House
Study
Bill
637
-
Introduced
HOUSE
FILE
_____
BY
(PROPOSED
COMMITTEE
ON
HUMAN
RESOURCES
BILL
BY
CHAIRPERSON
MILLER)
A
BILL
FOR
An
Act
relating
to
the
redesign
of
mental
health
and
1
disabilities
services
administered
by
regions
comprised
of
2
counties.
3
BE
IT
ENACTED
BY
THE
GENERAL
ASSEMBLY
OF
THE
STATE
OF
IOWA:
4
TLSB
5546HC
(8)
85
jp/rj
H.F.
_____
Section
1.
Section
135.180,
subsection
3,
Code
2014,
is
1
amended
to
read
as
follows:
2
3.
The
program
shall
provide
stipends
to
support
3
psychiatrist
positions
with
an
emphasis
on
securing
and
4
retaining
medical
directors
at
community
mental
health
centers
,
5
providers
of
mental
health
services
to
county
residents
6
pursuant
to
a
waiver
approved
under
section
225C.7,
subsection
7
3
,
and
hospital
psychiatric
units
that
are
located
in
mental
8
health
professional
shortage
areas.
9
Sec.
2.
Section
222.2,
subsection
3,
Code
2014,
is
amended
10
by
striking
the
subsection.
11
Sec.
3.
Section
222.2,
Code
2014,
is
amended
by
adding
the
12
following
new
subsections:
13
NEW
SUBSECTION
.
5A.
“Mental
health
and
disability
services
14
region”
means
a
mental
health
and
disability
services
region
15
formed
in
accordance
with
section
331.389.
16
NEW
SUBSECTION
.
5B.
“Regional
administrator”
means
the
17
regional
administrator
of
a
mental
health
and
disabilities
18
services
region,
as
defined
in
section
331.388.
19
Sec.
4.
Section
222.6,
Code
2014,
is
amended
to
read
as
20
follows:
21
222.6
State
districts.
22
The
administrator
shall
divide
the
state
into
two
districts
23
in
such
manner
that
one
of
the
resource
centers
shall
be
24
located
within
each
of
the
districts.
Such
districts
may
25
from
time
to
time
be
changed.
After
such
districts
have
been
26
established,
the
administrator
shall
notify
all
boards
of
27
supervisors,
regional
administrators
of
the
mental
health
and
28
disability
services
regions,
county
auditors,
and
clerks
of
29
the
district
courts
of
the
action.
Thereafter,
unless
the
30
administrator
otherwise
orders,
all
admissions
or
commitments
31
of
persons
with
an
intellectual
disability
from
a
district
32
shall
be
to
the
resource
center
located
within
such
district.
33
Sec.
5.
Section
222.12,
subsection
2,
Code
2014,
is
amended
34
to
read
as
follows:
35
-1-
LSB
5546HC
(8)
85
jp/rj
1/
50
H.F.
_____
2.
Notice
of
the
death
of
the
patient,
and
the
cause
1
of
death,
shall
be
sent
to
the
county
board
of
supervisors
2
regional
administrator
of
the
mental
health
and
disability
3
services
region
of
the
patient’s
county
of
residence
and
to
4
the
judge
of
the
court
that
had
jurisdiction
over
a
committed
5
patient.
The
fact
of
death
with
the
time,
place,
and
alleged
6
cause
shall
be
entered
upon
the
docket
of
the
court.
7
Sec.
6.
Section
222.13,
Code
2014,
is
amended
to
read
as
8
follows:
9
222.13
Voluntary
admissions.
10
1.
If
an
adult
person
is
believed
to
be
a
person
with
11
an
intellectual
disability,
the
adult
person
or
the
adult
12
person’s
guardian
may
submit
a
request
in
writing
through
the
13
central
point
of
coordination
process
for
the
county
board
of
14
supervisors
of
regional
administrator
of
the
mental
health
and
15
disability
services
region
for
the
adult
person’s
county
of
16
residence
to
apply
to
the
superintendent
of
any
state
resource
17
center
for
the
voluntary
admission
of
the
adult
person
either
18
as
an
inpatient
or
an
outpatient
of
the
resource
center.
The
19
board
of
supervisors
regional
administrator
shall,
on
forms
20
prescribed
by
the
department’s
administrator,
apply
to
the
21
superintendent
of
the
resource
center
in
the
district
for
22
the
admission
of
the
adult
person
to
the
resource
center.
23
An
application
for
admission
to
a
special
unit
of
any
adult
24
person
believed
to
be
in
need
of
any
of
the
services
provided
25
by
the
special
unit
under
section
222.88
may
be
made
in
the
26
same
manner,
upon
request
of
the
adult
person
or
the
adult
27
person’s
guardian.
The
superintendent
shall
accept
the
28
application
if
a
preadmission
diagnostic
evaluation,
performed
29
authorized
through
the
central
point
of
coordination
process
30
regional
administrator
,
confirms
or
establishes
the
need
for
31
admission,
except
that
an
application
shall
not
be
accepted
if
32
the
institution
does
not
have
adequate
facilities
available
or
33
if
the
acceptance
will
result
in
an
overcrowded
condition.
34
2.
If
the
resource
center
has
no
does
not
have
an
35
-2-
LSB
5546HC
(8)
85
jp/rj
2/
50
H.F.
_____
appropriate
program
for
the
treatment
of
an
adult
or
minor
1
person
with
an
intellectual
disability
applying
under
this
2
section
or
section
222.13A
,
the
board
of
supervisors
regional
3
administrator
shall
arrange
for
the
placement
of
the
person
in
4
any
public
or
private
facility
within
or
without
the
state,
5
approved
by
the
director
of
the
department
of
human
services,
6
which
offers
appropriate
services
for
the
person,
as
determined
7
through
the
central
point
of
coordination
process
by
the
8
regional
administrator
.
9
3.
Upon
applying
for
admission
of
an
adult
or
minor
person
10
to
a
resource
center,
or
a
special
unit,
or
upon
arranging
for
11
the
placement
of
the
person
in
a
public
or
private
facility,
12
the
board
of
supervisors
regional
administrator
shall
make
a
13
full
investigation
into
the
financial
circumstances
of
that
14
person
and
those
liable
for
that
person’s
support
under
section
15
222.78
to
determine
whether
or
not
any
of
them
are
able
to
16
pay
the
expenses
arising
out
of
the
admission
of
the
person
17
to
a
resource
center,
special
treatment
unit,
or
public
or
18
private
facility.
If
the
board
regional
administrator
finds
19
that
the
person
or
those
legally
responsible
for
the
person
20
are
presently
unable
to
pay
the
expenses,
the
board
regional
21
administrator
shall
direct
that
authorize
the
expenses
to
be
22
paid
by
the
county
region
.
The
board
regional
administrator
23
may
review
its
finding
at
any
subsequent
time
while
the
person
24
remains
at
the
resource
center,
or
is
otherwise
receiving
care
25
or
treatment
for
which
this
chapter
obligates
the
county
region
26
to
pay.
If
the
board
regional
administrator
finds
upon
review
27
that
the
person
or
those
legally
responsible
for
the
person
28
are
presently
able
to
pay
the
expenses,
the
finding
shall
29
apply
only
to
the
charges
incurred
during
the
period
beginning
30
on
the
date
of
the
review
and
continuing
thereafter,
unless
31
and
until
the
board
regional
administrator
again
changes
its
32
finding.
If
the
board
regional
administrator
finds
that
the
33
person
or
those
legally
responsible
for
the
person
are
able
34
to
pay
the
expenses,
the
board
regional
administrator
shall
35
-3-
LSB
5546HC
(8)
85
jp/rj
3/
50
H.F.
_____
direct
that
the
charges
be
so
paid
to
the
extent
required
by
1
section
222.78
,
and
the
county
auditor
of
the
person’s
county
2
of
residence
shall
be
responsible
for
the
collection
of
the
3
charges.
4
Sec.
7.
Section
222.13A,
Code
2014,
is
amended
to
read
as
5
follows:
6
222.13A
Voluntary
admissions
——
minors.
7
1.
If
a
minor
is
believed
to
be
a
person
with
an
8
intellectual
disability,
the
minor’s
parent,
guardian,
9
or
custodian
may
request
the
county
board
of
supervisors
10
regional
administrator
for
the
minor’s
county
of
residence
11
to
apply
for
admission
of
the
minor
as
a
voluntary
patient
12
in
a
state
resource
center.
If
the
resource
center
does
13
not
have
appropriate
services
for
the
minor’s
treatment,
the
14
board
of
supervisors
regional
administrator
may
arrange
for
15
the
admission
of
the
minor
in
a
public
or
private
facility
16
within
or
without
the
state,
approved
by
the
director
of
human
17
services,
which
offers
appropriate
services
for
the
minor’s
18
treatment.
19
2.
Upon
receipt
of
an
application
for
voluntary
admission
20
of
a
minor,
the
board
of
supervisors
regional
administrator
21
shall
provide
for
a
preadmission
diagnostic
evaluation
of
the
22
minor
to
confirm
or
establish
the
need
for
the
admission.
The
23
preadmission
diagnostic
evaluation
shall
be
performed
by
a
24
person
who
meets
the
qualifications
of
a
qualified
intellectual
25
disability
professional
who
is
designated
through
the
central
26
point
of
coordination
process
by
the
regional
administrator
.
27
3.
During
the
preadmission
diagnostic
evaluation,
the
28
minor
shall
be
informed
both
orally
and
in
writing
that
the
29
minor
has
the
right
to
object
to
the
voluntary
admission.
If
30
the
preadmission
diagnostic
evaluation
determines
that
the
31
voluntary
admission
is
appropriate
but
the
minor
objects
to
32
the
admission,
the
minor
shall
not
be
admitted
to
the
state
33
resource
center
unless
the
court
approves
of
the
admission.
A
34
petition
for
approval
of
the
minor’s
admission
may
be
submitted
35
-4-
LSB
5546HC
(8)
85
jp/rj
4/
50
H.F.
_____
to
the
juvenile
court
by
the
minor’s
parent,
guardian,
or
1
custodian.
2
4.
As
soon
as
practicable
after
the
filing
of
a
petition
for
3
approval
of
the
voluntary
admission,
the
court
shall
determine
4
whether
the
minor
has
an
attorney
to
represent
the
minor
in
the
5
proceeding.
If
the
minor
does
not
have
an
attorney,
the
court
6
shall
assign
to
the
minor
an
attorney.
If
the
minor
is
unable
7
to
pay
for
an
attorney,
the
attorney
shall
be
compensated
by
8
the
county
at
an
hourly
rate
to
be
established
by
the
county
9
board
of
supervisors
regional
administrator
in
substantially
10
the
same
manner
as
provided
in
section
815.7
.
11
5.
The
court
shall
order
the
admission
of
a
minor
who
12
objects
to
the
admission,
only
after
a
hearing
in
which
it
13
is
shown
by
clear
and
convincing
evidence
that
both
of
the
14
following
circumstances
exist:
15
a.
The
minor
needs
and
will
substantially
benefit
from
16
treatment
or
habilitation.
17
b.
A
placement
which
involves
less
restriction
of
the
18
minor’s
liberties
for
the
purposes
of
treatment
or
habilitation
19
is
not
feasible.
20
Sec.
8.
Section
222.14,
Code
2014,
is
amended
to
read
as
21
follows:
22
222.14
Care
by
county
region
pending
admission.
23
If
the
institution
is
unable
to
receive
a
patient,
the
24
superintendent
shall
notify
the
county
board
of
supervisors
25
of
regional
administrator
for
the
county
from
which
the
26
application
in
behalf
of
the
prospective
patient
was
made
of
27
the
time
when
such
person
may
be
received.
Until
such
time
as
28
the
patient
is
able
to
be
received
by
the
institution,
or
when
29
application
has
been
made
for
admission
to
a
public
or
private
30
facility
as
provided
in
section
222.13
and
the
application
is
31
pending,
the
care
of
said
person
the
patient
shall
be
provided
32
as
arranged
by
the
county
board
of
supervisors
regional
33
administrator
.
34
Sec.
9.
Section
222.22,
Code
2014,
is
amended
to
read
as
35
-5-
LSB
5546HC
(8)
85
jp/rj
5/
50
H.F.
_____
follows:
1
222.22
Time
of
appearance.
2
The
time
of
appearance
shall
not
be
less
than
five
days
3
after
completed
service
unless
the
court
orders
otherwise.
4
Appearance
on
behalf
of
the
person
who
is
alleged
to
have
5
an
intellectual
disability
may
be
made
by
any
citizen
of
the
6
county
or
by
any
relative.
The
district
court
shall
assign
7
counsel
for
the
person
who
is
alleged
to
have
an
intellectual
8
disability.
Counsel
shall
prior
to
proceedings
personally
9
consult
with
the
person
who
is
alleged
to
have
an
intellectual
10
disability
unless
the
judge
appointing
counsel
certifies
that
11
in
the
judge’s
opinion,
consultation
shall
serve
no
useful
12
purpose.
The
certification
shall
be
made
a
part
of
the
record.
13
An
attorney
assigned
by
the
court
shall
be
compensated
by
the
14
county
at
an
hourly
rate
to
be
established
by
the
county
board
15
of
supervisors
regional
administrator
for
the
person’s
county
16
of
residence
in
substantially
the
same
manner
as
provided
in
17
section
815.7
.
18
Sec.
10.
Section
222.28,
Code
2014,
is
amended
to
read
as
19
follows:
20
222.28
Commission
to
examine.
21
The
court
may,
at
or
prior
to
the
final
hearing,
appoint
22
a
commission
of
one
qualified
physician
and
one
qualified
23
psychologist,
designated
through
the
central
point
of
24
coordination
process
by
the
regional
administrator
for
the
25
person’s
county
of
residence
,
who
shall
make
a
personal
26
examination
of
the
person
alleged
to
have
an
intellectual
27
disability
for
the
purpose
of
determining
the
mental
condition
28
of
the
person.
29
Sec.
11.
Section
222.31,
subsection
1,
paragraph
b,
Code
30
2014,
is
amended
to
read
as
follows:
31
b.
(1)
Commit
the
person
to
the
state
resource
center
32
designated
by
the
administrator
to
serve
the
county
mental
33
health
and
disability
services
region
in
which
the
hearing
34
is
being
held,
or
to
a
special
unit.
The
court
shall,
prior
35
-6-
LSB
5546HC
(8)
85
jp/rj
6/
50
H.F.
_____
to
issuing
an
order
of
commitment,
request
that
a
diagnostic
1
evaluation
of
the
person
be
made
by
a
person
qualified
to
2
perform
the
diagnostic
evaluation.
The
cost
of
the
evaluation
3
shall
be
defrayed
by
the
committed
person’s
county
of
4
residence
unless
otherwise
ordered
by
the
court.
The
cost
5
of
the
evaluation
to
be
charged
may
be
equal
to
but
shall
6
not
exceed
the
actual
cost
of
the
evaluation.
An
order
of
7
commitment
shall
not
be
issued
unless
the
superintendent
of
the
8
institution
recommends
that
the
order
be
issued
and
advises
the
9
court
that
adequate
facilities
for
the
care
of
the
person
are
10
available.
11
(2)
The
court
shall
examine
the
report
of
the
county
12
attorney
filed
pursuant
to
section
222.13
,
and
if
the
report
13
shows
that
neither
the
person
nor
those
liable
for
the
person’s
14
support
under
section
222.78
are
presently
able
to
pay
the
15
charges
rising
out
of
the
person’s
care
in
a
resource
center,
16
or
special
treatment
unit,
shall
enter
an
order
stating
that
17
finding
and
directing
that
the
charges
be
paid
by
the
regional
18
administrator
for
the
person’s
county
of
residence.
The
19
court
may,
upon
request
of
the
board
of
supervisors
regional
20
administrator
,
review
its
finding
at
any
subsequent
time
while
21
the
person
remains
at
the
resource
center,
or
is
otherwise
22
receiving
care
or
treatment
for
which
this
chapter
obligates
23
the
county
to
pay.
If
the
court
finds
upon
review
that
24
the
person
or
those
legally
responsible
for
the
person
are
25
presently
able
to
pay
the
expenses,
that
finding
shall
apply
26
only
to
the
charges
incurred
during
the
period
beginning
on
the
27
date
of
the
board’s
regional
administrator’s
request
for
the
28
review
and
continuing
thereafter,
unless
and
until
the
court
29
again
changes
its
finding.
If
the
court
finds
that
the
person,
30
or
those
liable
for
the
person’s
support,
are
able
to
pay
the
31
charges,
the
court
shall
enter
an
order
directing
that
the
32
charges
be
so
paid
to
the
extent
required
by
section
222.78
.
33
Sec.
12.
Section
222.59,
subsection
1,
unnumbered
paragraph
34
1,
Code
2014,
is
amended
to
read
as
follows:
35
-7-
LSB
5546HC
(8)
85
jp/rj
7/
50
H.F.
_____
Upon
receiving
a
request
from
an
authorized
requester,
the
1
superintendent
of
a
state
resource
center
shall
coordinate
2
with
the
central
point
of
coordination
process
regional
3
administrator
for
the
person’s
county
of
residence
in
assisting
4
the
requester
in
identifying
available
community-based
services
5
as
an
alternative
to
continued
placement
of
a
patient
in
the
6
state
resource
center.
For
the
purposes
of
this
section
,
7
“authorized
requester”
means
the
parent,
guardian,
or
custodian
8
of
a
minor
patient,
the
guardian
of
an
adult
patient,
or
an
9
adult
patient
who
does
not
have
a
guardian.
The
assistance
10
shall
identify
alternatives
to
continued
placement
which
are
11
appropriate
to
the
patient’s
needs
and
shall
include
but
are
12
not
limited
to
any
of
the
following:
13
Sec.
13.
Section
222.60,
subsection
1,
unnumbered
paragraph
14
1,
Code
2014,
is
amended
to
read
as
follows:
15
All
necessary
and
legal
expenses
for
the
cost
of
admission
16
or
commitment
or
for
the
treatment,
training,
instruction,
17
care,
habilitation,
support
and
transportation
of
persons
with
18
an
intellectual
disability,
as
provided
for
in
the
county
19
applicable
regional
service
system
management
plan
provisions
20
implemented
pursuant
to
section
331.439,
subsection
1
331.393
,
21
in
a
state
resource
center,
or
in
a
special
unit,
or
any
public
22
or
private
facility
within
or
without
the
state,
approved
by
23
the
director
of
human
services,
shall
be
paid
by
either:
24
Sec.
14.
Section
222.60,
subsection
2,
Code
2014,
is
amended
25
to
read
as
follows:
26
2.
a.
Prior
to
a
county
of
residence
approving
the
payment
27
of
expenses
for
a
person
under
this
section
,
the
county
may
28
require
that
the
person
be
diagnosed
to
determine
if
the
person
29
has
an
intellectual
disability
or
that
the
person
be
evaluated
30
to
determine
the
appropriate
level
of
services
required
to
meet
31
the
person’s
needs
relating
to
an
intellectual
disability.
The
32
diagnosis
and
the
evaluation
may
be
performed
concurrently
and
33
shall
be
performed
by
an
individual
or
individuals
approved
34
by
the
regional
administrator
for
the
person’s
county
who
35
-8-
LSB
5546HC
(8)
85
jp/rj
8/
50
H.F.
_____
are
qualified
to
perform
the
diagnosis
or
the
evaluation.
1
Following
the
initial
approval
for
payment
of
expenses,
2
the
county
may
require
that
an
evaluation
be
performed
at
3
reasonable
time
periods.
4
b.
The
cost
of
a
county-required
diagnosis
and
an
evaluation
5
is
at
the
county’s
expense.
For
a
state
case,
the
state
6
may
apply
the
diagnosis
and
evaluation
provisions
of
this
7
subsection
at
the
state’s
expense.
8
c.
A
diagnosis
or
an
evaluation
under
this
section
may
be
9
part
of
a
county’s
central
point
of
coordination
process
under
10
section
331.440
diagnosis
and
assessment
process
implemented
11
by
the
applicable
regional
administrator
,
provided
that
a
12
diagnosis
is
performed
only
by
an
individual
qualified
as
13
provided
in
this
section
.
14
Sec.
15.
Section
222.61,
Code
2014,
is
amended
to
read
as
15
follows:
16
222.61
Residency
determined.
17
When
a
county
receives
an
application
on
behalf
of
any
18
person
for
admission
to
a
resource
center
or
a
special
unit
19
or
when
a
court
issues
an
order
committing
any
person
to
a
20
resource
center
or
a
special
unit,
the
board
of
supervisors
21
shall
refer
the
determination
of
residency
to
the
central
point
22
of
coordination
process
regional
administrator
for
the
county
23
to
determine
and
certify
that
the
residence
of
the
person
is
24
in
one
of
the
following:
25
1.
In
the
county
in
which
the
application
is
received
or
in
26
which
the
court
is
located.
27
2.
In
some
other
county
of
the
state.
28
3.
In
another
state
or
in
a
foreign
country.
29
4.
Unknown.
30
Sec.
16.
Section
222.62,
Code
2014,
is
amended
to
read
as
31
follows:
32
222.62
Residency
in
another
county.
33
When
the
board
of
supervisors
determines
through
the
central
34
point
of
coordination
process
regional
administrator
for
the
35
-9-
LSB
5546HC
(8)
85
jp/rj
9/
50
H.F.
_____
county
that
the
residency
of
the
person
is
other
than
in
the
1
county
in
which
the
application
is
received,
the
determination
2
shall
be
certified
to
the
superintendent
of
the
resource
3
center
or
the
special
unit
where
the
person
is
a
patient.
The
4
certification
shall
be
accompanied
by
a
copy
of
the
evidence
5
supporting
the
determination.
The
superintendent
shall
charge
6
the
expenses
already
incurred
and
unadjusted,
and
all
future
7
expenses
of
the
patient,
to
the
county
certified
to
be
the
8
county
of
residency.
9
Sec.
17.
Section
222.63,
Code
2014,
is
amended
to
read
as
10
follows:
11
222.63
Finding
of
residency
——
objection.
12
A
board
of
supervisors’
certification
utilizing
the
13
central
point
of
coordination
process
through
the
regional
14
administrator
for
a
county
that
a
person’s
residency
is
in
15
another
county
shall
be
sent
to
the
auditor
of
the
county
of
16
residence.
The
certification
shall
be
accompanied
by
a
copy
17
of
the
evidence
supporting
the
determination.
The
auditor
18
of
the
county
of
residence
shall
submit
the
certification
to
19
the
board
of
supervisors
of
the
auditor’s
county
and
it
shall
20
be
conclusively
presumed
that
the
patient
has
residency
in
21
that
county
unless
that
county
disputes
the
determination
of
22
residency
as
provided
in
section
331.394
.
23
Sec.
18.
Section
222.64,
Code
2014,
is
amended
to
read
as
24
follows:
25
222.64
Foreign
state
or
country
or
unknown
residency.
26
If
the
residency
of
the
person
is
determined
by
a
regional
27
administrator
on
behalf
of
a
county
or
by
the
state
to
be
in
28
a
foreign
state
or
country
or
is
determined
to
be
unknown,
29
the
county
regional
administrator
or
the
state
shall
certify
30
the
determination
to
the
administrator
.
The
certification
31
shall
be
accompanied
by
a
copy
of
the
evidence
supporting
the
32
determination.
The
care
of
the
person
shall
be
as
arranged
33
by
the
county
regional
administrator
or
the
state
or
by
an
34
order
as
the
court
may
enter.
Application
for
admission
or
35
-10-
LSB
5546HC
(8)
85
jp/rj
10/
50
H.F.
_____
order
of
commitment
may
be
made
pending
investigation
by
the
1
administrator.
2
Sec.
19.
Section
222.73,
subsection
2,
paragraph
a,
3
subparagraph
(6),
Code
2014,
is
amended
to
read
as
follows:
4
(6)
A
county
shall
not
be
billed
for
the
cost
of
a
patient
5
unless
the
patient’s
admission
is
authorized
through
the
6
applicable
central
point
of
coordination
process
regional
7
administrator
.
The
state
resource
center
and
the
county
8
regional
administrator
shall
work
together
to
locate
9
appropriate
alternative
placements
and
services,
and
to
educate
10
patients
and
the
family
members
of
patients
regarding
such
11
alternatives.
12
Sec.
20.
Section
222.73,
subsection
2,
paragraph
b,
Code
13
2014,
is
amended
to
read
as
follows:
14
b.
The
per
diem
costs
billed
to
each
county
shall
not
exceed
15
the
per
diem
costs
billed
to
the
county
in
the
fiscal
year
16
beginning
July
1,
1996.
However,
the
per
diem
costs
billed
17
to
a
county
may
be
adjusted
in
for
a
fiscal
year
to
reflect
18
increased
costs
to
the
extent
of
the
percentage
increase
in
the
19
total
of
county
fixed
budgets
pursuant
to
the
allowed
growth
20
factor
adjustment
authorized
statewide
per
capita
expenditure
21
target
amount,
if
any
per
capita
growth
amount
is
authorized
by
22
the
general
assembly
for
that
fiscal
year
in
accordance
with
23
section
331.439
331.424A
.
24
Sec.
21.
Section
222.74,
Code
2014,
is
amended
to
read
as
25
follows:
26
222.74
Duplicate
to
county.
27
When
certifying
to
the
department
amounts
to
be
charged
28
against
each
county
as
provided
in
section
222.73
,
the
29
superintendent
shall
send
to
the
county
auditor
of
and
the
30
regional
administrator
for
each
county
against
which
the
31
superintendent
has
so
certified
any
amount,
a
duplicate
of
32
the
certification
statement.
The
county
auditor
upon
receipt
33
of
the
duplicate
certification
statement
and
approval
by
the
34
regional
administrator
for
payment
of
the
certified
amount
35
-11-
LSB
5546HC
(8)
85
jp/rj
11/
50
H.F.
_____
shall
enter
it
to
the
credit
of
the
state
in
the
ledger
of
1
state
accounts,
and
shall
immediately
issue
a
notice
to
the
2
county
treasurer
authorizing
the
treasurer
to
transfer
the
3
amount
from
the
county
fund
to
the
general
state
revenue.
The
4
county
treasurer
shall
file
the
notice
as
authority
for
making
5
the
transfer
and
shall
include
the
amount
transferred
in
the
6
next
remittance
of
state
taxes
to
the
treasurer
of
state,
7
designating
the
fund
to
which
the
amount
belongs.
8
Sec.
22.
Section
222.92,
subsection
3,
paragraph
a,
Code
9
2014,
is
amended
to
read
as
follows:
10
a.
Moneys
received
by
the
state
from
billings
to
counties
11
and
regional
administrators
for
the
counties
.
12
Sec.
23.
Section
225.1,
Code
2014,
is
amended
to
read
as
13
follows:
14
225.1
Establishment
——
definitions
.
15
1.
There
shall
be
established
a
The
state
psychiatric
16
hospital
,
is
established.
The
hospital
shall
be
especially
17
designed,
kept,
and
administered
for
the
care,
observation,
18
and
treatment
of
those
persons
who
are
afflicted
with
abnormal
19
mental
conditions.
20
2.
For
the
purposes
of
this
chapter,
unless
the
context
21
otherwise
requires:
22
a.
“Mental
health
and
disability
services
region”
means
23
a
mental
health
and
disability
services
region
approved
in
24
accordance
with
section
331.389.
25
b.
“Regional
administrator”
means
the
administrator
of
a
26
mental
health
and
disability
services
region,
as
defined
in
27
section
331.388.
28
Sec.
24.
Section
225.10,
unnumbered
paragraph
1,
Code
2014,
29
is
amended
to
read
as
follows:
30
Persons
suffering
from
mental
diseases
may
be
admitted
to
31
the
state
psychiatric
hospital
as
voluntary
public
patients
32
if
a
physician
authorized
to
practice
medicine
or
osteopathic
33
medicine
in
the
state
of
Iowa
files
information
with
the
board
34
of
supervisors
regional
administrator
of
the
person’s
county
35
-12-
LSB
5546HC
(8)
85
jp/rj
12/
50
H.F.
_____
of
residence
or
the
board’s
designee
,
stating
all
of
the
1
following:
2
Sec.
25.
Section
225.11,
Code
2014,
is
amended
to
read
as
3
follows:
4
225.11
Initiating
commitment
procedures.
5
When
a
court
finds
upon
completion
of
a
hearing
held
pursuant
6
to
section
229.12
that
the
contention
that
a
respondent
is
7
seriously
mentally
impaired
has
been
sustained
by
clear
and
8
convincing
evidence,
and
the
application
filed
under
section
9
229.6
also
contends
or
the
court
otherwise
concludes
that
it
10
would
be
appropriate
to
refer
the
respondent
to
the
state
11
psychiatric
hospital
for
a
complete
psychiatric
evaluation
and
12
appropriate
treatment
pursuant
to
section
229.13
,
the
judge
13
may
order
that
a
financial
investigation
be
made
in
the
manner
14
prescribed
by
section
225.13
.
If
the
costs
of
a
respondent’s
15
evaluation
or
treatment
are
payable
in
whole
or
in
part
by
16
a
county,
an
order
under
this
section
shall
be
for
referral
17
of
the
respondent
through
the
central
point
of
coordination
18
process
regional
administrator
for
the
respondent’s
county
of
19
residence
for
an
evaluation
and
referral
of
the
respondent
20
to
an
appropriate
placement
or
service,
which
may
include
21
the
state
psychiatric
hospital
for
additional
evaluation
or
22
treatment.
For
purposes
of
this
chapter
,
“central
point
of
23
coordination
process”
means
the
same
as
defined
in
section
24
331.440
.
25
Sec.
26.
Section
225.12,
Code
2014,
is
amended
to
read
as
26
follows:
27
225.12
Voluntary
public
patient
——
physician’s
report.
28
A
physician
filing
information
under
section
225.10
shall
29
include
a
written
report
to
the
county
board
of
supervisors
30
or
the
board’s
designee
regional
administrator
for
the
31
county
of
residence
of
the
person
named
in
the
information
,
32
giving
a
history
of
the
case
as
will
be
likely
to
aid
in
the
33
observation,
treatment,
and
hospital
care
of
the
person
named
34
in
the
information
and
describing
the
history
in
detail.
35
-13-
LSB
5546HC
(8)
85
jp/rj
13/
50
H.F.
_____
Sec.
27.
Section
225.13,
Code
2014,
is
amended
to
read
as
1
follows:
2
225.13
Financial
condition.
3
The
county
board
of
supervisors
or
the
board’s
designee
4
regional
administrator
of
the
county
of
residence
of
a
person
5
being
admitted
to
the
state
psychiatric
hospital
is
responsible
6
for
investigating
the
financial
condition
of
a
person
being
7
admitted
to
the
state
psychiatric
hospital
the
person
and
of
8
those
legally
responsible
for
the
person’s
support.
9
Sec.
28.
Section
225.15,
Code
2014,
is
amended
to
read
as
10
follows:
11
225.15
Examination
and
treatment.
12
1.
When
a
respondent
arrives
at
the
state
psychiatric
13
hospital,
the
admitting
physician
shall
examine
the
respondent
14
and
determine
whether
or
not,
in
the
physician’s
judgment,
the
15
respondent
is
a
fit
subject
for
observation,
treatment,
and
16
hospital
care.
If,
upon
examination,
the
physician
decides
17
that
the
respondent
should
be
admitted
to
the
hospital,
the
18
respondent
shall
be
provided
a
proper
bed
in
the
hospital.
The
19
physician
who
has
charge
of
the
respondent
shall
proceed
with
20
observation,
medical
treatment,
and
hospital
care
as
in
the
21
physician’s
judgment
are
proper
and
necessary,
in
compliance
22
with
sections
229.13
to
229.16
.
After
the
respondent’s
23
admission,
the
observation,
medical
treatment,
and
hospital
24
care
of
the
respondent
may
be
provided
by
a
mental
health
25
professional,
as
defined
in
section
228.1
,
who
is
licensed
as
a
26
physician,
advanced
registered
nurse
practitioner,
or
physician
27
assistant.
28
2.
A
proper
and
competent
nurse
shall
also
be
assigned
to
29
look
after
and
care
for
the
respondent
during
observation,
30
treatment,
and
care.
Observation,
treatment,
and
hospital
care
31
under
this
section
which
are
payable
in
whole
or
in
part
by
a
32
county
shall
only
be
provided
as
determined
through
the
central
33
point
of
coordination
process
regional
administrator
of
the
34
respondent’s
county
of
residence
.
35
-14-
LSB
5546HC
(8)
85
jp/rj
14/
50
H.F.
_____
Sec.
29.
Section
225.16,
subsection
1,
Code
2014,
is
amended
1
to
read
as
follows:
2
1.
If
the
county
board
of
supervisors
or
the
board’s
3
designee
regional
administrator
for
a
person’s
county
of
4
residence
finds
from
the
physician’s
information
which
was
5
filed
under
the
provisions
of
section
225.10
that
it
would
6
be
appropriate
for
the
person
to
be
admitted
to
the
state
7
psychiatric
hospital,
and
the
report
of
the
county
board
of
8
supervisors
or
the
board’s
designee
regional
administrator
made
9
pursuant
to
section
225.13
shows
that
the
person
and
those
who
10
are
legally
responsible
for
the
person
are
not
able
to
pay
the
11
expenses
incurred
at
the
hospital,
or
are
able
to
pay
only
a
12
part
of
the
expenses,
the
person
shall
be
considered
to
be
a
13
voluntary
public
patient
and
the
board
of
supervisors
regional
14
administrator
shall
direct
that
the
person
shall
be
sent
to
the
15
state
psychiatric
hospital
at
the
state
university
of
Iowa
for
16
observation,
treatment,
and
hospital
care.
17
Sec.
30.
Section
225.17,
subsection
2,
Code
2014,
is
amended
18
to
read
as
follows:
19
2.
When
the
respondent
arrives
at
the
hospital,
the
20
respondent
shall
receive
the
same
treatment
as
is
provided
for
21
committed
public
patients
in
section
225.15
,
in
compliance
with
22
sections
229.13
to
229.16
.
However,
observation,
treatment,
23
and
hospital
care
under
this
section
of
a
respondent
whose
24
expenses
are
payable
in
whole
or
in
part
by
a
county
shall
25
only
be
provided
as
determined
through
the
central
point
of
26
coordination
process
regional
administrator
of
the
respondent’s
27
county
of
residence
.
28
Sec.
31.
Section
225.18,
Code
2014,
is
amended
to
read
as
29
follows:
30
225.18
Attendants.
31
The
county
board
of
supervisors
or
the
board’s
designee
32
regional
administrator
may
appoint
a
person
an
attendant
to
33
accompany
the
committed
public
patient
or
the
voluntary
public
34
patient
or
the
committed
private
patient
from
the
place
where
35
-15-
LSB
5546HC
(8)
85
jp/rj
15/
50
H.F.
_____
the
patient
may
be
to
the
state
psychiatric
hospital,
or
to
1
accompany
the
patient
from
the
hospital
to
a
place
as
may
be
2
designated
by
the
county
regional
administrator
.
If
a
patient
3
is
moved
pursuant
to
this
section
,
at
least
one
attendant
shall
4
be
of
the
same
gender
as
the
patient.
5
Sec.
32.
Section
225.19,
Code
2014,
is
amended
to
read
as
6
follows:
7
225.19
Compensation
for
attendant.
8
An
individual
appointed
by
the
county
board
of
supervisors
9
or
the
board’s
designee
regional
administrator
in
accordance
10
with
section
225.18
to
accompany
a
person
to
or
from
the
11
hospital
or
to
make
an
investigation
and
report
on
any
question
12
involved
in
the
matter
shall
receive
three
dollars
per
day
for
13
the
time
actually
spent
in
making
the
investigation
and
actual
14
necessary
expenses
incurred
in
making
the
investigation
or
15
trip.
This
section
does
not
apply
to
an
appointee
who
receives
16
fixed
compensation
or
a
salary.
17
Sec.
33.
Section
225.21,
Code
2014,
is
amended
to
read
as
18
follows:
19
225.21
Compensation
claims
——
filing
——
approval.
20
The
person
making
claim
to
compensation
under
section
225.19
21
shall
file
the
claim
in
the
office
of
the
county
auditor.
22
The
claim
is
subject
to
review
and
approval
by
the
board
of
23
supervisors
or
the
board’s
designee
regional
administrator
for
24
the
county
.
25
Sec.
34.
Section
225.24,
Code
2014,
is
amended
to
read
as
26
follows:
27
225.24
Collection
of
preliminary
expense.
28
Unless
a
committed
private
patient
or
those
legally
29
responsible
for
the
patient’s
support
offer
to
settle
the
30
amount
of
the
claims,
the
county
auditor
of
the
person’s
county
31
of
residence
shall
collect,
by
action
if
necessary,
the
amount
32
of
all
claims
for
per
diem
and
expenses
that
have
been
approved
33
by
the
county
board
of
supervisors
or
the
board’s
designee
34
regional
administrator
for
the
county
and
paid
by
the
county
35
-16-
LSB
5546HC
(8)
85
jp/rj
16/
50
H.F.
_____
as
provided
under
section
225.21
.
Any
amount
collected
shall
1
be
credited
to
the
county
treasury
county’s
mental
health
and
2
disabilities
services
fund
created
in
accordance
with
section
3
331.424A
.
4
Sec.
35.
Section
225.27,
Code
2014,
is
amended
to
read
as
5
follows:
6
225.27
Discharge
——
transfer.
7
The
state
psychiatric
hospital
may,
at
any
time,
discharge
8
any
patient
as
recovered,
as
improved,
or
as
not
likely
to
9
be
benefited
by
further
treatment.
If
the
patient
being
so
10
discharged
was
involuntarily
hospitalized,
the
hospital
shall
11
notify
the
committing
judge
or
court
of
the
discharge
as
12
required
by
section
229.14
or
section
229.16
,
whichever
is
13
applicable
,
and
the
applicable
regional
administrator
.
Upon
14
receiving
the
notification,
the
court
shall
issue
an
order
15
confirming
the
patient’s
discharge
from
the
hospital
or
from
16
care
and
custody,
as
the
case
may
be,
and
shall
terminate
the
17
proceedings
pursuant
to
which
the
order
was
issued.
The
court
18
or
judge
shall,
if
necessary,
appoint
a
person
to
accompany
the
19
discharged
patient
from
the
state
psychiatric
hospital
to
such
20
place
as
the
hospital
or
the
court
may
designate,
or
authorize
21
the
hospital
to
appoint
such
attendant.
22
Sec.
36.
Section
225C.2,
subsection
2,
Code
2014,
is
amended
23
by
striking
the
subsection.
24
Sec.
37.
Section
225C.5,
subsection
1,
paragraph
f,
Code
25
2014,
is
amended
to
read
as
follows:
26
f.
Two
members
shall
be
staff
members
of
regional
27
administrators
of
the
central
point
of
coordination
process
28
established
in
accordance
with
section
331.440
selected
from
29
nominees
submitted
by
the
community
services
affiliate
of
the
30
Iowa
state
association
of
counties.
31
Sec.
38.
Section
225C.6,
subsection
1,
paragraph
i,
32
subparagraph
(1),
Code
2014,
is
amended
to
read
as
follows:
33
(1)
The
extent
to
which
services
to
persons
with
34
disabilities
are
actually
available
to
persons
in
each
county
35
-17-
LSB
5546HC
(8)
85
jp/rj
17/
50
H.F.
_____
and
mental
health
and
disability
services
region
in
the
state
1
and
the
quality
of
those
services.
2
Sec.
39.
Section
225C.6,
subsection
1,
paragraph
m,
Code
3
2014,
is
amended
to
read
as
follows:
4
m.
Identify
disability
services
outcomes
and
indicators
to
5
support
the
ability
of
eligible
persons
with
a
disability
to
6
live,
learn,
work,
and
recreate
in
communities
of
the
persons’
7
choice.
The
identification
duty
includes
but
is
not
limited
to
8
responsibility
for
identifying,
collecting,
and
analyzing
data
9
as
necessary
to
issue
reports
on
outcomes
and
indicators
at
the
10
county
,
region,
and
state
levels.
11
Sec.
40.
Section
225C.12,
subsection
2,
Code
2014,
is
12
amended
to
read
as
follows:
13
2.
A
county
may
claim
reimbursement
by
filing
with
the
14
administrator
a
claim
in
a
form
prescribed
by
the
administrator
15
by
rule.
Claims
may
be
filed
on
a
quarterly
basis,
and
when
16
received
shall
be
verified
as
soon
as
reasonably
possible
by
17
the
administrator.
The
administrator
shall
certify
to
the
18
director
of
the
department
of
administrative
services
the
19
amount
to
which
each
county
claiming
reimbursement
is
entitled,
20
and
the
director
of
the
department
of
administrative
services
21
shall
issue
warrants
to
the
respective
counties
drawn
upon
22
funds
appropriated
by
the
general
assembly
for
the
purpose
23
of
this
section
.
A
county
shall
place
funds
credit
amounts
24
received
under
this
section
in
the
county
mental
health,
25
intellectual
disability,
and
developmental
disabilities
26
services
fund
created
under
section
331.424A
county’s
mental
27
health
and
disability
services
fund
.
If
the
appropriation
for
28
a
fiscal
year
is
insufficient
to
pay
all
claims
arising
under
29
this
section
,
the
director
of
the
department
of
administrative
30
services
shall
prorate
the
funds
appropriated
for
that
year
31
among
the
claimant
counties
so
that
an
equal
proportion
of
each
32
county’s
claim
is
paid
in
each
quarter
for
which
proration
is
33
necessary.
34
Sec.
41.
Section
225C.13,
subsection
1,
Code
2014,
is
35
-18-
LSB
5546HC
(8)
85
jp/rj
18/
50
H.F.
_____
amended
to
read
as
follows:
1
1.
The
administrator
assigned,
in
accordance
with
section
2
218.1
,
to
control
the
state
mental
health
institutes
and
3
the
state
resource
centers
may
enter
into
agreements
under
4
which
a
facility
or
portion
of
a
facility
administered
by
the
5
administrator
is
leased
to
a
department
or
division
of
state
6
government,
a
county
or
group
of
counties,
a
mental
health
and
7
disability
services
region,
or
a
private
nonprofit
corporation
8
organized
under
chapter
504
.
A
lease
executed
under
this
9
section
shall
require
that
the
lessee
use
the
leased
premises
10
to
deliver
either
disability
services
or
other
services
11
normally
delivered
by
the
lessee.
12
Sec.
42.
Section
225C.14,
Code
2014,
is
amended
to
read
as
13
follows:
14
225C.14
Preliminary
diagnostic
evaluation.
15
1.
Except
in
cases
of
medical
emergency,
a
person
shall
be
16
admitted
to
a
state
mental
health
institute
as
an
inpatient
17
only
after
a
preliminary
diagnostic
evaluation
performed
18
through
the
central
point
of
coordination
process
regional
19
administrator
of
the
person’s
county
of
residence
has
confirmed
20
that
the
admission
is
appropriate
to
the
person’s
mental
health
21
needs,
and
that
no
suitable
alternative
method
of
providing
the
22
needed
services
in
a
less
restrictive
setting
or
in
or
nearer
23
to
the
person’s
home
community
is
currently
available.
If
24
provided
for
through
the
central
point
of
coordination
process
25
regional
administrator
,
the
evaluation
may
be
performed
by
a
26
community
mental
health
center
or
by
an
alternative
diagnostic
27
facility.
The
policy
established
by
this
section
shall
be
28
implemented
in
the
manner
and
to
the
extent
prescribed
by
29
sections
225C.15
,
225C.16
and
225C.17
.
30
2.
As
used
in
this
section
and
sections
225C.15
,
225C.16
31
and
225C.17
,
the
term
“medical
emergency”
means
a
situation
32
in
which
a
prospective
patient
is
received
at
a
state
mental
33
health
institute
in
a
condition
which,
in
the
opinion
of
the
34
chief
medical
officer,
or
that
officer’s
physician
designee,
35
-19-
LSB
5546HC
(8)
85
jp/rj
19/
50
H.F.
_____
requires
the
immediate
admission
of
the
person
notwithstanding
1
the
policy
stated
in
subsection
1
.
2
Sec.
43.
Section
225C.15,
Code
2014,
is
amended
to
read
as
3
follows:
4
225C.15
County
implementation
of
evaluations.
5
The
board
of
supervisors
of
regional
administrator
for
a
6
county
shall
,
no
later
than
July
1,
1982,
require
that
the
7
policy
stated
in
section
225C.14
be
followed
with
respect
8
to
admission
of
persons
from
that
county
to
a
state
mental
9
health
institute.
A
community
mental
health
center
which
is
10
supported,
directly
or
in
affiliation
with
other
counties,
by
11
that
county
may
perform
the
preliminary
diagnostic
evaluations
12
for
that
county,
unless
the
performance
of
the
evaluations
13
is
not
covered
by
the
agreement
entered
into
by
the
county
14
regional
administrator
and
the
center,
and
the
center’s
15
director
certifies
to
the
board
of
supervisors
regional
16
administrator
that
the
center
does
not
have
the
capacity
to
17
perform
the
evaluations,
in
which
case
the
board
of
supervisors
18
regional
administrator
shall
proceed
under
section
225C.17
.
19
Sec.
44.
Section
225C.16,
Code
2014,
is
amended
to
read
as
20
follows:
21
225C.16
Referrals
for
evaluation.
22
1.
The
chief
medical
officer
of
a
state
mental
health
23
institute,
or
that
officer’s
physician
designee,
shall
advise
24
a
person
residing
in
that
county
who
applies
for
voluntary
25
admission,
or
a
person
applying
for
the
voluntary
admission
26
of
another
person
who
resides
in
that
county,
in
accordance
27
with
section
229.41
,
that
the
board
of
supervisors
regional
28
administrator
for
the
county
has
implemented
the
policy
29
stated
in
section
225C.14
,
and
shall
advise
that
a
preliminary
30
diagnostic
evaluation
of
the
prospective
patient
be
sought,
31
if
that
has
not
already
been
done.
This
subsection
does
not
32
apply
when
voluntary
admission
is
sought
in
accordance
with
33
section
229.41
under
circumstances
which,
in
the
opinion
of
the
34
chief
medical
officer
or
that
officer’s
physician
designee,
35
-20-
LSB
5546HC
(8)
85
jp/rj
20/
50
H.F.
_____
constitute
a
medical
emergency.
1
2.
The
clerk
of
the
district
court
in
that
county
shall
2
refer
a
person
applying
for
authorization
for
voluntary
3
admission,
or
for
authorization
for
voluntary
admission
of
4
another
person,
in
accordance
with
section
229.42
,
to
the
5
appropriate
entity
designated
through
the
central
point
of
6
coordination
process
regional
administrator
of
the
person’s
7
county
of
residence
under
section
225C.14
for
the
preliminary
8
diagnostic
evaluation
unless
the
applicant
furnishes
a
written
9
statement
from
the
appropriate
entity
which
indicates
that
the
10
evaluation
has
been
performed
and
that
the
person’s
admission
11
to
a
state
mental
health
institute
is
appropriate.
This
12
subsection
does
not
apply
when
authorization
for
voluntary
13
admission
is
sought
under
circumstances
which,
in
the
opinion
14
of
the
chief
medical
officer
or
that
officer’s
physician
15
designee,
constitute
a
medical
emergency.
16
3.
Judges
of
the
district
court
in
that
county
or
the
17
judicial
hospitalization
referee
appointed
for
that
county
18
shall
so
far
as
possible
arrange
for
the
entity
designated
19
through
the
central
point
of
coordination
process
regional
20
administrator
under
section
225C.14
to
perform
a
prehearing
21
examination
of
a
respondent
required
under
section
229.8,
22
subsection
3
,
paragraph
“b”
.
23
4.
The
chief
medical
officer
of
a
state
mental
health
24
institute
shall
promptly
submit
to
the
appropriate
entity
25
designated
through
the
central
point
of
coordination
process
26
regional
administrator
under
section
225C.14
a
report
of
the
27
voluntary
admission
of
a
patient
under
the
medical
emergency
28
clauses
provisions
of
subsections
1
and
2
.
The
report
shall
29
explain
the
nature
of
the
emergency
which
necessitated
the
30
admission
of
the
patient
without
a
preliminary
diagnostic
31
evaluation
by
the
designated
entity.
32
Sec.
45.
Section
225C.17,
Code
2014,
is
amended
to
read
as
33
follows:
34
225C.17
Alternative
diagnostic
facility.
35
-21-
LSB
5546HC
(8)
85
jp/rj
21/
50
H.F.
_____
If
a
county
is
not
served
by
a
community
mental
health
1
center
having
the
capacity
to
perform
the
required
preliminary
2
diagnostic
evaluations,
the
board
of
supervisors
regional
3
administrator
for
the
county
shall
arrange
for
the
evaluations
4
to
be
performed
by
an
alternative
diagnostic
facility
for
5
the
period
until
the
county
is
served
by
a
community
mental
6
health
center
with
the
capacity
to
provide
that
service.
An
7
alternative
diagnostic
facility
may
be
the
outpatient
service
8
of
a
state
mental
health
institute
or
any
other
mental
health
9
facility
or
service
able
to
furnish
the
requisite
professional
10
skills
to
properly
perform
a
preliminary
diagnostic
evaluation
11
of
a
person
whose
admission
to
a
state
mental
health
institute
12
is
being
sought
or
considered
on
either
a
voluntary
or
an
13
involuntary
basis.
14
Sec.
46.
Section
225C.19,
subsection
3,
paragraphs
a,
b,
and
15
c,
Code
2014,
are
amended
to
read
as
follows:
16
a.
Standards
for
accrediting
or
approving
emergency
mental
17
health
crisis
services
providers.
Such
providers
may
include
18
but
are
not
limited
to
a
community
mental
health
center,
a
19
provider
approved
in
a
waiver
adopted
by
the
commission
to
20
provide
services
to
a
county
in
lieu
of
a
community
mental
21
health
center,
a
unit
of
the
department
or
other
state
22
agency,
a
county,
a
mental
health
and
disability
services
23
region,
or
any
other
public
or
private
provider
who
meets
the
24
accreditation
or
approval
standards
for
an
emergency
mental
25
health
crisis
services
provider.
26
b.
Identification
by
the
division
of
geographic
regions,
27
groupings
of
mental
health
and
disability
services
regions,
28
service
areas,
or
other
means
of
distributing
and
organizing
29
the
emergency
mental
health
crisis
services
system
to
ensure
30
statewide
availability
of
the
services.
31
c.
Coordination
of
emergency
mental
health
crisis
services
32
with
all
of
the
following:
33
(1)
The
district
and
juvenile
courts.
34
(2)
Law
enforcement.
35
-22-
LSB
5546HC
(8)
85
jp/rj
22/
50
H.F.
_____
(3)
Judicial
district
departments
of
correctional
services.
1
(4)
County
central
point
of
coordination
processes
Mental
2
health
and
disability
services
regions
.
3
(5)
Other
mental
health,
substance
abuse,
and
co-occurring
4
mental
illness
and
substance
abuse
services
available
through
5
the
state
and
counties
to
serve
both
children
and
adults.
6
Sec.
47.
Section
225C.20,
Code
2014,
is
amended
to
read
as
7
follows:
8
225C.20
Responsibilities
of
counties
for
individual
case
9
management
services.
10
Individual
case
management
services
funded
under
medical
11
assistance
shall
be
provided
by
the
department
except
when
a
12
county
or
a
consortium
of
counties
regional
administrator
for
a
13
county
contracts
with
the
department
to
provide
the
services.
14
A
county
or
consortium
of
counties
regional
administrator
15
may
contract
for
one
or
more
counties
of
the
region
to
be
16
the
provider
at
any
time
and
the
department
shall
agree
to
17
the
contract
so
long
as
the
contract
meets
the
standards
for
18
case
management
adopted
by
the
department.
The
county
or
19
consortium
of
counties
regional
administrator
may
subcontract
20
for
the
provision
of
case
management
services
so
long
as
the
21
subcontract
meets
the
same
standards.
A
county
board
of
22
supervisors
regional
administrator
may
change
the
provider
23
of
individual
case
management
services
at
any
time.
If
the
24
current
or
proposed
contract
is
with
the
department,
the
county
25
board
of
supervisors
regional
administrator
shall
provide
26
written
notification
of
a
change
at
least
ninety
days
before
27
the
date
the
change
will
take
effect.
28
Sec.
48.
Section
225C.54,
subsection
1,
Code
2014,
is
29
amended
to
read
as
follows:
30
1.
The
mental
health
services
system
for
children
and
youth
31
shall
be
initially
implemented
by
the
division
commencing
with
32
the
fiscal
year
beginning
July
1,
2008.
The
division
shall
33
begin
implementation
by
utilizing
a
competitive
bidding
process
34
to
allocate
state
block
grants
to
develop
services
through
35
-23-
LSB
5546HC
(8)
85
jp/rj
23/
50
H.F.
_____
existing
community
mental
health
centers
,
providers
approved
1
in
a
waiver
adopted
by
the
commission
to
provide
services
to
a
2
county
in
lieu
of
a
community
mental
health
center,
and
other
3
local
service
partners.
The
implementation
shall
be
limited
to
4
the
extent
of
the
appropriations
provided
for
the
children’s
5
system.
6
Sec.
49.
Section
226.1,
Code
2014,
is
amended
by
adding
the
7
following
new
subsection:
8
NEW
SUBSECTION
.
4.
For
the
purposes
of
this
chapter
unless
9
the
context
otherwise
requires:
10
a.
“Administrator”
means
the
person
assigned
by
the
11
director
of
human
services
to
control
the
state
mental
health
12
institutes.
13
b.
“Department”
means
the
department
of
human
services.
14
c.
“Mental
health
and
disability
services
region”
means
15
a
mental
health
and
disability
services
region
formed
in
16
accordance
with
section
331.389.
17
d.
“Regional
administrator”
means
the
regional
administrator
18
of
a
mental
health
and
disabilities
services
region,
as
defined
19
in
section
331.388.
20
Sec.
50.
Section
226.9C,
subsection
2,
paragraphs
a
and
c,
21
Code
2014,
are
amended
to
read
as
follows:
22
a.
A
county
may
split
the
charges
between
the
county’s
23
county
mental
health
,
intellectual
disability,
and
24
developmental
and
disabilities
services
fund
created
pursuant
25
to
section
331.424A
and
the
county’s
budget
for
substance
abuse
26
expenditures.
27
c.
(1)
Prior
to
an
individual’s
admission
for
dual
28
diagnosis
treatment,
the
individual
shall
have
been
29
prescreened.
The
person
performing
the
prescreening
shall
30
be
either
the
mental
health
professional,
as
defined
in
31
section
228.1
,
who
is
contracting
with
the
county
central
32
point
of
coordination
process
regional
administrator
for
the
33
county’s
mental
health
and
disability
services
region
to
34
provide
the
prescreening
or
a
mental
health
professional
with
35
-24-
LSB
5546HC
(8)
85
jp/rj
24/
50
H.F.
_____
the
requisite
qualifications.
A
mental
health
professional
1
with
the
requisite
qualifications
shall
meet
all
of
the
2
following
qualifications:
is
a
mental
health
professional
as
3
defined
in
section
228.1
,
is
an
alcohol
and
drug
counselor
4
certified
by
the
nongovernmental
Iowa
board
of
substance
abuse
5
certification,
and
is
employed
by
or
providing
services
for
a
6
facility,
as
defined
in
section
125.2
.
7
(2)
Prior
to
an
individual’s
admission
for
dual
diagnosis
8
treatment,
the
individual
shall
have
been
screened
through
a
9
county’s
central
point
of
coordination
process
implemented
10
pursuant
to
section
331.440
regional
administrator
to
determine
11
the
appropriateness
of
the
treatment.
12
Sec.
51.
Section
226.32,
Code
2014,
is
amended
to
read
as
13
follows:
14
226.32
Overcrowded
conditions.
15
The
administrator
shall
order
the
discharge
or
removal
16
from
the
hospital
of
incurable
and
harmless
patients
whenever
17
it
is
necessary
to
make
room
for
recent
cases.
If
a
patient
18
who
is
to
be
so
discharged
entered
the
hospital
voluntarily,
19
the
administrator
shall
notify
the
auditor
of
regional
20
administrator
for
the
county
interested
at
least
ten
days
in
21
advance
of
the
day
of
actual
discharge.
22
Sec.
52.
Section
226.34,
subsection
2,
Code
2014,
is
amended
23
to
read
as
follows:
24
2.
If
a
patient
in
a
mental
health
institute
dies
from
any
25
cause,
the
superintendent
of
the
institute
shall
within
three
26
days
of
the
date
of
death,
send
by
certified
mail
a
written
27
notice
of
death
to
all
of
the
following:
28
a.
The
decedent’s
nearest
relative.
29
b.
The
clerk
of
the
district
court
of
the
county
from
which
30
the
patient
was
committed.
31
c.
The
sheriff
of
the
county
from
which
the
patient
was
32
committed.
33
d.
The
regional
administrator
for
the
county
from
which
the
34
patient
was
committed.
35
-25-
LSB
5546HC
(8)
85
jp/rj
25/
50
H.F.
_____
Sec.
53.
Section
227.1,
Code
2014,
is
amended
to
read
as
1
follows:
2
227.1
Supervision
Definitions
——
supervision
.
3
1.
For
the
purposes
of
this
chapter,
unless
the
context
4
otherwise
requires:
5
a.
“Administrator”
means
the
person
assigned
by
the
director
6
of
human
services
in
the
appropriate
division
of
the
department
7
to
administer
mental
health
and
disability
services.
8
b.
“Department”
means
the
department
of
human
services.
9
c.
“Mental
health
and
disability
services
region”
means
10
a
mental
health
and
disability
services
region
formed
in
11
accordance
with
section
331.389.
12
d.
“Regional
administrator”
means
the
regional
administrator
13
of
a
mental
health
and
disabilities
services
region,
as
defined
14
in
section
331.388.
15
2.
All
The
regulatory
requirements
for
county
and
private
16
institutions
wherein
where
persons
with
mental
illness
or
an
17
intellectual
disability
are
kept
admitted,
committed,
or
placed
18
shall
be
under
the
supervision
of
the
administrator.
19
Sec.
54.
Section
227.2,
subsection
1,
unnumbered
paragraph
20
1,
Code
2014,
is
amended
to
read
as
follows:
21
The
director
of
inspections
and
appeals
shall
make,
or
cause
22
to
be
made,
at
least
one
licensure
inspection
each
year
of
23
every
county
care
facility.
Either
the
administrator
of
the
24
division
or
the
director
of
the
department
of
inspections
and
25
appeals,
in
cooperation
with
each
other,
upon
receipt
of
a
26
complaint
or
for
good
cause,
may
make,
or
cause
to
be
made,
27
a
review
of
a
county
care
facility
or
of
any
other
private
28
or
county
institution
where
persons
with
mental
illness
or
29
an
intellectual
disability
reside.
A
licensure
inspection
30
or
a
review
shall
be
made
by
a
competent
and
disinterested
31
person
who
is
acquainted
with
and
interested
in
the
care
of
32
persons
with
mental
illness
and
persons
with
an
intellectual
33
disability.
The
objective
of
a
licensure
inspection
or
a
34
review
shall
be
an
evaluation
of
the
programming
and
treatment
35
-26-
LSB
5546HC
(8)
85
jp/rj
26/
50
H.F.
_____
provided
by
the
facility.
After
each
licensure
inspection
of
a
1
county
care
facility,
the
person
who
made
the
inspection
shall
2
consult
with
the
county
authorities
regional
administrator
3
for
the
county
in
which
the
facility
is
located
on
plans
and
4
practices
that
will
improve
the
care
given
patients
and
.
The
5
person
shall
also
make
recommendations
to
the
administrator
of
6
the
division
and
the
director
of
public
health
for
coordinating
7
and
improving
the
relationships
between
the
administrators
of
8
county
care
facilities,
the
administrator
of
the
division,
9
the
director
of
public
health,
the
superintendents
of
state
10
mental
health
institutes
and
resource
centers,
community
11
mental
health
centers,
mental
health
and
disability
services
12
regions,
and
other
cooperating
agencies,
to
cause
improved
13
and
more
satisfactory
care
of
patients.
A
written
report
of
14
each
licensure
inspection
of
a
county
care
facility
under
this
15
section
shall
be
filed
by
the
person
with
the
administrator
16
of
the
division
and
the
director
of
public
health
and
shall
17
include:
18
Sec.
55.
Section
227.2,
subsection
1,
paragraph
f,
Code
19
2014,
is
amended
to
read
as
follows:
20
f.
The
recommendations
given
to
and
received
from
county
21
authorities
the
regional
administrator
on
methods
and
practices
22
that
will
improve
the
conditions
under
which
the
county
care
23
facility
is
operated.
24
Sec.
56.
Section
227.2,
subsection
2,
Code
2014,
is
amended
25
to
read
as
follows:
26
2.
A
copy
of
the
written
report
prescribed
by
subsection
27
1
shall
be
furnished
to
the
county
board
of
supervisors,
28
to
the
county
mental
health
and
intellectual
disability
29
coordinating
board
or
to
its
advisory
board
if
the
county
board
30
of
supervisors
constitutes
ex
officio
the
coordinating
board
31
regional
administrator
for
the
county
,
to
the
administrator
32
of
the
county
care
facility
inspected
and
to
its
certified
33
volunteer
long-term
care
ombudsman,
and
to
the
department
on
34
aging.
35
-27-
LSB
5546HC
(8)
85
jp/rj
27/
50
H.F.
_____
Sec.
57.
Section
227.4,
Code
2014,
is
amended
to
read
as
1
follows:
2
227.4
Standards
for
care
of
persons
with
mental
illness
or
an
3
intellectual
disability
in
county
care
facilities.
4
The
administrator,
in
cooperation
with
the
department
of
5
inspections
and
appeals,
shall
recommend
and
the
mental
health
6
and
disability
services
commission
created
in
section
225C.5
7
shall
adopt
,
or
amend
and
adopt,
standards
for
the
care
of
and
8
services
to
persons
with
mental
illness
or
an
intellectual
9
disability
residing
in
county
care
facilities.
The
standards
10
shall
be
enforced
by
the
department
of
inspections
and
appeals
11
as
a
part
of
the
licensure
inspection
conducted
pursuant
to
12
chapter
135C
.
The
objective
of
the
standards
is
to
ensure
13
that
persons
with
mental
illness
or
an
intellectual
disability
14
who
are
residents
of
county
care
facilities
are
not
only
15
adequately
fed,
clothed,
and
housed,
but
are
also
offered
16
reasonable
opportunities
for
productive
work
and
recreational
17
activities
suited
to
their
physical
and
mental
abilities
and
18
offering
both
a
constructive
outlet
for
their
energies
and,
if
19
possible,
therapeutic
benefit.
When
recommending
standards
20
under
this
section
,
the
administrator
shall
designate
an
21
advisory
committee
representing
administrators
of
county
care
22
facilities,
county
mental
health
and
developmental
disabilities
23
regional
planning
councils
regional
administrators
,
mental
24
health
and
disabilities
services
region
governing
boards,
25
and
county
care
facility
certified
volunteer
long-term
care
26
ombudsmen
to
assist
in
the
establishment
of
standards.
27
Sec.
58.
Section
227.10,
Code
2014,
is
amended
to
read
as
28
follows:
29
227.10
Transfers
from
county
or
private
institutions.
30
Patients
who
have
been
admitted
at
public
expense
to
31
any
institution
to
which
this
chapter
is
applicable
may
be
32
involuntarily
transferred
to
the
proper
state
hospital
for
33
persons
with
mental
illness
in
the
manner
prescribed
by
34
sections
229.6
to
229.13
.
The
application
required
by
section
35
-28-
LSB
5546HC
(8)
85
jp/rj
28/
50
H.F.
_____
229.6
may
be
filed
by
the
administrator
of
the
division
or
1
the
administrator’s
designee,
or
by
the
administrator
of
the
2
institution
where
the
patient
is
then
being
maintained
or
3
treated.
If
the
patient
was
admitted
to
that
institution
4
involuntarily,
the
administrator
of
the
division
may
arrange
5
and
complete
the
transfer,
and
shall
report
it
as
required
of
6
a
chief
medical
officer
under
section
229.15,
subsection
5
.
7
The
transfer
shall
be
made
at
county
expense,
and
the
expense
8
recovered,
as
provided
in
section
227.7
.
However,
transfer
9
under
this
section
of
a
patient
whose
expenses
are
payable
in
10
whole
or
in
part
by
a
county
is
subject
to
an
authorization
for
11
the
transfer
through
the
central
point
of
coordination
process
12
regional
administrator
for
the
patient’s
county
of
residence
.
13
Sec.
59.
Section
227.11,
Code
2014,
is
amended
to
read
as
14
follows:
15
227.11
Transfers
from
state
hospitals.
16
A
regional
administrator
for
the
county
chargeable
with
17
the
expense
of
a
patient
in
a
state
hospital
for
persons
with
18
mental
illness
shall
transfer
the
patient
to
a
county
or
19
private
institution
for
persons
with
mental
illness
that
is
in
20
compliance
with
the
applicable
rules
when
the
administrator
21
of
the
division
or
the
administrator’s
designee
orders
the
22
transfer
on
a
finding
that
the
patient
is
suffering
from
23
chronic
mental
illness
or
from
senility
and
will
receive
equal
24
benefit
by
being
so
transferred.
A
county
shall
transfer
to
25
its
county
care
facility
any
patient
in
a
state
hospital
for
26
persons
with
mental
illness
upon
request
of
the
superintendent
27
of
the
state
hospital
in
which
the
patient
is
confined
28
pursuant
to
the
superintendent’s
authority
under
section
29
229.15,
subsection
5
,
and
approval
by
the
board
of
supervisors
30
of
regional
administrator
for
the
county
of
the
patient’s
31
residence.
In
no
case
shall
a
patient
be
thus
transferred
32
except
upon
compliance
with
section
229.14A
or
without
the
33
written
consent
of
a
relative,
friend,
or
guardian
if
such
34
relative,
friend,
or
guardian
pays
the
expense
of
the
care
of
35
-29-
LSB
5546HC
(8)
85
jp/rj
29/
50
H.F.
_____
such
patient
in
a
state
hospital.
Patients
transferred
to
a
1
public
or
private
facility
under
this
section
may
subsequently
2
be
placed
on
convalescent
or
limited
leave
or
transferred
to
3
a
different
facility
for
continued
full-time
custody,
care,
4
and
treatment
when,
in
the
opinion
of
the
attending
physician
5
or
the
chief
medical
officer
of
the
hospital
from
which
the
6
patient
was
so
transferred,
the
best
interest
of
the
patient
7
would
be
served
by
such
leave
or
transfer.
For
any
patient
8
who
is
involuntarily
committed,
any
transfer
made
under
this
9
section
is
subject
to
the
placement
hearing
requirements
of
10
section
229.14A
.
11
Sec.
60.
Section
227.12,
Code
2014,
is
amended
to
read
as
12
follows:
13
227.12
Difference
of
opinion.
14
When
a
difference
of
opinion
exists
between
the
15
administrator
of
the
division
and
the
authorities
in
charge
16
of
any
private
or
county
hospital
in
regard
to
the
removal
17
transfer
of
a
patient
or
patients
as
herein
provided
in
18
sections
227.10
and
227.11
,
the
matter
shall
be
submitted
to
19
the
district
court
of
the
county
in
which
such
hospital
is
20
situated
and
shall
be
summarily
tried
as
an
equitable
action,
21
and
the
judgment
of
the
district
court
shall
be
final.
22
Sec.
61.
Section
227.14,
Code
2014,
is
amended
to
read
as
23
follows:
24
227.14
Caring
for
persons
with
mental
illness
from
other
25
counties.
26
Boards
of
supervisors
of
counties
having
no
The
regional
27
administrator
for
a
county
that
does
not
have
proper
facilities
28
for
caring
for
persons
with
mental
illness
may,
with
the
29
consent
of
the
administrator
of
the
division,
provide
for
such
30
care
at
the
expense
of
the
county
in
any
convenient
and
proper
31
county
or
private
institution
for
persons
with
mental
illness
32
which
is
willing
to
receive
them
the
persons
.
33
Sec.
62.
Section
229.1,
subsection
3,
Code
2014,
is
amended
34
by
striking
the
subsection.
35
-30-
LSB
5546HC
(8)
85
jp/rj
30/
50
H.F.
_____
Sec.
63.
Section
229.1,
Code
2014,
is
amended
by
adding
the
1
following
new
subsections:
2
NEW
SUBSECTION
.
8A.
“Mental
health
and
disability
services
3
region”
means
a
mental
health
and
disability
services
region
4
formed
in
accordance
with
section
331.389.
5
NEW
SUBSECTION
.
14A.
“Regional
administrator”
means
the
6
regional
administrator
of
a
mental
health
and
disabilities
7
services
region,
as
defined
in
section
331.388.
8
Sec.
64.
Section
229.1B,
Code
2014,
is
amended
to
read
as
9
follows:
10
229.1B
Central
point
of
coordination
process
Regional
11
administrator
.
12
Notwithstanding
any
provision
of
this
chapter
to
the
13
contrary,
any
person
whose
hospitalization
expenses
are
14
payable
in
whole
or
in
part
by
a
county
shall
be
subject
15
to
all
administrative
requirements
of
the
central
point
of
16
coordination
process
regional
administrator
for
the
county
.
17
Sec.
65.
Section
229.2,
subsection
1,
paragraph
b,
18
subparagraph
(3),
Code
2014,
is
amended
to
read
as
follows:
19
(3)
As
soon
as
is
practicable
after
the
filing
of
a
20
petition
for
juvenile
court
approval
of
the
admission
of
the
21
minor,
the
juvenile
court
shall
determine
whether
the
minor
22
has
an
attorney
to
represent
the
minor
in
the
hospitalization
23
proceeding,
and
if
not,
the
court
shall
assign
to
the
minor
24
an
attorney.
If
the
minor
is
financially
unable
to
pay
for
25
an
attorney,
the
attorney
shall
be
compensated
by
the
county
26
at
an
hourly
rate
to
be
established
by
the
county
board
of
27
supervisors
regional
administrator
for
the
county
in
which
the
28
proceeding
is
held
in
substantially
the
same
manner
as
provided
29
in
section
815.7
.
30
Sec.
66.
Section
229.8,
subsection
1,
Code
2014,
is
amended
31
to
read
as
follows:
32
1.
Determine
whether
the
respondent
has
an
attorney
33
who
is
able
and
willing
to
represent
the
respondent
in
the
34
hospitalization
proceeding,
and
if
not,
whether
the
respondent
35
-31-
LSB
5546HC
(8)
85
jp/rj
31/
50
H.F.
_____
is
financially
able
to
employ
an
attorney
and
capable
of
1
meaningfully
assisting
in
selecting
one.
In
accordance
with
2
those
determinations,
the
court
shall
if
necessary
allow
the
3
respondent
to
select,
or
shall
assign
to
the
respondent,
an
4
attorney.
If
the
respondent
is
financially
unable
to
pay
an
5
attorney,
the
attorney
shall
be
compensated
by
the
county
6
at
an
hourly
rate
to
be
established
by
the
county
board
of
7
supervisors
regional
administrator
for
the
county
in
which
the
8
proceeding
is
held
in
substantially
the
same
manner
as
provided
9
in
section
815.7
.
10
Sec.
67.
Section
229.10,
subsection
1,
paragraph
a,
Code
11
2014,
is
amended
to
read
as
follows:
12
a.
An
examination
of
the
respondent
shall
be
conducted
by
13
one
or
more
licensed
physicians,
as
required
by
the
court’s
14
order,
within
a
reasonable
time.
If
the
respondent
is
detained
15
pursuant
to
section
229.11,
subsection
1
,
paragraph
“b”
,
16
the
examination
shall
be
conducted
within
twenty-four
hours.
17
If
the
respondent
is
detained
pursuant
to
section
229.11,
18
subsection
1
,
paragraph
“a”
or
“c”
,
the
examination
shall
19
be
conducted
within
forty-eight
hours.
If
the
respondent
20
so
desires,
the
respondent
shall
be
entitled
to
a
separate
21
examination
by
a
licensed
physician
of
the
respondent’s
own
22
choice.
The
reasonable
cost
of
the
examinations
shall,
if
the
23
respondent
lacks
sufficient
funds
to
pay
the
cost,
be
paid
by
24
the
regional
administrator
from
county
funds
upon
order
of
the
25
court.
26
Sec.
68.
Section
229.11,
subsection
1,
unnumbered
paragraph
27
1,
Code
2014,
is
amended
to
read
as
follows:
28
If
the
applicant
requests
that
the
respondent
be
taken
into
29
immediate
custody
and
the
judge,
upon
reviewing
the
application
30
and
accompanying
documentation,
finds
probable
cause
to
believe
31
that
the
respondent
has
a
serious
mental
impairment
and
is
32
likely
to
injure
the
respondent
or
other
persons
if
allowed
33
to
remain
at
liberty,
the
judge
may
enter
a
written
order
34
directing
that
the
respondent
be
taken
into
immediate
custody
35
-32-
LSB
5546HC
(8)
85
jp/rj
32/
50
H.F.
_____
by
the
sheriff
or
the
sheriff’s
deputy
and
be
detained
until
1
the
hospitalization
hearing.
The
hospitalization
hearing
shall
2
be
held
no
more
than
five
days
after
the
date
of
the
order,
3
except
that
if
the
fifth
day
after
the
date
of
the
order
is
a
4
Saturday,
Sunday,
or
a
holiday,
the
hearing
may
be
held
on
the
5
next
succeeding
business
day.
If
the
expenses
of
a
respondent
6
are
payable
in
whole
or
in
part
by
a
county,
for
a
placement
7
in
accordance
with
paragraph
“a”
,
the
judge
shall
give
notice
8
of
the
placement
to
the
central
point
of
coordination
process
9
regional
administrator
for
the
county
in
which
the
court
is
10
located
,
and
for
a
placement
in
accordance
with
paragraph
“b”
11
or
“c”
,
the
judge
shall
order
the
placement
in
a
hospital
or
12
facility
designated
through
the
central
point
of
coordination
13
process
regional
administrator
.
The
judge
may
order
the
14
respondent
detained
for
the
period
of
time
until
the
hearing
15
is
held,
and
no
longer,
in
accordance
with
paragraph
“a”
,
if
16
possible,
and
if
not
then
in
accordance
with
paragraph
“b”
,
17
or,
only
if
neither
of
these
alternatives
is
available,
in
18
accordance
with
paragraph
“c”
.
Detention
may
be:
19
Sec.
69.
Section
229.13,
subsection
1,
paragraph
a,
Code
20
2014,
is
amended
to
read
as
follows:
21
a.
The
court
shall
order
a
respondent
whose
expenses
are
22
payable
in
whole
or
in
part
by
a
county
placed
under
the
care
23
of
an
appropriate
hospital
or
facility
designated
through
24
the
central
point
of
coordination
process
county’s
regional
25
administrator
on
an
inpatient
or
outpatient
basis.
26
Sec.
70.
Section
229.14,
subsection
2,
paragraph
a,
Code
27
2014,
is
amended
to
read
as
follows:
28
a.
For
a
respondent
whose
expenses
are
payable
in
whole
29
or
in
part
by
a
county,
placement
as
designated
through
30
the
central
point
of
coordination
process
county’s
regional
31
administrator
in
the
care
of
an
appropriate
hospital
or
32
facility
on
an
inpatient
or
outpatient
basis,
or
other
33
appropriate
treatment,
or
in
an
appropriate
alternative
34
placement.
35
-33-
LSB
5546HC
(8)
85
jp/rj
33/
50
H.F.
_____
Sec.
71.
Section
229.14A,
subsections
7
and
9,
Code
2014,
1
are
amended
to
read
as
follows:
2
7.
If
a
respondent’s
expenses
are
payable
in
whole
or
in
3
part
by
a
county
through
the
central
point
of
coordination
4
process
county’s
regional
administrator
,
notice
of
a
placement
5
hearing
shall
be
provided
to
the
county
attorney
and
the
6
county’s
central
point
of
coordination
process
regional
7
administrator.
At
the
hearing,
the
county
may
present
evidence
8
regarding
appropriate
placement.
9
9.
A
placement
made
pursuant
to
an
order
entered
under
10
section
229.13
or
229.14
or
this
section
shall
be
considered
to
11
be
authorized
through
the
central
point
of
coordination
process
12
county’s
regional
administrator
.
13
Sec.
72.
Section
229.19,
subsection
1,
paragraphs
a
and
b,
14
Code
2014,
are
amended
to
read
as
follows:
15
a.
In
each
county
with
a
population
of
three
hundred
16
thousand
or
more
inhabitants
the
board
of
supervisors
county’s
17
regional
administrator
shall
appoint
an
individual
who
has
18
demonstrated
by
prior
activities
an
informed
concern
for
the
19
welfare
and
rehabilitation
of
persons
with
mental
illness,
20
and
who
is
not
an
officer
or
employee
of
the
department
of
21
human
services
nor
of
any
agency
or
facility
providing
care
22
or
treatment
to
persons
with
mental
illness,
to
act
as
an
23
advocate
representing
the
interests
of
patients
involuntarily
24
hospitalized
by
the
court,
in
any
matter
relating
to
the
25
patients’
hospitalization
or
treatment
under
section
229.14
26
or
229.15
.
In
each
county
with
a
population
of
under
three
27
hundred
thousand
inhabitants,
the
chief
judge
of
the
judicial
28
district
encompassing
the
county
shall
appoint
the
advocate.
29
b.
The
court
or,
if
the
advocate
is
appointed
by
the
30
county
board
of
supervisors
regional
administrator
,
the
board
31
regional
administrator
shall
assign
the
advocate
appointed
from
32
a
patient’s
county
of
residence
to
represent
the
interests
33
of
the
patient.
If
a
patient
has
no
county
of
residence
or
34
the
patient
is
a
state
case,
the
court
or,
if
the
advocate
35
-34-
LSB
5546HC
(8)
85
jp/rj
34/
50
H.F.
_____
is
appointed
by
the
county
board
of
supervisors
regional
1
administrator
,
the
board
regional
administrator
shall
assign
2
the
advocate
appointed
from
for
the
county
where
the
hospital
3
or
facility
is
located
to
represent
the
interests
of
the
4
patient.
5
Sec.
73.
Section
229.19,
subsection
3,
Code
2014,
is
amended
6
to
read
as
follows:
7
3.
The
court
or,
if
the
advocate
is
appointed
by
the
county
8
board
of
supervisors
regional
administrator
,
the
board
regional
9
administrator
shall
prescribe
reasonable
compensation
for
the
10
services
of
the
advocate.
The
compensation
shall
be
based
11
upon
the
reports
filed
by
the
advocate
with
the
court.
The
12
advocate’s
compensation
shall
be
paid
by
the
county
in
which
13
the
court
is
located,
either
on
order
of
the
court
or,
if
14
the
advocate
is
appointed
by
the
county
board
of
supervisors
15
regional
administrator
,
on
the
direction
of
the
board
regional
16
administrator
.
If
the
advocate
is
appointed
by
the
court,
the
17
advocate
is
an
employee
of
the
state
for
purposes
of
chapter
18
669
.
If
the
advocate
is
appointed
by
the
county
board
of
19
supervisors
regional
administrator
,
the
advocate
is
an
employee
20
of
the
county
for
purposes
of
chapter
670
.
If
the
patient
or
21
the
person
who
is
legally
liable
for
the
patient’s
support
is
22
not
indigent,
the
board
regional
administrator
shall
recover
23
the
costs
of
compensating
the
advocate
from
that
person.
If
24
that
person
has
an
income
level
as
determined
pursuant
to
25
section
815.9
greater
than
one
hundred
percent
but
not
more
26
than
one
hundred
fifty
percent
of
the
poverty
guidelines,
at
27
least
one
hundred
dollars
of
the
advocate’s
compensation
shall
28
be
recovered
in
the
manner
prescribed
by
the
county
board
of
29
supervisors
regional
administrator
.
If
that
person
has
an
30
income
level
as
determined
pursuant
to
section
815.9
greater
31
than
one
hundred
fifty
percent
of
the
poverty
guidelines,
at
32
least
two
hundred
dollars
of
the
advocate’s
compensation
shall
33
be
recovered
in
substantially
the
same
manner
prescribed
by
the
34
county
board
of
supervisors
as
provided
in
section
815.9
.
35
-35-
LSB
5546HC
(8)
85
jp/rj
35/
50
H.F.
_____
Sec.
74.
Section
229.24,
subsection
3,
unnumbered
paragraph
1
1,
Code
2014,
is
amended
to
read
as
follows:
2
If
all
or
part
of
the
costs
associated
with
hospitalization
3
of
an
individual
under
this
chapter
are
chargeable
to
a
county
4
of
residence,
the
clerk
of
the
district
court
shall
provide
5
to
the
regional
administrator
for
the
county
of
residence
and
6
to
the
regional
administrator
for
the
county
in
which
the
7
hospitalization
order
is
entered
the
following
information
8
pertaining
to
the
individual
which
would
be
confidential
under
9
subsection
1
:
10
Sec.
75.
Section
229.42,
subsection
1,
Code
2014,
is
amended
11
to
read
as
follows:
12
1.
If
a
person
wishing
to
make
application
for
voluntary
13
admission
to
a
mental
hospital
established
by
chapter
226
is
14
unable
to
pay
the
costs
of
hospitalization
or
those
responsible
15
for
the
person
are
unable
to
pay
the
costs,
application
for
16
authorization
of
voluntary
admission
must
be
made
through
a
17
central
point
of
coordination
process
regional
administrator
18
before
application
for
admission
is
made
to
the
hospital.
The
19
person’s
county
of
residence
shall
be
determined
through
the
20
central
point
of
coordination
process
regional
administrator
21
and
if
the
admission
is
approved
through
the
central
point
22
of
coordination
process
regional
administrator
,
the
person’s
23
admission
to
a
mental
health
hospital
shall
be
authorized
as
24
a
voluntary
case.
The
authorization
shall
be
issued
on
forms
25
provided
by
the
department
of
human
services’
administrator.
26
The
costs
of
the
hospitalization
shall
be
paid
by
the
27
county
of
residence
to
the
department
of
human
services
and
28
credited
to
the
general
fund
of
the
state,
provided
that
the
29
mental
health
hospital
rendering
the
services
has
certified
30
to
the
county
auditor
of
the
county
of
residence
and
the
31
regional
administrator
the
amount
chargeable
to
the
county
32
and
has
sent
a
duplicate
statement
of
the
charges
to
the
33
department
of
human
services.
A
county
shall
not
be
billed
34
for
the
cost
of
a
patient
unless
the
patient’s
admission
is
35
-36-
LSB
5546HC
(8)
85
jp/rj
36/
50
H.F.
_____
authorized
through
the
central
point
of
coordination
process
1
regional
administrator
.
The
mental
health
institute
and
the
2
county
regional
administrator
shall
work
together
to
locate
3
appropriate
alternative
placements
and
services,
and
to
4
educate
patients
and
family
members
of
patients
regarding
such
5
alternatives.
6
Sec.
76.
Section
230.1,
subsection
3,
Code
2014,
is
amended
7
to
read
as
follows:
8
3.
A
county
of
residence
is
not
liable
for
costs
and
9
expenses
associated
with
a
person
with
mental
illness
unless
10
the
costs
and
expenses
are
for
services
and
other
support
11
authorized
for
the
person
through
the
central
point
of
12
coordination
process
county’s
regional
administrator
.
For
13
the
purposes
of
this
chapter
,
“central
point
of
coordination
14
process”
“regional
administrator”
means
the
same
as
defined
in
15
section
331.440
331.388
.
16
Sec.
77.
Section
230.3,
Code
2014,
is
amended
to
read
as
17
follows:
18
230.3
Certification
of
residence.
19
If
a
person’s
county
of
residence
is
determined
by
the
20
county’s
central
point
of
coordination
process
regional
21
administrator
to
be
in
another
county
of
this
state,
the
county
22
regional
administrator
making
the
determination
shall
certify
23
the
determination
to
the
superintendent
of
the
hospital
to
24
which
the
person
is
admitted
or
committed.
The
certification
25
shall
be
accompanied
by
a
copy
of
the
evidence
supporting
26
the
determination.
Upon
receiving
the
certification,
the
27
superintendent
shall
charge
the
expenses
already
incurred
and
28
unadjusted,
and
all
future
expenses
of
the
person,
to
the
29
county
determined
to
be
the
county
of
residence.
30
Sec.
78.
Section
230.20,
subsection
2,
paragraph
b,
Code
31
2014,
is
amended
to
read
as
follows:
32
b.
The
per
diem
costs
billed
to
each
county
shall
not
exceed
33
the
per
diem
costs
billed
to
the
county
in
the
fiscal
year
34
beginning
July
1,
1996.
However,
the
per
diem
costs
billed
to
35
-37-
LSB
5546HC
(8)
85
jp/rj
37/
50
H.F.
_____
a
county
may
be
adjusted
annually
to
reflect
increased
costs
,
1
to
the
extent
of
the
percentage
increase
in
the
total
of
county
2
fixed
budgets
pursuant
to
the
allowed
growth
factor
adjustment
3
statewide
per
capita
expenditure
target
amount,
if
any
per
4
capita
growth
amount
is
authorized
by
the
general
assembly
for
5
the
fiscal
year
in
accordance
with
section
331.439
426B.3
.
6
Sec.
79.
Section
232.2,
subsection
4,
paragraph
f,
7
subparagraph
(3),
Code
2014,
is
amended
to
read
as
follows:
8
(3)
The
transition
plan
shall
be
developed
and
reviewed
9
by
the
department
in
collaboration
with
a
child-centered
10
transition
team.
The
transition
team
shall
be
comprised
of
11
the
child’s
caseworker
and
persons
selected
by
the
child,
12
persons
who
have
knowledge
of
services
available
to
the
child,
13
and
any
person
who
may
reasonably
be
expected
to
be
a
service
14
provider
for
the
child
when
the
child
becomes
an
adult
or
to
15
become
responsible
for
the
costs
of
services
at
that
time.
16
If
the
child
is
reasonably
likely
to
need
or
be
eligible
for
17
adult
services,
the
transition
team
membership
shall
include
18
representatives
from
the
adult
services
system.
The
adult
19
services
system
representatives
may
include
but
are
not
limited
20
to
the
administrator
of
county
general
relief
under
chapter
21
251
or
252
or
of
the
central
point
of
coordination
process
22
implemented
under
section
331.440
regional
administrator
of
23
the
county
mental
health
and
disabilities
services
region,
as
24
defined
in
section
331.388
.
The
membership
of
the
transition
25
team
and
the
meeting
dates
for
the
team
shall
be
documented
in
26
the
transition
plan.
27
Sec.
80.
Section
235.7,
subsection
2,
Code
2014,
is
amended
28
to
read
as
follows:
29
2.
Membership.
The
department
may
authorize
the
governance
30
boards
of
decategorization
of
child
welfare
and
juvenile
31
justice
funding
projects
established
under
section
232.188
to
32
appoint
the
transition
committee
membership
and
may
utilize
33
the
boundaries
of
decategorization
projects
to
establish
34
the
service
areas
for
transition
committees.
The
committee
35
-38-
LSB
5546HC
(8)
85
jp/rj
38/
50
H.F.
_____
membership
may
include
but
is
not
limited
to
department
of
1
human
services
staff
involved
with
foster
care,
child
welfare,
2
and
adult
services,
juvenile
court
services
staff,
staff
3
involved
with
county
general
relief
under
chapter
251
or
252
,
4
or
of
the
central
point
of
coordination
process
implemented
5
under
section
331.440
a
regional
administrator
of
the
county
6
mental
health
and
disabilities
services
region,
as
defined
7
in
section
331.388,
in
the
area
,
school
district
and
area
8
education
agency
staff
involved
with
special
education,
and
a
9
child’s
court
appointed
special
advocate,
guardian
ad
litem,
10
service
providers,
and
other
persons
knowledgeable
about
the
11
child.
12
Sec.
81.
Section
235A.15,
subsection
2,
paragraph
c,
13
subparagraph
(9),
Code
2014,
is
amended
to
read
as
follows:
14
(9)
To
the
administrator
of
an
agency
providing
mental
15
health,
intellectual
disability,
or
developmental
disability
16
services
under
a
county
management
plan
developed
pursuant
17
to
section
331.439
regional
service
system
management
plan
18
implemented
in
accordance
with
section
331.393
,
if
the
data
19
concerns
a
person
employed
by
or
being
considered
by
the
agency
20
for
employment.
21
Sec.
82.
Section
235B.6,
subsection
2,
paragraph
c,
22
subparagraph
(6),
Code
2014,
is
amended
to
read
as
follows:
23
(6)
To
the
administrator
of
an
agency
providing
mental
24
health,
intellectual
disability,
or
developmental
disability
25
services
under
a
county
management
plan
developed
pursuant
26
to
section
331.439
regional
service
system
management
plan
27
implemented
in
accordance
with
section
331.393
,
if
the
28
information
concerns
a
person
employed
by
or
being
considered
29
by
the
agency
for
employment.
30
Sec.
83.
Section
426B.2,
subsection
2,
Code
2014,
is
amended
31
to
read
as
follows:
32
2.
As
used
in
this
chapter
,
and
in
sections
331.438
and
33
331.439
section
331.424A
,
for
purposes
of
population-based
34
funding
calculations,
“population”
means
the
population
shown
35
-39-
LSB
5546HC
(8)
85
jp/rj
39/
50
H.F.
_____
by
the
latest
preceding
certified
federal
census
or
the
1
latest
applicable
population
estimate
issued
by
the
federal
2
government
,
available
as
of
July
1
of
the
fiscal
year
preceding
3
the
fiscal
year
to
which
the
funding
calculations
apply
.
4
Sec.
84.
Section
426B.5,
subsection
1,
Code
2014,
is
amended
5
by
striking
the
subsection.
6
Sec.
85.
Section
426B.5,
subsections
2
and
3,
Code
2014,
are
7
amended
to
read
as
follows:
8
2.
Risk
pool.
9
a.
For
the
purposes
of
this
subsection
section
,
unless
the
10
context
otherwise
requires
,
:
11
(1)
“Mental
health
and
disability
services
region”
means
12
a
mental
health
and
disability
services
region
formed
in
13
accordance
with
section
331.389.
14
(2)
“Regional
administrator”
means
the
regional
15
administrator
of
a
mental
health
and
disabilities
services
16
region,
as
defined
in
section
331.388.
17
(3)
“services
“Services
fund”
means
a
county’s
mental
18
health
,
intellectual
disability,
and
developmental
disabilities
19
services
fund
created
in
pursuant
to
section
331.424A
.
20
b.
A
risk
pool
is
created
in
the
property
tax
relief
fund.
21
The
pool
shall
consist
of
the
moneys
credited
to
the
pool
by
22
law.
23
c.
A
risk
pool
board
is
created.
The
board
shall
consist
24
of
two
county
supervisors,
two
county
auditors,
a
member
of
25
the
mental
health
and
disability
services
commission
who
is
26
not
a
member
of
a
county
board
of
supervisors,
a
member
of
27
the
county
finance
committee
created
in
chapter
333A
who
is
28
not
an
elected
official,
a
representative
of
a
provider
of
29
mental
health
or
developmental
disabilities
services
selected
30
from
nominees
submitted
by
the
Iowa
association
of
community
31
providers,
and
two
central
point
of
coordination
process
staff
32
members
of
regional
administrators
of
county
mental
health
and
33
disabilities
services
regions
,
all
appointed
by
the
governor,
34
and
one
member
appointed
by
the
director
of
human
services.
35
-40-
LSB
5546HC
(8)
85
jp/rj
40/
50
H.F.
_____
All
members
appointed
by
the
governor
shall
be
subject
to
1
confirmation
by
the
senate.
Members
shall
serve
for
three-year
2
terms.
A
vacancy
shall
be
filled
in
the
same
manner
as
the
3
original
appointment.
Expenses
and
other
costs
of
the
risk
4
pool
board
members
representing
counties
shall
be
paid
by
the
5
county
of
origin.
Expenses
and
other
costs
of
risk
pool
board
6
members
who
do
not
represent
counties
shall
be
paid
from
a
7
source
determined
by
the
governor.
Staff
assistance
to
the
8
board
shall
be
provided
by
the
department
of
human
services
and
9
counties.
Actuarial
expenses
and
other
direct
administrative
10
costs
shall
be
charged
to
the
pool.
11
d.
A
county
regional
administrator
must
apply
to
the
risk
12
pool
board
for
assistance
from
the
risk
pool
on
or
before
13
October
31.
The
purpose
of
the
assistance
shall
be
to
provide
14
financial
support
for
services
provided
by
one
or
more
of
the
15
counties
comprising
the
regional
administrator’s
mental
health
16
and
disability
services
region.
The
risk
pool
board
shall
17
make
its
final
decisions
on
or
before
December
15
regarding
18
acceptance
or
rejection
of
the
applications
for
assistance
and
19
the
total
amount
accepted
shall
be
considered
obligated.
20
e.
Basic
eligibility
for
risk
pool
assistance
requires
that
21
a
county
meet
all
of
the
following
conditions:
22
(1)
The
county
is
in
compliance
with
the
regional
service
23
system
management
plan
requirements
of
section
331.439
331.393
.
24
(2)
The
county
levied
the
maximum
amount
allowed
for
the
25
county’s
services
fund
under
section
331.424A
for
the
fiscal
26
year
of
application
for
risk
pool
assistance.
27
(3)
In
the
fiscal
year
that
commenced
two
years
prior
to
28
the
fiscal
year
of
application,
the
county’s
services
fund
29
ending
balance
under
generally
accepted
accounting
principles
30
was
equal
to
or
less
than
twenty
percent
of
the
county’s
actual
31
gross
expenditures
for
that
fiscal
year.
32
f.
The
board
shall
review
the
fiscal
year-end
financial
33
records
for
all
counties
that
are
granted
risk
pool
assistance.
34
If
the
board
determines
a
county’s
actual
need
for
risk
pool
35
-41-
LSB
5546HC
(8)
85
jp/rj
41/
50
H.F.
_____
assistance
was
less
than
the
amount
of
risk
pool
assistance
1
granted
to
the
county,
the
county
shall
refund
the
difference
2
between
the
amount
of
assistance
granted
and
the
actual
need.
3
The
county
shall
submit
the
refund
within
thirty
days
of
4
receiving
notice
from
the
board.
Refunds
shall
be
credited
5
to
the
risk
pool.
The
mental
health
and
disability
services
6
commission
shall
adopt
rules
pursuant
to
chapter
17A
providing
7
criteria
for
the
purposes
of
this
lettered
paragraph
and
as
8
necessary
to
implement
the
other
provisions
of
this
subsection
.
9
g.
The
board
shall
determine
application
requirements
to
10
ensure
prudent
use
of
risk
pool
assistance.
The
board
may
11
accept
or
reject
an
application
for
assistance
in
whole
or
in
12
part.
The
decision
of
the
board
is
final.
13
h.
The
total
amount
of
risk
pool
assistance
shall
be
limited
14
to
the
amount
available
in
the
risk
pool
for
a
fiscal
year.
Any
15
unobligated
balance
in
the
risk
pool
at
the
close
of
a
fiscal
16
year
shall
remain
in
the
risk
pool
for
distribution
in
the
17
succeeding
fiscal
year.
18
i.
Risk
pool
assistance
shall
only
be
made
available
to
19
address
one
or
more
of
the
following
circumstances:
20
(1)
Continuing
support
for
mandated
services.
21
(2)
Avoiding
the
need
for
reduction
or
elimination
of
22
critical
services
when
the
reduction
or
elimination
places
23
consumers’
health
or
safety
at
risk.
24
(3)
Avoiding
the
need
for
reduction
or
elimination
of
a
25
mobile
crisis
team
or
other
critical
emergency
services
when
26
the
reduction
or
elimination
places
the
public’s
health
or
27
safety
at
risk.
28
(4)
Avoiding
the
need
for
reduction
or
elimination
of
29
the
services
or
other
support
provided
to
entire
disability
30
populations.
31
(5)
Avoiding
the
need
for
reduction
or
elimination
of
32
services
or
other
support
that
maintain
consumers
in
a
33
community
setting,
creating
a
risk
that
the
consumers
would
be
34
placed
in
more
restrictive,
higher
cost
settings.
35
-42-
LSB
5546HC
(8)
85
jp/rj
42/
50
H.F.
_____
j.
Subject
to
the
amount
available
and
obligated
from
the
1
risk
pool
for
a
fiscal
year,
the
department
of
human
services
2
shall
annually
calculate
the
amount
of
moneys
due
to
eligible
3
counties
in
accordance
with
the
board’s
decisions
and
that
4
amount
is
appropriated
from
the
risk
pool
to
the
department
5
for
payment
of
the
moneys
due.
The
department
shall
authorize
6
the
issuance
of
warrants
payable
to
the
county
treasurer
for
7
the
amounts
due
and
the
warrants
shall
be
issued
on
or
before
8
January
1.
9
k.
On
or
before
March
1
and
September
1
of
each
fiscal
year,
10
the
department
of
human
services
shall
provide
the
risk
pool
11
board
with
a
report
of
the
financial
condition
of
each
funding
12
source
administered
by
the
board.
The
report
shall
include
13
but
is
not
limited
to
an
itemization
of
the
funding
source’s
14
balances,
types
and
amount
of
revenues
credited,
and
payees
15
and
payment
amounts
for
the
expenditures
made
from
the
funding
16
source
during
the
reporting
period.
17
l.
If
the
board
has
made
its
decisions
but
has
determined
18
that
there
are
otherwise
qualifying
requests
for
risk
pool
19
assistance
that
are
beyond
the
amount
available
in
the
risk
20
pool
fund
for
a
fiscal
year,
the
board
shall
compile
a
list
of
21
such
requests
and
the
supporting
information
for
the
requests.
22
The
list
and
information
shall
be
submitted
to
the
mental
23
health
and
disability
services
commission,
the
department
of
24
human
services,
and
the
general
assembly.
25
3.
Incentive
pool.
26
a.
An
incentive
pool
is
created
in
the
property
tax
relief
27
fund.
The
incentive
pool
shall
consist
of
the
moneys
credited
28
to
the
incentive
pool
by
law.
29
b.
Moneys
available
in
the
incentive
pool
for
a
fiscal
30
year
shall
be
distributed
to
those
counties
mental
health
and
31
disability
services
regions
that
either
meet
or
show
progress
32
toward
meeting
the
purposes
and
intent
described
in
section
33
331.439,
subsection
1
,
paragraph
”c“
225C.1
.
The
moneys
34
received
by
a
county
region
from
the
incentive
pool
shall
be
35
-43-
LSB
5546HC
(8)
85
jp/rj
43/
50
H.F.
_____
used
to
build
community
capacity
to
support
individuals
covered
1
by
the
county’s
region’s
regional
service
system
management
2
plan
approved
under
section
331.439
331.393
,
in
meeting
such
3
purposes.
4
Sec.
86.
REPEAL.
Sections
225C.7,
225C.18,
and
226.47,
Code
5
2014,
are
repealed.
6
EXPLANATION
7
The
inclusion
of
this
explanation
does
not
constitute
agreement
with
8
the
explanation’s
substance
by
the
members
of
the
general
assembly.
9
This
bill
relates
to
the
redesign
of
mental
health
and
10
disabilities
services
(MH/DS)
administered
by
regions
comprised
11
of
counties.
Under
the
redesign
provisions
initially
enacted
12
in
2012,
each
organization
of
counties
as
a
region
is
governed
13
by
a
Code
chapter
28E
agreement
and
the
region
is
to
have
14
an
administrative
office,
organization,
or
entity
formed
by
15
agreement
of
the
counties
participating
in
the
region
to
16
function
on
behalf
of
those
counties,
known
as
the
regional
17
administrator
and
defined
in
Code
section
331.388.
The
18
redesign
legislation
maintained
the
financial
responsibility
19
for
MH/DS
with
each
county
but
provided
for
the
regional
20
administrator
and
the
regional
governance
board
to
assume
the
21
administrative
functions
on
behalf
of
the
county.
The
bill
22
makes
conforming
Code
amendments
relating
to
the
redesign
23
legislation.
24
In
general,
references
throughout
the
Code
to
the
central
25
point
of
coordination
(CPC)
process
(codified
in
Code
section
26
331.440,
which
was
repealed
effective
July
1,
2013,
by
2011
27
Iowa
Acts,
ch.
123)
are
changed
to
instead
refer
to
regional
28
administrators;
references
to
the
county
mental
health,
29
intellectual
disability,
and
developmental
disabilities
30
services
fund
are
changed
to
mental
health
and
disabilities
31
services
fund
(codified
in
Code
section
331.424A,
amended
32
by
2012
Iowa
Acts,
ch.
1120
§132);
and
references
to
county
33
service
management
plans
(codified
in
Code
section
331.439,
34
repealed
effective
July
1,
2013,
by
2011
Iowa
Acts,
ch.
35
-44-
LSB
5546HC
(8)
85
jp/rj
44/
50
H.F.
_____
123)
are
changed
to
instead
refer
to
regional
service
system
1
management
plans
approved
in
accordance
with
Code
section
2
331.393.
References
throughout
the
Code
to
responsibilities
3
for
a
county
to
provide
or
have
administrative
responsibility
4
for
services
or
other
responsibilities
in
connection
with
a
5
person
in
need
of
mental
health
or
disability
services
are
6
changed
to
instead
refer
to
the
regional
administrator.
Prior
7
to
the
redesign,
MH/DS
services
in
each
county
were
delineated
8
in
a
service
management
plan
adopted
by
that
county,
subject
9
to
approval
by
the
department
of
human
services
(DHS).
These
10
individual
county
plans
are
to
be
replaced
by
a
regional
11
service
management
plan
effective
beginning
on
July
1,
2014.
12
County
MH/DS
levy
authority
and
spending
authority
remains
13
in
Code
section
331.424A.
However,
the
name
of
the
fund
14
was
changed
in
the
redesign
legislation
but
references
to
15
the
old
fund
in
other
Code
sections
are
corrected
in
the
16
bill.
In
addition,
related
Code
changes
are
reflected
in
this
17
explanation.
18
References
to
waivers
for
providers
of
mental
health
19
services
approved
under
Code
section
225C.7
to
operate
in
lieu
20
of
a
community
mental
health
center
are
stricken
because
the
21
Code
section
is
repealed
by
the
bill.
Code
chapter
230A,
22
relating
to
community
mental
health
centers,
was
substantially
23
rewritten
by
2011
Iowa
Acts,
ch.
121,
and
the
revisions
took
24
effect
July
1,
2012.
In
the
rewrite,
Code
section
230A.107,
25
codified
the
waiver
authorization
for
a
for-profit
corporation,
26
nonprofit
corporation,
or
county
hospital
providing
mental
27
health
services
to
county
residents
pursuant
to
a
waiver
28
approved
under
section
225C.7,
subsection
3,
Code
2011,
as
29
of
October
1,
2010,
to
be
designated
as
a
community
mental
30
health
center
under
Code
chapter
230A.
The
reference
change
is
31
applied
by
the
bill
in
the
following
Code
sections:
135.180,
32
relating
to
mental
health
professional
shortage
area
program;
33
225C.19,
relating
to
emergency
mental
health
crisis
services
34
system;
and
225C.54,
relating
to
the
mental
health
services
35
-45-
LSB
5546HC
(8)
85
jp/rj
45/
50
H.F.
_____
system
for
children
and
youth.
1
References
to
the
central
point
of
coordination
process
are
2
changed
to
instead
refer
to
the
regional
administrator
in
the
3
following
Code
sections:
222.2,
providing
definitions
for
Code
4
chapter
222,
relating
to
the
state
resource
centers;
222.13
and
5
222.13A,
relating
to
voluntary
admissions
of
persons
to
a
state
6
resource
center;
222.28,
relating
to
court
appointment
of
a
7
commission
to
examine
a
person
alleged
to
have
an
intellectual
8
disability;
222.59,
relating
to
coordination
between
a
state
9
resource
center
and
county
in
identifying
community-based
10
services
for
an
individual;
222.60,
relating
to
payment
11
of
costs
by
county
or
state
and
diagnosis
and
evaluation
12
requirements;
222.61,
relating
to
determination
of
a
person’s
13
residency
status;
222.62,
relating
to
the
procedure
when
a
14
person’s
residency
is
determined
to
be
another
county;
222.63,
15
providing
a
procedure
for
a
county
to
object
to
a
residency
16
determination;
222.64,
providing
a
procedure
for
when
a
17
person’s
residency
is
determined
to
be
outside
of
this
state
or
18
is
unknown;
222.73,
relating
to
billing
of
charges
to
counties
19
for
the
state
resource
centers;
225.11,
providing
a
procedure
20
for
commitment
of
a
person
to
the
state
psychiatric
hospital
21
at
the
university
of
Iowa;
225.12,
relating
to
the
physician’s
22
report
for
a
voluntary
patient
at
the
state
psychiatric
23
hospital;
225.15,
relating
to
examination
and
treatment
at
the
24
state
psychiatric
hospital;
225.17,
relating
to
examination
25
and
treatment
of
private
patients
at
the
state
psychiatric
26
hospital
when
costs
are
paid
by
a
county;
section
225C.2,
27
providing
definitions
for
Code
chapter
225C;
225C.5,
relating
28
to
membership
of
the
mental
health
and
disability
services
29
commission;
section
225C.6,
relating
to
the
duties
of
the
MH/DS
30
commission;
225C.14,
relating
to
requirements
for
a
preliminary
31
diagnostic
evaluation
before
a
person
is
admitted
to
a
state
32
mental
health
institute
(MHI);
225C.16,
requiring
referrals
for
33
a
preliminary
diagnostic
or
prehearing
evaluation
for
persons
34
desiring
voluntary
admission
to
a
state
MHI;
225C.19,
providing
35
-46-
LSB
5546HC
(8)
85
jp/rj
46/
50
H.F.
_____
requirements
for
implementation
of
an
emergency
mental
health
1
crisis
services
system;
226.9C,
relating
to
the
dual
diagnosis
2
program
at
the
state
mental
health
institute
at
Mount
Pleasant;
3
227.10,
relating
to
transfers
of
patients
from
county
or
4
private
facilities
for
mental
health
treatment
to
a
state
5
institution;
229.1,
providing
definitions
for
the
involuntary
6
commitment
Code
chapter;
229.1B,
providing
that
the
CPC
process
7
applies
to
persons
who
are
involuntarily
committed;
229.11,
8
relating
to
immediate
custody
of
a
person
who
is
involuntarily
9
committed;
229.13,
relating
to
evaluation
orders
for
persons
10
who
are
involuntarily
committed;
229.14,
relating
to
chief
11
medical
officer
reports;
229.14A,
relating
to
placement
orders;
12
229.42,
relating
to
county
payment
for
a
person
voluntarily
13
admitted
to
an
MHI;
232.2,
relating
to
the
membership
of
a
14
transition
team
for
a
child
adjudicated
as
a
child
in
need
of
15
assistance;
235.7,
relating
to
transition
committees
to
address
16
transition
needs
of
children
receiving
child
welfare
services
17
who
are
age
16
or
older;
and
426B.5,
relating
to
the
membership
18
of
the
risk
pool
board.
19
References
to
county
board
of
supervisors
or
to
a
county
20
responsibility
are
changed
to
instead
refer
to
the
regional
21
administrator
or
MH/DS
region,
or
to
add
such
a
reference
in
22
the
following
Code
sections:
222.6,
relating
to
the
catchment
23
areas
for
the
two
state
resource
centers;
222.12,
relating
to
24
investigations
of
deaths
at
a
state
resource
center;
222.13,
25
relating
to
referrals
for
voluntary
admissions
of
adults
to
26
a
state
resource
center;
222.13A,
relating
to
referrals
for
27
voluntary
admissions
of
minors
to
a
state
resource
center;
28
222.14,
relating
to
care
provided
pending
admission
of
a
person
29
to
a
state
resource
center;
222.22,
relating
to
compensation
30
of
attorneys
for
commitments
of
persons
with
an
intellectual
31
disability;
222.31,
relating
to
court
commitments
of
persons
32
with
an
intellectual
disability
and
liability
for
charges;
33
222.74,
relating
to
approval
of
state
resource
center
charges;
34
222.92,
relating
to
the
use
of
net
budgeting
by
the
state
35
-47-
LSB
5546HC
(8)
85
jp/rj
47/
50
H.F.
_____
resource
centers;
225.1,
providing
definitions
for
the
1
state
psychiatric
hospital
Code
chapter;
225.10,
relating
2
to
voluntary
patients
at
the
state
psychiatric
hospital;
3
225.12,
relating
to
reports
concerning
voluntary
public
4
patients
at
the
state
psychiatric
hospital;
225.13,
relating
5
to
investigations
of
the
financial
condition
of
persons
being
6
admitted
to
the
state
psychiatric
hospital;
225.16,
relating
to
7
admission
of
voluntary
public
patients
to
the
state
psychiatric
8
hospital;
225.18,
relating
to
appointment
of
attendants
to
9
accompany
committed
persons
to
or
from
the
hospital;
225.19,
10
relating
to
compensation
of
attendants;
225.21,
relating
to
11
claims
for
compensation
of
attendants;
225.24,
relating
to
12
county
collection
of
the
costs
of
care
provided
at
the
state
13
psychiatric
hospital;
225.27,
requiring
notice
of
the
discharge
14
or
transfer
of
a
patient
from
the
state
psychiatric
hospital;
15
225C.13,
authorizing
DHS
to
lease
portions
of
MHIs
to
certain
16
public
and
private
organizations;
225C.14,
225C.15,
225C.16,
17
and
225C.17,
relating
to
preliminary
diagnostic
evaluations
18
of
persons
with
respect
to
admission
to
an
MHI,
county
policy
19
regarding
the
evaluations,
referral
of
voluntary
patients
20
for
the
evaluations,
and
the
use
of
alternative
diagnostic
21
facilities
for
the
evaluations;
225C.20,
relating
to
provision
22
of
individual
case
management
services
under
the
medical
23
assistance
(Medicaid)
program
by
counties;
226.32,
requiring
24
notice
to
a
county
when
a
voluntary
patient
is
discharged
to
25
relieve
overcrowding;
226.34,
requiring
notice
when
a
patient
26
at
an
MHI
dies;
227.1,
relating
to
supervision
of
county
and
27
private
institutions
for
persons
with
mental
illness
or
an
28
intellectual
disability
(often
referred
to
as
”county
care
29
facilities“)
is
amended
to
provide
definitions
for
the
Code
30
chapter
including
DHS
and
the
MH/DS
regions;
227.2,
relating
31
to
state
inspection
of
county
facilities;
227.4,
relating
32
to
standards
adoption
pertaining
to
county
care
facilities;
33
227.11,
relating
to
transfers
of
patients
from
state
hospitals;
34
227.12,
relating
to
civil
trials
when
there
is
a
disagreement
35
-48-
LSB
5546HC
(8)
85
jp/rj
48/
50
H.F.
_____
between
DHS
and
the
authorities
in
charge
of
a
county
care
1
facility
as
to
transfer
of
patients;
227.14,
relating
to
care
2
provided
at
a
county
care
facility
to
patients
from
another
3
county;
229.2
and
229.8,
relating
to
compensation
of
attorneys
4
for
minors
applying
for
voluntary
admission
to
an
MHI
and
5
respondents
in
involuntary
commitment
proceedings;
229.10,
6
relating
to
the
payment
of
examinations
with
county
funds;
7
229.19,
relating
to
mental
health
advocates;
229.24,
relating
8
to
confidential
records
in
involuntary
commitment
proceedings;
9
and
426B.5,
relating
to
the
risk
pool
and
the
incentive
pool
10
within
the
property
tax
relief
fund.
11
References
to
county
management
plans
developed
pursuant
to
12
repealed
Code
section
331.439
are
changed
to
regional
services
13
system
management
plans
implemented
in
accordance
with
Code
14
section
331.393
in
the
following
Code
sections:
222.60,
15
relating
to
payment
of
costs
at
a
state
resource
center
by
16
county
or
state
and
diagnosis
and
evaluation
requirements;
17
222.73,
relating
to
billing
of
per
diem
costs
at
a
state
18
resource
center;
235A.15
and
235B.6,
relating
to
access
to
19
child
and
dependent
adult
abuse
registry
record
checks
for
20
employment
by
an
agency
providing
services
under
a
plan;
21
and
426B.5,
relating
to
the
risk
and
incentive
pools
of
the
22
property
tax
relief
fund.
23
References
to
the
county
mental
health,
intellectual
24
disability,
and
developmental
disabilities
services
fund
are
25
changed
to
mental
health
and
disabilities
services
fund
in
26
the
following
Code
sections:
225C.12,
relating
to
partial
27
reimbursement
to
counties
for
local
inpatient
mental
health
28
care
and
treatment;
226.9C,
relating
to
splitting
of
costs
29
for
charges
at
the
dual
diagnosis
program
at
the
state
mental
30
health
institute
at
Mount
Pleasant;
and
426B.5,
relating
to
the
31
risk
and
incentive
pools
of
the
property
tax
relief
fund.
32
Current
law
in
Code
sections
222.73
and
230.20,
limits
an
33
increase
in
the
per
diem
changed
to
a
county
for
services
34
provided
at
a
state
resource
center
or
a
state
mental
health
35
-49-
LSB
5546HC
(8)
85
jp/rj
49/
50
H.F.
_____
institute
to
the
percentage
increase
in
the
allowed
growth
1
factor
adjustment,
a
funding
formula
provision
repealed
by
the
2
redesign.
The
bill
instead
references
the
per
capita
growth
3
amount,
which
replaced
the
repealed
allowed
growth
factor
in
4
the
redesign
legislation.
5
The
following
Code
sections
are
repealed:
225C.7,
relating
6
to
the
MH/DS
community
services
fund
which
distributed
moneys
7
to
counties
until
the
state
assumed
responsibility
for
Medicaid
8
costs
from
counties
in
2012;
225C.18,
relating
to
mental
health
9
and
developmental
disabilities
regional
planning
councils
10
which
were
replaced
by
regional
governing
boards
and
advisory
11
committees
in
the
redesign
legislation;
and
226.47,
a
single
12
definition
section
which
is
replaced
in
the
bill
by
amending
13
Code
section
226.1
to
provide
a
multiple
definition
section.
14
-50-
LSB
5546HC
(8)
85
jp/rj
50/
50