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
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