House File 2543 S-5145 Amend House File 2543, as passed by the House, as follows: 1 1. By striking everything after the enacting clause and 2 inserting: 3 < Section 1. Section 135G.1, subsection 12, paragraph c, 4 Code 2026, is amended by striking the paragraph. 5 Sec. 2. Section 135G.3, Code 2026, is amended by adding the 6 following new subsection: 7 NEW SUBSECTION . 1A. Within twenty-four hours of a 8 resident’s admission to a subacute care facility, the subacute 9 care facility shall develop an initial treatment plan with the 10 resident. 11 Sec. 3. NEW SECTION . 135G.3A Insurance authorization. 12 1. If a mental health professional submits an electronic 13 request through an internet portal designated by the department 14 of health and human services for prior authorization for 15 insurance coverage for an individual’s subacute mental health 16 care service under chapter 249A or chapter 249N, the department 17 of health and human services or the managed care organization 18 responsible for administering the individual’s medical 19 assistance shall provide a determination to the mental health 20 professional for the preauthorization request as follows: 21 a. Within forty-eight hours after the date of receipt of an 22 urgent preauthorization request. 23 b. Within five calendar days after the date of receipt of a 24 nonurgent preauthorization request. 25 c. Within ten calendar days after the date of receipt of a 26 nonurgent preauthorization request involving complex or unique 27 circumstances. 28 2. The director of health and human services shall adopt 29 rules pursuant to chapter 17A as necessary to administer this 30 section. 31 Sec. 4. NEW SECTION . 135H.9A Bed tracking system. 32 The department of health and human services shall establish 33 an electronic system to track the availability of beds at each 34 psychiatric medical institution for children. 35 -1- HF 2543.3723 (2) 91 dg/ko 1/ 3 #1.

Sec. 5. DEPARTMENTS OF INSPECTIONS, APPEALS, AND LICENSING 1 AND HEALTH AND HUMAN SERVICES —— ADMINISTRATIVE RULE 2 REVIEW. The department of inspections, appeals, and licensing 3 and the department of health and human services shall do all 4 of the following: 5 1. Collaborate to review each department’s administrative 6 rules adopted pursuant to section 135G.10 and eliminate any 7 rule the departments determine impedes any of the following 8 goals without providing an equal or greater benefit: 9 a. Establishment of new subacute mental health care 10 facilities and services. 11 b. Expansion of existing subacute mental health care 12 facilities and services. 13 c. Ease of access to subacute mental health care facilities 14 and services. 15 2. Modify the departments’ respective rules so that the 16 requirements to employ an individual at a subacute mental 17 health care facility are less stringent than the requirements 18 for the same employment at a state mental health institute. 19 Sec. 6. DEPARTMENT OF HEALTH AND HUMAN SERVICES —— SUBACUTE 20 MENTAL HEALTH CARE SERVICES. 21 1. a. The department of health and human services shall 22 review the state’s capability to establish subacute mental 23 health care services, and additional psychiatric inpatient 24 services at the state mental health institute at Independence, 25 beginning on July 1, 2027. 26 b. At a minimum, the department’s review shall assess 27 the operational costs, bed capacity, staffing capabilities, 28 necessary infrastructure improvements, and reasonable 29 implementation time frames. 30 c. The department’s review shall investigate the 31 possibility of partnering with private operators to provide 32 subacute mental health care services at the state mental health 33 institute at Independence. 34 d. The department shall submit a report on the department’s 35 -2- HF 2543.3723 (2) 91 dg/ko 2/ 3

findings to the chairpersons of the house of representatives 1 committee on health and human services, the senate committee 2 on health and human services, the house committee on 3 appropriations, and the senate committee on appropriations no 4 later than January 4, 2027. 5 2. Following the review under subsection 1, if the director 6 of health and human services determines on or after July 7 1, 2026, that the department can provide subacute mental 8 health care services at the state mental health institute at 9 Independence within the department’s budget, the department 10 may provide such services until the general assembly directs 11 otherwise. 12 Sec. 7. EFFECTIVE DATE. This Act, being deemed of immediate 13 importance, takes effect upon enactment. > 14 2. Title page, by striking lines 1 through 8 and inserting 15 < An Act relating to subacute mental health care facilities and 16 services, and including effective date provisions. > 17 ______________________________ KARA WARME -3- HF 2543.3723 (2) 91 dg/ko 3/ 3 #2.