Senate Amendment to House File 2673 H-8336 Amend House File 2673, as amended, passed, and reprinted by 1 the House, as follows: 2 1. By striking everything after the enacting clause and 3 inserting: 4 < DIVISION I 5 BEHAVIORAL HEALTH SERVICE SYSTEM 6 Section 1. NEW SECTION . 225A.1 Definitions. 7 As used in this chapter unless the context otherwise 8 requires: 9 1. “Administrative services organization” means an entity 10 designated by the department pursuant to section 225A.4, to 11 develop and perform planning and administrative services in 12 accordance with a district behavioral health service system 13 plan. 14 2. “Behavioral health condition” means a substantial 15 limitation in major life activities due to a mental, 16 behavioral, or addictive disorder or condition diagnosed in 17 accordance with the criteria provided in the most current 18 edition of the diagnostic and statistical manual of mental 19 disorders, published by the American psychiatric association. 20 3. “Behavioral health district” or “district” means a 21 geographic, multicounty, sub-state area as designated by the 22 department under section 225A.4. 23 4. “Behavioral health provider” or “provider” means an 24 individual, firm, corporation, association, or institution 25 that, pursuant to this chapter, is providing or has been 26 approved by the department to provide services to an individual 27 with a behavioral health condition. 28 5. “Behavioral health service system” means the behavioral 29 health service system established in section 225A.3. 30 6. “Caregiver” means an adult family member, or other 31 individual, who is providing care to a person outside of a 32 formal program. 33 7. “Community mental health center” means an entity 34 designated by the department to address the mental health needs 35 -1- HF 2673.4273.S (1) 90 mb 1/ 92 #1.
of one or more counties. 1 8. “Department” means the department of health and human 2 services. 3 9. “Director” means the director of the department of health 4 and human services. 5 10. “District behavioral health advisory council” 6 or “advisory council” means a council established by an 7 administrative services organization under section 225A.5, to 8 identify opportunities, address challenges, and advise the 9 administrative services organization in accordance with section 10 225A.5. 11 11. “District behavioral health service system plan” or 12 “district behavioral health plan” means a plan developed by 13 an administrative services organization and approved by the 14 department to outline the services intended to be provided 15 within the administrative services organization’s behavioral 16 health district. 17 12. “Indicated prevention” means prevention activities 18 designed to prevent the onset of substance use disorders in 19 individuals who do not meet the medical criteria for addiction, 20 but who show early signs of developing a substance use disorder 21 in the future. 22 13. “Selective prevention” means prevention activities 23 designed to target subsets of the total population who are 24 considered at-risk for a substance use disorder by virtue of 25 their membership in a particular segment of the population. 26 Selective prevention targets the entire subgroup, regardless of 27 the degree of risk of any individual within the group. 28 14. “State behavioral health service system plan” or 29 “state behavioral health plan” means the plan developed by the 30 department that describes the key components of the state’s 31 behavioral health service system. 32 15. “Universal prevention” means prevention activities 33 designed to address an entire population class for the purpose 34 of preventing or delaying the use of alcohol, tobacco, and 35 -2- HF 2673.4273.S (1) 90 mb 2/ 92
other drugs. Population classes include but are not limited 1 to the national population, local populations, community 2 populations, school populations, and neighborhood populations. 3 Sec. 2. NEW SECTION . 225A.2 State mental health authority 4 —— state agency for substance abuse. 5 1. The department is designated as the state mental health 6 authority as defined in 42 U.S.C. §201(m) for the purpose of 7 directing benefits from the federal community mental health 8 services block grant, 42 U.S.C. §300x et seq., and the state 9 authority designated for the purpose of directing benefits 10 from the federal substance abuse prevention and treatment 11 block grant, 42 U.S.C. §300x-21 et seq. This designation 12 does not preclude the state board of regents from authorizing 13 or directing any institution under the board of regents’ 14 jurisdiction to carry out educational, prevention, and research 15 activities in the areas of mental health and intellectual 16 disability. 17 2. The department is designated as the single state agency 18 for substance abuse for the purposes of 42 U.S.C. §1396a et 19 seq. 20 3. For the purposes of effectuating the department’s roles 21 designated in this section, the department shall have the 22 following powers and the authority to take all of the following 23 actions: 24 a. Plan, establish, and maintain prevention, education, 25 early intervention, treatment, recovery support, and crisis 26 services programs as necessary or desirable for the behavioral 27 health service system established in section 225A.3. 28 b. Develop and submit a state plan as required by, and in 29 accordance with, 42 U.S.C. §300x-1. 30 c. Review and approve district behavioral health service 31 system plans developed in accordance with the state behavioral 32 health service system plan. 33 d. Perform all necessary acts to cooperate with any state 34 agency, political subdivision, or federal government agency to 35 -3- HF 2673.4273.S (1) 90 mb 3/ 92
apply for grants. 1 e. Solicit and accept for use any gift of money by will or 2 otherwise, and any grant of money or services from the federal 3 government, the state, or any political subdivision thereof, 4 or any private source. 5 f. Collect and maintain records, engage in studies and 6 analyses, and gather relevant statistics. 7 g. Take any other actions as necessary to execute the 8 duties granted to the department in this chapter, or that 9 are otherwise required to maintain compliance with federal 10 requirements related to the department’s roles as designated in 11 this section. 12 Sec. 3. NEW SECTION . 225A.3 Behavioral health service 13 system —— department powers and duties. 14 1. a. A behavioral health service system is established 15 under the control of the department for the purposes of 16 implementing a statewide system of prevention, education, early 17 intervention, treatment, recovery support, and crisis services 18 related to mental health and addictive disorders, including but 19 not limited to alcohol use, substance use, tobacco use, and 20 problem gambling. 21 b. The behavioral health service system shall support 22 equitable statewide access to all services offered through 23 the behavioral health service system and offer specialized 24 services with a focus on at-risk populations including but not 25 limited to children, youth, young adults, individuals with 26 disabilities, pregnant and parenting women, older adults, and 27 people with limited access to financial resources. 28 c. Services offered through the behavioral health service 29 system shall, at a minimum, include all of the following: 30 (1) Prevention intervention services and education 31 programs designed to reduce and mitigate behavioral health 32 conditions and future behavioral health conditions. Prevention 33 intervention programs shall incorporate indicated prevention, 34 selective prevention, and universal prevention activities. 35 -4- HF 2673.4273.S (1) 90 mb 4/ 92
(2) Evidence-based and evidence-informed early intervention 1 and treatment services. 2 (3) Comprehensive recovery support services with a focus on 3 community-based services that avoid, divert, or offset the need 4 for long-term inpatient services, law enforcement involvement, 5 or incarceration. 6 (4) Crisis services with a focus on reducing the escalation 7 of crisis situations, relieving the immediate distress of 8 individuals experiencing a crisis situation, and reducing the 9 risk that individuals in a crisis situation harm themselves. 10 2. To the extent funding is available, the department shall 11 perform all of the following duties to develop and administer 12 the behavioral health service system: 13 a. (1) Develop a state behavioral health service system 14 plan that accomplishes all of the following: 15 (a) Identifies the goals, objectives, and targeted outcomes 16 for the behavioral health service system. 17 (b) Identifies the strategies to meet system objectives and 18 ensure equitable access statewide to prevention, education, 19 early intervention, treatment, recovery support, and crisis 20 services. 21 (c) Is consistent with the state health improvement plan 22 developed under section 217.17. 23 (d) Is consistent with the department’s agency strategic 24 plan adopted pursuant to section 8E.206. 25 (2) The department shall do all of the following when 26 developing the state behavioral health service system plan: 27 (a) Collaborate with stakeholders including but not limited 28 to county supervisors and other local elected officials, 29 experienced behavioral health providers, and organizations that 30 represent populations, including but not limited to children, 31 served by the behavioral health service system. 32 (b) Publish the proposed state behavioral health service 33 system plan on the department’s internet site and allow the 34 public to review and comment on the proposed state behavioral 35 -5- HF 2673.4273.S (1) 90 mb 5/ 92
health system plan prior to the adoption of the proposed state 1 behavioral health plan. 2 b. Administer and distribute state appropriations, federal 3 aid, and grants that have been deposited into the behavioral 4 health fund established in section 225A.7. 5 c. Oversee, provide technical assistance to, and 6 monitor administrative services organizations to ensure the 7 administrative services organizations’ compliance with district 8 behavioral health plans. 9 d. Collaborate with the department of inspections, appeals, 10 and licensing on the accreditation, certification, and 11 licensure of behavioral health providers including but not 12 limited to the approval, denial, revocation, or suspension of 13 a behavioral health provider’s accreditation, certification, 14 or licensure. 15 e. Develop and adopt minimum accreditation standards for 16 the maintenance and operation of community mental health 17 centers to ensure that each community mental health center, 18 and each entity that provides services under contract with a 19 community mental health center, furnishes high-quality mental 20 health services to the community that the community mental 21 health center serves in accordance with rules adopted by the 22 department. 23 f. Designate community mental health centers. 24 g. Conduct formal accreditation reviews of community mental 25 health centers based on minimum accreditation standards adopted 26 by the department pursuant to paragraph “e” . 27 h. Establish and maintain a data collection and management 28 information system to identify, collect, and analyze service 29 outcome and performance data to address the needs of patients, 30 providers, the department, and programs operating within the 31 behavioral health service system. 32 i. Collect, monitor, and utilize information including but 33 not limited to behavioral health service system patient records 34 and syndromic surveillance data to understand emerging needs, 35 -6- HF 2673.4273.S (1) 90 mb 6/ 92
and to deploy information, resources, and technical assistance 1 in response. 2 j. Collaborate with the department of revenue for 3 enforcement of tobacco laws, regulations, and ordinances and 4 engage in tobacco control activities. 5 k. Adopt rules pursuant to chapter 17A to administer this 6 chapter. Such rules shall include but not be limited to rules 7 that provide for all of the following: 8 (1) Minimum access standards to ensure equitable access to 9 services provided through the behavioral health service system 10 including but not limited to when services are available, who 11 is eligible for services, and where services are available. 12 (2) Methods to ensure each individual who is eligible 13 for services receives an uninterrupted continuum of care for 14 prevention, education, early intervention, treatment, recovery 15 support, and crisis services. 16 (3) Standards for the implementation and maintenance 17 of behavioral health programs and services offered by the 18 behavioral health service system, and by each administrative 19 services organization. 20 (4) Procedures for the management and oversight of 21 behavioral health providers to ensure compliance with the terms 22 of the behavioral health providers’ contracts relating to the 23 behavioral health service system, and with state and federal 24 law and rules. 25 (5) Procedures for the suspension of an administrative 26 services organization’s services due to the administrative 27 services organization’s failure to comply with the terms and 28 conditions of its contract with the department. 29 (6) Procedures for the reallocation of funds from 30 an administrative services organization that is not in 31 compliance with the terms of its contract with the department 32 to an alternative administrative services organization or 33 a behavioral health provider to provide for services the 34 noncompliant administrative services organization failed to 35 -7- HF 2673.4273.S (1) 90 mb 7/ 92
provide. 1 (7) Procedures for the termination of an administrative 2 services organization’s designation as an administrative 3 services organization. 4 (8) Procedures for the collection, utilization, and 5 maintenance of the data necessary to establish a central data 6 repository in accordance with section 225A.6. 7 (9) Any other requirements the department deems necessary 8 to ensure that an administrative services organization 9 fulfills the administrative services organization’s duties 10 as established in this chapter, and as established in the 11 administrative services organization’s district behavioral 12 health plan. 13 Sec. 4. NEW SECTION . 225A.4 Behavioral health service 14 system —— districts and administrative services organizations. 15 1. a. The department shall divide the entirety of the 16 state into designated behavioral health districts. Behavioral 17 health prevention, education, early intervention, treatment, 18 recovery support, and crisis services related to mental health 19 and addictive disorders, including but not limited to alcohol 20 use, substance use, tobacco use, and problem gambling, shall 21 be made available through each behavioral health district in a 22 manner consistent with directives each district receives from 23 the department. 24 b. For the purpose of providing equitable access to all 25 services provided through the behavioral health service 26 system, the department shall consider all of the following when 27 designating behavioral health districts: 28 (1) City and county lines. 29 (2) The maximum population size that behavioral health 30 services available in an area are able to effectively serve. 31 (3) Areas of high need for behavioral health services. 32 (4) Patterns various populations exhibit when accessing or 33 receiving behavioral health services. 34 c. Notwithstanding chapter 17A, the manner in which the 35 -8- HF 2673.4273.S (1) 90 mb 8/ 92
department designates behavioral health districts including but 1 not limited to the determination of the boundaries for each 2 district shall not be subject to judicial review. 3 2. a. The department shall designate an administrative 4 services organization for each behavioral health district to 5 oversee and organize each district and the behavioral health 6 services associated with the district. The department shall 7 issue requests for proposals for administrative services 8 organization candidates. 9 b. At the department’s discretion, the department may 10 designate any of the following entities as an administrative 11 services organization: 12 (1) An organization that coordinated administrative 13 services or mental health and disability services for a mental 14 health and disability services region formed on or before June 15 30, 2024. 16 (2) A public or private nonprofit agency located in a 17 behavioral health district, or any separate organizational 18 unit within the public or private nonprofit agency, that has 19 the capabilities to engage in the planning or provision of a 20 broad range of behavioral health prevention, education, early 21 intervention, treatment, recovery support, and crisis services 22 related to mental health and addictive disorders, including but 23 not limited to alcohol use, substance use, tobacco use, and 24 problem gambling, only as directed by the department. 25 c. The department shall consider all of the following 26 factors in determining whether to designate an entity as an 27 administrative services organization: 28 (1) Whether the entity has demonstrated the capacity to 29 manage and utilize available resources in a manner required of 30 an administrative services organization. 31 (2) Whether the entity has demonstrated the ability to 32 ensure the delivery of behavioral health services within the 33 district as required by the department by rule. 34 (3) Whether the entity has demonstrated the ability to 35 -9- HF 2673.4273.S (1) 90 mb 9/ 92
fulfill the monitoring, oversight, and provider compliance 1 responsibilities as required by the department by rule. 2 (4) Whether the entity has demonstrated the capacity to 3 function as a subrecipient for the purposes of the federal 4 community mental health services block grant, 42 U.S.C. 5 §300x et seq., and the federal substance abuse prevention and 6 treatment block grant, 42 U.S.C. §300x-21 et seq., and the 7 ability to comply with all federal requirements applicable to 8 subrecipients under the block grants. 9 3. a. Upon designation by the department, an administrative 10 services organization shall be considered an instrumentality of 11 the state and shall adhere to all state and federal mandates 12 and prohibitions applicable to an instrumentality of the state. 13 b. An entity’s designation as an administrative services 14 organization shall continue until the designation is removed 15 by the department, the administrative services organization 16 withdraws, or a change in state or federal law necessitates the 17 removal of the designation. 18 4. Each administrative services organization shall function 19 as a subrecipient for the purposes of the federal community 20 mental health services block grant, 42 U.S.C. §300x et seq., 21 and the federal substance abuse prevention and treatment block 22 grant, 42 U.S.C. §300x-21 et seq., and shall comply with all 23 federal requirements applicable to subrecipients under the 24 block grants. 25 5. Each administrative services organization shall perform 26 all of the following duties: 27 a. Develop and administer a district behavioral health plan 28 in accordance with the standards adopted by the department by 29 rule. 30 b. Coordinate the administration of the district behavioral 31 health plan with federal, state, and local resources in order 32 to develop a comprehensive and coordinated local behavioral 33 health service system. 34 c. Enter into contracts necessary to provide services under 35 -10- HF 2673.4273.S (1) 90 mb 10/ 92
the district behavioral health plan. 1 d. Oversee, provide technical assistance to, and monitor 2 the compliance of providers contracted by the administrative 3 services organization to provide behavioral health services in 4 accordance with the district behavioral health plan. 5 e. Establish a district behavioral health advisory council 6 pursuant to section 225A.5. 7 Sec. 5. NEW SECTION . 225A.5 District behavioral health 8 advisory councils. 9 1. Each administrative services organization shall 10 establish a district behavioral health advisory council that 11 shall do all of the following: 12 a. Identify opportunities and address challenges based on 13 updates received from the administrative services organization 14 regarding the implementation of the district behavioral health 15 plan. 16 b. Advise the administrative services organization while the 17 administrative services organization is developing behavioral 18 health policies. 19 c. Advise the administrative services organization on 20 how to best provide access to behavioral health prevention, 21 education, early intervention, treatment, recovery support, 22 and crisis services related to mental health and addictive 23 disorders, including but not limited to alcohol use, substance 24 use, tobacco use, and problem gambling, throughout the district 25 as directed by the department. 26 2. An advisory council shall consist of ten members. 27 Members shall be appointed by the administrative services 28 organization subject to the following requirements: 29 a. Three members shall be local elected public officials 30 currently holding office within the behavioral health district, 31 or the public official’s designated representative. 32 b. Three members shall be chosen in accordance with 33 procedures established by the administrative services 34 organization to ensure representation of the populations 35 -11- HF 2673.4273.S (1) 90 mb 11/ 92
served within the behavioral health district. At least one 1 member chosen under this paragraph shall represent child and 2 adolescent persons. 3 c. Three members shall be chosen who have experience 4 or education related to core behavioral health functions, 5 essential behavioral health services, behavioral health 6 prevention, behavioral health treatment, population-based 7 behavioral health services, or community-based behavioral 8 health initiatives. 9 d. One member shall be a law enforcement representative from 10 within the behavioral health district. 11 3. An advisory council shall perform the duties required 12 under this section regardless of whether any seat on the 13 advisory council is vacant. 14 Sec. 6. NEW SECTION . 225A.6 Behavioral health service 15 system —— data collection and use. 16 1. The department shall take all of the following actions 17 for data related to the behavioral health service system: 18 a. Collect and analyze the data, including but not 19 limited to Medicaid and community services network data, as 20 necessary to issue cost estimates for serving populations, 21 providing treatment, making and receiving payments, conducting 22 operations, and performing prevention and health promotion 23 activities. In doing so, the department shall maintain 24 compliance with applicable federal and state privacy laws 25 to ensure the confidentiality and integrity of individually 26 identifiable data. The department shall periodically assess 27 the status of the department’s compliance to ensure that data 28 collected by and stored with the department is protected. 29 b. Establish and administer a central data repository for 30 collecting and analyzing state, behavioral health district, and 31 contracted behavioral health provider data. 32 c. Establish a record for each individual receiving publicly 33 funded services from an administrative services organization. 34 Each record shall include a unique client identifier for the 35 -12- HF 2673.4273.S (1) 90 mb 12/ 92
purposes of identifying and tracking the individual’s record. 1 d. Consult with administrative services organizations, 2 behavioral health service providers, and other behavioral 3 health service system stakeholders on an ongoing basis to 4 implement and maintain the central data repository. 5 e. Engage with all entities that maintain information the 6 department is required to collect pursuant to this section in 7 order to integrate all data concerning individuals receiving 8 services within the behavioral health service system. 9 f. Engage with all entities that maintain general population 10 data relating to behavioral health in order to develop action 11 plans, create projections relating to a population’s behavioral 12 health needs, develop policies concerning behavioral health, 13 and otherwise perform acts as necessary to enhance the state’s 14 overall behavioral health. 15 2. Administrative services organizations shall report all 16 data required to be maintained in the central data repository 17 to the department in a manner as established by the department 18 by rule. For the purpose of making such data reports, an 19 administrative services organization shall do one of the 20 following: 21 a. Utilize a data system that integrates with the data 22 systems used by the department. 23 b. Utilize a data system that has the capacity to securely 24 exchange information with the department, other behavioral 25 health districts, contractors, and other entities involved with 26 the behavioral health service system who are authorized to 27 access the central data repository. 28 3. Data and information maintained by and exchanged between 29 an administrative services organization and the department 30 shall be labeled consistently, share the same definitions, 31 utilize the same common coding and nomenclature, and be in a 32 form and format as required by the department by rule. 33 4. Administrative services organizations shall report 34 to the department, in a manner specified by the department, 35 -13- HF 2673.4273.S (1) 90 mb 13/ 92
information including but not limited to demographic 1 information, expenditure data, and data concerning the 2 behavioral health services and other support provided to 3 individuals in the administrative service organization’s 4 district. 5 5. The department shall ensure that public and private 6 agencies, organizations, and individuals that operate within 7 the behavioral health service system, or that make formal 8 requests for the release of data collected by the department, 9 maintain uniform methods for keeping statistical information 10 relating to behavioral health service system outcomes and 11 performance. 12 6. The department shall develop and implement a 13 communication plan that details how outcome and performance 14 data will be shared with stakeholders including but not limited 15 to the public, persons involved with the behavioral health 16 service system, and the general assembly. 17 Sec. 7. NEW SECTION . 225A.7 Behavioral health fund. 18 1. For purposes of this section: 19 a. “Population” means, as of July 1 of the fiscal year 20 preceding the fiscal year in which the population figure is 21 applied, the population shown by the latest preceding certified 22 federal census or the latest applicable population estimate 23 issued by the United States census bureau, whichever is most 24 recent. 25 b. “State growth factor” for a fiscal year means an amount 26 equal to the dollar amount used to calculate the appropriation 27 under this section for the immediately preceding fiscal year 28 multiplied by the percent increase, if any, in the amount of 29 sales tax revenue deposited into the general fund of the state 30 under section 423.2A, subsection 1, paragraph “a” , less the 31 transfers required under section 423.2A, subsection 2, between 32 the fiscal year beginning three years prior to the applicable 33 fiscal year and the fiscal year beginning two years prior 34 to the applicable year, but not to exceed one and one-half 35 -14- HF 2673.4273.S (1) 90 mb 14/ 92
percent. 1 2. A behavioral health fund is established in the state 2 treasury under the control of the department. The fund shall 3 consist of moneys deposited into the fund pursuant to this 4 section and section 426B.1, gifts of money or property accepted 5 by the state or the department to support any services under 6 this chapter or chapter 231, and moneys otherwise appropriated 7 by the general assembly. Moneys in the fund are appropriated 8 to the department to implement and administer the behavioral 9 health service system and related programs including but not 10 limited to all of the following: 11 a. Distributions to administrative services organizations 12 to provide services as outlined in the organizations’ district 13 behavioral health plan. 14 b. Distributions to providers of mental health services 15 and addictive disorder services, including but not limited to 16 tobacco use services, substance use disorder services, and 17 problem gambling services. 18 c. Funding of disability services pursuant to chapter 231. 19 This paragraph is repealed July 1, 2028. 20 3. For the fiscal year beginning July 1, 2025, there 21 is transferred from the general fund of the state to the 22 behavioral health fund an amount equal to forty-two dollars 23 multiplied by the state’s population for the fiscal year. 24 4. For the fiscal year beginning July 1, 2026, and each 25 succeeding fiscal year, there is transferred from the general 26 fund of the state to the behavioral health fund an amount equal 27 to the state’s population for the fiscal year multiplied by 28 the sum of the dollar amount used to calculate the transfer 29 from the general fund to the behavioral health fund for the 30 immediately preceding fiscal year, plus the state growth factor 31 for the fiscal year for which the transfer is being made. 32 5. For each fiscal year, an administrative services 33 organization shall not spend on administrative costs an amount 34 more than seven percent of the total amount distributed to the 35 -15- HF 2673.4273.S (1) 90 mb 15/ 92
administrative services organization through this section and 1 all other appropriations for the same fiscal year. 2 6. Moneys in the behavioral health fund may be used by the 3 department for cash flow purposes, provided that any moneys so 4 allocated are returned to the behavioral health fund by the end 5 of each fiscal year. 6 7. Notwithstanding section 12C.7, subsection 2, interest 7 or earnings on moneys deposited in the behavioral health fund 8 shall be credited to the behavioral health fund. 9 8. Notwithstanding section 8.33, moneys appropriated in 10 this section that remain unencumbered or unobligated at the 11 close of the fiscal year shall not revert but shall remain 12 available for expenditure for the purposes designated. 13 Sec. 8. NEW SECTION . 225A.8 Addictive disorders prevention 14 —— prohibitions. 15 1. For purposes of this section, “entity” means a 16 manufacturer, distributor, wholesaler, retailer, or 17 distributing agent, or an agent of a manufacturer, distributor, 18 wholesaler, retailer, or distributing agent as those terms are 19 defined in section 453A.1. 20 2. To promote comprehensive tobacco use prevention and 21 control initiatives outlined in the state behavioral health 22 service system plan, an entity shall not perform any of the 23 following acts: 24 a. Give away cigarettes or tobacco products. 25 b. Provide free articles, products, commodities, gifts, or 26 concessions in any exchange for the purchase of cigarettes or 27 tobacco products. 28 3. The prohibitions in this section shall not apply to 29 transactions between manufacturers, distributors, wholesalers, 30 or retailers as those terms are defined in section 453A.1. 31 Sec. 9. NEW SECTION . 225A.9 Application for services —— 32 minors. 33 A minor who is twelve years of age or older shall have 34 the legal capacity to act and give consent to the provision 35 -16- HF 2673.4273.S (1) 90 mb 16/ 92
of tobacco cessation coaching services pursuant to a tobacco 1 cessation telephone and internet-based program approved by 2 the department through the behavioral health service system 3 established in section 225A.3. Consent shall not be subject to 4 later disaffirmance by reason of such minority. The consent of 5 another person, including but not limited to the consent of a 6 spouse, parent, custodian, or guardian, shall not be necessary. 7 Sec. 10. CODE EDITOR DIRECTIVE. The Code editor is directed 8 to do all of the following: 9 1. Designate sections 225A.1 through 225A.9, as enacted 10 in this division of this Act, as Code chapter 225A entitled 11 “Department of Health and Human Services —— Behavioral Health 12 Service System”. 13 2. Correct internal references in the Code and in any 14 enacted legislation as necessary due to the enactment of this 15 division of this Act. 16 Sec. 11. EFFECTIVE DATE. This division of this Act takes 17 effect July 1, 2025. 18 DIVISION II 19 BEHAVIORAL HEALTH SERVICE SYSTEM —— CONFORMING CHANGES 20 Sec. 12. Section 11.6, subsection 1, paragraph b, Code 2024, 21 is amended to read as follows: 22 b. The financial condition and transactions of community 23 mental health centers organized under chapter 230A , substance 24 use disorder programs organized licensed under chapter 125 , and 25 community action agencies organized under chapter 216A , shall 26 be audited at least once each year. 27 Sec. 13. Section 97B.1A, subsection 8, paragraph a, 28 subparagraph (13), Code 2024, is amended by striking the 29 subparagraph. 30 Sec. 14. Section 123.17, subsection 5, Code 2024, is amended 31 to read as follows: 32 5. After any transfer provided for in subsection 3 is made, 33 the department shall transfer into a special revenue account 34 in the general fund of the state, a sum of money at least equal 35 -17- HF 2673.4273.S (1) 90 mb 17/ 92
to seven percent of the gross amount of sales made by the 1 department from the beer and liquor control fund on a monthly 2 basis but not less than nine million dollars annually. Of 3 the amounts transferred, two three million dollars, plus an 4 additional amount determined by the general assembly, shall be 5 appropriated to the department of health and human services for 6 use by the staff who administer the comprehensive substance use 7 disorder program under chapter 125 for substance use disorder 8 treatment and prevention programs shall be transferred to the 9 behavioral health fund established under section 225A.7 . Any 10 amounts received in excess of the amounts appropriated to the 11 department of health and human services for use by the staff 12 who administer the comprehensive substance use disorder program 13 under chapter 125 transferred to the behavioral health fund 14 shall be considered part of the general fund balance. 15 Sec. 15. Section 123.17, subsection 8, Code 2024, is amended 16 by striking the subsection. 17 Sec. 16. Section 123.17, subsection 9, Code 2024, is amended 18 to read as follows: 19 9. After any transfers provided for in subsections 3, 5, 20 6, and 7 , and 8 are made, and before any other transfer to the 21 general fund, the department shall transfer to the economic 22 development authority from the beer and liquor control fund the 23 lesser of two hundred fifty thousand dollars or one percent of 24 the gross sales of native distilled spirits by all class “A” 25 native distilled spirits license holders made by the department 26 for the purposes of promoting Iowa wine, beer, and spirits. 27 Sec. 17. Section 124.409, subsection 2, Code 2024, is 28 amended by striking the subsection. 29 Sec. 18. Section 125.2, subsections 4, 5, and 10, Code 2024, 30 are amended by striking the subsections. 31 Sec. 19. Section 125.91, subsection 1, Code 2024, is amended 32 to read as follows: 33 1. The procedure prescribed by this section shall only 34 be used for a person with a substance use disorder due to 35 -18- HF 2673.4273.S (1) 90 mb 18/ 92
intoxication or substance-induced incapacitation who has 1 threatened, attempted, or inflicted physical self-harm or harm 2 on another, and is likely to inflict physical self-harm or harm 3 on another unless immediately detained, or who is incapacitated 4 by a chemical substance, if an application has not been filed 5 naming the person as the respondent pursuant to section 125.75 6 and the person cannot be ordered into immediate custody and 7 detained pursuant to section 125.81 . 8 Sec. 20. Section 125.93, Code 2024, is amended to read as 9 follows: 10 125.93 Commitment records —— confidentiality. 11 Records of the identity, diagnosis, prognosis, or treatment 12 of a person which are maintained in connection with the 13 provision of substance use disorder treatment services are 14 confidential, consistent with the requirements of section 15 125.37 , and with the federal confidentiality regulations 16 authorized by the federal Drug Abuse Office and Treatment Act , 17 42 U.S.C. §290ee and the federal Comprehensive Alcohol Abuse 18 and Alcoholism Prevention, Treatment and Rehabilitation Act, 42 19 U.S.C. §290dd-2. However, such records may be disclosed to an 20 employee of the department of corrections, if authorized by the 21 director of the department of corrections, or to an employee 22 of a judicial district department of correctional services, if 23 authorized by the director of the judicial district department 24 of correctional services. 25 Sec. 21. Section 135.11, subsection 11, Code 2024, is 26 amended to read as follows: 27 11. Administer chapters 125, 136A , 136C , 139A , 142 , 28 142A , 144 , and 147A . 29 Sec. 22. Section 135C.2, subsection 5, unnumbered paragraph 30 1, Code 2024, is amended to read as follows: 31 The department shall establish a special classification 32 within the residential care facility category in order to 33 foster the development of residential care facilities which 34 serve persons with an intellectual disability, chronic mental 35 -19- HF 2673.4273.S (1) 90 mb 19/ 92
illness, a developmental disability, or brain injury, as 1 described under section 225C.26 , and which contain five or 2 fewer residents. A facility within the special classification 3 established pursuant to this subsection is exempt from the 4 requirements of section 10A.713 . The department shall adopt 5 rules which are consistent with rules previously developed for 6 the waiver demonstration waiver project pursuant to 1986 Iowa 7 Acts, ch. 1246, §206 , and which include all of the following 8 provisions: 9 Sec. 23. Section 135C.6, subsection 1, Code 2024, is amended 10 to read as follows: 11 1. A person or governmental unit acting severally or 12 jointly with any other person or governmental unit shall not 13 establish or operate a health care facility in this state 14 without a license for the facility. A supported community 15 living service, as defined in section 225C.21 249A.38A , is not 16 required to be licensed under this chapter , but is subject to 17 approval under section 225C.21 249A.38A in order to receive 18 public funding. 19 Sec. 24. Section 135C.23, subsection 1, unnumbered 20 paragraph 1, Code 2024, is amended to read as follows: 21 Each resident shall be covered by a contract executed 22 by the resident, or the resident’s legal representative, 23 and the health care facility at or prior to the time of the 24 resident’s admission or prior thereto by the resident, or the 25 legal representative, and the health care facility, except as 26 otherwise provided by subsection 5 with respect to residents 27 admitted at public expense to a county care facility operated 28 under chapter 347B . Each party to the contract shall be 29 entitled to a duplicate of the original thereof contract , and 30 the health care facility shall keep on file all contracts 31 which it has with residents and shall not destroy or otherwise 32 dispose of any such contract for at least one year after its 33 expiration. Each such contract shall expressly set forth: 34 Sec. 25. Section 135C.23, subsection 2, paragraph b, Code 35 -20- HF 2673.4273.S (1) 90 mb 20/ 92
2024, is amended to read as follows: 1 b. This section does not prohibit the admission of a 2 patient with a history of dangerous or disturbing behavior to 3 an intermediate care facility for persons with mental illness, 4 intermediate care facility for persons with an intellectual 5 disability, or nursing facility , or county care facility when 6 the intermediate care facility for persons with mental illness, 7 intermediate care facility for persons with an intellectual 8 disability, or nursing facility , or county care facility has a 9 program which has received prior approval from the department 10 to properly care for and manage the patient. An intermediate 11 care facility for persons with mental illness, intermediate 12 care facility for persons with an intellectual disability, 13 or nursing facility , or county care facility is required to 14 transfer or discharge a resident with dangerous or disturbing 15 behavior when the intermediate care facility for persons with 16 mental illness, intermediate care facility for persons with an 17 intellectual disability, or nursing facility , or county care 18 facility cannot control the resident’s dangerous or disturbing 19 behavior. The department , in coordination with the state 20 mental health and disability services commission created in 21 section 225C.5 , shall adopt rules pursuant to chapter 17A for 22 programs to be required in intermediate care facilities for 23 persons with mental illness, intermediate care facilities 24 for persons with an intellectual disability, and nursing 25 facilities , and county care facilities that admit patients 26 or have residents with histories of dangerous or disturbing 27 behavior. 28 Sec. 26. Section 135C.23, subsection 5, Code 2024, is 29 amended by striking the subsection. 30 Sec. 27. Section 135C.24, subsection 5, Code 2024, is 31 amended by striking the subsection. 32 Sec. 28. Section 135G.1, subsection 12, Code 2024, is 33 amended to read as follows: 34 12. a. “Subacute mental health services” means the same 35 -21- HF 2673.4273.S (1) 90 mb 21/ 92
as defined in section 225C.6 services that provide all of the 1 following: 2 (1) A comprehensive set of wraparound services for a 3 person who has had, or is at imminent risk of having, acute or 4 crisis mental health symptoms that do not permit the person to 5 remain in or threatens removal of the person from the person’s 6 home and community, but who has been determined by a mental 7 health professional and a licensed health care professional, 8 subject to the professional’s scope of practice, not to need 9 inpatient acute hospital services. For the purposes of this 10 subparagraph, “licensed health care professional” means a person 11 licensed under chapter 148, an advanced registered nurse 12 practitioner, or a physician assistant. 13 (2) Intensive, recovery-oriented treatment and monitoring 14 of a person. Treatment may be provided directly or remotely 15 by a licensed psychiatrist or an advanced registered nurse 16 practitioner. 17 (3) An outcome-focused, interdisciplinary approach designed 18 to return a person to living successfully in the community. 19 b. Subacute mental health services may include services 20 provided in a wide array of settings ranging from a person’s 21 home to a specialized facility with restricted means of egress. 22 c. Subacute mental health services shall be limited to a 23 period not to exceed ten calendar days or another time period 24 determined in accordance with rules adopted by the department 25 for this purpose, whichever is longer . 26 Sec. 29. Section 142.1, Code 2024, is amended to read as 27 follows: 28 142.1 Delivery of bodies. 29 The body of every person dying who died in a public asylum, 30 hospital, county care facility, penitentiary, or reformatory 31 in this state, or found dead within the state, or which who 32 is to be buried at public expense in this state, except those 33 buried under the provisions of chapter 144C or 249 , and which 34 is suitable for scientific purposes, shall be delivered to the 35 -22- HF 2673.4273.S (1) 90 mb 22/ 92
medical college of the state university, or some osteopathic 1 or chiropractic college or school located in this state, which 2 has been approved under the law regulating the practice of 3 osteopathic medicine or chiropractic; but no such body shall 4 be delivered to any such college or school if the deceased 5 person expressed a desire during the person’s last illness 6 that the person’s body should be buried or cremated, nor if 7 such is the desire of the person’s relatives. Such bodies 8 shall be equitably distributed among said colleges and schools 9 according to their needs for teaching anatomy in accordance 10 with such rules as may be adopted by the department of health 11 and human services. The expense of transporting said bodies to 12 such college or school shall be paid by the college or school 13 receiving the same. If the deceased person has not expressed 14 a desire during the person’s last illness that the person’s 15 body should be buried or cremated and no person authorized to 16 control the deceased person’s remains under section 144C.5 17 requests the person’s body for burial or cremation, and if a 18 friend objects to the use of the deceased person’s body for 19 scientific purposes, said deceased person’s body shall be 20 forthwith delivered to such friend for burial or cremation at 21 no expense to the state or county. Unless such friend provides 22 for burial and burial expenses within five days, the body shall 23 be used for scientific purposes under this chapter . 24 Sec. 30. Section 142.3, Code 2024, is amended to read as 25 follows: 26 142.3 Notification of department. 27 Every county medical examiner, funeral director or embalmer, 28 and the managing officer of every public asylum, hospital, 29 county care facility, penitentiary, or reformatory, as soon as 30 any dead body shall come into the person’s custody which may be 31 used for scientific purposes as provided in sections 142.1 and 32 142.2 , shall at once notify the nearest relative or friend of 33 the deceased, if known, and the department of health and human 34 services, and hold such body unburied for forty-eight hours. 35 -23- HF 2673.4273.S (1) 90 mb 23/ 92
Upon receipt of notification, the department shall issue verbal 1 or written instructions relative to the disposition to be made 2 of said body. Complete jurisdiction over said bodies is vested 3 exclusively in the department of health and human services. No 4 autopsy or post mortem, except as are legally ordered by county 5 medical examiners, shall be performed on any of said bodies 6 prior to their delivery to the medical schools. 7 Sec. 31. NEW SECTION . 217.17 State health improvement plan. 8 1. The department shall develop, implement, and administer 9 a state health improvement plan to identify health priorities, 10 goals, and measurable objectives, and outline strategies to 11 improve health statewide. 12 2. The state health improvement plan shall be developed 13 and updated in collaboration and in coordination with other 14 state departments, stakeholders, and statewide organizations 15 the department determines to be relevant. 16 3. The state health improvement plan may be updated by the 17 department at the department’s discretion. 18 Sec. 32. NEW SECTION . 217.37 Recovery of payment —— 19 assignment of liens —— county attorney to enforce. 20 1. For purposes of this section, “assistance” means all of 21 the following: 22 a. A payment by the state for services rendered through 23 the behavioral health service system established under section 24 225A.3. 25 b. A payment by the state for aging and disability services 26 rendered in accordance with chapter 231. 27 2. The department shall have the authority to investigate if 28 a person is eligible to have assistance paid on the person’s 29 behalf and whether payment of assistance was proper. 30 3. Notwithstanding any provision of law to the contrary, 31 assistance shall not be recoverable unless the department 32 finds that the assistance was paid for the benefit of a person 33 who was not entitled to have assistance paid on the person’s 34 behalf. 35 -24- HF 2673.4273.S (1) 90 mb 24/ 92
4. Assistance paid for the benefit of a person who was 1 not entitled to have assistance paid on the person’s behalf 2 shall be recoverable from the entity to which the assistance 3 was paid, from the person on whose behalf assistance was paid, 4 or from a third party who is liable for the person’s debts or 5 support. 6 5. Upon the death of a person who was not entitled to 7 have assistance paid on the person’s behalf, the department 8 shall have a lien equivalent in priority to liens described 9 in section 633.425, subsection 6, against the person’s estate 10 for the portion of the assistance improperly paid which the 11 department had not recovered at the time of the person’s death. 12 6. The department may waive all or a portion of improperly 13 paid assistance, or a lien created under subsection 5, if 14 the department finds that collection would result in undue 15 hardship. 16 7. The department shall adopt rules pursuant to chapter 17A 17 to implement and administer this section. 18 Sec. 33. Section 218.30, Code 2024, is amended to read as 19 follows: 20 218.30 Investigation of other facilities. 21 The director may investigate or cause the investigation of 22 charges of abuse, neglect, or mismanagement on the part of an 23 officer or employee of a private facility which is subject to 24 the director’s supervision or control. The director shall also 25 investigate or cause the investigation of charges concerning 26 county care facilities in which persons with mental illness are 27 served. 28 Sec. 34. Section 218.78, subsection 1, Code 2024, is amended 29 to read as follows: 30 1. All institutional receipts of the department, including 31 funds received from client participation at the state resource 32 centers under section 222.78 and at the state mental health 33 institutes under section 230.20 , shall be deposited in the 34 general fund except for reimbursements for services provided 35 -25- HF 2673.4273.S (1) 90 mb 25/ 92
to another institution or state agency, for receipts deposited 1 in the revolving farm fund under section 904.706 , for deposits 2 into the medical assistance fund under section 249A.11 , and for 3 rentals charged to employees or others for room, apartment, or 4 house and meals, which shall be available to the institutions. 5 Sec. 35. Section 222.1, subsection 1, Code 2024, is amended 6 to read as follows: 7 1. This chapter addresses the public and private services 8 available in this state to meet the needs of persons with an 9 intellectual disability. The responsibility of the mental 10 health and disability services regions formed by counties and 11 of the state for the costs and administration of publicly 12 funded services shall be as set out in section 222.60 and other 13 pertinent sections of this chapter . 14 Sec. 36. Section 222.2, Code 2024, is amended by adding the 15 following new subsection: 16 NEW SUBSECTION . 01. “Administrative services organization” 17 means the same as defined in section 225A.1. 18 Sec. 37. Section 222.2, subsections 6 and 7, Code 2024, are 19 amended by striking the subsections. 20 Sec. 38. Section 222.12, subsection 2, Code 2024, is amended 21 by striking the subsection. 22 Sec. 39. Section 222.13, Code 2024, is amended to read as 23 follows: 24 222.13 Voluntary admissions. 25 1. If an adult person is believed to be a person with an 26 intellectual disability, the adult person or the adult person’s 27 guardian may apply to the department and the superintendent of 28 any state resource center for the voluntary admission of the 29 adult person either as an inpatient or an outpatient of the 30 resource center. If the expenses of the person’s admission 31 or placement are payable in whole or in part by the person’s 32 county of residence, application for the admission shall be 33 made through the regional administrator. An application for 34 admission to a special unit of any adult person believed to be 35 -26- HF 2673.4273.S (1) 90 mb 26/ 92
in need of any of the services provided by the special unit 1 under section 222.88 may be made in the same manner. The 2 superintendent shall accept the application if a preadmission 3 diagnostic evaluation confirms or establishes the need for 4 admission, except that an application shall not be accepted if 5 the institution does not have adequate facilities available or 6 if the acceptance will result in an overcrowded condition. 7 2. If the resource center does not have an appropriate 8 program for the treatment of an adult or minor person with an 9 intellectual disability applying under this section or section 10 222.13A , the regional administrator for the person’s county 11 of residence or the department , as applicable, shall arrange 12 for the placement of the person in any public or private 13 facility within or without outside of the state, approved by 14 the director, which offers appropriate services for the person. 15 If the expenses of the placement are payable in whole or in 16 part by a county, the placement shall be made by the regional 17 administrator for the county. 18 3. If the expenses of an admission of an adult to a resource 19 center or a special unit, or of the placement of the person 20 in a public or private facility are payable in whole or in 21 part by a mental health and disability services region, the 22 regional administrator shall make a full investigation into 23 the financial circumstances of the person and those liable for 24 the person’s support under section 222.78 to determine whether 25 or not any of them are able to pay the expenses arising out of 26 the admission of the person to a resource center, special unit, 27 or public or private facility. If the regional administrator 28 finds that the person or those legally responsible for 29 the person are presently unable to pay the expenses, the 30 regional administrator shall pay the expenses. The regional 31 administrator may review such a finding at any subsequent 32 time while the person remains at the resource center, or is 33 otherwise receiving care or treatment for which this chapter 34 obligates the region to pay. If the regional administrator 35 -27- HF 2673.4273.S (1) 90 mb 27/ 92
finds upon review that the person or those legally responsible 1 for the person are presently able to pay the expenses, the 2 finding shall apply only to the charges incurred during the 3 period beginning on the date of the review and continuing 4 thereafter, unless and until the regional administrator again 5 changes such a finding. If the regional administrator finds 6 that the person or those legally responsible for the person 7 are able to pay the expenses, the regional administrator shall 8 collect the charges to the extent required by section 222.78 , 9 and the regional administrator shall be responsible for the 10 payment of the remaining charges. 11 Sec. 40. Section 222.13A, subsections 3 and 4, Code 2024, 12 are amended to read as follows: 13 3. During the preadmission diagnostic evaluation, the 14 minor shall be informed both orally and in writing that the 15 minor has the right to object to the voluntary admission. If 16 Notwithstanding section 222.33, if the preadmission diagnostic 17 evaluation determines that the voluntary admission is 18 appropriate but the minor objects to the admission, the minor 19 shall not be admitted to the state resource center unless the 20 court approves of the admission. A petition for approval of 21 the minor’s admission may be submitted to the juvenile court by 22 the minor’s parent, guardian, or custodian. 23 4. As soon as practicable after the filing of a petition for 24 approval of the voluntary admission, the court shall determine 25 whether the minor has an attorney to represent the minor in the 26 proceeding. If the minor does not have an attorney, the court 27 shall assign an attorney to the minor an attorney . If the 28 minor is unable to pay for an attorney, the attorney shall be 29 compensated by the mental health and disability services region 30 an administrative services organization at an hourly rate to be 31 established by the regional administrator in substantially the 32 same manner as provided in section 815.7 . 33 Sec. 41. Section 222.14, Code 2024, is amended to read as 34 follows: 35 -28- HF 2673.4273.S (1) 90 mb 28/ 92
222.14 Care by region pending admission. 1 If the institution is unable to receive a patient, the 2 superintendent shall notify the regional administrator for the 3 county of residence of the prospective patient anadministrative 4 services organization . Until such time as the patient is able 5 to be received by the institution, or when application has been 6 made for admission to a public or private facility as provided 7 in section 222.13 and the application is pending, the care 8 of the patient shall be provided as arranged by the regional 9 administrator administrative services organization . 10 Sec. 42. NEW SECTION . 222.33 State resource center —— 11 admissions and discharge. 12 1. The department shall make all final determinations 13 concerning whether a person may be admitted to a state resource 14 center. 15 2. If a patient is admitted to a state resource center 16 pursuant to section 222.13 or 222.13A, and the patient 17 wishes to be placed outside of the state resource center, the 18 discharge of the patient shall be made in accordance with 19 section 222.15. 20 Sec. 43. NEW SECTION . 222.35 State —— payor of last resort. 21 The department shall implement services and adopt rules 22 pursuant to chapter 17A in a manner that ensures that the state 23 is the payor of last resort, and that the department shall not 24 make any payments for services that have been provided until 25 the department has determined that the services provided are 26 not payable by a third-party source. 27 Sec. 44. Section 222.73, subsections 2 and 4, Code 2024, are 28 amended by striking the subsections. 29 Sec. 45. Section 222.77, Code 2024, is amended to read as 30 follows: 31 222.77 Patients on leave. 32 The cost of support of patients placed on convalescent leave 33 or removed as a habilitation measure from a resource center, 34 or a special unit, except when living in the home of a person 35 -29- HF 2673.4273.S (1) 90 mb 29/ 92
legally bound for the support of the patient, shall be paid by 1 the county of residence or the state as provided in section 2 222.60 . 3 Sec. 46. Section 222.78, subsection 1, Code 2024, is amended 4 to read as follows: 5 1. The father and mother of any patient admitted to a 6 resource center or to a special unit , as either an inpatient 7 or an outpatient, and any person, firm, or corporation bound 8 by contract made for support of the patient , are liable for 9 the support of the patient. The patient and those legally 10 bound for the support of the patient shall be liable to 11 the county or state , as applicable, for all sums advanced 12 in accordance with the provisions of sections 222.60 and 13 222.77 relating to reasonable attorney fees and court costs for 14 the patient’s admission to the resource center, and for the 15 treatment, training, instruction, care, habilitation, support, 16 transportation, or other expenditures made on behalf of the 17 patient pursuant to this chapter . 18 Sec. 47. Section 222.79, Code 2024, is amended to read as 19 follows: 20 222.79 Certification statement presumed correct. 21 In actions to enforce the liability imposed by section 22 222.78 , the superintendent or the county of residence, as 23 applicable, shall submit a certification statement stating 24 the sums charged, and the certification statement shall be 25 considered presumptively correct. 26 Sec. 48. Section 222.80, Code 2024, is amended to read as 27 follows: 28 222.80 Liability to county or state. 29 A person admitted to a county institution or home or admitted 30 at county or state expense to a private hospital, sanitarium, 31 or other facility for treatment, training, instruction, care, 32 habilitation, and support as a patient with an intellectual 33 disability shall be liable to the county or state , as 34 applicable, for the reasonable cost of the support as provided 35 -30- HF 2673.4273.S (1) 90 mb 30/ 92
in section 222.78 . 1 Sec. 49. Section 222.82, Code 2024, is amended to read as 2 follows: 3 222.82 Collection of liabilities and claims. 4 If liabilities and claims exist as provided in section 5 222.78 or any other provision of this chapter , the county of 6 residence or the state , as applicable, may proceed as provided 7 in this section . If the liabilities and claims are owed to 8 a county of residence, the county’s board of supervisors may 9 direct the county attorney to proceed with the collection of 10 the liabilities and claims as a part of the duties of the 11 county attorney’s office when the board of supervisors deems 12 such action advisable. If the liabilities and claims are owed 13 to the state, the state shall proceed with the collection. 14 The board of supervisors or the state , as applicable, may 15 compromise any and all liabilities to the county or state 16 arising under this chapter when such compromise is deemed to be 17 in the best interests of the county or state. Any collections 18 and liens shall be limited in conformance to section 614.1, 19 subsection 4 . 20 Sec. 50. Section 222.85, subsection 2, Code 2024, is amended 21 to read as follows: 22 2. Moneys paid to a resource center from any source other 23 than state appropriated funds and intended to pay all or a 24 portion of the cost of care of a patient, which cost would 25 otherwise be paid from state or county funds or from the 26 patient’s own funds, shall not be deemed “funds belonging to a 27 patient” for the purposes of this section . 28 Sec. 51. Section 222.86, Code 2024, is amended to read as 29 follows: 30 222.86 Payment for care from fund. 31 If a patient is not receiving medical assistance under 32 chapter 249A and the amount in the account of any patient 33 in the patients’ personal deposit fund exceeds two hundred 34 dollars, the department may apply any amount of the excess to 35 -31- HF 2673.4273.S (1) 90 mb 31/ 92
reimburse the county of residence or the state for liability 1 incurred by the county or the state for the payment of care, 2 support, and maintenance of the patient , when billed by the 3 county or state , as applicable . 4 Sec. 52. Section 222.92, subsection 1, Code 2024, is amended 5 to read as follows: 6 1. The department shall operate the state resource centers 7 on the basis of net appropriations from the general fund of 8 the state. The appropriation amounts shall be the net amounts 9 of state moneys projected to be needed for the state resource 10 centers for the fiscal year of the appropriations. The purpose 11 of utilizing net appropriations is to encourage the state 12 resource centers to operate with increased self-sufficiency, to 13 improve quality and efficiency, and to support collaborative 14 efforts between the state resource centers and counties and 15 other providers of funding for the services available from 16 the state resource centers. The state resource centers shall 17 not be operated under the net appropriations in a manner that 18 results in a cost increase to the state or in cost shifting 19 between the state, the medical assistance program, counties, or 20 other sources of funding for the state resource centers. 21 Sec. 53. Section 222.92, subsection 3, paragraph a, Code 22 2024, is amended by striking the paragraph. 23 Sec. 54. Section 225.1, subsection 2, Code 2024, is amended 24 to read as follows: 25 2. For the purposes of this chapter , unless the context 26 otherwise requires: 27 a. “Mental health and disability services region” means 28 a mental health and disability services region approved in 29 accordance with section 225C.56 . “Administrative services 30 organization” means the same as defined in section 225A.1. 31 b. “Regional administrator” means the administrator of a 32 mental health and disability services region, as defined in 33 section 225C.55 . “Department” means the department of health 34 and human services. 35 -32- HF 2673.4273.S (1) 90 mb 32/ 92
c. “Respondent” means the same as defined in section 229.1 . 1 Sec. 55. NEW SECTION . 225.4 State psychiatric hospital —— 2 admissions. 3 The department shall make all final determinations 4 concerning whether a person may be admitted to the state 5 psychiatric hospital. 6 Sec. 56. Section 225.11, Code 2024, is amended to read as 7 follows: 8 225.11 Initiating commitment procedures. 9 When a court finds upon completion of a hearing held pursuant 10 to section 229.12 that the contention that a respondent is 11 seriously mentally impaired has been sustained by clear and 12 convincing evidence, and the application filed under section 13 229.6 also contends or the court otherwise concludes that it 14 would be appropriate to refer the respondent to the state 15 psychiatric hospital for a complete psychiatric evaluation and 16 appropriate treatment pursuant to section 229.13 , the judge 17 may order that a financial investigation be made in the manner 18 prescribed by section 225.13 . If the costs of a respondent’s 19 evaluation or treatment are payable in whole or in part by a 20 county an administrative services organization , an order under 21 this section shall be for referral of the respondent through 22 the regional administrator for the respondent’s county of 23 residence by an administrative services organization for an 24 evaluation and referral of the respondent to an appropriate 25 placement or service, which may include the state psychiatric 26 hospital for additional evaluation or treatment. 27 Sec. 57. Section 225.12, Code 2024, is amended to read as 28 follows: 29 225.12 Voluntary public patient —— physician’s or physician 30 assistant’s report. 31 A physician or a physician assistant who meets the 32 qualifications set forth in the definition of a mental 33 health professional in section 228.1 filing information under 34 section 225.10 shall include a written report to the regional 35 -33- HF 2673.4273.S (1) 90 mb 33/ 92
administrator for the county of residence of the person named 1 in the information, giving shall submit a detailed history of 2 the case to an administrative services organization as will be 3 likely to aid in the observation, treatment, and hospital care 4 of the person and describing the history in detail . 5 Sec. 58. Section 225.13, Code 2024, is amended to read as 6 follows: 7 225.13 Financial condition. 8 The regional administrator for the county of residence of 9 a person being admitted to the state psychiatric hospital is 10 Administrative services organizations shall be responsible for 11 investigating the financial condition of the a person and of 12 those legally responsible for the person’s support. 13 Sec. 59. Section 225.15, Code 2024, is amended to read as 14 follows: 15 225.15 Examination and treatment. 16 1. When a respondent arrives at the state psychiatric 17 hospital, the admitting physician, or a physician assistant 18 who meets the qualifications set forth in the definition of a 19 mental health professional in section 228.1 , shall examine the 20 respondent and determine whether or not, in the physician’s 21 or physician assistant’s judgment, the respondent is a fit 22 subject for observation, treatment, and hospital care. If, 23 upon examination, the physician or physician assistant who 24 meets the qualifications set forth in the definition of a 25 mental health professional in section 228.1 decides that the 26 respondent should be admitted to the hospital, the respondent 27 shall be provided a proper bed in the hospital. The physician 28 or physician assistant who meets the qualifications set forth 29 in the definition of a mental health professional in section 30 228.1 who has charge of the respondent shall proceed with 31 observation, medical treatment, and hospital care as in the 32 physician’s or physician assistant’s judgment are proper and 33 necessary, in compliance with sections 229.13 , 229.14 , this 34 section , and section 229.16 . After the respondent’s admission, 35 -34- HF 2673.4273.S (1) 90 mb 34/ 92
the observation, medical treatment, and hospital care of the 1 respondent may be provided by a mental health professional, 2 as defined in section 228.1 , who is licensed as a physician, 3 advanced registered nurse practitioner, or physician assistant. 4 2. A proper and competent nurse shall also be assigned to 5 look after and care for the respondent during observation, 6 treatment, and care. Observation, treatment, and hospital 7 care under this section which are payable in whole or in part 8 by a county shall only be provided as determined through 9 the regional administrator for the respondent’s county of 10 residence. 11 Sec. 60. Section 225.16, subsection 1, Code 2024, is amended 12 to read as follows: 13 1. If the regional administrator for a person’s county of 14 residence department finds from the physician’s information 15 or from the information of a physician assistant who 16 meets the qualifications set forth in the definition of 17 a mental health professional in section 228.1 which was 18 filed under the provisions of section 225.10 225.12 that it 19 would be appropriate for the person to be admitted to the 20 state psychiatric hospital, and the report of the regional 21 administrator made pursuant to section 225.13 shows the 22 department finds that the person and those who are legally 23 responsible for the person are not able to pay the expenses 24 incurred at the hospital, or are able to pay only a part of 25 the expenses, the person shall be considered to be a voluntary 26 public patient and the regional administrator shall direct that 27 the person shall be sent to the state psychiatric hospital at 28 the state university of Iowa for observation, treatment, and 29 hospital care. 30 Sec. 61. Section 225.17, subsection 2, Code 2024, is amended 31 to read as follows: 32 2. When the respondent arrives at the hospital, the 33 respondent shall receive the same treatment as is provided for 34 committed public patients in section 225.15 , in compliance 35 -35- HF 2673.4273.S (1) 90 mb 35/ 92
with sections 229.13 through 229.16 . However, observation, 1 treatment, and hospital care under this section of a respondent 2 whose expenses are payable in whole or in part by a county 3 shall only be provided as determined through the regional 4 administrator for the respondent’s county of residence. 5 Sec. 62. Section 225.18, Code 2024, is amended to read as 6 follows: 7 225.18 Attendants. 8 The regional administrator An administrative services 9 organization may appoint an attendant to accompany the 10 committed public patient or the voluntary public patient 11 or the committed private patient from the place where the 12 patient may be to the state psychiatric hospital, or to 13 accompany the patient from the hospital to a place as may 14 be designated by the regional administrator administrative 15 services organization . If a patient is moved pursuant to this 16 section , at least one attendant shall be of the same gender as 17 the patient. 18 Sec. 63. Section 225.22, Code 2024, is amended to read as 19 follows: 20 225.22 Liability of private patients —— payment. 21 Every committed private patient, if the patient has an 22 estate sufficient for that purpose, or if those legally 23 responsible for the patient’s support are financially able, 24 shall be liable to the county and state for all expenses paid 25 by them in the state on behalf of such patient. All bills 26 for the care, nursing, observation, treatment, medicine, and 27 maintenance of such patients shall be paid by the director of 28 the department of administrative services in the same manner as 29 those of committed and voluntary public patients as provided in 30 this chapter , unless the patient or those legally responsible 31 for the patient make such settlement with the state psychiatric 32 hospital. 33 Sec. 64. Section 225.24, Code 2024, is amended to read as 34 follows: 35 -36- HF 2673.4273.S (1) 90 mb 36/ 92
225.24 Collection of preliminary expense. 1 Unless a committed private patient or those legally 2 responsible for the patient’s support offer to settle the 3 amount of the claims, the regional administrator for the 4 person’s county of residence department shall collect, by 5 action if necessary, the amount of all claims for per diem and 6 expenses that have been approved by the regional administrator 7 for the county an administrative services organization and 8 paid by the regional administrator as provided under section 9 225.21 administrative services organization . Any amount 10 collected shall be credited to the mental health and disability 11 services region combined account created behavioral health fund 12 established in accordance with section 225C.58 225A.7 . 13 Sec. 65. Section 225.27, Code 2024, is amended to read as 14 follows: 15 225.27 Discharge —— transfer. 16 The state psychiatric hospital may, at any time, discharge 17 any patient as recovered, as improved, or as not likely to 18 be benefited by further treatment. If the patient being so 19 discharged was involuntarily hospitalized, the hospital shall 20 notify the committing judge or court of the discharge as 21 required by section 229.14 or section 229.16 , whichever is as 22 applicable , and the applicable regional administrator . Upon 23 receiving the notification, the court shall issue an order 24 confirming the patient’s discharge from the hospital or from 25 care and custody, as the case may be, and shall terminate the 26 proceedings pursuant to which the order was issued. The court 27 or judge shall, if necessary, appoint a person to accompany the 28 discharged patient from the state psychiatric hospital to such 29 place as the hospital or the court may designate, or authorize 30 the hospital to appoint such attendant. 31 Sec. 66. Section 226.1, subsection 4, Code 2024, is amended 32 by adding the following new paragraph: 33 NEW PARAGRAPH . 0a. “Administrative services organization” 34 means the same as defined in section 225A.1. 35 -37- HF 2673.4273.S (1) 90 mb 37/ 92
Sec. 67. Section 226.1, subsection 4, paragraphs d and f, 1 Code 2024, are amended by striking the paragraphs. 2 Sec. 68. Section 226.8, subsection 2, Code 2024, is amended 3 to read as follows: 4 2. Charges for the care of any person with a diagnosis of 5 an intellectual disability admitted to a state mental health 6 institute shall be made by the institute in the manner provided 7 by chapter 230 , but the liability of any other person to any 8 mental health and disability services region the state for the 9 cost of care of such person with a diagnosis of an intellectual 10 disability shall be as prescribed by section 222.78 . 11 Sec. 69. Section 226.32, Code 2024, is amended to read as 12 follows: 13 226.32 Overcrowded conditions. 14 The director shall order the discharge or removal from the 15 mental health institute of incurable and harmless patients 16 whenever it is necessary to make room for recent cases. If 17 a patient who is to be discharged entered the mental health 18 institute voluntarily, the director shall notify the regional 19 administrator for the county interested at least ten days in 20 advance of the day of actual discharge. 21 Sec. 70. Section 226.34, subsection 2, paragraph d, Code 22 2024, is amended by striking the paragraph. 23 Sec. 71. Section 228.6, subsection 1, Code 2024, is amended 24 to read as follows: 25 1. A mental health professional or an employee of or 26 agent for a mental health facility may disclose mental health 27 information if and to the extent necessary, to meet the 28 requirements of section 229.24 , 229.25 , 230.20 , 230.21 , 230.25 , 29 230.26 , 230A.108 , 232.74 , or 232.147 , or to meet the compulsory 30 reporting or disclosure requirements of other state or federal 31 law relating to the protection of human health and safety. 32 Sec. 72. Section 229.1, Code 2024, is amended by adding the 33 following new subsection: 34 NEW SUBSECTION . 01. “Administrative services organization” 35 -38- HF 2673.4273.S (1) 90 mb 38/ 92
means the same as defined in section 225A.1. 1 Sec. 73. Section 229.1, subsections 11, 18, and 19, Code 2 2024, are amended by striking the subsections. 3 Sec. 74. Section 229.1B, Code 2024, is amended to read as 4 follows: 5 229.1B Regional administrator Administrative services 6 organization . 7 Notwithstanding any provision of this chapter to the 8 contrary, any person whose hospitalization expenses are 9 payable in whole or in part by a mental health and disability 10 services region an administrative services organization 11 shall be subject to all administrative requirements of the 12 regional administrator for the county administrative services 13 organization . 14 Sec. 75. Section 229.2, subsection 1, paragraph b, 15 subparagraph (3), Code 2024, is amended to read as follows: 16 (3) As soon as is practicable after the filing of a 17 petition for juvenile court approval of the admission of the 18 minor, the juvenile court shall determine whether the minor 19 has an attorney to represent the minor in the hospitalization 20 proceeding, and if not, the court shall assign to the minor 21 an attorney. If the minor is financially unable to pay for 22 an attorney, the attorney shall be compensated by the mental 23 health and disability services region an administrative 24 services organization at an hourly rate to be established 25 by the regional administrator for the county in which the 26 proceeding is held administrative services organization in 27 substantially the same manner as provided in section 815.7 . 28 Sec. 76. Section 229.2, subsection 2, paragraph a, Code 29 2024, is amended to read as follows: 30 a. The chief medical officer of a public hospital shall 31 receive and may admit the person whose admission is sought, 32 subject in cases other than medical emergencies to availability 33 of suitable accommodations and to the provisions of sections 34 section 229.41 and 229.42 . 35 -39- HF 2673.4273.S (1) 90 mb 39/ 92
Sec. 77. Section 229.8, subsection 1, Code 2024, is amended 1 to read as follows: 2 1. Determine whether the respondent has an attorney 3 who is able and willing to represent the respondent in the 4 hospitalization proceeding, and if not, whether the respondent 5 is financially able to employ an attorney and capable of 6 meaningfully assisting in selecting one. In accordance with 7 those determinations, the court shall if necessary allow the 8 respondent to select, or shall assign to the respondent, an 9 attorney. If the respondent is financially unable to pay an 10 attorney, the attorney shall be compensated by the mental 11 health and disability services region an administrative 12 services organization at an hourly rate to be established 13 by the regional administrator for the county in which the 14 proceeding is held administrative services organization in 15 substantially the same manner as provided in section 815.7 . 16 Sec. 78. Section 229.10, subsection 1, paragraph a, Code 17 2024, is amended to read as follows: 18 a. An examination of the respondent shall be conducted by 19 one or more licensed physicians or mental health professionals, 20 as required by the court’s order, within a reasonable time. 21 If the respondent is detained pursuant to section 229.11, 22 subsection 1 , paragraph “b” , the examination shall be conducted 23 within twenty-four hours. If the respondent is detained 24 pursuant to section 229.11, subsection 1 , paragraph “a” or 25 “c” , the examination shall be conducted within forty-eight 26 hours. If the respondent so desires, the respondent shall be 27 entitled to a separate examination by a licensed physician or 28 mental health professional of the respondent’s own choice. The 29 reasonable cost of the examinations shall, if the respondent 30 lacks sufficient funds to pay the cost, be paid by the regional 31 administrator from mental health and disability services region 32 funds an administrative services organization upon order of the 33 court. 34 Sec. 79. Section 229.11, subsection 1, unnumbered paragraph 35 -40- HF 2673.4273.S (1) 90 mb 40/ 92
1, Code 2024, is amended to read as follows: 1 If the applicant requests that the respondent be taken into 2 immediate custody and the judge, upon reviewing the application 3 and accompanying documentation, finds probable cause to believe 4 that the respondent has a serious mental impairment and is 5 likely to injure the respondent or other persons if allowed 6 to remain at liberty, the judge may enter a written order 7 directing that the respondent be taken into immediate custody 8 by the sheriff or the sheriff’s deputy and be detained until 9 the hospitalization hearing. The hospitalization hearing shall 10 be held no more than five days after the date of the order, 11 except that if the fifth day after the date of the order is 12 a Saturday, Sunday, or a holiday, the hearing may be held 13 on the next succeeding business day. If the expenses of a 14 respondent are payable in whole or in part by a mental health 15 and disability services region an administrative services 16 organization , for a placement in accordance with paragraph “a” , 17 the judge shall give notice of the placement to the regional 18 administrator for the county in which the court is located an 19 administrative services organization , and for a placement in 20 accordance with paragraph “b” or “c” , the judge shall order 21 the placement in a hospital or facility designated through 22 the regional administrator by an administrative services 23 organization . The judge may order the respondent detained for 24 the period of time until the hearing is held, and no longer, 25 in accordance with paragraph “a” , if possible, and if not then 26 in accordance with paragraph “b” , or, only if neither of these 27 alternatives is available, in accordance with paragraph “c” . 28 Detention may be in any of the following: 29 Sec. 80. Section 229.13, subsection 1, paragraph a, Code 30 2024, is amended to read as follows: 31 a. The court shall order a respondent whose expenses are 32 payable in whole or in part by a mental health and disability 33 services region an administrative services organization 34 placed under the care of an appropriate hospital or facility 35 -41- HF 2673.4273.S (1) 90 mb 41/ 92
designated through the regional administrator for the county 1 by an administrative services organization on an inpatient or 2 outpatient basis. 3 Sec. 81. Section 229.13, subsection 7, paragraph b, Code 4 2024, is amended to read as follows: 5 b. A region An administrative services organization shall 6 contract with mental health professionals to provide the 7 appropriate treatment including treatment by the use of oral 8 medicine or injectable antipsychotic medicine pursuant to this 9 section . 10 Sec. 82. Section 229.14, subsection 2, paragraph a, Code 11 2024, is amended to read as follows: 12 a. For a respondent whose expenses are payable in whole 13 or in part by a mental health and disability services region 14 an administrative services organization , placement as 15 designated through the regional administrator for the county 16 by an administrative services organization in the care of an 17 appropriate hospital or facility on an inpatient or outpatient 18 basis, or other appropriate treatment, or in an appropriate 19 alternative placement. 20 Sec. 83. Section 229.14A, subsections 7 and 9, Code 2024, 21 are amended to read as follows: 22 7. If a respondent’s expenses are payable in whole or in 23 part by a mental health and disability services region through 24 the regional administrator for the county an administrative 25 services organization , notice of a placement hearing shall be 26 provided to the county attorney and the regional administrator 27 an administrative services organization . At the hearing, the 28 county may present evidence regarding appropriate placement. 29 9. A placement made pursuant to an order entered under 30 section 229.13 or 229.14 or this section shall be considered to 31 be authorized through the regional administrator for the county 32 by an administrative services organization . 33 Sec. 84. Section 229.15, subsection 4, Code 2024, is amended 34 to read as follows: 35 -42- HF 2673.4273.S (1) 90 mb 42/ 92
4. When a patient has been placed in an alternative facility 1 other than a hospital pursuant to a report issued under section 2 229.14, subsection 1 , paragraph “d” , a report on the patient’s 3 condition and prognosis shall be made to the court which placed 4 the patient, at least once every six months, unless the court 5 authorizes annual reports. If an evaluation of the patient is 6 performed pursuant to section 227.2, subsection 4 , a copy of 7 the evaluation report shall be submitted to the court within 8 fifteen days of the evaluation’s completion. The court may in 9 its discretion waive the requirement of an additional report 10 between the annual evaluations. If the department exercises 11 the authority to remove residents or patients from a county 12 care facility or other county or private facility under section 13 227.6 , the department shall promptly notify each court which 14 placed in that facility any resident or patient removed. 15 Sec. 85. Section 229.19, subsection 1, paragraphs a and b, 16 Code 2024, are amended to read as follows: 17 a. In each county the board of supervisors shall appoint 18 an individual who has demonstrated by prior activities an 19 informed concern for the welfare and rehabilitation of persons 20 with mental illness, and who is not an officer or employee of 21 the department , an officer or employee of a region, an officer 22 or employee of a county performing duties for a region, or 23 an officer or employee of any agency or facility providing 24 care or treatment to persons with mental illness, to act as an 25 advocate representing the interests of patients involuntarily 26 hospitalized by the court, in any matter relating to the 27 patients’ hospitalization or treatment under section 229.14 or 28 229.15 . 29 b. The committing court shall assign the advocate for the 30 county where the patient is located. A county or region may 31 seek reimbursement from the patient’s county of residence or 32 from the region in which the patient’s county of residence is 33 located an administrative services organization . 34 Sec. 86. Section 229.19, subsection 4, unnumbered paragraph 35 -43- HF 2673.4273.S (1) 90 mb 43/ 92
1, Code 2024, is amended to read as follows: 1 The state mental health and disability services commission 2 created in section 225C.5 department , in consultation with 3 advocates and county and judicial branch representatives, shall 4 adopt rules pursuant to chapter 17A relating to advocates that 5 include but are not limited to all of the following topics: 6 Sec. 87. Section 229.22, subsection 2, paragraph b, Code 7 2024, is amended to read as follows: 8 b. If the magistrate orders that the person be detained, 9 the magistrate shall, by the close of business on the next 10 working day, file a written order with the clerk in the county 11 where it is anticipated that an application may be filed 12 under section 229.6 . The order may be filed by facsimile if 13 necessary. A peace officer from the law enforcement agency 14 that took the person into custody, if no request was made 15 under paragraph “a” , may inform the magistrate that an arrest 16 warrant has been issued for or charges are pending against the 17 person and request that any written order issued under this 18 paragraph require the facility or hospital to notify the law 19 enforcement agency about the discharge of the person prior to 20 discharge. The order shall state the circumstances under which 21 the person was taken into custody or otherwise brought to a 22 facility or hospital, and the grounds supporting the finding 23 of probable cause to believe that the person is seriously 24 mentally impaired and likely to injure the person’s self or 25 others if not immediately detained. The order shall also 26 include any law enforcement agency notification requirements if 27 applicable. The order shall confirm the oral order authorizing 28 the person’s detention including any order given to transport 29 the person to an appropriate facility or hospital. A peace 30 officer from the law enforcement agency that took the person 31 into custody may also request an order, separate from the 32 written order, requiring the facility or hospital to notify the 33 law enforcement agency about the discharge of the person prior 34 to discharge. The clerk shall provide a copy of the written 35 -44- HF 2673.4273.S (1) 90 mb 44/ 92
order or any separate order to the chief medical officer of 1 the facility or hospital to which the person was originally 2 taken, to any subsequent facility to which the person was 3 transported, and to any law enforcement department, ambulance 4 service, or transportation service under contract with a 5 mental health and disability services region an administrative 6 services organization that transported the person pursuant 7 to the magistrate’s order. A transportation service that 8 contracts with a mental health and disability services region 9 an administrative services organization for purposes of this 10 paragraph shall provide a secure transportation vehicle and 11 shall employ staff that has received or is receiving mental 12 health training. 13 Sec. 88. Section 229.24, subsection 3, unnumbered paragraph 14 1, Code 2024, is amended to read as follows: 15 If all or part of the costs associated with hospitalization 16 of an individual under this chapter are chargeable to a county 17 of residence an administrative services organization , the 18 clerk of the district court shall provide to the regional 19 administrator for the county of residence and to the regional 20 administrator for the county in which the hospitalization 21 order is entered an administrative services organization the 22 following information pertaining to the individual which would 23 be confidential under subsection 1 : 24 Sec. 89. Section 229.38, Code 2024, is amended to read as 25 follows: 26 229.38 Cruelty or official misconduct. 27 If any person having the care of a person with mental illness 28 who has voluntarily entered a hospital or other facility for 29 treatment or care, or who is responsible for psychiatric 30 examination care, treatment, and maintenance of any person 31 involuntarily hospitalized under sections 229.6 through 229.15 , 32 whether in a hospital or elsewhere, with or without proper 33 authority, shall treat such patient with unnecessary severity, 34 harshness, or cruelty, or in any way abuse the patient or if 35 -45- HF 2673.4273.S (1) 90 mb 45/ 92
any person unlawfully detains or deprives of liberty any person 1 with mental illness or any person who is alleged to have mental 2 illness, or if any officer required by the provisions of this 3 chapter and chapters chapter 226 and 227 , to perform any act 4 shall willfully refuse or neglect to perform the same, the 5 offending person shall, unless otherwise provided, be guilty of 6 a serious misdemeanor. 7 Sec. 90. Section 230.1, Code 2024, is amended by adding the 8 following new subsection: 9 NEW SUBSECTION . 01. “Administrative service organization” 10 means the same as defined in section 225A.1. 11 Sec. 91. Section 230.1, subsections 4 and 5, Code 2024, are 12 amended by striking the subsections. 13 Sec. 92. Section 230.10, Code 2024, is amended to read as 14 follows: 15 230.10 Payment of costs. 16 All legal costs and expenses for the taking into custody, 17 care, investigation, and admission or commitment of a person to 18 a state mental health institute under a finding that the person 19 has residency in another county of this state shall be charged 20 against the regional administrator of the person’s county of 21 residence to an administrative services organization . 22 Sec. 93. Section 230.11, Code 2024, is amended to read as 23 follows: 24 230.11 Recovery of costs from state. 25 Costs and expenses for the taking into custody, care, and 26 investigation of a person who has been admitted or committed 27 to a state mental health institute, United States department 28 of veterans affairs hospital, or other agency of the United 29 States government, for persons with mental illness and 30 who has no residence in this state or whose residence is 31 unknown, including cost of commitment, if any, shall be paid 32 as approved by the department. The amount of the costs and 33 expenses approved by the department is appropriated to the 34 department from any moneys in the state treasury not otherwise 35 -46- HF 2673.4273.S (1) 90 mb 46/ 92
appropriated. Payment shall be made by the department on 1 itemized vouchers executed by the regional administrator of 2 the person’s county which has paid them, and approved by the 3 department. 4 Sec. 94. Section 230.15, subsections 1 and 2, Code 2024, are 5 amended to read as follows: 6 1. A person with mental illness and a person legally liable 7 for the person’s support remain liable for the support of 8 the person with mental illness as provided in this section . 9 Persons legally liable for the support of a person with mental 10 illness include the spouse of the person, and any person 11 bound by contract for support of the person. The regional 12 administrator of the person’s county of residence, subject to 13 the direction of the region’s governing board, shall enforce 14 the obligation created in this section as to all sums advanced 15 by the regional administrator. The liability to the regional 16 administrator incurred by a person with mental illness or a 17 person legally liable for the person’s support under this 18 section is limited to an amount equal to one hundred percent 19 of the cost of care and treatment of the person with mental 20 illness at a state mental health institute for one hundred 21 twenty days of hospitalization. This limit of liability may 22 be reached by payment of the cost of care and treatment of the 23 person with mental illness subsequent to a single admission 24 or multiple admissions to a state mental health institute or, 25 if the person is not discharged as cured, subsequent to a 26 single transfer or multiple transfers to a county care facility 27 pursuant to section 227.11 . After reaching this limit of 28 liability, a person with mental illness or a person legally 29 liable for the person’s support is liable to the regional 30 administrator state for the care and treatment of the person 31 with mental illness at a state mental health institute or, 32 if transferred but not discharged as cured, at a county care 33 facility in an amount not in excess of to exceed the average 34 minimum cost of the maintenance of an individual who is 35 -47- HF 2673.4273.S (1) 90 mb 47/ 92
physically and mentally healthy residing in the individual’s 1 own home , which standard shall be as established and may be 2 revised by the department by rule . A lien imposed by section 3 230.25 shall not exceed the amount of the liability which may 4 be incurred under this section on account of a person with 5 mental illness. 6 2. A person with a substance use disorder is legally 7 liable for the total amount of the cost of providing care, 8 maintenance, and treatment for the person with a substance 9 use disorder while a voluntary or committed patient. When 10 a portion of the cost is paid by a county an administrative 11 services organization , the person with a substance use disorder 12 is legally liable to the county administrative services 13 organization for the amount paid. The person with a substance 14 use disorder shall assign any claim for reimbursement under any 15 contract of indemnity, by insurance or otherwise, providing 16 for the person’s care, maintenance, and treatment in a state 17 mental health institute to the state. Any payments received 18 by the state from or on behalf of a person with a substance use 19 disorder shall be in part credited to the county in proportion 20 to the share of the costs paid by the county. 21 Sec. 95. NEW SECTION . 230.23 State —— payor of last resort. 22 The department shall implement services and adopt rules 23 pursuant to chapter 17A in a manner that ensures that the state 24 is the payor of last resort, and that the department does not 25 make any payments for services that have been provided until 26 the department has determined that the services provided are 27 not payable by a third-party source. 28 Sec. 96. Section 230.30, Code 2024, is amended to read as 29 follows: 30 230.30 Claim against estate. 31 On the death of a person receiving or who has received 32 assistance under the provisions of this chapter , and whom the 33 board department has previously found , under section 230.25 , 34 is able to pay , there shall be allowed against the estate of 35 -48- HF 2673.4273.S (1) 90 mb 48/ 92
such decedent a claim of the sixth class for that portion of 1 the total amount paid for that person’s care which exceeds 2 the total amount of all claims of the first through the fifth 3 classes, inclusive, as defined in section 633.425 , which are 4 allowed against that estate. 5 Sec. 97. Section 232.78, subsection 5, unnumbered paragraph 6 1, Code 2024, is amended to read as follows: 7 The juvenile court, before or after the filing of a petition 8 under this chapter , may enter an ex parte order authorizing 9 a physician or physician assistant or hospital to conduct an 10 outpatient physical examination or authorizing a physician or 11 physician assistant, a psychologist certified under section 12 154B.7, or a community mental health center accredited pursuant 13 to chapter 230A section 225A.3 to conduct an outpatient mental 14 examination of a child if necessary to identify the nature, 15 extent, and cause of injuries to the child as required by 16 section 232.71B , provided all of the following apply: 17 Sec. 98. Section 232.83, subsection 2, unnumbered paragraph 18 1, Code 2024, is amended to read as follows: 19 Anyone authorized to conduct a preliminary investigation in 20 response to a complaint may apply for, or the court on its own 21 motion may enter, an ex parte order authorizing a physician 22 or physician assistant or hospital to conduct an outpatient 23 physical examination or authorizing a physician or physician 24 assistant, a psychologist certified under section 154B.7, or a 25 community mental health center accredited pursuant to chapter 26 230A section 225A.3 to conduct an outpatient mental examination 27 of a child if necessary to identify the nature, extent, and 28 causes of any injuries, emotional damage, or other such needs 29 of a child as specified in section 232.96A, subsection 3, 5, or 30 6 , provided that all of the following apply: 31 Sec. 99. Section 235.7, subsection 2, Code 2024, is amended 32 to read as follows: 33 2. Membership. The department may authorize the governance 34 boards of decategorization of child welfare and juvenile 35 -49- HF 2673.4273.S (1) 90 mb 49/ 92
justice funding projects established under section 232.188 to 1 appoint the transition committee membership and may utilize 2 the boundaries of decategorization projects to establish 3 the service areas for transition committees. The committee 4 membership may include but is not limited to department staff 5 involved with foster care, child welfare, and adult services, 6 juvenile court services staff, staff involved with county 7 general assistance or emergency relief under chapter 251 or 8 252, or a regional administrator of the county mental health 9 and disability services region, as defined in section 225C.55, 10 in the area, school district and area education agency staff 11 involved with special education, and a child’s court appointed 12 special advocate, guardian ad litem, service providers, and 13 other persons knowledgeable about the child. 14 Sec. 100. Section 235A.15, subsection 2, paragraph c, 15 subparagraphs (5) and (8), Code 2024, are amended by striking 16 the subparagraphs. 17 Sec. 101. Section 249A.4, subsection 15, Code 2024, is 18 amended by striking the subsection. 19 Sec. 102. Section 249A.12, subsection 4, Code 2024, is 20 amended by striking the subsection. 21 Sec. 103. NEW SECTION . 249A.38A Supported community living 22 services. 23 1. As used in this section, “supported community living 24 service” means a service provided in a noninstitutional setting 25 to persons sixteen years of age and older with mental illness, 26 an intellectual disability, brain injury, or developmental 27 disabilities to meet the persons’ daily living needs. 28 2. The department shall adopt rules pursuant to chapter 17A 29 establishing minimum standards for supported community living 30 services. 31 3. The department shall determine whether to grant, deny, or 32 revoke approval for any supported community living service. 33 4. Approved supported community living services may receive 34 funding from the state, federal and state social services block 35 -50- HF 2673.4273.S (1) 90 mb 50/ 92
grant funds, and other appropriate funding sources, consistent 1 with state legislation and federal regulations. The funding 2 may be provided on a per diem, per hour, or grant basis, as 3 appropriate. 4 Sec. 104. Section 249N.8, Code 2024, is amended by striking 5 the section and inserting in lieu thereof the following: 6 249N.8 Behavioral health services reports. 7 The department shall annually submit a report to the 8 governor and the general assembly with details related to the 9 department’s review of the funds administered by, and the 10 outcomes and effectiveness of, the behavioral health services 11 provided by, the behavioral health service system established 12 in section 225A.3. 13 Sec. 105. Section 252.24, subsections 1 and 3, Code 2024, 14 are amended to read as follows: 15 1. The county of residence, as defined in section 225C.61 16 331.190 , shall be liable to the county granting assistance for 17 all reasonable charges and expenses incurred in the assistance 18 and care of a poor person. 19 3. This section shall apply to assistance or maintenance 20 provided by a county through the county’s mental health 21 and disability services behavioral health service system 22 implemented under chapter 225C established in section 225A.3 . 23 Sec. 106. Section 256.25, subsections 2 and 3, Code 2024, 24 are amended to read as follows: 25 2. A school district, which may collaborate and partner 26 with one or more school districts, area education agencies, 27 accredited nonpublic schools, nonprofit agencies, and 28 institutions that provide children’s mental health services, 29 located in mental health and disability services regions 30 providing children’s behavioral health services in accordance 31 with chapter 225C, subchapter VII operating within the state’s 32 behavioral health service system under chapter 225A , may apply 33 for a grant under this program to establish a therapeutic 34 classroom in the school district in accordance with this 35 -51- HF 2673.4273.S (1) 90 mb 51/ 92
section . 1 3. The department shall develop a grant application 2 and selection and evaluation criteria. Selection criteria 3 shall include a method for prioritizing grant applications 4 submitted by school districts. First priority shall be 5 given to applications submitted by school districts that 6 submitted an application pursuant to this section for the 7 previous immediately preceding fiscal year. Second priority 8 shall be given to applications submitted by school districts 9 that, pursuant to subsection 2 , are collaborating and 10 partnering with one or more school districts, area education 11 agencies, accredited nonpublic schools, nonprofit agencies, 12 or institutions that provide mental health services for 13 children. Third priority shall be given to applications 14 submitted by school districts located in mental health and 15 disability services regions behavioral health districts as 16 defined in section 225A.1, and that are providing behavioral 17 health services for children in accordance with chapter 225C, 18 subchapter VII 225A . Grant awards shall be distributed as 19 equitably as possible among small, medium, and large school 20 districts. For purposes of this subsection , a small school 21 district is a district with an actual enrollment of fewer than 22 six hundred pupils; a medium school district is a district 23 with an actual enrollment that is at least six hundred pupils, 24 but less than two thousand five hundred pupils; and a large 25 school district is a district with an actual enrollment of two 26 thousand five hundred or more pupils. 27 Sec. 107. Section 321.189, subsection 10, Code 2024, is 28 amended to read as follows: 29 10. Autism spectrum disorder status. A licensee who has 30 autism spectrum disorder, as defined in section 514C.28 , may 31 request that the license be marked to reflect the licensee’s 32 autism spectrum disorder status on the face of the license 33 when the licensee applies for the issuance or renewal of a 34 license. The department may adopt rules pursuant to chapter 35 -52- HF 2673.4273.S (1) 90 mb 52/ 92
17A establishing criteria under which a license may be marked, 1 including requiring the licensee to submit medical proof of the 2 licensee’s autism spectrum disorder status. When a driver’s 3 license is so marked, the licensee’s autism spectrum disorder 4 status shall be noted in the electronic database used by 5 the department and law enforcement to access registration, 6 titling, and driver’s license information. The department, in 7 consultation with the mental health and disability services 8 commission department of health and human services , shall 9 develop educational media to raise awareness of a licensee’s 10 ability to request the license be marked to reflect the 11 licensee’s autism spectrum disorder status. 12 Sec. 108. Section 321.190, subsection 1, paragraph b, 13 subparagraph (6), Code 2024, is amended to read as follows: 14 (6) An applicant for a nonoperator’s identification 15 card who has autism spectrum disorder, as defined in section 16 514C.28 , may request that the card be marked to reflect 17 the applicant’s autism spectrum disorder status on the face 18 of the card when the applicant applies for the issuance or 19 renewal of a card. The department may adopt rules pursuant to 20 chapter 17A establishing criteria under which a card may be 21 marked, including requiring the applicant to submit medical 22 proof of the applicant’s autism spectrum disorder status. 23 The department, in consultation with the mental health and 24 disability services commission department of health and human 25 services , shall develop educational media to raise awareness of 26 an applicant’s ability to request the card be marked to reflect 27 the applicant’s autism spectrum disorder status. 28 Sec. 109. Section 321J.25, subsection 1, paragraph b, Code 29 2024, is amended to read as follows: 30 b. “Program” means a substance use disorder awareness 31 program , licensed under chapter 125, and provided under a 32 contract entered into between the provider and the department 33 of health and human services under chapter 125 or an 34 administrative services organization as defined in section 35 -53- HF 2673.4273.S (1) 90 mb 53/ 92
225A.1 . 1 Sec. 110. Section 321J.25, subsection 2, unnumbered 2 paragraph 1, Code 2024, is amended to read as follows: 3 A substance use disorder awareness program is established 4 in each of the regions established by the director of health 5 and human services pursuant to section 125.12 behavioral 6 health district designated pursuant to section 225A.4 . The 7 program shall consist of an insight class and a substance 8 use disorder evaluation, which shall be attended by the 9 participant, to discuss issues related to the potential 10 consequences of substance use disorder. The parent or parents 11 of the participant shall also be encouraged to participate 12 in the program. The program provider shall consult with the 13 participant or the parents of the participant in the program 14 to determine the timing and appropriate level of participation 15 for the participant and any participation by the participant’s 16 parents. The program may also include a supervised educational 17 tour by the participant to any or all of the following: 18 Sec. 111. Section 331.321, subsection 1, paragraph e, Code 19 2024, is amended by striking the paragraph. 20 Sec. 112. Section 331.323, subsection 1, paragraph a, 21 subparagraph (7), Code 2024, is amended by striking the 22 subparagraph. 23 Sec. 113. Section 331.381, subsections 4 and 5, Code 2024, 24 are amended to read as follows: 25 4. Comply with chapter 222 , including but not limited to 26 sections 222.13 , 222.14 , 222.59 through 222.70 , 222.73 through 27 222.75 , and 222.77 through 222.82 , in regard to the care of 28 persons with an intellectual disability. 29 5. Comply with chapters 227, 229 and 230 , including but not 30 limited to sections 227.11 , 227.14 , 229.42 , 230.25 , 230.27 , and 31 230.35 , in regard to the care of persons with mental illness. 32 Sec. 114. Section 331.382, subsection 1, paragraphs e, f, 33 and g, Code 2024, are amended by striking the paragraphs. 34 Sec. 115. Section 331.382, subsection 3, Code 2024, is 35 -54- HF 2673.4273.S (1) 90 mb 54/ 92
amended by striking the subsection. 1 Sec. 116. Section 331.432, subsection 3, Code 2024, is 2 amended by striking the subsection. 3 Sec. 117. Section 331.502, subsection 10, Code 2024, is 4 amended by striking the subsection. 5 Sec. 118. Section 331.502, subsection 12, Code 2024, is 6 amended to read as follows: 7 12. Carry out duties relating to the hospitalization and 8 support of persons with mental illness as provided in sections 9 229.42, 230.3 , 230.11 , and 230.15 , 230.21 , 230.22 , 230.25 , and 10 230.26 . 11 Sec. 119. Section 331.552, subsection 13, Code 2024, is 12 amended by striking the subsection. 13 Sec. 120. Section 331.756, subsections 25, 38, and 41, Code 14 2024, are amended by striking the subsections. 15 Sec. 121. Section 331.910, subsection 2, Code 2024, is 16 amended by adding the following new paragraph: 17 NEW PARAGRAPH . 0a. “Administrative services organization” 18 means the same as defined in section 225A.1. 19 Sec. 122. Section 331.910, subsection 2, paragraph d, Code 20 2024, is amended by striking the paragraph. 21 Sec. 123. Section 331.910, subsection 3, paragraphs a and c, 22 Code 2024, are amended to read as follows: 23 a. A region An administrative services organization may 24 contract with a receiving agency in a bordering state to secure 25 substance use disorder or mental health care and treatment 26 under this subsection for persons who receive substance use 27 disorder or mental health care and treatment pursuant to 28 section 125.33, 125.91 , 229.2 , or 229.22 through a region . 29 c. A region An administrative services organization may 30 contract with a sending agency in a bordering state to provide 31 care and treatment under this subsection for residents of 32 the bordering state in approved substance use disorder and 33 mental health care and treatment hospitals, centers, and 34 facilities in this state, except that care and treatment shall 35 -55- HF 2673.4273.S (1) 90 mb 55/ 92
not be provided for residents of the bordering state who are 1 involved in criminal proceedings substantially similar to the 2 involvement described in paragraph “b” . 3 Sec. 124. Section 347.16, subsection 3, Code 2024, is 4 amended to read as follows: 5 3. Care and treatment may be furnished in a county public 6 hospital to any sick or injured person who has residence 7 outside the county which maintains the hospital, subject to 8 such policies and rules as the board of hospital trustees 9 may adopt. If care and treatment is provided under this 10 subsection to a person who is indigent, the person’s county of 11 residence, as defined in section 225C.61 331.190 , shall pay to 12 the board of hospital trustees the fair and reasonable cost of 13 the care and treatment provided by the county public hospital 14 unless the cost of the indigent person’s care and treatment is 15 otherwise provided for. If care and treatment is provided to 16 an indigent person under this subsection , the county public 17 hospital furnishing the care and treatment shall immediately 18 notify, by regular mail, the auditor of the county of residence 19 of the indigent person of the provision of care and treatment 20 to the indigent person including care and treatment provided 21 by a county through the county’s mental health and disability 22 services system implemented under chapter 225C behavioral 23 health service system established in section 225A.3 . 24 Sec. 125. Section 423.3, subsection 18, paragraph d, Code 25 2024, is amended to read as follows: 26 d. Community mental health centers accredited by the 27 department of health and human services pursuant to chapter 28 225C section 225A.3 . 29 Sec. 126. Section 426B.1, subsection 2, Code 2024, is 30 amended to read as follows: 31 2. Moneys shall be distributed from the property tax relief 32 fund to the mental health and disability services regional 33 service system for mental health and disability services, 34 behavioral health fund established in section 225A.7 in 35 -56- HF 2673.4273.S (1) 90 mb 56/ 92
accordance with the appropriations made to the fund and other 1 statutory requirements. 2 Sec. 127. Section 437A.8, subsection 4, paragraph d, Code 3 2024, is amended to read as follows: 4 d. (1) Notwithstanding paragraph “a” , a taxpayer who owns 5 or leases a new electric power generating plant and who has 6 no other operating property in the state of Iowa except for 7 operating property directly serving the new electric power 8 generating plant as described in section 437A.16 shall pay 9 the replacement generation tax associated with the allocation 10 of the local amount to the county treasurer of the county in 11 which the local amount is located and shall remit the remaining 12 replacement generation tax, if any, to the director according 13 to paragraph “a” for remittance of the tax to county treasurers. 14 The director shall notify each taxpayer on or before August 31 15 following a tax year of its remaining replacement generation 16 tax to be remitted to the director. All remaining replacement 17 generation tax revenues received by the director shall be 18 deposited in the property tax relief fund created in section 19 426B.1 , and shall be distributed as provided in section 426B.2 . 20 (2) If a taxpayer has paid an amount of replacement tax, 21 penalty, or interest which was deposited into the property tax 22 relief fund and which was not due, all of the provisions of 23 section 437A.14, subsection 1 , paragraph “b” , shall apply with 24 regard to any claim for refund or credit filed by the taxpayer. 25 The director shall have sole discretion as to whether the 26 erroneous payment will be refunded to the taxpayer or credited 27 against any replacement tax due, or to become due, from the 28 taxpayer that would be subject to deposit in the property tax 29 relief fund. 30 Sec. 128. Section 437A.15, subsection 3, paragraph f, Code 31 2024, is amended to read as follows: 32 f. Notwithstanding the provisions of this section , if 33 a taxpayer is a municipal utility or a municipal owner of 34 an electric power facility financed under the provisions 35 -57- HF 2673.4273.S (1) 90 mb 57/ 92
of chapter 28F or 476A , the assessed value, other than the 1 local amount, of a new electric power generating plant shall 2 be allocated to each taxing district in which the municipal 3 utility or municipal owner is serving customers and has 4 electric meters in operation in the ratio that the number of 5 operating electric meters of the municipal utility or municipal 6 owner located in the taxing district bears to the total number 7 of operating electric meters of the municipal utility or 8 municipal owner in the state as of January 1 of the tax year. 9 If the municipal utility or municipal owner of an electric 10 power facility financed under the provisions of chapter 28F 11 or 476A has a new electric power generating plant but the 12 municipal utility or municipal owner has no operating electric 13 meters in this state, the municipal utility or municipal owner 14 shall pay the replacement generation tax associated with the 15 new electric power generating plant allocation of the local 16 amount to the county treasurer of the county in which the local 17 amount is located and shall remit the remaining replacement 18 generation tax, if any, to the director at the times contained 19 in section 437A.8, subsection 4 , for remittance of the tax to 20 the county treasurers. All remaining replacement generation 21 tax revenues received by the director shall be deposited in the 22 property tax relief behavioral health fund created established 23 in section 426B.1, and shall be distributed as provided in 24 section 426B.2 225A.7 . 25 Sec. 129. Section 483A.24, subsection 7, Code 2024, is 26 amended to read as follows: 27 7. A license shall not be required of minor pupils of the 28 Iowa school for the deaf or of minor residents of other state 29 institutions under the control of the department of health 30 and human services. In addition, a person who is on active 31 duty with the armed forces of the United States, on authorized 32 leave from a duty station located outside of this state, and 33 a resident of the state of Iowa shall not be required to 34 have a license to hunt or fish in this state. The military 35 -58- HF 2673.4273.S (1) 90 mb 58/ 92
person shall carry the person’s leave papers and a copy of 1 the person’s current earnings statement showing a deduction 2 for Iowa income taxes while hunting or fishing. In lieu of 3 carrying the person’s earnings statement, the military person 4 may also claim residency if the person is registered to vote 5 in this state. If a deer or wild turkey is taken, the military 6 person shall immediately contact a state conservation officer 7 to obtain an appropriate tag to transport the animal. A 8 license shall not be required of residents of county care 9 facilities or any person who is receiving supplementary 10 assistance under chapter 249 . 11 Sec. 130. Section 602.8102, subsection 39, Code 2024, is 12 amended to read as follows: 13 39. Refer persons applying for voluntary admission to a 14 community mental health center accredited by the department 15 of health and human services under section 225A.3, for a 16 preliminary diagnostic evaluation as provided in section 17 225C.16, subsection 2 . 18 Sec. 131. Section 714.8, subsection 12, Code 2024, is 19 amended to read as follows: 20 12. Knowingly transfers or assigns a legal or equitable 21 interest in property, as defined in section 702.14 , for less 22 than fair consideration, with the intent to obtain public 23 assistance under chapters 16 , 35B , and 35D , and 347B , or Title 24 VI, subtitles 2 through 6 , or accepts a transfer of or an 25 assignment of a legal or equitable interest in property, as 26 defined in section 702.14 , for less than fair consideration, 27 with the intent of enabling the party transferring the property 28 to obtain public assistance under chapters 16 , 35B , and 35D , 29 and 347B , or Title VI, subtitles 2 through 6 . A transfer or 30 assignment of property for less than fair consideration within 31 one year prior to an application for public assistance benefits 32 shall be evidence of intent to transfer or assign the property 33 in order to obtain public assistance for which a person is 34 not eligible by reason of the amount of the person’s assets. 35 -59- HF 2673.4273.S (1) 90 mb 59/ 92
If a person is found guilty of a fraudulent practice in the 1 transfer or assignment of property under this subsection the 2 maximum sentence shall be the penalty established for a serious 3 misdemeanor and sections 714.9 , 714.10 , and 714.11 shall not 4 apply. 5 Sec. 132. Section 812.6, subsection 1, Code 2024, is amended 6 to read as follows: 7 1. If the court finds the defendant does not pose a danger 8 to the public peace and safety, is otherwise qualified for 9 pretrial release, and is willing to cooperate with treatment, 10 the court shall order, as a condition of pretrial release, 11 that the defendant obtain mental health treatment designed to 12 restore the defendant to competency. The costs of treatment 13 pursuant to this subsection shall be paid by the mental 14 health and disability services region for the county of the 15 defendant’s residency pursuant to chapter 225C regardless of 16 whether the defendant meets financial eligibility requirements 17 under section 225C.62 or 225C.66 an administrative services 18 organization designated pursuant to section 225A.4 . 19 Sec. 133. Section 904.201, subsection 8, Code 2024, is 20 amended to read as follows: 21 8. Chapter 230 governs the determination of costs and 22 charges for the care and treatment of persons with mental 23 illness admitted to the forensic psychiatric hospital , 24 except that charges for the care and treatment of any person 25 transferred to the forensic psychiatric hospital from an adult 26 correctional institution or from a state training school shall 27 be paid entirely from state funds . Charges for all other 28 persons at the forensic psychiatric hospital shall be billed to 29 the respective counties at the same ratio as for patients at 30 state mental health institutes under section 230.20. 31 Sec. 134. REPEAL. Chapters 142A, 225C, 227, 230A, and 347B, 32 Code 2024, are repealed. 33 Sec. 135. REPEAL. Sections 125.1, 125.3, 125.7, 125.9, 34 125.10, 125.12, 125.25, 125.32A, 125.34, 125.37, 125.38, 35 -60- HF 2673.4273.S (1) 90 mb 60/ 92
125.39, 125.40, 125.41, 125.42, 125.43, 125.43A, 125.46, 1 125.48, 125.54, 125.55, 125.58, 125.59, 125.60, 135B.18, 2 218.99, 222.59, 222.60, 222.61, 222.62, 222.63, 222.64, 222.65, 3 222.66, 222.67, 222.68, 222.69, 222.70, 222.74, 222.75, 225.10, 4 225.19, 225.21, 226.45, 229.42, 230.1A, 230.2, 230.3, 230.4, 5 230.5, 230.6, 230.9, 230.12, 230.16, 230.17, 230.18, 230.19, 6 230.20, 230.21, 230.22, 230.25, 230.26, 230.27, 426B.2, 426B.4, 7 and 426B.5, Code 2024, are repealed. 8 Sec. 136. CODE EDITOR DIRECTIVE. The Code editor is 9 directed to correct internal references in the Code and in any 10 enacted legislation as necessary due to the enactment of this 11 division of this Act. 12 Sec. 137. EFFECTIVE DATE. This division of this Act takes 13 effect July 1, 2025. 14 DIVISION III 15 AGING AND DISABILITY 16 Sec. 138. Section 231.3, Code 2024, is amended to read as 17 follows: 18 231.3 State policy and objectives. 19 1. The general assembly declares that it is the policy of 20 the state to work toward attainment of the following objectives 21 for Iowa’s older individuals and individuals with disabilities : 22 1. a. An adequate income. 23 2. b. Access to physical and mental health care and 24 long-term living and community support services without regard 25 to economic status. 26 3. c. Suitable and affordable housing that reflects the 27 needs of older individuals. 28 4. d. Access to comprehensive information and a community 29 navigation system providing all available options related to 30 long-term living and community support services that assist 31 older individuals in the preservation of personal assets and 32 the ability to entirely avoid or significantly delay reliance 33 on entitlement programs. 34 5. e. Full restorative services for those who require 35 -61- HF 2673.4273.S (1) 90 mb 61/ 92
institutional care, and a comprehensive array of long-term 1 living and community support services adequate to sustain older 2 people in their communities and, whenever possible, in their 3 homes, including support for caregivers. 4 6. f. Pursuit of meaningful activity within the widest 5 range of civic, cultural, educational, recreational, and 6 employment opportunities. 7 7. g. Suitable community transportation systems to assist 8 in the attainment of independent movement. 9 8. h. Freedom, independence, and the free exercise of 10 individual initiative in planning and managing their own lives. 11 9. i. Freedom from abuse, neglect, and exploitation. 12 2. The general assembly declares that the state of Iowa 13 recognizes a brain injury as a disability, and each agency and 14 subdivision of this state shall recognize a brain injury as a 15 distinct disability. 16 3. It is the policy of this state that each state agency 17 shall make reasonable efforts to identify those persons with 18 brain injuries among the persons served by the state agency. 19 Sec. 139. Section 231.4, subsection 1, Code 2024, is amended 20 by adding the following new paragraph: 21 NEW PARAGRAPH . 0c. “Brain injury” means the same as defined 22 in section 135.22. 23 Sec. 140. Section 231.4, subsection 1, paragraph d, Code 24 2024, is amended to read as follows: 25 d. “Commission” means the commission on aging. “Council” 26 means the council on health and human services created in 27 section 217.2. 28 Sec. 141. Section 231.14, Code 2024, is amended to read as 29 follows: 30 231.14 Commission Council duties and authority. 31 1. The commission is the policymaking body of the sole state 32 agency responsible for administration of the federal Act. The 33 commission council shall do all of the following : 34 a. 1. Approve Make recommendations to the department 35 -62- HF 2673.4273.S (1) 90 mb 62/ 92
regarding approval of the state plan on aging developed under 1 section 231.31 and area plans on aging , developed under section 2 231.33 . 3 b. 2. Adopt Recommend policies to coordinate state 4 activities related to the purposes of this chapter . 5 c. 3. Serve as an effective and visible advocate for older 6 individuals and individuals with disabilities by establishing 7 recommending policies for reviewing and commenting upon 8 all state plans, budgets, and policies which affect older 9 individuals and for providing technical assistance to any 10 agency, organization, association, or individual representing 11 the needs of older individuals with disabilities . 12 d. Divide the state into distinct planning and service 13 areas after considering the geographical distribution of 14 older individuals in the state, the incidence of the need 15 for supportive services, nutrition services, multipurpose 16 senior centers, and legal services, the distribution of older 17 individuals who have low incomes residing in such areas, the 18 distribution of resources available to provide such services 19 or centers, the boundaries of existing areas within the 20 state which are drawn for the planning or administration of 21 supportive services programs, the location of units of general 22 purpose, local government within the state, and any other 23 relevant factors. 24 e. Designate for each planning and service area a public or 25 private nonprofit agency or organization as the area agency on 26 aging for that area. The commission may revoke the designation 27 of an area agency on aging pursuant to section 231.32 . 28 f. 4. Adopt policies to assure Make recommendations to 29 ensure that the department will take into account the views 30 of older individuals and individuals with disabilities in the 31 development of policy. 32 g. Adopt a method for the distribution of federal 33 Act and state funds taking into account, to the maximum 34 extent feasible, the best available data on the geographic 35 -63- HF 2673.4273.S (1) 90 mb 63/ 92
distribution of older individuals in the state, and publish the 1 method for review and comment. 2 h. 5. Adopt Recommend policies and measures to assure 3 ensure that preference will be given to providing services to 4 older individuals and individuals with disabilities with the 5 greatest economic or social needs, with particular attention to 6 low-income minority older individuals, older individuals with 7 limited English proficiency, and older individuals residing in 8 rural areas. 9 i. 6. Adopt Recommend policies to administer state programs 10 authorized by this chapter . 11 j. 7. Adopt Recommend policies and administrative rules 12 pursuant to chapter 17A that support the capabilities of the 13 area agencies on aging and the aging and disabilities resource 14 centers to serve older individuals and persons individuals 15 with disabilities experiencing Alzheimer’s disease or related 16 dementias. 17 2. The commission shall adopt administrative rules pursuant 18 to chapter 17A to administer the duties specified in this 19 chapter and in all other chapters under the department’s 20 jurisdiction. 21 Sec. 142. Section 231.21, Code 2024, is amended to read as 22 follows: 23 231.21 Administration of chapter —— department of health and 24 human services. 25 The department of health and human services shall administer 26 this chapter under the policy direction of the commission 27 on aging consider the recommendations of the council when 28 administering this chapter . 29 Sec. 143. Section 231.23, Code 2024, is amended to read as 30 follows: 31 231.23 Department —— duties and authority. 32 The department shall: 33 1. Develop and administer a Administer the state plan on 34 aging developed pursuant to section 231.31 . 35 -64- HF 2673.4273.S (1) 90 mb 64/ 92
2. Assist the commission in the review and approval of 1 Review and approve area plans developed under section 231.33 . 2 3. Pursuant to commission policy, coordinate Coordinate 3 state activities related to the purposes of this chapter and 4 all other chapters under the department’s jurisdiction . 5 State activities shall include, at a minimum, home and 6 community-based services such as employment support, community 7 living, and service coordination. 8 4. Advocate for older individuals and individuals with 9 disabilities by reviewing and commenting upon all state plans, 10 budgets, laws, rules, regulations, and policies which affect 11 older individuals or individuals with disabilities and by 12 providing technical assistance to any agency, organization, 13 association, or individual representing the needs of older 14 individuals or individuals with disabilities . 15 5. Assist the commission in dividing Divide the state into 16 distinct planning and service areas after considering the 17 geographical distribution of older individuals and individuals 18 with disabilities in the state, the incidence of the need 19 for supportive services, nutrition services, multipurpose 20 senior centers, and legal services, the distribution of older 21 individuals and individuals with disabilities with low income 22 residing in such areas, the distribution of resources available 23 to provide such services or centers, the boundaries of existing 24 areas within the state which are drawn for the planning or 25 administration of supportive services programs, the location of 26 units of general purpose, local government within the state, 27 and any other relevant factors . 28 6. Assist the commission in designating Designate for each 29 area a public or private nonprofit agency or organization as 30 the area agency on aging for that area. The department may 31 revoke the designation of an area agency on aging pursuant to 32 section 231.32. 33 7. Pursuant to commission policy, take Take into account the 34 views of older Iowans and Iowans with disabilities . 35 -65- HF 2673.4273.S (1) 90 mb 65/ 92
8. Assist the commission in adopting Adopt a method for 1 the distribution of funds available from the federal Act 2 and state appropriations and allocations that takes into 3 account, to the extent feasible, the best available data on the 4 geographic distribution of older individuals and individuals 5 with disabilities in the state . 6 9. Assist the commission in assuring Adopt policies and 7 measures to ensure that preference will be given to providing 8 services to older individuals and individuals with disabilities 9 with the greatest economic or social needs, with particular 10 attention to low-income minority older individuals, older 11 individuals with limited English proficiency, and older 12 individuals residing in rural areas. 13 10. Assist the commission in developing, adopting, and 14 enforcing Develop, adopt, and enforce administrative rules, 15 including by issuing necessary forms and procedures , to 16 administer the duties specified in this chapter . 17 11. Apply for, receive, and administer grants, devises, 18 donations, and gifts , or bequests of real or personal property 19 from any source to conduct projects consistent with the 20 purposes of the department. Notwithstanding section 8.33 , 21 moneys received by the department pursuant to this section are 22 not subject to reversion to the general fund of the state. 23 12. Administer state authorized programs. 24 13. Establish a procedure for an area agency on aging to 25 use in selection of members of the agency’s board of directors. 26 The selection procedure shall be incorporated into the bylaws 27 of the board of directors. 28 14. Adopt rules pursuant to chapter 17A that support the 29 capabilities of the area agencies on aging, and aging and 30 disabilities resource centers, to serve older individuals and 31 individuals with disabilities. 32 Sec. 144. Section 231.23A, subsections 1 and 3, Code 2024, 33 are amended to read as follows: 34 1. Services for older individuals, persons with 35 -66- HF 2673.4273.S (1) 90 mb 66/ 92
disabilities eighteen years of age and older, family 1 caregivers, and veterans as defined by the department in the 2 most current version of the department’s reporting manual and 3 pursuant to the federalAct and regulations. 4 3. The aging Aging and disability resource center centers . 5 Sec. 145. Section 231.23A, Code 2024, is amended by adding 6 the following new subsection: 7 NEW SUBSECTION . 7A. Services and supports available to 8 individuals with disabilities including but not limited to 9 individuals with mental illness, an intellectual disability or 10 other developmental disability, or a brain injury. 11 Sec. 146. Section 231.31, Code 2024, is amended to read as 12 follows: 13 231.31 State plan on aging. 14 The department shall develop , and submit to the commission 15 on aging for approval, a multiyear state plan on aging. 16 The state plan on aging shall meet all applicable federal 17 requirements. 18 Sec. 147. Section 231.32, Code 2024, is amended to read as 19 follows: 20 231.32 Criteria for designation of area agencies on aging. 21 1. The commission department shall designate an area 22 agency on aging for each planning and service area. The 23 commission shall continue the designation shall continue until 24 an area agency on aging’s designation is removed for cause as 25 determined by the commission department , until the time of 26 renewal or the annual update of an area plan, until the agency 27 voluntarily withdraws as an area agency on aging, or until a 28 change in the designation of planning and service areas or area 29 agencies on aging is required by state or federal law. In that 30 event, the commission department shall proceed in accordance 31 with subsections 2, 3, and 4 . Designated area agencies on 32 aging shall comply with the requirements of the federal Act. 33 2. The commission department shall designate an area 34 agency on aging to serve each planning and service area, after 35 -67- HF 2673.4273.S (1) 90 mb 67/ 92
consideration of the views offered by units of general purpose 1 local government. An area agency on aging may be: 2 a. An established office of aging which is operating within 3 a planning and service area designated by the commission 4 department . 5 b. Any office or agency of a unit of general purpose local 6 government, which is designated to function only for the 7 purpose of serving as an area agency on aging by the chief 8 elected official of such unit. 9 c. Any office or agency designated by the appropriate 10 chief elected officials of any combination of units of 11 general purpose local government to act only on behalf of such 12 combination for such purpose. 13 d. Any public or nonprofit private agency in a planning and 14 service area or any separate organizational unit within such 15 agency which is under the supervision or direction for this 16 purpose of the department and which can and will engage only in 17 the planning or provision of a broad range of long-term living 18 and community support services or nutrition services within the 19 planning and service area. 20 3. When the commission department designates a new area 21 agency on aging , the commission department shall give the right 22 of first refusal to a unit of general purpose local government 23 if: 24 a. Such unit can meet the requirements of subsection 1 . 25 b. The boundaries of such a unit and the boundaries of the 26 area are reasonably contiguous. 27 4. Each area agency on aging shall provide assurance, 28 determined adequate by the commission department , that the 29 area agency on aging has the ability to develop an area plan 30 and to carry out, directly or through contractual or other 31 arrangements, a program in accordance with the plan within the 32 planning and service area. In designating an area agency on 33 aging within the planning and service area, the commission 34 department shall give preference to an established office of 35 -68- HF 2673.4273.S (1) 90 mb 68/ 92
aging, unless the commission department finds that no such 1 office within the planning and service area has the capacity to 2 carry out the area plan. 3 5. Upon designation, an area agency on aging shall be 4 considered an instrumentality of the state and shall adhere to 5 all state and federal mandates applicable to an instrumentality 6 of the state. 7 Sec. 148. Section 231.33, subsections 1 and 13, Code 2024, 8 are amended to read as follows: 9 1. Develop and administer an area plan on aging approved by 10 the commission department . 11 13. Submit all fiscal and performance reports in accordance 12 with the policies of the commission department . 13 Sec. 149. NEW SECTION . 231.35 Procedures related to 14 expenditure of state and federal funds. 15 1. The department shall establish and enforce procedures 16 relating to expenditure of state and federal funds by area 17 agencies on aging that require compliance with both state and 18 federal laws, rules, and regulations, including but not limited 19 to all of the following: 20 a. Requiring that expenditures are incurred only for goods 21 or services received or performed prior to the end of the 22 fiscal period designated for use of the funds. 23 b. Prohibiting prepayment for goods or services not received 24 or performed prior to the end of the fiscal period designated 25 for use of the funds. 26 c. Prohibiting prepayment for goods or services not defined 27 specifically by good or service, time period, or recipient. 28 d. Prohibiting the establishment of accounts from which 29 future goods or services which are not defined specifically by 30 good or service, time period, or recipient, may be purchased. 31 2. The procedures shall provide that if any funds are 32 expended in a manner that is not in compliance with the 33 procedures and applicable federal and state laws, rules, and 34 regulations, and are subsequently subject to repayment, the 35 -69- HF 2673.4273.S (1) 90 mb 69/ 92
area agency on aging expending such funds in contravention of 1 such procedures, laws, rules and regulations, not the state, 2 shall be liable for such repayment. 3 Sec. 150. Section 231.56, Code 2024, is amended to read as 4 follows: 5 231.56 Services and programs. 6 The department shall administer long-term living and 7 community support services and programs that allow older 8 individuals and individuals with disabilities to secure and 9 maintain maximum independence and dignity in a home environment 10 that provides for self-care with appropriate supportive 11 services, assist in removing individual and social barriers 12 to economic and personal independence for older individuals 13 and individuals with disabilities , and provide a continuum of 14 care for older individuals and individuals with disabilities. 15 Funds appropriated for this purpose shall be allocated based 16 on administrative rules adopted by the commission department 17 pursuant to chapter 17A . The department shall require such 18 records as needed adopt rules pursuant to chapter 17A that 19 allow the department to collect information as necessary from 20 long-term living and community support services, program 21 providers, and patients to administer this section . 22 Sec. 151. Section 231.57, Code 2024, is amended to read as 23 follows: 24 231.57 Coordination of advocacy. 25 The department shall administer a program for the 26 coordination of information and assistance provided within 27 the state to assist older individuals and individuals with 28 disabilities, and their caregivers , in obtaining and protecting 29 their rights and benefits. State and local agencies providing 30 information and assistance to older individuals and individuals 31 with disabilities, and their caregivers , in seeking their 32 rights and benefits shall cooperate with the department in 33 administering this program. 34 Sec. 152. Section 231.58, Code 2024, is amended to read as 35 -70- HF 2673.4273.S (1) 90 mb 70/ 92
follows: 1 231.58 Long-term living coordination. 2 The director may convene meetings, as necessary, of the 3 director and the director of inspections, appeals, and 4 licensing, to assist in the coordination of policy, service 5 delivery, and long-range planning relating to the long-term 6 living system and older Iowans and Iowans with disabilities 7 in the state. The group may consult with individuals, 8 institutions, and entities with expertise in the area of the 9 long-term living system and older Iowans and Iowans with 10 disabilities , as necessary, to facilitate the group’s efforts. 11 Sec. 153. Section 231.64, Code 2024, is amended to read as 12 follows: 13 231.64 Aging and disability resource center centers . 14 1. The aging and disability resource center shall be 15 administered by the department consistent with the federal Act . 16 The department shall designate area agencies on aging and 17 disability resource centers to establish, in consultation with 18 other stakeholders including organizations representing the 19 disability community, a coordinated local aging and disability 20 service system for providing . In addition to services required 21 by the department by rules adopted pursuant to chapter 17A, 22 aging and disability resource centers shall provide for all of 23 the following: 24 a. Comprehensive information, referral, and assistance 25 regarding the full range of available public and private 26 long-term living and community support services, options, 27 service providers, and resources within a community, including 28 information on the availability of integrated long-term care. 29 b. Options counseling to assist individuals in assessing 30 their existing or anticipated long-term care needs and 31 developing and implementing a plan for long-term living and 32 community support services designed to meet their specific 33 needs and circumstances. The plan for long-term living 34 and community support services may include support with 35 -71- HF 2673.4273.S (1) 90 mb 71/ 92
person-centered care transitions to assist consumers and family 1 caregivers with transitions between home and care settings. 2 c. Consumer access to the range of publicly-supported 3 long-term living and community support services for which 4 consumers may be eligible, by serving as a convenient point 5 of entry for such services. The aging Aging and disability 6 resource center centers shall offer information online and 7 be available via a toll-free telephone number, electronic 8 communications, and in person. 9 2. The following entities shall be eligible to be designated 10 as an aging and disability resource center by the department: 11 a. An area agency on aging established on or before June 30, 12 2024. 13 b. A public or private nonprofit agency, or any separate 14 organizational unit within the public or private nonprofit 15 agency, that has the capabilities to engage in the planning or 16 provision of aging and disability services only as directed by 17 the department. 18 2. 3. The aging Aging and disability resource center 19 centers shall assist older individuals, persons individuals 20 with disabilities age eighteen or older , family caregivers, 21 and people who inquire about or request assistance on behalf 22 of members of these groups, as they seek long-term living and 23 community support services. 24 4. The department shall adopt rules pursuant to chapter 17A 25 to implement this section. 26 Sec. 154. NEW SECTION . 231.75 Scope. 27 The service quality standards and rights in this subchapter 28 VII shall apply to any person with an intellectual disability, 29 a developmental disability, brain injury, or chronic mental 30 illness who receives services which are funded in whole or in 31 part by public funds, or services which are permitted under 32 Iowa law. 33 Sec. 155. NEW SECTION . 231.76 Service quality standards. 34 As the state participates more fully in funding services 35 -72- HF 2673.4273.S (1) 90 mb 72/ 92
and other support for persons with an intellectual disability, 1 developmental disability, brain injury, or chronic mental 2 illness, it is the intent of the general assembly that the 3 state shall seek to attain the following quality standards in 4 the provision of services and other supports: 5 1. Provide comprehensive evaluation and diagnosis adapted 6 to the cultural background, primary language, and ethnic origin 7 of a person. 8 2. Provide an individual treatment, habilitation, and 9 program services plan. 10 3. Provide treatment, habilitation, and program services 11 that are individualized, flexible, cost-effective, and produce 12 results. 13 4. Provide periodic review of an individual’s treatment, 14 habilitation, and program services plan. 15 5. Provide for the least restrictive environment, and 16 age-appropriate services. 17 6. Provide appropriate training and employment 18 opportunities so that a person’s ability to contribute to, and 19 participate in, the community is maximized. 20 7. Provide an ongoing process to determine the degree of 21 access to, and the effectiveness of, the services and other 22 supports in achieving the disability service outcomes and 23 indicators identified by the department. 24 Sec. 156. NEW SECTION . 231.77 Rights. 25 All of the following rights shall apply to a person with an 26 intellectual disability, a developmental disability, a brain 27 injury, or a chronic mental illness: 28 1. Wage protection. A person engaged in a work program 29 shall be paid wages commensurate with the going rate for 30 comparable work and productivity. 31 2. Insurance protection. Pursuant to section 507B.4, 32 subsection 3, paragraph “g” , a person or designated group 33 of persons shall not be unfairly discriminated against for 34 purposes of insurance coverage. 35 -73- HF 2673.4273.S (1) 90 mb 73/ 92
3. Citizenship. A person retains the right to citizenship 1 in accordance with the laws of the state. 2 4. Participation in planning activities. A person has 3 the right to participate in the formulation of an individual 4 treatment, habilitation, and program plan developed for the 5 person. 6 Sec. 157. NEW SECTION . 231.78 Compliance. 7 1. A person’s sole remedy for a violation of a rule adopted 8 by the department to implement sections 231.75 through 231.77 9 shall be to initiate a proceeding with the department by 10 request pursuant to chapter 17A. 11 a. Any decision of the department shall be in accordance 12 with due process of law. A person or party who is aggrieved or 13 adversely affected by the department’s action may seek judicial 14 review pursuant to section 17A.19. A person or party who is 15 aggrieved or adversely affected by a final judgment of the 16 district court may appeal under section 17A.20. 17 b. Either the department or a party in interest may apply 18 to the Iowa district court for an order to enforce a final 19 decision of the department. 20 2. Any rules adopted by the department to implement sections 21 231.76 and 231.77 shall not create any right, entitlement, 22 property or liberty right or interest, or private cause of 23 action for damages against the state or a political subdivision 24 of the state, or for which the state or a political subdivision 25 of the state would be responsible. 26 3. Notwithstanding subsection 1, any violation of section 27 231.77, subsection 2, shall be subject to enforcement by the 28 commissioner of insurance pursuant to chapter 507B. 29 Sec. 158. NEW SECTION . 231.79 Appeals process. 30 The department shall establish an appeals process by which a 31 person or the person’s representative may appeal a decision of 32 the department concerning the provision or denial of aging or 33 disability services to the person. 34 Sec. 159. Section 231E.3, Code 2024, is amended to read as 35 -74- HF 2673.4273.S (1) 90 mb 74/ 92
follows: 1 231E.3 Definitions. 2 As used in this chapter , unless the context otherwise 3 requires: 4 1. “Client” means an individual for whom a representative 5 payee is appointed. 6 2. “Commission” means the commission on aging. 7 3. 2. “Conservator” means conservator as defined in section 8 633.3 . 9 4. 3. “Court” means court as defined in section 633.3 . 10 5. 4. “Department” means the department of health and human 11 services. 12 6. 5. “Director” means the director of health and human 13 services. 14 7. 6. “Guardian” means guardian as defined in section 15 633.3 . 16 8. 7. “Incompetent” means incompetent as defined in section 17 633.3 . 18 9. 8. “Local office” means a local office of public 19 guardian. 20 10. 9. “Local public guardian” means an individual under 21 contract with the department to act as a guardian, conservator, 22 or representative payee. 23 11. 10. “Public guardian” means the state public guardian 24 or a local public guardian. 25 12. 11. “Public guardianship services” means guardianship, 26 conservatorship, or representative payee services provided by 27 the state public guardian or a local public guardian. 28 13. 12. “Representative payee” means an individual 29 appointed by a government entity to receive funds on behalf of 30 a client pursuant to federal regulation. 31 14. 13. “State agency” means any executive department, 32 commission, board, institution, division, bureau, office, 33 agency, or other executive entity of state government. 34 15. 14. “State office” means the state office of public 35 -75- HF 2673.4273.S (1) 90 mb 75/ 92
guardian. 1 16. 15. “State public guardian” means the administrator of 2 the state office of public guardian. 3 17. 16. “Ward” means the individual for whom a guardianship 4 or conservatorship is established. 5 Sec. 160. REPEAL. Sections 231.11, 231.12, and 231.13, Code 6 2024, are repealed. 7 Sec. 161. CODE EDITOR DIRECTIVE. The Code editor is 8 directed to do all of the following: 9 1. Entitle Code chapter 231 “Department of Health and Human 10 Services —— Aging and Disability Services”. 11 2. Designate sections 231.75 through 231.79, as enacted in 12 this division of this Act, as subchapter VII entitled “Bill 13 of Rights and Service Quality Standards for Persons with an 14 Intellectual Disability, Developmental Disability, Brain 15 Injury, or Chronic Mental Illness”. 16 3. Correct internal references in the Code and in any 17 enacted legislation as necessary due to the enactment of this 18 division of this Act. 19 Sec. 162. EFFECTIVE DATE. The following take effect July 20 1, 2025: 21 1. The parts of the sections of this division of this Act 22 amending the following: 23 a. Section 231.3. 24 b. Section 231.4, subsection 1. 25 c. Section 231.23, subsections 4 and 7. 26 d. Section 231.23A, subsection 1. 27 e. Sections 231.56, 231.57, and 231.58. 28 f. Section 231.64, subsection 2. 29 2. The parts of the sections of this division of this Act 30 enacting the following: sections 231.23A, subsection 7A, 31 231.75, 231.76, 231.77, 231.78, and 231.79. 32 DIVISION IV 33 TRANSITION PROVISIONS 34 Sec. 163. DEPARTMENT OF HEALTH AND HUMAN SERVICES —— 35 -76- HF 2673.4273.S (1) 90 mb 76/ 92
TRANSITION OF MENTAL HEALTH SERVICES, ADDICTIVE DISORDER 1 SERVICES, AND DISABILITY SERVICES. 2 1. For purposes of this division: 3 a. “Administrative services organization” means the same 4 as defined in section 225A.1, as enacted in division I of this 5 Act. 6 b. “Behavioral health district” means the same as defined in 7 section 225A.1, as enacted in division I of this Act. 8 c. “Department” means the department of health and human 9 services. 10 d. “District behavioral health service system plan” means 11 the same as defined in section 225A.1, as enacted in division 12 I of this Act. 13 e. “Mental health and disability services region” means the 14 same as defined in section 225C.2, subsection 9. 15 f. “State behavioral health service system” means the state 16 behavioral health service system as established in section 17 225A.3, as enacted in division I of this Act. 18 g. “State behavioral health service system plan” means the 19 same as defined in section 225A.1, as enacted in division I of 20 this Act. 21 h. “Transition period” means the period beginning on the 22 date of enactment of this division of this Act and concluding 23 on June 30, 2025. 24 2. There is created a behavioral health service system under 25 the control of the department. For the fiscal year beginning 26 July 1, 2025, and each succeeding fiscal year, the behavioral 27 health service system shall be responsible for implementing and 28 maintaining a statewide system of prevention, education, early 29 intervention, treatment, recovery support, and crisis services 30 related to mental health and addictive disorders, including 31 but not limited to substance use, tobacco use, and problem 32 gambling. For the fiscal year beginning July 1, 2025, and each 33 succeeding fiscal year, the department’s division of aging 34 and disability services shall be responsible for disability 35 -77- HF 2673.4273.S (1) 90 mb 77/ 92
services. 1 3. During the transition period, the department may 2 exercise all policymaking functions and regulatory powers 3 established in division I of this Act, as necessary to 4 establish the state behavioral health service system. 5 4. To ensure the state behavioral health service system 6 and the division of aging and disability services are able to 7 operate as intended at the conclusion of the transition period, 8 the department shall perform all the following duties: 9 a. Make contracts as necessary to set up services and 10 administrative functions. 11 b. Adopt rules as necessary to establish and administer the 12 state’s behavioral health service system. 13 c. Establish policies as necessary to ensure efficient 14 implementation and operation of the behavioral health service 15 system. 16 d. Prepare forms necessary for the implementation and 17 administration of behavioral health services. 18 e. Prepare a state behavioral health service system plan for 19 the state behavioral health service system. 20 f. Designate behavioral health districts on or before 21 August 1, 2024. The behavioral health district designation 22 process shall include an opportunity for the public to 23 review and to comment on proposed behavioral health district 24 boundaries. 25 g. Designate an administrative services organization for 26 each behavioral health district on or before December 31, 2024. 27 h. Review and approve district behavioral health service 28 system plans for services related to the behavioral health 29 service system. 30 i. Issue all necessary licenses and certifications. 31 j. Establish contractual rights, privileges, and 32 responsibilities as necessary to establish and implement the 33 state behavioral health service system. 34 k. Develop and implement a plan to ensure that persons 35 -78- HF 2673.4273.S (1) 90 mb 78/ 92
currently receiving disability services or early intervention, 1 treatment, recovery support, or crisis services related 2 to mental health or addictive disorders, including but not 3 limited to alcohol use, substance use, tobacco use, and problem 4 gambling, have an uninterrupted continuum of care. 5 l. Establish a central data repository as described in 6 section 225A.6, as enacted in division I of this Act. 7 m. Collaborate with the department of revenue for 8 enforcement of tobacco laws, regulations, and ordinances and 9 engage in tobacco control activities. 10 n. Submit a report to the general assembly no later 11 than January 13, 2025, that details the administrative and 12 operational costs for the establishment, implementation, and 13 administration of the state behavioral health service system. 14 5. If the department determines that a federal waiver or 15 authorization is necessary to administer any provision of this 16 division of this Act or to effectuate the state behavioral 17 health service system by the conclusion of the transition 18 period, the department shall timely request the federal waiver 19 or authorization. Notwithstanding any other effective date to 20 the contrary, a provision the department determines requires a 21 federal waiver or authorization shall be effective only upon 22 receipt of federal approval for the waiver or authorization. 23 6. a. On or before July 1, 2024, the department shall 24 publish on the department’s internet site an initial transition 25 plan for establishing the state behavioral health service 26 system. The transition plan shall describe, at a minimum, all 27 of the following: 28 (1) All tasks that require completion before July 1, 2025. 29 The description of tasks shall include a description of how the 30 department will solicit comments from stakeholders, including 31 employees of the department, persons served by the department, 32 partners of the department, members of the public, and members 33 of the general assembly, and a detailed timeline for the 34 completion of the tasks described. 35 -79- HF 2673.4273.S (1) 90 mb 79/ 92
(2) The proposed organizational structure of the state 1 behavioral health service system. 2 (3) The transition of service delivery sites from locations 3 where people currently receive behavioral health services to 4 where the people will receive behavioral health services under 5 the state behavioral health service system. 6 (4) Procedures for the transfer and reconciliation of 7 budgeting and funding between the mental health and disability 8 services regions and the department. 9 (5) A description of how responsibilities for disability 10 services programs will be transferred from current program 11 administrators to the department’s division of aging and 12 disability services by the end of the transition period. 13 (6) Any additional known tasks that may require completion 14 after the transition on July 1, 2025. 15 b. The transition plan published under paragraph “a” shall: 16 (1) Be updated no less than quarterly during the transition 17 period with the current status of completing the tasks 18 identified in paragraph “a”, subparagraph (1). 19 (2) Describe how information regarding any changes in 20 service delivery will be provided to persons receiving services 21 from the mental health and disability services regions or 22 current behavioral health care providers contracted with the 23 department. 24 (3) Describe how the transition is being funded, including 25 how expenses associated with the transition will be managed. 26 7. a. Before the end of the transition period, the 27 governing board of each mental health and disability services 28 region that maintains a combined account pursuant to section 29 225C.58, subsection 1, shall transfer all unencumbered and 30 unobligated moneys remaining in the combined account to the 31 treasurer of state for deposit into the behavioral health fund 32 as established in section 225A.7 as enacted in division I of 33 this Act. 34 b. Before the end of the transition period, each county 35 -80- HF 2673.4273.S (1) 90 mb 80/ 92
which maintains a county mental health and disability services 1 fund pursuant to section 225C.58, subsection 1, shall transfer 2 all unencumbered and unobligated moneys remaining in the mental 3 health and disability services fund to the treasurer of state 4 for deposit into the behavioral health fund as established in 5 section 225A.7 as enacted in division I of this Act. 6 c. Moneys in the behavioral health fund as established 7 in section 225A.7 as enacted in division I of this Act are 8 appropriated to the department for the purposes established in 9 section 225A.7 as enacted in division I of this Act, and as 10 otherwise necessary to effectuate this division of this Act. 11 8. a. All debts, claims, or other liabilities owed to a 12 county, a mental health and disability services region, or 13 the state due to services rendered pursuant to chapter 125, 14 222, 225, 225C, 226, 227, 229, 230, or 230A, Code 2024, at the 15 conclusion of the transition period shall remain due and owing 16 after the transition period concludes. 17 b. After the transition period concludes, each county 18 auditor shall collect outstanding debts, claims, or other 19 liabilities owed to the county for services rendered pursuant 20 to chapter 125, 222, 225, 225C, 226, 227, 229, 230, or 230A, 21 Code 2024, before the transition period concluded. The county 22 attorney may bring a judicial action as necessary to collect 23 the outstanding debts, claims, or other liabilities. 24 9. With input from appropriate stakeholders, the department 25 shall identify each contract that will be impacted by mental 26 health and disability services being transferred to the state 27 behavioral health service system, or by responsibilities 28 being transferred to the department’s division of aging and 29 disabilities, pursuant to this Act. On or before June 30, 30 2025, a party to a contract identified by the department 31 under this subsection shall exercise the option, if available 32 pursuant to the terms of the contract, to terminate the 33 contract in accordance with the terms of the contract which 34 provide for termination. Contracts that do not provide for 35 -81- HF 2673.4273.S (1) 90 mb 81/ 92
termination shall not be renewed or extended at the end of the 1 current contract term. 2 10. A mental health and disability services region, a 3 regional administrator as defined in section 225C.55, and 4 any subdivision of the state shall not enter into, renew, or 5 extend any contract for services related to mental health and 6 disability services or addictive disorder services beyond June 7 30, 2025. 8 Sec. 164. DEPARTMENT OF HEALTH AND HUMAN SERVICES —— 9 TRANSITION FUNDING. 10 1. Notwithstanding any provision of law to the contrary, 11 there is appropriated from the region incentive fund of the 12 mental health and disability services regional service fund 13 created in section 225C.7A, subsection 8, to the department of 14 health and human services for the fiscal year beginning July 15 1, 2024, and ending June 30, 2025, the following amount, or 16 so much thereof as is necessary, to be used for the purposes 17 designated: 18 For the establishment of a central data repository as 19 described in section 225A.6, subsection 1, as enacted in 20 division I of this Act: 21 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ 645,179 22 2. There is appropriated from the region incentive fund 23 of the mental health and disability services regional service 24 fund created in section 225C.7A, to the department of health 25 and human services for the fiscal year beginning July 1, 2024, 26 and ending June 30, 2025, the following amount, or so much 27 thereof as is necessary, to be used to support the statewide 28 988 suicide and crisis line: 29 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ 3,000,000 30 3. There is appropriated from the region incentive fund of 31 the mental health and disability services regional service fund 32 created in section 225C.7A, to the department of health and 33 human services for the fiscal year beginning July 1, 2024, and 34 ending June 30, 2025, the following amount, or so much thereof 35 -82- HF 2673.4273.S (1) 90 mb 82/ 92
as is necessary, to be used to implement the provisions of this 1 division of this Act: 2 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ 1,000,000 3 4. Notwithstanding section 8.33, moneys appropriated in 4 this section that remain unencumbered or unobligated at the 5 close of the fiscal year shall not revert to the credit of 6 the region incentive fund of the mental health and disability 7 services regional service fund, but shall be credited to the 8 behavioral health fund created in section 225A.7, as enacted in 9 division I of this Act, and are appropriated to the department 10 of health and human services for expenditure for the purposes 11 of the behavioral health fund. 12 Sec. 165. EMERGENCY RULES. The department of health and 13 human services may adopt emergency rules under section 17A.4, 14 subsection 3, and section 17A.5, subsection 2, paragraph “b”, 15 to implement the provisions of this division of this Act and 16 the rules shall be effective immediately upon filing unless 17 a later date is specified in the rules. Any rules adopted 18 in accordance with this section shall also be published as a 19 notice of intended action as provided in section 17A.4. 20 Sec. 166. EFFECTIVE DATE. This division of this Act, being 21 deemed of immediate importance, takes effect upon enactment. 22 DIVISION V 23 ELIMINATION OF SPECIAL INTELLECTUAL DISABILITY UNITS 24 Sec. 167. Section 222.1, subsection 3, Code 2024, is amended 25 by striking the subsection. 26 Sec. 168. Section 222.2, subsection 8, Code 2024, is amended 27 by striking the subsection. 28 Sec. 169. Section 222.5, Code 2024, is amended to read as 29 follows: 30 222.5 Preadmission diagnostic evaluation. 31 A person shall not be eligible for admission to a resource 32 center or a special unit until a preadmission diagnostic 33 evaluation has been made by a resource center or a special unit 34 which confirms or establishes the need for admission. 35 -83- HF 2673.4273.S (1) 90 mb 83/ 92
Sec. 170. Section 222.7, unnumbered paragraph 1, Code 2024, 1 is amended to read as follows: 2 The department may transfer patients from one state resource 3 center to the other and may at any time transfer patients from 4 the resource centers to the hospitals for persons with mental 5 illness , or transfer patients in the resource centers to a 6 special unit or vice versa . The department may also transfer 7 patients from a hospital for persons with mental illness to a 8 resource center if consent is given or obtained as follows: 9 Sec. 171. Section 222.8, Code 2024, is amended to read as 10 follows: 11 222.8 Communications by patients. 12 Persons admitted to the resource centers or a special 13 unit shall have all reasonable opportunity and facility for 14 communication with their friends. Such persons shall be 15 permitted to write and send letters, provided the letters 16 contain nothing of an offensive character. Letters written by 17 any patient to the director or to any state or county official 18 shall be forwarded unopened. 19 Sec. 172. Section 222.9, Code 2024, is amended to read as 20 follows: 21 222.9 Unauthorized departures. 22 If any person with an intellectual disability shall depart 23 without proper authorization from a resource center or a 24 special unit , it shall be the duty of the superintendent 25 and the superintendent’s assistants and all peace officers 26 of any county in which such patient may be found to take 27 and detain the patient without a warrant or order and to 28 immediately report such detention to the superintendent who 29 shall immediately provide for the return of such patient to the 30 resource center or special unit . 31 Sec. 173. Section 222.12, subsection 1, Code 2024, is 32 amended to read as follows: 33 1. Upon the death of a patient of a resource center or 34 special unit , a preliminary investigation of the death shall be 35 -84- HF 2673.4273.S (1) 90 mb 84/ 92
conducted as required by section 218.64 by the county medical 1 examiner as provided in section 331.802 . Such a preliminary 2 investigation shall also be conducted in the event of a sudden 3 or mysterious death of a patient in a private institution 4 for persons with an intellectual disability. The chief 5 administrative officer of any private institution may request 6 an investigation of the death of any patient by the county 7 medical examiner. 8 Sec. 174. Section 222.73, subsections 1, 3, and 5, Code 9 2024, are amended to read as follows: 10 1. The superintendent of each resource center and special 11 unit shall compute by February 1 the average daily patient 12 charge and outpatient treatment charges for which each county 13 will be billed for services provided to patients chargeable to 14 the county during the fiscal year beginning the following July 15 1. The department shall certify the amount of the charges and 16 notify the counties of the billing charges. 17 a. The superintendent shall compute the average daily 18 patient charge for a resource center or special unit for 19 services provided in the following fiscal year, in accordance 20 with generally accepted accounting procedures, by totaling 21 the expenditures of the resource center or special unit for 22 the immediately preceding calendar year, by adjusting the 23 expenditures by a percentage not to exceed the percentage 24 increase in the consumer price index for all urban consumers 25 for the immediately preceding calendar year, and by dividing 26 the adjusted expenditures by the total inpatient days of 27 service provided during the immediately preceding calendar 28 year. 29 b. The department shall compute the outpatient treatment 30 charges, in accordance with generally accepted accounting 31 procedures, on the basis of the actual cost of the outpatient 32 treatment provided during the immediately preceding calendar 33 year. 34 3. 2. The superintendent shall compute in January the 35 -85- HF 2673.4273.S (1) 90 mb 85/ 92
actual per-patient-per-day cost for each resource center or 1 special unit for the immediately preceding calendar year, in 2 accordance with generally accepted accounting procedures, by 3 totaling the actual expenditures of the resource center or 4 special unit for the calendar year and by dividing the total 5 actual expenditures by the total inpatient days of service 6 provided during the calendar year. 7 5. 3. A superintendent of a resource center or special 8 unit may request that the director enter into a contract with 9 a person for the resource center or special unit to provide 10 consultation or treatment services or for fulfilling other 11 purposes which are consistent with the purposes stated in 12 section 222.1 . The contract provisions shall include charges 13 which reflect the actual cost of providing the services. Any 14 income from a contract authorized under this subsection may 15 be retained by the resource center or special unit to defray 16 the costs of providing the services or fulfilling the other 17 purposes. Except for a contract voluntarily entered into by a 18 county under this subsection , the costs or income associated 19 with a contract authorized under this subsection shall not 20 be considered in computing charges and per diem costs in 21 accordance with the provisions of subsections 1 through 4 and 22 2 . 23 Sec. 175. Section 222.83, Code 2024, is amended to read as 24 follows: 25 222.83 Nonresident patients. 26 The estates of all nonresident patients who are provided 27 treatment, training, instruction, care, habilitation, and 28 support in or by a resource center or a special unit , and all 29 persons legally bound for the support of such persons, shall be 30 liable to the state for the reasonable value of such services. 31 The certificate of the superintendent of the resource center 32 or special unit in which any nonresident is or has been a 33 patient, showing the amounts drawn from the state treasury or 34 due therefrom as provided by law on account of such nonresident 35 -86- HF 2673.4273.S (1) 90 mb 86/ 92
patient, shall be presumptive evidence of the reasonable value 1 of such services furnished such patient by the resource center 2 or special unit . 3 Sec. 176. Section 222.84, Code 2024, is amended to read as 4 follows: 5 222.84 Patients’ personal deposit fund. 6 There is established at each resource center and special 7 unit a patients’ personal deposit fund. In the case of a 8 special unit, the director may direct that the patients’ 9 personal deposit fund be maintained and administered as a part 10 of the fund established, pursuant to sections 226.43 through 11 226.46 , by the state mental health institute where the special 12 unit is located. 13 Sec. 177. Section 222.85, subsection 1, Code 2024, is 14 amended to read as follows: 15 1. Any funds coming into the possession of the 16 superintendent or any employee of a resource center or special 17 unit belonging to any patient in that institution shall be 18 deposited in the name of the patient in the patients’ personal 19 deposit fund, except that if a guardian of the property has 20 been appointed for the person, the guardian shall have the 21 right to demand and receive such funds. Funds belonging to a 22 patient deposited in the patients’ personal deposit fund may 23 be used for the purchase of personal incidentals, desires, and 24 comforts for the patient. 25 Sec. 178. Section 222.87, Code 2024, is amended to read as 26 follows: 27 222.87 Deposit in bank. 28 The department shall deposit the patients’ personal deposit 29 fund in a commercial account of a bank of reputable standing. 30 When deposits in the commercial account exceed average monthly 31 withdrawals, the department may deposit the excess at interest. 32 The savings account shall be in the name of the patients’ 33 personal deposit fund and interest paid on the account may be 34 used for recreational purposes for the patients at the resource 35 -87- HF 2673.4273.S (1) 90 mb 87/ 92
center or special unit . 1 Sec. 179. REPEAL. Sections 222.88, 222.89, 222.90, and 2 222.91, Code 2024, are repealed. 3 Sec. 180. EFFECTIVE DATE. This division of this Act, being 4 deemed of immediate importance, takes effect upon enactment. 5 DIVISION VI 6 COUNTY OF RESIDENCE DETERMINATIONS 7 Sec. 181. NEW SECTION . 331.190 County of residence —— 8 dispute resolution. 9 1. “County of residence” means the county in this state 10 in which, at the time a person applies for or receives 11 services, the person is living and has established an ongoing 12 presence with the declared, good faith intention of living 13 for a permanent or indefinite period of time. The county 14 of residence of a homeless person is the county in which 15 the homeless person usually sleeps. A person maintains 16 residency in the county or state in which the person last 17 resided during the time period that the person is present in 18 a different county or state receiving services in a hospital, 19 a correctional facility, a halfway house for community-based 20 corrections or substance use disorder treatment, a nursing 21 facility, an intermediate care facility for persons with an 22 intellectual disability, a residential care facility, or for 23 the purpose of attending a college or university. 24 2. a. The dispute resolution process in this subsection 25 shall apply to county of residence disputes. The dispute 26 resolution process shall not be applicable to any of the 27 following: 28 (1) Disputes involving persons committed to a state 29 facility pursuant to chapter 812. 30 (2) Disputes involving Iowa rule of criminal procedure 31 2.22(8)(b), commitment for evaluation. 32 (3) Disputes involving chapter 12 of Iowa court rules, rules 33 for involuntary hospitalization of mentally ill persons. 34 b. If a county objects to a billing for services or a 35 -88- HF 2673.4273.S (1) 90 mb 88/ 92
residency determination and asserts that either the person 1 has residency in a different county or the person is not a 2 resident of this state, the person’s county of residence 3 shall be determined as provided in this subsection. If the 4 county asserts that the person has residency in a different 5 county in this state, the county shall notify that county in 6 writing within one hundred twenty calendar days of receiving 7 the billing for services or of the county of residence 8 determination. 9 c. The county that receives the notification under paragraph 10 “b” shall respond in writing to the county that provided the 11 notification within forty-five calendar days of receiving the 12 notification. If the parties cannot agree as to the person’s 13 county of residence within ninety calendar days of the date of 14 notification, on motion of either of the parties, the matter 15 shall be referred to the administrative hearings division of 16 the department of inspections, appeals, and licensing for 17 a contested case proceeding under chapter 17A, before an 18 administrative law judge assigned in accordance with section 19 10A.801, to determine the person’s county of residence. 20 d. (1) Notwithstanding section 17A.15, the administrative 21 law judge’s determination of a person’s county of residence 22 shall be considered final agency action. Judicial review of 23 the determination may be sought in accordance with section 24 17A.19. 25 (2) If following the determination of a person’s county of 26 residence under this subsection additional evidence becomes 27 available that merits a change in the determination of the 28 person’s county of residence, the affected parties may change 29 the determination of county of residence by mutual agreement. 30 Otherwise, a party may move that the matter be reconsidered 31 by the county, or by an administrative law judge assigned in 32 accordance with section 10A.801. 33 e. Unless a petition is filed for judicial review, the 34 administrative law judge’s determination of the person’s county 35 -89- HF 2673.4273.S (1) 90 mb 89/ 92
of residence shall result in one of the following: 1 (1) If a county is determined to be the person’s county 2 of residence, that county shall pay any amounts due and shall 3 reimburse the other county for any amounts paid for services 4 provided to the person by the other county prior to the county 5 of residence determination. 6 (2) If it is determined that the person is not a resident of 7 this state, neither the state nor either county shall be liable 8 for payment of amounts due for services provided to the person 9 prior to the determination of the person’s county of residence. 10 f. (1) The party that does not prevail in a contested 11 case proceeding or a subsequent judicial review pursuant to 12 this subsection shall be liable for costs associated with 13 the proceeding or judicial review, including reimbursement 14 of the administrative hearings division of the department of 15 inspections, appeals, and licensing’s actual costs associated 16 with the administrative proceeding, court costs, and reasonable 17 attorney fees. 18 (2) A payment or reimbursement pursuant to this subsection 19 shall be remitted within forty-five calendar days of the 20 date the county of residence determination is issued by the 21 administrative law judge or the date the court files an order 22 determining the person’s county of residence, whichever is 23 later. After forty-five calendar days, the prevailing party 24 may add a penalty of up to one percent per month to any amounts 25 due. 26 Sec. 182. Section 35D.9, Code 2024, is amended to read as 27 follows: 28 35D.9 County of residence upon discharge. 29 A member of the home does not acquire residency in the county 30 in which the home is located unless the member is voluntarily 31 or involuntarily discharged from the home and the member 32 meets county of residence requirements. For purposes of this 33 section , “county of residence” means the same as defined in 34 section 225C.61 331.190 . 35 -90- HF 2673.4273.S (1) 90 mb 90/ 92
Sec. 183. Section 232.141, subsections 7 and 8, Code 2024, 1 are amended to read as follows: 2 7. A county charged with the costs and expenses under 3 subsections 2 and 3 may recover the costs and expenses from the 4 child’s custodial parent’s county of residence, as defined in 5 section 225C.61 331.190 , by filing verified claims which are 6 payable as are other claims against the county. A detailed 7 statement of the facts upon which a claim is based shall 8 accompany the claim. 9 8. This subsection applies only to placements in a juvenile 10 shelter care home which is publicly owned, operated as a county 11 or multicounty shelter care home, organized under a chapter 12 28E agreement, or operated by a private juvenile shelter care 13 home. If the actual and allowable costs of a child’s shelter 14 care placement exceed the amount the department is authorized 15 to pay, the unpaid costs may be recovered from the child’s 16 custodial parent’s county of residence. However, the maximum 17 amount of the unpaid costs which may be recovered under this 18 subsection is limited to the difference between the amount 19 the department is authorized to pay and the statewide average 20 of the actual and allowable rates as reasonably determined 21 by the department annually. A home may only be reimbursed 22 for the lesser of the home’s actual and allowable costs or 23 the statewide average of the actual and allowable rates as 24 determined by the department in effect on the date the costs 25 were paid. The unpaid costs are payable pursuant to filing of 26 verified claims against the child’s custodial parent’s county 27 of residence. A detailed statement of the facts upon which a 28 claim is based shall accompany the claim. Any dispute between 29 counties arising from filings of claims filed pursuant to this 30 subsection shall be settled in the manner provided to determine 31 residency county of residence in section 225C.61 331.190 . 32 Sec. 184. EFFECTIVE DATE. This division of this Act takes 33 effect July 1, 2025. 34 DIVISION VII 35 -91- HF 2673.4273.S (1) 90 mb 91/ 92
SUBSTANCE USE DISORDER —— BEER AND LIQUOR CONTROL FUND 1 Sec. 185. Section 123.17, subsection 5, Code 2024, is 2 amended to read as follows: 3 5. After any transfer provided for in subsection 3 is 4 made, the department shall transfer into a special revenue 5 account in the general fund of the state, a sum of money at 6 least equal to seven percent of the gross amount of sales made 7 by the department from the beer and liquor control fund on a 8 monthly basis but not less than nine million dollars annually. 9 Of the amounts transferred, two million dollars , plus an 10 additional amount determined by the general assembly, shall be 11 appropriated to the department of health and human services for 12 use by the staff who administer the comprehensive substance use 13 disorder program under chapter 125 for substance use disorder 14 treatment and prevention programs. Any amounts received in 15 excess of the amounts appropriated to the department of health 16 and human services for use by the staff who administer the 17 comprehensive substance use disorder program under chapter 125 18 shall be considered part of the general fund balance. 19 Sec. 186. EFFECTIVE DATE. This division of this Act, being 20 deemed of immediate importance, takes effect upon enactment. 21 DIVISION VIII 22 SUPPORTED COMMUNITY LIVING SERVICES 23 Sec. 187. Section 225C.21, subsection 1, Code 2024, is 24 amended to read as follows: 25 1. As used in this section , “supported community living 26 services” means services provided in a noninstitutional 27 setting to adult persons sixteen years of age and older with 28 mental illness, an intellectual disability, brain injury, or 29 developmental disabilities to meet the persons’ daily living 30 needs. 31 Sec. 188. EFFECTIVE DATE. This division of this Act, being 32 deemed of immediate importance, takes effect upon enactment. > 33 -92- HF 2673.4273.S (1) 90 mb 92/ 92