House File 2673 S-5160 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 2673.4203 (2) 90 dg/ko 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 2673.4203 (2) 90 dg/ko 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 2673.4203 (2) 90 dg/ko 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 2673.4203 (2) 90 dg/ko 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 2673.4203 (2) 90 dg/ko 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 2673.4203 (2) 90 dg/ko 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 2673.4203 (2) 90 dg/ko 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 2673.4203 (2) 90 dg/ko 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 2673.4203 (2) 90 dg/ko 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 2673.4203 (2) 90 dg/ko 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 2673.4203 (2) 90 dg/ko 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 2673.4203 (2) 90 dg/ko 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 2673.4203 (2) 90 dg/ko 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 2673.4203 (2) 90 dg/ko 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 d. Administrative costs associated with services described 21 under this subsection. For purposes of administrative costs, 22 the department shall not use more than five percent of the 23 moneys in the behavioral health fund at the beginning of each 24 fiscal year, excluding the total sum of any moneys deposited 25 into the fund from the federal community mental health service 26 block grant, 42 U.S.C. §300x et seq., and the federal substance 27 abuse prevention and treatment block grant, 42 U.S.C. §300x-21 28 et seq. 29 3. For the fiscal year beginning July 1, 2025, there 30 is transferred from the general fund of the state to the 31 behavioral health fund an amount equal to forty-two dollars 32 multiplied by the state’s population for the fiscal year. 33 4. For the fiscal year beginning July 1, 2026, and each 34 succeeding fiscal year, there is transferred from the general 35 -15- HF 2673.4203 (2) 90 dg/ko 15/ 92
fund of the state to the behavioral health fund an amount equal 1 to the state’s population for the fiscal year multiplied by 2 the sum of the dollar amount used to calculate the transfer 3 from the general fund to the behavioral health fund for the 4 immediately preceding fiscal year, plus the state growth factor 5 for the fiscal year for which the transfer is being made. 6 5. For each fiscal year, an administrative services 7 organization shall not spend on administrative costs an amount 8 more than seven percent of the total amount distributed to the 9 administrative services organization through this section and 10 all other appropriations for the same fiscal year. 11 6. Moneys in the behavioral health fund may be used by the 12 department for cash flow purposes, provided that any moneys so 13 allocated are returned to the behavioral health fund by the end 14 of each fiscal year. 15 7. Notwithstanding section 12C.7, subsection 2, interest 16 or earnings on moneys deposited in the behavioral health fund 17 shall be credited to the behavioral health fund. 18 8. Notwithstanding section 8.33, moneys appropriated in 19 this section that remain unencumbered or unobligated at the 20 close of the fiscal year shall not revert but shall remain 21 available for expenditure for the purposes designated. 22 Sec. 8. NEW SECTION . 225A.8 Addictive disorders prevention 23 —— prohibitions. 24 1. For purposes of this section, “entity” means a 25 manufacturer, distributor, wholesaler, retailer, or 26 distributing agent, or an agent of a manufacturer, distributor, 27 wholesaler, retailer, or distributing agent as those terms are 28 defined in section 453A.1. 29 2. To promote comprehensive tobacco use prevention and 30 control initiatives outlined in the state behavioral health 31 service system plan, an entity shall not perform any of the 32 following acts: 33 a. Give away cigarettes or tobacco products. 34 b. Provide free articles, products, commodities, gifts, or 35 -16- HF 2673.4203 (2) 90 dg/ko 16/ 92
concessions in any exchange for the purchase of cigarettes or 1 tobacco products. 2 3. The prohibitions in this section shall not apply to 3 transactions between manufacturers, distributors, wholesalers, 4 or retailers as those terms are defined in section 453A.1. 5 Sec. 9. NEW SECTION . 225A.9 Application for services —— 6 minors. 7 A minor who is twelve years of age or older shall have 8 the legal capacity to act and give consent to the provision 9 of tobacco cessation coaching services pursuant to a tobacco 10 cessation telephone and internet-based program approved by 11 the department through the behavioral health service system 12 established in section 225A.3. Consent shall not be subject to 13 later disaffirmance by reason of such minority. The consent of 14 another person, including but not limited to the consent of a 15 spouse, parent, custodian, or guardian, shall not be necessary. 16 Sec. 10. CODE EDITOR DIRECTIVE. The Code editor is directed 17 to do all of the following: 18 1. Designate sections 225A.1 through 225A.9, as enacted 19 in this division of this Act, as Code chapter 225A entitled 20 “Department of Health and Human Services —— Behavioral Health 21 Service System”. 22 2. Correct internal references in the Code and in any 23 enacted legislation as necessary due to the enactment of this 24 division of this Act. 25 Sec. 11. EFFECTIVE DATE. This division of this Act takes 26 effect July 1, 2025. 27 DIVISION II 28 BEHAVIORAL HEALTH SERVICE SYSTEM —— CONFORMING CHANGES 29 Sec. 12. Section 11.6, subsection 1, paragraph b, Code 2024, 30 is amended to read as follows: 31 b. The financial condition and transactions of community 32 mental health centers organized under chapter 230A , substance 33 use disorder programs organized licensed under chapter 125 , and 34 community action agencies organized under chapter 216A , shall 35 -17- HF 2673.4203 (2) 90 dg/ko 17/ 92
be audited at least once each year. 1 Sec. 13. Section 97B.1A, subsection 8, paragraph a, 2 subparagraph (13), Code 2024, is amended by striking the 3 subparagraph. 4 Sec. 14. Section 123.17, subsection 5, Code 2024, is amended 5 to read as follows: 6 5. After any transfer provided for in subsection 3 is made, 7 the department shall transfer into a special revenue account 8 in the general fund of the state, a sum of money at least equal 9 to seven percent of the gross amount of sales made by the 10 department from the beer and liquor control fund on a monthly 11 basis but not less than nine million dollars annually. Of 12 the amounts transferred, two three million dollars, plus an 13 additional amount determined by the general assembly, shall be 14 appropriated to the department of health and human services for 15 use by the staff who administer the comprehensive substance use 16 disorder program under chapter 125 for substance use disorder 17 treatment and prevention programs shall be transferred to the 18 behavioral health fund established under section 225A.7 . Any 19 amounts received in excess of the amounts appropriated to the 20 department of health and human services for use by the staff 21 who administer the comprehensive substance use disorder program 22 under chapter 125 transferred to the behavioral health fund 23 shall be considered part of the general fund balance. 24 Sec. 15. Section 123.17, subsection 8, Code 2024, is amended 25 by striking the subsection. 26 Sec. 16. Section 123.17, subsection 9, Code 2024, is amended 27 to read as follows: 28 9. After any transfers provided for in subsections 3, 5, 29 6, and 7 , and 8 are made, and before any other transfer to the 30 general fund, the department shall transfer to the economic 31 development authority from the beer and liquor control fund the 32 lesser of two hundred fifty thousand dollars or one percent of 33 the gross sales of native distilled spirits by all class “A” 34 native distilled spirits license holders made by the department 35 -18- HF 2673.4203 (2) 90 dg/ko 18/ 92
for the purposes of promoting Iowa wine, beer, and spirits. 1 Sec. 17. Section 124.409, subsection 2, Code 2024, is 2 amended by striking the subsection. 3 Sec. 18. Section 125.2, subsections 4, 5, and 10, Code 2024, 4 are amended by striking the subsections. 5 Sec. 19. Section 125.91, subsection 1, Code 2024, is amended 6 to read as follows: 7 1. The procedure prescribed by this section shall only 8 be used for a person with a substance use disorder due to 9 intoxication or substance-induced incapacitation who has 10 threatened, attempted, or inflicted physical self-harm or harm 11 on another, and is likely to inflict physical self-harm or harm 12 on another unless immediately detained, or who is incapacitated 13 by a chemical substance, if an application has not been filed 14 naming the person as the respondent pursuant to section 125.75 15 and the person cannot be ordered into immediate custody and 16 detained pursuant to section 125.81 . 17 Sec. 20. Section 125.93, Code 2024, is amended to read as 18 follows: 19 125.93 Commitment records —— confidentiality. 20 Records of the identity, diagnosis, prognosis, or treatment 21 of a person which are maintained in connection with the 22 provision of substance use disorder treatment services are 23 confidential, consistent with the requirements of section 24 125.37 , and with the federal confidentiality regulations 25 authorized by the federal Drug Abuse Office and Treatment Act , 26 42 U.S.C. §290ee and the federal Comprehensive Alcohol Abuse 27 and Alcoholism Prevention, Treatment and Rehabilitation Act, 42 28 U.S.C. §290dd-2. However, such records may be disclosed to an 29 employee of the department of corrections, if authorized by the 30 director of the department of corrections, or to an employee 31 of a judicial district department of correctional services, if 32 authorized by the director of the judicial district department 33 of correctional services. 34 Sec. 21. Section 135.11, subsection 11, Code 2024, is 35 -19- HF 2673.4203 (2) 90 dg/ko 19/ 92
amended to read as follows: 1 11. Administer chapters 125, 136A , 136C , 139A , 142 , 142A , 2 144 , and 147A . 3 Sec. 22. Section 135C.2, subsection 5, unnumbered paragraph 4 1, Code 2024, is amended to read as follows: 5 The department shall establish a special classification 6 within the residential care facility category in order to 7 foster the development of residential care facilities which 8 serve persons with an intellectual disability, chronic mental 9 illness, a developmental disability, or brain injury, as 10 described under section 225C.26 , and which contain five or 11 fewer residents. A facility within the special classification 12 established pursuant to this subsection is exempt from the 13 requirements of section 10A.713 . The department shall adopt 14 rules which are consistent with rules previously developed for 15 the waiver demonstration waiver project pursuant to 1986 Iowa 16 Acts, ch. 1246, §206 , and which include all of the following 17 provisions: 18 Sec. 23. Section 135C.6, subsection 1, Code 2024, is amended 19 to read as follows: 20 1. A person or governmental unit acting severally or 21 jointly with any other person or governmental unit shall not 22 establish or operate a health care facility in this state 23 without a license for the facility. A supported community 24 living service, as defined in section 225C.21 249A.38A , is not 25 required to be licensed under this chapter , but is subject to 26 approval under section 225C.21 249A.38A in order to receive 27 public funding. 28 Sec. 24. Section 135C.23, subsection 1, unnumbered 29 paragraph 1, Code 2024, is amended to read as follows: 30 Each resident shall be covered by a contract executed 31 by the resident, or the resident’s legal representative, 32 and the health care facility at or prior to the time of the 33 resident’s admission or prior thereto by the resident, or the 34 legal representative, and the health care facility, except as 35 -20- HF 2673.4203 (2) 90 dg/ko 20/ 92
otherwise provided by subsection 5 with respect to residents 1 admitted at public expense to a county care facility operated 2 under chapter 347B . Each party to the contract shall be 3 entitled to a duplicate of the original thereof contract , and 4 the health care facility shall keep on file all contracts 5 which it has with residents and shall not destroy or otherwise 6 dispose of any such contract for at least one year after its 7 expiration. Each such contract shall expressly set forth: 8 Sec. 25. Section 135C.23, subsection 2, paragraph b, Code 9 2024, is amended to read as follows: 10 b. This section does not prohibit the admission of a 11 patient with a history of dangerous or disturbing behavior to 12 an intermediate care facility for persons with mental illness, 13 intermediate care facility for persons with an intellectual 14 disability, or nursing facility , or county care facility when 15 the intermediate care facility for persons with mental illness, 16 intermediate care facility for persons with an intellectual 17 disability, or nursing facility , or county care facility has a 18 program which has received prior approval from the department 19 to properly care for and manage the patient. An intermediate 20 care facility for persons with mental illness, intermediate 21 care facility for persons with an intellectual disability, 22 or nursing facility , or county care facility is required to 23 transfer or discharge a resident with dangerous or disturbing 24 behavior when the intermediate care facility for persons with 25 mental illness, intermediate care facility for persons with an 26 intellectual disability, or nursing facility , or county care 27 facility cannot control the resident’s dangerous or disturbing 28 behavior. The department , in coordination with the state 29 mental health and disability services commission created in 30 section 225C.5 , shall adopt rules pursuant to chapter 17A for 31 programs to be required in intermediate care facilities for 32 persons with mental illness, intermediate care facilities 33 for persons with an intellectual disability, and nursing 34 facilities , and county care facilities that admit patients 35 -21- HF 2673.4203 (2) 90 dg/ko 21/ 92
or have residents with histories of dangerous or disturbing 1 behavior. 2 Sec. 26. Section 135C.23, subsection 5, Code 2024, is 3 amended by striking the subsection. 4 Sec. 27. Section 135C.24, subsection 5, Code 2024, is 5 amended by striking the subsection. 6 Sec. 28. Section 135G.1, subsection 12, Code 2024, is 7 amended to read as follows: 8 12. a. “Subacute mental health services” means the same 9 as defined in section 225C.6 services that provide all of the 10 following: 11 (1) A comprehensive set of wraparound services for a 12 person who has had, or is at imminent risk of having, acute or 13 crisis mental health symptoms that do not permit the person to 14 remain in or threatens removal of the person from the person’s 15 home and community, but who has been determined by a mental 16 health professional and a licensed health care professional, 17 subject to the professional’s scope of practice, not to need 18 inpatient acute hospital services. For the purposes of this 19 subparagraph, “licensed health care professional” means a person 20 licensed under chapter 148, an advanced registered nurse 21 practitioner, or a physician assistant. 22 (2) Intensive, recovery-oriented treatment and monitoring 23 of a person. Treatment may be provided directly or remotely 24 by a licensed psychiatrist or an advanced registered nurse 25 practitioner. 26 (3) An outcome-focused, interdisciplinary approach designed 27 to return a person to living successfully in the community. 28 b. Subacute mental health services may include services 29 provided in a wide array of settings ranging from a person’s 30 home to a specialized facility with restricted means of egress. 31 c. Subacute mental health services shall be limited to a 32 period not to exceed ten calendar days or another time period 33 determined in accordance with rules adopted by the department 34 for this purpose, whichever is longer . 35 -22- HF 2673.4203 (2) 90 dg/ko 22/ 92
Sec. 29. Section 142.1, Code 2024, is amended to read as 1 follows: 2 142.1 Delivery of bodies. 3 The body of every person dying who died in a public asylum, 4 hospital, county care facility, penitentiary, or reformatory 5 in this state, or found dead within the state, or which who 6 is to be buried at public expense in this state, except those 7 buried under the provisions of chapter 144C or 249 , and which 8 is suitable for scientific purposes, shall be delivered to the 9 medical college of the state university, or some osteopathic 10 or chiropractic college or school located in this state, which 11 has been approved under the law regulating the practice of 12 osteopathic medicine or chiropractic; but no such body shall 13 be delivered to any such college or school if the deceased 14 person expressed a desire during the person’s last illness 15 that the person’s body should be buried or cremated, nor if 16 such is the desire of the person’s relatives. Such bodies 17 shall be equitably distributed among said colleges and schools 18 according to their needs for teaching anatomy in accordance 19 with such rules as may be adopted by the department of health 20 and human services. The expense of transporting said bodies to 21 such college or school shall be paid by the college or school 22 receiving the same. If the deceased person has not expressed 23 a desire during the person’s last illness that the person’s 24 body should be buried or cremated and no person authorized to 25 control the deceased person’s remains under section 144C.5 26 requests the person’s body for burial or cremation, and if a 27 friend objects to the use of the deceased person’s body for 28 scientific purposes, said deceased person’s body shall be 29 forthwith delivered to such friend for burial or cremation at 30 no expense to the state or county. Unless such friend provides 31 for burial and burial expenses within five days, the body shall 32 be used for scientific purposes under this chapter . 33 Sec. 30. Section 142.3, Code 2024, is amended to read as 34 follows: 35 -23- HF 2673.4203 (2) 90 dg/ko 23/ 92
142.3 Notification of department. 1 Every county medical examiner, funeral director or embalmer, 2 and the managing officer of every public asylum, hospital, 3 county care facility, penitentiary, or reformatory, as soon as 4 any dead body shall come into the person’s custody which may be 5 used for scientific purposes as provided in sections 142.1 and 6 142.2 , shall at once notify the nearest relative or friend of 7 the deceased, if known, and the department of health and human 8 services, and hold such body unburied for forty-eight hours. 9 Upon receipt of notification, the department shall issue verbal 10 or written instructions relative to the disposition to be made 11 of said body. Complete jurisdiction over said bodies is vested 12 exclusively in the department of health and human services. No 13 autopsy or post mortem, except as are legally ordered by county 14 medical examiners, shall be performed on any of said bodies 15 prior to their delivery to the medical schools. 16 Sec. 31. NEW SECTION . 217.17 State health improvement plan. 17 1. The department shall develop, implement, and administer 18 a state health improvement plan to identify health priorities, 19 goals, and measurable objectives, and outline strategies to 20 improve health statewide. 21 2. The state health improvement plan shall be developed 22 and updated in collaboration and in coordination with other 23 state departments, stakeholders, and statewide organizations 24 the department determines to be relevant. 25 3. The state health improvement plan may be updated by the 26 department at the department’s discretion. 27 Sec. 32. NEW SECTION . 217.37 Recovery of payment —— 28 assignment of liens —— county attorney to enforce. 29 1. For purposes of this section, “assistance” means all of 30 the following: 31 a. A payment by the state for services rendered through 32 the behavioral health service system established under section 33 225A.3. 34 b. A payment by the state for aging and disability services 35 -24- HF 2673.4203 (2) 90 dg/ko 24/ 92
rendered in accordance with chapter 231. 1 2. The department shall have the authority to investigate if 2 a person is eligible to have assistance paid on the person’s 3 behalf and whether payment of assistance was proper. 4 3. Notwithstanding any provision of law to the contrary, 5 assistance shall not be recoverable unless the department 6 finds that the assistance was paid for the benefit of a person 7 who was not entitled to have assistance paid on the person’s 8 behalf. 9 4. Assistance paid for the benefit of a person who was 10 not entitled to have assistance paid on the person’s behalf 11 shall be recoverable from the entity to which the assistance 12 was paid, from the person on whose behalf assistance was paid, 13 or from a third party who is liable for the person’s debts or 14 support. 15 5. Upon the death of a person who was not entitled to 16 have assistance paid on the person’s behalf, the department 17 shall have a lien equivalent in priority to liens described 18 in section 633.425, subsection 6, against the person’s estate 19 for the portion of the assistance improperly paid which the 20 department had not recovered at the time of the person’s death. 21 6. The department may waive all or a portion of improperly 22 paid assistance, or a lien created under subsection 5, if 23 the department finds that collection would result in undue 24 hardship. 25 7. The department shall adopt rules pursuant to chapter 17A 26 to implement and administer this section. 27 Sec. 33. Section 218.30, Code 2024, is amended to read as 28 follows: 29 218.30 Investigation of other facilities. 30 The director may investigate or cause the investigation of 31 charges of abuse, neglect, or mismanagement on the part of an 32 officer or employee of a private facility which is subject to 33 the director’s supervision or control. The director shall also 34 investigate or cause the investigation of charges concerning 35 -25- HF 2673.4203 (2) 90 dg/ko 25/ 92
county care facilities in which persons with mental illness are 1 served. 2 Sec. 34. Section 218.78, subsection 1, Code 2024, is amended 3 to read as follows: 4 1. All institutional receipts of the department, including 5 funds received from client participation at the state resource 6 centers under section 222.78 and at the state mental health 7 institutes under section 230.20 , shall be deposited in the 8 general fund except for reimbursements for services provided 9 to another institution or state agency, for receipts deposited 10 in the revolving farm fund under section 904.706 , for deposits 11 into the medical assistance fund under section 249A.11 , and for 12 rentals charged to employees or others for room, apartment, or 13 house and meals, which shall be available to the institutions. 14 Sec. 35. Section 222.1, subsection 1, Code 2024, is amended 15 to read as follows: 16 1. This chapter addresses the public and private services 17 available in this state to meet the needs of persons with an 18 intellectual disability. The responsibility of the mental 19 health and disability services regions formed by counties and 20 of the state for the costs and administration of publicly 21 funded services shall be as set out in section 222.60 and other 22 pertinent sections of this chapter . 23 Sec. 36. Section 222.2, Code 2024, is amended by adding the 24 following new subsection: 25 NEW SUBSECTION . 01. “Administrative services organization” 26 means the same as defined in section 225A.1. 27 Sec. 37. Section 222.2, subsections 6 and 7, Code 2024, are 28 amended by striking the subsections. 29 Sec. 38. Section 222.12, subsection 2, Code 2024, is amended 30 by striking the subsection. 31 Sec. 39. Section 222.13, Code 2024, is amended to read as 32 follows: 33 222.13 Voluntary admissions. 34 1. If an adult person is believed to be a person with an 35 -26- HF 2673.4203 (2) 90 dg/ko 26/ 92
intellectual disability, the adult person or the adult person’s 1 guardian may apply to the department and the superintendent of 2 any state resource center for the voluntary admission of the 3 adult person either as an inpatient or an outpatient of the 4 resource center. If the expenses of the person’s admission 5 or placement are payable in whole or in part by the person’s 6 county of residence, application for the admission shall be 7 made through the regional administrator. An application for 8 admission to a special unit of any adult person believed to be 9 in need of any of the services provided by the special unit 10 under section 222.88 may be made in the same manner. The 11 superintendent shall accept the application if a preadmission 12 diagnostic evaluation confirms or establishes the need for 13 admission, except that an application shall not be accepted if 14 the institution does not have adequate facilities available or 15 if the acceptance will result in an overcrowded condition. 16 2. If the resource center does not have an appropriate 17 program for the treatment of an adult or minor person with an 18 intellectual disability applying under this section or section 19 222.13A , the regional administrator for the person’s county 20 of residence or the department , as applicable, shall arrange 21 for the placement of the person in any public or private 22 facility within or without outside of the state, approved by 23 the director, which offers appropriate services for the person. 24 If the expenses of the placement are payable in whole or in 25 part by a county, the placement shall be made by the regional 26 administrator for the county. 27 3. If the expenses of an admission of an adult to a resource 28 center or a special unit, or of the placement of the person 29 in a public or private facility are payable in whole or in 30 part by a mental health and disability services region, the 31 regional administrator shall make a full investigation into 32 the financial circumstances of the person and those liable for 33 the person’s support under section 222.78 to determine whether 34 or not any of them are able to pay the expenses arising out of 35 -27- HF 2673.4203 (2) 90 dg/ko 27/ 92
the admission of the person to a resource center, special unit, 1 or public or private facility. If the regional administrator 2 finds that the person or those legally responsible for 3 the person are presently unable to pay the expenses, the 4 regional administrator shall pay the expenses. The regional 5 administrator may review such a finding at any subsequent 6 time while the person remains at the resource center, or is 7 otherwise receiving care or treatment for which this chapter 8 obligates the region to pay. If the regional administrator 9 finds upon review that the person or those legally responsible 10 for the person are presently able to pay the expenses, the 11 finding shall apply only to the charges incurred during the 12 period beginning on the date of the review and continuing 13 thereafter, unless and until the regional administrator again 14 changes such a finding. If the regional administrator finds 15 that the person or those legally responsible for the person 16 are able to pay the expenses, the regional administrator shall 17 collect the charges to the extent required by section 222.78 , 18 and the regional administrator shall be responsible for the 19 payment of the remaining charges. 20 Sec. 40. Section 222.13A, subsections 3 and 4, Code 2024, 21 are amended to read as follows: 22 3. During the preadmission diagnostic evaluation, the 23 minor shall be informed both orally and in writing that the 24 minor has the right to object to the voluntary admission. If 25 Notwithstanding section 222.33, if the preadmission diagnostic 26 evaluation determines that the voluntary admission is 27 appropriate but the minor objects to the admission, the minor 28 shall not be admitted to the state resource center unless the 29 court approves of the admission. A petition for approval of 30 the minor’s admission may be submitted to the juvenile court by 31 the minor’s parent, guardian, or custodian. 32 4. As soon as practicable after the filing of a petition for 33 approval of the voluntary admission, the court shall determine 34 whether the minor has an attorney to represent the minor in the 35 -28- HF 2673.4203 (2) 90 dg/ko 28/ 92
proceeding. If the minor does not have an attorney, the court 1 shall assign an attorney to the minor an attorney . If the 2 minor is unable to pay for an attorney, the attorney shall be 3 compensated by the mental health and disability services region 4 an administrative services organization at an hourly rate to be 5 established by the regional administrator in substantially the 6 same manner as provided in section 815.7 . 7 Sec. 41. Section 222.14, Code 2024, is amended to read as 8 follows: 9 222.14 Care by region pending admission. 10 If the institution is unable to receive a patient, the 11 superintendent shall notify the regional administrator 12 for the county of residence of the prospective patient an 13 administrative services organization . Until such time as the 14 patient is able to be received by the institution, or when 15 application has been made for admission to a public or private 16 facility as provided in section 222.13 and the application 17 is pending, the care of the patient shall be provided as 18 arranged by the regional administrator administrative services 19 organization . 20 Sec. 42. NEW SECTION . 222.33 State resource center —— 21 admissions and discharge. 22 1. The department shall make all final determinations 23 concerning whether a person may be admitted to a state resource 24 center. 25 2. If a patient is admitted to a state resource center 26 pursuant to section 222.13 or 222.13A, and the patient 27 wishes to be placed outside of the state resource center, the 28 discharge of the patient shall be made in accordance with 29 section 222.15. 30 Sec. 43. NEW SECTION . 222.35 State —— payor of last resort. 31 The department shall implement services and adopt rules 32 pursuant to chapter 17A in a manner that ensures that the state 33 is the payor of last resort, and that the department shall not 34 make any payments for services that have been provided until 35 -29- HF 2673.4203 (2) 90 dg/ko 29/ 92
the department has determined that the services provided are 1 not payable by a third-party source. 2 Sec. 44. Section 222.73, subsections 2 and 4, Code 2024, are 3 amended by striking the subsections. 4 Sec. 45. Section 222.77, Code 2024, is amended to read as 5 follows: 6 222.77 Patients on leave. 7 The cost of support of patients placed on convalescent leave 8 or removed as a habilitation measure from a resource center, 9 or a special unit, except when living in the home of a person 10 legally bound for the support of the patient, shall be paid by 11 the county of residence or the state as provided in section 12 222.60 . 13 Sec. 46. Section 222.78, subsection 1, Code 2024, is amended 14 to read as follows: 15 1. The father and mother of any patient admitted to a 16 resource center or to a special unit , as either an inpatient 17 or an outpatient, and any person, firm, or corporation bound 18 by contract made for support of the patient , are liable for 19 the support of the patient. The patient and those legally 20 bound for the support of the patient shall be liable to the 21 county or state , as applicable, for all sums advanced in 22 accordance with the provisions of sections 222.60 and 222.77 23 relating to reasonable attorney fees and court costs for 24 the patient’s admission to the resource center, and for the 25 treatment, training, instruction, care, habilitation, support, 26 transportation, or other expenditures made on behalf of the 27 patient pursuant to this chapter . 28 Sec. 47. Section 222.79, Code 2024, is amended to read as 29 follows: 30 222.79 Certification statement presumed correct. 31 In actions to enforce the liability imposed by section 32 222.78 , the superintendent or the county of residence, as 33 applicable, shall submit a certification statement stating 34 the sums charged, and the certification statement shall be 35 -30- HF 2673.4203 (2) 90 dg/ko 30/ 92
considered presumptively correct. 1 Sec. 48. Section 222.80, Code 2024, is amended to read as 2 follows: 3 222.80 Liability to county or state. 4 A person admitted to a county institution or home or admitted 5 at county or state expense to a private hospital, sanitarium, 6 or other facility for treatment, training, instruction, care, 7 habilitation, and support as a patient with an intellectual 8 disability shall be liable to the county or state , as 9 applicable, for the reasonable cost of the support as provided 10 in section 222.78 . 11 Sec. 49. Section 222.82, Code 2024, is amended to read as 12 follows: 13 222.82 Collection of liabilities and claims. 14 If liabilities and claims exist as provided in section 15 222.78 or any other provision of this chapter , the county of 16 residence or the state , as applicable, may proceed as provided 17 in this section . If the liabilities and claims are owed to 18 a county of residence, the county’s board of supervisors may 19 direct the county attorney to proceed with the collection of 20 the liabilities and claims as a part of the duties of the 21 county attorney’s office when the board of supervisors deems 22 such action advisable. If the liabilities and claims are owed 23 to the state, the state shall proceed with the collection. 24 The board of supervisors or the state , as applicable, may 25 compromise any and all liabilities to the county or state 26 arising under this chapter when such compromise is deemed to be 27 in the best interests of the county or state. Any collections 28 and liens shall be limited in conformance to section 614.1, 29 subsection 4 . 30 Sec. 50. Section 222.85, subsection 2, Code 2024, is amended 31 to read as follows: 32 2. Moneys paid to a resource center from any source other 33 than state appropriated funds and intended to pay all or a 34 portion of the cost of care of a patient, which cost would 35 -31- HF 2673.4203 (2) 90 dg/ko 31/ 92
otherwise be paid from state or county funds or from the 1 patient’s own funds, shall not be deemed “funds belonging to a 2 patient” for the purposes of this section . 3 Sec. 51. Section 222.86, Code 2024, is amended to read as 4 follows: 5 222.86 Payment for care from fund. 6 If a patient is not receiving medical assistance under 7 chapter 249A and the amount in the account of any patient 8 in the patients’ personal deposit fund exceeds two hundred 9 dollars, the department may apply any amount of the excess to 10 reimburse the county of residence or the state for liability 11 incurred by the county or the state for the payment of care, 12 support, and maintenance of the patient , when billed by the 13 county or state , as applicable . 14 Sec. 52. Section 222.92, subsection 1, Code 2024, is amended 15 to read as follows: 16 1. The department shall operate the state resource centers 17 on the basis of net appropriations from the general fund of 18 the state. The appropriation amounts shall be the net amounts 19 of state moneys projected to be needed for the state resource 20 centers for the fiscal year of the appropriations. The purpose 21 of utilizing net appropriations is to encourage the state 22 resource centers to operate with increased self-sufficiency, to 23 improve quality and efficiency, and to support collaborative 24 efforts between the state resource centers and counties and 25 other providers of funding for the services available from 26 the state resource centers. The state resource centers shall 27 not be operated under the net appropriations in a manner that 28 results in a cost increase to the state or in cost shifting 29 between the state, the medical assistance program, counties, or 30 other sources of funding for the state resource centers. 31 Sec. 53. Section 222.92, subsection 3, paragraph a, Code 32 2024, is amended by striking the paragraph. 33 Sec. 54. Section 225.1, subsection 2, Code 2024, is amended 34 to read as follows: 35 -32- HF 2673.4203 (2) 90 dg/ko 32/ 92
2. For the purposes of this chapter , unless the context 1 otherwise requires: 2 a. “Mental health and disability services region” means 3 a mental health and disability services region approved in 4 accordance with section 225C.56 . “Administrative services 5 organization” means the same as defined in section 225A.1. 6 b. “Regional administrator” means the administrator of a 7 mental health and disability services region, as defined in 8 section 225C.55 . “Department” means the department of health 9 and human services. 10 c. “Respondent” means the same as defined in section 229.1 . 11 Sec. 55. NEW SECTION . 225.4 State psychiatric hospital —— 12 admissions. 13 The department shall make all final determinations 14 concerning whether a person may be admitted to the state 15 psychiatric hospital. 16 Sec. 56. Section 225.11, Code 2024, is amended to read as 17 follows: 18 225.11 Initiating commitment procedures. 19 When a court finds upon completion of a hearing held pursuant 20 to section 229.12 that the contention that a respondent is 21 seriously mentally impaired has been sustained by clear and 22 convincing evidence, and the application filed under section 23 229.6 also contends or the court otherwise concludes that it 24 would be appropriate to refer the respondent to the state 25 psychiatric hospital for a complete psychiatric evaluation and 26 appropriate treatment pursuant to section 229.13 , the judge 27 may order that a financial investigation be made in the manner 28 prescribed by section 225.13 . If the costs of a respondent’s 29 evaluation or treatment are payable in whole or in part by a 30 county an administrative services organization , an order under 31 this section shall be for referral of the respondent through 32 the regional administrator for the respondent’s county of 33 residence by an administrative services organization for an 34 evaluation and referral of the respondent to an appropriate 35 -33- HF 2673.4203 (2) 90 dg/ko 33/ 92
placement or service, which may include the state psychiatric 1 hospital for additional evaluation or treatment. 2 Sec. 57. Section 225.12, Code 2024, is amended to read as 3 follows: 4 225.12 Voluntary public patient —— physician’s or physician 5 assistant’s report. 6 A physician or a physician assistant who meets the 7 qualifications set forth in the definition of a mental health 8 professional in section 228.1 filing information under 9 section 225.10 shall include a written report to the regional 10 administrator for the county of residence of the person named 11 in the information, giving shall submit a detailed history of 12 the case to an administrative services organization as will be 13 likely to aid in the observation, treatment, and hospital care 14 of the person and describing the history in detail . 15 Sec. 58. Section 225.13, Code 2024, is amended to read as 16 follows: 17 225.13 Financial condition. 18 The regional administrator for the county of residence of 19 a person being admitted to the state psychiatric hospital is 20 Administrative services organizations shall be responsible for 21 investigating the financial condition of the a person and of 22 those legally responsible for the person’s support. 23 Sec. 59. Section 225.15, Code 2024, is amended to read as 24 follows: 25 225.15 Examination and treatment. 26 1. When a respondent arrives at the state psychiatric 27 hospital, the admitting physician, or a physician assistant 28 who meets the qualifications set forth in the definition of a 29 mental health professional in section 228.1 , shall examine the 30 respondent and determine whether or not, in the physician’s 31 or physician assistant’s judgment, the respondent is a fit 32 subject for observation, treatment, and hospital care. If, 33 upon examination, the physician or physician assistant who 34 meets the qualifications set forth in the definition of a 35 -34- HF 2673.4203 (2) 90 dg/ko 34/ 92
mental health professional in section 228.1 decides that the 1 respondent should be admitted to the hospital, the respondent 2 shall be provided a proper bed in the hospital. The physician 3 or physician assistant who meets the qualifications set forth 4 in the definition of a mental health professional in section 5 228.1 who has charge of the respondent shall proceed with 6 observation, medical treatment, and hospital care as in the 7 physician’s or physician assistant’s judgment are proper and 8 necessary, in compliance with sections 229.13 , 229.14 , this 9 section , and section 229.16 . After the respondent’s admission, 10 the observation, medical treatment, and hospital care of the 11 respondent may be provided by a mental health professional, 12 as defined in section 228.1 , who is licensed as a physician, 13 advanced registered nurse practitioner, or physician assistant. 14 2. A proper and competent nurse shall also be assigned to 15 look after and care for the respondent during observation, 16 treatment, and care. Observation, treatment, and hospital 17 care under this section which are payable in whole or in part 18 by a county shall only be provided as determined through 19 the regional administrator for the respondent’s county of 20 residence. 21 Sec. 60. Section 225.16, subsection 1, Code 2024, is amended 22 to read as follows: 23 1. If the regional administrator for a person’s county of 24 residence department finds from the physician’s information 25 or from the information of a physician assistant who 26 meets the qualifications set forth in the definition of 27 a mental health professional in section 228.1 which was 28 filed under the provisions of section 225.10 225.12 that it 29 would be appropriate for the person to be admitted to the 30 state psychiatric hospital, and the report of the regional 31 administrator made pursuant to section 225.13 shows the 32 department finds that the person and those who are legally 33 responsible for the person are not able to pay the expenses 34 incurred at the hospital, or are able to pay only a part of 35 -35- HF 2673.4203 (2) 90 dg/ko 35/ 92
the expenses, the person shall be considered to be a voluntary 1 public patient and the regional administrator shall direct that 2 the person shall be sent to the state psychiatric hospital at 3 the state university of Iowa for observation, treatment, and 4 hospital care. 5 Sec. 61. Section 225.17, subsection 2, Code 2024, is amended 6 to read as follows: 7 2. When the respondent arrives at the hospital, the 8 respondent shall receive the same treatment as is provided for 9 committed public patients in section 225.15 , in compliance 10 with sections 229.13 through 229.16 . However, observation, 11 treatment, and hospital care under this section of a respondent 12 whose expenses are payable in whole or in part by a county 13 shall only be provided as determined through the regional 14 administrator for the respondent’s county of residence. 15 Sec. 62. Section 225.18, Code 2024, is amended to read as 16 follows: 17 225.18 Attendants. 18 The regional administrator An administrative services 19 organization may appoint an attendant to accompany the 20 committed public patient or the voluntary public patient 21 or the committed private patient from the place where the 22 patient may be to the state psychiatric hospital, or to 23 accompany the patient from the hospital to a place as may 24 be designated by the regional administrator administrative 25 services organization . If a patient is moved pursuant to this 26 section , at least one attendant shall be of the same gender as 27 the patient. 28 Sec. 63. Section 225.22, Code 2024, is amended to read as 29 follows: 30 225.22 Liability of private patients —— payment. 31 Every committed private patient, if the patient has an 32 estate sufficient for that purpose, or if those legally 33 responsible for the patient’s support are financially able, 34 shall be liable to the county and state for all expenses paid 35 -36- HF 2673.4203 (2) 90 dg/ko 36/ 92
by them in the state on behalf of such patient. All bills 1 for the care, nursing, observation, treatment, medicine, and 2 maintenance of such patients shall be paid by the director of 3 the department of administrative services in the same manner as 4 those of committed and voluntary public patients as provided in 5 this chapter , unless the patient or those legally responsible 6 for the patient make such settlement with the state psychiatric 7 hospital. 8 Sec. 64. Section 225.24, Code 2024, is amended to read as 9 follows: 10 225.24 Collection of preliminary expense. 11 Unless a committed private patient or those legally 12 responsible for the patient’s support offer to settle the 13 amount of the claims, the regional administrator for the 14 person’s county of residence department shall collect, by 15 action if necessary, the amount of all claims for per diem and 16 expenses that have been approved by the regional administrator 17 for the county an administrative services organization and 18 paid by the regional administrator as provided under section 19 225.21 administrative services organization . Any amount 20 collected shall be credited to the mental health and disability 21 services region combined account created behavioral health fund 22 established in accordance with section 225C.58 225A.7 . 23 Sec. 65. Section 225.27, Code 2024, is amended to read as 24 follows: 25 225.27 Discharge —— transfer. 26 The state psychiatric hospital may, at any time, discharge 27 any patient as recovered, as improved, or as not likely to 28 be benefited by further treatment. If the patient being so 29 discharged was involuntarily hospitalized, the hospital shall 30 notify the committing judge or court of the discharge as 31 required by section 229.14 or section 229.16 , whichever is as 32 applicable , and the applicable regional administrator . Upon 33 receiving the notification, the court shall issue an order 34 confirming the patient’s discharge from the hospital or from 35 -37- HF 2673.4203 (2) 90 dg/ko 37/ 92
care and custody, as the case may be, and shall terminate the 1 proceedings pursuant to which the order was issued. The court 2 or judge shall, if necessary, appoint a person to accompany the 3 discharged patient from the state psychiatric hospital to such 4 place as the hospital or the court may designate, or authorize 5 the hospital to appoint such attendant. 6 Sec. 66. Section 226.1, subsection 4, Code 2024, is amended 7 by adding the following new paragraph: 8 NEW PARAGRAPH . 0a. “Administrative services organization” 9 means the same as defined in section 225A.1. 10 Sec. 67. Section 226.1, subsection 4, paragraphs d and f, 11 Code 2024, are amended by striking the paragraphs. 12 Sec. 68. Section 226.8, subsection 2, Code 2024, is amended 13 to read as follows: 14 2. Charges for the care of any person with a diagnosis of 15 an intellectual disability admitted to a state mental health 16 institute shall be made by the institute in the manner provided 17 by chapter 230 , but the liability of any other person to any 18 mental health and disability services region the state for the 19 cost of care of such person with a diagnosis of an intellectual 20 disability shall be as prescribed by section 222.78 . 21 Sec. 69. Section 226.32, Code 2024, is amended to read as 22 follows: 23 226.32 Overcrowded conditions. 24 The director shall order the discharge or removal from the 25 mental health institute of incurable and harmless patients 26 whenever it is necessary to make room for recent cases. If 27 a patient who is to be discharged entered the mental health 28 institute voluntarily, the director shall notify the regional 29 administrator for the county interested at least ten days in 30 advance of the day of actual discharge. 31 Sec. 70. Section 226.34, subsection 2, paragraph d, Code 32 2024, is amended by striking the paragraph. 33 Sec. 71. Section 228.6, subsection 1, Code 2024, is amended 34 to read as follows: 35 -38- HF 2673.4203 (2) 90 dg/ko 38/ 92
1. A mental health professional or an employee of or 1 agent for a mental health facility may disclose mental health 2 information if and to the extent necessary, to meet the 3 requirements of section 229.24 , 229.25 , 230.20 , 230.21 , 230.25 , 4 230.26 , 230A.108 , 232.74 , or 232.147 , or to meet the compulsory 5 reporting or disclosure requirements of other state or federal 6 law relating to the protection of human health and safety. 7 Sec. 72. Section 229.1, Code 2024, is amended by adding the 8 following new subsection: 9 NEW SUBSECTION . 01. “Administrative services organization” 10 means the same as defined in section 225A.1. 11 Sec. 73. Section 229.1, subsections 11, 18, and 19, Code 12 2024, are amended by striking the subsections. 13 Sec. 74. Section 229.1B, Code 2024, is amended to read as 14 follows: 15 229.1B Regional administrator Administrative services 16 organization . 17 Notwithstanding any provision of this chapter to the 18 contrary, any person whose hospitalization expenses are 19 payable in whole or in part by a mental health and disability 20 services region an administrative services organization 21 shall be subject to all administrative requirements of the 22 regional administrator for the county administrative services 23 organization . 24 Sec. 75. Section 229.2, subsection 1, paragraph b, 25 subparagraph (3), Code 2024, is amended to read as follows: 26 (3) As soon as is practicable after the filing of a 27 petition for juvenile court approval of the admission of the 28 minor, the juvenile court shall determine whether the minor 29 has an attorney to represent the minor in the hospitalization 30 proceeding, and if not, the court shall assign to the minor 31 an attorney. If the minor is financially unable to pay for 32 an attorney, the attorney shall be compensated by the mental 33 health and disability services region an administrative 34 services organization at an hourly rate to be established 35 -39- HF 2673.4203 (2) 90 dg/ko 39/ 92
by the regional administrator for the county in which the 1 proceeding is held administrative services organization in 2 substantially the same manner as provided in section 815.7 . 3 Sec. 76. Section 229.2, subsection 2, paragraph a, Code 4 2024, is amended to read as follows: 5 a. The chief medical officer of a public hospital shall 6 receive and may admit the person whose admission is sought, 7 subject in cases other than medical emergencies to availability 8 of suitable accommodations and to the provisions of sections 9 section 229.41 and 229.42 . 10 Sec. 77. Section 229.8, subsection 1, Code 2024, is amended 11 to read as follows: 12 1. Determine whether the respondent has an attorney 13 who is able and willing to represent the respondent in the 14 hospitalization proceeding, and if not, whether the respondent 15 is financially able to employ an attorney and capable of 16 meaningfully assisting in selecting one. In accordance with 17 those determinations, the court shall if necessary allow the 18 respondent to select, or shall assign to the respondent, an 19 attorney. If the respondent is financially unable to pay an 20 attorney, the attorney shall be compensated by the mental 21 health and disability services region an administrative 22 services organization at an hourly rate to be established 23 by the regional administrator for the county in which the 24 proceeding is held administrative services organization in 25 substantially the same manner as provided in section 815.7 . 26 Sec. 78. Section 229.10, subsection 1, paragraph a, Code 27 2024, is amended to read as follows: 28 a. An examination of the respondent shall be conducted by 29 one or more licensed physicians or mental health professionals, 30 as required by the court’s order, within a reasonable time. 31 If the respondent is detained pursuant to section 229.11, 32 subsection 1 , paragraph “b” , the examination shall be conducted 33 within twenty-four hours. If the respondent is detained 34 pursuant to section 229.11, subsection 1 , paragraph “a” or 35 -40- HF 2673.4203 (2) 90 dg/ko 40/ 92
“c” , the examination shall be conducted within forty-eight 1 hours. If the respondent so desires, the respondent shall be 2 entitled to a separate examination by a licensed physician or 3 mental health professional of the respondent’s own choice. The 4 reasonable cost of the examinations shall, if the respondent 5 lacks sufficient funds to pay the cost, be paid by the regional 6 administrator from mental health and disability services region 7 funds an administrative services organization upon order of the 8 court. 9 Sec. 79. Section 229.11, subsection 1, unnumbered paragraph 10 1, Code 2024, is amended to read as follows: 11 If the applicant requests that the respondent be taken into 12 immediate custody and the judge, upon reviewing the application 13 and accompanying documentation, finds probable cause to believe 14 that the respondent has a serious mental impairment and is 15 likely to injure the respondent or other persons if allowed 16 to remain at liberty, the judge may enter a written order 17 directing that the respondent be taken into immediate custody 18 by the sheriff or the sheriff’s deputy and be detained until 19 the hospitalization hearing. The hospitalization hearing shall 20 be held no more than five days after the date of the order, 21 except that if the fifth day after the date of the order is 22 a Saturday, Sunday, or a holiday, the hearing may be held 23 on the next succeeding business day. If the expenses of a 24 respondent are payable in whole or in part by a mental health 25 and disability services region an administrative services 26 organization , for a placement in accordance with paragraph “a” , 27 the judge shall give notice of the placement to the regional 28 administrator for the county in which the court is located an 29 administrative services organization , and for a placement in 30 accordance with paragraph “b” or “c” , the judge shall order 31 the placement in a hospital or facility designated through 32 the regional administrator by an administrative services 33 organization . The judge may order the respondent detained for 34 the period of time until the hearing is held, and no longer, 35 -41- HF 2673.4203 (2) 90 dg/ko 41/ 92
in accordance with paragraph “a” , if possible, and if not then 1 in accordance with paragraph “b” , or, only if neither of these 2 alternatives is available, in accordance with paragraph “c” . 3 Detention may be in any of the following: 4 Sec. 80. Section 229.13, subsection 1, paragraph a, Code 5 2024, is amended to read as follows: 6 a. The court shall order a respondent whose expenses are 7 payable in whole or in part by a mental health and disability 8 services region an administrative services organization 9 placed under the care of an appropriate hospital or facility 10 designated through the regional administrator for the county 11 by an administrative services organization on an inpatient or 12 outpatient basis. 13 Sec. 81. Section 229.13, subsection 7, paragraph b, Code 14 2024, is amended to read as follows: 15 b. A region An administrative services organization shall 16 contract with mental health professionals to provide the 17 appropriate treatment including treatment by the use of oral 18 medicine or injectable antipsychotic medicine pursuant to this 19 section . 20 Sec. 82. Section 229.14, subsection 2, paragraph a, Code 21 2024, is amended to read as follows: 22 a. For a respondent whose expenses are payable in whole 23 or in part by a mental health and disability services region 24 an administrative services organization , placement as 25 designated through the regional administrator for the county 26 by an administrative services organization in the care of an 27 appropriate hospital or facility on an inpatient or outpatient 28 basis, or other appropriate treatment, or in an appropriate 29 alternative placement. 30 Sec. 83. Section 229.14A, subsections 7 and 9, Code 2024, 31 are amended to read as follows: 32 7. If a respondent’s expenses are payable in whole or in 33 part by a mental health and disability services region through 34 the regional administrator for the county an administrative 35 -42- HF 2673.4203 (2) 90 dg/ko 42/ 92
services organization , notice of a placement hearing shall be 1 provided to the county attorney and the regional administrator 2 an administrative services organization . At the hearing, the 3 county may present evidence regarding appropriate placement. 4 9. A placement made pursuant to an order entered under 5 section 229.13 or 229.14 or this section shall be considered to 6 be authorized through the regional administrator for the county 7 by an administrative services organization . 8 Sec. 84. Section 229.15, subsection 4, Code 2024, is amended 9 to read as follows: 10 4. When a patient has been placed in an alternative facility 11 other than a hospital pursuant to a report issued under section 12 229.14, subsection 1 , paragraph “d” , a report on the patient’s 13 condition and prognosis shall be made to the court which placed 14 the patient, at least once every six months, unless the court 15 authorizes annual reports. If an evaluation of the patient is 16 performed pursuant to section 227.2, subsection 4 , a copy of 17 the evaluation report shall be submitted to the court within 18 fifteen days of the evaluation’s completion. The court may in 19 its discretion waive the requirement of an additional report 20 between the annual evaluations. If the department exercises 21 the authority to remove residents or patients from a county 22 care facility or other county or private facility under section 23 227.6 , the department shall promptly notify each court which 24 placed in that facility any resident or patient removed. 25 Sec. 85. Section 229.19, subsection 1, paragraphs a and b, 26 Code 2024, are amended to read as follows: 27 a. In each county the board of supervisors shall appoint 28 an individual who has demonstrated by prior activities an 29 informed concern for the welfare and rehabilitation of persons 30 with mental illness, and who is not an officer or employee of 31 the department , an officer or employee of a region, an officer 32 or employee of a county performing duties for a region, or 33 an officer or employee of any agency or facility providing 34 care or treatment to persons with mental illness, to act as an 35 -43- HF 2673.4203 (2) 90 dg/ko 43/ 92
advocate representing the interests of patients involuntarily 1 hospitalized by the court, in any matter relating to the 2 patients’ hospitalization or treatment under section 229.14 or 3 229.15 . 4 b. The committing court shall assign the advocate for the 5 county where the patient is located. A county or region may 6 seek reimbursement from the patient’s county of residence or 7 from the region in which the patient’s county of residence is 8 located an administrative services organization . 9 Sec. 86. Section 229.19, subsection 4, unnumbered paragraph 10 1, Code 2024, is amended to read as follows: 11 The state mental health and disability services commission 12 created in section 225C.5 department , in consultation with 13 advocates and county and judicial branch representatives, shall 14 adopt rules pursuant to chapter 17A relating to advocates that 15 include but are not limited to all of the following topics: 16 Sec. 87. Section 229.22, subsection 2, paragraph b, Code 17 2024, is amended to read as follows: 18 b. If the magistrate orders that the person be detained, 19 the magistrate shall, by the close of business on the next 20 working day, file a written order with the clerk in the county 21 where it is anticipated that an application may be filed 22 under section 229.6 . The order may be filed by facsimile if 23 necessary. A peace officer from the law enforcement agency 24 that took the person into custody, if no request was made 25 under paragraph “a” , may inform the magistrate that an arrest 26 warrant has been issued for or charges are pending against the 27 person and request that any written order issued under this 28 paragraph require the facility or hospital to notify the law 29 enforcement agency about the discharge of the person prior to 30 discharge. The order shall state the circumstances under which 31 the person was taken into custody or otherwise brought to a 32 facility or hospital, and the grounds supporting the finding 33 of probable cause to believe that the person is seriously 34 mentally impaired and likely to injure the person’s self or 35 -44- HF 2673.4203 (2) 90 dg/ko 44/ 92
others if not immediately detained. The order shall also 1 include any law enforcement agency notification requirements if 2 applicable. The order shall confirm the oral order authorizing 3 the person’s detention including any order given to transport 4 the person to an appropriate facility or hospital. A peace 5 officer from the law enforcement agency that took the person 6 into custody may also request an order, separate from the 7 written order, requiring the facility or hospital to notify the 8 law enforcement agency about the discharge of the person prior 9 to discharge. The clerk shall provide a copy of the written 10 order or any separate order to the chief medical officer of 11 the facility or hospital to which the person was originally 12 taken, to any subsequent facility to which the person was 13 transported, and to any law enforcement department, ambulance 14 service, or transportation service under contract with a 15 mental health and disability services region an administrative 16 services organization that transported the person pursuant 17 to the magistrate’s order. A transportation service that 18 contracts with a mental health and disability services region 19 an administrative services organization for purposes of this 20 paragraph shall provide a secure transportation vehicle and 21 shall employ staff that has received or is receiving mental 22 health training. 23 Sec. 88. Section 229.24, subsection 3, unnumbered paragraph 24 1, Code 2024, is amended to read as follows: 25 If all or part of the costs associated with hospitalization 26 of an individual under this chapter are chargeable to a county 27 of residence an administrative services organization , the 28 clerk of the district court shall provide to the regional 29 administrator for the county of residence and to the regional 30 administrator for the county in which the hospitalization 31 order is entered an administrative services organization the 32 following information pertaining to the individual which would 33 be confidential under subsection 1 : 34 Sec. 89. Section 229.38, Code 2024, is amended to read as 35 -45- HF 2673.4203 (2) 90 dg/ko 45/ 92
follows: 1 229.38 Cruelty or official misconduct. 2 If any person having the care of a person with mental illness 3 who has voluntarily entered a hospital or other facility for 4 treatment or care, or who is responsible for psychiatric 5 examination care, treatment, and maintenance of any person 6 involuntarily hospitalized under sections 229.6 through 229.15 , 7 whether in a hospital or elsewhere, with or without proper 8 authority, shall treat such patient with unnecessary severity, 9 harshness, or cruelty, or in any way abuse the patient or if 10 any person unlawfully detains or deprives of liberty any person 11 with mental illness or any person who is alleged to have mental 12 illness, or if any officer required by the provisions of this 13 chapter and chapters chapter 226 and 227 , to perform any act 14 shall willfully refuse or neglect to perform the same, the 15 offending person shall, unless otherwise provided, be guilty of 16 a serious misdemeanor. 17 Sec. 90. Section 230.1, Code 2024, is amended by adding the 18 following new subsection: 19 NEW SUBSECTION . 01. “Administrative service organization” 20 means the same as defined in section 225A.1. 21 Sec. 91. Section 230.1, subsections 4 and 5, Code 2024, are 22 amended by striking the subsections. 23 Sec. 92. Section 230.10, Code 2024, is amended to read as 24 follows: 25 230.10 Payment of costs. 26 All legal costs and expenses for the taking into custody, 27 care, investigation, and admission or commitment of a person to 28 a state mental health institute under a finding that the person 29 has residency in another county of this state shall be charged 30 against the regional administrator of the person’s county of 31 residence to an administrative services organization . 32 Sec. 93. Section 230.11, Code 2024, is amended to read as 33 follows: 34 230.11 Recovery of costs from state. 35 -46- HF 2673.4203 (2) 90 dg/ko 46/ 92
Costs and expenses for the taking into custody, care, and 1 investigation of a person who has been admitted or committed 2 to a state mental health institute, United States department 3 of veterans affairs hospital, or other agency of the United 4 States government, for persons with mental illness and 5 who has no residence in this state or whose residence is 6 unknown, including cost of commitment, if any, shall be paid 7 as approved by the department. The amount of the costs and 8 expenses approved by the department is appropriated to the 9 department from any moneys in the state treasury not otherwise 10 appropriated. Payment shall be made by the department on 11 itemized vouchers executed by the regional administrator of 12 the person’s county which has paid them, and approved by the 13 department. 14 Sec. 94. Section 230.15, subsections 1 and 2, Code 2024, are 15 amended to read as follows: 16 1. A person with mental illness and a person legally liable 17 for the person’s support remain liable for the support of 18 the person with mental illness as provided in this section . 19 Persons legally liable for the support of a person with mental 20 illness include the spouse of the person, and any person 21 bound by contract for support of the person. The regional 22 administrator of the person’s county of residence, subject to 23 the direction of the region’s governing board, shall enforce 24 the obligation created in this section as to all sums advanced 25 by the regional administrator. The liability to the regional 26 administrator incurred by a person with mental illness or a 27 person legally liable for the person’s support under this 28 section is limited to an amount equal to one hundred percent 29 of the cost of care and treatment of the person with mental 30 illness at a state mental health institute for one hundred 31 twenty days of hospitalization. This limit of liability may 32 be reached by payment of the cost of care and treatment of the 33 person with mental illness subsequent to a single admission 34 or multiple admissions to a state mental health institute or, 35 -47- HF 2673.4203 (2) 90 dg/ko 47/ 92
if the person is not discharged as cured, subsequent to a 1 single transfer or multiple transfers to a county care facility 2 pursuant to section 227.11 . After reaching this limit of 3 liability, a person with mental illness or a person legally 4 liable for the person’s support is liable to the regional 5 administrator state for the care and treatment of the person 6 with mental illness at a state mental health institute or, 7 if transferred but not discharged as cured, at a county care 8 facility in an amount not in excess of to exceed the average 9 minimum cost of the maintenance of an individual who is 10 physically and mentally healthy residing in the individual’s 11 own home , which standard shall be as established and may be 12 revised by the department by rule . A lien imposed by section 13 230.25 shall not exceed the amount of the liability which may 14 be incurred under this section on account of a person with 15 mental illness. 16 2. A person with a substance use disorder is legally 17 liable for the total amount of the cost of providing care, 18 maintenance, and treatment for the person with a substance 19 use disorder while a voluntary or committed patient. When 20 a portion of the cost is paid by a county an administrative 21 services organization , the person with a substance use disorder 22 is legally liable to the county administrative services 23 organization for the amount paid. The person with a substance 24 use disorder shall assign any claim for reimbursement under any 25 contract of indemnity, by insurance or otherwise, providing 26 for the person’s care, maintenance, and treatment in a state 27 mental health institute to the state. Any payments received 28 by the state from or on behalf of a person with a substance use 29 disorder shall be in part credited to the county in proportion 30 to the share of the costs paid by the county. 31 Sec. 95. NEW SECTION . 230.23 State —— payor of last resort. 32 The department shall implement services and adopt rules 33 pursuant to chapter 17A in a manner that ensures that the state 34 is the payor of last resort, and that the department does not 35 -48- HF 2673.4203 (2) 90 dg/ko 48/ 92
make any payments for services that have been provided until 1 the department has determined that the services provided are 2 not payable by a third-party source. 3 Sec. 96. Section 230.30, Code 2024, is amended to read as 4 follows: 5 230.30 Claim against estate. 6 On the death of a person receiving or who has received 7 assistance under the provisions of this chapter , and whom the 8 board department has previously found , under section 230.25 , 9 is able to pay , there shall be allowed against the estate of 10 such decedent a claim of the sixth class for that portion of 11 the total amount paid for that person’s care which exceeds 12 the total amount of all claims of the first through the fifth 13 classes, inclusive, as defined in section 633.425 , which are 14 allowed against that estate. 15 Sec. 97. Section 232.78, subsection 5, unnumbered paragraph 16 1, Code 2024, is amended to read as follows: 17 The juvenile court, before or after the filing of a petition 18 under this chapter , may enter an ex parte order authorizing 19 a physician or physician assistant or hospital to conduct an 20 outpatient physical examination or authorizing a physician or 21 physician assistant, a psychologist certified under section 22 154B.7, or a community mental health center accredited pursuant 23 to chapter 230A section 225A.3 to conduct an outpatient mental 24 examination of a child if necessary to identify the nature, 25 extent, and cause of injuries to the child as required by 26 section 232.71B , provided all of the following apply: 27 Sec. 98. Section 232.83, subsection 2, unnumbered paragraph 28 1, Code 2024, is amended to read as follows: 29 Anyone authorized to conduct a preliminary investigation in 30 response to a complaint may apply for, or the court on its own 31 motion may enter, an ex parte order authorizing a physician 32 or physician assistant or hospital to conduct an outpatient 33 physical examination or authorizing a physician or physician 34 assistant, a psychologist certified under section 154B.7, or a 35 -49- HF 2673.4203 (2) 90 dg/ko 49/ 92
community mental health center accredited pursuant to chapter 1 230A section 225A.3 to conduct an outpatient mental examination 2 of a child if necessary to identify the nature, extent, and 3 causes of any injuries, emotional damage, or other such needs 4 of a child as specified in section 232.96A, subsection 3, 5, or 5 6 , provided that all of the following apply: 6 Sec. 99. Section 235.7, subsection 2, Code 2024, is amended 7 to read as follows: 8 2. Membership. The department may authorize the governance 9 boards of decategorization of child welfare and juvenile 10 justice funding projects established under section 232.188 to 11 appoint the transition committee membership and may utilize 12 the boundaries of decategorization projects to establish 13 the service areas for transition committees. The committee 14 membership may include but is not limited to department staff 15 involved with foster care, child welfare, and adult services, 16 juvenile court services staff, staff involved with county 17 general assistance or emergency relief under chapter 251 or 18 252, or a regional administrator of the county mental health 19 and disability services region, as defined in section 225C.55, 20 in the area, school district and area education agency staff 21 involved with special education, and a child’s court appointed 22 special advocate, guardian ad litem, service providers, and 23 other persons knowledgeable about the child. 24 Sec. 100. Section 235A.15, subsection 2, paragraph c, 25 subparagraphs (5) and (8), Code 2024, are amended by striking 26 the subparagraphs. 27 Sec. 101. Section 249A.4, subsection 15, Code 2024, is 28 amended by striking the subsection. 29 Sec. 102. Section 249A.12, subsection 4, Code 2024, is 30 amended by striking the subsection. 31 Sec. 103. NEW SECTION . 249A.38A Supported community living 32 services. 33 1. As used in this section, “supported community living 34 service” means a service provided in a noninstitutional setting 35 -50- HF 2673.4203 (2) 90 dg/ko 50/ 92
to persons sixteen years of age and older with mental illness, 1 an intellectual disability, brain injury, or developmental 2 disabilities to meet the persons’ daily living needs. 3 2. The department shall adopt rules pursuant to chapter 17A 4 establishing minimum standards for supported community living 5 services. 6 3. The department shall determine whether to grant, deny, or 7 revoke approval for any supported community living service. 8 4. Approved supported community living services may receive 9 funding from the state, federal and state social services block 10 grant funds, and other appropriate funding sources, consistent 11 with state legislation and federal regulations. The funding 12 may be provided on a per diem, per hour, or grant basis, as 13 appropriate. 14 Sec. 104. Section 249N.8, Code 2024, is amended by striking 15 the section and inserting in lieu thereof the following: 16 249N.8 Behavioral health services reports. 17 The department shall annually submit a report to the 18 governor and the general assembly with details related to the 19 department’s review of the funds administered by, and the 20 outcomes and effectiveness of, the behavioral health services 21 provided by, the behavioral health service system established 22 in section 225A.3. 23 Sec. 105. Section 252.24, subsections 1 and 3, Code 2024, 24 are amended to read as follows: 25 1. The county of residence, as defined in section 225C.61 26 331.190 , shall be liable to the county granting assistance for 27 all reasonable charges and expenses incurred in the assistance 28 and care of a poor person. 29 3. This section shall apply to assistance or maintenance 30 provided by a county through the county’s mental health 31 and disability services behavioral health service system 32 implemented under chapter 225C established in section 225A.3 . 33 Sec. 106. Section 256.25, subsections 2 and 3, Code 2024, 34 are amended to read as follows: 35 -51- HF 2673.4203 (2) 90 dg/ko 51/ 92
2. A school district, which may collaborate and partner 1 with one or more school districts, area education agencies, 2 accredited nonpublic schools, nonprofit agencies, and 3 institutions that provide children’s mental health services, 4 located in mental health and disability services regions 5 providing children’s behavioral health services in accordance 6 with chapter 225C, subchapter VII operating within the state’s 7 behavioral health service system under chapter 225A , may apply 8 for a grant under this program to establish a therapeutic 9 classroom in the school district in accordance with this 10 section . 11 3. The department shall develop a grant application 12 and selection and evaluation criteria. Selection criteria 13 shall include a method for prioritizing grant applications 14 submitted by school districts. First priority shall be 15 given to applications submitted by school districts that 16 submitted an application pursuant to this section for the 17 previous immediately preceding fiscal year. Second priority 18 shall be given to applications submitted by school districts 19 that, pursuant to subsection 2 , are collaborating and 20 partnering with one or more school districts, area education 21 agencies, accredited nonpublic schools, nonprofit agencies, 22 or institutions that provide mental health services for 23 children. Third priority shall be given to applications 24 submitted by school districts located in mental health and 25 disability services regions behavioral health districts as 26 defined in section 225A.1, and that are providing behavioral 27 health services for children in accordance with chapter 225C, 28 subchapter VII 225A . Grant awards shall be distributed as 29 equitably as possible among small, medium, and large school 30 districts. For purposes of this subsection , a small school 31 district is a district with an actual enrollment of fewer than 32 six hundred pupils; a medium school district is a district 33 with an actual enrollment that is at least six hundred pupils, 34 but less than two thousand five hundred pupils; and a large 35 -52- HF 2673.4203 (2) 90 dg/ko 52/ 92
school district is a district with an actual enrollment of two 1 thousand five hundred or more pupils. 2 Sec. 107. Section 321.189, subsection 10, Code 2024, is 3 amended to read as follows: 4 10. Autism spectrum disorder status. A licensee who has 5 autism spectrum disorder, as defined in section 514C.28 , may 6 request that the license be marked to reflect the licensee’s 7 autism spectrum disorder status on the face of the license 8 when the licensee applies for the issuance or renewal of a 9 license. The department may adopt rules pursuant to chapter 10 17A establishing criteria under which a license may be marked, 11 including requiring the licensee to submit medical proof of the 12 licensee’s autism spectrum disorder status. When a driver’s 13 license is so marked, the licensee’s autism spectrum disorder 14 status shall be noted in the electronic database used by 15 the department and law enforcement to access registration, 16 titling, and driver’s license information. The department, in 17 consultation with the mental health and disability services 18 commission department of health and human services , shall 19 develop educational media to raise awareness of a licensee’s 20 ability to request the license be marked to reflect the 21 licensee’s autism spectrum disorder status. 22 Sec. 108. Section 321.190, subsection 1, paragraph b, 23 subparagraph (6), Code 2024, is amended to read as follows: 24 (6) An applicant for a nonoperator’s identification 25 card who has autism spectrum disorder, as defined in section 26 514C.28 , may request that the card be marked to reflect 27 the applicant’s autism spectrum disorder status on the face 28 of the card when the applicant applies for the issuance or 29 renewal of a card. The department may adopt rules pursuant to 30 chapter 17A establishing criteria under which a card may be 31 marked, including requiring the applicant to submit medical 32 proof of the applicant’s autism spectrum disorder status. 33 The department, in consultation with the mental health and 34 disability services commission department of health and human 35 -53- HF 2673.4203 (2) 90 dg/ko 53/ 92
services , shall develop educational media to raise awareness of 1 an applicant’s ability to request the card be marked to reflect 2 the applicant’s autism spectrum disorder status. 3 Sec. 109. Section 321J.25, subsection 1, paragraph b, Code 4 2024, is amended to read as follows: 5 b. “Program” means a substance use disorder awareness 6 program , licensed under chapter 125, and provided under a 7 contract entered into between the provider and the department 8 of health and human services under chapter 125 or an 9 administrative services organization as defined in section 10 225A.1 . 11 Sec. 110. Section 321J.25, subsection 2, unnumbered 12 paragraph 1, Code 2024, is amended to read as follows: 13 A substance use disorder awareness program is established 14 in each of the regions established by the director of health 15 and human services pursuant to section 125.12 behavioral 16 health district designated pursuant to section 225A.4 . The 17 program shall consist of an insight class and a substance 18 use disorder evaluation, which shall be attended by the 19 participant, to discuss issues related to the potential 20 consequences of substance use disorder. The parent or parents 21 of the participant shall also be encouraged to participate 22 in the program. The program provider shall consult with the 23 participant or the parents of the participant in the program 24 to determine the timing and appropriate level of participation 25 for the participant and any participation by the participant’s 26 parents. The program may also include a supervised educational 27 tour by the participant to any or all of the following: 28 Sec. 111. Section 331.321, subsection 1, paragraph e, Code 29 2024, is amended by striking the paragraph. 30 Sec. 112. Section 331.323, subsection 1, paragraph a, 31 subparagraph (7), Code 2024, is amended by striking the 32 subparagraph. 33 Sec. 113. Section 331.381, subsections 4 and 5, Code 2024, 34 are amended to read as follows: 35 -54- HF 2673.4203 (2) 90 dg/ko 54/ 92
4. Comply with chapter 222 , including but not limited to 1 sections 222.13 , 222.14 , 222.59 through 222.70 , 222.73 through 2 222.75 , and 222.77 through 222.82 , in regard to the care of 3 persons with an intellectual disability. 4 5. Comply with chapters 227, 229 and 230 , including but not 5 limited to sections 227.11 , 227.14 , 229.42 , 230.25 , 230.27 , and 6 230.35 , in regard to the care of persons with mental illness. 7 Sec. 114. Section 331.382, subsection 1, paragraphs e, f, 8 and g, Code 2024, are amended by striking the paragraphs. 9 Sec. 115. Section 331.382, subsection 3, Code 2024, is 10 amended by striking the subsection. 11 Sec. 116. Section 331.432, subsection 3, Code 2024, is 12 amended by striking the subsection. 13 Sec. 117. Section 331.502, subsection 10, Code 2024, is 14 amended by striking the subsection. 15 Sec. 118. Section 331.502, subsection 12, Code 2024, is 16 amended to read as follows: 17 12. Carry out duties relating to the hospitalization and 18 support of persons with mental illness as provided in sections 19 229.42, 230.3 , 230.11 , and 230.15 , 230.21 , 230.22 , 230.25 , and 20 230.26 . 21 Sec. 119. Section 331.552, subsection 13, Code 2024, is 22 amended by striking the subsection. 23 Sec. 120. Section 331.756, subsections 25, 38, and 41, Code 24 2024, are amended by striking the subsections. 25 Sec. 121. Section 331.910, subsection 2, Code 2024, is 26 amended by adding the following new paragraph: 27 NEW PARAGRAPH . 0a. “Administrative services organization” 28 means the same as defined in section 225A.1. 29 Sec. 122. Section 331.910, subsection 2, paragraph d, Code 30 2024, is amended by striking the paragraph. 31 Sec. 123. Section 331.910, subsection 3, paragraphs a and c, 32 Code 2024, are amended to read as follows: 33 a. A region An administrative services organization may 34 contract with a receiving agency in a bordering state to secure 35 -55- HF 2673.4203 (2) 90 dg/ko 55/ 92
substance use disorder or mental health care and treatment 1 under this subsection for persons who receive substance use 2 disorder or mental health care and treatment pursuant to 3 section 125.33, 125.91 , 229.2 , or 229.22 through a region . 4 c. A region An administrative services organization may 5 contract with a sending agency in a bordering state to provide 6 care and treatment under this subsection for residents of 7 the bordering state in approved substance use disorder and 8 mental health care and treatment hospitals, centers, and 9 facilities in this state, except that care and treatment shall 10 not be provided for residents of the bordering state who are 11 involved in criminal proceedings substantially similar to the 12 involvement described in paragraph “b” . 13 Sec. 124. Section 347.16, subsection 3, Code 2024, is 14 amended to read as follows: 15 3. Care and treatment may be furnished in a county public 16 hospital to any sick or injured person who has residence 17 outside the county which maintains the hospital, subject to 18 such policies and rules as the board of hospital trustees 19 may adopt. If care and treatment is provided under this 20 subsection to a person who is indigent, the person’s county of 21 residence, as defined in section 225C.61 331.190 , shall pay to 22 the board of hospital trustees the fair and reasonable cost of 23 the care and treatment provided by the county public hospital 24 unless the cost of the indigent person’s care and treatment is 25 otherwise provided for. If care and treatment is provided to 26 an indigent person under this subsection , the county public 27 hospital furnishing the care and treatment shall immediately 28 notify, by regular mail, the auditor of the county of residence 29 of the indigent person of the provision of care and treatment 30 to the indigent person including care and treatment provided 31 by a county through the county’s mental health and disability 32 services system implemented under chapter 225C behavioral 33 health service system established in section 225A.3 . 34 Sec. 125. Section 423.3, subsection 18, paragraph d, Code 35 -56- HF 2673.4203 (2) 90 dg/ko 56/ 92
2024, is amended to read as follows: 1 d. Community mental health centers accredited by the 2 department of health and human services pursuant to chapter 3 225C section 225A.3 . 4 Sec. 126. Section 426B.1, subsection 2, Code 2024, is 5 amended to read as follows: 6 2. Moneys shall be distributed from the property tax relief 7 fund to the mental health and disability services regional 8 service system for mental health and disability services, 9 behavioral health fund established in section 225A.7 in 10 accordance with the appropriations made to the fund and other 11 statutory requirements. 12 Sec. 127. Section 437A.8, subsection 4, paragraph d, Code 13 2024, is amended to read as follows: 14 d. (1) Notwithstanding paragraph “a” , a taxpayer who owns 15 or leases a new electric power generating plant and who has 16 no other operating property in the state of Iowa except for 17 operating property directly serving the new electric power 18 generating plant as described in section 437A.16 shall pay 19 the replacement generation tax associated with the allocation 20 of the local amount to the county treasurer of the county in 21 which the local amount is located and shall remit the remaining 22 replacement generation tax, if any, to the director according 23 to paragraph “a” for remittance of the tax to county treasurers. 24 The director shall notify each taxpayer on or before August 31 25 following a tax year of its remaining replacement generation 26 tax to be remitted to the director. All remaining replacement 27 generation tax revenues received by the director shall be 28 deposited in the property tax relief fund created in section 29 426B.1 , and shall be distributed as provided in section 426B.2 . 30 (2) If a taxpayer has paid an amount of replacement tax, 31 penalty, or interest which was deposited into the property tax 32 relief fund and which was not due, all of the provisions of 33 section 437A.14, subsection 1 , paragraph “b” , shall apply with 34 regard to any claim for refund or credit filed by the taxpayer. 35 -57- HF 2673.4203 (2) 90 dg/ko 57/ 92
The director shall have sole discretion as to whether the 1 erroneous payment will be refunded to the taxpayer or credited 2 against any replacement tax due, or to become due, from the 3 taxpayer that would be subject to deposit in the property tax 4 relief fund. 5 Sec. 128. Section 437A.15, subsection 3, paragraph f, Code 6 2024, is amended to read as follows: 7 f. Notwithstanding the provisions of this section , if 8 a taxpayer is a municipal utility or a municipal owner of 9 an electric power facility financed under the provisions 10 of chapter 28F or 476A , the assessed value, other than the 11 local amount, of a new electric power generating plant shall 12 be allocated to each taxing district in which the municipal 13 utility or municipal owner is serving customers and has 14 electric meters in operation in the ratio that the number of 15 operating electric meters of the municipal utility or municipal 16 owner located in the taxing district bears to the total number 17 of operating electric meters of the municipal utility or 18 municipal owner in the state as of January 1 of the tax year. 19 If the municipal utility or municipal owner of an electric 20 power facility financed under the provisions of chapter 28F 21 or 476A has a new electric power generating plant but the 22 municipal utility or municipal owner has no operating electric 23 meters in this state, the municipal utility or municipal owner 24 shall pay the replacement generation tax associated with the 25 new electric power generating plant allocation of the local 26 amount to the county treasurer of the county in which the local 27 amount is located and shall remit the remaining replacement 28 generation tax, if any, to the director at the times contained 29 in section 437A.8, subsection 4 , for remittance of the tax to 30 the county treasurers. All remaining replacement generation 31 tax revenues received by the director shall be deposited in the 32 property tax relief behavioral health fund created established 33 in section 426B.1, and shall be distributed as provided in 34 section 426B.2 225A.7 . 35 -58- HF 2673.4203 (2) 90 dg/ko 58/ 92
Sec. 129. Section 483A.24, subsection 7, Code 2024, is 1 amended to read as follows: 2 7. A license shall not be required of minor pupils of the 3 Iowa school for the deaf or of minor residents of other state 4 institutions under the control of the department of health 5 and human services. In addition, a person who is on active 6 duty with the armed forces of the United States, on authorized 7 leave from a duty station located outside of this state, and 8 a resident of the state of Iowa shall not be required to 9 have a license to hunt or fish in this state. The military 10 person shall carry the person’s leave papers and a copy of 11 the person’s current earnings statement showing a deduction 12 for Iowa income taxes while hunting or fishing. In lieu of 13 carrying the person’s earnings statement, the military person 14 may also claim residency if the person is registered to vote 15 in this state. If a deer or wild turkey is taken, the military 16 person shall immediately contact a state conservation officer 17 to obtain an appropriate tag to transport the animal. A 18 license shall not be required of residents of county care 19 facilities or any person who is receiving supplementary 20 assistance under chapter 249 . 21 Sec. 130. Section 602.8102, subsection 39, Code 2024, is 22 amended to read as follows: 23 39. Refer persons applying for voluntary admission to a 24 community mental health center accredited by the department 25 of health and human services under section 225A.3, for a 26 preliminary diagnostic evaluation as provided in section 27 225C.16, subsection 2 . 28 Sec. 131. Section 714.8, subsection 12, Code 2024, is 29 amended to read as follows: 30 12. Knowingly transfers or assigns a legal or equitable 31 interest in property, as defined in section 702.14 , for less 32 than fair consideration, with the intent to obtain public 33 assistance under chapters 16 , 35B , and 35D , and 347B , or Title 34 VI, subtitles 2 through 6 , or accepts a transfer of or an 35 -59- HF 2673.4203 (2) 90 dg/ko 59/ 92
assignment of a legal or equitable interest in property, as 1 defined in section 702.14 , for less than fair consideration, 2 with the intent of enabling the party transferring the property 3 to obtain public assistance under chapters 16 , 35B , and 35D , 4 and 347B , or Title VI, subtitles 2 through 6 . A transfer or 5 assignment of property for less than fair consideration within 6 one year prior to an application for public assistance benefits 7 shall be evidence of intent to transfer or assign the property 8 in order to obtain public assistance for which a person is 9 not eligible by reason of the amount of the person’s assets. 10 If a person is found guilty of a fraudulent practice in the 11 transfer or assignment of property under this subsection the 12 maximum sentence shall be the penalty established for a serious 13 misdemeanor and sections 714.9 , 714.10 , and 714.11 shall not 14 apply. 15 Sec. 132. Section 812.6, subsection 1, Code 2024, is amended 16 to read as follows: 17 1. If the court finds the defendant does not pose a danger 18 to the public peace and safety, is otherwise qualified for 19 pretrial release, and is willing to cooperate with treatment, 20 the court shall order, as a condition of pretrial release, 21 that the defendant obtain mental health treatment designed to 22 restore the defendant to competency. The costs of treatment 23 pursuant to this subsection shall be paid by the mental 24 health and disability services region for the county of the 25 defendant’s residency pursuant to chapter 225C regardless of 26 whether the defendant meets financial eligibility requirements 27 under section 225C.62 or 225C.66 an administrative services 28 organization designated pursuant to section 225A.4 . 29 Sec. 133. Section 904.201, subsection 8, Code 2024, is 30 amended to read as follows: 31 8. Chapter 230 governs the determination of costs and 32 charges for the care and treatment of persons with mental 33 illness admitted to the forensic psychiatric hospital , 34 except that charges for the care and treatment of any person 35 -60- HF 2673.4203 (2) 90 dg/ko 60/ 92
transferred to the forensic psychiatric hospital from an adult 1 correctional institution or from a state training school shall 2 be paid entirely from state funds . Charges for all other 3 persons at the forensic psychiatric hospital shall be billed to 4 the respective counties at the same ratio as for patients at 5 state mental health institutes under section 230.20. 6 Sec. 134. REPEAL. Chapters 142A, 225C, 227, 230A, and 347B, 7 Code 2024, are repealed. 8 Sec. 135. REPEAL. Sections 125.1, 125.3, 125.7, 125.9, 9 125.10, 125.12, 125.25, 125.32A, 125.34, 125.37, 125.38, 10 125.39, 125.40, 125.41, 125.42, 125.43, 125.43A, 125.46, 11 125.48, 125.54, 125.55, 125.58, 125.59, 125.60, 135B.18, 12 218.99, 222.59, 222.60, 222.61, 222.62, 222.63, 222.64, 222.65, 13 222.66, 222.67, 222.68, 222.69, 222.70, 222.74, 222.75, 225.10, 14 225.19, 225.21, 226.45, 229.42, 230.1A, 230.2, 230.3, 230.4, 15 230.5, 230.6, 230.9, 230.12, 230.16, 230.17, 230.18, 230.19, 16 230.20, 230.21, 230.22, 230.25, 230.26, 230.27, 426B.2, 426B.4, 17 and 426B.5, Code 2024, are repealed. 18 Sec. 136. CODE EDITOR DIRECTIVE. The Code editor is 19 directed to correct internal references in the Code and in any 20 enacted legislation as necessary due to the enactment of this 21 division of this Act. 22 Sec. 137. EFFECTIVE DATE. This division of this Act takes 23 effect July 1, 2025. 24 DIVISION III 25 AGING AND DISABILITY 26 Sec. 138. Section 231.3, Code 2024, is amended to read as 27 follows: 28 231.3 State policy and objectives. 29 1. The general assembly declares that it is the policy of 30 the state to work toward attainment of the following objectives 31 for Iowa’s older individuals and individuals with disabilities : 32 1. a. An adequate income. 33 2. b. Access to physical and mental health care and 34 long-term living and community support services without regard 35 -61- HF 2673.4203 (2) 90 dg/ko 61/ 92
to economic status. 1 3. c. Suitable and affordable housing that reflects the 2 needs of older individuals. 3 4. d. Access to comprehensive information and a community 4 navigation system providing all available options related to 5 long-term living and community support services that assist 6 older individuals in the preservation of personal assets and 7 the ability to entirely avoid or significantly delay reliance 8 on entitlement programs. 9 5. e. Full restorative services for those who require 10 institutional care, and a comprehensive array of long-term 11 living and community support services adequate to sustain older 12 people in their communities and, whenever possible, in their 13 homes, including support for caregivers. 14 6. f. Pursuit of meaningful activity within the widest 15 range of civic, cultural, educational, recreational, and 16 employment opportunities. 17 7. g. Suitable community transportation systems to assist 18 in the attainment of independent movement. 19 8. h. Freedom, independence, and the free exercise of 20 individual initiative in planning and managing their own lives. 21 9. i. Freedom from abuse, neglect, and exploitation. 22 2. The general assembly declares that the state of Iowa 23 recognizes a brain injury as a disability, and each agency and 24 subdivision of this state shall recognize a brain injury as a 25 distinct disability. 26 3. It is the policy of this state that each state agency 27 shall make reasonable efforts to identify those persons with 28 brain injuries among the persons served by the state agency. 29 Sec. 139. Section 231.4, subsection 1, Code 2024, is amended 30 by adding the following new paragraph: 31 NEW PARAGRAPH . 0c. “Brain injury” means the same as defined 32 in section 135.22. 33 Sec. 140. Section 231.4, subsection 1, paragraph d, Code 34 2024, is amended to read as follows: 35 -62- HF 2673.4203 (2) 90 dg/ko 62/ 92
d. “Commission” means the commission on aging. “Council” 1 means the council on health and human services created in 2 section 217.2. 3 Sec. 141. Section 231.14, Code 2024, is amended to read as 4 follows: 5 231.14 Commission Council duties and authority. 6 1. The commission is the policymaking body of the sole state 7 agency responsible for administration of the federal Act. The 8 commission council shall do all of the following : 9 a. 1. Approve Make recommendations to the department 10 regarding approval of the state plan on aging developed under 11 section 231.31 and area plans on aging , developed under section 12 231.33 . 13 b. 2. Adopt Recommend policies to coordinate state 14 activities related to the purposes of this chapter . 15 c. 3. Serve as an effective and visible advocate for older 16 individuals and individuals with disabilities by establishing 17 recommending policies for reviewing and commenting upon 18 all state plans, budgets, and policies which affect older 19 individuals and for providing technical assistance to any 20 agency, organization, association, or individual representing 21 the needs of older individuals with disabilities . 22 d. Divide the state into distinct planning and service 23 areas after considering the geographical distribution of 24 older individuals in the state, the incidence of the need 25 for supportive services, nutrition services, multipurpose 26 senior centers, and legal services, the distribution of older 27 individuals who have low incomes residing in such areas, the 28 distribution of resources available to provide such services 29 or centers, the boundaries of existing areas within the 30 state which are drawn for the planning or administration of 31 supportive services programs, the location of units of general 32 purpose, local government within the state, and any other 33 relevant factors. 34 e. Designate for each planning and service area a public or 35 -63- HF 2673.4203 (2) 90 dg/ko 63/ 92
private nonprofit agency or organization as the area agency on 1 aging for that area. The commission may revoke the designation 2 of an area agency on aging pursuant to section 231.32 . 3 f. 4. Adopt policies to assure Make recommendations to 4 ensure that the department will take into account the views 5 of older individuals and individuals with disabilities in the 6 development of policy. 7 g. Adopt a method for the distribution of federal 8 Act and state funds taking into account, to the maximum 9 extent feasible, the best available data on the geographic 10 distribution of older individuals in the state, and publish the 11 method for review and comment. 12 h. 5. Adopt Recommend policies and measures to assure 13 ensure that preference will be given to providing services to 14 older individuals and individuals with disabilities with the 15 greatest economic or social needs, with particular attention to 16 low-income minority older individuals, older individuals with 17 limited English proficiency, and older individuals residing in 18 rural areas. 19 i. 6. Adopt Recommend policies to administer state programs 20 authorized by this chapter . 21 j. 7. Adopt Recommend policies and administrative rules 22 pursuant to chapter 17A that support the capabilities of the 23 area agencies on aging and the aging and disabilities resource 24 centers to serve older individuals and persons individuals 25 with disabilities experiencing Alzheimer’s disease or related 26 dementias. 27 2. The commission shall adopt administrative rules pursuant 28 to chapter 17A to administer the duties specified in this 29 chapter and in all other chapters under the department’s 30 jurisdiction. 31 Sec. 142. Section 231.21, Code 2024, is amended to read as 32 follows: 33 231.21 Administration of chapter —— department of health and 34 human services. 35 -64- HF 2673.4203 (2) 90 dg/ko 64/ 92
The department of health and human services shall administer 1 this chapter under the policy direction of the commission 2 on aging consider the recommendations of the council when 3 administering this chapter . 4 Sec. 143. Section 231.23, Code 2024, is amended to read as 5 follows: 6 231.23 Department —— duties and authority. 7 The department shall: 8 1. Develop and administer a Administer the state plan on 9 aging developed pursuant to section 231.31 . 10 2. Assist the commission in the review and approval of 11 Review and approve area plans developed under section 231.33 . 12 3. Pursuant to commission policy, coordinate Coordinate 13 state activities related to the purposes of this chapter 14 and all other chapters under the department’s jurisdiction . 15 State activities shall include, at a minimum, home and 16 community-based services such as employment support, community 17 living, and service coordination. 18 4. Advocate for older individuals and individuals with 19 disabilities by reviewing and commenting upon all state plans, 20 budgets, laws, rules, regulations, and policies which affect 21 older individuals or individuals with disabilities and by 22 providing technical assistance to any agency, organization, 23 association, or individual representing the needs of older 24 individuals or individuals with disabilities . 25 5. Assist the commission in dividing Divide the state into 26 distinct planning and service areas after considering the 27 geographical distribution of older individuals and individuals 28 with disabilities in the state, the incidence of the need 29 for supportive services, nutrition services, multipurpose 30 senior centers, and legal services, the distribution of older 31 individuals and individuals with disabilities with low income 32 residing in such areas, the distribution of resources available 33 to provide such services or centers, the boundaries of existing 34 areas within the state which are drawn for the planning or 35 -65- HF 2673.4203 (2) 90 dg/ko 65/ 92
administration of supportive services programs, the location of 1 units of general purpose, local government within the state, 2 and any other relevant factors . 3 6. Assist the commission in designating Designate for each 4 area a public or private nonprofit agency or organization as 5 the area agency on aging for that area. The department may 6 revoke the designation of an area agency on aging pursuant to 7 section 231.32. 8 7. Pursuant to commission policy, take Take into account the 9 views of older Iowans and Iowans with disabilities . 10 8. Assist the commission in adopting Adopt a method for 11 the distribution of funds available from the federal Act 12 and state appropriations and allocations that takes into 13 account, to the extent feasible, the best available data on the 14 geographic distribution of older individuals and individuals 15 with disabilities in the state . 16 9. Assist the commission in assuring Adopt policies and 17 measures to ensure that preference will be given to providing 18 services to older individuals and individuals with disabilities 19 with the greatest economic or social needs, with particular 20 attention to low-income minority older individuals, older 21 individuals with limited English proficiency, and older 22 individuals residing in rural areas. 23 10. Assist the commission in developing, adopting, and 24 enforcing Develop, adopt, and enforce administrative rules, 25 including by issuing necessary forms and procedures , to 26 administer the duties specified in this chapter . 27 11. Apply for, receive, and administer grants, devises, 28 donations, and gifts , or bequests of real or personal property 29 from any source to conduct projects consistent with the 30 purposes of the department. Notwithstanding section 8.33 , 31 moneys received by the department pursuant to this section are 32 not subject to reversion to the general fund of the state. 33 12. Administer state authorized programs. 34 13. Establish a procedure for an area agency on aging to 35 -66- HF 2673.4203 (2) 90 dg/ko 66/ 92
use in selection of members of the agency’s board of directors. 1 The selection procedure shall be incorporated into the bylaws 2 of the board of directors. 3 14. Adopt rules pursuant to chapter 17A that support the 4 capabilities of the area agencies on aging, and aging and 5 disabilities resource centers, to serve older individuals and 6 individuals with disabilities. 7 Sec. 144. Section 231.23A, subsections 1 and 3, Code 2024, 8 are amended to read as follows: 9 1. Services for older individuals, persons with 10 disabilities eighteen years of age and older, family 11 caregivers, and veterans as defined by the department in the 12 most current version of the department’s reporting manual and 13 pursuant to the federal Act and regulations. 14 3. The aging Aging and disability resource center centers . 15 Sec. 145. Section 231.23A, Code 2024, is amended by adding 16 the following new subsection: 17 NEW SUBSECTION . 7A. Services and supports available to 18 individuals with disabilities including but not limited to 19 individuals with mental illness, an intellectual disability or 20 other developmental disability, or a brain injury. 21 Sec. 146. Section 231.31, Code 2024, is amended to read as 22 follows: 23 231.31 State plan on aging. 24 The department shall develop , and submit to the commission 25 on aging for approval, a multiyear state plan on aging. 26 The state plan on aging shall meet all applicable federal 27 requirements. 28 Sec. 147. Section 231.32, Code 2024, is amended to read as 29 follows: 30 231.32 Criteria for designation of area agencies on aging. 31 1. The commission department shall designate an area 32 agency on aging for each planning and service area. The 33 commission shall continue the designation shall continue until 34 an area agency on aging’s designation is removed for cause as 35 -67- HF 2673.4203 (2) 90 dg/ko 67/ 92
determined by the commission department , until the time of 1 renewal or the annual update of an area plan, until the agency 2 voluntarily withdraws as an area agency on aging, or until a 3 change in the designation of planning and service areas or area 4 agencies on aging is required by state or federal law. In that 5 event, the commission department shall proceed in accordance 6 with subsections 2, 3, and 4 . Designated area agencies on 7 aging shall comply with the requirements of the federal Act. 8 2. The commission department shall designate an area 9 agency on aging to serve each planning and service area, after 10 consideration of the views offered by units of general purpose 11 local government. An area agency on aging may be: 12 a. An established office of aging which is operating within 13 a planning and service area designated by the commission 14 department . 15 b. Any office or agency of a unit of general purpose local 16 government, which is designated to function only for the 17 purpose of serving as an area agency on aging by the chief 18 elected official of such unit. 19 c. Any office or agency designated by the appropriate 20 chief elected officials of any combination of units of 21 general purpose local government to act only on behalf of such 22 combination for such purpose. 23 d. Any public or nonprofit private agency in a planning and 24 service area or any separate organizational unit within such 25 agency which is under the supervision or direction for this 26 purpose of the department and which can and will engage only in 27 the planning or provision of a broad range of long-term living 28 and community support services or nutrition services within the 29 planning and service area. 30 3. When the commission department designates a new area 31 agency on aging , the commission department shall give the right 32 of first refusal to a unit of general purpose local government 33 if: 34 a. Such unit can meet the requirements of subsection 1 . 35 -68- HF 2673.4203 (2) 90 dg/ko 68/ 92
b. The boundaries of such a unit and the boundaries of the 1 area are reasonably contiguous. 2 4. Each area agency on aging shall provide assurance, 3 determined adequate by the commission department , that the 4 area agency on aging has the ability to develop an area plan 5 and to carry out, directly or through contractual or other 6 arrangements, a program in accordance with the plan within the 7 planning and service area. In designating an area agency on 8 aging within the planning and service area, the commission 9 department shall give preference to an established office of 10 aging, unless the commission department finds that no such 11 office within the planning and service area has the capacity to 12 carry out the area plan. 13 5. Upon designation, an area agency on aging shall be 14 considered an instrumentality of the state and shall adhere to 15 all state and federal mandates applicable to an instrumentality 16 of the state. 17 Sec. 148. Section 231.33, subsections 1 and 13, Code 2024, 18 are amended to read as follows: 19 1. Develop and administer an area plan on aging approved by 20 the commission department . 21 13. Submit all fiscal and performance reports in accordance 22 with the policies of the commission department . 23 Sec. 149. NEW SECTION . 231.35 Procedures related to 24 expenditure of state and federal funds. 25 1. The department shall establish and enforce procedures 26 relating to expenditure of state and federal funds by area 27 agencies on aging that require compliance with both state and 28 federal laws, rules, and regulations, including but not limited 29 to all of the following: 30 a. Requiring that expenditures are incurred only for goods 31 or services received or performed prior to the end of the 32 fiscal period designated for use of the funds. 33 b. Prohibiting prepayment for goods or services not received 34 or performed prior to the end of the fiscal period designated 35 -69- HF 2673.4203 (2) 90 dg/ko 69/ 92
for use of the funds. 1 c. Prohibiting prepayment for goods or services not defined 2 specifically by good or service, time period, or recipient. 3 d. Prohibiting the establishment of accounts from which 4 future goods or services which are not defined specifically by 5 good or service, time period, or recipient, may be purchased. 6 2. The procedures shall provide that if any funds are 7 expended in a manner that is not in compliance with the 8 procedures and applicable federal and state laws, rules, and 9 regulations, and are subsequently subject to repayment, the 10 area agency on aging expending such funds in contravention of 11 such procedures, laws, rules and regulations, not the state, 12 shall be liable for such repayment. 13 Sec. 150. Section 231.56, Code 2024, is amended to read as 14 follows: 15 231.56 Services and programs. 16 The department shall administer long-term living and 17 community support services and programs that allow older 18 individuals and individuals with disabilities to secure and 19 maintain maximum independence and dignity in a home environment 20 that provides for self-care with appropriate supportive 21 services, assist in removing individual and social barriers 22 to economic and personal independence for older individuals 23 and individuals with disabilities , and provide a continuum of 24 care for older individuals and individuals with disabilities. 25 Funds appropriated for this purpose shall be allocated based 26 on administrative rules adopted by the commission department 27 pursuant to chapter 17A . The department shall require such 28 records as needed adopt rules pursuant to chapter 17A that 29 allow the department to collect information as necessary from 30 long-term living and community support services, program 31 providers, and patients to administer this section . 32 Sec. 151. Section 231.57, Code 2024, is amended to read as 33 follows: 34 231.57 Coordination of advocacy. 35 -70- HF 2673.4203 (2) 90 dg/ko 70/ 92
The department shall administer a program for the 1 coordination of information and assistance provided within 2 the state to assist older individuals and individuals with 3 disabilities, and their caregivers , in obtaining and protecting 4 their rights and benefits. State and local agencies providing 5 information and assistance to older individuals and individuals 6 with disabilities, and their caregivers , in seeking their 7 rights and benefits shall cooperate with the department in 8 administering this program. 9 Sec. 152. Section 231.58, Code 2024, is amended to read as 10 follows: 11 231.58 Long-term living coordination. 12 The director may convene meetings, as necessary, of the 13 director and the director of inspections, appeals, and 14 licensing, to assist in the coordination of policy, service 15 delivery, and long-range planning relating to the long-term 16 living system and older Iowans and Iowans with disabilities 17 in the state. The group may consult with individuals, 18 institutions, and entities with expertise in the area of the 19 long-term living system and older Iowans and Iowans with 20 disabilities , as necessary, to facilitate the group’s efforts. 21 Sec. 153. Section 231.64, Code 2024, is amended to read as 22 follows: 23 231.64 Aging and disability resource center centers . 24 1. The aging and disability resource center shall be 25 administered by the department consistent with the federal 26 Act . The department shall designate area agencies on aging and 27 disability resource centers to establish, in consultation with 28 other stakeholders including organizations representing the 29 disability community, a coordinated local aging and disability 30 service system for providing . In addition to services required 31 by the department by rules adopted pursuant to chapter 17A, 32 aging and disability resource centers shall provide for all of 33 the following: 34 a. Comprehensive information, referral, and assistance 35 -71- HF 2673.4203 (2) 90 dg/ko 71/ 92
regarding the full range of available public and private 1 long-term living and community support services, options, 2 service providers, and resources within a community, including 3 information on the availability of integrated long-term care. 4 b. Options counseling to assist individuals in assessing 5 their existing or anticipated long-term care needs and 6 developing and implementing a plan for long-term living and 7 community support services designed to meet their specific 8 needs and circumstances. The plan for long-term living 9 and community support services may include support with 10 person-centered care transitions to assist consumers and family 11 caregivers with transitions between home and care settings. 12 c. Consumer access to the range of publicly-supported 13 long-term living and community support services for which 14 consumers may be eligible, by serving as a convenient point 15 of entry for such services. The aging Aging and disability 16 resource center centers shall offer information online and 17 be available via a toll-free telephone number, electronic 18 communications, and in person. 19 2. The following entities shall be eligible to be designated 20 as an aging and disability resource center by the department: 21 a. An area agency on aging established on or before June 30, 22 2024. 23 b. A public or private nonprofit agency, or any separate 24 organizational unit within the public or private nonprofit 25 agency, that has the capabilities to engage in the planning or 26 provision of aging and disability services only as directed by 27 the department. 28 2. 3. The aging Aging and disability resource center 29 centers shall assist older individuals, persons individuals 30 with disabilities age eighteen or older , family caregivers, 31 and people who inquire about or request assistance on behalf 32 of members of these groups, as they seek long-term living and 33 community support services. 34 4. The department shall adopt rules pursuant to chapter 17A 35 -72- HF 2673.4203 (2) 90 dg/ko 72/ 92
to implement this section. 1 Sec. 154. NEW SECTION . 231.75 Scope. 2 The service quality standards and rights in this subchapter 3 VII shall apply to any person with an intellectual disability, 4 a developmental disability, brain injury, or chronic mental 5 illness who receives services which are funded in whole or in 6 part by public funds, or services which are permitted under 7 Iowa law. 8 Sec. 155. NEW SECTION . 231.76 Service quality standards. 9 As the state participates more fully in funding services 10 and other support for persons with an intellectual disability, 11 developmental disability, brain injury, or chronic mental 12 illness, it is the intent of the general assembly that the 13 state shall seek to attain the following quality standards in 14 the provision of services and other supports: 15 1. Provide comprehensive evaluation and diagnosis adapted 16 to the cultural background, primary language, and ethnic origin 17 of a person. 18 2. Provide an individual treatment, habilitation, and 19 program services plan. 20 3. Provide treatment, habilitation, and program services 21 that are individualized, flexible, cost-effective, and produce 22 results. 23 4. Provide periodic review of an individual’s treatment, 24 habilitation, and program services plan. 25 5. Provide for the least restrictive environment, and 26 age-appropriate services. 27 6. Provide appropriate training and employment 28 opportunities so that a person’s ability to contribute to, and 29 participate in, the community is maximized. 30 7. Provide an ongoing process to determine the degree of 31 access to, and the effectiveness of, the services and other 32 supports in achieving the disability service outcomes and 33 indicators identified by the department. 34 Sec. 156. NEW SECTION . 231.77 Rights. 35 -73- HF 2673.4203 (2) 90 dg/ko 73/ 92
All of the following rights shall apply to a person with an 1 intellectual disability, a developmental disability, a brain 2 injury, or a chronic mental illness: 3 1. Wage protection. A person engaged in a work program 4 shall be paid wages commensurate with the going rate for 5 comparable work and productivity. 6 2. Insurance protection. Pursuant to section 507B.4, 7 subsection 3, paragraph “g” , a person or designated group 8 of persons shall not be unfairly discriminated against for 9 purposes of insurance coverage. 10 3. Citizenship. A person retains the right to citizenship 11 in accordance with the laws of the state. 12 4. Participation in planning activities. A person has 13 the right to participate in the formulation of an individual 14 treatment, habilitation, and program plan developed for the 15 person. 16 Sec. 157. NEW SECTION . 231.78 Compliance. 17 1. A person’s sole remedy for a violation of a rule adopted 18 by the department to implement sections 231.75 through 231.77 19 shall be to initiate a proceeding with the department by 20 request pursuant to chapter 17A. 21 a. Any decision of the department shall be in accordance 22 with due process of law. A person or party who is aggrieved or 23 adversely affected by the department’s action may seek judicial 24 review pursuant to section 17A.19. A person or party who is 25 aggrieved or adversely affected by a final judgment of the 26 district court may appeal under section 17A.20. 27 b. Either the department or a party in interest may apply 28 to the Iowa district court for an order to enforce a final 29 decision of the department. 30 2. Any rules adopted by the department to implement sections 31 231.76 and 231.77 shall not create any right, entitlement, 32 property or liberty right or interest, or private cause of 33 action for damages against the state or a political subdivision 34 of the state, or for which the state or a political subdivision 35 -74- HF 2673.4203 (2) 90 dg/ko 74/ 92
of the state would be responsible. 1 3. Notwithstanding subsection 1, any violation of section 2 231.77, subsection 2, shall be subject to enforcement by the 3 commissioner of insurance pursuant to chapter 507B. 4 Sec. 158. NEW SECTION . 231.79 Appeals process. 5 The department shall establish an appeals process by which a 6 person or the person’s representative may appeal a decision of 7 the department concerning the provision or denial of aging or 8 disability services to the person. 9 Sec. 159. Section 231E.3, Code 2024, is amended to read as 10 follows: 11 231E.3 Definitions. 12 As used in this chapter , unless the context otherwise 13 requires: 14 1. “Client” means an individual for whom a representative 15 payee is appointed. 16 2. “Commission” means the commission on aging. 17 3. 2. “Conservator” means conservator as defined in section 18 633.3 . 19 4. 3. “Court” means court as defined in section 633.3 . 20 5. 4. “Department” means the department of health and human 21 services. 22 6. 5. “Director” means the director of health and human 23 services. 24 7. 6. “Guardian” means guardian as defined in section 25 633.3 . 26 8. 7. “Incompetent” means incompetent as defined in section 27 633.3 . 28 9. 8. “Local office” means a local office of public 29 guardian. 30 10. 9. “Local public guardian” means an individual under 31 contract with the department to act as a guardian, conservator, 32 or representative payee. 33 11. 10. “Public guardian” means the state public guardian 34 or a local public guardian. 35 -75- HF 2673.4203 (2) 90 dg/ko 75/ 92
12. 11. “Public guardianship services” means guardianship, 1 conservatorship, or representative payee services provided by 2 the state public guardian or a local public guardian. 3 13. 12. “Representative payee” means an individual 4 appointed by a government entity to receive funds on behalf of 5 a client pursuant to federal regulation. 6 14. 13. “State agency” means any executive department, 7 commission, board, institution, division, bureau, office, 8 agency, or other executive entity of state government. 9 15. 14. “State office” means the state office of public 10 guardian. 11 16. 15. “State public guardian” means the administrator of 12 the state office of public guardian. 13 17. 16. “Ward” means the individual for whom a guardianship 14 or conservatorship is established. 15 Sec. 160. REPEAL. Sections 231.11, 231.12, and 231.13, Code 16 2024, are repealed. 17 Sec. 161. CODE EDITOR DIRECTIVE. The Code editor is 18 directed to do all of the following: 19 1. Entitle Code chapter 231 “Department of Health and Human 20 Services —— Aging and Disability Services”. 21 2. Designate sections 231.75 through 231.79, as enacted in 22 this division of this Act, as subchapter VII entitled “Bill 23 of Rights and Service Quality Standards for Persons with an 24 Intellectual Disability, Developmental Disability, Brain 25 Injury, or Chronic Mental Illness”. 26 3. Correct internal references in the Code and in any 27 enacted legislation as necessary due to the enactment of this 28 division of this Act. 29 Sec. 162. EFFECTIVE DATE. The following take effect July 30 1, 2025: 31 1. The parts of the sections of this division of this Act 32 amending the following: 33 a. Section 231.3. 34 b. Section 231.4, subsection 1. 35 -76- HF 2673.4203 (2) 90 dg/ko 76/ 92
c. Section 231.23, subsections 4 and 7. 1 d. Section 231.23A, subsection 1. 2 e. Sections 231.56, 231.57, and 231.58. 3 f. Section 231.64, subsection 2. 4 2. The parts of the sections of this division of this Act 5 enacting the following: sections 231.23A, subsection 7A, 6 231.75, 231.76, 231.77, 231.78, and 231.79. 7 DIVISION IV 8 TRANSITION PROVISIONS 9 Sec. 163. DEPARTMENT OF HEALTH AND HUMAN SERVICES —— 10 TRANSITION OF MENTAL HEALTH SERVICES, ADDICTIVE DISORDER 11 SERVICES, AND DISABILITY SERVICES. 12 1. For purposes of this division: 13 a. “Administrative services organization” means the same 14 as defined in section 225A.1, as enacted in division I of this 15 Act. 16 b. “Behavioral health district” means the same as defined in 17 section 225A.1, as enacted in division I of this Act. 18 c. “Department” means the department of health and human 19 services. 20 d. “District behavioral health service system plan” means 21 the same as defined in section 225A.1, as enacted in division 22 I of this Act. 23 e. “Mental health and disability services region” means the 24 same as defined in section 225C.2, subsection 9. 25 f. “State behavioral health service system” means the state 26 behavioral health service system as established in section 27 225A.3, as enacted in division I of this Act. 28 g. “State behavioral health service system plan” means the 29 same as defined in section 225A.1, as enacted in division I of 30 this Act. 31 h. “Transition period” means the period beginning on the 32 date of enactment of this division of this Act and concluding 33 on June 30, 2025. 34 2. There is created a behavioral health service system under 35 -77- HF 2673.4203 (2) 90 dg/ko 77/ 92
the control of the department. For the fiscal year beginning 1 July 1, 2025, and each succeeding fiscal year, the behavioral 2 health service system shall be responsible for implementing and 3 maintaining a statewide system of prevention, education, early 4 intervention, treatment, recovery support, and crisis services 5 related to mental health and addictive disorders, including 6 but not limited to substance use, tobacco use, and problem 7 gambling. For the fiscal year beginning July 1, 2025, and each 8 succeeding fiscal year, the department’s division of aging 9 and disability services shall be responsible for disability 10 services. 11 3. During the transition period, the department may 12 exercise all policymaking functions and regulatory powers 13 established in division I of this Act, as necessary to 14 establish the state behavioral health service system. 15 4. To ensure the state behavioral health service system 16 and the division of aging and disability services are able to 17 operate as intended at the conclusion of the transition period, 18 the department shall perform all the following duties: 19 a. Make contracts as necessary to set up services and 20 administrative functions. 21 b. Adopt rules as necessary to establish and administer the 22 state’s behavioral health service system. 23 c. Establish policies as necessary to ensure efficient 24 implementation and operation of the behavioral health service 25 system. 26 d. Prepare forms necessary for the implementation and 27 administration of behavioral health services. 28 e. Prepare a state behavioral health service system plan for 29 the state behavioral health service system. 30 f. Designate behavioral health districts on or before 31 August 1, 2024. The behavioral health district designation 32 process shall include an opportunity for the public to 33 review and to comment on proposed behavioral health district 34 boundaries. 35 -78- HF 2673.4203 (2) 90 dg/ko 78/ 92
g. Designate an administrative services organization for 1 each behavioral health district on or before December 31, 2024. 2 h. Review and approve district behavioral health service 3 system plans for services related to the behavioral health 4 service system. 5 i. Issue all necessary licenses and certifications. 6 j. Establish contractual rights, privileges, and 7 responsibilities as necessary to establish and implement the 8 state behavioral health service system. 9 k. Develop and implement a plan to ensure that persons 10 currently receiving disability services or early intervention, 11 treatment, recovery support, or crisis services related 12 to mental health or addictive disorders, including but not 13 limited to alcohol use, substance use, tobacco use, and problem 14 gambling, have an uninterrupted continuum of care. 15 l. Establish a central data repository as described in 16 section 225A.6, as enacted in division I of this Act. 17 m. Collaborate with the department of revenue for 18 enforcement of tobacco laws, regulations, and ordinances and 19 engage in tobacco control activities. 20 5. If the department determines that a federal waiver or 21 authorization is necessary to administer any provision of this 22 division of this Act or to effectuate the state behavioral 23 health service system by the conclusion of the transition 24 period, the department shall timely request the federal waiver 25 or authorization. Notwithstanding any other effective date to 26 the contrary, a provision the department determines requires a 27 federal waiver or authorization shall be effective only upon 28 receipt of federal approval for the waiver or authorization. 29 6. a. On or before July 1, 2024, the department shall 30 publish on the department’s internet site an initial transition 31 plan for establishing the state behavioral health service 32 system. The transition plan shall describe, at a minimum, all 33 of the following: 34 (1) All tasks that require completion before July 1, 2025. 35 -79- HF 2673.4203 (2) 90 dg/ko 79/ 92
The description of tasks shall include a description of how the 1 department will solicit comments from stakeholders, including 2 employees of the department, persons served by the department, 3 partners of the department, members of the public, and members 4 of the general assembly, and a detailed timeline for the 5 completion of the tasks described. 6 (2) The proposed organizational structure of the state 7 behavioral health service system. 8 (3) The transition of service delivery sites from locations 9 where people currently receive behavioral health services to 10 where the people will receive behavioral health services under 11 the state behavioral health service system. 12 (4) Procedures for the transfer and reconciliation of 13 budgeting and funding between the mental health and disability 14 services regions and the department. 15 (5) A description of how responsibilities for disability 16 services programs will be transferred from current program 17 administrators to the department’s division of aging and 18 disability services by the end of the transition period. 19 (6) Any additional known tasks that may require completion 20 after the transition on July 1, 2025. 21 b. The transition plan published under paragraph “a” shall: 22 (1) Be updated no less than quarterly during the transition 23 period with the current status of completing the tasks 24 identified in paragraph “a”, subparagraph (1). 25 (2) Describe how information regarding any changes in 26 service delivery will be provided to persons receiving services 27 from the mental health and disability services regions or 28 current behavioral health care providers contracted with the 29 department. 30 (3) Describe how the transition is being funded, including 31 how expenses associated with the transition will be managed. 32 7. a. Before the end of the transition period, the 33 governing board of each mental health and disability services 34 region that maintains a combined account pursuant to section 35 -80- HF 2673.4203 (2) 90 dg/ko 80/ 92
225C.58, subsection 1, shall transfer all unencumbered and 1 unobligated moneys remaining in the combined account to the 2 treasurer of state for deposit into the behavioral health fund 3 as established in section 225A.7 as enacted in division I of 4 this Act. 5 b. Before the end of the transition period, each county 6 which maintains a county mental health and disability services 7 fund pursuant to section 225C.58, subsection 1, shall transfer 8 all unencumbered and unobligated moneys remaining in the mental 9 health and disability services fund to the treasurer of state 10 for deposit into the behavioral health fund as established in 11 section 225A.7 as enacted in division I of this Act. 12 c. Moneys in the behavioral health fund as established 13 in section 225A.7 as enacted in division I of this Act are 14 appropriated to the department for the purposes established in 15 section 225A.7 as enacted in division I of this Act, and as 16 otherwise necessary to effectuate this division of this Act. 17 8. a. All debts, claims, or other liabilities owed to a 18 county, a mental health and disability services region, or 19 the state due to services rendered pursuant to chapter 125, 20 222, 225, 225C, 226, 227, 229, 230, or 230A, Code 2024, at the 21 conclusion of the transition period shall remain due and owing 22 after the transition period concludes. 23 b. After the transition period concludes, each county 24 auditor shall collect outstanding debts, claims, or other 25 liabilities owed to the county for services rendered pursuant 26 to chapter 125, 222, 225, 225C, 226, 227, 229, 230, or 230A, 27 Code 2024, before the transition period concluded. The county 28 attorney may bring a judicial action as necessary to collect 29 the outstanding debts, claims, or other liabilities. 30 9. With input from appropriate stakeholders, the department 31 shall identify each contract that will be impacted by mental 32 health and disability services being transferred to the state 33 behavioral health service system, or by responsibilities 34 being transferred to the department’s division of aging and 35 -81- HF 2673.4203 (2) 90 dg/ko 81/ 92
disabilities, pursuant to this Act. On or before June 30, 1 2025, a party to a contract identified by the department 2 under this subsection shall exercise the option, if available 3 pursuant to the terms of the contract, to terminate the 4 contract in accordance with the terms of the contract which 5 provide for termination. Contracts that do not provide for 6 termination shall not be renewed or extended at the end of the 7 current contract term. 8 10. A mental health and disability services region, a 9 regional administrator as defined in section 225C.55, and 10 any subdivision of the state shall not enter into, renew, or 11 extend any contract for services related to mental health and 12 disability services or addictive disorder services beyond June 13 30, 2025. 14 Sec. 164. DEPARTMENT OF HEALTH AND HUMAN SERVICES —— 15 TRANSITION FUNDING —— 988 SERVICE FUNDING. 16 1. Notwithstanding any provision of law to the contrary, 17 there is appropriated from the region incentive fund of the 18 mental health and disability services regional service fund 19 created in section 225C.7A, subsection 8, to the department of 20 health and human services for the fiscal year beginning July 21 1, 2024, and ending June 30, 2025, the following amount, or 22 so much thereof as is necessary, to be used for the purposes 23 designated: 24 For the establishment of a central data repository as 25 described in section 225A.6, subsection 1, as enacted in 26 division I of this Act: 27 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ 645,179 28 2. There is appropriated from the region incentive fund 29 of the mental health and disability services regional service 30 fund created in section 225C.7A, to the department of health 31 and human services for the fiscal year beginning July 1, 2024, 32 and ending June 30, 2025, the following amount, or so much 33 thereof as is necessary, to be used to support the statewide 34 988 suicide and crisis line: 35 -82- HF 2673.4203 (2) 90 dg/ko 82/ 92
. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ 3,000,000 1 3. Notwithstanding section 8.33, moneys appropriated in 2 this section that remain unencumbered or unobligated at the 3 close of the fiscal year shall not revert to the credit of 4 the region incentive fund of the mental health and disability 5 services regional service fund, but shall be credited to the 6 behavioral health fund created in section 225A.7, as enacted in 7 division I of this Act, and are appropriated to the department 8 of health and human services for expenditure for the purposes 9 of the behavioral health fund. 10 Sec. 165. EMERGENCY RULES. The department of health and 11 human services may adopt emergency rules under section 17A.4, 12 subsection 3, and section 17A.5, subsection 2, paragraph “b”, 13 to implement the provisions of this division of this Act and 14 the rules shall be effective immediately upon filing unless 15 a later date is specified in the rules. Any rules adopted 16 in accordance with this section shall also be published as a 17 notice of intended action as provided in section 17A.4. 18 Sec. 166. EFFECTIVE DATE. This division of this Act, being 19 deemed of immediate importance, takes effect upon enactment. 20 DIVISION V 21 ELIMINATION OF SPECIAL INTELLECTUAL DISABILITY UNITS 22 Sec. 167. Section 222.1, subsection 3, Code 2024, is amended 23 by striking the subsection. 24 Sec. 168. Section 222.2, subsection 8, Code 2024, is amended 25 by striking the subsection. 26 Sec. 169. Section 222.5, Code 2024, is amended to read as 27 follows: 28 222.5 Preadmission diagnostic evaluation. 29 A person shall not be eligible for admission to a resource 30 center or a special unit until a preadmission diagnostic 31 evaluation has been made by a resource center or a special unit 32 which confirms or establishes the need for admission. 33 Sec. 170. Section 222.7, unnumbered paragraph 1, Code 2024, 34 is amended to read as follows: 35 -83- HF 2673.4203 (2) 90 dg/ko 83/ 92
The department may transfer patients from one state resource 1 center to the other and may at any time transfer patients from 2 the resource centers to the hospitals for persons with mental 3 illness , or transfer patients in the resource centers to a 4 special unit or vice versa . The department may also transfer 5 patients from a hospital for persons with mental illness to a 6 resource center if consent is given or obtained as follows: 7 Sec. 171. Section 222.8, Code 2024, is amended to read as 8 follows: 9 222.8 Communications by patients. 10 Persons admitted to the resource centers or a special 11 unit shall have all reasonable opportunity and facility for 12 communication with their friends. Such persons shall be 13 permitted to write and send letters, provided the letters 14 contain nothing of an offensive character. Letters written by 15 any patient to the director or to any state or county official 16 shall be forwarded unopened. 17 Sec. 172. Section 222.9, Code 2024, is amended to read as 18 follows: 19 222.9 Unauthorized departures. 20 If any person with an intellectual disability shall depart 21 without proper authorization from a resource center or a 22 special unit , it shall be the duty of the superintendent 23 and the superintendent’s assistants and all peace officers 24 of any county in which such patient may be found to take 25 and detain the patient without a warrant or order and to 26 immediately report such detention to the superintendent who 27 shall immediately provide for the return of such patient to the 28 resource center or special unit . 29 Sec. 173. Section 222.12, subsection 1, Code 2024, is 30 amended to read as follows: 31 1. Upon the death of a patient of a resource center or 32 special unit , a preliminary investigation of the death shall be 33 conducted as required by section 218.64 by the county medical 34 examiner as provided in section 331.802 . Such a preliminary 35 -84- HF 2673.4203 (2) 90 dg/ko 84/ 92
investigation shall also be conducted in the event of a sudden 1 or mysterious death of a patient in a private institution 2 for persons with an intellectual disability. The chief 3 administrative officer of any private institution may request 4 an investigation of the death of any patient by the county 5 medical examiner. 6 Sec. 174. Section 222.73, subsections 1, 3, and 5, Code 7 2024, are amended to read as follows: 8 1. The superintendent of each resource center and special 9 unit shall compute by February 1 the average daily patient 10 charge and outpatient treatment charges for which each county 11 will be billed for services provided to patients chargeable to 12 the county during the fiscal year beginning the following July 13 1. The department shall certify the amount of the charges and 14 notify the counties of the billing charges. 15 a. The superintendent shall compute the average daily 16 patient charge for a resource center or special unit for 17 services provided in the following fiscal year, in accordance 18 with generally accepted accounting procedures, by totaling 19 the expenditures of the resource center or special unit for 20 the immediately preceding calendar year, by adjusting the 21 expenditures by a percentage not to exceed the percentage 22 increase in the consumer price index for all urban consumers 23 for the immediately preceding calendar year, and by dividing 24 the adjusted expenditures by the total inpatient days of 25 service provided during the immediately preceding calendar 26 year. 27 b. The department shall compute the outpatient treatment 28 charges, in accordance with generally accepted accounting 29 procedures, on the basis of the actual cost of the outpatient 30 treatment provided during the immediately preceding calendar 31 year. 32 3. 2. The superintendent shall compute in January the 33 actual per-patient-per-day cost for each resource center or 34 special unit for the immediately preceding calendar year, in 35 -85- HF 2673.4203 (2) 90 dg/ko 85/ 92
accordance with generally accepted accounting procedures, by 1 totaling the actual expenditures of the resource center or 2 special unit for the calendar year and by dividing the total 3 actual expenditures by the total inpatient days of service 4 provided during the calendar year. 5 5. 3. A superintendent of a resource center or special 6 unit may request that the director enter into a contract with 7 a person for the resource center or special unit to provide 8 consultation or treatment services or for fulfilling other 9 purposes which are consistent with the purposes stated in 10 section 222.1 . The contract provisions shall include charges 11 which reflect the actual cost of providing the services. Any 12 income from a contract authorized under this subsection may 13 be retained by the resource center or special unit to defray 14 the costs of providing the services or fulfilling the other 15 purposes. Except for a contract voluntarily entered into by a 16 county under this subsection , the costs or income associated 17 with a contract authorized under this subsection shall not 18 be considered in computing charges and per diem costs in 19 accordance with the provisions of subsections 1 through 4 and 20 2 . 21 Sec. 175. Section 222.83, Code 2024, is amended to read as 22 follows: 23 222.83 Nonresident patients. 24 The estates of all nonresident patients who are provided 25 treatment, training, instruction, care, habilitation, and 26 support in or by a resource center or a special unit , and all 27 persons legally bound for the support of such persons, shall be 28 liable to the state for the reasonable value of such services. 29 The certificate of the superintendent of the resource center 30 or special unit in which any nonresident is or has been a 31 patient, showing the amounts drawn from the state treasury or 32 due therefrom as provided by law on account of such nonresident 33 patient, shall be presumptive evidence of the reasonable value 34 of such services furnished such patient by the resource center 35 -86- HF 2673.4203 (2) 90 dg/ko 86/ 92
or special unit . 1 Sec. 176. Section 222.84, Code 2024, is amended to read as 2 follows: 3 222.84 Patients’ personal deposit fund. 4 There is established at each resource center and special 5 unit a patients’ personal deposit fund. In the case of a 6 special unit, the director may direct that the patients’ 7 personal deposit fund be maintained and administered as a part 8 of the fund established, pursuant to sections 226.43 through 9 226.46 , by the state mental health institute where the special 10 unit is located. 11 Sec. 177. Section 222.85, subsection 1, Code 2024, is 12 amended to read as follows: 13 1. Any funds coming into the possession of the 14 superintendent or any employee of a resource center or special 15 unit belonging to any patient in that institution shall be 16 deposited in the name of the patient in the patients’ personal 17 deposit fund, except that if a guardian of the property has 18 been appointed for the person, the guardian shall have the 19 right to demand and receive such funds. Funds belonging to a 20 patient deposited in the patients’ personal deposit fund may 21 be used for the purchase of personal incidentals, desires, and 22 comforts for the patient. 23 Sec. 178. Section 222.87, Code 2024, is amended to read as 24 follows: 25 222.87 Deposit in bank. 26 The department shall deposit the patients’ personal deposit 27 fund in a commercial account of a bank of reputable standing. 28 When deposits in the commercial account exceed average monthly 29 withdrawals, the department may deposit the excess at interest. 30 The savings account shall be in the name of the patients’ 31 personal deposit fund and interest paid on the account may be 32 used for recreational purposes for the patients at the resource 33 center or special unit . 34 Sec. 179. REPEAL. Sections 222.88, 222.89, 222.90, and 35 -87- HF 2673.4203 (2) 90 dg/ko 87/ 92
222.91, Code 2024, are repealed. 1 Sec. 180. EFFECTIVE DATE. This division of this Act, being 2 deemed of immediate importance, takes effect upon enactment. 3 DIVISION VI 4 COUNTY OF RESIDENCE DETERMINATIONS 5 Sec. 181. NEW SECTION . 331.190 County of residence —— 6 dispute resolution. 7 1. “County of residence” means the county in this state 8 in which, at the time a person applies for or receives 9 services, the person is living and has established an ongoing 10 presence with the declared, good faith intention of living 11 for a permanent or indefinite period of time. The county 12 of residence of a homeless person is the county in which 13 the homeless person usually sleeps. A person maintains 14 residency in the county or state in which the person last 15 resided during the time period that the person is present in 16 a different county or state receiving services in a hospital, 17 a correctional facility, a halfway house for community-based 18 corrections or substance use disorder treatment, a nursing 19 facility, an intermediate care facility for persons with an 20 intellectual disability, a residential care facility, or for 21 the purpose of attending a college or university. 22 2. a. The dispute resolution process in this subsection 23 shall apply to county of residence disputes. The dispute 24 resolution process shall not be applicable to any of the 25 following: 26 (1) Disputes involving persons committed to a state 27 facility pursuant to chapter 812. 28 (2) Disputes involving Iowa rule of criminal procedure 29 2.22(8)(b), commitment for evaluation. 30 (3) Disputes involving chapter 12 of Iowa court rules, rules 31 for involuntary hospitalization of mentally ill persons. 32 b. If a county objects to a billing for services or a 33 residency determination and asserts that either the person 34 has residency in a different county or the person is not a 35 -88- HF 2673.4203 (2) 90 dg/ko 88/ 92
resident of this state, the person’s county of residence 1 shall be determined as provided in this subsection. If the 2 county asserts that the person has residency in a different 3 county in this state, the county shall notify that county in 4 writing within one hundred twenty calendar days of receiving 5 the billing for services or of the county of residence 6 determination. 7 c. The county that receives the notification under paragraph 8 “b” shall respond in writing to the county that provided the 9 notification within forty-five calendar days of receiving the 10 notification. If the parties cannot agree as to the person’s 11 county of residence within ninety calendar days of the date of 12 notification, on motion of either of the parties, the matter 13 shall be referred to the administrative hearings division of 14 the department of inspections, appeals, and licensing for 15 a contested case proceeding under chapter 17A, before an 16 administrative law judge assigned in accordance with section 17 10A.801, to determine the person’s county of residence. 18 d. (1) Notwithstanding section 17A.15, the administrative 19 law judge’s determination of a person’s county of residence 20 shall be considered final agency action. Judicial review of 21 the determination may be sought in accordance with section 22 17A.19. 23 (2) If following the determination of a person’s county of 24 residence under this subsection additional evidence becomes 25 available that merits a change in the determination of the 26 person’s county of residence, the affected parties may change 27 the determination of county of residence by mutual agreement. 28 Otherwise, a party may move that the matter be reconsidered 29 by the county, or by an administrative law judge assigned in 30 accordance with section 10A.801. 31 e. Unless a petition is filed for judicial review, the 32 administrative law judge’s determination of the person’s county 33 of residence shall result in one of the following: 34 (1) If a county is determined to be the person’s county 35 -89- HF 2673.4203 (2) 90 dg/ko 89/ 92
of residence, that county shall pay any amounts due and shall 1 reimburse the other county for any amounts paid for services 2 provided to the person by the other county prior to the county 3 of residence determination. 4 (2) If it is determined that the person is not a resident of 5 this state, neither the state nor either county shall be liable 6 for payment of amounts due for services provided to the person 7 prior to the determination of the person’s county of residence. 8 f. (1) The party that does not prevail in a contested 9 case proceeding or a subsequent judicial review pursuant to 10 this subsection shall be liable for costs associated with 11 the proceeding or judicial review, including reimbursement 12 of the administrative hearings division of the department of 13 inspections, appeals, and licensing’s actual costs associated 14 with the administrative proceeding, court costs, and reasonable 15 attorney fees. 16 (2) A payment or reimbursement pursuant to this subsection 17 shall be remitted within forty-five calendar days of the 18 date the county of residence determination is issued by the 19 administrative law judge or the date the court files an order 20 determining the person’s county of residence, whichever is 21 later. After forty-five calendar days, the prevailing party 22 may add a penalty of up to one percent per month to any amounts 23 due. 24 Sec. 182. Section 35D.9, Code 2024, is amended to read as 25 follows: 26 35D.9 County of residence upon discharge. 27 A member of the home does not acquire residency in the county 28 in which the home is located unless the member is voluntarily 29 or involuntarily discharged from the home and the member 30 meets county of residence requirements. For purposes of this 31 section , “county of residence” means the same as defined in 32 section 225C.61 331.190 . 33 Sec. 183. Section 232.141, subsections 7 and 8, Code 2024, 34 are amended to read as follows: 35 -90- HF 2673.4203 (2) 90 dg/ko 90/ 92
7. A county charged with the costs and expenses under 1 subsections 2 and 3 may recover the costs and expenses from the 2 child’s custodial parent’s county of residence, as defined in 3 section 225C.61 331.190 , by filing verified claims which are 4 payable as are other claims against the county. A detailed 5 statement of the facts upon which a claim is based shall 6 accompany the claim. 7 8. This subsection applies only to placements in a juvenile 8 shelter care home which is publicly owned, operated as a county 9 or multicounty shelter care home, organized under a chapter 10 28E agreement, or operated by a private juvenile shelter care 11 home. If the actual and allowable costs of a child’s shelter 12 care placement exceed the amount the department is authorized 13 to pay, the unpaid costs may be recovered from the child’s 14 custodial parent’s county of residence. However, the maximum 15 amount of the unpaid costs which may be recovered under this 16 subsection is limited to the difference between the amount 17 the department is authorized to pay and the statewide average 18 of the actual and allowable rates as reasonably determined 19 by the department annually. A home may only be reimbursed 20 for the lesser of the home’s actual and allowable costs or 21 the statewide average of the actual and allowable rates as 22 determined by the department in effect on the date the costs 23 were paid. The unpaid costs are payable pursuant to filing of 24 verified claims against the child’s custodial parent’s county 25 of residence. A detailed statement of the facts upon which a 26 claim is based shall accompany the claim. Any dispute between 27 counties arising from filings of claims filed pursuant to this 28 subsection shall be settled in the manner provided to determine 29 residency county of residence in section 225C.61 331.190 . 30 Sec. 184. EFFECTIVE DATE. This division of this Act takes 31 effect July 1, 2025. 32 DIVISION VII 33 SUBSTANCE USE DISORDER —— BEER AND LIQUOR CONTROL FUND 34 Sec. 185. Section 123.17, subsection 5, Code 2024, is 35 -91- HF 2673.4203 (2) 90 dg/ko 91/ 92
amended to read as follows: 1 5. After any transfer provided for in subsection 3 is 2 made, the department shall transfer into a special revenue 3 account in the general fund of the state, a sum of money at 4 least equal to seven percent of the gross amount of sales made 5 by the department from the beer and liquor control fund on a 6 monthly basis but not less than nine million dollars annually. 7 Of the amounts transferred, two million dollars , plus an 8 additional amount determined by the general assembly, shall be 9 appropriated to the department of health and human services for 10 use by the staff who administer the comprehensive substance use 11 disorder program under chapter 125 for substance use disorder 12 treatment and prevention programs. Any amounts received in 13 excess of the amounts appropriated to the department of health 14 and human services for use by the staff who administer the 15 comprehensive substance use disorder program under chapter 125 16 shall be considered part of the general fund balance. 17 Sec. 186. EFFECTIVE DATE. This division of this Act, being 18 deemed of immediate importance, takes effect upon enactment. 19 DIVISION VIII 20 SUPPORTED COMMUNITY LIVING SERVICES 21 Sec. 187. Section 225C.21, subsection 1, Code 2024, is 22 amended to read as follows: 23 1. As used in this section , “supported community living 24 services” means services provided in a noninstitutional 25 setting to adult persons sixteen years of age and older with 26 mental illness, an intellectual disability, brain injury, or 27 developmental disabilities to meet the persons’ daily living 28 needs. 29 Sec. 188. EFFECTIVE DATE. This division of this Act, being 30 deemed of immediate importance, takes effect upon enactment. > 31 ______________________________ JEFF EDLER -92- HF 2673.4203 (2) 90 dg/ko 92/ 92