S.F. _____ H.F. _____ Section 1. Section 4.1, Code 2011, is amended by adding the 1 following new subsection: 2 NEW SUBSECTION . 12A. “Intellectual disability” means 3 a disability of children and adults who as a result of 4 inadequately developed intelligence have a significant 5 impairment in ability to learn or to adapt to the demands 6 of society, and, if a diagnosis is required, “intellectual 7 disability” means a diagnosis of mental retardation as defined 8 in the diagnostic and statistical manual of mental disorders, 9 fourth edition, text revised, published by the American 10 psychiatric association. 11 Sec. 2. Section 4.1, subsection 21A, Code 2011, is amended 12 to read as follows: 13 21A. Persons with mental illness. The words “persons 14 with mental illness” include persons with psychosis, persons 15 who are severely depressed, and persons with any type of 16 mental disease or mental disorder, except that mental illness 17 does not refer to mental retardation as defined in section 18 222.2 intellectual disability , or to insanity, diminished 19 responsibility, or mental incompetency as defined and used in 20 the Iowa criminal code or in the rules of criminal procedure, 21 Iowa court rules. A person who is hospitalized or detained for 22 treatment of mental illness shall not be deemed or presumed to 23 be incompetent in the absence of a finding of incompetence made 24 pursuant to section 229.27 . 25 Sec. 3. Section 8A.311, subsection 16, Code Supplement 26 2011, is amended to read as follows: 27 16. A state agency shall make every effort to purchase 28 those products produced for sale by sheltered workshops, work 29 activity centers, and other special programs funded in whole 30 or in part by public moneys that employ persons with mental 31 retardation an intellectual disability or other developmental 32 disabilities or mental illness if the products meet the 33 required specifications. 34 Sec. 4. Section 23A.2, subsection 10, paragraph l, 35 -1- LSB 5146IC (7) 84 ad/rj 1/ 67

S.F. _____ H.F. _____ subparagraph (4), Code 2011, is amended to read as follows: 1 (4) Nothing in this paragraph shall be construed to 2 prohibit a state resource center from providing a service a 3 resident needs for compliance with accreditation standards 4 for intermediate care facilities for persons with mental 5 retardation intellectual disability . 6 Sec. 5. Section 48A.2, subsection 3, Code 2011, is amended 7 to read as follows: 8 3. “Person who is incompetent to vote” means a person 9 described in section 222.2, subsection 5 , with an intellectual 10 disability who has been found to lack the mental capacity 11 to vote in a proceeding held pursuant to section 222.31 or 12 633.556 . 13 Sec. 6. Section 126.16, subsection 2, Code 2011, is amended 14 to read as follows: 15 2. For the purpose of this chapter , advertising is false if 16 it represents a drug, device, or cosmetic to have any effect 17 in the diagnosis, prevention, or treatment of arthritis, 18 blood disorders, bone or joint diseases, kidney diseases or 19 disorders, cancer, diabetes, gall bladder disease or disorders, 20 heart and vascular disease, high blood pressure, diseases or 21 disorders of the ear, mental disease or mental retardation 22 intellectual disability , degenerative neurological diseases, 23 paralysis, prostate gland disorders, conditions of the scalp 24 affecting hair loss, baldness, endocrine disorders, sexual 25 impotence, tumors, venereal diseases, varicose ulcers, 26 breast enlargement, purifying blood, metabolic disorders, 27 immune system disorders or conditions affecting the immune 28 system, extension of life expectancy, stress and tension, 29 brain stimulation or performance, the body’s natural defense 30 mechanisms, blood flow, and depression. However, advertising 31 not in violation of subsection 1 is not false under this 32 subsection if it is disseminated only to members of the 33 medical, dental, or veterinary professions, or appears only 34 in the scientific periodicals of these professions, or is 35 -2- LSB 5146IC (7) 84 ad/rj 2/ 67

S.F. _____ H.F. _____ disseminated only for the purpose of public health education by 1 persons not commercially interested, directly or indirectly, 2 in the sale of such drugs or devices. However, if the board 3 determines that an advance in medical science has made any 4 type of self-medication safe as to any of the diseases named 5 in this subsection , the board shall by rule authorize the 6 advertising of drugs having curative or therapeutic effect for 7 such disease, subject to the conditions and restrictions the 8 board deems necessary in the interests of the public health. 9 However, this subsection does not indicate that self-medication 10 for diseases other than those named in this subsection is safe 11 and efficacious. 12 Sec. 7. Section 135.63, subsection 1, Code 2011, is amended 13 to read as follows: 14 1. A new institutional health service or changed 15 institutional health service shall not be offered or developed 16 in this state without prior application to the department 17 for and receipt of a certificate of need, pursuant to this 18 division . The application shall be made upon forms furnished 19 or prescribed by the department and shall contain such 20 information as the department may require under this division . 21 The application shall be accompanied by a fee equivalent 22 to three-tenths of one percent of the anticipated cost of 23 the project with a minimum fee of six hundred dollars and a 24 maximum fee of twenty-one thousand dollars. The fee shall be 25 remitted by the department to the treasurer of state, who shall 26 place it in the general fund of the state. If an application 27 is voluntarily withdrawn within thirty calendar days after 28 submission, seventy-five percent of the application fee shall 29 be refunded; if the application is voluntarily withdrawn more 30 than thirty but within sixty days after submission, fifty 31 percent of the application fee shall be refunded; if the 32 application is withdrawn voluntarily more than sixty days 33 after submission, twenty-five percent of the application fee 34 shall be refunded. Notwithstanding the required payment of 35 -3- LSB 5146IC (7) 84 ad/rj 3/ 67

S.F. _____ H.F. _____ an application fee under this subsection , an applicant for a 1 new institutional health service or a changed institutional 2 health service offered or developed by an intermediate care 3 facility for persons with mental retardation an intellectual 4 disability or an intermediate care facility for persons with 5 mental illness as defined pursuant to section 135C.1 is exempt 6 from payment of the application fee. 7 Sec. 8. Section 135.63, subsection 2, paragraphs f and p, 8 Code 2011, are amended to read as follows: 9 f. A residential care facility, as defined in section 10 135C.1 , including a residential care facility for persons with 11 mental retardation an intellectual disability , notwithstanding 12 any provision in this division to the contrary. 13 p. The conversion of an existing number of beds by an 14 intermediate care facility for persons with mental retardation 15 an intellectual disability to a smaller facility environment, 16 including but not limited to a community-based environment 17 which does not result in an increased number of beds, 18 notwithstanding any provision in this division to the contrary, 19 including subsection 4 , if all of the following conditions 20 exist: 21 (1) The intermediate care facility for persons with mental 22 retardation an intellectual disability reports the number 23 and type of beds to be converted on a form prescribed by the 24 department at least thirty days before the conversion. 25 (2) The intermediate care facility for persons with mental 26 retardation an intellectual disability reports the conversion 27 of beds on its next annual report to the department. 28 Sec. 9. Section 135.63, subsection 4, unnumbered paragraph 29 1, Code 2011, is amended to read as follows: 30 A copy of the application shall be sent to the department 31 of human services at the time the application is submitted 32 to the Iowa department of public health. The department 33 shall not process applications for and the council shall not 34 consider a new or changed institutional health service for an 35 -4- LSB 5146IC (7) 84 ad/rj 4/ 67

S.F. _____ H.F. _____ intermediate care facility for persons with mental retardation 1 an intellectual disability unless both of the following 2 conditions are met: 3 Sec. 10. Section 135.63, subsection 4, paragraph a, Code 4 2011, is amended to read as follows: 5 a. The new or changed beds shall not result in an 6 increase in the total number of medical assistance certified 7 intermediate care facility beds for persons with mental 8 retardation an intellectual disability in the state, exclusive 9 of those beds at the state resource centers or other state 10 institutions, beyond one thousand six hundred thirty-six beds. 11 Sec. 11. Section 135C.1, subsections 6, 9, and 13, Code 12 2011, are amended to read as follows: 13 6. “Health care facility” or “facility” means a residential 14 care facility, a nursing facility, an intermediate care 15 facility for persons with mental illness, or an intermediate 16 care facility for persons with mental retardation an 17 intellectual disability . 18 9. “Intermediate care facility for persons with mental 19 retardation an intellectual disability ” means an institution 20 or distinct part of an institution with a primary purpose 21 to provide health or rehabilitative services to three or 22 more individuals, who primarily have mental retardation an 23 intellectual disability or a related condition and who are 24 not related to the administrator or owner within the third 25 degree of consanguinity, and which meets the requirements 26 of this chapter and federal standards for intermediate care 27 facilities for persons with mental retardation an intellectual 28 disability established pursuant to the federal Social Security 29 Act, § 1905(c)(d), as codified in 42 U.S.C. § 1936d, which are 30 contained in 42 C.F.R. pt. 483, subpt. D, § 410 – 480. 31 13. “Nursing facility” means an institution or a distinct 32 part of an institution housing three or more individuals not 33 related to the administrator or owner within the third degree 34 of consanguinity, which is primarily engaged in providing 35 -5- LSB 5146IC (7) 84 ad/rj 5/ 67

S.F. _____ H.F. _____ health-related care and services, including rehabilitative 1 services, but which is not engaged primarily in providing 2 treatment or care for mental illness or mental retardation an 3 intellectual disability , for a period exceeding twenty-four 4 consecutive hours for individuals who, because of a mental or 5 physical condition, require nursing care and other services in 6 addition to room and board. 7 Sec. 12. Section 135C.2, subsection 3, paragraphs b, c, and 8 d, Code 2011, are amended to read as follows: 9 b. The department may also establish by administrative 10 rule special classifications within the residential care 11 facility, intermediate care facility for persons with mental 12 illness, intermediate care facility for persons with mental 13 retardation an intellectual disability , or nursing facility 14 categories, for facilities intended to serve individuals who 15 have special health care problems or conditions in common. 16 Rules establishing a special classification shall define the 17 problem or condition to which the special classification is 18 relevant and establish requirements for an approved program of 19 care commensurate with the problem or condition. The rules 20 may grant special variances or considerations to facilities 21 licensed within the special classification. 22 c. The rules adopted for intermediate care facilities for 23 persons with mental retardation an intellectual disability 24 shall be consistent with, but no more restrictive than, the 25 federal standards for intermediate care facilities for persons 26 with mental retardation an intellectual disability established 27 pursuant to the federal Social Security Act, § 1905(c)(d), 28 as codified in 42 U.S.C. § 1396d, in effect on January 1, 29 1989. However, in order for an intermediate care facility for 30 persons with mental retardation an intellectual disability 31 to be licensed, the state fire marshal must certify to the 32 department that the facility meets the applicable provisions 33 of the rules adopted for such facilities by the state fire 34 marshal. The state fire marshal’s rules shall be based 35 -6- LSB 5146IC (7) 84 ad/rj 6/ 67

S.F. _____ H.F. _____ upon such a facility’s compliance with either the provisions 1 applicable to health care occupancies or residential board and 2 care occupancies of the life safety code of the national fire 3 protection association, 2000 edition. The department shall 4 adopt additional rules for intermediate care facilities for 5 persons with mental retardation an intellectual disability 6 pursuant to section 135C.14, subsection 8 . 7 d. Notwithstanding the limitations set out in this 8 subsection regarding rules for intermediate care facilities for 9 persons with mental retardation an intellectual disability , 10 the department shall consider the federal interpretive 11 guidelines issued by the federal centers for Medicare and 12 Medicaid services when interpreting the department’s rules 13 for intermediate care facilities for persons with mental 14 retardation an intellectual disability . This use of the 15 guidelines is not subject to the rulemaking provisions of 16 sections 17A.4 and 17A.5 , but the guidelines shall be published 17 in the Iowa administrative bulletin and the Iowa administrative 18 code. 19 Sec. 13. Section 135C.2, subsection 5, unnumbered paragraph 20 1, Code 2011, is amended to read as follows: 21 The department shall establish a special classification 22 within the residential care facility category in order 23 to foster the development of residential care facilities 24 which serve persons with mental retardation an intellectual 25 disability , chronic mental illness, a developmental disability, 26 or brain injury, as described under section 225C.26 , and which 27 contain five or fewer residents. A facility within the special 28 classification established pursuant to this subsection is 29 exempt from the requirements of section 135.63 . The department 30 shall adopt rules which are consistent with rules previously 31 developed for the waiver demonstration project pursuant to 1986 32 Iowa Acts, chapter 1246 , section 206, and which include all of 33 the following provisions: 34 Sec. 14. Section 135C.2, subsection 5, paragraphs a and f, 35 -7- LSB 5146IC (7) 84 ad/rj 7/ 67

S.F. _____ H.F. _____ Code 2011, are amended to read as follows: 1 a. A facility provider under the special classification must 2 comply with rules adopted by the department for the special 3 classification. However, a facility provider which has been 4 accredited by the accreditation council for services to persons 5 with mental retardation an intellectual disability and other 6 developmental disabilities shall be deemed to be in compliance 7 with the rules adopted by the department. 8 f. The facilities licensed under this subsection shall be 9 eligible for funding utilized by other licensed residential 10 care facilities for persons with mental retardation an 11 intellectual disability , or licensed residential care 12 facilities for persons with mental illness, including but not 13 limited to funding under or from the federal social services 14 block grant, the state supplementary assistance program, state 15 mental health and developmental disabilities services funds, 16 and county funding provisions. 17 Sec. 15. Section 135C.6, subsection 8, paragraphs a and b, 18 Code 2011, are amended to read as follows: 19 a. Residential programs providing care to not more than 20 four individuals and receiving moneys appropriated to the 21 department of human services under provisions of a federally 22 approved home and community-based services waiver for persons 23 with intellectual disabilities or other medical assistance 24 program under chapter 249A . In approving a residential program 25 under this paragraph, the department of human services shall 26 consider the geographic location of the program so as to avoid 27 an overconcentration of such programs in an area. In order 28 to be approved under this paragraph, a residential program 29 shall not be required to involve the conversion of a licensed 30 residential care facility for persons with mental retardation 31 an intellectual disability . 32 b. Not more than forty residential care facilities for 33 persons with mental retardation an intellectual disability 34 that are licensed to serve not more than five individuals may 35 -8- LSB 5146IC (7) 84 ad/rj 8/ 67

S.F. _____ H.F. _____ be authorized by the department of human services to convert 1 to operation as a residential program under the provisions 2 of a medical assistance home and community-based services 3 waiver for persons with intellectual disabilities. A converted 4 residential program operating under this paragraph is subject 5 to the conditions stated in paragraph “a” except that the 6 program shall not serve more than five individuals. 7 Sec. 16. Section 135C.6, subsection 9, Code 2011, is amended 8 to read as follows: 9 9. Contingent upon the department of human services 10 receiving federal approval, a residential program which 11 serves not more than eight individuals and is licensed as an 12 intermediate care facility for persons with mental retardation 13 an intellectual disability may surrender the facility license 14 and continue to operate under a federally approved medical 15 assistance home and community-based services waiver for persons 16 with intellectual disabilities, if the department of human 17 services has approved a plan submitted by the residential 18 program. 19 Sec. 17. Section 135C.23, subsection 2, paragraph b, Code 20 2011, is amended to read as follows: 21 b. This section does not prohibit the admission of a 22 patient with a history of dangerous or disturbing behavior 23 to an intermediate care facility for persons with mental 24 illness, intermediate care facility for persons with mental 25 retardation an intellectual disability , nursing facility, or 26 county care facility when the intermediate care facility for 27 persons with mental illness, intermediate care facility for 28 persons with mental retardation an intellectual disability , 29 nursing facility, or county care facility has a program which 30 has received prior approval from the department to properly 31 care for and manage the patient. An intermediate care 32 facility for persons with mental illness, intermediate care 33 facility for persons with mental retardation an intellectual 34 disability , nursing facility, or county care facility is 35 -9- LSB 5146IC (7) 84 ad/rj 9/ 67

S.F. _____ H.F. _____ required to transfer or discharge a resident with dangerous or 1 disturbing behavior when the intermediate care facility for 2 persons with mental illness, intermediate care facility for 3 persons with mental retardation an intellectual disability , 4 nursing facility, or county care facility cannot control the 5 resident’s dangerous or disturbing behavior. The department, 6 in coordination with the state mental health and disability 7 services commission created in section 225C.5 , shall adopt 8 rules pursuant to chapter 17A for programs to be required 9 in intermediate care facilities for persons with mental 10 illness, intermediate care facilities for persons with mental 11 retardation an intellectual disability , nursing facilities, and 12 county care facilities that admit patients or have residents 13 with histories of dangerous or disturbing behavior. 14 Sec. 18. Section 135C.25, subsection 1, Code 2011, is 15 amended to read as follows: 16 1. Each health care facility shall have a resident advocate 17 committee whose members shall be appointed by the director 18 of the department on aging or the director’s designee. A 19 person shall not be appointed a member of a resident advocate 20 committee for a health care facility unless the person is a 21 resident of the service area where the facility is located. 22 The resident advocate committee for any facility caring 23 primarily for persons with mental illness, mental retardation 24 an intellectual disability , or a developmental disability shall 25 only be appointed after consultation with the administrator 26 of the division of mental health and disability services of 27 the department of human services on the proposed appointments. 28 Recommendations to the director or the director’s designee for 29 membership on resident advocate committees are encouraged from 30 any agency, organization, or individual. The administrator of 31 the facility shall not be appointed to the resident advocate 32 committee and shall not be present at committee meetings except 33 upon request of the committee. 34 Sec. 19. Section 155.1, subsection 3, Code 2011, is amended 35 -10- LSB 5146IC (7) 84 ad/rj 10/ 67

S.F. _____ H.F. _____ to read as follows: 1 3. “Nursing home” means an institution or facility, or 2 part of an institution or facility, whether proprietary or 3 nonprofit, licensed as a nursing facility, but not including an 4 intermediate care facility for persons with mental retardation 5 an intellectual disability or an intermediate care facility 6 for persons with mental illness, defined as such for licensing 7 purposes under state law or administrative rule adopted 8 pursuant to section 135C.2 , including but not limited to, a 9 nursing home owned or administered by the federal or state 10 government or an agency or political subdivision of government. 11 Sec. 20. Section 217.1, Code 2011, is amended to read as 12 follows: 13 217.1 Programs of department. 14 There is established a department of human services to 15 administer programs designed to improve the well-being 16 and productivity of the people of the state of Iowa. The 17 department shall concern itself with the problems of 18 human behavior, adjustment, and daily living through the 19 administration of programs of family, child, and adult 20 welfare, economic assistance including costs of medical care, 21 rehabilitation toward self-care and support, delinquency 22 prevention and control, treatment and rehabilitation of 23 juvenile offenders, care and treatment of persons with mental 24 illness or mental retardation an intellectual disability , and 25 other related programs as provided by law. 26 Sec. 21. Section 218.92, Code 2011, is amended to read as 27 follows: 28 218.92 Patients with dangerous mental disturbances. 29 When a patient in a state resource center for persons 30 with mental retardation an intellectual disability , a state 31 mental health institute, or another institution under the 32 administration of the department of human services has become 33 so mentally disturbed as to constitute a danger to self, to 34 other patients or staff of the institution, or to the public, 35 -11- LSB 5146IC (7) 84 ad/rj 11/ 67

S.F. _____ H.F. _____ and the institution cannot provide adequate security, the 1 administrator in charge of the institution, with the consent 2 of the director of the Iowa department of corrections, may 3 order the patient to be transferred to the Iowa medical and 4 classification center, if the superintendent of the institution 5 from which the patient is to be transferred, with the support 6 of a majority of the medical staff, recommends the transfer in 7 the interest of the patient, other patients, or the public. If 8 the patient transferred was hospitalized pursuant to sections 9 229.6 to 229.15 , the transfer shall be promptly reported to 10 the court that ordered the hospitalization of the patient, as 11 required by section 229.15, subsection 5 . The Iowa medical 12 and classification center has the same rights, duties, and 13 responsibilities with respect to the patient as the institution 14 from which the patient was transferred had while the patient 15 was hospitalized in the institution. The cost of the transfer 16 shall be paid from the funds of the institution from which the 17 transfer is made. 18 Sec. 22. Section 222.1, Code 2011, is amended to read as 19 follows: 20 222.1 Purpose of state resource centers. 21 1. The Glenwood state resource center and the Woodward 22 state resource center are established and shall be maintained 23 as the state’s regional resource centers for the purpose of 24 providing treatment, training, instruction, care, habilitation, 25 and support of persons with mental retardation an intellectual 26 disability or other disabilities in this state, and providing 27 facilities, services, and other support to the communities 28 located in the region being served by a state resource center. 29 In addition, the state resource centers are encouraged to serve 30 as a training resource for community-based program staff, 31 medical students, and other participants in professional 32 education programs. A resource center may request the approval 33 of the council on human services to change the name of the 34 resource center for use in communication with the public, in 35 -12- LSB 5146IC (7) 84 ad/rj 12/ 67

S.F. _____ H.F. _____ signage, and in other forms of communication. 1 2. A special mental retardation intellectual disability 2 unit may be maintained at one of the state mental health 3 institutes for the purposes set forth in sections 222.88 to 4 222.91 . 5 Sec. 23. Section 222.2, subsections 5 and 6, Code 2011, are 6 amended to read as follows: 7 5. “Mental retardation” or “mentally retarded” “Intellectual 8 disability” means a term or terms to describe children and 9 adults who as a result of inadequately developed intelligence 10 are significantly impaired in ability to learn or to adapt to 11 the demands of society the same as defined in section 4.1 . 12 6. “Special unit” means a special mental retardation 13 intellectual disability unit established at a state mental 14 health institute pursuant to sections 222.88 to 222.91 . 15 Sec. 24. Section 222.6, Code 2011, is amended to read as 16 follows: 17 222.6 State districts. 18 The administrator shall divide the state into two districts 19 in such manner that one of the resource centers shall be 20 located within each of the districts. Such districts may 21 from time to time be changed. After such districts have been 22 established, the administrator shall notify all boards of 23 supervisors, county auditors, and clerks of the district courts 24 of the action. Thereafter, unless the administrator otherwise 25 orders, all admissions or commitments of persons with mental 26 retardation an intellectual disability from a district shall be 27 to the resource center located within such district. 28 Sec. 25. Section 222.9, Code 2011, is amended to read as 29 follows: 30 222.9 Unauthorized departures. 31 If any person with mental retardation an intellectual 32 disability shall depart without proper authorization from a 33 resource center or a special unit, it shall be the duty of the 34 superintendent and the superintendent’s assistants and all 35 -13- LSB 5146IC (7) 84 ad/rj 13/ 67

S.F. _____ H.F. _____ peace officers of any county in which such patient may be found 1 to take and detain the patient without a warrant or order and 2 to immediately report such detention to the superintendent who 3 shall immediately provide for the return of such patient to the 4 resource center or special unit. 5 Sec. 26. Section 222.10, Code 2011, is amended to read as 6 follows: 7 222.10 Duty of peace officer. 8 When any person with mental retardation an intellectual 9 disability departs without proper authority from an institution 10 in another state and is found in this state, any peace officer 11 in any county in which such patient is found may take and 12 detain the patient without warrant or order and shall report 13 such detention to the administrator. The administrator shall 14 provide for the return of the patient to the authorities in the 15 state from which the unauthorized departure was made. Pending 16 return, such patient may be detained temporarily at one of the 17 institutions of this state governed by the administrator or by 18 the administrator of the division of child and family services 19 of the department of human services. The provisions of this 20 section relating to the administrator shall also apply to the 21 return of other nonresident persons with mental retardation an 22 intellectual disability having legal settlement outside the 23 state of Iowa. 24 Sec. 27. Section 222.12, subsections 1 and 3, Code 2011, are 25 amended to read as follows: 26 1. Upon the death of a patient of a resource center or 27 special unit, a preliminary investigation of the death shall be 28 conducted as required by section 218.64 by the county medical 29 examiner as provided in section 331.802 . Such a preliminary 30 investigation shall also be conducted in the event of a sudden 31 or mysterious death of a patient in a private institution for 32 persons with mental retardation an intellectual disability . 33 The chief administrative officer of any private institution may 34 request an investigation of the death of any patient by the 35 -14- LSB 5146IC (7) 84 ad/rj 14/ 67

S.F. _____ H.F. _____ county medical examiner. 1 3. The parent, guardian, or other person responsible for 2 the admission of a patient to a private institution for persons 3 with mental retardation an intellectual disability may also 4 request such a preliminary investigation by the county medical 5 examiner in the event of the death of the patient that is not 6 sudden or mysterious. The person or persons making the request 7 are liable for the expense of such preliminary investigation 8 and payment for the expense may be required in advance. 9 Sec. 28. Section 222.13, subsections 1 and 2, Code 2011, are 10 amended to read as follows: 11 1. If an adult person is believed to be a person with mental 12 retardation an intellectual disability , the adult person or 13 the adult person’s guardian may submit a request through the 14 central point of coordination process for the county board 15 of supervisors to apply to the superintendent of any state 16 resource center for the voluntary admission of the adult 17 person either as an inpatient or an outpatient of the resource 18 center. After determining the legal settlement of the adult 19 person as provided by this chapter , the board of supervisors 20 shall, on forms prescribed by the administrator, apply to the 21 superintendent of the resource center in the district for the 22 admission of the adult person to the resource center. An 23 application for admission to a special unit of any adult person 24 believed to be in need of any of the services provided by the 25 special unit under section 222.88 may be made in the same 26 manner, upon request of the adult person or the adult person’s 27 guardian. The superintendent shall accept the application 28 providing a preadmission diagnostic evaluation, performed 29 through the central point of coordination process, confirms or 30 establishes the need for admission, except that an application 31 may not be accepted if the institution does not have adequate 32 facilities available or if the acceptance will result in an 33 overcrowded condition. 34 2. If the resource center has no appropriate program for the 35 -15- LSB 5146IC (7) 84 ad/rj 15/ 67

S.F. _____ H.F. _____ treatment of an adult or minor person with mental retardation 1 an intellectual disability applying under this section or 2 section 222.13A , the board of supervisors shall arrange for 3 the placement of the person in any public or private facility 4 within or without the state, approved by the director of the 5 department of human services, which offers appropriate services 6 for the person, as determined through the central point of 7 coordination process. 8 Sec. 29. Section 222.13A, subsections 1 and 2, Code 2011, 9 are amended to read as follows: 10 1. If a minor is believed to be a person with mental 11 retardation an intellectual disability , the minor’s parent, 12 guardian, or custodian may request the county board of 13 supervisors to apply for admission of the minor as a voluntary 14 patient in a state resource center. If the resource center 15 does not have appropriate services for the minor’s treatment, 16 the board of supervisors may arrange for the admission of the 17 minor in a public or private facility within or without the 18 state, approved by the director of human services, which offers 19 appropriate services for the minor’s treatment. 20 2. Upon receipt of an application for voluntary admission 21 of a minor, the board of supervisors shall provide for a 22 preadmission diagnostic evaluation of the minor to confirm 23 or establish the need for the admission. The preadmission 24 diagnostic evaluation shall be performed by a person who 25 meets the qualifications of a qualified mental retardation 26 intellectual disability professional who is designated through 27 the central point of coordination process. 28 Sec. 30. Section 222.16, Code 2011, is amended to read as 29 follows: 30 222.16 Petition for adjudication of mental retardation 31 intellectual disability . 32 A petition for the adjudication of the mental retardation 33 of a person as having an intellectual disability within the 34 meaning of this chapter may, with the permission of the court, 35 -16- LSB 5146IC (7) 84 ad/rj 16/ 67

S.F. _____ H.F. _____ be filed without fee against a person with the clerk of the 1 district court of the county or city in which the person who is 2 alleged to have mental retardation an intellectual disability 3 resides or is found. The petition may be filed by any relative 4 of the person, by a guardian, or by any reputable citizen of 5 the county where the person who is alleged to have mental 6 retardation an intellectual disability resides or is found. 7 Commitment of a person pursuant to section 222.31 does not 8 constitute a finding or raise a presumption that the person 9 is incompetent to vote. The court shall make a separate 10 determination as to the person’s competency to vote. The court 11 shall find a person incompetent to vote only upon determining 12 that the person lacks sufficient mental capacity to comprehend 13 and exercise the right to vote. 14 Sec. 31. Section 222.17, subsection 1, Code 2011, is amended 15 to read as follows: 16 1. Allege that such person is mentally retarded has an 17 intellectual disability within the meaning of this chapter . 18 Sec. 32. Section 222.18, Code 2011, is amended to read as 19 follows: 20 222.18 County attorney to appear. 21 The county attorney shall, if requested, appear on behalf 22 of any petitioner for the commitment of a person alleged to 23 be mentally retarded have an intellectual disability under 24 this chapter , and on behalf of all public officials and 25 superintendents in all matters pertaining to the duties imposed 26 upon them by this chapter . 27 Upon the filing of the petition, the court shall enter an 28 order directing the county attorney of the county in which 29 the person who is alleged to have mental retardation an 30 intellectual disability resides to make a full investigation 31 regarding the financial condition of that person and of those 32 persons legally liable for that person’s support under section 33 222.78 . 34 Sec. 33. Section 222.19, unnumbered paragraph 1, Code 2011, 35 -17- LSB 5146IC (7) 84 ad/rj 17/ 67

S.F. _____ H.F. _____ is amended to read as follows: 1 The following persons, in addition to the person alleged to 2 be mentally retarded have an intellectual disability , shall be 3 made party respondents if the persons reside in this state and 4 their names and residences are known: 5 Sec. 34. Section 222.21, Code 2011, is amended to read as 6 follows: 7 222.21 Order requiring attendance. 8 If the person alleged to have mental retardation an 9 intellectual disability is not before the court, the court may 10 issue an order requiring the person who has the care, custody, 11 and control of the person who is alleged to have mental 12 retardation an intellectual disability to bring the person into 13 court at the time and place stated in the order. 14 Sec. 35. Section 222.22, Code 2011, is amended to read as 15 follows: 16 222.22 Time of appearance. 17 The time of appearance shall not be less than five days 18 after completed service unless the court orders otherwise. 19 Appearance on behalf of the person who is alleged to have 20 mental retardation an intellectual disability may be made by 21 any citizen of the county or by any relative. The district 22 court shall assign counsel for the person who is alleged to 23 have mental retardation an intellectual disability . Counsel 24 shall prior to proceedings personally consult with the person 25 who is alleged to have mental retardation an intellectual 26 disability unless the judge appointing counsel certifies that 27 in the judge’s opinion, consultation shall serve no useful 28 purpose. The certification shall be made a part of the record. 29 An attorney assigned by the court shall be compensated by the 30 county at an hourly rate to be established by the county board 31 of supervisors in substantially the same manner as provided in 32 section 815.7 . 33 Sec. 36. Section 222.25, Code 2011, is amended to read as 34 follows: 35 -18- LSB 5146IC (7) 84 ad/rj 18/ 67

S.F. _____ H.F. _____ 222.25 Custody pending hearing. 1 Pending final hearing, the court may at any time after 2 the filing of the petition and on satisfactory showing that 3 it is in the best interest of the person who is alleged to 4 have mental retardation an intellectual disability and of the 5 community that the person be at once taken into custody, or 6 that service of notice will be ineffectual if the person is not 7 taken into custody, issue an order for the immediate production 8 of the person before the court. In such case, the court may 9 make any proper order for the custody or confinement of the 10 person as will protect the person and the community and insure 11 the presence of the person at the hearing. The person shall 12 not be confined with those accused or convicted of crime. 13 Sec. 37. Section 222.27, Code 2011, is amended to read as 14 follows: 15 222.27 Hearing in public. 16 Hearings shall be public, unless otherwise requested by the 17 parent, guardian, or other person having the custody of the 18 person with mental retardation an intellectual disability , 19 or if the judge considers, a closed hearing in the best 20 interests of the person with mental retardation an intellectual 21 disability . 22 Sec. 38. Section 222.28, Code 2011, is amended to read as 23 follows: 24 222.28 Commission to examine. 25 The court may, at or prior to the final hearing, appoint 26 a commission of one qualified physician and one qualified 27 psychologist, designated through the central point of 28 coordination process, who shall make a personal examination of 29 the person alleged to be mentally retarded have an intellectual 30 disability for the purpose of determining the mental condition 31 of the person. 32 Sec. 39. Section 222.31, subsection 1, unnumbered paragraph 33 1, Code 2011, is amended to read as follows: 34 If in the opinion of the court, or of a commission as 35 -19- LSB 5146IC (7) 84 ad/rj 19/ 67

S.F. _____ H.F. _____ authorized in section 222.28 , the person is mentally retarded 1 has an intellectual disability within the meaning of this 2 chapter and the court determines that it will be conducive 3 to the welfare of that person and of the community to commit 4 the person to a proper institution for treatment, training, 5 instruction, care, habilitation, and support, and that services 6 or support provided to the family of such a person who is a 7 child will not enable the family to continue to care for the 8 child in the child’s home, the court shall by proper order: 9 Sec. 40. Section 222.34, Code 2011, is amended to read as 10 follows: 11 222.34 Guardianship proceedings. 12 If a guardianship is proposed for a person with mental 13 retardation an intellectual disability , guardianship 14 proceedings shall be initiated and conducted as provided in 15 chapter 633 . 16 Sec. 41. Section 222.38, Code 2011, is amended to read as 17 follows: 18 222.38 Delivery of person to institution, resource center, or 19 special unit. 20 The court may, for the purpose of committing a person 21 direct the clerk to authorize the employment of one or 22 more assistants. If a person with mental retardation an 23 intellectual disability is taken to an institution, resource 24 center, or special unit, at least one attendant shall be of the 25 same sex. 26 Sec. 42. Section 222.43, subsection 1, paragraphs a, b, and 27 c, Code 2011, are amended to read as follows: 28 a. That the person adjudged to be mentally retarded is not 29 mentally retarded have an intellectual disability does not have 30 an intellectual disability . 31 b. That the person adjudged to be mentally retarded have an 32 intellectual disability has improved as to be capable of self 33 care self-care . 34 c. That the relatives or friends of the person with mental 35 -20- LSB 5146IC (7) 84 ad/rj 20/ 67

S.F. _____ H.F. _____ retardation an intellectual disability are able and willing 1 to support and care for the person with mental retardation an 2 intellectual disability and request the person’s discharge, 3 and in the judgment of the superintendent of the institution 4 or resource center having charge of the person, no harmful 5 consequences are likely to follow such discharge. 6 Sec. 43. Section 222.45, Code 2011, is amended to read as 7 follows: 8 222.45 Power of court. 9 On the hearing, the court may discharge the person with 10 mental retardation an intellectual disability from all 11 supervision, control, and care, or may transfer the person 12 from a public institution to a private institution, or vice 13 versa, or transfer the person from a special unit to a resource 14 center, or vice versa, as the court deems appropriate under 15 all the circumstances. If the person has been determined to 16 lack the mental capacity to vote, the court shall include in 17 its order a finding that this determination remains in force 18 or is revoked. 19 Sec. 44. Section 222.47, Code 2011, is amended to read as 20 follows: 21 222.47 Penalty for false petition of commitment. 22 Any person who shall maliciously seek to have any person 23 adjudged mentally retarded as a person with an intellectual 24 disability , knowing that such person is not mentally retarded 25 does not have an intellectual disability , shall be guilty of 26 a fraudulent practice. 27 Sec. 45. Section 222.49, Code 2011, is amended to read as 28 follows: 29 222.49 Costs paid. 30 The costs of proceedings shall be defrayed from the county 31 treasury unless otherwise ordered by the court. When the 32 person alleged to be mentally retarded have an intellectual 33 disability is found not to be mentally retarded have an 34 intellectual disability , the court shall render judgment for 35 -21- LSB 5146IC (7) 84 ad/rj 21/ 67

S.F. _____ H.F. _____ such costs against the person filing the petition except when 1 the petition is filed by order of court. 2 Sec. 46. Section 222.50, Code 2011, is amended to read as 3 follows: 4 222.50 County of legal settlement to pay. 5 When the proceedings are instituted in a county in which 6 the person who is alleged to have mental retardation an 7 intellectual disability was found but which is not the county 8 of legal settlement of the person, and the costs are not taxed 9 to the petitioner, the county which is the legal settlement of 10 the person shall, on presentation of a properly itemized bill 11 for such costs, repay the costs to the former county. When the 12 person’s legal settlement is outside the state or is unknown, 13 the costs shall be paid out of money in the state treasury not 14 otherwise appropriated, itemized on vouchers executed by the 15 auditor of the county which paid the costs, and approved by the 16 administrator. 17 Sec. 47. Section 222.51, Code 2011, is amended to read as 18 follows: 19 222.51 Costs collected. 20 Costs incident to the hearings and commitment of a 21 person with mental retardation an intellectual disability 22 to an institution, a resource center, or a special unit 23 may be collected from the person with mental retardation an 24 intellectual disability and from all persons legally chargeable 25 with the support of the person with mental retardation an 26 intellectual disability . 27 Sec. 48. Section 222.52, Code 2011, is amended to read as 28 follows: 29 222.52 Proceedings against delinquent —— hearing on 30 retardation intellectual disability . 31 When in proceedings against an alleged delinquent or 32 dependent child, the court is satisfied from any evidence that 33 such child is mentally retarded has an intellectual disability , 34 the court may order a continuance of such proceeding, and may 35 -22- LSB 5146IC (7) 84 ad/rj 22/ 67

S.F. _____ H.F. _____ direct an officer of the court or some other proper person 1 to file a petition against such child permitted under the 2 provisions of this chapter . Pending hearing of the petition 3 the court may by order provide proper custody for the child. 4 Sec. 49. Section 222.53, Code 2011, is amended to read as 5 follows: 6 222.53 Conviction —— suspension. 7 If on the conviction in the district court of any person 8 for any crime or for any violation of any municipal ordinance, 9 or if on the determination in said courts the court that a 10 child is dependent, neglected, or delinquent and it appears 11 from any evidence presented to the court before sentence, 12 that such person is mentally retarded has an intellectual 13 disability within the meaning of this chapter , the court may 14 suspend sentence or order, and may order any officer of the 15 court or some other proper person to file a petition permitted 16 under the provisions of this chapter against said such person. 17 Pending hearing of the petition, the court shall provide for 18 the custody of said such person as directed in section 222.52 . 19 Sec. 50. Section 222.54, Code 2011, is amended to read as 20 follows: 21 222.54 Procedure after hearing. 22 Should it be found under sections 222.52 and 222.53 that 23 said such person is not mentally retarded does not have an 24 intellectual disability , the court shall proceed with the 25 original proceedings as though no petition had been filed. 26 Sec. 51. Section 222.56, Code 2011, is amended to read as 27 follows: 28 222.56 Transfer to institution for persons with mental 29 retardation an intellectual disability . 30 When the mental condition of a person in a private 31 institution for persons with mental illness is found to be such 32 that the patient should be transferred to an institution for 33 persons with mental retardation an intellectual disability , the 34 person may be proceeded against under this chapter . 35 -23- LSB 5146IC (7) 84 ad/rj 23/ 67

S.F. _____ H.F. _____ Sec. 52. Section 222.58, Code 2011, is amended to read as 1 follows: 2 222.58 Administrator to keep record. 3 The administrator shall keep a record of all persons 4 adjudged to be mentally retarded have an intellectual 5 disability and of the orders respecting such persons by the 6 courts throughout the state. Copies of such orders shall be 7 furnished by the clerk of the court without the administrator’s 8 application therefor. 9 Sec. 53. Section 222.60, subsection 1, unnumbered paragraph 10 1, Code 2011, is amended to read as follows: 11 All necessary and legal expenses for the cost of admission or 12 commitment or for the treatment, training, instruction, care, 13 habilitation, support and transportation of persons with mental 14 retardation an intellectual disability , as provided for in 15 the county management plan provisions implemented pursuant to 16 section 331.439, subsection 1 , in a state resource center, or 17 in a special unit, or any public or private facility within or 18 without the state, approved by the director of the department 19 of human services, shall be paid by either: 20 Sec. 54. Section 222.60, subsection 2, paragraph a, Code 21 2011, is amended to read as follows: 22 a. Prior to a county of legal settlement approving the 23 payment of expenses for a person under this section , the county 24 may require that the person be diagnosed to determine if the 25 person has mental retardation an intellectual disability or 26 that the person be evaluated to determine the appropriate level 27 of services required to meet the person’s needs relating to 28 mental retardation an intellectual disability . The diagnosis 29 and the evaluation may be performed concurrently and shall 30 be performed by an individual or individuals approved by the 31 county who are qualified to perform the diagnosis or the 32 evaluation. Following the initial approval for payment of 33 expenses, the county of legal settlement may require that an 34 evaluation be performed at reasonable time periods. 35 -24- LSB 5146IC (7) 84 ad/rj 24/ 67

S.F. _____ H.F. _____ Sec. 55. Section 222.60, subsection 3, Code 2011, is amended 1 to read as follows: 2 3. a. A diagnosis of mental retardation an intellectual 3 disability under this section shall be made only when the onset 4 of the person’s condition was prior to the age of eighteen 5 years and shall be based on an assessment of the person’s 6 intellectual functioning and level of adaptive skills. The 7 diagnosis shall be made by an individual who is a psychologist 8 or psychiatrist who is professionally trained to administer 9 the tests required to assess intellectual functioning and to 10 evaluate a person’s adaptive skills. 11 b. A diagnosis of mental retardation an intellectual 12 disability shall be made in accordance with the criteria 13 provided in the diagnostic and statistical manual of 14 mental disorders, fourth edition, published by the American 15 psychiatric association , as provided in the definition of 16 intellectual disability in section 4.1 . 17 Sec. 56. Section 222.66, Code 2011, is amended to read as 18 follows: 19 222.66 Transfers —— expenses. 20 The transfer to a resource center or a special unit or to the 21 place of legal settlement of a person with mental retardation 22 an intellectual disability who has no legal settlement in this 23 state or whose legal settlement is unknown, shall be made 24 in accordance with such directions as shall be prescribed 25 by the administrator and when practicable by employees of 26 the state resource center or the special unit. The actual 27 and necessary expenses of such transfers shall be paid on 28 itemized vouchers sworn to by the claimants and approved by 29 the administrator from any funds in the state treasury not 30 otherwise appropriated. 31 Sec. 57. Section 222.78, Code 2011, is amended to read as 32 follows: 33 222.78 Parents and others liable for support. 34 The father and mother of any patient admitted or committed to 35 -25- LSB 5146IC (7) 84 ad/rj 25/ 67

S.F. _____ H.F. _____ a resource center or to a special unit, as either an inpatient 1 or an outpatient, and any person, firm, or corporation bound 2 by contract made for support of the patient are liable for the 3 support of the patient. The patient and those legally bound 4 for the support of the patient shall be liable to the county 5 for all sums advanced by the county to the state under the 6 provisions of sections 222.60 and 222.77 . The liability of 7 any person, other than the patient, who is legally bound for 8 the support of a patient who is under eighteen years of age 9 in a resource center or a special unit shall not exceed the 10 average minimum cost of the care of a normally intelligent 11 minor without a disability of the same age and sex as the 12 minor patient. The administrator shall establish the scale 13 for this purpose but the scale shall not exceed the standards 14 for personal allowances established by the state division 15 under the family investment program. The father or mother 16 shall incur liability only during any period when the father 17 or mother either individually or jointly receive a net income 18 from whatever source, commensurate with that upon which they 19 would be liable to make an income tax payment to this state. 20 The father or mother of a patient shall not be liable for the 21 support of the patient upon the patient attaining eighteen 22 years of age. Nothing in this section shall be construed to 23 prevent a relative or other person from voluntarily paying 24 the full actual cost as established by the administrator for 25 caring for the patient with mental retardation an intellectual 26 disability . 27 Sec. 58. Section 222.80, Code 2011, is amended to read as 28 follows: 29 222.80 Liability to county. 30 A person admitted or committed to a county institution 31 or home or admitted or committed at county expense to a 32 private hospital, sanitarium, or other facility for treatment, 33 training, instruction, care, habilitation, and support as a 34 patient with mental retardation an intellectual disability 35 -26- LSB 5146IC (7) 84 ad/rj 26/ 67

S.F. _____ H.F. _____ shall be liable to the county for the reasonable cost of the 1 support as provided in section 222.78 . 2 Sec. 59. Section 222.88, Code 2011, is amended to read as 3 follows: 4 222.88 Special mental retardation intellectual disability 5 unit. 6 The director of human services may organize and establish a 7 special mental retardation intellectual disability unit at an 8 existing institution which may provide: 9 1. Psychiatric and related services to children with mental 10 retardation an intellectual disability and adults who are also 11 emotionally disturbed or otherwise mentally ill. 12 2. Specific programs to meet the needs of such other special 13 categories of persons with mental retardation an intellectual 14 disability as may be designated by the director. 15 3. Appropriate diagnostic evaluation services. 16 Sec. 60. Section 225C.1, subsection 1, Code 2011, is amended 17 to read as follows: 18 1. The general assembly finds that services to persons with 19 mental illness, mental retardation an intellectual disability , 20 developmental disabilities, or brain injury are provided in 21 many parts of the state by highly autonomous community-based 22 service providers working cooperatively with state and county 23 officials. However, the general assembly recognizes that 24 heavy reliance on property tax funding for mental health and 25 mental retardation an intellectual disability services has 26 enabled many counties to exceed minimum state standards for the 27 services resulting in an uneven level of services around the 28 state. Consequently, greater efforts should be made to assure 29 close coordination and continuity of care for those persons 30 receiving publicly supported disability services in Iowa. It 31 is the purpose of this chapter to continue and to strengthen 32 the services to persons with disabilities now available in 33 the state of Iowa, to make disability services conveniently 34 available to all persons in this state upon a reasonably 35 -27- LSB 5146IC (7) 84 ad/rj 27/ 67

S.F. _____ H.F. _____ uniform financial basis, and to assure the continued high 1 quality of these services. 2 Sec. 61. Section 225C.2, subsections 6 and 8, Code 2011, are 3 amended to read as follows: 4 6. “Disability services” means services and other support 5 available to a person with mental illness, mental retardation 6 an intellectual disability or other developmental disability, 7 or brain injury. 8 8. “Person with a disability” means a person with mental 9 illness, mental retardation an intellectual disability or other 10 developmental disability, or brain injury. 11 Sec. 62. Section 225C.3, subsections 1 and 3, Code 2011, are 12 amended to read as follows: 13 1. The division is designated the state mental health 14 authority as defined in 42 U.S.C. § 201(m) (1976) for the 15 purpose of directing the benefits of the National Mental 16 Health Act, 42 U.S.C. § 201 et seq. This designation does not 17 preclude the board of regents from authorizing or directing any 18 institution under its jurisdiction to carry out educational, 19 prevention, and research activities in the areas of mental 20 health and mental retardation intellectual disability . The 21 division may contract with the board of regents or any 22 institution under the board’s jurisdiction to perform any of 23 these functions. 24 3. The division is administered by the administrator. 25 The administrator of the division shall be qualified in the 26 general field of mental health, mental retardation intellectual 27 disability , or other disability services, and preferably in 28 more than one field. The administrator shall have at least 29 five years of experience as an administrator in one or more of 30 these fields. 31 Sec. 63. Section 225C.4, subsection 1, paragraphs a, c, g, 32 and q, Code 2011, are amended to read as follows: 33 a. Prepare and administer the comprehensive mental 34 health and disability services plan as provided in section 35 -28- LSB 5146IC (7) 84 ad/rj 28/ 67

S.F. _____ H.F. _____ 225C.6B , including state mental health and mental retardation 1 intellectual disability plans for the provision of disability 2 services within the state and the state developmental 3 disabilities plan. The administrator shall consult with the 4 Iowa department of public health, the state board of regents or 5 a body designated by the board for that purpose, the department 6 of management or a body designated by the director of the 7 department for that purpose, the department of education, the 8 department of workforce development and any other appropriate 9 governmental body, in order to facilitate coordination of 10 disability services provided in this state. The state mental 11 health and mental retardation intellectual disability plans 12 shall be consistent with the state health plan, and shall 13 incorporate county disability services plans. 14 c. Emphasize the provision of outpatient services by 15 community mental health centers and local mental retardation 16 intellectual disability providers as a preferable alternative 17 to inpatient hospital services. 18 g. Administer state programs regarding the care, treatment, 19 and supervision of persons with mental illness or mental 20 retardation an intellectual disability , except the programs 21 administered by the state board of regents. 22 q. In cooperation with the department of inspections and 23 appeals, recommend minimum standards under section 227.4 for 24 the care of and services to persons with mental illness and 25 mental retardation an intellectual disability residing in 26 county care facilities. 27 Sec. 64. Section 225C.5, subsection 1, unnumbered paragraph 28 1, Code Supplement 2011, is amended to read as follows: 29 A mental health and disability services commission is 30 created as the state policy-making body for the provision of 31 services to persons with mental illness, mental retardation an 32 intellectual disability, or other developmental disabilities, 33 or brain injury. The commission’s voting members shall be 34 appointed to three-year staggered terms by the governor and 35 -29- LSB 5146IC (7) 84 ad/rj 29/ 67

S.F. _____ H.F. _____ are subject to confirmation by the senate. Commission members 1 shall be appointed on the basis of interest and experience in 2 the fields of mental health, mental retardation intellectual 3 disability, or other developmental disabilities, and brain 4 injury, in a manner so as to ensure adequate representation 5 from persons with disabilities and individuals knowledgeable 6 concerning disability services. The department shall provide 7 staff support to the commission, and the commission may utilize 8 staff support and other assistance provided to the commission 9 by other persons. The commission shall meet at least four 10 times per year. The membership of the commission shall consist 11 of the following persons who, at the time of appointment to the 12 commission, are active members of the indicated groups: 13 Sec. 65. Section 225C.7, subsections 2 and 4, Code 2011, are 14 amended to read as follows: 15 2. Moneys appropriated to the fund shall be allocated 16 to counties for funding of community-based mental health, 17 mental retardation intellectual disability , developmental 18 disabilities, and brain injury services in the manner 19 provided in the appropriation to the fund. If the allocation 20 methodology includes a population factor, the most recent 21 population estimates issued by the United States bureau of the 22 census shall be applied. 23 4. a. A county is entitled to receive money from the 24 fund if that county raised by county levy and expended for 25 mental health, mental retardation intellectual disability , 26 and developmental disabilities services, in the preceding 27 fiscal year, an amount of money at least equal to the amount so 28 raised and expended for those purposes during the fiscal year 29 beginning July 1, 1980. 30 b. With reference to the fiscal year beginning July 1, 1980, 31 money “raised by county levy and expended for mental health, 32 mental retardation intellectual disability , and developmental 33 disabilities services” means the county’s maintenance of effort 34 determined by using the general allocation application for the 35 -30- LSB 5146IC (7) 84 ad/rj 30/ 67

S.F. _____ H.F. _____ state community mental health and mental retardation services 1 fund under section 225C.10, subsection 1 , Code 1993. The 2 department, with the agreement of each county, shall establish 3 the actual amount expended by each county for persons with 4 mental illness, mental retardation an intellectual disability , 5 or a developmental disability in the fiscal year which began 6 on July 1, 1980, and this amount shall be deemed each county’s 7 maintenance of effort. 8 Sec. 66. Section 225C.12, subsection 2, Code 2011, is 9 amended to read as follows: 10 2. A county may claim reimbursement by filing with the 11 administrator a claim in a form prescribed by the administrator 12 by rule. Claims may be filed on a quarterly basis, and when 13 received shall be verified as soon as reasonably possible 14 by the administrator. The administrator shall certify to 15 the director of the department of administrative services 16 the amount to which each county claiming reimbursement is 17 entitled, and the director of the department of administrative 18 services shall issue warrants to the respective counties 19 drawn upon funds appropriated by the general assembly for 20 the purpose of this section . A county shall place funds 21 received under this section in the county mental health, 22 mental retardation intellectual disability , and developmental 23 disabilities services fund created under section 331.424A . If 24 the appropriation for a fiscal year is insufficient to pay 25 all claims arising under this section , the director of the 26 department of administrative services shall prorate the funds 27 appropriated for that year among the claimant counties so that 28 an equal proportion of each county’s claim is paid in each 29 quarter for which proration is necessary. 30 Sec. 67. Section 225C.13, subsection 2, Code 2011, is 31 amended to read as follows: 32 2. The division administrator may work with the appropriate 33 administrator of the department’s institutions to establish 34 mental health and mental retardation intellectual disability 35 -31- LSB 5146IC (7) 84 ad/rj 31/ 67

S.F. _____ H.F. _____ services for all institutions under the control of the director 1 of human services and to establish an autism unit, following 2 mutual planning and consultation with the medical director of 3 the state psychiatric hospital, at an institution or a facility 4 administered by the department to provide psychiatric and 5 related services and other specific programs to meet the needs 6 of autistic persons, and to furnish appropriate diagnostic 7 evaluation services. 8 Sec. 68. Section 225C.21, subsection 1, Code 2011, is 9 amended to read as follows: 10 1. As used in this section , “supported community living 11 services” means services provided in a noninstitutional setting 12 to adult persons with mental illness, mental retardation an 13 intellectual disability , or developmental disabilities to meet 14 the persons’ daily living needs. 15 Sec. 69. Section 225C.25, Code 2011, is amended to read as 16 follows: 17 225C.25 Short title. 18 Sections 225C.25 through 225C.28B shall be known as “the 19 bill of rights and service quality standards of persons with 20 mental retardation an intellectual disability , developmental 21 disabilities, brain injury, or chronic mental illness”. 22 Sec. 70. Section 225C.26, Code 2011, is amended to read as 23 follows: 24 225C.26 Scope. 25 These rights and service quality standards apply to any 26 person with mental retardation an intellectual disability , 27 a developmental disability, brain injury, or chronic mental 28 illness who receives services which are funded in whole or in 29 part by public funds or services which are permitted under Iowa 30 law. 31 Sec. 71. Section 225C.28A, unnumbered paragraph 1, Code 32 2011, is amended to read as follows: 33 As the state participates more fully in funding services 34 and other support to persons with mental retardation an 35 -32- LSB 5146IC (7) 84 ad/rj 32/ 67

S.F. _____ H.F. _____ intellectual disability , developmental disabilities, brain 1 injury, or chronic mental illness, it is the intent of the 2 general assembly that the state shall seek to attain the 3 following quality standards in the provision of the services: 4 Sec. 72. Section 225C.28B, Code 2011, is amended to read as 5 follows: 6 225C.28B Rights of persons with mental retardation an 7 intellectual disability , developmental disabilities, brain 8 injury, or chronic mental illness. 9 All of the following rights shall apply to a person with 10 mental retardation an intellectual disability , a developmental 11 disability, brain injury, or chronic mental illness: 12 1. Wage protection. A person with mental retardation an 13 intellectual disability , a developmental disability, brain 14 injury, or chronic mental illness engaged in work programs 15 shall be paid wages commensurate with the going rate for 16 comparable work and productivity. 17 2. Insurance protection. Pursuant to section 507B.4, 18 subsection 7 , a person or designated group of persons shall not 19 be denied insurance coverage by reason of mental retardation 20 an intellectual disability , a developmental disability, brain 21 injury, or chronic mental illness. 22 3. Due process. A person with mental retardation an 23 intellectual disability , a developmental disability, brain 24 injury, or chronic mental illness retains the right to 25 citizenship in accordance with the laws of the state. 26 4. Participation in planning activities. If an individual 27 treatment, habilitation, and program plan is developed for a 28 person with mental retardation an intellectual disability , 29 a developmental disability, brain injury, or chronic mental 30 illness, the person has the right to participate in the 31 formulation of the plan. 32 Sec. 73. Section 225C.32, Code 2011, is amended to read as 33 follows: 34 225C.32 Plan appeals process. 35 -33- LSB 5146IC (7) 84 ad/rj 33/ 67

S.F. _____ H.F. _____ The department shall establish an appeals process by which a 1 mental health, mental retardation intellectual disability , and 2 developmental disabilities coordinating board or an affected 3 party may appeal a decision of the department or of the 4 coordinating board. 5 Sec. 74. Section 225C.52, subsection 1, Code 2011, is 6 amended to read as follows: 7 1. Establishing a comprehensive community-based mental 8 health services system for children and youth is part of 9 fulfilling the requirements of the division and the commission 10 to facilitate a comprehensive, continuous, and integrated state 11 mental health and disability services plan in accordance with 12 sections 225C.4 , 225C.6 , and 225C.6A , and other provisions 13 of this chapter . The purpose of establishing the children’s 14 system is to improve access for children and youth with 15 serious emotional disturbances and youth with other qualifying 16 mental health disorders to mental health treatment, services, 17 and other support in the least restrictive setting possible 18 so the children and youth can live with their families and 19 remain in their communities. The children’s system is also 20 intended to meet the needs of children and youth who have 21 mental health disorders that co-occur with substance abuse, 22 mental retardation intellectual disability , developmental 23 disabilities, or other disabilities. The children’s system 24 shall emphasize community-level collaborative efforts between 25 children and youth and the families and the state’s systems 26 of education, child welfare, juvenile justice, health care, 27 substance abuse, and mental health. 28 Sec. 75. Section 226.8, Code 2011, is amended to read as 29 follows: 30 226.8 Persons with mental retardation an intellectual 31 disability not receivable —— exception. 32 No A person who is mentally retarded has an intellectual 33 disability , as defined by in section 222.2 4.1 , shall not 34 be admitted, or transferred pursuant to section 222.7 , to a 35 -34- LSB 5146IC (7) 84 ad/rj 34/ 67

S.F. _____ H.F. _____ state mental health institute unless a professional diagnostic 1 evaluation indicates that such person will benefit from 2 psychiatric treatment or from some other specific program 3 available at the mental health institute to which it is 4 proposed to admit or transfer the person. Charges for the 5 care of any person with mental retardation an intellectual 6 disability admitted to a state mental health institute shall 7 be made by the institute in the manner provided by chapter 8 230 , but the liability of any other person to any county for 9 the cost of care of such person with mental retardation an 10 intellectual disability shall be as prescribed by section 11 222.78 . 12 Sec. 76. Section 226.9C, subsection 2, paragraph a, Code 13 Supplement 2011, is amended to read as follows: 14 a. A county may split the charges between the county’s 15 mental health, mental retardation intellectual disability , and 16 developmental disabilities services fund created pursuant to 17 section 331.424A and the county’s budget for substance abuse 18 expenditures. 19 Sec. 77. Section 227.2, subsections 1, 2, and 4, Code 2011, 20 are amended to read as follows: 21 1. The director of inspections and appeals shall make, 22 or cause to be made, at least one licensure inspection each 23 year of every county care facility. Either the administrator 24 of the division or the director of inspections and appeals, 25 in cooperation with each other, upon receipt of a complaint 26 or for good cause, may make, or cause to be made, a review 27 of a county care facility or of any other private or county 28 institution where persons with mental illness or mental 29 retardation an intellectual disability reside. A licensure 30 inspection or a review shall be made by a competent and 31 disinterested person who is acquainted with and interested in 32 the care of persons with mental illness and persons with mental 33 retardation an intellectual disability . The objective of a 34 licensure inspection or a review shall be an evaluation of the 35 -35- LSB 5146IC (7) 84 ad/rj 35/ 67

S.F. _____ H.F. _____ programming and treatment provided by the facility. After each 1 licensure inspection of a county care facility, the person who 2 made the inspection shall consult with the county authorities 3 on plans and practices that will improve the care given 4 patients and shall make recommendations to the administrator of 5 the division and the director of public health for coordinating 6 and improving the relationships between the administrators of 7 county care facilities, the administrator of the division, the 8 director of public health, the superintendents of state mental 9 health institutes and resource centers, community mental health 10 centers, and other cooperating agencies, to cause improved 11 and more satisfactory care of patients. A written report of 12 each licensure inspection of a county care facility under this 13 section shall be filed with the administrator of the division 14 and the director of public health and shall include: 15 a. The capacity of the institution for the care of 16 residents. 17 b. The number, sex, ages, and primary diagnoses of the 18 residents. 19 c. The care of residents, their food, clothing, treatment 20 plan, employment, and opportunity for recreational activities 21 and for productive work intended primarily as therapeutic 22 activity. 23 d. The number, job classification, sex, duties, and salaries 24 of all employees. 25 e. The cost to the state or county of maintaining residents 26 in a county care facility. 27 f. The recommendations given to and received from county 28 authorities on methods and practices that will improve the 29 conditions under which the county care facility is operated. 30 g. Any failure to comply with standards adopted under 31 section 227.4 for care of persons with mental illness and 32 persons with mental retardation an intellectual disability in 33 county care facilities, which is not covered in information 34 submitted pursuant to paragraphs “a” to “f” , and any other 35 -36- LSB 5146IC (7) 84 ad/rj 36/ 67

S.F. _____ H.F. _____ matters which the director of public health, in consultation 1 with the administrator of the division, may require. 2 2. A copy of the written report prescribed by subsection 3 1 shall be furnished to the county board of supervisors, to 4 the county mental health and mental retardation intellectual 5 disability coordinating board or to its advisory board if 6 the county board of supervisors constitutes ex officio the 7 coordinating board, to the administrator of the county care 8 facility inspected and to its resident advocate committee, and 9 to the department on aging. 10 4. In addition to the licensure inspections required or 11 authorized by this section , the administrator of the division 12 shall cause to be made an evaluation of each person cared for 13 in a county care facility at least once each year by one or 14 more qualified mental health, mental retardation intellectual 15 disability , or medical professionals, whichever is appropriate. 16 a. It is the responsibility of the state to secure the 17 annual evaluation for each person who is on convalescent leave 18 or who has not been discharged from a state mental health 19 institute. It is the responsibility of the county to secure 20 the annual evaluation for all other persons with mental illness 21 in the county care facility. 22 b. It is the responsibility of the state to secure the 23 annual evaluation for each person who is on leave and has 24 not been discharged from a state resource center. It is the 25 responsibility of the county to secure the annual evaluation 26 for all other persons with mental retardation an intellectual 27 disability in the county care facility. 28 c. It is the responsibility of the county to secure an 29 annual evaluation of each resident of a county care facility to 30 whom neither paragraph “a” nor paragraph “b” is applicable. 31 Sec. 78. Section 227.4, Code 2011, is amended to read as 32 follows: 33 227.4 Standards for care of persons with mental illness or 34 mental retardation an intellectual disability in county care 35 -37- LSB 5146IC (7) 84 ad/rj 37/ 67

S.F. _____ H.F. _____ facilities. 1 The administrator, in cooperation with the department of 2 inspections and appeals, shall recommend and the mental health 3 and disability services commission created in section 225C.5 4 shall adopt standards for the care of and services to persons 5 with mental illness or mental retardation an intellectual 6 disability residing in county care facilities. The standards 7 shall be enforced by the department of inspections and appeals 8 as a part of the licensure inspection conducted pursuant to 9 chapter 135C . The objective of the standards is to ensure 10 that persons with mental illness or mental retardation an 11 intellectual disability who are residents of county care 12 facilities are not only adequately fed, clothed, and housed, 13 but are also offered reasonable opportunities for productive 14 work and recreational activities suited to their physical and 15 mental abilities and offering both a constructive outlet for 16 their energies and, if possible, therapeutic benefit. When 17 recommending standards under this section , the administrator 18 shall designate an advisory committee representing 19 administrators of county care facilities, county mental health 20 and developmental disabilities regional planning councils, and 21 county care facility resident advocate committees to assist in 22 the establishment of standards. 23 Sec. 79. Section 227.6, Code 2011, is amended to read as 24 follows: 25 227.6 Removal of residents. 26 If a county care facility fails to comply with rules and 27 standards adopted under this chapter , the administrator may 28 remove all persons with mental illness and all persons with 29 mental retardation an intellectual disability cared for in the 30 county care facility at public expense, to the proper state 31 mental health institute or resource center, or to some private 32 or county institution or hospital for the care of persons 33 with mental illness or mental retardation an intellectual 34 disability that has complied with the rules prescribed by the 35 -38- LSB 5146IC (7) 84 ad/rj 38/ 67

S.F. _____ H.F. _____ administrator. Residents being transferred to a state mental 1 health institute or resource center shall be accompanied by an 2 attendant or attendants sent from the institute or resource 3 center. If a resident is transferred under this section , 4 at least one attendant shall be of the same sex. If the 5 administrator finds that the needs of residents with mental 6 illness and residents with mental retardation an intellectual 7 disability of any other county or private institution are not 8 being adequately met, those residents may be removed from that 9 institution upon order of the administrator. 10 Sec. 80. Section 229.1, subsection 9, Code Supplement 2011, 11 is amended to read as follows: 12 9. “Mental illness” means every type of mental disease 13 or mental disorder, except that it does not refer to 14 mental retardation intellectual disability as defined in 15 section 222.2, subsection 5 4.1 , or to insanity, diminished 16 responsibility, or mental incompetency as the terms are defined 17 and used in the Iowa criminal code or in the rules of criminal 18 procedure, Iowa court rules. 19 Sec. 81. Section 229.26, Code 2011, is amended to read as 20 follows: 21 229.26 Exclusive procedure for involuntary hospitalization. 22 Sections 229.6 through 229.19 constitute the exclusive 23 procedure for involuntary hospitalization of persons by reason 24 of serious mental impairment in this state, except that this 25 chapter does not negate the provisions of section 904.503 26 relating to transfer of prisoners with mental illness to state 27 hospitals for persons with mental illness and does not apply 28 to commitments of persons under chapter 812 or the rules of 29 criminal procedure, Iowa court rules, or negate the provisions 30 of section 232.51 relating to disposition of children 31 with mental illness or mental retardation an intellectual 32 disability . 33 Sec. 82. Section 230.33, Code 2011, is amended to read as 34 follows: 35 -39- LSB 5146IC (7) 84 ad/rj 39/ 67

S.F. _____ H.F. _____ 230.33 Reciprocal agreements. 1 The administrator may enter into agreements with other 2 states, through their duly constituted authorities, to effect 3 the reciprocal return of persons with mental illness and 4 persons with mental retardation an intellectual disability 5 to the contracting states, and to effect the reciprocal 6 supervision of persons on convalescent leave. 7 Provided that in the case of a proposed transfer of 8 a person with mental illness or mental retardation an 9 intellectual disability from this state that no final action 10 be taken without the approval either of the commission of 11 hospitalization, or of the district court, of the county of 12 admission or commitment. 13 Sec. 83. Section 231.4, subsection 1, paragraph m, Code 14 Supplement 2011, is amended to read as follows: 15 m. “Resident” means a resident or tenant of a long-term 16 care facility, assisted living program, or elder group home, 17 excluding facilities licensed primarily to serve persons 18 with mental retardation an intellectual disability or mental 19 illness. 20 Sec. 84. Section 231.42, subsection 2, paragraph a, Code 21 2011, is amended to read as follows: 22 a. Establish and implement a statewide confidential 23 uniform reporting system for receiving, analyzing, referring, 24 investigating, and resolving complaints about administrative 25 actions and the health, safety, welfare, and rights of 26 residents or tenants of long-term care facilities, assisted 27 living programs, and elder group homes, excluding facilities 28 licensed primarily to serve persons with mental retardation an 29 intellectual disability or mental illness. 30 Sec. 85. Section 232.51, subsection 2, Code Supplement 31 2011, is amended to read as follows: 32 2. If the evidence received at an adjudicatory or a 33 dispositional hearing indicates that the child is mentally 34 retarded has an intellectual disability , the court may direct 35 -40- LSB 5146IC (7) 84 ad/rj 40/ 67

S.F. _____ H.F. _____ the juvenile court officer or the department to initiate 1 proceedings or to assist the child’s parent or guardian to 2 initiate civil commitment proceedings in the juvenile court and 3 such proceedings shall adhere to the requirements of chapter 4 222 . 5 Sec. 86. Section 232.51, subsection 3, paragraph a, Code 6 Supplement 2011, is amended to read as follows: 7 a. If prior to the adjudicatory or dispositional hearing 8 on the pending delinquency petition, the child is committed 9 as a child with a mental illness or mental retardation an 10 intellectual disability and is ordered into a residential 11 facility, institution, or hospital for inpatient treatment, 12 the delinquency proceeding shall be suspended until such time 13 as the juvenile court either terminates the civil commitment 14 order or the child is released from the residential facility, 15 institution, or hospital for purposes of receiving outpatient 16 treatment. 17 Sec. 87. Section 232.175, Code 2011, is amended to read as 18 follows: 19 232.175 Placement oversight. 20 Placement oversight shall be provided pursuant to this 21 division when the parent, guardian, or custodian of a child 22 with mental retardation an intellectual disability or other 23 developmental disability requests placement of the child 24 in foster family care for a period of more than thirty 25 days. The oversight shall be provided through review of 26 the placement every six months by the department’s foster 27 care review committees or by a local citizen foster care 28 review board. Court oversight shall be provided prior to the 29 initial placement and at periodic intervals which shall not 30 exceed twelve months. It is the purpose and policy of this 31 division to assure the existence of oversight safeguards as 32 required by the federal Child Welfare Act of 1980, Pub. L. No. 33 96-272, as codified in 42 U.S.C. § 671(a)(16), 627(a)(2)(B), 34 and 675(1),(5), while maintaining parental decision-making 35 -41- LSB 5146IC (7) 84 ad/rj 41/ 67

S.F. _____ H.F. _____ authority. 1 Sec. 88. Section 232.178, subsection 4, Code 2011, is 2 amended to read as follows: 3 4. The petition shall describe the child’s emotional, 4 physical, or intellectual disability which requires care and 5 treatment; the reasonable efforts to maintain the child in 6 the child’s home; the department’s request to the family of 7 a child with mental retardation an intellectual disability , 8 other developmental disability, or organic mental illness to 9 determine if any services or support provided to the family 10 will enable the family to continue to care for the child in the 11 child’s home; and the reason the child’s parent, guardian, or 12 custodian has requested a foster family care placement. The 13 petition shall also describe the commitment of the parent, 14 guardian, or custodian in fulfilling the responsibilities 15 defined in the case permanency plan and how the placement will 16 serve the child’s best interests. 17 Sec. 89. Section 232.182, subsection 5, paragraph a, 18 subparagraph (4), Code 2011, is amended to read as follows: 19 (4) A determination that services or support provided to 20 the family of a child with mental retardation an intellectual 21 disability , other developmental disability, or organic mental 22 illness will not enable the family to continue to care for the 23 child in the child’s home. 24 Sec. 90. Section 233A.14, Code 2011, is amended to read as 25 follows: 26 233A.14 Transfers to other institutions. 27 The administrator may transfer to the schools minor wards of 28 the state from any institution under the administrator’s charge 29 but no person shall be so transferred who is mentally ill or 30 mentally retarded has an intellectual disability . Any child 31 in the schools who is mentally ill or mentally retarded has an 32 intellectual disability may be transferred by the administrator 33 to the proper state institution. 34 Sec. 91. Section 233B.5, Code 2011, is amended to read as 35 -42- LSB 5146IC (7) 84 ad/rj 42/ 67

S.F. _____ H.F. _____ follows: 1 233B.5 Transfers. 2 The administrator may transfer to the home minor wards of the 3 state from any institution under the administrator’s charge or 4 under the charge of any other administrator of the department 5 of human services; but no person shall be so transferred who 6 is a person with mental illness or mental retardation an 7 intellectual disability , or who is incorrigible, or has any 8 vicious habits, or whose presence in the home would be inimical 9 to the moral or physical welfare of the other children within 10 the home, and any such child in the home may be transferred to 11 the proper state institution. 12 Sec. 92. Section 234.6, subsection 6, paragraph f, Code 13 2011, is amended to read as follows: 14 f. Services or support provided to a child with mental 15 retardation an intellectual disability or other developmental 16 disability or to the child’s family. 17 Sec. 93. Section 235.1, subsection 3, Code 2011, is amended 18 to read as follows: 19 3. “Child welfare services” means social welfare services 20 for the protection and care of children who are homeless, 21 dependent or neglected, or in danger of becoming delinquent, or 22 who have a mental illness or mental retardation an intellectual 23 disability or other developmental disability, including, when 24 necessary, care and maintenance in a foster care facility. 25 Child welfare services are designed to serve a child in the 26 child’s home whenever possible. If not possible, and the child 27 is placed outside the child’s home, the placement should be in 28 the least restrictive setting available and in close proximity 29 to the child’s home. 30 Sec. 94. Section 235A.15, subsection 2, paragraph c, 31 subparagraph (9), Code Supplement 2011, is amended to read as 32 follows: 33 (9) To the administrator of an agency providing mental 34 health, mental retardation intellectual disability , or 35 -43- LSB 5146IC (7) 84 ad/rj 43/ 67

S.F. _____ H.F. _____ developmental disability services under a county management 1 plan developed pursuant to section 331.439 , if the data 2 concerns a person employed by or being considered by the agency 3 for employment. 4 Sec. 95. Section 235B.6, subsection 2, paragraph c, 5 subparagraph (6), Code Supplement 2011, is amended to read as 6 follows: 7 (6) To the administrator of an agency providing mental 8 health, mental retardation intellectual disability , or 9 developmental disability services under a county management 10 plan developed pursuant to section 331.439 , if the information 11 concerns a person employed by or being considered by the agency 12 for employment. 13 Sec. 96. Section 249A.2, subsection 4, Code 2011, is amended 14 to read as follows: 15 4. “Discretionary medical assistance” means medical 16 assistance or additional medical assistance provided to 17 individuals whose income and resources are in excess of 18 eligibility limitations but are insufficient to meet all of the 19 costs of necessary medical care and services, provided that if 20 the assistance includes services in institutions for mental 21 diseases or intermediate care facilities for persons with 22 mental retardation an intellectual disability , or both, for any 23 group of such individuals, the assistance also includes for 24 all covered groups of such individuals at least the care and 25 services enumerated in Tit. XIX of the federal Social Security 26 Act, section 1905(a), paragraphs (1) through (5), and (17), 27 as codified in 42 U.S.C. § 1396d(a), pars. (1) through (5), 28 and (17), or any seven of the care and services enumerated in 29 Tit. XIX of the federal Social Security Act, section 1905(a), 30 paragraphs (1) through (7) and (9) through (18), as codified in 31 42 U.S.C. § 1396d(a), pars. (1) through (7), and (9) through 32 (18). 33 Sec. 97. Section 249A.5, subsection 2, unnumbered paragraph 34 1, Code 2011, is amended to read as follows: 35 -44- LSB 5146IC (7) 84 ad/rj 44/ 67

S.F. _____ H.F. _____ The provision of medical assistance to an individual who 1 is fifty-five years of age or older, or who is a resident of 2 a nursing facility, intermediate care facility for persons 3 with mental retardation an intellectual disability , or mental 4 health institute, who cannot reasonably be expected to be 5 discharged and return to the individual’s home, creates a 6 debt due the department from the individual’s estate for all 7 medical assistance provided on the individual’s behalf, upon 8 the individual’s death. 9 Sec. 98. Section 249A.5, subsection 2, paragraph f, 10 subparagraph (1), Code 2011, is amended to read as follows: 11 (1) If a debt is due under this subsection from the estate 12 of a recipient, the administrator of the nursing facility, 13 intermediate care facility for persons with mental retardation 14 an intellectual disability , or mental health institute in which 15 the recipient resided at the time of the recipient’s death, and 16 the personal representative of the recipient, if applicable, 17 shall report the death to the department within ten days of the 18 death of the recipient. 19 Sec. 99. Section 249A.12, subsection 1, Code 2011, is 20 amended to read as follows: 21 1. Assistance may be furnished under this chapter to an 22 otherwise eligible recipient who is a resident of a health 23 care facility licensed under chapter 135C and certified as an 24 intermediate care facility for persons with mental retardation 25 an intellectual disability . 26 Sec. 100. Section 249A.12, subsection 4, paragraphs a and c, 27 Code 2011, are amended to read as follows: 28 a. Effective July 1, 1995, the state shall be responsible 29 for all of the nonfederal share of the costs of intermediate 30 care facility for persons with mental retardation an 31 intellectual disability services provided under medical 32 assistance to minors. Notwithstanding subsection 2 and 33 contrary provisions of section 222.73 , effective July 1, 1995, 34 a county is not required to reimburse the department and shall 35 -45- LSB 5146IC (7) 84 ad/rj 45/ 67

S.F. _____ H.F. _____ not be billed for the nonfederal share of the costs of such 1 services provided to minors. 2 c. Effective February 1, 2002, the state shall be 3 responsible for all of the nonfederal share of the costs of 4 intermediate care facility for persons with mental retardation 5 an intellectual disability services provided under medical 6 assistance attributable to the assessment fee for intermediate 7 care facilities for individuals with mental retardation an 8 intellectual disability imposed pursuant to section 249A.21 . 9 Notwithstanding subsection 2 , effective February 1, 2003, a 10 county is not required to reimburse the department and shall 11 not be billed for the nonfederal share of the costs of such 12 services attributable to the assessment fee. 13 Sec. 101. Section 249A.12, subsection 5, Code 2011, is 14 amended to read as follows: 15 5. a. The mental health and disability services commission 16 shall recommend to the department the actions necessary to 17 assist in the transition of individuals being served in an 18 intermediate care facility for persons with mental retardation 19 an intellectual disability , who are appropriate for the 20 transition, to services funded under a medical assistance 21 home and community-based services waiver for persons with 22 intellectual disabilities in a manner which maximizes the use 23 of existing public and private facilities. The actions may 24 include but are not limited to submitting any of the following 25 or a combination of any of the following as a request for a 26 revision of the medical assistance home and community-based 27 services waiver for persons with intellectual disabilities: 28 (1) Allow for the transition of intermediate care 29 facilities for persons with mental retardation an intellectual 30 disability licensed under chapter 135C , to services funded 31 under the medical assistance home and community-based services 32 waiver for persons with intellectual disabilities. The request 33 shall be for inclusion of additional persons under the waiver 34 associated with the transition. 35 -46- LSB 5146IC (7) 84 ad/rj 46/ 67

S.F. _____ H.F. _____ (2) Allow for reimbursement under the waiver for day program 1 or other service costs. 2 (3) Allow for exception provisions in which an intermediate 3 care facility for persons with mental retardation an 4 intellectual disability which does not meet size and other 5 facility-related requirements under the waiver in effect on 6 June 30, 1996, may convert to a waiver service for a set period 7 of time such as five years. Following the set period of time, 8 the facility would be subject to the waiver requirements 9 applicable to services which were not operating under the 10 exception provisions. 11 b. In implementing the provisions of this subsection , the 12 mental health and disability services commission shall consult 13 with other states. The waiver revision request or other action 14 necessary to assist in the transition of service provision 15 from intermediate care facilities for persons with mental 16 retardation an intellectual disability to alternative programs 17 shall be implemented by the department in a manner that can 18 appropriately meet the needs of individuals at an overall 19 lower cost to counties, the federal government, and the state. 20 In addition, the department shall take into consideration 21 significant federal changes to the medical assistance program 22 in formulating the department’s actions under this subsection . 23 The department shall consult with the mental health and 24 disability services commission in adopting rules for oversight 25 of facilities converted pursuant to this subsection . A 26 transition approach described in paragraph “a” may be modified 27 as necessary to obtain federal waiver approval. 28 Sec. 102. Section 249A.12, subsection 6, paragraphs a and d, 29 Code 2011, are amended to read as follows: 30 a. The provisions of the home and community-based services 31 waiver for persons with an intellectual disabilities disability 32 shall include adult day care, prevocational, and transportation 33 services. Transportation shall be included as a separately 34 payable service. 35 -47- LSB 5146IC (7) 84 ad/rj 47/ 67

S.F. _____ H.F. _____ d. The county of legal settlement shall pay for one hundred 1 percent of the nonfederal share of the costs of care provided 2 for adults which is reimbursed under a home and community-based 3 services waiver that would otherwise be approved for provision 4 in an intermediate care facility for persons with mental 5 retardation an intellectual disability provided under the 6 medical assistance program. 7 Sec. 103. Section 249A.12, subsections 7 and 8, Code 2011, 8 are amended to read as follows: 9 7. When paying the necessary and legal expenses for 10 intermediate care facility for persons with mental retardation 11 an intellectual disability services, the cost requirements of 12 section 222.60 shall be considered fulfilled when payment is 13 made in accordance with the medical assistance payment rates 14 established by the department for intermediate care facilities 15 for persons with mental retardation an intellectual disability , 16 and the state or a county of legal settlement shall not be 17 obligated for any amount in excess of the rates. 18 8. If a person with mental retardation an intellectual 19 disability has no legal settlement or the legal settlement is 20 unknown so that the person is deemed to be a state case and 21 services associated with the mental retardation intellectual 22 disability can be covered under a medical assistance home and 23 community-based services waiver or other medical assistance 24 program provision, the nonfederal share of the medical 25 assistance program costs for such coverage shall be paid from 26 the appropriation made for the medical assistance program. 27 Sec. 104. Section 249A.21, subsections 1 and 6, Code 2011, 28 are amended to read as follows: 29 1. The department may assess intermediate care facilities 30 for persons with mental retardation an intellectual disability , 31 as defined in section 135C.1 , a fee in an amount not to exceed 32 six percent of the total annual revenue of the facility for the 33 preceding fiscal year. 34 6. The department may adopt administrative rules under 35 -48- LSB 5146IC (7) 84 ad/rj 48/ 67

S.F. _____ H.F. _____ section 17A.4, subsection 3 , and section 17A.5, subsection 2 , 1 paragraph “b” , to implement this section , and any fee assessed 2 pursuant to this section against an intermediate care facility 3 for persons with mental retardation an intellectual disability 4 that is operated by the state may be made retroactive to 5 October 1, 2003. 6 Sec. 105. Section 249A.26, subsection 2, paragraph a, Code 7 2011, is amended to read as follows: 8 a. Except as provided for disallowed costs in section 9 249A.27 , the county of legal settlement shall pay for fifty 10 percent of the nonfederal share of the cost and the state 11 shall have responsibility for the remaining fifty percent of 12 the nonfederal share of the cost of case management provided 13 to adults, day treatment, and partial hospitalization provided 14 under the medical assistance program for persons with mental 15 retardation an intellectual disability , a developmental 16 disability, or chronic mental illness. For purposes of 17 this section , persons with mental disorders resulting from 18 Alzheimer’s disease or substance abuse shall not be considered 19 chronically mentally ill. To the maximum extent allowed under 20 federal law and regulations, the department shall consult with 21 and inform a county of legal settlement’s central point of 22 coordination process, as defined in section 331.440 , regarding 23 the necessity for and the provision of any service for which 24 the county is required to provide reimbursement under this 25 subsection . 26 Sec. 106. Section 249A.26, subsections 3, 7, and 9, Code 27 2011, are amended to read as follows: 28 3. To the maximum extent allowed under federal law and 29 regulations, a person with mental illness or mental retardation 30 an intellectual disability shall not be eligible for any 31 service which is funded in whole or in part by a county share of 32 the nonfederal portion of medical assistance funds unless the 33 person is referred through the central point of coordination 34 process, as defined in section 331.440 . However, to the 35 -49- LSB 5146IC (7) 84 ad/rj 49/ 67

S.F. _____ H.F. _____ extent federal law allows referral of a medical assistance 1 recipient to a service without approval of the central point of 2 coordination process, the county of legal settlement shall be 3 billed for the nonfederal share of costs for any adult person 4 for whom the county would otherwise be responsible. 5 7. Unless a county has paid or is paying for the nonfederal 6 share of the costs of a person’s home and community-based 7 waiver services or placement in an intermediate care 8 facility for persons with mental retardation an intellectual 9 disability under the county’s mental health, mental retardation 10 intellectual disability , and developmental disabilities 11 services fund, or unless a county of legal settlement would 12 become liable for the costs of services for a person at the 13 level of care provided in an intermediate care facility for 14 persons with mental retardation an intellectual disability due 15 to the person reaching the age of majority, the state shall pay 16 for the nonfederal share of the costs of an eligible person’s 17 services under the home and community-based services waiver for 18 persons with brain injury. 19 9. Notwithstanding section 8.39 , the department may 20 transfer funds appropriated for the medical assistance program 21 to a separate account established in the department’s case 22 management unit in an amount necessary to pay for expenditures 23 required to provide case management for mental health, 24 mental retardation intellectual disability , and developmental 25 disabilities services under the medical assistance program 26 which are jointly funded by the state and county, pending final 27 settlement of the expenditures. Funds received by the case 28 management unit in settlement of the expenditures shall be used 29 to replace the transferred funds and are available for the 30 purposes for which the funds were originally appropriated. 31 Sec. 107. Section 249A.30A, Code Supplement 2011, is 32 amended to read as follows: 33 249A.30A Medical assistance —— personal needs allowance. 34 The personal needs allowance under the medical assistance 35 -50- LSB 5146IC (7) 84 ad/rj 50/ 67

S.F. _____ H.F. _____ program, which may be retained by a person who is a resident of 1 a nursing facility, an intermediate care facility for persons 2 with mental retardation an intellectual disability , or an 3 intermediate care facility for persons with mental illness, as 4 defined in section 135C.1 , or a person who is a resident of 5 a psychiatric medical institution for children as defined in 6 section 135H.1 , shall be fifty dollars per month. A resident 7 who has income of less than fifty dollars per month shall 8 receive a supplement from the state in the amount necessary to 9 receive a personal needs allowance of fifty dollars per month, 10 if funding is specifically appropriated for this purpose. 11 Sec. 108. Section 249A.31, subsection 1, Code 2011, is 12 amended to read as follows: 13 1. Providers of individual case management services for 14 persons with mental retardation an intellectual disability , 15 a developmental disability, or chronic mental illness shall 16 receive cost-based reimbursement for one hundred percent of 17 the reasonable costs for the provision of the services in 18 accordance with standards adopted by the mental health and 19 disability services commission pursuant to section 225C.6 . 20 Sec. 109. Section 252.16, subsection 6, paragraph c, Code 21 2011, is amended to read as follows: 22 c. A blind person who is an inpatient or resident of, is 23 supported by, or is receiving treatment or support services 24 from a state resource center created under chapter 222 , a 25 state mental health institute created under chapter 226 , the 26 Iowa braille and sight saving school administered by the state 27 board of regents, or any community-based provider of treatment 28 or services for mental retardation intellectual disability , 29 developmental disabilities, mental health, or substance abuse, 30 does not acquire legal settlement in the county in which the 31 institution, facility, or provider is located, unless the blind 32 person has resided in the county in which the institution, 33 facility, or provider is located for a period of six months 34 prior to the date of commencement of receipt of assistance 35 -51- LSB 5146IC (7) 84 ad/rj 51/ 67

S.F. _____ H.F. _____ under the laws of this state or for a period of six months 1 subsequent to the date of termination of assistance under the 2 laws of this state. 3 Sec. 110. Section 252.16, subsection 8, Code 2011, is 4 amended to read as follows: 5 8. A person receiving treatment or support services from 6 any provider, whether organized for pecuniary profit or not or 7 whether supported by charitable or public or private funds, 8 that provides treatment or services for mental retardation 9 intellectual disability , developmental disabilities, mental 10 health, brain injury, or substance abuse does not acquire legal 11 settlement in a county unless the person continuously resides 12 in that county for one year from the date of the last treatment 13 or support service received by the person. 14 Sec. 111. Section 262.70, Code 2011, is amended to read as 15 follows: 16 262.70 Education, prevention, and research programs in mental 17 health and disability services. 18 The division of mental health and disability services of 19 the department of human services may contract with the board 20 of regents or any institution under the board’s jurisdiction 21 to establish and maintain programs of education, prevention, 22 and research in the fields of mental health, mental retardation 23 intellectual disability , developmental disabilities, and 24 brain injury. The board may delegate responsibility for these 25 programs to the state psychiatric hospital, the university 26 hospital, or any other appropriate entity under the board’s 27 jurisdiction. 28 Sec. 112. Section 263.11, subsection 2, Code 2011, is 29 amended to read as follows: 30 2. Persons who are not eligible for admission to the schools 31 already established for persons with mental retardation an 32 intellectual disability or epilepsy or persons who are deaf or 33 blind. 34 Sec. 113. Section 331.381, subsection 4, Code 2011, is 35 -52- LSB 5146IC (7) 84 ad/rj 52/ 67

S.F. _____ H.F. _____ amended to read as follows: 1 4. Comply with chapter 222 , including but not limited to 2 sections 222.13 , 222.14 , and 222.59 to 222.82 , in regard to 3 the care of persons with mental retardation an intellectual 4 disability . 5 Sec. 114. Section 331.424A, subsections 1, 2, and 5, Code 6 Supplement 2011, are amended to read as follows: 7 1. For the purposes of this chapter , unless the context 8 otherwise requires, “services fund” means the county mental 9 health, mental retardation intellectual disability , and 10 developmental disabilities services fund created in subsection 11 2 . The county finance committee created in section 333A.2 12 shall consult with the state commission in adopting rules and 13 prescribing forms for administering the services fund. 14 2. For the fiscal year beginning July 1, 1996, and 15 succeeding fiscal years, county revenues from taxes and other 16 sources designated for mental health, mental retardation 17 intellectual disability , and developmental disabilities 18 services shall be credited to the mental health, mental 19 retardation intellectual disability , and developmental 20 disabilities services fund of the county. The board shall make 21 appropriations from the fund for payment of services provided 22 under the county management plan approved pursuant to section 23 331.439 . The county may pay for the services in cooperation 24 with other counties by pooling appropriations from the fund 25 with other counties or through county regional entities 26 including but not limited to the county’s mental health and 27 developmental disabilities regional planning council created 28 pursuant to section 225C.18 . 29 5. Appropriations specifically authorized to be made from 30 the mental health, mental retardation intellectual disability , 31 and developmental disabilities services fund shall not be made 32 from any other fund of the county. 33 Sec. 115. Section 331.432, subsection 3, Code Supplement 34 2011, is amended to read as follows: 35 -53- LSB 5146IC (7) 84 ad/rj 53/ 67

S.F. _____ H.F. _____ 3. Except as authorized in section 331.477 , transfers of 1 moneys between the county mental health, mental retardation 2 intellectual disability , and developmental disabilities 3 services fund and any other fund are prohibited. 4 Sec. 116. Section 331.438, subsection 1, paragraphs a and b, 5 Code Supplement 2011, are amended to read as follows: 6 a. “Base year expenditures” means the amount selected by a 7 county and reported to the county finance committee pursuant 8 to this paragraph. The amount selected shall be equal to the 9 amount of net expenditures made by the county for qualified 10 mental health, mental retardation intellectual disability , and 11 developmental disabilities services provided in one of the 12 following: 13 (1) The actual amount reported to the state on October 15, 14 1994, for the fiscal year beginning July 1, 1993. 15 (2) The net expenditure amount contained in the county’s 16 final budget certified in accordance with chapter 24 for the 17 fiscal year beginning July 1, 1995, and reported to the county 18 finance committee. 19 b. “Qualified mental health, mental retardation intellectual 20 disability , and developmental disabilities services” means the 21 services specified in the rules adopted by the state commission 22 for administering the services fund, pursuant to section 23 331.424A . 24 Sec. 117. Section 331.438, subsection 4, paragraph a, Code 25 Supplement 2011, is amended to read as follows: 26 a. The state commission shall make recommendations and take 27 actions for joint state and county planning, implementing, 28 and funding of mental health, mental retardation intellectual 29 disability or other developmental disabilities, and brain 30 injury services, including but not limited to developing and 31 implementing fiscal and accountability controls, establishing 32 management plans, and ensuring that eligible persons have 33 access to appropriate and cost-effective services. 34 Sec. 118. Section 331.438, subsection 4, paragraph b, 35 -54- LSB 5146IC (7) 84 ad/rj 54/ 67

S.F. _____ H.F. _____ subparagraph (6), Code Supplement 2011, is amended to read as 1 follows: 2 (6) Consider recommendations for measuring and improving 3 the quality of state and county mental health, mental 4 retardation intellectual disability , and developmental 5 disabilities services and other support. 6 Sec. 119. Section 331.439, subsection 1, paragraphs a, b, 7 and f, Code Supplement 2011, are amended to read as follows: 8 a. The county accurately reported by December 1 the county’s 9 expenditures for mental health, mental retardation intellectual 10 disability , and developmental disabilities services and the 11 information required under section 225C.6A, subsection 3 , 12 paragraph “c” , for the previous fiscal year in accordance with 13 rules adopted by the state commission. If the department 14 determines good cause exists, the department may extend a 15 deadline otherwise imposed under this chapter , chapter 225C , or 16 chapter 426B for a county’s reporting concerning mental health, 17 mental retardation intellectual disability , or developmental 18 disabilities services or related revenues and expenditures. 19 b. The county developed and implemented a county management 20 plan for the county’s mental health, mental retardation 21 intellectual disability , and developmental disabilities 22 services system in accordance with the provisions of this 23 paragraph “b” . The plan shall comply with the administrative 24 rules adopted for this purpose by the state commission and is 25 subject to the approval of the director of human services in 26 consultation with the state commission. The plan shall include 27 a description of the county’s service management provision for 28 mental health, mental retardation intellectual disability , and 29 developmental disabilities services. For mental retardation 30 intellectual disability and developmental disabilities service 31 management, the plan shall describe the county’s development 32 and implementation of a system of cost-effective individualized 33 services and shall comply with the provisions of paragraph 34 “f” . The goal of this part of the plan shall be to assist 35 -55- LSB 5146IC (7) 84 ad/rj 55/ 67

S.F. _____ H.F. _____ the individuals served to be as independent, productive, 1 and integrated into the community as possible. The service 2 management provisions for mental health shall comply with the 3 provisions of paragraph “e” . A county is subject to all of the 4 following provisions in regard to the county’s services system 5 management plan and planning process: 6 (1) The county shall have in effect an approved policies and 7 procedures manual for the county’s services fund. The county 8 management plan shall be defined in the manual. The manual 9 submitted by the county as part of the county’s management plan 10 for the fiscal year beginning July 1, 2000, as approved by the 11 director of human services, shall remain in effect, subject to 12 amendment. An amendment to the manual shall be submitted to 13 the department of human services at least forty-five days prior 14 to the date of implementation. Prior to implementation of any 15 amendment to the manual, the amendment must be approved by 16 the director of human services in consultation with the state 17 commission. 18 (2) For informational purposes, the county shall submit a 19 management plan review to the department of human services by 20 December 1 of each year. The annual review shall incorporate 21 an analysis of the data associated with the services system 22 managed during the preceding fiscal year by the county or by 23 a private entity on behalf of the county. The annual review 24 shall also identify measurable outcomes and results showing 25 the county’s progress in fulfilling the purposes listed 26 in paragraph “c” , and in achieving the disability services 27 outcomes and indicators identified by the commission pursuant 28 to section 225C.6 . 29 (3) For informational purposes, every three years the 30 county shall submit to the department of human services 31 a three-year strategic plan. The strategic plan shall 32 describe how the county will proceed to attain the plan’s 33 goals and objectives, and the measurable outcomes and results 34 necessary for moving the county’s services system toward 35 -56- LSB 5146IC (7) 84 ad/rj 56/ 67

S.F. _____ H.F. _____ an individualized, community-based focus in accordance 1 with paragraph “c” . The three-year strategic plan shall be 2 submitted by April 1, 2000, and by April 1 of every third year 3 thereafter. 4 f. For mental retardation intellectual disability and 5 developmental disabilities services management, the county must 6 either develop and implement a system of care which addresses a 7 full array of appropriate services and cost-effective delivery 8 of services by contracting directly with service providers 9 or by contracting with a state-approved private entity to 10 manage the county services system. The county services system 11 shall incorporate a central point of coordination and clinical 12 assessment process developed in accordance with the provisions 13 of section 331.440 . The elements of a county services system 14 shall be specified in rules developed by the department of 15 human services in consultation with and adopted by the state 16 commission. 17 Sec. 120. Section 331.439, subsection 3, paragraph a, Code 18 Supplement 2011, is amended to read as follows: 19 a. For the fiscal year beginning July 1, 1996, and 20 succeeding fiscal years, the county’s mental health, mental 21 retardation intellectual disability , and developmental 22 disabilities service expenditures for a fiscal year are limited 23 to a fixed budget amount. The fixed budget amount shall be 24 the amount identified in the county’s management plan and 25 budget for the fiscal year. The county shall be authorized an 26 allowed growth factor adjustment as established by statute for 27 services paid from the county’s services fund under section 28 331.424A which is in accordance with the county’s management 29 plan and budget, implemented pursuant to this section . The 30 statute establishing the allowed growth factor adjustment shall 31 establish the adjustment for the fiscal year which commences 32 two years from the beginning date of the fiscal year in 33 progress at the time the statute is enacted. 34 Sec. 121. Section 331.439, subsection 6, Code Supplement 35 -57- LSB 5146IC (7) 84 ad/rj 57/ 67

S.F. _____ H.F. _____ 2011, is amended to read as follows: 1 6. The director’s approval of a county’s mental health, 2 mental retardation intellectual disability , and developmental 3 disabilities services management plan shall not be construed to 4 constitute certification of the county’s budget. 5 Sec. 122. Section 331.440, subsection 1, paragraphs a and b, 6 Code Supplement 2011, are amended to read as follows: 7 a. For the purposes of this section , unless the context 8 otherwise requires, “central point of coordination process” 9 means a central point of coordination process established 10 by a county or consortium of counties for the delivery of 11 mental health, mental retardation intellectual disability , and 12 developmental disabilities services which are paid for in whole 13 or in part by county funds. The central point of coordination 14 process may include but is not limited to reviewing a person’s 15 eligibility for services, determining the appropriateness of 16 the type, level, and duration of services, and performing 17 periodic review of the person’s continuing eligibility and 18 need for services. Any recommendations developed concerning 19 a person’s plan of services shall be consistent with the 20 person’s unique strengths, circumstances, priorities, concerns, 21 abilities, and capabilities. For those services funded 22 under the medical assistance program, the central point of 23 coordination process shall be used to assure that the person 24 is aware of the appropriate service options available to the 25 person. 26 b. The central point of coordination process may include 27 a clinical assessment process to identify a person’s service 28 needs and to make recommendations regarding the person’s plan 29 for services. The clinical assessment process shall utilize 30 qualified mental health professionals and qualified mental 31 retardation intellectual disability professionals. 32 Sec. 123. Section 331.440, subsection 2, paragraph d, Code 33 Supplement 2011, is amended to read as follows: 34 d. “State case services and other support” means the mental 35 -58- LSB 5146IC (7) 84 ad/rj 58/ 67

S.F. _____ H.F. _____ health, mental retardation intellectual disability , and 1 developmental disabilities services and other support paid for 2 under the rules and requirements in effect prior to October 1, 3 2006, from the annual appropriation made to the department of 4 human services for such services and other support provided 5 to persons who have no established county of legal settlement 6 or the legal settlement is unknown so that the person is 7 deemed to be a state case. Such services and other support do 8 not include medical assistance program services or services 9 provided in a state institution. 10 Sec. 124. Section 331.502, subsection 11, Code 2011, is 11 amended to read as follows: 12 11. Carry out duties relating to the determination of legal 13 settlement, collection of funds due the county, and support of 14 persons with mental retardation an intellectual disability as 15 provided in sections 222.13 , 222.50 , 222.61 to 222.66 , 222.69 , 16 and 222.74 . 17 Sec. 125. Section 331.756, subsections 42 and 43, Code 18 Supplement 2011, are amended to read as follows: 19 42. Carry out duties relating to the commitment of a person 20 with mental retardation an intellectual disability as provided 21 in section 222.18 . 22 43. Proceed to collect, as requested by the county, 23 the reasonable costs for the care, treatment, training, 24 instruction, and support of a person with mental retardation 25 an intellectual disability from parents or other persons who 26 are legally liable for the support of the person with mental 27 retardation an intellectual disability as provided in section 28 222.82 . 29 Sec. 126. Section 335.25, subsection 2, paragraph b, 30 subparagraphs (1) and (2), Code 2011, are amended to read as 31 follows: 32 (1) Attributable to mental retardation an intellectual 33 disability , cerebral palsy, epilepsy, or autism. 34 (2) Attributable to any other condition found to be closely 35 -59- LSB 5146IC (7) 84 ad/rj 59/ 67

S.F. _____ H.F. _____ related to mental retardation an intellectual disability 1 because the condition results in impairment of general 2 intellectual functioning or adaptive behavior similar to that 3 of persons with mental retardation an intellectual disability 4 or requires treatment and services similar to those required 5 for the persons. 6 Sec. 127. Section 347.9A, subsection 3, Code 2011, is 7 amended to read as follows: 8 3. This section does not prohibit a licensed health 9 care practitioner from serving as a hospital trustee if the 10 practitioner’s sole use of the county hospital is to provide 11 health care service to an individual with mental retardation an 12 intellectual disability as defined in section 222.2 4.1 . 13 Sec. 128. Section 414.22, subsection 2, paragraph b, 14 subparagraphs (1) and (2), Code 2011, are amended to read as 15 follows: 16 (1) Attributable to mental retardation an intellectual 17 disability , cerebral palsy, epilepsy, or autism. 18 (2) Attributable to any other condition found to be closely 19 related to mental retardation an intellectual disability 20 because the condition results in impairment of general 21 intellectual functioning or adaptive behavior similar to that 22 of persons with mental retardation an intellectual disability 23 or requires treatment and services similar to those required 24 for the persons. 25 Sec. 129. Section 422.7, subsection 12, paragraph c, 26 subparagraph (1), Code Supplement 2011, is amended to read as 27 follows: 28 (1) “Physical or mental impairment” means any physiological 29 disorder or condition, cosmetic disfigurement, or anatomical 30 loss affecting one or more of the body systems or any mental 31 or psychological disorder, including mental retardation 32 intellectual disability , organic brain syndrome, emotional or 33 mental illness and specific learning disabilities. 34 Sec. 130. Section 422.35, subsection 6, paragraph c, 35 -60- LSB 5146IC (7) 84 ad/rj 60/ 67

S.F. _____ H.F. _____ subparagraph (1), Code Supplement 2011, is amended to read as 1 follows: 2 (1) “Physical or mental impairment” means any physiological 3 disorder or condition, cosmetic disfigurement, or anatomical 4 loss affecting one or more of the body systems or any mental 5 or psychological disorder, including mental retardation 6 intellectual disability , organic brain syndrome, emotional or 7 mental illness, and specific learning disabilities. 8 Sec. 131. Section 423.3, subsection 18, paragraphs a and c, 9 Code Supplement 2011, are amended to read as follows: 10 a. Residential care facilities and intermediate care 11 facilities for persons with mental retardation an intellectual 12 disability and residential care facilities for persons with 13 mental illness licensed by the department of inspections and 14 appeals under chapter 135C . 15 c. Rehabilitation facilities that provide accredited 16 rehabilitation services to persons with disabilities which are 17 accredited by the commission on accreditation of rehabilitation 18 facilities or the accreditation council for services for 19 persons with mental retardation an intellectual disability 20 and other persons with developmental disabilities and adult 21 day care services approved for reimbursement by the state 22 department of human services. 23 Sec. 132. Section 426B.2, subsection 3, paragraph b, Code 24 2011, is amended to read as follows: 25 b. Any replacement generation tax in the property tax relief 26 fund as of May 1 shall be paid to the county treasurers in July 27 and January of the fiscal year beginning the following July 1. 28 The department of management shall determine the amount each 29 county will be paid pursuant to this lettered paragraph for 30 the following fiscal year. The department shall reduce by the 31 determined amount the amount of each county’s certified budget 32 to be raised by property tax for that fiscal year which is to 33 be expended for mental health, mental retardation intellectual 34 disability , and developmental disabilities services and 35 -61- LSB 5146IC (7) 84 ad/rj 61/ 67

S.F. _____ H.F. _____ shall revise the rate of taxation as necessary to raise the 1 reduced amount. The department of management shall report 2 the reduction in the certified budget and the revised rate of 3 taxation to the county auditors by June 15. 4 Sec. 133. Section 426B.3, subsection 1, Code 2011, is 5 amended to read as follows: 6 1. The county auditor shall reduce the certified budget 7 amount received from the board of supervisors for the 8 succeeding fiscal year for the county mental health, mental 9 retardation intellectual disability , and developmental 10 disabilities services fund created in section 331.424A by an 11 amount equal to the amount the county will receive from the 12 property tax relief fund pursuant to section 426B.2 , for the 13 succeeding fiscal year and the auditor shall determine the rate 14 of taxation necessary to raise the reduced amount. On the tax 15 list, the county auditor shall compute the amount of taxes due 16 and payable on each parcel before and after the amount received 17 from the property tax relief fund is used to reduce the county 18 budget. The director of human services shall notify the county 19 auditor of each county of the amount of moneys the county will 20 receive from the property tax relief fund pursuant to section 21 426B.2 , for the succeeding fiscal year. 22 Sec. 134. Section 426B.5, subsection 1, paragraph d, 23 subparagraph (1), subparagraph divisions (a) and (b), Code 24 Supplement 2011, are amended to read as follows: 25 (a) The county is levying the maximum amount allowed for 26 the county’s mental health, mental retardation intellectual 27 disability , and developmental disabilities services fund under 28 section 331.424A for the fiscal year in which the funding is 29 distributed. 30 (b) In the latest fiscal year reported in accordance with 31 section 331.403 , the county’s mental health, mental retardation 32 intellectual disability , and developmental disabilities 33 services fund ending balance under generally accepted 34 accounting principles was equal to or less than twenty-five 35 -62- LSB 5146IC (7) 84 ad/rj 62/ 67

S.F. _____ H.F. _____ percent of the county’s actual gross expenditures for that 1 fiscal year. 2 Sec. 135. Section 426B.5, subsection 2, paragraph a, Code 3 Supplement 2011, is amended to read as follows: 4 a. For the purposes of this subsection , unless the context 5 otherwise requires, “services fund” means a county’s mental 6 health, mental retardation intellectual disability , and 7 developmental disabilities services fund created in section 8 331.424A . 9 Sec. 136. Section 514E.7, subsection 2, paragraph a, 10 subparagraph (1), Code 2011, is amended to read as follows: 11 (1) Incapable of self-sustaining employment by reason 12 of mental retardation an intellectual disability or physical 13 disability. 14 Sec. 137. Section 602.8102, subsections 36 and 37, Code 15 2011, are amended to read as follows: 16 36. Carry out duties relating to the commitment of a person 17 with mental retardation an intellectual disability as provided 18 in sections 222.37 through 222.40 . 19 37. Keep a separate docket of proceedings of cases relating 20 to persons with mental retardation an intellectual disability 21 as provided in section 222.57 . 22 Sec. 138. Section 633.556, subsection 1, Code 2011, is 23 amended to read as follows: 24 1. If the allegations of the petition as to the status of 25 the proposed ward and the necessity for the appointment of 26 a guardian are proved by clear and convincing evidence, the 27 court may appoint a guardian. If the court appoints a guardian 28 based upon mental incapacity of the proposed ward because 29 the proposed ward is a person described in section 222.2, 30 subsection 5 with an intellectual disability, as defined in 31 section 4.1 , the court shall make a separate determination as 32 to the ward’s competency to vote. The court shall find a ward 33 incompetent to vote only upon determining that the person lacks 34 sufficient mental capacity to comprehend and exercise the right 35 -63- LSB 5146IC (7) 84 ad/rj 63/ 67

S.F. _____ H.F. _____ to vote. 1 Sec. 139. Section 633C.1, subsection 4, Code 2011, is 2 amended to read as follows: 3 4. “Maximum monthly medical assistance payment rate for 4 services in an intermediate care facility for persons with mental 5 retardation an intellectual disability ” means the allowable 6 rate established by the department of human services and as 7 published in the Iowa administrative bulletin. 8 Sec. 140. Section 633C.3, subsection 3, paragraph a, Code 9 2011, is amended to read as follows: 10 a. For a beneficiary who meets the medical assistance level 11 of care requirements for services in an intermediate care 12 facility for persons with mental retardation an intellectual 13 disability and who either resides in an intermediate care 14 facility for persons with mental retardation an intellectual 15 disability or is eligible for services under the medical 16 assistance home and community-based services waiver except 17 that the beneficiary’s income exceeds the allowable maximum, 18 the applicable rate is the maximum monthly medical assistance 19 payment rate for services in an intermediate care facility for 20 persons with mental retardation an intellectual disability . 21 Sec. 141. Section 904.108, subsection 1, paragraph d, Code 22 2011, is amended to read as follows: 23 d. Establish and maintain acceptable standards of treatment, 24 training, education, and rehabilitation in the various 25 state penal and corrective institutions which shall include 26 habilitative services and treatment for offenders with mental 27 retardation an intellectual disability . For the purposes of 28 this paragraph, “habilitative services and treatment” means 29 medical, mental health, social, educational, counseling, 30 and other services which will assist a person with mental 31 retardation an intellectual disability to become self-reliant. 32 However, the director may also provide rehabilitative treatment 33 and services to other persons who require the services. 34 The director shall identify all individuals entering the 35 -64- LSB 5146IC (7) 84 ad/rj 64/ 67

S.F. _____ H.F. _____ correctional system who are persons with mental retardation 1 an intellectual disability , as defined in section 222.2, 2 subsection 5 4.1 . Identification shall be made by a qualified 3 professional in the area of mental retardation intellectual 4 disability . In assigning an offender with mental retardation 5 an intellectual disability , or an offender with an inadequately 6 developed intelligence or with impaired mental abilities, to 7 a correctional facility, the director shall consider both the 8 program needs and the security needs of the offender. The 9 director shall consult with the department of human services 10 in providing habilitative services and treatment to offenders 11 with mental illness or mental retardation an intellectual 12 disability . The director may enter into agreements with 13 the department of human services to utilize mental health 14 institutions and share staff and resources for purposes of 15 providing habilitative services and treatment, as well as 16 providing other special needs programming. Any agreement to 17 utilize mental health institutions and to share staff and 18 resources shall provide that the costs of the habilitative 19 services and treatment shall be paid from state funds. Not 20 later than twenty days prior to entering into any agreement 21 to utilize mental health institution staff and resources, 22 other than the use of a building or facility, for purposes of 23 providing habilitative services and treatment, as well as other 24 special needs programming, the directors of the departments 25 of corrections and human services shall each notify the 26 chairpersons and ranking members of the joint appropriations 27 subcommittees that last handled the appropriation for their 28 respective departments of the pending agreement. Use of a 29 building or facility shall require approval of the general 30 assembly if the general assembly is in session or, if the 31 general assembly is not in session, the legislative council 32 may grant temporary authority, which shall be subject to final 33 approval of the general assembly during the next succeeding 34 legislative session. 35 -65- LSB 5146IC (7) 84 ad/rj 65/ 67

S.F. _____ H.F. _____ Sec. 142. Section 904.205, Code 2011, is amended to read as 1 follows: 2 904.205 Clarinda correctional facility. 3 The state correctional facility at Clarinda shall be 4 utilized as a secure men’s correctional facility primarily 5 for offenders with chemical dependence, mental retardation an 6 intellectual disability , or mental illness. 7 Sec. 143. Section 915.38, subsections 1 and 2, Code 2011, 8 are amended to read as follows: 9 1. Upon its own motion or upon motion of any party, a court 10 may protect a minor, as defined in section 599.1 , from trauma 11 caused by testifying in the physical presence of the defendant 12 where it would impair the minor’s ability to communicate, by 13 ordering that the testimony of the minor be taken in a room 14 other than the courtroom and be televised by closed-circuit 15 equipment for viewing in the courtroom. However, such an order 16 shall be entered only upon a specific finding by the court that 17 such measures are necessary to protect the minor from trauma. 18 Only the judge, prosecuting attorney, defendant’s attorney, 19 persons necessary to operate the equipment, and any person 20 whose presence, in the opinion of the court, would contribute 21 to the welfare and well-being of the minor may be present in 22 the room with the minor during the minor’s testimony. The 23 judge shall inform the minor that the defendant will not be 24 present in the room in which the minor will be testifying 25 but that the defendant will be viewing the minor’s testimony 26 through closed-circuit television. 27 During the minor’s testimony the defendant shall remain in 28 the courtroom and shall be allowed to communicate with the 29 defendant’s counsel in the room where the minor is testifying 30 by an appropriate electronic method. 31 In addition, upon a finding of necessity, the court may 32 allow the testimony of a victim or witness with a mental 33 illness, mental retardation an intellectual disability , or 34 other developmental disability to be taken as provided in this 35 -66- LSB 5146IC (7) 84 ad/rj 66/ 67

S.F. _____ H.F. _____ subsection , regardless of the age of the victim or witness. 1 2. The court may, upon its own motion or upon motion of 2 a party, order that the testimony of a minor, as defined in 3 section 599.1 , be taken by recorded deposition for use at 4 trial, pursuant to rule of criminal procedure 2.13(2)(b). 5 In addition to requiring that such testimony be recorded by 6 stenographic means, the court may on motion and hearing, and 7 upon a finding that the minor is unavailable as provided 8 in rule of evidence 5.804(a), order the videotaping of the 9 minor’s testimony for viewing in the courtroom by the court. 10 The videotaping shall comply with the provisions of rule 11 of criminal procedure 2.13(2)(b), and shall be admissible 12 as evidence in the trial. In addition, upon a finding of 13 necessity, the court may allow the testimony of a victim 14 or witness with a mental illness, mental retardation an 15 intellectual disability , or other developmental disability to 16 be taken as provided in this subsection , regardless of the age 17 of the victim or witness. 18 EXPLANATION 19 This bill replaces the terms “mental retardation” and 20 “mentally retarded” with the term “intellectual disability” 21 throughout the Iowa Code. 22 The bill defines “intellectual disability” for the entire 23 Iowa Code as a disability of children and adults who as 24 a result of inadequately developed intelligence have a 25 significant impairment in ability to learn or to adapt to 26 the demands of society. This is the current definition of 27 “mental retardation” in Code chapter 222. The bill also 28 provides for the entire Iowa Code that if a diagnosis is 29 required, “intellectual disability” means a diagnosis of mental 30 retardation as defined in the diagnostic and statistical manual 31 of mental disorders, fourth edition, text revised, published by 32 the American psychiatric association. This language currently 33 exists in Code section 222.60. 34 -67- LSB 5146IC (7) 84 ad/rj 67/ 67