House
File
478
-
Introduced
HOUSE
FILE
478
BY
HEDDENS
,
WESSEL-KROESCHELL
,
PETERSEN
,
STECKMAN
,
THEDE
,
WINCKLER
,
ABDUL-SAMAD
,
and
MASCHER
A
BILL
FOR
An
Act
relating
to
state
and
county
responsibilities
for
1
adult
mental
health,
mental
retardation,
and
developmental
2
disabilities
services
and
including
effective
date
3
provisions.
4
BE
IT
ENACTED
BY
THE
GENERAL
ASSEMBLY
OF
THE
STATE
OF
IOWA:
5
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DIVISION
I
1
MENTAL
HEALTH
COMMITMENT
AND
FACILITY
COSTS
2
Section
1.
Section
218.44,
Code
2011,
is
amended
to
read
as
3
follows:
4
218.44
Wages
paid
to
dependent
——
deposits.
5
If
such
wage
be
wages
are
paid
to
a
resident
,
the
6
administrator
in
control
of
such
the
institution
in
which
7
the
resident
is
placed
may
pay
all
or
any
part
of
the
same
8
wages
directly
to
any
dependent
of
such
the
resident,
or
may
9
deposit
such
the
wage
to
the
account
of
such
the
resident,
or
10
may
so
deposit
part
thereof
of
the
wage
and
allow
the
resident
11
a
portion
part
for
the
resident’s
own
personal
use,
or
may
12
pay
to
the
county
of
commitment
state
all
or
any
part
of
the
13
resident’s
care,
treatment
,
or
subsistence
while
at
said
the
14
institution
from
any
credit
balance
accruing
to
the
account
of
15
said
the
resident.
16
Sec.
2.
Section
218.99,
Code
2011,
is
amended
to
read
as
17
follows:
18
218.99
Counties
Department
to
be
notified
of
patients’
19
personal
accounts.
20
The
administrator
in
control
of
a
state
institution
shall
21
direct
the
business
manager
of
each
institution
under
the
22
administrator’s
jurisdiction
which
is
mentioned
in
section
23
331.424,
subsection
1
,
paragraph
“a”
,
subparagraphs
(1)
24
and
(2),
and
for
which
services
are
paid
under
section
25
331.424A
,
to
quarterly
inform
the
county
of
legal
settlement’s
26
entity
designated
to
perform
the
county’s
central
point
27
of
coordination
process
to
quarterly
inform
the
department
28
of
human
services
of
any
patient
or
resident
who
has
an
29
amount
in
excess
of
two
hundred
dollars
on
account
in
the
30
patients’
personal
deposit
fund
and
the
amount
on
deposit.
The
31
administrators
shall
direct
the
business
manager
to
further
32
notify
the
entity
designated
to
perform
the
county’s
central
33
point
of
coordination
process
department
at
least
fifteen
days
34
before
the
release
of
funds
in
excess
of
two
hundred
dollars
35
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or
upon
the
death
of
the
patient
or
resident.
If
the
patient
1
or
resident
has
no
county
of
legal
settlement,
notice
shall
be
2
made
to
the
director
of
human
services
and
the
administrator
in
3
control
of
the
institution
involved.
4
Sec.
3.
Section
226.9C,
subsection
1,
paragraph
a,
Code
5
2011,
is
amended
to
read
as
follows:
6
a.
Moneys
received
by
the
state
from
billings
to
counties
7
under
section
230.20
.
8
Sec.
4.
Section
226.45,
Code
2011,
is
amended
to
read
as
9
follows:
10
226.45
Reimbursement
to
county
or
state.
11
If
a
patient
is
not
receiving
medical
assistance
under
12
chapter
249A
and
the
amount
to
the
account
of
any
patient
13
in
the
patients’
personal
deposit
fund
exceeds
two
hundred
14
dollars,
the
business
manager
of
the
hospital
may
apply
any
of
15
the
excess
to
reimburse
the
county
of
legal
settlement
or
the
16
state
in
a
case
where
no
legal
settlement
exists
,
as
applicable
17
as
provided
by
section
230.1,
for
liability
incurred
by
the
18
county
or
the
state
for
the
payment
of
care,
support
,
and
19
maintenance
of
the
patient
,
when
billed
by
the
county
of
legal
20
settlement
or
by
the
administrator
for
a
patient
having
no
21
legal
settlement
at
the
state
mental
health
institute
.
22
Sec.
5.
Section
230.1,
Code
2011,
is
amended
to
read
as
23
follows:
24
230.1
Liability
of
county
and
state.
25
1.
The
necessary
and
legal
costs
and
expenses
attending
26
the
taking
into
custody,
care,
investigation,
admission,
27
commitment,
and
support
of
a
person
resident
of
this
state
28
with
mental
illness
admitted
or
committed
to
a
federal,
state
,
29
county,
or
private
hospital
or
facility
on
or
after
July
1,
30
2012,
shall
be
paid
by
a
county
or
by
the
state
.
as
follows:
31
a.
By
the
county
in
which
such
person
has
a
legal
32
settlement,
if
the
person
is
eighteen
years
of
age
or
older.
33
b.
By
the
state
when
such
person
has
no
legal
settlement
in
34
this
state,
when
the
person’s
legal
settlement
is
unknown,
or
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if
the
person
is
under
eighteen
years
of
age.
1
2.
The
legal
settlement
of
any
person
found
mentally
ill
who
2
is
a
patient
of
any
state
institution
shall
be
that
existing
3
at
the
time
of
admission
thereto.
The
necessary
and
legal
4
costs
and
expenses
attending
the
taking
into
custody,
care,
5
investigation,
admission,
commitment,
and
support
of
a
resident
6
of
this
state
with
mental
illness
admitted
or
committed
to
7
a
federal,
state,
county,
or
private
hospital
or
facility
8
before
July
1,
2012,
which
were
incurred
prior
to
July
1,
2012,
9
shall
be
paid
by
the
state
or
a
county
in
accordance
with
this
10
chapter,
Code
2011,
as
applicable.
Such
costs
and
expenses
11
incurred
on
or
after
July
1,
2012,
shall
be
paid
by
the
state
as
12
provided
in
subsection
1.
13
3.
A
county
of
legal
settlement
is
not
liable
for
costs
14
and
expenses
associated
with
a
person
with
mental
illness
15
unless
the
costs
and
expenses
are
for
services
and
other
16
support
authorized
for
the
person
through
the
central
point
17
of
coordination
process.
For
the
purposes
of
this
chapter
,
18
“central
point
of
coordination
process”
means
the
same
as
19
defined
in
section
331.440
.
20
Sec.
6.
Section
230.15,
unnumbered
paragraph
1,
Code
2011,
21
is
amended
to
read
as
follows:
22
A
person
with
mental
illness
and
a
person
legally
liable
23
for
the
person’s
support
remain
liable
for
the
support
of
24
the
person
with
mental
illness
as
provided
in
this
section
.
25
Persons
legally
liable
for
the
support
of
a
person
with
mental
26
illness
include
the
spouse
of
the
person,
any
person
bound
27
by
contract
for
support
of
the
person,
and,
with
respect
to
28
persons
with
mental
illness
under
eighteen
years
of
age
only,
29
the
father
and
mother
of
the
person.
The
county
auditor,
30
subject
to
the
direction
of
the
board
of
supervisors,
shall
31
enforce
the
obligation
created
in
this
section
as
to
all
32
sums
advanced
by
the
county.
The
liability
to
the
state
or
33
county
incurred
by
a
person
with
mental
illness
or
a
person
34
legally
liable
for
the
person’s
support
under
this
section
35
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is
limited
to
an
amount
equal
to
one
hundred
percent
of
the
1
cost
of
care
and
treatment
of
the
person
with
mental
illness
2
at
a
state
mental
health
institute
for
one
hundred
twenty
days
3
of
hospitalization.
This
limit
of
liability
may
be
reached
4
by
payment
of
equal
to
the
cost
of
care
and
treatment
of
the
5
person
with
mental
illness
subsequent
to
a
single
admission
6
or
multiple
admissions
to
a
state
mental
health
institute
or,
7
if
the
person
is
not
discharged
as
cured,
subsequent
to
a
8
single
transfer
or
multiple
transfers
to
a
county
care
facility
9
pursuant
to
section
227.11
.
If
the
person
is
discharged
10
from
a
state
mental
health
institute
or
other
inpatient
11
placement
and
the
limit
of
liability
has
not
been
reached,
the
12
liability
extends
to
costs
provided
for
outpatient
treatment.
13
After
reaching
this
limit
of
liability,
a
person
with
mental
14
illness
or
a
person
legally
liable
for
the
person’s
support
15
is
liable
to
the
state
or
county
,
as
applicable,
for
the
care
16
and
treatment
of
the
person
with
mental
illness
at
a
state
17
mental
health
institute
or
other
inpatient
placement,
or,
if
18
transferred
but
not
discharged
as
cured,
at
a
county
care
19
facility
or
from
an
outpatient
treatment
provider
in
an
amount
20
not
in
excess
of
the
average
minimum
cost
of
the
maintenance
21
of
an
individual
who
is
physically
and
mentally
healthy
22
residing
in
the
individual’s
own
home,
which
standard
shall
23
be
established
and
may
from
time
to
time
be
revised
by
the
24
department
of
human
services.
A
lien
imposed
by
section
230.25
25
shall
not
exceed
the
amount
of
the
liability
which
may
be
26
incurred
under
this
section
on
account
of
a
person
with
mental
27
illness.
28
Sec.
7.
Section
230.16,
Code
2011,
is
amended
to
read
as
29
follows:
30
230.16
Presumption.
31
In
actions
to
enforce
the
liability
imposed
by
section
32
230.15
,
the
certificate
from
the
superintendent
to
the
or
the
33
county
auditor
stating
the
sums
charged
in
such
cases,
shall
be
34
presumptively
correct.
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Sec.
8.
Section
230.17,
Code
2011,
is
amended
to
read
as
1
follows:
2
230.17
Board
or
department
may
compromise
lien.
3
1.
The
board
of
supervisors
is
hereby
empowered
to
may
4
compromise
any
and
all
liabilities
to
the
county
,
created
by
5
this
chapter
,
when
such
compromise
is
deemed
to
be
for
the
best
6
interests
of
the
county.
7
2.
The
department
of
human
services
may
compromise
any
and
8
all
liabilities
to
the
state
created
by
this
chapter,
when
such
9
compromise
is
deemed
to
be
for
the
best
interests
of
the
state.
10
Sec.
9.
Section
230.18,
Code
2011,
is
amended
to
read
as
11
follows:
12
230.18
Expense
in
county
or
private
hospitals.
13
The
estates
of
persons
with
mental
illness
who
may
be
treated
14
or
confined
in
any
county
hospital
or
home,
or
in
any
private
15
hospital
or
sanatorium,
or
receive
outpatient
services,
and
16
the
estates
of
persons
legally
bound
for
their
support,
shall
17
be
liable
to
the
county
or
state,
as
applicable,
for
the
18
reasonable
cost
of
such
support
paid
by
the
county
or
state
.
19
Sec.
10.
Section
230.20,
subsections
1,
2,
3,
4,
and
5,
Code
20
2011,
are
amended
by
striking
the
subsections.
21
Sec.
11.
Section
230.20,
subsections
6,
7,
and
8,
Code
2011,
22
are
amended
to
read
as
follows:
23
6.
All
or
any
reasonable
portion
of
the
charges
incurred
24
for
services
provided
to
a
patient,
to
the
most
recent
date
for
25
which
the
charges
have
been
computed,
may
be
paid
at
any
time
26
by
the
patient
or
by
any
other
person
on
the
patient’s
behalf.
27
Any
payment
made
by
the
patient
or
other
person,
and
any
28
federal
financial
assistance
received
pursuant
to
Tit.
XVIII
or
29
XIX
of
the
federal
Social
Security
Act
for
services
rendered
30
to
a
patient,
shall
be
credited
against
the
patient’s
account
31
and,
if
the
charges
paid
as
described
in
this
subsection
have
32
previously
been
billed
to
a
county,
reflected
in
the
mental
33
health
institute’s
next
general
statement
to
that
county
.
34
7.
A
superintendent
of
a
mental
health
institute
may
request
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that
the
director
of
human
services
enter
into
a
contract
1
with
a
person
for
the
mental
health
institute
to
provide
2
consultation
or
treatment
services
or
for
fulfilling
other
3
purposes
which
are
consistent
with
the
purposes
stated
in
4
section
226.1
.
The
contract
provisions
shall
include
charges
5
which
reflect
the
actual
cost
of
providing
the
services
or
6
fulfilling
the
other
purposes.
Any
income
from
a
contract
7
authorized
under
this
subsection
may
be
retained
by
the
8
mental
health
institute
to
defray
the
costs
of
providing
the
9
services.
Except
for
a
contract
voluntarily
entered
into
by
a
10
county
under
this
subsection
,
the
costs
or
income
associated
11
with
a
contract
authorized
under
this
subsection
shall
not
12
be
considered
in
computing
charges
and
per
diem
costs
in
13
accordance
with
the
provisions
of
subsections
1
through
6
of
14
this
section
.
15
8.
The
department
shall
provide
a
county
with
information,
16
which
is
not
otherwise
confidential
under
law,
in
the
17
department’s
possession
concerning
a
patient
whose
cost
of
18
care
provided
outside
a
state
mental
health
institute
or
other
19
inpatient
setting
is
chargeable
to
the
county,
including
but
20
not
limited
to
the
information
specified
in
section
229.24,
21
subsection
3
.
22
Sec.
12.
Section
331.424A,
subsection
2,
Code
2011,
is
23
amended
to
read
as
follows:
24
2.
For
the
fiscal
year
beginning
July
1,
1996,
and
25
succeeding
fiscal
years,
county
revenues
from
taxes
and
other
26
sources
designated
for
mental
health,
mental
retardation,
27
and
developmental
disabilities
services
shall
be
credited
28
to
the
mental
health,
mental
retardation,
and
developmental
29
disabilities
services
fund
of
the
county.
The
board
shall
30
make
appropriations
from
the
fund
for
payment
of
services
31
provided
under
the
county
management
plan
approved
pursuant
32
to
section
331.439
.
The
county
may
pay
for
the
services
in
33
cooperation
with
other
counties
by
pooling
appropriations
34
from
the
fund
with
other
counties
or
through
county
regional
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entities
including
but
not
limited
to
the
county’s
mental
1
health
and
developmental
disabilities
regional
planning
council
2
created
pursuant
to
section
225C.18
.
The
costs
of
placement,
3
treatment,
or
other
service
ordered
under
chapter
812
shall
not
4
be
paid
from
the
fund.
5
Sec.
13.
REPEAL.
Sections
230.2,
230.3,
230.4,
230.5,
6
230.6,
230.9,
230.10,
230.11,
230.12,
and
230.22,
Code
2011,
7
are
repealed.
8
Sec.
14.
EFFECTIVE
DATE.
This
division
of
this
Act
takes
9
effect
July
1,
2012.
10
DIVISION
II
11
STATE
RESOURCE
CENTERS
12
Sec.
15.
Section
222.13,
Code
2011,
is
amended
to
read
as
13
follows:
14
222.13
Voluntary
admissions.
15
1.
If
an
adult
person
is
believed
to
be
a
person
with
mental
16
retardation,
the
adult
person
or
the
adult
person’s
guardian
17
may
submit
a
request
through
the
central
point
of
coordination
18
process
for
the
county
board
of
supervisors
to
apply
to
the
19
superintendent
of
any
state
resource
center
for
the
voluntary
20
admission
of
the
adult
person
either
as
an
inpatient
or
an
21
outpatient
of
the
resource
center.
After
determining
the
legal
22
settlement
of
the
adult
person
as
provided
by
this
chapter
,
23
the
board
of
supervisors
shall,
on
forms
prescribed
by
the
24
administrator,
apply
to
the
superintendent
of
the
resource
25
center
in
the
district
for
the
admission
of
the
adult
person
to
26
the
resource
center.
An
application
for
admission
to
a
special
27
unit
of
any
adult
person
believed
to
be
in
need
of
any
of
the
28
services
provided
by
the
special
unit
under
section
222.88
may
29
be
made
in
the
same
manner,
upon
request
of
the
adult
person
or
30
the
adult
person’s
guardian.
The
superintendent
shall
accept
31
the
application
providing
a
preadmission
diagnostic
evaluation
,
32
performed
through
the
central
point
of
coordination
process,
33
confirms
or
establishes
the
need
for
admission,
except
that
an
34
application
may
not
be
accepted
if
the
institution
does
not
35
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have
adequate
facilities
available
or
if
the
acceptance
will
1
result
in
an
overcrowded
condition.
2
2.
If
the
resource
center
has
no
appropriate
program
for
the
3
treatment
of
an
adult
or
minor
person
with
mental
retardation
4
applying
under
this
section
or
section
222.13A
,
the
board
of
5
supervisors
central
point
of
coordination
for
the
person’s
6
county
of
residence
shall
arrange
for
the
placement
of
the
7
person
in
any
public
or
private
facility
within
or
without
the
8
state,
approved
by
the
director
of
the
department
of
human
9
services,
which
offers
appropriate
services
for
the
person
,
as
10
determined
through
the
central
point
of
coordination
process
.
11
3.
Upon
applying
application
for
admission
of
an
12
adult
or
minor
person
to
a
resource
center,
or
a
special
13
unit,
or
upon
arranging
arrangement
for
the
placement
of
14
the
person
in
a
public
or
private
facility,
the
board
of
15
supervisors
superintendent
or
the
department
shall
make
a
16
full
investigation
into
the
financial
circumstances
of
that
17
person
and
those
liable
for
that
person’s
support
under
section
18
222.78
to
determine
whether
or
not
any
of
them
are
able
to
pay
19
the
expenses
arising
out
of
the
admission
of
the
person
to
a
20
resource
center,
special
treatment
unit,
or
public
or
private
21
facility.
If
the
board
superintendent
or
the
department
finds
22
that
the
person
or
those
legally
responsible
for
the
person
are
23
presently
unable
to
pay
the
expenses,
the
board
shall
direct
24
that
the
expenses
shall
be
paid
by
the
county
department
.
The
25
board
superintendent
or
the
department
may
review
its
the
26
finding
at
any
subsequent
time
while
the
person
remains
at
the
27
resource
center,
or
is
otherwise
receiving
care
or
treatment
28
for
which
this
chapter
obligates
the
county
to
pay
.
If
the
29
board
superintendent
or
the
department
finds
upon
review
that
30
the
person
or
those
legally
responsible
for
the
person
are
31
presently
able
to
pay
the
expenses,
the
finding
shall
apply
32
only
to
the
charges
incurred
during
the
period
beginning
on
the
33
date
of
the
review
and
continuing
thereafter,
unless
and
until
34
the
board
superintendent
or
the
department
again
changes
its
35
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the
finding.
If
the
board
superintendent
or
the
department
1
finds
that
the
person
or
those
legally
responsible
for
the
2
person
are
able
to
pay
the
expenses,
the
board
superintendent
3
or
the
department
shall
direct
that
the
charges
be
so
paid
to
4
the
extent
required
by
section
222.78
,
and
the
county
auditor
5
shall
be
responsible
for
the
collection
of
the
charges
.
6
Sec.
16.
Section
222.13A,
subsections
1
and
2,
Code
2011,
7
are
amended
to
read
as
follows:
8
1.
If
a
minor
is
believed
to
be
a
person
with
mental
9
retardation,
the
minor’s
parent,
guardian,
or
custodian
may
10
request
the
county
board
of
supervisors
to
apply
for
admission
11
of
the
minor
as
a
voluntary
patient
in
a
state
resource
center.
12
If
the
resource
center
does
not
have
appropriate
services
for
13
the
minor’s
treatment,
the
board
of
supervisors
central
point
14
of
coordination
for
the
minor’s
county
of
residence
may
arrange
15
for
the
admission
of
the
minor
in
a
public
or
private
facility
16
within
or
without
the
state,
approved
by
the
director
of
human
17
services,
which
offers
appropriate
services
for
the
minor’s
18
treatment.
19
2.
Upon
receipt
of
an
application
for
voluntary
admission
20
of
a
minor,
the
board
of
supervisors
state
resource
center
21
shall
provide
for
a
preadmission
diagnostic
evaluation
of
the
22
minor
to
confirm
or
establish
the
need
for
the
admission.
23
The
preadmission
diagnostic
evaluation
shall
be
performed
by
24
a
person
who
meets
the
qualifications
of
a
qualified
mental
25
retardation
professional
who
is
designated
through
the
central
26
point
of
coordination
process
.
27
Sec.
17.
Section
222.31,
subsection
1,
paragraph
b,
Code
28
2011,
is
amended
to
read
as
follows:
29
b.
(1)
Commit
the
person
to
the
state
resource
center
30
designated
by
the
administrator
to
serve
the
county
in
which
31
the
hearing
is
being
held,
or
to
a
special
unit.
The
court
32
shall,
prior
to
issuing
an
order
of
commitment,
request
33
that
a
diagnostic
evaluation
of
the
person
be
made
by
the
34
superintendent
of
the
resource
center
or
the
special
unit,
or
35
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the
superintendent’s
qualified
designee.
The
evaluation
shall
1
be
conducted
at
a
place
as
the
superintendent
may
direct.
The
2
cost
of
the
evaluation
shall
be
defrayed
by
the
county
of
legal
3
settlement
department
unless
otherwise
ordered
by
the
court.
4
The
cost
may
be
equal
to
but
shall
not
exceed
the
actual
cost
5
of
the
evaluation.
Persons
referred
by
a
court
to
a
resource
6
center
or
the
special
unit
for
diagnostic
evaluation
shall
be
7
considered
as
outpatients
of
the
institution.
No
An
order
of
8
commitment
shall
not
be
issued
unless
the
superintendent
of
the
9
institution
recommends
that
the
order
be
issued,
and
advises
10
the
court
that
adequate
facilities
for
the
care
of
the
person
11
are
available
at
the
state
resource
center
.
12
(2)
The
court
shall
examine
the
report
of
the
county
13
attorney
filed
pursuant
to
section
222.13
,
and
if
the
report
14
shows
that
neither
the
person
nor
those
liable
for
the
person’s
15
support
under
section
222.78
are
presently
able
to
pay
the
16
charges
rising
out
of
the
person’s
care
in
a
resource
center,
17
or
special
treatment
unit,
shall
enter
an
order
stating
that
18
finding
and
directing
that
the
charges
be
paid
by
the
person’s
19
county
of
residence
department
.
The
court
may,
upon
request
20
of
the
board
of
supervisors
department
,
review
its
finding
at
21
any
subsequent
time
while
the
person
remains
at
the
resource
22
center
,
or
is
otherwise
receiving
care
or
treatment
for
which
23
this
chapter
obligates
the
county
to
pay
.
If
the
court
finds
24
upon
review
that
the
person
or
those
legally
responsible
for
25
the
person
are
presently
able
to
pay
the
expenses,
that
finding
26
shall
apply
only
to
the
charges
incurred
during
the
period
27
beginning
on
the
date
of
the
board’s
department’s
request
for
28
the
review
and
continuing
thereafter,
unless
and
until
the
29
court
again
changes
its
finding.
If
the
court
finds
that
the
30
person,
or
those
liable
for
the
person’s
support,
are
able
31
to
pay
the
charges,
the
court
shall
enter
an
order
directing
32
that
the
charges
be
so
paid
to
the
extent
required
by
section
33
222.78
.
34
Sec.
18.
Section
222.49,
Code
2011,
is
amended
to
read
as
35
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follows:
1
222.49
Costs
paid.
2
1.
The
Except
as
provided
in
subsection
2,
the
costs
of
3
proceedings
for
placement
of
a
person
at
a
state
resource
4
center
shall
be
defrayed
from
the
county
treasury
paid
by
the
5
department
unless
otherwise
ordered
by
the
court.
6
2.
The
costs
of
proceedings
for
placement
of
a
person
at
a
7
state
resource
center
which
commenced
prior
to
July
1,
2012,
8
shall
be
paid
by
the
person’s
county
of
legal
settlement
unless
9
otherwise
ordered
by
the
court.
Such
costs
shall
be
paid
in
10
accordance
with
this
chapter,
Code
2011,
as
applicable.
11
3.
When
If
the
person
alleged
to
be
mentally
retarded
have
12
mental
retardation
is
found
not
to
be
mentally
retarded
have
13
mental
retardation
,
the
court
shall
render
judgment
for
such
14
costs
against
the
person
filing
the
petition
except
when
the
15
petition
is
filed
by
order
of
court.
16
Sec.
19.
Section
222.50,
Code
2011,
is
amended
to
read
as
17
follows:
18
222.50
County
of
legal
settlement
to
pay
Payment
19
responsibility
.
20
1.
When
the
Except
as
provided
in
subsection
2,
if
the
costs
21
of
proceedings
for
placement
of
a
person
at
a
state
resource
22
center
are
not
paid
by
the
petitioner,
the
costs
shall
be
paid
23
by
the
department.
24
2.
If
proceedings
for
placement
of
a
person
at
a
state
25
resource
center
commenced
prior
to
July
1,
2012,
and
the
26
proceedings
are
were
instituted
in
a
county
in
which
the
person
27
who
is
alleged
to
have
mental
retardation
was
found
resided
but
28
which
is
not
the
county
of
legal
settlement
of
the
person,
and
29
the
costs
are
not
taxed
to
the
petitioner,
the
county
which
is
30
the
legal
settlement
of
the
person
shall,
on
presentation
of
31
a
properly
itemized
bill
for
such
costs,
repay
the
costs
to
32
the
former
county.
When
If
the
person’s
legal
settlement
is
33
was
outside
the
state
or
is
unknown,
the
costs
shall
be
paid
34
out
of
money
in
the
state
treasury
not
otherwise
appropriated,
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itemized
on
vouchers
executed
by
the
auditor
of
the
county
1
which
paid
the
costs,
and
approved
by
the
administrator.
2
Sec.
20.
Section
222.60,
subsection
1,
Code
2011,
is
amended
3
to
read
as
follows:
4
1.
All
necessary
and
legal
expenses
for
the
cost
of
5
admission
or
commitment
or
for
the
treatment,
training,
6
instruction,
care,
habilitation,
support
and
transportation
7
of
persons
with
mental
retardation,
as
provided
for
in
the
8
county
management
plan
provisions
implemented
pursuant
to
9
section
331.439,
subsection
1
,
in
a
state
resource
center,
or
10
in
a
special
unit,
or
any
public
or
private
facility
within
or
11
without
the
state,
approved
by
the
director
of
the
department
12
of
human
services,
shall
be
paid
by
either:
13
a.
The
county
in
which
such
person
has
legal
settlement
as
14
defined
in
section
252.16
,
when
the
person
received
services
at
15
a
state
resource
center
prior
to
July
1,
2012.
Such
expenses
16
relating
to
services
received
at
a
state
resource
center
prior
17
to
July
1,
2012,
shall
be
paid
in
accordance
with
this
chapter,
18
Code
2011,
as
applicable
.
19
b.
The
state
when
such
person
has
no
legal
settlement
or
20
when
such
settlement
is
unknown
,
or
when
the
person
receives
21
services
at
a
state
resource
center
on
or
after
July
1,
2012
.
22
Sec.
21.
Section
222.63,
Code
2011,
is
amended
to
read
as
23
follows:
24
222.63
Finding
of
settlement
——
objection.
25
A
If
payment
for
a
person’s
necessary
and
legal
expenses
26
is
a
county
responsibility
under
section
222.60,
a
board
of
27
supervisors’
certification
utilizing
the
central
point
of
28
coordination
process
that
a
the
person’s
legal
settlement
is
in
29
another
county
shall
be
sent
by
the
board
of
supervisors
to
the
30
auditor
of
the
county
of
legal
settlement.
The
certification
31
shall
be
accompanied
by
a
copy
of
the
evidence
supporting
the
32
determination.
The
auditor
of
the
county
of
legal
settlement
33
shall
submit
the
certification
to
the
board
of
supervisors
of
34
the
auditor’s
county
and
it
shall
be
conclusively
presumed
35
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that
the
patient
has
a
legal
settlement
in
that
county
unless
1
that
county
disputes
the
determination
of
legal
settlement
as
2
provided
in
section
225C.8
.
3
Sec.
22.
Section
222.64,
Code
2011,
is
amended
to
read
as
4
follows:
5
222.64
Foreign
state
or
country
or
unknown
State
case
legal
6
settlement.
7
If
the
legal
settlement
of
the
person
is
determined
by
the
8
board
of
supervisors
through
the
central
point
of
coordination
9
process
to
be
in
a
foreign
state
or
country
or
is
determined
10
to
be
unknown
responsibility
under
section
222.60
,
the
11
board
of
supervisors
shall
certify
the
determination
to
the
12
administrator.
The
certification
shall
be
accompanied
by
a
13
copy
of
the
evidence
supporting
the
determination.
The
care
of
14
the
person
shall
be
as
arranged
by
the
board
of
supervisors
or
15
by
an
order
as
the
court
may
enter.
Application
for
admission
16
or
order
of
commitment
may
be
made
pending
investigation
by
the
17
administrator.
18
Sec.
23.
Section
222.70,
Code
2011,
is
amended
to
read
as
19
follows:
20
222.70
Legal
settlement
disputes.
21
If
a
dispute
arises
between
counties
or
between
the
22
department
and
a
county
as
to
the
legal
settlement
of
a
person
23
admitted
or
committed
to
a
resource
center,
a
special
unit,
or
24
a
community-based
service,
the
dispute
shall
be
resolved
as
25
provided
in
section
225C.8
.
26
Sec.
24.
Section
222.78,
Code
2011,
is
amended
to
read
as
27
follows:
28
222.78
Parents
and
others
liable
for
support.
29
The
father
and
mother
of
any
patient
admitted
or
committed
to
30
a
resource
center
or
to
a
special
unit,
as
either
an
inpatient
31
or
an
outpatient,
and
any
person,
firm,
or
corporation
bound
32
by
contract
made
for
support
of
the
patient
are
liable
for
the
33
support
of
the
patient.
The
patient
and
those
legally
bound
34
for
the
support
of
the
patient
shall
be
liable
to
the
county
35
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for
all
sums
advanced
by
the
county
to
or
the
state
under
the
1
provisions
of
sections
222.60
and
222.77
.
The
liability
of
2
any
person,
other
than
the
patient,
who
is
legally
bound
for
3
the
support
of
a
patient
who
is
under
eighteen
years
of
age
4
in
a
resource
center
or
a
special
unit
shall
not
exceed
the
5
average
minimum
cost
of
the
care
of
a
normally
intelligent
6
minor
without
a
disability
of
the
same
age
and
sex
as
the
7
minor
patient.
The
administrator
shall
establish
the
scale
8
for
this
purpose
but
the
scale
shall
not
exceed
the
standards
9
for
personal
allowances
established
by
the
state
division
10
under
the
family
investment
program.
The
father
or
mother
11
shall
incur
liability
only
during
any
period
when
the
father
12
or
mother
either
individually
or
jointly
receive
a
net
income
13
from
whatever
source,
commensurate
with
that
upon
which
they
14
would
be
liable
to
make
an
income
tax
payment
to
this
state.
15
The
father
or
mother
of
a
patient
shall
not
be
liable
for
the
16
support
of
the
patient
upon
the
patient
attaining
eighteen
17
years
of
age.
Nothing
in
this
section
shall
be
construed
to
18
prevent
a
relative
or
other
person
from
voluntarily
paying
the
19
full
actual
cost
as
established
by
the
administrator
for
caring
20
for
the
patient
with
mental
retardation.
21
Sec.
25.
Section
222.79,
Code
2011,
is
amended
to
read
as
22
follows:
23
222.79
Certification
statement
presumed
correct.
24
In
actions
to
enforce
the
liability
imposed
by
section
25
222.78
,
the
a
certification
statement
sent
from
the
26
superintendent
to
the
county
auditor
pursuant
to
section
222.74
27
stating
the
sums
charged
in
such
cases
shall
be
considered
to
28
be
presumptively
correct.
29
Sec.
26.
Section
222.86,
Code
2011,
is
amended
to
read
as
30
follows:
31
222.86
Payment
for
care
from
fund.
32
If
a
patient
is
not
receiving
medical
assistance
under
33
chapter
249A
and
the
amount
in
the
account
of
any
patient
34
in
the
patients’
personal
deposit
fund
established
pursuant
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to
section
222.84
exceeds
two
hundred
dollars,
the
business
1
manager
of
the
resource
center
or
special
unit
may
apply
2
any
amount
of
the
excess
to
reimburse
the
county
of
legal
3
settlement
or
the
state
in
a
case
where
no
legal
settlement
4
exists
,
as
applicable
in
accordance
with
section
222.60,
for
5
liability
incurred
by
the
county
or
the
state
for
the
payment
6
of
care,
support,
and
maintenance
of
the
patient
,
when
billed
7
by
the
county
of
legal
settlement
or
by
the
administrator
for
a
8
patient
having
no
legal
settlement
at
a
state
resource
center
.
9
Sec.
27.
Section
222.92,
subsection
1,
Code
2011,
is
amended
10
to
read
as
follows:
11
1.
The
department
shall
operate
the
state
resource
centers
12
on
the
basis
of
net
appropriations
from
the
general
fund
of
13
the
state.
The
appropriation
amounts
shall
be
the
net
amounts
14
of
state
moneys
projected
to
be
needed
for
the
state
resource
15
centers
for
the
fiscal
year
of
the
appropriations.
The
purpose
16
of
utilizing
net
appropriations
is
to
encourage
the
state
17
resource
centers
to
operate
with
increased
self-sufficiency,
to
18
improve
quality
and
efficiency,
and
to
support
collaborative
19
efforts
between
the
state
resource
centers
and
counties
and
20
other
providers
of
funding
for
the
services
available
from
21
the
state
resource
centers.
The
state
resource
centers
shall
22
not
be
operated
under
the
net
appropriations
in
a
manner
that
23
results
in
a
cost
increase
to
the
state
or
in
cost
shifting
24
between
the
state,
the
medical
assistance
program,
counties,
or
25
other
sources
of
funding
for
the
state
resource
centers.
26
Sec.
28.
Section
222.92,
subsection
3,
paragraph
a,
Code
27
2011,
is
amended
by
striking
the
paragraph.
28
Sec.
29.
REPEAL.
Sections
222.61,
222.62,
222.65,
222.67,
29
222.68,
222.69,
222.73,
222.74,
and
222.75,
Code
2011,
are
30
repealed.
31
Sec.
30.
EFFECTIVE
DATE.
This
division
of
this
Act
takes
32
effect
July
1,
2012.
33
DIVISION
III
34
LEGISLATIVE
INTENT
AND
EFFECTIVE
DATES
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Sec.
31.
LEGISLATIVE
INTENT
——
PLANNING.
1
1.
The
general
assembly
intends
to
assign
the
2
responsibilities
of
the
state
and
counties
for
the
costs
of
3
services
as
follows:
4
a.
The
necessary
and
legal
nonfederal
costs
and
expenses
5
attending
the
taking
into
custody,
care,
investigation,
6
admission,
commitment,
and
support
of
a
person
with
mental
7
illness
admitted
or
committed
to
a
federal,
state,
county,
or
8
private
hospital
or
facility
on
or
after
July
1,
2012,
shall
be
9
paid
by
the
state.
10
b.
The
costs
of
community-based
mental
health
services
for
11
adults
on
or
after
July
1,
2012,
shall
be
paid
by
counties.
12
c.
The
nonfederal
share
of
the
costs
of
state
resource
13
centers
on
or
after
July
1,
2012,
shall
be
paid
by
the
state.
14
d.
The
nonfederal
share
of
costs
for
services,
other
than
15
those
associated
with
the
state
resource
centers,
provided
to
16
adults
with
mental
retardation
or
intellectual
disabilities
on
17
or
after
July
1,
2012,
shall
be
paid
by
counties.
18
e.
The
costs
associated
with
court-ordered
commitments
of
19
persons
with
mental
retardation
under
chapter
222
on
or
after
20
July
1,
2012,
shall
be
paid
by
the
state.
21
2.
The
department
of
human
services
shall
work
with
22
representatives
designated
by
the
Iowa
state
association
23
of
counties,
service
providers,
and
service
consumers
and
24
advocates
to
develop
plans
to
implement
the
provisions
of
25
this
Act,
including
formulating
recommendations
for
statutory
26
changes,
funding
provisions,
and
other
measures
to
implement
27
the
intent
expressed
in
subsection
1.
In
addition,
the
plans
28
and
recommendations
shall
also
provide
for
development
and
29
funding
of
a
subacute
level
of
care
to
address
behavioral
and
30
mental
health
needs
of
children
and
adults.
The
department
31
shall
report
the
plans
and
recommendations
to
the
governor
and
32
general
assembly
on
or
before
December
15,
2011.
33
3.
The
office
of
the
citizens’
aide
shall
consult
with
34
stakeholders
in
reviewing
the
role,
funding,
and
appropriate
35
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administrative
entity
for
mental
health
advocates
currently
1
appointed
under
section
229.19.
The
office
shall
submit
2
a
report
with
findings
and
recommendations
to
the
general
3
assembly
and
governor
on
or
before
December
15,
2011.
4
Sec.
32.
EFFECTIVE
DATE.
This
division
of
this
Act
takes
5
effect
upon
enactment.
6
EXPLANATION
7
This
bill
revises
state
and
county
responsibilities
for
8
adult
mental
health,
mental
retardation,
and
developmental
9
disabilities
services
effective
July
1,
2012.
The
bill
is
10
organized
into
divisions.
11
MENTAL
HEALTH
COMMITMENT
AND
FACILITY
COSTS.
This
division
12
provides
for
the
state
to
pay
necessary
and
legal
nonfederal
13
costs
and
expenses
attending
the
taking
into
custody,
care,
14
investigation,
admission,
commitment,
and
support
of
a
person
15
with
mental
illness
admitted
or
committed
to
a
federal,
state,
16
county,
or
private
hospital
or
facility
on
or
after
July
17
1,
2012.
Current
law
requires
counties
to
pay
capped
per
18
diem
rates
for
the
services
at
the
four
state
mental
health
19
institutes
and
the
nonfederal
share
of
other
noninstitutional
20
mental
health
services
provided
to
adults
with
legal
settlement
21
and
for
the
state
to
pay
for
children’s
services
and
state
22
cases
for
adults
with
mental
illness.
23
Provisions
in
Code
chapter
218,
relating
to
the
state
24
institutions
controlled
by
the
department
of
human
services,
25
are
amended
to
provide
that
certain
excess
moneys
from
state
26
institution
patient
wages
and
accounts
are
to
be
paid
to
the
27
department
instead
of
counties.
A
similar
provision
in
Code
28
section
226.45
is
also
amended.
29
Code
section
226.9C,
relating
to
operation
of
the
dual
30
diagnosis
mental
health
and
substance
abuse
program
at
the
31
state
mental
health
institute
at
Mount
Pleasant
on
a
net
32
budgeting
basis,
is
amended
to
strike
a
reference
to
a
section
33
repealed
by
the
bill.
34
Code
section
230.1,
relating
to
the
liability
of
the
state
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and
counties
for
the
costs
and
expenses
of
adults
and
children
1
with
mental
illness
committed
to
facilities,
is
amended
to
2
provide
for
the
state
to
pay
these
costs
on
or
after
July
3
1,
2012.
For
costs
incurred
before
that
date,
the
payment
4
responsibility
is
determined
by
the
provisions
repealed
by
the
5
bill.
These
provisions
assign
the
responsibility
for
persons
6
age
18
and
older
to
the
county
of
legal
settlement
or
to
the
7
state
when
a
person
has
no
legal
settlement
in
this
state,
when
8
the
person’s
legal
settlement
is
unknown,
or
if
the
person
is
9
under
18
years
of
age.
10
Code
section
230.15,
relating
to
the
liability
of
a
person
11
with
mental
illness
and
persons
liable
for
that
person’s
12
support
and
establishing
a
limitation
on
that
liability,
is
13
amended
to
also
provide
for
payment
to
the
state.
Code
section
14
230.16,
relating
to
presumption
of
accuracy
of
certificates
15
from
the
superintendent
of
a
state
resource
center
in
actions
16
relating
to
liability
for
services,
is
also
made
applicable
to
17
a
statement
from
a
county
auditor.
18
Code
section
230.17,
relating
to
the
authority
of
the
county
19
auditor
to
compromise
a
lien
for
cost
liability
when
in
the
20
best
interests
of
the
county,
is
expanded
to
provide
similar
21
authority
to
the
department
of
human
services
when
it
is
in
the
22
best
interests
of
the
state.
23
Code
section
230.18,
relating
to
liability
of
an
estate
to
a
24
county
for
costs
of
services
provided
in
a
county
hospital
or
25
home,
or
in
any
private
hospital
or
sanatorium,
is
also
made
26
applicable
to
the
state.
27
Code
section
230.20,
relating
to
billings
to
counties
for
28
services
provided
at
a
state
mental
health
institute
and
how
29
the
billings
are
computed,
is
amended
to
repeal
the
subsections
30
involving
the
requirement
for
counties
to
be
billed
for
31
services
provided
at
a
state
mental
health
institute
and
the
32
computation
methodology.
Subsections
relating
to
crediting
of
33
federal
payment
offsets
and
authorization
for
a
state
mental
34
health
institute
to
provide
other
services
are
amended
to
35
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delete
references
to
county
liability
for
the
cost
of
services.
1
Subsection
6,
requiring
the
department
to
provide
information
2
possessed
by
the
department
to
a
county,
if
such
information
3
is
not
confidential
under
law,
is
modified
to
apply
when
the
4
county
is
obligated
to
pay
for
services
provided
outside
a
5
state
mental
health
institution
or
other
inpatient
setting.
6
Code
section
331.424A,
relating
to
the
county
mental
health,
7
mental
retardation,
and
developmental
disabilities
services
8
funds,
is
amended
to
prohibit
the
use
of
moneys
in
these
funds
9
to
pay
for
the
costs
of
placement,
treatment,
or
other
service
10
ordered
by
a
court
under
Code
chapter
812.
This
Code
chapter
11
relates
to
the
confinement
of
persons
accused
of
a
crime
who
12
may
be
incompetent
to
stand
trial.
13
The
following
Code
sections
are
repealed
by
the
division:
14
section
230.2,
relating
to
finding
of
legal
settlement;
section
15
230.3,
relating
to
certification
of
legal
settlement;
section
16
230.4,
relating
to
certification
of
legal
settlement
to
a
17
debtor
county;
section
230.5,
relating
to
state
cases;
section
18
230.6,
relating
to
investigation
of
legal
settlement
by
the
19
department;
section
230.9,
relating
to
changing
a
state
case
to
20
a
county
of
legal
settlement
case;
section
230.10,
requiring
21
all
legal
costs
and
expenses
relating
to
state
hospital
22
placements
to
be
charged
to
the
county
of
legal
settlement;
23
section
230.11,
providing
a
standing
appropriation
to
repay
24
counties
for
state
cases;
section
230.12,
requiring
the
state
25
and
counties
to
resolve
legal
settlement
disputes
using
a
26
procedure
in
Code
section
225C.8;
section
230.20,
providing
for
27
computation
of
charges
and
billings
to
counties
for
services
28
provided
at
a
state
mental
health
institute;
and
section
29
230.22,
relating
to
financial
penalties
for
counties
who
pay
30
the
billings
late.
31
STATE
RESOURCE
CENTERS.
This
division
provides
for
the
32
state
to
assume
responsibility
for
the
cost
of
services
33
provided
at
the
state
resource
centers
and
the
costs
of
34
court-ordered
commitments
effective
July
1,
2012.
Current
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law
requires
counties
to
pay
capped
per
diem
rates
for
the
1
services.
Code
chapter
222,
relating
generally
to
persons
with
2
mental
retardation
and
the
state
resource
centers
specifically,
3
is
amended.
4
References
to
county
responsibility
for
the
cost
of
services
5
at
the
state
resource
centers,
court-ordered
commitments,
and
6
county
of
legal
settlement
determinations
are
changed
to
the
7
state,
revised,
or
deleted
throughout
the
chapter.
Counties
8
retain
current
responsibility
for
services
provided
to
adults
9
with
mental
retardation
outside
the
state
resource
centers.
10
The
change
in
legal
settlement
processes
and
the
shift
11
in
responsibilities
involving
the
state
resource
centers
12
and
court-ordered
commitments
are
specifically
addressed
in
13
the
following
Code
sections:
section
222.13,
relating
to
14
voluntary
admissions
of
adults;
section
222.13A,
relating
to
15
voluntary
admissions
of
children;
section
222.31,
relating
to
16
liability
of
charges
for
commitments
to
placements;
section
17
222.49,
relating
to
responsibility
for
the
costs
of
commitment
18
proceedings;
section
222.50,
relating
to
the
county
of
legal
19
settlement’s
responsibilities
for
service
costs;
section
20
222.60,
relating
to
state
and
county
responsibilities
for
21
service
costs;
section
222.63,
relating
to
certifications
22
between
counties
regarding
legal
settlement
determinations;
23
section
222.70,
relating
to
resolution
of
legal
settlement
24
disputes;
section
222.64,
relating
to
state
case
legal
25
settlement
determinations;
section
222.70,
relating
to
26
resolution
of
legal
settlement
disputes;
section
222.78,
27
relating
to
the
responsibility
of
parents
and
others
liable
for
28
the
support
of
persons
placed
at
a
resource
center;
section
29
222.79,
relating
to
state
certification
of
resource
center
30
cost
statements;
section
222.86,
relating
to
care
payments
31
from
a
special
patient
fund;
and
section
222.92,
relating
to
32
the
operation
of
the
resource
centers
using
a
net
general
fund
33
appropriation.
34
The
following
Code
sections
are
repealed
by
the
division:
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sections
222.61,
222.62,
222.65,
222.67,
222.68,
and
222.69,
1
relating
to
legal
settlement
determinations,
investigations,
2
charges,
and
payments;
and
sections
222.73,
222.74,
and
222.75,
3
providing
for
computation
of
charges
and
billings
to
counties
4
for
services
provided
at
a
state
resource
center
and
financial
5
penalties
for
counties
who
pay
the
billings
late.
6
LEGISLATIVE
INTENT
AND
EFFECTIVE
DATES.
This
division
7
states
legislative
intent
as
to
the
change
in
responsibilities
8
between
the
state
and
counties
and
requires
the
department
9
of
human
services
to
work
with
representatives
designated
by
10
the
Iowa
state
association
of
counties,
service
providers,
11
and
service
consumers
and
advocates
to
develop
plans
to
12
implement
the
bill
and
intent
expressed,
including
formulating
13
recommendations
for
statutory
changes,
funding
provisions,
and
14
other
measures.
The
department
is
also
required
to
address
15
implementation
of
a
subacute
level
of
care
for
children
and
16
adults
with
behavioral
and
mental
health
needs.
The
department
17
is
required
to
report
the
plans
and
recommendations
to
the
18
governor
and
general
assembly
on
or
before
December
15,
2011.
19
The
office
of
the
citizens’
aide
is
required
to
review
and
make
20
recommendations
regarding
the
appropriate
role,
funding,
and
21
administrative
entity
for
mental
health
advocates
generally
22
appointed
by
the
courts
and
funded
by
counties.
This
provision
23
takes
effect
upon
enactment
and
the
remainder
of
the
bill
takes
24
effect
July
1,
2012.
25
The
bill
amends
numerous
Code
provisions
and
other
26
amendments
of
related
provisions
will
be
necessary
to
fully
27
implement
this
bill.
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