43 substance abuse treatment. However, the total number 44 of beds approved under subsection 6 and this subsection 45 shall not exceed four hundred thirty. Conversion of 46 beds under this subsection shall not require a revision 47 of the certificate of need issued for the psychiatric 48 institution making the conversion. Beds for children 49 who do not reside in this state and whose service costs 50 -26- HF697.3306 (4) 84 tm/jp 26/ 57
are not paid by public funds in this state are not 1 subject to the limitations on the number of beds and 2 certificate of need requirements otherwise applicable 3 under this section. 4 Sec. ___. PSYCHIATRIC MEDICAL INSTITUTIONS FOR 5 CHILDREN AND RELATED SERVICES —— TRANSITION COMMITTEE. 6 1. For the purposes of this section, unless the 7 context otherwise requires: 8 a. “Iowa plan” means the contract to administer the 9 behavioral health managed care plan under the state’s 10 Medicaid program. 11 b. “PMIC” means a psychiatric medical institution 12 for children. 13 2. It is the intent of the general assembly to do 14 the following under this section: 15 a. Improve the reimbursement, expected outcomes, 16 and integration of PMIC services to serve the best 17 interests of children within the context of a redesign 18 of the delivery of publicly funded children’s mental 19 health services in this state. 20 b. Support the development of specialized programs 21 for children with high acuity requirements whose needs 22 are not met by Iowa’s current system and must be served 23 in out-of-state placements. 24 c. Transition PMIC services while providing 25 services in a manner that applies best practices and is 26 cost-effective. 27 3. The department of human services, in 28 collaboration with PMIC providers, shall develop a 29 plan for transitioning the administration of PMIC 30 services to the Iowa plan. The transition plan 31 shall address specific strategies for appropriately 32 addressing PMIC lengths of stay by increasing the 33 availability of less intensive levels of care, 34 establishing vendor performance standards, identifying 35 levels of PMIC care, providing for performance and 36 quality improvement technical assistance to providers, 37 identifying methods and standards for credentialing 38 providers of specialized programs, using innovative 39 reimbursement incentives to improve access while 40 building the capacity of less intensive levels of care, 41 and providing implementation guidelines. 42 4. a. The transition plan shall address the 43 development of specialized programs to address the 44 needs of children in need of more intensive treatment 45 who are currently underserved. All of the following 46 criteria shall be used for such programs: 47 (1) Geographic accessibility. 48 (2) Expertise needed to assure appropriate and 49 effective treatment. 50 -27- HF697.3306 (4) 84 tm/jp 27/ 57
(3) Capability to define and provide the 1 appropriate array of services and report on 2 standardized outcome measures. 3 (4) Best interests of the child. 4 b. The transition plan shall also address all of 5 the following: 6 (1) Providing navigation, access, and care 7 coordination for children and families in need of 8 services from the children’s mental health system. 9 (2) Integrating the children’s mental health 10 waiver services under the Medicaid program with 11 other services addressed by the transition plan as a 12 means for supporting the transition plan and ensuring 13 availability of choices for community placements. 14 (3) Identifying admission and continued stay 15 criteria for PMIC providers. 16 (4) Evaluating changes in licensing standards for 17 PMICs as necessary to ensure that the standards are 18 aligned with overall system goals. 19 (5) Evaluating alternative reimbursement and 20 service models that are innovative and could support 21 overall system goals. The models may include but are 22 not limited to accountable care organizations, medical 23 or other health homes, and performance-based payment 24 methods. 25 (6) Evaluating the adequacy of reimbursement at all 26 levels of the children’s mental health system. 27 (7) Developing profiles of the conditions and 28 behaviors that result in a child’s involuntary 29 discharge or out-of-state placement. The plan shall 30 incorporate provisions for developing specialized 31 programs that are designed to appropriately meet the 32 needs identified in the profiles. 33 (8) Evaluating and defining the appropriate array 34 of less intensive services for a child leaving a 35 hospital or PMIC placement. 36 (9) Evaluating and defining the standards for 37 existing and new PMIC and other treatment levels. 38 5. a. The department shall establish a 39 transition committee that includes departmental 40 staff representatives for Medicaid, child welfare, 41 field, and mental health services, the director of 42 the Iowa plan, the department of inspections and 43 appeals, a representative of each licensed PMIC, the 44 executive director of the coalition of family and 45 children’s services in Iowa, a person with knowledge 46 and expertise in care coordination and integration 47 of PMIC and community-based services, two persons 48 representing families affected by the children’s mental 49 health system, and a representative of juvenile court 50 -28- HF697.3306 (4) 84 tm/jp 28/ 57
officers. 1 b. The transition committee shall develop the plan 2 and manage the transition if the plan is implemented. 3 The plan shall be developed by December 31, 2011, 4 and shall be submitted to the general assembly by 5 January 16, 2012. The submitted plan shall include 6 an independent finding by the director of human 7 services, in consultation with the office of the 8 governor and the chairpersons and ranking members of 9 the joint appropriations subcommittee on health and 10 human services, that the plan meets the intent of the 11 general assembly under this section. Unless otherwise 12 directed by enactment of the general assembly the 13 department and the transition committee may proceed 14 with implementation of the submitted plan on or before 15 July 1, 2012. 16 c. The transition committee shall continue to meet 17 through December 31, 2013, to oversee transition of 18 PMIC services to the Iowa plan. 19 6. The director of the Medicaid enterprise of the 20 department of human services shall annually report on 21 or before December 15 to the chairpersons and ranking 22 members of the joint appropriations subcommittee on 23 health and human services through December 15, 2016, 24 regarding the implementation of this section. The 25 content of the report shall include but is not limited 26 to information on children served by PMIC providers, 27 the types of locations to which children are discharged 28 following a hospital or PMIC placement and the 29 community-based services available to such children, 30 and the incidence of readmission to a PMIC within 12 31 months of discharge. The report shall also recommend 32 whether or not to continue administration of PMIC 33 services under the Iowa plan based upon the quality 34 of service delivery, the value of utilizing the Iowa 35 plan administration rather than the previous approach 36 through the Medicaid enterprise, and analysis of the 37 cost and benefits of utilizing the Iowa plan approach. 38 DIVISION ___ 39 MENTAL HEALTH AND DISABILITY SERVICES REDESIGN 40 COMMUNITY MENTAL HEALTH CENTERS 41 COMMUNITY MENTAL HEALTH CENTERS —— CATCHMENT AREAS 42 Sec. ___. NEW SECTION . 230A.101 Services system 43 roles. 44 1. The role of the department of human services, 45 through the division of the department designated as 46 the state mental health authority with responsibility 47 for state policy concerning mental health and 48 disability services, is to develop and maintain 49 policies for the mental health and disability services 50 -29- HF697.3306 (4) 84 tm/jp 29/ 57
system. The policies shall address the service 1 needs of individuals of all ages with disabilities 2 in this state, regardless of the individuals’ places 3 of residence or economic circumstances, and shall be 4 consistent with the requirements of chapter 225C and 5 other applicable law. 6 2. The role of community mental health centers in 7 the mental health and disability services system is 8 to provide an organized set of services in order to 9 adequately meet the mental health needs of this state’s 10 citizens based on organized catchment areas. 11 Sec. ___. NEW SECTION . 230A.102 Definitions. 12 As used in this chapter, unless the context 13 otherwise requires: 14 1. “Administrator” , “commission” , “department” , 15 “disability services” , and “division” mean the same as 16 defined in section 225C.2. 17 2. “Catchment area” means a community mental health 18 center catchment area identified in accordance with 19 this chapter. 20 3. “Community mental health center” or “center” 21 means a community mental health center designated in 22 accordance with this chapter. 23 Sec. ___. NEW SECTION . 230A.103 Designation of 24 community mental health centers. 25 1. The division, subject to agreement by any 26 community mental health center that would provide 27 services for the catchment area and approval by the 28 commission, shall designate at least one community 29 mental health center under this chapter to serve as 30 lead agency for addressing the mental health needs of 31 the county or counties comprising the catchment area. 32 The designation process shall provide for the input 33 of potential service providers regarding designation 34 of the initial catchment area or a change in the 35 designation. 36 2. The division shall utilize objective criteria 37 for designating a community mental health center 38 to serve a catchment area and for withdrawing such 39 designation. The commission shall adopt rules 40 outlining the criteria. The criteria shall include but 41 are not limited to provisions for meeting all of the 42 following requirements: 43 a. An appropriate means shall be used for 44 determining which prospective designee is best able to 45 serve all ages of the targeted population within the 46 catchment area with minimal or no service denials. 47 b. An effective means shall be used for determining 48 the relative ability of a prospective designee to 49 appropriately provide mental health services and other 50 -30- HF697.3306 (4) 84 tm/jp 30/ 57
support to consumers residing within a catchment area 1 as well as consumers residing outside the catchment 2 area. The criteria shall address the duty for a 3 prospective designee to arrange placements outside the 4 catchment area when such placements best meet consumer 5 needs and to provide services within the catchment area 6 to consumers who reside outside the catchment area when 7 the services are necessary and appropriate. 8 3. The board of directors for a designated 9 community mental health center shall enter into 10 an agreement with the division. The terms of the 11 agreement shall include but are not limited to all of 12 the following: 13 a. The period of time the agreement will be in 14 force. 15 b. The services and other support the center will 16 offer or provide for the residents of the catchment 17 area. 18 c. The standards to be followed by the center in 19 determining whether and to what extent the persons 20 seeking services from the center shall be considered to 21 be able to pay the costs of the services. 22 d. The policies regarding availability of the 23 services offered by the center to the residents of the 24 catchment area as well as consumers residing outside 25 the catchment area. 26 e. The requirements for preparation and submission 27 to the division of annual audits, cost reports, program 28 reports, performance measures, and other financial and 29 service accountability information. 30 4. This section does not limit the authority of 31 the board or the boards of supervisors of any county 32 or group of counties to continue to expend money to 33 support operation of a center. 34 Sec. ___. NEW SECTION . 230A.104 Catchment areas. 35 1. The division shall collaborate with affected 36 counties in identifying community mental health center 37 catchment areas in accordance with this section. 38 2. a. Unless the division has determined that 39 exceptional circumstances exist, a catchment area 40 shall be served by one community mental health center. 41 The purpose of this general limitation is to clearly 42 designate the center responsible and accountable for 43 providing core mental health services to the target 44 population in the catchment area and to protect the 45 financial viability of the centers comprising the 46 mental health services system in the state. 47 b. A formal review process shall be used in 48 determining whether exceptional circumstances exist 49 that justify designating more than one center to 50 -31- HF697.3306 (4) 84 tm/jp 31/ 57
serve a catchment area. The criteria for the review 1 process shall include but are not limited to a means 2 of determining whether the catchment area can support 3 more than one center. 4 c. Criteria shall be provided that would allow 5 the designation of more than one center for all 6 or a portion of a catchment area if designation or 7 approval for more than one center was provided by the 8 division as of October 1, 2010. The criteria shall 9 require a determination that all such centers would be 10 financially viable if designation is provided for all. 11 Sec. ___. NEW SECTION . 230A.105 Target population 12 —— eligibility. 13 1. The target population residing in a catchment 14 area to be served by a community mental health 15 center shall include but is not limited to all of the 16 following: 17 a. Individuals of any age who are experiencing a 18 mental health crisis. 19 b. Individuals of any age who have a mental health 20 disorder. 21 c. Adults who have a serious mental illness or 22 chronic mental illness. 23 d. Children and youth who are experiencing a 24 serious emotional disturbance. 25 e. Individuals described in paragraph “a” , “b” , 26 “c” , or “d” who have a co-occurring disorder, including 27 but not limited to substance abuse, mental retardation, 28 a developmental disability, brain injury, autism 29 spectrum disorder, or another disability or special 30 health care need. 31 2. Specific eligibility criteria for members of the 32 target population shall be identified in administrative 33 rules adopted by the commission. The eligibility 34 criteria shall address both clinical and financial 35 eligibility. 36 Sec. ___. NEW SECTION . 230A.106 Services offered. 37 1. A community mental health center designated 38 in accordance with this chapter shall offer core 39 services and support addressing the basic mental health 40 and safety needs of the target population and other 41 residents of the catchment area served by the center 42 and may offer other services and support. The core 43 services shall be identified in administrative rules 44 adopted by the commission for this purpose. 45 2. The initial core services identified shall 46 include all of the following: 47 a. Outpatient services. Outpatient services shall 48 consist of evaluation and treatment services provided 49 on an ambulatory basis for the target population. 50 -32- HF697.3306 (4) 84 tm/jp 32/ 57
Outpatient services include psychiatric evaluations, 1 medication management, and individual, family, and 2 group therapy. In addition, outpatient services shall 3 include specialized outpatient services directed to the 4 following segments of the target population: children, 5 elderly, individuals who have serious and persistent 6 mental illness, and residents of the service area 7 who have been discharged from inpatient treatment 8 at a mental health facility. Outpatient services 9 shall provide elements of diagnosis, treatment, and 10 appropriate follow-up. The provision of only screening 11 and referral services does not constitute outpatient 12 services. 13 b. Twenty-four-hour emergency services. 14 Twenty-four-hour emergency services shall be 15 provided through a system that provides access to a 16 clinician and appropriate disposition with follow-up 17 documentation of the emergency service provided. 18 A patient shall have access to evaluation and 19 stabilization services after normal business hours. 20 The range of emergency services that shall be available 21 to a patient may include but are not limited to direct 22 contact with a clinician, medication evaluation, 23 and hospitalization. The emergency services may be 24 provided directly by the center or in collaboration 25 or affiliation with other appropriately accredited 26 providers. 27 c. Day treatment, partial hospitalization, or 28 psychosocial rehabilitation services. Such services 29 shall be provided as structured day programs in 30 segments of less than twenty-four hours using a 31 multidisciplinary team approach to develop treatment 32 plans that vary in intensity of services and the 33 frequency and duration of services based on the needs 34 of the patient. These services may be provided 35 directly by the center or in collaboration or 36 affiliation with other appropriately accredited 37 providers. 38 d. Admission screening for voluntary patients. 39 Admission screening services shall be available for 40 patients considered for voluntary admission to a state 41 mental health institute to determine the patient’s 42 appropriateness for admission. 43 e. Community support services. Community support 44 services shall consist of support and treatment 45 services focused on enhancing independent functioning 46 and assisting persons in the target population who 47 have a serious and persistent mental illness to live 48 and work in their community setting, by reducing or 49 managing mental illness symptoms and the associated 50 -33- HF697.3306 (4) 84 tm/jp 33/ 57
functional disabilities that negatively impact such 1 persons’ community integration and stability. 2 f. Consultation services. Consultation services 3 may include provision of professional assistance and 4 information about mental health and mental illness to 5 individuals, service providers, or groups to increase 6 such persons’ effectiveness in carrying out their 7 responsibilities for providing services. Consultations 8 may be case-specific or program-specific. 9 g. Education services. Education services may 10 include information and referral services regarding 11 available resources and information and training 12 concerning mental health, mental illness, availability 13 of services and other support, the promotion 14 of mental health, and the prevention of mental 15 illness. Education services may be made available to 16 individuals, groups, organizations, and the community 17 in general. 18 3. A community mental health center shall be 19 responsible for coordinating with associated services 20 provided by other unaffiliated agencies to members 21 of the target population in the catchment area and 22 to integrate services in the community with services 23 provided to the target population in residential or 24 inpatient settings. 25 Sec. ___. NEW SECTION . 230A.107 Form of 26 organization. 27 1. Except as authorized in subsection 2, a 28 community mental health center designated in accordance 29 with this chapter shall be organized and administered 30 as a nonprofit corporation. 31 2. A for-profit corporation, nonprofit corporation, 32 or county hospital providing mental health services to 33 county residents pursuant to a waiver approved under 34 section 225C.7, subsection 3, Code 2011, as of October 35 1, 2010, may also be designated as a community mental 36 health center. 37 Sec. ___. NEW SECTION . 230A.108 Administrative, 38 diagnostic, and demographic information. 39 Release of administrative and diagnostic 40 information, as defined in section 228.1, and 41 demographic information necessary for aggregated 42 reporting to meet the data requirements established by 43 the division, relating to an individual who receives 44 services from a community mental health center, may 45 be made a condition of support of that center by the 46 division. 47 Sec. ___. NEW SECTION . 230A.109 Funding —— 48 legislative intent. 49 1. It is the intent of the general assembly that 50 -34- HF697.3306 (4) 84 tm/jp 34/ 57
public funding for community mental health centers 1 designated in accordance with this chapter shall be 2 provided as a combination of federal and state funding. 3 2. It is the intent of the general assembly that 4 the state funding provided to centers be a sufficient 5 amount for the core services and support addressing the 6 basic mental health and safety needs of the residents 7 of the catchment area served by each center to be 8 provided regardless of individual ability to pay for 9 the services and support. 10 3. While a community mental health center must 11 comply with the core services requirements and other 12 standards associated with designation, provision of 13 services is subject to the availability of a payment 14 source for the services. 15 Sec. ___. NEW SECTION . 230A.110 Standards. 16 1. The division shall recommend and the commission 17 shall adopt standards for designated community 18 mental health centers and comprehensive community 19 mental health programs, with the overall objective of 20 ensuring that each center and each affiliate providing 21 services under contract with a center furnishes 22 high-quality mental health services within a framework 23 of accountability to the community it serves. The 24 standards adopted shall conform with federal standards 25 applicable to community mental health centers and 26 shall be in substantial conformity with the applicable 27 behavioral health standards adopted by the joint 28 commission, formerly known as the joint commission 29 on accreditation of health care organizations, and 30 other recognized national standards for evaluation of 31 psychiatric facilities unless in the judgment of the 32 division, with approval of the commission, there are 33 sound reasons for departing from the standards. 34 2. When recommending standards under this section, 35 the division shall designate an advisory committee 36 representing boards of directors and professional 37 staff of designated community mental health centers to 38 assist in the formulation or revision of standards. 39 The membership of the advisory committee shall include 40 representatives of professional and nonprofessional 41 staff and other appropriate individuals. 42 3. The standards recommended under this section 43 shall include requirements that each community mental 44 health center designated under this chapter do all of 45 the following: 46 a. Maintain and make available to the public a 47 written statement of the services the center offers 48 to residents of the catchment area being served. The 49 center shall employ or contract for services with 50 -35- HF697.3306 (4) 84 tm/jp 35/ 57
affiliates to employ staff who are appropriately 1 credentialed or meet other qualifications in order to 2 provide services. 3 b. If organized as a nonprofit corporation, be 4 governed by a board of directors which adequately 5 represents interested professions, consumers of 6 the center’s services, socioeconomic, cultural, and 7 age groups, and various geographical areas in the 8 catchment area served by the center. If organized 9 as a for-profit corporation, the corporation’s policy 10 structure shall incorporate such representation. 11 c. Arrange for the financial condition and 12 transactions of the community mental health center to 13 be audited once each year by the auditor of state. 14 However, in lieu of an audit by state accountants, 15 the local governing body of a community mental health 16 center organized under this chapter may contract with 17 or employ certified public accountants to conduct the 18 audit, pursuant to the applicable terms and conditions 19 prescribed by sections 11.6 and 11.19 and audit format 20 prescribed by the auditor of state. Copies of each 21 audit shall be furnished by the accountant to the 22 administrator of the division of mental health and 23 disability services. 24 d. Comply with the accreditation standards 25 applicable to the center. 26 Sec. ___. NEW SECTION . 230A.111 Review and 27 evaluation. 28 1. The review and evaluation of designated centers 29 shall be performed through a formal accreditation 30 review process as recommended by the division and 31 approved by the commission. The accreditation process 32 shall include all of the following: 33 a. Specific time intervals for full accreditation 34 reviews based upon levels of accreditation. 35 b. Use of random or complaint-specific, on-site 36 limited accreditation reviews in the interim between 37 full accreditation reviews, as a quality review 38 approach. The results of such reviews shall be 39 presented to the commission. 40 c. Use of center accreditation self-assessment 41 tools to gather data regarding quality of care and 42 outcomes, whether used during full or limited reviews 43 or at other times. 44 2. The accreditation process shall include but is 45 not limited to addressing all of the following: 46 a. Measures to address centers that do not meet 47 standards, including authority to revoke accreditation. 48 b. Measures to address noncompliant centers that 49 do not develop a corrective action plan or fail to 50 -36- HF697.3306 (4) 84 tm/jp 36/ 57
implement steps included in a corrective action plan 1 accepted by the division. 2 c. Measures to appropriately recognize centers that 3 successfully complete a corrective action plan. 4 d. Criteria to determine when a center’s 5 accreditation should be denied, revoked, suspended, or 6 made provisional. 7 Sec. ___. REPEAL. Sections 230A.1 through 230A.18, 8 Code 2011, are repealed. 9 Sec. ___. IMPLEMENTATION —— EFFECTIVE DATE. 10 1. Community mental health centers operating 11 under the provisions of chapter 230A, Code 2011, and 12 associated standards, rules, and other requirements as 13 of June 30, 2012, may continue to operate under such 14 requirements until the department of human services, 15 division of mental health and disability services, and 16 the mental health and disability services commission 17 have completed the rules adoption process to implement 18 the amendments to chapter 230A enacted by this division 19 of this Act, identified catchment areas, and completed 20 designations of centers. 21 2. The division and the commission shall complete 22 the rules adoption process and other requirements 23 addressed in subsection 1 on or before June 30, 2012. 24 3. Except for this section, which shall take effect 25 July 1, 2011, this division of this Act takes effect 26 July 1, 2012. 27 DIVISION ___ 28 MENTAL HEALTH AND DISABILITY SERVICES REDESIGN 29 PERSONS WITH SUBSTANCE-RELATED DISORDERS 30 AND PERSONS WITH MENTAL ILLNESS 31 Sec. ___. Section 125.1, subsection 1, Code 2011, 32 is amended to read as follows: 33 1. That substance abusers and persons suffering 34 from chemical dependency persons with substance-related 35 disorders be afforded the opportunity to receive 36 quality treatment and directed into rehabilitation 37 services which will help them resume a socially 38 acceptable and productive role in society. 39 Sec. ___. Section 125.2, subsection 2, Code 2011, 40 is amended by striking the subsection. 41 Sec. ___. Section 125.2, subsection 5, Code 2011, 42 is amended by striking the subsection and inserting in 43 lieu thereof the following: 44 5. “Substance-related disorder” means a diagnosable 45 substance abuse disorder of sufficient duration to meet 46 diagnostic criteria specified within the most current 47 diagnostic and statistical manual of mental disorders 48 published by the American psychiatric association that 49 results in a functional impairment. 50 -37- HF697.3306 (4) 84 tm/jp 37/ 57
Sec. ___. Section 125.2, subsection 9, Code 2011, 1 is amended to read as follows: 2 9. “Facility” means an institution, a 3 detoxification center, or an installation providing 4 care, maintenance and treatment for substance abusers 5 persons with substance-related disorders licensed 6 by the department under section 125.13 , hospitals 7 licensed under chapter 135B , or the state mental health 8 institutes designated by chapter 226 . 9 Sec. ___. Section 125.2, subsections 13, 17, and 10 18, Code 2011, are amended by striking the subsections. 11 Sec. ___. Section 125.9, subsections 2 and 4, Code 12 2011, are amended to read as follows: 13 2. Make contracts necessary or incidental to the 14 performance of the duties and the execution of the 15 powers of the director, including contracts with public 16 and private agencies, organizations and individuals 17 to pay them for services rendered or furnished to 18 substance abusers, chronic substance abusers, or 19 intoxicated persons persons with substance-related 20 disorders . 21 4. Coordinate the activities of the department and 22 cooperate with substance abuse programs in this and 23 other states, and make contracts and other joint or 24 cooperative arrangements with state, local or private 25 agencies in this and other states for the treatment 26 of substance abusers, chronic substance abusers, and 27 intoxicated persons persons with substance-related 28 disorders and for the common advancement of substance 29 abuse programs. 30 Sec. ___. Section 125.10, subsections 2, 3, 4, 5, 31 7, 8, 9, 11, 13, 15, and 17, Code 2011, are amended to 32 read as follows: 33 2. Develop, encourage, and foster statewide, 34 regional and local plans and programs for the 35 prevention of substance abuse misuse and the treatment 36 of substance abusers, chronic substance abusers, and 37 intoxicated persons persons with substance-related 38 disorders in cooperation with public and private 39 agencies, organizations and individuals, and provide 40 technical assistance and consultation services for 41 these purposes. 42 3. Coordinate the efforts and enlist the assistance 43 of all public and private agencies, organizations and 44 individuals interested in the prevention of substance 45 abuse and the treatment of substance abusers, chronic 46 substance abusers, and intoxicated persons persons with 47 substance-related disorders . 48 4. Cooperate with the department of human 49 services and the Iowa department of public health 50 -38- HF697.3306 (4) 84 tm/jp 38/ 57
in establishing and conducting programs to provide 1 treatment for substance abusers, chronic substance 2 abusers, and intoxicated persons persons with 3 substance-related disorders . 4 5. Cooperate with the department of education, 5 boards of education, schools, police departments, 6 courts, and other public and private agencies, 7 organizations, and individuals in establishing programs 8 for the prevention of substance abuse and the treatment 9 of substance abusers, chronic substance abusers, and 10 intoxicated persons persons with substance-related 11 disorders , and in preparing relevant curriculum 12 materials for use at all levels of school education. 13 7. Develop and implement, as an integral part 14 of treatment programs, an educational program for 15 use in the treatment of substance abusers, chronic 16 substance abusers, and intoxicated persons persons 17 with substance-related disorders , which program shall 18 include the dissemination of information concerning the 19 nature and effects of chemical substances. 20 8. Organize and implement, in cooperation with 21 local treatment programs, training programs for all 22 persons engaged in treatment of substance abusers, 23 chronic substance abusers, and intoxicated persons 24 persons with substance-related disorders . 25 9. Sponsor and implement research in cooperation 26 with local treatment programs into the causes and 27 nature of substance abuse misuse and treatment of 28 substance abusers, chronic substance abusers, and 29 intoxicated persons persons with substance-related 30 disorders , and serve as a clearing house for 31 information relating to substance abuse. 32 11. Develop and implement, with the counsel and 33 approval of the board, the comprehensive plan for 34 treatment of substance abusers, chronic substance 35 abusers, and intoxicated persons persons with 36 substance-related disorders in accordance with this 37 chapter . 38 13. Utilize the support and assistance of 39 interested persons in the community, particularly 40 recovered substance abusers and chronic substance 41 abusers, persons who are recovering from 42 substance-related disorders to encourage substance 43 abusers and chronic substance abusers persons with 44 substance-related disorders to voluntarily undergo 45 treatment. 46 15. Encourage general hospitals and other 47 appropriate health facilities to admit without 48 discrimination substance abusers, chronic substance 49 abusers, and intoxicated persons persons with 50 -39- HF697.3306 (4) 84 tm/jp 39/ 57
substance-related disorders and to provide them with 1 adequate and appropriate treatment. The director may 2 negotiate and implement contracts with hospitals and 3 other appropriate health facilities with adequate 4 detoxification facilities. 5 17. Review all state health, welfare, education and 6 treatment proposals to be submitted for federal funding 7 under federal legislation, and advise the governor on 8 provisions to be included relating to substance abuse, 9 substance abusers, chronic substance abusers, and 10 intoxicated persons and persons with substance-related 11 disorders . 12 Sec. ___. Section 125.12, subsections 1 and 3, Code 13 2011, are amended to read as follows: 14 1. The board shall review the comprehensive 15 substance abuse program implemented by the department 16 for the treatment of substance abusers, chronic 17 substance abusers, intoxicated persons persons with 18 substance-related disorders , and concerned family 19 members. Subject to the review of the board, the 20 director shall divide the state into appropriate 21 regions for the conduct of the program and establish 22 standards for the development of the program on 23 the regional level. In establishing the regions, 24 consideration shall be given to city and county lines, 25 population concentrations, and existing substance abuse 26 treatment services. 27 3. The director shall provide for adequate and 28 appropriate treatment for substance abusers, chronic 29 substance abusers, intoxicated persons persons with 30 substance-related disorders , and concerned family 31 members admitted under sections 125.33 and 125.34 , or 32 under section 125.75 , 125.81 , or 125.91 . Treatment 33 shall not be provided at a correctional institution 34 except for inmates. 35 Sec. ___. Section 125.13, subsection 1, paragraph 36 a, Code 2011, is amended to read as follows: 37 a. Except as provided in subsection 2 , a person 38 shall not maintain or conduct any chemical substitutes 39 or antagonists program, residential program, or 40 nonresidential outpatient program, the primary purpose 41 of which is the treatment and rehabilitation of 42 substance abusers or chronic substance abusers persons 43 with substance-related disorders without having first 44 obtained a written license for the program from the 45 department. 46 Sec. ___. Section 125.13, subsection 2, paragraphs 47 a and c, Code 2011, are amended to read as follows: 48 a. A hospital providing care or treatment to 49 substance abusers or chronic substance abusers persons 50 -40- HF697.3306 (4) 84 tm/jp 40/ 57
with substance-related disorders licensed under chapter 1 135B which is accredited by the joint commission 2 on the accreditation of health care organizations, 3 the commission on accreditation of rehabilitation 4 facilities, the American osteopathic association, or 5 another recognized organization approved by the board. 6 All survey reports from the accrediting or licensing 7 body must be sent to the department. 8 c. Private institutions conducted by and 9 for persons who adhere to the faith of any well 10 recognized church or religious denomination for the 11 purpose of providing care, treatment, counseling, 12 or rehabilitation to substance abusers or chronic 13 substance abusers persons with substance-related 14 disorders and who rely solely on prayer or other 15 spiritual means for healing in the practice of religion 16 of such church or denomination. 17 Sec. ___. Section 125.15, Code 2011, is amended to 18 read as follows: 19 125.15 Inspections. 20 The department may inspect the facilities and review 21 the procedures utilized by any chemical substitutes 22 or antagonists program, residential program, or 23 nonresidential outpatient program that has as a 24 primary purpose the treatment and rehabilitation of 25 substance abusers or chronic substance abusers persons 26 with substance-related disorders , for the purpose of 27 ensuring compliance with this chapter and the rules 28 adopted pursuant to this chapter . The examination 29 and review may include case record audits and 30 interviews with staff and patients, consistent with the 31 confidentiality safeguards of state and federal law. 32 Sec. ___. Section 125.32, unnumbered paragraph 1, 33 Code 2011, is amended to read as follows: 34 The department shall adopt and may amend and repeal 35 rules for acceptance of persons into the treatment 36 program, subject to chapter 17A , considering available 37 treatment resources and facilities, for the purpose of 38 early and effective treatment of substance abusers, 39 chronic substance abusers, intoxicated persons, persons 40 with substance-related disorders and concerned family 41 members. In establishing the rules the department 42 shall be guided by the following standards: 43 Sec. ___. Section 125.33, subsections 1, 3, and 4, 44 Code 2011, are amended to read as follows: 45 1. A substance abuser or chronic substance abuser 46 person with a substance-related disorder may apply 47 for voluntary treatment or rehabilitation services 48 directly to a facility or to a licensed physician and 49 surgeon or osteopathic physician and surgeon. If the 50 -41- HF697.3306 (4) 84 tm/jp 41/ 57
proposed patient is a minor or an incompetent person, a 1 parent, a legal guardian or other legal representative 2 may make the application. The licensed physician 3 and surgeon or osteopathic physician and surgeon or 4 any employee or person acting under the direction or 5 supervision of the physician and surgeon or osteopathic 6 physician and surgeon, or the facility shall not 7 report or disclose the name of the person or the fact 8 that treatment was requested or has been undertaken 9 to any law enforcement officer or law enforcement 10 agency; nor shall such information be admissible as 11 evidence in any court, grand jury, or administrative 12 proceeding unless authorized by the person seeking 13 treatment. If the person seeking such treatment or 14 rehabilitation is a minor who has personally made 15 application for treatment, the fact that the minor 16 sought treatment or rehabilitation or is receiving 17 treatment or rehabilitation services shall not be 18 reported or disclosed to the parents or legal guardian 19 of such minor without the minor’s consent, and the 20 minor may give legal consent to receive such treatment 21 and rehabilitation. 22 3. A substance abuser or chronic substance abuser 23 person with a substance-related disorder seeking 24 treatment or rehabilitation and who is either addicted 25 or dependent on a chemical substance may first be 26 examined and evaluated by a licensed physician and 27 surgeon or osteopathic physician and surgeon who may 28 prescribe a proper course of treatment and medication, 29 if needed. The licensed physician and surgeon 30 or osteopathic physician and surgeon may further 31 prescribe a course of treatment or rehabilitation 32 and authorize another licensed physician and surgeon 33 or osteopathic physician and surgeon or facility to 34 provide the prescribed treatment or rehabilitation 35 services. Treatment or rehabilitation services may 36 be provided to a person individually or in a group. 37 A facility providing or engaging in treatment or 38 rehabilitation shall not report or disclose to a law 39 enforcement officer or law enforcement agency the name 40 of any person receiving or engaged in the treatment 41 or rehabilitation; nor shall a person receiving or 42 participating in treatment or rehabilitation report 43 or disclose the name of any other person engaged in 44 or receiving treatment or rehabilitation or that the 45 program is in existence, to a law enforcement officer 46 or law enforcement agency. Such information shall 47 not be admitted in evidence in any court, grand jury, 48 or administrative proceeding. However, a person 49 engaged in or receiving treatment or rehabilitation 50 -42- HF697.3306 (4) 84 tm/jp 42/ 57
may authorize the disclosure of the person’s name and 1 individual participation. 2 4. If a patient receiving inpatient or residential 3 care leaves a facility, the patient shall be encouraged 4 to consent to appropriate outpatient or halfway house 5 treatment. If it appears to the administrator in 6 charge of the facility that the patient is a substance 7 abuser or chronic substance abuser person with a 8 substance-related disorder who requires help, the 9 director may arrange for assistance in obtaining 10 supportive services. 11 Sec. ___. Section 125.34, Code 2011, is amended to 12 read as follows: 13 125.34 Treatment and services for intoxicated 14 persons and persons incapacitated by alcohol persons 15 with substance-related disorders due to intoxication and 16 substance-induced incapacitation . 17 1. An intoxicated A person with a substance-related 18 disorder due to intoxication or substance-induced 19 incapacitation may come voluntarily to a facility 20 for emergency treatment. A person who appears to be 21 intoxicated or incapacitated by a chemical substance 22 in a public place and in need of help may be taken to a 23 facility by a peace officer under section 125.91 . If 24 the person refuses the proffered help, the person may 25 be arrested and charged with intoxication under section 26 123.46 , if applicable. 27 2. If no facility is readily available the 28 person may be taken to an emergency medical service 29 customarily used for incapacitated persons. The 30 peace officer in detaining the person and in taking 31 the person to a facility shall make every reasonable 32 effort to protect the person’s health and safety. In 33 detaining the person the detaining officer may take 34 reasonable steps for self-protection. Detaining a 35 person under section 125.91 is not an arrest and no 36 entry or other record shall be made to indicate that 37 the person who is detained has been arrested or charged 38 with a crime. 39 3. A person who arrives at a facility and 40 voluntarily submits to examination shall be examined 41 by a licensed physician as soon as possible after the 42 person arrives at the facility. The person may then 43 be admitted as a patient or referred to another health 44 facility. The referring facility shall arrange for 45 transportation. 46 4. If a person is voluntarily admitted to a 47 facility, the person’s family or next of kin shall be 48 notified as promptly as possible. If an adult patient 49 who is not incapacitated requests that there be no 50 -43- HF697.3306 (4) 84 tm/jp 43/ 57
notification, the request shall be respected. 1 5. A peace officer who acts in compliance with 2 this section is acting in the course of the officer’s 3 official duty and is not criminally or civilly liable 4 therefor, unless such acts constitute willful malice 5 or abuse. 6 6. If the physician in charge of the facility 7 determines it is for the patient’s benefit, the patient 8 shall be encouraged to agree to further diagnosis and 9 appropriate voluntary treatment. 10 7. A licensed physician and surgeon or osteopathic 11 physician and surgeon, facility administrator, or an 12 employee or a person acting as or on behalf of the 13 facility administrator, is not criminally or civilly 14 liable for acts in conformity with this chapter , unless 15 the acts constitute willful malice or abuse. 16 Sec. ___. Section 125.43, Code 2011, is amended to 17 read as follows: 18 125.43 Funding at mental health institutes. 19 Chapter 230 governs the determination of the 20 costs and payment for treatment provided to substance 21 abusers or chronic substance abusers persons with 22 substance-related disorders in a mental health 23 institute under the department of human services, 24 except that the charges are not a lien on real estate 25 owned by persons legally liable for support of the 26 substance abuser or chronic substance abuser person 27 with a substance-related disorder and the daily per 28 diem shall be billed at twenty-five percent. The 29 superintendent of a state hospital shall total only 30 those expenditures which can be attributed to the 31 cost of providing inpatient treatment to substance 32 abusers or chronic substance abusers persons with 33 substance-related disorders for purposes of determining 34 the daily per diem. Section 125.44 governs the 35 determination of who is legally liable for the cost 36 of care, maintenance, and treatment of a substance 37 abuser or chronic substance abuser person with a 38 substance-related disorder and of the amount for which 39 the person is liable. 40 Sec. ___. Section 125.43A, Code 2011, is amended to 41 read as follows: 42 125.43A Prescreening —— exception. 43 Except in cases of medical emergency or 44 court-ordered admissions, a person shall be admitted 45 to a state mental health institute for substance 46 abuse treatment only after a preliminary intake and 47 assessment by a department-licensed treatment facility 48 or a hospital providing care or treatment for substance 49 abusers persons with substance-related disorders 50 -44- HF697.3306 (4) 84 tm/jp 44/ 57
licensed under chapter 135B and accredited by the 1 joint commission on the accreditation of health care 2 organizations, the commission on accreditation of 3 rehabilitation facilities, the American osteopathic 4 association, or another recognized organization 5 approved by the board, or by a designee of a 6 department-licensed treatment facility or a hospital 7 other than a state mental health institute, which 8 confirms that the admission is appropriate to the 9 person’s substance abuse service needs. A county board 10 of supervisors may seek an admission of a patient 11 to a state mental health institute who has not been 12 confirmed for appropriate admission and the county 13 shall be responsible for one hundred percent of the 14 cost of treatment and services of the patient. 15 Sec. ___. Section 125.44, Code 2011, is amended to 16 read as follows: 17 125.44 Agreements with facilities —— liability for 18 costs. 19 The director may, consistent with the comprehensive 20 substance abuse program, enter into written 21 agreements with a facility as defined in section 22 125.2 to pay for one hundred percent of the cost of 23 the care, maintenance, and treatment of substance 24 abusers and chronic substance abusers persons with 25 substance-related disorders , except when section 26 125.43A applies. All payments for state patients shall 27 be made in accordance with the limitations of this 28 section . Such contracts shall be for a period of no 29 more than one year. 30 The contract may be in the form and contain 31 provisions as agreed upon by the parties. The contract 32 shall provide that the facility shall admit and 33 treat substance abusers and chronic substance abusers 34 persons with substance-related disorders regardless 35 of where they have residence. If one payment for 36 care, maintenance, and treatment is not made by the 37 patient or those legally liable for the patient, the 38 payment shall be made by the department directly to 39 the facility. Payments shall be made each month and 40 shall be based upon the rate of payment for services 41 negotiated between the department and the contracting 42 facility. If a facility projects a temporary cash flow 43 deficit, the department may make cash advances at the 44 beginning of each fiscal year to the facility. The 45 repayment schedule for advances shall be part of the 46 contract between the department and the facility. This 47 section does not pertain to patients treated at the 48 mental health institutes. 49 If the appropriation to the department is 50 -45- HF697.3306 (4) 84 tm/jp 45/ 57
insufficient to meet the requirements of this section , 1 the department shall request a transfer of funds and 2 section 8.39 shall apply. 3 The substance abuser or chronic substance abuser 4 person with a substance-related disorder is legally 5 liable to the facility for the total amount of the cost 6 of providing care, maintenance, and treatment for the 7 substance abuser or chronic substance abuser person 8 with a substance-related disorder while a voluntary or 9 committed patient in a facility. This section does not 10 prohibit any individual from paying any portion of the 11 cost of treatment. 12 The department is liable for the cost of 13 care, treatment, and maintenance of substance 14 abusers and chronic substance abusers persons with 15 substance-related disorders admitted to the facility 16 voluntarily or pursuant to section 125.75 , 125.81 , 17 or 125.91 or section 321J.3 or 124.409 only to those 18 facilities that have a contract with the department 19 under this section , only for the amount computed 20 according to and within the limits of liability 21 prescribed by this section , and only when the substance 22 abuser or chronic substance abuser person with a 23 substance-related disorder is unable to pay the costs 24 and there is no other person, firm, corporation, or 25 insurance company bound to pay the costs. 26 The department’s maximum liability for the costs 27 of care, treatment, and maintenance of substance 28 abusers and chronic substance abusers persons with 29 substance-related disorders in a contracting facility 30 is limited to the total amount agreed upon by the 31 parties and specified in the contract under this 32 section . 33 Sec. ___. Section 125.46, Code 2011, is amended to 34 read as follows: 35 125.46 County of residence determined. 36 The facility shall, when a substance abuser 37 or chronic substance abuser person with a 38 substance-related disorder is admitted, or as 39 soon thereafter as it receives the proper information, 40 determine and enter upon its records the Iowa county of 41 residence of the substance abuser or chronic substance 42 abuser person with a substance-related disorder , or 43 that the person resides in some other state or country, 44 or that the person is unclassified with respect to 45 residence. 46 Sec. ___. Section 125.75, unnumbered paragraph 1, 47 Code 2011, is amended to read as follows: 48 Proceedings for the involuntary commitment or 49 treatment of a chronic substance abuser person with 50 -46- HF697.3306 (4) 84 tm/jp 46/ 57
a substance-related disorder to a facility may be 1 commenced by the county attorney or an interested 2 person by filing a verified application with the 3 clerk of the district court of the county where 4 the respondent is presently located or which is 5 the respondent’s place of residence. The clerk or 6 the clerk’s designee shall assist the applicant in 7 completing the application. The application shall: 8 Sec. ___. Section 125.75, subsection 1, Code 2011, 9 is amended to read as follows: 10 1. State the applicant’s belief that the 11 respondent is a chronic substance abuser person with a 12 substance-related disorder . 13 Sec. ___. Section 125.80, subsections 3 and 4, Code 14 2011, are amended to read as follows: 15 3. If the report of a court-designated physician 16 is to the effect that the respondent is not a chronic 17 substance abuser person with a substance-related 18 disorder , the court, without taking further action, may 19 terminate the proceeding and dismiss the application on 20 its own motion and without notice. 21 4. If the report of a court-designated physician 22 is to the effect that the respondent is a chronic 23 substance abuser person with a substance-related 24 disorder , the court shall schedule a commitment 25 hearing as soon as possible. The hearing shall be 26 held not more than forty-eight hours after the report 27 is filed, excluding Saturdays, Sundays, and holidays, 28 unless an extension for good cause is requested by 29 the respondent, or as soon thereafter as possible if 30 the court considers that sufficient grounds exist for 31 delaying the hearing. 32 Sec. ___. Section 125.81, subsection 1, Code 2011, 33 is amended to read as follows: 34 1. If a person filing an application requests that 35 a respondent be taken into immediate custody, and the 36 court upon reviewing the application and accompanying 37 documentation, finds probable cause to believe that the 38 respondent is a chronic substance abuser person with 39 a substance-related disorder who is likely to injure 40 the person or other persons if allowed to remain at 41 liberty, the court may enter a written order directing 42 that the respondent be taken into immediate custody 43 by the sheriff, and be detained until the commitment 44 hearing, which shall be held no more than five days 45 after the date of the order, except that if the fifth 46 day after the date of the order is a Saturday, Sunday, 47 or a holiday, the hearing may be held on the next 48 business day. The court may order the respondent 49 detained for the period of time until the hearing is 50 -47- HF697.3306 (4) 84 tm/jp 47/ 57
held, and no longer except as provided in section 1 125.88 , in accordance with subsection 2 , paragraph 2 “a” , if possible, and if not, then in accordance with 3 subsection 2 , paragraph “b” , or, only if neither of 4 these alternatives is available in accordance with 5 subsection 2 , paragraph “c” . 6 Sec. ___. Section 125.82, subsection 4, Code 2011, 7 is amended to read as follows: 8 4. The respondent’s welfare is paramount, and the 9 hearing shall be tried as a civil matter and conducted 10 in as informal a manner as is consistent with orderly 11 procedure. Discovery as permitted under the Iowa rules 12 of civil procedure is available to the respondent. The 13 court shall receive all relevant and material evidence, 14 but the court is not bound by the rules of evidence. 15 A presumption in favor of the respondent exists, and 16 the burden of evidence and support of the contentions 17 made in the application shall be upon the person who 18 filed the application. If upon completion of the 19 hearing the court finds that the contention that the 20 respondent is a chronic substance abuser person with a 21 substance-related disorder has not been sustained by 22 clear and convincing evidence, the court shall deny the 23 application and terminate the proceeding. 24 Sec. ___. Section 125.83, Code 2011, is amended to 25 read as follows: 26 125.83 Placement for evaluation. 27 If upon completion of the commitment hearing, 28 the court finds that the contention that the 29 respondent is a chronic substance abuser person with 30 a substance-related disorder has been sustained by 31 clear and convincing evidence, the court shall order 32 the respondent placed at a facility or under the 33 care of a suitable facility on an outpatient basis as 34 expeditiously as possible for a complete evaluation 35 and appropriate treatment. The court shall furnish to 36 the facility at the time of admission or outpatient 37 placement, a written statement of facts setting forth 38 the evidence on which the finding is based. The 39 administrator of the facility shall report to the court 40 no more than fifteen days after the individual is 41 admitted to or placed under the care of the facility, 42 which shall include the chief medical officer’s 43 recommendation concerning substance abuse treatment. 44 An extension of time may be granted for a period not 45 to exceed seven days upon a showing of good cause. A 46 copy of the report shall be sent to the respondent’s 47 attorney who may contest the need for an extension of 48 time if one is requested. If the request is contested, 49 the court shall make an inquiry as it deems appropriate 50 -48- HF697.3306 (4) 84 tm/jp 48/ 57
and may either order the respondent released from 1 the facility or grant extension of time for further 2 evaluation. If the administrator fails to report to 3 the court within fifteen days after the individual is 4 admitted to the facility, and no extension of time has 5 been requested, the administrator is guilty of contempt 6 and shall be punished under chapter 665 . The court 7 shall order a rehearing on the application to determine 8 whether the respondent should continue to be held at 9 the facility. 10 Sec. ___. Section 125.83A, subsection 1, Code 2011, 11 is amended to read as follows: 12 1. If upon completion of the commitment hearing, 13 the court finds that the contention that the 14 respondent is a chronic substance abuser person with a 15 substance-related disorder has been sustained by clear 16 and convincing evidence, and the court is furnished 17 evidence that the respondent is eligible for care 18 and treatment in a facility operated by the United 19 States department of veterans affairs or another 20 agency of the United States government and that the 21 facility is willing to receive the respondent, the 22 court may so order. The respondent, when so placed in 23 a facility operated by the United States department 24 of veterans affairs or another agency of the United 25 States government within or outside of this state, 26 shall be subject to the rules of the United States 27 department of veterans affairs or other agency, but 28 shall not lose any procedural rights afforded the 29 respondent by this chapter . The chief officer of the 30 facility shall have, with respect to the respondent 31 so placed, the same powers and duties as the chief 32 medical officer of a hospital in this state would 33 have in regard to submission of reports to the court, 34 retention of custody, transfer, convalescent leave, or 35 discharge. Jurisdiction is retained in the court to 36 maintain surveillance of the respondent’s treatment and 37 care, and at any time to inquire into the respondent’s 38 condition and the need for continued care and custody. 39 Sec. ___. Section 125.84, subsections 2, 3, and 4, 40 Code 2011, are amended to read as follows: 41 2. That the respondent is a chronic substance 42 abuser person with a substance-related disorder who 43 is in need of full-time custody, care, and treatment 44 in a facility, and is considered likely to benefit 45 from treatment. If the report so states, the court 46 shall enter an order which may require the respondent’s 47 continued placement and commitment to a facility for 48 appropriate treatment. 49 3. That the respondent is a chronic substance 50 -49- HF697.3306 (4) 84 tm/jp 49/ 57
abuser person with a substance-related disorder who is 1 in need of treatment, but does not require full-time 2 placement in a facility. If the report so states, 3 the report shall include the chief medical officer’s 4 recommendation for treatment of the respondent on an 5 outpatient or other appropriate basis, and the court 6 shall enter an order which may direct the respondent to 7 submit to the recommended treatment. The order shall 8 provide that if the respondent fails or refuses to 9 submit to treatment, as directed by the court’s order, 10 the court may order that the respondent be taken into 11 immediate custody as provided by section 125.81 and, 12 following notice and hearing held in accordance with 13 the procedures of sections 125.77 and 125.82 , may order 14 the respondent treated as a patient requiring full-time 15 custody, care, and treatment as provided in subsection 16 2 , and may order the respondent involuntarily committed 17 to a facility. 18 4. That the respondent is a chronic substance 19 abuser person with a substance-related disorder who is 20 in need of treatment, but in the opinion of the chief 21 medical officer is not responding to the treatment 22 provided. If the report so states, the report shall 23 include the facility administrator’s recommendation 24 for alternative placement, and the court shall enter 25 an order which may direct the respondent’s transfer 26 to the recommended placement or to another placement 27 after consultation with respondent’s attorney and the 28 facility administrator who made the report under this 29 subsection . 30 Sec. ___. Section 125.91, subsections 1, 2, and 3, 31 Code 2011, are amended to read as follows: 32 1. The procedure prescribed by this section 33 shall only be used for an intoxicated a person with 34 a substance-related disorder due to intoxication or 35 substance-induced incapacitation who has threatened, 36 attempted, or inflicted physical self-harm or harm on 37 another, and is likely to inflict physical self-harm or 38 harm on another unless immediately detained, or who is 39 incapacitated by a chemical substance, if that person 40 cannot be taken into immediate custody under sections 41 125.75 and 125.81 because immediate access to the court 42 is not possible. 43 2. a. A peace officer who has reasonable 44 grounds to believe that the circumstances described 45 in subsection 1 are applicable may, without a 46 warrant, take or cause that person to be taken to the 47 nearest available facility referred to in section 48 125.81, subsection 2 , paragraph “b” or “c” . Such 49 an intoxicated or incapacitated a person with a 50 -50- HF697.3306 (4) 84 tm/jp 50/ 57
substance-related disorder due to intoxication or 1 substance-induced incapacitation who also demonstrates 2 a significant degree of distress or dysfunction may 3 also be delivered to a facility by someone other than 4 a peace officer upon a showing of reasonable grounds. 5 Upon delivery of the person to a facility under this 6 section , the examining physician may order treatment 7 of the person, but only to the extent necessary to 8 preserve the person’s life or to appropriately control 9 the person’s behavior if the behavior is likely to 10 result in physical injury to the person or others 11 if allowed to continue. The peace officer or other 12 person who delivered the person to the facility 13 shall describe the circumstances of the matter to 14 the examining physician. If the person is a peace 15 officer, the peace officer may do so either in person 16 or by written report. If the examining physician has 17 reasonable grounds to believe that the circumstances in 18 subsection 1 are applicable, the examining physician 19 shall at once communicate with the nearest available 20 magistrate as defined in section 801.4, subsection 10 . 21 The magistrate shall, based upon the circumstances 22 described by the examining physician, give the 23 examining physician oral instructions either directing 24 that the person be released forthwith, or authorizing 25 the person’s detention in an appropriate facility. 26 The magistrate may also give oral instructions and 27 order that the detained person be transported to an 28 appropriate facility. 29 b. If the magistrate orders that the person be 30 detained, the magistrate shall, by the close of 31 business on the next working day, file a written order 32 with the clerk in the county where it is anticipated 33 that an application may be filed under section 125.75 . 34 The order may be filed by facsimile if necessary. The 35 order shall state the circumstances under which the 36 person was taken into custody or otherwise brought to 37 a facility and the grounds supporting the finding of 38 probable cause to believe that the person is a chronic 39 substance abuser person with a substance-related 40 disorder likely to result in physical injury to the 41 person or others if not detained. The order shall 42 confirm the oral order authorizing the person’s 43 detention including any order given to transport the 44 person to an appropriate facility. The clerk shall 45 provide a copy of that order to the chief medical 46 officer of the facility attending physician, to 47 which the person was originally taken, any subsequent 48 facility to which the person was transported, and 49 to any law enforcement department or ambulance 50 -51- HF697.3306 (4) 84 tm/jp 51/ 57
service that transported the person pursuant to the 1 magistrate’s order. 2 3. The chief medical officer of the facility 3 attending physician shall examine and may detain the 4 person pursuant to the magistrate’s order for a period 5 not to exceed forty-eight hours from the time the order 6 is dated, excluding Saturdays, Sundays, and holidays, 7 unless the order is dismissed by a magistrate. The 8 facility may provide treatment which is necessary to 9 preserve the person’s life or to appropriately control 10 the person’s behavior if the behavior is likely to 11 result in physical injury to the person or others if 12 allowed to continue or is otherwise deemed medically 13 necessary by the chief medical officer attending 14 physician , but shall not otherwise provide treatment to 15 the person without the person’s consent. The person 16 shall be discharged from the facility and released 17 from detention no later than the expiration of the 18 forty-eight-hour period, unless an application for 19 involuntary commitment is filed with the clerk pursuant 20 to section 125.75 . The detention of a person by the 21 procedure in this section , and not in excess of the 22 period of time prescribed by this section , shall not 23 render the peace officer, attending physician, or 24 facility detaining the person liable in a criminal or 25 civil action for false arrest or false imprisonment 26 if the peace officer, physician, or facility had 27 reasonable grounds to believe that the circumstances 28 described in subsection 1 were applicable. 29 Sec. ___. Section 226.9C, subsection 2, paragraph 30 c, Code 2011, is amended to read as follows: 31 c. (1) Prior to an individual’s admission for dual 32 diagnosis treatment, the individual shall have been 33 prescreened. The person performing the prescreening 34 shall be either the mental health professional, as 35 defined in section 228.1, who is contracting with the 36 county central-point-of-coordination process to provide 37 the prescreening or a mental health professional 38 with the requisite qualifications. A mental health 39 professional with the requisite qualifications shall 40 meet all of the following qualifications: is a mental 41 health professional as defined in section 228.1, is 42 a certified alcohol and drug counselor certified by 43 the nongovernmental Iowa board of substance abuse 44 certification, and is employed by or providing services 45 for a facility, as defined in section 125.2. 46 (2) Prior to an individual’s admission for dual 47 diagnosis treatment, the individual shall have 48 been screened through a county’s central point of 49 coordination process implemented pursuant to section 50 -52- HF697.3306 (4) 84 tm/jp 52/ 57
331.440 to determine the appropriateness of the 1 treatment. 2 Sec. ___. Section 229.1, subsection 12, Code 2011, 3 is amended to read as follows: 4 12. “Psychiatric advanced registered nurse 5 practitioner” means an individual currently licensed as 6 a registered nurse under chapter 152 or 152E who holds 7 a national certification in psychiatric mental health 8 care and who is registered with the board of nursing as 9 an advanced registered nurse practitioner. 10 Sec. ___. Section 229.15, subsection 3, paragraph 11 a, Code 2011, is amended to read as follows: 12 a. A psychiatric advanced registered nurse 13 practitioner treating a patient previously hospitalized 14 under this chapter may complete periodic reports 15 pursuant to this section on the patient if the patient 16 has been recommended for treatment on an outpatient or 17 other appropriate basis pursuant to section 229.14, 18 subsection 1 , paragraph “c” , and if a psychiatrist 19 licensed pursuant to chapter 148 personally evaluates 20 the patient on at least an annual basis . 21 Sec. ___. Section 229.21, subsection 2, Code 2011, 22 is amended to read as follows: 23 2. When an application for involuntary 24 hospitalization under this chapter or an application 25 for involuntary commitment or treatment of chronic 26 substance abusers persons with substance-related 27 disorders under sections 125.75 to 125.94 is filed with 28 the clerk of the district court in any county for which 29 a judicial hospitalization referee has been appointed, 30 and no district judge, district associate judge, or 31 magistrate who is admitted to the practice of law in 32 this state is accessible, the clerk shall immediately 33 notify the referee in the manner required by section 34 229.7 or section 125.77 . The referee shall discharge 35 all of the duties imposed upon the court by sections 36 229.7 to 229.22 or sections 125.75 to 125.94 in the 37 proceeding so initiated. Subject to the provisions of 38 subsection 4 , orders issued by a referee, in discharge 39 of duties imposed under this section , shall have the 40 same force and effect as if ordered by a district 41 judge. However, any commitment to a facility regulated 42 and operated under chapter 135C , shall be in accordance 43 with section 135C.23 . 44 Sec. ___. Section 229.21, subsection 3, paragraphs 45 a and b, Code 2011, are amended to read as follows: 46 a. Any respondent with respect to whom the 47 magistrate or judicial hospitalization referee has 48 found the contention that the respondent is seriously 49 mentally impaired or a chronic substance abuser person 50 -53- HF697.3306 (4) 84 tm/jp 53/ 57
with a substance-related disorder sustained by clear 1 and convincing evidence presented at a hearing held 2 under section 229.12 or section 125.82 , may appeal from 3 the magistrate’s or referee’s finding to a judge of the 4 district court by giving the clerk notice in writing, 5 within ten days after the magistrate’s or referee’s 6 finding is made, that an appeal is taken. The appeal 7 may be signed by the respondent or by the respondent’s 8 next friend, guardian, or attorney. 9 b. An order of a magistrate or judicial 10 hospitalization referee with a finding that the 11 respondent is seriously mentally impaired or a chronic 12 substance abuser person with a substance-related 13 disorder shall include the following notice, located 14 conspicuously on the face of the order: 15 NOTE: The respondent may appeal from this order to a 16 judge of the district court by giving written notice of 17 the appeal to the clerk of the district court within 18 ten days after the date of this order. The appeal may 19 be signed by the respondent or by the respondent’s next 20 friend, guardian, or attorney. For a more complete 21 description of the respondent’s appeal rights, consult 22 section 229.21 of the Code of Iowa or an attorney. 23 Sec. ___. Section 229.21, subsection 4, Code 2011, 24 is amended to read as follows: 25 4. If the appellant is in custody under the 26 jurisdiction of the district court at the time 27 of service of the notice of appeal, the appellant 28 shall be discharged from custody unless an order 29 that the appellant be taken into immediate custody 30 has previously been issued under section 229.11 or 31 section 125.81 , in which case the appellant shall 32 be detained as provided in that section until the 33 hospitalization or commitment hearing before the 34 district judge. If the appellant is in the custody of 35 a hospital or facility at the time of service of the 36 notice of appeal, the appellant shall be discharged 37 from custody pending disposition of the appeal unless 38 the chief medical officer, not later than the end of 39 the next secular day on which the office of the clerk 40 is open and which follows service of the notice of 41 appeal, files with the clerk a certification that in 42 the chief medical officer’s opinion the appellant is 43 seriously mentally ill or a substance abuser person 44 with a substance-related disorder . In that case, the 45 appellant shall remain in custody of the hospital 46 or facility until the hospitalization or commitment 47 hearing before the district court. 48 Sec. ___. Section 230.15, unnumbered paragraph 2, 49 Code 2011, is amended to read as follows: 50 -54- HF697.3306 (4) 84 tm/jp 54/ 57
A substance abuser or chronic substance abuser 1 person with a substance-related disorder is legally 2 liable for the total amount of the cost of providing 3 care, maintenance, and treatment for the substance 4 abuser or chronic substance abuser person with a 5 substance-related disorder while a voluntary or 6 committed patient. When a portion of the cost is paid 7 by a county, the substance abuser or chronic substance 8 abuser person with a substance-related disorder is 9 legally liable to the county for the amount paid. 10 The substance abuser or chronic substance abuser 11 person with a substance-related disorder shall assign 12 any claim for reimbursement under any contract of 13 indemnity, by insurance or otherwise, providing for 14 the abuser’s person’s care, maintenance, and treatment 15 in a state hospital to the state. Any payments 16 received by the state from or on behalf of a substance 17 abuser or chronic substance abuser person with a 18 substance-related disorder shall be in part credited 19 to the county in proportion to the share of the costs 20 paid by the county. Nothing in this section shall be 21 construed to prevent a relative or other person from 22 voluntarily paying the full actual cost or any portion 23 of the care and treatment of any person with mental 24 illness , substance abuser, or chronic substance abuser 25 or a substance-related disorder as established by the 26 department of human services. 27 Sec. ___. Section 232.116, subsection 1, paragraph 28 l, subparagraph (2), Code 2011, is amended to read as 29 follows: 30 (2) The parent has a severe , chronic substance 31 abuse problem, substance-related disorder and presents 32 a danger to self or others as evidenced by prior acts. 33 Sec. ___. Section 600A.8, subsection 8, paragraph 34 a, Code 2011, is amended to read as follows: 35 a. The parent has been determined to be a chronic 36 substance abuser person with a substance-related 37 disorder as defined in section 125.2 and the parent has 38 committed a second or subsequent domestic abuse assault 39 pursuant to section 708.2A . 40 Sec. ___. Section 602.4201, subsection 3, paragraph 41 h, Code 2011, is amended to read as follows: 42 h. Involuntary commitment or treatment of substance 43 abusers persons with a substance-related disorders . 44 Sec. ___. IMPLEMENTATION OF ACT. Section 25B.2, 45 subsection 3, shall not apply to this division of this 46 Act. 47 Sec. ___. EFFECTIVE DATE. This division of this 48 Act takes effect July 1, 2012. > 49 17. Page 475, before line 24 by inserting: 50 -55- HF697.3306 (4) 84 tm/jp 55/ 57 #17.
< DIVISION ___ 1 HEALTH AND HUMAN SERVICES STATUTORY 2 Sec. ___. Section 153.14, subsection 1, Code 2011, 3 is amended to read as follows: 4 1. Students of dentistry who practice dentistry 5 upon patients at clinics in connection with their 6 regular course of instruction at the state an 7 accredited dental college, students of dental 8 hygiene who practice upon patients at clinics in 9 connection with their regular course of instruction 10 at state-approved schools, and students of dental 11 assisting who practice upon patients at clinics 12 in connection with a regular course of instruction 13 determined by the board pursuant to section 153.39 . 14 Sec. ___. Section 154A.24, subsection 3, paragraph 15 s, Code 2011, is amended by striking the paragraph. 16 Sec. ___. Section 235B.19, Code 2011, is amended by 17 adding the following new subsection: 18 NEW SUBSECTION . 2A. a. The department shall 19 serve a copy of the petition and any order authorizing 20 protective services, if issued, on the dependent adult 21 and on persons who are competent adults and reasonably 22 ascertainable at the time the petition is filed in 23 accordance with the following priority: 24 (1) An attorney in fact named by the dependent 25 adult in a durable power of attorney for health care 26 pursuant to chapter 144B. 27 (2) The dependent adult’s spouse. 28 (3) The dependent adult’s children. 29 (4) The dependent adult’s grandchildren. 30 (5) The dependent adult’s siblings. 31 (6) The dependent adult’s aunts and uncles. 32 (7) The dependent adult’s nieces and nephews. 33 (8) The dependent adult’s cousins. 34 b. When the department has served a person in one 35 of the categories specified in paragraph “a” , the 36 department shall not be required to serve a person in 37 any other category. 38 c. The department shall serve the dependent adult’s 39 copy of the petition and order personally upon the 40 dependent adult. Service of the petition and all other 41 orders and notices shall be in a sealed envelope with 42 the proper postage on the envelope, addressed to the 43 person being served at the person’s last known post 44 office address, and deposited in a mail receptacle 45 provided by the United States postal service. The 46 department shall serve such copies of emergency orders 47 authorizing protective services and notices within 48 three days after filing the petition and receiving such 49 orders. 50 -56- HF697.3306 (4) 84 tm/jp 56/ 57
d. The department and all persons served by the 1 department with notices under this subsection shall 2 be prohibited from all of the following without prior 3 court approval after the department’s petition has been 4 filed: 5 (1) Selling, removing, or otherwise disposing of 6 the dependent adult’s personal property. 7 (2) Withdrawing funds from any bank, savings and 8 loan association, credit union, or other financial 9 institution, or from an account containing securities 10 in which the dependent adult has an interest. 11 Sec. ___. Section 237A.1, subsection 3, paragraph 12 n, Code 2011, is amended to read as follows: 13 n. A program offered to a child whose parent, 14 guardian, or custodian is engaged solely in a 15 recreational or social activity, remains immediately 16 available and accessible on the physical premises on 17 which the child’s care is provided, and does not engage 18 in employment while the care is provided. However, 19 if the recreational or social activity is provided in 20 a fitness center or on the premises of a nonprofit 21 organization the parent, guardian, or custodian of the 22 child may be employed to teach or lead the activity. > 23 18. Page 475, before line 24 by inserting: 24 < DIVISION ___ 25 PUBLIC LIBRARIES 26 Sec. ___. Section 256.51, subsection 1, Code 2011, 27 is amended by adding the following new paragraph: 28 NEW PARAGRAPH . l. Allow a public library that 29 receives state assistance under section 256.57, or 30 financial support from a city or county pursuant 31 to section 256.69, to dispose of, through sale, 32 conveyance, or exchange, any library materials that may 33 be obsolete or worn out or that may no longer be needed 34 or appropriate to the mission of the public library. 35 These materials may be sold by the public library 36 directly or the governing body of the public library 37 may sell the materials by consignment to a public 38 agency or to a private agency organized to raise funds 39 solely for support of the public library. Proceeds 40 from the sale of the library materials may be remitted 41 to the public library and may be used by the public 42 library for the purchase of books and other library 43 materials or equipment, or for the provision of library 44 services. > 45 19. By renumbering as necessary. 46 ______________________________ COWNIE of Polk -57- HF697.3306 (4) 84 tm/jp 57/ 57 #18. #19.