House File 2089 - Introduced HOUSE FILE BY HEATON Passed House, Date Passed Senate, Date Vote: Ayes Nays Vote: Ayes Nays Approved A BILL FOR 1 An Act relating to adult persons with mental retardation or other 2 developmental disabilities who pose a severe and persistent 3 threat to themselves or others by authorizing the creation of 4 an expert mobile team and specialized treatment unit, 5 establishing a commitment process for placements in the 6 specialized unit, and including a contingent effective date. 7 BE IT ENACTED BY THE GENERAL ASSEMBLY OF THE STATE OF IOWA: 8 TLSB 5422YH 81 9 jp/je/5 PAG LIN 1 1 Section 1. NEW SECTION. 223.1 DEFINITIONS. 1 2 As used in this chapter, unless the context otherwise 1 3 requires: 1 4 1. "Department" means the department of human services. 1 5 2. "Developmental disability" means the same as defined in 1 6 the federal Developmental Disabilities Assistance and Bill of 1 7 Rights Act of 2000, Pub. L. No. 106=402, as codified in 42 1 8 U.S.C. } 15002. 1 9 3. "Expert mobile team" means the team created by the 1 10 department under this chapter. 1 11 4. "Mental retardation" means the same as defined in 1 12 section 222.2. 1 13 5. "Person in need of specialized treatment" means an 1 14 adult person with mental retardation or a developmental 1 15 disability who needs minimal to moderate support with the 1 16 activities of daily living and who poses a severe and 1 17 persistent threat to themselves or others and is described by 1 18 one or more of the following conditions: 1 19 a. The person was committed to the department under 1 20 section 812.6. 1 21 b. The person was determined to be incompetent to stand 1 22 trial. 1 23 c. The person's behavior is frequently of a severe nature 1 24 such that an intensive and secure level of treatment is needed 1 25 to prevent serious injury to the person or to others. 1 26 6. "Specialized treatment unit" means the unit created by 1 27 the department under this chapter. 1 28 Sec. 2. NEW SECTION. 223.2 EXPERT MOBILE TEAM. 1 29 1. The department shall establish an expert mobile team to 1 30 assist public and private providers of services to persons 1 31 with mental retardation or other developmental disability in 1 32 managing the behavior and addressing the needs of persons who 1 33 may be a person in need of specialized treatment. 1 34 2. The team shall be multidisciplinary with members who 1 35 have experience and knowledge in developmental disabilities, 2 1 behavior analysis, or forensic services and members who are 2 2 trained, direct=service workers. The team members may have 2 3 either professional or paraprofessional skills. The team 2 4 shall be part of or associated with the staff for the 2 5 specialized treatment unit. 2 6 3. The purpose of the team is to provide specialized 2 7 training and consultation on treatment options to providers of 2 8 services to persons with mental retardation or other 2 9 developmental disability so that a person who may be in need 2 10 of specialized treatment may continue to receive services from 2 11 such providers and the need to utilize the specialized 2 12 treatment unit for the person may be prevented or eliminated. 2 13 The services offered by the team may include but are not 2 14 limited to the following: 2 15 a. Clinical evaluation and development of intensive 2 16 behavioral treatment programs and psychiatric services. 2 17 b. Time=limited supplemental staff assistance to support a 2 18 provider in maintaining a safe environment and in implementing 2 19 an intensive behavioral treatment program. 2 20 c. Consultation and training on a range of treatment and 2 21 security approaches to enhance provider capacity to manage 2 22 dangerous behaviors. 2 23 4. The department shall implement eligibility criteria for 2 24 providers to access team services based upon the presence of a 2 25 person who may be in need of specialized treatment. 2 26 Sec. 3. NEW SECTION. 223.3 SPECIALIZED TREATMENT UNIT. 2 27 1. The department shall operate or contract for the 2 28 operation of a specialized treatment unit for persons 2 29 determined by the court to be persons in need of specialized 2 30 treatment. 2 31 2. The specialized treatment unit shall provide a 2 32 restricted, secure setting to safely address the needs of a 2 33 person in need of specialized treatment. 2 34 3. A departmental recommendation to the court for a 2 35 person's admission to the specialized treatment unit shall be 3 1 based upon an evaluation of the person performed by the unit 3 2 administrator and the expert mobile team or other qualified 3 3 person designated by the department to determine the potential 3 4 benefit to the person from admission to the unit. Other 3 5 recommendation criteria shall include a determination of 3 6 whether a person's behaviors have caused or have potential to 3 7 cause injury to the person or others; identification of the 3 8 person as meeting the definition of a person in need of 3 9 specialized treatment; an unsuccessful attempt by the expert 3 10 mobile team to develop an effective treatment for the person's 3 11 behavior or a determination that treatment cannot be safely 3 12 provided except in a restricted, secure setting; and a 3 13 specific assessment of the level of the person's dangerousness 3 14 indicating a high probability of harm occurring without 3 15 intervention. 3 16 Sec. 4. NEW SECTION. 223.4 COMMITMENT ORDER. 3 17 1. A person shall only be admitted to the specialized 3 18 treatment unit pursuant to a court order. 3 19 2. The following procedures shall apply to a hearing for a 3 20 commitment order to the specialized treatment unit held under 3 21 this section: 3 22 a. The department shall initiate a hearing for a 3 23 commitment order by making application to the court through 3 24 the county attorney. The county attorney may request a 3 25 hearing by ex parte written motion. Upon receiving the 3 26 motion, the court may issue an order for detention of the 3 27 person, if the person is not detained at the time of the 3 28 motion. 3 29 b. An application for a commitment order under this 3 30 section shall indicate the reasons for the application. The 3 31 person and the person's attorney shall be served notice of the 3 32 hearing and be provided with a copy of the application and the 3 33 notice. 3 34 c. The commitment hearing shall be held immediately upon 3 35 the person being brought before the court for the hearing 4 1 unless the person or the county attorney moves for a 4 2 continuance. A continuance granted on motion of the person 4 3 shall not exceed three calendar days. A continuance on motion 4 4 of the county attorney shall be granted only upon good cause 4 5 shown and shall not exceed three calendar days. The person 4 6 may be detained pending the hearing. 4 7 d. The person is entitled to representation by counsel, 4 8 including appointed counsel for indigent persons, and shall be 4 9 entitled to the right of cross=examination and to present 4 10 information, to testify, and to present witnesses on the 4 11 person's own behalf. 4 12 e. Information stated in, or offered in connection with, 4 13 any order entered pursuant to this section need not conform to 4 14 the formal rules of evidence. 4 15 f. Unless the person otherwise requests in writing, the 4 16 district court shall conduct the hearing as a private hearing, 4 17 and any order entered shall remain confidential as to the 4 18 public generally until the conclusion of the hearing. 4 19 g. The matter may be heard by a judicial hospitalization 4 20 referee or a magistrate. An appeal from a commitment order 4 21 entered under this section shall be addressed in the manner 4 22 provided for an involuntary hospitalization order under 4 23 section 229.21. The person shall remain in the specialized 4 24 treatment unit pending outcome of the appeal. 4 25 h. If the court issues a commitment order for placement of 4 26 the person in the specialized treatment unit, it shall be 4 27 accompanied by written findings of fact and the reasons for 4 28 the commitment order. 4 29 3. If the department recommends commitment of a person to 4 30 the specialized treatment unit, the department shall provide 4 31 to the court a written report of an evaluation of the person 4 32 performed in accordance with the criteria provided in section 4 33 223.3. 4 34 4. If the court determines the person is a person in need 4 35 of specialized treatment, the court shall commit the person to 5 1 the specialized treatment unit for a period of not more than 5 2 eighteen months or until an evaluation indicates the person no 5 3 longer meets the definition of a person in need of specialized 5 4 services. If supported by a departmental recommendation, the 5 5 court may extend the initial period of commitment by up to 5 6 twelve months. 5 7 5. The department shall report to the court annually 5 8 concerning a person committed to the specialized treatment 5 9 unit and more often as required by the court. 5 10 6. A person committed to the department of corrections 5 11 under section 812.6 is not eligible for a hearing or order 5 12 under this chapter. 5 13 7. If a subsequent evaluation indicates the person no 5 14 longer meets the definition of a person in need of specialized 5 15 treatment, the department shall submit a written report of the 5 16 evaluation to the court. The court shall furnish a copy of 5 17 the report to the person's attorney. The court shall examine 5 18 the report and take action as the court deems appropriate. 5 19 8. If the court determines that the person shall be 5 20 released from the specialized treatment unit, the unit 5 21 administrator and the expert mobile team shall develop a 5 22 transition plan for the person. The transition plan is 5 23 subject to approval by the court. The transition plan shall 5 24 identify the services to be provided by the expert mobile team 5 25 in the transition which may include any service implemented 5 26 pursuant to section 223.2. 5 27 Sec. 5. NEW SECTION. 223.5 FUNDING == CONTINGENT 5 28 EFFECTIVE DATE. 5 29 1. State or county financial responsibility for the costs 5 30 of services provided to a person by an expert mobile team or a 5 31 specialized treatment unit shall be determined in the same 5 32 manner as it is determined for other services provided to a 5 33 person with mental retardation or other developmental 5 34 disability, except as follows: 5 35 a. If the person is under the jurisdiction of the 6 1 department of corrections, the department of corrections is 6 2 responsible. 6 3 b. If the person is placed in a state resource center or 6 4 state mental health institute and has a county of legal 6 5 settlement, the county's responsibility shall be limited to a 6 6 capped amount in the manner provided in sections 222.73 and 6 7 230.20 with the remainder a state responsibility. 6 8 2. Implementation of this chapter is contingent upon 6 9 enactment of an appropriation for the implementation costs. 6 10 The department shall notify the Iowa Code editor if such an 6 11 appropriation is enacted. This subsection is repealed on June 6 12 30 immediately preceding the fiscal year for which an 6 13 implementation appropriation is made. 6 14 Sec. 6. IMPLEMENTATION OF ACT. Section 25B.2, subsection 6 15 3, shall not apply to this Act. 6 16 EXPLANATION 6 17 This bill relates to adult persons with a developmental 6 18 disability who pose a severe and persistent threat to 6 19 themselves or others by authorizing the department of human 6 20 services to create an expert mobile team and specialized 6 21 treatment unit and providing for a commitment process. 6 22 Implementation of the bill is contingent upon appropriation of 6 23 implementation funding. 6 24 The bill creates new Code chapter 223. 6 25 New Code section 223.1 defines the terms "department", 6 26 "developmental disability", "expert mobile team", "mental 6 27 retardation", "person in need of specialized treatment", and 6 28 "specialized treatment unit". 6 29 New Code section 223.2 requires the department to establish 6 30 an expert mobile team, provides a purpose for the team, and 6 31 lists services to be provided by the team in support of public 6 32 and private providers of services. 6 33 New Code section 223.3 directs the department to operate or 6 34 contract for the operation of a specialized treatment unit for 6 35 persons in need of specialized treatment. The unit is to be a 7 1 secure facility. 7 2 New Code section 223.4 provides that a person can only be 7 3 confined by a court order committing a person to the unit. 7 4 Procedural provisions include a requirement for the department 7 5 to initiate an application for a commitment order through the 7 6 county attorney, the application and hearing notice must be 7 7 provided to the person and the person's attorney, a magistrate 7 8 or judicial hospitalization referee may hear the matter, and 7 9 the person shall remain confined pending an appeal of a 7 10 commitment order. The duration of an initial commitment order 7 11 is limited to 18 months and may be extended for up to 12 7 12 months. If a subsequent evaluation indicates the person is no 7 13 longer in need of specialized treatment, the department is to 7 14 report to the court and the court is to act on the report. If 7 15 the court determines the person shall be released, the 7 16 specialized treatment unit and the expert mobile team are to 7 17 develop a transition plan for the court's approval. 7 18 New Code section 223.5 outlines how county and state 7 19 financial responsibility for the costs of the team and unit 7 20 are assessed to the state and counties and provides that 7 21 implementation of the bill is contingent upon the provision of 7 22 implementation funding. The department is directed to report 7 23 to the Iowa Code editor concerning the provision of funding. 7 24 The bill may include a state mandate as defined in Code 7 25 section 25B.3. The bill makes inapplicable Code section 7 26 25B.2, subsection 3, which would relieve a political 7 27 subdivision from complying with a state mandate if funding for 7 28 the cost of the state mandate is not provided or specified. 7 29 Therefore, political subdivisions are required to comply with 7 30 any state mandate included in the bill. 7 31 LSB 5422YH 81 7 32 jp:rj/je/5