House
File
689
-
Introduced
HOUSE
FILE
689
BY
COMMITTEE
ON
APPROPRIATIONS
(SUCCESSOR
TO
HF
626)
(SUCCESSOR
TO
HSB
83)
A
BILL
FOR
An
Act
relating
to
mental
health
and
disability
services
and
1
substance-related
disorders
and
mental
illness
commitment
2
proceedings,
making
appropriations,
and
including
effective
3
date
provisions.
4
BE
IT
ENACTED
BY
THE
GENERAL
ASSEMBLY
OF
THE
STATE
OF
IOWA:
5
TLSB
2002HZ
(3)
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689
DIVISION
I
1
SERVICES
SYSTEM
REDESIGN
——
FUNDING
2
Section
1.
MENTAL
HEALTH
SERVICES
SYSTEM
REDESIGN.
3
1.
The
general
assembly
intends
to
implement
service
system
4
redesign
for
mental
health
services
in
which
the
department
5
of
human
services
assumes
responsibility
for
administering
6
publicly
funded
mental
health
services
for
children
and
adults
7
beginning
on
July
1,
2012.
8
2.
The
legislative
council
is
requested
to
authorize
9
a
legislative
interim
committee
to
meet
during
the
2011
10
legislative
interim
to
develop
a
plan
for
implementing
the
11
redesigned
mental
health
services
system
for
children
and
12
adults.
The
plan
shall
be
submitted
to
the
general
assembly
13
for
consideration
and
enactment
in
the
2012
legislative
14
session.
The
plan
shall
include
but
is
not
limited
to
all
of
15
the
following:
16
a.
Identifying
clear
definitions
and
requirements
for
the
17
following:
18
(1)
Characteristics
of
the
service
populations.
19
(2)
The
array
of
core
services
to
be
delivered
by
providers
20
in
a
manner
that
promotes
cost-effectiveness,
uniformity,
21
accessibility,
and
best
practices
approaches.
22
(3)
Outcome
measures
that
focus
on
consumer
needs.
23
(4)
Quality
assurance
measures.
24
(5)
Provider
accreditation,
certification,
or
licensure
25
requirements.
26
b.
A
proposal
for
developing
treatment
services
in
this
27
state
to
meet
the
needs
of
children
who
are
placed
out
of
state
28
due
to
the
lack
of
treatment
services
in
this
state.
29
c.
A
proposal
for
implementing
the
delivery
of
regionally
30
coordinated
and
community-based
information
and
referral,
31
options
counseling,
care
coordination,
and
targeted
case
32
management
services.
33
Sec.
2.
DEPARTMENTS
OF
HUMAN
SERVICES
AND
PUBLIC
HEALTH.
34
1.
The
departments
of
human
services
and
public
health
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shall
work
with
appropriate
stakeholders
designated
by
the
1
departments
to
develop
the
proposals
described
in
subsection
2.
2
Progress
on
the
proposals
shall
be
shared
with
the
legislative
3
interim
committee
authorized
pursuant
to
this
division
of
this
4
Act
and
a
final
report
on
the
proposals
shall
be
submitted
to
5
the
governor
and
general
assembly
on
or
before
December
15,
6
2011.
7
2.
The
departments
shall
develop
the
following
proposals:
8
a.
A
proposal
to
emphasize
service
providers
addressing
9
co-occurring
mental
health
and
substance
abuse
disorders.
10
b.
A
proposal
to
address
service
provider
shortages.
In
11
developing
the
proposal,
the
departments
and
appropriate
12
stakeholders
shall
examine
barriers
to
recruiting
providers,
13
including
but
not
limited
to
variation
in
health
insurance
14
payment
provisions
for
the
services
provided
by
different
types
15
of
providers.
16
Sec.
3.
INTELLECTUAL
AND
OTHER
DEVELOPMENTAL
DISABILITY
AND
17
BRAIN
INJURY
SERVICES
SYSTEM
REDESIGN.
18
1.
In
addition
to
mental
health
services,
the
general
19
assembly
intends
to
implement
service
system
redesign
in
which
20
the
department
of
human
services
assumes
responsibility
for
21
the
administration
of
intellectual
and
other
developmental
22
disability
and
brain
injury
services
for
adults
and
children
at
23
a
later
time.
24
2.
The
legislative
council
is
requested
to
extend
the
25
interim
committee
authorized
pursuant
to
this
division
of
26
this
Act
for
the
2011
legislative
interim
or
authorize
a
27
different
legislative
interim
committee
to
meet
during
the
28
2012
legislative
interim
to
develop
a
plan
for
implementing
29
the
redesigned
disability
services
system
for
adults
and
30
children.
The
plan
shall
be
submitted
to
the
general
assembly
31
for
consideration
and
enactment
in
the
2013
legislative
32
session.
The
plan
shall
include
but
is
not
limited
to
all
of
33
the
following:
34
a.
Identifying
clear
definitions
and
requirements
for
the
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following:
1
(1)
Characteristics
of
the
service
populations.
2
(2)
The
array
of
core
services
to
be
delivered
by
providers
3
in
a
manner
that
promotes
cost-effectiveness,
accessibility,
4
and
the
best
practices
approaches.
5
(3)
Outcome
measures.
6
(4)
Quality
assurance
measures.
7
(5)
Provider
accreditation,
certification,
or
licensure
8
requirements.
9
b.
A
proposal
developed
in
conjunction
with
the
department
10
of
public
health
to
emphasize
service
providers
addressing
11
co-occurring
mental
health,
intellectual
disability,
or
12
substance
abuse
disorders.
13
c.
A
proposal
for
implementing
the
delivery
of
regionally
14
coordinated
and
community-based
information
and
referral,
15
options
counseling,
care
coordination,
and
targeted
case
16
management
services.
17
Sec.
4.
CONTINUATION
OF
WORKGROUP
BY
JUDICIAL
BRANCH
18
AND
DEPARTMENT
OF
HUMAN
SERVICES.
The
judicial
branch
and
19
department
of
human
services
shall
continue
the
workgroup
20
implemented
pursuant
to
2010
Iowa
Acts,
chapter
1192,
section
21
24,
subsection
2,
to
improve
the
processes
for
involuntary
22
commitment
for
chronic
substance
abuse
under
chapter
125
and
23
serious
mental
illness
under
chapter
229.
The
recommendations
24
issued
by
the
workgroup
shall
address
options
to
the
current
25
provision
of
transportation
by
the
county
sheriff;
to
the
role,
26
supervision,
and
funding
of
mental
health
patient
advocates;
27
and
for
civil
commitment
prescreening.
Additional
stakeholders
28
shall
be
added
as
necessary
to
facilitate
the
workgroup
29
efforts.
the
workgroup
shall
complete
deliberations
and
submit
30
a
final
report
providing
findings
and
recommendations
on
or
31
before
December
15,
2011.
32
Sec.
5.
SERVICE
SYSTEM
DATA
AND
STATISTICAL
INFORMATION
33
INTEGRATION.
The
department
of
human
services,
department
of
34
public
health,
and
the
community
services
affiliate
of
the
Iowa
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state
association
of
counties
shall
agree
on
implementation
1
provisions
for
an
integrated
data
and
statistical
information
2
system
for
mental
health,
disability
services,
and
substance
3
abuse
services.
The
departments
and
affiliate
shall
report
on
4
the
integrated
system
to
the
governor,
the
joint
appropriations
5
subcommittee
on
health
and
human
services,
and
the
legislative
6
services
agency,
providing
findings
and
recommendations,
on
or
7
before
December
15,
2011.
8
Sec.
6.
NEW
SECTION
.
225C.7A
Disability
services
system
9
redesign
savings
fund.
10
1.
A
disability
services
system
redesign
savings
fund
11
is
created
in
the
state
treasury
under
the
authority
of
the
12
department.
Moneys
credited
to
the
fund
are
not
subject
to
13
section
8.33.
Moneys
available
in
the
fund
for
a
fiscal
14
year
shall
be
used
in
accordance
with
appropriations
made
by
15
the
general
assembly
to
implement
disability
services
system
16
improvements.
17
2.
Notwithstanding
section
8.33,
appropriations
made
to
the
18
department
for
disabilities
services
that
remain
unencumbered
19
or
unobligated
at
the
close
of
the
fiscal
year
as
a
result
of
20
implementation
of
disabilities
services
system
efficiencies
21
shall
not
revert
but
shall
be
credited
to
the
disability
22
services
system
redesign
savings
fund.
23
DIVISION
II
24
APPROPRIATIONS
AND
CONFORMING
PROVISIONS
25
Sec.
7.
CONFORMING
PROVISIONS.
The
legislative
services
26
agency
shall
prepare
a
study
bill
for
consideration
by
the
27
committees
on
human
resources
of
the
senate
and
house
of
28
representatives
for
the
2012
legislative
session,
providing
any
29
necessary
conforming
Code
changes
for
implementation
of
the
30
system
redesign
provisions
contained
in
this
Act.
31
Sec.
8.
PROPERTY
TAX
RELIEF
FUND
——
MENTAL
HEALTH
AND
32
INTELLECTUAL
AND
OTHER
DEVELOPMENTAL
DISABILITIES
SERVICES
33
SYSTEM
REFORM.
34
1.
The
moneys
appropriated
and
credited
to
the
property
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tax
relief
fund
pursuant
to
2011
Iowa
Acts,
Senate
File
209,
1
section
21,
if
enacted,
shall
be
credited
to
the
risk
pool
2
within
the
property
tax
relief
fund,
to
be
distributed
as
3
provided
in
this
section.
4
2.
The
amount
credited
to
the
risk
pool
pursuant
to
this
5
section
is
appropriated
from
the
risk
pool
to
the
department
of
6
human
services
for
distribution
as
provided
in
this
section.
7
3.
a.
For
the
purposes
of
this
section,
“services
fund”
8
means
a
county’s
mental
health,
mental
retardation,
and
9
developmental
disabilities
services
fund
created
in
section
10
331.424A.
11
b.
The
risk
pool
board
shall
implement
a
process
for
12
distribution
of
the
amount
appropriated
in
this
section
to
13
counties
to
be
used
to
provide
eligibility
for
services
and
14
other
support
payable
from
the
counties’
services
funds
for
15
persons
who
are
eligible
under
county
management
plans
in
16
effect
as
of
December
31,
2010,
but
due
to
insufficient
funding
17
are
on
a
waiting
list
for
the
services
and
other
support.
The
18
period
addressed
by
the
funding
appropriated
in
this
section
19
begins
on
or
after
the
effective
date
of
this
section
and
ends
20
June
30,
2012.
The
distribution
allocations
shall
be
completed
21
on
or
before
July
1,
2011.
22
c.
The
general
assembly
finds
that
as
of
the
time
of
23
enactment
of
this
section,
the
funding
appropriated
in
this
24
section
is
sufficient
to
eliminate
the
need
for
continuing,
25
instituting,
or
reinstituting
waiting
lists
during
the
26
period
addressed
by
the
appropriation.
However,
the
process
27
implemented
by
the
risk
pool
board
shall
ensure
there
is
28
adequate
funding
so
that
a
person
made
eligible
for
services
29
and
other
support
from
the
waiting
list
would
not
be
required
30
to
return
to
the
waiting
list
if
a
later
projection
indicates
31
the
funding
is
insufficient
to
cover
for
the
entire
period
all
32
individuals
removed
from
the
waiting
list
pursuant
to
this
33
section.
34
d.
The
funding
provided
in
this
section
is
intended
to
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provide
necessary
services
for
adults
in
need
of
publicly
1
funded
mental
health
and
intellectual
and
other
developmental
2
disabilities
services
until
the
system
reform
provisions
3
addressed
by
this
Act
are
developed
and
enacted.
4
Sec.
9.
IMPLEMENTATION.
There
is
appropriated
from
the
5
general
fund
of
the
state
to
the
department
of
human
services
6
for
the
fiscal
year
beginning
July
1,
2011,
and
ending
June
30,
7
2012,
the
following
amount,
or
so
much
thereof
as
is
necessary,
8
to
be
used
for
the
purposes
designated:
9
For
costs
associated
with
implementation
of
this
Act:
10
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
$
50,000
11
Sec.
10.
EFFECTIVE
UPON
ENACTMENT.
This
division
of
this
12
Act,
being
deemed
of
immediate
importance,
takes
effect
upon
13
enactment.
14
DIVISION
III
15
PSYCHIATRIC
MEDICAL
INSTITUTIONS
FOR
CHILDREN
16
Sec.
11.
Section
135H.3,
subsection
1,
Code
2011,
is
amended
17
to
read
as
follows:
18
1.
A
psychiatric
medical
institution
for
children
shall
19
utilize
a
team
of
professionals
to
direct
an
organized
program
20
of
diagnostic
services,
psychiatric
services,
nursing
care,
21
and
rehabilitative
services
to
meet
the
needs
of
residents
22
in
accordance
with
a
medical
care
plan
developed
for
each
23
resident.
The
membership
of
the
team
of
professionals
may
24
include
but
is
not
limited
to
an
advanced
registered
nurse
25
practitioner.
Social
and
rehabilitative
services
shall
be
26
provided
under
the
direction
of
a
qualified
mental
health
27
professional.
28
Sec.
12.
Section
135H.6,
subsection
8,
Code
2011,
is
amended
29
to
read
as
follows:
30
8.
The
department
of
human
services
may
give
approval
to
31
conversion
of
beds
approved
under
subsection
6
,
to
beds
which
32
are
specialized
to
provide
substance
abuse
treatment.
However,
33
the
total
number
of
beds
approved
under
subsection
6
and
this
34
subsection
shall
not
exceed
four
hundred
thirty.
Conversion
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of
beds
under
this
subsection
shall
not
require
a
revision
of
1
the
certificate
of
need
issued
for
the
psychiatric
institution
2
making
the
conversion.
Beds
for
children
who
do
not
reside
3
in
this
state
and
whose
service
costs
are
not
paid
by
public
4
funds
in
this
state
are
not
subject
to
the
limitations
on
the
5
number
of
beds
and
certificate
of
need
requirements
otherwise
6
applicable
under
this
section.
7
Sec.
13.
Section
249A.31,
subsection
2,
Code
2011,
is
8
amended
to
read
as
follows:
9
2.
Effective
July
1,
2010
2012
,
the
department
shall
apply
10
a
cost-based
reimbursement
methodology
for
reimbursement
11
of
services
provided
by
psychiatric
medical
institution
12
for
children
providers
shall
be
reimbursed
as
determined
13
in
accordance
with
the
managed
care
contract
awarded
for
14
authorizing
payment
for
such
services
under
the
medical
15
assistance
program
.
16
Sec.
14.
PSYCHIATRIC
MEDICAL
INSTITUTIONS
FOR
CHILDREN
17
——
MANAGED
CARE
CONTRACT.
The
department
of
human
services
18
shall
issue
a
request
for
proposals
to
procure
a
contractor
19
to
authorize,
reimburse,
and
manage
benefits
for
psychiatric
20
medical
institution
for
children
services
reimbursed
under
21
the
medical
assistance
program
beginning
July
1,
2012.
The
22
department
shall
not
procure
this
contract
through
a
sole
23
source
contract
process
or
other
limited
selection
process.
24
Sec.
15.
PSYCHIATRIC
MEDICAL
INSTITUTIONS
FOR
CHILDREN
——
25
LEVEL
2.
26
1.
For
the
purposes
of
this
section,
unless
the
context
27
otherwise
requires:
28
a.
“Psychiatric
institution-level
1”
means
a
psychiatric
29
medical
institution
for
children
licensed
under
chapter
135H
30
and
receiving
medical
assistance
program
reimbursement.
31
b.
“Psychiatric
institution-level
2”
means
a
psychiatric
32
medical
institution
for
children
licensed
under
chapter
33
135H
and
receiving
medical
assistance
program
reimbursement
34
and
providing
more
intensive
treatment
as
described
in
this
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section.
1
2.
The
department
of
human
services
shall
work
with
the
2
department
of
inspections
and
appeals
to
develop
a
second
level
3
of
care
for
psychiatric
medical
institutions
for
children
4
licensed
under
chapter
135H,
to
be
known
as
“psychiatric
5
institution-level
2”
to
address
the
needs
of
children
in
need
6
of
more
intensive
treatment.
The
number
of
beds
authorized
for
7
psychiatric
institution-level
2
shall
not
exceed
60
beds.
The
8
number
of
beds
in
a
level
2
program
shall
be
limited
to
12
beds.
9
3.
The
department
of
human
services
shall
select
providers
10
to
be
authorized
to
provide
psychiatric
institution-level
2
11
beds
using
a
request-for-proposal
process.
The
providers
shall
12
be
selected
and
contracts
finalized
on
or
before
January
1,
13
2012.
At
least
three
but
not
more
than
five
providers
shall
be
14
selected
based
upon
the
following
criteria:
15
a.
Geographic
accessibility.
16
b.
Ability
to
provide
needed
expertise,
including
but
not
17
limited
to
psychiatry,
nursing,
specialized
medical
care,
or
18
specialized
programming.
19
c.
Ability
to
meet
and
report
on
standardized
outcome
20
measures.
21
d.
Ability
to
provide
treatment
to
children
whose
treatment
22
needs
have
resulted
in
an
out-of-state
placement.
23
e.
Ability
to
transition
children
from
psychiatric
24
institution-level
2
care
to
psychiatric
institution-level
1
25
care.
26
4.
a.
Notwithstanding
any
provision
of
law
to
the
contrary,
27
for
the
fiscal
year
beginning
July
1,
2011,
the
reimbursement
28
rate
for
psychiatric
institution-level
1
providers
shall
be
the
29
actual
cost
of
care,
not
to
exceed
103
percent
of
the
statewide
30
average
of
the
costs
of
psychiatric
institution-level
1
31
providers
for
the
fiscal
year.
The
costs
shall
not
incorporate
32
the
uniform
5
percent
reduction
applied
to
such
provider
rates
33
in
fiscal
year
2010-2011.
It
is
the
intent
of
the
general
34
assembly
that
such
reimbursement
rates
in
subsequent
years
be
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recalculated
annually
at
the
beginning
of
the
fiscal
year.
1
The
average
of
the
costs
limitation
shall
not
apply
to
the
2
psychiatric
medical
institution
for
children
located
at
the
3
state
mental
health
institute
at
Independence.
4
b.
Notwithstanding
any
provision
of
law
to
the
contrary,
5
for
the
fiscal
year
beginning
July
1,
2011,
the
initial
6
reimbursement
rate
for
psychiatric
institution-level
2
7
providers
shall
be
based
on
a
prospective
cost
of
care
basis,
8
not
to
exceed
the
actual
cost
of
care
for
the
psychiatric
9
medical
institution
for
children
located
at
the
state
mental
10
health
institute
at
Independence.
In
subsequent
years,
it
11
is
the
intent
of
the
general
assembly
that
the
reimbursement
12
rate
for
psychiatric
institution-level
2
providers
be
the
13
actual
cost
of
care,
not
to
exceed
103
percent
of
the
statewide
14
average
of
the
costs
of
psychiatric
institution-level
2
15
providers
for
the
fiscal
year.
16
5.
The
department
of
human
services
shall
create
an
17
oversight
committee
comprised
of
psychiatric
institution-level
18
2
providers
and
representatives
of
other
mental
health
19
organizations
with
expertise
in
children’s
mental
health
20
treatment
to
address
the
following
issues
concerning
21
psychiatric
institution-level
2
providers
and
report
to
the
22
department,
governor,
and
general
assembly
as
needed:
23
a.
Identifying
the
target
population
to
be
served
by
24
providers.
25
b.
Identifying
admission
and
continued
state
criteria
for
26
the
providers.
27
c.
Reviewing
potential
changes
in
licensing
standards
28
for
psychiatric
institution-level
1
providers
in
order
to
29
accommodate
the
higher
acuity
level
and
increased
treatment
30
needs
of
children
to
be
served
by
psychiatric
institution-level
31
2
providers.
32
d.
Reviewing
the
children
in
out-of-state
placements
with
33
providers
similar
to
psychiatric
medical
institutions
for
34
children
to
determine
which
children
could
be
better
served
in
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this
state
by
a
psychiatric
institution-level
2
provider.
1
6.
The
department
of
human
services
shall
annually
report
2
not
later
than
December
15
to
the
chairpersons
and
ranking
3
members
of
the
joint
appropriations
subcommittee
on
health
4
and
human
services
through
2016
regarding
implementation
of
5
this
section.
The
report
shall
include
but
is
not
limited
6
to
information
on
children
served
by
both
level
1
and
level
7
2
providers,
the
types
of
locations
to
which
children
are
8
discharged
after
level
1
and
level
2
treatment
and
the
9
community-based
services
available
to
such
children,
and
the
10
incidence
of
readmission
for
level
1
and
level
2
treatment
11
within
12
months
of
discharge.
12
DIVISION
IV
13
MEDICATION
THERAPY
MANAGEMENT
14
Sec.
16.
NEW
SECTION
.
249A.20B
Medication
therapy
15
management.
16
1.
Beginning
July
1,
2011,
the
department
shall
utilize
a
17
request
for
proposals
process
to
select
an
entity
to
contract
18
beginning
July
1,
2012,
for
the
provision
of
medication
therapy
19
management
for
any
medical
assistance
program
recipient
who
20
meets
any
of
the
following
criteria:
21
a.
Is
an
individual
who
takes
prescription
drugs
to
treat
or
22
prevent
chronic
mental
illness,
or
is
an
individual
who
takes
23
four
or
more
prescription
drugs
to
treat
or
prevent
two
or
more
24
chronic
medical
conditions.
25
b.
Is
an
individual
with
a
prescription
drug
therapy
26
problem
who
is
identified
by
the
prescribing
physician
or
27
other
appropriate
prescriber,
and
referred
to
a
pharmacist
for
28
medication
therapy
management
services.
29
c.
Is
an
individual
who
meets
other
criteria
established
by
30
the
department.
31
2.
For
the
initial
contract
period
beginning
July
1,
2012,
32
the
primary
focus
shall
be
provision
of
medication
therapy
33
management
services
to
individuals
with
chronic
mental
illness.
34
3.
a.
The
contract
shall
require
the
selected
entity
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to
provide
annual
reports
to
the
general
assembly
detailing
1
the
costs,
savings,
estimated
cost
avoidance
and
return
on
2
investment,
and
patient
outcomes
related
to
the
medication
3
therapy
management
services
provided.
4
b.
The
entity
shall
guarantee
demonstrated
annual
savings,
5
including
any
savings
associated
with
cost
avoidance
at
least
6
equal
to
the
medication
therapy
management
services
program’s
7
costs
with
any
shortfall
amount
refunded
to
the
state.
8
c.
As
a
proof
of
concept
in
the
program
for
the
initial
year
9
of
the
contract,
the
entity
shall
offer
a
dollar-for-dollar
10
guarantee
for
drug
product
costs
savings
alone.
11
d.
Prior
to
entering
into
a
contract
with
an
entity,
the
12
department
and
the
entity
shall
agree
on
the
terms,
conditions,
13
and
applicable
measurement
standards
associated
with
the
14
demonstration
of
savings.
The
department
shall
verify
that
the
15
demonstrated
savings
reported
by
the
entity
was
performed
in
16
accordance
with
the
agreed
upon
measurement
standards.
17
e.
The
entity
shall
contract
with
Iowa
licensed
pharmacies,
18
pharmacists,
or
physicians
to
provide
the
medication
therapy
19
management
services.
20
4.
The
fees
for
pharmacist-delivered
medication
therapy
21
management
services
shall
be
separate
from
the
reimbursement
22
for
prescription
drug
product
or
dispensing
services;
shall
23
be
determined
under
the
terms
of
the
contract;
and
must
be
24
reasonable
based
on
the
resources
and
time
required
to
provide
25
the
services.
26
5.
A
fee
shall
be
established
for
physician
reimbursement
27
for
services
delivered
for
medication
therapy
management
28
as
determined
under
the
terms
of
the
contract,
and
must
be
29
reasonable
based
on
the
resources
and
time
required
to
provide
30
the
services.
31
6.
If
any
part
of
the
medication
therapy
management
32
plan
developed
by
a
pharmacist
incorporates
services
which
33
are
outside
the
pharmacist’s
independent
scope
of
practice,
34
including
the
initiation
of
therapy,
modification
of
dosages,
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therapeutic
interchange,
or
changes
in
drug
therapy,
the
1
express
authorization
of
the
individual’s
physician
or
other
2
appropriate
prescriber
is
required.
3
7.
For
the
purposes
of
this
section,
“medication
therapy
4
management”
means
a
systematic
process
performed
by
a
licensed
5
pharmacist,
designed
to
optimize
therapeutic
outcomes
through
6
improved
medication
use
and
reduced
risk
of
adverse
drug
events
7
in
order
to
reduce
overall
health
care
costs,
including
all
of
8
the
following
services:
9
a.
A
medication
therapy
review
and
in-person
consultation
10
relating
to
all
medications,
vitamins,
and
herbal
supplements
11
currently
being
taken
by
an
eligible
individual.
12
b.
A
medication
action
plan,
subject
to
the
limitations
13
specified
in
this
section,
communicated
to
the
individual
and
14
the
individual’s
primary
care
physician
or
other
appropriate
15
prescriber
to
address
safety
issues,
inconsistencies,
16
duplicative
therapy,
omissions,
and
medication
costs.
The
17
medication
action
plan
may
include
recommendations
to
the
18
prescriber
for
changes
in
drug
therapy.
19
c.
Documentation
and
followup
to
ensure
consistent
levels
of
20
pharmacy
services
and
positive
outcomes.
21
Sec.
17.
EFFECTIVE
UPON
ENACTMENT.
This
division
of
this
22
Act,
being
deemed
of
immediate
importance,
takes
effect
upon
23
enactment.
24
DIVISION
V
25
COMMUNITY
MENTAL
HEALTH
CENTERS
26
COMMUNITY
MENTAL
HEALTH
CENTERS
——
CATCHMENT
AREAS
27
Sec.
18.
NEW
SECTION
.
230A.101
Services
system
roles.
28
1.
The
role
of
the
department
of
human
services,
through
29
the
division
of
the
department
designated
as
the
state
30
mental
health
authority
with
responsibility
for
state
policy
31
concerning
mental
health
and
disability
services,
is
to
develop
32
and
maintain
policies
for
the
mental
health
and
disability
33
services
system.
The
policies
shall
address
the
service
needs
34
of
individuals
of
all
ages
with
disabilities
in
this
state,
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regardless
of
the
individuals’
places
of
residence
or
economic
1
circumstances,
and
shall
be
consistent
with
the
requirements
of
2
chapter
225C
and
other
applicable
law.
3
2.
The
role
of
community
mental
health
centers
in
the
4
mental
health
and
disability
services
system
is
to
provide
5
an
organized
set
of
services
in
order
to
adequately
meet
the
6
mental
health
needs
of
this
state’s
citizens
based
on
organized
7
catchment
areas.
8
Sec.
19.
NEW
SECTION
.
230A.102
Definitions.
9
As
used
in
this
chapter,
unless
the
context
otherwise
10
requires:
11
1.
“Administrator”
,
“commission”
,
“department”
,
“disability
12
services”
,
and
“division”
mean
the
same
as
defined
in
section
13
225C.2.
14
2.
“Catchment
area”
means
a
community
mental
health
center
15
catchment
area
identified
in
accordance
with
this
chapter.
16
3.
“Community
mental
health
center”
or
“center”
means
a
17
community
mental
health
center
designated
in
accordance
with
18
this
chapter.
19
Sec.
20.
NEW
SECTION
.
230A.103
Designation
of
community
20
mental
health
centers.
21
1.
The
division,
subject
to
agreement
by
any
community
22
mental
health
center
that
would
provide
services
for
the
23
catchment
area
and
approval
by
the
commission,
shall
designate
24
at
least
one
community
mental
health
center
under
this
chapter
25
to
serve
as
lead
agency
for
addressing
the
mental
health
needs
26
of
the
county
or
counties
comprising
the
catchment
area.
The
27
designation
process
shall
provide
for
the
input
of
potential
28
service
providers
regarding
designation
of
the
initial
29
catchment
area
or
a
change
in
the
designation.
30
2.
The
division
shall
utilize
objective
criteria
for
31
designating
a
community
mental
health
center
to
serve
a
32
catchment
area
and
for
withdrawing
such
designation.
The
33
commission
shall
adopt
rules
outlining
the
criteria.
The
34
criteria
shall
include
but
are
not
limited
to
provisions
for
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meeting
all
of
the
following
requirements:
1
a.
An
appropriate
means
shall
be
used
for
determining
which
2
prospective
designee
is
best
able
to
serve
all
ages
of
the
3
targeted
population
within
the
catchment
area
with
minimal
or
4
no
service
denials.
5
b.
An
effective
means
shall
be
used
for
determining
the
6
relative
ability
of
a
prospective
designee
to
appropriately
7
provide
mental
health
services
and
other
support
to
consumers
8
residing
within
a
catchment
area
as
well
as
consumers
residing
9
outside
the
catchment
area.
The
criteria
shall
address
the
10
duty
for
a
prospective
designee
to
arrange
placements
outside
11
the
catchment
area
when
such
placements
best
meet
consumer
12
needs
and
to
provide
services
within
the
catchment
area
to
13
consumers
who
reside
outside
the
catchment
area
when
the
14
services
are
necessary
and
appropriate.
15
3.
The
board
of
directors
for
a
designated
community
mental
16
health
center
shall
enter
into
an
agreement
with
the
division.
17
The
terms
of
the
agreement
shall
include
but
are
not
limited
18
to
all
of
the
following:
19
a.
The
period
of
time
the
agreement
will
be
in
force.
20
b.
The
services
and
other
support
the
center
will
offer
or
21
provide
for
the
residents
of
the
catchment
area.
22
c.
The
standards
to
be
followed
by
the
center
in
determining
23
whether
and
to
what
extent
the
persons
seeking
services
from
24
the
center
shall
be
considered
to
be
able
to
pay
the
costs
of
25
the
services.
26
d.
The
policies
regarding
availability
of
the
services
27
offered
by
the
center
to
the
residents
of
the
catchment
area
as
28
well
as
consumers
residing
outside
the
catchment
area.
29
e.
The
requirements
for
preparation
and
submission
to
the
30
division
of
annual
audits,
cost
reports,
program
reports,
31
performance
measures,
and
other
financial
and
service
32
accountability
information.
33
4.
This
section
does
not
limit
the
authority
of
the
board
or
34
the
boards
of
supervisors
of
any
county
or
group
of
counties
to
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continue
to
expend
money
to
support
operation
of
a
center.
1
Sec.
21.
NEW
SECTION
.
230A.104
Catchment
areas.
2
1.
The
division
shall
collaborate
with
affected
counties
in
3
identifying
community
mental
health
center
catchment
areas
in
4
accordance
with
this
section.
5
2.
a.
Unless
the
division
has
determined
that
exceptional
6
circumstances
exist,
a
catchment
area
shall
be
served
by
one
7
community
mental
health
center.
The
purpose
of
this
general
8
limitation
is
to
clearly
designate
the
center
responsible
and
9
accountable
for
providing
core
mental
health
services
to
the
10
target
population
in
the
catchment
area
and
to
protect
the
11
financial
viability
of
the
centers
comprising
the
mental
health
12
services
system
in
the
state.
13
b.
A
formal
review
process
shall
be
used
in
determining
14
whether
exceptional
circumstances
exist
that
justify
15
designating
more
than
one
center
to
serve
a
catchment
area.
16
The
criteria
for
the
review
process
shall
include
but
are
not
17
limited
to
a
means
of
determining
whether
the
catchment
area
18
can
support
more
than
one
center.
19
c.
Criteria
shall
be
provided
that
would
allow
the
20
designation
of
more
than
one
center
for
all
or
a
portion
of
a
21
catchment
area
if
designation
or
approval
for
more
than
one
22
center
was
provided
by
the
division
as
of
October
1,
2010.
The
23
criteria
shall
require
a
determination
that
all
such
centers
24
would
be
financially
viable
if
designation
is
provided
for
all.
25
Sec.
22.
NEW
SECTION
.
230A.105
Target
population
——
26
eligibility.
27
1.
The
target
population
residing
in
a
catchment
area
to
be
28
served
by
a
community
mental
health
center
shall
include
but
is
29
not
limited
to
all
of
the
following:
30
a.
Individuals
of
any
age
who
are
experiencing
a
mental
31
health
crisis.
32
b.
Individuals
of
any
age
who
have
a
mental
health
disorder.
33
c.
Adults
who
have
a
serious
mental
illness
or
chronic
34
mental
illness.
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d.
Children
and
youth
who
are
experiencing
a
serious
1
emotional
disturbance.
2
e.
Individuals
described
in
paragraph
“a”
,
“b”
,
“c”
,
3
or
“d”
who
have
a
co-occurring
disorder,
including
but
not
4
limited
to
substance
abuse,
mental
retardation,
a
developmental
5
disability,
brain
injury,
autism
spectrum
disorder,
or
another
6
disability
or
special
health
care
need.
7
2.
Specific
eligibility
criteria
for
members
of
the
target
8
population
shall
be
identified
in
administrative
rules
adopted
9
by
the
commission.
The
eligibility
criteria
shall
address
both
10
clinical
and
financial
eligibility.
11
Sec.
23.
NEW
SECTION
.
230A.106
Services
offered.
12
1.
A
community
mental
health
center
designated
in
13
accordance
with
this
chapter
shall
offer
core
services
and
14
support
addressing
the
basic
mental
health
and
safety
needs
of
15
the
target
population
and
other
residents
of
the
catchment
area
16
served
by
the
center
and
may
offer
other
services
and
support.
17
The
core
services
shall
be
identified
in
administrative
rules
18
adopted
by
the
commission
for
this
purpose.
19
2.
The
initial
core
services
identified
shall
include
all
20
of
the
following:
21
a.
Outpatient
services.
Outpatient
services
shall
consist
22
of
evaluation
and
treatment
services
provided
on
an
ambulatory
23
basis
for
the
target
population.
Outpatient
services
include
24
psychiatric
evaluations,
medication
management,
and
individual,
25
family,
and
group
therapy.
In
addition,
outpatient
services
26
shall
include
specialized
outpatient
services
directed
to
27
the
following
segments
of
the
target
population:
children,
28
elderly,
individuals
who
have
serious
and
persistent
mental
29
illness,
and
residents
of
the
service
area
who
have
been
30
discharged
from
inpatient
treatment
at
a
mental
health
31
facility.
Outpatient
services
shall
provide
elements
of
32
diagnosis,
treatment,
and
appropriate
follow-up.
The
provision
33
of
only
screening
and
referral
services
does
not
constitute
34
outpatient
services.
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b.
Twenty-four-hour
emergency
services.
1
Twenty-four-hour
emergency
services
shall
be
provided
through
2
a
system
that
provides
access
to
a
clinician
and
appropriate
3
disposition
with
follow-up
documentation
of
the
emergency
4
service
provided.
A
patient
shall
have
access
to
evaluation
5
and
stabilization
services
after
normal
business
hours.
The
6
range
of
emergency
services
that
shall
be
available
to
a
7
patient
may
include
but
are
not
limited
to
direct
contact
with
8
a
clinician,
medication
evaluation,
and
hospitalization.
The
9
emergency
services
may
be
provided
directly
by
the
center
10
or
in
collaboration
or
affiliation
with
other
appropriately
11
accredited
providers.
12
c.
Day
treatment,
partial
hospitalization,
or
psychosocial
13
rehabilitation
services.
Such
services
shall
be
provided
as
14
structured
day
programs
in
segments
of
less
than
twenty-four
15
hours
using
a
multidisciplinary
team
approach
to
develop
16
treatment
plans
that
vary
in
intensity
of
services
and
the
17
frequency
and
duration
of
services
based
on
the
needs
of
the
18
patient.
These
services
may
be
provided
directly
by
the
center
19
or
in
collaboration
or
affiliation
with
other
appropriately
20
accredited
providers.
21
d.
Admission
screening
for
voluntary
patients.
22
Admission
screening
services
shall
be
available
for
patients
23
considered
for
voluntary
admission
to
a
state
mental
health
24
institute
to
determine
the
patient’s
appropriateness
for
25
admission.
26
e.
Community
support
services.
Community
support
services
27
shall
consist
of
support
and
treatment
services
focused
28
on
enhancing
independent
functioning
and
assisting
persons
29
in
the
target
population
who
have
a
serious
and
persistent
30
mental
illness
to
live
and
work
in
their
community
setting,
by
31
reducing
or
managing
mental
illness
symptoms
and
the
associated
32
functional
disabilities
that
negatively
impact
such
persons’
33
community
integration
and
stability.
34
f.
Consultation
services.
Consultation
services
may
include
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provision
of
professional
assistance
and
information
about
1
mental
health
and
mental
illness
to
individuals,
service
2
providers,
or
groups
to
increase
such
persons’
effectiveness
3
in
carrying
out
their
responsibilities
for
providing
services.
4
Consultations
may
be
case-specific
or
program-specific.
5
g.
Education
services.
Education
services
may
include
6
information
and
referral
services
regarding
available
7
resources
and
information
and
training
concerning
mental
8
health,
mental
illness,
availability
of
services
and
other
9
support,
the
promotion
of
mental
health,
and
the
prevention
10
of
mental
illness.
Education
services
may
be
made
available
11
to
individuals,
groups,
organizations,
and
the
community
in
12
general.
13
3.
A
community
mental
health
center
shall
be
responsible
14
for
coordinating
with
associated
services
provided
by
other
15
unaffiliated
agencies
to
members
of
the
target
population
in
16
the
catchment
area
and
to
integrate
services
in
the
community
17
with
services
provided
to
the
target
population
in
residential
18
or
inpatient
settings.
19
Sec.
24.
NEW
SECTION
.
230A.107
Form
of
organization.
20
1.
Except
as
authorized
in
subsection
2,
a
community
mental
21
health
center
designated
in
accordance
with
this
chapter
shall
22
be
organized
and
administered
as
a
nonprofit
corporation.
23
2.
A
for-profit
corporation,
nonprofit
corporation,
or
24
county
hospital
providing
mental
health
services
to
county
25
residents
pursuant
to
a
waiver
approved
under
section
225C.7,
26
subsection
3,
Code
2011,
as
of
October
1,
2010,
may
also
be
27
designated
as
a
community
mental
health
center.
28
Sec.
25.
NEW
SECTION
.
230A.108
Administrative,
diagnostic,
29
and
demographic
information.
30
Release
of
administrative
and
diagnostic
information,
as
31
defined
in
section
228.1,
and
demographic
information
necessary
32
for
aggregated
reporting
to
meet
the
data
requirements
33
established
by
the
division,
relating
to
an
individual
who
34
receives
services
from
a
community
mental
health
center,
may
be
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made
a
condition
of
support
of
that
center
by
the
division.
1
Sec.
26.
NEW
SECTION
.
230A.109
Funding
——
legislative
2
intent.
3
1.
It
is
the
intent
of
the
general
assembly
that
public
4
funding
for
community
mental
health
centers
designated
in
5
accordance
with
this
chapter
shall
be
provided
as
a
combination
6
of
federal
and
state
funding.
7
2.
It
is
the
intent
of
the
general
assembly
that
the
state
8
funding
provided
to
centers
be
a
sufficient
amount
for
the
core
9
services
and
support
addressing
the
basic
mental
health
and
10
safety
needs
of
the
residents
of
the
catchment
area
served
by
11
each
center
to
be
provided
regardless
of
individual
ability
to
12
pay
for
the
services
and
support.
13
3.
While
a
community
mental
health
center
must
comply
with
14
the
core
services
requirements
and
other
standards
associated
15
with
designation,
provision
of
services
is
subject
to
the
16
availability
of
a
payment
source
for
the
services.
17
Sec.
27.
NEW
SECTION
.
230A.110
Standards.
18
1.
The
division
shall
recommend
and
the
commission
shall
19
adopt
standards
for
designated
community
mental
health
centers
20
and
comprehensive
community
mental
health
programs,
with
21
the
overall
objective
of
ensuring
that
each
center
and
each
22
affiliate
providing
services
under
contract
with
a
center
23
furnishes
high-quality
mental
health
services
within
a
24
framework
of
accountability
to
the
community
it
serves.
The
25
standards
adopted
shall
be
in
substantial
conformity
with
26
the
applicable
behavioral
health
standards
adopted
by
the
27
joint
commission,
formerly
known
as
the
joint
commission
28
on
accreditation
of
health
care
organizations,
and
other
29
recognized
national
standards
for
evaluation
of
psychiatric
30
facilities
unless
in
the
judgment
of
the
division,
with
31
approval
of
the
commission,
there
are
sound
reasons
for
32
departing
from
the
standards.
33
2.
When
recommending
standards
under
this
section,
the
34
division
shall
designate
an
advisory
committee
representing
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boards
of
directors
and
professional
staff
of
designated
1
community
mental
health
centers
to
assist
in
the
formulation
2
or
revision
of
standards.
The
membership
of
the
advisory
3
committee
shall
include
representatives
of
professional
and
4
nonprofessional
staff
and
other
appropriate
individuals.
5
3.
The
standards
recommended
under
this
section
shall
6
include
requirements
that
each
community
mental
health
center
7
designated
under
this
chapter
do
all
of
the
following:
8
a.
Maintain
and
make
available
to
the
public
a
written
9
statement
of
the
services
the
center
offers
to
residents
of
10
the
catchment
area
being
served.
The
center
shall
employ
or
11
contract
for
services
with
affiliates
to
employ
staff
who
are
12
appropriately
credentialed
or
meet
other
qualifications
in
13
order
to
provide
services.
14
b.
If
organized
as
a
nonprofit
corporation,
be
governed
by
15
a
board
of
directors
which
adequately
represents
interested
16
professions,
consumers
of
the
center’s
services,
socioeconomic,
17
cultural,
and
age
groups,
and
various
geographical
areas
in
18
the
catchment
area
served
by
the
center.
If
organized
as
a
19
for-profit
corporation,
the
corporation’s
policy
structure
20
shall
incorporate
such
representation.
21
c.
Arrange
for
the
financial
condition
and
transactions
of
22
the
community
mental
health
center
to
be
audited
once
each
year
23
by
the
auditor
of
state.
However,
in
lieu
of
an
audit
by
state
24
accountants,
the
local
governing
body
of
a
community
mental
25
health
center
organized
under
this
chapter
may
contract
with
26
or
employ
certified
public
accountants
to
conduct
the
audit,
27
pursuant
to
the
applicable
terms
and
conditions
prescribed
by
28
sections
11.6
and
11.19
and
audit
format
prescribed
by
the
29
auditor
of
state.
Copies
of
each
audit
shall
be
furnished
by
30
the
accountant
to
the
administrator
of
the
division
of
mental
31
health
and
disability
services.
32
d.
Comply
with
the
accreditation
standards
applicable
to
the
33
center.
34
Sec.
28.
NEW
SECTION
.
230A.111
Review
and
evaluation.
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1.
The
review
and
evaluation
of
designated
centers
shall
1
be
performed
through
a
formal
accreditation
review
process
as
2
recommended
by
the
division
and
approved
by
the
commission.
3
The
accreditation
process
shall
include
all
of
the
following:
4
a.
Specific
time
intervals
for
full
accreditation
reviews
5
based
upon
levels
of
accreditation.
6
b.
Use
of
random
or
complaint-specific,
on-site
limited
7
accreditation
reviews
in
the
interim
between
full
accreditation
8
reviews,
as
a
quality
review
approach.
The
results
of
such
9
reviews
shall
be
presented
to
the
commission.
10
c.
Use
of
center
accreditation
self-assessment
tools
to
11
gather
data
regarding
quality
of
care
and
outcomes,
whether
12
used
during
full
or
limited
reviews
or
at
other
times.
13
2.
The
accreditation
process
shall
include
but
is
not
14
limited
to
addressing
all
of
the
following:
15
a.
Measures
to
address
centers
that
do
not
meet
standards,
16
including
authority
to
revoke
accreditation.
17
b.
Measures
to
address
noncompliant
centers
that
do
not
18
develop
a
corrective
action
plan
or
fail
to
implement
steps
19
included
in
a
corrective
action
plan
accepted
by
the
division.
20
c.
Measures
to
appropriately
recognize
centers
that
21
successfully
complete
a
corrective
action
plan.
22
d.
Criteria
to
determine
when
a
center’s
accreditation
23
should
be
denied,
revoked,
suspended,
or
made
provisional.
24
Sec.
29.
REPEAL.
Sections
230A.1
through
230A.18,
Code
25
2011,
are
repealed.
26
Sec.
30.
IMPLEMENTATION
——
EFFECTIVE
DATE.
27
1.
Community
mental
health
centers
operating
under
28
the
provisions
of
chapter
230A,
Code
2011,
and
associated
29
standards,
rules,
and
other
requirements
as
of
June
30,
2012,
30
may
continue
to
operate
under
such
requirements
until
the
31
department
of
human
services,
division
of
mental
health
and
32
disability
services,
and
the
mental
health
and
disability
33
services
commission
have
completed
the
rules
adoption
process
34
to
implement
the
amendments
to
chapter
230A
enacted
by
this
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Act,
identified
catchment
areas,
and
completed
designations
of
1
centers.
2
2.
The
division
and
the
commission
shall
complete
the
rules
3
adoption
process
and
other
requirements
addressed
in
subsection
4
1
on
or
before
June
30,
2012.
5
3.
Except
for
this
section,
which
shall
take
effect
July
1,
6
2011,
this
division
of
this
Act
takes
effect
July
1,
2012.
7
DIVISION
VI
8
PERSONS
WITH
SUBSTANCE-RELATED
DISORDERS
9
AND
PERSONS
WITH
MENTAL
ILLNESS
10
Sec.
31.
Section
125.1,
subsection
1,
Code
2011,
is
amended
11
to
read
as
follows:
12
1.
That
substance
abusers
and
persons
suffering
from
13
chemical
dependency
persons
with
substance-related
disorders
14
be
afforded
the
opportunity
to
receive
quality
treatment
and
15
directed
into
rehabilitation
services
which
will
help
them
16
resume
a
socially
acceptable
and
productive
role
in
society.
17
Sec.
32.
Section
125.2,
subsection
2,
Code
2011,
is
amended
18
by
striking
the
subsection.
19
Sec.
33.
Section
125.2,
subsection
5,
Code
2011,
is
amended
20
by
striking
the
subsection
and
inserting
in
lieu
thereof
the
21
following:
22
5.
“Substance-related
disorder”
means
a
diagnosable
23
substance
abuse
disorder
of
sufficient
duration
to
meet
24
diagnostic
criteria
specified
within
the
most
current
25
diagnostic
and
statistical
manual
of
mental
disorders
published
26
by
the
American
psychiatric
association
that
results
in
a
27
functional
impairment.
28
Sec.
34.
Section
125.2,
subsection
9,
Code
2011,
is
amended
29
to
read
as
follows:
30
9.
“Facility”
means
an
institution,
a
detoxification
center,
31
or
an
installation
providing
care,
maintenance
and
treatment
32
for
substance
abusers
persons
with
substance-related
disorders
33
licensed
by
the
department
under
section
125.13
,
hospitals
34
licensed
under
chapter
135B
,
or
the
state
mental
health
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institutes
designated
by
chapter
226
.
1
Sec.
35.
Section
125.2,
subsections
13,
17,
and
18,
Code
2
2011,
are
amended
by
striking
the
subsections.
3
Sec.
36.
Section
125.9,
subsections
2
and
4,
Code
2011,
are
4
amended
to
read
as
follows:
5
2.
Make
contracts
necessary
or
incidental
to
the
6
performance
of
the
duties
and
the
execution
of
the
powers
of
7
the
director,
including
contracts
with
public
and
private
8
agencies,
organizations
and
individuals
to
pay
them
for
9
services
rendered
or
furnished
to
substance
abusers,
chronic
10
substance
abusers,
or
intoxicated
persons
persons
with
11
substance-related
disorders
.
12
4.
Coordinate
the
activities
of
the
department
and
13
cooperate
with
substance
abuse
programs
in
this
and
other
14
states,
and
make
contracts
and
other
joint
or
cooperative
15
arrangements
with
state,
local
or
private
agencies
in
this
16
and
other
states
for
the
treatment
of
substance
abusers,
17
chronic
substance
abusers,
and
intoxicated
persons
persons
with
18
substance-related
disorders
and
for
the
common
advancement
of
19
substance
abuse
programs.
20
Sec.
37.
Section
125.10,
subsections
2,
3,
4,
5,
7,
8,
9,
21
11,
13,
15,
and
17,
Code
2011,
are
amended
to
read
as
follows:
22
2.
Develop,
encourage,
and
foster
statewide,
regional
23
and
local
plans
and
programs
for
the
prevention
of
substance
24
abuse
misuse
and
the
treatment
of
substance
abusers,
chronic
25
substance
abusers,
and
intoxicated
persons
persons
with
26
substance-related
disorders
in
cooperation
with
public
and
27
private
agencies,
organizations
and
individuals,
and
provide
28
technical
assistance
and
consultation
services
for
these
29
purposes.
30
3.
Coordinate
the
efforts
and
enlist
the
assistance
of
all
31
public
and
private
agencies,
organizations
and
individuals
32
interested
in
the
prevention
of
substance
abuse
and
the
33
treatment
of
substance
abusers,
chronic
substance
abusers,
and
34
intoxicated
persons
persons
with
substance-related
disorders
.
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4.
Cooperate
with
the
department
of
human
services
and
1
the
Iowa
department
of
public
health
in
establishing
and
2
conducting
programs
to
provide
treatment
for
substance
abusers,
3
chronic
substance
abusers,
and
intoxicated
persons
persons
with
4
substance-related
disorders
.
5
5.
Cooperate
with
the
department
of
education,
boards
6
of
education,
schools,
police
departments,
courts,
and
other
7
public
and
private
agencies,
organizations,
and
individuals
in
8
establishing
programs
for
the
prevention
of
substance
abuse
9
and
the
treatment
of
substance
abusers,
chronic
substance
10
abusers,
and
intoxicated
persons
persons
with
substance-related
11
disorders
,
and
in
preparing
relevant
curriculum
materials
for
12
use
at
all
levels
of
school
education.
13
7.
Develop
and
implement,
as
an
integral
part
of
treatment
14
programs,
an
educational
program
for
use
in
the
treatment
of
15
substance
abusers,
chronic
substance
abusers,
and
intoxicated
16
persons
persons
with
substance-related
disorders
,
which
program
17
shall
include
the
dissemination
of
information
concerning
the
18
nature
and
effects
of
chemical
substances.
19
8.
Organize
and
implement,
in
cooperation
with
local
20
treatment
programs,
training
programs
for
all
persons
engaged
21
in
treatment
of
substance
abusers,
chronic
substance
abusers,
22
and
intoxicated
persons
persons
with
substance-related
23
disorders
.
24
9.
Sponsor
and
implement
research
in
cooperation
with
local
25
treatment
programs
into
the
causes
and
nature
of
substance
26
abuse
misuse
and
treatment
of
substance
abusers,
chronic
27
substance
abusers,
and
intoxicated
persons
persons
with
28
substance-related
disorders
,
and
serve
as
a
clearing
house
for
29
information
relating
to
substance
abuse.
30
11.
Develop
and
implement,
with
the
counsel
and
approval
of
31
the
board,
the
comprehensive
plan
for
treatment
of
substance
32
abusers,
chronic
substance
abusers,
and
intoxicated
persons
33
persons
with
substance-related
disorders
in
accordance
with
34
this
chapter
.
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13.
Utilize
the
support
and
assistance
of
interested
1
persons
in
the
community,
particularly
recovered
substance
2
abusers
and
chronic
substance
abusers,
persons
who
are
3
recovering
from
substance-related
disorders
to
encourage
4
substance
abusers
and
chronic
substance
abusers
persons
with
5
substance-related
disorders
to
voluntarily
undergo
treatment.
6
15.
Encourage
general
hospitals
and
other
appropriate
7
health
facilities
to
admit
without
discrimination
substance
8
abusers,
chronic
substance
abusers,
and
intoxicated
persons
9
persons
with
substance-related
disorders
and
to
provide
them
10
with
adequate
and
appropriate
treatment.
The
director
may
11
negotiate
and
implement
contracts
with
hospitals
and
other
12
appropriate
health
facilities
with
adequate
detoxification
13
facilities.
14
17.
Review
all
state
health,
welfare,
education
and
15
treatment
proposals
to
be
submitted
for
federal
funding
under
16
federal
legislation,
and
advise
the
governor
on
provisions
to
17
be
included
relating
to
substance
abuse,
substance
abusers,
18
chronic
substance
abusers,
and
intoxicated
persons
and
persons
19
with
substance-related
disorders
.
20
Sec.
38.
Section
125.12,
subsections
1
and
3,
Code
2011,
are
21
amended
to
read
as
follows:
22
1.
The
board
shall
review
the
comprehensive
substance
23
abuse
program
implemented
by
the
department
for
the
treatment
24
of
substance
abusers,
chronic
substance
abusers,
intoxicated
25
persons
persons
with
substance-related
disorders
,
and
concerned
26
family
members.
Subject
to
the
review
of
the
board,
the
27
director
shall
divide
the
state
into
appropriate
regions
28
for
the
conduct
of
the
program
and
establish
standards
for
29
the
development
of
the
program
on
the
regional
level.
In
30
establishing
the
regions,
consideration
shall
be
given
to
city
31
and
county
lines,
population
concentrations,
and
existing
32
substance
abuse
treatment
services.
33
3.
The
director
shall
provide
for
adequate
and
appropriate
34
treatment
for
substance
abusers,
chronic
substance
abusers,
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intoxicated
persons
persons
with
substance-related
disorders
,
1
and
concerned
family
members
admitted
under
sections
125.33
and
2
125.34
,
or
under
section
125.75
,
125.81
,
or
125.91
.
Treatment
3
shall
not
be
provided
at
a
correctional
institution
except
for
4
inmates.
5
Sec.
39.
Section
125.13,
subsection
1,
paragraph
a,
Code
6
2011,
is
amended
to
read
as
follows:
7
a.
Except
as
provided
in
subsection
2
,
a
person
shall
not
8
maintain
or
conduct
any
chemical
substitutes
or
antagonists
9
program,
residential
program,
or
nonresidential
outpatient
10
program,
the
primary
purpose
of
which
is
the
treatment
and
11
rehabilitation
of
substance
abusers
or
chronic
substance
12
abusers
persons
with
substance-related
disorders
without
having
13
first
obtained
a
written
license
for
the
program
from
the
14
department.
15
Sec.
40.
Section
125.13,
subsection
2,
paragraphs
a
and
c,
16
Code
2011,
are
amended
to
read
as
follows:
17
a.
A
hospital
providing
care
or
treatment
to
substance
18
abusers
or
chronic
substance
abusers
persons
with
19
substance-related
disorders
licensed
under
chapter
135B
which
20
is
accredited
by
the
joint
commission
on
the
accreditation
of
21
health
care
organizations,
the
commission
on
accreditation
22
of
rehabilitation
facilities,
the
American
osteopathic
23
association,
or
another
recognized
organization
approved
by
the
24
board.
All
survey
reports
from
the
accrediting
or
licensing
25
body
must
be
sent
to
the
department.
26
c.
Private
institutions
conducted
by
and
for
persons
who
27
adhere
to
the
faith
of
any
well
recognized
church
or
religious
28
denomination
for
the
purpose
of
providing
care,
treatment,
29
counseling,
or
rehabilitation
to
substance
abusers
or
chronic
30
substance
abusers
persons
with
substance-related
disorders
and
31
who
rely
solely
on
prayer
or
other
spiritual
means
for
healing
32
in
the
practice
of
religion
of
such
church
or
denomination.
33
Sec.
41.
Section
125.15,
Code
2011,
is
amended
to
read
as
34
follows:
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125.15
Inspections.
1
The
department
may
inspect
the
facilities
and
review
the
2
procedures
utilized
by
any
chemical
substitutes
or
antagonists
3
program,
residential
program,
or
nonresidential
outpatient
4
program
that
has
as
a
primary
purpose
the
treatment
and
5
rehabilitation
of
substance
abusers
or
chronic
substance
6
abusers
persons
with
substance-related
disorders
,
for
the
7
purpose
of
ensuring
compliance
with
this
chapter
and
the
rules
8
adopted
pursuant
to
this
chapter
.
The
examination
and
review
9
may
include
case
record
audits
and
interviews
with
staff
and
10
patients,
consistent
with
the
confidentiality
safeguards
of
11
state
and
federal
law.
12
Sec.
42.
Section
125.32,
unnumbered
paragraph
1,
Code
2011,
13
is
amended
to
read
as
follows:
14
The
department
shall
adopt
and
may
amend
and
repeal
rules
15
for
acceptance
of
persons
into
the
treatment
program,
subject
16
to
chapter
17A
,
considering
available
treatment
resources
and
17
facilities,
for
the
purpose
of
early
and
effective
treatment
18
of
substance
abusers,
chronic
substance
abusers,
intoxicated
19
persons,
persons
with
substance-related
disorders
and
concerned
20
family
members.
In
establishing
the
rules
the
department
shall
21
be
guided
by
the
following
standards:
22
Sec.
43.
Section
125.33,
subsections
1,
3,
and
4,
Code
2011,
23
are
amended
to
read
as
follows:
24
1.
A
substance
abuser
or
chronic
substance
abuser
person
25
with
a
substance-related
disorder
may
apply
for
voluntary
26
treatment
or
rehabilitation
services
directly
to
a
facility
27
or
to
a
licensed
physician
and
surgeon
or
osteopathic
28
physician
and
surgeon.
If
the
proposed
patient
is
a
minor
29
or
an
incompetent
person,
a
parent,
a
legal
guardian
or
30
other
legal
representative
may
make
the
application.
The
31
licensed
physician
and
surgeon
or
osteopathic
physician
and
32
surgeon
or
any
employee
or
person
acting
under
the
direction
33
or
supervision
of
the
physician
and
surgeon
or
osteopathic
34
physician
and
surgeon,
or
the
facility
shall
not
report
or
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disclose
the
name
of
the
person
or
the
fact
that
treatment
1
was
requested
or
has
been
undertaken
to
any
law
enforcement
2
officer
or
law
enforcement
agency;
nor
shall
such
information
3
be
admissible
as
evidence
in
any
court,
grand
jury,
or
4
administrative
proceeding
unless
authorized
by
the
person
5
seeking
treatment.
If
the
person
seeking
such
treatment
or
6
rehabilitation
is
a
minor
who
has
personally
made
application
7
for
treatment,
the
fact
that
the
minor
sought
treatment
or
8
rehabilitation
or
is
receiving
treatment
or
rehabilitation
9
services
shall
not
be
reported
or
disclosed
to
the
parents
or
10
legal
guardian
of
such
minor
without
the
minor’s
consent,
and
11
the
minor
may
give
legal
consent
to
receive
such
treatment
and
12
rehabilitation.
13
3.
A
substance
abuser
or
chronic
substance
abuser
person
14
with
a
substance-related
disorder
seeking
treatment
or
15
rehabilitation
and
who
is
either
addicted
or
dependent
on
a
16
chemical
substance
may
first
be
examined
and
evaluated
by
a
17
licensed
physician
and
surgeon
or
osteopathic
physician
and
18
surgeon
who
may
prescribe
a
proper
course
of
treatment
and
19
medication,
if
needed.
The
licensed
physician
and
surgeon
20
or
osteopathic
physician
and
surgeon
may
further
prescribe
a
21
course
of
treatment
or
rehabilitation
and
authorize
another
22
licensed
physician
and
surgeon
or
osteopathic
physician
and
23
surgeon
or
facility
to
provide
the
prescribed
treatment
or
24
rehabilitation
services.
Treatment
or
rehabilitation
services
25
may
be
provided
to
a
person
individually
or
in
a
group.
A
26
facility
providing
or
engaging
in
treatment
or
rehabilitation
27
shall
not
report
or
disclose
to
a
law
enforcement
officer
or
28
law
enforcement
agency
the
name
of
any
person
receiving
or
29
engaged
in
the
treatment
or
rehabilitation;
nor
shall
a
person
30
receiving
or
participating
in
treatment
or
rehabilitation
31
report
or
disclose
the
name
of
any
other
person
engaged
in
or
32
receiving
treatment
or
rehabilitation
or
that
the
program
is
33
in
existence,
to
a
law
enforcement
officer
or
law
enforcement
34
agency.
Such
information
shall
not
be
admitted
in
evidence
in
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any
court,
grand
jury,
or
administrative
proceeding.
However,
1
a
person
engaged
in
or
receiving
treatment
or
rehabilitation
2
may
authorize
the
disclosure
of
the
person’s
name
and
3
individual
participation.
4
4.
If
a
patient
receiving
inpatient
or
residential
care
5
leaves
a
facility,
the
patient
shall
be
encouraged
to
consent
6
to
appropriate
outpatient
or
halfway
house
treatment.
If
it
7
appears
to
the
administrator
in
charge
of
the
facility
that
8
the
patient
is
a
substance
abuser
or
chronic
substance
abuser
9
person
with
a
substance-related
disorder
who
requires
help,
the
10
director
may
arrange
for
assistance
in
obtaining
supportive
11
services.
12
Sec.
44.
Section
125.34,
Code
2011,
is
amended
to
read
as
13
follows:
14
125.34
Treatment
and
services
for
intoxicated
persons
and
15
persons
incapacitated
by
alcohol
persons
with
substance-related
16
disorders
due
to
intoxication
and
substance-induced
17
incapacitation
.
18
1.
An
intoxicated
A
person
with
a
substance-related
19
disorder
due
to
intoxication
or
substance-induced
20
incapacitation
may
come
voluntarily
to
a
facility
for
21
emergency
treatment.
A
person
who
appears
to
be
intoxicated
or
22
incapacitated
by
a
chemical
substance
in
a
public
place
and
in
23
need
of
help
may
be
taken
to
a
facility
by
a
peace
officer
under
24
section
125.91
.
If
the
person
refuses
the
proffered
help,
the
25
person
may
be
arrested
and
charged
with
intoxication
under
26
section
123.46
,
if
applicable.
27
2.
If
no
facility
is
readily
available
the
person
may
28
be
taken
to
an
emergency
medical
service
customarily
used
29
for
incapacitated
persons.
The
peace
officer
in
detaining
30
the
person
and
in
taking
the
person
to
a
facility
shall
make
31
every
reasonable
effort
to
protect
the
person’s
health
and
32
safety.
In
detaining
the
person
the
detaining
officer
may
take
33
reasonable
steps
for
self-protection.
Detaining
a
person
under
34
section
125.91
is
not
an
arrest
and
no
entry
or
other
record
35
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shall
be
made
to
indicate
that
the
person
who
is
detained
has
1
been
arrested
or
charged
with
a
crime.
2
3.
A
person
who
arrives
at
a
facility
and
voluntarily
3
submits
to
examination
shall
be
examined
by
a
licensed
4
physician
as
soon
as
possible
after
the
person
arrives
at
the
5
facility.
The
person
may
then
be
admitted
as
a
patient
or
6
referred
to
another
health
facility.
The
referring
facility
7
shall
arrange
for
transportation.
8
4.
If
a
person
is
voluntarily
admitted
to
a
facility,
the
9
person’s
family
or
next
of
kin
shall
be
notified
as
promptly
10
as
possible.
If
an
adult
patient
who
is
not
incapacitated
11
requests
that
there
be
no
notification,
the
request
shall
be
12
respected.
13
5.
A
peace
officer
who
acts
in
compliance
with
this
section
14
is
acting
in
the
course
of
the
officer’s
official
duty
and
is
15
not
criminally
or
civilly
liable
therefor,
unless
such
acts
16
constitute
willful
malice
or
abuse.
17
6.
If
the
physician
in
charge
of
the
facility
determines
it
18
is
for
the
patient’s
benefit,
the
patient
shall
be
encouraged
19
to
agree
to
further
diagnosis
and
appropriate
voluntary
20
treatment.
21
7.
A
licensed
physician
and
surgeon
or
osteopathic
22
physician
and
surgeon,
facility
administrator,
or
an
23
employee
or
a
person
acting
as
or
on
behalf
of
the
facility
24
administrator,
is
not
criminally
or
civilly
liable
for
acts
25
in
conformity
with
this
chapter
,
unless
the
acts
constitute
26
willful
malice
or
abuse.
27
Sec.
45.
Section
125.43,
Code
2011,
is
amended
to
read
as
28
follows:
29
125.43
Funding
at
mental
health
institutes.
30
Chapter
230
governs
the
determination
of
the
costs
and
31
payment
for
treatment
provided
to
substance
abusers
or
chronic
32
substance
abusers
persons
with
substance-related
disorders
in
a
33
mental
health
institute
under
the
department
of
human
services,
34
except
that
the
charges
are
not
a
lien
on
real
estate
owned
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by
persons
legally
liable
for
support
of
the
substance
abuser
1
or
chronic
substance
abuser
person
with
a
substance-related
2
disorder
and
the
daily
per
diem
shall
be
billed
at
twenty-five
3
percent.
The
superintendent
of
a
state
hospital
shall
total
4
only
those
expenditures
which
can
be
attributed
to
the
cost
of
5
providing
inpatient
treatment
to
substance
abusers
or
chronic
6
substance
abusers
persons
with
substance-related
disorders
for
7
purposes
of
determining
the
daily
per
diem.
Section
125.44
8
governs
the
determination
of
who
is
legally
liable
for
the
9
cost
of
care,
maintenance,
and
treatment
of
a
substance
abuser
10
or
chronic
substance
abuser
person
with
a
substance-related
11
disorder
and
of
the
amount
for
which
the
person
is
liable.
12
Sec.
46.
Section
125.43A,
Code
2011,
is
amended
to
read
as
13
follows:
14
125.43A
Prescreening
——
exception.
15
Except
in
cases
of
medical
emergency
or
court-ordered
16
admissions,
a
person
shall
be
admitted
to
a
state
mental
17
health
institute
for
substance
abuse
treatment
only
after
a
18
preliminary
intake
and
assessment
by
a
department-licensed
19
treatment
facility
or
a
hospital
providing
care
or
treatment
20
for
substance
abusers
persons
with
substance-related
disorders
21
licensed
under
chapter
135B
and
accredited
by
the
joint
22
commission
on
the
accreditation
of
health
care
organizations,
23
the
commission
on
accreditation
of
rehabilitation
facilities,
24
the
American
osteopathic
association,
or
another
recognized
25
organization
approved
by
the
board,
or
by
a
designee
of
a
26
department-licensed
treatment
facility
or
a
hospital
other
27
than
a
state
mental
health
institute,
which
confirms
that
28
the
admission
is
appropriate
to
the
person’s
substance
abuse
29
service
needs.
A
county
board
of
supervisors
may
seek
an
30
admission
of
a
patient
to
a
state
mental
health
institute
who
31
has
not
been
confirmed
for
appropriate
admission
and
the
county
32
shall
be
responsible
for
one
hundred
percent
of
the
cost
of
33
treatment
and
services
of
the
patient.
34
Sec.
47.
Section
125.44,
Code
2011,
is
amended
to
read
as
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follows:
1
125.44
Agreements
with
facilities
——
liability
for
costs.
2
The
director
may,
consistent
with
the
comprehensive
3
substance
abuse
program,
enter
into
written
agreements
with
a
4
facility
as
defined
in
section
125.2
to
pay
for
one
hundred
5
percent
of
the
cost
of
the
care,
maintenance,
and
treatment
6
of
substance
abusers
and
chronic
substance
abusers
persons
7
with
substance-related
disorders
,
except
when
section
125.43A
8
applies.
All
payments
for
state
patients
shall
be
made
9
in
accordance
with
the
limitations
of
this
section
.
Such
10
contracts
shall
be
for
a
period
of
no
more
than
one
year.
11
The
contract
may
be
in
the
form
and
contain
provisions
12
as
agreed
upon
by
the
parties.
The
contract
shall
provide
13
that
the
facility
shall
admit
and
treat
substance
abusers
14
and
chronic
substance
abusers
persons
with
substance-related
15
disorders
regardless
of
where
they
have
residence.
If
one
16
payment
for
care,
maintenance,
and
treatment
is
not
made
17
by
the
patient
or
those
legally
liable
for
the
patient,
18
the
payment
shall
be
made
by
the
department
directly
to
the
19
facility.
Payments
shall
be
made
each
month
and
shall
be
20
based
upon
the
rate
of
payment
for
services
negotiated
between
21
the
department
and
the
contracting
facility.
If
a
facility
22
projects
a
temporary
cash
flow
deficit,
the
department
may
23
make
cash
advances
at
the
beginning
of
each
fiscal
year
to
the
24
facility.
The
repayment
schedule
for
advances
shall
be
part
25
of
the
contract
between
the
department
and
the
facility.
This
26
section
does
not
pertain
to
patients
treated
at
the
mental
27
health
institutes.
28
If
the
appropriation
to
the
department
is
insufficient
to
29
meet
the
requirements
of
this
section
,
the
department
shall
30
request
a
transfer
of
funds
and
section
8.39
shall
apply.
31
The
substance
abuser
or
chronic
substance
abuser
person
32
with
a
substance-related
disorder
is
legally
liable
to
the
33
facility
for
the
total
amount
of
the
cost
of
providing
care,
34
maintenance,
and
treatment
for
the
substance
abuser
or
chronic
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substance
abuser
person
with
a
substance-related
disorder
while
1
a
voluntary
or
committed
patient
in
a
facility.
This
section
2
does
not
prohibit
any
individual
from
paying
any
portion
of
the
3
cost
of
treatment.
4
The
department
is
liable
for
the
cost
of
care,
treatment,
5
and
maintenance
of
substance
abusers
and
chronic
substance
6
abusers
persons
with
substance-related
disorders
admitted
to
7
the
facility
voluntarily
or
pursuant
to
section
125.75
,
125.81
,
8
or
125.91
or
section
321J.3
or
124.409
only
to
those
facilities
9
that
have
a
contract
with
the
department
under
this
section
,
10
only
for
the
amount
computed
according
to
and
within
the
limits
11
of
liability
prescribed
by
this
section
,
and
only
when
the
12
substance
abuser
or
chronic
substance
abuser
person
with
a
13
substance-related
disorder
is
unable
to
pay
the
costs
and
there
14
is
no
other
person,
firm,
corporation,
or
insurance
company
15
bound
to
pay
the
costs.
16
The
department’s
maximum
liability
for
the
costs
of
care,
17
treatment,
and
maintenance
of
substance
abusers
and
chronic
18
substance
abusers
persons
with
substance-related
disorders
in
19
a
contracting
facility
is
limited
to
the
total
amount
agreed
20
upon
by
the
parties
and
specified
in
the
contract
under
this
21
section
.
22
Sec.
48.
Section
125.46,
Code
2011,
is
amended
to
read
as
23
follows:
24
125.46
County
of
residence
determined.
25
The
facility
shall,
when
a
substance
abuser
or
chronic
26
substance
abuser
person
with
a
substance-related
disorder
is
27
admitted,
or
as
soon
thereafter
as
it
receives
the
proper
28
information,
determine
and
enter
upon
its
records
the
Iowa
29
county
of
residence
of
the
substance
abuser
or
chronic
30
substance
abuser
person
with
a
substance-related
disorder
,
or
31
that
the
person
resides
in
some
other
state
or
country,
or
that
32
the
person
is
unclassified
with
respect
to
residence.
33
Sec.
49.
Section
125.75,
unnumbered
paragraph
1,
Code
2011,
34
is
amended
to
read
as
follows:
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Proceedings
for
the
involuntary
commitment
or
treatment
of
1
a
chronic
substance
abuser
person
with
a
substance-related
2
disorder
to
a
facility
may
be
commenced
by
the
county
attorney
3
or
an
interested
person
by
filing
a
verified
application
4
with
the
clerk
of
the
district
court
of
the
county
where
the
5
respondent
is
presently
located
or
which
is
the
respondent’s
6
place
of
residence.
The
clerk
or
the
clerk’s
designee
shall
7
assist
the
applicant
in
completing
the
application.
The
8
application
shall:
9
Sec.
50.
Section
125.75,
subsection
1,
Code
2011,
is
amended
10
to
read
as
follows:
11
1.
State
the
applicant’s
belief
that
the
respondent
is
12
a
chronic
substance
abuser
person
with
a
substance-related
13
disorder
.
14
Sec.
51.
Section
125.80,
subsections
3
and
4,
Code
2011,
are
15
amended
to
read
as
follows:
16
3.
If
the
report
of
a
court-designated
physician
is
to
the
17
effect
that
the
respondent
is
not
a
chronic
substance
abuser
18
person
with
a
substance-related
disorder
,
the
court,
without
19
taking
further
action,
may
terminate
the
proceeding
and
dismiss
20
the
application
on
its
own
motion
and
without
notice.
21
4.
If
the
report
of
a
court-designated
physician
is
to
the
22
effect
that
the
respondent
is
a
chronic
substance
abuser
person
23
with
a
substance-related
disorder
,
the
court
shall
schedule
a
24
commitment
hearing
as
soon
as
possible.
The
hearing
shall
be
25
held
not
more
than
forty-eight
hours
after
the
report
is
filed,
26
excluding
Saturdays,
Sundays,
and
holidays,
unless
an
extension
27
for
good
cause
is
requested
by
the
respondent,
or
as
soon
28
thereafter
as
possible
if
the
court
considers
that
sufficient
29
grounds
exist
for
delaying
the
hearing.
30
Sec.
52.
Section
125.81,
subsection
1,
Code
2011,
is
amended
31
to
read
as
follows:
32
1.
If
a
person
filing
an
application
requests
that
a
33
respondent
be
taken
into
immediate
custody,
and
the
court
upon
34
reviewing
the
application
and
accompanying
documentation,
finds
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probable
cause
to
believe
that
the
respondent
is
a
chronic
1
substance
abuser
person
with
a
substance-related
disorder
who
2
is
likely
to
injure
the
person
or
other
persons
if
allowed
3
to
remain
at
liberty,
the
court
may
enter
a
written
order
4
directing
that
the
respondent
be
taken
into
immediate
custody
5
by
the
sheriff,
and
be
detained
until
the
commitment
hearing,
6
which
shall
be
held
no
more
than
five
days
after
the
date
of
the
7
order,
except
that
if
the
fifth
day
after
the
date
of
the
order
8
is
a
Saturday,
Sunday,
or
a
holiday,
the
hearing
may
be
held
9
on
the
next
business
day.
The
court
may
order
the
respondent
10
detained
for
the
period
of
time
until
the
hearing
is
held,
and
11
no
longer
except
as
provided
in
section
125.88
,
in
accordance
12
with
subsection
2
,
paragraph
“a”
,
if
possible,
and
if
not,
then
13
in
accordance
with
subsection
2
,
paragraph
“b”
,
or,
only
if
14
neither
of
these
alternatives
is
available
in
accordance
with
15
subsection
2
,
paragraph
“c”
.
16
Sec.
53.
Section
125.82,
subsection
4,
Code
2011,
is
amended
17
to
read
as
follows:
18
4.
The
respondent’s
welfare
is
paramount,
and
the
hearing
19
shall
be
tried
as
a
civil
matter
and
conducted
in
as
informal
a
20
manner
as
is
consistent
with
orderly
procedure.
Discovery
as
21
permitted
under
the
Iowa
rules
of
civil
procedure
is
available
22
to
the
respondent.
The
court
shall
receive
all
relevant
and
23
material
evidence,
but
the
court
is
not
bound
by
the
rules
of
24
evidence.
A
presumption
in
favor
of
the
respondent
exists,
25
and
the
burden
of
evidence
and
support
of
the
contentions
made
26
in
the
application
shall
be
upon
the
person
who
filed
the
27
application.
If
upon
completion
of
the
hearing
the
court
finds
28
that
the
contention
that
the
respondent
is
a
chronic
substance
29
abuser
person
with
a
substance-related
disorder
has
not
been
30
sustained
by
clear
and
convincing
evidence,
the
court
shall
31
deny
the
application
and
terminate
the
proceeding.
32
Sec.
54.
Section
125.83,
Code
2011,
is
amended
to
read
as
33
follows:
34
125.83
Placement
for
evaluation.
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If
upon
completion
of
the
commitment
hearing,
the
court
1
finds
that
the
contention
that
the
respondent
is
a
chronic
2
substance
abuser
person
with
a
substance-related
disorder
3
has
been
sustained
by
clear
and
convincing
evidence,
the
4
court
shall
order
the
respondent
placed
at
a
facility
or
5
under
the
care
of
a
suitable
facility
on
an
outpatient
basis
6
as
expeditiously
as
possible
for
a
complete
evaluation
and
7
appropriate
treatment.
The
court
shall
furnish
to
the
facility
8
at
the
time
of
admission
or
outpatient
placement,
a
written
9
statement
of
facts
setting
forth
the
evidence
on
which
the
10
finding
is
based.
The
administrator
of
the
facility
shall
11
report
to
the
court
no
more
than
fifteen
days
after
the
12
individual
is
admitted
to
or
placed
under
the
care
of
the
13
facility,
which
shall
include
the
chief
medical
officer’s
14
recommendation
concerning
substance
abuse
treatment.
An
15
extension
of
time
may
be
granted
for
a
period
not
to
exceed
16
seven
days
upon
a
showing
of
good
cause.
A
copy
of
the
report
17
shall
be
sent
to
the
respondent’s
attorney
who
may
contest
18
the
need
for
an
extension
of
time
if
one
is
requested.
If
19
the
request
is
contested,
the
court
shall
make
an
inquiry
20
as
it
deems
appropriate
and
may
either
order
the
respondent
21
released
from
the
facility
or
grant
extension
of
time
for
22
further
evaluation.
If
the
administrator
fails
to
report
to
23
the
court
within
fifteen
days
after
the
individual
is
admitted
24
to
the
facility,
and
no
extension
of
time
has
been
requested,
25
the
administrator
is
guilty
of
contempt
and
shall
be
punished
26
under
chapter
665
.
The
court
shall
order
a
rehearing
on
the
27
application
to
determine
whether
the
respondent
should
continue
28
to
be
held
at
the
facility.
29
Sec.
55.
Section
125.83A,
subsection
1,
Code
2011,
is
30
amended
to
read
as
follows:
31
1.
If
upon
completion
of
the
commitment
hearing,
the
court
32
finds
that
the
contention
that
the
respondent
is
a
chronic
33
substance
abuser
person
with
a
substance-related
disorder
34
has
been
sustained
by
clear
and
convincing
evidence,
and
the
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court
is
furnished
evidence
that
the
respondent
is
eligible
1
for
care
and
treatment
in
a
facility
operated
by
the
United
2
States
department
of
veterans
affairs
or
another
agency
of
3
the
United
States
government
and
that
the
facility
is
willing
4
to
receive
the
respondent,
the
court
may
so
order.
The
5
respondent,
when
so
placed
in
a
facility
operated
by
the
United
6
States
department
of
veterans
affairs
or
another
agency
of
7
the
United
States
government
within
or
outside
of
this
state,
8
shall
be
subject
to
the
rules
of
the
United
States
department
9
of
veterans
affairs
or
other
agency,
but
shall
not
lose
any
10
procedural
rights
afforded
the
respondent
by
this
chapter
.
11
The
chief
officer
of
the
facility
shall
have,
with
respect
to
12
the
respondent
so
placed,
the
same
powers
and
duties
as
the
13
chief
medical
officer
of
a
hospital
in
this
state
would
have
14
in
regard
to
submission
of
reports
to
the
court,
retention
15
of
custody,
transfer,
convalescent
leave,
or
discharge.
16
Jurisdiction
is
retained
in
the
court
to
maintain
surveillance
17
of
the
respondent’s
treatment
and
care,
and
at
any
time
to
18
inquire
into
the
respondent’s
condition
and
the
need
for
19
continued
care
and
custody.
20
Sec.
56.
Section
125.84,
subsections
2,
3,
and
4,
Code
2011,
21
are
amended
to
read
as
follows:
22
2.
That
the
respondent
is
a
chronic
substance
abuser
23
person
with
a
substance-related
disorder
who
is
in
need
of
24
full-time
custody,
care,
and
treatment
in
a
facility,
and
is
25
considered
likely
to
benefit
from
treatment.
If
the
report
so
26
states,
the
court
shall
enter
an
order
which
may
require
the
27
respondent’s
continued
placement
and
commitment
to
a
facility
28
for
appropriate
treatment.
29
3.
That
the
respondent
is
a
chronic
substance
abuser
person
30
with
a
substance-related
disorder
who
is
in
need
of
treatment,
31
but
does
not
require
full-time
placement
in
a
facility.
If
the
32
report
so
states,
the
report
shall
include
the
chief
medical
33
officer’s
recommendation
for
treatment
of
the
respondent
on
34
an
outpatient
or
other
appropriate
basis,
and
the
court
shall
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enter
an
order
which
may
direct
the
respondent
to
submit
to
the
1
recommended
treatment.
The
order
shall
provide
that
if
the
2
respondent
fails
or
refuses
to
submit
to
treatment,
as
directed
3
by
the
court’s
order,
the
court
may
order
that
the
respondent
4
be
taken
into
immediate
custody
as
provided
by
section
125.81
5
and,
following
notice
and
hearing
held
in
accordance
with
6
the
procedures
of
sections
125.77
and
125.82
,
may
order
the
7
respondent
treated
as
a
patient
requiring
full-time
custody,
8
care,
and
treatment
as
provided
in
subsection
2
,
and
may
order
9
the
respondent
involuntarily
committed
to
a
facility.
10
4.
That
the
respondent
is
a
chronic
substance
abuser
11
person
with
a
substance-related
disorder
who
is
in
need
of
12
treatment,
but
in
the
opinion
of
the
chief
medical
officer
is
13
not
responding
to
the
treatment
provided.
If
the
report
so
14
states,
the
report
shall
include
the
facility
administrator’s
15
recommendation
for
alternative
placement,
and
the
court
shall
16
enter
an
order
which
may
direct
the
respondent’s
transfer
17
to
the
recommended
placement
or
to
another
placement
after
18
consultation
with
respondent’s
attorney
and
the
facility
19
administrator
who
made
the
report
under
this
subsection
.
20
Sec.
57.
Section
125.91,
subsections
1,
2,
and
3,
Code
2011,
21
are
amended
to
read
as
follows:
22
1.
The
procedure
prescribed
by
this
section
shall
only
23
be
used
for
an
intoxicated
a
person
with
a
substance-related
24
disorder
due
to
intoxication
or
substance-induced
25
incapacitation
who
has
threatened,
attempted,
or
inflicted
26
physical
self-harm
or
harm
on
another,
and
is
likely
to
inflict
27
physical
self-harm
or
harm
on
another
unless
immediately
28
detained,
or
who
is
incapacitated
by
a
chemical
substance,
29
if
that
person
cannot
be
taken
into
immediate
custody
under
30
sections
125.75
and
125.81
because
immediate
access
to
the
31
court
is
not
possible.
32
2.
a.
A
peace
officer
who
has
reasonable
grounds
to
believe
33
that
the
circumstances
described
in
subsection
1
are
applicable
34
may,
without
a
warrant,
take
or
cause
that
person
to
be
taken
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to
the
nearest
available
facility
referred
to
in
section
1
125.81,
subsection
2
,
paragraph
“b”
or
“c”
.
Such
an
intoxicated
2
or
incapacitated
a
person
with
a
substance-related
disorder
due
3
to
intoxication
or
substance-induced
incapacitation
who
also
4
demonstrates
a
significant
degree
of
distress
or
dysfunction
5
may
also
be
delivered
to
a
facility
by
someone
other
than
a
6
peace
officer
upon
a
showing
of
reasonable
grounds.
Upon
7
delivery
of
the
person
to
a
facility
under
this
section
,
the
8
examining
physician
may
order
treatment
of
the
person,
but
only
9
to
the
extent
necessary
to
preserve
the
person’s
life
or
to
10
appropriately
control
the
person’s
behavior
if
the
behavior
is
11
likely
to
result
in
physical
injury
to
the
person
or
others
12
if
allowed
to
continue.
The
peace
officer
or
other
person
13
who
delivered
the
person
to
the
facility
shall
describe
the
14
circumstances
of
the
matter
to
the
examining
physician.
If
the
15
person
is
a
peace
officer,
the
peace
officer
may
do
so
either
16
in
person
or
by
written
report.
If
the
examining
physician
17
has
reasonable
grounds
to
believe
that
the
circumstances
in
18
subsection
1
are
applicable,
the
examining
physician
shall
19
at
once
communicate
with
the
nearest
available
magistrate
20
as
defined
in
section
801.4,
subsection
10
.
The
magistrate
21
shall,
based
upon
the
circumstances
described
by
the
examining
22
physician,
give
the
examining
physician
oral
instructions
23
either
directing
that
the
person
be
released
forthwith,
or
24
authorizing
the
person’s
detention
in
an
appropriate
facility.
25
The
magistrate
may
also
give
oral
instructions
and
order
that
26
the
detained
person
be
transported
to
an
appropriate
facility.
27
b.
If
the
magistrate
orders
that
the
person
be
detained,
28
the
magistrate
shall,
by
the
close
of
business
on
the
next
29
working
day,
file
a
written
order
with
the
clerk
in
the
county
30
where
it
is
anticipated
that
an
application
may
be
filed
31
under
section
125.75
.
The
order
may
be
filed
by
facsimile
if
32
necessary.
The
order
shall
state
the
circumstances
under
which
33
the
person
was
taken
into
custody
or
otherwise
brought
to
a
34
facility
and
the
grounds
supporting
the
finding
of
probable
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cause
to
believe
that
the
person
is
a
chronic
substance
abuser
1
person
with
a
substance-related
disorder
likely
to
result
in
2
physical
injury
to
the
person
or
others
if
not
detained.
The
3
order
shall
confirm
the
oral
order
authorizing
the
person’s
4
detention
including
any
order
given
to
transport
the
person
5
to
an
appropriate
facility.
The
clerk
shall
provide
a
copy
6
of
that
order
to
the
chief
medical
officer
of
the
facility
7
attending
physician,
to
which
the
person
was
originally
taken,
8
any
subsequent
facility
to
which
the
person
was
transported,
9
and
to
any
law
enforcement
department
or
ambulance
service
that
10
transported
the
person
pursuant
to
the
magistrate’s
order.
11
3.
The
chief
medical
officer
of
the
facility
attending
12
physician
shall
examine
and
may
detain
the
person
pursuant
to
13
the
magistrate’s
order
for
a
period
not
to
exceed
forty-eight
14
hours
from
the
time
the
order
is
dated,
excluding
Saturdays,
15
Sundays,
and
holidays,
unless
the
order
is
dismissed
by
a
16
magistrate.
The
facility
may
provide
treatment
which
is
17
necessary
to
preserve
the
person’s
life
or
to
appropriately
18
control
the
person’s
behavior
if
the
behavior
is
likely
to
19
result
in
physical
injury
to
the
person
or
others
if
allowed
20
to
continue
or
is
otherwise
deemed
medically
necessary
by
21
the
chief
medical
officer
attending
physician
,
but
shall
not
22
otherwise
provide
treatment
to
the
person
without
the
person’s
23
consent.
The
person
shall
be
discharged
from
the
facility
and
24
released
from
detention
no
later
than
the
expiration
of
the
25
forty-eight-hour
period,
unless
an
application
for
involuntary
26
commitment
is
filed
with
the
clerk
pursuant
to
section
125.75
.
27
The
detention
of
a
person
by
the
procedure
in
this
section
,
and
28
not
in
excess
of
the
period
of
time
prescribed
by
this
section
,
29
shall
not
render
the
peace
officer,
attending
physician,
or
30
facility
detaining
the
person
liable
in
a
criminal
or
civil
31
action
for
false
arrest
or
false
imprisonment
if
the
peace
32
officer,
physician,
or
facility
had
reasonable
grounds
to
33
believe
that
the
circumstances
described
in
subsection
1
were
34
applicable.
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Sec.
58.
NEW
SECTION
.
125.95
Advocates
——
duties
——
1
compensation
——
state
and
county
liability.
2
1.
a.
In
each
county
with
a
population
of
three
hundred
3
thousand
or
more
inhabitants,
the
board
of
supervisors
shall
4
appoint
an
individual
who
has
demonstrated
by
prior
activities
5
an
informed
concern
for
the
welfare
and
rehabilitation
of
6
persons
with
substance-related
disorders,
and
who
is
not
an
7
officer
or
employee
of
the
department
of
public
health
nor
8
of
any
agency
or
facility
providing
care
or
treatment
to
9
persons
with
substance-related
disorders,
to
act
as
an
advocate
10
representing
the
interests
of
persons
involuntarily
committed
11
by
the
court,
in
any
matter
relating
to
the
persons’
commitment
12
for
treatment
under
section
125.84
or
125.86.
In
each
county
13
with
a
population
of
under
three
hundred
thousand
inhabitants,
14
the
chief
judge
of
the
judicial
district
encompassing
the
15
county
shall
appoint
the
advocate.
16
b.
The
court
or,
if
the
advocate
is
appointed
by
the
county
17
board
of
supervisors,
the
board
shall
assign
the
advocate
18
appointed
from
the
person’s
county
of
legal
settlement
to
19
represent
the
interests
of
the
person.
If
a
person
has
no
20
county
of
legal
settlement,
the
court
or,
if
the
advocate
21
is
appointed
by
the
county
board
of
supervisors,
the
board
22
shall
assign
the
advocate
appointed
from
the
county
where
the
23
treatment
facility
is
located
to
represent
the
interests
of
the
24
person.
25
c.
The
advocate’s
responsibility
with
respect
to
any
26
person
shall
begin
at
whatever
time
the
attorney
employed
27
or
appointed
to
represent
that
person
as
respondent
in
28
commitment
proceedings,
conducted
under
sections
125.75
to
29
125.83,
reports
to
the
court
that
the
attorney’s
services
30
are
no
longer
required
and
requests
the
court’s
approval
to
31
withdraw
as
counsel
for
that
person.
However,
if
the
person
is
32
found
to
be
a
person
with
a
substance-related
disorder
at
the
33
commitment
hearing,
the
attorney
representing
the
person
shall
34
automatically
be
relieved
of
responsibility
in
the
case
and
an
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advocate
shall
be
assigned
to
the
person
at
the
conclusion
of
1
the
hearing
unless
the
attorney
indicates
an
intent
to
continue
2
the
attorney’s
services
and
the
court
so
directs.
If
the
3
court
directs
the
attorney
to
remain
on
the
case,
the
attorney
4
shall
assume
all
the
duties
of
an
advocate.
The
clerk
shall
5
furnish
the
advocate
with
a
copy
of
the
court’s
order
approving
6
the
withdrawal
and
shall
inform
the
person
of
the
name
of
the
7
person’s
advocate.
8
d.
With
regard
to
each
person
whose
interests
the
advocate
9
is
required
to
represent
pursuant
to
this
section,
the
10
advocate’s
duties
shall
include
all
of
the
following:
11
(1)
To
review
each
report
submitted
pursuant
to
sections
12
125.84
and
125.86.
13
(2)
If
the
advocate
is
not
an
attorney,
to
advise
the
court
14
at
any
time
it
appears
that
the
services
of
an
attorney
are
15
required
to
properly
safeguard
the
person’s
interests.
16
(3)
To
be
readily
accessible
to
communications
from
the
17
person
and
to
originate
communications
with
the
patient
within
18
five
days
of
the
person’s
commitment.
19
(4)
To
visit
the
person
within
fifteen
days
of
the
person’s
20
commitment
and
periodically
thereafter.
21
(5)
To
communicate
with
medical
personnel
treating
the
22
person
and
to
review
the
person’s
medical
records
pursuant
to
23
section
125.93.
24
(6)
To
file
with
the
court
quarterly
reports,
and
additional
25
reports
as
the
advocate
feels
necessary
or
as
required
by
the
26
court,
in
a
form
prescribed
by
the
court.
The
reports
shall
27
state
what
actions
the
advocate
has
taken
with
respect
to
each
28
person
and
the
amount
of
time
spent.
29
2.
The
treatment
facility
to
which
a
person
is
committed
30
shall
grant
all
reasonable
requests
of
the
advocate
to
visit
31
the
person,
to
communicate
with
medical
personnel
treating
the
32
person,
and
to
review
the
person’s
medical
records
pursuant
to
33
section
125.93.
An
advocate
shall
not
disseminate
information
34
from
a
person’s
medical
records
to
any
other
person
unless
done
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for
official
purposes
in
connection
with
the
advocate’s
duties
1
pursuant
to
this
chapter
or
when
required
by
law.
2
3.
The
court
or,
if
the
advocate
is
appointed
by
the
3
county
board
of
supervisors,
the
board
shall
prescribe
4
reasonable
compensation
for
the
services
of
the
advocate.
The
5
compensation
shall
be
based
upon
the
reports
filed
by
the
6
advocate
with
the
court.
The
advocate’s
compensation
shall
7
be
paid
by
the
county
in
which
the
court
is
located,
either
8
on
order
of
the
court
or,
if
the
advocate
is
appointed
by
the
9
county
board
of
supervisors,
on
the
direction
of
the
board.
10
If
the
advocate
is
appointed
by
the
court,
the
advocate
is
an
11
employee
of
the
state
for
purposes
of
chapter
669.
If
the
12
advocate
is
appointed
by
the
county
board
of
supervisors,
the
13
advocate
is
an
employee
of
the
county
for
purposes
of
chapter
14
670.
If
the
person
or
another
person
who
is
legally
liable
for
15
the
person’s
support
is
not
indigent,
the
board
shall
recover
16
the
costs
of
compensating
the
advocate
from
that
other
person.
17
If
that
other
person
has
an
income
level
as
determined
pursuant
18
to
section
815.9
greater
than
one
hundred
percent
but
not
more
19
than
one
hundred
fifty
percent
of
the
poverty
guidelines,
at
20
least
one
hundred
dollars
of
the
advocate’s
compensation
shall
21
be
recovered
in
the
manner
prescribed
by
the
county
board
of
22
supervisors.
If
that
other
person
has
an
income
level
as
23
determined
pursuant
to
section
815.9
greater
than
one
hundred
24
fifty
percent
of
the
poverty
guidelines,
at
least
two
hundred
25
dollars
of
the
advocate’s
compensation
shall
be
recovered
in
26
substantially
the
same
manner
prescribed
by
the
county
board
of
27
supervisors
as
provided
in
section
815.9.
28
Sec.
59.
Section
229.1,
subsection
14,
Code
2011,
is
amended
29
by
striking
the
subsection
and
inserting
in
lieu
thereof
the
30
following:
31
14.
“Mental
health
professional”
means
the
same
as
defined
32
in
section
228.1.
33
Sec.
60.
Section
229.1,
subsection
16,
Code
2011,
is
amended
34
to
read
as
follows:
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16.
“Serious
emotional
injury”
is
an
injury
which
does
not
1
necessarily
exhibit
any
physical
characteristics,
but
which
can
2
be
recognized
and
diagnosed
by
a
licensed
physician
or
other
3
qualified
mental
health
professional
and
which
can
be
causally
4
connected
with
the
act
or
omission
of
a
person
who
is,
or
is
5
alleged
to
be,
mentally
ill.
6
Sec.
61.
Section
229.10,
subsection
1,
paragraphs
b
and
c,
7
Code
2011,
are
amended
to
read
as
follows:
8
b.
Any
licensed
physician
conducting
an
examination
pursuant
9
to
this
section
may
consult
with
or
request
the
participation
10
in
the
examination
of
any
qualified
mental
health
professional,
11
and
may
include
with
or
attach
to
the
written
report
of
the
12
examination
any
findings
or
observations
by
any
qualified
13
mental
health
professional
who
has
been
so
consulted
or
has
so
14
participated
in
the
examination.
15
c.
If
the
respondent
is
not
taken
into
custody
under
16
section
229.11
,
but
the
court
is
subsequently
informed
that
17
the
respondent
has
declined
to
be
examined
by
the
licensed
18
physician
or
physicians
pursuant
to
the
court
order,
the
19
court
may
order
such
limited
detention
of
that
the
respondent
20
as
is
necessary
be
detained
for
a
period
of
not
more
than
21
twenty-three
hours
to
facilitate
the
examination
of
the
22
respondent
by
the
licensed
physician
or
physicians
or
other
23
mental
health
professionals
.
The
detention
period
begins
upon
24
the
respondent’s
admission.
Except
as
otherwise
provided,
the
25
court
may
also
order
that
payment
be
made
to
the
appropriate
26
provider
for
services
associated
with
the
detention
period
27
under
this
paragraph.
28
Sec.
62.
Section
229.12,
subsection
3,
paragraph
b,
Code
29
2011,
is
amended
to
read
as
follows:
30
b.
The
licensed
physician
or
qualified
mental
health
31
professional
who
examined
the
respondent
shall
be
present
at
32
the
hearing
unless
the
court
for
good
cause
finds
that
the
33
licensed
physician’s
or
qualified
mental
health
professional’s
34
presence
or
testimony
is
not
necessary.
The
applicant,
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respondent,
and
the
respondent’s
attorney
may
waive
the
1
presence
or
the
telephonic
appearance
of
the
licensed
physician
2
or
qualified
mental
health
professional
who
examined
the
3
respondent
and
agree
to
submit
as
evidence
the
written
4
report
of
the
licensed
physician
or
qualified
mental
health
5
professional.
The
respondent’s
attorney
shall
inform
the
6
court
if
the
respondent’s
attorney
reasonably
believes
that
7
the
respondent,
due
to
diminished
capacity,
cannot
make
an
8
adequately
considered
waiver
decision.
“Good
cause”
for
finding
9
that
the
testimony
of
the
licensed
physician
or
qualified
10
mental
health
professional
who
examined
the
respondent
is
not
11
necessary
may
include
but
is
not
limited
to
such
a
waiver.
12
If
the
court
determines
that
the
testimony
of
the
licensed
13
physician
or
qualified
mental
health
professional
is
necessary,
14
the
court
may
allow
the
licensed
physician
or
the
qualified
15
mental
health
professional
to
testify
by
telephone.
16
Sec.
63.
Section
229.15,
subsection
3,
paragraph
a,
Code
17
2011,
is
amended
to
read
as
follows:
18
a.
A
psychiatric
advanced
registered
nurse
practitioner
19
treating
a
patient
previously
hospitalized
under
this
chapter
20
may
complete
periodic
reports
pursuant
to
this
section
on
the
21
patient
if
the
patient
has
been
recommended
for
treatment
on
22
an
outpatient
or
other
appropriate
basis
pursuant
to
section
23
229.14,
subsection
1
,
paragraph
“c”
,
and
if
a
psychiatrist
24
licensed
pursuant
to
chapter
148
personally
evaluates
the
25
patient
on
at
least
an
annual
basis
.
26
Sec.
64.
Section
229.21,
subsection
2,
Code
2011,
is
amended
27
to
read
as
follows:
28
2.
When
an
application
for
involuntary
hospitalization
29
under
this
chapter
or
an
application
for
involuntary
commitment
30
or
treatment
of
chronic
substance
abusers
persons
with
31
substance-related
disorders
under
sections
125.75
to
125.94
is
32
filed
with
the
clerk
of
the
district
court
in
any
county
for
33
which
a
judicial
hospitalization
referee
has
been
appointed,
34
and
no
district
judge,
district
associate
judge,
or
magistrate
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who
is
admitted
to
the
practice
of
law
in
this
state
is
1
accessible,
the
clerk
shall
immediately
notify
the
referee
in
2
the
manner
required
by
section
229.7
or
section
125.77
.
The
3
referee
shall
discharge
all
of
the
duties
imposed
upon
the
4
court
by
sections
229.7
to
229.22
or
sections
125.75
to
125.94
5
in
the
proceeding
so
initiated.
Subject
to
the
provisions
6
of
subsection
4
,
orders
issued
by
a
referee,
in
discharge
of
7
duties
imposed
under
this
section
,
shall
have
the
same
force
8
and
effect
as
if
ordered
by
a
district
judge.
However,
any
9
commitment
to
a
facility
regulated
and
operated
under
chapter
10
135C
,
shall
be
in
accordance
with
section
135C.23
.
11
Sec.
65.
Section
229.21,
subsection
3,
paragraphs
a
and
b,
12
Code
2011,
are
amended
to
read
as
follows:
13
a.
Any
respondent
with
respect
to
whom
the
magistrate
or
14
judicial
hospitalization
referee
has
found
the
contention
that
15
the
respondent
is
seriously
mentally
impaired
or
a
chronic
16
substance
abuser
person
with
a
substance-related
disorder
17
sustained
by
clear
and
convincing
evidence
presented
at
a
18
hearing
held
under
section
229.12
or
section
125.82
,
may
appeal
19
from
the
magistrate’s
or
referee’s
finding
to
a
judge
of
the
20
district
court
by
giving
the
clerk
notice
in
writing,
within
21
ten
days
after
the
magistrate’s
or
referee’s
finding
is
made,
22
that
an
appeal
is
taken.
The
appeal
may
be
signed
by
the
23
respondent
or
by
the
respondent’s
next
friend,
guardian,
or
24
attorney.
25
b.
An
order
of
a
magistrate
or
judicial
hospitalization
26
referee
with
a
finding
that
the
respondent
is
seriously
27
mentally
impaired
or
a
chronic
substance
abuser
person
with
a
28
substance-related
disorder
shall
include
the
following
notice,
29
located
conspicuously
on
the
face
of
the
order:
30
NOTE:
The
respondent
may
appeal
from
this
order
to
a
judge
of
31
the
district
court
by
giving
written
notice
of
the
appeal
to
32
the
clerk
of
the
district
court
within
ten
days
after
the
date
33
of
this
order.
The
appeal
may
be
signed
by
the
respondent
or
34
by
the
respondent’s
next
friend,
guardian,
or
attorney.
For
a
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more
complete
description
of
the
respondent’s
appeal
rights,
1
consult
section
229.21
of
the
Code
of
Iowa
or
an
attorney.
2
Sec.
66.
Section
229.21,
subsection
4,
Code
2011,
is
amended
3
to
read
as
follows:
4
4.
If
the
appellant
is
in
custody
under
the
jurisdiction
5
of
the
district
court
at
the
time
of
service
of
the
notice
of
6
appeal,
the
appellant
shall
be
discharged
from
custody
unless
7
an
order
that
the
appellant
be
taken
into
immediate
custody
has
8
previously
been
issued
under
section
229.11
or
section
125.81
,
9
in
which
case
the
appellant
shall
be
detained
as
provided
in
10
that
section
until
the
hospitalization
or
commitment
hearing
11
before
the
district
judge.
If
the
appellant
is
in
the
custody
12
of
a
hospital
or
facility
at
the
time
of
service
of
the
notice
13
of
appeal,
the
appellant
shall
be
discharged
from
custody
14
pending
disposition
of
the
appeal
unless
the
chief
medical
15
officer,
not
later
than
the
end
of
the
next
secular
day
on
16
which
the
office
of
the
clerk
is
open
and
which
follows
service
17
of
the
notice
of
appeal,
files
with
the
clerk
a
certification
18
that
in
the
chief
medical
officer’s
opinion
the
appellant
19
is
seriously
mentally
ill
or
a
substance
abuser
person
with
20
a
substance-related
disorder
.
In
that
case,
the
appellant
21
shall
remain
in
custody
of
the
hospital
or
facility
until
the
22
hospitalization
or
commitment
hearing
before
the
district
23
court.
24
Sec.
67.
Section
230.15,
unnumbered
paragraph
2,
Code
2011,
25
is
amended
to
read
as
follows:
26
A
substance
abuser
or
chronic
substance
abuser
person
27
with
a
substance-related
disorder
is
legally
liable
for
the
28
total
amount
of
the
cost
of
providing
care,
maintenance,
and
29
treatment
for
the
substance
abuser
or
chronic
substance
abuser
30
person
with
a
substance-related
disorder
while
a
voluntary
or
31
committed
patient.
When
a
portion
of
the
cost
is
paid
by
a
32
county,
the
substance
abuser
or
chronic
substance
abuser
person
33
with
a
substance-related
disorder
is
legally
liable
to
the
34
county
for
the
amount
paid.
The
substance
abuser
or
chronic
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substance
abuser
person
with
a
substance-related
disorder
1
shall
assign
any
claim
for
reimbursement
under
any
contract
2
of
indemnity,
by
insurance
or
otherwise,
providing
for
the
3
abuser’s
person’s
care,
maintenance,
and
treatment
in
a
state
4
hospital
to
the
state.
Any
payments
received
by
the
state
from
5
or
on
behalf
of
a
substance
abuser
or
chronic
substance
abuser
6
person
with
a
substance-related
disorder
shall
be
in
part
7
credited
to
the
county
in
proportion
to
the
share
of
the
costs
8
paid
by
the
county.
Nothing
in
this
section
shall
be
construed
9
to
prevent
a
relative
or
other
person
from
voluntarily
paying
10
the
full
actual
cost
or
any
portion
of
the
care
and
treatment
11
of
any
person
with
mental
illness
,
substance
abuser,
or
chronic
12
substance
abuser
or
a
substance-related
disorder
as
established
13
by
the
department
of
human
services.
14
Sec.
68.
Section
232.116,
subsection
1,
paragraph
l,
15
subparagraph
(2),
Code
2011,
is
amended
to
read
as
follows:
16
(2)
The
parent
has
a
severe
,
chronic
substance
abuse
17
problem,
substance-related
disorder
and
presents
a
danger
to
18
self
or
others
as
evidenced
by
prior
acts.
19
Sec.
69.
Section
600A.8,
subsection
8,
paragraph
a,
Code
20
2011,
is
amended
to
read
as
follows:
21
a.
The
parent
has
been
determined
to
be
a
chronic
substance
22
abuser
person
with
a
substance-related
disorder
as
defined
23
in
section
125.2
and
the
parent
has
committed
a
second
or
24
subsequent
domestic
abuse
assault
pursuant
to
section
708.2A
.
25
Sec.
70.
Section
602.4201,
subsection
3,
paragraph
h,
Code
26
2011,
is
amended
to
read
as
follows:
27
h.
Involuntary
commitment
or
treatment
of
substance
abusers
28
persons
with
a
substance-related
disorders
.
29
Sec.
71.
CONFORMING
PROVISIONS.
The
legislative
services
30
agency
shall
prepare
a
study
bill
for
consideration
by
the
31
committee
on
human
resources
of
the
senate
and
the
house
of
32
representatives
for
the
2012
legislative
session,
providing
any
33
addition
necessary
conforming
Code
changes
for
implementation
34
of
the
provisions
of
this
division
of
this
Act.
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Sec.
72.
EFFECTIVE
DATE.
This
division
of
this
Act
takes
1
effect
July
1,
2012.
2
EXPLANATION
3
This
bill
relates
to
mental
health
and
disability
services
4
and
substance-related
disorders
and
mental
illness
commitment
5
proceedings
and
makes
appropriations.
The
bill
is
organized
6
into
divisions.
7
SERVICES
SYSTEM
REDESIGN
——
FUNDING.
This
division
states
8
legislative
intent
to
redesign
the
services
system
for
mental
9
health,
intellectual
and
other
developmental
disabilities,
and
10
brain
injury
over
the
next
several
years.
11
2011
Iowa
Acts,
Senate
File
209,
provides
for
the
repeal
of
12
the
statutory
authority
for
significant
elements
of
the
county
13
administered
adult
mental
health
and
intellectual
and
other
14
developmental
disability
services
effective
July
1,
2013.
15
The
division
states
legislative
intent
to
implement
the
16
redesign
by
having
the
department
of
human
services
assume
17
responsibility
for
administering
publicly
funded
mental
health
18
services
for
adults
and
children
beginning
on
July
1,
2012.
19
The
legislative
council
is
requested
to
authorize
a
20
legislative
interim
committee
during
the
2011
legislative
21
interim
to
develop
a
plan
for
the
mental
health
services
22
redesign
for
consideration
by
the
general
assembly
in
the
2012
23
legislative
session.
The
plan
is
required
to
identify
clear
24
definitions
and
requirements
for
core
services,
outcomes
that
25
focus
on
consumer
needs,
and
various
other
elements
of
the
26
system.
27
The
departments
of
human
services
and
public
health
are
28
required
to
develop
and
submit
proposals
relating
to
services
29
addressing
co-occurring
mental
health
and
substance
abuse
30
disorders
and
to
address
service
provider
shortages,
including
31
barriers
to
recruiting
providers.
The
departments
are
required
32
to
submit
the
proposals
to
the
governor
and
general
assembly
33
on
or
before
December
15,
2011.
34
The
legislative
council
is
also
requested
to
either
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continue
the
2011
legislative
interim
committee
or
authorize
1
a
different
legislative
interim
committee
to
meet
during
2
the
2012
legislative
interim
to
develop
a
redesign
plan
for
3
the
department
of
human
services
to
assume
responsibility
4
for
administration
of
intellectual
and
other
developmental
5
disabilities
and
brain
injury
services.
The
plan
is
to
include
6
elements
similar
to
the
plan
for
mental
health
services
and
is
7
to
be
submitted
for
consideration
and
enactment
in
the
2013
8
legislative
session.
9
A
directive
is
provided
for
continuation
of
the
judicial
10
branch
and
department
of
human
services
workgroup
which
met
11
during
the
2010
legislative
interim
to
improve
the
processes
12
for
involuntary
commitment
for
substance
abuse
under
Code
13
chapter
125
and
serious
mental
illness
under
Code
chapter
229.
14
Additional
recommendation
requirements
are
added
along
with
a
15
requirement
to
report
by
December
15,
2011.
16
The
departments
of
human
services
and
public
health,
and
17
the
community
services
affiliate
of
the
Iowa
state
association
18
of
counties
are
required
to
agree
on
implementation
of
an
19
integrated
data
and
statistical
information
system
for
mental
20
health,
disability,
and
substance
abuse
services
and
report
to
21
the
governor
and
representatives
of
the
legislative
branch
by
22
December
15,
2011.
23
New
Code
section
225C.7A,
creates
a
new
disability
services
24
system
redesign
savings
fund
to
which
savings
resulting
from
25
implementation
of
services
system
efficiencies
are
to
be
26
credited.
Moneys
in
the
fund
are
required
to
be
appropriated
27
to
implement
services
system
improvements.
28
APPROPRIATIONS
AND
CONFORMING
PROVISIONS.
This
division
29
addresses
conforming
statutory
provisions
and
provides
30
appropriations.
31
The
legislative
services
agency
is
required
to
prepare
a
32
study
bill
for
the
committees
on
human
resources
of
the
senate
33
and
house
of
representatives
for
the
2012
legislative
session
34
providing
any
conforming
Code
changes
for
implementation
of
the
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sytem
redesign
provisions
contained
in
the
bill.
1
In
2011
Iowa
Acts,
Senate
File
209,
an
appropriation
was
made
2
from
the
general
fund
of
the
state
for
fiscal
year
2010-2011
3
to
the
property
tax
relief
to
be
distributed
in
accordance
4
with
a
later
enactment.
The
bill
provides
for
the
Senate
File
5
209
appropriation
to
be
credited
to
the
risk
pool
within
the
6
property
tax
relief
fund.
The
risk
pool
board
is
required
7
to
implement
a
distribution
process
that
will
ensure
there
8
is
sufficient
funding
to
eliminate
the
need
for
continuing,
9
instituting,
or
reinstituting
waiting
lists
for
services
10
covered
under
county
service
management
plans
through
June
30,
11
2012.
12
An
appropriation
is
provided
to
the
department
of
human
13
services
for
costs
associated
with
implementation
of
the
14
division.
15
The
division
takes
effect
upon
enactment.
16
PSYCHIATRIC
MEDICAL
INSTITUTIONS
FOR
CHILDREN.
This
17
division
relates
to
psychiatric
medical
institutions
for
18
children
(PMICs).
19
Code
section
135H.3,
relating
to
the
nature
of
care
20
provided,
is
amended
to
provide
that
the
membership
of
the
team
21
of
professionals
utilized
by
a
PMIC
may
include
an
advanced
22
registered
nurse
practitioner.
23
Code
section
135H.6,
relating
to
conditions
for
issuance
of
24
a
PMIC
license,
is
amended
to
provide
that
the
requirement
for
25
a
certificate
of
need
and
the
limitation
on
the
number
of
beds
26
statewide
for
PMICs
does
not
apply
to
beds
for
children
who
do
27
not
reside
in
this
state
and
whose
service
costs
are
not
paid
28
by
public
funds
in
this
state.
29
Code
section
249A.31,
relating
to
cost-based
reimbursement
30
under
the
medical
assistance
(Medicaid)
program,
is
amended
to
31
provide
that
effective
July
1,
2012,
Medicaid
reimbursement
for
32
PMIC
providers
will
be
provided
in
accordance
with
the
managed
33
care
contract
for
authorizing
PMIC
services.
34
The
department
of
human
services
is
required
to
issue
a
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request
for
proposals
to
procure
a
contractor
to
authorize,
1
reimburse,
and
mange
PMIC
benefits
under
the
Medicaid
program.
2
The
department
is
prohibited
from
procuring
the
contract
3
through
a
sole
source
or
other
limited
selection
process.
4
The
department
of
human
services
is
required
to
work
with
the
5
department
of
inspections
and
appeals
to
develop
a
second
level
6
of
PMIC
care
for
children
in
need
of
more
intensive
treatment.
7
Limitations
on
numbers
of
level
2
beds
and
providers
are
8
applicable.
9
MEDICATION
THERAPY
MANAGEMENT.
This
division
relates
to
10
implementation
of
medication
therapy
management
provisions
11
under
the
Medicaid
program
in
new
Code
section
249A.20B.
The
12
department
of
human
services
is
required
to
implement
the
13
provisions
through
a
request
for
proposals
process
to
select
a
14
contractor
beginning
July
1,
2012.
15
Criteria
for
participation
by
individuals
who
take
a
number
16
of
prescription
drugs,
fees
and
reimbursement
provisions,
and
17
definitions
are
included.
18
The
division
takes
effect
upon
enactment.
19
COMMUNITY
MENTAL
HEALTH
CENTERS.
This
division
relates
to
20
the
requirements
of
community
mental
health
centers
under
Code
21
chapter
230A
and
repeals
and
replaces
Code
chapter
230A
which
22
was
originally
enacted
by
1974
Iowa
Acts,
chapter
1160.
23
The
division
maintains
the
requirements
under
current
law
24
for
accreditation
of
community
mental
health
centers
to
be
25
performed
by
the
department
of
human
services
(DHS),
division
26
of
mental
health
and
disability
services,
in
accordance
27
with
standards
adopted
by
the
mental
health
and
disability
28
services
commission.
2008
Iowa
Acts,
chapter
1187,
required
29
the
division
to
utilize
an
advisory
group
to
develop
a
30
proposal
for
revising
Code
chapter
230A
and
for
revising
the
31
accreditation
process
for
centers.
Until
the
proposal
has
been
32
considered
and
acted
upon
by
the
general
assembly,
the
division
33
administrator
is
authorized
to
defer
consideration
of
requests
34
for
accreditation
of
a
new
community
mental
health
center
or
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for
approval
of
a
provider
to
fill
the
role
of
a
center.
The
1
proposal
was
submitted
to
the
governor
and
general
assembly
2
April
17,
2009.
The
division
provides
for
implementation
of
3
the
proposal.
4
The
current
Code
chapter
provides
for
community
mental
5
health
centers
to
either
be
directly
established
by
a
county
6
or
counties
and
administered
by
a
board
of
trustees
or
by
7
establishment
of
a
nonprofit
corporation
operating
on
the
basis
8
of
an
agreement
with
a
county
or
counties.
Code
section
225C.7
9
allows
the
department
of
human
services
to
authorize
the
center
10
services
to
be
provided
by
an
alternative
provider.
11
The
division
of
the
bill
replaces
this
approach
by
requiring
12
the
mental
health
and
disability
services
division
and
13
commission
to
identify
catchment
areas
of
counties
to
be
served
14
by
a
center.
The
general
requirement
is
for
one
center
to
be
15
designated
to
serve
a
catchment
area
but
more
than
one
can
16
be
designated
if
exceptional
circumstances
outlined
in
the
17
division
are
determined
to
exist.
18
New
Code
section
230A.101
describes
the
regulatory
and
19
policy
role
to
be
filled
by
the
department
and
the
service
20
provider
role
of
the
community
mental
health
centers.
21
New
Code
section
230A.102
provides
definitions.
These
22
terms,
defined
in
Code
chapter
225C,
are
adopted
by
reference:
23
“administrator”
(administrator
of
MH
and
disability
services
24
division),
“commission”
(mental
health
and
disability
services
25
commission),
“department”
(DHS),
“disability
services”
26
(services
and
other
support
available
to
a
person
with
mental
27
illness,
MR
or
other
developmental
disability
or
brain
injury),
28
and
“division”
(MH
and
disability
services
division).
In
29
addition,
the
terms
“community
mental
health
center”
and
30
“catchment
area”
are
defined
to
reflect
the
contents
of
the
31
division.
32
New
Code
section
230A.103
provides
criteria
to
be
33
implemented
by
the
division
for
designation
of
at
least
one
34
community
mental
health
center
to
serve
a
catchment
area
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consisting
of
a
county
or
counties.
Various
operating
and
1
services
requirements
are
to
be
addressed
in
the
terms
of
an
2
agreement
between
the
designated
center,
the
division,
and
the
3
counties
comprising
the
catchment
area.
4
New
Code
section
230A.104
provides
for
the
division
to
5
implement
objective
criteria
for
identifying
catchment
areas
6
for
centers.
A
general
limitation
of
one
center
per
catchment
7
area
is
stated,
however,
the
criteria
are
to
include
a
formal
8
review
process
for
use
in
determining
whether
exceptional
9
circumstances
exist
for
designating
more
than
one
center
10
for
a
catchment
area.
The
other
stated
criteria
involve
11
determinations
of
financial
viability
for
a
center
to
operate.
12
New
Code
section
230A.105
lists
the
characteristics
of
the
13
target
population
required
to
be
served
by
a
center.
The
14
list
includes
individuals
of
any
age
experiencing
a
mental
15
health
crisis
or
disorder,
adults
who
have
a
serious
or
chronic
16
mental
illness,
children
and
youth
experiencing
a
serious
17
emotional
disturbance,
and
listed
individuals
who
also
have
a
18
co-occurring
disorder.
The
specific
clinical
and
financial
19
eligibility
criteria
are
required
to
be
identified
in
rules
20
adopted
by
the
commission.
21
New
Code
section
230A.106
requires
each
designated
center
22
to
offer
core
services
and
support
addressing
the
basic
mental
23
health
and
safety
needs
of
the
target
population
and
other
24
residents
of
the
catchment
area.
The
core
services
are
to
be
25
identified
in
rules
adopted
by
the
commission.
26
An
initial
list
of
core
services
is
specified
to
include
the
27
following:
outpatient
services;
24-hour
emergency
services;
28
day
treatment,
partial
hospitalization,
or
psychological
29
rehabilitation
services;
admission
screening
for
voluntary
30
patients;
community
support
services;
consultation
services;
31
and
education
services.
32
In
addition,
a
center
is
responsible
for
coordinating
33
associated
services
provided
by
other
unaffiliated
agencies
to
34
members
of
the
target
population
and
for
integrating
services
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provided
to
the
target
population
in
residential
or
inpatient
1
settings.
2
New
Code
section
230A.107
requires
a
designated
center
to
be
3
organized
as
a
nonprofit
corporation.
However,
a
for-profit
4
corporation,
nonprofit
corporation,
or
county
hospital
5
providing
services
under
a
waiver
approved
as
of
October
1,
6
2010,
may
also
be
designated.
7
New
Code
section
230A.108
requires
release
of
8
administrative,
diagnostic,
and
demographic
information
as
a
9
condition
of
support
by
any
of
the
counties
in
the
catchment
10
area
served
by
a
center.
Language
with
a
similar
requirement
11
is
part
of
current
law
in
Code
section
230A.13,
relating
to
12
annual
budgets
of
centers.
13
New
Code
section
230A.109
states
legislative
intent
14
regarding
provision
of
federal
and
state
funding
supporting
15
centers
and
for
the
amount
of
funding
to
be
sufficient
for
16
core
services
to
be
provided
regardless
of
an
individual’s
17
ability
to
pay
for
the
services.
This
section
also
states
that
18
provision
of
services
is
subject
to
the
availability
of
payment
19
sources
for
the
services.
20
New
Code
section
230A.110
provides
for
accreditation
21
standards
for
centers
to
be
recommended
by
the
division
22
and
adopted
by
the
commission.
The
standards
are
to
be
in
23
substantial
conformity
with
certain
national
standards.
The
24
division
is
directed
to
use
an
advisory
committee
to
assist
in
25
standards
development.
In
addition,
the
standards
recommended
26
are
required
to
include
various
organizational
requirements.
27
New
Code
section
230A.111
addresses
how
the
review
and
28
evaluation
components
of
the
accreditation
process
are
to
be
29
performed.
30
An
implementation
section
authorizes
centers
operating
31
under
current
law
as
of
June
30,
2012,
to
continue
operating
32
until
the
rules
are
adopted,
catchment
areas
are
identified,
33
and
centers
are
designated,
as
required
by
the
division
of
the
34
bill.
The
division
and
commission
are
required
to
complete
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those
requirements
on
or
before
June
30,
2012.
1
Except
for
the
requirement
for
the
division
and
commission
2
to
develop
administrative
rules,
which
takes
effect
July
1,
3
2011,
the
division
takes
effect
July
1,
2012.
4
PERSONS
WITH
SUBSTANCE-RELATED
DISORDERS
AND
PERSONS
5
WITH
MENTAL
ILLNESS.
This
division
makes
various
changes
6
to
Code
chapters
125
(chemical
substance
abuse)
and
229
7
(hospitalization
of
persons
with
mental
illness).
8
Code
chapter
125:
The
division
replaces
the
terms
“chemical
9
dependency”,
“chronic
substance
abuser”,
and
“substance
abuser”
10
in
Code
chapter
125
with
the
terms
“substance-related
disorder”
11
or
“person
with
a
substance-related
disorder”,
and
makes
12
conforming
Code
changes.
A
“substance-related
disorder”
is
13
defined
as
a
diagnosable
substance
abuse
disorder
of
sufficient
14
duration
to
meet
diagnostic
criteria
specified
within
the
15
most
current
diagnostic
and
statistical
manual
of
mental
16
disorders
published
by
the
American
psychiatric
association
17
that
results
in
a
functional
impairment.
The
division
also
18
replaces
the
term
“intoxicated
person”
with
the
term
“a
19
person
with
a
substance-related
disorder
due
to
intoxication
20
or
substance-induced
intoxication”
and
makes
conforming
Code
21
changes.
22
The
division
provides
that
a
peace
officer
who
23
has
reasonable
grounds
to
believe
that
a
person
with
24
a
substance-related
disorder
due
to
intoxication
or
25
substance-induced
incapacitation
who
has
threatened
or
26
inflicted
physical
self-harm
or
harm
on
another
person
in
an
27
emergency
situation
who
also
demonstrates
a
significant
degree
28
or
distress
or
dysfunction
may
be
delivered
to
a
facility
by
29
someone
other
than
a
peace
officer
upon
a
showing
of
reasonable
30
grounds.
31
New
Code
section
125.95
provides
for
the
appointment
32
of
an
advocate
to
represent
the
interests
of
persons
with
33
substance-related
disorders
in
any
matter
relating
to
the
34
person’s
commitment
for
treatment,
either
by
the
county
board
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of
supervisors
or
the
chief
judge
of
the
appropriate
judicial
1
district.
The
advocate’s
duties
include
reviewing
reports,
2
visiting
the
person
who
has
been
committed,
communicating
with
3
medical
personnel
treating
the
person,
and
filing
reports
with
4
the
court.
The
advocate
shall
receive
reasonable
compensation
5
for
the
advocate’s
services.
6
Code
chapter
229:
The
division
replaces
the
term
“qualified
7
mental
health
professional”
with
the
term
“mental
health
8
professional”,
defined
as
an
individual
who
holds
at
least
a
9
master’s
degree
in
a
mental
health
field,
including
but
not
10
limited
to
psychology,
counseling
and
guidance,
nursing,
and
11
social
work,
or
the
individual
is
a
physician
and
surgeon
or
an
12
osteopathic
physician
and
surgeon,
holds
a
current
Iowa
license
13
if
practicing
in
a
field
covered
by
an
Iowa
licensure
law,
and
14
has
at
least
two
years
of
post-degree
clinical
experience,
15
supervised
by
another
mental
health
professional,
in
assessing
16
mental
health
needs
and
problems
and
in
providing
appropriate
17
mental
health
services.
This
definition
is
the
same
18
definition
for
a
mental
health
professional
contained
in
Code
19
section
228.1
(disclosure
of
mental
health
and
psychological
20
information).
21
The
division
provides
in
Code
section
229.10,
relating
to
22
physician’s
examination
and
report,
that
a
person
who
is
the
23
subject
of
an
application
for
involuntary
hospitalization
who
24
has
declined
to
be
examined
pursuant
to
court
order
may
be
25
ordered
by
the
court
to
be
detained
for
not
more
than
a
23-hour
26
period
to
facilitate
the
examination.
The
court
may
also
order
27
that
payment
be
made
to
the
appropriate
provider
for
services
28
associated
with
the
detention.
29
Code
section
229.15,
relating
to
periodic
reports
required
30
by
care
providers,
is
amended
to
eliminate
a
requirement
for
31
patients
receiving
outpatient
treatment
from
an
advanced
32
registered
nurse
practitioner
to
have
an
annual
personal
33
evaluation
from
a
psychiatrist.
34
The
division
takes
effect
July
1,
2012.
35
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